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BackgroundSmartphone-based fundus imaging allows for mobile and inexpensive fundus examination with the potential to revolutionize eye care, particularly in lower-resource settings. However, most smartphone-based fundus imaging adapters convey image quality not comparable to conventional fundus imaging. ObjectiveThe purpose of this study was to evaluate a novel smartphone-based fundus imaging device for documentation of a variety of retinal/vitreous pathologies in a patient sample with wide refraction and age ranges. MethodsParticipants’ eyes were dilated and imaged with the iC2 funduscope (HEINE Optotechnik) using an Apple iPhone 6 in single-image acquisition (image resolution of 2448 × 3264 pixels) or video mode (1248 × 1664 pixels) and a subgroup of participants was also examined by conventional fundus imaging (Zeiss VISUCAM 500). Smartphone-based image quality was compared to conventional fundus imaging in terms of sharpness (focus), reflex artifacts, contrast, and illumination on semiquantitative scales. ResultsA total of 47 eyes from 32 participants (age: mean 62.3, SD 19.8 years; range 7-93; spherical equivalent: mean –0.78, SD 3.21 D; range: –7.88 to +7.0 D) were included in the study. Mean (SD) visual acuity (logMAR) was 0.48 (0.66; range 0-2.3); 30% (14/47) of the eyes were pseudophakic. Image quality was sufficient in all eyes irrespective of refraction. Images acquired with conventional fundus imaging were sharper and had less reflex artifacts, and there was no significant difference in contrast and illumination (P

The purpose of this prospective case-control study is to investigate differences in quantitative autofluorescence (qAF) in clinically affected and unaffected eyes of patients with inactive posterior uveitis compared to healthy, age-matched controls. Patients with posterior uveitis and healthy controls were imaged using fundus autofluorescence (488 nm excitation; Spectralis HRA + OCT; Heidelberg Engineering) to measure qAF values using the proprietary HEYEX software. Mean background qAF (excluding vessels and retinal lesions) across all segments (as previously defined by Delori et al.) and in the segment with the highest mean qAF value were compared between affected and unaffected eyes from patients with posterior uveitis, and healthy age-matched control eyes using the Kruskal-Wallis-test. A total of 83 eyes from 83 patients were included: 33 affected eyes (33 patients with uni-/bilateral posterior uveitis), 21 clinically unaffected eyes (21 patients with unilateral posterior uveitis), and 29 healthy, age-matched control eyes (29 patients). Mean qAF values were significantly higher (p-value < 0.0001) in both clinically affected (177.0 ± 83.8 qAF arbitrary units [qAF a.u.]) and unaffected (173.8 ± 56.4 qAF a.u.) eyes compared to healthy, age-matched controls (135.7 ± 41.8 qAF a.u.). Likewise, mean qAF in the segment with the highest mean qAF value was significantly higher (p-value: <0.01) in affected (243.2 ± 103.1 qAF a.u.) and unaffected eyes (227.1 ± 63.4 qAF a.u.) in comparison to controls (168.9 ± 48.5 qAF a.u.). In conclusion, both clinically affected and unaffected eyes from patients with posterior uveitis demonstrated increased fundus autofluorescence. The results of our study could indicate subclinical inflammation in currently inactive and (yet) unaffected eyes of posterior uveitis patients. This could be caused by accumulation of fluorophores or an increased metabolic activity generated by low-grade inflammation. As these changes may precede future inflammation in yet unaffected eyes, additional longitudinal studies including analysis of eyes with active disease are warranted. [ABSTRACT FROM AUTHOR]

Purpose The Treatment exit Options For non-infectious Uveitis (TOFU) registry documents disease courses for non-anterior non-infectious uveitis entities with and without treatment to generate more evidence for clinical management recommendations including treatment exit strategies. In this article, we present the participants’ baseline characteristics after the first 3 years. Methods TOFU is an observational, prospective registry and recruits patients ≥18 years of age with non-anterior non-infectious uveitis with or without a history of previous disease-modifying antirheumatic drugs (DMARDs) treatment. The data are collected in the electronic data capture software REDCap and include ophthalmological and general medical history as well as clinical findings. Results Between 24.10.2019 and 27.12.2022, 628 patients were enrolled at 25 clinical sites in Germany and Austria. Patients with intermediate uveitis were most frequently included (n=252; 40.1%) followed by posterior uveitis (181; 28.8%), panuveitis (n=154; 24.5%) and retinal vasculitis (n=41, 6.5%). At baseline, 39.6% were treated with systemic corticosteroids, 22.3% with conventional synthetic (cs) DMARDs, 20.5% with biological (b) DMARDs and 3.6% with other systemic treatments. Average best corrected visual acuity (BCVA) was 0.69 decimal. Patients with panuveitis had the worst BCVA with 0.63 decimal. Overall, only 8 patients (1.3%) suffered from severe visual impairment. Conclusions Less than half of participants required DMARD treatment at baseline, with csDMARDs used more frequently than bDMARDs. The presence of severe visual impairment was low, mostly affecting patients with panuveitis. These findings are in line with comparable monocentric cross-sectional studies of tertiary uveitis centres in Germany and will allow us to generate generalisable evidence in TOFU. [ABSTRACT FROM AUTHOR]

Macular Telangiectasia Type 2 (MacTel) is a chronic, progressive disease of the central retina characterized by vascular and neurodegenerative changes. As there is currently no treatment for non-neovascular MacTel, there is a dearth for biomarkers identifying eyes with an increased risk for disease progression for patient counseling and clinical trial recruitment. Eyes were classified to be stable or progressive, defined by the fundus photography-based grading system by Gass and Blodi. First, structural differences between these two groups were assessed, employing optical coherence tomography (OCT) and OCT-angiography. Univariate regression analyses revealed evidence towards a lower superficial retinal layer (SRL) vessel density (VD), skeleton density (SD) and deep retinal layer (DRL) SD in progressing compared to stable eyes (p = 0.05, p = 0.05, p = 0.07). Second, a multivariable predictive model was employed to examine the predictive value of structural and functional parameters for disease progression. Baseline best corrected visual acuity (BCVA) and SRL SD are prognostic for disease progression (p < 0.001, p = 0.05). The presence of ellipsoid zone (EZ) loss is prognostic for future central retinal thickness (p < 0.01). We propose SRL SD, BCVA, and EZ loss as prognostic biomarkers and as possible outcome measures in future interventional studies in MacTel. [ABSTRACT FROM AUTHOR]