Analysis of retinal sensitivity between acute and recurrent central serous chorioretinopathy by microperimetry.

PURPOSE: To evaluate the retinal sensitivity of macular region in acute and recurrent central serous chorioretinopathy (CSCR) using microperimetry. METHODS: This was a retrospective observational study. Twenty-five eyes of 25 subjects diagnosed with either acute or recurrent CSCR without any previous treatment were included in this study. All subjects underwent complete ophthalmological examinations, including central retinal thickness (CRT) using spectral domain OCT and the retinal sensitivity assessments of macular region using microperimeter MP-3. The mean global macular sensitivity (GMS) of 64 loci in the 20° central macular area and the local macular sensitivity (LMS) of the test locations in affected region of serous retinal detachment (SRD) were analyzed. RESULTS: Twelve eyes of 12 subjects with acute CSCR (Group A) and 13 eyes of 13 subjects with recurrent CSCR (Group R) were enrolled. Clinical parameters, including age, duration, mean LogMAR best-corrected visual acuity and CRT, were not statistically significant (p = 0.688, 0.080, 0.222, 0.394, respectively) between Group A and Group R. There were significant differences in the GMS and LMS between the two groups. Compared to group A (24.9 ± 1.6 dB), the mean GMS of group R was significantly (p = 0.018) lower (23.0 ± 2.0 dB). Furthermore, the mean LMS of group R (20.8 ± 3.4 dB) was also significantly lower (p = 0.026) than that of group A (22.3 ± 3.1 dB). CONCLUSIONS: Recurrent CSCR often show worse retinal function in focal areas of the affected macular areas than in acute CSCR. Microperimetry may be a promising method for distinguish between the acute and recurrent CSCR.

Spectral-domain optical coherence tomography characteristics of cystic retinal tuft.

OBJECTIVE: To investigate the characteristics of cystic retinal tufts (CRTs) with 55° widefield spectral-domain optical coherence tomography. METHODS: This was a retrospective study. All subjects underwent a complete ocular examination, ultra-widefield (UWF) pseudocolor fundus photography and Spectral domain optical coherence tomography (SD-OCT) with a 55° widefield lens. The SD-OCT characteristics were analyzed in subjects with CRT. RESULTS: Twenty-six eyes of 25 subjects were scanned and 29 CRTs were analyzed for SD-OCT characteristics. On SD-OCT images, the CRTs exhibited hyperreflective irregular elevated lesions with internal hyporeflective cystoid cavities. Normal layers of the neuroepithelium could not be distinguished. The mean diameter of CRTs was 1022 microns (range, 117-3711 microns; standard deviation, 815 microns). There was vitreoretinal traction at the apex of CRTs. Among them, retinal tears in 24.14% (7/29), suspected retinal tears in 27.59% (8/29), and shallow neuroepithelium detachment in 31.03% (9/29). CONCLUSIONS: The widefield SD-OCT imaging can provide detailed cross-sectional anatomic information of CRT and may guide clinical treatment.

Optical coherence tomography with or without enhanced depth imaging for peripapillary retinal nerve fiber layer and choroidal thickness.

AIM: To assess peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness obtained with enhanced depth imaging (EDI) mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography (OCT). METHODS: Fifty eyes of 25 normal healthy subjects and 32 eyes of 20 patients with different eye diseases were included in the study. All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols. The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale. The paired t-test, intraclass correlation coefficient (ICC), 95% limits of agreement (LoA), and Bland and Altman plots were used to test the agreement of measurements. RESULTS: The visibility score of RNFL obtained with and without EDI was of no significant difference (P=0.532), the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol (P<0.001). Peripapillary RNFL thickness obtained with EDI was slightly thicker than that obtained without EDI (103.25±9.42 µm vs 101.87±8.78 µm, P=0.010). The ICC of the two protocols was excellent with the value of 0.867 to 0.924, the 95% LoA of global RNFL thickness was between -10.0 to 7.4 µm. Peripapillary choroidal thickness obtained with EDI was slightly thinner than that obtained without EDI (147.23±51.04 µm vs 150.90±51.84 µm, P<0.001). The ICC was also excellent with the value of 0.960 to 0.987, the 95% LoA of global choroidal thickness was between -12.5 to 19.8 µm. CONCLUSION: Peripapillary circular OCT scan with or without EDI mode shows comparable results in the measurement of peripapillary RNFL and choroidal thickness.

Pretreatment with proteasome inhibitors protects against oxidative injuries via PPARα-dependent and -independent pathways in ARPE-19 cells.

PURPOSES: Oxidative processes may play important roles in age-related macular degeneration. Previous studies have suggested that enhancing proteasome activity by pretreatment with low doses of proteasome inhibitors reduces injury from oxidative damage in neuronal cultures. The objective of the current study was to determine whether proteasome inhibitors could ameliorate the toxicity from oxidative stresses in ARPE-19 cells and to dissect the pathways that may mediate these protective effects. METHODS: The toxicity of oxidative stressors menadione (VK3) and 4-hydroxynonenal (4-HNE) and the protective effects of proteasome inhibitors, including MG-132 and clasto-lactacystin-ß-lactone (LA), were studied in ARPE-19 cells. Binding and activation of the peroxisome proliferator-activated receptors (PPARs) family of transcription factors were studied using electrophoretic mobility shift assay (EMSA) and a peroxisome proliferator-activated response element (PPRE)-driven dual-luciferase reporter gene. RESULTS: An 18-hour pretreatment with 30 to 300 nM MG-132 or 300 to 1000 nM LA reduced the toxicity of menadione or 4-HNE in ARPE-19 cells. The protective effects of MG-132 pretreatment were partially reversed by the PPARα antagonist GW6471 but not by the PPARγ antagonist GW9662; in contrast, neither agent reduced the protective effects of LA. MG-132 but not LA induced increased expression of a PPRE-driven luciferase reporter gene in a dose-dependent manner. Nuclear proteins isolated from ARPE-19 cells treated by MG-132 had increased binding to PPRE sequences as measured by EMSA. CONCLUSIONS: Our data suggest that pretreatment with proteasome inhibitors reduces oxidative injury in ARPE-19 cells and that the underlying mechanisms are different for different proteasome inhibitors, with PPARα-dependent effects for MG-132 and PPAR-independent effects for LA.