Optical Coherence Tomography Angiography of the Optic Disc; an Overview.

Different diseases of the optic disc may be caused by or lead to abnormal vasculature at the optic nerve head. Optical coherence tomography angiography (OCTA) is a novel technology that provides high resolution mapping of the retinal and optic disc vessels. Recent studies have shown the ability of OCTA to visualize vascular abnormalities in different optic neuropathies. In addition, quantified OCTA measurements were found promising for differentiating optic neuropathies from healthy eyes

Surgical Removal of Submacular Perfluorocarbon Liquid Using a 41-Gauge Extendible Subretinal Injection Needle

Submacular perfluorocarbon liquid (PFCL) retention is a well-known complication of vitreoretinal surgeries; however, the optimal surgical technique for the removal of subfoveal PFCL is yet to be determined. We describe a novel surgical technique for the removal of retained submacular PFCL by performing a retinotomy adjacent to the inferotemporal arcade using a 41-gauge extendible subretinal injection needle and inducing a therapeutic retinal detachment. Through the same retinotomy, the bent 41-gauge needle was advanced into the subretinal space to reach the PFCL bubble. Subsequently, active aspiration of PFCL was performed. The surgical procedure was successfully performed in two patients. This technique appears to be an effective surgical approach for removing retained submacular PFCL bubble

Anteriorization of inferior oblique muscle and downward transposition of medial rectus muscle for lost inferior rectus muscle

A 6-year-old boy who had been treated with bilateral medial rectus muscle recessions 3 years earlier for congenital esotropia was undergoing bilateral inferior oblique muscle recessions to correct inferior oblique muscle overaction. The right inferior rectus muscle was inadvertently cut during this surgery and was irretrievable. To manage this complication, the medial rectus muscle was transposed toward the inferior rectus insertion and the inferior oblique muscle was anteriorized. At the 1 year follow-up visit, no infraduction deficit was present on downgaze and only 8� of left hypertropia was present in primary position. © 2006 American Association for Pediatric Ophthalmology and Strabismus

Peripapillary nerve fiber layer thickness changes after macular photocoagulation for clinically significant diabetic macular edema

Purpose: To evaluate the effect of macular photocoagulation (MPC) on peripapillary nerve fiber layer (PNFL) thickness measurement in patients with clinically significant diabetic macular edema (CSME). Methods: This study was a prospective interventional case series. Patients with CSME underwent MPC. Optical coherence tomography (OCT) was used to measure the PNFL and central macular thicknesses before and 3. months after MPC. Results: Thirty-three eyes of 25 patients with a mean age of 59.4. ±. 7.2. years were included. There was no statistically significant difference between pre- and post-MPC mean best corrected visual acuity (0.35. ±. 0.29 and 0.40. ±. 0.23 LogMAR, respectively, P= 0.2). Mean baseline and 3. months central macular subfield thickness was 305.9. ±. 90.7 and 317.5. ±. 112.4 microns, respectively (P= 0.1). Peripapillary nerve fiber layer thickness was 105.7. ±. 10.0 before and 106.1. ±. 9.9 three months after MPC (P= 0.7). No significant differences were found between pre and post MPC measurements in temporal, nasal, inferior and superior nerve fiber layer thickness in each quadrant around optic nerve head (P>. 0.05). Conclusions: Macular photocoagulation has no statistically significant effect on PNFL thickness measurements in patients with CSME. © 2014 The Authors

Intravitreal Methotrexate

Intravitreal methotrexate (MTX) has been proven to be an effective treatment for various intraocular diseases. In this article, a comprehensive review was performed on intravitreal applications of methotrexate. Different aspects of the administration of intravitreal MTX for various clinical conditions such as intraocular tumors, proliferative vitreoretinopathy, diabetic retinopathy, age-related macular degeneration, and uveitis were reviewed and the adverse effects of intravitreal injection of MTX were discussed. The most common indications are intraocular lymphoma and uveitis. Other applications remain challenging and more studies are needed to establish the role of intravitreal MTX in the management of ocular diseases

“Inverted Snowing-Cloud” Sign in Endogenous Candida Endophthalmitis

Candida spp. is the most common cause of endogenous fungal endophthalmitis. The diagnosis of this rare disease is based on clinical findings supported by positive blood culture. Recently, it has been shown that optical coherence tomography (OCT) characteristic findings are beneficial in making a correct diagnosis of fungal infection in cases with endogenous endophthalmitis. The current photo-essay aims to highlight the role of OCT in diagnosis of Candida endogenous endophthalmitis where OCT imaging of one of the retinal lesions disclosed a pre-retinal hyper reflective lesion with overlying punctate vitreous opacities. We propose “inverted snowing-cloud” sign for this OCT pattern considering the resemblance of the vitreous opacities to snowflakes