Superficial and Deep Foveal Avascular Zone Area Measurement in Healthy Subjects Using Two Different Spectral Domain Optical Coherence Tomography Angiography Devices.

PURPOSE: To compare the area of the foveal avascular zone (FAZ) in the superficial and deep retinal layers using two different spectral-domain optical coherence tomography angiography (OCTA) devices. METHODS: A cross-sectional comparative study was conducted to obtain macular OCTA images from healthy subjects using Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA) and Spectralis HRA+OCTA (Heidelberg Engineering, Heidelberg, Germany). Two independent trained graders measured the FAZ area using automated slab segmentation. The FAZ area in the superficial and deep retinal layers were compared. RESULTS: Twenty-three eyes of 23 subjects were included. The graders agreement was excellent ( > 0.86) for all measurements. The mean FAZ area was significantly larger at the superficial retinal layer as compared to the deep retinal layer on both devices (0.31 ± 0.08 mm 2 vs 0.26 ± 0.08 mm 2 in Optovue and 0.55 ± 0.16 mm 2 vs 0.36 ± 0.13 mm 2 in Spectralis, both P < 0.001). The mean FAZ area was significantly greater in the superficial and deep retinal layers using Spectralis as compared to Optovue measurements (P < 0.001 for both comparisons). CONCLUSION: In contrast to previous reports, the FAZ area was larger in the superficial retina as compared to deep retinal layers using updated software versions. Measurements from different devices cannot be used interchangeably.

Retinal anaplastic pleomorphic xanthoastrocytoma unassociated with phakomatosis.

PURPOSE: To present a rare anaplastic form of retinal pleomorphic xanthoastrocytoma (PXA) unassociated with phakomatosis. METHODS: A 9-year-old girl, presented with a rapidly growing unilateral intraocular white mass unresponsive to intra-arterial chemotherapy, underwent enucleation with the clinical suspicion of retinoblastoma versus malignant astrocytoma. RESULTS: Histopathology revealed pleomorphic cells with rosenthal fibers, mitosis, and necrosis. Immunohistochemistry confirmed the diagnosis of anaplastic pleomorphic xanthoastrocytoma (aPXA). The patient had no signs of phakomatosis. CONCLUSION: Retinal PXA may occur in patients without phakomatosis and rarely progress toward malignant transformation.

Behavior disorders in children with significant refractive errors.

PURPOSE: To evaluate the frequency of behavioral disorders in children with significant refractive error and to compare the results with those of emmetropic children. METHODS: In this prospective, comparative study from January to September 2013, refractive errors of all 5-12-year-old children who referred to a general eye clinic were recorded. A validated Persian version of the Rutter A scale was filled out by the parents for the evaluation of the child's behavioral disorders. The Rutter A scale scores of children with significant refractive error were compared with those of emmetropic eyes. Student t test, Chi square test, and Fisher's exact test were used for analysis. Differences with a P value less than 0.05 were considered significant. RESULTS: One hundred eighty-three patients, including 101 patients with significant refractive error and 82 emmetropic subjects, were studied. Overall, 44 patients (24%) had behavioral disorders, according to the Rutter A scale scores. Thirty patients (29.7%) with significant refractive error and 14 emmetropic subjects (16.9%) had behavioral disorders (P = 0.043). The prevalence of behavioral disorders were 37.5% in hyperopia, 35.7% in hyperopia-astigmatism, 21.4% in simple astigmatism, 16.7% in myopia-astigmatism, and 14.3% in myopia. Compared with emmetropic subjects, the prevalence of behavioral disorders was statistically significantly higher only in patients with hyperopia and hyperopia-astigmatism (P = 0.019 and P = 0.040). CONCLUSION: The prevalence of behavioral disorders is higher in children with hyperopia and hyperopia-astigmatism.