Eccentric Macular Hole after Pars Plana Vitrectomy for Idiopathic Macular Hole: A Case Report

Introduction: Postoperative eccentric macular hole (MH) formation is an uncommon complication after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for epiretinal membrane or MH treatment. Herein, we present a case of eccentric MH formation after PPV with ILM peeling for MH. Case Description: A 72-year-old female patient underwent 23-gauge PPV with ILM peeling for idiopathic MH in her right eye. The visual acuity was 6/24 in the right eye. One week postoperatively the retina was attached and the MH seemed to be closed, while visual acuity was 6/12. One month after PPV, there was a single eccentric retinal hole below the macula, which was detected at the fundoscopy and was confirmed by OCT. The visual acuity was 6/9 and the patient referred no symptoms. No further intervention was attempted, and at the 6-month follow-up the visual acuity and the size of the eccentric MH remained stable. Conclusions: Eccentric MHs can develop after PPV and are usually managed conservatively by observation

One year outcomes of treat and extend and pro re nata (PRN) treatment regimens with aflibercept for polypoidal choroidal vasculopathy

Purpose: To compare the 1-year outcomes of treat-and-extend and pro re nata (PRN) treatment regimens with aflibercept for polypoidal choroidal vasculopathy (PCV), by the means of visual acuity (VA), frequency of recurrence of polypoidal lesions and developed fibrosis, and the number of intravitreal injections, and thus to determine which one is preferable in the maintenance phase in PCV. Methods: In our prospective study, only naive and previously untreated PCV patients were included. Initially one session of photodynamic therapy (PDT) and three monthly intravitreal injections of 2.0 mg aflibercept (IAIs) were applied in 38 eyes. After this loading phase, they were re-examined and 30 PCV eyes with no exudative phenomena were included in the study. They were divided in two groups; in the first one (16 patients) the PRN treatment modality of IAIs was applied, while in the second one (14 patients) the treat-and-extend regimen was applied. Results: Over a 12-month period, VA significantly improved in treat-and-extend group (logMAR BCVA 0.41 +/- 0.15 vs 0.57 +/- 0.24 at baseline, p = 0.044), while in the PRN group VA remained stable (logMAR BCVA 0.70 +/- 0.36 vs 0.65 +/- 0.18 at baseline, p = 0.61). During the maintenance phase, the patients of treat-and-extend group did not encounter development/progression of fibrosis or any recurrent episodes, whereas the patients of PRN group had significantly more recurrent episodes (0 vs 1.37 +/- 0.5, p < 0.001) and the frequency of development/progression of fibrosis was significantly higher (0% vs 44%, p = 0.02). However, the treat-and-extend treatment regimen was accompanied by significantly more administered IAIs (6 +/- 0 vs 5.13 +/- 1.08, p = 0.006). Conclusion: We highlighted the superiority of treat-and-extend regime with IAIs, which seems to yield better functional outcomes by preventing recurrence and subfoveal fibrosis, although a greater number of injections is required

PHOTODYNAMIC THERAPY, RANIBIZUMAB, AND RANIBIZUMAB WITH PHOTODYNAMIC THERAPY FOR THE TREATMENT OF POLYPOIDAL CHOROIDAL VASCULOPATHY

Purpose: The purpose of this study was to compare photodynamic therapy (PDT), ranibizumab, and ranibizumab with PDT in polypoidal choroidal vasculopathy. Methods: In this retrospective comparative study, 30 eyes of 30 patients with polypoidal choroidal vasculopathy were assigned to 1 of the 3 groups. The patients in Group 1 (n = 11) received 1 session of PDT. The patients in Group 2 (n = 10) received 3 monthly intravitreal injections of 0.5 mg ranibizumab, and the patients in Group 3 (n = 9) received 1 session of PDT and 3 injections of 0.5 mg ranibizumab. Retreatment, with the same therapeutic scheme in each group, was considered in case of leaking polyps on the indocyanine green angiography in Groups 1 and 3 and persistence or recurrence of subretinal fluid, intraretinal fluid, and/or hemorrhages in Group 2. Results: All the patients completed 12 months of follow-up. The visual acuity in the patients of Group 1 improved by 0.25 logarithm of the minimum angle of resolution units (P< 0.001), whereas the differences in the visual acuity in the other 2 groups were not statistically significant (0.04 logarithm of the minimum angle of resolution, P = 0.8118 in Group 2 and 0.18 logarithm of the minimum angle of resolution, P> 0.05 in Group 3). Of the patients in Group 1, 45.45% gained more than 3 lines (P = 0.0056), whereas no patient in Groups 2 and 3 experienced such a difference. No patient in Group 1 and 11.1% (n = 1) in Group 3 had angiographically evident polyps at 12 months, whereas 90% (n = 9) of the patients in Group 2 had persistent leakage. No extensive submacular hemorrhage or other complications were noted during the follow-up period. Conclusion: Photodynamic therapy resulted in a significantly better outcome at the end of the follow-up, whereas the patients who received ranibizumab or PDT and ranibizumab experienced a stabilization of the disease. RETINA 31: 464-474, 201

Effect of Macular Ischemia on Intravitreal Ranibizumab Treatment for Diabetic Macular Edema

Purpose: To evaluate the impact of macular ischemia on the functional and anatomical outcome after intravitreal injections of ranibizumab for the treatment of diabetic macular edema (DME). Procedures: Participants were 49 patients with diabetes mellitus, divided into two groups based on the presence of ischemia on fluorescein angiography: (i) nonischemic group (n = 32) and (ii) ischemic group (n = 17). All patients were treated with intravitreal ranibizumab and were followed up for 6 months. The main outcome measures were changes in visual acuity (VA) and central foveal thickness (CFT). Results: There was a statistically significant improvement in VA and CFT between baseline and the end of the follow-up in the nonischemic group, while in the ischemic group there was no significant difference in VA but CFT differed significantly at the 6-month follow-up. Conclusions: Macular ischemia may have a negative impact on functional outcomes 6 months after intravitreal ranibizumab treatment in patients with DME but has no effect on anatomical outcomes. (C) 2014 S. Karger AG, Base

Alkaline Earth Metal Ion/Dihydroxy–Terephthalate MOFs: Structural Diversity and Unusual Luminescent Properties

Alkaline earth (group 2) metal ion organic frameworks (AEMOFs) represent an important subcategory of MOFs with interesting structures and physical properties. Five MOFs, namely, [Mg-2(H(2)dhtp)(2)(mu-H2O)(NMP)(4)] (AEMOF-2), [Mg-2(H(2)dhtp)(1.5)(DMAc)(4)]Cl center dot DMAc (AEMOF-3), [Ca(H(2)dhtp)(DMAc)(2)] (AEMOF-4), [Sr-3(H(2)dhtp)(3)(DMAc)(6)]center dot H2O (AEMOF-5), and [Ba(H2dhtp)(DMAc)] (AEMOF-6) (H4dhtp = 2,5-dihydroxy-terepthalic acid; DMAc = N,Ndimethylacetamide; NMP = N-methylpyrrolidone), are presented herein. The reported MOFs display structural variety with diverse topologies and new structural features. Interestingly, AEMOF-6 is the first example of a Ba2+-H(2)dhtp(2-) MOF, and AEMOF-5 is only the second known Sr2+-H(2)dhtp(2-) MOF. Detailed photoluminescence studies revealed alkaline earth metal ion-dependent fluorescence properties of the materials, with the heavier alkaline earth metal ions exhibiting red-shifted emission with respect to the lighter ions at room temperature. A bathochromic shift of the emission was observed for the MOFs (mostly for AEMOF-3 and AEMOF-4) at 77 K as a result of excited state proton transfer (ESIPT), which involves an intramolecular proton transfer from a hydroxyl to an adjacent carboxylic group of the H(2)dhtp(2-) ligand. Remarkably, AEMOF-6 displays rare yellow fluorescence at room temperature, which is attractive for solid state lighting applications. To probe whether the alkaline earth metal ions are responsible for the unusual luminescence properties of the reported MOFs, the potential energy surfaces (PESs) of the ground, S-0, and lowest energy excited singlet, SD states of model complexes along the intrarnolecular proton transfer coordinate were calculated by DFT and TD-DFT methods

Alkaline Earth Metal Ion/Dihydroxy–Terephthalate MOFs: Structural Diversity and Unusual Luminescent Properties

Alkaline earth (group 2) metal ion organic frameworks (<b>AEMOFs</b>) represent an important subcategory of MOFs with interesting structures and physical properties. Five MOFs, namely, [Mg₂(H₂dhtp)₂(μ-H₂O)­(NMP)₄] (<b>AEMOF-2</b>), [Mg₂(H₂dhtp)_1.5(DMAc)₄]­Cl·DMAc (<b>AEMOF-3</b>), [Ca­(H₂dhtp)­(DMAc)₂] (<b>AEMOF-4</b>), [Sr₃(H₂dhtp)₃(DMAc)₆]·H₂O (<b>AEMOF-5</b>), and [Ba­(H₂dhtp)­(DMAc)] (<b>AEMOF-6</b>) (H₄dhtp = 2,5-dihydroxy-terepthalic acid; DMAc = <i>N,N</i>-dimethylacetamide; NMP = <i>N</i>-methylpyrrolidone), are presented herein. The reported MOFs display structural variety with diverse topologies and new structural features. Interestingly, <b>AEMOF-6</b> is the first example of a Ba²⁺–H₂dhtp^2– MOF, and <b>AEMOF-5</b> is only the second known Sr²⁺–H₂dhtp^2– MOF. Detailed photoluminescence studies revealed alkaline earth metal ion-dependent fluorescence properties of the materials, with the heavier alkaline earth metal ions exhibiting red-shifted emission with respect to the lighter ions at room temperature. A bathochromic shift of the emission was observed for the MOFs (mostly for <b>AEMOF-3</b> and <b>AEMOF-4</b>) at 77 K as a result of excited state proton transfer (ESIPT), which involves an intramolecular proton transfer from a hydroxyl to an adjacent carboxylic group of the H₂dhtp^2– ligand. Remarkably, <b>AEMOF-6</b> displays rare yellow fluorescence at room temperature, which is attractive for solid state lighting applications. To probe whether the alkaline earth metal ions are responsible for the unusual luminescence properties of the reported MOFs, the potential energy surfaces (PESs) of the ground, S₀, and lowest energy excited singlet, S₁, states of model complexes along the intramolecular proton transfer coordinate were calculated by DFT and TD-DFT methods