Spectral-domain Optical Coherence Tomography Research Articles

Topographic correlation of microperimetry with foveal microstructure characteristics in idiopathic epiretinal membrane patients with an ectopic inner foveal layer

PurposeTo identify foveal structure-function topographic association and relationship in patients with idiopathic epiretinal membrane (ERM) related to ectopic inner foveal layer (EIFL).MethodsThis was a cross-sectional, observational study that involved 40 individuals with idiopathic ERM: 22 without EIFL (Group 1) and 18 with EIFL (Group 2). Quantitative foveal light sensitivity was measured using microperimetry, and foveal microstructure was assessed using spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA). Multiple indices of microvascular parameters of OCTA images were further processed using the AngioTool software. LASSO regression and quantile regression analyses were performed to identify the spatial distribution correlation between foveal light sensitivity and foveal microstructure parameters.ResultsGroup 2 exhibited reduced light sensitivity across all parameters of microperimetry compared to Group 1 (P < 0.001). Additionally, the central foveal thickness, the percentage of ellipsoid zone disruption, and the foveal avascular zone area were significantly lower in Group 1 than in Group 2 (all P < 0.005). Compared to Group 1, the vessel density (VD) and perfusion density of the foveal region was significantly increased in Group 2 (P < 0.001). In contrast, Group 2 showed significantly decreased VD in the parafoveal region compared with Group 1 (P < 0.05). Significant differences in OCTA parameters including ‘total number of junctions’, ‘junction density’, ‘total vessel length’, ‘average vessel length’, ‘total number of end points’ were observed between Group 1 and Group 2 (all P < 0.01). The foveal light sensitivity was significantly positively correlated with VD in the parafoveal region and negatively correlated with EIFL alteration, best-corrected visual acuity and ellipsoid zone disruption [Log(λ) = − 0.18303, λ = 0.6561].ConclusionsThe presence of EIFL and decreased VD in the parafoveal region, factors that collectively elevate the risk of disease progression, are significantly and independently correlated with reduced microperimetric retinal sensitivity in patients with idiopathic ERM.

Intravitreal Administration of Avacincaptad Pegol in a Nonhuman Primate Model of Dry Age-Related Macular Degeneration.

The lack of effective treatments for dry age-related macular degeneration (AMD) is in part due to a lack of a preclinical animal model that recapitulates features of the clinical state including macular retinal pigment epithelium (RPE) degeneration, also known as geographic atrophy (GA). A nonhuman primate model of GA was developed and its responsiveness to an approved treatment, avacincaptad pegol (ACP), a complement C5 inhibitor, was evaluated. Intravitreal (ivt) administration of sodium iodate (SI) into one eye of male Macaca fascicularis leads to retinal areas (mm2) of hyper- or hypo-autofluorescence. Qualitative changes to the retinal structure over time were observed with spectral domain optical coherence tomography (OCT). Six days after SI administration, prior to treatment, mean (± SEM) GA of all eyes was 8.2 ± 1.8 mm2. Following randomization to treatment groups, either vehicle or ACP was ivt injected and treatment was continued every 4 weeks, for a total of four treatments. Sixteen weeks after SI administration, the GA area in vehicle-treated eyes was 18.9 ± 6.6 mm2, whereas GA in ACP-treated eyes was 11.4 ± 4.0 mm2, a reduction by about 36%. Increased, followed by decreased, overall macular thickness was observed with OCT over time following SI administration. Treatment with ACP did not change alter macular thickness thinning. Geographic atrophy-like lesions that expand over time are observed following SI administration. The current macaque model could be utilized to further explore the mechanism of dry AMD and to develop more novel therapeutics.

Repeatability and reproducibility of a new spectral-domain optical coherence tomography biometer and agreement with swept-source optical coherence tomography based biometer.

To assess the repeatability and reproducibility of the Colombo IOL biometer (Moptim, China), which utilizes spectral-domain optical coherence tomography (SD-OCT), in measuring ocular parameters of normal subjects and to compare its agreement with the swept-source optical coherence tomography (SS-OCT)-based IOLMaster 700 biometer (Carl Zeiss Meditec AG, Germany). This prospective study included 91 eyes from 91 normal subjects. The evaluated parameters were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), anterior chamber depth (ACD), lens thickness (LT), flattest and steepest meridian keratometry (Kf and Ks), mean keratometry (Km), astigmatism (AST) magnitude, white-to-white (WTW) distance, and pupil diameter (PD). The within-subject standard deviation (Sw), test-retest repeatability (TRT), coefficient of variation (CoV), and intraclass correlation coefficient (ICC) were calculated to determine the repeatability and reproducibility. Paired t-tests and Bland-Altman plots with 95% limits of agreement (LoA) were employed to assess the agreement. With respect to intraobserver repeatability, the Sw and TRT values of all evaluated parameters were low. Except J45 and PD, the ICCs were all higher than 0.928. The reproducibility Sw and TRT values of Colombo IOL were also low, and ICCs were not lower than 0.900. Comparing Colombo IOL and IOLMaster 700, the 95% LoA of AL, CCT, AQD, ACD, LT, Kf, Ks, Km, AST, J0, J45, WTW and PD ranged from - 0.08 to 0.03mm, - 21.58 to 5.09μm, 0.01 to 0.15mm, - 0.01 to 0.14mm, - 0.05 to 0.10mm, - 0.14 to 0.59 D, - 0.31 to 0.40 D, - 0.13 to 0.40 D, - 0.68 to 0.32 D, - 0.09 to 0.34 D, - 0.07 to 0.25 D, 0.11 to 1.47mm, and - 0.97 to 2.31mm, respectively. The new SD-OCT-based Colombo IOL biometer demonstrates excellent repeatability and reproducibility. Moreover, it generally agrees well with the SS-OCT-based IOLMaster 700, except for the WTW and PD measurements.

Comparison of macular retinal thickness measurements using spectral-domain and swept-source optical coherence tomography in healthy eyes

Comparison of macular retinal thickness measurements using spectral-domain and swept-source optical coherence tomography in healthy eyes

Relationship between outer retinal tubulation, retinal volume, and visual field in Bietti crystalline dystrophy.

To investigate the presence of tubulation in the outer nuclear layer of patients with Bietti crystalline dystrophy (BCD) using optical coherence tomography (OCT) and evaluate its relationship with visual field, visual field progression, and retinal volume. This retrospective cross-sectional study included 37 patients diagnosed with BCD who underwent spectral-domain OCT examination. OCT examinations and Humphrey visual field tests (10-2 program) were conducted. We performed correlation analyses to assess the correlation of the number of tubulations with the visual field parameters and retinal volume. We also compared the number and prevalence of tubulations in groups based on median values of the parameters. The primary outcome measure was the number and prevalence of tubulations. The average age of the participants was 58.7 ± 9.6years. The mean deviation (MD) value was -25.0 ± 9.0 decibels (dB). The MD slope value during an average follow-up period of 5.9 ± 3.8years was -0.91 ± 1.02dB/year. The number of tubulations tended to increase as the MD values worsened (P = 0.055, r = -0.33). Moreover, the number (P = 0.48) and prevalence (P = 0.42) of tubulations tended to be higher in the group with lower MD values. The number of tubulations decreased with worsening logarithmic minimum angle of resolution (logMAR) (P = 0.68, r = -0.07). The prevalence of tubulations was higher in the group with poorer logMAR (P = 0.068). We observed no significant correlations between the number of tubulations and the retinal outer, inner, or center volume (P = 0.46, r = -0.13; P = 0.76, r = 0.05; P = 0.47, r = 0.12, respectively). However, the prevalence of tubulations in the group with smaller retinal center volume was lower (P = 0.054). The number of tubulations correlated with the severity of visual field loss in patients with BCD; however, it did not correlate with visual field progression or retinal volume measurements. Further studies are needed to understand the development of tubulations and their implications for retinal atrophy in BCD.

Dynamics of retinal changes in early-stage Parkinson’s disease

Parkinson’s disease (PD) is a neurodegenerative disorder primarily characterized by motor symptoms, with emerging evidence suggesting retinal pathology, particularly in the ganglion cell-inner plexiform layer (GCIPL), detectable via optical coherence tomography (OCT). This study aimed to characterize early retinal dynamics in PD using OCT. We conducted a prospective one-year longitudinal multicenter study involving 53 early-stage PD patients with a disease duration of 5 years or less and 52 controls. The participants underwent retinal spectral-domain OCT, primary visual function and cognitive examinations. We examined baseline retinal measures and short-term longitudinal differences between groups via linear mixed effects models. In PD patients, the baseline GCIPL thickness in central regions was increased by up to 4 μm, and the rate of thinning in the parafoveal GCIPL was − 0.61 [0.29] µm/year faster over a one-year follow-up period than in controls in the 2- to 3-mm ring (p = 0.039). In PD patients, greater central GCIPL thickness was associated with poorer contrast sensitivity and reduced performance on the Farnsworth D15 color vision test. It also predicted subsequent thinning in both the GCIPL (2- to 3-mm ring) and the inner nuclear layer (2- to 5-mm rings). However, this increased thickness was not linked to prevalent or progressive motor or cognitive manifestations. In conclusion, this study provides the first detailed topographical description of early retinal dynamics in PD patients, revealing increased central GCIPL thickness and accelerated parafoveal GCIPL thinning in PD. However, the macular region shows complex and variable dynamics among PD patients, but these changes precede detectable progression in clinical scales.

Chromatic dispersion based axial length estimation using retinal spectral domain optical coherence tomography

We propose a method for extracting the axial length of the human eye from high-resolution spectral domain optical coherence tomography (SD-OCT) retinal scans. The method evaluates the chromatic dispersion introduced by the anterior segment and the vitreous of the eye. By analyzing sub-spectral scans, we quantify the axial shift caused by dispersion and relate it to the thicknesses of the media passed by the OCT beam. The method depends on accurate k-linearization and pixel-to-wavenumber calibration. First, we demonstrate the feasibility of our approach using a model eye with adjustable water chamber length. Subsequently, the method is explored for in vivo retinal OCT scans. Challenges are inter-subject variability and limited availability of exact chromatic dispersion data for ocular tissues in the relevant spectral range for OCT imaging. By interpolating the refractive indices of an established eye model from visible wavelengths to the infrared wavelengths of the OCT system using the dispersion of water and estimating refined dispersion properties of the lens, we improve the model’s agreement with in vivo measurements.

Diagnostic Capacity and Correlation of Optic Nerve Colorimetry with Structural Parameters in Primary Open-Angle Glaucoma.

The discriminant function of glaucoma, obtained by the Laguna ONhE colorimetric program, significantly correlates with the BMO-MRW. Furthermore, the diagnostic capacity was inferior to other structural tests in POAG patients. To evaluate the diagnostic capability for glaucoma and the correlation between peripapillary and macular parameters using spectral domain optical coherence tomography (SD-OCT) and optic nerve head hemoglobin (OHN Hb) levels assessed by the Laguna ONhE® software using colorimetric analysis. This cross-sectional study included 112 eyes from 112 primary open-angle glaucoma (POAG) patients and 112 eyes from 112 healthy controls. The peripapillary analysis included standard peripapillary retinal nerve fiber layer (pRNFL), Bruch's membrane opening-minimum ring width (BMO-MRW), and peripapillary RNFL thickness measured with the Glaucoma Module Premium Edition program (RNFLT). The macular analysis assessed the ganglion cell layer (GCL), inner plexiform layer (IPL), macular RNFL (mRNFL), total retina, ganglion cell complex (GCC), and the GCL-IPL complex. The Laguna ONhE program evaluated ONH Hb levels and the glaucoma discriminant function (GDF). Pearson correlation was used to analyze the relationships between variables, and the area under the curve (AUC) was calculated. Significant differences in AUC were found between GDF (0.80) and RNFLT global (G) (0.91), BMO-MRW G (0.89), and outer-temporal GCL (0.88). BMO-MRW showed the strongest correlation with the Laguna ONhE parameters (r from 0.271 to 0.682). Additionally, a significant correlation was observed between the temporal-inferior sector of ONH Hb and the inferior macular sector (r=0.40-0.56 for GCL-IPL) (P<0.05 for all). GDF demonstrated lower diagnostic capacity compared to other structural tests. BMO-MRW showed the strongest correlation with the Laguna ONhE parameters, and a significant relationship was identified between the temporal-inferior sector ONH Hb and the inferior macular region.

Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration

To assess retinal pigment epithelium (RPE) tears in eyes which underwent pars plana vitrectomy (PPV) for submacular hemorrhage (SMH) secondary to age-related macular degeneration and to investigate the prognostic factors of visual outcomes. This study was a retrospective, observational case series that included 24 eyes of 24 patients who underwent PPV with subretinal tissue plasminogen activator and air for SMH. RPE tears were investigated using spectral-domain or swept-source optical coherence tomography images with raster scan, combined confocal scanning laser ophthalmoscope near-infrared images and color fundus photographs. Multiple regression analysis was performed to identify the predictors of visual outcome at month 3 and 6 after surgery. In 21 eyes out of 24 eyes (87.5%), RPE tear was detected in the posterior pole. Eight eyes (33.3%) had large RPE tears ( ≧ 1 disc diameter (DD)). Out of the 8 eyes, 5 eyes progressed fibrotic scars within 3 months despite successful SMH removal and showed decrease in their visual acuity (VA). The ratio of eyes with large RPE tears ( ≧ 1DD) were significantly higher in eyes which had undergone anti-VEGF therapy within 3 months than in treatment-naïve eyes (71.4% vs. 25.0%, p = 0.048). The multiple regression analysis revealed that a small RPE tear (< 1DD) and treatment-naïve condition were associated with better VA at month 3 and 6. SMH within 3 months after anti-VEGF therapy might be accompanied by a large RPE tear. An RPE tear which was smaller than 1DD and treatment-naïve condition were associated with better prognosis.

Ibuprofen reduces inflammation, necroptosis and protects photoreceptors from light-induced retinal degeneration

BackgroundThe retinal degenerative diseases retinitis pigmentosa (RP) and atrophic age- related macular degeneration (AMD) are characterized by vision loss from photoreceptor (PR) degeneration. Unfortunately, current treatments for these diseases are limited at best. Genetic and other preclinical evidence suggest a relationship between retinal degeneration and inflammation. To further explore this relationship, we tested whether Ibuprofen (IBU), an FDA-approved non-steroidal anti-inflammatory drug (NSAID), could promote PR survival and function in a mouse model of light damage (LD)-induced PR degeneration.MethodsLD was induced by exposing mice to 4000 lx of light for 2–4 hours (h). IBU (100 or 200 mg/kg) or vehicle was administered by daily intraperitoneal injection. Retinal structure and function were evaluated by spectral-domain optical coherence tomography (SD-OCT) and electroretinography (ERG). Cell death genes were analyzed at 24 and 72 h after LD using the Mouse Pan-Cell Death Pathway PCR Array (88 genes). The cellular location and protein expression of key necroptosis genes were assessed by immunohistochemistry.ResultsRetinal outer nuclear layer (ONL) thickness in vehicle-injected LD animals was 8.7 ± 0.6% of retinas without LD (p < 0.0001). In IBU 200 mg/kg treated mice, central ONL thickness was 74.9 ± 7.7% of untreated retinas (p < 0.001). A-wave and b-wave ERG amplitudes were significantly preserved in IBU-treated animals. IBU significantly inhibited retinal inflammation. Twenty-four hour after LD, retinal mRNA expression for the inflammatory-factors tumor necrosis factor (Tnf), interleukin-1 beta (Il1B), and C-C motif chemokine ligand 2 (Ccl2) increased by 10-, 17-, and 533-fold, respectively; in IBU-treated animals, the expression levels of these inflammatory factors were not significantly different from no-LD controls. Expression of key necroptosis genes, including Ripk3 and Mlkl, were upregulated in LD vehicle-treated mice, but dramatically reduced to near no LD levels in LD IBU-treated mice. Microglia activation and MLKL protein upregulation were observed primarily in photoreceptors 12 h after LD, as assessed by immunohistochemistry. IBU reduced the upregulation of MLKL protein and microglia migration in the ONL and outer plexiform layer (OPL) of treated retinas.ConclusionsSystemic administration of the anti-inflammatory drug IBU partially protected mouse retinas from light-induced photochemical damage and inhibited both inflammation and the necroptosis cell death pathways. Our results suggest that NSAIDs may provide a promising therapeutic approach for treatment of the human retinal degenerative diseases.

A Pilot Study Investigating the Relationship Between Choroidal Thickness and Choroidal Vascular Index and Coronary Artery Ectasia

Objective: The objective of this study was to compare changes in choroidal thickness (ChT) and choroidal vascular index (CVI) between patients with coronary artery ectasia (CAE) and healthy individuals. Methods: This study included 34 patients with CAE and 40 age-matched healthy subjects with normal coronary arteries. Measurements of ChT and CVI were taken using spectral-domain optical coherence tomography, employing the binarization method for CVI calculation. Additional parameters, including central macula thickness (CMT), retinal nerve fiber layer (RNFL), and ganglion cell layer (GCC) thickness, were also documented. Results: The results indicated no significant differences in either subfoveal ChT or in ChT at 1500 µm both nasal and temporal to the fovea. However, significant differences were noted in ChT at the 500 µm nasal and temporal areas. The CVI was found to be significantly lower in the CAE group compared to the healthy controls. Furthermore, this study noted a significant difference in GCC thickness between the two groups, while no significant differences were observed in CMT and RNFL measurements. Conclusions: The findings suggest that patients with CAE exhibit decreased ChT and CVI in comparison to healthy controls. This highlights the potential role of ChT and CVI as important markers of disease in coronary artery ectasia, offering valuable insights into systemic cardiovascular health.

Effectiveness of vitrectomy with inverted internal limiting membrane flap in the treatment of macular hole retinal detachment in high myopia

PurposeThis study evaluates the effectiveness of the inverted internal limiting membrane (ILM) flap technique during vitrectomy for treating macular hole-induced retinal detachment (MHRD) in high myopia patients, a challenging complication for vitreoretinal surgeons due to its treatment complexity.MethodsWe conducted a prospective study analyzing 92 eyes diagnosed with MHRD, all undergoing vitrectomy using the inverted ILM flap technique between February 2022 and September 2024. Successful surgery was defined as achieving retinal reattachment, macular hole closure, and improvement in visual acuity by the 12-month postoperative follow-up. Microstructural recovery was assessed using spectral domain optical coherence tomography. Logistic regression analysis was performed to identify prognostic factors of surgical outcome.ResultsOf the 92 eyes, 94.6% achieved retinal reattachment, and 92.4% experienced macular hole closure. Visual acuity significantly improved in 91.3% of cases, with a mean improvement of 0.95 logarithm of the minimum angle of resolution. Recovery rates for the external limiting membrane, the ellipsoid zone, and the cone outer segment tip were 76.1%, 66.3%, and 66.3%, respectively. Larger retinal detachments and macular holes were important predictors of lower surgical success (p < 0.001; p = 0.015, respectively). There was a significant correlation between vision improvement and the recovery of structural integrity and foveal microstructures.ConclusionsThe ILM coverage technique represents a breakthrough in the treatment of MHRD, promoting both anatomical and functional recovery. This approach enhances the management of this complex condition, ultimately improving the quality of life for affected individuals.

Analysis of choroidal markers of activity in pachychoroid disease spectrum.

To detect choroidal markers of disease activity in eyes with chronic active unilateral pachychoroid disease spectrum (PDS) compared to the non-active contralateral eyes, based on multimodal imaging and particularly indocyanine green angiography (ICGA). An observational retrospective case-control study. The study evaluated individuals diagnosed with chronic active unilateral PDS (group 1) by comparing the eyes with the non-active fellow eyes (group 2). Imaging was performed using fundus photographs, ICGA, and spectral-domain optical coherence tomography (SD-OCT). Choroidal thickness, choroidal vascular density, choroidal vasodilation, choroidal vascular leakage, and choroidal meridian breakdown were evaluated. Of the 90 patients with chronic PDS with ICGA at our database, 27 Caucasians (mean age: 55.9 years) were identified with active unilateral PDS. Group 1 showed a higher prevalence of the following parameters compared to Group 2: choroidal meridian breakdown (81.5% vs. 25.9%; p < 0.001), choroidal vasodilation (88.9% vs. 48.1%; p < 0.001), greater subfoveal choroidal thickness (420 ± 79.8μm vs. 346 ± 78.5μm; p = 0.002), ICGA choroidal vascular leakage (96.3% vs. 29.6%; p < 0.001), and choroidal hyperpermeability (100% vs. 29.6%; p < 0.001), with a nonsignificant increase in choroidal vascular density (55.4%±13.4 vs. 49.3%±13.5 in the contralateral eye; p = 0.167). Choroidal meridian breakdown, thicker choroid, choroidal vasodilation, and ICGA choroidal vascular leakage are potential posterior choroidal markers of disease activity in PDS.

Relationship between central corneal thickness and optic nerve head parameters in primary open-angle glaucoma

Background: Primary open-angle glaucoma (POAG) is an ocular entity that causes optic neuropathy. Thin central corneal thickness (CCT) in patients with POAG correlates with changes in various optic nerve head structural parameters. Additionally, racial differences exist in CCT and optic disc parameters. Herein, we assessed the potential relationship between CCT and optic nerve head parameters in treatment-naive patients of Persian ethnicity who were diagnosed with POAG of varying severity levels. Methods: This hospital-based analytical cross-sectional study recruited patients of Persian ethnicity diagnosed with treatment-naive POAG. Participants underwent detailed optometric and ophthalmic examinations. Visual field testing was performed using a Humphrey perimeter. Spectral-domain optical coherence tomography (OCT) was performed using a Cirrus OCT device to record optic nerve head parameters: disc area, rim area, vertical cup-to-disc ratio, average cup-to-disc ratio, cup volume, and average retinal nerve fiber layer thickness (RNFLT). The CCT was measured using an ultrasonic pachymeter. Results: We recruited 168 eyes of 84 patients with POAG with a mean (standard deviation) age of 60.30 (12.50) years, comprising 33 (39.29%) men and 51 (60.71%) women. While weak but statistically significant inverse correlations of CCT with the vertical cup-to-disc ratio (r = - 0.19; P &lt; 0.05), average cup-to-disc ratio (r = - 0.17; P &lt; 0.05), and cup volume (r = - 0.17; P &lt; 0.05) were found, other optic nerve parameters showed no significant correlations with CCT (all P &gt; 0.05). Stepwise multiple linear regression analysis indicated that, for each unit increase in the vertical cup-to-disc ratio, the CCT decreased by 54.98 µm (P &lt; 0.05). Conclusions: The CCT in eyes with treatment-naive POAG of varying severity levels in a Persian ethnic group was weakly but statistically significantly inversely correlated with the vertical cup-to-disc ratio, average cup-to-disc ratio, and cup volume. For every unit increase in the vertical cup-to-disc ratio, the CCT decreased by 54.98 µm. Our findings indicate that in patients with POAG, CCT correlates with some changes in structural optic nerve head parameters, including the cup volume and vertical/average cup-to-disc ratios. Further longitudinal studies including individuals from various racial backgrounds and POAG severity levels are needed to verify the relationship between CCT and optic nerve parameters at different time points of disease progression.

P0208 Can we predict inflammatory activity of Ulcerative Colitis by just looking into eyes?

Abstract Background With the introduction of Optical Coherence Tomography-Angiography(OCT-A) in ophthalmology it has been suggested that the true prevalence of posterior segment manifestations in patients with Inflammatory Bowel Diseases(IBD) may be higher than previously thought and OCT-A findings would correlate with the inflammatory burden of the IBD[1-4]. In this prospective study, the relationship with retinal vascular structures and choroidal changes in patients with Ulcerative Colitis(UC) were investigated. Methods 47 UC patients and 42 healthy volunteers with a similar age-sex distribution were employed in this study. Epidemiological, clinical and biochemical data were recorded and patients were grouped as active (55%, n=26) and remission (45%, n=21) according to Mayo Scores. All participants underwent right-left eye anterior and posterior segment examinations, but only right eye data were used. Retinal vascular structures were evaluated on 6x6 mm sections with OCT-A, while choroidal thickness was assessed using the EDI mode of the spectral-domain Optical Coherence Tomography. All measurements were made at similar times of the day to avoid changes due to diurnal rhythm. Results No evidence of past or active uveitis was detected in all participants. It is found that the foveal avascular zone area was enlarged and the subfoveal choroidal thickness was increased in UC patients, compared to the findings of healthy participants(p&amp;lt;0.05). In addition, serum CRP, ESR and fibrinogen levels were generally increased in the active group compared to the remission group and had significant linear relationships with disease activity(p&amp;lt;0.05). No significant relationship was found between the obtained posterior segment eye findings and disease activity, serum CRP, ESR and fibrinogen(p&amp;gt;0.05). Conclusion Retinal vascular structure changes in UC patients compared to healthy participants were associated with systemic inflammation leading to ischemic damage. While choroidal atrophy and thinning were expected with ischemia in UC patients, an increase in subfoveal choroidal thickness was observed in our patients. Furthermore, the study showed that posterior segment eye findings were not superior to traditional biomarkers routinely used in clinical practice in assessing disease activity. References 1-Yilmaz S, Aydemir E, Maden A, Unsal B. The prevalence of ocular involvement in patients with inflammatory bowel disease. Int J Colorectal Dis. 2007;22(9):1027-1030. doi:10.1007/s00384-007-0275-1 2-Felekis T, Katsanos K, Kitsanou M, et al. Spectrum and frequency of ophthalmologic manifestations in patients with inflammatory bowel disease: a prospective single-center study. Inflamm Bowel Dis. 2009;15(1):29-34. doi:10.1002/ibd.20584 3-Nakayama LF, Bergamo VC, Conti ML, et al. The retinal foveal avascular zone as a systemic biomarker to evaluate inflammatory bowel disease control. Int J Retina Vitreous. 2019;5:16. Published 2019 Aug 6. doi:10.1186/s40942-019-0168-9 4-Debourdeau E, Charmard C, Carriere I, et al. Retinal Microcirculation Changes in Crohn’s Disease Patients under Biologics, a Potential Biomarker of Severity: A Pilot Study. J Pers Med. 2022;12(2):230. Published 2022 Feb 7. doi:10.3390/jpm12020230

Evaluation of Retinal Changes in Women with Different Phenotypes of Polycystic Ovary Syndrome.

Background: The aim of our study was to evaluate the retinal nerve fiber layer (RNFL) and macular and choroidal thicknesses in women with different phenotypes of polycystic ovary syndrome (PCOS), and compare these measurements with those of healthy women of reproductive age. Materials and Methods: This prospective case-control study included 120 eyes of 120 women with PCOS, with each of the four distinct phenotypes comprising 30 eyes of 30 women. Additionally, 30 eyes from 30 healthy women were included in the control group. All participants underwent comprehensive ophthalmologic examinations, and RNFL thickness, macular thickness (MT), and choroidal thickness (CT) in each eye were measured via spectral-domain optical coherence tomography. The body mass index (BMI) of the patients was recorded and compared with the retinal changes. Results: The average mean and nasal segments of the RNFL were significantly greater in the PCOS group than in the healthy control group (p < 0.001). There was a statistically significant difference in foveal retinal thickness between the groups (p < 0.001). Our study revealed significant choroidal tissue thickening subfoveally and at locations 500 μm temporal, 500 μm nasal, 1500 μm nasal, and 1500 μm temporal to the fovea in all phenotypes of the PCOS group (p < 0.001). Additionally, there was a positive correlation between BMI and all CT changes. Conclusions: Our findings indicate that the retinal layers and choroid are affected by all phenotypes of PCOS, one of the most common reproductive abnormalities, albeit to varying degrees. Furthermore, these changes were found to be correlated with BMI.

SD-OCT-histopathologic correlation in Schnabel's cavernous optic nerve atrophy.

Until now, Schnabel's cavernous optic nerve atrophy (SCONA) has solely been a histopathological diagnosis exhibiting variable degrees of optic nerve (ON) atrophy with characteristic cavernous spaces filled with acid mucopolysaccharides. We report the first correlation of histopathologic findings with spectral domain-optical coherence tomography (SD-OCT) imaging in SCONA. We examined the eye of an index patient with histopathologically identified SCONA who had undergone multimodal imaging before enucleation for iris ring melanoma. The extent of SCONA in the index patient and three other enucleated eyes with SCONA were determined histopathologically. The histopathological findings of our index patient were correlated with in vivo SD-OCT images before enucleation and compared to representative images from eyes with a normal versus glaucomatous optic disc. Histopathologic examination of our index patient showed a pre- and intralaminar extension of SCONA. Atrophy of the inner retinal layers was observed corresponding to the extent of SCONA. Correlation with SD-OCT showed small intralaminar hyporeflective pseudocysts which were detected in multiple scans corresponding to the histologically affected areas. These changes were neither visible in scans of patients with glaucomatous atrophy nor those with a normal ON. We present the first correlation of clinical and pathological findings in SCONA and were able to identify distinct SD-OCT characteristics for this condition. These findings may help to detect SCONA in vivo and to study this rare entity clinically with regard to its clinical course, risk factors, and pathogenesis. However, more cases of SCONA are needed to confirm our findings.

Neurodegeneration and choroidal vascular features on OCT in the progression to advanced age-related macular degeneration.

To quantify and compare longitudinal thickness changes of the ganglion cell complex (GCC) and the choroid in patients with different patterns of age-related macular degeneration (AMD) progression. Retrospective cohort analysis of anonymized data from participants aged 50y or more and diagnosed with early/intermediate AMD in at least one eye (with no evidence of advanced AMD). A total of 64 participants were included from the Instituto de Retina de Lisboa (IRL) study (IPL/2022/MetAllAMD_ESTeSL) and divided into 4 groups according to the Rotterdam classification for AMD. Spectral domain optical coherence tomography (SD-OCT) was used to assess and quantify GCC and choroid thickness at two time points (first visit vs last visit) with a minimum interval of 3y. In the GCC inner ring, a thinner thickness (P=0.001) was observed in the atrophic AMD group (51.3±21.4 µm) compared to the early AMD (84.3±11.5 µm), intermediate AMD (77.6±16.1 µm) and neovascular AMD (88.9±16.3 µm) groups. Choroidal thickness quantification showed a generalized reduction in the central circle (P=0.002) and inner ring (P=0.001). Slight reductions in retinal thickness were more accentuated in the inner ring in the atrophic AMD (-13%; P<0.01). The variation of the analyzed structures could be an indicator of risk of progression with neurodegenerative (GCC) or vascular (choroid) pattern in the intermediate and atrophic AMD. The quantification of both structures can provide important information about the risk of disease progression in the early and intermediate stages but also for the evolution pattern into late stages (atrophic or neovascular).

Efficacy and Safety of Intravitreal Dexamethasone Implant in Treatment-Resistant Diabetic Macular Edema: Six-month Results.

To investigate the efficacy and safety of intravitreal Dexamethasone implant (DEX-I) therapy in the treatment of diabetic macular edema (DME) refractory to intravitreal bevacizumab (IVB). This retrospective and cross-sectional study included 37 eyes of 37 patients who received 3 loading doses of IVB injections for DME with no response and underwent DEX-Iimplant. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurements and central foveal thickness (CFT) measured by spectral domain optical coherence tomography (SD-OCT) were recorded and compared before DEX-I, at the first week, first, second, third and sixth months. Duration of DME, glycated hemoglobin (HbA1c) levels, DME types and lens status (phakic, pseudophakic) were also recorded. The mean age of the patients was 61.14 ±8.69 years (59.5% male, 40.5% female). 35.1% of the patients had cystoid macular edema, 64.9% had diffuse macular edema and 73 % were phakic and 27% were pseudophakic. BCVA, CFT and IOP values before DEX-Iinjection were 0.78 ±0.16 LogMAR, 493.73 ±107.6 µm and 13.05 ±2.59 mmHg, respectively. At 6 months after DEX-I, BCVA, CFT and IOP values were 0.64 ±0.11 LogMAR, 397.35 ±59.72µm and 16.3 ±2.51 mmHg, respectively. In all follow-ups, there was asignificant improvement in BCVA, asignificant decrease in CFT and asignificant increase in IOP compared to pre-injection. Ocular hypertension was observed in 0.8 % of patients and progression of cataract progression in 1% of patients after treatment. DEX-Itherapy is an effective and safe treatment option for DME refractory to IVB treatment.

Delayed macular development in preterm infants with spontaneously regressed retinopathy of prematurity

PurposeTo evaluate the macular development in preterm infants with spontaneously regressed retinopathy of prematurity (ROP) utilizing handheld spectral domain optical coherence tomography (SD-OCT) during the early postnatal period.DesignA cross-sectional observational study.MethodsUsing handheld SD-OCT, OCT images were acquired in non-sedated infants ages about 37 weeks(w) post-menstrual-age (PMA = gestational age in weeks + chronological age). Central foveal thickness (CFT), mean parafoveal thickness (PT, mean of the temporal and nasal-lateral retinal thickness 1000 μm from the foveal center), the thickness of inner retina layers (IRL) and outer retina layers (ORL) of the foveal center and parafoveal, the depth of the macular fovea (FD), and the angle of the macular fovea (FA) were measured and analyzed.ResultsIn contrast to the infants without ROP (group 1), OCT images of the infants with spontaneously regressed ROP (group 2) were more immature. The FD of Group 2 was shallower than Group 1 (P < 0.05); CFT and the foveal center IRL (FIRL) of Group 2 were thicker than Group 1 (P < 0.05); conversely, PT and the mean parafoveal IRL (PIRL) of Group 2 were thinner than Group 1 (P < 0.05); FA of Group 2 was bigger than Group 1 (P < 0.05); however, there was no significant difference in the foveal center ORL (FORL) and the mean parafoveal ORL (PORL) between Groups 1 and 2 (P > 0.05). Furthermore, in preterm infants, ROP was moderately correlated with FD, CFT, PT, FIRL, and PIRL (P < 0.05).ConclusionsThe spontaneously regressed ROP resulted in immature macular development in the early postnatal period. The inner retinal layers mainly contribute to this but not the outer retinal layers, indicating that the macular fovea’s inner and outer retina layers developed asynchronously. ROP is an influential factor in macular development and maturation. This may be associated with the higher probability of visual impairment in children with a history of spontaneous regression of ROP at a prior time.