Changes In Macular Thickness Research Articles

Clinical Research of Lupus Retinopathy: Quantitative Analysis of Retinal Vessels by Optical Coherence Tomography Angiography in Patients with Systemic Lupus Erythematosus.

Lupus retinopathy, an ocular manifestation of systemic lupus erythematosus (SLE), is the major pathology attributed to retinal vasculopathy. Our study is to analyze the changes in retinal vessels in patients with SLE by optical coherence tomography angiography. A total of 61 SLE patients without obvious retinal manifestation and 71 healthy people were included. The SLE patients were further divided into a lupus nephritis (LN) group and a non-LN group. The changes in central macular thickness (CMT) and the retinal vessel densities were compared between the two groups, and the correlation between retinal vascular changes and disease activity was analyzed. Compared with healthy control, the CMT and the retinal vascular densities in both superficial and deep retina were decreased significantly in SLE patients. There was no significant difference in retinal vascular densities between LN groups and non-LN groups. The CMT and retinal vessel densities were decreased in SLE patients without clinical manifestations, which might serve as a sensitive biomarker for early changes of lupus retinopathy in SLE patients.

Smoking and short-term response to intravitreal anti-Vascular Endothelial Growth Factor injections in neovascular age-related macular degeneration

To evaluate the role of smoking status on the response to three monthly intravitreal anti-Vascular Endothelial Growth Factor (anti-VEGF) injections in treatment-naive neovascular AMD (nAMD) patients. We conducted a single-center, retrospective, case-control cohort study in Belgium. Intravitreal treatment (IVT) was performed in 147 eyes of 131 patients, including 92 females (70%). Mean age at the time of the first IVT was 79±9 years. Seventeen patients (13%) were actively smoking at the time of the anti-VEGF IVT. On average, active smokers were 11 years younger than non-smokers when starting IVT treatment. They also showed more frequent subretinal fluid than non-smokers (94% vs. 65%). Mann-Whitney analyses comparing change in central macular thickness and change in logarithm of the minimum angle of resolution visual acuity between active smokers and non-smokers showed no significant difference in treatment response between both groups. Likewise, no significant difference was found when comparing treatment response between patients with less than 10 pack-years (PY) (including never-smokers) and patients with over 10 PY. In a binary logistic regression model, male patients responded worse to anti-VEGF IVT than their female counterparts, with an odds ratio (OR) of 0.27 for good response. This was the only statistically significant predictor of treatment response. Our study failed to demonstrate an effect of smoking on the short-term treatment response to anti-VEGF in nAMD.

Central retina thickness measured with spectral-domain optical coherence tomography in Parkinson disease: A meta-analysis.

Optical coherence tomography (OCT) can detect visual alterations associated with Parkinson disease, such as damage to the retinal nerve fiber layer or changes in retinal vasculature. Macula thinning in association with Parkinson disease (PD) remains controversial. Therefore, we conducted a meta-analysis to investigate the central retina thickness in PD measured using spectral-domain OCT (SD-OCT). We searched PubMed and the Excerpta Medica database to identify studies that compared macular thickness between patients with PD and healthy controls published before July 31, 2021. A random-effects model was used to examine PD-associated changes in macular thickness. Meta-regression analysis was performed by assessing heterogeneity, publication bias, and study quality. Thirty-two studies with a cross-sectional design were selected, including 2118 patients with PD and 2338 controls. We identified significant differences in the thickness of the ganglion cell-inner plexiform layer (standardized mean difference [SMD], -0.41; 95% confidence interval [CI], -0.66 to -0.16; I2 = 80%), ganglion cell complex (SMD, -0.33; 95% CI, -0.50 to -0.17; I2 = 0%), and of all inner and outer sectors of the macula (SMD range, -0.21 to -0.56; all P < .05) between patients with PD and controls. These results corroborate the increased prevalence of changes in OCT measures in individuals with PD, highlighting the efficacy of SD-OCT-determined macular thickness as a biomarker for PD. Our findings may provide helpful guidelines for clinicians in rapidly evolving areas of PD diagnosis.

Evaluating the effect of Perfluoropropane assisted pneumatic vitreolysis in cases of symptomatic focal vitreomacular traction

Purpose The aim of this study was to evaluate the effect of pneumatic vitreolysis (PVL) in the management of symptomatic focal vitreomacular traction (VMT). Patients and methods This prospective non-comparative interventional study was conducted on 21 eyes of 20 patients with isolated focal VMT detected by optical coherence tomography (OCT). All patients were symptomatic complaining of decreased vision and/or metamorphopsia with persistence of VMT for at least 3 months before intervention. All patients received a single intravitreal injection of 0.3 ml pure perfluoropropane (C3F8) and were followed up for 6 months post-injection. During the follow up period, the patients were evaluated regarding the occurrence of release of VMT as detected by OCT, the change in best corrected visual acuity (BCVA), and the change in central macular thickness (CMT) by OCT. Results The single intravitreal gas injection of C3F8 resulted in the release of VMT in 16 (76.2%) eyes. The mean BCVA significantly improved from 0.71±0.16 LogMAR (range: 1–0.5) at baseline to 0.38±0.22 LogMAR (range: 1.0–0.2) by the final visit at 6 months postoperatively (P&lt;0.001). In addition, the mean CMT significantly decreased from 461.67±68.60 µm (range: 318–573 µm) at baseline to 331.55±90.27 µm (range: 278–568 µm) at 6 months postoperatively (P&lt;0.001). One patient developed a retinal break and was treated by retinopexy, and one patient developed a full-thickness macular hole that was treated by vitrectomy. Conclusions PVL was found to be an effective method for treatment of symptomatic VMT.

Efficacy and safety of pan retinal photocoagulation combined with intravitreal anti-VEGF agents for high-risk proliferative diabetic retinopathy: A systematic review and meta-analysis.

High-risk proliferative diabetic retinopathy (HR-PDR) is the advanced stage of diabetic retinopathy progression with poor prior treatment efficacy and high rates of blindness. This meta-analysis aims to compare the efficacy and safety of pan retinal photocoagulation (PRP) combined with intravitreal anti-vascular endothelial growth factor (aVEGF) (PRP + aVEGF) versus PRP monotherapy in HR-PDR patients. A thorough search was performed through PubMed, Web of Science, EMBASE, and the Cochran Library from inception to December 18, 2022. Outcome measures included change in central macular thickness, best-corrected visual acuity, fluorescein angiography, incidence of undergoing vitrectomy, and adverse events during the follow-up period. Eight studies (6 randomized controlled trials and 2 retrospective studies) with 375 eyes were included in this meta-analysis. There were no obvious differences in the changes of best-corrected visual acuity and fluorescein angiography between the PRP + aVEGF and PRP monotherapy groups. However, PRP + aVEGF group had a significant reduction in the change of central macula thickness (standard mean deviations = -1.44, 95%CI = -2.55 to -0.32, P = .01) and the rate of undergoing vitrectomy (odds ratio = 0.20, 95%CI = 0.05-0.83, P = .01). Additionally, the risks of vitreous hemorrhage and other complications were not significantly different between the 2 groups. Our meta-analysis indicated that PRP + aVEGF might have potential benefits in the treatment of HR-PDR patients. However, given several limitations of this study, more research is needed to confirm our findings.

Early Postoperative Changes in Macular Choroidal Thickness After Uncomplicated Phacoemulsification in Patients With and Without Glaucoma: A Swept-Source Optical Coherence Tomography Study.

Purpose The objective of this study was to examine the impact of uncomplicated phacoemulsification on macular choroidal thickness (CT) within the first three postoperative months and to investigate its relationship with postoperative cystoid macular edema (CME) in both glaucomatous and healthy subjects, utilizing swept-source optical coherence tomography (SS-OCT). Methods The non-randomized prospective study involved 82 patients, selected via convenience sampling from the First Department of Ophthalmology, Medical School of Athens, "G. Gennimatas" Hospital, Athens, Greece, between May 2018 and May 2022, undergoing phacoemulsification and intraocular lens (IOL) implantation. The inclusion criteria encompassed patients aged 50 years or above, with or without glaucoma. Patients with ocular pathologies that could influence macula or CT measurements were excluded. Data collection focused on retinal and CT variablesof the macular area, measured using SS-OCT. Baseline measurements were established preoperatively, with follow-up assessments at one week, one month, and three months postoperatively to monitor CT and macular edema onset. Results A total of 82 eyes from 82 patients with a mean age of 79.1±8.3 years were included. The study population was divided into a glaucoma group (n=28 eyes) and a control group (n=54 eyes). Our findings indicate a consistently significant increase in macular CT measurements one month after cataract surgery, observed in both glaucomatous and non-glaucomatous eyes. In the first postoperative week, statistically significant changes in CT were observed only in patients with CME. Subsequently, at one-month interval, both patient groups, those with and without CME, exhibited statistically significant changes in CT across all macular sectors. CME was detected in 10 out of 28 eyes in the glaucoma group and in 16 out of 54 eyes in the control group. When evaluating the impact of postoperative CME on groups of glaucomatous and non-glaucomatous eyes, it was observed that glaucomatous eyes exhibited a significantly larger magnitude of change in subfoveal CT (SFCT) (p=0.03) at one month (relative to baseline) compared to non-glaucomatous eyes. There was also a 31% increase in the odds of developing CME for glaucoma patients; this result was not statistically significant (odds ratio {OR}, 1.31; 95% confidence interval {CI}, 0.50-3.47; p=0.57). Conclusions During the early postoperative period, the study revealed a significant increase in CT at one month after phacoemulsification in both glaucomatous and non-glaucomatous eyes. When CME was present, a significantly more pronounced magnitude of change in SFCT was observed at one month in glaucomatous eyes, as opposed to non-glaucomatous eyes. This observation suggests a possible selective susceptibility of glaucomatous eyes in the early postoperative period that requires further research.

Optical coherence tomography angiography in birdshot chorioretinopathy.

To describe the retinal vascular changes in birdshot chorioretinopathy (BSCR) using optical coherence tomography angiography (OCTA) and to compare them with changes in macular thickness. In this multicenter study, patients with a diagnosis of BSCR and a positive HLA-A29 underwent fluorescein angiography, spectral domain optical coherence tomography (SD-OCT), and OCTA. The foveal avascular zone (FAZ) and the area of capillary non-perfusion were manually measured by two examiners in fluorescein angiography (FA) and 3 × 3-mm OCTA images of the superficial retinal layer. These measurements were compared to central retinal thickness. To calculate normal capillary density, we collected data from 22 controls who had OCTA performed on one visit only. A total of 44 eyes with BSCR were enrolled. The mean automated parafoveal superficial capillary density in BSCR eyes was 0.47 ± 0.03. The differences between the foveal capillary density of BSCR patients and healthy subjects were statistically significant (P < 0.001). The mean area of FAZ manually measured on the 3 × 3 mm unsegmented OCTA images was larger in eyes with BSCR (1.34 ± 0.41 mm2; P < 0.0001). Measurement of FAZ area showed good interobserver (κ 0.88) and intraobserver repeatability (κ 0.79) on OCTA images. The intraclass correlation coefficient for FAZ measurements on FA between the two observers was 0.48. The OCT retinal thickness maps of all BSCR eyes demonstrated statistically significant thinning compared to those of control subjects (P < 0.01). Our study demonstrates the potential contribution of OCTA as a new non-invasive imaging technology that monitors disease activity in BSCR patients.

Longitudinal Assessment of Macular Thickness and Microvascular Changes in Children with Sickle Cell Disease

To longitudinally assess macular thickness and microvascular changes in children with sickle cell disease (SCD). A retrospective consecutive series. Children with SCD aged ≤ 18 years who had an ophthalmic examination at Boston Children's Hospital between January 1998 and August2022. Qualitative and quantitative analyses of both OCT and OCT angiography (OCTA) images were performed. Total retinal thickness measured on macular OCT, superficial capillary plexus and deep capillary plexus (DCP) vessel density (VD), and foveal avascular zone (FAZ) area measured on 6-× 6-mm OCTA scans. International Classification of Diseases, 10th Revision, code search identified 303 pediatric SCD patients who underwent ophthalmic examination during the study period. OCT and OCTA images were acquired on 104 (17.2%) and 60 (9.9%) eyes at presentation and on 159 (26.2%) and 100 (16.5%) eyes at final visit, respectively. Overall, temporal retinal thinning was noted qualitatively in 35.6% of SCD patients at presentation and 39.6% at final visit. Of those patients with macular thinning, 94.6% and 90.5% had peripheral sickle cell retinopathy (SCR) at presentation and final visit. On quantitative OCT analysis, HbSS eyes had a lower retinal thickness in the fovea and temporal parafovea compared with HbSC (P < 0.05). Eyes with peripheral SCR had a larger FAZ at presentation compared with eyes without peripheral SCR (P= 0.004), a lower DCP VD at final visit in the inferior temporal macula (P= 0.03), and a higher DCP VD at final visit in the superior nasal macula (P= 0.01). Eighty eyes of 40 patients had OCT, and 34 eyes of 20 patients had both OCT and OCTA images acquired at both initial and final visits. At final visit, retinal thickness decreased at the fovea, inferior perifovea, and temporal perifovea compared with presentation (P < 0.05). In parallel, VD DCP in the superonasal quadrant increased at final visit (P= 0.03). Macular retinal thinning was progressive and observed in eyes with and without peripheral SCR. Over time, there was a compensatory increase in DCP VD in the nasal macula on OCTA. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Intravitreal Injection of Anti-Vascular Endothelial Growth Factors Combined with Corticosteroids for the Treatment of Macular Edema Secondary to Retinal Vein Occlusion: A Systematic Review and Meta-Analysis

ABSTRACT Purpose To evaluate the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) and corticosteroid combination therapy for the management of treatment-naïve or recurrent/refractory macular edema caused by retinal vein occlusion (RVO) in comparison with anti-VEGF monotherapy. Methods In this systematic review and meta-analysis study, the data from publications in the electronic databases including PubMed, Embase, Cochrane Library Central Register of Controlled Trials, ISI and Scopus from January 1, 2007, through November 20, 2020, were compiled. Heterogeneity was statistically quantified by the I2 statistic, and meta-analysis was performed using a random-effects model. Results Twenty-four related studies were identified, including a total of 1280 eyes, which consisted of 685 and 507 patients with central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO), respectively. This study demonstrated a greater improvement in best-corrected visual acuity (BCVA) in the combination group compared to anti-VEGF monotherapy for both CRVO and BRVO cases at 6 months after initiating therapy. The improvement in vision was more notable in BRVO cases than in CRVO cases. However, the changes in central macular thickness (CMT) did not differ significantly between the different treatment approaches, and the results were inconclusive. Including all cases with RVO, there was no inferiority in terms of BCVA improvement and CMT reduction in the triamcinolone subgroup compared with the slow-release dexamethasone implant subgroup. A greater improvement was noticed in terms of BCVA in the sequentially treated subgroup compared to the simultaneous treatment subgroup, while there was a greater reduction in CMT in the simultaneous subgroup with the highest reduction recorded at 1 month after treatment. Conclusions This study suggests that combination therapy with intravitreal anti-VEGF and corticosteroid (such as intravitreal or subtenon triamcinolone or dexamethasone implant) has a slightly better effect on improving BCVA in cases with BRVO or CRVO at 6 months compared to monotherapy.

Beyond the Blur: Clinical Outcomes of Nd: YAG Laser Posterior Capsulotomy Intraocular Pressure, Refraction, Anterior Chamber Depth, and Macular Thickness

Background: Nd: YAG laser posterior capsulotomy is a commonly performed procedure to treat posterior capsular opacification following cataract surgery. While the procedure is known to effectively improve visual acuity, its potential impact on Intraocular Pressure (IOP), refraction, Anterior Chamber Depth (ACD), and macular thickness remains a subject of debate. This study aims to investigate the effects of Nd: YAG laser posterior capsulotomy on these ocular parameters. Methods: This study was designed as a prospective analysis conducted at a tertiary eye care center on patients who underwent Nd: YAG laser posterior capsulotomy between January 2020 and December 2020. Preoperative and postoperative measurements of IOP, refraction, ACD, and macular thickness were collected and compared. Statistical analyses were performed using paired t-tests, and p-values&lt;0.05 were considered statistically significant. Results: A total of 30 eyes from 25 patients (mean age, 65.4±8.2 years) were included in the analysis. Following Nd: YAG laser posterior capsulotomy, the mean IOP from 15.2±2.3 mmHg to 17.0±2.7 mmHg (p&lt;0.001). The refractive status showed a mean myopic shift of -0.35±0.16 diopters (p&lt;0.001,). Additionally, there was a statistically significant reduction in ACD from 3.15±0.42 mm to 2.90±0.37 mm (p=0.003,). However, there was no statistically significant change in macular thickness after the procedure (p=0.287). Conclusion: Nd: YAG laser posterior capsulotomy leads to a mild but statistically significant increase in IOP and a small myopic shift in refraction. Additionally, the procedure results in a decrease in ACD but does not significantly affect macular thickness. Ophthalmologists should consider these effects when performing Nd: YAG laser posterior capsulotomy and carefully monitor patients postoperatively.

Evaluation of Macular Thickness Changes Following Large Horizontal Rectus Muscle Recession: A Prospective Cohort Study.

Aim The aim of the study was to evaluate the long-termeffect of large horizontal rectus muscle recession on macula thickness using spectral domain optical coherence tomography (SD-OCT). Material and methods Forty-twochildren were included in the study. The intervention groups were the medial rectus (MR) group (=20 eyes ) and the lateral rectus (LR) group (=22 eyes), including the eyes that underwent large medial and lateral rectus muscle recession, respectively. The control group included the fellow 42 unoperated eyes of the same children. Each eye was scanned using Topcon Maestro2 OCT-Angiography (OCTA; Topcon, Tokyo, Japan) preoperatively and then two months following surgery. A paired t-test was used to compare the mean difference in macular thickness between the intervention and control groups using the statistical program R (R Foundation for Statistical Computing, Vienna, Austria). Results The mean change in central, parafoveal, and perifoveal macular thickness of the intervention group was not statistically significant. Conclusion The long-term changes in macular thickness, as evaluated using SD-OCT both for the central and peripheral regions of the fovea, following large horizontal rectus muscle recession surgery, are not statistically significant.

Systematic Review of Neovascular Age-Related Macular Degeneration Disease Activity Criteria Use to Shorten, Maintain or Extend Treatment Intervals with Anti-VEGF in Clinical Trials: Implications for Clinical Practice.

Clinical trials in neovascular age-related macular degeneration (nAMD) using anti-vascular endothelial growth factor (ant-VEGF) injections use disease activity (DA) criteria to shorten, maintain or increase the interval between injections. Differences in these DA criteria may contribute to differences in the proportions of patients with macular fluid at key timepoints or achieving extended dosing intervals in these trials. We identified, collated and evaluated DA criteria from pivotal anti-VEGF nAMD trials to understand how differences impact on these studies and real-world visual acuity and extending dosing outcomes. This was a systematic review of literature on Pubmed for randomised clinical trials in nAMD using a proactive treatment regimen. We excluded case reports, review articles and studies on fewer than 50 participants. Twelve clinical trials (LUCAS, VIEW, TREX-AMD, FLUID, TREND, RIVAL, ALTAIR, CANTREAT, ARIES, TREX-Conbercept, HAWK & HARRIER, TENAYA & LUCERNE) investigating anti-VEGF treatment of nAMD were identified according to our search strategy. Different studies utilised a different combination of DA criteria. Specifically, six trials included visual acuity change; four included macular thickness change; one included visual acuity change if associated with macular thickness change; one with qualitative optical coherence tomography (OCT) features; four with qualitative OCT features if also associated with visual acuity change; 10 with macular haemorrhage and five with other fluorescein angiographic features. Different clinical trials use different DA criteria when altering the interval between anti-VEGF injections. This makes it difficult to draw meaningful conclusions about secondary outcomes such as proportion of patients treated at extended dosing intervals or proportions of eyes with persistent subretinal or intraretinal fluid. Standardising DA criteria in clinical trials and preferentially using those easily applied in a real-world setting would lead to results more achievable in real-world settings and for a meaningful comparison of treatment durability.

Change in macular thickness after uncomplicated phacoemulsification surgery using optical coherence tomography in a tertiary care hospital.

To determine the change in macular thickness after uncomplicated phacoemulsification surgery using optical coherence tomography in a tertiary care hospital. This study was conducted at Department of Ophthalmology Jinnah Postgraduate Medical Centre Karachi, for 6 months from 10th Dec 2019 to 10th June 2020. Sample size calculation of 52 eyes was done by using open epi software. Patients who fulfilled the inclusion criteria that is age ranging from 50 to 75 years, either gender with senile cataract having no preexisting ocular or systemic disease and those giving consent were included in this study. Patients with any comorbidity ocular trauma, having pre-existing ocular diseases such as active ocular infection, glaucoma, maculopathy or retinopathy were excluded from study. Patients with secondary cataract also excluded from study. After complete history, all patients underwent detailed ophthalmologic examination and Pre-surgery macular thickness recorded by using swept source OCT (DRI-OCT-2 Triton; Topcon). Surgery was performed and intraocular lens was implanted in all cases. Post procedure Macular thickness was measured using swept source OCT at 1st postoperative day, 1st month and 6th month after surgery. The mean age of patients was 62.06 ± 5.1 years. Total of 52 eyes diagnosed with senile cataract were included in this study. There were 30 (57.7%) males and 22(42.3%) females. The mean preoperative central foveal thickness was 201.3±24.8μm. The postoperative central foveal thickness was 200.3±25.2μm (153-265μm) at day 1st of surgery, 224.1 ± 53.8 μm (151-458 μm) at 1st month and 212.4±28.3μm (167-255μm) 6th month after surgery. The mean preoperative BCVA was 0.70 ± 0.43 (0.1-1.7) logMAR. The postoperative mean BCVA was 0.26 ± 0.42 (0.00-3.10) logMAR at 1st day, 0.07± 0.10 (0.000.7) logMAR at 1st month and 0.05 ± 0.10 (0.00-0.3) logMAR at 6th month. In our study we found an increase in macular thickness but there was no loss of BCVA from changes of macular thickness after surgery and the mean BCVA increased progressively in postoperative period.

Clinical Outcomes of Nd: YAG Laser Posterior Capsulotomy: Impact on Intraocular Pressure, Refraction, Anterior Chamber Depth, and Macular Thickness

Background: Nd: YAG laser posterior capsulotomy is a commonly performed procedure to treat posterior capsular opacification following cataract surgery. While the procedure is known to effectively improve visual acuity, its potential impact on intraocular pressure (IOP), refraction, anterior chamber depth (ACD), and macular thickness remains a subject of debate. This study aims to investigate the effects of Nd: YAG laser posterior capsulotomy on these ocular parameters. Methods: This study was designed as a prospective analysis conducted at a tertiary eye care center on patients who underwent Nd: YAG laser posterior capsulotomy at a tertiary eye care center between January 2020 and December 2020. Preoperative and postoperative measurements of IOP, refraction, ACD, and macular thickness were collected and compared. Statistical analyses were performed using paired t-tests, and p-values &lt;0.05 were considered statistically significant. Results: A total of 30 eyes from 25 patients (mean age, 65.4 ± 8.2 years) were included in the analysis. Following Nd: YAG laser posterior capsulotomy, the mean intraocular pressure (IOP) increased from 15.2 ± 2.3 mmHg to 17.0 ± 2.7 mmHg (p &lt; 0.001). The refractive status showed a mean myopic shift of -0.35 ± 0.16 diopters (p &lt; 0.001,). Additionally, there was a statistically significant reduction in anterior chamber depth (ACD) from 3.15 ± 0.42 mm to 2.90 ± 0.37 mm (p = 0.003,). However, there was no significant change in macular thickness after the procedure (p = 0.287). Conclusion: Nd: YAG laser posterior capsulotomy leads to a mild but statistically significant increase in IOP and a small myopic shift in refraction. Additionally, the procedure results in a decrease in ACD but does not significantly affect macular thickness. Ophthalmologists should consider these effects when performing Nd: YAG laser posterior capsulotomy and carefully monitor patients postoperatively.

Comparative study of effect of phacoemulsification on central macular thickness in diabetic and nondiabetic patients assessed with spectral domain optical coherence tomography

Abstract Purpose: The aim of this work was to study the effect of uneventful phacoemulsification on central macular thickness (CMT) in diabetic and nondiabetic patients as assessed with spectral domain-optical coherence tomography. Materials and Methods: A prospective, observational, comparative, cohort study was carried out at a tertiary care center in North India from January 1, 2018 to June 30, 2019. A total of 90 diabetic patients and 95 nondiabetic controls undergoing phacoemulsification surgery were evaluated. CMT and visual acuity (VA) were noted preoperatively and postoperatively at the 6th and 12th weeks, respectively. Results: A total of 185 patients, 95 nondiabetic, and 90 diabetic patients were included in the study. The mean age (years) of the study population was 64.56 (10.38). The subclinical increase in macular thickness was maximum at 6 weeks postoperatively (P &lt; 0.001) and was more in diabetic as compared to nondiabetic patients. Final macular thickness at 12 weeks was comparable in both diabetic and nondiabetic patients (P &lt; 0.05). However, the difference in change in macular thickness (preoperative versus postoperative) between the two groups was not clinically significant at 6 weeks (0.67 µm) and 12 weeks (0.08 µm). Conclusion: Uncomplicated phacoemulsification surgery with posterior chamber implantation of an intraocular lens is associated with subclinical macular thickening. However, there is no significant increase in macular thickness after phacoemulsification, irrespective of the glycemic status.

Changes in central macular thickness before and after cataract surgery evaluated by optical coherence tomography in non-diabetic patient

Background: Optical coherence tomography (OCT) has been useful for objectively observing central macular thickness (CMT) changes inpre-operative and post-operative uneventful cataract surgery. Aims and Objectives: This study was done to compare changes in CMT in small incision cataract surgery (SICS) and phacoemulsification surgery and to illuminate the OCT features of CMT after uneventful cataract surgery. Materials and Methods: A prospective observational study was done at the tertiary eye care center from December 2019 to November 2020, a total of 60 patients underwent SICS and Phacoemulsification cataract surgery, were followed and examined postoperatively at day 1, 1 week, 1 month, and 6 months for whole ocular examination and OCT. Results: Comparison analysis was performed using Friedman’s analysis of variance test.In SICS and Phacoemulsification group, statistical analysis differences between the mean CMT at pre-operative, post-operative 1 week, 1 month, and 6 months were found statistically significant (P &gt; 0.001), subclinical macular edema (increase CMT without affecting visual acuity) was noted at 1 week and 1 month reviews. Conclusion: The changes in CMT after cataract surgery are reversible, since the maximum measured increase in macular thickness at 1 month after surgery then gradually decreased at 6 months follow-up. This increase remained subclinical, and no evidence of clinical cystoid macular edema was seen on OCT.

Evaluation of changes in epivascular glia before and after intravitreal dexamethasone implant: An OCT pilot study

PurposeTo detect changes in epivascular glia (EVG) in diabetic retinopathy after intravitreal dexamethasone implant using en face optical coherence tomography (enface OCT) and OCT angiography (OCTA) and to correlate improvements in functional and structural features. MethodsA total of 38 eyes of 38 patients were enroled in this prospective study. They were divided into two different study groups: the first group including 20 eyes with diabetic retinopathy type 1 complicated by macular oedema and the control group including 18 eyes from 18 healthy age-matched patients. The main outcome measures were: (i) differences at baseline in the foveal avascuar zone (FAZ) area in the study group versus control; (ii) the presence of epivascular glia in the study group versus control, (iii) differences at baseline between foveal macular thickness versus control; (iv) changes in foveal macular thickness, FAZ and epivascular glia in the study group before and after intravitreal dexamethasone implant. ResultsAt baseline FAZ area detected at OCTA was larger in the study group than in the control group, and epivascular glia was only detected in the study group. Three months after intravitreal injection of dexamethasone implant in the study group the best corrected visual acuity (BCVA) improved and central macular tickness reduced (P<0.0001). No significant differences were found in FAZ area while epivascular glia disappeared in 80% of the patients after treatment. ConclusionsGlia activation due to retinal inflammation in diabetic retinopathy (DR) can be detected on en face-OCT as epivascular glia. Intravitreal dexamethasone (DEX) implant improves both the anatomical and functional condition in the presence of these signs.

Changes in Subfoveal Choroidal Thickness Following Uncomplicated Cataract Surgery: A Scoping Review.

This scoping review investigates the relationship between subfoveal choroidal thickness (SFCT) and cataract surgery. We synthesized existing research to clarify SFCT changes following surgery and identify contributing factors. Our aim was to enhance understanding of the ocular changes associated with cataract surgery. A comprehensive database search identified studies on SFCT changes after uncomplicated cataract surgery, categorized as "SFCT changes after cataract surgery," "Factors influencing SFCT," "Macular thickness changes,"and "Long-term changes."Quantitative data and findings were extracted from a total of 13 research articles. Studies on SFCT changes after cataract surgery provided valuable insights for the subject under review. Factors influencing SFCT changes included age, axial length, and cataract surgery. Macular thickness increased at various time points. Long-term SFCT changes varied among studies. The present research provides valuable insights into SFCT changes after cataract surgery. Factors including age, axial length, and cataract surgery consistently influence SFCT. The clinical relevance of macular thickness changes remains uncertain, and the influence of age, ocular pathologies, and patient populations is highlighted. Long-term changes in SFCT vary, suggesting a need for further research. Standardized measurement techniques and larger cohort studies are recommended to enhance comparability and generalizability. This review enhances understanding of ocular changes associated with cataract surgery and informs future research.

Pre-operative versus post-operative intravitreal aflibercept injection for management of DME in patients undergoing cataract surgery.

The aim of this paper is to investigate the need of deferring cataract surgery until treating the co-existing diabetic macular edema (DME) using intravitreal (IVI) anti-vascular endothelial growth factor (anti-VEGF). A prospective randomized interventional study included diabetic patients with visually significant cataract and DME. Patients were divided into 2 groups. Group A received three preoperative intravitreal (IVI) aflibercept injections with a monthly interval; the third injection was given intra-operatively. Group B received a single intra-operative injection, and two post-operative injections with a monthly interval. The primary outcome measure was the change in central macular thickness (CMT) at 1st and 6th month post-operative. The secondary outcome measures were best corrected visual acuity (BCVA) at same points and any documented adverse effects. Forty patients were enrolled in the study, 20 patients in each group. Means of CMT at 1month post-operatively were significantly higher in group B than group A but no statistical difference at 6months. There was no statistical difference between the 2 groups regarding BCVA at 1 or 6months post-operatively. Compared with the baseline values, BCVA and CMT improved significantly after 1 and 6months within both groups. IVI of aflibercept given before cataract surgeries does not seem to have superior effect over postoperative injections in either macular thickness or visual outcomes. Hence, preoperative controlling of DME might not be mandatory in patients undergoing cataract surgery. The study is registered in clinical trial. Gov (NCT05731089).

Faricimab for Diabetic Macular Edema in Patients Refractory to Ranibizumab or Aflibercept.

Background and Objectives: Faricimab is the first intravitreal injection of vascular endothelial growth factor-A and angiopoietin-2 bispecific monoclonal antibody. Here, we evaluate the functional and anatomical outcomes of faricimab treatment in patients with diabetic macular edema (DME) that was refractory to ranibizumab or aflibercept. Materials and Methods: We performed a retrospective, observational, consecutive-case study of patients who had DME that was refractory to treatment with ranibizumab or aflibercept and were treated with faricimab between July 2022 and January 2023 under a pro re nata regimen. All the participants were followed for ≥4 months after the initiation of faricimab. The primary outcome was a recurrence interval of ≥12 weeks, and the secondary outcomes were the changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: We analyzed 18 eyes of 18 patients. The mean recurrence interval of previous anti-VEGF injection was 5.8 ± 2.5 weeks, which was significantly extended to 10.8 ± 4.9 weeks (p = 0.0005) by the switch to faricimab. Eight patients (44.4%) achieved a recurrence interval of ≥12 weeks. A history of subtenon injection of triamcinolone acetonide (p = 0.0034) and the presence of disorganization of the retinal inner layers (p = 0.0326) were found to be significantly associated with a recurrence interval of <12 weeks. The mean BCVAs were 0.23 ± 0.28 logMAR and 0.19 ± 0.23 logMAR, and the mean CMTs were 473.8 ± 222.0 µm and 381.3 ± 219.4 µm at baseline and 4 months, respectively, but these changes were not statistically significant. None of the patients experienced serious adverse events. Conclusions: Faricimab may extend the treatment interval for patients with DME that is refractory to ranibizumab or aflibercept. DME previously treated with the subtenon injection of triamcinolone acetonide or associated with disorganization of the retinal inner layers may be less likely to be associated with a longer recurrence interval after switching to faricimab.