Clinical relevance of quantified fundus autofluorescence in diabetic macular oedema.

PURPOSE: To quantify the signal intensity of fundus autofluorescence (FAF) and evaluate its association with visual function and optical coherence tomography (OCT) findings in diabetic macular oedema (DMO). METHODS: We reviewed 103 eyes of 78 patients with DMO and 30 eyes of 22 patients without DMO. FAF images were acquired using Heidelberg Retina Angiograph 2, and the signal levels of FAF in the individual subfields of the Early Treatment Diabetic Retinopathy Study grid were measured. We evaluated the association between quantified FAF and the logMAR VA and OCT findings. RESULTS: One hundred and three eyes with DMO had lower FAF signal intensity levels in the parafoveal subfields compared with 30 eyes without DMO. The autofluorescence intensity in the parafoveal subfields was associated negatively with logMAR VA and the retinal thickness in the corresponding subfields. The autofluorescence levels in the parafoveal subfield, except the nasal subfield, were lower in eyes with autofluorescent cystoid spaces in the corresponding subfield than in those without autofluorescent cystoid spaces. The autofluorescence level in the central subfield was related to foveal cystoid spaces but not logMAR VA or retinal thickness in the corresponding area. CONCLUSIONS: Quantified FAF in the parafovea has diagnostic significance and is clinically relevant in DMO.

Structural changes of fovea during remission of Behçet's disease as imaged by spectral domain optical coherence tomography.

PURPOSE: To acquire the image of the fovea during remission of ocular Behçet's disease using spectral domain optical coherence tomography (SD-OCT) and to further assess the correlation between best-corrected visual acuity (BCVA) and SD-OCT findings. METHODS: A total of 24 eyes of 14 patients with ocular Behçet's disease were examined with SD-OCT. The relationships between BCVA and other clinical characteristics, including foveal thickness and status of external limiting membrane (ELM) or the junction between photoreceptor inner and outer segments (IS/OS), were analysed for statistical significance. RESULTS: BCVA in eyes with intact IS/OS was significantly better than that in eyes with ill-defined IS/OS (P=0.0001). Foveal thickness (P=0.0001) and male sex (P=0.03) were also significantly different between eyes with and without complete IS/OS line. CONCLUSIONS: Definition of the IS/OS line by SD-OCT, but not status of the ELM line, appears to be associated with BCVA in patients with ocular Behçet's disease. Accordingly, SD-OCT may prove useful in the evaluation of visual function after ocular attacks of Behçet's disease.

Randomised controlled trial of posterior sub-Tenon triamcinolone as adjunct to panretinal photocoagulation for treatment of diabetic retinopathy.

AIMS: To evaluate the efficacy of a single posterior sub-Tenon capsule injection of triamcinolone acetonide (PSTA) before panretinal photocoagulation (PRP). METHODS: This 6-month study involved the randomisation of 82 eyes of 41 patients, with bilateral severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy to a single PSTA 20 mg or to no injection before PRP. The primary end-point was change in best-corrected visual acuity (BCVA) at 6 months compared with that at baseline using the logarithm of the minimum angle of resolution (logMAR). Secondary end-points were changes in retinal thickness and intraocular pressure. RESULTS: The mean changes in logMAR BCVA at 6 months compared with that at baseline were a worsening of 0.010 (SD 0.029) in the control group (no injection) and an improvement of 0.072 (0.028) in the PSTA group (p = 0.04). The mean changes in foveal thickness at 6 months compared with baseline measurements were an increase of 32.8 (82.8) mum in the control group and a lessening of 9.7 (85.6) mum in the PSTA group (p = 0.03). CONCLUSIONS: PSTA before PRP appears to be beneficial in preventing PRP-induced visual loss in eyes with diabetic retinopathy by reducing the chance of macular thickening.