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Salcedo-Ledesma A, Ledesma-Gil G, Spaide RF. DESCRIBING THE LOCATION AND MORPHOLOGY OF THE DOTS IN WHITE DOT FOVEA USING ADAPTIVE OPTICS. Retin Cases Brief Rep 2024; 18:275-278. [PMID: 36657154 DOI: 10.1097/icb.0000000000001403] [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: 06/17/2023]
Abstract
PURPOSE To characterize the white dots in white dot fovea, an entity chiefly described in Japan, using adaptive optics imaging and propose a hypothesis regarding their origin. METHOD The patient underwent comprehensive ophthalmic examination, including color and green monochromatic fundus photography, fluorescein angiography, spectral-domain optical coherence tomography, and adaptive optics imaging. RESULTS An asymptomatic 66-year-old Korean woman presented with bilateral white, glistening deposits in a ring pattern around the fovea of both eyes. The dots were highly reflective on green monochromatic images, were not visible on fluorescein angiography, and appeared hyperreflective in the inner retina using spectral-domain optical coherence tomography. Adaptive optics showed polygonal granules ranging from 1 to 10 μ m in size. The patient denied any systemic disorder or the use of any medications related to crystalline retinopathy. The patient had lived in Japan for 35 years before just moving to the United States. CONCLUSION The location, small size, and polygonal shape of the dots in white dot fovea are suggestive of intraretinal deposition of crystals, and not cells on the surface of the fovea as has been previously proposed. Carotenoid deposition related to dietary habits is a plausible cause because of the similarity to other retinopathies associated to these compounds.
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Schopp MJ, Strzalkowski P, Dithmar S. SUBFOVEAL CHOROIDAL TUBERCULOMA IN A HEALTHY YOUNG WOMAN CAUSED BY MYCOBACTERIUM BOVIS. Retin Cases Brief Rep 2024; 18:323-327. [PMID: 36800533 DOI: 10.1097/icb.0000000000001377] [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: 12/31/2021] [Accepted: 11/01/2022] [Indexed: 02/19/2023]
Abstract
PURPOSE To describe a case of a macular tuberculoma in a young and healthy woman after developing a tuberculous lymphadenitis caused by Mycobacterium bovis . METHODS Retrospective case report. RESULTS Tuberculous lymphadenitis caused by M. bovis was detected after biopsy and histological examination as well as polymerase chain reaction test testing of cervical lymph nodes in a 20-year-old patient. An interferon gamma was positive. Shortly starting antitubercular therapy, the patient developed visual deterioration caused by a single yellowish subretinal structure in the macula of the right eye. Optical coherence tomography showed a dome-shaped, hyperreflective, subfoveal choroidal lesion with subtle subretinal fluid. Antitubercular therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide was performed, and the deescalation therapy with isoniazid and rifampicin was extended to 7 months. Further examinations showed regression of choroidal tuberculoma to a scar. CONCLUSION This is the first reported case of choroidal tuberculoma after tuberculous lymphadenitis caused by M. bovis .
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Affiliation(s)
- Maya J Schopp
- Department of Ophthalmology, Helios HSK, Wiesbaden, Germany
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El-Sehemy A, Martins Melo I, Pecaku A, Zajner C, Naidu S, Motekalem Y, Muni RH. POSTOPERATIVE PHOTORECEPTOR INTEGRITY AND ANATOMICAL OUTCOMES BASED ON PRESENTING MORPHOLOGIC STAGE OF RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2024; 44:756-763. [PMID: 38207330 DOI: 10.1097/iae.0000000000004034] [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: 01/13/2024]
Abstract
PURPOSE To evaluate outer retinal recovery on postoperative optical coherence tomography (OCT) based on presenting morphologic stage of rhegmatogenous retinal detachment (RRD). METHODS Retrospective cohort of consecutive primary fovea-involving RRDs, referred from January 2012 to September 2022. Baseline OCTs were assessed for morphologic stage of RRD. Postoperative OCT scans were graded at 3, 6, and 12 months for external limiting membrane, ellipsoid zone and interdigitation zone discontinuity, epiretinal membrane formation and severity, and residual subfoveal fluid. RESULTS Three hundred and fifty-one patients were included. Increasing baseline morphologic stage of RRD was significantly associated with external limiting membrane, ellipsoid zone, and interdigitation zone discontinuity at all time points postoperatively ( P < 0.001) and was shown to be an independent predictor of foveal photoreceptor integrity after adjusting for height of detachment, time to surgery, and duration of fovea involvement ( P < 0.001). Earlier stages were associated with residual subfoveal fluid ( P < 0.001). There was no association between the stages of RRD and epiretinal membrane severity. However, late stages presented with earlier development of epiretinal membrane ( P = 0.012). CONCLUSION Increasing morphologic stage of RRD is associated with delayed recovery of outer retinal bands in the first year and faster development of epiretinal membrane after RRD repair. The results of this study suggest that the stages may serve as a prognostic biomarker for postoperative photoreceptor recovery.
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Affiliation(s)
- Ahmed El-Sehemy
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Isabela Martins Melo
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Aurora Pecaku
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Chris Zajner
- Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada ; and
| | - Sumana Naidu
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Yasmin Motekalem
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rajeev H Muni
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Institute, Toronto, Ontario, Canada
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Sardana A, Singh K, Singh A, Singh VK. Optical coherence tomography biomarkers DROL, PROS, SND, hyperreflective walls of foveal cystoid spaces as predictors of central macular thickness and visual acuity in diabetic macular edema treated with intravitreal ranibizumab. Indian J Ophthalmol 2024; 72:722-727. [PMID: 38648434 DOI: 10.4103/ijo.ijo_903_23] [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: 04/06/2023] [Accepted: 10/28/2023] [Indexed: 04/25/2024] Open
Abstract
PURPOSE This study aims to establish DROL (disruption of retinal outer layers), PROS (photoreceptor outer segment length), SND (subfoveal neuroretinal detachment), and hyperreflective walls of foveal cystoid spaces (HRW) as optical coherence tomography (OCT) biomarkers and predictors of central macular thickness (CMT) and visual acuity in diabetic macular edema (DME) treated with intravitreal ranibizumab (IVR). METHODS In this prospective, interventional study performed at a tertiary care center over a span of 1 year from December 2021 to December 2022, 50 eyes of 46 patients of DME were included. Visual acuity and spectral domain OCT imaging were performed at baseline. Using inbuilt calipers on SD-OCT, the horizontal extent of DROL and the vertical extent of PROS were measured manually. SND and HRW were assessed qualitatively. IVR was administered and patients were followed up at 4, 8, and 12 weeks. RESULTS The eyes without DROL had statistically significant (P < 0.05) lesser CMT and better BCVA (best-corrected visual acuity) (P < 0.05) after pro re nata injection of IVR. There was a positive correlation between the extent of baseline DROL with final CMT (P < 0.05) and final logMAR BCVA (P > 0.05), whereas negative correlation with the extent of baseline PROS with final CMT (P < 0.05) and final logMAR BCVA (P > 0.05). The presence of HRW and SND predicted non-resolution of CMT and worse visual acuity after treatment with IVR in DME. CONCLUSION DROL, PROS, SND, and hyperreflective walls of foveal cystoid spaces may be utilized as qualitative as well as quantitative biomarkers to predict the post-treatment CMT and visual acuity in DME.
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Affiliation(s)
- Ayushi Sardana
- Department of Ophthalmology, Regional Institute of Ophthalmology, M.L.N. Medical College, Prayagraj, Uttar Pradesh, India
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Cicinelli MV, Barlocci E, Giuffrè C, Rissotto F, Introini U, Bandello F. Integrating Machine Learning and Traditional Survival Analysis to Identify Key Predictors of Foveal Involvement in Geographic Atrophy. Invest Ophthalmol Vis Sci 2024; 65:10. [PMID: 38709525 PMCID: PMC11078169 DOI: 10.1167/iovs.65.5.10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/17/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose The purpose of this study was to investigate the incidence of foveal involvement in geographic atrophy (GA) secondary to age-related macular degeneration (AMD), using machine learning to assess the importance of risk factors. Methods Retrospective, longitudinal cohort study. Patients diagnosed with foveal-sparing GA, having GA size ≥ 0.049 mm² and follow-up ≥ 6 months, were included. Baseline GA area, distance from the fovea, and perilesional patterns were measured using fundus autofluorescence. Optical coherence tomography assessed foveal involvement, structural biomarkers, and outer retinal layers thickness. Onset of foveal involvement was recorded. Foveal survival rates were estimated using Kaplan-Meier curves. Hazard ratios (HRs) were assessed with mixed model Cox regression. Variable Importance (VIMP) was ranked with Random Survival Forests (RSF), with higher scores indicating greater predictive significance. Results One hundred sixty-seven eyes (115 patients, average age = 75.8 ± 9.47 years) with mean follow-up of 50 ± 29 months, were included in this study. Median foveal survival time was 45 months (95% confidence interval [CI] = 38-55). Incidences of foveal involvement were 26% at 24 months and 67% at 60 months. Risk factors were GA proximity to the fovea (HR = 0.97 per 10-µm increase, 95% CI = 0.96-0.98), worse baseline visual acuity (HR = 1.37 per 0.1 LogMAR increase, 95% CI = 1.21-1.53), and thinner outer nuclear layer (HR = 0.59 per 10-µm increase, 95% CI = 0.46-0.74). RSF analysis confirmed these as main predictors (VIMP = 16.7, P = 0.002; VIMP = 6.2, P = 0.003; and VIMP = 3.4, P = 0.01). Lesser baseline GA area (HR = 1.09 per 1-mm2 increase, 95% CI = 1.01-1.16) and presence of a double layer sign (HR = 0.42, 95% CI = 0.20-0.88) were protective but less influential. Conclusions This study identifies anatomic and functional factors impacting the risk of foveal involvement in GA. These findings may help identify at-risk patients, enabling tailored preventive strategies.
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Affiliation(s)
- Maria Vittoria Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- https://orcid.org/0000-0003-2938-0409
| | - Eugenio Barlocci
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Giuffrè
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federico Rissotto
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Ugo Introini
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Yii F, Bernabeu MO, Dhillon B, Strang N, MacGillivray T. Retinal Changes From Hyperopia to Myopia: Not All Diopters Are Created Equal. Invest Ophthalmol Vis Sci 2024; 65:25. [PMID: 38758640 DOI: 10.1167/iovs.65.5.25] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
Purpose To quantitatively characterize retinal changes across different quantiles of refractive error in 34,414 normal eyes of 23,064 healthy adults in the UK Biobank. Methods Twelve optic disc (OD), foveal and vascular parameters were derived from color fundus photographs, correcting for ocular magnification as appropriate. Quantile regression was used to test the independent associations between these parameters and spherical equivalent refraction (SER) across 34 refractive quantiles (high hyperopia to high myopia)-controlling for age, sex and corneal radius. Results More negative SER was nonlinearly associated with greater Euclidian (largely horizontal) OD-fovea distance, larger OD, less circular OD, more obliquely orientated OD (superior pole tilted towards the fovea), brighter fovea, lower vascular complexity, less tortuous vessels, more concave (straightened out towards the fovea) papillomacular arterial/venous arcade and wider central retinal arterioles/venules. In myopia, these parameters varied more strongly with SER as myopia increased. For example, while every standard deviation (SD) decrease in vascular complexity was associated with 0.63 D (right eye: 95% confidence interval [CI], 0.58-0.68) to 0.68 D (left eye: 95% CI, 0.63-0.73) higher myopia in the quantile corresponding to -0.60 D, it was associated with 1.61 D (right eye: 95% CI, 1.40-1.82) to 1.70 D (left eye: 95% CI, 1.56-1.84) higher myopia in the most myopic quantile. OD-fovea angle (degree of vertical separation between OD and fovea) was found to vary linearly with SER, but the magnitude was of little practical importance (less than 0.10 D variation per SD change in angle in almost all refractive quantiles) compared with the changes in OD-fovea distance. Conclusions Several interrelated retinal changes indicative of an increasing (nonconstant) rate of mechanical stretching are evident at the posterior pole as myopia increases. These changes also suggest that the posterior pole stretches predominantly in the temporal horizontal direction.
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Affiliation(s)
- Fabian Yii
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
| | - Miguel O Bernabeu
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- The Bayes Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
- Princess Alexandra Eye Pavilion, Edinburgh, United Kingdom
| | - Niall Strang
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Tom MacGillivray
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
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Sukkarieh G, Lejoyeux R, Bonnin S, Tadayoni R. Update on the grading of foveal hypoplasia. Int Ophthalmol 2024; 44:197. [PMID: 38662268 DOI: 10.1007/s10792-024-03129-2] [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: 06/22/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Affiliation(s)
| | | | - Sophie Bonnin
- Rothschild Foundation Hospital, 75019, Paris, France
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Azevedo LS, Alvarez MAM, Botelho GIS, Rosa AAM, Souza GS. Genetic, morphological and electrophysiological findings in a patient with a rare pathogenic variant in the RS1 gene. Doc Ophthalmol 2024; 148:65-71. [PMID: 38172268 DOI: 10.1007/s10633-023-09959-2] [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: 04/04/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE In this study, we report a case of a young adult with X-linked juvenile retinoschisis (XLRS) with a rare pathogenic variant in the RS1 gene (c.522 + 2 T > A). METHODS Ophthalmological evaluation, optical coherence tomography, full-field and multifocal electroretinograms and extensive genetic screening of genes related to visual loss were carried out in the participant. RESULTS Clinical ophthalmological exams revealed a mild to moderate impairment of visual acuity. Retinal imaging showed bilateral foveal schisis, as well as normal a-wave, reduction in the b-wave amplitudes in dark- and light- adapted full-field electroretinograms, and abnormal oscillatory potentials. We found also diffuse amplitude reduction in multifocal electroretinogram arrays. A canonical splice variant was identified in the RS1 gene (c.522 + 2 T > A). CONCLUSION A rare pathogenic variant of the RS1 gene was associated with diffuse retinal involvement (central and peripheral retina), probably in inner retina, and mild to moderate visual acuity impairment. The phenotypical characterization of rare mutations is relevant to provide information about the disease.
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Affiliation(s)
- Lorrana Souza Azevedo
- Instituto de Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Pará, Belém, Brazil
| | | | | | - Alexandre Antônio Marques Rosa
- Instituto de Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Pará, Belém, Brazil
- Clínica Oftalmológica RetinaPro, Belém, Brazil
| | - Givago Silva Souza
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Av Generalíssimo Deodoro, 92, Umarizal, Belém, Pará, 66055240, Brazil.
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Yang X, Wu X, Qi B, Zhang K, Yu Y, Wang X, Feng X, Jia Q, Jin ZB, Liu W. Foveal Microstructure and Visual Outcomes after Pars Plana Vitrectomy in Patients with Different Types of Epiretinal Membrane Foveoschisis. Ophthalmic Res 2024; 67:137-144. [PMID: 38246146 DOI: 10.1159/000536206] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 01/07/2024] [Indexed: 01/23/2024]
Abstract
INTRODUCTION The aim of this study was to evaluate the clinical characteristics and surgical outcomes of the epiretinal membrane foveoschisis (ERM-FS) with different morphological types. METHODS This retrospective observational study reviewed 44 consecutive ERM-FS patients who underwent ERM surgery. According to the optical coherence tomography images, ERM-FS was classified into three groups: group A, FS crossed the fovea with the foveola elevated; group B, FS located at the foveal edges with a near-normal central foveal point thickness; and group C, FS with undermined foveal edges with a near-normal central foveal point thickness. RESULTS There were 10 eyes in group A, 20 eyes in group B, and 14 eyes in group C. Preoperatively, eyes in group A had the best best-corrected visual acuity (BCVA), the thickest central foveal point thickness, and the highest ellipsoid zone (EZ) intact rate among the three groups. After surgery, a resolution of foveoschisis was observed in 40.0%, 45.0%, and 50.0% of the eyes in group A, group B, and group C (p = 0.928), respectively. BCVA was significantly improved postoperatively. Although there was no significant difference in BCVA among the three groups at 1 month postoperatively, BCVA of group A was the best at 4 and 10 months. Correlation analysis indicated that the type of ERM-FS, baseline BCVA, central foveal point thickness, and postoperative EZ continuity (all p < 0.05) were important factors for the final BCVA. CONCLUSIONS The damage to the retinal structure and visual function was milder in group A ERM-FS. Our study emphasized the necessity of OCT-based subtyping in patients with ERM-FS.
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Affiliation(s)
- Xiaohan Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Xijin Wu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Biying Qi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Ke Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Yanping Yu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Xinbo Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Xiao Feng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Qinlang Jia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wu Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
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Agrawal S, Ramanjulu R. Foveal Pseudoduplication in a Young Male Patient. JAMA Ophthalmol 2024; 142:e234703. [PMID: 38236266 DOI: 10.1001/jamaophthalmol.2023.4703] [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: 01/19/2024]
Abstract
This case report describes a diagnosis of pseudofovea found on examination in an otherwise asymptomatic young male patient.
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Gokmen O, Ozgur G. Effects of COVID-19 infection on retinal vascular density and choroidal thickness measured by optical coherence tomography angiography. Photodiagnosis Photodyn Ther 2023; 44:103859. [PMID: 37871811 DOI: 10.1016/j.pdpdt.2023.103859] [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: 07/18/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023]
Abstract
AIM The present study evaluates the possible effects of COVID-19 on choroid thickness, the Foveal Avascular Zone (FAZ) and retinal vascular indices in the same individuals who had Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) data prior to the COVID-19 pandemic. METHODS The OCT and OCTA images of the same individuals with no known ophthalmic pathology who developed a COVID-19 infection were obtained were retrieved retrospectively from the database and compared with the repeated images of OCT and OCTA images 1-2 months after COVID-19 infection. RESULTS Eighty eyes of 40 patients (26 female [65%], 14 male [35%]) who had developed a prior Covid-19 infection were included in the study. When comparing the measurements of the same participants before and after Covid-19 infection, no significant difference was detected in the mean average choroidal thicknesses (p=0.998), average superficial (p=0.425) and deep (p=0.333) retinal vascular densities, and superficial (p=0.991) and deep (p=0.075) FAZ measurements. CONCLUSIONS No significant effect of COVID-19 on choroid thickness, FAZ or retinal vascular densities was noted in the present study, although there are some studies in literature with equivocal results.
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Affiliation(s)
- Onur Gokmen
- Department of Ophthalmology Van, Yuzuncu Yil University Dursun Odabasi Tip Merkezi - Van, Bardakcı Mah. Kampus, Turkey.
| | - Gokhan Ozgur
- Department of Ophthalmology Samsun, Health Sciences University Samsun Training and Research Hospital, Turkey
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Qi B, Yu Y, Yang X, Zhang K, Wu X, Wang X, Feng X, Jia Q, Liu W. Photoreceptor Outer Segment Loss at the Macular Hole Border: Clinical Characteristics and Surgical Prognosis. Ophthalmic Res 2023; 66:1335-1341. [PMID: 37926088 PMCID: PMC10668620 DOI: 10.1159/000534576] [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: 04/12/2023] [Accepted: 10/09/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION During macular hole (MH) formation, the vitreofoveal traction may lead to foveal neural tissue avulsion and consequent photoreceptor loss. However, the clinical significance of the photoreceptor outer segment disruption at the MH border remains unclear. This study aims to investigate the clinical features and surgical outcomes of MHs with photoreceptor outer segment disruption at the MH border. METHODS This study retrospectively reviewed 86 eyes from 85 patients who underwent vitrectomy combined with internal limiting membrane peeling for idiopathic MHs. Baseline and postoperative best-corrected visual acuity (BCVA) and foveal microstructure on optical coherence tomography images were compared between eyes with smooth and bumpy morphology, the latter of which was defined as those with an uneven and irregular surface with evident lumps and indentations at the MH border. RESULTS The bumpy morphology was identified in 59 of 86 eyes (68.9%). At baseline, eyes with a bumpy MH morphology had a significantly larger minimum linear diameter (p = 0.043), a longer external limiting membrane defect (p = 0.013), and a worse baseline BCVA (p = 0.017) than those with a smooth morphology. Postoperatively, in a multivariate regression model adjusting preoperative confounding effects, eyes with bumpy borders were associated with a longer ellipsoid zone defect (p = 0.006) and a thinner central fovea (p = 0.002) at 1 month, and a thinner central fovea (p = 0.005) and a worse BCVA (p = 0.015) at 10 months. CONCLUSION A severe photoreceptor outer segment loss is common at the MH border, which represents a chronic pathogenic process and may be an independent predictor for an incomplete photoreceptor recovery and worse long-term visual outcomes after surgery.
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Affiliation(s)
- Biying Qi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Yanping Yu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Xiaohan Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Ke Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Xijin Wu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Xinbo Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Xiao Feng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Qinlang Jia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
| | - Wu Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Capital Medical University, Beijing, China
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Oliveira AVAD, Porto JSP, Aguiar LP, Bastos ALCDM. 360-degree pedicled inverted internal limiting membrane flap technique without face-down posturing for large idiopathic macular holes: a retrospective case series. Arq Bras Oftalmol 2023; 87:e20220252. [PMID: 37851742 DOI: 10.5935/0004-2749.2022-0252] [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: 07/27/2022] [Accepted: 12/15/2022] [Indexed: 04/03/2023] Open
Abstract
PURPOSE This study aimed to determine closure rates of large idiopathic macular holes treated with pars plana vitrectomy and 360-degree pedicled inverted internal limiting membrane flap without face-down posturing and define visual improvement, types of macular hole closure, and external retina integrity as secondary outcomes. METHODS This retrospective case series analyzed all patients who were treated by vitrectomy, 360-degree pedicled inverted internal limiting membrane flap, and gas tamponade, without face-down posturing postoperatively. Age, sex, time of visual acuity reduction, other ocular pathologies, and lens status were collected. The best-corrected visual acuity and optical coherence tomography results were recorded during pre- and postoperative follow-up examinations (15 days and 2 months after surgery). RESULTS This study enrolled 20 eyes of 19 patients, and the mean age was 66 years. Optical coherence tomography performed 2 months after surgery revealed hole closure in 19 (95%) eyes. The median best-corrected visual acuity improved from +1.08 preoperatively to +0.66 LogMAR 2 months postoperatively (p<0.001), with a median of 20 letters of visual improvement (0.4 LogMAR) on the Early Treatment Diabetic Retinopathy Study chart. V (47.36%)- and U (52.63%)-types of closure were observed. CONCLUSION The 360-degree pedicled inverted internal limiting membrane flap technique, without face-down posturing, provided a high closure rate (95%), external layer recovery, and V- and U-type foveal closure contours, in addition to visual improvement in most cases of large macular holes (even macular holes >650 μm). This technique may be a viable alternative to patients in whom traditional postoperative face-down positioning for large macular hole treatment is not possible.
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Affiliation(s)
| | | | - Levy Paz Aguiar
- Department of Ophthalmology, Hospital Humberto de Castro Lima, Salvador, BA, Brazil
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14
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Hoyek S, da Cruz NFS, Sengillo J, Patel NA, Eliott D, Berrocal AM. Concurrent Foveoschisis and Atrophy in a Patient With X-Linked Retinoschisis and Type 1 Diabetes Mellitus. Ophthalmic Surg Lasers Imaging Retina 2023; 54:603-606. [PMID: 37847164 DOI: 10.3928/23258160-20230915-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
We report the case of a 28-year-old man with X-linked retinoschisis (XLRS) and type I diabetes mellitus. The patient had bilateral foveoschisis with a tractional retinal fold in the right eye. Optical coherence tomography (OCT) revealed hyperreflective material within the inner nuclear and outer plexiform layers, photoreceptor atrophy, and retinal pigment epithelium irregularities in both eyes. Fluorescein angiography showed hyperfluorescent foveal spots corresponding to the hyperreflective material observed on OCT. This is a unique presentation of XLRS, with concurrent foveoschisis and photoreceptor atrophy in both eyes. The hyperreflective material on OCT serves as a distinctive feature of XLRS. [Ophthalmic Surg Lasers Imaging Retina 2023;54:603-606.].
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Kuht HJ, Thomas MG, McLean RJ, Sheth V, Proudlock FA, Gottlob I. Abnormal foveal morphology in carriers of oculocutaneous albinism. Br J Ophthalmol 2023; 107:1202-1208. [PMID: 35379600 PMCID: PMC10359511 DOI: 10.1136/bjophthalmol-2020-318192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 10/16/2020] [Accepted: 03/18/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND/AIMS To investigate the foveal morphology in carriers of oculocutaneous albinism (OCA) using spectral domain optical coherence tomography (SD-OCT). A cross-sectional, observational study. METHODS Handheld SD-OCT (Envisu C2300) was used to acquire horizontal scans through the centre of the fovea in biological parents of patients with OCA (n=28; mean age±SD=40.43±8.07 years) and age-matched and ethnicity-matched controls (n=28; mean age±SD=38.04±10.27 years). Sequence analysis was performed for variants in known genes associated with OCA. Best-corrected visual acuity (BCVA), presence of foveal hypoplasia and grade, foveal, parafoveal and perifoveal thickness measurements of total retinal layers (TRL), inner retinal layers (IRL) and outer retinal layers (ORL) thickness were measured. RESULTS Foveal hypoplasia was identified in 32.14% of OCA carriers; grade 1 in all cases. OCA carriers demonstrated significant thicker TRL thickness (median difference: 13.46 µm, p=0.009) and IRL thickness (mean difference: 8.98 µm, p<0.001) at the central fovea compared with controls. BCVA of carriers was between -0.16 and 0.18 logMAR (mean: 0.0 logMAR). No significant differences in BCVA was noted between OCA carriers or controls (p=0.83). In the OCA carriers, we identified previously reported pathogenic variants in TYR, OCA2 and SLC45A2, novel OCA2 variants (n=3) and heterozygosity of the pathogenic TYR haplotype. CONCLUSION We have, for the first time, identified foveal abnormalities in OCA carriers. This provides clinical value, particularly in cases where limited phenotype data are available. Our findings raise the possibility that previously reported mild cases of foveal hypoplasia or isolated foveal hypoplasia could correspond to OCA carrier status.
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Affiliation(s)
- Helen J Kuht
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Mervyn G Thomas
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Rebecca J McLean
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Viral Sheth
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Frank A Proudlock
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Irene Gottlob
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
- Cooper Medical School of Rowan University, Cooper Neurological Institute, Camden, New Jersey, USA
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16
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Venkatesh R, Mishra P, Nahata H, Reddy NG, Yadav NK, Chhablani J. Retinal arcades in posterior microphthalmos: biometric correlation. Clin Exp Optom 2023; 106:619-625. [PMID: 35878881 DOI: 10.1080/08164622.2022.2104628] [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: 01/12/2022] [Revised: 07/02/2022] [Accepted: 07/17/2022] [Indexed: 10/16/2022] Open
Abstract
CLINICAL RELEVANCE Posterior microphthalmos (PM) is a rare developmental disorder characterised by high hyperopia, short axial length, presence of retinal papillomacular fold and relatively normal anterior segment findings. BACKGROUND The purpose of the study was to compare the retinal arcade distance from fovea between PM cases and to correlate axial shortening in PM eyes with imaging findings. METHODS This retrospective, comparative case series included 24 eyes of 12 patients with PM as cases and an equal number of age- and sex-matched controls. Retinal findings on optical coherence tomography (OCT), OCT-angiography, Multicolour® image, axial length and corneal biometry were computed, compared and correlated between two groups. RESULTS Retinal papillomacular fold was noted in all 24 PM eyes. Retinal arcade narrowing was noted in PM (p < 0.001). The central retina (p < 0.001) and choroid (p = 0.003) was thick in PM. Corneal biometry showed shorter axial length (p < 0.001), high keratometry readings (p < 0.001) and small corneal diameters (p = 0.011) in PM. Vessel density (p = 0.031) on OCTA was denser and foveal avascular zone area (p = 0.033) reduced in PM. Strong negative correlation of axial length with spherical equivalent (r = > -0.804;p < 0.001), vessel density (r = > -0.803; p = <0.001) and K1 (r = > -0.76; p < 0.001) and K2 (r = > -0.67; p = 0.001) keratometry readings was noted in PM. Significant positive correlation was noted between axial length and anterior chamber depth (r = 0.75; p < 0.001), foveal avascular zone area (r = 0.56; p = 0.033) and corneal diameter (r = 0.65; p = 0.001). Vessel density on OCT-angiography correlated positively with central corneal thickness (r = 0.552;p = 0.005) and corneal powers K1 (r = 0.709; p = 0.001) and K2 (r = 0.56; p = 0.004) and negatively with corneal diameter (r = > -0.521; p = 0.033). CONCLUSION Increased choroidal thickening and retinal vascular arcade narrowing were two important, interesting observations noted with PM. Intercorrelation between the axial length, OCT, OCT-angiography and corneal biometry helped in understanding the pathogenesis and the structural and vascular changes in PM eyes.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Karnataka, India
| | - Pranjal Mishra
- Department of Retina and Vitreous, Narayana Nethralaya, Karnataka, India
| | - Harshita Nahata
- Department of Retina and Vitreous, Narayana Nethralaya, Karnataka, India
| | | | - Naresh Kumar Yadav
- Department of Retina and Vitreous, Narayana Nethralaya, Karnataka, India
| | - Jay Chhablani
- Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, Pittsburg, PA, USA
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Moraes RT, Vianna RNG, Cunha de Souza E, Moraes LS. CLINICAL VARIANTS OF PRESUMED ACUTE FOVEALITIS. Retin Cases Brief Rep 2022; 16:754-758. [PMID: 33165300 DOI: 10.1097/icb.0000000000001080] [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: 06/11/2023]
Abstract
PURPOSE To describe four eyes of three patients with presumed acute fovealitis to expand the clinical variants of this recently described disorder. METHOD The patients underwent a comprehensive ophthalmic examination, including multimodal imaging and electrophysiological tests. RESULTS Three female patients aged from 18 to 24 years presented sudden central visual disturbances in one or both eyes. The visual acuity ranged from 20/25 to 20/70 in the affected eyes. All of them showed a subtle yellowish lesion in the foveola. Fundus autofluorescence and fluorescein angiography were unremarkable. Optical coherence tomography disclosed focal disarrangement of the outer retinal layers restricted to the fovea and hyperreflective lesions above the external limiting membrane. Multifocal electroretinography responses were attenuated. The electrooculogram response was normal. All patients recovered normal visual acuity and the outer retinal layers. CONCLUSION Attenuated multifocal electroretinography foveal response and normal electrooculogram are newly described clinical findings in patients with acute fovealitis.
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18
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Patterson EJ, Kalitzeos A, Kane TM, Singh N, Kreis J, Pennesi ME, Hardcastle AJ, Neitz J, Neitz M, Michaelides M, Carroll J. Foveal Cone Structure in Patients With Blue Cone Monochromacy. Invest Ophthalmol Vis Sci 2022; 63:23. [PMID: 36301530 PMCID: PMC9624264 DOI: 10.1167/iovs.63.11.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 09/22/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Blue cone monochromacy (BCM) is a rare inherited cone disorder in which both long- (L-) and middle- (M-) wavelength sensitive cone classes are either impaired or nonfunctional. Assessing genotype-phenotype relationships in BCM can improve our understanding of retinal development in the absence of functional L- and M-cones. Here we examined foveal cone structure in patients with genetically-confirmed BCM, using adaptive optics scanning light ophthalmoscopy (AOSLO). Methods Twenty-three male patients (aged 6-75 years) with genetically-confirmed BCM were recruited for high-resolution imaging. Eight patients had a deletion of the locus control region (LCR), and 15 had a missense mutation-Cys203Arg-affecting the first two genes in the opsin gene array. Foveal cone structure was assessed using confocal and non-confocal split-detection AOSLO across a 300 × 300 µm area, centered on the location of peak cell density. Results Only one of eight patients with LCR deletions and 10 of 15 patients with Cys203Arg mutations had analyzable images. Mean total cone density for Cys203Arg patients was 16,664 ± 11,513 cones/mm2 (n = 10), which is, on average, around 40% of normal. Waveguiding cone density was 2073 ± 963 cones/mm2 (n = 9), which was consistent with published histological estimates of S-cone density in the normal eye. The one patient with an LCR deletion had a total cone density of 10,246 cones/mm2 and waveguiding density of 1535 cones/mm2. Conclusions Our results show that BCM patients with LCR deletions and Cys203Arg mutations have a population of non-waveguiding photoreceptors, although the spectral identity and level of function remain unknown.
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Affiliation(s)
- Emily J. Patterson
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Angelos Kalitzeos
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Thomas M. Kane
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Navjit Singh
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Joseph Kreis
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Mark E. Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
| | - Alison J. Hardcastle
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Jay Neitz
- Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Maureen Neitz
- Ophthalmology, University of Washington, Seattle, Washington, United States
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Joseph Carroll
- Cell Biology, Neurobiology & Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Lee W, Su PY, Zernant J, Nagasaki T, Tsang SH, Allikmets R. Longitudinal Analysis of a Resolving Foveomacular Vitelliform Lesion in ABCA4 Disease. Ophthalmol Retina 2022; 6:847-860. [PMID: 35413457 PMCID: PMC9464664 DOI: 10.1016/j.oret.2022.04.005] [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: 02/01/2022] [Revised: 03/27/2022] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe the longitudinal progression and phenotypic association of bilateral foveomacular vitelliform lesions in the setting of ABCA4 disease. DESIGN Case report and cross-sectional cohort study. PARTICIPANTS Nineteen patients with confirmed ABCA4 disease exhibiting an optical gap phenotype. METHODS Multimodal retinal imaging across multiple visits included autofluorescence imaging, spectral-domain OCT (SD-OCT), and OCT angiography. Electro-oculogram (EOG) and full-field electroretinogram testing results were analyzed. Exome sequencing was performed for diagnostic confirmation and the verification of other variations. MAIN OUTCOME MEASURES Light-peak-to-dark-trough ratio (Arden ratio) on EOG; thickness and en face maps of various retinal layers on SD-OCT; area measurements on 488- and 787-nm autofluorescence images; and the presence of variation in vitelliform-associated genes identified using exome sequencing. RESULTS A 25-year-old White man presented with bilateral central vision loss due to foveal lesions consisting of vitelliform fluid. The result of EOG testing was inconsistent with bestrophinopathy (Arden ratio = 1.62), and no generalized rod or cone dysfunction was detected on full-field electroretinogram. Exome sequencing identified the pathogenic variants c.5882G>A (p.(Gly1961Glu)) and c.4139C>T (p.(Pro1380Leu)) in ABCA4 and no other vitelliform-associated genes. Significant thinning and abnormal reflectivity of photoreceptor-attributable layers as well as near-infrared autofluorescence abnormalities were found in lesion-adjacent areas. Complete resorption of the vitelliform fluid occurred after 30 months, after which the optical gap lesions exhibited an enlarged and "cavitated" appearance. Phenotypic screening for additional cases from a large ABCA4 disease database (n = 602) identified 18 additional patients at various stages of optical gap lesion formation, most of whom harbored the c.5882G>A (p.(Gly1961Glu)) variant (P < 0.001), although none had apparent vitelliform fluid. At least 5 of the 18 (31.6%) patients exhibited optical gap lesions with the distinct "cavitated" appearance, whereas the lesions remained unperturbed in the other patients over the course of examination. CONCLUSIONS Foveomacular vitelliform deposition is a mechanistically congruent but rare manifestation of ABCA4 disease. Specifically, this disease phenotype may be clinically associated with the c.5882G>A (p.(Gly1961Glu)) allele and optical gap lesions.
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Affiliation(s)
- Winston Lee
- Department of Genetics & Development, Columbia University, New York, New York; Department of Ophthalmology, Columbia University, New York, New York
| | - Pei-Yin Su
- Department of Ophthalmology, Columbia University, New York, New York
| | - Jana Zernant
- Department of Ophthalmology, Columbia University, New York, New York
| | - Takayuki Nagasaki
- Department of Ophthalmology, Columbia University, New York, New York
| | - Stephen H Tsang
- Department of Genetics & Development, Columbia University, New York, New York; Department of Pathology & Cell Biology, Columbia University, New York, New York
| | - Rando Allikmets
- Department of Genetics & Development, Columbia University, New York, New York; Department of Pathology & Cell Biology, Columbia University, New York, New York.
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Torm MEW, Eckmann-Hansen C, Christensen SK, Larsen M. A UNILATERAL FOVEAL VITELLIFORM LESION IN A CHOROIDEREMIA CARRIER. Retin Cases Brief Rep 2022; 16:663-666. [PMID: 33003127 PMCID: PMC9394496 DOI: 10.1097/icb.0000000000001062] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a unilateral foveal vitelliform lesion associated with subnormal visual acuity in a choroideremia carrier. METHODS A retrospective case report, assessment of the best-corrected visual acuity, fundus photography, wide-angle scanning laser ophthalmoscopy, optical coherence tomography, and microperimetry. RESULTS A 37-year-old woman with a pathogenic 907C>T mutation in the choroideremia gene encoding Rab escort protein-1 presented with blurred vision in her left eye.The Snellen best-corrected visual acuity was 20/20 in the right eye and 20/32 in the left eye, a unilateral decrease because it was 20/20 in both eyes at the most recent examination nine years earlier. In the left eye, a large vitelliform lesion with a diameter of 1,300 µ m had developed in the fovea, whereas in the right eye, a smaller similar lesion was seen close to the fovea. Both eyes showed classical radial patterns of multiple bright fundus patches with associated autofluorescence defects and focal drusenoid lesions of the outer retina. CONCLUSION With its large size and foveal location the vitelliform lesion in this patient's left eye is an unusual manifestation in an otherwise common Rab escort protein-1 mutation carrier state, and its unilaterality fits the assumption of random X-chromosome inactivation.
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Affiliation(s)
- Marie E. W. Torm
- Department of Ophthalmology, Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark; and
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
| | - Christina Eckmann-Hansen
- Department of Ophthalmology, Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark; and
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
| | - Søren K. Christensen
- Department of Ophthalmology, Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark; and
| | - Michael Larsen
- Department of Ophthalmology, Rigshospitalet, Valdemar Hansens Vej 13, Glostrup, Denmark; and
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, Denmark.
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Campagna GA, Chew L, Pettenkofer M, Nicoletti E, Schwartz JD, Choi G, Fernandes AO, Terrazas D, Kohn DB, Tsui I. Findings on Optical Coherence Tomography in Malignant Infantile Osteopetrosis. Ophthalmic Surg Lasers Imaging Retina 2022; 53:398-402. [PMID: 35858232 DOI: 10.3928/23258160-20220613-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Malignant infantile osteopetrosis is a rare inherited disorder with neurological complications and a shortened life expectancy. Vision loss is typically attributed to osseous compression of the optic nerves at the level of the optic canal. Fundus imaging is reported, as well as the first optical coherence tomography and optical coherence tomography angiography in this rare condition. Imaging revealed optic nerve pallor, subfoveal ellipsoid zone disruption, and an enlarged foveal avascular zone. These results provide insight regarding other potential mechanisms of vision loss in these patients. [Ophthalmic Surg Lasers Imaging Retina 2022; 53:398-402.].
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22
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Gerardy M, Yesilirmak N, Legras R, Behar-Cohen F, Bousquet E. CENTRAL SEROUS CHORIORETINOPATHY: High-Resolution Imaging of Asymptomatic Fellow Eyes Using Adaptive Optics Scanning Laser Ophthalmoscopy. Retina 2022; 42:375-380. [PMID: 34620798 PMCID: PMC8765211 DOI: 10.1097/iae.0000000000003311] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate cone density in the asymptomatic fellow eye of patients with unilateral central serous chorioretinopathy (CSCR). METHODS Seventeen asymptomatic fellow eyes of patients with unilateral CSCR and 17 eyes of aged-matched and gender-matched healthy controls underwent adaptive optics ophthalmoscopy. Cone density and spacing were assessed at the fovea. Clinical and multimodal imaging findings were also recorded. RESULTS In the CSCR group, the patient mean age was 48.9 ± 9.8 years. The mean (±SD) subfoveal choroidal thickness was 417.8 ± 125.2 µm. The foveal external limiting membrane and ellipsoid zone were intact in all patients. Adaptive optics fundus imaging showed a significant decrease in cone density at 2° of eccentricity nasal and temporal to the fovea in asymptomatic fellow eyes of patients with unilateral CSCR compared with controls (P = 0.001 and P = 0.027, respectively). No statistically significant difference in cone density was found at 4° of eccentricity nasal and temporal to the fovea between both groups. CONCLUSION Asymptomatic fellow eyes of patients with unilateral CSCR showed a reduced density of foveal cones in the absence of a decreased visual acuity and photoreceptor line disruption on optical coherence tomography. These results suggest that the photoreceptors could be damaged independently of the occurrence of a serous retinal detachment.
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Affiliation(s)
- Melvin Gerardy
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - Nilufer Yesilirmak
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
| | - Richard Legras
- Laboratoire Lumière, Matière et Interfaces, CNRS, ENS Paris-Saclay, Centrale Supelec, Université Paris Saclay, Orsay, France; and
| | - Francine Behar-Cohen
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
- Centre de Recherche des Cordeliers, INSERM U1138, Physiopathology of Ccular Diseases: Therapeutic Innovations, Université de Paris, Paris, France.
| | - Elodie Bousquet
- Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, Paris, France
- Centre de Recherche des Cordeliers, INSERM U1138, Physiopathology of Ccular Diseases: Therapeutic Innovations, Université de Paris, Paris, France.
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Lee R, Shields RA, Maywood MJ, Nemeth C, Wa CA, Williams GA, Hassan TS, Garretson BR, Capone A, Ruby AJ, Drenser KA, Faia LJ, Randhawa S, Mahmoud TH, Wolfe JD. LONG-TERM VISUAL OUTCOMES AND THE TIMING OF SURGICAL REPAIR OF FOVEA-SPLITTING RHEGMATOGENOUS RETINAL DETACHMENTS. Retina 2022; 42:244-249. [PMID: 34469406 DOI: 10.1097/iae.0000000000003293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/26/2022]
Abstract
PURPOSE To evaluate the visual outcomes and the affect of timing of surgical repair of fovea-splitting rhegmatogenous retinal detachments. METHOD A retrospective, consecutive cohort from multiple surgeons at a single center. Fovea status (fovea-on, fovea-splitting, or fovea-off) was classified by preoperative optical coherence tomography. The primary outcome measure was the visual acuity at the last follow-up that was further correlated with the timing of surgical repair. RESULTS One hundred and ninety-five eyes were included with 62 fovea-on, 65 fovea-splitting, and 68 fovea-off detachments. The mean preoperative logarithm of the minimum angle of resolution visual acuity for fovea-on, fovea-splitting, and fovea-off groups was 0.16 ± 0.21, 0.70 ± 0.56, and 1.67 ± 0.87, respectively (P = <0.001). Mean postoperative logarithm of the minimum angle of resolution visual acuity for fovea-on, fovea-splitting, and fovea-off groups were 0.07 ± 0.13, 0.10 ± 0.15, and 0.20 ± 0.22, respectively (P = <0.001). A statistically significant difference in mean postoperative logMAR visual acuity was found between fovea-off and fovea-on groups (P = 0.003) and between fovea-off and fovea-splitting groups (P = 0.013), however not between fovea-on and fovea-splitting groups (P = 0.827). Visual acuity improved when repair was performed earlier after presentation for fovea-on (R = 0.378, P = 0.002) and fovea-off groups (R = 0.277, P = 0.022), but not for the fovea-splitting group (R = 0.089, P = 0.481). CONCLUSION We described the favorable visual outcomes of surgery for fovea-splitting rhegmatogenous retinal detachment and correlated these with the timing of surgical repair, which may help guide the management of this urgent, vision-threatening condition.
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Affiliation(s)
- Ramon Lee
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
| | - Ryan A Shields
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
| | - Michael J Maywood
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Cire Nemeth
- Michigan State University College of Osteopathic Medicine, East Lansing, Michigan
| | - Christianne A Wa
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
| | - George A Williams
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Tarek S Hassan
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Bruce R Garretson
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Antonio Capone
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Alan J Ruby
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Kimberly A Drenser
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Lisa J Faia
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Sandeep Randhawa
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Tamer H Mahmoud
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
| | - Jeremy D Wolfe
- Associated Retinal Consultants, P.C., Royal Oak, Michigan; William Beaumont Hospital, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Rochester, Michigan; and
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Sheludchenko VM, Kozlovskaya NL, Budzinskaya MV, Krasnolutskaya EI, Durzhinskaya MH, Smirnova TV, Bondarenko TV. [The role of optical coherence tomography angiography in the assessment of retinal microcirculation in thrombotic microangiopathy associated with malignant arterial hypertension]. Vestn Oftalmol 2022; 138:177-185. [PMID: 36287153 DOI: 10.17116/oftalma2022138052177] [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: 06/16/2023]
Abstract
UNLABELLED Optical coherence tomography angiography (OCT-A) allows detailed assessment of the state of local blood flow in various systemic ischemic diseases, which include thrombotic microangiopathy (TMA) associated with malignant arterial hypertension (MAH). PURPOSE To evaluate retinal microcirculation using OCT-A imaging data in the group of patients with TMA associated with MAH. MATERIAL AND METHODS The study consisted of a qualitative and quantitative analysis of OCT-A data from 7 patients (14 eyes) with TMA associated with MAH and verified by renal biopsy. The control group included 7 healthy individuals (14 eyes). The following parameters were analyzed: area size of the foveal avascular zone FAZ, mm, vessel density (VD, %) and vessel skeleton density (VSD, %). The indicators were measured separately in the deep and superficial vascular plexuses and divided by localization into: the total density of the entire measured area, central density, density by quadrants (superior, inferior, nasal and temporal). All quadrants were subdivided into inner (corresponding to parafovea) and outer (corresponding to perifovea). RESULTS Local foci of vascular attenuation of the deep retinal capillary plexus, pathological tortuosity of blood vessels in the deep and superficial retinal capillary plexuses were found in 100% of study group patients. Per-quadrant analysis of OCT-A finding in the macular zone revealed a statistically significant decrease in VD of the deep retinal capillary plexus (p<0.05). A direct correlation was found between glomerular filtration rate and the VD index in the outer inferior (r=0.567; p=0.034) and inner temporal quadrants (r=0.613; p=0.020) of the deep retinal capillary plexus, as well as the level of hemoglobin in blood serum and VD in inner temporal quadrant of the deep vascular plexus (r=0.596; p=0.025). CONCLUSION Changes revealed with OCT-A are the symptoms of TMA in MAH patients spreading to the retinal microvasculature, mainly at the level of the deep retinal capillary plexus.
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Affiliation(s)
| | - N L Kozlovskaya
- City Clinical Hospital No. 20 named after A.K. Yeramishantsev, Moscow, Russia
- Peoples' Friendship University of Russia, Moscow, Russia
| | | | | | | | - T V Smirnova
- Research Institute of Eye Diseases, Moscow, Russia
| | - T V Bondarenko
- City Clinical Hospital No. 20 named after A.K. Yeramishantsev, Moscow, Russia
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Fırat M, Kobat SG. How are central foveal and choroidal thickness affected in patients with mild COVID-19 infection? Bosn J Basic Med Sci 2021; 21:782-786. [PMID: 34157253 PMCID: PMC8554697 DOI: 10.17305/bjbms.2021.5840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/01/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the effects of COVID-19 on central foveal and choroidal thicknesses. Thirty-two patients with a positive SARS-CoV-2 PCR test who received outpatient treatment within the previous two months and 32 healthy controls were included in the study. Patients requiring hospitalization due to COVID-19 as well as the patients who received either intensive care support and/or antiplatelet therapy, smokers, or patients with systemic or ocular diseases were excluded from the study. After full ophthalmological examination, central foveal and choroidal thicknesses were evaluated by using optical coherence tomography. Statistical analysis of the study data demonstrated no significant difference between the groups in terms of age or gender (p>0.05). There was also no statistically significant difference between the groups in terms of central foveal thickness, central choroidal thickness, or nasal 500, nasal 1500, temporal 500, or temporal 500-micron distances (p>0.05 for all parameters). Choroidal and retinal thicknesses were not affected in patients with recent mild COVID 19 without comorbidities.
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Affiliation(s)
- Müge Fırat
- Department of Ophthalmology, Elazığ City Hospital, Elazığ, Turkey
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Kim BH, Kim DI, Bae KW, Park UC. Influence of postoperative ectopic inner foveal layer on visual function after removal of idiopathic epiretinal membrane. PLoS One 2021; 16:e0259388. [PMID: 34735519 PMCID: PMC8568108 DOI: 10.1371/journal.pone.0259388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose To investigate the functional and anatomical parameters and their postoperative changes according to the ectopic inner foveal layer (EIFL) staging scheme for idiopathic epiretinal membrane (ERM). Methods In this prospective study, patients with idiopathic ERM underwent pars plana vitrectomy and ERM removal, and were followed-up for 6 months. The associations of EIFL with pre- and postoperative functional and anatomical parameters were analyzed. Results A total of 84 eyes (84 patients) were included: 39 (46.4%), 33 (39.3%), and 12 (14.3%) as EIFL stages 2, 3, and 4, respectively. At 6 months after surgery, the mean best-corrected visual acuity (BCVA) significantly improved in all EIFL stages (P ≤ 0.003); however, metamorphopsia improved only in eyes with EIFL stage 2 (P = 0.039) and 3 (P = 0.011). The aniseikonia and foveal avascular zone (FAZ) area showed no significant postoperative changes in any of the EIFL stages. Both preoperatively and during 6 months after surgery, the EIFL stage showed a significant correlation with BCVA (P ≤ 0.033), metamorphopsia (P ≤ 0.008), central macular thickness (P < 0.001), and FAZ parameters (P ≤ 0.016) at each time point, but not with aniseikonia. Significant correlations of EIFL thickness with BCVA (P = 0.028) and metamorphopsia (P = 0.006) before surgery were not persistent after surgery. Conclusion Both pre- and postoperatively, the staging of EIFL, rather than its thickness, is a simple and adequate surrogate marker for visual acuity and metamorphopsia in eyes with idiopathic ERM.
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Affiliation(s)
- Bo Hee Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Ik Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Woong Bae
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Fieß A, Wagner FM, Urschitz MS, Nagler M, Stoffelns B, Wild PS, Münzel T, Beutel ME, Lackner KJ, Pfeiffer N, Schuster AK. Association of Birth Weight With Foveolar Thickness in Adulthood: Results From a Population-Based Study. Invest Ophthalmol Vis Sci 2021; 62:9. [PMID: 34757404 PMCID: PMC8590182 DOI: 10.1167/iovs.62.14.9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 10/04/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose Low birth weight (BW) is associated with alterations of foveal shape development in childhood-leading to an increased retinal thickness of the fovea. The aim of the present study was to assess whether BW has a long-term effect on foveal retinal thickness (RT) and is still present in adulthood. Methods In the German population-based Gutenberg Health Study (GHS), participants were examined with spectral-domain optical coherence tomography. The association between self-reported BW and RT in the foveolar and perifoveal locations was assessed. Multivariable linear regression analyses with adjustment for potential confounders and grading of foveal hypoplasia were performed. Results Overall, RT measurements and self-reported BW were available for 2,539 participants (1300 female, mean age 54.5 ± 9.7 years). The absolute foveolar RT was 239.6 ± 25.8 µm, 232.2 ± 20.1 µm and 234.8 ± 21.0 µm, respectively, in the low (<2500 g), normal (2500-4000 g) and high (>4000 g) BW groups (P < 0.001). After adjustment for confounders, an association was observed between lower BW and increased foveolar thickness (B = -0.35 [95% confidence interval {CI}: -0.49; -0.20] µm/100 g; P < 0.001), whereas only a weak association with RT was observed with the nasal (P = 0.010), temporal (P = 0.011), and inferior (P = 0.021) quadrants in the 1 mm distance, with no association in the 2 mm distance to the fovea. Foveal hypoplasia grade 1 was more frequent in the low BW group (6.8%) compared to the normal (0.9%) and high BW group (1.2%). Conclusions This study provides evidence of an association between lower BW and increased foveolar thickness and foveal hypoplasia, indicating that prenatal growth may affect macular morphology, which in turn may persist until adulthood and predispose to retinal disease later in life.
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Affiliation(s)
- Achim Fieß
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Felix M. Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S. Urschitz
- Division of Pediatric Epidemiology, Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine/Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernhard Stoffelns
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine/Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Yamada H, Imai H, Tetsumoto A, Hayashida M, Otsuka K, Miki A, Nakamura M. The contribution of the proximity of the retinal detachment to the fovea for postoperative metamorphopsia after 27-gauge pars plana vitrectomy for the primary rhegmatogenous retinal detachment. PLoS One 2021; 16:e0258775. [PMID: 34710146 PMCID: PMC8553140 DOI: 10.1371/journal.pone.0258775] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 10/05/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To investigate clinical factors contributing to metamorphopsia after 27-gauge pars plana vitrectomy (27GPPV) for primary rhegmatogenous retinal detachment (RRD) to reveal whether the proximity of the preoperative retinal detachment to the fovea is associated with postoperative metamorphopsia. Methods We retrospectively reviewed medical records of 77 eyes of 77 patients after 27GPPV for RRD. Patients were subdivided into three groups using optical coherence tomography findings: Group A, patients with RRD outside the vascular arcade; Group B, patients whose condition was present within the vascular arcade, but without foveal detachment; and Group C, patients with foveal detachment. Results The average metamorphopsia score (°) assessed with M-charts 12 months after surgery was 0.01 ± 0.04 in Group A (24 eyes), 0.08 ± 0.18 in Group B (20 eyes), and 0.49 ± 0.48 in Group C (33 eyes) (p<0.001). Logistic regression analysis revealed that metamorphopsia at 12 months after surgery significantly correlated with the proximity of the retinal detachment to the fovea (p = 0.007). Conclusion Metamorphopsia after 27GPPV for RRD correlated with the proximity of the preoperative retinal detachment to the fovea. Attention should be paid to the possibility of postoperative metamorphopsia development when retinal detachment is present within a vascular arcade even if the fovea is not involved.
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Affiliation(s)
- Hiroko Yamada
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisanori Imai
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
- * E-mail:
| | - Akira Tetsumoto
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mayuka Hayashida
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keiko Otsuka
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiko Miki
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Makoto Nakamura
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
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Ansari D, Borkar PP, Davis PL, Collison FT, Wynne N, Zangler N, Fishman GA, Carroll J, Yao X, Grassi MA. Pathognomonic macular ripples are revealed by polarized infrared retinal imaging. Exp Biol Med (Maywood) 2021; 246:2202-2206. [PMID: 34233520 PMCID: PMC8718259 DOI: 10.1177/15353702211021089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/30/2021] [Accepted: 05/10/2021] [Indexed: 01/21/2023] Open
Abstract
A pathognomonic macular ripple sign has been reported with scanning laser ophthalmoscopy images in patients with foveal hypoplasia, though the optical basis of this sign is presently unknown. Here we present a case series of seven individuals with foveal hypoplasia (based on spectral domain optical coherence tomography). Each patient underwent infrared scanning laser ophthalmoscopy retinal imaging in both eyes, acquired with and without a polarization filter and assessment for a ripple-like effect in the fovea. On imaging, macular ripples were present in all eyes with foveal hypoplasia when using a polarization filter, but not when imaged without the filter. We conclude that the macular ripple sign is an imaging artifact attributable to the unique pattern of phase retardation of the Henle fiber layer in the setting of foveal hypoplasia. By utilizing a polarization filter with retinal photography, this feature can be exploited to promptly identify foveal hypoplasia in settings where OCT is not possible due to nystagmus.
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Affiliation(s)
- Darius Ansari
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
| | - Poulami P Borkar
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
| | | | - Frederick T Collison
- The Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, IL 60608, USA
- Chicago College of Optometry, Midwestern University, Downers Grove, IL 60515, USA
| | - Niamh Wynne
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | - Gerald A Fishman
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- The Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, IL 60608, USA
| | - Joseph Carroll
- Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Xincheng Yao
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- Department of Bioengineering, University of Illinois at Chicago College of Engineering, Chicago, IL 60607, USA
| | - Michael A Grassi
- Department of Ophthalmology, University of Illinois at Chicago College of Medicine, Chicago, IL 60612, USA
- Grassi Retina, Naperville, IL 60564, USA
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Kang HM, Choi JH, Koh HJ, Lee SC. Changes in peripapillary and subfoveal choroidal thickness in patients with central retinal vein occlusion. PLoS One 2021; 16:e0255182. [PMID: 34415912 PMCID: PMC8378679 DOI: 10.1371/journal.pone.0255182] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/10/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE We sought to evaluate changes of mean peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) over 12 months in patients with unilateral central retinal vein occlusion (CRVO). METHODS Our retrospective, observational study included 19 patients with treatment-naïve, unilateral CRVO who completed at least 12 months of follow-up period. Mean PCT and mean SFCT in CRVO-affected eyes and unaffected contralateral eyes were measured at each follow-up visit, and then compared. Differences between baseline and 12 months (ΔSFCT and ΔPCT) and percentage changes (ΔSFCT or ΔPCT/baseline×100%) were determined. We also investigated the predictive factors for visual outcome in the CRVO-affected eyes. RESULTS In the CRVO-affected eyes, mean PCT was 146.7±41.9 μm at baseline, and 106.5±24.2 μm at 12 months (P < 0.001). Mean PCT of the contralateral eyes was 129.8±42.6 μm at baseline and 124.6±39.7 μm at 12 months (P = 0.089). Mean SFCT of CRVO-affected eyes was 225.8±77.9 μm at baseline, and 199.4±66.6 μm at 12 months (P = 0.009). Mean SFCT of the contralateral eyes was 218.4±83.0 μm at baseline, and 208.4±78.1 μm at 12 months (P = 0.089). Δ PCT was -41.6±25.3 μm in the CRVO-affected eyes, and -5.2±5.8 μm in the contralateral eyes (P<0.001). % PCT was -24.9±14.0% in the CRVO-affected eyes, and -4.0±0.4% in the contralateral eyes (P = 0.001). Δ SFCT was -26.4±24.6 μm in the CRVO-affected eyes, and -9.5±16.7μm in the contralateral eyes (P = 0.016). % SFCT was -10.4±9.8% in the CRVO-affected eyes, and -3.4±6.4% in the contralateral eyes (P = 0.015). Among the various factors, BCVA at baseline (β = 0.797, P = 0.001) and % SFCT (β = 0.712, P = 0.001) were significantly associated with visual outcome at 12 months in the CRVO-affected eyes. CONCLUSION Both peripapillary and subfoveal choroidal thickness reduced significantly over 12 months in the CRVO-affected eyes, but not in the contralateral eyes. In addition, the absolute reduction amount and reduction ratio of PCT and SFCT were significantly greater in the CRVO-affected eyes than the contralateral eyes.
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Affiliation(s)
- Hae Min Kang
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, Gangneung, Gangwon-do, South Korea
- * E-mail:
| | | | - Hyoung Jun Koh
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Chul Lee
- Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea
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Borooah S, Papastavrou VT, Lando L, Moghimi S, Lin T, Dans K, Motevasseli T, Cameron JR, Freeman WR, Dhillon B, Browning AC. CHARACTERIZING THE NATURAL HISTORY OF FOVEAL-SPARING ATROPHIC LATE-ONSET RETINAL DEGENERATION. Retina 2021; 41:1329-1337. [PMID: 33149097 DOI: 10.1097/iae.0000000000003017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/14/2022]
Abstract
PURPOSE To identify quantifiable markers of disease progression in patients with foveal-sparing atrophic late-onset retinal degeneration using fundus autofluorescence and spectral-domain optical coherence tomography imaging. METHODS Natural history study evaluating patients within a 3-year interval. Disease progression was assessed based on the area of retinal atrophy, macular topographic distribution of lesions, retinal and choroidal thickness and volume, and choroidal vascularity index. RESULTS Twenty-four eyes (12 individuals) were included for fundus autofluorescence, and 31 eyes (16 individuals) for spectral-domain optical coherence tomography studies. Measurements were symmetrical between eyes of the same patient. The area of atrophy significantly enlarged (P = 0.002), with a growth rate of 2.67 mm2/year (SD: 2.13; square rooted: 0.57 mm/year, SD = 0.34). Baseline area of atrophy and progression both correlated with age. Most atrophic lesions were found in the temporal macula and progressed nasally at follow-up. Central choroidal and retinal thicknesses and volume in late-onset retinal degeneration cases were significantly reduced compared with controls, but only central retinal thickness decreased significantly at follow-up. CONCLUSION This study identifies the area of atrophy and central retinal thickness, but not chorioretinal volume or choroidal thickness, as markers of short-term progression in late-onset retinal degeneration. These findings may be useful for disease monitoring and late-onset retinal degeneration interventional studies.
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Affiliation(s)
- Shyamanga Borooah
- Jacobs Retina Center, University of California San Diego, La Jolla, California
- Princess Alexandra Eye Pavilion, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Leonardo Lando
- Shiley Eye Institute, University of California San Diego, La Jolla, California; and
- Department of Ophthalmology, Federal University of Goias, Goiania, Brazil
| | - Sasan Moghimi
- Shiley Eye Institute, University of California San Diego, La Jolla, California; and
| | - Tiezhu Lin
- Jacobs Retina Center, University of California San Diego, La Jolla, California
| | - Kunny Dans
- Jacobs Retina Center, University of California San Diego, La Jolla, California
| | | | - James R Cameron
- Princess Alexandra Eye Pavilion, University of Edinburgh, Edinburgh, United Kingdom
| | - William R Freeman
- Jacobs Retina Center, University of California San Diego, La Jolla, California
| | - Baljean Dhillon
- Princess Alexandra Eye Pavilion, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew C Browning
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
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Shim KY, Bae JG, Lee JK, Kim YC. Relationship between proteinuria and optical coherence tomographic features of the chorioretina in patients with pre-eclampsia. PLoS One 2021; 16:e0251933. [PMID: 34015042 PMCID: PMC8136667 DOI: 10.1371/journal.pone.0251933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/05/2021] [Indexed: 11/18/2022] Open
Abstract
This retrospective study aimed to evaluate the correlation between ophthalmologic factors and proteinuria in patients with pre-eclampsia using swept-source optical coherence tomography (OCT) and OCT angiography. In total, 61 pregnant patients diagnosed with pre-eclampsia were recruited during their hospital stay. The authors investigated the relationship between urine protein–creatinine ratio (PCR) and chorioretinal measurements including choroidal thickness (CT), choroidal vascularity index (CVI), foveal avascular zone (FAZ), vascular density (VD), ganglion cell layer+ (GCL+) and GCL++. The associations between mean arterial pressure (MAP) and ophthalmologic factors were also evaluated. Central subfield CT of the right eye (p = 0.031) and paracentral CT of both eyes were related to higher PCR (≥1.35 mg/mg). A significant association with PCR after logarithm transformation was noted (r = 0.284, p = 0.026). Retinal measurements (FAZ, VD, GCL+ and GCL++) and CVI were not related with PCR. There was a positive association between MAP and PCR after logarithm transformation (r = 0.296, p = 0.021); however, chorioretinal factors were not related with MAP. In pregnant women with pre-eclampsia, CT using OCT is a novel factor that is correlated with PCR. Ocular structural alteration in patients with pre-eclampsia may be one of systemic vascular changes caused by pre-eclampsia rather than hypertension.
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Affiliation(s)
- Kyu Young Shim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Jin Gon Bae
- Department of Obstetrics, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Kyoung Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea
- * E-mail:
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Obeid A, Hsu J, Ehmann D, Gao X, Sridhar J, Chiang A, Park CH, Ho AC. TOPICAL DORZOLAMIDE-TIMOLOL WITH INTRAVITREOUS ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR FOR RETINAL VEIN OCCLUSION: A PILOT STUDY. Retin Cases Brief Rep 2021; 15:120-126. [PMID: 29864044 DOI: 10.1097/icb.0000000000000752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/25/2022]
Abstract
PURPOSE To evaluate topical dorzolamide hydrochloride-timolol maleate as an adjunct therapy to intravitreous anti-vascular endothelial growth factor injections in eyes with retinal vein occlusion resistant to treatment. METHODS Retinal vein occlusion patients with a history of persistent macular edema, despite fixed-interval intravitreous anti-vascular endothelial growth factor injections, were enrolled between April 4, 2016, and June 4, 2017. On enrollment, patients were instructed to administer one drop of topical dorzolamide-timolol twice daily for the duration of the study. They were maintained on the same anti-vascular endothelial growth factor drug and same interval between injections as preenrollment for the subsequent two visits. Primary outcome measures were change in central foveal thickness, central subfield thickness, and thickest macular cut at the final study visit. RESULTS Eight patients (8 eyes) were eligible for enrollment and completed the study. There was a significant decrease in central foveal thickness (P = 0.02), central subfield thickness (P = 0.03), and thickest macular cut (P = 0.01) between the enrollment visit and the final visit. There was a decrease in mean (±SD) logarithm of the minimal angle of resolution from 0.52 (±0.35) (20/66, Snellen equivalent) at the enrollment visit to 0.41 (±0.35) (20/51, Snellen equivalent) at the final visit (P = 0.08). CONCLUSION Topical dorzolamide-timolol may have a beneficial anatomical and functional effect in eyes with macular edema secondary to retinal vein occlusion resistant to treatment.
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Affiliation(s)
- Anthony Obeid
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Jason Hsu
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - David Ehmann
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Xinxiao Gao
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China ; and
| | - Jayanth Sridhar
- Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida
| | - Allen Chiang
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Carl H Park
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Allen C Ho
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania
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Puthalath AS, Samanta R, Jamil M, Sood G, Kumawat D, Agrawal A. Case Report: Foveolitis as an Indicator of Underlying Undiagnosed Dengue Fever. Am J Trop Med Hyg 2021; 104:110-114. [PMID: 33124538 DOI: 10.4269/ajtmh.20-0806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We describe a case of dengue fever-associated foveolitis that presented initially to the ophthalmologists with complaints of unilateral diminution of vision. A 30-year-old Indian woman had presented with sudden onset diminution of vision in the left eye (LE) for the past 2 days. It was also associated with low-grade fever and myalgia, which started few days before visual deterioration. Fundus showed few retinal hemorrhages and tiny subretinal yellowish lesions at the fovea in the LE. Optical coherence tomography and fluorescein angiography were indicative of foveolitis. Amsler charting showed a central scotoma in the LE. She was treated with oral steroids along with supportive treatments. A near-complete anatomical and functional recovery was noted. Our case depicts the significance of awareness of the ophthalmic complications of dengue fever among both ophthalmologists and physicians, and also highlights the key clinical and multimodal imaging findings in a case of dengue foveolitis.
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Schiff ER, Tailor VK, Chan HW, Theodorou M, Webster AR, Moosajee M. Novel Biallelic Variants and Phenotypic Features in Patients with SLC38A8-Related Foveal Hypoplasia. Int J Mol Sci 2021; 22:ijms22031130. [PMID: 33498813 PMCID: PMC7866073 DOI: 10.3390/ijms22031130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 12/19/2022] Open
Abstract
Biallelic pathogenic variants in solute carrier family 38 member 8, SLC38A8, cause a pan-ocular autosomal recessive condition known as foveal hypoplasia 2, FVH2, characterised by foveal hypoplasia, nystagmus and optic nerve chiasmal misrouting. Patients are often clinically diagnosed with ocular albinism, but foveal hypoplasia can occur in several other ocular disorders. Here we describe nine patients from seven families who had molecularly confirmed biallelic recessive variants in SLC38A8 identified through whole genome sequencing or targeted gene panel testing. We identified four novel sequence variants (p.(Tyr88*), p.(Trp145*), p.(Glu233Gly) and c.632+1G>A). All patients presented with foveal hypoplasia, nystagmus and reduced visual acuity; however, one patient did not exhibit any signs of chiasmal misrouting, and three patients had features of anterior segment dysgenesis. We highlight these findings in the context of 30 other families reported to date. This study reinforces the importance of obtaining a molecular diagnosis in patients whose phenotype overlap with other inherited ocular conditions, in order to support genetic counselling, clinical prognosis and family planning. We expand the spectrum of SLC38A8 mutations which will be relevant for treatment through future genetic-based therapies.
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Affiliation(s)
- Elena R. Schiff
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Vijay K. Tailor
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Department of Experimental Psychology, University College London, London WC1H 0AP, UK
| | - Hwei Wuen Chan
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
- Department of Ophthalmology, National University Hospital, Singapore S118177, Singapore
| | - Maria Theodorou
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
| | - Andrew R. Webster
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
| | - Mariya Moosajee
- Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK; (E.R.S.); (V.K.T.); (H.W.C.); (M.T.); (A.R.W.)
- Institute of Ophthalmology, University College London, London EC1V 9EL, UK
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
- The Francis Crick Institute, London NW1 1AT, UK
- Correspondence:
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Verhoekx JSN, Smid LM, Vermeer KA, Martinez Ciriano JP, Yzer S. ANATOMICAL CHANGES ON SEQUENTIAL MULTIMODAL IMAGING IN PERIFOVEAL EXUDATIVE VASCULAR ANOMALOUS COMPLEX. Retina 2021; 41:162-169. [PMID: 32271275 DOI: 10.1097/iae.0000000000002809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/26/2022]
Abstract
PURPOSE To report a series of 21 patients with perifoveal exudative vascular anomalous complex (PEVAC) and to investigate the anatomical changes over time. METHODS We conducted a retrospective study. Clinical data of consecutive patients, presenting at the Rotterdam Eye Hospital between 2014 and 2019, were analyzed. The data collected included best-corrected visual acuity, fundus photography, optical coherence tomography (OCT), OCT-angiography, fluorescence angiography, and indocyanine green angiography. RESULTS We included 21 patients with a PEVAC lesion with a mean follow-up of 24.3 ± 13.8 months (range, 9-46 months). Patients with PEVAC were on average 75.3 ± 11.1 years (range, 53-90 years). The large perifoveal vascular aneurysmal abnormality was associated with small retinal hemorrhages in six patients and hard exudates in three patients. The PEVAC lesion was associated with intraretinal cystic spaces on OCT in 15 patients. Twelve of 21 patients showed no changes in cystic spaces on OCT during follow-up: 9 patients had stable cystic spaces and 3 patients had no cystic spaces. In contrast, in 9 of 21 patients, we observed changes in cystic spaces on OCT during follow-up. In two patients, cystic spaces appeared during follow-up, and in seven patients, there was a spontaneous resolution of cystic spaces. In three of these seven patients, the PEVAC lesion completely disappeared. Two patients, with stable intraretinal cystic spaces on OCT, were treated with intravitreal injections of anti-vascular endothelial growth factor without improvement. CONCLUSION Perifoveal exudative vascular anomalous complex is an idiopathic perifoveal retinal vascular abnormality that is associated with intraretinal cystic spaces. These intraretinal cystic spaces associated with a PEVAC lesion, and even the PEVAC lesion itself, can have a spontaneous resolution over time.
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Affiliation(s)
| | - Lisette M Smid
- The Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands
| | | | | | - Suzanne Yzer
- The Rotterdam Eye Hospital, Rotterdam, the Netherlands ; and
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Mehta N, Lavinsky F, Larochelle R, Rebhun C, Mehta NB, Yanovsky RL, Cohen MN, Lee GD, Dedania V, Ishikawa H, Wollstein G, Schuman JS, Waheed N, Modi Y. ASSESSING THE ABILITY OF PREOPERATIVE QUANTITATIVE SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY CHARACTERISTICS TO PREDICT VISUAL OUTCOME IN IDIOPATHIC MACULAR HOLE SURGERY. Retina 2021; 41:29-36. [PMID: 32251240 PMCID: PMC7529763 DOI: 10.1097/iae.0000000000002797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine which spectral domain optical coherence tomography biomarkers of idiopathic macular hole (MH) correlate with the postoperative best-corrected visual acuity (BCVA) in anatomically closed MH. METHODS Retrospective analysis of spectral domain optical coherence tomography scans of 44 patients presenting with MH followed for a mean of 17 months. Widths of MH aperture, base, and ellipsoid zone disruption were calculated from presenting foveal spectral domain optical coherence tomography B-scans. Macular hole base area and ellipsoid zone disruption area were calculated through the custom in-house software. RESULTS Poorer postoperative BCVA correlated with increased preoperative choroidal hypertransmission (r = 0.503, P = 0.0005), minimum diameter (r = 0.491, P = 0.0007), and base diameter (r = 0.319, P = 0.0348), but not with preoperative ellipsoid zone width (r = 0.199, P = 0.2001). Applying en-face analysis, the BCVA correlated weakly with preoperative ellipsoid zone loss area (r = 0.380, P = 0.013), but not with preoperative MH base area (r = 0.253, P = 0.1058). CONCLUSION Increased MH minimum diameter, base diameter, base area, and choroidal hypertransmission are correlated with a poorer postoperative BCVA. Ellipsoid zone loss measurements were not consistently correlated with a BCVA. Choroidal hypertransmission width may be an easy-to-visualize predictive imaging biomarker in MH surgery.
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Affiliation(s)
- Nitish Mehta
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Fabio Lavinsky
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Ryan Larochelle
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Carl Rebhun
- New England Eye Center, Tufts Medical Center, Boston, Massachusetts
| | - Nihaal B Mehta
- New England Eye Center, Tufts Medical Center, Boston, Massachusetts
| | | | - Michael N Cohen
- New England Eye Center, Tufts Medical Center, Boston, Massachusetts
| | - Gregory D Lee
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Vaidehi Dedania
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Joel S Schuman
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
| | - Nadia Waheed
- New England Eye Center, Tufts Medical Center, Boston, Massachusetts
| | - Yasha Modi
- Department of Ophthalmology, NYU Langone Health, New York, New York; and
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Sung YC, Yang CH, Yang CM, Lin CW, Huang DS, Huang YS, Hu FR, Chen PL, Chen TC. Genotypes Predispose Phenotypes-Clinical Features and Genetic Spectrum of ABCA4-Associated Retinal Dystrophies. Genes (Basel) 2020; 11:genes11121421. [PMID: 33261146 PMCID: PMC7759801 DOI: 10.3390/genes11121421] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 12/31/2022] Open
Abstract
The ABCA4 gene is one of the most common disease-causing genes of inherited retinal degeneration. In this study, we report different phenotypes of ABCA4-associated retinal dystrophies in the Taiwanese population, its clinical progression, and its relationship with genetic characteristics. Thirty-seven subjects were recruited and all patients underwent serial ophthalmic examinations at a single medical center. Fundus autofluorescence (FAF) images were quantified for clinical evaluation, and panel-based next-generation sequencing testing was performed for genetic diagnosis. Visual preservation, disease progression, and genotype–phenotype correlation were analyzed. In this cohort, ABCA4-associated retinal degeneration presented as Stargardt disease 1 (STGD1, 62.16%), retinitis pigmentosa (32.43%), and cone-rod dystrophy (5.41%). STGD1 could be further divided into central and dispersed types. In each phenotype, the lesion areas quantified by FAF increased with age (p < 0.01) and correlated with poorer visual acuity. However, three patients had the foveal sparing phenotype and had relatively preserved visual acuity. Forty-two ABCA4 variants were identified as disease-causing, with c.1804C>T (p.Arg602Trp) the most frequent (37.84%). Patients with a combination of severe/null variants could have more extensive phenotypes, such as arRP and dispersed STGD1. This is the first cohort study of ABCA4-associated retinal degeneration in Taiwan with wide spectrums of both genotypic and phenotypic characteristics. An extremely high prevalence of c.1804C>T, which has not been reported in East Asia before, was noted. The extensiveness of retinal involvement might be regarded as a spectrum of ABCA4-associated retinal dystrophies. Different types of genetic variations could lead to distinctive phenotypes, according to the coding impact of variants.
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Affiliation(s)
- Yu-Chi Sung
- Department of Medical Education, National Taiwan University Hospital, Taipei 100, Taiwan;
| | - Chang-Hao Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (D.-S.H.); (Y.-S.H.); (F.-R.H.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Chung-May Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (D.-S.H.); (Y.-S.H.); (F.-R.H.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (D.-S.H.); (Y.-S.H.); (F.-R.H.)
| | - Ding-Siang Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (D.-S.H.); (Y.-S.H.); (F.-R.H.)
| | - Yu-Shu Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (D.-S.H.); (Y.-S.H.); (F.-R.H.)
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (D.-S.H.); (Y.-S.H.); (F.-R.H.)
- Department of Ophthalmology, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Pei-Lung Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Graduate Institute of Medical Genomics and Proteomics, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: (P.-L.C.); (T.-C.C.); Tel.: +886-2-23123456 (ext. 71942) (P.-L.C.); +886-2-23123456 (ext. 63783) (T.-C.C.); Fax: +886-2-23934420 (T.-C.C.)
| | - Ta-Ching Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei 100, Taiwan; (C.-H.Y.); (C.-M.Y.); (C.-W.L.); (D.-S.H.); (Y.-S.H.); (F.-R.H.)
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Correspondence: (P.-L.C.); (T.-C.C.); Tel.: +886-2-23123456 (ext. 71942) (P.-L.C.); +886-2-23123456 (ext. 63783) (T.-C.C.); Fax: +886-2-23934420 (T.-C.C.)
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Kuht HJ, Han J, Maconachie GDE, Park SE, Lee ST, McLean R, Sheth V, Hisaund M, Dawar B, Sylvius N, Mahmood U, Proudlock FA, Gottlob I, Lim HT, Thomas MG. SLC38A8 mutations result in arrested retinal development with loss of cone photoreceptor specialization. Hum Mol Genet 2020; 29:2989-3002. [PMID: 32744312 PMCID: PMC7645707 DOI: 10.1093/hmg/ddaa166] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 01/09/2023] Open
Abstract
Foveal hypoplasia, optic nerve decussation defects and anterior segment dysgenesis is an autosomal recessive disorder arising from SLC38A8 mutations. SLC38A8 is a putative glutamine transporter with strong expression within the photoreceptor layer in the retina. Previous studies have been limited due to lack of quantitative data on retinal development and nystagmus characteristics. In this multi-centre study, a custom-targeted next generation sequencing (NGS) gene panel was used to identify SLC38A8 mutations from a cohort of 511 nystagmus patients. We report 16 novel SLC38A8 mutations. The sixth transmembrane domain is most frequently disrupted by missense SLC38A8 mutations. Ninety percent of our cases were initially misdiagnosed as PAX6-related phenotype or ocular albinism prior to NGS. We characterized the retinal development in vivo in patients with SLC38A8 mutations using high-resolution optical coherence tomography. All patients had severe grades of arrested retinal development with lack of a foveal pit and no cone photoreceptor outer segment lengthening. Loss of foveal specialization features such as outer segment lengthening implies reduced foveal cone density, which contributes to reduced visual acuity. Unlike other disorders (such as albinism or PAX6 mutations) which exhibit a spectrum of foveal hypoplasia, SLC38A8 mutations have arrest of retinal development at an earlier stage resulting in a more under-developed retina and severe phenotype.
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Affiliation(s)
- Helen J Kuht
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Jinu Han
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Gail D E Maconachie
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
- Academic Unit of Ophthalmology and Orthoptics, University of Sheffield, Sheffield S10 2RX, UK
| | - Sung Eun Park
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Seung-Tae Lee
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Rebecca McLean
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Viral Sheth
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Michael Hisaund
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Basu Dawar
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Nicolas Sylvius
- Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, UK
| | - Usman Mahmood
- Department of Ophthalmology, Hull and East Yorkshire Hospitals NHS Trust, Hull HU3 2JZ, UK
| | - Frank A Proudlock
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Irene Gottlob
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
| | - Hyun Taek Lim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
| | - Mervyn G Thomas
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester – RKCSB, PO Box 65, Leicester LE2 7LX, UK
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Litts KM, Georgiou M, Langlo CS, Patterson EJ, Mastey RR, Kalitzeos A, Linderman RE, Lam BL, Fishman GA, Pennesi ME, Kay CN, Hauswirth WW, Michaelides M, Carroll J. Interocular Symmetry of Foveal Cone Topography in Congenital Achromatopsia. Curr Eye Res 2020; 45:1257-1264. [PMID: 32108519 PMCID: PMC7487033 DOI: 10.1080/02713683.2020.1737138] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 12/15/2019] [Accepted: 02/25/2020] [Indexed: 01/26/2023]
Abstract
Purpose: To determine the interocular symmetry of foveal cone topography in achromatopsia (ACHM) using non-confocal split-detection adaptive optics scanning light ophthalmoscopy (AOSLO). Methods: Split-detector AOSLO images of the foveal cone mosaic were acquired from both eyes of 26 subjects (mean age 24.3 years; range 8-44 years, 14 females) with genetically confirmed CNGA3- or CNGB3-associated ACHM. Cones were identified within a manually delineated rod-free zone. Peak cone density (PCD) was determined using an 80 × 80 μm sampling window within the rod-free zone. The mean and standard deviation (SD) of inter-cell distance (ICD) were calculated to derive the coefficient of variation (CV). Cone density difference maps were generated to compare cone topography between eyes. Results: PCD (mean ± SD) was 17,530 ± 9,614 cones/mm2 and 17,638 ± 9,753 cones/mm2 for right and left eyes, respectively (p = .677, Wilcoxon test). The mean (± SD) for ICD was 9.05 ± 2.55 µm and 9.24 ± 2.55 µm for right and left eyes, respectively (p = .410, paired t-test). The mean (± SD) for CV of ICD was 0.16 ± 0.03 µm and 0.16 ± 0.04 µm for right and left eyes, respectively (p = .562, paired t-test). Cone density maps demonstrated that cone topography of the ACHM fovea is non-uniform with local variations in cone density between eyes. Conclusions: These results demonstrate the interocular symmetry of the foveal cone mosaic (both density and packing) in ACHM. As cone topography can differ between eyes of a subject, PCD does not completely describe the foveal cone mosaic in ACHM. Nonetheless, these findings are of value in longitudinal monitoring of patients during treatment trials and further suggest that both eyes of a given subject may have similar therapeutic potential and non-study eye can be used as a control.
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Affiliation(s)
- Katie M. Litts
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Michalis Georgiou
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Christopher S. Langlo
- Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Emily J. Patterson
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Rebecca R. Mastey
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Angelos Kalitzeos
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Rachel E. Linderman
- Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - Byron L. Lam
- Bascom Palmer Eye Institute, University of Miami, Miami, Florida, United States of America
| | - Gerald A. Fishman
- Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, Illinois, United States
| | - Mark E. Pennesi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR 97239
| | | | | | - Michel Michaelides
- Moorfields Eye Hospital, London, United Kingdom
- UCL Institute of Ophthalmology, University College London, London, United Kingdom
| | - Joseph Carroll
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
- Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
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Balon A, Guagnini AP. Absence of foveal avascular zone in two adult patients with mild hyperopia: Fovea plana. J Fr Ophtalmol 2020; 43:e379-e381. [PMID: 33008641 DOI: 10.1016/j.jfo.2020.02.015] [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: 12/03/2019] [Accepted: 02/14/2020] [Indexed: 11/18/2022]
Affiliation(s)
- A Balon
- Cliniques Universitaires Saint-Luc, Brussels, Belgium, for Université Catholique de Louvain, Louvain-La-Neuve, Belgium; Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Belgium.
| | - A-P Guagnini
- Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Belgium; Department of ophthalmology at Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Anwar S, Nath M, Patel A, Lee H, Brown S, Gottlob I, Proudlock FA. POTENTIAL UTILITY OF FOVEAL MORPHOLOGY IN PRETERM INFANTS MEASURED USING HAND-HELD OPTICAL COHERENCE TOMOGRAPHY IN RETINOPATHY OF PREMATURITY SCREENING. Retina 2020; 40:1592-1602. [PMID: 31356497 PMCID: PMC7392578 DOI: 10.1097/iae.0000000000002622] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate dynamic foveal morphology with postmenstrual age, in preterm infants with and without retinopathy of prematurity using hand-held optical coherence tomography, adjusting for gestational age (GA) and birthweight (BW). METHODS Prospective mixed cross-sectional/longitudinal observational study of 87 participants (23-36 weeks GA; n = 30 with, n = 57 without retinopathy of prematurity) using hand-held optical coherence tomography images (n = 278) acquired between 31 weeks and 44 weeks postmenstrual age excluding treated retinopathy of prematurity. Measurements included foveal width, area, depth, central foveal thickness, maximum slope, and parafoveal retinal thickness at 1,000 µm nasal and temporal to the central fovea. RESULTS Retinopathy of prematurity was significantly correlated with only foveal width in either GA or BW adjusted statistical models. In contrast, severity of prematurity (GA, BW) correlated with foveal area (P < 0.005), depth (P ≤ 0.001), and slope (P < 0.01), although central foveal thickness (P = 0.007) and parafoveal retinal thickness (P < 0.001) correlated with GA, but not with BW. CONCLUSION Foveal width is independent of GA and BW with potential in retinopathy of prematurity screening assessment using hand-held optical coherence tomography. Foveal morphology could be graded in prematurity during development, with possible implications for future management of preterm infants.
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Affiliation(s)
- Samira Anwar
- Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, University of Leicester, Leicester, United Kingdom
- Department of Ophthalmology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Mintu Nath
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, United Kingdom
| | - Aarti Patel
- Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, University of Leicester, Leicester, United Kingdom
| | - Helena Lee
- Department of Ophthalmology, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton University Hospital, Southampton, United Kingdom; and
| | - Samantha Brown
- Department of Neonatology, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Infirmary Square, Leicester, United Kingdom
| | - Irene Gottlob
- Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, University of Leicester, Leicester, United Kingdom
| | - Frank A. Proudlock
- Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, University of Leicester, Leicester, United Kingdom
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Au A, Hilely A, Scharf J, Gunnemann F, Wang D, Chehaibou I, Iovino C, Grondin C, Farecki ML, Falavarjani KG, Phasukkijwatana N, Battista M, Borrelli E, Sacconi R, Powell B, Hom G, Greenlee TE, Conti TF, Ledesma-Gil G, Teke MY, Choudhry N, Fung AT, Krivosic V, Baek J, Lee MY, Sugiura Y, Querques G, Peiretti E, Rosen R, Lee WK, Yannuzzi LA, Zur D, Loewenstein A, Pauleikhoff D, Singh R, Modi Y, Hubschman JP, Ip M, Sadda S, Freund KB, Sarraf D. Relationship Between Nerve Fiber Layer Hemorrhages and Outcomes in Central Retinal Vein Occlusion. Invest Ophthalmol Vis Sci 2020; 61:54. [PMID: 32460316 PMCID: PMC7405700 DOI: 10.1167/iovs.61.5.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 03/09/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. Methods Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. Results 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 µm) compared to the group with deep hemorrhages alone (455 ± 273 µm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). Conclusions NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.
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Affiliation(s)
- Adrian Au
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Assaf Hilely
- Stein Eye Institute, University of California, Los Angeles, California, United States
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jackson Scharf
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Frederic Gunnemann
- Stein Eye Institute, University of California, Los Angeles, California, United States
- Department of Ophthalmology, St. Franziskus-Hospital, Münster, Germany
| | - Derrick Wang
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Ismael Chehaibou
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Claudio Iovino
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Christelle Grondin
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | | | - Khalil Ghasemi Falavarjani
- Eye Research Center and Eye Department, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Nopasak Phasukkijwatana
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Marco Battista
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Enrico Borrelli
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Riccardo Sacconi
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Brittany Powell
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Grant Hom
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Tyler E. Greenlee
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Thais F. Conti
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | | | - Mehmet Yasin Teke
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
| | - Adrian T. Fung
- Discipline of Ophthalmology, Westmead and Central Clinical Schools, University of Sydney; Department of Ophthalmology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Valerie Krivosic
- Hôpital Lariboisière, AP-HP, Université Paris-Diderot, Sorbonne Paris Cité. France
| | - Jiwon Baek
- Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Mee Yon Lee
- Department of Ophthalmology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Republic of Korea
| | - Yoshimi Sugiura
- Vitreous Retina Macula Consultants of New York, New York, United States
| | - Giuseppe Querques
- Department of Ophthalmology, Ospedale San Raffaele Scientific Institute University Vita-Salute San Raffaele, Milan, Italy
| | - Enrico Peiretti
- Department of Surgical Science, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Richard Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Won Ki Lee
- Retina Center, Nune Eye Hospital, Gangnam-gu, Seoul, Republic of Korea
| | | | - Dinah Zur
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Ophthalmology Division, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Rishi Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
| | - Yasha Modi
- Department of Ophthalmology, New York University School of Medicine, New York, New York, United States
| | - Jean Pierre Hubschman
- Stein Eye Institute, University of California, Los Angeles, California, United States
| | - Michael Ip
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, United States
| | - SriniVas Sadda
- Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, United States
| | - K. Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, United States
| | - David Sarraf
- Stein Eye Institute, University of California, Los Angeles, California, United States
- VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
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Banda HK, Dang S, Rothman RJ. Perifoveal Exudative Vascular Anomalous Complex With Suspended Scattered Particles in Motion. Ophthalmic Surg Lasers Imaging Retina 2020; 50:796-800. [PMID: 31877226 DOI: 10.3928/23258160-20191119-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/11/2019] [Indexed: 11/20/2022]
Abstract
Perifoveal exudative anomalous complex (PEVAC) is an uncommon entity that occurs in isolation or in association with retinal vascular disorders. The authors describe a case of a 47-year-old man presenting with a central scotoma in the left eye found to have an isolated PEVAC. Fundus photography, optical coherence tomography (OCT), and intravenous fluorescein angiography were collected. OCT angiography of the lesion revealed suspended scattered particles in motion, a newly described finding in exudative macular retinopathies. The authors describe the first case of PEVAC with angiographic evidence of suspended scattered particles in motion. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:796-800.].
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Mir TA, Thomas AS, Yoon SP, Birnbaum F, Goerlitz-Jessen M, Fekrat S. Eyes With Acute, Treatment-Naïve CRVO and Foveal Intraretinal Hemorrhage: Characteristics and Outcomes. Ophthalmic Surg Lasers Imaging Retina 2020; 50:752-759. [PMID: 31877220 DOI: 10.3928/23258160-20191119-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 06/10/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare outcomes in eyes with central retinal vein occlusion (CRVO) presenting with (group 1) or without (group 2) fovea-involving intraretinal hemorrhage (IRH). PATIENTS AND METHODS Retrospective review of patients diagnosed with acute, treatment-naïve CRVO between January 2009 and July 2016. RESULTS One hundred fifteen (39.8%) of 289 CRVO eyes had fovea-involving IRH. At baseline, eyes in group 1 had significantly worse visual acuity (VA) (1.2 ± 0.10 logMAR vs. 0.9 ± 0.06 logMAR; P = .001) and greater central subfield thickness (CST) (610.4 μm ± 35.9 μm vs. 435.0 μm + 21.6 μm; P < .001) than eyes in group 2. Final visual outcomes were comparable between groups (1.24 ± 0.09 logMAR vs. 1.02 ± 0.08 logMAR; P = .08). Group 1 received a significantly greater number of intravitreal anti-vascular endothelial growth factor injections during the first year (7.80 ± 0.40 vs. 5.20 ± 0.40; P = .001). CONCLUSIONS Although treatment-naïve eyes with acute CRVO and fovea-involving IRH had worse VA and greater CST at presentation, the final VA was comparable to eyes without such a hemorrhage. Eyes with foveal IRH had a greater treatment burden in the first 12 months. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:752-759.].
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Resch MD, Balogh A, Deák GG, Nagy ZZ, Papp A. Vascular density in age-related macular degeneration after one year of antiVEGF treatment with treat-and-extend and fixed regimens. PLoS One 2020; 15:e0229388. [PMID: 32101581 PMCID: PMC7043775 DOI: 10.1371/journal.pone.0229388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/05/2020] [Indexed: 01/11/2023] Open
Abstract
Treatment of neovascular age-related macular degeneration (nAMD) with VEGF can be performed with several posologies. The purpose of our cross-sectional study was to analyze retinal vessel density by quantitative OCT-angiography (OCT-A) and to compare treat-and-extend (T&E) and fixed treatment protocols to a control group with dry AMD. Altogether 48 patients were enrolled: 13 eyes with T&E protocol ranibizumab treatment (group A) and 17 eyes with fixed regimen aflibercept therapy (group B), the control group comprised 18 eyes with dry AMD (group C). One year after the start of the treatment, quantitative OCT-A (AngioVue—Optovue, Fermont, USA) was performed: superficial and deep retinal vessel densities were analyzed in the foveal and parafoveal regions. Our results show, that the density of retinal superficial vasculature in the fovea was not different between the treatment groups (A: 25.9±9.1%; B: 24.3%±8.9), neither from group C (25.6±4.8%). Superficial parafoveal vascular density of the retina, however, was decreased in both treated groups (A: 46.7±9.1%, B: 42.9±6.1%, C: 49.7±4.9%). In the deep retinal plexus, vascular density was lower in both treatment groups compared to that of in controls in both the foveal and parafoveal area (A: 29.8±6.3%, B: 32.5±6.9%, C: 36.4±1.7% and A: 46.3±3.8%, B: 47.1±5.3%, C: 49.7±4.9%, foveal and parafoveal respectively). Our data suggest, that after one year of anti-VEGF treatment, reduced macular vessel density in three of the four examined vascular regions can be found independent of the treatment regimen.
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Affiliation(s)
- Miklós D. Resch
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- * E-mail:
| | - Anikó Balogh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Department of Ophthalmology, Uzsoki Hospital, Budapest, Hungary
| | - Gábor Gy Deák
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Zoltán Z. Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - András Papp
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Lee JY, Kim JY, Lee SY, Jeong JH, Lee EK. Foveal Microvascular Structures in Eyes with Silicone Oil Tamponade for Rhegmatogenous Retinal Detachment: A Swept-source Optical Coherence Tomography Angiography Study. Sci Rep 2020; 10:2555. [PMID: 32054939 PMCID: PMC7018724 DOI: 10.1038/s41598-020-59504-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/29/2020] [Indexed: 11/08/2022] Open
Abstract
Silicone oil (SO) is widely used as a long-term intravitreal tamponading agent for rhegmatogenous retinal detachment (RRD) repair. This study investigated the structural changes of the foveal microvasculature using optical coherence tomography angiography (OCTA) in patients with RRD treated with vitrectomy and SO tamponade. Thirty-eight patients with unilateral RRD who were treated with vitrectomy and SO tamponade and were followed up for ≥3 months after SO removal were included. En face OCTA images were obtained and foveal avascular zone (FAZ) area and vascular density (VD) were compared between study eyes and unaffected contralateral eyes. The FAZ area in deep capillary plexus (DCP) was larger (P < 0.001) and the VD in DCP was lower (P = 0.022) in the study eyes than in the fellow eyes. The duration of SO tamponade was significantly correlated with the enlargement of FAZ area (P = 0.034) and reduction of VD in DCP (P = 0.015). These changes could reflect vascular insufficiency in eyes with SO tamponade and may represent a potential explanation for the pathogenesis of retinal thinning and unexplained visual loss.
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Affiliation(s)
- Jong Young Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea
| | - Jin Young Kim
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea
| | - Sang-Yoon Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea
| | - Jin Ho Jeong
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea
| | - Eun Kyoung Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju National University Hospital, Jeju, Korea.
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
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Kaizu Y, Nakao S, Wada I, Arima M, Yamaguchi M, Ishikawa K, Akiyama M, Kishimoto J, Hisatomi T, Sonoda KH. Microaneurysm Imaging Using Multiple En Face OCT Angiography Image Averaging: Morphology and Visualization. Ophthalmol Retina 2020; 4:175-186. [PMID: 31753811 DOI: 10.1016/j.oret.2019.09.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 06/25/2019] [Revised: 08/27/2019] [Accepted: 09/20/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE In diabetic retinopathy (DR), OCT angiography (OCTA) could not image all fluorescein angiography (FA)-detected microaneurysms. We investigated whether multiple image averaging could enhance the microaneurysm detection capability of OCTA in patients with DR. DESIGN Prospective and cross-sectional observational study. PARTICIPANTS Consecutive 31 patients (n = 62 eyes) with DR. METHODS All eyes underwent FA and 3 × 3 mm fovea-centered OCTA images were obtained using 2 devices: RTVue XR Avanti (Optovue Inc, Fremont, CA) and OCT HS-100 (Canon Inc, Toyko, Japan). OCTA imaging (HS-100) was performed 10 consecutive times. Microaneurysm detection capability was compared among 5 OCTA images (single image, ×3, ×5, and ×10 averaged images and single scan image with the RTVue XR Avanti device). MAIN OUTCOME MEASURES Microaneurysm detection capability and the correlation between microaneurysm clinical characteristics or morphology and the extent of image averaging required for OCTA detection. RESULTS A total of 415 microaneurysms could be analyzed in 31 eyes from 25 patients. Microaneurysms detected on single image, ×3, ×5, and ×10 averaged OCTA images were 144 (34.7%), 227 (54.7%), 285 (68.7%), and 306 (73.7%), respectively. Microaneurysm detection capability was significantly increased with increased image averaging. Microaneurysm detection with OCTA was not correlated with retinal thickness, FA leakiness, and indocyanine green angiogram detection or the number of averaged images, whereas there was significant correlation between microaneurysm morphology and microaneurysm visibility by the image-averaging process for 4 morphologies, particular the focal bulge types (P < 0.01). CONCLUSIONS In DR, multiple image averaging is useful for increasing the microaneurysm detection capability of OCTA, especially for focal bulge-type microaneurysms.
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Affiliation(s)
- Yoshihiro Kaizu
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shintaro Nakao
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Iori Wada
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mitsuru Arima
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Muneo Yamaguchi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keijiro Ishikawa
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masato Akiyama
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Junji Kishimoto
- Department of Research and Development of Next Generation Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshio Hisatomi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Wang KL, Chen X, Stinnett S, Tai V, Winter KP, Tran-Viet D, Toth CA. Understanding the variability of handheld spectral-domain optical coherence tomography measurements in supine infants. PLoS One 2019; 14:e0225960. [PMID: 31825990 PMCID: PMC6905571 DOI: 10.1371/journal.pone.0225960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/15/2019] [Indexed: 12/04/2022] Open
Abstract
Purpose Central foveal thickness (CFT) measurements from optical coherence tomography (OCT) scans provide a precise measure of severity of pathologic changes in the fovea, progress of disease and response to treatment. Although these measures are additionally valuable to assess foveal development in infants, their reproducibility is not known. The goal of this retrospective study is to evaluate the variation and reproducibility of CFT measurements using handheld spectral-domain OCT (hh-SDOCT) in supine infants compared to conventional adult tabletop imaging. Methods Imaging sessions with multiple macular, volume scans in one eye were selected for analysis from two participant groups: Group 1, 25 imaging sessions from 21 preterm infants without macular edema imaged supine in the nursery using hh-SDOCT (Leica/Bioptigen Envisu C2300, RTP, NC); Group 2, 25 imaging sessions from 25 adults imaged using tabletop Bioptigen SDOCT. For each imaging session, three macular OCT volumes with acceptable image quality were selected for analysis. CFTs were measured using a customized script for automatic segmentation. An expert grader and a typical grader corrected the segmentation lines for the central foveal frame. Coefficient of variations (CV) and intraclass correlation coefficients (ICC) were calculated for graders and systems and compared to the previous literature on OCT reproducibility. Results CFT measurements were repeatable and reproducible for both handheld and tabletop SDOCT systems. For handheld, grader ICC (CI) and mean CV were 0.94 (0.90–0.97) and 3.8 (typical) and 0.98 (0.96–0.99) and 2.9 (expert), and for tabletop were 0.91(0.83–0.96) and 2.1 (typical) and 0.92 (0.86–0.96) and 1.9 (expert). Intergrader reproducibility of handheld and tabletop SDOCT systems were ICC(CI) 0.97 (0.95–0.98) and 0.93 (0.89–0.96) respectively, and both are comparable to previously reported reproducibility of tabletop systems. Conclusion Handheld SDOCT is a reproducible instrument to measure foveal thicknesses in supine infants. It can be used in clinical research to evaluate foveal changes during retinal development and pathological conditions.
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Affiliation(s)
- Kira L. Wang
- Department of Ophthalmology, Duke University, Durham, North Carolina, United States of America
| | - Xi Chen
- Department of Ophthalmology, Division of Vitreoretinal Diseases and Surgery, Duke University, Durham, North Carolina, United States of America
| | - Sandra Stinnett
- Department of Ophthalmology, Duke University, Durham, North Carolina, United States of America
- Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, United States of America
| | - Vincent Tai
- Department of Ophthalmology, Duke University, Durham, North Carolina, United States of America
| | - Katrina P. Winter
- Department of Ophthalmology, Duke University, Durham, North Carolina, United States of America
| | - Du Tran-Viet
- Department of Ophthalmology, Duke University, Durham, North Carolina, United States of America
| | - Cynthia A. Toth
- Department of Ophthalmology, Division of Vitreoretinal Diseases and Surgery, Duke University, Durham, North Carolina, United States of America
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, United States of America
- * E-mail:
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50
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Brücher VC, Heiduschka P, Grenzebach U, Eter N, Biermann J. Distribution of macular ganglion cell layer thickness in foveal hypoplasia: A new diagnostic criterion for ocular albinism. PLoS One 2019; 14:e0224410. [PMID: 31738774 PMCID: PMC6860421 DOI: 10.1371/journal.pone.0224410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/11/2019] [Indexed: 02/06/2023] Open
Abstract
Background/Aims To analyse the distribution of macular ganglion cell layer thickness (GCLT) in patients with foveal hypoplasia (FH) with or without albinism to obtain new insights into visual pathway anomalies in albinos. Methods Patients with FH who presented at our institution between 2013 and 2018 were retrospectively drawn for analysis. Mean GCLT was calculated after automated segmentation of spectral domain-optical coherence tomography (SD-OCT) scans. Patients with FH due to albinism (n = 13, termed ‘albinism FH’) or other kinds (n = 10, termed ‘non-albinism FH’) were compared with control subjects (n = 15). The areas: fovea (central), parafovea (nasal I, temporal I) and perifovea (nasal II, temporal II) along the horizontal meridian were of particular interest. Primary endpoints of this study were the ratios (GCLT-I- and GCLT-II-Quotient) between the GCLT measured in the temporal I or II and nasal I or II areas. Results There was a significant difference between the GCLT-I-Quotient of healthy controls and albinism FH (p<0.001), as well as between non-albinism FH and albinism FH (p = 0.004). GCLT-II-Quotient showed significant differences between healthy controls and albinism FH (p<0.001) and between non-albinism FH and albinism FH (p = 0.006). The best measure for distinguishing between non-albinism FH and albinism FH was the calculation of GCLT-II-Quotient (area temporal II divided by area nasal II), indicating albinism at a cut-off of <0.7169. The estimated specificity and sensitivity for this cut-off were 84.6% and 100.0%, respectively. The estimated area under the curve (AUC) was 0.892 [95%CI: 0.743–1.000, p = 0.002]. Conclusion Macular GCLT-distribution showed a characteristic temporal to central shift in patients with FH due to albinism. Calculation of the GCLT-II-Quotient at a cut-off of <0.7169 presents a new diagnostic criterion for identification of ocular albinism.
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Affiliation(s)
- Viktoria C. Brücher
- Dept. of Ophthalmology, University of Muenster Medical Centre, Muenster, Germany
| | - Peter Heiduschka
- Dept. of Ophthalmology, University of Muenster Medical Centre, Muenster, Germany
| | - Ulrike Grenzebach
- Dept. of Ophthalmology, University of Muenster Medical Centre, Muenster, Germany
| | - Nicole Eter
- Dept. of Ophthalmology, University of Muenster Medical Centre, Muenster, Germany
| | - Julia Biermann
- Dept. of Ophthalmology, University of Muenster Medical Centre, Muenster, Germany
- * E-mail:
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