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Purpose: To longitudinally investigate choroidal and choriocapillaris perfusion metrics and the number of choroidal hyperreflective foci (HRF) in patients with acute leukaemia (AL) before and after disease remission and to correlate these metrics with systemic parameters during active disease. Methods: Prospective, longitudinal study of 26 eyes of 14 AL patients. All patients underwent optical coherence tomography (OCT) and OCT‐angiography (OCTA) in the acute phase. Subfoveal choroidal thickness (CT), total, luminal and stromal choroidal area (TCA, LCA, SCA), choroidal vascularity index (CVI), choriocapillaris flow deficits (cFD) density, and choroidal HRF number were computed. In a subset, the measurements were repeated after AL remission. Age‐ and gender‐matched 26 healthy controls were recruited for cross‐sectional comparisons. Results: Patient's mean age was 59 ± 12 years. The TCA, LCA, SCA and choroidal HRF number were significantly higher in patients than controls (p = 0.028, p = 0.044, p = 0.024 and p = 0.001, respectively). Lower haemoglobin levels were associated with lower CT (r = 0.58, p = 0.008). Higher D‐dimer values were associated with lower TCA (r = −0.52, p = 0.008), lower LCA (r = −0.50, p = 0.006), higher cFD density (r = 0.41, p = 0.044) and higher choroidal HRF number (r = 0.47, p = 0.008). The CT, TCA, SCA and choroidal HRF number significantly reduced after AL remission (p = 0.001, p = 0.047, p = 0.007 and p = 0.002 respectively). The CVI increased significantly compared to the active phase (p = 0.013). Conclusion: The study demonstrates a subclinical choroidal involvement in patients with AL, with relative stromal thickening in the acute phase, and normalization after disease remission. Choroidal HRF were identified as a biomarker of leukaemic choroidopathy. Choriocapillaris and choroidal vascularity were inversely correlated with a systemic pro‐coagulant state. [ABSTRACT FROM AUTHOR]

Purpose: To describe the distinguishing features of retinitis-like lesions seen in vitreoretinal lymphoma (VRL) from viral and toxoplasma retinitis.Methods: In this multicenter, retrospective study, we reviewed charts and imaging of consecutive patients with VRL. The associated features and the characteristics of retinitis-like lesions were assessed and compared with those of viral and toxoplasmic retinochoroiditis. Primary outcome measures were the unique features of VRL retinitis-like lesions.Results: Out of 76 eyes of 38 patients with VRL, retinitis-like lesions were identified in 6 eyes and confirmed on OCT. Distinctive features of VRL retinitis-like lesions were massive retinal thickening, associated sub-retinal pigment epithelium infiltrates and partial restoration of retinal layers after specific therapy.Conclusion: VRL can present with retinitis-like lesions that have distinctive OCT features on presentation as well as healing that can help to differentiate them from other lookalike etiologies and can guide further diagnostic and therapeutic interventions. [ABSTRACT FROM AUTHOR]

To identify main qualitative and quantitative changes by spectral-domain optical coherence tomography (SD-OCT) in eyes with vitreoretinal lymphoma (VRL) shifting form active to remission phase, after intravitreal rituximab (IVR).SD-OCT scans retrospectively assessed for: hyperreflective retinal dots (HRD), intraretinal infiltration, subretinal infiltration, outer retina (OR) fuzzy borders, and pigment epithelium detachments (PED).Central macular thickness (CMT) and choroidal thickness (CT) were measured. These features were examined in active and in remission phase.Eighteen eyes of nine patients enrolled. Patients received 5.3 ± 2.1 IVR according to a 2-weekly or monthly schedule. In remission phase, presence of HRD (p = 0.02), intraretinal infiltration (p = 0.02), OR fuzzy borders (p = 0.01) significantly reduced. Treatment frequency did not influence rate of disappearance of these features. CMT (p = 0.04) and CT (P = 0.004) became thinner.Signs referable to lymphoma-induced inflammation (CMT, CT, HRD) and infiltration (intraretinal infiltrates, OR fuzzy borders) decreased in remission phase. Further comparative studies needed to identify the specific role of IVR in inducing these changes. [ABSTRACT FROM AUTHOR]

Advances in multimodal imaging have significantly contributed to the management of many uveitis diseases in recent years. The most significant developments include the use of optical coherence tomography to obtain a more accurate and reproducible assessment of ocular inflammation, the application of optical coherence tomography angiography in choroiditis and retinal vasculitis, new possibilities for studying vitritis with ultrawide field imaging, and the most recent applications of fundus autofluorescence in uveitis. In this review, we provide an overview of the most significant advances in multimodal imaging of uveitis achieved in recent years. [ABSTRACT FROM AUTHOR]

The authors report a pseudo-vitelliform subretinal lesion associated with multiple retinal pigment epithelium apertures in vitreoretinal lymphoma; the case might represent a sign of macular infiltration, a paraneoplastic maculopathy, or coexistence of both. Retinal pigment epithelium apertures are a novel finding in vitreoretinal lymphoma. Purpose: To describe the case of a 66-year-old man with bilateral cytologically proven vitreoretinal lymphoma who presented with a pseudo-vitelliform macular lesion and multiple retinal pigment epithelium apertures. Methods: The patient underwent comprehensive ophthalmologic evaluation, including best-corrected visual acuity, intraocular pressure, anterior segment and fundus examination, and optical coherence tomography, at baseline and during follow-up. Results: A new-onset foveal yellow, ill-defined lesion was noticed in the right eye during the follow-up; best-corrected visual acuity was 20/20, and the patient was asymptomatic. The lesion was isoautofluorescent with the surrounding retina. The optical coherence tomography revealed hyperreflective subretinal material, an irregularly thickened retinal pigment epithelium, and a shallow, hyperreflective retinal pigment epithelium detachment with multiple retinal pigment epithelium apertures. After 15 days, the lesion was completely reabsorbed and replaced by outer retinal atrophy and cystoid macular edema; best-corrected visual acuity dropped to 20/100. Conclusion: The macular lesion may be a sign of macular infiltration, a case of paraneoplastic cloudy vitelliform submaculopathy, or coexistence of both. Retinal pigment epithelium apertures are not disease-specific and are described in vitreoretinal lymphoma for the first time. [ABSTRACT FROM AUTHOR]

Aims/Purpose: Autoimmune diseases are characterized by a pro‐inflammatory environment, with over‐release of chemokines, as IL‐6, IL‐1β and TNFα. These might have a pro‐vasodilation effect at a conjunctival level, with the clinical result of hyperaemia. Hyperaemia is hardly evaluable from a research point of view. The aim of this study is to investigate the use of conjunctival vessel density (CVD) as a marker of vessel dilation and, indirectly, of ocular surface inflammation, in a cohort of patients affected by autoimmune diseases. Methods: Study design: cross‐sectional, observational. CVD score was obtained analysing vessel‐enhanced images obtained by R‐scan module of Keratograph 5M (OCULUS Optikgeräte GmbH, Wetzlar, Germany). Images were loaded in ImageJ software package and in‐house scripts were used to analyse CVD at baseline and at follow‐up visit. CVD was obtained through the same methodology widely used in retinal research to study macular vessel density. Clinical data were collected and the correlations were reported. Results: We collected data from a cohort of patients suffering from autoimmune diseases. All the eyes were categorized considering both systemic and topic treatments, co‐existence of more autoimmune disorders, clinical signs and severity of dry eye. CVD values resulted significantly correlated with dry eye severity, in particular the higher was dry eye severity score, the higher was CVD (p < 0.05). Conclusions: CVD is a new quantitative metric to objectively measure conjunctival hyperaemia; this diagnostic methodology resulted highly feasible to be performed in clinical practice, without inducing patients' distress, and resulted a parameter highly correlated with the pro‐inflammatory status of the patients. Reference 1.Singh RB, Liu L, Anchouche S, Yung A, Mittal SK, Blanco T et al. Ocular redness ‐ I: Aetiology, pathogenesis, and assessment of conjunctival hyperemia. Ocul Surf 2021. 2. Wu S, Hong J, Tian L, Cui X, Sun X, Xu J. Assessment of Bulbar Redness with a Newly Developed Keratograph. Optom Vis Sci 2015. 3. Arrigo A, Aragona E, Saladino A, Amato A, Bandello F, Battaglia Parodi M. The impact of different thresholds on optical coherence tomography angiography images binarization and quantitative metrics. Sci Rep 2021. [ABSTRACT FROM AUTHOR]

Purpose: To describe a case of multiple detachments of the neurosensory retina mimicking multifocal vitelliform macular dystrophy after chemotherapy with mitogen/extracellular signal--regulated kinase inhibitor for metastatic ovarian cancer. Methods: Case report. Results: A 38-year-old woman presented to our clinic for eye examination before the initiation of chemotherapy with trametinib. One month after starting treatment, the patient complained of vision loss and metamorphopsia in both eyes. Best-corrected visual acuity decreased from 20/20 at baseline to 20/32 in both eyes, and fundus examination revealed multiple detachments of the neurosensory retina with vitelliformlike appearance, involving the central macula and the posterior pole with a circular distribution along the retinal vascular arcades. Spectral-domain optical coherence tomography showed widespread thickening of the interdigitation zone, particularly in areas with and without detachments, and also some hyporeflective fluid accumulating beneath the detached retina. Mitogen/extracellular signal--regulated kinase inhibitor therapy was discontinued, and after 1 week, best-corrected visual acuity recovered to 20/20 bilaterally, with complete resolution of the serous retinal detachments and normalization of interdigitation zone. Conclusion: The development of a central serous chorioretinopathylike retinopathy is a relatively common secondary event of mitogen/extracellular signal--regulated kinase inhibitors therapy, and typically, it resolves after the discontinuation of the treatment. Our case is peculiar in that the lesions were bilateral, involving the central macula and the posterior pole with a circular distribution along the retinal vascular arcades and in that the interdigitation zone showed a widespread thickening at spectral-domain optical coherence tomography, mimicking multifocal vitelliform macular dystrophy. [ABSTRACT FROM AUTHOR]