Retinal vascular findings in patients with COVID-19.

PURPOSE: The purpose of this study was to compare the retinal vascular caliber of COVID-19 patients with that of healthy subjects. METHODS: This was a prospective case-control study. Forty-six patients who had COVID-19 were successfully treated, and 38 age- and gender-matched healthy subjects were enrolled in this study. Fundus photography was taken using fundus fluorescein angiography (FA; Visucam 500; Carl Zeiss Meditec, Jena, Germany). Retinal vascular caliber was analyzed with IVAN, a semi-automated retinal vascular analyzer (Nicole J. Ferrier, College of Engineering, Fundus Photography Reading Center, University of Wisconsin, Madison, WI, USA). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery-vein ratio (AVR) were compared between groups. RESULTS: The mean age was 37.8 ± 9.5 years in the COVID-19 group (n = 46) and 40 ± 8 years in the control group (n = 38) (p = 0.45). The mean CRAE was 181.56 ± 6.40 in the COVID-19 group and 171.29 ± 15.06 in the control group (p = 0.006). The mean CRVE was 226.34 ± 23.83 in the COVID-19 group and 210.94 ± 22.22 in the control group (p = 0.044). AVR was 0.81 ± 0.09 in the COVID-19 group and 0.82 ± 0.13 in the control group (p = 0.712). CONCLUSION: Patients who had COVID-19 have vasodilation in the retinal vascular structure after recovery. As they may be at risk of retinal vascular disease, COVID-19 patients must be followed after recovery.

Densitometric analysis of cornea in patients with neovascular age-related macular degeneration after intravitreal aflibercept loading dose.

PURPOSE: To evaluate the anatomic changes in the cornea and anterior segment following intravitreal aflibercept loading dose for neovascular age-related macular degeneration. METHODS: The study included 40 eyes of 40 patients with neovascular age-related macular degeneration. Each patient underwent a loading dose of one injection per month for three consecutive doses of aflibercept (0.05 ml/2 mg). Before and after the loading dose, a record was made for each patient of corneal topography, anterior segment, corneal densitometry, and lens densitometry parameters with the Pentacam HR and specular microscopy parameters with a non-contact specular microscope. The data before and after the aflibercept loading dose were compared. RESULTS: Corneal densitometry parameters in the 0- to 2-mm and 2- to 6-mm concentric zones of the posterior layer were significantly higher after the loading dose compared with baseline (p = 0.03, p = 0.04, respectively). Corneal densitometry parameters of the anterior, central, and total corneal layer in the 10- to 12-mm concentric zone were also significantly higher after the loading dose compared with baseline (p = 0.009, p = 0.02, and p = 0.007, respectively). No significant changes were determined in respect of corneal topography, anterior segment, lens densitometry, and specular microscopy parameters (p > 0.05 for all). CONCLUSION: The aflibercept loading dose caused slightly increased densitometric values in some corneal regions while it did not affect the corneal topography, anterior segment, lens densitometry, and specular microscopy parameters.

Early and Late Switch from Ranibizumab to an Intravitreal Dexamethasone Implant in Patients with Diabetic Macular Edema in the Event of a Poor Anatomical Response.

BACKGROUND AND OBJECTIVE: Patients with diabetic macular edema may not have optimal outcomes even with monthly ranibizumab intravitreal injections. A corticosteroid implant might be considered in such patients. The objective of this study was to compare the outcomes of switching from ranibizumab to an intravitreal dexamethasone implant after three or six consecutive monthly injections of ranibizumab. METHODS: Patients with treatment-naïve diabetic macular edema who showed a poor anatomical response to three or six consecutive intravitreal ranibizumab injections and received an intravitreal dexamethasone implant were enrolled in this retrospective study. Patients were divided into two groups as early- and late-switch groups. The early-switch group consisted of the patients who initially received three consecutive monthly ranibizumab injections and the late-switch group consisted of the patients who initially received six consecutive monthly ranibizumab injections and switched to a dexamethasone implant because of a poor anatomical response. Best corrected visual acuity and central retinal thickness at the baseline and 3, 6, 9, and 12 months in the study population were recorded. RESULTS: Sixty-eight eyes of 68 patients were included. The early-switch group consisted of 34 eyes and the late-switch group consisted of 34 eyes. The mean change in best corrected visual acuity was similar between the two groups at 3, 9, and 12 months; however, it was significantly better in the early-switch group than the late-switch group at 6 months. The change in central retinal thickness was similar between the two groups at 3, 9, and 12 months; however, it was significantly better in the early-switch group than the late-switch group at 6 months. CONCLUSIONS: Although both early switching and late switching are similar in terms of providing functional and morphological improvement, early switching appeared better for ensuring patient well-being in the early period and improving patient adherence.

Multimodal imaging of type 1 aneurysmal telangiectasia in a Turkish female with giant arteriovenous aneurysmal malformation.

We present a case with giant arteriovenous aneurysmal malformation with different imaging modalities, including fundus photography, fundus fluorescein angiography, spectral domain optical coherence tomography, and optical coherence tomography angiography. A 43-year-old Turkish female presented with gradual blurred vision in her left eye. Her best-corrected visual acuity was 20/200. The fundoscopic examination revealed hard exudates and microaneurysms around the macula. Spectral domain optical coherence tomography showed cystoid macular edema and serous macular detachment. Fundus fluorescein angiography and optical coherence tomography angiography showed bean-like arteriovenous anastomosis between the inferior venous vascular arcade and the superior arterial vascular arcade. An en face angiogram using optical coherence tomography angiography within the deep capillary plexus also showed venous collateral channels across the horizontal raphe. The patient was diagnosed with arteriovenous aneurysmal malformation in association with type 1 aneurysmal telangiectasia. Ophthalmologists should note that giant aneurysmal lesions can occur in type 1 aneurysmal telangiectasia patients.