Fluorescein Angiographic Findings and Recurrence of Human Leukocyte Antigen-B27-Associated Anterior Uveitis

Purpose@#To evaluate the associations of fluorescein angiographic findings with recurrence of human leukocyte antigen (HLA)-B27-associated anterior uveitis. @*Methods@#Medical records of 56 eyes of 56 patients with first-onset, treatment-naive HLA-B27-associated anterior uveitis who performed fluorescein angiography was analyzed. We recorded the fluorescein angiographic findings of optic disc and peripheral vascular leakage and anterior chamber inflammation at the first visit. The 1-year recurrences and times to the first recurrences and the associations between them were investigated. @*Results@#Fluorescein angiography revealed optic disc leakage in 23 patients (41.1%) and peripheral vascular leakage in 36 (64.3%). We found no significant association between the anterior chamber inflammation grade and either optic disc (p = 0.841) or peripheral vascular (p = 0.775) leakage. The 1-year recurrence rate in the optic disc leakage-positive group was significantly higher than in the leakage-negative group (14 patients, 60.9% vs. 11 patients, 33.3%) (p = 0.041), but peripheral vascular leakage status did not significantly affect the recurrence rate (19 leakage-positive patients, 52.8% vs. 8 leakage-negative patients, 40.0%) (p = 0.602). The time to first recurrence was not significantly associated with age (p = 0.772), anterior chamber inflammation (p = 0.841), optic disc leakage (p = 0.108), or systemic corticosteroid use (p = 0.321). @*Conclusions@#We sought correlations between angiographic leakage in patients with HLA-B27-associated anterior uveitis, and the 1-year recurrence rate and the time to first recurrence. Careful follow-up for at least 1 year after initial diagnosis is essential to monitor possible recurrence in patients with optic disc leakage.

Comparison of Blue and Green Confocal Scanning Laser Ophthalmoscope Imaging to Detect Retinal Nerve Fiber Layer Defects

PURPOSE: We detected retinal nerve fiber layer (RNFL) defects using a confocal scanning laser ophthalmoscopy (CSLO) with both blue and green laser sources and evaluated image quality based on laser wavelength. METHODS: This was a retrospective observational case study. Blue and green CSLO images of 181 eyes with suspected glaucoma were evaluated and compared. Three independent observers identified the presence of RNFL defects and determined which CSLO imaging source provided superior visibility of the defect. After assessing the defect imaging by laser source, demographics and image quality indices of optical coherence tomography between blue better and green better groups were analyzed. RESULTS: Both blue and green CSLO showed high discriminating ability for RNFL defects. The discriminating ability of blue CSLO was significantly greater than that of green CSLO (p = 0.004). Among eyes with a detectable RNFL defect, 61.8% were better visualized with the blue laser compared to the green laser. Compared with the blue better group, the green better group was significantly older (p = 0.009), had a greater proportion of females (p = 0.005), had poorer best-corrected visual acuity (p = 0.001), more severe cataracts (p = 0.001), lower signal strength (p = 0.003), and poor image quality indices (p = 0.001). CONCLUSIONS: Both blue and green CSLO imaging was useful for detecting RNFL defects, but blue CSLO was superior to green CSLO in quality of RNFL defect imaging in most patients with clear media.

Hydroxychloroquine Retinopathy Update

Hydroxychloroquine (HCQ) has been used widely for the treatment of several rheumatologic and dermatologic conditions, including systemic lupus erythematosus and rheumatoid arthritis. Its toxic effects on the retina, HCQ retinopathy, is not uncommon among long-term users, and produces characteristic irreversible and progressive outer retinal damage. Recent studies of Asian populations showed different patterns of retinopathy according to ethnicity; for example, a pericentral pattern is more common in Asian populations, whereas the parafoveal type is more prevalent in Caucasian patients. The pericentral pattern, which is common in Asian patients, is likely to lead to a late diagnosis with conventional imaging modalities, thereby necessitating increased attention to the screening of Asian patients. The most recent American Academy of Ophthalmology guidelines suggest optical coherence tomography and a visual field examination as the primary screening tests, and multifocal electroretinogram and fundus autofluorescence as other recommended objective screening tests. The optimal timing and frequency of annual screening depend on the systemic and ocular risk factors. Annual screening should begin from 5 years of drug use in cases without any known risk factors, but patients with major risk factors require earlier regular screening. After a diagnosis of HCQ retinopathy, a decision regarding whether to stop the drug should be made in consultation with the prescribing physician, and the progression of retinopathy should be monitored carefully because the retinopathy can progress even after drug cessation.

Comparison of Image Quality between Swept-Source and Spectral-Domain Optical Coherence Tomography According to Ocular Media Opacity

PURPOSE: To compare the image quality between swept-source optical coherence tomography (SS-OCT) and spectral domain optical coherence tomography (SD-OCT), especially in eyes with media opacity. METHODS: Forty eyes without media opacity and 60 eyes with media opacity (30 eyes with cataract, 20 eyes with vitreous opacity, and 10 eyes with corneal opacity) were included in this study. SD-OCT and SS-OCT 6 x 6 macular scans were taken by a single operator. For image quality analysis, a total of 200 OCT images were subjectively graded by two trained retina specialists and measured quantitatively using the image quality factor (QF) built into the OCT devices. RESULTS: Compared to conventional SD-OCT, SS-OCT had statistically significantly better subjective and objective grades in the normal group, as well as each of the media opacity groups (p-value < 0.001). In both the subjective and objective grades, there was no significant difference according to the types of media opacity (QF: p = 0.188, subject grading scale [SGS]: p = 0.635) and the degree of media opacity (Group I: 20 < or = QF < 50, Group II: 0 < or = QF < 20; QF: p = 0.088, SGS: p = 0.051) in the superiority of image quality of SS-OCT to SD-OCT. CONCLUSIONS: In this media opacity patient population, swept-source OCT is a superior diagnostic tool when compared with SD-OCT in both objective and subjective assessments, even in the ocular media opacity. This result may be useful in diagnosis and progression detection of retinal disease in media opacity eyes.

Evaluation of the Cortical Vitreous Using Swept-Source Optical Coherence Tomography in Normal Eyes

PURPOSE: To observe the shape of posterior vitreous spaces using swept-source optical coherence tomography (SS-OCT) in normal eyes. METHODS: The posterior vitreous of 80 eyes of 80 volunteers without ocular disease was imaged. The DRI OCT-1 Atlantis (Topcon, Oakland, NJ, USA) was used to acquire scans of the posterior vitreous over an 18 × 18-mm2 area using the 12-mm horizontal line scan protocol. The size of the premacularis bursa was measured by the aliper function of the OCT. RESULTS: A boat-shape bursa was found in most cases. The prevalence of detected bursa fell with further increases in the extent of posterior vitreous detachment. The mean width of the bursa premacularis was 7,679.1 µm and the mean depth was 471.4 µm. CONCLUSIONS: Deep range imaging optical coherence tomography will provide improvement for in vivo anatomic characterization of the cortical vitreous, and allow better visualization of the dimensions of the bursa premacularis.

Evaluation of the Cortical Vitreous Using Swept-Source Optical Coherence Tomography in Normal Eyes

PURPOSE: To observe the shape of posterior vitreous spaces using swept-source optical coherence tomography (SS-OCT) in normal eyes. METHODS: The posterior vitreous of 80 eyes of 80 volunteers without ocular disease was imaged. The DRI OCT-1 Atlantis (Topcon, Oakland, NJ, USA) was used to acquire scans of the posterior vitreous over an 18 × 18-mm2 area using the 12-mm horizontal line scan protocol. The size of the premacularis bursa was measured by the aliper function of the OCT. RESULTS: A boat-shape bursa was found in most cases. The prevalence of detected bursa fell with further increases in the extent of posterior vitreous detachment. The mean width of the bursa premacularis was 7,679.1 µm and the mean depth was 471.4 µm. CONCLUSIONS: Deep range imaging optical coherence tomography will provide improvement for in vivo anatomic characterization of the cortical vitreous, and allow better visualization of the dimensions of the bursa premacularis.

Macular Choroidal Thickness and Volume Measured by Swept-source Optical Coherence Tomography in Healthy Korean Children

PURPOSE: To evaluate the thickness and volume of the choroid in healthy Korean children using swept-source optical coherence tomography. METHODS: We examined 80 eyes of 40 healthy children and teenagers ( or =18 years) and compared adult measurements with the findings in children. RESULTS: The mean age of the children and teenagers was 9.47 +/- 3.80 (4 to 17) vs. 55.04 +/- 12.63 years (36 to 70 years) in the adult group (p < 0.001, Student's t-test). Regarding the Early Treatment Diabetic Retinopathy Study subfields, the inner temporal subfield was the thickest (247.96 microm). The inner and outer nasal choroid were thinner (p = 0.004, p = 0.002, respectively) than the surrounding areas. The mean choroidal volumes of the inner and outer nasal areas were smaller (p = 0.004, p = 0.003, respectively) than those of all the other areas in each circle. Among the nine subfields, all areas in the children, except the outer nasal subfield, were thicker than those in adults (p < 0.05). Regression analysis showed that age, axial length, and refractive error correlated with subfoveal choroidal thickness (p < 0.05). CONCLUSIONS: Overall macular choroidal thickness and volume in children and teenagers were significantly greater than in adults. The nasal choroid was significantly thinner than the surrounding areas. The pediatric subfoveal choroid is prone to thinning with increasing age, axial length, and refractive error. These differences should be considered when choroidal thickness is evaluated in children with chorioretinal diseases.

Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage

OBJECTIVE: Terson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH. MATERIALS AND METHODS: The authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan. 2007 and Dec. 2013. Medical records including demographics, neurologic examination, and radiologic images were collected to clarify the risk factors of Terson's syndrome. Patients with visual problem were consulted to the Department of Ophthalmology. RESULTS: Among 332 patients with aneurysmal SAH, 34 patients were diagnosed as Terson's syndrome. Four individual factors, including World Federation of Neurosurgical Societies (WFNS) grade at admission, aneurysm size, method of operation, and Glasgow outcome scale showed statistically significant association with occurrence of Terson's syndrome. Of these, WFNS grade at admission, aneurysm size, and method of operation showed strong association with Terson's syndrome in multivariate analysis. Terson's syndrome accompanied by papilledema due to increased intracranial pressure led to permanent visual complication. CONCLUSION: In patients with aneurysmal SAH, the patients' WFNS grade at admission, the size of the aneurysms, particularly the diameter of the aneurysm dome, and the method of operation might influence development of Terson's syndrome.

Practical Incidence and Risk Factors of Terson's Syndrome: A Retrospective Analysis in 322 Consecutive Patients with Aneurysmal Subarachnoid Hemorrhage

OBJECTIVE: Terson's syndrome, a complication of visual function, has occasionally been reported in patients with aneurysmal subarachnoid hemorrhage (SAH), however the factors responsible for Terson's syndrome in aneurysmal SAH patients have not yet been fully clarified. In this study, we report on potential risk factors for prediction and diagnosis of Terson's syndrome in the earlier stage of the disease course in patients with aneurysmal SAH. MATERIALS AND METHODS: The authors retrospectively analyzed the data of 322 consecutive patients who suffered from aneurysmal SAH in a single institution between Jan. 2007 and Dec. 2013. Medical records including demographics, neurologic examination, and radiologic images were collected to clarify the risk factors of Terson's syndrome. Patients with visual problem were consulted to the Department of Ophthalmology. RESULTS: Among 332 patients with aneurysmal SAH, 34 patients were diagnosed as Terson's syndrome. Four individual factors, including World Federation of Neurosurgical Societies (WFNS) grade at admission, aneurysm size, method of operation, and Glasgow outcome scale showed statistically significant association with occurrence of Terson's syndrome. Of these, WFNS grade at admission, aneurysm size, and method of operation showed strong association with Terson's syndrome in multivariate analysis. Terson's syndrome accompanied by papilledema due to increased intracranial pressure led to permanent visual complication. CONCLUSION: In patients with aneurysmal SAH, the patients' WFNS grade at admission, the size of the aneurysms, particularly the diameter of the aneurysm dome, and the method of operation might influence development of Terson's syndrome.

Retromode imaging: review and perspectives

Retromode imaging with infrared lasers is a novel imaging method which has been made possible by the newly introduced confocal scanning laser ophthalmoscope. Retromode imaging uses a laterally deviated confocal aperture with a central stop, which creates a shadow and allows deep retinal and retinal pigment epithelium changes to be visualized as pseudo-3-dimensional images. Its clinical value coupled with its simple, rapid, and noninvasive nature is increasingly appreciated. The combination of retromode imaging with conventional imaging methods such as fundus photography, fluorescein angiography, and optical coherence tomography can help to precisely and comprehensively evaluate pathophysiologic features of retinal disorders. This review summarizes basic principles of imaging and retromode findings in various retinal disorders and is expected to guide future investigations of retromode imaging

Peripheral Vascular Leakage Findings of Asymptomatic Eyes Based on Fluorescein Angiography

PURPOSE: To report peripheral vascular retinal leakage findings of asymptomatic eyes based on fluorescein angiography, and investigate the associated factors. METHODS: Data were collected retrospectively from 47 subjects (94 eyes) and the peripheral leakage results based on fluorescein angiography were analyzed. The relationship between peripheral leakage findings and other factors including-arm-retinal circulation time (ARCT) and venous filling time (VFT), refractive error, age, hypertension, and diabetes- was evaluated. RESULTS: Ten eyes had peripheral leakage (21.3%). The mean age was 34.7 +/- 7.86 years in the non-leakage group and 44.3 +/- 9.63 years in the leakage group; the difference between the groups was statistically significant (p = 0.001). The mean spherical equivalent was -2.85 +/- 2.71 diopter in the non-leakage group and -3.46 +/- 3.62 diopter in the leakage group; the difference between the groups were not significant (p = 0.471). The mean ARCT was 10.50 +/- 2.06 seconds in the non-leakage group and 11.76 +/- 2.47 seconds in the leakage group; the difference between the groups was statistically significant (p = 0.041). The mean VFT was 9.70 +/- 1.91 seconds in the non-leakage group and 10.75 +/- 1.40 seconds in the leakage group; the difference between the groups was statistically significant (p = 0.048). CONCLUSIONS: Peripheral leakage can be found in asymptomatic eyes. Age, VFT, and ARCT were correlated to peripheral leakage findings based on angiography. These leakage findings were thought to be related with histological properties and physiological changes in peripheral retina.

Intravitreal Bevacizumab Injection for the Treatment of Choroidal Neovascularization Secondary to Candida Chorioretinitis

PURPOSE: To report a case of choroidal neovascularization (CNV) secondary to candida chorioretinitis initially treated with an intravitreal bevacizumab injection. CASE SUMMARY: A 50-year-old female presented at our clinic with decreased vision and metamorphopsia in her left eye of 5 days duration. She received an anti-fungal treatment 2 months prior due to the presence of endogenous candida choroiditis in both eyes. Fluorescein angiography and optical coherence tomography (OCT) revealed juxtafoveal CNV in her left eye. Three monthly intravitreal injections of bevacizumab were administered as the initial loading dosage. Her visual symptoms improved and CNV regression was observed on OCT. No recurrence or complications were observed during the 6 month follow-up. CONCLUSIONS: Based on the present study results we suggest that intravitreal bevacizumab injection can be used to effectively treat CNV and improve visual symptoms during the treatment of juxtafoveal CNV associated with candida choroiditis.

Cystoid Macular Edema Detected by Scanning Laser Ophthalmoscopy in Retro-Mode

PURPOSE: To investigate the visualization of cystoid macular edema (CME) using noninvasive retromode imaging by a new scanning laser ophthalmoscope (SLO) and compare to previous imaging modalities. METHODS: The authors of the present study retrospectively reviewed the medical records of 21 eyes of 20 patients with CME due to various etiologies. All eyes were examined with fundus camera, fluorescein angiography (TRC-50EX, Topcon, Tokyo, Japan), SLO (F-10, Nidek, Gamagori, Japan), and spectral-domain optical coherence tomography (OCT) (3D OCT-1000, Topcon, Tokyo, Japan). In the present study the SLO was used in the retro-mode with an infrared laser. RESULTS: Previous fundus photography could not detect CME adequately although SLO retro-mode could show numerous oval or polygonal cystoid spaces more readily. Furthermore, each individual small cystoid space could be detected and the area of each cystoid space could be measured. The area of the largest cystoid space showed a correlation with its height, as measured with OCT (R = 0.606, p = 0.004). The area of the whole foveal cystoid space showed a correlation with central macular thickness, as measured with OCT (R = 0.493, p = 0.023). CONCLUSIONS: A new commercially available SLO (F-10) in the retro-mode can allow us to detect each cystoid space non-invasively and to measure the extent of CME.

Measurement of Choroidal Thickness in Normal Eyes Using 3D OCT-1000 Spectral Domain Optical Coherence Tomography

PURPOSE: To study choroidal thickness and its topographic profile in normal eyes using 3D OCT-1000 spectral domain optical coherence tomography and the correlation with age and refractive error. METHODS: Fifty-seven eyes (45 individuals) with no visual complaints or ocular disease underwent horizontal and vertical line scanning using 3D OCT-1000. The definition of choroidal thickness was the vertical distance between the posterior edge of the hyper-reflective retinal pigment epithelium and the choroid/sclera junction. Choroidal thickness was measured in the subfoveal area at 500 microm intervals from the fovea to 2,500 microm in the nasal, temporal, superior, and inferior regions. The spherical equivalent refractive error was measured by autorefractometry. Statistical analysis was used to confirm the correlations of choroidal thickness with age and refraction error. RESULTS: The mean age of the 45 participants (57 eyes) was 45.28 years. Detailed visualization of the choroid for measuring its thickness was possible in 63.3% of eyes. The mean subfoveal choroidal thickness was found to be 270.8 microm (standard deviation [SD], +/-51 microm), in horizontal scanning and 275.0 microm (SD, +/-49 microm) in vertical scanning. The temporal choroidal thickness was greater than any 500 microm interval in corresponding locations, and there was no significant difference between the superior and inferior choroid as far as 2,000 microm from the fovea. Age and refractive error were associated with subfoveal choroidal thickness in terms of regression (p < 0.05). CONCLUSIONS: Choroidal thickness in normal Korean eyes can be measured using 3D OCT-1000 with high resolution line scanning. The topographical profile of choroidal thickness varies depending on its location. Age and refractive error are essential factors for interpretation of choroidal thickness.

The Comparison of SLO Retromode Images with Conventional Fundus Photography for the Detection of Drusen

PURPOSE: To compare SLO (scanning laser ophthalmoscope) retromode images with conventional color fundus photography for the detection of drusen. METHODS: We obtained color fundus photography and SLO retromode images of the ten fellow eyes of ten patients with unilateral exudative age-related macular degeneration (AMD) and twenty eyes of 20 patients who had only drusen without exudative AMD. The numbers of druse in each image were compared within the same retinal boundary. RESULTS: In the fellow eyes of unilateral exudative AMD, an average number of 63.1 +/- 81.9 drusen in color fundus photography and an average number of 141.3 +/- 124.1 drusen in SLO retromode images were detected (p = 0.005). In the eyes with only drusen, an average number of 57.0 +/- 43.9 drusen in color fundus photography and an average number of 112.2 +/- 82.0 drusen in SLO retromode images were detected (p = 0.000). In the presence of media opacity like cataract, drusen were better detected in SLO retromode images than they were in color fundus photography. CONCLUSIONS: About twice as many drusen were detected in SLO retromode images than in color fundus photography. Drusen were also better detected in SLO retromode images in cases of media opacity. SLO retromode images might provide more sensitive images for the detection of drusen than does color fundus photography.

Analysis of Various Artifacts Produced by Spectral-Domain Optical Coherence Tomography Based on Macular Pathologies

PURPOSE: To report the frequency, severity and various types of artifacts associated with spectral-domain optical coherence tomography (SD-OCT) based on macular pathologies. METHODS: Data was collected retrospectively from 116 eyes of 116 subjects. SD-OCT (3D-1000, Topcon Corp., Japan) imaging was performed in 40 healthy eyes, 45 eyes with intraretinal pathology (IRP) and 31 eyes with subretinal pathology (SRP). The scan protocol was 12x6 mm radial scan. The frequency and types of artifacts were investigated in each scan and were analyzed based on macular disease. Additionally, the effect of artifacts on the measurement of macular thickness was studied. RESULTS: Errors occurred in 77 eyes (66.38%). Inner retinal boundary misidentification (IRBM) was the most common error (25.86%), with the frequencies of other types of artifacts being 10.34% for off-center fixation, 15.52% for degraded image and 8.6% for outer retinal boundary misidentification (ORBM). The overall error rate of SD-OCT in the retinal pathology group was much higher than that in the normal group. Macular thickness was underestimated in the IRP group because the outer retinal boundary of the IRP group tended to be misidentified toward the inner retina (p<0.01). CONCLUSIONS: SD-OCT can frequently cause various types of artifacts in patients with macular disease. When interpreting OCT images, the artifacts of SD-OCT should be considered in order to obtain accurate macular thickness and to prevent erroneous clinical decisions.

Ultrastructure of Rapidly Proliferating Preretinal Membrane of Very Extensive Ischemic Diabetic Retinopathy

PURPOSE: Using transmission electron microscopy (TEM), we studied the ultrastructures of rapidly proliferating preretinal membranes of young patients with very extensive ischemic proliferative diabetic retinopathy and diabetes with uncontrollable blood sugar level. METHODS: Nine cases of preretinal membranes were obtained from six eyes of five patients with rapidly progressed proliferative diabetic retinopathy (mean age, 35 years) during vitrectomy. We obtained each preretinal membrane bimanually as one single sheet membrane using intraocular scissors and forceps. Each tissue was fixed in 3% glutaraldehyde in the operating room. All specimens were prepared and studied using TEM. RESULTS: The preretinal membranes were composed of blood vessels and some interstitial cells. The blood vessels within the preretinal membranes varied in developmental stages, from the immature stage to the mature stage. The blood vessels were highly active, in that primitive cells showed a large nucleus and prominent chromatin clumping with abundant cytoplasm. Highly active fibroblast-like cells were also noted. CONCLUSIONS: We observed highly active angiogenesis in preretinal membranes, which rapidly proliferated in cases of severe retinal ischemia in young diabetes patients. This is the first report of such a finding, which may help to explain the poor prognosis of this disease modality.

The Results of Nation-Wide Registry of Age-related Macular Degeneration in Korea

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.

Repeatability of Spectral Domain OCT (3D-OCT 1000) in Normal Subjects and Various Macular Diseases

PURPOSE: To evaluate the repeatability of macular thickness and total macular volume measurements made using spectral domain optical coherence tomography (OCT) in normal subjects and subjects with macular disease. METHODS: Among a total of 108 subjects, there were 50 normal subjucts, 20 patients with diabetic macular edema, 10 patients with retinal vein occlusion, 15 patients with age-related macular degeneration, and 13 subjects with other conditions. Two serial macular measurements were obtained from each subject by a single experienced examiner using spectral domain OCT. The repeatability of the measurements was evaluated by comparing two consecutive foveal and perifoveal thickness measurements and total macular volume measurements. The intraclass correlation coefficient was also calculated to evaluate the repeatability of measurements made in normal and macular disease subjects. Result: Spectral domain OCT measurements of macular thickness and macular volume were found to be consistent. Measurements of normal subjects were the most consistent, followed by measurements of patients with age-related macular degeneration, retinal vein occlusion, and diabetic macular edema. CONCLUSIONS: Although measurements made using spectral domain OCT were repeatable across all subjects, they were more consistent in normal subjects than in patients with macular disease. The differences in repeatability should be considered in the context of diseased pathologic anatomy. Physicians should remain cautious when using these measurements for clinical evaluation.

The Effect of Intravitreal Bevacizumab Injection in Eales' Disease

PURPOSE: To report on 2 cases of Eales' disease that were successfully regressed with laser photocoagulation and intravitreal bevacizumab (Avastin; Genetech, Inc, San Francisco, California, USA) injection. CASE SUMMARY: Two male patients (30 years and, 40 years of age,) with a history of recurrent vitreous hemorrhage were diagnosed with Eales' disease. The 2 patients had peripheral retina neovascularization and active phlebitis in fundus fluorescein angiography. No other findings were observed in their eyes in the general examination. Scatter laser photocoagulation and intravitreal bevacizumab injection were performed. After 1 month follow-up, neovascularization completely regressed. There was no complication or recurrent vitreous hemorrhage at the 1 year follow up. CONCLUSIONS: Intravitreal bevacizumab injection, as combination treatment of laser photocoagulation, may be helpful in the regression of neovascularization due to Eales' disease.