Background: To assess retinal and optical changes associated with near vision reading for different lighting conditions in electronic screens. Methods: Twenty-four young healthy subjects participated in the study; an iPad and an Ebook were chosen as stimuli for 5 min of reading task with different lighting conditions. Central and peripheral retinal thicknesses in the macular ETDRS areas by optical coherence tomography were analyzed. Results: Significant differences were found between basal retinal thickness and retinal thickness after reading with iPad and high illumination, in the N6 (p = 0.021) and I6 (p = 0.049) areas, and low illumination (S3: p = 0.008, N3: p = 0.018, I3: p = 0.021, N6: p = 0.018 and I6: p = 0.020), being thinner after reading. The same trend was observed after reading with an Ebook and high lighting in the N3 (p = 0.037) and N6 (p = 0.028). For low lighting conditions, only retinal thinning was observed. After reading, retinal shape analysis revealed significant changes from computed basal eccentricity for high lighting conditions only. At the periphery, those differences in eccentricity values were statistically significant for both lighting conditions. Conclusions: Young people can recover visual quality after 5 min of reading tasks at different lighting levels on electronic devices, while peripheral retinal expansion remains altered, especially at low lighting levels.

Diabetic retinopathy (DR) is the most severe and frequent retinal vascular disease that causes significant visual loss on a global scale. The purpose of our study was to evaluate retinal vascularization in the superficial capillary plexus (SCP), the deep capillary plexus (DCP) and the choriocapillaris (CC) and changes in the foveal avascular zone (FAZ) by optical tomography angiography (OCTA) in patients with type 2 diabetes mellitus (DM2) with moderate DR but without diabetic macular oedema (DME). Fifty-four eyes of DM2 with moderate DR (level 43 in the ETDRS scale) and without DME and 73 age-matched healthy eyes were evaluated using OCTA with swept-source (SS)-OCT to measure microvascularization changes in SCP, DCP, CC and the FAZ. The mean ages were 64.06 ± 11.98 and 60.79 ± 8.62 years in the DM2 and control groups, respectively. Visual acuity (VA) was lower in the DM2 patients (p = 0.001), OCTA showed changes in the SCP with a significant diminution in the vascular density and the FAZ area was significantly higher compared to healthy controls, with p < 0.001 at the SCP level. The most prevalent anatomical alterations were peripheral disruption in the SCP (83.3%), microaneurysms (MA) in the SCP and in the DCP (79.6% and 79.6%, respectively) and flow changes in the DCP (81.5%). A significant positive correlation was observed between the DM2 duration and the FAZ area in the SCP (0.304 with p = 0.025). A significant negative correlation was also found between age and CC central perfusion (p < 0.001). In summary, a decrease in the vascular density in DM2 patients with moderate DR without DME was observed, especially at the retinal SPC level. Furthermore, it was found that the FAZ was increased in the DM2 group in both retinal plexuses and was greater in the SCP group.

Background: To study choroidal thickness (CT) in type 2 diabetes mellitus (DM2) patients with moderate diabetic retinopathy (DR) and to correlate with changes in retinal thickness (RT) with swept-source OCT (SS-OCT) compared to healthy subjects. Methods: Fifty-four DM2 patients with moderate DR without diabetic macular edema (DME) and 73 age-matched healthy subjects were evaluated using SS-OCT to measure changes in total RT and CT in the nine areas of the Early Treatment Diabetic Retinopathy Study (ETDRS) macular grid. Results: The mean age was 64.06 ± 11.98 years and 60.79 ± 8.62 years in the diabetic and control groups, respectively. Total RT showed statistically significant differences in the temporal inner area, with higher values in the DM2 group (p = 0.010,). CT did not show differences between the groups. There was a significant negative correlation between RT and age in all of the outer ETDRS areas and a positive significant correlation in the central area for the DM2 group. There was also a negative significant correlation between CT and age in all of the ETDRS areas except for the inferior inner area. In the DM2 group, a negative correlation was observed between RT and CT in the central area (p = 0.039) and in both horizontal parafoveal areas (temporal inner, p = 0.028; nasal inner, p= 0.003). Conclusion: DM2 patients with moderate DR have no changes with regard to CT. Both CT and RT decreased with age in DM2, showing a negative correlation between these factors in the central and horizontal parafoveal areas of the ETDRS grid.

Purpose: To evaluate the influence of age in the repeatability of retinal thickness measurements in a healthy paediatric population with spectral domain Optical Coherence Tomography (SD‐OCT). Knowledge of RNFL parameters and macular characteristics in a normal population and differences between ages and sexes is useful for evaluating normal development of the eyes. Also, an essential quality in determining the utility of a device for clinical use is its measurement variability. Repeatability is important for distinguishing normal subjects from patients with disease as well as for following ocular modifications over time for follow‐up after treatment, especially in young population. Methods: Seventy‐six eyes from 76 healthy paediatric subjects underwent three fast macula scans and 81 eyes from 81 healthy paediatric subjects were studied by three retinal nerve fiver layer (RNFL) measurements using a Spectralis OCT device. Mean thicknesses in the nine Early Treatment Diabetic Retinopathy Study (ETDRS) and in the seven optic nerve RNFL areas were measured. Mean values were evaluated by age and by sex. Children were divided in two groups, Group 1/ 6 years old or younger and group 2/ children older than 6 years. We calculated the repeatability comparing the two age groups, looking for intraclass correlation coefficient (ICC) and coefficient of variation (COV) values. Results: In the younger group central macular thickness value was 262.52 ± 18.28, and the central RNFL 104.03 ± 7.99. In the group of children older than 6, central macular thickness was 270.57 ± 18.49 and the central RNFL 100.27 ± 8.58. No statistically significant differences were found. Central retina thickness COVs were 7.00 in group 1% and 6.83% in Group 2. Optic disc RNFL thickness COVs were 7.72% in Group 1 and 8.69% in Group 2. All ICCs were higher than 0.8 showing excellent correlation among the three measurements performed by the same operator. Conclusions: Repeatability of Spectralis OCTs is high in healthy macula measurements, and significantly higher with Spectralis. Small differences were found between repeatability of macular thickness measurements obtained by both devices analysed by age.

Purpose: To study choroidal thickness (CT) in type 2 diabetes mellitus (DM2) patients with moderate diabetic retinopathy (DR) without diabetic macular edema (DME) and to correlate with changes in retinal thickness (RT) with swept source OCT (SS‐OCT)) compared to healthy subjects. Methods: Fifty‐four DM2 patients with moderate DR without DME and 73 age‐matched healthy subjects were evaluated using SS‐OCT to measure changes in total RT and the CT in the nine areas of the Early Treatment Diabetic Retinopathy Study (ETDRS) macular grid. Results: The mean ages were 64.06 ± 11.98 years and 60.79 ± 8.62 years in the diabetic and control groups, respectively. Visual acuity (VA) with ETDRS 100% was lower in the DM2 patients (p < 0.001). In the total RT, statistically significant differences were found in the temporal inner area being thicker thickness in the DM2 group (260.70 ± 19.22 μm vs. 271.90 ± 37.61 μm with p = 0.010, in control and DM2 group, respectively). The CT did not show significant differences between both groups (p > 0.05) in any ETDRS area. There was a significant negative correlation between RT and age in all of the external ETDRS areas and a positive significant correlation in the central area for DM2 group. There was also a negative significant correlation between CT and age in all ETDRS areas except for the inferior inner area. In the DM2 group, a negative correlation was observed between RT and CT in the central area (p = 0.039) and in both horizontal parafoveal areas (temporal inner: p = 0.028, central: p = 0.039 and nasal inner: p = 0.003). Conclusions: DM2 patients with moderate DR have no changes in CT. CT and RT decrease with age and show a negative correlation with RT in the central and horizontal parafoveal areas of the ETDRS grid.

Purpose: To assess anatomical changes in the retinal superficial capillary (SCP) and deep capillary (PCP) plexuses, as well as choriocapillary (CC) in patients with diabetes mellitus (DM) without diabetic retinopathy (DR), and in DM patients with mild and moderate DR without diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Methods: Ninety eyes were included, 34 patients with long‐term DM (more than 10 years) but without DR signs, and 54 patients with mild or moderate DR (levels 35 and 43 on the ETDRS scale) without DME. All participants underwent a complete ophthalmic examination including best corrected visual acuity (BCVA) and OCTA examination using deep‐range imaging with the DRI‐Triton SS‐OCT. Results: The mean age was 63.82 ± 8.56 years and 63.00 ± 13.21 years in long‐term DM without DR and with DR, respectively. In patients with long‐term DM without DR, foveal avascular zone (FAZ) abnormalities were seen in both SCP and DCP (55% and 5%), and microaneurysms (MAs) were present in SCP and DCP (35% and 47.5%). Loss of perfusion was detected in SCP and DCP (30% and 47.5%), and ischemia was observed in SCP, DCP and CC (60%, 37.5% and 10%). In patients with mild or moderate DR without DME, OCTA also detected morphological abnormalities such as FAZ changes and MAs (79.6% and 81.11%), loss of perfusion (83.3% and 64.2%), and ischemia (66.67%, 81.1% and 18.5%) in SCP, DCP and CC respectively. Microvascular tortuosity and intraretinal microvascular anomalies (IRMAs) were detected in 48.1% and 46.3% in SCP vs 22.6% and 20.8% in DCP, respectively. Conclusions: Patients with long‐term DM without DR present morphological changes measured with OCTA, such as MAs in both retinal plexuses. The changes in the FAZ are more evident in the SCP due to the capillary anastomosis. Capillary dropout can be found in both plexuses. Patients with DR show more evident changes that include MAs, loss of perfusion and ischemia and other vascular abnormalities.

Purpose: To study fundus autofluorescence (FAF) with blue light excitation (488 nm) in different cases of cone inherited macular dystrophies an to assess differential characteristics. Methods: We studied different cone inherited retinal dystrophies due primary to ABCA4 mutation with blue FAF and correlate the findings with the clinical impairment. We compared with the findings in other mutations. Results: We presented 9 cases of Stargardt diseases with ABCA4 mutation with different blue FAF characteristics, from single macular impairment with an hypofluorescence, pattern, hyperreflective flecks around the central lesion or flecks extended outside the vascular branches. The extension of the flecks was no correlate with the degree of functional impairment. We compared with other cone dystrophies such as CRX mutation, with similar findings than the ones with only central impairment. Asymptomatic CRX mutation showed a hyperreflective central lesion. Conclusions: FAF is an essential tool to diagnose and follow‐up inherited retinal dystrophies with primary macular manifestation. Same mutation and clinical stage could present different patterns.

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