Reduced light sensitivity due to impaired retinal perfusion in branch retinal vein occlusion

Purpose

To study the reduction in light sensitivity in areas where impaired retinal perfusion was established by fluorescein angiogram (FA) in eyes with branch retinal vein occlusion (BRVO) that recovered from retinal edema and hemorrhage.

Design

Retrospective observational case series.

Methods

A study of the reduction in light sensitivity demonstrated by total deviation display of the Humphrey perimetry program 30-2 in 43 eyes from 42 patients with BRVO, whose perfusion status was assessed by FA images taken at least 6 months after disease onset. Each of the 15 retinal squares in the FA images, corresponding to the 15 Humphrey test points around the fixation point in the affected vertical hemisphere, was classified as either perfused, partially perfused, or non-perfused. Correlation between light sensitivity and perfusion status was investigated by three evaluators in a total of 645 squares, 15 squares from each of the 43 subject eyes.

Results

In 459 retinal squares (71.2%) with complete agreement on the perfusion status among the three evaluators, light sensitivity was significantly different among retinal squares of perfused (median: ? 4.0 dB, n = 258), partially perfused (median: ? 8.0 dB, n = 41), and non-perfused (median: ? 16.0 dB, n = 160) (P < .000001, Kruskal–Wallis test).

Conclusions

Light sensitivity is decreased in retinal areas exhibiting impaired perfusion, likely due to neuronal loss in the inner retinal layer in eyes with chronic BRVO.

     

Crossover clinical trial of pain relief in cataract surgery

Purpose

To determine the effects of intra-operative Korean traditional music on pain experienced by Korean patients undergoing sequential bilateral cataract surgery.

Methods

This was a two-sequence, two-period, and two-treatment crossover study. Fifty-two patients with cataracts were divided into two groups by block randomization, and bilateral cataract surgery was performed. In group 1, patients listened to Korean traditional music (KTM) during their first but not second cataract surgery. This sequence was reversed for patients in group 2. After each surgery, patients scored their pain intensity (PI) using a visual analog scale (VAS) ranging from 0 to 10, where 0 was ‘no pain’ and 10 was ‘unbearable pain.’

Result

There was a statistically significant reduction in the mean VAS score with KTM (3.1 ± 2.0) compared to that without KTM (4.1 ± 2.2; p = 0.013). However, there were no statistically significant differences in blood pressure or pulse rates.

Conclusion

KTM had a significant effect on reducing pain experienced by patients during cataract surgery. This may be useful in the context of other surgical procedures to reduce pain in Korean patients.

     

Evaluating retinal vessel diameter with optical coherence tomography in normal-tension glaucoma patients

Purpose

To investigate a novel optical coherence tomography (OCT)-derived variable, circumpapillary mean retinal shadow width (cpMRSW), and to elucidate its association with normal-tension glaucoma (NTG).

Methods

For the purpose of validation, we measured retinal vascular calibers in 68 arterioles and 100 venules of 12 NTG patients and 12 healthy subjects and compared the width of the visible retinal shadows in spectral-domain OCT images and the caliber of retinal vessels in retinal photographs. Then we calculated cpMRSW in 78 NTG eyes and 25 age-matched healthy control eyes. Additionally, we divided the patients into early (mean deviation: MD > ?6 dB), moderate (MD ?6 to ?12 dB), and severe (MD < ?12 dB) NTG groups, and compared cpMRSW in these groups. Finally, we calculated the area under the receiver operating characteristic (ROC) curve in order to determine the power of mean retinal shadow width to distinguish the groups.

Results

OCT retinal shadow width was significantly correlated with photography-measured retinal caliber (r = 0.82, P < 0.001). CpMRSW was significantly different between the control and NTG patients (control: 107.3 ± 7.0 µm, mild: 99.4 ± 8.6 µm, moderate: 99.7 ± 9.5 µm, severe: 90.5 ± 12.0 µm, P < 0.001), despite similar distributions in systemic variables. An ROC analysis revealed that cpMRSW could differentiate NTGs from normal eyes (area under the ROC curve: 0.81).

Conclusions

Our new software for measuring mean retinal shadow width in OCT images may be a valuable tool for detecting NTG and diagnosing its severity.

     

Choroidal thickness in chronic rhegmatogenous retinal detachment before and after surgery,and comparison with acute cases

Purpose

To evaluate subfoveal choroidal thickness (SCT) in cases with chronic rhegmatogenous retinal detachment (RRD), before and after pars plana vitrectomy, and cases with acute RRD using optical coherence tomography.

Methods

This retrospective study included 24 eyes with chronic RRD and 26 eyes with recent-onset RRD. Best corrected visual acuity, intraocular pressure, and SCT were measured and compared between the two groups. Of 24 eyes with chronic RRD, 11 had primary pars plana vitrectomy. Measurements of operated and fellow eyes were also compared before surgery and 1 week, 1 and 3 months after surgery.

Results

The preoperative mean SCT in eyes with chronic RRD was 342.6 ± 111.7 µm and in fellow eyes 342.4 ± 116.7 µm (P = 0.83) and in eyes with acute RRD was 346.2 ± 51 µm and in fellow eyes 262.7 ± 46.8 µm (P < 0.001). There was also no significant change in SCT between baseline before surgery and 3 months after surgery in eyes with chronic RRD (P = 0.20).

Conclusion

No significant difference was found in the mean SCT between affected and fellow eyes in chronic RRD. This may be related to intraocular inflammation, which is more limited in chronic than in acute RRD. There was also no significant difference in the SCT in eyes with chronic RRD between the operated and fellow eyes after surgery. It may be concluded that vitrectomy does not affect choroidal thickness.

     

Evaluation of the effect of fluorescein angiography on retinal vessel diameter: an optical coherence tomography study

Purpose

To evaluate the effect of fluorescein angiography on retinal vessel diameter with Optical Coherence Tomography (OCT).

Methods

In this cross-sectional study, a total of 81 eyes of 81 patients who were performed fluorescein angiography (FA) procedure were included. Retinal vessels were examined with the Spectral-domain OCT at baseline and immediately after FA procedure. A cube scan consisting of seven horizontal scans were placed at the inferior border of the disk to include the inferior temporal retinal vessels. Vessels diameters were measured at five measurement points (480–1440 μm inferiorly from the optic disk border).

Results

The mean age of the study subjects was 58.02 ± 14.1 years. At baseline, the mean diameter of the retinal artery was 120.16 ± 24.56 µm and of the vein 157.94 ± 32.34 µm at the measurement point of 480 μm, with a gradual decrease to 114.91 ± 25.59 and 152.17 ± 28.17 µm, respectively, at 1440 μm. After FA procedure, the mean diameter of the retinal artery was 122.85 ± 26.35 and of the vein 158.30 ± 32.21 µm at the measurement point of 480 μm, with a gradual decrease to 115.22 ± 22.91 and 151.94 ± 28.93 µm, respectively, at 1440 μm. There were no statistical differences for either of these comparisons at any of the points of both artery and vein measurements.

Conclusion

There was not any clinically significant change in retinal artery diameter such as a dilatatory response after FA procedure in patients with hypertension, diabetes, and age-related macular degeneration (AMD).

     

Glaucoma following childhood cataract surgery: the South India experience

Purpose

To determine the characteristics and risk factors for the development of glaucoma after cataract surgery in children seen at a major referral tertiary eye centre in South India.

Methods

This is a retrospective review of the medical records of consecutive patients seen at the glaucoma/paediatric eye clinic of the centre, with a diagnosis of glaucoma secondary to aphakia/pseudophakia over a 5-year period.

Results

There were 21 eyes of 14 children that developed glaucoma and 23 eyes of 12 children were selected as control. The mean age (standard deviation SD) at the time of cataract surgery for the glaucoma group was 7.4 (± 10.1) months and 39.13 (± 41.2) months for the control. The mean follow-up (SD) period was 114.29 (± 61.9) months and 97.61 (± 43.5) months for the glaucoma and control, respectively. The mean duration from cataract surgery to onset of glaucoma was 81.19 (± 52.4) months (median 66 months, range 21–172 months). Multivariate analysis detected age at surgery younger than 12 months (OR 10.45, 95%CI 1.76–62.03, p = 0.010) and ocular anomalies mainly microcornea (OR 7.11, 95%CI 1.14–44.46, p = 0.036) as risk factors for development of glaucoma after paediatric cataract surgery.

Conclusion

Glaucoma can develop several years after childhood cataract surgery. Surgery in the first year of life and microcornea are risk factors for the development of glaucoma post-surgery. Signs of glaucoma should specifically be looked for during follow-up visits.

     

Treatment of Branch Retinal Vein Occlusion induced Macular Edema with Bevacizumab

Background

Branch retinal vein occlusion is a frequent cause of visual loss with currently insufficient treatment options. We evaluate the effect of Bevacizumab (Avastin^®) treatment in patients with macular edema induced by branch retinal vein occlusion.

Methods

Retrospective analysis of 32 eyes in 32 patients with fluorescein angiography proven branch retinal vein occlusion, macular edema and Bevacizumab treatment. Outcome measures were best corrected visual acuity in logMAR and central retinal thickness in OCT.

Results

Visual acuity was significantly better 4 to 6 weeks after Bevacizumab treatment compared to visual acuity prior to treatment (before 0.7 ± 0.3 and after 0.5 ± 0.3; mean ± standard deviation; p < 0.01, paired t-test). Gain in visual acuity was accompanied by a significant decrease in retinal thickness (454 ± 117 to 305 ± 129 μm, p < 0.01, paired t-test). Follow up (170, 27 – 418 days; median, range) shows that improvement for both visual acuity and retinal thickness last for several months after Bevacizumab use.

Conclusion

We present evidence that intravitreal Bevacizumab is an effective and lasting treatment for macular edema after branch retinal vein occlusion.

     

Effects of phacoemulsification with versus without viscoelastic devices on surgical outcomes

Purpose

The aim of this study is to report surgical outcomes in patients undergoing phacoemulsification surgery (PE) with versus without ophthalmic viscosurgical devices (OVDs).

Methods

This is a comparative case series study. In total, 145 patients who performed PE with OVDs in 68 eyes (Group 1) and without OVD in 77 eyes (Group 2) were enrolled. A comprehensive ophthalmological examination was performed including slit-lamp, fundus examination. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) specular endothelial microscopy (SM), and ultrasound pachymetry (UP) were also measured before surgery and at four-time points postoperatively. The differences in baseline characteristics as well as in outcomes were compared between the two groups.

Results

The mean BCVA was 0.41 ± 0.26 logMAR in Group 1 and 0.54 ± 0.34 in Group 2 at postoperative first day, with a significant difference (p < 0.01). The mean BCVA, IOP, and UP at 6 months did not differ between the groups. The mean baseline and postoperative SMs were 2063 and 1910 cells/mm², respectively, and the endothelial cell loss (ECL) was 153.89 ± 189 in Group 1. The mean baseline and postoperative SMs were 2153 and 1948 cells/mm², respectively, and the ECL was 205 ± 200 in Group 2. The difference between the groups was not statistically significant (p = 0.105).

Conclusions

The ECL seemed to be higher in the Group 2, but the difference was not significant. The final clinical outcomes were similar between the groups. In selected cases, PE without OVD may be preferable to reduce the cost of surgery in places with low economic status and to prevent side-effects of these devices.

     

Clinical utility of femtosecond laser-assisted astigmatic keratotomy after cataract surgery

Purpose

To examine the clinical utility of femtosecond laser-assisted astigmatic keratotomy (FSL-AK) for eyes after cataract surgery.

Methods

Eight eyes of 6 patients with an intraocular lens and corneal astigmatism of 2.0 diopters (D) or more underwent FSL-AK. The mean preoperative manifest cylindrical refraction was 2.88 ± 0.64 D and the mean corneal astigmatism was 2.84 ± 0.83 D. Paired symmetrical arcuate incisions were created with the same settings, except for the incision depth. Uncorrected distance visual acuity (UDVA), manifest cylindrical power, and surgically induced astigmatism (SIA) were measured at 1 day, 1 week, and 1 month postoperatively. Fourier analysis of corneal topography and incision depths measured with anterior-segment optical coherence tomography were evaluated 1 month postoperatively.

Results

In all eyes, the UDVA improved at 1 week and 1 month postoperatively, and the manifest cylinder also decreased postoperatively, while the SIA showed overcorrections in 6 eyes. Fourier analysis showed decreases in spherical and regular astigmatic components and increases in higher-order irregularity. The mean incision depth was measured as 60 µm deeper than the intended depth.

Conclusion

The FSL-AK effectively reduced corneal astigmatism and improved the UDVA, although it was demonstrated that the deeper incisions led to overcorrection.

     

Outcomes of 23- and 25-gauge transconjunctival sutureless vitrectomies for dislocated intraocular lenses

Purpose

To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs).

Design

Retrospective, non-consecutive, comparative, interventional case series.

Participants

Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments.

Methods

The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued.

Results

Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9).

Conclusions

25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.

     

Contribution of dual fluorescein and indocyanine green angiography to the appraisal of posterior involvement in birdshot retinochoroiditis and Vogt–Koyanagi–Harada disease

Purpose

To assess the levels of retinal and choroidal involvement in initial-onset birdshot retinochoroiditis (BRC) and Vogt–Koyanagi–Harada (VKH) disease, two stromal choroiditis entities.

Methods

This retrospective study included patients diagnosed with BRC and VKH, seen during initial-onset disease at the Centre for Ophthalmic Specialized Care, Lausanne, Switzerland. Angiographic signs were quantified, using an established dual fluorescein angiography (FA) and indocyanine green angiography (ICGA) scoring system for uveitis, and the FA/ICGA score ratios were compared between diseases.

Results

Among 1793 patients with uveitis seen from 1995 to 2015, 7 newly diagnosed BRC patients and 4 patients with newly diagnosed VKH disease had sufficient data for study inclusion. Patients with BRC and VKH at initial onset had mean FA angiographic scores of 16.91 ± 3.42 and 4.06 ± 1.87; mean ICGA angiographic scores of 21.34 ± 3.49 and 25.75 ± 3.88; and mean FA/ICGA ratios of 0.79 ± 0.21 and 0.16 ± 0.09, respectively.

Conclusion

This study showed the differential involvements of the retina and choroid in BRC and VKH. The choroid was preponderantly involved in both diseases; thus, ICGA is essential for disease assessment and follow-up. However, these diseases also differed substantially. The origin of inflammation was primarily in the choroid in VKH and in both the choroid and retina in BRC. We recommend dual FA and ICGA for evaluating posterior uveitis, when choroiditis is suspected.

     

Quantification of retinal changes after resolution of submacular hemorrhage secondary to polypoidal choroidal vasculopathy

Purpose

To evaluate changes in the thickness of retinal layers after resolution of submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV).

Study design

Retrospective, observational study.

Methods

This study included 21 patients (21 eyes) who had been diagnosed with submacular hemorrhage secondary to PCV and treated using anti-vascular endothelial growth factor monotherapy. After the hemorrhage had resolved, the thicknesses of the retinal layers were measured on horizontal- and vertical-crosshair optical coherence tomography scan images. The thickness of each layer in the region affected by the hemorrhage was compared with the thickness of the layer in the corresponding region in the fellow eye, as well as between an unaffected region in the eye with the hemorrhage and the corresponding region in the fellow eye.

Results

Optical coherence tomography (OCT) was performed 5.5±2.8 months after diagnosis. In the horizontal OCT images, the outer plexiform layer (OPL) and outer nuclear layer (ONL) + photoreceptor layer (PRL) were significantly thinner in the affected region than in the corresponding region (P = 0.019 and P <0.001, respectively). In the vertical OCT image, the ONL+PRL was significantly thinner in the affected region than in the corresponding region (P <0.001). The thickness of the retinal layer in the unaffected region did not differ from that in the corresponding region of the fellow eye.

Conclusions

The significant thinning of the outer retinal layers in the regions affected by submacular hemorrhage suggests that the hemorrhage induces marked damage in the outer retinal layers, explaining the poor visual prognosis of submacular hemorrhage.

     

Retinal thinning after internal limiting membrane peeling for idiopathic macular hole

Purpose

To determine the changes in retinal thickness and whether they correlate with the size of the macular hole (MH) after vitrectomy with internal limiting membrane peeling.

Study design

Retrospective, interventional case series

Methods

Consecutive patients with an MH and undergoing pars plana vitrectomy with internal limiting membrane peeling were studied. The retinal thicknesses in the inner 4 sectors as defined by the Early Treatment of Diabetic Retinopathy Study were measured using spectral-domain optical coherence tomography (SD-OCT) before and at 2 weeks and 1, 3, 6, and 12 months after the surgery. The basal and minimum diameters of the MHs were measured. The correlations between the retinal thicknesses and the size of the MH were determined.

Results

Thirty-three eyes of 32 consecutive patients (18 women; mean age, 64.2 ± 8.8 years) with an MH were studied. Thirteen eyes had a stage-2 MH; 12 eyes, a stage-3 MH; and 8 eyes, a stage-4 MH. The mean retinal thickness in the temporal sector was 362.8 ± 29.9 µm preoperatively, 337.9 ± 20.6 µm at 2 weeks postoperatively, and 307.6 ± 20.2 µm at 12 months postoperatively (P < .001 for both, paired t tests). The respective mean thicknesses in the superior, inferior, and nasal sectors were 373.9 ± 34.9, 367 ± 28.7, and 385.5 ± 35.9 µm preoperatively; 361.6 ± 22.7, 359.4 ± 20.6, and 383.4 ± 29.0 µm at 2 weeks postoperatively (P = .0087, P = .049, P = .635); and 339.4 ± 18.9, 331.6 ± 21.4, and 371.3 ± 23.2 µm at 12 months postoperatively (P < .001, P < .001, P = .033). The changes in the retinal thickness at 2 weeks and 12 months in all 4 sectors were significantly correlated with the basal and minimum diameters of the MH.

Conclusions

Retinal thinning was observed soon after the MH surgery mainly in the temporal sector but also in the superior and inferior sectors. The thinning was greater in eyes with a larger MH, indicating that retinal structures dynamically change after internal limiting membrane peeling.

     

Long-term surgical outcome of conventional trabeculotomy for childhood glaucoma

Purpose

To investigate the long-term surgical outcomes of conventional trabeculotomy in eyes with childhood glaucoma in a Japanese population.

Methods

In this retrospective observational study, we enrolled Japanese patients with childhood glaucoma who underwent a conventional trabeculotomy at least once before age 3 years from 1986 to 2014 in our hospital.

Results

One hundred seven eyes of 64 patients (24 girls, 40 boys; mean age, 2.8 ± 5.1 months) were included. Sixty-eight (64%) eyes had primary childhood glaucoma (PCG) and 39 (36%) eyes had secondary childhood glaucoma (SCG). The average numbers of surgical operations performed to treat the two glaucoma types that resulted in significantly (p < 0.001) different surgical success rates were 1.4 ± 0.7 and 2.1 ± 0.8. Statistical analysis showed that eyes with PCG, compared with those with SCG, were successfully treated by one trabeculotomy and up to three trabeculotomies (hazard ratios 6.66 and 4.02, respectively). Age, gender, systemic complications, corneal diameter, corneal edema, and preoperative intraocular pressure did not significantly affect the surgical outcomes.

Conclusions

Most eyes with PCG are treatable with a maximum of three trabeculotomies. However, SCG usually is refractory to trabeculotomy, and a more promising surgery must be designed.

     

Subretinal injection of recombinant tissue plasminogen activator for submacular hemorrhage associated with ruptured retinal arterial macroaneurysm

Purpose

To evaluate the surgical outcomes of small-gauge vitrectomy with subretinal injection of recombinant tissue plasminogen activator (rt-PA) for a submacular hemorrhage caused by a ruptured retinal arterial macroaneurysm (RAM).

Methods

Non-comparative, consecutive case-series performed at two ophthalmological institutions. We examined 22 eyes of 22 patients with a submacular hemorrhage associated with a RAM but without a preretinal or sub-internal limiting membrane hemorrhage at the fovea. During 25-gauge vitrectomy, approximately 4000–8000 IU of rt-PA was injected subretinally, followed by the injection of air or 10 % sulfur hexafluoride as a tamponade. The patients maintained an upright position for 1 hour, then turned to a facedown position for 1 to 3 days. The best-corrected visual acuity (BCVA) and postoperative complications were evaluated.

Results

The average interval from the onset of symptoms to surgery was 8.4?±?7.6 days, and the average size of the subretinal hemorrhage was 3.4?±?1.0 disc diameters. The submacular hemorrhage was displaced from the foveal area in all eyes after 1 week. The mean baseline BCVA was 1.41?±?0.41 logMAR units, and it improved to 0.91?±?0.43 at 1 month and to 0.64?±?0.45 at the final visit (P?=?0.0001, P?<?0.0001 respectively). A macular hole was detected intraoperatively in two eyes and postoperatively in two eyes, and both were closed by internal limiting membrane peeling or a second vitrectomy.

Conclusions

Small-gauge vitrectomy with subretinal rt-PA injection and gas tamponade were effective in displacing a submacular hemorrhage associated with a RAM.

     

Evaluation of factors affecting visual acuity after Descemet stripping automated endothelial keratoplasty

Purpose

To elucidate the factors affecting visual acuity after Descemet stripping automated endothelial keratoplasty (DSAEK).

Methods

We reviewed consecutive patients who underwent primary DSAEK for corneal endothelial dysfunction at Inouye Eye Hospital from January 2010 through January 2015 and who had a follow-up of at least 6 months. Fifty-four eyes of 49 patients (24 men and 25 women) were enrolled; the mean age was 72.5 ± 8.7 years. Medical charts were retrospectively examined for best spectacle-corrected visual acuity (BSCVA), intraocular pressure, keratometric value, keratometric cylinder, grade of preoperative corneal edema, preoperative graft thickness, and endothelial cell density (ECD) before and at 1, 3, 6, 12, and 24 months after surgery. A multiple regression analysis was used to evaluate the factors associated with BSCVA at 3, 6 months, and 1 year after surgery. Explanatory variables included age, sex, preoperative factors (BSCVA, degree of corneal edema, donor ECD, and graft thickness), and factors at each time point (keratometric value, keratometric cylinder, and intraocular pressure).

Results

The mean logarithms of the minimum angle of resolution (logMAR) BSCVA preoperatively and at 1, 3, 6, and 12 months after surgery were 1.03 ± 0.49, 0.42 ± 0.26, 0.29 ± 0.21, 0.24 ± 0.20, and 0.22 ± 0.20, respectively. Multiple regression analysis showed that preoperative BSCVA alone was significantly associated with BSCVA at 3, 6, and 12 months.

Conclusion

A better preoperative BSCVA was associated with a better BSCVA after DSAEK, which suggests that DSAEK should be considered earlier than stromal changes such as subepithelial fibrosis occurrence.

     

Topography and correlation of radial peripapillary capillary density network with retinal nerve fibre layer thickness

Purpose

To analyse the expansion of radial peripapillary capillary (RPC) network with optical coherence tomography angiography (OCT-A) in normal human eyes and correlate RPC density with retinal nerve fibre layer thickness (RNFLT) at various distances from the optic nerve head (ONH) edge.

Methods

Fifty eyes of 50 healthy subjects underwent imaging with RTVue XR-100 Avanti OCT. OCT-A scans of Angio disc (6 × 6 mm) and Angio retina (8 × 8 mm) were combined to create a wide-field montage image of the RPC network. RPC density and RNFLT was calculated at different circle diameter around the ONH, and their correlation was measured.

Results

In the arcuate region, RPC was detected as far as 8.5 mm from the ONH edge, but not around the perifoveal area within 0.025 ± 0.01 mm². The mean RPC density (0.1556 ± 0.015) and RNFLT (245.96 ± 5.79) were highest at 1.5 mm from ONH margin, and there was a trend in its decline, in a distance-dependent manner, with the least density at 8.5 mm (all P < 0.0001). Highest RPC density was noted in the arcuate fibre region at all the distances. Overall mean RPC density correlated significantly (P < 0.0001) with the overall mean RNFLT.

Conclusions

Wide-field montage OCT-A angiograms can visualize expansion of the RPC network, which is useful in obtaining information about various retinal disorders. The results obtained support the hypothesis that the RPC network could be responsible for RNFL nourishment.

     

Surgical outcomes of 27-gauge pars plana vitrectomy with short-term postoperative tamponade of perfluorocarbon liquid for repair of giant retinal tears

Purpose

To investigate the use of 27-gauge pars plana vitrectomy (PPV) with short-term tamponade of perfluorocarbon liquid (PFCL) for repair of giant retinal tears (GRT).

Methods

Retrospective case series study. Consecutive patients with GRT were treated with 27-gauge PPV and short-term tamponade of PFCL for 7–10 days. PFCL was completely removed with a secondary surgery.

Results

Twenty-three eyes of 23 patients were included. All the patients achieved primary anatomic success. Preoperative logarithm of the minimum angle of resolution (logMAR) BCVA was 1.59 ± 0.58 (Snellen 20/778). Five (21.7%), nine (39.1%), eleven (47.8%) and fifteen (65.2%) eyes experienced vision improvement at the Month-1, Month-3, Month-6 and final follow-ups, respectively. The final logMAR BCVA was 0.84 ± 0.51 (Snellen 20/138), being statistically better than the preoperative one (P < 0.001). Surgical complications included foreign body response (n = 7), transient elevated intraocular pressure (n = 5), cataract formation/deterioration (n = 11) and posterior capsule opacity (n = 16).

Conclusions

27-Gauge PPV with short-term tamponade of PFCL is safe and effective for the repair of GRT. Side effects of the surgery mainly included foreign body response, transient elevated intraocular pressure, cataract formation/deterioration and posterior capsule opacity.

     

Safety of intravitreal clindamycin in albino rabbit eyes

Purpose

To study the potential toxic effects of intravitreal clindamycin on the retina of albino rabbits, by assessing functional and morphological retinal changes.

Methods

Eight albino rabbits were included in the study. In each rabbit, 1 mg/0.1 ml clindamycin was injected into the vitreous of the right (experimental) eye, and 0.1 ml saline was injected into the vitreous of the left (control) eye. The electroretinogram (ERG) was recorded before injection, 3 days, 1, 2, and 4 weeks post-injection. The visual evoked potential (VEP) was recorded 4 weeks post-injection. Clinical examination was conducted at all time points. The eyes were enucleated at the termination of the follow-up period in order to prepare the retinas for histology in order to assess retinal structure.

Results

ERG and VEP responses that were recorded from the experimental eye at different times following intravitreal clindamycin injection were very similar to the corresponding responses that were recorded from the control eyes. Clinical examination was normal in all eyes, and no histological damage was observed.

Conclusions

Intravitreal injection of 1 mg clindamycin does not cause functional or morphological signs of retinal toxicity in albino rabbits, during a period of 4 weeks post-injection. These findings support the clinical use of 1 mg intravitreal clindamycin.