The dexamethasone implant improved macular edema in refractory cases resulting in statistically significant improvements in best-corrected visual acuity and central macular thickness that remained stable to 3 months and 6 months, respectively.

PurposeTo report spectral-domain optical coherence tomography (SD-OCT) findings in polypoidal choroidal vasculopathy (PCV).Patients and methodsSeventeen eyes of 15 consecutive patients diagnosed with PCV based on typical clinical and angiographic findings were imaged with macular SD-OCT including line scans passing through the polyps.ResultsSD-OCT findings included typical and atypical retinal pigment epithelial (RPE) detachments and subretinal and intraretinal fluid in all eyes. In the areas corresponding to the polypoidal lesions, well-delineated round-oval, sub-RPE cavities were present and were adherent to the posterior surface of the detached RPE above Bruch membrane. No retinal or choroidal connections to the cavities were noted.ConclusionThese SD-OCT findings document that the vascular lesions in PCV are not located in the inner choroid, but in the sub-RPE space, suggesting that PCV is a variant of type 1 choroidal neovascularization rather than a distinct clinical entity as initially thought.

PurposeTo investigate the clinical findings and outcomes of rhegmatogenous retinal detachment (RRD) in Stickler syndrome on affected and fellow eyes that underwent prophylactic retinopexy.Patients and methodsChart review of 70 eyes (62 patients). Incidence of RRD, postoperative visual acuity, and risk factors were evaluated.ResultsTwenty-two patients (35%) had RRD in the fellow eye, 37% of the eyes had cataract, 93% had macular detachment, 50% had proliferative vitreoretinopathy, and 41% had posterior vitreous detachment. Success rates were: 60% of patients after scleral buckling; 57.1% after pars plana vitrectomy; and 75% after combined scleral buckling and pars plana vitrectomy. Sixty-one (93.8%) of patients had successful surgery (including second surgery). Silicone oil tamponade was significantly associated with final anatomic outcome, with a protective odds ratio of 0.11 (P=0.027). Visual acuity improved in 54% of eyes and decreased in 5%. Statistically significant associations were present for eyes with final visual acuity ≥20/200, and total retinal detachment (P<0.001); preoperative cataract (P=0.023); and proliferative vitreoretinopathy (P<0.001). RRD developed in 16/44 eyes despite laser prophylaxis.ConclusionProphylactic retinopexy was not beneficial for Stickler syndrome patients. Success of primary surgery for RRD remains low. The primary surgery should be vitrectomy combined with scleral buckling and silicone oil tamponade.