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Purpose: To report two cases of persistent macular edema caused by the exudation of diabetic telangiectatic capillaries (TelCaps), which have been successfully treated with photodynamic therapy (PDT). Methods: Review of data from two patients suffering from persistent macular edema caused by parafoveolar TelCaps. In both cases, conventional laser was impossible because TelCaps were to close from foveal center. Results: The use of focal PDT on perifoveolar TelCaps permitted to reduce persistent macular edema and to avoid inefficient intravitreal anti-vascular epithelial growth factor or steroid injections. In both cases, visual acuity was fully restored four to six months after PDT. Central macular thickness was also normalized in the first case and significantly reduced in the second case. In both cases, visual gain was sustained throughout the whole follow-up period (2 and 1 year, respectively). Conclusion: Photodynamic therapy can be helpful to treat diabetic macular edema caused by TelCaps nonresponding to approved intravitreal therapy or for which conventional laser is contraindicated. [ABSTRACT FROM AUTHOR]

Purpose: To report binocular visual function changes after pars plana vitrectomy for epiretinal membrane (ERM) and the related outcomes. Methods: Twenty‐three eyes of 23 patients operated on for ERM were included in a retrospective study. Clinical data, best‐corrected visual acuity (BCVA), contrast sensitivity and binocular visual function were assessed pre‐ and 1 and 3 months post‐operatively. Binocular visual function assessment included the evaluation of fusional amplitudes (i.e., vergences) by the synoptophore, far distance stereopsis using polarized glasses and near stereopsis using Randot and TNO tests. Central macular thickness (CMT) was measured on Spectral Domain – Optical Coherence Tomography. Results: Mean age of the patients was 67 years. Mean BCVA and contrast sensitivity significantly improved post‐operatively at one (p = 0.0006 and p = 0.0022, respectively) and 3 months (p < 0.0001 and p < 0.0001, respectively), while CMT significantly decreased after 1–3 months (p < 0.0001 and p < 0.0001, respectively). Fusional amplitudes improved after 3 months (p < 0.0001). Far distance and near stereopsis significantly improved after 3 months (p < 0.0001 and p = 0.0007 for Randot test, and p < 0.0001 for TNO test, respectively). Conclusions: Pars plana vitrectomy for ERM surgery leads to an improvement of monocular and binocular visual functions (i.e., binocular fusion, near and far distance stereopsis), within 3 months post‐operatively. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether strabismus surgery improves the learning performance – calculation, reading and drawing – of school‐aged children. Methods: In a case–control study, patients between the ages of 7 and 10 years with horizontal strabismus, recommended for surgical correction, were prospectively included. Reading, calculating and drawing abilities were evaluated before and 3 months after corrective strabismus surgery using standardized tests. Cases were compared to control patients: patients with a surgical indication postponed due to the COVID lockdown. Results: Forty‐two operated patients and 42 controls between the ages of 7 and 10 years with horizontal strabismus were included. The average reading speed was 65.8 words per minute pre‐operatively compared to 80.6 words per minute post‐operatively (p = 0.0038). The average drawing score was 71.1 pre‐operatively compared to 84.3 post‐operatively (p = 0.012). The average calculation score was 3.2 pre‐operatively compared to 3.4 post‐operatively (p = 0.363). Improvement given by strabismus surgery was confirmed avoiding the learning effect by comparison with the control group. The improvements observed were more significant in the youngest patients and esotropia. Conclusions: This study highlights that strabismus surgery significantly improved the children's reading fluency and drawing task execution. These encouraging data should be taken into account when considering the indications for strabismus surgery. [ABSTRACT FROM AUTHOR]

Introduction: Central vision loss due to diabetic macular edema (DME) is related to the macular edema itself but also, in some cases, to alterations of the foveal avascular zone (FAZ). The aim of this trial was to study changes in macular vessels in eyes with DME treated with aflibercept using optical coherence tomography angiography (OCTA). Methods: This was a longitudinal, prospective, noncontrolled, single-arm study. The primary objective was the quantitative assessment of macular vessels over time in patients with DME treated with intravitreal aflibercept during a 48-week follow-up using OCTA. Results: Twenty-six DME eyes from 26 patients were included (mean age, 64.6 years; women, 53.8%; prior anti-VEGF treatment, 46.1%). Each eye received a mean (SD) of 7.2 (2.2) injections. The following parameters of the FAZ did not change during the 48-week follow-up: the mean (SD) FAZ area varied from 0.19 (0.19) mm2 at baseline (n = 22) to 0.23 (0.20) mm2 at week 48 (n = 15), boundary from 1.54 (1.21) to 2.04 (1.20) mm, and circularity from 0.45 (0.33)% to 0.57 (0.20)%. There was no change in perfusion density and vessel density of the macula in the 3-mm circle. As expected, mean central retinal thickness, macular volume, and visual acuity improved during follow-up. Conclusion: No change in macular perfusion was observed in eyes with DME during a 48-week follow-up after intravitreal injections of aflibercept. Randomized controlled trials using OCT angiography in large populations with extended observation periods are needed to assess changes in macular vessels after intravitreal anti-VEGF treatment. [ABSTRACT FROM AUTHOR]

Aim To analyse the choroidal thickness (CT) and vessel pattern of myopic patients with dome-shaped macula (DSM) and their association with the DSM axis and serous retinal detachment (SRD). Methods Retrospective study. The CT and vessel pattern were assessed on optical coherence tomography (OCT), OCT-angiography and ultra-wide-field photography. Results 27 eyes of 18 subjects (mean age: 65 years) were included. Compared with the 11 eyes (41%) with horizontal DSM, the 16 eyes (59%) with vertical DSM had a shorter axial length (25.8±2 mm vs 28.3±2.5 mm; p=0.01), a higher mean macular bulge height (624.4±207 µm vs 255.4±160.3 µm; p=0.0001) and a thicker CT (183.1±91.1 µm vs 72±38.3 µm; p<0.001). Large choroidal vessels crossed the macular area in 75% of eyes with vertical DSM vs 27% of eyes with horizontal DSM (p=0.02), whereas a watershed zone framing the macula was more often seen in horizontal DSM (72% vs 25%, p=0.02). Thirteen eyes (48%) had an SRD that was not associated with the DSM axis, the mean bulge height, the CT or the vessel pattern. Conclusion The presence of an SRD did not correlate with the DSM axis, the CT or the vessel pattern. However, the rate of large choroidal vessels crossing the macula was higher in vertical DSM than in horizontal DSM. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to assess OCT-angiography (OCT-A) contribution for choroidal neovascularization (CNV) detection, with respect to multimodal imaging (MMI) modality (including OCT, fluorescein angiography (FFA), and indocyanine green angiography [ICG]), in a real-life consultation practice. Methods: Data of all consecutive patients undergoing OCT-A examination for CNV suspicion were collected between September 2017 and September 2019 at Strasbourg University Hospital, France. Only eyes which had anti-VEGF injection in the last 3 months were excluded. All types of neovascularization were included. For all patients, data from OCT, OCT-A, FFA, and ICG were interpreted by residents and retinal specialists, independently. Final diagnosis of CNV was based on decision to treat. Sensibility, specificity, and predictive values were computed for OCT-A alone and for MMI (OCT combined to angiography). They were computed for each group. OCT-A was also assessed as "contributory" (i.e., assessing without doubt the presence or absence of CNV) or not, with respect to MMI. Results: In total, 161 eyes of 145 patients were included. MMI sensibility was better than OCT-A sensibility (93.8 vs. 65.6%). OCT-A specificity was better than MMI specificity (96.9 vs. 89.5%). OCT-A was essential for diagnosis in 16.9% of cases. Sensibility and specificity values for all exams were better when interpreted by retinal specialists than residents. OCT-A was judged "contributory" in 57.4% of eyes. OCT-A was significantly less contributory when artefacts were present (32.9% of eyes with artefacts vs. 63.5% without, p < 0.001). Conclusion: OCT-A showed to be essential in diagnosing CNV in >16% of cases. However, it often failed to conclude for the absence of CNV, which obliged to perform more exams such as angiography. OCT-A must be part of diagnostic procedure for CNV detection but does not discard angiography in everyday life practice. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the post‐approval long‐term outcomes of the Argus II Retinal Prosthesis, with a specific focus on its functional visual benefit in patients' daily activities. Methods: Eighteen patients with bare light perception due to end‐stage retinitis pigmentosa were included in a French prospective, multicentre, single‐arm study and followed for 2 years. Visual benefit in patients' daily activities was monitored through the use of the Functional Low‐vision Observer Rated Assessment (FLORA), and the final score at 2 years was the primary effectiveness outcome. Standardized visual assessments were also performed. Device‐ or procedure‐related adverse events were recorded. Results: Seventeen subjects completed the study. Positive impacts of the Argus II system on functional vision and well‐being were demonstrated for over 70% of subjects on the FLORA. Among the daily activities/tasks tested, finding doorways was one of the most statistically significantly improved tasks (p < 0.001), along with estimating the size of an obstacle (p < 0.001), visually locating a place setting on a dining table (p < 0.001) and visually locating people in a non‐crowded setting (p < 0.001). Visual function was improved on most standardized tests. Only two device‐ or procedure‐related serious adverse events were observed (one vitreous haemorrhage and one endophthalmitis, both resolved with treatment). No explantation was required. Conclusion: This first report of a completed post‐approval study of Argus II with a two‐year follow‐up demonstrates the safety and effectiveness of the Argus II System in a real‐world cohort of patients and further highlights its real functional benefit in implanted patients' daily activities. [ABSTRACT FROM AUTHOR]

Purpose: To report visual and anatomical outcomes and determine predictors of good visual acuity (VA) recovery after macula‐off rhegmatogenous retinal detachment (RD). Methods: Prospective multicentre study including 115 eyes from 115 patients successfully operated on for RD, with assessment of VA and spectral‐domain optical coherence tomography (SD‐OCT) macular images at 1, 3, 6 and 12 months after surgery. Results: Over the follow‐up period, VA significantly improved from median [IQR] 62 [46; 72] ETDRS letters at 1 month to 75 [67; 80] ETDRS letters at 12 months (p < 0.001) with a concomitant decreased number of eyes with any SD‐OCT lesions (p < 0.001). The presence of subretinal fluid (SRF) significantly decreased (p < 0.001), as did the number of photoreceptor (PR) layer lesions (p = 0.04). At 12 months, lesions in the PR layer and poor VA recovery were significantly associated with a longer time to surgery (p = 0.007 and p < 0.001, respectively). The rate of patients without PR lesions increased from 40.9% at 1 month to 60.0% at 6 months and 73.9% at 12 months (p < 0.001). The incidence of epiretinal membrane (ERM) significantly increased (p < 0.001), while cystoid macular oedema (CME) remained stable over time. Visual acuity (VA) at 3 months postoperatively was a good reflection of final VA recovery (p < 0.001). Conclusion: Visual acuity (VA) improved in parallel with the decreasing number of eyes with SD‐OCT lesions after macula‐off rhegmatogenous RD. A long time to surgery was the only preoperative factor associated with poor VA recovery after retinal detachment surgery. [ABSTRACT FROM AUTHOR]

Aim: To compare the treatment effect of brolucizumab, a novel anti–vascular endothelial growth factor therapeutic, with a putative placebo in patients with wet age-related macular degeneration. Materials and Methods: Clinical treatment-effect data from patients receiving brolucizumab 6 mg in the HAWK and HARRIER studies were compared with modelled placebo data using a previously developed and validated indirect response, non-linear, mixed effects model describing the natural visual acuity decline in wet age-related macular degeneration. The placebo model incorporated patient-level data from the sham injection arms of the MARINA and PIER studies, corrected for baseline best corrected visual acuity and age difference between these studies and the HAWK and HARRIER studies. Results: Compared with a modelled placebo, brolucizumab treatment was associated with an overall best corrected visual acuity gain of approximately 22 Early Treatment Diabetic Retinopathy Study letters at Week 48 and 28 letters at Week 96. Conclusions: As anti–vascular endothelial growth factor therapy is now a standard of care for wet age-related macular degeneration, it is not feasible to conduct placebo-controlled trials for new wet age-related macular degeneration treatments. By allowing comparison with the natural decline in visual acuity without treatment, this analysis conveys the clinical importance of brolucizumab for the treatment of wet age-related macular degeneration. [ABSTRACT FROM AUTHOR]

Purpose: Dome-shaped macula (DSM) is characterized by an inward bulge in the macula, often associated with a myopic staphyloma. One complication of DSM is particularly studied: foveolar serous retinal detachment (SRD). This study analyzed the variations of optical coherence tomography angiography (OCT-A) decorrelation signal in cases of DSM with and without SRD. Methods: This was a retrospective study including twenty height eyes presenting with DSM. OCT-A scans were recorded, and the intensity of the choroidal decorrelation signal was quantified to analyze choroidal blood flow (CBF) in central, temporal, and nasal macular areas. The size of retinal pigment epithelium (RPE) atrophy was evaluated. Results: CBF in the central area was significantly greater in the SRD group than in the no-SRD group (7.00 × 105 vs. 2.58 × 105) (p = 0.0049). CBF appeared decreased in the subfoveal area compared with the periphery for patients without SRD (p = 0.0107). The size of RPE atrophy was 0.762 optic disc area ±0.87. RPE atrophy correlated very significantly with CBF (p = 0.0012). Conclusion: A greater retrofoveolar CBF intensity is associated with the presence of SRD. These changes could reflect variations of CBF, and may represent a potential explanation for the pathogenesis of SRD in DSM. [ABSTRACT FROM AUTHOR]

Purpose: The host immune reaction during endophthalmitis, studied in particular through the intraocular cytokine network, is essential for the comprehension of the disease and the development of new therapies. Therefore, the purpose of this study was to elucidate the cytokine composition of aqueous humor during endophthalmitis.Methods: In a multicenter case-control study, forty-nine patients with postoperative endophthalmitis and 60 controls (cataract surgery) were included. Visual acuity, local inflammatory grading, medical history and intraocular levels of 27 cytokines and chemokines (measured by multiplex immunoassay) were recorded.Results: During endophtalmitis, an increase in total cytokines was observed. The raise of Th1 cytokines was particularly noticeable. Chemokines, such as IL-8, MIP-1 β, MCP-1, G-CSF and IP-10, also increased. Pearson's correlation analyses showed a poor visual prognosis with high levels of IL-8, MCP-1 and VEGF and a low level of IL-10 at admission.Conclusion: An increase in inflammatory cytokines is noticeable during endophthalmitis, with a particular emphasis on IL-8, MCP-1 and VEGF. Targeted anti-inflammatory and anti-VEGF treatments may be of interest in the future. [ABSTRACT FROM AUTHOR]