Topographical Choroidal Thickness Change Following PDT for CSC: An OCT Case Report

Purpose. To describe topographical changes in choroidal thickness as measured by optical coherence tomography following photodynamic therapy (PDT) for central serous chorioretinopathy (CSC). Methods. Case report. Results. By 1 month following PDT, mean (SD) choroidal thickness decreased from 562 microns (24) to 424 microns (27) (P < 0.01) at 3 mm temporal to fovea, 483 microns (9) to 341 microns (21) (P < 0.01) at 1.5 mm temporal to fovea, 576 microns (52) to 370 microns (81) (P < 0.01) under the fovea, 442 microns (30) to 331 microns (54) (P < 0.04) at 1.5 mm nasal to fovea, and 274 microns (39) to 171 microns (17) (P < 0.01) at 3 mm nasal to fovea. The Location of greatest choroidal thickness (648 microns) prior to treatment was at point of leakage on fluorescein angiogram (FA). This region decreased to 504 microns following treatment. Conclusion. A decrease in choroidal thickness can be seen following PDT for CSC as far as 3 mm temporal and 3 mm nasal to fovea. The Location of greatest choroidal thickness may be at point of leakage on FA

Upper limits of intraocular pressure in glaucoma clinical trials

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110560/1/ceo12357.pd

Age-related macular degeneration and the aging eye

Age-related macular degeneration (AMD) is an ocular disease that causes damage to the retinal macula, mostly in the elderly. Normal aging processes can lead to structural and blood flow changes that can predispose patients to AMD, although advanced age does not inevitably cause AMD. In this review, we describe changes that occur in the macular structure, such as the retinal pigment epithelium and Bruch’s membrane, with advancing age and in AMD. The role of genetics in AMD and age-related changes in ocular blood flow that may play a role in the pathogenesis of AMD are also discussed. Understanding the pathophysiology of AMD development can help guide future research to further comprehend this disease and to develop better treatments to prevent its irreversible central vision loss in the elderly

Ocular safety of sildenafil citrate when administered chronically for pulmonary arterial hypertension: results from phase III, randomised, double masked, placebo controlled trial and open label extension

Objective To assess the ocular effects and safety profile of chronic sildenafil oral dosing in patients with pulmonary arterial hypertension

Management of Glaucoma in Pregnancy

Management of glaucoma during pregnancy represents a challenge for the physician. Important disease and patient health decisions begin even prior to conception and continue throughout pregnancy and breastfeeding. Data on this topic is limited due to ethical and legal constraints and challenges of conducting large, prospective, and randomized clinical trials on this patient population. Our review suggests that individually, intraocular pressure is lower in a pregnant woman when compared to a non-pregnant woman. Importantly, the medical management of glaucoma during pregnancy poses special challenges due to the possibility of adverse effects of medications on the fetus and newborn. Laser trabeculoplasty and traditional filtration surgery, as well as minimally invasive glaucoma surgery, represent non-drug management options. Thus, managing glaucoma in pregnancy is a delicate balance between treatment to prevent damage to the optic nerve in the mother and avoidance of interventions potentially harmful to the fetus. This literature review of published individual and population-based studies was performed in order to explore current knowledge and guidelines in the management of glaucoma in pregnancy

Relationship Between Foveal Cone Specialization and Pit Morphology in Albinism

Purpose.Albinism is associated with disrupted foveal development, though intersubject variability is becoming appreciated. We sought to quantify this variability, and examine the relationship between foveal cone specialization and pit morphology in patients with a clinical diagnosis of albinism. Methods. We recruited 32 subjects with a clinical diagnosis of albinism. DNA was obtained from 25 subjects, and known albinism genes were analyzed for mutations. Relative inner and outer segment (IS and OS) lengthening (fovea-to-perifovea ratio) was determined from manually segmented spectral domain-optical coherence tomography (SD-OCT) B-scans. Foveal pit morphology was quantified for eight subjects from macular SD-OCT volumes. Ten subjects underwent imaging with adaptive optics scanning light ophthalmoscopy (AOSLO), and cone density was measured. Results. We found mutations in 22 of 25 subjects, including five novel mutations. All subjects lacked complete excavation of inner retinal layers at the fovea, though four subjects had foveal pits with normal diameter and/or volume. Peak cone density and OS lengthening were variable and overlapped with that observed in normal controls. A fifth hyper-reflective band was observed in the outer retina on SD-OCT in the majority of the subjects with albinism. Conclusions. Foveal cone specialization and pit morphology vary greatly in albinism. Normal cone packing was observed in the absence of a foveal pit, suggesting a pit is not required for packing to occur. The degree to which retinal anatomy correlates with genotype or visual function remains unclear, and future examination of larger patient groups will provide important insight on this issue

Rates of Progression in Diabetic Retinopathy During Different Time Periods: A systematic review and meta-analysis

10.2337/dc09-0615Diabetes Care32122307-2313DICA