Comparison of retinal thickness values and segmentation performance of different OCT devices in acute branch retinal vein occlusion.

PURPOSE: To compare retinal thickness (RT) measurement and segmentation performance of time domain (TD, Stratus) and spectral domain (SD) optical coherence tomography (OCT) devices (Cirrus, Spectralis) for imaging macular oedema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: In this study, 20 eyes of 20 consecutive patients with acute BRVO were included. A total of 18 unaffected fellow eyes served as control group. RT measurement was analysed in the five inner fields of the early-treatment diabetic retinopathy grid, and proportional segmentation errors were evaluated. RESULTS: Central millimetre thickness (CMT) showed a mean difference of -64, -74, and -18 µm (P < 0.001) in the control group and -31 µm (P=0.107), -92 µm (P<0.001), and -105 µm (P=0.016) in the BRVO group, between Stratus and Cirrus, between Stratus and Spectralis, and between Cirrus and Spectralis, respectively. Mean RT showed the highest variability between different devices in the area most intensively affected by BRVO-related ME. In eyes with BRVO, 14.6% of Spectralis, 20% of Stratus, and 36.6% of Cirrus scans demonstrated moderate and severe segmentation errors. CONCLUSION: RT measurement in eyes with BRVO, by TD and SD OCT, is compromised by a significant rate of segmentation errors. Deviations are most pronounced in the areas most severely affected by ME.

Thirty-month follow-up after intravitreal bevacizumab in progressive idiopathic macular telangiectasia type 2.

AIM: The aim of this study is to evaluate the long-term efficacy of intravitreal bevacizumab (IVB) for eyes with non-proliferative idiopathic macular telangiectasia type 2 (IMT2) and acute vision loss. METHODS: In this interventional case series, treatment-naive eyes of 13 consecutive patients with IMT2 were included. Eyes with a recent onset of visual loss were treated with 0.04 ml IVB (n=7). Fellow eyes and eyes of patients without disease progression served as control group (CG) (n=12). Follow-up examinations included ophthalmoscopy, best-corrected visual acuity (BCVA), optical coherence tomography, and fluorescein angiography (FA). RESULTS: Mean follow-up time was 32±5.7 months in the treatment group (TG) (n=7) vs 29±8.8 months in the CG (n=16). Mean BCVA increased from logMAR 0.47±0.32 at baseline to logMAR 0.33±0.31 (P=0.21) at the last visit in the TG and decreased from logMAR 0.25±0.39 to logMAR 0.30±0.40 in the CG (P=0.17). All patients in the TG showed stabilisation or improvement in vision in Snellen lines in contrast to the CG (χ(2)-test P=0.04). Patients received on average 2.3±1.3 IVB injections. Mean central millimetre thickness in TG and CG was 260±83 and 201±32 µm at baseline vs 237±69 and 199±29 µm at the last visit, respectively (P=0.23 and 0.77). FA revealed a significant decrease of the juxtafoveal staining size at month 3 (P= 0.004) and a slight reduction at the last visit (P= 0.11) in the TG. CONCLUSION: Despite an overall moderate effect of IVB treatment, individual patients experience a marked functional and morphological long-term benefit.

Randomised clinical trial of intravitreal Avastin vs photodynamic therapy and intravitreal triamcinolone: long-term results.

PURPOSE: To compare 1-year functional and anatomic outcomes of intravitreal bevacizumab (IVB) and photodynamic therapy plus intravitreal triamcinolone (PDT+IVTA) combination in patients with neovascular age-related macular degeneration (AMD). METHODS: In this prospective, randomised, controlled clinical trial, 28 patients were included. All patients were randomised 1 : 1 to 0.04 ml/1 mg of IVB or PDT plus same day 0.1 ml/4 mg IVTA (PDT+IVTA). Follow-up examinations were performed in monthly intervals in IVB group and every 3 months in PDT+IVTA group. Main outcomes were change in mean visual acuity (VA), mean central retinal thickness (CRT) and the mean number of treatments. RESULTS: At month 12, mean VA improved to a 1.5-line gain in IVB group, and lost three letters in PDT+IVTA group (P=0.02). Mean CRT was reduced from 357 microm at baseline to 244 microm at month 12 in IVB group and from 326 microm to 254 microm, respectively, in PDT+IVTA group (P=0.8). The mean number of treatments was 6.8 in the IVB group vs 1.9 in the PDT+IVTA group. No significant local or systemic safety concerns were detected during follow-up time. CONCLUSIONS: Patients treated with IVB showed a significant better VA outcome compared with the PDT+IVTA group despite the fact that both modalities showed equal potency in reducing CRT during a 12-month period.

[Bilateral uveal melanoma: a case report]. / Bilaterales uveales Melanom: ein Fallbericht.

BACKGROUND: The occurrence of bilateral uveal melanoma is rare. This is the first reported case of bilateral melanoma of the choroidea in Austria. METHODS: The chart of a 62-year-old male patient with bilateral melanoma of the choroidea was reviewed. RESULTS: In October 1992, a patient was diagnosed with a choroidal melanoma in the left eye. After two treatments with a ruthenium applicator in 1992 and 1995, the left eye was enucleated in 1999 due to recurrent growth of the choroidal melanoma. In September 2005, the patient presented with a primary choroidal melanoma in the remaining right eye. Sonography of the liver as well as CCT and bone marrow scintigraphy showed no sign of metastatic disease. A ruthenium-106 brachytherapy was performed and the size and height of the melanoma showed decreases. In July 2006, the patient developed metastatic disease and died the following month due to metastasis of the liver. In the genetic analysis, monosomy 3 was detected in both melanoma, an amplification of c-MYC of chromosome 8 was detected in the melanoma of the right eye only. CONCLUSION: Bilateral uveal melanoma is a rare diagnosis. This case shows the importance of a thorough and recurrent examination of the second eye. The results of the genetic analysis are discussed.

[Foreign bodies of the iris as a rare differential diagnosis of malignant melanoma of the iris]. / Irisfremdkörper als seltene Differenzialdiagnose zum Irismelanom.

BACKGROUND: Lesions of the iris require a thorough examination to differentiate them from malignant melanoma because of the severe therapeutic consequences of the latter entity. METHODS: We observed two cases with a unilateral lesion on the iris, both suspicious of malignant melanoma of the iris. Ophthalmological, echographic and ultrasound biomicroscopic examinations were done. RESULTS: The cases of a 66-year-old man with a metallic foreign body and a 37-year-old man with a foreign body, both located on the iris, are presented. CONCLUSION: In both patients an unclear lesion of the iris, suspicious of a malignant melanoma of the iris, turned out to be a foreign body after ophthalmoscopic examination. Both echography and ultrasound biomicroscopy were carried out and proved to be useful to confirm the diagnosis. No ocular inflammations, siderosis or secondary glaucoma occurred in the described cases. Observation of dormant foreign bodies is sufficient.