Central Serous Chorioretinopathy in a 14-year-old atopic boy: a case report.

BACKGROUND: Corticosteroids are widely used in medicine. Few cases of central serous chorioretinopathy (CSC) have been reported following topical corticosteroid administration. We describe the first case of pediatric CSC related to topical corticosteroid administration. CASE PRESENTATION: A 14-year-old boy presented with decreased vision, pigment epithelial detachments, and serous retinal detachments in the right eye after starting treatment for atopic dermatitis with Betamethasone Valerate 0.1% topical ointment. His condition resolved 2 weeks after discontinuing the steroid and administering Bromfenac 0.9 mg/ml eyedrops. CONCLUSIONS: Although the pathogenesis of CSC is poorly understood, ophthalmologists should be informed about the potential link between CSC and topical corticosteroid treatment, and they should be aware that CSC might, albeit infrequently, affect children.

Macular Holes: Main Clinical Presentations, Diagnosis, and Therapies.

Macular holes are a spectrum of retinal diseases that comprehends full-thickness macular holes (FTMHs), refractory/recurrent macular holes, lamellar macular holes (LMHs), myopic macular holes (MMHs), traumatic macular holes, and macular holes secondary to other retinal pathologies or injuries. There are various classifications of the subtypes of macular hole, and only in recent times researchers defined a common nomenclature, especially thanks to the evolution in retinal imaging, offered by new instruments like the swept-source OCT. The proposed therapies for macular holes are different and range from a "wait-and-see" approach to the vitrectomy, with different results in each subtype of macular hole. This narrative review has the purpose to investigate the available evidence in literature to give a summary of the knowledge about these retinal pathologies.

OCT Biomarkers in Neovascular Age-Related Macular Degeneration: A Narrative Review.

Age-related macular degeneration (AMD) is the leading cause of legal blindness in elderly people. Neovascular AMD (nAMD) is responsible for the majority of cases of severe visual loss in eyes with AMD. Optical coherence tomography (OCT) is the most widely used technology for the diagnosis and follow-up of nAMD patients, which is widely used to study and guide the clinical approach, as well as to predict and evaluate treatment response. The aim of this review is to describe and analyze various structural OCT-based biomarkers, which have practical value during both initial assessment and treatment follow-up of nAMD patients. While central retinal thickness has been the most common and one of the first OCT identified biomarkers, today, other qualitative and quantitative biomarkers provide novel insight into disease activity and offer superior prognostic value and better guidance for tailored therapeutic management. The key importance of retinal fluid compartmentalization (intraretinal fluid, subretinal fluid, and subretinal pigment epithelium (RPE) fluid) will be discussed firstly. In the second part, the structural alterations of different retinal layers in various stages of the disease (photoreceptors layer integrity, hyperreflective dots, outer retinal tubulations, subretinal hyperreflective material, and retinal pigment epithelial tears) will be analyzed in detail. The last part of the review will focus on how alterations of the vitreoretinal interface (vitreomacular adhesion and traction) and of the choroid (sub-RPE hyperreflective columns, prechoroidal clefts, choroidal caverns, choroidal thickness and choroidal volume, and choroidal vascular index) interact with nAMD progression. OCT technology is evolving very quickly, and new retinal biomarkers are continuously described. This up-to-date review article provides a comprehensive description on how structural OCT-based biomarkers provide a valuable tool to monitor the progression of the disease and the treatment response in nAMD patients. Thus, in this perspective, clinicians will be able to allocate hospital resources in the best possible way and tailor treatment to the individual patient's needs.

Optic Nerve Sheath Diameter Ultrasound: Optic Nerve Growth Curve and Its Application to Detect Intracranial Hypertension in Children.

PURPOSE: First, to create an optic nerve growth curve from normal optic nerve sheath diameter (ONSD) values measured by using B-scan ultrasonography in subjects 0-18 years of age. Second, to identify age-appropriate cutoff values of ONSD to be used in the diagnosis of intracranial hypertension (IHT). DESIGN: Prospective cross-sectional study. METHODS: B-scan ocular ultrasonography was performed on both eyes of 215 subjects 0-18 years of age, divided into 3 groups: 165 healthy children, 29 children with IHT (all >4 years of age), and 21 children with optic disc drusen (ODD). RESULTS: There were no statistically significant differences in between the ONSDs of healthy children and those in subjects with ODD. An optic nerve growth curve was created by using ONSDs measured in healthy subjects 0-18 years of age, using the equation: ONSD = ln [33.15] - (-0.18 × ln [children's age]). The curve showed a progressive increase of ONSD up to 10 years of age, and it remained constant until the age of 18. For this reason, 2 different cutoff values were calculated for age groups 4-10 and 11-18. Values were 4.10 mm and 4.4 mm, respectively, with a 100.0% sensitivity and a specificity ranging from 83.9% to 98.8%. A sensitivity of 28.6% was reached for the population of subjects 4-18 years of age with a threshold value of 5 mm, as used in published reports. CONCLUSIONS: The ONSD continued to enlarge gradually until the age of 10. Therefore, 2 different cutoff values for the age groups 4-10 and 11-18 were calculated, considering the ONSDs of subjects 11-18 years of age overlapping with those of adults. No patients with IHT <4 years old were found. Further studies are needed to evaluate the correct cutoff values for these ages.