Assessment of macular choroidal thickness by optical coherence tomography and angiographic changes in central serous chorioretinopathy.

[Objective]: To investigate the relationship between macular choroidal thickness measured by highpenetrating swept-source optical coherence tomography (SS-OCT) and angiographic findings in central serous chorioretinopathy (CSC). [Design]: Prospective cross-sectional case series. [Participants and Controls]: Thirty-four patients with CSC (44 eyes) and 17 volunteer subjects (17 normal eyes). [Methods]: All subjects underwent a comprehensive ophthalmologic and SS-OCT prototype examination. All patients with CSC also underwent simultaneous fluorescein angiography (FA) and indocyanine green angiography (IA). Mean regional choroidal thickness measurements on the Early Treatment Diabetic Retinopathy Study (ETDRS) layout and squared sector grids were obtained by 3-dimensional raster scanning using SS-OCT. [Main Outcome Measures]: Macular choroidal thickness and angiographic abnormalities. [Results]: Mean whole macular choroidal thickness in eyes with CSC (total, 329.3_83.0 _m; classic CSC, 326.9_83.1 _m; chronic CSC, 325.4_93.3 _m; and multifocal posterior pigment epitheliopathy, 359.0_15.5 _m) was greater than that in normal eyes (233.0_67.0_m) (P_ 0.001). In unilateral cases, mean whole macular choroidal thickness was greater in eyes with unilateral CSC than in unaffected fellow eyes (P_0.021). There was no significant difference in choroidal thickness between active eyes and resolved eyes in any of the ETDRS sectors. Mean choroidal thickness was greater in areas with leakage on FA than in areas without leakage (P_0.001). Mean choroidal thickness was greater in areas with choroidal vascular hyperpermeability and in areas with punctate hyperfluorescent spots on IA than in unaffected areas (P_0.001 for both). [Conclusions]: Increased choroidal thickness was observed in the whole macular area of eyes with any of the CSC subtypes. Choroidal thickness was related to leakage from the retinal pigment epithelium, choroidal vascular hyperpermeability, and punctate hyperfluorescent lesions. These findings provide evidence that CSC may be caused by focally increased hydrostatic pressure in the choroid. [Financial Disclosure(s)]: Proprietary or commercial disclosure may be found after the references

The Impact of Vision Impairment (IVI) Questionnaire; Validation of the Thai-Version and the Implementation on Vision-Related Quality of Life in Thai Rural Community

<div><p>The objective of this study is to validate the Thai-version of the impact of vision impairment (IVI) questionnaire and to evaluate its impact on vision-related quality of life (VRQoL) in southern Thailand. The IVI questionnaire was translated into Thai according to WHO translation guidelines. In addition to the routine ophthalmological examinations, a Thai version of the IVI questionnaire was administered to all participants. A total of 120 patients with visual impairment who presented at Songklanagarind hospital, Songkhla province, were enrolled in the study; 30 had age-related macular degeneration (AMD), 30 had cataract, 30 had diabetic retinopathy, 30 had glaucoma, and 30 non-visually impaired individuals comprised the control group. Statistical analysis demonstrated the Thai-version IVI questionnaire is valid and reliable to evaluate the VRQoL of the Thai patients through three subscales: (i) mobility and independence, (ii) reading and accessing information, and (iii) emotional well-being. The results demonstrated high consistency in all subscales with Cronbach’s alpha ranging from 0.787 to 0.849. Rasch analysis revealed the validity of the Thai-version IVI to assess VRQoL through all three subscales. Test-retest reliability was also high (intraclass correlation coefficient = 0.96). The composite score of the IVI was significantly higher in participants with visual impairment compared with healthy participants. Moreover, the subscale scores of reading and accessing information, and emotional well-being were highest in participants with AMD. While the subscale scores of mobility and independence were highest among those with either cataracts or diabetic retinopathy. The symptoms of the common vision impairment diseases are associated with an adverse impact on VRQoL in a clinic-based population as demonstrated in this study.</p></div

The demographic characteristics of participants, mean subscale and composite score of IVI in all subjects.

<p>The demographic characteristics of participants, mean subscale and composite score of IVI in all subjects.</p

Items and subscale scores.

<p>Items and subscale scores.</p

Person measures for IVI overall and three subscale scores for the normal control and cataract patients.

<p>Person measures for IVI overall and three subscale scores for the normal control and cataract patients.</p

High-dose antioxidants for central serous chorioretinopathy; The randomized placebo-controlled study

<p>Abstract</p> <p>Background</p> <p>To determine the efficacy of high-dose antioxidants in the acute stage of central serous chorioretinopathy (CSC).</p> <p>Methods</p> <p>This was a randomized placebo-controlled study. The patients with acute CSC (onset within 6 weeks) were randomized to receive either high-dose antioxidant tablets (study group A) or placebo tablets (control group B) for 3 months or until the complete resolution of subretinal fluid. After 3 months, additional treatment with laser or photodynamic therapy (PDT) was considered if any fluorescein leakage persisted. The outcomes measured were the changes in visual acuity (VA) and central macular thickness (CMT), the number of patients with subretinal fluid at each follow-up time, the number of patients with fluorescein leakage at the end of the 3^rd month and patients who received additional treatments.</p> <p>Results</p> <p>Fifty-one of 58 patients (88%) completed the follow-up criteria. The baseline demographic data were comparable in both groups. At the end of the 3^rd month, the VA and CMT showed no statistical difference between the groups but the patients in group A has less fluorescein leakage and additional treatments than in group B (p = 0.027 and 0.03).</p> <p>Conclusion</p> <p>The high-dose antioxidants for acute CSC did not show any benefits in VA and CMT. However, the drugs might decrease the chance for fluorescein leakage and additional treatments at the end of the 3^rd month.</p