Total Macular Volume Research Articles

Punctate hyperreflective vitreous opacities: a ubiquitous finding in healthy children beyond infancy.

The vitreous evolves from birth over lifetime. Little is known about the appearance of the healthy vitreous during childhood. We aimed to characterise posterior vitreous features in healthy children using spectral domain optical coherence tomography (SD-OCT). Retrospective cohort study including healthy eyes of 78 children aged 2-12 years and 39 healthy adults. Patients diagnosed with intraocular inflammation or vitreoretinal pathology were excluded. Proportion of eyes with presence of punctate hyperreflective vitreous opacities (PHVO). Percentage of B-scans demonstrating PHVO within an OCT volume scan, correlation between presence of PHVO and patients' age group, retinal measurements, and presence of premacular bursa were analysed. 154 paediatric eyes (median age 9.08 (IQR 5.17-9.75) years) and 76 adult eyes (30.75 (IQR 26.42-38.08) years) were included; 12244 OCT images were reviewed. All eyes (100%) in the paediatric group and 73% in the adult group presented PHVO. The median percentage of OCT images showing PHVO was 77.05% (IQR 51.23-88.52) in children and 8.0% (IQR 0-16.03) in adults (p < 0.001). Separate analysis of right and left eyes confirmed the results (p < 0001). Premacular bursa appeared in 20.5% of paediatric and 31.6% of adult eyes (p = 0.103). Mean central subfield thickness was significantly lower in children (257 ± 21 µm vs. 276 ± 18 µm, p < 0.001), while median total macular volume was similar (8.59 (IQR 8.25-8.86) mm3 vs. 8.62 (IQR 8.39-8.96) mm3, p = 0.145). This study demonstrates that PHVO are ubiquitous physiologic vitreous findings in healthy children beyond infancy. These findings enhance the understanding of the development of the posterior segment of the eye and might improve paediatric OCT interpretation, potentially avoiding misdiagnoses and unnecessary interventions in children.

Longitudinal evaluation of retinal neuroaxonal loss in epilepsy using optical coherence tomography.

People with epilepsy (PwE) suffer from progressive brain atrophy, which is reflected as neuroaxonal loss on the retinal level. This study aims to provide initial insight into the longitudinal dynamics of the retinal neuroaxonal loss and possible driving factors. PwE and healthy controls (HC; 18-55 years of age) underwent spectral domain optical coherence tomography at baseline and 7.0 ± 1.5 and 6.7 ± 1.0 months later, respectively. The change in retinal thickness/volume and annualized percentage change (APC) were calculated for the peripapillary retinal nerve fiber layer (pRNFL), the macular RNFL (mRNFL), the ganglion cell inner plexiform layer (GCIP), the inner nuclear layer, and the total macular volume (TMV). Group comparisons and multiple linear models with stepwise backward selection were performed to evaluate associations with demographic and clinical parameters. PwE (n = 44, 21 females, mean age = 35.6 ± 10.9 years) revealed a significant decrease in the pRNFL, mRNFL, GCIP, and TMV thickness or volume in the study interval. When compared to HC (n = 56, 37 females, mean age = 32.7 ± 8.3 years), the APC of the pRNFL (-.98 ± 3.13%/year) and the GCIP (-1.24 ± 2.56%/year) were significantly more pronounced in PwE (p = .01 and p = .046, respectively). Of note, atrophy of the mRNFL was significantly influenced by the number of antiseizure medications (ASMs; p = .047) and increasing age of PwE (p = .03). Contradictory results, however, were revealed for the impact of seizures. In epilepsy, progression of retinal neuroaxonal loss was already detectable at short-term follow-up. PwE who receive a high number of ASMs seem to be at risk for accelerated neuroaxonal loss, stressing the importance of well-considered and effective antiseizure therapy.

The Effect of Perinatal High‐Dose Erythropoietin on Retinal Structural and Vascular Characteristics in Children Born Preterm

To study the long-term effects of perinatal high-dose recombinant human erythropoietin (rhEPO) on macular structural and vascular development in preterm children. Randomized, double-blind clinical trial follow-up plus cohort study. Setting: Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. extremely or very preterm born children aged 7-15 years from an ongoing neuropediatric study (EpoKids). These had been previously randomized to receive either high-dose rhEPO or placebo perinatally. participation in the EpoKids Study, written informed consent (IC). previous ocular trauma or surgery; retinal or developmental disease unrelated to prematurity. Term-born children of comparable age were enrolled as a healthy control (HC) group. term birth, IC. any ocular or visual abnormality, high refractive error. Examiners were blinded regarding intervention status until completion of all analyses. (Participants/guardians remain blinded). Spectral-domain OCT scans (Heidelberg Spectralis system) and OCTA imaging (Zeiss PlexElite 9000) were obtained. Ophthalmological and orthoptic examinations excluded ocular comorbidities. OCT (central retinal thickness, CRT; total macular volume, TMV), superficial plexus OCTA (foveal avascular zone, FAZ; vessel density, VD; vessel length density, VLD) parameters and foveal hypoplasia grade according to published criteria. Macular vessel density parameters (VD and VLD) were significantly lower (p =0.015, CI-95: 0.01 to 0.06 and p=0.015, CI-95: 0.74 to 3.64) in the EPO group (n= 52) when compared to placebo (n=35). No other significant differences were observed between the EPO and placebo group. When comparing the intervention subgroups to HC we found six significant differences in OCT and OCTA parameters (FAZ, VD, VLD and CRT comparing HC and EPO group; FAZ and CRT when comparing HC and placebo group). Early high-dose rhEPO in infants born extremely or very preterm affects macular vessel density parameters compared to placebo. Premature birth (regardless of intervention status) affects retinal structure and vascular development. Our findings on macular vascular development do not contraindicate the administration of early high-dose EPO in preterm infants. For further understanding of the role of EPO on macular development and its clinical significance, future studies are needed.

Role of nonsteroidal anti-inflammatory drugs on change in macular volume postcataract surgery in diabetic eyes: A retrospective comparative study.

Diabetic eyes suffer from variety of complications including macular edema. Cataract surgery is the most commonly done procedure throughout the world and majority would be diabetics. As pseudophakic-cystoid macular edema (CME) is a known complication following cataract surgery, our study concentrated on finding the role of prophylactic topical nonsteroidal anti-inflammatory drugs (NSAIDs) on change in total macular volume (TMV) postcataract surgery in diabetic eyes. To evaluate the role of NSAIDs on change in TMV postcataract surgery in diabetic eyes. Retrospective comparative study. Data were collected from the medical records department of our institute constituting diabetics undergoing cataract surgery from June-2021 to February-2022. Eighty diabetic eyes were divided into two groups: one group were given topical nepafenac drops and another who were not given. Demographic details, diabetic retinopathy stage, preoperative optical coherence tomography (OCT), and postoperative day (POD) 7, day 28, and 3 months OCT were collected. Statistical analysis was done to compare the change in TMV between both the groups. Student's t-test and Chi-squared/Fisher's exact test were employed to find statistically significant differences between the two groups using SPSS-22.0 software. In our study, the mean age in the group with nepafenac was 60.93 ± 5.86 years and 31 (77.5%) had moderate nonproliferative diabetic retinopathy (NPDR), and in the group without nepafenac, the mean age was 58.53 ± 7.41 years and 30 (75%) had moderate NPDR. Majority of the individuals in the study group were known diabetic for 2-5 years. Change in TMV at POD 3 months among two groups was not statistically significant; P = 0.758 (P < 0.05-significant). Our study concluded that topical-NSAIDs played no role in postoperative period following cataract surgery with respect to change in TMV in diabetic eyes. Thus, prophylactic usage of topical-NSAIDs can be a burden on patient as it has no role in prevention of pseudophakic-CME in those with the duration of diabetes mellitus <5 years and with mild-to-moderate NPDR.

The Impact of a Single Haemodialysis Session on the Retinal Thickness and Optic Nerve Morphology

Background: The aim of the study was to assess the influence of a single haemodialysis (HD) session on the retinal and optic nerve morphology in end-stage kidney disease (ESKD) patients. Methods: It is a prospective study including only the right eye of 35 chronic kidney disease (CKD) patients subjected to HD. Each patient underwent a full eye examination 30 min before HD (8 a.m.) and 15 min after HD. Optical coherence tomography (OCT) was used to assess the peripapillary retinal nerve fibre layer (pRNFL) thickness, macular nerve fibre layer (mRNFL) thickness, ganglion cell layer with inner plexiform layer thickness (GCL+), GCL++ (mRNFL and GCL+) thickness, total retinal thickness (RT) and total macular volume (TMV). The correlation was tested between such systemic parameters changes as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), body weight, plasma osmolarity and ocular perfusion pressure (OPP) and ultrafiltration volume with total RT and pRNFL thickness changes during HD. Results: In the results of a single HD session, we could observe a statistically significant increase in the total RT thickness (pre-HD 270.4 ± 19.94 μm, post-HD 272.14 ± 20.11 μm; p = 0.0014), TMV (pre-HD 7.48 ± 0.53 mm3, post-HD 7.52 ± 0.55 mm3; p = 0.0006), total pRNFL thickness (pre-HD 97.46 ± 15.71 μm, post-HD 100.23 ± 14.7 μm; p = 0.0039), total GCL+ thickness (pre-HD 70.11 ± 9.24 μm, post-HD 70.6 ± 9.7 μm; p = 0.0044), and GCL++ thickness (pre-HD 97.46 ± 12.56 μm, post-HD 97.9 ± 12.94 μm; p = 0.0081). We observed a significant correlation between the change in total RT and DBP change, as well as between body weight change and the change in total pRNFL thickness. There was also a correlation between total pRNFL thickness change and the presence of diabetes mellitus. Conclusion: Even a single HD session affects the retinal and pRNFL thickness, which should be taken into account when interpreting the OCT results in patients subjected to HD. The impact of changes after a single HD session on selected parameters requires further assessment in subsequent studies, including long-term observation.

Clinical efficacy of subthreshold micropulse laser combined with anti-VEGF drugs in the treatment of diabetic macular edema: A meta-analysis.

To systematically evaluate the efficacy and safety of subthreshold micropulse laser (SML) combined with anti-vascular endothelial growth factor (VEGF) drugs for the treatment of diabetic macular edema (DME). The randomized controlled trials on SML combined with anti-VEGF drugs for DME were retrieved from China National Knowledge Infrastructure, Wan Fang Data, VIP Data, Sino Med (China Biomedical Literature Database), PubMed, Web of Science, The Cochrane Library, and Embase by computer from inception to April 19, 2022. The observation group was treated with SML combined with anti-VEGF drugs, while the control group was treated with anti-VEGF agents alone or SML. And the references of the included literature were manually searched. The Meta-analysis was performed using Revman 5.4 and STATA SE 15. This study finally included 15 randomized controlled trials involving 891 eyes for Meta-analysis. The results showed that there was no statistically significant difference between the 2 groups in best-corrected visual acuity at 1, 3, 6, 9, and 12 months after treatment. There was no statistical difference between the 2 groups in central macular thickness (CMT) at 1, 3, and 6 months after treatment (P > .05). CMT in the observation group was lower than that in the control group at 9 and 12 months (P < .05). There was no statistical difference between the 2 groups in total macular volume at 3, 6, 9, and 12 months in CMT (P > .05). The number of anti-VEGF drugs injections in the observation was lower than that in the control group (P < .05). The occurrence of complications between the 2 groups was not statistically significant difference (P > .05). SML in combination with anti-VEGF drugs in patients with DME are comparable in reducing the number of anti-VEGF drugs injections and CMT, thereby reducing the financial burden on patients. It does not differ in best-corrected visual acuity and total macular volume.

Choroid plexus volume as a marker of retinal atrophy in relapsing remitting multiple sclerosis

ObjectiveTo evaluate choroid plexus (CP) volume as a biomarker for predicting clinical disability and retinal layer atrophy in relapsing remitting multiple sclerosis (RRMS). MethodsNinety-five RRMS patients and 26 healthy controls (HCs) underwent 3 T whole brain MRI, expanded disability status scale (EDSS) and optical coherence tomography (OCT). Fully automated intra-retinal segmentation was performed to obtain the volumes of the retinal nerve fiber layer (RNFL), combined ganglion cell layer -inner plexiform layer (GCIPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), total macular volume (TMV) and papillomacular bundle (PMB). Automated segmentation of the CP within the lateral ventricles was performed and the choroid plexus volume (CPV) was normalized by total intracranial volume (TIV). Linear regression analysis and generalized estimating equation (GEE) models were applied to evaluate relationships between nCPV and EDSS, T2 lesion volume, disease duration, and retinal layer volumes, followed by Bonferroni correction analysis for multiple comparisons. ResultsRRMS patients had larger tChPV compared to HCs (p < 0.001). After Bonferroni correction, there was a significant positive correlation between tChPV and EDSS (r2 = 0.25, p = 0.0002), disease duration (r2 = 0.30, p = 0.01), and T2 lesion volume (r2 = 0.39, p = 0.0000). A robust negative correlation was found between tChPV and RNFL (p < 0.001), GCIPL (p = 0.003), TMV (p = 0.0185), PMB (p < 0.0001), G (p = 0.04), T(p = 0.0001). ConclusionsOur findings support the association of tChPV with disability and altered retinal integrity in RRMS.

Pupillary Light Reflex and Multimodal Imaging in Patients With Central Serous Chorioretinopathy.

The purpose of this study was to investigate and compare the corresponding alterations of the pupillary response between acute and chronic central serous chorioretinopathy (CSC) and between different disease categories. We recruited patients with unilateral acute and chronic CSC. An eye tracker was applied to determine the pupillary light reflex (PLR) and evaluate the following PLR metrics in healthy eyes: pupil diameter, diameter changes, including relative constriction amplitude (AMP%), and re-dilation ratio (D1%). Baseline optical coherence tomography (OCT), and fluorescein and indocyanine green angiography (FA/ICGA) were performed to analyze the relationship between pupillary response and retinal/choroidal architecture. In total, 52 patients were enrolled, including 25 with acute CSC and 27 with chronic CSC. Compared to the chronic CSC group, the acute CSC group displayed a significantly larger baseline pupil diameter (BPD; of 5.51 mm, P = 0.015), lower AMP% (34.40%, P = 0.004), and higher D1% (93.01%, P = 0.002), indicating sympathetic overactivity. On OCT, the total macular volume was positively correlated with the D1% (r=0.48, P = 0.005) and negatively with AMP (r=-0.47, P = 0.007). On ICGA, the intense choroidal vascular hyperpermeability (CVH) group displayed a greater BPD than the nonintense CVH group. Additionally, 9 cases with later recurrent episodes following therapy showed a lower AMP% and higher D1% than the nonrecurrent group. The PLR revealed sympathetic excitation in patients with acute CSC. The stronger D1% was significantly associated with greater total macular volume, and it may be a potential biomarker for predicting the later recurrence of CSC.

Inner Retinal Layer Changes Reflect Changes in Ambulation Score in Patients with Primary Progressive Multiple Sclerosis.

The establishment of surrogate markers to detect disability progression in persons with multiple sclerosis (PwMS) is important to improve monitoring of clinical deterioration. Optical coherence tomography (OCT) could be such a tool. However, sufficient longitudinal data of retinal neuroaxonal degeneration as a marker of disease progression exist only for PwMS with a relapsing-remitting course (RRMS) so far. In contrast, longitudinal data of retinal layers in patients with primary-progressive MS (PPMS) are inconsistent, and the association of OCT parameters with ambulatory performance in PwMS has rarely been investigated. We aimed to investigate the relative annual rates of change in retinal layers in PwMS (RRMS and PPMS) compared with healthy controls (HC) using OCT and to evaluate their association with ambulatoryfunctionalscore (AS) worsening in PPMS. A retrospective analysis of a longitudinal OCT dataset of the retinal layers of PwMS and HC from two MS centers in Germany was performed. Walking ability was measured over a standardized distance of 500 m, and changes during the observation period were categorized using the AS and the expanded disability status scale (EDSS). 61 HC with 121 eyes and 119 PwMS (PPMS: 57 patients with 108 eyes; RRMS: 62 patients with 114 eyes) were included. The median follow-up time for PwMS was 3 years. The relative annual change of pRNFL (peripapillary retinal nerve fiber layer) and INL (inner nuclear layer) was significantly different in PwMS compared with HC. RRMS and PPMS subgroups did not differ in the annual atrophy rates. In patients with PPMS, worsening of the AS was significantly associated with increased thinning of the TMV (total macular volume), GCIP (ganglion cell and inner plexiform layer), and ONPL (outer nuclear and outer plexiform layer) (all p-value < 0.05, r > 0.30). For every -0.1% decrease in the TMV, GCIP, and ONPL, the risk of a deterioration in the AS increased by 31% (hazard ratio (HR): 1.309), 11% (HR: 1.112), and 16% (HR: 1.161), respectively. In addition, worsening EDSS in PPMS was significantly associated with the relative annual atrophy rates of pRNFL, TMV, and GCIP (all p-value < 0.05). Disability progression in PPMS can be measured using OCT, and increasing annual atrophy rates of the inner retinal layers are associated with worsening ambulation. OCT is a robust and side-effect-free imaging tool, making it suitable for routine monitoring of PwMS.

Evaluation of the Relationship Between Diabetic Macular Edema and Renal Function in a Latino Population.

Diabetic macular edema (DME) is one of the leading causes of vision impairment. The relationship between DME and estimated glomerular filtration rate (eGFR) has not been clearly evaluated in Hispanic or Latino populations. The objective of this study was to evaluate the eGFR in a Latino population with DME. A cross-sectional, observational, and descriptive study was carried out on the basis of a multicenter phaseIII clinical trial. A total of 82 subjects diagnosed with DME (36 women and 46 men) were included in the study. The mean age was 61.93 ± 6.71years. Mean values of the blood chemistry parameters glycated hemoglobin and eGFR were 7.20 ± 0.95% and 74.42 ± 26.82mL/min/1.73m2, respectively. The time elapsed since diagnosis of diabetes mellitus was 15.30 ± 7.35years, while the duration of DME was 1.41 ± 1.75years. Mean values for central macular thickness (CMT) and total macular volume (TMV) were 440.99 ± 132.22µm and 11.97 ± 2.11mm3, respectively. DME duration had a negative correlation with TMV (Rho- 0.26, p < 0.05) and a positive correlation with mean arterial pressure (Rho0.26, p < 0.05). CMT was correlated with TMV (Rho0.43, p < 0.0001) and visual acuity (Rho0.26, p < 0.05). No significant correlations were observed between eGFR and CMT, TMV, or any demographic variable (p > 0.05). Chronic kidney disease (CKD) was associated with hypertension (OR9.32, p = 0.035), elevated intraocular pressure (IOP) (OR0.03, p = 0.011), and advanced age (OR0.45, p = 0.011). CMT was significantly associated with TMV (β = 27.69, p < 0.0001). We did not find a correlation between eGFR and DME. Our findings suggest that the presence of hypertension is associated with a decrease in the GFR < 60mL/min/1.73m2, and CKD may be associated with advanced age and elevated IOP which may increase the risk for the development of glaucoma. NCT05217680 (clinicaltrials.gov).

Effects of Calcium Dobesilate on Inner Retinal Thickness in Severe Non-proliferative Diabetic Retinopathy

Purpose: To investigate the effect of calcium dobesilate on inner macular thickness measured with optical coherence tomography in the eyes with severe non-proliferative diabetic retinopathy (NPDR).Methods: The study participants were 28 patients (n = 28 eyes) who had severe NPDR without severe diabetic macular edema and who were followed up after treatment with calcium dobesilate for ≥ 3 months. Central macular thickness (CMT), total macular volume (TMV), and ganglion cell complex (GCC) at baseline and the 3 months follow-up were analyzed retrospectively. The matched patients with bilberry dried extract were selected and compared as a control group.Results: In the calcium dobesilate group, the CMT and TMV measured before and 3 months after treatment were 265.36 ± 16.31 µm, 8.72 ± 0.45 mm3 and 262.39 ± 15.13 µm, 8.67 ± 0.46 mm3, respectively. A significant decrease in observation time was observed p = 0.009, p = 0.010). GCC decreased from 106.31 ± 8.16 µm to 105.18 ± 7.53 µm p = 0.036), of which retinal nerve fiber layer decreased from 34.27 ± 3.96 µm to 33.93 ± 3.80 µm p = 0.219), and GCL from 39.47 ± 3.61 µm to 38.87 ± 3.217 µm p = 0.012), inner plexiform layer changed from 32.56 ± 2.24 µm to 32.39 ± 2.14 µm p = 0.211).Conclusions: In patients with severe NPDR, a decrease in inner retinal thickness was observed after 3 months of taking calcium dobesilate, and the ganglion cell layer showed a significant decrease in thickness.

Multimodal Phenomap of Stargardt Disease Integrating Structural, Psychophysical, and Electrophysiologic Measures of Retinal Degeneration

To cluster the diverse phenotypic features of Stargardt disease (STGD) using unsupervised clustering of multimodal retinal structure and function data. Retrospective cross-sectional study. Eyes of subjects with STGD and fundus autofluorescence (FAF), OCT, electroretinography (ERG), and microperimetry (MP) data available within 1year of the baseline evaluation. A total of 46 variables from FAF, OCT, ERG, and MP results were recorded for subjects with STGD as defined per published criteria. Factor analysis of mixed data identified the most informative variables. Unsupervised hierarchical clustering and silhouette analysis identified the optimal number of clusters to classify multimodal phenotypes. Phenotypic clusters of STGD subjects and the corresponding cluster features. We included 52 subjects and 102 eyes with a mean visual acuity (VA) at the time of multimodal testing of 0.69±0.494 logarithm of minimum angle of resolution (20/63 Snellen). We identified 4 clusters of eyes. Compared to the other clusters, cluster 1 (n=16) included younger subjects, VA greater than that of clusters 2 and 3, normal or moderately low total macular volume (TMV), greater preservation of scotopic and photopic ERG responses and fixation stability, less atrophy, and fewer flecks. Cluster 2 (n=49) differed from cluster 1 mainly with less atrophy and relatively stable fixation. Cluster 3 (n=10) included older subjects than clusters 1 and 2 and showed the lowest VA, TMV, ERG responses, and fixation stability, with extensive atrophy. Cluster 4 (n=27) showed better VA, TMV similar to clusters 1 and 2, moderate ERG activity, stable fixation, and moderate-high atrophy and flecks. Reflecting the phenotypic complexity of STGD, an unsupervised clustering approach incorporating phenotypic measures can be used to categorize STGD eyes into distinct clusters. The clusters exhibit differences in structural and functional measures including quantity of flecks, extent of retinal atrophy, visual fixation accuracy, and ERG responses, among other features. If novel pharmacologic, gene, or cell therapy modalities become available in the future, the multimodal phenomap approach may be useful to individualize treatment decisions, and its utility in aiding prognostication requires further evaluation. Proprietary or commercial disclosure may be found after the references.

A CROSS-SECTIONAL, OBSERVATIONAL AND ANALYTICAL STUDY TO DETERMINE TOTAL MACULAR VOLUME AND FOVEAL RETINAL THICKNESS IN PREGNANT WOMEN

INTRODUCTION: Owing to the hemodynamic changes due to hormones during pregnancy, multiple anatomical, physiological and biochemical changes occur in all systems. These changes are transient in nature but may cause permanent damage if not caught early. To evaluate Total Macular Volume a PURPOSE: nd Foveal Retinal Thickness in 3rd trimester Pregnancy between (Normal Pregnant, Pregnancy Induced Hypertensives, Gestational Diabetics) and to compare these values with healthy non-pregnant females of the same age matched group. A total of 140 eyes of 70 patients were evaluated for Total m METHODOLOGY: acular volume and foveal retinal thickness changes using OCT (3D Macula scan) and the results were compared by ANOVA and Paired-T test (SPSS software, version-26.0). Notable difference was noted in Total macular volume and Foveal ret RESULTS: inal thickness between pregnant and nonpregnant. Also, notable difference noted between 3rd trimester healthy pregnant, gestational diabetics and pregnancy induced hypertensives (p value &lt;0.05). Pregnancy summated with Diabetes / Hypertension may lead to permane CONCLUSION: nt damage. Hence awareness and screening of pregnant females' post-partum is necessary.

Neuroprotective influence of macular xanthophylls and retinal integrity on cognitive function among persons with multiple sclerosis

BackgroundNo studies to date have examined if macular xanthophyll accumulation and retinal integrity are independently associated with cognitive function in individuals with multiple sclerosis (MS). This study explored whether macular xanthophyll accumulation and structural morphometry in the retina were associated with behavioral performance and neuroelectric function during a computerized cognitive task among persons with MS and healthy controls (HCs). Methods42 HCs and 42 individuals with MS aged 18–64 years were enrolled. Macular pigment optical density (MPOD) was measured using heterochromatic flicker photometry. Optic disc retinal nerve fiber layer (odRNFL), macular retinal nerve fiber layer, and total macular volume were assessed via optical coherence tomography. Attentional inhibition was assessed using an Eriksen flanker task while underlying neuroelectric function was recorded using event-related potentials. ResultsPersons with MS had a slower reaction time, lower accuracy, and delayed P3 peak latency time during both congruent and incongruent trials compared with HCs. Within the MS group, MPOD explained variance in incongruent P3 peak latency, and odRNFL explained variance in congruent reaction time and congruent P3 peak latency. ConclusionsPersons with MS exhibited poorer attentional inhibition and slower processing speed, yet higher MPOD and odRNFL levels were independently associated with greater attentional inhibition and faster processing speed among persons with MS. Future interventions are necessary to determine if improvements in these metrics may promote cognitive function among persons with MS.

Is retina affected in Huntington's disease? Is optical coherence tomography a good biomarker?

Comparative cross-sectional study of retinal parameters in Huntington's disease and their evaluation as marker of disease progression. Huntington's disease (HD) is a neurodegenerative disorder with dominant motor and neuropsychiatric symptoms. Involvement of sensory functions in HD has been investigated, however studies of retinal pathology are incongruent. Effect sizes of previous findings were not published. OCT data of the subjects in previous studies have not been published. Additional examination of structural and functional parameters of retina in larger sample of patients with HD is warranted. This is a prospective cross-sectional study that included: peripapillary retinal nerve fiber layer thickness (RNFL) and total macular volume (TMV) measured by spectral domain optical coherence tomography (OCT) of retina, Pelli-Robson Contrast Sensitivity test, Farnsworth 15 Hue Color discrimination test, ophthalmology examination and Unified Huntington's disease Rating Scale (UHDRS). Ninety-four eyes of 41 HD patients examined in total 47 visits and 82 eyes of 41 healthy controls (HC) examined in total 41 visits were included. Analyses were performed by repeated measures linear mixed effects model with age and gender as covariates. False discovery rate was corrected by Benjamini-Hochberg procedure. HD group included 21 males and 20 females (age 50.6±12.0 years [mean ± standard deviation], disease duration 7.1±3.6 years, CAG triplet repeats 44.1±2.4). UHDRS Total Motor Score (TMS) was 30.0±12.3 and Total Functional Capacity 8.2±3.2. Control group (HC) included 19 males and 22 females with age 48.2±10.3 years. There was no statistically significant difference between HD and HC in age. The effect of the disease was not significant in temporal segment RNFL thickness. It was significant in the mean RNFL thickness and TMV, however not passing false discovery rate adjustment and with small effect size. In the HD group, the effect of disease duration and TMS was not significant. The Contrast Sensitivity test in HD was within normal limits and the 15-hue-test in HD did not reveal any specific pathology. The results of our study support possible diffuse retinal changes in global RNFL layer and in macula in Huntington's disease, however, these changes are small and not suitable as a biomarker for disease progression. We found no other structural or functional changes in retina of Huntington's disease patients using RNFL layer and macular volume spectral domain OCT and Contrast Sensitivity Test and 15-hue-test. Current retinal parameters are not appropriate for monitoring HD disease progression.

Retinal neurodegeneration in metabolic syndrome: a spectral optical coherence tomography study.

To evaluate the effects of metabolic syndrome (MetS) on retinal neurodegeneration by optical coherence tomography (OCT). Patients diagnosed as MetS were compared with the age and sex-matched healthy control group (CG). Waist circumference measurements, fasting serological biochemical tests, and systemic blood pressures of all participants were evaluated. The MetS group was divided into 3 subgroups according to the number of MetS components: hypertension, diabetes mellitus, dyslipidemia (low-, high-density lipoprotein, hypertriglyceridemia), and visceral obesity findings; 3-component MetS3, 4-component MetS4, and all-component MetS5. All patients underwent complete eye examination and spectral OCT retinal imaging. Totally 58 eyes of 58 patients were included in the MetS group and 63 eyes of 63 age and sex-matched healthy subjects were included in CG. MetS group was composed of 22 subjects in MetS3, 21 subjects in MetS4, and 15 subjects in the MetS5 subgroup. Mean foveal thickness (MetS, 218.7±23.1 µm vs CG, 228.8±21.9 µm, P=0.015), mean inferior (MetS, 283.4±17.0 µm vs CG, 288.7±38.4 µm, P=0.002), superior (MetS, 287.0±18.5 µm vs CG 297.3±17.1 µm, P=0.001), nasal (MetS 287.3±16.7 µm vs CG 297.9±13.9 µm, P=0.000) and temporal (274.5±17.6 µm vs CG 285.6±13.6 µm, P=0.000) thickness in the 3 mm Early Treatment of Diabetic Retinopathy Study (ETDRS) circle was significantly lower in the MetS group. There was no statistically significant difference in the mean inferior, superior, nasal, and temporal thickness of 6 mm ETDRS circle, total macular volume, peripapillary and macular retinal nerve fiber layer, macular ganglion cell layer with inner plexiform layer, and ganglion cell complex. No statistically significant difference was found in these values ​​between the MetS3, MetS4, and the MetS5 groups. A significant reduction in central macular region thickness in MetS is detected and macular thickness is more susceptible to MetS induced neurodegeneration than peripapillary retinal nerve fiber layer.

Total macular volume as a potential biomarker in the assessment of anti-VEGF response in patients with diabetic macular edema: real-life data analysis

Aim: To evaluate the functional and anatomic efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with diabetic macular edema (DME) and investigate the association between central macular thickness (CMT) and total macular volume (TMV) in real-life settings.Material and Method: In this retrospective, observational, longitudinal study 38 eyes of 23 consecutive patients with center-involving DME were included. A loading phase of three monthly intravitreal anti-VEGF injections was initiated, followed by anti-VEGF injections if needed as per clinicians’ discretion. Results: Mean Early Treatment Diabetic Retinopathy Study (ETDRS) letters gained was 3.2 letters at month 12. The reduction in the mean of CMT and TMV were 60 μm and 1.33 mm3 respectively at the end of 12 months. Best-corrected visual acuity (BCVA) was negatively correlated with CMT (r=-0.573, p &amp;lt; 0.01) and TMV (r=-0.533, p &amp;lt; 0.01) initially. There was a statistically significant positive correlation between the CMT and the TMV initially (r=0.765, p &amp;lt; 0.01) and month 12 (r=0.937, p &amp;lt; 0.01). Baseline TMV was found to be more predictive of treatment response at the 9th month than baseline CMT. Conclusion: It is demonstrated that TMV may be a suitable biomarker in the assessment of treatment response of the macular region when regarded as a complete three-dimensional macular unit instead of central vertical thickness only. Although the present study contributes to a better understanding of managing DME in real-life settings, further prospective, and controlled investigations are needed.

Relationship between Glycosylated Haemoglobin Levels and Macular Thickness on Optical Coherence Tomography in Type 2 Diabetic Patients: A Cross-sectional Study

Introduction: Diabetic Macular Oedema (ME) is the main cause of poor visual acuity due to the breakdown of the inner and/or outer Blood Retinal Barrier (BRB). This can occur at any stage of Diabetic Retinopathy (DR) due to increased vascular permeability from retinal capillaries, as well as from microaneurysms and Intraretinal Microvascular Abnormalities (IRMAs). A high level of Glycosylated Haemoglobin (HbA1c) is a well known risk factor for diabetic ME. Aim: To evaluate the relationship between glycosylated Haemoglobin (Hb) and macular thickness on Optical Coherence Tomography (OCT) in patients with Type 2 Diabetes Mellitus (T2DM). Materials and Methods: A cross-sectional study was in the Department of Ophthalmology at RL Jalappa Hospital, Kolar, Karnataka, India. The study duration was one year and eight months, conducted from January 2021 to September 2022. A total of 162 eyes of 81 patients with Diabetes Mellitus (DM) were included. Patients were assessed for age, gender, duration of diabetes, subfield macular thickness, total macular volume as measured by Optical Coherence Tomography (OCT), and HbA1c levels. Pearson’s correlation and paired t-test were used to identify the mean difference between paired data. A p-value &lt;0.05 was considered statistically significant. Results: Out of 81 patients, 52 (64.2%) were males and 29 (35.8%) were females, with a mean age of 59.36±8.98 years (range 40-81 years) and a duration of diabetes of 14.61±4.2 years. The mean HbA1c level was 8.18±1.47% (range 5.5-12.1). A significant positive correlation was observed between central subfield thickness and total macular volume with HbA1c among both eyes (p-value=0.001). This correlation was more prominent in patients with HbA1c values &gt;8% compared to those with HbA1c values &lt;8% (p-value=0.001). Additionally, a positive correlation was observed between duration of diabetes and right central macular thickness (p-value=0.046) and HbA1c levels (p-value=0.027). Age did not have a major influence on central subfield thickness and total macular volume, but it did show a positive Pearson’s correlation with HbA1c levels (p-value=0.008). Conclusion: A significant positive correlation was observed between central subfield thickness and total macular volume in both eyes with HbA1c levels. Patients with HbA1c levels &gt;8% and a longer duration of diabetes exhibited increased macular thickness and total macular volume as measured by OCT, which was also observed in patients with severe non proliferative DR and proliferative DR.

Effect of fingolimod therapy on quantitative macular changes among patients with relapsing-remitting multiple sclerosis: a four-year follow-up study from Oman

PurposeFingolimod (FTY-720) is an immunomodulatory oral agent approved for the treatment of relapsing-remitting multiple sclerosis (RRMS); however, several clinical trials have shown that some recipients may develop macular oedema (ME) as an adverse reaction. As there are no studies assessing the long-term (> 1 year) effect of fingolimod on the macula, this study aimed to evaluate the quantitative effect of fingolimod therapy on central macular thickness (CMT) and total macular volume (TMV) over a four-year period.MethodsThis retrospective longitudinal cohort study was performed between January 2014 and December 2018. A total of 21 patients with RRMS receiving fingolimod therapy were recruited and followed-up over 4 years to assess CMT and TMV changes measured using spectral domain optical coherence tomography. A paired sample t-test was used to compare mean CMT and TMV values calculated at baseline prior to the initiation of fingolimod therapy with those observed at three, six, 12, 24, 36 and 48 months of treatment.ResultsNone of the patients developed ME over the four-year study period. In addition, there was no significant difference in baseline mean CMT values and those observed at a four-year follow-up. Although mean TMV values remained constant initially, there was a significant decrease towards the end of the study period.ConclusionsLong-term fingolimod therapy did not result in significant CFT changes. While there was a reduction in TMV towards the end of the study, this is likely due to the degenerative effect of the disease itself on the nerve fibres of the retina.

Expression of poly(ADP-ribose) polymerase-1 gene and optical coherence tomography angiographic parameters among patients with multiple sclerosis

Back ground/aimsTo analyse different parameters of the macula, disc and their vascular affection using optical coherence tomography (OCT) and angiography (OCT-A) in patients with multiple sclerosis (MS) correlating these changes...