Intraocular Metastases Secondary to Breast Carcinoma Correlates With Upregulation of Estrogen and Progesterone Receptor Expression in the Primary Tumor

To compare estrogen (ER), progesterone (PR), and human epidermal growth factor-2 (HER2) receptor expression in the primary tumor of patients affected by choroidal metastases from breast carcinoma (BC) versus those with extraocular metastases

A retrospective study on novel cardiometabolic parameters in patients with Klinefelter's syndrome

reserved

HYPERREFLECTIVE INTRARETINAL SPOTS IN RADIATION MACULAR EDEMA ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY

PURPOSE:: To better pathophysiologically characterize macular edema secondary to eye irradiation, analyzing the presence of optical coherence tomography (OCT) hyperreflective spots. METHODS:: Twenty-five consecutive eyes affected by radiation maculopathy, secondary to irradiation for a primary uveal melanoma, without macular involvement in the irradiation field, were consecutively enrolled. All subjects underwent full ophthalmologic examination, including fluorescein angiography, color fundus photography, and spectral domain OCT, even in en face modality. Optical coherence tomography central subfield thickness was stratified into the following 3 categories: 600 \u3bcm. Spectral domain OCT images were analyzed to measure and localize hyperreflective spots by two independent masked graders. RESULTS:: Hyperreflective spots were documented in all eyes (100%). Hyperreflective spots significantly increased in number according to OCT central subfield thickness (600 \u3bcm, P < 0.05). The intergrader agreement was at least substantial for all measurements (intraclass correlation coefficient: 0.80). CONCLUSION:: Spectral domain OCT documents discrete intraretinal reflectivity changes (hyperreflective spots) in all (studied) eyes affected by radiation maculopathy. Hyperreflective spots increase in number with increasing central subfield thickness and could be considered as a new clinical biomarker of intraretinal inflammation in patients affected by macular edema secondary to irradiation for uveal melanoma. \ua9 2016 by Ophthalmic Communications Society, Inc

Intravitreal dexamethasone implant in radiation-induced macular oedema

To evaluate the efficacy and duration of activity of a single intravitreal dexamethasone implant in patients affected by radiation maculopathy.METHODS: Thirteen consecutive eyes of 13 patients affected by radiation maculopathy secondary to eye irradiation for a primary uveal melanoma (Iodine-125 brachytherapy) and treated with a single intravitreal 0.7\u2009mg dexamethasone implant were retrospectively evaluated. Each patient underwent full ophthalmological examination, including fluorescein angiography and spectral domain optical coherence tomography (SD-OCT), even in en-face modality. Follow-up was performed monthly over a 6-month period. RESULTS: At preinjection visit, the median central subfield thickness (CST) by SD-OCT was 407\u2009\ub5m (IQR, 357-524\u2009\ub5m) and the median best-corrected visual acuity (BCVA) was 61 ETDRS score (IQR, 54-67). The median gain of ETDRS letter at 1 month was 6.5 (IQR, 4-15) (p<0.01). The median CST showed a reduction of 120\u2009\ub5m (IQR, 62-134) (p<0.01). Further CST reduction was reported at 2 months' follow-up, with CST stabilisation at 3 months and maintenance of BCVA. At 4, 5 and 6 months' follow-up, all patients presented progressive retinal thickening (p<0.01) and BCVA reduction (p<0.01). No side effects were documented. CONCLUSION: Intravitreal dexamethasone implant reduces macular oedema secondary to radiation maculopathy and also improved visual acuity in a consistent proportion of patients. Signs of macular oedema recurrence may be detected at a median of 4 months after injection

Retinal Vascular and Neural Remodeling Secondary to Optic Nerve Axonal Degeneration

Purpose: To investigate the pathophysiologic interrelations between retinal neural and vascular changes, detected by spectral-domain OCT (SD-OCT) and OCT angiography (OCTA), resulting from optic nerve axonal degeneration. Design: Institutional, observational, case-control study with prospective enrollment. Participants: Twenty-six patients affected by optic nerve axonal degeneration secondary to posterior optic pathway glioma (OPG) involving the chiasma, the postchiasmatic visual pathway, or both (but not involving optic nerves) and 24 gender- and age-matched healthy participants were included consecutively. Methods: Best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study score) was measured and SD-OCT (Heidelberg Engineering, Heidelberg, Germany) and OCTA (Nidek RS-3000 Advance device; Nidek, Gamagori, Japan) were performed. Main Outcome Measures: Peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell complex (GCC), and inner nuclear layer (INL) were analyzed using SD-OCT. The radial peripapillary capillary plexus, fullthickness peripapillary retina vascularization, and the macular superficial plexus (SCP) and deep capillary plexus (DCP) were analyzed using OCTA. Results: Peripapillary retinal nerve fiber layer and GCC thickness were reduced in eyes affected by OPG (P < 0.0001). Radial peripapillary capillary plexus perfusion also was reduced, as well as full-thickness peripapillary retina vascularization (P < 0.01 and P < 0.05, respectively). Macular DCP perfusion was reduced in eyes affected by OPG, whereas macular SCP perfusion did not differ between the 2 groups (P 0.05, respectively). Global pRNFL thickness reduction correlated with the reduction of peripapillary perfusion (P 0.05). The reduction of macular DCP perfusion did not correlate with inner nuclear layer thickness (P > 0.05). Conclusions: Retinal neural remodeling secondary to optic nerve axonal degeneration resulting from OPG located at or posterior to the chiasm is accompanied by a secondary retinal vascular remodeling involving not only the peripapillary area, but also the macular area (DCP). Ophthalmology Retina 2017;-:1e9 \uaa 2017 Published by Elsevier Inc. on behalf of the American Academy of Ophthalmolog

IDENTIFICATION AND CLASSIFICATION OF MACULAR MORPHOLOGIC BIOMARKERS RELATED TO VISUAL ACUITY IN RADIATION MACULOPATHY: A Multimodal Imaging Study

To identify and classify, by a multimodal imaging approach, the most relevant macular morphologic biomarkers related to visual acuity in patients affected by radiation maculopathy secondary to brachytherapy

Retinal Vascular Abnormalities related to Neurofibromatosis Type 1: Natural History and Classification by OCT Angiography in 473 Patients

PURPOSE: To analyze and classify neurofibromatosis type 1 (NF1) related retinal vascular abnormalities (RVAs), their natural history and correlation with disease severity, in a large cohort of patients.METHODS: This was an observational longitudinal study with prospective enrollment. Four hundred and seventy-three patients affected by NF1 and 150 age-matched healthy subjects were consecutively enrolled. RVAs were detected by means of near-infrared reflectance and studied by optical coherence tomography angiography (OCTA). The superficial vascular plexus (SVP) and the deep vascular complex (DVC) were quantitatively and qualitatively analyzed.RESULTS: We identified RVAs in 82 of 473 (17%) NF1 patients, but in none of the 150 healthy subjects. A comparison revealed that NF1 patients with RVAs showed a higher number of NF1 diagnostic criteria (4.3 \ub1 1.5 versus 3.9 \ub11.5, respectively; p=0.02) than patients without RVAs. Three different RVA types were identified on OCTA: macrovascular angiomatosis of the sole SVP; macrovascular angiomatosis of the SVP combined with microvascular angiomatosis of the DVC; and combined macrovascular angiomatosis of both SVP and DVC. The prospective analysis of OCTA images showed no significant longitudinal evolution of RVAs (mean follow-up: 3.7 \ub1 2.8 years). A single patient developed de novo a single RVA, and two RVAs showed detectable changes during follow-up.CONCLUSION: In NF1 patients RVAs are a characteristic sign that correlates with a more severe systemic disease expression, usually remaining stable during time. OCTA allows for the identification of different RVAs subtypes

Choroidal Abnormalities in Pediatric NF1: A Cohort Natural History Study

The purpose of this study was to assess the long-term natural history of choroidal abnormalities (CAs) in a large pediatric neurofibromatosis type 1 (NF1) population, quantifying their progression in number and dimensions. Pediatric patients (p p = 0.0068), while no correlation was found between the patient age and CAs progression in size. In conclusion, we provide evidence that, in NF1 pediatric patients, CAs change over time, increasing both in number and dimensions, independently from the physiological growth of the eye. While the increase of the CAs number occurs particularly at an earlier age, the increase in the CAs dimensions is a slow process that remains constant during childhood