Purpose To study the prevalence, the clinical features, and the visual prognosis without treatment of polypoidal choroidal vasculopathy (PCV) in a large series of Greek patients presenting with exudative maculopathy. Methods The medical records, photographs, as well as fluorescein and indocyanine green (ICG) angiograms of a series of 268 consecutive elderly white Greek patients, who were originally diagnosed as having exudative age-related macular degeneration (AMD) were reviewed retrospectively. Results In all, 22 of the 268 (8.2%) patients initially suspected of having AMD were ultimately diagnosed with PCV. In 15 of the 22 (68.2%) patients with PCV, the polypoidal lesions were located in the peripapillary area. Large soft drusen were present in only two fellow eyes of the 10 (20%) patients with unilateral PCV compared with 120 fellow eyes of the 148 (81.1%) patients with unilateral AMD. At the last examination, 11 of the 22 (50%) patients with PCV and 120 of the 246 (48.8%) patients with AMD presented a visual acuity of less than 6/60 in at least one eye due to scar formation in the macula. Conclusions PCV is not an infrequent disease in Greece. A measurable number of Greek patients with findings suggestive of exudative AMD will instead have PCV. ICG angiography is important in differentiating between these two clinical entities. In Greeks, polypoidal lesions are predominately peripapillary and are not usually associated with macular drusen in the fellow eye. PCV and exudative AMD do not differ significantly in terms of their natural course and visual prognosis in Greek patients.

To assess the accuracy of standard clinical grading of aqueous flare in uveitis according to the Standardization of Uveitis Nomenclature consensus, and compare the results with the readings of the laser flare meter, Kowa 500. Two examiners clinically graded the flare in 110 eyes. The flare was then measured using the Kowa laser flare meter. Twenty-nine eyes were graded as anterior chamber flare +2; for 18 of these, the clinicians were in agreement, the rest differed by the order of one grade. The range of the laser flare meter for these eyes was 5.2-899.1 photons/ms. The median value was 41.4. Seventy-four eyes were graded with flare +1. Agreement was established in 51 of these eyes. Disagreement for the rest was again by the order of 1, and the flare meter range was 1.1-169.9 photons/ms, median value 18.4. For the clinical measure of flare 0, the clinicians disagreed on three out of five eyes. The flare meter readings ranged from 2.5 to 14.1 photons/ms, median value 9.9. Only two eyes were graded with flare +3 and there was one step disagreement on both of them. We found little evidence of association between the flare readings and intraocular pressure or age. Our findings suggest that clinical evaluation of aqueous flare is subjective. Compared with the Kowa laser flare meter's numeric readings, the discrepancies observed indicate that clinical grading is an approximate science. The laser flare meter provides an accurate, reproducible, non-invasive assessment of aqueous flare that can prove valuable in research and clinical decisions.

The use of intravitreal injections of anti-Vascular Endothelial Growth Factor (anti-VEGF) has been used for a broad spectrum of ocular pathologic entities. Although the dose of anti-VEGF agents used for treating eye disease is minute compared with that used intravenously, intraocular administration can lead to systemic absorption and reduce serum VEGF levels. Several systemic side effects, such as hypertension and cardiovascular complications have been rarely reported in the literature. Renal complications of intravenous administration of anti-VEGF, are well known and include a variety of renal pathological damage which can induce proteinuria and hypertension. We describe herein, 2 cases of diabetic patients with preexisting kidney disease who presented severe reduction of their renal function after intraocular administration of anti-VEGF. Although a cause -effect correlation cannot be established unless further studies are performed, we believe that pretreatment counseling should include a discussion outlining the possible risk of aggravating of the renal function in patients with kidney disease. Close cooperation with the patient's nephrologist and close monitoring of the patient may be required, in such cases, in order to monitor the renal function before and after the intravitreal administration of anti-VEGF.

Cataract surgery is not a common cause of persistent diplopia. However, this report highlights that prevalence of diplopia related to cataract is high among cases of diplopia in general, with diplopia being mostly vertical (p=0.001), affecting females (p=0.006), and being more common in left eyes, although results did not reach statistical significance (p=0.133).

In this large series of patients with macular CNV secondary to angioid streaks, the functional and the anatomic results of PDT were not satisfactory, even when retreatments were performed earlier than the conventional time of 3 months.