BackgroundTo assess posterior pole (PP) retinal structure in patients with genetically confirmed autosomal dominant optic atrophy (ADOA) using new spectral domain optical coherence tomography (SD-OCT) segmentation technology. To analyze retinal PP thickness in relation to retinal sensitivity data from microperimetry (MP) in ADOA patients.Methods and findingsThis prospective cross-sectional study included 11 patients with ADOA and 11 age-matched healthy subjects. All participants underwent both a “Posterior Pole” and “peripapillary RNFL (pRNFL)” scanning protocol using SD-OCT. Functional mapping of the PP was also performed using MP. A customized program was implemented in order to achieve accurate superimposition of MP sensitivity map onto SD-OCT map. The thickness of the PP different retinal layers and pRNFL was obtained and measured for each eye. Mean retinal sensitivity values and fixation stability were obtained and compared between ADOA patients and healthy subjects. Correlation analysis was performed on a point-to-point basis to evaluate the association between mean thickness and retinal sensitivity of each retinal layer. Total retinal thickness (TRT), Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Layer (GCL), Inner Plexiform Layer (IPL), Inner Nuclear Layer (INL) and Inner Retinal Layers (IRL) at the posterior pole as well as pRNFL were significantly thinner in ADOA patients (P < 0.0001). On the contrary, the Outer Plexiform Layer (OPL) and the Outer Nuclear Layer (ONL) were significantly thicker in the ADOA group (P < 0.001). No significant differences were found in Retinal Pigment Epithelium (RPE) and Outer Retinal Layers (ORL) thickness between ADOA and controls. The average PP retinal sensitivity was significantly reduced in ADOA patients compared with controls (P < 0.001), as measured by microperimeter Nidek MP-1 (MP1). Fixation stability was significantly worse in the ADOA group (P = 0.01). The most severe sensitivity defects in ADOA patients were found at the level of the papillo-macular bundle (PMB).ConclusionsInner retinal layers showed pathological changes in ADOA patients. In addition, the whole retinal PP (not only the PMB) was significantly altered in ADOA, both in terms of retinal thickness and sensitivity.

BackgroundOne of the most challenging problems in vitro-retinal surgery is the recurrence of retinal detachment in the context of high-grade proliferative vitreoretinopathy (PVR). The aim of our retrospective study was to assess the surgical outcomes of pars plana vitrectomy, 180° inferior retinotomy and silicone oil tamponade combined with phacoemulsification and IOL implantation for recurrent inferior retinal detachment with grade C PVR in phakic eyes. The study was carried out at tertiary referral centre - University Hospital of Rome “Tor Vergata”.MethodsRetrospective analysis of 33 eyes affected by recurrent inferior retinal detachment and grade C PVR after primary encircle scleral buckling (SB group – 12 eyes), or pars plana vitrectomy (PPV group – 21 eyes). All patients subsequently underwent PPV and silicone oil tamponade at our Institution. The first outcome measure was retinal reattachment, and second outcomes were reoperation rates, best-corrected visual acuity (BCVA) and postoperative complications.ResultsAll patients in the SB group and 19 (90 %) patients of the PPV group achieved retinal reattachment. Final BCVA was better in the SB group (p = 0.045). Two eyes in the PPV group required a third vitrectomy with heavy silicone oil tamponade. Postoperative complications included silicone oil in a deep anterior chamber (3 eyes in each group), untreatable hypotony in 1 eye in the PPV group (that led to enucleation due to phthisis bulbi), and elevated intraocular pressure in 3 patients (2 eyes in the PPV group).ConclusionsPhacoemulsification with IOL implant, PPV with silicone oil tamponade associated with 180° inferior retinotomy may lead to better anatomical success in patients who have previously undergone SB procedure for inferior retinal detachment repair compared with eyes that underwent a primary PPV.

C3F8 and internal limiting membrane peeling could represent the most effective strategy in highly myopic patients with macular hole retinal detachment. Other tamponade agents must be investigated.

Recent literature agrees that neurodegenerative processes involve both the retina and the central nervous system, which are two strictly related anatomical structures. However, the causal mechanisms of this dual involvement are still uncertain. To date, anterograde transynaptic neurodegeneration, triggered by retinal ganglion cells' death, and retrograde transynaptic neurodegeneration, induced by neurodegenerative processes of the central nervous system, have been considered the major possible causal mechanisms. The development of novel neuroimaging techniques has recently supported both the study of the central stations of the visual pathway as well as the study of the retina which is a possible open window to the central nervous system.

Aim: To assess the frequency of glaucoma-like alterations in Alzheimer's disease (AD) patients using Heidelberg Retinal Tomograph III (HRT-3) and Frequency Doubling Technology (FDT) perimetry.Methods: The study included 51 eyes of 51 AD subjects and 67 eyes of 67 age- and sex-matched controls. Subjects underwent an ophthalmological examination including measurements of intraocular pressure (IOP), Matrix FDT visual field testing, optic nerve head morphology and retinal nerve fiber layer thickness (RNFLt) assessment by slit-lamp biomicroscopy and HRT-3.Results: The frequency of alterations was significantly higher in the AD group (27.5 vs. 7.5%; p = 0.003; OR = 4.69). AD patients showed lower IOP (p = 0.000) despite not significantly different values of central corneal thickness (CCT) between the groups (p = 0.336). Of all the stereometric parameters measured by HRT-3, RNFLt was significantly lower in AD patients (p = 0.013). This group also had significantly worse results in terms of Moorfields Regression Analysis (p = 0.027). Matrix showed significantly worse Mean Deviation (MD) (p = 0.000) and Pattern Standard Deviation (PSD) (p = 0.000) values and more altered Glaucoma Hemifield Test (p = 0.006) in AD patients. Pearson's R correlation test showed that Mini Mental State Examination is directly correlated with MD (R = 0.349; p = 0.034) and inversely correlated with PSD (R = −0.357; p = 0.030).Conclusion: Patients with AD have a higher frequency of glaucoma-like alterations, as detected by the use of HRT-3. These alterations were not associated with elevated IOP or abnormal CCT values.