Diabetic maculopathy (DM) is one of the major causes of vision impairment in individuals with diabetes. The traditional approach to diagnosis of DM includes fundus ophthalmoscopy and fluorescein angiography. Although very useful clinically, these methods do not contribute much to the evaluation of retinal morphology and its thickness profile. That is why a new technique called optical coherence tomography (OCT) was utilized to perform cross-sectional imaging of the retina. It facilitates measuring the macular thickening, quantification of diabetic macular oedema, and detecting vitreoretinal traction. Thus, OCT may assist in patient selection with DM who can benefit from treatment, identify what treatment is indicated, guide its implementing, and allow precise monitoring of treatment response. It seems to be the technique of choice for the early detection of macular oedema and for the followup of DM.

Pseudophakic cystoid macular edema: update 2016 Andrzej Grzybowski,1,2 Bartosz L Sikorski,3 Francisco J Ascaso,4,5 Valentín Huerva6,7 1Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland; 2Department of Ophthalmology, Poznan City Hospital, Poznan, Poland; 3Department of Ophthalmology, Nicolaus Copernicus University, Bydgoszcz, Poland; 4Department of Ophthalmology, Hospital Clínico Universitario “Lozano Blesa”, Zaragoza, Spain; 5Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; 6Department of Ophthalmology, Universitary Hospital Arnau de Vilanova, Lleida, Spain; 7IRB Lleida, Lleida, Spain Pseudophakic cystoid macular edema (PCME) is the most common complication of cataract surgery, leading in some cases to a decrease in vision. Although the pathogenesis of PCME is not completely understood, the contribution of postsurgical inflammation is generally accepted. Consequently, anti-inflammatory medicines, including steroids and nonsteroidal anti-inflammatory drugs, have been postulated as having a role in both the prophylaxis and treatment of PCME. However, the lack of a uniformly accepted PCME definition, conflicting data on some risk factors, and the scarcity of studies comparing the role of nonsteroidal anti-inflammatory drugs to steroids in PCME prevention make the problem of PCME one of the puzzles of ophthalmology. This paper presents an updated review on the pathogenesis, risk factors, and use of anti-inflammatory drugs in PCME that reflect current research and practice. Keywords: Pseudophakic cystoid macular edema, cataract surgery, cataract surgery complications, retina, post-operative complications

Corneal evaluation in ophthalmology necessitates cellular-resolution and fast imaging techniques that allow for accurate diagnoses. Currently, the fastest volumetric imaging technique is Fourier-domain full-field optical coherence tomography (FD-FF-OCT), which uses a fast camera and a rapidly tunable laser source. Here, we demonstrate high-resolution, high-speed, non-contact corneal volumetric imaging in vivo with FD-FF-OCT that can acquire a single 3D volume with a voxel rate of 7.8 GHz. The spatial coherence of the laser source was suppressed to prevent it from focusing on a spot on the retina, and therefore, exceeding the maximum permissible exposure (MPE). The inherently volumetric nature of FD-FF-OCT data enabled flattening of curved corneal layers. The acquired FD-FF-OCT images revealed corneal cellular structures, such as epithelium, stroma and endothelium, as well as subbasal and mid-stromal nerves.

Aims: To determine the spatial location of lesions in multiple evanescent white dot syndrome (MEWDS) with the aid of spectral optical coherence topography (SOCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA). Methods: A novel method of three-dimensional SOCT data analysis called reflectivity maps was introduced. The reflectivity maps display the distribution of a back-reflected intensity taken only from individual retinal layers located at specific distance from the reference plane. Reflectivity maps of the inner retina, the junction between photoreceptor inner and outer segments (IS/OS), retinal pigment epithelium and choroid of the patient with MEWDS were created and correlated with FA and ICGA. Results: During the acute stage of MEWDS, the reflectivity map of the IS/OS junction displayed areas of reduced reflectivity that showed a strong positive correlation with hypofluorescent ICGA spots and a weaker but positive correlation with hyperfluorescent FA dots. SOCT examination did not reveal any pathological changes involving either any other retinal layers or the inner choroid. Conclusion: Disseminated disruptions of the IS/OS junction seen on SOCT cross-sectional images in the acute stage of MEWDS form the pattern of spots that can be correlated with those revealed by ICGA. This suggests that hypofluorescent ICGA spots indicate alternations in the retinal pigment epithelium–photoreceptor complex and do not represent inflammatory choroidal lesions.

Background. Noninvasive assessment of metabolic processes that sustain regeneration of human retinal visual pigments (visual cycle) is essential to improve ophthalmic diagnostics and to accelerate development of new treatments to counter retinal diseases. Fluorescent vitamin A derivatives, which are the chemical intermediates of these processes, are highly sensitive to UV light; thus, safe analyses of these processes in humans are currently beyond the reach of even the most modern ocular imaging modalities. Methods. We present a compact, 2-photon-excited fluorescence scanning laser ophthalmoscope and spectrally resolved images of the human retina based on 2-photon excitation (TPE) with near-infrared light. A custom Er:fiber laser with integrated pulse selection, along with intelligent postprocessing of data, enables excitation with low laser power and precise measurement of weak signals. Results. We demonstrate spectrally resolved TPE fundus images of human subjects. Comparison of TPE data between human and mouse models of retinal diseases revealed similarity with mouse models that rapidly accumulate bisretinoid condensation products. Thus, visual cycle intermediates and toxic byproducts of this metabolic pathway can be measured and quantified by TPE imaging. Conclusion. Our work establishes a TPE instrument and measurement method for noninvasive metabolic assessment of the human retina. This approach opens the possibility for monitoring eye diseases in the earliest stages before structural damage to the retina occurs. Funding. NIH, Research to Prevent Blindness, Foundation for Polish Science, European Regional Development Fund, Polish National Agency for Academic Exchange, and Polish Ministry of Science and Higher Education.