OPHTHALMOLOGICA update: The peer-reviewed journal of EURETINA edited by Sebastian Woolf

NEW EURETINA GUIDELINES FOR DME This issue of Ophthalmologica features the European Society of Retina Specialists’ (EURETINA) new Guidelines for the Management of Diabetic Macular Edema (DME). Among their chief recommendations is that anti-vascular endothelial growth factor (anti-VEGF) therapy should be considered as the first-line therapy for DME, rather than laser photocoagulation, which is now obsolete for the condition. The guidelines' authors note that the advent of optical coherence tomography-angiography (OCT-A) has raised the question of whether fluorescein angiography (FA) is also obsolete. They point out that FA allows a more comprehensive assessment of the extent of the morphological damage to the macular microcirculation. U Schmidt-Erfurth et al, “Guidelines for the Management of Diabetic Macular Edema by the European Society of Retina Specialists (EURETINA)”; Ophthalmologica 2017, Volume 237, Issue 4. SD-OCT FINDINGS REVEAL EARLY SIGNS OF RETINAL NEURODEGENERATION IN DIABETIC PATIENTS Patients with diabetes mellitus type 1 (DM1), but with no signs or only early signs of diabetic retinopathy, nonetheless have detectable retinal changes that may correlate with initial neurodegeneration, a new study suggests. The authors of the study obtained nine individual retinal layer thickness measurements in 76 eyes of 38 DM1 patients and 26 control eyes using a spectral domain-optical coherence tomography (SD-OCT) automated segmentation algorithm. They found that the inner nuclear layer (INL) thickness was thicker in all DM1 eyes than in the control eyes in all quadrants (p<0.050). They also found that the retinal ganglion cell layer was about 3.5% thinner in DM1 patients than in controls (p<0.050). F Scarinci et al, "Single Retinal Layer Evaluation in Patients with Type 1 Diabetes with No or Early Signs of Diabetic Retinopathy: The First Hint of Neurovascular Crosstalk Damage between Neurons and Capillaries"; Ophthalmologica 2017, Volume 237, Issue 4. GOOD REPEATABILITY AND INTER-DEVICE AGREEMENT WITH ANGIOGRAPHIC OCT Two new OCT-A devices, the AngioVue (Optovue) and AngioPlex (Zeiss), have demonstrated a low intra-device variability and a high inter-device correlation in the measurement of choriocapillaris (CC) perfusion. A study involving 36 eyes of 36 volunteers showed that the mean CC decorrelation signal index, a measure of the differences in backscattered light between sequential scans, was 104.3 with the AngioVue and 81.3 with the AngioPlex in a 3×3mm2 field, and 95.6 and 81.1, respectively, in a 6x6mm2 field. There was also a high correlation between both devices (3x3mm2: p=0.0053; 6x6mm2: p=0.0139). JL Lauermann et al, “Comparison of Choriocapillaris Flow Measurements between Two Optical Coherence Tomography Angiography Devices”; Ophthalmologica 2017, Volume 237, Issue 4.