Average Macular Thickness Research Articles

Characteristics of retinal layer thickness in acute anterior uveitis: an optical coherence tomography study.

To determine the changes in peripapillary retinal nerve fiber layer (pRNFL), macular and ganglion cell-inner plexiform layer (GC-IPL) thicknesses in patients with acute anterior uveitis (AAU). Patients diagnosed with unilateral non-infectious AAU and normal control were enrolled retrospectively. Optical coherence tomography scans were performed during the initial active phase and inactive phase of AAU. Patients were followed for at least 3months after resolution of inflammatory activity. Thirty-seven AAU patients and 40 controls were included. The average RNFL and central macular thickness (CMT) showed significant differences between patients and control groups during active phase (p<0.001 and p=0.022, respectively). The average pRNFL thicknesses of affected eyes and fellow eyes during the active phase were 109.4±12.5μm and 96.5±8.0μm, respectively (p<0.001). During the inactive phase, the average thicknesses were 99.3±8.9μm and 97.0±7.5, respectively; they were not significantly different (p=0.236). The CMTs of affected and fellow eyes during the active phase were 261.6±24.7μm and 251.5±17.3μm, respectively; the difference was significant (p=0.047). The average GC-IPL thicknesses of affected and fellow eyes were not significantly different (p=0.061). The pRNFL and central macula thickened during the active phase of AAU and decreased to a similar degree with fellow eyes during the inactive phase. Additionally, pRNFL thickness showed a sensitive response to the degree of inflammation in AAU. This suggests that pRNFL thickness may be useful in assessing disease activity.

Retinal nerve fibre and ganglion cell inner plexiform layer analysis by optical coherence tomography in asymptomatic empty sella patients

Purpose: To investigate the clinical importance of the thicknesses of the retinal nerve fibre (RNFL) and ganglion cell and inner plexiform layer (GCL+) by spectral domain optic coherence tomography (SD-OCT) in asymptomatic empty sella (ES) patients.Materials and methods: In this cross-sectional, non-randomized prospective study, 44 ES patients and 74 age- and sex-matched healthy individuals were evaluated. All the patients and controls competed an automated 30-2 visual field (VF) test. The mean deviation (MD), pattern standard deviation (PSD), RNFL, and GCL + thickness values obtained with SD-OCT were compared statistically between the two groups.Results: No marked VF defects were found in either group, and there was no statistically significant between-group difference in MD or PSD values. In terms of RNFL thickness, the average and superior quadrant RNFL values of the ES patients were thinner than those of the controls, with statistical significance (p = 0.013 and p = 0.043, respectively). Although other measured RNFL quadrant thicknesses and foveal thickness (FT), macular volume (MV), and average macular thickness (AMT) values were reduced in the ES group, these differences were not statistically significant. The average GCL + value and GCL + values in six sectors in the patient group were significantly lower than those in the control group.Conclusions: Asymptomatic ES patients have a risk of primary ES syndrome and should be followed up using a multidisciplinary approach. Objective and quantitative RNFL and GCL + thickness measurements obtained with OCT can provide valuable data for monitoring these patients.

Optical Coherence Tomography Angiography and Macular Vessel Density Analysis of Cystoid Macular Edema in Gyrate Atrophy.

To understand the microvascular abnormalities in cystoid macular edema (CME) in gyrate atrophy. Spectral-domain optical coherence tomography (SD-OCT) and OCT angiography (OCTA) were used in four consecutive female patients (eight eyes) with clinically and biochemistry-confirmed cases of gyrate atrophy and associated CME. Foveal avascular zone (FAZ) area and macular vessel density percentage were calculated and compared with normal subjects. The average age was 20 years (range: 13 years to 32 years). The mean refractive error was -6.5 diopters (D) (range: -1.0 D to -11.0 D). The average central macular thickness was 509 μm (range: 291 μm to 750 μm). OCTA showed an enlarged FAZ in the deep capillary plexus (DCP) with presence of hyporeflective cysts in both the superficial and deep capillary layers corresponding to CME. Compared to the normal subjects, the mean FAZ area was enlarged and macular vessel density was reduced in both the superficial capillary plexus and DCP; this was statistically significant (P < .05). En face OCT of the DCPs showed classical hyporeflective honeycomb pattern delineating the structural pattern of CME in the inner plexiform and outer plexiform layer. OCTA helps understand the basic pathophysiologic mechanisms in gyrate atrophy of choroid as well as etiology for CME and macular schisis. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:423-427.].

Two-year analysis of changes in the optic nerve and retina following anti-VEGF treatments in diabetic macular edema patients.

Purpose: To evaluate long-term structural and functional changes that happen to the optic nerve and retina following ranibizumab (Lucentis) injections in diabetic macular edema (DME) patients.Methods: Patients with clinically significant DME requiring anti-VEGF injections underwent pre-injection baseline, 6, 12, and 24 month follow-up tests. The tests performed were optical coherence tomography (OCT), best-corrected visual acuity (BCVA), and visual field (VF). Wide-field fluorescein angiogram (IVFA) was performed to monitor the progression of diabetic ischemia.Results: A total of 30 patients requiring anti-VEGF injections and 21 control patients not requiring anti-VEGF injections were enrolled in the study. From baseline, the average macular thickness significantly decreased (p<0.0002) over the 24-month time period. Mean perfused ratio significantly increased (p<0.0005) at 6, 12, and 24 months. Cup volume and vertical cup-to-disk ratio significantly increased (p<0.0014) over the study period. This was verified by masked independent grading of patient optic nerve stereo-photographs by glaucoma specialists. BCVA significantly (p<0.0006) improved over the study period. VFs showed a non-significant trend of deteriorating peripheral vision at 12 and 24 months.Conclusion: Clinically, anti-VEGF therapy appears to affect the optic nerve by increasing cup volume and increasing vertical cup/disk ratio over time. The results provide a cautionary note to monitor both the retina and optic nerve status in patients undergoing frequent injections.

Pattern of Cystoid Macular Edema in Erbil

Cystoid Macular Edema (CME) in its various forms can be considered one of the leading causes of central vision loss in the developed world. It is not a disease itself, It represents a common pathologic sequel of the retina and occurs in a variety of pathological conditions such as, diabetic retinopathy, central or branch retinal vein occlusion, intraocular inflammation and following cataract extraction. This study was done to investigate the pattern of CME in patient attending Erbil Teaching Hospitals. This is a hospital base prospective study that included 61 patients (75 eyes) conducted at Erbil Teaching Hospital and Rigor Teaching Hospital for six months. All patients underwent a comprehensive assessment including medical and ophthalmic history and detailed ophthalmic examination including slit lamp examination, intraocular pressure measurement (IOP), Best corrected visual acuity (BCVA), dilated fundus examination and Optical Coherence Tomography (OCT) examination. It was found that of the 61 patients 32 (52.5%) were females and 29 (47.5%) were males. The mean age (56.4±10.8) years. Out of the 75 eyes included in the study, 41 eyes (54.66%) had diabetic retinopathy, 10 (13.34%) eyes had CME following cataract operation (Irvine-Gass syndrome), 8 eyes (10.67%) had BRVO, 6 eyes (8%) were had CRVO, 5 eyes (6.66%) had Age related Macular Degeneration, 3 eyes (4%) with uveitis, and 2 (2.67%) had Retinitis Pigmentosa. The average macular thickness was (415.6± 107). It was concluded that diabetic retinopathy is the most common predictive factor of CME, followed by cataract surgery. CME is more severe in diabetic retinopathy, CRVO and after cataract surgery.

Pediatric Normative Database of Retinal, Macular and Choroidal Values obtained with Spectral-Domain Optical Coherence Tomography

Purpose: To establish normative values in a Portuguese pediatric population for retinal nerve fiber layer (RNFL), macular, macular ganglion cell-inner plexiform layer (GCIPL) and subfoveal choroidal (SFC) thicknesses Methods: This cross-sectional study enrolled children, 4 to 17 years old, attending the Ophthalmology Department of Hospital de Braga. All subjects underwent comprehensive ophthalmologic examination and were scanned with Cirrus Spectral-Domain Optical Coherence Tomography (SD-OCT). Results: A total of 348 children (9.85±3.49 years) were included. Average RNFL thickness was 97.45±9.78µm and the distribution of RNFL thickness was in agreement with the ISNT rule. Average RNFL thickness showed a positive significant relationship with optic disc (OD) area (p=0.007). A significant positive relationship was also found for OD area (p=0.001 and p=0.04, respectively) and spherical equivalent (SE) (p=0.008 and p=0.004, respectively), in the inferior and nasal quadrants. Average macular thickness was 282.22±11.91µm. Central subfield was the thinnest region, followed by the external ring, while the internal ring was the thickest (p<0.001). Age, SE and gender were the strongest predictors of macular thickness. A negative association was found between the superior external macular thickness and age (p=0.009). A lower thickness in the outer macular region was associated with higher myopic refractive error (p<0.05). Boys had on average a thicker macula (p<0.05). Average GCIPL thickness was 84.97±4.78 µm and average SFC thickness was 374.76±42.51 µm. Conclusion: This study established a SD-OCT normative database for healthy Portuguese children aged 4 to 17 years old, which could improve diagnosis and management of pediatric ophthalmic disorders in children.

RESPONSE OF INFLAMMATORY CYSTOID MACULAR EDEMA TO TREATMENT USING ORAL ACETAZOLAMIDE.

To determine the treatment effect of oral acetazolamide on refractory inflammatory macular edema. A retrospective review of identified patients with uveitic or pseudophakic macular edema treated using acetazolamide between 2007 and 2014. Visual acuity and central macular subfield thickness was determined at baseline and at first follow-up. Baseline optical coherence tomography features were analyzed as predictors of acetazolamide response. Sixteen patients (19 eyes) of 61 screened met all criteria. Mean age was 57.9 years (19.7-81.1). The most common diagnosis was idiopathic uveitis (n = 6, 31.6%). Mean uveitis duration was 4.4 years (0.2-27.5). Average central macular subfield thickness decreased significantly (from 471.8 ± 110.6 μm to 358.3 ± 50.4 μm) (P < 0.0001). Average visual acuity (logarithm of the minimum angle of resolution) improved significantly from 20/54 (0.43 ± 0.25) to 20/37 (0.27 ± 0.16) (P = 0.003). Pretreatment optical coherence tomographies demonstrated intraretinal fluid (n = 19, 100%), subretinal fluid (n = 8, 42.1%), epiretinal membrane (n = 13, 68.3%), and vitreomacular traction (n = 1, 5.2%). No optical coherence tomography characteristic was predictive of a response to therapy. There is a significant benefit to vision and central macular subfield thickness after acetazolamide treatment in patients with inflammatory macular edema. In patients with refractory inflammatory macular edema, treatment using acetazolamide can provide anatomical and visual benefit without corticosteroid-related adverse effects.

Structure versus function in high myopia using optical coherence tomography and automated perimetry

BackgroundTo examine the structure–function relationship between retinal thickness using spectral‐domain optical coherence tomography and standard automated perimetry in high myopia.MethodsThe study population comprised 58 highly myopic individuals with no posterior abnormalities (mean spherical equivalent refraction ≤ −6.00 D and axial length ≥ 26.0-mm). All eyes underwent optical coherence tomography with the Spectralis spectral domain optical coherence tomograph and visual field evaluation with the Humphrey Field Analyzer II‐i. Average macular layer thicknesses in each quadrant were calculated in a 6 × 6-mm area centred on the fovea. The visual field was assessed from 17 central locations (10°), approximately the equivalent of the area tested by optical coherence tomography in the macular scan. Linear correlations were made between different macular layer thicknesses and peripapillary retinal nerve layer thickness with their matched visual field sensitivities.ResultsParticipant ages were 28.2 ± 6.4-years, mean spherical equivalent refractions were −8.20 ± 1.40-D and axial lengths were 26.7 ± 0.7-mm. There were significant positive correlations between layer thickness and corresponding visual field sensitivities as follows: ganglion cell layer in all quadrants, temporal quadrant of the nerve fibre layer with nasal quadrant of the visual field, inferior quadrant of the outer nuclear layer with superior visual field, and temporal‐superior peripapillary nerve fibre layer with nasal‐inferior visual field.ConclusionThe correlation between retinal layer thicknesses and visual field sensitivity could be explained by myopia‐related losses due to lateral retinal stretching, with further research required to investigate this.

Ophthalmic, systemic, and genetic characteristics of patients with Wolfram syndrome.

To evaluate the ophthalmic, systemic, and genetic characteristics of patients with Wolfram syndrome. In total, 13 patients with suspected or clinically diagnosed Wolfram syndrome underwent ophthalmic and systemic examinations and genetic analyses for Wolfram syndrome between August and October 2018. The mean age of the subjects was 24.2 ± 7.1 years, of which 5 (38.5%) subjects were male and 8 (61.5%) were female. The mean best-corrected visual acuity ranged from counting fingers to 20/40, with a mean of 20/250 (1.10 ± 0.69 logarithm of the minimum angle of resolution). Dyschromatopsia was present in all patients (100%). There was a severe decrease in the average peripapillary retinal nerve fiber layer and macular ganglion cell-inner plexiform layer thicknesses (54.7 ± 6.5 and 51.9 ± 4.8 µm, respectively). Optical coherence tomography angiography showed significantly lower whole-image, inside disk, and peripapillary vessel densities in the patients with Wolfram syndrome than in the healthy controls (p < 0.001 for all). All patients who underwent genetic analyses had mutations in the WFS1 gene. Moreover, two novel mutations, p.Met623Trpfs*2 (c.1867delA) and p.Arg611Profs*9 (c.1832_11847del16) at exon 8, were detected. The frequency of systemic findings was as follows: optic atrophy (100%), diabetes mellitus (92.3%), central diabetes insipidus (38.5%), sensorineural hearing loss (38.5%), and presence of urological (30.8%), psychiatric (30.8%), and neurological (23.1%) diseases. Wolfram syndrome is a rare genetic disorder that can be associated with severe ophthalmic and systemic abnormalities. All patients who present with unexplained optic atrophy should be evaluated for Wolfram syndrome, even if they do not have diabetes mellitus because optic atrophy can sometimes manifest before diabetes mellitus.

Clinical characteristics and outcomes of myelin oligodendrocyte glycoprotein antibody-seropositive optic neuritis in varying age groups: A cohort study in China

PurposeTo investigate the clinical characteristics and outcomes of myelin oligodendrocyte glycoprotein antibody-seropositive optic neuritis (MOG-ON) in patients with varying ages of onset in China. MethodsPatients displaying symptoms of MOG-ON were recruited from the Neuro-ophthalmology Department in the Chinese People's Liberation Army General Hospital from January 2016 to May 2018. They were assigned to one of three subgroups based on age of onset: pediatric (<18 years), young (18–46 years), and middle-aged (>46 years) MOG-ON. Results110 patients (188 eyes) were assessed, including 58 pediatric (52.7%), 34 young (30.9%), and 18 middle-aged (16.4%) patients. Of the pediatric patients, 93.9% had good recovery of visual acuity (≥0.5) compared with 79.7% of young patients and 66.7% of middle-aged patients (p < .001). The annual relapse rate was lower in the pediatric group than young and middle-aged groups (0.32 ± 0.50 vs 0.73 ± 0.87 vs 0.49 ± 1.08, p = .036). Six children (10.3%) were diagnosed with acute disseminated encephalomyelitis, while seven young patients (20.6%) were diagnosed with aquaporin-4 antibody seronegative neuromyelitis optica spectrum disorder upon follow-up. The average peripapillary RNFL and macular GCIPL thicknesses were not statistically different between subgroups (p = .996, p = .608). Overall, MRIs of the optic nerve showed perineural enhancement in 52.0% of patients and longitudinal extensive involvement in 87.7%. MRIs also revealed a greater proportion of pediatric patients with intracranial optic nerve involvement than in the other two subgroups (45.4% vs. 21.2% vs. 36.7%, p = .014). ConclusionPediatric ON was the most common MOG-ON subgroup. Pediatric patients had different clinical features, including better recovery of visual acuity, lower annual relapse rate, and more intracranial optic nerve involvement than young and middle-aged patients. Additionally, age of onset may be a potential predictor for determining visual prognosis with MOG-ON.

Delay of cone degeneration in retinitis pigmentosa using a 12-month treatment with Lycium barbarum supplement

Ethnopharmacological relevanceLycium barbarum L. (also known as “Goji berry”), a traditional Chinese herbal medicine, has been a common herb in the traditional Chinese pharmacopoeia for centuries. The main active component is the Lycium barbarum polysaccharides and its antioxidative effect has been widely shown to provide neuroprotection to the eye, and it would, therefore, be interesting to determine if Lycium barbarum help delay vision deterioration in patients with retinitis pigmentosa. Aim of the studyCone rescue is a potential method for delaying deterioration of visual function in Retinitis pigmentosa (RP). This study aimed to investigate the treatment effect of Lycium barbarum L. (LB) supplement on retinal functions and structure in RP patients after a 12-month intervention trial. MethodsThe investigation was a double-masked and placebo-controlled clinical study. Each of forty-two RP subjects who completed the 12-month intervention (23 and 19 in the treatment and placebo groups respectively) received a daily supply of LB or placebo granules for oral administration. The primary outcome was change of best corrected visual acuity (VA) (90% and 10% contrast) from the baseline to the end of treatment. The secondary outcomes were sensitivity changes of the central visual field, amplitude of full-field electroretinogram (ffERG) (including scotopic maximal response and photopic cone response), and average macular thickness. ResultsThe compliance rates for both groups exceeded 80%. There were no deteriorations of either 90% or 10% contrast VA in the LB group compared with the placebo group (p = 0.001). A thinning of macular layer was observed in the placebo group, which was not observed in the LB group (p = 0.008). However, no significant differences were found in the sensitivity of visual field or in any parameters of ffERG between the two groups. No significant adverse effects were reported in the treatment group. ConclusionsLB supplement provides a neuroprotective effect for the retina and could help delay or minimize cone degeneration in RP. ClassificationsClinical Studies (1.05). Trial registrationclinicaltrials.gov Identifier NCT02244996.

Evolution of retinal changes measured by optical coherence tomography in the assessment of hydroxychloroquine ocular safety in patients with systemic lupus erythematosus.

The objective of this report is to analyse retinal changes over a five-year period, assessed by spectral domain-optical coherence tomography (SD-OCT), in patients from the Lupus-Cruces cohort treated with hydroxychloroquine (HCQ). SD-OCT screening was performed annually between 2012 and 2017. Average macular thickness (AMT), ganglion cell layer thickness (GCLT) and qualitative data of retinal pigment epithelium (RPE) and external retina (ExtR) were collected prospectively. We compared data from 2012 (first) and 2017 (second) SD-OCT. We studied 110 patients and 195 eyes. No cases of HCQ toxicity were detected. At the time of the second SD-OCT, 99% patients had taken a daily dose of HCQ ≤5 mg/kg/day. The median time on HCQ was 133 months. The mean AMT and GCLT were significantly lower in both eyes at the second SD-OCT; however, all the differences were clinically insignificant at less than 1%. Qualitative analysis of RPE and ExtR showed no significant changes. Similar results were found among patients with risk factors for retinopathy. The comparison of patients with and without risk factors showed no differences. This study shows clinically irrelevant retinal changes in an SLE cohort on HCQ treatment over a five-year follow-up. Our findings support the safety of long-term HCQ at doses ≤5 mg/kg/day.

Optical coherence tomography-based comparison of retinal nerve fiber layer thickness and macular thickness in amblyopic and fellow eyes

Objectives The aim of the present study was to compare the retinal nerve fiber layer thickness (RNFLT), macular thickness, and ganglion cell layer thickness between amblyopic and fellow eyes using spectral domain optical coherence tomography (OCT). Patients and methods Seventy-six patients were included in the study (32 males and 44 females; age range, 18–40 years; mean age, 27.21±8.25 years). Detailed medical history of all patients was obtained. All patients underwent detailed ophthalmologic and fundoscopic examination by slit-lamp biomicroscopy, visual acuity by Landolt’s chart, cycloplegic refraction, ocular alignment, applanation tonometry, and OCT imaging by spectral domain OCT (Cirrus-5000 OCT). Results There was no significant difference between the amblyopic and fellow eyes regarding central macular thickness, average macular thickness, or ganglion cell complex thickness. By further secondary analysis aiming to compare subgroups according to the refractive status, only the RNFLT was significantly lower in the amblyopic eyes compared with the fellow eyes in the myopic amblyopic subgroup only. Other OCT values were not significantly different in other amblyopic eyes versus fellow eyes in different subgroups. Conclusion There was no significant correlation between amblyopia and OCT parameters. However, OCT revealed a significant reduction in the mean RNFLT in myopic amblyopic eyes only compared with their fellow eyes. Axial length may be more influential than amblyopia.

Relationship between erythrocyte sedimentation rate and choroidal and retinal thickness in Behçet's disease.

To compare retinal and choroidal thickness in patients with Behçet's disease with and without ocular involvement as well as to evaluate the correlation between erythrocyte sedimentation rate and choroidal thickness among patients with Behçet's disease. This was a prospective interventional study investigating erythrocyte sedimentation as well as choroidal and retinal thickness among patients with Behçet's disease. Patients who were diagnosed based on The International Criteria for Behçet's Disease with (Group A) or without (Group B) ocular involvement and a matched control group (Group C) participated in the study. Optical coherence tomography measurements and blood tests were performed on the same day. Retinal and choroidal thickness were measured using spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany), and central macular thickness, central subfoveal choroidal thickness, and retinal nerve fiber layer thickness were measured using optical coherence tomography. Average erythrocyte sedimenta-tion values were 9.89 mm/h in Group A, 16.21 mm/h in Group B, and 3.89 mm/h in Group C; average central subfoveal choroidal thickness values were 350.66, 331.74, and 325.95 mm, respectively. Average central macular thickness and retinal nerve fiber layer thickness values of patients in Groups A, B and C were 226.39 and 225.97mm; 234.11 and 92.00 mm; and 97.58 and 99.84 mm, respectively. No significant difference was seen between Group A and B patients in central subfoveal choroidal thickness, central macular thickness, or retinal nerve fiber layer thickness values. Central macular thickness was statistically significantly thinner in Groups A and B than in Group C (p=0.016). Group A had thinning in the nasal quadrant of the retinal and general retinal nerve fiber layers when compared with those in Group C (p=0.010 and 0.041, respectively). A connection could not be established between the erythrocyte sedimentation, central subfoveal cho-roidal thickness, central macular thickness, and retinal nerve fiber layer thickness in the patients with Behçet's disease. The erythrocyte sedimentation rate is typically used to test for activation of Behçet's disease and assess treatment response. In our study, we could not establish a connection between the erythrocyte sedimentation rate and central subfoveal choroidal thickness, central macular thickness, and retinal nerve fiber layer thickness in patients with systematically active Behçet's disease without ocular involvement.

The assessment of structural changes on optic nerve head and macula in primary open angle glaucoma and ocular hypertension

To assess morphological changes in macula, retinal nerve fiber layer (RNFL) and optic nevre head (ONH) of cases with primary open angle glaucoma (POAG) and ocular hypertension (OH) with spectral domain optic coherence tomography (OCT). This study included 109 eyes from 62 POAG patients, 50 eyes from 30 OH patients, and 101 eyes from 53 healthy volunteers. Data gained by OCT were compared with perimetry indexes. ONH, RNFL and macula analysis were performed for all subjects. Rim area, disc area, average cup/disc (C/D) ratio, vertical C/D ratio, cup volume data were recorded during ONH analysis. Average RNFL thickness and the thickness of four quadrants (superior, inferior, nasal and temporal) was established in microns. In total, nine macular quadrants involving the foveal region mentioned in the Early Treatment Diabetic Treatment Study (ETDRS) template were measured, and average macular thickness and macular volume data were recorded during macula analysis. Differences between groups were evaluated with the one-way ANOVA test. Tukey's multiple comparison test was performed to detect difference between groups. Receiver-operating characteristic (ROC) analysis was done for early stage POAG patients to establish sensitivity and specificity of chosen parameters in early stage POAG. Area under the receiver operating characteristic (AUROC) values were calculated to compare ROC areas. Statistically significant differences were found in all ONH parameters, except optic disc area. Neuroretinal rim area was identified as the parameter with the highest difference between groups (F=21.72, P<0.05). The highest correlation between ONH parameters and perimetry was observed at neuroretinal rim region (r=0.487). Inferior RNFL thickness was established as the parameter with the highest difference between groups among RNFL parameters. In the mean of all glaucoma patients, the highest correlation between data handled with OCT and mean deviation was observed in RNFL thickness. Average macular thickness was detected as the parameter with the highest difference between groups among macular parameters. The highest correlation between macula parameters and perimetry indexes was observed between average macular thickness and perimetry indexes (r=0.514). Although the assessment of ONH and the analysis of macular thickness are important in diagnosis and treatment, RNFL assessment is the most valuable parameter.

Microalbuminuria Is Associated With Early Retinal Neurodegeneration in Patients With Type 2 Diabetes.

To evaluate retinal layer changes in patients with type 2 diabetes, microalbuminuria, and no diabetic retinopathy, and to investigate its possible relationship with age, gender, diabetes duration, urinary albumin excretion (UAE), glycosylated hemoglobin, and hypertension. A prospective, cross-sectional study was performed in 60 patients divided into three groups: diabetic patients with normal UAE, diabetic patients with microalbuminuria, and controls. Retinal thickness was evaluated by Early Treatment Diabetic Retinopathy Study grid using spectral-domain optical coherence tomography. The average and sectoral macular thicknesses of the ganglion cell layer (GCL) were significantly thinner in the microalbuminuria group compared to normal UAE group and controls (P < .005). UAE was the only factor related to this reduction in a multiple linear regression analysis. The GCL thickness was reduced in eyes in patients with type 2 diabetes and microalbuminuria before clinical signs of diabetic retinopathy. Inner retinal neurodegeneration was independently associated with albuminuria. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e36-e43.].

Racial differences and determinants of macular thickness profiles in multiethnic Asian population: the Singapore Epidemiology of Eye Diseases Study

AimTo evaluate racial differences, and ocular and systemic determinants of macular thickness (MT), measured by spectral-domain optical coherence tomography (SD-OCT) in a normal multiethnic Asian population.MethodMT was measured from a...

Correlation between aqueous flare and residual visual field area in retinitis pigmentosa.

To investigate the relationship between aqueous flare, visual function and macular structures in retinitis pigmentosa (RP). Clinical data from 123 patients withRP (227 eyes), 35 patients withmacular dystrophy (68 eyes) and 148 controls (148 eyes) were analysed. The differences in aqueous flare between clinical entities and the correlation between aqueous flare (measured with a laser flare cell meter) versus visual acuity, visual field area (Goldmann perimetry) and macular thickness (optical coherence tomography) in patients withRP were determined. Influence of selected clinical data on flare was assessed using linear mixed-effects model. Aqueous flare was higher in patients withRP than patients withmacular dystrophy or controls (p=7.49×E-13). Aqueous flare was correlated with visual field area (R=-0.379, p=3.72×E-9), but not with visual acuity (R=0.083, p=0.215). Macular thickness (R=0.234, p=3.74×E-4), but not foveal thickness (R=0.122, p=0.067), was positively correlated with flare. Flare was not affected by the presence of macular complications. All these associations were maintained when the right and the left eyes were assessed separately. Analysis by linear mixed-effects model revealed that age (p=8.58×E-5), visual field area (p=8.01×E-7) and average macular thickness (p=0.037) were correlated with flare. Aqueous flare and visual field area were correlated in patients withRP. Aqueous flare may reflect the degree of overall retinal degeneration more closely than the local foveal impairment.

S160. Retinal involvement by optical coherence tomography and its correlation with disease severity in amyotrophic lateral sclerosis

Non motor involvement in Amyotrophic lateral sclerosis is being increasingly recognized and studies on involvement of retina have conflicting results. Optical coherence tomography (OCT) as a tool for analysis of retinal neurons and axons has been used in various neurodegenerative disorders. Our aim was to study the involvement of retina by measuring the retinal nerve fiber layer and macular thickness in ALS and correlate with disease severity. Prospective cross sectional comparative study in patients diagnosed with ALS based on revised El-Escorial criteria. 50 subjects (25 cases; 25 age and gender matched controls) were recruited for the study. The disease severity was assessed using “Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS)” – Revised scale. Retinal nerve fiber layer thickness (RNFL) and macular thickness was measured using SD-OCT (Spectralis; Heidelberg Engineering). The mean age was 51.43 ± 11.2 years in cases, 48.8 ± 11.9 years in controls. There was no significant difference between the two groups and were comparable. The mean ALSFRS score was 31.96 ± 5.99. 24% had bulbar onset and the reminder had limb onset ALS. Mean duration of illness was 14.07 ± 7.8 months. Mean RNFL in cases was 102.2 ± 9.7 μm and in controls was 100.7 ± 7.2 μm which was not statistically significant. Average macular thickness in cases was 304.3 ± 12.7 μm in cases and 304.5 ± 11.2 μm in controls. Central foveal thickness was 253.5 ± 21.4 μm in cases and 256.2 ± 23.6 μm in controls. There was no positive/ negative correlation between ALSFRS and RNFL/ macular thickness. Mean RNFL, six sector RNFL, average macular thickness and nine segment Early Treatment Diabetic Retinopathy Study (ETDRS) grid macular thickness done in 25 patients (50 eyes) and 25 controls (50 eyes) did not show difference in thickness and there is no correlation between disease severity and retinal thickness. There was no difference in retinal thickness between bulbar onset or limb onset ALS. Retina is the window to the brain and our study attempted to look for possibility for any changes though retinal involvement may not be a part of ALS. Previous studies on OCT had shown conflicting evidence. Our study shows that retinal thinning may not be part of the non-motor involvement in ALS. Further studies may be required to validate on a large cohort.

An efficacy analysis of anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to multifocal choroiditis and comparison with wet age-related macular degeneration.

To evaluate the effect of anti-vascular endothelial growth factor (VEGF) on juxtafoveal choroidal neovascularization (CNV) secondary to multifocal choroiditis (MFC) and wet age-related macular degeneration (AMD). In this retrospective, comparative study, 20 unique eyes with CNV were divided into two groups: 10 patients affected by MFC and 10 patients diagnosed with wet AMD. They all received local intravitreal (IVT) injections of ranibizumab, with 6 months of follow-up. Retreatment injections were performed based on findings suggestive of active neovascularization. Significant improvements were observed in the juxtafoveal CNV lesions, and average central macular thickness decreased in both groups following the anti-VEGF therapy (P<0.05). The average number of injections used in MFC patients was 1.6, while three injections on average were used in wet AMD patients (Z=-2.844, P=0.009). Best-corrected visual acuity was significantly improved in MFC patients after anti-VEGF therapy (P<0.05), and there was no significant difference in wet AMD patients between before anti-VEGF therapy and 6 months later (P>0.05). IVT ranibizumab resulted in good clinical outcomes for juxtafoveal CNV secondary to MFC and wet AMD, but the average number of injections used in MFC was fewer than that used in wet AMD over a 6-month observation period. Compared with the wet AMD group, visual acuity was obviously improved in the MFC group at 6 months.