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Purpose: The aim of the study is to evaluate the relationship between functional defects shown by cluster analysis of computerized visual field and anatomic defects from optical coherence tomography–ganglion cell complex examination in ocular hypertension or eyes affected by glaucoma. Methods: 205 eyes affected by ocular hypertension (intraocular pressure > 22 mmHg) or early stage glaucoma were enrolled. The age of the patients ranged from 26 to 87 years (average: 61.83 ± 1.54 years). Computerized 30° visual field (Octopus G1x Dynamic strategy) and optical coherence tomography–ganglion cell complex (I-Vue Optovue) analyses were performed for each eye selected; 68 eyes were tested and retested from two to seven times for a total of 320 visual fields and 320 optical coherence tomography–ganglion cell complex examinations. The visual field was considered abnormal with a mean defect < –2 and loss variance > 6. The optical coherence tomography–ganglion cell complex was considered abnormal with a significant focal loss volume (p < 5%) and/or a significant thinning of total, superior, or inferior thickness (p < 5%). Four different groups of examinations were created according to the results of visual field and ganglion cell complex: normal visual field and normal ganglion cell complex (group 1), abnormal visual field and abnormal ganglion cell complex (group 2), normal visual field and abnormal ganglion cell complex (group 3), and abnormal visual field and normal ganglion cell complex (group 4). The cluster analysis of visual fields (EyeSuite software Interzeag CH) was performed only in the visual field of group 3, and the correlation between cluster values and topographical changes at optical coherence tomography–ganglion cell complex was analyzed. Results: The results of the ganglion cell complex and visual field examinations matched 247 (77.19%) times. In 143 cases, the examinations belonged to group 1, in 104 to group 2, in 23 to group 3, and, finally, in 50 to group 4. The visual field cluster analysis performed on group 3 showed that the correlation between optical coherence tomography–ganglion cell complex and visual field cluster analysis defects was 100% (both the exams altered). In 72% of them, there was also a topographical correspondence between the visual field and optical coherence tomography–ganglion cell complex defects. Conclusion: In the early stages of glaucoma, the visual field cluster analysis seems to be useful to detect some focal defects that can be otherwise underestimated when globally considering the visual field. In group 3, where the conventional analysis of visual field was normal while the optical coherence tomography–ganglion cell complex exam was abnormal, the visual field cluster analysis showed a topographical correlation with optical coherence tomography–ganglion cell complex defects in more than 70% of the examinations performed. In addition, the patients with abnormal visual field and normal optical coherence tomography–ganglion cell complex were older than those with normal visual field and abnormal optical coherence tomography–ganglion cell complex (66.44 ± 3.51 vs 57.04 ± 5.96 years, p < 0.001 (0.0002)). These results confirm that the reliability of a visual field examination is subjective and decreases with age because of its difficulty and the personal compliance of the patient toward this examination.

Purpose: To describe which bacteria can be found on lid margins in patients affected with blepharitis, to show their antibiotic susceptibility pattern, and to evaluate the antibiotic resistance trend of coagulase-negative Staphylococcus through time. Materials and methods: Consecutive cases of 198 eyes affected with blepharitis between 2012 and 2018 were reviewed. A sample was collected by rubbing a swab against the base of the eyelashes of both the eyes of all patients. The samples were inoculated in blood agar and chocolate agar. The susceptibility of the identified bacteria to common antibiotics was tested. In addition, the antibiotic susceptibility pattern of coagulase-negative Staphylococcus detected from year 2016 to 2018 was compared with that of 4 years before. Results: The most common isolated bacterium was coagulase-negative Staphylococcus (89%) and Staphylococcus aureus (28%). Coagulase-negative Staphylococcus showed highest susceptibility to vancomycin (100%), neomycin (94%) and chloramphenicol (91%). Coagulase-negative Staphylococcus and Staphylococcus aureus were the most resistant to penicillin and erythromycin (resistance in 92%, 91% for coagulase-negative Staphylococcus, 86% and 43% of eyes for Staphylococcus aureus). Corynebacterium was resistant to oxacillin and erythromycin. Streptococcus viridans showed resistance to gentamycin and tobramycin. Moraxella was susceptible to most antibiotics. Bacillus was resistant to oxacillin. The antibiotic resistance trend of coagulase-negative Staphylococcus showed that the resistance to rifampicin increased through the years 2012–2018. Conclusion: Coagulase-negative Staphylococcus and Staphylococcus aureus were the most isolated bacteria in patients affected by blepharitis in our tertiary eye centre. Both bacteria were resistant to erythromycin. Through the years, it seems that coagulase-negative Staphylococcus gained resistance to penicillin, erythromycin, ciprofloxacin and rifampicin.

This paper aims to study adaptative vascular arrangements in idiopathic fovea plana with volume-rendered optical coherence tomography angiography (OCTA). A retrospective review of two cases of idiopathic fovea plana (mean age: 26.5 years) and two age-matched controls imaged with OCTA was conducted using spectral-domain OCTA (RTVue XR Avanti, Optovue, Inc., Fremont, CA) equipped with the AngioVue software. Both en face OCTA slabs and OCTA b scans were processed through Fiji software (http://fiji.sc; software version 2.0.0-rc-68/1.52e), and then extracted as image sequences for volume rendering reconstructions using the ImageVis3D volume rendering system (3.1.0 release). Eyes with idiopathic fovea plana demonstrated a regular superficial vascular plexus connecting to a single vascular monolayer representing the deeper vascular plexuses. At this location, several vertical short path connections were demonstrated, in contraposition with normal eyes where short path connections were infrequently observed. Advances in three-dimensional OCTA reconstruction increase the understanding of vascular connections and arrangement in retinal plexuses and possible anatomical variations that cannot be detected with conventional two-dimensional b scans.

Purpose: To evaluate the effect of IOP lowering on the capillary density of optic nerve head and retinal nerve fiber layer in patients with primary open angle glaucoma. Methods: Twenty eyes of 14 glaucomatous patients and 15 eyes of nine normal patients were enrolled. The most appropriate hypotonic treatment was applied to every patient. A HD Angio Disc 4.5 scan (Avanti-AngioVue) was performed at baseline and after a month in the glaucomatous eyes. The following parameters were analyzed: Radial Papillary Capillaries (RPC) density, inside disc, peripapillary, superior-hemi, inferior-hemi, quadrants, and peripapillary, hemi-superior, hemi-inferior, and quadrants RNFL thickness. Optic nerve head analysis was also evaluated. In addition, the RPC density and the RNFL were assessed in the eight sectors provided by the software. Results: The RPC density did not significantly change after IOP reduction ( p > 0.05). The inferior-temporal ( p = 0.005) and inferior-nasal sectors ( p < 0.001) showed a greater capillary density than the respective superior sectors in healthy eyes. In contrast in the glaucomatous eyes, the superior-nasal exhibited greater capillary density with respect to the inferior-nasal sectors. The aggregate RPC density of the inferior sectors was greater than the superior ones in the control group ( p < 0.001). An improvement of the average disc area ( p = 0.01) and the average cup volume ( p = 0.059) were also observed along with increased RNFL thickness at different locations (all, p < 0.05) after IOP lowering therapy was initiated. Conclusion: The glaucomatous eyes presented rarefaction of the radial papillary capillaries density in the inferior sectors, but no significant changes in the density after IOP-lowering medications.