OPHTHALMOLOGICA

Macular bending increases risk of retinal pathology

Macular bending is a common clinical feature of highly myopic eyes and is associated with a range of retinal pathologies, according to the findings of a retrospective study. Macular bending is a smooth macular elevation found in optical coherence tomography (OCT) of patients with high myopia related to either dome-shaped macula or the border of an inferior staphyloma, the study's authors noted. Their review of 330 files, comprising all of the highly myopic eyes that have undergone OCT at a single clinic over a five-year period, showed that 68 eyes of 45 patients (13.63 per cent) presented with macular bending. Among those 68 eyes 41 (60.29 per cent) had retinal pathologies, including choroidal neovascularisation, subretinal fluid and macular holes.
(Coco et al, Ophthalmologica 2012; DOI:10.1159/000336910.)

SD OCT provides objective determination of vision loss

Spectral domain optical coherence tomography (OCT) (Spectralis, Heidelberg Engineering) can reveal the morphological features most closely associated with vision loss in eyes with uveitic macular oedema, according to the results of a prospective study. The study included 71 eyes of 55 patients with uveitic macular oedema who underwent spectral domain OCT. The authors noted that logMAR bestcorrected visual acuity was 0.2 in eyes with cystoid macular oedema, 0.1 in eyes with diffuse oedema (p = 0.008). Furthermore BCVA was 0.3 in eyes with serous retinal detachment and 0.2 in eyes without SRD (p = 0.02). Moreover, BCVA was 0.4 in eyes with inner segment/outer segment (IS/OS) disruption, 0.1 in eyes with integrity of the IS/OS junction (p = 0.01).
(Iannetti et al, Ophthalmologica 2012; DOI:10.1159/000337234.)

Mean foveal thickness

Cataract surgery appears to increase mean foveal thickness in most patients but the increase persists longer in eyes of patients with diabetes and eyes with epiretinal membranes, a new study suggests. The study included a total of 202 eyes of consecutive patients who underwent cataract surgery between November 2007 and June 2009. The researchers found that mean foveal thickness values were significantly higher at the first and third postoperative month than preoperatively (p < 0.01) in all groups, that is, in historyfree patients, patients with diabetes mellitus without macular involvement at baseline, patients with glaucoma, and in patients with epiretinal membrane. However, by six months' follow-up the mean foveal thickness remained elevated only in patients with diabetes and epiretinal membranes. Visual outcomes appeared to be unaffected by the increases in foveal thickness observed in the study, the authors added. 
(Tsilimbaris et al, Ophthalmologica 2012; DOI:10.1159/000336908.)

Optic disc drusen

Careful ophthalmoscopic examination of the morphological features of eyes with retinal pathology can help distinguish between optic disc drusen and papilloedema, according to the findings of a new study. The study's authors compared 100 eyes of 55 patients with confirmed optic disc drusen with 100 eyes of 60 patients presenting for differential diagnosis. Comparison of eyes with hidden optic disc drusen with eyes having papilloedema showed statistically significant differences in blurred edges, disc elevation, absence of optic disc cupping, altered colour, anomalous vascular branching and optic disc haemorrhages (p < 0.005), the study's authors noted.
(Flores-Rodríguez et al, Ophthalmologica 2012; DOI:10.1159/000337842.)