Purpose: To study vitreoretinal interface (VRI) abnormalities in diabetic macular edema (DME) and the influence of these on the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) therapy. Methods: VRI status and central retinal thickness (CRT) were evaluated using line and 3D-reference scans obtained using spectral domain-optical coherence tomography RTVue-100 before and 1 month after intravitreal anti-VEGF injection (IVI). VRI status was categorized into five subgroups: normal VRI, retinal surface wrinkling associated with the eccentric epiretinal membrane (ERM), ERM involving the macular center, vitreomacular adhesion (VMA), and vitreomacular traction (VMT). Results: A total of 105 eyes of 89 patients were included in the study. One month after IVI, the mean change of CRT in normal VRI eyes and eyes with VRI abnormalities was –128.0±144.7 µm and –53.0±96.4 µm (p<0.05), respectively. The mean change of CRT 1 month after IVI in each subgroup with VRI abnormalities, apart from the subgroup with retinal wrinkling associated with eccentric ERM, was statistically significantly lower compared to the eyes with normal VRI (p<0.05). Conclusion: VRI abnormalities significantly reduce the effectiveness of intravitreal anti-VEGF therapy in eyes with DME. Eyes with noticeable changes of VRI, including ERM involving the macular center, VMA, and VMT have a poorer response to anti-VEGF therapy compared to eyes with normal VRI or eccentric ERM.

Purpose To identify the factors predicting the visual and anatomical outcomes in eyes with central serous chorioretinopathy (CSCR) through 12 months. Methods Patients with diagnosis of CSCR, either acute or chronic, were included in this multicentric, retrospective study. Demographic factors; systemic risk factors; central macular thickness (CMT), subfoveal choroidal thickness (SFCT), linear extent of ellipsoid zone (EZ) and interdigitation zone damage on optical coherence tomography; details of leak on fluorescein angiography and indocyanine green angiography were included as predictors of anatomical and visual outcomes. Regression analysis was performed to correlate the changes in best corrected visual acuity (BCVA) and resolution of disease activity. Results A total of 231 eyes of 201 patients with a mean age (49.7±11.8 years) were analysed. A total of 97 and 134 eyes were classified as acute and chronic CSCR. BCVA (0.35±0.31 to 0.24±0.34; p<0.001), baseline optical coherence tomography (OCT) parameters including CMT (p<0.001), subretinal fluid (SRF) height (p<0.001) and SFCT (p=0.05) showed a significant change through 12 months. Multivariate regression analysis showed change in CMT (p≤0.01) and SRF height at baseline (p=0.05) as factors predictive of good visual outcome. Logistic regression analysis revealed changes in both CMT (p=0.009) and SFCT (p=0.01) through 12 months to correlate with the resolution of disease. Conclusion OCT parameters such as changes in both CMT and SFCT along with subfoveal EZ damage can be predictive of disease resolution whereas changes in CMT and baseline SRF height correlate well with changes in BCVA through 12 months.

Purpose: To study the prevalence of resolved paracentral acute middle maculopathy (PAMM) lesions in fellow eyes of patients with unilateral retinal vein occlusion (RVO) and eyes of healthy individuals.Methods: This case–control observational study took place in a referral university medical centre. Forty‐five (17 males, 28 females, 64.7 ± 10.8 years) patients with branch retinal vein occlusion (BRVO), 21 (17 males, 4 females, 68.8 ± 11.2 years) patients with central retinal vein occlusion (CRVO) and 57 healthy individuals (25 males, 32 females, 67.4 ± 10.5 years) were included. Presence of resolved PAMM lesions was evaluated by reviewing cross‐sectional scans of 8‐mm optical coherence tomography angiography protocol. Resolved PAMM lesion was defined as inner nuclear layer thinning with outer plexiform layer elevation.Results: Resolved PAMM lesions were found in 32/45 (71.1%) and 15/21 (71.4%) of BRVO and CRVO patients, respectively. In healthy volunteers, resolved PAMM lesions were found in 11/57 (19.3%) individuals with bilateral involvement in 8 individuals (72.7%). RVO patients demonstrated the presence of resolved PAMM lesions in fellow eye significantly more frequently than healthy individuals (odds ratio (OR) 10.6, p < 0.001, 95% CI 4.5–24.6). OR for the presence of large resolved PAMM lesions in BRVO patients and CRVO patients versus healthy individual was 12.1 (p = 0.02, 95% CI 1.5–100.9) and 22.4 (p = 0.005, 95% CI 2.5–200.6), respectively.Conclusion: Resolved PAMM lesions defined as inner nuclear layer thinning associated with outer plexiform layer elevation are highly prevalent in fellow eyes of patients with unilateral RVO. Resolved PAMM lesions may have an association with RVO.

Purpose To identify optical coherence tomography (OCT) findings associated with the leakage points in patients with central serous chorioretinopathy (CSC) to provide fluorescein angiography (FA)-free focal laser photocoagulation (FLP) of the leakage point. Methods A retrospective study included 48 patients with CSC (48 eyes). Colocalisation of leakage points with pigment epithelial detachments (PEDs) and with areas of photoreceptor outer segments (PROS) layer thinning was evaluated with OCT. Using FA for each leakage point, the relationship to neurosensory detachment was evaluated with retro-mode confocal scanning laser ophthalmoscopy. Results Coincidence with PED was found in 52 of 65 (80.0%) leakage points. The PROS thinning was found in 47 of 52 (90.4%) of the PEDs coincided with leakage point. The mean distance from the upper border of neurosensory detachment to the leakage point was 27.3%±13.0% of the vertical dimension of the neurosensory detachment. Conclusion This study demonstrates that PEDs localised in the upper half of the neurosensory detachment area and associated with the PROS thinning area coincided with the leakage point in a significant number of patients with CSC. The patients with non-resolving CSC with a small single PED localising in the upper one-third to one-half of the neurosensory detachment area with an area of PROS thinning above this PED may undergo FA-free OCT-guided FLP treating whole PED.

Purpose: To present a series of idiopathic paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) cases and to compare the microvascular retinal status of PAMM/AMN eyes with those of healthy individuals. Methods: Six eyes with PAMM and two eyes with AMN in a total of six patients were included in this study. Multimodal retinal imaging, including optical coherence tomography angiography, was performed in all patients. The vessel density of the superficial capillary plexus and deep capillary plexus, as well as the area, circularity, and angle of the superficial foveal avascular zone (FAZ) were measured and compared with the same parameters in age-matched healthy individuals. Results: The optical coherence tomography angiography showed a decreased vessel density of both superficial capillary plexus and deep capillary plexus in PAMM/AMN eyes versus control eyes (12.2 ± 0.74 vs. 14.0 ± 1.62 mm⁻¹ [P = 0.01] in superficial capillary plexus and 18.5 ± 1.2 vs. 20.2 ± 1.0 mm⁻¹ [P = 0.02] in deep capillary plexus). There was no statistically significant change in the FAZ area between PAMM/AMN and healthy eyes. However, FAZ circularity in PAMM/AMN eyes was statistically significantly lower compared with healthy eyes (0.64 ± 0.09 and 0.77 ± 0.07, respectively; P = 0.01). The angle of FAZ was statistically significantly higher in PAMM/AMN eyes compared with healthy eyes (27.6 ± 16.2 and 11.2 ± 5.5°, respectively; P = 0.005). Conclusion: Paracentral acute middle maculopathy and AMN eyes demonstrated not only an isolated alteration of deep retinal circulation but also general nonspecific changes in retinal microvasculature, including a decrease in the vessel density of the superficial capillary plexus and distortion of the FAZ.