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AIM To evaluate the role of intravitreal Triamcinolone (TA) in the early management of Coats disease. METHODS Retrospective, interventional case series. RESULTS 15 consecutive cases with Coats disease were managed with 4 mg/0.1 ml intravitreal TA injection on presentation and were followed for a minimum of 1 year duration. Additional management strategies including drainage of subretinal fluid through an inferior sclerotomy, peripheral laser ablation and/or cryotherapy, cataract extraction and vitrectomy were performed. Improvement of visual acuity could be achieved compared with preoperative vision in all cases in this series, even when 40% needed cataract extraction with intraocular lens implantation. One patient needed antiglaucoma treatment to control raised intraocular pressure in this series. CONCLUSIONS Triamcinolone has a role in improving the rate of absorption of subretinal fluid and macular exudates in Coats disease. The major complication of 4 mg/0.1 ml intravitreal triamcinolone is cataract in 40% of cases in children.

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Objective. To compare the efficacy of different therapies in the treatment of macular edema associated with retinal vein occlusion (RVO). Design. This is a nonrandomized, multicenter collaborative study. Participants. 86 retina specialists from 29 countries provided clinical information, including choice of treatment and outcome, on 2,603 patients with macular edema including 738 cases of RVO. Methods. Reported data included the type and number of treatments performed, visual acuities, and other clinical and diagnostic findings. Main Outcome Measures. The mean increase in visual acuity and mean number of treatments performed. Results. 358 cases of central retinal vein occlusion (CRVO) and 380 cases of branch retinal vein occlusion (BRVO) were included in this investigation. Taking all RVO cases together, pars plana vitrectomy with internal limiting membrane (ILM) peeling alone resulted in an improvement in vision greater than other therapies. Those treated with intravitreal antivascular endothelial growth factor (anti-VEGF) injection alone showed the second greatest improvement in vision. Dexamethasone intravitreal implant alone and intravitreal triamcinolone alone both resulted in modest visual gains. Conclusions. In the treatment of macular edema in RVO, vitrectomy with ILM peeling may achieve visual improvement and may be a good option for certain cases. Anti-VEGF injection is the most effective of the nonsurgical treatments.

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Purpose: To determine the accuracy of various corneal parameters in keratoconus diagnosis using Scheimpflug camera combined with Placido disk corneal topography (Sirius, CSO). Methods: One hundred and fifteen keratoconic eyes (group1) and a 111 normal eyes (group2) were assessed prospectively between March 2018 and July 2019 for: corneal keratometric indices (K1, K2, sim K, apex curvature) at different corneal rings of both corneal surfaces, central corneal thickness (CCT), thinnest corneal thickness (TL), corneal asphericity (Q), elevation at thinnest point, root mean square (RMS), and root mean square per area (RMS/A) in spherical, aspheric and aspherotoric reference for both corneal surfaces and keratoconus summary parameters; surface asymmetry index of front and back (SIf, SIb respectively), elevation at keratoconus vertex front and back (KVf, KVb respectively), Baiocchi Calossi Versaci front and back index (BCVf, BCVb) and its vector summation (BCV) and convergence radius and cutoff value for each was calculated Results: All studied indices were significantly different between the two groups. The highest predictive accuracy “Area under receiver operating characteristic curve (AUROC)” of 0.999 was observed for BCVf, KVb, RMS and RMS/A at 6 mm aspherotoric reference posterior surface. Keratoconus summary indices had high AUROC (0.986, 0.984, 0.948, 0.999, 0.999, 0.998 respectively). Curvature indices had lower AUROC than elevation indices, except for curvature of corneal apex at anterior (0.98) and posterior surface (0.99). Higher AUROC was noted with elevation at thinnest point especially at aspherotoric reference surface. Conclusion: Sirius topography showed high predictive accuracy in detection of keratoconus. Elevation indices and keratoconus summary parameters have the highest diagnostic ability.

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