Efficacy and safety of intravitreal dexamethasone implant (Ozurdex®) in real-life practice

Millions of patients worldwide suffer from macular edema and associated loss of visual acuity. Luckily, the range of available treatments has widened over the past few years including the dexamethasone sustained-release implant (Ozurdex®) - a biodegradable intravitreal implant that maintains a high concentration of corticosteroids in the vitreous for up to 3 - 4 months. This progressive release decreases treatment burden compared to anti-VEGF that often require monthly injections.We present the results of 3 real-life studies investigating the effects of Ozurdex® in diabetic macular edema (RELDEX study), non-infectious uveitis (RUVDEX study) and persistent postsurgical macular edema (EPISODIC 2 study). A known side effect of steroids is ocular hypertension. Real-life studies SAFODEX 1 and 2 report new data on pressure tolerance of Ozurdex® and identify risk factors for ocular hypertension after dexamethasone implant offering scientific proof for better patient selection and follow-up.</p

Acute macular neuroretinopathy secondary to central retinal artery occlusion

Purpose: Acute Macular Neuroretinopathy (AMN) may be the result of deep retinal capillary plexus (DCP) impairment, but its mechanism remains elusive. A recent study has described simultaneous onset of Paracentral Acute Middle Maculopathy (PAMM) and AMN, suggesting a related pathogenic pathway. In this report, we analyze and describe the imaging characteristics of patients with concomitant Central Retinal Artery Occlusion (CRAO) and AMN and suggest a mechanistic pathway to explain this relationship. Observations: A total of 2 cases of CRAO, arteritic and non arteritic, were included in this report. At initial presentation, outer retinal layers were intact. At the two-week follow-up visit, both cases displayed Henle fiber layer hyperreflectivity and ellipsoid zone disruption consistent with AMN. Conclusions: Secondary development of AMN in CRAO is a new finding. DCP ischemia secondary to CRAO may lead to Henle fiber layer disruption, leading to the characteristic findings of AMN. Keywords: AMN; AMN secondary to CRAO; AMN, Acute Macular Neuroretinopathy; APMPPE, Acute Posterior Multifocal Placoid Pigment Epitheliopathy; ASHH; ASHH, Angular Sign of HFL Hyperreflectivity; CRAO; CRAO, Central Retinal Artery Occlusion; CRVO, Central Retinal Vein Occlusion; DCP, Deep Capillary Plexus; EZ, Ellipsoid Zone; FA, Fluorescein Angiogram; HFL, Henle Fiber Layer; INL, Inner Nuclear Layer; IZ, Interdigitation Zone; OCT, Optical Coherence Tomography; OD, Oculus Dexter; ONL, Outer Nuclear Layer; OPL, Outer Plexiform Layer; OS, Oculus Sinister; PAMM; PAMM, Paracentral Acute Middle Maculopathy; SD, Spectral Domain.</p

Bilateral Loss of Vision a Few Hours After a Motor Vehicle Crash

A 74-year-old woman was referred for a bilateral blurry vision occurring 2 hours after a car crash

Conjunctivitis with Monkeypox Virus Positive Conjunctival Swabs

A 39-year-old man consulted for unilateral red eye and itchiness (Fig A, C) 5 days after positive monkeypox virus (MPOX) cutaneous polymerase chain reaction (PCR) swab from chin and lip lesions (Fig B). Slit-lap examination showed conjunctival follicular reaction and the presence of small white vesicles on the nasal bulbar conjunctiva (Fig C, arrow). The rest of the anterior and posterior segment were normal, and the fellow eye remained uninvolved during follow up. Two separate conjunctival PCR swabs were positive for MPOX, confirming indirectly similar loads of the virus on conjunctival and eye secretions compared with cutaneous lesions (26.7 vs 24.8 [cycle threshold] respectively), raising the possibility of transmission via eye contact, i.e., during ophthalmologic examination. Healthcare professionals should be aware of this fact and employ adequate personal protection.</p

Fundus Abnormalities in Acute Leukemia

A 13-year-old with a medullar and meningeal relapse of T-cell acute lymphocytic leukemia presents with decreased visual acuity in both eyes from a rare, leukemia-associated cause