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Vitreoretinal lymphomas (VRLs) present with different clinical characteristics. However, only a few case reports have been published that evaluated the retinal function and the retinal morphology. The relationship between retinal morphology and function of eyes with a vitreoretinal lymphoma (VRL) was investigated via optical coherence tomography (OCT) and electroretinography (ERG). The ERG and OCT findings in 11 eyes of 11 patients (69.4 ± 11.5 years old) who were diagnosed with VRL at the Saitama Medical University Hospital between December 2016 to May 2022 were studied. The decimal best-corrected visual acuity ranged from hand movements to 1.2 (median 0.2). Histopathological studies of the vitreous specimens showed class II VRL in one eye, class III VRL in seven eyes, class IV VRL in two eyes, and class V VRL in one eye. The IgH gene rearrangement was positive in three of the six eyes tested. The OCT images showed morphological abnormalities in 10 of the 11 (90.9%) eyes. Severe attenuation was found for the amplitudes of the b-wave of the DA 0.01 ERG in 6 of 11 eyes (54.5%), the DA 3.0 a-wave in 5 of 11 eyes (45.5%), the DA 3.0 b-wave in 36.4%, the LA 3.0 a-wave in 36.4%, the LA 3.0 b-wave in 18.2%, and flicker responses in 36.4% of the eyes. None of the DA 3.0 ERGs had a negative shape (b/a < 1.0). In the five eyes in which the a-wave was severely attenuated, hyperreflective dots were observed subretinally. The ERG analysis in eyes with a VRL indicates a relatively severe dysfunction of the outer retinal layer and was helpful in determining the site of the morphological changes in eyes with VRL.

We evaluated the macular visibility of a newly designed extended depth of focus (EDOF) intraocular lenses (IOL) using a wide viewing system for macular manipulation (Risight;60D, Carl Zeiss Meditec AG) in a model eye and compared it with various other types of IOLs. We used a model eye that was constructed based on the Glustrand model to compare a newly designed EDOF IOL (DIB00V; JohnsonJohnson Surgical Vision), an EDOF IOL with a diffraction grating (ZXR00V; JohnsonJohnson surgical Vision), and a monofocal aspheric (DCB00V; JohnsonJohnson Vision, XY-1; HOYA Surgical Optics, Tokyo, Japan) or spherical IOL (NX70s; Santen Pharmaceutical Co., Ltd). In the model eye, a 1951 United States Air Force (USAF) test was placed at the location of the macula. The contrasts in a range of spatial frequencies were quantified using the images obtained from the 1951 USAF test target. The contrast at each spatial frequency was plotted and integrated to calculate the area under the curve contrast (AUC-contrast). Qualitative evaluations showed that good-quality images were obtained for all IOLs. At a spatial frequency of 16 LP/mm, the average contrast was the highest for the DIB00V and NX70s (0.216 each). The highest average contrast at 32 LP/mm was obtained using the NX70s (0.128), and at 64 LP/mm using the DIB00V (0.123). The horizontal AUC-contrast was the highest for the NX70s (8.754), and the vertical AUC-contrast was the highest for the DIB00V (8.334). On average, the DIB00V had the highest AUC-contrast value (8.227). The high-order aspheric IOL, DIB00V, was found to exhibit good macular visibility despite being an EDOF IOL.

ObjectiveTo identify the degree of loss of the circumpapillary retinal nerve fibre layer (cpRNFL), the layer from the macular RNFL to the inner plexiform layer (mGCL++), circumpapillary (cpVD) and macular vascular density (mVD), Pulsar perimetry and standard perimetry in early glaucoma.MethodsIn this cross-sectional study, one eye from each of 96 healthy controls and 90 eyes with open-angle glaucoma were measured with cpRNFL, mGCL++, cpVD, mVD, Pulsar perimetry with Octopus P32 test (Pulsar) and standard perimetry with Humphrey field analyser 24-2 test (HFA). For direct comparison, all parameters were converted to relative change values adjusted in both their dynamic range and age-corrected normal value.ResultsThe degree of loss in mGCL++ (−24.7%) and cpRNFL (−25.8%) was greater than that in mVD (−17.3%), cpVD (−14.9%), Pulsar (−10.1%) and HFA (−5.9%) (each pConclusionThe degree of loss of cpRNFL and mGCL++ thickness preceded by approximately 7%–10% and 15%–20% compared with the micro-VD and visual fields in early glaucoma, respectively.Trial registration numberUMIN Clinical Trials Registry (http://www.umin.ac.jp/; R000046076 UMIN000040372).

Background/AimsTo evaluate quantitative changes in the foveal avascular zone (FAZ) area after glaucoma surgery using swept-source optical coherence tomography angiography (SS-OCTA).MethodsFifty-four consecutive patients with primary open-angle glaucoma (POAG) who met the inclusion criteria and underwent unilateral glaucoma surgery to reduce intraocular pressure (IOP) between April 2018 and July 2019.Eyes underwent IOP-lowering glaucoma surgery and their fellow (non-surgical) eyes were included. OCTA of the macula was performed in both eyes before glaucoma surgery and 3 months postoperatively. Two blinded examiners reviewed the image quality. Within- and between-group comparisons of the FAZ area and correlation of the FAZ area with age, IOP, central sensitivity and clinical variables.ResultsThe mean (±SD) age was 66.7±11.3 years. After surgery, the IOP and FAZ area significantly decreased from 22.1±9.5 mmHg to 10.3±3.5 mmHg and from 0.485±0.193 mm2 to 0.446±0.174 mm2, respectively (both p2 and 0.396±0.110 mm2, respectively) did not significantly differ (p=0.469). Change in the FAZ area significantly correlated with the preoperative FAZ area, preoperative foveal sensitivity and change in IOP (all pConclusionsThe FAZ area is decreased with IOP-lowering surgery in patients with POAG, and change in the FAZ area was significantly correlated with both preoperative foveal sensitivity and change in IOP.

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To investigate the effects of adjusting the ocular magnification during OCT-based angiography imaging on structure-function relationships and glaucoma detection.Cross-sectional study.A total of 96 healthy control participants and 90 patients with open-angle glaucoma were included.One eye of each patient in the control group and the patient group was evaluated. The layers comprising the macula vascular density (VD) and circumpapillary VD were derived from swept-source OCT angiography imaging. The mean sensitivity (MS) of the standard automated perimetry was measured using the Humphrey 24-2 test. Structure-function relationships were evaluated with simple and partial correlation coefficients. A receiver operating characteristic analysis was performed to evaluate the diagnostic accuracy for glaucoma using the area under the receiver operating characteristic curve (AUC). Ocular magnification was adjusted using Littmann's formula modified by Bennett.The association between the axial length and VD, structure-function relationships, and glaucoma detection with and without magnification correction.The superficial layer of the macular region was not significantly correlated to the axial length without magnification correction (Adjustment of the ocular magnification is important for accurate VD measurements; however, it may not significantly impact structure-function relationships and glaucoma detection.

The extraction of the foveal avascular zone (FAZ) from optical coherence tomography angiography (OCTA) images has been used in many studies in recent years due to its association with various ophthalmic diseases. In this study, we investigated the utility of a dataset for deep learning created using Kanno Saitama Macro (KSM), a program that automatically extracts the FAZ using swept-source OCTA. The test data included 40 eyes of 20 healthy volunteers. For training and validation, we used 257 eyes from 257 patients. The FAZ of the retinal surface image was extracted using KSM, and a dataset for FAZ extraction was created. Based on that dataset, we conducted a training test using a typical U-Net. Two examiners manually extracted the FAZ of the test data, and the results were used as gold standards to compare the Jaccard coefficients between examiners, and between each examiner and the U-Net. The Jaccard coefficient was 0.931 between examiner 1 and examiner 2, 0.951 between examiner 1 and the U-Net, and 0.933 between examiner 2 and the U-Net. The Jaccard coefficients were significantly better between examiner 1 and the U-Net than between examiner 1 and examiner 2 (p < 0.001). These data indicated that the dataset generated by KSM was as good as, if not better than, the agreement between examiners using the manual method. KSM may contribute to reducing the burden of annotation in deep learning.

To evaluate the correlation between macular retinal function and the changes in the macular retinal vascular structure in glaucomatous eyes.The study included patients with glaucoma who visited Saitama Medical University and underwent optical coherence tomography angiography, and multifocal electroretinographic examinations at the same time between February 2020 and April 2021. Correlations among the ocular parameters, macular vessel density, and multifocal electroretinographic parameters were evaluated using a mixed model.Forty-one eyes (mean deviation, -12.4 ± 7.8 dB) of 24 subjects (mean age, 75.2 ± 8.3 years) were included in the analysis. There were no significant correlations for macular vessel density in the superficial retinal layer. However, macular vessel density in the deep retinal layer showed a significant positive correlation with P1-N1 amplitude (coefficient = 0.724; P = 0.001). There were no significant correlations between the optical coherence tomography parameters and any of the multifocal electroretinographic parameters.A decrease in N1-P1 amplitude was observed in glaucomatous eyes in relation to a reduction in macular vessel density in the deep retinal layer, which suggests that ischemia-induced bipolar cell dysfunction may be involved in the intermediate retinal dysfunction associated with glaucoma.Intermediate retinal dysfunction in glaucoma is related to the changes in deep retinal microvasculature.

To evaluate the automated determination of the center of an idiopathic macular hole (MH) by using swept-source optical coherence tomography (OCT) images with new macro-based algorithms in ImageJ and to compare the difference between the MH center measurements obtained automatically and manually. This cross-sectional study included 39 eyes of 39 elderly individuals (22 women, 17 men) with stage 3 and 4 MH. The MH center was automatically determined using the ImageJ macro. The foveal center was also manually identified by two masked examiners using horizontal and vertical serial B-scan OCT angiography images. The mean age was 68.8 ± 8.3 years. After adjusting for the effect of magnification, the mean distance between the MH center determined manually by Examiner 1 and that determined automatically was 15.5 ± 9.9 µm. The mean distance between the two manually determined measurements of the MH center was 20.3 ± 19.7 µm. These two mean distance values did not differ significantly (Welch t-test, p = 0.27) and was non-inferior (p < 0.0001). The automated ImageJ-based method for determining the MH center was comparable to manual methods. This study showed that automated measurements were non-inferior to manual measurements, and demonstrated a substitutable usefulness, at least for use in clinical practice.