Vitreomacular Interphase Disorders in Eyes with Proliferative Sickle Cell Retinopathy

Purpose: To describe the type of vitreomacula interface disorders (VID) seen in eyes with proliferative sickle cell retinopathy, based on optical coherence tomography findings and assess their effect on visual acuity. Patients and Methods: This was a retrospective observational case study. Clinical records and imaging records were reviewed to identify all PSR cases with Fourier-domain OCT imaging showing VIDs at a single academic private-practice office location from January 1, 2015 to July 30, 2018. Identified VIDs were classified as Vitreomacula Adhesions, Vitreomacula Traction, Lamellar Macula Hole, Full Thickness Macula Hole, Epiretina membranes and Macula Pseudohole. Results: Out of a total of 98 eyes of 78 patients with PSR evaluated, only 12 eyes had VIDs; this represents 12.2% of PSR patients. There were 3 (25%) males and 9 (75%) females with ages ranging from 32 to 64 years, a mean age of 45.42yrs [SD 10.27], 9(75%) right eyes were affected. In 9(75%) patients their genotype was SC and 3(25%) with genotype SS. PSR was at stage 3 in 6(50%) eyes, while the remaining 6(eyes) were at stage 4. The most common VID was epiretina membranes (ERM) seen in 7(58.3%)eyes, in 2(16.6%) ERMs eyes were associated with Lamella Macula Holes and in 1(8.3%) the ERM was associated with a pseudohole. VMAs were seen in in 3(25%) eyes and FTMHs were seen in 2 (16.6%) eyes. ERMs were thus seen in 7.1% (7 eyes) of the 98 eyes with PSR that were considered. Conclusion: Epiretina membranes with or without macular holes are the most common vitreomacular interphase disorders seen in our series of eyes with proliferative sickle cell retinopathy. They were associated with mild to moderate impairment in visual acuity.

Cardiac Imaging: OCT

Introduction Intracoronary imaging by means of optimal coherence tomography (OCT) provides valuable incremental information that can be used clinically to optimize stent implantation and minimize stent-related problems. Over the past decades, OCT has progressively evolved with respect to technical performance and procedural aspects. Principle OCT is a fiberoptic wire with a rotating lens emitting near infrared (1,300 nm) light and records the light reflected from the tissue. The currently used Fourier domain-OCT allows superior image quality and faster image acquisition. OCT in Acute Coronary Syndrome (ACS) It helps in accurate detection of actual event leading to ACS among plaque rupture, plaque erosion, and calcified nodule. OCT has an advantage over intravascular ultrasound for identification of vulnerable plaque and also detection of thin cap fibroatheroma < 65 µm. Clinical Utility OCT helps in diagnosis of an angiographically ambiguous lesion such as dissection, thrombus, and calcified nodule. It also helps in planning different aspects of percutaneous coronary intervention such as lesion preparation, determining stent size and length and also helps in optimization of results of stent deployment.Certain nonatherosclerotic events such as coronary arteritis can be diagnosed with OCT.Continued advancement in technology, faster image acquisition, and more sophisticated coregistered image analysis will facilitate greater adoption through ease of use and interpretation.