Clinical Correlation Between Optical Coherence Tomography Biomarkers and Retinal Sensitivity in Best Vitelliform Macular Dystrophy.

Purpose: To investigate the clinical and imaging features associated with retinal sensitivity in Best vitelliform macular dystrophy (BVMD). Methods: This was a cross-sectional, single-center, observational study. Each patient underwent optical coherence tomography (OCT), near-infrared fundus autofluorescence, and OCT angiography. Macular integrity assessment microperimetry under mesopic conditions was performed to obtain retinal sensitivity thresholds from 68 testing points in the central macula. Structural OCT was used to classify BVMD lesions into four types according to their composition: vitelliform, mixed, subretinal fluid, and atrophy. Multilevel, mixed-effects linear regression was used to determine the factors associated with retinal sensitivity. Results: The study included 57 eyes of 30 patients with BVMD, 48 of which (84%) were in a clinical stage. Mean retinal sensitivity varied according to the composition of the lesion: the vitelliform type registering the highest (22 ± 4.1 dB), followed by mixed (18.73 ± 2.7 dB), subretinal fluid (15.68 ± 4.2 dB), and atrophy types (11.85 ± 4.6 dB). The factors most strongly associated with mean retinal sensitivity in BVMD proved to be the OCT lesion type and outer nuclear layer thickness. Conclusions: Retinal sensitivity in BVMD is influenced by lesion composition and outer nuclear layer thickness. Further studies with long-term follow-up are warranted to examine retinal sensitivity over time and to validate retinal sensitivity changes as biomarkers for BVMD. Translational Relevance: Assessing retinal sensitivity in BVMD provides a new instrument in the clinical characterization of the disease and offers the opportunity to identify imaging biomarkers for use as outcome measures in future clinical trials.

Assessment of Optic Nerve Sheath Diameter and Its Postoperative Regression among Patients Undergoing Brain Tumor Resection in a Tertiary Care Center.

Introduction Bedside measurement of optic nerve sheath diameter (ONSD) using ultrasonography (USG) is a useful method for detecting raised intracranial pressure (ICP). The primary and main objective of this study is to estimate ONSD among patients with brain tumor and its regression post tumor resection to assess the correlation as well as diagnostic accuracy of the same. Materials and Methods This prospective observational study was performed in a tertiary health care center over a span of 3 months on 68 adults of either sex, out of which 30 were nonneurosurgical patients, taken as control group. Rest 38 were neurosurgical patients posted for brain tumor resection. Normal ONSD in our population was determined by calculating average ONSD using transorbital USG in individuals of control group. ONSD in neurosurgical patients taken as case group was recorded before surgery, intraoperatively immediately post tumor resection, as well as 12 and 24 hours post surgery. These values were analyzed to see the correlation of ONSD with tumor resection. Results The mean (±standard deviation) binocular ONSD in our population was 4.28 ± 0.28 mm. The mean preoperative binocular ONSD in cases using transorbital USG came out to be 5.43 ± 0.37 mm with 88.23% sensitivity and 100% specificity. Postoperatively, transorbital ONSD showed significant regression at 12 and 24 hours as compared with preoperative values ( p -value < 0.05). Conclusion Transorbital ultrasonographic measurement of ONSD could be considered as an indirect indicator of ICP in neurosurgical patients perioperatively. The technique is quick to perform at bedside, feasible in critical patients, and without any harmful effects.

Real-Life Management of Central and Branch Retinal Vein Occlusion: A Seven-Year Follow-Up Study.

Retinal vein occlusion is the second most common retinal vascular pathology after diabetic retinopathy and a major cause of vision impairment. Nowadays, both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) can be well-managed by intravitreal treatments. However, considering the long-life expectance of the patients, few data are present in the literature about the very long-term outcome of CRVO and BRVO. The present study was an interventional, retrospective analysis of the morphological and functional long-term outcome of CRVO and BRVO patients, followed in an Italian referral center. We collected data from 313 eyes (178 CRVO eyes and 135 BRVO eyes). Mean follow-up was 45 ± 25 months (range 12-84 months). Both CRVO and BRVO eyes experience a significant visual acuity improvement secondary to anti-vascular endothelial growth factor/dexamethasone treatments (from 0.57 ± 0.25 to 0.41 ± 0.24 LogMAR in CRVO and from 0.53 ± 0.42 to 0.30 ± 0.41 LogMAR in BRVO, respectively) (p < 0.01). Also, central macular thickness (CMT) resulted significant recovery at the end of the follow-up (from 585.54 ± 131.43 to 447.88 ± 245.07 µm in CRVO and from 585.54 ± 131.43 to 447.88 ± 245.07 µm in BRVO, respectively) (p < 0.01). CRVO eyes received a mean of 10.70 ± 4.76 intravitreal treatments, whereas BRVO underwent 9.80 ± 5.39 injections over the entire 7-year follow-up. Our analyses highlighted different time points indicating the best obtainable improvement. This was the first year for CRVO (12-month follow-up) and the second year for BRVO (24-month follow-up). After these two time points, both visual acuity and CMT resulted stable up to the end of the follow-up. Ischemia was associated with significantly worse outcome.