Background: Primary open-angle glaucoma is a multifactorial serious disease characterized by progressive retinal ganglion cell death and loss of visual field.Objectives: The purposes of this study were to investigate shear wave elastography (SWE) use in the evaluation of the optic nerve (ON) and peripapillary structures, and to compare the findings between glaucomatous and control eyes.Patients and Methods: A case-controlled study, including 21 patients with primary open-angle glaucoma and 21 age-matched control subjects, was carried out. All of the participants had comprehensive ophthalmological exams that included corneal biomechanical measurements with ocular response analyzer. In vivo evaluation of the biomechanical properties of the ON and peripapillary structures were performed with SWE in all participants. The Kolmogorov–Smirnov test was used to analyze the normal distribution of data. Differences of parameters in ophthalmologic data and stiffness values of patients with and without glaucoma were evaluated using the Mann-Whitney U test.Results: There were no statistically significant differences between the glaucoma and control groups in terms of age (P>0.05) and gender (P>0.05). Corneal hysteresis was lower in the glaucoma group (P<0.05). Corneal compensated intraocular pressure and Goldmann correlated intraocular pressure were higher in the glaucoma group (P<0.0001 for both). The mean stiffness of the ON and peripapillary structures were significantly higher in glaucoma patients for each measured region (P<0.05).Conclusion: The study evaluated the biomechanical properties of theONandperipapillary structures in vivo withSWEin glaucoma.We observed stifferONand peripapillary tissue in glaucomatous eyes, indicating thatSWEclaimsnewperspectives in the evaluation of ON and peripapillary structures in glaucoma disease.

Purpose: To evaluate the peripapillary choroidal thickness (CT) in children with unilateral amblyopia using spectral‑ domain optical coherence tomography (SD‑ OCT). Methods: One hundred and six eyes of 53 children with unilateral amblyopia and 20 eyes of 20 children with normal vision were involved in this study. Of the 53 children with unilateral amblyopia, 29 (54. 7%) had hyperopic anisometropic amblyopia and 24 (45. 3%) had strabismic amblyopia. Peripapillary CT was measured from 6 mm length radial B‑ scans at the optic nerve head using the enhanced depth imaging program of an SD‑ OCT (Heidelberg Engineering, Germany). Age, sex, refractive error, and best‑ corrected visual acuity were also recorded. Results: The average peripapillary CT was greater in amblyopic eyes than in the fellow eyes of the children with amblyopia (P = 0. 002), and control eyes (P < 0. 001). There was no significant difference between the fellow eyes of children with amblyopia and the control eyes (P = 0. 158). The average peripapillary CT was negatively correlated with axial length (AL) in amblyopic eyes (r = ‑ 0. 381; P = 0. 005) and fellow eyes (r = ‑ 0. 392; P = 0. 004) but not in control eyes (r = ‑ 0. 232; P = 0. 325). After adjustment for the possible effects of AL, the average peripapillary CT in amblyopic eyes was still greater than in fellow eyes (P = 0. 014) and control eyes (P = 0. 022). Conclusion: The peripapillary choroid of eyes with amblyopia was thicker than that of the fellow eyes and control eyes. No significant difference was observed between fellow eyes and control eyes.

Purpose: To present the optical coherence tomography angiography (OCTA) findings of the radial peripapillary capillary (RPC) network in an individual with severe bilateral methanol-induced toxic optic neuropathy (MTON) in comparison to a normal subject and a patient with retinitis pigmentosa. Case Report: A 35-year-old man with severe bilateral MTON was referred to the neuro-ophthalmology clinic at the Labbafinejad Medical Center. The Angio Vue OCT 3D set of 4. 5 × 4. 5 mm was used to measure the disc and peripapillary vessel density. Two subjects were examined with the same protocol as controls to determine the effect on the RPC vessel density in multiple scenarios. One of the controls was a healthy individual with the prerequisite matches of age and sex while the second one was a known retinitis pigmentosa (RP) patient. RPC density was measured as 37. 7 in the patient with MTON, 46. 9 in the RP patient, and 54. 7 in the healthy control. Conclusion: The reduction in the RPC vessel density in a patient with MTON compared to that of a healthy individual and also a patient with RP may be due to the loss of capillaries secondary to the loss of nerve fibers and ganglion cells. Moreover, MTON can be considered an optic neuropathy with direct mitochondrial damage to the endothelial cells of the capillaries.

Purpose: This study aimed to report a case of peripapillary choroidal neovascularization (CNV) with a pitchfork sign. Case Report: A young female presented with a progressive and painless visual blurring of the left eye. Ophthalmoscopic findings and results of optical coherence tomography (OCT), OCT angiography (OCTA), and fluorescein angiography (FAG) were evaluated. OCT showed subretinal hyperreflective material adjacent to the optic nerve head with multiple vertical finger-like projections extending into the outer retina (pitchfork sign). OCTA revealed that seafan-shaped high-flow vessels above the retinal pigment epithelium (RPE) were compatible with CNV type 2 with a large feeder vessel completely contiguous with the optic nerve. No evidence of ocular or systemic inflammation was found. Conclusion: Pitchfork sign can be seen in CNV type 2 in either inflammatory or noninflammatory conditions.

PRESENTATION: Pathologic myopia is defined as myopic refractive error greater than ‑6.00 diopters (D).[1] Axial myopia progression results in stretching of ocular layers which may be imaged by optical coherence tomography (OCT).These findings consist of dehiscence of retinal layers, retinal cysts, intrachoroidal cavitation, macular holes, posterior retinal detachment and choroidal neovascular membranes.[2] Furthermore, it has been suggested that scleral protrusion temporal to the optic disc in highly myopic eyes could cause excessive tension on the retinal nerve fiber layer which may result in visual field defects...

Although choroid has been shown to have a vital role in the pathophysiology of many ocular diseases, its role in the pathogenesis of several other conditions remains uncertain. The authors propose a novel methodology to establish a more accurate Peripapillary Choroidal Thickness (PPCT), using an image-processing software. This study sought to evaluate the reproducibility and repeatability of PPCT evaluation with ImageJ software in healthy volunteers. Forty-eight eyes of 24 volunteers were subjected to PPCT area determination, after imaging acquisition and recording with Spectral-domain Optical Coherence Tomography (SD-OCT) Heidelberg Spectralis® , during two different sessions, by two blinded assessors. The age of the subjects was 29. 2 ± 4. 5 years (mean ± SD). The Coefficient of Repeatability (CR) average measurements of PPCT area was 17. 06 mm2 and 9. 48 mm2 correspondingly, for the first and second examiners. Intra-class Correlation Coefficient (ICC) was 0. 994 (95% CI 0. 989 to 0. 997) and 0. 998 (95% CI 0. 997 to 0. 999). Inter-observer Concordance Correlation Coefficient (CCC) was 0. 998 (95% CI 0. 996 to 0. 999) for both examiners. Intra-observer CCC ranged from 0. 997 (95% CI 0. 996 to 0. 999) to 0. 998 (95% CI 0. 997 to 0. 999), correspondingly, for the first and second examiners. The PPCT quantification by means of the proposed methodology showed good inter-and intra-observer agreement for both operators, indicating feasibility and good reproducibility of the proposed methodology. This approach might be used in different clinical settings and potentially contributes to elucidation of the choroid role in ocular pathology.

Purpose: This study aimed to measure the peripapillary retinal nerve fiber layer (RNFL) thickness using spectral‑ domain optical coherence tomography (SD‑ OCT) in normal Iranian children aged below 18 years. Methods: Peripapillary RNFL imaging was performed in the right eye of normal Iranian children aged below 18 years using Spectralis SD‑ OCT (Heidelberg Engineering; Vista, CA). The effects of age, gender, cup‑ to‑ disc ratio, and spherical equivalent (SE) on global and sectoral RNFL thicknesses were evaluated. Results: A total of 115 eyes were imaged. Approximately 51 (44. 3%) of the cases were female children. The mean age was 12. 44 ± 2. 52 years. The SE of refractive error was 0. 39 ± 1. 38 diopters (range: − 3. 00 to +4. 5 D). The RNFL thickness measurements in the superior, inferior, nasal, and temporal quadrants were 129. 25 ± 14. 52, 128. 16 ± 13. 46, 76. 76 ± 10. 58, and 69. 58 ± 9. 94 µ m, respectively. The global RNFL thickness was 101. 01 ± 7. 74 µ m. In both univariate and multiple regression analyses, SE was the only determinant of RNFL thickness (all P values < 0. 05). Conclusion: OCT analysis can effectively measure RNFL thickness in children, and SE is the only determinant of RNFL thickness in normal Iranian patients aged below 18 years.