Purpose To demonstrate axonal loss in the retinal nerve fiber layer (RNFL) of patients with Parkinson's disease (PD) and to evaluate the ability of Fourier-domain optical coherence tomography (OCT) to detect RNFL degeneration and retinal thinning in these patients. Methods PD patients (n ¼ 100) and healthy subjects (n ¼ 100) were included in the study and underwent visual acuity, color vision, and OCT examinations using two nextgeneration Fourier-domain devices (Spectralis and Cirrus). Differences in the RNFL thicknesses were compared between patients and controls. Results RNFL thicknesses were significantly reduced in PD patients compared with healthy subjects, especially those obtained using the Spectralis OCT, in the inferotemporal quadrant (155.6 ± 16.5 lm in healthy eyes vs 142.1 ± 24.9 lm in patients, P ¼ 0.040) and in the superotemporal quadrant (142.6±20.9 lm in healthy eyes vs 132.77±18.6 lm in PD patients, P ¼ 0.046). Significant differences were observed between controls and patients in relation to mean macular thickness (P ¼ 0.031), foveal thickness (P ¼ 0.030), and inferior outer thickness (P ¼ 0.019). Conclusion PD is associated with RNFL loss and retinal thinning, which is detectable by Fourier-domain OCT measurements.
ABSTRACT.Purpose: To test intrasession, intersession, intervisit and interoperator reproducibility of retinal nerve fibre (RNFL) measurements and retinal thickness in healthy subjects using Cirrus Fourier-domain optical coherence tomography (OCT) (Carl Zeiss Meditec, Inc). Methods: Seventy-two eyes of 72 healthy subjects were included in the study. All the eyes underwent three 512 · 128 volume cube centred on the fovea and three 360°circular scans centred on the optic disc by one observer. This sequence was redone by another observer on a second visit within a 2-week period. Descriptive statistics, analysis of variance, intraclass correlation coefficients (ICCs) and coefficients of variation (COVs) were calculated for the nine areas corresponding to the Early Treatment Diabetic Retinopathy Study and for quadrants and RNFL clock hr sectors. Results: Retinal thickness and RNFL measurements were highly reproducible. Mean total retinal thickness was 285.2 ± 15.3 lm by observer 1 and 284.2 ± 12.9 lm by observer 2. Mean COV was 1.2%. Mean RNFL average thicknesses were 96.0 ± 7.7 and 95.7 ± 7.9 lm by observer 1 and 2, respectively. Mean COV was 4.4%. The ICCs ranged from 0.823 to 0.992. Mean differences between both operators were lower than 3 lm, and no significant differences were found. Conclusions: Retinal and RNFL thickness measurements obtained using Cirrus OCT show good repeatability for healthy eyes and few differences between intra-and interobserver evaluations. It can be considered a valid device for measuring retinal and optic nerve parameters in normal eyes.
This study demonstrates efficacy and the duration of effect using a combination of bevacizumab and dexamethasone versus dexamethasone alone. The combination is synergistic, increasing visual acuity and prolonging the time between injections, compared with either of these medications alone. Therefore, the combination of a vascular endothelial growth factor inhibitor and a dexamethasone implant may be a valuable option for RVO treatment.
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