Purpose To describe the relations between foveal avascular zone (FAZ) size and outline in patients presenting diabetic retinopathy. Methods 110 high-quality fluorescein angiograms from 110 diabetics were chosen from our digital retinal image databank. Patients with significant media opacities, macular scars, macular hard exsudates, high ametropia, and associated macular pathology were excluded. Both FAZ perimeter and surface area were measured with image analysis software. FAZ outline was graded according to ETDRS report Number 11 (from 0 ¼ normal to 4 ¼ capillary outline completely destroyed). Data were compared to that of 31 healthy controls. FAZ surface in diabetics was compared to that of controls and FAZ surface was compared to FAZ grade, FAZ perimeter and retinopathy stage in diabetics. Quantitative variables were compared using the U-test of Mann-Whitney or Kruskal-Wallis test and correlations between quantitative variables were estimated with the Spearmann coefficient. Results All patients presented diabetic retinopathy (54 BDR, 30 PPDR, 26 PDR). FAZ size was larger in diabetics than controls (Po0.001). In diabetics, FAZ size increased with FAZ grade (Poor ¼ 0.006 except between grades 1 and 2 ¼ NS) and with retinopathy stage (Poor ¼ 0.024). As retinopathy advanced, there was a higher proportion of altered FAZ outlines (P ¼ 0.003). Conclusions This study confirms capillary alteration to be the cause of increase in FAZ size in diabetics and presents an alternative evaluation method of the FAZ to FAZ size measurement. No qualitative studies using the ETDRS FAZ grading scale have been performed to our knowledge.

The importance of venous sinus disease in the etiology of idiopathic intracranial hypertension is probably underestimated. Patients with idiopathic intracranial hypertension in whom a venous sinus stenosis is demonstrated by a noninvasive radiologic workup should be evaluated with direct retrograde cerebral venography and manometry. In patients with a lesion of the venous sinuses who experienced medical treatment failure, endovascular stent placement seems to be an interesting alternative to classic surgical approaches.

No abstract

No abstract

ABSTRACT.Purpose: To evaluate prospectively the efficacy and safety of one intravitreal injection of 4 mg triamcinolone acetonide for refractory diffuse diabetic macular edema. Methods: Seventeen patients with bilateral diabetic macular edema unresponsive to laser photocoagulation. In all patients, one eye was injected, and the other served as a control. The intervention consisted in intravitreal injection of 4 mg triamcinolone acetonide. The main outcome measure was central macular thickness (CMT) at 4, 12 and 24 weeks, measured by Optical Coherence Tomography. Secondary outcomes were Early Treatment Diabetic Rentinopathy Study (ETDRS) scores, intraocular pressure and cataract progression. Results: Before injection, mean ± SD CMT was 566.4 ± 182.4 lm in injected eyes. Four, 12, and 24 weeks after injection, it was 228.4 ± 47.5 lm, 210.9 ± 87.2 lm and 358.5 ± 160.5 lm respectively. CMT was significantly lower in injected eyes vs. control eyes except 24 weeks after injection because of a recurrence of macular edema in 9/17 injected eyes. Mean ± SD gain in ETDRS score was significantly better in injected eyes vs. control eyes 4, 12 and 24 weeks after TA injection. In 9 of the 17 injected eyes, intraocular pressure exceeded 24 mmHg and was controlled by topical medication. Conclusion: In the short-term, intravitreal injection of triamcinolone effectively reduces macular thickening due to diffuse diabetic macular edema and improves visual acuity in most cases. The long-term effect of this treatment and predictive factors of visual recovery remain to be elucidated.