Mental health measures of anxiety and depression in patients with retinal detachment

In this study, the researchers examined anxious and depressive symptoms of patients with rhegmatogenous retinal detachment (RRD) prior to and up to year after retinal detachment surgery. One hundred and thirteen (113) patients with RRD took part in this prospective longitudinal study. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). Visual acuity (VA) results and HADS scores of all participants were recorded prior to and 3, 6 and 12 months after retinal detachment surgery. Pearson correlation analysis showed a significant association between the patients' VA and HADS psychological scores both prior to and three months after surgery, regardless of the type of surgery performed. Psychological distress is a significant problem associated with retinal detachments that requires more attention

The Intraocular Cytokine Profile and Therapeutic Response in Persistent Neovascular Age-Related Macular Degeneration

Citation: Rezar-Dreindl S, Sacu S, Eibenberger K, et al. The intraocular cytokine profile and therapeutic response in persistent neovascular agerelated macular degeneration. Invest Ophthalmol Vis Sci. 2016;57:4144-4150. DOI:10.1167/iovs.16-19772 PURPOSE. To investigate the course of inflammatory and angiogenic cytokines in the aqueous humor of patients with persistent/recurrent neovascular age-related macular degeneration (nAMD) under ranibizumab monotherapy (IVM) or ranibizumab plus dexamethasone combination treatment. METHODS. In this 12-month prospective study, 40 eyes with nAMD were treated with either IVM or combined treatment with ranibizumab plus intravitreal dexamethasone implant (IVC). Patients in the IVM group were treated following an ''as needed'' treatment regimen; patients in the IVC group received ranibizumab and a dexamethasone implant at baseline and were retreated with ranibizumab. At baseline and at each time of retreatment aqueous humor samples were taken. RESULTS. Before treatment, levels of macrophage chemoattractant protein (MCP)-1, monokine induced by c interferon (MIG), and lipocalin-2/ neutrophil gelatinase-associated lipocalin (NGAL) were elevated in nAMD patients compared to healthy controls (P ¼ 0.024; P ¼ 0.04; P ¼ 0.01). In contrast, tumor necrosis factor a, IL-12p70, and secreted protein acidic and rich in cysteine (SPARC) concentrations were lower (P ¼ 0.001; P ¼ 0.008; P ¼ 0.03), while vascular endothelial growth factor (VEGF) was not altered (45 6 6/51 6 12 pg/mL nAMD/ control group; P ¼ 0.6). During IVC, levels of VEGF, MIG, platelet-derived growth factor (PDGF)-AA, and transforming growth factor b1 (P ¼ 0.005; P ¼ 0.011; P ¼ 0.008; P ¼ 0.013) were reduced. Ranibizumab monotherapy did not influence the course of any inflammatory/ angiogenic cytokine. Interleukin 6 and PDGF-AA levels correlated with central retinal thickness changes (P ¼ 0.007; P ¼ 0.022). Over the 12-month period visual function was maintained with no significant differences during or between both treatment groups. CONCLUSIONS. Inflammatory proteins are involved in the pathogenesis of chronic macular edema due to AMD and are associated with disease activity. During combined treatment, levels of inflammatory and angiogenic cytokines decreased over a 12-month period with no superiority in functional outcome

Comparison of Stimulus Types for Retinotopic Cortical Mapping of Macular Disease

Published: March 13, 2023Purpose: Retinotopic maps acquired using functional magnetic resonance imaging (fMRI) provide a valuable adjunct in the assessment of macular function at the level of the visual cortex. The present study quantitatively assessed the performance of different visual stimulation approaches for mapping visual field coverage. Methods: Twelve patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD)were examined using high-resolution ultra-high field fMRI (Siemens Magnetom 7T) and microperimetry (MP; Nidek MP-3). The population receptive field (pRF)-based coverage maps obtained with two different stimulus techniques (moving bars, and rotating wedges and expanding rings) were compared with the results of MP. Correspondence between MP and pRF mapping was quantified by calculating the simple matching coefficient (SMC). Results: Stimulus choice is shown to bias the spatial distribution of pRF centers and eccentricity values with pRF sizes obtained fromwedge/ring or bar stimulation showing systematic differences. Wedge/ring stimulation results show a higher number of pRF centers in foveal areas and strongly reduced pRF sizes compared to bar stimulation runs. A statistical comparison shows significantly higher pRF center numbers in the foveal 2.5 degrees region of the visual field for wedge/ring compared to bar stimuli. However, these differences do not significantly influence SMC values when compared to MP (bar 2.5 degrees: 0.88±0.11;wedge/ring<2.5 degrees: 0.89 ± 0.12 wedge/ring; >2.5 degrees: 0.86 ± 0.10) for the peripheral visual field. Conclusions: Both visual stimulation designs examined can be applied successfully in patients with GA. Although the two designs show systematic differences in the distribution of pRF center locations, this variability has minimal impact on the SMC when compared to the MP outcome.Supported by the Austrian Science Fund (FWF); KLI 670-B3

Automated Identification and Quantification of Subretinal Fibrosis in Neovascular Age-Related Macular Degeneration Using Polarization-Sensitive OCT

Citation: Roberts P, Sugita M, Deák G, et al. Automated identification and quantification of subretinal fibrosis in neovascular age-related macular degeneration using polarization-sensitive OCT. Invest Ophthalmol Vis Sci

Three-dimensional ultrahigh resolution optical coherence tomography of macular pathologies

purpose. To demonstrate a new generation of three-dimensional (3-D) ultrahigh-resolution optical coherence tomography (UHR OCT) technology for visualization of macular diseases. methods. One hundred forty eyes with a distinct disease in each of the posterior pole compartments were examined with 3-D UHR OCT. 3-D imaging was performed with a high axial resolution of 3 ?m with a compact, commercially available, ultra–broad-bandwidth (160 nm) titanium:sapphire laser at a video rate of up to 25 B-scans/s. Each tomogram consisted of 1024 × 1024 pixels, resulting in 25 megavoxels/s. results. 3-D UHR OCT offers high-precision 3-D visualization of macular diseases at all structural levels. The UHR modality allows identification of the contour of the hyaloid membrane, tractive forces of epiretinal membranes, and changes within the inner limiting membrane. The system provides quality 3-D images of the topographic dynamics of traction lines from the retinal surface down to the level of the photoreceptor segments. Intraretinal diseases are identified by their specific location in different layers of the neurosensory ultrastructure. Photoreceptor inner and outer segments are clearly delineated in configuration and size, with a characteristic peak in the subfoveal area. The microarchitecture of choroidal neovascularization is distinctly imaged, related leakage can be identified, and the volume can be quantified. conclusions. High-speed UHR OCT offers unprecedented, realistic, 3-D imaging of ocular diseases at all epi-, intra- and subretinal levels. A complete 3-D data set of the macular layers allows a comprehensive analysis of focal and diffuse diseases, as well as identification of dynamic pathomechanisms

The role of the carotenoids, lutein and zeaxanthin, in protecting against age-related macular degeneration: A review based on controversial evidence

PURPOSE: A review of the role of the carotenoids, lutein and zeaxanthin, and their function in altering the pathogenesis of age-related macular degeneration (AMD). METHODS: Medline and Embase search. RESULTS: Recent evidence introduces the possibility that lutein and zeaxanthin, carotenoids found in a variety of fruits and vegetables may protect against the common eye disease of macular degeneration. This potential and the lack to slow the progression of macular degeneration, has fueled high public interest in the health benefits of these carotenoids and prompted their inclusion in various supplements. The body of evidence supporting a role in this disease ranges from basic studies in experimental animals to various other clinical and epidemiological studies. Whilst some epidemiological studies suggest a beneficial role for carotenoids in the prevention of AMD, others are found to be unrelated to it. Results of some clinical studies indicate that the risk for AMD is reduced when levels of the carotenoids are elevated in the serum or diet, but this correlation is not observed in other studies. Published data concerning the toxicity of the carotenoids or the optimum dosage of these supplements is lacking. CONCLUSION: An intake of dietary supplied nutrients rich in the carotenoids, lutein and zeaxanthin, appears to be beneficial in protecting retinal tissues, but this is not proven. Until scientifically sound knowledge is available we recommend for patients judged to be at risk for AMD to: alter their diet to more dark green leafy vegetables, wear UV protective lenses and a hat when outdoors. Future investigations on the role of nutrition, light exposure, genetics, and combinations of photodynamic therapy with intravitreal steroid (triamcinolone-acetonide) injections hold potential for future treatment possibilities

Weghaupt H. Contrast acuity in cataracts of different morphology and association to self-reported visual function. Invest Ophthalmol Vis Sci

PURPOSE. To evaluate the relationship between contrast acuity at declining contrast levels and the type and density of lens opacity in cataract. METHODS. Contrast acuity at declining contrast levels was determined with the Holladay Contrast Acuity Test, in relation to the type and density of age-related cataract in 180 patients with bilateral cataract and 20 control subjects with normal macular function. Cataracts were graded according to the Lens Opacities Classification System (LOCS) III of nuclear color (NC), nuclear opalescence (NO), cortical (C), and posterior subcapsular (P) cataract. Best-corrected visual acuity and near contrast acuity were determined in randomized order monocularly in both eyes. Visual difficulties in everyday life were evaluated, using the VF-14 questionnaire and the Cataract Symptom Score. RESULTS. The contrast-dependent effect of cataract on contrast acuity was statistically significant (P Ͻ 0.001; two-way ANOVA). In the comparison of early, intermediate, and advanced nuclear, nuclear-cortical, and posterior subcapsular cataracts (PSCs), significantly reduced contrast acuity scores were found for the PSC groups (P Ͻ 0.001). Comparison of nuclear and nuclear-cortical cataracts showed the contrast acuity scores to be comparable at all contrast levels (P Ͼ 0.05). High correlation coefficients were found between the LOCS III P score and the contrast acuity measurements (r ϭ 0.77-0.84; P Ͻ 0.001). In contrast, the correlation coefficients of the NO, NC, and C scores were considerably lower (r ϭ 0.45-0.66; P Ͻ 0.001). High correlation coefficients were also found between the contrast acuity measurements and self-reported functional vision. CONCLUSIONS. The statistically significant, contrast-dependent effect of cataract on contrast acuity supports the clinical relevance of recording visual acuity at low contrast levels in patients with age-related cataract. Particularly, the severity of PSC has a strong influence on the impairment of contrast acuity. Contrast acuity corresponded closely to the self-reported visual difficulties in everyday life. (Invest Ophthalmol Vis Sci. 2006; 47:5412-5422 As a standardized procedure, high-contrast VA measurements are based on the ability to discriminate standardized optotypes of logarithmically decreasing print size. 14 -16 Even though VA is the main outcome variable of many clinical studies, high-contrast black optotypes on white background cannot represent real-world vision. This may be one of the reasons why self-reported functional vision reflects patients&apos; satisfaction with visual performance better than high-contrast VA alone. 12 Particularly, when considering day and night driving, contrast sensitivity is often used in clinical studies for evaluating visual function, because impairment in real-world visual performance is better predicted by a contrast-sensitivity test than by high-contrast VA measurements. Because cataract morphologies directly influence the optical quality of the retinal image, clinically relevant differences between nuclear, nuclear-cortical, and posterior subcapsular cataracts (PSCs) have been observed for the functional vision VF-14 score and reading performance in previous studies: both were significantly reduced in patients with PSCs. PATIENTS AND METHODS The present study was conducted at the Department of Ophthalmology, Medical University of Vienna, Austria, according to the tenets of the Declaration of Helsinki. One-hundred-eighty patients with bilateral cataract and 20 normalsighted control subjects (mean age Ϯ SD: 66.9 Ϯ 9.2 years; 400 eyes) were included in the study. Exclusion criteria were a history of ocular disease, intraocular surgery, laser treatment, glaucoma, diabetic retinopathy, amblyopia, and age-related macular degeneration. In the control group, only participants without ocular disease and full VA (logMAR 0.0 or better) were included