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Purpose To compare the efficacy and safety of half-dose and one-third-dose photodynamic therapy (PDT) with verteporfin in patients with chronic central serous chorioretinopathy (CSC). Methods This retrospective study included 72 eyes from 72 patients with chronic CSC treated with either one-third-dose (2 mg/m²) or half-dose (3 mg/m²) PDT. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), subretinal fluid (SRF) thickness, subfoveal choroidal thickness (SFCT), and optical coherence tomography (OCT) features were evaluated at baseline, 3 months, and 12 months. Fluorescein angiography (FA) was used to guide laser application. Treatment outcomes, including SRF resolution, BCVA gain, and recurrence rates, were compared between the two groups. Results At 12 months, complete SRF resolution was achieved in 40 eyes (78.4%) in the half-dose group and 15 eyes (71.4%) in the one-third-dose group. The recurrence rate of SRF was significantly higher in the one-third-dose group (20%) compared to the half-dose group (7.5%) ( P  =.015). BCVA improved significantly in both groups, with mean increases from 72.4 ± 3.9 to 77.1 ± 5.6 letters in the one-third-dose group and from 74.4 ± 4.2 to 80.2 ± 2.19 letters in the half-dose group. The proportion of patients achieving a ≥ 10-letter gain was higher in the half-dose group (52%) compared to the one-third-dose group (28.5%, P  =.001). Both groups exhibited significant reductions in CRT, SRF thickness, and SFCT ( P  <.001), with no significant intergroup differences. Baseline CRT and fluorescein leakage patterns influenced treatment response. Conclusions Both one-third-dose and half-dose PDT effectively improved visual and anatomical outcomes in patients with chronic CSC. However, half-dose PDT demonstrated superior efficacy in achieving SRF resolution and greater visual acuity gains with a lower recurrence rate. Clinical trial number Not applicable.

BackgroundThis study aims to identify the risk factors in peripheral retinal changes (PRC) associated with high myopes among children and adolescents.MethodsThis is a cross-sectional study on children and adolescents diagnosed with high myopia. The subjects involved underwent a series of ocular examinations, including the dilated fundus examination for PRC and the swept-source optical coherence tomography for foveal retinal, choroidal and scleral thickness measurement. Then, the variables were compared among the eyes with high risk, low risk, and no PRC. Spearman correlation was applied to evaluate the relationship between the parameters and the extent of PRC. Logistic regression was performed to identify the potential risk factors.ResultsA total of 117 eyes from 117 subjects were recruited. The prevalence of PRC was 57.3% (67 eyes), while that of high-risk PRC was 22.2% (26 eyes). Significant differences were found in the mean subfoveal scleral thickness, spherical equivalent refraction, and axial length among the eyes with high-risk, low-risk, and no PRC (p < 0.01, p < 0.01, p = 0.048, respectively). Compared with spherical equivalent (r = 0.32, p < 0.01) and axial length (r = 0.18, p = 0.05), subfoveal scleral thickness exhibited higher correlation coefficient with PRC (r =  − 0.38, p < 0.01). Subfoveal scleral thickness and spherical equivalent refraction were identified as the independent risk factors for PRC and high-risk PRC.ConclusionIt was demonstrated that there was a correlation between subfoveal scleral thickness and PRC. The eyes with thinner subfoveal scleral thickness carried a higher risk of PRC.

Purpose This study aimed to evaluate choroidal and macular thickness, as well as vascular structures in female fibromyalgia syndrome (FMS) patients using optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT), and to compare the results with healthy controls. Additionally, the relationship between these findings and disease severity was explored. Methods The study included 62 female FMS patients and 60 healthy controls, conducted between January 2022 and October 2022 at the Antalya Training and Research Hospital. FMS patients were assessed based on American College of Rheumatology criteria. Tear production and stability were evaluated using Schirmer and Tear Break-Up Time (TBUT) tests, while OCTA and OCT were used to examine vascular and choroidal structures. Results The mean age of the FMS group was 43.11 ± 7.94 years. No significant difference was found in the Schirmer test, but the TBUT was significantly lower in the FMS group ( p  < 0.001). OCTA showed significantly lower deep capillary plexus (DCP) values in the FMS group, with a weak negative correlation between DCP and disease severity (r = −0.227, p  = 0.012). Foveal avascular zone (FAZ), non-flow, and choroidal thickness were significantly higher in FMS patients ( p  < 0.050). Conclusion The study demonstrated a relationship between dry eye, vascular changes, and increased choroidal thickness with disease severity in female patients with FMS. The reduction in DCP, along with increases in FAZ, non-flow, and choroidal thickness, may be linked to vascular and inflammatory processes involved in FMS pathogenesis. The decrease in tear quality may be due to autonomic nervous system dysfunction. In conclusion, we suggest that autonomic dysfunction and inflammation in FMS may negatively affect retinal vascular structures and tear function.

To evaluate changes in choroidal thickness (CT) and their association with refractive outcomes after phacoemulsification combined with goniosynechialysis (Phaco-GSL) in patients with primary angle-closure/glaucoma (PAC/PACG). This study involved 79 eyes from 54 patients with PAC/PACG who underwent Phaco-GSL. Intraocular pressure (IOP), best-corrected visual acuity (BCVA), and CT were measured preoperatively and at 1 week (W1), 1 month (M1), 3 months (M3), and 6 months (M6) postoperatively. In addition, anterior chamber depth (ACD), axial length (AL), visual field mean deviation (MD), and mean refractive error (MRE) were recorded preoperatively and at the final follow-up visit. Correlations between ocular biometric parameters and MRE were analyzed using appropriate statistical methods. Within 6 months after Phaco-GSL, CT measured at 13 predefined locations showed an initial postoperative increase, followed by a gradual decline, eventually returning to baseline levels. IOP decreased at W1 and stabilized at M6. In addition, subfoveal choroidal thickness (SFCT) was negatively correlated with IOP preoperatively ( < 0.05) and AL both preoperatively and at M6 ( < 0.01) but positively related to MD at M6. Moreover, CT changes were positively correlated with MRE ( < 0.05), while changes in ACD, AL, and IOP were not associated with MRE (all, > 0.05). These findings suggest that CT initially increases and then decreases over a 6-month period following Phaco-GSL. CT is associated with IOP, AL, and MD reductions. Furthermore, CT changes are associated with an increase in MRE, offering valuable insights into the refractive shifts in PAC/PACG patients after Phaco-GSL.

Aging of the microcirculatory network plays a central role in the pathogenesis of a wide range of age-related diseases, from heart failure to Alzheimer’s disease. In the eye, changes in the choroid and choroidal microcirculation (choriocapillaris) also occur with age, and these changes can play a critical role in the pathogenesis of age-related macular degeneration (AMD). In order to develop novel treatments for amelioration of choriocapillaris aging and prevention of AMD, it is essential to understand the cellular and functional changes that occur in the choroid and choriocapillaris during aging. In this review, recent advances in in vivo analysis of choroidal structure and function in AMD patients and patients at risk for AMD are discussed. The pathophysiological roles of fundamental cellular and molecular mechanisms of aging including oxidative stress, mitochondrial dysfunction, and impaired resistance to molecular stressors in the choriocapillaris are also considered in terms of their contribution to the pathogenesis of AMD. The pathogenic roles of cardiovascular risk factors that exacerbate microvascular aging processes, such as smoking, hypertension, and obesity as they relate to AMD and choroid and choriocapillaris changes in patients with these cardiovascular risk factors, are also discussed. Finally, future directions and opportunities to develop novel interventions to prevent/delay AMD by targeting fundamental cellular and molecular aging processes are presented.

Objectives: The aim of this study was to investigate retinal and choroidal microvascular changes in patients with axial spondyloarthritis (axSpA) treated with long-term anti-TNF therapy and NSAIDs and in healthy control subjects using optical coherence tomography angiography (SS-OCT-A). Methods: A total of 162 eyes from 81 participants were included: 52 eyes from 26 axSpA patients treated with anti-TNF therapy (≥5 years), 44 eyes from 22 axSpA patients treated with NSAIDs, and 66 eyes from 33 healthy control subjects. SS-OCT-A imaging was used to assess retinal thickness, ganglion cell layer thickness, retinal nerve fiber layer thickness, and the vessel densities of the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC). Disease activity was assessed with ASDAS-CRP. Results: Both axSpA subgroups showed a significant expansion of the foveal avascular zone and reduced SCP and DCP densities compared to the controls. The CC vessel density was higher in axSpA patients than in healthy subjects. The anti-TNF group had a lower CC vascular density than the NSAIDs group. The disease duration correlated with a decreased central DCP density and increased paracentral SCP and CC densities. Conclusions: SS-OCT-A revealed subclinical retinal and choroidal changes in axSpA patients, highlighting the impact of chronic inflammation on the retinal vasculature. While anti-TNF therapy effectively controls systemic inflammation, it cannot completely prevent microvascular changes. Further studies are needed to assess the clinical relevance of these results.

Purpose To investigate longitudinal changes in intraocular pressure (IOP), axial length (AL), and choroidal thickness (ChT) in primary open-angle glaucoma (POAG) eyes after trabeculectomy and to evaluate the parameters that might influence those changes. Methods In this prospective observational study, we recruited 28 patients with POAG (28 eyes) scheduled for trabeculectomy. The average macular ChTs and foveal retinal thicknesses along 6-mm segments centered on the fovea were examined preoperatively and postoperatively (at 1, 3, and 6 months) using swept-source optical coherence tomography. The IOP, AL, and mean deviation (MD) of standard automated perimetry (SAP) were also analyzed as independent variables. Results Results from 16 patients were included in the final analysis. A significant increase in ChT with respect to the preoperative value was observed at every postoperative stage (1 month, P  < 0.001; 3 months, P  < 0.001; 6 months, P  = 0.011), whereas the retinal thickness showed no significant change over the study period. The ChT increase and IOP reduction were sustained throughout the 6-month period without further significant changes. Stepwise multivariate analyses showed significant correlations between the percentage decrease in IOP and the percentage increase in ChT at 1 and 6 months postoperatively. The percentage increase in ChT was also significantly correlated with a better MD of the SAP at 1 month ( β  = 0.01; P  = 0.009). Conclusions The ChT increase following trabeculectomy was sustained at 1, 3, and 6 months postoperatively. The percentage increase in ChT was significantly correlated with the percentage change in IOP and (more weakly) with better SAP MD values.

The aim of this article is to underline the effect of pregnancy on the variations of choroidal thickness caused by hormonal and haemodynamic changes.The aim of this article is to underline the effect of pregnancy on the variations of choroidal thickness caused by hormonal and haemodynamic changes.

Neoplasms of the lacrimal drainage system are uncommon, but potentially life-threatening and are often difficult to diagnose. Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

Pyomyositis is a primary bacterial infection of striated muscles nearly always caused by Staphylococcus aureus. Development of the intramuscular abscess involving the extra-ocular muscles (EOMs) remains an extremely rare process. We herein present a case of isolated EOM pyomyositis involving superior rectus muscle in a 2-year male child who was referred with complaints of swelling in left eye (LE) and inability to open LE since last 1-month. Orbital computed tomography (CT) scan showed a well-defined, hypo-dense, peripheral rim-enhancing lesion in relation to left superior rectus muscle suggestive of left superior rectus abscess. The abscess was drained through skin approach. We concluded that pyomyositis of EOM should be considered in any patient presenting with acute onset of orbital inflammation and characteristic CT or magnetic resonance imaging features. Management consists of incision and drainage coupled with antibiotic therapy.