Subthreshold micropulse diode laser treatment resulted in better visual acuity compared with conventional laser, although the differences before 12 months are likely to be too small to be of clinical relevance and may be dependent on baseline best-corrected visual acuity. The two types of treatment seem to have similar anatomical outcome.
Our aim was to describe the visual function characteristics of affected members from two unrelated families with different dominant mutations in the CRX gene. Standard full-field ERGs and high-intensity a-wave series were obtained. In addition, in most subjects, dark-adapted (DA) thresholds, color vision function (arrangement tests), and static perimetry were assessed. A point mutation in codon 41 of the CRX gene (Arg41Gln) was identified in family members from the RFS087 family who were tested on several occasions since 1983. Depending on age, affected members showed varying degrees of acuity loss, normal or slightly elevated DA thresholds, reduced cone a- and b-wave amplitudes, normal or minimally delayed cone b-wave implicit times, and normal rod and cone phototransduction gain parameters. An insertion mutation (Ala196+1bp) was found in two members of another family (RFS014). Affected members showed reduced visual acuity, normal or slightly elevated DA thresholds, relatively preserved rod ERG and substantially reduced or undetectable cone ERG, and normal rod phototransduction gain parameters. The Arg41Gln was associated with a late-onset, slowly progressing mild form of cone-rod dystrophy with cone loss but preserved rod and cone sensitivity until later in life. The Ala196+1bp mutation was associated with an early-onset, severe form of cone-rod dystrophy similar to that described in the original CORD2 family (Evans et al., Arch Ophthalmol 1995;113:195-201).
A 63-year-old male with a history of bladder cancer in remission presented with progressive vision loss during a period of 2 years. Slit-lamp and funduscopic examination were unremarkable. Electroretinogram (ERG) revealed an unrecordable scotopic response and a moderately decreased photopic response. Computed tomography of the chest, abdomen, and pelvis showed a new duodenal mass. Subsequent biopsy disclosed malignant melanoma, and a diagnosis of melanoma-associated retinopathy (MAR) was made. The patient was then treated with a dexamethasone intravitreal implant 0.7 mg in his left eye. Two months after the implant, the patient reported a mild symptomatic improvement in his left eye, and ERG testing performed after the implant insertion revealed partial improvement in several scotopic and photopic ERG parameters. Repeat spectral-domain optical coherence tomography disclosed an improvement in retinal thickening. To the best of the authors' knowledge, this is the first report illustrating potential subjective visual improvement, improvement in retinal thickening, and ERG changes following treatment by intravitreal dexamethasone implant for MAR.
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Ophthalmic Surg Lasers Imaging Retina
. 2021;52:454–456.]
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