bluuebunny/crossref_metadata_2025 huggingface dataset:
Episcleritis following intravitreal ranibizumab injection for exudative age‐related macular degeneration
Authors: PRIETO CALVO E , GUERRI MONCLUS N , EGEA ESTOPINAN C , FERRER NOVELLA E
Published: November 2010

Purpose Ranibizumab is a recombinant, humanized, monoclonal antibody antigen‐binding fragment that neutralizes all biologically active forms of vascular endothelial growth factor (VEGF), and is effectively used in the treatment of neovascular age‐related macular degeneration (AMD). Ocular and systemic side effects may be encountered after its intravitreal injection. We report the importance of provide information for patients about the alarm signs and when to seek urgent attention from their doctor.

Methods Prospective, interventional, single case report. A 79‐year‐old male patient controlled to our department for exudative AMD since 1997. The process started in the right eye (RE), which had been treated by argon laser photocoagulation. Twelve years later, visual acuity in his left eye (LE) decreased to 5/10 and ophthalmoscopy showed a subretinal macular haemorrhage corresponding with an occult choroidal neovascular membrane in fluorescein angiography image. In this time, we decided to proceed with intravitreal ranibizumab treatment in the LE.

Results Two days following de second injection, the patient is referred to our department for ocular pain with severe episcleral inflammation, located at the injection site. Not visual loss was documented. A good response to topical steroids was obtained, and so, one month later, the third injection is performed with no complications.

Conclusion Intravitreal ranibizumab therapy is associated with various complications, the most of which are related with the injection procedure. However ranibizumab´s benefits are greater than its risks, for the treatment of exudative AMD.
Retrospective analysis of ranibizumab therapy
Authors: ISLAM N , PEDEN R , SALOM R
Published: November 2010

Purpose Anti‐VEGF clinical trials have shown stabilisation and improvement in visual acuity following intravitreal Ranibizumab (Lucentis) injections. Audit to evaluate the efficacy & safety of Ranibizumab injections in wet macular degeneration patients recruited over 18 months (Oct 07–Mar 09) with 12 months follow‐up

Methods Retrospective case note review of 121 patients (130 eyes) who had undergone intravitreal anti‐VEGF treatment for wet macular degeneration using solely povidone‐iodine, without topical antibiotic cover or prophylaxis. Patients were divided by treatment type (Lucentis alone (Groups A and B) and other/mixed antiVEGF treatment(Group C)) and initiation date Oct 07‐Dec 08 (Group B and C)& Jan‐Mar 09(Group A)

Results 78 eyes of 75 patients received solely Lucentis.60 eyes of 57 patients completed 12 month follow‐up. Classic Predominantly Classic Minimal Classic Occult Group A 2 2 14 18 Group B 5 5 6 26 Group C 7 7 10 29 Total 14 14 30 73 Table 1: Lesion sub‐types in the 3 study groups Queen’s King’s MARINA ANCHOR PRONTO n 60 184 240 139 40 Mean VA improvement +4.0 +4.5 +7.2 +11.3 +9.3 Mean number of injections 6.6 6.0 12 12 5.6 Table 2: Comparison with King's(London)/MARINA/ANCHOR/PRONTO studies Mean VA Change at 3 Months (logMAR letters) Mean VA Change at 1 year (logMAR letters) Mean number of injections in the first year Group A (n=29) +3.5 +5.5 7.5 Group B (n=31) +6.7 +2.6 5.7 Group C (n=47) +4.3 +2.7 7.2 Table 3: Mean VA improvements in 3 study groups. Serious Adverse Effects:No cases of endophthalmitis or retinal detachment.

Conclusion Mean visual acuity change has improved markedly alongside an increased mean number of injections & a reduced delay in treatment initiation. Earlier and sustained intervention provides better outcomes.
Intravitreal injection of triamcinolone combined with bevacizumab for choroidal neovascularization associated with retinal pigment epithelial detachment in age‐related macular degeneration
Authors: CHEBIL A , KORT F , BOULADI M , BOURAOUI R , CHAABANI L , EL MATRI L
Published: November 2010

Purpose To discuss the effect and outcome of a combined intravitreal triamcinolone acetonide (IVTA) injection with intravitreal bevacizumab (IVB) in treating choroidal neovascularization (CNV) associated with retinal pigment epithelial detachment (PED) in age‐related macular degeneration (AMD).

Methods Ten eyes (10 patients) with CNV associated with PED in AMD were treated by IVT (4 mg/ 0.1 ml) followed by a IVB (1.25 mg/0.05 ml) one week later. Indications for retreatment by combined injection was defined as persistent DEP with subretinal and/or intraretinal fluid on OCT. Patients with flattening of the DEP and activity leakage demonstrated by OCT underwent subsequent IVT.

Results The mean duration of follow up was 12 months (6 to 16 months). BCVA at baseline averaged 20/63 (range 20/200 to 20/32) and 20/58 (range 20/125 to 20/32) at the end of follow‐up. FA showed no leakage from the lesion in 6 eyes at the end of follow‐up examination and three eyes showed a decrease in leakage from that seen at baseline. Average central foveal thickness was (CFT) 366.9 microns (range 253 to 388) at baseline and 212.1 microns (range 168 to 245) at the end. the PED had disappeared in six eyes, while in the remaining four they had decreased in size at the end. The subretinal fluid had disappeared in all patients at the end. The combined treatment was repeated in 6 eyes and the number of IVB after combined injection ranged from one to three. No RPE tear appeared during follow‐up.

Conclusion combined IVB and IVT therapy seems to be an effective and safe therapeutical procedure to treat CNV associated with large PED in AMD.
Retrospective study of outcome of diabetic laser treatment in Singapore National Eye Centre
Authors: WONG HYM , LIM LH , WONG YME
Published: November 2010

Purpose To describe 2 year clinical outcomes for a retrospective study group of patients undergoing photocoagulation and focal laser treatment for diabetic retinopathy (DR)or maculopathy at an eye institution in Singapore.

Methods Retrospective study

Results 150 consecutive eyes were recruited.The mean age was 59.3 years old with 46% males and 54% females.Majority were type 2 diabetics (146 out of 150) with mean HBA1c of 8.4 %. Indication for pan retinal laser photocoagulation (PRP) was severe non proliferative DR and indication for macula laser was clinically significant macular edema(CSME). For patients with only PRP performed, the mean change in log mar visual acuity (VA) at 2 yrs was +0.121 +/‐0.46. DR status at 2 yrs was stable in 90.6% of the patients and the macula was unremarkable in 86.8% of the patients. In patients requiring only macula laser, there was improvement in log mar VA at 2 years, with a mean change of ‐0.085 +/‐ 0.18. Diabetic status was stable in 91.3% of the patients and the macula was dry in 95.7% of the patients. In patients undergoing both PRP and macula laser , there was improvement in VA with a mean log mar VA change of ‐0.095 +/‐0.45. DR status at 2 years was stable in 92% of the patients and the macula was dry in 88% of the patients.Complications of laser treatment include epiretinal membrane (5.3%), cystoid macular edema(0.7%)and scar creep(0.7%).0.9% of the patients developed CSME after commencing PRP.

Conclusion There is an overall improvement in visual acuity in DR patients undergoing laser treatment. Most patients had stable DR at 2 yrs and there were few complications of the laser.
Share & correlation of data between the South‐East Anglia Diabetic Retinopathy Screening Services (SEA‐DRSS) & Addenbrooke’s University Hospital Diabetic Retinopathy Service (AUH‐DRS)
Authors: KARTHIKEYAN M , CILLIERS H , CHOW L , VERMA D
Published: November 2010

Purpose The SEA‐DRSS refer mainly to AUH‐DRS. To better monitor outcomes, a database of referrals was created aimed to establish a network between SEA‐DRSS &AUH‐DRS to share &correlate data. 1. To assess referrals from SEA‐DRSS to AUH‐DRS &once assessed to monitor outcomes. 2. Are NICE referral guidelines being met &to predict impact on AUH‐DRS.

Methods Prospective data of referrals &review of 50 patients in database from July–September 2009. All referral data recorded &at hospital assessment: visual acuities, ocular &systemic co‐morbidity, BP, HBA1c, grading according to DRS & EDTRS, outcomes for treatment &follow‐up.

Results Data were collected for 46 patients with 3(6%) non‐attendance. Male:female=1.2: 1 DMType1:Type2=1:8 Mean age 26yrs DM Type1; 64yrs for DM Type2. 9.6w between referral &assessment. Meeting NICE guidelines &DR progression due to delay will be discussed. Correlation of VA &grading data between SEA‐DRSS &AUH‐DRS will be compared by statistical analysis taking contributing factors for DR like BP &HBA1c into account. Laser required by 16% with treatment &frequency will be discussed. Of 16(32%) referred for cataracts 50% were listed for surgery. 92% required follow‐up &we plan to elaborate on the impact on AUH‐DRS.

Conclusion Increased demand is generated by referrals. Though few required laser, there is significant follow‐up required. Efficient &accurate DRSS‐referrals need to be matched in assessment by excellent hospital‐DRS with capacity to provide laser/surgical treatments &follow‐up. Prospective review of referrals &outcomes is required for future planning &cost‐structuring of AUH‐DRS.
Fluorescein angiography patterns associated with the effect of intravitreal bevacizumab injection for diabetic macular edema
Authors: KIM HS
Published: November 2010

Purpose To analyze the fluorescein angiography (FAG) findings associated with the effect of intravitreal bevacizumab injection (IVB) for treatment of diabetic macular edema (DME).

Methods Seventy eyes of 65 patients with DME were included in this prospective, non‐randomized pilot study. The changes in best‐corrected visual acuity (BCVA) and central macular thickness (CMT) on optical coherence tomography were evaluated considering the FAG pattern at baseline and 3 month after IVB.

Results On baseline FAG, 20 eyes (28.6%) showed honeycomb type hyperfluorescence; 9 eyes (12.9%), petaloid type; and 41 eyes (58.6%), diffuse type. Three months after IVB, the mean decrease in CMT was 250.5 (198.78) μm in the case of the honeycomb and petaloid type, which was significantly larger than that in the case of the diffuse type 102.5 (147.72) μm (p = 0.03). The improvement in BCVA was 0.27 (0.30) logMAR in the case of the honeycomb and petaloid type and 0.11 (0.27) logMAR in the case of the diffuse type; this difference was statistically significant (p < 0.02). There was no statistical relationship between the leakage starting time and CMT or BCVA.

Conclusion The effect of IVB for treatment of DME was better in eyes showing honeycomb and petaloid type hyperfluorescence on baseline FAG than those exhibiting diffuse type hyperfluorescence.
Non‐invasive imaging of human foveal capillary network using dual‐conjugate adaptive optics
Authors: SJÖSTRAND J , POPOVIC Z , KNUTSSON P , THAUNG J , OWNER‐PETERSEN M
Published: November 2010

Purpose To demonstrate non‐invasive imaging of foveal capillary networks with a high‐resolution wide‐field dual‐conjugate adaptive optics (DCAO) imaging instrument.

Methods The foveal capillary networks of five normal subjects were imaged with a novel high‐resolution wide‐field DCAO instrument. The foveal avascular zone (FAZ) in each image was defined using a manual procedure. An automated algorithm was used to identify vessels and extract morphological FAZ and vessel parameters. Capillary densities were calculated in two annular regions of interest (ROI) outside the FAZ (500 µm and 750 µm outer radius from the foveal center).

Results Results: Mean FAZ area was 0.302 ± 0.100 mm2 and mean capillary density (length/area) in the inner ROI was 38.0 ± 4.0 mm‐1 and 36.4 ± 4.0 mm‐1 in the outer ROI. The difference in ROI capillary density was not significant.

Conclusion We have demonstrated our technique for non‐invasive imaging and semi‐automated detection. Analysis of foveal capillaries yields lower capillary densities than reported in histological studies, but similar results compared to the current clinical gold standard of fluorescein angiography and AO‐SLO. The increased field of view of the DCAO instrument opens up new possibilities for high‐resolution non‐invasive clinical imaging of foveal capillaries.
Differences between the thickness measurements by the fast and normal StratusTM OCT protocols in diabetic macular edema
Authors: SZALAI I , TATRAI E , SOMFAI GM , NEMETH J
Published: November 2010

Purpose Stratus OCT enables fast and normal scanning of the macula. It is unknown whether there are any differences between the measured values by these two protocols, therefore our purpose was to compare the central subfield mean thickness (CSMT), center point thickness (CPT) and total macular volume (TMV) measured by the fast and the normal protocols of Stratus OCT.

Methods Twenty‐two eyes of 22 diabetic patients were recruited in this study. The inclusion criteria were diffuse diabetic macular edema on the fundus and CSMT more than 250 µm measured by the OCT fast protocol. Each eye was scanned by both types of OCT scanning protocols. CSMT, CPT and TMV values were recorded. The thickness values measured by the two types of protocols were compared using paired Student t‐test. The level of significance was set at 0.05.

Results No significant difference was found between any of the parameters measured by the two OCT protocols. The mean difference (MD) between CSMT and CPT measured by fast and normal protocols were 0.77 ± 10.50 µm (range, 1‐29 µm; p=0.73) and 1.36 ± 21.55 µm (range, 0‐52 µm; p=0.77) which were 0.24% and 0.45% of the mean thickness, respectively. In case of TMV, the MD was 0.01 ± 0.12 mm3 (range, 0‐0.29 mm3; p=0.68) which was 0.12% of the mean TMV.

Conclusion However, no significant difference was found between the thickness measurements, care must be taken when comparing CSMT and CPT values between the fast and normal protocols in eyes with diffuse diabetic macular edema because inner retinal boundary detection errors can be present at the cystoid cavities influencing the thickness measurements.
Reproducibility of non‐mydriatic retinographies
Authors: RAMIREZ MERCADO G , BONNIN‐ARIAS C , NAVARRO‐VALLS JJ , GONZALEZ‐ MONTERO G , MARTIN‐PEREZ Y , SANCHEZ RAMOS C
Published: November 2010

Purpose The purpose is to know the stability of the taken registries basic of eye by means of non‐Mydriatic retinography.

Methods The sample has been of 20 eyes of young people of both sexes between 19 and 35 years old. The measurements were carried out with a non‐mydriatic retinal camera model Topcon TRC‐NW8 in mesopic conditions maintaining the fixation point stable. The number of times in wich each eye was measured was 10. Two coordinates in each of the five points determined were located, points that are: P1_First intersection point between the nasal Vein superior and papilla; P2_First intersection point between the nasal Artery inferior with papilla; P3_First intersection point of the nasal Vein inferior with papilla (the direction always was according to the needles of the clock); P4_First Bifurcation nasal Vein; P5 superior_First Bifurcation nasal Artery superior. For the statistic analysis was used the Statgraphics plus 5.0.

Results OD: x1= 2735.7 ± 18.1,y1= 1248.6 ± 8.12,x2= 2821 ± 20,y2= 1599.1 ± 11.94,x3= 2888.6 ± 18.88,y3= 1554.5 ± 9.8,x4= 2727.5 ± 19.2,y4= 1095.5 ± 9.9,x5= 2347.5 ± 18.7,y5= 609 ± 12 OI:x1= 1511.36 ± 6.5,y1= 1153 ± 12.5,x2= 1507.36 ± 7.2,y2= 1512.63 ± 14.7,x3= 1432.45 ± 8.2,y3= 1497.36± 13.2,x4= 1691.36 ± 6.5,y4= 988.72 ± 13.1,x5= 1833.18 ± 8.2,y5= 840.54 ± 10.8 The measurements obtained with non‐mydriatic retinal camera are very similar, therefore, the variations of the deviation only oscillated between the 0,16% and 4,85%

Conclusion The reproducibility of the registries of non‐mydriatic retinal camera is very elevated for the selected points. These results enable us to consider the retina as a key element to implement in new security devices.
Intravitreal bevacizumab (AVASTIN®) in the treatment of diabetic macular oedema
Authors: ADEPEGBA OA , SIVAPRASAD S , MCHUGH DM
Published: November 2010

Purpose To report visual acuity and anatomic response to intravitreal bevacizumab(IVB) injection in patients with persistent diabetic macular oedma(DMO).

Methods Clinic notes of 19 patients (20eyes)were retrospectively evaluated. VA in ETDRS, central retinal thickness (CRT) and number of IVB (1.25mg/0.05mi)injections required was recorded. All patients underwent at least one FFA prior to IVB therapy. Re‐treatment was PRN based on persistent or increase in fluid with drop of VA.Previous treatments included triamcinolone (IVTA),grid (micropulse and green) lasers.Follow up was every 6weeks.

Results The mean age was 69.5±6.9 (range 59‐81) years. All eyes had previous lasers. Seven eyes had both laser and IVTA. Mean number of bevacizuamab injection was 1.15. Three eyes received 2nd injection at mean of 13.3weeks (range 4‐24) and 1 eye a 3rd injection at 9weeks. The average interval between the grid lasers and avastin therapy was 18.9weeks (SD=10.35). Mean follow up was 6.45±1.1 (6‐9) months. The mean baseline VA was 42.51±16.24 and mean baseline CRT was 471±95.23. The mean change in vision at 1st 3rd and 6th month was +10.8, +11.8 and +13.2(p=0.0867) The mean reduction in CRT from baseline was ‐101.36µm,‐167.7µm and‐149.25µm at month 1, 3 and 6 respectively. (p= 0.00912). Three patients completed 9months follow up with a mean change in VA of +10.83 and CRT of‐105µm. Twenty‐ five percent gained >15letters, 75% maintained stable vision and none lost more than 15 letters. No complications recorded.

Conclusion Intravitreal bevacizumab 1.25mg was followed by improvement of vision and a significant reduction in persistent DMO. Further, larger studies are needed to evaluate the long term efficacy and safety of IVB on persistent diabetic macular oedema.
Clinical management of vascular retinopathy in diabetic patients and the impact on their QoL: REDIMA Study
Authors: LOPEZ MI , GOMEZ ULLA F , TORRES IMAZ R , CERVERA TAULET E , FERNANDEZ ARIAS I
Published: November 2010

Purpose to determine the clinical management of vascular retinopathy (VR) in diabetic patients and the impact on their QoL. Determine the progression of the VR in the 6 months after diagnosis and evaluate the correlation between the evolution of the systemic disease and progression of the VR

Methods Patients with type 1 or 2 diabetes, ≥18 years, with new diagnosed vascular retinopathy (without treatment and with clinically significant macular edema) were included in this ongoing, epidemiological, 6‐months prospective, multicentric study

Results Data of 219 patients were evaluated at baseline. Mean age was 64 ± 11.8 years, 179 (85.2%) had type 2 diabetes and 31 (14.8%) type 1. 93.9% (200/213) presented diabetic retinopathy (DR), 71.2% (151/212) had bilateral macular edema, 5.7% (11/194) showed central retinal vein occlusion, and 10.2% (18/177) presented branch retinal vein occlusion. Surgical treatment for retinal pathology was started with laser in 64.4% of patients (112/174), panphotocoagulation in 41.1% (58/141) and vitrectomy for 9.1% (12/132) and medical treatment with sodium pegaptanib in 61 subjects (29.8%), triamcinolone in 19 (9.3%), in 8 (3.9%) with bevacizumab and in 4 (2.0%) with ranibizumab. 81.3% (170/209) were considered to have cardiovascular risk. Mean score for General Health subscale (NEI VFQ‐25;100 best; 0 worst) was 37.4±19, and 56.8±16.4 for General Vision subscale

Conclusion Data recording is continuing to study the evolution after 6 months
Hyperbaric oxygen and nadroparin calcium in the therapy of combined branch retinal artery and central retinal vein occlusion
Authors: PINNA A , FIMIANI F , TENDAS D , BOLOGNINI A , CARTA F
Published: November 2010

Purpose Branch retinal artery obstruction with simultaneous central retinal vein occlusion (BRAO/CRVO) is a rare condition. We describe 3 cases of BRAO/CRVO successfully treated with hyperbaric oxygen (HBO) and subcutaneous nadroparin calcium.

Methods The first patient, a 42‐year‐old man, developed sudden visual loss (hand‐motion) in his left eye one day after tonsillectomy. The second patient, a 60‐year‐old man with hypercholesterolemia, complained of sudden visual loss (finger counting) in his left eye upon arising. The third patient, an apparently healthy 39‐year‐old bricklayer, noted an acute decrease in his left vision (20/70) while working. In all patients, fundus evaluation and fluorescein angiography revealed BRAO/CRVO.

Results All patients were treated with HBO at 2.5 atmospheres (15‐20 sessions) and subcutaneous nadroparin calcium (200 UI/Kg/die) for 6 weeks. Two months later, there was complete resolution of the clinical signs of BRAO/CRVO and left visual acuity was 20/25 in patient 1, 20/32 in patient 2, and 20/20 in patient 3. Patient 2 had an improvement in the left visual field, but there was still a discrete cecocentral scotoma.

Conclusion In these 3 patients with BRAO/CRVO, vision returned to near normal after prompt treatment with HBO and subcutaneous nadroparin calcium. We have to acknowledge that the effect of our intervention cannot be determined from 3 cases and no control. Nevertheless, a comparison between our results and those reported in similar cases seem to suggest that this therapy may be beneficial in the management of BRAO/CRVO.
Ranibizumab for macular edema following branch retinal vein occlusion
Authors: CRUZ N , PINILLA I , CASAS P , GARCIA‐MARTIN E , IDOIPE M , FUERTES I , CASCANTE M , CRISTOBAL BESCOS JA
Published: November 2010

Purpose To evaluate the efficacy and safeness of intraocular injections of Ranibizumab followed by grid photocoagulation in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

Methods Prospective study of 12 eyes with ME secondary to BRVO. Eyes were injected with 0.5 of Ranibizumab at the diagnosis time. Thirty days after the injection grid laser was applied in the area of capillary diffusion. Best corrected visual acuity (BCVA) and macular thickness measured by Cirrus‐HD Optical Coherence Tomography were evaluate, at the time of diagnosis, 1 month after injection an 3, 6, and 12 months after the laser.

Results The mean BCVA at diagnosis was 0.34. One month after Ranibizumab BCVA was 0.53. Three,6 and 12 months after the laser the BCVA was 0.56, 0.65 and 0.73. The macular average thickness 1, 3, 6 and 12 months of treatment was 437, 300, 292 and 232 microns respectively. No safety events were found.

Conclusion Single intraocular injection of Ranibizumab at the diagnosis of BRVO combined with grid photocoagulation could be an effectiveopton to accelerate visual recovery, improving the quality of life and VA since the first month of treatment.
Intravitreal bevacizumab for the treatment of macular edema secondary to branch and central vein occlusion
Authors: KORT F , CHEBIL A , BOURAOUI R , BOULADI M , CHAKER N , LAAJIMI M , EL MATRI L
Published: November 2010

Purpose To evaluate functional and anatomic response after intravitreal Bevacizumab (IVB) injections in patients with macular edema secondary to branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO).

Methods Records of thirty patients (30 eyes) with macular edema secondary to BRVO (28 eyes) and CRVO (12 eyes) treated with IVB, were retrospectively reviewed. Best‐corrected visual acuity (BCVA) evaluation, fluorescein angiography (FA), central retinal thickness (CRT) measured with optical coherence tomography (OCT) were assessed at baseline and follow up visits in all the cases for up to 12 months. IVB injections (1.25 mg, 0.05 ml) were performed at 4‐week intervals. Retreatment was based on BCVA and CRT findings.

Results Mean BCVA was 20/200 at baseline and improved significantly to 20/57 after 6 months (p = .029). At 12 months mean BCVA was 20/100 (p = .055). Mean CRT was 568 μm at baseline and decreased to 211 μm after 6 months (p <.05) and 223µm at 12 months (p<.05). Mean number of injections was 4.2 over 12 months. No complications were observed.

Conclusion In patients with macular edema secondary to branch and central retinal vein occlusion, intravitreal bevacizumab injection seems to be an effective and safe therapeutic option.
Management of talc retinopathy in addicts on crushed tianeptine tablets solution
Authors: BARDEEVA J , RYABTCEVA A
Published: November 2010

Purpose Description of retinopathy among drug addicts using intravenous mortars from the crushed tianeptine tablets appeared in Russia since 2006.

Methods 11 patients were treated. In all patients there was a decrease in visual acuity of both eyes, less than 10/100. In 7 patients neoangiogenesis retina of both eyes was revealed, 4 of those were complicated by intravitreal hemorrhages and iris rubeoz. 1 male had peripheral, others ‐ central neovascularization including of the optic disk. The follow up period was about 2 years.In patients referred during first month of decreasing visual acuity no ophthalmoscope signs оf proliferation and angiogenesis was noted. Fluorescent angiography identified total violation of perfusion of the retina. That was argument for laser photocoagulation. Laser treatment had being done within 4 months, consisted in application of 1600‐2600 spots 300‐500 mkn. Blockers VEGF had been used in the cases of neovascular glaucoma. Vitrectomy was the last chance in cases with tractional retinal detachment and hemophthalm.

Results The stabilization of process was achieved in patients with early retinopathy during the of laser coagulation before development newly formed vessels. As a result of early treatment a complete resorbtion of macular edema by 6 months with a gradual atrophy nerve fiber layer according to the OCT. Visual acuity was maintained the same as at the first referral. Benefits of panretinal laser photocoagulation in cases of retinal neovascularization and optic nerve is doubtful, positive dynamics was not observed.

Conclusion Retinopathy as a result of intravenous оf crushed tianeptine solution use is similar to talc retinopathy.Early laser treatment can be recommended before proliferation occur.
Bilateral obliterating periphlebitis in Gitelman syndrome
Authors: FUERTES MI , GARCIA‐MARTIN E , PINILLA I , IDOIPE M , CRUZ N , CALVO P
Published: November 2010

Purpose Gitelman syndrome (GS) is a rare inherited defect in the distal tubule of the kidneys, characterized by a remarkable reduction of salt transportation. Consequently, GS patients present renal salt wasting, low blood pressure, hypochloremia, hypokalemia, metabolic alkalosis and hypercalciuria. Some patients are completely asymptomatic but others show transient periods of muscle weakness, tetany, paresthesias, paralysis or cardiac rhythm alterations. Sclerochoroidal calcifications have been reported in GS.

Methods A 44 year old female, diagnosed as GS after suffering an acute hypopotassemia episode 2 months before, arrived at the ER complaining of sudden vision diminution in her left eye (LE). She underwent a comprehensive ophthalmic examination and a fluorescein angiography (FA).

Results The best‐corrected visual acuity on Snellen chart was RE 10/10 and LE 6/10. Funducopic examination showed a bilateral obliterating periphlebitis with sheathed venous vessels and vitritis in her LE. Blood pressure was 96/63 mm Hg. Blood and urine test showed hypopotassemia (2.6mEq/l) and hypocalciuria, despite of the administration of magnessium, postassium and aspartic acid oral supplements. The FA showed vascular sheathed, venous occlusion, macular edema and peripheral ischemia. The patient received medical treatment including a subtenon injection of triamcinolone, mydriatic and esteroid eye drops and oral prednisone 1mg/Kg per day. After a worsening of her RE BCVA, she showed a slow improvement being the prednisone dose progressively reduced. The vasculitis subsided with persistence of peripheral sclerosed vessels in both eyes.

Conclusion GS can be the cause of an acute obliterating periphlebitis that required high corticosteroid doses to be controlled.
Coats´ disease diagnosed in the adulthood
Authors: CRUZ N , PINILLA I , GARCIA‐MARTIN E , IDOIPE M , FUERTES I , CABEZON L , JIMENEZ DEL RIO B , CRISTOBAL BESCOS JA
Published: November 2010

Purpose Coast´s disease is an idiopathic unilateral exudative retinal vasculopathy characterized by telangiectasias and irregular dilatation of retinal vessels leading to intra‐and subretinal exudation and lipid deposition. Typically occurs in childhood but sometimes could be found in adults.

Methods 34 years old male referred diminished visual acuity (VA) of the left eye (LE). VA was RE 10/10, LE 3/10. Anterior pole and IOP were normal. LE fundoscopy showed peripheral telangiectasias, vascular sheathing and subretinal exudation. Macular edema existed beyond the vascular arcades surrounded by lipid exudation. Optical coherence tomography (Stratus OCT) showed an increase macular thickness (370µ), and fluorescence angiography showed early hyperfluorescence the telangiectasias, and mild late hyperfluorescence of the subretinal fluid.

Results Coats´ disease was diagnosed and photocoagulacion was performed. Two months later, VA was 9/10 with diminution of lipid exudation. Macular thikness was 232µ.

Conclusion The diagnosis of Coats´ disease is established by the appearance of the retina. OCT and AGF are useful for monitoring the progression. Coats´ disease the adulthood remains localized, and with slower progression. Laser treatment is still the first option.
Choroidal neovascularization associated with adult‐onset vitelliform dystrophy treated with intravitreal ranibizumab
Authors: PRIETO CALVO E , EGEA ESTOPINAN C , GUERRI MONCLUS N , TORRÓN FERNÁNDEZ‐BLANCO C , IDOIPE CORTA M
Published: November 2010

Purpose Adult‐onset foveomacular dystrophy (AFVD) is a hereditary ocular condition, which results in the presence of slightly elevated and yellowish subretinal macular lesions, similar to those of Best’s disease, but smaller than these. Usually, these patients have a fair visual prognosis if there are no complications in the clinical course of the disease. We report a case describing a patient affected with occult choroidal neovascularization (CNV) associated with AFVD, who underwent treatment with intravitreal ranibizumab.

Methods Prospective, interventional, single case report. A 70‐year‐old male patient diagnosed with bilateral adult‐onset vitelliform dystrophy, presents a sudden decrease of vision in his left eye (LE) associated with a subretinal haemorrhage and serous detachment in the macular area, on fundus examination. Fluorescein angiography in the LE confirmed the presence of an occult choroidal neovascular membrane. Intravitreal ranibizumab was performed because of the juxtafoveal localization of the CNV.

Results Two consecutive injections were needed to induce total regression of the lesion. Six months after the last injection, visual acuity remained stable at 7/10 with no recurrence as evaluated by fundus biomicroscopy and optical coherence tomography (OCT).

Conclusion Intravitreal ranibizumab has shown a satisfactory morphological and functional improvement in this case of CNV associated with adult‐onset vitelliform dystrophy. Further case series are required to confirm this observation.
Influence of age on visual results of intravitreal bevacizumab for myopic choroidal neovascularization
Authors: KORT F , CHEBIL A , BOULADI M , BOURAOUI R , BEN YOUSSEF N , MERDASSI A , EL MATRI L
Published: November 2010

Purpose To evaluate the influence of age on the visual and anatomic outcome of myopic patients with choroidal neovascularization (CNV) treated with intravitreal bevacizumab (IVB).

Methods Review of retrospectively collected data of 52 eyes in 50 patients with myopic CNV treated with IVB injections (1.25 mg/ 0.05ml). According to the age at onset of CNV, patients were divided into 2 groups: A younger group (< 50 years); (n=25, 27 eyes) and an older group (≥ 50 years); (n=25, 25 eyes). Best corrected visual acuity (BCVA) and central retinal thickness (CRT) measured with optical coherence tomography (OCT) were compared between the two groups over 12 months.

Results The mean number of IVB injections was 1.8 in the younger group and 2.0 in the older group. In the younger group, mean BCVA improved from 1.32 logMAR at baseline to 0.77 logMAR at 12 months (p=.002). In the older group, BCVA improved from 1.0 logMAR to 0.84 logMAR at 12 moths (p=.035). There was a mean of 5.1 lines improvement in BCVA from baseline in the younger group versus a mean of 2.2 lines improvement in the older group (p<.05). Decrease in mean CRT was significantly higher in the younger group than in the older one at 12 months: 114.02µm and 68.8µm respectively (p=.003).

Conclusion Visual prognosis of myopic CNV treated with IVB seems to be better in patients younger than 50 years.
Spontaneous peeling of idiopathic epiretinal membranes: a case series
Authors: LOH BK , LEE SY , YEO I , ANG CL , WONG D
Published: November 2010

Purpose To report clinical presentations and optical coherence tomographic features of spontaneous peeling of idiopathic epiretinal membranes in two young myopic females

Methods Retrospective review of cases including clinical presentations and optical coherence tomography (OCT) scans

Results Spontaneous peeling of idiopathic epiretinal membranes occurred in two young myopic females. The peeling occurred with posterior vitreous detachments which were documented sequentially with OCT over a 3 to 6 months duration. Case 1, a 31‐year‐old lady, with myopia of ‐6.0 dioptres spherical equivalent(SE), presented with decreased left visual acuity for one week. Left best corrected visual acuity (BCVA) was 6/12. Fundus examination revealed ERM confirmed by OCT. One month later BCVA improved to 6/9 as the ERM spontaneously peeled off partially with presence of PVD. However OCT still demonstrated vitreofoveal traction. BCVA normalized to 6/6 with complete peeling of ERM, resolution of vitreofoveal traction at both months 2 and 6. Case 2, a 35‐year‐old lady, with myopia of ‐2.0 dioptres SE, experienced 2 week history of decreased left visual acuity to BCVA 6/9 from ERM. 3 months later, spontaneous peeling of ERM occurred simultaneously with PVD. BCVA improved to 6/6 which remained stable one year later.

Conclusion Spontaneous peeling of idiopathic ERM can occur in young female myopes. Two cases developed early PVD with spontaneous ERM peeling. OCT confirms the simultaneous occurrence of PVD with peeling of membranes which has not been demonstrated before. Idiopathic ERM should be monitored closely in myopic eyes of young females as they may undergo spontaneous peeling with normalisation of visual acuity.
Macular thickness measurements in epiretinal membrane using Fourier domain optical coherence tomography devices
Authors: GARCIA MARTIN E , PINILLA I , IDOIPE M , CRUZ N , FUERTES MI , ABECIA E , CALVO P , PRIETO E , GUERRI MONCLUS N
Published: November 2010

Purpose To compare new Fourier‐domain optical coherence tomographies (OCT) for measuring retinal thickness in eyes with idiopatic epiretinal membrane (EM).

Methods Forty eyes diagnosed of EM of 40 patients (24 men and 16 women, aged 37 to 81 years) without other ophthalmic diseases, were prospective and consecutively studied. All of them underwent a ophthalmic examination including best corrected visual acuity, fundus examination, three Cirrus HD‐OCT (Carl Zeiss Meditec, Inc., Ca, USA) and three Spectralis OCT (Heidelberg Engineering, Germany). Comparisons of OCT measurements were done for the nine macular areas defined by the Early Treatment Diabetic Retinopathy Study (ETDRS). Correlations between OCT measures were studied by Pearson test.

Results Mean total retinal thicknesses were 425.36 ± 88.62 μm using Cirrus HD and 440.75 ± 97.02 μm with Spectralis OCT. All retinal measurements showed significant differences between the two devices (p<0.05), except in inferior inner ETDRS area. The mean value for retinal thickness measurements was 15.39 µm less using Cirrus HD‐OCT. Cirrus and Spectralis OCT parameters showed good correlations.

Conclusion Epirretinal membrane eyes evaluated by Cirrus and Spectralis OCT show differences in their macular measurements.
Macular thickness measurements in macular hole using Fourier domain optical coherence tomography devices
Authors: PINILLA I , GARCIA‐MARTIN E , IDOIPE M , FUERTES I , CRUZ N , ABECIA E
Published: November 2010

Purpose To compare new Fourier‐domain optical coherence tomographies (OCT) for measuring retinal thickness in eyes with macular hole (MH).

Methods Thirty‐eight eyes from 38 patients diagnosed of MH (17 men and 21 women, aged 51‐ 82 years) without other ophthalmic diseases, were prospective and consecutively studied. All of them underwent a ophthalmic examination including best corrected visual acuity, fundus examination, three Cirrus HD‐OCT (Carl Zeiss Meditec, Inc., Ca, USA) and three Spectralis OCT (Heidelberg Engineering, Germany). Comparisons of OCT measurements were done for the nine macular areas defined by the Early Treatment Diabetic Retinopathy Study (ETDRS). Correlations between OCT measures were studied by Pearson test.

Results Mean total retinal thicknesses were 347.0 ± 67.78 μm using Cirrus HD and 344.71 ± 43.63 μm with Spectralis OCT. All retinal measurements showed significant differences between the two devices (p<0.05), except in superior and nasal inner ETDRS area. The mean value for retinal thickness measurements was 21.44 µm less using Cirrus HD‐OCT. Cirrus and Spectralis OCT parameters showed good correlations.

Conclusion MH eyes evaluated by Cirrus and Spectralis OCT show differences in their macular measurements.
Prospective study of anatomical and functional outcome after surgery of phakic and pseudophakic rhegmatogenous retinal detachments in high myopia
Authors: BERNHEIM DB
Published: November 2010

Purpose To compare anatomic and functional results of primary rhegmatogenous retinal detachment (RD) in high myopic eyes according to the lens status

Methods From the database of 835 patients prospectively studied, 191 patients with high myopia were included (151 phakic and 40 pseudophakic eyes) and assessed for a minimal 6 months follow‐up examination in this multicentric study. Each patient underwent a detailed preoperative evaluation including symptom duration, best corrected visual acuity (logMAR), intraocular pressure, lens status, fundus examination, and axial length. Surgery (pars plana vitrectomy (PPV) or scleral buckling) was left to the surgeon choice. Baseline and follow‐up data were recorded at presentation, 1 and 6 months or more. The main endpoints were the primary reattachment rate at the 6‐month visit; the final anatomical success rate, the postoperative VA (>20/40) and intra‐ and postoperative complications.

Results The analysis showed 96% primary reattachment, and 54% (single surgery) or 44% (multi‐surgery) visual acuity equal to or better than (≥20/40). Pseudophakic eyes differed from phakic eyes by age (older: 60.810.4 vs 49.912.3, p<0.001), smaller pupil dilation (8.01.5 mm vs 8.51.2 mm, p=0.02), more frequent PPV (80% vs 28.5%, p<0.001) and an higher rate of primary reattachment (92.5% vs 80.7%, p=0.05).

Conclusion This prospective study showed similar baseline RD characteristics for high myopic phakic or pseudophakic eyes, and a primary reattachment rate higher for pseudophakic eyes. After single or multi‐surgery the functional prognosis was the same in the two groups and close to the published results in emmetropic eyes. Despite its anatomic particularities and morbidity risk
Paediatric retinal detachments: clinical characteristics and surgical outcomes
Authors: TAN GS , LEE SY , WONG E
Published: November 2010

Purpose To evaluate the clinical characteristics and surgical outcomes of paediatric retinal detachment in an Asian population.

Methods A retrospective case series of all patients aged 18 years and under who underwent retinal detachment surgery at the Singapore National Eye Centre from 1994 to 2008.

Results 133 eyes in 116 patients were treated for retinal detachment over 15 years. 88 patients (75.9%) were male. The mean age was 14.0 years (range 3 to 18 years; median 15 years). Retinal detachment was caused by trauma in 13.5% (18 eyes). Myopia was the most common risk factor, present in 57 eyes (42.9%). 9% (12 eyes) had pseudophakic retinal detachment and 3.0% (4 eyes) had aphakic retinal detachment. The mean duration from onset of symptoms to presentation was 43 days (+/‐92.4). Initial visual acuity (VA) was 6/12 or better in 19.5% of eyes, while 53.9% of eyes had VA worse than 6/60 at presentation. The macula was still attached in only 22.1% of eyes. 85% of eyes had one retinal detachment surgery performed. 74% of our patients were treated with a sclera buckling procedure at the first instance. 18.3% had a combined vitrectomy with sclera buckling. Only 7.6% had primary vitrectomy as the initial treatment. 85% (113) of eyes achieved anatomical success defined by a completely attached retina on last followup, at least 6 months after last surgical procedure. 43.7% of eyes achieved a final postoperative VA of 6/12 or better. 76.2% of eyes had VA 6/60 or better.

Conclusion Paediatric retinal detachments are characterised by delayed diagnosis, high incidence of macular involvement on presentation and a male predominance. In our series, myopia was the most common risk factor, which is not unexpected given the high incidence of childhood myopia in our population.
The role of nd:yag laser anterior hyaloidotomy to treat an entrapment of intravitreal triamcinolone in the beger´s space
Authors: ASCASO FJ , RUIZ DE GOPEGUI E , CASCANTE JM , DEL BUEY MA , CRISTOBAL BESCOS JA
Published: November 2010

Purpose To describe a persistent entrapment of triamcinolone acetonide behind the crystalline lens (Berger´s space), a rare complication of intravitreal triamcinolone acetonide (IVTA) injection, and its successful drainage using a Nd:YAG laser anterior hyaloidotomy.

Methods A case report providing a new indication of Nd:YAG laser, performing an anterior hyaloidotomy to release triamcinolone acetonide entrapped between the crystalline lens and the anterior hyaloids membrane following an IVTA injection.

Results A 66‐year‐old male suffering from diffuse diabetic macular edema in his left eye was treated with an IVTA injection. The following day he complained from sudden loss of vision. Visual acuity dropped from 20/80 to "hand motion", and biomicroscopy showed a drug entrapment in the Berger´space. After a couple of weeks of observation treatment, Nd:YAG laser anterior hyaloidotomy was performed. One week later, slit lamp examination of the retrolental space revealed the complete disappearance of triamcinolone, visual acuity recovered to 20/50, remaining the means transparent.

Conclusion We describe a minimally invasive, quick, simple and effective outpatient procedure to release rests of triamcinolone acetonide entrapped behind the crystalline lens. This indication of Nd:YAG laser has never been described before.
rtPA with SF6 gas usage in traumatic macular subretinal hemorrhage: a case report
Authors: MIGDAL E , HELEMEJKO I , MISIUK‐HOJLO M
Published: November 2010

Purpose The eyeball blunt trauma, because of its specificity, may cause damage to the eye with various aspects. Retinal hemorrhages in the area of central vision, and thus in the macula area, threaten with irretrievable loss of vision. At the moment there is no precise standard of conduct prescribed for subretinal hemorrhage of various etiology and duration. In the Department of Ophthalmology at the Medical University in Wroclaw, in case of a subretinal hemorrhage not cutting across the vascular arches, the procedure is an intravitreal injection of recombinant tissue plasminogen activator (rtPA) with SF6 gas.

Methods We report the case of a 39‐year‐old patient who came to the Department of Ophthalmology during emergency service due to blunt trauma of the left eye.

Results rtPA with SF6 gas appears to be one of the best treatment strategy in macular subretinal hemorrhages caused by eyeball blunt trauma

Conclusion The aim of this study is to show the rapid improvement of the vision after intravitreal injection of rtPA and gas SF6 in the described patient.
Pathophysiology of persistent submacular fluid after surgery for macula‐involving rhegmatogenous retinal detachment: hypothesis and review
Authors: VAN AKEN E , DERYCKE L , CORNELISSEN M , VECKENEER M
Published: November 2010

Purpose To unravel the physiopathology of persistent submacular fluid (PSF) after successful primary rhegmatogenous retinal detachment (RD) repair for macula‐involving RD. To propose therapeutical and preventive measures for this phenomenon.

Methods 9 eyes from 9 patients with macula‐involving RD underwent RD repair: 6/9 eyes got buckle surgery and 3/9 eyes got 20 gauge pars plana vitrectomy. The cellular content of subretinal fluid was studied by electron microscopy and anti‐Rhodopsin immunostaining. All eyes were followed further postoperatively for 12 months by spectral domain optical coherence tomography (SD‐OCT) for detection of PSF.

Results Three out of nine samples were cell rich with cell counts of 7304/mm2, 20 270/mm2 and 9092/mm2 on cytospin. Six out of nine samples contained less than 1500 cells/mm2 and were scored as scantily cellular. The cells in the samples were predominantly rhodopsin immunopositive and showed structural features of photoreceptors or photoreceptor fragments on electron microscopy. Postoperative SD‐OCT scans demonstrating PSF in 3 eyes corresponded to the 3 cell rich peroperative subretinal samples.

Conclusion Subretinal fluid obtained from patients with PSF is cell rich and contains predominantly photoreceptors and photoreceptor fragments. We speculate that a peroperative subretinal lavage might prevent postoperative PSF.
Coats disease: clinical findings and prognosis
Authors: DE FRANCESCO S , DE LUCA M , PIOZZI E , HADJISTILIANOU T
Published: November 2010

Purpose To review the clinical variations and natural course of Coats disease.

Methods We reviewed our experience with clinical features, staging and progression of the disease. In 37 consecutive patients, Coats disease was diagnosed in 15 under the age of 4y and in 22 over the age of 4y. All 37 patients had unilateral disease. The referral diagnoses were Coats disease and retinoblastoma. Patients in both groups (<4y and >4y) were classified into Stages 1 to 5.

Results 15 out of 37 patients were diagnosed under the age of 4y (mean age 2.1y) and were Stage 4 and 5 at diagnosis. In the older group (>4y – mean age 7.1y) most cases were Stage 2 and 3; only one case was Stage 4. Most cases of the first group (<4y) presented a rapid progression of the disease, while older children with earlier stages have been successfully treated.

Conclusion Coats disease is much more aggressive in very young children (<4y). Children diagnosed at an early age present a rapid progression to total exudative detachment, secondary glaucoma and phthisis. One of these cases presented Stage 5 disease at diagnosis with cholesterolosis of the anterior chamber. Older Children present a rather slow progression, a better response to treatment and a better visual prognosis.