To investigate the anatomical and functional results in eyes with peripapillary pachychoroid syndrome (PPS) undergoing photodynamic therapy (PDT).
A total of 25 eyes from 23 patients with PPS treated ...with PDT were retrospectively evaluated in this multicentric study. Main outcome measure was the proportion of eyes that achieved treatment success, defined as a decrease in both subretinal fluid (SRF) height and central subfield thickness (CST), at 3 months after PDT compared to baseline. Secondary outcomes were the change in CST, SRF, and best-corrected visual acuity (BCVA) 3 months after treatment and predictive factors for treatment success. When available, data between 3 and 12 months were also reviewed.
Treatment success was achieved in 16 eyes (64%). In the total cohort, CST decreased significantly from 356 ± 118 µm at baseline to 282 ± 90 µm and 270 ± 91 µm at 1 and 3 months, respectively (p < 0.001). Maximal SRF height decreased significantly from 102 ± 83 µm at baseline to 38 ± 46 µm and 32 ± 42 µm at 1 and 3 months, respectively (p < 0.001), and remained stable at month 6 (29 ± 44 µm) and month 12 (23 ± 35 µm). BCVA improved significantly from baseline to month 3 (p = 0.021).
PDT can be considered an efficacious treatment option in patients with PPS. Prospective data with longer follow-up in a bigger cohort are needed in order to determine the optimal treatment algorithm in this relatively novel disease.
Introduction
Photorefractive keratectomy (PRK) was introduced in the late 1980s to correct myopia. The purpose of this study was to assess its long-term efficacy and safety, analyzing patients with ...at least 20-year follow-up.
Methods
This retrospective observational study was carried out on 85 eyes of 54 patients (33 females) that underwent PRK between 1991 and 1998 (mean age 32.62 ± 9.74, range 18–55 years). Both preoperatively and postoperatively, patients underwent a complete ophthalmological evaluation, including uncorrected and corrected distance visual acuity, slit-lamp, intraocular pressure, dilated fundus, and corneal topographic examinations. The outcome assessment was made by comparing the preoperative refraction, as spherical equivalent, with the postoperative ones, taking into account the planned refractive correction. Safety and efficacy indices were also calculated. All the data were evaluated with a paired
t
test.
Results
The mean attempted correction as spherical equivalent was – 5.64 ± 3.01 D (range – 1.00 to – 15.00 D), while the mean achieved correction after 20 years was – 4.30 ± 3.13 D (range – 1.88 to – 14.25 D), with a significant statistical difference (
p
< 0.01).
The mean expected refractive outcome was – 0.27 ± 0.81 D (range – 4.00 to + 1.25 D). The mean difference between achieved and attempted treatment was 1.33 ± 1.92 D (range – 4.25 to + 6.25 D), with a significant difference (
p
< 0.01).
The safety index was 1.00 and the efficacy index was 0.63.
Conclusion
The results provided by this study highlight that the procedure could be considered safe, with no long-term sight-threatening complications such as late ectasia or haze.
The identification of non-invasive biomarkers to investigate and monitor retinal structural and vascular changes in multiple sclerosis (MS) represents an interesting source of debate. Until now ...optical coherence tomography angiography (OCTA) evaluated the foveal avascular zone (FAZ) and areas of retinal non-perfusion only in the macular region in MS patients. It could be interesting to identify possible biomarkers, useful in assessing the ischemic areas also in the near peripheral retina, since FAZ enlargement and the areas of peripheral retinal non-perfusions share common pathogenic processes. In this cross-sectional study, we investigated the correlation between the FAZ area and retinal vessel density (VD) in the near peripheral retina by new wide-field optical coherence tomography angiography (OCTA) in patients affected by relapsing-remitting multiple sclerosis (RR-MS). Moreover, we compared the FAZ area and the VD of superficial and deep capillary plexuses in the fovea region and in the near peripheral retina (6.4 × 6.4 mm) between RR-MS patients and healthy controls by means of a Solix full-range OCTA. Last, we also detected the changes in structural OCT parameters (ganglion cell complex and retinal nerve fiber layer). Thirty-three eyes of 33 RR-MS patients and 35 eyes of 35 healthy controls were enrolled. RR-MS patients showed a lower VD in the superficial capillary plexus and a significant increase in the FAZ area compared with controls. The deep capillary plexus revealed a reduced VD although not statistically significant in patients with respect to controls. In the patients' group, the FAZ area showed significantly negative correlations with VD of superficial capillary plexuses in the foveal and whole region, while the FAZ area did not negatively correlate with the VD of the deep capillary plexus. The significant correlations among OCTA parameters could demonstrate the FAZ area as a possible biomarker for assessing the perfusion status in the near peripheral retina, useful in RR-MS management. These findings could confirm the role of vascular dysfunction in the pathogenetic mechanisms of MS.
Dear Editor,
Vogt-Koyanagi-Harada（VKH）disease is a cell-mediated autoimmune syndrome directed against melanocytes.It is considered a multisystem disorder characterized by granulomatous panuveitis ...often associated with neurologic and cutaneous manifestations.
Introduction
The aim of this study was to evaluate retinal and choriocapillaris (CC) vessel density, using optical coherence tomography angiography (OCTA), in the macular region at baseline and after ...three once-monthly intravitreal injections of bevacizumab (loading phase) in patients affected by exudative age-related macular degeneration (AMD).
Methods
A total 38 eyes of 38 patients with exudative AMD (16 women, 22 men; mean age 72.47 ± 7.46 years) were included in this study. We evaluated vessel density in different macular areas (whole image, fovea and parafovea) of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and CC. In addition, central macular thickness (CMT) and choroidal thickness in the foveal region and 500 µm in the nasal and temporal directions were analyzed by enhanced depth image-OCT.
Results
There were no significant differences in vessel density in the SCP, DCP and CC after the loading phase compared to baseline (
p
> 0.05). In contrast, CMT (
p
= 0.039; 320.63 ± 175.05 vs. 372.47 ± 167.05 µm) and subfoveal choroidal thickness (SFCT) (
p
< 0.001; 189.21 ± 37.66 µm vs 170.37 ± 37.96 µm) significantly decreased after the loading phase compared to baseline. No significant correlations were found between SFCT and CC vessel density in the fovea, and between CMT and SCP and DCP (
p
> 0.05) at baseline and after the loading phase. Also, best corrected visual acuity did not correlate with CMT, SCP and DCP at baseline and after treatment (
p
> 0.05).
Conclusion
Macular and choroidal thickness did not correlate with vessel density, but probably correlated to vascular exudation. The anti-VEGF treatment, acting on vascular hyperpermeability, determines the reduction of the retinal and choroidal exudation, resulting in a decrease of their thicknesses. Consequently, these parameters could reflect the effectiveness of the anti-VEGF injections for treating exudative AMD respect to OCTA parameters.
Trial Registration
ClinicalTrials.gov indentifier, NTC04138420.
To investigate the vascular status of the macula in psoriasis patients without history of ocular inflammation by Optical Coherence Tomography Angiography (OCTA).
This prospective cross-sectional ...multicenter study included 55 psoriasis patients and 55 control healthy subjects. A complete eye examination and 6 mm × 6 mm OCTA imaging were performed. Retinal vascular status was evaluated by analyzing vascular density (VD) of superficial vascular plexus (superficial wVD) and deep vascular plexuses (deep wVD) in a 6 mm × 6 mm area and in foveal (superficial fVD and deep fVD) and parafoveal sectors (superficial pVD and deep pVD). In addition, foveal thickness (FT) and foveal avascular zone (FAZ) and clinical variables, including best corrected visual acuity (BCVA), intraocular pressure and refractive condition, were collected.
BCVA, intraocular pressure and refractive condition were comparable between cases and controls. OCTA imaging showed that superficial wVD and superficial pVD were lower in the psoriasis group in comparison with controls (
= 0.009 and
= 0.01, respectively). Similarly, deep wVD and pVD were lower in the psoriasis group in comparison with control subjects (
= 0.03 and
= 0.01, respectively). In a sub-analysis of 47 patients affected by psoriasis without psoriatic arthritis, lower values of wVD and pVD in both superficial and deep capillary plexuses were registered.
OCTA is a useful tool which provides data on vascular status of the retina in psoriasis with no ocular involvement. VD data may suggest that vascular changes may occur earlier than clinical onset of posterior inflammation.
Acanthamoeba keratitis is a rare but serious corneal disease, often observed in contact lens wearers. Clinical treatment of infected patients frequently involves the use of polyhexamethylene ...biguanide (PHMB), a polymer used as a disinfectant and antiseptic, which is toxic also for the epithelial cells of the cornea. Prompt and effective diagnostic tools are hence highly desiderable for both starting early therapy and timely suspension of the treatment. In this work we use Raman microspectroscopy to analyse in vitro a single Acanthamoeba cell in cystic phase. In particular, we investigate the effect of PHMB at the single-cell level, providing useful information on both the underlying biochemical mechanism and the time frame for Acanthamoeba eradication in ocular infections. Furthermore, we demonstrate that Raman spectroscopy, in conjunction with standard multivariate analysis methods, allows discriminating between live and dead Acanthamoebas, which is fundamental to optimizing patients' treatment.
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