Search

PURPOSE: To investigate the differences in the optical density ratios between chronic central serous chorioretinopathy (CSC) and polypoidal choroidal vasculopathy (PCV) obtained from subretinal fluid (SRF) analyses to identify the diagnostic role of optical density ratios. DESIGN: Retrospective cohort study. METHODS: Patients with acute CSC (n = 36), chronic CSC (n = 38), and PCV (n = 32) were included in the study. Spectral-domain optical coherence tomography (SD OCT) images of SRF were analyzed. The optical density measurements were obtained by using ImageJ. The optical density ratios were calculated from the SRF to the vitreous, retinal pigment epithelium (RPE), and retinal nerve fiber layer (RNFL) reflectivity ratios. RESULTS: Optical density ratios of SRF to the vitreous, RPE, and RNFL were significantly higher in patients with PCV than in those with chronic CSC (P = .002, P = .001, P = .001). There was no significant difference between acute and chronic CSC (P = .358, P = .433, P = .774). RPE reflectivity was significantly different between groups (P = .002) but no significant difference in vitreous and RNFL reflectivity were detected between groups (P = .172, P = .171). CONCLUSIONS: The optical density ratio differs significantly between chronic CSC and PCV, but not between chronic and acute CSC. This suggests the usefulness of this parameter in differentiating between chronic CSC resembling PCV and PCV itself. [ABSTRACT FROM AUTHOR]

PURPOSE: To better characterize a novel spectraldomain optical coherence tomography (OCT) presentation, termed paracentral acute middle maculopathy, to describe this finding in patients with nonischemic central retinal vein occlusion (CRVO), and to support a proposed pathogenesis of intermediate and deep retinal capillary ischemia. DESIGN: Retrospective observational case series. METHODS: Clinical histories, high-resolution digital color imaging, red-free photography, fluorescein angiography, near-infrared reflectance, and spectral-domain OCT images of 484 patients with acute CRVO from 2 centers were evaluated for the presence of coexisting paracentral acute middle maculopathy. RESULTS: Of 484 patients diagnosed with CRVO, 25 (5.2%) demonstrated evidence of concurrent paracentral acute middle maculopathy. Patients averaged 51 years of age and presented with complaints of paracentral scotomas. All patients demonstrated hyper-reflective plaquelike lesions at the level of the inner nuclear layer by spectral-domain OCT and showed corresponding darkgray lesions on near-infrared reflectance and perivenular deep retinal whitening on color fundus photography. There was no fluorescein angiographic correlate to these lesions. On follow-up spectral-domain OCT imaging, the lesions had resolved into areas of inner nuclear layer atrophy with persistence of scotomas. CONCLUSIONS: Paracentral acute middle maculopathy refers to characteristic hyper-reflective spectral-domain OCT lesions involving the middle layers of the retina at the level of the inner nuclear layer that may develop in response to ischemia of the intermediate and deep capillary plexuses. This series is the largest to describe this spectral-domain OCT finding to date, and it is the first to associate it with nonischemic CRVO. [ABSTRACT FROM AUTHOR]

PURPOSE: To describe the spectrum of ultra-widefield autofluorescence (AF) and indocyanine green (ICG) angiographic findings in central serous chorioretinopathy (CSC). DESIGN: Retrospective observational case series. METHODS: In 37 patients, 65 eyes with CSC from 2 vitreoretinal clinical practices were imaged using ultrawidefield AF and 24 of these eyes with ultra-widefield ICG angiography. Images were correlated with clinical findings and spectral-domain optical coherence tomography (OCT). RESULTS: In 37 (57%) eyes, a variety of altered AF patterns, including gravitational tracts, extended beyond the posterior 50 degrees of retina. Hyper-AF corresponded to areas of subretinal fluid (SRF) on spectraldomain OCT and was found to persist in 44 (70%) eyes for up to 8 years despite resolution of SRF. These areas corresponded to outer retinal atrophy with viable retinal pigment epithelium (RPE) on spectral-domain OCT and may be explained by the unmasking of normal background RPE AF. Ultra-widefield ICG angiography revealed dilated choroidal vessels and choroidal hyperpermeability in areas corresponding to altered AF on ultra-widefield AF in all 24 eyes. In 20 (83.3%) eyes, dilated vessels were observed in association with 1 or more congested vortex veins ampullas, suggesting that outflow congestion may be a contributing factor to the pathogenesis of CSC. CONCLUSIONS: Ultra-widefield AF and ICG angiography in CSC revealed more widespread disease in a single image than with standard field imaging and may be useful for identifying peripheral areas of previous or ongoing SRF and choroidal hyperpermeability that can assist in the diagnosis of CSC, surveillance of recurrent disease and treatment of active disease. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the change of epithelial and flap thickness after femtosecond laser-assisted in situ keratomileusis (LASIK) using spectral-domain optical coherence tomography (SD OCT) in correlation with the spherical equivalent refraction treated and clinical outcomes. DESIGN: Prospective, randomized, contralateral-eye study. METHODS: Forty myopic eyes underwent LASIK using an excimer laser with refraction ranging from -- 1.00 to --7.25 diopters (mean --3.25 ± 1.9). Flap creation was randomized between eyes, using the IntraLASE FS60 laser (IL) in 1 eye and WaveLight FS200 laser (FS) in the contralateral eye. SD OCT was used to evaluate the epithelial and flap thickness profiles and corneal power preoperatively and at 1 week and 1, 3, and 9 months postoperatively. Manifest and wavefront refractions were performed at each postoperative visit. RESULTS: Statistically significant epithelial thickening was observed in both IL and FS groups as early as 1 month postoperatively (P = .033 and P = .042), but this stabilized between 3 (P = .042 and P = .035) and 9 months (P = .043 and P = .041). Femtosecond-LASIK flaps were thicker in the IL group in comparison to the FS group at 3 and 9 months postoperatively (P = .003 and P = .005, respectively). There was a statistically significant correlation between the magnitude of preoperative myopic refraction and the central epithelial thickness at 1, 3, and 9 months (Pearson correlation coefficients 0.485, 0.587 and 0.576) (P = .0021, P = .0010, and P = .0011), respectively. SD OCT corneal power maps showed steepening at 3 and 9 months along with mild myopic shift. CONCLUSION: Progressive epithelial and flap thickening with increased corneal power were observed after femtosecond laser-assisted in situ keratomileusis for myopia with consequent stabilization between 3 to 9 months postoperatively. The magnitude of epithelial and flap thickness remodeling correlated to the preoperative myopic refractive error. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the effects of ranibizumab 0.5 mg on gray hyper-reflective subretinal lesions diagnosed by spectral-domain optical coherence tomography (SD OCT) in patients with exudative age-related macular degeneration (AMD). DESIGN: Retrospective interventional study. METHODS: Data from 28 consecutive patients affected with neovascular AMD that presented subretinal hyperreflective lesions as visualized by SD OCT were collected. Gray hyper-reflective subretinal lesion characteristics were analyzed before and after intravitreal ranibizumab 0.5 mg injection. RESULTS: Thirty eyes of 28 patients (5 male, 23 female, aged 57-91 years) were included. At study entry, gray lesion was associated with exudative features in 24 of 30 eyes (80%), including subretinal fluid (SRF) in 20 of 30 eyes (67%) and retinal cystoid spaces in 11 of 30 eyes (37%). Twenty-four eyes with exudative features at study entry received prompt treatment; 6 eyes without exudative features at study entry received deferred treatment (after 1 month observation), when exudative signs emerged (SRF in 3/6 eyes and retinal cystoid spaces in 5/6 eyes). Ninety-three percent of the gray lesions responded to ranibizumab treatment at 2 months and 77% at 6 months. Gray hyper-reflective subretinal lesion thickness was significantly reduced after treatment at both 2 months (from 482 ±116 μm to 367 ±102 μm, P < .0001) and 6 months (from 482 ± 1 1 6 μm to 369 ± 71 μm, P < .0001). CONCLUSION: Our findings suggest that gray hyperreflective subretinal lesions might be considered as a qualitative criterion for retreatment of exudative AMD. They may represent an early sign of active choroidal neovascularization, and should prompt to early treatment. [ABSTRACT FROM AUTHOR]

PURPOSE: To compare the 6-line radial vs the 25-line raster spectral-domain optical coherence tomography (SD OCT) acquisition patterns at detecting intraretinal fluid, subretinal fluid, vitreomacular traction, and fullthickness macular hole (MH). DESIGN: Retrospective cross-sectional analysis. METHODS: Series of 365 eyes with neovascular agerelated macular degeneration (AMD), diabetic macular edema (DME), central and branch retinal vein occlusion (CRVO/BRVO), central serous chorioretinopathy, vitreomacular traction, and full-thickness MH. Sequential 6-line radial and 25-line raster scans were evaluated for intraretinal/subretinal fluid and, when applicable, vitreomacular traction and MH. RESULTS: For neovascular AMD (133 scans), 7 25-line raster scans confirmed subretinal/intraretinal fluid not identified by the 6-line radial (P = .02). For DME (140 scans) and central serous chorioretinopathy (91 scans), 25-line raster confirmed fluid in 4 scans (P = .13) and 1 scan (P = .32), respectively, that was not observed with the 6-line radial. For CRVO (123 scans) and BRVO (126 scans), 25-line raster confirmed fluid on 2 (P = .25) and 4 scans (P = .13), respectively, that was not detected by the 6-line radial. Conversely, for focal vitreomacular traction (70 scans) and full-thickness MH (82 scans), 25-line raster missed focal traction (< 1500 mm) and MH in 5 scans (P = .07) and 7 scans (P = .02), respectively, that were identified using the 6-line radial. CONCLUSIONS: The 6-line radial scan is statistically comparable to the 25-line raster at detecting fluid in DME, BRVO/CRVO, and central serous chorioretinopathy, but not neovascular AMD. Furthermore, it is superior to the 25 -line raster pattern at detecting early MH formation, while demonstrating a positive trend in identifying focal vitreomacular traction. [ABSTRACT FROM AUTHOR]

• PURPOSE: To compare analyses of choroidal thickness and volume in healthy eyes measured concurrently with prototype long-wavelength swept-source optical coherence tomography (OCT) and commercially available spectral-domain optical coherence tomography (OCT) with and without enhanced depth imaging (EDI). DESIGN: Prospective cross sectional study. METHODS: The study included 19 healthy subjects (19 eyes), who were prospectively recruited to undergo 2 consecutive imaging sessions on the same randomly selected eye using spectral domain OCT and a prototype long-wavelength swept-source OCT. On spectral domain OCT, 2 line scans, 1 with and 1 without EDI, and 1 volumetric scan were obtained. On swept-source OCT, 1 line scan and 1 volumetric scan were obtained. Scan patterns on swept-source OCT were created to simulate those available on Cirrus HD-OCT to keep the time of image acquisition constant. Swept-source OCT volumetric scans were motion corrected using a novel registration algorithm. Choroidal thickness and volume were analyzed. RESULTS: The choroidoscleral interface was clearly visualized in 19/19 (100%) of eyes imaged by sweptsource OCT, compared to 14/19 (73.6%) and 13/19 (68.4%) eyes imaged by spectral domain OCT, with and without EDI, respectively. There was no significant difference in choroidal thickness measurements on the line scans obtained on either system (P [ 0.10). Choroidal volume could not be assessed on volumetric scans from spectral domain OCT. Mean choroidal volume from swept-source OCT volumetric scans was 11.77 ± 3.13 mm³ (6.43 mm3-17.15 mm³). • CONCLUSION: This is the first study that compares simultaneously a prototype long-wavelength sweptsource OCT to a commercially available spectral domain OCT for a detailed analysis of choroid in healthy eyes. Swept-source OCT shows potential for better choroidal analysis. Studies using swept-source OCT in diseased eyes will further define this new technology's utility in chorioretinal diseases. (Am J Ophthalmol 2014;157: 1272-1281. 2014 by Elsevier Inc. All rights reserved.) [ABSTRACT FROM AUTHOR]

PURPOSE: To test whether the minimum rim area assessed by spectral domain optical coherence tomography (SD-OCT), based on the shortest distance from the Bruch membrane opening (BMO) to the inner limiting membrane, corresponds more closely to retinal nerve fiber layer (RNFL) thickness and visual field mean deviation (MD) than current rim measures in early glaucoma. DESIGN: Prospective cross-sectional study. METHODS: We studied 221 participants with nonendstage glaucoma or high-risk ocular hypertension and performed standard automated perimetry. We received SD-OCT and confocal scanning laser ophthalmoscopy (CSLO) scans on the same day. Rim area measured by CSLO was compared with 3 SD-OCT rim measures from radial B-scans: horizontal rim area between BMO and inner limiting membrane within the BMO plane; mean minimum rim width (BMO-MRW); and minimum rim area (BMO-MRA) optimized within sectors and then summed. Correlations between these measures and either MD from perimetry or RNFL thickness from SD-OCT were compared using the Steiger test. RESULTS: RNFL thickness was better correlated with BMO-MRA (r = 0.676) or BMO-MRW (r = 0.680) than with either CSLO rim area (r = 0.330, P < 0.001) or horizontal rim area (r = 0.482, P<0.001). MD was better correlated with BMO-MRA (r = 0.534) or BMO-MRW (r = 0.546) than with either CSLO rim area (r = 0.321, P < 0.001) or horizontal rim area (0.403, P < 0.001). The correlation between MD and RNFL thickness was r = 0.646. CONCLUSIONS: Minimum rim measurements from SD-OCT are significantly better correlated to both RNFL thickness and MD than rim measurements within the BMO plane or based on the clinical disc margin. They provide new structural parameters for both diagnostic and research purposes in glaucoma. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the use of spectral-domain optical coherence tomography (SDOCT) for imaging of nonpigmented iris tumors, through its comparison with ultrasound biomicroscopy (UBM). DESIGN: Retrospective observational case series. METHODS: Consecutive patients with non-pigmented iris tumors, not extending to the ciliary body, who were concurrently evaluated with SD-OCT and UBM were included. Demographics, anterior segment clinical photographs, images obtained with SD-OCT(CirrusHD-OCT, Zeiss Meditec, Dublin, California, USA) with 5.1.1 anterior segment software upgrade, and UBM (Humphrey Instruments, San Leandro, California, USA) were reviewed. The images produced were compared regarding the degree of anterior and posterior tumor surface resolution, internal structures, tumor thickness measurement, image artefacts, and overall tumor visualization. RESULTS: Thirty-seven patients with nonpigmented iris tumors were included. Comparing SDOCT to UBM, the image definitions of anterior tumor surface and internal tumor heterogeneity were equivalent. Posterior tumor surface was well defined in 54% of SDOCT vs 100% in UBM images. Full tumor thickness measurement was possible in 86% of SDOCT vs 100% with UBM. The maximum measurable tumor thickness with SDOCT was 1.34 mm. SDOCT images showed optical aberrations such as shadowing and ghost images in 22 tumors (59%), which encroached on the tumor image in 8 patients (22%). The overall tumor visualization with SDOCT was possible in 65% of the iris tumors. CONCLUSIONS: UBM generally provides superior imaging quality and reproducible measurements of nonpigmented iris tumors. Nevertheless, SDOCT, being a noncontact technique, can be a reliable alternative in imaging and following some selected nonpigmented iris tumors. [ABSTRACT FROM AUTHOR]

PURPOSE: To report a novel method for measuring the vertical tilt angle of the optic nerve (ON) head and to investigate the associated factors. DESIGN: Cross-sectional diagnostic study. METHODS: One hundred and twelve normal, glaucomatous, and glaucoma suspect eyes (99 patients) were enrolled in this study. Subjects underwent a full eye examination, biometry, and spectral-domain optical coherence tomography (SDOCT). The vertical tilt angle was measured on high-resolution cross-sectional SDOCT images passing through the ON head and foveal centers using the inner edges of the Bruch membrane opening as the reference plane. The correlation between the vertical tilt angle with the ovality index and the potential associated factors was estimated with univariate and multivariate linear regression analyses. RESULTS: The median (interquartile range, [IQR]) axial length and visual field mean deviation were 24.5 (23.8-25.3) mm and L0.9 (L2.76 to 0.26) dB. The median (IQR) tilt angle was 3.5 (1.2-11.2) degrees. There was a moderate correlation between the ovality index and tilt angle (Spearman r [ 0.351; P < .001). In univariate analyses, axial length, spherical equivalent, and mean deviation were correlated with the tilt angle (P[.002, P[.011, and P[.013, respectively). Axial length, mean deviation, and their interaction showed a statistically significant correlation with the tilt angle in multivariate analyses (P [ .044 for axial length, P [ .039 for mean deviation, and P [ .028 for their interaction). CONCLUSIONS: We describe a new method for measuring the ON head vertical tilt angle with highresolution SDOCT imaging. The ovality index demonstrated only a moderate correlation with the tilt angle measurements and hence is not a good proxy measure for the verticalONhead tilt angle. Axial length and visual field mean deviation are the main factors associated with the ON head vertical tilt angle. The underlying basis for the relationship of vertical tilt angle and glaucoma severity should be further explored. [ABSTRACT FROM AUTHOR]

PURPOSE: To determine how evaluations of macular structures on spectral-domain optical coherence tomography compare with those of the optic disc and circumpapillary retinal nerve fiber layer (RNFL) in discriminating between highly myopic eyes with and without glaucoma. DESIGN: Retrospective, comparative study. METHODS: The appearances of ganglion cell layer and RNFL on Spectralis macular scans (Heidelberg Engineering) and optic disc on photographs were evaluated by 2 observers. The receiver operating characteristic regression was conducted for macular ganglion cell complex and circumpapillary RNFL measurements on RTVue-100 (Optovue). RESULTS: Ninety highly myopic eyes (L6.0 to L15.0 diopters; mean deviation [MD], L5.6 ± 5.1 dB) and 91 non-highly myopic eyes (1.0 to L5.5 diopters; MD, L4.9 ± 5.7 dB) were enrolled. In highly myopic eyes (

PURPOSE: To determine whether patients with a sicklecell hemoglobinopathy without glaucoma have peripapillary retinal nerve fiber layer (RNFL) thinning by spectral-domain optical coherence tomography. DESIGN: Prospective study. METHODS: All patients with a sickle cell hemoglobinopathy (sickle-cell disease, sickle-cell hemoglobin C disease, and sickle-cell thalassemia) and age-similar, race-matched controls underwent a comprehensive eye examination and spectral-domain optical coherence tomography of the macula and optic nerve head using the Heidelberg Spectralis (Heidelberg Engineering, Inc, Carlsbad, California, USA). Participants with prior retinal treatments (laser or surgery), diabetes mellitus, glaucoma, or other ocular diseases were excluded. The sickle-cell disease patients were grouped into those with focal macular thinning and those without. Those with macular thinning were grouped further into mild, moderate, and severe thinning groups based on temporal macular thickness. Analysis of variance testing and post hoc analysis with the Tukey test and Pearson correlation were performed to assess for peripapillary RNFL thickness differences among different groups. RESULTS: One hundred fifty-one eyes of 88 sickle-cell patients and 55 eyes of 30 age-similar and race-matched (black) controls were included. Sickle-cell patient eyes with macular thinning (n[81) had thinner mean peripapillary RNFL thicknesses in the nasal sector (P [ .01) compared with non-sickle-cell control eyes and in the superotemporal sector (P [ .01) compared with sicklecell patient eyes without macular thinning (n [ 70). In the severe macular thinning subgroup (n [ 55), the mean peripapillary RNFL thickness was significantly thinner than that of controls (P<.05) in 6 of 7 sectors. There is a positive linear relationship between temporal macular thickness and global peripapillary RNFL thickness with a Pearson correlation coefficient of 0.60 (P<.0001). [ABSTRACT FROM AUTHOR]

The article focuses on a prospective cross-sectional study to establish a normative database of peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness, and retinal layer thickness in healthy North American children, using spectral-domain optical coherence tomography (SD OCT). The results of this study indicated that SD OCT can be used to assess peripapillary RNFL thickness, macular thickness, and retinal layer thickness in children as young as 5 years.

The article focuses on a prospective cross-sectional study related to the evaluation of a new computerized segmentation technique for the quantification of intra-retinal and sub-retinal fluid in spectral-domain optical coherence tomography (SD OCT) images of the retina. It mentions that scan images with age-related macular degeneration were chosen for this study. The results indicated that this method allows for accurate and fast quantification of fluid in retinal SD OCT images.

Purpose: To report the morphologic changes of the subfoveal choroidal thickness using spectral-domain optical coherence tomography following segmental scleral buckling. Design: Retrospective, observational case series. Methods: The study included 21 eyes of 20 patients who underwent segmental scleral buckling for the treatment of rhegmatogenous retinal detachment. All patients underwent the measurements of the subfoveal choroidal thickness preoperatively and 1 week, 1 month, and 3 months after the surgery. The changes in choroidal thickness, 4 mm from the fovea, before and 1 week after surgery were analyzed in the buckled and unbuckled side. Results: The preoperative mean subfoveal choroidal thickness of operated eyes was 239.2 ± 91.0 μm. The postoperative mean subfoveal choroidal thicknesses of operated eyes at 1 week, 1 month, and 3 months were 267.6 ± 96.8 μm, 250.6 ± 95.8 μm, and 239.4 ± 95.6 μm, respectively. There were significant differences between preoperative subfoveal choroidal thickness and 1-week-postoperative and 1-month-postoperative subfoveal choroidal thicknesses (P < .01, P = .03, ANOVA), and there was no significant difference between subfoveal choroidal thicknesses preoperatively and 3 months postoperatively (P > .99, ANOVA). The changes in choroidal thickness of the buckled and unbuckled side preoperatively and 1 week postoperatively were not significantly different (n = 8, P = .589, 2-way ANOVA). Conclusion: The subfoveal choroidal thickness may change temporarily following segmental scleral buckling surgery. This may be the result of reversible subclinical microcirculatory dysfunction of the choroid. [ABSTRACT FROM AUTHOR]

Purpose: To correlate human foveal development visualized by spectral-domain optical coherence tomography (SDOCT) with histologic specimens. Design: Retrospective, observational case series. Methods: Morphology and layer thickness of retinal SDOCT images from 1 eye each of 22 premature infants, 30 term infants, 16 children, and 1 adult without macular disease were compared to light microscopic histology from comparable ages. Results: SDOCT images correlate with major histologic findings at all time points. With both methods, preterm infants demonstrate a shallow foveal pit indenting inner retinal layers (IRL) and short, undeveloped foveal photoreceptors. At term, further IRL displacement forms the pit and peripheral photoreceptors lengthen; the elongation of inner and outer segments (IS and OS, histology) separates the IS band from retinal pigment epithelium. Foveal IS and OS are shorter than peripheral for weeks after birth (both methods). By 13 months, foveal cone cell bodies stack >6 deep, Henle fiber layer (HFL) thickens, and IS/OS length equals peripheral; on SDOCT, foveal outer nuclear layer (which includes HFL) and IS/OS thickens. At 13 to 16 years, the fovea is fully developed with a full complement of SDOCT bands; cone cell bodies >10 deep have thin, elongated, and tightly packed IS/OS. Conclusions: We define anatomic correlates to SDOCT images from normal prenatal and postnatal human fovea. OCT bands typical of photoreceptors of the adult fovea are absent near birth because of the immaturity of foveal cones, develop by 24 months, and mature into childhood. This validates the source of SDOCT signal and provides a framework to assess foveal development and disease. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the vitreomacular interface in idiopathic full-thickness macular holes (MHs) using spectral-domain optical coherence tomography. Design: Prospective cross-sectional case series. Methods: Ninety-one eyes of 86 consecutive patients with a MH were examined by spectral-domain optical coherence tomography. The vitreomacular interface was assessed and the presence or absence of an operculum was analyzed. Results: Fifty-two eyes had a stage 2 MH, 12 eyes a stage 3 MH, and 27 eyes a stage 4 MH. No posterior hyaloid membrane was detected in any eyes with a stage 4 MH. In 35 (54.7%) of the 64 eyes with an MH without a complete posterior vitreous detachment (PVD), we saw a perifoveal PVD with vitreofoveal adhesion and partial dehiscence of the raised inner retina with an outer retinal separation in the MHs. In 24 (37.5%) of the 64 eyes without a complete PVD, an operculum, which is a hyperreflective structure of the foveal retina, was in front of the MH. The posterior hyaloid membrane was separated completely but adhered to the optic disc. In 2 (3.1%) of the 64 eyes without a complete PVD, the posterior hyaloid membrane was separated from the macula without an operculum. In 3 (4.7%) of the 64 eyes without a complete PVD, vitreofoveal adhesion on both edges of the hole was connected to the taut posterior hyaloid membrane without an operculum. Conclusions: The vitreomacular interface had 4 configurations in MHs without a complete PVD. Approximately 55% of cases with an open roof in the eyes without a complete PVD may be at risk for progression to operculum formation (loss of retinal tissue). [ABSTRACT FROM AUTHOR]

Purpose: Ultraviolet-B (UV-B) radiation can cause phototoxic macular injuries in young people who have been sunbathing but not sungazing and in welders. Welders have a reportedly increased risk of uveal melanoma. We analyze phakic and pseudophakic risks for solar and welding arc UV-B exposure., Design: Optical radiation measurement, analysis, and perspective., Methods: Spectral transmittances were measured for UV-transmitting, UV-blocking, and blue-blocking intraocular lenses (IOLs). The photoprotective performances of crystalline and intraocular lenses were analyzed using relevant epidemiologic and laboratory data and action spectra for acute retinal phototoxicity and melanoma photocarcinogenesis., Results: Crystalline lens UV-B retinal protection is deficient in children and young adults, increasing their potential susceptibility to acute retinal phototoxicity and hypothetical photomelanomagenesis. UV-B radiation has sufficient energy/photon to induce primary melanomagenic DNA lesions, unlike blue light or UV-A radiation. UV-blocking and blue-blocking IOLs have negligible UV-B transmittance. UV-transmitting IOL transmittance of UV-B radiation is equivalent to that of a 15-year-old crystalline lens., Conclusions: If optical radiation exposure is responsible for welders' increased risk of uveal melanoma, then UV-B radiation is the most probable causative agent and spectacle wear is a potential confounding factor in epidemiologic studies of ocular melanoma. Welders under 30 years of age are at greater risk for welding maculopathy than older welders. Children, adults under 30 years of age, and pseudophakic individuals with UV-transmitting IOLs should wear sunglasses in bright environments because of the UV-B window in their crystalline lenses or IOLs., (Copyright 2010 Elsevier Inc. All rights reserved.)

Long-term ingestion of allopurinol, an antihyperuricemic agent used to treat gout, may be related to the development of lens opacities in relatively young patients (second to fifth decades of life). Cataracts obtained from three patients taking allopurinol were subjected to high-resolution phosphorescence spectroscopy. The characteristic allopurinol triplet was demonstrated in all three cataracts. Identical spectra were obtained for normal human lenses incubated in media containing 10(-3)M allopurinol and exposed to 1.2 mW/cm2 ultraviolet radiation for 16 hours; control lenses (irradiated without allopurinol) showed no allopurinol triplets. Similar data were obtained for lenses from rats given one dose of allopurinol and exposed to ultraviolet radiation overnight. These data provide evidence that allopurinol can be photobound in rat and human lenses and suggest its cataractogenic potential.

We performed experiments to determine the potential usefulness of nuclear magnetic resonance spectra in the diagnosis and follow-up of ocular melanoma. High-resolution phosphorus 31 nuclear magnetic resonance spectra at 109.3 MHz were obtained for human uveal melanoma, Greene hamster melanoma, and normal human diploid fibroblast cells. Phosphate metabolites were identified and their concentrations were shown to vary among the different cell lines. Uveal melanoma cells contain unusually high concentrations of the phospholipid metabolite phosphorylcholine and the phosphodiesters glycerol 3-phosphoryl choline and glycerol 3-phosphoryl ethanolamine. Baseline data are thus provided for studies of the effect of various treatment modalities on uveal melanoma. These initial results suggest that the data provided by high-resolution phosphorus 31 nuclear magnetic resonance spectra can provide useful diagnostic and follow-up data with respect to ocular melanoma.