Purpose: The aim of this study was to examine the hyperreflective dots seen in choroid on spectral domain optical coherence tomography (SDOCT) in eyes with diabetic macular edema (DME) and correlate it with visual acuity. Design: Consecutive, cross-sectional case series of patients with DME between January 2017 and December 2017. Methods: Eyes with DME having central foveal thickness ≥250 μm were included. SDOCT was performed using Spectralis system (Heidelberg Engineering, Germany). Hyperreflective choroidal foci (HCF) were defined as well-circumscribed dots within choroid having reflectivity equal to or higher than adjacent retinal pigment epithelium. HCF were counted manually within 1500 μm of fovea using a horizontal line scan by a blinded observer. Eyes were divided in 3 groups: group A (no HCF), group B (1–10 HCF), and group C (>10 HCF). Results: One hundred nineteen eyes of 60 DME patients were included. Sixty (50.4%) eyes were in group A, whereas 42 (33.6%) and 17 (14.2%) eyes belonged to group B and group C, respectively. The mean logMAR best corrected visual acuity was significantly lower in group B (0.76 ± 0.79) and C (1.2 ± 0.78) as compared with group A (0.22 ± 0.49) ( P = 0.001). Mean central foveal thickness in group A (300.4 ± 122.4 μm) was significantly lower than group B (455.52 ± 209.1 μm) and group C (529.4 ± 196.4 μm) with P value of 0.001. Conclusions: The present study describes HCF as novel prognostic SDOCT biomarker in DME whose presence denotes poor visual acuity. Further longitudinal studies are required to substantiate our findings.

BACKGROUND AND OBJECTIVE: To analyze the visibility of various diabetic retinopathy lesions in multicolor imaging (MCI) and compare them to corresponding color fundus photography (CFP). PATIENTS AND METHODS: Retrospective review of 130 eyes of 65 consecutive patients with diabetic retinopathy who underwent multicolor confocal scanning laser ophthalmoscopy and CFP. RESULTS: Hard exudates (Hex) were seen in 74 eyes (71.2%). In all 74 eyes, Hex were visible on both CFP and MCI. Among other color channels, Hex were picked up most in green reflectance (GR) images in 73 eyes (70.2%). Cotton-wool spots (CWS) were picked up in 29 eyes (27.9%) on MCI and in 27 eyes (26%) on CFP. In both GR and blue reflectance (BR) imaging, they were equally picked up in 29 eyes (27.9%). Retinal hemorrhages were picked up in 83 eyes (79.8%) on MCI and in 82 eyes (72.8%) on CFP. Among other channels, they were picked up most in GR images in 81 (77.9%) eyes. Hex, CWS, and hemorrhages were seen better on MCI and in GR images as compared to CFP, BR, and infrared imaging, respectively. With CFP as the comparator, the sensitivity and specificity of MCI to detect of these lesions were more than 90%. CONCLUSIONS: The authors' pilot study validates the efficacy of MCI in picking up lesions of DR vis a vis CFP. MCI has potential to replace CFP in clinical and DR screening setting. [ Ophthalmic Surg Lasers Imaging Retina. 2019;50:8–15.]

Purpose:To describe treatment outcomes of eyes with pachychoroid neovasculopathy (PNV) with PDT and anti-(vascular endothelial growth factor) VEGF therapy.Methods:Retrospective interventional case series. Records of six consecutive cases of PNV were reviewed. Four cases were treated with PDT+ inj ranibizumab. Two cases underwent only PDT. Final visual outcomes and functional outcome including macular status and choroidal thickness were assessed.Results:We analysed six eyes of six patients with PNV. There were four males and two females. Mean age of the patients was 56.5 years. Mean duration of follow up was 8.2 months. All patients received reduced fluence PDT. Four patients received ranibizumab along with PDT; mean BCVA at presentation was 0.41 log MAR units and mean BCVA at final follow up was 0.44 log MAR units. There was significant improvement at final follow up (P = 0.03). Mean subfoveal choroidal thickness (SFCT) at presentation was 445 microns and mean SFCT at final follow up was 293 microns. There was a significant reduction at final follow up (P = 0.02).Conclusion:PDT with or without ranibizumab appears to be an effective treatment modality for PNV.