Purpose: To evaluate the use of intravitreal bevacizumab injections for the treatment of intraretinal cystic spaces associated with gyrate atrophy of the choroid and retina. Methods: Retrospective chart review of 5 eyes of 3 patients with intraretinal cystic spaces associated with gyrate atrophy and treated with intravitreal bevacizumab injections was performed. Information obtained included history, examination findings, optical coherence tomography (OCT), OCT angiography, fluorescein angiography, and microperimetric findings before and after the injections. Results: The mean age of patients was 11 ± 4.6 years. All patients received three monthly bevacizumab injections. The mean corrected distance visual acuity was 0.27 ± 0.10 at baseline and improved to 0.36 ± 0.12 after the injections ( P = .015). The mean central macular thickness was 569 ± 127 µm at baseline and improved to 422 ± 123 µm after the injections ( P = .067). Microperimetry and OCT angiography performed in 1 patient before and after the three injections showed improved macular sensitivity and vascular density measurements following the injections. Conclusions: Intravitreal bevacizumab is safe and effective in the treatment of intraretinal cystic spaces associated with gyrate atrophy. [ J Pediatr Ophthalmol Strabismus . 2020;57(6):400–406.]
Purpose: To evaluate corneal biomechanical parameters with an ocular response analyzer (ORA) in patients with psoriasis and compare these parameters with age-matched control subjects. Study Design: This was a cross-sectional observational case-control study. Methods: Thirty eyes of 15 psoriasis patients were included in the study and compared with 30 eyes of 15 control subjects. Corneal biomechanical properties were calculated by ORA. Central corneal thickness (CCT) was measured by anterior-segment optical coherence tomography. The main outcome measures were corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg). For dry-eye evaluation, Schirmer's test was used. Results: Mean CH in the psoriasis group was 10.20±1.55 mmHg and in the control group 10.66±1.36 mmHg (p=0.215). Mean CRF in the psoriasis group was 9.76±1.60 mmHg and in the control group 10.97±1.42 mmHg (p=0.003). Mean IOPcc in the psoriasis group was 14.84±3.43 mmHg and in the control group 16.67±3.17 mmHg (p=0.035). Mean IOPg in the psoriasis group was 13.92±3.35 mmHg and in the control group 16.62±3.10 mmHg (p=0.002). Mean CCT in the psoriasis group was 543.90±37.27 µm and in the control group 551.23±28.63 µm (p=0.392). Schirmer's test results in the psoriasis group were 11.4 ±1.57 mm/5 min and in the control group 17.5±1.52 mm/5 min (p<0.001). Conclusion: Psoriasis affects corneal biomechanical properties with statistically significantly lower corneal biomechanics than normal. CH correlates negatively with disease activity. These corneal biomechanical changes should be considered when determining IOP values and during corneal evaluation for keratoconus-suspected patients.
Purpose: To evaluate the corneal pachymetric and topographic parameters of systemic Lupus Erythematosus (SLE) patients using Dual Scheimpflug Imaging. Methods: This observational cross-sectional controlled study included the right eye of 30 SLE patients and 30 age-matched controls. Corneal measurements were acquired by dual Scheimpflug imaging including anterior and posterior corneal curvatures, central, midperipheral corneal thickness (measured at the 5 mm zone) and peripheral pachymetry (measured at the 7 mm zone). SLE disease activity index (SLEDAI) was calculated and correlated with corneal pachymetry. Results: SLE patients had significantly thicker corneal periphery than controls. Mean central corneal pachymetry was 530.4± 27.3 microns (SD) in SLE and 547.5±31.5 microns (SD) in control group, p = 0.032. The corneal peripheryexcept superiorlywas significantly thicker in SLE patients than controls (p ˂0.001). Nasal peripheral corneal thickness positively correlated with disease activity index SLEDAI (p=0.03). Conclusion: SLE patients present with thicker corneal periphery than controls characteristically sparing the superior quadrant. Possible corneal photosensitivity leading to peripheral immune complex deposition as well as flatter posterior corneal surface at the periphery are proposed explanations for these findings.
Purpose:This study aimed to evaluate the alignment pattern of the graft–host junction after penetrating keratoplasty (PK) by anterior segment-optical coherence tomography (AS-OCT) and to correlate this pattern with the magnitude of postoperative astigmatism.Methods:This retrospective observational study was carried out on forty patients who underwent PK from February 2013 to August 2014. AS-OCT was performed, and the graft–host junctions were classified into well-apposed junction, malapposed junction, and equally apposed junction. Mal-apposition is subdivided into gap and protrusion. The correlations between clinical characteristics, wound profiles from the AS-OCT, and the magnitude of postoperative astigmatism by Sirius camera (Costruzione Strumenti Oftalmici [CSO], Florence, Italy (CSO, Sirius), were analyzed.Results:Graft–host junctions from forty patients were analyzed; 18 eyes had well-apposed junctions, ten eyes had malapposed junctions, and 12 had equally apposed junctions. The mean cylinder was −9.44 ± −4.00D in well-apposed group, −13.40 ± −5.01D in malapposed group, and −4.67 ± −0.94D in equally apposed group. Alignment pattern of the graft–host junction correlated significantly with the magnitude of astigmatism (P = 0.034). Preoperative corneal diseases did not have an effect on the magnitude of astigmatism (P = 0.123).Conclusion:The alignment pattern of the graft–host junction by AS-OCT can explain the postoperative astigmatism after PK where it correlates significantly with the magnitude of astigmatism.
The purpose of the study is to assess the retinal sensitivity, using microperimetry, before and after silicone removal. It included 22 patients admitted for silicone removal after vitrectomy for macula-off retinal detachment. Patients were divided into 2 groups according to the duration of silicone tamponade: Group A: <3 months (included 10 patients), and Group B: 3–6 months (included 12 patients). Retinal sensitivity was tested, using microperimetry, one day before and one month after silicone removal. The best-corrected visual acuity (in LogMAR) significantly improved postoperatively (0.69 versus 1.06 and 0.69 versus 1.07 in Groups A and B, respectively). The mean intraocular pressure (IOP) was 12.89 ± 1.05 mmHg postoperatively versus 14.89 ± 1.76 mmHg preoperatively in Group A (p=0.011) and was 13.33 ± 1.30 mmHg postoperatively versus 15.33 ± 3.11 mmHg preoperatively in Group B (p=0.008). In Group A, the mean postoperative overall retinal sensitivity was 8.70 ± 2.56 dB versus 5.68 ± 2.00 dB preoperatively (p=0.008). In Group B, it was 9.83 ± 3.36 dB versus 7.00 ± 2.55 dB (p=0.002). No statistically significant difference was found between the two groups as regards improvement in overall retinal sensitivity. We concluded that the overall retinal sensitivity significantly increased following silicone removal in both groups. This trial is registered with ISRCTN43187564.
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