The aim of this study was to identify any changes that occur in the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) in patients with exudative age-related macular degeneration (AMD) during treatment with anti-vascular endothelial growth factor (VEGF) injections. Patients were enrolled in this retrospective study if they had exudative AMD, had received at least 3 injections of ranibizumab or aflibercept, and had a minimum of 12 months of follow-up. We analyzed the changes in the RNFL and GC-IPL using spectral-domain optical coherence tomography in rescan mode. Fifty-two eyes of 52 patients who had been treated with repeated anti-VEGF injections for exudative AMD were included. At the final visit, there was no significant between-group difference in best-corrected visual acuity or intraocular pressure. There was a significant decrease in central macular thickness in all groups (P < .05). There was a decrease in RNFL thickness that was only statistically significant in the ranibizumab group and when the ranibizumab or aflibercept groups were combined (P = .036 and .044, respectively). The thickness of the GC-IPL layer was significantly decreased in the aflibercept and total group (P = .035 and P = .048, respectively). The thicknesses of the RNFL and GC-IPL decreased in patients with exudative AMD who underwent repeated anti-VEGF injections.
Purpose: To evaluate the effects of glycemic variability on the progression of diabetic retinopathy (DR) among individuals with Type 2 diabetes and to test the hypothesis that consistent glycemic control delays the progression of DR.Methods: This retrospective study included 1,125 participants with a follow-up period of more than 5 years and more than 20 glucose laboratory test results. The hazard ratio of $3 steps of progression on the Early Treatment Diabetic Retinopathy Study person scale and progression to proliferative DR were assessed.Results: An increase in the HbA1c SD was associated with a higher risk of $3 step progression (P , 0.001) and progression to proliferative DR (P , 0.001). Not only mean HbA1c, but also HbA1c SD was associated with a lower risk of $3 steps of progression (P , 0.001), and progression to proliferative DR (P , 0.001).Conclusion: Achievable and consistent glycemic control may contribute to the delay in DR progression.
Purpose: To evaluate topographic changes in choroidal thickness during development of choroidal neovascularization (CNV) in treatment-naive age-related macular degeneration (AMD) and to test the value of such changes as a predictive tool of CNV development. Methods: This retrospective cohort included 86 eyes that developed CNV from intermediate AMD, 43 eyes with intermediate AMD, and 36 eyes without AMD. Patients with intermediate AMD underwent spectral domain optical coherence tomography using enhanced depth imaging mode every 6 months until CNV was detected. Choroidal neovascularization was localized to one of the subfields of Early Treatment of Diabetic Retinopathy Study grid on fluorescein angiography. Average choroidal thickness of each subfield was calculated. Results: Choroidal thickness of the subfield where CNV developed at first clinical detection significantly increased compared with that 6 months before (P = 0.000 for central, P = 0.001 for superior parafoveal, P = 0.002 for temporal parafoveal, P = 0.002 for inferior parafoveal, and P = 0.001 for nasal parafoveal subfield). In eight patients who visited unexpectedly 3 months before CNV development in central subfield, choroidal thickness of central subfield increased significantly compared with that 6 months before CNV development (P = 0.001). Conclusion: Choroidal neovascularization development accompanied choroidal thickening of the corresponding subfield. Regular measurement of choroidal thickness may assist in prediction of CNV.
This report describes a patient with bilateral endogenous candida chorioretinitis. The patient had a 2-day history of bilateral blurred vision. Fundus photography revealed multiple chorioretinal infiltrations in both eyes and a parafoveal hemorrhage in the left eye. After 2 days, fundus examination showed an increased number of infiltrations and hemorrhages in both eyes and worsening vitreous inflammation. A large infiltrative intraretinal lesion and a retinal hemorrhage of the left eye were discovered on optical coherence tomography. Candida albicans was diagnosed from blood culture. The bilateral candida chorioretinitis had not responded to systemic or topical antifungal medication. The chorioretinitis was refractory to intravitreal amphotericin B as well. Intravitreal voriconazole injection in both eyes and intravitreal bevacizumab injection in the left eye were performed thereafter. The chorioretinal infiltrations and hemorrhages decreased in both eyes. Intravitreal voriconazole injection was effective in the treatment of intractable candida chorioretinitis.
To report long-term outcomes of intravitreal ceftazidime injection in patients with endogenous Klebsiella pneumoniae endophthalmitis (EKPE). This was a retrospective observational case study, including 7 eyes from 6 patients with EKPE. The medical records from January 2010 to December 2018 were reviewed. Diagnosis of EKPE was made based on the finding of endophthalmitis with concurrent systemic infection and positive blood culture result. All patients received tap and intravitreal ceftazidime injection base on the results of antibiotics sensitivity test. Visual acuity ranged from no light perception to 20/60 at initial visit, and the final visual acuity was 20/20. Two eyes underwent evisceration after intravitreal injection. Intravitreal ceftazidime injection showed favorable results in patients with EKPE.
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