Total Macular Volume Research Articles

Reduced effect of anti-vascular endothelial growth factor agents on diabetics with vitreomacular interface abnormalities

This study investigated whether the presence of vitreomacular interface abnormalities (VMIAs) affects the improvement in visual acuity and edema of patients with diabetic macular edema (DME) who received three anti-vascular endothelial growth factor (VEGF) injections. Fifteen eyes of 11 patients with clinically significant macular edema were retrospectively divided into either the control group (only DME) or the experimental group (DME and VMIA) based on optical coherence tomography images. We defined VMIA patterns as epiretinal membrane and/or anomalous vitreomacular adhesion. Changes in central macular thickness (CMT), total macular volume (TMV), and best-corrected visual acuity (BCVA) from the baseline to post third injection were compared between the two groups. After the third injection, the decreases in CMT and TMV were not statistically different between the two groups. The improvement in BCVA was larger in the control group (0.1742 ± 0.0508 logMAR) than in the experimental group (0.0766 ± 0.0562 logMAR; p < 0.01). Our study showed that after the third anti-VEGF injection, the BCVA of patients with both DME and VMIAs improved significantly less than that of patients with only DME. Our results suggest that VMIAs may play a crucial role in reducing the therapeutic effects of anti-VEGF agents.

NAVILAS Laser System Focal Laser Treatment for Diabetic Macular Edema - One Year Results of a Case Series

Purpose: To report one year outcomes of focal Navigated Retina Laser Therapy (NAVILAS) for diabetic macular edema (DME).Methods: Retrospective cohort series of 7 diabetic patients treated with NAVILAS focal laser. Statistical analysis included descriptive and continuous variables (Best-corrected logMAR Visual Acuity and time-domain optical coherence tomography (OCT) parameters) which were compared using a non-parametric procedure, the Friedman tests for repeated measures. A p-value of less than 0.05 was considered to denote statistical significance.Results: diabetic patients (4 male; 3 female) with an average age of 60.8 years (range 48-85 years) were included. All treated eyes were phakic; patients had an average hemoglobin A1C of 9.1 (range 7.8-11.7) at baseline and 8.0 (range 7.4-8.4) at 12 months. Six of the 7 patients had intravitreal bevacizumab injections prior to focal laser treatment with 1 patient having had more than 1 prior injection (total 3). At 12 months, median logMAR improved from 0.695 (± interquartile range 0.574) to 0.477 (± 0.573, p <0.001). OCT median central foveal thickness decreased from 248 (± 112) to 220 µm (± 41, p <0.001); total macular volume decreased from 7.84 (± 0.8) to 7.44 mm3 (± 0.7, p = 0.117); and largest macular subfield thickness decreased from 354 (± 116) to 289 µm (± 42, p <0.001). All patients were treated without complications.Conclusions: Focal NAVILAS showed to be safe and effective in treating DME with improvement in visual acuity and macular edema on OCT over 12 months in this case series. In clinical practice, combined treatment with focal laser including NAVILAS and anti-vascular endothelial growth factor may provide long-term improvement in DME.

Glaucomatous optic neuropathy in congenital glaucoma

AbstractPurpose Morphometric analysis of posterior pole structures of the eye in children with congenital glaucoma (CG)Methods 34 children aged 3 months‐11 yrs with various forms and stages of CG were examined with HRT‐3 and Spectralis HRA+OCT .Results We established the early appearance of deep and bulk excavation and reduction of neuroretinal rim area and volume at the beginning of glaucoma manifestation, mean total RNFL thickness reducing, reflecting the degree of the optic nerve structures atrophy. Correlations between changes of the optic disc parameters, glaucoma stages and the eye size were revealed. In all glaucoma eyes we noted thinning of peripapillary RNFL. 89% of children showed a decrease of arteries caliber (8‐25% of normal) and veins (23‐40% of normal). In 80% of the eyes there was an increase in AVI (ave 0.81).The choroidal topography study showed an increase of the subfoveolar thickness (305‐957 µm) in 80% of children. Examination of the macular area revealed OD‐OS asymmetry of total macular volume in glaucoma eyes(healthy eyes ‐ 8,50±0.36mm³, glaucoma eyes ‐ 7.51±0,63 mm³,p&lt;0.001).Ganglion cell layer (GCL) thickness in the perifoveolar area in glaucoma eyes was significantly below normal and averaged 34.4±9.65 µm, the thickness of the temporal section was lower than the nasal (34.20±9.53 µm, 39.06±10.60 µm, resp.). GCL is affected earlier than the changes in other layers of macular area.Conclusion The distinctive feature of glaucomatous optic neuropathy in CG is a combination of significant structural changes in the optic nerve and retinal layers due to secondary distension of the membranes of the eye, with retinal vessels involved in the process, with some hemodynamic changes in the retina and choroid, all of which worsened with the progression of glaucoma.

Accelerometer measured physical activity and the integrity of the anterior visual pathway in multiple sclerosis

PurposeTo examine the associations among objectively-measured physical activity with the optical coherence tomography (OCT) metrics of retinal nerve fiber layer (RNFL) thickness and total macular volume (TMV) in persons with multiple sclerosis (MS). MethodsEighty four participants with MS, without ocular disease or high myopia underwent a neurological examination for Expanded Disability Status Scale (EDSS) scoring, followed by OCT. Participants then wore an accelerometer during the waking hours of a 7-day period to objectively measure physical activity as steps/day. ResultsMean RNFL thickness for the sample was 91.46μm (SD=15.0), and mean TMV was 6.61mm3 (SD=0.5). The mean score from the accelerometer was 4287 steps/day (SD=2563). Steps/day was significantly associated with both RNFL thickness (Wald χ2=46.48, p<0.001) and TMV (Wald χ2=1798.27, p<0.001). After controlling for sex, MS subtype, disease duration, disability, and visual function, steps/day was significantly associated with TMV (Wald χ2=58.93, p<0.001), but not RNFL (Wald χ2=0.001, p=0.973). ConclusionsPhysical activity was associated with integrity of the anterior visual pathway, assessed by OCT, in persons with MS, and this association was independent of sex, MS subtype, disease duration, disability, and visual function. Researchers should consider examining the causal nature of the association between physical activity and markers of the visual system in MS.

Treatment paradigm after uncomplicated cataract surgery: a prospective evaluation

PURPOSE To compare 3 clinical variables, namely, visual recovery, anterior chamber inflammation, and macular edema, between 2 different regimens after uncomplicated cataract surgery. DESIGN Prospective, randomized, single-blind study at a single center, private, teaching practice in Las Vegas, NV. METHODS Patients randomized to group I (nonsteroidal anti-inflammatory drugs, n = 113) received besifloxacin ophthalmic suspension 0.6% and bromfenac 0.09%, whereas those randomized to group II (steroid, n = 109) received besifloxacin ophthalmic suspension 0.6% and prednisolone acetate 1%.Preoperative evaluation included a baseline macular optical coherence tomography. Postoperative data collected included visual acuity, direct visual anterior segment cell and flare counts, and macular optical coherence tomographies. Foveal thickness and total macular volume were used to assess the presence of cystoid macular edema. RESULTS Visual recovery was statistically insignificant with P values at 0.7, 0.10, 0.2, and 0.7 at 1 day, 1 week, 1 month, and 2 months, respectively.The degree of anterior segment inflammation was not statistically significant (P = 0.8) between the studied populations.The foveal thickness (1 week, P = 0.8; 1 month, P = 0.2; 2 months, P = 0.2) and total macular volume (1 week, P = 0.7; 1 month, P = 0.1; 2 months, P = 0.2) were not statistically significant between the groups, and the observed power were 0.902 and 0.666, respectively. CONCLUSIONS This study demonstrated that bromfenac was equally efficacious when compared with a potent topical steroid in restoring visual function, decreasing and resolving anterior chamber inflammation, and preventing the development of macular edema.

Influence of retinal ischemia on macular function after pars plana vitrectomy for macular edema with branch retinal vein occlusion

The influence of retinal ischemia on changes of visual acuity, macular sensitivity, macular thickness, and macular volume is unclear after pars plana vitrectomy (PPV) for macular edema with branch retinal vein occlusion (BRVO). Twenty-three patients (23 eyes) with BRVO and macular edema underwent PPV. Retinal ischemia was evaluated from capillary non-perfusion on fluorescein angiography, and patients were classified as ischemic or nonischemic. Microperimetry was performed with a Micro Perimeter 1. Macular thickness and volume were measured by optical coherence tomography. Mean macular thickness within the central 4°, 10°, and 20° fields decreased significantly from before to 3 and 6months after PPV (all P<0.001). Likewise, total macular volume within the central 4°, 10°, and 20° fields decreased significantly from before to 3 and 6months after PPV (all P<0.001). Best-corrected visual acuity (BCVA) improved significantly from before to 3 and 6months after PPV (P<0.001). Furthermore, mean macular sensitivity within the central 4°, 10°, and 20° fields increased significantly from before to 3 and 6months after PPV (P=0.002, P=0.001, and P=0.001, respectively). There were no significant differences in the trend profiles of macular thickness, macular volume, and BCVA between the ischemic and nonischemic groups. However, there was a significant difference in the trend profile of macular sensitivity within the central 4°, 10°, and 20° fields between the ischemic and nonischemic groups (P=0.017, P=0.010 and P=0.025, respectively). These findings suggest PPV may be more effective for improving macular sensitivity in ischemic than nonischemic BRVO.

A prospective study on 71 children to investigate normative pediatric values in optical coherence tomography

Aims: Optical coherence tomography (OCT) is a noninvasive radiation-free method for imaging retinal structures and measuring retinal nerve fiber layer (RNFL) thickness and total macular volume (TMV). Newer devices even allow segmentation of all retinal layers and individualized follow-up comparisons.

Effect of a single intravitreal bevacizumab injection on different optical coherence tomographic patterns of diabetic macular oedema

The aim of this study is to compare the therapeutic effect of a single intravitreal bevacizumab (IVB) injection in eyes with diabetic macular oedema (DMO) of different patterns determined by optical coherence tomography (OCT). Medical records of patients who had a single IVB injection for DMO were analysed retrospectively. Eyes with a clinically significant DMO and a central foveal thickness (CFT) of 250 μm or more determined by OCT were included in the analysis. Best-corrected visual acuity (BCVA), CFT and total macular volume values before and after the injection were recorded. Eyes were divided into sponge-like diffuse retinal thickening (DRT), cystoid macular oedema (CMO) and serous retinal detachment (SRD) groups according to the morphology on OCT. A total of 92 eyes (42 with DRT, 31 with CMO and 19 with SRD) were included in the study. There was no statistically significant variation between three groups regarding the change in BCVA (P=0.695). CMO and SRD groups had greater reductions in their mean CFT, and the amount of reduction showed statistically significant variation between three groups (P=0.048). However, no statistically significant difference was found between groups in terms of percentage of change in CFT (P=0.278). CMO and SRD subtypes are associated with a greater reduction in the CFT than the DRT subtype. Although the change in BCVA was not significantly different between groups, the DRT group showed markedly better visual improvement in proportion to the decrease in CFT.

Total Macular Volume and Foveal Retinal Thickness Alterations in Healthy Pregnant Women

ABSTRACTPurpose: To evaluate whether there are alterations in total macular volume (TMV) and foveal retinal thickness (FT) values during pregnancy. Methods: This study included 60 healthy pregnant women in their first, second, and third trimester (groups 1, 2, and 3) and 20 nonpregnant women (group 4). TMV and FT values were measured by optical coherence tomography (OCT) in each group. Results: Mean TMV was 1.43 ± 0.56 mm3, 1.88 ± 0.54 mm3, 2.04 ± 0.66 mm3 and 1.35 ± 0.41 mm3 in groups 1, 2, 3, and 4, respectively. Mean FT was 199.20 ± 64.35 µ, 274.35 ± 67.45 µ, 287.95 ± 95.50 µ and 192.100 ± 58.61 µ in groups 1, 2, 3, and 4, respectively. There was statistical significance among group 1–2 (p1 = 0.014, p2 = 0.001), group 1–3 (p1 = 0.003, p2 = 0.002), group 2–4 (p1 = 0.001, p2 = 0.001), and group 3–4 (p1 = 0.001, p2 = 0.001) for both TMV and FT, respectively. Conclusion: The increase of fluid in the body, in particular in the second and last trimester, may cause an increase of TMV and FT.

Loss of retinal nerve fibre layer axons indicates white but not grey matter damage in early multiple sclerosis

Optical coherence tomography (OCT) has shown thinning of the retinal nerve fibre layer (RNFL) and total macular volume (TMV) in multiple sclerosis (MS) patients. Measures of retinal atrophy are associated with the brain parenchymal fraction (BPF) assessed by magnetic resonance imaging (MRI). However, in MS, data on the relation of OCT measures and grey and white matter volumes are contradictory. We performed a prospective cross-sectional study with a statistically pre-defined endpoint to test our hypothesis that OCT measures of neuro-axonal degeneration are related to global and partial brain atrophy in early forms of MS. Forty-four patients with clinically isolated syndrome (n = 10) or relapsing-remitting MS (n = 34; mean disease duration = 3.2 years, median EDSS = 1.5) were enrolled in the study. Peripapillary- and volumetric OCT scans of the macula were performed using latest spectral-domain OCT technology. BPF as well as white and grey matter fractions (WMF/GMF) were assessed by 1.5 Tesla MRI scans. Generalized estimating equation models adjusted for age and linear regression statistics were used to assess the association between OCT and MRI measures. RNFL thickness, TMV and age were significantly associated with BPF. RNFL thickness and TMV independently predicted WMF (P = 0.003 and P = 0.032) but not GMF (P = 0.717 and P = 0.357) when corrected for age. In contrast, age was strongly associated with GMF (P < 0.001) but not WMF. Our study suggests that, in early MS, OCT measures of retinal atrophy are related to volumetric changes in the white but not grey matter compartment as assessed by MRI. It further substantiates the association of retinal thinning and brain tissue loss in MS.

Integrity of the Anterior Visual Pathway and Its Association with Ambulatory Performance in Multiple Sclerosis

Background. Retinal nerve fiber layer thickness (RNFLT) and total macular volume (TMV) represent markers of neuroaxonal degeneration within the anterior visual pathway that might correlate with ambulation in persons with multiple sclerosis (MS). Objective. This study examined the associations between RNFLT and TMV with ambulatory parameters in MS. Methods. Fifty-eight MS patients underwent a neurological examination for generation of an expanded disability status scale (EDSS) score and measurement of RNFLT and TMV using optical coherence tomography (OCT). Participants completed the 6-minute walk (6MW) and the timed 25-foot walk (T25FW). The associations were examined using generalized estimating equation models that accounted for within-patient, inter-eye correlations, and controlled for disease duration, EDSS score, and age. Results. RNFLT was not significantly associated with 6MW (P = 0.99) or T25FW (P = 0.57). TMV was significantly associated with 6MW (P = 0.023) and T25FW (P = 0.005). The coefficients indicated that unit differences in 6MW (100 feet) and T25FW (1 second) were associated with 0.040 and −0.048 unit differences in TMV (mm3), respectively. Conclusion. Integrity of the anterior visual pathway, particularly TMV, might represent a noninvasive measure of neuroaxonal degeneration that is correlated with ambulatory function in MS.

Higher macular volume in patients with MS receiving fingolimod

In the evaluation of patients with multiple sclerosis (MS), optical coherence tomography (OCT) is gaining traction as a tool to assess thinning of the retinal nerve fiber layer (RNFL) and, more recently, for looking at total macular volume (TMV) thickness, with both measures used as potential biomarkers for progression of disease. In medicine, it is not uncommon for structural changes to be presumed to reflect a certain physiologic process, when in fact, an alternative mechanism is at play. Fingolimod (FTY-720) is a sphingosine-1-phosphate receptor modulator that is an approved oral treatment for MS and leads to reduced cortical volume loss in patients with MS.(1) Similar to other disease-modifying agents, it is likely to be judged in part by its ability to slow loss of the RNFL and TMV. But would such a judgment be valid?

Longitudinal reproducibility of optical coherence tomography measurements in children

To evaluate the longitudinal reproducibility of optical coherence tomography (OCT) measurements in normal and glaucomatous eyes of children. In this 2-setting prospective study, OCT-3 was used to obtain fast retinal nerve fiber layer (RNFL) and macular thickness scans. In the first study setting, the normal eyes of healthy children were scanned on presentation, at 2 weeks, and 3 years, with axial length measured at the first and last examinations. In the second setting, OCT scans of patients in the pediatric glaucoma clinic were performed over 4 years as clinically indicated. Eyes were classified as "normal" (normal eyes and those with physiologic cupping but normal intraocular pressure [IOP]); "mild glaucoma" (increased IOP and a normal optic nerve appearance); or "advanced glaucoma" (severe cupping or progressive glaucoma). Intraclass correlation coefficients were used to evaluate the reproducibility of measurements on the same day and over time. In the first setting, 8 normal eyes were included. Axial length increased 0.11 ± 0.04 mm/year over an average of 3.3 years (P = 0.03); there was no statistically significant change in RNFL thickness (P = 0.30). In our second setting, 27 normal eyes and 37 eyes with glaucoma were included. Intraclass correlation coefficients across the 3 visits for total macular volume were 0.80-0.91 and for average RNFL were 0.73-0.95. Global OCT measurements in children were reproducible over years and were not affected by normal increase in axial length. OCT shows promise as an objective tool for longitudinal assessment of children.

Sequential posterior subtenon injection of triamcinolone acetonide with macular grid/focal photocoagulation for clinically significant diabetic macular edema

PurposeTo evaluate the efficacy of sequential posterior subtenon triamcinolone acetonide (PSTA) injection with macular grid/focal laser photocoagulation for clinically significant diabetic macular edema (CSME). MethodsProspective, interventional clinical trial. Between July 2007 and March 2008, 41 eyes of 32 patients (17 males and 15 females) with Type II diabetes mellitus and diffuse clinically significant macular edema according to the Early Treatment Diabetic Retinopathy Study criteria were recruited. PSTA was used as the first line of treatment, followed by macular focal/grid photocoagulation 2 weeks later. In patients with persistent macular edema, a second dose of PSTA followed by additional focal laser treatment was administered 8–10 weeks later. ResultsBest-corrected visual acuity (BCVA) calculated as logarithm of the minimum angle of resolution (logMAR) unit showed significant improvement both after 3 weeks (0.79±0.27, p=0.001) and after 6 months (0.77±0.29, p=0.001) in comparison with the baseline values 0.92±0.24. Central macular thickness (CMT) was significantly reduced both after 3 weeks (336.2±125.8μm, p=0.001) and after 6 months (342.2±127.2μm, p=0.001) in comparison with the baseline values 437.1±186.5μm. Total macular volume (TMV) was also significantly reduced both after 3 weeks (10.2±1.8mm3, p<0.05) and after 6 months (10.3±2.0mm3, p<0.05) in comparison with the baseline values 11.9±2.1mm3. There were no significant differences in BCVA, CMT, and TMV between 3 weeks and 6 months posttreatment. ConclusionOne or two sessions of sequential PSTA injection and macular grid/focal photocoagulation may improve or stabilize visual acuity, CMT, and TMV for at least 6 months in patients with CSME.

Repeatability of Spectralis OCT Measurements of Macular Thickness and Volume in Diabetic Macular Edema

We estimated coefficients of repeatability for Spectralis optical coherence tomography (OCT)-derived automated retinal thickness and volume measurements in subjects with center-involving diabetic macular edema (DME). A total of 50 eyes of 50 consecutive patients with center-involving DME underwent four consecutive "fast" volume scans at a single session using one OCT device operated by one of two experienced operators. Bland-Altman coefficients of repeatability (CR) were calculated for automated retinal thickness measurements in the nine Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields, center point thickness, and total macular volume. Scans were evaluated for significant automated retinal boundary detection error and revised estimates for CR calculated with these scans excluded. CR in the central subfield was 8.03 μm (95% confidence interval [CI] 7.70-8.35 μm). In other subfields, CR ranged from 6.54 to 18.25 μm. Scan sets from 13 subjects had significant boundary detection error; reanalysis with these excluded yielded a CR for the central subfield of 7.44 μm with CR for all other subfields <8 μm. Retinal thickness measurements in subjects with DME obtained using Spectralis OCT are considerably less variable than has been reported with other devices. Changes in central subfield thickness >8 μm can be considered more indicative of true clinical change rather than measurement variability. This finding informs clinical practice and clinical trial design.

Influence of scanning density on macular choroidal volume measurement using spectral-domain optical coherence tomography

To evaluate the impact of scanning density on macular choroidal volume measurement using spectral-domain optical coherence tomography (SD-OCT). Thirty eyes of normal subjects underwent consecutive raster choroidal scanning protocols using SD-OCT in enhanced-depth imaging mode. Manual choroidal segmentation was performed using the built-in automated retinal segmentation software to obtain five analyses with different inter-scan distances, including inter-scan distances of 30 μm, 60 μm, 120 μm, 240 μm, and 480 μm. The built-in software of the device automatically generated the choroidal thickness and volume map in the similar manner as for the retinal volume map, using the standardized Early Treatment Diabetic Retinopathy Study (ETDRS) grid. For each raster scan, mean absolute difference and relative difference of mean foveal choroidal thickness (FCT), foveal choroidal volume (FCV) and total macular choroidal volume (TCV) in comparison to "true value" (i.e., 30-μm inter-scan distance) were calculated. The maximum relative differences were 10% and 16% for TCV and FCV respectively. For mean FCT, the maximum absolute difference was 31 μm, and maximum relative difference was 12.7%. No statistically significant differences were found in measurements of mean foveal choroidal thickness (p = 0.912) and volume (p = 0.944), as well as macular choroidal volume (p = 0.912), with varying inter-scan distance. Our study shows that approximately 16 scans over the macula with a inter-scan distance of 480 μm is sufficient to provide a clinically relevant and reliable choroidal thickness/volume map. This information could be useful in the design of choroidal scanning protocols for future clinical trials.

VISUAL OUTCOME CORRELATES WITH INNER MACULAR VOLUME IN EYES WITH SURGICALLY CLOSED MACULAR HOLE

To determine the macular morphologic features that correlate best with visual outcome in eyes with surgically closed idiopathic macular hole. Transversal observational case series of 24 eyes (22 subjects) imaged postoperatively using high-resolution Fourier domain optical coherence tomography (FD-OCT). Total and inner macular volume for central 3 mm area, central foveal thickness, and size of foveal inner segment-outer segment junction abnormality were correlated with best-corrected visual acuity. Microperimetry (MP-1) test was performed in a subset of 18 eyes. Mean postoperative best-corrected visual acuity was 20/36 (range, 20/25-20/70). Postoperative follow-up mean was 32.97 ± 24.68 months (range, 5-96 months). Eighteen eyes underwent internal limiting membrane (ILM) peeling. Among FD-OCT parameters, logarithm of the minimum angle of resolution best-corrected visual acuity and mean total microperimetry-1 sensitivity correlated best with inner macular volume in all eyes and ILM-peeled eyes (P < 0.05). Macular surface irregularities were noted in 12 eyes (66.7%) with ILM peeling but in none of the non-ILM-peeled eyes (P = 0.02). No significant correlation was found between microperimetry-1 sensitivity and other FD-OCT parameters. Because inner macular volume strongly correlated with visual outcome in eyes with surgically closed macular hole, the possible effect of ILM peeling on visual outcome needs to be further investigated.

LOW-DOSE METHOTREXATE FOR THE TREATMENT OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY

To evaluate the utility of oral methotrexate (MTX) for the treatment of chronic central serous chorioretinopathy (CSCR). Retrospective review of all eyes of patients on oral MTX as treatment for chronic CSCR in three different centers. Visual acuity as well as optical coherence tomography central macular thickness and total volume parameters were analyzed. Complete blood count and serum chemistry results were monitored. Nine eyes of 9 patients treated with MTX for chronic CSCR met the criteria for analysis. Mean duration of CSCR was 28 months (range, 3-94 months). Mean starting dose of oral MTX was 7.04 mg (range, 5-10 mg), and mean final dose was 7.27 mg (range, 5-10 mg). The mean duration of treatment was 89 days. Mean visual acuity improved from 20/67 at baseline to 20/35 at 8 weeks (P < 0.01, paired t-test). Mean central macular thickness improved from 309 μm to 213 μm at 8 weeks (P < 0.01, paired t-test). Mean total macular volume improved from 8.14 to 7.21 at 8 weeks (P ≤ 0.02, paired t-test). Eighty-three percent of the patients achieved total resolution of subretinal fluid. No MTX-associated toxicity was evident. Methotrexate may have a role in the treatment of chronic CSCR as evidenced by these results. A randomized controlled clinical trial is warranted to better understand the effects of MTX in these patients.

Macular thickness measured by spectral-domain optical coherence tomography in healthy Thai eyes

To describe the macular thickness measured by spectral-domain optical coherence tomography (SD-OCT) in healthy eyes of Thai people. Prospective cross-sectional study. Three hundred sixty-eight healthy participants underwent a comprehensive ophthalmic examination, including Spectralis SD-OCT scanning, at Chiang Mai University Hospital. The images were obtained over maculae, using a high-speed volumetric raster scan pattern with lines 240 μm apart. Information was collected from both eyes of each person, with only the right one being used unless it was found to be ineligible (in which case the left eye was studied). A mean retinal thickness was calculated based on nine areas that corresponded to the Early Treatment Diabetic Retinopathy Study by OCT mapping software. The relationships between retinal thickness and sex, age, axial length, and spherical equivalence were analyzed. The mean age of the subjects was 49.17 ± 17.24 years. The mean central retinal thickness was 259.18 ± 19.08 μm, the mean foveal volume was 0.20 ± 0.02, and the mean total macular volume was 8.59 ± 0.37 mm(3). Central subfield (CSF) thickness and foveal volume were significantly greater in men than in women (both P < 0.001). When analyzed for six age groups by ANOVA, the CSF thickness showed no significant difference among the groups, with a P value of 0.280, and foveal volume showed no significant difference among the six groups, with a P value of 0.341. After age adjustment, axial length was correlated positively with the CSF thickness (P < 0.001, Pearson correlation). The normal macular thickness in Thais is thinner than those reported for other populations when measured using the Spectralis SD-OCT. Male gender and axial length were correlated positively with CSF thickness.

MACULAR SENSITIVITY AND MORPHOLOGY AFTER INTRAVITREAL INJECTION OF TRIAMCINOLONE ACETONIDE FOR MACULAR EDEMA WITH BRANCH RETINAL VEIN OCCLUSION

To evaluate the changes of macular sensitivity, thickness, and total macular volume after intravitreal injection of triamcinolone acetonide to treat macular edema with branch retinal vein occlusion. Seventeen eyes of 17 patients with branch retinal vein occlusion with macular edema received intravitreal triamcinolone acetonide. Using capillary nonperfusion on fluorescein angiography, patients were classified into nonischemic or ischemic groups. Microperimetry was used to measure macular sensitivity within the central 4°, 10°, and 20° fields. Macular thickness and macular volume within these fields were measured by optical coherence tomography. The mean macular thickness within the central 4°, 10°, and 20° fields decreased significantly after intravitreal therapy (all Ps < 0.001) as did total macular volume (all Ps < 0.001). Visual acuity was significantly better at 3 and 6 months (P = 0.002) as was the mean macular sensitivity within the three fields (all Ps < 0.05). There were no significant differences in the trend profile of macular thickness and volume within the three fields between the ischemic and nonischemic groups. There were also no significant differences in the trend profile of visual acuity and macular sensitivity. Intravitreal triamcinolone acetonide may improve macular sensitivity and morphology in patients with ischemic and nonischemic branch retinal vein occlusion.