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Purpose To assess morphological changes and visual results in eyes with pachychoroid neovasculopathy (PNV) that underwent different intravitreal anti-vascular endothelial growth factor (VEGF) agents. Materials and methods This is a retrospective, observational, comparative study that included 76 PNV eyes in 76 patients that were allocated to three groups according to the monotherapy injection procedure, as follows: the intravitreal bevacizumab (IVB) group, intravitreal ranibizumab (IVR) group, and intravitreal aflibercept (IVA) group. Central macular thickness (CMT), best-corrected visual acuity (BCVA), and subfoveal choroidal thickness (SFCT) were measured at baseline, after treatment 1st month, 3rd month, 6th month, and 12th month, and at the final post-treatment examination. Results Mean age of the patients was 57.31 +/- 5.91 years (range: 34-67 years). The mean duration of follow-up was 31.50 +/- 12.91 months (range: 13-60 months). The IVB group included 30 eyes, the IVR group included 22 eyes, and the IVA group included 24 eyes. There weren\"t any significant differences in BCVA changes between the groups at any post-baseline measurement time point. Although CMT did not change significantly in the IVB group from baseline to the final follow-up visit (baseline: 376.33 +/- 86.31 mu m; final visit: 340.80 +/- 122.70 mu m) (p = 0.172), CMT did change significantly in the IVA group (baseline: 383.41 +/- 131.83 mu m; final visit: 297.33 +/- 103.81 mu m) (p = 0.029) and IVR group (baseline: 379.18 +/- 97.93 mu m; final visit: 335.72 +/- 111.45 mu m) (p = 0.041). SFCT decreased significantly in the IVR and IVA groups (p = 0.015 and p < 0.001, respectively). The mean number of injections was 12.06 +/- 4.72 (range: 6-20) in the IVB group, 11.81 +/- 3.31(range: 7-17) in the IVR group, and 7.16 +/- 3.15 (range: 4-13) in the IVA group (p = 0.004). Conclusion All three anti-VEGFs were effective in terms of visual results in patients with PNV. Patients treated with IVA required fewer injections than those treated with IVB or IVR. Furthermore, IVR and IVA treatment significantly decreased SFCT, whereas IVB did not.

Purpose To evaluate the efficacy and safety of topical dexamethasone (DEX) eye drops in combination with a single perioperative subtenon triamcinolone acetonide (sTA) injection versus conventional topical DEX eye drops in the prevention of ocular inflammation and cystoid macular edema following cataract surgery. Materials and methods Medical records of 245 eyes of 245 patients who underwent uncomplicated cataract surgery were analyzed in this retrospective controlled clinical study. Topical DEX eye drops were administered to 128 eyes routinely postoperatively, and 117 eyes were given a single dose of sTA (40 mg/ml) together with topical DEX eye drops for postoperative care. Postoperative topical antibiotic prophylaxis was applied to all eyes. The primary outcomes were anterior chamber (AC) cells and flare, central macular thickness (CMT), best corrected visual acuity (BCVA), and intraocular pressure (IOP) measurements on day 7, day 30, day 90, and day 180 following surgery. Results Although CMT increased in the DEX group, no increment was observed in the DEX + sTA treated group for all follow-up periods (on day 7 (+1.3 +/- 18.6 and -8.7 +/- 21.9 mu m, p = 0.038), on day 30 (+20.5 +/- 58.4 and -4.1 +/- 25.2 mu m, p = 0.009), on day 90 (+7.2 +/- 19.9 and -5.7 +/- 30.6 mu m, p = 0.029), and on day 180 (+8.2 +/- 22.6 and -6.4 +/- 32.9 mu m, p = 0.032)). There was no significant difference in terms of AC cells and flare between the two groups during the entire follow-up period (p > 0.05). Significant improvement in BCVA was observed in the DEX + sTA group at day 30 (p = 0.008). IOP differences were comparable, and both groups had high ocular tolerance. There were no severe adverse effects recorded. Conclusions Topical DEX eye drops in combination with single dose perioperative injection of sTA have robust efficacy in preventing ocular inflammation and the development of cystoid macular edema following uncomplicated cataract surgery.

Purpose: The aim of this study is to compare the efficacy of half-fluence photodynamic therapy (PDT) and half-dose PDT on the choroidal structure via perfusion of the retinal plexus and choriocapillaris in eyes with chronic central serous chorioretinopathy (cCSCR). Materials and Methods: This retrospective study included 43 eyes in 43 patients with cCSCR. Patients in group 1 received half-fluence (verteporfin 6 mg m−2) PDT and those in group 2 received half-dose (verteporfin 3 mg m−2) PDT. Enhanced depth imaging optical coherence tomography and optical coherence tomography angiography (OCTA) images were recorded 1 day before and 3 months after PDT. Total choroidal area (TCA), luminal area (LA), and stromal area (SA) were calculated using Image J software. Results: From baseline to 3 months post PDT TCA decreased from 2.43 ± 0.47 mm2 to 2.08 ± 0.59 mm2 (p < 0.001), LA decreased from 1.78 ± 0.11 mm2 to 1.54 ± 0.26 mm2 (p < 0.001), and SA decreased from 0.76 ± 0.33 mm2 to 0.53 ± 0.37 mm2 (p < 0.001) in group 1. Choriocapillaris vascular density measured via OCTA increased from 37.82 ± 10.99 at the initial visit to 44.96 ± 15.34 at month 3 after half-fluence PDT administered to the fovea (p < 0.001). Deep capillary plexus vessel density was 32.49 ± 11.36 at baseline and increased to 43.27 ± 11.40 at month 3 after half-fluence PDT administered to the fovea (p < 0.001) in group 1. TCA decreased to 2.00 mm2 ± 0.51 mm2 from 2.39 mm2 ± 0.43 mm2 (p < 0.001), LA decreased to 1.53 ± 0.29 mm2 from 1.74 ± 0.16 mm2 (p = 0.019). Although SA decreased from 0.76 ± 0.33 mm2 to 0.53 ± 0.37 mm2 in group 2, the difference was not significant (p = 0.07). Based on OCTA, choriocapillaris vascular density increased from 43.68 ± 10.38 mm2 at baseline to 47.46 ± 6.42 mm2 at 3 months after half-dose PDT onto the fovea (p = 0.049). Deep capillary plexus vessel density increased from 34.37 ± 9.36 mm2 at the initial visit to 38.17 ± 8.81 mm2 3 months after half-dose PDT onto the fovea (p = 0.046) in group 2. At 3 months, post-PDT subretinal fluid (SRF) was significantly higher resolution in group 1 than in group 2 (p = 0.021). Conclusions: OCTA shows there is a significant increase in deep capillary plexus and choriocapillaris perfusion 3 months after both half-fluence PDT and half-dose PDT. Although there was a significant decrease in LA in both groups, based on OCTA there was a significant decrease in SA, a significant increase in choriocapillaris and deep capillary perfusion in group 1; therefore, the level of SRF resolution at month 3 post PDT might explain its higher incidence in group 1.

To evaluate anatomical and visual results of eyes with naive myopic choroidal neovascularization (mCNV) in patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) therapies.This is a retrospective, non-randomized, comperative, intervetional study. One hundred fourteen eyes of 114 patients with mCNV who underwent intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR) or intravitreal aflibercept (IVA) monotherapy injections were enrolled into the study. The best corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were compared among the groups during the follow-up periods at the beginning, months 1, 3, 6, 12, and the final visit.The mean age of the patients was 47.76 ± 10.57 years (range, 33-72 years) and the mean follow-up period was 23.34 ± 6.81 months (range, 13-38 months). The mean BCVA denoted a significantly improve at each group (p 0.05). In terms of an inter-group analysis of all 3 groups, at months 1, 6, and 12 and final visit, the BCVA were statistically significantly better in the IVA group when compared to both IVB and IVR groups (p = 0.021, p = 0.032, p = 0.024, p = 0.012). There was a significant decrease in CMT following IVB (236.49 ± 40.91 μm-190.74 ± 50.12 μm), IVA (232.91 ± 46.29 μm-193.73 ± 46.81 μm) and IVR (234.78 ± 45.37 μm-192.21 ± 37.27 μm) between baseline and final visit (p = 0.018, p = 0.002, p 0.001, respectively). There was a statistically significant decrease in SFCT values between baseline and final examination only in the IVA group (p 0.001). The mean number of injections were 9.18 ± 3.18 (range; 3 to 13) in IVB, 6.46 ± 2.93 (range; 3-11) in IVR and 4.45 ± 1.42 (range; 2-7) in IVA (p = 0.028).All three anti-VEGFs were found to be effective in terms of visual results in patients with mCNV. However, we demonstrated that IVA reduces the need for anti-VEGF when compared to patients who received both IVB and IVR. Furthermore, IVA induced a prominent reduction in SFCT, whereas IVR and IVB did not have a significant action on SFCT.

To evaluate anatomical and visual outcomes in patients who received intravitreal anti-vascular endothelial growth factor (VEGF) agents in combination with full-dose photodynamic therapy (PDT) on eyes with choroidal neovascularization (CNV) secondary to naive pachychoroid neovasculopathy (PNV).Medical records on 19 eyes of 19 patients whom intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR), and intravitreal aflibercept (IVA) injections were administered for CNV caused by PNV were enrolled into the study. The central macular thickness (CMT), best-corrected visual acuity (BCVA), and subfoveal choroidal thickness (SFCT) were recorded at the baseline, months 1, 3, 6, 12, and final control visit following treatment.The age average was 53.84 ± 5.23 years (range, 46-62 years), and mean follow-up time was 33.42 ± 9.43 months (range, 16-49 months). The change in BCVA was found statistically significant in the IVA group only during follow-up visits (p = 0.007). Although there was no statistically significant change in CMT following IVR (360.60 ± 75.64-252 ± 75.04 µm) (p = 0.077), significant changes were observed in IVB (397.14 ± 122.59-275.28 ± 63.82 µm) (p = 0.004) and IVA (385.85 ± 43.82-244.42 ± 51.57 µm) (p = 0.005) between the baseline and the final visit. SFCT significantly decreased following both IVR and IVA treatments (p = 0.016, p = 0.039, respectively). In consideration of the number of injections, significantly fewer injections were needed in the IVA group than the others (p = 0.018).Anti-VEGF agents with full-dose PDT were well tolerated for the first 3 months and were highly effective treatment option in order to naive PNV patients. However, in long-term follow-ups, the effectiveness of IVA was superior to other anti-VEGFs.