Although most of the complications were transient in nature, 1 patient developed persistent facial edema that became a scar and another developed pseudomelolabial fat atrophy. Furthermore, 3 patients experienced previously unrecognized transient lip and/or brow paralysis. All patients tolerated concurrent neck ultrasound and ablative fractionated CO₂ laser resurfacing well.

A 37-year-old woman with bilateral obliterative retinal vasculitis and macular ischemia received intravitreal bevacizumab for rapidly progressive neovascularization of the optic disc and vitreous hemorrhage in the left eye. One week after treatment, she presented with central scotoma and fluorescein angiography revealed increased parafoveal capillary dropout and progressive macular ischemia in the treated eye.

Orofacial granulomatosis is a relapsing nonnecrotizing granulomatous syndrome that classically presents with lip and perioral swelling. Over the years, several patients have been referred to the Duke Eye Center Oculoplastics Department for severe, progressive, recurrent eyelid swelling interfering with both their functional vision and their appearance. In this IRB approved retrospective case series, we describe the clinical course of 5 such patients, including their presenting symptoms, diagnosis, and response to treatment. We hope that oculoplastics specialists will consider this entity in the differential diagnosis of periorbital edema and consider initiating localized anti-inflammatory treatment once the diagnosis has been made.

A 31-year-old woman developed subacute bilateral visual loss over a 2-week period. Two months later, the diagnosis of Leber hereditary optic neuropathy (LHON) 11778/ND4 was established and the patient was treated with 900 mg of idebenone daily. Over the ensuing 9 months, visual acuity improved from 20/200 to 20/25 in each eye with near-total resolution in visual field abnormalities. Our case report is in agreement with 2 large published series of patients with LHON treated with idebenone, raising hope for treatment of this visually devastating mitochondrial disorder.

NHL can manifest as latent Bell palsy and facial mass in addition to the more common symptoms of uveitis. Intraocular NHL should be suspected in any patient of any age with persistent uveitis.

A 63-year-old man with decreased vision due to postsurgical chronic cystoid macular edema that was recalcitrant to topical nonsteroidal anti-inflammatory drops had resolution of cystoid macular edema after intravitreal triamcinolone injection. However, 3 months later he developed increased intraocular pressure and a recurrence of the cystoid macular edema. Intravitreal bevacizumab was administered and optical coherence tomography revealed worsening of the cystoid macular edema 1 month after the injection. Chronic cystoid macular edema that does not respond to topical nonsteroidal antiinflammatory drops may resolve with intravitreal triamcinolone but not with bevacizumab. The current case demonstrates that some cystoid macular edema may not be responsive to vascular endothelial growth factor blockade alone. Further studies are needed to evaluate the pathogenesis of cystoid macular edema and determine whether vascular endothelial growth factor blockade should be included in treatment modalities for this condition.

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