To evaluate the efficacy of intravitreal triamcinolone acetonide in the management of persistent macular edema secondary to nonischemic central retinal vein occlusion (CRVO). Methods: Twenty consecutive patients were selected with a 3-to 4-month history of nonischemic CRVO and persistent macular edema. These patients received a single intravitreal injection of 4 mg of triamcinolone acetonide (40 mg/mL). The follow-up period ranged from 10 to 12 months. The amount of macular edema was assessed by the amount of retinal thickening on clinical examination using the Goldmann contact lens and by the area and intensity of staining on fluorescein angiography. Treated patients were compared with a retrospectively matched group of patients who were managed with observation only. Main Outcome Measures: Changes in visual acuity and amount of macular edema were assessed in the treated patients and compared with the observation group. Results: The mean baseline visual acuity in the treatment group was 20/132 vs 20/123 for the observation group (P=.57). After 1 week, the treated group had a mean visual acuity of 20/51. At final follow-up, the treated group had a mean visual acuity of 20/37 while the observation group had a mean visual acuity of 20/110 (P=.001). Sixty percent of treated patients had a final visual acuity of 20/40 or better vs only 20% in the observation group (P=.01). Forty percent of the untreated patients had a final visual acuity worse than 20/200 while none of the treated patients did (PϽ.001). At final follow-up, 75% of treated patients had complete resolution of macular edema on clinical examination vs only 20% of the untreated patients (PϽ.001). Two of the treated patients had recurrence of macular edema at 6 months, and 3 had elevated intraocular pressure. Conclusion: This study shows a treatment benefit from intravitreal triamcinolone in terms of visual acuity and macular edema for nonischemic CRVO.

Purpose To prospectively evaluate the intraocular pressure (IOP) lowering ability, retreatment rate, and complications of transcleral Diode laser cyclophotocoagulation using a higher power setting than what is generally recommended. Patients and methods A total of 36 eyes of thirty six patients with refractory glaucoma, and who fitted our inclusion criteria underwent Diode cyclophotocoagulation. The laser power was set at 2250 mW, with a duration of 2000 ms, and a total number of 28 shots for the first treatment and 20 shots for any consequent one. The patients were followed up for 1 year with the following outcomes being analysed: IOP, visual acuity, change in the number of medications, and complications. Results The mean IOP decrease was 53% (Po0.05), and 72.2% of the patients maintained an IOP r21 mmHg for the whole duration of the study The number of medications necessary to control the pressure, significantly dropped from 2.8 to 0.89 (Po0.05), and 25% of the patients needed the treatment to be repeated only once. In all, 33% of the patients improved their visual acuity after the treatment, while 22% worsened, and the rest stayed the same. The most common treatment complications were conjunctival injection and corneal oedema, and these were both transient and reversible. Conclusion The use of the higher power setting of 2250 mW, resulted in a sustained lower IOP, less use of medications, less need for retreatment, relative preservation of visual acuity, and only reversible complications.

Mitomycin C appears to be a safe and effective adjunct therapy in correcting punctal stenosis.

Upper eyelid retraction after filtering surgery is a rarely reported entity. Müller muscle overaction, independent of Graves disease, is a likely cause and has been pointed out as a possible factor in one previous report. Müller muscle fibrosis, euthyroid Graves disease, and mechanical hindrance to an elevated bleb are other possible factors.

Retinoblastoma is an ocular tumor that occurs in young children, in either heritable or sporadic manner. The relative rarity of retinoblastoma, and the need for expensive equipment, anesthesia, and pediatric ophthalmologic expertise, are barriers for effective treatment in developing countries. Also, with an average age-adjusted incidence of two to five cases per million children, patient number limits development of local expertise in countries with small populations. Lebanon is a small country with a population of approximately 4.5 million. In 2012, a comprehensive retinoblastoma program was formalized at the Children's Cancer Institute (CCI) at the American University of Beirut Medical Center, and resources were allocated for efficient interdisciplinary coordination to attract patients from neighboring countries such as Syria and Iraq, where such specialized therapy is also lacking. Through this program, care was coordinated across hospitals and borders such that patients would receive scheduled chemotherapy at their institution, and monthly retinal examinations and focal laser therapy at the CCI in Lebanon. Our results show the feasibility of successful collaboration across borders, with excellent patient and physician adherence to treatment plans. This was accompanied by an increase in patient referrals, which enables continued expertise development. However, the majority of patients presented with advanced intraocular Abbreviations: CCI, Children's Cancer Institute; EBRT, external-beam radiation therapy; EUA, examination under anesthesia; PFV, persistent fetal vasculature.