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

Vitrectomy and Release of Presumed Epipapillary Vitreous Traction for Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy Associated with Partial Posterior Vitreous Detachment

Objective: To study the results of vitrectomy and release of epipapillary vitreous adhesions for the treatment of nonarteritic anterior ischemic optic neuropathy (NAION) associated with partial posterior vitreous detachment (PVD). Design: Prospective noncomparative interventional case series. Participants: A series of 16 patients with clinical picture of NAION and small discs associated with partial PVD, diagnosed clinically and confirmed by optical coherence tomography and B-scan ultrasonography. Intervention: All patients underwent standard pars plana vitrectomy with meticulous removal of epipapillary vitreous adhesions within 1 month from the onset of visual symptoms. Main Outcome Measures: Best-corrected visual acuity (BCVA), mean deviation of visual fields, and color vision testing. Results: In 15 patients BCVA improved (93.7), mean preoperative BCVA was 6/38 (0.82±0.53 logarithm of the minimum angle of resolution logMAR), which improved to 6/18 (0.49±0.37 logMAR) postoperatively at 3 months. Nine eyes (56%) had �3 lines of visual improvement. Visual fields improved in 4 patients and color vision improved in 1 patient. Conclusion: Vitreous traction from partial PVD may have a causative role in some cases of NAION associated with small discs. In these cases, vitrectomy and removal of epipapillary vitreous may result in improvement of visual acuity. © 2007 American Academy of Ophthalmology

Perfluorocarbon liquid migration into the subarachnoid space in a patient with morning glory syndrome

Purpose: To report a case of perfluorocarbon liquid (PFCL) migration into the subarachnoid space at the time of vitreoretinal surgery in a patient with morning glory syndrome associated retinal detachment. Case report: A 9-year-old girl underwent pars plana vitrectomy and silicone oil injection for retinal detachment associated with morning glory syndrome. PFCL was used for retinal stabilization before endolaser photocoagulation. The retina detached, and repeated vitrectomy and silicone oil injection was performed. Postoperative magnetic resonance imaging revealed PFCL in the subarachnoid space. Conclusion: The migration of perfluorocarbon into the subarachnoid space is a rare complication of vitrectomy in patients with morning glory syndrome. © 2015 Iranian Society of Ophthalmology

Macular thickness measurement in clinically significant macular edema before and after meal

Purpose: To evaluate the macular thickness changes in diabetic macular edema after meal. Methods: In this prospective case series, macular thicknesses of diabetic patients with clinically significant macular edema (CSME) were measured after 7 h of fasting and repeated 2 h after breakfast. Results: Thirty six eyes of 20 diabetic patients were evaluated. The mean central subfield thickness (CST) and maximum retinal thickness (MRT) significantly decreased after meal (mean change of -10.3 ± 14.3 μm and -13.1 ± 12.7 μm, respectively, both P < 0.001). A decrease in CST and MRT values was found in 23 (63.8) and 28 (77.7) eyes, respectively, and no eye had an increase in retinal thickness measurements. Significant correlation was found between CST and MRT change and fasting thickness measurements (P = 0.001 and P = 0.01, respectively) and intraretinal cystic spaces (P = 0.001 and P = 0.03, respectively). Mean MRT change was significantly higher in the presence of subretinal fluid (P = 0.01). Conclusion: Retinal thickness measurements may change after meal. So, fasting state of diabetic patient should be considered in measurement of macular thickness of patients with CSME. © 2015 Iranian Society of Ophthalmology

Therapeutic effect of bevacizumab injected into the silicone oil in eyes with neovascular glaucoma after vitrectomy for advanced diabetic retinopathy

Purpose To evaluate the effect of intra-silicone injection of bevacizumab for the treatment of neovascular glaucoma (NVG) after vitrectomy for advanced proliferative diabetic retinopathy.Methods Bevacizumab was injected into the silicone oil in five pseudophakic eyes of five patients with NVG. The iris neovascularization (INV) and NVG had developed 1.5-4 months after vitrectomy and silicone oil tamponade. The main outcome measures were regression of INV, intraocular pressure and visual acuity.Results In all eyes, INV regressed and intraocular pressure was controlled within 7 days. Visual acuity improved in all eyes. In one patient, INV and NVG recurred 10 weeks after the injection and was successfully treated with a repeat intra-silicone bevacizumab injection.Conclusion Intra-silicone injection of bevacizumab is effective in the treatment of patients with INV and NVG after vitrectomy for advanced proliferative diabetic retinopathy. © 2010 Macmillan Publishers Limited All rights reserved

Posterior sub-tenon's bevacizumab injection in diabetic macular edema; a pilot study

Purpose: To evaluate the short-term results of sub-tenon's injection of bevacizumab in patients with clinically significant macular edema (CSME). Methods: In this prospective non-comparative interventional case series, sub-tenon's injection of 2.5. mg/0.1. ml bevacizumab was performed for eyes with CSME. Macular thickness and best corrected visual acuity measurements were performed before and one month after injections. Results: Nineteen eyes of twelve patients with a mean age of 59.8. ±. 5.7. years were evaluated. Thirteen eyes (68.4) had center-involving macular edema. No significant difference was observed between pre- and post-injection central subfield retinal thickness measurements (P= 0.3). Central subfield thickness measurements improved or remained unchanged in 13 eyes (68.4). Baseline BCVA of 0.48. ±. 0.35 LogMAR improved to 0.36. ±. 0.26 LogMAR after injection (P= 0.01). Improvement of. > 2 lines in BCVA was found in 5 eyes (26.3), and no eye lost. > 2 lines of BCVA. No complication associated with sub-tenon's injection was observed. Conclusion: Sub-tenon's injection of bevacizumab resulted in significant short-term visual improvement in eyes with CSME. Retinal thickness changes were not significant. © 2015 The Authors

Half-dose photodynamic therapy for chronic central serous chorioretinopathy

Purpose: To report the outcomes of half-dose photodynamic therapy (PDT) in patients with chronic central serous chorioretinopathy (CSC). Methods: A chart review of patients with chronic CSC who had received half-dose verteporfin PDT (3 mg/m2) was performed. The main outcome measures were resolution of subretinal fluid and best corrected visual acuity (BCVA). Results: Fifty-three eyes of 51 patients with mean age of 45.01 ± 8.9 years were studied. Three, 6 and 12 months after half-dose PDT, subretinal fluid was completely resolved in 51 eyes (96.2). In 2 eyes (one patient), subretinal fluid decreased at 3 months but one year later, an increase in subretinal fluid was detected on optical coherence tomography (OCT) which completely resolved following additional PDT. Another patient with recurrence of subretinal fluid rejected further treatment. Mean baseline central subfield thickness was 385 ± 113.0 μm which was decreased to 235 ± 39.7, 247 ± 49.7, and 244 ± 49.52 μm after 3, 6 and 12 months, respectively (all P-values &lt; 0.001). Mean BCVA was 0.33 ± 0.27 LogMAR before PDT and 0.11 ± 0.18, 0.11 ± 0.17, 0.17 ± 0.26 and 0.10 ± 0.23 LogMAR, 3, 6 and 12 months and at final visit (up to 60 months) after PDT, respectively (all P-values &lt; 0.001). Improvement �2 lines in BCVA occurred in 20 eyes (37.7). Statistically significant correlations were found between improvement in BCVA and baseline BCVA, baseline central subfield thickness and central subfield thickness after resorption of subretinal fluid (P &lt; 0.001, P= 0.04 and P= 0.01, respectively). No complications attributed to PDT were observed. Conclusion: Half-dose PDT is effective for treatment of patients with chronic CSC. © 2016 Journal of Ophthalmic and Vision Research

Cataract surgery for congenital cataract: Endothelial cell characteristics, corneal thickness, and impact on intraocular pressure

Purpose: To investigate whether central corneal thickness (CCT), endothelial cell characteristics, and intraocular pressure (IOP) are affected in patients with previous congenital cataract surgery and to focus on their clinical significance. Methods: CCT and IOP measurements and specular microscopy were performed in 31 eyes of 17 cases of extracted congenital cataracts and 40 eyes of 20 age- and sex-matched participants as control group. The mean of three pachymetry measurements of the central cornea was taken as CCT. IOP was checked using an applanation tonometer. Results: The mean corneal thickness of the eyes with extracted congenital cataract (632 ± 45 μm) was significantly greater than that of the control eyes (546 ± 33 μm; p < 0.001). There was no significant difference in the corneal endothelial cell count, coefficient of variation (CV), and mean cell area (AVG) of endothelial cells between operated eyes and the control group. The mean measured IOP in the operated group (22.8 ± 3.3 mm Hg) was significantly greater than IOP in controls (14.1±1.8 mm Hg, p < 0.001). Conclusions: Although the corneas were clinically clear and there was no significant difference in endothelial characteristics of eyes with extracted congenital cataract and controls, central corneas of operated eyes were significantly thicker than those of controls. To differentiate the actual glaucoma from ocular hypertension in these patients, the central corneal thickness measurement should strongly be considered. © 2007 American Association for Pediatric Ophthalmology and Strabismus

Anterior lamellar recession, blepharoplasty, and supratarsal fixation for cicatricial upper eyelid entropion without lagophthalmos

PurposeTo assess the results of anterior lamellar recession, blepharoplasty, and supratarsal fixation procedure in patients with upper eyelid cicatricial entropion without lagophthalmos.MethodsIn a prospective interventional case series, 52 eyelids (32 patients) were included (April 2009-December 2010). Excluded were patients with previous eyelid surgeries, lagophthalmos, and <12 months of follow-up. Using a microscope, after recessing anterior lamella 3-4 mm above the eyelid margin, it was fixed with 4-5 interrupted 6-0 vicryl sutures. Excess anterior lamella was then excised (blepharoplasty), supratarsal fixation sutures (6-0 vicryl) were put and the skin was closed with 6-0 nylon sutures. Success and failure defined based upon eyelash-globe touch on the last follow-up visit (at least 12 months), respectively.ResultsThere were 21 females (65.6) and 11 males (34.4) with a mean age of 69.7 years (SD=6.9) and mean follow-up of 21.06 months (SD=8.26). Success was observed in 39 (75) and failure in 13 (25). Mean time of failure was 4.5 months (SD=3). Although re-treatment with radio-frequency electrolysis (eight eyelids) and re-anterior lamellar recession (two eyelids) resulted in success in 12 eyelids with failure, two patients (three eyelids) declined further procedure. Except for thickened eyelid margin, no complications were observed.ConclusionAnterior lamellar recession, blepharoplasty, and supratarsal fixation procedure is an effective and safe technique for the treatment of the upper eyelid cicatricial entropion without lagophthalmos. © 2016 Macmillan Publishers Limited All rights reserved