Recovery course of persistent posterior subretinal fluid after successful repair of rhegmatogenous retinal detachment.

PURPOSE: To investigate best corrected visual acuity (BCVA), subretinal fluid (SRF) absorption time or ellipsoid zone (EZ) restoration time and various variables in patients with persistent SRF after successful primary repair of rhegmatogenous retinal detachment (RRD). METHODS: This retrospective multicenter study allowed independent analysis of the healing pattern by two observers based on composite of serial cross-sectional macular optical coherence tomography (OCT) scans. Univariate and multivariate analyses were implemented. RESULTS: One hundred and three cases had persistent SRF after pars plana vitrectomy, scleral buckling, or pneumatic retinopexy. By univariate analysis, SRF resolution time correlated positively with the number of retinal breaks (p < 0.001) and with increased myopia (p = 0.011). Using multivariate analysis, final BCVA (log MAR) correlated positively with age, duration of RRD, initial BCVA (OR = 3.28; [95%CI = 1.44-7.47]; p = 0.015), and SRF resolution time (OR = 0.46 [95%CI 0.21-1.05]; p = 0.049). EZ restoration time was longer with increasing number of retinal tears (OR = 0.67; [95%CI 0.29-1.52]; p = 0.030), worse final BCVA, and presence of macula-off RRD (OR = 0.26; [95%CI 0.08-0.88]; p = 0.056). SRF resolution time correlated marginally with prone position. CONCLUSIONS: Residual posterior SRF is more common in eyes with multiple breaks or in myopic eyes. Final BCVA is better in younger subjects and in eyes with shorter duration of RRD. Persistent SRF is a self-limited disorder with a mean resolution of 11.2 months with good visual prognosis improving from a mean baseline logMAR of 1.08 to 0.25 at one year.

Macular Anatomy Differs in Dyslexic Subjects.

The macula, as the central part of the retina, plays an important role in the reading process. However, its morphology has not been previously studied in the context of dyslexia. In this research, we compared the thickness of the fovea, parafovea and perifovea between dyslexic subjects and normal controls, in 11 retinal segmentations obtained by optical coherence tomography (OCT). With this aim, we considered the nine sectors of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid and also summarized data from sectors into inner ring subfield (parafovea) and outer ring subfield (perifovea). The thickness in all the four parafoveal sectors was significantly thicker in the complete retina, inner retina and middle retina of both eyes in the dyslexic group, as well as other macular sectors (fovea and perifovea) in the inner nuclear layer (INL), inner plexiform layer (IPL), IPL + INL and outer plexiform layer + outer nuclear layer (OPL + ONL). Additionally, the inner ring subfield (parafovea), but not the outer ring subfield (perifovea), was thicker in the complete retina, inner retina, middle retina (INL + OPL + ONL), OPL + ONL, IPL + INL and INL in the dyslexic group for both eyes. In contrast, no differences were found between the groups in any of the sectors or subfields of the outer retina, retinal nerve fiber layer, ganglion cell layer or ganglion cell complex in any eye. Thus, we conclude from this exploratory research that the macular morphology differs between dyslexic and normal control subjects, as measured by OCT, especially in the parafovea at middle retinal segmentations.

Macular Structure-Function Relationships of All Retinal Layers in Primary Open-Angle Glaucoma Assessed by Microperimetry and 8 × 8 Posterior Pole Analysis of OCT.

Purpose: The aim of this study is too correlate the sensitivity and thickness values of intraretinal layers at macula in healthy eyes and primary open-angle glaucoma (POAG) eyes. Methods: The thickness of different intraretinal segmentations was estimated by means of optical coherence tomography (OCT) Spectralis (Heidelberg, Engineering, Inc., Heidelberg, Germany) with the posterior pole analysis program 8 × 8 in 91 eyes from 91 patients (60 with glaucoma and 31 healthy patients). Macular sensitivity was also measured with an MP-1 microperimeter (Nidek Instruments, Inc Padova, Italy) with a customized, 36-stimulus pattern adjusted to an anatomical correspondence with the OCT grid. Correlations were calculated by using Spearman's rho and the results were represented in color maps. Results: Significant structure-function correlations were much more frequent in the glaucoma group than in control group. In general terms, associations were positive for inner retinal layers but negative correlations were also found for the inner nuclear layer and outer retinal layer in glaucoma. Conclusions: In general terms, significant structure-function correlations for different intraretinal layers are higher and wider in POAG eyes than in healthy eyes. Inner and outer retinal layers behave differently in terms of the structure-function relationship in POAG as assessed by microperimetry and OCT.

Glaucoma and Antioxidants: Review and Update.

Glaucoma is a neurodegenerative disease characterised by the progressive degeneration of retinal ganglion cells. Oxidative stress has been related to the cell death in this disease. Theoretically, this deleterious consequence can be reduced by antioxidants substances. The aim of this review is to assemble the studies published in relation to antioxidant supplementation and its effects on glaucoma and to offer the reader an update on this field. With this purpose, we have included studies in animal models of glaucoma and clinical trials. Although there are variable results, supplementation with antioxidants in glaucoma may be a promising therapy in glaucoma.

Normative Database for All Retinal Layer Thicknesses Using SD-OCT Posterior Pole Algorithm and the Effects of Age, Gender and Axial Lenght.

Our aim was to provide, for the first time, reference thickness values for the SD-OCT posterior pole algorithm (PPA) available for Spectralis OCT device (Heidelberg Engineering, Heidelberg, Germany) and to analyze the correlations with age, gender and axial length. We recruited 300 eyes of 300 healthy Caucasian subjects between 18 and 84 years. By PPA, composed of 64 (8 × 8) cells, we analyzed the thickness of the following macular layers: retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), inner retina, outer retina and full retina. Mean ± SD, 1st, 5th, 95th percentiles were obtained for each cell at all macular layers. Significant negative correlations were found between age and thickness for most macular layers. The mean thickness of most macular layers was thicker for men than women, except for RNFL, OPL and RPE, with no gender differences. GCL, IPL and INL thicknesses positively correlated with axial length in central cells, and negatively in the cells near the optic disk. The mean RNFL thickness was positively associated with axial length. This is the first normative database for PPA. Age, gender and axial length should be taken into account when interpreting PPA results.

Optical Coherence Tomography Angiography of Macula and Optic Nerve in Autism Spectrum Disorder: A Pilot Study.

The aim of this study was to compare retinal thicknesses and vascular parameters between autism spectrum disorder (ASD) and neurotypical (NT) individuals. Recruited ASD subjects and age- and sex-matched NT controls underwent 2 optical coherence tomography scans (OCT) (macular cube and optic nerve cube) and 2 OCT angiography (OCTA) scans (macular and optic nerve head (ONH) OCTA) with the device Cirrus 5000 (Zeiss). Concerning OCT, we considered full retina thickness in 9 macular sectors of the Early Treatment Diabetic Retinopathy Study (ETDRS) pattern and peripapillary retinal nerve fiber layer (pRNFL) thickness in 4 quadrants and 12 clock-hour sectors. Vessel density and capillary perfusion density in 9 sectors were measured using 6 × 6 mm macular OCTA. Foveal avascular zone (FAZ) parameters were also considered. ONH 4.5 × 4.5 mm OCTA estimated perfusion density and flux index in 4 peripapillary quadrants. Comparisons between groups of all these parameters were performed. ASD subjects showed higher ONH perfusion density and lower ONH flux index at the peripapillary inferior quadrant when compared with NT individuals (p < 0.05). Plus, a trend towards higher macular thicknesses, higher pRNFL thickness at inferior clock-hour sectors and higher macular vessel density and perfusion was observed in ASD. No differences were found in FAZ parameters. In conclusion, retinas of ASD subjects may present some structural and vascular differences when compared with retinas of NT individuals.

Update on the Effects of Antioxidants on Diabetic Retinopathy: In Vitro Experiments, Animal Studies and Clinical Trials.

Current therapies for diabetic retinopathy (DR) incorporate blood glucose and blood pressure control, vitrectomy, photocoagulation, and intravitreal injections of anti-vascular endothelial growth factors or corticosteroids. Nonetheless, these techniques have not been demonstrated to completely stop the evolution of this disorder. The pathophysiology of DR is not fully known, but there is more and more evidence indicating that oxidative stress is an important mechanism in the progression of DR. In this sense, antioxidants have been suggested as a possible therapy to reduce the complications of DR. In this review we aim to assemble updated information in relation to in vitro experiments, animal studies and clinical trials dealing with the effect of the antioxidants on DR.

Vault changes after cyclopentolate instillation in eyes with posterior chamber phakic intraocular lens.

Posterior chamber phakic intraocular lens (pIOL) implantation is a common option for correcting moderate-to-high ocular refractive defects. Because this pIOL is implanted on ciliary sulcus, the distance between the back surface of the pIOL and the anterior surface of the crystalline lens, that it is known as vault, should be measured in different conditions to ensure the technique's safety. Cyclopentolate is a drug that dilates the pupil and relaxes accommodation (cycloplegia). It is often used for different ocular examinations and for other medical purposes. However, there is no evidence of the effect of this drug on vault. This study quantified central vault changes associated with cyclopentolate instillation. We measured the vault under normal conditions (pre-cycloplegic instillation) and after instilling cyclopentolate on 39 eyes of 39 patients with implanted pIOL. Our results suggest that cyclopentolate instillation may induce changes to vault in eyes with implanted pIOL. These changes seem safe and are mainly associated with vault under normal conditions, but also with anterior chamber depth, pupillary diameter and pIOL size.

Focal vitreomacular traction: Resolution after ocular massage.

PURPOSE: Vitreomacular traction (VMT) is a relatively common ocular disorder that may distort the foveal structure causing visual symptoms. The influence of ocular massage (OM) on this condition has not been considered yet. We aim to report clinical and OCT features of VMT release associated with OM. OBSERVATIONS: A 70-year-old woman complained about blurred vision and metamorphopsia in her right eye for one month. Her best-corrected visual acuity (BCVA) was 20/50. Macular OCT showed focal VMT in this eye. Moderate intensity, digital OM was performed by an ophthalmologist. However, the traction was still present. The patient was instructed to perform the same OM every 8 hours at home herself. Four days later she indicated disappearance of metamorphopsia, her BCVA increased to 20/25 and OCT showed VMT release with 39-µm foveal thinning. CONCLUSIONS AND IMPORTANCE: OM may be useful for focal VMT release.

Toxicidad retiniana por antipalúdicos: frecuencia y factores de riesgo / Retinal toxicity due to antimalarials: Frequency and risk factors

Objetivo: Estudiar la frecuencia de toxicidad retiniana y factores de riesgo asociados en una cohorte de pacientes tratados con antipalúdicos de un hospital comarcal. Material y métodos: Estudio retrospectivo de 40 pacientes. Se recogieron: tipo de antipalúdico, dosis diaria y acumulada, enfermedad reumatológica de base, enfermedad concomitante y estudio oftalmológico. Se definió toxicidad retiniana como alteración en 2 de las 4 siguientes pruebas: examen de fondo de ojo, campo visual con patrón macular, tomografía de coherencia óptica de dominio espectral y electrorretinografía de campo completo. Resultados: La frecuencia de toxicidad retiniana fue del 13,1% (intervalo de confianza [IC] del 95%, 5- 21%), con tendencia a un mayor riesgo en los pacientes en tratamiento con cloroquina (CQ). En estos pacientes con toxicidad retiniana, la dosis media acumulada de CQ fue de 229 g y la de hidroxicloroquina (HCQ) de 111 g. La dosis media diaria de CQ fue de 250 mg y la de HCQ fue de 333 mg. Encontramos una asociación positiva entre toxicidad retiniana e hipertensión arterial. Conclusiones: La frecuencia de toxicidad retiniana, valorada objetivamente mediante técnicas oftalmológicas, fue alta, con una mayor tendencia en pacientes en tratamiento con cloroquina(AU)

Objective: To study the frequency of retinal toxicity and associated risk factors in a cohort of patients treated with antimalarials and seen at a tertiary level hospital. Material and methods: Retrospective study of 40 patients treated with antimalarials, who were referred to ophthalmology for the study of retinal toxicity during 2011. Data collection included type of antimalarial prescribed, daily and cumulative doses, presence of rheumatic disease, corticosteroid use, associated diseases and ophthalmologic examination. Retinal toxicity was confirmed if two of the following tests were altered: fundus examination, visual field with a macular pattern, changes in spectral domain optical coherence tomography and full-field electroretinography. Results: Toxic retinopathy was detected in 13.1% of patients (95% confidence interval 5-21%) and a trend for a higher risk was observed in case of chloroquine (CQ) treatment. Among the patients with retinopathy, the mean cumulative dose was 229 g for CQ and 111 g for Hydroxychloroquine (HCQ), and the mean daily dose of CQ was 250 mg and 333 mg for HCQ. Arterial hypertension had a statistically significant effect on retinopathy development. Conclusions: Toxic retinopathy defined by ophthalmological evaluation was detected in 13.1% of patients. A trend for a higher risk was observed in case of chloroquine treatment(AU)

Retinal toxicity due to antimalarials: frequency and risk factors.

OBJECTIVE: To study the frequency of retinal toxicity and associated risk factors in a cohort of patients treated with antimalarials and seen at a tertiary level hospital. MATERIAL AND METHODS: Retrospective study of 40 patients treated with antimalarials, who were referred to ophthalmology for the study of retinal toxicity during 2011. Data collection included type of antimalarial prescribed, daily and cumulative doses, presence of rheumatic disease, corticosteroid use, associated diseases and ophthalmologic examination. Retinal toxicity was confirmed if two of the following tests were altered: fundus examination, visual field with a macular pattern, changes in spectral domain optical coherence tomography and full-field electroretinography. RESULTS: Toxic retinopathy was detected in 13.1% of patients (95% confidence interval 5-21%) and a trend for a higher risk was observed in case of chloroquine (CQ) treatment. Among the patients with retinopathy, the mean cumulative dose was 229 g for CQ and 111 g for Hydroxychloroquine (HCQ), and the mean daily dose of CQ was 250 mg and 333 mg for HCQ. Arterial hypertension had a statistically significant effect on retinopathy development. CONCLUSIONS: Toxic retinopathy defined by ophthalmological evaluation was detected in 13.1% of patients. A trend for a higher risk was observed in case of chloroquine treatment.