Jelena Vasilijevic

Background and Objectives: Optical coherence tomography angiography (OCTA) devices convert scan angle into retinal distance with a schematic eye, so eyes whose axial length (AL) differs from the assumed value are measured on an incorrect transverse scale. We quantified how this magnification error affects seven OCTA metrics and how well geometric and empirically calibrated corrections perform. Materials and Methods: In this controlled image-based simulation study, segmentation masks of 300 eyes from the public OCTA-500 dataset (6 × 6 mm scans) were re-rendered at ten simulated ALs (21.5 to 30.0 mm). Co-primary outcomes were seven metric-specific scaling exponents from per-eye log–log regression, tested against their geometric values (Holm-adjusted and equivalence tests). Secondary analyses separated field-content from pixel-sampling effects and assessed corrections in individual eyes by cross-fitting. Results: Between simulated ALs of 23.58 and 27.91 mm, uncorrected foveal avascular zone (FAZ) area changed by −30.8% and branch-point density by +37.4%. The FAZ-area exponent was equivalent to its geometric value (−1.985 vs −2), whereas skeleton-derived metrics fell short of theirs (branch-point density +1.72, vessel length density +0.91, caliber −0.74). A decomposition attributed the shortfall of the skeleton-derived exponents mainly to pixel sampling and the vessel density exponent to field content. Empirical exponents reduced the mean bias to 1.0% or less, but individual-eye errors exceeded 5% in 12% to 36% of eyes for vessel density, vessel length density, FAZ circularity and branch-point density. Exploratory analyses showed curved responses for all metrics, negligibly so for FAZ area, and category-dependent responses for vessel density, vessel length density and branch-point density. Conclusions: In this simulation, magnification artifacts were metric-specific: FAZ area followed geometric scaling, whereas skeleton-derived metrics also depended on pixel sampling and field content. Calibrated corrections apply to group means within the tested workflow and require validation in eyes with measured axial length.

Pterygium is a common ocular surface disorder linked to chronic ultraviolet exposure, local inflammation, and oxidative stress, yet no reliable circulating biomarker currently guides diagnosis, activity assessment, or recurrence risk. Peripheral-blood studies addressing this gap have produced inconsistent findings across hematological, inflammatory, and micronutrient domains, often using heterogeneous case definitions and isolated marker panels. In this prospective case–control study, 30 patients with newly diagnosed, clinically active primary pterygium and 17 healthy controls frequency-matched for age and sex underwent a comprehensive peripheral blood panel comprising 46 hematological, biochemical, iron-related, inflammatory, and vitamin/metabolic-bone parameters, including osteocalcin, ceruloplasmin, and immunoglobulin E. Lesions were graded using the Maheshwari and Tan classification systems, and group and severity-stratified comparisons were corrected for multiple testing using the Benjamini–Hochberg procedure. No parameter differed significantly between groups after correction. Nominal, uncorrected differences included higher total protein, albumin, and mean platelet volume in patients with pterygium, and severity-linked patterns of higher platelet count, plateletcrit, and ceruloplasmin, and higher vitamin B12, folic acid, and serum iron in less advanced lesions. None of these nominal differences survived correction, so no single marker distinguished pterygium from controls or tracked severity. Platelet indices and ceruloplasmin showed the most consistent severity-linked pattern, but this was nominal only and hypothesis-generating, warranting evaluation in larger, adequately powered cohorts.

Background/Objectives: This study investigates the correlation between substantia nigra (SN) hyperechogenicity, detected via transcranial sonography (TCS), and retinal thinning in patients with Parkinson’s disease (PD). Methods: In this cross-sectional study, 86 PD patients (172 eyes) underwent clinical assessment (UPDRS, Hoehn–Yahr), TCS for SN area measurement, and optical coherence tomography (OCT) for retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), and macular thickness analysis. Results: PD patients exhibited significant thinning of the GCIPL, average RNFL, and central macular thickness compared to healthy controls (p < 0.001 in all instances). Pathological SN hyperechogenicity (>0.19 cm²) was detected in 85.9% of patients with a preserved temporal bone window (71 out of 86). A significant negative correlation was found specifically between the SN echogenic area and central macular thickness (r = −0.248, p = 0.003). Patients with pathological SN findings had a significantly thinner central macula (p = 0.006) compared to those with a normal SN, while no significant correlations were observed between the SN area and RNFL or GCIPL. Conclusions: These findings demonstrate a specific correlation between SN hyperechogenicity and central macular thinning. While RNFL and GCIPL effectively differentiate PD from controls, the central macula might serve as a promising biomarker candidate reflecting SN changes. Further longitudinal studies are required to evaluate the role of these combined markers in the PD diagnostic algorithm.

Background/Objectives: Clinical differentiation between Parkinson’s disease (PD) and atypical parkinsonism (AP) remains complex. Current diagnostic procedures helpful in their distinction lack specificity, making non-invasive tools like optical coherence tomography (OCT) crucial in evaluating possible retinal changes as potential biomarkers. Our study examined the thickness of the ganglion cell inner plexiform layer complex (GCIPL), peripapillary retinal nerve fiber layer (RNFL) and macular segments in individuals with PD, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and healthy controls (HC). The objective of our study was to determine if OCT analyses can effectively discriminate PD patients from HC and whether retinal thickness can distinguish typical PD patients from those with AP. Methods: Research was an observational, cross-sectional study. Multiple retinal layers measured with OCT of PD and AP patients were compared with age- and sex-matched HC. An intergroup assessment was conducted. Results: Patients with PD and PSP exhibit a thinner GCIPL compared to HC, with no difference observed in the MSA group. GCIPL thickness between investigational groups does not differentiate between PD and AP. The RNFL and central macula thickness were statistically significantly reduced in all patient groups compared to HC. The RNFL was thinner in PSP compared to PD. Nearly all inner and outer macular segments were thinner in the investigational groups compared to HC. The preservation of outer nasal segments distinguished HC from both typical and AP. Patients with PSP and PD differed in the thickness of all macular segments, being thinner in PSP patients. Conclusions: Thickness of multiple retinal layers and macular regions might serve as a distinguishing feature between PD, AP and HC.

Introduction/Objective. Rhegmatogenous retinal detachment is an ophthalmic emergency which can result in vision loss. The aim of our study was to evaluate the demographic, epidemiological, clinical characteristics and treatment method of rhegmatogenous retinal detachment. Methods. This retrospective study was conducted at the Department of Vitreoretinal Surgery and Eye Trauma in the period between January 1, 2024 and December 31, 2025. The data included sex, age, season, onset of symptoms, presence of myopia, previous cataract surgery, as well as the method of treatment. Results. Out of 275 patients, there were 177 males (64.36%) and 98 females (35.64%). The majority of the study population was between 61 and 80 years old (n = 140, 50.91%). The most commonly selected surgical procedure was PPV (n = 226, 81.88%). Silicon oil was the preferred tamponade (n = 191, 75.2%). Best corrected visual acuity on admission was worse than 0.1 in the majority of the affected eyes (n = 177, 64.13%), while one month after surgery nearly half (n = 130, 47.1%) achieved visual acuity between 0.1 and 0.5. Recurrent detachment had 29 patients (10.32%). Conclusion. In conclusion, our study emphasizes that rhegmatogenous retinal detachment primarily affects males and individuals over 60 years of age within our region. Consequently, there is an urgent need to implement targeted public health initiatives to educate high-risk individuals on early symptoms, optimize primary ophthalmic triage, and establish efficient referral pathways to ensure timely surgical intervention and preserve functional vision.

Optical coherence tomography angiography (OCTA) is a non-invasive, quantitative tool for imaging the retina and choroid that can visualize the microvasculature in three dimensions. It is widely used for diagnosing and monitoring treatment response for various diseases of the anterior and posterior segments of the eye. A systematic search of the relevant literature was conducted, focusing on the period of the most intensive development and clinical application of OCT angiography. This paper aims to summarize current knowledge of OCTA applications in the diagnosis and monitoring of posterior segment retinal pathologies and to discuss its advantages over traditional imaging techniques.

Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive and inflammatory disease of the airways that often leads to cardiovascular and microvascular changes. This study aimed to analyze retinal microcirculation in patients with COPD using optical coherence tomography angiography (OCTA)Materials and methods: Cross-sectional study. A total of 44 subjects were analyzed, including 28 with COPD and 16 healthy controls. Inclusion criteria were subjects older than 18 years with a confirmed COPD diagnosis based on spirometric parameters.Results: Statistically significant differences were observed between the groups for the following parameters: deep capillary plexus macular (p = 0.009), parafoveal (p = 0.026), and perifoveal (p = 0.034). A significant negative correlation was observed between the ratio of residual volume to total lung capacity (RV/TLC) and the vessel density in the macular and perifoveal superficial capillary plexus regions (p<0.05). The choriocapillaris flow also demonstrates a significant inverse relationship with the RV/TLC ratio. Regarding the deeper retinal layers, our analysis revealed a significant negative correlation between outer retina Flow and forced vital capacity (FVC).Conclusion: Monitoring changes in OCTA parameters, particularly in relation to lung volume parameters such as RV/TLC and FVC, suggests that OCTA may provide valuable insights into systemic vascular progression and the overall severity of the disease in COPD patients.

Background/Objectives: This study aimed to evaluate estimated pulse wave velocity (ePWV) in different glaucoma types. Methods: This was observational, cross-sectional, non-interventional study conducted on 127 primary open-angle glaucoma (POAG) patients, 59 primary angle-closure glaucoma (PACG) patients, 34 pseudoexfoliative glaucoma (PEX) patients, and 55 normotensive glaucoma (NTG) patients (total of 275 glaucoma patients). The control group (CG, 92 patients) consisted of patients with cataract. ePWV was calculated by the formula that was recommended by the Reference Values for Arterial Stiffness Collaboration from data on age and mean arterial blood pressure. The obtained results were processed by applying methods of descriptive (arithmetical mean, standard deviation) and analytical statistics, and comparisons of tested variables were performed using ANOVA. A p value less than 0.05 was considered statistically significant. Results: Statistically significant differences were found between patients with POAG and the CG (p value 0.042), and between those with NTG and the CG (p value 0.001). There was a statistically significant difference in ePWV values when comparing all tested patients with glaucoma and the control group (p = 0.001). Conclusions: Estimated pulse wave velocity may be a helpful tool in future risk assessment models for glaucoma.

Background/Objectives: The aim of this study was to investigate quantitative differences in optical coherence tomography angiography (OCTA) between diabetic patients and healthy controls and to identify the early OCTA biomarkers for diabetic macular changes. Methods: Ophthalmological examination and OCTA were performed on two groups of diabetic patients (with and without mild diabetic retinopathy) and healthy controls. Macular, foveal, perifoveal, and parafoveal vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ), and flow area in the choriocapillaris were calculated. Results: A total of 431 eyes of 233 participants were analyzed. The VD in the SCP in the whole macula was the lowest in the DM + DR group and lower than in the DMnoDR group; however, in the fovea, it was the highest in the DM + DR group and higher than in the DMnoDR group. The VD in the SCP in the parafovea was lower in the DM + DR group than in the DMnoDR group, and in the perifovea, it was lower in the DMnoDR group than in the control group. The VD in the DCP in the macula, parafovea, and perifovea was lower in the DM + DR group than in the DMnoDR and control groups. The FAZ and flow areas in the choriocapillaris were smaller in the DM + DR group than in both the DMnoDR and control groups. Conclusions: VD reduction in the SCP and the DCP of the macular and parafoveal regions, as well as in the DCP of the perifoveal region, may indicate progression of diabetic retinopathy from subclinical to clinical stages; however, an increase in the foveal region in the SCP can be a compensatory mechanism. VD reduction in the perifovea and whole macula in the SCP can be a screening factor for subclinical macular changes. FAZ reduction before clinical signs of retinopathy may be an early compensatory vascular mechanism.

(1) Background: This study aims to evaluate retinal perfusion by optical coherence tomography angiography (OCTA) in pediatric patients with type 1 diabetes mellitus (T1D) without diabetic retinopathy (DR). (2) Methods: Thirty-one patients affected by T1D were enrolled. All participants were evaluated using OCTA. The foveal avascular zone (FAZ) and superficial and deep macular vessel density (VD) were analyzed. The correlation of these parameters with metabolic factors such as body mass index (BMI), glycated hemoglobin (HbA1c), and the type of insulin therapy (multiple daily injections, MDI vs. continuous subcutaneous insulin infusion, CSII) was determined. (3) Results: None of the OCTA parameters were significantly different between the groups. The patients’ HbA1C level did not influence any of the OCTA parameters. The use of MDI tended to reduce the parafoveal and perifoveal deep VD (p = 0.048 and p = 0.021, respectively) compared to CSII. An elevated BMI tended to increase the deep macular (p = 0.005) and perifoveal VD (p = 0.006). (4) Conclusion: VD and FAZ are normal in pubescent children with T1D without signs of DR. Treatment with CSII may be a better choice compared to MDI, as CSII may be protective against retinal microvascular damage. Our results indicate the need for new clinical parameters of glycemic control in addition to HbA1c which could assess the risk of DR.