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Abstract Background To report two cases of atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy. Case presentation Two patients with incidentally discovered abnormalities of the retina without specific symptoms were referred to our hospital for consultation. Bilateral macula atrophic lesions were observed and optical coherence tomography revealed serous retinal detachment in the macula. Fluorescein angiography showed multiple leakages around the central hypofluorescent area and indocyanine green angiography showed partially dilated choroidal vessels. Fundus autofluorescence (FAF) showed a decreasing pattern of autofluorescence in the subretinal fluid area, and increasing autofluorescence at the border of the serous retinal detachment. Both patients were diagnosed with chronic central serous chorioretinopathy. Photodynamic therapy and intravitreal bevacizumab injection were administered for engorged choroidal vessels during follow-up, but neither patient showed improvement in symptoms or ophthalmologic findings. Based on re-evaluation by fundus photography, optical coherence tomography, fluorescein angiography, and comparison of the results of FAF with the first visit, vitelliform macular dystrophy was suspected and a definite diagnosis was made by electrooculography and genetic testing. Conclusion In patients with continuous serous retinal detachment without response to photodynamic therapy or intravitreal bevacizumab injection, careful fundus exam and FAF can be used to diagnose atypical vitelliform macular dystrophy.

Purpose: To investigate longitudinal changes and associated factors for microvascular parameters in macula-off rhegmatogenous retinal detachment (RRD) after repair surgery. Methods: This is a retrospective study of 34 eyes with macula-off RRD. The foveal avascular zone (FAZ) area and parafoveal vessel density were recorded every 3 months for 1 year after surgery. We analyzed 3 × 3 mm and 6 × 6 mm swept-source optical coherence tomographic (OCT) angiography images to quantify microvascular parameters. Individual clinical factors and pre- and postoperative OCT images were analyzed to find factors associated with changes in the FAZ area and vessel density 12 months after surgery. Results: The differences in FAZ area and vessel density between the operated and fellow eye at 3, 6, 9, and 12 months postoperatively were 0.127 ± 0.05, 0.111 ± 0.06, 0.108 ± 0.07, and 0.105 ± 0.06 mm2 and 4.33 ± 1.42, 3.56 ± 2.05, 2.73 ± 1.72, and 2.61 ± 1.71/mm. Preoperative sensory retina thickness and surgical methods significantly correlated with decreased vessel density at 12 months. Surgical method-based analysis found that postoperative vessel density damage in the pars plana vitrectomy (PPV) group was more prominent than in the buckling group. Conclusion: After macula-off RRD surgery, microvascular parameters were impaired after successful anatomical repair but recovered over 12 months. The PPV group exhibited significantly lower postoperative parafoveal vessel density than the buckling group. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incidence and risk factors of neovascular age-related macular degeneration (nAMD) including polypoidal choroidal vasculopathy (PCV) or any type of choroidal neovascularization (CNV) in fellow eyes of unilateral PCV. Methods: This retrospective study included 48 patients with unilateral PCV. For the initial PCV diagnosis, optical coherence tomography and indocyanine green angiography were performed, and patients with and without neovascularization were compared. Results: Of 48 fellow eyes, 10 (20.8%) had drusen, 9 (18.8%) had retinal pigment epitheliopathy, 9 (18.8%) had irregular retinal pigment epithelium (RPE) elevation, 13 (27.1%) had choroidal vascular dilation, 12 (25%) had choroidal vascular hyperpermeability, and 9 (18.8%) had branching vascular network (BVN) at baseline. The development of nAMD was noted in 8 eyes (17%). The subfoveal choroidal thickness (p = 0.001), irregular RPE elevation (p < 0.001), choroidal vascular dilation (p < 0.001), choroidal vascular hyperpermeability (p < 0.001), and BVN (p < 0.001) in fellow eyes were significantly correlated with development of PCV. After multivariate analysis, BVN (p = 0.045, odds ratio = 24.66) in the fellow eye was the only significant risk factor for the development of nAMD. Conclusions: PCV or CNV developed in 17% of fellow eyes during the 5 years. Unilateral PCV with contralateral BVN requires careful monitoring for future development of PCV or CNV in fellow eyes. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of full-fluence photodynamic therapy (PDT) and half-fluence PDT in chronic central serous chorioretinopathy (CSC). Procedures: A retrospective review of CSC patients treated with full-fluence or half-fluence PDT for 12 months was performed. Best-corrected visual acuity (BCVA), central macular thickness (CMT), neural retinal thickness, subfoveal choroidal thickness (SFCT), resolution of subretinal fluid (SRF), and incidence of retinal pigment epithelium (RPE) atrophy at 12, 24, and 36 months were assessed. Results: Thirty-seven and 30 eyes received full-fluence and half-fluence PDT, respectively. The BCVA and CMT improved significantly in both the full-fluence and half-fluence groups at 36 months, without a significant difference between the groups. Both groups showed significant reductions in SFCT with full-fluence (416.8–316.8 µm) being better overall than half-fluence (409.7–349.1 µm, p = 0.002). All patients achieved complete resolution without recurrence after one PDT treatment per eye. A few cases of RPE atrophy occurred, which could be correlated to PDT in both groups during the follow-up. Conclusion: Both treatments were effective and safe in chronic CSC, with significant improvements in anatomic and visual parameters, without recurrence of SRF. [ABSTRACT FROM AUTHOR]