Chromatic vision and structural assessment in primary congenital glaucoma.

Primary congenital glaucoma is a rare disease that occurs in early birth and can lead to low vision. Evaluating affected children is challenging and there is a lack of studies regarding color vision in pediatric glaucoma patients. This cross-sectional study included 21 eyes of 13 children with primary congenital glaucoma who were assessed using the Farnsworth D-15 test to evaluate color vision discrimination and by spectral domain optical coherence tomography to measure retinal fiber layer thickness. Age, visual acuity, cup-to-disc ratio and spherical equivalent data were also collected. Global and sectional circumpapillary and macular retinal fiber layer thicknesses were measured and compared based on color vision test performance. Four eyes (19%) failed the color vision test with diffuse dyschromatopsia patterns. Only age showed statistical significance in color vision test performance. Global and sectional circumpapillary and macular retinal fiber layer thicknesses were similar between the color test outcomes dyschromatopsia and normal. While the color vision test could play a role in assessing children with primary congenital glaucoma, further studies are needed to correlate it with damage to retinal fiber layer thickness.

Comparison of anterior segment optical coherence tomography angiography and fluorescein angiography for iris vasculature analysis.

PURPOSE: The aim of this study is to perform imaging of irises of different colors using spectral domain anterior segment optical coherence tomography angiography (AS-OCTA) and iris fluorescein angiography (IFA) and compare their effectiveness in examining iris vasculature. METHODS: This is a cross-sectional observational clinical study. Patients with no vascular iris alterations and different pigmentation levels were recruited. Participants were imaged using OCTA adapted with an anterior segment lens and IFA with a confocal scanning laser ophthalmoscope (cSLO) adapted with an anterior segment lens. AS-OCTA and IFA images were then compared. Two blinded readers classified iris pigmentation and compared the percentage of visible vessels between OCTA and IFA images. RESULTS: Twenty eyes of 10 patients with different degrees of iris pigmentation were imaged using AS-OCTA and IFA. Significantly more visible iris vessels were observed using OCTA than using FA (W = 5.22; p < 0.001). Iris pigmentation was negatively correlated to the percentage of visible vessels in both imaging methods (OCTA, rho = - 0.73, p < 0.001; IFA, rho = - 0.77, p < 0.001). Unlike FA, AS-OCTA could not detect leakage of dye, delay, or impregnation. Nystagmus and inadequate fixation along with motion artifacts resulted in lower quality images in AS-OCTA than in IFA. CONCLUSIONS: AS-OCTA is a new imaging modality which allows analysis of iris vasculature. In both AS-OCTA and IFA, iris pigmentation caused vasculature imaging blockage, but AS-OCTA provided more detailed iris vasculature images than IFA. Additional studies including different iris pathologies are needed to determine the most optimal scanning parameters in OCTA of the anterior segment.

Aqueous misdirection syndrome in persistent fetal vasculature (PFV).

We report a case of a 5-year-old girl with persistent fetal vasculature who presented with unilateral acute angle closure caused by aqueous misdirection syndrome that was apparently associated with regression of cycloplegia. Initial treatment with topical steroids, anti-glaucomatous drops, and atropine showed insufficient control of the intraocular pressure (IOP). Surgical treatment with lensectomy and vitrectomy resulted in satisfactory IOP control and no complications at the 6-month follow-up.

Aqueous misdirection syndrome in persistent fetal vasculature (PFV) / Síndrome de mau direcionamento do humor aquoso em persistência da vasculatura fetal (PVF)

ABSTRACT We report a case of a 5-year-old girl with persistent fetal vasculature who presented with unilateral acute angle closure caused by aqueous misdirection syndrome that was apparently associated with regression of cycloplegia. Initial treatment with topical steroids, anti-glaucomatous drops, and atropine showed insufficient control of the intraocular pressure (IOP). Surgical treatment with lensectomy and vitrectomy resulted in satisfactory IOP control and no complications at the 6-month follow-up.

RESUMO Relatamos o caso de uma criança de 5 anos, sexo feminino com persistência do vítreo primário que apresentou crise de fechamento angular por síndrome do mau direcionamento do humor aquoso, aparentemente associado a regressão da cicloplegia. Tratamento inicial com corticoide tópico, colírios antiglaucomatosos e atropina mostraram controle insuficiente da pressão intraocular (PIO). Tratamento cirúrgico com lensectomia e vitrectomia anterior permitiu o controle satisfatório da PIO, sem intercorrências no seguimento de 6 meses.

Comparison of Optical Coherence Tomography Angiography and Fluorescein Angiography for the Identification of Retinal Vascular Changes in Eyes With Diabetic Macular Edema.

BACKGROUND AND OBJECTIVE: To compare the visualization of microaneurysms (MA) and the foveal avascular zone (FAZ) area using optical coherence tomography angiography (OCTA) versus fluorescein angiography (FA) in patients with diabetic macular edema (DME). PATIENTS AND METHODS: Patients were prospectively recruited for same-day imaging on spectral-domain OCTA and FA. OCTA images were automatically segmented into superficial (sOCTA) and deep (dOCTA) capillary plexuses. The number of visible MAs and the FAZ area were compared between the two imaging modalities. RESULTS: Nineteen eyes of 10 patients were included. There was a statistically significant difference between MA counts for FA, sOCTA, and dOCTA (P = .002), and median MA counts were 14.5 (range: 2-43), 9.75 (range: 0-37.5), and 22.5 (range: 5.5-46.5), respectively. dOCTA showed significantly more MAs than sOCTA (P < .001). Although not significant statistically, dOCTA revealed more MAs than FA (P = .06). There was a statistically significant difference between FAZ area for FA, sOCTA, and dOCTA (P = .046), and median FAZ areas were 0.444 (range: 0.1-0.689), 0.224 (range: 0.335-0.806), and 0.345 (range: 0.106-0.881), respectively. FA showed a significantly larger FAZ area than sOCTA (P = .04). CONCLUSIONS: Deep plexus OCTA can better identify microaneurysms compared to either sOCTA or FA. The FAZ area appears larger on FA in contrast to OCTA of both plexuses. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1013-1019.].