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BackgroundTo explore the role of foveal and parafoveal Müller cells in the morphology and pathophysiology of tractional macular disorders with a mathematical model of mechanical force transmission.MethodsIn this retrospective observational study, spectral-domain optical coherence tomography images of tractional lamellar macular holes and patients with myopic foveoschisis were reviewed and analysed with a mathematical model of force transmission. Parafoveal z-shaped Müller cells were modelled as a structure composed of three rigid rods, named R1, R2 and R3. The angle formed between the rods was referred to as θ . R1, R2 and R3 lengths as well as the variation of the angle θ were measured and correlated with best corrected visual acuity (BCVA).ResultsIn tractional lamellar macular holes, there was a significant reduction of the angle θ towards the foveal centre (p

Objectives: The aim of this study is to describe and validate an optical-coherence-tomography (OCT)-based method to easily calculate specific volumes, addressing the limitations of current OCT software in automating volumetric analysis for specific entities in retinal pathologies. Methods: After manually drawing the specific entity on linear OCT scans using the calliper function and automated measurement of its area, the following formula was used for volumetric calculation: Volume [mm3] = ∑area [mm2] × OCT-scan distance [mm]. Retinal volume (RV) was measured by two independent observers in eyes with a normal foveal profile (NFP) and was compared with the automated measurements performed by the OCT software (Engineering GmbH, Heidelberg, Germany); the same process was repeated for the volume of the foveal cavity (FC) or foveoschisis (FS) in eyes with lamellar macular holes (LMHs). Power calculations were conducted to ensure adequate sample size. The measurements were re-acquired after six weeks. Intra- and inter-observer variability as well as comparison to automated RV calculations were analysed. Results: This study included a total of 62 eyes divided into two groups: the NFP (30 eyes) and LMH (32 eyes) groups. The Bland–Altman plots showed a high degree of agreement in both groups for inter-observer and intra-observer agreement. In addition, in the NFP group, a high degree of agreement was demonstrated between human observers and the OCT software (Spectralis). Conclusions: An easy, reliable, and widely applicable method to calculate volumes is described and validated in this paper, showing excellent inter- and intra-observer agreement, which can be applied to any entity requiring a specific study in the context of retinal pathologies. [ABSTRACT FROM AUTHOR]

Background: We investigate novel OCT parameters, based on the volumetric analysis of lamellar macular holes (LMHs), as prognostic indicators for visual outcomes after surgery. Methods: LMHs were divided into degenerative LMHs (D-LMHs) and ERM-foveoschisis (ERM-FS). Pre-operative clinical, OCT linear and volumetric parameters were collected. Volumes were obtained using the OCT automatic segmentation, such as central retinal volume (CRV) and outer nuclear layer (ONL) volume, or using a novel method to calculate volumes of specific LMH entities like epiretinal proliferation (ERP), foveal cavity (FC) in D-LMH and schitic volume (SV) in ERM-FS. Univariate and multivariate linear regression analysis evaluated the factors predictive for post-operative best-corrected visual acuity (BCVA). Results: We included 31 eyes of 31 patients (14 D-LMH,17 ERM-FS). A pre-operative BCVA ≤ 0.48 logMAR was a predictor for achieving ≤0.30 logMAR at final follow-up. A lower pre-operative BCVA (p = 0.008) and the presence of ERP (p = 0.002) were associated with worse visual outcomes post-surgery. Moreover, novel pre-operative OCT parameters significantly associated with worse post-operative BCVA, such as increased FC volume (p = 0.032) and lower CRV (p = 0.034) in the D-LMH subtype and lower CRV (p < 0.001) and ERP volume (p < 0.001), higher SV (p < 0.001) and foveal ONL volume (p < 0.001) in the ERM-FS subtype. Conclusions: Novel volumetric OCT parameters can be prognostic indicators of visual outcome following surgery in LMHs. [ABSTRACT FROM AUTHOR]

Topical antimicrobials and antiseptics are used perioperatively to reduce the ocular surface bacteria flora (OSBF) that are involved in the development of post‐operative infectious complications. However, their effectiveness is still a controversial topic. This systematic review, performed according to the PRISMA guidelines and registered in PROSPERO, aims to provide an overview of the efficacy of the agents currently used in peri‐cataract surgery and ‐intravitreal injections (IVI) in lowering the OSBF. Although effective in lowering OSBF, perioperative topical antimicrobials are associated with the risk of resistance development, with no obvious additional benefit compared with topical antisepsis. Conversely, the effectiveness of topical antiseptics before cataract surgery and IVI is strongly supported. Based on the available evidence, perioperative antimicrobials are not recommended, whereas the perioperative use of antiseptics is strongly recommended as prophylactic treatment for lowering the infection due to OSBF. Post‐operative antimicrobials may be considered in eyes at higher risk for infection. [ABSTRACT FROM AUTHOR]