ABSTRACT
Purpose: The study aimed to investigate the quantitative changes of retinal pigment epithelial (RPE) atrophy during a 24‑month follow‑up period of anti‑vascular endothelial growth factor (VEGF) for exudative age‑related macular degeneration (AMD). Materials and Methods: This is a retrospective study. Sixty‑five eyes of 62 consecutive patients with naïve exudative AMD who had received treatment with anti‑VEGF therapy and followed for more 24 months were enrolled. All patients received three initial monthly injections of anti‑VEGF (ranibizumab or bevacizumab), followed by pro re nata or treat‑and‑extend protocol. Color fundus image, optical coherence tomography, and fundus autofluorescence were evaluated for RPE atrophy. Multiple regression analysis was performed to investigate the predictive factors found during univariate analysis to identify an association with increased RPE atrophic areas. Results: The mean number of anti‑VEGF treatments was 9.18. RPE atrophic area was 1.293 ± 1.298 mm2 at baseline and enlarged to 2.394 ± 1.940 mm2 after 24 months, which differed significantly (P = 0.001). Multiple regression analysis revealed that larger areas of RPE atrophy at month 4 and larger numbers of anti‑VEGF treatments were associated with increased RPE atrophic areas. Conclusions: RPE atrophy progresses in eyes with exudative AMD during anti‑VEGF treatment. Larger areas of RPE atrophy at month 4 and larger numbers of anti‑VEGF injections were associated with an increased risk of progression of RPE atrophy the following treatment. These findings may be useful to clinicians using intravitreal anti‑VEGF for the treatment of exudative AMD, both for selecting an appropriate treatment plan and for predicting the progression of RPE atrophy.
ABSTRACT
Purpose: To improve our understanding of hyperacuity defects measured with preferential hyperacuity perimetry (PHP) by correlating PHP findings with the retinal microstructural changes visible on spectral‑domain optical coherence tomography (OCT) in patients with polypoidal choroidal vasculopathy (PCV). Materials and Methods: Twenty‑eight eyes of 28 patients with PCV were retrospectively reviewed. All patients underwent a complete ophthalmologic examination, including best‑corrected visual acuity (logMAR) testing, PHP, and OCT. The functional ‘PHP test score’ and ‘total volume of hyperacuity defect zone’ were also analyzed. Results: Patients were classified based on the hyperacuity defect by PHP, as follows: Hyperacuity defect (n = 17 eyes) group and hyperacuity intact (n = 11 eyes) group. The mean best‑corrected visual acuity in the hyperacuity intact group (0.46 ± 0.39) was better than that in the hyperacuity defect group (0.82 ± 0.37) (P = 0.014). The presence of serous retinal detachment and retinal pigment epithelial detachment did not differ significantly between groups (P = 0.120 and P = 0.689, respectively). A disrupted photoreceptor layer was more common in the hyperacuity defect group compared with the hyperacuity intact group (P = 0.0001). Among 17 eyes with a hyperacuity defect, 9 eyes showing intra‑retinal pathology (intra‑retinal cyst or hard exudates) and had a significantly higher PHP test score and larger total volume of the hyperacuity defect zone than 8 eyes without intra‑retinal pathology (P = 0.006 and P = 0.021, respectively). Conclusion: A hyperacuity defect in PCV was associated with photoreceptor disarrangement. Furthermore, PCV lesions on the inner retina that invaded the photoreceptor layer were associated with a more severe hyperacuity defect.
ABSTRACT
Purpose: To evaluate frequency and severity of segmentation errors of two spectral-domain optical coherence tomography (SD-OCT) devices and error effect on central macular thickness (CMT) measurements. Materials and Methods: Twenty-seven eyes of 25 patients with neovascular age-related macular degeneration, examined using the Cirrus HD-OCT and Spectralis HRA + OCT, were retrospectively reviewed. Macular cube 512 × 128 and 5-line raster scans were performed with the Cirrus and 512 × 25 volume scans with the Spectralis. Frequency and severity of segmentation errors were compared between scans. Results: Segmentation error frequency was 47.4% (baseline), 40.7% (1 month), 40.7% (2 months), and 48.1% (6 months) for the Cirrus, and 59.3%, 62.2%, 57.8%, and 63.7%, respectively, for the Spectralis, differing significantly between devices at all examinations (P < 0.05), except at baseline. Average error score was 1.21 ± 1.65 (baseline), 0.79 ± 1.18 (1 month), 0.74 ± 1.12 (2 months), and 0.96 ± 1.11 (6 months) for the Cirrus, and 1.73 ± 1.50, 1.54 ± 1.35, 1.38 ± 1.40, and 1.49 ± 1.30, respectively, for the Spectralis, differing significantly at 1 month and 2 months (P < 0.02). Automated and manual CMT measurements by the Spectralis were larger than those by the Cirrus. Conclusions: The Cirrus HD-OCT had a lower frequency and severity of segmentation error than the Spectralis HRA + OCT. SD-OCT error should be considered when evaluating retinal thickness.
ABSTRACT
A 34-year-old male visited the hospital due to decreased visual acuity in the left eye following an injury from a car accident. In the left eye, best-corrected visual acuity (BCVA) was hand motion and intraocular pressure (IOP) was 8 mmHg. Choroidal vasodilation and chorioretinal folds were observed by spectral domain-optical coherence tomography (SD-OCT). Topical and systemic steroid treatments did not improve the chorioretinal folds. Twelve months after the injury, intra-vitreal triamcinolone (4 mg/0.1 ml) was injected. Six months after intra-vitreal triamcinolone injection, BCVA in the left eye had improved to 20/100. Fundus examination showed improvement in retinal vascular tortuosity and SD-OCT revealed improvements in choroidal vasodilation and chorioretinal folds. Intra-vitreal triamcinolone injection (IVTI) was effective against traumatic chorioretinal folds with no recurrence based on objective observation by fundus photography and SD-OCT.