An international collaborative evaluation of central serous chorioretinopathy: different therapeutic approaches and review of literature. The European Vitreoretinal Society central serous chorioretinopathy study

Purpose: To study and compare the efficacy of different therapeutic options for the treatment of central serous chorioretinopathy (CSCR). Methods: This is a nonrandomized, international multicentre study on 1719 patients (1861 eyes) diagnosed with CSCR, from 63 centres (24 countries). Reported data included different methods of treatment and both results of diagnostic examinations [fluorescein angiography and/or optical coherent tomography (OCT)] and best-corrected visual acuity (BCVA) before and after therapy. The duration of observation had a mean of 11 months but was extended in a minority of cases up to 7 years. The aim of this study is to evaluate the efficacy of the different therapeutic options of CSCR in terms of both visual (BCVA) and anatomic (OCT) improvement. Results: One thousand seven hundred nineteen patients (1861 eyes) diagnosed with CSCR were included. Treatments performed were nonsteroidal anti-inflammatory eye drops, laser photocoagulation, micropulse diode laser photocoagulation, photodynamic therapy (PDT; Standard PDT, Reduced-dose PDT, Reduced-fluence PDT), intravitreal (IVT) antivascular endothelial growth factor injection (VEGF), observation and other treatments. The list of the OTHERS included both combinations of the main proposed treatments or a variety of other treatments such as eplerenone, spironolactone, acetazolamide, beta-blockers, anti-anxiety drugs, aspirin, folic acid, methotrexate, statins, vitis vinifera extract medication and pars plana vitrectomy. The majority of the patients were men with a prevalence of 77%. The odds ratio (OR) showed a partial or complete resolution of fluid on OCT with any treatment as compared with observation. In univariate analysis, the anatomical result (improvement in subretinal fluid using OCT at 1 month) was favoured by age <60 years (p < 0.005), no previous observation (p < 0.0002), duration less than 3 months (p < 0.0001), absence of CSCR in the fellow eye (p = 0.04), leakage outside of the arcade (p = 0.05) and fluid height >500 \u3bcm (p = 0.03). The OR for obtaining partial or complete resolution showed that anti-VEGF and eyedrops were not statistically significant; whereas PDT (8.5), thermal laser (11.3) and micropulse laser (8.9) lead to better anatomical results with less variability. In univariate analysis, the functional result at 1 month was favoured by first episode (p = 0.04), height of subretinal fluid >500 \u3bcm (p < 0.0001) and short duration of observation (p = 0.02). Finally, there was no statistically significant difference among the treatments at 12 months. Conclusion: Spontaneous resolution has been described in a high percentage of patients. Laser (micropulse and thermal) and PDT seem to lead to significant early anatomical improvement; however, there is little change beyond the first month of treatment. The real visual benefit needs further clarification

epicardial adipose tissue-bone crosstalk

Objectives: Osteocalcin (OC) appears to be involved in the regulation of glucose and fat metabolism. We aimed to determine the association between OC and epicardial adipose tissue (EAT) in premenopausal obese women. Design: The study included 73 premenopausal obese women and 55 non-obese women. Echocardiographic examination was performed to measure EAT. Serum OC levels were measured by chemiluminescence immunoassay. Results: OC levels were significantly lower in obese women than controls (18.26 +/- 5.27 vs. 22.53 +/- 6.84 ng/ml, p < .001). EAT thickness was higher in obese women than controls (5.19 +/- 0.73 vs. 3.25 +/- 1.35 mm, p < .001). In obese women, OC was positively correlated with EAT thickness (p = .043; r = 0.326). There was no correlation in controls. Conclusions: Premenopausal obese women had lower OC levels and thicker EAT than controls. There was a weak positive correlation between OC and EAT in premenopausal obese women. This potential cross talk between bone metabolism and EAT could play a role in the development of atherosclerosis in obesity.C1 [Yaylali, Yalin Tolga] Pamukkale Univ, Fac Med, Dept Cardiol, Denizli, Turkey.[Fidan-Yaylali, Guzin] Pamukkale Univ, Fac Med, Dept Endocrinol & Metab Dis, Denizli, Turkey.[Dedeoglu, Ozen] Marmara Univ Training & Res Hosp, Dept Hematol, Istanbul, Turkey.[Senol, Hande] Pamukkale Univ, Fac Med, Dept Biostat, Denizli, Turkey

Gallium-67 citrate scintigraphy and marginal zone lymphoma of the mucosa-associated lymphoid tissue. Ocular MALT.

We describe marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) and especially MALT lymphoma occurring in the conjunctiva. Tumors of the conjunctiva and cornea are grouped into two major categories of congenital and acquired lesions. Lymphoid tumors of the conjunctiva are acquired tumors and can occur as an isolated lesion or can be a manifestation of systemic lymphoma. Primary lymphomas of the conjunctiva are extremely rare usually originate from extranodal marginal zone B-cell non-Hodgkin's lymphomas of MALT and occur among older adults with a mean age of 61 years. In the last decade it has been reported that MALT lymphomas may develop in various extraintestinal locations, sometimes even without the presence of a mucosa. Half of MALT lymphomas occur in the gastrointestinal tract. MALT lymphomas of the eye are rare and originate from the conjunctiva and the lacrimal glands. Studies evaluating the clinical impact of 67Ga-C scintigraphy for MALT-type lymphomas imaging are rare, based on small numbers, heterogenous groups of patients. Clinical examination, excisional biopsy, histopathology and immunohistochemical studies, computerized tomography and magnetic resonance imaging are also used for the diagnosis of cunjunctival MALT disease. A case of ours gives reason for further discussion. Treatment and follow-up of MALT lymphoma is described