Aim: Cirrus spectral-domain optical coherence tomography (SD-OCT) being noninvasive is gaining more popularity in identifying, monitoring, and classifying children with vitreo-retinal disorder. Normal values of cirrus SD-OCT from children are currently available from developed countries, but not from India. Objective: The primary objective of this study is to provide a normative pediatric database for macular thickness in healthy Indian children using the cirrus SD-OCT. Materials and Methods: The prospective observational study on 157 consecutive healthy children seen between January 2013 and January 2014. Included in the study were 157 subjects with no ocular abnormality, normal (20/20) visual acuity and normal fundoscopy. Cirrus HD-OCT (Carl Zeiss, Dublin, California, USA) device was used. Outcome: Study patients have a mean age of 12.59 ± 3.5 years, with 112 male (12.88 ± 3.5 years) and 45 female (11.8612.88 ± 3.5 years) children. In the linear regression analysis, changes in central subfield thickness and field of the outer macula were independently affected by increase in the age (β = −1.17-1.7, P = 0.004-0.022) and male are found to have significantly higher value when compared with the female (the t-test; t = 1.9-4.8, P = 0.00-0.24). Conclusion: This study established normal reference values for macular parameters measured by Cirrus SD-OCT in healthy Indian children 6-17 years of age, which is statistically different from the databases from other countries. It establishes the importance of the fact that age and gender warrants special consideration during cirrus SD-OCT interpretations in children.

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Purpose: The purpose was to compare between color fundus photography (CFP) images and fundus autofluorescence (FAF) images of cases with geographical atrophy (GA) about size. To evaluate the relation between different phenotypes of FAF changes and best corrected visual acuity (BCVA) in cases with late dry age-related macular degeneration (AMD) (GA). Materials and Methods: This study was conducted on 18 eyes of 18 patients aged 55 years. Patients unwilling to participate in the study, suffering from hereditary fundus diseases, had previous laser photocoagulation treatment for any cause, were excluded. BCVA using Snellen chart was measured. Retinal imaging including CFP with 50° field camera: Topcon TRC-50 IX - and FAF using spectralis Heidelberg retinal angiograph (HRA) + optical coherence tomography (HRA, Heidelberg Engineering, Germany) were done. All images were optimized and then manually measured using image analysis software (Adobe Photoshop version CS6; Inc., San Jose, California, USA). Images of fundus autofluorescence in cases of late dry AMD were classified to phenotypes at the junctional zone according to the classification of abnormal FAF patterns. Results: According to sex distribution, 33.3% (6 eyes) were males and 66.7% (12 eyes) were females . The mean age of the study participants was 72.89 ± 9.09 years. About surface area of GA, the mean surface area of GA by FAF was 71094.56 ± 21490.53 pixels and by color fundus camera were 46236.56 ± 13153.46 pixels. About FAF phenotypes in late dry AMD cases, Twelve eyes (66.7%) had diffuse pattern, 11.1% (2 eyes) had a none pattern (no specific pattern), and 22.2% (4 eyes) had focal pattern. Color fundus camera underestimated the surface area of GA in cases of late dry AMD. BCVA was best in cases with no specific pattern of autofluorescence at the junctional zone of the GA, followed by cases with focal pattern of hyperautofluorescence while cases with diffuse increases of autofluorescence at the junctional zone showed the worst VA. Conclusions: CFP underestimated the size of the GA, as compared with FAF measured sizes. BCVA was best in cases with no specific pattern of autofluorescence at the junctional zone of the GA, followed by cases with focal pattern of hyperautofluorescence while cases with diffuse increases of autofluorescence at the junctional zone showed the worst VA.

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Purpose: The aim was to evaluate visual and anatomical outcome of intravitreal bevacizumab (IVB) in eyes with macular edema (ME) due to branch retinal vein occlusion (BRVO). Methods: Retrospective, consecutive case series. Study was done on 26 eyes of 26 patients. Outcome measures include: Best corrected visual acuity (BCVA), central macular thickness (CMT) by spectral domain optical coherence tomography, and complications. Results: BCVA improved by a mean of 3.2 lines from an initial mean BCVA: 0.1 (counting fingers: 1 m-0.3) to a mean BCVA 0.4 (0.05-0.8) over the follow-up period of 6.9 months (4-12 months). CMT was reduced from an initial mean of 613 (401-959 μ) to the mean of 400 μ (274-623 μ) at the end of the follow-up period. No complications were recorded. This was achieved through a mean number of injections: Four with a range (3-6 injections). Conclusion: IVB is an effective treatment for ME secondary to BRVO. There was a significant improvement of VA and significant reduction in macular thickness in many cases, but not in all cases.

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Purpose: To evaluate the effect of intravitreal Ranibizumab on central choroidal thickness (CCT) in eyes treated for diabetic macular edema (DME). Materials and Methods: This prospective non-randomized interventional cohort study included 20 eyes of 20 diabetic patients, recruited between March 2013 and March 2014. Eyes with DME (thickness from 290 to 600 μm) underwent intravitreal injection of Ranibizumab (three consecutive injections, 1 month apart). Prior to injection, all patients had a complete ophthalmic examination, including manifest refraction, slit-lamp bio-microscopy, intraocular pressure measurement, and a detailed fundus examination. Prior to injection and 1 month from the third injection, the central macular thickness and CCT were assessed again by SD-OCT. After each injection, patients were followed to diagnose and treat any complications from injections. Results: Twenty eyes of 20 diabetic retinopathy (DR) patients, 9 females and 11 males with a mean age of 49.7 ± 4.1 years, were included. The pre-injection mean CCT was 234.35 ± 38.36 μm. In the NPDR group, it was 238.2 ± 41.36 μm; and in the PDR group, it was 228.5 ± 35.26 μm. This was not significantly different (P = 0.851). After injections, the mean CCT in all patients, in the NPRD group and in the PDR group showed a decrease to 215.5 ± 39.08, 224.9 ± 40.72 and 201.31 ± 34.02 μm, respectively (P = 0.362). There was a statistically significant difference between the pre-injection and the post-injection CCT (P < 0.001). The improvement in the CCT after treatment was not significantly correlated with the pre-injection CCT or the pre-injection CMT (P = 0.346, P = 0.096 respectively). No significant correlation was found between post-injection CCT and CMT in all patients (P = 0.436) or in the different groups separately (P = 0.191, P = 0.817, respectively). No injection-related complication was observed in either group. Conclusion: Intravitreal injection of Ranibizumab was effective in significantly decreasing the CCT as well as the CMT after three consecutive injections, 1 month apart regardless of the level of DR. Whether the number of injections can influence the amount of this reduction or not should be evaluated in future studies. No correlation was found between the reduction in CMT and that of the CCT after intravitreal injection with 0.5 mg of Ranibizumab.

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