Choroidal Neovascularization Associated with Best Vitelliform Macular Dystrophy.

Objectives: The aim of the study was to evaluate the clinical and optical coherence tomography (OCT) findings of patients with choroidal neovascularization (CNV) due to best vitelliform macular dystrophy (BVMD). Methods: Six eyes that were diagnosed with CNV associated with BVMD were evaluated retrospectively. A standard ophthalmologic examination, a fundus fluorescein angiography (FA), and the OCT findings of the patients were examined. Anatomical and functional changes seen after treatment were evaluated. Results: One (16%) of the cases was female and five (83%) were male. The mean age was calculated as 36.3±24.9 years (range 11-73 years). The mean follow-up period of the cases after detecting CNV was determined as 26 months (range 6-168 months). Best corrected visual acuities were 0.65±0.39 logMAR (1.0-0.2 logMAR) when CNV was detected and 0.42±0.25 logMAR (limits 0.7-0.2 logMAR) at the end of the follow-up. Photodynamic therapy was applied to one (17%) of the cases, and intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment was applied to the others (83%). The mean number of intravitreal injections was found to be 3±1.37 (range 2-4).In all cases, intraretinal fluid (IRF), subretinal fluid (SRF), external limiting membrane, and irregularities in inner retinal layers were observed in the initial OCT examinations. In all cases, it was observed that the IRF regressed with treatment and SRF continued in five eyes. Hypertrophic outer retinal scarring developed in all cases. Conclusion: In cases with CNV due to BVMD, regression in CNV activity was achieved with intravitreal anti-VEGF injection treatment. The IRF is a marker that can be used both in the diagnosis and treatment monitoring of CNV associated with BVMD.

Is pseudoexfoliation syndrome associated with vitreoretinal interface abnormalities?

BACKGROUND: To evaluate vitreoretinal interface abnormalities in patients with pseudoexfoliation (PEX) syndrome. METHODS: This case-control study was performed in 136 patients diagnosed with unilateral PEX (PEX group) and 139 age- and sex-matched healthy volunteers (Control group). Both the affected and contralateral eyes were evaluated in the PEX group and the right eye was evaluated in the Control group. Vitreoretinal interface abnormalities and posterior vitreous detachment (PVD) were evaluated on optical coherence tomography (OCT) examination. RESULTS: The incidences of incomplete and complete PVD were significantly higher in the affected than contralateral eye in the PEX group and in the right eye in the Control group (P = 0.009, P = 0.012 and P = 0.004, P = 0.017, respectively). The rates of 'no PVD' were significantly higher in the contralateral eye in the PEX group and the Control group compared to the affected eye in the PEX group (P = 0.003 and P = 0.001, respectively). The odds ratio for incomplete PVD was 3.1 in PEX eyes compared to the contralateral eye in the PEX group and 3.9 compared to the Control group. The rate of epiretinal membranes (ERMs) in the affected eye was significantly different from the contralateral eye in the PEX and Control groups (P < 0.001 and P < 0.001, respectively). The odds ratio for ERM in PEX eyes was 3.51 compared to the contralateral eye in the PEX group and 4.23 compared to the Control group. In the presence of incomplete PVD, the odds ratio for ERM development was 3.81 in PEX eyes. CONCLUSIONS: We detected high rates of ERMs and incomplete PVD in patients with PEX. It is important to evaluate and follow up PEX cases in terms of vitreoretinal interface abnormalities.

Optical coherence tomography findings in toxoplasma retinochoroiditis.

Purpose: This study aimed to evaluate the optic coherence tomography (OCT) findings in patients with toxoplasmic retinochoroiditis (TRC). Methods: A total of 12 eyes of 12 patients with active TRC were included in the study. At baseline, at the first-month follow-up, at the sixth-month follow-up and at the 1-year follow-up, the TRC lesion OCT and macula OCT were evaluated. Results: Hyperreflectivity of the inner retinal layers and an increase in retinal thickness were observed on the OCT examinations of all the patients with an active TRC lesion. The retinal thickness decreased and the reflectivity of retinal layers was disorganized in the OCT images obtained in the follow-up period. Partial posterior hyaloid detachment (PHD) and no PHD were detected in 11 cases and 1 case, respectively. Epiretinal membrane (ERM) had developed in the adjacent region of the scar in 7 patients. With the regression of the lesion, the disruption of the ellipsoid zone (EZ), retinal pigment epithelium (RPE) and external limiting membrane (ELM) improved in the adjacent areas. In all the eyes, ERM and the PHD configuration did progress during the follow-up period. Vitreoschisis was found in 4 of the 11 patients with partial PHD. It was observed that ERM developed in all the patients with vitreoschisis. Conclusion: ERM and partial PHD were common in the TRC patients, and there was no progression during the follow-up period. Regeneration of the EZ, RPE and ELM was observed in the follow-up period.

THICKNESSES OF SCLERA AND LAMINA CRIBROSA IN PATIENTS WITH CENTRAL RETINAL VEIN OCCLUSION.

PURPOSE: To evaluate thicknesses of sclera and lamina cribrosa (LC) in central retinal vein occlusion (CRVO). METHOD: Thirty-two patients with CRVO (mean age 62.2 ± 11.6 years, women/men 18/14) and 35 age- and sex-matched healthy volunteers were included into the study. Scleral thickness was measured at scleral spur and at 1 to 3 mm from scleral spur in four quadrants (temporal, nasal, super, and inferior) using anterior segment optical coherence tomography. Lamina cribrosa was measured using optic disk enhanced depth imaging optical coherence tomography. RESULTS: The sclera was thicker in affected eyes of the CRVO group than healthy subjects at scleral spur in four quadrants (738.7 ± 30.9 µm vs. 702 ± 30.8 µm in temporal, 700.4 ± 19.7 µm vs. 673 ± 13.7 µm in superior, 693 ± 19.3 µm vs. 665.3 ± 24.2 µm in nasal, 810.7 ± 28.9 µm vs. 784.5 ± 23.7 µm in inferior quadrants, respectively; P < 0.05 for all). Lamina cribrosa thickness in affected eyes of the CRVO group was significantly higher than that of healthy subjects (285.2 ± 12.7 µm vs. 266.4 ± 10.7 µm, respectively; P < 0.01). The correlation between scleral thickness and LC thickness was moderate at scleral spur of temporal and superior quadrants of affected eyes (r = 0.510 and r = 0.420, respectively). CONCLUSION: Thicknesses of sclera and LC are increased in the CRVO, which may play a role in the pathogenesis of the disease.

Increased Subfoveal Choroidal Thickness and Retinal Structure Changes on Optical Coherence Tomography in Pediatric Alport Syndrome Patients.

OBJECTIVE: To evaluate optical coherence tomography (OCT) findings of pediatric Alport syndrome (AS) patients with no retinal pathology on fundus examination. MATERIALS AND METHODS: Twenty-one patients being followed up with the diagnosis of AS (Group 1) and 24 age- and sex-matched healthy volunteers (Group 2) were prospectively evaluated. All participants underwent standard ophthalmologic examination, retinal nerve fibre layer (RNFL) analysis, and horizontal and vertical scan macula enhanced depth imaging OCT (EDI-OCT). Statistical analysis of the data obtained in this study was performed with SPSS 15.0. RESULTS: Macula thickness was significantly decreased in the temporal quadrant in Group 1 compared to those of the control group (p=0.013). RNFL measurements revealed statistically significant thinning in the temporal, superior, inferotemporal, and inferonasal quadrants and in average thicknesses in cases with AS compared to the controls (p < 0.001, p < 0.001, p=0.022, p=0.016, p < 0.001, respectively). The mean subfoveal coronial thickness (SCT) was 362.2 ± 77.8 µm in Group 1 and 256,18 ± 71.7 µm in Group 2. There was a statistically significant difference between the two groups in terms of mean CT (p < 0.001). CONCLUSION: OCT provides valuable information in identifying the structural changes and evaluation of ocular findings in patients with AS. Even if no pathological retinal findings were found in the clinical examination, structural changes in the OCT examination begin in early period of AS.

The factors influencing peripapillary choroidal thickness in primary open-angle glaucoma.

PURPOSE: To investigate whether there is a difference between primary open-angle glaucoma (POAG) patients and control group with regard to choroidal thickness (CT) and the factors influencing CT. METHODS: Ninety eyes of 90 patients who were being followed up with POAG and 72 eyes of 72 healthy subjects matched for age and gender were included. Peripapillary retinal nerve fiber layer thickness (RNFLT), peripapillary CT, lamina cribrosa thickness (LCT), and prelaminar tissue thickness (PTT) were measured with spectral-domain optical coherence tomography (SD-OCT) enhanced depth imaging (EDI) in all patients. RESULTS: According to multi-variable linear regression analysis results, the factors influencing CT were found as axial length (AL) (B = -22.78, p = 0.002), intraocular pressure (IOP) (B = -7.95, p = 0.001), age (B  = -1.77, p = 0.009), and radial pulse rate (B  = 1.42, p = 0.015). A statistically significant relationship was not detected between CT and central corneal thickness, mean deviation value of visual field, cup/disk ratio, RNFLT, LCT, PTT. CT was found significantly thinner in glaucoma group (147.5 ± 61.2 µm) compared to control group (167.1 ± 37.3 µm). However, IOP was found significantly higher (p < 0.001) and pulse rate was found significantly lower (p = 0.021) in POAG group. IOP and pulse rate were considered to have affected CT difference between the groups. In advanced and worser stage patients, there were significant positive correlations between CT and RNFLT in inferior and superior quadrants. CONCLUSIONS: In addition to previous studies, IOP and pulse rate were detected to be effective on CT. Further studies are required for determining the whole factors effective on CT and better understanding CT and glaucoma relationship.