To develop a reliable and efficient method for quantifying the area of preserved retinal pigment epithelium (RPE), facilitating the evaluation of disease progression or response to therapy in choroideremia (CHM). The fundus autofluorescence images of CHM patients were captured at baseline and 1 year. A Photoshop-based method was developed to allow the reliable measurement of the RPE area. The results were compared with measurements generated by the Heidelberg Eye Explorer 2 (HEYEX2). The areas measured by two independent graders were compared to assess the test-retest reliability. By using the Photoshop-based method, the area of the RPE measured from 64 eyes was seen to decrease significantly ( < 0.001) at a rate of 2.57 ± 3.22 mm annually, and a percentage of 8.39% ± 5.24%. The average standard deviations for Photoshop were less than that for HEYEX2 (0.5-1.1 in grader 1; 0.4-1.6 in grader 2), indicating less intragrader variability. The RPE decrease as determined by the Photoshop-based method showed excellent reliability with an intraclass correlation coefficient of 0.944 (95% confidence interval, 0.907-0.966). In Bland-Altman plots, the Photoshop method also exhibited better intergrader agreement. Photoshop-based quantification of preserved RPE area in patients with CHM is feasible and has better test-retest reliability compared with the HEYEX2 method. An accurate quantification method for longitudinal RPE change in CHM patients is an important tool for the evaluation of efficacy in any therapeutic trials. An accurate quantification method for longitudinal RPE change in CHM patients is an important tool for the evaluation of efficacy in any therapeutic trials. Macular Integrity Assessment (MAIA) microperimetry is used widely in clinical trials and routine practice to assess paracentral scotoma. Current interpretation of MAIA is based on an assumed uniform 25 decibel (dB) cutoff for normal function irrespective of subject age and retinal location. We examined this convention by establishing an age- and loci-specific reference in healthy eyes and comparing this to the <25 dB cutoff. Retrospective MAIA results from healthy eyes were analyzed for prevalence of loci with <25 dB. https://www.selleckchem.com/products/osmi-4.html At each locus, a new reference cutoff was derived from quantile regression of sensitivity against age at the 2.5th percentile. Two clinical cases of serial MAIA testing were analyzed using the new approach and compared to the <25 dB cutoff. Fifty-four and 56 age-matched (range 16-75 years) healthy eyes underwent small (37 loci) and large (68 loci) grid testing, respectively. Retinal sensitivity <25 dB was found in 5% of the small grid (1998 data points) and 10% of the large grid (3808 data points). These were found predominantly in older subjects and at the central point or in the perifoveal region. Quantile regression at each individual locus showed age-related decline with a median gradient of 0.6 dB/decade. We caution against using <25 dB cutoff in MAIA interpretation and advocate an age- and loci-specific cutoff criterion. Our study suggests that MAIA interpretation is influenced by the criterion used for defining abnormal pointwise measurement. Our study suggests that MAIA interpretation is influenced by the criterion used for defining abnormal pointwise measurement. To evaluate the potential value of microscope-integrated optical coherence tomography (MI-OCT) in anterior segment surgical maneuvers. Twenty-four ophthalmology residents, who were randomly and evenly divided into two groups, performed four anterior segment surgical maneuvers (corneal tunnel, scleral tunnel, simple corneal suture, and corneal laceration repair) on porcine eyes with (group B) or without (group A) real-time MI-OCT feedback. All residents performed the maneuvers again without MI-OCT. Compared with group A, group B (with MI-OCT) showed better accuracy in the length/depth of the corneal tunnel and the length of the scleral tunnel. However, both groups showed similar performances in the depth of both the simple corneal suture and the corneal laceration suture. When both groups performed the maneuvers again without MI-OCT, group B still showed better results than group A for the length of both the corneal and scleral tunnels. Primary results suggest that real-time MI-OCT images are valuable for some anterior segment surgical maneuvers and could be helpful in surgical training. MI-OCT systems can be valuable in improving accuracy and decision making during anterior segment surgery and will be useful in surgical training. MI-OCT systems can be valuable in improving accuracy and decision making during anterior segment surgery and will be useful in surgical training. The purpose of this study was to investigate the relationship between the lamina cribrosa (LC) thickness (LCT) as assessed using enhanced depth-imaging (EDI) optical coherence tomography (OCT) and cognitive function in primary open-angle glaucoma (POAG). The study consisted of 105 POAG eyes and 23 nonglaucomatous control eyes that completed neuropsychological tests. The optic nerve heads of the patients were imaged using EDI-OCT. B-scan images were constructed in three dimensions using maximum intensity projection (MIP), and the LCT was measured using the thin-slab MIP images. A comprehensive battery consisting of 15 neuropsychological tests was used to evaluate cognitive function. POAG eyes had smaller mean LCT as compared with control eyes ( < 0.001). Age and Mini Mental State Examination (MMSE) scores did not differ between the two groups. Linear regression analysis revealed that lower scores on the MMSE ( < 0.001), presence of glaucoma ( = 0.006), and a smaller global retinal nerve fiber layer thickness ( < 0.001) were independently associated with a smaller mean LCT. Davies' test revealed a statistically significant breakpoint for the mean LCT (221.14 µm), below which a smaller MMSE score was significantly associated with a smaller mean LCT. In POAG eyes with a mean LCT smaller than the breakpoint (< 221.14 µm), not only the global cognition but also the visuospatial function and visual memory were worse than in those with a larger mean LCT (all ≤ 0.003). Impairment of cognitive function was observed in patients with POAG with a thinner LC. The role of LC imaging as a potential biomarker to monitor cognitive impairment needs further investigation. LC thinning may reflect a shared mechanism of neurodegenerative diseases in the brain and optic nerve. LC thinning may reflect a shared mechanism of neurodegenerative diseases in the brain and optic nerve.