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To investigate the changes in outer nuclear layer (ONL) thickness during anti-vascular endothelial growth factor (VEGF) treatment in type 1 choroidal neovascularization (CNV) and its impact on vision. Type 1 CNV eyes (n = 94) were retrospectively compared to normal control eyes (n = 35). Along with best-corrected visual acuity (BCVA), the location of CNV, foveal ONL thickness, and subretinal fluid height were measured using optical coherence tomography (OCT) and analyzed. Visual outcome and OCT biomarkers were compared. As a result, the CNV group had thinner foveal ONL and worse BCVA compared to the control group. ONL thickness recovered partially along with visual improvement following 3 monthly initial loading doses of aflibercept injections, and it correlated with the final BCVA during the 1-year follow-up. Eyes achieved foveal ONL recovery over + 10 µm had lower subfoveal CNV (45.5%) and showed better visual outcomes than eyes with stationary ONL or suboptimal ONL recovery (76.0%, p = 0.012). In conclusion, type 1 CNV eyes that recovered foveal ONL thickness at initial loading of anti-VEGF demonstrated good final visual outcome during the 1-year follow-up. Monitoring the foveal ONL thickness during early anti-VEGF treatment can give information about the visual outcomes in type 1 CNV. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the visual prognostic factors in patients with pseudophakic epiretinal membrane (ERM) after vitrectomy using spectral domain optical coherence tomography (SD-OCT). Method: A retrospective review of patients with pseudophakic ERM having undergone vitrectomy was conducted. Best corrected visual acuity (BCVA) and SD-OCT were conducted before and 1, 3, and 6 months after vitrectomy. Known visual prognostic factors, such as inner-retina irregularity index, central foveal thickness (CFT), central inner retinal layer thickness (CIRLT), cone outer segment tip defect length, and photoreceptor outer segment length, were reviewed and their correlation with BCVA was analyzed. Results: Forty-three patients (mean age: 64.88 ± 10.46 years) with pseudophakic ERM were included. BCVA significantly improved after vitrectomy (logMAR 0.30 ± 0.24 vs. 0.11 ± 0.14, p < 0.001). The preoperative high inner-retina irregularity index significantly correlated with poor postoperative BCVA in patients with pseudophakic ERM (correlation coefficient 0.583, p < 0.001). Postoperative improvements of inner retinal SD-OCT findings, such as inner-retina irregularity index, CFT, and CIRLT, were significantly associated with the amount of BCVA improvement after ERM surgery (correlation coefficients were as follows: inner-retina irregularity index – 0.711, p < 0.001; CFT – 0.462, p = 0.002; CIRLT – 0.596, p < 0.001). However, preoperative outer retinal SD-OCT findings were not associated with postoperative visual prognosis. Conclusion: From this study, we determined the visual prognostic factors of ERM surgery without confounding factors, such as visual acuity improvement following combined cataract surgery, and inner retinal SD-OCT findings more significantly associated with the visual prognosis of ERM surgery compared to outer retinal SD-OCT findings. [ABSTRACT FROM AUTHOR]

Purpose. To investigate the associations between hyperreflective foci (HRF) on spectral-domain optical coherence tomography (SD-OCT) and early recurrence of macular edema after intravitreal dexamethasone (DEX) implantation in eyes with refractory diabetic macular edema (DME) to bevacizumab. Methods. Medical records of patients with refractory DME to bevacizumab, who underwent intravitreal DEX implantation and 12-month follow-up, were reviewed. Eyes in which central subfield thickness (CST) increased over 50 μm at 3 months compared with the first month after intravitreal DEX implantation were categorized into the early recurrence group, and the others were categorized into the late recurrence group. Best-corrected visual acuity (BCVA), CST, and number of HRF on SD-OCT were analyzed. Results. Twenty-nine eyes of 26 patients (16 eyes in the early recurrence group and 13 eyes in the late recurrence group) were included in this study. The numbers of HRF in entire retina, inner retina, and outer retina at baseline in the early recurrence group (11.38 ± 3.07 in entire retina, 5.44 ± 1.50 in inner retina, 5.94 ± 2.74 in outer retina) were significantly greater than those in the late recurrence group (7.54 ± 3.60 in entire retina, p=0.006; 4.08 ± 1.70 in inner retina, p=0.034; 3.46 ± 2.30 in outer retina, p=0.013). Multivariate logistic regression analysis showed that a higher number of HRF increased the risk of early recurrence after intravitreal DEX implantation (odds ratio in entire retina: 1.518, p=0.012; odds ratio in inner retina: 2.058, p=0.027; odds ratio in outer retina: 1.610, p=0.029). Conclusions. Higher baseline numbers of HRF on SD-OCT may be a predictive indicator of early recurrence of macular edema after intravitreal DEX implantation for DME. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the associations between early anatomical responses and intraocular pressure (IOP) changes in macular edema (ME) due to retinal vascular diseases treated with an intravitreal dexamethasone (DEX) implant. Methods: A retrospective review was conducted involving ME patients who underwent intravitreal DEX implantation. The eyes were divided into increased IOP (IIOP) or non-IIOP (nIIOP) groups according to the presence or absence of significant IOP elevation. Significant IOP elevation was defined by both the absolute value of IOP elevation (5 mmHg or higher) and an elevation percentage of the baseline IOP (an increase equal to 30% of the pre-injection IOP or higher). We analyzed the difference in central subfield thickness (CST) change according to the IOP elevation after DEX implantation. Relationships between IOP change and CST reduction after intravitreal DEX implantation were analyzed by Pearson correlation coefficients. Results: A total of 49 eyes, 29 with diabetic ME and 20 with ME due to retinal vein occlusion (RVO), were included in this study. Of the 49 eyes, 18 eyes (36.7%) were classified as IIOP group and 31 (63.3%) as nIIOP group. Significant differences in mean CST reductions over baseline one week after DEX implantation were observed between the groups. The degree of CST reduction from baseline to 1 week was significantly correlated with the degree of IOP change from baseline at 1 week and 1 month after intravitreal DEX implantation. Conclusions: In patients with ME due to retinal vascular diseases, we noted an early anatomical response significantly correlated with IOP change after intravitreal DEX implantation. Therefore, patients with favorable early anatomical responses to DEX implantation should be carefully monitored for IOP elevation. [ABSTRACT FROM AUTHOR]

Background: To evaluate long-term visual/anatomic outcome after anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with fovea-involving fibrovascular pigment epithelium detachment (PED) presenting with choroidal neovascularization (CNV) on optical coherence tomography angiography (OCTA). Methods: Patients with fibrovascular PED or subretinal CNV confirmed by OCTA who were treated by a relaxed treat-and-extend regimen for 2 years were retrospectively reviewed. The best-corrected visual acuity (BCVA) and central subfield retinal thickness (CST) before and after anti-VEGF injection were analyzed. Furthermore, changes in photoreceptor layer (PRL) thickness and outer retinal bands in the fovea after injection were evaluated. Results: A total of 31 eyes with fibrovascular PED and 24 eyes with subretinal CNV were included. Following a relaxed treat-and-extend regimen with anti-VEGF agents, BCVA and CST were improved, and the PRL thickness was decreased significantly. There were no differences in BCVA, CST, changes in PRL thickness, or the status of outer retinal bands between the groups. However, the difference in the amount of decrease in PRL thickness between the two groups was increased at 2 years, and the slope tended to be steeper in the subretinal CNV group. Conclusions: Exudative age-related macular degeneration (AMD) with fibrovascular PED or subretinal CNV showed good visual/anatomic outcomes after anti-VEGF treatment, regardless of the CNV type. By 2 years, fibrovascular PED did not have an additional protective effect on the outer retina, compared with subretinal CNV over 2 years. Further follow-up study might be needed to conclude that fibrovascular PED has a protective effect on the surrounding photoreceptor area. [ABSTRACT FROM AUTHOR]