Our results suggest that various kinds of brain lesions with different locations show considerable reduction in GCIPL thickness. Thickness of the GCIPL performed better than conventional pRNFL thickness for the diagnosis of retinal ganglion cell damage induced by brains lesions. The pattern of GCIPL loss may be of particular usefulness in recognising a potential intracranial lesion in cases suspected of having normal-tension glaucoma. GCIPL thickness determined by OCT can be an early and useful marker to estimate the status of the visual pathway in various brain lesions.

PurposeTo evaluate the effects of posterior subtenon triamcinolone acetonide injection on refractory diabetic macular edema (DME) after intravitreal bevacizumab (IVB) injection failure.MethodsPatients with DME and central subfield thickness (CST) >300 µm who did not respond to IVB injections were retrospectively included. Specifically, we enrolled patients who were diagnosed with refractory DME and who experienced an increase in CST after 1 to 2 IVB injections or no decrease after ≥3 consecutive IVB injections. One clinician injected 20 mg of triamcinolone acetonide into the posterior subtenon space. All patients received ophthalmic examinations at baseline and at 2, 4, and 6 months post-baseline. Examinations included Snellen visual acuity, intraocular pressure, and spectral-domain optical coherence tomography.ResultsForty eyes of 34 patients were included. The average baseline CST was 476 µm. The average CST decreased to 368 µm at 2 months, 374 µm at 4 months, and 427 µm at 6 months (p < 0.001 for all results, Wilcoxon signed-rank test). The average intraocular pressure increased from 15.50 to 16.92 mmHg at 2 months but decreased to 16.30 mmHg at 4 months and 15.65 mmHg at 6 months. Logarithm of the minimum angle of resolution visual acuity improved from 0.56 to 0.50 at 2 months (p = 0.023), 0.50 at 4 months (p = 0.083), and 0.48 at 6 months (p = 0.133, Wilcoxon signed-rank test). No complications were detected.ConclusionsPosterior subtenon triamcinolone acetonide is an effective and safe treatment for reducing CST in DME refractory to IVB.