Retinal Arterial Macroaneurysms

Overview of the Repeatability, Reproducibility, and Agreement of the Biometry Values Provided by Various Ophthalmic Devices

Importance The incidence of dengue fever (DF) increases every year. Macular complications of patients with DF may be more common than many ophthalmologists realize. During a DF outbreak in South China in 2014, we observed acute macular neuroretinopathy associated with DF. Observations Among 9 patients (17 eyes) with maculopathy post-DF, 5 patients (55.6%) (9 eyes) manifesting acute macular neuroretinopathy were recruited from August 1, 2014, to September 30, 2014, with a 6-month ophthalmic follow-up. Infrared reflectance imaging demonstrated localized areas of hyporeflection in the macula. Spectral-domain (SD) optical coherence tomography (OCT) scanning through these areas revealed hyperreflection in the photoreceptor layer and disruption of its normal reflective structures. Subsequent SD-OCT demonstrated that the hyperreflection of the photoreceptor layer regressed gradually, followed by thinning of the outer nuclear layer. The external limiting membrane and ellipsoid zone became continuous; however, the interdigitation zone was not restored. The scotomas persisted in all 5 patients (9 eyes) by the last visit. All 5 patients (9 eyes) in this case series were complicated with classic dengue maculopathy signs, such as intraretinal hemorrhage and exudation, which were completely resolved during the follow-up. Conclusions and Relevance These data suggest that acute macular neuroretinopathy is a major manifestation of dengue maculopathy, with persistent scotomas through at least 6 months.

/pdf/acute-macular-neuroretinopathy-in-dengue-fever-short-term-2brqz8cero.pdf

Acute Macular Neuroretinopathy in Dengue Fever: Short-term Prospectively Followed Up Case Series.

Ruptured retinal arterial macroaneurysm: Diagnosis and management

Purpose Retinal arterial macroaneurysms (RAMAs) are acquired dilations of branches of the central retinal artery. Treatment depends on vision-limiting complications. We compare the long-term visual acuity (VA) in three groups according to treatment. Methods 49 charts of patients with RAMA were reviewed. 16 remained untreated, 15 received photocoagulation and 18 vitrectomy. Patients underwent full ophthalmological examinations and up-to-date imaging. We evaluated chosen therapy, complications and final VA at the last visit. Results 65% of the cohort was female, aged 75±11 years (mean±SD). Follow-up was 34±23 months. These parameters did not differ significantly between the three groups. In the observed group, initial VA was 0.48 (mean log MAR) vs 0.35 at the final visit, in the photocoagulation group 0.55 vs 0.59, and in the vitrectomy group 1.8 vs 0.77. VA was significantly worse at enrolment in the vitrectomy group, while all other VA differences were not significant. Conclusions The overall visual prognosis of RAMA was good, even after macular complications. VA remained unchanged in the observed and the laser groups and was comparable in all groups after 3 years. Based on an individual treatment decision, all therapies were effective and efficient. If subfoveal haemorrhage caused a macular hole, the VA outcome was limited.

https://bjo.bmj.com/content/bjophthalmol/99/10/1345.full.pdf

Long-term, therapy-related visual outcome of 49 cases with retinal arterial macroaneurysm: a case series and literature review

Intravitreal Bevacizumab for Symptomatic Retinal Arterial Macroaneurysm

Dengue fever is a viral disease that is transmitted by mosquitoes and affects humans. In rare cases, dengue fever can cause visual impairment, which usually occurs within 1 month after contracting dengue fever and ranges from mild blurring of vision to severe blindness. Visual impairment due to dengue fever can be detected through angiography, retinography, optical coherence tomography (OCT) imaging, electroretinography, event electroencephalography (visually evoked potentials), and visual field analysis. The purpose of this study is to report changes in the eye captured using fluorescein angiography, indocyanine green, and OCT in 3 cases of dengue fever visual impairment associated with consistent visual symptoms and similar retinochoroidopathic changes. The OCT results of the three patients with dengue fever showed thinning of the outer retinal layer and disruption of the inner segment/outer segment (IS/OS) junction. While thinning of the retina outer layer is an irreversible process, disruption of IS/OS junction is reported to be reversible. Follow-up examination of individuals with dengue fever and associated visual impairment should involve the use of OCT to evaluate visual acuity and visual field changes in patients with acute choroidal ischemia.

/pdf/use-of-optical-coherence-tomography-to-evaluate-visual-2ye9dzuzkq.pdf

Use of optical coherence tomography to evaluate visual acuity and visual field changes in dengue fever

Purpose: To compare the results of anterior segment biometry including white-to-white (WTW) between scanning-slit topography (ORBscan IIz, Bausch & Lomb), optical low-coherence reflectometry (OLCR) biometry (Lenstar, Haag-Streit), and Castroviejo calipers. Methods: Measurements on 72 eyes of 36 patients that underwent refractive surgery were measured using ORBscan, Lenstar, and calipers and compared. Ocular biometry parameters used in this study included the WTW, central corneal thickness, anterior chamber depth (ACD), keratometry, and pupil size. Results: The WTW measurements using ORBscan and calipers (11.57 ± 0.35 mm and 11.58 ± 0.34 mm, respectively) were statistically similar. However, the measurement using Lenstar (12.05 ± 0.40 mm) was significantly greater than with the other methods (p < 0.001). Central corneal thickness and keratometry measurements using ORBscan were greater than when using Lenstar (p = 0.01 for both). ACD and pupil size measurement using Lenstar were greater than when using ORBscan (p < 0.001 for both). Conclusions: Because WTW and ACD measurements using Lenstar were greater than when using ORBscan and calipers, unexpected high-vaulting may be observed due to the selection of a larger-sized posterior chamber phakic intraocular lens. Therefore, the differences in measurements obtained when using these methods should be considered. J Korean Ophthalmol Soc 2014;55(5):656-661

/pdf/comparison-of-anterior-segment-measurements-using-scanning-136x0txdow.pdf

Comparison of Anterior Segment Measurements Using Scanning-Slit Topography and Optical Low-Coherence Reflectometry (OLCR) Biometry

Reply: To PMID 23385203.

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Intravitreal Bevacizumab for Symptomatic Retinal Arterial Macroaneurysm

Use of optical coherence tomography to evaluate visual acuity and visual field changes in dengue fever

Comparison of Anterior Segment Measurements Using Scanning-Slit Topography and Optical Low-Coherence Reflectometry (OLCR) Biometry

Reply: To PMID 23385203.