A review of unilateral acute idiopatic maculopathy related to hand-foot-mouth disease with a representative case.

The purpose of this study was to review unilateral acute maculopathy associated with hand-foot-mouth disease with a representative case. Clinical course of a 24-year-old male case with unilateral acute idiopatic maculopathy documented by multimodal imaging is presented, and a review of similar cases is given. On initial examination, best-corrected visual acuity was 20/200 in the left eye. Fundoscopy revealed grayish-yellowish subretinal exudate, and fluorescein angiography demonstrated irregular mottled hyperfluorescence at the central macula. Spectral domain optical coherence tomography demonstrated disruption of ellipsoid layer, which partially resolved on follow-up examinations. Best-corrected visual acuity increased to 20/20 at 3 months, with persistent retinal changes, and mild disruption of ellipsoid layer and persistent mild metamorphopsia. Although hand-foot-mouth disease is usually benign and self-limited in childhood, it may be rarely associated with unilateral vision loss due to maculopathy, especially at early adulthood in both sexes. Vision loss associated with this eruption is acute and reversible in most cases, despite some residual pigmentary and scarring changes in all cases and persistent mild visual loss in some cases. Exact pathophysiology, the causes of variability of clinical features, adulthood onset, unilateral involvement, and role of multimodal imaging are issues which need to be clarified with further research.

Macular pigment optical density after panretinal photocoagulation.

CLINICAL RELEVANCE: Panretinal photocoagulation, an important treatment method in diabetic retinopathy, can affect macular pigment optical density, which has protective and antioxidant properties. As a result of this effect, the retina may become more sensitive to high-energy visible light. BACKGROUND: The current study assesses the effect of panretinal photocoagulation treatment on macular pigment optical density, which has essential functions for the retina. METHODS: In this prospective clinical study, the colour perimetry method was used to measure macular pigment optical density. Thirty-six eyes of 36 participants with severe non-proliferative diabetic retinopathy without macular involvement were included in the study. Conventional panretinal photocoagulation treatments were applied at baseline, one month, two months, and at three months to the participants who clinically required this treatment. Macular pigment optical density and retinal thickness measurements were performed at baseline, months one, two, three and six. RESULTS: The mean macular pigment optical density reduction in the fovea over the six-months was 0.02 ± 0.02 logarithmic units (p < 0.001). Similarly, the pericentral areas declined by 0.04 ± 0.03 logarithmic units (p < 0.001). Mean central macular thickness and foveal thickness increased by 5.03 ± 5.02 µm and 2.78 (interquartile range 2-4) µm, respectively. In this study, correlation analysis shows that the laser energy applied was significantly and strongly correlated with reductions in macular pigment optical density (for the fovea and pericentral area respectively: r = -0.855, p < 0.001; r = -0.895, p < 0.001). Further, there were significant and strong correlations between the applied laser energy, and central macular thickness and fovea thickness (r = 0.751, p < 0.001; ρ = 0.718, p < 0.001, respectively). CONCLUSION: Panretinal photocoagulation may potentially cause a decrease in macular pigment density in proportion to the laser energy applied.

Choroidal Thickness and its Correlations with Ocular Parameters in Primary Open-angle Glaucoma.

OBJECTIVES: To evaluate the relationships between macular choroidal thickness (mCT) and ocular parameters, such as optic nerve head (ONH) and multifocal electroretinogram (mf-ERG) parameters, in cases with primary open-angle glaucoma (POAG). METHODS: This controlled and prospective clinical trial included 49 patients with POAG diagnosed for the first time and 47 healthy participants. Macular CTs, ONH and mf-ERG parameters were measured, and the examination findings were recorded at baseline and follow-ups. RESULTS: In the POAG group, the mean mCT was 254.92±37.65 µm at baseline, and it was 235.6±38.48 µm at 3-month and was 237.55±37.27 µm at 6-month. In the glaucoma group, there was a significant decrease in the first three months despite the treatment, but no significant change was observed in the next three months. In the healthy group, the mean mCTs were 287.78±26.77 µm, 285.48±25.58 µm and 285.02±27.44 µm at baseline, at 3-month and at 6-month, respectively. No significant change was observed in the control group throughout the process. However, the mean mCT values in the glaucoma group were significantly thinner in all controls compared to the healthy group (p<0.05). Furthermore, significant correlations were found between CT and some ONH, as well as mf-ERG parameters. CONCLUSION: The choroid can play an important role in the pathogenesis of glaucoma. Significant correlations in parameters support this relationship. We have observed that the glaucomatous effect initiated first in the inferior quadrant of ONH.

The Effects of Systemic Alfuzosin and Tamsulosin Hydrochloride on Choroidal Thickness and Pupil Diameter Sizes in Cases with Benign Prostatic Hyperplasia.

PURPOSE: To compare the effects of alfuzosin hydrochloride and tamsulosin hydrochloride on choroidal thickness (CT) and pupil diameter (PD) sizes in patients with benign prostatic hyperplasia. SUBJECTS AND METHODS: Sixty-three men patients with newly diagnosis of benign prostatic hyperplasia were randomly assigned to either alfuzosin hydrochloride or to tamsulosin hydrochloride groups in this prospective, randomized, parallel-group clinical trial. Enhanced depth imaging spectral-domain optical coherence tomography, pupillography were obtained at baseline, 1st and 3rd month, and choroidal thicknesses and pupil diameter sizes were compared between the two groups. RESULTS: The mean subfoveal choroidal thickness (SCT), nasal choroidal thickness (NCT), and temporal choroidal thickness (TCT) in AH group were 275.70 ± 32.14 µm, 269.7 ± 33.54 µm and 270.71 ± 33.52 µm at baseline, respectively; and they were 275.46 ± 31.6 µm, 268.73 ± 33.08 µm and 270.73 ± 33.05 µm at baseline in TH group, respectively (P = 0.97, P = 0.84, P = 0.99, for SCT, NCT, and TCT, respectively). The mean SCT, NCT, and TCT after 3 months were 278.93 ± 34.58 µm, 272.62 ± 34.17 µm, and 273.6 ± 34.17 µm in AH group, respectively; and they were 274.36 ± 31.91 µm, 264.70 ± 33.59 µm, and 267.72 ± 33.6 µm in TH group, respectively (P = 0.6, P = 0.37, P = 0.43, for SCT, NCT, and TCT, respectively). The mean scotopic pupil diameter (SPD), mesopic pupil diameter (MPD), and photopic pupil diameter (PPD) sizes in AH group were 6.46 ± 0.84 mm, 5.07 ± 0.72 mm and 3.66 ± 0.46 mm at baseline, respectively; and they were 6.44 ± 1.14 mm, 5.01 ± 0.79 mm and 3.62 ± 0.53 mm at baseline in TH group, respectively (P = 0.89, P = 0.74, P = 0.68, for SPD, MPD, and PPD, respectively). The mean SPD, MPD, and PPD sizes after 3 months were 5.96 ± 0.76 mm, 4.67 ± 0.74 mm, and 3.15 ± 0.47 mm in AH group, respectively; and they were 6.42 ± 0.89 mm, 5.05 ± 0.75 mm, and 3.55 ± 0.53 mm in TH group respectively (P = < 0.001, P = < 0.001, P = < 0.001, for SPD, MPD, and PPD, respectively). CONCLUSION: The repeated measure of ANOVA for the mean CT values within AH group showed statistically significant increases in baseline CTs, although these differences did not reach statistical significance between 2 groups at follow-ups. We found significant different outcomes for PD sizes during study in the groups. The mean outcome in this study is that using αAR antagonists have potential effects on CT and PD sizes. Abbreviations and Acronyms: AH: alfuzosin hyrdrochloride; ANOVA: analyses of variance; AR: adrenergic receptor; BCVA: best-corrected visual acuity; BPH: benign prostatic hyperplasia; CT: choroidal thickness; EDI-OCT: enhanced depth imaging spectral-domain optical coherence tomography; IFIS: intraoperative floppy iris syndrome; MPD: mesopic pupil diameter; NCT: nasal choroidal thickness; PD: pupil diameter; PPD: photopic pupil diameter; SCT: subfoveal choroidal thickness; SPD: scotopic pupil diameter; TCT: temporal choroidal thickness; TH: tamsulosin hydrochloride.