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Purpose To study the corneal and internal astigmatism and the age-related changes underlying the known refractive shift with-the-rule (WTR) towards against-the-rule (ATR) astigmatism. Methods Refractive and corneal biometry data were collected for a total of 1195 healthy Caucasian subjects, recruited by ophthalmological centres across Europe. After conversion of refractive and corneal surface astigmatism to power vectors J(0) and J(45), the total corneal and internal astigmatism were calculated. Results Both refractive power vectors had leptokurtic distributions with a narrow peak at zero, and a broader, secondary distribution at its base, corresponding to eyes without balanced components. This may be fitted with a bigaussian function (J(0): r(2) = 0.87; J(45): r(2) = 0.98). Statistically significant changes in these distributions are seen with age: for refractive J(0) the narrow peak shortens progressively, while the broad peak shifts positive from to negative values, corresponding to increased astigmatism and a shift from with-the-rule towards against-the-rule. For J(45) the narrow peak shortens with age as well, while the broad peak flattens. These changes in refractive J(0) result from statistically significant negative shifts in both the corneal and internal components with age (Kruskal-Wallis, p < 0.05). Conclusion In young participants corneal and internal astigmatism partially cancel each other out. This balance between both is gradually lost after age 50, leading to larger amounts of refractive astigmatism, as well as a reorientation of the axis. Given the small amplitude of these changes, they are unlikely to have repercussions for long term stability toric cataract or refractive surgery outcomes.

BACKGROUND AND OBJECTIVE: The aim of the study was to determine optical coherence tomography angiography (OCTA) findings and to identify mutations in the RS1 gene in a three-generation family with X-linked juvenile retinoschisis (XLRS). PATIENTS AND METHODS: Clinical and genetic assessments were performed in 12 family members. OCTA was performed at baseline (12 members including cases and carriers) and after acetazolamide administration (three cases). Twenty healthy subjects (20 eyes, controls) were chosen for comparison. Molecular genetic analysis of the RS1 gene was performed in all family members. RESULTS: Deep capillary plexus density was reduced in cases compared with controls ( P < .01) and was negatively related with retinal thickness ( P < .05). After treatment, retinal thickness decreased ( P < .05) and deep capillary plexus density increased ( P < .05) in cases. In three cases and in four carriers, p.Arg197 His mutation was found. CONCLUSION: OCTA shows reduced macular deep vessel density in patients with XLRS probably related to vessel displacement and disruption due to schitic cysts. [ Ophthalmic Surg Lasers Imaging Retina . 2018;49:e20–e31.]

The aim of this work was to investigate the changes in aqueous humor cytokine levels after intravitreal injection of aflibercept in diabetic macular edema (DME) and to evaluate the relationship between cytokines modifications and central macular thickness (CMT) and retinal/choroidal vascular changes using structural and functional optical coherence tomography (OCT). Aqueous concentrations of 38 cytokines were measured via multiplex bead assay. In addition, spectral domain OCT and OCT angiography with SSADA software (XR Avanti® AngioVue) were performed at baseline and after intravitreal injections. VEGF, IL-6, IL-5, IL-1β, Eotaxin, GRO, IL-12p40, IL-12p70, IL-1RA, Flt-3L and IP-10 showed a statistically significant decrease through the follow-up (p

Purpose Choroideremia is a rare degenerative retinal disease that causes incurable blindness. It occurs as a result of the deficiency of the X-linked CHM gene, which encodes the Rab escort protein 1 (REP1). Gene therapy has been developed to treat CHM using adeno-associated viral vectors and is currently undergoing clinical trials. Expression of the CHM gene is ubiquitous throughout the retina, and it is therefore important to identify which retinal layers are affected in the disease process. The purpose of this study was to assess in particular the choriocapillaris using optical coherence tomography angiography because this layer is difficult to see with conventional imaging techniques. Methods Six men with choroideremia were identified and underwent standardized optical coherence tomography angiography as part of an ethics-approved clinical study and were compared with age-matched control subjects. Results The choriocapillaris appeared normal in regions where the retinal pigment epithelium remained intact, but it was deficient elsewhere. The outer retinal vasculature showed significant changes peripherally but also some changes centrally. The inner retinal vasculature appeared unaffected by the disease process. Conclusion Choroideremia is a disease in which the choriocapillaris maintains a normal structure until the loss of the overlying retinal pigment epithelium. The inner retina also appears not to be affected at the vascular level. Although this study is limited by the small number of patients eligible for inclusion in the study, the observations support the concept of targeting gene therapy to the retinal pigment epithelium and outer retina because there is no evidence of independent degeneration of the choriocapillaris.

The aim of this study was to investigate retinal and choriocapillaris vessel changes in diabetic macular edema (DME) after the intravitreal dexamethasone implant (IDI) using optical coherence tomography angiography (OCTA). Moreover, a comparison between morphological and functional parameters of DME and healthy patients was performed. Twenty-five eyes of 25 type 2 diabetic retinopathy patients complicated by macular edema (DME group) and 25 healthy subjects (control group) were enrolled. Superficial capillary plexus density (SCPD) and deep capillary plexus density (DCPD) in the foveal and parafoveal areas, choricapillary density (CCD) and optic disc vessel density (ODVD) were detected using OCTA at baseline and after 7, 30, 60, 90 and 120 days post injection. Best corrected visual acuity (BCVA), retinal sensitivity, and central retinal thickness (CMT) were also evaluated in both groups of patients. A statistically significant difference between the two groups (DME and controls) was found in terms of functional (MP, p < 0.001 and BCVA, p < 0.001) and morphological (CMT, p < 0.001; SCPD in the parafoveal area, p < 0.001; DCPD in the foveal area, p < 0.05 and parafoveal area, p < 0.001; CCD, p < 0.001) parameters. After the treatment, SCPD and DCPD in the foveal and parafoveal areas did not modify significantly during the follow up.