Retinal Thickness In Patients Research Articles

Tracking Macular Sensitivity and Inner Retinal Thickness in Long-Term Type 1 Diabetes: A Five-Year Prospective Examination in Patients without Diabetic Retinopathy.

The aim of the study is to compare macular sensitivity and retinal thickness in patients with long-term type 1 diabetes mellitus (DM1) without diabetic retinopathy (DR) after 5 years of follow-up. Thirty-two eyes from 32 long-term DM1 patients without DR were included. All participants underwent a complete ophthalmological examination, including microperimetry and spectral domain optical coherence tomography (SD-OCT). The data were compared with results from 5 years prior. The mean age of the DM1 patients was 43.19 ± 10.17 years, with a mean disease duration of 29.84 ± 8.98 years and good glycemic control. In 2023, patients exhibited a significantly worse best corrected visual acuity (BCVA) compared to 2018 (p < 0.001). DM1 patients did not show statistically significant changes in macular sensitivity over the 5-year follow-up period. Macular integrity showed significant differences between the two time points (p = 0.045). Retinal thickness showed significant differences, particularly in inner retinal layers (IRL) across most of the ETDRS areas. Long-term DM1 patients without DR lesions showed worsened macular integrity and a lower BCVA in 2023. Additionally, they displayed significant alterations in retinal thicknesses, especially in the IRL, between 2018 and 2023. These findings suggest that even in the absence of visible DR, long-term DM1 patients may experience subclinical retinal changes and functional deterioration over time, highlighting the importance of regular monitoring for the early detection and management of potential complications.

Differences in macular thickness associated with peripheral retinal vessel whitening in diabetic patients

This study aimed to determine the difference in macular thickness among patients with diabetes mellitus (DM) with and without peripheral retinal vessel whitening (PRVW). PRVW was defined by retinal vessel whitening outside the standard seven ETDRS fields. Subjects were divided into DM with PRVW, DM without PRVW, and normal age-matched controls. Optical coherence tomography scans were divided into total, inner, and outer retinal layer thicknesses and were compared in the macula's central, inner, and outer rings. Forty-seven eyes were included: DM with PRVW = 15, DM without PRVW = 16, and Controls = 16. Overall, the mean retinal thickness in patients with DM with PRVW was lower than in patients with DM without PRVW and controls. In the inner macula, DM patients with PRVW showed a significantly lower mean inner superior, nasal, inferior, and temporal macula compared to DM patients without PRVW (p = 0.014, 0.008, 0.005, < 0.001, respectively). DM patients with PRVW also showed a significantly lower mean outer superior, nasal, inferior, and temporal macula than controls (p = 0.005, 0.005, 0.016, 0.025, respectively). This study demonstrates that PRVW in DM patients may be associated with global structural changes to the macular region, promoting a decrease in inner and outer retinal thickness. Further studies should investigate the functional correlation with PRVW in DM patients in order to better understand its potential implications in diabetic patients.

Морфофункциональные параметры диабетического макулярного отека после витреоретинальной хирургии

Background. Diabetic macular edema (DME) is a socially significant disease of our time. At the moment, intravitreal administration of antivasoproliferative drugs is the “gold standard” for the treatment of DME. Currently, indication for vitrectomy and membrane peeling for macular edema is the presence of an epiretinal membrane or vitreoretinal traction syndrome. Some authors consider use of vitrectomy with internal limiting membrane peeling to be justified in patients with DME. Purpose. To evaluate changes in the morphofunctional parameters of the retina in patients after vitreoretinal intervention for resistant diabetic macular edema. Methods. 44 patients diagnosed with DME with no response to previous conservative treatment (laser coagulation, angiogenesis inhibitors) underwent surgery at the ophthalmology center of the National Medical Research Center named after N. I. Pirogov. Results When analyzing BCVA after vitreoretinal surgery, a significant increase in functional parameters was revealed in patients of group 2 (vitrectomy) compared with similar parameters in patients of group 1 (continuing treatment) within 6 months from the date of surgery (p = 0.027). There is also a statistically significant decrease in retinal thickness in patients of group 2 compared with patients of group 1 within 1 month (p = 0.035). When assessing photosensitivity, there was a significant increase in parameters in patients of group 2 compared with preoperative parameters and with similar parameters in patients of group 1 within 1 week from the moment of surgery (p = 0.023). Conclusion. It was found that vitreoretinal surgery with membrane peeling provides a higher functional result compared to the group where only angiogenesis inhibitors and retinal laser coagulation were used from 6 to 12 months of observation. By the 1st week of observation, in patients of group 2, in comparison with the results of patients in group 1, there was a more pronounced positive dynamics of photosensitivity which persisted for 12 months. More pronounced edema resorption was also observed in the group in which vitrectomy with internal limiting membrane peeling was used. Thus, these data confirm that use of vitreoretinal surgery is possible in the treatment of diabetic macular edema. Further study of this issue is required. This study was conducted on a small sample of patients. To confirm the statistical reliability of the results, it is necessary to study the data when examining a larger sample in groups. Key words: DME; diabetic macular edema; vitrectomy; membrane peeling.

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.

Longitudinal changes in the ganglion cell complex thickness in acute central serous chorioretinopathy using spectral-domain optical coherence tomography

In this retrospective longitudinal cohort study, we investigated the temporal changes in the peripapillary retinal nerve fiber layer (pRNFL) and inner retinal thickness in patients with acute central serous chorioretinopathy (CSC) using spectral-domain optical coherence tomography (SD-OCT). We followed up with these patients for 6 months, and during this period, the thickness of the pRNFL and the ganglion cell complex (GCC) in CSC patients were compared with the eyes of normal healthy individuals. The study also examined the correlation between the pRNFL thickness, GCC thickness, and visual acuity. The research sample consisted of 67 patients (43 male and 24 female) with an average age of 49.72 ± 9.87 years. The initial findings showed no significant differences in the pRNFL and GCC thickness between the study and fellow eye, study and normal healthy eyes, and fellow and normal healthy eyes. There was no significant difference in the pRNFL and GCC thickness when comparing the study eye with the fellow eye for 6 months. In the study eye, no significant difference was observed when comparing the initial GCC and pRNFL thickness with those at 1, 3, and 6 months. Visual acuity improved significantly from 0.18 ± 0.23 logMAR to 0.04 ± 0.06 logMAR (p < 0.001). The GCC and pRNFL thickness did not significantly affect visual acuity. In conclusion, acute CSC patients did not show significant changes in the pRNFL and inner retinal thickness, suggesting that the GCC and pRNFL do not substantially influence the short-term visual prognosis in these patients.

Changes in retinal nerve fiber layer, ganglion cell complex, and ganglion cell layer thickness in thyroid eye disease: A systematic review.

Thyroid eye disease (TED) is characterized by progressive orbital inflammation. In severe cases, it can lead to dysthyroid optic neuropathy (DON), involving death of retinal ganglion cells and permanent vision loss. Imaging with optical coherence tomography (OCT) has enabled noninvasive examination of the structural impact of the disease, including of the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), and the inner plexiform layer (IPL). In this study, we systematically review 20 studies (897 patients, 1430 eyes) to evaluate changes in retinal thickness in patients with TED, stratified by severity. Most studies found a decrease in thickness in peripapillary RNFL (pRNFL), non-pRNFL, combined RNFL/GCL/IPL, or combined GCL/IPL when comparing patients with DON to healthy controls or to patients without DON. However, results were equivocal regarding differences between non-DON TED patients and controls. In addition, several studies reported a postoperative decrease in pRNFL thickness after orbital decompression surgery. Future studies examining OCT changes of retinal thickness along with disease progression are needed to assess the potential of OCT in diagnosis and management of patients with TED.

Decrease Retinal Thickness in Patients with Chronic Migraine Evaluated by Optical Coherence Tomography.

The purpose of this study is to determine the possible alterations that may occur in the thickness of the retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), and macular thickness in patients with chronic migraines compared with healthy controls. Hence, we examined some of the possibilities that are offered by optical coherence tomography (OCT) in order to study different neurological diseases and to study its application, in this case, how it may be applied to patients with chronic migraines. This was an observational cross-sectional study in adults aged 18-65 years. The study group consisted of 90 patients (90 eyes) with chronic migraines who met the inclusion criteria, and 90 healthy controls (90 eyes) matched for age and sex. Retinal thickness was measured by spectral domain OCT (SD-OCT). The thickness of the superior quadrant of the peripapillary RNFL, as well as the mean thickness in the macula, RNFL macular, and GCL was significantly thinner in chronic migraine patients than in healthy controls (p ≤ 0.05). Chronic migraines are associated with a decrease in retinal thickness which is detectable by an OCT diagnostic technique. The quantification of the axonal damage could be used as a biomarker to help in the diagnosis and monitoring of this pathology. Further studies will be needed to confirm these findings.

Evaluation of retinal and optic disc vascular structures in patients with familial Mediterranean fever (FMF) via optical coherence tomography angiography.

Familial Mediterranean fever (FMF) is an auto-immune disease characterized by fever and serositis. With this study, we aimed at comparing the retinal vascular structures of FMF patients and healthy individuals using optical coherence tomography angiography (OCTA) device. Sixty-nine patients with FMF and 52 healthy controls who were matched by age and sex, didn't have any comorbidities and were admitted to our clinic for routine ophthalmic examination were enrolled in the study. Sixty-nine eyes of 69 patients and 52 eyes of 52 healthy controls that were not disqualified due to the exclusion criteria were included in the study. OCTA images of the patients and controls were analyzed. The mean average age (± SD) of 69 FMF patients included in the study was 39.86 ± 13.16. Forty-nine patients were female, and twenty patients were male. Total vascular density of deep capillary plexus (DCP) and vascular density of DCP parafovea of the FMF patients were found to be statistically significantly lower than those of the controls (p = 0.045, p = 0.034, respectively), while total retinal parafoveal thickness, total retinal perifoveal thickness, outer retinal parafoveal thickness and outer retinal perifoveal thickness were statistically significantly higher in the patient group compared with the control group (p = 0.012, p = 0.014, p = 0.013, p = 0.009, respectively). This study found reduced vascular density and increased retinal thickness in patients with FMF compared to controls. Larger studies are required to further explore the effect of FMF on the retina.

Choroidal and retinal thickness in patients with vitamin C deficiency using swept-source optical coherence tomography

BackgroundTo investigate the effects of vitamin C on central retinal thickness and choroidal thickness.MethodsA total of 69 patients diagnosed with vitamin C deficiency and 1:1 age- and gender-matched 69 healthy individuals with normal serum vitamin C were included in this study. Demographic characteristics of the individuals were collected. All patients underwent a comprehensive ophthalmic examination. Subfoveal choroidal thickness and retinal thickness were measured using a swept-source optical coherence tomography (SS-OCT).ResultsThe average retinal thickness was 269.07 ± 13.51 μm in the vitamin C deficiency group and 276.92 ± 13.51 μm in the control group. The average choroidal thickness was 195.62 ± 66.40 μm in the in the vitamin C deficiency group and 238.86 ± 55.08 μm in the control group. There was a significant decrease in both average choroidal thickness and retinal thickness in vitamin C deficiency group compared with normal individuals (p < 0.001, and = 0.001 respectively).ConclusionThe central retinal and choroidal thickness were thinner in vitamin C deficiency group compared with normal individuals. These findings suggested that vitamin C deficiency might play an important role in retinal and choroidal diseases.

Huntington’s disease and neurovascular structure of retina

Retinal biomarkers in neurodegenerative disorders have attracted much attention in recent years. Recent studies have reported visual dysfunction in Huntington's disease (HD). However, little is known about retinal structural changes in HD. A total of 50 subjects, including 25 motor-manifest HD patients and 25 gender- and age-matched controls, were enrolled. Unified Huntington's Disease Rating Score-Motor part was assessed in HD patients. Spectral-domain Optical Coherence Tomography (SD-OCT) was used to evaluate the macular thickness and peripapillary retinal nerve fiber layer (pRNFL). Superficial and deep capillary plexus densities were measured using OCT angiography (OCTA). To account for inter-eye correlation, generalized estimating equation (GEE) model was used. HD patients had a significant reduction in macular thickness in both inner and outer superior sectors and the inferior outer sector. Inferior pRNFLs were significantly decreased in thickness. There was no significant difference in retinal capillary plexus density between the two groups. Age and disease duration were negatively correlated with macular thickness in HD patients. However, the severity of motor involvement was not correlated with SD-OCT or OCTA parameters. We observed attenuated pRNFL and macular retinal thickness in patients with HD, independent of macular capillary plexus parameters. It can support the hypothesis that the retina may be a potential biomarker for monitoring the neurodegenerative process in HD.

Decreased Macular Retinal Thickness in Patients With Pterygium

PurposeTo explore alterations in macular retinal thickness (RT) and analyze correlation between macular RT and pterygium area, length in pterygium patients.MethodsTotally 13 patients with pterygium (left eye) and 13 healthy controls (left eye) were recruited. OCTA was applied to scan each eye to generate three-dimensional images. Based on the Early Treatment Diabetic Retinopathy Study (ETDRS) method, each image was divided into nine subregions for the ETDRS: central (C); inner superior (IS); outer superior (OS); inner nasal (IN); outer nasal (ON); inner inferior (II); outer inferior (OI); inner temporal (IT); and outer temporal (OT). The macular RT in each subregion was measured. Furthermore, the correlation between RT and the area, length of pterygium was analyzed.ResultsThe visual acuity of pterygium patient was different from that of the control (P < 0.05). Besides, decreased intraretinal thickness of the IN and ON, increased intraretinal thickness of OT, decreased extraretinal thickness of OT, IN, ON, OS, and decreased retinal full layer thickness of medial superior, OS, IN, ON, and II subregions in pterygium group were observed. There was a negative correlation between RT of the IN and ON subregions and the length of pterygium (r = −0.5803 and r = −0.6013, P = 0.0376 and P = 0.0297). The RT of IN subregion was negatively correlated with pterygium area (r = −0.5844, P = 0.0359). According to the receiver operating characteristic analysis, in the ON subregion, the areas under the curve of the inner retinal thickness, outer retinal thickness and the whole retinal thickness were 1.0 (95% CI: 1.0), 0.882 (95% CI: 0.715 and 0.963), and 1.0 (95% CI: 1.0). The smallest area under the curve of retinal thickness in OT subregion was 0.018 (95% CI: 0–0.059).ConclusionRT of pterygium patients was significantly decreased, and the main alterations occurred in the temporal side suggesting there might exist retinal structural alterations in pterygium.

Reduced macular vessel density and inner retinal thickness correlate with the severity of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), caused by mutations in NOTCH3, is the most common cause of hereditary cerebral small vessel disease. Whether it will involve systemic vasculopathy such as retinal vessel remains unknown. Optical coherence tomography angiography (OCT-A) is a noninvasive technique for visualising retinal blood flow. We analysed vessel density and retinal thickness in patients with CADASIL and investigated their correlations with disease severity. This prospective study enrolled 35 patients with CADASIL (59 eyes) and 35 healthy controls (54 eyes). OCT-A was used to measure the vessel density of the macular region and the thickness of retinal layers. Patients with CADASIL were divided into stroke (n = 20) and nonstroke (n = 15) subgroups and underwent cognition and gait speed evaluation. Neuroimaging markers of cortical thickness, white matter hyperintensity, lacunae, and cerebral microbleeds were examined through brain magnetic resonance imaging. The OCT-A parameters, including vessel density, were comparable between the patients with CADASIL and the controls. In patients with CADASIL, vessel density in the superficial retinal plexus in the macula as was inner retinal thickness was significantly lower in the stroke than the nonstroke subgroup. Macular vessel density and inner retinal thickness were positively correlated with gait speed, while negatively correlated with number of lacunae. OCT-A is potentially a useful tool for evaluating disease severity, ischaemic burden, and neurodegeneration in patients with advanced CADASIL.

Short-Term Outcomes of Switching Therapy from Bevacizumab Non-Responder to Ranibizumab in Diabetic Macular Edema

Objective: To evaluate the short-term efficacy of ranibizumab therapy in terms of visual function and retinal thickness in patients with diabetic macular edema (DME) who failed to respond to treatment with repeated bevacizumab injections. Additionally, parameters affecting outcomes after switching were investigated. Materials and Methods: The present study was a multicenter, retrospective study of 70 eyes with DME non-responding to bevacizumab. All patients were initially treated with at least three consecutive injections of bevacizumab then switched to at least one injection of ranibizumab. A monthly follow-up after the first ranibizumab injection to the last injection within six months was monitored. Primary outcomes included mean change in best-corrected visual acuity (BCVA) and central subfield thickness (CSFT) changes from baseline. Exploratory outcomes included parameters affecting prognosis after switching. Results: Seventy eyes with DME were included in the present study. The mean change of BCVA (logMAR) was 0.075±0.375 (95% CI 0.014 to 0.164, p=0.098). The mean change of CSFT was 58.85±110.37 μm (95% CI 32.54 to 85.17, p&lt;0.001). Forty-two percent of patients had BCVA improvement and 75.71% had CSFT improvement after switching to ranibizumab. Factors associated with BCVA and CSFT improvement were baseline BCVA, baseline CSFT, and older than 50 years old. Conclusion: Switching to ranibizumab therapy in DME patients unresponsive to repeated bevacizumab injection provides better anatomical outcomes than visual acuity improvement. This will help ophthalmologists better understand the benefits on switching therapy to ranibizumab in terms of visual function and retinal thickness in patients with DME in the real-world setting. Keywords: Diabetes, macular edema; Anti-vascular endothelial growth factor (VEGF); Intravitreal injection; Non-responder; Persistent diabetic macular edema

Aqueous Lumican Correlates with Central Retinal Thickness in Patients with Idiopathic Epiretinal Membrane: A Proteome Study.

Idiopathic epiretinal membrane (iERM) is a pathological fibrocellular change in the vitreoretinal junction over the macular area; however, possible pathogenic mechanisms remain unclear. Changes in the differential protein composition of the aqueous humor (AH) may represent potential molecular changes associated with iERM. To gain new insights into the molecular mechanisms of iERM pathology, a sensitive label-free proteomics analysis was performed to compare AH protein expressions in patients with cataracts with or without iERM. This study employed nanoflow ultra-high-performance liquid chromatography-tandem mass spectrometry to investigate protein compositions of the AH obtained from individual human cataract eyes from 10 patients with iERM and 10 age-matched controls without iERM. Eight proteins were differentially expressed between the iERM and control samples, among which six proteins were upregulated and two were downregulated. A gene ontology (GO) analysis revealed that iERM was closely associated with several biological processes, such as immunity interactions, cell proliferation, and extracellular matrix remodeling. Additionally, multiple proteins, including lumican, cyclin-dependent kinase 13, and collagen alpha-3(VI) chain, were correlated with the central retinal thickness, indicating a multifactorial response in the pathogenic process of iERM. Changes in the AH level of lumican between iERM and control samples were also confirmed by an enzyme-linked immunosorbent assay. In conclusion, several pathological pathways involved in iERM were identified in the AH by a proteomic analysis, including immune reactions, cell proliferation, and remodeling of the extracellular matrix. Lumican is a potential aqueous biomarker for predicting iERM development and monitoring its progression. More clinical parameters also need to be identified to complete the analysis, and those could provide additional targets for treating and preventing iERM.

Retinal Vessel Density in Age-Related Macular Degeneration Patients with Geographic Atrophy

We compared the retinal vessel density and inner retinal thickness in patients who had one eye with geographic atrophy (GA) and a fellow eye with intermediate age-related macular degeneration (iAMD). The vessel density from the superficial vascular complex (SVC) and deep vascular complex (DVC) through optical coherence tomography angiography and the thickness of the nerve fiber layer, ganglion cell–inner plexiform layer (GCIPL), inner nuclear layer (INL), outer nuclear layer (ONL) on a structural optical coherence tomography thickness map were measured in 28 eyes of 14 GA patients with iAMD in the fellow eye. GA eyes had significantly lower vessel density in the SVC (26.2 ± 3.9% vs. 28.3 ± 4.4%; p = 0.015) and DVC (24.2 ± 2.6% vs. 26.8 ± 1.9%; p = 0.003) than fellow eyes (iAMD). GCIPL and ONL were significantly thinner in GA eyes than in the fellow eyes (p = 0.032 and 0.024 in the foveal areas, p = 0.029 and 0.065 in the parafovea areas, respectively). Twenty-four eyes of 12 patients were followed up for 2 years and seven of the fellow eyes (58.3%) developed GA during the follow-up period and showed reduced vessel density in the SVC (26.4 ± 3.0% vs. 23.8 ± 2.9%; p = 0.087) and DVC (25.8 ± 2.2% vs. 22.4 ± 4.4%; p = 0.047) compared to baseline. Vessel density and GCIPL thickness map measurements are potential GA markers in non-neovascular AMD.

Comparing the Efficacy of Intravitreal Dexamethasone and Time-displaced Fluocinolone Acetonide on Central Retinal Thickness in Patients with Uveitis

ABSTRACT Background To compare the efficacy of intravitreally administered dexamethasone (Dex) and subsequent time-displaced fluocinolone acetonide (FA) on central subfield thickness (CST) in eyes with noninfectious uveitis. Methods Retrospective analysis of twenty-three eyes (18 patients) subsequently receiving intravitreal Dex and FA implants. The main outcome measures were CST, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and status of inflammation. Results CST (Dex: p < .0001; FA: p = .0008) and BCVA (Dex: p = .0009; FA: p = .0005) improved significantly with both implants. Significantly better effects were noted with Dex for absolute and relative CST reduction (p = .0089 and p = .0051, respectively). Final BCVA did not differ between groups (p = .1893). Dex significantly increased IOP, whereas FA did not. One eye was actively inflamed after Dex and FA injection at follow-up (inflamed eyes before injection: [Dex: 2; FA: 6]) Conclusion Both implants significantly reduced CST and induced a significant gain in visual acuity. Dex might be more effective in reducing CST.

Effect of Supra-Choroidal Triamcinolone Injection on Best-Corrected Visual Acuity and Central Retinal Thickness in Patients with Macular Edema Secondary to Retinal Vein Occlusion

Purpose: To find out the effect of suprachoroidal Triamcinolone injection on best corrected visual acuity (BCVA) and central retinal thickness (CRT) in patients with macular edema secondary to retinal vein occlusion. Study Design: Interventional case series. Place and Duration of Study: College of Ophthalmology and Allied vision Sciences, Ophthalmology department, Unit II Mayo hospital, Lahore, from September 2019 to January 2020. Methods: This study included 45 patients diagnosed with unilateral, retinal vein occlusion associated with macular edema. Patients with previous anti-vascular endothelial growth factor injection or any steroid injection received in the last 3 months or macular edema due to any other cause were excluded from the study. Only one eye of each patient was enrolled. The patients were treated with suprachoroidal triamcinolone injection (4 mg/100µL concentration). Patients with baseline central retinal thickness (CRT) of &gt; 300 µm were included in the study. Serial changes in this parameter were evaluated at 1 week, 1 month and 3?months after suprachoroidal triamcinolone injection. Final CRT and Best-corrected visual acuity (BCVA) was recorded after three months. Results: Out of 45 patients, 26 (57.7%) were males and 19 (42.2%) were females. Majority of the patients (35.4%) were 51–60 years old. During first week the visual acuity was 0.321 ± 0.273 LogMAR, after one month it was 0.468 ± 0.291 and 0.406 ± 0.318 after 03 months with a p value of 0.003. After three months significant decrease in CRT was observed. With a p-value of 0.002. Conclusions: Suprachoroidal injection significantly improves BCVA and decreases CRT in patients with macular edema due to retinal vein Occlusion. Keywords: Retinal vein occlusion, suprachoroidal injection, triamcinolone acetonide.

The thickness changes of retina in high myopia patients during the third trimester of pregnancy: a pilot study

ObjectivesTo observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women.MethodsA case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test.ResultsAmong the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P < 0.05). Compared with the control group, the average thickness of all quadrants of the retina in the parafoveal area except the nasal quadrant were significantly decreased in the study group (P < 0.05).ConclusionsIn this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.

Intravitreal Anti-Vascular Endothelial Growth Factor Agents for the Treatment of Diabetic Retinopathy: A Review of the Literature.

Background: Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. The purpose of this review is to gather the existing literature regarding the use of the approved anti-vascular endothelial growth (anti-VEGF) agents in the treatment of DR. Methods: A comprehensive literature review in PubMed engine search was performed for articles written in English language up to 1 July 2021, using the keywords “diabetic retinopathy”, “ranibizumab”, “aflibercept”, and “anti-VEGF”. Emphasis was given on pivotal trials and recent robust studies. Results: Intravitreal anti-VEGF agents have been found to significantly improve visual acuity and reduce retinal thickness in patients with diabetic macular edema (DME) in a long-term follow-up ranging from 1 to 5 years and are considered the standard-of-care in such patients. Regarding DR, intravitreal anti-VEGF agents provided ≥2-step improvement in DR severity on color fundus photography in about 30–35% of patients with NPDR at baseline, in the majority of clinical trials originally designed to evaluate the efficacy of intravitreal anti-VEGF agents in patients with DME. Protocol S and CLARITY study have firstly reported that intravitreal anti-VEGF agents are non-inferior to panretinal photocoagulation (PRP) in patients with proliferative DR (PDR). However, the use of new imaging modalities, such as optical coherence tomography-angiography and wide-field fluorescein angiography, reveals conflicting results about the impact of anti-VEGF agents on the regression of retinal non-perfusion in patients with DR. Furthermore, one should consider the high “loss to follow-up” rate and its devastating consequences especially in patients with PDR, when deciding to treat the latter with intravitreal anti-VEGF agents alone compared to PRP. In patients with PDR, combination of treatment of intravitreal anti-VEGF agents and PRP has been also supported. Moreover, in the specific case of vitreous hemorrhage or tractional retinal detachment as complications of PDR, intravitreal anti-VEGF agents have been found to be beneficial as an adjunct to pars plana vitrectomy (PPV), most commonly given 3–7 days before PPV, offering reduction in the recurrence of vitreous hemorrhage. Conclusions: There is no general consensus regarding the use of intravitreal anti-VEGF agents in patients with DR. Although anti-VEGF agents are the gold standard in the treatment of DME and seem to improve DR severity, challenges in their use exist and should be taken into account in the decision of treatment, based on an individualized approach.

Evaluation of the Changes in Vessel Density and Retinal Thickness in Patients Who Underwent Unilateral Congenital Cataract Extraction by OCTA.

PurposeTo evaluate the changes in vessel density in patients with unilateral congenital cataract after cataract extraction.Materials and MethodsChildren with unilateral congenital cataract were enrolled in our study. All of the patients underwent congenital cataract extraction and intraocular lens (IOL) implantation successfully. Optical coherence tomography angiography (OCTA) was performed to image the retinal vasculature in the macular and optic disc areas before and after surgery. The differences in vessel density and retinal thickness between groups were compared.ResultsWe found that the best corrected visual acuity (BCVA) was significantly improved one month after surgery compared with that before surgery (t=5.179, p<0.001). The axial length was also changed one month after surgery (t=5.350, p<0.001). The vessel density in the macular and optic disc areas of the affected eyes was significantly lower than that in the normal eyes, while the vessel density at the posterior pole was significantly improved one month after cataract extraction.ConclusionThe decrease in vessel density in the macular and optic disc areas might be a consequence of the congenital cataract. Cataract extraction can relieve the form deprivation of the affected eye and increase the vessel density at the posterior pole of the affected eye significantly.