Lamina cribrosa surface position in idiopathic intracranial hypertension with swept-source optical coherence tomography.

Purpose: The purpose of this study is to compare the thickness and depth measurements of the lamina cribrosa (LC) obtained using a swept-source optical coherence tomography (SS-OCT) device in idiopathic intracranial hypertension (IIH) patients and healthy subjects. Methods: This retrospective, cross-sectional observational study included 16 eyes with IIH and 20 control eyes. The LC measurements with serial horizontal B scans of the optic nerve head were obtained using SS-OCT (Topcon 3D DRI OCT Triton). The anterior lamina surface (ALS) depth, posterior lamina surface (PLS) depth, and LC thickness measurements were evaluated. Results: In patients with IIH, the mean ALS depth was 225.00 ± 58.57 µm and the mean PLS depth was 449.75 ± 63.50 µm. In the IIH control group, the corresponding values were 359.40 ± 105.38 and 570.10 ± 99.41 µm (P < 0.05). The difference in LC thickness between the IIH and control subjects was not statistically significant. Conclusion: LC can be evaluated using an SS-OCT device. LC was displaced anteriorly in patients with IIH compared with normal controls. The assessment of LC level with SS-OCT in IIH cases is a valuable and reproducible adjunctive imaging method in terms of diagnosis and follow-up.

Macular toxicity after short-term hydroxychloroquine therapy.

We report an unusual case of hydroxychloroquine (HCQ) toxicity after only 2 months of starting the treatment. A 42-year-old woman presented with visual impairment. Her visual acuity was 20/20 in the right eye and 20/25 in the left eye. Ophthalmologic examination revealed a bull's eye pattern in both eyes which was more prominent in the left eye. She had received HCQ therapy (400 mg/day) for 1 month, and had been taking 200 mg/day for 1 month for the treatment of rheumatoid arthritis. HCQ macular toxicity is rarely seen in short-term use, before 5 years, and to our knowledge, there is only one other case reported in the literature.

A comparison of optic nerve head topographic measurements by Stratus OCT in patients with macrodiscs and normal-sized healthy discs.

PURPOSE: To evaluate and compare optic nerve head parameters and retinal nerve fiber layer (RNFL) thickness between large discs and normal-sized vital discs using Stratus optical coherence tomography (OCT). METHODS: A total of 293 healthy eyes (145 with macrodisc and 148 with normal-sized disc) were enrolled in the study. After a complete ophthalmic evaluation, measurement of optic nerve head parameters and RNFL thickness using OCT was performed in all subjects. Optic disc areas larger than 2.80 mm were accepted as macrodiscs. All OCT parameters were compared between normal-sized discs and macrodiscs. RESULTS: Participants' mean age was 46.5±10.6 years (range, 13 to 74 y). Average optic disc areas were 2.19±0.29 and 3.02±0.29 mm in the normal and the macrodisc groups, respectively. The optic disc area (P<0.0001), the cup area (P<0.0001), the horizontal cup disc ratio (P<0.0001), the vertical cup disc ratio (P<0.0001), and the cup disc area ratio (P<0.0001) were found to be significantly different in the macrodisc group and the control group. Rim areas (P=0.57) and RNFL thicknesses (inferior, superior, and mean) were found to be similar in both groups (P=0.75, 0.65, 0.85, respectively). CONCLUSIONS: A macrodisc may have a macrocup and should not be misdiagnosed as glaucoma. The present study showed that macrodiscs are identical to normal-sized discs in terms of rim area and RNFL thickness. We suggest that these 2 OCT parameters can help to differentiate a healthy macrodisc from a glaucomatous optic disc.