We report 4 cases of silicone intraocular lens (IOL) opacification (SI-40NB, Allergan Inc.) in patients who had phacoemulsification between April and June 2003. The opacification was observed on the first postoperative day in all cases. The appearance of the silicone IOLs ranged from milky gray to a yellow hue and affected the entire optical component homogeneously. The patients did not complain about their vision, and visual acuity was only slightly affected; 3 of the 4 patients had a best corrected visual acuity of 20/30, and no anterior chamber reaction was observed. Contrast sensitivity was reduced in all cases. Careful scrutiny of medical histories failed to reveal factors that might have predisposed the patients to IOL opacification.

Mean intraocular pressure and fibrosis were lower in animals receiving bevacizumab in combination with mitomycin C but did not differ from values in animals receiving mitomycin C alone. Inhibition of VEGF was greater when bevacizumab was used alone than when bevacizumab was combined with mitomycin C.

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A 40-year-old otherwise healthy woman presented with a 10-day history of visual disturbance in the right eye and pain of 24-hour duration in the left eye. The medical and family histories were unremarkable. The best-corrected visual acuity in the right and left eyes was 20/400 and 20/50, respectively. Slit-lamp examination was unremarkable. Funduscopy showed creamy-white deep multifocal plaques bilaterally, predominantly in the right eye, and no vitreous cells. Fluorescein angiography showed initial hypofluorescent plaques with a hyperfluorescent aspect in the later phases. Spectral-domain optical coherence tomography (SD-OCT) showed increased choroidal thickness bilaterally, a subfoveal bacillary detachment in the right eye, with hyperreflectivity to the outer retinal layers (Figure 1).Question: What is the most likely diagnosis? Response: Serpiginous choroidopathy, multifocal choroiditis, Vogt-Koyanagi-Harada disease, syphilis, and acute posterior multifocal placoid pigment epitheliopathy (APMPPE).