Indocyanine green-assisted internal limiting membrane peeling for macular holes: toxicity?

Indocyanine green (ICG) staining facilitates definitive internal limiting membrane (ILM) peeling during macular hole surgery (MHS), but might cause toxicity. To determine if ICG to assist in ILM peeling has an effect on anatomic or visual results in MHS with ILM peeling. Retrospective, comparative review including primary analysis of 173 cases undergoing MHS. Visual acuity >or=20/50, <or=20/200, three-line visual acuity improvement, and anatomic success rates were analyzed as endpoints. The single operation hole closure rate was 87% with ICG versus 83% without ICG (P = 0.52). Postoperative median best-corrected visual acuity was 20/70 and 20/80 in the ICG and no ICG groups with median follow-up intervals of 8 and 9 months. The use of ICG was associated with a higher rate of or=20/50 visual acuity. ICG usage during macular hole surgery was not associated with worse visual outcomes, suggesting possible toxic effects reported are not clinically significant. If the ILM cannot be peeled effectively, ICG should be considered a safe option

One-year safety and efficacy of intravitreal triamcinolone acetonide for the management of macular edema secondary to central retinal vein occlusion

To evaluate the safety and efficacy of intravitreal triamcinolone acetonide (IVTA) as treatment for macular edema associated with central retinal vein occlusion (CRVO). A retrospective review was performed of data for 40 consecutive patients (40 eyes) with CRVO and macular edema treated with IVTA at the Bascom Palmer Eye Institute (Miami, FL). Median duration of symptoms before the first injection was 3 months (range, 1 day to 8 years). Median Snellen visual acuity was 20/400 at baseline (range, 20/60 to light perception; n = 40), 20/300 at 1 month (P = 0.010; n = 37), 20/300 at 3 months (P = 0.007; n = 33), 20/400 at 6 months (P = 0.726; n = 28), and 8/200 at 1 year (P = 0.569; n = 17). Vision improved by > or =3 lines in 21% of eyes at 1 month, 27% at 3 months, 14% at 6 months, and 12% at 1 year. Visual acuity was unchanged from baseline in 71% of eyes at 6 months and 1 year. By 1 year, 50% of eyes received more than one injection (mean = 1.6 injections; range 1-4 injections). Overall, intraocular pressure increased by > or =10 mmHg in 24% of eyes at 1 year. Trabeculectomy was performed on 2 of 12 eyes with preexisting open-angle glaucoma. IVTA can substantially improve vision in some patients, but most patients have stable visual acuity compared with baseline at 1 year despite repeated injections

Alternative Methods For The Screening Of Retinopathy of Prematurity: Binocular Indirect Ophthalmoscopy Vs Wide-Field Digital Retinal Imaging

Purpose To compare the diagnostic efficacy of wide-field digital retinal imaging (WFDRI) with binocular indirect ophthalmoscopy (BIO) for retinopathy of prematurity (ROP) screening. Methods Premature infants admitted for ROP screening were included in this prospective, randomized and double-blind comparative study. They were examined by using BIO and WFDRI. Results A total of 58 infants were enrolled in the study. The sensitivities of WFDRI in detecting any stage of ROP, treatment-requiring ROP and plus disease were 58.6, 100, and 100% respectively, with a specificity of 100% for all. The proportional agreement between WFDRI and BIO was 0.903 for detection of any stage of ROP, 1.0 for treatment-requiring ROP, and 1.0 for plus disease. Conclusion The sensitivity and specificity of WFDRI was excellent for the diagnosis of severe and treatment-requiring ROP. However, BIO was superior in mild ROP particularly for the ones in retinal periphery.WoSScopu