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Purpose: A new easy-to-place titanium macular buckle implant and the surgical technique for placing it in myopic macular holes are presented. A 60-year-old patient with pathologic myopia presented with macular holes in both eyes. The hole in the right eye was recurrent and long-standing since the initial diagnosis, which was over 5 years ago. He refused surgery for the better seeing left eye. The vision of the right eye was 20/200. The patient only wanted macular hole repair in the right eye if a macular buckle could be incorporated in the surgery. Methods: Because there was no commercially available macular buckle in the United States, a custom-made titanium buckle was designed and manufactured for this patient. In addition to the standard pars plana vitrectomy, internal limiting membrane peel, and gas tamponade, the titanium macular buckle was placed externally to provide indentation over the macula. Results: The titanium macular buckle provided approximately 1 mm of indentation, shortening the axial length from 28.88 mm to 27.94 mm. The macular hole was closed postoperatively. Postoperative best-corrected visual acuity was 20/200 at 1 month with no complications from the titanium macular buckle implant or the surgical technique. There was no improvement in the final visual acuity, which was attributed to foveal atrophy because of the long-standing nature of the macular hole. Conclusion: This titanium macular buckle implant designed for an easy placement could be an invaluable addition for surgical success in myopic macular pathologies, including myopic macular holes. [ABSTRACT FROM AUTHOR]

Axial myopia is a risk factor for the development of many concomitant pathological conditions, including those likely to lead to an irreversible loss of visual functions. Until now, specialists disagree about the terminology and the approaches to classification of pathological myopia. We propose a critical analysis of the state-of-the-art research and use them to offer, the definitions of such conditions as “myopic macular degeneration (myopic maculopathy)”, “myopic choroidal neovascularization” and “myopic traction maculopathy” and recommend them for use in the healthcare system of the Russian Federation

High myopia is a common ametropia associated with a significant risk of multiple comorbidities. Decreased visual functions of myopic patients may be caused by non-specific diseases such as cataracts, glaucoma and rhegmatogenous retinal detachment, which are very likely in myopia. Yet especially important are the specific changes such as atrophic, traction and neovascular manifestations of pathological myopia, the totality of which is defined as myopic macular degeneration or myopic maculopathy. The review highlights current approaches to the diagnosis and treatment of various diseases associated with high myopia, including original schemes for managing patients with myopic choroidal neovascularization and myopic traction maculopathy, developed by experts from the Expert Council on Retinal and Optic Nerve Diseases of the Russian nationwide public body Association of ophthalmologists, and includes an information leaflet for patients.

Myopic refraction is the most common ocular pathology, currently affecting about 1.5 billion people worldwide. Recent decades have seen a trend towards a significant increase in myopia prevalence, which is likely to continue in the near future. Therefore, we observe some kind of an epidemic of myopia. The greatest concern is caused by cases of uncorrectable visual impairment associated with myopia, which make pathological (degenerative) myopia one of the leading causes of low vision and blindness in many countries. At the same time, there is still no uniform interpretation of such important concepts as “high myopia” and “pathological myopia”, which can negatively affect various aspects of clinical and scientific interaction among ophthalmologists. The article provides an overview of modern work on the above issues and proposes definitions of terms to be used in the healthcare system of the Russian Federation

PurposeTo evaluate the clinical characteristics of myopic choroidal neovascularization (mCNV) according to peripapillary atrophy (PPA) and optic disk tilt and to explore whether those myopic disk deformations are associated with the prognosis of mCNV.MethodsPatients with subfoveal mCNV who received intravitreal bevacizumab injection and followed for ≥3 years were included. PPA was quantified as area of the ß-zone PPA/disk area ratio (PDR) and optic disk tilt as the tilt ratio (the longest/shortest disk diameter). We compared the clinical characteristics in terms of PDR and tilt ratio and identified the poor prognostic factors using Logistic regression and Cox proportional hazard model.ResultsAmong 80 eyes of 80 patients, 29 (36.30%) eyes developed macular atrophy during 80.71 ± 34.76 months. PDR and tilt ratio are strongly correlated with each other (P = 0.004). Higher PDR showed significant correlations with longer axial length (P = 0.013), worse baseline and final VA (P = 0.007 and P = 0.047), and thinner subfoveal choroidal thickness (P = 0.039), while higher tilt ratio showed significant correlations only with longer axial length (P = 0.036). High PDR was also an independent risk factor for both macular atrophy (OR = 2.257, P < 0.001) and poor visual outcome (HR = 1.174, P = 0.007), while high disk tilt ratio was not.ConclusionSubfoveal mCNV with higher ß-zone PPA area/disk area ratio had worse functional and structural outcomes.

Macular hole is characterized by a full-thickness defect of the retinal layers in the center of the fovea and is an important cause of central vision loss. Spontaneous closure of a macular hole is rare, most often occurring in traumatic and idiopathic macular holes. In this case report, we present a 51-year-old woman with a myopic macular hole that closed spontaneously. The patient had degenerative myopia and a history of clear lens surgery and multiple laser retinopexy procedures due to retinal tear in both eyes. A macular hole was detected in her right eye, but she declined surgery and was followed up. At 66 months after presentation, bridge formation and spontaneous closure of the macular hole were observed. Spontaneous closure is extremely rare in cases of myopic macular hole, but may be seen in patients who are followed for a long time.

Abstract Background To evaluate the detailed structural profile of dome-shaped macula and its association with myopic macular complications. Methods This retrospective study included 147 eyes of 93 patients who were diagnosed with degenerative myopia. The height of the scleral dome and diameter of the dome base were measured via enhanced depth imaging optical coherence tomography images with 1:1 μm setting. Spherical equivalent and best-corrected visual acuity were compared in eyes with and without dome-shaped macula. In eyes with dome-shaped macula, the height and diameter of the dome were compared in eyes with and without myopic macular complications including choroidal neovascularization, myopic foveoschisis, and macular hole. Results Dome-shaped macula was noted in 60 eyes (40.8%) of 42 patients. The mean height of the dome in the eyes with dome-shaped macula was 126.5 ± 69.4 μm (53 to 345 μm) and the mean diameter of the dome base was 2862.1 ± 794.9 μm (1567 μm to 4886 μm). In comparing eyes with and without dome-shaped macula, eyes with dome-shaped macula had higher myopia (− 13.7 diopters vs − 12.1 diopters, P = 0.022). There was no difference in visual acuity in eyes with or without dome-shaped macula (P = 0.132). The height and diameter of the dome in eyes with and without myopic foveoschisis were 78.6 ± 20.6 μm and 134.9 ± 71.6 μm, 2499.2 ± 303.1 μm and 2969.3 ± 645.7 μm, respectively (P = 0.009 and P = 0.017). However, the height and diameter of the dome were not related to the incidence of a macular hole (P = 0.324 and P = 0.605) and choroidal neovascularization (P = 0.835 and P = 0.905). Conclusions The prevalence of dome-shaped macula was about 40% in the eyes with degenerative myopia. Although dome-shaped macula was associated with higher degrees of myopia, a prominent dome seemed to be protective against myopic foveoschisis.

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Abstract Background We report a case of macular hole (MH) formation and retinal detachment after intravitreal conbercept injection for the treatment of choroidal neovascularization (CNV) secondary to degenerative myopia. Case presentation A 60-year-old woman presented with blurred vision in her left eye was diagnosed as CNV secondary to degenerative myopia. Intravitreal injection of conbercept, an anti -vascular endothelial growth factor (VEGF) agent, was uneventfully performed in the left eye. Unfortunately, a full thickness MH and retinal detachment was found three weeks postoperatively by ophthalmoscopy and spectral-domain optical coherence tomography. Vitrectomy, internal limiting membrane peeling and silicone oil tamponade were then performed, and macular retina was reattached soon after surgery. However, MH still kept open during three months’ follow-up. Conclusion MH is a quite rare complication of intravitreal anti- VEGF agent injection, tangential contraction secondary to CNV shrinkage and regression caused by anti-VEGF agent is proposed to be the major pathogenesis of MH formation.

Macular hole is characterized by a full-thickness defect of the retinal layers in the center of the fovea and is an important cause of central vision loss. Spontaneous closure of a macular hole is rare, most often occurring in traumatic and idiopathic macular holes. In this case report, we present a 51-year-old woman with a myopic macular hole that closed spontaneously. The patient had degenerative myopia and a history of clear lens surgery and multiple laser retinopexy procedures due to retinal tear in both eyes. A macular hole was detected in her right eye, but she declined surgery and was followed up. At 66 months after presentation, bridge formation and spontaneous closure of the macular hole were observed. Spontaneous closure is extremely rare in cases of myopic macular hole, but may be seen in patients who are followed for a long time. [ABSTRACT FROM AUTHOR]

Purpose: To compare and assess anterior segment measurements including corneal endothelial parameters in phakic and pseudophakic patients with degenerative myopia and emmetropia participants. Materials and Methods: The individuals were divided into two main groups of Group 1 (control group) and Group 2 (study group).Emmetropic, mild myopic and/or hypermetropic patients were enrolled in Group 1. Degenerative Myopic Patients Were Enrolled in Group 2. Group 1 and 2 were composed of phakic (Group 1A, Group 2A) n pseudophakic (Group 1B, Group 2B) eyes. Corneal endothelial cell density (CD), the coefficient of variation of cell size (CV), hexagonality (HEX) and central corneal thickness (CCT) were of the parameters measured by the specular microscope. Anterior chamber depth (ACD), white to white (WTW) diameter and axial length (AXL) were the parameters measured by optical biometer. Results: The mean ACD was 3.45±0.55 mm and 3.74±0.61 mm (p=0.005), and the mean AXL was 23.3±0.9 mm and 28.6±5.3 mm (p<0.001) in the control and study group, respectively. Mean BCVA values were worse and mean SE values were higher in degenerative myopic eyes than in emmetropic eyes of both phakic and pseudophakic subjects. Mean ACD was higher in degenerative myopia. Mean K2 was different between Group 1B and Group 2B (p=0.003). Conclusion: Degenerative myopia has high SE, ACD and AXL values. However, most of the specular microscope measurements did not show a significant difference in degenerative myopia. [ABSTRACT FROM AUTHOR]

Background: To evaluate the detailed structural profile of dome-shaped macula and its association with myopic macular complications.Methods: This retrospective study included 147 eyes of 93 patients who were diagnosed with degenerative myopia. The height of the scleral dome and diameter of the dome base were measured via enhanced depth imaging optical coherence tomography images with 1:1 μm setting. Spherical equivalent and best-corrected visual acuity were compared in eyes with and without dome-shaped macula. In eyes with dome-shaped macula, the height and diameter of the dome were compared in eyes with and without myopic macular complications including choroidal neovascularization, myopic foveoschisis, and macular hole.Results: Dome-shaped macula was noted in 60 eyes (40.8%) of 42 patients. The mean height of the dome in the eyes with dome-shaped macula was 126.5 ± 69.4 μm (53 to 345 μm) and the mean diameter of the dome base was 2862.1 ± 794.9 μm (1567 μm to 4886 μm). In comparing eyes with and without dome-shaped macula, eyes with dome-shaped macula had higher myopia (- 13.7 diopters vs - 12.1 diopters, P = 0.022). There was no difference in visual acuity in eyes with or without dome-shaped macula (P = 0.132). The height and diameter of the dome in eyes with and without myopic foveoschisis were 78.6 ± 20.6 μm and 134.9 ± 71.6 μm, 2499.2 ± 303.1 μm and 2969.3 ± 645.7 μm, respectively (P = 0.009 and P = 0.017). However, the height and diameter of the dome were not related to the incidence of a macular hole (P = 0.324 and P = 0.605) and choroidal neovascularization (P = 0.835 and P = 0.905).Conclusions: The prevalence of dome-shaped macula was about 40% in the eyes with degenerative myopia. Although dome-shaped macula was associated with higher degrees of myopia, a prominent dome seemed to be protective against myopic foveoschisis. [ABSTRACT FROM AUTHOR]

Abstract Pathologic myopia is associated with degenerative changes of the globe, especially at the posterior pole. Eyes affected by pathologic myopia have higher odds to undergo posterior segment surgery and, in those eyes, vitreoretinal surgery is challenging. Many practical tips and tricks can make the surgical procedures simpler, significantly preventing sight-threatening intra- and post-operative complications. Moreover, novel surgical techniques and technological advancements (i.e. ad-hoc instrumentation, minimally invasive vitreoretinal surgery, filters, dye staining, intraoperative optical coherence tomography and 3-dimensional surgery) may play role in highly myopic eyes. The aim of the present work is to review practical tips and tricks, novel surgical techniques and technological advancements.

Purpose. Morphological and functional evaluation of results of intravitreal injections of ranibizumab in treatment of choroidal neovascularization (CNV) caused by degenerative myopia (DM). patients and methods. The study included 32 patients (32 eyes) aged from 29 to 55 years with the CNV, developed due to the DM. They received 0.5 mg (0.05 ml) ranibizumab according to the standard. Indications for repeat intravitreal injections of ranibizumab were retention of the CNV activity or its recurrence. In addition to the standard ophthalmologic examination all patients were examined with fluorescein angiography (FAG) with photodetection of fundus picture and optical coherence tomography (OCT) of the retina (sizing subretinal neovascular membrane (SNM), evaluation of retinal foveal thickness (FCS). The study was conducted before the introduction of ranibizumab, monthly during the first 6 months after surgery, and then, in the absence of symptoms of CNV activity, every 2-3 months. The total follow-up was 12 months. results. the transition the CNV in inactive form according to FAG was observed in 25 people (78.1%) was observed after 1 month (single injection of ranibizumab). The angiographic signs of CNV activity remained after the first injection in 7 patients (21/9%). They received second intravitreal injection of ranibizumab. After 3 months from the beginning of observation according to FAG and OCT data relapse of activity of myopic CNV occurred in 5 patients (15.6%) after a single injection, and in 2 patients (6.3%) — after a double injection of ranibizumab. After 6 months according to FAG disappearance of pathological leakage of the dye was diagnosed in 87.5% of patients (28 eyes). After 12 months follow-up all 32 patients had remission of the pathological process with no evidence of CNV activity with formation of local subretinal fibrosis with choriocapillaries atrophy. Conclusions. It took from 1 to 3 (average 1.58) injections of ranibizumab to transfer the active phase of the CNV in inactive. Complete inhibition of the growth and activity of myopic CNV was accompanied by positive morphological and functional results, which led to a significant improvement in visual acuity in 2 times at the observation period of 12 months.

The choroid is the most vascular tissue in the eye and it plays an important role in the pathophysiology of various common chorioretinal diseases such as central serous retinopathy, age-related macular degeneration and degenerative myopia. Quantitative assessment of the choroid has been quite challenging with traditional imaging modalities such as indocyanine green angiography and ultrasonography due to limited resolution and repeatability. With the advent of optical coherence tomography (OCT) technology, detailed visualization of the choroid in vivo is now possible. Measurements of choroidal thickness have also enabled new directions in research to study normal and pathological processes within the choroid. The aim of the present study is to review the current literature on choroidal imaging using OCT

Vision is the motor that drives the psychomotor development of a person. The absence or inadequate interaction with visual stimuli becomes a problem with high emotional, social, and economic repercussions. The diagnosis and treatment of visual or pathological alterations that lead to low vision should be managed by a multidisciplinary team, which includes an optometrist, an ophthalmologist, a psychologist, and a rehabilitator, in order to implement vision stimulation programs and to prescribe non-conventional optical and non-optical aids. In the present case report, the patient was diagnosed with degenerative myopia in both eyes. For this reason, she was referred to low vision assessment and visual rehabilitation. A complete examination was carried out and the existing alternatives for the correction of the problem were analyzed in depth. Finally, a non-conventional optical aid was adapted for far vision--3x telescope--and another one for near vision--1x microscope + 3x magnifying glass; subsequently, the patient was discharged given that the objectives set during the treatment were met. [ABSTRACT FROM AUTHOR]

La miopía degenerativa constituye una de las causas fundamentales de pérdida de la visión. Esto está relacionado con las alteraciones del polo posterior, que afectan la retina neurosensorial, el epitelio pigmentario de la retina y las capas más internas de la coroides. Su curso lento y progresivo demanda una exploración integral, con seguimiento en el tiempo y constituye un reto para el oftalmólogo. Se realizó una revisión de artículos publicados e indexados en la base de datos de PubMed que se refirieran a las características clínicas del fondo de ojo en pacientes con miopía degenerativa, para describir las principales alteraciones del polo posterior del globo ocular en esta entidad. Se encontró entre las lesiones típicas de la alta miopía, al estafiloma posterior como un signo patognomónico de la enfermedad, asociado a la atrofia coriorretiniana en parches o difusa, así como las estrías de laca y las hemorragias maculares secundarias a ellas o provenientes de membranas neovasculares coroideas. La tomografía de coherencia óptica ha permitido un diagnóstico más preciso de otras lesiones maculares como la foveosquisis, el agujero macular y, más recientemente, la mácula en domo. Los cambios degenerativos del polo posterior parecen guardar relación unos con otros pero la patogenia no ha sido bien esclarecida a pesar de los avances tecnológicos.Degenerative myopia is one of the main causes of visual impairment. This is related to disorders in the posterior pole, affecting the neurosensorial retina, the retinal pigmented epithelium and the inner choroidal layers. The slow and progressive course of this condition demands comprehensive assessment and long follow-up, which is a challenging task for ophthalmologists. A review of the articles indexed in PubMed regarding the clinical characteristics of the fundus in patients with degenerative myopia was made to describe the main disorders of the posterior pole of the eyeball. Posterior staphyloma was found among the typical lesions of high myopia, associated with patchy or diffuse chorioretinal atrophy, lacker cracks, choroidal neovascular membranes and macular hemorrhages secondary to them or stemmed from choroidal neovascular membranes. More accurate diagnosis of foveoschisis, macular holes, and more recently dome-shaped macula has been achieved with optical coherence tomography. The degenerative changes of posterior pole seem to be associated each other, but pathogenesis of myopic retinopathy has not been clearly stated, despite the recent technological advances.

Se efectuó un estudio descriptivo y transversal de 73 pacientes con baja visión, que asistieron a la consulta del Centro Oftalmológico del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde julio hasta diciembre del 2009, a fin de describir algunas características clínicas y demográficas. La degeneración macular asociada a la edad primó en más de 25,0 % de los integrantes de la casuística, seguida por el glaucoma crónico simple y la miopía degenerativa y, según lugar de procedencia, los pertenecientes al municipio de Santiago de Cuba representaron 73,0 % del total. Se logró rehabilitar a 89,0 % de los pacientes examinados y tratados.A descriptive and cross sectional study of 73 patients with low vision who visited the Ophthalmologic Center at "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out from July to December 2009 in order to describe some clinical and demographic characteristics. Macular degeneration associated with age prevailed in more than the 25,0% of the case material, followed by simple chronic glaucoma and degenerative myopia and, according to origin place, those belonging to Santiago de Cuba municipality represented 73,0% of the total. It was possible to rehabilitate the 89,0% of the examined and treated patients.

Introduction: The purpose of the study was to evaluate selected visual parameters in the group of patients undergoing long-term treatment with trimetazidine as an adjuvant therapy for primary open angle glaucoma and degenerative myopia.Material and methods: Thirty patients, including 20 patients with advanced primary open angle glaucoma (40 eyes) and 10 patients with severe degenerative myopia (20 eyes), were treated with trimetazidine 20 mg twice a day. We excluded from the study patients with: systemic hypertension and/or diabetes, cataract, history of chronic and recurrent severe inflammatory eye disease and smokers. Patients with primary open angle glaucoma were taking various ocular hypotensive drops topically. Ophthalmic examination has been performed before administration of trimetazidine and then every month. Visual acuity, contrast sensitivity test (Pelli-Robson test), glare test, color vision (Farnsworth-Munsell test) and visual field were recorded. Follow-up period was 6 months. For statistical analysis paired Student’s t- test (p

Background: Degenerative myopia is identified by excessive and progressive elongation of the globe in combination with refractive error of greater than -6.00D and an axial length greater than 26mm. Though it has long been debated whether school myopia is of solely genetic origin, influenced by environmental factors, or a mixture of the two, degenerative myopia is thought to be more genetic in cause. Case Study: This case series was conducted on a family of seven degenerative myopes, comparing clinical findings as well as A-scan and visual evoked potential (VEP) alternating pattern testing. Data was gathered from the most recent examinations to determine the most common degenerative myopic findings within the family unit. VEP alternating pattern testing was conducted with best-corrected spectacle lenses at time of testing. Only one subject was tested before and after being fit with contact lenses. Conclusion: Upon clinical comparison of the seven family members, genetic inheritance appeared to be the most obvious causative factor of myopia progression in this family. Though it is still debated whether environmental factors take part in the early phases of degenerative myopia, heredity has been found to be the dominant predicting factor for the extent of the myopic changes. Further testing through a larger scale study is warranted to determine whether contact lens wear improves VEP amplitude and latency recording when compared to spectacle wear in degenerative myopia patients. [ABSTRACT FROM AUTHOR]

The choroid is the most vascular tissue in the eye and it plays an important role in the pathophysiology of various common chorioretinal diseases such as central serous retinopathy, age-related macular degeneration and degenerative myopia. Quantitative assessment of the choroid has been quite challenging with traditional imaging modalities such as indocyanine green angiography and ultrasonography due to limited resolution and repeatability. With the advent of optical coherence tomography (OCT) technology, detailed visualization of the choroid in vivo is now possible. Measurements of choroidal thickness have also enabled new directions in research to study normal and pathological processes within the choroid. The aim of the present study is to review the current literature on choroidal imaging using OCT. [ABSTRACT FROM AUTHOR]

To present the clinical and imaging findings and treatment results of a patient with myopic choroidal neovascularization and foveoschisis. A 45-year old female patient admitted with the complaint of visual acuity loss in the left eye. Best corrected visual acuity was 20/40 in the right eye, and 20/200 in the left eye. Anterior segment examination was normal. There was a subretinal hemorrhage at the inferior part of the fovea in the left eye. In the light of these findings, the patient was diagnosed as myopic CNV, and underwent two consecutive monthly intravitreal bevacizumab injections. After the treament, BCVA improved to 20/64, subretinal hemorrhage disappeared, and there was a window defect in FFA in the left eye. After seven months of follow-up time, BCVA decreased to 20/80 and OCT revealed foveoschisis in the left eye. The patient was informed about the disease and offered to undergo pars plana vitrectomy with internal limiting membrane peeling. She did not want to undergo surgery, and was called for periodic follow-up examinations. Degenerative myopia may lead to severe visual acuity loss because of choroidal neovascularization, Fuchs spot, Lacquer cracks that involve the fovea, myopic foveoschisis, and the combinations of these. It is very important to detect and treat these problems via different imaging and treatment modalities for preventing visual loss. [ABSTRACT FROM AUTHOR]

AIM: To investigate the correlation between degenerative myopia and diabetic retinopathy(DR). METHODS: Totally 106 cases with diabetes B were divided into the degenerative myopia group(48 cases)and the no degenerative myopia group(58 cases). Fundus examination and fluorescence fundus angiography(FFA)were performed on all cases. The occurrence and stage of DR were compared between the 2 groups. RESULTS: The occurrence of DR of the no degenerative myopia group(93.1%)was much higher than that of the degenerative myopia group(70.8%). Only retinopathy of stageⅠor Ⅱ was observed in the degenerative myopia group without lesion in proliferating phase, while retinopathy of stageⅠto Ⅴ could be found in the no degenerative myopia group.CONCLUSION: Degenerative myopia can prevent DR from occurrence and may be a protective factor for DR.

Degenerative myopia is one of the leading cause of visual impairment in the population aging between 20 and 50 years. Pathological mechanism is not fully known but might probably involve genetical and environmental factors. Degenerative myopia is associated with a range of secondary ocular changes in sclera, choroid, Bruch membrane, retinal pigment epithelium and retina. Clear lens extraction is one of the options for treatment of degenerative myopia. A 26 old woman presented with bilateral degenerative myopia and underwent bilateral clear lens extraction and foldable intraocular lens implantation surgery. The patient developed anisocoria after the first surgery that applied to the right eye. Anisocoria recovered and pupils became isocoric after the clear lens extraction that applied to the left eye. We proposed anisocoria might develop due to removal of mechanical effect of crystalline lens on iris. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical characteristics of myopic choroidal neovascularization (mCNV) according to peripapillary atrophy (PPA) and optic disk tilt and to explore whether those myopic disk deformations are associated with the prognosis of mCNV., Methods: Patients with subfoveal mCNV who received intravitreal bevacizumab injection and followed for ≥3 years were included. PPA was quantified as area of the ß-zone PPA/disk area ratio (PDR) and optic disk tilt as the tilt ratio (the longest/shortest disk diameter). We compared the clinical characteristics in terms of PDR and tilt ratio and identified the poor prognostic factors using Logistic regression and Cox proportional hazard model., Results: Among 80 eyes of 80 patients, 29 (36.30%) eyes developed macular atrophy during 80.71 ± 34.76 months. PDR and tilt ratio are strongly correlated with each other ( P = 0.004). Higher PDR showed significant correlations with longer axial length ( P = 0.013), worse baseline and final VA ( P = 0.007 and P = 0.047), and thinner subfoveal choroidal thickness ( P = 0.039), while higher tilt ratio showed significant correlations only with longer axial length ( P = 0.036). High PDR was also an independent risk factor for both macular atrophy (OR = 2.257, P < 0.001) and poor visual outcome (HR = 1.174, P = 0.007), while high disk tilt ratio was not., Conclusion: Subfoveal mCNV with higher ß-zone PPA area/disk area ratio had worse functional and structural outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Han, Kim, Yang, Moon, Lee, Kim and Yoon.)

Purpose: To evaluate the efficacy of intravitreal ranibizumab injection in choroidal neovascularization (CNV) secondary to causes other than age-related macular degeneration (AMD). Materials and Methods: We retrospectively reviewed the medical records of 23 eyes of 19 patients who were diagnosed with CNV secondary to causes other than AMD and treated with intravitreal ranibizumab injection during May 2006 and June 2010 at Ankara University Department of Ophthalmology. Ranibizumab injections were performed at intervals of 4 weeks as monotherapy and Best Corrected Visual Acuity (BCVA), fundus examination, optical coherence tomography (OCT) and fundus angiography (FA) findings were retrospectively reviewed at each visit. Results: 10 patients were male (52.6%), 9 were female (47.4%). The mean age was 46.37±18.7 (21-84). Mean follow-up was 16.8±7.9 (2-34) months. 6 eyes (26.10%) had degenerative myopia, 5 eyes (21.70%) had angioid streaks, 4 eyes (%17.40) had Best vitelliform dystrophy and 8 eyes (34.80%) had idiopathic CNV. The mean number of injections were 4±2.8 in eyes with degenerative myopia, 2.8±0.44 in eyes with angioid streaks, 2.75±1.25 in eyes with Best vitelliform dystrophy and 2.12±0.99 in eyes with idiopathic CNV. The mean BCVA before and after injection were 1.45±0.73 and 1.00±0.50 logMAR (p>0.05) in eyes with degenerative myopia, 0.44±0.31 and 0.20 ±0.18 logMAR (p>0.05) in eyes with angioid streaks, 0.92±0.71 and 0.22±0.26 logMAR (p>0.05) in eyes with Best vitelliform dystrophy, 0.47±0.36 and 0.22±0.40 (p<0.0125) logMAR in eyes with idiopathic CNV. After the treatment, the numerical increase in BCVA levels were found in all diagnostic groups, but this increase was statistically significant only in eyes with idiopathic CNV group due to high number of cases compared with other groups. Subretinal/intraretinal fluid decreased or disappeared on OCT scans in accordance with the increase in BVCA. Conclusion: Short term results of intravitreal ranibizumab injection for CNV from causes other than AMD seem to be a safe and effective method but larger series, longer term studies are needed to determine the effectiveness of the long-term. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Here we document 2 cases of macular schisis-like appearance in high myopia analyzed with spectral domain optical coherence tomography (SDOCT). Methods: In Case 1, a 58-year-old patient with high myopia manifesting a recent onset of decreased vision in the right eye (OD) is presented. In Case 2, a 45-year-old patient with a lifelong history of no light perception and high myopia OD is presented. Results: In Case 1, biomicroscopy found a posterior staphyloma associated with subtle retinal thickening in the patient’s right eye. SDOCT confirmed the presence of macular traction associated with a schisis-like appearance. In Case 2, a posterior staphyloma associated with significant macular thickening was observed during biomicroscopy. SDOCT found macular traction and a schisis-like appearance. Conclusions: These presentations are consistent with myopic traction maculopathy. Few myopic traction maculopathy cases have been studied with SDOCT. The time domain optical coherence tomography and SDOCT analysis suggests that the etiology of this condition may be secondary to preretinal and extraretinal traction exhibited in degenerative high myopia. [Copyright &y& Elsevier]

PurposeTo evaluate anti-VEGF and photodynamic therapy (PDT) for juxtafoveal and extrafoveal choroidal neovascularization (CNV) due to age-related macular degeneration (ARMD), ocular histoplasmosis syndrome (OHS), and degenerative myopia.MethodsA total of 10 eyes with juxtafoveal or extrafoveal choroidal neovascularization underwent intravitreal anti-VEGF therapy combined with verteporfin PDT (689 nm). Most treatments consisted of PDT every 12 weeks and either ranibizumab 0.5 mg every 4 weeks or bevacizumab 1.25 mg every 6 weeks, initiated concurrently. Retreatment criteria were persistent exudative signs on optical coherence tomography or fluorescein angiography.ResultsPresenting visual acuity (VA) ranged from 20/20 to 20/60 (mean log MAR±SD, 0.338±0.16 (20/44 equivalent)). After a mean follow-up of 17.5 months, it ranged from 20/15 to 20/40 (mean log MAR±SD, 0.150±0.14 (20/28 equivalent); P=0.027, paired t-test). Six eyes improved by 2 lines and four remained within 2 lines of initial VA. Non-ARMD eyes required much fewer treatments than ARMD eyes. All five non-ARMD eyes and three of five ARMD eyes showed no CNV activity at least 5 months after last treatment.ConclusionsAnti-VEGF therapy and PDT can preserve good visual function and may be suited to some cases of nonfoveal CNV. ARMD eyes require longer courses of treatment than non-ARMD eyes. [ABSTRACT FROM AUTHOR]

PurposeTo provide contemporary data on the aetiology of paediatric rhegmatogenous retinal detachment (RRD) in the UK population.MethodsRetrospective case series.ResultsEighty-eight eyes in 82 patients (aged 0–16 years) were treated for RRD at Bristol Eye Hospital between 1 January 1990 and 31 December 2004. Seventy-three per cent of patients were male and the main predisposing factors were trauma (53%), associated conditions (27%), and high myopia (17%). Nineteen per cent of RRDs were idiopathic, and the majority of these were due to infero-temporal dialyses. The macula was detached on presentation in 66% of eyes.ConclusionsThe principal causes of paediatric RRDs have not changed over the past 40 years. Those due to congenital cataracts, retinopathy of prematurity, uveitis, and glaucoma are now less prevalent, presumably reflecting advances in their management. Differences with other contemporary series may arise from geographical variation in the prevalence of myopia and other associated conditions, as well as institutional referral patterns. Full examination of the retinal periphery is advised for children with eye injuries (to exclude dialyses).Eye (2008) 22, 636–640; doi:10.1038/sj.eye.6702724; published online 9 February 2007 [ABSTRACT FROM AUTHOR]