Chronic Central Serous Chorioretinopathy in a Patient with Pigment Dispersion Syndrome: A Possible Correlation

Chronic central serous chorioretinopathy (CSCR) is a progressive chorioretinopathy with widespread atrophic RPE abnormalities and serous retinal detachments (SRDs) present for 6 months or longer. We report a case of CSCR in a 38-year-old patient with Pigment Dispersion Syndrome (PDS). In the presented case of CSCR, the chronic course of the disease may in part be associated with an underlying generalized degenerative dysfunction of the pigmented cells of the eye on grounds of PDS. We suggest that a chronic course of disease may be suspected in the setting of CSCR with concurrent RPE pathology, such as what is found in PDS

Optical coherence tomography angiography in Alzheimer's disease: a systematic review and meta-analysis

Background To assess the association between optical coherence tomography angiography (OCTA) retinal measurements and Alzheimer’s disease (AD). Methods We searched MEDLINE and EMBASE from inception up to October 28th, 2020 for studies assessing the association between OCTA retinal measurements and AD. Estimates from eligible studies were meta-analysed and pooled standardized mean differences (SMDs) between AD patients and healthy participants with corresponding 95% confidence intervals (95% CI) were calculated, using the Hartung-Knapp/Sidik-Jonkman random-effects method. In addition, we quantified the minimum strength on the risk ratio scale (E value) required for an unmeasured confounder to nullify these associations. Results Ten eligible studies for our systematic review were identified through our search strategy. The pooled SMD between the retinal vessel density of AD patients and healthy participants in the whole superficial vascular plexus (SVP), parafoveal SVP and foveal avascular zone (FAZ) was -0.41 (95% CI: -0.69 to -0.13, p value = 0.01, I-2 = 15%, seven studies), -0.51 (95% CI: -0.84 to -0.18, p value = 0.01, I-2 = 40%, six studies), and 0.87 (95% CI: -0.03 to 1.76, p value = 0.05, I-2 = 91%, seven studies), respectively. An unmeasured confounder would need to be associated with a 2.26-, 2.56- and 3.82-fold increase in the risk of AD and OCTA retinal measurements, in order for the pooled SMD estimate of vessel density in whole SVP, parafoveal SVP and FAZ, respectively, to be nullified. Conclusions In our study, whole and parafoveal SVP vessel density were inversely associated with AD. However, prospective longitudinal studies with larger sample sizes are needed to furtherly assess these associations

Reduction of Foveal Avascular Zone After Vitrectomy Demonstrated by Optical Coherence Tomography Angiography

Purpose: To investigate the effect of pars plana vitrectomy on foveal circulation, and in particular the foveal avascular zone (FAZ), using optical coherence tomography angiography (OCTA). Methods: This was a prospective, non-randomized, comparative case series of patients that underwent vitrectomy. Twenty-six eyes of 26 patients that underwent vitrectomy were studied postoperatively by OCTA. Our patients underwent 23 or 25G pars plana vitrectomy (PPV) for any posterior segment pathology. Three-dimensional OCTAs (DRI Triton Swept Source OCT; Topcon) of the capillary plexus were obtained three months post-operatively. The FAZ measurements of the fellow eyes were used as controls. Main outcome measures: Change in FAZ area between vitrectomized eyes and controls. Results: From a total of 26 patients, 17 underwent vitrectomy due to retinal detachment (RD). Almost all patients demonstrated a statistically significant reduction in FAZ size based on the OCTA measurements..he mean difference in FAZ size for the superficial capillary plexus (SCP) was -93.77 +/- 71.73 mu m and for the deep capillary plexus (DCP) -88.87 +/- 75.41 mu m, both statistically significant (p=0.000), while the amount of reduction in mu m was the same for both SCP and DCP. Conclusion: The foveal avascular zone seems to be reduced following vitrectomy as shown by optical coherence tomography angiography. It is postulated that this may be the result of changes in the physiology of the vitrectomized eye, and that this change should be attributed to the removal of the vitreous itself rather than other structures such as the internal limiting membrane

Factors Associated with the Clinical Course of Vitreomacular Traction

Background. To analyze the optical coherence tomography (OCT) characteristics as well as the clinical and demographic features to investigate their possible role to the course of vitreomacular traction syndrome. Methods. The inclusion criteria were vitreomacular adhesion with traction causing distortion of the retinal architecture, with or without the presence of an epiretinal membrane, regardless of the size of the adhesion; age >18 years; follow-up of at least three months; and adequate quality OCT scan. Measurements of foveal thickness, average macular thickness, macular volume, maximum vertical and horizontal vitreomacular adhesion, nasal and temporal angles of traction, hyaloid hyperreflectivity, the presence of an epiretinal membrane (ERM), and cone outer segment tips detachment were obtained. Results. 150 eyes were included in the analysis. 36 eyes (24%) developed complete resolution at the last visit, 19 eyes (12.7%) formed a full-thickness macular hole, and 95 eyes (63.3%) showed no resolution of the traction. Better BCVA at the first visit was associated with an increased likelihood of resolution of the VMT, but increasing age, CMT, and BCVA in the end of the follow-up was associated with a reduction in the likelihood of resolving. Of the other variables that were studied, no statistical significant predictors were identified. Conclusions. Better BCVA in the first visit was associated with an increased likelihood of resolution of the VMT that occurred in 24% of our cases. Other factors such as the vertical area of adhesion and the angle of adhesion were not identified as prognostic factors affecting the clinical course of the disease