Structure-function relationship and diagnostic value of macular ganglion cell complex measurement using Fourier-domain OCT in glaucoma

PURPOSE

To evaluate the relationship between visual function and macular ganglion cell complex (GCC) thickness measured by Fourier-domain optical coherence tomography (OCT) and evaluate the diagnostic value of GCC measurement compared to retinal nerve fiber layer (RNFL) thickness and macular thickness in detecting early, moderate, and severe glaucomas.

METHODS

Subjects underwent standard automated perimetry (SAP), OCT imaging with optic nerve head mode and GCC mode. The relationship between OCT parameters (mean GCC thickness, mean RNFL thickness, and macular thickness) and perimetry global indices (mean deviation [MD] and pattern standard deviation [PSD]) was evaluated by regression analysis. Diagnostic values of mean RNFL thickness, GCC parameters, and macular thickness were compared with the area under the receiver operating characteristic curves (AUC).

RESULTS

A total of 84 eyes, 42 of each normal and primary open-angle glaucoma patients were included in the study. Compared with linear models, second-order polynomial models better described relationships between GCC thickness and MD ( P < 0.001), and between GCC thickness and PSD ( P = 0.00). RNFL parameter, inferior RNFL thickness had the highest AUC for detecting early glaucoma. The AUC of mean GCC thickness for early glaucoma was higher than that of mean RNFL; however, the difference was not significant ( P = 0.09), which was higher than that of macular thickness.

CONCLUSION

The relationship between visual field (VF) sensitivity and GCC thickness is best expressed by the curvilinear function. Macular GCC thickness and RNFL thickness showed similar diagnostic values but were better than macular thickness for detecting early glaucoma but inferior to macular thickness and RNFL thickness for detecting moderate glaucoma.

Association of Metabolic Syndrome with Macular Thickness and Volume in Older Adults: A Population-Based Optical Coherence Tomography Study

Background: To explore the associations of the metabolic syndrome (MetS) and individual components with macular thickness and volume among rural-dwelling Chinese older adults. Methods: This population-based cross-sectional study included 705 participants (age ≥60 years) derived from the MIND-China study. In 2018-2019, we collected data through face-to-face interview, clinical examination, optical coherence tomography (OCT) examination, and blood test. We measured macular thickness and volume using spectral-domain OCT. MetS was defined following the International Diabetes Federation (IDF) criteria, the IDF/American Heart Association (AHA) criteria, the National Cholesterol Education Program-Adult Treatment Panel III criteria, and the Chinese Diabetes Society (CDS) criteria. Data were analyzed with multivariable general linear models. Results: MetS was significantly associated with thinner macula in central (multivariable-adjusted β = -5.29; 95% confidence interval: -9.31 to -1.26), parafoveal (-2.85; -5.73 to 0.04) and perifoveal regions (-4.37; -6.79 to -1.95) when using the IDF criteria, in the perifoveal regions (-3.82; -6.18 to -1.47) when using the IDF/AHA criteria, and in the central region (-5.63; -10.25 to -1.02) when using the CDS criteria, and with reduced macular volume when using the IDF (-0.16; -0.26 to -0.07) and IDF/AHA (-0.13; -0.22 to -0.04) criteria. In the parafoveal region, the IDF-defined MetS was significantly associated with thinner retina in men (β = -6.25; -10.94 to -1.56) but not in women. Abdominal obesity (-2.83; -5.41 to -0.25) and elevated fasting blood glucose (-2.65; -5.08 to -0.21) were associated with thinner macular thickness in the perifoveal region. Conclusion: MetS is associated with macular thinning and reduced macular volume among rural-dwelling older adults, and the associations vary by the defining criteria of MetS.

Five-year changes in macular thickness in the elderly population: A cohort study

BACKGROUND

The aim of this study is to determine the 5-year changes in macular thickness and related factors.

METHODS

Data were from the second (2014) and third (2019) phases of the Shahroud Eye Cohort Study. Examinations included measurement of uncorrected and best-corrected visual acuity, non-cycloplegic autorefraction, slit-lamp biomicroscopy, and funduscopy. Participants underwent Cirrus HD-OCT 4000 (Carl Zeiss Meditec, Dublin, CA).

IMAGING

RESULTS

The 5-year changes (95% confidence interval) of central and overall macular thicknesses were - 3.48 ± 8.16 μ (-3.92, -3.03) and - 0.79 ± 4.06 μ (-1.03, -0.54), respectively. The median and IQR of 5-year changes in the central subfield thickness were -3 and 10, although they were 0 and 5 in the overall macular thickness, respectively. Multiple regression model showed the central macular thickness (CMT) decreased with a U-shape pattern with increasing age. The 5-year changes in CMT were significantly lower in females compared to males β = -1.55; (-2.78, -0.32) and in smokers compared to non-smokers β = -1.92; (-3.55, -0.28). Moreover, higher body mass index β = -0.12; (-0.22, -0.02) and CMT at baseline β = -0.08; (-0.10, -0.06) were significantly associated with lower CMT changes. The average 5-year changes in overall macular thickness showed a non-linear decrease with age and was significantly higher in females β = 0.93; (0.4, 1.43). These changes were directly related to the anterior chamber depth β = 0.87; (0.10, 1.64) in the baseline.

CONCLUSIONS

The macular thickness decreased slightly after 5 years; however, this change is not clinically significant. Demographic factors such as age and sex and refractive errors were significantly related to macular thickness changes.

Continuous Laser Versus Micropulse Laser in the Treatment of Central Serous Chorioretinopathy: A Retrospective Study

BACKGROUND

Central serous chorioretinopathy (CSCR) is a retinal disorder characterized by complex mechanisms leading to abnormal fluid accumulation under the retina. While management remains controversial, laser therapy has been successfully used. This study compares the efficacy of continuous laser (CL) and micropulse laser (ML) therapy in treating CSCR, focusing on reduction in macular thickness and improvement in visual acuity.

METHODS

A retrospective cohort study was conducted, including patients with CSCR treated with either CL or ML. The primary outcome measured was the reduction in average macular thickness (AMT), alongside secondary outcomes like changes in best corrected visual acuity (BCVA), subfoveal choroidal thickness (SFCT), and resolution of subretinal fluid (SRF).

RESULTS

The study evaluated 121 patients with CSCR, treated either with CL or ML. The primary outcome showed that the mean reduction in AMT was 51.14 µm (±20) in the CL group and 29.88 µm (±22) in the ML group, without a statistically significant difference (p=0.10). For the secondary outcomes, the improvement in BCVA was comparable in both groups, with CL at 0.15 (±0.1) and ML at 0.12 (±0.1) and no significant difference (p=0.41). However, in SFCT reduction, CL showed greater efficacy with a mean reduction of 32.19 µm (±15) compared to ML's 4.85 µm (±18), which was statistically significant (p=0.0004). The degree of SRF resolution showed no significant difference between the treatments (p=0.065).

CONCLUSIONS

Both CL and ML are effective in the management of CSCR, with CL being more effective in reducing SFCT. These findings suggest the need for personalized treatment strategies based on individual patient characteristics and underline the complexity of CSCR management.

Retinal neural tissue and vascular calibres in migraine: the Northern Finland Birth Cohort Eye Study

PURPOSE

To evaluate the possible effects of migraine on retinal nerve fibre layer (RNFL), ganglion cell-inner plexiform layer (GC-IPL), macular thickness and retinal arteriolar and venular diameters (CRAE, CRVE) in a population-based birth cohort.

METHODS

375 migraineurs and 1489 healthy controls were included in this cross-sectional cohort study. RNFL, GC-IPL and macular thickness parameters were measured by spectral domain optical coherence tomography (OCT), and vascular parameters were measured from fundus photographs. Migraine was determined by a questionnaire and specific features were selected as covariates (gender, smoking status, systolic blood pressure, refraction and diabetes).

RESULTS

There were no statistically significant differences between healthy controls and migraineurs in average RNFL (p = 0.123), macular (p = 0.488) or GC-IPL (p = 0.437) thickness. Migraine did not have a significant effect on any of the macular or GC-IPL subfields. For RNFL subfields, only temporal inferior was borderline significantly increased in migraineurs (p = 0.039) in adjusted results. No statistically significant differences were found between study groups on retinal vascular calibres CRAE (p = 0.879), CRVE (p = 0.145) or AVR (p = 0.259). GC-IPL thickness was found to be positively correlated with CRAE and CRVE in both study groups as GC-IPL thickness increased together with the increase in CRAE and CRVE (p-trend < 0.001 in both), and a similar trend was detected with central macular subfield thickness and systolic (p-trend < 0.001) and diastolic (p-trend = 0.010) blood pressure, but only in the control group.

CONCLUSION

There were no remarkable differences between migraineurs and healthy controls in retinal vascular or structural parameters in our study.

Central macular morphology and optic nerve fibre layer thickness in young adults born premature and screened for retinopathy of prematurity

PURPOSE

To investigate central retinal morphology and optic retinal nerve fibre layer (RNFL) in prematurely born young adults and compare to term born controls.

MATERIALS AND METHODS

The participants were 59 prematurely born individuals, with a birthweight ≤1.500 g, and 44 term born controls, all 25-29 years of age. Visual acuity (VA) and contrast sensitivity (CS) were assessed. The retinal macular thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness and RNFL thickness were assessed with Cirrus optical coherence tomography (OCT).

RESULTS

Central macular thickness was increased (mean 26.7 μm) in prematurely born individuals compared to controls. The macular GC-IPL was thinner (mean 3.84 μm), also when excluding those with previous retinopathy of prematurity (ROP) and those with neurological complications. Gestational age at birth and previous treatment of ROP were risk factors for a thicker macula, however, not for reduced GC-IPL. The average peripapillary RNFL was thinner (mean 4.61 μm) in the prematurely born individuals, also when excluding those with previous ROP and/or neurological complications. Within the prematurely born group, treated ROP was correlated with increased average RNFL. Further, both better VA and CS were associated with thinner optic nerve RNFL and thicker average GC-IPL.

CONCLUSION

Macular and optic nerve morphology were influenced by premature birth as assessed with OCT in adult individuals. Gestational age at birth and treatment for ROP seemed to affect central macular thickness, and treated ROP affected the peripapillary RNFL. Thus, retinal sequelae remained in adulthood.

Macular changes following cataract surgery in eyes with early diabetic retinopathy: an OCT and OCT angiography study

Background

To evaluate changes in macular status and choroidal thickness (CT) following phacoemulsification in patients with mild to moderate nonproliferative diabetic retinopathy (NPDR) using optical coherence tomography.

Methods

In this prospective study, all of the patients underwent uncomplicated phacoemulsification. Retinal superficial capillary plexus vascular density (SCP-VD), macular thickness (MT), and CT were measured pre- and postoperatively.

Results

Twenty-two eyes of 22 cataract patients with mild to moderate NPDR without diabetic macular edema (DME) and 22 controls were enrolled. BCVA increased in two groups at 3 months postoperatively. At 1 and 3 months postoperatively, SCP-VD in the diabetic retinopathy (DR) group significantly increased; changes in SCP-VD in parafovea were significantly greater in the DR group than in the control group. MT and CT in the DR group significantly increased at all visits postoperatively in the fovea and perifovea. Changes in parafoveal MT were significantly greater in the DR group than in the control group at all visits postoperatively. Changes in CT and MT in the fovea were significantly greater in patients with DR than in the controls 1 and 3 months postoperatively.

Conclusion

Uncomplicated phacoemulsification resulted in greater increases in SCP-VD, MT and CT in patients with early DR without preoperative DME than in controls.

Associations of pre- and postnatal exposures with optic nerve status in young adults

PURPOSE

We aimed to explore the effect of multiple pre- and postnatal exposures on optic nerve status in young adults due to this critical period for development.

METHODS

We analysed peripapillary retinal nerve fibre layer (RNFL) status and macular thickness at age 18 years in the Copenhagen Prospective Studies on Asthma in Childhood 2000 (COPSAC2000 ) cohort in relation to several exposures.

RESULTS

Of the 269 participants (median (IQR) age, 17.6 (0.6) years; 124 boys), 60 participants whose mothers had smoked during pregnancy had a thinner RNFL: adjusted mean difference -4.6 μm (95% CI -7.7; -1.5 μm, p = 0.004) compared with participants whose mothers had not smoked during pregnancy. A total of 30 participants who were exposed to tobacco smoke both during foetal life and childhood had thinner RNFL: -9.6 μm (-13.4; -5.8 μm, p < 0.001). Smoking during pregnancy was also associated with a macular thickness deficit: -4.7 μm (-9.0; -0.4 μm, p = 0.03). Higher indoor concentrations of particulate matter 2.5 (PM2.5) was associated with thinner RNFL: -3.6 μm (-5.6; -1.6 μm, p < 0.001) and a macular deficit: -2.7 μm (-5.3; -0.1 μm, p = 0.04) in the crude analyses, but not in the adjusted analyses. No difference was found among participants who smoked at age 18 years compared with non-smokers on RNFL or macular thickness.

CONCLUSIONS

We found that exposure to smoking during early life was associated with a thinner RNFL and macula at age 18 years. The absence of an association between active smoking at 18 years suggests that the vulnerability of the optic nerve is highest during prenatal life and early childhood.

Impact of Prophylactic Ranibizumab to Prevent Neovascular Age-Related Macular Degeneration on Eyes With Intermediate Age-Related Macular Degeneration

Purpose

The purpose of this study was to determine the impact of prophylactic ranibizumab (PR) injections given every 3 months in eyes with intermediate nonexudative age-related macular degeneration (AMD) on drusen volume, macular layer thicknesses, and progression of geographic atrophy (GA) area over 24 months in the PREVENT trial.

Methods

This post hoc analysis of the prospective PREVENT trial compared eyes with intermediate AMD randomized to PR versus sham injections to determine rates of conversion to neovascular AMD over 24 months. Drusen area and volume, macular thickness and volume, and retinal layer thicknesses were measured on spectral-domain optical coherence tomography images and analyzed. Masked grading of GA area and subretinal drusenoid deposits (SDDs) using fundus autofluorescence images was performed.

Results

There were no statistical differences in drusen area and volumes between groups, and similar reductions in central subfield thickness, mean cube thickness, cube volume, and retinal sublayer thickness from baseline to 24 months (P = 0.018 to < 0.001), with no statistical differences between groups in any of these anatomic parameters. These findings were not impacted by the presence or absence of SDD. Among the 9 eyes with GA in this study, mean GA growth rate from baseline to 24 months was 1.34 +/- 0.79 mm2/year after PR and 1.95 +/- 1.73 mm2/year in sham-treated eyes (P = 0.49), and similarly showed no statistical difference with square root transformation (P = 0.61).

Conclusions

Prophylactic ranibizumab given every 3 months did not appear to affect drusen volume, macular thinning, or GA progression in eyes with intermediate AMD.

Translational Relevance

This work investigates the impact of PR on progressive retinal degeneration in a clinical trial.

Systemic isotretinoin therapy and central macular and choroidal thicknesses in acne vulgaris: is there any association?

PURPOSE

To investigate the effect of oral isotretinoin therapy on central macular thickness (CMT) thickness and choroidal thickness (CT) using optical coherence tomography (OCT).

METHODS

CT and CMT thickness of 43 eyes were evaluated at baseline, the third, and sixth month of isotretinoin therapy by spectral-domain OCT. For assessment of CT, OCT measurements were obtained at the fovea with six additional measurements at adjacent locations (at 500-1000 µm temporal to the fovea and 500-1000 µm nasal to the fovea).

RESULTS

Forty-three eyes from 43 patients with acne vulgaris, including 33 females (76.7%), who had a mean age of 24.81 ± 6.60 years, completed the study. The mean CMT was 231.49 ± 19.52 at the baseline and significantly decreased to 229.0 ± 19.57 (p = 0.02) and 229.28 ± 18.83 after three and six months, respectively (p < 0.03). The change in the macular thicknesses measured at four quadrants and choroidal thicknesses were not statistically significant during the study (p > 0.05).

CONCLUSION

The result of our study demonstrated choroidal thickness change is not significant in patients with acne vulgaris after systemic isotretinoin therapy during six months of follow-up. The decreased CMT amount was 2.2 microns; even if statistically significant, this amount is clinically insignificant.

Evaluation of Retinal Nerve Fiber Layer and Macular Thickness Pre- and Post-Chemotherapy With Carboplatin and Paclitaxel in Patients With Endometrial and Ovarian Cancer

Background Carboplatin and paclitaxel are two standard chemotherapeutic agents known to cause neurotoxicity. In this study, we aim to evaluate the toxicity of these agents by measuring the peripapillary retinal nerve fiber layer (RNFL) and macular thickness in patients with endometrial and ovarian cancers who are receiving them. Methods A one-year prospective cohort study involving 28 patients who were treated intravenously with carboplatin (200-400 mg/m2) and paclitaxel (175 mg/m2) three-weekly for six cycles was conducted. RNFL and macula thickness were measured using optical coherence tomography (OCT) before the commencement of chemotherapy, after the third cycle, and one month after the sixth cycle. The main outcome measurements were the average RNFL thickness and central subfield thickness of the macula. Results The mean age of the 28 participants was 54.68 years old (standard deviation [SD] 9.03). Eleven had endometrial cancer, while 17 had ovarian cancer. The mean of the average RNFL thickness during baseline pre-chemotherapy was 96.43 µm (SD 11.39). One month after cessation of treatment, the mean RNFL thickness increased to 101.57 µm (SD 13.54). Statistical analysis showed a significant increment in the mean RNFL thickness (p ≤ 0.001), from baseline to after three cycles, and baseline to one month after six cycles of chemotherapy, except the nasal quadrant. The increment of all macular quadrants was statistically significant (p < 0.05) except for central subfield thickness. Conclusion Systemic administration of carboplatin and paclitaxel affected both the peripapillary RNFL and macula thickness. This represents early evidence of subacute subclinical retinal toxicity. OCT can be used as a screening tool to assess peri-chemotherapeutic retinal alterations.

Optical Coherence Tomography Assessment of Macular Thickness in Alzheimer's Dementia with Different Neuropsychological Severities

This retrospective case-control study aimed to investigate associations between disease severity of Alzheimer's dementia (AD) and macular thickness. Data of patients with AD who were under medication (n = 192) between 2013 and 2020, as well as an age- and sex-matched control group (n = 200) with normal cognitive function, were included. AD patients were divided into subgroups according to scores of the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Macular thickness was analyzed via the Early Treatment Diabetic Retinopathy Study (ETDRS) grid map. AD patients had significant reductions in full macula layers, including inner circle, outer inferior area, and outer nasal area of the macula. Similar retinal thinning was noted in ganglion cells and inner plexiform layers. Advanced AD patients (MMSE score < 18 or CDR ≥ 1) showed more advanced reduction of macular thickness than the AD group (CDR = 0.5 or MMSE ≥ 18), indicating that severe cognitive impairment was associated with thinner macular thickness. Advanced AD is associated with significant macula thinning in full retina and inner plexiform layers, especially at the inner circle of the macula. Macular thickness may be a useful biomarker of AD disease severity. Retinal imaging may be a non-invasive, low-cost surrogate for AD.

The Relationship between Fixation Stability and Retinal Structural Parameters in Children with Anisometropic, Strabismic and Mixed Amblyopia

(1) Background: Amblyopia is an ocular condition leading to structural and functional changes. The relationship between these changes is complex and remains poorly understood. (2) Methods: Participants included 31 children aged 5 to 9 years with strabismic (n = 9), anisometropic (n = 16) and mixed (n = 6) unilateral amblyopia, and 14 age-matched non-amblyopic children. The 95% and 63% Bivariate Contour Ellipse Area (BCEA), axial length, Foveal Avascular Zone (FAZ) area, center macular thickness and volume were assessed. The relationship between these parameters was explored. (3) Results: Statistically significant differences were found among the four groups in best corrected distance visual acuity (BCVA) (p < 0.001), BCEA 95% (p = 0.002) and BCEA 63% (p = 0.002), but not in the FAZ area, central macular thickness, central macular volume and axial length. Eyes with amblyopia had poorer BCVA and larger fixation instability than controls. Inter-ocular differences were more significant in patients with strabismic amblyopia, particularly in BCVA (p = 0.003), central macular thickness (p < 0.001) and central macular volume (p = 0.002). In amblyopic eyes, BCEA 95% and 63% were correlated with BCVA, but not with the FAZ area. (4) Conclusion: Amblyopia is associated with a reduction in fixation stability and BCVA, although there is a general lack of correlation with structural changes, suggesting a complex interaction between anatomy and function in amblyopia.

Retinal Thickness Deviation: A New OCT Parameter for Assessing Diabetic Macular Edema

(1) Purpose: To determine the "retinal thickness deviation" (RTD) in diabetic macular edema (DME) eyes treated with intravitreal therapy and to establish associations between RTD and best-corrected visual acuity (BCVA). (2) Methods: We conducted a retrospective study, including consecutive patients with DME eyes undergoing intravitreal therapy with two years of follow-up. BCVA and central subfield thickness (CST) were collected at baseline and at 12 months and 24 months of follow-up. RTD was calculated as the absolute difference between measured and normative CST values at each time point. Linear regression analyses were performed between RTD and BCVA and between CST and BCVA. (3) Results: One hundred and four eyes were included in the analysis. The RTD was 177.0 (117.2) μm at baseline, 97.0 (99.7) μm at 12 months and 89.9 (75.3) μm at 24 months of follow-up (p < 0.001). RTD showed a moderate association with BCVA at baseline (R² = 0.134, p < 0.001) and 12 months (R² = 0.197, p < 0.001) and a substantial association at 24 months (R² = 0.272, p < 0.001). The CST showed a moderate association with BCVA at baseline (R² = 0.132, p < 0.001) and 12 months (R² = 0.136, p < 0.001), while the association was weak at 24 months (R² = 0.065, p = 0.009). (4) Conclusions: RTD showed a good association with visual outcome in patients with DME eyes undergoing intravitreal treatment.

Impact of Valsalva Manuever on Choroidal Vascularity Index, Central Choroid and Central Macula

BACKGROUND

Evaluation of the effects of the Valsalva maneuver on choroidal vascularity index, central choroid and the central macula.

METHODS

Eighty-four eyes of 42 healthy volunteers were evaluated in this prospective study. The central macular layer was assesed using the retinal map mode of the spectral domain OCT (Optovue RTVue XR, Optovue Inc., Fremont, CA), OCT images taken in the Enhanced Deep Imaging mode were transferred to the Image J program and the choroidal vascularity index and subfoveal choroidal thickness measurements were calculated.

RESULTS

The mean age of volunteers was 35.4±7.2 years. Choroidal vascularity index, subfoveal choroidal thickness, central macular thickness and intraocular pressure measurements in the resting position were 67.99±2.1%, 337.73±12.8 µm, 232.04± 8.4 µm, 14.04±2.5 mmHg respectively, during Valsalva maneuver were 69.44±2.1%, 351.15±12.2 µm, 238.84±8.1 µm, 19.4±5.4 mmHg respectively. There was a statistically significant increase during valsalva maneuver.

CONCLUSION

The valsalva maneuver may cause temporary changes in choroidal vascularity index, subfoveal choroidal thickness, central macular thickness and intraocular pressure. These measurements may be misinterpreted in situations where patients breath-hold inadvertantly causing the Valsalva maneuver.

Pyridostigmine Bromide Pills and Pesticides Exposure as Risk Factors for Eye Disease in Gulf War Veterans

To examine associations between the pyridostigmine bromide (PB) pill and/or pesticide exposure during the 1990-1991 Gulf War (GW) and eye findings years after deployment. A cross-sectional study of South Florida veterans who were deployed on active duty during the GW Era (GWE). Information on GW exposures and ocular surface symptoms were collected via standardized questionnaires and an ocular surface examination was performed. Participants underwent spectral domain-ocular coherence tomography (SD-OCT) imaging that included retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and macular maps. We examined for differences in eye findings between individuals exposed versus not exposed to PB pills or pesticides during service. A total of 40.7% (n = 44) of individuals reported exposure to PB pills and 41.7% (n = 45) to pesticides; additionally, 24 reported exposure to both in the GW arena. Demographics were comparable across groups. Individuals exposed to PB pills reported higher dry eye (DE) symptoms scores (the 5-Item Dry Eye Questionnaire, DEQ-5: 9.3 ± 5.3 vs. 7.3 ± 4.7, p = 0.04) and more intense ocular pain (average over the last week: 2.4 ± 2.6 vs. 1.5 ± 1.8, p = 0.03; Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-E): 18.2 ± 20.0 vs. 10.8 ± 13.8, p = 0.03) compared to their non-exposed counterparts. DE signs were comparable between the groups. Individuals exposed to PB pills also had thicker OCT measurements, with the largest difference in the outer temporal segment of the macula (268.5 ± 22.2 μm vs. 260.6 ± 14.5 μm, p = 0.03) compared to non-exposed individuals. These differences remained significant when examined in multivariable models that included demographics and deployment history. Individuals exposed to pesticides had higher neuropathic ocular pain scores (NPSI-E: 17.1 ± 21.1 vs. 11.6 ± 12.9, p = 0.049), but this difference did not remain significant in a multivariable model. Individuals exposed to PB pills during the GWE reported more severe ocular surface symptoms and had thicker OCT measures years after deployment compared to their non-exposed counterparts.

Normative data for macular and retinal nerve fibre layer thickness in healthy German children and adolescents using optical coherence tomography

PURPOSE

To establish normative data for macular thickness, macular volume and peripapillary retinal nerve fibre layer (RNFL) thickness using Spectralis® spectral-domain optical coherence tomography (SD-OCT) in healthy German children and adolescents and investigate influencing factors.

METHODS

The cross-sectional study included the right eye of 695 children with at least one complete retinal OCT scan. As part of the LIFE Child study, the children underwent an ophthalmological examination including axial length (AL), spherical equivalent (SE) and OCT measurements. Various questionnaires were answered by the children or their parents to identify media use or outdoor time. Multiple linear regression models were used to investigate the potential influencing factors.

RESULTS

A total of 342 boys and 353 girls with an average age (SD) of 12.91 (3.29) years participated. The mean AL (SD) was 23.20 (0.86) mm. The mean macular thickness (SD) was 320.53 (12.29) μm and the mean RNFL thickness (SD) was 102.88 (8.79) μm. Statistical analysis revealed a significant correlation between average macular thickness and age (p < 0.001, β = 0.77) as well as AL (p < 0.001, β = -4.06). In addition, boys had thicker maculae (p < 0.001, β = 5.36). The RNFL thickness showed no significant correlation with children's age (p > 0.05), but with AL (p = 0.002, β = -2.15), birth weight (p = 0.02, β = 0.003) and a gender-specific effect of the body mass index standard deviation score for male participants (p = 0.02, β = 1.93).

CONCLUSION

This study provides normative data and correlations between macular and RNFL thickness in healthy German children. Especially age, gender and AL must be taken into account when evaluating quantitative OCT measurements to classify them as normal.

Real Life Multicenter Comparison of 24-Month Outcomes of Anti-VEGF Therapy in Diabetic Macular Edema in Turkey: Ranibizumab vs. Aflibercept vs. Ranibizumab-Aflibercept Switch

The aim of this study was to compare the outcomes of diabetic macular edema (DME) treated with aflibercept (AFB) or ranibizumab (RNB) only, and after switching from RNB to AFB. This was a retrospective, real-world, multicenter (7 cities) 24 month study. Overall, 212 eyes in the AFB group, 461 in the RNB group, and 141 in the RNB to AFB group were included. The primary endpoints were differences in visual acuity (VA) and central macular thickness (CMT) from baseline to the final visit. The secondary outcomes were the percentage of eyes that achieved ≥10 letters gain and ≥10 letters loss in vision at month 12 and 24, and the percentage of eyes that achieved a thinning of ≥20% in CMT at month 3 and month 6. The results showed that VA did not significantly differ at baseline (AFB: 0.62 ± 0.38, RNB: 0.61 ± 0.36, RNB to AFB: 0.61 ± 0.38), at checkpoints, or at the final visit (AFB: 0.46 ± 0.38, RNB: 0.5 ± 0.37, RNB to AFB: 0.53 ± 0.36) (p > 0.05). Though the mean CMT at baseline was significantly thicker in the RNB to AFB group (479 ± 129.6 μm) when compared to the AFB (450.5 ± 122.6 μm) and RNB (442 ± 116 μm) groups (p < 0.01), similar measurements were obtained after 12 months. The percentages of eyes that gained or lost ≥10 letters in the AFB, RNB, and RNB to AFB groups at year 1 and 2 were similar, as was the percentages of eyes that demonstrated ≥20% CMT thinning at month 3 and 6. Our study showed similar visual improvements in non-switchers (AFB and RNB groups) and switchers (RNB to AFB group) through 2 years follow-up, however, AFB patients required fewer injections, visits, or need for additional treatments.

Evaluation of Macular Thickness Changes after Uncomplicated Phacoemulsification Surgery in Healthy Subjects and Diabetic Patients without Retinopathy by Spectral Domain OCT

PURPOSE

To assess differences in the evolution of macular thickness after uncomplicated phacoemulsification surgery between non-diabetic subjects and patients with diabetes mellitus (DM) without diabetic retinopathy (DR), using Spectral Domain OCT (SD-OCT).

METHODS

We performed a unicentric prospective study including one hundred and thirty-one eyes of 70 patients divided into two groups-34 well-controlled DM patients without DR and 36 non-diabetic subjects-who underwent phacoemulsification for cataract surgery. Eyes that developed pseudophakic cystoid macular edema (PCME) were excluded from the study, leaving us with 64 patients. Macular thickness was analyzed using Cirrus HD-OCT (Macular Cube 512 × 128 protocol) preoperatively and on postoperative days 7, 30, 90, and 180. For cases with information available for both eyes, one eye was randomly selected for analysis.

RESULTS

A total of 64 eyes from 64 patients were analyzed in this study. The mean value of HbA1c in the diabetic group was 7%. After uncomplicated cataract surgery, patients showed no increase of the foveal, parafoveal, and perifoveal retinal thickness on postoperative day 7. However, thickness values increased on days 30, 90, and 180 after surgery in both groups, and peak at 90 days. There was no difference in macular thickness before or after surgery between DM and non-diabetic patients (p = 0.540).

CONCLUSION

Macular thickness increases up to 6 months after uncomplicated cataract surgery in both DM patients without DR and non-diabetic subjects, with no differences between increases in both groups.

Normative Data of Macular Thickness Using Spectral Domain Optical Coherence Tomography for Healthy Jordanian Children

Purpose

To report normative values of macular thickness and volume by spectral-domain optical coherence tomography (SD-OCT) in the eyes of healthy Jordanian children aged 6–16 years and assess the correlation of macular parameters with age, sex, and refractive error.

Patients and Methods

This observational study included 144 eyes of 144 healthy children. All children underwent comprehensive ocular examination and cycloplegic refraction. Average macular thickness, macular volume, central subfield thickness (CST), and macular thickness for all the Early Treatment Diabetic Retinopathy Study (ETDRS) quadrants were obtained using Primus SD-OCT (Carl Zeiss Meditec).

Results

The study group consisted of 68 boys and 76 girls with a mean age (SD) of 10.8 (3.0) years. The mean (SD) spherical equivalent refraction (SER) was 0.56 (1.73) diopters (range: −4.75 to 4.75). The mean of macular average thickness was 277.2±12.5 μm, and the mean of the central subfield thickness was 246.7±16.8 μm. In multivariate analysis, all macular parameters except the central subfield thickness (CST) correlated positively with the SER. Boys had significantly higher CST than girls (p=0.008). None of the macular parameters were correlated with age.

Conclusion

Normative data of macular thickness for healthy Jordanian children were established for sex and age groups using SD-OCT.

Temporal macular thinning and vessel density correlation in children and young adults with sickle cell disease

Optical coherence tomography angiography (OCTA) is a recent noninvasive imaging technology that has proved to provide a comprehensive evaluation of retinal vascular abnormalities in adult patients with sickle cell disease (SCD). However, the pediatric population remains less studied. The purpose of this study is to evaluate the correlation between temporal vessel density (VD) in OCTA and temporal macular thinning in optical coherence tomography (OCT) in children and young adults with SCD. We reviewed medical records, OCT and OCTA (Spectralis®) scans from a sample of 32 eyes from 16 patients (7 female + 9 male) under 25 years old. The OCT macular thickness data and OCTA image data were processed using Python 3.9 programming language, and statistical analysis was performed. Pearson Correlation Coefficient between macular thickness and VD for inner and outer temporal areas was 0.47 (p-value = 0.006) and 0.74 (p-value < 0.001), respectively. A t-test was also performed to prove that there is a statistically significant VD difference in patients with higher and lower macular thickness (p < 0.001). These results show that children with outer temporal macular thinning on OCT have lower outer temporal VD on OCTA suggesting that microvascular insults may lead to chronic ischemic changes in the inner retinal layers.

Factors Influencing the Success of Atropine Penalization Treatment in Amblyopia Patients Non-Responsive to Occlusion Treatment

PURPOSE

To evaluate the efficacy of atropine penalization after non-response to patch therapy in amblyopic children and investigate the factors associated with treatment success.

PATIENTS AND METHODS

In this retrospective study, 26 children with amblyopia who were non-responders to patch therapy who were then switched to 1% atropine eye drops in the sound eye for a minimum follow-up of one year were included. All patients underwent detailed eye examinations, including optical coherence tomography and fundus autofluorescence (FAF) imaging. Response to treatment was defined as a two-line improvement in best-corrected visual acuity (BCVA) in the amblyopic eye, and patients were divided into two groups: the responder group and the non-responder group. Demographic and clinical parameters were compared between the two groups. The average central macular thickness and FAF were analyzed.

RESULTS

Sixteen of 26 patients (61.5%) showed treatment response. The mean age of the patients was 10.62 ± 3.42 (5-17) years. There was no difference between the groups in age, age at start of patch therapy, sex, follow-up period, refractive errors, type of amblyopia, reason for patch therapy non-response, or mean effective patching time per day. In the responder group, the LogMAR values of pretreatment BCVA, BCVA after optical correction, and BCVA after occlusion were significantly higher, but BCVA after atropine treatment showed no difference. FAF images of all patients were normal, and the mean central macular thickness did not significantly differ between the groups.

CONCLUSIONS

Atropine penalization can improve BCVA in children with amblyopia who are non-responders to patch therapy. Atropine penalization may be more successful in children with poor BCVA at the start of atropine penalization in the amblyopic eye. The results of FAF imaging and mean central macular thickness were not associated with treatment outcomes.

Safety and outcomes of intravitreal aflibercept in diabetic macular edema - a systematic review

BACKGROUND

Recent evidence on the role of vascular endothelial growth factor (VEGF) in the pathogenesis of ischemia and microvascular hyperpermeability leading to macular edema has brought anti-VEGF intravitreal therapy into the limelight.

OBJECTIVE

We performed a systematic literature review focusing on the outcomes and safety of the intravitreal use of aflibercept in diabetic macular edema.

METHODS

The studies documented cases with at least three consecutive intravitreal injections of aflibercept (IVA) repeated monthly with a follow-up period of at least one year. The outcomes were evaluated in terms of reported functional and anatomical improvement of the macula, as reflected by changes in visual acuity and macular thickness measured by Optical Coherence Tomography (OCT). In addition, for safety assessment, all reported local and general adverse effects were analyzed.

RESULTS

All studies showed an overall significant anatomical and functional improvement. In patients with the 5 IVA monthly at the beginning of the therapy, the visual gain at 52 weeks varied widely between 5 and 18.9 EDRS letters, with a mean value of 9.48 letters. The higher gain was obtained in treatment naïve patients, with worse VA and increased CST at baseline. The lower gain was obtained in patients previously treated with anti-VEGF. Anti-Platelet Trialists' Collaboration-defined arterial thromboembolic events were not statistically different between the aflibercept group and the laser group.

CONCLUSIONS

Intravitreal aflibercept therapy provides significant improvement in visual acuity and a good safety profile. Randomized studies are needed to document the optimal frequency of intravitreal injections for optimal treatment.

Comparison of once daily dose of 0.3% nepafenac alone and three times dose of 0.1% nepafenac alone in pain and inflammation control after phacoemulsification

Purpose:

To compare the efficacy of a once-daily dose of 0.3% nepafenac and three times daily dose of 0.1% nepafenac in controlling pain and inflammation following phacoemulsification.

Methods:

In this prospective randomized control single-blind study. patients who underwent uneventful phacoemulsification were divided into two groups. Group A received 0.1% nepafenac eye drops three times/day for 4 weeks and group B received 0.3% nepafenac eye drops once daily for 4 weeks following phacoemulsification. All the patients received moxifloxacin 0.5% eye drops four times/day for 2 weeks. None of the patients in any group received any form of corticosteroids.

Results:

The mean age of the patients in group A was 63.55 ± 8.5 years, while in group B, it was 60.05 ± 7.76 years. There was no significant result in the preoperative baseline demographics and intraoperative parameters between both the groups. The results were statistically insignificant in terms of inflammatory markers between both groups on day 1. But, on day 7, group B showed better results in terms of lid edema, conjunctival congestion, and anterior chamber cells. The patients in group B also perceived significantly less pain on day 1 (P = 0.02) and day 7 (P < 0.001). The central macular thickness was also significantly lower in group B at day 30 (P < .001) and day 90 (P < .001), respectively.

Conclusion:

Once-daily dose of higher concentrated nepafenac (0.3%) is equally effective and shows better results than 0.1% nepafenac for pain and inflammation control.

Retinal Degeneration in Patients with Wilson's Disease: An OCT Study in Asian Indian Population

Background

Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism. We aimed to study the abnormalities in the retinal layers in patients with WD using optical coherence tomography (OCT).

Methods

The study is a chart review of 16 patients with WD (six females) who underwent OCT at our hospital during follow-up visits. Spectral-domain OCT was performed in all subjects to assess the thickness of macula and retinal nerve fiber layer (RNFL) and the data was compared with 14 healthy controls (three females).

Results

The mean age of the patients was 20.81 ± 7.47 years and controls was 26.86 ± 9.95 years. The mean age at the onset of the illness was 16.25 ± 5.57 years (range 11-28 years) with the mean duration of illness being 4.81 ± 3.31 years at the final follow-up examination. The mean macular thickness was found to be significantly reduced in patients (232.13 ± 19.39) when compared to controls (271.30 ± 17.32 μm; P = 0.01). There was a significant difference in the ganglion cell and inner plexiform (GCIP) layer between the patients (86.83 ± 8.20 μm) and controls (97.72 ± 5.31 μm; P = 0.01). In addition, the outer nuclear layer with the photoreceptor layer (ONL + PRL) thickness was also reduced in WD (93.90 ± 10.23 μm vs. 108.43 ± 10.00 μm; P = 0.01) There was no change in the RNFL thickness, between the two groups (P = 0.53).

Conclusions

Abnormalities of the retinal layers were observed in the patients with WD. OCT is a non-invasive tool to identify and quantify the abnormalities of the retinal layers.

The Changes of Irisin and Inflammatory Cytokines in the Age-Related Macular Degeneration and Retinal Vein Occlusion

PURPOSE

Age-related macular degeneration (AMD) and retinal vein occlusion (RVO) are irreversible chorioretinal diseases, which might induce severe damage in visual function. The metabolic factor and inflammatory factors might play important roles in the pathogenesis of AMD and RVO. The levels of irisin and 14 cytokines were analyzed in aqueous humor of AMD and RVO eyes to evaluate the roles of irisin and inflammatory factors.

METHODS

We collected aqueous humor samples from patients with AMD (n = 27), RVO (n = 30), and cataract (as control, n = 23) eyes. Samples were assayed using ELISA kit for irisin and a multiplex immunoassay kit for 14 cytokines. The macular thickness (MT) was measured with OCT in all included eyes.

RESULTS

MT in the RVO group is significantly higher than that in the AMD or control group. Irisin levels in the aqueous samples of AMD and RVO eyes were both significantly lower than that in the control. Furthermore, a positive correlation was found between irisin and MT in the RVO. Compared with the controls, AMD eyes had significantly higher levels of BDNF, VEGF-A, VEGF-R1, VEGF-R2, IL-10, TNF-α, VCAM-1, IP-10, and MCP-1. Similarly, RVO eyes had significantly higher levels of BDNF, VEGF-A, VEGF-R1, VEGF-R2, IL-6, IL-8, IL-10, TNF-α, ICAM-1, VCAM-1, IP-10, and MCP-1. However, there was no significant difference between the levels of PDGF-BB or TNF-β in these three groups. A negative correlation was found between VEGF-A and MT in AMD, as well as in control. Furthermore, a positive correlation was found between IL-6 and MT in the 80 included eyes, as well as in RVO. A positive correlation was found between ICAM-1 and MT in the 80 included eyes, as well as in RVO.

CONCLUSIONS

The metabolic factor, irisin levels in the aqueous humor are decreased in AMD and RVO eyes and show a positive correlation between irisin and MT in RVO eyes, prompting researchers to explore the relationship between irisin and macular edema. We also identified the higher expression of vascular growth factors (VEGF-A, VEGF-R1, and PDGF-BB), inflammatory cytokines (IL-6, IL-8, IL-10, and TNF-α), and chemokines (ICAM-1, VCAM-1, IP-10, and MCP-1) in AMD and RVO eyes.

Retinal Nerve Fibre Layer Thickness Change Following Femtosecond Laser-Assisted in situ Keratomileusis

Purpose: To evaluate the effect of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) on retinal fovea thickness, volume, and retinal nerve fibre layer (RNFL) thickness. Methods: Thirty-seven eyes (37 patients) undergoing FS-LASIK were included in this prospective study. Optical coherence tomography (OCT) was performed 1 day before, 1 h and 1 day after FS-LASIK surgery. Result: Eighteen male and nineteen females were enrolled. Mean patient age was 22.94 ± 4.22 years. One hour postoperatively, macula fovea thicknesses, macula fovea volume, macula parafovea thickness, macula parafovea volume, macula perifovea thickness, macula perifove volume, temporal RNFL thickness, and superior RNFL thickness measures showed significant decrease (t = 6.171, 6.032, and 9.837, 9.700, 2.532, 4.393, 4.926, 2.265; p = 0.000, 0.000, 0.000, 0.000, 0.016, 0.000, 0.000, and 0.011). Day 1 post-operation, macula fovea thicknesses, macula fovea volume, macula parafovea thickness, macula parafovea volume, and inferior RNFL thickness measures showed significant change compared to preoperative measures (t = 3.620, 3.220, 2.901, 2.910, 3.632; p = 0.001, 0.003, 0.006, 0.006, and 0.001). Conclusion: Our data suggest there are alterations in retinal foveal and RNFL measurements by OCT 1 h and 1 day after FS-LASIK surgery.

Evaluation of Macular Thickness, Retinal Nerve Fiber Layer and Ganglion Cell Layer Thickness in Patients among Type 2 Diabetes Mellitus Using Optical Coherence Tomography

BACKGROUND

Vascular abnormalities and microvasculopathy are one of the widely accepted factors of diabetic retinopathy (DR). Retinal Neuronal dysfunction and neurodegeneration are also important components in the pathogenesis of DR. However recent investigations show neurodegenerative alterations before the appearance of microvascular changes in patients having DR.

AIMS AND OBJECTIVES

(1) To measure the macular thickness, retinal nerve fiber layer thickness, and ganglion cell complex thickness among patients with type 2 diabetes mellitus using optical coherence tomography. (2) To compare the macular thickness, retinal nerve fiber layer thickness and ganglion cell complex thickness in type 2 diabetic patients with and without DR with normal controls using optical coherence tomography.

MATERIALS AND METHODS

Thirty Patients with type 2 diabetes mellitus without DR, 30 having mild and moderate DR and 30 healthy normals are taken considering the inclusion and exclusion criteria. Macular thickness, retinal nerve fiber layer (RNFL) thickness, ganglion cell layer-inner plexiform layer (GCL-IPL) thickness was measured in each individual and it was compared using one way ANOVA test, post hoc test and Pearson correlation was performed to evaluate the linear correlation between variables and calculated P < 0.05 was regarded as its significance.

RESULTS

The average RNFL thickness was 90.27 ± 5.57 and 107.7 ± 5.32 um in diabetic patients and controls respectively (P < 0.001). Furthermore, for two different groups of diabetic patients, the average RNFL thickness was 89.92 ± 6.62 um in the no DR group and 78.6 ± 3.93 in the DR group (P = 0.339). The average GCL-IPL thickness was 82.65 ± 2.25 um and 92.10 ± 2.41 um in diabetic patients and controls, respectively (P < 0.001). Furthermore, for two different groups of diabetic patients, the average GCL-IPL thickness was 82.22 ± 2.11 um in the no DR group and 71.55 ± 2.34 in the DR group (P = 0.535). The average macular thickness was 238.03 ± 4.42 and 277.9 ± 5.85 um in diabetic patients and controls, respectively (P < 0.001). Furthermore, for two different groups of diabetic patients, the average macular thickness was 236.56 ± 4.10 um in the no DR group and 242.8 ± 4.95 um in the DR group (P = 0.585).

CONCLUSION

There was a statistically significant reduction of mean RNFL, GCL-IPL and macular thickness in type 2 diabetic patients with no DR compared with a homogenous control group indicating neuroretinal changes occur before vascular changes of DR.

Ocular parameters alterations after hemodialysis in patients with chronic kidney diseases

PURPOSE

To evaluate the effects of hemodialysis (HD) on visual acuity (VA), central corneal thickness (CCT), intraocular pressure (IOP), and macular thickness (MT) in chronic kidney disease (CKD) patients and also to investigate the relationship between the ocular parameters and blood biochemical parameters such as serum albumin, creatinine, sodium, and urea levels.

METHODS

A prospective cohort study including a total of 24 CKD patients of both genders (above 18 years old) undergoing HD in XXX was conducted. The participants were divided into three sub-groups based on the primary cause of renal failure, group 1: Hypertensive kidney disease, group 2: Diabetic kidney disease, group 3: Other causes. All subjects underwent full ophthalmological examinations including measurement of VA using LogMAR, IOP, CCT, and CMT. Comparisons between different ocular parameters during pre- and post-HD sessions were done using the paired t-test. The relationship between changes in ophthalmologic and blood biochemical parameters was calculated using Pearson correlation coefficient.

RESULTS

HD did not significantly alter any ocular parameter within and between CKD groups. Spherical equivalent changes were found to be significantly correlated with serum K (r = -0.315; P = 0.038), and IOP results were positively correlated with serum creatinine (r = 0.330; P = 0.029) and negatively correlated with hemoglobin (r = -0.349; P = 0.020). Bodyweight alterations were significantly correlated with CCT (r = -0.03; P = 0.0001). However, no correlation between ocular parameters and duration of HD was detected.

CONCLUSION

Following a single HD session, ocular parameters did not alter significantly.

Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 4: Glycated Haemoglobin

The purpose of this study was to evaluate specifically the relationship between glycated haemoglobin (HbA1c) levels and retinal optical coherence tomography (OCT) and OCT angiography (OCTA) parameters in type 1 Diabetes Mellitus (DM). A total of 478 type 1 DM patients and 115 controls were included in a prospective OCTA trial (ClinicalTrials.gov NCT03422965). Subgroup analysis was performed for controls, no diabetic retinopathy (DM-no DR) and DR patients (DM-DR), and HbA1c levels. OCT and OCTA measurements were compared with HbA1c levels (current and previous 5 years). DM-no DR patients with HbA1c levels >7.5% showed lower VD than DM-DR and controls (20.16 vs. 20.22 vs. 20.71, p < 0.05), and showed a significant correlation between HbA1c levels and FAZc (p = 0.04), after adjusting for age, gender, signal strength index, axial length, and DM disease duration. DM-DR patients with HbA1c > 7.5% presented greater CRT than DM-no DR and controls (270.8 vs. 260 vs. 251.1, p < 0.05) and showed a significant correlation between HbA1c and CRT (p = 0.03). In conclusion, greater levels of HbA1c are associated with OCTA changes in DM-no DR patients, and with structural OCT changes in DM-DR patients. The combination of OCTA and OCT measurements and HbA1c levels may be helpful to identify patients at risk of progression to greater stages of the diabetic microvascular disease.

Changes in the Macular Vascular Density After Bariatric Surgery Measured by Optical Coherence Tomography Angiography

Purpose

To evaluate the effect of the weight loss, 3 months after bariatric surgery, on the macular thickness and macular vascular density by optical coherence tomography angiography (OCTA).

Methods

Forty obese patients were included in this prospective study. Body mass index (BMI), macular thickness (whole, fovea, parafovea and perifovea), macular vascular density (VD) in superficial capillary plexus (whole, fovea, parafovea and perifovea), and macular vascular density in deep capillary plexus (whole, fovea, parafovea and perifovea) were measured before and 3 months after bariatric surgery.

Results

The BMI was significantly reduced postoperatively to 43.75±4.4 kg/m² compared to the preoperative results, 55.31±5.1 kg/m² (p<0.05). There was significant increase in macular thickness in the fovea and parafovea postoperatively (p<0.05) but no significant increase in the perifovea. There was significant increase in macular vascular density in the deep capillary plexus postoperatively (p<0.05) but no significant increase in the macular vascular density in the superficial capillary plexus postoperatively (p>0.05). Significant correlations were detected between the BMI changes and changes in different macular parameters.

Conclusion

Bariatric surgery showed significant effect on certain indices in macular thickness and macular vascular density, especially in the deep capillary plexus. Therefore, OCTA is considered a valuable tool to assess the short-term changes in macular microcirculation following significant weight reduction.

Changes in choroidal thickness after anti-vascular endothelial growth factor treatment of diabetic macular edema, real-life data, 2-year results

PURPOSE

To evaluate the effect of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection on central choroidal thickness (CCT), central macular thickness (CMT) and best-corrected visual acuity (BCVA) in diabetic macular edema (DME).

METHODS

Retrospective, cohort analysis of 90 eyes of 90 patients receiving anti-VEGF therapy for DME. In patients' records, measurements of CCT, CMT, and BCVA before treatment and at 2 years after treatment were recorded. Using enhanced-depth imaging optical coherence tomography (EDI-OCT) images, choroidal thickness and macular thickness measurements were recorded in the subfoveal area and 1 mm nasal to 1 mm temporal to the central foveal area. The baseline and final CMT and CCT values measured from all three quadrants were analyzed statistically.

RESULTS

Mean age of the patients was 59.60 ± 9.78 (range, 40-77) years. Mean baseline nasal-CT 226.4 ± 52.5 µm, central-CT 243.2 ± 51.1 μm and temporal-CT 224.6 ± 47.9 μm. Mean final nasal-CT 220.0 ± 50.2 µm, central-CT 235.3 ± 53.6 μm, temporal-CT 220.5 ± 48.1 μm (p = 0.122, p = 0.056, p = 0.184, respectively). Mean baseline nasal- MT 385.3 ± 67.7, central-MT 345.5 ± 119.7 μm and temporal-MT 365.0 ± 64.9 μm. Mean final nasal-MT 359.6 ± 59.2 µm, central-MT 306.2 ± 98.4 μm and temporal-MT 353.4 ± 63.3 μm (p = 0.001, p = 0.002, p = 0.234, respectively). The BCVA improved from 0.52 ± 0.44 logMAR at baseline to 0.38 ± 0.33 at final (p = 0.002).

CONCLUSION

After treatment of diabetic macular edema with intravitreal anti-VEGF injection, CMT and BCVA improved significantly, but CCT did not decrease significantly.

Influence of one or two horizontal muscle surgeries on OCT findings

We investigate the effects of differences between one or two horizontal rectus muscle surgeries (recession ± resection) on the central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and retinal nerve fiber layer (RNFL). Measurements of the CMT, SFCT, and RNFL in patients who underwent horizontal rectus muscle surgery were obtained using optical coherence tomography (OCT). Patients were grouped as those who had undergone rectus muscle recession surgery (Group 1) and those who had undergone rectus muscle recession + resection surgery (Group 2). The CMT, SFCT, and RNFL in patients were measured preoperatively and 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. A total of 65 eyes of 50 patients were analyzed retrospectively. The average age of the 25 patients in Group 1 was 8.96 ± 7.966 years (min 3, max 38). The average age of the 25 patients in Group 2 was 15.17 ± 6.806 years (min 2, max 34). The comparison of the preoperative and the 1-day and 1-week postoperative values revealed an increase in CMT and SFCT in Group 1 and Group 2. There were no significant differences between the two groups. It was observed that this increase reached the preoperative values after 1-3 months and 6 months in both groups. There was no statistically significant change in the RNFL. Rectus muscle surgery (recession±resection) caused an increase in CMT and SFCT in the early stage, which was possibly caused by the altered choroidal microcirculation resulting from mechanical traction during surgery and by postoperative inflammation. There was no difference between one or two muscle surgeries.

Microvascular Changes in Macular Area After Phacoemulsification and Its Influencing Factors Assessed by Optical Coherence Tomography Angiography

OBJECTIVE

To investigate macular vascular changes and underlying influencing factors using optical coherence tomography angiography (OCTA) after phacoemulsification in patients with cataracts.

METHODS

Patients diagnosed with cataracts at the First Affiliated Hospital of Anhui Medical University from March to September 2019 were included. The macular retinal thickness, the microvascular density in the foveal, parafoveal, and perifoveal area, and the area of the foveal avascular zone (FAZ) were measured using OCTA at baseline, 1-week, 1-month, and 3-month post-operation.

RESULTS

Forty-seven cataract patients (58 eyes) were eligible for this study. Compared with baseline thickness, the foveal, parafoveal, and perifoveal thicknesses, particularly in the inner retina, significantly increased at 1- and 3-month post-operation (P<0.05). There was a nonsignificant difference in the microvascular density of the foveal and perifoveal areas at 1-week, 1-month, and 3-month post-operation (P>0.05). At 1-month post-operation, the deep vessel density at the perifovea significantly increased (P<0.05). The FAZ area significantly diminished at 1- and 3-month post-operation compared with the baseline data (P<0.05).

CONCLUSION

Phacoemulsification offers a satisfactory efficacy response, with an increased macular thickness, reduced FAZ area, and nonsignificant changes in the microvascular density at the perifovea after surgery.

Comparison of Macular Thickness Measurements Using Swept-Source and Spectral-Domain Optical Coherence Tomography in Healthy and Diabetic Subjects

Purpose: To establish normative data for macular thickness in Chinese aged 30 to 80 years using the swept-source optical coherence tomography (SS-OCT) device.Methods: The study included 290 normal eyes, 430 NDR eyes and 150 DR eyes of community residents aged 30 to 80 years in Guangzhou, China. Mean macular thicknesses in Early Treatment Diabetic Retinopathy Study (ETDRS) subfields, central point thicknesses (CPT), and macular volume was measured by SS-OCT (Triton DRI OCT, Topcon, Tokyo, Japan) and Spectral-Domain OCT (SD-OCT; Heidelberg Engineering, Heidelberg, Germany). We assessed agreement between SS-OCT and SD-OCT measurements by intraclass correlation coefficients (ICC) and Bland-Altman plots. We established a conversion equation relating central subfield (CSF), CPT and macular volume between the two OCT devices.Results: Macular thickness measurements in SS-OCT were significantly thinner than in SD-OCT. The mean CSF thickness in normal eyes measured by SS-OCT and SD-OCT were 227.8 ± 19.4 μm and 260.0 ± 19.7 μm (p < .0001). CSF thickness was a significantly difference between genders (SS-OCT: male 237.2 ± 18.8 μm vs female 222.0 ± 17.5 μm, p < .0001). In all three groups, the agreement between SS-OCT and SD-OCT was excellent (all ICC > 0.9). The conversion equations for CSF, CPT and macular volume from SS-OCT to SD-OCT were derived, with over 95% of the predicted values fell within 10% of the actual measurements in DR and NDR eyes.Conclusion: We propose SS-OCT CSF thicknesses of 275 μm for males and 260 μm for females as the minimum criteria for macular edema in Chinese aged 30 to 80 years based on 2 SDs above the mean CSF. SS-OCT measurements were significantly thinner than SD-OCT. We derived equations from converting SS-OCT measurements to SD-OCT equivalents.

Effect of smoking on the macula and optic nerve integrity using optical coherence tomography angiography

OBJECTIVE

To investigate the effect of chronic smoking on the macula and optic nerve integrity using optical coherence tomography angiography (OCTA).

METHODS

This prospective, comparative study involved the right eyes of 160 healthy subjects (80 smokers group, and 80 control group). OCTA scanning was performed for all subjects. All macular subfields thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, superficial and deep macular vessel density, foveal avascular zone (FAZ) area, and the macular outer retina flow area, were measured and analyzed.

RESULTS

The thickness of some macular subfields, inferior GCC, and RNFL was statistically significantly lower in the smokers' group (p < 0.05). The FAZ area was 0.409 ± 0.048 mm² in the smokers' group and 0.327 ± 0.055 mm² in the control group (p < 0.001). The superficial foveal VD was 31.35 ± 5.79% in the smokers' group and 33.63 ± 4.78% in the control group (p = 0.06). The deep foveal VD was 39.38 ± 4.56% in the smokers' group and 34.15 ± 6.57% in the control group (p ≤ 0.001). The superficial and deep parafoveal VD was 52.09 ± 4.56% and 59.99 ± 2.25% respectively in the smokers' group, and 54.75 ± 2.30% and 55.58 ± 4.69% respectively in the control group (p < 0.05). The macular outer retina flow area was 1.29 ± 0.12 mm² in the smokers' group and 1.16 ± 0.11 mm² in the control group (p < 0.001).

CONCLUSION

Chronic smoking affected the integrity of the macula and optic nerve. It decreased the macular VD, enlarged the FAZ, and increased outer retinal flow area.

Retinal morphological changes during the two years of follow-up in Parkinson's disease

Background and purpose

The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology.

Methods

The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson's Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit.

Results

The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p=0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05).

Conclusion

Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

Analysis of macular microvasculature and thickness after ICL implantation in patients with myopia using optical coherence tomography

AIM

To investigate changes in macular vessels and thickness in myopic eyes after intraocular collamer lens (ICL) implantation using quantitative optical coherence tomography angiography (OCTA).

METHODS

This retrospective included 73 myopic eyes of 73 patients (average age, 27.53±6.16y) who underwent ICL implantation (28 eyes were Toric ICL). Axial length (AL), uncorrected visual acuity (UCVA), refractive dioptre (RD), intraocular pressure (IOP) and OCTA were measured and compared with before and 1wk, 1, and 3mo after surgery. OCTA was used to image vessel density (VD) and skeleton density (SD) in both the superficial (SCP) and deep capillary plexus (DCP). Central retinal thickness (CRT) and ganglion cell-inner plexiform layer thickness (GCT) were also measured. Changes between pre- and postoperative measurements were analysed by repeated measures analysis of variance.

RESULTS

Compared with preoperative data, postoperative data on UCVA revealed significant improvements in all patients (P<0.05). However, there was no significant difference in IOP. After the operation, CRT and GCT exhibited significant changes (P<0.05). Among these measures, CRT was significantly higher at one and three months postoperative (all P<0.01). GCT was significantly higher at 1wk, 1, and 3mo postoperative (all P<0.01). Changes in VD and SD were nonsignificant in both the SCP and DCP. There was no difference in postoperative changes between the ICL and Toric ICL groups.

CONCLUSION

ICL and Toric ICL implantation both have good efficacy and safety for myopic eyes, but macular area changes that occur after surgery need attention.

Effect of Transcatheter Aortic Valve Replacement on Retinal Layer Thickness Measured by Optical Coherence Tomography

Transcatheter aortic valve replacement (TAVR) is associated with clinically significant cerebral microembolism and cognitive status changes. There are no data on the impact of TAVR on retinal layers. We assessed the influence of TAVR on the retinal nerve fiber layer, ganglion cell complex (GCC), and macular thickness (MT) measured by spectral domain optical coherence tomography (SD-OCT). Elderly patients (n = 50) with severe aortic stenosis undergoing TAVR were included in this study (mean age: 78.5 ± 6.9 years). Retinal nerve fiber layer, GCC, and MT were measured with SD-OCT by an ophthalmologist before and on the first day and in the first month after TAVR. The average MT was significantly increased on the first day after TAVR compared with the basal value (P = .04). Ganglion cell complex thickness was significantly thinner on the first day after TAVR than the basal value in the inner inferior quadrant and outer temporal quadrant of the left eye (P = .03 and .04, respectively). Postoperative changes observed on the first day compared with the preoperative period returned to basal values in the first month. In conclusion, TAVR did not cause permanent changes in retinal layers.

Can Vitreous Reflux Affect The Short-Term Treatment Response After Intravitreal Ranibizumab Injection?

PURPOSE

The aim of this study was to evaluate the effect of vitreous reflux (VR) on the short-term effect of intravitreal ranibizumab injection.

MATERIALS AND METHODS

The study included 181 eyes of 81 age-related macular degeneration (AMD) and 100 diabetic macular edema (DME) patients. Treatment response was evaluated by measuring central macular thickness (CMT) as well as 1 mm and 3 mm central macular thicknesses (MT1 and MT3). Patients were grouped as; Group 1: no VR, Group 2: <3 mm VR, and Group 3: >3 mm VR according to conjunctival bleb diameters. The data were analyzed using variance, correlation and regression analyses.

RESULTS

In AMD patients, reduction of CMT values following the treatment were 88.3 ± 110.6 µm in Group 1, 85.6 ± 158.7 µm in Group 2, and 93.1 ± 92.2 µm in Group 3. Likewise, in DME patients, it was 82.4 ± 88.4 µm, 72.9 ± 109.9 µm, and 73.7 ± 113.7 µm, respectively. Reduction of MT1 values after the treatment were 47.4 ± 72.6 µm, 36.0 ± 131.9 µm, and 36.7 ± 114.4 µm in AMD patients, and 33.3 ± 72.5 µm, 36.6 ± 90.2 µm, and 46.9 ± 83.4 µm in DME patients. In all comparisons among groups of VR, macular thickness (MT) change did not exhibit significant difference following an intravitreal ranibizumab treatment (p > .05).

CONCLUSION

We found that the increase in VR amount did not adversely affect the decrease in MT after intravitreal ranibizumab treatment in AMD and DME patients.

Normal Reference Ranges of Optical Coherence Tomography Parameters in Children

AIM

To measure the macular thickness, macular volume and peripapillary retinal nerve fiber layer (RNFL) in healthy Caucasian chil-dren using spectral domain optical coherence tomography (SDOCT) and analyze the correlation of these values with age, refraction, and biometric measurements.

MATERIALS AND METHODS

In this cross-sectional study, we recruited 270 healthy children (150 female and 120 male) aged 6 to 17 years with no ocular abnormalities. All children underwent a detailed eye examination. The measurements were obtained using a SDOCT device (SOCT Copernicus REVO). Main outcome measures were macular thickness, macular volume and RNFL thickness. Their correlations with age, refractive error, anterior chamber depth (ACD) and axial length (AL) was analyzed. Right eyes of all subjects were selected for analysis.

RESULTS

In this study group (mean age 10.70±2.82 years), the average peripapillary RNFL thickness was 117.11±9.15 μm, the central macular thickness was 232.10±15.81 μm, the average macular thickness was 286.70±9.82 μm, and the average macular volume was 8.01±0.28 mm³. The average values for the biometric data were: axial length - 23.16±0.94 mm, anterior chamber depth - 3.64±0.26 mm, the spherical equivalent (SE) value - +0.81±0.58 diopter. Central macular thickness, inner macular thickness (superior, inferior, nasal, temporal quadrants) values, total macular thickness and macular volume were significantly higher in males than in females. We found a positive correlation between central macular thickness, inner nasal macular thickness, outer inferior macular thickness values, and age. Also, we found a significant correlation between the average macular thickness values and the average macular volume values (p<0.0001). RNFL measurements did not correlate with age (p=0.199). Almost all macular parameters were consistently positively cor-related with SE. A significant correlation was also found between the central macular thickness, inner inferior macular thickness, inner nasal macular thickness and the ACD. We found a significant correlation between the average macular thickness, macular volume, inner superior macular thickness, outer macular thickness (superior, inferior, nasal, temporal quadrants) values and the AL.

CONCLUSION

This study found normal reference ranges for RNFL and macular parameters measured by SOCT Copernicus REVO in healthy Caucasian children aged 6-17 years. This normative values could be very useful in early diagnosing and monitoring of optic neuropathy, glaucoma and macular diseases in childhood.

Effect of Vitamin D Deficiency on Contrast Sensitivity Function

PURPOSE

The purpose of this study is to investigate the effects of vitamin D (vit D) deficiency on contrast sensitivity (CS) function and retinal layers.

MATERIALS AND METHODS

Group 1 consisted of 42 patients aged between 18 and 50 years with vit D deficiency and Group 2 consisted of sex- and age-matched 34 healthy subjects with normal vit D levels. Functional acuity contrast testing (FACT) was performed using the Optec 6500 vision testing system. The average retinal nerve fiber layer (RNFL) thickness and macular thickness (MT) obtained from nine macular areas in the Early Treatment Diabetic Retinopathy Study were evaluated using SD-OCT (RS-3000; Nidek Inc., Fremont, CA, USA) following a detailed ophthalmologic examination. Measurements were performed on both eyes.

RESULTS

A lower CS was found in Group 1 compared to Group 2 in all spatial frequencies. A statistically significant difference was observed between the groups in 6, 12 and 18 cpd spatial frequencies, respectively. (p = .004, p = .001, p = .042, respectively). There was no statistically significant difference between groups in terms of RNFL thicknesses (p = .200). There was an increase in MT in Group 1. However, this increase was statistically significant in the inferior inner area in the right eye, and in the inferior inner, temporal inner and outer macular areas in the left eye (p = .018, p = .003, p = .033, p = .040, respectively).

CONCLUSION

It was observed that vit D deficiency had negative effects on CS function and also caused thickness difference in certain segments of retinal layers.

Macular and Retinal Nerve Fibre Layer Thickness in Pregnant Women with Gestational Diabetes Mellitus

Background

The information about macular and retinal nerve fibre layer (RNFL) thickness in women with gestational diabetes mellitus (GDM) is scarce. GDM is a risk factor for development of type 2 diabetes mellitus.

Purpose

The purpose of this study was to evaluate mean macular and RNFL thickness in pregnant women with GDM in a teaching institution in Malaysia. We also analyzed the association of age, HbA1c level, duration of GDM, type of treatment, family history, previous history of GDM and spherical equivalent with the macular and RNFL thickness.

Patients and Methods

This was a prospective and cross-sectional study involving 78 pregnant women with GDM, 72 healthy pregnant and 70 healthy non-pregnant women. The study was conducted in Hospital Universiti Sains Malaysia from 2016 to 2018. Macular and RNFL thickness were measured during the third trimester using spectral-domain optical coherence tomography. Age, HbA1c level, duration of GDM, type of treatment, family history, previous history of GDM and spherical equivalent were analysed.

Results

The mean macular thickness was 236.08 (16.44) µm, 237.26 (22.42) µm and 240.66 (20.95) µm for GDM, healthy pregnant, and healthy non-pregnant women. The mean RNFL thickness was 97.27 (9.14) µm, 99.83 (12.44) µm and 97.97 (10.07) µm for GDM, healthy pregnant, and healthy non-pregnant women. There was no significant difference in the mean macular and RNFL thickness in pregnant women with GDM when compared to the control groups (p>0.05). Age, HbA1c, duration of diabetes, treatment received, history of GDM and spherical equivalent did not show significant association with mean macular and retinal thickness (p>0.05).

Conclusion

Pregnant women with GDM have similar thickness of the macular and RNFL with the healthy pregnant and healthy non-pregnant women. Age, HbA1c, duration of diabetes, treatment received, history of GDM and spherical equivalent showed no significant association with mean macular and retinal thickness in pregnant women with GDM.

Optical coherence tomography analysis of inner and outer retinal layers in eyes with chiasmal compression caused by suprasellar tumours

PURPOSE

To compare postoperative macular thickness measurements of inner and outer retinal layers in eyes of patients with chiasmal compression with or without visual field (VF) recovery and healthy controls using optical coherence tomography (OCT).

METHODS

Macular spectral-domain OCT has been used for the auto-segmentation of images obtained from 100 eyes affected with chiasmal compression compared with 100 healthy controls enrolled in this study. We have divided eyes with chiasmal compression into two groups: group 1 characterized by VF recovery after tumour excision and group 2 showing partial or no recovery of VF. The thickness of the macular retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor layer (PRL), inner retinal layer (IRL) and outer retinal layer (ORL) was segmented. The correlation between macular RNFL (mRNFL) and functional parameters has been analysed.

RESULTS

Both groups 1 and 2 showed significant thinning of RNFL, GCL, IPL and IRL in all quadrants. However, no significant changes have been detected in PRL and ORL of patients in either group compared with healthy controls. A significant thickening was detected in INL and ONL of group 2 compared with healthy controls and group 1. Postoperative mRNFL thickness is significantly correlated with VF defects and visual acuity except temporal quadrant.

CONCLUSIONS

Eyes with chiasmal compression showed thinning of the inner retinal layers with thickening of the INL and ONL in patients with partial to no recovery of VF. The changes in retinal microstructures are well-correlated with functional recovery. Further studies are needed to reveal the clinical implications of these findings in patients with chiasmal compression.

The effect of contact lens wear on retinal spectral domain optical coherence tomography

BACKGROUND

This study assessed the impact of contact lens wear on retinal spectral domain optical coherence tomography (SD-OCT) image quality and macular thickness measurements, among subjects with myopia.

METHODS

This was a prospective study including 34 subjects (26.59 ± 3.19 years) with myopia or myopic astigmatism. Twelve were imaged wearing spherical soft contact lenses, eight non-contact lens wearers were imaged with a plano soft contact lens, and 14 with significant astigmatism were fitted with a rigid gas permeable (RGP) contact lens. For each group of contact lens types, the average image quality index (Q-index), and the average macular thickness measurements were compared between macular OCT scans obtained from the same eyes with and without a contact lens.

RESULTS

Among the subjects assessed with their habitual spherical soft lenses, the average Q-index was similar for scans acquired with and without a contact lens (30.10 ± 1.94 versus 31.03 ± 2.55; p = 0.18). Among non-contact lens wearers, the average Q-index was slightly higher for scans acquired without a contact lens, compared to scans with a plano contact lens (31.99 ± 2.06 versus 29.51 ± 1.56; p = 0.006). Among 14 subjects imaged wearing a fitted RGP contact lens, the Q-index was similar for scans acquired with and without a contact lens (29.04 ± 2.73 versus 28.75 ± 2.86; p = 0.78). In all groups, there were no correlations between the power of the sphere and change in the Q-index (that is, post- minus pre-contact lens Q-index), and no differences were found between OCT-derived macular thickness measurements from scans with and without a contact lens. The magnitude of cylinder was not correlated with the change in the Q-index in the habitual and RGP contact lens groups. However, an inverse correlation between cylinder power and change in the Q-index was found in the plano contact lens group.

CONCLUSION

In low to intermediate levels of myopia, with or without regular astigmatism, macular SD-OCT imaging does not merit placement of a soft or rigid contact lens, nor is there an added benefit from removing a habitual spherical soft lens prior to scanning.

Intraocular Inflammation Control and Changes in Retinal and Choroidal Architecture in Refractory Non-Infectious Uveitis Patients after Adalimumab Therapy

Background: Non-infectious uveitis represents a leading cause of visual impairment, and inflammation control represents a major priority in tackling visual acuity loss due to complications such as macular edema; different immunomodulatory drugs are currently being used, including anti-TNF-alpha Adalimumab. Methods: This was a monocentric observational study of 18 eyes of 18 patients with non-infectious uveitis treated with Adalimumab. The primary endpoint was the control of ocular inflammation. The secondary endpoints included the study of macular and choroidal thickness and architecture, visual acuity, changes in other treatments, and adverse effects. Results: Ocular inflammation was controlled at 12 months for 83.3% of patients. Central macular thickness improved from a median of 229.75 µm at baseline to 213 µm at 12 months, while choroidal thickness decreased by 11.54% at the end of the follow-up. A reduction of vasculitis on fluorescein angiography and of hyperreflective spots on optical coherence tomography was noted. Visual acuity also improved from 0.51 (logMAR) before treatment to 0.24 at more than 12 months (p = 0.01). A total of 11.1% of patients experienced side effects. Conclusion: Our study confirms the efficacy of adalimumab for the control of ocular inflammation, visual acuity preservation, and for corticosteroid sparing.

Comparison of optical coherence tomography measurements between high hyperopic and low hyperopic children

Purpose:

To identify the peripapillary retinal nerve fiber layer, total macular, ganglion cell layer, and inner plexiform layer thicknesses in children with high hyperopia using spectral domain optical coherence tomography.

Methods:

Twenty-one children with high hyperopia and 20 controls were enrolled in this study. Subjects with spherical equivalent +5.0 D or higher were evaluated in the study group and subject with spherical equivalent between +0.25 and +2.0 D in the control group. The retinal nerve fiber layer thickness, macular thickness, macular ganglion cell layer and inner plexiform layer thicknesses were measured using a spectral domain optical coherence tomography, and results were compared between groups.

Results:

The nasal and inferior quadrant and the global retinal nerve fiber layer thickness were significantly thicker in the study group. The mean thickness of inferior quadrant of the inner macula was significantly thicker in the study group than those in the control group. The mean thickness of the ganglion cell layer in nasal, temporal and inferior quadrant of outer macula was significantly thinner in the study group than the control group. The mean thickness of the inner plexiform layer in the inferior quadrant of the inner macula and nasal and inferior quadrant of the outer macula were significantly higher in study group than those in control group.

Conclusion:

High hyperopic children had thicker retinal nerve fiber layer when compared to the controls. This difference should be taken into account when evaluating children with glaucoma or other optic disc disorders.

Changes in macular ultrastructural morphology in unilateral anisometropic amblyopia

It is controversial that retina and photoreceptors are involved in amblyopic development. Lack of imaging devices for quantitative assessment of photoreceptors in vivo impedes further investigation. In this study we investigated the differences of macular thickness, outer nuclear layer (ONL) thickness and cone density among eyes with unilateral anisometropic amblyopia, amblyopic fellow eyes, and normal control eyes using high-definition spectral-domain optical coherence tomography and adaptive optics imaging system. Thicker fovea and parafovea with characteristic quantitative retinal changes in unilateral amblyopic patients indicated that the amblyopic process might involve the retina. Cones tended to be homogeneously distributed at 1.5° from the foveal center in all participants. However, we did not detect any significant differences in cone density and ONL thickness at 1.5° from the foveal center in patients with unilateral amblyopia when compared with the fellow eyes and the normal control eyes. This is the first study to explore whether photoreceptors are involved in amblyopic development in vivo that would help for understanding the underlying mechanisms of amblyopia. Whether macular changes relate to cone photoreceptors migration of the amblyopic eyes remains to be determined.

Analysis of macular, foveal, and retinal nerve fiber layer thickness in children with unilateral anisometropic amblyopia and their changes following occlusion therapy

Purpose:

To analyze macular thickness (MT), foveal thickness (FT), and retinal nerve fibre layer thickness (RNFLT) in children with unilateral anisometropic amblyopia and their changes following occlusion therapy.

Methods:

A prospective, longitudinal, and comparative study of 60 children aged between 5 and 18 years consisted of two groups, group 1: 30 children with unilateral anisometropic amblyopia; group 2: 30 normal children. Best corrected visual acuity (BCVA), a detailed ocular examination, spectral domain optical coherence tomography for MT, FT, and RNFLT in both eyes were done at visit one (baseline) and every 3 months for a year following occlusion therapy (initiated one month after first visit) in group 1.

Results:

Mean BCVA, MT, FT, and RNFLT in amblyopic eyes at first visit were 0.63 ± 0.405, 286.9 ± 6.522 μm, 195.90 ± 8.462 μm, and 100.87 ± 6.240 μm, respectively and at last visit after occlusion therapy were 0.50 ± 0.318, 248.9 ± 11.681 μm, 169.47 ± 10.941 μm, and 99.43 ± 5.722 μm, respectively. At first visit, mean BCVA, MT, FT, and RNFLT in nonamblyopic eyes (group 1) were 0 ± 0, 240 ± 10.447 μm, 159.27 ± 9.285 μm, 98.63 ± 4.723 μm and in normal eyes (group 2: average of right and left eyes) were 0 ± 0, 239.8 ± 4.294 μm, 143.6 ± 4.61 μm, 100.5 ± 2.895 μm, respectively.

Conclusion:

MT and FT, which were more in amblyopic eyes as compared to normal fellow eyes and group 2, decreased with improvement in BCVA after occlusion therapy. However, there was no difference in RNFLT between amblyopic eyes and normal fellow eyes and group 2 before and after occlusion therapy.