Fourier-Domain Optical Coherence Tomography and Microperimetry Findings in Retinitis Pigmentosa

PURPOSE: To investigate the relation between the optical coherence tomography (OCT) findings and retinal sensitivity in patients with retinitis pigmentosa (RP) by assessing the retinal thickness and retinal function using Fourier-domain OCT (FD-OCT) and microperimetry, respectively. DESIGN: Observational case series. METHODS: Fifty-nine patients (118 eyes) were enrolled, mean age 47 +/- 14.8 years. Thirty-two healthy subjects (HS) were enrolled as a control group. Patients were assessed by means of FD-OCT and microperimetry. We analyzed the average foveal thickness (diameter of 1 mm centered on the point of fixation), the value of the retinal sensitivities corresponding to the 4 degrees centered on the fixation point, and logMAR visual acuity for regression analysis converted from Snellen chart. RESULTS: We distinguished 4 groups of RP patients according to the macular pattern seen on OCT images. The first group of 36 eyes, mean age of 33.5 +/- 7.4 years, had no macular changes, mean best-corrected visual acuity (BCVA) of 0.95 +/- 0.07, mean foveal thickness of 256.3 +/- 9.14 mu m, and mean retinal sensitivities inside the central 4 degrees of 19.27 +/- 0.87 dB (P > .05 for all the values). The second group of 28 eyes, mean age 35.4 +/- 6.3 years, showed clinical macular edema (CME) on OCT images with mean BCVA of 0.72 +/- 0.22, mean foveal thickness of 363.5 +/- 93.45 mu m, and mean retinal sensitivity inside the central 4 degrees of 15.94 +/- 3.6 dB (P < .01 for all the values). The third group of 26 eyes, mean age 50.8 +/- 8.7 years, showed macular vitreoretinal traction on OCT images with a mean BCVA of 0.5 +/- 0.2, mean foveal thickness of 337.1 +/- 71.7 mu m, and mean retinal sensitivity inside the central 4 degrees of 11.78 +/- 3.09 dB (P < .01 for all the values). The last group of 28 eyes, mean age 52.1 +/- 13.6 years, showed macular retinal thinning on OCT images with mean BCVA of 0.36 +/- 0.15, mean foveal thickness of 174.2 +/- 24.40 mu m, and mean retinal sensitivity inside the central 4 degrees of 10.22 +/- 3.82 dB (P < .01 for all the values). CONCLUSIONS: MP-1 and FD-OCT showed high sensitivity for identifying functional and structural macular abnormalities, respectively. Future studies should investigate the relationships among photoreceptor cell loss, retinal sensitivity, and fixation in patients with RP. (Am J Ophthalmol 2011;151:106-111. (C) 2011 by Elsevier Inc. All rights reserved.

Microperimetric evaluation in patients with adult-onset foveomacular vitelliform dystrophy

INTRODUCTION: To compare mean best-corrected visual acuity (BCVA), retinal sensitivity (RS), and bivariate contour ellipse area (BCEA) in patients with adult-onset foveomacular vitelliform dystrophy (AOFVD) and healthy subjects (HSs), reporting also functional disease-related changes in the different stages of the AOFVD disease. MATERIALS AND METHODS: In this observational cross-sectional study, a total of 19 patients (30 eyes; 12 female and 7 male) with AOFVD were enrolled, and 30 patients (30 eyes; 16 female and 14 male) were recruited as age-matched control group (74.36 ± 9.17 years vs. 71.83 ± 6.99 years respectively, P= 0.11). All patients underwent a complete ophthalmologic examination, fundus autofluorescence and fluorescein angiography, spectral-domain optical coherence tomography and microperimetry (MP)-1 analysis. The data collection included mean BCVA, mean RS measured by means of MP-1, BCEA, and central retinal thickness. RESULTS: All the functional parameters (BCVA, RS, and BCEA) were significantly worse in AOFVD group than HS. Subgroup analysis showed that the most significant functional changes, quantified by mean BCVA, RS, and BCEA, were in the atrophic stage (P = 0.03, P= 0.01, and P= 0.001, respectively). All the functional parameters were well correlated in the different stages. CONCLUSIONS: This study further confirms the good visual prognosis in the AOFVD eyes. Fixation stability measurement using BCEA demonstrates good evaluation of visual performance integrating traditional functional parameters. It may also serve for further rehabilitative purposes in atrophic eyes

Psychosis, Mood and Behavioral Disorders in Usher Syndrome: Review of the Literature

The aim of this review is to focus the current knowledge about mental and behavioral disorders in Usher syndrome. Previous studies described the presence of various mental disorders associated with Usher syndrome, suggesting possible mechanisms of association between these disorders. The most common manifestations are schizophrenia-like disorder and psychotic symptoms. Mood and behavioral disorders are rarely described, and often are associated with more complex cases in co-occurrence with other psychiatric disorders. Neuroimaging studies reported diffuse involvement of central nervous system (CNS) in Usher patients, suggesting a possible role of CNS damage in the pathogenesis of psychiatric manifestations. Genetic hypothesis and stress-related theories have also been proposed

Effect of basic fibroblast growth factor and cytochrome c peroxidase combination in transgenic mice corneal epithelial healing process after excimer laser photoablation

Purpose: To evaluate the role of prepared basic fibroblast growth factor (bFGF) and cytochrome c peroxidase (CCP) combination eyedrops in corneal epithelial healing of transgenic mice (B6(A)-Rperd12/J ) after excimer laser photoablation. Materials and methods: In this prospective study, 216 eyes of 108 mice underwent bilateral photorefractive keratectomy. We considered 4 groups: A, B, C, and D. Group A received standard topical postoperative therapy with tobramycin, diclofenac, and dexamethasone eyedrops plus CCP at 3 drops per day for a week or until corneal re-epithelialization was achieved. Group B received standard topical postoperative therapy plus bFGF eyedrops and phosphate-buffered saline (PBS) 3 drops per day for a week or until corneal re-epithelialization was complete. In group C, 1 eye received standard topical postoperative therapy plus CCP eyedrops, bFGF eyedrops, and PBS 3 drops per day for a week or until corneal re-epithelialization was complete. Control eyes (group D) received a standard topical postoperative therapy plus placebo eyedrops. Mice were followed-up for a week from the day after the surgery to evaluate the rate of corneal re-epithelialization. Results: Data were analyzed by ANOVA using the XLSTAT 2010 software. Eyes in group A, B, and C healed completely before the fifth postoperative day, achieving, respectively, a re-epithelialization time of 92 hours ± 10 SD, 90 hours ± 12 SD, and 86 hours ± 12 SD. Group D had a re-epithelialization time of 121 hours ± 8 SD (P < 0.05). No side effects or toxic effects were documented

Hess area ratio and diplopia: Evaluation of 30 patients undergoing surgical repair for orbital blow-out fracture

PURPOSE: To determine if the Hess area ratio is effective in predicting postoperative diplopia in patients undergoing surgery for orbital blow-out fracture. METHODS: Our retrospective, interventional case series study involved 30 consecutive cases affected by orbital fractures and diplopia undergoing surgical correction within 7 days after injury. To evaluate ocular motility disturbance, we measured the involved ocular motility range by use of a manual Hess screen test before and 4 months after surgery. The percentage of Hess area ratio % was used to express the range of ocular motility in a numerical value. RESULTS: All patients with preoperative Hess area ratio >85% had no postoperative diplopia, and most patients (57%) having a preoperative Hess area ratio <65% had postoperative diplopia. When the Hess area ratio was between 65% and 85%, surgical outcomes were variable and most patients (55%) described no problematic diplopia in the peripheral visual field. CONCLUSIONS: The Hess area ratio is a useful procedure to convert Hess graphic representation in a numerical value so that Hess chart data can be compared among clinicians and used to predict surgical outcomes in patients undergoing surgery for orbital blow-out fractures. © 2009 The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc

Acute exudative polymorphous vitelliform maculopathy: To bolus or not to bolus?

Acute exudative polymorphous vitelliform maculopathy (AEPVM) is a rare bilateral maculopathy characterized by chronic and long-term course. We report a case of AEPVM with an unusual presentation and management in a middle-aged man. He presented with clinical features of bilateral AEPVM accompanied by multiple intraretinal cysts, with a sudden increase of intraretinal fluid and visual function deterioration over a span of few days. Therefore, we administered empirically an intravenous bolus injection of methylprednisolone. One week after, there was a full recovery of visual acuity and cystic intraretinal spaces completely disappeared

Microperimetric biofeedback in a patient with oculocutaneous albinism

[No abstract available