No abstract

Myopia is increasing rapidly worldwide. We performed a cross-sectional study to investigate the prevalence of posterior staphyloma, a complication of myopia, and its shape characteristics in relation to age, sex, and axial length (AL) in a Japanese community-based cohort. The right eyes of 3748 participants who underwent fundus photography and optical coherence tomography (OCT) examination were evaluated. Posterior staphyloma prevalence was evaluated using fundus photographs and OCT images. Furthermore, fundus shapes were analyzed by measuring local fundus curvatures on 6 mm cross-line OCT images at intervals of 1 µm. The mean and variance of the curvatures were calculated to represent the fundus shape of each eye for investigation of the relationship between fundus curvature and age, sex, and AL. Seventy-seven eyes (2.05%) had posterior staphyloma. The mean and variance of the fundus curvatures were significantly greater in women than in men and became greater with age, suggesting that the shape of the staphyloma was steeper and less smooth in women and elderly subjects. AL and mean curvature showed a significant correlation (P = 2 × 10−16, R = 0.480), which was significantly affected by age (P < 2 × 10−16). Quantitative analysis of fundus shapes was useful for statistical analysis of posterior staphyloma in relation to age, sex, and AL.

BackgroundInherited retinal degeneration (IRD) refers to a heterogenous group of progressive diseases that cause death of photoreceptor cells and subsequent vision loss. These diseases often affect the peripheral retina, objective evaluation of which has been difficult until recently. Fundus autofluorescence (FAF) is a non-invasive retinal imaging technique that depicts the distribution of intrinsic fluorophores in the retina. The primary source of retinal autofluorescence is lipofuscin, which is contained in the retinal pigment epithelium (RPE). Excessive accumulation of lipofuscin and a window defect attributable to loss of photoreceptor pigment result in increased FAF whereas loss of the RPE results in decreased FAF. These changes can be seen during the course of IRD.MainbodyWhile conventional modalities are limited in their angle of view, recent technologic advances, known as wide-field and ultra-widefield FAF imaging, have enabled visualization of the far peripheral retina. Although clinical application of this technique in patients with IRD is still in its infancy, some studies have already indicated its usefulness. For example, an area with decreased FAF correlates well with a visual field defect in an eye with retinitis pigmentosa (RP) or cone-rod dystrophy. An abnormal FAF pattern may help in the diagnosis of IRD and associated diseases. In addition, female carriers of X-linked RP and female choroideremia show characteristic appearance. Conversely, absence of abnormal FAF despite severe retinal degeneration helps differentiation of cancer-associated retinopathy.ConclusionThis paper reviews the principles of FAF, wide-field imaging, and findings in specific diseases. Wide-field imaging, particularly wide-field FAF, will provide further information for the characteristics, prognosis, and pathogenesis of IRD.

A PRN regimen for PCV may have a limited effect for the long-term maintenance of improved VA. Macular atrophy may occur more frequently with combination therapy and is possibly associated with the 5-year VA. Thus, combination therapy should be carefully selected for patients susceptible to macular atrophy.

PURPOSE. We investigate whether choriocapillaris deficits can be visualized in patients with retinitis pigmentosa (RP) using wide-angle swept-source optical coherence tomography angiography (OCTA), and whether angiography or structure en face images depict a wider area of residual choriocapillaris. METHODS. This cross-sectional study included 43 eyes of 43 consecutive patients with RP with a visual acuity ‡0.1, and 12 healthy eyes of 12 volunteers. Using an OCTA device (PLEX Eite 9000), we obtained angiography and structure en face images in the choriocapillaris. The residual choriocapillaris area in a 12 3 12 mm macular cube was measured manually. RESULTS. In patients with RP, the residual choriocapillaris area was 113.1 6 41.9 and 64.0 6 47.8 mm 2 in angiography and structure images, respectively (P < 0.001). Concentric and vermicular choriocapillaris flow deficits were observed in 10 (23%) and 17 (40%) eyes of RP patients, respectively; no deficits were observed in 16 eyes (37%). Mean age was higher in eyes with concentric, vermicular, and nondeficit choriocapillaris. No healthy eye showed choriocapillaris deficits. CONCLUSIONS. Using wide-angle swept-source OCTA, concentric and vermicular choriocapillaris flow deficits were observed in the eyes of RP patients. A comparison of angiography and structure en face images of the choriocapillaris in RP cases suggests that angiography images can evaluate a wider area of the choriocapillaris than structure images.