Retinal Vascular Changes during the Menstrual Cycle Detected with Optical Coherence Tomography Angiography.

PURPOSE: To evaluate the effects of the menstrual cycle on the retinal vascular status of healthy women by optical coherence tomography angiography (OCTA). MATERIALS AND METHODS: Healthy women with regular natural menstrual cycles of 28 to 30 days were recruited for this prospective study. The women's retinal vascular status was measured by OCTA at 3 time points: the early follicular, ovulatory, and midluteal phases of the menstrual cycle. The main outcome measures were foveal avascular zone (FAZ) parameters, perfusion density (PD) percentage in the superficial retinal capillary plexus (SCP), and PD percentage in the deep retinal capillary plexus (DCP). The mean arterial pressure (MAP), spherical equivalent (SE), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and axial (AL) were also measured in a same menstrual cycle. RESULTS: In total, 62 right eyes of 62 women were included in the study. The mean age was 27.0 ± 1.73 (range, 24 to 31) years, and the mean menstrual cycle was 28.90 ± 0.84 (range, 28 to 30) days. The mean values of the DCP-PD parameters were significantly decreased in the nasal and inferior ETDRS subfields during the ovulatory phase. The mean DCP-PD in the nasal ETDRS subfield in the early follicular, ovulatory, and luteal phases was 54.11 ± 2.85, 56.39 ± 3.03, and 55.70 ± 3.27, respectively. The mean DCP-PD in the inferior ETDRS subfield in the early follicular, ovulatory, and midluteal phases was 52.90 ± 3.30, 54.86 ± 2.51, and 55.21 ± 2.64, respectively. No significant differences were found in MAP, SE, AL, IOP, FAZ area, or other quadrants of PD parameters, and no significant correlation was found between parameters by OCTA and age, MAP,SE, axial length, or IOP. CONCLUSIONS: The DCP-PD decreased in the nasal and inferior ETDRS subfields during the ovulatory phase in our study. This may indicate the need to consider the menstrual phase when interpreting DCP-PD parameters by OCTA in healthy women.

Optical quality assessment in branch retinal vein occlusion after monthly intravitreal ranibizumab injection: a prospective, case-control study.

PURPOSE: To evaluate optical quality and intraocular scattering using the Optical Quality Analysis System (OQAS) II in branch retinal vein occlusion (BRVO) and to investigate the influences of retinal changes on optical quality. MATERIALS AND METHODS: Sixty-two patients with diagnosis of BRVO were enrolled in this prospective, case-control study. The control group consisted of the patients' fellow eyes. Initial logMAR visual acuity, central macular thickness, and optical quality parameters including modulation transfer function cutoff frequency (MTF cut off), Strehl ratio (SR), objective scatter index (OSI) and OQAS values (OVs) at 100%, 20%, and 9% contrast levels were measured. Every BRVO-affected eye was treated with monthly intravitreal ranibizumab injection. We investigated the differences between clinical parameters of the BRVO-affected eye and those of the control eye and changes in those parameters on the basis of the clinical course of BRVO over 3 months. RESULTS: All the OQAS parameters measured except objective refraction error differed statistically significantly between the two groups. As macular thickness decreased and visual acuity improved, all the optical quality parameters except for objective refraction error and OV at 100% contrast gradually recovered with time after treatment but did not return to normal compared with the control eye. Only visual acuity was found to be significantly related to central macular thickness change (p = .027). CONCLUSIONS: BRVO resulted in declined visual acuity and optical quality. It is suggested that the optical quality parameters are affected by the inner layers of the retina in BRVO.

Clinicopathologic Characteristics and the Surgical Outcome of Conjunctival Granulomas After Pterygium Surgery.

PURPOSE: To measure the incidence and evaluate the clinicopathologic characteristics, surgical outcome, and prognosis of conjunctival granulomas (CGs) after pterygium surgery. METHODS: This was a retrospective review of 3851 pterygium eyes (3330 patients) that underwent pterygium surgery from March 2004 to May 2017. The outcomes were evaluated in 52 eyes (50 patients) that developed CGs after pterygium surgery. RESULTS: CGs developed in 52 of 3851 operated pterygium eyes (1.4%) over a 13-year period. Mean patient age was 54.4 ± 9.9 years (range, 28-72 years). The mean onset time of the CG after pterygium surgery was 42.8 ± 18.3 days (range, 12-90 days). The location of the granulation was around the free conjunctival flap. Histopathologic examination showed inflammatory granulation tissue with large amounts of inflammatory cell infiltration. All CGs were successfully cured by surgical excision combined with corticosteroid eye drops. No patient had recurrence at a mean follow-up time of 6 months. Kaplan-Meier analysis showed that the difference of the cumulative survival rate of pterygium surgery methods was statistically significant (P < 0.001). Using the multivariate Cox regression model, 2 factors were found to be not correlated with the survival rate of patients with CGs: sex (P = 0.17) and the category of pterygium (primary or recurrent) (P = 0.96). CONCLUSIONS: CGs are an uncommon potential complication of pterygium surgery. The histologic characteristics, including the proliferation of inflammatory granulation tissue with large amounts of inflammatory cell infiltration, could be helpful to diagnose this disease. Surgical excision combined with corticosteroid drops proved to be a simple and effective treatment of CGs.