Purpose: To assess choriocapillaris vascular density (VD) in healthy and advanced exudative age-related macular degeneration (ae-AMD) patients by new full-range optical coherence tomography angiography (OCT-A). Method: In this observational, cross-sectional study, 21 healthy and 21 ae-AMD eyes, already treated with anti-VEGF, were enrolled. Angio-View retina patterns centered on fovea (6.4 × 6.4 mm) were acquired for all participants using Solix full-range OCT (Optovue Inc., Freemont, CA, USA). The main outcome was to compare choriocapillaris VD between healthy and ae-AMD eyes. Automated measurements of whole image choriocapillaris VD (%) and fovea grid-based (%) were collected for the analysis. Angio-View patterns were used to assess the flow area (mm2) of macular neovascularization (MNV) by contour flow measure algorithm. Best-corrected visual acuity (BCVA) of both groups was also used for the statistical analysis. Results: The mean age was 60.9 (±8.3) in healthy and 73.33 (±15.05) in ae-AMD eyes. The mean BCVA (ETDRS letters) was 98.47 (±1.50) in healthy and 7.04 (±5.96) in ae-AMD eyes. The Mann–Whitney test comparing choriocapillaries VD for whole and fovea healthy and ae-AMD eyes showed statistical significance (p < 0.0001 (t = 4.91; df = 40) and p < 0.0001 (t = 6.84; df = 40), respectively). Regarding, the correlation between MNV and VD of choriocapillaries, neither whole nor fovea areas were statistically significant (F = 0.38 (R2 = 0.01) and 1.68 (R2 = 0.08), respectively). Conclusions: Choriocapillaris VD showed a statistically significant reduction in comparison to healthy eyes in ae-AMD eyes. Choriocapillaris impairment can be seen in the early phase of MNV pathogenesis.
Background/Objectives: Terson Syndrome (TS) is a rare entity consisting of an intraocular hemorrhage secondary to subarachnoid hemorrhage (SAH) or intracerebral hemorrhage (IH). This study aimed to retrospectively describe the experience of the Ophthalmology Unit of Policlinico Gemelli, Rome, in the management of TS. Methods: Twenty-four eyes of 19 patients (10 males—53%; 9 females—47%; mean age of 44.73 ± 12.49 years) with TS who had pars plana vitrectomy between 2011 and 2024 were included. The primary outcome was the mean change in best-corrected visual acuity (BCVA) 1–3 months after surgery. The secondary outcome was the correlation of post-operative BCVA with the timing of vitrectomy (early vs. late, ≤100 or >100 days). Results: The time between diagnosis and surgery ranged from 33 to 284 days (median = 102 days, interquartile range IQR = 74–161). Baseline BCVA ranged from 6 to 50 ETDRS letters with a median of 17 letters (IQR = 15–25) and significantly increased after surgery, with a median value of 80 (IQR = 70–85). The BCVA percentage improvement had a median of 325% (IQR = 300–431%). No differences in post-operative BCVA were found between patients who underwent early or late vitrectomy. One vitrectomy was complicated by an endophthalmitis. Conclusions: Although no clear guidelines exist on managing TS, vitrectomy significantly improves BCVA, and a delay in surgical intervention does not necessarily worsen the functional outcome. However, an early vitrectomy could improve the stimuli perception, facilitating the rehabilitation process.
Purpose: To evaluate a dual-implant system combining a capsular-bag monofocal intraocular lens with a sulcus-implanted small-incision new-generation implantable miniature telescope (SING-IMT). Methods: Optical simulations quantified retinal spot size, modulation transfer function (MTF), and tolerance to misalignment. Preclinical porcine experiments evaluated surgical feasibility, anatomical stability, and early safety. First-in-human (FiH) implantation assessed surgical outcomes, anterior segment behaviour using ultrasound biomicroscopy and optical coherence tomography, functional vision, and safety over 6 months. Results: Optical modelling demonstrated that the dual-implant configuration maintained retinal image quality within the rehabilitative regime for advanced AMD, with root-mean-square retinal spot radii of 18.7 µm (0°) and 20.4 µm (2.5°), below the estimated retinal sampling limit (∼49 µm), consistent with an expected visual acuity improvement of approximately 2 Snellen lines. Decentration up to 0.5 mm was optically well tolerated, whereas tilt produced rapid mid-frequency contrast loss. In vivo porcine studies confirmed stable sulcus seating without disruption of the capsular-bag IOL or anterior segment structures. FiH implantation was completed without intraoperative complications. At 6 months, distance visual acuity improved from 20/200 to 20/125, near acuity from 56 to 15 Colenbrander units, and reading speed from non-assessable preoperatively to 20 words/min, with no device-related adverse events. Conclusion: This integrated evaluation supports the feasibility and short-term safety of sulcus-based SING-IMT implantation as a minimally invasive intraocular magnification strategy for selected pseudophakic patients with advanced AMD.