The authors of the following Korean retrospective, observational cohort study investigated the progression rates of superior and inferior hemifield defects and each hemifield in bihemifield defects in normal-tension glaucoma (NTG) patients and compared the progression rates of each hemifield between groups in eyes with similar baseline hemifield defects.

They analyzed the medical records of 142 NTG patients who performed more than five reliable standard visual field tests with superior (group 2; n=51), inferior (group 1; n=44) or both hemifield (group 3; n=47) defects. They also inspected the changes in the mean thresholds of the 10 zones of the glaucoma hemifield test and the entire hemifield. Additionally, they used a linear mixed-effect model with age, gender, initial IOP, mean deviation and pattern standard deviation controlled.

The authors reported that there were no significant differences in age and systemic and ocular factors between groups except for female gender, which showed a significant difference among the three groups (p=.032). They also noted that the progression rate in group 2 was significantly faster than in group 1 (–0.713 dB/year versus –0.516 dB/year; p=.019), especially in central and nasal zones or than in the superior hemifield of group 3 (–0.717 dB/year versus –0.470 dB/year; p=.001). They found no significant difference in the progression rates between group 1 and the inferior hemifield in group 3 (–0.508 dB/year versus –0.441 dB/year; p=.312) or between the superior and inferior hemifields in group 3 (–0.468 dB/year versus –0.442 dB/year; p=.662).

To conclude, more careful examination and caution is required in the treatment of NTG patients with superior hemifield defect.

Researchers sought to describe the clinical effectiveness of a new imaging approach: en face spectral domain optical coherence tomography (SD-OCT) of the retinal surface before and after epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling.

They performed a retrospective analysis of preoperative and postoperative en face SD-OCT images of the inner face of the macula obtained from 20 eyes of 20 patients undergoing vitrectomy with ILM peeling for ERM.

According to the researchers, preoperatively, en face SD-OCT imaging of the retinal surface clearly showed plaques surrounded by radiating folds because of ERM. It could also disclose areas possibly devoid of ILM secondary to ERM contraction. A rough retinal surface was visible to reserachers in the peeled area during the first postoperative month. At three months, they progressively observed various amounts of dimples in 13 of 15 eyes (87%). In all of these cases, they lasted or increased in size and number at the last follow-up examination. Some residual epiretinal tissue was also detected by this technique.

En face SD-OCT of the retinal surface is an interesting complement to standard retinal OCT section that provides an easy-to-understand global overview of the retinal surface. It can detect and classify tiny progressive morphologic changes in the texture of the retinal surface occurring after ILM peeling.

Danish investigators sought to evaluate the effect of verteporfin photodynamic treatment (PDT) on choroidal thickness in patients with central serous chorioretinopathy (CSC).

They measured choroidal thickness with enhanced depth imaging–optical coherence tomography (EDI–OCT) before and after verteporfin PDT (full-dose verteporfin, half-light dose) in 16 eyes in 16 patients with serous detachment of the fovea secondary to extrafoveal angiographic fluorescein leakage. They confined treatment to the area of leakage, and assessed choroidal thickness before and after treatment over a larger area of the fundus using OCT.

The study investigators reported complete resolution of the serous detachment in all 16 eyes within one month of extrafoveal PDT, while choroidal thickness in the area where PDT was applied decreased from 407 µm [mean; 95% confidence interval (CI₉₅) 356–458 µm] to 349 µm (mean; CI₉₅ 300–399 µm; p<0.0001), and subfoveal choroidal thickness was reduced from 421 µm (mean; CI95 352–489 µm) to 346 pm (mean; CI₉₅ 278–414 µm; p=0.0001). Initially, subfoveal choroidal thickness was significantly increased in the treated eye compared with the healthy fellow eye (mean 324 µm; CI₉₅ 273–376 µm; p=0.0003), but after treatment, the difference was not significant.

PDT of active CSC was followed by choroidal thickness reduction, not only locally, but also at considerable distance from the treated area. Thus, the process that causes choroidal thickening in CSC appears to spread laterally within the choroid.