Optical coherence tomography angiography (OCTA) is a non-invasive retinal imaging innovation that has been gaining popularity for the evaluation of the retinal vasculature. Of clinical importance is its current use either as an alternative or in conjunction with conventional dye-based angiography in neovascular age-related macular degeneration. OCTA is not without limitations and these include image artefact, a relatively small field of view and failure of the segmentation algorithms, which can confound the interpretation of findings. While there are numerous publications on OCTA in neovascular AMD, few have examined the diagnostic accuracy of this new technology compared with the accepted gold standard of fundus fluorescein angiography (FFA). In this review, we summarise the literature on the clinical application of OCTA in nAMD. In particular, we have reviewed the published articles that have reported the sensitivity and specificity of OCTA in the diagnosis of nAMD, and those that have described and or correlated the morphological findings and compared them to dye-based angiography.

NITRO trial, ISRCTN35236442.

Purpose: To evaluate the safety and efficacy of the treatment of secondary graft failure in penetrating keratoplasty (PK) by performing Descemet membrane endothelial keratoplasty (DMEK) without host descemetorhexis. Methods: This is a retrospective case series study of 8 eyes from 8 patients who underwent non host Descemet membrane stripping DMEK surgery under a previously failed PK. The DMEK graft diameter was either matched or 0.25 to 0.5 mm undersized in relation to the PK diameter. Six-month postoperative data are presented. Primary outcome measures were safety and anatomical success. Results: No intraoperative complications were registered. Postoperatively, 1 case developed a PK host–donor junction dehiscence in relation to a previous early suture removal, requiring PK resuturing and DMEK rebubbling. Only 1 additional case required DMEK rebubbling. No primary graft failure was detected, and all cases achieved full PK transparency within 2 weeks. Corrected distance visual acuity improved from a median of counting fingers (CF-0.2) to 0.57 (0.05–0.7). Median central corneal thickness improved from 650.5 (497–897) to 464 (372–597) μm. Median endothelial cell density was 1080 (581–2043) cells/mm2. Rebubbling rate (25%) was lower than that previously reported. All patients had extensive preoperative ocular comorbidity. Conclusions: DMEK under PK without host descemetorhexis is a feasible surgical alternative for the treatment of graft failure after PK. It is associated with equivalent levels of efficacy and safety compared with Descemet membrane stripping DMEK techniques but simplifies the surgical procedure and avoids potential intraoperative complications associated with Descemet stripping. Further studies with a larger sample and a longer follow-up are necessary to confirm our preliminary outcomes.

Patient-reported outcomes after enucleation for uveal melanoma indicate no major differences between hydroxyapatite and acrylic implants in surgical outcomes and patient satisfaction. There was a higher prevalence of ptosis with AC and a greater need of ocularists' visits with HA at around 6 months observed by ocularists.

No abstract

Purpose Retrospective case series evaluating the efficacy and safety of implanting XtraFocus ™ pinhole device in pseudophakic patients with irregular corneal astigmatism with concurrent or standalone iris defect. Methods Electronic case records were searched for: uncorrected distance visual acuities (UDVA) and corrected distance visual acuities (CDVA), automatic or manifest refraction and spherical equivalent (SE). All main outcomes were evaluated preoperatively and postoperatively at 1, 3, 6, 9 and 12 months, along with patients’ satisfactory outcome and complications. Results Eleven pseudophakic eyes of 11 patients with a mean age of 54 (range 27–81) years were included. Median UDVA improved significantly from logMAR 0.7 (range 0.1–1.22) pre-operatively to 0.4 (range 0–1.3) at 1-month ( p = 0.002); median CDVA remained unchanged at logMAR 0.4 (range 0–0.1) pre-operatively and 0.4 (range 0–0.8) at 1-month ( p = 0.36). There were no significant statistical differences in both UDVA and CDVA between the post-operative periods. Ten patients (90.9%) had initial UDVA improvement at 1-month post op. Eight (72.7%) patients expressed satisfaction with improved vision or reduction of glare/halos. Three (27.3%) patients had unsatisfactory visual outcome resulting in 2 requested for implant explantation due to worsening of glare and distressing floaters. Conclusions XtraFocus ™ is effective in improving vision or reducing glare in pseudophakic patients with irregular corneal astigmatism or intragenic iris trauma, with over 70% expressed satisfactory outcome. Disturbing floaters and glare preclude its use in some resulting in implant explantation.

Purpose:To report two cases of spontaneous Descemet's membrane detachment (DMD) and dehiscence following penetrating keratoplasty (PK).Case Reports:Spontaneous DMD or Descemet's membrane (DM) dehiscence following PK is a rare occurrence. Here, we describe two cases of such an occurrence following PK arising from the graft–host interface. A possible causative relation between DMD/dehiscence and DM–stromal interface attachment is suggested.Conclusion:DMD and dehiscence after PK can be explained by the peripheral thinning of DM and possible changes to the recently characterized anchoring zone of interwoven collagen fibers and proteoglycans at the Descemet–stroma interface.

DSAEK is a viable alternative to PK to restore visual function in eyes with an AGV sited in the anterior chamber. IOP is an important risk factor for graft failure.