Artifact-Removed Quantitative Analysis of Choriocapillaris Flow Voids

Objectives:To investigate choriocapillaris flow voids (FV) with a new optical coherence tomography angiography (OCTA) image processing strategy that can eliminate artifacts caused by vitreous opacities, sub-retinal pigment epithelium fluid and deposits, and subretinal fluid (SRF) by thresholding the en-face OCT image of the outer retina.Materials and Methods:We retrospectively reviewed medical records of patients with drusen and patients with active central serous chorioretinopathy (CSC). FV number (FVn), average area (FVav), and maximum area (FVmax) and the percentage of nonperfused choriocapillaris area (PNPCA) obtained using the proposed strategy were compared with those obtained by removing only artifacts caused by the superficial capillary plexus (SCP).Results:The SRF group included 21 eyes with active CSC and the drusen group included 29 eyes with nonexudative age-related macular degeneration. FVav, FVmax, FVn, and PNPCA obtained using the algorithm were significantly lower than those obtained by removing only SCP-related artefacts in both groups (all p<0.05). The algorithm was also able to remove 96.9% of artifacts secondary to vitreous opacities and all artifacts secondary to serous pigment epithelial detachments.Conclusion:Choriocapillaris nonperfusion areas on OCTA images may be overestimated in eyes with RPE abnormalities and SRF due to artifacts. These artifact areas on choriocapillaris OCTA images can be removed using thresholded images of the outer retina en-face OCT scans. Our new artifact-removal strategy is useful in the assessment of choriocapillaris FV in eyes with SRF, drusen, drusen-like deposits, and pigment epithelial detachment

Occult Macular Dystrophy

Occult macular dystrophy is an inherited macular dystrophy characterized by a progressive decline of bilateral visual acuity with normal fundus appearance, fluorescein angiogram and full-field electroretinogram. This case report presents a 20-year-old female patient with bilateral progressive decline of visual acuity for six years. Her visual acuity was 3-4/10 in both eyes. Anterior segment and fundus examination, fluorescein angiogram and full-field electroretinogram were normal. She could read all Ishihara pseudoisochromatic plates. Fundus autofluorescence imaging was normal. There was a mild central hyporeflectance on fundus infrared reflectance imaging in both eyes. Reduced foveal thickness and alterations of the photoreceptor inner and outer segment junction were observed by optical coherence tomography in both eyes. Central scotoma was also found by microperimetry and reduced central response was revealed by multifocal electroretinogram in both eyes. These findings are consistent with the clinical characteristics of occult macular dystroph

Macular Burns from Nonmedical Lasers

Laser devices are widely used for medical, military, industrial and entertainment purposes. This extensive and unregulated use of lasers can cause a variety of maculopathies that can result in permanent vision loss. Uncontrolled and inappropriate use of laser instruments should be prevented with strict rules. We strongly emphasize the importance of changing the general misperception that lasers are safe to use for entertainment purposes. In this study we aim to report the clinical features of three patients with a history of maculopathy caused by exposure to laser light in an entertainment venue

Microperimetry

Visual acuity is still considered the gold standard in clinical practice of vision testing, but it does not entirely reflect functional vision. Therefore, we need other functional tests to perform more detailed assessment of macular function in retinal diseases. A test of visual function which may help to better understand the characteristics of visual loss in retinal diseases could be microperimetry. With microperimetry, retinal fixation and macular sensitivity may be accurately tested, with strict correspondence between visual parameters and macular morphology. In this paper, we review the literature regarding the results of microperimetry. Results on known diseases and reproducibility of the technique were published, but a lot of research was also performed on the combination of different examination methods. (Turk J Oph thal mol 2011; 41: 401-6

Serous Macular Detachments

Serous macular detachment has only recently been recognized to occur in a significant number of eyes with macular pathology including diabetic retinopathy, retinal vein occlusion, Behçet disease, Irvine-Gass syndrome and pars planitis. These serous retinal detachments associated with retinal vascular leakage are not suspected clinically or angiographically but can be diagnosed with optical coherence tomography (OCT) beneath the edematous neurosensory retina. The detection of shallow foveal detachment may be helpful in better understanding the pathogenesis of these disorders. In addition, the detection of serous macular detachment may also help to better guide and assess the results of therapy in the future. (Turk J Oph thal mol 2012; 42: 146-9

High-Resolution Optical Coherence Tomography in Late-Stage Familial Foveal Retinoschisis

A 35-year-old male patient with blurred vision in both eyes since childhood has been diagnosed with foveaschisis at the age of 14. The patient had 5 brothers, all reported to have similar retinal problems. His best-corrected visual acuity was 4/10 in both eyes. Fundus examination showed retinoschisis in the lower temporal quadrants in both eyes, pigmented laser scars in the same area in the right eye, and a dull foveal reflex was observed in both eyes. The foveal sections examined with high-resolution optical coherence tomography (OCT) demonstrated atrophy in the fovea bilaterally. OCT sections did not show any accumulation of intraretinal or subretinal fluid or any cystic cavities; yet, thinning was observed especially on the superficial retinal layers. Structures under the outer plexiform layer were observed as normal. Even though these OCT findings are not merely diagnostic as in early-stage familial foveal retinoschisis, there is no doubt that they still facilitate the diagnosis. (Turk J Oph thal mol 2012; 42: 81-3

Correspondence between Multifocal Electroretinography and Microperimetry in Benign Concentric Annular Macular Dystroph

A 32-year-old woman with benign concentric annular macular dystrophy (BCAMD) was examined with multifocal electroretinography (mfERG) and microperimetry. The mfERG demonstrated reduced focal responses in the area corresponding to the scotoma shown by microperimetry. The correspondence between mfERG and microperimetry in a patient with BCAMD shows that inner retinal layers, which include photoreceptors, are affected and these changes lead to visual field defects. (Turk J Oph thal mol 2011; 41: 351-3

A case of morning glory syndrome associated with persistent hyperplastic primary vitreous and Peters’ anomaly

We report a case of morning glory syndrome (MGS) associated with persistent hyperplastic primary vitreous (PHPV) and Peters’ anomaly. A 2-day-old girl, born at term with a birth weight of 3,350 g was diagnosed with Peters’ anomaly, cataract, microphthalmia, PHPV, and MGS. A right limbal lensectomy and vitrectomy with stalk cauterization was performed 8 days later. No early postoperative complication occurred, the family was discharged with advice on medication, and follow-up examination was scheduled. The case report reveals the coexistence of PHPV, Peters’ anomaly, and MGS, which may suggest a genetic link

A case of morning glory syndrome associated with persistent hyperplastic primary vitreous and Peters’ anomaly

We report a case of morning glory syndrome (MGS) associated with persistent hyperplastic primary vitreous (PHPV) and Peters’ anomaly. A 2-day-old girl, born at term with a birth weight of 3,350 g was diagnosed with Peters’ anomaly, cataract, microphthalmia, PHPV, and MGS. A right limbal lensectomy and vitrectomy with stalk cauterization was performed 8 days later. No early postoperative complication occurred, the family was discharged with advice on medication, and follow-up examination was scheduled. The case report reveals the coexistence of PHPV, Peters’ anomaly, and MGS, which may suggest a genetic link

Microperimetric Changes After Photodynamic Therapy for Central Serous Chorioretinopathy

PURPOSE: To evaluate the effect of half-dose verteporfin photodynamic therapy (PDT) on macular function in cases of central serous chorioretinopathy (CSC)