Changes in body weight, serum osmolarity, and blood pressure during hemodialysis may affect choroidal thickness in and outside the macula.

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PurposeTo report a case of unilateral central retinal vein occlusion (CRVO) with central retinal artery occlusion (CRAO) in a patient with elevated Factor VIII.Case presentationA 48-year-old woman presented with a complaint of decreased visual acuity in her left eye that began 6 weeks prior. The patient had diabetes. The best-corrected visual acuity (BCVA) was hand motion, IOP was 34 mmHg, and there was a neovascularization of the iris in the left eye. A complete fundus evaluation including fluorescein angiography showed non-proliferative diabetic retinopathy in the right eye and CRVO with CRAO in the left eye. Systemic evaluation revealed elevated fibrinogen and Factor VIII suggestive of the diagnosis of thrombophilia due to elevated Factor VIII. This symptom was the first sign of the underlying disorder. IOP was normalized 1 week after IOP lowering agents were applied. Intravitreal anti-vascular endothelial growth factor treatment and pan-retinal photocoagulation were performed in the left eye. Additionally, to treat thrombophilia, warfarin treatment was started and flame-shaped retinal hemorrhage with cotton wool patch near the optic disc and around the retinal vascular arcade at the posterior pole had occurred in the right eye during treatment. Then, warfarin treatment was discontinued and retinal hemorrhage was decreased. In the left eye, the BCVA did not change during treatment.ConclusionElevated levels of Factor VIII as an independent risk in the development of venous thromboembolism. Combined cases usually present with severe visual loss and such patients should be thoroughly evaluated to diagnose underlying factors including Factor VIII, and initiate appropriate management at the earliest.

Background: To evaluate the macular pigment optical density (MPOD) with age in the Korean population using the Macular Pigment Screener II (MPSII ®). Methods: One hundred and twenty-six eyes were retrospectively reviewed. MPOD was measured using MPSII ® , which uses a heterochromatic flicker photometry method, and the estimated values were analyzed. Spearman's correlation test was used to evaluate correlations between MPOD and age. The association between MPOD and age was determined using a simple linear regression analysis. MPODs among the four groups were compared via the post hoc analysis with Bonferroni correction, MPODs between the age-related macular degeneration (AMD) group and aged-matched healthy subjects were compared via the Mann-Whitney U test. Other risk factors for AMD were identified via a logistic regression analysis. Results: Estimated MPOD decreased significantly with increasing age in the general population. In the simple regression analysis, a statistically significant linear regression model was observed, and the estimated values of MPOD decreased by −0.005 as age increased by 1 year. Aged (> 50 years) showed lower MPOD than younger (30-49 years) subjects. But, in the healthy population, the estimated MPOD values exhibited a decreasing trend with age, but there were no significant differences according to age, after excluding patients with AMD. MPOD was significantly lower in patients with AMD than in aged healthy controls. Furthermore, hypertension, dyslipidemia, and smoking were identified as risk factors for AMD. Conclusion: MPOD measured with MPSII ® reflects the MP density in healthy individuals and patients with dry AMD. Aging was not significantly associated with low MPOD in healthy population, but the presence of dry AMD was significantly associated with low MPOD. Then, low MPOD may be a risk factor for development of dry AMD. Furthermore, routine screening with MPS II ® for ages 50 and older is thought to help detect early low MPOD and identify individuals who should take supplements.