Maximum Retinal Thickness Research Articles

Retinal and Choroidal Thickness Changes in Populations with Helicobacter pylori Infection by Swept-Source Optical Coherence Tomography.

Around half of the world's population is infected with Helicobacter pylori (H. pylori), which is closely related to several ocular diseases. The study aims to evaluate the retinal and choroidal thickness changes in subjects with H. pylori infection by swept-source optical coherence tomography (SS-OCT). The ophthalmic examination and 13C-urea breath test (13C-UBT) were performed on all subjects participating in the cross-sectional study. The participants were divided into H. pylori (+) and H. pylori (-) groups depending on the 13C-UBT results. This study covered 2574 right eyes from 2574 subjects with H. pylori infection and 2574 right eyes from 2574 age- and sex-matched individuals without H. pylori infection. Out of the nine sectors of the early treatment diabetic retinopathy study (ETDRS) grid, the maximum retinal thickness was in the inner superior sector, while the minimum was in the center sector. The maximum choroidal thickness was in the inner superior sector, while the minimum was in the outer nasal sector. The choroid of each area of the ETDRS subfield in the H. pylori (+) group was significantly thicker than that in the H. pylori (-) group, but retinal thickness did not show any difference between the two groups. Increased choroidal thickness may be an early indicator of H. pylori-associated retinal or choroidal diseases.

Modified pro re nata regimen of brolucizumab in treatment-naive neovascular age-related macular degeneration.

Purpose- To study the efficacy and safety of pro re nata regimen of brolucizumab, without loading dose, in treatment-naive patients with neovascular age-related macular degeneration (nAMD). Case series- Retrospective, observational study. We included all consecutive patients diagnosed with treatment- naïve nAMD undergoing Brolucizumab in Humanitas eye clinic, Turin, Italy between April 2022 and May 2023. Treatment was performed following pro re nata regimen without loading phase. Injection intervals (time between two injections), adverse events, changes in best corrected visual acuity (BCVA), central macular thickness (CMT), maximal retinal thickness (MRT), intraretinal and subretinal fluid (IRF, SRF) were evaluated descriptively up to one year after the first injection. Twenty-one eyes of 21 patients were included in the study. The mean number of injections was 2.4±0.7 at 3 month, 3.0±2.0 at 6 month, 3.1±2.4 at 9 month and 3.8±2.8 at 12 month, respectively. BCVA significantly improved from 20/80 Snellen (0.6±0.3 LogMar) to 20/50 Snellen (0.4±0.3 LogMar) at month 12 (p = 0.044). CMT and MRT significantly reduced from 426 μm and 606 μm at baseline, to 248 μm and 356 μm at one-year follow-up (p=0.00067 and p=0.02, respectively). SRF and IRF also progressively resolved. On the other hand, intraocular inflammation (IOI) events occurred in 9.5% of cases during follow-up. IOI resolved in all cases with prompt treatment without visual sequelae. Conclusions- In our study, pro re nata regimen of brolucizumab without loading phase appears to be an effective treatment option in treatment-naive nAMD patients, with IOI rate similar to the one reported in trials and lower number of injections.

Six-month results of 577 nm subthreshold micropulse laser therapy in non-center involving diabetic macular edema

BackgroundThis study aimed to evaluate the efficacy of 577 nm subthreshold micropulse laser (SML) therapy in patients with non-center involving diabetic macular edema (DME). MethodsTwenty-two eyes of 18 patients diagnosed with non-center involving DME were included in this prospective, observational study. The patient's baseline best corrected visual acuity (BCVA), maximum retinal thickness (MRT), central macular thickness (CMT), and the area of macular exudates were determined and re-evaluated at 1, 3, and 6 months after laser treatment. ResultsThere was no statistically significant change in BCVA at the 1st, 3rd and 6th months compared to the baseline in the follow-up (p = 0.067, p = 0.270, p = 0.027 according to Bonferroni correction p < 0,01). 1st, 3rd, and 6th month MRT was statistically significantly lower than baseline (p = 0,009, p = 0,006, p = 0,007). No statistically significant change was detected in CMT at the 1st, 3rd and 6th months compared to the baseline in the follow-up (p = 0.384, p = 0.794, p = 0.363). No statistically significant change in the area of macular exudates was detected at the 1st, 3rd, and 6th months compared to the baseline (p = 0.904, p = 0.444, p = 0.277). ConclusionsThis study observed a significant decrease in extrafoveal retinal thickness in patients with DME. There was no progression to central macular involvement, an increase in the area of exudates, and a decrease in BCVA in any patient. SML may be an effective alternative to conventional argon laser in non-center involving DME.

Assessment of Macular Thickness in Different Grades of Myopia: An Optical Coherence Tomography Study in a Rural Tertiary Care Hospital

Abstract Background: Myopia is a condition related to the refractive error that causes visual disability. Due to its high prevalence, it can contribute to complicated cataracts and related conditions such as primary open-angle glaucoma. The risks of retinal detachment, chorioretinal atrophy, pigmentary degeneration, vitreous degeneration and retinal breaks may increase with an increase in axial length and severity of myopia, among other long-term effects of high myopia. The aim of this study was to assess the role of macular thickness and myopia in non-invasive optical coherence tomography (OCT). Materials and Methods: This was a prospective, hospital-based observational study conducted for 18 months in a tertiary care centre in Karnataka. A total of 155 consecutive myopia patients aged ≥10 years attending the outpatient Department of Ophthalmology were included in the study. The data were analysed using the Statistical Package for Social Sciences (SPSS) for Windows, version 22.0 (SPSS Inc., Chicago). Result: The participants aged from 10 to 75 years with a female preponderance of 60%. The mean age of participants is 31.95 yrs. The majority of the patients had mild myopia (91.6%), compared with moderate (5.8%) and high (2.6%) myopia. The mean value of best-corrected visual acuity improved from 0.67 to 0.08 in high, 0.94 to 0.22 in mild and 0.71 to 0.26 in moderate myopia patients. The mean maximum retinal thickness was 472 micrometres, and the mean minimum retinal thickness was 178 micrometres. Conclusion: There is a high prevalence of mild myopia cases, especially at extremes of age. Myopia was more common among females. There was a significant difference among different classes of myopia with respect to uncorrected and best-corrected visual acuity. The parafovea was thinner and the fovea thicker among myopia.

Evaluation of the optical coherence tomography findings of patients with idiopathic epiretinal membrane.

This study aimed to determine the relationship between basal visual acuity (VA) and basal optical coherence tomography (OCT) parameters of patients with idiopathic epiretinal membrane (iERM). The study included 200 eyes of 200 patients with iERM. In the evaluation of basal VAs, logMAR 0.3 (0.5 on Snellen chart) was accepted as the limit, and the patients were divided into two groups as Group 1 with VA values below logMAR 0.3 and Group 2 with those above logMAR 0.3. Using OCT, the ellipsoid zone (EZ), interdigitation zone (IZ), external limiting membrane (ELM) integrity, peaked appearance of EZ in the fovea, disorganization of the inner retinal layers (DRIL), central foveal thickness (CFT), maximum retinal thickness (MRT), total photoreceptor length (TPL), photoreceptor outer segment length (PROSL), photoreceptor deformity index (PDI), and inner retinal layer irregularity index (IRLII) were evaluated and compared between the groups. There were an equal number of patients in Group 1 and Group 2. The preservation of ELM, EZ, and IZ integrity and the peaked appearance of EZ in the fovea were observed at higher rates in Group 1, whereas the rate of DRIL was higher in Group 2 (p<0.05 for all). In the multiple regression analysis performed to evaluate categorical OCT parameters, only the presence of DRIL was found to be significantly associated with VA (p<0.003). CFT*, MRT*, and IRLII** were significantly lower in Group 1 (*p<0.001, **p=0.001). TPU, PROSL, and FDI were similar between the two groups (p>0.05 for all). According to the multiple regression analysis, only the presence of DRIL was correlated with lower VA values. Among the OCT parameters, an increase in CFT and MRT, as well as the IRLII value moving away from 1 were related to lower VA values.

Vitrectomy with ILM peeling and subretinal injections of BSS in diabetic macular oedema in one eye vs. intravitreal anti‐VEGF injections in the second eye – A swept source OCT angiography study

AbstractPurpose: The aim of this study was to compare the results of vitrectomy performed in patients' worse eyes with diabetic macular oedema to the results of continuous anti‐VEGF treatment performed in patients' fellow eyes.Methods: A retrospective interventional study of patients with diabetic macular edema in both eyes. The better eye was always qualified for aflibercept injections (group 1), and the worse eye was scheduled for vitrectomy (group 2). The follow‐up lasted 12 months. The following parameters were measured: visual acuity (V), central retinal thickness (CRT), maximum retinal thickness (MRT), central choroidal thickness (CCT), superficial (sFAZ) and deep fovea avascular zone (dFAZ), and vessel density at the level of superficial (sVD) and deep (dVD) retinal vessels.Results: None of the analysed factors differed between groups with statistical significance at any timepoint. The time of recovery of vision was identical in both eyes (F = 0.91, p = 0.449). The final sFAZ was significantly smaller for group 2 (median 196 μm), than for group one (median 375 μm; U = 101.0; p = 0.022; r = 0.44).Conclusion: Both techniques resulted in similar improvements in visual acuity and decreases in CRT after one year. sFAZ decreased in all eyes, with a higher extent after vitrectomy.

Vitrectomy with ILM peeling in diabetic macular edema in one eye vs. intravitreal anti-VEGF injections in the second eye: a comparative study.

The aim of this study was to compare the results of vitrectomy performed in patients' worse eyes with diabetic macular edema to the results of continuous anti-VEGF treatment performed in patients' fellow eyes. A retrospective interventional study of 14 patients with diabetic macular edema in both eyes. The better eye was always qualified for aflibercept injections (group 1), and the worse eye was scheduled for vitrectomy (group 2). The follow-up lasted 12months. The following parameters were measured: visual acuity (V), central retinal thickness (CRT), maximum retinal thickness (MRT), central choroidal thickness (CCT), superficial fovea avascular zone (sFAZ) and deep fovea avascular zone (dFAZ), and vessel density at the level of superficial (sVD) and deep (dVD) retinal vessels. None of the analyzed factors differed between groups with statistical significance at any timepoint. The time of recovery of vision was identical in both eyes (F = 0.91, p = 0.449). The final sFAZ was significantly smaller for group 2 (median 196μm) than for group 1 (median 375μm; U = 101.0; p = 0.022; r = 0.44). Both techniques resulted in similar improvements in visual acuity and decreases in CRT after 1year. sFAZ decreased in all eyes, with a higher extent after vitrectomy.

A preliminary observation on rod cell photobiomodulation in treating diabetic macular edema

PurposeTo evaluate the safety and effectiveness of photobiomodulation (PBM) in the treatment of diabetic macular edema (DME). MethodsIt was a single-center, self-controlled prospective study. The clinical records of 12 diabetic retinopathy patients (5 males and 7 females, 20 eyes in total) who were treated with PBM for DME at the Second Affiliated Hospital, Zhejiang University School of Medicine, were analyzed. The mean age was 56 (26–68) years. All the participants received PBM treatment during darkness at night in no less than 5 days per week and no less than 8 ​h per day. In the baseline check and follow-up checks (1, 2, 6, 10, and 12 months after the start of treatment), the best-corrected visual acuity, the thickness of the retina in the macula, and the changes of the fundus lesions were observed. Wilcoxon signed rank test was used to compare the results before and after treatment. P ​< ​0.05 was considered statistically significant. ResultsNo fundus complication was observed during follow-up checks. In baseline and 12-month follow-up checks, the best-corrected visual acuity was 71.75 ​± ​12.47 and 79.50 ​± ​10.85, maximal retinal thickness in macular area was 390.95 ​± ​77.12 ​μm and 354.13 ​± ​55.03 ​μm, average retinal thickness in macular area was 334.25 ​± ​36.45 ​μm and 314.31 ​± ​33.28 ​μm, foveal thickness was 287.00 ​± ​46.79 ​μm and 265.63 ​± ​67.14 ​μm. The best-corrected visual acuity, average retinal thickness in macular area in consecutive follow-up results except that in the 1st month showed significant difference compared with baseline results. There were significant difference between every follow-up result and baseline result of maximal retinal thickness in macular area (P ​< ​0.05). All follow-up results of foveal thickness were not significantly different (P ​> ​0.05) from the baseline result, except that in the 6th month (P ​= ​0.049). Obvious improvement could be observed in retinal fundus fluorescein angiography images. ConclusionsPBM is a safe and effective treatment of DME, which deserves further investigation.

Elevated Intracranial Pressure in Patients with Craniosynostosis by Optical Coherence Tomography.

Craniosynostosis may lead to elevated intracranial pressure, which may be implicated with impaired neurocognitive development. However, accurately measuring intracranial pressure is challenging, and patterns in craniosynostosis patients are poorly characterized. Spectral-domain optical coherence tomography may enable noninvasive assessment of intracranial pressure in pediatric patients with craniosynostosis. Pediatric patients with craniosynostosis undergoing surgical intervention between 2014 and 2019 prospectively underwent optical coherence tomographic evaluation. Intracranial pressure was directly measured intraoperatively in a subset of cases. Optical coherence tomographic parameters were compared to directly measured intracranial pressure and used for pattern assessment. Optical coherence tomography was performed in 158 subjects, among which 42 underwent direct intracranial pressure measurement during an initial cranial procedure. Maximal retinal nerve fiber layer thickness, maximal retinal thickness, and maximal anterior projection optical coherence tomographic parameters were positively correlated with intracranial pressure (p ≤ 0.001), with all parameters showing significantly higher values in patients with intracranial pressure thresholds of 15 mmHg (p < 0.001) and 20 mmHg (p ≤ 0.007). Patients with maximal retinal nerve fiber layer thickness and maximal anterior projection exceeding set thresholds in optical coherence tomography of either eye demonstrated 77.3 percent sensitivity and 95.0 percent specificity for detecting intracranial pressure above 15 mmHg, and 90.0 percent sensitivity and 81.3 percent specificity for detecting intracranial pressure above 20 mmHg. Patients with associated syndromes or multiple suture involvement and patients aged 9 months or older were significantly more likely to have elevated intracranial pressure above 15 mmHg (p ≤ 0.030) and above 20 mmHg (p ≤ 0.035). Spectral-domain optical coherence tomography can noninvasively detect elevated intracranial pressure in patients with craniosynostosis with reliable sensitivity and specificity. This technology may help guide decisions about the appropriate type and timing of surgical treatment. Diagnostic, I.

A novel biomarker for increased intracranial pressure in idiopathic intracranial hypertension.

Changes in optic disc and peripapillary structures associated with optic nerve edema in idiopathic intracranial hypertension (IIH), can be evaluated with spectral domain optical coherence tomography (SD-OCT). We aimed to evaluate the association between increased cerebrospinal fluid (CSF) opening pressure and changes in peripapillary structures detected by SD-OCT and to determine whether these changes can be used to assess the changes in CSF pressure without performing lumbar puncture (LP). Retrospective study METHODS: We included 54 eyes of 28 patients with bilateral papilledema who had peripapillary SD-OCT imaging within 24h before the LP. Correlation between CSF pressure and peripapillary OCT parameters including maximal retinal thickness, maximal anterior retinal projection, maximal retinal nerve fiber layer (RNFL) thickness and Bruch membrane opening (BMO) was evaluated. Bruch Membrane openingand maximal RNFL thickness were significantly higher in patients with increased CSF pressure. There exist correlations between CSF pressure and BMO, maximal RNFL thickness and maximal retinal thickness. (Spearman's Rho: 0.791, 0.482 and 0.297, p < 0.001, < 0.001 and 0.029, respectively) The cut off value of BMO for the prediction of increased CSF pressure was 1785µm, with a sensitivity of 78.8% and a specificity of 81%. The cut off value for maximal RNFL thickness was 174µm, with a sensitivity of 75.8% and a specificity of 61.9%. Bruch membrane opening and maximal RNFL thickness can give an idea about increased CSF pressure values in IIH patients. Thus SD-OCT can be used to detect CSF pressure changes in these patients.

ОКТ-ДИАГНОСТИКА ОТЕКА ЗРИТЕЛЬНОГО НЕРВА В КОСМИЧЕСКОМ ПОЛЕТЕ. АНАЛИЗ ТОЛЩИНЫ ПЕРИПАПИЛЛЯРНОЙ СЕТЧАТКИ

In-flight analysis of 20 eyes (10 cosmonauts) was possible owing to the kindly granted fundus photos, multicolor images, HRA- and ОCТ-images made on optical coherent tomographs Spectralis I and II onboard the International space station (ISS). Ophtalmoscopic examinations diagnosed papilledemas graded stages II and III on the L. Frisen scale (4 eyes, 20.0 %). Mean retinal thickness and volume were determined using the Thickness Map protocols. Quantified were Bruch membrane, maximal retinal thickness in the temporal and nasal optic nerve disk (OND), and lateral papilledema sizes. The Bruch membrane was used to detect the OND center and to correct circle alignment in the sectors selected for the retinal thickness data analysis. Since papilledemas did not exceed 2.5 mm (2503 µm), mean thickness was measured in the OND center and edges along the circle of 2 mm in diameter. Conventional normal values of the mean temporal thickness within this circle and a circle of 1 mm in diameter in the OND central area vary within a wide range. Dynamic ONL observation in space missions will be credible provided a correct OND alignment with the ocular axis.

A study on laser photocoagulation in diabetic macular edema: Assessment with optical coherence tomography

Introduction: Diabetic macular edema (DME) is the most common cause of visual loss among diabetic patients. Macular photocoagulation is the established mode of treatment for clinically significant macular edema (CSME). Objective: This study was conducted to know the response of focal and diffuse diabetic edema separately to frequency doubled Nd:YAG. Materials and Methods: A prospective study with total of 30 consecutive eyes with Clinically Significant Macular Edema (CSME) over 8 months in our institution and divided into two groups with 15 each as focal and diffuse on the basis of fundus bio-microscopy and fluorescein angiography. Baseline measurements were done by OCT. Patients with diffuse diabetic macular edema underwent modified grid laser photocoagulation with Frequency Doubled Nd: YAG. Patients of focal diabetic macular edema underwent focal photocoagulation with Frequency Doubled Nd: YAG. Patients were followed up at 4 weeks and 12 weeks with repeat measurements by OCT with Humphrey Zeiss Stratus 3.0. Data entered in excel sheet and analyzed using SPSS software. The demographical data was analyzed with descriptive and the correlations by Pearson correlation. Results: Among 15 eyes with focal macular edema mean age of patients was 59.80 ± 5.13 years whereas among diffuse macular edema, it was 67.80 ± 3.76 years. In the focal group, the mean BCVA letter score did not reveal a significant change at 4 and 12 weeks compared with the baseline (p=0.52 and p=0.74, respectively). In the diffuse group, the mean BCVA letter score showed a gradual decrease at 4 weeks and increased at 12 weeks compared with the baseline however this was not statistically significant. When central foveal thickness, perifoveal thickness, maximum retinal thickness and total macular volume were compared at baseline, 4 weeks and 12 weeks after surgery, it was found that visual outcome was better after laser photocoagulation in CSME when assessed using OCT. Conclusion: Laser photocoagulation

Optical coherence tomography biomarkers for visual acuity in patients with idiopathic epiretinal membrane.

To investigate the correlation between outer and inner retina optical coherence tomography (OCT) biomarkers and visual acuity in patients with idiopathic epiretinal membrane (iERM) and identify which of them may be predictive of visual function. A retrospective cross-sectional single-center study was conducted that included patients diagnosed with iERM. Spectral domain OCT images were obtained and assessed qualitatively and quantitatively. The association of OCT parameters with best corrected visual acuity was analyzed. Charts of 97 eyes of 97 patients were reviewed. Central foveal thickness, maximal retinal thickness (MRT), photoreceptor outer segment length, outer foveal thickness, ganglion cell-inner plexiform layer complex thickening, inner retinal thickness and inner retinal layer irregularity index were among the major outcome measures. OCT scans were also assessed for the presence of cotton ball sign, ellipsoid zone disruption, ectopic inner foveal layer, disorganization of retinal inner layers (DRIL), intraretinal fluid, subretinal fluid (SRF) and epimacular membrane rip. Univariate analysis showed statistically significant association between all the aforementioned parameters with worse vision, except for cotton ball sign and SRF. Multivariate analysis found that MRT and severe DRIL were strongly correlated with worse vision (p < 0.001). MRT and severe DRIL should be considered as negative prognostic factors for visual acuity.

Angiogenin, FGF-\u03b1, and IL-36\u03b2 have higher expression levels in aqueous humor of nAMD patients in comparison to cataract patients

BackgroundNumerous cytokines have been proven to participate in the pathogenesis of neovascular age-related macular degeneration (nAMD). The present study aimed to investigate the aqueous humor cytokine expression profile in nAMD patients before and after ranibizumab treatments in comparison to cataract patients.MethodsThis prospective study included 20 treatment-naïve nAMD eyes of 20 patients who received three consecutive monthly injections of ranibizumab. Aqueous humor samples were collected before the first (baseline), second (1 month later), and third (2 months later) injections. Controls were 20 age- and gender-matched cataract patients without any other ocular disease. The aqueous concentrations of 28 cytokines were measured using a multiplex bead assay. Central macular thickness (CMT) and maximum retinal thickness (MRT)-3 mm were measured by spectral domain optical coherence tomography (SD-OCT). The greatest linear diameter (GLD) was measured by fundus fluorescein angiography (FA).ResultsThree cytokines in aqueous humor, including angiogenin, interleukin-36β (IL-36β), and fibroblast growth factor-acidic (FGF-α) were significantly higher in nAMD patients in comparison to cataract patients, both before and after two consecutive monthly ranibizumab injections. Compared with the nAMD patients’ basal levels, two consecutive monthly ranibizumab injections effectively reduced the aqueous concentrations of VEGF-A and placental growth factor (PlGF), as well as the values of CMT, MRT-3 mm, and GLD.ConclusionsAngiogenin, IL-36β, and FGF-α have higher expression levels in nAMD patients in comparison to cataract patients, both before and after 2 months of ranibizumab therapy. These cytokines may have correlations with the pathogenesis of nAMD.

Correlations between intraretinal cystoid cavities and pre- and postoperative characteristics of eyes after closure of idiopathic macular hole

Intraretinal cystoid cavities have been detected at the edges of macular holes (MHs) but their clinical characteristics and their relationship to the MH variables have not been determined. We measured the areas of the intraretinal cystoid cavity in 111 eyes with MHs in the OCT images preoperatively. Our results showed that the intraretinal cystoid cavities were located in the Henle fiber layer-outer nuclear layer (HFL-ONL) complex in 106 eyes and in the inner nuclear layer (INL) in 89 eyes. All were resolved after the initial vitrectomy to close the MH. The mean area of the cystoid cavity was greater in the HFL-ONL complex (55.9 ± 42.7 × 103 μm2) than in the INL (9.1 ± 9.8 × 103 μm2; P < 0.001). The area of the cystoid cavities was significantly correlated with the basal MH size (r = 0.465,P < 0.001), the external limiting membrane height (r = 0.793, P < 0.001), and the maximum retinal thickness (r = 0.757, P < 0.001). The area of the cystoid cavities was significantly correlated with the preoperative best-corrected visual acuity (BCVA; r = 0.361, P < 0.001), but not with the postoperative BCVA or the integrity of any of the outer retinal microstructural bands. The presence of intraretinal cystoid cavities was related to some morphological characteristics, but not to the postoperative BCVA or the restoration of the outer retinal bands.

Long-term functional outcomes after congenital cataract extraction with intraocular lens implantation in children of the first year of life

To study best corrected visual acuity (BCVA) and identify its relationship with various factors in eyes with pseudophakia in long-term periods after removal of congenital cataract (CC) in the first year of life. The study included 54 children (72 eyes) aged 4 to 12 years who had undergone CC removal with intraocular lens (IOL) implantation at the age of 2-11 months. Examination included: visual acuity testing, Flicker ERG 30 Hz electroretinography (MBN, Russia), optical coherence tomography (HRT-OCT) on the Heidelberg Spectralis (Heidelberg Engineering, Germany) platform. The best results were obtained after removal of bilateral congenital cataract (BCC): BCVA in 58.0% of cases was 0.15-0.3, and in 12.0% of cases - 0.4-0.8. BCVA was 0.1 or less in 95.5% of cases and only one child had 0.2 after removal of unilateral congenital cataract (UCC). The best BCVA was achieved in children operated on the 2-5 month of age (BCVA more than 0.3 in 68.7%; only children from that group had 0.5-0.8), without any concomitant pathology and with normal indicators of ERG Flicker 30 Hz. Deviations from physiological formation of the macula were revealed using OCT. The direct relationship was shown between BCVA, and the maximal retinal thickness in parafovea and choroidal thickness in the subfoveal area. BCVA significantly varies after CC removal with IOL implantation in infancy: 0.02-0.8. The main factors influencing BCVA in that case are: laterality of cataract, child age at the time of operation, duration of visual deprivation, concomitant eye pathology and refractive amblyopia accompanying incomplete correction of aphakia.

Optical coherence tomogrpaphy in differential diagnosis of retinal arteriolar macroaneurysms

Aim. To study the prevalence and topographical distribution of retinal exudation in eyes with retinal arteriolar macroaneurysms (RAM) and in those with macular branch retinal vein occlusions (mBRVO).&#x0D; Methods. The prevalence of optical coherence tomography (OCT) signs (different types of retinal hemorrhages and accumulation of fluid as well as hard and soft exudates) was evaluated in 28 eyes with RAM (22 males, 6 females, mean age 66.0 9.9 years) versus 17 eyes with mBRVO (9 males, 7 females, mean age 56.9 10.5 years). Topographical distribution of retinal exudation on OCT retinal maps was evaluated in 7 RAM eyes (6 males, 1 female, mean age 66.0 11.7 years) and 8 mBRVO eyes (5 males, 3 females, mean age 60.1 19.2 years). The measures were 1) position of the point of the maximum retinal thickness in relation to the macular center and RAM, 2) difference between maximum retinal thickness in the macular center and that at the site of RAM localization (surrogate control point in mBRVO eyes).&#x0D; Results. Soft exudates and intraretinal fluid accumulation were mostly associated with mBRVO (p = 0.007 and p 0.001, respectively), while hard exudates were found almost exclusively in RAM eyes (p 0.001). Central retinal thickness in RAM eyes was lower than that of mBRVO eyes, 453.1 148.6 m and 797.5 179.6 m, respectively (p = 0.001). The point of maximum retinal thickness was found at the site of RAM localization in 8 out of 9 RAM cases (88.9%), and within the central subfield in 8 out of 8 mBRVO cases (100%). The difference between maximum retinal thickness in the macular center and at the site of RAM localization (surrogate control point in mBRVO eyes) was 77.9 174.1 m and 148.3 100.4 m for RAM and mBRVO eyes, respectively (p 0.001).&#x0D; Conclusions. Evaluation of exudative signs and their topographic distribution based on OCT data may be used for differential diagnosis and laser treatment planning in RAM.

Short-term Efficacy of Micropulse Yellow Laser in Non-center-involving Diabetic Macular Edema: Preliminary Results.

Objectives:The aim of this study was to evaluate the efficacy of micropulse yellow laser (MPL) on best corrected visual acuity (BCVA) and retinal thickness in patients with non-center-involving diabetic macular edema (DME).Materials and Methods:We retrospectively reviewed 9 eyes of 8 patients with non-center-involving DME who underwent MPL treatment between January 2015 and December 2016. BCVA (logMAR) and retinal thickness were evaluated before and 3 months after treatment. Maximum retinal thickness was determined manually from simultaneous spectral-domain optical coherence tomography images and recorded. The change in the measurements from before to after treatment was analyzed statistically.Results:Of the 8 patients, 3 were female and 5 were male. The mean age was 52.8 years. Two of the 9 eyes had received previous intravitreal anti-vascular endothelial growth factor injection(s). Median BCVA was improved 3 months after treatment, although the difference was not statistically significant (0.34 logMAR before and 0.29 logMAR after treatment). BCVA was improved in 4 eyes while it showed no change in the remaining 5 eyes. The mean retinal thickness was 470.6 μm at baseline and 416 μm at 3 months after MPL treatment (p=0.01). Retinal thickness decreased in all eyes after treatment.Conclusion:In this study, parafoveal retinal thickness showed significant decrease after MPL treatment in patients with DME. The limited increase in BCVA may be due to the inclusion of a low number of patients and only those with non-center-involving macular edema. MPL may be used as an alternative to conventional argon laser in non-center-involving DME.

Disorganization of Retinal Inner Layers as a Biomarker for Idiopathic Epiretinal Membrane After Macular Surgery—The DREAM Study

Epiretinal membrane (ERM) can cause distortion and disorganization of all inner retinal layers. The purpose of our study was to evaluate the extent of disorganization of the retinal inner layers (DRIL) and to investigate its predictive value for visual outcome in cases of idiopathic ERM that were treated by pars plana vitrectomy (PPV) and ERM peeling. Multicenter international retrospective case series. In 90 eyes from 90 patients with idiopathic ERM treated by PPV and membrane peeling with 12-month follow-up, optical coherence tomography (OCT) scans previous to surgery were evaluated for presence and severity of DRIL, central foveal subfield thickness (CST), maximal retinal thickness (MRT), presence of intraretinal cystoid changes and subretinal fluid, and integrity of the inner/outer segment layer and of the interdigitation zone. Best-corrected visual acuity (BCVA), CST, and MRT were recorded at baseline and at 3, 6, and 12months after surgery. Correlations between baseline OCT measures (DRIL) and functional and visual outcome were analyzed. Main outcome measures are presence and severity of DRIL at baseline; anatomic and functional outcomes after 3, 6, and 12months; and the correlation between DRIL and baseline characteristics and outcome measures. Patients without and with mild DRIL had a significantly better baseline BCVA compared with patients with severe DRIL (0.61 ± 0.13, 0.56 ± 0.23, 0.73 ± 0.20 [logMAR], respectively). BCVA, CST, and MRT at baseline were statistically significantly correlated with DRIL severity (P= .003, P < .001, and P < .001, respectively). DRIL status before surgery showed a statistically significant interaction with change in BCVA, CST, and MRT over 12months (P < .001 for all). Patients without and with mild DRIL gained a mean of 3 lines of vision after 12months, in contrast to 1 line in patients with severe DRIL. DRIL grading correlates with functional and anatomic measures in patients with idiopathic ERM and could serve as a biomarker to predict outcome after surgery. Patients with severe DRIL have limited benefits from surgery. This should be considered in the decision process whether to perform ERM peeling in this patient group.

The outcomes of aflibercept therapy in patients with age-related macular degeneration resistant to bevacizumab or ranibizumab

PurposeThis study was designed to assess the functional and anatomic outcomes of intravitreal aflibercept injection in patients with wet age-related macular degeneration (AMD) refractory to intravitreal bevacizumab or ranibizumab therapy. MethodsThis retrospective study included 43 eyes of 43 patients resistant to treatment with at least 6 injections of bevacizumab or ranibizumab. Persistent intraretinal and subretinal fluid (IRF and SRF) on optical coherence tomography (OCT), no improvement in best corrected visual acuity (BCVA), and a central macular thickness (CMT) increase of more than 100 μm due to SRF and/or IRF compared to baseline for at least 6 monthly intravitreal bevacizumab or ranibizumab injections were defined as resistant to bevacizumab/ranibizumab therapy. BCVA, intraocular pressure (IOP), CMT, maximum retinal thickness (MRT), and maximum pigment epithelial detachment (PED) height (MPEDH) were evaluated before and after aflibercept injections. ResultAfter initiating aflibercept treatment, the mean final BCVA logarithm of the minimum angle of resolution or recognition (logMAR) improved to 0.84 ± 0.59 which was statistically significant compared to baseline (1.14 ± 0.51), (P < 0.001). After aflibercept injection, statistically significant reduction was noted in mean CMT (402.6 ± 196.7 μm vs 264.2 ± 52.85 μm, P < 0.05), MRT (435.3 ± 195.2 μm vs 282.2 ± 31.8 μm, P < 0.05), and MPEDH (154.2 ± 86.0 μm vs 68.3 ± 70.6 μm, P < 0.05). There was no correlation between the total number of previous injections and the increase of BCVA (r = −0.10, P = 0.265). The decrease of mean IOP was statistically significant under aflibercept treatment (P < 0.001). ConclusionsThe present study showed the efficacy of aflibercept treatment in eyes with persistent retinal or SRF under bevacizumab or ranibizumab therapy. A significant anatomical and functional improvement was noted.