This study evaluates the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV) using spectral-domain optical coherence tomography in treatment naïve patients with the clinically isolated syndrome (CIS) and different multiple sclerosis (MS) types. A total of 126 patients (15 CIS, 65 relapsing-remitting MS, 14 secondary progressive MS, 11 primary progressive MS, 21 benign MS) with or without optic neuritis (ON) history and 63 healthy age-similar controls were assessed. Concerning controls’ eyes, pRNFL thickness was significantly reduced in CIS-ON eyes (p < 0.01), while both TMV and pRNFL thickness was decreased in all MS eyes regardless of ON history (p < 0.01). Significant differences in pRNFL thickness and TMV between MS variants were observed for non-ON eyes (p < 0.01), with the lowest values in benign and secondary progressive disease type, respectively. The pRNFL thickness was inversely correlated with Expanded Disability Status Scale (EDSS) score in non-ON subgroups (p < 0.01), whereas TMV was inversely correlated with EDSS score in both ON and non-ON subgroups (p < 0.01). Concluding, pRNFL thinning confirms optic nerve damage in CIS-ON eyes and appears to be disproportionately high with respect to the disability status of benign MS patients. The values of TMV and pRNFL in non-ON eyes significantly correspond to MS course heterogeneity and patients’ disability than in ON eyes.

Introduction and objective: The diagnosis of multiple sclerosis (MS) affects the socio-economic aspects of patients’ lives and poses new challenges. The objectives of the study were: 1) to determine selected socio-economic aspects of MS in Poland in relation to the disease type and...

Backgrounds: Photodynamic therapy (PDT) is an established treatment modality in central serous chorioretinopathy (CSCR). The goal of our study was to evaluate the morphological and functional effects of PDT in patients with long-lasting CSCR and determine the related predictive factors for improvement. Methods: This retrospective analysis included consecutive patients with chronic CSCR who consented to PDT. The material comprised 98 eyes of 81 patients (67 males and 14 females) with a disease duration longer than 6 months followed for 6 months post treatment. All patients underwent a basic ophthalmological examination including best corrected visual acuity (BCVA) testing and imaging, spectral-domain optical coherence tomography (SD-OCT), and fluorescein angiography. Patients without macular neovascularization (MNV) were subjected to half-dose PDT (3 mg/m²) with standard fluence (50 J/cm²), guided by indocyanine green angiography. Cases complicated by MNV were subjected to full-dose PDT. Results: A morphological response, defined as complete resolution of subretinal fluid, was achieved in 76.29% of cases, and an improvement in BCVA of at least one logMAR line was obtained in 77.53% of cases. The mean BCVA gain was 1.2 logMAR line. All SD-OCT measurements (central retinal thickness, macular volume, mean subfield thickness, subretinal fluid height, and subfoveal choroidal thickness) showed a significant reduction post PDT. A multivariate analysis proved better morphological outcome associations with a younger age and male gender and better visual gains achieved in patients without intraretinal abnormalities. Univariate testing also showed strong relationships between better baseline BCVA and greater functional and morphological improvements, between shorter disease duration and morphological gains, and between the absence of MNV or intraretinal abnormalities and morphological gains. PDT was highly effective in providing a resolution of pigment epithelial detachment (p = 0.0004). The observed effect was significantly dependent upon the lower baseline central retinal thickness (p = 0.0095). Patients with intraretinal abnormalities or MNV showed moderate improvements post PDT. Conclusions: PDT in long-lasting CSCR cases provides good morphological results but generally minor visual gains. Patients’ expectations of significant increases in BCVA after prolonged disease with distinct alterations of the neurosensory retina should be managed.

Purpose: To evaluate anatomical and functional outcomes after switching from aflibercept to faricimab in patients with neovascular age-related macular degeneration (nAMD) with suboptimal response. Methods: This retrospective study included 72 eyes of 66 patients with nAMD previously treated with intravitreal aflibercept using a treat-and-extend regimen. Indications for switching included persistent retinal fluid, pigment epithelial detachment (PED), lack of best-corrected visual acuity (BCVA) improvement, or inability to extend treatment intervals beyond four weeks. Patients received three monthly loading doses of faricimab followed by individualized 8- to 16-week dosing. Follow-up comprised six visits over a mean of 8.5 ± 1.4 months. Outcomes included BCVA (logMAR), retinal morphology (subretinal fluid—SRF; intraretinal fluid—IRF; pigment epithelial detachment—PED), central subfoveal thickness (CST), and treatment interval changes. Results: Switching to faricimab led to significant short-term anatomical improvement, primarily reduction in subretinal fluid (p < 0.0001), with maximal effect during the loading phase. Resolution of SRF was significant at the end of the follow up; however, IRF changes were transient and not sustained beyond three months. PED reduction reached borderline significance (p = 0.0455). CST decreased during the loading phase (p < 0.0001) but returned to baseline thereafter. BCVA improved only after loading (p = 0.0287) but not at final follow-up. Treatment intervals were extended by a mean of ~2 weeks (p < 0.0001), increasing in 80% of eyes. Eyes with fewer prior injections and better baseline BCVA achieved superior final visual outcomes. Conclusions: Switching to faricimab provides short-term anatomical benefits and treatment-interval extension without sustained visual gain. Functional improvements tended to be greater in patients with fewer injections and shorter treatment duration prior to switch.

Odwarstwienie nabłonka barwnikowego jest częstą patologią występującą w różnych chorobach siatkówki. Rozpoznanie to jest używane bardzo często, ale nie zawsze w prawidłowym znaczeniu i bez wyraźnego rozróżnienia między jego typami. Odmienna patogeneza i typ zmian wiążą się z charakterystycznymi cechami w badaniu angiografii fluoresceinowej, autofluorescencji, spektralnej koherentnej tomografii optycznej i badaniu angiograficznym opartym na koherentnej tomografii optycznej. W niniejszym artykule spróbujemy zwrócić uwagę na istotne elementy stosowanej w codziennej praktyce klinicznej diagnostyki multimodalnej tej patologii, pozwalające prawidłowo określić jej typ, naturalny przebieg oraz postępowanie terapeutyczne.

Purpose: To analyze choroidal thickness (CT) and choroidal volume (CV) using ultra-wide-field (UWF) spectral-domain optical coherence tomography (SD-OCT) in patients with central serous chorioretinopathy (CSC) and to assess their associations with disease duration and best-corrected visual acuity (BCVA). Methods: This prospective case–controlled study included 50 eyes of 41 CSC patients and 56 eyes of 32 healthy controls matched for age and sex. CT was measured at 24 points using the REVO 130 UWF SD-OCT device with a wide-field adapter, covering a 21 × 21 mm retinal area across central, mid-peripheral (4 mm), and peripheral (8 mm) zones. CV was estimated using a quadratic nonlinear model. ROC curve analysis and univariate logistic regression were applied to evaluate discriminative capacity and odds ratios (OR) for CT and CV. Results: CT was significantly higher in CSC eyes at all 24 measurement points (all p < 0.0001). Mean subfoveal CT was 472.6 µm vs. 344.8 µm in controls (+37%), with greater relative increases at mid-peripheral (+46%) and peripheral (+44%) zones. Mean CV was 61.47 (±11.37) mm³ vs. 42.29 (±10.02) (+45%; p < 0.0001). CV showed a higher OR for CSC occurrence than central CT (OR = 2.88; 95% CI: 1.53–5.42 vs. OR = 1.04; 95% CI: 1.02–1.07). Significant discriminative CT points (AUC > 0.60) clustered at the 2/8, 4/10, and 6/12 clock meridians. Both CT and CV correlated positively with disease duration (Spearman rho 0.35–0.41; p ≤ 0.0004) but not with BCVA. Conclusions: UWF SD-OCT confirms diffuse pachychoroid thickening in CSC extending to the periphery. CV is a sensitive biomarker in association with CSC status. Peripheral CT and CV correlate with disease duration, supporting the link between higher volumetric choroidal values and longer disease course. Integration of these parameters may improve CSC diagnosis and prognostic evaluation.