Optic disc pits (ODPs) are associated with serous macular detachment (SMD), which causes visual loss in 25% to 75% patients with ODPs. There are various modalities of noninvasive and invasive treatment options; however, the best method of treatment is to seal the optic disc to prevent further egress of fluid into the subretinal space. The authors report a technique that involves sealing of ODPs with autologous free flap of the internal limiting membrane (ILM). After trans pars plana vitrectomy, the ILM was peeled and plugged into the ODP. This procedure gave good anatomical and functional success. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:350-353.].

A 12-year-old boy presented with best-corrected visual acuity (BCVA) of 6/9 in both eyes following an episode of electric shock. Optical coherence tomography (OCT) showed disruption of the ellipsoid zone as well as retinal pigment epithelium (RPE) layer. Fundus autofluorescence (FAF) showed increased central hypoautofluorescence in both eyes. At 3-month follow-up, BCVA improved to 6/6 with OCT showing spontaneous resolution of maculopathy in both eyes with reorganized RPE layer and ellipsoid zone. To the best of our knowledge, this is the first case of bilateral electric shock maculopathy (ESM) with spontaneous anatomical as well as functional recovery. Ophthalmologists must be aware of various forms of ESM. OCT and FAF must be done in patients presenting with defective vision and history of electric shock for the diagnostic as well as prognostic evaluation.

Purpose To evaluate the anatomical and visual outcomes in optic disc pit maculopathy following pars plana vitrectomy (PPV) with inverted internal limiting membrane (ILM) flap Methods Retrospective interventional case series of 10 patients diagnosed with serous macular detachment secondary to optic disc pit who underwent PPV with inverted ILM flap and were followed up for a year. Results A p-value of less than 0.05 was defined as statistically significant. The mean age of patients was 27.2 ± 10.6 years, preoperatively the mean best-corrected visual acuity of the logarithm of the minimum angle of resolution was 0.91 ± 0.42 (approximate Snellen equivalent 20/162), which improved to the logarithm of the minimum angle of resolution of 0.58 ± 0.29 (approximate Snellen equivalent 20/76) at end of one year, (p=0.008). The mean central macular thickness was 804.9 ± 294.1 m which improved to 273.4 ± 102.54 m, (p=0.002). After surgery, at end of one year, 60% of patients (6/10) had 15- or more-than-15-letter improvement of vision on Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing, 20% (2/10) gained a 10-letter improvement and 20% (2/10) retained the same vision. Conclusion PPV with inverted ILM flap can be considered as a good approach for the management of serous macular detachment secondary to optic disc pit and produce good anatomical and visual results at one year with stabilization of the disease.

For inflammatory CNVM, in addition to immunosuppression in cases with active inflammation, anti-vascular endothelial growth factor therapy seems as a very effective treatment modality resulting in significant visual improvement and foveal flattening. Incidence of major complications is rare, and the recurrence rate seems low.

Purpose: To describe the etiology and treatment outcomes of choroidal neovascularization (CNV) in a pediatric population with intravitreal anti-vascular endothelial growth factors (VEGF) Methods: Retrospective single center interventional case series. A total of 26 eyes of 23 consecutive pediatric patients with CNV of various etiologies were treated with intravitreal injection of anti-VEGF agents. Results: There were 15 males (65.2%) and eight females (34.8%), diagnosed with CNV during the study period. The mean age at presentation with CNV was 11.7 ± 3.3 years, (range 4–16 years) and the mean follow was 28.1 ± 18 months, (range 8–72 months). Inflammatory CNV was the most common etiology. The mean best corrected visual acuity (BCVA) and mean central macular thickness (CMT) at presentation, were logMAR 0.8 ± 0.3 and 367.6 ± 134.8 µm respectively. At the final visit, CNV in all eyes remained regressed with significant improvement in mean BCVA to logMAR 0.4 ± 0.4 ( p < 0.0001) and mean CMT to 242.5 ± 82.4 µm ( p < 0.0001). A mean of two intravitreal injections per eye was required for CNV regression. Conclusion: Intravitreal anti-VEGF therapy for pediatric CNV is an effective treatment in majority of affected eyes.

Purpose: To report a cluster of postoperative Acanthamoeba endophthalmitis after routine cataract surgeries. Methods: A brief summary of sentinel events leading to the referral of 4 patients of postoperative endophthalmitis to our hospital is followed by clinical descriptions and the various diagnostic approaches and interventions used. Genotyping and phylogenetic analysis are also discussed. Results: Four cases of postoperative cluster endophthalmitis, presumed to be bacterial and treated as such, were referred to our hospital. The presence of an atypical ring infiltrate in the first case facilitated the diagnosis of Acanthamoeba endophthalmitis. All patients had vitritis, corneal involvement, and scleral inflammation. Multiple diagnostic methods, such as corneal scrapings, confocal microscopy, aqueous and vitreous taps, scleral abscess drainage, histopathological studies, polymerase chain reaction, and genotyping and phylogenetic analyses of isolated Acanthamoeba, were used to confirm the diagnosis of endophthalmitis and to establish the extent of ocular involvement. Various medical and therapeutic interventions used to control the infections were also documented. The isolated Acanthamoeba were confirmed as belonging to the T10 genotype, an environmentally and clinically rare variety. Conclusions: This is the first report of a cluster of postoperative T10 genotype Acanthamoeba endophthalmitis, occurring after routine cataract surgery in immunocompetent individuals. Contrary to current perceptions, a rapidly evolving infection can occur with Acanthamoeba.

Purpose:To review the surgical outcomes of intravitreal bevacizumab (IVB) along with subretinal fluid drainage with cryotherapy in patients with stage 3B Coats’ disease.Materials and Methods:A retrospective study of seven cases of stage 3B Coats’ disease, who underwent subretinal fluid drainage with cryopexy, from May 2011 to March 2014. Five eyes received additional IVB at the end of surgery. Green laser therapy was performed on telangiectatic vessels postoperatively.Results:The mean age was 34 months (range, 10-84 months). Mean follow-up was 19 months. Six patients (85.7%) had an attached retina at final follow-up. Three out of four patients (75%) that received IVB developed tractional retinal detachments (TRDs). Two eyes that did not receive bevacizumab did not develop any traction. None progressed to neovascular glaucoma or phthisis bulbi.Conclusion:Simultaneous injection of bevacizumab along with subretinal drainage and cryotherapy for advanced Coats’ disease could not avoid TRD.