Patients Underwent Pars Plana Vitrectomy Research Articles

Eales disease: A case report

The ocular manifestation of Eales Disease results from overlapping stages of vasculitis, occlusion, and neovascularization. This mimics several disease entities ranging from infectious to inflammatory causes. We report a case of a young healthy Filipino male with few months painless monocular sudden blurring of vision. On eye exam, there was vitreous hemorrhage with ultrasound evidence of retinal detachment on the bad eye. The good eye, on the other hand, has perivascular sheathing of peripheral vessels, which, on fluorescein angiography showed dye staining, extravasation, vessel obliteration, capillary dropouts, and collateral formation. Laboratory studies were normal except for positive PPD skin test. Infectious and inflammatory entities were considered less likely and Eales disease as a more probable diagnosis. The patient underwent pars plana vitrectomy on the bad eye where intraoperatively revealed fibrovascular fronds and an attached retina. Pan-retinal photocoagulation was also done on both eyes. Visual acuity after 3 months was 6/6 for both eyes. Management of Eales disease is similar to other vasoocclusive diseases where prevention of further ischemia and neovascularization is the main goal of treatment.

Intravitreal Angiostrongylus cantonensis: first case report in South America

This study reports the first case of intravitreal angiostrongyliasis in South America treated with posterior worm removal via pars plana vitrectomy. This was a retrospective, observational case study. Data from medical charts, wide-field digital imaging, ocular ultrasound, and visual evoked potential studies were reviewed. A 20-month-old boy presented with eosinophilic meningitis and right eye exotropia. Polymerase chain reaction analysis of the cerebrospinal fluid showed a positive result for Angiostrongylus cantonensis. Fundus examination revealed a pale optic disc, subretinal tracks, vitreous opacities, peripheral tractional retinal detachment, and a dead worm in the vitreous cavity. The patient underwent pars plana vitrectomy with worm removal. This case report illustrates the first case of intravitreal angiostrongyliasis in South America, possibly related to the uncontrolled spread of an exotic invasive species of snail.

Macular Buckling Surgery for Retinal Detachment Associated with Macular Hole in High Myopia Eye.

A 68-year-old woman presented to our clinic with a 1-month history of central scotoma and visual loss in her right eye. The best corrected visual acuity (BCVA) was hand motion in her right eye. Fundus examination showed myopic chorioretinal degeneration in association with posterior staphyloma and the retina was slightly elevated throughout the macula. Optical coherence tomography (OCT) revealed retinal detachment involving the posterior pole with a macular hole and staphyloma. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, macular buckling, and perfluoropropane gas tamponade. At 3-month follow-up, her BCVA was improved to counting fingers at 1 meter and flattened retina with closed macular hole was observed by OCT. Myopic macular hole with retinal detachment associated with posterior staphyloma represent a challenge regarding their management and several surgical techniques have been described. Although satisfactory anatomical improvement is achieved in these eyes after surgery, the visual acuity outcomes may be poorer than expected due to the chorioretinal atrophy at the posterior pole.

Timing of vitrectomy for retained lens fragments after cataract surgery.

To determine the outcomes of early (less than 7 inter-operative days) versus late (7 or greater inter-operative days) vitrectomy in patients with retained lens fragments in the posterior segment after cataract surgery. This was a retrospective review of all patients underwent pars plana vitrectomy for retained lens fragments at the University of Virginia Hospital from 2002 to 2015. Forty-one eyes were included in the analysis. Mean follow-up time was 25.3months (range 3.2months-13years). Patients in the early vitrectomy group had poorer baseline visual acuity than those in the late vitrectomy group (mean logMAR, 1.10 vs. 0.53, p=0.030). No other pre-operative differences existed between the two groups. At the final follow-up, there was no significant difference in visual acuity between the early (mean logMAR, 0.41) and the late (mean logMAR, 0.45) vitrectomy groups. There were no differences in rates of glaucoma, retinal detachment, or cystoid macular edema between the groups. Factors associated with final visual acuity of worse than 20/40 were diabetes mellitus, placement of anterior chamber intraocular lens at cataract surgery, cortical as opposed to nuclear retained lens fragments, post-cataract extraction complications, need for glaucoma medications, and additional surgery after vitrectomy. Separate analysis was done for patients with pre-existing eye disease resulting in worse than 20/40 vision, which showed. Clinical outcomes were similar in patients undergoing early and late vitrectomy. Patients with poorer baseline visual acuity were more likely to receive early vitrectomy. Worse final visual acuity was seen in patients with baseline diagnosis of diabetes and in those who experienced post-operative complications.

Characteristics, socioeconomic status and ethnic variations of primary idiopathic macular hole repair in vitreoretinal centers in the United Kingdom.

The purpose of this multicentre retrospective study was to investigate the characteristics and role of ethnicity and socioeconomic status amongst patients with idiopathic macular holes (IMH) and the surgical outcome. Consecutive patients undergoing primary IMH surgery at three vitreoretinal units in the UK (King's College Hospital, London, UK, Western Eye Hospital, London, UK, Sunderland Eye Infirmary, Sunderland, UK) between January 2007 and May 2017 were included. The main outcome measure was anatomical closure of IMH. Two hundred and thirty three primary IMH surgeries were included. All patients underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. 69.10% of patients were European Caucasian, 6.44% were Asian, and 24.46% were Afro-Caribbean. The mean base macular hole diameter (BD) was 475.5mcm. Mean BD was 432.2mcm in European Caucasian patients, 481.3mcm in Asians (P=0.005), and 505.61mcm in Afro-Caribbeans (P=0.006). Regression analysis demonstrated that BD and Afro-Caribbean ethnicity were independent significant risk factors for surgical failure. Those who have longer duration of symptoms (Afro-Caribbeans) and leave in more deprived places (Afro-Caribbeans) in England where found to have lower success rate on macular hole closure. Asian and Afro-Caribbean patients present with larger IMH than European Caucasians. In addition to IMH base diameter, black origin and lower socioeconomic status are independent risk factors for surgical failure. This study presents a large population-based data analysis on ethnic variation in macular holes and may assist in the management and predicting the surgical outcome.

Management of a case of myopic foveoschisis with phakic intraocular lens (pIOL) in situ: intraoperative challenges

We describe the case of a 30-year-old man with pathological myopia with a phakic intraocular lens (IOL) (Visian ICL V4c model; STAAR, Monrovia, California, USA) in situ having complaints of...

PARS PLANA VITRECTOMY AND WIDE INTERNAL LIMITING MEMBRANE PEELING WITH PERFLUOROPROPANE TAMPONADE FOR HIGHLY MYOPIC FOVEOSCHISIS-ASSOCIATED MACULAR HOLE.

To evaluate the outcomes of pars plana vitrectomy and wide internal limiting membrane peeling with perfluoropropane tamponade (C3F8) for highly myopic foveoschisis-associated macular hole. Prospective consecutive cases with highly myopic foveoschisis-associated macular hole were recruited. All the patients underwent pars plana vitrectomy and indocyanine green-aided internal limiting membrane peeling, the range of internal limiting membrane peeling was broadened beyond the vascular arcades and to the nasal side of the optic disc. With tamponade of 16% C3F8, all the patients kept a face-down position postoperatively. The main outcomes were best-corrected visual acuity and primary anatomical success rate. There were 25 patients (25 eyes) included, with a mean age of 54.8 ± 7.2 years. The mean follow-up duration was 14.2 ± 3.9 months. The mean preoperative logarithm of the minimum angle of resolution best-corrected visual acuity (Snellen equivalent) was 1.489 ± 0.558 (20/617). The mean postoperative logarithm of the minimum angle of resolution best-corrected visual acuity at the final follow-up was 0.882 ± 0.522 (20/152), the difference being statistically significant with the preoperative one (P < 0.001). At the final follow-up, 17 eyes (68.0%) had vision improvement, and the primary anatomical success rate was 84.0% (21/25). Pars plana vitrectomy and wide internal limiting membrane peeling with C3F8 tamponade is effective and safe to achieve a high anatomical success rate of highly myopic foveoschisis-associated macular hole closure and regain visual function.

Our experience with ocular perforation resulting from peribulbar anesthesia

Purpose: The purpose of this study is to analyze the clinical presentation and outcome of treatment for globe perforation secondary to peribulbar perforation. Materials and Methods: A total of 10 patients were included in the study, of which nine patients referred to vitreoretina unit from outside for the management and one patient, that is, eye with altered axial length (eye with previous buckle), at our setting. Three eyes were myopic. One patient underwent indirect argon laser photocoagulation to seal the retinal break, another patient underwent peripheral break sealed with cryotherapy, and six patients underwent pars plana vitrectomy with fluid gas exchange and endolaser. Two patients had sclera buckling in addition. Results: The final visual acuity after follow-up of 1 year was better than 20/30 in two patients, between 20/30 and 20/40 in four patients, and perception of light in two patients. One eye became phthyesical due to recurrent retinal detachment. Conclusion: If diagnosed early and treated adequately, a majority of patients with globe perforation during peribulbar anesthesia can have a good visual outcome.

Analysis of factors affecting the visual outcome after vitrectomy for idiopathic macular hole

Objective To investigate the factors correlated with the visual outcome of idiopathic macular holes (IMH) after vitreoretinal surgery. Methods A total of 57 eyes of 57 patients with IMH were included. There were 43 females (43 eyes) and 14 male (14 eyes), mean age was (60.46±4.79) years. All the eyes underwent best corrected visual acuity (BCVA), slit-lamp microscope, three-mirror contact-lens and optical coherence tomography (OCT) examinations. BCVA were examined with interactional visual chart and recorded with logarithm of the minimum angle of resolution (logMAR) acuity. The minimum diameter and base diameter of macular holes and central retinal thickness (CRT) were detected by OCT. The average logMAR BCVA of 57 eyes was 0.98±0.41. The minimum diameter and base diameter of macular holes were (479.53±164.16) μm and (909.14±278.65) μm. All the patients underwent pars plana vitrectomy combined with phacoemulsification cataract extraction and intraocular lens implantation. The mean follow-up period was (173.44±147.46) months. The relationships between final BCVA and these parameters were examined by single and multiple regression analysis. The valuable influence factors were filtrated and formulated using multiple linear regression models. Results At the final follow-up, the logMAR BCVA of 57 eyes was 0.44±0.31, the CRT was (158.79±86.96) μm. The final BCVA was positive related to minimum diameter of macular holes and preoperative BCVA (r=0.420, 0.448; P=0.001, 0.000), negative related to postoperative CRT (r=-0.371, P=0.004). There was no relationship between the final BCVA and base diameter of macular holes, age and follow-up (r=0.203, -0.015, 0.000; P=0.130, 0.913, 0.999). The incidence of preoperative BCVA for postoperative BCVA was bigger than preoperative minimum diameter of macular holes (P=0.008, 0.020). Conclusion The preoperative minimum diameter of macular holes and BCVA are related to postoperative BCVA in IMH eyes. Key words: Retinal perforations/surgery; Vitreoretinal surgery; Root cause analysis

The efficacy of vitrectomy for myopic traction maculopathy

Objective To observe the anatomical and functional changes in patients with different degrees of myopic traction maculopathy (MTM) after vitrectomy. Methods It was a retrospective case series study. Forty-seven consecutive patients (47 eyes) diagnosed with MTM were studied between January 2010 and May 2014. There were 38 females (38 eyes) and 9 male (9 eyes), mean age was (65.13±6.98) years, mean axial length was (29.23±1.77) mm. The eyes was divided into 3 groups according to the macular morphologies on optical coherence tomography (OCT), including macular retinoschisis only group (MRS group, 18 eyes), foveal retinal detachment group (FD group, 13 eyes) and full-thickness macular hole group (MH group, 16 eyes). All the eyes underwent minimum resolution angle in logarithmic (logMAR) best corrected visual acuity (BCVA), intraocular pressure, axial length, A or B- ultrasonography, fundus photography, OCT and microperimetry examinations. The average logMAR BCVA of 47 eyes was 1.43±0.52. The center retinal thickness (CRT) of eyes in MRS and FD group was (528.45±167.61) μm. All the patients underwent pars plana vitrectomy combined with internal limiting membrane peeling. The mean follow-up period was 23.4 months. The changes of logMAR BCVA, microperimetry and macular microstructural were observed. Results At the final follow-up, the logMAR BCVA of 47 eyes was 0.86±0.42, which improved compared with the preoperative vision (t=7.36, P<0.001). The mean CRT of eyes in MRS and FD group was (250.90±91.81) μm, which improved compared with the preoperative CRT (t=8.17, P<0.001). In MRS group, the retina was attached in 18 eyes. In FD group, the retina was attached in 11 eyes, MH was observed in 2 eyes. In MH group, recurrent retinal detachment was observed in 1 eye. The differences of logMAR BCVA and retinal sensitivity among MRS, FD and MH groups were significant (χ2=6.38, 11.08; P=0.030, 0.004). Conclusion The macular structural and visual function in MTM eyes with macular retinoschisis only after vitrectomy are better than those in MTM eyes with MH and foveal retinal detachment. Key words: Myopia, degenerative/complications; Myopia, degenerative/surgery; Vitreoretinal surgery

Résultats anatomiques et fonctionnels de la chirurgie du trou maculaire avec pelage de membrane limitante interne après suivi de 10 ans

To evaluate the anatomical and functional results of macular hole surgery with internal limiting membrane (ILM) peeling after 10years follow-up. Monocentric retrospective study of patients who had undergone macular hole surgery between 2003and 2005in the Nancy University Medical Center and still followed in the department in 2014. All patients underwent pars plana vitrectomy and ILM peeling without staining. Clinical examination at ten years including determination of best-corrected visual acuity (BCVA), evaluation of quality of life and spectral domain optical coherence tomography was performed. Four men and six women with mean age of 64±8years were included. The mean diameter of the MH was 395±133μm. The mean best corrected visual acuity improved significantly from 0.90±0.22logMAR to 0.14±0.14logMAR after 10years with a satisfactory quality of life in 90% of patients. The integrity of the IS/OS layer was preserved in 9eyes. Inner retinal dimples located in the temporal quadrant related to ILM peeling initiation were observed in 8eyes. No significant RNFL or ganglion cell complex changes were found compared to the contralateral eye. Macular hole surgery with ILM peeling in this series resulted in a visual acuity gain of 8ETDRS lines and persistent improvement in quality of life after a 10-year follow-up.

A Case of Failed Macular Hole Closure Associated with an Entrapped Microbubble in the Hole

Purpose: To report a case of failed sealing of full-thickness macular hole associated with an entrapped microbubble in the hole after vitrectomy, peeling of the internal limiting membrane and C3F8 (14%) gas injection. Case summary: A 69-year-old female visited our clinic for decreased visual acuity in her right eye. The best corrected visual acuity (BCVA) was 20/200 in the right eye. The fundoscopy and spectral domain optical coherence tomography (SD-OCT) showed a full-thickness macular hole. She had a history of spine surgery and, thus was unable to maintain a prone position after surgery. The patient underwent pars plana vitrectomy, peeling of the internal limiting membrane and C3F8 (14%) gas injection in a sitting position postoperatively. Three weeks postoperatively, fundoscopy showed an entrapped microbubble within the macular hole, which was not sealed as observed on SD-OCT. We thought the entrapped microbubble within the macular hole prevented closure of the hole and removed it during the repeated surgery. At 2 weeks after the microbubble removal, fundoscopy and SD-OCT in the right eye showed the closure of the macular hole and the BCVA was improved to 20/40. Conclusions: We experienced a failed sealing of full-thickness macular hole due to an entrapped microbubble within the hole after macular hole surgery and observed the closure of the macular hole after removal of the microbubble. Based on our results, early microbubble removal operation should be considered in the treatment of an entrapped microbubble within the hole. J Korean Ophthalmol Soc 2016;57(5):853-856

Fulminant Ocular Toxoplasmosis: The Hazards of Corticosteroid Monotherapy

ABSTRACTPurpose: To describe fulminant toxoplasma retinochoroiditis induced by corticosteroid monotherapy.Methods: Clinical records of nine patients were reviewed.Results: All patients (five female, four male; aged 15–64 years) had been misdiagnosed as unilateral non-infectious uveitis and given systemic and/or local corticosteroid injections elsewhere. Mean disease duration before referral was 105.6 ± 71 (45–240) days. Visual acuity at presentation was <20/200 in six eyes. Average lesion size was 6.6 disc areas in eight eyes and all four quadrants were involved in one. Toxoplasma DNA was detected in eight tested eyes. Mean duration of anti-toxoplasmic therapy was 92.5 ± 37.1 days. Three eyes developed rhegmatogenous retinal detachment. Four patients underwent pars plana vitrectomy. Final visual acuity was <20/200 in five eyes.Conclusions: Iatrogenic immunosuppression due to initial misdiagnosis may lead to an aggressive course and serious complications of ocular toxoplasmosis, a potentially self-limiting infection.

Vitreous haemorrhage in massive hemorrhagic polypoidal choroidal vasculopathy: clinical characteristics and surgical outcomes: Vitreous hemorrhage in PCV.

BackgroundTo report the outcomes of vitreous hemorrhage (VH) associated with hemorrhagic polypoidal choroidal vasculopathy (PCV).MethodsA retrospective study of 28 eyes of 27 consecutive patients of hemorrhagic PCV with VH, which were managed surgically between January 2003 and December 2011, was performed. All patients underwent pars plana vitrectomy for VH associated with PCV. The main outcome measure was best-corrected visual acuity (BCVA) at baseline, at 1, 3 and 6 months post operatively and at last follow up.ResultsThe visual acuity measured on early treatment diabetic retinopathy study (ETDRS) chart improved in 16 eyes (57.1 %) by two or more lines, remained unchanged in nine eyes (32.1 %) and decreased in three (10.7 %) after surgery when compared to baseline VA. The mean baseline VA was 2.69 ± 0.57 logMAR units (<20/2000) which improved to 1.65 ± 0.93 logMAR units (20/800) at 1 month post operative visit and was sustained at 1.72 ± 1.12 (20/800) with an improvement of 0.96 logMAR units (p < 0.001, 95 % CI 0.54–1.37). The average postoperative follow up was for 14.2 months (range 1–84). The complications noted in postoperative follow up were cataract (n = 10), macular scaring (n = 9), organised dehemoglobinised blood (n = 7), retinal tear or detachment (n = 5), recurrent VH (n = 3) and choroidal detachment (n = 1).ConclusionMajority of patients with loss of vision due to VH secondary to hemorrhagic PCV have sustained improvement in visual acuity following surgery.

Vitrectomy without laser treatment for macular serous detachment associated with optic disc pit: long-term outcomes.

To evaluate the clinical outcome of surgical treatment for macular serous detachment associated with optic disc pit with pars plana vitrectomy (PPV) without laser photocoagulation on the temporal edge. Vitrectomy was performed in 8 eyes of 8 patients (mean age 27.25 years; range 12-57 years) with unilateral macular detachment associated with optic disc pit. All patients underwent pars plana vitrectomy (cases 1, 2, 3, and 4, PPV 20 G; cases 5, 6, 7, and 8, PPV 25 G), internal limiting membrane(ILM) peeling, and SF6 20% gas tamponade (case 1 was treated with silicone oil tamponade). Endolaser on the temporal margin of the optic disk was not performed. Every patient was observed for a follow-up period of 59.25 months after surgery. Statistical analysis was carried out using Student t test paired data. p Value &lt;0.05 was considered to be significant. Complete retinal reattachment was achieved in 7 of 8 patients. Case 8 was operated 11 months ago and he still has a small area of subretinal fluid not completely reabsorbed. Mean preoperative best-corrected visual acuity (BCVA) was 20/83 and the mean postoperative BCVA was 20/40. Mean preoperative foveal thickness was 973 μm and mean postoperative foveal thickness was 363.5 μm. Case 7 developed a macular hole after treatment. Pars plana vitrectomy, ILM peeling, and endotamponade (SF6 20% gas) without endolaser on the temporal edge of optic disc is an effective treatment. This procedure achieved successful anatomical and functional results.

Outer retina reflectivity changes on sd-oct after intravitreal ocriplasmin for vitreomacular traction and macular hole.

To report initial experience with intravitreal ocriplasmin (IVO) and to describe outer retina reflectivity changes observed on spectral domain optical coherence tomography (SD-OCT) after IVO injection in patients with vitreomacular traction (VMT) with or without macular holes (MHs). A consecutive retrospective review of patients with VMT and MH who were treated with IVO was performed. Patients underwent complete ophthalmic evaluation, including nonstandardized Snellen visual acuity testing, and SD-OCT at baseline and follow-up visits. A total of 23 patients who received IVO for VMT and/or MH were included for analysis. Patient age ranged from 53 years to 93 years with a mean of 74 years. The mean follow-up was 174 days (range: 20-291 days). Vitreomacular traction release at Day 30 after IVO was achieved in 11 of 23 patients (47.82%), at an average of 14.54 days (range: 1-30 days) after treatment. The mean visual acuity improved from 0.50 to 0.38. At presentation, eight patients had MH associated with VMT. Closure of the MH with ocriplasmin was achieved in two patients, and six patients underwent pars plana vitrectomy for MH repair. Ten of 23 patients (43.47%) presented with changes in the outer retina reflectivity on SD-OCT after IVO, 4 patients of this group experienced a decrease in visual acuity. In 7 of these 10 patients (70%), VMT release was documented on OCT by Day 30 postinjection compared with 4 of 13 patients (30.76%) without outer retina changes post-IVO. Normalization of the outer retina reflectivity was achieved in all cases. In this case series of VMT/MH patients treated with ocriplasmin, changes in the SD-OCT outer retina reflectivity were relatively common. Within weeks, the outer retinal reflectivity on SD-OCT improved, as did the visual acuity. Further studies to investigate the association between outer retina reflectivity changes with the use of IVO and long-term visual acuity outcomes are warranted.

Late in-the-bag intraocular lens dislocation in patients with uveitis.

Late in-the-bag intraocular lens (IOL) dislocation is an unusual complication of cataract surgery, being strongly associated with pseudoexfoliation, less so with previous vitreoretinal surgery, myopia and uveitis. We present the clinical features, management and outcomes of late spontaneous IOL dislocation in a series of patients with uveitis. A retrospective case series of IOL dislocation affecting patients in the Manchester Uveitis Clinic, UK. The uveitis diagnosis, IOL type, presentation and management are discussed. Six patients from out of 1056 undergoing cataract surgery (0.57%) were affected. Uveitis was the only identified risk factor for IOL dislocation, which occurred a mean 10.3 years following uncomplicated cataract surgery by phakoemulsification with endocapsular IOL implantation. The dislocation was in-the-bag in all six cases. Two patients presented with the IOL in the anterior chamber, and required removal of the IOL-bag complex, and are using aphakic refractive correction. Two patients with inferior IOL subluxation have been managed conservatively. Two patients underwent pars plana vitrectomy with sutureless scleral fixation of the existing IOL in one case, and IOL exchange with a scleral sutured IOL in the other. IOL dislocation is an uncommon late complication in patients with uveitis. Conservative management is appropriate in patients with tolerable symptoms, or in those with difficult uveitis. Otherwise, fixation of the existing IOL, or removal and implantation of a secondary IOL, may be necessary. Angle-supported, or iris-enclaved IOLs, are not of proven safety in this patient group; scleral-fixated posterior chamber IOLs are the favoured approach in our service.

One-year results from clinical practice of epimacular strontium-90 brachytherapy for the treatment of subfoveal choroidal neovascularization secondary to AMD.

To evaluate clinical feasibility, safety, and efficacy of epiretinal strontium-90 brachytherapy in subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) in eyes unresponsive to repeated anti-VEGF injections. A retrospective, single-center study on patients treated with strontium-90 brachytherapy for CNV secondary to neovascular AMD. Patients underwent pars plana vitrectomy with a single 24 Gy dose brachytherapy. They were re-treated with anti-VEGF injections on an as-needed basis if subretinal or intraretinal fluid was detected on optical coherence tomography imaging. Twenty-two patients were treated, and 20 completed 12 months of follow-up. Ten patients maintained stable vision, eight gained vision, and two lost more than three Snellen lines. The mean best corrected visual acuity change from baseline was -8 ± 5.7 letters. A mean of 5.5 ± 4.4 anti-VEGF injections were administered throughout 12 months. Epimacular brachytherapy is feasible in clinical practice. While some patients benefit from the treatment and need significantly fewer as-needed injections, others appear not to react to irradiation treatment after 1 year of follow-up. Larger numbers of patients are needed to evaluate therapeutic efficacy and to determine which patients can benefit from combined radiation and anti-VEGF therapy.

Clinical findings and genetic expression profiling of three pigmented lesions of the optic nerve.

Background. Optic disk melanocytoma is a primary tumor of the optic disk that represents a clinical diagnostic challenge due to its similarities with melanoma. Purpose. The authors present three cases in which genetic expression profiling was used to identify tumor prognosis of optic disk melanocytoma. Case Series. In two cases fine-needle aspiration biopsy was performed to obtain tissue through a transvitreal route into the apex of the tumor while the patient underwent pars plana vitrectomy, laser ablation, phacoemulsification with posterior chamber intraocular lens implantation, and intravitreal triamcinolone acetonide. In the other case the tissue was obtained after definite enucleation. Conclusion. Genetic expression profiling is a useful diagnostic tool for classification and can provide vital information to the ocular oncologist regarding prognosis.

A Case of Postpartum Macular Hole in a Young Woman

Purpose: To describe a case of macular hole (MH) in a 29-year-old non-myopic woman after uncomplicated delivery. Case summary: A 29-year-old woman visited our clinic complaining of decreased visual acuity in her left eye after uncomplicated delivery. Fundoscopy and optical coherence tomography showed a full thickness macular hole in the left eye. However, we found not posterior vitreous detachment or vitreomacular traction in the posterior pole. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, and SF6 gas tamponade. Three months after vitrectomy, the patient’s visual acuity was improved and the macular hole was closed successfully. Conclusions: We experienced and treated a case of postpartum MH developed in a young woman without posterior vitreous detachment or vitreomacular traction in the posterior pole. This suggests another mechanism of MH formation. Postpartum MH was successfully treated by existing idiopathic macular hole surgery. J Korean Ophthalmol Soc 2015;56(3):463-465