تقاطع شریعتی و بزرگراه همت، خیابان گل نبی غربی، پلاک 3

American Journal of Ophthalmology

Analysis of Choroidal Vascularity Index in Keratoconus Patients Using Swept-Source Optical Coherence Tomography-Based Binarization Techniques
Rosa Gutierrez-Bonet, Jorge Ruiz-Medrano ,Marc Biarnés, Mohammed Abdul Rasheed, Kiran Kumar Vupparaboina, Jay Chhablani, and José M. Ruiz-Moreno
Abstract
Purpose. To analyse the vascular density of the choroid in a keratoconus (KC) population using swept-source optical coherence tomography (SS-OCT). Methods. Prospective, noninterventional study that analysed 97 eyes from 52 KC patients and 145 eyes from 89 healthy controls. The sample was divided in four different age groups. Inclusion criteria were topographic diagnosis of KC using Pentacam, axial length shorter than 26 mm, good quality of the images, and no other systemic or ocular diseases. A 12 mm horizontal single-line SS-OCT b-scan was performed to create a choroidal thickness (CT) profile. Validated automated segmentation and binarization were used in order to analyse choroidal, stromal, and vascular areas. Results. The percentage of choroidal vascularity (vascular area/total area) was 56.6% in KC patients vs. 49.4% in controls. Aged-adjusted choroidal, stromal, and vascular areas and corrected choroidal percentage of vascularity are statistically increased in KC patients when compared with healthy controls (). All these parameters show a decreasing trend with age. Both stromal and vascular areas were thicker in KC patients (). Conclusions. Choroidal, stromal, and vascular areas and corrected choroidal percentage of vascularity are statistically increased in KC patients when compared with healthy controls. All these parameters tend to decrease with age.

Fluorescein Angiographic Findings of Peripheral Retinal Vasculature after Intravitreal Conbercept versus Ranibizumab for Retinopathy of Prematurity
Enzhong Jin, Hong Yin , Yufei Gui, Juan Chen, Jian Zhang, Jianhong Liang ,Xiao-xin Li ,and Mingwei Zhao
Abstract
Purpose. To evaluate angiographic findings of peripheral retina vasculature in retinopathy of prematurity (ROP) neonates who received intravitreal conbercept (IVC) or ranibizumab (IVR). Methods. Fluorescein angiography (FA) findings were retrospectively evaluated for ROP neonates who received IVC or IVR. Outcome measures included peripheral avascular zone, vascular leakage, vascular blunting, vascular loops, vascular dilatation, arteriovenous shunt, and capillary dropout. Results. Fifty-four eyes (28 patients) with ROP were included. Twenty-nine eyes (15 patients) received IVC, and 25 eyes (13 patients) received IVR. For infants of the IVC group, the mean gestational age, birth weight, and postmenstrual age (PMA) at the initial treatment were 28.96 ± ۲.۳۶ weeks, 1168.8 ± ۳۴۴.۵ g, and 41.22 ± ۴.۳۹ weeks, respectively. For the IVR group, they were 28.83 ± ۲.۳۴ weeks, 1255.0 ± ۳۵۶.۹ g, and 39.42 ± ۲.۷۷ weeks, respectively (, 0.522, and 0.075). For the IVC group, FA performed at 71.29–۱۱۵.۴۳ weeks PMA showed 96.55% of eyes had avascular zone; vascular leakage was found in 24.14% eyes; vascular blunting, vascular dilation, vascular loops, arteriovenous shunt, and capillary dropout were found in 96.55%, 72.41%, 79.31%, 48.28%, and 68.97% eyes, respectively. For the IVR group, FA performed at 65.57–۱۳۳.۷۱ weeks PMA showed 92.0% of eyes had avascular zone; vascular leakage was found in 40.0% eyes; vascular blunting, dilatation, loops, arteriovenous shunt, and capillary dropout were found in 100%, 60.0%, 64.0%, 36.0%, and 68.0% eyes, respectively. Conclusion. No significant difference can be observed between the IVC group and IVR group for peripheral vascular structure anomalies with FA evidence. FA studies should be considered to assess the status of the peripheral retinal vasculature to determine therapeutic outcomes and potential functional outcomes.

Evaluation of Retinal Nerve Fiber Layer Thickness, Electroretinogram and Visual Evoked Potential in Patients with Alzheimer’s Disease
Qi Zhe Ngoo , Wan Hazabbah Wan Hitam , and Asrenee Ab Razak
Abstract
Objective. To study the retinal nerve fibre layer (RNFL) thickness and visual electrophysiology testing in patients with Alzheimer’s disease (AD). Methods. A cross-sectional, hospital-based study: 25 AD subjects and 25 controls were recruited. Candidates who fulfil the criteria with normal ocular examinations were made to proceed with scanning laser polarimetry, pattern electroretinogram (PERG), and pattern visual evoked potential (PVEP) examinations of the right eye. RNFL thickness, PERG, and PVEP readings were evaluated. Results. In AD, the mean of average RNFL thickness was 45.28 μm, SD = ۳.۶۱, (), while the superior RNFL thickness was 54.44 μm, SD = ۲.۸۵, () and inferior RNFL thickness was 47.11 μm, SD = ۴.۵۲, (). For PERG, the mean P50 latency was 63.88 ms, SD = ۷.۹۴, () and the mean amplitudes of P50 waves were 1.79 μV, SD = ۰.۶۴, () and N95 waves were 2.43 μV, SD = ۰.۹۰, (). For PVEP, the mean latency of P100 was 119.00 ms, SD = ۹.۰۷, (), while the mean latency of N135 was 145.20 ms, SD = ۸.۵۳, (). The mean amplitude of P100 waves was 3.71 μV, SD = ۱.۶۰, (), whereas the mean amplitude of N135 waves was 3.67 μV, SD = ۲.۰۲, (). RNFL thickness strongly correlates with PERG readings, with P50 latency R = ۰.۵۸۲, R2 = ۰.۳۳۹, (), amplitude of P50 wave at R = ۰.۷۴۹, R2 = ۰.۵۶۱, (), and amplitude of N95 wave at R = ۰.۵۰۰, R2 = ۰.۲۵۰, (). No significant difference and correlation were observed on PVEP readings. Conclusion. The mean of the average, superior and inferior RNFL thickness were significantly lower in the AD group compared with control. There is also significant difference of PERG and PVEP parameters between AD and controls. Regression analysis showed average RNFL thickness having significantly linear relationship with the PERG parameters.

Novel Technique of Pneumatic Posterior Capsulorhexis for Treatment and Prevention of Posterior Capsular Opacification
Ahmed M. Eid , Shaaban Abd-Elhamid Mehany Elwan ,Ahmed M. Sabry, Hossam M. Moharram, and Ashraf M. Bakhsh
Abstract
Purpose. To evaluate a new technique of posterior capsulorhexis using air support to treat primary posterior capsular opacification (PCO) during cataract extraction surgery or to prevent postoperative PCO. Setting. (1) Ophthalmology department, Faculty of Medicine, Minia University, 61519, El-Minia, Egypt. (2) Security Forces Hospital, Ophthalmology Department, Riyadh, Kingdom of Saudi Arabia. Design. Prospective, randomized, consecutive case comparative non controlled study. Methods. One hundred eyes of 100 patients with a mean age of 63.3 years with dense cataract were enrolled in the study. Fifty of them (group (1)) were with primary PCO (discovered during the operations) and fifty (group (2)) with clear posterior capsule. All of the patients underwent phacoemulsification and posterior capsulorhexis using the air to support the posterior capsule. Then, IOL implantations were done between the anterior and posterior capsular rims. Postoperatively, each patient was evaluated for the following: visual acuity (UCVA and BCVA), manifest refractive spherical equivalent (MRSE), intraocular pressure, intraocular lens (IOL) stability, visual axis opacification, and posterior segment complications as retinal breaks, retinal detachment, or cystoid macular edema (CME). Results. There were no significant differences in UCVA, BCVA, and MRSE. All cases had a clear visual axis, with stable IOL and normal IOP during the follow-up period without posterior segment complications. The VA improved significantly throughout the follow-up periods in both groups without significant clinical difference. Conclusion. Pneumatic posterior capsulorhexis is a new effective technique for the treatment of primary PCO in dense cataract and for prevention of postoperative PCO with the good visual outcomes and minimal complications. This trial is registered with NCT04007965.

Detection Rate and Diagnostic Value of Optical Coherence Tomography Angiography in the Diagnosis of Polypoidal Choroidal Vasculopathy: A Systematic Review and Meta-Analysis

Yuelin Wang, Jingyuan Yang, Bing Li, Mingzhen Yuan, and Youxin Chen

Abstract
Purpose. This study aimed to evaluate the detection rate of polyps and branching vascular networks (BVNs) in polypoidal choroidal vasculopathy (PCV) by optical coherence tomography angiography (OCTA) and assess the sensitivity and specificity of OCTA in differentiating PCV from wet age-related macular degeneration (wAMD). Materials and Methods. We searched PubMed, EMBASE, Cochrane Library, and other sources. The detection rates of polyps and BVNs in observational studies and the sensitivity and specificity of PCV diagnosis from wAMD in diagnostic studies were extracted. Results. Twenty studies (573 eyes) were eligible. The combined detection rate of OCTA in PCV polyp lesion diagnosis was 0.67 (95% CI: 0.55–۰.۷۹), while that of BVNs was 0.86 (95% CI: 0.81–۰.۹۱). The detection rate of polyps was compared with that of BVNs in the same study, and the combined relative risk was 0.82 (95% CI: 0.72–۰.۹۲). The combined sensitivity of PCV diagnosis in wAMD patients using OCTA was 0.77 (95% CI: 0.55–۰.۹۰), combined specificity 0.84 (95% CI: 0.60–۰.۹۵), and area under the SROC curve 0.87 (95% CI: 0.84–۰.۹۰). Conclusion. OCTA has a high PCV polyp and BVN detection rate, and the detection rate of BVNs is higher than that of the polyp. OCTA has acceptable sensitivity and specificity for diagnosing PCV from wAMD. Thus, OCTA may be helpful for clinical diagnosis of PCV.