Background and Objectives: The purpose of this study is to describe the effects of photobiomodulation on drusen regression with patients presenting with reticular pseudodrusen (RPD). Materials and Methods: This study is a retrospective observational case series study including patients presenting with RPD who underwent treatment by photobiomodulation. All patients underwent a complete ophthalmic examination and multimodal imaging prior to treatment, including spectral-domain optical coherence tomography (SD-OCT). Eyes were treated two times per week for six consecutive weeks. Best corrected-visual acuity (BVCA) was measured prior and after treatment for all patients. The number of RPD on the SD-OCT scans centered on the macula and stages of RPD was noted at baseline and 6 months after the first treatment session. Results: Five eyes of five patients were included in the study. Mean BCVA did not change 6 months after treatment compared to baseline. Mean number of RPD per eye was 112.60 +/− 48.33 RPD at baseline and 111.6 +/− 49.29 in the same area 6 months after treatment. Changes in RPD distribution according to RPD classification were observed before and after treatment with photobiomodulation. Changes in distribution mostly concerned stages 1 and 3 RPD: Total number of stage 1 RPD was 289 and increased to 324 after treatment. Total number of stage 3 RPD was 97 at baseline and decreased to 67 6 months after treatment. Percentage of stage 1 RPD increased from 46% to 56% after treatment. Percentage of stage 3 RPD decreased from 20% to 13% after treatment. Conclusions: Changes in RPD distribution were observed before and after treatment with photobiomodulation. The number of stage 3 reticular pseudodrusen decreased while number of stage 1 reticular pseudodrusen increased after treatment.

This study aims to quantitatively analyze choriocapillaris (CC) alterations using swept-source optical coherence tomography angiography (SS-OCTA) in eyes presenting with hydroxychloroquine (HCQ) toxic retinopathy and to compare it to patients under HCQ without toxic retinopathy and to healthy controls. For image analysis, CC en-face slabs were extracted from macular 6 × 6 mm SS-OCTA scans and a compensation method followed by the Phansalkar local thresholding was performed. Percentage of flow deficits (FD%) and other related biomarkers were computed for comparison. Fourteen eyes (7 patients) presenting with HCQ toxic retinopathy, sixty-two eyes (31 patients) under HCQ without signs of toxicity, and sixty eyes of 34 healthy controls were included. With regards to FD%, FD average size, and FD number there was a significant difference between the three groups (p < 0.05 with radius 4 and radius 8 pixels). Eyes presenting with HCQ toxicity had significantly higher FD% and average size, and a significantly lower number of FDs, with both radius 4 and 8 pixels. In conclusion, FD quantification demonstrates that CC involvement is present in HCQ toxic retinopathy, therefore giving pathophysiological insights with regards to the CC as being either the primary or secondary target of HCQ toxicity.

Purpose: To evaluate retromode scanning laser ophthalmoscopy (RM-SLO) for detecting and characterizing angioid streaks (AS). Methods: Retrospective case series of five patients (10 eyes) imaged with color fundus, fundus autofluorescence, spectral-domain optical coherence tomography (OCT), and RM-SLO using right-deviated, left-deviated (DL), and ring/central apertures. Two graders assessed images; disagreements were adjudicated by a third expert. Results: Retromode scanning laser ophthalmoscopy depicted AS as hyporeflective bands. Right-deviated and DL produced polarity-dependent, relief-like pseudo-3D cues attributable to lateral aperture deviation and collection of multiply scattered infrared light at the retinal pigment epithelium (RPE)/Bruch membrane interface. Ring/central maximized border sharpness and preserved apparent streak width, closely matching color images. Fundus autofluorescence confirmed hypoautofluorescent bands but provided less edge detail. Spectral-domain optical coherence tomography (SD-OCT) corroborated RPE/Bruch complex abnormalities with focal discontinuities and localized hypertransmission. In this cohort, no choroidal neovascularization was present at imaging or during documented follow-up. Conclusion: Retromode scanning laser ophthalmoscopy complements conventional en-face modalities by enhancing border delineation and rapid mapping of AS and can guide targeted OCT/optical coherence tomography angiography. Given the small sample and retrospective design, this series was not powered for head-to-head detection-rate comparisons; prospective studies are warranted.