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Venkatesh R, Mangla R, Handa A, Chitturi SP, Parmar Y, Sangoram R, Yadav NK, Chhablani J. Vitreomacular interface abnormalities in type 2 macular telangiectasia (MacTel). Graefes Arch Clin Exp Ophthalmol 2024; 262:1455-1463. [PMID: 38108907 DOI: 10.1007/s00417-023-06330-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 11/20/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To describe the different types of vitreomacular interface abnormalities (VMIA) seen on optical coherence tomography (OCT) in type 2 macular telangiectasia (MacTel) and explain the possible reasons for its development. METHODS In this retrospective cross-sectional study, type 2 MacTel eyes with macular volumetric OCT imaging protocol were included to identify different types of VMIA such as abnormal PVD, vitreomacular traction (VMT), ERM, and lamellar and full-thickness macular hole. The VMIA findings were then correlated with different MacTel disease stages and visual acuity. RESULTS One thousand forty-three OCTs of 332 type 2 MacTel eyes from 169 patients at different visits were examined. VMIA was detected in 709 (68%) of those OCT scans in 216 (65%) eyes. There were 273 (39%), 31 (4%), 89 (13%), 7 (1%), and 381 (54%) OCT scans with vitreomacular adhesion, VMT, ERM, and inner and outer lamellar macular holes discovered respectively. VMIA eyes had a high frequency of abnormal PVD (p = 0.001) and retinal pigment clumps (RPCs) [p = 0.032]. Eyes with abnormal PVD (p = 0.034) and RPC (p = 0.000) had a higher rate of ERM development. RPC was linked to an increased risk of developing ERM (odd ratio 2.472; 95% CI 1.488-4.052). RPC and ERM contributed significantly to poor visual acuity (0.661 ± 0.416, 20/92). CONCLUSION OCT reveals a high frequency of VMIA in advanced type 2 MacTel eyes. RPC could be responsible for the development of anomalous PVD, as well as subsequent VMIAs and ERM. Additional work is required to examine the long-term changes and surgical outcomes of these eyes.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India.
| | - Rubble Mangla
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Ashit Handa
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Sai Prashanti Chitturi
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Yash Parmar
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Rohini Sangoram
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1stR Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India
| | - Jay Chhablani
- University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, 203 Lothrop Street, Suite 800, Pittsburgh, PA, 15213, USA
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Limoli C, Raja LD, Wagner SK, Ferraz D, Bolz M, Vujosevic S, Nucci P, Nicholson L, Keane PA, Khalid H, Huemer J. Exploring Patient Demographics and Presence of Retinal Vascular Disease in Paracentral Acute Middle Maculopathy. Am J Ophthalmol 2024; 260:182-189. [PMID: 38104758 DOI: 10.1016/j.ajo.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE To investigate the sociodemographic profile, the association with retinal vascular diseases (RVD) and systemic comorbidities, and visual outcomes of patients with paracentral acute middle maculopathy (PAMM) in a large, ethnically diverse single-center cohort. DESIGN Retrospective cohort study. METHODS Electronic health record query for all patients presenting with PAMM at Moorfields Eye Hospital, London, was completed. Detailed demographic, clinical, and systemic information were collected and analyzed. RESULTS A total of 78 eyes of 78 patients with confirmed PAMM were included in the study. Forty patients (51.3%) presented with no RVD, 20 patients (25.6%) with retinal vein occlusion (RVO), 16 patients (20.5%) with retinal artery occlusion (RAO), and 2 patients (2.6%) with concomitant RAO and RVO. Patients with PAMM+RAO were older than those with RVO (P = .02) and more likely to have a history of major adverse cardiovascular events (MACE) (P = .01), with a significantly worse presenting best corrected visual acuity (BCVA) (20/50) compared to patients with RVO (P = .02) and no RVD (P < .001). Individuals with isolated PAMM had a significantly higher prevalence of previous MACE (P = .04) and sickle cell disease (SCD) (P = .04) compared to those with RVO. At the last follow-up, 64 patients (85.3%) had a good BCVA (>20/32). CONCLUSIONS The significant association of PAMM with RVD supports the hypothesis of an ischemic etiology. Individuals with isolated PAMM had a higher prevalence of MACE and SCD. Thus, it is important to prompt immediate referral for a comprehensive systemic evaluation. Across the whole cohort, PAMM was associated with good BCVA improvement during follow-up, indicating a good visual prognosis.
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Affiliation(s)
- Celeste Limoli
- From the Moorfields Eye Hospital NHS Foundation Trust (C.L., L.D.R., S.K.W., L.N., P.A.K., H.K., J.H.), London, United Kingdom; Ophthalmology, Università degli Studi di Milano (C.L.), Milano, Lombardia, Italy
| | - Laxmi Deepa Raja
- From the Moorfields Eye Hospital NHS Foundation Trust (C.L., L.D.R., S.K.W., L.N., P.A.K., H.K., J.H.), London, United Kingdom
| | - Siegfried Karl Wagner
- From the Moorfields Eye Hospital NHS Foundation Trust (C.L., L.D.R., S.K.W., L.N., P.A.K., H.K., J.H.), London, United Kingdom; Institute of Ophthalmology, University College London (S.K.W., P.A.K., H.K.), London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (S.K.W., P.A.K.), London, United Kingdom
| | - Daniel Ferraz
- IDOR-d'Or Institute for Research and Education (D.F.), Rede d'Or, Sao Paolo, Brazil
| | - Matthias Bolz
- Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University (M.B., J.H.), Linz, Austria
| | - Stela Vujosevic
- Eye Clinic, IRCCS MultiMedica (S.V.), Lombardia, Italy;; Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano (S.V., P.N.), Milano, Lombardia, Italy
| | - Paolo Nucci
- Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano (S.V., P.N.), Milano, Lombardia, Italy
| | - Luke Nicholson
- From the Moorfields Eye Hospital NHS Foundation Trust (C.L., L.D.R., S.K.W., L.N., P.A.K., H.K., J.H.), London, United Kingdom
| | - Pearse Andrew Keane
- From the Moorfields Eye Hospital NHS Foundation Trust (C.L., L.D.R., S.K.W., L.N., P.A.K., H.K., J.H.), London, United Kingdom; Institute of Ophthalmology, University College London (S.K.W., P.A.K., H.K.), London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (S.K.W., P.A.K.), London, United Kingdom
| | - Hagar Khalid
- From the Moorfields Eye Hospital NHS Foundation Trust (C.L., L.D.R., S.K.W., L.N., P.A.K., H.K., J.H.), London, United Kingdom; Institute of Ophthalmology, University College London (S.K.W., P.A.K., H.K.), London, United Kingdom; Ophthalmology Department, Faculty of Medicine, Tanta University (H.K.), Tanta, Al Gharbiya, Egypt
| | - Josef Huemer
- From the Moorfields Eye Hospital NHS Foundation Trust (C.L., L.D.R., S.K.W., L.N., P.A.K., H.K., J.H.), London, United Kingdom; Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University (M.B., J.H.), Linz, Austria.
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Wardeh R, Wardeh I. [An unclear macular alteration]. Ophthalmologie 2024; 121:323-325. [PMID: 38453716 DOI: 10.1007/s00347-024-02010-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Rima Wardeh
- Augenärzte an der Geibelstraße, Geibelstraße 54, 30173, Hannover, Deutschland.
| | - Ibrahim Wardeh
- Augenärzte an der Geibelstraße, Geibelstraße 54, 30173, Hannover, Deutschland
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Chen G, Tzekov R, Fang Y, Tong Y, Li W. Internal limiting membrane peeling in rhegmatogenous retinal detachment: A meta-analysis. PLoS One 2024; 19:e0297230. [PMID: 38489304 PMCID: PMC10942048 DOI: 10.1371/journal.pone.0297230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/29/2023] [Indexed: 03/17/2024] Open
Abstract
PURPOSE To determine whether pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for rhegmatogenous retinal detachment (RRD) could get better functional and anatomical outcomes. METHODS A comprehensive literature search was performed to find relevant studies. A meta-analysis was conducted by comparing the weighted mean differences (WMD) in the mean change of best corrected visual acuity (BCVA) from baseline and calculating the odd ratios (OR) for rates of epiretinal membrane (ERM) formation and recurrence of retinal detachment (RD). RESULTS Fourteen studies were selected, including 2259 eyes (825 eyes in the ILM peeling group and 1434 eyes in the non-ILM peeling group). There was no significant difference in terms of mean change in BCVA from baseline and the rate of RD recurrence (WMD = 0.02, 95% CI, -0.20 to 0.24, P = 0.86, and OR = 0.55, 95% CI, 0.24 to 1.26, P = 0.16), but ILM peeling was associated with a significantly lower frequency of postoperative ERM formation (OR = 0.13, 95% CI, 0.06 to 0.26, P<0.00001). Similar results were obtained in a sub-analysis based on macula-off RRD. CONCLUSION ILM peeling results in similar BCVA, with same rate of RD recurrence, but lower rate of postoperative ERM development. ILM peeling could be considered in selected cases with risk factors that are likely to develop an ERM.
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Affiliation(s)
- Guohai Chen
- Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, PR China
| | - Radouil Tzekov
- Department of Ophthalmology, University of South Florida, Tampa, Florida, United States of America
| | - Yan Fang
- Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, PR China
| | - Yuhua Tong
- Department of Ophthalmology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, PR China
| | - Wensheng Li
- Shanghai Aier Eye Hospital, Shanghai, PR China
- Shanghai Aier Eye Institute, Shanghai, PR China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, PR China
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Al-Shehri AM, Aljohani S, Aldihan KA, Alrashedi MJ, Alrasheed S, Schatz P. Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment. BMC Ophthalmol 2024; 24:119. [PMID: 38486220 PMCID: PMC10938769 DOI: 10.1186/s12886-024-03377-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 03/01/2024] [Indexed: 03/18/2024] Open
Abstract
PURPOSE To analyze structural changes in the macular retinal layers and sub-foveal choroidal thickness (SFCT) in eyes after macula-on rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy with either silicone oil (SO) or gas tamponade, and the effect of these changes on visual acuity. PATIENTS AND METHODS Retrospective study which included 26 eyes in the SO Group and 32 in the Gas Group. Optical coherence tomography (OCT) scans of the affected eyes were obtained before surgery, and 3 months after PPV in the Gas Group, and during silicone oil in situ and 3 months after SO removal, in the SO Group. Qualitative assessment of photoreceptor layer and foveal contour, along with quantitative assessment of macular retinal thickness and SFCT was performed. Postoperative OCT macular microstructural changes were recorded and correlated to corrected distance visual acuity (CDVA). Intraocular pressure (IOP) was measured preoperative and at 3 months post operative. RESULTS There was a 2-line loss (from 20/28 preoperatively to 20/40 at final follow-up) of CDVA in the SO Group (p=0.051), while there was no statistically significant change in CDVA in the Gas Group (p=0.786). There was no significant correlation between CDVA loss and duration of silicon tamponade (r=-0.031, p=0.893). There was a statistically significant increase in IOP from its baseline to final follow-up of 0.7 mmHg in the SO Group (p=0.023) while there was no statistically significant change in IOP in the Gas Group. During silicone oil tamponade, there was approximately 11% and 5% of retinal and sub-foveal choroidal thinning respectively, which was moderately resolved following silicone oil removal. 20% (5/24) of eyes in the SO Group had qualitative flattening of foveal contour during SO tamponade that resolved after SO removal. CONCLUSION Thinning of the macula was noticed after macula-on RRD repair with SO tamponade. Such thinning was only partially reversible after the removal of SO.
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Affiliation(s)
- Abdulaziz Mohammed Al-Shehri
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
- Surgery Department, Taif university, Taif, Saudi Arabia.
| | - Saud Aljohani
- Ophthalmology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid Abdulaziz Aldihan
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Musa Johaiman Alrashedi
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Fellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Saad Alrasheed
- Diagnosic imaging department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Patrik Schatz
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology, Clinical Sciences, Skane University Hospital, Lund University, Lund, Sweden
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Untracht GR, Durkee MS, Zhao M, Kwok-Cheung Lam A, Sikorski BL, Sarunic MV, Andersen PE, Sampson DD, Chen FK, Sampson DM. Towards standardising retinal OCT angiography image analysis with open-source toolbox OCTAVA. Sci Rep 2024; 14:5979. [PMID: 38472220 PMCID: PMC10933365 DOI: 10.1038/s41598-024-53501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/01/2024] [Indexed: 03/14/2024] Open
Abstract
Quantitative assessment of retinal microvasculature in optical coherence tomography angiography (OCTA) images is important for studying, diagnosing, monitoring, and guiding the treatment of ocular and systemic diseases. However, the OCTA user community lacks universal and transparent image analysis tools that can be applied to images from a range of OCTA instruments and provide reliable and consistent microvascular metrics from diverse datasets. We present a retinal extension to the OCTA Vascular Analyser (OCTAVA) that addresses the challenges of providing robust, easy-to-use, and transparent analysis of retinal OCTA images. OCTAVA is a user-friendly, open-source toolbox that can analyse retinal OCTA images from various instruments. The toolbox delivers seven microvascular metrics for the whole image or subregions and six metrics characterising the foveal avascular zone. We validate OCTAVA using images collected by four commercial OCTA instruments demonstrating robust performance across datasets from different instruments acquired at different sites from different study cohorts. We show that OCTAVA delivers values for retinal microvascular metrics comparable to the literature and reduces their variation between studies compared to their commercial equivalents. By making OCTAVA publicly available, we aim to expand standardised research and thereby improve the reproducibility of quantitative analysis of retinal microvascular imaging. Such improvements will help to better identify more reliable and sensitive biomarkers of ocular and systemic diseases.
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Affiliation(s)
- Gavrielle R Untracht
- Department of Health Technology, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
- School of Biosciences, The University of Surrey, Guildford, GU27XH, UK
| | | | - Mei Zhao
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Andrew Kwok-Cheung Lam
- Centre for Myopia Research, School of Optometry, Faculty of Health and Social Science, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Bartosz L Sikorski
- Department of Ophthalmology, Nicolaus Copernicus University, 85-090, Bydgoszcz, Poland
- International Center for Translational Eye Research (ICTER), Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224, Warsaw, Poland
| | - Marinko V Sarunic
- Department of Medical Physics and Biomedical Engineering, University College London, London, WC1E6BT, UK
- Institute of Ophthalmology, University College London, London, EC1V2PD, UK
| | - Peter E Andersen
- Department of Health Technology, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - David D Sampson
- School of Computer Science and Electronic Engineering, The University of Surrey, Guildford, GU27XH, UK
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, 6009, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, WA, 6000, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, 3002, Australia
| | - Danuta M Sampson
- School of Biosciences, The University of Surrey, Guildford, GU27XH, UK.
- Institute of Ophthalmology, University College London, London, EC1V2PD, UK.
- Centre for Ophthalmology and Visual Science (Incorporating Lions Eye Institute), The University of Western Australia, Perth, WA, 6009, Australia.
- Department of Optometry, School of Allied Health, The University of Western Australia, Perth, WA, 6009, Australia.
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Curcio CA, Kar D, Owsley C, Sloan KR, Ach T. Age-Related Macular Degeneration, a Mathematically Tractable Disease. Invest Ophthalmol Vis Sci 2024; 65:4. [PMID: 38466281 PMCID: PMC10916886 DOI: 10.1167/iovs.65.3.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024] Open
Abstract
A progression sequence for age-related macular degeneration onset may be determinable with consensus neuroanatomical nomenclature augmented by drusen biology and eye-tracked clinical imaging. This narrative review proposes to supplement the Early Treatment of Diabetic Retinopathy Study (sETDRS) grid with a ring to capture high rod densities. Published photoreceptor and retinal pigment epithelium (RPE) densities in flat mounted aged-normal donor eyes were recomputed for sETDRS rings including near-periphery rich in rods and cumulatively for circular fovea-centered regions. Literature was reviewed for tissue-level studies of aging outer retina, population-level epidemiology studies regionally assessing risk, vision studies regionally assessing rod-mediated dark adaptation (RMDA), and impact of atrophy on photopic visual acuity. The 3 mm-diameter xanthophyll-rich macula lutea is rod-dominant and loses rods in aging whereas cone and RPE numbers are relatively stable. Across layers, the largest aging effects are accumulation of lipids prominent in drusen, loss of choriocapillary coverage of Bruch's membrane, and loss of rods. Epidemiology shows maximal risk for drusen-related progression in the central subfield with only one third of this risk level in the inner ring. RMDA studies report greatest slowing at the perimeter of this high-risk area. Vision declines precipitously when the cone-rich central subfield is invaded by geographic atrophy. Lifelong sustenance of foveal cone vision within the macula lutea leads to vulnerability in late adulthood that especially impacts rods at its perimeter. Adherence to an sETDRS grid and outer retinal cell populations within it will help dissect mechanisms, prioritize research, and assist in selecting patients for emerging treatments.
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Affiliation(s)
- Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
| | - Deepayan Kar
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
| | - Kenneth R. Sloan
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
| | - Thomas Ach
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
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Tong J, Alonso-Caneiro D, Kugelman J, Phu J, Khuu SK, Kalloniatis M. Characterisation of the normal human ganglion cell-inner plexiform layer using widefield optical coherence tomography. Ophthalmic Physiol Opt 2024; 44:457-471. [PMID: 37990841 DOI: 10.1111/opo.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE To describe variations in ganglion cell-inner plexiform layer (GCIPL) thickness in a healthy cohort from widefield optical coherence tomography (OCT) scans. METHODS Widefield OCT scans spanning 55° × 45° were acquired from 470 healthy eyes. The GCIPL was automatically segmented using deep learning methods. Thickness measurements were extracted after correction for warpage and retinal tilt. Multiple linear regression analysis was applied to discern trends between global GCIPL thickness and age, axial length and sex. To further characterise age-related change, hierarchical and two-step cluster algorithms were applied to identify locations sharing similar ageing properties, and rates of change were quantified using regression analyses with data pooled by cluster analysis outcomes. RESULTS Declines in widefield GCIPL thickness with age, increasing axial length and female sex were observed (parameter estimates -0.053, -0.436 and -0.464, p-values <0.001, <0.001 and 0.02, respectively). Cluster analyses revealed concentric, slightly nasally displaced, horseshoe patterns of age-related change in the GCIPL, with up to four statistically distinct clusters outside the macula. Linear regression analyses revealed significant ageing decline in GCIPL thickness across all clusters, with faster rates of change observed at central locations when expressed as absolute (slope = -0.19 centrally vs. -0.04 to -0.12 peripherally) and percentage rates of change (slope = -0.001 centrally vs. -0.0005 peripherally). CONCLUSIONS Normative variations in GCIPL thickness from widefield OCT with age, axial length and sex were noted, highlighting factors worth considering in further developments. Widefield OCT has promising potential to facilitate quantitative detection of abnormal GCIPL outside standard fields of view.
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Affiliation(s)
- Janelle Tong
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - David Alonso-Caneiro
- School of Science, Technology and Engineering, University of Sunshine Coast, Sunshine Coast, Queensland, Australia
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Jason Kugelman
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Jack Phu
- Centre for Eye Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
- Concord Clinical School, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- School of Medicine (Optometry), Deakin University, Waurn Ponds, Victoria, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Kalloniatis
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- School of Medicine (Optometry), Deakin University, Waurn Ponds, Victoria, Australia
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9
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Gutierrez-Benitez L, Biarge G, Salcedo E, Asaad M. Scharioth macula lens: Three-year follow-up. J Fr Ophtalmol 2024; 47:104006. [PMID: 37925324 DOI: 10.1016/j.jfo.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/21/2023] [Accepted: 10/04/2023] [Indexed: 11/06/2023]
Affiliation(s)
- L Gutierrez-Benitez
- Ophthalmology department, Consorci Sanitari de Terrassa, Hospital de Terrassa, Carr. Torrebonica, s/n, 08227 Terrassa, Barcelona, Spain.
| | - G Biarge
- Ophthalmology department, Consorci Sanitari de Terrassa, Hospital de Terrassa, Carr. Torrebonica, s/n, 08227 Terrassa, Barcelona, Spain
| | - E Salcedo
- Ophthalmology department, Consorci Sanitari de Terrassa, Hospital de Terrassa, Carr. Torrebonica, s/n, 08227 Terrassa, Barcelona, Spain
| | - M Asaad
- Ophthalmology department, Consorci Sanitari de Terrassa, Hospital de Terrassa, Carr. Torrebonica, s/n, 08227 Terrassa, Barcelona, Spain
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Errera C, Romann J, Solecki L, Gaucher D, Ballonzoli L, Bourcier T, Sauer A. Retinal microvascular changes in unilateral functional amblyopia detected by oct-angiography and follow-up during treatment. Eur J Ophthalmol 2024; 34:399-407. [PMID: 37464746 DOI: 10.1177/11206721231188987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVE To evaluate the macular microvascular changes using optical coherence tomographic angiography (OCT-A) in children with unilateral amblyopia and their reversibility during treatment. METHODS Patients with unilateral strabismic or anisometropic amblyopia or residual amblyopia from early congenital cataract surgery, examined between October 2019 and March 2021, were included. Vessel density and perfusion density in the superficial capillary plexus and area, perimeter and circularity of the foveal avascular zone (FAZ) were analysed using OCT-A in amblyopic eyes, contralateral eyes and control group healthy eyes. Correlation analyses between the microvascular parameters and the visual acuity were performed. In a pilot study on a few patients from the amblyopic cohort, longitudinal follow-up during treatment was also performed. RESULTS A total of 128 eyes of 64 patients were included: 32 amblyopic eyes compared with 32 contralateral eyes and 64 control eyes. Vessel density and perfusion density in the superficial capillary plexus were significantly lower in amblyopic eyes compared to control eyes in 6 × 6 mm (p < 0.02) and 3 × 3 mm (p < 0.01) scans. Correlation analyses showed a linear decrease in vessel density and perfusion density with decreasing visual acuity. The microvascular changes observed were reversible with the occlusion treatment of amblyopia (p < 0.001). CONCLUSIONS The study found a decrease in vessel density and perfusion density in the macula of children with unilateral functional amblyopia. These microvascular changes were correlated with visual acuity and appeared to be reversible with treatment of amblyopia. On the whole, OCT-A appears to be a relevant complementary examination when it comes to diagnosing and monitoring functional amblyopia.
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Affiliation(s)
- Charlotte Errera
- Department of Ophthalmology, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Julia Romann
- Department of Ophthalmology, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Lauriana Solecki
- Department of Ophthalmology, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - David Gaucher
- Department of Ophthalmology, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Laurent Ballonzoli
- Department of Ophthalmology, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Tristan Bourcier
- Department of Ophthalmology, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Arnaud Sauer
- Department of Ophthalmology, Strasbourg University Hospital, FMTS, Strasbourg, France
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Razavi P, Baldwin G, Vingopoulos F, Garg I, Tracy J, Wescott H, Choi H, Zeng R, Lains I, Husain D, Kim LA, Vavvas DG, Miller JB. Associations of quantitative contrast sensitivity with wide-field swept-source optical coherence tomography angiography in retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 2024; 262:789-799. [PMID: 37955700 DOI: 10.1007/s00417-023-06288-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/20/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
PURPOSE To investigate associations between contrast sensitivity (CS) and vascular metrics on wide-field swept-source optical coherence tomography angiography (WF-SS-OCTA) in patients with retinal vein occlusion (RVO). METHODS This prospectively recruited, cross-sectional observational study included RVO patients who underwent quantitative CS function (qCSF) testing and WF-SS-OCTA using 3 × 3, 6 × 6, and 12 × 12 mm angiograms on the same day. The study measured several qCSF outcomes and WF-SS-OCTA vascular metrics, including vessel density (VD), vessel skeletonized density (VSD), and foveal avascular zone (FAZ). The data were analyzed using multivariable regression analysis controlling for age and central subfield thickness (CST). RESULTS A total of 43 RVO eyes of 43 patients and 30 fellow eyes were included. In RVO eyes, multiple vascular metrics were associated with CS outcomes but not visual acuity (VA). On 12 × 12 images, CS thresholds at 1 cpd, 1.5 cpd, and 3 cpd were significantly associated with VD and VSD, but VA was not. When comparing standardized regression coefficients, we found that vascular metrics had a larger effect size on CS than on VA. For instance, the standardized beta coefficient for FAZ area and CS at 6 cpd (β* = - 0.46, p = 0.007) was larger than logMAR VA (β* = 0.40, p = 0.011). CONCLUSION Microvascular changes on WF-SS-OCTA in RVO had a larger effect size on CS than VA. This suggests CS may better reflect the microvascular changes of RVO compared to VA. qCSF-measured CS might be a valuable adjunct functional metric in evaluating RVO patients.
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Affiliation(s)
| | | | | | - Itika Garg
- Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Jack Tracy
- Harvard Retinal Imaging Lab, Boston, MA, USA
| | | | - Hanna Choi
- Harvard Retinal Imaging Lab, Boston, MA, USA
| | | | - Ines Lains
- Harvard Retinal Imaging Lab, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA
| | - Deeba Husain
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA
| | - Leo A Kim
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA
| | | | - John B Miller
- Harvard Retinal Imaging Lab, Boston, MA, USA.
- Retina Service, Massachusetts Eye and Ear, Boston, MA, USA.
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12
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Chou HD, Chang YC, Wu PY, Kang EYC, Chen YH, Liu L, Chen KJ, Hwang YS, Chao AN, Wu WC, Lai CC. Retinal vascular arcade angle as a biomarker for visual improvement after epiretinal membrane surgery. Eye (Lond) 2024; 38:778-785. [PMID: 37865724 PMCID: PMC10920802 DOI: 10.1038/s41433-023-02776-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023] Open
Abstract
OBJECTIVES To investigate the changes in the temporal vascular angles after epiretinal membrane (ERM) surgery and utilize the angles to predict visual outcomes. METHODS A total of 168 eyes from 84 patients with unilateral ERM who underwent vitrectomy were enrolled from a single institution. The angles of temporal venous (anglevein) and arterial arcades (angleartery) were measured on fundus photographs. The relationships between the angles and the best-corrected visual acuity (BCVA) were explored and multivariable logistic models and receiver operating characteristic (ROC) curves were analyzed to identify the factors that predicted visual outcomes. RESULTS At baseline, both angleartery and anglevein were narrower in the eyes with ERM than the fellow eyes (p < 0.001 and 0.007) but had no correlation with the baseline BCVA (p = 0.754 and 0.804). Postoperatively, the angleartery and anglevein significantly widened (both p < 0.001) and a greater BCVA improvement was associated with a greater widening of the angleartery (p = 0.029) and anglevein (p = 0.050). Multivariable logistic analyses found a narrower baseline angleartery compared to the fellow eye had a higher chance for BCVA improvement ≧ 2 lines (Odds ratio = 0.97; 95% CI, 0.94-0.99; p = 0.016). ROC curve showed the baseline difference in the angleartery between bilateral eyes predicted BCVA improvement ≧ 2 lines (area under the curve = 0.74; p = 0.035), and a 0.73 sensitivity and 0.80 specificity with a cut-off value of -27.19 degrees. CONCLUSIONS The retinal vascular angles widened after ERM surgery and the fundus photograph-derived angles may serve as a highly-accessible biomarker to predict postoperative visual outcomes.
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Affiliation(s)
- Hung-Da Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Chieh Chang
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Po-Yi Wu
- Department of Medical Education, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Eugene Yu-Chuan Kang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsing Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Laura Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yih-Shiou Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - An-Ning Chao
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
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Sangani P, Temple S, Bhandary S, Narayanan R, Johnson E, Das AV, Ali MH, Takkar B. Macular Pigment Assessment in Indian Population Using Degree of Polarization Threshold: Impact of Diet on Macular Pigment Density. Transl Vis Sci Technol 2024; 13:20. [PMID: 38517446 PMCID: PMC10981160 DOI: 10.1167/tvst.13.3.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
Purpose To determine macular pigment (MP) density scores in healthy Indians and examine correlations with demographic and lifestyle variables. Methods We observed 484 Indians without an ocular pathology. Body mass index (BMI) and self-reported lifestyle factors (sunglasses usage, physical activity, and smoking) were noted. MP density was assessed as the threshold of perception of the shadow of their macular pigments on their retina using a new MP assessment tool (MP-eye). Lutein and zeaxanthin intake was assessed using a prevalidated questionnaire regionally designed for the Indian diet. Clusters of participants were created for statistical analysis based on MP-eye scores secondarily to detect any relevant effects in very low, low, medium, and high ranges of MPs. Results Data analyzed included 235 males and 249 females with mean age of 36.1 ± 12.9 years (range, 14-72). The median MP-eye score was 6 (range, 0-10, with 10 being high). Most were non-smokers (413, 85.3%) and did not use sunglasses (438, 90.5%), and 314 (64.9%) had low physical activity. Diabetes was present in 62 participants (12.8%) and hypertension in 53 (10.9%). Advancing age (r = -0.209; P < 0.000) and BMI (r = -0.094; P = 0.038) had weak negative correlation with MP-eye scores. Hypertension was less prevalent (7/88) in the cluster with the highest median MP-eye score (P = 0.033). Dietary intake of MPs and other lifestyle factors did not correlate significantly with MP-eye score overall or when analyzed in clusters. Conclusions MP-eye scores of an Indian population were normally distributed. Higher age, high BMI, and presence of hypertension were weakly associated with lower MP-eye scores. The impact of diet on MPs requires further evaluation. Translational Relevance This normative regional database enables risk stratification of macular degeneration.
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Affiliation(s)
- Payal Sangani
- Indian Health Outcomes, Public Health, and Economics Research Centre (IHOPE), LV Prasad Eye Institute, Hyderabad, India
| | - Shelby Temple
- School of Optometry, Aston University, Birmingham, United Kingdom
- School of Biological Sciences, The University of Bristol, Bristol, United Kingdom
- Azul Optics, Bristol, United Kingdom
| | - Shashank Bhandary
- Suven Clinical Research Centre, LV Prasad Eye Institute, Hyderabad, India
| | - Raja Narayanan
- Indian Health Outcomes, Public Health, and Economics Research Centre (IHOPE), LV Prasad Eye Institute, Hyderabad, India
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
| | | | - Anthony Vipin Das
- Indian Health Outcomes, Public Health, and Economics Research Centre (IHOPE), LV Prasad Eye Institute, Hyderabad, India
| | - Md Hasnat Ali
- Indian Health Outcomes, Public Health, and Economics Research Centre (IHOPE), LV Prasad Eye Institute, Hyderabad, India
- Department of Computational Biostatistics and Data Science, LV Prasad Eye Institute, Hyderabad, India
| | - Brijesh Takkar
- Indian Health Outcomes, Public Health, and Economics Research Centre (IHOPE), LV Prasad Eye Institute, Hyderabad, India
- Anant Bajaj Retina Institute, LV Prasad Eye Institute, Hyderabad, India
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Mairot K, Gascon P, Levy N, Comet A, Denis D, Stolowy N, David T. Acute Macular Neuroretinopathy Associated With Idiopathic Intracranial Hypertension. J Neuroophthalmol 2024; 44:e12-e13. [PMID: 36255099 DOI: 10.1097/wno.0000000000001728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kevin Mairot
- Department of Ophthalmology (KM, PG, NL, AC, DD, NS, TD), Centre Hospitalier Universitaire de l'Hôpital Nord, Marseille, France; and Department of Ophthalmology (KM, PG, NL, AC, DD, NS, TD), Centre Hospitalier Universitaire de La Timone, Marseille, France
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15
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Houghton OM. IRREVERSIBLE RETINAL PIGMENT EPITHELIUM TOXICITY ASSOCIATED WITH FIBROBLAST GROWTH FACTOR RECEPTOR INHIBITOR THERAPY. Retin Cases Brief Rep 2024; 18:214-217. [PMID: 36121823 PMCID: PMC10898545 DOI: 10.1097/icb.0000000000001354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Erdafitinib is a fibroblast growth factor receptor inhibitor indicated for the treatment of cancer. A case of fibroblast growth factor receptor inhibitor-associated retinopathy that resulted in significant visual symptoms and chronic subretinal abnormalities is reported. METHODS A 73-year-old man with a history of relapsed multiple myeloma was treated with erdafitinib. Soon after his fourth treatment cycle, he developed blurred vision in both eyes. Therapy with erdafitinib was subsequently discontinued. RESULTS Funduscopic examination and optical coherence tomography of both eyes revealed multifocal subretinal fluid in the macula of both eyes. Eleven weeks after cessation of the erdafitinib, the visual acuity improved but the patient reported bilateral annular scotomas. Evaluation was notable for resolution of the subretinal fluid with the development irregular subfoveal thickening in both eyes. The patient's symptoms improved, but the subfoveal abnormalities were persistent at 14 months follow-up. CONCLUSION Erdafitinib may be associated with permanent retinal pigment epithelium toxicity.
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16
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Sharma A, Wu L, Bloom S, Stanga P, Agrawal R, Downes RA, Rachitskaya AV, Ghalibafan S, Cai LZ, Yannuzzi NA, Shanmugam PM, Wakabayashi T, Avci R, Rezaei KA. RWC Update: Unstapling the Retina From a Firecracker Injury; Macula-On Retinal Detachment: When To Operate?; Choroidal Coloboma. Ophthalmic Surg Lasers Imaging Retina 2024; 55:125-128. [PMID: 38466966 DOI: 10.3928/23258160-20240212-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
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17
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Adrean SD, Peng ET, Chaili S, Grant S. PURPOSEFUL GAS-INDUCED RESORPTION OF SUBMACULAR FLUID IN MACULA-OFF RETINAL DETACHMENTS (PERSIMMON STUDY). Retina 2024; 44:414-420. [PMID: 37972942 DOI: 10.1097/iae.0000000000003996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE To examine the visual outcomes in patients with macula-off rhegmatogenous retinal detachments with intentional submacular fluid retention after pars plana vitrectomy (PPV) or PPV/scleral buckle surgery (PPV/SB). METHODS Patients with macula-off retinal detachments were included if they had a PPV or PPV/SB without drainage retinotomy or perfluorocarbon liquid to flatten the retina. RESULTS The mean age of the patients was 65.0 years. The mean presenting vision was 20.0 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. Six months after repair, the vision improved to 62.9; 75.4% of patients had 20/40 or better at best achieved visual acuity. Pseudophakic eyes had better vision compared with phakic eyes ( P = 0.049). Patients younger than 80 years had better best achieved vision ( P = 0.0118) compared with patients 80 years or older. Patients with initial vision better than or equal to 20/100 had better best achieved vision ( P = 0.016) compared with those with initial vision worse than 20/100. CONCLUSION Leaving submacular fluid after macula-off retinal detachments surgery was not detrimental for visual outcomes or anatomic success for retinal detachments repair and may lead to better visual outcomes for patients, specifically for those patients younger than 80 years, who are pseudophakic, and have presenting vision 20/100 or better.
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Affiliation(s)
- Sean D Adrean
- Retina Consultants of Orange County, Fullerton, California
| | - Enoch T Peng
- Retina Consultants of Orange County, Fullerton, California
- University of Texas Southwestern Medical School, Dallas, Texas; and
| | - Siyang Chaili
- Retina Consultants of Orange County, Fullerton, California
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Scott Grant
- Retina Consultants of Orange County, Fullerton, California
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Cicinelli MV, Gravina S, Rutigliani C, Checchin L, La Franca L, Lattanzio R, Bandello F. Assessing Diabetic Retinopathy Staging With AI: A Comparative Analysis Between Pseudocolor and LED Imaging. Transl Vis Sci Technol 2024; 13:11. [PMID: 38488432 PMCID: PMC10946690 DOI: 10.1167/tvst.13.3.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/04/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose To compare the diagnostic performance of artificial intelligence (AI)-based diabetic retinopathy (DR) staging system across pseudocolor, simulated white light (SWL), and light-emitting diode (LED) camera imaging modalities. Methods A cross-sectional investigation involved patients with diabetes undergoing imaging with an iCare DRSplus confocal LED camera and an Optos confocal, ultra-widefield pseudocolor camera, with and without SWL. Macula-centered and optic nerve-centered 45 × 45-degree photographs were processed using EyeArt v2.1. Human graders established the ground truth (GT) for DR severity on dilated fundus exams. Sensitivity and weighted Cohen's weighted kappa (wκ) were calculated. An ordinal generalized linear mixed model identified factors influencing accurate DR staging. Results The study included 362 eyes from 189 patients. The LED camera excelled in identifying sight-threatening DR stages (sensitivity = 0.83, specificity = 0.95 for proliferative DR) and had the highest agreement with the GT (wκ = 0.71). The addition of SWL to pseudocolor imaging resulted in decreased performance (sensitivity = 0.33, specificity = 0.98 for proliferative DR; wκ = 0.55). Peripheral lesions reduced the likelihood of being staged in the same or higher DR category by 80% (P < 0.001). Conclusions Pseudocolor and LED cameras, although proficient, demonstrated non-interchangeable performance, with the LED camera exhibiting superior accuracy in identifying advanced DR stages. These findings underscore the importance of implementing AI systems trained for ultra-widefield imaging, considering the impact of peripheral lesions on correct DR staging. Translational Relevance This study underscores the need for artificial intelligence-based systems specifically trained for ultra-widefield imaging in diabetic retinopathy assessment.
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Affiliation(s)
- Maria Vittoria Cicinelli
- Department of Ophthalmology, IRCCS San Raffaele Hospital, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Salvatore Gravina
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Carola Rutigliani
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Lisa Checchin
- Department of Ophthalmology, IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Hospital, Milan, Italy
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
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Nassar GA, Makled HS, Youssef MM, Hassan LM. Functional and perfusion changes associated with silicone oil tamponade after macula-off rhegmatogenous retinal detachment surgery: an optical coherence tomography angiography/microperimetry study. Int Ophthalmol 2024; 44:107. [PMID: 38386180 PMCID: PMC10884141 DOI: 10.1007/s10792-024-03037-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/12/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE The current study utilizes microperimetry and optical coherence tomography angiography (OCTA) to assess the optic nerve head vasculature, retinal microvasculature, and retinal sensitivity before and after silicone oil (SO) removal. METHODS This prospective observational case series study involved 30 eyes subjected to silicone oil endotamponade. Microperimetry and OCTA were utilized to assess the vascular density (VD) of the macula and optic nerve head, as well as the retinal sensitivity (RS), of the participants preoperatively and 1 month following SO removal. The correlation between the various parameters of OCTA and microperimetry was evaluated. RESULTS There was a significant improvement in the postoperative best-corrected visual acuity (BCVA) (p-value < 0.001) and the postoperative total RS, which was 6.38 ± 2.34 dB as compared to a mean preoperative total RS of 5.04 ± 2.06 dB (p-value < 0.001) and showing a significant increase in all rings. However, there was no significant difference in the pre and postoperative macular VD. On the other hand, there was a significant increase in the postoperative VD of the whole disk and the peripapillary capillary plexus, p-values < 0.001 and 0.002, respectively. CONCLUSION The removal of SO resulted in significant improvements in retinal sensitivity, vision, and optic nerve perfusion. However, no significant change was observed in macular VD. CLINICAL TRIALS gov Identifier: NCT04928196.
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Affiliation(s)
- Ghada A Nassar
- Ophthalmology Department, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt
| | - Hebatalla Samir Makled
- Ophthalmology Department, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt.
| | - Maha Mohamed Youssef
- Ophthalmology Department, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt
| | - Lameece Moustafa Hassan
- Ophthalmology Department, Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt
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Ozsaygılı C, Bayram N. Does dexamethasone implant combination with aflibercept monotherapy affect one-year outcomes in treatment-naive diabetic macular edema with inflammatory biomarkers? Int Ophthalmol 2024; 44:51. [PMID: 38336941 DOI: 10.1007/s10792-024-02963-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/04/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE To compare the anatomical and functional outcomes of the combination of aflibercept and dexamethasone implant (CT) against aflibercept monotherapy (AM) in treatment-naive diabetic macular edema (DME) patients with serous macular detachment and hyperreflective foci. METHODS This study included 82 eyes of 82 patients with treatment-naive DME who completed the follow-up period of 12 months. All patients had optical coherence tomography biomarkers of an inflammatory DME phenotype. Patients were consecutively selected and classified into two groups: The CT group consisted of 39 eyes treated with aflibercept therapy and initially combined with a single-dose dexamethasone implant. The AM group consisted of 43 eyes treated with aflibercept alone. The primary outcome measures of the study were the mean reduction of the central macular thickness (CMT) and total macular volume parameters (TMV) and improvement in best-corrected visual acuity. RESULTS In both groups, the patient characteristics, including age, gender, duration of diabetes, HbA1c levels, phakic percentage, and diabetic retinopathy status were similar (P > 0.05). The mean reduction in CMT and TMV was significantly higher in the CT group compared to the AM group (P < 0.001 and P = 0.002, respectively). In contrast, mean letter gains were not significantly higher (P = 0.240) at the end of the study. In the CT group, 20.5% of patients showed a transient IOP increase, and 18% developed cataracts. In subgroup analysis, the mean letter gain in pseudophakic eyes was significantly higher (12.5 in the CT vs. 9.3 in the AM group, P = 0.027). CONCLUSION The CT, where inflammation is prominent, can provide faster recovery. The pseudophakic eyes seem to be the ideal patient group for CT.
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Affiliation(s)
- Cemal Ozsaygılı
- Department of Ophthalmology, University of Health Sciences, Kayseri City Training and Research Hospital, Kocasinan, Kayseri, Turkey.
| | - Nurettin Bayram
- University of Health Sciences, Ankara Etlik City Hospital, Yenimahalle, Ankara, Turkey
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Smith MJ, Sia DIT, Greve M. Torpedo maculopathy-inferior variant. Can J Ophthalmol 2024; 59:e94-e96. [PMID: 33745872 DOI: 10.1016/j.jcjo.2021.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/11/2021] [Accepted: 02/07/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Meghan J Smith
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB
| | - David I T Sia
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB
| | - Mark Greve
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB..
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Goerdt L, Holz FG, Finger RP. [Retinal optical coherence tomography biomarkers in dementia]. Ophthalmologie 2024; 121:84-92. [PMID: 37847375 DOI: 10.1007/s00347-023-01947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Due to the general aging of society, the prevalence and incidence of dementia are expected to increase considerably. In order to timely identify patients and assess their need for treatment and/or supportive measures, comprehensive and easy access screening methods are required, which, however, are yet to be developed. To date, several biomarkers for the presence of dementia on high-resolution spectral domain optical coherence tomography (OCT) and OCT angiography (OCT-A) images were identified. AIM To summarize previously identified OCT biomarkers in dementia and to assess their suitability for comprehensive screening examinations. MATERIAL AND METHODS A literature search was conducted on PubMed until March 2023 for the keywords "dementia", "mild cognitive impairment", "OCT", "OCT angiography" and "retinal biomarkers". Relevant publications were identified and summarized. RESULTS Numerous unspecific alterations on OCT imaging and OCT‑A were identified in patients with (predementia) dementia according to many population and clinical studies. These include a reduced thickness of the peripapillary retinal nerve fiber layer, the ganglion cell complex and the central retinal region. Additionally, a reduced vascular density and an enlarged foveal avascular zone (FAZ) were identified on OCT‑A imaging. CONCLUSION The currently known OCT biomarkers are too unspecific, and there is to date no OCT or OCT-A-based signature distinguishing between different types of dementia. Further longitudinal studies with larger sample sizes are warranted to develop and evaluate such distinct OCT signatures for different types of dementia and their respective early disease stages and to assess their prognostic value. Only then is the inclusion in comprehensive screening investigations feasible.
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Affiliation(s)
- L Goerdt
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
| | - F G Holz
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland
| | - R P Finger
- Universitäts-Augenklinik Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
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23
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Amoaku WM, Cushley L, Silvestri V, Akafo S, Amissah-Arthur KN, Lartey S, Hageman CN, Pappas CM, Hubbard WC, Bernstein PS, Vitale A, Roberts M, Virgili G, Hageman GS, Silvestri G. Vitreomacular interface abnormalities in the Ghanaian African. Eye (Lond) 2024; 38:578-584. [PMID: 37773435 PMCID: PMC10858261 DOI: 10.1038/s41433-023-02737-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND/OBJECTIVE Describe vitreomacular interface abnormalities (VMIA) using spectral-domain optical coherence tomography (SD-OCT), and correlations with age-related macular degeneration (AMD) grade in Ghanaian Africans. SUBJECTS/METHODS Prospective, cross-sectional study of adults aged ≥50 years recruited in Ghana AMD Study. Participant demographics, medical histories, ophthalmic examination, digital colour fundus photography (CFP) were obtained. High-resolution five-line raster OCT, Macular Cube 512 × 128 scans, and additional line scans in areas of clinical abnormality, were acquired. SD-OCT VMI features classified by International Vitreomacular Traction Study Group system and relationships to AMD grade were evaluated. OUTCOMES VMIA prevalence, posterior vitreous detachment (PVD), vitreomacular adhesions (VMA), vitreomacular traction (VMT), epiretinal membranes (ERM), correlations with AMD grade. RESULTS The full Ghana AMD cohort included 718 participants; 624 participants (1248 eyes) aged ≥50 years (range = 50-101, mean = 68.8), 68.9% female were included in this analysis. CFP with OCT scans were available for 776 eyes (397 participants); 707 (91.1%) had gradable CFP and OCT scans for both AMD and VMI grading forming the dataset for this report. PVD was absent in 504 (71.3%); partial and complete PVD occurred in 16.7% and 12.0% respectively. PVD did not increase with age (p = 0.720). VMIA without traction and macular holes were observed in 12.2% of eyes; 87.8% had no abnormalities. VMIA was not significantly correlated with AMD grade (p = 0.819). CONCLUSIONS This provides the first assessment of VMIA in Ghanaian Africans. VMIA are common in Africans; PVD may be less common than in Caucasians. There was no significant association of AMD grade with VMIA.
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Affiliation(s)
- Winfried M Amoaku
- Academic Ophthalmology, Mental Health & Clinical Neurosciences, University of Nottingham and University Hospitals, Nottingham, UK.
| | - Laura Cushley
- Centre for Public Health, Queen's University of Belfast, Belfast, UK
| | | | - Stephen Akafo
- Unit of Ophthalmology, Department of Surgery, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Kwesi N Amissah-Arthur
- Unit of Ophthalmology, Department of Surgery, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | - Seth Lartey
- Eye Unit, Eye Ear Nose and Throat Department, Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Courtney N Hageman
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Christian M Pappas
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - William C Hubbard
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Paul S Bernstein
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Albert Vitale
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Megan Roberts
- Ophthalmology Services, Eye and ENT Clinic, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK
| | | | - Gregory S Hageman
- Department of Ophthalmology & Visual Sciences, Moran Eye Center, Sharon Eccles Steele Center for Translational Medicine, University of Utah, Salt Lake City, UT, USA
| | - Giuliana Silvestri
- Ophthalmology Services, Eye and ENT Clinic, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK
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24
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Matulevičiūtė I, Tatarūnas V, Skipskis V, Čiapienė I, Veikutienė A, Lesauskaitė V, Dobilienė O, Žaliūnienė D. Coronary artery disease, its associations with ocular, genetic and blood lipid parameters. Eye (Lond) 2024; 38:372-379. [PMID: 37587376 PMCID: PMC10810895 DOI: 10.1038/s41433-023-02703-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND/OBJECTIVES To investigate the associations between ophthalmic parameters, CYP4F2 (rs2108622) and ABCA1 (rs1883025) polymorphisms and coronary artery disease, considering the accessibility, non-invasive origin of retinal examination and its possible resemblance to coronary arteries. SUBJECTS/METHODS Overall 165 participants divided into groups based on the coronary angiography results and clinical status: control group (N = 73), MI group (N = 63), 3VD (three vessel disease) (N = 24). All the participants underwent total ophthalmic examination - optical coherence tomography (OCT) and OCT angiography of the macula region were performed and evaluated. Total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride cholesterol (Tg-C) were tested. A standard manufacturer's protocol for CYP4F2 (rs2108622) and ABCA1 (rs1883025) was used for genotyping with TaqMan probes. RESULTS GCL+ layer was thicker in control group vs. 3VD group (74.00; 62.67-94.67 (median; min.-max.) vs. 71.06; 51.33-78.44, p = 0.037). T allele carriers under ABCA1 rs1883025 dominant model were shown to have ticker retina and smaller foveal avascular zone in superficial capillary plexus and smaller Tg-C concentration. ABCA1 rs1883025 was associated with retinal thickness (OR = 0.575, 95% CI 0.348-0.948, p = 0.030). Univariate logistic regression showed that ABCA1 rs1883025 CT genotype is associated with decreased risk for coronary artery disease development under overdominant genetic model (OR = 0.498, 95% CI 0.254-0.976; p = 0.042) and codominant genetic model (OR = 0.468, 95% CI 0.232-0.945, p = 0.034). CONCLUSIONS Results of this study confirmed that non-invasive methods such as OCT of eye might be used for identification of patients at risk of CAD.
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Affiliation(s)
- Indrė Matulevičiūtė
- Department of Ophthalmology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Vacis Tatarūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilius Skipskis
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ieva Čiapienė
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Audronė Veikutienė
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vaiva Lesauskaitė
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Olivija Dobilienė
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Dalia Žaliūnienė
- Department of Ophthalmology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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25
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Chen YK, Lai CH, Chen NN, Wu WC, Ling XC, Lai SC, Kao LY, Chen CY. Possible Choroidal Hyperpermeability in Cherry-Red Spot: A Connection to Transretinal Hyperreflective Foveola in Type 1 Sialidosis. Retina 2024; 44:e14-e15. [PMID: 37748461 DOI: 10.1097/iae.0000000000003942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Affiliation(s)
- Yung-Kang Chen
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Hsiung Lai
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Nan-Ni Chen
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; and
| | - Xiao-Chun Ling
- Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; and
| | - Szu-Chia Lai
- Department of Neurology, West Garden Hospital, Taipei, Taiwan
| | - Ling-Yuh Kao
- Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; and
| | - Chau-Yin Chen
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Ophthalmology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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26
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Çiçek N, Demirayak B, Yigit FU. Evaluation of the macular sensitivity and retinal ganglion cell layer in unilateral amblyopia. Indian J Ophthalmol 2024; 72:232-235. [PMID: 38273685 PMCID: PMC10941918 DOI: 10.4103/ijo.ijo_3382_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/16/2023] [Accepted: 08/04/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To assess macular sensitivity and fixation pattern obtained by microperimetry and ganglion cell complex (GCC) obtained by optical coherence tomography (OCT) in cases with unilateral amblyopia and to compare with control. METHODS The study was conducted with 30 patients with amblyopia, aged 5-18 years, and 30 control eyes of healthy children in the same age group. Participants underwent full ophthalmological examination. Macular sensitivity, stabilization, and location of fixation values were measured using microperimetry. The GCC values were obtained by OCT. Measurements were compared between amblyopic eyes, fellow eyes, and controls. Any correlation between GCC, macular sensitivity, and fixation was investigated. P < 0.05 was considered statistically significant. RESULTS The mean age was 10.13 ± 3.49 years in the amblyopia group and 11.53 ± 2.7 years in the control group. Three groups were formed: amblyopic eyes (Group 1, n = 30), fellow eyes (Group 2, n = 30), and control eyes (Group 3, n = 30). The macular sensitivity values were found highest in the control group (P = 0.007). Bivariate contour ellipse area 1, which is the numerical value of fixation stabilization, was measured to be the lowest in the control group (P < 0.0001). In the analysis among the three groups, no significant difference was observed in terms of the GCC (P = 0.229). In the correlation analyses, a significant correlation was detected between macular sensitivity and GCC values in amblyopic eyes. CONCLUSION In amblyopic eyes, the macular sensitivity was significantly lower and the GCC thickness was found to be in a positive correlation with macular sensitivity.
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Affiliation(s)
- Nilay Çiçek
- Department of Ophthalmology, Corlu State Hospital, Tekirdağ
| | - Bengi Demirayak
- Department of Ophthalmology, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul
| | - Fadime U Yigit
- Department of Ophthalmology, Haliç University, İstanbul, Turkey
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27
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Fasih-Ahmad S, Wang Z, Mishra Z, Vatanatham C, Clark ME, Swain TA, Curcio CA, Owsley C, Sadda SR, Hu ZJ. Potential Structural Biomarkers in 3D Images Validated by the First Functional Biomarker for Early Age-Related Macular Degeneration - ALSTAR2 Baseline. Invest Ophthalmol Vis Sci 2024; 65:1. [PMID: 38300559 PMCID: PMC10846345 DOI: 10.1167/iovs.65.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Purpose Lack of valid end points impedes developing therapeutic strategies for early age-related macular degeneration (AMD). Delayed rod-mediated dark adaptation (RMDA) is the first functional biomarker for incident early AMD. The relationship between RMDA and the status of outer retinal bands on optical coherence tomography (OCT) have not been well defined. This study aims to characterize these relationships in early and intermediate AMD. Methods Baseline data from 476 participants was assessed including eyes with early AMD (n = 138), intermediate AMD (n = 101), and normal aging (n = 237). Participants underwent volume OCT imaging of the macula and rod intercept time (RIT) was measured. The ellipsoid zone (EZ) and interdigitation zone (IZ) on all OCT B-scans of the volumes were segmented. The area of detectable EZ and IZ, and mean thickness of IZ within the Early Treatment Diabetic Retinopathy Study (ETDRS) grid were computed and associations with RIT were assessed by Spearman's correlation coefficient and age adjusted. Results Delayed RMDA (longer RIT) was most strongly associated with less preserved IZ area (r = -0.591; P < 0.001), followed by decreased IZ thickness (r = -0.434; P < 0.001), and EZ area (r = -0.334; P < 0.001). This correlation between RIT and IZ integrity was not apparent when considering normal eyes alone within 1.5 mm of the fovea. Conclusions RMDA is correlated with the status of outer retinal bands in early and intermediate AMD eyes, particularly, the status of the IZ. This correlation is consistent with a previous analysis of only foveal B-scans and is biologically plausible given that retinoid availability, involving transfer at the interface attributed to the IZ, is rate-limiting for RMDA.
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Affiliation(s)
| | - Ziyuan Wang
- Doheny Eye Institute, Pasadena, California, United States
| | - Zubin Mishra
- Doheny Eye Institute, Pasadena, California, United States
| | | | - Mark E Clark
- Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Thomas A Swain
- Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Christine A Curcio
- Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Cynthia Owsley
- Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
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28
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Navneet S, Wilson K, Rohrer B. Müller Glial Cells in the Macula: Their Activation and Cell-Cell Interactions in Age-Related Macular Degeneration. Invest Ophthalmol Vis Sci 2024; 65:42. [PMID: 38416457 PMCID: PMC10910558 DOI: 10.1167/iovs.65.2.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/10/2024] [Indexed: 02/29/2024] Open
Abstract
Müller glia, the main glial cell of the retina, are critical for neuronal and vascular homeostasis in the retina. During age-related macular degeneration (AMD) pathogenesis, Müller glial activation, remodeling, and migrations are reported in the areas of retinal pigment epithelial (RPE) degeneration, photoreceptor loss, and choroidal neovascularization (CNV) lesions. Despite this evidence indicating glial activation localized to the regions of AMD pathogenesis, it is unclear whether these glial responses contribute to AMD pathology or occur merely as a bystander effect. In this review, we summarize how Müller glia are affected in AMD retinas and share a prospect on how Müller glial stress might directly contribute to the pathogenesis of AMD. The goal of this review is to highlight the need for future studies investigating the Müller cell's role in AMD. This may lead to a better understanding of AMD pathology, including the conversion from dry to wet AMD, which has no effective therapy currently and may shed light on drug intolerance and resistance to current treatments.
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Affiliation(s)
- Soumya Navneet
- Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States
| | - Kyrie Wilson
- Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States
| | - Bärbel Rohrer
- Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, United States
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, United States
- Ralph H. Johnson VA Medical Center, Division of Research, Charleston, South Carolina, United States
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29
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Qi Z, Liu X, Xiong S, Wang J, Chen J, Zhu Z, Brochert G, Zhang B, Deng J, Cheng T, He X, Xu X. Macular and peripapillary Choroidal Vascularity Index in children with different refractive status. Eye (Lond) 2024; 38:606-613. [PMID: 37770533 PMCID: PMC10858217 DOI: 10.1038/s41433-023-02743-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 08/24/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES To characterize choroidal vascular changes in children with different refractive status. METHODS A study including 5864 children aged 6-9 years was performed to investigate the choroidal vascular index (CVI) in myopic, emmetropic and hyperopic eyes. Each participant had a comprehensive ocular examination with cycloplegic autorefraction performed, axial length (AL) measured and Swept Source-Optical Coherence Tomography (SS-OCT) scans acquired. Choroidal thickness (ChT) was measured by built-in software, and CVI was calculated using a previously validated self-developed algorithm. RESULTS The mean ChT and CVI were 275.88 ± 53.34 μm and 34.91 ± 3.83 in the macula region, and 191.96 ± 46.28 μm and 32.35 ± 4.21 in the peripapillary region. CVI was significantly lowest for myopes, followed by emmetropes and hyperopes (P < 0.001). CVI varied between different sectors separated by the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid (P < 0.001). Macular CVI decreased horizontally from nasal to temporal quadrant with lowest in center fovea, and vertically from superior to inferior quadrants. Peripapillary CVI was highest in the nasal and lowest in the inferior sector. Multiple regression showed that spherical equivalent (SE), AL, intraocular pressure (IOP), ChT, age, and gender were significantly related to CVI (P < 0.05). CONCLUSIONS In children, the distribution of CVI in the posterior pole is not uniform. A decreased CVI was observed from hyperopia to myopia and was associated with decreased SE, elongated AL, and choroidal thinning. Further study of changes in CVI during myopia onset and progression is required to better understand the role of the choroidal vasculature in myopia development.
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Affiliation(s)
- Ziyi Qi
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xiaoxiao Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Shuyu Xiong
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Jingjing Wang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jun Chen
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
| | - Grace Brochert
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
| | - Bo Zhang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Junjie Deng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Tianyu Cheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xiangui He
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
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30
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Ng HJ, Vermeer KA, Kok A, La Heij EC, van Meurs JC. Treatment of aniseikonia in patients after macula-off retinal detachment surgery: A pilot study. Acta Ophthalmol 2024; 102:e133-e134. [PMID: 37218080 DOI: 10.1111/aos.15710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Hei Jan Ng
- Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Koenraad A Vermeer
- Rotterdam Ophthalmic Institute, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Alexander Kok
- Oculenti Contactlenzen, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Ellen C La Heij
- Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Jan C van Meurs
- Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
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31
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Martin-Pinardel R, Izquierdo-Serra J, De Zanet S, Parrado-Carrillo A, Garay-Aramburu G, Puzo M, Arruabarrena C, Sararols L, Abraldes M, Broc L, Escobar-Barranco JJ, Figueroa M, Zapata MA, Ruiz-Moreno JM, Moll-Udina A, Bernal-Morales C, Alforja S, Figueras-Roca M, Gómez-Baldó L, Ciller C, Apostolopoulos S, Mosinska A, Casaroli Marano RP, Zarranz-Ventura J. Artificial intelligence-based fluid quantification and associated visual outcomes in a real-world, multicentre neovascular age-related macular degeneration national database. Br J Ophthalmol 2024; 108:253-262. [PMID: 36627173 DOI: 10.1136/bjo-2022-322297] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/27/2022] [Indexed: 01/12/2023]
Abstract
AIM To explore associations between artificial intelligence (AI)-based fluid compartment quantifications and 12 months visual outcomes in OCT images from a real-world, multicentre, national cohort of naïve neovascular age-related macular degeneration (nAMD) treated eyes. METHODS Demographics, visual acuity (VA), drug and number of injections data were collected using a validated web-based tool. Fluid compartment quantifications including intraretinal fluid (IRF), subretinal fluid (SRF) and pigment epithelial detachment (PED) in the fovea (1 mm), parafovea (3 mm) and perifovea (6 mm) were measured in nanoliters (nL) using a validated AI-tool. RESULTS 452 naïve nAMD eyes presented a mean VA gain of +5.5 letters with a median of 7 injections over 12 months. Baseline foveal IRF associated poorer baseline (44.7 vs 63.4 letters) and final VA (52.1 vs 69.1), SRF better final VA (67.1 vs 59.0) and greater VA gains (+7.1 vs +1.9), and PED poorer baseline (48.8 vs 57.3) and final VA (55.1 vs 64.1). Predicted VA gains were greater for foveal SRF (+6.2 vs +0.6), parafoveal SRF (+6.9 vs +1.3), perifoveal SRF (+6.2 vs -0.1) and parafoveal IRF (+7.4 vs +3.6, all p<0.05). Fluid dynamics analysis revealed the greatest relative volume reduction for foveal SRF (-16.4 nL, -86.8%), followed by IRF (-17.2 nL, -84.7%) and PED (-19.1 nL, -28.6%). Subgroup analysis showed greater reductions in eyes with higher number of injections. CONCLUSION This real-world study describes an AI-based analysis of fluid dynamics and defines baseline OCT-based patient profiles that associate 12-month visual outcomes in a large cohort of treated naïve nAMD eyes nationwide.
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Affiliation(s)
- Ruben Martin-Pinardel
- IDIBAPS, Barcelona, Spain
- School of Medicine, University of Barcelona, Barcelona, Spain
| | | | | | | | | | - Martin Puzo
- Miguel Servet Ophthalmology Research Group (GIMSO), Miguel Servet University Hospital, Zaragoza, Spain
| | | | - Laura Sararols
- Fundació Privada Hospital Asil Granollers, Granollers, Spain
| | | | - Laura Broc
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | | | | | | | - Aina Moll-Udina
- IDIBAPS, Barcelona, Spain
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Socorro Alforja
- IDIBAPS, Barcelona, Spain
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | | | | | | | - Ricardo P Casaroli Marano
- IDIBAPS, Barcelona, Spain
- School of Medicine, University of Barcelona, Barcelona, Spain
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - Javier Zarranz-Ventura
- IDIBAPS, Barcelona, Spain
- School of Medicine, University of Barcelona, Barcelona, Spain
- Hospital Clinic de Barcelona, Barcelona, Spain
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Maruko I, Irie K, Hasegawa T, Takagi M, Iida T. Misalignment of center of foveal avascular zone and center of photoreceptors in eyes with history of retinopathy of prematurity. Sci Rep 2024; 14:2017. [PMID: 38263428 PMCID: PMC10805909 DOI: 10.1038/s41598-024-52407-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/18/2024] [Indexed: 01/25/2024] Open
Abstract
To determine the relationship between the center of the foveal avascular zone (FAZ) and the center of the foveal photoreceptors in eyes with a history of retinopathy of prematurity (ROP). To accomplish this, we reviewed the medical records of patients with ROP who were examined at the ROP Clinic of the Tokyo Women's Medical University Hospital. We studied 43 eyes of 23 children with ROP and 67 eyes of 36 control children without any fundus abnormalities. The optical coherence tomography angiographic (OCTA) en face images were used to measure the size and location of the foveal avascular zone (FAZ), and cross-sectional OCT images to measure the central retinal thickness (CRT). Our results showed that the size of the FAZ was significantly smaller in the ROP group (0.200 ± 0.142 mm2) than in the control group (0.319 ± 0.085 mm2; P < 0.01). The CRT was significantly thicker in the ROP group (228 ± 30 µm) than in the control group (189 ± 13 µm; P < 0.01). The mean length of the foveal bulge was not significantly different between the two groups. The actual distance of the misalignment between the center of the FAZ and the center of the photoreceptors was significantly greater in the ROP group (50.4 ± 29.5 µm) than in the control group (39.6 ± 21.9 µm; P = 0.001). The correlations between the actual distance of misalignment and the size of the FAZ, CRT, and length of the foveal bulge in both groups were not significant. Despite the significant misalignment in eyes with a history of ROP, the center of the foveal photoreceptors was consistently located within the narrow FAZ which indicates that the development of the FAZ and photoreceptor formation are interrelated.
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Affiliation(s)
- Ichiro Maruko
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan.
| | - Kotaro Irie
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Taiji Hasegawa
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Manami Takagi
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
| | - Tomohiro Iida
- Department of Ophthalmology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-Ku, Tokyo, 162-8666, Japan
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Sayanagi K, Fujimoto S, Hara C, Fukushima Y, Maruyama K, Kawasaki R, Sato S, Nishida K. Effect of polyp regression and reduction on treatment efficacy in polypoidal choroidal vasculopathy treated with aflibercept. Sci Rep 2024; 14:1833. [PMID: 38246960 PMCID: PMC10800340 DOI: 10.1038/s41598-024-52448-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/18/2024] [Indexed: 01/23/2024] Open
Abstract
Intravitreal injection of aflibercept (IVA) has successfully treated polypoidal choroidal vasculopathy (PCV), and polyp morphology is an important indicator of treatment efficacy. However, many studies have not reported the presence or absence of polyp regression and treatment outcomes, and few studies have reported polyp reduction and treatment outcomes in cases with residual polyps. We retrospectively measured the polyp area on indocyanine green angiography images before and after the IVA loading phase and investigated the regression and reduction of polyps and treatment outcomes of 81 eyes with PCV treated with IVA. We investigated the relationship between the presence or absence of complete regression of polyps and the percentage change in the polyp area and treatment outcomes. Eyes with complete polyp regression had significantly better visual acuity improvements compared with baseline at 12 months (P = 0.0108), fewer treatments (P = 0.0024), fewer recurrences during 12-months follow-up (P = 0.0010), and more "dry maculas" at 3 months (P = 0.0048) than eyes in which polyp regression did not occur. A significant correlation was seen only between the percentage of polyp regression and visual acuity at 3 months (P = 0.0395). Regarding IVA therapy for PCV, the presence or absence of complete polyp regression at the end of the loading phase affected the treatment outcome, whereas the degree of polyp reduction in cases of residual polyps had no effect.
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Affiliation(s)
- Kaori Sayanagi
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.
| | - Satoko Fujimoto
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Chikako Hara
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Yoko Fukushima
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Kazuichi Maruyama
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Ryo Kawasaki
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Shigeru Sato
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
| | - Kohji Nishida
- Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan
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Corradetti G, Oncel D, Kadomoto S, Arakaki X, Kloner RA, Sadun AA, Sadda SR, Chan JW. Choriocapillaris and Retinal Vascular Alterations in Presymptomatic Alzheimer's Disease. Invest Ophthalmol Vis Sci 2024; 65:47. [PMID: 38294804 PMCID: PMC10839815 DOI: 10.1167/iovs.65.1.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
Purpose To compare optical coherence tomography angiography (OCTA) retina metrics between cognitively healthy subjects with pathological versus normal cerebrospinal fluid (CSF) Aβ42/tau ratios. Methods Swept-source OCTA scans were collected using the Zeiss PLEX Elite 9000 and analyzed on 23 cognitively healthy (CH) subjects who had previously undergone CSF analysis. Thirteen subjects had a pathological Aβ42/tau (PAT) ratio of <2.7132, indicative of presymptomatic Alzheimer's disease (AD), and 10 had a normal Aβ42/tau (NAT) ratio of ≥2.7132. OCTA en face images of the superficial vascular complex (SVC) and deep vascular complex were binarized and skeletonized to quantify the perfusion density (PD), vessel length density (VLD), and fractal dimension (FrD). The foveal avascular zone (FAZ) area was calculated using the SVC slab. Choriocapillaris flow deficits (CCFDs) were computed from the en face OCTA slab of the CC. The above parameters were compared between CH-PATs and CH-NATs. Results Compared to CH-NATs, CH-PATs showed significantly decreased PD, VLD, and FrD in the SVC, with a significantly increased FAZ area and CCFDs. Conclusions Swept-source OCTA analysis of the SVC and CC suggests a significant vascular loss at the CH stage of pre-AD that might be an indicator of a neurodegenerative process initiated by the impaired clearance of Aβ42 in the blood vessel wall and by phosphorylated tau accumulation in the perivascular spaces, a process that most likely mirrors that in the brain. If confirmed in larger longitudinal studies, OCTA retinal and inner choroidal metrics may be important biomarkers for assessing presymptomatic AD.
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Affiliation(s)
- Giulia Corradetti
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Deniz Oncel
- Doheny Eye Institute, Pasadena, California, United States
| | - Shin Kadomoto
- Doheny Eye Institute, Pasadena, California, United States
| | - Xianghong Arakaki
- Cognition and Brain Integration Laboratory, Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, California, United States
| | - Robert A. Kloner
- Clinical Neuroscience, Department of Neurosciences, Huntington Medical Research Institutes, Pasadena, California, United States
- Cardiovascular Research Institute, Huntington Medical Research Institutes, Pasadena, California, United States
- Cardiovascular Division, Department of Medicine Keck School of Medicine of University of Southern California, Los Angeles, California, United States
| | - Alfredo A. Sadun
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - SriniVas R. Sadda
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Jane W. Chan
- Doheny Eye Institute, Pasadena, California, United States
- Department of Ophthalmology David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States
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Vidal-Oliver L, Gallego-Pinazo R, Dolz-Marco R. Astigmatism Influences Quantitative and Qualitative Analysis in Optical Coherence Tomography Angiography Imaging. Transl Vis Sci Technol 2024; 13:10. [PMID: 38224331 PMCID: PMC10795549 DOI: 10.1167/tvst.13.1.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose The purpose of this paper was to study the influence of astigmatism in optical coherence tomography angiography (OCTA) images in a quantitative and qualitative analysis. Methods This was a prospective, cross-sectional study. We included 110 eyes of 110 patients: 20 eyes without astigmatism and 90 eyes with astigmatism ≥0.5 diopters (D). We performed a macula centered OCTA as a reference image. In patients without astigmatism, registered follow-up scans were performed after induction of -1 and -2 D astigmatism. In patients with astigmatism, we performed the follow-up scan after astigmatism correction. We used a set of cylindrical lenses attached to the camera head of the SPECTRALIS (Heidelberg Engineering, Heidelberg, Germany). A quantitative and qualitative analysis of the superficial vascular complex (SVC) and deep vascular complex (DVC) was performed. The main outcome measures were vessel density (VD), image quality, and the presence of artifacts. Results Mean VD of the SVC was significantly higher in the reference images compared with the images after induction of -2 D. Differences with -1 D were nonsignificant. Higher degrees of astigmatisms had higher VD dropout (0.012-0.02 per diopter in SVC). Astigmatism axis showed no relevance in our cohort. Image quality assessed by two independent observers was graded as higher in images without astigmatism. Defocus and attenuation were more prevalent in images with astigmatism. Conclusions Astigmatism of -2 D affects quantification of VD in OCTA images, mainly affecting the SVC, as well as the subjective quality assessment. Correction of this refractive error might be necessary for an accurate quantitative assessment of OCTA images. Translational Relevance Correcting astigmatism of 2 D or greater appears to be necessary when analyzing OCTA images.
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Affiliation(s)
- Lourdes Vidal-Oliver
- Fundación Oftalmología Médica de la Comunidad Valenciana, Valencia, Spain
- Macula Unit, Oftalvist Clinic, Valencia, Spain
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Morita H, Matsushita I, Fujino Y, Obana A, Kondo H. Measuring macular pigment optical density using reflective images of confocal scanning laser system. Jpn J Ophthalmol 2024; 68:19-25. [PMID: 37966565 DOI: 10.1007/s10384-023-01031-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE To develop a method to measure the macular pigment optical density (MPOD) using scanning laser ophthalmoscopic images in young adults and children. STUDY DESIGN Cross-sectional study. METHODS Blue light reflectance fundus images of 32 healthy subjects were used. A profile of the linear reflectance changes across the center of the fovea on a grayscale fundus image was generated. The ratio of the macula-to-periphery reflection was designated as the peak value of the MPOD (MPOD[FR]) based on established fundamentals. In the MPOD profile, the basal width of the pixels at MPOD < 0 (wMP) and width at one-half value of the MPOD[FR] (wMP0.5) were determined. The MOPD at eccentricity of 0.5° was measured by heterochromatic flicker photometry (MPOD[HFP]), and the correlation between the MPOD[FR] and MPOD[HFP] was evaluated. RESULTS The MPOD[FR] ranged from 0.17 to 0.73 with a mean of 0.40 ± 0.13. The wMP ranged from 88 to 173 pixels with a mean of 121.7 ± 24.2 pixels, and the wMP0.5 ranged from 38 to 83 pixels with a mean of 54.1 ± 10.3 pixels. A significant correlation was found between the MPOD[FR] and MPOD[HFP] (r = 0.41, P = 0.02). CONCLUSIONS This simplified method can provide accurate and reliable values of the MPOD comparable to heterochromatic flicker photometry. Obtaining the fundus images in this fast and easy way should be suitable for children thus enabling clinicians to determine the MPODs for children.
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Affiliation(s)
- Hirofumi Morita
- Department of Ophthalmology, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu, 807-8555, Japan
| | - Itsuka Matsushita
- Department of Ophthalmology, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu, 807-8555, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Hiroyuki Kondo
- Department of Ophthalmology, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu, 807-8555, Japan.
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Bartsch AJ, Skornia AA, Mardin CY, Hohberger B. Bilateral Acute Macular Neuroretinopathy (AMN) after COVID-19 and its Clinical Course. Klin Monbl Augenheilkd 2024; 241:95-101. [PMID: 37156501 DOI: 10.1055/a-2022-8462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Acute macular neuroretinopathy (AMN) is a rare disease entity. It is mainly observed in young women with a history of influenza-like infection or who have been taking oral contraceptives for several years. Patients typically describe subjective visual deterioration and mono- or bilateral paracentral relative scotomas. In some cases, funduscopic ophthalmic examination may reveal subtle sharply demarcated flat lesions of reddish-brown or orange colour in the macular region. Diagnosis is usually made by near-infrared fundus imaging which shows hyporeflective areas, and SD-OCT imaging which manifests changes in the outer retinal layers. In the following, three patient cases with bilateral AMN are described which occurred in direct temporal relationship to a recent SARS-CoV-2 infection.
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Xie H, Pan Z, Xue CC, Chen D, Jonas JB, Wu X, Wang YX. Arterial hypertension and retinal layer thickness: the Beijing Eye Study. Br J Ophthalmol 2023; 108:105-111. [PMID: 36428008 DOI: 10.1136/bjo-2022-322229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/11/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate relationships between blood pressure and the thickness of single retinal layers in the macula. METHODS Participants of the population-based Beijing Eye Study, free of retinal or optic nerve disease, underwent medical and ophthalmological examinations including optical coherence tomographic examination of the macula. Applying a multiple-surface segmentation solution, we automatically segmented the retina into its various layers. RESULTS The study included 2237 participants (mean age 61.8±8.4 years, range 50-93 years). Mean thicknesses of the retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer, inner nuclear layer (INL), outer plexiform layer, outer nuclear layer/external limiting membrane, ellipsoid zone, photoreceptor outer segments (POS) and retinal pigment epithelium-Bruch membrane were 31.1±2.3 µm, 39.7±3.5 µm, 38.4±3.3 µm, 34.8±2.0 µm, 28.1±3.0 µm, 79.2±7.3 µm, 22.9±0.6 µm, 19.2±3.3 µm and 20.7±1.4 µm, respectively. In multivariable analysis, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with thinner GCL and thicker INL, after adjusting for age, sex and axial length (all p<0.0056). Higher SBP was additionally associated with thinner POS and higher DBP with thinner RNFL. For an elevation of SBP/DBP by 10 mm Hg, the RNFL, GCL, INL and POS changed by 2.0, 3.0, 1.5 and 2.0 µm, respectively. CONCLUSIONS Thickness of RNFL, GCL and POS was inversely and INL thickness was positively associated with higher blood pressure, while the thickness of the other retinal layers was not significantly correlated with blood pressure. The findings may be helpful for refinement of the morphometric detection of retinal diseases.
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Affiliation(s)
- Hui Xie
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
| | - Zhe Pan
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Can Can Xue
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Danny Chen
- Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, Indiana, USA
| | - Jost B Jonas
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
- Ruprecht-Karls-University Heidelberg, Seegartenklinik Heidelberg, Heidelberg University, Heidelberg, Baden-Württemberg, Germany
- Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Xiaodong Wu
- Department of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa, USA
- Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
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Verma A, Corradetti G, He Y, Nittala MG, Nassisi M, Velaga SB, Haines JL, Pericak-Vance MA, Stambolian D, Sadda SR. Relationship between the distribution of intra-retinal hyper-reflective foci and the progression of intermediate age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2023; 261:3437-3447. [PMID: 37566303 PMCID: PMC10667133 DOI: 10.1007/s00417-023-06180-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/08/2023] [Accepted: 07/17/2023] [Indexed: 08/12/2023] Open
Abstract
PURPOSE To assess the relationship between the distribution of intra-retinal hyper-reflective foci (IHRF) on optical coherence tomography (OCT) and progression of intermediate age-related macular degeneration (iAMD) over 2 years. METHODS Cirrus OCT volumes of the macula of subjects enrolled in the Amish Eye Study with 2 years of follow-up were evaluated for the presence of iAMD and IHRF at baseline. The IHRF were counted in a series of 5 sequential en face slabs from outer to inner retina. The number of IHRF in each slab at baseline and the change in IHRF from baseline to year 2 were correlated with progression to late AMD at 2 years. RESULTS Among 120 eyes from 71 patients with iAMD, 52 eyes (43.3%) of 42 patients had evidence of both iAMD and IHRF at baseline. Twenty-three eyes (19.0%) showed progression to late AMD after 2 years. The total IHRF count increased from 243 at baseline to 604 at 2 years, with a significant increase in the IHRF number in each slab, except for the innermost slab 5 which had no IHRF at baseline or follow-up. The IHRF count increased from 121 to 340 in eyes that showed progression to late AMD. The presence of IHRF in the outermost retinal slabs 1 and 2 was independently associated with a significant risk of progression to late AMD. A greater increase in IHRF count over 2 years in these same slabs 1 and 2 was also associated with a higher risk of conversion to late AMD. CONCLUSIONS The risk of progression to late AMD appears to be significantly associated with the distribution and extent of IHRF in the outermost retinal layers. This observation may point to significant pathophysiologic differences of IHRF in inner versus outer layers of the retina.
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Affiliation(s)
- Aditya Verma
- Doheny Eye Institute, Pasadena, CA, USA
- Department of Ophthalmology and Visual Sciences, University of Louisville Health Eye Specialists, Louisville, KY, USA
| | - Giulia Corradetti
- Doheny Eye Institute, Pasadena, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
| | - Ye He
- Doheny Eye Institute, Pasadena, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | | | - Marco Nassisi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Jonathan L Haines
- Department of Population & Quantitative Health Sciences and Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Dwight Stambolian
- Department of Ophthalmology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - SriniVas R Sadda
- Doheny Eye Institute, Pasadena, CA, USA.
- Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, USA.
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Iyengar R, Deardorff M, Schmidt R, Nagiel A. Retinal manifestations in autosomal recessive MPDZ maculopathy: report of two cases and literature review. Ophthalmic Genet 2023; 44:572-576. [PMID: 36594712 PMCID: PMC10315413 DOI: 10.1080/13816810.2022.2161580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND To present the retinal and systemic findings in two siblings with compound heterozygous MPDZ variants that were found to have different chorioretinal manifestations. Materials and Methods: Two sibling patients underwent comprehensive ophthalmic examination, including ophthalmoscopy, fundus photography, optical coherence tomography (OCT), and genetic testing by whole exome sequencing. RESULTS A 4-year-old male presented with intermittent exotropia and decreased vision in both eyes. Ophthalmologic examination was notable for macular colobomas and far temporal chorioretinal atrophy in both eyes. OCT of the macula in both eyes demonstrated a caldera with severe retinal and choroidal thinning. Fluorescein angiography of the central macula showed hypofluorescence with persistence of deep choroidal vessels. An ocular gene panel was nondiagnostic, but subsequent whole-exome sequencing noted compound heterozygous, likely pathogenic MPDZ variants (c.3100C>T p.(Arg1034*) from father and c.747 + 2T>G p.(?) from mother). His older brother, a 9-year-old male, had a history of macrocephaly but had not undergone further workup. On exam, he had a visual acuity of 20/25 in the right eye and 20/40 in the left eye and was found to have subtle changes in the foveal reflex of both eyes. OCT revealed thinning of the outer nuclear layer (ONL) temporal to the fovea bilaterally. Sanger sequencing revealed he was positive for the same two MPDZ variants. CONCLUSIONS MPDZ variants have been described in cases of congenital hydrocephalus with varying ophthalmologic manifestations. We present a case series describing retinal phenotypes associated with MPDZ variants in a single family through multimodal imaging.
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Affiliation(s)
- Rahul Iyengar
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California
- The Vision Center, Department of Surgery, Children’s Hospital Los Angeles, Los Angeles, California
| | - Matthew Deardorff
- Department of Pediatrics, Children’s Hospital Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
- Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles, Los Angeles, CA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ryan Schmidt
- Department of Pathology and Laboratory Medicine, Children’s Hospital Los Angeles, Los Angeles, CA
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Aaron Nagiel
- Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California
- The Vision Center, Department of Surgery, Children’s Hospital Los Angeles, Los Angeles, California
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Chen Z, Mo K, Ou S. Dynamic modeling of Haidinger's brush phenomenon and analysis of the cornea effect based on the model. Vision Res 2023; 213:108306. [PMID: 37660627 DOI: 10.1016/j.visres.2023.108306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 07/11/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
Starting from the dynamic feature of the vision process and taking into account the time constants of the polarization-dependent process of cones, this study proposed a physical model that can mathematically describe the transient nature of Haidinger's brushes (HB). A saturated exponential growth function was proposed to describe the dynamic process, and the corresponding formulas were derived and discussed. The sensitivities of both static and rotating HB were considered in the model, and the visibility of HB was also investigated. Additionally, the impact of the cornea on the visions of HB was examined by using this model. Analytical results reveal that there exist two types of patterns in the rotating HB phenomenon. The visual perception of the rotating HB is related to the magnitude and interaction of these two patterns, as well as the corneal phase shift. The rotation orientation reversal at large corneal phase shifts observed by some researchers can also be explained by the model. The results are consistent with experimental observations and might help with the clinical diagnosis of macula disorders and corneal abnormalities.
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Affiliation(s)
- Zhuo Chen
- School of Energy Science and Engineering, Central South University, Changsha, PR China
| | - Kewei Mo
- School of Physics and Electronic Science, Changsha University of Science and Technology, Changsha, PR China
| | - Shaoduan Ou
- School of Energy Science and Engineering, Central South University, Changsha, PR China.
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Handa S, Dogra M, Tigari B, Katoch D, Singh R. Displacement of Submacular Hemorrhage With Vitrectomy Combined With Subretinal Balanced Salt Solution and Air. Retina 2023; 43:2194-2198. [PMID: 37490775 DOI: 10.1097/iae.0000000000003879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
PURPOSE To describe a technique of displacement of submacular hemorrhage (SMH) using subretinal injection of balanced salt solution and filtered air. METHODS Patients presenting within 2 weeks of massive SMH (>4 disk diameter) were prospectively included. All patients underwent 25-gauge pars plana vitrectomy, posterior vitreous detachment, injection of subretinal balanced salt solution and filtered air followed by partial fluid air exchange, 20% sulfur hexafluoride tamponade, and heads-up positioning postoperatively. Degree of displacement of SMH was assessed at 1 month and change in best-corrected visual acuity was assessed at 3 months. RESULTS Ten patients with massive SMH who underwent the aforementioned procedure were included. Complete displacement of bleed from the macula was achieved in nine (90%) of 10 eyes at 1 month. There was significant improvement in best-corrected visual acuity from baseline at 1 month ( P = 0.015) and 3 months ( P = 0.043). CONCLUSION Pars plana vitrectomy with injection of subretinal balanced salt solution and filtered air was well-tolerated and efficacious in displacing large and thick SMH in patients operated within 2 weeks of onset of symptoms.
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Affiliation(s)
- Sabia Handa
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Hood DC, La Bruna S, Leshno A, Gomide GA, Kim MJ, Cioffi GA, Liebmann JM, De Moraes CG, Tsamis E. A Model of Progression to Help Identify Macular Damage Due to Glaucoma. Invest Ophthalmol Vis Sci 2023; 64:8. [PMID: 38060217 PMCID: PMC10709805 DOI: 10.1167/iovs.64.15.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023] Open
Abstract
The central macula contains a thick donut shaped region of the ganglion cell layer (GCL) that surrounds the fovea. This region, which is about 12 degrees (3.5 mm) in diameter, is essential for everyday functions such as driving, reading, and face recognition. Here, we describe a model of progression of glaucomatous damage to this GCL donut. This model is based upon assumptions supported by the literature, and it predicts the patterns of glaucomatous damage to the GCL donut, as seen with optical coherence tomography (OCT). After describing the assumptions and predictions of this model, we test the model against data from our laboratory, as well as from the literature. Finally, three uses of the model are illustrated. One, it provides an aid to help clinicians focus on the essential central macula and to alert them to look for other, non-glaucomatous causes, when the GCL damage does not fit the pattern predicted by the model. Second, the patterns of progression predicted by the model suggest alternative end points for clinical trials. Finally, the model provides a heuristic for future research concerning the anatomic basis of glaucomatous damage.
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Affiliation(s)
- Donald C. Hood
- Department of Psychology, Columbia University, New York, New York, United States
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
| | - Sol La Bruna
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Ari Leshno
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabriel A. Gomide
- Vagelos College of Physicians and Surgeons, New York, New York, United States
| | - Mi Jeung Kim
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
- Department of Ophthalmology, Hangil Eye Hospital, Incheon, Republic of Korea
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - George A. Cioffi
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
| | - Jeffrey M. Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
| | - Carlos Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
| | - Emmanouil Tsamis
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
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Trivizki O, Varcheie M, Bello S, Raden I, Iyer P, Marquez M, Chaudhry A, Al-Dabbagh A, Gregori G, Rosenfeld PJ. Assessing Change in Exudative Age-Related Macular Degeneration With Macular Thickness Maps as a Surrogate Strategy for Remote Patient Monitoring. Am J Ophthalmol 2023; 256:1-8. [PMID: 37499893 PMCID: PMC10808271 DOI: 10.1016/j.ajo.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE To determine if macular thickness maps (MTMs) are sufficient to guide management of eyes with exudative age-related macular degeneration (eAMD), we compared the ability to detect change using MTMs with the ability to detect change using the entire optical coherence tomography (OCT) scan in patients undergoing therapy. DESIGN Retrospective, comparative diagnostic analysis. METHODS Patients with eAMD were imaged using macula-centered 6 × 6-mm OCT scans (CIRRUS HD-OCT 5000; Zeiss). In each case, graders were asked to determine if there were changes that warranted a full clinical assessment after viewing 2 consecutive scans using one of 3 different imaging strategies: MTMs alone, individual foveal-centered B scans alone, or 5 macular B scans including the foveal-centered B scan. Graders were told the 2 scans were taken 2 weeks apart. The consensus ground truth was reached by the graders using a CIRRUS review station to evaluate all the information contained within the OCT scans. RESULTS A total of 53 eyes were included in this study with 1385 imaging sessions. The Fleiss kappa was highest when graders were given MTMs alone compared with the ground truth. When the averages of all 5 graders were compared with the ground truth, the MTMs alone showed the highest level of agreement (90.05%, SD 0.78%) followed by the central B scans (87.87%, SD 1.59%) and the 5-B scan method (86.512%, SD 0.64%). CONCLUSION MTMs alone provide sufficient information to easily identify recurrent exudation in patients with eAMD, and these maps may be all that is needed for remote monitoring.
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Affiliation(s)
- Omer Trivizki
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (O.T., P.I., M.M., A.C., A.A.-D., G.G., P.J.R.), Miami, Florida, USA; Department of Ophthalmology, Tel Aviv Medical Center, University of Tel Aviv (O.T.), Tel Aviv, Israel
| | - Masha Varcheie
- Carl Zeiss Meditec, Inc. (M.V., S.B., I.R.), Dublin, California, USA
| | - Simon Bello
- Carl Zeiss Meditec, Inc. (M.V., S.B., I.R.), Dublin, California, USA
| | - Ian Raden
- Carl Zeiss Meditec, Inc. (M.V., S.B., I.R.), Dublin, California, USA
| | - Prashanth Iyer
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (O.T., P.I., M.M., A.C., A.A.-D., G.G., P.J.R.), Miami, Florida, USA
| | - Marlyn Marquez
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (O.T., P.I., M.M., A.C., A.A.-D., G.G., P.J.R.), Miami, Florida, USA
| | - Amina Chaudhry
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (O.T., P.I., M.M., A.C., A.A.-D., G.G., P.J.R.), Miami, Florida, USA
| | - Alaa Al-Dabbagh
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (O.T., P.I., M.M., A.C., A.A.-D., G.G., P.J.R.), Miami, Florida, USA
| | - Giovanni Gregori
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (O.T., P.I., M.M., A.C., A.A.-D., G.G., P.J.R.), Miami, Florida, USA
| | - Philip J Rosenfeld
- From the Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (O.T., P.I., M.M., A.C., A.A.-D., G.G., P.J.R.), Miami, Florida, USA.
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Hoshi K, Kunikata H, Aizawa N, Yasuda M, Okabe T, Takizawa H, Abe T, Nakazawa T. Baseline characteristics associated with the incidence of intraocular inflammation after the intravitreous injection of brolucizumab. Int Ophthalmol 2023; 43:4701-4709. [PMID: 38044420 DOI: 10.1007/s10792-023-02870-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/20/2023] [Indexed: 12/05/2023]
Abstract
PURPOSE To investigate baseline characteristics associated with the incidence of intraocular inflammation (IOI) after the intravitreal injection of brolucizumab (IVBr) for the treatment of neovascular age-related macular degeneration (nAMD). METHODS This retrospective study included 66 eyes of 62 consecutive patients with nAMD who received IVBr (18 eyes were treatment naïve and 48 eyes had switched from other anti-vascular endothelial growth factor [VEGF] therapy). Baseline clinical characteristics were compared in non-IOI and IOI groups. RESULTS Although a dry macula was achieved at a high rate even 6 months after IVBr, IOI occurred in 8 of 66 eyes (12.1%; all had switched therapy) during the study period. Baseline characteristics including age, sex, nAMD type, lens status, visual acuity, central macular thickness, and a history of diabetes did not differ between the groups. The number of previous anti-VEGF injections before IVBr was greater in the IOI group (P = 0.004), and the ratio of patients with a laser flare-cell photometry (LFCP) value over 15 photon count per millisecond (pc/ms) was higher in the IOI group (P = 0.017). Multivariate logistic regression analysis showed that a greater number of previous anti-VEGF injections (odds ratio [OR]: 1.12, P = 0.006; area under the curve: 0.82, cut-off score: 14.0) and an LFCP value over 15 pc/ms (OR: 81.6, P = 0.031) were significantly associated with the incidence of IOI after IVBr. CONCLUSION A number of previous anti-VEGF injections greater than 14 and an LFCP value more than 15 pc/ms might be useful predictors of the incidence of IOI after IVBr in eyes with nAMD.
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Affiliation(s)
- Keisuke Hoshi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan
| | - Hiroshi Kunikata
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan.
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Naoko Aizawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan
| | - Masayuki Yasuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan
| | - Tatsu Okabe
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan
| | - Hiroki Takizawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan
| | - Toshiaki Abe
- Division of Clinical Cell Therapy Center for Advanced Medical Research and Development, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, 980-8574, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Bommakanti N, Young BK, Johnson MW, Miller JML. Optical coherence tomography angular hyperreflectivity as an early sign in acute macular neuroretinopathy. Can J Ophthalmol 2023; 58:e272-e274. [PMID: 37545046 DOI: 10.1016/j.jcjo.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/12/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Nikhil Bommakanti
- W. K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Mich
| | - Benjamin K Young
- W. K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Mich.; Casey Eye Institute, Oregon Health and Science University, Portland, Ore
| | - Mark W Johnson
- W. K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Mich
| | - Jason M L Miller
- W. K. Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, Mich..
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Wu J, Lin C, Du Y, Fan SJ, Pan L, Pan Q, Cao K, Wang N. Macular thickness and its associated factors in a Chinese rural adult population: the Handan Eye Study. Br J Ophthalmol 2023; 107:1864-1872. [PMID: 36162970 DOI: 10.1136/bjo-2022-321766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/04/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE To describe the normal macular thickness and assess its associations. METHODS The Handan Eye Follow-up Study was conducted between 2012 and 2013. Macular thickness was scanned by spectral-domain optical coherence tomography (OCT). The built-in software generated a retinal thickness (RT) map, which was divided into three regions (central, internal and external regions) and nine quadrants (one in central and four in internal and external regions each). RESULTS For 5394 subjects in the Handan Eye Follow-up Study, 4793 received OCT examination, 2946 of whom (accounting for 61.46% of the total subjects, mean age 58.91±10.95, 55.6% were women) were included for analysis. The mean RT in central macula, inner and outer rings were (237.38 µm±23.05 µm), (309.77 µm±18.36 µm) and (278.29 µm±14.38 µm), respectively (overall difference, p<0.001). In inner ring, the RT in temporal was thinnest, followed by nasal, superior and inferior. In outer ring, the RT in superior was thinnest, with the next subfields being temporal, inferior and nasal, respectively. The RT in central macula, inner and outer rings were significantly thicker in men than in women. Multivariate linear regression analysis showed that in central macula, RT increased in subjects younger than 60 years and thinned above the age of 60. In inner and outer rings, RT thinned along with age (p<0.001). CONCLUSIONS This study finds that RT in central macula is the thinnest, followed by the outer ring, the RT in the inner ring is the thickest. Age and gender are related to RT. These associated factors need to be considered when explaining RT.
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Affiliation(s)
- Jian Wu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, Beijing, China
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, Stanford, California, USA
| | - Caixia Lin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, Beijing, China
| | - Yifan Du
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, Beijing, China
| | - Su Jie Fan
- Department of Ophthalmology, Handan City Eye Hospital, Handan, Hebei, China
| | - Lijie Pan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, Beijing, China
| | - Qing Pan
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, Beijing, China
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Lee SM, Kim KH, Kang HG, Choi EY, Lee J, Kim M. Vascular abnormalities in fellow eyes of patients with unilateral coats' disease. Sci Rep 2023; 13:19380. [PMID: 37938623 PMCID: PMC10632512 DOI: 10.1038/s41598-023-45838-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
Coats' disease is an idiopathic retinal vascular disorder, known to usually occur unilaterally; however, recent studies have highlighted vascular abnormalities in the fellow unaffected eyes. This retrospective study investigated the peripheral vascular features and macular vascular structure of unaffected fellow eyes in patients with unilateral Coats' disease using multimodal imaging tools. We analysed images of patients, including bilateral ultra-widefield imaging, fluorescein angiography (FA), ultra-widefield FA, or standard fundus photography. Available bilateral optical coherence tomography angiography (OCT-A) images were used for macular vascular structure analysis. OCT-A parameters, including foveal avascular zone (FAZ), perfusion index, and vessel density (VD) in the superficial and deep capillary plexuses (SCP, DCP), were calculated using Image J software. The mean age at diagnosis was 34.5 ± 17.9 years. The mean final best-corrected visual acuity of the affected eyes was logMAR 0.78 ± 0.79, while that of the fellow eyes was logMAR 0.04 ± 0.12. Ten fellow eyes had microaneurysms (47.6%), two had tortuous vessel abnormalities (9.5%), and 11(52.4%) had abnormal vascular findings on FA. Although there was a trend towards larger DCP FAZ (1.201 ± 0.086 vs. 1.072 ± 0.226), and lower DCP VD (8.593 ± 1.583 vs. 10.827 ± 3.392) in the affected eyes as measured by the Cirrus machine, the difference was not statistically significant between affected and fellow eyes when measured using the Zeiss Cirrus machine (P = 0.686, P = 0.343, respectively). However, when measured with the Spectralis machine, DCP FAZ was larger in affected eyes (0.828 ± 0.426 vs. 0.254 ± 0.092, P = 0.002) and DCP VD was lower in affected eyes (6.901 ± 2.634 vs. 17.451 ± 7.207, P = 0.002) compared to the fellow eyes, while other parameters showed no significant variations. These findings indicate that there may be subtle vascular abnormalities primarily located in the peripheral regions of the unaffected fellow eyes in patients with unilateral Coats' disease, while the macular microvasculature remains unaffected.
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Affiliation(s)
- Seung Min Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Kang Hyun Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Hyun Goo Kang
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-gu, Seoul, Republic of Korea
| | - Eun Young Choi
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Junwon Lee
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Min Kim
- Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 06273, Republic of Korea.
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Totsuka K, Aoki S, Arai T, Kitamoto K, Azuma K, Fujino R, Inoue T, Obata R. Longitudinal anatomical and visual outcome of macular telangiectasia type 2 in Asian patients. Sci Rep 2023; 13:18954. [PMID: 37919473 PMCID: PMC10622519 DOI: 10.1038/s41598-023-46394-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/31/2023] [Indexed: 11/04/2023] Open
Abstract
Limited information regarding the anatomical and visual prognosis of macular telangiectasia (MacTel) type 2 in the Asian population is currently available. Herein, we conducted a retrospective longitudinal analysis of Japanese patients diagnosed with MacTel type 2. Disease progression was evaluated using the Simple MacTel Classification developed by Chew EY et al. in 2023, and its association with visual changes was analyzed. Sixteen eyes of eight Japanese patients were included in the study, with an average follow-up period of 8.2 ± 3.9 years (range, 2.2-14.0). At the initial visit, 7 (44%) and 5 (31%) eyes were classified as Grade 2 (central ellipsoid zone break) and Grade 3 (noncentral pigment), respectively. The proportion of eyes that progressed by 1 or 2-steps in grade after 1, 3, 5, 8, and 12 years was 0%, 14%, 43%, 70%, and 100%, or 0%, 7%, 7%, 30%, and 75%, respectively. The visual acuity significantly deteriorated during the follow-up period, particularly in the two eyes with full-thickness macular holes (FTMH). Three out of 7 patients exhibited low serum serine concentrations, although no apparent correlation with anatomical or visual outcomes was observed. Overall, this cohort demonstrated chronic disease progression, both anatomically and functionally, in eyes with MacTel type 2, with FTMH potentially associated with greater visual loss.
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Affiliation(s)
- Kiyoto Totsuka
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Shuichiro Aoki
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Takahiro Arai
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Kodai Kitamoto
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Keiko Azuma
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Ryosuke Fujino
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
- Department of Ophthalmology and Micro-Technology, Yokohama City University, 4-57 Urafune, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Ryo Obata
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
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Tozzi L, Gius I, Greggio A, Meduri A, De Salvo G, Parolini B, Frisina R. Case Report: Spontaneous Closure of Idiopathic Full-thickness Macular Hole and Early Development of Lamellar Hole. Optom Vis Sci 2023; 100:804-809. [PMID: 37678581 DOI: 10.1097/opx.0000000000002070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
SIGNIFICANCE Spontaneous closure of an idiopathic full-thickness macular hole (FTMH) is a rare event. The underlying mechanisms are unclear because of the difficulty in detecting subtle structural changes even with serial imaging. Previous reports are largely optical coherence tomography (OCT) based, but multimodal imaging could highlight new information. PURPOSE This study aimed to report the spontaneous closure of an idiopathic FTMH (iFTMH) and its recurrence and late closure documented by serial OCT integrated with multimodal imaging modalities and microperimetry (MP). CASE REPORT A healthy 46-year-old man was referred to the Department of Ophthalmology of the University of Padova for an iFTMH in the right eye with preserved visual acuity. The patient was scheduled for monthly controls up to 12 months by an integrated assessment of OCT, angiography-OCT, short-wavelength fundus autofluorescence, and MP. Two months later, tracked OCT scans showed a closure of the hole with a residual lamellar macular hole. Sequential examinations revealed a discontinuation of photoreceptors (ellipsoid zone) and a recurrence of iFTMH, and 7 months later, iFTMH reclosed without any relevant changes up to 12 months. Foveal avascular zone area increased from the baseline reaching its maximum value when iFTMH recurred. Two hyper-fundus autofluorescence points were detected in the foveal area, one progressively decreased and one reached the most intense signal when iFTMH recurred. Retinal sensitivity decreased mostly in one hyper-fundus autofluorescence point when the ellipsoid zone line discontinued and reached the lowest value when iFTMH recurred, and increased mostly in the other points when iFTMH reclosed. CONCLUSIONS Spontaneous iFTMH closure, as well as its recurrence and reclosure, is a rare event. By monitoring with multiple imaging modalities, MP and their overlaying elaboration can add new biomarkers with diagnostic and prognostic value.
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Affiliation(s)
| | - Irene Gius
- Department of Ophthalmology of University of Padova, Padova, Italy
| | - Angelo Greggio
- Department of Ophthalmology of University of Padova, Padova, Italy
| | - Alessandro Meduri
- Department of Biomedical Sciences, Eye Clinic, University of Messina, Messina, Italy
| | - Gabriella De Salvo
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - Rino Frisina
- Department of Ophthalmology of Guglielmo da Saliceto Hospital of Piacenza, Piacenza, Italy
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