Macular Volume Research Articles

Multi-modal retinal scanning to measure retinal thickness and peripheral blood vessels in multiple sclerosis

Our purpose was to investigate changes to the retina in multiple sclerosis (MS) using established and novel modes of retinal image acquisition and analysis. 72 participants with MS and 80 healthy volunteers underwent retinal scanning with optical coherence tomography (OCT) and ultra-widefield (UWF) scanning laser ophthalmoscopy (SLO), over a two-year period. Changes in retinal nerve fibre layer (RNFL) thickness, macular volume and retinal blood vessel diameter were measured and parameters were then tested for associations with MS. Measurements from OCT showed that individuals with MS had a thinner RNFL and reduced macular volume when compared to healthy volunteers. On UWF images, participants with MS had reduced arterial widths in the inferior nasal quadrant of both eyes and reduced venous widths in the inferior nasal quadrant of right eyes. Longitudinal analysis showed that participants with MS had an accelerated annual rate of RNFL thinning in several regions of the retina. In conclusion, the assessment of OCT showed thinning of the RNFL and macula in concordance with previous reports on MS, while analysis of blood vessels in the retinal periphery from UWF-SLO images revealed novel changes.

Short-term outcomes in patients with center-involving diabetic macular edema after a single dose of intravitreal bevacizumab

BackgroundA significant portion of diabetic macular edema (DME) is refractory to anti-vascular endothelial growth factor (anti-VEGF) agents. This study investigates morphological and functional outcomes to a single intravitreal bevacizumab (IVB) injection in patients with center-involving DME (ciDME) at 4–6 weeks and compares treatment responders and non-responders based on spectral domain optical coherence tomography (SD-OCT) features.MethodsIRB approved observational, retrospective chart review of patients with ciDME, identified by ICD-10 code, who received IVB and underwent baseline and 4–6 weeks follow-up SD-OCT imaging between January 1, 2016 and January 19, 2021. Patients who had received previous treatment with anti-VEGF or intraocular steroids within 1 year were excluded. Variables included best-corrected visual acuity (BCVA), central subfield thickness (CST) and total macular volume (TMV). Eyes were classified as responders if CST reduction was greater than 10%. OCT scans were graded qualitatively by two masked graders using Imagivault software. Paired Student’s t-tests, Wilcoxon signed rank tests and Chi-Square tests were used for analysis.ResultsA total of 334 prospective subjects were identified, and after applying exclusion criteria 52 eyes from 46 patients (mean age 64.22 ± 8.12 years, 58.7% male) were included. Mean BCVA did not significantly change with treatment, 63.9 ETDRS letters (~ 20/50) at baseline and 65.9 ETDRS letters (~ 20/50) post-treatment (p = 0.07). Mean CST decreased from 466 ± 123 μm at baseline to 402 ± 86 μm post-treatment (p < 0.001). 22 (42.3%) of eyes were categorized as responders and 30 (57.7%) as non-responders. Average change in CST from baseline in responders was -164 μm (p < 0.001) and + 9 μm in non-responders (p = 0.47). Vitreomacular adhesion (VMA) was more prevalent in non-responders (28.7% vs. 4.8%, p = 0.03). In addition, cyst location in the inner nuclear layer (INL) was present more frequently in responders (95.5% vs. 73.3%, p = 0.037) as was subretinal fluid (45.5% vs. 13.3%, p = 0.01).ConclusionThe short-term response to a single IVB was sub-optimal with structural but no functional improvements. Greater baseline CST, presence of INL cysts and subretinal fluid may represent factors indicative of a better treatment response.

Biomarkers predicting central serous chorioretinopathy episode persistence.

The purpose of this study was to identify biomarkers at presentation that are associated with a persistent central serous chorioretinopathy (CSC) episode. The prospective study included 35 patients with an acute CSC episode. Potential clinical and imaging biomarkers were evaluated at baseline and 3 months from the episode onset. As biomarkers age, sex, steroid use, episode recurrence, central retinal thickness (CRT), macular volume (MV), choroidal thickness (CT), pigment epithelial detachment (PED) height, and width, number of retinal hyperreflective foci (HF), leakage pattern, and area of retinal pigment epithelial (RPE) alterations were investigated. At 3 months from the CSC episode onset, spontaneous resolution occurred in 19 patients, while 16 patients had a persistent CSC episode. The group of patients with a persistent episode was statistically significantly associated with female sex (p = 0.032), older age (p = 0.015), wider PED (p = 0.005), and higher number of HF (p = 0.02). Moreover, this group of patients had a significant association with thinner choroid and diffuse RPE alterations as a pair (p = 0.008). Older and female CSC patients with wider PED, increased number of HF, thinner choroid, and diffuse RPE alterations at presentation are inclined to episode persistence and could benefit from earlier treatment.

Impact of intravitreal ranibizumab, aflibercept and bevacizumab on retinal ganglion cell and nerve fibre layer thickness in Neovascular age-related macular degeneration.

To compare the effects of monotherapy with intravitreal ranibizumab, aflibercept and bevacizumab on retinal ganglion cell layer (RGCL) and retinal nerve fibre layer (RNFL) in patients with naïve neovascular age-related macular degeneration (nAMD). This is a retrospective cohort study with three-groups comparison. 83 patients and 97 eyes on continuous monotherapy with an intravitreal anti-vascular endothelial growth factor (anti-VEGF) were followed for 24 months and divided into three groups according to anti-VEGF (aflibercept: 25 eyes, ranibizumab: 34 eyes, bevacizumab: 38 eyes). Main outcome measures included: RGCL and RNFL thickness, best corrected visual acuity (BCVA), central macular thickness (CMT), macular volume (MV) and the presence of intraretinal fluids (IRF), subretinal fluids (SRF) and retinal pigment epithelial atrophy (RPE-atrophy). All outcome measures were recorded at the time of the first injection, 1 and 2 years after treatment and compared longitudinally and between groups. The mean age was 79 ± 7 years. The RGCL thickness, MV, CMT and the presence of IRF and SRF decreased significantly within all three medication groups (p < 0.05 for all) with no significant difference between groups over the 2-year follow-up period (p > 0.10 for all). The decrease in RNFL thickness was not significant within or between the groups after a 2-year follow-up (p > 0.055 for all). RPE-atrophy increased significantly after 2 years in all three groups (p < 0.028 for all) with no significant difference between groups at all three time points (p > 0.307 for all). BCVA was comparable between the three groups over the 2-year follow-up period (p > 0.22 for all). Monotherapy with intravitreal aflibercept, bevacizumab and ranibizumab was associated with comparable significant decreases in RGCL thickness, CMT, MV, IRF and SRF in naïve nAMD patients during the first 2 years of treatment. Furthermore, no significant differences either in BCVA or RNFL thickness were observed between the three intravitreal anti-VEFGs during the first 2 years of treatment.

Retinal layer segmentation in a cohort of healthy children via optical coherence tomography.

High-resolution optical coherence tomography (OCT) allows the detection of macular pathology and involvement of the optic nerve in a wide spectrum of diseases. For the differentiation of diseased and healthy status, normal values of retinal layer segmentation are critical. Yet, normative values mostly cover adult populations with only sparse data for paediatric cohorts. We present data of retinal layer characteristics via OCT in a healthy paediatric cohort. This prospective cross-sectional study screened 75 healthy children (male = 42, female = 33, range 4-17 years) without visual problems. OCT was performed with a peripapillary ring and macula scan protocol to determine paediatric normative values for routine parameters (peripapillary retinal nerve fibre layer thickness (pRNFL), total macular volume (TMV), macular retinal thickness (RT)). The macula scan (6mm grid) was segmented using the device-inherent automated segmentation software (Heidelberg Eye Explorer) for retinal layers: RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL) in 9 segments each and mean of the 9 segments. We obtained OCT data of 72 children with mean age 12.49 years (standard deviation, SD, 2.18; minimum 3.93). Mean global pRNFL was 102.20 μm (SD 8.24), mean TMV 8.81 mm3 (0.30) and mean RT (all segments) 318.22 μm (10.19). Segmented macular retinal layer thicknesses (mean of all segments) were: RNFL 27.67 μm (2.14), GCL 41.94 μm (2.50), IPL 34.97 μm (2.10), INL 35.18 μm (2.15), OPL 29.06 μm (2.24), ONL 68.35 μm (6.20). The OCT is a useful non-invasive imaging technique for the examination of the retina in children with short duration, high imaging resolution and no known adverse effects. Normative values may serve as a comparator for different neuropaediatric disorders and are first presented with this study using an up-to-date and standardized OCT imaging technique.

Moderate-to-Vigorous Physical Activity is Related With Retinal Neuronal and Axonal Integrity in Persons With Multiple Sclerosis

Background Moderate-to-vigorous physical activity (MVPA) may confer benefits for axonal and/or neuronal integrity in adults with multiple sclerosis (MS). Purpose Examine the association between device-measured MVPA with optical coherence tomography (OCT) metrics of retinal nerve fiber layer (RNFL) thickness and total macular volume (TMV) in persons with and without MS. Methods Adults with MS (N = 41), along with sex-matched healthy control (HC) participants (N = 79), underwent measurements of retinal morphology via OCT and wore an accelerometer for a period of 7 days as a measure of MVPA. Results Persons with MS had significantly lower MVPA, RNFL thickness, and TMV compared with HCs. MVPA was correlated with RNFL (r = .38, P < .01) thickness and TMV (r = .49, P < .01). Hierarchical linear regression analyses indicated that addition of MVPA attenuated the Group effect on RNFL and TMV. MVPA accounted for 8% and 3% of the variance in TMV (β = .343, P < .01) and RNFL thickness (β = .217, P = .03), respectively. Conclusion MVPA was positively associated with axonal and neuronal integrity assessed by OCT and partially explained group differences in those metrics. These results present possible future targets for MS management by increasing MVPA.

Thinning of specific retinal layers as a novel biomarker for adverse outcomes in high-risk pregnancy

To investigate a potential association between retinal layer thinning and pregnancy-related adverse outcomes. A prospective observational study included 32 pregnant women between the ages of 18 and 45. Seventeen had uneventful pregnancies, and 15 experienced an adverse obstetrical outcome. Macular swept-source ocular coherence tomography was performed, and selective layers of the retina were evaluated. Adverse obstetrical outcome was defined as any of the following: preterm delivery, preeclampsia, pregnancy-induced hypertension, elevated liver function tests, thrombocytopenia and need for magnesium. The inner superior ganglion cell layer (GCL) was found to be thinner in the cohort with composite adverse obstetrical outcomes than in the cohort without complications (84.5±6.9 vs. 89.5±6.1μm respectively; P=0.04). Total inner superior (295.5±39.1 vs. 302.5±12.7μm; P=0.03) and inferior retinal thickness (289.0±13.9 vs. 301.0±17.1μm; P=0.03) as well as total macular volume (7.5±0.3 vs. 7.7±0.3 mm3; P=0.02) were also lower in women with adverse obstetrical outcomes. Thinning of the macular ganglion cell layer was associated with adverse outcomes in pregnancy. Larger studies are necessary to assess the potential role of macular GCL analysis in pregnancy.

Peripapillary retinal nerve fibre layer thickness and macular ganglion cell layer volume in association with motor and cognitive outcomes in 11-year-old children born very preterm.

The purpose of the study was to study the association between retinal parameters and motor and cognitive outcomes in children born very preterm. This study is part of a prospective cohort study of very preterm infants (birth weight ≤ 1500 grams/gestational age < 32 weeks). At 11 years of age, the ophthalmological assessment included a retinal optical coherence tomography (OCT) examination of the peripapillary retinal nerve fibre layer (PRNFL) and the macular ganglion cell layer (GCL). The motor performance was assessed with the Movement Assessment Battery for Children-Second Edition (Movement ABC-2), and the cognitive outcome with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). A total of 141 children were included. The mean (SD) average PRNFL was 95 μm (10.2μm). The mean (SD) macular GCL volume was 0.34 mm3 (0.03 mm3 ). Higher PRNFL thickness associated with higher percentiles for total scores in the motor assessment (b=0.5, 95% CI 0.1-0.8, p=0.01) and higher macular GCL volume with higher scores in the cognitive assessment (b=1.4, 95% CI 0.5-2.3, p=0.002), also when adjusted for gender, birth weight z-score (birth weight in relation to gestational age) and major brain pathology at term. The associations between higher average PRNFL thickness and better motor performance as well as higher macular GCL volume and better cognitive performance refer to more generalized changes in the brain of 11-year-old children born very preterm. Retinal OCT examinations might provide a deeper insight than mere eyesight in long-term neurodevelopmental follow-up of children born very preterm.

Rate of Retinal Layer Thinning as a Biomarker for Conversion to Progressive Disease in Multiple Sclerosis.

Background and ObjectivesThe diagnosis of secondary progressive multiple sclerosis (SPMS) is often delayed because of the lack of objective clinical tools, which increases the diagnostic uncertainty and hampers the therapeutic development in progressive multiple sclerosis (MS). Optical coherence tomography (OCT) has been proposed as a promising biomarker of progressive neurodegeneration. To explore longitudinal changes in the thicknesses of retinal layers on OCT in individuals with relapsing-remitting MS (RRMS) who converted to SPMS vs matched patients with RRMS who did not convert to SPMS. Our hypothesis is that the 2 cohorts exhibit different rates of retinal thinning.MethodsFrom our prospective observational cohort of patients with MS at the American University of Beirut, we selected patients with RRMS who converted to SPMS during the observation period and patients with RRMS, matched by age, disease duration, and Expanded Disability Status Scale (EDSS) at the first visit. Baseline retinal measurements were obtained using spectral domain OCT, and all patients underwent clinical and OCT evaluation every 6–12 months on average throughout the study period (mean = 4 years). Mixed-effect regression models were used to assess the annualized rates of retinal changes and the differences between the 2 groups and between converters to SPMS before and after their conversion.ResultsA total of 61 participants were selected (21 SPMS and 40 RRMS). There were no differences in baseline characteristics and retinal measurements between the 2 groups. The annualized rates of thinning of all retinal layers, except for macular volume, were greater in converters before conversion compared with nonconverters by 112% for peripapillary retinal nerve fiber layer (p = 0.008), 344% for tRNFL (p < 0.0001), and 82% for cell-inner plexiform layer (GCIPL) (p = 0.002). When comparing the annualized rate of thinning for the same patients with SPMS before and after conversion, no significant differences were found except for tRNFL and GCIPL with slower thinning rates postconversion (46% and 68%, respectively).DiscussionPatients who converted to SPMS exhibited faster retinal thinning as reflected on OCT. Longitudinal assessment of retinal thinning could confirm the transition to SPMS and help with the therapeutic decision making for patients with MS with clinical suspicion of disease progression.

Normative Data of Macular Thickness Using Spectral Domain Optical Coherence Tomography for Healthy Jordanian Children.

PurposeTo report normative values of macular thickness and volume by spectral-domain optical coherence tomography (SD-OCT) in the eyes of healthy Jordanian children aged 6–16 years and assess the correlation of macular parameters with age, sex, and refractive error.Patients and MethodsThis observational study included 144 eyes of 144 healthy children. All children underwent comprehensive ocular examination and cycloplegic refraction. Average macular thickness, macular volume, central subfield thickness (CST), and macular thickness for all the Early Treatment Diabetic Retinopathy Study (ETDRS) quadrants were obtained using Primus SD-OCT (Carl Zeiss Meditec).ResultsThe study group consisted of 68 boys and 76 girls with a mean age (SD) of 10.8 (3.0) years. The mean (SD) spherical equivalent refraction (SER) was 0.56 (1.73) diopters (range: −4.75 to 4.75). The mean of macular average thickness was 277.2±12.5 μm, and the mean of the central subfield thickness was 246.7±16.8 μm. In multivariate analysis, all macular parameters except the central subfield thickness (CST) correlated positively with the SER. Boys had significantly higher CST than girls (p=0.008). None of the macular parameters were correlated with age.ConclusionNormative data of macular thickness for healthy Jordanian children were established for sex and age groups using SD-OCT.

Evaluation of retinal nerve fiber layer thickness in children with autism spectrum disorders

BackgroundThe study compared retinal nerve fiber layer (RNFL) thickness, macular thickness, and macular volume of children with autism spectrum disorder (ASD) to those of healthy control group and correlated the RNFL thickness with symptom severity in children with ASD. MethodForty children between the ages of 7 and 12 with normal intelligence levels and who were diagnosed with ASD as per DSM-5 were included in the ASD group. The control group consisted of healthy children, who were matched with subjects in the ASD group in terms of age and gender. The Autism Behavior Checklist (ABC) and Childhood Autism Rating Scale (CARS) were used to evaluate the severity of the disease in the cases diagnosed with ASD. The RNFL, macular thickness, and macular volume of all participants were measured optical coherence tomography (OCT). ResultsThe temporal, temporal superior, nasal superior, temporal inferior, and global RNFL thicknesses were significantly lower in the ASD group than in the control group. There was no correlation between the RNFL thickness and ASD symptom severity. The macular thickness and volume were not significantly different between the groups. ConclusionOur data suggest that lower RNFL thickness may relate to atypical brain development in the ASD, and this can be measured in the retina.

Assessment of severity of Parkinson’s disease by optical coherence tomography

Background: Parkinson’s disease (PD) is the second most common movement disorder after essential tremor. Diminished visual acuity, color vision, and contrast sensitivity are also described in PD. Optical coherence tomography (OCT), a producible test for axonal degeneration, helps in prognosticating diseases such as Alzheimer’s, Parkinson’s, and multiple sclerosis. Aims and Objectives: To assess the severity of Parkinson’s disease with the changes in various variables of OCT. The objective is to evaluate variables such as (RNFL, CMT, TMV) of both eyes with SD – OCT. Materials and Methods: It is a hospital-based cross-sectional study conducted for a period of 22 months at the department of neurology. A total of 55 PD patients and 30 age- and sex-matched controls were evaluated. Results: There was a significant difference between patients and controls in average retinal nerve fiber layer (RNFL) and all RNFL quadrants in both the eyes (P&lt;0.001). A significant negative correlation was found between the RNFL thickness and Unified Parkinson’s Disease Rating Scale (UPDRS) motor score and Hoehn and Yahr (H&amp;Y) score in both the eyes (P&lt;0.001). A significant negative correlation was found between total macular volume (TMV) and central macular thickness (CMT) with UPDRS motor score in both the eyes (P&lt;0.001). A significant negative correlation was found between CMT and H&amp;Y stage in both the eyes (P&lt;0.001). There was a significant difference between patients and controls in CMT and TMV in both the eyes (P&lt;0.001). Conclusion: A significant negative correlation between severity and stage of the PD with OCT values was identified, which may suggest the possibility of dopaminergic depletion in the retina corresponding with basal ganglia dopamine depletion.

Effect of Intravitreal Ranibizumab Injection on Different Optical Coherence Tomographic Patterns of Diabetic Macular Edema

Giriş ve Amaç: Spektral-domain optik koherens tomografi (SD-OKT) ile belirlenen farklı paternlerdeki diyabetik maküla ödemi (DMÖ) olgularında intravitreal ranibizumab (İVR) enjeksiyonunun erken dönem etkinliğini karşılaştırmak.&#x0D; Gereç ve Yöntemler: Tek doz İVR uygulanmış nonproliferatif diyabetik retinopatiye sekonder DMÖ olguları retrospektif olarak analiz edildi. Klinik anlamlı santral DMÖ’sü olan ve santral fovea kalınlığı (SFK)≥250 µm olan gözler çalışmaya dahil edildi. Olgular SD-OKT morfolojisine göre; süngerimsi diffüz retina kalınlaşması (DRK), kistoid maküla ödemi (KMÖ) ve seröz retina dekolmanı (SRD) gruplarına ayrıldı. Gruplar enjeksiyon öncesi ve enjeksiyon sonrası birinci ay kontrollerinde, en iyi düzeltilmiş görme keskinliği (EİDGK), SFK ve total maküla volümü (TMV) değişimi açısından karşılaştırıldı. SFK değişimi üzerindeki başlangıç SFK değerlerinin etkisini dışlamak için ANCOVA analizi ve gruplar arasında randomizasyon yapılarak alt analizler yapıldı. &#x0D; Bulgular: Çalışmaya 101 olgu (44 DRK, 40 KMÖ ve 17 SRD) dahil edildi. Gruplar yaş ve cinsiyet dağılımı açısından benzerdi (p&gt;0,05). Başlangıç EİDGK ve TMV değerleri arasında anlamlı fark yok iken (p&gt;0,05), başlangıç SFK değerleri büyükten küçüğe doğru sırası ile SRD, KMÖ ve DRK şeklinde sıralandı (p

The STArgardt Remofuscin Treatment Trial (STARTT): design and baseline characteristics of enrolled Stargardt patients.

Background: This report describes the study design and baseline characteristics of patients with Stargardt disease (STGD1) enrolled in the STArgardt Remofuscin Treatment Trial (STARTT). Methods: In total, 87 patients with genetically confirmed STGD1 were randomized in a double-masked, placebo-controlled proof of concept trial to evaluate the safety and efficacy of 20 milligram oral remofuscin for 24 months. The primary outcome measure is change in mean quantitative autofluorescence value of an 8-segment ring centred on the fovea (qAF 8). Secondary efficacy variables are best corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), mesopic microperimetry (mMP), spectral domain optical coherence tomography (SD-OCT), reading speed on Radner reading charts, and patient-reported visual function as assessed by the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25) and Functional Reading Independence (FRI) Index. Results: Mean age of participants was 35±11 years with 49 (56%) female. Median qAF 8 value was 438 Units (range 210-729). Median BCVA and LLVA in decimal units were 0.50 (range 0.13-0.80) and 0.20 (range 0.06-0.63), respectively. The median of the mean retinal sensitivity with mMP was 20.4 dB (range 0.0-28.8). SD-OCT showed median central subfield retinal thickness of 142 µm (range 72-265) and median macular volume of 1.65 mm 3 (range 1.13-2.19). Compared to persons without vision impairment, both reading performance and patient-reported visual function were significantly lower (p<0.001, one sample t-test). Mean reading speed was 108±39 words/minute with logRAD-score of 0.45±0.28. Mean VFQ-25 composite score was 72±13. Mean FRI Index score 2.8±0.6. Conclusions: This trial design may serve as reference for future clinical trials as it explores the utility of qAF 8 as primary outcome measure. The baseline data represent the largest, multi-national, STGD1 cohort to date that underwent standardized qAF imaging, reading speed assessment and vision-related quality of life measures which all contribute to the characterization of STGD1. EudraCT registration: 2018-001496-20 (09/05/2019).

Optical coherence tomography assessment of axonal and neuronal damage of the retina in patients with familial and sporadic multiple sclerosis.

ObjectiveTo assess axonal and neuronal damage of the retina in patients with familial (fMS) and sporadic multiple sclerosis (sMS).Methods87 relapsing-remitting MS patients (45 patients with sMS, 42 patients with fMS) and 30 healthy controls were included in the study. Optical coherence tomography (OCT) was performed with the spectral domain optical coherence tomography (SD-OCT, Heidelberg Engineering, Germany). The peripapillary retinal nerve fiber layer (pRNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, total macular volume (TMV) and the inner nuclear layer (INL) thickness were measured.ResultsA significant reduction of the pRNFL thickness was detected in sMS and fMS compared to the control group (86.29 (+/- 16.13) μm in sMS, 84.78 (+/- 12.92) μm in fMS, 98.93 (+/- 6.71) μm in control group; p < 0.001). There was no significant difference in the pRNFL thickness between sMS and fMS (p = 0.5239). The GCIPL thickness was significantly decreased in sMS and fMS compared to the control group [66.0581 (+/- 11.2674) μm in sMS, 63.8386 (+/-10.004) μm in fMS, 76.5074 (+/- 5.0004) μm in control group; p < 0.001]. A significant reduction of the TMV was shown in sMS and fMS compared to the control group [8.4541(+/- 0.4727) mm3 in sMS, 8.3612 (+/- 0.4448) mm3 in fMS, 8.8387 (+/- 0.314) mm3 in control group; p < 0.0011]. No difference in the GCIPL thickness and TMV between sMS and fMS was found (p = 0.3689 and p = 0.3758, respectively). The INL thickness in sMS and fMS did not differ compared to the control group [34.2323 (+/- 2.7006) μm in sMS, 34.5159 (+/- 2.9780) μm in fMS, 33.6148 (+/- 2.0811) μm in control group; p = 0.5971 and p = 0.1870, respectively] and between the two forms (p = 0.4894).ConclusionWe confirmed the presence of axonal and neuronal damage of the retina in sMS and fMS. Both forms of MS did not differ significantly from each other with respect to RFNL, GCIPL, MV and INL. ON induced significant reduction of the pRNFL, GCIPL and MV in both groups of pwMS.

Parameters affecting the anatomical and functional success of macular hole surgery

Aim: To evaluate the effect of preoperative Spectral Domain Optical Coherence Tomography (SD-OCT) parameters on macular hole surgery (MHS) and their predictive value for postoperative best corrected visual acuity (BCVA).&#x0D; Materials and Methods: This retrospective study included 30 eyes of 30 patients with macular hole (MH). All patients underwent pars plana 23-gauge vitrectomy. A detailed macular analysis including MH minimum diameter (MD), base diameter (BD), opening diameter (OD), height, nasal arm (NA), temporal arm (TA), macular hole index (MHI), diameter hole index (DHI), tractional hole index (THI), hole form factor (HHF), macular hole area (MHA), and macular hole volume (MHV) were performed preoperatively. Presence of inner segment–outer segment (IS/OS) line, external limiting membrane (ELM), and cyst was noted postoperatively. Relationships between these parameters and postoperative BCVA were evaluated.&#x0D; Results: The study group comprised 25 (83.3%) women. Mean pre and postoperative BCVA values were 0.924±0.320 and 0.487±0.287 logMAR, respectively. BCVA improved significantly after MHS (p

Machine learning based on Optical Coherence Tomography images as a diagnostic tool for Alzheimer's disease.

We mainly evaluate retinal alterations in Alzheimer's disease (AD) patients, investigate the associations between retinal changes with AD biomarkers, and explore an optimal machine learning (ML) model for AD diagnosis based on retinal thickness. A total of 159 AD patients and 299 healthy controls were enrolled. The retinal parameters of each participant were measured using optical coherence tomography (OCT). Additionally, cognitive impairment severity, brain atrophy, and cerebrospinal fluid (CSF) biomarkers were measured in AD patients. AD patients demonstrated a significant decrease in the average, superior, and inferior quadrant peripapillary retinal nerve fiber layer, macular retinal nerve fiber layer, ganglion cell layer (GCL), inner plexiform layer (IPL) thicknesses, as well as total macular volume (TMV) (all p < 0.05). Moreover, TMV was positively associated with Mini-Mental State Examination and Montreal Cognitive Assessment scores, IPL thickness was correlated negatively with the medial temporal lobe atrophy score, and the GCL thickness was positively correlated with CSF Aβ42 /Aβ40 and negatively associated with p-tau level. Based on the significantly decreased OCT variables between both groups, the XGBoost algorithm exhibited the best diagnostic performance for AD, whose four references, including accuracy, area under the curve, f1 score, and recall, ranged from 0.69 to 0.74. Moreover, the macular retinal thickness exhibited an absolute superiority for AD diagnosis compared with other enrolled variables in all ML models. We identified the retinal alterations in AD patients and found that macular thickness and volume were associated with AD severity and biomarkers. Furthermore, we confirmed that OCT combined with ML could serve as a potential diagnostic tool for AD.

Use of retinal optical coherence tomography to differentiate suspected neuromyelitis optica spectrum disorder from multiple sclerosis: A cross-sectional study

BackgroundRetinal optical coherence tomography (OCT) can differentiate definite NMOSD (dNMOSD) from multiple sclerosis (MS), but has not been evaluated in patients with a high clinical suspicion of NMOSD and not fulfilling the current consensus diagnostic criteria, referred in this paper as “potential” NMOSD (pNMOSD). AimTo compare the retinal OCT measurements between patients with pNMOSD, dNMOSD, MS, and reference healthy controls (HC). Material and methodsIn this cross-sectional study, clinical and demographic characteristics, as well as OCT measurements of peripapillary retinal nerve fiber layer (pRNFL), inner nuclear layer (INL), macular retinal nerve fiber layer (mRNFL), outer nuclear layer (ONL) ganglion cell/inner plexiform layer (GCIPL), and macular volume (MV) were compared between groups. Mixed-effects regression models adjusting for within-patient inter-eye correlations, controlling for age, gender, disease duration and history of optic neuritis per eye were explored. Subgroup analyses were performed on eyes with previous optic neuritis. Results234 eyes (20 pNMOSD, 33 dNMOSD, 138 MS, and 43 HC) were included. Controlling for age, gender, disease duration, and history of optic neuritis per eye, pNMOSD eyes showed decreased GCIPL, pRNFL, mRNFL and MV thicknesses, similar to eyes with dNMOSD, but significantly thinner than MS and HC subjects’ eyes. Similar results were obtained for the pRNFL, mRNFL, GCIPL, INL and MV thickness in the subgroup analysis exploring only eyes with history of optic neuritis (12 pNMOSD, 15 dNMOSD, and 27 MS). ConclusionRetinal OCT measurements in patients with pNMOSD were similar to dNMOSD, but significantly lower than patients with MS and healthy controls. This suggests that retinal OCT measures could be helpful markers supportive of NMOSD diagnosis and should be explored in larger studies as a valuable addition to the current consensus diagnostic criteria.

Optical Coherence Tomography in Chronic Relapsing Inflammatory Optic Neuropathy, Neuromyelitis Optica and Multiple Sclerosis: A Comparative Study.

Purpose: To examine the optical coherence tomography (OCT) features of the retina in patients with chronic relapsing inflammatory optic neuropathy (CRION) and compare them with those of neuromyelitis optica spectrum disorder (NMOSD), relapsing-remitting multiple sclerosis (RRMS) with and without optic neuritis (ON), and healthy controls (HC). Methods: In this retrospective cross-sectional study, we used spectral domain OCT to evaluate the retinal structure of 14 participants with CRION, 22 with NMOSD, 40 with RRMS with unilateral ON, and 20 HC. The peripapillary retinal nerve fiber layer (pRNFL), total macular volume (TMV), and papillomacular bundle (PMB) were measured, and intra-retinal segmentation was performed to obtain the retinal nerve fiber (RNFL), ganglion cell (GCL), inner plexiform (IPL), inner nuclear (INL), outer plexiform (OPL) and outer nuclear (ONL) layer volumes. Results: The global pRNFL [39.33(±1.8) µm] and all its quadrants are significantly thinner in CRION compared with all other groups (p < 0.05). CRION patients have decreased volumes of TMV, RNFL, GCL, and IPL compared with all other groups (p < 0.05). Conclusion: Severe thinning in pRNFL and thinning in intra-retinal segments of IPL, GCL, RNFL, and TMV could be helpful in differentiating CRION from NMOSD and RRMS.

Clinical Characteristics and Long-term Outcomes in Diabetic Macular Edema Patients: With or without Additional Injection Following Ranibizumab Loading

PurposeTo investigate the baseline characteristics in patients with diabetic macular edema (DME) during 7 years according to the need for additional treatments after intravitreal ranibizumab (RBZ) loading injections.MethodsThe medical records of 32 patients treated with intravitreal RBZ loading for DME during 7 years were reviewed. After three-consecutive monthly RBZ injections, additional treatment was decided according to the patient’s response to RBZ loading. Based on whether the patients received treatment with or without additional injections, including intravitreal antivascular endothelial factor or steroid injection, they were divided into the “no add (NA)” or “add” groups, respectively. The baseline best-corrected visual acuity (BCVA), macular volume (MV), central subfoveal thickness, and other clinical factors were analyzed, and their 7-year changes were compared between the two groups.ResultsThe BCVA of the NA group was better than that of the add group at 2, 3, 5, and 7 years (year 2, 3, and 5; p < 0.01, respectively). Baseline MV was significantly smaller in the NA group than in the add group (10.72 ± 0.88 μm vs. 11.98 ± 1.64 μm, p = 0.008). The DME duration before treatment in the NA group was significantly shorter than in the add group (1.03 ± 0.98 years vs. 1.91 ± 1.33 years, p = 0.042). The proportion of patients with serous retinal detachment or cystic macular edema was significantly lower in the NA group than in the add group (35.3% vs. 73.3%, p = 0.042). The NA group had smaller MV until 2 years than the add group (year 1, p = 0.002; year 2, p = 0.006).ConclusionsThe DME patients without additional treatments during 7 years after the initial loading treatment had shorter duration of DME and diffuse retinal thickening morphologic type with lower MV at baseline, and better long-term visual prognosis.