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We present a novel method for generating optical vortex needle beams (focused optical vortices with extended depth-of-focus) using a compact flat multilevel diffractive lens (MDL). Our experiments demonstrate that the MDL can produce focused optical vortices (FOVs) with topological charges l = 1 − 4 (extendable to other l values), maintaining focus over distances significantly longer than conventional optical vortices. Specifically, FOVs exhibit non-diffracting behavior with a depth-of-focus (DOF) extended beyond 5 cm, compared to conventional optical vortices, which show continuous size increase due to diffraction. When the MDL is illuminated by an optical vortex of 3 mm diameter, it achieves a transmission efficiency of approximately 90 % and extends the DOF several times beyond that of traditional lenses. Increasing the size of the input optical vortex further extends the DOF but introduces additional rings, with their number increasing proportionally to the value of l. Our approach, validated by both experimental results and numerical simulations, proves effective for beams such as optical vortex and Hermite-Gaussian modes and holds potential applications in high-resolution imaging, material processing, optical coherence tomography, and three-dimensional optical tweezers, offering a simple and efficient solution for generating non-diffracting beams. [ABSTRACT FROM AUTHOR]

Multiple scattering poses a fundamental limitation in deep imaging, especially for high-resolution optical imaging methods. The amalgamation of reflection matrix measurements and optical coherence tomography (OCT) has afforded significant advantages for deep imaging through highly scattering media. To empirically exhibit the superior performance of reflection matrix OCT (RMOCT), this study proposes a unique method to ascertain the actual resolutions at each imaging point. In contrast to conventional theoretical lateral resolutions, these resolutions are derived by applying time-reversal decomposition to the time-gated reflection matrix. Moreover, the concept of contribution rate, which quantifies the imaging contributions for each point, is introduced by considering the local imaging point itself and its neighboring points. The contribution rate provides a quantitative evaluation of the imaging quality afforded by a system. To the best of our knowledge, this study represents the comprehensive assessment of the practical performance of RMOCT in terms of actual resolving power and imaging quality. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions To compare vitrectomy with and without internal limiting membrane (ILM) peeling in small idiopathic macular holes.Retrospective multicentre study including consecutive eyes with ≤250 μm idiopathic macular hole treated with vitrectomy. The primary outcome was hole closure rate. Best‐corrected visual acuity (BCVA) change, closure patterns on optical coherence tomography, rates of external limiting membrane (ELM) and ellipsoid zone (EZ) recovery, and rate of complications were also investigated.In total, 693 eyes were included. Hole closure rate was 98% in the peeling and 85% in the no‐peeling group (p < 0.001). At 12 months, mean BCVA change was 0.38 ± 0.22 logMAR in the peeling and 0.45 ± 0.21 logMAR in the no‐peeling group (p = 0.02); 66% versus 80% of eyes had a U‐shaped morphology, respectively; EZ recovery rate was 75% and 93%, respectively (p = 0.02). In the no‐peeling group, eyes with a vitreomacular traction (VMT) showed a 96% closure rate, comparable to the peeling group (p = 0.40). The incidence of adverse events was similar except for dissociated optic nerve fibre layer (55% in the peeling vs. 9% in the no‐peeling group, p < 0.001).In small idiopathic macular holes, ILM peeling provides a higher closure rate compared to no‐peeling; however, if a VMT is present closure rates are comparable. In closed macular holes, the no‐peeling technique provides advantages in terms of visual outcome and anatomical recovery. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions This study measured associations between ON and OFF functional indicators and structural optical coherence tomography (OCT) and OCT angiography (OCTA) markers in diabetic retinal disease.Fifty‐four participants with type 1 or type 2 diabetes (mean age = 34.1 years; range 18–60) and 48 age‐matched controls (mean age = 35.4 years, range 18–59) underwent visual psychophysical testing, OCT and OCTA retinal imaging. Psychophysical tasks measuring (A) contrast increment and decrement sensitivity and (B) response times to increment and decrement targets were assessed as surrogate measures of ON and OFF retinal ganglion cell function.The group with diabetes had worse foveal contrast increment and decrement thresholds (p = 0.04) and were slower to search for increment and decrement targets relative to controls (p = 0.009). Individuals with diabetes had a less circular foveal avascular zone (FAZ) (p < 0.001) but did not differ from controls in foveal vessel density and FAZ area. Functional and structural outcome measures related to the peripheral retina were also comparable between those with and without diabetes. Functional responses to increments and decrements were not significantly correlated with FAZ circularity or vessel density in individuals with diabetes.Diabetic retinal disease results in impaired performance on measures of inferred ON and OFF pathway function in addition to vascular deficits measurable with OCTA. Future longitudinal studies may determine the temporal relationship between these deficits, and whether they predict future diabetic retinopathy. [ABSTRACT FROM AUTHOR]

Central serous chorioretinopathy (CSCR) is a retinal disease characterised by the accumulation of subretinal fluid, which often resolves spontaneously in acute cases. However, approximately one-third of patients experience recurrences that may cause severe and irreversible vision. This study aimed to identify parameters derived from optical coherence tomography (OCT) that are associated with CSCR recurrence. Our dataset included 5211 OCT scans from 344 eyes of 255 patients diagnosed with CSCR. 178 eyes were identified as recurrent, 109 as non-recurrent, and 57 were excluded. We extracted parameters using artificial intelligence algorithms based on U-Nets, convolutional kernels, and morphological operators. We applied inferential statistics to evaluate differences between the recurrent and non-recurrent groups, and we used a logistic regression predictive model, reporting the coefficients as a measure of biomarker importance. We identified nine predictive biomarkers for CSCR recurrence: age, intraretinal fluid, subretinal fluid, pigment epithelial detachments, choroidal vascularity index, integrity of photoreceptors and retinal pigment epithelium layer, choriocapillaris and choroidal stroma thickness, and thinning of the outer nuclear layer, and of the inner nuclear layer combined with the outer plexiform layer. These results could enable future developments in the automatic detection of CSCR recurrence, paving the way for translational medical applications. [ABSTRACT FROM AUTHOR]

Background: We aimed to compare choroidal thickness (ChT) and retinal nerve fiber layer (RNFL) thickness in the affected and contralateral eyes of patients with Posner-Schlossman Syndrome (PSS) during acute, remission, and intermittent phases. Methods: This prospective observational study included 18 patients(36 eyes) diagnosed with PSS. These patients underwent a comprehensive ophthalmologic evaluation including slit lamp examination, visual acuity testing, intraocular pressure (IOP) measurement, and funduscopic examination, and assessment of RNFL thickness, macular thickness, and macular ChT. Patient data collected included gender, age, number of keratic precipitates (KPs), and number of episodes. Optical coherence tomography (OCT) was used to measure RNFL thickness, macular thickness, and macular ChT in both eyes during the acute, remission, and intermittent phases. The affected eye was compared with the unaffected eye at each phase. Results: In affected eyes, macular ChT was lower in the acute phase compared to the remission phase at N1500, N1000, N500, and subfoveal locations (allp < 0.05).The central macular recess ChT was also significantly thinner in the acute phase compared to the intermittent and remission phases. Age significantly correlated with ChT in the central recess (p =.024). Macular thickness was thinner during the acute phase in the affected eye (p =.048). The RNFL in the affected eye was thinner in the intermittent phase than in the acute phase at the inferior-temporal (p =.011) and global sectors (p =.044). During the acute phase, RNFL in the affected eye was thinner at the superior-nasal (p =.049), inferior-temporal (p =.003), and global (p =.041) sectors compared to the unaffected eye. In the intermittent phase, the affected eye's RNFL was thinner at the superior-nasal, inferior-temporal, inferior-nasal, and global sectors compared to the unaffected eye (allp < 0.05), while no difference was observed in both eyes at the nasal, superior-temporal, and temporal sectors. The number of episodes and age were significantly associated with RNFL thickness (p <.05). Conclusion: This study demonstrated that in eyes affected by PSS, RNFL, macular ChT, and macular thickness thinned during the acute phase. The number of episodes and age are significant factors in the development of PSS. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare demographics, clinical characteristics, and post-surgical outcomes between idiopathic and secondary full-thickness macular holes (MHs). Methods: A retrospective analysis of 348 eyes from 339 patients treated between June 2017 and December 2023 was conducted. The study included both idiopathic and secondary MHs, excluding cases where surgery was not performed or lacked sufficient follow-up. Demographic data, visual acuity (VA), ocular characteristics, and optical coherence tomography measurements were analyzed. Results: Idiopathic MHs were identified in 308 eyes (89%), and secondary MHs in 40 eyes (11%). Idiopathic MH patients were older (mean age: 68.26 vs. 60.13 years; p = 0.001) and more commonly female (63% vs. 40%; p = 0.005). Post-surgical closure was achieved in 86% of all MHs, with a median VA improvement of 15 ETDRS letters (3 Snellen lines). However, secondary MHs had a lower closure rate (67% vs. 89%, p = 0.001) and less VA improvement (2 lines vs. 3 lines, p = 0.001) compared to idiopathic MHs. Significant differences in maximal basal diameter and diameter hole index were noted between the groups. Conclusions: Secondary MHs, accounting for 11% of surgical cases, show poorer anatomical and visual outcomes than idiopathic MHs. Despite lower success rates, early surgical intervention in secondary MHs is recommended to enhance outcomes. Differentiating between idiopathic and secondary MHs is crucial for optimal management. [ABSTRACT FROM AUTHOR]

This prospective study aimed to investigate microvascular changes in diabetic patients undergoing cataract surgery. Foveal avascular zone (FAZ) area, as well as vessel density (VD) in the macula and radial peripapillary capillary plexus (RPC), were compared before and after surgery. Sixty eyes (72.3%) had no diabetic retinopathy (no DR group) and 23 eyes (27.7%) had non-proliferative diabetic retinopathy (DR group). In the no DR group, the FAZ area in the superficial capillary plexus (SCP) decreased from 0.41 ± 0.13 to 0.38 ± 0.11 mm2 (P = 0.036), while no significant change was observed in the DR group (0.33 ± 0.12 to 0.30 ± 0.12 mm2, P = 0.091) at 6 months postoperatively. VD in the RPC increased from 34.4 ± 2.3% to 35.6 ± 2.3% in the no DR group (P = 0.009), but there was no significant change in the DR group (33.0 ± 3.5% vs. 34.0 ± 2.3%, P = 0.051) after 6 months. VD in the macula did not change in either group. Phacoemulsification reduced the FAZ area in the SCP and increased the VD in the RPC in diabetic patients without diabetic retinopathy at six months postoperatively. [ABSTRACT FROM AUTHOR]

The synthesis of novel contrast agents based on carbon nanomaterials is garnering significant attention because of their unique properties, such as biocompatibility, ease of fabrication, colloidal stability, and low cost. This article describes a possible and sustainable approach for developing blue‐emitting fluorescent carbon nano‐onions from low‐quality Indian coal using simple mild acid oxidation. The high‐resolution transmission electron micrograph of prepared carbon nanomaterials reveals the crystalline graphitic and multilayer nano‐onion morphology, further supported by Raman and X‐ray diffraction study. Optical coherence tomography was used to capture the tissue image by employing carbon nano‐onions as a contrast agent. The surface defect caused by the carboxylic and hydroxyl functional groups of fluorescent carbon nano‐onions enhances the contrast by increasing the backscattering signal received from the deeper regions in the tissue sample. The transmission electron microscopic study and tunable emission property of carbon nano‐onions confirmed the different sizes of carbon nano‐onions, which also play a crucial role in backscattering. This inventive approach for producing large‐scale fluorescent carbon nano‐onions from low‐quality Indian coal opens up new possibilities for the economical and sustainable development of contrast agents for biomedical imaging. [ABSTRACT FROM AUTHOR]

Analyze the prognostic factors of visual outcome in central serous choriretinopathy (CSC) treated with subthreshold micropulse laser (SML) therapy through the most fundamental medical history and clinical examinations. It was a retrospective clinical study. We collected the most fundamental medical history and clinical examinations of CSC patients who received SML treatment, including visual acuity (VA) and spectral-domain optical coherence tomography (SD-OCT) of macular. Eyes were divided into two groups according the change of central macular thickness (CMT) before and one month after SML: CMT improvement and CMT deterioration group; divided into three groups according the change of VA: VA improvement, VA stability and VA decline group. Seventy-eight patients (eighty-three eyes) were enrolled. The baseline CMT was 339.83 ± 115.72 μm, and the baseline VA was 0.43 ± 0.36. One month after SML, CMT was 281.13 ± 121.48 μm, had a significant statistical improvement (p = 0.000); and VA was 0.46 + 0.42, had no significant statistical difference compared to baseline VA (p = 0.114). CMT of sixty-three eyes (75.90%) declined, and twenty eyes (24.10%) increased; VA of thirty-one eyes (37.35%) improved, fourteen eyes (16.87%) remained unchanged, and thirty-eight eyes (45.78%) declined. CMT and VA of twenty-seven eyes (32.53%) were both improved, and eleven eyes (13.25%) were both deteriorated. VA one month after SML was statistically correlated with age (p = 0.000), baseline VA (p = 0.000), and baseline CMT (P = 0.002). CMT and VA both improved one month after SML, and the improvement of CMT was more significant than VA. Elder age and poorer baseline vision indicated poorer VA one month after SML, while higher baseline CMT indicated better VA one month after SML. [ABSTRACT FROM AUTHOR]

To determine the characteristics of posterior precortical vitreous pockets (PPVPs) and to observe vitreous changes in myopic eyes by swept-source optical coherence tomography (SS-OCT) and en face imaging in a cohort of the Chinese Han population. This was a cross-sectional study. Volunteers (235 participants, 374 eyes) received an SS-OCT examination. The heights and widths of the PPVPs were measured by SS-OCT. The area of the PPVPs was measured on en face images. The relationships between PPVP size and sex, age, axial length (AL) and spherical equivalent (SE) were evaluated. The mean width and height were 6711.64 ± 1241.87 μm and 662.47 ± 326.39 μm, respectively. The area of the PPVPs was 30.296 ± 9.114 mm2. Boat-shaped, oval, and hook-shaped PPVPs were observed in 73.26%, 21.12%, and 5.62% of all eyes, respectively; 73.53% of all PPVPs had channels communicating with Cloquet's tubes. There was a significant difference in the PPVP width among the participates over and under 50 years old (t = -2.508, P = 0.031). Age had a positive correlation with the PPVP width (r = 0.53, P = 0.001). The PPVP height showed significant differences among the different myopia groups (F = 3.618, P = 0.013). SE had a negative correlation with the PPVP height (r = -0.176, P = 0.001). However, there were no correlations between the AL and the width, height or area of the PPVPs (P = 0.117; P = 0.334; P = 0.057, respectively). Age and myopia affect the size of PPVPs. SS-OCT greatly facilitates visualization of the complex structure of the vitreous. [ABSTRACT FROM AUTHOR]

Swimming goggles (SG) are widely used in water sports, and this study aimed to evaluate the acute effects of wearing SG on intraocular pressure (IOP), anterior chamber biometrics, axial length (AL), and optic nerve head (ONH) morphology. Twenty-eight healthy young adults participated in this cross-sectional study, with assessed parameters including IOP, central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber angle (ACA), AL, and optical coherence tomography (OCT) imaging of the ONH, specifically Bruch membrane opening (BMO), Bruch membrane opening-minimum rim width (BMO-MRW), lamina cribrosa depth (LCD), and prelaminar tissue (PLT). Measurements were taken at four time points: before wearing SG, at the 1st and 10th minutes of wearing, and immediately after removal. The results showed a significant increase in IOP at the 1st and 10th minutes of SG wear compared to pre-wear and post-removal values. Additionally, decreases in CCT, ACD, and ACA, along with an increase in AL, were observed while wearing SG. However, these changes reverted to baseline after the goggles were removed. No significant alterations were detected in ONH parameters during the study. The findings suggest that wearing SG induces an acute rise in IOP and changes in anterior segment parameters, likely due to oculopression, but does not appear to affect ONH morphology in the short term. Further studies are needed to investigate any potential long-term effects. [ABSTRACT FROM AUTHOR]

This study aimed to assess the efficacy of hyperbaric oxygen therapy (HBOT) in patients with central retinal artery occlusion (CRAO) by analyzing changes in visual acuity (VA) and enhanced depth imaging optical coherence tomography (EDI-OCT) parameters. A comparative retrospective study was conducted by reviewing the medical records of all HBO-treated RAO patients in our department and comparing them with matched RAO patients who did not receive HBO treatment. All patients treated with HBO received treatment within 7 days of the onset of visual symptoms. Baseline characteristics were compared, and VA and OCT parameters were evaluated at baseline and follow-up visits. A total of 50 eyes from 50 patients were included, with 29 eyes in the HBOT group and 21 eyes in the control group. The mean BCVA of the HBOT group at the initial visit was 2.03 logMAR, which improved to 1.55 logMAR at 6 months, with the change being statistically significant (P < 0.01), while the control group's BCVA remained almost unchanged, from 2.1 to 2.11 logMAR (P = 0.762). The central choroidal thickness increased significantly in the HBOT group over the subsequent period. The central fovea, and outer retinal layer thickness in the HBOT group were significantly greater than those in the control group at the 6-month follow-up after treatment. HBOT appears to be effective in improving VA and inducing favorable changes in OCT parameters in patients with CRAO. It helps to preserve retinal layer thickness, especially in the outer retinal layer. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusion\nSUMMARY STATEMENTTo assess the effectiveness and risk of intravitreal injection of dexamethasone implants in treating macular edema (ME) secondary to acute retinal necrosis (ARN).In this retrospective, noncomparative case series study, five patients who developed secondary ME after ARN and received an intravitreal dexamethasone implant injection were enrolled. The features of secondary ME on OCT and the outcomes of dexamethasone intravitreal implanting were presented.The mean age of the patients was 59 years (range, 51–61 years). All patients had unilateral involvement, and all 5 eyes showed mild to moderate anterior uveitis, retinal necrosis, and vasculitis. Herpes zoster virus was detected in all eyes using PCR, and timely antiviral and anti-inflammatory treatment was performed. Aqueous humor samples were negative for herpes zoster virus DNA, and resolution of viral retinitis was noted upon the occurrence of ME. Additionally, three eyes received pars plana vitrectomy with silicone oil prior to ME development. All eyes presented with intraretinal fluid, hyper-reflective foci, and impairments of the external limiting membrane/ellipsoid zone at varying degrees on OCT images. Epiretinal membrane was exhibited in 80% of eyes, but no vitreoretinal traction was detected. Subretinal fluid was visible in 60% of eyes. ME was relieved effectively in all eyes after intravitreal dexamethasone implanting. One of these patients experienced three episodes of ME. No recurrence of retinal necrosis or corticosteroid-associated ocular hypertension was observed during the follow-up period.Intravitreal injection of dexamethasone implants can effectively alleviate ME secondary to ARN and improve visual acuity with no adverse reactions.Macular edema secondary to acute retinal necrosis was characterized by the presence of intraretinal fluid, hyper-reflective foci, and external limiting membrane/ellipsoid zone fracture. The intravitreal injection of dexamethasone implants effectively alleviated this type of edema with no adverse reactions. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions Recently, an ‘hyperreflective ganglion cell layer band’ (HGB) has been described on spectral‐domain optical coherence tomography (SD‐OCT) in a subset of patients with retinitis pigmentosa (RP). This study aims to validate and describe the frequency of HGB in a large cohort of Portuguese patients with RP.This single‐centre, cross‐sectional cohort study included consecutive patients with a genetic diagnosis of RP. SD‐OCT images were reviewed to identify the presence of the HGB and other retinal comorbidities. The HGB was defined as a continuous hyperreflective band within the thickness of the ganglion cell layer (GCL). We built mixed‐effects regression models, accounting for inter‐eye correlations, to investigate features predictive of visual acuity. Subsequently, a reduced model was fitted.A total of 398 eyes from 201 patients were included. HGB was identified in 69 (17.3%) eyes from 39 (19.4%) patients. Patients presenting with the HGB were significantly younger at diagnosis and at symptom onset. Median BCVA [ETDRS (IQR)] was 65 (29) letters in eyes with the HGB and 70 (21) letters in eyes without HGB (p < 0.001). In both the full and reduced mixed‐effects models, the presence of HGB and macular hole (MH) was significantly associated with worse BCVA.This study validates the recent description of HGB within the GCL in a subset of patients with RP. Eyes with HGB demonstrated significantly worse BCVA compared to those without HGB, suggesting that the presence of HGB may serve as an SD‐OCT biomarker of worse visual prognosis in these patients. [ABSTRACT FROM AUTHOR]

Objective Methods Results Significance People with epilepsy (PwE) suffer from progressive brain atrophy, which is reflected as neuroaxonal loss on the retinal level. This study aims to provide initial insight into the longitudinal dynamics of the retinal neuroaxonal loss and possible driving factors.PwE and healthy controls (HC; 18–55 years of age) underwent spectral domain optical coherence tomography at baseline and 7.0 ± 1.5 and 6.7 ± 1.0 months later, respectively. The change in retinal thickness/volume and annualized percentage change (APC) were calculated for the peripapillary retinal nerve fiber layer (pRNFL), the macular RNFL (mRNFL), the ganglion cell inner plexiform layer (GCIP), the inner nuclear layer, and the total macular volume (TMV). Group comparisons and multiple linear models with stepwise backward selection were performed to evaluate associations with demographic and clinical parameters.PwE (n = 44, 21 females, mean age = 35.6 ± 10.9 years) revealed a significant decrease in the pRNFL, mRNFL, GCIP, and TMV thickness or volume in the study interval. When compared to HC (n = 56, 37 females, mean age = 32.7 ± 8.3 years), the APC of the pRNFL (−.98 ± 3.13%/year) and the GCIP (−1.24 ± 2.56%/year) were significantly more pronounced in PwE (p = .01 and p = .046, respectively). Of note, atrophy of the mRNFL was significantly influenced by the number of antiseizure medications (ASMs; p = .047) and increasing age of PwE (p = .03). Contradictory results, however, were revealed for the impact of seizures.In epilepsy, progression of retinal neuroaxonal loss was already detectable at short‐term follow‐up. PwE who receive a high number of ASMs seem to be at risk for accelerated neuroaxonal loss, stressing the importance of well‐considered and effective antiseizure therapy. [ABSTRACT FROM AUTHOR]

For optimum performance, deep learning methods, such as those applied for retinal and choroidal layer segmentation in optical coherence tomography (OCT) images, require sufficiently large and diverse labelled datasets for training. However, the acquisition and labelling of such data can be difficult or infeasible due to privacy reasons (particularly in the medical domain), accessing patient images such as those with specific pathologies, and the cost and time investment to annotate large volumes of data by clinical experts. Data augmentation is one solution to address this issue, either using simple variations and transformations of the images (e.g. flips, brightness) or using synthetic data from sophisticated generative methods such as generative adversarial networks (GANs). Semi-supervised learning (SSL) is another technique which aims to utilise unlabelled data to enhance the performance of deep learning methods and is beneficial where significant amounts of data may be available but are not labelled. In this study, we aim to enhance patch-based OCT retinal and choroidal layer segmentation with both GAN-based data augmentation and SSL. In particular, we employ a conditional StyleGAN2 to generate synthetic patches for data augmentation and a similar unconditional GAN for pre-training the patch classifier to perform SSL. In doing so, we propose a new patch classifier architecture based on the discriminator architecture to improve performance, in addition to the SSL benefit. Compared to previous methods, the proposed data augmentation approach provides an improved data augmentation performance for patch classification with its effectiveness widespread, particularly in the case of low data, across three different OCT datasets encompassing a range of scanning parameters, noise levels, pathology and participant variability. The method provides some subsequent improvements in boundary delineation which is of high importance from a clinical perspective. Additionally, the proposed SSL approach boosts classification performance and boundary delineation performance in some cases which provides further usefulness in the case of low data. The proposed methods can be utilised to enhance OCT segmentation methods, which may be of considerable benefit for both clinicians and researchers. [ABSTRACT FROM AUTHOR]

Purpose: The interplay between myopia and glaucoma has gained attention, with escalating myopia demonstrating a significant association with increased POAG rates, particularly in patients with severe myopia. This systematic review aimed to comprehensively analyze the relationship between myopia and glaucoma, focusing on the structural and functional implications, risk factors, and assessment modalities. Optical coherence tomography (OCT) played a crucial role in this study, particularly in highly myopic populations. Methods: This study's rigor is underscored by using the PRISMA guidelines, which ensured a meticulous search strategy was employed across multiple databases from 2012 to 2024. The inclusion criteria included individuals aged 18 years or older with high myopia, defined as a spherical equivalent of less than -6.0 diopters or an axial length > 26.0 mm, diagnosed with chronic glaucoma. Various study designs were incorporated, including randomized controlled trials, prospective cohort studies, and observational studies. Quality assessment was performed using the Jadad Scale, and statistical analyses were performed to summarize the study characteristics and outcomes. Results: Of the 350 initial articles, 15 met the inclusion criteria. OCT assessments revealed structural changes such as thinning of the retinal nerve fiber layer preceding functional losses. Meta-analyses demonstrated a heightened risk of POAG with increasing myopia severity, showing a significant nonlinear relationship. This meta-analysis of six studies involving 3040 patients revealed a relationship between myopia and glaucoma (OR = 12.0, 95% CI 10.1–4.7, P < 0.00001). Conclusion: This comprehensive analysis consolidates the evidence of the relationship between myopia and glaucoma, emphasizing the pivotal role of OCT and other imaging modalities in early detection and monitoring. Plain language summary: Glaucoma is a significant cause of permanent blindness worldwide. This causes damage to the visual nerve that worsens over time. The primary way to treat open-angle glaucoma and its many causes is to lower eye pressure. Further research is being conducted to determine the relationship between nearsightedness and glaucoma. Increased nearsightedness is significantly linked to higher rates of glaucoma, especially in people with severe nearsightedness. This review aimed to examine the link between myopia and glaucoma in greater depth, focusing on structural and functional effects, risk factors, and assessment methods, especially optical coherence tomography (OCT), in very nearsighted people. We conducted a thorough search of several databases between 2012 and 2024. Individuals aged 18 years or older with myopia greater than six diopters or an axial length greater than 26 mm and a diagnosis of chronic glaucoma were eligible. Randomized controlled trials, prospective cohort studies, and observational studies were some of the methods used in this study. The quality of the work and statistical methods were used to summarize the features and results of the study. Of the 350 articles initially published, only 15 met the inclusion criteria. These studies mostly used different optical tomography tests to detect structural changes, such as ocular nerve fiber layer damage, before functional loss. According to meta-analyses, the risk of chronic glaucoma increases as myopia worsens, indicating a solid nonlinear relationship. Myopia and glaucoma are linked, demonstrating the importance of thorough evaluation. Severe myopia is strongly associated with damage to the visual nerve. Over the past few years, optical tomography has become a vital imaging tool for identifying early damage to the optic nerve. However, further research is needed on the sex-related tendencies of glaucoma patients. This study provides data that reveal a link between nearsightedness and glaucoma, highlighting the importance of optical tomography and other imaging techniques for early detection and monitoring. To better manage glaucoma in highly myopic individuals, we need to understand how the severity of myopia, changes in structure, and changes in function affect each other. [ABSTRACT FROM AUTHOR]

Background: Although there has been a large increase in the number of extensive macular atrophy with pseudodrusen (EMAP) cases, the basic aspects of this disease remain unknown. Brazilian patients have a common past history of rheumatic fever (RF) and/or benzathine penicillin (BP) treatment possibly related to the disease. We analyzed how RF and BP might be correlated with EMAP in Brazilian patients. Design: Observational, retrospective, case-control study. Methods: The databases of three private eye clinics in Brazil were searched for patients with an EMAP-like appearance. Each patient was asked about a previous history of RF and/or long-term use of BP. Patients underwent best-corrected visual acuity (BCVA) measurement, color fundus imaging, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT) imaging, and electroretinography (ERG). The following characteristics were analyzed: subretinal drusenoid deposits (SDD), pigment mottling, retinal pigment epithelial/basement membrane (RPE/BM) separation, outer retinal or RPE atrophy, and identification of a paving stone-like appearance. The choroidal thickness was measured using enhanced depth imaging OCT. The central atrophic area was measured manually on ultra-wide-field FAF. Results: A total of 154 eyes of 77 patients (women, 66.2%; mean age, 58.6 years) with EMAP were included; 90.9% of patients were diagnosed with RF; 94.8% had been treated with BP and treatment was started at an average age of 7.3 years (mean duration, 11.8 years). The treatment duration was significant for the area of atrophy (P = 0.027) in which each 1-year increase in treatment duration led to an average reduction of 6.91 mm2 in area. The age at diagnosis of RF was significant (P = 0.026) for SDD. The increase of 1 year in the diagnosis of RF (late disease) led to a reduction of 24% in the chance of central SDD being present. On OCT, 65.5% eyes had SDD and more than 70% had a split RPE/BM and outer retinal or RPE atrophy. The choroidal thickness in patients with EMAP was significantly (P < 0.001) thinner than the control group. The ERG was abnormal in all eyes. Conclusion: These findings may suggest a relation between RF and EMAP in Brazilian patients. Patients with EMAP should be questioned about a history of RF. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionAbetalipoproteinemia (ABL, MIM 200,100) is a rare autosomal recessive disorder caused by nonfunctional microsomal triglyceride transfer protein leading to absence of apolipoprotein B-containing lipoproteins in plasma and a retinitis pigmentosa-like fundus. The MTTP gene is expressed in retinal pigment epithelium (RPE) and ganglion cells of the human retina. Understanding ABL pathophysiology would benefit from new cellular-level clinical imaging of affected retinas.We report multimodal retinal imaging in two patients with ABL. Case 1 (67-year-old woman) exhibited a bilateral decline of vision due to choroidal neovascularization (CNV) associated with angioid streaks and calcified Bruch membrane. Optical coherence tomography were consistent with basal laminar deposits and subretinal drusenoid deposits (SDD).Case 2 (46-year-old woman) exhibited unusual hyperpigmentation at the right fovea with count-fingers vision and a relatively unremarkable left fundus with 20/30 vision. The left eye exhibited the presence of nodular drusen and SDD and the absence of macular xanthophyll pigments.We propose that mutated MTTP within the retina may contribute to ABL retinopathy in addition to systemic deficiencies of fat-soluble vitamins. This concept is supported by a new mouse model with RPE-specific MTTP deficiency and a retinal degeneration phenotype. The observed range of human pathology, including angioid streaks, underscores the need for continued monitoring in adulthood, especially for CNV, a treatable condition. [ABSTRACT FROM AUTHOR]

Biofilm formation by Shewanella oneidensis has been extensively studied under oxic conditions; however, relatively little is known about biofilm formation under anoxic conditions and how biofilm architecture and composition can positively influence current generation in bioelectrochemical systems. In this study, we utilized a recently developed microfluidic biofilm analysis setup with automated 3D imaging to investigate the effects of extracellular electron acceptors and synthetic modifications to the extracellular polymeric matrix on biofilm formation. Our results with the wild type strain demonstrate robust biofilm formation even under anoxic conditions when fumarate is used as the electron acceptor. However, this pattern shifts when a graphite electrode is employed as the electron acceptor, resulting in biofilm formation falling below the detection limit of the optical coherence tomography imaging system. To manipulate biofilm formation, we aimed to express BpfG with a single amino acid substitution in the catalytic center (C116S) and to overexpress bpfA. Our analyses indicate that, under oxic conditions, overarching mechanisms predominantly influence biofilm development, rather than the specific mutations we investigated. Under anoxic conditions, the bpfG mutation led to a quantitative increase in biofilm formation, but both strains exhibited significant qualitative changes in biofilm architecture compared to the controls. When an anode was used as the sole electron acceptor, both the bpfA and bpfG mutations positively impacted mean current density, yielding a 1.8-fold increase for each mutation. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionTo present a presumed case of non-paraneoplastic autoimmune retinopathy (nPAIR) following COVID-19 in a healthy woman.A single case was evaluated and followed for 32 months.A healthy 32-year-old woman presented with photopsia and paracentral scotoma (OU) after a recent COVID-19 infection. Past medical history and family history were unremarkable. Her visual acuity was normal (OU). Retinal atrophy, mild disc pallor, and foveal reflex attenuation were observed (OU). Optical coherence tomography (OCT) scans showed outer nuclear layer thinning and ellipsoid zone disruption (OU). The visual field test showed blind spot enlargement and arcuate scotomas (OU). Uveitis workup and underlying malignancy investigations were negative. A diagnosis of nPAIR was presumed. At the time, she refused therapy, and 20 months later, her visual acuity was stable, but there were progressive retinal atrophic changes and visual field constriction. After initiation of glucocorticoids and immunosuppressive therapy, flashing lights completely disappeared, her visual field was stabilized without progression, and OCT scans showed partial recovery of ellipsoid zone.SARS-CoV-2 infection may be a trigger for nPAIR in susceptible individuals, but further research is needed to determine this association. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsTo compare the impact of 8 mm versus 9 mm optical zone (OZ) diameters on corneal astigmatism correction and to evaluate the impact of incision depth percentage after femtosecond laser corneal relaxing incisions (CRIs) combined with cataract surgery.Thirty-nine eyes from 39 patients were enrolled and randomly assigned to two groups based on the OZ diameter: 8 mm and 9 mm. Corneal astigmatism and CRI depth were measured using Pentacam and anterior segment optical coherence tomography. Vector analysis was performed using Alpins method.In the 8 mm group, postoperative corneal astigmatism was reduced by 0.77 ± 0.61 diopters (D), significantly greater than the reduction of 0.42 ± 0.40 D in the 9 mm group (p < 0.05). The 8 mm group exhibited greater surgically induced astigmatism (SIA), net corneal changes, and a smaller angle of error (AE) (p < 0.05). At 3 months postsurgery, the correction index (CI) values were 0.84 ± 0.39 for the 8 mm group, exceeding the 0.52 ± 0.32 observed in the 9 mm group (p < 0.05). The mean incision depth percentage was significantly higher in the 9 mm group (79.30 ± 10.76%) compared to the 8 mm group (72.58 ± 8.73%) (p < 0.05). In the 8 mm group, CI values closer to 1.00 were associated with lower percentages of incision depth.CRIs with an 8 mm OZ diameter demonstrated superior efficacy in correcting corneal astigmatism with shallower incision depths compared to those with a 9 mm diameter. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the baseline characteristics of fundus autofluorescence (FAF) in patients with submacular hemorrhage (SMH). Methods: This retrospective study included patients diagnosed with treatment-naive, foveal-involving subretinal hemorrhage (size > 2-disc diameters) of any etiology, presenting between June 2017 and June 2023. Only cases with good-quality color fundus photographs, optical coherence tomography (OCT) scans, and blue-light FAF images at baseline were included. SMH imaging characteristics were documented and correlated with treatment outcomes. A successful treatment outcome was defined as the reduction, displacement or clearance of the SMH from beneath the fovea. Results: Nineteen cases of SMH (13 males, 6 females), ranging from 14 to 85 years, were analyzed. Neovascular age-related macular degeneration (nAMD) was the most common etiology (n = 11, 58%). Baseline visual acuity ranged from 6/9 to counting fingers at ½ meter, with a median presentation time of 7 days from symptom onset (range: 1–57 days). Treatment success was observed in 13 eyes (68%). Hypoautofluoroscence on FAF was significantly associated with SMH resolution (p = 0.021). However, no association was found between treatment success and clinical hemorrhage characteristics (p = 0.222), OCT findings (p = 0.222), or specific treatments (p > 0.05). Hypoautofluoroscence on FAF was the sole predictor of treatment success, as demonstrated by Spearman's correlation (r = 0.637; p = 0.003) and linear regression analysis (p = 0.003). Conclusion: FAF, in conjunction with color fundus photography and OCT, may provide valuable insights for clinicians in formulating treatment strategies for patients with SMH. Hypoautofluoroscence on FAF was a significant predictor of successful SMH resolution in this study. [ABSTRACT FROM AUTHOR]

The increasing incidence and mortality rates of cerebrovascular disease impose a heavy burden on both patients and society. Retinal imaging techniques, such as fundus photography, optical coherence tomography, and optical coherence tomography angiography, can be used for rapid, non-invasive evaluation of cerebral microcirculation and brain function since the retina and the central nervous system share similar embryonic origin characteristics and physiological features. This article aimed to review retinal imaging biomarkers related to cerebrovascular diseases and their applications in cerebrovascular diseases (stroke, cerebral small vessel disease [CSVD], and vascular cognitive impairment [VCI]), thus providing reference for early diagnosis and prevention of cerebrovascular diseases. [ABSTRACT FROM AUTHOR]

Background: Congenital optic disc pit (ODP) is a relatively uncommon congenital anomaly of the optic disc, which seriously affects the patient's vision when combined with optic disc pit maculopathy(ODP-M). Currently, the treatment of ODP-M remains a clinical challenge and a focus of research. Case presentation: A boy had a pit in the inferotemporal segment of the optic disc with ODP-M. Optical Coherence Tomography(OCT) showed ODP and serous retinal detachment. He was treated with pars plana vitrectomy(PPV), followed by Corneal Stromal Lenticule (CSL) sealing and C3F8 tamponade. In the end, significant anatomical improvement was achieved, and the Best Corrected Visual Acuity(BCVA) was improved. Conclusions: The CSL transplantation may be a viable therapeutic option for improving ODP-M with stable anatomical and functional result. However, more cases and longer follow-up are needed to confirm the safety and effectiveness of the technology. [ABSTRACT FROM AUTHOR]

Classification and identification of eye diseases using Optical Coherence Tomography (OCT) has been a challenging task and a trending research area in recent years. Accurate classification and detection of different diseases are crucial for effective care management and improving vision outcomes. Current detection methods fall into two main categories: traditional methods and deep learning-based approaches. Traditional approaches rely on machine learning for feature extraction, while deep learning methods utilize data-driven classification model training. In recent years, Deep Learning (DL) and Machine Learning (ML) algorithms have become essential tools, particularly in medical image classification, and are widely used to classify and identify various diseases. However, due to the high spatial similarities in OCT images, accurate classification remains a challenging task. In this paper, we introduce a novel model called "OCTNet" that integrates a deep learning model combining InceptionV3 with a modified multi-scale attention-based spatial attention block to enhance model performance. OCTNet employs an InceptionV3 backbone with a fusion of dual attention modules to construct the proposed architecture. The InceptionV3 model generates rich features from images, capturing both local and global aspects, which are then enhanced by utilizing the modified multi-scale spatial attention block, resulting in a significantly improved feature map. To evaluate the model's performance, we utilized two state-of-the-art (SOTA) datasets that include images of normal cases, Choroidal Neovascularization (CNV), Drusen, and Diabetic Macular Edema (DME). Through experimentation and simulation, the proposed OCTNet improves the classification accuracy of the InceptionV3 model by 1.3%, yielding higher accuracy than other SOTA models. We also performed an ablation study to demonstrate the effectiveness of the proposed method. The model achieved an overall average accuracy of 99.50% and 99.65% with two different OCT datasets. [ABSTRACT FROM AUTHOR]

Objectives To investigate optical coherence microscopy (OCM) imaging features and the application value of these high-resolution images for identifying endocervical canal lesions (ECLs), which is a clinical dilemma in cervical cancer screening programs. Methods In total, 520 OCM images were obtained by scanning the cervical canal lesions with an ultra-high-resolution OCM system (204 specimens from 73 patients). The OCM morphologic characteristics of ECLs were observed and summarized, and then 3 researchers performed a diagnostic test of OCM images of cervical canal lesions. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, 95% confidence interval of each parameter, and interinvestigator agreement (κ) were calculated. Results Normal endocervix, cysts, squamous metaplasia, high-grade squamous intraepithelial lesions involving glands, and invasive carcinoma had distinct OCM characteristics, which correlated well with corresponding H&E histologic sections. The accuracy, sensitivity, and specificity of the 3 researchers were 90.6%, 89.3% (95% CI, 86.5%-91.7%) and 91.6% (95% CI, 89.2%-93.5%), respectively. The positive predictive value was 90.1% (95% CI, 87.3%-92.4%), and the negative predictive value was 90.9% (95% CI, 88.5%-92.9%), with almost perfect agreement (κ = 0.874). Conclusions The application of the OCM system in cervical canal lesions is feasible and could help improve detection of occult ECLs in cervical cancer screening programs. This study lays the foundation for further research on OCM in cervical canal lesions in vivo, which also has a potential impact on projecting pathologic evaluation beyond what is currently possible, perhaps globally. [ABSTRACT FROM AUTHOR]

Many non-destructive optical testing methods are currently used for material research, providing various information about material parameters. At RECENDT, a multimodal experimental setup has been designed that combines terahertz (THz) spectroscopy, optical coherence tomography (OCT), infrared (IR), and Raman spectroscopy with a tensile test stage. This setup aims to gather material information such as crystallinity and optical parameters of high-density polyethylene (HDPE) during a tensile test. The setup compares common IR and Raman spectroscopy and the less common optical methods THz and OCT. Complementarity is achieved through different frequency ranges and measurement approaches, resulting in different measured optical material parameters and depths. During tensile testing, HDPE samples with varying crystallinity were analysed, and the determined optical parameters such as refractive index, birefringence, scattering coefficient of decay, and penetration depth can be correlated with the change in crystallinity. These findings demonstrate that the optical methods and their outcomes can be interconnected. With further optimization of the experimental setup, it would be possible to observe the alignment of fibres in fibre composite panels and the stress distribution of polymers effectively. This opens interesting possibilities for polymer characterization in the future, including quality control during moulding processes and material testing. [ABSTRACT FROM AUTHOR]

Objectives: Achromatopsia (ACHM) is a rare autosomal, recessively inherited disease that is characterized by cone dysfunction, for which several gene therapies are currently on trial. The aim of this study was to find correlations between the morphological macular changes identified using optical coherence tomography (OCT) and some visual functional parameters. Visual acuity (VA), contrast sensitivity (CS), and macular sensitivity obtained by means of microperimetry were assessed. Methods: Adolescents with ACHM underwent macular microperimetry (S-MAIA device) in mesopic condition, macular OCT, best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), near vision acuity (NVA), and CS measurement. Results: Eight patients (15 eyes) with ACHM were analyzed. The mean age was 17 ± 2.7 years, and genetic variants involved the CNGA3 gene (37.5%) and CNGB3 gene (62.5%). OCT staging significantly correlated with microperimetry sensitivity parameters, namely the sensitivity of the central foveal point (p = 0.0286) and of the first and second perifoveal rings (p = 0.0008 and p = 0.0014, respectively). No correlations were found between OCT staging and VA measurements, nor with CS value. Conclusions: Among the extensive evaluated visual function tests, only microperimetry sensitivity showed a correlation with morphological macular changes identified at OCT. Microperimetry sensitivity may thus represent a useful visual function tool in natural ACHM history studies considering the upcoming research on gene therapies for the treatment of ACHM. [ABSTRACT FROM AUTHOR]

In acute myocardial infarction (AMI), the urgency of coronary revascularization through percutaneous coronary intervention (PCI) is paramount, offering notable advantages over pharmacologic treatment. However, the persistent risk of adverse events, including recurrent AMI and heart failure post-revascularization, underscores the necessity for enhanced strategies in managing coronary artery disease. Traditional angiography, while widely employed, presents significant limitations by providing only two-dimensional representations of complex three-dimensional vascular structures, hampering the accurate assessment of plaque characteristics and stenosis severity. Intravascular imaging, specifically optical coherence tomography (OCT), significantly addresses these limitations with superior spatial resolution compared to intravascular ultrasound (IVUS). Within the context of AMI, OCT serves dual purposes: as a diagnostic tool to accurately identify culprit lesions in ambiguous cases and as a guide for optimizing PCI procedures. Its capacity to differentiate between various mechanisms of acute coronary syndrome, such as plaque rupture and spontaneous coronary dissection, enhances its diagnostic potential. Furthermore, OCT facilitates precise lesion preparation, optimal stent sizing, and confirms stent deployment efficacy. Recent meta-analyses indicate that OCT-guided PCI markedly improves safety and efficacy in revascularization, subsequently decreasing the risks of mortality and complications. This review emphasizes the critical role of OCT in refining patient-specific therapeutic approaches, aligning with the principles of precision medicine to enhance clinical outcomes for individuals experiencing AMI. [ABSTRACT FROM AUTHOR]

Background/Objectives: The diagnosis of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) represent a significant challenge in oral medicine. Optical coherence tomography (OCT) shows promise for evaluating oral tissue microstructure but lacks standardized diagnostic protocols tailored to the structural variability and lesions of oral mucosa. Methods: This cross-sectional observational study aims to evaluate the diagnostic accuracy of targeted biopsy-based and site-coded OCT protocols for common OPMDs and OSCC. Adult patients clinically diagnosed with OPMDs, including oral leukoplakia (OL), oral lichen planus (OLP), and OSCC were enrolled. Clinical and OCT evaluation before and after punch scalpel-site registration preceding diagnostic biopsy on the target site was performed. Blinded observers analyzed the OCT scans for OCT-based diagnoses. Sensitivity, specificity, and diagnostic accuracy for OCT evaluations before and after punch scalpel-site registration were statistically compared with histological findings. Results: A dataset of 2520 OCT scans and 210 selected images from 21 patients was obtained. Sensitivity and specificity post-target site registration were high for OSCC (98.57%, 100.00%), OL (98.57%, 98.57%), and OLP (97.14%, 98.57%). The positive predictive values ranged from 97.14% to 100.00%, while negative predictive values ranged from 98.57% to 99.29%. Inter-observer agreements were strong for OSCC (0.84) and moderate for OL (0.54) and OLP (0.47–0.49). Targeted OCT scans significantly improved diagnostic accuracy for all conditions (p < 0.001). Conclusions: This preliminary study supports using site-targeted OCT scans followed by a site-targeted punch biopsy, enhancing precision in oral diagnostics. This approach is foundational for developing pioneering automated algorithms guiding oral cancer and pre-cancer diagnosis via OCT imaging. [ABSTRACT FROM AUTHOR]

Objectives: The most important phase in the endometrial pathologies diagnostics is the histological examination of tissue biopsies obtained under visual hysteroscopic control. However, the unclear visual diagnostics characteristics of subtle focal endometrial pathologies often lead to selection errors regarding suspicious endometrial lesions and to a subsequent false pathological diagnosis/underestimation of precancer or early-stage cancer. Methods: In this study, we investigate the potential of Multimodal Optical Coherence Tomography (MM OCT) to verify suspicious endometrial lesion regions before biopsy collection. We study the polarization (by cross-polarization OCT, CP OCT) and elastic (by compression OCT-elastography, C-OCE) properties of ex vivo endometrial tissue samples in normal conditions (proliferative and secretory phases to the menstrual cycle, atrophic endometrium) with endometrial hyperplasia (non-atypical and endometrial intraepithelial neoplasia) and endometrial cancer subtypes (low-grade, high-grade, clear cell and serous). Results: To the best of our knowledge, this is the first quantitative assessment of relevant OCT parameters (depth-resolved attenuation coefficient in co-[Att(co) values] and cross-[(Att(cross) values] polarizations and Young's elastic modulus [stiffness values]) for the selection of the most objective criteria to identify the clinically significant endometrial pathologies: endometrial intraepithelial neoplasia and endometrial cancer. The study demonstrates the possibility of detecting endometrial pathologies and establishing optimal threshold values of MM OCT criteria for the identification of endometrial cancer using CP OCT (by Att(co) values = 3.69 mm−1, Sensitivity (Se) = 86.1%, Specificity (Sp) = 92.6%; by Att(cross) values = 2.27 mm−1, Se = 86.8%, Sp = 87.0%) and C-OCE (by stiffness values = 122 kPa, Se = 93.2%, Sp = 91.1%). The study also differentiates endometrial intraepithelial neoplasia from non-atypical endometrial hyperplasia and normal endometrium using C-OCE (by stiffness values = 95 kPa, Se = 87.2%, Sp = 90.1%). Conclusions: The results are indicative of the efficacy and potential of clinical implementation of in vivo hysteroscopic-like MM OCT in the diagnosis of endometrial pathologies. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate the impact of compensating retinal nerve fiber layer (RNFL) thickness for demographic and anatomical factors on glaucoma detection in Chinese and Indian adults. A population‐based study included 1995 healthy participants (1076 Chinese and 919 Indians) to construct a multivariable linear regression compensation model. This model was applied to 357 Chinese glaucoma patients, 357 healthy Chinese, and 357 healthy Indians using Cirrus spectral‐domain optical coherence tomography (OCT). The compensated RNFL thickness considered age, refractive error, optic disc parameters, and retinal vessel density. Results showed that although the average RNFL thickness was significantly higher in Chinese participants compared to Indians, the compensation model reduced this difference to nonsignificance. Moreover, the compensation model significantly improved the area under the receiver operating characteristic curve (0.90 vs. 0.78; p<0.001), sensitivity (75% vs. 51%), and specificity (67% vs. 32%) in distinguishing Chinese glaucoma patients from healthy Indian individuals. The compensation model significantly enhanced the diagnostic accuracy of RNFL thickness in distinguishing glaucoma in the Chinese ethnic group compared to the OCT instrument's default values. These results suggest that modifying RNFL measurements based on individual characteristics can yield substantial benefits for glaucoma detection across ethnicities. [ABSTRACT FROM AUTHOR]

Thiamine-responsive megaloblastic anemia (TRMA) syndrome is a rare syndrome with an autosomal recessive manner that develops due to a mutation in the SLC19A2gene. SLC19A2 encodes the highaffinity thiamine transport protein 1 (THTR1), which mediates the active transport of thiamine. The classical triad consists of megaloblastic anemia, sensorineural hearing loss, and non-autoimmune diabetes. Apart from this, ophthalmological, cardiological, and neurological findings have also been described. We present a case of thiamine-responsive megaloblastic anemia (TRMA) syndrome diagnosed in an adult with a novel mutation in the SLC19A2 gene. This 38-year-old female patient, a third child from a consanguineous marriage, presented with the classic TRMA triad: sensorineural deafness, megaloblastic anemia, and autoimmune diabetes. Starting thiamine treatment is essential in reducing the devel opmen t/pro gress ion of some complications; it is crucial to increase awareness of the disease and make an early diagnosis. [ABSTRACT FROM AUTHOR]

Purpose: This review focuses on extensive macular atrophy with pseudodrusen-like appearance (EMAP), a recently described maculopathy presenting with pseudodrusen-like lesions and chorioretinal atrophy more pronounced in the vertical axis. Methods: Narrative review of the literature published until May 2024. Results: The early onset age of EMAP (50–55 years) and its distinctive natural history, which includes night blindness followed by severe vision loss, differentiate it from atrophic age-related macular degeneration (AMD). A clear pathogenesis has not been determined, but risk factors include female gender and complement system abnormalities (altered levels of C3 and CH50). Moreover, lifelong exposure to pesticides has been suggested as risk factor for direct neuronal degeneration involving rods and cones. In the early phase of the disease, reticular pseudodrusen-like lesions appear in the superior perifovea and tend to coalescence horizontally into a flat, continuous, reflective material localized between the retinal pigmented epithelium and Bruch's membrane. Over time, EMAP causes profound RPE and outer retinal atrophy in the macular area, with a recent classification reporting a 3-stages evolution pattern. Blue autofluorescence showed rapidly evolving atrophy with either hyperautofluorescent or isoautofluorescent borders. Significant similarities between the diffuse-trickling phenotype of geographic atrophy and EMAP have been reported. Macular neovascularization is a possible complication. Conclusion: EMAP is specific form of early-onset atrophic macular degeneration with rapid evolution and no treatment. Further studies are needed to assess the best management. Key messages: What is known • Extensive Macular Atrophy with Pseudodrusen (EMAP) is a rapidly-progressive macular atrophy developing in the fifth-decade and leading to legal blindness. • Typical characteristics at multimodal imaging are reticular pseudodrusen-like lesions starting at the superior perifovea and vertically-oriented macular atrophy. What is new • Dysregulated complement cascade and pesticide-related toxicity have been proposed as possible etiologies. • In the late stages of the disease 50% of EMAP patients were legally blind by US standards and, after 7 years on average, atrophy reaches the mid-periphery. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to answer a key question: is MYO7A-inherited retinal dystrophy (MYO7A-IRD) a photoreceptor-first or retinal pigment epithelium-first disease? A second aim was to determine the most useful biomarkers to monitor disease progression in pediatric patients with Usher syndrome type 1B (USH1) secondary to MYO7A mutation. Methods: Fifty-two eyes from 26 patients with genetically-confirmed MYO7A-IRD underwent swept-source optical coherence tomography (SS-OCT). Structural abnormalities were evaluated and correlated with follow-up time and best corrected visual acuity (BCVA). All patients were evaluated at baseline and after ≥ 40 months of follow-up. Results: The mean (SD) patient age was 9.92 (± 4.1) years. Mean follow-up time was 43 (± 3.2) months. At the final evaluation, the most common qualitative abnormalities in the subfoveal area were alterations in the photoreceptor outer segments (76.9% of eyes) and in the interdigitation zone (IZ) (80.8%). The presence of cystoid macular edema at baseline was independently associated with worse BCVA at the final assessment (increase in LogMAR estimate = 0.142; t(45.00) = 2.78, p = 0.009). The mean width of the ellipsoid and interdigitation zones decreased significantly (by 668 μm and 278 μm, respectively; both p < 0.001). Conclusion: This study shows that disruption of the photoreceptor outer segments and the IZ are the first alterations detected by SS-OCT in the early phases of MYO7A-IRD. These data highlight the potential value of measuring the width of the ellipsoid and IZ to evaluate disease progression. These findings also demonstrate the utility of monitoring for the emergence of cystic lesions as biomarkers of worse visual prognosis in patients with MYO7A-IRD. [ABSTRACT FROM AUTHOR]

Purpose: To assess the choroidal status of Systemic Lupus Erythematosus (SLE) patients using Optical Coherence Tomography (OCT) and OCT-Angiography. Methods: SLE patients with disease duration < 10 years, no disease activity and no ocular involvement were recruited and cross-sectionally evaluated. A demographically similar cohort of healthy subjects was used for comparison. The main outcome is choroidal vascularity index (CVI). As secondary outcomes, choriocapillaris parameters and choroidal thickness (CT) were evaluated. Results: Forty eyes of 40 subjects (20 SLE patients and 20 healthy subjects) were studied with a mean ± SD age of 36.7 ± 9.9 years. In the SLE group, the mean ± SD duration of disease was 7.35 ± 2.21 years. Increased CVI was found in the SLE group (p = 0.022). Considering the choriocapillaris, SLE patients presented a lower number (p = 0.037) and a smaller total area (p = 0.041) of signal voids. No differences between groups were found in CT. For SLE patients, CT at subfoveal, temporal and inferior locations presented a negative moderate correlation with disease duration. A strong correlation between choriocapillaris parameters and age was demonstrated for both groups. Conclusions: This study provides evidence of subclinical choroidal changes in adult SLE patients with inactive disease and no overt ocular manifestation. Increased CVI and fewer and smaller flow voids in choriocapillaris with normal CT suggest increased choroidal vascularity in SLE. [ABSTRACT FROM AUTHOR]

Purpose: Although leukemic retinopathy accounts for 80% of ocular complications in acute leukemia, its pathogenesis remains unclear. To evaluate changes in retinal and choroicapillaris and structural parameters in patients with acute leukemia, we analyzed the correlation between vascular perfusion metrics and laboratory parameters and assessed the changes after hematopoietic stem cell transplantation (HSCT). Methods: Herein, 104 eyes of 52 patients aged 18 and above with acute leukemia were enrolled. 80 eyes of 40 healthy patients were recruited as control participants. All participants underwent optical coherence tomography (OCT) and OCT angiography (OCTA) at baseline. Results: Patients with acute leukemia had a significantly thicker ganglion cell-inner plexiform layer (GCIPL) and lower circularity index than the control participants. Post-HSCT perfusion metrics did not differ significantly, but parafoveal thickness decreased significantly. During the active phase of acute leukemia, lower platelet levels were associated with significant GCIPL thickening and increased foveal avascular zone and perimeter. D-dimer levels positively correlated with GCIPL thickness. Conclusion: Patients with acute leukemia had subclinical retinal microvascular deficits on OCTA and GCIPL thickening on OCT, possibly associated with bone marrow function. GCIPL thickness may indicate acute ischemia in such patients. Further studies must elucidate their clinical and prognostic significance. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the factors associated with retinal pigment epithelium (RPE) tear development in the early phase after anti-vascular endothelial growth factor (VEGF) drug initiation in eyes with neovascular age-related macular degeneration (nAMD) and retinal pigment epithelial detachment (PED). Methods: Treatment-naive eyes with nAMD and PED for which anti-VEGF drug injections had been initiated and followed up for at least 3 months after the 1st anti-VEGF drug injection, were retrospectively investigated. Baseline characteristics of the PEDs, including type, height, and area, were evaluated using fundus photographs, fluorescein angiography, and optical coherence tomography images. The association between patient age, sex, medical history, PED characteristics, and the development of RPE tears within 3 months of starting anti-VEGF therapy was examined. Results: This study included 244 eyes (230 patients; mean age 75.0 years, 159 males and 71 females). RPE tears occurred in 13 eyes (5.3%) within 3 months of the start of anti-VEGF therapy. Multivariate analysis showed an association of the development of RPE tears with PED height (every 100 µm, odds ratio [OR]: 1.50, 95% confidence interval [CI]: 1.07–2.12, p = 0.019), PED area (every 10 mm2, OR: 3.02, CI: 1.22–7.46, p = 0.016), and the presence of fibrovascular PED (OR: 59.22, CI: 4.12–850.59, p = 0.002). Eyes with cleft (the hypo-reflective space beneath the fibrovascular PED) were more likely to develop an RPE tear (p = 0.01, χ-square test). Conclusions: Fibrovascular PED, large PED area, high PED height, and the cleft finding are independent risk factors for the development of RPE tears early after the administration of anti-VEGF drugs. [ABSTRACT FROM AUTHOR]

Purpose: To identify optical coherence tomography (OCT) parameters that predict postoperative best corrected visual acuity (BCVA) and are based on recent understanding of the pathomechanism of idiopathic full thickness macular hole (iFTMH) formation and closure. Methods: A retrospective consecutive case series of patients who had macular hole (MH) surgery at our institution between 2016 and 2022 was performed. 32 eyes of 30 patients were selected with at least 12 months of follow-up, closed MH and good quality OCT at each visit. Univariate correlation analysis, multiple logistic regression with forward stepwise selection, and Akaike's Information Criterion (AIC) were used to identify the best predictors for postoperative BCVA at 6 and 12 months (M), and final (≥ 12 M) visits, and a new OCT index was created. Abilities of best models/indices to predict < 0.30 logMAR (> 20/40) BCVA were compared to macular hole index (MHI) using the area under the receiver operating curve (AU-ROC) analysis. Results: Statistical analysis revealed base diameter (B) (6 M), preoperative BCVA and B (12 M) and smaller ELM-GCL distance (A), and B (final visit) as predictors for postoperative BCVA. AU-ROC analysis indicated greatest AUC at 6 M for MHI and B (0.797, p = 0.004 and 0.836 p = 0.001, respectively) and for the new A/B index at 12 M and final visit (0.844, p = 0.002 and 0.913, p = 0.003, respectively). Conclusion: Our study suggests that MHI and B can be useful predictors of short term BCVA while the new A/B index that incorporates OCT parameters indicating potential preoperative photoreceptor damage may be a good predictor for long term postoperative BCVA. Our findings support the theory that initial hole formation mechanisms and photoreceptor damage define visual prognosis. [ABSTRACT FROM AUTHOR]

Purpose: To assess the intraday repeatability of macular architecture measurements in glaucomatous and non-glaucomatous patients using spectral-domain optical coherence tomography (SD-OCT) and to evaluate the independence from intraindividual intraocular pressure (IOP) fluctuations. Methods: In this single-center, time-point comparison study, 88 eyes with glaucoma, 53 eyes with ocular hypertension (OHT), and 253 healthy eyes underwent two standardized SD-OCT and intraocular pressure (IOP) measurements on the same day with a 5-h time gap. Bland–Altman plots, intraclass correlation coefficients (ICC), and random-effects model were used to analyze repeatability of entire retinal thickness, retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, and inner nuclear layer measurements. Results: Intraday measurements were highly reproducible in all 3 groups. ICC were greater than 0.90, respectively. The pairwise comparisons of morphometric parameters showed a statistically significant difference (P < 0.001, respectively) between groups (glaucoma vs. control, glaucoma vs. OHT) and a significant influence of time points. No correlation was found between IOP fluctuations and morphometric parameters (P > 0.05, respectively), except for a weak positive correlation with GCL (rho = 0.109, P = 0.031). Conclusions: The evaluation of macular morphometric parameters of SD-OCT showed a high intraday repeatability and an excellent degree of agreement in glaucoma, ocular hypertension, and healthy groups. The fixed effects of time points were statistically significant. Except for a weak positive correlation of ganglion cell layer, variability did not appear to be affected by intraday IOP changes. Additional research is required to fully understand the impact of IOP fluctuations on macular morphometric parameters, considering the small observed IOP changes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to compare choroidal thickness in juvenile open angle glaucoma (JOAG) and healthy controls using spectral domain optical coherence tomography (SD-OCT) and study its correlations. Methods: In this case–control study, 56 eyes of 28 JOAG patients and an equal number of controls were recruited. SD-OCT was used to measure the choroidal thickness (ChT), in the macular region at 5 locations: subfoveal, 1500 µm and 3000 µm nasal and temporal to the foveal center, and in the peripapillary region at 6 locations: up to 1500 µm, nasal and temporal to the disc, respectively. The ChT and its correlations with age, intraocular pressure, cup-to-disc ratio, central corneal thickness, mean deviation, and axial length were studied. Results: The average macular ChT in JOAG was 306.30 ± 56.49 µm vs. 277.12 ± 64.68 µm in controls. The average peripapillary ChT in JOAG was 197.79 ± 44.05 µm vs. 187.24 ± 38.89 µm in controls. The average total ChT (p = 0.042), the average macular ChT (p = 0.022), the subfoveal ChT (p = 0.022), the ChT 1500 µm (p < 0.001), and 3000 µm temporal to the fovea (p = 0.002) were significantly thicker in the JOAG group. In the JOAG group, the average macular ChT had a significant negative correlation with age, whereas axial length was positively correlated with the average peripapillary ChT. Conclusions: In this South Asian cohort of JOAG, the average total ChT, average macular ChT, subfoveal ChT, and ChT at 1500 µm, and 3000 µm temporal to the fovea were significantly thicker when compared to healthy controls. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to compare morphology and location of crystalline lens between acute acquired concomitant esotropia (AACE) patients and control subjects, both before and after cycloplegia. Methods: This is a prospective and observational clinical study. Morphological and locational parameters of the crystalline lens in 53 AACE patients and 32 control subjects were assessed before and after cycloplegia using CASIA2 system, which represents the latest swept-source anterior segment optical coherence tomography. Cycloplegic refraction was recorded by administering 1% atropine in patients younger than 12 years and 1% cyclopentolate in those > 12 years old. Morphological parameters included anterior radius of curvature (ARC), posterior radius of curvature (PRC), lens thickness (LTH), and equivalent diameter of lens (LED). Locational parameters comprised lens decentration (LD) and lens tilt (LT). Comparison of these parameters before and after cycloplegia were conducted between AACE and controls. Additionally, the study analyzed and compared the changes in these parameter post-cycloplegia. Results: Our findings suggest no significant difference in morphological parameters including ARC, PRC, LTH and LED between AACE patients and controls before or after cycloplegia. However, 2D-modeling data in the 0° meridian revealed that variation post-cycloplegia of LD (lens shift) in right eyes was different in AACE patients, measuring − 0.03(0.08) [median(interquartile range)] which was significantly distinct from the control group, exhibiting a measurement of 0.01(0.06) (z = − 2.373, p = 0.018). In left eyes, a similar trend was observed with lens shift in the 0° meridian being 0.02(0.06) in AACE, significantly differing from control group's measurement of − 0.02(0.08) (z = − 2.809, p = 0.005). Further, correlation analysis revealed that larger temporal shift of lens was associated with greater changes in ARC (r = 0.294, p = 0.006) and LTH (r = − 0.230, p = 0.031). Conclusions: The morphological features of the crystalline lens were similar in AACE patients and controls; however, the change of lens location by cycloplegia was observed only in AACE patients, suggesting an association with excessive accommodation. [ABSTRACT FROM AUTHOR]

Objective: We aimed to compare retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness in bipolar disorder (BD) and major depressive disorder (MDD). Method: The study included thirty MDD, thirty-two BD participants in depressive episode, and thirty-seven controls matched according to age, gender, body mass index (BMI), and smoking status. Optic coherence tomography (OCT) measurements were performed for both participants and controls. The RNFL and GCC thickness were measured and recorded automatically by a spectral OCT device. Participants were also subjected to Hamilton Depression Rating Scale (HAM-D). Results: RNFL superior thickness was significantly lower in BD participants, compared to the MDD participants and controls (p = 0.001). GCC inferior (p = 0.022) and inferonasal (p = 0.005) thickness were detected lower in BD group, compared to the control groups. In the BD group, HAM-D scores were negatively correlated with RNFL-temporal (p = 0.049, r= −0.357), GCC inferotemporal (p = 0.02, r= −0.416) and superotemporal thickness (p = 0.002, r= −0.546). Conclusions: RNFL thickness were lower in BD participants compared to the MDD and controls and, GCC thickness were lower in BD participants compared to the controls. Our findings support the hypothesis that neurodegeneration is part of the pathogenesis of BD. Future research are needed to confirm the lack of RNFL thickness in MDD, which could have immediate therapeutic consequences as well as implications for distinguishing BD from MDD. KEY POINTS: RNFL thickness is lower in BD participants compared to the MDD and controls. GCC thickness were lower in BD participants compared to the controls. HAM-D scores are negatively correlated with RNFL temporal and, GCC inferotemporal and superotemporal thickness. [ABSTRACT FROM AUTHOR]

Background: A connection has been established between ocular structural changes and various neurodegenerative diseases. Several studies utilizing optical coherence tomography (OCT) have detected signs of ocular structural alterations among individuals with Huntington's disease (HD). The inconsistent results reported in the literature regarding alterations in the retina and choroid encouraged us to conduct this systematic review and meta-analysis to accumulate the findings. Methods: A systematic search was carried out in three electronic databases (PubMed, Embase, Scopus) to find studies reporting OCT measurements in HD cases compared with healthy controls (HC). A fixed-effects or random-effects meta-analysis was conducted according to the detected heterogeneity level. Furthermore, subgroup and sensitivity analyses, meta-regression, and quality assessment were performed. Results: Eleven studies were included in the systematic review and 9 studies with a total population of 452 participants (241 cases, and 211 HC) underwent meta-analysis. Results of the analysis denoted that subfoveal choroid had a significantly reduced thickness in HD eyes compared to HC (p < 0.0001). Moreover, our analysis indicated that HD cases had a significantly thinner average (p = 0.0130) and temporal peripapillary retinal nerve fiber layer (pRNFL) (p = 0.0012) than HC. However, subjects with pre-HD had insignificant differences in average (p = 0.44) and temporal pRNFL thickness (p = 0.33) with the HC group. Conclusion: Results of the current systematic review and meta-analysis revealed the significant thinning of average and temporal pRNFL and subfoveal choroid in HD compared to HC. However, OCT currently might be considered insensitive to be applied in the pre-HD population at least until further longitudinal investigations considering variables such as the duration between OCT measurement and disease onset validating OCT as a routine diagnostic tool in HD clinics. [ABSTRACT FROM AUTHOR]

Background: In multiple sclerosis (MS), imaging biomarkers play a crucial role in characterizing the disease at the time of diagnosis. MRI and optical coherence tomography (OCT) provide readily available biomarkers that may help to define the patient's clinical profile. However, the evaluation of cortical and paramagnetic rim lesions (CL, PRL), as well as retinal atrophy, is not routinely performed in clinic. Objective: To identify the most significant MRI and OCT biomarkers associated with early clinical disability in MS. Methods: Brain, spinal cord (SC) MRI, and OCT scans were acquired from 45 patients at MS diagnosis to obtain: brain PRL and non-PRL, CL, SC lesion volumes and counts, brain volumetric metrics, SC C2-C3 cross-sectional area, and retinal layer thickness. Regression models assessed relationships with physical disability (Expanded Disability Status Scale [EDSS]) and cognitive performance (Brief International Cognitive Assessment for Multiple Sclerosis [BICAMS]). Results: In a stepwise regression (R2 = 0.526), PRL (β = 0.001, p = 0.023) and SC lesion volumes (β = 0.001, p = 0.017) were the most significant predictors of EDSS, while CL volume and age were strongly associated with BICAMS scores. Moreover, in a model where PRL and non-PRL were pooled, only the contribution of SC lesion volume was retained in EDSS prediction. OCT measures did not show associations with disability at the onset. Conclusion: At MS onset, PRL and SC lesions exhibit the strongest association with physical disability, while CL strongly contribute to cognitive performance. Incorporating the evaluation of PRL and CL into the initial MS patient assessment could help define their clinical profile, thus supporting the treatment choice. [ABSTRACT FROM AUTHOR]

Mohs micrographic surgery (MMS) is the gold standard for removing basal cell carcinomas (BCCs) due to its ability to guarantee 100% margin evaluation through frozen section histopathology, offering the highest cure rate among current treatments. However, noninvasive imaging technologies have emerged as promising alternatives to clinical assessment for defining presurgical margins. This systematic scoping review examines the efficacy of these imaging modalities, focusing on those approved for clinical use by the United States Food and Drug Administration (FDA) or the European Medicines Agency (EMA). A systematic search of EMBASE, Scopus, PubMed, and the Cochrane Public Library databases identified 11 relevant studies out of 2123 records, encompassing 644 lesions across five imaging techniques. The findings suggest that dermoscopy, high‐frequency ultrasound (HFUS), optical coherence tomography (OCT), line‐field optical coherence tomography (LC‐OCT), and reflectance confocal microscopy (RCM) show potential in detecting BCC margins, which could enhance MMS by providing better preoperative planning, informing patients of expected defect size, aiding in reconstruction decisions, and reducing overall procedure costs. This review discusses the benefits and limitations of each technique, offering insights into how these innovations could influence the future of BCC management. Emerging imaging techniques could enhance MMS by improving BCC margin assessment and reducing costs. Their adoption will depend on price and ease of use. [ABSTRACT FROM AUTHOR]

Progressive multiple sclerosis poses a considerable challenge in the evaluation of disease progression and treatment response owing to its multifaceted pathophysiology. Traditional clinical measures such as the Expanded Disability Status Scale are limited in capturing the full scope of disease and treatment effects. Advanced imaging techniques, including MRI and PET scans, have emerged as valuable tools for the assessment of neurodegenerative processes, including the respective role of adaptive and innate immunity, detailed insights into brain and spinal cord atrophy, lesion dynamics and grey matter damage. The potential of cerebrospinal fluid and blood biomarkers is increasingly recognized, with neurofilament light chain levels being a notable indicator of neuro-axonal damage. Moreover, patient-reported outcomes are crucial for reflecting the subjective experience of disease progression and treatment efficacy, covering aspects such as fatigue, cognitive function and overall quality of life. The future incorporation of digital technologies and wearable devices in research and clinical practice promises to enhance our understanding of functional impairments and disease progression. This Review offers a comprehensive examination of these diverse evaluation tools, highlighting their combined use in accurately assessing disease progression and treatment efficacy in progressive multiple sclerosis, thereby guiding more effective therapeutic strategies. The approval of therapies for progressive multiple sclerosis has heightened the need for thorough assessment of disease progression and treatment response. This Review provides a comprehensive summary of available and emerging techniques, including advanced imaging, fluid biomarkers and patient-reported outcomes, highlighting their combined use for the accurate assessment of disease. Key points: Effective treatment of progressive multiple sclerosis (MS) remains an urgent medical need. The recent approvals of treatments for progressive forms of MS highlight the importance of better disease monitoring measures in clinical trials and practice. Traditional MRI biomarkers do not adequately track progressive MS. Advances in MRI, such as brain atrophy and lesion volume analysis, show promise in assessing disease progression and response to treatment. Remyelination is key in MS neuroprotection. MRI techniques such as magnetization transfer and myelin water fraction imaging, alongside PET scans, provide deeper insights into myelin repair and inflammation. Changes in optical coherence tomography, a non-invasive imaging modality that measures retinal layer thickness, reflect brain atrophy and MS progression, offering a valuable window into neurodegeneration and treatment efficacy. Body fluid biomarkers, such as neurofilament light in blood, and immune activation and neuronal damage markers in cerebrospinal fluid are emerging as important tools for assessing disease activity and treatment response in progressive MS. Patient-reported outcomes capture the unique experience of individuals with MS, which is of particular importance in progressive forms of the disease. These assessments can help evaluate hidden symptoms such as fatigue and cognitive impairment and are becoming vital in clinical trials and routine practice. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions To describe the incidence and pattern of reactivation of neovascular age‐related macular degeneration (nAMD) following successful treatment with treat‐and‐extend intravitreal anti‐vascular endothelial growth factor therapy.Consecutive patients with treated nAMD who did not require further treatment over a 6‐month period and who attended their 3‐monthly optical coherence tomography monitoring clinic in Moorfields Eye Hospital from 1 November 2019 to 31 January 2020 were included. Patients with diagnoses of macular neovascularization other than AMD, and patients with incomplete data were excluded. Baseline demographics recorded were age, sex, race, laterality, cause of macular neovascularization, drug, number of injections, and duration of treatment. Date, setting, symptoms, and time to retreatment were collected among patients with disease reactivation.The medical records of 286 patients were included. Most patients were female (64.3%), white (68.18%), and were receiving aflibercept monotherapy (55.2%). Mean number of injections at baseline was 17.79 ± 11.74 (range 3–62) with a mean treatment duration of 39.47 ± 30.68 months (range 2–139). Reactivation of AMD was identified in 32.2% of cases with 87% of recurrences identified via scheduled visit. The most common symptom was blurring of vision in 44.6%, while 39.1% were asymptomatic. Mean time from baseline to retreatment was 29.37 ± 22.40 months (range 5–104), with 20.7%, 73.9% and 88.04% of these patients requiring retreatment within 1, 3, and 5 years, respectively.Despite prior treatment with no reactivation in 6 months, 32.2% reactivate, 73.9% of which within 3 years. A significant proportion, 39.1%, reactivated without symptoms necessitating regular monitoring in the first 5 years. [ABSTRACT FROM AUTHOR]