Anterior Vitreous Face Behavior

Hugo Scarfone, MD; Jose Jeronimo Riera, MD; Maria Carolina Rodriguez, MD; and Sergio Epelbaum, MD

Eyetube

Keratoconus and Visual Rehabilitation

Two studies provide insight into current modalities.

Dimitrios Kyroudis, MD, FWCRS, and Michael Tsatsos, MD, PhD, FEBOS-CR, FWCRS, MRCOphth

Cataract and Refractive Surgery Today

Comparison of Long-Term Outcomes of Simultaneous Accelerated Corneal Cross-Linking Combined With Intracorneal Ring Segment or Topography-Guided Photorefractive Keratectomy Cohen E, Tone SO, Mimouni M, et al1Industry support: None ABSTRACT SUMMARY A prospective, nonrandomized, interventional study compared the long-term outcomes of simultaneous accelerated CXL combined with either intrastromal corneal ring segments (CXL-ICRS) or topography-guided PRK (CXL-TG-PRK) in eyes that had progressive keratoconus. The research builds upon an earlier study with 1 year of follow-up by the same group.2 Of the original 248 eyes, 57 (CXL-ICRS, n = 32; CXL-TG-PRK, n = 25) were included. The mean follow-up duration was 51.28 months for the CXL-ICRS group and 54.57 months for the CXL-TG-PRK group. Study in Brief A prospective, nonrandomized, interventional study compared the 5-year clinical outcomes of CXL with two adjunctive modalities—intrastromal corneal ring segments (ICRSs) and topography-guided PRK (TG-PRK)—for the treatment of progressive keratoconus. Only patients in the CXL-ICRS group experienced an improvement in visual parameters. Both treatment groups achieved an improvement in topographic parameters, although the change was greater in the CXL-TG-PRK group. The improvement in topography remained stable over the long term in the CXL-ICRS group but regressed in the CXL-TG-PRK group. Safety was excellent in both groups. WHY IT MATTERS The study offers insight into the long-term efficacy of ICRS implantation and TG-PRK when these procedures are combined with CXL for the visual rehabilitation of patients with keratoconus. At the final follow-up visit, the change (improvement) in patients’ logMAR uncorrected distance visual acuity (UDVA) compared to preoperative values was significant in the CXL-ICRS group (-0.31 ±0.27, P < .001; equivalent to approximately 3 lines) but not the CXL-TG-PRK group (-0.06 ±0.42, P = .43; < 1 line).

Capturing Geographic Atrophy with Multimodal Imaging

Noninvasive technologies are redefining how we diagnose and monitor atrophic AMD.

Eric H. Souied, MD; Oudy Semoun, MD; and Vittorio Capuano, MD

Retina Today

AT A GLANCE Color fundus photography is often not sufficient for the diagnosis and monitoring of geographic atrophy (GA), and other imaging modalities are needed. OCT and fundus autofluorescence are the standard imaging modalities for the diagnosis of GA. Invasive techniques (ie, fluorescein angiography and ICG angiography) should be reserved for specific cases in which the diagnosis is unclear. OCT angiography may be useful to detect nonexudative macular neovascularization associated with GA. Diagnosis of geographic atrophy (GA) relies on multimodal imaging, including color fundus photography, fundus autofluorescence (FAF) imaging, and structural OCT.1 Diagnosis can be difficult and, at times, may require more invasive tests such as fluorescein angiography (FA) and ICG angiography (ICGA). More recently, OCT angiography (OCTA) has become a useful tool to capture associated choroidal neovascularization as part of mixed GA and wet AMD.2 Here, we discuss noninvasive imaging techniques that can help clinicians establish a definitive diagnosis of GA and follow patients appropriately.