Enhanced depth imaging optical coherence tomography in patients with different phases of Behcet's panuveitis

OBJECTIVE

To evaluate the changes in choroidal thickness (CT) at 13 different points between "active," "remission," and "end-stage" phase of Behcet's panuveitis and compare this with the age, sex, and spherical equivalent matched healthy controls using enhanced depth imaging optical coherence tomography.

DESIGN

Prospective study.

PARTICIPANTS

Eighty-five eyes of 45 patients with Behcet's panuveitis (19 eyes with active phase, 48 eyes with remission phase, and 18 eyes with end-stage phase) and 84 eyes of 42 controls were enrolled in this study.

METHODS

CT measurements were obtained beneath the fovea and at 500-µm intervals for 3 mm nasal and temporal to the centre of the fovea. Correlation analyses were calculated to assess the relationship of the CT with age and disease duration.

RESULTS

At all 13 measurement points, CT was significantly thinnest in end-stage-phase eyes and thickest in active-phase eyes (p < 0.01). CT was thicker in remission-phase eyes compared with control eyes at foveal and perifoveal points, but the trend was not statistically significant. The mean CT at each of the 13 measured points showed a negative correlation with age and disease duration (p < 0.01).

CONCLUSIONS

Submacular CT, as measured by enhanced depth imaging optical coherence tomography, was significantly reduced in eyes with Behcet's panuveitis in the end-stage phase and increased in those in the active phase.

Long-term results of half-dose photodynamic therapy for chronic central serous chorioretinopathy with contrast sensitivity changes

PURPOSE

To evaluate the efficacy and safety of photodynamic therapy (PDT) with half-dose verteporfin in patients with chronic central serous chorioretinopathy (CCSC) and retinal functional changes, by functional acuity contrast test (FACT).

METHODS

In this study, 27 eyes of 24 patients with CCSC were treated with PDT with half-dose verteporfin. Best-corrected visual acuity (BCVA), central foveal thickness (CFT) and resolution of subretinal fluid on optical coherence tomography (OCT), and leakage on fluorescein angiography (FA) and indocyanine green angiography (ICGA) were assessed. Contrast sensitivity test was performed at baseline and at 12th month for investigating retinal functional changes.

RESULTS

The mean follow-up period was 25.33 ± 11.08 months. The mean age was 43.7 ± 8.6 years. Seventeen patients were male (70.8%) and seven patients were female (29.2%). Post PDT at 1st, 3rd, 6th, 12th month and at last follow-up, BCVA were significantly improved compared with the baseline BCVA (P<0.001), and CFT post PDT were significantly thinner than the baseline measurement (P<0.001). There was significant difference between pre- and post-PDT 12th month contrast sensitivities at all five different spatial frequency channels (P<0.01).

CONCLUSIONS

Half-dose PDT is an effective and safe method in the treatment of CCSC with anatomical and functional success. The measurement of contrast sensitivity by FACT can be useful for evaluating the functional effectiveness of half-dose PDT for CCSC.

The effect of smoking on choroidal thickness measured by optical coherence tomography

BACKGROUND/AIMS

To investigate the effect of smoking on choroidal thickness using Fourier domain optical coherence tomography.

METHODS

17 otherwise healthy smokers (study group) and 17 non-smokers (control group) were enrolled. In the study group, all participants underwent optical coherence tomography scanning at baseline, and 1 and 3 h following smoking one standard cigarette. Also the participants of the control group underwent optical coherence tomography scanning in the morning which was followed by two further examinations at the first and third hours, respectively. Choroidal thickness measurements were performed.

RESULTS

The mean choroidal thickness at the fovea prior to smoking was 301.1±63.1 μm, which decreased to 284.2±56.7 μm at 1 h and 270.8±80.0 μm at 3 h following smoking (p=0.001). The mean choroidal thickness was significantly decreased following smoking at all five extrafoveal points. The difference in choroidal thickness was not statistically significant at 1 and 3 h of smoking at all six points. In the control group, the mean baseline choroidal thickness at the fovea was 270.6±57.9 μm, which was 272.5±52.4 μm at 1 h and 273.8±57.4 μm at 3 h (p=0.816).

CONCLUSIONS

Cigarette smoking causes a significant decrease in choroidal thickness following smoking. Fourier domain optical coherence tomography can effectively demonstrate choroidal thickness.

The results of pars plana vitrectomy and silicone oil tamponade for endophthalmitis after intravitreal injections

To report the role of early vitrectomy and silicone oil tamponade in acute endophthalmitis following intravitreal injection. Medical records of eight patients who presented with acute endophthalmitis after intravitreal injection of different drugs were retrospectively reviewed. Initial treatment consisted of vitreous tap with cultures and injection of intravitreal antibiotics, with the patients subsequently undergoing pars plana vitrectomy and silicone oil tamponade within 24 h following initial vitreous tap. The mean time to presentation was 1.7 days (1-3 days). The initial best-corrected visual acuity was hand motion to 0.05 before treatment and 0.05-0.8 (Snellen) after treatment. Vitreous cultures were obtained from all patients, of which four were culture positive. Endophthalmitis was controlled in all patients. There was no retinal detachment or phthisis bulbi during the follow-up period (1-4 years). Acute endophthalmitis following intravitreal injection occurs rapidly and requires urgent treatment. If intravitreal antibiotics fail to control inflammation, early pars plana vitrectomy and silicone oil tamponade would be an appropriate option.

Intravitreal bevacizumab followed by laser photocoagulation for retinal capillary hemanginoblastomas

PURPOSE

To report a patient with retinal capillary hemangioblastomas associated with Von Hippel-Lindau syndrome who achieved long-term visual improvement with single intravitreal bevacizumab injection followed by laser photocoagulation.

METHODS

Intravitreal bevacizumab injection was performed in a 17-year-old girl with bilateral multiple retinal capillary hemangioblastomas. Laser photocoagulation was then performed to augment the initial response to bevacizumab. The visual acuity, fundus photography, fundus fluorescein angiography, and ocular coherence tomography were obtained at each visit. The patient was followed-up for 3 years.

RESULTS

Two weeks after injection, the macular edema and exudation significantly decreased with an improvement in the visual acuity. Laser photocoagulation performed 2 weeks after the intravitreal bevacizumab injection provided further regression of exudation and scarring of the hemangioblastomas. No further intervention was required, and the visual acuity returned to baseline at the third year of follow-up.

CONCLUSION

Combined intravitreal bevacizumab with laser photocoagulation is a viable option in retinal capillary hemangioblastomas associated with Von Hippel-Lindau syndrome.