The Differences in the Pattern of OCT and OCTA Examinations between Early Normal- and High-Tension Pseudoexfoliative Glaucoma.

Purpose. The aim of this study was to compare the results of optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT) examinations in patients with normal-tension glaucoma (NTG) in comparison to high-tension pseudoexfoliative glaucoma (HTG) patients at the early stage of glaucoma. Material and methods. The studied groups consisted of patients in the early stage of NTG (70 eyes) and the early stage of HTG (71 eyes). In NTG and HTG groups, a detailed ophthalmic examination was performed. Optic disc OCT with peripapillary RNFL measurements and OCTA examination with the evaluation of the macula and optic disc were performed for all participants using Zeiss Cirrus 5000. Results. NTG and HTG groups were statistically similar as far as the MD was concerned, and both groups had early glaucoma. When evaluating the RNFL thickness, the only statistical difference between early NTG and HTG was observed in the thicknesses in the temporal sector of peripapillary RNFL, with thinner values in the NTG group (53.94 vs. 59.94, p = 0.0071). When the OCTA results of the macula and optic disc were evaluated, there were no statistical differences between early NTG and HTG. Conclusions. The vascular density and flow parameters assessed in OCTA were equal between early NTG and HTG, and therefore the involvement of vascular factors in NTG pathogenesis could not be confirmed. Our results confirm the preponderance of more frequent temporal RNFL involvement in early NTG.

Biometric Risk Factors for Central Serous Chorioretinopathy.

INTRODUCTION: Central serous chorioretinopathy (CSCR) is a common disease that in chronic form can lead to significant visual impairment. Hence, the systemic and local risk factors of CSCR have been analyzed to possibly prevent its onset. The goal of the present study was to find the biometric parameters characteristic for CSCR. METHODS: The study included 66 eyes of 60 consecutive patients who were diagnosed with acute or chronic CSCR between January 01 2021 and June 30 2021. There were 46 males and 14 females with a mean age of 48.8 ± 10.0 years in the study cohort. Six patients had symptomatic binocular disease. The axial length and retinal parameters of all patients were measured with spectral domain optical coherence tomography (SD-OCT), and refraction error was tested after cycloplegia. The results of the affected eyes were compared with those of healthy fellow eyes (with exclusion of eyes previously affected by CSCR or with any other ocular disorder) (39 eyes) and the control group (75 eyes), and correlated to the duration of the disease. RESULTS: No significant differences were revealed in axial length between the affected eyes, healthy fellow eyes, and controls (23.31 ± 1.06 mm versus 23.59 ± 1.20 mm versus 23.33 ± 1.19 mm, respectively). The distribution of refraction errors was similar in the three analyzed groups. A hypermetropic shift was noted in the affected eyes versus controls (p = 0.030); however, no difference was noted in refraction error between the healthy fellow CSCR eyes and controls (p = 0.418). Both acute and chronic CSCR cases, as well as their fellow eyes, demonstrated significantly greater choroidal thickness compared with healthy individuals (p < 0.001). Longer disease duration was correlated with a significant deficit in macular volume and average central retinal thickness (p < 0.05). CONCLUSIONS: CSCR is a clinical entity that can occur in patients with every type of refraction error. A shorter axial length of the eyeball is not associated with the diagnosis of CSCR; however, increased choroidal thickness is typical of this entity. Longer disease duration is correlated with the loss of retinal thickness and volume.

Central serous chorioretinopathy (CSCR) is nowadays classified as a clinical entity belonging to the spectrum of pachychoroid disorders characterized by increased choroidal thickness. Quite often, a shorter axial length and hypermetropia were thought to cause choroidal congestion, and as such, were believed to be associated with the incidence of CSCR. This study aimed to evaluate this relationship in the context of the disease duration. The analysis included comparisons among affected CSCR eyes, healthy fellow eyes, and a control group. The results did not prove a relationship between a shorter eyeball or any specific refraction error and CSCR. Both acute and chronic cases of CSCR presented with significantly greater values of choroidal thickness compared with healthy individuals. A loss of retinal thickness and volume was observed with a longer disease duration.

Variability of Grading DR Screening Images among Non-Trained Retina Specialists.

Poland has never had a widespread diabetic retinopathy (DR) screening program and subsequently has no purpose-trained graders and no established grader training scheme. Herein, we compare the performance and variability of three retinal specialists with no additional DR grading training in assessing images from 335 real-life screening encounters and contrast their performance against IDx-DR, a US Food and Drug Administration (FDA) approved DR screening suite. A total of 1501 fundus images from 670 eyes were assessed by each grader with a final grade on a per-eye level. Unanimous agreement between all graders was achieved for 385 eyes, and 110 patients, out of which 98% had a final grade of no DR. Thirty-six patients had final grades higher than mild DR, out of which only two had no grader disagreements regarding severity. A total of 28 eyes underwent adjudication due to complete grader disagreement. Four patients had discordant grades ranging from no DR to severe DR between the human graders and IDx-DR. Retina specialists achieved kappa scores of 0.52, 0.78, and 0.61. Retina specialists had relatively high grader variability and only a modest concordance with IDx-DR results. Focused training and verification are recommended for any potential DR graders before assessing DR screening images.

The Inhibitory Effect of Selected D2 Dopaminergic Receptor Agonists on VEGF-Dependent Neovascularization in Zebrafish Larvae: Potential New Therapy in Ophthalmic Diseases.

Pathological angiogenesis is correlated with many ophthalmic diseases. The most common are exudative age-related macular degeneration and proliferative diabetic retinopathy. The current treatment for these diseases is based on regularly administered anti-VEGF antibodies injections. In the study, we investigated selected D2 dopaminergic receptor agonists, namely bromocriptine, cabergoline and pergolide, on hypoxia-induced neovascularization. We used the zebrafish laboratory model, specifically three-day post fertilization (dpf) Tg(fli-1: EGFP) zebrafish larvae. To induce abnormal angiogenesis of hyaloid-retinal vessels (HRVs) and intersegmental vessels (ISVs), the larvae were treated with cobalt chloride (II) (CoCl2) (a hypoxia-inducing agent) from 24 h post fertilization. The inhibitory role of D2 dopaminergic receptor agonists was investigated using confocal microscopy and qPCR. Additionally, the results were compared to those obtained in the group treated with CoCl2 followed by bevacizumab, the well-known antiangiogenic agent. Confocal microscopy analyses revealed severe deformation of vessels in the CoCl2 treated group, while co-incubation with bromocriptine, cabergoline, pergolide and bevacizumab, respectively, significantly inhibited abnormalities of angiogenesis. The qPCR analyses supported the protective role of the chosen dopaminergic agonists by demonstrating their influence on CoCl2-derived upregulation of vegfaa expression. The present results suggest that the D2 receptor agonists can be considered as a new direction in research for antiangiogenic therapy.

Quality of life among patients from urban and rural areas with advanced age-related macular degeneration assessed using the NEI-VFQ-25.

OBJECTIVE: The aim of the study was to explore the influence of exudative age-related macular degeneration on the quality of life of patients from urban and rural areas. MATERIAL AND METHODS: The retrospective study included 144 Polish Caucasians with exudative age-related macular degeneration, treated with anti-VEGF, recruited from Department of Medical Retina in Lublinbetween March and June 2017. Clinical assessment included age, gender, visual acuity, complete ophthalmic examination, fundus fluorescein angiography and optical coherence tomography, medical history and the NEI VFQ-25 questionnaire. RESULTS: The mean age of the study group was 76.73±12.3 years, average time of AMD was 4.24±4.1 years. 21.5% of patients reported comorbidities such as hypertension, cardiovascular disease, diabetes mellitus. 99 (68.75%) lived in a city, while 45(31.25%) in a village. There was a tendency of females to complain more than males about moderate and severe discomfort and pain (p = 0.09). Most of the patients did not drive a car before the onset of the disease (female vs.male: 81% vs 62.9%; p = 0.01). 62.8% males and 25.8% females gave up driving (p = 0.003), whereas significantly more males gave up driving' and 25% of villagers gave up driving (p = 0.07). The parameter because of the eyesight - female vs. male: 50% vs. 20.8%; p = 0.03. There was a tendency of village respondents to complain more often about extreme difficulty in reading newspapers, street signs or the names of stores than (p = 0.08). 44.2% city residents. Rural patients felt to achieve much less because of their eyesight, which was not observed in patients from the city (p = 0.06). CONCLUSIONS: The place of residence and gender influenced perception of the disease in exudative form of age-related macular degeneration.

Bleb Compressive Sutures in the Management of Hypotony Maculopathy after Glaucoma Surgery.

PURPOSE: The aim of the study was to assess the efficacy and safety of compressive sutures in patients with hypotony maculopathy after glaucoma surgery. METHODS: This retrospective case series analyzes the clinical outcomes of conjunctival compressive sutures in 17 patients with hypotony maculopathy developed after glaucoma surgery. Compressive Nylon 10-0 single sutures were used in all patients; in two patients, the procedure was repeated. All patients underwent ophthalmic evaluation and macular OCT scanning before the surgery, one month, six months, and one year after the procedure. RESULTS: Mean intraocular pressure (IOP) before suturing was 2.3 ± 1.57 mmHg and increased to 14.2 ± 7.03 mmHg (p = 0.00065) one month after the procedure. After six months, mean IOP was 10.2 ± 4.3 mmHg (p = 0.005), and after one year ± 4.7 mmHg (p = 0.0117). To obtain the target pressure, the sutures had to be removed in one patient, and medical therapy was undertaken in three patients. Mean decimal best-corrected visual acuity (BCVA) before the sutures was 0.18 ± 0.13 and increased to 0.53 ± 0.25 (p = 0.0004) after one month, to 0.46 ± 0.31 (p = 0.005) after six months, and to 0.31 ± 0.22 (p = 0.025) after one year. In one case, leakage from the bleb was observed after the procedure and bleb revision was required. CONCLUSIONS: transconjuctival compressive sutures seem to be an efficient and safe technique for managing hypotony maculopathy after glaucoma surgery.

Levels of Trace Elements in the Aqueous Humor of Cataract Patients Measured by the Inductively Coupled Plasma Optical Emission Spectrometry.

Trace elements play an important role in the pathogenesis of several serious ophthalmological disorders, such as glaucoma, age-related macular degeneration (AMD), diabetic retinopathy, cataract, etc. This study aimed to measure alterations of chemical elements' (67) levels in the aqueous humor of patients undergoing cataract surgery. The pilot study included 115 patients, (age 74 ± 7.27, female 64.35%, male 35.65%). The aqueous levels of elements were measured by the use of the inductively coupled plasma optical emission spectrometry (ICP-OES), quality controlled with certified standards. The classification of elements based on their concentration was achieved by hierarchical cluster analysis. This is the first screening study that quantifies over 60 elements which are present in the fluid from the anterior chamber of the eye of cataract patients. The obtained results can be suitable for understanding and identifying the causes that may play a role in the initiation and progression of lens opacity.