Mean Central Foveal Thickness Research Articles

Optimal fluence rate of photodynamic therapy for chronic central serous chorioretinopathy

AimsTo investigate the lowest effective fluence rate of photodynamic therapy (PDT) for treating chronic central serous chorioretinopathy (CSC).MethodsFifty-one eyes of 51 patients with chronic CSC were randomly treated with 30%...

Effect of cataract surgery on macular thickness in diabetic patients

Purpose: To study the effect of cataract surgery on macular thickness in diabetic patients. Materials and Method: This prospective comparative study enrolled 100 diabetics and 100 non-diabetics undergoing cataract surgery fulfilling inclusion criteria. Complete ocular examination was done for both the groups preoperatively and postoperatively at 1 week, 1month and 3 months including central macular thickness evaluation using optical coherence tomography. Result: Significant increase in mean central foveal thickness in diabetics and in non-diabetics post 1 month (P

One-year real-life results on effect of intravitreal aflibercept in patients with diabetic macular oedema switched from ranibizumab.

To assess visual and optical coherence tomography-derived anatomical outcomes of treatment with intravitreal aflibercept (Eylea®) for diabetic macular oedema in patients switched from intravitreal ranibizumab (Lucentis®). Retrospective, cohort study. Ninety eyes (of 67 patients) receiving intravitreal anti-vascular endothelial growth factor therapy were included. This is a retrospective, real-life, cohort study. Each patient had visual acuity measurements and optical coherence tomography scans performed at baseline and 12 months after the first injection of aflibercept was given. We measured visual acuities in Early Treatment Diabetic Retinopathy Study letters, central foveal thickness and macular volume at baseline and at 12 months after the first aflibercept injection was given. Ninety switched eyes were included in this study. The mean (standard deviation) visual acuity was 63 (15.78) Early Treatment Diabetic Retinopathy Study letters. At baseline, the mean (standard deviation) central foveal thickness was 417.7 (158.4) μm and the mean macular volume was 9.96 (2.44) mm3. Mean change in visual acuity was +4 Early Treatment Diabetic Retinopathy Study letters (p = 0.0053). The mean change in macular volume was -1.53 mm3 in SW group (p = 0.21), while the change in central foveal thickness was -136.8 μm (p = 0.69). There was a significant improvement in visual acuity and in anatomical outcomes in the switched group at 12 months after commencing treatment with aflibercept for diabetic macular oedema.

Intravitreal aflibercept for diabetic macular oedema in real-world: 36-month visual acuity and anatomical outcomes.

To assess structural and functional outcomes of treatment with intravitreal aflibercept (®Eylea) for diabetic macular oedema in treatment-naïve patients. Sixty-four eyes receiving intravitreal anti-vascular endothelial growth factor therapy were included in the data analysis of this retrospective, real-life study which follow-up was 3 years. Each patient had corrected visual acuity in Early Treatment Diabetic Retinopathy Study letters and optical coherence tomography central foveal thickness and macular volume performed at baseline, 12, 24 and 36 months. Patients were initiated on a loading phase of five 1-monthly intravitreal aflibercept injections, followed by injections if needed as per clinicians' discretion. The mean number of aflibercept injections received over 3 years was 12.59. At baseline, the mean visual acuity (standard deviation) (Snellen) was 61.45 (16.30) (20/63) Early Treatment Diabetic Retinopathy Study letters, the mean central foveal thickness (standard deviation) was 422 (138) µm, while the mean macular volume (standard deviation) was 9.51 (2.01) mm3. At 36 months, the mean visual acuity (standard deviation) (Snellen) was 68.34 (13.66) (20/50) Early Treatment Diabetic Retinopathy Study letters (p = .0003). Mean central foveal thickness (standard deviation) was 303 (106) µm (p < .0001) and mean macular volume (standard deviation) was 8.35 (1.62) mm3 (p = .0022) at 36 months. Sixteen (25%) eyes gained ≥15 ETDRS letters at month 36, and 33 (52%) eyes had a decrease in central foveal thickness of ≥ 100 µm at the same time. There was a significant improvement in visual acuity and in anatomical outcomes in aflibercept-treated eyes at 36 months after commencing treatment for diabetic macular oedema in real-life settings. The good vision and anatomical outcomes were maintained over second and third year of treatment with mean 2.93 and 2.57 intravitreal injections, respectively.

Foveal thickness, foveal microvasculature, and refractive error in children with asymmetric involvement of retinopathy of prematurity.

To evaluate foveal thickness, foveal microvasculature, and refractive error in children with asymmetric involvement of retinopathy of prematurity who had laser treatment in one eye and spontaneously regressed retinopathy of prematurity in the fellow eye. Totally, 17 children (34 eyes) with a history of asymmetric course of acute Zone II retinopathy of prematurity were assessed. Data on best-corrected visual acuity, refractive status, axial length, anterior chamber depth, and optical coherence tomography angiography findings were analyzed between treated and non-treated fellow eyes. Treated eyes were more myopic than non-treated eyes (mean, -0.09 ± 1.86 diopters vs mean, 0.07 ± 0.98 diopters, p = 0.026). Compared to non-treated eyes, treated eyes had shallower anterior chamber depth (mean, 3.27 ± 0.24mm vs mean, 3.55 ± 0.19mm, p = 0.02). No significant difference was observed regarding optical coherence tomography angiography parameters between two eyes of the children. The mean central foveal thickness was found to be higher in treated eyes than in non-treated eyes (297.46 ± 22.03 vs 275.55 ± 18.45, p = 0.009). Higher number of laser spots were associated with decreased parafoveal superficial capillary plexus vessel density (r = -0.56, p = 0.02) and increased central foveal thickness (r = 0.62, p = 0.008). Our results revealed no difference in optical coherence tomography angiography parameters between laser-treated and non-treated eyes in children with asymmetric involvement of Zone II retinopathy of prematurity except for a higher central foveal thickness in laser-treated eyes. Treated eyes were more myopic than the non-treated eyes. Number of laser applications during treatment had an impact on parafoveal superficial capillary plexus vessel density.

Evaluation of macula in high myopic fundus using optical coherence tomography

: High myopia is a risk factor for a number of retinal pathologies. OCT is very useful in eyes with high myopia and allows the detection of subtle macular changes that are otherwise undetectable.To evaluate relationship between the axial length, refractive error and macular thickness in subjects with high myopia.Cross sectional observational single centric study. 50 diagnosed patients of high myopia(refractive error&amp;#62;= -6 dioptres and/or axial length&amp;#62;=24 mm) along with a control of 50 emmetropic patients were included. Patient’s anterior segment evaluation was done by slit lamp. Detailed fundus evaluation was done with indirect ophthalmoscopy and with +78 Dioptre lens along with measuring BCVA (Best corrected Visual Acuity). Axial length was measured using contact biometry. OCT was performed with TOPCON SD-OCT. Average macular thickness, central foveal thickness and total macular volume measured using 3D macula scan of all the cases and controls. Unpaired t test.The mean axial length was 27.40 mm among cases (SD±0.99) and 22.84 mm among controls (SD±0.422). The mean macular volume in cases was 6.90 and in controls was 7.82. The macular volume decreased with increasing axial length (ρ=-0.673) and increasing spherical equivalent (ρ=-0.035). The average macular thickness was inversely correlated with axial length (ρ=-0.605) and directly correlated with spherical equivalent (ρ=-0.049).The mean central subfield foveal thickness was 170.10 µm amongcases and 158.34µm among controls. The axial length and central foveal thickness were found to be positively correlated (ρ=0.727).Average macular thickness and total macular volume are inversely correlated to the degree of myopia, whereas central foveal thickness is positively correlated to the degree of myopia.

Retinal thickness among normal myopic Filipinos using spectral domain optical coherence tomography

Purpose: To determine mean macular and retinal nerve fiber layer (RNFL) thickness of myopic Filipinos using spectral domain optical coherence tomography (SD-OCT) and to evaluate influence of age, gender, and degree of myopia.&#x0D; Design: Observational clinic-based cohort.&#x0D; Methods: Participants were divided into two groups: low-moderate myopia [spherical equivalent (SE) -0.50 D to -6.00 D] and high-pathologic myopia (SE &lt; -6.00 D and AL &gt; 26.5 mm). Subgroup analyses between low myopia (refraction &lt; -3.00 D or less) and moderate myopia (&gt; -3.00 D to -6.00 D), and high myopia (&gt; -6.00 D to -8.00 D) and pathologic myopia (more than -8.00 D) were done. Macular and RNFL thickness were measured by a SD-OCT and axial length (AL) with non-contact biometry.&#x0D; Results: Of 156 eyes, 88/156 (56%) had low-moderate myopia, 68/156 (44%) had high-pathologic myopia. There were 67/156 (43%) male and 89/156 (57%) female subjects. Mean central foveal subfield thickness measurements were 264 ± 24 μm for low myopia, 258 ± 17 μm for moderate myopia, 253 ± 25 μm for high myopia, and 218 ± 48 μm for pathologic myopia. Mean RNFL thickness measurements were 105.62 ± 3.89 μmfor low myopia, 97.6 ± 2.45 μm for moderate myopia, 85.9 ± 3.87 μm for high myopia, and 75.14 ± 3.89 μm for pathologic myopia. Average SE (p &lt; 0.0001) decreased while AL (p &lt; 0.0001) increased with more myopia. Myopia and age significantly affected macular and RNFL thickness parameters except for the following where only the degree of myopia was a significant factor: central foveal, temporal parafoveal, nasal perifoveal, inferior and nasal RNFL thicknesses.&#x0D; Conclusion: Retinal SD-OCT thickness measurements decreased with increasing level of myopia and age. Central foveal, temporal parafoveal, nasal perifoveal, inferior and nasal RNFL thicknesses may be more appropriate SD-OCT parameters among myopic Filipino patients to monitor for glaucoma since they may be less influenced by age.

Retinal thickness fluctuations in patients receiving fluocinolone acetonide implant for diabetic macular edema

Objectives To evaluate central foveal thickness (CFT) variability and accompanying changes in visual acuity (VA) 12 months before and after treatment with the 190 mcg fluocinolone acetonide (FAc) intravitreal implant for diabetic macular edema (DME). Methods The Iluvien Clinical Evidence cohort study in the United Kingdom (ICE-UK) investigated the effectiveness of the FAc implant in people treated at 13 hospitals from April 2013 to April 2015. The following parameters were calculated for CFT for each patient: mean, standard deviation (SD), retinal thickness amplitude (RTA, the difference between maximum and minimum values), and coefficient of variation (CV). Results In 149 eyes with ≥2 CFT observations both before and after FAc implantation, the median VA was 50 ETDRS letters at implantation. Mean CFT was 487 µm at implantation and 135 µm at 12 months post-implant. Before implantation, the mean CV and mean SD for CFT were 24.6% and 112 µm, respectively; the mean RTA was 254 µm. A statistically significant (p < .001) decrease in all three parameters was observed after implantation (18.3%, 68.2 μm and 146 μm, respectively). There was an association between CFT change between extremes and the corresponding change in VA (Pearson’s correlation coefficient, r = −0.292, p < .001, prior to the implant; r = −0.379, p < .001, post-implant). Conclusions After accounting for the reduction in CFT, retinal thickness stabilized following FAc implantation. There might be VA benefits in reducing variability in CFT over time. This merits further exploration but would require more frequent CFT observations in order to properly determine patterns of retinal thickness variability.

Bare retinal nerve fiber layer and internal limiting membrane tear associated with epiretinal membrane: OCT findings and visual outcomes.

This study aims to describe spectral-domain optical coherence tomography (OCT) characteristics and assess surgical outcomes for bare retinal nerve fiber layer (RNFL) and internal limiting membrane (ILM) tear associated with the epiretinal membrane (ERM). This retrospective study comprised 158 consecutive patients with idiopathic ERM with (group A) or without (group B) bare RNFL (19 and 139 patients, respectively) who underwent vitrectomy between March 2016 and May 2019. Surgical videos and pre- and postoperative OCT images were reviewed to characterize bare RNFL and ILM tear and analyze postoperative visual outcomes. Typically, the torn ILM is seen as a mono- or multi-layered thin scrolled membrane in OCT, correlated frequently with areas of RNFL schisis. On the near-infrared fundus images, a hypo-reflective band corresponding to rolled-up edge of torn ILM and ERM was identified. The bare RNFL area was located adjacent to and peripheral to this band and showed a less-wrinkled retina preoperatively. Mean logMAR BCVA and central foveal thickness (CFT) progressively improved in both groups. However, group A had greater mean CFT change than group B (P = 0.001). Typical appearances of bare RNFL and ILM tear associated with ERM were identified. Thorough evaluation of preoperative OCT is important for vitreoretinal surgeons to recognize bare RNFL and ILM tear to minimize surgical trauma.

A randomized clinical trial comparing prompt photodynamic therapy with 3 months observation in patients with acute central serous chorioretinopathy with central macular leakage.

The purpose of the study was to demonstrate whether photodynamic therapy in patients with acute central serous chorioretinopathy, with the leakage point within one optic disk diameter from the fovea, can be safely deferred. A single-center, randomized, controlled trial was conducted. Patients were randomized to photodynamic therapy within a week after presentation (Group I, 26 patients) or observation during 3 months (Group II, 26 patients). If leakage or subretinal fluid was observed during any control visit, photodynamic therapy was performed (again) within a week. Primary outcome was change of visual acuity (Early Treatment Diabetic Retinopathy Study) after 12 months. Secondary outcomes were visual acuity, central foveal thickness, metamorphopsia, and color discrimination. Photodynamic therapy procedures: group I, 26 at baseline, 2 retreatments at 3 months; group II, 10 at 3 months, 1 at 6 months (2 subjects refusing treatment), 2 retreatments at 6 months. At 12 months, mean visual acuity of all patients had improved by 6.5 letters (P < 0.001), mean central foveal thickness was 172 µm less (P < 0.001). After photodynamic therapy, visual acuity recovered faster and metamorphopsia significantly improved (3 months, P < 0.001). Differences between groups at 12 months were not significant. The (intended) number of photodynamic therapy (re)treatments in group II (n = 15) was 46% less than in group I (n = 28). Visual acuity and central foveal thickness at 12 months were similar. Therefore, the preferred management of acute central serous chorioretinopathy at presentation appears to be observation for 3 months.

One-year outcome of combination therapy with intravitreal anti-vascular endothelial growth factor and photodynamic therapy in patients with pachychoroid neovasculopathy.

To identify the functional outcome and evaluate the morphologic changes of patients with pachychoroid neovasculopathy (PNV) undergoing intravitreal anti-vascular endothelial growth factor (VEGF) combined with photodynamic therapy (PDT) at the 1-year follow-up. We retrospectively studied all the treatment-naïve PNV patients who were scheduled to undergo combination therapy between September 2017 and November 2018. All the patients received three consecutive monthly injections of 0.5mg/0.05mL ranibizumab as loading doses. Full-dose PDT was performed within 1week of the first injection. Retreatment was allowed if evidence of clinical deterioration or the presence of fluid on spectral-domain optical coherence tomography examination performed at the 1-month follow-up was noted. The best-corrected visual acuity (BCVA) was compared before treatment and at 3, 6, and 12months after the initial treatment. Changes in the central foveal thickness (CFT), central choroidal thickness (CCT), and retreatment rate during the maintenance phase were also evaluated. Eleven eyes were enrolled in this study. Significantly, better BCVA was observed at 12months than at baseline (P = 0.010). The mean CFT significantly decreased from 331 ± 93 to 237 ± 72μm at 12months (P < 0.001). The mean CCT also significantly decreased from 361 ± 74 to 310 ± 83μm at 12months (P < 0.001). The mean number of injections per eye was 3.9 ± 1.3 during the follow-up period. A total of 45.5% (5 /11) of the patients required retreatment during the maintenance phase. Anti-VEGF combined with full-dose PDT was well tolerated and appeared to be effective treatment for patients with treatment-naïve PNV. Combination therapy might also reduce the treatment burden with fewer injections in patients with PNV.

Eye of Stranger: Evaluate of Chorioretinal Microvascular Networks on Ventricular Assist Device

To evaluate microvascular architecture of eyes in cases with continuous-flow (CF) left ventricular assist device (LVAD) to find out the possible effects of LVADs over blood supply of end organs. For each study eye, high resolution scans of chorioretinal microvascular networks were captured via optical coherence tomography angiography (OCTA); which is a novel noninvasive, dye free, three dimensional angiography technique using the movement of red blood cells within chorioretinal capillaries against static ocular tissue as an intrinsic contrast to generate flow imaging. Eyes with any ocular diseases and those depicted low quality OCTA images according to optic media opacities were excluded. Study group included the eyes of LVAD cases with a minimum two years of follow-up. Demographics and OCTA findings were recorded and statistically analyzed to find out possible alterations of retinal and choroidal blood supply between LVAD cases and the controls. Comparison of OCTA findings between patients with LVAD implantation by thoracotomy with anastomosis of the outflow graft to the descending aorta (DA group) and those with the standard approach (AA group) was the secondary end point. Twenty three eyes of 13 LVAD implanted cases and 21 eyes of 12 healthy controls were included. There was no statistical difference in age and gender distribution between two groups (p=0.945 and p=0.601, respectively). Mean central foveal thickness (CFT) and choroidal thickness (CT) were 228.0±17.0 µm and 314.5±50.8 µm in study group; whereas they were 223.0±13.0 µm and 256.1±36.1 µm in the controls (p=0.287 and p<0.001, respectively). No statistical significance was found in total and four quadrant OCTA findings of superficial and deep retinal capillary plexuses as well as choriocapillaris between two groups (p>0.05 for all). Among cases with LVAD implantation, any statistically significant difference was also not found in OCTA scores between DA and AA subgroups which comprised of 6 and 17 eyes, respectively. Increased CT was found in patients underwent CF LVADs possibly due to raised capillary pressure in such cases. Except for CT measurements, similar scores of studied OCTA parameters between LVAD cases and the controls revealed that CF LVADs have not any negative impact over end organ blood supply in late term without any respect to being in either DA or AA subgroup.

Glucose Metabolic Characterization of Human Aqueous Humor in Relation to Wet Age-Related Macular Degeneration.

PurposeEnergy compromise underpins wet age-related macular degeneration (wAMD) pathogenesis, but the relationship between glucose metabolism and the disease remains unclear. Here, we characterized aqueous humor (AH) to elucidate glucose-related metabolic signatures in patients with wAMD.MethodsIn total, 25 eyes of 25 patients with wAMD were divided into phakic (15 eyes), pseudophakic (10 eyes), and intravitreal injections of ranibizumab (13 eyes) wAMD groups. Twenty patients with cataract (21 eyes) served as controls. Ultrahigh-performance liquid chromatography tandem mass spectrometry was used to quantitatively characterize AH.ResultsTwenty-one metabolites related to glucose metabolism were identified in AH from 45 patients. Tricarboxylic acid (TCA)-related metabolic substrates, including citrate, were detected in AH and were significantly increased in AMD (P < 0.01) and AMD pseudophakic groups (P < 0.05). In contrast, α-ketoglutarate levels were decreased in the AMD group (P < 0.05). The α-ketoglutarate/citrate ratio was significantly decreased, corresponding to 71.71% and 93.6% decreases in the AMD (phakic and pseudophakic) groups as compared with controls (P < 0.001), revealing a significant positive correlation with glutamine. A lower mean glutamine and higher glutamate level were detected in AMD cases compared with controls. No significant differences were observed for lactic acid or other Krebs cycle metabolites. Intravitreal injection significantly alleviated mean central foveal thickness but did not significantly alter metabolites.ConclusionsCompromised glucose TCA cycle and altered glutamine metabolism are implicated in the AH metabolism in wAMD. These findings highlight potential treatments for alleviating wAMD from a metabolic perspective.

The efficacy of selective retina therapy for diabetic macular edema based on pretreatment central foveal thickness.

To evaluate the efficacy of selective retina therapy (SRT) in patients with diabetic macular edema (DME) based on pretreatment central foveal thickness (CFT). Seventy-two eyes of 63 patients with DME who had previously undergone SRT were included. Patients were divided into two groups based on the CFT at baseline. Group 1 was composed of 35 eyes with CFT < 400μm and group 2 was composed of 37 eyes with CFT ≥ 400μm. Changes in best corrected visual acuity (BCVA) and CFT were measured at baseline, 3 and 6months after SRT. A single-session retreatment was performed at 3-month posttreatment if there was no reduction in CFT. Rescue treatment with intravitreal anti-VEGF injections was performed if persistent DME or vision loss of 1 ≥ logMAR VA line was observed by 6months after initial SRT. Six months after SRT, group 1 showed reduction of 45.9μm in mean CFT (P < 0.001) and gain of 0.13 logMAR in mean BCVA (P < 0.001), whereas group 2 experienced no significant change in CFT or BCVA. In group 1, retreatments were performed in 6 eyes (17.1%), and rescue treatment was performed in 1 eye (2.9%), whereas in group 2, retreatment was performed in 17 eyes (45.9%), and rescue treatments were administered in 27 eyes (73%) during a 6-month follow-up. Although SRT had limited effects as a treatment for severe DME, SRT monotherapy for mild DME was effective in improving BCVA and reducing CFT during a 6-month follow-up period.

Comparison of various surgical techniques for optic disc pit maculopathy: vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap ‘plug’ versus autologous scleral ‘plug’

AimTo compare the anatomical and visual outcomes of vitrectomy with internal limiting membrane (ILM) peeling alone versus inverted ILM flap to plug the pit versus autologous scleral plug for the...

Quantification of Diabetic Retinopathy Lesions in DME Patients With Intravitreal Conbercept Treatment Using Deep Learning.

To quantitatively evaluate diabetic retinopathy (DR) lesions using the authors' validated machine learning algorithms and provide physicians with an automated and precise method to follow the progression of DR and outcome of interventions. Retrospective analyses were conducted of 3,496 color fundus photography images from 19 patients with clinically significant diabetic macular edema receiving conbercept treatment. The modified seven-field fundus images were obtained at baseline and at the third, sixth, and twelfth month visit, whereas the modified two-field fundus images were obtained at the other monthly visits. The area of intraretinal hemorrhage and hard exudate lesions was traced by the authors' validated algorithms. The mean central foveal thickness at baseline was 459.9 μm ± 127.5 μm. Mean central foveal thickness was 316.5 μm ± 53.0 μm at the twelfth month visit, which decreased by 143.4 μm when compared with the baseline optical coherence tomography. The mean total area of intraretinal hemorrhage in the study eye in seven fields was 5.656 ± 1.176 mm2 at baseline, 2.438 ± 0.976 mm2 at the third month, 2.901 ± 0.521 mm2 at the sixth month, and 2.122 ± 0.582 mm2 at the end of the study. The area of intraretinal hemorrhage was reduced by 62.49% from baseline to the end of study (P < .0001). The mean total area of hard exudates in the study eye was 2.549 ± 0.776 mm2 at baseline, 2.233 ± 0.576 mm2 at the third month, 2.710 ± 0.621 mm2 at the sixth month, and 1.473 ± 0.564 mm2 at the end of the study. The mean total area of hard exudates decreased by 41.1% at the twelfth month (P < .0001) compared with the first visit. Significant decrease was observed in the area of intraretinal hemorrhage during conbercept treatment. The hard exudates area fluctuated during loading then subsequently decreased at the twelfth month. The present study quantitatively analyzed the change in the area change of intraretinal hemorrhage and hard exudate lesions during the course of conbercept treatment. The automated system is promising to be a precise and objective method for monitoring the progression of DR and outcomes of interventions in clinical settings. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:95-100.].

Multifocal electroretinography in patients with macular telangiectasia type 2.

To evaluate the multifocal electroretinographic (mfERG) response in patients with macular telangiectasia (MacTel) type 2. Prospective, observational case series. Thirty-four eyes of 18 patients diagnosed with nonproliferative MacTel type 2 underwent recording of best-corrected visual acuity (BCVA), fundus fluorescein angiography, spectral domain optical coherence tomography (SD-OCT) and mfERG using 61 hexagonal elements, in accordance with ISCEV guidelines. The P1 average response densities and implicit times of the first-order kernel responses were grouped into five concentric rings centred on the fovea. Data from the left eyes of cases (18 eyes) were compared with 34 eyes of age- and sex-matched controls. Correlation analyses were performed between BCVA, mfERG parameters and SD-OCT measurements. Mean BCVA of the cases was 0.3 ± 0.26 ranging from 0 to 1. On SD-OCT, mean central foveal thickness was 205.78 ± 40.92μm and average mean macular thickness was 248.22 ± 23.08μm. Mean P1 amplitudes were significantly decreased in eyes with MacTel type 2 as compared to controls in ring 1 (p = 0.039). Mean P1 implicit time in all the rings was comparable between the two groups. BCVA was significantly and negatively correlated with P1 amplitude in ring 1 (r = - 0.518, p = 0.028) in eyes with MacTel type 2. mfERG reflects localised inner retinal dysfunction in MacTel type 2. Correlation with BCVA reinforces that mfERG should be used to objectively assess the macular function in these patients.

Effectiveness and Safety of Intravitreal Injection of Conbercept as an Initial Treatment for Exudative Circumscribed Choroidal Hemangioma

Objective: To investigate the effectiveness and safety of intravitreal injection of conbercept (IVC) as the initial treatment for exudative circumscribed choroidal hemangioma (CCH). Methods: Forty-two eyes of 42 patients received 3 monthly IVC (0.5 mg/0.05 mL) as the initial treatment. Three months later, the patients were assessed for further treatment including observation, reinjection of conbercept, laser photocoagulation (if the lesion was 3,000 μm away from the macular fovea), or photodynamic therapy (PDT; if the lesion was under the macular fovea). Anatomical and functional responses including best corrected visual acuity (BCVA), central foveal thickness (CFT), and tumor size were analyzed. Results: Twenty-three patients (54.76%) were sensitive to the monotherapy of IVC. Fourteen patients (33.33%) were insensitive to IVC and underwent rescue laser photocoagulation, and 5 patients (11.90%) underwent rescue PDT due to insensitivity to IVC treatment at 3 months. For subgroup analysis, although no statistical difference was found for BCVA at any follow-up time point compared to baseline, an increasing tendency of BCVA was found in the IVC group (p> 0.05). The mean CFT decreased significantly from 427.13 ± 214.74 μm at baseline to 259.83 ± 61.68 μm at 6 months in the IVC group (p< 0.05). No influence on tumor size was found in the IVC group. Conclusion: IVC as the initial treatment might be an option for exudative CCH.

Effects of Switching to Aflibercept in Treatment Resistant Macular Edema Secondary to Retinal Vein Occlusion.

Purpose:The aim of this study was to examine 12-month outcomes of eyes switched from intravitreal ranibizumab or bevacizumab to aflibercept for cystoid macular edema due to retinal vein occlusion (RVO).Design:Retrospective, observation, case series.Methods:A retrospective study was performed assessing eyes with RVO switched to aflibercept for at least 12 months. To be included in the study, eyes had to have macular edema despite treatment for at least 6 months with bevacizumab and/or ranibizumab before the switch, central foveal thickness (CFT) ≥300 μm at time of switch, and visual acuity (VA) ≤60 early treatment of diabetic retinopathy score (ETDRS) letters (20/40 Snellen equivalent). Outcome measures included change in VA (in ETDRS letters), CFT, and interval between intravitreal injections.Results:27 eyes of 27 patients were included in the analysis: 13 with branch RVO, and 14 with central RVO. Mean VA before switch was 54.2 ± 23.7 letters (20/80 Snellen equivalent) and mean CFT was 460.4 ± 178.2 μm. Mean number of previous anti-vascular endothelial growth factor (VEGF) injections was 29.5 ± 19.2. At 12 months, mean VA improved by 8.7 ± 13.2 letters (P < 0.01) and mean CFT decreased by 180.9 ± 207.7 μm compared with baseline (P < 0.01). Mean injection interval increased by 1.6 ± 2.0 weeks to 6.9 ± 1.2 weeks, but this was not statistically significant (P = 0.18).Conclusions:In our small retrospective study, eyes switched to intravitreal aflibercept for persistent cystoid macular edema (CME) due to RVO improved vision and macular thickness; however, larger prospective studies are required to validate our findings.

Clinical impact of the 0.2 µg/day fluocinolone acetonide intravitreal implant: outcomes from the ILUVIEN® clinical evidence study in Portugal.

Introduction:The ILUVIEN® (fluocinolone acetonide) Clinical Evidence in Portugal (ICE-PT) study is a retrospective, multicenter, observational study evaluating the effectiveness and safety of the FAc implant in patients with diabetic macular edema.Methods:Patients included in this study had received the 0.2 µg/day fluocinolone acetonide implant for the treatment of diabetic macular edema and had measurements of visual acuity and retinal thickness assessed by optical coherence tomography for at least 12 months pre- and post-fluocinolone acetonide implant administration, with ⩾2 follow-up visits. Outcomes measured included visual acuity, central foveal thickness, and intraocular pressure.Results:There was a significant increase in mean visual acuity compared with baseline at 3, 6, 9, and 12 months post-fluocinolone acetonide in both the overall study population and the pseudophakic subgroup (p < 0.05 at all time points in both groups). A significant reduction in mean central foveal thickness compared with baseline was seen in the overall study population at 3, 6, 9, and 12 months post-fluocinolone acetonide (p < 0.05 at all time points). At 12-month post-fluocinolone acetonide, a small but significant intraocular pressure increase of 1.0 mmHg was seen in the overall study population.Conclusion:The results of this analysis show that switching from the current standard of care to the fluocinolone acetonide implant leads to beneficial effects in terms of vision and retinal structure in patients with diabetic macular edema and that patients benefited from FAc implant administration, regardless of lens status.