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ObjectiveTo evaluate the morphologic and functional outcomes of different optical coherence tomography (OCT) patterns of myopic foveoschisis after vitrectomy with Inner Limiting Membrane (ILM) peeling.MethodsIn this prospective non-randomised study, 62 consecutive eyes with Myopic Foveoschisis were categorised into three groups according to OCT pattern: retinoschisis type (Rt) Group (23/62), foveal detachment type (FDt) Group (20/62) and macular hole type (MHt) Group (19/62). All patients underwent 25-Gauge vitrectomy and ILM peeling. Air or gas tamponade was used. All patients were observed at month 1, 2, 4 and 6 after surgery. Main outcomes measures: surgical success as resolution of myopic foveoschisis, central retinal thickness (CRT), IS/OS junction recovery and best-corrected visual acuity (BCVA) measurement. Any complication was reported.ResultsIn all eyes OCT showed a resolution of the retinoschisis, foveal detachment and macular hole pattern, respectively. CRT significantly decreased in all Groups (p < .001), mainly in MHt. IS/OS junction recovery was mainly observed in MHt. BCVA significantly increased in all Groups (p < .01). A functional gain ≥2 Snellen lines occurred in 70, 85 and 68% in the Rt, FDt and MHt Group, respectively. Final BCVA was correlated with preoperative BCVA (R 0.74, p < 0.0001), postoperative CRT (R −0.49, p < 0.0001), and the recovery of IS/OS junction at 6 months (R 0.76, p < 0.0001). Few postoperative complications occurred.ConclusionsVitrectomy with ILM peeling results in favourable anatomic and functional outcomes for different patterns of myopic foveoschisis.

The purpose of the present study was to evaluate the intraretinal migration of the retinal pigment epithelium (RPE) cells in age-related macular degeneration (AMD) using polarimetry. We evaluated 155 eyes at various AMD stages. Depolarized light images were computed using a polarization-sensitive scanning laser ophthalmoscope (PS-SLO), and the degree of polarization uniformity was calculated using polarization-sensitive optical coherence tomography (OCT). Each polarimetry image was compared with the corresponding autofluorescence (AF) images at 488 nm (SW-AF) and at 787 nm (NIR-AF). Intraretinal RPE migration was defined by the presence of depolarization at intraretinal hyperreflective foci on PS-SLO and PS-OCT images, and by the presence of hyper-AF on both NIR-AF and SW-AF images. RPE migration was detected in 52 of 155 eyes (33.5%) and was observed in drusenoid pigment epithelial detachment (PED) and serous PED with significantly higher frequencies than in other groups (P = 0.015). The volume of the migrated RPE cluster in serous PED was significantly correlated with the volume of the PED (R2 = 0.26; P = 0.011). Overall, our results showed that intraretinal RPE migrations occurred in various AMD stages, and that they occurred more commonly in eyes with serous and drusenoid PED.

Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. POCUS confirmation of intrauterine pregnancy rules out an ectopic pregnancy. In the third trimester of high-risk pregnancies, umbilical artery Doppler ultrasonography can improve perinatal outcomes. Musculoskeletal POCUS is used to diagnose and guide treatment of many joint and soft tissue conditions. It is as accurate as magnetic resonance imaging in the diagnosis of complete rotator cuff tears. Ultrasound guidance improves outcomes in the placement of central venous catheters and fluid drainage from body cavities and lumbar punctures. Ultrasonography can reduce the use of CT for diagnosis of appendicitis; however, negative scan results do not rule out disease. POCUS can accurately diagnose and rule out gallbladder pathology, and is effective for diagnosing urolithiasis. Focused cardiac ultrasonography can detect pericardial effusion and decreased systolic function, but is less accurate than lung ultrasonography at diagnosing acute heart failure. Limited evidence demonstrates a benefit of diagnosing testicular and gynecologic conditions. The American College of Emergency Physicians, the American Institute of Ultrasound in Medicine, the Society for Academic Emergency Medicine, the American College of Radiology, and others offer POCUS training. Training standards for POCUS have been defined for residency programs but are less established for credentialing. Illustration by Jonathan Dimes

Pachychoroid spectrum diseases have attracted increasing attention, though their pathophysiology has yet to be fully elucidated. In this study, we assessed the vascular diameters of vortex veins in pachychoroid spectrum diseases such as central serous chorioretinopathy (CSC), pachychoroid neovasculopathy without polypoidal lesions (PNV), and pachychoroid neovasculopathy with polypoidal lesions (polypoidal choroidal vasculopathy: PCV). In a retrospective case series of 94 eyes with CSC, 60 eyes with PNV and 57 with PCV, we binarized en face optical coherence tomography (OCT) images of choroidal vortex veins and analyzed the mean diameter of vortex veins. The presence of anastomosis between the superior and inferior vortex veins and central choroidal thickness (CCT) were also evaluated using OCT images. CSC showed significantly larger mean diameter of vortex veins than PCV (P < 0.05). Anastomosis between superior and inferior vortex veins was observed in over 90% of eyes with each pachychoroid spectrum disease. The patients with CSC were the youngest, followed by PNV patients, and then patients with PCV. The largest CCT values were observed in CSC eyes, followed by PNV eyes, and then PCV eyes. CCT correlated with the mean diameter of vortex veins (rs = 0.51, P < 0.01). These findings suggest that congestion of vortex veins might show gradual amelioration corresponding to the development of anastomosis between the superior and inferior vortex veins during the course of progression of pachychoroid spectrum diseases. Moreover, the mean diameter of vortex veins can be used as a parameter indicating choroidal congestion.

To study the significance and correlation of choroidal and retinal pigment epithelial changes with disease activity in Central Serous Chorioretinopathy (CSCR) eyes. This was a retrospective analysis of clinical records and optical coherence tomography (OCT) images of CSCR cases presenting to a tertiary eye hospital in Nepal between October 2021 to November 2022. The study included 145 CSCR eyes from 132 cases compared with 290 eyes of 145 age- and sex-matched healthy volunteers. Chi square test, Paired T-test and Independent sample t-test were used for statistical analysis. Average subfoveal choroidal thickness (SFCT) of the CSCR eyes (453.13 um) and the fellow eyes (403.44 um) was significantly greater (p < 0.001) than that of the control group (372.29um). Notably, the eyes affected by CSCR also had significantly greater SFCT than fellow eyes (p < 0.01). No significant correlation was observed between subfoveal choroidal thickness (SFCT) and either central subfield macular thickness (CST) (p = 0.559) or pigment epithelial detachment (PED) (p = 0.145). Chronic CSCR eyes showed a significant association with PED (Chi-square test, p < 0.013), and a trend toward reduced CST and SFCT compared to acute eyes, as indicated by the independent t-tests (p = 0.04 and p = 0.023, respectively). Flat and irregular PEDs were more common in chronic CSCR eyes compared to acute CSCR eyes (p = 0.027). Increased SFCT and PED are significant pathophysiological markers in CSCR, exhibiting distinct variations between acute and chronic forms. However, the lack of a direct correlation of SFCT with CST and PED underscores the limitation of relying solely on SFCT to fully characterize choroidal changes in CSCR. Further exploration of additional OCT biomarkers may offer deeper insights into the complex pathophysiology of these changes, paving the way for enhanced understanding and more targeted therapeutic strategies.

Background Neuroimaging evidence indicates brain alterations in rhegmatogenous retinal detachment (RRD), but the molecular and neurochemical correlates of these macroscale patterns remain unclear. Methods We examined gray matter volume (GMV), intrinsic neural timescale (INT) and structural covariance network (SCN) gradients in 51 patients with RRD and 45 healthy controls (HCs). Two‐sample Mendelian randomization (MR) evaluated whether RRD‐related genetic liability was consistent with a putative causal effect on GMV. SCN‐gradient alterations were further evaluated using exploratory spatial association analyses based on the Allen Human Brain Atlas (AHBA) and complementary neurotransmitter maps. SHAP‐explainable machine‐learning classification models compared the discriminative utility of structural versus functional features. Results Patients with RRD showed reduced GMV in the visual network (VN) and shortened INT in the default mode network (DMN). MR results were consistent with a putative causal effect of RRD genetic liability on VN atrophy. SCN gradients revealed a hierarchical “visual‐downward and limbic‐upward” shift. Exploratory imaging‐transcriptomic spatial association analyses suggested that gradient alterations were spatially aligned with gene expression patterns enriched for neurodevelopmental and synaptic pathways, including excitatory/inhibitory neuronal and microglial signatures; complementary neurotransmitter mapping analyses further suggested spatial correspondence with normative monoaminergic/cholinergic and μ‐opioid maps, together with an inverse spatial association with GABAa receptor density maps. INT‐based ML models outperformed GMV‐based models (best AUC = 0.753), with SHAP identifying INT as the predominant contributor. Conclusion RRD is associated with coordinated structural and functional alterations across cortical hierarchies. Exploratory transcriptomic and neurotransmitter spatial association patterns may provide biological context for these imaging abnormalities and inform future studies of prognosis and underlying mechanisms. RRD triggers multiscale cortical reorganization, including visual‐network atrophy, shortened intrinsic neural timescale, and altered structural covariance gradients. Integrating Mendelian randomization with AHBA and PET/SPECT biological anchoring and SHAP‐based classification highlights INT as a sensitive imaging biomarker for RRD‐related brain remodeling.

Thromboembolic phenomenon related to Coronavirus disease 2019 (COVID-19) has been well documented in literature; however, reported ocular manifestations of COVID-19 are limited to vision sparing ocular conditions like conjunctivitis. We report a case of a 17-year-old female who presented to us with central retinal vein occlusion with proven recent past COVID-19 infection as presumed etiology which was not known to her at the time of presentation.

To study the clinical characteristics of macula off rhegmatogenous retinal detachment (RRD) with peripheral causative breaks and concomitant macular hole (RRD+MH). This is a bi-center study. Consecutive eyes of macula off RRD with or without macular hole (MH) were collected. Eyes in these two groups were compared with best corrected visual acuity in logarithm of minimal angle of resolution (logMAR BCVA), the presence of choroidal detachment (CD), proliferative vitreoretinopathy (PVR) and the extent of RRD. In the group of RRD+MH, regression analysis was used to evaluate the correlation of clinical factors and final logMar BCVA. In addition, optical coherence tomography was performed both pre-and post-operatively if possible. There were 40 eyes in the RRD+MH group and 80 eyes in the control group. Eyes with RRD+MH had worse initial and final logMar BCVA (p < 0.001), higher incidence of CD (p < 0.001), PVR and extensive RRD at baseline (p < 0.001). Among the eyes with RRD+MH, final BCVA was correlated with initial BCVA (p < 0.001, CI 0.637 to 0.837), recurrent RRD (p = 0.004, CI − 0.661 to − 0.126), duration of RRD (p = 0.021, CI − 0.576 to − 0.048) and presence of PVR (p = 0.001, CI − 0.131 to − 0.035). The hole closure rate at final follow up is 87.5%.11 of the 17 eyes had preoperative optical coherence tomography (OCT) obtained had ellipsoid zone lining the bottom of MH. CD, PVR and extensive RRD were more commonly observed in RRD+MH. The morphology of MH may suggest the pathogenesis of MH in RRD+MH include mechanism different from that of idiopathic MH.

The rd6 mouse model, characterized by retinal degeneration due to an Mfrp mutation, has been widely studied. However, we identified a subset of rd6 mice that developed severe non-rhegmatogenous retinal detachment (rd6-RD), suggesting the presence of additional genetic factors. This study aimed to characterize the retinal phenotype of rd6-RD mice and identify potential causative genetic mutations. We performed optical coherence tomography, fundus imaging, electroretinography, and histological analysis to compare retinal structures and functions between rd6, rd6-RD, and C57BL/6J mice. Whole-genome sequencing was conducted to identify potential mutations associated with the retinal detachment phenotype. Optical coherence tomography revealed retinal detachment in rd6-RD mice as early as 4 weeks old, with complete loss of the outer nuclear layer by 6 weeks. Fundus examination at 11 weeks showed pale fundi and narrowed, whitened retinal vessels in rd6-RD mice, distinct from rd6 mice. On electroretinography, rd6-RD mice displayed significantly diminished a- and b-wave amplitudes, with no detectable responses by 10 weeks. Histological analysis confirmed severe outer retinal degeneration and disappearance of the outer layers in rd6-RD mice. Whole-genome sequencing identified a missense R560C mutation in Pde6b, corresponding to the Pde6brd10 mutation, in rd6-RD mice. A subset of rd6 mice exhibited severe retinal detachment and outer retinal degeneration, distinct from the previously characterized Mfrp-related phenotype. The identification of the Pde6brd10 mutation suggests that these mice possess a dual-mutant genotype (Mfrprd6 and Pde6brd10), exacerbating retinal degeneration. These findings highlight the importance of genetic verification in commercially available mouse models and provide new insights into the genetic complexity of inherited retinal degenerations.

To compare postoperative changes in peripapillary retinal nerve fiber layer (pRNFL) thickness between macula-off and macula-on rhegmatogenous retinal detachment (RRD). Patients with RRD who had undergone a single, uncomplicated vitrectomy and been followed for ≥ 3 years postoperatively were included. Based on preoperative status, patients were categorized into a macula-on group (Group 1) and a macula-off group (Group 2). The baseline was established after complete gas dissipation from the vitreous cavity, followed by three additional examinations at 1-year intervals. In total, 62 eyes were analyzed: 30 in Group 1 and 32 in Group 2. Global pRNFL thicknesses in Group 1 were 100.0 ± 19.5, 99.4 ± 19.6, 98.4 ± 19.4, and 97.0 ± 20.3 μm at baseline, 1 year, 2 years, and 3 years, respectively ( P  = 0.001). In Group 2, the corresponding values were 99.6 ± 15.0, 96.2 ± 16.4, 95.4 ± 16.3, and 94.1 ± 17.6 μm ( P  < 0.001). Sectoral analysis showed statistically significant changes in the inferotemporal ( P  < 0.001) and inferonasal ( P  = 0.003) sectors in Group 2. The reduction rates of global pRNFL thickness were − 0.89 μm/y in Group 1 and − 1.81 μm/y in Group 2; these rates significantly differed between the groups ( P  = 0.026). Among RRD patients, pRNFL thickness gradually declined over time, with a more pronounced reduction in the macula-off group. A substantial decrease in inferior pRNFL thickness was observed in macula-off patients.