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Purpose To quantify and compare the different prevalence rates of specific retinal imaging biomarkers in patients with intermediate AMD (iAMD) and advanced non-neovascular AMD (nnAMD).Methods Cross-sectional study of patients with iAMD and advanced nnAMD. Imaging studies were reviewed for qualitative imaging biomarkers. Choroidal thickness measurements were obtained subfoveally and in 1000 um and 2000 um intervals away from the fovea. The Chi-squared test and Fisher's exact test were used to compare rates of imaging biomarkers among the two cohorts. P-value of <0.05 was considered significant.Results 376 eyes of 197 patients with iAMD and 187 eyes of 97 patients with advanced nnAMD were recruited. There were significantly lower rates of the following imaging biomarkers in the iAMD compared with the advanced nnAMD cohorts: soft drusen (66.0% vs. 84.2%, p= 0.001), calcified drusen (4.3% vs. 40.0%, p< 0.0001), RPD (26.2% vs. 53.3%, p< 0.0001), ORT (0.5% vs. 46.9%, p< 0.0001), RP (1.1% vs. 46.3%, p< 0.0001), pigment migration (53.2% vs. 100%, p< 0.0001), and iRORA (17.9% vs. 80.2%, p< 0.0001). In the iAMD cohort, choroidal thickness was significantly greater at 188 µm (SD: 60) and 194 µm (SD: 69), compared to the advanced nnAMD with measurements of 153 µm (SD: 68), and 161 µm (SD: 76). This difference was statistically significant (p< 0.0001 and p= 0.0002).Conclusions Our results highlight significant differences in imaging biomarkers between both cohorts. Key biomarkers, such as iRORA, RPD, pigment migration, and thinner choroidal thickness, were associated with advanced nnAMD. Identifying these biomarkers early may help target patients who could benefit from new treatments, potentially delaying vision loss.

To analyze the spectrum of the perivenular fernlike leakage on ultrawide-field fluorescein angiography (UWFA) and discuss its potential implications in the current understanding of the retinal venous outflow.

Lamellar macular hole is a macular lesion characterized by a partial thickness foveal defect and commonly associated with epiretinal proliferation. In this report, we present two cases of spontaneous closure of lamellar macular holes by extension of epiretinal proliferation filling the retinal defect.

The vitreous humor is a highly aqueous eye fluid interfacing with the retina and lens and providing shape. Its molecular composition provides a readout for the eye’s physiological status. Changes in cellular metabolism underlie vitreoretinal pathologies, but despite routine surgical collection of vitreous, only limited reports of metabolism in the vitreous of human patients have been described. Vitreous samples from patients with rhegmatogenous retinal detachment (n= 25) and proliferative diabetic retinopathy (n= 9) were profiled along with control human vitreous samples (n= 8) by untargeted mass-spectrometry-based metabolomics. Profound changes were observed in diabetic retinopathy vitreous, including altered glucose metabolism and activation of the pentose phosphate pathway, which provides reducing equivalents to counter oxidative stress. In addition, purine metabolism was altered in diabetic retinopathy, with decreased xanthine and elevated levels of related purines (inosine, hypoxanthine, urate, allantoate) generated in oxidant-producing reactions. In contrast, the vitreous metabolite profiles of retinal detachment patients were similar to controls. In total, our results suggest a rewiring of vitreous metabolism in diabetic retinopathy that underlies disease features such as oxidative stress and furthermore illustrates how the vitreous metabolic profile may be impacted by disease.

Purpose: To compare the image quality and clinical utility of oral versus intravenous (IV) dye administration for fluorescein widefield angiography in pediatric patients.Design: Retrospective observational case series.Methods: Retrospective chart review of pediatric patients who underwent noncontact widefield fluorescein angiography (FA; Optos plc) at a single tertiary referral center (UCHealth Eye Center, Aurora, Colorado) between January 1, 2014, and May 31, 2016. Fluorescein angiography images were de-identified, and FA timing was hidden. A masked retinal specialist graded FA image quality and clinical utility.Results: A total of 103 FAs (62 IV and 41 oral) in 82 patients were reviewed. Oral fluorescein administration was more common in young patients (mean age: 8.1 years) compared to IV administration (mean age: 14.5 years; P< .001). Multivariate analysis with adjustment for age showed no statistical difference between oral and IV FA image quality (P= .59). There was a high incidence of excellent clinical utility in both oral and IV FAs, with no statistically significant difference between the 2 methods. Subgroup analysis of familial exudative vitreoretinopathy, Coats’ disease, choroidal neovascular membrane, and uveitis also showed no statistical difference in clinical utility between IV and oral FA.Conclusion: Oral widefield FA had excellent clinical utility and comparable image quality to IV fluorescein widefield angiography (with adjustment for age). For the evaluation of pediatric retinal disease, oral FA can be a clinically useful diagnostic tool in pediatric patients who are intolerant to IV access, which may avoid some need for FA under general anesthesia.

Geographic atrophy is an advanced form of dry age-related macular degeneration that can lead to irreversible vision loss and high burden of disease. We aimed to assess efficacy and safety of avacincaptad pegol 2 mg in reducing geographic atrophy lesion growth.