AMBULATORY BLOOD PRESSURE PATTERNS IN PATIENTS WITH RETINAL VEIN OCCLUSION

Failure of blood pressure (BP) to dip during sleep (non-dipper pattern) is associated with cardiovascular disease (CVD) and stroke. The prevalence and degree of non-dipping and masked hypertension in patients with retinal vein occlusion (RVO), which is associated with stroke, has not been previously examined

Ultra-Widefield Imaging of the Retinal Macrovasculature in Parkinson Disease Versus Controls With Normal Cognition Using Alpha-Shapes Analysis

Purpose: To investigate retinal vascular characteristics using ultra-widefield (UWF) scanning laser ophthalmoscopy in Parkinson disease (PD).Methods: Individuals with an expert-confirmed clinical diagnosis of PD and controls with normal cognition without PD underwent UWF imaging (California, Optos). Patients with diabetes, uncontrolled hypertension, glaucoma, dementia, other movement disorders, or known retinal or optic nerve pathology were excluded. Images were analyzed using Vasculature Assessment and Measurement Platform for Images of the Retina (VAMPIRE-UWF; Universities of Edinburgh and Dundee, UK) software which described retinal vessel width gradient and tortuosity, vascular network fractal dimension, as well as alpha-shape analysis to further characterize vascular morphology [complexity (Opαmin) and spread (OpA)].Results: In the PD cohort, 53 eyes of 38 subjects, and in the control cohort, 51 eyes of 33 subjects were assessed. Eyes with PD had more tortuous retinal arteries in the superotemporal quadrant (p = 0.043). In eyes with PD, alpha-shape analysis revealed decreased OpA, indicating less retinal vasculature spread compared to controls (p = 0.032). Opαmin was decreased in PD (p = 0.044), suggesting increased vascular network complexity. No differences were observed in fractal dimension in any ROI.Conclusions: This pilot study suggests that retinal vasculature assessment on UWF images using alpha-shape analysis reveals differences in retinal vascular network spread and complexity in PD and may be a more sensitive metric compared to fractal dimension.Translational Relevance: Retinal vasculature assessment using these novel methods may be useful in understanding ocular manifestations of PD and the development of retinal biomarkers

Retinal vascular changes in Alzheimer’s dementia and mild cognitive impairment:a pilot study using ultra-widefield imaging

Purpose: Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer’s dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging. Methods: UWF images from 103 participants (28 with Alzheimer’s dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity. Results: Participants with Alzheimer’s dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching. Conclusions: Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer’s disease. Translational Relevance: This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential

CENTRAL RETINAL VEIN OCCLUSION IN YOUNG INDIVIDUALS A Comparison of Risk Factors and Clinical Outcomes

Purpose: To compare the presentation and outcomes of patients younger than 50 years versus patients aged 50 years and older with central retinal vein occlusion (CRVO). Methods: This single-center retrospective study included patients with CRVO presenting between January 2009 and July 2016. Charts were reviewed and data were abstracted. Presenting and final clinical parameters, treatment burden, and predisposing factors for CRVO were compared between the two groups. Results: Thirty-six patients younger than 50 years and 233 patients aged 50 years and older at the time of CRVO onset were included. At presentation, younger patients had better visual acuity than older patients (20/80 vs. 20/224, P = 0.001) and a lower incidence of cystoid macular edema (54 vs. 79%, P = 0.001). Twenty-one of 36 (58%) younger patients had at least one identifiable nontraditional risk factor for CRVO. At final follow-up, younger patients received fewer total intravitreal injections (3.8 +/- 5.8 at 34.2 months) compared with older patients (6.5 +/- 8.8, at 37.6 months, P = 0.03) and had better final acuity (20/85 vs. 20/289, P = 0.004, respectively). Conclusion: Younger patients had better baseline and final acuities, a lower incidence of cystoid macular edema at presentation, and received fewer intravitreal injections than older patients. Workup for etiology of CRVO in younger patients may reveal nontraditional risk factors for CRVO

Choroidal rupture: Eyewiki

<p>Choroidal rupture</p> <p>-</p> <p>Original article contributed by: Sharon Fekrat, MD<br>All contributors: Koushik Tripathy, Sharon Fekrat, MD and Theodore Leng, MD, MS</p> <p> </p> <p>http://eyewiki.org/Choroidal_rupture</p> <p> </p

Bilateral recurrent macular holes

Purpose: To report an unusual case of bilateral recurrent full-thickness macular holes (FTMH) in both eyes of a single patient over a 15-year period, with a total of 3 FTMH in the right eye and 2 in the left eye. Each FTMH was successfully treated with vitreous surgery, resulting in hole closure and visual acuity improvement. Observations: During the previous 15 years, a 59-year-old female developed a total of 3 FTMH in the right eye and 2 FTMH in the left eye. The initial FTMH in each eye was surgically closed with pars plana vitrectomy (PPV), epiretinal membrane (ERM) peeling, 14% C3F8 gas placement, and face down positioning. Subsequent recurrences of FTMH, 2 in the right and 1 in the left, were surgically closed with PPV and ERM peeling and/or indocyanine green-assisted internal limiting membrane peeling, 14% C3F8 gas placement, and face down positioning. Seven years following the last FTMH surgical closure, the patient's best-corrected visual acuity was 20/50 in the right eye and 20/32 in the left eye with no FTMH in either eye. Conclusions and importance: This case illustrates that a rare individual may have more than one recurrent FTMH in both eyes. Final visual outcome can be favorable following closure of more than one recurrent FTMH. Keywords: Macular hole, Recurrent macular hole, Reopening macular hole, Vitrectomy, Internal limiting membrane peel, Optical coherence tomograph

Longitudinal Follow-Up of Choroidal Thickness in Central Retinal Vein Occlusion With and Without Cystoid Macular Edema

Purpose: To investigate the longitudinal relationship between subfoveal choroidal thickness (CT) and central retinal vein occlusion (CRVO). Methods: Retrospective cohort of 104 subjects with enhanced-depth imaging optical coherence tomography for unilateral CRVO. Mean CT and best-corrected visual acuity (BCVA) were compared in eyes with and without CRVO and in eyes with CRVO with and without cystoid macular edema (CME). Results: CT was thicker in eyes with CRVO-related CME than uninvolved contralateral eyes at baseline (263.9 ± 86.9 versus 230.2 ± 87.9 µm; P .05). Conclusions: CT was greater in eyes with CRVO-related CME compared to eyes with CRVO but no CME and compared to uninvolved contralateral eyes. CT decreased in eyes with CRVO over time both among eyes that received intravitreal injections and among eyes that did not receive injections. CT may be a prognosticator of treatment response in CRVO-related CME