No abstract

The authors report spectral-domain optical coherence tomography findings of laser pointer-induced maculopathy in a 25-year-old man after accidental laser pointer exposure of less than 1 second. The Class 3R laser pointer (output wavelength 532 nm and output power 3.5 to 4.5 mW [continuous wave]) had U.S. Food and Drug Administration certification. One day after exposure, he had visual blurring and metamorphopsia of his right eye. He was treated with a systemic high-dose corticosteroid. Spectral-domain optical coherence tomography disclosed a hyperreflective band in the foveal region. After 1 week of treatment, disappearance of hyperreflectivity was observed on spectral-domain optical coherence tomography. At 6 months, residual disruption of the outer retinal layer at the fovea remained unchanged. Spectral-domain optical coherence tomography was a useful and sensitive tool for evaluating retinal damage and subsequent resolution after treatment.

Cases with a larger extent of retinal detachment, more advanced preoperative PVR and poorer preoperative visual acuity have less favorable anatomical and functional results.

Postoperative oral prednisolone does not seem to improve the visual outcomes and complications of scleral buckling in simple phakic RRD.

The purpose of this study was to describe the EDI-OCT findings in an acute phase of sympathetic ophthalmia (SO). A 24-year-old gentleman was referred to clinic complaining of progressive blurry vision of his right eye within last 3 days. He had a history of repaired corneoscleral laceration in his left eye followed by lensectomy and anterior vitrectomy approximately 1 month before his recent right eye discomfort. Physical examination revealed a granulomatous uveitis with an exudative RD of the right eye consistent with SO. EDI-OCT was done at initial exam and repeated 1 and 15 months after therapy. EDI-OCT 1 month following therapy showed significant improvement in choroidal thickening and outer retinal cell layers. The choroidal thickness in the right sympathizing eye decreased from 617 to 568 μm and in the left exciting eye from 539 to 521 μm. After 15 month follow-up, choroidal thickness that is reported in EDI-OCT is 436 μm in the right and 382 μm in the left eye. SO should be added to the list of choroidopathies that cause an increase in choroidal thickness in acute phase of disorder with subsequent decrease after therapy, so help us in assessing and estimation of response to treatment.

PurposeTo evaluate visual and anatomical results and identify factors that influence vitrectomy and silicone oil (SO) injection outcomes in proliferative diabetic retinopathy (PDR).MethodsThis retrospective study included 236 eyes with PDR that were undergoing vitrectomy and SO injection with >3-month follow-up. The primary outcomes were final best-corrected visual acuity (BCVA) and retinal attachment rate.ResultsAt the final visit (mean, 88 ± 58 weeks), complete, partial, and no retinal attachment were observed in 86.9%, 10.6%, and 2.5% of patients, respectively. A total of 155 eyes had experienced SO removal, while 81 had SO in place. The mean initial BCVA was 1.9 ± 0.7 logarithm of the minimum angle of resolution (logMAR) and significantly improved to 1.7 ± 0.8 logMAR (p = 0.001). Initial macular detachment (adjusted odds ratio [AOR], 0.25), development of iatrogenic break (AOR, 0.25), and use of heavy SO (AOR, 0.13) were independently associated with a lower risk of final retinal attachment, and SO removal was associated with a higher incidence (AOR, 7.55). Better baseline BCVA was associated with a higher risk of final BCVA ≥20 / 200.ConclusionsDespite an encouraging outcome based on anatomical data in advanced PDR treated with vitrectomy and SO, the functional prognosis was not satisfying for patients. Eyes with better vision at baseline had a more favorable prognosis, whereas eyes with initial macular detachment, intraoperative iatrogenic break, or heavy SO showed more unfavorable outcomes. In selected cases, extending the time of SO use did not worsen the prognosis.

Topiramate should be added to the list of drugs that may cause anterior uveitis and hypopyon formation.

A 25-year-old woman with myopia who had an AC pIOL implantation in the left eye and posterior chamber pIOL implantation in the right eye developed bilateral granulomatous panuveitis 2 months after the second surgery. Physical examination showed bilateral Koeppe and Busacca nodules. Fluorescein angiography showed diffuse vascular and retinal pigment epithelial leakage in both eyes. With assessment of sympathetic ophthalmia, treatment with a high-dose systemic steroid was started. Oral cyclosporine and azathioprine were later added. Because the uveitis was not controlled, adalimumab was added. After 6 doses of adalimumab (40 mg subcutaneously), the uveitis subsided and corticosteroid and other immunosuppressive agents were tapered. Refractive AC pIOL implantation should be added to the list of intraocular procedures that may induce sympathetic ophthalmia. Adalimumab may have a therapeutic role in its management.