Purpose:The objective of this study is to evaluate the diagnostic ability of retinal nerve fiber layer (RNFL), macular, optic nerve head (ONH) parameters in healthy subjects, ocular hypertension (OHT), preperimetric glaucoma (PPG), and early glaucoma (EG) patients, to reveal factors affecting the diagnostic ability of spectral domain-optical coherence tomography (SD-OCT) parameters and risk factors for glaucoma.Methods:Three hundred and twenty-six eyes (89 healthy, 77 OHT, 94 PPG, and 66 EG eyes) were analyzed. RNFL, macular, and ONH parameters were measured with SD-OCT. The area under the receiver operating characteristic curve (AUC) and sensitivity at 95% specificity was calculated. Logistic regression analysis was used to determine the glaucoma risk factors. Receiver operating characteristic regression analysis was used to evaluate the influence of covariates on the diagnostic ability of parameters.Results:In PPG patients, parameters that had the largest AUC value were average RNFL thickness (0.83) and rim volume (0.83). In EG patients, parameter that had the largest AUC value was average RNFL thickness (0.98). The logistic regression analysis showed average RNFL thickness was a risk factor for both PPG and EG. Diagnostic ability of average RNFL and average ganglion cell complex thickness increased as disease severity increased. Signal strength index did not affect diagnostic abilities. Diagnostic ability of average RNFL and rim area increased as disc area increased.Conclusion:When evaluating patients with glaucoma, patients at risk for glaucoma, and healthy controls RNFL parameters deserve more attention in clinical practice. Further studies are needed to fully understand the influence of covariates on the diagnostic ability of OCT parameters.
Objectives: To evaluate the efficacy of intravitreal bevacizumab treatment in type 2 idiopathic macular telangiectasia (IMT).Materials and Methods: Six eyes of 5 patients with type 2 IMT who received intravitreal bevacizumab between 2009 and 2014 were included in this study. All the patients had an ophthalmological examination including best corrected visual acuity (BCVA), dilated fundus examination, spectral domain optical coherence tomography (OCT) and fluorescein angiography. Intravitreal bevacizumab injection was planned for patients who had macular edema and/or decreased visual acuity at baseline. Patients were examined 1 week and 1 month after the intravitreal injection. Intravitreal injection was repeated in patients whose visual acuity decreased and/or whose macular edema persisted or increased. Changes in BCVA, central macular thickness (CMT) and central macular volume from baseline at 1 month after the first injection and at final examination were evaluated.Results: Average age of the patients (4 female and 1 male) was 62±11.8 years. Average follow-up period was 26±11 months. Patients received an average of 2.3 (range 1-4) injections during follow-up. Average Snellen BCVA of the patients was 0.48±0.29. BCVA increased at final examination compared to baseline in all of the patients. The difference between baseline and final visual acuities was significant (p<0.05). The patients’ average CMT was 328±139 µm at baseline and decreased by a mean of 85±153 µm at 1 month after the first injection and 65±142 µm at final examination, but the changes were not significant. CMT decreased at final examination compared to baseline in four patients and increased in both eyes of one patient.Conclusion: Intravitreal bevacizumab injection is a preferable treatment method in regard to both visual acuity and OCT findings.
Purpose:To compare the outcomes of treatment with intravitreal bevacizumab (IVB) versus observation in central serous chorioretinopathy (CSCR).Methods:In a retrospective comparative study, records of 45 patients with CSCR were reviewed. Twenty-two patients received IVB (1.25 mg/0.05 ml) while 23 subjects were observed. All subjects underwent measurement of best corrected visual acuity (BCVA) and intraocular pressure (IOP), dilated fundus examination and optical coherence tomography (OCT) imaging at baseline and follow up visits. Outcome measures included central macular thickness (CMT) and BCVA in logarithm of minimum angle of resolution (logMAR) notations.Results:Mean age was 44.1 ± 9.3 (range: 24 to 64) years and mean follow-up period was 10.4 ± 11.2 (range: 3 to 43; median: 6) months. All patients demonstrated resolution of neurosensory detachment and improvement in visual acuity. At final visit, there was no significant difference in mean CMT between the IVB and observation groups (275 vs 284 μm, P> 0.05). Mean baseline logMAR visual acuity was 0.38 ± 0.24 in the IVB group which improved to 0.24 ± 0.31 at final follow-up (P = 0.011); mean baseline logMAR visual acuity was 0.42 ± 0.28 in the observation group and improved to 0.12 ± 0.18 (P = 0.001). Visual improvement was more marked in the observation group (0.30 vs 0.14 logMAR, P< 0.05) and mean final visual acuity was also significantly better (P = 0.05).Conclusion:There was no significant difference between IVB injection and observation in terms of anatomical outcomes of treatment for CSCR. In terms of visual outcomes, observation was superior to IVB injection.
Considering the effects of dexamethasone on macular edema intravitreal dexamethasone implant can be used in selected cases. Randomized clinical trials with larger sample size are needed for further evaluation.
A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes' best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA) showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF) was slightly increased. Spectral domain optical coherence tomography (SD-OCT) showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL). One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.
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