OBJECTIVE

This study compared the choroidal vascularity indices (CVI) among eyes with neovascular, nonneovascular age-related macular degeneration (AMD) and healthy controls.

Spectral-domain optical coherence tomography (OCT) with enhanced depth imaging (EDI) from 52 eyes of 33 subjects were analyzed and designated into 3 groups: control, non-neovascular AMD, and neovascular AMD. Using Image J software, a 1.5 mm subfoveal choroidal area was segmented and binarized to measure total and luminal choroidal areas. The CVI was calculated as the ratio of luminal to total choroidal area. Correlation studies were done to assess relationship of CVI with best-corrected visual acuity (BCVA) and disease severity.

The overall median CVI was 0.66 (IQR = 0.62 – 0.69), with overall median total choroidal area of 696,707.60 (IQR = 530,776.80 – 806,348.00), overall median luminal choroidal area of 442,884.60 (IQR = 351,612.80 – 549,540.30), and an overall median choroidal thickness of 237.10 (IQR = 178.43 – 270.25). The overall median LogMAR BCVA was 0.30 (IQR = 0.10 – 0.54). Statistical comparisons showed no significant differences in the median CVI, median total choroidal area, median luminal choroidal area, and median choroidal thickness among the three groups (p > 0.05). However, median BCVA was significantly different among the groups (χ2=35.98, p=0.001). Specifically, those with non-neovascular AMD and neovascular AMD had significantly worse visual acuity compared to the control group (p < 0.05).

The study found that CVI, as measured by binarization of EDI-OCT images, was not significantly different among AMD and control groups. BCVA, however, was significantly affected by AMD. These findings suggest that while CVI may not vary with AMD severity, BCVA remains a crucial diagnostic factor. Further research is needed to explore the relationship between choroidal vascularity and AMD using advanced imaging techniques.

Background: Avascular necrosis (AVN) of the femoral head results from intraosseous pathology causing functional impairment. Early diagnosis allows conservative treatment like core decompression, delaying total hip arthroplasty. Objective: This meta-analysis aims to summarize platelet-rich plasma's (PRP) impact as an adjunct to core decompression (CD) on treatment outcomes and femoral head preservation in hip AVN. Methods: The study conducted a comprehensive literature search using PubMed, Cochrane Library, Science Direct, Google Scholar and Med Line, including randomized controlled trials (RCTs) and previous meta-analyses from various databases. Using a random effects model, it compared PRP+CD with bone grafting to CD with bone grafting alone in AVN patients, evaluating function, pain scores, disease progression and the need for hip surgery. Results: The meta-analysis examined 1041 records and included three studies. The primary outcomes were function and pain scores using Harris Hip Scoring (HHS) and Visual Analog Scale (VAS). Postoperative HHS scores at final follow-up favored the PRP+CD group significantly over CD alone. Postoperative VAS scores showed a trend towards higher scores in the CD alone group. The PRP+CD group demonstrated higher survival from disease progression compared to CD alone. Overall, the study suggests that PRP+CD led to better functional outcomes and disease progression outcomes than CD alone in AVN of the hip. Conclusion The PRP+CD treatment group showed significant benefits in AVN patients compared to CD alone, including higher HHS scores, improved disease progression survival and reduced need for hip surgery. Although PRP+CD resulted in decreased VAS scores, the difference was not statistically significant.
Osteonecrosis ; Femur Head ; Platelet-Rich Plasma ; Randomized Controlled Trial