OCT Findings in Myopic Traction Maculopathy

The prevalence of myopia is constantly on a rise. Patients with high myopia and pathological myopia can lose vision due to a number of degenerative changes occurring at the macula. With recent advances in imaging techniques such as spectral domain optical coherence tomography (OCT) and swept-source OCT, our understanding of macular pathology in myopia has improved significantly. New conditions such as myopic traction maculopathy have been identified and defined. Treatment approaches are now being planned on the basis of the pathoanatomy of myopic traction maculopathy on OCT. In this chapter, we discuss the role of OCT imaging in myopic traction maculopathy

Multicolor imaging findings in torpedo maculopathy

We describe the multicolor imaging findings in two cases of Torpedo maculopathy (TM). Multicolor imaging can be a useful tool in identifying the level of retinal and choroidal layer involvement in TM. This imaging modality further confirms the hypothesis that TM is a localized congenital abnormality of retinal pigment epithelium pigmentation which leads to outer retinal and inner choroidal degeneration

Predictors for choroidal neovascular membrane formation and visual outcome following blunt ocular trauma

Aim: The aim of this study was to determine the predictors for choroidal neovascular membrane formation and visual outcome after blunt ocular trauma. Methods: Retrospective review of electronic medical records of patients with blunt ocular trauma from January 2013 to December 2016 at Narayana Nethralaya Super Speciality Eye Hospital (Bangalore, India) was done. Cases with positive macular findings were enrolled. Data such as age, sex, laterality, mode of injury, presenting and final vision, follow-up duration and retinal findings were noted. Results: A total of 853 cases were referred to the retina clinic with history of blunt ocular trauma. Of which, 37 cases with positive macular findings were identified. Trauma with ball (18/37, 49%) was the most common mode of injury. Choroidal rupture was seen in 33 (89%) eyes. Other retinal findings noted were as follows: retinal haemorrhages (11%), commotio retinae (22%), submacular haemorrhage (43%), macular hole (11%), epiretinal membrane (3%), macular scar (8%) and vitreous haemorrhage (4%). Choroidal neovascular membrane was noted in 6 (16%) out of 37 eyes. No retinal findings showed any positive association with choroidal neovascular membrane formation. Using Pearson’s correlation test, independent variables such as presenting visual acuity ( r  = 0.601, p  = 0.000) and choroidal neovascular membrane formation ( r  = –0.356, p  = 0.031) showed a strong correlation with final visual acuity. Conclusion: The occurrence rate of post-traumatic choroidal neovascular membranes is about 12% in eyes with choroidal rupture. Most choroidal neovascular membranes occur within 1 year of trauma. Eyes with poor presenting vision and choroidal rupture or subretinal haemorrhage warrant regular and shorter follow-up intervals for long periods to identify the choroidal neovascular membrane. Treatment with intravitreal anti-vascular endothelial growth factor therapy is useful

Multicolor imaging in choroidal osteomas

Abstract Background To describe the multicolour (MC) imaging characteristics associated with choroidal osteomas (CO) and their secondary complications. Methods Retrospective descriptive case series of eleven eyes of ten patients with CO. Findings of multicolour imaging were correlated with visual acuity, clinical features, lesion characteristics and findings from other imaging modalities. Results Infrared reflectance (IR) images showed calcified CO lesions as hyporeflectance (dark) areas while decalcified lesions were seen as iso reflectance (normal) areas. Overlying RPE atrophy on IR were seen as white areas. MC images showed color variations depending upon the reflectivity of the tumour material tumour and retinal pigment epithelial (RPE) atrophy. Green color was noted in calcified CO tumour while decalcified CO tumour showed no color change. RPE atrophy were seen as bright orange areas. Green and blue reflectance images were not able to pick the choroidal osteoma lesion. Other changes secondary to CO like presence of choroidal neovascular membrane, hemorrhage and/or fluid in the retinal layers were identified on green and blue reflectance images. Conclusion MC imaging is a useful tool in our arsenal of existing imaging modalities in the assessment of CO and its secondary changes. Change in reflectance of the IR and MC images can be used as an indicator to assess the extent of tumour decalcification and its secondary changes and therefore, can aid in prognostication in the same. It has the potential to replace color fundus photography in documentation and follow up of patients with CO

Oral Eplerenone Versus Observation in the Management of Acute Central Serous Chorioretinopathy: A Prospective, Randomized Comparative Study

In this prospective, interventional case-control study, 58 patients with unilateral acute central serous chorioretinopathy (CSCR) were recruited. Patients ≥ 18 years age, presenting with first episodes of acute CSCR, were included. Acute CSCR was defined by the presence of subretinal fluid (SRF) and symptoms for <12 weeks duration with no clinical or imaging features of chronicity. Patients were alternately divided into treatment (Table Eplerenone 50 mg/day for minimum 1 month) and observation groups. Vision, SRF height and subfoveal choroidal thickness (SFCT) were checked at 1-, 2- and 3-months in both eyes of each group. Each group had 29 eyes. Mean age was 40.4 ± 7.1 and 43.3 ± 8.34 years in treatment and observation group, respectively. Mean symptom duration was 6.46 ± 1.45 and 5.87 ± 2.09 weeks, respectively. Vision improvement to 6/6 was seen in 92%, 100% and 100% cases in treatment group and 74%, 86% and 100% in control group at each visit, respectively. Complete SRF resolution in the treatment group was noted in 45%, 55% and 62% cases at each respective monthly visit. In the observation group, complete SRF resolution was noted in 10%, 21% and 31% at 1-, 2- and 3-month visits, respectively. SRF (p < 0.001) and SFCT (p < 0.001) reduction was noted in the affected eye of both groups. SFCT was reduced in the fellow eye after treatment (p = 0.005) compared to the observation group (p = 0.276). In conclusion, oral eplerenone achieves faster SRF resolution and vision improvement in acute CSCR. Additionally, it shows beneficial effects on the fellow eye