In Norway, investigators sought to analyze the topography of proliferative diabetic retinopathy (DR) and visualize the distribution of neovascularization of the optic disc (NVD) and elsewhere in the retina (NVE).

They included 174 eyes of 106 patients with early PDR in their study. The investigators converted data on the size and location of 391 NVE and 73 NVD into a database of two-dimensional retinal and optic disc charts. They then plotted the geometric centers of the neovascular lesions into corresponding areas of the charts and visualized the topographical distributions of the NVE and NVD by merging the charts and displaying the number of overlapping lesions on color-coded contour maps.

The investigators located 141 (36%) NVE in the temporal and 250 (64%) in the nasal hemisphere (p<0.001). They noted that the distribution of the NVD in the temporal and the nasal half of the optic disc was 46 (63%) and 27 (37%), respectively (p=0.03). They also reported that NVE in type 1 diabetes were located significantly farther from the fovea and optic disc and were more numerous and larger than in type 2 diabetes. Moreover, they found that the number and diameter of the NVE were also significantly higher when the time from the last examination prior to the appearance of PDR exceeded 12 months.

The majority of NVE are located inferonasal to the optic disc and along the superior vascular arcades, while NVD have a predilection for the upper temporal disc rim. More extensive PDR is found in patients with type 1 diabetes and those with examination intervals longer than one year.

Here, the optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) results of the Macular Epiretinal Brachytherapy in Treated Age-Related Macular Degeneration study are reported.

A total of 53 eyes of 53 participants with chronic, active neovascular age-related macular degeneration (AMD) requiring frequent anti-vascular endothelial growth factor (anti-VEGF) retreatment were included in this prospective, multicenter, interventional, noncontrolled clinical trial. They underwent pars plana vitrectomy with a single 24-gray dose of epimacular brachytherapy (EMB) delivered with an intraocular handheld cannula containing a strontium 90/yttrium 90 source positioned over the active lesion. Participants were retreated with ranibizumab administered monthly as needed, using predefined retreatment criteria. They underwent FFA at baseline, month 1 and month 12 and OCT at baseline and then monthly for 12 months. The FFA and OCT images were evaluated by independent, central reading facilities. Change in OCT centerpoint thickness and angiographic lesion size 12 months after EMB was the main outcome measure.

It was reported that mean centerpoint thickness increased by 50 µm, from 186 µm to 236 µm (p=0.292), but 70% of participants had an increase of less than the mean, with a median increase of only 1.8 µm. It was also noted that the FFA total lesion size increased slightly by 0.79 mm², from 14.69 to 15.48 mm² (p=0.710). Total choroidal neovascularization (CNV) area increased by 1.17 mm², from 12.94 to 14.12 mm² (p=0.556). The classic CNV area decreased substantially by 3.70 mm², from 3.90 to 0.20 mm² (p<0.01). Predominantly classic lesions showed the greatest response, with mean Early Treatment Diabetic Retinopathy Study visual acuity improving by 1.5 letters (versus −4.0 for all participants combined); mean centerpoint thickness decreased by 43 µm (p=0.875). The angiographic and OCT response did not correlate with lesion size at baseline.

To conclude, in chronic, active, neovascular AMD, EMB is associated with nonsignificant changes in centerpoint thickness and FFA total lesion size over 12 months.

Japanese investigators evaluated the association between the foveal external limiting membrane (ELM) status and visual acuity (VA) in diabetic macular edema (DME) and found that, in DME, the ELM status may be as closely related to VA as the IS/OS status.

They retrospectively reviewed the spectral domain optical coherence tomography images of 127 eyes from 127 patients with DME and evaluated the correlation between the logarithm of the minimal angle of resolution (logMAR) VA and the statuses of the foveal ELM, inner segment/outer segment (IS/OS) and cone outer segment tips (COST); foveal macular thickness (FMT); and presence or absence of hard exudates (HE), serous retinal detachment (SRD) and vitreous adhesion. They then classified the integrity of the ELM, IS/OS and COST into three categories (absent, disrupted and complete).

According to the study investigators, there was a strong correlation between VA and the statuses of the ELM (r=0.699, p<0.001), IS/OS (r=0.716, p<0.001) and COST (r=0.471, p<0.001). They found no correlation between FMT and logMAR VA (r=–0.036, p=0.687). However, when they analyzed the correlation between FMT and VA by dividing patients into those with FMT ≤250 µm and those with FMT >250 µm, there was a positive correlation between FMT and VA in eyes with FMT ≤250 μm (r=–0.601, p<0.0001) and a negative correlation in eyes with FMT>250 µm (r=0.290, p<0.01). Other factors HE, SRD and vitreous adhesion did not correlate with VA.