Optical Coherence Tomography Characteristics of Quiescent Type 1 Neovascularization in Eyes with Nonexudative Age-related Macular Degeneration

Objectives:To describe the lesion characteristics of nonexudative, quiescent, asymptomatic type 1 neovascularization (NV) on B-scan and en face spectral domain optical coherence tomography (SD-OCT) in eyes with nonexudative age-related macular degeneration (AMD).Materials and Methods:In this retrospective, observational, consecutive case series, 27 patients who were already being followed and treated for exudative AMD in one eye were included in the study for their fellow eyes, which were initially nonexudative but developed exudative findings during follow-up. Initial B-scan and en face SD-OCT, fluorescein angiography (FA), and indocyanine green angiography (ICGA) images of these 27 eyes were examined retrospectively. The characteristic B-scan SD-OCT features of type 1 NV in this silent and asymptomatic stage were described.Results:The 27 eyes of 27 patients (13 males and 14 females; mean age 69.5±8.2 years) with nonexudative AMD had a mean best corrected visual acuity (BCVA) of 0.6±0.3 Snellen. Initial B-scan OCT images of all eyes (100%) showed retinal pigment epithelium (RPE) elevations and irregularities caused by a moderately reflective material in the sub-RPE space without fluid accumulation in the intraretinal/subretinal or sub-RPE space. Twenty-four eyes (88.8%) showed sub-RPE hyperreflective lesions consistent with type 1 NV on en face OCT images. While none of the eyes showed signs of type 1 NV in FA, macular plaque was observed in 8 eyes (29.6%) in ICGA. The mean time to onset of exudative findings was 8.3±4.03 months.Conclusion:In eyes with nonexudative AMD, there may be quiescent and asymptomatic type 1 NV lesions which do not yet show exudative changes. This NV has characteristic features on B-scan SD-OCT and can also be detected with en face OCT. Detection and close monitoring of these quiescent and inactive type 1 NV lesions during the asymptomatic, pre-exudative period are important for early treatment

A Case of Concurrent Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy Following Pfizer-BioNTech COVID-19 Vaccination

We present a 65-year-old woman who developed sudden and severe vision loss in her left eye one day after the administration of the second dose of coronavirus disease-19 vaccine. The best corrected visual acuity in this eye was 1/10. Diffuse paracentral acute middle maculopathy was detected on spectral domain optical coherence tomography (OCT). OCT angiography images revealed concurrent vascular flow defects consistent with acute macular neuroretinopathy in the deep retinal capillary plexus and choriocapillaris layers. At the end of the six-month follow-up, there was no improvement in visual acuity, and atrophy and thinning developed in all layers of the retina

Vitreomacular Traction and Outer Retinal Structural Changes

In this case report we aimed to present the outer retinal structural changes secondary to vitreomacular traction (VMT). Outer retinal structural changes occurring secondary to VMT due to incomplete posterior vitreous detachment were described retrospectively with spectral-domain optical coherence tomography in 3 eyes of 3 patients. The patients ranged in age from 58 to 65 years and best corrected visual acuity in the 3 eyes was 4/10, 8/10, and 9/10. All of the patients were symptomatic and exhibited outer retinal microholes at the fovea extending from the retinal pigment epithelium to outer limiting membrane, with an overlying operculum on the detached posterior hyaloid membrane over the macula following spontaneous resolution of VMT. In the mean follow-up period of 32 months, the outer retinal microholes decreased in size but did not completely resolve. As demonstrated in these cases, VMT can cause small outer retinal layer defects without signs of full-thickness macular hole. These lesions can cause symptoms and affect visual function, and may be permanent structural changes

Toxocara Neuroretinitis Associated with Raw Meat Consumption

Neuroretinitis characterized by optic disc edema and star-like exudates in the macula was detected in a patient who presented with sudden unilateral painless vision loss and had a history of raw meat consumption. The patient tested seropositive for Toxocara. Combination therapy with steroid and albendazole resulted in an increase in visual acuity and complete resolution of clinical signs

Multimodal Imaging of Reticular Pseudodrusen in Turkish Patients

Objectives:To investigate the presence and prevalence of reticular pseudodrusen (RPD) in patients with age-related macular degeneration using multiple imaging modalities and to compare the sensitivity and specificity of these modalities in the detection of RPD.Materials and Methods:Images from a total of 198 consecutive patients were analyzed prospectively. Color fundus photography, red-free imaging, spectral domain optical coherence tomography (SD-OCT), infrared and blue reflectance (BR) imaging, fundus autofluorescence (FAF), enhanced-depth imaging OCT (EDI-OCT), fundus fluorescein angiography (FFA) and indocyanine green angiography were performed. RPD was diagnosed in the presence of relevant findings in at least two of the imaging methods used.Results:RPD were detected in 149 eyes (37.6%). In the detection of RPD, color fundus photography, red-free photography, SD-OCT, infrared, FAF, BR, and FFA imaging had sensitivity values of 50%, 57.7%, 91.6%, 95%, 74.6%, 65.7%, and 28.2% and specificity values of 99.6%, 100%, 98.4%, 94.6%, 100%, 99.6%, and 69.8%, respectively.Conclusion:Infrared imaging had the highest sensitivity. SD-OCT combined with infrared imaging was the most sensitive imaging technique for detecting RPD. The high specificity of FAF, red-free, and BR imaging may be useful to confirm a diagnosis of RPD

Stargardt ve Fundus Flavimakulatus; Patofizyoloji, Klinik Bulgular,Görüntüleme Bulguları ve Tanı

Stargardt hastalığı (STGD), resesif olarak geçiş gösteren maküla distrofileri içinde en sık görülen formdur. Atrofik bir maküla ile onu çevreleyen irregüler, sarı-beyaz renkli, derin retinal lezyonlar ile karekterizedir. Hastalar arasında başlangıç yaşı, görme keskinliği, fundus görünümü ve hastalık şiddeti açısından büyük değişkenlikler vardır. Hastalığın seyri esnasında erken dönemlerde fundus muayenesi normal olmasına karşın görme keskinliği azalmış olabilir. Bu tür hastalarda STGD tanısı koymada pattern elektroretinogram (PERG) ve fundus otofloresans (FOF) tanı koymada çok yardımcı yöntemlerdir. Fluoressein anjiografideki “koroidal sessizlik” ya da karanlık koroid görüntüsü STGD’li hastaların hepsinde görülmez ve sadece bu hastalığa özgün bir bulgu değildir

Retinal Anjiyomatöz Proliferasyon: Öncü Lezyon Multimodal Görüntüleme Özellikleri ve "Eye-Tracked" Spektral Domain Optik Koherens Tomografi ile Takibi

Objectives: To present the multimodal imaging characteristics of precursor retinal angiomatous proliferation (RAP) lesions and follow-up results with eye-tracked spectral-domain optical coherence tomography (SD-OCT). Materials and Methods: Six eyes of 6 patients aged 77.5;plusmn;5.9 years diagnosed with precursor RAP lesion were included in this prospective observational case series. Best corrected visual acuity (BCVA) measurement and complete ophthalmologic examination were performed for all subjects, as well as fundus photography (FP), fundus autofluorescence (FAF), SD-OCT, fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography angiography (OCTA), and their long-term follow-up results are presented. Results: The mean BCVA was 0.8;plusmn;0.16 Snellen and the mean follow-up was 26.3;plusmn;14.8 months. Images of the precursor RAP lesions demonstrated no specific findings on FP and FAF, showed focal hypofluorescent foci with no leakage on FA and IGA, and appeared as extrafoveal small, round, well-defined, hyperreflective foci typically located in the outer retinal layers on SD-OCT B-scans with high sampling density. OCTA demonstrated the precursor lesions as the deep capillary plexus abnormalities in 3 eyes. Two eyes progressed to stage 1 RAP during the follow-up period. Conclusion: This study defined the diagnostic characteristics and clinical course of precursor RAP lesions. Our findings highlight the importance of B-scans with high sampling density for the diagnosis of precursor lesions and using eye-tracking mode SD-OCT during follow-up.Amaç: Öncü retinal anjiyomatöz proliferasyon (RAP) lezyonu olan gözlerin multimodal görüntüleme özellikleri ve "Eye-Tracked" mod spektral domain optik koherens tomografi (SD-OKT) ile takip sonuçlarını sunmaktır. Gereç ve Yöntem: Bu prospektif, gözlemsel olgu serisine öncü RAP lezyonu tanısı alan ve ortalama yaşları 77,5±5,9 yıl olan 6 hastanın 6 gözü dahil edilmiştir. Olgularda en iyi düzeltilmiş görme keskinliği (EİDGK) ölçümü ve tam oftalmolojik muayene yanı sıra fundus fotoğrafı (FF), fundus otofloresans (FOF), SD-OKT, floresein anjiyografi (FA), indosiyanin yeşili anjiyografi (İSYA) ve optik koherens tomografi anjiyografi (OKTA) tetkikleri yapılarak tanısal özellikleri tanımlanmış ve uzun süreli takip sonuçları sunulmuştur. Bulgular: Ortalama ondalık EİDGK 0,8±0,16 seviyesinde ve ortalama izlem süresi 26,3±14,8 ay olan gözlerde öncü RAP lezyonlarının FF ve FOF'de spesifik bulguya sahip olmadıkları, FA ve İSYA'da sızıntı yapmayan fokal hipofloresan odaklar olarak görüntülendikleri, kesit aralıkları sıklaştırılmış B-scan SD-OKT görüntülemede ise tipik olarak retinanın dış katlarında ekstrafoveal, küçük, yuvarlak, iyi sınırlı, hiperreflektif odaklar olarak görüntülendikleri tespit edilmiştir. Üç gözde OKTA öncü lezyonları derin kapiller pleksus anormallikleri olarak göstermiştir. Takip süresinde 2 gözde öncü RAP lezyonlarının evre 1 RAP'ye progreseyon gösterdikleri saptanmıştır. Sonuç: Öncü RAP lezyonlarının multimodal görüntüleme ile tanısal özellikleri ve klinik seyirlerinin tanımlandığı bu çalışmada, tanı için kesit aralıkları sıklaştırılmış B-scan SD-OKT görüntülemenin önemi ve takip süresince çekimlerin "Eye-Tracked" modda yapılması gerekliliği vurgulanmıştır

Silikon göz içi lensi üzerinde katlama penseti izi: Üç yıllık bir olgu takibi

Three years ago, a three piece silicone intraocular lens (IOL) was implanted to the right eye of a woman of 68-years-old during the phacoemulsification procedure. on postoperative examination, a superficial mark produced by folding forceps was seen at the periphery of both anterior and posterior surfaces of the lens, during biomicroscopy. Visual acuity was not affected and no inflammatory reaction was seen during three years follow-up.Üç yıl önce kliniğimizde, katarakt ameliyatı olan 68 yaşındaki bayan hastanın sağ gözüne fakoemülsifikasyonu takiben üç parçalı silikon göz içi lensi yerleştirildi. Postoperatif muayenede, lensin her iki yüzünde de, katlama pensetine ait belirgin izler gözlendi. Hastanın, 3 senelik takipleri boyunca, izlerde bir miktar silinme gözlendi. Bu süre boyunca, hastanın görme kalitesinde düşme ya da ön kamara reaksiyonu gözlenmedi

An Unusual Case: Self-separation of an Idiopathic Epiretinal Membrane

Parsiyel posterior vitreus dekolmanı (PVD) olan bir gözde idiyopatik epiretinal membran’nın (ERM) spontan ve akut olarak ayrılması oldukça nadir bir olaydır. Sağ gözünde uçuşma şikayetleri ile kliniğimize başvuran 56 yaşındaki kadın hastanın klinik muayene ve spektral domain optik koherens tomografi tetkikinde idiyopatik ERM ve evre 3 PVD bulguları saptanmış olup en iyi düzeltilmiş görme keskinliği (EİDGK) 9/10 olarak ölçüldü. Dört ay sonra metamorfopsi şikayeti ile başvuran hastanın sağ göz EİDGK’nin 7/10olduğu, ERM bulgularında hemen hemen değişiklik olmadığı tespit edildi. Bir hafta sonra metamorfopsi şikayetlerinin aniden ortadan kaybolması ile tekrar başvuran hastanın muayenesinde, EİDGK’nin 10/10 olduğu, ERM’nin spontan olarak retina yüzeyinden bir flep şeklinde ayrılmış olarak vitreusta yüzmekte olduğu ve foveal kontürün normale döndüğü tespit edildi. Etiyolojik mekanizma immatür bir ERM içindeki kontraksiyon güçlerinin membranın retinaya yapışma güçlerinden daha kuvvetli olması ile açıklanabilirSelf-separation or peeling of an idiopathic epiretinal membrane (ERM) in an eye with partial posterior vitreous detachment (PVD) is a rare event. A 56-year-old woman presented to our clinic with complaints of floaters in her right eye. Best-corrected visual acuity (BCVA) was 9/10 in this eye. Fundus examination and Spectral domain optical coherence tomography (SD-OCT) revealed an idiopathic ERM and grade 3 PVD in this eye. Four months later, she had complaints of metamorphopsia in her right eye. BCVA was 7/10, while SDOCT images of the right macula were similar to previous images. One week after the last visit, she presented again due to the sudden disappearance of her metamorphopsia complaints. BCVA had improved to 10/10. Fundus examination demonstrated that the ERM had spontaneously separated from the retinal surface as a flap floating in the vitreous and the foveal contour had returned to normal. the etiologic mechanism may be explained as the contracting forces within an immature ERM being stronger than its adhesion to the retin