RESUMEN
PURPOSE: To investigate the distribution of hyperreflective foci (HRF) in eyes with dry age-related macular degeneration (AMD). METHODS: We retrospectively reviewed optical coherence tomography (OCT) images of 58 dry AMD eyes presenting HRF. The distribution of HRF according to the early treatment diabetic retinopathy study area was analyzed according to the presence of subretinal drusenoid deposits (SDDs). RESULTS: We classified 32 eyes and 26 eyes into the dry AMD with SDD group (SDD group) and dry AMD without SDD group (non-SDD group), respectively. The non-SDD group had higher prevalence and density of HRF at the fovea (65.4% and 1.71 ± 1.48) than the SDD group (37.5% and 0.48 ± 0.63, P = 0.035 and P < 0.001, respectively). However, the prevalence and density of HRF in the outer circle area of the SDD group (81.3% and 0.11 ± 0.09) were greater than those of the non-SDD group (53.8% and 0.05 ± 0.06, p = 0.025 and p = 0.004, respectively). The SDD group showed higher prevalence and mean densities of HRF in the superior and temporal area than in the non-SDD group (all, p < 0.05). CONCLUSION: HRF distributions in dry AMD varied according to the presence of SDDs. This might support that the degenerative features may be different between dry AMD eyes with and without SDDs.
Asunto(s)
Atrofia Geográfica , Drusas Retinianas , Humanos , Drusas Retinianas/diagnóstico , Drusas Retinianas/etiología , Estudios Retrospectivos , Estudios Prospectivos , Tomografía de Coherencia Óptica/métodosRESUMEN
PURPOSE: We sought to investigate the clinical features of eyes with unilateral type 3 macular neovascularization (MNV) according to the degenerative features of fellow eyes. METHODS: We retrospectively reviewed 55 patients with unilateral type 3 MNV and identified degenerative features including geographic atrophy (GA) in fellow eyes using multimodal imaging. Then, the clinical features of eyes with type 3 MNV at baseline and during follow-up with anti-vascular endothelial growth factor treatment and an as-needed regimen were compared according to the degenerative features of fellow eyes. RESULTS: Eighteen patients (32.7%) had GA in fellow eyes; initial disease manifestations of type 3 MNV eyes including stage, best-corrected visual acuity, and choroidal thickness (CT) did not vary between groups (all P > 0.05). During follow-up, a rate of complete fluid resolution after three monthly loading injections was not associated with GA in fellow eyes (P = 0.703), while a lower rate of early recurrence within 3 months after loading treatment was associated with thinner CT in type 3 MNV eyes and GA over one disc area in fellow eyes (P = 0.025 and P = 0.021). CONCLUSION: Degenerative features of fellow eyes in patients with unilateral type 3 MNV may be associated with the clinical characteristics of affected eyes.
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Neovascularización Coroidal , Atrofia Geográfica , Degeneración Macular Húmeda , Humanos , Inhibidores de la Angiogénesis/uso terapéutico , Estudios Retrospectivos , Neovascularización Coroidal/diagnóstico , Neovascularización Coroidal/tratamiento farmacológico , Angiografía con Fluoresceína , Tomografía de Coherencia Óptica/métodos , Atrofia/complicaciones , Atrofia/tratamiento farmacológico , Degeneración Macular Húmeda/tratamiento farmacológicoRESUMEN
PURPOSE: We evaluated the relationship between macular fluorescein leakage and retinal nerve fiber layer (RNFL) schisis and investigated the visual prognostic values after pars plana vitrectomy (PPV) and idiopathic epiretinal membrane removal. METHODS: We analyzed the correlations between preoperative optical coherence tomography (OCT) parameters and macular leakage. The final best-corrected visual acuity and central macular thickness were compared according to the presence or absence of macular leakage and RNFL schisis. RESULTS: In 80 eyes with idiopathic epiretinal membrane treated with PPV and membrane peeling, preoperative macular leakage was associated with the presence of preoperative RNFL schisis and inner nuclear layer microcysts. Eyes with both macular leakage and RNFL schisis showed worse postoperative best-corrected visual acuity than those without both factors. CONCLUSION: In the presence of macular fluorescein leakage and RNFL schisis, postoperative best-corrected visual acuity is worse, and improvements in the central macular thickness are greater than those in the absence of both factors.
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Membrana Epirretinal , Humanos , Membrana Epirretinal/diagnóstico , Membrana Epirretinal/cirugía , Agudeza Visual , Estudios Retrospectivos , Vitrectomía/métodos , Tomografía de Coherencia Óptica/métodos , Fibras Nerviosas , FluoresceínasRESUMEN
PURPOSE: To investigate the effect of the foveal Müller cell cone structure on the anatomical and functional response to intravitreal bevacizumab treatment in patients with diabetic macular edema. METHODS: In 93 treatment-naive eyes with center-involved cystic type diabetic macular edema, spectral-domain optical coherence tomography scans of baseline were retrospectively evaluated to determine the foveal Müller cell cone structure and prognostic features including length of disorganization in the retinal inner layers and ellipsoid zone disruption. The area and circularity of the foveal avascular zone of the superficial and deep capillary plexus 1 month after intravitreal bevacizumab treatment were evaluated using optical coherence tomography angiography. RESULTS: Destruction of the foveal Müller cell cone structure and a large foveal avascular zone in the deep capillary plexus (mm2) correlated strongly with a poor anatomical response (CST > 250 µm) at 1 month after first intravitreal bevacizumab (Exp [B] = 29.444, P = 0.002 and Exp [B] = 12.419, P = 0.013, respectively). A destroyed Müller cell cone structure (P = 0.008) and length of ellipsoid zone disruption (P < 0.001) at baseline were associated with poor visual acuity at 1 month after the first intravitreal bevacizumab. CONCLUSION: The foveal Müller cell cone structure correlates with the response to initial antivascular endothelial growth factor treatment.
Asunto(s)
Bevacizumab/administración & dosificación , Retinopatía Diabética/tratamiento farmacológico , Células Ependimogliales/patología , Angiografía con Fluoresceína/métodos , Fóvea Central/diagnóstico por imagen , Edema Macular/tratamiento farmacológico , Agudeza Visual , Inhibidores de la Angiogénesis/administración & dosificación , Retinopatía Diabética/complicaciones , Retinopatía Diabética/diagnóstico , Células Ependimogliales/efectos de los fármacos , Femenino , Fóvea Central/efectos de los fármacos , Fondo de Ojo , Humanos , Inyecciones Intravítreas , Edema Macular/diagnóstico , Edema Macular/etiología , Masculino , Persona de Mediana Edad , Pronóstico , Receptores de Factores de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodosRESUMEN
PURPOSE: To evaluate the morphologic features of macular neovascularization (MNV) trunks at different layers using optical coherence tomography angiography. METHODS: Type 1 MNV trunks in age-related macular degeneration were retrospectively evaluated at the subretinal pigment epithelium and sub-Bruch membrane (subBM) layers. The detectability and location of the trunks were compared. MNV trunks at the subBM layer on optical coherence tomography angiography B-scans were evaluated using a flow overlay. The correlations of the MNV trunk with optical coherence tomography angiography and optical coherence tomography parameters were evaluated. RESULTS: Among the 63 included eyes, 27 showed core vessels at the subretinal pigment epithelium layer and 52 showed MNV trunks at the subBM layer, which were connected with the MNV at the subretinal pigment epithelium layer. The locations of the MNV trunks in each layer were different. MNV trunk types at the subBM layer were related to disease duration, distance from the large choroidal vessels, and MNV vessel density. The large choroidal vessel diameter was correlated with the MNV trunk diameter at the subBM layer. CONCLUSION: Macular neovascularization trunks at the subBM layer were detected more frequently than distal MNV trunks at the subretinal pigment epithelium layer. Macular neovascularization trunk features at the subBM layer may be related to disease duration and a large choroidal vessel.
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Neovascularización Coroidal/diagnóstico , Angiografía por Tomografía Computarizada , Neovascularización Retiniana/diagnóstico , Tomografía de Coherencia Óptica , Degeneración Macular Húmeda/diagnóstico , Anciano , Anciano de 80 o más Años , Lámina Basal de la Coroides/patología , Coroides/irrigación sanguínea , Neovascularización Coroidal/fisiopatología , Femenino , Humanos , Masculino , Neovascularización Retiniana/fisiopatología , Epitelio Pigmentado de la Retina/patología , Vasos Retinianos/patología , Estudios Retrospectivos , Degeneración Macular Húmeda/fisiopatologíaRESUMEN
BACKGROUND: We sought to investigate the chorioretinal thickness and retinal pigment epithelial (RPE) degenerative features of eyes with early age-related macular degeneration (AMD) and subretinal drusenoid deposits (SDDs) according to the presence of macular neovascularization (MNV) in the fellow eyes. METHODS: We classified 70 eyes into two groups of 47 eyes with non-neovascular AMD and 23 eyes with neovascular AMD, respectively, according to the presence of MNV in the fellow eyes. The mean macular retinal, ganglion cell-inner plexiform layer (GCIPL), and choroidal thickness values and RPE features of the 6-mm-diameter zone were compared. RPE degeneration was defined as a lesion with an incomplete RPE and outer retinal atrophy (iRORA) or attenuated RPE reflectivity with diffuse basal laminar deposits, which was defined as when the eye showed an attenuated RPE line with granular features and mixed reflectivity in combination with sub-RPE deposits with a lesion ≥ 1,000 µm in length. RESULTS: Mean retinal, GCIPL, and choroidal thickness values (286.69 ± 15.02 µm, 64.36 ± 4.21 µm, and 156.11 ± 33.10 µm) of the neovascular AMD group were greater than those (278.61 ± 13.96 µm, 61.44 ± 4.63 µm, and 133.59 ± 34.33 µm) of the non-neovascular AMD group (all P < 0.05). RPE degeneration was more prevalent in the neovascular AMD group (65.2%) than the non-neovascular AMD group (38.3%; P = 0.034). Greater mean GCIPL and choroidal thickness values and the presence of RPE degeneration were associated with type 3 MNV in fellow eyes (all P < 0.05). CONCLUSIONS: Different degenerative features according to MNV in fellow eyes of patients with AMD and SDDs suggest that variable degenerative features might be present during disease progression and have an association with the phenotype.
Asunto(s)
Neovascularización Coroidal , Degeneración Macular , Coroides/patología , Neovascularización Coroidal/complicaciones , Neovascularización Coroidal/diagnóstico , Angiografía con Fluoresceína , Humanos , Degeneración Macular/complicaciones , Degeneración Macular/diagnóstico , Degeneración Macular/patología , Epitelio Pigmentado de la Retina/patología , Pigmentos Retinianos , Estudios Retrospectivos , Tomografía de Coherencia ÓpticaRESUMEN
PURPOSE: We sought to investigate the ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with nonexudative age-related macular degeneration. METHODS: We classified eyes into four categories-pachydrusen, soft drusen, subretinal drusenoid deposit (SDD), and soft drusen with SDD-and compared the baseline mean macular GCIPL thickness according to the Early Treatment Diabetic Retinopathy Study grid and its change between groups. RESULTS: We classified 53, 29, 36, and 34 eyes into the four categories, respectively. The mean GCIPL thickness values in the 3-mm area were 82.61 ± 9.54 µm for the pachydrusen group, 79.11 ± 10.26 µm for the soft drusen group, 77.72 ± 6.04 µm for the SDD group, and 71.63 ± 8.69 µm for the soft drusen with SDD group (P < 0.001). The soft drusen with the SDD group showed a greater change in GCIPL thickness (-2.50 ± 0.29 µm/year) in the 3-mm area as compared with the pachydrusen group (-0.18 ± 0.35 µm/year), soft drusen group (-0.55 ± 0.36 µm/year), and SDD group (-0.55 ± 0.37) (all P < 0.001). CONCLUSION: The GCIPL thickness varied according to the type of nonexudative age-related macular degeneration. The thinner baseline GCIPL and its greater change in eyes with soft drusen with SDD may suggest that these eyes are experiencing more prominent neuroretinal degeneration in the central 3-mm area than those in the other groups.
Asunto(s)
Angiografía con Fluoresceína/métodos , Degeneración Macular/diagnóstico , Drusas Retinianas/diagnóstico , Células Ganglionares de la Retina/patología , Segmento Interno de las Células Fotorreceptoras Retinianas/patología , Tomografía de Coherencia Óptica/métodos , Anciano , Femenino , Estudios de Seguimiento , Fondo de Ojo , Humanos , Degeneración Macular/complicaciones , Masculino , Drusas Retinianas/etiología , Estudios RetrospectivosRESUMEN
PURPOSE: We investigated macular and peripapillary choroidal thickness (CT) and flow voids in the choriocapillaris in eyes with nonexudative age-related macular degeneration. METHODS: We retrospectively reviewed the medical records of patients with nonexudative age-related macular degeneration and classified their eyes into three categories: pachydrusen, drusen, and subretinal drusenoid deposit. Mean macular and peripapillary CT and choriocapillaris flow void area were compared among the three groups. RESULTS: The three groups included 29, 33, and 33 patients, respectively. The mean macular and peripapillary CT findings were 260.64 ± 75.85 µm and 134.47 ± 46.28 µm for the pachydrusen group; 163.63 ± 64.08 µm and 93.47 ± 39.07 µm for the drusen group; and 95.33 ± 28.87 µm and 56.06 ± 11.64 µm for the subretinal drusenoid deposit group (all, P < 0.001). Mean macular and peripapillary flow void area varied among the subretinal drusenoid deposit group (57.07 ± 6.16% and 55.38 ± 6.65%), drusen group (58.30 ± 6.98% and 49.11 ± 9.11%) and pachydrusen group (50.09 ± 5.77% and 45.47 ± 8.06%) (all P < 0.001). CONCLUSION: The peripapillary CT and flow voids in the choriocapillaris varied according to the features of drusen in nonexudative age-related macular degeneration eyes. Greater flow voids and thinner CT in eyes with subretinal drusenoid deposits may suggest that these eyes have diffuse choroidal abnormalities both in and outside the macula.
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Coroides/irrigación sanguínea , Coroides/patología , Atrofia Geográfica/fisiopatología , Drusas Retinianas/fisiopatología , Anciano , Anciano de 80 o más Años , Femenino , Angiografía con Fluoresceína , Atrofia Geográfica/diagnóstico , Humanos , Mácula Lútea/irrigación sanguínea , Masculino , Persona de Mediana Edad , Disco Óptico/irrigación sanguínea , Drusas Retinianas/diagnóstico , Estudios Retrospectivos , Tomografía de Coherencia ÓpticaRESUMEN
PURPOSE: To investigate the features of the retinal pigment epithelium (RPE) on optical coherence tomography in eyes with early age-related macular degeneration with subretinal drusenoid deposit. METHODS: We classified the eyes into three types: nonundulating RPE, undulating RPE, and wedge-shaped RPE. We compared the retinal vessel densities, retinal thickness, and choroidal thickness of a 3-mm-diameter zone. RESULTS: We classified 33, 27, and 20 as nonundulating RPE, undulating RPE, and wedge-shaped RPE eyes, respectively. The vascular densities of the superficial and deep capillary plexus showed differences; nonundulating RPE group (23.93 ± 2.26% and 23.54 ± 1.78%), undulating RPE group (22.29 ± 2.80% and 21.94 ± 2.42%), and wedge-shaped RPE group (21.93 ± 2.70% and 20.63 ± 2.42%, P = 0.010 and P < 0.001). The mean retinal thickness and choroidal thickness were also different, nonundulating RPE group (298.26 ± 13.81 µm and 180.08 ± 55.49 µm), undulating RPE group (285.29 ± 21.88 µm and 148.45 ± 55.08 µm), and wedge-shaped RPE group (274.86 ± 20.62 µm and 135.75 ± 39.77 µm) (P = 0.001 and P = 0.007). CONCLUSION: Altered features of the RPE on optical coherence tomography may indicate advancement in disease and be part of an overall degeneration process in these eyes.
Asunto(s)
Coroides/patología , Drusas Retinianas/diagnóstico , Epitelio Pigmentado de la Retina/patología , Vasos Retinianos/patología , Agudeza Visual , Degeneración Macular Húmeda/diagnóstico , Anciano , Femenino , Angiografía con Fluoresceína/métodos , Estudios de Seguimiento , Fondo de Ojo , Humanos , Masculino , Oftalmoscopía/métodos , Drusas Retinianas/etiología , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Degeneración Macular Húmeda/complicacionesRESUMEN
PURPOSE: To investigate the features of the choriocapillaris using four different optical coherence tomography angiography (OCTA) devices. METHODS: OCTA images of the choriocapillaris from consecutive healthy subjects were obtained with four different OCTA devices (Zeiss PLEX Elite, Topcon DRI OCT-1 Atlantis, Zeiss AngioPlex, and Heidelberg Spectralis OCTA). The 3 × 3 mm OCTA images were processed with ImageJ. The mean vascular density and mean flow void area of the choriocapillaris were compared among devices. Flow voids were analyzed with two different imaging adjustment methods, auto-local threshold with the Phansalkar method and a method using a device-specific threshold value. RESULTS: The mean vascular density of the choriocapillaris differed among the four devices (all P < 0.001). The mean flow void area as measured with the auto-local threshold method also differed among devices (P < 0.001) and was not correlated among devices (all P > 0.05). Results for mean flow void area measured with a device-specific threshold value using the Plex-Elite and DRI OCT-1 Atlantis were correlated (ß = 2.271, P < 0.001), but there were no correlations among other devices (P > 0.05). For the Plex-Elite and DRI OCT-1 Atlantis, the mean flow void area was positively correlated between the two image adjustment methods (all P < 0.05). CONCLUSIONS: Vascular densities and flow void areas of the choriocapillaris varied according to the device used and the image adjustment method. The characteristics of different devices and the image adjustment method should be considered for analysis of the choriocapillaris.
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Coroides/irrigación sanguínea , Angiografía con Fluoresceína/instrumentación , Vasos Retinianos/diagnóstico por imagen , Tomografía de Coherencia Óptica/instrumentación , Adulto , Diseño de Equipo , Femenino , Estudios de Seguimiento , Fondo de Ojo , Voluntarios Sanos , Humanos , Masculino , Estudios Prospectivos , Valores de Referencia , Reproducibilidad de los ResultadosRESUMEN
PURPOSE: To investigate the effects of anti-vascular endothelial growth factor (anti-VEGF) on the peripapillary choroid and choriocapillaris in eyes with neovascular age-related macular degeneration (nAMD). METHODS: We included consecutive patients who underwent three monthly intravitreal injections of aflibercept or ranibizumab for nAMD, followed by swept-source optical-coherence tomography angiography (SS-OCTA). Peripapillary choroidal thickness (CT) and vascular density (VD) of the peripapillary choriocapillaris were measured in SS-OCT and OCTA images at baseline and at 1 month after three monthly injections of anti-VEGF. RESULTS: In 68 eyes of 68 patients with nAMD, peripapillary CT decreased from 124.5 ± 69.9 µm to 116.5 ± 68.2 µm (P = 0.003) after three monthly intravitreal injections of anti-VEGF. The mean vascular density (VD) of the peripapillary choriocapillaris also decreased from 73.99 ± 6.33 to 71.82 ± 6.51 (P < 0.001). The change in the peripapillary choriocapillaris VD was significantly affected by baseline peripapillary choriocapillaris VD, baseline peripapillary CT, and type of nAMD (P = 0.004, P = 0.028, P = 0.015, respectively). The baseline VD of the choriocapillaris was lower in non-responders (median, 70.63; 25-75%, 68.12-71.27) than in responders (median, 75.32; 25-75%, 70.09-79.96) (P = 0.032). CONCLUSION: These results suggest that anti-VEGF injection influences the peripapillary choriocapillaris flow out of exudative lesions, and that its effects depend on the baseline status of the choroid and choriocapillaris.
Asunto(s)
Capilares/patología , Coroides/irrigación sanguínea , Angiografía con Fluoresceína/métodos , Ranibizumab/administración & dosificación , Receptores de Factores de Crecimiento Endotelial Vascular/administración & dosificación , Proteínas Recombinantes de Fusión/administración & dosificación , Tomografía de Coherencia Óptica/métodos , Degeneración Macular Húmeda/tratamiento farmacológico , Anciano , Inhibidores de la Angiogénesis/administración & dosificación , Femenino , Estudios de Seguimiento , Fondo de Ojo , Humanos , Masculino , Disco Óptico/irrigación sanguínea , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Agudeza Visual , Degeneración Macular Húmeda/diagnósticoRESUMEN
PURPOSE: The purpose of the study is to investigate the characteristics of choriocapillaris flow based on the underlying choroidal vasculature in fellow eyes with central serous chorioretinopathy (CSC). METHODS: We included 57 patients with CSC and normal controls. Characteristics of choriocapillaris flow were evaluated using swept-source optical coherence tomography (OCT) angiography. We divided the choroidal layer into the vascular and stromal beds according to the choroid vessels on en-face OCT images. We compared the flow void area and mean vascular density of the choriocapillaris according to the underlying choroidal beds in the CSC and control group. RESULTS: The mean vascular density of the choriocapillaris in the CSC group was not different from that of the control group (P = 0.289). The flow void area was more frequently found in the CSC group (59.6%) than in the control group (29.8%, P = 0.002). The presence of the flow void area in the CSC group was associated with greater macular choroidal thickness (P = 0.004). In the CSC group, the mean flow void area and ratio of the choriocapillaris over the vascular bed were larger than those over the stromal bed (all P < 0.001). CONCLUSIONS: The location of the flow void area of the choriocapillaris was associated with the distribution of the underlying choroidal vessels. This suggests that the underlying choroidal vessels may affect choriocapillaris perfusion in pachychoroid eyes.
Asunto(s)
Capilares/fisiopatología , Coriorretinopatía Serosa Central/diagnóstico , Coroides/irrigación sanguínea , Angiografía con Fluoresceína/métodos , Microcirculación/fisiología , Flujo Sanguíneo Regional/fisiología , Tomografía de Coherencia Óptica/métodos , Enfermedad Aguda , Adulto , Capilares/patología , Coriorretinopatía Serosa Central/fisiopatología , Femenino , Estudios de Seguimiento , Fondo de Ojo , Humanos , Masculino , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Agudeza VisualRESUMEN
PURPOSE: To investigate ocular perfusion pressure (OPP) in patients with central serous chorioretinopathy (CSC) and pigment epitheliopathy (PE). METHODS: In this retrospective study, we included patients with acute idiopathic unilateral CSC and age- and sex-matched normal controls. The patients with CSC were classified into two groups according to the PE presence on their fellow eyes. We compared OPP among CSC patients with or without PE and normal controls. RESULTS: Among a total of 47 patients with CSC, 21 were classified into the PE group and 26 into the non-PE group. The mean OPP (±SD) of CSC and fellow eyes in the PE group (50.02 ± 4.98 and 50.83 ± 4.12 mmHg, respectively) was greater than that in the non-PE group (43.69 ± 6.88 and 44.0 ± 6.57 mmHg, respectively) and normal controls (45.64 ± 8.73 mmHg) (all, P < 0.05). The mean macular choroidal thickness of CSC and fellow eyes in the PE group (344.4 ± 31.8 and 310.1 ± 37.0 µm, respectively) was thicker than that in the non-PE group (318.5 ± 43.8 and 282.8 ± 36.1 µm, respectively) (all, P < 0.05). Greater macular choroidal thickness and higher OPP were associated with PE (P = 0.002 and P = 0.003). CONCLUSION: Forty-five percent of the patients with acute unilateral CSC had PE in their fellow eyes. Increased OPP may influence the development of bilateral CSC characteristics.
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Velocidad del Flujo Sanguíneo/fisiología , Presión Sanguínea/fisiología , Coriorretinopatía Serosa Central/fisiopatología , Coroides/patología , Presión Intraocular/fisiología , Epitelio Pigmentado de la Retina/patología , Vasos Retinianos/fisiopatología , Adulto , Coriorretinopatía Serosa Central/diagnóstico , Coroides/irrigación sanguínea , Femenino , Angiografía con Fluoresceína , Estudios de Seguimiento , Fondo de Ojo , Humanos , Mácula Lútea/patología , Masculino , Flujo Sanguíneo Regional/fisiología , Vasos Retinianos/diagnóstico por imagen , Estudios Retrospectivos , Tomografía de Coherencia Óptica , Agudeza VisualRESUMEN
BACKGROUND: To investigate the characteristics of retinal vessels and retinal thickness in eyes with early age-related macular degeneration (AMD) with or without reticular pseudodrusen. METHODS: We retrospectively evaluated the clinical history and optical coherence tomography (OCT) and OCT angiography images of consecutive patients with early AMD. We calculated the retinal vessel densities of the superficial and deep capillary plexus with the ImageJ software (National Institutes of Health, Bethesda, MD, USA) and investigated the relationship with mean retinal thickness and subfoveal choroidal thickness. RESULTS: We included 135 early AMD eyes and classified 60 of them into a reticular pseudodrusen group and 75 into a non-reticular pseudodrusen group. The vascular densities of the superficial and deep capillary plexus in the reticular pseudodrusen group (32.35% ± 3.67 and 26.71% ± 2.88%) were not different from those of the non-reticular pseudodrusen group (33.18% ± 2.2% and % 27.43 ± 1.79%; P = 0.546 and P = 0.318, respectively). The retinal thickness of the reticular pseudodrusen group (287.31 µm ± 24.36 µm) did not differ from that of the non-reticular pseudodrusen group (294.27 µm ± 20.71 µm; P = 0.493), while subfoveal choroidal thickness in the reticular pseudodrusen group (158.13 µm ± 42.53 µm) was lower than that in the non-reticular pseudodrusen group (237.89 µm ± 60.94 µm; P < 0.001). Multivariate analysis revealed that lower vascular density of the superficial capillary plexus and subfoveal choroidal thickness were associated with retinal thinning in reticular pseudodrusen group (P = 0.003 and P = 0.036) and older age was associated with retinal thickness in the non-reticular pseudodrusen group (P = 0.005). CONCLUSIONS: Retinal thinning in early AMD patients with reticular pseudodrusen was accompanied by choroidal and retinal vascular loss, which suggests a possible linkage of retinal thinning with vascular alterations.
Asunto(s)
Coroides/patología , Flujo Sanguíneo Regional/fisiología , Retina/fisiopatología , Drusas Retinianas/complicaciones , Degeneración Macular Húmeda/fisiopatología , Anciano , Femenino , Angiografía con Fluoresceína , Estudios de Seguimiento , Fondo de Ojo , Humanos , Masculino , Retina/diagnóstico por imagen , Drusas Retinianas/diagnóstico , Drusas Retinianas/fisiopatología , Estudios Retrospectivos , Factores de Tiempo , Tomografía de Coherencia Óptica/métodos , Degeneración Macular Húmeda/complicaciones , Degeneración Macular Húmeda/diagnósticoRESUMEN
PURPOSE: The purpose of our study was to investigate characteristics of retinal vessels in eyes with surgically closed macular holes (MH). METHODS: We included patients who underwent surgery for idiopathic MH and a follow-up examination using optical coherence tomography angiography (OCTA). The area of the foveal avascular zone (FAZ) and retinal vascular densities of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were calculated on the postoperative OCTA images and compared with those of age-matched normal controls. RESULTS: Twenty-eight patients with MH and 28 controls were included. Mean postoperative FAZ areas of SCP and DCP (0.317 ± 0.129 mm2 and 0.500 ± 0.174 mm2) were smaller than those of normal controls (0.406 ± 0.131 mm2 and 0.687 ± 0.147 mm2) (P = 0.013 and P < 0.001, respectively). Retinal vascular densities of SCP and DCP in the MH group (32.23 ± 1.45% and 31.85 ± 1.28%) were lower than those of the control group (33.26 ± 1.71% and 33.18 ± 1.89%) (P = 0.019 and P = 0.003, respectively). The retinal vascular densities of SCP and DCP were associated with postoperative mean ganglion cell-inner plexiform layer (GC-IPL) thickness (P = 0.033 and P = 0.035, respectively). The vascular densities were horizontally asymmetric and related to asymmetric distribution of GC-IPL thickness in the MH group. CONCLUSIONS: Surgically closed MH eyes had remodeled retinal vascular patterns, which were related to morphologic changes in the inner retinal layer. The healing process after MH surgery may be involved in asymmetric change in anatomy and hemodynamics of the inner retina.
Asunto(s)
Angiografía con Fluoresceína/métodos , Fóvea Central/irrigación sanguínea , Mácula Lútea/patología , Perforaciones de la Retina/diagnóstico , Vasos Retinianos/diagnóstico por imagen , Agudeza Visual , Vitrectomía/métodos , Anciano , Capilares/patología , Femenino , Fondo de Ojo , Humanos , Masculino , Periodo Posoperatorio , Perforaciones de la Retina/cirugía , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodosRESUMEN
PURPOSE: To evaluate the effect of photobleaching on fundus autofluorescence (FAF) images in acute central serous chorioretinopathy. METHODS: We obtained prephotobleaching and postphotobleaching images using an Optomap 200Tx, and photobleaching was induced with a Heidelberg Retina Angiograph 2. Degrees of photobleaching were assessed as grayscale values in Optomap images. Concordances among the three kinds of images were analyzed. Hyper-AF lesions in prephotobleaching images were classified as Type 1 (changed to normal-AF after photobleaching) and Type 2 (unchanged after photobleaching). The FAF composite patterns of central serous chorioretinopathy lesions were classified as diffuse or mottled. Initial and final best-corrected visual acuity, central retinal thickness, and disease duration were compared according to fovea FAF type. RESULTS: Forty-one eyes of 41 patients were analyzed. The lesion brightness of postphotobleaching Optomap FAF showed greater concordance with Heidelberg Retina Angiograph 2 FAF (94.74%) than the prephotobleaching Optomap FAF (80.49%). Eyes with Type 1 fovea had greater initial and final best-corrected visual acuity (20/23 vs. 20/41, 20/21 vs. 20/32, P < 0.0001, P = 0.001, respectively) and shorter disease duration (19.68 ± 12.98 vs. 51.55 ± 44.98 days, P = 0.043) than those with Type 2 fovea. However, eyes with diffuse Type 2 fovea had only lower initial and final best-corrected visual acuity (20/23 vs. 20/45, 20/21 vs. 20/36, P < 0.0001, P < 0.0001, respectively) than those with Type 1 fovea. CONCLUSION: Understanding the photobleaching effect is necessary for the accurate interpretation of FAF images. Furthermore, comparing prephotobleaching and postphotobleaching FAF images may be helpful for estimation of lesion status in central serous chorioretinopathy.
Asunto(s)
Coriorretinopatía Serosa Central/diagnóstico por imagen , Imagen Óptica , Retina/patología , Pigmentos Retinianos/efectos de la radiación , Enfermedad Aguda , Adulto , Coriorretinopatía Serosa Central/fisiopatología , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Luz , Masculino , Persona de Mediana Edad , Fotobiología , Estudios Retrospectivos , Tomografía de Coherencia Óptica , Agudeza Visual/fisiologíaRESUMEN
The aim of this study was to evaluate the relationship between the expression of proinflammatory cytokines and the apoptosis of corneal endothelial cells after argon laser iridotomy (ALI). ALI was performed on each quadrant of the iris in the right eye of mice (ALI1 group). Left eyes were used as control group. The levels of interleukin (IL)-1ß, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-ß, and interferon (IFN)-γ in mice eyes were measured, and TUNEL staining was performed 12 h after ALI. Mice in the ALI-Dexa group were pretreated daily with an intraperitoneal injection of dexamethasone for 4 days before undergoing ALI and compared with mice without dexamethasone pretreatment (ALI2 group). Twelve corneas from six rabbits were incubated ex vivo with (n = 6) or without (n = 6) IL-1ß. TUNEL staining was performed 24 h after ex vivo incubation. In the mice experiment, the levels of IL-1ß, TNF-α, TGF-ß, and IFN-γ were increased in the ALI1 group compared to the control group. Although many TUNEL-positive cells were observed in the ALI1 group, those were not detected in the control group. Dexamethasone pretreatment inhibited the increase in the levels of all four proinflammatory cytokines and reduced TUNEL-positive cells. In the rabbit experiment, TUNEL-positive cells were increased in the incubated corneas with IL-1ß compared to those without IL-1ß. Expression of proinflammatory cytokines following ALI seems to play a role in the apoptosis of corneal endothelial cells after ALI. Dexamethasone pretreatment inhibited increases in proinflammatory cytokines and reduced the apoptosis of corneal endothelial cells.
Asunto(s)
Apoptosis/fisiología , Pérdida de Celulas Endoteliales de la Córnea/metabolismo , Citocinas/metabolismo , Endotelio Corneal/metabolismo , Iris/cirugía , Terapia por Láser/efectos adversos , Procedimientos Quirúrgicos Oftalmológicos/efectos adversos , Animales , Western Blotting , Células Cultivadas , Pérdida de Celulas Endoteliales de la Córnea/etiología , Pérdida de Celulas Endoteliales de la Córnea/patología , Modelos Animales de Enfermedad , Endotelio Corneal/patología , Inmunohistoquímica , Etiquetado Corte-Fin in Situ , Láseres de Gas/uso terapéutico , Ratones , Ratones Endogámicos C57BL , ConejosRESUMEN
PURPOSE: The purpose of this study was to investigate peripapillary and macular choroidal thickness (CT) in patients with early age-related macular degeneration (AMD) with or without reticular pseudodrusen (RPD). METHODS: We investigated the medical records of 89 patients (89 eyes) with early AMD. The eyes were grouped into three categories according to the extent of RPD: no RPD, localized RPD, and diffuse RPD. Peripapillary and macular CT were measured with images obtained by spectral domain optical coherence tomography. CT in the peripapillary and macular areas was compared among groups. RESULTS: Both RPD groups exhibited an older subject age and a greater female predominance compared to the non-RPD group (P = 0.007 and P = 0.030, respectively). Macular and peripapillary CT were different among the three groups (all, P < 0.001), and both RPD groups showed a thinner choroid in all areas compared to the non-RPD group after adjusting for age and sex (all, P ≤ 0.016). Temporal peripapillary and nasal macular CT at 500 µm and 1500 µm, respectively, from the fovea in eyes with diffuse RPD were significantly thinner than that in eyes with localized RPD (P = 0.008, P = 0.016 and P < 0.001, respectively). CONCLUSIONS: In addition to the macular area, the peripapillary CT, including the area outside the macula, was thinner in eyes with RPD than in those without RPD. Significant differences in the papillomacular choroid were observed based on RPD distribution type, which suggests that variation in CT is based on the extent of RPD.