Assessment of the retinal and choroidal microvascularization in polycystic ovary syndrome: an optical coherence tomography angiography study.

PURPOSE: To examine the retinal, peripapillary, choroidal microvascularization and the choroid thickness (CT) of the patients with polycystic ovary syndrome (PCOS) using optical coherence tomography angiography (OCT-A) and compare the results to measurements obtained from healthy controls. METHODS: In total, 47 eyes of 47 patients recently diagnosed with PCOS and 47 eyes of 47 age-matched healthy women were included in this study. An RT XR Avanti instrument with AngioVue software was used for the OCT-A imaging using 6 × 6 mm macular and 4.5 × 4.5 mm optic nerve head scans. Quantitative vessel density results of superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillaries (RPC); flow area and flow density of choriocapillaris; and foveal avascular zone (FAZ) area were analyzed. CT was evaluated by using the measurements obtained from the subfoveolar area. RESULTS: No significant differences were detected between the groups for any of vessel density results for the SCP, DCP, and RPC as well as the FAZ area. The difference in the choriocapillaris flow area and flow density between the groups was not statistically significant. The choroid was significantly thicker in women with PCOS than in the healthy group (p = 0.002). CONCLUSION: Retinal and choroidal microvascularization was comparable between the women who were evaluated early after diagnosed with PCOS and age-matched healthy controls. Choroid was found thicker in patients with PCOS than in healthy women. OCT-A, as a new and noninvasive imaging method, may help in understanding the effect of PCOS on the posterior segment of the eye.

Macula halo syndrome.

INTRODUCTION: Niemann-Pick disease (NPD) is a hereditary lysosomal storage disorder in which mutations in the sphingomyelin phosphodiesterase gene leads to partial or complete deficiency of the sphingomyelinase enzyme. Niemann-Pick Type B is the intermediate form associated with hepatosplenomegaly, foam cells in the bone marrow, hyperlipidemia and diffuse pulmonary infiltrates, which is generally diagnosed in late adolescence. Central nervous system is not affected, and some cases may display macular halo. CASE: A 45-year-old female seen in ophthalmology clinic for the examination of the eyes. Extraocular motility was normal bilaterally, and the visual acuity was 20/25 for both eyes. Biomicroscopic examination revealed faint corneal haze bilaterally, Circular pale granular depositions were detected in the parafoveal retina on both eyes. Optical coherence tomography (OCT) revealed thin hyperreflective band corresponding to depositions located in the parafoveolar inner retina. Microperimeter showed slight depression in retinal sensitivity, which was more pronounced particularly on perifovea rather than parafovea. CONCLUSIONS: Challenge to identify the NPD subtype of this case is associated with phenotypic characteristics on a wider spectrum that overlap the currently described subtypes.

Assessment of vascular leakage and its development with FFA among patients treated with intravitreal anti-VEGF due to aggressive posterior ROP.

OBJECTIVE: Evaluation of vascular leakage and retinal vascular development with fundus fluorescein angiography for infants diagnosed with aggressive posterior retinopathy of prematurity who underwent intravitreal anti-VEGF treatment. METHOD: Medical recordings of 30 patients who received RetCam fluorescein angiography during follow-up and had been treated with anti-VEGF on diagnosis of aggressive posterior ROP in the zone I or zone II between the dates of April 2014-January 2017 were evaluated retrospectively. RESULTS: Fifty-nine eyes of 30 patients were included in the study. Mean birth weight was 1145 g; gestation week was 28.4. Recurrence occurred in 30.5% of the patients, and 10.1% of them were given a second dose of injection of anti-VEGF. Leakage was detected in 15.3% of the eyes during angiography, and all of these eyes were treated with laser photocoagulation. Evaluation of vascular development revealed that in the temporal, complete retinal vascular development was achieved in only 8% of the eyes. It was detected that complete retinal vascularization was not observed in any of the cases which were given second dose of injection due to recurrence. The patients were distributed into groups according to postmenstrual week taken to angiography as 32 eyes of 16 patients in group 1, 17 eyes of 9 patients in group 2 and 10 eyes of 5 patients in group 3. The vascular leakage rate of group 3 patients was statistically significantly higher (p < 0.05) and vascular development between groups was not statistically significant (p > 0.05). DISCUSSION: With the initiation of FFA usage in pediatric cases, especially treated with anti-VEGF due to retinopathy of prematurity (ROP), more findings (vascular arrest, leakage, and abnormalities, etc.) are obtained than those achieved via ophthalmoscopic examination. In the light of these findings, early intervention with laser photocoagulation in early stages becomes possible enabling prevention of possible blindness.

Comparison of fluorescein angiographic findings in type 1 and type 2 retinopathy of prematurity with intravitreal bevacizumab monotherapy and spontaneous regression.

PURPOSE: To investigate the extent of vascularization of the peripheral retina and vascular development patterns in patients with type 1 retinopathy of prematurity (ROP) treated with intravitreal injection of bevacizumab (IVB) and compare fluorescein angiography (FA) findings of them to those seen in patients with type 2 ROP who have recovered spontaneously. METHODS: Between May 2014 and September 2016, patients with type 1 ROP who had a single 0.025 ml (0.625 mg) IVB were evaluated as study group. On the other hand, type 2 ROP patients with stage 2 or stage 3 ROP in zone II without plus disease on indirect ophthalmoscopy were not treated and included as a control group. The progression of ROP and vascularization of retina were evaluated by FA under sedation analgesia in all patients. RESULTS: Sixty-two eyes of 31 premature infants were included in the study: 36 eyes/18 patients were treated for type 1 ROP and 26 eyes/13 patients were followed conservatively with the diagnoses of type 2 ROP. In the last FA examination among the study group, vascular terminal was in zone II in 8 eyes/4 patients (22.22%) and in zone III in 28 eyes/14 patients (77.78%). Vascular terminal was in zone III in all eyes of the control group (100%). We noted circumferential vessels in 12 eyes/8 patients (33.3%) and 7 eyes/5 patients (26.92%) in the study and control groups, respectively. Abnormal branching was noticed in 13 eyes/7 patients (46.42%) in the control group, whereas it was not detected in the study group. Arteriovenous shunts were noted in 1 eye of a patient in the study group and in 5 eyes/4 patients in the control group. In 6 eyes/3 patients among the study group, we performed laser photocoagulation to the avascular retina because of profound vascular leakage. CONCLUSION: Peripheral vascular abnormalities probably occur as a result of ROP itself because similar FA findings were detected both in type 1 and type 2 ROP patients with or without treatment, although significantly less in IVB-treated group. Retinal vascularization usually reaches the farthermost limits with time even though it slows down in eyes treated with IVB, indicating the importance of a longer follow-up.

Correction to: Assessment of vascular leakage and its development with FFA among patients treated with intravitreal anti-VEGF due to aggressive posterior ROP.

In the original publication, the authors' affiliations were published incorrectly.

Efficacy of intravitreal aflibercept monotherapy in retinopathy of prematurity evaluated by periodic fluorescence angiography and optical coherence tomography.

PURPOSE: To evaluate the efficacy of intravitreal aflibercept (IVA) in vascular and macular maturation in neonates with type 1 retinopathy of prematurity (ROP) and aggressive posterior retinopathy of prematurity (APROP). MATERIALS AND METHODS: Thirty-six eyes of 18 patients with type 1 ROP or APROP in zone I or posterior zone II were enrolled in our study. At baseline, only fluorescein angiography (FA) was performed. After IVA injection, both FA and optical coherence tomography (OCT) were performed after 6.8 ± 0.8 (range 6-8) and 19 ± 0.9 (range 18-20) weeks to follow vascular and macular changes. RESULTS: Both diffuse flat neovascularization with leakage and abnormal vascular branching at the small arteriolar level were detected in all eyes (100%) at baseline FA. Regression of the disease was observed in 34 eyes (94.4%) in the first week with binocular indirect ophthalmoscopy. Early unresponsiveness in remaining two eyes of an infant required an IVA re-treatment. Late reactivation was detected only in 19.4% of eyes, none of which required treatment during 12 months of follow-up. The most common feature after IVA injection was abnormal branching at capillary level, which was noted in 100% in the first post-injection FA and 50.0% of all eyes in the second FA. Meanwhile, the end limit of vascularization was observed in zone III in 83.3% of eyes. No vascular abnormality was also detected in 27.3% of eyes. The OCT examination at a mean postmenstrual age of 43.4 weeks revealed cystoid macular changes in four eyes of two infants (11.1%), normal foveal contour in 30 eyes of 15 infants (83.3%) and matured ellipsoid zone at the foveal center in 28 eyes of 14 infants (77.8%). Macular maturation was complete in all eyes in the last OCT analyses. CONCLUSION: Intravitreal aflibercept monotherapy has been an effective treatment in type I ROP and APROP with much lower early and late re-treatment rates because of early unresponsiveness and late reactivation, respectively. In most of the eyes, rapid vascular outgrowth beyond zone III together with normal macular maturation was observed more precisely by periodic FA and OCT.

Factors Influencing Stereopsis Outcomes in Adults Following Strabismus Surgery.

Objectives: The aim of the study was to evaluate binocular vision after adult strabismus surgery and to investigate the predictive factors on improvement stereoacuity. Methods: Patients aged upper from 16 years who underwent strabismus surgery in our hospital reviewed retrospectively. Age, existence of amblyopia, pre-operative and postoperatively fusion ability, stereoacuity, and deviation angle were recorded. Patients were divided into two groups according to final stereoacuity; 200 sn/arc and lower: Good stereopsis (Group 1), upper 200 sn/arc: Poor stereopsis (Group 2). Characteristics were compared between groups. Results: A total of 49 patients, who were 16-56 years of age, were included in the study. The mean follow-up time was 37.8 months (range 12-72 months). Of patients, 26 had improvement in stereopsis scores after surgery (53.0%). Group 1 includes 200 sn/arc and lower (n=18, 36.7%) and Group 2 includes higher than 200 sn/arc (n=31, 63.3%). The presence of amblyopia and higher refraction error was frequent significantly in Group 2 (p=0.01 and p=0.02, respectively). The existence of fusion postoperatively was significantly frequent in Group 1 (p=0.02). Type of strabismus and the amount of deviation angle were not found in a relationship with good stereopsis. Conclusion: In adults, surgical correction of horizontal deviation improves stereoacuity. Having no amblyopia, having fusion after surgery, and low refraction error are predictive for the improvement in stereoacuity.

Can optical coherence tomography findings be related with suicide attempt in bipolar disorder?

BACKGROUND: The aim was to investigate the relationship between OCT findings and suicidal behavior (SB) in patients with Bipolar Disorder type 1 (BPD1) in comparison to healthy controls. METHODS: Forty five euthymic BPD1 patients with previous suicide attempts (BPD1+), 46 euthymic BPD1 patients without previous suicide attempts (BPD1-) and 63 healthy controls were included. The subjects were evaluated with Sociodemographic Data Form, SCID, Suicide Behaviors Questionnaire, Beck Depression Inventory, Young Mania Rating Scale and OCT. RESULTS: All OCT measures were lower in patients with BPD1 than healthy controls (p<0.001). While no significant differences were found between (BPD1+) and (BPD1-) in all GCC levels and inferior RNFL values (p>0.05), the superior RNFL and global RNFL values were found to be lower in the (BPD1+) than in the (BPD1-) (p = 0.037, p = 0.028, respectively). Global RNFL was found to significantly predict suicide risk in a multivariate logistic regression model (p = 0.024 Exp(B):0.930). CONCLUSIONS: Neurodegeneration might occur during the course of BPD1 and SB. Decreased RNFL may be important for neurodegeneration related to SB.

Based on the Real-Life Data of Türkiye; Comparison of Anatomical and Functional Outcomes of Phakic and Pseudophakic Patients in Wet Type Age-Related Macular Degeneration.

Objectives: The aim of the study was comparison of wet-type age-related macular degeneration in phakic and pseudophakic patients in terms of anatomical and functional success based on the real-life data of Türkiye. Methods: The multicenter retrospective real-life study data of the. retinal study group were used in this study. Among 867 eyes of 867 patients were included in the study. Patients were divided into two groups according to the status of the lens; phakic group and pseudophakic group. The follow-up period of the two groups, the number of injections at the 1st, 2nd, and 3rd years, and changes in the central macular thickness (CMT, µ) and visual acuity (VA, logMAR) of the patients at the beginning, 6th, 12th, 24th, and 36th months were examined. Results: In our study, the number of injections in the 1st, 2nd, and 3rd years, respectively, was 4.2±2.0, 1.8±1.9, and 1.0±1.7 in the phakic group, and 3.9±2.0, 1.7±1.9, and 0.8±1.4 in the pseudophakic group. When the two groups were compared in terms of the number of injections, there was a statistically significant difference in the 1st year, but there was no significant difference in the 2nd and 3rd years (p=0.001, p=0.350, and p=0.288, respectively). There was no statistically significant difference between the groups in terms of CMT in the baseline, 6th, 12th, 24th, and 36th months (p=0.991, p=0.327, p=0.652, p=0.599, and p=0.873, respectively). Although there was no difference in VA between groups at the beginning (p=0.052), the phakic group showed statistically better VA in controls at 3rd, 6th, 12th, 24th, and 36th months (p=0.001, p=0.001, p=0.000, p=0.000, and p=0.003, respectively). Conclusion: Differences in the number of injections and visual results between phakic and pseudophakic patients in wet type AMD may necessitate the creation of different treatment and follow-up protocols.

Results of anti-VEGF treatment for neovascular AMD in eyes with different baseline visual acuity in Turkish population-based on real life data-Bosphorus retina study group.

BACKGROUND: To investigate the anatomical and visual outcomes of the patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (anti-VEGF), according to the baseline best-corrected visual acuity (BCVA) based on the multicenter real-life data. METHODS: Five-hundred-ninety patients who had taken the Pro Re Nata (PRN) treatment regimen with three loading doses and at least one year of follow-up were included. The patients were divided into three groups according to the baseline BCVA: Group 1 (BCVA ≥ 1.3 Logmar), Group 2 (1.3 Logmar > BCVA ≥ 0.3 Logmar), and Group 3 (BCVA ≤ 0.2 Logmar). BCVA, central macular thickness (CMT), and the number of injections and visits were evaluated. RESULTS: There were 175, 322, and 93 patients in Group 1, Group 2, and Group 3, respectively. The number of visits and injections in the 1st year was not different between the groups (p = 0.58 and p = 0.08) and was 7.09 and 4.41 (Group 1), 6.59 and 5.58 (Group 2), 6.77 and 4.08 (Group 3). There was a significant difference in CMT between the baseline and 12th month in Group 1 and Group 2 (p < 0.001, p < 0.001, respectively) but not in Group 3 (p = 0.84). BCVA was significantly better in the 12th month in Group 1 (p < 0.001), slightly worse in Group 2 (p = 0.79), and significantly worse in Group 3 (p < 0.001). CONCLUSION: This study provides evidence that an inadequate number of injections cannot protect vision. Moreover, it can cause vision loss, especially in the eyes with good vision.

Effect of panretinal photocoagulation on retina and choroid in diabetic retinopathy: An optical coherence tomography angiography study.

BACKGROUND: To analyze the quantitative changes in both macular, and choroidal thickness, and microvascularization after panretinal photocoagulation (PRP) in eyes with proliferative diabetic retinopathy (PDR) or severe non-proliferative diabetic retinopathy (NPDR) by using optical coherence tomography angiography (OCT-A). METHODS: The patients diagnosed with severe NPDR or PDR according to the Early Treatment Diabetic Retinopathy Study (ETDRS) and decided to be treated with PRP were included in this prospective and observational study. Ten eyes of 10 patients with PDR and twelve eyes of 12 patients with severe NPDR were examined. Macular scans (6 × 6 mm) were obtained from OCT-A at baseline and at month 6 after PRP. Subfoveal choroidal thickness (SFCT) measurements that were obtained through the foveolar center on a high-definition line scan were recorded. RESULTS: Best-corrected visual acuity (BCVA) significantly decreased (p = 0.018), central foveal thickness and mean parafoveal thickness significantly increased (p < 0001 and p < 0.001, respectively) six months after PRP. The thickness of all parafoveal retinal quadrants (temporal, superior, nasal, inferior) increased (p = 0.001, p = 0.003, p < 0.001, p < 0.001, respectively) and mean parafoveal, parafoveal temporal, and parafoveal nasal vessel density of the deep capillary plexus (DCP) significantly decreased six months after PRP compared with the baseline values (p = 0.023, p = 0.041, p = 0.018, respectively). CONCLUSIONS: The parafoveal vessel density of DCP decreased significantly 6 months after PRP in eyes with PDR or severe NPDR. While the difference in SFCT and choroidal flow density was not significant from the baseline; central and parafoveal retinal thickness increased and BCVA decreased significantly 6 months after PRP treatment.

Serum vascular endothelial growth factor, insulin-like growth factor-1 and aflibercept levels in retinopathy of prematurity.

PURPOSE: To evaluate the serum levels of vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1) after intravitreal injection of aflibercept (IVA) and the transition of aflibercept into systemic circulation in infants with severe retinopathy of prematurity (ROP). STUDY DESIGN: Prospective study. METHODS: This single-centered prospective cohort study included infants who received IVA for the treatment of type 1 ROP in zone I and posterior zone II. Blood samples were collected before IVA and at 1 day and 1, 2, 4, and 8 weeks after IVA. VEGF, IGF-1 and aflibercept levels were measured. RESULTS: Thirty eyes of 15 infants received IVA of 1 mg/0.025 mL. Serum VEGF levels decreased significantly at 1 day and 1, 2, 4, and 8 weeks after IVA compared with baseline (P < 0.05). Serum aflibercept levels decreased significantly 1, 2, 4, and 8 weeks after IVA compared with the level at 1 day after IVA (P < 0.05) and increased significantly at 1 day, 1, 2, and 4 weeks after IVA compared with the baseline level (P < 0.05). No significant difference was detected between serum IGF-1 levels any time in any infant (P > 0.05). CONCLUSION: Serum VEGF levels are suppressed for at least 8 weeks, and aflibercept could be detected in the systemic circulation at 4 weeks after injection. Clinicians should be cautious about changes in systemic VEGF levels and passage of the agent into systemic circulation after IVA in infants.

Vessel density in early-stage primary open angle glaucoma and pseudoexfoliation glaucoma: a comparative controlled optical coherence tomography angiography study.

PURPOSE: This study aimed to compare the vessel density of the optic nerve head and radial peripapillary capillary in the eyes with early-stage primary open angle glaucoma and pseudoexfoliation glaucoma and control eyes. METHODS: With visual field mean deviation scores >-6.0 dB, 54 eyes from 37 patients diagnosed with primary open angle glaucoma (n=18) and pseudoexfoliation glaucoma (n=18) and healthy controls (n=18) were enrolled in this cross-sectional observational study. Retrieved from optical coherence tomography angiography, vessel density for the optic nerve head and radial peripapillary capillary were analyzed according to the distribution of the data and appropriate tests. The diagnostic accuracy of vessel density parameters was also assessed. RESULTS: The whole-image vessel density of the radial peripapillary capillary and inside-disc vessel density of the optic nerve head were significantly lower in eyes with primary open angle glaucoma and pseudoexfoliation glaucoma compared to those in the control eyes (p<0.05). Compared to that in pseudoexfoliation glaucoma, the inside-disc vessel density of the optic nerve head was significantly lower in primary open angle glaucoma (p<0.05). Inferotemporal sector vessel density of the optic nerve head for both primary open angle glaucoma and pseudoexfoliation glaucoma was significantly lower than that of the controls (p=0.009). In discrimination of primary open angle glaucoma vs. control and pseudoexfoliation glaucoma vs. control, area under the receiver operating characteristic curve values for inside-disc vessel density of the optic nerve head were 0.855 and 0.731, respectively (p<0.001, p=0.018). However, in discrimination of primary open angle glaucoma vs. pseudoexfoliation glaucoma, area under the receiver operating characteristic curve values for whole-image and inside-disc vessel densities of the optic nerve head were 0.707 and 0.722 (p=0.034, p=0.023). CONCLUSIONS: Vessel densities of the optic nerve head and radial peripapillary capillary were significantly lower in eyes with primary open angle glaucoma and pseudoexfoliation glaucoma compared to healthy control eyes. In the early stage of glaucoma, the inside-disc vessel density of the optic nerve head slab may be lower in eyes with primary open angle glaucoma eyes compared to eyes with pseudoexfoliation glaucoma.

Refractive precision in uncomplicated eyes with pseudoexfoliation: three-piece versus one-piece intraocular lens implantation.

PURPOSE: To evaluate the refractive precision of three-piece versus one-piece intraocular lenses (IOLs) in eyes with pseudoexfoliation (PXF) and changes in anterior chamber depth (ACD) following cataract surgery. METHODS: This prospective, nonrandomized, interventional, comparative case series included PXF eyes, which were implanted with one-piece acrylic IOL or three-piece acrylic IOLs (Group A; n = 31, Group B; n = 30). Non-PXF control eyes were implanted with one-piece acrylic IOL (Group C; n = 30). Postoperative refractive error (RE) and absolute RE, as well as pre- to postoperative ACD changes, were statistically analysed. A p value < 0.05 was considered statistically significant. RESULTS: Changes in ACD (mean ± standard deviation) in Groups A, B and C were 0.9 ± 0.4, 1.0 ± 0.3 and 0.7 ± 0.4 mm, respectively. Significant differences were found between Groups A and C (p = 0.043) and between Groups B and C (p = 0.008). In Groups A, B and C, the median and interquartile (Q1 to Q3) values were 0.3 (-0.8 to 1.0), -0.5 (-0.8 to -0.3) and 0.1 (-0.4 to 0.3) for RE and 1.0 (0.4 to 1.3), 0.5 (0.3 to 0.8) and 0.3 (0.3 to 0.5) for absolute RE, respectively. The RE differences between Group A and B (p = 0.009) and Group B and C (p < 0.001) were statistically significant. For absolute RE, the differences were significant for all comparisons (p < 0.05). CONCLUSION: Refractive precision in PXF eyes may be better with three-piece than with one-piece IOL implantation, but worse than with one-piece IOL implantation in non-PXF eyes. Significant changes in ACD in PXF eyes may be related to RE.

Evaluation of Retinal and Choroidal Microcirculation Alterations After a Single Dose of Oral 5-mg Tadalafil: A Prospective Pilot Optical Coherence Tomography Angiography Study.

Purpose: To evaluate the effects of a single dose of oral 5-mg tadalafil on macular microcirculation as measured using optical coherence tomography (OCT) and angiography (OCTA) in healthy volunteers. Methods: Twenty-two healthy, middle-aged, sexually active, and male health care worker volunteers were included in this prospective study. All volunteers have a history of occasionally using off-label 5 mg tadalafil to enhance sexual performance. Superficial and deep capillary plexus vascular densities, foveal avascular zone parameters, outer retina, and choriocapillaris flow areas were performed using the OCTA, and subfoveal-choroidal thickness (CT) was performed by using the OCT. Measurements were performed preintake, 30 min, 1, 4, 24 h, 2, 3, 4, and 7 days after the intake of tadalafil off-label. Results: Twenty-two eyes of 22 male volunteers were included in the study. The mean age was 37.16 ± 4.52 years. At 30 min, 1 h, and 4 h after intake, a statistically significant increase was observed in the choriocapillaris flow area and CT compared with preintake (Friedman test, P = 0.034 and P < 0.001, respectively). Conclusion: This study showed that a single dose of oral 5-mg tadalafil causes an increase in choriocapillaris flow and CT. To evaluate the effects of tadalafil on the retina and choroid, an OCTA assessment may be helpful.

Blood-aqueous barrier deterioration following retained metallic corneal foreign body: A laser flare photometric study.

BACKGROUND: This study aims to use laser flare photometry to evaluate flare changes in patients following corneal damage from a metallic foreign body (FB). METHODS: Foreign body injured eyes and the healthy fellow eyes of 54 consecutive patients were studied in this comparative, observational, cross-sectional study. Flare levels were analyzed according to demographics, history of previous exposures, foreign body location, and foreign body penetration into the injured cornea. RESULTS: The mean flare value was significantly higher for the eyes with corneal foreign body injury compared to the fellow-control eyes (11.35±14.17 ph/ms and 6.30±3.81 ph/ms, respectively) (p=0.014). The mean flare values were significantly lower in eyes with a history of more than one previous corneal foreign body removal flare values than in other eyes (p=0.029). CONCLUSION: Flare is increased by corneal foreign body exposure. However, eyes that experience multiple previous corneal foreign body exposures may show relatively low flare, probably due to corneal desensitization.

Assessment of retinal vessel density in adult-onset foveomacular vitelliform dystrophy by optical coherence tomography angiography.

BACKGROUND: To evaluate retinal thickness, area of foveal avascular zone (FAZ), flow area and flow density of choriocapillaris, vessel density of both superficial capillary plexus (SCP) and deep capillary plexus (DCP) of eyes with adult-onset foveomacular vitelliform dystrophy (AOFVD) using optical coherence tomography angiography (OCT-A) and compare the results with healthy controls. METHODS: 17 eyes of 14 patients diagnosed with AOFVD and 17 eyes of 17 healthy subjects were enrolled in this study. All patients underwent a complete ophthalmological examination and a 6 x 6 mm macular OCT-A scanning. Quantiative results of retinal thickness, retinal vessel density of SCP and DCP, FAZ area, flow area and flow density of choriocapillaris were analyzed. RESULTS: No statistically significant differences were noted in the vessel density of the SCP, except for the parafoveal nasal sector (P = 0.048). Similarly, no statistically significant differences were observed in the vessel density of the DCP, except for the parafoveal (P = 0.037) and the parafoveal temporal (P = 0.048) sectors. The choriocapillaris flow area and the flow density were significantly lower in the patients with AOFVD than in the healthy controls (P = 0.001 for both). The mean FAZ area and the retinal thickness measurements were comparable in both groups. CONCLUSIONS: Patients with AOFVD show vascular abnormalities that can be detected with OCT-A. OCT-A, as a noninvasive imaging modality, could provide a new perspective for understanding the pathophysiology of AOFVD and could also be useful in the follow-up of these patients and in the management of the disease progression.

Comparison of two different treatment regimens' efficacy in neovascular age-related macular degeneration in Turkish population-based on real life data-Bosphorus RWE Study Group.

AIM: To compare two different anti-vascular endothelial growth factor (anti-VEGF) treatment regimens'-a priori pro re nata (PRN) and PRN regimen following the loading phase-anatomical and functional results in neovascular age-related macular degeneration (nAMD) patients. METHODS: Totally 544 nAMD patients followed and treated with aflibercept (n=135) and ranibizumab (n=409) at 9 different centers between 2013 and 2015 were enrolled into this retrospective multicenter study. Patients with initial best corrected visual acuity (BCVA) interval of 1.3-0.3 (logMAR) and a minimum follow-up of 12mo were included. Patients under two different regimens-a priori pro re nata (1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen (3+PRN)-were compared in BCVA at 3th, 6th and 12th months, and in central macular thickness (CMT) at 6th and 12th months. The total study group, intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in the 1+PRN (n=101) regimen from 407 to 358 and 340 µm and in the 3+PRN (n=443) group from 398 to 318 and finally to 310 µm at months 6 and 12, respectively. Anatomically, the CMT reduction at 6th month (48.5 vs 76.4; P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75; in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3th month (-0.01 vs 0.12; P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6th (44 vs 72) and 12th month (61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3th month (-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction (61 vs 89, 6th month; 85 vs 97, 12th month) and visual gain (0.02 vs 0.16; 0.02 vs 0.14; 0.05 vs 0.11) was found in favor of 3+PRN group at all visits. CONCLUSION: The loading dose of anti-VEGF treatments in nAMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.

Optical Coherence Tomography Findings in Pre-Eclampsia: A Preliminary Receiver Operating Characteristic Analysis on Choroidal Thickness for Disease Severity.

Purpose: To evaluate qualitative optical coherence tomography (OCT) findings and quantitative parameters, such as central macular thickness (CMT) and subfoveolar choroidal thickness (SFCT), in the eyes of preeclamptic women. Methods: The prospective, comparative, cross-sectional study included 52 eyes of 52 preeclamptic (PE) women and 54 eyes of 54 healthy pregnant women in their second or third trimester. Central macular thickness (CMT), subfoveolar choroidal thickness (SFCT), were evaluated in relation to presence of positive qualitative OCT findings such as any subretinal or intraretinal fluid, irregularity on the external photoreceptor and RPE layer, or presence of pigment epithelial detachment. Results: No significant difference was detected between the PE group and the healthy pregnant group with respect to CMT (P= 0.905), but the mean SFCT value was significantly higher in the PE group than in the healthy pregnant group (391.4 ± 71.1 vs 331.5 ± 53.8 µm, P < 0.001). Receiver operating characteristic analysis revealed that SFCT could predict qualitative OCT findings in preeclampsia, and the optimal cut-off value was 400 µm with a sensitivity of 91% and a specificity of 85%. Conclusion: The eyes of preeclamptic women, and particularly those with positive qualitative OCT findings, showed significantly increased SFCT values. A preliminary cut-off level of 400 µm for SFCT is proposed for the prediction of severe preeclampsia.

Analysis of Macular Vessel Density and Foveal Avascular Zone Using Spectral-Domain Optical Coherence Tomography Angiography in Children With Amblyopia.

PURPOSE: To quantify the foveal avascular zone and the whole, parafoveal, and foveal vessel density of superficial and deep capillary plexus in amblyopic eyes and age-matched controls and to compare the measurements. METHODS: This cross-sectional study involved 49 eyes from 17 patients with amblyopia and 21 healthy children (aged 6 to 16 years). Optical coherence tomography angiography was performed for all participants and superficial capillary plexus, deep capillary plexus, and foveal avascular zone were evaluated. Data from amblyopic eyes, fellow eyes with unilateral amblyopia, and control eyes were compared using the Mann-Whitney U test. RESULTS: The mean patient age was 8.6 ± 2.5 years in the amblyopia group and 9.6 ± 2.9 years in the control group. The mean foveal avascular zone measurements were 0.251 ± 0.1 mm2 in the amblyopia group and 0.291 ± 0.1 mm2 in the control group. The whole, foveal, and parafoveal vessel densities of superficial capillary plexus were 48.8% ± 3.7%, 23.8% ± 8.8%, and 50.9% ± 4.6% in the amblyopia group and 48.4% ± 2.5%, 19.3% ± 5.4%, and 51.3% ± 2.7% in the control group. The whole, foveal, and parafoveal vessel densities of deep capillary plexus were 51.8% ± 4.3%, 37.6% ± 5.8%, and 54.8% ± 4.2% in the amblyopia group and 54.4% ± 3.2%, 34.9% ± 7.4%, and 56.8% ± 3.2% in the control group. No statistically significant difference was detected in all measurements. CONCLUSIONS: Assessment of the foveal avascular zone and vessel density of superficial capillary plexus and deep capillary plexus with optical coherence tomography angiography revealed no difference between amblyopic eyes, controls, and fellow eyes of patients with unilateral amblyopia. [J Pediatr Ophthalmol Strabismus. 2019;56(1):55-59.].