Height Of Serous Retinal Detachment Research Articles

Biochemical and microstructural determinants of the development of serous retinal detachment secondary to retinal vein occlusion

PurposeTo study the alteration of cytokine factors in aqueous humor and retinal microstructure in the formation of serous retinal detachment (SRD) secondary to retinal vein occlusion. MethodsThe subjects were 39 patients with RVO, of whom 31 patients had SRD (RVO-SRD). Spectral Domain Optical Coherence Tomography (SD-OCT) was used to measure the completeness of photoreceptor inner segment/outer segment (IS/OS) and the external limiting membrane (ELM) as well as the structure of RVO-SRD, including the height and shape of SRD. The aqueous humor was collected before intravitreal injection of Ranibizumab. The concentrations of VEGF, MCP-1, IL-8, IL-6, b-FGF and TNF-α in the aqueous humor were measured. All patients participated in the 6-month follow-up examinations, which included visual acuity, intraocular pressure, ophthalmologic examination, and SD-OCT. The time of recurrence of RVO-SRD was recorded. ResultsThe formation of SRD was associated with the area of congested vein, disrupted IS/OS, ELM layers and high VEGF, MCP-1, IL-8, IL-6 levels. However, the height and shape of SRD were not relevant to any inflammatory factors. Moreover, high levels of MCP-1, IL-8 and IL-6 were found in large areas of congested veins. High levels of MCP-1 and IL-6 were observed in the patients with incomplete IS/OS and ELM. The recurrence of SRD was related to the high MCP-1 level. ConclusionHigh concentrations of cytokine factors in aqueous humor could induce vascular leakage, exacerbate the extent of macular edema, disrupt the structure of ELM and IS/OS, and develop SRD in RVO.

Staphyloma-induced Serous Maculopathy: Natural Course and Treatment Effects

To study the natural course of staphyloma-induced serous maculopathy (SISM) and the effects of treatments. Retrospective case series. This retrospective analysis included 26 eyes of 20 patients with SISM and at least 12 months of follow-up. Medical records were reviewed for patient demographics, such as age, sex, spherical equivalent, best-corrected visual acuity (BCVA), type of staphyloma, and imaging characteristics. Spectralis OCT B-scans were evaluated for the presence and height of the serous retinal detachment (SRD) at each follow-up visit. An SRD episode was defined as a period with SRD in 1 patient. Changes in SRD height and BCVA. Twenty-six eyes of 20 patients (70% female) were included. The mean age was 54 ± 11 years, and the mean spherical equivalent was -4.8 ± 3.3 diopters at baseline. The staphyloma was located inferior in 12 eyes (46%), inferonasal in 7 eyes (27%), and nasal in 7 eyes (27%). The mean follow-up duration was 73 ± 34 months. During follow-up, the SRD height fluctuated in all eyes, with a mean change of 125 ± 56 μm. The SRD disappeared completely during follow-up in 13 eyes (50%) and then reappeared in 7 eyes (35%). Resolution occurred spontaneous in 8 eyes (31%). The median time of an SRD episode was 25 (interquartile range 14-57) months. Treatment was performed in 20 eyes (77%) and led to resolution of SRD in 3 of the 15 photodynamic therapy treatments (21%), 2 of 5 (40%) anti-VEGF series, and 2 of 4 eyes (50%) treated with topical prednisolone. Best-corrected visual acuity at the final visit (0.42 ± 0.25) was not significantly different from BCVA at baseline (0.34 ± 0.27 logarithm of the minimum angle of resolution, P= 0.07), nor was BCVA change significantly different between treated eyes (n= 19) and nontreated eyes (n= 7, P= 0.3). Serous retinal detachment in patients with SISM fluctuated over time and resolved without treatment in 31% of the eyes. Because treatment does not change the course of BCVA, a wait-and-see policy is advocated in these patients on the exclusion of treatable causes of SRD. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Incidence and Risk Factors of Recurrent Anterior Uveitis in Initial Acute-Onset Vogt-Koyanagi-Harada Disease.

We report the estimated incidence of, and risk factors for, recurrent anterior uveitis in patients with initial acute-onset Vogt-Koyanagi-Harada (VKH) disease using survival analyses. Patients who were diagnosed with initial acute-onset VKH disease during 2003-2022 at two university hospitals were included. Recurrent anterior uveitis was defined as the first occurrence of the granulomatous anterior uveitis with anterior chamber cells and flare of 2+ or more by the Standardization of Uveitis Nomenclature (SUN) Working Group grading scheme, after the disappearance of conspicuous uveitis and serous retinal detachment for at least 3 months, regardless of systemic or local treatment. The univariate log-rank test and multivariate Cox regression analyses were performed, including patients' demographic characteristics, underlying diseases, presence of prodromal symptoms, duration of visual symptoms, visual acuity, slit-lamp and fundus findings, and height of serous retinal detachment. The treatment method and response to treatment were also included. The estimated incidence was 39.3% at 10 years. Fifteen of 55 patients (27.3%) had recurrent anterior uveitis during the mean follow-up of 4.5 years. The presence of focal posterior synechiae at the diagnosis increased the risk of recurrent anterior uveitis 6.97-fold compared to the absence of synechiae (95% confidence interval [CI], 2.20-22.11; p < 0.001). Use of systemic high-dose steroid therapy more than 7 days after the development of visual symptoms resulted in a hazard ratio of 4.55 (95% CI, 1.27-16.40; p = 0.020). This study reports the estimated incidence and risk factors of recurrent anterior uveitis in VKH disease from survival analyses. However, because of the retrospective nature of this study, it is hard to confirm the consistency of the medical records regarding risk factors, thus, the presence of focal posterior synechiae can be inconclusive as a risk factor. Further studies are warranted.

Branch Retinal Vein Occlusion Occurring After Second Dose of Sinopharm COVID-19 Vaccine: A Case Report

: An old-aged woman was evaluated with branch retinal vein occlusion (BRVO) vision reduction in his left eye three weeks after the Sinopharm coronavirus disease 2019 (COVID-19) vaccination. Her best-corrected visual acuity (BCVA) was 1m counting finger in the left eye and 10/10 in the right eye. Initial retinal findings were superior retinal hemorrhage with prominent retinal vein dilation and tortuosity in the left eye. Fluorescein angiography (FA) and optical coherence tomography (OCT) confirmed a BRVO diagnosis. Blood reports showed no abnormalities. Antithrombotic treatment of 80 mg/d low-dose entrocoated ASA was administered. In addition, an intravitreal Aflibercept (Eylea) injection, monthly and ongoing, was prescripted, which led to a decrease in macular edema, retinal hemorrhage, and height of serous retinal detachment. Moreover, the BCVA improved to 2/10 after a three-week follow-up.

The Incidence and the Clinical Course of Retinal Complications of Intracameral Cefuroxime in Cataract Surgery

Aim. To determine the incidence and the clinical course of retinal complications of intracameral administration of cefuroxime in minimally invasive cataract surgery.Methods. From 2016 to 2021, a prospective clinical study was conducted at the Volga District Medical Center of the Federal Medical and Biological Agency of Russia, which included patients with cataract in one or two eyes to be surgically treated. All patients received 1 mg of cefuroxime injected into the anterior chamber at the end of surgery. All patients underwent ophthalmological examination including evaluation of best corrected visual acuity with determination of logarithm of minimum angle of resolution (logMAR), tonometry, biomicroscopy, and ophthalmoscopy. Each patient before and the day after surgery underwent optical coherence tomography of the retina on a spectral optical tomograph RTVue-100 (Optovue). The dynamics of the condition was evaluated on days 3 and 7 after surgery.Results. Five cases of retinal complications of intracameral cefuroxime injection were identified during the 5-year study period. According to data of optical coherence tomography, retinal edema was localized in the internal nuclear layer of the retina, and the height of serous retinal detachment in the fovea area on the next day after surgery was 315.0 ± 11.0 µm and reduced statistically significantly to 59.8 ± 42.3 µm on the 3rd day after the intervention (p = 0.043). One week later, all patients had complete retinal adherence and recovery of visual function. Retinal edema did not recur in the long term after surgery.Conclusion. Serous retinal detachment with macular edema is the most common clinically relevant complication of intracameral antibiotic prophylaxis, which develops both in compliance with the dilution protocol and in overdose, and has a favourable prognosis.

Comparison of intravitreal ranibizumab, aflibercept and bevacizumab therapies in diabetic macular edema with serous retinal detachment.

To compare the effects of ranibizumab, aflibercept and bevacizumab treatments in treatment-naive diabetic macular edema(DME) patients with serous retinal detachment(SRD). This is a retrospective, comparative study. In a sample of 86 eyes of 86 untreated DME patients with accompanying SRD, 23 patients were treated with ranibizumab (IVR), 28 patients with aflibercept (IVA), and 35 patients with bevacizumab (IVB). All were injected intravitreally once a month for a 3-month loading dose. Subsequently, all participants were evaluated every months and if neccessary they received additional intravitreal treatments.Mean changes in best corrected visual acuity (BCVA), central retinal thickness (CRT), and SRD height over the 6-months study period were compared. At baseline, the groups did not differ in mean BCVA,CRT and SRD height. During the first 3 months, in IVA group the mean decrease in CRT and SRD height were significantly more than in the other two groups (p < 0.05 for all). However, these differences disappeared at 6 months.The number of injections was similar between the groups during the study period. In patients with DME accompanied by SRD, IVA is a more advantageous option in terms of reduction in CRT and SRD height from baseline to 3 months. In the 6-month period of treatment, IVR, IVA and IVB therapies areanatomically and functionally similar and significant effective modalities.

Bacillary Layer Detachment in Acute Vogt-Koyanagi-Harada Disease.

To evaluate the frequency and treatment response of eyes with bacillary layer detachment (BLD) in acute Vogt-Koyanagi-Harada (VKH) disease using spectral-domain optical coherence tomography (SD-OCT). We retrospectively reviewed the medical records of 58 eyes of acute VKH patients with at least 6 months of follow-up between January 2009 and March 2021. SD-OCT, color fundus photographs, and fluorescein angiography images were analyzed in all patients. The study included 58 eyes of 29 patients. BLD was detected in 33 of the 58 eyes (56.9%) at baseline. Mean serous retinal detachment (SRD) height was 918.50±336.64 μm in the BLD group and 215.33±167.83 μm in the group without BLD (p<0.05). A positive correlation was found between SRD height and the presence of BLD (r=0.783, p<0.05). BLD was significantly more common in patients with a baseline SRD height greater than 500 μm (p<0.05). As subfoveal central choroidal thickness (CCT) could not be measured by enhanced depth imaging-OCT at baseline due to extreme choroidal thickness in all eyes, the earliest post-treatment CCT measurements were analyzed. At the completion of pulse steroid therapy, mean CCT was 425±82.87 μm in the BLD group and 385.58±82.87 μm in the group without BLD (p=0.04). The mean time to BLD resolution was 12.88±6.5 days (range: 2-26). BLD is a common tomographic finding in eyes with acute VKH disease and can be differentiated from the associated SRD through careful SD-OCT analysis. Though it is mostly observed in patients with more serious disease, the presence of BLD has no negative effect on long-term visual function.

Predicting retinal sensitivity using optical coherence tomography parameters in central serous chorioretinopathy.

To predict changes in retinal sensitivity using optical coherence tomography (OCT) in eyes with central serous chorioretinopathy (CSC). Twenty-three eyes in 23 patients with CSC were enrolled. Retinal sensitivity was measured twice using microperimetry in all the examined eyes. Spectral domain OCT measurements were simultaneously conducted. The relationship between retinal sensitivity and the thicknesses of (i) the retinal nerve fiber layer plus the ganglion cell layer (RNFL + GCL), (ii) the inner nuclear layer (INL), (iii) the outer nuclear layer (ONL), and (iv) the serous retinal detachment height (SRDH) were investigated in a point-wise manner. The associations between the change in retinal sensitivity and the OCT parameters at baseline were also investigated. The mean age of the participants was 49.8 ± 10.7years. The mean SRDH was significantly lower (p < 0.001), and the mean retinal sensitivity (p < 0.001) was significantly higher at the second examination, compared with the first; however, the logMAR visual acuity (VA) did not differ significantly between the two examinations (p = 0.063). The logMAR VA was associated with retinal sensitivity at both the first and second examinations (p < 0.001). The retinal sensitivity at the second examination was significantly correlated with the retinal sensitivity, RNFL + GCL, INL, ONL, and SRDH at the first examination and with the improvement in SRDH. Retinal sensitivity was associated with the retinal structure in eyes with CSC; these parameters could be useful for predicting the change in visual function prior to treatment.

Changes of Optical Coherence Tomography Biomarkers in Macular Edema Secondary to Retinal Vein Occlusion After Anti-VEGF and Anti-Inflammatory Therapies.

PurposeThis study aimed to assess the short-term changes of macular microstructures following anti-VEGF and anti-inflammatory therapies in patients with macular edema secondary to retinal vein occlusion (RVO-ME).Patients and MethodsIn this retrospective study, 70 eyes of 70 patients with RVO-ME were divided into the anti-VEGF (Group A, 35 eyes) and anti-inflammatory (Group B, 35 eyes) treatment groups. All patients underwent best-corrected visual acuity (BCVA) assessment, intraocular pressure (IOP) assessment, slit lamp, fundus fluorescein angiography (FA), scanning laser ophthalmoscopy (SLO), and spectral-domain optical coherence tomography (SD-OCT). Group A received intravitreal injection of 0.05 mL anti-VEGF antibodies (Lucentis® or Aflibercept®) monthly for 3 consecutive months, while Group B received 0.7 mg dexamethasone (Ozurdex®) single intravitreal injection. BCVA and SD-OCT biomarkers were recorded at baseline and 3 months after the first injection. Changes of BCVA and SD-OCT biomarkers following these treatments were compared between the two groups.ResultsBCVA and SD-OCT biomarkers, except choroidal thickness, in both groups were significantly improved after treatment (all P < 0.01). At 3 months, the height of serous retinal detachment (SRD) was markedly lower (P = 0.006), with significantly less hyperreflective dots (HRD, P = 0.037) in Group B compared with Group A. Other SD-OCT biomarkers and BCVA were not significantly different between the two groups (all P > 0.05).ConclusionAnti-VEGF and anti-inflammatory therapies are both effective in RVO-ME, with improvement in BCVA and SD-OCT biomarkers. Anti-inflammatory therapy may be more effective than anti-VEGF therapy in SRD and HRD resolution.

Factors Associated With the Presence of Foveal Bulge in Eyes With Resolved Diabetic Macular Edema.

Purpose: To evaluate factors associated with the presence of foveal bulge (FB) in resolved diabetic macular edema (DME) eyes.Methods: A total of 165 eyes with complete integrity of ellipsoid zone (EZ) at the fovea and resolved DME were divided into two groups according to the presence of FB at 6 months after intravitreal injection of ranibizumab treatment. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), outer nuclear layer (ONL) thickness, height of serous retinal detachment (SRD) and non-SRD, and inner segment (IS) and outer segment (OS) lengths of the two groups were measured and compared at baseline and each follow-up. The correlations between the presence of FB and pre- and post-treatment factors were determined by logistic regression analysis.Results: At baseline, BCVA was significantly better, and CFT and incidence and height of SRD were significantly lower in the FB (+) group (all P < 0.05). At 6 months, FB was present in 65 (39.39%) eyes. Post-treatment BCVA was significantly better and OS length was significantly longer in the FB (+) group at 6 months (all P < 0.05). Multivariate analysis identified younger age, better BCVA, and lower CFT before treatment as significant predictors of the existence of FB at 6 months (all P < 0.05). At 6 months, better BCVA and longer OS length were significantly correlated with the existence of FB (all P < 0.05).Conclusions: Factors associated with the presence of FB after the resolution of DME include younger age, better baseline BCVA and lower baseline CFT, and better post-treatment BCVA and longer post-treatment OS length.

Type one macular neovascularization in central serous chorioretinopathy: Short-term response to anti-vascular endothelial growth factor therapy.

The aim of this study was to assess the short-term effect of anti-vascular endothelial growth factor (VEGF) treatment on type 1 macular neovascularization (MNV) secondary to central serous chorioretinopathy (CSCR) and to identify potential predictive factors for treatment response using multimodal imaging. Retrospective, multicentre study in CSCR patients with MNV detected by OCT-angiography and treated with anti-VEGF injections. Clinical and multimodal imaging data before and after anti-VEGF injections was reviewed. Univariate and multivariate linear regression analyses were performed to evaluate associations between the change in central macular thickness (CMT) after anti-VEGF therapy and other factors. Forty patients were included. One month after receiving a mean number of 2.7 anti-VEGF intravitreal injections, visual acuity increased significantly from 0.46 ± 0.3 logMAR at baseline to 0.38 ± 0.4 logMAR (p = 0.04). The CMT and foveal serous retinal detachment (SRD) decreased significantly from 330 ± 81.9 µm at baseline to 261.7 ± 63.1 µm after treatment (p < 0.001) and from 145.1 ± 98.8 µm at baseline to 52.6 ± 71.3 µm (p < 0.001), respectively. Subretinal fluid and/or intraretinal fluid were still present in 18 eyes (45%) one month after treatment. In the multivariate analysis, a higher SRD height was associated with a greater CMT change (p = 0.002) and a lower CMT change with the presence of subretinal hyperreflective material (SHRM) (p = 0.04). Fluid resorption was incomplete in about half of the patients with MNV secondary to CSCR after anti-VEGF injections. Shallower SRD or the presence of SHRM were predictors of poor response to anti-VEGF.

Mitochondrial DNA as a Biomarker for Acute Central Serous Chorioretinopathy: A Case-Control Study

Background: The literature suggests that stress may play a pivotal role in the precipitation of acute central serous chorioretinopathy (CSC) because chorioretinal integrity can be affected by the psychosocial state of the patient, indicating the need for a biomarker. Methods: This observational case series included 45 eyes of 45 consecutive patients with treatment-naive acute CSC. Fifty eyes of 50 age-matched healthy volunteers were included in this study as non-CSC controls. Serum samples were collected from all participants, and the levels of mitochondrial DNA (mtDNA) were measured by quantitative real-time (RT)-PCR. Serum levels of high-mobility group box (HMGB) 1 and 8-hydroxy-2’-deoxyguanosine (8-OHdG), biological markers of acute/chronic inflammation and oxidative stress, were also measured. The relationships between serum mtDNA, 8-OHdG, and HMGB1 concentrations were investigated by multivariate regression analysis, alongside an assessment of clinical data. Findings: In the acute CSC group, serum mtDNA concentrations, at 36.5 ± 32.4 ng/mL, were significantly higher than the levels in the control group (7.4 ± 5.9 ng/mL; p < 0.001). Serum levels of 8-OHdG and HMGB1 in acute CSC patients measured 0.12 ± 0.08 ng/mL and 18.1 ± 35.0 ng/mL, respectively, indicating that HMGB1 levels were elevated in CSC compared with the values in the published literature. Multivariate regression analysis demonstrated that increased serum mtDNA levels were significantly associated with the height of serous retinal detachment. Interpretation: We showed serum mtDNA and HMGB1 level elevation and relation to the clinical activities of CSC, providing possible biomarkers for the acute phase of the disease. Trial Registration: This study was registered with the Osaka University Clinical Research Review Committee Registry (registration number, CRB5180007-13448). Funding: Center of Innovation Program from the Japan Science and Technology Agency, JST. Declaration of Interest: All authors declare no competing interests. Ethical Approval: All patients provided written informed consent for the investigation, and the study adhered to the tenets of the Declaration of Helsinki. The local ethics committee of the Osaka University Medical Hospital approved the study.

Optical coherence tomographic patterns in patients with retinal vein occlusion and macular edema treated by ranibizumab: a predictive and personalized approach.

To establish the morphological and functional parameters to predict the effectiveness of intravitreal injections (IVI) of ranibizumab in macular edema due to retinal vein occlusion and to develop a mathematical model forpersonalized treatment algorithms. This is a retrospective study of 98 patients (98 eyes) with macular edema, who received IVI of ranibizumab and were followed up for 12months. Spectral optical coherence tomography scans and best corrected visual acuity (BCVA) assessments were conducted every 3months. Treatment outcome predictors were calculated based on logistic regression analysis. The most significant prognostic factors for the long-term BCVA were baseline BCVA (OR 11.1, p = 0.001), foveal volume (OR 10.8, p = 0.001), destruction of external limiting membrane (OR 15.8, p = 0.001), photoreceptor inner/outer segments (OR 11.1, p = 0.001) and retinal pigment epithelium (OR 9.1, p = 0.001). It has also been discovered that post-treatment BCVA correlated with the height of serous retinal detachment (SRD) (r = -0.4, p = 0.001), ganglion cell complex thickness (r = + 0.3, p = 0.01) and focal loss of ganglion cells (r =-0.3, p = 0.005). Patients without SRD required fewer ranibizumab injections (3.8 ± 1.1) for macular edema fluid resorption compared to those with SRD (5.7 ± 1.2, p = 0.03). A mathematical model for predicting and personalized approach therapy of ranibizumab has been obtained (accuracy of 89%). The effectiveness of IVI of ranibizumab depends on baseline morphological and functional changes. The obtained mathematical model allows for predicting the outcomes of therapy, determining individualized algorithms to increase thetreatment effectiveness and toprevent low vision that corresponds to the principles of predictive, preventive, and personalized medicine.

Efficacy of Intravitreal Dexamethasone Implant in Different Patterns of Diabetic Macular Edema.

PurposeDifferent patterns of diabetic macular edema (DME) suggest different pathogenesis and drug response. We evaluated the outcomes after intravitreal dexamethasone (DEX) implant for DME with or without serous retinal detachment (SRD).MethodsIn this retrospective study, 22 naïve patients (23 eyes) with DME who underwent a single DEX implant were evaluated. Based on the optical coherence tomographic pattern of DME, 12 eyes had a cystoid macular edema pattern (Group 1) and 11 eyes had an SRD pattern (Group 2). The best-corrected visual acuity (BCVA), central retinal thickness (СRТ), central retinal volume (CRV), SRD height (SRDh), and intraocular pressure (IOP) were recorded before and at two and four months after the treatment.ResultsThere were no significant differences between the groups regarding demographic, clinical data and outcomes at baseline. In Group 1, the CRT and CRV significantly decreased at two months (P = 0.002 and P = 0.01, respectively), while the BCVA significantly improved at four months (P = 0.03). In Group 2, the CRT and CRV significantly improved (P 0.01 and P 0.01, respectively) during the follow-up period. At four months, both groups showed a recurrence of DME, Group 1 in particular (two-month CRT reduction, –149 127 µm vs four-month CRT reduction, –72 174 µm; P = 0.04). The mean reduction in CRV was significantly different at four months (Group 1, –0.49 1.7 mm vs Group 2, –1.3 1.3 mm; P = 0.04). In Group 2, the SRDh significantly decreased at two (P = 0.01) and four months (P = 0.01). Four cases with elevated IOP were managed.ConclusionDEX implants were found to be effective in different patterns of DME. The SRD pattern may predict a longer-lasting morphologic efficacy.

Short wavelength automated perimetry and standard automated perimetry in central serous chorioretinopathy

Short wavelength automated perimetry (SWAP) is known for detecting the early reduction of retinal sensitivity (RS) in glaucoma. It’s application in retinal diseases have also been discussed previously. We investigated the difference in RS measured between standard white-on-white automated perimetry (WW) and blue-on-yellow SWAP in central serous chorioretinopathy (CSC). The overall RS (W-RS, S-RS) as well as the RS inside and outside of the serous retinal detachment (SRD) region were investigated in 26 eyes of 26 CSC patients using WW and SWAP. The central retinal thickness, central choroidal thickness, SRD area (SRDa), and SRD height at the fovea were measured using optic coherence tomography. RS inside the SRD region was lower than that of outside for both perimetries (both p < 0.001). The difference between RS inside and outside of the SRD region was greater in SWAP compared to WW (p < 0.001). Univariate analysis revealed significant correlations between SRDa and both W-RS and S-RS (both p < 0.001); moreover, multivariate analysis indicated that only S-RS was selected as the optimal model for SRDa. Our study demonstrated that SWAP was detected the decrease in RS more accurately than WW in CSC. These results may suggest the usefulness of SWAP for detecting change of retinal function in CSC.

Long-term natural history of highly myopic eyes with a dome-shaped macula with or without untreated serous retinal detachment: a 4-year follow-up study

PurposeTo evaluate the long-term functional and morphological changes occurring in myopic eyes with a dome-shaped macula (DSM), with or without untreated serous retinal detachment (SRD).MethodsThis prospective, single-centre study enrolled consecutive...

Comparison of Ranibizumab versus Aflibercept in Treating Macular Edema among Patients with Serous Retinal Detachment Secondary to Branch Retinal Vein Occlusion

ABSTRACT Purpose: To compare the effectiveness of ranibizumab and aflibercept in macular edema (ME) with serous retinal detachment (SRD) following branch retinal vein occlusion (BRVO). Methods: Once every month for 3 months, 33 patients were treated with ranibizumab (Group 1), whereas 30 others were treated with aflibercept (Group 2). In 9 months after that, patients were evaluated every 4 weeks and received additional injections if they met prespecified criteria for retreatment. Corrected visual acuity (BCVA), central foveal thickness (CFT), and height of SRD was measured. Results: During the first 3 months, the improvement of CFT, BCVA, and height of SRD were greater in Group 2 than Group 1. Those differences disappeared in the subsequent 9 months, and changes in CFT, BCVA, and height of SRD were similar between groups at all other visits. Conclusion: Aflibercept was more effective than ranibizumab from baseline to Month 3 in ME with SRD following BRVO.

Comparison of the short-term effect of aflibercept and dexamethasone implant on serous retinal detachment in the treatment of naive diabetic macular edema

Purpose: The aim of this study is to compare the efficacy of intravitreal injection of aflibercept and dexamethasone implant in the early treatment period of naive diabetic macular edema (DME) with serous retinal detachment (SRD).Materials and methods: In this retrospective comparative study, medical records of patients who received treatment for naive DME with SRD and underwent three monthly intravitreal aflibercept (IVA) injections (2 mg) or one intravitreal dexamethasone implant (IDI) injection (0.7 mg) were reviewed. The best corrected visual acuity (BCVA), central macular thickness (CMT), and presence and height of SRD were compared three months after IDI injection and one month after the third IVA injection.Results: A total of 57 eyes of 49 patients were included in the study. The IVA group consisted of 32 eyes of 27 patients, whereas the IDI group consisted of 25 eyes of 22 patients. Both groups were similar in terms of gender, baseline intraocular pressure, HbA1c levels, types of diabetes, BCVA, CMT, and height of SRD (p = 0.469, p = 0.089, p = 0.889, p = 0.461, p = 0.072, p = 0.073, and p = 0.064, respectively). The mean CMT changes were 228.6 ± 109.8 µm and 168.5 ± 106.4 µm in the IDI and IVA groups, respectively (p < 0.001 for both groups). The change in CMT was statistically significantly greater in IDI group than in IVA group (p = 0.041). The mean SRD changes were 162.7 ± 106.9 µm and 110.7 ± 51.9 µm in the IDI and IVA groups, respectively (p < 0.001 for both groups), and the change in SRD height was statistically significantly greater in IDI group than in IVA group (p = 0.019). SRD completely resolved in 92% and 91.2% of the patients in IDI and IVA groups, respectively (p = 0.856). Moreover, BCVA was significantly increased after the injections in both groups (p < 0.001 for both groups), and the change in BCVA was comparable between the groups (p = 0.245).Conclusions: Fewer injections of dexamethasone implant demonstrated better morphological results than aflibercept in the early treatment period of naive diabetic macular edema (DME) with serous retinal detachment (SRD).

Findings of OCT-angiography compared to fluorescein and indocyanine green angiography in central serous chorioretinopathy.

The present study analyzed the appearances of optical coherence tomography angiography (OCTA) in patients with central serous chorioretinopathy (CSC) based on fluorescein angiography (FA) and indocyanine green angiography (ICGA). In the current case series, 54 eyes of 50 patients diagnosed as CSC were evaluated retrospectively. OCTA, FA, and ICGA were performed on each patient. Two trained observers examined the OCTA images independently to confirm and compare the choriocapillary appearance with that on FA/ICGA. Also, the leakage of vessels on FA, perfusion of choroidal blood flow on ICGA, blood flow density, and vascular morphology on OCTA, as well as, the effect of serous retinal detachment (SRD) on imaging were observed. Furthermore, the image findings of contralateral eyes were included. 47/54 eyes (corresponding to 43 patients in 50 patients) were finally diagnosed with CSC that presented a leakage on FA and dilated vessels on ICGA, and the corresponding areas could be recognized on OCTA. However, in some of the cases (15 eyes, 31.9%), a portion of the leakage lesion on FA did not overlap completely with that on OCTA. On the OCTA B-scan, six eyes did not show a choriocapillary flow signal under subretinal fluid (SRF) with a median SRD height of 485 µm, despite the dilated vessels on ICGA. Approximately, 21 contralateral eyes without SRD and leakage presented dilated vessels on ICGA; however, only 13 eyes could be recognized on OCTA. In addition, seven eyes presented CSC on FA/ICGA but manifested explicit abnormal vascularization beneath the retinal pigment epithelium (RPE) on OCTA. FA/ICGA remains the gold standard for the diagnosis of CSC and cannot be completely replaced by OCTA. However, in some cases displaying hot-spots CNV, OCTA can contribute toward a definite diagnosis. The SRD height may exert a shielding effect on the choriocapillary flow signals on OCTA. Lasers Surg. Med. 50:987-993, 2018. © 2018 Wiley Periodicals, Inc.

The association between visual function and retinal structure in chronic central serous chorioretinopathy

The purpose of the current study was to investigate the association between visual function and retinal structure in central serous chorioretinopathy (CSC). In 22 eyes of 22 chronic CSC patients with serous retinal detachment at the macula, retinal sensitivity was measured using MP3 microperimetry (NIDEK, Japan) and mean sensitivity within two degrees (MS2), four degrees (MS4) and six degrees (MS6), as well as foveal sensitivity (MS0), were calculated. Retinal structure was measured using optical coherence tomography (OCT, Spectralis, Heidelberg). The relationship between visual function (LogMAR best-corrected visual acuity [LogMAR VA] and MS0, MS2, MS4, MS6) and serous retinal detachment height at the fovea (SRDH), central retinal thickness (CRT), macular volume (MV) and central choroidal thickness (CCT) was investigated. There were significant negative correlations between LogMAR VA and MS0 (p = 0.016), MS2 (p = 0.049). No significant relationship was observed between LogMAR VA and SRDH (p = 0.97) although there was a significant negative correlation between SRDH and MS2 (p = 0.028), MS4 (p = 0.049), MS6 (p = 0.023). In conclusion, in CSC, serous retinal detachment was significantly correlated with retinal sensitivity measured with MP3, but not with LogMAR VA.