mRNFL, mGCL, and mIPL are significantly reduced in MS patients without concomitant pRNFL thinning. These retinal changes show a significant association with cortical regions that are known to be important for visuospatial performance.
PurposeTo identify systemic risk factors for sickle cell maculopathy, and to analyze the microstructure of the macula of Sickle Cell Disease (SCD) patients by using automated segmentation of individual retinal layers.MethodsThirty consecutive patients with SCD and 30 matched controls underwent spectral-domain optical coherence tomography (SD-OCT) and automated thickness measurement for each retinal layer; thicknesses for SCD patients were then compared to normal controls. Demographic data, systemic data, and lab results were collected for each SCD patient; multivariate logistic regression analysis was used to identify potential risk factors for sickle cell maculopathy.ResultsOngoing chelation treatment (p = 0.0187) was the most predictive factor for the presence of sickle cell maculopathy; the odds were 94.2% lower when chelation was present. HbF level tended to influence sickle cell maculopathy (p = 0.0775); the odds decreased by 12.9% when HbF increased by 1%. Sickle cell maculopathy was detected in 43% of SCD patients as patchy areas of retinal thinning on SD-OCT thickness map, mostly located temporally to the macula, especially in eyes with more advanced forms of sickle cell retinopathy (p = 0.003). In comparison to controls, SCD patients had a subtle thinning of the overall macula and temporal retina compared to controls (most p<0.0001), involving inner and outer retinal layers. Thickening of the retinal pigment epithelium was also detected in SCD eyes (p<0.0001).ConclusionsChronic chelation therapy and, potentially, high levels of HbF are possible protective factors for the presence of sickle cell maculopathy, especially for patients with more advanced forms of sickle cell retinopathy. A subtle thinning of the overall macula occurs in SCD patients and involves multiple retinal layers, suggesting that ischemic vasculopathy may happen in both superficial and deep capillary plexi. Thinning of the outer retinal layers suggests that an ischemic insult of the choriocapillaris may also occur in SCD patients.
Choroidal thickness and CVI significantly increased with active disease in nAMD eyes. Changes in choroidal thickness may predict CNV development or recurrence before they are otherwise evident clinically.
Purpose
To evaluate temporal changes and predictors of accuracy in the alignment between simultaneous near-infrared image and optical coherence tomography (OCT) scan on the Heidelberg Spectralis using a model eye.
Design
Laboratory investigation.
Methods
After calibrating the device, six sites performed weekly testing of the alignment for 12 weeks using a model eye. The maximum error was compared to multiple variables to evaluate predictors of inaccurate alignment. Variables included the number of weekly scanned patients, total number of OCT scans and B-scans performed, room temperature and its variation, and working time of the scanning laser. A 4-week extension study was subsequently performed to analyze short-term changes in the alignment.
Results
The average maximum error in the alignment was 15±6 µm; the greatest error was 35 µm. The error increased significantly at week 1 (p=0.01), specifically after the second imaging study (p<0.05), reached a maximum after the eighth patient (p<0.001), and then it varied randomly overtime. Predictors for inaccurate alignment were temperature variation and scans per patient (p<0.001). For each 1 unit of increase in temperature variation, the estimated increase in maximum error was 1.26 µm. For the average number of scans per patient, each increase of 1 unit increased the error of 0.34 µm.
Conclusion
Overall, the accuracy of the Heidelberg Spectralis was excellent. The greatest error happened in the first week after calibration, and specifically after the second imaging study. To improve the accuracy, room temperature should be kept stable and unnecessary scans should be avoided. The alignment of the device does not need to be checked on a regular basis in the clinical setting, but should be checked after every other patient for more precise research purposes.
GDx ECC and RTVue show a very good diagnostic ability to detect glaucoma. Most of the RNFL parameters had high AUCs and sensitivities. The diagnostic validity of GCC was comparable with that of the RNFL parameters, and they may be very useful in detecting RNFL damage.
Purpose: Optic disk pit (ODP) is a rare congenital abnormality of the optic nerve head that can lead to a maculopathy characterized mainly by serous retinal detachment. Optic disk pit maculopathy (ODP-M) in children is rare, and at present, the best management is still unknown. Long-lasting ODP-M can lead to organic amblyopia and photoreceptor damage, whereas surgical treatments are invasive and have an uncertain prognosis. We present a case of spontaneous resolution of ODP-M in a child who was monitored morphologically and functionally during a 6-year follow-up.Methods: Between January 2010 and January 2016, we conducted follow-up examinations by fundus photography, optical coherence tomography, and microperimetry.Results: At the first visit, a 12-year-old girl was asymptomatic with a visual acuity of 20/20 in both eyes. Optic disk pit maculopathy was observed, and the progression was monitored by follow-up optical coherence tomography. A progressive anatomical improvement with a spontaneous resolution of ODP-M occurred over a 2-year period. However, at the last follow-up visit, microperimetry showed a loss of threshold values of visual sensitivity.
Conclusion:The combination of morphologic and functional evaluation over time can be useful to determine the best management of ODP-M, particularly in children for whom the conservative approach seems to be a valid alternative to surgery.
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