Central Macular Thickness Values Research Articles

Comparison of ocular posterior segment parameters in the pediatric population with migraine without aura and tension-type headache.

This study aims to compare the posterior ocular structure parameters in children with migraine without aura (MWA), tension-type headache (TTH), and a healthy control group. The study included 31 patients with MWA, 29 patients with TTH, and 38 healthy controls between 6 and 18 years of age. For all participants, the detailed eye examination and measurements including peripapillary retinal nerve fiber layer (pRNFL) thickness, central macular thickness (CMT), subfoveal choroidal thickness (SCT), macular vessel densities and foveal avascular zone (FAZ) parameters measured by optical coherence tomography (OCT) and OCT-angiography (OCTA), were obtained from the patient files. The mean age was 12.1±3.3 years in MWA patients, 12.4±2.8 years in TTH patients, and 11.9±3.8 years in the healthy controls (p=0.844). Among the groups, the mean pRNFL thickness, CMT, and SCT values were lowest in the MWA group. However, this difference was not statistically significant (p=0.621, p=0.854 and p=0.201, respectively). The mean and four-quadrant (superior, inferior, temporal, nasal) pRNFL thicknesses, the CMT, and the SCT were not statistically significant between the groups (p=0.621, p=0.500, p=0.186, p=0.565, p=0.744, p=0.854 and p=0.201, respectively). The macular vascular densities were lower in MWA patients than in the other two groups, and there was a statistically significant difference between the groups only in the nasal quadrant of the deep retinal capillary plexus (p = 0.014). There were also no statistically significant differences between the groups in the superficial and deep FAZ area parameters (p=0.652 and p=0.985). This study suggested that differential diagnosis between MWA and TTH can be difficult in childhood, as these conditions, which can present with ocular symptoms, may also be characterized by changes in posterior segment parameters. Long-term studies incorporating OCT-A in larger patient populations may provide valuable insights into retinal changes associated with these two distinct headache spectrums.

Investigation of the Reproducibility of Portable Optical Coherence Tomography in Diabetic Macular Edema

Background: Diabetic macular edema (DME) causes vision impairment and significant vision loss. Portable optical coherence tomography (OCT) has the potential to enhance the accessibility and frequency of DME screening, facilitating early diagnosis and continuous monitoring. This study aimed to evaluate the reliability of a portable OCT device (ACT100) in assessing DME compared with a traditional stationary OCT device (Cirrus 5000 HD-OCT plus). Methods: This prospective clinical investigation included 40 eyes of 33 patients with DME. Participants with significant refractive errors (myopia > −6.0 diopters or hyperopia > +3.0 diopters), vitreous hemorrhage, tractional retinal detachment, or other ocular diseases affecting imaging were excluded. Spectral-domain OCT was performed by a single examiner using both devices to capture macular volume scans under mydriasis. Central macular thickness (CMT) was evaluated using the analysis software for each device: Cirrus used version 6.0.4, and ACT100 used version V20. We analyzed inter-evaluator and inter-instrument agreements for qualitative assessments of the intraretinal fluid (IRF), subretinal fluid (SRF), and epiretinal membrane (ERM) using Cohen’s kappa coefficient, whereas quantitative CMT assessments were correlated using Spearman’s correlation coefficient. Results: Substantial inter-evaluator agreement for IRF/SRF (κ = 0.801) and ERM (κ = 0.688) with ACT100 and inter-instrument agreement (κ = 0.756 for IRF/SRF, κ = 0.684 for ERM) were observed. CMT values measured using ACT100 were on average 29.6 μm lower than that of Cirrus (285.8 ± 56.6 vs. 315.4 ± 84.7 μm, p < 0.0001) but showed a strong correlation (R = 0.76, p < 0.0001). Conclusions: ACT100 portable OCT demonstrated high reliability for DME evaluations, comparable to that of stationary systems.

Evaluation of the effect of vitreomacular interface disorders on anti-VEGF treatment in patients with diabetic macular edema in real life: MARMASIA study group report No. 10.

The aim of this study is to investigate the effect of vitreomacular interface disorders (VMID) on treatment response in patients treated with anti-vascular endothelial growth factor (anti-VEGF) due to diabetic macular edema (DME). Three hundred seventy-seven eyes of 239 patients in the MARMASIA Study Group who received intravitreal anti-VEGF treatment (IVT) due to DME were included in the study. The group 1 consisted of 44 eyes of the patients who had not received any treatment before, were followed up regularly for 24months after at least a 3-month loading dose, and suffered from VMID such as epiretinal membrane, vitreomacular adhesion or traction, and lamellar hole. The group 2 consisted of 333 eyes of the patients without VMID. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) of the patients at baseline, 3rd month, 6th month, 1st year and 2nd year follow-ups were measured. The mean age of the Groups 1 and 2 was 67.1 ± 11.3 and 61.9 ± 10.2 years, respectively. 61.3% of the group 1 and 58.8% of the group 2 were female (p > 0.05). The duration of diabetes was 19.2 ± 3.7 and 15.8 ± 3.2 years, respectively, and the number of follow-ups was 16.09 ± 4.68 and 12.06 ± 4.58, respectively in the groups (p < 0.001, 0.001, respectively). The number of IVT was 7.13 ± 2.71 and 7.20 ± 2.22, respectively in the groups 1 and 2 and no statistically significant difference was observed between them (p = 0.860). According to logMAR, BCVA values at baseline were 0.63 ± 0.24 and 0.59 ± 0.26 (p = 0.29), respectively, in the groups and the amount of change in BCVA at the end of the 2nd year was -0.02 ± 0.48 in the group 1 and -0.12 ± 0.48 in the group 2. It was observed as 0.48 (p = 0.13). Although the increase in BCVA was greater at all follow-ups in the group 2 compared to their initial examination, no significant difference was observed between the groups in terms of BCVA change. The CMT values of the groups at baseline were 442.5 ± 131.3µm and 590.9 ± 170.6µm, respectively (p = 0.03) The decrease in CMT after IVT was significantly greater in the group 2 at all follow-ups when compared to the first group (p < 0.05). While the presence of VMID in DME patients receiving IVT did not affect visual results, it negatively affected the anatomical response and macular edema morphology. The presence of VMID at baseline affected the success of IVT. It should be taken into consideration that VMID may resolve spontaneously or with IVT, and new cases of VMID may occur in patients during the treatment process.

Choroidal Alterations in Diabetic Macular Edema Treated with Intravitreal Dexamethasone: What Can Choroidal Vascularity Index Tell Us?

Diabetes mellitus (DM) significantly impacts ocular health, particularly the retina and choroid, leading to diabetic retinopathy (DR) and diabetic macular edema (DME). This study aimed to evaluate the effects of intravitreal dexamethasone (IVD) on the choroidal vascularity index (CVI) in order to evaluate its potential as a biomarker. This was a retrospective observational study in which 37 eyes with DME treated with IVD were included. Baseline and follow-up (2 and 4 months post-injection) comprehensive ophthalmological examinations and spectral domain optical coherence tomography (SD-OCT) were performed. The CVI, luminal area (LA), stromal area (SA), and total area (TA) were assessed. No statistically significant changes in CVI, LA, SA, and TA were observed in the overall patient sample from baseline to 2 and 4 months post-IVD injection. However, a significant CVI reduction was noted in responder patients at 4 months. Positive correlations were found between the CVI and central macular thickness (CMT) at 2 months, suggesting that higher CMT values are associated with higher CVI values. This study indicated that IVD influences choroidal circulation, as evidenced by CVI reduction in responder patients. The CVI could potentially serve as an objective biomarker for treatment response in DME. Larger, prospective studies are warranted to clarify these findings further.

Effects of vitrectomy combined with internal limiting membrane peeling in patients with diabetic macular edema.

Diabetic macular edema (DME), a chronic microvascular complication of diabetes, is a leading cause of visual impairment and blindness. Pars plana vitrectomy (PPV) can restore the normal macular structure and reduce macular edema, whereas internal limiting membrane (ILM) peeling is used to treat tractional macular diseases. Despite the advantages, there is limited research on the combined effects of PPV with ILM peeling. To observe the effects of PPV combined with ILM peeling on postoperative central macular thickness (CMT), best-corrected visual acuity (BCVA), cystoid macular edema (CME) volume, and complications in patients with DME. Eighty-one patients (92 eyes) diagnosed with DME at the Beijing Shanqu Liangxiang Hospital between January and December 2022 were randomly divided to undergo PPV alone (control group: 41 patients, 47 eyes) or PPV + ILM peeling (stripping group: 40 patients, 45 eyes); a single surgeon performed all surgeries. The two groups were compared preoperatively and 1 and 3 months postoperatively. Preoperatively, both groups had comparable values of CMT, BCVA, and CME volume (P > 0.05). After surgery (both 1 and 3 months), both groups showed significant reductions in CMT, BCVA, and CME volume compared to preoperative levels, with the stripping group showing more significant reductions compared to the control group (P < 0.05). Further repeated-measures ANOVA analysis for within-group differences revealed significant effects of group and time, and interaction effects for CMT, BCVA, and CME volume (P < 0.05). There were no significant differences in the incidence of complications between the groups (retinal detachment: control = 2, stripping = 1; endophthalmitis: Control = 4, stripping = 1; no cases of secondary glaucoma or macular holes; χ 2 = 0.296, P = 0.587). PPV with ILM peeling can significantly improve the visual acuity of patients with DME, reduce CMT, and improve CME with fewer complications.

Visual evoked potentials in patients with congenital color vision deficiency.

Congenital color vision deficiency (CCVD) is an eye disease characterized by abnormalities in the cone cells in the photoreceptor layer. Visual evoked potentials (VEPs) are electrophysiological tests that physiologically examine the optic nerve, other visual pathways, and the visual cortex. The aim of this research was to determine whether there are VEP abnormalities in CCVD patients. Patients with CCVD and healthy individuals were included in this prospective case-control study. Participants with eye disease or neurodegenerative disease were excluded from the study. Pattern reversal VEP (PVEP), flash VEP (FVEP), and optical coherence tomography were performed on all participants. Twenty healthy individuals (15 male) and 21 patients with CCVD (18 male) were included in the study. The mean ages of healthy individuals and patients with CCVD were 29.8 ± 9.6 and 31.1 ± 10.9years (p = 0.804). Retinal nerve fiber layer thickness and central macular thickness values did not differ between the two groups. In PVEP, Right P100, Left N75, P100, N135 values were delayed in CCVD patients compared to healthy individuals (p = 0.001, p = 0.032, p = 0.003, p = 0.032). At least one PVEP and FVEP abnormality was present in nine (42.9%) and six (28.6%) of the patients, respectively. PVEP or FVEP abnormalities were found in 13 (61.9%) of the patients. This study indicated that there may be PVEP and FVEP abnormalities in patients with CCVD.

Comparison of the cytokines levels in aqueous humor in vitrectomized eyes versus non-vitrectomized eyes with diabetic macular edema.

This study was conducted to compare concentrations of VEGF family growth factors, inflammation-related factors, and adhesion molecules in the aqueous humor of eyes with diabetic macular edema (DME), with and without prior vitrectomy. A total of 31 eyes were included, 11 with DME that had undergone vitrectomy, 9 with DME but without vitrectomy, and 11 from age-related cataract patients as controls. The concentrations of cytokines including TNF-α, IL-6, IL-8, IP-10, MCP-1, IFN-γ, MIP-1 α, MIP-1 β, PECAM-1, MIF, VCAM-1, ICAM-1, PIGF were quantified using Luminex Human Discovery Assay. Central macular thickness (CMT) values of all eyes were measured using optical coherence tomography (OCT). (1) Vitrectomized DME eyes exhibited significantly higher levels of IL-6 and IL-8 compared to non-vitrectomized eyes (P < 0.05). (2) In vitrectomized group, after Benjamini-Hochberg correction, there was a significant positive correlation between the levels of VEGF and PlGF (rs = 0.855, P < 0.05), as well as the levels of TNF-α and IFN-γ (rs = 0.858, P < 0.05). In non-vitrectomized group, significant positive correlations were found between VEGF and PlGF levels after correcting for multiple comparisons (rs = 0.9, P < 0.05). (3) In non-vitrectomized group, the concentrations of VEGF and PlGF in aqueous humor were significantly positively correlated with CMT values (rs = 0.95, P < 0.05; rs = 0.9, P < 0.05, respectively). The concentrations of IL-6 and IL-8 in the aqueous humor were significantly higher in vitrectomized DME eyes compared to nonvitrectomized DME eyes and the levels of VEGF were similar in the two groups, suggesting that inflammation after vitrectomy may be a key factor in the occurrence and development of DME.

Effect of Pro Re Nata Regimen with Anti-VEGF on Type 3 Macular Neovascularization: Long-Term Outcomes

Introduction: The purpose of this study was to investigate long-term outcomes of intravitreal injections (IVI) of antivascular endothelial growth factor (VEGF) in neovascular age-related macular degeneration (nAMD) with type 3 macular neovascularization (MNV). Methods: This retrospective study included 19 eyes of 17 patients with nAMD and type 3 MNV treated with anti-VEGF IVI with a loading dose and a PRN regimen. Best corrected visual acuity (BCVA), central macular thickness (CMT), presence of macular intraretinal fluid (IRF) and subretinal fluid (SRF), flow area (FA), subfoveal choroidal thickness (CT), and macular atrophy (MA) were assessed at baseline (T0) and during follow-up (T1, post-loading phase; T2, 1 year; T3, 2 years; T4 >2 years). The correlations between MA at the last follow-up and standard deviation (SD) values of CMT and CT during follow-up were assessed. The influence of the number of injections on the change in MA over time was also analyzed. MA differences at T4 were assessed for pseudodrusen presence. Results: BCVA improved significantly during follow-up (p = 0.013) particularly increasing from baseline to post-loading phase and then did not modify significantly thereafter. CMT significantly reduced from T0 to T1 and remained stable during follow-up (p = <0.001). MNV flow area showed a trend toward an increase in the post-loading phase that was not statistically significant (p = 0.082) and CT decreased significantly during follow-up (p < 0.001). MA changed significantly during follow-up (p < 0.001) with a significant increase from T0 to T3 and from T0 to T4 (p < 0.010). A Cochran-Armitage test for trend showed a significant reduction (p = 0.001) of macular IRF and SRF during follow-up. MA at T4 showed a significant positive correlation with SD (standard deviation) values of CMT (p = 0.040) and CT (p = 0.020). Indeed, the number of injections did not influence the change over time of MA (p = 0.709). MA at T4 was not statistically significantly different between patients with pseudodrusen at baseline (p = 0.497). Conclusions: Intravitreal anti-VEGF injections with PRN regimen in MNV type 3 showed functional and anatomical benefits. Variations of retinal thickness and choroidal thickness during treatment were related to MA modification over time.

Intravitreal injection of conbercept for diabetic macular edema complicated with diabetic nephropathy.

To observe the therapeutic effect of conbercept on diabetic macular edema (DME) complicated with diabetic nephropathy (DN). In this retrospective study, 54 patients (54 eyes) that diagnosed as DME from January 2017 to October 2021 were collected. The patients were divided into two groups: DME patients with DN (25 eyes), and DME patients without DN (29 eyes). General conditions were collected before treatment, laboratory tests include fasting blood glucose, HbA1c, microalbumin/creatinine, serum creatinine. Optical coherence tomography (OCT) was used to check the ellipsoidal zone (EZ) and external limiting membrane (ELM) integrity. Central macular thickness (CMT), best corrected visual acuity (BCVA), and retinal hyperreflective foci (HF) as well as numbers of injections were recorded. There were significant differences between fasting blood glucose, HbA1c, serum creatinine, urinary microalbumin/creatinine, and estimated glomerular filtration rate (eGFR) between the two groups (all P<0.05). EZ and ELM continuity in the DME+DN group was worse than that in the DME group (P<0.05). BCVA (logMAR) in the DME group was significantly better than that in the DME+DN group at the same time points during treatment (all P<0.05). CMT and HF values were significantly higher in the DME+DN group than that in the DME group at the all time points (all P<0.05) and significantly decreased in both groups with time during treatment. At 6mo after treatment, the mean number of injections in the DME+DN and DME group was 4.84±0.94 and 3.79±0.86, respectively. Conbercept has a significant effect in short-term treatment of DME patients with or without DN, and can significantly ameliorate BCVA, CMT and the number of HF, treatment efficacy of DME patients without DN is better than that of DME patients with DN.

Effect of aflibercept combined with triamcinolone acetonide on aqueous humor growth factor and inflammatory mediators in diabetic macular edema.

To investigate the efficacy of aflibercept combined with sub-tenon injection of triamcinolone acetonide (TA) in treating diabetic macular edema (DME) and to examine changes in growth factors and inflammatory mediator levels in aqueous humor after injection. Totally 67 DME patients (67 eyes) and 30 cataract patients (32 eyes) were enrolled as the DME group and the control group, respectively. The DME group was divided into the aflibercept group (34 cases) and the aflibercept combined with TA group (combined group, 33 cases). The aqueous humor of both groups was collected during the study period. The aqueous levels of vascular endothelial growth factor (VEGF), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and interleukin-1β (IL-1β) were detected using a microsphere suspension array technology (Luminex 200TM). Aqueous cytokines, best-corrected visual acuity (BCVA), central macular thickness (CMT), and complications before and after treatment were compared between the aflibercept group and combined group. The concentrations of VEGF, MCP-1, IL-6, and IL-8 in the aqueous humor were significantly higher in the DME group than those of the control group (all P<0.01). After 1mo of surgery, the concentrations of VEGF, MCP-1, IL-6, and IL-8 in the aqueous humor were significantly lower in the combined group than those of the aflibercept group (all P<0.01). The BCVA and CMT values of the two groups were statistically different after 1 and 2mo of treatment (P<0.01). However, the difference was not statistically significant after 3mo of treatment (P>0.05). The cytokines VEGF, MCP-1, IL-6, and IL-8 in the aqueous humor of DME patients are significantly increased. Aflibercept and aflibercept combined with TA have good efficacy in DME patients, can effectively reduce CMT, improve the patient's vision, and have high safety. Aflibercept combined with TA can quickly down-regulate the aqueous humor cytokines and help to relieve macular edema rapidly. However, the long-term efficacy is comparable to that of aflibercept alone.

Changes in Central Corneal Thickness and Central Macular Thickness following Uncomplicated Small-incision Cataract Surgery.

Cataract surgery is an invasive procedure that causes mechanical and inflammatory insult to the eye. The objective was to study the changes in central corneal thickness (CCT) which is an indirect indicator of corneal endothelial dysfunction and the changes in macular thickness following uncomplicated small incision cataract surgery (SICS) Materials and methods: This was a prospective observational study with a before-and-after design conducted in Reiyukai Eiko Masunaga eye hospital, Banepa, Kavrepalanchok, Nepal. SICS was performed on 68 eyes of 62 patients. Change in CCT and central macular thickness (CMT) from baseline was observed post-surgery on the first day, one week, and six weeks. There were 27 (43.5%) females and 35 males (56.5%) in the study. Mean age was 58.26 ±10 years. This difference of visual acuity between pre and post-operative state was statistically significant. The first post-operative day (POD) and first week post-operative CCT values when compared with preoperative CCT values were statistically significant. However, post-operative CCT values at six weeks were similar to preoperative values. Also, the differences at day one, first week and six weeks post-operative CMT values when compared with preoperative CMT values were statistically significant. This study revealed that there is a significant rise in CCT after SICS which gradually tends to normalize at six weeks. Similarly there is a gradual rise in CMT after SICS persisting even at six weeks. These changes were subtle and there was a marked improvement of visual acuity at six weeks after SICS.

A quantitative evaluation of the effect of meals on macular thickness in diabetic patients with diabetic macular edema.

Central subfoveal thickness measurement is used in a large number of clinical trials to monitor the progression and treatment response of diabetic macular edema (DME) in patients of diabetic retinopathy (DR). Several studies have been carried out to investigate various factors affecting the central subfoveal thickness in order to minimize errors in the testing. We planned a study to investigate the effect of meals on central macular thickness (CMT) in patients with DME and compare that with nondiabetic patients. In this observational study, 50 patients of diabetes with DME and 50 normal controls were included. Macular thickness was measured after overnight fasting and 2 h postprandial for both the groups. Any changes in morphology and CMT were evaluated. Each group had 22 females and 28 males with a mean age of 60.6 ± 6.6 in the diabetic group and of 49.66 ± 11.13 in the control group. Reduction in the CMT was noticed after the meals (mean: -9.78 ± 12.77 μm; P < 0.001) in those with DME as compared to the control group. This was more prominent in those who had intraretinal cystic spaces (17.14 ± 10.33 μm) and neurosensory detachment (66 µ). Patients with high blood sugar levels had higher CMT and a greater reduction in thickness was noticed in them postprandially (r = 0.414; P = 0.0028). The CMT values in patients with DME are significantly affected by meals. Hence, an attempt should be made to measure CMT during the fasting state for more accurate results.

Comparison of the efficacy of Diclofenac 0.1% and Nepafenac 0.1% on anterior chamber cells in patients undergoing cataract surgery: A prospective clinical practice trial.

To compare the efficacy of topical Nepafenac 0.1 % and Diclofenac 0.1% eye drops in reducing the aqueous cells in the anterior chamber in an un-eventful post cataract surgery. This prospective, clinical trial was conducted at an Eye OPD of Qazi Hussain Ahmad Medical Complex, Nowshera from January till December 2021. Ophthalmic assessment included Visual acuity (VA), slit-lamp examination, Intraocular pressure (IOP), Central macular thickness (CMT) by Optical coherence tomography (OCT) and anterior chamber-aqueous cells measurement pre-operatively and at day 1st, 2nd, 4th and 8th week post-operatively. Patients were randomly allocated to topical diclofenac 0.1% (TD) four times a day and nepafenac 0.1% (TN) three times a day for four weeks each along with topical steroids and antibiotics. Seventy patients (70) were randomly distributed into two treatment arms of 35 each. In both the arms VA improved which achieved a level of statistical significance post-operatively, however statistically insignificant difference was observed between the groups at 8th week follow up visit (p= 0.62). However, IOP and CMT values didn't achieve statistical significance between the arms pre and post operatively. In TN arm, level of AC-cells at 2nd and 4th week post-operatively were significantly lower (10.54 ± 4.05 and 08.20 ± 4.44) than TD arm (11.28 ± 5.04 and 09. 66 ± 5.50) with statistically significant difference (p < 0.05). Topical Nepafenac 0.1% was more effective in suppressing the anterior chamber inflammation as compared to diclofenac during the early few post-operative weeks.

The effect of Nd:YAG Laser applied in the posterior capsule opacification on retinal and choroidal structures

PurposeTo assess the effect of neodymium:yttrium–aluminum–garnet (Nd-YAG) laser procedure on the choroid and retina in patients who developed posterior capsular opacification (PCO) after cataract surgery. MethodsIn this study, 32 eyes of 30 patients who underwent Nd:YAG laser treatment for PCO were evaluated. Visual acuity (VA), intraocular pressure (IOP), central macular thickness (CMT) with optical coherence tomography device (OCT), ganglion cell layer (GCL), inner plexiform layer (IPL), retinal nerve fiber layer (RNFL) and subfoveal choroidal thickness (SCT) were measured. Choroidal vascular index (CVI) was calculated from HD line images obtained by spectral domain OCT with the software Image J. ResultsThe mean age of the patients participating in the study was 60.1 ± 8.9 years. There was no significant difference in IOP, CMT, RNFL, GCL, IPL and SCT values ​​in all comparisons before and after laser (p>0.05 for all values). While Nd:YAG laser pretreatment CVI was 63.2 ± 3.2%, it was 66.8 ± 2.9% at 1 week and 67.1 ± 2.6% at 1 month after laser treatment. A significant difference was detected in the comparison of pre-laser CVI and post-laser 1 week and 1 month CVI (p<0.05 for all values). DiscussionCVI was found to be significantly higher in the post-laser period in patients who underwent Nd:YAG laser. As far as the author knows, this study is the first research in the literature to evaluate this relationship. CVI can be used to evaluate choroidal vascular changes after Nd:YAG laser.

Non-damaging retinal laser therapy in chronic central serous chorioretinopathy.

To investigate the functional and anatomical outcomes of non-damaging retinal laser therapy (NRT), in cases with chronic central serous chorioretinopathy (CSCR). Twenty-three eyes of 23 treatment-naïve chronic CSCR patients were included in this study. The irradiation of 577nm yellow light was conducted on the serous detachment area after switching over to the NRT algorithm. Anatomical and functional changes after treatments were investigated. The mean age of the subjects was 48.68 ± 5.93years (41-61). The mean best-corrected visual acuity (BCVA) and the mean central macular thickness (CMT) values were 0.42 ± 0.12logMAR (0.20-0.70) and 315.69 ± 61.25µm (223-444) before NRT; and 0.28 ± 0.11logMAR (0.10-0.50) and 223.26 ± 60.91µm (134-336) at the 2nd month follow-up visit (p < 0.001, for both). At the 2nd-month follow-up visit after NRT, complete resorption of subretinal fluid was observed in 18 eyes (78.3%) and incomplete resorption in five eyes (21.7%). Worse values of BCVA and CMT before NRT were found as increased risk for incomplete resorption (p = 0.002 and ρ = 0.612 for BCVA, and p < 0.001 and ρ = 0.715 for CMT). Significant functional and anatomical improvements can be observed in the early period after NRT in patients with chronic CSCR. Patients having worse baseline BCVA and CMT have increased risk for incomplete resorption.

Combination of cataract surgery with intravitreal injection of dexamethasone intravitreal implant (Ozurdex) for uveitis-induced cataract.

To evaluate the long-term results of patients with chronic uveitis-induced cataract by phacoemulsification with IOL implantation and intravitreal injection of dexamethasone (DEX) intravitreal implant (Ozurdex). The study included 32 eyes of 26 patients treated with DEX implant due to chronic uveitis-induced cataract and followed up for at least a year. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior chamber reaction, central macular thickness (CMT), intraoperative and postoperative complications and uveitis recurrence were analyzed retrospectively. A successful surgery was performed in all patients. The average follow-up period was 12mo. The female/male ratio was 13/13. Mean age was 45.65±3.83y (range 26 to 65y). Etiologically, rheumatic arthritis occurred in 6 patients (18.75%), ankylosing spondylitis in 4 (12.50%), HLA-B27 associated uveitis in 3 (9.38%), Vogt-Koyanagi-Harada-associated uveitis in 4 (12.50%) , Behcet's disease in 2 (6.25%), and 7 (21.88%) suffered from unknown diseases. All 32 eyes had varying degrees of improvement at 12mo after surgery, with 2 eyes showing BCVA of 0.1 or below (6.25%), 6 having 0.1-0.5 (18.75%), 18 of 0.5-1.0 (56.25%), and 6 of 1.0 or above (18.75%). No cases with increased IOP were observed. The values of mean CMT was increased at day 1, decreased at 1, 3mo after surgery and increased at 6, 12mo after surgery. No severe uveitis reactions, such as fibrinous exudates in the anterior chamber and exudative membrane formation on the anterior surface of the IOL, were observed after surgery. The present studies show that intravitreal injection of Ozudex during cataract operation can provide a new option for the clinical treatment of uveitis-induced cataract.

Evaluation of the choroidal vascular index and choroidal changes in migraine subgroups

PurposeTo investigate binarized choroidal structural parameters, retinal nerve fiber layer (RNFL) thickness, and retina changes duringattack-free periods in patients with migraine using enhanced depth imaging optic coherence tomography (EDI-OCT), and compare patients with migraine with aura and without aura (MwA and MoA, respectively) and aura subgroups (visual aura, non-visual aura), with age and sex-matched healthy subjects. MethodThis observational, prospective study included 102 patients with migraine and 36 healthy controls. Central macular thickness (CMT), retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and choroidal thickness (CT) were measured using a Spectralis OCT device. The choroid vascularity index (CVI) was evaluated using the Image-J software. CVI was calculated as the proportion of the luminal area (LA) to the total choroidal area (TCA). RNFL, CMT, CT, and CVI measurements were compared statistically. ResultsChoroidal thickness at 1500 µm temporal of the fovea was found to be statistically significantly thinner in the MwA and MoA groups compared with the control group (p ≤ 0.01). There was a significant difference in the subfoveal CT values of the MwA and control groups (p < 0.05). The mean RNFL thickness of patients with migraine with visual aura was found to be statistically significantly thinner than in the migraine group with non-visual aura (98.73 ± 8.4 and 109.4 ± 16.8) (p < 0.05). There were no statistically significant differences between the RNFL CMT, GCC, and CVI values in the MwA, MoA, and control groups (p > 0.05). ConclusionWe found that the choroidal thickness was significantly decreased in patients with migraine, especially in the MwA group. In the visual aura subgroup, the mean RNFL thickness was significantly decreased compared with the non-visual aura subgroup.

Evaluation of subclinical changes in recently diagnosed pediatric hypertension patients without hypertensive retinopathy: an OCT study.

To investigate subclinical choroidal and retinal changes in recently diagnosed pediatric hypertension (HT) patients. This prospective case-control study consisted of 62 treatment naive HT patients (34 essential HT and 28 renal-induced HT) and 62 control subjects aged 10-16years. All demographic data and ocular parameters were noted. Macula and choroid measurements were acquired by spectral domain optical coherence tomography (SD-OCT). Choroidal measurements were obtained by taking the mean of the measurements taken from 3 nasal and 3 temporal locations at 500µ intervals (mean nasal, mean temporal) in addition to the subfoveal area. All choroidal thickness (ChT) values in HT subjects were significantly lower than in the healthy group (p < 0.001 for all). Also, there was no statistically significant difference between central macular thickness (CMT) and mean macular thickness (MMT) between the two groups. Subfoveal ChT, mean ChT, and CMT values were statistically lower in patients with renal-induced HT compared to essential HT subjects (p < 0.001, p = 0.04, p = 0.014, respectively). No significant correlation was observed between choroidal thicknesses and blood pressure values in essential and renal HT groups except weak correlation between mean temporal ChT and systolic blood pressure (SBP) in renal HT group (r = - 0.464, p = 0.013). This study demonstrated that choroidal thickness decreased even during the subclinical period in treatment naive pediatric HT subjects. In addition, it has been shown that the choroid is more affected in renal-induced HT compared to essential HT group.

Posterior sub-Tenon triamcinolone injection in the treatment of postoperative cystoid macular edema secondary to pars plana vitrectomy.

To evaluate the efficacy and safety of posterior sub-Tenon triamcinolone (PSTA) in chronic postoperative cystoid macular edema (PCME) after pars plana vitrectomy (PPV). Consecutive 22 patients who developed chronic PCME after PPV and underwent PSTA treatment were included in this retrospective study. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured pre injection and post injection at one month, three months, six months, and at last visit. The patients were divided into three groups according to the injection response status: complete, partial, and resistant. The mean follow-up period was 26.4 ± 16.2 months after PSTA. According to pre-injection values, there was a significant improvement in the values of BCVA and CMT at the first, third, and sixth months and at the last examination (P < 0.05). In the final examination, PCME recovered completely in 12 patients, partially in 8 patients, and resistance was observed in 2 patients. Posterior sub-Tenon triamcinolone seems to be effective in chronic PCME following PPV.

Optic disc, macula and ganglion cell layer measurements obtained with optical coherence tomography in patients with thyroid disorder

Purpose: The aim of this study was to compare retinal nerve layer thickness, central macula thickness and ganglion cell layer measurements using optical coherence tomography (OCT) between thyroid patients and age- and sex-matched healthy controls.&#x0D; Materials and Methods: Eighty eyes of 80 patients in the thyroid patient group and 48 eyes of 48 patients in the control group were included in the study. After evaluating the exclusion criteria, visual acuity, anterior segment biomicroscopy, intraocular pressure, fundoscopy and spectral field optic coherence tomography (SF-OCT) imaging tests were performed on all patients included in the study. These data have been recorded. Central macular thickness (CMT), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) measurements were evaluated by statistical methods for both groups.&#x0D; Results: There was no statistically significant difference between the demographic data of the groups included in the study. IOP measurements were found to be statistically significantly higher in the patient group compared to the control group. CMT values were 258.2±16.1 µm in the patient group and 273.1±23.8 µm in the control group, and statistically significant differences were observed between the groups. &#x0D; Conclusion: The findings supports that changes in the optic nerve and macula develop before vision loss in TO patients compared to the healthy control group. We can follow TO patients more objectively and reliably and make treatment planning more accurately by adding OCT, which is a noninvasive test, to our clinical practice, since structural changes develop before functional deterioration in TO patients.