Pterygium surgery produces improvements in visual acuity, decreases of refractive spherocylinder power, topographic irregularity, and topographic astigmatism. Three-millimeter topographic irregularity and astigmatism have a close correlation with refractive spherocylinder power.

Background/Objectives: The purpose of this study was to present an association between the treatment response of diabetic macular edema (DME) to intravitreal ranibizumab (IVR) injections and different morphology patterns using spectral domain optical coherence tomography (SD-OCT). Subjects/Methods: This retrospective study included 216 eyes of 142 subjects who received IVR for DME and were observed for at least 2 years. Medical charts and SD-OCT images of consecutive patients were reviewed at baseline, 1, 3, 6, 12, and 24 months after first IVR treatment. The OCT patterns were characterized as diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD), and vitreomacular interface abnormalities (VMIAs). All patients were classified into four groups based on the OCT findings. Results: For a total of 216 eyes, 36 eyes were classified into the DRT group, 76 in the CME group, 42 in the SRD group, and 62 in the VMIA group. There were significant central macula thickness (CMT) improvements in all groups at the 1st month and the 2nd year, except for the DRT group at the 2nd year. Patients with OCT findings of hyperreflective dots (HRDs), metabolic parameters of hyperlipidemia, and coronary artery disease (CAD) had significantly less improvements in CMT at 2-year follow-up (P=0.029, 0.007, <0.001, respectively). Conclusion: A trend toward decreased effectiveness after long-term IVR treatment was observed in the DRT group. Consistent IVR treatment could still achieve favorable improvement in the reduction of CMT in 2-year follow-up in the VMIA group. Different OCT patterns in DME may affect the therapeutic role of anti-VEGF agents and predict the structure outcome.

Dome-shaped macula (DSM) is a morphological feature outlined through the use of optical coherence tomography and characterized by an inward or anterior deviation of the macula with respect to chorioretinal concavity. Currently, there is no validated therapy for serous retinal detachment secondary to DSM. The authors report a case of childhood unilateral DSM in a hyperopic eye with normal axial length that was complicated with subretinal fluid (SRF). Topical carbonic anhydrase inhibitors may be an acceptable and safer option for patients presented with nonresolving SRF associated with DSM. Further randomized controlled trials are necessary to confirm the efficacy of this therapeutic approach. [ Ophthalmic Surg Lasers Imaging Retina . 2019;50:e218–e221.]

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