Correlation of the macular microvasculature to the axial length in pediatric patients with high axial refractive errors.

AIMS: To compare the vascular density (VD) of the macular superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), and the foveal avascular zone (FAZ) among high hyperopic, high myopic, and emmetropic children using optical coherence tomography angiography (OCTA). METHODS: This was a cross sectional comparative study of otherwise healthy children with different refractive errors. Patients were recruited from Cairo University Children's Hospital. OCTA imaging was performed using the RTVue XR Avanti device with AngioVue software. Both the 3 × 3 and 6 × 6 mm macular scans were utilized. Automated measurements were obtained from the built-in machine software. Axial length (AL) measurements were done using Lenstar LS 900 optical biometer. RESULTS: Ninety eyes from 51 healthy children were included. Among high myopes, there was significant thinning of the parafovea (p < 0.001). SCP-VD was also lower in high myopes in all areas except the fovea (all p < 0.001). The DCP-VD was significantly lower in high myopes in the parafovea and perifovea. High hyperopes had lower subfoveal CC-VD. Despite high myopes showing a significantly lower OCTA signal strength, linear regression analysis revealed that AL was an independent and significant predictor for the FAZ-area, as well as parafoveal and perifoveal SCP and DCP-VD. CONCLUSION: High myopia results in a reduction of VD in both the SCP and DCP, which can be non-invasively detected and monitored using OCTA. While lower VD may, in part, be attributed to lower OCTA image quality, our findings demonstrate that AL independently and significantly predicts macular vascular parameters on OCTA in children.

Vitrectomy with scleral buckling versus with inferior retinectomy in treating primary rhegmatogenous retinal detachment with PVR and inferior breaks.

PURPOSE: To evaluate anatomic and functional outcomes of patients treated with pars plana vitrectomy (PPV) with scleral buckling versus PPV with inferior retinectomy for treatment of cases of primary rhegmatogenous retinal detachment (RRD) associated with proliferative vitreoretinopathy (PVR) and inferior retinal breaks. METHODS: Retrospective, comparative, interventional, single-center study. Fifty-one eyes of fifty-one patients with primary RRD associated with inferior breaks and PVR grade C1 or more were reviewed over 3 years. Twenty-one eyes underwent PPV with encircling band 360° and thirty eyes underwent PPV with primary inferior retinectomy. The primary outcome was final anatomic success. Secondary outcomes included change in visual acuity, primary anatomical success, the mean number of operations, and incidence of postoperative complications. RESULTS: Primary anatomical success of 85.7% was achieved in buckle group compared to 83.3% in retinectomy group (p = 0.82). Mean duration of follow-up and mean number of operations was 9.8 ± 2.26 and 9.97 ± 2.44 months; 1.24 ± 0.62 and 1.3 ± 0.75 in buckle group and retinectomy group, respectively, achieving final anatomical success of 95.2% for the buckle group and 90% for the retinectomy group with no statistical significant difference (p = 0.49). Although visual acuity (logMAR) was better in the buckle group in the 1st month, it became nearly equal thereafter during the follow-up period (p = 0.5). CONCLUSION: Similar anatomical and functional outcomes were achieved by combining PPV with scleral buckle or inferior retinectomy for treatment of primary RRD with PVR and inferior breaks.

Effect of Topical Nepafenac on Central Foveal Thickness following Panretinal Photocoagulation in Diabetic Patients.

PURPOSE: To evaluate effectiveness of topical nepafenac in reducing macular edema following panretinal photocoagulation (PRP). DESIGN: Prospective randomized double-blinded controlled study. METHODS: Sixty eyes of 60 patients having proliferative or severe nonproliferative diabetic retinopathy had PRP. Patients were then divided into two groups: nepafenac group (30 eyes) receiving 1% topical nepafenac eye drops for 6 months and control group (30 eyes) receiving carboxymethylcellulose eye drops for 6 months. Best-corrected visual acuity (BCVA) and macular optical coherence tomography were followed up at 1, 2, 4, and 6 months after PRP. RESULTS: BCVA was significantly better in nepafenac group than in control group at all follow-ups (P < 0.01). At 6 months post-PRP, logMAR BCVA was 0.11 ± 0.04 (equivalent to 20/26 Snellen acuity) in the nepafenac group and 0.18 ± 0.08 (equivalent to 20/30 Snellen acuity) in the control group (P < 0.01). Central foveal thickness (CFT) increased in both groups from the first month after PRP. Increase in CFT was higher in control group than in nepafenac group throughout follow-up, but the difference became statistically significant only after 4 months. No significant ocular adverse events were reported with topical nepafenac. CONCLUSION: Topical nepafenac can minimize macular edema and stabilize visual acuity following PRP for diabetic patients.

Effect of lens status on intraocular pressure in siliconized eyes.

PURPOSE: To evaluate the effect of lens status on intraocular pressure (IOP) in siliconized eyes and also on the emulsification of silicone oil. PATIENTS AND METHODS: A total of 31 eyes of 31 patients with retinal detachment were operated on with pars plana vitrectomy and silicone oil injection: 16 phakic (Group A) and 15 pseudophakic (Group B). During the 6-month follow-up period, IOP was measured: 1 day postoperative, then at 1 week, 1 month, 2 months, 3 months, and 6 months postoperative. At the end of the follow-up period, gonioscopy was carried out to check emulsified silicone at the anterior chamber angle and also the presence of emulsified silicone on the back of the cornea when the patient was lying down. RESULTS: There was no significant difference between both groups until the first week (P value = 0.15). Starting from the first month, the difference was statistically significant, with mean IOPs in Groups A and B of 14.9 mmHg and 18.2 mmHg, respectively, up to the sixth month (P value = 0.002), with a mean IOP in Groups A and B of 14.4 mmHg and 19.4 mmHg, respectively. Emulsified silicone was clinically stated in twelve cases (80%) in Group B and in three cases (19%) in Group A. CONCLUSION: There is a higher incidence of increased IOP and emulsification of silicone oil in pseudophakic eyes than in phakic eyes.