Search

Objectives: This study aimed to determine the frequency of epiretinal membrane (ERM) in the long term after neodymium-doped yttrium aluminum garnet laser iridotomy (LI) using spectral domain optical coherence tomography (SD-OCT). Materials and Methods: This retrospective study included 94 eyes that underwent LI for primary angle-closure glaucoma, were followed for at least 4 years, and had no ERM before the procedure. The control group consisted of 66 eyes that were followed for suspected glaucoma did not have a previous ERM. We compared the ERM frequencies of the groups at the last visit. Additionally, ERM frequencies were compared between those who had cataract surgery in the post-LI period and those who did not. Results: After a follow-up period of at least 4 years, ERM developed in 36 of 94 eyes (38.2%) in the LI group. Of these, 32 were stage 1 ERM (34.0%) and 4 were stage 2 ERM (4.2%). In the control group, ERM developed in 13 of 66 eyes (19.6%), 12 of which were stage 1 ERM (18.1%) and 1 was stage 2 ERM (1.5%) (p=0.012). ERM developed in 14 of 32 eyes (43.7%) who underwent phacoemulsification surgery after LI and in 22 of 62 eyes (35.4%) that underwent only LI without subsequent cataract surgery (p=0.435). ERM developed significantly more frequently in the 62 phakic eyes that underwent only LI than in the eyes in the control group (p=0.045) Conclusion: LI appears to be a predisposing factor for the development of ERM, regardless of subsequent cataract surgery. [ABSTRACT FROM AUTHOR]

Purpose: To explore ocular changes in patients with MS and NMOSD via SDOCT and PVEP analysis. Methods: From August 2020 to July 2021, 82 patients (164 eyes) diagnosed with MS, 59 patients (118 eyes) diagnosed with NMOSD and 50 healthy controls (100 eyes) were retrospectively selected. SD-OCT and PVEP were performed to compare retinal nerve fibre layer (RNFL) thickness around the optic disc, ganglion cell inner plexiform layer (GCIPL) thickness in the macula and P100 latency and amplitude between the disease groups and the control group. Results: In the NMOSD and MS groups, the thickness of the GCIPL quadrants in eyes with optic neuritis was thinner than that in eyes without optic neuritis, and the amplitude of the P100 wave decreased. In addition, in eyes with optic neuritis, patients with NMOSD have thinner RNFL thicknesses in the temporal and superior quadrants than patients with MS, and the thickness of the GCIPL is thinner in each region. In eyes without optic neuritis, patients with MS have thinner nasal RNFL than do those with NMOSD. Conclusion: SD-OCT and VEP may be useful for monitoring and distinguishing pathological changes in MS and NMOSD patients. [ABSTRACT FROM AUTHOR]

Myopia is rising as a silent epidemic across the globe with marked ocular morbidity and pathological changes. The retinal nerve fiber layer (RNFL) thinning is indicative of glaucomatous damage; it remains uncertain whether RNFL thickness would vary with the refractive status of the eye. It is therefore important to investigate whether any correlation exists between RNFL measurements and axial length/refractive error in myopia. Purpose. To assess the peripapillary RNFL thickness by spectral domain optical coherence tomography (SD-OCT) and to determine the correlation between axial length and peripapillary RNFL thickness in myopia patients. Material and methods. A total of 100 patients (200 eyes) with low, moderate and high myopia (ave -3.58 ± 2.45 D) aged 15 to 40 years were examined to assess the peripapillary RNFL thickness by SD-OCT and to determine the correlation between axial length (AL) and peripapillary RNFL thickness myopia patients. Results. Average 360-degree RNFL thickness (mean ± SD) was 92.25 ± 10.04 μm. In the low myopic group this parameter was 98.82 ± 6.67 μm, in the moderate myopic group — 89.28±5.23 μm, and in the high myopic group — 78.54 ± 7.32 μm. The average 360-degree mean RNFL thickness in patients with AL < 24 mm was 100.06 ± 5.92 μm, in patients with AL between 24–26 mm — 89.48 ± 4.59 μm, and in patients with AL > 26 mm — 78.2 ± 6.77 μm. There was significant association between thinning of the average 360-degree RNFL thickness with increasing degree of myopia and AL (p < 0.0001). Conclusion. The study shows RNFL thickness decreases with increase in refractive error and increase in axial length of myopic eyes. The degree of myopia may affect the RNFL thickness differently.

Purpose: This study aimed to investigate the presence of choroidal vascular parameters, which have a predictive value for diabetic macular edema (DME) development, in eyes with non-proliferative diabetic retinopathy (NPDR). Methods: 148 eyes of 120 patients were included in the study. Eyes with an untreated mild-to-moderate NPDR stage were divided into 2 groups as those with and without DME. The diabetic retinopathy (DR) group was created from the eyes of patients diagnosed with diabetes mellitus without DR. Choroidal layers were segmented using the enhanced depth imag- ing mode of spectral domain optical coherence tomography. Choroidal vascular indexes (CVI) of the full-thickness choroid, sattler-choriocapillaris layer, and Haller's layer were calculated separately. Results: Full-thickness CVI values of the choroid were 65.2±3.1% in the DR-group, 64.2±3.4% in the DME-group, and 64.8±3.08% in the DME+ group (P = 0.318). The CVI values in the Sattler-choriocapillaris complex were 71.3±4.5% in the DR- group, 70.9±5.9% in the DME-group, and 71.7±5.2% in the DME+ group (P = 0.746). The CVI values in the Haller layer were 61.6±4.1% in the DR-group, 60.3±3.7% in the DME-group, and 61.1±3.1% in the DME+ group (P = 0.252). Conclusion: There was no significant difference between NPDR eyes with and without DME and eyes without DR in terms of CVI. These results may suggest that DME develops due to retinal vascular factors rather than choroidal vascular factors. [ABSTRACT FROM AUTHOR]

The aim of the study was to characterize retinal atrophy (RA) with progressive retinal atrophy symptoms in mixed breed dogs using ophthalmoscopy, spectral domain optical coherence tomography (SD-OCT) and electroretinography (ERG). The study was performed on 13 mixed breed dogs affected by retinal atrophy (11 males and 2 females that were 1.5–14 years old). Depending on the advancement of RA, SD-OCT examinations identified retinal abnormalities ranging from layer disorganisation to advanced atrophy. The most advanced RA occurred ventral to the optic disc. Total retinal thickness in both eyes (mean ± SD) was lower in dogs with RA compared to controls dorsally (77.7 ± 39.5 μm vs 173.5 ± 13.3 μm), ventrally (33.4 ± 29.9 μm vs 139.5 ± 10.8 μm), nasally (65.0 ± 34.5 μm vs 163.9 ± 11.0 μm) and temporally (61.8 ± 41.7 μm vs 171.9 ± 11.1 μm) to the optic disc. In dogs with locally normal architecture of inner retina, loss of definition of outer retinal layers occurred in many regions. Dark and light-adapted ERGs were reduced in 2 dogs with RA and were unrecordable in 11 dogs. Lesions evident in SD-OCT scans of mixed breed dogs affected with retinal atrophy initially appear ventrally to the optic disc and ventro-dorsally in advanced RA. In all mixed breed dogs with retinal atrophy, clinical signs and SD-OCT results correlate with ERG findings. [ABSTRACT FROM AUTHOR]

BackgroundRetinitis pigmentosa (RP) represents a group of progressive, genetically heterogenous blinding diseases. Recently, relationships between measures of retinal function and structure are needed to help identify outcome measures or biomarkers for clinical trials. The ability to align retinal multimodal images, taken on different platforms, will allow better understanding of this relationship. We investigate the efficacy of artificial intelligence (AI) in overlaying different multimodal retinal images in RP patients.MethodsWe overlayed infrared images from microperimetry on near-infra-red images from scanning laser ophthalmoscope and spectral domain optical coherence tomography in RP patients using manual alignment and AI. The AI adopted a two-step framework and was trained on a separate dataset. Manual alignment was performed using in-house software that allowed labelling of six key points located at vessel bifurcations. Manual overlay was considered successful if the distance between same key points on the overlayed images was ≤1/2°.ResultsFifty-seven eyes of 32 patients were included in the analysis. AI was significantly more accurate and successful in aligning images compared to manual alignment as confirmed by linear mixed-effects modelling (p

The aim of this paper is to investigate whether a multifractal analysis can be applied to study choroidal blood vessels and help ophthalmologists in the early diagnosis of retinitis pigmentosa (RP). In a case study, we used spectral domain optical coherence tomography (SDOCT), which is a noninvasive and highly sensitive imaging technique of the retina and choroid. The image of a choroidal branching pattern can be regarded as a multifractal. Therefore, we calculated the generalized Renyi point-centered dimensions, which are considered a measure of the inhomogeneity of data, to prove that it increases in patients with RP as compared to those in the control group.

Introduction: Acute Central Serous Chorioretinopathy (CSCR) is an important form of acquired maculopathy that usually presents as localised serous detachment of the neurosensory retina. Although, the disease is typically self limiting over a period of 2-3months, a percentage of patients ultimately develop chronic RPE changes. Eplerenone, a potential Mineralocorticoid Receptor (MR) antagonist, may play a role in regulating choroidal vascularity and modifying the disease in chronic CSCR. Aim: To assess the safety and efficacy of oral eplerenone medication in acute CSCR. Materials and Methods: This was a randomised controlled trial that included 162 eyes of 162 patients with acute CSCR. Patients were divided into two groups– Group-A, which received oral Eplerenone, and Group-B, which received Placebo therapy. Each group comprised 81 eyes. Best Corrected Visual Acuity (BCVA), Central Macular Thickness (CMT), and serum potassium (K+) levels were measured at baseline and monthly intervals for three consecutive months. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) Statistics version 20 software (IBM Corp., Armonk, NY, USA). A p-value less than 0.05 was considered statistically significant. Results: The differences in CMT in Group-A and Group-B were 279±56.41μm and 207±68.88 μm (p

Diagnosis of Uveitic Macular Edema (UME) using Spectral Domain OCT (SD-OCT) is a promising method for early detection and monitoring of sight-threatening visual impairment. Viewing multiple B-scans and identifying biomarkers is challenging and time-consuming for clinical practitioners. To overcome these challenges, this paper proposes an image classification hybrid framework for predicting the presence of biomarkers such as intraretinal cysts (IRC), hyperreflective foci (HRF), hard exudates (HE) and neurosensory detachment (NSD) in OCT B-scans along with their severity. A dataset of 10880 B-scans from 85 Uveitic patients is collected and graded by two board-certified ophthalmologists for the presence of biomarkers. A novel image classification framework, Dilated Depthwise Separable Convolution ResNet (DDSC-RN) with SVM classifier, is developed to achieve network compression with a larger receptive field that captures both low and high-level features of the biomarkers without loss of classification accuracy. The severity level of each biomarker is predicted from the feature map, extracted by the proposed DDSC-RN network. The proposed hybrid model is evaluated using ground truth labels from the hospital. The deep learning model initially, identified the presence of biomarkers in B-scans. It achieved an overall accuracy of 98.64%, which is comparable to the performance of other state-of-the-art models, such as DRN-C-42 and ResNet-34. The SVM classifier then predicted the severity of each biomarker, achieving an overall accuracy of 89.3%. A new hybrid model accurately identifies four retinal biomarkers on a tissue map and predicts their severity. The model outperforms other methods for identifying multiple biomarkers in complex OCT B-scans. This helps clinicians to screen multiple B-scans of UME more effectively, leading to better treatment outcomes. [ABSTRACT FROM AUTHOR]

Purpose: In patients with retinal vein occlusion (RVO), the presence of pearl necklace sign is often overlooked; however, this sign should be sought among optical coherence tomography (OCT) findings. Our aim is to evaluate retrospectively the presence of pearl necklace sign and other OCT (findings in patients with RVO at their first visit. Furthermore, to reveal any association between pearl necklace sign and other OCT findings. Methods: In this retrospective cross-sectional study, OCT features of the patients with RVO who were examined between 2009 and 2019 were analyzed. Only the OCT findings at the first visit were taken into consideration. Both treatment-naïve patients and patients previously treated elsewhere were included in the study. OCT findings, particularly the pearl necklace sign (circular localization of the hyperreflective dots (HRDs) around the inner retinal cyst wall or the sensory retinal detachment wall) were looked for. Results: The study population was 100 eyes of 100 patients with RVO. The pearl necklace sign was found in 20 of 100 eyes with RVO (20%). The presence of the pearl necklace sign and serous retinal detachment had a statistically significant connection (P = 0.026). Moreover, the pearl necklace sign group was shown to have statistically higher HRDs than the other groups (P = 0.002). Conclusion: Even though the common OCT findings were meticulously elaborated in many of the previous studies, pearl necklace sign has not been particularly looked for in eyes with RVO. Overall, pearl necklace sign was present in 20% of 100 patients with RVO in this single-visit OCT study. This ratio makes us think that the pearl necklace sign actually accompanies RVO more often than previously thought. [ABSTRACT FROM AUTHOR]

The aim of this paper is to investigate whether a multifractal analysis can be applied to study choroidal blood vessels and help ophthalmologists in the early diagnosis of retinitis pigmentosa (RP). In a case study, we used spectral domain optical coherence tomography (SDOCT), which is a noninvasive and highly sensitive imaging technique of the retina and choroid. The image of a choroidal branching pattern can be regarded as a multifractal. Therefore, we calculated the generalized Renyi point-centered dimensions, which are considered a measure of the inhomogeneity of data, to prove that it increases in patients with RP as compared to those in the control group. [ABSTRACT FROM AUTHOR]

Introduction: Acute Central Serous Chorioretinopathy (CSCR) is an important form of acquired maculopathy that usually presents as localised serous detachment of the neurosensory retina. Although, the disease is typically self limiting over a period of 2-3months, a percentage of patients ultimately develop chronic RPE changes. Eplerenone, a potential Mineralocorticoid Receptor (MR) antagonist, may play a role in regulating choroidal vascularity and modifying the disease in chronic CSCR. Aim: To assess the safety and efficacy of oral eplerenone medication in acute CSCR. Materials and Methods: This was a randomised controlled trial that included 162 eyes of 162 patients with acute CSCR. Patients were divided into two groups-Group-A, which received oral Eplerenone, and Group-B, which received Placebo therapy. Each group comprised 81 eyes. Best Corrected Visual Acuity (BCVA), Central Macular Thickness (CMT), and serum potassium (K+) levels were measured at baseline and monthly intervals for three consecutive months. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) Statistics version 20 software (IBM Corp., Armonk, NY, USA). A p-value less than 0.05 was considered statistically significant. Results: The differences in CMT in Group-A and Group-B were 279±56.41μm and 207±68.88 μm (p<0.01) at the end of the first month and 361±33.56 μm and 278±46.27 μm at three months (p<0.01), respectively. The average BCVA improvement in Group-A and Group-B was 6.05 lines and 4.21 LogMAR lines, respectively, at the conclusion (p=0.002). Deterioration to chronicity was seen in 3.7% of the eyes in Group A and 17.3% of the eyes in Group B. The increase in Serum K+ at three months was 0.61±0.27 mg/dL in Group-A and 0.1±0.21 mg/dL in Group-B (p=0.03). Conclusion: Eplerenone is a safe and effective first-line treatment option for acute CSCR, leading to faster and higher resolution with protection from progression to chronicity. [ABSTRACT FROM AUTHOR]

Abstract Background To compare the choroidal thickness and vascular profile of premature infants with ROP (retinopathy of prematurity) using a handheld SD-OCT device. Methods We performed horizontal SD-OCT scans through the fovea in 115 eyes of 66 premature infants. Premature infants included 2 groups [infants with ROP requiring treatment (as treatment group) vs. infants without ROP or with ROP not- requiring treatment (as no-treatment group)] Choroidal thicknesses (CT) were measured at 5 points, including the fovea, 250 µm, and 500 µm mm nasal and temporal to the fovea. The choroidal vascularity index (CVI) and choroidal stromal index (CSI) were also calculated. The classification and regression tree (CRT) algorithm was used to predict the need for treatment based on all OCT characteristics. Results Mean CT was higher in 500 µm nasal to the fovea compared to temporal CT (275.8 ± 64.8 and 257.1 ± 57.07, P value 0.05, GEE). The decision tree analysis showed that in infants with ROP, the most important predictor for the need for treatment is CSI. Conclusion This study delineated the possible effectiveness of choroidal measurements as an additive to decision-making for ROP. We also demonstrated that choroidal involution is associated with the presence of plus disease, not with the stage of ROP. We demonstrated that choroidal measurements are very sensitive but not specific tools for assessing the need for treatment in ROP patients.

Background: To compare the choroidal thickness and vascular profile of premature infants with ROP (retinopathy of prematurity) using a handheld SD-OCT device. Methods: We performed horizontal SD-OCT scans through the fovea in 115 eyes of 66 premature infants. Premature infants included 2 groups [infants with ROP requiring treatment (as treatment group) vs. infants without ROP or with ROP not- requiring treatment (as no-treatment group)] Choroidal thicknesses (CT) were measured at 5 points, including the fovea, 250 µm, and 500 µm mm nasal and temporal to the fovea. The choroidal vascularity index (CVI) and choroidal stromal index (CSI) were also calculated. The classification and regression tree (CRT) algorithm was used to predict the need for treatment based on all OCT characteristics. Results: Mean CT was higher in 500 µm nasal to the fovea compared to temporal CT (275.8 ± 64.8 and 257.1 ± 57.07, P value < 0.03). No statistically significant difference was found regarding CVI, corrected CVI, and temporal and nasal CT in the treatment group versus the no-treatment group. The foveal CT was significantly lower in ROP patients with the plus disease compared to not-plus ROP (P value = 0.03. ANOVA, Bonferroni posthoc test). CT was not significantly different between plus and pre-plus patients (P-value = 0.9, ANOVA, Bonferroni posthoc test). No significant relationship was found between the stage of ROP and choroidal thickness (P value > 0.05, GEE). The decision tree analysis showed that in infants with ROP, the most important predictor for the need for treatment is CSI. Conclusion: This study delineated the possible effectiveness of choroidal measurements as an additive to decision-making for ROP. We also demonstrated that choroidal involution is associated with the presence of plus disease, not with the stage of ROP. We demonstrated that choroidal measurements are very sensitive but not specific tools for assessing the need for treatment in ROP patients. [ABSTRACT FROM AUTHOR]

Purpose:To study the correlation of retinal nerve fibre layer and ganglion cell layer thickness withglycaemic control in patients of diabetes mellitus Methods:This cross-sectional study was carried out on 100 eyes of 100patients of type 2 diabetes. Diabetic patients with evidence of macular oedema were excluded. Demographic data and relevant medical details were documented and all study subjects underwent a comprehensive ophthalmic evaluation. Glycosylatedhaemoglobin(HbA1c) was estimated for all individuals using venous blood sample. Peripapillary RNFL andmacular GC-IPL thickness were assessed for all study participants by SD-OCT (Carl Zeiss Cirrus HD-OCT). Pearson coefficient was used to study the correlation of RNFL and GC-IPL thickness withglycaemic control. Results:Only a weak negative correlation was seen between glycaemic status and RNFL thickness as well as GC-IPL thickness for both controlled diabetics as well as poorly controlled diabetics. This weak negative correlation was statistically insignificant. Conclusion:No significant correlation could be established with HbA1c levels either with RNFL thickness or GC-IPL thickness in diabetic patients. [ABSTRACT FROM AUTHOR]

Hui Xiao,&ast; Ni Guo,&ast; Junyi Li, Ling Jin, Yuan Liu, Shufen Lin, Lei Fang, Xing Liu, Chengguo Zuo State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xing Liu; Chengguo Zuo, Zhongshan Ophthalmic Center, Sun Yat-sen University, 7 Jinsui Road, Guangzhou, 510000, People’s Republic of China, Email liuxing@mail.sysu.edu.cn; zuochengguo@mail.sysu.edu.cnPurpose: To report the prevalence, clinical characteristics and risk factors for paracentral acute middle maculopathy (PAMM) following acute primary angle closure (APAC) and acute primary angle closure glaucoma (APACG).Methods: This retrospective study consecutively recruited patients diagnosed with APAC or APACG. Based on the spectral domain optical coherence tomography characteristics, PAMM eyes were divided into three stages. Characteristics of different stages such as the time from symptoms to treatment (TST), retinal thickness and BCVA improvement were analyzed. The risk factors of PAMM were evaluated by binary logistic regression models.Results: A total of 781 eyes of 781 APAC or APACG patients were included, and PAMM was found in 22 (2.9%) of them. Stage III eyes had a significantly longer TST than stage I eyes (P = 0.008) while exhibiting significantly thinner retinal thicknesses (P < 0.0001). The BCVA improvement was significantly worse in the eyes treated in stage III than in those treated in stage I (P = 0.008). Older age, longer axial length and without type 2 diabetes were associated with a lower risk of incident PAMM (OR = 0.95, P = 0.028; OR = 0.52, P = 0.019; OR = 3.92, P = 0.022).Conclusion: PAMM can be secondary to APAC or APACG at a rate of 2.9%. Different visual outcomes were observed in patients who received the intervention at different stages of PAMM. Younger patients with a shorter axial length and type 2 diabetes were found to be more susceptible to PAMM.Keywords: paracentral acute middle maculopathy, acute primary angle closure, acute primary angle closure glaucoma, risk factors, spectral domain optical coherence tomography

We present a 65-year-old woman who developed sudden and severe vision loss in her left eye one day after the administration of the second dose of coronavirus disease-19 vaccine. The best corrected visual acuity in this eye was 1/10. Diffuse paracentral acute middle maculopathy was detected on spectral domain optical coherence tomography (OCT). OCT angiography images revealed concurrent vascular flow defects consistent with acute macular neuroretinopathy in the deep retinal capillary plexus and choriocapillaris layers. At the end of the six-month follow-up, there was no improvement in visual acuity, and atrophy and thinning developed in all layers of the retina.

The aim of this case series and narrative literature review is to highlight the importance of multimodal imaging in the ophthalmological examination of patients with spinocerebellar ataxia type 7 and provide a summary of the most relevant imaging techniques. Three patients with SCA7 were included in this case series. A literature review revealed twenty-one publications regarding ocular manifestations of SCA7, and the most relevant aspects are summarized. The role of different imaging techniques in the follow-up of SCA7 patients is analyzed, including color vision testing, corneal endothelial topography, color fundus photography (CFP) and autofluorescence, near infrared reflectance imaging, spectral domain optical coherence tomography (SDOCT), visual field examination, and electrophysiological tests. SDOCT provides a rapid and non-invasive imaging evaluation of disease progression over time. Additional examination including NIR imaging can provide further information on photoreceptor alteration and subtle disruption of the RPE, which are not evident with CFP at an early stage. Electrophysiological tests provide essential results on the state of cone and rod dystrophy, which could be paramount in guiding future genetic therapies. Multimodal imaging is a valuable addition to comprehensive ophthalmological examination in the diagnosis and management of patients with SCA7. [ABSTRACT FROM AUTHOR]

Abstract Background The study aims to investigate the relationship between the volume-accumulated reflectivity (termed “integral”) on spectral domain optical coherence tomography (SD-OCT) and cone density on adaptive optics (AO) imaging. Methods In this cross-sectional study, both eyes of 32 healthy subjects and 5 patients with inherited retinal diseases (IRD) were studied. The parameter, integral, was defined as the volume-accumulated reflectivity values in a selected region on OCT images; integrals of the ellipsoid zone (EZ) and interdigitation zone (IZ) were measured at 2°, 3°, 4°, 5°and 6° eccentricity along the four meridians on fovea-centered OCT B-scans. Cone density in the same region was measured using a flood illumination adaptive optics camera RTX1. Results Integrals of EZ, IZ and cone density shared similar distribution patterns. Integral of the IZ was better correlated with cone density in both healthy people (r = 0.968, p

We evaluated the closure of full-thickness macular holes (MHs) the day after surgery in minimizing the burden and maximizing patient outcomes. Herein, 25-gauge pars plana vitrectomy, internal limiting membrane peeling, and fluid–gas (20% sulfur hexafluoride) were performed for the treatment. Patients were instructed to remain in the facedown position until the confirmation of MH closure, and the position was discontinued in cases where the closure was confirmed. In total, 43 eyes of 43 patients, whose average age was 69.7 ± 8.6 years, were enrolled in this study. We used swept source (SS)-optical coherence tomography (OCT) for the confirmation of MH closure for gas-filled eyes and used spectral domain (SD)-OCT for the reconfirmation of MH closure after the gas volume was reduced to less than half of the vitreous cavity. MH closure was confirmed in 40 eyes (93%, the closure group) on the next day after surgery. The time from surgery to SS-OCT imaging was 24.7 h. Although facedown positioning was terminated in cases where MH closure was confirmed, there were no cases in which the MH was re-opened afterward. The basal and minimum MH size was significantly larger in the non-closure group than that in the closure group (p = 0.027, p = 0.043, respectively). Therefore, checking with SS-OCT the day after surgery and terminating facedown positioning in cases where MH closure was confirmed would be a useful method, removing a great burden for the elderly without sacrificing the MH closure rate. [ABSTRACT FROM AUTHOR]

Background: To quantify the degree of ganglion cell degeneration through spectral domain optical coherence tomography (SD-OCT) in adult patients with post-stroke homonymous visual field defect. Methods: Fifty patients with acquired visual field defect due to stroke (mean age = 61 years) and thirty healthy controls (mean age = 58 years) were included. Mean deviation (MD) and pattern standard deviation (PSD), average peripapillary retinal nerve fibre layer thickness (pRNLF-AVG), average ganglion cell complex thickness (GCC-AVG), global loss volume (GLV) and focal loss volume (FLV) were measured. Patients were divided according to the damaged vascular territories (occipital vs. parieto-occipital) and stroke type (ischaemic vs. haemorrhagic). Group analysis was conducted with ANOVA and multiple regressions. Results: pRNFL-AVG was significantly decreased among patients with lesions in parieto-occipital territories compared to controls and to patients with lesions in occipital territories (p =.04), with no differences with respect to stroke type. GCC-AVG, GLV and FLV differed in stroke patients and controls, regardless of stroke type and involved vascular territories. Age and elapsed time from stroke had a significant effect on pRNFL-AVG and GCC-AVG (p <.01), but not on MD and PSD. Conclusions: Reduction of SD-OCT parameters occurs following both ischaemic and haemorrhagic occipital stroke, but it is larger when the injury extends to parietal territories and increases as time since stroke increases. The size of visual field defect is unrelated to SD-OCT measurements. Macular GCC thinning appeared to be more sensitive than pRNFL in detecting retrograde retinal ganglion cell degeneration and its retinotopic pattern in stroke. [ABSTRACT FROM AUTHOR]

Purpose: Polypoidal choroidal vasculopathy (PCV) is a disease characterized by a branching neovascular network and polypoidal lesions typically originating from the internal choroidal vessels, and is a subtype of neovascular age-related macular degeneration (nAMD). It is important to make a differential diagnosis due to high prevalence of PCV in all populations and differing clinical course and treatment from nAMD. Although indocyanine green angiography (ICGA) is considered as gold standard in the diagnosis of PCV, it is an invasive method, impractical, and has limited access in many clinics. Therefore, non-invasive, less time-consuming, reliable and easily reproducible diagnostic methods are needed for diagnosis of PCV. In recent years, it has been suggested that there are typical findings for the diagnosis of PCV on spectral-domain optical coherence tomography (SD-OCT) and color fundus images (CFIs), and that the diagnosis can be made with a very high accuracy without ICGA. In this article, typical CFI and SD-OCT findings for the differential diagnosis of PCV were described. In addition, findings supporting the diagnosis of PCV on other noninvasive imaging modalities such as fundus autofluorescence (FOF) and optical coherence tomography angiography (OCTA) were also noted. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Shenzhen University Science & Engineering is the property of Editorial Department of Journal of Shenzhen University Science & Engineering and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We present a 65-year-old woman who developed sudden and severe vision loss in her left eye one day after the administration of the second dose of COVID vaccine. The best corrected visual acuity in this eye was 1/10. Diffuse paracentral acute middle maculopathy was detected on spectral domain optical coherence tomography (OCT). OCT angiography images revealed concurrent vascular flow defects consistent with acute macular neuroretinopathy in the deep retinal capillary plexus and choriocapillaris layers. At the end of the six-month follow-up, there was no improvement in visual acuity, and atrophy and thinning developed in all layers of the retina. [ABSTRACT FROM AUTHOR]

Interpretation of common optical coherence tomography imaging features in neovascular age-related macular degeneration can benefit from clinicopathologic correlation with high-resolution histology. Purpose: Clinicopathologic correlation of two optical coherence tomography (OCT) features in neovascular age-related macular degeneration. Methods: Case report, clinicopathologic correlation. Results: A patient in her 90s was diagnosed with Type 3 macular neovascularization secondary to age-related macular degeneration in the index right eye and underwent intravitreal antivascular endothelial growth factor treatment for 5 years. A double-layer sign on in vivo OCT was correlated to calcified drusen on histology. Furthermore, hyperfluorescence on fluorescein angiography corresponded on histology to choroidal hypertransmission on OCT and retinal pigment epithelium atrophy above calcified drusen. Conclusion: A double-layer sign on OCT can represent nonneovascular subretinal pigment epithelium material including wide and flat calcific nodules. Furthermore, hyperfluorescence on FA, among different origins, can be due to a window defect corresponding to retinal pigment epithelium atrophy, which can be confirmed with OCT. Clinicopathological correlation using high-resolution histology can demonstrate the fine details available to clinical decision making through currently available in vivo OCT imaging. [ABSTRACT FROM AUTHOR]

Plain Language Summary Central serous chorioretinopathy (CSCR) is nowadays classified as a clinical entity belonging to the spectrum of pachychoroid disorders characterized by increased choroidal thickness. Quite often, a shorter axial length and hypermetropia were thought to cause choroidal congestion, and as such, were believed to be associated with the incidence of CSCR. This study aimed to evaluate this relationship in the context of the disease duration. The analysis included comparisons among affected CSCR eyes, healthy fellow eyes, and a control group. The results did not prove a relationship between a shorter eyeball or any specific refraction error and CSCR. Both acute and chronic cases of CSCR presented with significantly greater values of choroidal thickness compared with healthy individuals. A loss of retinal thickness and volume was observed with a longer disease duration.

Purpose: To assess the reproducibility of retinal nerve fiber layer (RNFL) and macular thickness by spectral domain optical coherence tomography (SD-OCT) when the same investigator does scan thrice in a span of one hour without reference to the previous scan, is able to get similar results or not, without using the repeat function.Methods. In this prospective observational study 200 subjects who fulfilled the inclusion & exclusion criteria were scanned 3 times as per pre-defined guidelines at 0 minutes, 30 minutes; 60 minutes on the same day, by the same investigator using SD-OCT for measurements of RNFL and macular thickness & observations were statistically analyzed & correlated.Results. In RNFL thickness, temporal sector shows the worst reproducibility as compared to other sectors. The RNFL thickness was greatest in superior quadrant and thinnest in temporal quadrant. Female values were significantly higher than males in RNFL superior and RNFL symmetry. For macular thickness, temporal sector (mid-zone) showed the worst reproducibility and in outer-zone, Inferior sector showed the worst reproducibility. It also shows that macular thickness was thinnest at the central zone (innermost 1 mm ring), thickest within the inner 3 mm ring and diminished peripherally.Conclusion. RNFL and macular thickness measurements by SD-OCT by the same observer at 0 minutes, 30 minutes and 60 minutes were very reproducible except in the sectors specifically mentioned. The greater the thickness of RNFL in any sector, the better will be the reproducibility in that sector. For macular thickness, temporal sector (mid-zone) showed the worst reproducibility & with an increase in age the macular thickness measurements decreases.

We present an acute case of West Nile virus chorioretinitis with multimodal imaging findings in the acute phase of infection. Purpose: To describe multimodal imaging findings of acute West Nile virus chorioretinitis. Methods: Observational case report. Fundus photographs, fluorescein angiography, indocyanine green angiography, and swept-source optical coherence tomography angiography were used to characterize and describe the clinical findings. Results: A 58-year-old man presented with acute painless vision loss in the right eye. Multimodal imaging demonstrated multifocal pinpoint early-phase hyperfluorescence with late expanding leakage on fluorescein angiography and late hyperfluorescence on indocyanine green angiography. Swept-source optical coherence tomography angiography en face imaging of the ellipsoid zone layer revealed target-like lesions with central hyperreflectivity with surrounding hyporeflectivity. At 4-week follow-up, the chorioretinal lesions now demonstrated greater demarcation of borders with increased pigmentation. At 8-week follow-up, fundus examination revealed multiple target-like lesions with hyperpigmentation centrally surrounded by a hypopigmented rim. Repeat fluorescein angiography demonstrated central hypofluorescence with surrounding hyperfluorescent staining rim prompting workup for West Nile virus, which was later confirmed by laboratory testing. The patient's visual acuity and clinical examination remained stable on subsequent follow-up visits. Conclusion: Our case highlights multimodal imaging findings in the acute phase of West Nile virus chorioretinitis, which may be crucial to early diagnosis and identification. [ABSTRACT FROM AUTHOR]

Introduction: Central serous chorioretinopathy (CSCR) is a common disease that in chronic form can lead to significant visual impairment. Hence, the systemic and local risk factors of CSCR have been analyzed to possibly prevent its onset. The goal of the present study was to find the biometric parameters characteristic for CSCR. Methods: The study included 66 eyes of 60 consecutive patients who were diagnosed with acute or chronic CSCR between January 01 2021 and June 30 2021. There were 46 males and 14 females with a mean age of 48.8 ± 10.0 years in the study cohort. Six patients had symptomatic binocular disease. The axial length and retinal parameters of all patients were measured with spectral domain optical coherence tomography (SD-OCT), and refraction error was tested after cycloplegia. The results of the affected eyes were compared with those of healthy fellow eyes (with exclusion of eyes previously affected by CSCR or with any other ocular disorder) (39 eyes) and the control group (75 eyes), and correlated to the duration of the disease. Results: No significant differences were revealed in axial length between the affected eyes, healthy fellow eyes, and controls (23.31 ± 1.06 mm versus 23.59 ± 1.20 mm versus 23.33 ± 1.19 mm, respectively). The distribution of refraction errors was similar in the three analyzed groups. A hypermetropic shift was noted in the affected eyes versus controls (p = 0.030); however, no difference was noted in refraction error between the healthy fellow CSCR eyes and controls (p = 0.418). Both acute and chronic CSCR cases, as well as their fellow eyes, demonstrated significantly greater choroidal thickness compared with healthy individuals (p < 0.001). Longer disease duration was correlated with a significant deficit in macular volume and average central retinal thickness (p < 0.05). Conclusions: CSCR is a clinical entity that can occur in patients with every type of refraction error. A shorter axial length of the eyeball is not associated with the diagnosis of CSCR; however, increased choroidal thickness is typical of this entity. Longer disease duration is correlated with the loss of retinal thickness and volume. Plain Language Summary: Central serous chorioretinopathy (CSCR) is nowadays classified as a clinical entity belonging to the spectrum of pachychoroid disorders characterized by increased choroidal thickness. Quite often, a shorter axial length and hypermetropia were thought to cause choroidal congestion, and as such, were believed to be associated with the incidence of CSCR. This study aimed to evaluate this relationship in the context of the disease duration. The analysis included comparisons among affected CSCR eyes, healthy fellow eyes, and a control group. The results did not prove a relationship between a shorter eyeball or any specific refraction error and CSCR. Both acute and chronic cases of CSCR presented with significantly greater values of choroidal thickness compared with healthy individuals. A loss of retinal thickness and volume was observed with a longer disease duration. [ABSTRACT FROM AUTHOR]

Background: The study aims to investigate the relationship between the volume-accumulated reflectivity (termed "integral") on spectral domain optical coherence tomography (SD-OCT) and cone density on adaptive optics (AO) imaging. Methods: In this cross-sectional study, both eyes of 32 healthy subjects and 5 patients with inherited retinal diseases (IRD) were studied. The parameter, integral, was defined as the volume-accumulated reflectivity values in a selected region on OCT images; integrals of the ellipsoid zone (EZ) and interdigitation zone (IZ) were measured at 2°, 3°, 4°, 5°and 6° eccentricity along the four meridians on fovea-centered OCT B-scans. Cone density in the same region was measured using a flood illumination adaptive optics camera RTX1. Results: Integrals of EZ, IZ and cone density shared similar distribution patterns. Integral of the IZ was better correlated with cone density in both healthy people (r = 0.968, p < 0.001) and those with IRD (r = 0.823, p < 0.001) than direct measurements of reflectivity on OCT images. A strong correlation was found between best corrected visual acuity (BCVA) and cone density at 2° eccentricity (r = -0.857, p = 0.002). BCVA was also correlated with the integral of the IZ at the foveola (r = -0.746, p = 0.013) and fovea (r = -0.822, p = 0.004). Conclusions: The new parameter "integral" of the photoreceptor outer segment measured from SD-OCT was noted to correlate with cone density and visual function in this pilot study. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a neurodegenerative condition characterized by the progressive deterioration of dopaminergic neurons in the central and peripheral autonomous system and the intraneuronal cytoplasmic accumulation of misfolded α-synuclein. The clinical features are the classic triad of tremor, rigidity, and bradykinesia and a set of non-motor symptoms, including visual deficits. The latter seems to arise years before the onset of motor symptoms and reflects the course of brain disease. The retina, by virtue of its similarity to brain tissue, is an excellent site for the analysis of the known histopathological changes of PD that occur in the brain. Numerous studies conducted on animal and human models of PD have shown the presence of α-synuclein in retinal tissue. Spectral-domain optical coherence tomography (SD-OCT) could be a technique that enables the study of these retinal alterations in vivo. The objective of this review is to describe recent evidence on the accumulation of native or modified α-synuclein in the human retina of patients with PD and its effects on the retinal tissue evaluated through SD-OCT. [ABSTRACT FROM AUTHOR]

AIM: To evaluate temporal retinal thinning changes in retinal layers using spectral-domain optical coherence tomography (SD-OCT) in pediatric X-linked Alport syndrome (XLAS) patients. METHODS: A retrospective case-control study. SD-OCT scans of pediatric patients diagnosed with XLAS and age- and sex-matched healthy control participants were reviewed. Automated segmentation of SD-OCT scans was induced to analyze the retinal thickness (RT) of different layers. The temporal thinning index (TTI) was calculated for each layer and compared between the patients and the control group. RESULTS: Forty-three pediatric XLAS patients and 60 healthy controls were included. Temporal retinal thinning was present in 33 patients (76.74%), while 28 patients (65.11%) had severe pathological temporal retinal thinning and 5 patients (11.63%) had moderate thinning. The temporal inner sector RT (P

Objective Diabetic retinopathy (DR), a microvascular complication of diabetes, is a leading cause of preventable blindness. Spectral domain optical coherence tomography (SD-OCT) provides cross-sectional and topographical imaging of the retina. SD-OCT resolves outer retinal layers into three hyperreflective bands—external limiting membrane (ELM), ellipsoid zone (EZ), and retinal pigment epithelium (RPE). In this article, we have studied the role of these outer retinal layers in structural and molecular changes taking place in DR. Materials and Methods Articles with clinical features, pathogenesis, diagnosis, and treatment of DR were thoroughly studied. Articles were searched on PubMed, MEDLINE, and Cochrane Library from 2000 to 2020. Studies focusing on the role of ELM, EZ, and RPE in pathogenesis of DR based on SD-OCT were included. Results The long-standing hyperglycemia leads to protein glycosylation resulting in formation of advanced glycation end products (AGEs). AGEs have an impact through their effect on retinal microvasculature, vascular endothelial growth factor (VEGF), intercellular adhesion molecule-1, nitrosative and oxidative stress, and vitamin D and calcium metabolism. All these factors have been linked with disruption of outer retinal layers. AGEs lead to vascular endothelial dysfunction and release of proangiogenic factors by increasing the expression of VEGF in retinal pericytes and RPE cells. This leads to leakage and fluid accumulation resulting in diabetic macular edema (DME). In DME, there is sequential disruption of ELM and EZ and decrease in visual acuity (VA). The RPE alterations have been reported to be associated with the severity of DR and decrease in VA. Anti-VEGF therapy, most common treatment of DME, leads to restoration of barrier effect of ELM, it was found to be restored first followed by EZ restoration. Newer anti-AGEs agents and their receptor blockers are being developed which have a positive effect on maintaining the health of RPE. Conclusion A complex molecular association exists between the structural changes in ELM, EZ, and RPE in DR. SD-OCT is an indispensable tool to study these changes as integrity of these outer layers of retina is essential for maintaining visual function of retina in DR.

Introduction: Central serous chorioretinopathy (CSCR) as a clinical entity is potentially damaging and may significantly affect retinal morphology and function, especially in the chronic form. Our study aimed to determine the amount of deficit of best corrected visual acuity (BCVA) and individual retinal layers, including ganglion cells, in different types of CSCR and with reference to its duration. Methods: The retrospective analysis included 69 eyes of patients with resolved CSCR managed in Dobry Wzrok Ophthalmological Clinic between 1 January 2019 and 30 June 2022. The diagnosis of CSCR was based on the criteria outlined by the Central Serous Chorioretinopathy International Group. The analysis included data obtained from medical history, BCVA testing, and spectral domain optical coherence tomography (SD-OCT) measurements, with specific thickness values for individual retinal layers. The results were compared among affected eyes, unaffected fellow eyes, and healthy controls. Results: BCVA values were significantly lower in acute (0.08 ± 0.12 logMAR) and chronic (0.26 ± 0.19 logMAR) cases versus controls (0.0 logMAR). The thickness of all retinal layers (central subfoveal thickness, CST; inner retina with ganglion cell complex, GC; outer retina, ORT; and photoreceptor outer segments, POS) and macular volume (MV) were significantly decreased in chronic eyes versus controls (p < 0.01). Acute eyes had significant thinning of the outer retina and POS only compared to control eyes (p < 0.01). The amount of deficit in CST, ORT, GC, and MV was strongly correlated with poorer BCVA (p < 0.001), and the deficit of CST, ORT, and GC was correlated with disease duration (p < 0.05). The subfoveal choroidal thickness was significantly greater in affected and fellow eyes versus controls (p < 0.001). Conclusion: Damage to the outer retina and photoreceptors occurs early in the course of CSCR, with a deficit in ganglion cells noted adjunctively in chronic forms of the disease. Further studies are required to precisely determine correlation between visual loss in CSCR and deficits in individual retinal layers. Plain Language Summary: Central serous chorioretinopathy (CSCR) is a common condition typically affecting young and middle-aged individuals. In its chronic form, it can lead to changes in retinal morphology and significant visual impairment. This disorder occurs basically in two forms: acute and chronic, depending on its duration. The study aimed to determine the amount of morphological and functional deficit occurring in the course of acute and chronic CSCR and refer it to healthy controls. The analysis of 69 resolved cases of CSCR was performed, including results of visual acuity testing and spectral domain coherence tomography (SD-OCT) measurements. Visual acuity was significantly lower in both acute and chronic groups compared to healthy control eyes, with greater deficit in the chronic group. Analysis revealed also a significant thinning of the retina in the chronic group versus control group. Chronic group demonstrated substantial loss of ganglion cells, which was not noted in acute form of the disease. Acute eyes demonstrated only a partial deficit in the outer retina, with the ganglion cell layer remaining intact. The amount of deficit of all retinal layers was strongly correlated with poorer visual acuity and disease duration. [ABSTRACT FROM AUTHOR]

Age-related macular degeneration (AMD) is the leading cause of blindness in the Western world. In this work, the non-invasive imaging technique spectral domain optical coherence tomography (SD-OCT) is used to acquire retinal images, which are then analyzed using deep learning techniques. The authors trained a convolutional neural network (CNN) using 1300 SD-OCT scans annotated by trained experts for the presence of different biomarkers associated with AMD. The CNN was able to accurately segment these biomarkers and the performance was further enhanced through transfer learning with weights from a separate classifier, trained on a large external public OCT dataset to distinguish between different types of AMD. Our model is able to accurately detect and segment AMD biomarkers in OCT scans, which suggests that it could be useful for prioritizing patients and reducing ophthalmologists' workloads. [ABSTRACT FROM AUTHOR]

Backgrounds and Objectives: To analyze the influence of multiple anti-VEGF intravitreal injections for exudative age-related macular degeneration on the thickness of peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC + IPL) using spectral domain optical coherence tomography (SD-OCT). Materials and Methods: A prospective interventional study of consecutive patients treated with intravitreal bevacizumab (IVB) was performed. Average and sectorial values of RNFL and GC + IPL thickness were recorded using Cirrus SD-OCT at 0, 6, 12, and 24 months. Patients suffering from any ocular disease that could affect RNFL or GC + IPL thickness were excluded. Results: A total of 135 patients (70 women and 65 men, aged 65 ± 15 years) were included. The average number of injections per patient was 12.4 ± 2.4. Average RNFL and GC + IPL thickness prior to the first injection (87.6 ± 12.2 and 47.2 ± 15.5 respectively), and after 24-month follow-up (86.2 ± 12.6 and 46.7 ± 11.9 respectively) did not differ significantly (p > 0.05). There was a significant decrease in GC2, GC5 segments, and minimum GC + IPL thickness. Conclusion: Repeated anti-VEGF treatment did not cause significant changes in the thickness of RNFL and GC + IPL layers over a period of 24 months. The detected decrease in GC2 and GC5 sectors, as well as in minimum GC + IPL thickness, could be a sign of ganglion cell damage induced by the treatment or could occur during the natural course of the disease. [ABSTRACT FROM AUTHOR]

Purpose: Indication of laser peripheral iridotomy (LPI) is often conjectural due to dependency on gonioscopy and strict dichotomous classification of occludability. Indentation gonioscopy is the gold standard but is under-utilized for various reasons. The prevalence of primary angle closure disease (PACD) in eastern India is 1.5-1.9%, with a 22% five-year progression rate. Many angle closure patients may go blind without timely diagnosis and iridotomy. General ophthalmologists need alternate, validated methods for diagnoses. Pilocarpine eye drop causes miosis, and flattens the iris, producing angle changes detectable by spectral domain optical coherence tomography (SD-OCT). We hypothesized that the amount of angle change may be a suitable indicator for iridotomy.Methods: Our prospective cross-sectional single-masked observational study evaluated pilocarpine-induced changes in angle parameters detected by SD-OCT. Out of 372 patients enrolled, 273 patients (539 eyes) remained, with a mean age of 48.6 years (SD = 10.36). All eyes were graded by the Van Herick (VH) method, gonioscopy, and anterior segment (AS) SD-OCT and reassessed after pilocarpine drops.Results: The sensitivity and specificity of tomography measurements against gonioscopy grades were 61% and 85%, respectively. The receiver operating characteristic (ROC) curve was 0.85. Pilocarpine-induced angle widening was significant in gonioscopically narrower angles. Low Van Herick grades (217 eyes), narrow gonioscopy grades (238 eyes), and a narrow OCT angle value (165 eyes) were candidates for iridotomy.Conclusion: Our study results showed that pilocarpine-induced angle widening detected by SD-OCT could be a strong objective indicator for LPI. [ABSTRACT FROM AUTHOR]

The aim of this case series and narrative literature review is to highlight the importance of multimodal imaging in the ophthalmological examination of patients with spinocerebellar ataxia type 7 and provide a summary of the most relevant imaging techniques. Three patients with SCA7 were included in this case series. A literature review revealed twenty-one publications regarding ocular manifestations of SCA7, and the most relevant aspects are summarized. The role of different imaging techniques in the follow-up of SCA7 patients is analyzed, including color vision testing, corneal endothelial topography, color fundus photography (CFP) and autofluorescence, near infrared reflectance imaging, spectral domain optical coherence tomography (SDOCT), visual field examination, and electrophysiological tests. SDOCT provides a rapid and non-invasive imaging evaluation of disease progression over time. Additional examination including NIR imaging can provide further information on photoreceptor alteration and subtle disruption of the RPE, which are not evident with CFP at an early stage. Electrophysiological tests provide essential results on the state of cone and rod dystrophy, which could be paramount in guiding future genetic therapies. Multimodal imaging is a valuable addition to comprehensive ophthalmological examination in the diagnosis and management of patients with SCA7.

Background: Phacoemulsification (phaco) is one of the most widely used cataract surgery techniques nowadays. Various factors can influence the tissue structures of the eyeball eg. Ultrasonic energy, fluidics, mechanical effects, compression, and hypoxia on the tissue. Every step of this maneuver can cause direct or indirect effects on ocular tissues. Ultrasonic energy and fluidics produce mechanical effects that cause an inflammatory reaction which affects cornea, retina and choroid. Objective: To evaluate the effect of phacoemulsification on retina to compare these effects in diabetic and non-diabetic patient to reach a conclusion whether diabetic patient are more vulnerable to these effects or not. Patients and Methods: This is a prospective cohort observational study that included 100 eyes of 100 patients (50 diabetic patients (Type II), 50 non diabetic patients) having immature senile cataract. Patients were recruited from the ophthalmology department of Beni-Suef University. Results: In our study results noted a statistically significant increase in the central macular thickness 1day, 1 week & 1 month postoperatively also there was no statistically significant difference in the central macular thickness between the Diabetic and Non-diabetic group neither pre-operatively, nor post-operatively. Conclusion: Phacoemulsification affects the macula, phaco power used during the surgery and inflammatory mediators released after the surgery leads to long term increase in Central macular thickness in both diabetic and non-diabetic patients. It was noticed that phacoemulsification causes increase in Central macular thickness noticed at one week & one month post-operatively in both diabetic and non-diabetic patients. Finally we can say that cataract phacoemulsification cause t increase in central macular thickness.

Purpose: Indication of laser peripheral iridotomy (LPI) is often conjectural due to dependency on gonioscopy and strict dichotomous classification of occludability. Indentation gonioscopy is the gold standard but is under-utilized for various reasons. The prevalence of primary angle closure disease (PACD) in eastern India is 1.5–1.9%, with a 22% five-year progression rate. Many angle closure patients may go blind without timely diagnosis and iridotomy. General ophthalmologists need alternate, validated methods for diagnoses. Pilocarpine eye drop causes miosis, and flattens the iris, producing angle changes detectable by spectral domain optical coherence tomography (SD-OCT). We hypothesized that the amount of angle change may be a suitable indicator for iridotomy. Methods: Our prospective cross-sectional single-masked observational study evaluated pilocarpine-induced changes in angle parameters detected by SD-OCT. Out of 372 patients enrolled, 273 patients (539 eyes) remained, with a mean age of 48.6 years (SD = 10.36). All eyes were graded by the Van Herick (VH) method, gonioscopy, and anterior segment (AS) SD-OCT and reassessed after pilocarpine drops. Results: The sensitivity and specificity of tomography measurements against gonioscopy grades were 61% and 85%, respectively. The receiver operating characteristic (ROC) curve was 0.85. Pilocarpine-induced angle widening was significant in gonioscopically narrower angles. Low Van Herick grades (217 eyes), narrow gonioscopy grades (238 eyes), and a narrow OCT angle value (165 eyes) were candidates for iridotomy. Conclusion: Our study results showed that pilocarpine-induced angle widening detected by SD-OCT could be a strong objective indicator for LPI.

Purpose The aim of this study was to investigate the role of sex on retinal nerve fiber layer (RNFL) thickness and macular thickness measurement by spectral domain optical coherence tomography (SD-OCT). Patients and methods In this prospective observational study, 200 participants who fulfilled the inclusion and exclusion criteria were scanned three times as per predefined guidelines at 0, 30, and 60 min on the same day, by the same investigator using SD-OCT for measurement of RNFL and macular thickness. The observations were statistically analyzed and correlated. Results The RNFL thickness was greatest in the superior quadrant and thinnest in the temporal quadrant. The mean value of average RNFL thickness was 87.90±6.12 μm in females and 93.18±4.04 μm in males (range=74.33–99.67 μm). A statistically significant difference was found between males and females in all quadrants and in average RNFL thickness (P

PurposeTo describe the sequential evolution of outer retinal tubulations (ORTs) in patients diagnosed with choroidal neovascularization and/or retinal pigment epithelium atrophy.MethodsRetrospective evaluation of spectral domain optical coherence tomography of a consecutive cohort of patients with various retinal conditions.ResultsWe reviewed the clinical findings of 238 eyes of 119 consecutive patients (54 men and 65 women) with a mean age of 76.2 ± 14.2 years (range: 57-90) and a mean follow-up of 3 ± 1.6 years (range 1-7). Over the follow-up period, ORTs were diagnosed in 67 of 238 eyes (28.1%), 9 of which were imaged with sequential, eye-tracked spectral domain optical coherence tomography dating from the beginning of ORT formation. The presence of geographic atrophy and subretinal hyperreflective material at baseline were found to be risk factors for ORT development (P < 0.001 and P < 0.001, respectively). Outer retinal tubulations were divided into forming versus formed morphologies. The latter was comprised open and closed ORTs of which the open subtype was the most common. The formation of ORTs was significantly associated with microcystic macular lesions in the inner nuclear layer and the downward displacement of the outer plexiform layer, referred to as the outer plexiform layer subsidence sign (P < 0.001).ConclusionOuter retinal tubulation is a frequent optical coherence tomography finding in eyes with choroidal neovascularization and geographic atrophy. Open ORTs with progressive scrolled edges and shortened diameter were significantly associated with microcystic macular lesions in the inner nuclear layer and the outer plexiform layer subsidence sign.

Purpose: Hyperreflective dots (HRDs) can be observed in spectral domain optical coherence tomography (SD‐OCT), which can provide a sensitive marker in the treatment decision process. Quantitative analyses of HRDs are the key to make appropriate decisions on observation, treatment, and retreatment. The purpose of this study is to automatically and accurately segment HRDs in SD‐OCT B‐scans with diabetic retinopathy (DR). Methods: The authors propose an automatic segmentation algorithm of HRDs via focal priors and visual saliency. The algorithm is divided into three stages: segmentation of retinal layers, calculation of the multiscale local contrast saliency map, and adaptive threshold segmentation. First, a method based on improved graph search is used to segment retinal layers to obtain the region of interest (ROI) and the reflectivity estimation of the retinal pigment epithelium (RPE) layer; then, the multiscale local contrast saliency map is obtained by using a local contrast measure, which measures the dissimilarity between the current pixels and corresponding neighborhoods; finally, an adaptive threshold is applied to segment HRDs. Results: Experimental results on 20 SD‐OCT B‐scans demonstrate that our method is effective for HRDs segmentation. The average dice similarity coefficient (DSC) and detection accuracy are 71.12% and 85.07%, respectively. Conclusions: The proposed method can accurately segment HRDs in SD‐OCT B‐scans with DR and outperforms current state‐of‐the‐art methods. Our method can provide reliable HRDs segmentation to assist ophthalmologists in clinical diagnosis, treatment, disease monitoring, and progression. [ABSTRACT FROM AUTHOR]

Introduction: The role of the human eye in severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is still under investigation. The pathophysiology of the ocular findings is arduous when dealing with critically ill Covid-19 patients with comorbidities. Multiorgan involvement and the effects of inflammation, infection and systemic treatment on the retina are complex, and comparison of studies is difficult. Most studies in human patients have investigated the anterior segment, whereas few reports deal with the posterior segment of the eye. The present review aims to evaluate the retinal manifestations and imaging features in COVID-19 patients. Methods: Studies on the retinal manifestations and retinal imaging in COVID-19 patients published through June 2021 were reviewed. We included cross-sectional and case–control studies, case series, case reports and correspondence in the analysis. Results: Flame-shaped hemorrhages, cotton wool spots, augmented diameter and tortuosity of retinal vessels were found on funduscopic examination. Peripapillary, macular retinal nerve fiber layer and ganglion cell layer thickness alterations were reported on spectral domain optical coherence tomography. Reduced vessel density of the superficial and deep retinal capillary plexus on optical coherence tomography angiography was reported. Conclusions: Retinal complications may arise in COVID-19 patients. Although no consensus on presentation is currently available, retinal funduscopy and imaging has shown neuronal and vascular alterations. Systemic neurological complications and microangiopathy are associated with SARS-COV-2; thus, as the retina has a neuronal and vascular component, funduscopy and retinal imaging on COVID-19 patients can provide further insight to SARS-COV-2 disease and the follow-up of patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate the peripapillary retinal nerve fiber layer (RNFL) thickness of patients with retinitis pigmentosa (RP) and patients with early- and late-stage glaucoma using spectral domain optical coherence tomography (SD-OCT), and investigate the similarity and differences of RNFL thickening and thinning regions between these groups. Methods: This cross-sectional study was carried out in Niğde Ömer Halisdemir University Training and Research Hospital. The patients were divided into three groups; retinitis pigmentosa (group 1), early-stage glaucoma (group 2), and medium- and advanced-stage glaucoma (group 3). The RNFL thickness of all patients were measured. Each group consisted of 20 patients. Results: RNFL thinning was most frequently detected in the inferior quadrant, and then in the superior quadrant in all 3 groups and thickening was not detected in these 2 quadrants in glaucoma groups. The thickening was most frequently detected in the temporal quadrant, and in the 9 o' clock segment in all groups. In groups 1 and 2, the nasal quadrant was second after the temporal quadrant in RNFL thickening. RNFL thickening and thinning regions were found to be similar in these 2 diseases, which progress with ganglion cell damage. The horizontal quadrants were less affected and vertical quadrants were more affected regardless of the disease. Conclusion: The similar changes in the RNFL layer in these 2 different diseases with different mechanisms suggest that ganglion cells might have a specific response to various disease processes. [ABSTRACT FROM AUTHOR]

This report describes a case with paracentral acute middle maculopathy revealing a giant aortic aneurysm. A 41-year-old man presented with unilaterally unexplained sudden vision loss in the left eye. Fundoscopy revealed a slightly pale r -26etinal reflex in the superior retinal hemifield. SDOCT revealed blurred boundaries between retinal segments and prominent edema in the middle retinal layers. OCTA revealed decreased vascular density in the deep capillary plexus. FA showed low arterial circulation mainly in the superior retinal hemifield. Humphrey VFT revealed an inferior altitudinal defect in the left eye, implying a related circulatory disturbance in the corresponding region. A thorough systemic work-up, including a cardiovascular etiological investigation, revealed giant aortic aneurysm in the ascending aorta, necessitating emergency surgery. This report highlights the importance of a systemic etiological investigation in patients with PAMM to rule out any potential cardiovascular issues. [ABSTRACT FROM AUTHOR]

To investigate associations and predictive factors between macular neovascularization (MNV) lesion variants and drusen types in patients with treatment-naïve neovascular age-related macular degeneration (AMD). Methods: Multimodal imaging was retrospectively reviewed for druse type (soft drusen, subretinal drusenoid deposits (SDDs) or mixed) and MNV type (MNV 1, MNV 2, MNV 1/2 or MNV 3). The Consensus on Neovascular AMD Nomenclature (CONAN) classification was used for characterizing MNV at baseline. Results: One eye of each eligible patient was included (n = 191). Patients with predominant SDDs had an increased adjusted odds ratio (aOR) for MNV 2 (23.4453, p = 0.0025) and any type of MNV 3 (8.7374, p < 0.0001). Patients with MNV 1/2 had an aOR for predominant SDDs (0.3284, p = 0.0084). Patients with MNV1 showed an aOR for SDDs (0.0357, p < 0.0001). Eyes with SDDs only without other drusen types showed an aOR for MNV 2 (9.2945, p < 0.0001). Conclusions: SDDs represent a common phenotypic characteristic in AMD eyes with treatment-naïve MNV. The aOR for eyes with predominant SDDs to develop MNV 2 and MNV 3 was much higher, possibly due to their location in the subretinal space. The predominant druse type may help to predict which type of MNV will develop during the course of AMD. [ABSTRACT FROM AUTHOR]

To evaluate the effect of hyperbaric oxygen therapy (HBOT) for idiopathic sudden sensorineural hearing loss (ISSNHL) on central macular thickness (CMT) and choroidal thickness (CT). The study included 42 healthy eyes of 21 patients with ISSNHL (aged 24–61 years) who started HBOT within the first three days of the onset of hearing loss. Duration and severity of hearing loss were noted before starting HBOT. Central macular thickness (CMT), choroidal thickness (CT) 1500 µm nasal and temporal of the fovea, and subfoveal CT were measured by spectral domain optic coherence tomography before the first session of HBOT and after sessions 10 and 20. Measurements obtained before and after HBOT were compared. Eleven patients (52.4%) were men and 10 (47.6%) were women. The mean age was 44.67 ± 10.1 years. The mean duration of sudden hearing loss before HBOT was 2.05 ± 1 day. Hearing loss was mild in five patients, moderate in five patients, moderate to severe in 2 patients, severe in 4 patients and profound in 5 patients. Comparison of measurements obtained before HBOT and after 10 and 20 sessions of HBOT revealed no significant differences in CMT (219.17 ± 22.91, 220.33 ± 19.66, and 220.21 ± 19.3 µm), subfoveal CT (347.71 ± 66.82, 348.38 ± 74.55, and 345.45 ± 75.39 µm), nasal CT (328.64 ± 82.31, 316.02 ± 79.32, and 313.52 ± 89.92 µm), or temporal CT (321.76 ± 71.29, 317.05 ± 73.94, and 314.05 ± 74.61 µm, respectively) (p > 0.05). HBOT for the treatment of ISSNHL had no significant effect on CMT or CT in healthy eyes. [ABSTRACT FROM AUTHOR]