Purpose: To analyze the retinal and choriocapillaris changes in diabetic patients with no or with early signs of diabetic retinopathy using high-definition (HD) angio optical coherence tomography angiography (OCTA) software and spectral-domain (SD) OCT. Methods: A total of 112 eyes (54 eyes from 27 diabetic patients and 58 eyes from 29 control subjects) were included in this retrospective cross-sectional study of healthy and diabetic adults. Retinal microvascular changes were assessed by using HD-OCTA software to calculate vascular density (VD) and foveal avascular zone (FAZ). SD-OCT was used to assess retinal thickness and volume in parafovea as well as ganglion cell complex (GCC) parameters. Results: The VD-whole image was significantly higher in the healthy control group (MW z = 1109.5, p = 0.012; t = 2.611, p = 0.010). Also, VD-parafovea was significantly higher in the healthy subjects (MW z = 1053.5, p = 0.004; t = 3.207, p = 0.002). GCC focal loss volume (FLV) was significantly decreased in diabetic patients (p = 0.051). Non-flow FAZ did not show a statistically significant difference between groups, although the FAZ was larger in the diabetic patients. Conclusions: Diabetic patients with no or early signs of diabetic retinopathy have decreased VD compared to healthy individuals. They also present retinal changes at the GCC that are correlated with initial neurodegeneration. HD-OCTA and SD-OCT can detect vascular changes and structural signs of retinal neurodegeneration before clinically apparent diabetic retinopathy. Potentially, these methods may offer new biomarkers for monitoring disease progression and visual prognosis.

Cilj: Prikazati slučaj pacijenta s akutnom posteriornom multifokalnom plakoidnom pigmentnom epiteliopatijom (APMPPE) u sklopu infekcije borelijom Lyme. Prikaz slučaja: Šesnaestogodišnjeg pacijenta uputio je pedijatar zbog naglog pada vidne oštrine na desnom oku. Vidna oštrina kod dolaska bila je 0,01 po Snellenu. Žalio se i na zatiljnu glavobolju unazad nekoliko dana i naveo ubod nepoznatog kukca s okolnim osipom na koži. Na oba oka na fundusu su se utvrdili znakovi korioretinitisa. Učinjena je optička koherentna tomografija (OCT, engl. optical coherence tomography), OCT-angiografija (OCT-A), vidno polje (VP), fluoresceinska angiografija (FA), angiografija indocijanin zelenilom (ICGA, engl. indocyanine green angiography), kompletna laboratorijska, serološka i imunološka obrada, rendgen srca i pluća, magnetska rezonancija (MR) mozga, pregled i konzultacija infektologa i neuropedijatra. Postavljena je dijagnoza APMPPE-a i uvedena peroralna terapija metilprednizolonom 0,5 mg/kg tjelesne težine i doksiciklinom 2 x 100 mg dnevno. Serodijagnostika je pokazala povišene vrijednosti IgM i IgG na Borreliu spp metodom imunoenzimske analize (ELISA, engl. Enzyme Linked Immuno Sorbent Assay), što je bilo potvrđeno western blot analizom. Terapija je dovela do brzog poboljšanja kliničke slike i vidne oštrine na 0,75. Zaključci: Želimo naglasiti da je u slučaju APMPPE-a potrebno napraviti kompletnu obradu kako bi se isključile konkomitantne infekcije, a potrebno je posumnjati i na okularnu boreliozu, osobito u slučaju ugriza krpelja ili nepoznatog kukca, čak i kad se pacijenti ne sjećaju ugriza. Ovakav pristup omogućava promptno liječenje APMPPE-a i borelioze kako bi se smanjile okularne ili/i sistemske komplikacije.

Background/Objectives: Thyroid eye disease (TED) can lead to structural and microvascular changes in the orbit and retina. This study aimed to investigate the associations between Clinical Activity Score (CAS), orbital magnetic resonance imaging (MRI) measurements, and retinal microvascular changes in TED patients. Methods: This cross-sectional study included 38 patients (76 eyes) with TED. Each patient underwent a comprehensive ophthalmological evaluation, CAS assessment, and a detailed medical history. Optical coherence tomography angiography (OCTA) was performed to quantify vessel density (VD) in the superficial and deep capillary plexus (SCP and DCP). Exophthalmos, extraocular muscle thickness and orbital fat thickness were measured on MRI scans to evaluate structural changes. Laboratory analyses included thyroid hormone levels, thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase antibodies (anti-TPO), and lipid profile. Results: Active TED patients (CAS ≥ 3) had significantly higher TRAb levels (p < 0.001), while anti-TPO did not differ between groups. Active eyes showed significantly higher DCP VD in the whole image (p = 0.013), parafovea (p = 0.012), and perifovea (p = 0.009) across all quadrants, with no difference in SCP or the foveal avascular zone (FAZ). In linear mixed model regression analyses, after adjusting for previous glucocorticosteroid therapy, higher triglycerides, greater medial rectus thickness, and whole-image DCP VD independently predicted higher CAS values (R² = 42, p < 0.001). After adjusting for age and sex, CAS remained significantly positive predictor of DCP VD in the parafovea (R² = 0.22, p < 0.001). Conclusions: Changes in DCP VD reflect TED activity and structural orbital involvement.