To test the hypothesis that tolerating some subretinal fluid (SRF) in patients with neovascular agerelated macular degeneration (nAMD) treated with ranibizumab using a treat-and-extend (T&E) regimen can achieve similar visual acuity (VA) outcomes as treatment aimed at resolving all SRF.Design: Multicenter, randomized, 24-month, phase 4, single-masked, noninferiority clinical trial.Participants: Participants with treatment-naïve active subfoveal choroidal neovascularization (CNV). Methods: Participants were randomized to receive ranibizumab 0.5 mg monthly until either complete resolution of SRF and intraretinal fluid (IRF; intensive arm: SRF intolerant) or resolution of all IRF only (relaxed arm: SRF tolerant except for SRF >200 mm at the foveal center) before extending treatment intervals. A 5-letter noninferiority margin was applied to the primary outcome.Main Outcome Measures: Mean change in best-corrected VA (BCVA), and central subfield thickness and number of injections from baseline to month 24.Results: Of the 349 participants randomized (intensive arm, n ¼ 174; relaxed arm, n ¼ 175), 279 (79.9%) completed the month 24. The mean change in BCVA from baseline to month 24 was 3.0 letters (standard deviation, 16.3 letters) in the intensive group and 2.6 letters (standard deviation, 16.3 letters) in the relaxed group, demonstrating noninferiority of the relaxed compared with the intensive treatment (P ¼ 0.99). Similar proportions of both groups achieved 20/40 or better VA (53.5% and 56.6%, respectively; P ¼ 0.92) and 20/200 or worse VA (8.7% and 8.1%, respectively; P ¼ 0.52). Participants in the relaxed group received fewer ranibizumab injections over 24 months (mean, 15.8 [standard deviation, 5.9]) than those in the intensive group (mean, 17 [standard deviation, 6.5]; P ¼ 0.001). Significantly more participants in the intensive group never extended beyond 4-week treatment intervals (13.5%) than in the relaxed group (2.8%; P ¼ 0.003), and significantly more participants in the relaxed group extended to and maintained 12-week treatment intervals (29.6%) than the intensive group (15.0%; P ¼ 0.005).Conclusions: Patients treated with a ranibizumab T&E protocol who tolerated some SRF achieved VA that is comparable, with fewer injections, with that achieved when treatment aimed to resolve all SRF completely.

Aims To report observations relating to the clinical recognition and possible basis of reticular pseudodrusen (RPD). Methods This retrospective study reports the evolution of RPD in 166 patients who had follow-up of over 1 year using multiple imaging techniques. Mean age when first seen was 73.3 years and the mean period of observation was 4.9 years (range 1e18 years). Associated macular changes were recorded. Results RPD were first identified in the upper fundus as a reticular network, which then became less obvious, developing a diffuse yellowish appearance. RPD also faded around choroidal neovascularisation (CNV). RPD therefore could be transient but the pattern often remained visible outside the macula or nasal to the discs. Manifestations of age-related macular degeneration (AMD) were present in nearly all eyes and there was a particularly high association with CNV (52.1%). In one clinicopathological case abnormal material was found in the subretinal space.Conclusions The prevalence of RPD may be underestimated because their recognition depends upon the imaging method used, the area of fundus examined and the confusion with typical drusen. The pathology of one eye suggests that RPD may correspond to material in the subretinal space.

These short-term results support the use of intravitreal bevacizumab for the management of CNV in patients with PXE. Continued experience with intravitreal bevacizumab in this population will help establish its longer-term efficacy and better define the potential need for serial injections to maintain these results.

Most acute cases of central serous chorioretinopathy resolve spontaneously with minimal visual impairment. The small percentage of eyes developing chronic or recurrent disease that do warrant treatment is often difficult to control. Emergent investigations and treatments have added to the established options available to manage these cases. Optical coherence tomography has proved valuable for both imaging subtle fundoscopic findings and monitoring disease progression. Fluorescein angiography aids identification of pigment epithelial leaks and targets the use of argon laser treatment if outside the fovea. Fluorescein angiography also assists differentiation from other choroidal pathologies such as choroidal neovascularization and polypoidal choroidal vasculopathy. Where the diagnosis is uncertain, indocyanine green angiography can demonstrate classic midphase hyperpermeability. This is also useful to guide the application of photodynamic therapy. Newer treatments such as intravitreal anti-vascular endothelial growth factor are as yet unproven.

The neovascularization in RAP may originate not only from deep retinal capillaries but also from the choroid. We therefore propose the more descriptive term "Type 3 neovascularization" for this entity to emphasize the intraretinal location of the vascular complex and distinguish this type from the two types of neovascularization previously described by J. Donald Gass in his classic text.

Inadvertent macular translocation can occur following repair of macula-off retinal detachment, and may be a significant contributor to poorer visual outcome after retinal detachment, despite objective surgical success.

These results have implications for current diabetic retinopathy screening guidelines and has identified future areas where research could be improved.

Perfluoro-n-octane is efficacious and safe as a short-term vitreous substitute in primary rhegmatogenous retinal detachment repair cases with inferior/multiple breaks or GRTs. Perfluoro-n-octane removal within 10 days reduces its side effect profile considerably. The highest anatomical retinal reattachment rates were observed when C3F8 or silicone oil was exchanged for PFO.