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Silicone oils (SO) are used as long-term intraocular tamponades and have an irreplaceable role in vitreoretinal surgery. They can, however, be associated with multiple and potentially severe complications, involving different ocular tissues, in particular retina and cornea. Recent advances in ophthalmic imaging have allowed the precise characterization of retinal and corneal microstructural changes, at a subclinical level. This detailed analysis of SO-related retinal and corneal changes has improved our understanding of their pathogenesis and offer the potential for optimized monitoring and management of patients with SO-filled eyes. This review aims to provide clinicians and ophthalmic scientists with an updated and comprehensive overview of the corneal and retinal changes associated with SO tamponade.

Introduction: The UK Government imposed a COVID19 lockdown (LD) restricting all but essential activities from 24th March 2020. Subsequently, there has been a significant reduction in casualty attendances nationwide including for ophthalmic emergencies. We aim to study the presentation of rhegmatogenous retinal detachments (RRD) and significant vitreous haemorrhage caused by posterior vitreous detachment (PVD-VH) in three tertiary centres covering most of the North West of England in the 6 weeks before and during the lockdown. Methods: A retrospective multicenter non-randomised consecutive case series study was designed to collect information on all cases of RRD and PVD-VH requiring surgery presenting to the vitreoretinal departments of Manchester Royal Eye Hospital, East Lancashire NHS Foundation Trust and the Lancashire NHS Foundation Trust from 11th February to 4th May 2020. Results: A total of 137 eyes of 137 patients were identified between the three centres of which 132 eyes were operated for RRD. Of these, 86 (64.7%) were operated pre-LD compared with 46 eyes (34.8%) during LD. Forty-five out of 86 eyes (52.3%) were macula-off pre-LD compared with 31 out of 46 eyes (67.3%) during LD ( p = 0.06). There was lower proportion of non-PVD related RRD during LD (11 pre-LD to 1 during LD, p = 0.05). PVR was present in four cases during LD compared to 2 before ( p = 0.19). Conclusion: There was a clinically significant reduction in the overall incidence of RRD in our centres with an increase in the proportion of macula-off and proliferative vitreoretinopathy during the LD period compared to a similar period before.

Torpedo maculopathy is a rare congenital anomaly of the retinal pigment epithelium (RPE). Various imaging modalities have been used to assess cases of torpedo maculopathy, including optical coherence tomography (OCT) and fundus autofluorescence (FAF). OCT angiography (OCTA) offers combined structural and flow characteristics of imaged lesions. The authors present OCTA findings in two cases of torpedo maculopathy. Common features include loss of RPE and choriocapillaris allowing greater visualization of larger vessels in the outer choroid. This confirms the potential of OCTA to provide greater detail of retinal and choroidal architecture and elucidate the histopathology of retino-choridal lesions. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:932-935.].

Purpose: To evaluate a sequential approach of pneumatic displacement followed by vitrectomy (pars plana vitrectomy) in failed cases to deal with submacular hemorrhage (SMH) of various etiologies.Methods: Retrospective, nonrandomized interventional case series of consecutive patients with SMH of up to 2 weeks' duration, who were treated with a stepwise approach.Step 1 involved intravitreal injection of 0.3 mL 100% C3F8 and recombinant tissue plasminogen activator 50 mg/0.1 mL. If unsuccessful, a prompt pars plana vitrectomy with subretinal recombinant tissue plasminogen activator 50 mg/0.1 mL and 20% SF6 gas tamponade was performed as a second attempt to displace the SMH.Results: Thirty-one patients with SMH underwent pneumatic displacement; 24 (77.4%) had a successful outcome without further intervention. The mean presenting visual acuity of the "successful cohort" was 1.34 logMAR (20/440 Snellen), improving to 0.83 logMAR (20/135 Snellen) 1 month after treatment. Five of the seven patients with failed pneumatic displacement underwent pars plana vitrectomy with subretinal recombinant tissue plasminogen activator at an average of 5 days poststep 1, with successful SMH displacement in 3 patients, giving an overall success of 87.1% for this treatment protocol.Conclusion: A sequential approach of expansile gas injection followed by prompt pars plana vitrectomy, aided by recombinant tissue plasminogen activator at both steps, is a coherent, logical pathway to treat SMH with high anatomical and functional success.

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Long-term oral corticosteroid therapy leads to suppression of the hypothalamo-pituitary-adrenal (HPA) axis (Paris, 1961;Treadwell, Savage, Sever, and Copeman, 1963; Jasani, Boyle, Greig, Dalakos, Browning, Thompson, andBuchanan, 1967). Much work has been done on the influence of the regimen of corticosteroid administration on this suppression. Harter, Reddy, and Thorn (1963) have presented evidence that administration of oral corticosteroid in a single dose given every other day leads to substantially less adrenal suppression than that which occurs with a regimen giving divided doses of corticosteroid over the same period. The doses used in this study were not physiological; that is to say patients received doses of prednisone or prednisolone-equivalent ranging from 20 to 40 mg. daily. Grant, Forsham, and DiRaimondo (1965) have shown that a daily morning dose of 8 mg. Triamcinolone administered to normal subjects over a period of 8 days does not lead to lasting adrenal suppression. Nichols, Nugent, and Tyler (1965) have demonstrated virtually complete suppression of the secretion of cortisol by the adrenal gland for a period of 24 hours following the administration of a physiological dose of corticosteroid (0 5 mg. dexamethasone) given at midnight. The same amount given at 8 a.m. or 4 p.m. caused only temporary suppression of cortisol secretion.In the present study we have compared the effect of two regimens of corticosteroid administration on *Present Address: Senior Clinical Research Associate in Pharmacology,