e-Abstracts 2025
All accepted abstracts are avalaible here below. Click on the icon to view the abstract.

Purpose :
To present the performances of various machine learning models to detect drusens using a novel hyperspectral eye fundus camera.
 

Materials and Methods :
An exploratory trial aiming at validating the feasibility of recording hyperspectral images of the retina and investigate its interest in several ophthalmological conditions. The clinical trial has taken place at Sundets Ögonläkare, Helsingborg (Sweden). 
 
A patented snapshot hyperspectral camera mounted on top of a TRC 50-IX fundus camera was used to record the retina of patients at Sundets Ögonläkare, Helsingborg (Sweden). The camera provides images at a 30x30 degree field of view of the retina with 150 x150 pixels and 12nm spectral resolution sampled at 7nm in the 450-700nm spectral band thus providing 36 different spectral channels.
 
10 eyes with drusen and 8 healthy eyes were used for this study. The drusen were identified using both color fundus imaging and OCT scans.
 
The spectrum of each drusen were fed into several machine learning models:
Linear Discriminant analysis (LDA), Support vector mode (SVM), Cat Boost.
 
The following metrics were used for comparing the algorithms with a 4 fold cross validation: Area under the curve, accuracy, specificity.
 

Results :
Catboost: AUC 0.81, accuracy 0.81, specificity 0.92
LDA: AUC 0.75 accuracy 0.74, specificity 0.97

SVM: AUC 0.77 accuracy 0.76, specificity 0.98

 

Conclusions :
SVM had the highest specifity of the tested models although all had specificity abov 0.9
 

Drusen prediction of the CATBOOST , LDA and SVM model for 3 retina. Both the probability and laber maps are shown

Purpose :
Artificial intelligence as a medical device (AIaMD) has the potential to transform ophthalmic care. Robust clinical evaluation is essential to ensure safety and effectiveness, but evidence requirements to support regulatory approval are less transparent compared to established interventions such as drugs. This scoping review aims to identify regulator-approved ophthalmic imaging AIaMDs in Europe, Australia, and the USA, examine their characteristics and regulatory approvals, and evaluate the available clinical evidence underpinning them, as a first step towards identifying best practice and areas for improvement.

Materials and Methods :
FDA (USA), ARTG (Australia), and EUDAMED (EU) regulatory databases were searched. For each eligible AIaMD, studies investigating clinical effectiveness were identified through a systematic literature search on PubMed and supplemented by contacting manufacturers. Characteristics of the AIaMDs, their regulatory approvals, and peer-reviewed clinical evaluation studies were extracted.

Results :
36 AIaMDs from 28 manufacturers were identified, with 97% approved in the EU, 22% in Australia, and 8% in the USA. Deep learning models predominated (29/36,81%). All AIaMDs focused on the posterior segment, with most targeting diabetic retinopathy detection (36%,13/36). 19% (7/36) did not have published evidence describing performance. For the remainder, 131 clinical evaluation studies (range 1-22 per AIaMD) describing 192 datasets/cohorts were identified. Demographics were poorly reported (age recorded in 52%, sex 51%, ethnicity 21%). On a study-level, few included head-to-head comparisons against other AIaMDs (8%,10/131) or humans (22%, 29/131), and 37% (49/131) were conducted independently of the manufacturer. Only 11 studies (8%) were interventional. 

Conclusions :
There is scope for expanding AIaMD applications to other conditions and use cases. Facilitating greater transparency from manufacturers is key in building trust among stakeholder groups, as is considering incentives (regulatory, financial, or reputational) to support evidence generation for real-world deployment. More transparent dataset reporting, validation across diverse populations, and high-quality interventional studies with implementation-focused outcomes are needed to support clinical integration. 

ask(s) performed by commercially available ophthalmic imaging AIaMDs - all focusing on the posterior segment

Regulatory approvals for ophthalmic imaging AIaMDs across three jurisdictions.

Purpose :
The primary objective was to analyze the choroid in diabetic patients recently treated with
intravitreal injections for macular edema, compared to untreated diabetic patients. The
secondary objective was to assess the performance of an automated choroidal analysis in real-
world clinical practice.

Materials and Methods :


Results :
When comparing 40 eyes treated with intravitreal injections (mean age 65.7 years) to 35 eyes
that were never treated (mean age 69.4 years), no statistically significant differences were found
in thickness (p = 0.26), area (p = 0.32), vascular index (p = 0.45), or vessel area (p = 0.41). In
real-world clinical practice, when acquiring OCT EDI images of acceptable quality in a busy
diabetic ophthalmology clinic, Choroidalyzer provided reliable values for 54.7% of the eyes
analyzed (75/137 eyes).

Conclusions :
No statistically significant differences were observed between treated and untreated diabetic
patients in terms of the four choroidal parameters evaluated (thickness, area, vascular index,
and vessel area), although the sample size was small. A larger study is necessary to further
investigate the potential choroidal effects of intravitreal injections in diabetic patients.

Purpose :
This study aims to evaluate the frequency of vitreomacular interface( VMI ) abnormalities in diabetic macular edema (DME), their impact on treatment response to intravitreal injections of bevacizumab(IVB), and the evolution of these abnormalities during treatment.

Materials and Methods :
We conducted cross-sectional study  on patients with DME managed at the Ophthalmology Department of Habib Bourguiba University Hospital in Sfax during 3 years . Included were all diabetic patients with OCT-confirmed DME who received at least three IVB. All patients underwent a complete ophthalmologic examination, including qualitative and quantitative analysis of OCT reports before and after the intravitreal injections.

 

Results :
We included 71 eyes from 47 patients, with an average of 5.83 ± 3.38 intravitreal bevacizumab injections. Table 1 reports the changes in the VMI in diabetic eyes before and after IVB.Cataract surgery was identified as a significant risk factor for the development of VMI abnormalities (p = 0.007).
 These changes in the VMI  were significantly associated with a longer duration of diabetes (p = 0.028), a higher number of IVB (p = 0.047), and a longer time interval between the first and last injection (p = 0.008).
Functionally, IVB  were not effective in eyes with epiretinal membranes or vitreomacular traction, with p-values of 0.57 and 0.59, respectively.



 

Conclusions :
VMI  abnormalities are common in diabetics and can affect the response to intravitreal anti-VEGF injections for DME. These injections can lead to changes such as posterior vitreous detachment, resolution of vitreomacular traction, and the development of epiretinal membranes.

Table1 : Qualitative analysis of the VMI before and after IVB

Purpose :
Premacular subhyaloid hemorrhage is a retinal condition that can lead to sudden, painless visual loss. ND:YAG laser posterior hyaloidotomy (NYLH) offers a minimally invasive treatment option. This study evaluates the efficacy of NYLH in two patients with subhyaloid hemorrhage involving the macular area, using fundus photography and optical coherence tomography (OCT).

Materials and Methods :
The first case involves a 53-year-old male with a history of hypertension and type II diabetes, but no prior ophthalmologic pathology. He presented with painless visual blurring in the left eye, starting five days earlier. Fundoscopic examination revealed proliferative diabetic retinopathy (PDR) in both eyes and a premacular subhyaloid hemorrhage in the left eye. He underwent panretinal photocoagulation (PRP), followed by NYLH to facilitate drainage of the hemorrhage into the vitreous cavity. The second case concerns a 42-year-old male with no significant medical history, who presented within hours of sudden visual loss in the right eye following intense coughing. Fundus examination confirmed a premacular subhyaloid hemorrhage, and NYLH was performed the same day.

Results :
In Case 1, PRP effectively managed the PDR. However, no drainage of the hemorrhage occurred following NYLH. Although vitrectomy was initially planned, follow-up at two months showed spontaneous resolution on OCT and marked improvement in visual acuity.
In Case 2, gradual visual improvement was noted post-procedure, with OCT confirming hemorrhage clearance.

Conclusions :
ND:YAG laser posterior hyaloidotomy is generally a safe and effective treatment for premacular subhyaloid hemorrhage. However, therapeutic outcomes depend on timing and hemorrhage density. While visual recovery is often rapid, not all cases benefit directly from NYLH. Spontaneous resolution may still occur.

Purpose :
To describe a case of acute diabetic macular edema following intensive insulin therapy, highlighting the role of rapid glycemic correction in triggering transient macular edema and underlining the need for ophthalmologic monitoring in high-risk patients.

Materials and Methods :
We report the case of a 39-year-old woman with a history of poorly controlled gestational diabetes (HbA1c = 12%), who was admitted to the intensive care unit for diabetic ketoacidosis secondary to sepsis. She received intravenous insulin and antibiotic therapy, achieving rapid glycemic control within 48 hours. Two days later, she developed rapidly progressive bilateral blurred vision. The patient had a complete ophthalmological examination, an optical coherence tomography and a retinal fluorescein angiography. 

Results :
Ophthalmological examination found a best-corrected visual acuity reduced to 1/10 in both eyes. Fundus examination showed a dull foveal reflex and signs of severe non-proliferative diabetic retinopathy, which was confirmed by fluorescein angiography in both eyes. Optical coherence tomography revealed bilateral cystoid macular edema associated with serous retinal detachment. Due to contraindications to anti-VEGF therapy, a conservative approach with close observation was chosen. The patient’s vision improved spontaneously over the following two weeks, with best-corrected visual acuity returning to 10/10 bilaterally. Follow-up optical coherence tomography demonstrated complete resolution of the macular edema and serous retinal detachment.

Conclusions :
This case highlights that intensive insulin therapy, especially in patients with poorly controlled blood glucose levels, may precipitate acute diabetic macular edema. Although spontaneous resolution can occur, vigilant ophthalmologic follow-up is essential to detect and manage such complications promptly. Further studies are warranted to define optimal strategies for preventing and managing diabetic macular edema in the context of rapid glycemic normalization.

Purpose :
The aim of this study is to describe ophthalmological care of adults with diabetes in France and its evolution between 2010 and 2022.

Materials and Methods :
 In this study, we used the ESND, a representative permanent random sample of 2/100th of the entire French population. Ophthalmological care was defined by the combination of ophthalmological procedures (fundus examination, color fundus photography, Optical Coherence Tomography..) and/or ophthalmological treatment (intravitreal injection or laser treatment) during the year. Changes in annual rates during the study period were assessed using linear regression models excluding 2020.

Results :
From 2010 to 2022, the number of adults treated for diabetes in the ENSD increased from 48 329 patients (mean age 65.3 ±13.0, 46.3% women) to 68 397 patients (mean age 67.0±13.2, 44.8% women). Among them, the annual rate of ophthalmological care was stable (46.5% in 2010 and 48.5% in 2022) and the difference was not significant (β = 0.10% per year, p=0.11). The yearly ophthalmological treatment rate increased significantly (3.3% in 2010 and 5.3% in 2022, β= 0.2% per year, p <0.0001).  Rates were lower during the COVID-19 outbreak in 2020.Women, individuals aged between 66-80 years, those living in the least deprived areas and those treated with combined insulin and non-insulin treatment had higher yearly ophthalmological care rate.

Conclusions :
In this large nationwide representative study with recent and updated data, although ophthalmological treatment rate has increased over the decade mainly due to intravitreal injections, less than half of the diabetic patients receive yearly ophthalmological care.

Yearly rates of ophthalmological treatment, ophthalmological exams and ophthalmological care (treatment and/or exams), in adults treated for diabetes in France (ESND database, 2010–2022)

Rates of yearly ophthalmological treatment by intravitreal injections (IVI) of Ranibizumab, Aflibercept, Dexamethasone implant and Triamcinolone, in adults treated for diabetes in France (ESND database, 2010–2022)

Purpose :
Évaluer les résultats anatomiques et fonctionnels du protocole « 3+PRN » pour l’œdème maculaire diabétique (OMD), identifier les facteurs prédictifs d’une acuité visuelle améliorée et comparer son efficacité avec d’autres approches thérapeutiques.

Materials and Methods :
Nous avons mené une étude transversale rétrospective, descriptive et comparative auprès de patients atteints d'OMD traités au HTSM. Tous les patients ont reçu trois injections intravitréennes (IVT) mensuelles initiales de 1,25 mg de bévacizumab, suivies d'un traitement au prorata (PRN) pendant trois ans. Le suivi a été mensuel pendant les trois premiers mois, puis progressivement espacé. Des injections supplémentaires ont été administrées en cas d'aggravation de l'OMD.

Results :
Cinquante -deux patients ont été inclus, avec un âge moyen de 65 ans. Le diabète de type 2 était le plus fréquent. La durée moyenne du traitement PRN était de 6 mois, avec une moyenne de 6 injections. L'acuité visuelle (AV) s'est améliorée de 1/10 à l'inclusion à 3/10 à la fin du suivi. Un gain de plus de cinq lettres a été observé dans 77,6 % des cas. L'épaisseur maculaire centrale (ÉMC) a diminué de 451,5 µm à 298,5 µm. L'épaisseur choroïdienne sous-fovéale a diminué de 304,2 µm à 284,5 µm. L'amélioration de l'AV était significativement associée à une réduction de l'ÉMC (p < 0,05), à une membrane limitante externe intacte et à une zone ellipsoïdale (p = 0,04) et à l'absence de décollement séreux de la rétine (p < 0,001). Le décollement postérieur du vitré était fréquent mais n'influençait pas significativement l'AV finale.

Conclusions :
Le protocole 3+PRN est efficace dans l'OMD, tant sur le plan fonctionnel qu'anatomique. Des biomarqueurs OCT spécifiques pourraient contribuer à prédire de meilleurs résultats, mais des recherches supplémentaires sont nécessaires pour confirmer ces associations.

Purpose :
The EviRed project aims to develop a tool to improve the prediction of diabetic retinopathy (DR) complications by integrating multiple imaging modalities, including ultra wide-field (UWF) fundus photographs. As part of the EviRed project, this study focuses on comparing the assessment of neovascularization and DR severity using two UWF imaging systems: Optos (Optos, Dunfermline, Scotland) and Clarus (Carl Zeiss Meditec). The objective was to evaluate their ability to detect neovascularization and assess DR severity.
 

Materials and Methods :
This study included 1,366 patients and 3,493 visits, with images acquired between December 2020 and April 2024 across 14 centers in France. Patients with type 1 and type 2 diabetes underwent UWF imaging with both devices.  Each image was independently graded at the EviRed Reading Center by two trained graders, followed by validation by a supergrader. Grading included assessments of image quality, neovascularization presence, and DR stage.
 

Results :
In 92.4% of visits, there was no significant difference in neovascularization grading between the two devices. The most frequent discrepancy was: neovascularization absent with Clarus and present in the 7 ETDRS fields with Optos.
Regarding DR severity within the seven ETDRS fields, 34,9% of visits showed disagreement in supergrading. The most frequent discrepancy was moderate non-proliferative diabetic retinopathy (NPDR) with Optos and severe NPDR with Clarus.
Disagreements were more pronounced in medium-quality images.
 

Conclusions :
Our findings reveal variability in neovascularization and DR grading between the two UWF imaging systems, even within the seven ETDRS fields. Both image quality and field of view significantly impact the detection of neovascularization and DR grading. Cross-validation between imaging technologies is needed to improve diagnostic consistency and clinicians must be aware of each modality’s limitations to avoid missing critical signs of neovascularization.
 

Purpose :
Définir la prévalence de la maculopathie diabétique(MD) dans la population de Rabat-Salé-Zemmour-Zaer et explorer l’association entre la prévalence de la MD et les FDR du diabète

Materials and Methods :

¨Etude prospective, 602 patients âgés de plus de 20 ans connus diabétiques qui ont bénéficié d’un dépistage de la rétinopathie diabétique (y compris la maculopathie diabetique), service d’ophtalmologie B de l’hôpital des spécialités de Rabat. La saisie et l’analyse des données ont été réalisées à l’aide du logiciel SPSS
¨ Pour identifier les facteurs de risques associes avec la survenue de la maculopathie diabétique chez notre population nous avons effectue une analyse univariée puis une analyse multivariée par une régression logistique et nous avons calculé les rapports de cotes, les intervalles de confiance a 95%
 

Results :
L’âge moyen de nos patients était de 58,5 ± 12 ans .73% étaient des femmes .
86,4% étaient des diabétiques du type2 et 13,6% étaient des diabétiques du type1.
 La durée moyenne connue du diabète était de 10,20 ± 7,2 ans.
La valeur moyenne de la glycémie à jeun était de 1,91 g/dl ± 0,82 et celle de l’Hémoglobine A1c: 9,62% ±2,53% 
la survenue de la MD a été statiquement associée avec l’ ancienneté du diabète, l’HTA et la sevérité de la RD  .
Ainsi ,les patients sous ADO avaient  moins de risque de développer une MD par rapport aux patients insulino-traités. le contrôle des FDR est la base du traitement de la MD.Les injections en série des anti-VEGF constituent le traitement de première intention de l'OMD.Le laser focal/grille

Conclusions :
La prévalence de la MD est de 10.2 % des patients diabétiques dans la région de Rabat Sale Zemmour Zaer. Les facteurs de risque associes avec la survenue de MD dans notre contexte étaient l’ancienneté du diabète et l’hypertension artérielle. Sa diminution passe par la sensibilisation de la population diabétique. 
 

Purpose :
Managing sight-threatening macular pathology in pregnant or breastfeeding women can be challenging – intravitreal anti-VEGF injections are controversial due to lack of data on systemic effects on mother and child, although systemic comorbidities may play a more prominent role in obstetric risks. There are no established guidelines on counselling and managing these women. This survey aims to investigate UK ophthalmologists’ practice patterns and perspectives.

Materials and Methods :
A survey developed with a panel of retinal and obstetric medicine specialists was disseminated to UK-based consultant ophthalmologists via the Royal College of Ophthalmologists. Demographic data, experience, perspectives and perceived risks on anti-VEGF treatment and dye-based imaging in this population were collated.

Results :
Seventy-seven eligible responses were evaluated. Slightly more respondents were male(51.9%), with an even mix of experience levels and representation across the UK. Medical retina specialists predominated(64.0%). 
Few respondents had a departmental protocol for intravitreal anti-VEGF injections in women of childbearing age (14.3%), pregnant (13%), or breastfeeding women (6.5%). Few (14.3%) had access to a multidisciplinary team to discuss pregnant patients who might potentially benefit from anti-VEGF, even as most ophthalmologists(83.2%) lacked confidence in management, citing uncertain systemic effects and limited experience as key barriers to offering treatment. As a result, most favoured monitoring (41.6%) or considering alternatives (83.1%), despite anti-VEGF being the only option for pathologies such as macular neovascularization. 
Most would not offer fluorescein angiography to pregnant women (70.1%) even if clinically indicated without suitable alternatives, citing lack of safety data/experience and medicolegal concerns as primary drivers. Hesitancy was greater for indocyanine green angiography (81.8% pregnancy, 66.2% breastfeeding).

Conclusions :
Most clinicians were uncertain about managing sight-threatening macular pathology in pregnant and breastfeeding women, potentially leading to undertreatment. Practice patterns and perspectives diverged from the limited available data. This survey will inform future research supporting the development of consensus guidelines for this underserved group.

Purpose :
To evaluate parameters evolution along time for patients with non neovascular age-related macular degeneration

Materials and Methods :
A retrospective, observational, mono-center, study enrolled a total of 159 eyes. Only eyes (66) with a follow-up of more than 6 months are included. Only patients who have never had intravitreal injections of anti-VEGF or anti-inflammatory drugs, homo or contralateral, are included. The main measures are best corrected visual acuity (BCVAL ETDRS letters), type of geographic atrophy (GA), GA size, different types of configuration, localisation, fundus autofluorescence, foveal macular thickness values, from the ETDRS protocol grille (EPG). Choroidal central thickness (CCT) was also recorded. Atrophic area (AA) values are also measured with the Heidelberg RegionFinder application. 

Results :
22 (70.97%) women and 9 (29.03%) men are included. Mean age is 77 (± 8) years. 32 (48.48%) right eyes and 34 (51.52%) left eyes are included. Mean follow-up is 4.9 (± 3.4) years (range 1-13). BCVAL decrease between baseline (66 ± 16) and final test (48 ± 22) (p value <0.001). CMT in the first ring (CMT1) of EPG decrease also from 240 to 224 microns from the first to the last control respectively (p = 0.35). But CCT decreases significantly from 183 to 160 microns from the first to the last control respectively (p < 0.001). AA values increase from 3.59 to 9.39 microns2 (p < 0.01). Extra-foveal localisation of AA between first and last control decrease from 30.3 % to 13.64%, but foveal localisation increase respectively from 19.7% to 36.36% (p < 0.01). Kaplan Meier curve for BCVA lower than 20/100 gives a median survival time of 76 months. 

Conclusions :
BCVA is age, AA, CMT1 dependent. These results indicates there is multiples pathways leading to GA.

Purpose :
Disease-slowing therapies are available in the U.S. for dry age-related macular degeneration (dAMD). The risk-benefit ratio and reimbursement models of these therapies are under debate. The aim of this study is to identify patients in Europe that might benefit most from novel dAMD therapies. To this purpose, we performed a semi-automated, artificial-intelligence-based analysis of the regional growth in one of the most extensive long-term cohorts of geographic atrophy (GA) in Scandinavia.

Materials and Methods :
Prospective, single-centre, observational study, was conducted between 02/2013 - 09/2024 at the Department of Clinical Neuroscience, Karolinska Institute, Stockholm and at St. Erik Eye Hospital, Solna, Sweden. Patient charts with GA in dAMD with at least one follow-up visit (FU) with 30° fundus autofluorescence (FAF) imaging were included. A custom developed Matlab algorithm was used to calculate total area as well as regional growth in anatomical quadrants defined as: nasal (N), inferior (I), temporal (T), superior (S). Left eye images were flipped to right eye format to be consistent with anatomy.

Results :
Images of 126 eyes (87 patients) were included and processed by the algorithm. The mean GA area at baseline (BL) was 10.39±7.02mm2 and at the participants’ last FU (LFU) 13.88 ±8.36mm2. The median follow-up period of the included eyes was 20.5 months (interquartile range, IQR=28.5 months). The total growth rate (GR) between BL and LFU was 1.63 ±0.95mm2/yr, square-root transformed GR (sqrtGR) 0.25 ±0.13mm/yr. The sectoral growth was fastest for the superior and inferior quadrants (S: GR=0.43mm2/yr, sqrtGR=0.11mm/yr; I: GR=0.41mm2/yr, sqrtGR=0.13mm/yr). The Friedman test did not show statistically significant differences in GR and sqrtGR between the quadrants (all p>0.05).

Conclusions :
In our long-term cohort, GA lesions seem to expand concentrically as the regional growth rates were not significantly different. Still, this is clinically relevant, especially in patients with a GA lesion outside the fovea.

Purpose :
To report a case of congenital achromatospia revealed by outer foveal defects and associated to a macula bombee. 

Materials and Methods :
We report the case of a 40-year-old female patient, with a history of parental consanguinity. She had mild intellectual disability, hearing loss and severe myopia. The patient underwent corneal refractive surgery one year ago with no improvement in vision. She presented with diurnal visual discomfort and photophobia. Complete ophthalmological examination and multimodal retinal imaging including fundus autofluorescence, optical coherence tomography (OCT) and OCT- angiography (OCTA) were performed. 

Results :
Best-corrected visual acuity was limited to 1/20 in both eyes. Anterior segment was unremarkable. Fundus examination revealed a tesselated fundus with papillary dysversion and nasal staphyloma in both eyes. Fundus autofluoresence showed an attenuation of the physiological foveal hypoautofluorescence. Swept-source OCT of both eyes showed a macula bombee, choroidal pachyvessels and well-limited defects of the outer retina with focal loss of the photoreceptors layer, and an intact pigment epithelium and outer limiting membrane. OCTA showed no perifoveolar vascular anomalies. An Ishihara test was performed. It revealed a color vision deficiency and allowed to make the diagnosis of congenital achromatopsia associated to a macula bombee. 

Conclusions :
Achromatopsia is a cause of hereditary congenital visual impairment. Diagnosis is based on a combination of anamnestic, clinical and imaging findings. This diagnosis should be on the list of the differential diagnoses of focal disruptions of the photoreceptors layer in addition to other macular dystrophies including traumatic, toxic and idiopathic etiologies. Color vision tests should be carried out when in doubt to help guide the diagnosis.

Purpose :
To report the value of wield field angiography (WFA) in familial exudative vitreoretinopathy (FEVR).  

Materials and Methods :
A case report 

Results :
An 18-year-old girl with negative family history was presented with bilateral reduced visual acuity since a very young age. On examination, horizontal nystagmus was noted. Her best corrected visual acuity was 20/100 in the right eye (OD)and 20/125 in the left eye (OS). Anterior segment and intraocular pressure were unremarkable in both eyes. Fundus examination showed temporal dragged disc, dull macular reflex and temporal macular traction in OD, and dragged retinal vessels, macular heterotopy and temporal areas of pigmentation and fibrosis in OS. Fluorescein angiography revealed macular leakage in both eyes (OU) with retinal ischemia in the infero-temporal area without evidence of neovascularization in OD, and optic disk leakage with extended ischemia and neovascularization in OS. OCT showed diminished foveal contour in OU with retinal thickening followed by retinal atrophy in the area of the pigmented lesion in OS. She underwent WFA that showed peripheral retinal neovascularization in OU for which we performed localized pan retinal photocoagulation.  

Conclusions :
Familial exudative vitreoretinopathy is a rare disorder characterized by avascular peripheral retina. Fluorescein angiography and most importantly WFA is crucial in the diagnosis and management of FEVR.

Purpose :
To report a case of Gardner syndrome on optical coherence tomography (OCT). 

Materials and Methods :
A case report 

Results :
A 16-year-old male with no significant medical or ophthalmologic history presented for a routine eye exam. Best-corrected visual acuity was 20/20 in both eyes. Fundus examination revealed multiple bilateral pigmented retinal lesions with irregular borders and depigmented « fish tail- like » edges suggestive of congenital hypertrophy of the retinal pigment epithelium (CHRPE). Spectral-domain OCT revealed multiple flat, hyperreflective lesions at the level of the retinal pigment epithelium, with overlying photoreceptor disruption and no associated subretinal fluid corresponding to the clinically observed CHRPE plaques.  OCT angiography confirmed the absence of abnormal vascular networks or flow voids in the surrounding retina or choriocapillaris confirming their avascular nature. 

Conclusions :
This case emphasizes the diagnostic value of OCT in detecting retinal markers suggestive of systemic disease. In particular, multiple bilateral CHRPE lesions with typical OCT features should prompt consideration of Gardner syndrome, enabling early diagnosis and preventive management of colorectal cancer.

Purpose :
To report multimodal imaging in fundus albipunctatus (FA)


Materials and Methods :
Observational case series of 3 patients who underwent clinical examinations including optical coherence tomography (OCT) and fundus autofluorescence (FAF). 

Results :
Fundus examination revealed bilateral numerous small, yellow-white punctate lesions distributed throughout the retina. OCT demonstrated multiple hyperreflective deposits at the level of the retinal pigment epithelium, consistent with "retinal flecks." These deposits exhibited a characteristic sawtooth pattern, generating a choroidal artifact that resembled a "barcode-like" signal. FAF imaging revealed numerous diffuse, punctate hyperautofluorescent lesions, predominantly in the equatorial retina, with sparing of the central foveal autofluorescence. 

Conclusions :
Multimodal imaging, including fundus photography and spectral-domain OCT plays a crucial role with characteristic findings in the diagnosis of FA.

Purpose :
Macular neovascularization (MNV) is a rare complication in recessive Stargardt Disease (STGD1). STGD1 is also an important consideration in the differential diagnosis of Age-related Macular Degeneration (AMD).
We report an elderly patient with MNV associated with Late-onset STGD1, who was treated with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) in both eyes.

Materials and Methods :
A 66-year-old man presented in our office for decreased vision in his right eye due to a hemorrhagic detachment of the macula from a MNV. STGD1 was clinically suspected on the basis of central atrophy in the macula, pisciform retinal flecks, and sparing of the peripapillary area.
Later, a new macular hemorrhage was recorded in the left eye at age 75. Retinal findings and MNV were assessed with a multimodal imaging approach, including quantitative fundus autofluorescence (qAF) and swept-source optical coherence tomography angiography (SS-OCTA).

Results :
His best corrected visual acuity (BCVA) at presentation was 20/20 in the left eye. qAF imaging highlighted hyperautofluorescent retinal flecks and low qAF levels due to atrophy in both eyes, before the molecular diagnostic report confirmed two pathogenic mutations in the ABCA4 gene.
A small ridge of CNV was detected by SS-OCTA, between two lobules of atrophy. This MNV was treated with several intravitreal injections of anti-VEGF medication in a prolonged treat & extend schedule.
However, a six-month follow-up recorded a BCVA of 20/200 from a subfoveal MNV in this eye.

Conclusions :
By a wise use of diagnostic studies, the real identity of this AMD masquerader can be revealed. The quantification of fundus autofluorescence can be used to guide clinical diagnosis and genetic testing in ABC4A-related diseases and define genotype/phenotype correlations. OCTA also allows for differentiation between RPE atrophy secondary to STGD1 versus AMD. Late-onset STGD1 might increase susceptibility to AMD-like features over the years.

Retinography at presentation : BCVA 20200 right eye and BCVA 20/25 left eye

SS-OCT Angiography depicted a type 1 macular neovascularization between two lobules of atrophy

Purpose :
To present imaging findings of a congenital retinal macrovessel (CRM) in an asymptomatic patient.

Materials and Methods :
A complete clinical examination was performed, including fundus autofluorescence, swept-source optical coherence tomography (SS-OCT), and cross-sectional OCT angiography (OCT-A).

Results :
A 57-year-old woman with history of central serous chorioretinopathy (CSC) in the right eye (RE) presented for a routine ophthalmic evaluation. On examination, best corrected visual acuity was 10/10 in both eyes. Anterior segment exam was unremarkable. Dilated fundoscopy of the RE revealed an aberrant large retinal vessel crossing the macula and drained in the inferotemporal vein, with numerous tributaries crossing the horizontal raphe and bypassing the fovea. Fundus examination of the left eye was unremarkable. Fundus autofluorescence (FAF) clearly visualized the CRM crossing the macula. Moreover, we noted patchy areas of hyperautofluorescence, consistent with the pachychoroid disease alterations. Structural SS-OCT of the RE revealed a normal foveal contour with a hyperreflective tubular structure in the parafoveal edges reaching up to the inner nuclear layer with a back shadowing, corresponding to the aberrant vessel. Moreover, we noted the presence of pachychoroid disease signs such as choroidal pachyvessels associated with retinal pigment epithelium irregularities and outer retinal layers alterations, consistent with sequelae of CSC. Cross-sectional OCT-A highlighted the presence of high-flow within the hyperreflective lesions aforementioned, confirming its vascular nature. 

Conclusions :
CRMs have been reported in association with various ocular conditions, including branch retinal artery occlusion, macroaneurysms, telangiectasia, macular hemorrhage, and cavernous hemangiomas. Multimodal imaging, including OCT-A, plays a crucial role in diagnosing CRMs and assessing any associated changes or complications over time. 

Purpose :
To report and characterize clinical and multimodal imaging findings of a case of focal choroidal excavation (FCE) associated to pachychoroid neovascularization (PNV) as well as to evaluate choroidal vascular patterns in this disease.

Materials and Methods :
A complete clinical examination was performed including swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCT-A).

Results :
A 47-year-old male patient with no medical history, presented with progressive painless blurred vision in the right eye (RE). Best-corrected visual acuity was 7/10 in the RE and 10/10 in the left eye (LE). Anterior segment examination was unremarkable. On fundus examination, we noted areas of pigmentary changes in the macular area of the RE. SS-OCT highlighted the presence of a choroidal concavity corresponding to a perifoveal FCE, associated to two choroidal pachyvessels bridging the bottom of the excavation with an increased subfoveal choroidal thickness and thinning of choriocapillaris layer. We also noted a shallow irregular retinal pigmented epithelium detachment running along the concavity, corresponding to type 1 choroidal neovascularization, confirmed on dye angiographies and SS-OCT-Angiography. Non-conforming cone-shaped foveal FCE associated to PNV was diagnosed.

Conclusions :
Although the exact pathogenesis of FCE remains unclear, this case report describes a well-defined pachychoroid features in an eye with FCE associated to choroidal neovascularization. Multimodal imaging can be of great help in vascular-structural correlation in FCE cases, allowing a better understanding of the underlying pathophysiogenic process.

Purpose :
To describe the long-term natural history of non-neovascular pigment epithelial detachments (nnPEDs), by comparing the multimodal imaging features of either serous or drusenoid PEDs (SPED and DPED) in patients with age-related macular degeneration.
 

Materials and Methods :
Eyes with nnPEDs > 700 μm in width and a height > 150 μm on spectral domain optical coherence tomography (SD-OCT), with at least 12 months follow up, were included. SPED and DPED were distinguished. SD-OCT qualitative and quantitative variables were compared at baseline, at the time of maximal PED height, and at the final visit.
 

Results :
Forty-seven eyes of 31 patients were followed during 69 ± 35 months (mean age 68 ± 7.2 years): 27 eyes in the DPED group and 20 eyes in the SPED group. There was no significant difference between the two groups neither in the qualitative analysis, nor in the evolution over time toward geographic atrophy, that appeared in 10 (50%) eyes with SPEDs and in 11 (41%) eyes with DPEDs (p=0.46) and toward fibrosis that appeared in 4 (20%) eyes with SPEDs and in 3 (11%) eyes with DPEDs (p=0.68).
SPEDs were significantly higher and wider than DPEDs at the maximal PED height visit (p=0.007 and p=0.023 respectively). More apertures (p=0.007) and lateral subretinal fluid (p=0.008) were observed in SPEDs. Apertures are sharply demarked round discontinuities of the PED, while tears are discontinuities at the base of the PED.
 

Conclusions :
This analysis of large nnPED revealed that large PEDs pose a high risk of complications regardless of their nature.
 

Multimodal imaging of a patient with a serous non-neovascular pigment epithelial detachment (SPED) (upper panel) and a drusenoid non-neovascular pigment epithelial detachment (DPED) (lower panel).

Eight years follow-up on spectral domain optical coherence tomography on the same B-scan level of a patient with a serous non-neovascular pigment epithelial detachment (PED) (upper panel) and a heterogenous drusenoid non-neovascular PED (lower panel)

Purpose :
To report the sensitivity and ability of different swept source optical coherence tomography angiography (SS-OCTA) to detect neovascularization when a significant pigment epithelium detachment (PED) is present in the setting of neovascular age related macular degeneration (nAMD).

Materials and Methods :
We inclued eyes with either treatment-naive or previously treated type 1 MNV which had PEDs higher than 250 microns. Two SS-OCTA devices were used, PlexElite 9000 (Carl Zeiss Meditec, Inc., Dublin, CA, USA) and BMiZar (TowardPi Medical Technology, Beijing, China), images were analysed by two senior retina specialists using the automatic slabs alone versus manual segmentation slabs. We divided our results in four groups: Plexelite with automated slabs and manual slabs (Group1,2), BMizar with automated slabs and manual slabs (Group3,4) A global comparison between the groups was made, followed by an analysis of variables associated with (un)detectability for each OCTA device.

Results :
A total of 16 eyes of 12 patients were included (4 men and 8 women), aged from 54 years to 88 years (mean:75.5 +/- 10.6). The mean PED height was 410 microns +/- 157. SS-OCTA was able to show abnormal blood flow suggestive of type 1 MNV in group 1 for 18% of the eyes, 87% in group 2, 75% in group 3 and 81% in group 4.

Conclusions :
The sensitivity of the two SS-OCTA devices to detect an abnormal blood flow in Type 1 MNV, when the PED height is above 250 microns, was significantly lower with automatic segmentation than with manual segmentation. The diagnosis of Type 1 MNV using OCTA requires the use of manual segmentation and a multimodal imaging approach.
 

Purpose :
To describe three cases of Unilateral Acute Idiopathic Maculopathy

Materials and Methods :
A retrospective review of three cases diagnosed with unilateral acute idiopathic maculopathy. Clinical
and multimodal imaging findings, treatment, and outcomes were described.
 

Results :
We report three cases of two males and one female, aged 48, 26 and 19 years-old, presented with
unilateral acute blurred vision. Mean best corrected visual acuity (BCVA) at presentation was 20/63.
Slit-lamp examination revealed no anterior chamber or vitreous cells in all cases. Fundus examination
of the affected eye showed macular alterations in all cases. Fluorescein angiography demonstrated
early hypofluorescence with late staining in the macular area in all cases. Indocyanine green
angiography showed persistent macular hypofluorescence throughout the angiographic sequence in
all cases. Macular optical coherence tomography (OCT) showed a serous retinal detachment in one
eye, a bacillary layer detachment in one eye and outer retinal disruption in two eyes. OCT angiography
showed a focal area of non detectable flow at the level of the choriocapillaris in all cases. Slit lamp
examination and multimodal imaging findings were within normal in the fellow eye in all cases. One
patient had a history of hand, foot, and mouth disease. On follow up, an improvement of BCVA and a
resolution of OCT and OCT angiography abnormalities were noted in two cases.

Conclusions :

Multimodal imaging techniques are valuable tools for both the diagnosis and monitoring of unilateral
acute idiopathic maculopathy. OCT angiography is a non-invasive retinal imaging modality that
provides significant insights, suggesting that the inner choroid is the primary site of an ischemic
process likely responsible for the pathogenesis of this condition.

Purpose :
To describe three cases of Acute Idiopathic Maculopathy

Materials and Methods :
A  report of three cases
 

Results :
The first case involves a 48-year-old patient ,referred for a one-month history of progressive vision loss. Best corrected visual acuity (BCVA) was 20/1000 in the affected eye and 20/20 in the fellow eye. Fundus examination showed a gray-yellow macular lesion. Fluorescein angiography (FA) demonstrated early hypofluorescence with late hyperfluorescence .Macular optical coherence tomography (OCT) revealed irregular thickening of the retinal pigment epithelium and disruption of the outer retinal layers. OCT-angiography (OCT-A) showed a focal area of decreased flow in the choriocapillaris. Over time, the BCVA remained stable, and OCT-A showed no improvement in choriocapillaris perfusion.
The second patient is a 26-year-old, referred for blurry vision evolving over the past 3 days. BCVA was 20/40 in the affected eye and 20/20 in the fellow eye.the Fundus examination , FA and ICGA were alike to Case 1. OCT revealed a serous retinal detachment with irregular thickening of the outer retina. OCT-A showed choriocapillaris hypoperfusion. The patient was treated with oral corticosteroids. One month later, BCVA improved to 20/20, OCT-A and OCT showed resolution of abnormalities.
The third patient is a 19-year-old female, referred for a one-month history of visual blurring. BCVA was 20/40 in the affected eye and 20/20 in the fellow eye . Fundus examination showed an altered macular reflex. FA showed early hypofluorescence with late hyperfluorescence. OCT revealed a bifid bacillary detachment with focal thickening of the inner choroid, and loss of the normal mottled appearance. OCT-A revealed decreased flow in the choriocapillaris . The patient was managed conservatively with observation, resulting in full spontaneous recovery.
 

Conclusions :
OCT-A  provides significant insights, suggesting that the inner choroid is the primary site of an ischemic process likely responsible for the pathogenesis of this condition.
 

Purpose :
To describe a case of acute exudative polymorphous vitelliform maculopathy of paraneoplastic origin in a patient with renal carcinoma.

Materials and Methods :
Case report.

Results :
A 64-year-old patient with a history of renal carcinoma undergoing radiochemotherapy presented with progressive bilateral visual loss. Visual acuity was 7/10 in the right eye and 8/10 in the left. Fundus examination revealed multiple yellowish vitelliform lesions predominantly in the posterior pole of both eyes, along with a poor foveal reflex in the right eye. OCT confirmed localized serous retinal detachments and hyperreflective subretinal deposits. Fluorescein angiography showed hyperfluorescence corresponding to the areas of detachment. These findings supported the diagnosis of acute exudative paraneoplastic polymorphous vitelliform maculopathy (AEPVM), likely mediated by anti-retinal autoantibodies in the context of an underlying malignancy. No specific ocular treatment was initiated. The visual prognosis remains closely linked to the systemic evolution of the oncologic disease.

Conclusions :
AEPVM is a rare, often underrecognized paraneoplastic maculopathy. Its presentation can mimic other retinal conditions, making multimodal imaging essential for accurate diagnosis. Management primarily focuses on treating the underlying malignancy, with variable visual outcomes depending on systemic disease progression.

Purpose :
To report a case of laser-induced photic maculopathy in a professional setting, secondarily complicated by choroidal neovascularization.

Materials and Methods :
Case report

Results :
A 26-year-old male with no prior medical history presented with a central scotoma in the right eye, 7 days after unprotected accidental exposure to a green laser during professional equipment adjustment. Initial visual acuity in the right eye was 6/10. Anterior segment examination was unremarkable, and fundus examination revealed a grayish central foveal lesion. The diagnosis of laser-induced photic maculopathy was made based on clinical findings and patient history. A decision was initially made for regular monitoring.

One month later, the patient reported worsening visual acuity, with new macular syndrome. Fundus examination showed enlargement of the grayish lesion. Fluorescein angiography demonstrated late hyperfluorescence and the presence of a neovascular membrane. OCT revealed subretinal exudation, and OCT-Angiography confirmed the presence of an active neovascular lacy pattern. An intravitreal injection of Avastin was administered.

At one-month follow-up, a partial improvement in visual acuity and reduction of neovascular activity were observed. By three months, visual acuity reached 4/10, with persistent macular scarring but no recurrence or exudation on OCT.

Conclusions :
Laser-induced photic maculopathy is a rare but visually significant condition, particularly in young patients. Multimodal imaging plays a critical role in diagnosis and follow-up. In cases complicated by choroidal neovascularization, anti-VEGF therapy may offer clinical benefit. In the absence of standardized treatment, prevention through education and protective measures remains essential.

Purpose :
To describe a case of peripapillary central serous chorioretinopathy (CSCR) associated to prepapillary vascular loop. 

Materials and Methods :
A case report 

Results :
A 46-year-old man with no relevant medical or ocular history presented with recent-onset near visual disturbance. Spectral-domain optical coherence tomography (OCT) revealed a serous retinal detachment extending from the optic disc toward the macula, along with a clear detachment of the retinal pigment epithelium. OCT angiography (OCT-A) showed no evidence of macular neovascularization. Fluorescein angiography demonstrated a focal leak located in the interpapillomacular area, consistent with active CSCR. Additionally, a prepapillary vascular loop was observed but showed no leakage or signs of exudation, confirming its incidental and congenital nature. Indocyanine green angiography (ICGA) revealed diffuse choroidal hyperpermeability, especially nasal to the fovea, along with dilated choroidal vessels and pachyvessel patterns. 

Conclusions :
Prepapillary vascular loop could alter the local choroidal dynamics, contribute to focal choroidal hyperpermeability and hence influence the development of atypical CSCR

Purpose :
To evaluate the performance of SHIFT Spectral-domain Optical Coherence Tomography (SD-OCT) in patients with severe media opacities precluding fundus examination.

Materials and Methods :
A case series of four patients where a view of the retina was precluded by a dense subcapsular cataract, corneal edema (2 eyes) and capsular bag remnant imaged with the Spectralis SHIFT OCT system (Heidelberg Engineering, Germany) with acquisition scanning speeds of 20 kHz and 85 kHz. The primary outcome measure was a foveal B-scan that was deemed to reveal sufficient information, as assessed by an independent retinal specialist, from which clinical treatment decisions could be made. Secondary outcome was scan quality measured by the Q score, a signal-to-noise ratio (SNR) measured in dB.

Results :
Clinically useful retinal details were revealed in all eyes using this technique. In two patients with opacities precluding visualization of the fundus using near infrared reflectance (NIR), foveal contour was detected only at 20 kHz. In two patients with media opacities with blurred visualization on NIR, retinal details inspection was superior in B-scans acquired at 20 kHz. Q-score was superior in B-scans acquired at 20 kHz compared to 85 kHz (18.50 dB vs 10.75 dB), even with smaller ART.

Conclusions :
SD-OCT acquisition at 20 kHz improves retinal layer detection by improving SNR compared to faster SD-OCT acquisition speeds. This technology might be useful for clinical decision making in patients with media opacities that prevent fundus visualization.

Purpose :
To describe clinical and multimodal imaging findings in a case of multiple evanescent white dot syndrome (MEWDS) associated with chrysanthemum lesion leading to a choroidal neovascularization.

Materials and Methods :
A case report. 

Results :
A 22-year-old myopic female presented with blurred vision in the right eye. Ophthalmologic examination revealed acuity of 20/80 with central scotoma in the right eye, normal anterior segment, no evidence of intraocular inflammation, whitish lesions characteristic of MEWDS and a yellowish subretinal parafoveal lesion surrounded by small satellite dots resembling chrysanthemum lesions.
Autofluorescence showed a hypoautofluorescent chrysanthemum lesion in the macula with multiple hyperautofluorescent spots in the posterior pole. The lesions were hyperfluorescent on fluorescein angiography. Spectral-domain optical coherence tomography revealed disruption of the ellipsoid zone, and subretinal hyperreflective material splitting the retinal pigment epithelium/Bruch membrane complex with a posterior choroidal hypertransmission at the level of yellowish lesion. The diagnosis of Epi-MEWDS associated with chrysanthemum lesion was made and the patient was treated by systemic corticosteroid. On follow-up, the MEWDS lesions resolved, but the juxta-macular chrysanthemum lesion progressed to active choroidal neovascularization requiring intravitreal anti-VEGF therapy.

Conclusions :
Our case highlights an unusual presentation of MEWDS associated with features of chrysanthemum lesions. Multimodal imaging is useful for accurate diagnosis and guiding management. 

Purpose :
To report the multimodal imaging findings in a 19-year-old male patient who presented with commotio retinae (CR) after a ball blunt trauma in a football match.

Materials and Methods :
A 19-year-old male presented to the emergency department with decreased vision in the right eye after being struck by a football. Visual Acuity in his right eye was 8/10 at the Snellen chart , intraocular pression within normal limits and pigmented cells in the anterior chamber. A multimodal imaging  was performed, including Multicolor Imaging (MCI), Blue Autofluorescence (BAF), Optical Coherence Tomography (OCT), and Infrared (IR) imaging. 

Results :
Multimodal imaging revealed findings consistent with selective disruption of the rod outer segments, as described in the literature. OCT demonstrated increased reflectivity and obliteration of the ellipsoid zone (EZ) and interdigitation zone (IZ) in the affected peripheral retinal region. MCI showed hyperreflective areas on individual color reflectance channels, while IR imaging confirmed outer retinal layer involvement. No abnormalities were detected on BAF imaging, as the underlying retinal pigment epithelium (RPE) remains intact, preserving the normal autofluorescence pattern. Fourteen days Follow-up imaging demonstrated partial restoration of outer retinal integrity with improvement in visual acuity.

Conclusions :
This case highlights the importance of multimodal imaging in diagnosing and monitoring commotio retinae. The findings demonstrate how MCI and OCT contribute to assessing retinal trauma, providing valuable insights into both the extent of the damage and the healing process.

Purpose :
To document the evolution of large colloid drusen (LCD) through multimodal imaging over a 10-year follow-up.

Materials and Methods :
Medical records of 44 eyes of 26 patients with a history of LCD were analyzed. Inclusion criteria were the presence of bilateral LCD diagnosed at least 10 years before inclusion, having undergone spectral-domain optical coherence tomography (SD-OCT), fundus autofluorescence (FAF), fluorescein angiography (FA) and indocyanine green angiography (ICGA) and having shown the typical donut shape. Follow-up imaging, including color fundus photography, FAF, SD-OCT and SS-Swept-Source OCT-angiography (SS-OCTA) was compared to baseline imaging. The pattern of FAF, SD-OCT characteristics of LCD and the presence of macular neovascularization (MNV) or atrophy were analyzed.

Results :
Fourteen eyes of 7 patients were included. Mean age at diagnosis was 45 years +/- 9.17 SD (range, 37–68 years). Best-corrected visual acuity (BCVA) was 0.15 logMAR +/-0.07 SD at baseline and 0.10 log MAR +/- 0.10 at 10-year follow-up. In SD-OCT, we noted LCD resorption in 10 eyes, with outer retinal layers atrophy in 6 eyes, ellipsoid zone defects in 4 eyes, RPE-Bruch’s membrane disruption in 6 eyes, an increase in LCD reflectivity in 2 eyes and a coalescence of LCD in 2 eyes. FAF showed the same pattern of autofluorescence in 6 eyes and a speckled autofluorescence of the surrounding ring in 4 eyes. SS-OCTA showed a non-exudative MNV in one eye.

Conclusions :
Long-term follow-up of LCD showed frequent resorption, with a relatively stable BCVA. Neovascular complications were present in 1 of 14 eyes and outer retinal atrophy in 6 eyes.

Purpose :
The goal of this study was to evaluate the sensibility and specificity of ultra-wide field computer tomography angiography (UWF-OCTA) in the screening and classification of sickle cell retinopathy (SCR) by ophthalmologists of different skill levels.

Materials and Methods :
This is a prospective study done at Creteil Intercommunal Hospital in which 40 eyes of 22 patients clinically diagnosed with sickle cell disease were included. Each patient underwent multimodal imaging including UWF-OCTA and ultra wide field fluorescein angiography (UWF-FA) on the same day. The images acquired were graded individually by a retina specialist and an ophthalmology resident. The retina expert settled all disagreements.

Results :
The sensibility of UWF-OCTA compared to UWF-FA was 52% for the retina specialist and 48% for the ophthalmology resident. The specificity was 100% for both. Inter-method agreement was 70% for the retina specialist and 67.50% for the ophthalmology resident.  Inter-grader agreement was 90% in UWF-OCTA and 95% in UWF-FA.

Conclusions :
In this study we demonstrated that UWF-OCTA is a useful technique in detecting and staging SCR with medium sensitivity and excellent specificity and a very good inter-grader agreement by ophthalmologists of different skills.

Purpose :

Materials and Methods :

Results :

Conclusions :

AMN-case report Maculart.pptx

Purpose :
To characterize the long-term polarization and autofluorescent properties of induced pluripotent stem cell-derived retinal pigment epithelium (iPSC-RPE) sheet 10 years post-subretinal transplantation in a patient with neovascular age-related macular degeneration by utilizing polarization-sensitive optical coherence tomography (PS-OCT) and near-infrared autofluorescence (NIRAF).

Materials and Methods :
A comprehensive fundus examination, including routine fundus photographs, PS-OCT and NIRAF, was performed 10 years after iPSC-RPE sheet transplantation. PS-OCT and NIRAF, both detecting fundus melanin distribution, were employed to assess RPE graft engraftment. We measured polarimetric entropy at the RPE line to quantify RPE layer-specific melanin distribution, and compare it with the intensity of NIRAF and fundus photographs.

Results :
The PS-OCT en face image, extracting RPE layer-specific melanin distribution, clearly visualized subretinal iPSC-RPE sheet engraftment, consistent with pigmented areas in normal fundus photographs. In unaffected retinal regions, both PS-OCT and NIRAF demonstrated high entropy and autofluorescence, respectively. Within the transplanted area, PS-OCT revealed high entropy, while NIRAF showed low-to-iso-autofluorescence. This discrepancy suggests differing information content between the modalities.

Conclusions :
PS-OCT effectively visualized subretinal engraftment of iPSC-RPE sheet through layer-specific melanin distribution. The contrasting findings between PS-OCT and NIRAF within the graft area indicate that while both modalities primarily depict fundus melanin, NIRAF likely reflects a more complex status of retinal components, potentially including photoreceptor-RPE interactions, beyond solely RPE melanin. This study highlights the complementary value of PS-OCT and NIRAF in assessing long-term iPSC-RPE graft characteristics.

Purpose :


Materials and Methods :


Results :
We report the case of a thirty-year-old male who presented for a routine ocular checkup. An incidental finding of bilateral numerous bright patchy areas was made on near infrared reflectance imaging, alongside retinal microvascular anomalies. Further questioning and examination revealed 20 café-au-lait macules and axillary freckling, but no Lisch nodules. The patient was referred for genetic testing and a somatic mosaic mutation was found on the NF1 gene (c.4084C>T on the exon 30) with a variant allele frequency of 20%.

Conclusions :
This report highlights the role of near infrared reflectance imaging in the incidental finding of choroidal alterations, which led to the diagnosis of NF1 mosaicism.

Near-infrared fundus image of the right eye showing multiple bright patchy areas on the posterior pole, extending beyond the arcades

Near-infrared fundus image of the left eye showing multiple bright patchy areas on the posterior pole, extending beyond the arcades

Purpose :
To determine the prevalence of confluent hypo-autofluorescence (hypo-AF) in central serous chorioretinopathy (CSCR) and identify imaging features preceding its development.

Materials and Methods :
This is a retrospective, longitudinal study conducted in Lariboisière Hospital. Patients with CSCR who underwent 55° blue autofluorescence imaging between April 2011 and November 2024 were included in the evaluation of confluent hypo-AF prevalence. Eyes that developed confluent hypo-AF during follow-up were included in the imaging analysis. Subretinal fluid, retinal cysts, incomplete and complete RPE and outer retina atrophy (iRORA, cRORA), and choroidal thickness were evaluated at the site of subsequent hypo-AF using spectral-domain OCT. Additionally, the presence of pachyvessels, hyperfluorescent areas during mid-phase, and leakage points were analyzed using indocyanine green and fluorescein angiography

Results :
896 eyes with CSCR were identified. Confluent hypo-AF was detected in 49 eyes (5.47%). Eighteen  eyes had imaging before the development of hypo-AF. Mean age was 70.61 ± 10.41 years old with a follow-up of 7.56 ± 3.43 years. At the first visit, no patient had confluent hypo-AF, 88.89% had granular hypo-AF and 11.09% had no hypo-AF lesion.  Best-corrected visual acuity was lower in the last visit (p=0.02). cRORA was observed in 100% of eyes in the last visit (p<0.01).  Subretinal fluid decreased from 77.78% to 16.67% of eyes (p<0.01), whereas degenerative cysts increased from 16.67% to 55.56% (p<0.01). Subfoveal and sub-lesion choroidal thickness remained unchanged. At the first visit, 78.57% of eyes had pachy-vessels, 50% hyperfluorescent plaques and 15.38% leakage points.

Conclusions :
Confluent hypo-AF is an uncommon finding in CSCR, with a prevalence of 5.47% in a cohort of 896 patients. Most confluent lesions developed in areas with pachyvessels, subretinal fluid, and granular hypo-AF. Over time, subretinal fluid decreased, while degenerative cysts increased, coinciding with the development of confluent hypoAF. This observation raises questions about the role of RPE cells in subretinal fluid dynamics.

BAF and SD-OCT before the development of confluent hypo-AF showing the presence of subretinal fluid.

BAF and SD-OCT showing the development of confluent hypo-AF in the area of sub retinal fluid.

Purpose :
Traditional OCT techniques visualize a limited portion of the retina.
Wide-field OCT allows for the capture of images of a much larger portion of the retina, up to the periphery. this presentation will show the state of the art about Ultrawidefield OCT imaging

Materials and Methods :
TowardPi Bmizar SS OCTA 400KHz was tested on several pathologies that require ultra widefield to be imaged. This is particularly important because many retinal diseases, such as diabetic retinopathy and macular degeneration, can begin or manifest in the retinal periphery

Results :
The advantages of this technology are: Early diagnosis of peripheral retinal diseases.
More comprehensive monitoring of disease progression.
Better visualization of lesions that might be missed with traditional OCT techniques.
 

Conclusions :
the UWF technology is rapidly evolving, with continuous improvements in: Image resolution and
Image acquisition speed, ability to visualize deeper structures.
Finally the integration of analysis software allows a better quantification of the pathological alterations.

Purpose :
To report a rare case of intermediate age-related macular degeneration (AMD) with atypical central retinal
pigment epithelium (RPE) defects and preservation of the photoreceptors layer, in the absence of macular
neovascularization (MNV) or geographic atrophy.

Materials and Methods :
A 64-year-old woman, with no prior medical history, presented for a routine ophthalmologic check-up.
Comprehensive ophthalmic examination and multimodal retinal imaging using fundus autofluorescence
(FAF), optical coherence tomography (OCT), OCT-Angiography (OCT-A), and fluorescein angiography
(FA) were performed.

Results :
Initial best-corrected visual acuity (BCVA) was 10/10 in both eyes. Anterior segment examination was
unremarkable. Fundus examination revealed confluent soft drusen, with partial foveal sparing in the left
eye. Fundus autofluorescence showed limited, irregular, stippled hyperautofluorescence. OCT B-scans
revealed multiple serous drusens and drusenoid pigment epithelium detachments. OCT-A showed
choriocapillaris flow voids without MNV. At one-year follow-up, progressive decline of the right eye’s
BCVA to 6.3/10 was noted. OCT showed multiple central RPE defects with subretinal fluid and a
preservation of the photoreceptors layer. The RPE defects were hypoautofluorescent on FAF surrounded
by areas of stippled hyperautofluorescence. Fluorescein angiography revealed window defects with late
subretinal pooling, without leakage. Given the absence of MNV, a conservative approach with close
observation was chosen. A four-year follow-up revealed a progressive thinning of the photoreceptors
layer, an enlargement of the RPE defect with persistent subretinal fluid, and no evidence of RPE or
drusenoid material migration on OCT B-scans. The diagnosis of intermediate AMD with atypical central
RPE defects and retained photoreceptors layer was made, and the patient was closely monitored.

Conclusions :
This case illustrates an atypical phenotype of intermediate AMD characterized by central RPE defects
with long-term retained photoreceptors layer in the absence of MNV. These patients have a relatively
stable visual function over time. And the recognition of this subgroup may have implications regarding
therapeutic decisions.

Purpose :
A 65-year-old patient is referred for a malignant lesion in the fundus.
The patient is symptomatic and has a history of chronic lymphocytic leukemia.
A choroidal melanoma of the posterior pole was suspected.
Several differential diagnoses need to be ruled out, including the most serious and those that are treatable.
In this case, the two main diagnoses being considered are a macular hemorrhage and a choroidal melanoma.

Materials and Methods :
Visual acuity was 1/10 in the eye with the lesion and 7/10 in the fellow eye.
Slit-lamp examination revealed a clear cornea, a quiet and deep anterior chamber, and a well-centered anterior chamber intraocular lens.
A large pigmented lesion was found in the right eye, with no orange pigment observed.
Drusen were present in both eyes.
A retinal ultrasound was performed and did not reveal any "collar-button" appearance.The lesion appeared hypoechoic on ultrasound.
No choroidal excavation was detected.
Macular OCT revealed a retinal hemorrhage with neovascularization and a break in Bruch's membrane.
Angiography showed a masking effect with no intralesional vascularization.

Results :
All these findings are consistent with a macular hemorrhage.Indeed, other etiologies such as retinal arterial macroaneurysms, idiopathic polypoidal choroidal vasculopathies, high myopia, and trauma can also be associated with
AMD.
The patient was treated with intravitreal injection.

Conclusions :
Macular hemorrhage is an uncommon but potentially serious and rapidly progressive complication of age-related macular degeneration (AMD).
In most cases, the diagnosis is straightforward and quickly made, but in certain situations, the deceptive appearance of the lesion may lead to consideration of alternative diagnoses.

Purpose :
We aim to evaluate the choroidal luminal and stromal compartments in eyes with atrophic age-related macular degeneration (aAMD) using the choroidal vascular index (CVI).

Materials and Methods :
In this retrospective study, patients with atrophic age-related macular degeneration (aAMD) were investigated using a multimodal imaging approach that included color fundus photography, swept-source optical coherence tomography (OCT), and OCT-Angiography (OCT-A)  (DRI Triton, Topcon). The choroidal vascular index (CVI), defined as the ratio of the luminal choroidal area (LCA) to the total choroidal area (TCA), was calculated subfoveally.

Results :
Twenty-three eyes of 15 patients were included. The mean age was 72.9± 5.1 years. Six eyes were diagnosed with drusen and/or reticular pseudodrusen (RPD), twelve eyes with geographic atrophy and five eyes with choroidal neovascularization (CNV). Choroidal vascular index showed a different distribution; eyes with CNV had a lower CVI in comparison to GA and drusen/RPD (p=0.05). Eyes with GA showed a lower CVI in comparison to drusen/RPD (p = 0.003). 

Conclusions :
Atrophic AMD is characterized by impairments in the choroidal vascular component, which may reflect varying degrees of AMD severity. The choroidal vascularity index could be considered a potential new biomarker for evaluating different stages of aAMD.

Purpose :
Recovery after rhegmatogenous retinal detachment (RRD) depends on several preoperative factors. Muni recently proposed a classification system for outer retinal corrugation (ORC), with higher stages linked to worse visual outcomes and longer detachment duration. His studies focused on the perifoveal retina (12mm OCT scans). Our study aimed to evaluate the peripheral detached retina in acute RRD using UWF OCT, which provides 26mm-wide scans.

Materials and Methods :
This single-center prospective study included consecutive patients with primary RRD who presented at Lariboisière Hospital, Paris, from November 2024 to February 2025. All underwent comprehensive clinical exams and UWF imaging, including Optos and Dream OCT (120°, 26mm). Exclusion criteria included prior vitrectomy, concomitant retinal disease, or poor-quality imaging. Data collected included demographics, best-corrected visual acuity, spherical equivalent, axial length, lens status, and symptom duration. RRDs were analyzed using Dream OCT for ORC (per Muni’s classification), intraretinal cysts, hyperreflective foci, macular and vitreous status, and detachment height. 

Results :
Fourteen patients with acute RRD were included. 43% were macula-on and ORC was present in 93% of cases. Corrugation stages followed a gradient from the macula to the periphery, with more advanced stages in peripheral areas. Stage 5 (patchy photoreceptor loss or “motten eaten” appearance) was associated with peripheral intraretinal schisis. Full-thickness retinal folds were seen in 35%, corresponding to complete disorganization of all retinal layers, unlike ORC which involves only outer layers. 

Conclusions :
This is the first study assessing RRD with UWF OCT. We observed loss of ORC towards periphery and two novel OCT features: peripheral intraretinal schisis in Muni’s stage 5 and full-thickness retinal folds. UWF OCT enables detailed evaluation of the detached retina. Larger studies are needed to validate these findings as prognostic markers.

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Paris,2025.ppt

Purpose :
In previous studies, intraoperative optical coherence tomography(iOCT) has revealed microstructural changes not visible on pre-and post-operative examinations. This study aims to explore these macular changes using a new generation of microscope-integrated iOCT and to evaluate their clinical relevance.
Additionally, we will assess the utility of digital coloration assistance and double resolution iOCT for ERM visualization and peeling.

Materials and Methods :
Observational case series conducted in Lariboisiere Hospital, APHP, Paris, France, with a retrospective analysis using the new ARTEVO 850 device(Zeiss ®). 
ERM primary outcomes will include central macular thickness(CMT), intra-retinal cystic changes, outer retinal changes, subretinal changes. FTMH primary outcomes will include minimal and base horizontal diameters, intra-retinal cystic changes, and closure type.
Secondary endpoints will assess the need of additional Membraneblue-Dual(DORC®) dye use and qualitative analysis ERM edges visibility using DCA and double resolution iOCT. 

Results :
As of April 17th, 2025, 29 eyes of 28 patients- 24 eyes with ERM and 5 with FTMH has been enrolled. 
In the ERM group (n=23, mean age of 77±14.1years), the mean preoperative visual acuity (VA) was 0.4±0.5LogMAR (0.4±0.4 Snellen). The mean preoperative CMT was 400±157.9mm and decreased to 378.1 ±206.9mm after vitrectomy and to 383.1±195.3mm after ERM peeling (p=0.60 and 0.67 respectively). 
In the FTMH group the mean preoperative VA was 0.6±0.5 LogMAR (0.3±0.4 Snellen equivalent). The mean minimal horizontal diameter increased from 400±200mm preoperatively to 500±170mm after PVD induction and then decreased to 385±50 after ILM peeling and 310mm after air tamponade. 

Conclusions :
Recent technological advances have considerably improved iOCT image quality and ease of use. Preliminary findings from this ongoing study indicate that intraoperative OCT may provide potentially predictive insights into anatomical outcomes. Further data will clarify the role of these new technologies in enhancing patient management and surgical results.
 

Purpose :
To describe the clinical presentation, diagnostic approach, and therapeutic management of endogenous Candida endophthalmitis through a series of four cases, and to highlight key risk factors and outcomes.

Materials and Methods :
We conducted a retrospective descriptive study of four patients diagnosed with endogenous Candida endophthalmitis. All patients presented with decreased visual acuity and had systemic risk factors such as immunosuppression, recent surgery, or systemic candidemia. Clinical findings, imaging, microbiological results, and therapeutic strategies were analyzed.

Results :
Four patients (2 women, 2 men; aged 26–48 years) were included.  
- Case 1: A 38-year-old woman with ulcerative colitis post-colectomy had bilateral visual loss. She tested positive for Candida glabrata antigenemia and was treated with intravenous voriconazole and intravitreal amphotericin B. 
- Case 2: A 45-year-old man with ulcerative colitis presented with unilateral vitritis and “string of pearls” vitreous opacities. Vitrectomy confirmed Candida albicans, and he received oral and intravitreal voriconazole.  
- Case 3: A 26-year-old man with leukemia under chemotherapy showed bilateral macular chorioretinitis but was lost to follow-up.  
- Case 4: A 48-year-old diabetic woman with candidemia due to obstructive pyelonephritis had bilateral vitritis and a macular hemorrhage. She was treated with intravenous anidulafungin and intravitreal voriconazole, with favorable evolution.

Conclusions :
Endogenous Candida endophthalmitis is a rare but serious condition, often affecting immunocompromised or critically ill patients. Early diagnosis, based on characteristic fundus findings and microbiological testing, is essential. Treatment requires systemic and intravitreal antifungal therapy, and vitrectomy in severe cases. Despite appropriate management, the visual prognosis remains guarded.

Purpose :
To report a case of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome, illustrating the usefulness of ultra-widefield fluorescein angiography (UWFA) for confirming the precise stage and guiding early treatment.
 

Materials and Methods :
Case report

Results :
 A 44-year-old women, with medical history of type 2 diabetes, complained about near vision decline. On examination, her best corrected visual acuity was 20/20 P2 in both eyes. The anterior segment and the intraocular pressure were normal in both eyes. Systematic fundus examination showed vasculitis, multiple arterial aneurysms and peripapillary exudation. Conventional angiography showed, areas of peripapillary hypofluorescence related to exsudates, parietal vascular diffusion, rounded hyperfluoresence related to arterial macroanevrysms and limited area of non perfusion. UWFA showed large circonferancial retinal ischemia extending over 360° with peripheral retinal neovascularisation in both eyes. Macular swept source optical coherence tomography was normal. Panretinal laser photocoagulation was performed in both eyes guided by the result of UWFA.

Conclusions :
UWFA can provide additional valuable information useful for staging, follow up and treatment strategy of IRVAN syndrome.

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Cherry on top of Syphilis - Maculart.pptx

Purpose :
To report a case of acquired pseudo vitelliform lesion in a young patient with idiopathic bilateral panuveitis

Materials and Methods :
A case report 

Results :
An 11-year-old caucasian boy, with no significant medical history, referred to our ophthalmology department for investigation and management of bilateral panuveitis. His best corrected visual acuity was 6/30 in the right eye, and 20/20 in the left eye. Dilated fundus examination showed optic disc hyperemia and a unique well-circumscribed yellowish macular lesion with no other peripheral retinal nor retinochoroidal lesions.Fundus autofluorescence and swept-source optical coherence tomography demonstrated hyperreflective material without macular edema. Fluorescein angiography showed an early hypofluorescent lesion with inhomogeneous staining in late phase. Systemic examination, as well as paraclinic investigations, were unremarkable. He was started on corticosteroid therapy and immunosuppressive therapy du corticodependance. Resolution of the vitelliform lesion was observed during the follow-up.

Conclusions :
A variety of conditions could be associated to pseudo vitelliform lesion. In this case it occurred in conjunction to inflammatory macular edema. 

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Materials and Methods :

Results :

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Cas clinique maculart.pptx

Purpose :
To assess long-term efficiency and safety of fluocinolone acetonide intravitreal implant (ILUVIEN, ILU) in patients with uveitis and pseudo-uveitis. 

Materials and Methods :
Bicentric retrospective study.

Results :
19 eyes from 16 patients were included (69% female, mean age 67.3 years-old, range 43-86) and followed for at least 12 months after ILU injection (mean = 30, range 12-58 months). Etiologies were: multiple sclerosis (n=2), retinitis pigmentosa (n=1), irvine-gass syndrome (n=2), sarcoidosis (n=1), spondyloarthritis (n=1), multifocal choroiditis (n=1), sympathetic ophthalmia (n=1), drug-induced (n=3) and idiopathic (n= 3).
On average 54 days prior to ILU injection, patients received intravitreal dexamethasone (OZURDEX, OZD) or subtenon triamcinolone acetonide (KENACORT, KNC) injections.
Patients required fewer OZD injections post-ILU (mean 5.4 versus 1.1, p<0.05). Systemic treatments decreased from 3.1 (range = 0-9) to 1.0 post-IL, though not statistically significant. No significant differences were observed in anti-VEGF of KNC injections. Baseline (prior to any injection) central retinal thickness significantly decreased from 556 µm to 294µm (p = 0.000012) and best corrected visual acuity significantly increased (+2lines, p=0.03) post-ILU.
Of note, among 4 eyes followed over 36 months post-ILU (theoretical efficacy duration), only 1 (25%) needed subsequent injection (OZD and KNC) but not after 24 months.
There was no difference in the proportions of eyes treated with intraocular pressure-lowering drops pre and post-ILU (31.58 % versus 63.16 %, OR = 0.25 ; CI [0.026 ; 1.25] ; p=0.114), nor in intraocular pressure (13.3 versus 13.4 mmHg, p = 0.89).
Noticeable adverse events were 1 glaucoma surgery (5.3%), 1 transitory severe hypotony (5.3%) and 1 anterior chamber migration (5.3%) with no subsequent damages.

Conclusions :
ILUVIEN is a safe and efficient intravitreal implant for managing chronic uveitic macular edema, even in severe cases requiring multiple systemic treatments.

Purpose :
Vasoproliferative retinal tumors (VPRTs) represent a benign gliovascular tissue proliferation. They are classified as primary (idiopathic) or secondary (associated with other chorioretinal pathologies). They are usually unilateral and located in the inferotemporal retina. The most common causes of visual impairment are their complications such as cystoid macular edema, epimacular membrane, macular hole, vitreous hemorrhage, or exudative retinal detachment. The aim of this study is to report the clinical characteristics and therapeutic management, and treatment reponse of macular complications in VPRTs through five case studies.

Materials and Methods :
This series includes five cases of VPRTs associated with macular complications. All patients underwent a dilated fundus examination, ultra-wide-field retinal imaging, spectral domain optical coherence tomography, fluorescein angiography, and ocular B-ultrasound.

Results :
All examined patients showed a macular complication related to a VPRT. Two cases were idiopathic and three secondary to intermediate or posterior uveitis. The involvement was either unilateral or bilateral. Macular edema was observed in three cases, while the epiretinal membrane with vitreomacular traction in two cases. In one patient, the macular edema led to the diagnosis of the VPRT.
All patients with macular edema received treatment, including intravitreal dexamethasone implant, anti-VEGF therapy, and systemic treatment. In two cases, the macular edema resolved after treatment, while one patient showed no improvement and experienced progressive visual loss due to an exudative retinal detachment.
The patients who developed an epimacular membrane with vitreomacular traction were monitored, none of them developed exudative complications or required a vitrectomy.

Conclusions :
The diagnosis of macular complications of VPRTs is facilitated by multimodal retinal imaging techniques. Although managing these complications involves different effective treatment modalities, outcomes remain unpredictable and can have significant impacts on visual function.

Purpose :
To report a case of intraocular inflammation occurring two days after intravitreal injection of Aflibercept. Initial diagnosis retained was sterile endophthalmitis. Comprehensive assessment confirmed the presence of ocular toxoplasmosis.

Materials and Methods :
Observational case report

Results :
A 74-year-old male patient with no know systemic medical history, treated for bilateral exudative neovascular age-related macular degeneration, presented with acute painless vision loss in his left eye two days following intravitreal injection of Aflibercept.
Visual acuity was limited to hand movement. Anterior segment was calm. We noted a dense vitritis with a very blurred fundus. On ccular ultrasonography, vitreous cavity was moderate amplitude point echoes.
The patient was initially treated with oral and topical antibiotics and corticosteroids. Subsequent follow-up showed resolution of the vitritis, revealing papillitis and vitreous condensation in front of a focus of retinochoroiditis, having an appearance suggestive of ocular toxoplasmosis.
Comprehensive etiologic assessment was performed. Serology for Toxoplasma gondii was positive (Positive IgM).
Patient was treated oral Azithromycin and corticosteroids with complete resolution of the papillary edema and visual improvement

Conclusions :
Ocular toxoplasmosis can be observed following intravitreal anti-VEGF injections, masquerading a sterile endophthalmitis. Comprehensive etiologic assessment should be systematically performed in presence of acute vitritis, This rare complication requires thorough knowledge and great caution. Indeed, with adequate treatment, we can observe rapid resolution of intraocular inflammation and visual restoration.

Purpose :
To describe tomographic findings in bilateral retinitis in a patient with endocarditis and a serologically confirmed Q fever

Materials and Methods :
A case report of bilateral retinitis linked to Coxiella burnetii, documented with Optical Coherence Tomography (OCT).

Results :
Ophthalmologic examination of a 55-year-old patient with culture-negative endocarditis revealed 20/20 visual acuity in both eyes, normal anterior segments, and white retinal infiltrates in the posterior pole accompanied by superficial retinal hemorrhages in the fundus examination of both eyes. OCT through the lesions showed heightened inner retinal reflectivity with a localized region of retinal thickening. Fluorescein angiography revealed no staining of the retinal lesions. Q fever serology was positive, and the patient was treated with doxycycline. A 2-week follow-up OCT showed a focal area of inner retinal atrophy in the right eye, indicating a resolved retinal infiltrate, and a focal thinning of the retina in the left eye, corresponding to a partial resolution of the lesion.

Conclusions :
Retinitis is an exceptionally rare condition in Q fever. OCT is a valuable diagnostic tool for identifying and monitoring the progression of retinal lesions caused by Coxiella burnetii.

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When Everything is positive !.pptx

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White dots can hide others.pptx

Purpose :
To explore prevalence and associated factors of parapapillary scleral ridges (PSRs).
 

Materials and Methods :
Out of the cohort of the population-based Beijing Eye Study (n=3468 participants), the study included all eyes with an axial length of ≥25 mm, and a randomized sample of eyes with an axial length of <25 mm.  Using optical coherence tomographic (OCT) images and fundus photographs, we examined presence and height of PSRs, defined as a ridge-like structure located on the OCT scans in the parapapillary region. 
 

Results :
The study cohort consisted of 366 eyes (314 individuals;mean age:63.7±9.7 years).  PSR prevalence increased from 0% in the non-myopic group, to 3.8% (95%CI:0.3,7.3) in moderately myopic group and 29.2% (95%CI:15.7,42.5) in the highly myopic group.  All PSRs were located in the temporal parapapillary gamma zone and corresponded to an ophthalmoscopically visible demarcation line running almost parallel to the optic disc border.  Higher PRS prevalence correlated with longer axial length (OR:2.98;95%CI:1.99,4.46;P<0.001), female sex (OR:6.48;95%CI:1.56,27.0;P=0.01), and older age (OR:1.09;95%CI:1.01,1.18;P=0.02).  Axial length had the strongest influence (beta:0.48), followed by sex (beta:0.20) and age (beta:0.14).  If age was dropped from the multivariable model, myopic maculopathy prevalence (OR:10.0; 95%CI:1.41,70.9;P=0.02) and stage (OR:3.57;95%CI:1.21,10.6;P=0.02) became significantly correlated with higher PSR prevalence. 

Conclusions :
With a PSR prevalence of >60% in eyes with an axial length of >28mm, PSRs are a common morphologic feature of high myopia, with age and female sex as additional associated factors.  PSRs may be due to a biomechanical interplay between the optic nerve and the posterior ocular segment of markedly axially elongated eyes.
 

Purpose :
To explore prevalence and associated factors of macular ridges in a population-based study sample

Materials and Methods :
From the participants of the population-based Beijing Eye Study (n=3468), we included all eyes with an axial length of ≥25 mm, and a randomized sample of the remaining -myopic eyes.  Using optical coherence tomographic images, we assessed prevalence and height of macular ridges, defined as an elevation of the foveal region in one meridian. 

Results :
Among 366 study eyes, 50 (13.7%;95%CI:10.1,17.2) showed macular ridges.  Macular ridge prevalence increased from 0/78 (0%) in the group with an axial length of ≤23 mm, to 18/71 (25.4%), 7/27 (25.9%) and 15/29 (51.7%) in axial length groups of 26-26.99mm, 27-27.99mm, and ≥28 mm, respectively.  Higher macular ridge prevalence was associated (multivariable analysis) with longer axial length (OR:1.79;95%CI:1.48,2.16;P<0.001) and older age (OR:1.08;95%CI:1.04,1.12;P<0.001).  Macular ridge height (mean:128±79µm) increased with longer axial length (0.31;B:7.84;95%CI:5.39,10.3; P<0.001) and older age (beta:0.16;B:0.88;95%CI:0.34,1.42;P<0.001).  Macular ridge orientation was most often in the horizontal meridian (28/50 eyes;56%), followed by the vertical meridian (9/50 eyes;18%), and the 7 o´clock-to-1 o´clock meridian (8/50 eyes;16%).  It was not significantly (P=0.17) associated with the axis of cylindrical corneal refractive error. 
 

Conclusions :
Macular ridges were relatively common in myopic eyes, with macular ridge prevalence and height increasing with longer axial and older age in a curvilinear manner.  They were not significantly associated with corneal astigmatism or best corrected visual acuity.  They may be explained by an inter-plane asymmetry in axial elongation-associated enlargement of Bruch´s membrane in the fundus midperiphery.  
 

Purpose :
Prevalence of myopia and vision impairment due to myopic macular degeneration and myopia-related optic neuropathies have markedly increased worldwide.  We evaluated whether myopia is associated with the prevalence of other ocular disorders in a positive or negative sense. 
 

Materials and Methods :
The Russian Ural Eye and Medical Study (UEMS) and the Beijing Eye Study (BES) included 5899 individuals and 4439 individuals (all aged 40+ years), respectively, and the Central India Eye and Medical Study (CIEMS) consisted of 4711 individuals, aged 30+ years.  The studies were conducted in rural and urban regions in Bashkortostan/Russia, Nagpur/India, and Beijing/China.

Results :
In the UEMS, diabetic retinopathy (DR) prevalence (OR:0.73;95%CI:0.56,0.96), age-related macular degeneration (AMD) prevalence (OR:0.85;95%CI:0.74,0.98) and angle-closure glaucoma (ACG) prevalence (OR:0.72;95%CI:0.55,0.95) decreased, and open-angle glaucoma (OAG) prevalence (OR:1.65;95%CI:1.45,1.88) increased with longer axial length in multivariable analyses.  In the CIEMS, lower AMD prevalence (OR:0.81;95%CI:0.69,0.95) and lower ACG prevalence (OR:0.55;95%CI:0.36,0.83), and higher OAG prevalence (OR:1.45;95%CI:1.15,1.83) were associated with longer axial length.  DR prevalence (0.33%;95%CI:0.16,0.50) was too low for statistical analysis in the CIEMS.  In the BES, prevalence (OR:0.64;95%CI:0.50,0.81) and 10-year incidence of DR (OR:0.48;95%CI:0.33,0.71) and prevalence (OR:0.83;95%CI:0.77,0.89) and 5-year incidence of AMD (OR:0.996;95%CI:0.993,0.999) decreased, and prevalence (OR:1.35;95% CI:1.17,1.56) and 10-year incidence of OAG (OR:1.40;95%CI:1.22,1.61) increased with longer axial length.  In all three studies, the association between higher OAG prevalence and longer axial length was nonlinear with a slight increase for the moderate myopia range, and a steep increase in the highly myopic range.   

Conclusions :
Myopia is associated with a lower prevalence of DR, AMD and ACG and lower incidence of DR and AMD, while high myopia more than moderate myopia is associated with a higher prevalence and incidence of OAG. In moderate myopia, myopia-related advantages, i.e., lower prevalence of DR, AMD and ACG, may partially outweigh increased risks for OAG and other myopia-related disorders.

Purpose :
IRVAN syndrome (Idiopathic Retinitis, Vasculitis, Aneurysms and Neuroretinitis ) is a rare condition characterized by idiopathic retinal vasculitis associated with aneurysmal dilatations and neuroretinitis, and whose diagnosis can be challenging in our daily clinical practice. 
Epidemiologically, IRVAN syndrome more often affects young women from the Mediterranean region.
The course of the disease can be marked by macular exudation or neovascular glaucoma, which threatens the patient's vision.

Materials and Methods :
A 42-year-old female patient of Albanian origin with a history of Steinert's myotonic dystrophy and untreated sleep apnea was referred to our department for a systemic work-up. There were no functional complaints, but questioning and visual acuity were difficult due to cognitive retardation. Anterior segment examination revealed only a bilateral ptosis.

Results :
Fundus examination revealed 360° peripheral retinal ischemia in both eyes, complicated on the right eye by preretinal neovascularization along the superior temporal artery and an inferior intravitreal hemorrhage. Macular Optical Coherence Tomography showed a normal foveolar profile with no subretinal fluid. Fluorescein angiography confirmed the presence of large areas of retinal non-perfusion, dye diffusion on the preretinal neovessel, and macular pinpoints on the right eye corresponding to arterial aneurysms on OCT-Angiography.  
A wide-ranging investigation including an uveitis work-up and a cardiovascular examination with supra-aortic trunk echodoppler was carried out, and all the results were negative.
Stage 3 IRVAN syndrome was diagnosed, and the patient rapidly underwent bilateral panretinal photocoagulation, which stabilized the disease.

Conclusions :
IRVAN syndrome is a rare condition that all ophthalmologists should be aware of and consider in the presence of an isolated occlusive retinal vasculitis. Early diagnosis and management are important to avoid complications threatening the visual prognosis.

Purpose :
The aim of this study was to compare fundus blue autofluorescence (BAF) images, indicating photoreceptors alteration, and indocyanine green angiography (ICGA), indicating retinal pigment epithelium (RPE) alteration, in multiple evanescent white dot syndrome (MEWDS) to investigate the initial damage location within the RPE-photoreceptor complex.
It is a multicentric retrospective cohort, carried out across tertiary centers for retinal and inflammatory diseases in France.

Materials and Methods :
A total of 31 eyes affected by primary MEWDS were included. Only primary MEWDS with high-quality images were analyzed cross-sectionally at baseline and recovery between 4 and 8 weeks. A standardized protocol was used to measure MEWDS-affected areas on late-phase ICGA and BAF, always realized by the same investigator. On 55° macular-centered images, BAF and ICGA areas were delimited and calculated in FIJI/ImageJ Software, then compared. The same process was used for macular areas within a 6-mm ETDRS circle centered on the fovea. The main outcome measure was areas (mm²) affected by MEWDS on BAF and ICGA.

Results :
The median hypofluorescent area on ICGA (93.03 mm2 [IQR 54.08-134.00]) was significantly larger than that affected on BAF (76.22 mm2 [IQR 43.65-122.20], p < 0,0001). The median damaged surface was 37.21% (IQR 21.63-53.61%) on ICGA versus 30.49% (IQR 17.15-46.60%) on BAF (p<0.0001). Regarding only the macular area, damage was also significantly larger on ICGA than in BAF (15.16 (9.55-24.08) mm2 vs 13.48 (4.87-17.82) mm2, p < 0.0001).

Conclusions :
Our study showed that MEWDS lesions are more extensive in ICGA than in BAF, indicating a predominant RPE dysfunction. We therefore support the hypothesis that MEWDS is a primary retinal pigment epitheliopathy, causing reversible and non-destructive dysfunction of the RPE and photoreceptors. Our results support recent analysis of modern multimodal imaging.  Further studies using en-face OCT are needed to analyze the outer retinal layers and corroborate the hypothesis.

Three cases of ICGA hypofluoresence and BAF hyperautofluorescence measurement of MEWDS

Spatial distribution of MEWDS lesions at T0

Purpose :
To investigate efficacity and safety of faricimab in real life practice

Materials and Methods :
Retrospective case series of a single French ophthalmic retinal center where 60 eyes of 50 patients were treated with faricimab for Aged-related Macular Degeneration (AMD). Faricimab was used in pretreated patients,  and we excluded for the analysis naïve patients, and patients treated for diabetic macular oedema or other etiologies of choroidal neovascularisation. Collected datas include demographics background, treatment history, best-corrected visual acuity (BCVA), treatments intervals, anatomic changes and adverse events. 

Results :
We included 60 pre-treated eyes of patients for AMD, mean aged was 78.5 years with a mean of 24 injections before switching to faricimab. Visual acuity at baseline was at 65 letters and was maintained stable during the study, final visual acuity was at 63 letters (p=0.23). The central subfield thickness decreased from 325 µm to 283 µm (p=0.007) during the study and the treatments interval increased from 5,1 weeks to 7,5 weeks (p<0.001) at the end of the follow-up. Two intraocular inflammations have been reported (3,3 %).  

Conclusions :
Faricimab have demonstrate a significant decrease of the retinal thickness and extended intervals in a population based of pretreated AMD patients. Two ocular inflammations have been reported. Future datas on the efficacy and safety of faricimab are needed in order to precise these previous results. 
 

Purpose :
to describe multimodal imaging findings in a case of type 3 macular neovascularisation (MNV).

Materials and Methods :
a case report.

Results :
We report the case of a 76-year-old patient with a history of hypertension and pseudophakia, who presented with decreased vision of the right eye (RE). On examination, visual acuity was limited to 20/100. Anterior segment examination was unremarkable. Fundus examination revealed perifoveal greyish lesion with associated drusen. Macular optic coherence tomography (OCT) showed a hyperreflective ovoid lesion extending from the middle retina toward the level of the RPE associated with intraretinal edema, exudates and drusen. OCT Angiography showed a flow signal originating from the deep vascular plexus with progressive downgrowth of vessels into the deeper capillary plexus of the retina. Multimodal imaging was suggestive of type 3 MNV and the patient was treated by intravitreal anti-VEGF therapy. 

Conclusions :
Type 3 MNV is a distinct entity of neovessels that originate in the deep retina and progressively progress to the choroid. Multimodal imaging mainly OCT and OCTA provide characteristic features of the disease for accurate diagnosis and follow-up.

Purpose :
Alvotech is developing AVT06 as a proposed biosimilar to reference product (RP) aflibercept. A pre-filled syringe (PFS) was developed for AVT06 to improve the ease of drug delivery for retinal physicians, and to ensure delivery of the correct drug volume to the subject (Figure 1). This study (NCT05986786) aims to show that intended users are able to use AVT06 PFS safely and appropriately, and to evaluate safety of AVT06, in participants with chorioretinal vascular disease. It is part of the AVT06 clinical development program, which also includes a study to assess comparative efficacy (NCT05155293).

Materials and Methods :
This is a single arm, open label study. 35 participants received AVT06 on Day 1 followed by 4 weeks of observation. Participants could then enter an Optional Extension Phase according to the dosing regimen for the respective indication. Study endpoints were the proportion of AVT06 injections successfully administered with PFS at Day 1, and incidence of ocular TEAEs, AESIs, and SAEs from baseline to Week 4. This abstract reports the primary endpoint and data up to Week 4. The study continues to Week 52.

Results :
The proportion of AVT06 injections successfully administered with PFS at Day 1 was 100%. All the preparation and administration steps were observed during injection procedure under aseptic technique and assessed as “successful” attempt by the independent observer. Treatment with AVT06 PFS was safe and well-tolerated in participants with chorioretinal vascular disease up to Week 4. Neither ocular, non-ocular AEs, nor SAEs were reported in any of the participants up to Week 4.

Conclusions :
Analysis of the proportion of AVT06 injections successfully administered with PFS at Day 1 supports a demonstration of appropriate and safe handling of AVT06 PFS. The intravitreal injection of AVT06 administered with PFS was safe and well tolerated after single dose during the treatment of chorioretinal vascular disease.

AVT06 PFS

Purpose :
Alvotech is developing AVT06 as a proposed biosimilar to reference product (RP) aflibercept. This study (NCT05155293) aims to demonstrate comparative efficacy between AVT06 and RP in participants with neovascular (wet) age-related macular degeneration.

Materials and Methods :
This is a randomized, double-masked, parallel group study. Participants received AVT06 (n = 205) or RP (n = 205) every 4 weeks for the first 3 doses, followed by every 8 weeks. Randomization was stratified by geographical origin, baseline BCVA, and iris color. Primary endpoint was change from baseline to Week 8 in BCVA measured by Early Treatment Diabetic Retinopathy Study (ETDRS) letter score. Safety endpoints included incidence of ocular and non-ocular treatment-emergent adverse events (TEAEs) and intraocular pressure (IOP). Immunogenicity endpoints comprised treatment-related incidence of anti-drug antibodies (ADAs) and neutralizing antibodies (NAbs). This abstract reports the primary endpoint and data up to Week 24. The study continues to Week 52.

Results :
The Least Squares (LS) mean difference (AVT06-RP) (SE) in BCVA letter score from baseline to Week 8 was 0.77 (0.829 [95% CI: -0.86, 2.40]). Results were completely contained within the prespecified equivalence margin of letters of [-3.5 to 3.5], supporting demonstration of comparative efficacy. Sensitivity analysis supported the robustness of the primary endpoints. There were no notable differences in subgroup analysis (Figure 1). Up to Week 24, the percentage of participants who reported TEAEs in the AVT06 group (46.3%) was similar to RP group (43.4%). There was a comparable increase in the mean IOP results following the intravitreal injection in both treatment groups. Immunogenicity profile was comparable between treatment groups.

Conclusions :
Analysis of the change in BCVA letter score from baseline to Week 8 supports a demonstration of comparative efficacy between AVT06 and RP. AVT06 had a safety and immunogenicity profile similar to that observed for RP up to Week 8, persisting to Week 24.

Least Squares Mean Difference in Change from Baseline to Week 8 in BCVA Letter Score with 95% Confidence Interval

Purpose :

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Results :

Conclusions :

Maculart_casereport.pptx

Purpose :
​The Treatment Burden Score (TBS) is a single score established from the Questionnaire to Assess Life Impact of Treatment by Intravitreal Injections (QUALITII) and composed of 9 items from the 50-items QUALITII. The objective was to translate and cross-culturally adapt the TBS in French.

Materials and Methods :
Localization process was conducted to ensure semantic, conceptual, and idiomatic equivalence with the original English version. The process included 6 steps:
1/Two translations by independent linguistic experts were compared, enabling detection of errors and divergent interpretation of ambiguous items in the original survey
2/Translations reconciliation into a single translation
3/Back translation of the reconciled translation into the source language
4/Review and harmonization of the back translation against the source language
5/Cognitive debriefing of the translation with nAMD patients
6/Translation finalization
Six patients participated in the qualitative cognitive interviews conducted by 3 expert ophthalmologists, asking information regarding comprehension and clarity of each question, ease and adequation of answer options.

Results :
Four out of 9 questions had similar translations from the 2 linguistic experts. Wording differences observed were reconciled with expert ophthalmologists.
Small semantic differences were observed in the back translation, which did not lead to changes.
During qualitative cognitive interviews, the majority of patients considered the questions to be clear (ranging from 67.4% for 1 question; 83.3% for 3 questions and 100% for 5 questions), easy to answer (ranging from 83.3% for 3 questions to 100% for 6 questions) and have adequate options to respond (ranging from 67.4% for 1 question, 83.3% for 3 questions and 100% for 5 questions).
Interviews led to modification of 5 questions to improve clarity.

Conclusions :
Items were well understood, with some revisions incorporated after cognitive interviews.
The translated TBS has linguistic and cultural equivalence to the original version and face validity. The TBS French version is now available to evaluate IVI treatment burden.

Purpose :
To assess prevalence and associations of polypoidal choroidal vasculopathy (PCV) in a general population.

Materials and Methods :
Participants of the population-based Beijing Eye Study, undergoing a detailed ocular and systemic examination.  Using conventional fundus photographs and optical coherence tomographic images with a macular volume scan, we assessed the presence and location of PCV lesions

Results :
Out of 6551 eyes, PCV was detected in 30 eyes (prevalence:0.46%;95%CI:0.29,0.62) of 23 (0.70%) participants (12 (52.2%) men; age:72.4±8.9 years;range:54-87 years).  PCV location was foveal in 7 (23%) eyes, extrafoveal in 4 (13%) eyes, and mixed in 19 (63%) eyes.  PCV occurred bilaterally in 7 (30%) patients (14 (47%) eyes).   All eyes with PCV showed dilated large choroidal vessels, and all patients with unilateral PCV showed dilated large choroidal vessels in both eyes.  Higher PCV prevalence was associated (multivariable analysis) with thicker age- and axial length-adjusted subfoveal choroidal thickness (OR:1.007;95%CI:1.002,1.0011;P=0.006), higher prevalences of dilated large choroidal vessels (OR:14.9;95%CI:4.59,48.4;P<0.001), ophthalmoscopic macular hyperpigmentations (OR:3.71;95%CI:1.84,7.47;P<0.001), intraretinal hyperreflective bodies internal to the ellipsoid zone (OR:21.0;95%CI:3.97,111;P<0.001), worse best corrected visual acuity (OR:11.2;95%CI:2.11,59.1;P=0.005), and higher level of education (OR:3.55;95%CI:1.40,8.98;P=0.007). The height of the largest polypoidal lesion (mean:251±134µm) was not significantly (P=0.26) associated with subfoveal choroidal thickness.  Subfoveal choroidal thickness if age- and axial length-adjusted compared to the raw data, correlated better with PCV prevalence (P=0.006 versus P=0.03).  PCV prevalence was not related to smoking package years (P=0.21) or axial length (P=0.17).

Conclusions :
PCV occurs relatively frequently in an adult and elderly Chinese population, with dilated large choroidal vessels as a main, potentially causative, feature present bilaterally also in all patients with unilateral PCV.  Except for higher educational level (and older age), PCV prevalence was not associated with major systemic parameters.  Age- and axial length-related adjustment of subfoveal choroidal thickness improves the correlation with the PCV prevalence. 
 

Purpose :


Materials and Methods :


Results :


Conclusions :

Purpose :
To evaluate the extension of injection intervals 6 months after switching to faricimab in patients with neovascular age-related macular degeneration (nAMD) and identify predictive factors for interval extension.

Materials and Methods :
This retrospective multicentre study included nAMD patients treated with anti-VEGF intravitreal injections (IVIs) for at least one year before switching to faricimab (November 2023-May 2024). Last injection interval without recurrence, best-corrected visual acuity (BCVA), central macular thickness (CMT), and exudation status were collected just before switch (M0) and 6 months after. Safety outcomes included intraocular inflammation and other adverse events.

Results :
A total of 814 eyes from 705 patients were included in 23 centres (5 university hospitals, 7 hospitals and 11 private centres). At 6 months, the recurrence-free injection interval increased significantly from 5.6 to 7.2 weeks (+1.6 weeks, p<0.0001). The proportion of exudative patients decreased by 37% (p<0.0001). Among refractory cases at M0, 39% achieved a dry macula at M6. Subgroup analyses revealed significantly greater interval extension in patients with immediate interval extension after the second injection, and in patients switched from aflibercept (p<0.0001). There was no difference based on the age, the duration since the first injection, the type of neovascularization, or the injection interval before the switch. The intraocular inflammation rate was 0.6% (5 cases, including 1 case of retinal vasculitis).

Conclusions :
Switching to faricimab significantly extended the recurrence-free injection interval and decreased the proportion of exudative patients. Subgroup analyses suggested that the treatment effect is generalizable across a broad range of patients with similar extension intervall between subgroups. Switch seems all the more relevant for refractory patients or those with a short reinjection interval. Safety outcomes were consistent with previous studies.

Purpose :
To report a case of a man in his twenties presenting with low visual acuity in his left eye for 6 months. Ocular examination revealed a juxtapapillary retinal capillary hemangioblastoma with contiguous serous retinal detachment. Treatment with oral belzutifan was started. Herein we present the results from this therapy.

Materials and Methods :
Full ophthalmic examination and multimodal imaging, including color fundus photography, optical coherence tomography, OCT-angiography and indocyanine green angiography were performed at baseline, along with genetic testing for VHL gene mutations. Subsequent follow-up visits included comprehensive examination, and imaging was repeated as clinically indicated.

Results :
A healthy 29-year-old man was referred for left eye (OS) visual impairment for the last 6 months. Visual acuity at presentation was 20/20 in his right eye and counting fingers in his left. Anterior segment examination was unremarkable, but OS fundus examination revealed a pinkish juxtapapillary vascularized lesion, compatible with a retinal capillary hemangioblastoma. Intra and subretinal exudation with contiguous serous retinal detachment were also present, with foveal involvement. Genetic testing revealed a pathogenic deletion at the VHL gene. Treatment with oral belzutifan (120mg/day) was started, along with intravitreal monthly bevacizumab injections, to help control the exudation. Three months later, the tumour showed significant shrinkage, with resorption of the serous detachment and mild improvement in visual acuity.

Conclusions :
Belzutifan demonstrates promising clinical activity against VHL-associated retinal hemangioblastomas.

Purpose :
This case highlights the potential role of hyperbaric oxygen therapy (HBOT) as an adjunctive intervention in the acute management of paracentral acute middle maculopathy (PAMM) with branch retinal artery occlusion (BRAO) in Susac syndrome.

Materials and Methods :
A case report 

Results :
A 30-year-old female with a known history of Susac syndrome, managed chronically with corticosteroids and immunosuppressive therapy, presented with acute, painless vision loss in her left eye. Her prior ophthalmic history included a central retinal artery occlusion in her right eye with optic nerve atrophy. Visual acuity in her left eye was reduced to counting fingers. Anterior segment examination was unremarkable. Fundoscopic examination revealed localized retinal whitening in the superotemporal quadrant of the macula, consistent with BRAO. Swept-source optical coherence tomography demonstrated hyperreflectivity of the inner retinal layers corresponding to PAMM. She was admitted for urgent management and received high-dose intravenous methylprednisolone alongside ten sessions of HBOT. Following treatment, her visual acuity improved significantly to 20/32.

Conclusions :
Given the vascular pathophysiology of the syndrome and the limited window for intervention in retinal ischemia, HBOT may provide a beneficial strategy to salvage PAMM

Purpose :
This study evaluates the effectiveness of the fluocinolone acetonide (FAc) implant in managing radiation maculopathy, a complication following ocular irradiation. The primary outcomes were to assess changes in best-corrected visual acuity (BCVA) and central foveal thickness (CFT), as well as the impact on therapeutic burden and intraocular pressure (IOP).

Materials and Methods :
This was a retrospective, multicenter, observational study conducted across three French oncology-ophthalmology reference centers. Twelve eyes from twelve patients with radiation maculopathy following ocular irradiation for uveal melanoma were included. All patients received at least one injection of the FAc implant between February 2021 and July 2023. Data on tumor characteristics, lens status, BCVA, CFT, IOP, and SD-OCT findings were collected. The number and types of intravitreal injections before and after FAc implantation were analyzed.

Results :
Median final BCVA significantly improved to 72.5 ETDRS letters (IQR 57.5–76.2) (p=0.03). Median final CFT significantly decreased to 328.0 μm (IQR 286.0-405.0) (p=0.04). The therapeutic burden was significantly reduced, with the mean injection interval increasing from 4.2 to 6.5 months (p=0.03) and the annual number of injections decreasing from 3.2 to 0.2 (p<0.001). IOP significantly increased during follow-up, with a peak of 21.5 mmHg (IQR 18–25) (p<0.001) but returned to baseline of 13 mmHg after treatment adjustments at final visit (IQR 11.5–17.2) (p=0.20).

Conclusions :
The FAc implant improved BCVA and significantly reduced the therapeutic burden in patients with radiation maculopathy. However, careful IOP monitoring is required to manage intraocular hypertension effectively.

Purpose :

Materials and Methods :

Results :

Conclusions :

Maculart Kovach 2025 without.pptx

Purpose :
To assess prevalence and associations of ellipsoid zone (EZ) defects on optical coherence tomographic (OCT) images in a general population, affected by age-related macular degeneration (AMD) or free of any retinal disease.

Materials and Methods :
For the participants of the population-based Beijing Eye Study 2011, we assessed macular volume OCT scans centered on the fovea were assessed for EZ defects.

Results :
:  In the studied population of 1610 eyes (1103 participants;mean age:65.4±9.8 years, EZ defect prevalence increased (P<0.001) from 1.0% (6/591) in the normal group to 13.3% (95/712), 56.3% (166/295) and to 91.7% (11/12) in early AMD, intermediate AMD, and late AMD, respectively.  Higher EZ defect prevalence was associated with higher AMD stage (OR:2.67;P<0.001), higher prevalences of external limiting membrane defects (OR:175;P<0.001), intraretinal hyperreflective bodies (iHRBs) superior to the EZ (OR:42.9;P<0.001) and localized retinal pigment epithelium (RPE) thinning (OR:2.59;P=0.01), higher drusen number (OR:1.03;P=0.001), and lower prevalence of iHRBs inferior to the EZ (OR:0.05;P<0.001).  In a reduced multivariable model, higher EZ defect prevalence was associated with higher prevalence of localized RPE thinning (OR:10.2; P<0.001) and a lower prevalence of reticular pseudodrusen (OR:0.12; P=0.04). 
 

Conclusions :
In view of the spatial correlation between EZ defects and iHRBs located superior to EZ defects, the EZ may be a barrier for RPE cells migrating from Bruch´s membrane into the retina.  It may explain the spatial association of localized RPE thinnings with the presence of EZ defects, and the association between a higher prevalence of reticular pseudodrusen and an absence of EZ defects. 
 

Purpose :
To assess prevalence and associations of localized thinnings of the retinal pigment epithelium (“RPElocThin”) without adjacent drusen or reticular pseudodrusen in a general population, affected by age-related macular degeneration (AMD), or free of any other retinal disease.

Materials and Methods :
On optical coherence tomographic (OCT) images, taken from the macula of the participants of the population-based Beijing Eye Study, we searched for RPElocThins defined as a localized RPE-band thinnings, without adjacent drusen or reticular pseudodrusen.  

Results :
The study population included 1271 eyes (mean age:64.7±9.8 years;range:50-91 years), randomly selected within each group of normal eyes (n=442;34.8%), and eyes with early AMD (n=543;42.7%), intermediate AMD (n=275;21.6%), and late AMD (n=11;0.9%).  RPElocThin prevalence increased from 2/442 (0.5%;95%CI:0.0,1.0) in the normal group to 49/543 (9.0%;95%CI:7.0,11.0), 90/275 (32.7%;95%CI:27.2,38.2), and 9/11 (81.8%;95%CI:55.0,100) in the group with early, intermediate or late AMD, respectively.  RPElocThins were spatially associated with ellipsoid zone (EZ) defects (114/150 (76.0%) eyes), external limiting membrane (ELM) defects (92/150 (61.3%) eyes), intraretinal hyperreflective bodies (iHRBs) in the outer nuclear layer or beyond (111/150 (74.0%) eyes), ophthalmoscopical macular hypopigmentation (76/150 (50.7%) eyes), and RPE-band hypertransmission (46/150 (30.7%) eyes). 
 

Conclusions :
RPElocThins are a morphologic hallmark of AMD including the early AMD stage and correspond in some eyes to ophthalmoscopic macular hypopigmentations.  Their spatial association with overlying defects in the EZ and ELM and occurrence of IHRBs in the outer nuclear layer etiologically suggests an intraretinal migration of RPE cells, without the formation of drusen or reticular pseudodrusen, to play a role in the etiology of RPElocThins. 
 

Purpose :
To assess prevalence and associations of reticular pseudodrusen (RPD) on optical coherence tomographic (OCT) images in a general population, affected by age-related macular degeneration (AMD) or free of any retinal disease.

Materials and Methods :
In participants of the population-based Beijing Eye Study, macular volume OCT scans were assessed for the presence of RPDs.  

Results :
The study included 1558 eyes (1078 participants; mean age: 65.5±9.8 years), randomly selected within each group of normal eyes (n=549;35.2%), and eyes with early AMD (n=721;46.3%), intermediate AMD (n=283;18.2%), and late AMD (n=5;0.5%).  RPD prevalence increased from 0% (0/549) in normal eyes to 11.7% (84/721;95%CI:9.2-14.2%) in early AMD, 32.5% (92/283;95%CI:27.0-38.0%) in intermediate AMD, and 100% (5/5) in late AMD. Higher RPD prevalence was associated with higher AMD stage (OR:23.7;P<0.001) and older age (OR:1.07;P=0.01), higher prevalences of intraretinal hyperreflective bodies (iHRBs) (OR:6.77;P=0.02), macular hyperpigmentations (OR:2.70;P=0.01), outer nuclear layer clouding (OR:1.60;P=0.03) and localized retinal pigment epithelium (RPE) thinning (OR:2.84;P=0.04), smaller drusen size (OR:0.25;P<0.001), thinner subfoveal choroidal thickness (OR:0.995;P=0.04), and thinner central corneal thickness (OR:0.975;P<0.001). 
 

Conclusions :
RPD prevalence increased with AMD severity, from 11.7% in early AMD to 32.5% in intermediate AMD and 100% in late non-exudative AMD.  The association of the RPDs with iHRBs, macular hyperpigmentations, outer nuclear layer clouding and localized RPE thinning may fit with a hypothesis of RPDs representing activated RPE cells at the start of their migration into the retina.  Associations of RPDs with smaller drusen size, thinner subfoveal choroidal thickness, and thinner central corneal thickness warrant further exploration.

 

Purpose :
To assess prevalence and associations of intraretinal hyperreflective foci (HRF) in a general population

Materials and Methods :
Participants of the population-based Beijing Eye Study underwent optical coherence tomography and conventional macula photography.

Results :
The study cohort included 1641 eyes (mean age:62.8±9.1 years;range:50-93 years).  Prevalence of any HRF or of HRF located only superior to the ellipsoid zone (EZ) increased from 33/590 (5.6%;95%CI:4.0,7.0) and 22/590 (3.7%;95%CI:2.2,5.2), respectively, in normal eyes to 371/725 (51.2%;95%CI:47.7,54.7) and 246/725 (33.9%;95%CI:30.4,37.4), respectively, in eyes with early age-related macular degeneration (AMD), to 283/314 (90.1%;95%CI:87.1,93.1) and 260/314 (82.8%;95%CI:78.8,86.8), respectively, in eyes with intermediate AMD, and to 12/12 (100%) and 12/12 (100%), respectively, in late AMD.  HRF beyond the EZ were spatially associated with EZ defects in 298/540 (55.2%) eyes and external limiting membrane (ELM) defects in 203/540 (37.6%) eyes.  Fifty-two (96%) of 54 eyes with macular hyperpigmentations showed HRF beyond the EZ, 52 (9.6%) of 540 eyes with HRF beyond the EZ had corresponding macular hyperpigmentations.  Higher HRF prevalence was associated (multivariable analysis) with higher AMD stage (OR:2.78;95%CI:2.16,3.58;P<0.001), higher prevalences of EZ defects (OR:61.2;95%CI:7.38,508;P<0.001), reticular pseudodrusen (OR:3.98;95%CI:1.87,8.48;P<0.001), RPE elevations (OR:62.6;95%CI:8.43,466;P<0.001) and RPE thinnings (OR:2.42;95%CI:1.07,5.46;P=0.03). 

Conclusions :
The HRF prevalence was relatively high in early AMD and increased to late AMD.  HRF location and shape suggested intraretinally migrated RPE cells as their equivalent.  The majority of HRF were not associated with an ophthalmoscopically detected macular hyperpigmentation.  HRF can also be found in locations spatially correlating with an RPE loss without drusen, but with EZ defects and ELM defects

Purpose :
To characterize the phenotype of pachy-reticular pseudodrusen (pachy-RPD) associated with pachyvitelliform maculopathy (PVM).

Materials and Methods :
This retrospective case-control study included patients over 50 years old with pachy-RPD (defined as subfoveal choroidal thickness >250 μm) associated with PVM. Patients with acquired vitelliform lesions (AVL) without other comorbidities served as controls. Clinical data and multimodal imaging were analyzed, including structural optical coherence tomography (OCT), fundus autofluorescence, OCT angiography (OCTA), and fluorescein/ICG angiography.

Results :
A total of 25 eyes from 17 patients (mean age 74 ± 11 years) met the inclusion criteria. The mean best-corrected visual acuity was 20/64 (range 20/32 to 20/250). Most lesions were unilateral (59%) with foveal involvement. Compared to AVL eyes, pachy-RPD/PVM eyes exhibited smaller lesion size, significantly lower central macular thickness (P=0.04), and reduced vertical (P=0.008) and horizontal lesion diameters (P<0.001). However, pachy-RPD/PVM eyes showed a higher prevalence of external limiting membrane discontinuities (56% vs. 27%, P=0.03) and marked hypertransmission (68% vs. 8%, P<0.001). Notably, 6 out of 25 PVM eyes (24%) developed late-stage complications in the fellow eye, including type 1 macular neovascularization (4 eyes) and macular atrophy (2 eyes). These eyes demonstrated significant thinning of the outer retina (306 ± 32 μm vs. 277 ± 13 μm, P=0.007) and reduced macular cube volume (9.1 ± 1.0 mm³ vs. 8.1 ± 0.4 mm³, P=0.01).

Conclusions :
Pachy-RPD and PVM represent a distinct phenotypic variant within the spectrum of vitelliform maculopathies. This study identifies specific structural and imaging biomarkers that distinguish pachy-RPD/PVM from AVL, highlighting a strong correlation between choroidal thickness, outer retinal changes, and hypertransmission features.
 

Purpose :

Materials and Methods :

Results :

Conclusions :

A Blind Spot in the Heart- Diagnosing Infective Endocarditis via Retinal Artery Occlusion .pptx

Purpose :
Our objective is to present a case of a CRAO due to a bacterial endocarditis.

Materials and Methods :
Clinical case report

Results :
Central retinal artery occlusion (CRAO) is a rare but blinding disorder. We present a case of a 81-year-old woman with multiple cardiovascular comorbidities admitted to the emergency department due to sudden, painless vision loss on left eye on awakening. The patient also reported long standing fatigue associated with effort that started 4months before admission. She presented best corrected visual acuity of counting fingers OS. Funduscopy OS revealed macular oedema with cherry red spot pattern. Blood cultures came positive for Streptococcus gallolyticus in the context of a bacteremia and native mitral valve vegetation identified on transoesophageal echocardiography. CRAO of embolic origin was admitted in the context of an infective endocarditis. 

Conclusions :
CRAO can be the first manifestation of a potentially fatal systemic condition and thus multidisciplinary approach is warranted with close collaboration between ophthalmologists and internists in order to provide proper management and the best possible treatment.

Purpose :
It is crucial to perform a systematic ophthalmologic examination in all patients diagnosed with acute leukemia to detect any ocular abnormalities at an early stage and adjust management accordingly.

Materials and Methods :
We report the case of a 38-year-old patient with a history of otalgia, peripheral facial paralysis, binocular diplopia, vertigo, and limitation of abduction one month before admission.
The ophthalmologic examination revealed cotton-wool spots, flame-shaped hemorrhages, retinal vasculitis, and Roth spots in the left eye fundus, Which was complicated by an intravitreal hemorrhage and profoundly decreased visual acuity, limited to hand movements.

Results :
the patient underwent a vitrectomy combined with intraoperative laser treatment, and postoperative visual acuity improved to 5/10.

Conclusions :
Ocular involvement can often be the first clinical sign of acute leukemia or indicate a relapse of the disease after a period of complete remission. This manifestation requires special attention, as it may go unnoticed.

Fundus photography showing cotton wool spots, flame-shaped hemorrhages, retinal vasculitis, and Roth spots (left eye)

Retinal angiography showing papillitis and occlusive vasculitis with peripheral ischemia (left eye)

Purpose :
To report a case series of patients who developed retinal vascular complications following COVID-19
vaccination.

Materials and Methods :
All three patients had a complete ophthalmological examination, fundus imaging, and retinal fluorescein
angiography (FA).

Results :
A 36-year-old woman with no prior medical conditions reported unilateral visual disturbances one month
after her third dose of the Pfizer-BioNTech COVID-19 vaccine. Fundus examination revealed a combined
retinal arteriole and hemicentral retinal vein occlusion, confirmed by FA. Serological tests identified
antinuclear and anti-SSB antibodies, along with false-positive results for CMV, HSV, and Lyme
disease—likely due to immune cross-reactivity. An internal medicine consultation suggested an immune-
mediated reaction potentially triggered by the vaccine.
Case 2:
A 42-year-old woman experienced sudden unilateral vision loss one month after her first AstraZeneca
COVID-19 vaccine dose. Ophthalmic exam of the affected eye found a best-corrected visual acuity limited
to 1/10. Fundus examination and FA revealed a central retinal vein occlusion accompanied by cilioretinal
artery occlusion. Systemic examination and laboratory tests were unremarkable.
Case 3:
A 73-year-old man with no known health issues presented with sudden sequential bilateral vision loss
occurring 18 and 28 days after receiving his third dose of Pfizer-BioNTech vaccine in the right and left
eye, respectively. Best-corrected visual acuity was reduced to counting fingers in both eyes. Fundus
examination and FA revealed bilateral severe ischemic central retinal vein occlusion. Mild hypertension
was discovered during systemic evaluation.

Conclusions :
The potential association between COVID-19 vaccination and retinal vascular occlusions remains
uncertain. Possible mechanisms include vaccine-induced immune thrombotic thrombocytopenia, retinal
vasculitis, elevated homocysteine levels, or a heightened proinflammatory and/or procoagulant
responses. While causality cannot be definitely established, clinicians should be aware of this possible
rare adverse effect in post-vaccination patients presenting with visual symptoms.