Purpose: The aim of this study was to determine whether spectral-domain optical coherence tomography (SD-OCT) can detect and quantify the number of hyperreflective foci attached to the retina and in the vitreous of patients at different stages of diabetic retinopathy (DR). Methods: The medical charts of 929 eyes of 465 patients who had undergone SD-OCT were reviewed. The number of hyperreflective foci in the vitreous and attached to the retina was determined in the SD-OCT images. Results: Of the 929 eyes, 284 eyes from diabetic patients and 265 eyes from controls met the inclusion criteria. The number of hyperreflective foci increased significantly as the severity of DR increased. Conclusions: The correlation between the average number of hyperreflective foci and the severity of DR indicates that quantifying the number of hyperreflective foci may be used to estimate the severity of DR and, thus, identify eyes which require further tests or treatments.

Background and Objectives: In this study, our objective was to assess and compare the changes in visual and structural outcomes among patients with neovascular age-related macular degeneration (nAMD) who were switched from intravitreal aflibercept (IVA) to either intravitreal brolucizumab (IVBr) or intravitreal faricimab (IVF) injections in a clinical setting. Materials and Methods: This observational clinical study included 20 eyes of 20 patients switched to brolucizumab and 15 eyes of 14 patients switched to faricimab from aflibercept in eyes with nAMD. We measured the structural outcome (central macular thickness (CMT)) and the visual outcome (best-corrected visual acuity (BCVA); logMAR) as follows: just before the most recent IVA injection (B0), one month after the most recent IVA injection (B1), just before the first IVBr or IVF injection (A0), one month after (A1) and three months after (A3) the first IVBr or IVF injection. Results: BCVA showed significant improvement at A1 (0.25 ± 0.34) and at A3 (0.19 ± 0.24) compared to A0 (0.38 ± 0.35) in the IVBr group (p = 0.0156, p = 0.0166, respectively). CMT (μm) was significantly thinner at A1 (IVBr: 240.55 ± 51.82, IVF: 234.91 ± 47.29) and at A3 (IVBr: 243.21 ± 76.15, IVF: 250.50 ± 72.61) compared to at A0 (IVBr: 303.55 ± 79.18, IVF: 270.33 ± 77.62) in the IVBr group (A1: p = 0.0093, A3: p = 0.0026) and in the IVF group (A1: p = 0.0161, A3: p = 0.0093). There was no significant difference in BCVA and CMT improvement observed between two groups at any time point (p > 0.05 for all). Conclusions: Switching from aflibercept to either brolucizumab or faricimab has a significant anatomical effect in eyes with nAMD and both treatments appear to be effective short-term treatment options. There is a trend towards greater visual improvements and reductions in CMT with brolucizumab.

Purpose: In this study, we aimed to evaluate and compare the effects of intravitreal aflibercept (IVA) and intravitreal faricimab (IVF) injections on the blood flow of retinal vessels in the peripapillary region and optic nerve head (ONH) in eyes with diabetic macular edema (DME) using laser speckle flowgraphy (LSFG). Patients and Methods: This study included 20 eyes of 18 patients treated with IVA and 15 eyes of 11 patients treated with IVF for DME. The mean blur rate (MBR) of the ONH and retinal artery and vein of the peripapillary region were measured using LSFG at baseline and 1 month after injection. Central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured for all patients. Results: CRT decreased significantly in both IVA-treated (p = 0.0003) and IVF-treated groups (p = 0.0004). Some of the MBR-related parameters of the ONH, such as MBR of all areas (MA), MBR of vascular areas (MV), and MBR of tissue areas (MT), decreased significantly 1 month after IVA and IVF compared to baseline values (MA of IVA, p < 0.0001; MT of IVA, p = 0.0220; MA of IVF, p = 0.0002; MT of IVF, p = 0.0461). MBR of the retinal artery (MBR-A) and vein (MBR-V) also decreased significantly 1 month after IVA and IVF compared with baseline values (MBR-A of IVA, p = 0.0002; MBR-V of IVA, p = 0.0010; MBR-A of IVF, p = 0.0368). No significant difference in ocular perfusion was observed between the IVA-treated and IVF-treated groups. Conclusion: Intravitreal injection led to a reduction in ocular blood flow in both retinal peripapillary vessels and the ONH in both IVA-treated and IVF-treated groups. No significant difference was observed in MBR reduction between the IVA-treated and IVF-treated groups. Our findings warrant further long-term investigations to reveal differences between aflibercept and faricimab.

Background: This study aimed to evaluate the impact of image enhancement techniques on the interobserver reliability of tear break-up time (TBUT), tear meniscus height (TMH), corneal fluorescein staining (CFS) scoring, and conjunctivochalasis detection using the Smart Eye Camera (SEC), a portable device for anterior segment examination. Methods: A retrospective analysis was conducted on video recordings captured by the SEC from 46 patients with dry eye disease (DED). Separate sets of images were created for each level of enhancement: unenhanced (G0), mildly enhanced (G3), and strongly enhanced (G7). These sets were not intermixed, ensuring that each enhancement level was assessed independently. Three observers—two DED specialists and one general ophthalmologist—assessed TBUT, TMH, CFS scores, and conjunctivochalasis. Interobserver reliability was evaluated using intraclass correlation coefficients (ICCs) for each image set. Results: Interobserver reliability for CFS scores significantly improved with G3, yielding an ICC of 0.8413. In contrast, G7 improved reliability for TBUT measurements (ICC = 0.7381), but led to a notable decrease in reliability for both CFS scoring (ICC = 0.2259) and conjunctivochalasis detection (ICC = 0.0786). Furthermore, the assessment of TMH demonstrated a progressive decline in accuracy with increasing levels of image enhancement. Conclusions: Image enhancement using the SEC improved the diagnostic consistency of dry eye specialists and general ophthalmologists, especially for TBUT and CFS assessments. However, excessive enhancement may obscure key diagnostic features, indicating the need for careful optimization of image processing techniques depending on the diagnostic focus.

Accurate evaluation of anterior chamber depth (ACD), a major risk factor for angle closure, is clinically important. Although standard techniques provide reliable measurements, they are often labor-intensive, technically demanding, and time-consuming. To address this, we previously developed an artificial intelligence (AI) algorithm capable of estimating ACD from slit lamp photographs. This study sought to assess the performance of this AI model when applied via the Smart Eye Camera (SEC), a smartphone-compatible slit lamp imaging system, by comparing its estimates to those obtained with anterior segment OCT (AS-OCT) at a separate institution. An evaluation of diagnostic test. Five hundred fifty-six phakic eyes (268 nondilated and 288 dilated eyes) from 329 Asian patients. A retrospective analysis was performed on images captured using both the SEC and AS-OCT. Anterior chamber depth values generated by the AI model embedded in the SEC were compared with corresponding measurements obtained using AS-OCT. Metrics, including mean absolute error (MAE), mean squared error (MSE), Pearson correlation coefficient, and the intraclass correlation coefficient (ICC), were calculated to evaluate model performance. The AI algorithm integrated into the SEC demonstrated the capability to estimate the ACD with an MAE of 0.119 ± 0.0949 mm and an MSE of 0.0233 ± 0.0557 mm. A strong correlation was observed between ACD measurements obtained using AS-OCT and those estimated by AI (R = 0.922; 95% confidence interval, 0.908-0.933). The ICC for agreement between AI-estimated and AS-OCT-measured ACD was 0.903, indicating excellent reliability. Our AI model, embedded within the SEC platform, demonstrated high accuracy in estimating ACD when benchmarked against AS-OCT. Given its portability and user-friendliness, the SEC presents a promising option for accessible ACD screening across diverse clinical environments. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.