Zhangwren9927

To report the incidence and clinical features of neovascular complications from cytomegalovirus (CMV) necrotizing retinopathy in patients after haploidental hematopoietic stem cell transplantation (HHSCT).

Thirty-nine patients (58 eyes) of CMV necrotizing retinopathy after HHSCT in our institute between 2018 January and 2020 June were retrospectively reviewed and cases that developed neovascular complications during follow up were identified and described.

Two (2 eyes) cases that developed neovascular glaucoma (NVG) from CMV necrotizing retinopathy were indentified. Both of them manifested as granular peripheral retinitis, panretinal occlusive vasculitis and some degree of intraocular inflammation, which were consistent with chronic retinal necrosis (CRN). Insidiously progression of isolated immune-mediated occlusive vasculitis that could only be observed on fundus fluorescence angiography (FFA) without active retinitis or intraocular inflammation was recognized to be the cause in one of two cases.

NVG developed in 5.1%/cases and 3.4%/eyes complicated by CMV CRN and vasculitis in patients after HHSCT, which warrants the needs for long-term follow up. Immune mediated CMV vasculitis could be an isolated manifestation in patients with minimal immune deviation and may only be found on FFA, which emphasizing the importance of FFA on regular basis during follow-up.

NVG developed in 5.1%/cases and 3.4%/eyes complicated by CMV CRN and vasculitis in patients after HHSCT, which warrants the needs for long-term follow up. Immune mediated CMV vasculitis could be an isolated manifestation in patients with minimal immune deviation and may only be found on FFA, which emphasizing the importance of FFA on regular basis during follow-up.

To report on the reliability of optical coherence tomography angiography (OCTA) to diagnose fovea plana.

A retrospective, cross-sectional, case-control study included patients with foveal persistence of the inner retinal layers, confirmed by spectral domain OCT (SD-OCT), and superficial (SCP) and deep capillary plexus (DCP) foveal vascularization confirmed by OCTA. A healthy control group was selected. Best-corrected visual acuity (BCVA) was obtained.SD-OCT was used for measuring the outer nuclear layer thickness and OCTA determined the foveal avascular zone (FAZ), SCP and DCP vascular density (VD).

OCTA reliability, based on all parameters, reached 97%, while based only on SCP VD 91%. The plana group (n=57) differed significantly from the control group (n=28) in terms of FAZ, SCP and DCP foveal VD (p<0.005). Subjects with SCP foveal VD >30% or FAZ <0.1 mm had fovea plana. The BCVA of the plana group had no correlation with OCTA quantitative parameters (Pearson |r|<0.18, Spearman |r|<0.44).

OCTA has a high accuracy in diagnosing fovea plana, as its characteristics differ significantly from the normal population. The lack of correlation between BCVA and OCTA parameters implies that reduced BCVA is likely to result from co-existent diseases rather than from the foveal structure.

OCTA has a high accuracy in diagnosing fovea plana, as its characteristics differ significantly from the normal population. The lack of correlation between BCVA and OCTA parameters implies that reduced BCVA is likely to result from co-existent diseases rather than from the foveal structure.

Human photoreceptors are sensitive to infrared light (IR). This sensitivity can be used as a novel indicator of retinal function. We measured diabetic retinopathy patients using in-vivo two-photon excitation and compared their scotopic IR threshold with that of healthy patients.

Sixty-two participants, 28 healthy and 34 with diabetic retinopathy; all underwent a comprehensive eye exam, where we assessed visual acuity and contrast sensitivity. IR thresholds were measured in the fovea and parafovea following 30-min dark-adaptation. We used a two-photon excitation device with integrated pulsed laser light (1045 nm) for sensitivity testing and scanning laser ophthalmoscopy for fundus imaging.

The mean Snellen visual acuity of diabetic patients (6/7.7) was worse than in the healthy group (6/5.5), which was significantly different (P<.001). Disease patients had decreased contrast sensitivity, especially at 6 and 18 cycles/degree. RMC-6236 The mean retinal sensitivity to IR light in diabetic retinopathy (11.6 ±2.0 dB) was significantly (P<.001) lower than in normal eyes (15.5 ±1.3 dB).

Compared to healthy controls, the IR-light sensitivity of diabetic patients was significantly impaired. Two-photon measurements can be used in the assessment of retinal disease, but further studies are needed to validate IR-light stimulation in various stages of diabetic retinopathy.

Compared to healthy controls, the IR-light sensitivity of diabetic patients was significantly impaired. Two-photon measurements can be used in the assessment of retinal disease, but further studies are needed to validate IR-light stimulation in various stages of diabetic retinopathy.

To investigate changes in subfoveal choroidal thickness (SFCT) and their relationship with best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) parameters after intravitreal dexamethasone implant (DEX) injection for diabetic macular edema (DME) METHODS Eighty-one eyes treated with DEX injection for DME were evaluated for BCVA, central macular thickness (CMT), SFCT, and OCT parameters at baseline and weeks 7 and 14.

The mean baseline SFCT significantly decreased at weeks 7 (P<0.001) and 14 (P<0.001). At week 7, each 1-μm reduction in CMT and 5 Early Treatment Diabetic Retinopathy Study letters (-0.1 logMAR) improvement were associated with SFCT reductions of 0.09 (P=0.002) and 3.91 (P=0.044) μm, respectively. At week 14, each 1-μm reduction in CMT was associated with a 0.14-μm reduction in SFCT (P<0.001). Eyes with good functional and anatomical responses exhibited significantly greater SFCT reductions. Subretinal fluid resulted in greater SFCT changes (P=0.039) and better BCVA (P=0.033) at week 7. A continuous ellipsoid zone/interdigitation zone layer was associated with a smaller mean SFCT at week 7 (P=0.002) and better BCVA at weeks 7 and 14 (both, P<0.001).

Changes in SFCT after DEX injection therapy for DME may predict anatomical and functional outcomes and correlate with OCT features that are known as predictors of treatment response.

Changes in SFCT after DEX injection therapy for DME may predict anatomical and functional outcomes and correlate with OCT features that are known as predictors of treatment response.

To examine angiographic risk factors for recurrence of macular edema (ME) associated with branch retinal vein occlusion (BRVO) METHODS We consecutively included 51 patients with treatment-naïve BRVO involving the macular area. Each eye initially received three monthly ranibizumab injections, with additional injections as necessary. At month 3, we examined parafoveal vessel diameter indexes (VDI) in all sectors using optical coherence tomography angiography and determined the association with retinal thickness changes (month 3 to month 5) and the number of ranibizumab injections during 12 months.

Parafoveal VDIs in the affected, nasal, and temporal sectors at month 3 were significantly associated with corresponding parafoveal thickening (P=0.020, 0.010, and <0.001, respectively), and the parafoveal VDIs in the affected, and temporal sectors were significantly associated with future foveal thickening (P=0.037, and 0.026, respectively). Moreover, the parafoveal VDI in the temporal sector showed a significant association with the total required number of ranibizumab injections (P=0.040).

The parafoveal VDI may adequately represent the degree of congestion associated with BRVO. Particularly, the VDI in the temporal sector may be a good predictor of future retinal thickening in the corresponding parafovea and the fovea and the number of ranibizumab injections.

The parafoveal VDI may adequately represent the degree of congestion associated with BRVO. Particularly, the VDI in the temporal sector may be a good predictor of future retinal thickening in the corresponding parafovea and the fovea and the number of ranibizumab injections.

To report a case of early post-operative scleral buckle slippage due to the dehiscence of scleral belt loop tunnels.

Case report RESULTS A 54-year-old female presented with painful diplopia after a combination pars plana vitrectomy and scleral buckling procedure. Ocular movements were limited. Forced duction testing was restricted in all directions. Anterior slippage of the silicone band was suggested on computer tomography (CT) scans and was confirmed with surgical exploration. During surgery, it was found that thin-roofed scleral belt loop tunnels were dehisced in three quadrants leading to anterior slippage of the buckle. The displaced buckle was removed. Diplopia and pain resolved, and ocular motility improved immediately afterwards. The retina remained attached at six months follow up. A supplemental video summarizes the surgical findings and postoperative results.

Spontaneous dehiscence of scleral belt loops may occur in thinly dissected scleral tunnels. Painful eye movement, diplopia, and a positive forced duction test should raise suspicion about a displaced scleral buckle. CT scan may help with the diagnosis. Early diagnosis and immediate surgical intervention are needed to minimize patient discomfort and to improve long term ocular motility.

Spontaneous dehiscence of scleral belt loops may occur in thinly dissected scleral tunnels. Painful eye movement, diplopia, and a positive forced duction test should raise suspicion about a displaced scleral buckle. CT scan may help with the diagnosis. Early diagnosis and immediate surgical intervention are needed to minimize patient discomfort and to improve long term ocular motility.

To report a case of syphilitic outer retinopathy revealed after progression to panuveitis following a course of oral steroids for suspected poison ivy.

Retrospective case report.

A 44-year-old diabetic man presented with progressive symptoms of nyctalopia and color vision changes associated with outer retinal disruption on macular imaging but minimal evidence of intraocular inflammation on examination. A short-course of oral steroids for an unrelated skin condition induced rapid progression to frank panuveitis with retinal vascular sheathing and retinal whitening. Systemic work-up identified syphilis as the etiology. The patient's visual symptoms and disruption of the photoreceptor and retinal pigment epithelial layers on OCT improved after treatment with intravenous penicillin.

Syphilitic outer retinopathy (SOR) represents an unusual manifestation of ocular syphilis that can present with minimal exam findings. We present here a case of oral steroid use resulting in progression of SOR to a more fulminant form of syphilitic uveitis which ultimately revealed the correct diagnosis and prompted the correct intervention. This case highlights the importance of maintaining a high level of suspicion for this treatable condition.

Syphilitic outer retinopathy (SOR) represents an unusual manifestation of ocular syphilis that can present with minimal exam findings. We present here a case of oral steroid use resulting in progression of SOR to a more fulminant form of syphilitic uveitis which ultimately revealed the correct diagnosis and prompted the correct intervention. This case highlights the importance of maintaining a high level of suspicion for this treatable condition.