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Analysis of OCT images by trained graders using computer-assisted grading software allows for highly reproducible quantitative measurements, even in eyes with complex diseases such as neovascular AMD. Quantitative subanalysis may be useful in studying the differential morphologic effect of therapies on various anatomic components.

Manual identification of the inner and outer retinal boundaries on OCT scans can produce retinal thickness measurements consistent with those derived from the automated StratusOCT analysis. Computer-assisted OCT grading may be useful for correcting thickness measurements in cases with errors of automated retinal boundary detection and may be useful for quantitative subanalysis of clinically relevant features, such as subretinal fluid volume or pigment epithelial detachment volume.

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Intravitreal bevacizumab (Avastin) resulted in a reduction of leakage, intra- and subretinal fluid. An increase in visual acuity was seen already 4 weeks after first injection. However, a complete occlusion of feeder vessels could not be achieved within this 3-month period. Randomized clinical trials would be required to evaluate dose and frequency of injections and possible beneficial effects of combination therapies, as well as the long-term results.

Aim To evaluate the long-term (1 year) functional and anatomical outcome of autologous translocation of peripheral choroid and retinal pigment epithelium (RPE) in 30 patients with age-related macular degeneration (AMD). Methods After the extraction of the neovascular complex, an autologous peripheral full-thickness graft of RPE and choroid was positioned under the macula. Functional tests included ETDRS vision, reading (Radner test), and microperimetry (scanning laser ophthalmoscope). Fluorescein, indocyanine green angiography, and autofluorescence were monitored.

The foveal reflection analyser is a device recently developed at our department. 3 Healthy cones show a strong directional reflex towards the centre of the pupil, the so called ''optical Stiles Crawford'' effect. An FRA measurement provides a parameter rho as a quantitative measure of the cone directionality. In addition, it provides estimates of the densities of lens, macular pigment and melanin (not shown). At initial presentation, rho was 0.00 (fig 2, left). Ten weeks later rho was 0.12, within normal limits. Visual acuity was 1.0 at that time. Twenty one weeks after the initial presentation, OCT (fig 1, bottom) and FRA (fig 2, right) were repeated, both with normal outcomes (rho 0.12). Visual acuity had not changed. Comment The foveal reflection analyser that measures the cone specific optical Stiles Crawford effect in a fast and patient friendly way, indicates that in MEWDS the cones are temporarily in disarray, but regain their original orientation in a matter of weeks. This is in agreement with OCT findings, where a transient disruption of the foveal photoreceptor outer segments is seen. In conclusion, this case demonstrates the usefulness of the new, sensitive FRA technique, in studying small, central visual defects, not discernible on full field ERG, in places where multifocal ERG is not available. In such cases OCT is also helpful.

Surgical therapy for diabetic retinopathy has been refined since the 1960s (Early Treatment Diabetic Retinopathy Study). While the Early Treatment Diabetic Retinopathy Study abstained from panretinal photocoagulation at the time of surgery, today, endophotocoagulation is the most important singular reason for vitrectomy, e.g., in vitreous hemorrhage. Despite improved techniques, the surgical prognosis is lagging behind patient expectations, especially in cases of advanced proliferative stages. The following review addresses current surgical options and indications of diabetic retinopathy/maculopathy.