Total Retinal Volume Research Articles

Retinal Vascular Changes in Heart Failure with Preserved Ejection Fraction Using Optical Coherence Tomography Angiography.

Background: Systemic microvascular regression and dysfunction are considered important underlying mechanisms in heart failure with preserved ejection fraction (HFpEF), but retinal changes are unknown. Methods: This prospective study aimed to investigate whether retinal microvascular and structural parameters assessed using optical coherence tomography angiography (OCT-A) differ between patients with HFpEF and control individuals (i.e., capillary vessel density, thickness of retina layers). We also aimed to assess the associations of retinal parameters with clinical and echocardiographic parameters in HFpEF. HFpEF patients, but not controls, underwent echocardiography. Macula-centered 6 × 6 mm volume scans were computed of both eyes. Results: Twenty-two HFpEF patients and 24 controls without known HFpEF were evaluated, with an age of 74 [68-80] vs. 68 [58-77] years (p = 0.027), and 73% vs. 42% females (p = 0.034), respectively. HFpEF patients showed vascular degeneration compared to controls, depicted by lower macular vessel density (p < 0.001) and macular ganglion cell-inner plexiform layer thickness (p = 0.025), and a trend towards lower total retinal volume (p = 0.050) on OCT-A. In HFpEF, a lower total retinal volume was associated with markers of diastolic dysfunction (septal e', septal and average E/e': R2 = 0.38, 0.36, 0.25, respectively; all p < 0.05), even after adjustment for age, sex, diabetes mellitus, or atrial fibrillation. Conclusions: Patients with HFpEF showed clear levels of retinal vascular changes compared to control individuals, and retinal alterations appeared to be associated with markers of more severe diastolic dysfunction in HFpEF. OCT-A may therefore be a promising technique for monitoring systemic microvascular regression and cardiac diastolic dysfunction.

Optic disc edema during strict 6° head-down tilt bed rest is related to one-carbon metabolism pathway genetics and optic cup volume.

Some astronauts on International Space Station missions experience neuroophthalmological pathologies as part of spaceflight associated neuro-ocular syndrome (SANS). Strict head-down tilt bed rest (HDTBR) is a spaceflight analog that replicates SANS findings and those who had 3-4 risk alleles (G and C alleles from the methionine synthase reductase [MTRR] A66G and serine hydroxymethyltransferase [SHMT1] C1420T, respectively) as compared to 1-2 risk alleles, had a greater increase in total retinal thickness (TRT). The objective of this study was to identify factors that contribute to the individual variability of the development of SANS in a 60d HDTBR at the German Aerospace Center's:envihab facility, Cologne Germany. 22 of 24 subjects who participated in the HDTBR study provided blood samples for genetic analysis. Total retinal thickness and optic cup volume were measured before and after bed rest. Subjects with 3-4 versus 0-2 risk alleles had greater ΔTRT during and after bed rest, and the model improved with the addition of baseline optic cup volume. This bed rest study confirms that variants of MTRR and SHMT1 are associated with ocular pathologies. Subjects with more risk alleles had the greatest HDTBR-induced ΔTRT, reaffirming that genetics predispose some individuals to developing SANS. Preflight optic cup volume and genetics better predict ΔTRT than either one alone. Whether nutritional supplements can override the genetic influences on biochemistry, physiology, and pathophysiology remains to be tested. These findings have significant implications for both aerospace and terrestrial medicine.

TLR4 GENE POLYMORPHISM rs2149356 IN TYPE 2 DIABETES - POSSIBLE RELATIONSHIP WITH DIABETIC MACULAR EDEMA

Background. Polymorphisms in the non-coding regions of the TLR4 gene are known to be associated with the risk of ocular complications of type 2 diabetes (T2DM), with some polymorphisms having no association, others increasing the risk, and some reducing the risk of complications.&#x0D; Aim: to establish the association of the TLR4 gene polymorphism rs2149356 with diabetic retinopathy (DR) and diabetic macular edema (DME) in T2DM.&#x0D; Materials and methods. The study included 81 patients (81 eyes) with T2DM, in whom, according to the guidelines of the American Academy of Ophthalmology (2002), DR and DME were detected, the control group consisted of 50 patients (50 eyes) with T2DM, normalized carbohydrate metabolism, DR 0 (no retinopathy) and absent DME. Genotypes of rs2149356 were determined by real-time polymerase chain reaction using the Gene Amp® PCR System 7500 amplifier (Applied Biosystems, USA) and TaqMan Mutation Detection Assays Life-Technology (USA). MedStat and MedCalc v.15.1 software packages (MedCalc Software bvba) were used for statistical research.&#x0D; Results. In this study, no association of the genetic polymorphism rs2149356 of the TLR4 gene with the development of DR and DME in T2DM was found (p=0.326). Stratification by stages of DR showed no dependence of the distribution of genotypes, while according to the degree of DME, the distribution of genotypes was definitely different in DME 3. Thus, among the carriers of the ancestral genotype G/G, none of DME 3 was found, the borderline level of the total retinal volume (TRV) was 6.7 mm3, above which DME 1 or DME 2 was determined. All carriers of the heterozygote G/T had DME 3, and for carriers of the minor homozygote T/T, two threshold values of TRV were determined: above 6.7 mm3, DME 1 or DME 2 was determined, and higher than 8.7 mm3 – DME 3. Analysis of the relationship between the rs2149356 TLR4 and the phenotype of patients showed greater central retinal thickness and TRV in heterozygous and minor homozygous T/T carriers, which corresponded to greater retinal damage compared to ancestral homozygous G/G carriers (p&lt;0.001).&#x0D; Conclusion. Data were obtained on the association of diabetic retinal damage with the rs2149356 TLR4 – retinal edema was more pronounced in carriers of the T allele.

Diurnal variation of optical coherence tomography–based macular fluid in exudative age-related macular degeneration

BackgroundSignificant diurnal fluctuation of optical coherence tomography (OCT)-based macular fluid occurs in patients with several macular conditions including diabetic macular edema (DME) and cystoid macular edema due to retinal venous occlusion (RVO). OCT imaging and analysis of macular fluid status plays a central role in clinical management of exudative age-related macular degeneration (eAMD), however diurnal variation of eAMD OCT findings has not yet been formally studied. Herein, we investigate whether clinically meaningful fluctuation of OCT-based macular fluid occurs in patients with eAMD.MethodsProspective observational study. Patients with eAMD and intra- and/or sub-retinal fluid on early AM OCT were enrolled to receive two consecutive OCT scans at least four hours later. Retinal layers were manually segmented on all OCT rasters and AM-to-PM and PM-to-PM image pairs were analyzed for total retinal and neurosensory retinal volume changes within the central 1 and 3 mm ETDRS subfields. Finally, two masked retinal specialists analyzed all OCT image pairs for qualitative differences that may impact clinical management.Results21 patients with eAMD and fluid on OCT were recruited between January 2020 and November 2021. There was no mean difference between AM and PM central 3 mm total retinal volume (p = 0.56), central 3 mm neurosensory retinal volume (p = 0.25), central 1 mm total retinal mean thickness (p = 0.96), or central 1 mm neurosensory retinal mean thickness (p = 0.63), nor were any differences identified in PM-to-PM control comparisons. Qualitative analysis by two masked experts identified no clinically significant differences between any AM-to-PM OCT image pairs.ConclusionsNo significant diurnal variation in OCT-based macular fluid or thickness was identified in patients with eAMD, either quantitatively or qualitatively.

The use of OCT to detect signs of intracranial hypertension in patients with sagittal suture synostosis: Reference values and correlations

PurposeTo obtain pediatric normative reference values and determine whether optical coherence tomography (OCT) corresponds better with clinical signs of intracranial hypertension (ICH) compared to the traditional screening method fundoscopy in a large cohort of one type of single suture craniosynostosis.MethodsControl subjects without optic nerve diseases and isolated sagittal synostosis patients aged 3–10 years who underwent fundoscopy and OCT were included in this prospective cohort study. Normative reference values were obtained through bootstrap analysis. Main outcome was the association between peripapillary total retinal thickness (TRT) and total retinal volume (TRV) and appearance on fundoscopy. Signs and symptoms suggestive of ICH, including skull growth arrest, fingerprinting, and headache, were scored.ResultsSixty-four healthy controls and 93 isolated sagittal synostosis patients were included. Normative cut-off values for mean TRT are < 256 μm and > 504 μm and for mean TRV < 0.21 mm3 and > 0.39 mm3. TRT was increased in 16 (17%) and TRV in 15 (16%) of 93 patients, compared to only 4 patients with papilledema on fundoscopy (4%). Both parameters were associated with papilledema on fundoscopy (OR = 16.7, p = 0.02, and OR = 18.2, p = 0.01). Skull growth arrest was significantly associated with abnormal OCT parameters (OR = 13.65, p < 0.01).ConclusionsThe established cut-off points can be applied to screen for ICH in pediatrics. The present study detected abnormalities with OCT more frequent than with fundoscopy, which were associated with skull growth arrest. Therefore, a combination of OCT, fundoscopy, and skull growth arrest can improve clinical decision-making in craniosynostosis.

Effectiveness of Panretinal Photocoagulation Plus Intravitreal Anti-VEGF Treatment Against PRP Alone for Diabetic Retinopathy: A Systematic Review With Meta-Analysis.

ObjectiveTo compare the efficacy and safety of panretinal photocoagulation (PRP) combined with intravitreal anti-vascular endothelial growth factor (anti-VEGF) against PRP monotherapy for diabetic retinopathy (DR).MethodsWe searched Pubmed, Cochrane Library, Web of Science, Embase, and Science Direct Register of Controlled Trials from April 2011 to January 2021 to identify the randomized trials that compared the efficacy and safety between PRP combined with intravitreal anti-VEGF and PRP monotherapy for DR. We searched in the following databases between April 2011 and January 2021: Pubmed, Cochrane Library, Web of Science, Embase, and Science Direct without any restriction of countries or article type. The outcome measures were the best-corrected visual acuity (BCVA), neovascularization on the disc (NVD), neovascularization elsewhere (NVE), central macula thickness (CMT), and total retinal volume over time (FAS), and we also observed the adverse events (AEs) between the two groups.ResultsA total of 351 studies were identified, of which 11 studies were included in this meta-analysis (N = 1,182 eyes). Compared with PRP monotherapy, PRP plus anti-VEGF combination treatment produced a mean reduction in BCVA in units of logMAR of -0.23 [95% CI -0.32, -0.15] or a mean improvement in BCVA in units of letters of 4.99 [95% CI 3.79, 6.19], and also yielded a mean reduction in NVD of -28.41 [95% CI -30.30, -26.52], in NVE of -1.33 [95% CI -1.52, -1.14], in CMT of -1.33 [95% CI -1.52, -1.14], or in total FAS. No significant difference was observed on the risk of AEs as vitreous hemorrhage, elevation in intraocular pressure, and cataract between the two different treatments.ConclusionPRP with anti-VEGF combination treatment can achieve the ideal efficacy on DR by improving BCVA and NV regression, with no potential increased incidence of AEs, which proves that the combination therapy is an efficient therapeutic strategy that could improve the management of patients with DR.

Retinal damage related to high-intensity light-emitting diode exposure: An in vivo study

The objective of this investigation was to evaluate the effects of high-intensity light-emitting diode (LED) light from a curing device on the retinas of Wistar rats. Six male Wistar rats were used, and their ocular structures were the focus of this study. During the photostimulation of each animal, the right eye of the animal, considered the control sample, was covered with a removable polyvinyl chloride cap, and the contralateral eye, the experimental sample, was exposed to high-intensity LED light, 3200 mW/cm2 (VALO Ortho; Ultradent Products, South Jordan, Utah) for 144 seconds from a distance of 30 cm. The animals were exposed to the LED light 3 times on the same day to investigate if any acute inflammatory changes in the retina occurred. Seven days after the photostimulation sessions, the animals were anesthetized and perfused with paraformaldehyde solution. After which, the eyes were resected and processed histologically. The histologic sections were analyzed stereologically and histomorphometrically to measure the parameters of the retina under investigation. There was a statistically significant increase in total retinal volume in the experimental group because of the increased volume of the ganglion cell layers, inner plexiform layers, outer nuclear layers, and the cone and rod extensions. There was no statistically significant difference in terms of density. However, there was a statistically significant increase in the nuclear area of the cells in all the studied layers in the group exposed to high-intensity LED light. In addition, hyperchromatic cells that are suggestive of pyknosis were observed. An acute but short protocol of exposure of high-intensity LED light to the eye caused morphometric alterations in the retinal structures, specifically in the nuclear area of the photosensitive cells.

Correlation of Volume of Macular Edema with Retinal Tomography Features in Diabetic Retinopathy Eyes.

Optical coherence tomography (OCT) enables the detection of macular edema, a significant pathological outcome of diabetic retinopathy (DR). The aim of the study was to correlate edema volume with the severity of diabetic retinopathy and response to treatment with intravitreal injections (compared to baseline). Diabetic retinopathy (DR; n = 181) eyes were imaged with OCT (Heidelberg Engineering, Germany). They were grouped as responders (a decrease in thickness after intravitreal injection of Bevacizumab), non-responders (persistent edema or reduced decrease in thickness), recurrent (recurrence of edema after injection), and treatment naïve (no change in edema at follow-up without any injection). The post-treatment imaging of eyes was included for all groups, except for the treatment naïve group. All eyes underwent a 9 × 6 mm raster scan to measure the edema volume (EV). Central foveal thickness (CFT), central foveal volume (CFV), and total retinal volume (TRV) were obtained from the early treatment diabetic retinopathy study (ETDRS) map. The median EV increased with DR severity, with PDR having the greatest EV (4.01 mm3). This correlated positively with TRV (p < 0.001). Median CFV and CFT were the greatest in severe NPDR. Median EV was the greatest in the recurrent eyes (4.675 mm3) and lowest (1.6 mm3) in the treatment naïve group. Responders and non-responders groups had median values of 3.65 and 3.93 mm3, respectively. This trend was not observed with CFV, CFT, and TRV. A linear regression yielded threshold values of CFV (~0.3 mm3), CFT (~386 µm), and TRV (~9.06 mm3), above which EV may be detected by the current scanner. In this study, EV provided a better distinction between the response groups when compared to retinal tomography parameters. The EV increased with disease severity. Thus, EV can be a more precise parameter to identify subclinical edema and aid in better treatment planning.

A normative database of A-scan data using the Heidelberg Spectralis Spectral Domain Optical Coherence Tomography machine.

PurposeTo develop the first normative database of macular and circumpapillary scans with reference values at the level of the A-scan using the Heidelberg Spectralis Optical Coherence Tomography (OCT) machine.MethodsThis study is a retrospective cross sectional analysis of macular and circumpapillary OCT scans of healthy individuals. All participants had a full ophthalmic examination, including best corrected visual acuity, intraocular pressure, biomicroscopy, posterior segment examination and OCT scan. The volume and thickness of each of the nine Early Treatment Diabetic Retinopathy zones at the macula were analysed for the total retinal thickness, retinal nerve fibre layer (RNFL), ganglion cell layer (GCL) and inner plexiform layer (IPL). The thickness of the circumpapillary RNFL was analysed at the disc. Associations between age, gender, refractive error and OCT measurements were explored. De-identified A-scans were extracted from the OCT machine as separate tab-separated text file and made available according to the data sharing statement.ResultsTwo-hundred eyes from 146 participants were included of which 69 (47%) were female. The mean age (SD) was 48.52 (17.52). Participants were evenly distributed across four age groups and represented nine broad ethnic groups in proportions comparable to the local distribution. All the macular scans were 20° x 20° (5.9 mm x 5.9 mm), with a total scan density between 12,800 and 49,152 A-scans. The peripapillary scans were all 12° (3.5 mm), at a scan density of 768 A-scans. The mean retinal, GCL and IPL volumes were significantly greater in males than females. Mean peripapillary RNFL thickness did not differ significantly between males and females. Age and total retinal volume (r = –0.2561, P = 0.0003), GCL volume (–0.2911, P < 0.0001) and IPL volume (–0.3194, P < 0.0001) were negatively correlated. The IPL had the strongest three significant negatively associated segments; superior inner IPL (r = –0.3444, P < 0.0001), nasal outer IPL (r = –0.3217, P < 0.0001) and inferior inner IPL (r = –0.3179, P < 0.0001). The temporal inner macular RNFL showed a statistically significant positive correlation (r = 0.1929, P = 0.0062) with age. The only significant association between age and thickness at the peripapillary disc scan was the superior temporal sector (r = –0.1910, P = 0.0067). All retinal layers were negatively correlated for refractive error, except for the central RNFL which was positively correlated (r = 0.1426, P = 0.044).ConclusionThis study provides a normative database of macular and circumpapillary scans with reference values at the level of the A-scan using the Heidelberg Spectralis Optical Coherence Tomography (OCT) machine.

Microcystic macular degeneration in autosomal hereditary optic neuropathies: A cross-sectional retrospective study

Patients with autosomal optic neuropathies (AON) may develop microcystic macular degeneration (MMD), observed on retinal optical coherence tomography (OCT) examination. This study aimed to report the prevalence of MMD in AON patients and to assess the consequences of MMD on retinal architecture. Retrospective single-center study conducted between 2001 and 2018. Patients affected by AON secondary to OPA1 or WFS1 gene mutations were included. The following data were collected: visual acuity, macular volume, vitreomacular interface and presence or absence of MMD. Forty-two subjects (34 OPA1, 8 WFS1) were included. MMD was found in 12 (29%) patients, i.e. 6 of the 8 WFS1 patients (75%) and 6 of the 34 OPA1 patients (17%). In cases with MMD, total retinal volume was greater (P=0.02) in accordance with thickening of the inner nuclear layer (P<0.001). WFS1 subjects had the highest total retinal volume (P=0.01), in relation to a thickening of the inner plexiform layer (P=0.02), inner nuclear layer (P<0.001) and outer plexiform layer (P=0.002). MMD was significantly associated with the WFS1 mutation (P<0.001). No significant association was found between the presence of vitreomacular adhesion and MMD. MMD was found in 29% of patients affected by AON and was more frequent in cases with a WFS1 gene mutation. MMD appears to be related to primary ganglion cell degeneration and Müller cell dysfunction. The vitreomacular interface does not appear to play a role in the occurrence of MMD.

Associations between Macular OCT Angiography and Nonproliferative Diabetic Retinopathy in Young Patients with Type 1 Diabetes Mellitus.

Methods OCTA of both eyes was performed in a cross-sectional study of 14 to 30-year-old individuals with at least 10-year duration of T1D and controls recruited from the Norwegian Atherosclerosis and Childhood Diabetes (ACD) study. Vessel density (VD) and foveal avascular zone (FAZ) area in the superficial and deep capillary plexus (SCP and DCP), total retinal volume (TRV), and central macular thickness (CMT) were calculated using automated software. Univariate and multivariate ordered logistic regression (OLR) models were used accordingly. Results We included 168 control eyes and 315 T1D eyes. Lower VD in DCP (OR 0.65, 95% CI 0.51–0.83), longer diabetes duration (OR 1.51, 95% CI 1.22–1.87), and higher waist circumference (OR 1.08, 95% CI 1.02–1.14) were significantly associated with progression of NPDR. VD in SCP and DCP were significantly lower in T1D patients without diabetic retinopathy than in controls. Conclusions Sparser VD in DCP is significantly associated with severity of NPDR, supporting that OCTA might detect the earliest signs of NPDR before it is visible by ophthalmoscopy.

Efficacy of intravitreal Lucentis injection on major and macular branch retinal vein occlusion

BackgroundThe objective of our study was to assess the efficacy of intravitreal Lucentis injection on major and macular branch retinal vein occlusion (BRVO).MethodsIn this retrospective analysis, 43 patients (major BRVO n = 24; macular BRVO, n = 19) were treated with intravitreal injection of Lucentis with a 1 + PRN regimen, which is diagnosed by fluorescein fundus angiography (FFA). “1 + PRN”, namely, one intravitreal injection of Lucentis at the baseline, and then continue or stop according to the condition of the patient. The following observation indexes were measured at baseline and follow-up (1–6 months): best corrected visual acuity (BCVA), foveal thickness (CFT), total retinal volume with macular diameter of 6 mm. During the follow-up, repeated injections were given according to patients’ demand, and the number of injections was recorded.ResultThe observation indexes of patients with BRVO were significantly improved after 6 months of Lucentis treatment in both major and macular groups, including BCVA, CFT and the retinal volume of the 6 mm-diameter macula. Interestingly, there were significant differences in the therapeutic effect between the two groups, and the macular group had better therapeutic effect than the major group with the less number of repeated injections.ConclusionsTo sum up, intravitreal injection of Lucentis was effective for both major and macular BRVO, and the efficacy in macular subtype group was better than that in major subtype group with the more obviously improvement and the less number of injections.

Segmented Macular Layer Volumes from Spectral Domain Optical Coherence Tomography in 184 Adult Twins: Associations With Age and Heritability.

PurposeTo investigate segmented macular layer volumes from a healthy adult twin cohort (TwinsUK), exploring changes with age and heritability.MethodsMacular spectral domain optical coherence tomography images were acquired from monozygotic (MZ) and dizygotic (DZ) twins in a cross-sectional study. The following layer volumes were derived for circles of 3 and 6 mm diameter around the foveal center, using automated segmentation software: retinal nerve fiber layer (RNFL), ganglion cell–inner plexiform layer (GCIPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptors (PR), retinal pigment epithelium (RPE), and total retinal volume (TRV). Correlation coefficients (intereye; age; intrapair for MZ and DZ pairs) were quantified; heritability was estimated using structural equation modeling.ResultsScans from 184 participants were included. Intereye correlation was highest for TRV and GCIPL. Negative correlations with age (for 3- or 6-mm areas, or both) were observed for TRV, RNFL, GCIPL, and INL. Positive correlations were observed for PR, RPE, and OPL. For all layers, intrapair correlation was greater for MZ than DZ pairs. Heritability estimates were highest (>80%) for TRV and GCIPL volume, and lowest for RPE volume.ConclusionsAlthough TRV was negatively correlated with age, all layers did not show negative correlation. Some inner layers thinned with age, whereas some outer volumes increased (not the ONL). Reduced RPE phagocytic function with age and remodeling in the OPL could be contributing factors. Heritability estimates were highest for inner retinal layers (particularly GCIPL), and lowest for RPE volume.

Retinal neurodegeneration in patients with end-stage renal disease assessed by spectral-domain optical coherence tomography

Spectral-domain optical coherence tomography (SD-OCT) represents a reliable tool for retinal layer volume and thickness measurement. The aim of this study was to evaluate retinal changes indicating neurodegenerative processes in patients with end-stage renal disease (ESRD) compared to healthy controls. This was a cross-sectional, single-center study comprising 32 ESRD patients and 38 controls. Sectoral retinal nerve fiber layer (RNFL) thickness and retinal layer volumes were obtained by SD-OCT. Age- and gender-adjusted retinal layer volumes such as total retinal volume (p = 0.037), ganglion cell layer volume (GCL, p = 0.003), ganglion cell layer – inner plexiform layer volume (GCL-IPL, p = 0.005) and inner retinal layer volume (IRL, p = 0.042) of the right eye were lower in ESRD patients. Inner plexiform layer volume of both eyes (IPL, right eye: p = 0.017; left eye: 0.044) was reduced, as was RNFL thickness in the temporal superior sector (right eye: p = 0.016). A subgroup analysis excluding patients with diabetes revealed that GCL (p = 0.014) and GCL-IPL volume of the right eye (p = 0.024) and temporal superior sector of the RNFL scan (p = 0.021) in ESRD patients were still significantly thinner. We observed a decrease in several retinal layer volumes and temporal RNFL thickness indicative of retinal neurodegenerative processes in patients with ESRD.

Evidence of neurodegeneration in individuals with only mildly elevated blood pressure.

Initiation of antihypertensive drug treatment in low-risk individuals with grade 1 hypertension is under debate. The aim of this study was to examine the impact of mildly elevated blood pressure (BP) on early neurodegenerative processes independent of ageing. Sixty-two individuals were included in this study: 25 young (aged <40 years) and 37 older (aged ≥40 years) individuals at low cardiovascular risk and grade 1 hypertension at most. Macular retinal layer volumes of both eyes were determined by SD-OCT. Total retinal volume but also each inner retinal layer volume separately including retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and GCL-IPL were measured in each individual. Retinal layer volumes were lower among older individuals compared with young individuals (RNFL right eye: P = 0.037/left eye: P = 0.021; GCL and GCL-IPL: both eyes P < 0.001; IPL right eye: P = 0.005/left eye: P = 0.002; total retinal volume: both eyes P = 0.002) and there was an inverse correlation between retinal layer volumes and age. Partial correlation analysis, excluding age as a cofactor, revealed an inverse association between retinal layer volumes and DBP. In multiple regression analysis, DBP was identified as a determinant of retinal neurodegenerative processes. In the current study, we observed an inverse association between retinal neurodegenerative processes and DBP, suggesting that BP-lowering therapy by early antihypertensive drug-treatment might be beneficial to avoid early neurodegeneration.

Longitudinal reproducibility of spectral domain optical coherence tomography in children with physiologic cupping and stable glaucoma

To determine whether Spectralis (Heidelberg, Germany) spectral domain optical coherence tomography (SD-OCT) measurements are reproducible over time in children with physiologic cupping and stable glaucoma. Subjects were identified from a subset of participants in an earlier retrospective study conducted by our group and included children (<18years of age) with physiologic cupping and stable primary congenital glaucoma (PCG) having had at least 2 SD-OCTs over a period of more than 1 between April 2010 and September 2015. Thicknesses of average peripapillary retinal nerve fiber layer (pRNFL) and six individual sectors and volumes of three segmented retinal layers and total retina were measured. Spectralis review software was used for segmentation. Intraclass correlation coefficients (ICC) and coefficient of variation (COV) were calculated. A total of 35 eyes of 35 children were included: 15 eyes had physiologic cupping; 20 eyes, PCG. Mean ages at initial SD-OCT were 11.2±3.3years and 9.7±3.3, respectively; mean intervals between first and last imaging were 2.2±1.1 and 3.0±1.4years, respectively. ICCs across three visits for both groups for average and sectoral pRNFL thicknesses were 0.887-0.997 and for segmented retinal volumes were 0.806-0.993. ICCs for total retinal volume for physiologic cupping and PCG were 0.993 and 0.954, respectively. COVs for average pRNFL thickness were 0.9% and 1.7%, respectively. For all other measurements, COVs ranged from 0.3% to 5.4%. Reproducibility of longitudinal SD-OCT measurements for average pRNFL thickness in children with stable glaucoma over about 2years is comparable to short-term reproducibility (COV) in normal children (1.16%) and normal and glaucoma adults (1.62%-3.4%).

Short-term effect of intravitreal conbercept injection on major and macular branch retinal vein occlusion.

ObjectiveTo evaluate the effectiveness of intravitreal conbercept injection on major and macular branch retinal vein occlusion (BRVO).MethodsThis retrospective analysis involved 43 patients with BRVO (major BRVO n = 24; macular BRVO, n = 19) who were diagnosed by fluorescein fundus angiography (FFA) and injected with intravitreal conbercept. The following outcomes were measured at baseline and follow-up (1-6 months): best-corrected visual acuity (BCVA), central foveal thickness (CFT), total retinal volume in a 6-mm diameter section of the macula, choroidal thickness under the central fovea of the macula, relative area of retinal hemorrhage, complications, and times when repeated injection was performed.ResultsThere were significant differences between the two groups in terms of BCVA, CFT, and total retinal volume in a 6-mm diameter section of the macula at 6 months after treatment. Choroidal thickness under the central fovea of the macula and relative area of retinal hemorrhage showed no significant differences between the two groups at 6 months after treatment; however, they significantly differed from baseline measurements.ConclusionIn general, intravitreal injection of conbercept may have a better short-term effect in patients with macular BRVO than in patients with major BRVO.

The thickness and volume of the choroid, outer retinal layers and retinal pigment epithelium layer changes in patients with diabetic retinopathy.

To evaluate the thickness and volume changes of the choroidal, outer retinal layers (ORL) and retinal pigment epithelium (RPE) in patients with diabetic retinopathy (DR) using optical coherence tomography (OCT) and correlate them with visual acuity. We carried out a retrospective observational case series. Consecutive DR patients were recruited for color fundus photography and OCT assessment. The RPE, ORL and choroidal thickness were measured. The correlation with the best-corrected visual acuity (BCVA) was also investigated. The study included 128 eyes, comprising 45 eyes of 25 diabetic macular edema (DME) patients, 34 eyes of 20 DR without DME (non-DME) patients, and 49 eyes of 25 age-matched normal individuals. The choroidal thickness in DR patients were decreased statistically significantly compared with the control group (P<0.05). The mean macular ORL thickness in DME (73.02±15.34 µm) and non-DME groups (76.35±7.32 µm) were decreased statistically significantly compared with the control group (80.20±5.85 µm; P=0.006, P=0.013, respectively). In both the non-DME and DME groups, the RPE thickness were decreased compared with the control group (P<0.05), except in the macular and central ring. The BCVA were significant interactions with the total inner retinal volume and macular RPE thickness in the DME group (r=0.115, P<0.001, r=-0.013, P=0.017, respectively). The choroid, ORL and RPE thickness are significantly decreased in DR patients compared with controls in different segments.

Optical coherence tomography and magnetic resonance imaging visual pathway evaluation in Wolfram syndrome.

The aim of this study was to assess parameters of retinal morphology by using high-definition optical coherence tomography (OCT) in patients with Wolfram syndrome (WFS) and their relation to optic tract atrophy in magnetic resonance imaging (MRI). High-definition OCT and MRI parameters were evaluated in 12 patients with WFS (three males, nine females; median age at examination 12y 8mo, range 10y 2mo-15y 11mo) and referred to 30 individuals with type 1 diabetes (T1D) (12 males, 18 females; median age at examination 20y 5mo, range 16y 8mo-21y 4mo) and 33 typically developing comparison participants (10 males, 23 females; median age at examination 20y 7mo, range 13y-22y 4mo). Total thickness and quadrant thickness of the retinal nerve fibre layer (RNFL), macular full-thickness parameters and macular ganglion cell layer/inner plexiform layer, intraorbital and intracranial thickness of the optical nerve, as well as the optic chiasm and visual tracts were significantly reduced in patients with WFS compared with those having T1D and the typically developing comparison participants. Optic chiasm thickness correlated negatively in patients with WFS with both age (r=-0.79; p=0.002) and duration of diabetes (r=-0.62; p=0.032). Thickness of the intraorbital parts of the optic nerves in patients with WFS correlated positively with thickness of the superior RNFL (r=0.73; p=0.006). High-definition OCT in combination with MRI could become an important tool for evaluating the effectiveness of therapeutic trials in patients with WFS. Provides evidence of significant reduction of retinal parameters and optic nerves in patients with Wolfram syndrome (WFS). Shows correlations between magnetic resonance imaging parameters and retinal morphology parameters in patients with WFS.

Discriminative power of intra-retinal layers in early multiple sclerosis using 3D OCT imaging.

To evaluate volumetric changes and discriminative power of intra-retinal layers in early-stage multiple sclerosis (MS) using a 3D optical coherence tomography (OCT) imaging method based on an in-house segmentation algorithm. 3D analysis of intra-retinal layers was performed in 71 patients with early-stage MS (mean disease duration 2.2 ± 3.5years) at baseline and 40 healthy controls (HCs). All patients underwent a follow-up OCT scan within 23 ± 9months. Patients with a clinical episode of optic neuritis (ON) more than 6months prior to study entrance were compared with patients who never experienced clinical symptoms of an ON episode (NON). Significantly decreased total retinal volume (TRV), macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GCIPL) volumes were detected in ON patients compared to NON patients (all p values < 0.05) at baseline. Each parameter on its own allowed identification of prior clinical ON based on a discriminative model (ROC analysis). Over time, TRV decreased in both ON (p = 0.013) and NON patients (p = 0.002), whereas mRNFL volume (p = 0.028) decreased only in ON and GCIPL volume (p = 0.003) decreased only in NON patients. Our 3D-OCT data demonstrated that TRV, mRNFL and GCIPL allow discrimination between ON and NON patients in a cross-sectional analysis. However, the subsequent retinal atrophy pattern diverges in the initial phase of MS: Prior ON promotes sustained axonal thinning over time indicated by mRNFL loss, whereas longitudinal measurement of GCIPL volume better depicts continuous retrograde neurodegeneration in NON patients in early-stage MS.