RETINA

RETINAL VASCULITIS SEVERITY ASSESSMENT: Intraobserver and Interobserver Reliability of a New Scheme for Grading Wide-Field Fluorescein Angiograms in Retinal Vasculitis

imagePurpose:

Wide-field fluorescein angiography is commonly used to assess retinal vasculitis (RV), which manifests as vascular leakage and occlusion. Currently, there is no standard grading scheme for RV severity. The authors propose a novel RV grading scheme and assess its reliability and reproducibility.

Methods:

A grading scheme was developed to assess both leakage and occlusion in RV. Wide-field fluorescein angiography images from 50 patients with RV were graded by four graders, and one grader graded them twice. An intraclass correlation coefficient (ICC) was used to determine intraobserver–interobserver reliability. Generalized linear models were calculated to associate the scoring with visual acuity.

Results:

Repeated grading by the same grader showed good intraobserver reliability for both leakage (ICC = 0.85, 95% CI 0.78–0.89) and occlusion (ICC = 0.82, 95% CI 0.75–0.88) scores. Interobserver reliability among four independent graders showed good agreement for both leakage (ICC = 0.66, 95% CI 0.49–0.77) and occlusion (ICC = 0.75, 95% CI 0.68–0.81) scores. An increasing leakage score was significantly associated with worse concurrent visual acuity (generalized linear models, β = 0.090, P

By , ago

ASSESSMENT AND ROLE OF ARTERY–VEIN COMPLEX IN MYOPIC CHOROIDAL NEOVASCULARIZATION USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

imagePurpose:

To analyze the presence of an artery–vein complex (AVC) underneath myopic choroidal neovascularization (mCNV) and to determine its relationship with neovascular activity.

Methods:

Retrospective analysis of 681 eyes from 362 patients with high myopia defined by an axial length of >26 mm using optical coherence tomography (OCT) and OCT angiography imaging. Patients with clinical diagnosis of mCNV and good quality OCT angiography images were then selected. An AVC was defined by the identification of both perforating scleral vessels and dilated choroidal veins under or in contact with the mCNV in the same case. Swept source OCT (SS-OCT) and SS-OCT angiography images (TRITON; Topcon Corporation, Tokyo, Japan) were reviewed to detect AVC in the mCNV area.

Results:

Fifty eyes of 49 highly myopic patients with mCNV were analyzed. Eyes with AVC were statistically older (69.95 ± 13.53 vs. 60.83 ± 10.47 years old; P 0.05) or best-corrected visual acuity (0.4 ± 0.5 vs. 0.4 ± 0.5 Logarithm of the Minimum Angle of Resolution (logMAR), P > 0.05) between groups.

Conclusion:

AVC complex has an influence over myopic choroidal neovascularization activity resulting in less aggressive neovascular lesions than those with perforating scleral vessels only.

By , ago

CLINICAL CHARACTERISTICS AND SURGICAL OUTCOMES IN STAGE 4 MACULAR HOLE WITH EPIRETINAL PROLIFERATION

imagePurpose:

To investigate the clinical characteristics and surgical outcomes of Stage 4 macular holes (MHs) with epiretinal proliferation (EP) and explore the pathogenesis of MH formation.

Methods:

This retrospective study included consecutive patients who underwent pars plana vitrectomy for Stage 4 MH. Patients were divided into two groups based on the presence or absence of EP. Baseline characteristics, optical coherence tomography features of MHs, and surgical outcomes were compared between the groups.

Results:

EP was detected in 31 of 102 eyes with Stage 4 MH (30%). Patients with EP were older (P = 0.044), predominantly male (P = 0.047), had a greater axial length (P = 0.008), and had better preoperative visual acuity (P

By Uemura, Akinori; Miyake, Syoki; Funatsu, Ryoh; Yamakiri, Keita, ago