Choroidal vascular flow area in central serous chorioretinopathy using swept-source optical coherence tomography angiography

PURPOSE. To report the choroidal vascular flow area in eyes with central serous chorioretinopathy (CSC) compared with healthy subjects and unaffected fellow eyes using swept-source (SS) optical coherence tomography (OCT) angiography. METHODS. Prospective case series of 19 eyes of 19 consecutive patients affected by CSC, compared with 15 unaffected fellow eyes and 20 eyes of 10 healthy subjects. Patients underwent SS-OCT angiography in order to evaluate the choroidal vascular flow area of choriocapillaris (CC) and deeper choroidal layers. RESULTS. The choroidal vascular flow area was higher in eyes with CSC than in control eyes (53.4 \ub1 5.8% vs. 49.45 \ub1 8.16%; P = 0.0001). Within the choroid of CSC patients choroidal vascular flow area of the CC was significantly lower than the deeper level (50.97 \ub1 2.8% vs. 54.22 \ub1 6.3%; P = 0.025). There were no differences within the choroid of control eyes. The choroidal vascular flow area at the level of the CC was higher in the unaffected fellow eye (50.74 \ub1 0.9%; P = 0.019) than in control eyes. Choroidal vascular flow area of unaffected fellow eyes did not differ from CSC eyes (P = 0.17). The choroidal vascular flow area at the level of the CC was higher in the CSC eyes (P = 0.0009) compared with unaffected fellow eyes. CONCLUSIONS. Choroidal vascular flow area is larger in CSC eyes compared with control eyes. However, within the choroid of eyes with CSC, there might be some differences in flow area between CC and deeper choroidal levels. This difference might be secondary to a compensatory mechanism of the choroid

Early Postoperative Intraocular Pressure is Associated with Better Pressure Control After XEN Implantation

Purpose: To identify the variables associated with the success of the XEN procedure. Patients and methods: This was part of a prospective, uncontrolled, consecutive case series study. Patients with primary open-angle glaucoma or pseudo-exfoliative glaucoma were included. All the patients underwent surgical Xen implant procedure with MMC subconjunctival injection 20 minutes before surgery. Success criteria were an off-medication IOP of 6 to 16\u2592mmHg 12 months after surgery; no additional glaucoma surgery; no visual threatening complications, no visual acuity loss greater than 1 Snellen line. One eye per patient was considered for statistical analysis. A univariate Cox's proportional hazard regression analysis was performed to identify potential risk factors for surgical failure. Then, a multivariate cox model was built. Results: 123 patients were recruited in this study: 93 patients underwent Xen implantation alone whereas 30 the combined procedure with phacoemulsification and IOL implantation. Univariate cox regression showed that the day after surgery IOP greater than 9\u2592mmHg was associated with surgical failure (P=0.02) and a postoperative number of needlings greater or equal to 2 in the follow-up was also predictive of surgical failure (P<0.01). These data were confirmed by a multivariate model too. At 1-year the surgical success criteria were 76% in the group with 24-hour IOP below or equal to 9\u2592mmHg, while it was 43% when above 9\u2592mmHg (P=0.026). Conclusion: Our study shows that an early IOP below or equal to 9\u2592mmHg is predictive of the efficacy of the procedure during 1-year follow-up, while more than two needlings are predictive of failure