There are significant differences between patients with AMD and DME regarding compliance and adherence, which also affects outcome. Strategies to tie patients with DME to costly intravitreal therapy need to be developed to improve outcomes and efficacy.

Access to large, annotated samples represents a considerable challenge for training accurate deep-learning models in medical imaging. While current leading-edge transfer learning from pre-trained models can help with cases lacking data, it limits design choices, and generally results in the use of unnecessarily large models. We propose a novel, self-supervised training scheme for obtaining high-quality, pre-trained networks from unlabeled, cross-modal medical imaging data, which will allow for creating accurate and efficient models. We demonstrate this by accurately predicting optical coherence tomography (OCT)-based retinal thickness measurements from simple infrared (IR) fundus images. Subsequently, learned representations outperformed advanced classifiers on a separate diabetic retinopathy classification task in a scenario of scarce training data. Our cross-modal, three-staged scheme effectively replaced 26,343 diabetic retinopathy annotations with 1,009 semantic segmentations on OCT and reached the same classification accuracy using only 25% of fundus images, without any drawbacks, since OCT is not required for predictions. We expect this concept will also apply to other multimodal clinical data-imaging, health records, and genomics data, and be applicable to corresponding sample-starved learning problems. 2.

Our case series could confirm a positive influence of spironolactone on the course CSC. Longer follow-up with a larger number of cases could provide more data about the long-term efficiency, recurrences, and safety of this well-tolerated and non-invasive treatment option of CSC.

Our observations suggest that topical interferon alpha-2b might be an effective agent for the adjuvant treatment of melanocytic conjunctival tumors without side-effects. It might be an alternative to other more toxic chemotherapeutical agents. A prospective multicenter study will help to finally evaluate the potential of topical interferon therapy for melanocytic conjunctival tumors, in particular PAM with atypia and minimal invasive conjunctival melanoma.

Purpose To determine the anatomical and functional outcomes of an extended 6-month intravitreal anti-vascular endothelial growth factor (anti-VEGF) upload in choroidal neovascularization (CNV) secondary to chronic central serous chorioretinopathy (CSCR). Methods A retrospective database analysis was performed applying the following inclusion criteria: (1) diagnosis of CSCR, (2) diagnosis of secondary CNV, and (3) treatment of at least six consecutive injections of anti-VEGF. Outcome measures included the change of central retinal subfield thickness, remodeling of the pigment epithelium detachments, and change in visual function. Results Twenty-one eyes of 21 patients were included. Mean patient age was 65 ± 8.3 years, and 35% of the patients (n = 8) were female. Mean disease duration before diagnosis of CNV was 48 ± 25.3 months. Mean central retinal thickness decreased from 346 ± 61 to 257 ± 57 μm (p < 0.01) after the sixth injection while mean visual acuity improved from 0.65 ± 0.35 to 0.49 ± 0.29 (logMAR; p < 0.01). Of note, an extended upload of six as opposed to three injections yielded an additional mean central retinal thickness reduction (280 ± 46 μm vs. 257 ± 57 μm, p = 0.038). Significant CNV remodeling was observed as a decrease in pigment epithelium detachment (PED) vertical (p = 0.021) and horizontal diameter (p = 0.024) as well as PED height (p < 0.01). Conclusion An extended anti-VEGF upload of six consecutive injections seems to be effective in inducing CNV remodeling and fluid resorption in CNV complicating chronic CSCR.