Avoiding errors in the diagnosis of polypoidal choroidal vasculopathy in patients with age-related macular degeneration (Part 1)

Background: Poor availability of indocyanine green angiography (ICGA) raises the question of how to improve the diagnosis of polypoidal choroidal vasculopathy (PCV) using alternative imaging modalities, optical coherence tomography (OCT) and OCR angiography (OCTA). Purpose: To optimize the diagnosis of PCV in patients with age-related macular degeneration (AMD) using non-invasive methods, OCT and OCTA. Material and Methods: One hundred and sixty-nine patients (228 eyes) with neovascular AMD underwent OCT and OCTA study as per the proposed algorithm to differentiate between PCV and other types of subretinal neovascularization. Of these, 14 patients (8.28%; 14 eyes) were found to have PCV. Results: Major and additional signs of PCV, secondary neovascularization and activity of the process on OCT were determined. In addition, we determined the signs of PCV on OCTA manu-al and automatic segmentation which will be helpful in accurate differential diagnosis of the disease. On the basis of these data, we developed a step-by-step algorithm of the OCT and OC-TA diagnosis of PCV in patients suspected of the disease, which allows the accurate diagnosis when ICGA is unavailable. Conclusion: Systematic step-by-step interpretation of OCT and OCTA scans allow the reliable differential diagnosis of PCV in patients with exudative AMD

OCTA-based retinal microvascular bed assessment at the zones ranging from the fovea to the periphery

Background: Studies (particularly, optical coherence tomography angiography (OCTA) studies) on the peripheral microvascular bed in health are important because many retinal disorders involve its injury. Purpose: To improve the efficacy of diagnosing the changes in the retinal microvascular bed through its OCTA-based assessment at the zones ranging from the fovea to the periphery in normal eyes. Material and Methods: Fourteen healthy individuals were included in the study. Three sequential 3 mm x 3 mm OCTA scans with displacement from the center of the fovea to the periphery for each of the three directions (superior, inferior and temporal directions) were registered. Results: Superficial plexus vessel density and deep plexus vessel density were assessed at 1-9 mm from the center of the fovea. We found that superficial plexus vessel density progressively increased (38-46%) with distance from the center of the fovea, whereas deep plexus vessel density moderately decreased (18-25%) with distance from the center. Superficial plexus vessel density was significantly increased in the superior and inferior directions at the zones with the presence of vascular arcades, and these arcades are absent in the temporal direction; this makes the temporal direction most reliable and promising for studies on microcirculation at the ocular periphery. Conclusion: OCTA is an effective technique for assessing the retinal microvascular bed at the zones ranging from the fovea to the far periphery

Features of the metabolic syndrome and type 2 diabetes mellitus in schizotypal disorder

To describe the features and mechanisms of development of metabolic syndrome, type 2 diabetes melitus and intermediate states of glycemia in psychosis the occurrence of these disorders, the values of total cholesterol, fractions of high density lipoproteins, very low density lipoproteins, triglycerides, values of atherogenic coefficient, insulinemia, С-peptidemia, insulin resistance the level of glycated hemoglobin in a sample of patients with schizophrenia and in mentally healthy individual