Fellow eye data for intraocular lens calculation in eyes undergoing combined phacovitrectomy.

PURPOSE: To evaluate whether the intraocular lens (IOL) calculation of the fellow eye (FE) can be used in eyes undergoing combined phacovitrectomy. METHODS: In this retrospective, consecutive case series, we enrolled patients who underwent combined phacovitrectomy with silicone oil removal and IOL implantation at the Goethe-University. Preoperative examinations included biometry (IOLMaster 700; Carl Zeiss). We used the IOL calculation of the FE (FE group) to calculate the prediction error compared with the IOL calculation using only the axial length (AL) of the FE (AL-FE group), as well as using the AL of the operated eye (OE group) in addition to the measurable biometric parameters. IOL calculation was performed using the Barrett Universal II formula. We compared the mean (MAE) and median absolute prediction error (MedAE) with each other. Furthermore, the number of eyes with ±0.50, ±1.00 and ±2.00 dioptres (D) deviation from the target refraction was compared. RESULTS: In total, 79 eyes of 79 patients were included. MedAE was lowest in the OE group (0.41 D), followed by FE group (1.00 D) and AL-FE group (1.02 D). Comparison between the AL-FE and FE groups showed no statistically significant difference (p = 0.712). Comparing eyes within ±0.50 D of the target refraction, the OE group (63.3%) performed best, followed by the AL-FE group (27.8%) and the FE group (26.6%). CONCLUSION: Our results indicate no clinically relevant difference between using the IOL calculation of the FE versus using only the AL of the FE in addition to the measurable parameters for the IOL calculation. A two-step procedure should always be strived for.

Vitreoretinal interface abnormalities in fellow eyes of patients with a macular hole.

Objectives: This study aimed to determine the incidence of bilateral macular holes (MHs), and to investigate the incidence and characteristics of retinal abnormalities in the fellow eyes, using high-definition optical coherence tomography (OCT). Methods: Medical records from 724 consecutive patients diagnosed with full-thickness MHs, who underwent surgery at Fujita Health University Hospital from May 2015 to March 2022, were retrospectively reviewed. Based on the exclusion criteria, 658 patients with idiopathic MHs were included. B-scan OCT images of the fellow eyes were used to identify vitreoretinal interface abnormalities, such as MHs, epiretinal membranes (ERMs), vitreomacular traction syndrome (VMTS) and lamellar macular holes (LMHs). Results: The mean age of the patients was 65.9±9.0 years. There were 292 males (44.4%) and 366 females (55.6%). There were 39 fellow eyes with MHs (5.9%), 77 with ERMs (11.7%), 32 with VMTS (4.9%) and 11 with LMHs (1.7%). Thirty-four fellow eyes (5.2%) could not be classified and 469 fellow eyes were normal (71.3%). Furthermore, the 39 bilateral MHs were divided into four stages according to the Gass classification, as follows: stage 1, 32 eyes (82.1%); stage 2, none (0%); stage 3, 5 eyes (12.8%); and stage 4, 2 eyes (5.1%). Conclusions: Vitreoretinal interface abnormalities, such as MHs, ERMs, VMTS and LMHs, are more common in the fellow eyes of patients with MHs than in the healthy population. The fellow eyes of patients with MHs should be carefully followed using OCT.

Relationship between long-term visual function and the ratio of foveal avascular zone area in eyes with macular hole and healthy fellow eyes.

PURPOSE: This study is to investigate the relationship between long-term changes in the foveal avascular zone (FAZ) and visual function of eyes with macular hole (MH) and compare the relationship between the FAZ of MH eyes and fellow eyes. METHODS: This study included 31 patients with unilateral MH who underwent vitrectomy and their fellow eyes. Best-corrected visual acuity (BCVA) and metamorphopsia were measured preoperatively and at 1, 3, 6, and 12 months postoperatively. We evaluated retinal parameters using optical coherence tomography (OCT) and the superficial FAZ using OCT angiography. The FAZ ratio was defined as follows: (preoperative FAZ area of the MH eye)/(FAZ area of the fellow eye). RESULTS: The preoperative FAZ area of MH eyes was 0.42 ± 0.08 mm2, which decreased to 0.24 ± 0.07 mm2 1 month postoperatively (p < 0.001) and slightly increased to 0.25 ± 0.06 mm2 12 months postoperatively (p = 1.000). The FAZ area did not differ significantly from that of fellow eyes (0.39 ± 0.06 mm2, p = 0.281). The FAZ area of MH eyes was not associated with visual function at any time point. The FAZ ratio showed a correlation with the preoperative, 6-month, and 12-month BCVA (r = 0.604, p < 0.001; r = 0.510, p = 0.003; and r = 0.475, p = 0.007, respectively). CONCLUSIONS: A larger FAZ in the MH eye than that in the fellow eye is associated with poorer long-term visual acuity. The preoperative comparison of the FAZ of the MH eye with that of the fellow eye may be a biomarker for predicting long-term visual acuity.

Fellow-Eye Comparison between Phaco-Tanito Microhook Trabeculotomy and Phaco-iStent Inject W.

This study aims to compare the surgical efficacy and safety of the Tanito microhook trabeculotomy (TMH-CE) and iStent inject W (Inject-CE) when performed in combination with cataract surgery on the eyes of glaucoma patients. A total of 78 glaucomatous eyes from 39 participants were retrospectively analyzed. Intraocular pressure (IOP), the number of antiglaucoma medications, best-corrected visual acuity (BCVA), anterior chamber flare (ACF), and corneal endothelial cell density (CECD) were all evaluated preoperatively and at multiple postoperative time points. The preoperative IOP was significantly higher in the TMH-CE (19.6 ± 6.7 mmHg) than in the Inject-CE (15.7 ± 3.8 mmHg) (p < 0.0001). At the 12-month follow-up, reductions in IOP and the number of medications were more pronounced in the TMH-CE (6.6 mmHg, 27.6% and -1.1, respectively) group than Inject-CE (2.7 mmHg, 12.4% and -0.7, respectively) (p < 0.0001 and p = 0.0034), while the IOP and medication-number levels were identical between TMH-CE (13.0 ± 3.3 mmHg and 1.3 ± 0.9, respectively) and Inject-CE (12.9 ± 2.6 mmHg and 1.9 ± 0.9, respectively) (p = 0.88 and p > 0.99, respectively). The TMH-CE group exhibited a higher ACF, a higher frequency of layered hyphema, and a greater anterior chamber floating red blood cells score in the early postoperative periods. Despite these differences, the changes in BCVA, ACF, and CECD were equivalent between the two groups in later follow-up periods. TMH-CE provides a more significant IOP reduction and medication-number reduction compared to Inject-CE, while Inject-CE shows quicker BCVA recovery. This study provides valuable insights for ophthalmologists choosing the most suitable surgical approach for glaucoma and cataract patients.

The fellow eye of retinal detachment patients: Vision and clinical presentation.

Background: The fellow eye of a retinal detachment is at risk of developing a retinal detachment and other visually debilitating disease. Aim: To investigate the rate of bilaterality of retinal detachment (RD), the presenting visual acuity (VA), and the presence of ocular morbidity in the fellow eye of patients with RD. Patients and Methods: A multicenter, prospective, cross-sectional study examining the fellow eye of consecutive patients who were diagnosed with different types of RD. The patients were seen within one year and examined in four Nigerian eye hospitals and clinics. Demographics, VA, and clinical findings at the presentation were reported on examination of the fellow eyes. Results: Twenty-seven (11.4%) out of 237 patients (264 eyes) had an RD in the fellow eye. The mean age of all study patients was 46.2 ± 16.8 years, M/F: 161 (67.9%)/76 (32.1%). The rates of bilaterality for rhegmatogenous, exudative, and tractional RDs were 4.2%, 11.1%, and 31.1%, respectively. Diagnosis of RD in an eye was associated with a risk of developing fellow eye rhegmatogenous retinal detachment (RRD) (P < 0.001) and tractional RD (P < 0.001), respectively. RRD in an eye was associated with a 17% risk of developing RD in the fellow eye (ß = -1.6, OR = 0.202, P < 0.001). The BCVA in the fellow eye of the three types of RD varied significantly (P < 0.001). The fellow eye was blind in 25.2% of RRD, 54.1% of tractional retinal detachment (TRD), and 11.1% of exudative retinal detachment (ERD). Bilateral RD eyes were blind in RRD (85.7%), TRD (71.1%), and ERD (50%). One hundred and seven eyes (40.5%) of the total 264 RD eyes studied had other fellow eye events at the presentation. Conclusion: A patient with an RD in one eye is at significant risk of developing a blinding RD in the fellow eye. This risk varies with the type of RD and is highest with TRD. However, RRD, the commonest type of RD, can benefit from prophylactic treatment to the fellow eye RD predisposing lesions.

Retinal Detachment and Epiretinal Membrane Development in Fellow-Eye Laser Prophylaxis.

Purpose: To determine the safety and efficacy of fellow-eye laser prophylaxis (FELP) in reducing the rate of retinal detachment (RD) in patients undergoing repair of a primary RD. Methods: Retrospective data were collected on the fellow eyes of consecutive patients undergoing primary RD repair. Patients lacking peripheral retinal pathology in the fellow eye or with less than 3 years of follow-up were excluded. Ninety-eight consecutive patients were identified who underwent FELP as compared with 28 who did not. No patient had symptoms in their fellow eye upon presentation. Rates of RD and epiretinal membrane (ERM) formation in the treatment group were compared with the control group. Results: Three of 98 (3.1%) patients developed RD despite having FELP compared with 5 of 28 (17.9%) in the control group (P = .005). In the FELP group, 16 (16.3%) patients developed ERM vs 7 of 28 (25.0%) in the group that did not receive prophylactic laser (P = .29). No patients in either the FELP or control group required surgery for ERM. Conclusions: Prophylactic laser to the fellow eye of patients undergoing primary RD repair reduced the risk of RD without significant risk of ERM formation.

Second eyes to develop neovascular age-related macular degeneration have fewer symptoms and better one-year visual outcomes.

BACKGROUND: This study compares the visual and anatomical outcomes for the eyes of patients who developed sequential neovascular age-related macular degeneration (nAMD), both at the time of diagnosis and at one year after treatment. METHODS: The study comprised a retrospective case series of 52 patients whose eyes were diagnosed sequentially with nAMD. All eyes were treated with three monthly loading doses of anti-vascular endothelial growth factor agents, followed by further intravitreal injections, as required. Baseline characteristics and outcomes at one year after diagnosis and initial treatment were compared between first and second eyes and included visual acuity (VA), central macular thickness (CMT), and pigment epithelial detachment (PED) height on optical coherence tomography (OCT) imaging. RESULTS: VA at diagnosis was better for second eyes compared with first eyes to develop nAMD (logMAR 0.68 ± 0.51 versus logMAR 0.41 ± 0.34, P = 0.002) and remained so at one year (logMAR 0.61 ± 0.60 versus logMAR 0.42 ± 0.37, P = 0.041). Similarly, PED height at diagnosis was higher in first eyes (225 ± 176 µm versus 155 ± 144 µm, P = 0.003) and also at one year (188 ± 137 µm versus 140 ± 112 µm, P = 0.019). Whereas most patients reported symptoms at first eye diagnosis (71.2%), half as many second eyes were symptomatic (28.8%, P < 0.001). Significantly more symptomatic first eyes experienced visual distortions (32.4% versus 13.3%) or scotomas (29.4% versus 6.7%), compared with a less specific visual complaint of blurry vision (38.2% versus 80.0%, P = 0.006). CONCLUSIONS: Compared with first eyes to develop nAMD, second eyes tended to have better vision, smaller PED heights, and fewer symptoms likely because monitoring permitted earlier diagnosis.

Accuracy of tomographic and biomechanical parameters in detecting unilateral post-LASIK keratoectasia and fellow eyes.

Background: Patients with unilateral post-LASIK keratectasia (KE) have clinical ectasia in one eye but not in the fellow eye. As serious complications, these cases are rarely reported but are worth investigating. This study aimed to explore the characteristics of unilateral KE and the accuracy of corneal tomographic and biomechanical parameters to detect KE and distinguish fellow eyes from control eyes. Methods: The study analyzed 23 KE eyes, 23 KE fellow eyes, and 48 normal eyes from age- and sex-matched patients who had undergone LASIK. The Kruskal-Wallis test and further paired comparisons were performed to compare the clinical measurements of the three groups. The receiver operating characteristic curve was used to evaluate the ability to distinguish KE and fellow eyes from the control eyes. Binary logistic regression with the forward stepwise method was performed to produce a combined index, and the DeLong test was used to compare the discriminability difference of the parameters. Results: Males accounted for 69.6% of patients with unilateral KE. The duration between corneal surgery and the onset of ectasia ranged from 4 months to 18 years, with a median time of 10 years. The KE fellow eye had a higher posterior evaluation (PE) value than the control eyes (5 vs. 2, p = 0.035). Diagnostic tests showed that PE, posterior radius of curvature (3 mm), anterior evaluation (FE), and Corvis biomechanical index-laser vision correction (CBI-LVC) were sensitive indicators for distinguishing KE in the control eyes. The ability of PE to detect the KE fellow eye from the control eye was 0.745 (0.628 and 0.841), with 73.91% sensitivity and 68.75% specificity at a cut-off value of 3. The ability of a combined index, constructed using PE and FE, to distinguish fellow eyes of KE from controls was 0.831 (0.723 and 0.909), which was higher than that of PE and FE individually (p < 0.05). Conclusion: The fellow eyes of patients with unilateral KE had significantly higher PE values than control eyes, and a combination of PE and FE enhanced this differentiation in a Chinese population. More attention should be paid to the long-term follow-up of patients after LASIK and to be wary of the occurrence of early KE.

Short-Term Effect of Micropulse Transscleral Laser Therapy on Intraocular Pressure in Untreated Fellow Eyes of Glaucoma Patients: Preliminary Results.

It has been observed that an intraocular pressure (IOP) altering intervention in one eye is followed by a consensual response in the untreated fellow eye. The underlying mechanisms remain unclear. Involvement of neuronal, cytokine, and hormonal regulation of aqueous humor dynamics, as well as improved treatment adherence or systemic absorption of topically administered medical compounds, have been suggested. Our aim was to investigate the short-term effects of unilateral micropulse transscleral laser therapy on IOP in the fellow eye. All medical records of glaucoma patients who underwent micropulse transscleral laser therapy in a tertiary referral center between May 2019 and February 2023 were collected and analyzed. We found a significant reduction in IOP in the treated eyes, indicating successful treatment. In the fellow eyes, despite not having changed any of the pharmacological IOP-reducing therapies, a significant reduction in IOP from 17.0 ± 5.1 mmHg to 13.5 ± 4.4 mmHg (p < 0.01) was observed. This reduction was, however, short-term and reached statistical significance on the first postoperative day only. Our findings support the concept of consensual inter-eye responses to unilateral IOP changes. Further research is warranted to elucidate the mechanisms underlying this phenomenon.

Three-Year Outcomes of Immediate Primary Phacoemulsification on Acute Primary Angle Closure Eyes and the Fellow Eyes.

Purpose: This study investigated the long-term outcomes (> 3 years) of immediate primary phacoemulsification in eyes with acute primary angle closure (APAC) and in the fellow eyes with shallow anterior chamber to prevent APAC development. Patients and Methods: This is a retrospective study of phacoemulsification for APAC using bilateral eyes. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), and number of IOP-lowering medications at the preoperative examination (Pre), postoperative month 1 (1m), year 3 (3y), and last visit were compared between 14 eyes with APAC and their 14 fellow eyes. The number of corneal endothelial cells (CECs) at Pre and at more than 2 weeks after phacoemulsification was compared. The visual field mean deviation (MD) within 1 year after phacoemulsification and at the last visit was also compared. Results: For APAC eyes, BCVA was significantly improved at 1m, 3y, and at the last visit as compared with Pre (p < 0.05). IOP significantly decreased at 1m, 3y, and at the last visit compared with Pre (p < 0.05). IOP-lowering medication use decreased significantly from Pre to 1m (p < 0.05). The number of CECs was not significantly different between Pre and more than 2 weeks after phacoemulsification. BCVA was significantly worse in APAC eyes than in fellow eyes at Pre (p < 0.05). IOP and the number of IOP-lowering medications were significantly higher in APAC eyes than in fellow eyes at Pre (p < 0.05). Conclusion: Primary phacoemulsification improved visual acuity for APAC eyes and maintained good IOP control without the need for reoperation. Moreover, it preserved the number of CECs for the APAC and fellow eyes in the long term.

Risk of Pseudophakic Cystoid Macular Edema in Fellow-Eye Cataract Surgeries: A Multicenter Database Study.

PURPOSE: To quantify the risk of pseudophakic cystoid macular edema (pCME) in fellow-eye cataract surgery and to determine risk factors, including prior first-eye pCME. DESIGN: Retrospective, clinical database study. PARTICIPANTS: Patients undergoing bilateral nonsimultaneous cataract surgeries in 8 UK National Health Service clinical centers between July 2003 and March 2015. METHODS: We excluded patients with a history of diabetic macular edema (DME) or CME and perioperative topical nonsteroidal anti-inflammatory drug use in either eye. We calculated the overall risk of pCME and used Poisson model with robust estimation of standard error to identify potential risk factors for pCME in the fellow eye. MAIN OUTCOME MEASURE: The risk of postoperative clinical pCME in the fellow eye. RESULTS: A total of 54 209 patients were included. The mean age was 74.6 ± 10.4 years, and 38.8% were male. The fellow eye developed pCME in 544 patients (1%). The risk of fellow-eye pCME among patients without first-eye pCME was 0.9%. However, the risk of fellow-eye pCME among those with first-eye pCME was 10.7%. In the fully adjusted model, we found that the risk factors for the development of fellow-eye pCME were first-eye pCME (RR, 8.55, 95% confidence interval [CI], 6.19-11.8), epiretinal membrane (ERM) (RR, 4.1, CI, 2.63-6.19), history of retinal vein occlusion (RR, 2.94, CI, 1.75-4.93), diabetes without history of DME (RR, 2.08, CI, 1.73-2.5), advanced cataract (RR, 1.75, CI, 1.16-2.65), prostaglandin analogue use preoperatively (RR, 1.49, CI, 1.13-1.97), and male sex (RR, 1.19, CI, 1.0-1.41). CONCLUSIONS: History of pCME in the first-operated eye is the strongest independent risk factor for the development of pCME in the fellow eye. Our findings may guide clinicians in counseling patients on the risk of pCME before performing cataract surgery in the fellow eye and help in identifying high-risk patients who may benefit from prophylactic therapy. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

[Optical coherence tomography analysis of the optic nerve head and macula of the fellow eye in acute unilateral nonarteritic anterior ischemic optic neuropathy]. / Analyse en tomographie à cohérence optique du nerf optique et de la macula des yeux controlatéraux de neuropathie optique ischémique antérieure aiguë.

INTRODUCTION: The objective of the study was to compare the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) of the fellow eyes of patients with acute nonarteritic anterior ischemic optic neuropathy (NAAION) to those of control subjects. METHODS: This study included 46 patients with NAAION matched for age, sex and refraction data (spherical equivalent and/or axial length) to 46 control subjects. The anatomical parameters assessed using the Cirrus SD-OCT were the mean RNFL thickness, in the 4 quadrants (inferior, nasal, temporal, superior) and according to the 12 hourly meridians, GCC mean and in 6 quadrants centered on the fovea (infero-nasal, supero-nasal, infero-temporal, supero-temporal, superior and inferior) and parameters of the optic disc (Cup ratio - Vertical and Average Disc, Rim Area, Disc Area, Cup Volume). RESULTS: Compared to the control group, the eyes contralateral to those affected by NAAION showed a greater value of the area of the neuro-retinal rim (rim area), and a smaller vertical cup/disc (C/D) ratio, mean C/D, and cup volume than the control group. There was no significant difference between the two groups for peripapillary RNFL thickness and GCC parameters. CONCLUSION: The absence of damage to the RNFL or GCC of the unaffected fellow eyes of patients with NAAION does not explain the perimetric damage. The eyes contralateral to those affected by NAAION are characterized by an overall size of the optic disc identical to those of the control subjects, but a smaller cup, a recognized risk factor for NAAION.

Normotensive Glaucoma in the Fellow Eye of Patient with Unilateral Pseudoexfoliation.

PURPOSE: To investigate the characteristics of normotensive glaucoma (NTG) in the fellow eye of patients with unilateral pseudoexfoliation syndrome (PXS). METHODS: This study is a retrospective chart review. We included 313 patients with NTG. Using the 1:1 matched propensity score, only 94 well-matched patients were selected. A total of 47 NTG patients who had PXS in their contralateral eye (PXS group) and 47 NTG patients who did not (control group) were compared. The propensity score was matched based on age, mean intraocular pressure (IOP), baseline retinal nerve fiber layer (RNFL) thickness and baseline mean deviation (MD) of visual field (VF) score. The diagnosis of NTG was based on the presence of glaucomatous optic nerve head injury with VF defect, intraocular pressure less than 22 mmHg, open angles and no pseudoexfoliation material. RESULTS: The PXS group had a higher ratio of males (34.0%) than the control group (17.0%). No significant differences were observed between the two groups in terms of CCT, axial length, untreated baseline IOP, baseline PSD of VF, systemic blood pressure and follow-up duration. The rate of RNFL thinning was significantly faster in the PXS group (-1.88 ± 2.83 µm/year) compared with the control group (-0.27 ± 5.29 µm/year) (p = 0.02). The progression rate of VF MD was slightly faster in PXS than in the control group, but there was no statistically significant difference (PXS group, -0.33 ± 0.90 dB/year; control group, -0.11 ± 0.84 dB/year; p = 0.236). CONCLUSIONS: NTG eyes with PXS showed faster RNFL thinning than did control NTG eyes.

Rates of Fellow Eye Macular Hole Development During Long Term Follow-Up.

Purpose: Identify the long-term rate of fellow eye full-thickness macular hole (FTMH) development. Patients and Methods: In this single site, single provider retrospective consecutive case series, idiopathic FTMH patients who underwent surgery from 2003 to 2014 who also had at least 5 years of follow-up information within our electronic medical record (EMR) which was started in 2014 were identified. Cases with secondary causes (ie, trauma), high myopia, bilateral FTMH on presentation, previous retinal surgery, retinal breaks, or intraocular inflammation were excluded. Demographics, medical and ocular history, refractive error, phakic status, best corrected visual acuity, follow-up duration, surgical technique, single operation anatomic success, and reoperations were recorded. Results: The rate of fellow eye FTMH was 2.6% (2/77) at 1 year, 5.2% (4/77) at 3 years, 9.1% (6/66) at 6 years, and 9.1% (7/77) as of final follow up. There were 2 cases by year 1, 2 additional cases by year 3, 2 additional cases by year 6, and 1 additional case reported thereafter. The average follow up was 11.1 ± 4.5 years. There was no significant difference in visual outcomes between primary eyes and fellow eyes. There was no significant difference in gender, age, ocular comorbidities, refractive error, phakic status, and visual acuity between the unilateral and bilateral groups. Conclusion: The rate of FTMH in the fellow eye was low but significant, increased during long-term follow up, and may stabilize after 6 years.

Optical coherence tomography angiography (OCT angiography) in anterior ischemic optic neuropathy (AION): A systematic review and meta-analysis.

PURPOSE: To summarize the evidence available on optical coherence tomography angiography (OCTA) in patients with anterior ischemic optic neuropathy (AION). METHODS: Systematic searches were conducted on PubMed, Embase, Web of Science, Scopus, Cochrane, and Google Scholar Databases. The quality assessment of the included studies was performed using Newcastle -Ottawa Scale. The data were extracted to an Excel sheet. Vessel density (VD) data were pooled by random effects model, presented as pooled percentage change (PPC), and weighted mean differences (WMD). Additional subgroup analysis was also conducted. RESULTS: In initial searches in online databases, we found 3535 citations, and after screening and checking the titles and abstracts, 26 articles were ultimately eligible for our meta-analysis. The overall PPC of Intra-optic-disc (IOD) VD (-10.73%; p = 0.017, I2 = 0.0%; p = 0.898) was lower than that of radial peripapillary (RP) VD (-17.57%; p < 0.001, I2 = 44.3%; p = 0.002). The overall PPC of peripapillary choroid VD (-6.99%; p < 0.001, I2 = 0.0%; p = 0.766) was significant, but noticeably lower than the pooled percentage change of RPVD and IOD VD. The WMD of RPVD was significant when non-affected fellow eyes were compared to the healthy subjects' eyes (-36.26; p < 0.001, I2 = 0.0%; p = 0.706). CONCLUSIONS: The central retinal artery and its branches might be the main vessels which are affected in AION. The superficial retina was more affected than choroid layer in AION. Also, radial peripapillary retinal nerve fibre layer was more affected than the IOD area. OCTA might be a suitable tool for prediction of AION in susceptible eyes.

Characteristics of Bilateral Retinal Detachment.

INTRODUCTION: Rhegmatogenous retinal detachment (RD) is still a sight-threatening and potentially blinding disease, especially if both eyes are affected. The purpose of this study is analysing the specific characteristics of bilateral rhegmatogenous RD. METHODS: The files of all 5,791 consecutive eyes undergoing vitreoretinal surgery for uncomplicated RD in a single tertiary retinal centre between January 2005 and June 2021 were retrospectively reviewed. RESULTS: A total of 300 patients (600 eyes) had bilateral retinal detachment. Interval between initial and subsequent RD surgery was 2.6 ± 2.8 (mean ± SD, median 1.5) years. Symptoms were reported by the patients for 20 ± 75 (median 5) days before presentation in the initial eye and 12 ± 32 (median 4) days in the subsequent eye. 220 patients were male (73%), and mean age at initial RD was 55 years. 183 (61%) of the initial RD eyes were phakic. In the initial eye, more patients had a detached macula, worse visual acuity, and more quadrants involved. Primary anatomic success rate was higher in the subsequent eye (90%) compared to the initial eye (83%). There was no difference in the reattachment rate of fellow eyes with primary failure in the first eye (91%) compared to those with primary success in the first eye (90%). There was a high symmetry between the eyes in terms of type of retinal break, number of breaks, and presumed localization of the causative retinal break. CONCLUSION: Patients with bilateral RD were more commonly male and younger than the group of all RD patients. The proportion of pseudophakia was not different. The majority of fellow eye RD occurred within 2 years after the RD in the first eye. Second eye RD was less advanced and had a better anatomical repair rate. Despite their experience in the first eye and despite typical symptoms, patients presented only after a mean of 12 days with RD in the second eye. RD in the initial and the subsequent eye showed a high symmetry. The anatomic result in the first eye is not a predictor for the anatomic result in the subsequent eye.

Effect of Selective Laser Trabeculoplasty on the Fellow Eye.

Aim: Determine if selective laser trabeculoplasty (SLT) affects the fellow eye's intraocular pressure (IOP). Materials and methods: A retrospective review of 76 pairs of eyes from 76 adult glaucoma patients who underwent SLT in one eye with at least 2 months between treatments were evaluated for IOP and medication reduction in the untreated fellow eye. Success was defined as ≥20% IOP reduction or ≥1 medication reduction without any additional IOP lowering procedures or medication. The primary outcome measures were success, IOP, and medication reduction in the untreated fellow eye at 6 months. Results: At 6 months after SLT treatment, 48.7% (38/76) treated eyes and 36.8% (28/76) untreated fellow eyes met success criteria. IOP reduction in the treated eye was 2.6 ± 5.8 (14.1%; p < 0.002) and 0.8 ± 4.3 (5.1%, p = 0.122) in the fellow eye. The fellow eye was significantly more likely to meet success criteria if the treated eye was successful [odds ratio (OR): 6.00, 95% confidence interval (CI) (2.11-17.06), p < 0.002]. Conclusion: After a unilateral treatment with SLT, over one-third of the fellow eyes experienced either ≥20% IOP reduction or medication reduction. Additionally, fellow eyes were six times as likely to meet success criteria if this was observed in the treated eye. These findings may support the proposed biochemical mechanism for the therapeutic action of SLT. Clinical significance: The implication for clinicians is that SLT treatment in one eye may allow the fellow eye to benefit and provide a prediction on the fellow eye's response without subjecting both eyes to the rare but present complications of SLT. How to cite this article: Hirabayashi M, Mellencamp E, Duong S, et al. Effect of Selective Laser Trabeculoplasty on the Fellow Eye. J Curr Glaucoma Pract 2023;17(4):175-177.

What about the fellow eye in treatment of neovascular age-related macular degeneration? Analysis of data from the Swedish macula register.

PURPOSE: To analyse the development of neovascular age-related macular degeneration (nAMD) in the fellow eye in patients initially presenting with unilateral nAMD, using data from the Swedish Macula Register. METHODS: This observational study included data on treatment-naïve patients who initially underwent unilateral treatment for nAMD, and then required bilateral treatment, between 2010 and 2018, according to the Swedish Macula Register (SMR). The data were also stratified according into three time periods (2010-2013; 2014-2016; 2017-2018). Treatment duration, best-corrected visual acuity (BCVA) in the first and second eye, number of injections in the first eye before falling ill in the second, and the time between the last injection in the first eye and the start of treatment of the fellow eye were analysed. RESULTS: 5216 out of 28 670 (18%) patients treated for nAMD subsequently required bilateral treatment. The mean age was 77.7 ± 7.3 years, and 69% were female. The mean duration of treatment of the first eye before nAMD was diagnosed in the fellow eye was 1.58 years, and the mean number of injections in the first eye was 8.9 ± 8.6. Best-corrected visual acuity, according to the ETDRS chart, was higher in the second eye at the time when treatment started in that eye compared to treatment start in the first eye: 62.8 (14.7) versus 57.6 (15.5); p < 0.001, and was higher in the 66% whose first eye was still undergoing treatment: 63.6 ± 14.5 versus 61.0 ± 14.8; p = 0.001. CONCLUSIONS: The mean duration of treatment of the first eye before treatment started in the fellow eye was 19 months, and treatment of the second eye had started within 2 years in 61% of the patients. Best-corrected visual acuity was higher in the second eye than in the first eye at the start of treatment of that eye and was higher in the second eye at the start of treatment of that eye when the first eye was still being treated.

Influence of fellow eye on the diagnosis and classification of central serous chorioretinopathy.

PURPOSE: To assess the influence of fellow eye information on diagnosis and classification of central serous chorioretinopathy (CSCR) using multimodal imaging-based classification. METHODS: This was a retrospective, observational study including patients with CSCR with unilateral or bilateral involvement. Multimodal images of both eyes of each patient were compiled and presented to two masked retina specialists subdivided into three groups: (1) both eye data, (2) right eye data and (3) left eye data. The masked observers graded the CSCR as per the new CSCR classification into simple and complex CSCR in three different scenarios as subdivided above. Interobserver and intraobserver agreement was assessed using Cohen's kappa (95% confidence intervals). RESULTS: A total of 206 eyes of 103 patients with unilateral or bilateral CSCR were graded. We found a "strong" intraobserver and interobserver agreement when one eye versus both eye data was provided in terms of "simple CSCR" or "complex CSCR" (kappa value = 0.77 and 0.87, p < 0.001, and kappa value = 0.85 and 0.76, p < 0.001, respectively). Forty-three eyes (10.55%) showed discrepancy in classification between observers for individual eyes, whereas only 13 eyes (6.53%) showed discrepancy between observers when both eye data was provided. CONCLUSION: We conclude that fellow eye information was helpful in solving diagnostic dilemmas and reached 85% consensus in the diagnosis of CSCR between the observers. We found that information of fellow eyes led to a discrepancy only in 6.53% cases with 2.42% cases that had a controversial diagnosis of CSCR. Multimodal imaging-based CSCR classification provides objective approach to diagnose and classify CSCR.

Trabeculectomy with Mitomycin-C in Post-Traumatic Angle Recession Glaucoma in Phakic Eyes With no Prior Intraocular Intervention.

PURPOSE: : To evaluate the outcomes of primary trabeculectomy with mitomycin-C (trab MMC) in phakic eyes with post-traumatic angle recession glaucoma with no prior intraocular surgeries. METHODS: : We included 32 phakic eyes of 32 patients who underwent trab MMC between January-2002 and December-2017. Complete success was IOP between 6 and 21 mm Hg without anti-glaucoma medications (AGM) and failure was when IOP >21 mm Hg with AGM or need for additional intervention for IOP control or loss of light perception. RESULTS: : Thirty-two eyes of 32 subjects with a mean age (± standard deviation) of 30.6 ± 12.6 years were included. The majority were male (97.6%) and the major cause of blunt trauma were sports injury in 28/32 eyes (88%) and 24/32 eyes (75%) had >180-degree angle recession. The Median (interquartile range) follow-up duration was 1.3 years (0.3,3.5). There was significant IOP reduction at 1-year postoperatively (34 (28,40) to 13 (12,16) mm Hg; p < .001). The median postoperative AGM at 1-year was significantly less (4 (3,4) to 0; p < .001) with stable Log MAR visual acuity (p = .24). The complete survival of trab MMC was 88% at 1 year and was 77% from 2 to 5 years. Complications were intraoperative vitreous prolapse needing limited vitrectomy in two eyes and postoperative choroidal detachment in two eyes that resolved with conservative management. The contralateral eyes of three patients (9.7%) developed elevated IOP during the follow-up period. CONCLUSION: : Trabeculectomy with mitomycin-C in phakic eyes with traumatic angle recession glaucoma showed good safety and efficacy in the medium-term follow-up. The contralateral fellow eye needs monitoring for glaucoma in these patients.