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Objective To investigate the efficacy of intravitreal injection of Ozurdex® in the treatment of refractory diabetic macular edema (DME) with different optical coherence tomography (OCT) patterns. Methods A total of 38 patients (41 eyes) who underwent fundus examination and were diagnosed with refractory DME in Department of Ophthalmology in our hospital from June 2018 to June 2020 were enrolled in this study, and according to the OCT pattern, they were divided into diffuse retinal thickening (DRT) group, cystoid macular edema (CME) group, and serous retinal detachment (SRD) group. Intravitreal injection of Ozurdex® was performed for all diseased eyes as needed, and best corrected visual acuity (BCVA) and OCT measurements were performed before treatment and at 1, 3, and 6 months after treatment. The three groups were compared in terms of BCVA, central foveal thickness (CFT), the integrity of external limiting membrane, ellipsoid zone integrity, and the number of hyperreflective dots (HRDs) before and after treatment. Results All three groups had a significant improvement in BCVA at 1, 3, and 6 months after treatment (Fintra-group=15.334-42.187,P0.05), and at 1, 3, and 6 months after treatment, there was a significant change in the proportion of diseased eyes with different numbers of HRDs (H=23.645-39.117,P

Background To investigate the association of glycemic control and retinal microvascular changes in patients with type 2 diabetes mellitus (T2DM) without diabetic retinopathy (DR). Methods This retrospective, observational, cohort study included patients with T2DM without DR. The patients were categorized into intensive control (IC; mean glycosylated hemoglobin [HbA1c] ≤7.0%) and moderate control (MC; mean HbA1c >7.0%) groups. Optical coherence tomography (OCT) and swept-source OCT angiography (OCTA) image parameters were compared between three groups, including healthy controls. Results In total, 259 eyes of 259 participants (88 IC, 81 MC, and 90 controls) were included. The foveal avascular zone area was significantly larger in the MC group than IC and control groups (all P

Objective To investigate the changes of retinal nerve fiber layer (RNFL) thickness and superficial vascular density in patients with Parkinson's disease (PD), and analyze the correlation between the changes and disease severity. Methods Total 43 patients (76 eyes) with PD admitted to the Affiliated Hospital of North Sichuan Medical College from June 2021 to March 2022, and 45 patients (90 eyes) with normal neurological and visual functions from their family members were recruited as the control group. Optical coherence tomography angiography (OCTA) was used to measure RNFL thickness, retinal blood vessel length density and perfusion density, and the area and circumference of foveal avascular zone (FAZ). Disease severity was evaluated by modified Hoehn - Yahr staging, and motor function was evaluated by Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) in PD group. Pearson and partial correlation analyses were used to investigate the correlation between retinal parameters and PD severity. Results Comparison of OCTA related parameters between the 2 groups: RNFL thickness (t = - 6.424, P = 0.000), central length density (t = - 3.629, P = 0.000), inner ring length density (Z = - 2.846, P = 0.004) and central perfusion density (Z = - 2.703, P = 0.007) in the PD group were lower than those in the control group. Correlation analysis showed that RNFL thickness was negatively correlated with UPDRSⅢ score (r = - 0.625, P = 0.000). Conclusions RNFL thickness may be a potential indicator for early diagnosis and evaluation of the severity of PD.

Objectives: Optic nerve head edema (ONHE) detected by fundoscopy is observed in one-third of patients presenting optic neuritis (ON). While ONHE is an important semiological feature, the correlation between ONHE and optic nerve head MRI abnormalities (ONHMA), sometimes called "optic nerve head swelling," remains unknown. Our study aimed to assess the diagnostic accuracy of T2 fluid-attenuated inversion recovery (FLAIR) MRI sequence in detecting ONHE in patients with acute ON. Methods: In the present single-center study, data were extracted from two prospective cohort studies that consecutively included adults with a first episode of acute ON treated between 2015 and 2020. Two experienced readers blinded to study data independently analyzed imaging. A senior neuroradiologist resolved any discrepancies. The primary judgment criterion of ONHMA was assessed as optic nerve head high signal intensity on gadolinium-enhanced T2FLAIR MRI sequence. Its diagnostic accuracy was evaluated with both the gold standard of ONHE on fundus photography (FP) and peripapillary retinal nerve fiber layer thickening on optic coherence tomography (OCT). Results: A total of 102 patients were included, providing 110 affected and 94 unaffected optic nerves. Agreement was high between the different modalities: 92% between MRI and FP (k = 0.77, 95% CI: 0.67–0.88) and 93% between MRI and OCT (k = 0.77, 95% CI: 0.67–0.87). MRI sensitivity was 0.84 (95% CI: 0.70–0.93) and specificity was 0.94 (95% CI: 0.89–0.97) when compared with the FP. Conclusion: Optic nerve head high T2FLAIR signal intensity corresponds indeed to the optic nerve head edema diagnosed by the ophthalmologists. MRI is a sensitive tool for detecting ONHE in patients presenting acute ON. Clinical relevance statement: In patients with optic neuritis the high T2FLAIR (fluid-attenuated inversion recovery) signal intensity of the optic nerve head corresponds indeed to optic nerve head edema, which is a useful feature in optic neuritis etiological evaluation and treatment. Key Points: Optic nerve head edema is a prominent clinical feature of acute optic neuritis and is usually diagnosed during dilated or non-dilated eye fundus examination. Agreement was high between magnetic resonance imaging, fundus photography, and optical coherence tomography. Optic nerve head high T2 fluid attenuation inversion recovery signal intensity is a promising detection tool for optic nerve head edema in patients presenting acute optic neuritis. [ABSTRACT FROM AUTHOR]

Purpose: To compare the injection of small amounts of undiluted C3F8 with the traditional gas injection in vitrectomy for macular hole treatment. Methods: This clinical trial included 26 individuals divided into two groups. Group 1 received an intravitreal injection of 0.9-1.0 mL of 100% C3F8, and Group 2 received 15-20 mL of 20% C3F8. Results: The median intraocular gas duration was 31 days in Group 1 and 34 in Group 2. The median letter gains in corrected distance visual acuity for the 26th postoperative week were 20 letters in Group 1 and 12.5 in Group 2. The median intraocular pressure was normal in both groups. Primary anatomical success was 11/13 in both groups. Conclusions: The use of C3F8 gas in a small undiluted volume is an alternative that slightly reduces the duration of the gas without negatively affecting the anatomical and visual response. [ABSTRACT FROM AUTHOR]

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Background: Retinal health indices were suggested to be related to psychopathological symptoms, such as depressive symptoms. However, large-scale studies using optical coherence tomography (OCT) are missing to investigate the associations among them. Methods: In the META-KLS cohort study, 1456 participants (mean age [standard deviation]= 54.6 [11.91] years; n= 680 [47.8%] women) completed the Patient Health Questionnaire (PHQ-9) to measure depressive symptoms and underwent OCT. Poor-quality OCTs and multivariate outliers were excluded, and principal component analysis was performed to obtain retinal health indices separately for macular (n= 930) and optic nerve head (ONH) thicknesses (n= 800). Linear regressions were run controlling for covariates. Exploratory interaction models were run with demographic, lifestyle and health markers. Results: Although there were no direct significant associations between the retinal indices and depressive symptoms (macular: B= −0.05, 95% CI= [-0.15, 0.05], p= 0.32; ONH index: B= -0.02, 95% CI= [-0.11, 0.08], p= 0.71), their associations were moderated by demographic and health factors, e.g., C-reactive protein (CRP) (macular index: B= −0.03, 95% CI= [-0.05, −0.01], p= 0.002; ONH index: B= 0.05, 95% CI= [0.02, 0.08], p= 0.002). Limitations: Study was cross-sectional and there were no functional assessments of vision. Conclusions: In a large cohort, we observed associations between retinal indices and self-reported depressive symptoms depending on demographic and health factors, notably CRP. Following up, the study will investigate the prospective prediction of retinal health on depressive symptoms, especially in persons who may have chronic inflammation.

Optical coherence tomography angiography (OCTA) is a new noninvasive fundus angiography technique that has been widely used in recent years, and compared with traditional optical coherence tomography, OCTA has a higher resolution and a faster scanning speed. Compared with fundus fluorescein angiography and indocyanine green angiography, OCTA has its own advantages in the diagnosis and treatment of various fundus diseases, such as no need for the injection of contrast agent, a short time for examination, and clear display of the three-dimensional structure of retina and choroid. Although OCTA cannot replace fundus fluorescein angiography in clinical practice at present, it can still be used as an important auxiliary examination in the diagnosis of fundus diseases. Fer this reason, our article reviews the advances in the application of OCTA in the diagnosis of common fundus diseases such as senile macular degeneration, retinal vein occlusion, diabetic retinopathy, and central serous chorioretinopathy.

Abstract Background Previous studies have generally focused on dry eye test abnormalities and ocular involvements such as uveitis, and blepharitis in psoriasis. Psoriasis area severity ındex (PASI), which is used to assess psoriasis severity, is a time-consuming and complex tool. Objective To evaluate the relationship between disease severity and central corneal epithelial thickness (CCET) in psoriasis. Methods 175 eyes of 175 psoriasis patients and 57 eyes of 57 healthy individuals as a control group was included in this study. Psoriasis patients were divided into three subgroups according to PASI score as < 10 mild, 10‒20 moderate and > 20 severe. CCET was measured by spectral domain-optical coherence tomography (SD-OCT), and mean values were recorded. Mean CCET values were compared between the psoriasis groups and the control group. Additionally, the relationship between PASI score and CCET was examined. Results The mean CCET value was 58.06 ± 3.1 μm in the mild group, 60.10 ± 5.0 μm in the moderate group, 65.75 ± 6.3 μm in the severe group and 56.16 ± 3.1 μm in the control group. It was determined that the mean CCET value was significantly higher in all psoriasis groups compared to the control group (p < 0.001). The mean CCET value was significantly higher in the moderate psoriasis group than in the mild psoriasis group (p = 0.018), and in the severe psoriasis group compared to the moderate psoriasis group (p < 0.001). There was a strong positive correlation between PASI score and CCET (p < 0.001, r = 0.519). Study limitations Cross-sectional design and a relatively small number of participants. Conclusions There is a strong positive correlation between psoriasis severity and CCET. Contactless measurement of CCET by SD-OCT can be an indicator of psoriasis severity.

Objective: Unusual clinical course Background: We report a case of late-onset chronic fistula in a decompensated cornea after multiple ocular surgeries and a recent phototherapeutic keratectomy (PTK). Case Report: A 73-year-old woman presented to our service with a past ocular history of bilateral chronic angle closure glaucoma and pseudophakic bullous keratopathy in the left eye. Given a history of long-term uncontrolled glaucoma with advanced disc cupping and poor visual potential, the patient underwent multiple palliative procedures, including, most recently, a PTK. Few years later she presented with a spontaneous late onset of slowly appearing corneal leak on fluorescein staining upon routine clinical examination. Corrected distance visual acuity was hand motion and intraocular pressure (IOP) was 40 mmHg in the affected eye. Serial anterior segment optical coherence tomography (AS-OCT) sections were obtained, which aided in understanding the current presentation and revealed distinctive multilayer corneal changes during the healing process. The patient was successfully managed with cyanoacrylate corneal gluing and ocular hypotensive medications, which halted the corneal leak. Conclusions: We report a case of a rare finding of corneal fistula in an eye with multiple previous ocular surgeries, and provide an explanation of the possible etiopathogenesis. We also highlight the pivotal role of AS-OCT for evaluating such cases and stress the importance of early detection of similar subtle leaks in the setting of a formed anterior chamber, which can often be missed, carrying a risk of infection. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to investigate the clinical efficacy of near-infrared reflectance (NIR) imaging and optical coherence tomography (OCT) in identifying ocular manifestations of neurofibromatosis type 1 (NF1) in Korean children. Methods This retrospective chart review study included five Korean children with NF1 aged under 18 years who had undergone ophthalmic procedures, including slit-lamp examinations, NIR imaging, and OCT scanning. Results Multiple patchy bright lesions were observed on NIR imaging in all eyes (10 eyes in five patients). Further NIR imaging and OCT scans showed that these lesions, confined to the choroid, were choroidal nodules. Lisch nodules, contrastingly, were found in only four of 10 eyes by slit-lamp examinations on the same day as the NIR imaging. One of those four eyes had only one Lisch nodule, which did not meet the NF1 diagnostic criteria. Conclusion NIR imaging enabled the detection of choroidal nodules in Korean children with NF1. Moreover, for Korean children with NF1, choroidal nodules were earlier-detected ocular manifestations relative to Lisch nodules. NIR imaging, along with OCT, is a useful protocol for localizing NF1 nodules in children.

Objective To investigate the correlation between retinal thickness in macular area and urinary protein in adult patients with nephrotic syndrome. Methods A total of 112 inpatients admitted to the internal medicine department were selected and divided into the normal urine protein group (28 cases, 56 eyes), the mildly abnormal urine protein group (30 cases, 58 eyes), the moderately abnormal urine protein group (27 cases, 51 eyes) and the nephrotic syndrome group (27 cases, 53 eyes) according to results of urine protein detection. Optical coherence tomography (OCT) was used to measure the average retinal thickness of the nine divisions in the macula regions, including the central region (Center), temporal side of the inner ring (InT), superior the inner ring (InS), nasal side of the inner ring (InN), inferior the inner ring (InI), temporal side of the outer ring (OutT), superior the outer ring (OutS), inferior the outer ring (OutI) and nasal side of the outer ring (OutN). The correlation ratio E2 was used to analyze the correlation between the mean retinal thickness of different macular regions and the grading of urinary protein in each group. Results The mean retinal thickness of Center, InT, InN and InI in the macular area was higher in the mildly abnormal urine protein group than that in the normal urine protein group. The mean retinal thickness of Center, InT, InS, InN, InI and OutN in the macular area was lower in the moderately abnormal urine protein group than that in the mildly abnormal urine protein group, and the mean retinal thickness of InT, InS, InN and InI in the macular area was higher in the nephrotic syndrome group than that in the moderately abnormal urinary protein group (All P＜0.05). The mean retinal thickness of InT, InS, InN and InI in macular area was moderately correlated with the severity of urinary protein group (0.06≤E2 ＜0.16), while the mean retinal thickness of Center and OutN in macular area was weakly correlated with the severity of urinary protein group (E2 ＜0.06). Conclusion The mean retinal thickness of InT, InS, InN and InI in macular area may be biomarkers of early lesions of adult nephrotic syndrome. [ABSTRACT FROM AUTHOR]

Abstract: This study tested a novel in vitro dental erosion-abrasion model and the performance of cross-polarization optical coherence tomography (CP-OCT) in longitudinally monitoring the simulated lesions. Thirty human enamel specimens were prepared and randomized to receive three dental erosion-abrasion (EA) protocols: severe (s-EA, lemon juice/pH:2.5/4.25%w/v citric acid), moderate (m-EA, grapefruit juice/pH:3.5/1.03%w/v citric acid) and no-EA (water, control). EA challenge was performed by exposing the specimens to acidic solutions 4x/day and to brushing 2x/day with 1:3 fluoridated toothpaste slurry, for 14 days. Enamel thickness measurements were obtained using CP-OCT at baseline (D0), 7 (D7) and 14 days (D14) and micro-computed tomography (micro-CT) at D14. Enamel surface loss was measured with both CP-OCT and optical profilometry at D0, D7 and D14. Data was analyzed with repeated-measures ANOVA and Pearson's correlation (r) (α = 0.05). CP-OCT enamel thickness decreased over time in the s-EA group (D0 >D7 > D14, p < 0.001) and m-EA group (D0 > D14, p = 0.019) but did not change in the no-EA group (p = 0.30). Overall, CP-OCT and micro-CT results at D14 correlated moderately (r = 0.73). CP-OCT surface loss was highest for s-EA (p m-EA>s-EA, p < 0.001). D14 surface loss was higher than D7 for both methods except for the no-EA group with profilometry. CP-OCT and profilometry had moderate overall correlation (r = 0.70). Our results revealed that the currently proposed in vitro dental erosion-abrasion model is valid and could simulate lesions of different severities over time. CP-OCT was a suitable method for monitoring the EA lesions.

Purpose: The aim of this study was to investigate the clinical efficacy of near-infrared reflectance (NIR) imaging and optical coherence tomography (OCT) in identifying ocular manifestations of neurofibromatosis type 1 (NF1) in Korean children. Methods: This retrospective chart review study included five Korean children with NF1 aged under 18 years who had undergone ophthalmic procedures, including slit-lamp examinations, NIR imaging, and OCT scanning. Results: Multiple patchy bright lesions were observed on NIR imaging in all eyes (10 eyes in five patients). Further NIR imaging and OCT scans showed that these lesions, confined to the choroid, were choroidal nodules. Lisch nodules, contrastingly, were found in only four of 10 eyes by slit-lamp examinations on the same day as the NIR imaging. One of those four eyes had only one Lisch nodule, which did not meet the NF1 diagnostic criteria. Conclusion: NIR imaging enabled the detection of choroidal nodules in Korean children with NF1. Moreover, for Korean children with NF1, choroidal nodules were earlier-detected ocular manifestations relative to Lisch nodules. NIR imaging, along with OCT, is a useful protocol for localizing NF1 nodules in children. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Kawasaki disease (KD), a systemic vasculitis, affects children aged <5 years and is the leading acquired cardiovascular disease in developed countries. Although intravenous immunoglobulin is an effective treatment for KD and decreases the rate of cardiovascular complications, some patients still develop coronary sequelae, including coronary aneurysms and myocardial infarction. Case Report: A 9-year-old boy was diagnosed with KD at the age of 6 years. For coronary sequelae of a giant coronary artery aneurysm (CAA) 8.8 mm in diameter, he was prescribed aspirin and warfarin. At 9 years old, he visited the Emergency Department because of acute chest pain. Electrocardiography revealed an incomplete right bundle branch block and ST-T change over right and inferior leads. Also, troponin I was elevated. Coronary angiography found acute thrombotic occlusion of the right CAA. We performed aspiration thrombectomy with intravenous tirofiban. Coronary angiography and optical coherence tomography (OCT) images later found white thrombi, calcification, destruction of media layer, irregular intimal thickening, and uneven intima edge. We prescribed antiplatelet therapy and warfarin, and he was doing well at a 3-year follow-up. Conclusions: OCT is a promising modality that can impact the clinical care in patients with coronary artery disease. This report presents treatment management and OCT images of KD complicated with a giant CAA and acute myocardial infarction. We used aspiration thrombectomy in combination with medical treatments as the initial intervention strategy. Afterward, the OCT images showed vascular wall abnormalities, which were helpful for defining the future risk and decision making of further coronary interventions and medical treatments. [ABSTRACT FROM AUTHOR]

Background/Aim. Unilateral optic neuritis (ON), and its pathological substrate, retrobulbar neuritis (RBN), is a common presentation of multiple sclerosis (MS). The aim of the study was to determine the diagnostic and prognostic value of structural and functional examination using novel 'swept-source' optical coherence tomography (SS-OCT) and OCT angiography (OCTA) techniques in patients with MS who experienced RBN. Methods. For examining retinal structural and functional changes in both the affected and nonaffected eye of patients with MS, novel techniques, OCT and OCTA, were used. The obtained results were compared with the results of the same examination on the left and right eye of the healthy controls. Results. Using OCT, significant differences in the structural integrity and thickness of retinal layers between the eye in which RBN had been detected and the contralateral, nonaffected eye were found (83.73 ± 18.36 vs. 98.67 ± 11.84; p = 0.013). On the other hand, the functional examination of the macular vascular plexus did not show significant differences between the affected and the nonaffected eye in these patients (41.86 ± 1.52 vs. 42.52 ± 1.40; p = 0.228). Interestingly, comparing the nonaffected eye of patients with RBN and healthy controls, a significant difference in the thickness of the retinal layers between the contralateral eye of the patient and both healthy eyes of healthy subjects was found. OCT examination showed particularly significant thinning of the macular ganglion cell-inner plexiform layer (mGCIPL) (61.07 ± 5.04 vs. 67.53 ± 4.57; p < 0.001). Conclusion. Overall, our research showed that OCT and OCTA offer an unprecedented opportunity for a safe, reliable, and repetitive assessment of structural and functional retinal changes as invaluable diagnostic and prognostic tools, paving the way for a better understanding of pathogenic mechanisms underlying inflammatory demyelinating and neurodegenerative diseases. In addition, mGCIPL may be a particularly sensitive and reliable biomarker of pathological changes in MS and perhaps in other neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

Background/Aim. Spectral domain optical coherence tomography (SDOCT) is very useful for the accurate examination of macular microstructure. The aim of this study was to evaluate macular morphologic changes after successful retinal detachment (RD) surgery by scleral buckling (SB) using SDOCT and assess their impact on vision repair. Methods. SDOCT examination was performed in 1, 6, and 12 months in 27 eyes following SB surgery with the successful anatomical repair of rhegmatogenous RD, which also affected the macular region. The examination was performed in a 6 mm diameter central macular region and included measurements of the central foveal thickness, average total retinal thickness (TRT), and thickness of the inner and outer retinal layer (ORT) separately. The numerical values of parameters for each operated eye were compared with those of the fellow (control) eye of each patient. The condition of the external limiting membrane (ELM) and inner segment (IS) and outer segment (OS) of the photoreceptors was also examined. Results. The mean TRT and ORT in the reattached regions in the operated eyes were significantly thinner than the corresponding regions of the fellow (control) eye, and throughout the follow-up period, the difference was statistically significant. There was a statistically significant difference in TRT (after 1 month, p = 0.021, after 6 months, p = 0.026, after 12 months, p = 0.027) and ORT (after 1 month, p = 0.018, after 6 months, p = 0.019, after 12 months, p = 0.021) between the eyes with a longer preoperative duration of macular detachment (MD) of 2 weeks and eyes with shorter detachment period. Disruptions of the IS and OS of photoreceptors and ELM on SDOCT examination after one month were observed in 37.04% of eyes, after 6 months in 29.6% of eyes, and at the end of the follow-up period in 14.8% of eyes. A statistically significant difference was found in the frequency of disruptions of the IS and OS, and ELM depending on the pre-operative duration of RD (p = 0.007). Conclusion. The overall decrease in the mean retinal thickness after successful anatomical repair of RD is the result of a decrease in the thickness of the outer retinal layers. The alterations of the ELM, IS and OS of photoreceptors observed on the early SDOCT scans are mostly associated with limited vision recovery. The prolonged MD leads to damaging the neurosensory tissue of the retina and especially the photo-receptors, which may explain the limited visual acuity recovery after successful SB repair of RD.

Background/Aim. Unilateral optic neuritis (ON), and its pathological substrate, retrobulbar neuritis (RBN), is a common presentation of multiple sclerosis (MS). The aim of the study was to determine the diagnostic and prognostic value of structural and functional examination using novel ‘swept-source’ optical coherence tomography (SS-OCT) and OCT angiography (OCTA) techniques in patients with MS who experienced RBN. Methods. For examining retinal structural and functional changes in both the affected and nonaffected eye of patients with MS, novel techniques, OCT and O CTA, w ere u sed. The obtained results w ere compared with the results of the same examination on the left and right eye of the healthy controls. Results. Using OCT, significant differences in the structural integrity and thickness of retinal layers between the eye in which RBN had been detected and the contralateral, nonaffected eye were found (83.73 ± 18.36 vs. 98.67 ± 11.84; p = 0.013). On the other hand, the functional examination of the macular vascular plexus did not show significant differences between the affected and the nonaffected eye in these patients (41.86 ± 1.52 vs. 42.52 ± 1.40; p = 0.228). Interestingly, comparing the nonaffected eye of patients with RBN and healthy controls, a significant difference in the thickness of the retinal layers between the contralateral eye of the patient and both healthy eyes of healthy subjects was found. OCT examination showed particularly significant thinning of the macular ganglion cell-inner plexiform layer (mGCIPL) (61.07 ± 5.04 vs. 67.53 ± 4.57; p < 0.001). Conclusion. Overall, our research showed that OCT and OCTA offer an unprecedented opportunity for a safe, reliable, and repetitive assessment of structural and functional retinal changes as invaluable diagnostic and prognostic tools, paving the way for a better understanding of pathogenic mechanisms underlying inflammatory demyelinating and neurodegenerative diseases. In addition, mGCIPL may be a particularly sensitive and reliable biomarker of pathological changes in MS and perhaps in other neurodegenerative diseases.

With the development of optical coherence tomography (optical coherence tomography angiography, OCTA), quantitative study of choriocapillaris (choriocapillaris, CC) has become a novel evaluation method. The occurrence and development of eye diseases, such as retina and choroid are closely related to the morphology and function of choroidal vessels, especially the change of choriocapillaris. The CC flow deficits parameters, such as density, area and number can be obtained after processing and quantitative analysising images of CC layer from OCTA, assess changes in choroid blood capillary perfusion, explore the pathogenesis of related diseases and provide certain help for disease diagnosis and intervention therapy. This paper reviews the clinical application and research progress of choroid capillary flow deficits. [ABSTRACT FROM AUTHOR]

ABSTRACT Occult macular dystrophy is characterized by a slowly progressive bilateral reduction of visual acuity in patients with normal fundus and fluorescein angiography. We describe a case of a 36-year-old male patient diagnosed with this condition, after extensive investigation with multimodal imaging, electrophysiology tests, and systemic screening.

The characteristic optical coherence tomography finding in solar maculopathy is a well-defined outer retinal hyporeflective space primarily involving the photoreceptor inner and outer segment layers. This typical optical coherence tomography image may be present in a few other pathologies, which currently constitute their main differential diagnoses. Our study shows the report of 12 eyes of 6 patients treated at the Hospital de Olhos do Paraná, presenting their clinical history and diagnostic images, with the purpose of comparing the findings of the first 3 patients (diagnosed with solar maculopathy) with the last 3 patients, which are also cases of external macular holes. [ABSTRACT FROM AUTHOR]

ABSTRACT Structural imaging of the brain is the most widely used diagnostic tool for investigating neurodegenerative diseases. More advanced structural imaging techniques have been applied to early or prodromic phases, but they are expensive and not widely available. Therefore, it is highly desirable to search for noninvasive, easily accessible, low-cost clinical biomarkers suitable for large-scale population screening, in order to focus on making diagnoses at the earliest stages of the disease. In this scenario, imaging studies focusing on the structures of the retina have increasingly been used for evaluating neurodegenerative diseases. The retina shares embryological, histological, biochemical, microvascular and neurotransmitter similarities with the cerebral cortex, thus making it a uniquely promising biomarker for neurodegenerative diseases. Optical coherence tomography is a modern noninvasive imaging technique that provides high-resolution two-dimensional cross-sectional images and quantitative reproducible three-dimensional volumetric measurements of the optic nerve head and retina. This technology is widely used in ophthalmology practice for diagnosing and following up several eye diseases, such as glaucoma, diabetic retinopathy and age-related macular degeneration. Its clinical impact on neurodegenerative diseases has raised enormous interest over recent years, as several clinical studies have demonstrated that these diseases give rise to reduced thickness of the inner retinal nerve fiber layer, mainly composed of retinal ganglion cells and their axons. In this review, we aimed to address the clinical utility of optical coherence tomography for diagnosing and evaluating different neurodegenerative diseases, to show the potential of this noninvasive and easily accessible method.

Abstract Background Implantable Collamer lens (ICL) vaulting is one of the most important parameters for the safety, aqueous humor circulation, and lens transparency after ICL implantation. This study aimed to investigate the factors associated with the actual vaulting after refractive EVO-ICL surgery. Methods This retrospective study included patients who underwent EVO-ICL surgery at a tertiary eye hospital between October and December 2019. A RESCAN 700 was used for the intraoperative and CIRRUS HD-OCT was used for postoperative observation of vaulting. Subjective and objective refractions, anterior ocular segment, corneal morphology, intraocular pressure (IOP), anterior chamber volume (ACV), crystalline lens rise (CLR), white-to-white distance (WTW), anterior chamber depth (ACD), axial length, corneal endothelial cell density (ECD), and fundoscopy were examined. A multivariable analysis was performed to determine the factors independently associated with 1-month postoperative vaulting. Results Fifty-one patients (102 eyes) were included. Compared with the eyes with normal vaulting, those with high vaulting had higher preoperative diopter values (P = 0.039), lower preoperative corrected visual acuity (P = 0.006), lower preoperative IOP (P = 0.029), higher preoperative ACD (P = 0.004), lower preoperative CLR (P = 0.046), higher ICL spherical equivalent (P = 0.030), higher intraoperative vaulting (P

Background/Aim. It is possible that patients with open-angle glaucoma be asymptomatic in the early stage of the disease. The aim of this study was to determine the structural and vascular changes of the optic disc (OD) and macula in healthy and primary open-angle glaucoma (POAG) eyes, detected by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) as well as the correlation of the OCT and OCTA measurements and their association with the presence of POAG. Methods. A total of 196 eyes were included and classified into four groups, out of them 48 were healthy eyes, 51 eyes were with mild POAG, 50 eyes with moderate POAG, and 47 eyes with advanced glaucoma. All subjects underwent standard ophthalmic examination. OCT measured the mean, superior and inferior retinal nerve fiber layer (RNFL) thickness and macular ganglion cell complex (GCC). OCTA evaluated the vessel capillary density (VCD) in OD, foveal avascular zone (FAZ) and macular vessel density (VD) in the superficial (SL) and deep (DL) retinal vascular plexus. Results. Patient characteristics were similar except for decreased visual acuity, thinner corneas, higher intraocular pressure and higher cup/disc ratio in POAG patients. OCT results showed that RNFL and GCC thickness gradually de-creased according to POAG severity. Within the assessment conducted by OCTA, VCD’s value in OD also diminished with the progression of POAG, having the lowest value in patients with advanced glaucoma. The same pattern was observed in vessel density around FAZ and VD values. Comparing the structural and vascular changes, a significant positive correlation was found between RNFL thickness and VCD inside OD, and GCC and VD SL in the macular zone. Conclusion. OCT and OCTA allow of a noninvasive quantification of the structural and vascular changes in OD and the macular zone and accurately distinguish between healthy eyes and eyes with POAG, showing an association with the presence and progression of glaucoma.

ABSTRACT Objective: To evaluate structural and visual field (VF) changes after ≥1 year of a single acute primary angle closure (APAC) attack using spectral-domain optical coherence tomography (SD-OCT) and standard automated perimetry (SAP). Methods: Patients with a single unilateral APAC crisis at least 1 year ago were included consecutively from 2013 to 2016. Contralateral eye was used as control. All patients underwent ophthalmic examination, RNFL imaging by SD-OCT, and SAP using Octopus 1-2-3. Results: 54 eyes (27 patients) were enrolled. Male-to-female ratio was 1:2. Mean time for the SD-OCT and SAP assessment after the crisis was 5.0±5.1 (1.0–23.5) years, and IOP was 52.5±9.8 mmHg. In APAC eyes, the thicknesses of all quadrants of peripapillary RNFL (36.3%; P

Deferasirox (DFS) is an oral iron chelator that is employed in retinal ailments as a neuroprotectant against retinal injury and thus has utility in treating disorders such as excitoneurotoxicity and age-related macular degeneration (AMD). However, the conventional oral route of administration can present several disadvantages, e.g., the need for more frequent dosing and the first-pass effect. Microneedles (MNs) are minimally invasive systems that can be employed for intrascleral drug delivery without pain and can advantageously replace intravitreal injections therapy (IVT) as well as conventional oral routes of delivery for DFS. In this study, DFS was formulated into a nanosuspension (NS) through wet media milling employing PVA as a stabilizer, which was successfully loaded into polymeric dissolving MNs. DFS exhibited a 4-fold increase in solubility in DFS-NS compared to that of pure DFS. Moreover, the DFS-NSs exhibited excellent short-term stability and enhanced thermal stability, as confirmed through thermogravimetric analysis (TGA) studies. The mechanical characterization of the DFS-NS loaded ocular microneedles (DFS-NS-OcMNs), revealed that the system was sufficiently strong for effective scleral penetration. Optical coherence tomography (OCT) images confirmed the insertion of 81.23 ± 7.35 % of the total height of the MN arrays into full-thickness porcine sclera. Scleral deposition studies revealed 64 % drug deposition after just 5 min of insertion from DFS-NS-loaded ocular microneedles (OcMNs), which was almost 5 times greater than the deposition from pure DFS-OcMNs. Furthermore, both DFS and DFS-NS-OcMN exhibited remarkable cell viability when evaluated on human retinal pigment (ARPE) cells, suggesting their safety and appropriateness for use in the human eye. Therefore, loading DFS-NS into novel MN devices is a promising technique for effectively delivering DFS to the posterior segment of the eye in a minimally invasive manner., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Aim: The aim of this study was to evaluate the potential protective effect of Qiju Granule in a rat model of age-related macular degeneration (AMD) and investigate the underlying mechanisms involved., Methods: Rats were injected intravenously with 40 mg/kg of sodium iodate (SI) to induce a dry AMD model. The rats in the treatment group received three different doses of Qiju Granule once a day via gavage, while the rats in the control group were given an equal volume of physiological saline. On day 14 and day 28 following the intervention, various methods were employed to evaluate retinal function and structure, including electroretinography (ERG), optical coherence tomography (OCT), and histological examination. The expression of glial fibrillary acidic protein (GFAP), basic fibroblast growth factor (bFGF), brain-derived neurotrophic factor (BDNF), and ciliary neurotrophic factor (CNTF) was assessed via immunofluorescence. Beyond immunofluorescence, the mRNA levels of bFGF, BDNF, and CNTF were quantitatively determined using real-time polymerase chain reaction (qRT-PCR)., Results: Rats treated with Qiju Granule exhibited significant improvements in both retinal function and structure compared to the model group. The most noteworthy effects were observed at a high dose of Qiju Granule. Furthermore, the expression levels of bFGF, BDNF, and CNTF were significantly unregulated in the treated groups compared to the model group., Conclusions: Qiju Granule demonstrated a protective effect on the retina in the SI-induced rat model of AMD. The protective mechanism may be attributed to the upregulation of retinal neurotrophic factors expression., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests related to this study. There are no financial or personal relationships with other people or organizations that could influence the conduct or interpretation of the research., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: To investigate the risk factors and prognosis of clinical pseudophakic cystoid macular edema (PCME) after uneventful phacoemulsification surgery in patients without pre-existing fundus diseases., Methods: This was a retrospective case-control study. Medical records between August 2020 and August 2023 were reviewed for patients who had no previous fundus diseases and developed clinical PCME. A control group was randomly chosen and the risk factors for PCME was analyzed by binary logistic regression. Structure and visual prognosis of the PCME cohort were observed and compared among subgroups undergoing different treatment measures., Results: Forty-seven eyes of 47 patients with PCME were included. The development of PCME was associated with higher systolic blood pressure (OR, 1.048; 95%CI 1.002, 1.097; P = .042), no posterior vitreous detachment (OR, 0.215; 95%CI: 0.553, 0.887; P = .032) and shorter axial lengths (OR, 0.401; 95%CI 0.161, 0.997; P = .049) compared to controls. During a mean follow-up of 8.26 months, 36 eyes (76.6%) showed visual improvement with decreased macular thickness. Different treatment modalities, including observation, topical NSAIDs, and intervention therapy, have no significant differences on the visual prognosis (P = 1.000). However, the intervention group had a shorter recovery time compared to the observation group (28.6 vs. 45.9 days, P = .037)., Conclusion: PCME remains an encountered morbidity in patients without pre-existing fundus diseases. Shorter axial lengths, absence of posterior vitreous detachment, and higher systolic blood pressure are risk factors of PCME. Active intervention failed to improve the prognosis of PCME but could shorten the recovery time., (© 2024. The Author(s).)

Purpose: To report two cases of ibrutinib-related uveitis and review the literature to date., Methods: We report two cases of ibrutinib-related uveitis using CARE guidelines and review the cases reported in the literature., Results: Case 1) A 55-year-old female with recurrent primary central nervous system lymphoma presented with bilateral decreased visual acuity, photophobia, and floaters that started one month after initiating oral treatment with ibrutinib. Chronic non-granulomatous bilateral anterior-intermediate uveitis with macular edema was identified. Secondary causes were ruled out, and a presumptive diagnosis of ibrutinib-related uveitis was made. Case 2) A 57-year-old female with Waldenström macroglobulinemia who was treated with ibrutinib for two years presented with bilateral blurred vision, photophobia, red eyes, and floaters. A diagnosis of non-granulomatous, noninfectious panuveitis with bilateral cystoid macular edema was made. Secondary causes were ruled out, and ibrutinib toxicity was the most likely cause., Conclusion: Ibrutinib-related uveitis is a novel and under-diagnosed clinical entity. The most frequent clinical presentation in the literature is bilateral, non-granulomatous, anterior, and intermediate uveitis. Macular edema is a frequent complication. Uveitis usually requires topical treatment and the suspension of ibrutinib. Switching to second-generation Bruton tyrosine kinase inhibitors is proposed as a potential therapeutic alternative.

In May 2023, a 36-year-old carpenter complained of a sudden decrease in visual acuity in both eyes after his fourth COVID-19 vaccination. He underwent extensive evaluation by ophthalmological, neurological, and internal medicine specialists elsewhere, which was unremarkable, except for a computed tomography scan of his brain showing minor occipital calcifications. In 2021, he had been diagnosed with anterior basement membrane dystrophy and treated with phototherapeutic keratectomy (PTK) of the left eye, leading to significant postoperative haze. On referral in July 2023, slitlamp examination showed significant anterior basement membrane dystrophy in the right eye, whereas the left eye had an extensive central scar in the anterior stroma, measuring up to 6 mm in width and 140 µm in depth (Figures 1-3JOURNAL/jcrs/04.03/02158034-202410000-00017/figure1/v/2024-09-18T130724Z/r/image-tiffJOURNAL/jcrs/04.03/02158034-202410000-00017/figure2/v/2024-09-18T130724Z/r/image-tiffJOURNAL/jcrs/04.03/02158034-202410000-00017/figure3/v/2024-09-18T130724Z/r/image-tiff). His corrected distance visual acuity was 20/80 in his right eye and 20/200 in his left eye, with a manifest refraction of -0.50 -3.75 × 170 and +0.00 -4.75 × 180, respectively. Corneal Scheimpflug topography showed regular corneal astigmatism of 3.3 diopters (D) and 5.5 D in the right and left eyes, respectively, with a corneal thickness of 550 and 566 µm (Figure 4JOURNAL/jcrs/04.03/02158034-202410000-00017/figure4/v/2024-09-18T130724Z/r/image-tiff). The Schirmer tear test was 20-20 mm. Fundoscopy, electrophysiological testing, and retinal optical coherence tomography (OCT) showed no abnormalities. The patient mentioned he had Crohn disease, managed with ustekinumab (a monoclonal antibody inhibitor of cytokines interleukin [IL]-12 and IL-23), but he had discontinued it because of the apparent remission of the disease. Attempts to improve visual acuity involved a soft bandage contact lens in the right eye, which was discontinued after 2 days because of the occurrence of a small corneal infiltrate that healed with a short course of topical antibiotics. Unfortunately, because of his vision, he cannot perform his tasks as a carpenter anymore. Which is your recommended treatment for both eyes?, (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)