CHANGE OF CHOROIDAL VOLUME IN UNTREATED CENTRAL SEROUS CHORIORETINOPATHY.

PURPOSE: Choroidal hyperpermeability plays a central role in the pathophysiology of central serous chorioretinopathy (CSC). In active CSC undergoing treatment, choroidal thickness decreases if subretinal fluid (SRF) resolves. This study aimed to investigate the change in choroidal thickness and volume in eyes with untreated CSC. METHODS: The authors retrospectively analyzed 27 eyes with treatment-naïve CSC (25 patients), who had a follow-up of 4 to 6 weeks. Retinal and choroidal volume and SRF were segmented manually and calculated using the Spectralis OCT built-in software (Spectralis; Heidelberg Engineering). RESULTS: In treatment-naïve eyes with CSC, an increase in SRF was significantly associated with an increase in choroidal thickness and volume (rho = 0.93, P < 0.01). Eyes with greater baseline choroidal volume showed a significantly greater decrease in SRF during follow-up (rho = -0.47, P = 0.03). CONCLUSION: In this study, an increase in SRF was associated with an increase in both choroidal thickness and volume in eyes with treatment-naïve CSC. Eyes with thicker baseline choroidal volume showed a greater reduction in SRF.

Assessment of vision-related quality of life in patients with central retinal artery occlusion.

BACKGROUND: Central retinal artery occlusion (CRAO) is a major cause for severe visual impairment. Its effect on vision-related quality of life has not yet been determined. The purpose of the present study was thus to assess vision-related quality of life in patients with CRAO using the 39-item National Eye Institute Visual Function Questionnaire. METHODS: The case-control study comprised 26 patients with unilateral CRAO and a control group consisting of 26 control subjects, matched for age and sex. Vision-related quality of life was measured using the 39-item National Eye Institute Visual Function Questionnaire. RESULTS: After Bonferroni correction, the median 39-item National Eye Institute Visual Function Questionnaire composite score was significantly lower in patients with CRAO than in those in the control group (P(corr) < 0.001). Patients with CRAO showed significantly lower median scores in 9 of 12 subscales: general vision (P(corr) < 0.001), peripheral vision (P(corr) < 0.001), difficulties with near-vision activities (P(corr) < 0.001), difficulties with distance-vision activities (P(corr) < 0.001), role difficulties as a result of vision problems (P(corr) < 0.001), dependency on others because of vision problems (P(corr) < 0.001), limitations in social functioning because of vision problems (P(corr) < 0.001), mental health symptoms because of vision problems (P(corr) < 0.001), and general health (P(corr) = 0.008). CONCLUSION: Our data suggest that vision-related quality of life is reduced in patients with CRAO.

Introducing a new parameter for the assessment of the tear film lipid layer.

PURPOSE: The differential diagnosis of dry eye syndrome is still a challenging task. The purpose of this study was to understand the relationship between a novel, objective clinical parameter, the "corrected lipid layer stabilization time," and commonly performed clinical tests for dry eye patients. METHODS: Data were obtained from a prospective clinical study with 59 patients of different subjective severity, as determined with the Ocular Surface Disease Index (OSDI). The dynamics of the tear film lipid layer were made visible through a white light source and were stored digitally. Because the distance between the upper and lower eyelid affects the lipid layer dynamics and varies significantly between subjects, the distance of the eyelids was determined and used to correct the lipid layer stabilization time. The resulting parameter was compared with common clinical procedures. RESULTS: The corrected lipid layer stabilization time has a highly significant correlation with tear film breakup time (Spearman r = -0.485, P < 0.01), Schirmer test without anesthesia (r = -0.431, P < 0.01) and with the Ocular Surface Disease Index (r = 0.498, P < 0.01). It also correlates with the lissamine green staining score (r = 0.379, P < 0.05), but shows no correlation with the osmolarity of the tear film. Without the correction for the eyelid opening, the correlations decrease considerably. CONCLUSIONS: These data suggest that the diagnostic value of the lipid layer stabilization time for the assessment of the severity of dry eye syndrome increases considerably when it is corrected by the distance of the eyelids.