Explore the vast range of titles available.

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.

PurposeTo identify characteristics of Caucasian chronic central serous chorioretinopathy (cCSC) patients without a complete resolution of subretinal fluid (SRF) after reduced-settings photodynamic therapy (PDT), or with a recurrence of SRF after PDT.MethodsChronic CSC patients treated with reduced-settings PDT were divided into a successful PDT group and unsuccessful PDT group. Patients in the successful PDT group did not have any subretinal fluid (SRF) during follow-up after PDT, whereas the unsuccessful PDT group was categorized based on either persistence or recurrence of SRF after PDT treatment. Data on age, sex, best-corrected visual acuity (BCVA), PDT spot size, characteristics on fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT) were obtained.ResultsTwenty-six patients in the successful PDT group (20 males, 6 females) had a mean age of 51 years (range, 25–78). In the unsuccessful PDT group, 20 males with a mean age of 60 years (range, 34–78) were included. At last visit before PDT, age, percentage of males, and percentage of patients with diffuse leakage > 1 optic disc diameter on FA were higher in the unsuccessful PDT group (p = 0.010, p = 0.029, and p = 0.008, respectively). At last visit before PDT, BCVA and the percentage of patients with intense hyperfluorescence on ICGA were lower in the unsuccessful group (p = 0.017 and p = 0.004, respectively). Patients with intense hyperfluorescence on ICGA were more likely (95% CI 1.3–333 times) to have a successful outcome (p = 0.045). A decrease in SFCT at final visit was observed in both groups (− 111 μm and p = 0.013, and − 141 μm and p = 0.007, respectively). BCVA only improved at final visit in the successful PDT group (5 Early Treatment of Diabetic Retinopathy Study letters, p < 0.001).ConclusionsChronic CSC patients with recurrent or persistent SRF after PDT are characterized by a higher percentage of males, more patients with diffuse leakage on FA, more patients without intense hyperfluorescence on ICGA, higher age, and lower pre-PDT and long-term BCVA than in the successful PDT group. A reduction in SFCT after PDT does not necessarily lead to complete resolution of SRF, while a resolution of SRF appears to be required to lead to a significant BCVA improvement in cCSC.

PurposeTo determine the characteristics of eyes with treatment-naïve quiescent choroidal neovascularization (CNV) detected by optical coherence tomography angiography (OCTA).MethodsThirty-eight eyes of 37 treatment-naïve consecutive patients (30 men, 7 women, average 69.8 years) were studied. Quiescent CNVs were detected by OCTA (RTVue XR Avanti, Optovue, Fremont, CA) in all eyes. Swept-source OCT (SS-OCT; DRI-OCT, Topcon, Japan) confirmed the absence of exudation. The symptoms, visual acuity, CNV size, and status of the fellow eye were evaluated. Patients were followed longitudinally and the length of follow-up period and development of exudation were recorded for each patient. We also investigated patients’ medical records from their referral hospitals in search of prior exudation.ResultsAll eyes with quiescent CNV were diagnosed at the initial visit with sub-retinal pigment epithelium CNVs, i.e., type 1 CNV, from the OCT and OCTA images. Prior exudation was confirmed in 15 eyes (39.5%) from their medical records of the referral hospitals. Symptoms were present in 18 eyes (47.3%). An exudative CNV was present in 12 of the fellow eyes. Exudation developed in 12 eyes (31.6%) during an average follow-up period of 25.1 months. One-half of the eyes had a prior exudation. The CNV at the baseline in eyes that developed exudation during the follow-up period was larger than eyes without exudation; however, the difference was not significant (0.59±0.47 vs 0.48±0.32 mm2, P = 0.50).ConclusionQuiescent CNVs will develop exudation in approximately 30% of the eyes during a mean 2-year follow-up period. These findings must be remembered when investigating quiescent CNVs that could not be distinguished from eyes with former active CNV and naturally deactivate CNV.

Purpose To assess the efficacy of photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (cCSC), in whom subretinal fluid (SRF) was solely present outside the foveal area. Methods In this retrospective study, 16 eyes of 15 cCSC patients who received half-dose PDT because of notable subjective visual complaints due to the presence of extrafoveal SRF, were included. An ophthalmic examination was performed before treatment, including Early Treatment Diabetic Retinopathy Study best-corrected visual acuity measurement, applanation tonometry, slit-lamp examination, and indirect ophthalmoscopy, followed by multimodal imaging, including fundus photography, fundus autofluorescence, spectral-domain optical coherence tomography (OCT), enhanced-depth imaging OCT of the choroid, fluorescein angiography, and indocyanine green angiography. Results In 7 treated patients (47%), PDT led to a decrease in visual complaints at the first evaluation visit. At this visit, extrafoveal SRF on OCT had resolved in 14 eyes (88%), whereas a complete resolution of extrafoveal SRF had occurred in all eyes at final follow-up visit. At baseline, posterior cystoid retinal degeneration was also present in 5 eyes (31%) and this remained present at all evaluation visits in these patients. Choroidal thickness decreased statistically significantly in the treated eyes, both foveally and at the location of the maximum height of extrafoveal SRF. No complications of PDT were observed. Conclusions Half-dose PDT treatment of cCSC patients with visual complaints due to extrafoveal SRF accumulation is a safe procedure leading to complete SRF resolution, a decrease in choroidal thickness, and a reduction in visual symptoms.

Spectral-domain optical coherence tomography (SD-OCT) is a non-invasive imaging modality that generates detailed images of retinal microstructure. In this study, this technology was employed to investigate changes that occur intraoperatively during repair of complex rhegmatogenous retinal detachment using perfluorocarbon liquids. Intraoperative SD-OCT images were obtained for two patients who underwent pars plana vitrectomy, perfluoro-n-octane instillation, and silicone oil fill for rhegmatogenous retinal detachment. The results demonstrate the ability to obtain high-resolution images of retinal architecture intraoperatively through perfluoro-n-octane and silicone oil. Residual subretinal fluid may be identified intraoperatively despite tamponade with perfluoro-n-octane.

Aim: To evaluate the predictive factors for visual outcome after intravitreal triamcinolone acetonide injection to treat refractory diabetic macular oedema (DME). Methods: A retrospective chart review of patients with DME who met the following inclusion criteria was performed: clinically significant diabetic macular oedema, receipt of a 4 mg/0.1 ml intravitreal triamcinolone acetonide injection and an optical coherence tomography (OCT) of the macula performed up to 10 days before injection. All patients received a full ophthalmic examination including best-corrected Snellen visual acuity (VA). The main outcome measure was the mean change in vision 3 months after injection. Results: Data from 73 eyes of 59 patients were analysed. After a mean follow-up of 324 days, the mean change in vision was −0.075 logarithm of minimum angle of resolution (logMAR) units, with 27.3% improving ⩾3 lines, 6.8% declining ⩾3 lines and 60.2% remaining stable within 1 line of baseline vision. Statistical analysis was performed using multivariate generalised estimating equations on the basis of data from 52 eyes of 42 patients. Factors associated with an improvement in vision 3 months after injection were worse baseline VA (−0.27 logMAR units/unit increase in baseline VA, p = 0.002) and presence of subretinal fluid (−0.17 logMAR units, p = 0.06). The presence of cystoid macular oedema negatively affected the visual outcome (0.15 logMAR units, p = 0.03). In addition, the presence of an epiretinal membrane (ERM) was associated with less visual improvement. ERM modified the effect of baseline VA as demonstrated by a significant interaction between these two variables (0.34 logMAR units/unit increase in baseline VA, p = 0.04). Conclusions: OCT factors and baseline VA can be useful in predicting the outcomes of VA 3 months after intravitreal triamcinolone acetonide injection in patients with refractory DME.

Bilateral diffuse uveal melanocytic proliferation is a rare paraneoplastic syndrome that presents with bilateral progressive loss of vision. A 70-year-old woman presented with a 3-month history of progressive, bilateral vision loss. The patient had bilateral, diffuse, shallow, subretinal fluid with patchy, reddish-brown lesions at the level of the retinal pigment epithelium (RPE) that showed significant early hyperfluorescence on fluorescein angiography and a corresponding loss of autofluorescence. Optical coherence tomography of both eyes revealed complete RPE and inner segment/outer segment junction loss with adjacent areas of thickening at the level of the RPE. Bilateral diffuse uveal melanocytic proliferation was diagnosed based on these clinical findings, and a systemic evaluation for malignancy revealed metastatic endometrial adenocarcinoma. Both autofluorescence and optical coherence tomography demonstrated unique imaging characteristics that correlated with the reported histopathology of bilateral diffuse uveal melanocytic proliferation. These imaging modalities can contribute to the rapid and accurate diagnosis of bilateral diffuse uveal melanocytic proliferation.