@article {118, title = {Assessment of estimated retinal atrophy progression in Stargardt macular dystrophy using spectral-domain optical coherence tomography.}, journal = {Br J Ophthalmol}, volume = {100}, year = {2016}, month = {2016 Jul}, pages = {956-962}, abstract = {

AIMS: To estimate disease progression based on analysis of macular volume measured by spectral-domain optical coherence tomography (SD-OCT) in patients affected by Stargardt macular dystrophy (STGD1) and to evaluate the influence of software errors on these measurements.

METHODS: 58 eyes of 29 STGD1 patients were included. Numbers and types of algorithm errors were recorded and manually corrected. In a subgroup of 36 eyes of 18 patients with at least two examinations over time, total macular volume (TMV) and volumes of all nine Early Treatment of Diabetic Retinopathy Study (ETDRS) subfields were obtained. Random effects models were used to estimate the rate of change per year for the population, and empirical Bayes slopes were used to estimate yearly decline in TMV for individual eyes.

RESULTS: 6958 single B-scans from 190 macular cube scans were analysed. 2360 (33.9\%) showed algorithm errors. Mean observation period for follow-up data was 15 months (range 3-40). The median (IQR) change in TMV using the empirical Bayes estimates for the individual eyes was -0.103 (-0.145, -0.059) mm per year. The mean ({\textpm}SD) TMV was 6.321{\textpm}1.000 mm at baseline, and rate of decline was -0.118 mm per year (p=0.003). Yearly mean volume change was -0.004 mm in the central subfield (mean baseline=0.128 mm), -0.032 mm in the inner (mean baseline=1.484 mm) and -0.079 mm in the outer ETDRS subfields (mean baseline=5.206 mm).

CONCLUSIONS: SD-OCT measurements allow monitoring the decline in retinal volume in STGD1; however, they require significant manual correction of software errors.

}, keywords = {Adolescent, Adult, Aged, Child, Disease Progression, Female, Humans, Macula Lutea, Macular Degeneration, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Tomography, Optical Coherence, Visual Acuity, Young Adult}, issn = {1468-2079}, doi = {10.1136/bjophthalmol-2015-307035}, author = {Strauss, Rupert W and Mu{\~n}oz, Beatriz and Wolfson, Yulia and Sophie, Raafay and Fletcher, Emily and Bittencourt, Millena G and Scholl, Hendrik P N} } @article {530, title = {Evidence of macular pigment in the central macula in albinism.}, journal = {Exp Eye Res}, volume = {145}, year = {2016}, month = {2016 04}, pages = {468-471}, abstract = {

PURPOSE: Albinism represents a spectrum of disorders with diminished to absent amounts of melanin pigmentation including the posterior segment of the eye. Macular pigment (MP) consists of two main carotenoids, lutein and zeaxanthin, concentrated in the macula. MP serves as blue light absorbent, antioxidant, and may reduce chromatic aberration and glare. It remains unclear if albinos have detectable MP. The purpose was to investigate the distribution of MP in albino patients with psychophysical and imaging techniques.

METHODS: MP was measured at the eccentricity of 0.5{\textdegree} by heterochromatic flicker perimetry (QuantifEye({\textregistered}); Tinsley Precision Instruments Ltd.) or by scanning laser ophthalmoscopy (MPOD module, MultiColor Spectralis({\textregistered}), Heidelberg Engineering, Heidelberg, Germany) in four albino patients, who were also investigated with multimodal ophthalmic imaging.

RESULTS: Visual acuity ranged from 20/32 to 20/125, nystagmus was present in three patients, and all patients showed typical foveal hypoplasia on fundus exam and optical coherence tomography. Fundus autofluorescence (FAF) demonstrated various degrees of central FAF signal attenuation. Genetic testing was available in three patients and confirmed the diagnosis. Measurable amounts of MP were detected in all four patients and ranged from 0.05 to 0.24, which is below the normal range.

CONCLUSIONS: We conclude that MP can be demonstrated and measured in albinos. Further studies are needed to investigate MP accumulation following carotenoid supplementation and its impact on visual performance.

}, keywords = {Adult, Aged, Albinism, Ocular, Fluorescein Angiography, Humans, Macula Lutea, Macular Pigment, Male, Middle Aged, Tomography, Optical Coherence, Visual Acuity, Visual Field Tests, Visual Fields}, issn = {1096-0007}, doi = {10.1016/j.exer.2015.10.006}, author = {Wolfson, Yulia and Fletcher, Emily and Strauss, Rupert W and Scholl, Hendrik P N} } @article {106, title = {Safety and Proof-of-Concept Study of Oral QLT091001 in Retinitis Pigmentosa Due to Inherited Deficiencies of Retinal Pigment Epithelial 65 Protein (RPE65) or Lecithin:Retinol Acyltransferase (LRAT).}, journal = {PLoS One}, volume = {10}, year = {2015}, month = {2015}, pages = {e0143846}, abstract = {

UNLABELLED: Restoring vision in inherited retinal degenerations remains an unmet medical need. In mice exhibiting a genetically engineered block of the visual cycle, vision was recently successfully restored by oral administration of 9-cis-retinyl acetate (QLT091001). Safety and visual outcomes of a once-daily oral dose of 40 mg/m2/day QLT091001 for 7 consecutive days was investigated in an international, multi-center, open-label, proof-of-concept study in 18 patients with RPE65- or LRAT-related retinitis pigmentosa. Eight of 18 patients (44\%) showed a >=20\% increase and 4 of 18 (22\%) showed a >=40\% increase in functional retinal area determined from Goldmann visual fields; 12 (67\%) and 5 (28\%) of 18 patients showed a >=5 and >=10 ETDRS letter score increase of visual acuity, respectively, in one or both eyes at two or more visits within 2 months of treatment. In two patients who underwent fMRI, a significant positive response was measured to stimuli of medium contrast, moving, pattern targets in both left and right hemispheres of the occipital cortex. There were no serious adverse events. Treatment-related adverse events were transient and the most common included headache, photophobia, nausea, vomiting, and minor biochemical abnormalities. Measuring the outer segment length of the photoreceptor layer with high-definition optical coherence tomography was highly predictive of treatment responses with responders having a significantly larger baseline outer segment thickness (11.7 {\textpm} 4.8 μm, mean {\textpm} 95\% CI) than non-responders (3.5 {\textpm} 1.2 μm). This structure-function relationship suggests that treatment with QLT091001 is more likely to be efficacious if there is sufficient photoreceptor integrity.

TRIAL REGISTRATION: ClinicalTrials.gov NCT01014052.

}, keywords = {Acyltransferases, Administration, Oral, Adult, Anticarcinogenic Agents, Cerebral Cortex, Child, cis-trans-Isomerases, Drug Dosage Calculations, Female, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Radiography, Retinal Ganglion Cells, Retinal Neurons, Retinitis Pigmentosa, Treatment Outcome, Visual Acuity, Visual Fields, Vitamin A, Young Adult}, issn = {1932-6203}, doi = {10.1371/journal.pone.0143846}, author = {Scholl, Hendrik P N and Moore, Anthony T and Koenekoop, Robert K and Wen, Yuquan and Fishman, Gerald A and van den Born, L Ingeborgh and Bittner, Ava and Bowles, Kristen and Fletcher, Emily C and Collison, Frederick T and Dagnelie, Gislin and Degli Eposti, Simona and Michaelides, Michel and Saperstein, David A and Schuchard, Ronald A and Barnes, Claire and Zein, Wadih and Zobor, Ditta and Birch, David G and Mendola, Janine D and Zrenner, Eberhart} } @article {315, title = {Macular telangiectasia type 2.}, journal = {Prog Retin Eye Res}, volume = {34}, year = {2013}, month = {2013 May}, pages = {49-77}, abstract = {

Macular telangiectasia type 2 is a bilateral disease of unknown cause with characteristic alterations of the macular capillary network and neurosensory atrophy. Its prevalence may be underestimated and has recently been shown to be as high as 0.1\% in persons 40 years and older. Biomicroscopy may show reduced retinal transparency, crystalline deposits, mildly ectatic capillaries, blunted venules, retinal pigment plaques, foveal atrophy, and neovascular complexes. Fluorescein angiography shows telangiectatic capillaries predominantly temporal to the foveola in the early phase and a diffuse hyperfluorescence in the late phase. High-resolution optical coherence tomography (OCT) may reveal disruption of the photoreceptor inner segment-outer segment border, hyporeflective cavities at the level of the inner or outer retina, and atrophy of the retina in later stages. Macular telangiectasia type 2 shows a unique depletion of the macular pigment in the central retina and recent therapeutic trials showed that such depleted areas cannot re-accumulate lutein and zeaxanthin after oral supplementation. There have been various therapeutic approaches with limited or no efficacy. Recent clinical trials with compounds that block vascular endothelial growth factor (VEGF) have established the role of VEGF in the pathophysiology of the disease, but have not shown significant efficacy, at least for the non-neovascular disease stages. Recent progress in structure-function correlation may help to develop surrogate outcome measures for future clinical trials. In this review article, we summarize the current knowledge on macular telangiectasia type 2, including the epidemiology, the genetics, the clinical findings, the staging and the differential diagnosis of the disease. Findings using retinal imaging are discussed, including fluorescein angiography, OCT, adaptive optics imaging, confocal scanning laser ophthalmoscopy, and fundus autofluorescence, as are the findings using visual function testing including visual acuity and fundus-controlled microperimetry. We provide an overview of the therapeutic approaches for both non-neovascular and neovascular disease stages and provide a perspective of future directions including animal models and potential therapeutic approaches.

}, keywords = {Diagnosis, Differential, Humans, Macula Lutea, Retinal Diseases, Telangiectasis, Visual Acuity}, issn = {1873-1635}, doi = {10.1016/j.preteyeres.2012.11.002}, author = {Charbel Issa, Peter and Gillies, Mark C and Chew, Emily Y and Bird, Alan C and Heeren, Tjebo F C and Peto, Tunde and Holz, Frank G and Scholl, Hendrik P N} }