Retinal sensitivity improvement after intravitreal triamcinolone acetonide injection for macular edema secondary to branch retinal vein occlusion.

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide (IVTA) on retinal sensitivity in cases of macular edema(ME) secondary to branch retinal vein occlusion (BRVO). MATERIALS AND METHODS: Total of 14 eyes of 14 cases of BRVO were included in this prospective study. In each eye, at baseline and 1, 3, and 6 months after IVTA injection, logMAR visual acuity, central 4° retinal sensitivity by MP-1 microperimetry, and optical coherence tomography foveal thickness were assessed. RESULTS: Cases ages ranged from 60 to 79 years (mean 68 ± 8 years). At 1, 3, and 6 months, the logMAR visual acuity had increased from 0.71 ± 0.21 to 0.42 ± 0.21, 0.46 ± 0.30, and 0.46 ± 0.27; the mean foveal thickness had decreased from 540 ± 88 µm to 254 ± 51 µm, 288 ± 84 µm, and 280 ± 91 µm; and the mean retinal sensitivity had increased from 4.7 ± 2.5 dB to 7.9 ± 2.7 dB, 8.2 ± 3.6 dB, and 8.3 ± 4.6 dB, respectively. CONCLUSION: In eyes with ME secondary to BRVO, IVTA injections result in a significant increase in not only the visual acuity but also the central 4° retinal sensitivity in 6 months follow-up.

Microperimetric changes after intravitreal bevacizumab injection for exudative age-related macular degeneration.

PURPOSE: To evaluate the effect of intravitreal bevacizumab on macular function in the cases of exudative age-related macular degeneration (AMD). METHODS: A total of 21 eyes of 21 patients with exudative AMD were included in this study. In each eye, at baseline and 1, 3 and 6 months after intravitreal bevacizumab injection, logMAR visual acuity, central 4° macular sensitivity, absolute scotoma size, fixation stability and fixation location by MP-1 microperimetry and optical coherence tomography (OCT) foveal morphologic changes were assessed. After the initial treatment phase which included three consecutive injections, the decision to re-treat was based on OCT and clinical findings. Subsequent injections could be administered at least 1 month after the previous injection period according to the OCT-guided treatment regimen. RESULTS: Mean retinal sensitivity within central 4° (12 points) area had increased from 3.69 ± 3.44 dB at baseline to 7.16 ± 3.27 dB at month 6. In all controls after the treatment, there was significant increase in logMAR visual acuity (p < 0.001) and MP-1 retinal sensitivity (p < 0.001). Mean absolute scotoma in test point location had decreased significantly from 12 of the 76 applied test point locations measured at baseline to five test point locations (-7 test point locations; p < 0.001) at month 6 showing statistical significance. Fixation properties had preserved in all patients 6 months after intravitreal bevacizumab treatment. CONCLUSION: Intravitreal bevacizumab therapy induced a significant increase in mean retinal sensitivity and significant decrease in mean absolute scotoma size during 6 months. The MP1 microperimetry proved to be a valuable tool in the evaluation of functional benefit of exudative AMD therapy with intravitreal bevacizumab.

Microperimetric changes after photodynamic therapy for central serous chorioretinopathy.

PURPOSE: To evaluate the effect of half-dose verteporfin photodynamic therapy (PDT) on macular function in cases of central serous chorioretinopathy (CSC). DESIGN: Interventional case series. METHODS: A total of 24 eyes from 24 cases of CSC were included in this study. In each eye, at baseline and 1, 3, and 6 months after half-dose PDT, logMAR best-corrected visual acuity (BCVA); central 10-degree, 20-degree, and paracentral 10-degree to 20-degree retinal sensitivity; and also mean retinal sensitivity results for each case over the area that was treated with half-dose PDT (PDT spot area) by MP-1 microperimetry and optical coherence tomography (OCT) foveal morphologic changes were assessed. The MP-1 microperimetry sensitivity map was overlaid onto an indocyanine green angiography image recorded on a Heidelberg scanning laser ophthalmoscope using dedicated MP-1 software to evaluate the PDT laser spot area. RESULTS: After treatment, BCVA and central 10-degree, 20-degree, paracentral 10-degree to 20-degree, and PDT laser spot area retinal sensitivity were improved significantly. In OCT in 20 of 24 eyes (83%), subretinal fluid (SRF) was resolved 1 month after half-dose PDT. At 3 and 6 months after treatment, SRF was resolved at all eyes. None of the patients in this study developed any systemic or ocular adverse events associated with verteporfin treatment. CONCLUSION: Half-dose verteporfin PDT induced a significant increase in central 10-degree, 20-degree, paracentral 10-degree to 20-degree, and also PDT laser spot area retinal sensitivity over 6 months in cases of CSC.

Microperimetric changes after intravitreal triamcinolone acetonide injection for macular edema due to central retinal vein occlusion.

PURPOSE: The purpose of this study was to evaluate the effect of intravitreal triamcinolone acetonide on macular function in cases of macular edema because of central retinal vein occlusion. METHODS: Twelve eyes of 12 patients with central retinal vein occlusion were included in this study. In each eye, at baseline and 1, 3, and 6 months after intravitreal triamcinolone acetonide injection, logarithm of the minimum angle of resolution visual acuity, macular sensitivity, fixation stability and fixation location by MP-1 microperimetry, and foveal thickness by optical coherence tomography were assessed. RESULTS: Patients' ages ranged from 50 to 75 years (mean +/- SD, 59 +/- 8 years). All patients were classified as nonischemic. At 1, 3, and 6 months, the mean foveal thickness had decreased from 453 +/- 108 microm to 254 +/- 40.3 microm, 297 +/- 90 microm, and 320 +/- 82 microm and the mean retinal sensitivity had increased from 5.5 +/- 3.3 dB to 9.4 +/- 3.5 dB, 7.8 +/- 3.3 dB, and 7.2 +/- 4.2 dB, respectively. At baseline, fixation was stable in one, relatively unstable in six, and unstable in five eyes. However, 6 months after intravitreal triamcinolone acetonide injection, fixation was stable in 8, relatively unstable in 3, and unstable in one. At baseline, in eyes with macular edema, fixation location was predominantly central in 2, poor central in 4, and predominantly eccentric in 6. And 6 months after treatment, fixation location was predominantly central in 8, poor central in 3, and predominantly eccentric in 1. CONCLUSION: In eyes with macular edema in central retinal vein occlusion, a short-term improvement in retinal sensitivity and fixation properties can be achieved by intravitreal triamcinolone acetonide injection.

Correlation of retinal sensitivity with visual acuity and macular thickness in eyes with idiopathic epimacular membrane.

The aim of this study was to analyze macular function by measuring the sensitivity of the macula with fundus-related microperimetry and to compare the results with the best corrected visual acuity (BCVA) and foveal retinal thickness measured by optical coherence tomography (OCT) in patients with idiopathic epimacular membrane. We prospectively reviewed 66 eyes with idiopathic epimacular membrane and 35 normal healthy eyes in patients who had undergone fundus-related microperimetry and OCT. The macular sensitivity was measured using the recently introduced fundus-related microperimeter, MP-1. The mean retinal sensitivities in the central 10 degrees (central microperimetry, cMP-1) and in the paracentral 10-20 degrees (paracentral microperimetry, pMP-1) areas were determined and correlated with the BCVA and OCT-measured foveal thickness. Eyes with epimacular membranes showed significantly lower log MAR BCVA (P < 0.001) and cMP-1 microperimetry sensitivity (P < 0.001) and significantly higher OCT foveal thickness (P < 0.001) than control eyes. There was a significant correlation between the BCVA and mean retinal sensitivity in the cMP-1 (r (2) = 0.26, P < 0.001) and the pMP-1 (r (2) = 0.07, P = 0.008) areas. A significant negative correlation was observed between the foveal thickness and the mean retinal sensitivity in the cMP-1 (r (2) = 0.13, P < 0.001) area. Retinal sensitivity in the central macular area determined by MP-1 microperimetry was significantly correlated with BCVA and with foveal thickness. The combination of OCT and microperimetry may help a better evaluation of the patients with idiopathic epimacular membrane.

Macular function after intravitreal triamcinolone acetonide injection for diabetic macular oedema.

PURPOSE: We aimed to evaluate the effect of intravitreal triamcinolone acetonide (IVTA) on macular function in patients with diabetic macular oedema (DMO). METHODS: Eleven eyes in 11 patients with DMO were enrolled. In each eye, at baseline and at 30 days after IVTA injection, logMAR visual acuity (VA), macular sensitivity, fixation stability and fixation location by MP-1 microperimetry and optical coherence tomography (OCT) foveal thickness were assessed. RESULTS: Thirty days after IVTA injection, eyes with DMO showed a significant (p<0.001) reduction in foveal thickness and significant (p<0.01) increases in logMAR VA and MP-1 retinal sensitivity (p<0.001). There was also significant (p=0.046) improvement in fixation location and some improvement in fixation stability, although the latter was not significant (p=0.08). CONCLUSIONS: In eyes with DMO, short-term improvement in retinal sensitivity and fixation properties can be achieved by IVTA injection.

Intravitreal triamcinolone acetonide for treatment of serous macular detachment in central retinal vein occlusion.

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide (IVTA) treatment on serous macular detachment in patients with central retinal vein occlusion (CRVO). METHODS: Ten eyes of 10 patients with CRVO (6 men and 4 women; age range, 54-78 years) made up the study population. The eligibility criteria for this study included clinically and angiographically detectable cystoid macular edema (CME) in which the presence of serous macular detachment was documented by optical coherence tomography (OCT). After IVTA (4 mg/0.1 mL) injection, visual and anatomical responses were observed. RESULTS: In all eyes, after IVTA injection, CME and serous macular detachment regressed. At 3 months and 6 months, CME and serous macular detachment had recurred in 4 (40%) and 5 eyes (50%), respectively. Patients with recurrence were retreated. No eyes lost vision at 1 month, and all eyes had improvement. At 3 months, no eyes had lost vision from baseline, and 7 eyes (70%) had improvement. At 6 months, again no eyes had lost vision from baseline, and 6 eyes (60%) maintained improved visual acuity. CONCLUSIONS: Our study shows that IVTA is effective treatment for serous macular detachment in patients with CRVO.

Optical coherence tomography in optic pit maculopathy.

PURPOSE: To report the optical coherence tomography (OCT) findings in patients with optic pit maculopathy. METHODS: Twelve eyes of 12 patients with optic pit maculopathy were evaluated. Cross-sectional OCT images were correlated with findings from slit-lamp biomicroscopy and fluorescein angiography. The presence of retinoschisis and serous macular detachment was evaluated and the height of the serous detachment also measured. RESULTS: Visual acuities varied between 20/400 and 20/63. The height of the serous macular detachment at the fovea was between 323 and 548 mum. OCT findings showed that ten (83.3%) patients had both retinoschisis and serous macular detachment, one (8.3%) patient had only retinoschisis and one (8.3%) patient had only serous macular detachment. None of the patients had macular hole or vitreoretinal traction. CONCLUSION: These findings support the concept of a bilaminar structure that contains retinoschisis and serous macular detachment. Our data also showed that in some patients, the sole component of maculopathy was serous macular detachment or retinoschisis.

Focal detachment of fovea in patients with idiopathic epiretinal membrane.

PURPOSE: To report three cases of focal foveal detachment evident by optical coherence tomography (OCT) in idiopathic epiretinal membrane (ERM). METHODS: A retrospective case series of three patients who had focal foveal detachment shown by OCT and recent visual deterioration and metamorphopsia due to idiopathic ERM. RESULTS: Three patients with idiopathic ERM had recent visual deterioration and metamorphopsia. Although fundus examination, fluorescein angiography, and central macular thickness findings were stable, focal foveal detachment was identified by OCT in all patients. CONCLUSION: Our findings suggest a sequence of events to explain the OCT findings for and visual changes in these three patients. It is probable that contraction of the ERM on the surface of the retina may have led to dragging of the outer structure in the retina, resulting in focal detachment of the fovea.

Optical coherence tomography after photodynamic therapy for patients with pathologic myopia.

PURPOSE: To evaluate early changes after photodynamic therapy (PDT) for patients with subfoveal choroidal neovascularization (CNV) due to pathologic myopia by optical coherence tomography (OCT). METHODS: PDT was performed on 10 eyes of 10 patients who presented with subfoveal CNV due to pathologic myopia. OCT was used to evaluate changes 1 day, 3 days, and 7 days after therapy. Changes in intraretinal and subretinal fluid and CNV were examined on the images obtained. The retinal elevation and the height of the neurosensory retinal detachment were calculated. From these two values, the thickness of the neurosensory retina was obtained. The thickness of the neurosensory retina was measured to ascertain the intraretinal fluid change, and the height of the neurosensory retinal detachment was measured to ascertain the subretinal fluid change. RESULTS: The mean pretherapy retinal elevation+/-SD increased from 211+/-28 microm to 230+/-39 microm 1 day after PDT and decreased to 221+/-36 microm 3 days after therapy. At 7 days after therapy, the mean retinal elevation+/-SD was 211+/-22 microm. The retinal elevation was due to a subretinal fluid accumulation, whereas the thickness of the neurosensory retina increased only to a minor extent (range, 0-22 microm) and the foveal architecture remained unchanged. The mean pretherapy height+/-SD of the neurosensory retinal detachment was 6+/-11 microm. It was 18+/-20 microm, 12+/-12 microm, and 3+/-6 microm 1 day, 3 days, and 7 days after therapy, respectively. No change in CNV was observed during follow-up. CONCLUSION: The results of our study indicate that the acute infiltration observed in patients with pathologic myopia after PDT occurs in the first day and regresses during the first week. Yet, it should be noted that, unlike in patients with age-related macular degeneration, the acute infiltration phase can be observed by OCT only to a limited extent.

Early optical coherence tomography changes after photodynamic therapy in patients with age-related macular degeneration.

PURPOSE: To evaluate early changes after photodynamic therapy (PDT) in patients with age-related macular degeneration (AMD) by optical coherence tomography (OCT). DESIGN: Prospective interventional case series. METHODS: PDT was performed on 20 eyes of 20 patients who presented with subfoveal choroidal neovascularization (CNV) attributable to AMD. OCT was used to evaluate changes at 2, 12, and 24 hours and at 3, 7, 15, and 30 days after therapy. RESULTS: In the first 24 hours, OCT showed an increase in the subretinal fluid (SF) in all eyes and an increase in intraretinal fluid (IF) in 13 eyes. On the 15th day and the 30th day after therapy, reduction of SF and IF was observed in almost all eyes. CONCLUSIONS: Serial OCT evaluation of patients with subfoveal CNV attributable to AMD suggests that the initial response after PDT is an increase in SF and IF.

Resolution of serous macular detachment after intravitreal triamcinolone acetonide treatment of patients with branch retinal vein occlusion.

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide on serous macular detachment in patients with branch retinal vein occlusion (BRVO). METHODS: Eight eyes of 8 patients with BRVO (6 men and 2 women; age range, 52-76 years) made up the study population. The eligibility criteria for this study included clinically and angiographically detectable cystoid macular edema (CME) in which the presence of serous macular detachment was documented by optical coherence tomography (OCT). After intravitreal injection of 0.1 mL (4 mg) of triamcinolone acetonide, the visual and anatomical responses were observed. RESULTS: In all eyes, after injection of triamcinolone acetonide, CME and serous macular detachment regressed. At 3 and 6 months, CME and serous macular detachment had recurred in 1 eye (12.5%) and 2 eyes (25%), respectively. Patients with recurrence were retreated. No eyes lost vision at 1 month, and all eyes showed improvement. At 3 months, no eyes had lost vision from baseline, and 7 eyes (87.5%) showed improvement. At 6 months, again no eyes had lost vision from baseline, and 7 eyes (87.5%) maintained improved visual acuity. CONCLUSIONS: The preliminary results of our study showed prompt resolution of serous macular detachment with corresponding improved visual acuity in patients with CME secondary to BRVO. Further study with longer follow-up and a larger series is warranted to assess the long-term efficacy and safety.

Regression of serous macular detachment after intravitreal triamcinolone acetonide in patients with diabetic macular edema.

PURPOSE: To evaluate the effect of intravitreal triamcinolone acetonide on serous macular detachment in eyes with diabetic macular edema. DESIGN: Interventional case series. METHODS: The study population comprised twenty eyes of 20 patients with diabetic macular edema (12 men, eight women), aged 48 to 76 years. The eligibility criteria for this study included clinically detectable macular edema in which the presence of serous macular detachment was documented by optical coherence tomography. After intravitreal injection of 0.1 ml (4 mg) triamcinolone acetonide, visual and anatomic responses were observed. RESULTS: In all eyes, after an injection of triamcinolone acetonide, macular edema and serous macular detachment regressed. At 3 and 6 months, macular edema and serous macular detachment had recurred in eight (40%) and nine eyes (45%), respectively. Patients with recurrence were re-treated. No eyes lost vision at 1 month, and all eyes showed improvement. At 3 months, no eyes had lost vision from baseline, and 17 eyes (85%) showed improvement. At 6 months, again no eyes had lost vision from baseline, and 16 eyes (80%) maintained improved visual acuity. CONCLUSION: Intravitreal triamcinolone acetonide is an effective treatment for serous macular detachment in patients with diabetic macular edema.

Intravitreal triamcinolone acetonide for the treatment of cystoid macular edema secondary to Behçet disease.

PURPOSE: To evaluate the safety and effectiveness of intravitreal triamcinolone acetonide in patients with cystoid macular edema (CME) associated with Behçet disease. DESIGN: Interventional case series. METHODS: Ten eyes of 10 patients with CME from Behçet disease made up the study population. All eyes had persistent CME despite medical treatment for at least 2 months. Intravitreal injection of 4 mg (0.1 ml) of triamcinolone acetonide was offered to treat macular edema. The visual and anatomic responses were observed. RESULTS: At 1-month follow-up, a reduction in mean foveal thickness of 37.4%, from 416 microm to 260.5 microm, was attained. At 3-month follow-up, mean foveal thickness was 286.2 microm and at 6 months, 263.7 microm. No eyes had lost vision at 1 month, and eight eyes (80%) showed improvement in visual acuity. At 3-month and 6-month follow-up, three eyes (30%) remained stable and the other eyes had maintained the improved acuity. CONCLUSION: Intravitreal triamcinolone acetonide is a promising therapeutic method for CME from Behçet disease.