Search

Introduction: Central vision loss due to diabetic macular edema (DME) is related to the macular edema itself but also, in some cases, to alterations of the foveal avascular zone (FAZ). The aim of this trial was to study changes in macular vessels in eyes with DME treated with aflibercept using optical coherence tomography angiography (OCTA)., Methods: This was a longitudinal, prospective, noncontrolled, single-arm study. The primary objective was the quantitative assessment of macular vessels over time in patients with DME treated with intravitreal aflibercept during a 48-week follow-up using OCTA., Results: Twenty-six DME eyes from 26 patients were included (mean age, 64.6 years; women, 53.8%; prior anti-VEGF treatment, 46.1%). Each eye received a mean (SD) of 7.2 (2.2) injections. The following parameters of the FAZ did not change during the 48-week follow-up: the mean (SD) FAZ area varied from 0.19 (0.19) mm2 at baseline (n = 22) to 0.23 (0.20) mm2 at week 48 (n = 15), boundary from 1.54 (1.21) to 2.04 (1.20) mm, and circularity from 0.45 (0.33)% to 0.57 (0.20)%. There was no change in perfusion density and vessel density of the macula in the 3-mm circle. As expected, mean central retinal thickness, macular volume, and visual acuity improved during follow-up., Conclusion: No change in macular perfusion was observed in eyes with DME during a 48-week follow-up after intravitreal injections of aflibercept. Randomized controlled trials using OCT angiography in large populations with extended observation periods are needed to assess changes in macular vessels after intravitreal anti-VEGF treatment., (© 2023 S. Karger AG, Basel.)

Purpose: The purpose of the study was to assess OCT-angiography (OCT-A) contribution for choroidal neovascularization (CNV) detection, with respect to multimodal imaging (MMI) modality (including OCT, fluorescein angiography (FFA), and indocyanine green angiography [ICG]), in a real-life consultation practice., Methods: Data of all consecutive patients undergoing OCT-A examination for CNV suspicion were collected between September 2017 and September 2019 at Strasbourg University Hospital, France. Only eyes which had anti-VEGF injection in the last 3 months were excluded. All types of neovascularization were included. For all patients, data from OCT, OCT-A, FFA, and ICG were interpreted by residents and retinal specialists, independently. Final diagnosis of CNV was based on decision to treat. Sensibility, specificity, and predictive values were computed for OCT-A alone and for MMI (OCT combined to angiography). They were computed for each group. OCT-A was also assessed as "contributory" (i.e., assessing without doubt the presence or absence of CNV) or not, with respect to MMI., Results: In total, 161 eyes of 145 patients were included. MMI sensibility was better than OCT-A sensibility (93.8 vs. 65.6%). OCT-A specificity was better than MMI specificity (96.9 vs. 89.5%). OCT-A was essential for diagnosis in 16.9% of cases. Sensibility and specificity values for all exams were better when interpreted by retinal specialists than residents. OCT-A was judged "contributory" in 57.4% of eyes. OCT-A was significantly less contributory when artefacts were present (32.9% of eyes with artefacts vs. 63.5% without, p < 0.001)., Conclusion: OCT-A showed to be essential in diagnosing CNV in >16% of cases. However, it often failed to conclude for the absence of CNV, which obliged to perform more exams such as angiography. OCT-A must be part of diagnostic procedure for CNV detection but does not discard angiography in everyday life practice., (© 2021 S. Karger AG, Basel.)

Purpose: Dome-shaped macula (DSM) is characterized by an inward bulge in the macula, often associated with a myopic staphyloma. One complication of DSM is particularly studied: foveolar serous retinal detachment (SRD). This study analyzed the variations of optical coherence tomography angiography (OCT-A) decorrelation signal in cases of DSM with and without SRD., Methods: This was a retrospective study including twenty height eyes presenting with DSM. OCT-A scans were recorded, and the intensity of the choroidal decorrelation signal was quantified to analyze choroidal blood flow (CBF) in central, temporal, and nasal macular areas. The size of retinal pigment epithelium (RPE) atrophy was evaluated., Results: CBF in the central area was significantly greater in the SRD group than in the no-SRD group (7.00 × 105 vs. 2.58 × 105) (p = 0.0049). CBF appeared decreased in the subfoveal area compared with the periphery for patients without SRD (p = 0.0107). The size of RPE atrophy was 0.762 optic disc area ±0.87. RPE atrophy correlated very significantly with CBF (p = 0.0012)., Conclusion: A greater retrofoveolar CBF intensity is associated with the presence of SRD. These changes could reflect variations of CBF, and may represent a potential explanation for the pathogenesis of SRD in DSM., (© 2019 S. Karger AG, Basel.)

Background and Objective: Dome-shaped macula (DSM) has recently been described with myopic staphyloma, which may cause decreased vision. The purpose of this study was to evaluate the choroidal thickness of eyes with and eyes without DSM., Methods: A total of 26 eyes with DSM were paired based on axial length with 26 eyes without DSM. All patients underwent spectral-domain OCT examination using the 7-line EDI (enhanced depth imaging) protocol. The mean choroidal thickness was measured using Early Treatment Diabetic Retinopathy Study (ETDRS) grid areas., Results: Both nasal choroidal thickness and temporal choroidal thickness were significantly thinner in the DSM group (120.43 vs. 159.46 µm, p = 0.035, and 142.17 vs. 187.23 µm, p = 0.021, respectively). However, the mean central choroidal thickness did not differ (152.61 vs. 175.96 µm, p = 0.20). The ratio between central and peripheral choroidal thickness was very significantly elevated with DSM (1.18 ± 0.12 vs. 0.99 ± 0.09, p < 0.0001)., Conclusion: Choroidal thickness decreases at the periphery but not in the macular area with DSM. DSM seems not to be due to an inward protrusion of the globe but due to macular anatomical preservation in a growing staphyloma., (© 2016 S. Karger AG, Basel.)

Background/aims: To compare the efficacy of intravitreal injections of dexamethasone implants (IVD) with those of bevacizumab (IVB) for the treatment of macular oedema associated with branch retinal vein occlusion., Methods: A total of 19 patients (19 eyes) were included in this prospective pilot study. Initially, 8 eyes received three IVBs (group 1) and 11 received one IVD (group 2). All the patients underwent a 1-, 3-, 4- and 6-month follow-up visit. A repeated IVB (group 1) or IVD (group 2) was proposed at 4 months when necessary., Results: The mean visual acuity was significantly better 1 month after treatment in group 2, while the mean central macular thickness was also significantly lower in group 2. However, there was no longer any difference between the two groups at 3, 4 and 6 months, neither in terms of visual acuity nor in terms of retinal thickness. More than three IVBs were needed in 3 of 10 patients in group 1 while two IVDs were required in 10 of 11 patients in group 2., Conclusion: There was no significant difference between the two treatment regimens at the 6-month follow-up visit. A more rapid functional and anatomical efficacy was noted with IVD during the first month; however, reinjection at 4 months seemed more frequent with IVD than with IVB treatment., (Copyright © 2013 S. Karger AG, Basel.)