Interdigitation and Ellipsoid Zones Disruption Correlate with Visual Outcomes among Treatment-Naive Patients with Diabetic Macular Edema

Publisher Copyright: © 2020 The Author(s). Published by S. Karger AG, Basel.Introduction: We have recently shown that defects in interdigitation and ellipsoid zones (IZ and EZ) can predict response to anti-VEGF therapy in a small group of treatment-naive diabetic macular edema (DME) patients. The aim of the current study is to further evaluate this association in a larger study group of patients over a longer follow-up time. Methods: Thirty eyes of 30 treatment-naive DME patients were analyzed in this retrospective study. The integrity of foveal IZ and EZ was evaluated using optical coherence tomography at the diagnosis of DME and following anti-VEGF injections. The defect size was correlated with best-corrected visual acuity (BCVA) and central macular thickness (CMT). Results: The mean patients' age at baseline was 63.0 ± 10.0 years. Patients underwent 3.9 ± 2.9 anti-VEGF injections for a mean of 9.1 ± 4.8 months. Following treatment, the mean Snellen visual acuity (VA) improved from 20/52 to 20/44 (p = 0.05), CMT decreased from 432.5 ± 141.4 μm to 375.2 ± 121.4 μm (p = 0.05) and IZ/EZ defect size decreased from 259.83 ± 375.94 μm to 65.34 ± 143.97 μm (p = 0.001). In patients with no IZ/EZ defects at baseline, the mean Snellen VA was better when compared to those with IZ/EZ defects (20/36 vs. 20/70, p = 0.031). The number of eyes with IZ/EZ defects decreased from 17 (57%) at baseline to 6 (20%) at end of follow-up (p < 0.01). BCVA gain correlated with IZ/EZ defect size reduction (r = 0.41, p = 0.02) but not with improvement in CMT (r = 0.28, p = 0.121). Conclusions: IZ/EZ defect size correlated not only with baseline BCVA but also predicted the change in BCVA after anti-VEGF treatment. Possible future automatic measurement of IZ/EZ defect size might prove helpful for the evaluation of treatment response.Peer reviewe

Vision Loss and Ocular Movement Disorders in two young women after bariatric surgery

We present two cases of combined optic neuropathy and ocular movement disorders secondary to a dietary deficiency. A thorough medical history and neuro-ophthalmologic exam have enabled to list the most proper differential diagnoses and have an efficient work-up

A National Neuro-Ophthalmology Consensus Statement on the Terminology for Automated Visual Field Abnormalities

A multitude of terms have been used to describe automated visual field abnormalities. To date, there is no universally accepted system of definitions. Variability among clinicians creates the risk of miscommunication and the compromise of patient care. The purposes of this study were to 1) assess the degree of consistency among the nation's neuro-ophthalmologists in the description of visual field abnormalities, and 2) to create a national consensus statement with standardized terminology and definition