The discrepancy in VA derived from Snellen and ETDRS charts was nonuniform across VA range. This has implications on interpretation of published studies converting Snellen fractions to logMAR for analysis and reporting of VA outcomes.
Acute angle closure glaucoma (AACG) is a painful, potentially blinding condition with patients frequently presenting within hours of onset with ocular pain, nausea and vomiting. Argon laser pan-retinal photocoagulation (PRP) is one of the commonest ophthalmic outpatient procedures. It is used in the treatment of vascular disorders of the retina; most commonly diabetic retinopathy. AACG following PRP is a recognised, but rarely occurring, complication. Prompt treatment alleviates pain and improves visual prognosis. The authors report a case of AACG following PRP treatment which was initially mistaken for a viral illness.
Purpose:To evaluate the impact of lesion size on the observed growth of the choroidal neovascularisation (CNV) following the first application of photodynamic therapy (PDT). Methods: A retrospective study of consecutive patients with subfoveal classic CNV or predominantly classic CNV undergoing first verteporfin photodynamic therapy (VPDT) according to treatment of age-related macular degeneration with photodynamic therapy (TAP) protocol between June 2005 and September 2005. Patients were classified into two groups according to baseline greatest linear dimension (GLD) at the time of VPDT monotherapy. Group 1 comprised patients with lesion GLD less then 2000 mm and Group 2, patients with lesion GLD 2000 mm or larger. Difference between the mean GLD at baseline and at three months post-treatment were investigated for clinical significance using the paired t-test. Results: Group 1 (n = 16) showed a mean change in GLD from 1380.25 mm to 2031.25 mm, while Group 2 (n = 26) showed a mean change of 2909.26 mm to 3023.07 mm. Data of mean percentage change in GLD for Group 1 showed a 51.97 per cent increase in the lesion size [95% CI, 22.93 -81.01%] in comparison to Group 2, which showed only 5.8 per cent increase in the lesion [95% CI, -9.65 -21.61%]. Comparison of the mean percentage change in GLD between the two groups showed a statistically significant difference (p = 0.003). Conclusions: Our study demonstrates that following the first application of VPDT, smaller lesions enlarge disproportionately more than larger lesions. As we have entered into the era of using angiostatic agents in combination with VPDT, it may be important to evaluate this effect with regards to the timing of VPDT commencement.
Case 2A 71-year-old Afro-Caribbean woman presented with decreased vision LE; BCVA was 20/200. Anterior segments examination was unremarkable. Fundoscopy in the LE disclosed a stage-5 FTMH. Few superficial refractile crystals were visible within the vascular arcades situated at the level of the inner retina (Figure 2). The patient decided against any surgical intervention and 11 months later, the distribution and appearance of crystals remained unchanged.
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