Fundus topographical distribution patterns of ocular toxoplasmosis.

BACKGROUND: To establish topographic maps and determine fundus distribution patterns of ocular toxoplasmosis (OT) lesions. METHODS: In this retrospective study, patients who presented with OT to ophthalmology clinics from four countries (Argentina, Turkey, UK, USA) were included. Size, shape and location of primary (1°)/recurrent (2°) and active/inactive lesions were converted into a two-dimensional retinal chart by a retinal drawing software. A final contour map of the merged image charts was then created using a custom Matlab programme. Descriptive analyses were performed. RESULTS: 984 lesions in 514 eyes of 464 subjects (53% women) were included. Mean area of all 1° and 2° lesions was 5.96±12.26 and 5.21±12.77 mm2, respectively. For the subset group lesions (eyes with both 1° and 2° lesions), 1° lesions were significantly larger than 2° lesions (5.52±6.04 mm2 vs 4.09±8.90 mm2, p=0.038). Mean distances from foveola to 1° and 2° lesion centres were 6336±4267 and 5763±3491 µm, respectively. The majority of lesions were found in temporal quadrant (p<0.001). Maximum overlap of all lesions was at 278 µm inferotemporal to foveola. CONCLUSION: The 1° lesions were larger than 2° lesions. The 2° lesions were not significantly closer to fovea than 1° lesions. Temporal quadrant and macular region were found to be densely affected underlining the vision threatening nature of the disease.

Sub-Tenon Triamcinolone Acetonide Injection in the Acute Treatment of Handheld Laser-Induced Maculopathy.

Handheld laser (HHL)-induced maculopathy has increased in frequency in recent years and can lead to severe retinal damage and vision loss. Although there is no consensus on the treatment of HHL-induced maculopathy, the use of systemic steroids to limit damage to the retina has been discussed. In this article, we present a patient who underwent early sub-Tenon triamcinolone acetonide injection for HHL-induced maculopathy. To our knowledge, sub-Tenon steroid administration has not been previously reported in the treatment of HHL-induced retinopathy.

Analysis of Corneal Densitometry and Endothelial Cell Function in Fuchs Uveitis Syndrome.

OBJECTIVES: To evaluate corneal densitometry and endothelial cell properties in patients with unilateral Fuchs uveitis syndrome (FUS), and to compare results with unaffected contralateral eyes and healthy control subjects. METHODS: A total of 90 participants were included in this prospective cross-sectional study. Forty-five affected eyes of patients with FUS were regarded as group 1 (FUSa), 45 fellow eyes were regarded as group 2 (FUSf), and 45 healthy-control eyes were regarded as group 3. Corneal densitometry was measured with densitometry software of Scheimpflug Corneal Topography (Pentacam HR, Oculus GmbH, Wetzlar, Germany), whereas endothelial cell measurement was evaluated with specular microscopy (Tomey, EM4000, GmbH, Germany). RESULTS: The mean corneal densitometry values were higher in the midstromal (zones; 2-6, 6-10 mm), posterior (all zones), and total thickness (zones; 2-6, 6-10 mm) layers in the FUSa compared with FUSf and control eyes (P<0.05 for all comparisons). The mean values of average cell area and cell size characteristics (minimum, maximum, SD, and coefficient of variation) were higher; endothelial cell density and percentage of hexagonal cells were lower in the FUSa than in the other two groups (P<0.05 for all comparisons). There was a significantly strong correlation between specular microscopy parameters and posterior corneal densitometry values in the FUSa group. CONCLUSIONS: Impairment of endothelial cell function in affected eyes of patients with FUS resulted in increased values of corneal densitometry, especially posterior layer.

The effects of epiretinal membranes on the treatment outcomes of intravitreal aflibercept injection in diabetic macular edema: a real-life study.

PURPOSE: To evaluate the effects of epiretinal membrane (ERM) formation on the anatomic and functional results of subjects with diabetic macular edema (DME) who are receiving intravitreal aflibercept injections (IAIs). MATERIALS AND METHODS: This retrospective comparative study includes 29 eyes with DME (Group 1) and 43 eyes with DME and ERM (Group 2). After three consecutive monthly 2.0 mg IAIs, subjects received monthly follow-ups and retreatment was performed if needed. Corrected visual acuity (CVA), central macular thickness (CMT), and central macular volume (CMV) parameters were recorded tri-monthly, and the 36-month follow-up was designated the primary endpoint of the study. RESULTS: There was no significant difference between groups when comparing the mean ages and male-to-female ratios (p > 0.05, for both). At the baseline, the mean CVA value was significantly worse (p = 0.002), and the mean CMT was significantly lower (p = 0.016) in Group 1, while there was no significant difference in terms of the mean CMV (p = 0.625). The mean number of IAIs was similar at the first (p < 0.102), second (p = 0.363), and third year (p = 0.850) follow-ups. The mean CVA was significantly worse, and CMT was significantly lower in Group 1 at most of the visits in the first half of the follow-up period (p < 0.05, for all), while there was no significant difference in the second half of the follow-up period. There was no significant difference between groups in terms of CMV at any visit (p > 0.05, for all). CONCLUSION: Despite a similar number of IAIs needed, worse baseline clinical parameters are associated with poorer early- or mid-term outcomes. At the long-term follow-up, CVA and CMT became similar in DME independent of ERM.