Key Clinical Message Posterior polar annular choroidal dystrophy (PPACD) is an uncommon retinal dystrophy causing nyctalopia. PPACD has been characteristically described as a foveal sparing dystrophy. We report the first case with cystoid macular edema association.

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Background Despite the constant refinement of techniques and surgical aids, extremely large and refractory macular holes continue to have poor surgical outcomes with the current standard of care. The objective of the present study is to assess the anatomical and functional outcomes, as well as the structural change through time, of the optical coherence tomography of patients with refractory macular holes treated with a full-thickness autologous retinal transplant. Methods Prospective, case series. We include patients with a clinical diagnosis of refractory macular holes with a minimum diameter of at least 500 µm. All the patients had a comprehensive ophthalmological examination, which included a best-corrected visual acuity assessment, fundus examination, and optical coherence analysis. All the patients underwent a 23-gauge pars plana vitrectomy with a full-thickness retinal transplant and silicone oil tamponade (5000 cs<). Follow-up was done at 1, 3, 6, and 12 months. Statistical analysis was done with a test for repeated measurements and Bonferroni correction, with an alpha value of 0.05 for statistical significance and a Mann-Whitney U test for nonparametric continuous variables. Results We enrolled 13 eyes from 13 patients (mean age: 67.15 years) with refractory macular holes, with a mean base diameter of 1615.38 ± 689.19 µm and a minimum diameter of 964.08 ± 709.77 µm. The closure rate after 12 months of follow-up was 76.92%. Six patients with a closed macular hole at the end of the follow-up had complete recovery of the myoid/ellipsoid layer. The remaining showed a 44.9% reduction of the initial gap. Most patients formed a pseudofovea and normalization of the internal retinal layers. Despite a positive trend toward visual recovery (p = 0.034), after the correction of the alpha value, the change lost its statistical significance. During follow-up, one patient developed mild proliferative vitreoretinopathy and epiretinal membrane without anatomical or functional consequences. Conclusions An autologous full-thickness retinal transplant may improve the anatomical and structural outcome of patients with refractory macular holes. The full safety profile of this new technique is still unknown. More studies are needed in order to assess functional changes through time.

The use of YL-577 as an alternative approach for PRP reduces pain perception and is preferred by patients. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:902-905.].

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The purpose of the present case is to describe a patient with tractional retinal detachment (RD) associated with contractile morning glory: a 17-year-old female, with a history of failed surgery for RD when she was 2 years old in her right eye (OD), nystagmus, and a limited visual acuity in the left eye (OS). The slit lamp examination showed phthisis bulbi in OD and the anterior segment was unremarkable in OS. Dilated fundus examination revealed a tractional RD in the posterior pole and peripapillary and preretinal fibrosis without evidence of intravitreal dispersion of retinal pigment epithelial cells. After surgery treatment, the RD resolved and the posterior segment showed a staphylomatous excavation around the optic disc anomaly with irregular contractions that folded the macular area. This were unrelated to light, breathing, or eye movements. Although morning glory disc anomaly is associated with RD, the early diagnosis can reverse structural changes. In this case, the rare association with contractile movements was found posterior to the pars plana vitrectomy after all the fibroglial epiretinal tissue was removed.

Background/Purpose: To report a surgical approach of combined vitrectomy, gas endotamponade, and transscleral diode laser cyclopexy treatment for hypotony maculopathy induced by traumatic cyclodialysis.Methods: A case of a 37-year-old male patient with decreased vision in his right eye because of hypotony maculopathy and 360°traumatic cyclodialysis is reported. Patient was initially treated conservatively with topical steroid + cycloplegic eye drops and repeated periocular corticosteroid injections with no improvement in the intraocular pressure and the anatomical defect. The patient underwent 23 G pars plana vitrectomy with 20% SF 6 gas endotamponade and supine position. Transscleral 810-nm laser burns were applied at 1.5 mm from the scleral limbus around the cornea in two confluent rows avoiding the horizontal meridians. Parameters used were 700-1,000 mW of power with a 2-second exposure in a continuous wave mode, and postoperative supine positioning of the head was indicated.Results: Preoperative intraocular pressure improved from 2 mmHg to 10 mmHg at one week after surgical treatment and achieved 16 mmHg at one month to remain stable during a 6 months follow-up period. Presenting visual acuity was 1.0 logMAR (20/200 Snellen) and improved to 0.3 logMAR (20/40 Snellen) at Month 1 and achieved 0.1 logMAR (20/20 Snellen) at the third month. Complete closure of the cyclodialysis cleft and peripheral anterior synechiae formation were also observed at 3 months after treatment, with complete reattachment of the ciliary body demonstrated by ultrasound biomicroscopy and significant improvement of the macular anatomy demonstrated by spectral-domain optical coherence tomography. Conclusion:The combination of pars plana vitrectomy, supine positioning with gas endotamponade, and transscleral laser cyclopexy can successfully improve the visual and anatomical outcomes in patients with hypotony maculopathy and 360°traumatic cyclodialysis.