SD-OCT reveals formation of a premacular cavity following laser puncture for premacular hemorrhage in Valsalva retinopathy, which may persist despite successful drainage of blood. This may later result in metamorphopsia in certain patients.
Congenital retinal macrovessel (CRM) refers to an aberrant vessel, usually a vein, which traverses the macula and supplies both sides of the horizontal raphe. It is a rare condition, mostly asymptomatic and discovered on routine examination. We describe a case of both arterial and venous CRM with a macroaneurysm along the arterial CRM that presented with decreased vision due to prominent lipid exudation at the macula. Treatment with intravitreal bevacizumab resulted in a favourable anatomical as well as functional outcome. To the best of our knowledge, this is the first report of this unusual presentation of CRM, and its successful management with intravitreal bevacizumab.
A congenital retinal macrovessel (CRM) is a large retinal vessel, usually a vein, which traverses through the central macula and has large tributaries extending on both sides of the horizontal raphe. In the majority of cases, CRM have no effect on visual acuity, although in rare cases, macular hemorrhage, foveolar cysts, serous macular detachment, and the presence of the anomalous vessel in the foveola can affect vision. We describe a case of CRM with decreased vision secondary to a branch retinal artery occlusion (BRAO). To the best of our knowledge, this association has not been reported previously.
To evaluate the role of intravitreal bevacizumab in the treatment of Coats' disease diagnosed in adulthood. Prospective, interventional case series. Three patients with Coats' disease diagnosed in adulthood were managed with a single intravitreal injection of bevacizumab (1.25 mg) with peripheral laser photocoagulation 3 weeks later. All three patients had exudation at the macula (Stage 2B) along with peripheral retinal telangiectasia and aneurysms. They were followed up for 9 months. An appreciable reduction in the exudation at the macula and macular edema was observed in all cases following intravitreal bevacizumab therapy. In all patients, the visual acuity improved, and no signs of recurrence were observed at the final follow-up at 9 months. Intravitreal bevacizumab injections may be effective as an adjunctive treatment for adult-onset Coats' disease with foveal exudation along with laser photocoagulation to the peripheral retinal vascular abnormalities. Intravitreal bevacizumab was well tolerated by our patients, and no adverse effects were observed.
Large macular holes have poor surgical outcomes with conventional vitrectomy and internal limiting membrane (ILM) peeling surgery, but improved anatomical closure rates have been seen with an inverted ILM flap technique. Many studies have been reported with modifications in the original inverted ILM technique that help in better retention of the flap over the macular hole. The authors describe a new technique of inverted ILM flap in a case of chronic, large, full-thickness macular holes, in which multiple ILM flaps were inverted over each other and the hole-like cabbage leaves. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:830-832.].
The 25-gauge vitrectomy system allows sutureless surgery with excellent intraoperative control and minimal postoperative inflammation and astigmatism with clear visual axis by both the transcorneal and pars plana routes.
Cat scratch disease is a febrile illness caused by Bartonella henselae and is associated with rash at the site of cat bite or scratch and regional lymphadenopathy. Various ocular manifestations of cat scratch disease have been described, mainly retinochoroiditis, optic disc swelling, neuroretinitis, vascular occlusive events, serous retinal detachment, vitreous hemorrhage, intermediate uveitis, inflammatory lesions of the optic nerve head and rarely full thickness macular hole. We describe a case of an 11-year-old girl who presented 2 weeks after the onset of symptoms, with B. Henselae neuroretinitis with full thickness macular hole at presentation.
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