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Introduction To assess inter-device agreement in optical coherence tomography-derived retinal thickness measurements in patients with known macular conditions between spectral-domain and swept-source optical coherence tomography (OCT). Methods Two hundred seventy-two subjects were included in the study. They consisted of 91 male (33.5%) and 181 female (66.5%) subjects, and 132 left (48.5%) and 140 right (51.5%) eyes. Each subject underwent spectral-domain OCT (SD-OCT, Spectralis, Heidelberg Engineering; RTVue XR Avanti XR HD, Optovue) and swept-source OCT (SS-OCT; DRI-OCT-1, Atlantis, Topcon) in a single imaging session performed by the same clinical trial-certified technician. The comparison of retinal thickness reproducibility between devices was performed using Bland-Altman analyses and across the entire data set using the intraclass correlation coefficient (ICC). Results The ICC of the retinal thickness measurements (95% confidence interval) made using all three OCT instruments was 0.81 (0.77-0.84). The mean difference in mean retinal thickness between Spectralis SD-OCT and Topcon SS-OCT was 59.1 μm (95% limit of agreement [LoA] -21.7 to 139.8 μm). The mean difference in mean retinal thickness between Optovue SD-OCT and Topcon SS-OCT was 21.8 μm (95% LoA -34.7 to 78.3 μm). Conclusions Retinal layer thickness measurements vary between SS-OCT and SD-OCT devices. We describe inter-device agreement in retinal thickness between SS-OCT and SD-OCT in patients with macular conditions. Clinicians should be aware of the differences in retinal thickness values when imaging patients using different OCT devices and should consider using the same OCT device model in order to monitor clinical change. Trial registration ClinicalTrials.gov Identifier (NCT02828215).

Laurent Kodjikian,1 Amélie Lecleire-Collet,2 Corinne Dot,3 Marie-Laure Le Lez,4 Stéphanie Baillif,5 Ali Erginay,6 Eric Souied,7 Eric Fourmaux,8 Philippe Gain,9 Anne Ponthieux10 1Department of Ophthalmology, Croix-Rousse University Hospital, Lyon, France; 2Mathilde Clinic, Rouen, France; 3Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France and French Military Health Service Academy, Val-de-Grâce, Paris, France; 4Ophthalmology Department, Centre Hospitalier Regional Universitaire de Tours, Tours, France; 5Department of Ophthalmology, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur-2, Nice, France; 6Department of Ophthalmology, Lariboisière Hospital, AP HP, University Paris-Diderot Paris-7, Paris, France; 7Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France; 8Centre Gallien, Bordeaux, France; 9Ophthalmology Department, University Hospital, Saint-Etienne, France, Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA2521, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint‐Etienne, France; 10Novartis Pharma SAS, Rueil-Malmaison, FranceCorrespondence: Laurent KodjikianDepartment of Ophthalmology, Croix-Rousse University Hospital, 103 Grande Rue de la Croix-Rousse, Lyon, 69004, FranceTel +33 4 26 10 94 29Fax + 33 4 72 07 26 45Email Kodjikian.laurent@wanadoo.frPurpose: To evaluate the real-world effectiveness of intravitreal ranibizumab 0.5 mg (Lucentis) in improving visual acuity (VA) in adults with decreased VA due to diabetic macular edema (DME).Patients and Methods: Real-world prospective observational 24-month study. Ranibizumab-naïve patients (n=116) were enrolled, treated and followed up according to investigators’ usual procedures. Outcomes included change from baseline to month 24 in best-corrected VA (BCVA; primary outcome), central retinal thickness (CRT), treatment exposure and safety.Results: Overall, 62.9% of patients completed the study per protocol, 68.6% completed the induction phase (first three injections one month apart). On average, patients had 12.5 ophthalmologist visits and 5.74 injections in year 1, decreasing to 4.6 visits and 1.94 injections in year 2. Mean baseline BCVA was 58.4 letters, mean gain at M24 was +6.08 letters (95% CI: 2.95, 9.21). Gains were higher for patients who completed induction, and for patients who did not switch treatment. Mean CRT improved by 149.17 μm at M24. There were no new safety signals. BCVA variation of ≥ 6 letters by M3 was predictive of BCVA gains at M24 (p=0.007), as was hypertension medication at baseline (p=0.022).Conclusion: Real-world ranibizumab treatment improved VA in DME patients, despite fewer injections than recommended.Keywords: real-world study, retinal thickness, visual acuity, switch, induction

Retinal fluid and thickness are important anatomical features of disease activity in neovascular age-related macular degeneration. This review describes how these anatomical features relate to the visual acuity and the efficacy of dosing regimens that make use of these features for determining dosing interval durations., Purpose: Retinal fluid and thickness are important anatomical features of disease activity in neovascular age-related macular degeneration, as evidenced by clinical trials that have used these features for inclusion criteria, retreatment criteria, and outcome measures of the efficacy of intravitreal injections of anti–vascular endothelial growth factor agents. Methods: A literature review of anatomical measures of disease activity was conducted. Results: Treatment goals for neovascular age-related macular degeneration include improving/maintaining vision by drying the retina, and several analyses have evaluated the relationship between visual function and anatomy. The change in retinal thickness has been found to correlate with the change in the visual acuity, and variation in retinal thickness may predict visual acuity outcomes. In addition, specific fluid compartments may have different prognostic values. For example, the presence of intraretinal fluid has been associated with poorer visual acuity, whereas the presence of subretinal fluid has been associated with better visual acuity. Retinal fluid and thickness are important for selecting dosing interval durations in clinical trials and clinical practice. Conclusion: Retinal thickness and retinal fluid are common anatomical measures of disease activity in neovascular age-related macular degeneration. Further research is required to fully elucidate the relationship between anatomical features and visual outcomes in neovascular age-related macular degeneration.

Aim The aim of this study is to compare the choroidal, retinal, and peripapillary nerve fiber layer thickness of the patients diagnosed with hyperthyroidism but did not develop ophthalmopathy with the euthyroid patients.Material and Methods: Thyroid stimulating hormone (TSH), freeT3 (fT3) and freeT4 (fT4) tests of the patients were analyzed. Cases who came in with symptoms of hyperthyroidism and had a TSH lower than 0.5 mu/L were included to the study. Retinal thickness (RT), retinal nerve fiber layer (RNFL) thickness, and choroidal thickness (CT) were calculated by means of spectral domain optical coherence tomography.Results: A total of 82 participants, covering 40 (49%) hyperthyroid patients and 42 (51%) euthyroid healthy individuals, were examined. In terms of RT measurements, T500,T1000,T1500 and N1500 values were found to be lower in the HT group compared to the control group, and they were statistically significant (p, Amaç: Bu çalışmada, hipertiroidi tanısı olan ve oftalmopati gelişmemiş hastalardaki koroid, retina ve peripapiller sinir lifi tabakasının kalınlığını ötiroid hasta grubuyla karşılaştırmak amaçlanmıştır.Gereç ve Yöntemler: Hastaların serum tiroid stimülan hormon (TSH), serbest T3 (fT3), serbest T4 (fT4) değerleri incelendi. Hipertiroidi semptomları ile başvuran ve tetkiklerinde TSH; 0,5 mu/L’nin altında saptanan olgular çalışmaya dahil edildi. Spektral domain optik koherens tomografi ile retina kalınlığı (RT), retina sinir lifi tabakası (RSLT) kalınlığı ve koroid kalınlığı (CT) hesaplandı.Bulgular: Çalışmaya 40’ı (%49) hipertiroidi hastası (HT), 42’si (%51) ötiroidik sağlıklı bireyler olmak üzere toplamda 82 kişi dahil edildi. RT ölçümleri açısından T500, T1000, T1500 ve N1500 değerlerinin HT grupta kontrol grubuna göre daha düşük olduğu olduğu ve bunların istatistiksel olarak anlamlı olduğu görüldü (sırasıyla p

Gürlevik, Uğur ( Aksaray, Yazar ), Purpose: To investigate the effect of oral isotretinoin use on refractive error, axial length, and anteroposterior segment parameters. Materials and methods: In this prospective study, 50 eyes of 50 patients using isotretinoin with a diagnosis of acne vulgaris and 50 eyes of 50 healthy control subjects were included. After detailed biomicroscopy, measurements were taken of axial length, lens thickness, central corneal thickness, anterior chamber depth, central retinal thickness, and subfoveal choroidal thickness. The pupils of both eyes were dilated with one drop of cycloplegic drops after refraction measurement. Visual acuity examination was performed with a Snellen chart the next day. The same procedure was repeated at the end of the third and sixth month of drug treatment. Results: Forty-seven patients with acne vulgaris and 45 healthy controls met the inclusion criteria and were included in the analysis. The mean ages of the patients and the controls were 21.7 ± 2.5 years (range, 18–28 years) and 22.6 ± 2.7 years (range, 19–27 years), respectively. No significant changes were observed in any parameters in the third and sixth month in the control group (p > 0.05). The most important result was significant increases in myopia and axial length in the sixth month of isotretinoin use (p = 0.01, p = 0.04, respectively). There were no significant relationships between increases in myopia and axial length and patients’ age, sex, drug dose, and initial refraction (p > 0.05). The changes in spherical equivalent and axial length differed significantly between the drug group and the control group (p = 0.001, p = 0.001, respectively). Conclusions: Isotretinoin is one of the important molecules in the aetiology of myopia. Oral isotretinoin treatment may increase myopia and axial length, although not to a clinically significant degree. However, as this was a pilot study, there is a need for further studies with more patients and longer follow-up periods.

BACKGROUND The relation of retinal thickness to neuropsychological indexes of cognitive impairment in patients with Alzheimer disease (AD) remains an area of investigation. The scope of this investigation was to compare volume and thickness changes of neuronal retinal layers in subjects with AD with those of age-matched healthy controls and to estimate the relation between cognitive functioning evaluated by neuropsychological assessment and thickness changes of the retina. METHODS This was a prospective single-site study where we evaluated 25 subjects with probable AD matched for age, sex, and education to 17 healthy control subjects (HC). All participants underwent a full medical evaluation, neuropsychological assessment, and optical coherence tomography (OCT) to evaluate the peripapillary retinal nerve fiber layer (pRNFL) thickness, ganglion cell complex (GCC) thickness, and macular volume. RESULTS The pRNFL thickness of AD patients showed a significant overall reduction compared with healthy controls (P =

Purpose: To investigate the effects of refraction on retinal thickness measurements at different locations and layers in healthy eyes of Saudi participants. Methods: Thirty-six randomly selected adults aged 27.0 ± 5.7 years who attended a Riyadh hospital from 2016 to 2017 were categorized into three groups: non-myopic (spherical equivalent refraction [SER], +1.00 to –0.50 diopters [D]), low myopic (SER, –0.75 to –3.00D), and moderate to high myopic (SER ≤ –3.25D). Full, inner, and outer retinal thicknesses were measured at nine locations by spectral-domain stratus optical coherence tomography (Optovue Inc., Fremont, CA, USA) and were compared according to refractive group and sex. Results: The mean SERs for the non-myopia, low myopia, and moderate to high myopia groups were 0.2 ± 0.6, –1.5 ± 0.5, and –7.5 ± 1.9 D, respectively. Refractive error, but not sex, had significant effects on the retinal layer thickness measurements at different locations (P < 0.05). The parafoveal and outer retinal layers were significantly thicker than the perifoveal and inner retina layers in all groups (P < 0.05). The full foveal thickness was higher and the full parafoveal and perifoveal regions were thinner in moderate to high myopic eyes than in the non-myopic eyes (P < 0.05), but were similar to those in the low myopic eyes (P > 0.05). The foveal thicknesses measured in the inner and outer layers of the retina were higher but the thicknesses measured at the inner and outer layers of the parafoveal and perifoveal regions were lower in moderate to high myopic eyes. Conclusion: There were regional differences in the retinal layer thicknesses of healthy Saudi eyes, which was dependent on the central refractions. This is important when interpreting retinal nerve fiber layer thicknesses in myopia and disease management in Saudi participants.

Background: Optical coherence tomography (OCT) of the retina is a fast and easily accessible tool for the quantification of retinal structural measurements. Multiple studies show that patients with Alzheimer's disease (AD) exhibit thinning in several retinal layers compared to age-matched controls. Subjective cognitive decline (SCD) has been proposed as a risk factor for progression to AD. There is little data about retinal changes in preclinical AD and their correlation with amyloid-β (Aβ) uptake. Aims: We investigated the association of retinal thickness quantified by OCT with Aβ accumulation and conversion to mild cognitive impairment (MCI) over 24 months in individuals with SCD. Methods: One hundred twenty-nine individuals with SCD enrolled in Fundació ACE Healthy Brain Initiative underwent comprehensive neuropsychological testing, OCT scan of the retina and florbetaben (FBB) positron emission tomography (PET) at baseline (v0) and after 24 months (v2). We assessed the association of sixteen retinal thickness measurements at baseline with FBB-PET status (+/-) and global standardize uptake value ratio (SUVR) as a continuous measure at v0 and v2 and their predictive value on clinical status change (conversion to mild cognitive impairment (MCI)) at v2. Results: Mean age of the sample was 64.72 ± 7.27 years; 62.8% were females. Fifteen participants were classified as FBB-PET+ at baseline and 22 at v2. Every 1 μm of increased thickness in the inner nasal macular region conferred 8% and 6% higher probability of presenting a FBB-PET+ status at v0 (OR = 1.08, 95% CI = 1.02-1.14, p = 0.007) and v2 (OR = 1.06, 95% CI = 1.02-1.11, p = 0.004), respectively. Inner nasal macular thickness also positively correlated with global SUVR (at v0: β = 0.23, p = 0.004; at v2: β = 0.26, p = 0.001). No retinal measurements were associated to conversion to MCI over 24 months. Conclusions: Subtle retinal thickness changes in the macular region are already present in SCD and correlate with Aβ uptake. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement no. 796706, and the Instituto de Salud Carlos III (ISCIII) grant PI19/00335 Acción Estratégica en Salud, integrated in the Spanish National R+D+I Plan and financed by ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER-Una manera de hacer Europa") awarded to M.M. Funds were also obtained from donations from “La nit de l’Alzheimer”, a charity dinner initiative that takes place yearly as part of the “Festival Castell de Peralada” (2016-2018). The neuro-ophthalmology exam devices were acquired with a grant EFSD/Lilly Mental Health and Diabetes 2013 Programme of the European Foundation for the Study of Diabetes (EFSD) awarded to the project “Retinal neurodegeneration in type 2 diabetes as biomarker of Alzheimer’s disease” under the leadership of C.H. Funds from Fundació ACE Institut Català de Neurociències Aplicades, Grifols, Life Molecular Imaging, Araclon Biotech, Alkahest, Laboratorio de análisis Echevarne and IrsiCaixa are supporting the FACEHBI study. These sponsors were not involved in the study design, data collection, analysis or interpretation. The sponsors have reviewed the manuscript and have given their approval.

Purpose: Early detection of structural changes in retinal ganglion cells (RGCs) and corresponding changes in visual function is important in early degenerative diseases of the retina, but the sensitivity of both measurements is limited by the inherent variability in healthy subjects. This study investigates the relationships between RGC-related layer thicknesses and foveal and parafoveal flicker modulation sensitivity (FMS) across photopic and mesopic light levels in healthy subjects.\ud \ud Methods: Photopic and mesopic FMS was measured in 56 young adults, at the point of fixation and at an eccentricity of 5 degrees, in each of the four quadrants. Spectral-domain optical coherence tomography (SD-OCT) was used to measure retinal thicknesses. Relationships between foveal and parafoveal FMS and the retinal thickness in the corresponding region were examined after adjusting for confounding variables.\ud \ud Results: Total macular and inner retinal layer (IRL) thicknesses in the parafoveal ring were significant predictors of photopic (P = 0.034) and mesopic (P = 0.034) parafoveal FMS, respectively. The superior peripapillary retinal nerve fiber layer (pRNFL) thickness was a contributing factor to the inferior parafoveal FMS (photopic: P = 0.006 and mesopic: P = 0.021) and the inferior pRNFL thickness was also a contributing factor to the superior parafoveal FMS (photopic: P < 0.001 and mesopic: P = 0.015).\ud \ud Conclusions: The pRNFL thicknesses predict parafoveal FMS for both mesopic and photopic conditions in healthy eyes.\ud \ud Translational Relevance: The measurement of rapid flicker sensitivity in the parafoveal retina together with the pRNFL thickness profiles measured before the onset of disease, may provide a more sensitive biomarker for detecting loss of sensitivity caused by the earliest neurodegenerative changes in the eyes.

Objectives To observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women. Methods A case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test. Results Among the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P P Conclusions In this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.

Objective To evaluate changes in retinal nerve fiber layer (RNFL) and macular thicknesses, included ganglion cell-inner plexiform layer (GCIPL) thickness, in patients with spontaneous intracranial hypotension (SIH). Methods This was a retrospective, nonrandom, observational case series study. Comprehensive ophthalmic examinations and systemic examinations were performed. Spectral domain optical coherence tomography angiography scanning was used to measure peripapillary RNFL thickness and macular volume. Results In total, 108 eyes in 54 patients with SIH were evaluated; these were compared with 108 eyes in 54 healthy controls. The mean ages were 38.2 ± 9.4 years (patients with SIH) and 38.9 ± 9.4 years (healthy controls). In both groups, 33 patients were women (61.1%). The peripapillary RNFL and GCIPL were thinner in patients with SIH than in healthy controls (100.08 ± 9.94 µm vs 104.83 ± 8.35 µm and 81.46 ± 5.67 µm vs 85.67 ± 4.57 µm, respectively). Among patients with SIH, the GCIPL was thinner in patients with visual field defects (79.81 ± 5.62 µm vs 82.39 ± 5.12 µm). Conclusions The RNFL and GCIPL were thinner in patients with SIH than in healthy controls. The GCIPL was thinner in eyes with visual field defects among patients with SIH.

Previous studies based on clinical trial data have demonstrated that greater fluctuations in retinal thickness during the course of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD) is associated with poorer visual acuity outcomes. However, it was unclear whether similar findings would be observed in real-world clinical settings. This study aimed to evaluate the association between retinal thickness variability and visual outcomes in eyes receiving anti-VEGF therapy for nAMD using pro re nata treatment regimen. A total of 64 eyes which received intravitreal anti-VEGF therapy (bevacizumab, ranibizumab or aflibercept) for the treatment of nAMD were evaluated. Variability in spectral-domain optical coherence tomography (OCT) central subfield thickness (CST) was calculated from the standard deviation (SD) values of all follow-up visits after three loading doses from month 3 to month 24. Eyes were divided into quartiles based on the OCT CST variability values and the mean best-corrected visual acuity values at 2 years were compared. At baseline, the mean ± SD logMAR visual acuity and CST were 0.59 ± 0.39 and 364 ± 113 µm, respectively. A significant correlation was found between CST variability and visual acuity at 2 years (Spearman’s ρ = 0.54, p &lt, 0.0001), indicating that eyes with lower CST variability had better visual acuity at 2 years. Eyes with the least CST variability were associated with the highest mean visual acuity improvement at 2 years (quartile 1: +9.7 letters, quartile 2: +1.1 letters, quartile 3: −2.5 letters, quartile 4: −9.5 letters, p = 0.018). No significant difference in the number of anti-VEGF injections was found between the four CST variability quartile groups (p = 0.21). These findings showed that eyes undergoing anti-VEGF therapy for nAMD with more stable OCT CST variability during the follow-up period were associated with better visual outcomes. Clinicians should consider adopting treatment strategies to reduce CST variability during the treatment course for nAMD.

Purpose To provide a comprehensive analysis of light- and dark-adapted luminance thresholds and their associations with retinal structure in X-linked retinoschisis (XLRS). Methods Nine subjects with XLRS and 10 visually-normal individuals participated. Threshold was measured at 15 locations along the horizontal meridian of the visual field at several adaptation levels (5 × 10-5 to 50 cd/m2) after dark-adaptation. The relationship between threshold and adaptation level across the field was described using a standard "threshold-versus-illuminance" model. Optical coherence tomography images were obtained and segmented to quantify outer nuclear layer (ONL+) and outer segment (OS+) thickness. A linear structure-function model was used to describe the relationship between threshold and the product of ONL+ and OS+ thickness. Results For peripheral field measurements, thresholds were generally normal for most subjects with XLRS. All subjects had perifoveal and parafoveal threshold elevations under dark-adapted and high illuminance conditions, with thresholds at moderate illuminances being closer to normal. For foveal measurements, seven of nine subjects with XLRS had normal dark-adapted thresholds, and all had abnormally elevated high illuminance thresholds. Threshold-versus-illuminance curves in the fovea, parafovea, and perifovea were abnormally steep for subjects with XLRS, appearing similar to the normal peripheral field shape. Under both dark- and light-adapted conditions, threshold was predicted by ONL+ × OS+ thickness at nearly all field locations. Conclusions Threshold elevation in XLRS is complex, depending on both the adaptation level and the visual field location. The pattern of threshold-versus-illuminance suggests that macular function in XLRS is similar to the periphery of controls.

Background Tissue derived biomarkers may offer utility as indicators of accumulated damage. Reduced thickness of retinal neuronal tissue and the vascular choroid have previously been associated with vascular damage and diabetes. We evaluated associations between retinal thickness, retinal microvascular and choroidal measures, and renal function in a population with a high burden of comorbidity. Methods Participants were recruited from nuclear cardiology or renal medicine clinics. Retinal and choroidal thickness were measured from spectral-domain optical coherence tomograms. Retinal microvascular parameters were assessed from digital fundus photographs using a semi-automated software package. Main Outcome Measure: Chronic kidney disease (CKD) categorised as: CKD stages 1–2, eGFR ≥60 ml/min/1.73m2; CKD stage 3, eGFR 30–59 ml/min/1.73m2, and CKD stages 4–5, eGFR ≤29 ml/min/1.73m2. Results Participants (n = 241) had a mean age of 65 years and a mean eGFR of 66.9 ml/min/1.73m2. Thirty–nine % of the cohort had diabetes and 27% were using diuretics. Thinning of the inner retina and changes to its microvascular blood supply were associated with lower eGFR and CKD stages 4 and 5, while no associations were found between the outer retinal layers or their choroidal blood supply and CKD of any stage. These associations remained following adjustment for age, mean arterial blood pressure, diabetes status, low-density lipoprotein, body mass index, and sex. Conclusions Inner retinal thinning and retinal microvascular variation is associated with advanced CKD (stages 4 & 5) independent of important confounding factors, but not with earlier stage CKD (stage 3) and, therefore, its utility as a biomarker for early CKD is not supported in this study.

Purpose: To study the structural and functional changes of retinal ischemia and investigate their association with macular edema (ME) or microaneurysm (MA) formation in eyes with retinal vein occlusion (RVO). Methods: Sixty eyes of 30 patients (27 eyes with branch [b]RVO, 3 with central RVO, and 30 fellow eyes) were retrospectively reviewed. Optical coherence tomography (OCT), OCT angiography (OCTA), and microperimetry were performed simultaneously to measure retinal thickness and sensitivity. The presence of ME or MA was also assessed using OCT and fluorescein angiography. Results: The mean retinal sensitivity in the nonperfused areas (NPAs) deteriorated, and this was significantly (r = –0.379, p = 0.0391*) and inversely correlated with duration from disease onset. ME and MA were unlikely to be observed around the area where the retinal sensitivity decreased. In the NPAs, the mean retinal thickness of the superficial capillary plexus (SCP) (p < 0.0001), deep capillary plexus (DCP) (p = 0.0323), and outer retina (p = 0.0008) were significantly thinner than those in the fellow eyes, respectively. Multivariate regression analysis revealed that the thicknesses of the DCP (β: 0.3107, p = 0.0007) and outer retina (β: 0.3482, p = 0.0001) were the independent correlative factors of the retinal sensitivity, but that SCP thickness was not. Conclusion: Deep retinal thinning in NPAs was correlated significantly with a decreased retinal sensitivity, which might be a negative predictor of ME and MA in eyes with RVO.

Aim Randomized pilot study comparing clinical outcomes with bromfenac ophthalmic solution 0.07% versus nepafenac 0.3% ophthalmic suspension administered as identical dosing regimens in patients undergoing uncomplicated phacoemulsification with intraocular lens implantation. Methods Forty-nine subjects were treated with bromfenac (n = 25) or nepafenac (n = 24) once daily starting 3 days before cataract surgery, continued on the day of surgery, and for 21 days following surgery, in addition to standard of care. Subjects were followed at 1 day and 7, 21, and 42 days postoperatively. Assessments included best-corrected visual acuity [Early Treatment Diabetic Retinopathy Study (ETDRS)], summed ocular inflammation score (SOIS; anterior chamber cells plus flare grading), macular volume and thickness (spectral domain optical coherence tomography), intraocular pressure, and adverse events. Results Treatment groups were similar at baseline. Outcomes for mean letters read (p = 0.20), mean change in macular volume (p = 0.98), and retinal thickness (p = 0.93) were not statistically different between the groups at day 42. Mean SOIS dropped markedly and similarly from post-surgical day 1 to day 7 in both treatment groups and was statistically equivalent to baseline in both groups by day 21. At day 42, 87% of subjects in the bromfenac group and 82% of subjects in the nepafenac group demonstrated stable or improved visual acuity. The proportions of eyes with mean retinal thickness of 10 µm or less at days 7, 21, and 42 were similar for the bromfenac (95.8%, 78.3%, 73.9%, respectively) and nepafenac (91.7%, 87.5%, 66.7%) groups (all p = NS, bromfenac vs. nepafenac). Conclusion Both bromfenac 0.07% and nepafenac 0.3% produced positive and similar clinical outcomes with regard to ETDRS visual acuity post-cataract surgery when dosed using identical regimens. Increases in mean retinal thickness and mean macular volume were small and similar between treatments. Trial Registration number NCT01847638. Funding Bausch & Lomb Incorporated.

Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head‐down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two‐thirds of the subjects received a daily 30‐min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short‐arm centrifugation to investigate whether this intervention would attenuate headward fluid shift‐induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9–51.9 µm, p, Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. To investigate this condition, healthy subjects were exposed to strict 6º head‐down tilt bed rest (HDTBR), a spaceflight analog that causes a chronic headward fluid shift and can lead to the development of optic disc edema in some participants. For the first time, we demonstrate that chorioretinal folds develop during HDTBR, along with signs of optic disc edema, similar to findings that occur in astronauts during spaceflight. However, ocular changes were not mitigated in subjects who were exposed for 30 min per day to continuous or intermittent artificial gravity (AG) via centrifugation during HDTBR. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating these ocular changes and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye than used here may be required to prevent or mitigate spaceflight associated neuro‐ocular syndrome findings.

We aimed to investigate the relationship between subfoveal choroidal thickness (SCT) and treatment outcomes of intravitreal aflibercept (IVA) for macular edema (ME) due to branch retinal vein occlusion (BRVO). We retrospectively evaluated 46 patients with treatment-naive BRVO-ME who underwent IVA treatment between March 2016 and February 2017. There was no significant difference in visual acuity within 6 months (0.29 ± 0.20 vs. 0.27 ± 0.19, p = 0.338), the mean central foveal thickness improvement (332.0 ± 162.2 μm vs. 303.9 ± 166.6 μm, p = 0.492), and the mean number of IVA injections (1.7 ± 0.7 vs. 1.6 ± 0.7 times, p = 0.658) between the SCT thickened (n = 26 patients, 26 eyes) and SCT non-thickened groups (n = 20 patients, 20 eyes). The rate of ME recurrence was significantly lower in the SCT decreased group (6/17 eyes (35.2%) vs. 19/30 eyes (63.3%), p = 0.038). In conclusion, pretreatment choroidal thickening does not affect the therapeutic effect of IVA for BRVO, but ME recurrence was lower in cases of treatment-related choroidal thinning. Thus, changes in SCT may be a therapeutic indicator of IVA for acute BRVO.

(1) Introduction: The aim of this study is to assess retinal vessel density (VD) in the superficial capillary plexus layer (SP) and deep capillary plexus layer (DP) in children with chronic heart failure (CHF) in the course of dilated cardiomyopathy (DCM) using optical coherence tomography angiography (OCTA). (2) Methods: Thirty children with CHF due to DCM lasting more than six months, with an enlarged left ventricle and impaired left ventricular systolic function (left ventricular ejection fraction (LVEF) ≤ 55%), were enrolled to have both their eyes assessed for this study. Mean age of the children was 9.9 ± 3.57 years. The control group consisted of an additional 30 children without CHF (mean age 11.27 ± 3.33 years) matched for age and gender against the study group. All participants underwent transthoracic echocardiography to measure LVEF using Simpson method. Blood serum was tested for N-terminal-pro-brain natriuretic peptide (NT-proBNP) marker value. All children underwent OCTA with evaluation of the foveal avascular zone (FAZ), whole superficial vessel density (wsVD), foveal superficial vessel density (fsVD), parafoveal superficial vessel density (psVD), whole deep vessel density (wdVD), foveal deep vessel density (fdVD), parafoveal deep vessel density (pdVD), whole thickness (WT), foveal thickness (FT), and parafoveal thickness (PFT). (3) Results: Retinal VD in SP was significantly lower in children with CHF as compared to the controls. The following SP parameters in the study group were statistically significantly lower than these same measurements for the control group. Details, with study group findings quantified first, include wsVD (46.2% vs. 49.83%, p &lt, 0.05), fsVD (18.07% vs. 24.15%, p &lt, 0.05), and psVD (49.24% vs. 52.51%, p &lt, 0.05). The WT (311.03 micrometers (μm) vs. 323.55 μm, p &lt, 0.05), FT (244.57 μm vs. 256.98 μm, p &lt, 0.05), and PFT (320.63 μm vs. 332.02 μm, p &lt, 0.05). No significant differences in DP retinal VD were found between the two groups. No statistically significant differences in the FAZ were found. The fsVD and FT were correlated with biometry and the age of the study participants. There was a correlation between FAZ and FT (p &lt, 0.001). There were no correlations between retinal VD in both plexuses and refractive error, sex, NT-proBNP, and LVEF. (4) Conclusions: In children with CHF in the course of DCM as compared to the control group, significantly decreased retinal VD in SP was observed. The results of our study indicate that measurements of the OCTA may be a useful diagnostic method in children with chronic heart failure, but it is necessary to conduct further studies in larger groups of participants and long-term observation of these patients.

Background Diabetic retinopathy is the most common microvascular complication of diabetes; however, early changes in retinal microvessels are difficult to detect clinically, and a patient’s vision may have begun to deteriorate by the time a problem is identified. Optical coherence tomography angiography (OCTA) is an innovative tool for observing capillaries in vivo. The aim of this study was to analyze retinal vessel density and thickness changes in patients with diabetes. Methods This was a retrospective, observational cross-sectional study. Between August 2018 and February 2019, we collected OCTA data from healthy participants and diabetics from the First Affiliated Hospital of Harbin Medical University. Analyzed their retinal vessel density and thickness changes. Results A total of 97 diabetic patients with diabetes at different severity stages of diabetic retinopathy and 85 controls were involved in the experiment. Diabetic patients exhibited significantly lower retinal VD (particularly in the deep vascular complexes), thickening of the neurosensory retina, and thinning of the retinal pigment epithelium compared with controls. In the control group, nondiabetic retinopathy group and mild diabetic retinopathy group, superficial VD was significantly correlated with retinal thickness (r = 0.3886, P r = 0.3276, P = 0.0019; r = 0.4614, P = 0.0024, respectively). Conclusions Patients with diabetes exhibit ischemia of the retinal capillaries and morphologic changes in vivo prior to vision loss. Therefore, OCTA may be useful as a quantitative method for the early detection of diabetic retinopathy.

Background: To characterize the longitudinal changes of macular vessel density in young adults and its associated factors.Methods: The right eyes of 309 participants (75 high myopic, 194 mild-to-moderate myopic, and 40 healthy) were followed up for 21 months. OCTA images were acquired at two visits using follow-up scans. Macular vessel density was calculated globally and in the nine early treatment diabetic retinopathy study (ETDRS) subfields of the macula superficial layer.Results: The macular vessel density significantly decreased in young myopes after a 21-month follow up (p < 0.05), with variations among sectors. Compared with healthy eyes, HM group exhibited a faster reduction in global macular vessel density (p = 0.0307) as well as in sectors of inner-inferior (II), inner-temporal (IT), and outer-temporal (OT) (all p < 0.05). Multivariate regression analysis showed that longer baseline axial length (AL) was significantly associated with larger reduction of macular vessel density in the inner-inferior, inner-temporal and outer-temporal sectors (all p < 0.05).Conclusions: Compared with emmetropes, high myopes presented greater loss of macular vessel density over time in global and in the inner-inferior, inner-temporal and outer-temporal sectors. A longer baseline AL was associated with larger changes of macular vessel density in the inner-inferior, inner-temporal and outer-temporal sectors.

Background: We study the retinal function measured by macular integrity assessment microperimetry (MAIA) and structural changes assessed by scanning swept source optical coherence tomography (SS-OCT) between healthy individuals and patients undergoing pars plana vitrectomy (PPV) after rhegmatogenous retinal detachment (RRD). Methods: Cross-sectional study. Early Treatment Diabetic Retinopathy Study (ETDRS) grids were measured by SS-OCT and compared with the MAIA parameters. Results: Thirty-eight eyes with RRD (19 macula-on and 19 macula-off) were compared with 113 healthy eyes. The retinal sensitivity and average total threshold were reduced in all sectors in the RRD group, macular integrity index was increased. Macular thicknesses in total retina and ganglion cell layer (GCL)++ protocols were higher in the RRD group in nasal outer (NO) and central (C) sectors and only in C sector for GCL+ protocol. Thicknesses were lower in total retina, GCL++ protocols in the temporal outer (TO) sector and in the GCL+ protocol in NO sector. Best-corrected visual acuity (BCVA) correlated moderately with retinal sensitivity in all sectors and in just several sectors with time between the date of surgery and the test. The central nasal (CN) sector thickness and the average total threshold were higher in the macula-on subgroup. Conclusions: RRD and subsequent surgery results in functional and structural changes, especially in individuals with macular detachment.

Background Idiopathic epiretinal membrane (iERM) is a common retinal disease in the elderly population. The exact pathogenesis of iERM is unknown. The present study aimed to evaluate the relationship between aqueous flare and morphology of iERM using swept-source optical coherence tomography (OCT). Methods A consecutive series of 36 eyes of 33 patients with iERM and 109 control eyes of 109 patients were retrospectively examined. Aqueous flare measurements and OCT images were obtained on the same day. The average total retinal, inner retinal, outer retinal, and choroidal thicknesses were calculated using the thickness map mode with an Early Treatment Diabetic Retinopathy Study nine-zone grid that was divided into three zones. The maximum depth of the retinal folds in iERMs was manually measured. The correlation among flare value, maximum depth of folds, and retinal and choroidal thicknesses was evaluated. The morphological changes between the control eyes and the eyes with iERM in different stages were examined. Results The result demonstrated a significant positive correlation between the aqueous flare value and total and inner retinal thicknesses in the early stage of iERM. There was a significant positive correlation between the maximum depth of folds and total and inner retinal thicknesses in the early stage of iERM, and the maximum depth of folds significantly increased in the advanced stage. The total and inner retinal thicknesses and proportion of inner retinal thickness significantly increased as the stage of iERM progressed. Conclusions The aqueous flare value was associated with retinal thickness in the early stage of iERM, which supports the idea that inflammation or breakdown of blood–ocular barrier is involved in the process of iERM formation. The maximum retinal folds increased as the stage of iERM progressed and retinal thickness increased, which indicates that the tangential force increases as the iERM stage progresses.

To assess the hypofluorescent foci (HFF) on late-phase indocyanine green angiography (ICGA) in central serous chorioretinopathy (CSC) using short-wavelength fundus autofluorescence (SW-FAF), near-infrared autofluorescence (NIR-AF), and fluorescein angiography (FA). The HFF area on late-phase ICGA for at least 20 min was compared with the area of abnormal foci on SW-FAF, NIR-AF, and FA. In 14 consecutive patients (12 men, including 1 with bilateral CSC, and 2 women with unilateral CSC), four kinds of images of 27 eyes were acquired. The mean age ± standard deviation (range) was 46 ± 9.2 years (31–69 years). The HFF on late-phase ICGA were found in 23 eyes (in all 15 CSC eyes and the contralateral 8 eyes). From the results of simple regression analysis, we obtained the following three formulas. The HFF area on ICGA = 1.058 × [abnormal SW-FAF area] + 0.135, the HFF area on ICGA = 1.001 × [abnormal NIR-AF area] + 0.015, and the HFF area on ICGA = 1.089 × [abnormal FA area] + 0.135. Compared to SW-FAF and FA, NIR-AF was found to be the easiest method to detect the HFF on late-phase ICGA, which may indicate melanin abnormalities, especially a decrease, in the retinal pigment epithelium.

Mice are widely used as models for many diseases, including eye and neurodegenerative diseases. However, there is a lack of normative data for retinal thickness over time, especially at young ages. In this work, we present a normative thickness database from one to four-months-old, for nine layers/layer-aggregates, including the total retinal thickness, obtained from the segmentation of spectral-domain optical coherence tomography (SD-OCT) data from the C57BL6/129S mouse strain. Based on fifty-seven mice, this normative database provides an opportunity to study the ageing of control mice and characterize disease models' ageing, such as the triple transgenic mouse model of Alzheimer's disease (3×Tg-AD) used in this work. We report thickness measurements, the differences in thickness per layer, demonstrate a nasal-temporal asymmetry, and the variation of thickness as a function to the distance to the optic disc center. Significant differences were found between the transgenic group's thickness and the normative database for the entire period covered in this study. Even though it is well accepted that retinal nerve fiber layer (RNFL) thinning is a hallmark of neurodegeneration, our results show a thicker RNFL-GCL (RNFL-Ganglion cell layer) aggregate for the 3×Tg-AD mice until four-months-old. This study was supported by The Portuguese Foundation for Science and Technology (FCT) through PTDC/ EMD-EMD/28039/2017, UIDB/04950/2020, Pest-UID/ NEU/04539/2019, and by FEDER-COMPETE through POCI-01-0145-FEDER-028039. info:eu-repo/semantics/publishedVersion

Purpose: To describe the thickness profiles of the full retinal and outer retinal layers (ORL) at the macula in healthy young adults, and associations with best-corrected visual acuity (BCVA). Methods: In total, 1604 participants (19-30 years) underwent an eye examination that included measurements of their BCVA, axial length, and autorefraction. The retinal thickness at the foveal pit and at the nine Early Treatment of Diabetic Retinopathy Study macular regions (0.5-mm radius around the fovea, and superior, inferior, temporal, and nasal quadrants of the inner and outer rings of the macula) were obtained using spectral-domain optical coherence tomography imaging. A custom program was used to correct for transverse magnification effects because of different axial lengths. Results: The median full retinal and ORL thicknesses at the central macula were 285 µm and 92 µm. The full retina was thinnest centrally and thickest at the inner macula ring, whereas the ORL was thickest centrally and gradually decreased in thickness with increasing eccentricity. There was no association between axial length and the full retinal or ORL thickness. Increased thicknesses of the full retina at the central macula was associated with better BCVA; however, the effect size was small and not clinically significant. Conclusions: This article mapped the full retinal and ORL thickness profile in a population-based sample of young healthy adults. Translational relevance: Thickness values presented in this article could be used as a normative reference for future studies on young adults and in clinical practice.

Purpose To report the resolution of subretinal drusenoid deposits (SDDs) and the changes in macular thickness at various segmentation levels in a patient who was treated for vitamin A deficiency-related retinopathy. Observations A 67-year-old man with cirrhosis secondary to hepatitis C was referred for unexplained vision decline and nyctalopia. He was diagnosed with vitamin A deficiency after he was found to have yellow-white drusen-like deposits in the posterior pole and midperiphery, which corresponded to SDDs on optical coherence tomography (OCT). Treatment with vitamin A supplementation was initiated, and, over the course of eight months, the symptoms improved, the SDDs resolved, and retinal thickness generally increased, although the rate and pattern of change differed depending on the macular quadrant and the segmentation layer being analyzed. Conclusions and importance Vitamin A deficiency should be considered in patients with liver disease who present with drusen-like deposits in the macula and midperiphery. Prompt recognition and treatment may improve symptoms and reverse some retinal pathology, including the presence of SDDs. Vitamin A supplementation in these patients seems to affect the inner retina and outer retina differently.

Healthy human aging is associated with a deterioration of visual acuity, retinal thinning, visual field map shrinkage and increasing population receptive field sizes. Here we ask how these changes are related to each other in a cross-sectional sample of fifty healthy adults aged 20–80 years. We hypothesized that age-related loss of macular retinal ganglion cells may lead to decreased visual field map sizes, and both may lead to increased pRF sizes in the cortical central visual field representation. We measured our participants’ perceptual corrected visual acuity using standard ophthalmological letter charts. We then measured their early visual field map (V1, V2 and V3) functional population receptive field (pRF) sizes and structural surface areas using fMRI, and their retinal structure using high-definition optical coherence tomography. With increasing age visual acuity decreased, pRF sizes increased, visual field maps surface areas (but not whole-brain surface areas) decreased, and retinal thickness decreased. Among these measures, only functional pRF sizes predicted perceptual visual acuity, and Bayesian statistics support a null relationship between visual acuity and cortical or retinal structure. However, pRF sizes were in turn predicted by cortical structure only (visual field map surface areas), which were only predicted by retinal structure (thickness). These results suggest that simultaneous disruptions of neural structure and function throughout the early visual system may underlie the deterioration of perceptual visual acuity in healthy aging. Supplementary Information The online version contains supplementary material available at 10.1007/s00429-021-02338-0.

Ethan Pillay, Thiroshnee Naidoo, Khadija Asmal, Lilitha Maliwa, Sinenhlanhla Mchunua, Diane Beverly van Staden, Nishanee Rampersad Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Durban X54001, South AfricaCorrespondence: Nishanee RampersadDiscipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag, Durban X54001, South AfricaTel +27 31 260 7562Fax +27 31 260 7666Email rampersadn@ukzn.ac.zaIntroduction: The central retina is responsible for several visual functions and continues to develop postnatally. In albinism, which is a genetic disorder characterized by impaired melanin biosynthesis, the development of the central retina is prematurely arrested and results in foveal hypoplasia. Retinal thickness measurements can be determined non-invasively using optical coherence tomography systems. This article reports on the retinal thickness measurements of individuals with albinism in South Africa to aid in the assessment and management of affected individuals.Methods: The study used a comparative research design and included 60 individuals (30 albinism and 30 controls) aged from 10 to 30 years who accessed the eye clinic at a tertiary institution in KwaZulu-Natal, South Africa. The Optovue iVue100 optical coherence tomographer was used to measure retinal thickness in the nine Early Treatment Diabetic Retinopathy Study (ETDRS) sectors including the central foveal, parafoveal and perifoveal regions. Study data were analysed using descriptive and inferential statistics.Results: The mean central foveal thickness was significantly higher in individuals with albinism compared with controls (289 μm versus 239 μm, p < 0.001). In contrast, control participants showed thicker retinal thickness measurements in the other ETDRS sectors (p < 0.001). The nasal and temporal quadrants were thickest and thinnest, respectively, in the parafoveal and perifoveal regions for the albinism and control groups.Conclusion: Individuals with albinism, aged from 10 to 30 years, have higher central foveal thickness but thinner retinal thickness measurements in the parafoveal and perifoveal regions. Optometric personnel should consider these measurements when assessing individuals with albinism with foveal retinal diseases.Keywords: albinism, fovea, foveal hypoplasia, optical coherence tomography, retinal thickness

Graefe's archive for clinical and experimental ophthalmology 259(9), 2731-2741 (2021). doi:10.1007/s00417-021-05203-2, Published by Springer, Berlin ; Heidelberg

BackgroundTo explore the retinal vascular density changes in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) patients using optical coherence tomography angiography (OCTA).MethodsWe recruit 62 AD patients, 47 MCI patients, and 49 cognitively healthy controls (HC) in this study. All participants in the study received a comprehensive ophthalmological and neurological evaluation, including global cognitive screening, as well as the Mini-Mental State Examination (MMSE), and completed the following eye examinations: visual acuity (VA), intraocular pressure (IOP), examination with slit-lamp, fundus photography (Version 1.5.0.0, NIDEK CO, LTD) and Optical coherence tomography imaging (software ReVue version 2017.1.0.155, Optovue Inc., Fremont, CA, United States). The visual rating scales for atrophy and white matter lesion in MRI was evaluated for all the patients with AD and MCI.ResultsIn the AD patient group, the superficial vascular density in the superior, inferior and whole retina was 44.64 ± 3.34, 44.65 ± 3.55, and 44.66 ± 3.36, respectively. These values were 44.24 ± 3.15, 43.72 ± 3.16, and 44 ± 3.07, respectively, in the MCI patient group. After multivariate analysis of the generalized linear model, adjustments for the confounding factors of sex, age, hypertension, diabetes and the quality index of OCTA image, the superficial vascular density in the AD and MCI patient groups was significantly lower than that in the HC group (P < 0.05): 46.94 ± 2.04, 46.67 ± 2.26, and 46.82 ± 2.08, respectively. No difference in the area of the FAZ among the three groups was observed (AD group: 0.34 ± 0.11 mm2; MCI group: 0.36 ± 0.12 mm2; control group: 0.33 ± 0.12 mm2, p > 0.05). The ganglion cell complex (GCC) thickness, inner parafovea thickness, and peripapillary retinal nerve fiber layer (p-RNFL) thickness were associated with the superficial vascular density. We found no significant correlation between the global cognition (MMSE scores) or between the Fazekas score and retinal OCT angiogram flow density.ConclusionThe superficial vascular density in the AD and MCI patient groups was significantly lower than that in the HC group. Our findings suggest the retinal microvascular dysfunction occurred in MCI and AD.

Manual assessment of the retinal thickness in optical coherence tomography images is a time-consuming task, prone to error and inter-observer variability. The wide variability of the retinal appearance makes the automation of retinal image processing a challenging problem to tackle. The difficulty is even more accentuated in practice when the retinal tissue exhibits large structural changes due to disruptive pathology. In this work, we propose an ensemble-learning-based method for the automated segmentation of retinal boundaries in optical coherence tomography images that is robust to retinal abnormalities. The segmentation accuracy of the proposed algorithm was evaluated on two publicly available datasets that included cases of severe retinal edema. Moreover, the performance of the proposed method was compared to two existing methods, widely referenced in the relevant literature. The proposed algorithm outperformed reference methods at segmenting the retinal boundaries in both normal and pathological images. Furthermore, a thorough reliability analysis showed a strong agreement between the retinal thickness measurements derived from the segmentation obtained with the proposed method and corresponding manual measurements computed with the manual annotations.

WOS:000596627600009 PubMed: 33344188 AIM: To evaluate the effect of topical preoperative nepafenac 0.1% treatment on postoperative macular edema using optical coherence tomography (OCT) after uncomplicated cataract surgery. METHODS: Ninety eyes of 90 patients without any risk factors were included in the study. The patients were assigned to three groups: group 1, treated with topical prednisolone acetate 1%; group 2, treated with topical nepafenac 0.1% in addition to prednisolone acetate (1%); and group 3, those who started receiving nepafenac 0.1% treatment 3d prior to surgery and continued the treatment postoperatively in addition to prednisolone acetate (1%). Central retinal thickness (CRT) and macular volume values were recorded using OCT at weeks 3 and 6. RESULTS: The increases in macular volume in the central 1 mm area after 3 and 6wk were significantly lower in patients who used prophylactic topical nepafenac preoperatively (group 3) compared with those in group 1 (P=0.028 and 0.008, respectively). No significant differences in the increase in macular volume and CRT were noted between groups 2 and 3 (P>0.05). In group 1, the increases in macular volume in the central 3 mm area at weeks 3 and 6 were significantly higher than that in group 2 and 3 (3rd week, P=0.004; 6th week, P=0.005). CONCLUSION: Nepafenac 0.1% treatment in addition to topical steroids after uncomplicated cataract surgery reduce the increase in macular volume in the early postoperative period.

Background and objective To report novel findings and limitations from optical coherence tomography angiography (OCTA) in the evaluation of autoimmune retinopathy (AIR). Study design We retrospectively reviewed features of five patients diagnosed with AIR and five controls. OCTA scans were obtained and manually segmented to provide accurate measurements of foveal avascular zone (FAZ), vessel density, and retinal thickness at different levels. Results The total retina and superficial vessel density throughout the whole scan were similar between AIR and controls (p = 0.14 and p = 0.11), whereas deep vessel density was decreased in AIR compared controls (p = 0.02). Decreased vessel density was most pronounced in the parafoveal and perifoveal areas (p = 0.01 and p = 0.01). AIR patients also had reduction of total retinal thickness in the perifoveal zone (p = 0.03), corresponding to outer retinal thinning (p = 0.001). Conclusion This small series shows that AIR patients have reduced deep vessel density, particularly in the parafoveal and perifoveal regions and a decrease in macular thickness. These findings show correlation with the classic “flying saucer” sign seen on OCT.

Supplemental Digital Content is available in the text., Precis: In open-angle glaucoma, when neuroretinal rim tissue measured by volumetric optical coherence tomography (OCT) scans is below a third of the normal value, visual field (VF) damage becomes detectable. Purpose: To determine the amount of neuroretinal rim tissue thickness below which VF damage becomes detectable. Methods: In a retrospective cross-sectional study, 1 eye per subject (of 57 healthy and 100 open-angle glaucoma patients) at an academic institution had eye examinations, VF testing, spectral-domain OCT retinal nerve fiber layer (RNFL) thickness measurements, and optic nerve volumetric scans. Using custom algorithms, the minimum distance band (MDB) neuroretinal rim thickness was calculated from optic nerve scans. “Broken-stick” regression was performed for estimating both the MDB and RNFL thickness tipping-point thresholds, below which were associated with initial VF defects in the decibel scale. The slopes for the structure-function relationship above and below the thresholds were computed. Smoothing curves of the MDB and RNFL thickness covariates were evaluated to examine the consistency of the independently identified tipping-point pairs. Results: Plots of VF total deviation against MDB thickness revealed plateaus of VF total deviation unrelated to MDB thickness. Below the thresholds, VF total deviation decreased with MDB thickness, with the associated slopes significantly greater than those above the thresholds (P

Purpose To report the individual retinal layer thickness in healthy subjects using wide-field optical coherence tomography. Methods This was a prospective, cross-sectional study involving healthy subjects. A custom-designed semiautomated segmentation algorithm was used to split the retinal layers in seven bands, and individual retinal layer thicknesses were measured in horizontal (nasal, macular, and temporal segments) and vertical meridians (superior, macular, and inferior segments). The variation in retinal thickness was analyzed in different segments at an interval of 1 mm from reference points. Regression analysis was performed to identify the factors affecting retinal thickness. Results Twenty eyes of 20 healthy subjects with mean age of 28.9 ± 6.3 years were analyzed. Overall, nasal and superior segments (mean ± standard deviation: 279.6 ± 17.0 and 234.4 ± 19.2 µm) had maximum and minimum retinal thicknesses, respectively. A total of seven bands were delineated in each optical coherence tomography b scan in each segment. Retinal nerve fiber layer was thickest immediately nasal to optic disk margin in horizontal scan (72.4 ± 32.4 µm) and near the vascular arcades in vertical meridian. Outer plexiform layer, external limiting membrane–ellipsoid zone and interdigitation zone–retinal pigment epithelium–Bruch’s complex showed significant variation in both horizontal and vertical meridians (all p values Conclusions Wide-field optical coherence tomography shows significant regional variation in overall and individual retinal layer thicknesses in macular and peripheral areas in healthy eyes with the highest variation in macular segment.

Purpose To characterize the progression in retinopathy severity of different phenotypes of mild nonproliferative diabetic retinopathy (NPDR) in patients with type 2 diabetes. Design and methods Patients with type 2 diabetes and mild NPDR (ETDRS 20 or 35) were followed in a 5-year longitudinal study. Examinations, including color fundus photography (CFP) and optical coherence tomography (OCT and OCTA), were performed at baseline, 6 months and then annually. Phenotype classification was performed based on microaneurysm turnover (MAT, on CFP) and central retinal thickness (CRT, on OCT). Phenotype A is characterized by low MAT ( Results Analysis of ETDRS grade step changes showed significant differences in diabetic retinopathy (DR) progression between the different phenotypes (p p p 1c (p = 0.019), LDL levels (p = 0.043), and ocular factors as MAT (p = 0.010), MA formation rate (p = 0.014) and MA disappearance rate (p = 0.005). Capillary closure at 5-year follow-up, identified by lower vessel density (VD) on OCTA, was also associated with diabetic DR severity progression (p = 0.035). Conclusions Different DR phenotypes in type 2 diabetes show different risks of retinopathy progression. Phenotype C is associated with increased HbA1c values and presents a higher risk of a 2-or-more-step worsening of the ETDRS severity score.

Introduction Schizophrenia patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, the degree and type of brain and retinal alterations associated with combined AHs and VHs in schizophrenia patients remain unknown. There is an urgent need for a study that investigates the trajectory of brain and retinal alterations in patients with first‐episode untreated schizophrenia accompanied by combined AHs and VHs (FUSCHAV). Methods FUSCHAV patients (n = 120), divided into four groups according to AH and VH symptom severity (severe AHs combined with severe VHs [FUSCHSASV, 20 patients]; middle‐to‐moderate AHs combined with severe VHs [FUSCHMASV, 23 patients]; severe AHs combined with middle‐to‐moderate VHs [FUSCHSAMV, 28 patients]; and middle‐to‐moderate AHs combined with middle‐to‐moderate VHs [FUSCHMAMV, 26 patients]), were compared to healthy controls (n = 30). Gray matter volume (GMV) was adopted for brain structural alteration assessment. Total retinal thickness was adopted as a measure of retinal thickness impairment. Results In the pilot study, the rate of GMV reduction showed an inverted U‐shaped pattern across the different FUSCHAV patient groups according to AH and VH severity. The degree of retinal impairment remained stable across the groups. More notably, in the secondary follow‐up study, we observed that, after 6 months of treatment with antipsychotic agents, all the GMV reduction‐related differences across the different patient groups disappeared, and both GMV and retinal thickness demonstrated a tendency to deteriorate. Conclusions These findings indicate the need for heightened alertness on brain and retinal impairments in patients with FUSCHAV. Further deteriorations induced by antipsychotic agent treatment should be monitored in clinical practice., (1) GMV reduction and gFCD increases in the frontal–parietal lobule of FUSCHAV patients demonstrate an inverted U‐shape pattern according to differences in AH and VH severity, indicating functional compensation correlated with volume reduction. (2) There appears to be reciprocal deterioration in auditory and visual disturbances among FUSCHAV patients as observed through both brain and retinal abberations. (3) Although brain alterations in FUSCHAV patients differ with degree of AH and VH severity, retinal impairment remains constant among FUSCHAV groups.

Background To evaluate postoperative changes in retinal capillary plexus and to assess contributing factors in postoperative visual improvement using optical coherence tomography angiography (OCT-A) in patients with idiopathic epiretinal membrane (iERM) post membrane removal. Methods Patients scheduled for vitrectomy and membrane peel for iERM were enrolled. 35 subjects were included for this study. OCT-A was used to measure the FAZ related parameters and the superficial and deep capillary plexus layers using 3 mm × 3 mm scans. Measurements were taken before surgery and at every post-surgical follow-up. The unaffected fellow eyes were used as controls. Evaluated factors included: BCVA, vessel density (VD) and retinal thickness (RT) in five regions, FAZ area, FAZ perimeter (PERIM), acircularity index (AI) and foveal vessel density (FD). Results Compared with the control group, the foveal vessel density (FVD) in superficial capillary plexus (SCP) was greater in the epi-retinal membrane group (P p > 0.05). After surgery there was a reduction in the PRVD in SCP. The FVD in DCP increased and the PRVD in DCP decreased at baseline (p p > 0.05). D-value of LogMAR BCVA was positively correlated with pre-op LogMAR BCVA (p p P P Conclusions Vitrectomy and membrane removal led to the decrease of VD in SCP and the increase of PRVD in DCP. Patients with a more severe iERM may receive greater visual improvement with surgery. Trial registration Trial registration number (TRN) and date of registration. ChiCTR2000031289, retrospectively registered, 2020.03.26.

Purpose:to study the effectiveness of the posterior microinvasive vitrectomy in the surgical treatment of non-full thickness macular holes on the basis of the retrospective analysis of the retina changes, identified by OCT, and functional outcomes of surgical treatment.Patients and Methods. A retrospective analysis of outcomes of posterior microinvasive vitrectomy was performed in 30 patients operated about non-full thickness macular holes. The following features were assessed: maximum diameter of the non-full thickness macular holes, the diameter at the base of the hole, the minimum thickness of the retina before and after operation, the maximum thickness of the retina before and after surgery. In addition, the configuration of the hole edges before surgery, the presence of intraretinal cysts before and after surgery, the integrity of the ellipsoid zone of the photoreceptors before and after the operation and the restoration of fovea centralis as a result of surgical treatment were assessed.Results. As a result of surgical treatment the closure of non-full thickness macular holes was reached in all cases. The most corrected visual acuity in the postoperative period was ranged from 0.1 to 1.0 (0,66 ± 0,04). The visual acuity improved in 20 cases (64.5%), remained at the same level in 8 cases (25.8%) and decreased in 3 cases (9.6%, in 1 case due to the development of cataracts). The results of correlation analysis has allowed to establish correlation between the initial BCVA and the maximum retinal thickness (R = –0.4), and residual retinal thickness in the area of the hole (R = –0.3). The increase in visual acuity after surgical treatment significantly affected the recovery of the ellipsoid zone of the photoreceptors (RD = 0.833), regression of the retinal thickness (R = 0.42). In addition, the initial diameter of non-full thickness macular holes, both external and at the base, also had an impact on the increase in BCVA (R = –0.3 and R = –0.25, respectively).Conclusion. Posterior microinvasive vitrectomy in the surgical treatment of non-full thickness macular holes is a highly effective method of treatment, as evidenced by the closure of the defect and improvement or stabilization of the most corrected visual acuity 90.4% cases. On the basis of the retrospective analysis it is found that the most significant increase in the most corrected visual acuity was increased in patients with low visual acuity. The recovery of the ellipsoid zone of photoreceptors, regression of the retinal thickness and the diameter of non-full thickness macular holes, both external and at the base mostly influences nn the recovery of the most corrected visual acuity.

Introduction The retina may reflect Alzheimer's disease (AD) neuropathological changes and is easily visualized with optical coherence tomography (OCT). Retinal thickness decrease has been correlated to AD, however, without information on amyloid status. We correlated retinal (layer) thickness to AD biomarkers in amyloid-positive early-onset AD (EOAD) patients and amyloid-negative controls. Methods We measured macular thickness and peripapillary retinal nerve fiber layer thickness with OCT in 15 EOAD patients and 15 controls and correlated retinal thickness to visual rating scores for atrophy on magnetic resonance imaging. Results Total macular thickness correlated to parietal cortical atrophy in both groups (Spearman ρ −0.603, P = .001). Macular and peripapillary retinal nerve fiber layer thicknesses were not significantly decreased in EOAD compared to controls. Discussion Retinal thickness does not discriminate EOAD from controls but is correlated to parietal cortical atrophy in both groups. These findings may suggest reflection of cerebral cortical changes in the retina, independent of amyloid., Highlights • Retinal thickness correlates with parietal cortical atrophy in amyloid-positive early-onset Alzheimer's disease patients and amyloid-negative controls. • Macular and retinal nerve fiber layer thicknesses do not discriminate amyloid-positive early-onset AD patients from amyloid-negative controls. • Reflection of cerebral cortical changes may be present in the retina, independent of amyloid.

This study aimed to evaluate and compare the retinal and choroidal thickness and vessel density (VD) changes between silicone oil (SO) tamponade and after SO removal using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Thirty patients who underwent pars plana vitrectomy for retinal detachment (RD) with SO tamponade were included. SS-OCT and OCTA were conducted before RD surgery, during SO tamponade, and after SO removal. A 3-dimensional volumetric wide scan protocol was used for the analysis. The segmented retina, choroidal thickness map, and peripapillary thickness were then measured. For the OCTA analysis, 4.5 × 4.5 mm scans were used. Superficial and deep capillary plexus VDs in unaffected fellow eyes and eyes after SO removal were compared. During the SO tamponade period, the thickness of the parafoveal total retina, ganglion cell-inner plexiform layer, and peripapillary retinal nerve fiber layer (ppRNFL) were significantly thinner than those of unaffected fellow eyes (p < 0.05). The parafoveal layer thickness thinning recovered up to three to six months after SO removal. Moreover, six months after SO removal, the parafoveal thickness was not significantly different compared to that of unaffected fellow eyes (p > 0.05). However, the ppRNFL thickness was significantly decreased during SO tamponade and remained unrecovered six months after SO removal. There was no significant difference in the VD on the OCTA. Thus, SO tamponade and removal for RD resulted in a change in the retinal and peripapillary thickness. This may be due to the mechanical pressure effect of SO.