Differences In Central Retinal Thickness Research Articles

The effect of long-term hemodialysis on diabetic retinopathy observed by swept-source optical coherence tomography angiography

BackgroundDiabetes can cause chronic microvascular complications such as diabetic retinopathy (DR) and diabetic nephropathy (DN). DR and DN can lead to or exacerbate diabetic macular edema (DME). Hemodialysis (HD) is the main treatment method for patients with end-stage kidney disease (ESKD) secondary to DN.PurposeThe aim of this prospective cohort study was to determine the immediate effect of single HD session on retinal and choroidal thickness in DR patients with ESKD and the features of DR and the prevalence of DME in these patients who have received long-term HD.MethodsEighty-five eyes of 44 DR patients with ESKD who underwent long-term HD were examined by swept-source optical coherence tomography angiography (SS-OCTA). Based on OCTA images, the characteristics of DR and the prevalence of DME in these patients were analyzed. Changes in central retinal thickness (CRT), central retinal volume (CRV), subfoveal choroidal thickness (SFCT) and subfoveal choroidal volume (SFCV) within 30 min before and after single HD session were compared. CRT, CRV, SFCT and SFCV were compared before single HD session and before the next single HD session.ResultsThere was no significant difference in the average CRT (251.69 ± 39.21 μm vs. 251.46 ± 39.38 μm, P = 0.286) or CRV (0.15 ± 0.62 μm vs. 0.15 ± 0.63 μm, P = 0.324) between before and after single HD session. After single HD session, SFCT (243.11 ± 77.15 μm vs. 219.20 ± 72.84 μm, P < 0.001) and SFCV (0.15 ± 0.10 μm vs. 0.13 ± 0.90 μm, P < 0.001) significantly decreased. There was no statistically significant difference in CRT (251.69 ± 39.21 μm vs. 251.11 ± 38.47 μm, P = 0.206), CRV (0.15 ± 0.62 μm vs. 0.15 ± 0.61 μm, P = 0.154), SFCT (243.11 ± 77.15 μm vs. 245.41 ± 76.23 μm, P = 0.108), or SFCV (0.15 ± 0.10 μm vs. 0.16 ± 0.10 μm, P = 0.174) before HD and before the next single HD session. On en face OCTA images, eighty-five eyes (100%) had retinal nonperfusion areas, foveal avascular zone (FAZ) enlargement, and abnormal retinal microvasculature. Based on cross-sectional OCTA images, retinal neovascularization (RNV) was confirmed in 42 eyes (49.41%), and intraretinal microvascular abnormalities (IRMAs) were detected in 85 eyes (100%). Seventeen eyes (20%) still had DME, all of which were cystoid macular edema (CME). Among eyes with DME, the epiretinal membrane (ERM) was present in 7 eyes (8.24%).ConclusionsFor DR patients with ESKD who have undergone long-term HD, the choroidal thickness still changes significantly before and after single HD session, which may be related to short-term effects such as reduced blood volume and plasma osmotic pressure caused by single HD session. Although macular features seem to have stabilized in DR patients undergoing long-term dialysis, the DR of patients with ESKD should still be given attention.

Macular Thickness After Ultrathin Descemet Stripping Automated Endothelial Keratoplasty and Descemet Membrane Endothelial Keratoplasty Combined With Cataract Surgery: A Randomized Controlled Clinical Trial.

The aim was to investigate alterations in central retinal thickness (CRT) and their implications for visual acuity after ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) combined with cataract surgery. A total of 72 eyes of 72 patients with Fuchs endothelial dystrophy and cataract were included and equally randomized to either UT-DSAEK or DMEK. A control group of 40 eyes of 40 patients with cataract were included for cataract surgery. All participants were examined preoperatively as well as 3 and 6 months postoperatively. There was no significant difference in CRT between the study groups after surgery (P = 0.896). A significant difference in best-corrected visual acuity (BCVA) progression over time was found between the study groups (P < 0.0001). Average improvements of 8.03 EDTRS after UT-DSAEK (P < 0.001) and 16.77 EDTRS after DMEK (P < 0.001) were found 6 months postoperatively. No significant correlation was found between the change in BCVA and CRT from baseline to 3 months postoperatively (r2 < 0.0001, P = 0.96) and from baseline to 6 months postoperatively (r2 = 0.0053, P = 0.46). CRT was not altered by UT-DSAEK, DMEK, or cataract surgery 3 and 6 months postoperatively. BCVA significantly improved 3 and 6 months after UT-DSAEK and DMEK, respectively. No significant correlations were found between the change in BCVA and CRT postoperatively. As such CRT alterations were comparable after UT-DSAEK, DMEK, and cataract surgery.

Atrophy of retinal vessels in neovascular age-related macular degeneration following long-term treatment with 20 intravitreal anti-VEGF injections

BackgroundThe study aimed to evaluate the changes in retinal vascular density in exudative age-related macular degeneration (AMD) after long-term anti-VEGF treatment using optical coherence tomography angiography (OCT-A), and to compare these changes with the vascular density in AMD treated for one year and healthy eyes.MethodsIn our cross-sectional study OCT-A was performed on 60 eyes of 60 patients. Group AMD 20 × consisted of patients receiving long-term (minimum 20 injections) aflibercept therapy (n = 17), and Group AMD one year consisted of patients treated for one year with a treat & extend protocol (n = 25). The vascular density values obtained with OCT-A were compared with an age-matched control group of 18 healthy eyes. We examined the central retinal thickness (CRT), the vascular density of the fovea and parafovea in the superficial and deep retinal plexus, and evaluated the extent of the non-flow area and the foveal avascular zone (FAZ) on a 3 × 3 mm macular region. Kruskal–Wallis test was performed for statistical analysis.ResultsIn Group AMD 20x, the vascular density of superficial retinal plexus in the fovea (p = 0.0022) and parafovea (p < 0.0001) was significantly lower compared to Group one year and control group. In the deep retinal plexus, vascular density in the fovea (p = 0.0033) was significantly lower in both AMD groups compared to the control group, with no difference in the parafoveal region (p = 0.0774). The extent of non-flow area (p = 0.0003) and FAZ (p = 0.0008) were significantly larger in both AMD groups compared to the control group. There was a significant difference in CRT between those treated for one year and control eyes (p = 0.0036).ConclusionsIn our study, we demonstrated that macular vessel density was lower in the foveal area in the superficial retinal plexus in AMD patients after one year and long-term anti-VEGF treatment. These vascular density changes were absent in the parafoveal and whole areas of the deep retinal plexus. Our results indicate that long-term anti-VEGF treatment reduces the vascular density of the superficial retinal plexus to a greater extent compared to the deep retinal plexus.

Subthreshold Micropulse Treatment Laser versus Half-Dose Photo Dynamic Therapy for the Chronic Central Serous Chorioretinopathy with Parafoveal or Subfoveal Leakage STML versus PDT for Treatment of Chronic CSC.

Purpose The study aimed to compare the efficacy and safety outcomes of a subthreshold micropulse treatment laser (SMTL) versus half-dose photodynamic therapy (PDT) for treatment of chronic central serous chorioretinopathy (cCSC) with parafoveal or subfoveal leakage to persistent subretinal fluid. Methods One hundred and forty-eight patients (148 eyes) with persistent cCSC were enrolled in this retrospective study and treated with SMTL or half-dose PDT. All patients were diagnosed according to clinical characteristics and findings on multimodal imaging. The medical records including patients with a minimum follow-up period of 3 months were reviewed. The patients were divided into two groups according to the application of the SMTL or PDT. The group of the SMTL or PDT was also divided into two subgroups according to parafoveal or subfoveal leakage. The primary outcomes included best-corrected visual acuity (BCVA) and central retinal thickness (CRT) before and 1, 2, and 3 months after treatment. The repeat treatment and resolution of subretinal fluid were also collected. Results Seventy-nine patients (79 eyes) treated with half-dose PDT and 69 Patients (69 eyes) treated with the STML were included. The mean age was 44.20 ± 7.42 years and 80% were male. No significant difference in age, gender, baseline logMAR BCVA or CRT between the half-dose PDT group and the SMTL group (P=0.201; 0.051) can be defined. The BCVA of the SMTL group improved at 1, 2, and 3 months after treatment, while that of the half-dose PDT group improved like the SMTL group. There were no significant differences between the SMTL and the PDT group at 1, 2, and 3 months (P=0.723; 0.139; 0.896). The CRT for the SMTL group decreased at 1, 2, and 3 months after treatment, while that of the half-dose PDT group changed like the SMTL group. However, there were significant differences between the SMTL group and the PDT group at 1and 3 months (P=0.010; 0.009). 13/69 (18.84%) and 9/79 (11.39%) patients underwent treatment at least twice in the SMTL and half-dose PDT group, respectively, and achieved resolution of SRF after treatment. The results of subgroups analysis showed no significant differences between the logMAR BCVA of the SMTL and PDT group which were divided into parafoveal and subfoveal leakage groups after treatment, but significant difference in CRT between subgroups can be found after treatment at 1and 3 months (P=0.003; 0.04). Conclusions The SMTL can be an effective candidate for the treatment of persistent cCSC where leakage occurred at parafoveal or subfoveal and improvement of logMAR BCVA, but half-dose PDT has been more effective for resolution of SRF.

Efficacy and safety of vitamin supplements with resveratrol in diabetic macular edema: Long-term results of a comparative study.

To investigate the adjunct efficacy and safety of vitamin supplements, including resveratrol, in patients with diabetic macular edema (DME) treated with intravitreal anti-vascular endothelial factor (anti-VEGF) agents. Participants in this prospective study were 45 patients with DME, who were treated with either intravitreal anti-VEGF injections (n = 23, Group I) or with combination of intravitreal anti-VEGF injections and vitamin supplements, including resveratrol (n = 22, Group II). All patients underwent visual acuity measurement, slit-lamp examination and spectral domain-optical coherence tomography (SD-OCT) at baseline and monthly after the loading phase of three-monthly anti-VEGF injections, following a PRN protocol. There was a statistically significant improvement in visual acuity in both groups at month 12 compared to baseline, although the mean change in visual acuity did not differ between the two groups (p = 0.183). Accordingly, there was a statistically significant decrease in central retinal thickness in both groups at month 12 compared to baseline, while the mean difference in central retinal thickness was significantly greater in the "combination" group. The mean number of intravitreal anti-VEGF injection was less in Group II (6.45 ± 1.12 in Group II vs. 7.39 ± 1.31 in Group I, p = 0.018). Vitamin supplements with resveratrol was found to be an effective adjunct to intravitreal anti-VEGF injections in patients with DME, offering better anatomic restoration with less injections at the 12-month follow-up.

Predicting visual outcomes in patients treated with aflibercept for neovascular age-related macular degeneration: Data from a real-world clinical setting.

There is a significant variation in the way neovascular age-related macular degeneration patients respond to anti-vascular endothelial growth factor treatment. Both the financial and time cost of treatment are significant. As such, being able to predict patient response to treatment is valuable. 72 eyes treated with intravitreal aflibercept were retrospectively included in analysis. For each subject, visual acuity (letters) and central retinal thickness (µm) at baseline, second, third and fourth visits, as well as 12-month visits, were collated; a plot of visual acuity versus time was generated and a slope of the first three (slope3) and first four (slope4) visits was calculated. Differences in visual acuity at each visit compared to baseline were determined, as well as percentage differences in central retinal thickness at each visit compared to baseline. Lesion sub-type and the presence of fluid and haemorrhage were also recorded. The average change in visual acuity over 12 months was +3.2 ± 13.4 letters with 91.2% of patients losing <15 letters. Slope4 was the only significant predictive factor for 'visual acuity change over 12 months' (p < 0.001). Change in central retinal thickness, lesion sub-type, haemorrhage at baseline and the location of fluid at baseline were not useful predictive factors in long-term outcome. Aflibercept is an effective treatment option for neovascular age-related macular degeneration; however, the long-term response should not be predicted until at least three loading dose injections have been given. Visual acuity measures at each visit should be examined, as it is the trend in visual acuity across the first four visits (slope4) rather than the difference in visual acuity between two visits that is the predictive factor.

Comparative analysis of morphometric parameters of the retina and optic nerve head, obtained with different types of optical coherence tomographs

The article presents the results of a comparative analysis of central retinal thickness, macular volume and retinal nerve fiber layer thickness obtained with Stratus OCT 3000, Cirrus HD-OCT 4000 and Spectralis OCT. Statistically significant differences in central retinal thickness and macular volume were revealed. The absence of a difference pattern in retinal nerve fiber layer thickness measurements on different tomographs was found.

Ergebnisse spektraler optischer Kohärenztomografie bei den mit Chloroquin behandelten Patienten mit systemischem Lupus erythematodes

To recognise possible retinal changes in patients with SLE treated with chloroquine phosphate, as depending on the duration of treatment. The study included 41 patients (82 eyes) who received treatment for SLE with chloroquine or hydroxychloroquine phosphate and had not previously been diagnosed with retinal pathology. Participants were divided into two groups according to the duration of treatment. The first group included 18 patients (36 eyes) treated for up to five years and the second group consisted of 23 patients (46 eyes) treated from five to twenty years. We performed a thorough eye exam, including best-corrected visual acuity, colour vision, visual field examination, dilated fundus examination, autofluorescence imaging, color fundus photography and spectral domain optical coherence tomography. Mean duration of treatment in the first group was 2.79 ± 1.37 years, and in the second group 8.67 ± 2.26 years. The difference in central retinal thickness between the two groups was not statistically significant (p > 0.05). Comparison of parafoveal thickness between the two groups was statistically non-significant in all quadrants (p > 0.05). Visual field examination, autofluorescence images and colour fundus photographs were without noteworthy pathology. Our results indicate that there were no significant changes in retinal structure between groups that depended on the duration of treatment. Hence, we can conclude that a yearly follow-up of these patients is sufficient to discover possible preclinical maculopathy.

Effect of intravitreal triamcinolone acetonide injection at the end of vitrectomy for vitreous haemorrhage related to proliferative diabetic retinopathy

Background/AimsTo investigate whether intravitreal injection of triamcinolone acetonide (IVTA) combined with vitrectomy prevents postoperative inflammation in patients with vitreous haemorrhage (VH) due to proliferative diabetic retinopathy (PDR).MethodsThis prospective, multicentre, randomised...

Prevalence of ocular abnormalities in prediabetic patients.

The aim of our study was to evaluate the prevalence of ocular abnormalities in prediabetic individuals. 61 subjects aged 37-78 (41 women, 20 men), with impaired fasting glucose and/or impaired glucose tolerance, were enrolled in the study and compared to 30 healthy volunteers, aged 39-75 (20 women, 10 men), without prediabetes and history of previous ocular diseases. Both groups of patients underwent a complete physical examination, biochemical tests and ophthalmic examination: visual acuity testing, intraocular pressure measurement, anterior and posterior segment evaluation, fundus photographs, optical coherence tomography, colour vision and letter contrast sensitivity tests. The prevalence rates of various ocular abnormalities in prediabetic subjects as compared to healthy controls were as follows: acquired colour vision impairment 8.2% vs. 0% (p<0.05), signs of retinopathy: 9.8% vs. 0% (p<0.05), cataract: 32.8%/ vs. 6.7% (p<0.05), and corneal surface disorders: 19.7% vs. 3.3% (p<0.05). Optical coherence tomography revealed increased prevalence of posterior vitreous detachments and epiretinal membranes in prediabetic individuals as compared to healthy controls. There were no statistically significant differences in central retinal thickness, mean visual acuity and mean intraocular pressure between the two groups. Patients with prediabetes present with numerous ocular abnormalities. The prevalence of ocular disorders in prediabetic subjects is significantly higher as compared to healthy population. Regular ophthalmic monitoring seems to be essential at this stage of hyperglycemic disorders. A dedicated prevention and screening programs should be implemented in prediabetic population in order to early detect ocular abnormalities and identify individuals at risk of other diabetic complications.

The effect of internal limiting membrane peeling in surgical treatment of combined hamartoma and epiretinal membrane

PurposeThis study was designed to evaluate the effect of internal limiting membrane (ILM) peeling in the surgical management of combined hamartoma of the retina and retinal pigment epithelium and epiretinal membrane (ERM).MethodsThe records of 11 patients (11 eyes) with ERM of combined hamartoma of the retina and retinal pigment epithelium, 22 patients (22 eyes) with ERM who had undergone pars plana vitrectomy with removal of the ERM were retrospectively reviewed. The patients were divided into four groups: eyes without (6 eyes) or with (5 eyes) ILM peeling in ERM of combined hamartoma of the retina and retinal pigment epithelium and eyes without (12 eyes) or with (10 eyes) ILM peeling in ERM. Anatomical outcomes, functional outcomes, complications and recurrences were compared between the eyes without and with ILM peeling. Anatomical outcome included the central retinal thickness and subfoveal choroidal thickness from optical coherence tomography (OCT). Functional outcomes included the change in best‐corrected visual acuity (BCVA).ResultsCentral retinal thickness and subfoveal choroidal thickness decreased and postoperative BCVA improved in without and with ILM peeling in ERM of combined hamartoma and ERM. But there were no statistically significant differences in central retinal thickness, subfoveal choroidal thickness, BCVA between without and with ILM peeling in ERM of combined hamartoma and ERM. There was no complicated and recurred case in four groups.ConclusionsThe additional ILM peeling in patients with ERM of combined hamartoma of the retina and retinal pigment epithelium, ERM doesn't affect the postoperative results in central retinal thickness, subfoveal choroidal thickness and visual acuity.

Pseudophakic cystoid macular edema and spectral-domain optical coherence tomography–detectable central macular thickness changes with perioperative prostaglandin analogs

To define the incidence of cystoid macular edema (CME) and spectral-domain optical coherence tomography-detectable (SD-OCT) subclinical changes in central retinal thickness in patients using prostaglandin analog (PGA) eyedrops after phacoemulsification. Royal Bolton Hospital, Bolton, United Kingdom. Prospective case series. A consecutive analysis of the incidence of postoperative CME after phacoemulsification by a single surgeon was performed in eyes of patients using PGA eyedrops between March 2010 and January 2014. The presence of CME was determined using SD-OCT (Cirrus) 3weeks and 6weeks postoperatively. Exclusion criteria included preexisting pathology known to predispose to CME and previous ophthalmic surgery. The paired Wilcoxon signed-rank test was used to compare central retinal thickness measurements at baseline and 3weeks and 6weeks postoperatively. All 48 patients (mean age 78.4years; 60 eyes) had uneventful surgery. There were no cases of clinically significant CME. Subclinical CME detected by SD-OCT was confirmed in 2eyes of different patients (3.3% of eyes), 1 eye 3weeks postoperatively and another eye at 6weeks. Subclinical CME resolved in both cases within 8weeks. In both cases, the difference in central retinal thickness at baseline and 6weeks postoperatively was statistically significant (P<.05). The incidence of subclinical CME detectable on SD-OCT after routine phacoemulsification in patients using PGA eyedrops throughout the perioperative period was 3.3%. There were no cases of clinical CME. These findings might guide clinicians in their decision to use PGAs perioperatively.

Switching from pro re nata to treat-and-extend regimen improves visual acuity in patients with neovascular age-related macular degeneration.

To evaluate the visual outcome after transitioning from a pro re nata (PRN) intravitreal injection regimen to a treat-and-extend (TAE) regimen for patients with neovascular age-related macular degeneration (AMD). A retrospective review of patients who were switched from a PRN regimen with intravitreal injections of bevacizumab, ranibizumab or aflibercept to a TAE regimen. The best corrected visual acuity (BCVA), central retinal thickness (CRT) and type of medication used at baseline, at the time of changing treatment regimen and at the end of the study were analysed. Twenty-one eyes of 21 patients met the inclusion criteria. Prior to the switch, the patients received a mean of 13.8 injections (median, 10; range, 3-39 injections) with the PRN regimen for 44months (range, 3-100months), which improved the visual acuity in five patients (24%). After a mean of 6.1 injections (median, 5; range, 3-14 injections) with the TAE regimen over 8months (range, 2-16months), the visual acuity improved in 12 patients (57%). The improvement in visual acuity during treatment with the TAE regimen was statistically significant (p=0.005). The proportion of patients with a visual acuity of 0.2 or better was significantly higher after treatment with the TAE regimen than after treatment with the PRN regimen (p=0.048). No significant differences in CRT were found between the two treatment regimens. Even after prolonged treatment and a high number of intravitreal injections, switching AMD patients from a PRN regimen to a strict TAE regimen significantly improves visual acuity.

Effects of intravitreal ranibizumab on the untreated eye and systemic gene expression profile in age-related macular degeneration.

The purpose of this study was to evaluate the systemic effects of intravitreal ranibizumab (Lucentis) treatment in patients with neovascular age-related macular degeneration (AMD). The impact of intravitreal ranibizumab injections on central retinal thickness (CRT) of treated and contralateral untreated eyes, and differences in gene expression patterns in the peripheral blood mononuclear cells were analyzed. The study included 29 patients aged 50 years old and over with diagnosed neovascular AMD. The treatment was defined as 0.5 mg of ranibizumab injected intravitreally in the form of one injection every month during the period of 3 months. CRT was measured by optical coherence tomography. The gene expression profile was assigned using oligonucleotide microarrays of Affymetrix HG-U133A. Studies have shown that there was a change of CRT between treated and untreated eyes, and there were differences in CRT at baseline and after 1, 2, and 3 months of ranibizumab treatment. Three months after intravitreal injection, mean CRT was reduced in the treated eyes from 331.97±123.62 to 254.31±58.75 μm, while mean CRT in the untreated fellow eyes reduced from 251.07±40.29 to 235.45±36.21 μm at the same time. Furthermore, the research has shown that among all transcripts, 3,097 expresses change after the ranibizumab treatment in relation to controls. Among these transcripts, 1,339 were up-regulated, whereas 1,758 were down-regulated. Our results show the potential systemic effects of anti-VEGF therapy for AMD. Moreover, our study indicated different gene expression in peripheral blood mononuclear cells before and after intravitreal ranibizumab treatment.

Normal Value Ranges for Central Retinal Thickness Asymmetry in Healthy Caucasian Adults Measured by SPECTRALIS SD-OCT Posterior Pole Asymmetry Analysis.

To determine the normal variation in central retinal thickness asymmetry in healthy Caucasian adults using the posterior pole asymmetry analysis (PPAA) of a SPECTRALIS spectral-domain optical coherence tomography (SD-OCT) device. Healthy Caucasian individuals aged between 18 and 45 years with a visual acuity of minimum 20/20 and a spherical equivalent between -1.5 and +1.5 diopters were recruited. Retinal thickness and retinal nerve fiber layer thickness (RNFL) were using measured SPECTRALIS SD-OCT. Inter- and intraocular differences in central retinal thickness were calculated using the PPAA. The association between age, sex, and interocular asymmetry was evaluated by a linear model with Gaussian correlation structure. A total of 105 individuals, 30 men and 75 women, were studied. The mean age ± SD was 28.8 ± 7.87 years. The grand mean interocular retinal thickness asymmetry was 5.6 μm (95% confidence interval [CI]: 4.6-6.5) and the grand mean intraocular retinal thickness asymmetry was 8.3 μm (95% CI: 6.8-9.9) in the right eye and 8.4 μm (95% CI: 6.7-10.0) in the left eye. The highest local asymmetries were found in the nasal corners of macula were the posterior pole thickness map overlaps the temporal vascular arches. A slight general age and sex effect on the mean interocular retinal thickness asymmetry was found to be respectively 0.04 μm/year (95% CI: 0.02-0.06 μm) and 0.54 μm (95% CI: 0.19-0.88 μm) for men compared with women. Statistically significant physiological asymmetries in inter- and intraocular central retinal thickness exist. This must be considered when early signs of glaucoma or other pathologies are evaluated based on the retinal thickness asymmetry. (http://www.controlled-trials.com/isrctn/ number, ISRCTN09017572.).

Long-term follow-up of standard photodynamic therapy with standardized small spot size for diffuse retinal pigment epitheliopathy.

To evaluate the long-term efficacy and safety of standard-fluence photodynamic therapy (PDT) with verteporfin using the minimum PDT spot size in patients with diffuse retinal pigment epitheliopathy (DRPE). This is a retrospective study of 67 DRPE cases treated with PDT using a standardized minimum spot size of 850 μm. Indocyanine green angiography (ICGA) was used to guide and determine the outcome of PDT treatment. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), recurrences, and adverse events were recorded and analyzed. The mean follow-up period of the study was 35.8 ± 16.6 months. There was a statistically significant difference in BCVA between baseline and the end of the follow-up (p&lt;0.001). The BCVA improved in 41 eyes (61.2%), remained stable in 20 eyes (29.9%), and deteriorated in 6 eyes (9%). Accordingly, there was a statistically significant difference in CRT between the baseline and the last follow-up visit (p&lt;0.001). The recurrence rate was 13.4% and only one eye presented a recurrence at the same site as the laser treatment. No adverse events were noted. Application of ICGA-guided standard PDT, with a laser spot size of minimum diameter, on the site of active leakage seems to be effective and safe in a long-term follow-up period, presenting improvement in BCVA, decrease in CRT, and low rate of recurrence.

Aniseikonia Following Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment

To evaluate the characteristics of aniseikonia in patients with rhegmatogenous retinal detachment (RD) after pneumatic retinopexy. Prospective, interventional case series study. Thirty patients who had undergone pneumatic retinopexy as the initial procedure for rhegmatogenous retinal detachment were selected for this study. The principal outcomes included visual acuity, postoperative aniseikonia measured by the New Aniseikonia Test, anatomical success, and measurement of central retinal thickness using optical coherence topography (OCT). These outcomes were measured postoperatively at 3, 6, and 12 months. The median patient age was 37 years (range, 13-57 years), with 17 cases of macula-off RD and 13 cases of macula-on RD. All of these patients achieved anatomical success, proven by OCT after surgical repair. Three months after pneumatic retinopexy, 18 patients (60.0%) developed micropsic aniseikonia and aniseikonia was diagnosed in 15 patients (88.2%) in the macula-off RD group, leaving 2 patients (11.8%) unaffected. In the macula-on RD group, 3 patients (23.1%) were found to have aniseikonia, while 10 patients (76.9%) were unaffected. The presence of aniseikonia was strongly linked to the difference in central retinal thickness, between the operated eye and the fellow eye, measured at 12 months postoperatively. Aniseikonia after pneumatic retinopexy for rhegmatogenous RD may be related to the preoperative macular status. Macula-off RD patients had a higher incidence of aniseikonia, compared to macula-on RD patients, following retina reattachment. There was a moderate to high correlation between the grading of aniseikonia and the difference in central retinal thickness.

Retrospective study of low-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy

Objective To evaluate the efficacy of 30％ and 50％ dose photodynamic therapy (PDT) for acute central serous chorioretinopathy (CSC).Methods A retrospective cohort study.Ninety-two eyes of 88 patients with CSC,diagnosed by best corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR),indirect ophthalmoscope,fundus colorized photography,fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and optical coherence tomography (SD-OCT) treated with 30％ and 50％ doses of verteporfin respectively between March 2007 and August 2013,were enrolled.The eyes were divided into 50％ dose group (49 eyes) and 30％ dose group (43 eyes).The differences of age (t=-1.45),gender (x2=0.011),eyes (x2 =2.140),mean logMAR BCVA (t=-0.40),mean central retinal thickness (CRT) and the maximum thickness of serous retinal detachment (SRD) between two groups were not significant (P＞0.05).The difference of spot size between two groups was significant (t=-2.84,P＜0.05).The follow-up time was ranged from 6 to 68 months,with a mean of (17.16 ±11.30) months.The difference of follow-up between two groups was significant (P＞0.05).The BCVA,cure rate,recurrence rate and the changes of CRT and maximum SRT were observed by SD-OCT.Results The subretinal fluid (SRF) of 31 eyes (72.09％) in the 30％ dose group and that of 47 eyes (95.92％) in the 50％ dose PDT group was absorbed completely respectively.The cure rates in the 30％ dose PDT group was significantly less than that in the 50％ dose group (x2=10.077,P=0.020).There was a significant negative association between the cure rate and spot size by Logistic regression (odds ratio＞1,P=0.040).The difference of changes in the BCVA of logMAR in 50％ dose group was better than that in 30％ dose group after more than 12 months after PDT (P=0.036).On 3,6,12 and more than 12 months after PDT,the difference in CRT in 50％ dose group and 30％ dose group were not statistically significant (P =0.068,0.060,0.082,0.067).The difference in maximum thickness of SRD was not statically significant (P＞0.05).SRF was appeared in 8 eyes (25.81％) of 31 eyes in the 30％ dose group,while SRF was appeared in 1 eye (2.13％) of 47 eyes in the 50％ dose group.The recurrence rate of 30％ dose group was much higher than that of 50％ dose group (P＜0.05).Conclusions For acute CSC treated by PDT,the curative effect of 50 ％ dose group is better than the 30 ％ dose group. Key words: Central serous chorioretinopathy /therapy; Photosensitizing agents/administration & dosage; Photochemotherapy; Treatment outcome

Fundus autofluorescence characteristics in patients with diabetic macular edema

Background Diabetic macular edema (DME) is one of the major causes of visual impairment in patients with diabetes mellitus. DME shows a variety of clinical characteristics with unpredictable results to treatment. The purpose of this study was to investigate the characteristics of fundus autofluorescence (FAF) in DME, which is a rapid, noninvasive technique for fundus diseases. Methods A total of 18 patients (30 eyes) with clinically significant macular edema (CSME) were enrolled. FAF imaging was performed with a confocal scanning laser ophthalmoscope. Other ophthalmic examinations included best corrected visual acuity (BCVA), MP-1 microperimetry, and spectral-domain optical coherence tomography (SD-OCT). Main outcome measurements included BCVA, macular sensitivity (MS), central retinal thickness (CRT), central retinal volume (CRV), the integrity of the inner segment-outer segment junction (IS/OS), and the integrity of the external limiting membrane (ELM). Results Among the 30 eyes, four eyes (13.3%) had normal foveal FAF and 26 eyes (86.7%) had abnormal FAF. Abnormal FAF was mainly divided into three types: cystoid increased FAF (iFAF) 16 eyes (53.3%), spot iFAF six eyes (20%), irregular decreased FAF (dFAF) four eyes (13.3%). According to the FAF morphology, patients were categorized into four groups: normal, cystoid iFAF, spot iFAF, and irregular dFAF. There was a significant difference in BCVA (P &lt;0.001) and MS (P &lt;0.05) among the four groups. The visual function of patients with spot iFAF and irregular dFAF was relatively poor. However, there was no difference in CRT (P=0.186) and CRV (P=0.191) among the four groups. In the normal FAF group, the photoreceptor layers were mostly intact. Regarding the cystoid iFAF group, the photoreceptor layers were relatively intact, while in the other two groups, IS/OS and ELM were disrupted in most patients. No one had intact IS/OS or ELM layer. Conclusions FAF might reflect the damage of the retina and had a relationship with visual function as well as photoreceptor integrity, which gives new insight into the evaluation of DME. Dynamic FAF monitoring helps to better evaluate the disease progression of DME as well as visual function.

Central retinal thickness changes and visual outcomes following uncomplicated small-incision phacoemulsification cataract surgery in diabetic without retinopathy patients and nondiabetic patients

ObjectiveTo compare the visual outcomes and central retinal thickness (CRT) 1 week, 2 weeks, and 4 weeks after surgery in diabetic patients without retinopathy and nondiabetic patients. The relationships between glycated hemoglobin (HbA1c) and visual outcomes and changes in CRT were also evaluated. MethodsPatients who underwent uncomplicated phacoemulsification cataract surgery were enrolled from May 2009 to December 2010, excluding those with preoperative retinal diseases. CRT and best-corrected visual acuity were obtained preoperatively and at 1 week, 2 weeks, and 4 weeks. ResultsThere were 101 eyes in the nondiabetic group and 58 eyes in the diabetic without retinopathy group. There was no difference in preoperative CRT between the two groups. A significant increase in thickness was observed at postoperative Week 4 (p < 0.001) in both groups. However, there were no significant differences in CRT and best-corrected visual acuity before surgery and in all postoperative periods between the groups. In the diabetic without retinopathy group, CRT and visual outcomes were not statistically related to HbA1c level at any time point. ConclusionThere were no significant differences in improvements in postphacoemulsification CRT and visual outcomes between the groups. In the diabetic without retinopathy group, the visual outcomes and CRT were not related to the level of HbA1c. Therefore, as long as there is no diabetic retinopathy, the early postoperative visual recovery and central retinal thickness may not be different from patients without diabetes mellitus.