Absorption Of Subretinal Fluid Research Articles

Long-term prognostic factors of chronic central serous chorioretinopathy after half-dose photodynamic therapy: A 3-year follow-up study.

PurposeTo evaluate the long-term efficacy and factors involved in the recurrence and persistence of subretinal fluid (SRF) after half-dose photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC).MethodsIn this retrospective observational case series, 79 eyes (73 patients) with chronic CSC were treated with half-dose PDT and followed up for at least 3 years. They were divided into successful (64 eyes) and unsuccessful (15 eyes) groups based on SRF absorption and disease recurrence after one PDT session. Age, best-corrected visual acuity (BCVA), central foveal thickness, neuroretinal thickness, height of SRF, subfoveal choroidal thickness, window defect area detected by fluorescein angiography, and PDT spot area were compared between the groups. Factors associated with PDT success and BCVA at 3 years were investigated.ResultsLogMAR BCVA improved from 0.21±0.24 to 0.08±0.16 (P<0.001) at 3 years after PDT. Compared with the unsuccessful group, the successful group had a significantly younger mean age (50.5±9.7 vs. 56.5±9.1 years, P = 0.032) and better baseline BCVA (0.18±0.23 vs. 0.32±0.25, P = 0.034). Other parameters were not significantly different. Multivariate analyses showed that unsuccessful PDT was significantly associated with lower baseline BCVA (P = 0.026) and older age (P = 0.029) and that BCVA at 3 years after PDT was positively associated with baseline BCVA (P<0.001).ConclusionsHalf-dose PDT has a long-term efficacy in chronic CSC. Relatively early PDT may improve anatomic and functional outcomes of chronic CSC.

Incidence and Evolution of Subretinal Precipitates in Optic Disc Pit Maculopathy.

To study the evolution of subretinal precipitates coexistent with optic disc pit (ODP) maculopathy from their appearance at baseline examination until their absorption after successful treatment. Participants in this retrospective, multicenter study were 42 patients with ODP maculopathy, in whom complete ocular examination was performed, including visual acuity (VA) measurement, slit-lamp examination, color or red-free fundus photography, and optical coherence tomography at baseline after surgical treatment. Out of 42 cases, 17 (40.5%) cases of ODP maculopathy, which were examined between 2002 and 2015, were found to have subretinal precipitates associated with multilayer fluid accumulation at baseline. Precipitates were located at the outer part of the photoreceptor layer and remained for 3-6 months after successful treatment and absorption of subretinal fluid. The mean VA was 0.99 ± 0.21 logMAR at baseline and improved to 0.54 ± 0.25 logMAR at the final examination. Macular precipitates in association with signs of disease chronicity, such as multilayer fluid accumulation, became evident at baseline examination. Precipitates' disappearance in 15 out of 17 cases coincided with the absorption of subretinal fluid. The relative low VA at baseline probably could be attributed to the chronicity of the disease.

The effects of a treatment combination of anti-VEGF injections, laser coagulation and cryotherapy on patients with type 3 Coat\u2019s disease

BackgroundTo examined the curative effect of vitreous injection with ranibizumab,laser coagulation and cryotherapy in treating stage 3 Coats’ disease with exudative retinal detachment.MethodsSeventeen patients with stage 3 Coats’ disease were enrolled in the study. All eyes were treated with vitreous injection of ranibizumab as initial treatment, and subsequent treatment depended on the absorption of subretinal fluid, Including cryotherapy and laser photocoagulation. Repeat treatment for the two treatment intervals occurred in ≥1 month. The mean follow-up time was 24.12 ± 5.99 months. The main data evaluation and outcome measurements included the patient’s vision, intraocular pressure(IOP), optical coherence tomography (OCT), slit lamp examination, indirect ophthalmoscopy, color Doppler imaging (CDI) and color fundus image analysis. The following variables were compared between groups: abnormal vascular changes, subretinal fluid and exudate absorption, retinal reattachment and complications. The final follow-up results were used to determine the effectiveness of treatment.ResultsOf the 17 patients included, 88.24% were male and 11.76% were female. Visual acuity was less than 0.02 in 12 eyes before surgery and 8 eyes after surgery. Visual acuity improved in 7 eyes, accounting for 41.18% of cases, and remained unchanged in 7 eyes, accounting for 41.18% of cases. Three patients were too young to undergo the operation, accounting for 17.65% of cases. The best vision was 0.1. Patients were treated 1 to 5 times for an average of 2.82 ± 0.95 times each. There was no statistically significant difference (t = 1.580, p = 0.135) between the preoperative and postoperative intraocular pressures. However, there was a statistically significant difference between the preoperative and postoperative retinal detachment height (2- related samples Wilcoxon signed rank test with z = 3.517, p = 0.000). The results further showed that all patients had different degrees of subretinal fluid absorption, and some of the new blood vessels subsided. All patients were successfully treated with laser and cryosurgery. No ocular or systemic complications were observed during follow-up.ConclusionsIntravitreal ranibizumab (IVR), laser coagulation and cryotherapy were effective in the treatment of Coats’ disease with exudative retinal detachment.Trial registration numberWe retrospectively registered our study, The trial registration number (TRN) is ChiCTR-ONC-17011161 and date of registration is April 16, 2017.

Optic coherence tomography-guided repeated intravitreal injections of conbercept for macular edema of retinal vein occlusion

Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO), guided by optic coherence tomography (OCT). Methods It is a retrospective case study. Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study. There were 19 males (19 eyes) and 21 females (21 eyes), with the mean age of (53.58±13.19) years and the mean course of 1.5 months. The best corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus fluorescein angiography (FFA) and OCT were performed. The mean baseline of BCVA, central macular thickness (CMT) were 0.25±0.18 and (509.48±170.13) μm respectively. All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg). Follow-up of these patients was 1 to 6 months after treatments, the BCVA, fundus manifestations, OCT were retrospectively observed by every month, the FFA was retrospectively observed by every 3 months. When there was retinal edema or CMT ≥50 μm by OCT during follow-up, those patients were retreated with intravitreal conbercept injection. The changes of the BCVA, CMT were evaluated before and after treatment. Meanwhile, complications in eyes related to medicine and treatment methods were evaluated too. Results At the 6 months, the BCVA was improved (increase≥2 lines) in 25 eyes (62.50%), stabilized (±1 line) in 13 eyes (32.50%) and decreased 2 lines in 2 eyes (5.00%). Retinal hemorrhage and exudates were absorbed in most patients. FFA showed no fluorescein leakage in 11 eyes (27.50%), minor fluorescein leakage in 26 eyes (65.00%), and retinal capillary non-perfusion in 3 eyes (7.50%). OCT showed absorption of the subretinal fluid. The mean CMT were (235.20±100.44) μm at 6 months. Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00%), 3 times for 18 eyes (45.00%), and 2 times for 14 eyes (35.00%). The mean number of intravitreal injection was 2.85 times. There were no ocular or systemic adverse events observed in all patients. Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT. It can stabilize and improve the visual acuity. Key words: Retinal vein occlusion/therapy; Macular edema /therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use; Tomography, optical coherence

Delayed Absorption of Subretinal Fluid after Retinal Reattachment Surgery and Associated Choroidal Features.

PurposeThe aim of this study was to investigate the incidence and associated clinical factors of delayed absorption of subretinal fluid (SRF) after surgery for rhegmatogenous retinal detachment.MethodsThis study involved 36 eyes of 36 consecutive patients who underwent successful surgery for rhegmatogenous retinal detachment. A complete ophthalmologic evaluation, including clinical fundus examination, optical coherence tomography, and indocyanine green angiography, was conducted before and after surgery. Delayed absorption was defined as the presence of residual concave SRF or an SRF bleb at 6 months after surgery. Clinical factors and choroidal features on indocyanine green angiography were compared according to the presence and absence of delayed absorption.ResultsEighteen of 36 eyes (50%) showed delayed absorption. Macular involvement and worse preoperative visual acuity were significantly related to the presence of delayed absorption (p = 0.001 and p = 0.034, respectively). On indocyanine green angiography, preoperative choroidal vascular hyperpermeability was noted in 70% of eyes with delayed absorption and in 14% of eyes without it (p = 0.010).ConclusionsDelayed absorption of SRF after retinal reattachment surgery was not rare, with a 50% of incidence in this study. Macula-off status was significantly related to the incidence of delayed SRF absorption, and choroidal features such as choroidal vascular hyperpermeability might be responsible in part, possibly through the resultant exudative property of choroid.

Guidelines for the Management of Wet Age-Related Macular Degeneration: Recommendations from a Panel of Greek Experts.

PurposeTo propose guidelines for the management of patients with wet age-related macular degeneration (wAMD), taking into account the results of large multicenter studies and clinical experience of retina experts.MethodA team of retina experts developed a consensus paper after three consecutive meetings. The group was focused on guidelines to help clinical decision-making around the definition of successful treatment and the definition of non-response to therapy.ResultsParameters suggestive of a successful response to treatments included: any gain in best corrected visual acuity (BCVA) or vision loss that is less than 5–10 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, reduction of central retinal thickness, partial or complete absorption of subretinal fluid (SRF), reduction of intraretinal fluid, reduction of pigment epithelial detachment or restoration of the anatomy of outer retinal layers. Non-response to current treatment was considered in the case of loss of BCVA greater than 10 ETDRS letters, increased retinal edema or increase of SRF as evidenced by optical coherence tomography or new bleeding in biomicroscopy.ConclusionThe introduction of anti-VEGF agents revolutionized the treatment of wAMD. Given the complexity of the disease, the emerging new agents and the difference of cases recruited in clinical trials compared to those appearing in every-day practice, it is essential to individualize treatment options taking into account the results of clinical trials.

Spectral-domain optical coherence tomography analysis of persistent subretinal fluid after scleral buckling surgery for macula-off retinal detachment.

To determine the predictive value of markers for persistent subretinal fluid (SRF) absorption and the influence of subfoveal fluid on visual outcome after scleral buckle (SB) surgery for rhegmatogenous retinal detachment (RRD). This was a retrospective, observational study. We reviewed the medical records of 64 eyes of 64 patients who underwent SB surgery for macula-off RRD. Patients underwent clinical examination and spectral-domain optical coherence tomography before surgery, at 1 month and every 3 months postoperatively. The height and width of SRF bleb(s) were measured over time. Persistent SRF at 1 month was observed in 40 eyes (62.5%). SRF blebs were first detected 1.7 ± 2.2 months postoperatively. In 29 cases that could be fully followed up, SRF blebs were completely absorbed 7.8 ± 4.4 months postoperatively. Resolution of fluid was associated with an improvement of VA (P = 0.003). Serial measurements of SRF bleb size showed that bleb width decreased significantly at all time points during the 12-month follow-up period (P < 0.05), while significant bleb height decrease occurred from postoperative sixth month only (P < 0.05). There was no correlation between VA outcomes and subfoveal bleb height or width (P > 0.05). The cut-off value of the bleb width-to-height ratio level for predicting bleb absorption at 6 months was 7, with 89% sensitivity and 83% specificity. Visual improvement may occur with late resolution of residual subfoveal fluid. A bleb width-to-height ratio >7 indicates a higher risk of SRF to persist beyond 6 months after surgery.

Persistent Subretinal Fluid After Successful Full-Thickness Macular Hole Surgery: Prognostic Factors, Morphological Features and Implications on Functional Recovery.

The present study aimed to identify preoperative factors that predispose the development of subretinal fluid (SRF) following successful macular hole (MH) surgery. Thirty-four eyes of 33 consecutive patients that underwent pars plana vitrectomy for idiopathic full-thickness MH surgery were included in this retrospective study. Best corrected visual acuity (BCVA), and spectral domain-optical coherence tomography (OCT) images were evaluated pre- and postoperatively in all cases. Patient's demographic characteristics, stage of MH, measurements of base diameter and minimum aperture diameter of the MH, preoperative foveal vitreomacular traction and selected intra-operative parameters were correlated with the development of postoperative SRF. Postoperative SRF was observed in 15 cases (48%). Total absorption of SRF was observed in 73% of affected eyes and was most commonly seen between the third and the fifth postoperative month. One patient developed lamellar hole leading to full-thickness MH. Postoperative BCVA was similar between the eyes that did and the eyes that did not develop postoperative SRF (0.31±0.2 vs 0.35±0.2; p≥0.05). Development of postoperative SRF was significantly associated with the presence of preoperative foveal vitreomacular traction (p=0.048), stage II MH (p=0.017) and smaller size of the closest distance between the MH edges (p=0.046). Postoperative SRF is a common occurrence following successful MH surgery. Meticulous evaluation of preoperative clinical and OCT findings may disclose risk factors associated with this condition. Based on our observations, idiopathic holes of early stage appear to be at a higher risk of developing postoperative SRF. This could be a point of interest with the advancing use of enzymatic proteolysis.

Choroidal Thickness Changes After Photodynamic Therapy and Recurrence of Chronic Central Serous Chorioretinopathy

To investigate long-term changes in subfoveal choroidal thickness (SCT) after photodynamic therapy (PDT) and their relationship with chronic central serous chorioretinopathy (CSC) recurrence. Retrospective, observational, comparative case series. Fifty-seven eyes with chronic CSC (52 patients, ≥2 years follow-up) treated with half-fluence or half-dose PDT were divided into 2 groups: those with incomplete CSC resolution or subretinal fluid (SRF) recurrence (SRF+) and those with complete SRF absorption without disease recurrence (SRF-). The SCT was measured using spectral-domain optical coherence tomography and relative SCT ratios (follow-up SCT: baseline SCT ratio) were compared between the 2 groups. Mean follow-up period was 33.9 ± 9.9 months (range: 24-62 months). Four of 57 eyes (7%) had persistent SRF after PDT and 12 of 53 eyes (22.6%) had initial SRF resolution with SRF recurrence. The SRF+ group had a slower reduction in SCT during the first month (P < .001) and a higher relative SCT ratio than the SRF- group throughout follow-up (P < .001). The relative SCT ratio at 1 month was highly predictive of CSC recurrence (area under the curve = 0.902, 95% confidence interval: 0.823-0.982). Using a relative SCT ratio cutoff of 93.1%, sensitivity of this measure was 93.8% and specificity was 78.1%. Those with incomplete SRF absorption or SRF recurrence had a slower SCT decline at 1 month and a higher SCT ratio throughout follow-up compared to those without CSC recurrence. The SCT changes may reflect PDT efficacy and help predict long-term recurrence and early treatment outcomes.

Idiopathic Necrotizing Scleritis, Anterior Uveitis, and Localized Retinal Detachment

Aim: To present clinical picture and treatment of anterior idiopathic necrotizing scleritis. Methods: Clinical and laboratory examination; B-scan ultrasound; tissue biopsy and histological analysis, were performed. Results: Herewith we depict a case of 74 year old man, with unilateral granulomatous, anterior, necrotizing scleritis. Etiology has, through extensive testing, both laboratorial and clinical, not been proven and thus the patient has been classified as having idiopathic scleritis. Complications on both anterior (anterior uveitis) and posterior (subretinal granulomatous infiltrates with localized retinal detachment) segments of the eye are a consequence of granulomatous necrotizing scleritis. Both tissue biopsy of granulomatous scleral infiltrates and histological analysis showed that this is the case of granulomatous, partially necrotizing scleritis with some elements of vasculitis. Progression of granulomatous scleral infiltrates into the eye has also been shown through clinical examination and B-scan ultrasound, and depicted subretinal lesion of medium reflectivity that is in contact with the epibulbar lesion. Retinal detachment in this area had progressed and required Case Study Paovic et al.; BJMMR, 10(8): 1-9, 2015; Article no.BJMMR.19161 2 excessive laser photocoagulation barrage and resulted in absorption of subretinal fluid. Positive therapeutic outcome was achieved through the use Methotrexate and corticosteroids. Conclusion: Granulomatous infiltrates that spread towards the subretinal space and result in localized retinal detachment are a rare complication that may occur during the evolution of necrotizing scleritis and require regular monitoring and followup. Treatment, both pharmaceutical and laser photocoagulation, should be adjusted in order to affect progression and prevent possible complications of the disease.

Refractory subretinal fluid in patients with neovascular age-related macular degeneration treated with intravitreal ranibizumab: visual acuity outcome.

To investigate the functional outcome of eyes with neovascular AMD (nAMD) and subretinal fluid (SRF) refractory to treatment with ranibizumab. Retrospective chart review of consecutive treatment-refractory SRF in nAMD despite monthly ranibizumab injections during 12 months or more. Data were evaluated for baseline characteristics, location of the refractory SRF, mean visual acuity (VA) change, number of injections, and timepoint of first complete disappearance of SRF. Forty-five eyes in 44 patients (mean age of 76 years) were included. The mean follow-up was 32.4 months (range 12-73 months). The mean number of injections was 11.6 in the first year and 27.5 over follow-up. The refractory SRF was located subfoveally in 66.7 %. In 12 eyes (26.7 %), complete absorption of SRF was found after a mean of 22.6 months (range, 13-41 months). Mean VA increased by 10.4, 8.2, and 8.6 letters by month 12, 24, and 36, respectively. Neovascular AMD with SRF refractory to monthly retreatment with ranibizumab may still allow good and maintained visual improvement, even if the fluid is located subfoveally. SRF may progressively absorb under continuous monthly treatment. The necessity to treat refractory SRF with monthly injections could be questioned and would need future investigations.

Réponse tonométrique à l’acétazolamide dans le décollement de rétine

Acetazolamide reduces intraocular pressure and stimulates absorption of subretinal fluid by the retinal pigment epithelium. Recording the intraocular pressure response to systemic acetazolamide might enable an indirect evaluation of retinal pigment epithelial carbonic anhydrase. The intraocular pressure response to a standardized dose of intravenous acetazolamide (5mg/kg) was evaluated in a "case" group of 15 patients undergoing retinal detachment (RD) surgery and in a control group of 15 patients undergoing epiretinal membrane peeling. Intraocular pressure was measured with a handheld Perkins tonometer in a supine position before (t-2 min) and after the intravenous administration of acetazolamide (t+2 min, t+6 min, t+10 min and t+30 min). The mean variation of the intraocular pressure was compared between the two groups in the non-operated eye at each time point. A significant reduction of the intraocular pressure was observed in both groups at 2, 6 and 10 minutes (P<0.01) after the injection of acetazolamide (5mg/kg). The reduction was significantly lower in the group of patients who underwent retinal detachment surgery when compared with the group of patients in whom epiretinal membrane peeling had been performed. This difference remained significant up to 10 minutes (P<0.01 at t=2, 6 and 10 min). At t=30 min, the intraocular pressure reduction was comparable in both groups. The vitreous plays a fundamental role in the pathogenesis of retinal detachment via peripheral traction. However, since not all tears lead inevitably to retinal detachment, there must also be adherence factors which can prevent the latter. The response to acetazolamide differs significantly in patients undergoing retinal detachment surgery compared with patients treated with epiretinal membrane peeling. In the occurrence of retinal detachment, deficient photoreceptor adherence to the retinal pigment epithelium has been hypothesized. Further research should aim to correlate the tonometric response to acetazolamide with photoreceptor adherence.

Intravitreous injection of bevacizumab for chronic central serous chorioretinopathy

Background/PurposeTo evaluate the effect of intravitreal bevacizumab on subretinal fluid absorption in patients with chronic central serous chorioretinopathy (CSCR). Materials and methodsThis was a retrospective case series study. Patients with CSCR symptoms for > 3 months and who received intravitreal injection of bevacizumab were included. Ocular examinations were carried out at baseline and every follow-up visit, including visual acuity, fundus examination, and optic coherence tomography. ResultsTwelve eyes in 12 patients were included in this study. One month after injection, three of the 12 patients who had increased central macular thickness were considered nonresponders. Nine of the 12 patients who had decreased central macular thickness were considered to have responded to intravitreal bevacizumab injection. The response rate was 75%. In the response group, the mean central macular thickness significantly decreased, from 306.7 ± 77.8 μm to 204.3 ± 59.3 μm (p = 0.001) at 1 month. The mean Logarithm of the Minimum Angle of Resolution (logMAR) visual acuity was significantly improved from 0.72 ± 0.35 to 0.50 ± 0.28 (p = 0.008). Six of these nine patients had stable conditions lasting > 6 months. Three of them had recurrence. ConclusionIntravitreal bevacizumab injections improved subretinal fluid absorption in some patients with CSCR. It could be an alternative therapy for patients with CSCR, especially when they are not suitable for other treatments.

Morphologic Changes in the Foveal Photoreceptor Layer before and after Laser Treatment in Acute and Chronic Central Serous Chorioretinopathy Documented in Spectral-Domain Optical Coherence Tomography

Purpose. To analyze microstructural changes in the external limiting membrane (ELM) and photoreceptor layer before and after early and late conventional laser treatment in central serous chorioretinopathy (CSC) in 12 months follow-up study. Methods. A retrospective observational study included Group A: 19 patients (19 eyes) with symptomatic acute CSC and Group B: 16 patients (16 eyes) with symptomatic chronic CSC. Retinal microstructural changes were analyzed with SD-OCT paying a particular role in examining the photoreceptor layer and ELM. Results. The length of the photoreceptors, prior to treatment, was approximately 84 μm in Group A and 82,5 μm in Group B. Twelve months after laser treatment, photoreceptor length was approximately 49 μm in Group A and 43 μm (range 20–55 μm) in Group B. No patients in Group A had noticeable photoreceptor defects nor ELM defects, but in 15 eyes in Group B photoreceptor and ELM defects were detected (P < 0.0001). Conclusions. When analyzing the photoreceptor layer and ELM during active CSC, it is not possible to evaluate any irreversible changes which have already occurred in this layer. Damage to the photoreceptor layer and ELM in patients with chronic CSC was only found after laser treatment and the absorption of subretinal fluid.

Review and meta-analysis of therapy on subretinal fluid after rhegma-togenous retinal detachment Surgery

objectivetoevaluate clinical efficacy of post retinalDetachment by integrative medicine through literature, and to perform meta-analysis on their subretinal fluid ABSORption time after retinal detachment surgery.METHODSLiterature published between1994 and 2014 inKnowledge infrastructure, VIP database, Wanfang Data, involving integrative medicine all randomized controlled forTreatment of retinal detachment or quasi-randomized controlled trials or claimed mainly randomized controlled trials wereSearched by strategy of Retina Detachment surgery and Traditional Chinese medicine/traditional Chinese Medicine/chinESE medicine/integrative medicine/acupuncture/ethnic Medicine .Studies met the requirements were included.RevMan 5.3 Statistical software provided by the Cochrane collaboration is used for meta-analysis.RESULTSInitial Search found literature and 6 of that were includedNg to final inclusion and exclusion the criteria, however, high quality randomized controlled trial is in absence while blindNess was seldomly elaborated.Meta-analysis utilized a random effects model, and standard mean difference was-0.99 while confidence intervaltween-1.34 and-0.64;For the combined effect of the test, Z value is 5.56 (p<0.00001).The result suggested that medicine enjoyed a shorter fluid absorption time than Western medicine treatmentd The difference was statistically significant.conclusionsforsubretinal fluid cases after retinal detachment surgery, integrative medicine could effectively reduce the absorption time in contrast toWestern Medical.

Restoration of the photoreceptor layer and improvement of visual acuity in successfully treated optic disc pit maculopathy: a long follow-up study by optical coherence tomography

To investigate by optical coherence tomography (OCT) the evolution of the photoreceptor layer and its association with best-corrected visual acuity (BCVA) in optic disc pit (ODP) maculopathy after successful surgical treatment. Fourteen eyes of 14 patients were included in this study, and followed up from 36 to 95months (mean 57.36 ± 18.32months). The follow-up period started at the time of complete subretinal fluid absorption. Examination was performed by time-domain OCT before and after treatment. Spectral-domain OCT was used after treatment. Parameters assessed were type of elevation, central foveal thickness, time elapsed from onset to treatment, type of treatment, BCVA, and inner segment outer segment (IS/OS) junction line. The IS/OS junction was characterized after treatment as intact, interrupted, or absent (not distinguishable). Significant restoration of the IS/OS junction line was first noticed between 6 and 12months after fluid absorption (p = 0.02; Wilcoxon signed rank test). Restoration was continuous up to the 24th month of postoperative examination after fluid absorption (p = 0.14; Wilcoxon signed rank test). BCVA was 0.99 ± 0.38 logMar before treatment, 0.81 ± 0.26 logMar (p = 0.011; paired t-test) immediately after fluid absorption and 0.61 ± 0.33 logMar (p = 0.026; one-way ANOVA) 24months after fluid resolution. BCVA was significantly positively correlated with the integrity of the IS/OS junction line during follow-up (Pearson r = 0.775; p < 0.001). The IS/OS junction restoration cannot be detected immediately after fluid resolution in the majority of cases. It became evident 6-12months later and was completed 24months after fluid absorption. Improvement in BCVA was noticed only during the first 2years of follow-up. No significant changes were noticed in BCVA or the IS/OS line after 2years. Among the studied variables, the final photoreceptor layer condition and BCVA immediately after fluid absorption are the main factors predicting final BCVA after successful surgical treatment of ODP maculopathy.

INFLUENCE OF SYSTEMIC STEROIDS ON SUBRETINAL FLUID AFTER SCLERAL BUCKLE SURGERY FOR MACULA-OFF RETINAL DETACHMENT

To investigate the effect of postoperative systemic steroid therapy on the incidence and duration of the subretinal fluid (SRF) and its correlation with the visual outcome after scleral buckle surgery for macula-off rhegmatogenous retinal detachment. Prospective interventional study of sixty patients with macula-off rhegmatogenous retinal detachment who undertook scleral buckle surgery. Those patients who had recurrent retinal detachment, proliferative preretinal membrane, or primary surgical failure were excluded. Patients were assigned to Group 1 (with prescription of oral prednisolone for 3 days postoperatively) and Group 2 (with no such prescription).Furthermore, patients in Group 1 were subdivided into Group 1A (0.5 mg prednisolone/kg)and Group 1B (1 mg prednisolone/kg) according to the dosage of prednisolone. Patients were followed-up initially 1 week and 2 weeks after surgery and then on a monthly basis for at least 1 year. After the operation, all patients had corrected visual acuity and also received examinations of indirect ophthalmoscopy and optical coherence tomography. We compared the incidence, duration of SRF, and the correlation with the visual outcome between the groups. Lower incidence of SRF was noted in Group 1 than in Group 2 (56.7% vs. 80%;P = 0.052), and the duration of SRF was significantly shorter in Group 1 than in Group 2 (218 days vs. 286 days; P = 0.039). There was no significant difference in the final BCVA between the two groups. However, patients in Group 1 had greater improvements of BCVA 1 year after operation (13 lines vs. 7 lines in Groups 1 and 2, respectively; P = 0.026). Statistically,there were no difference between Groups 1A and 1B, in terms of the incidence of SRF,duration of SRF, final BCVA, and improvement of BCVA. Postoperative systemic steroid treatment may decrease the incidence of SRF and facilitate the absorption of SRF. Patients treated with steroids had greater improvement of BCVA.

The efficacy of intravitreal bevacizumab for idiopathic central serous chorioretinopathy

To evaluate the efficacy of intravitreal bevacizumab injection in the treatment of central serous chorioretinopathy (CSC). In a prospective interventional case series, 40 eyes of 40 patients with idiopathic CSC at least 3months in duration were included. Patients were treated with once or twice intravitreal bevacizumab injections initially and completed at least 12months follow-up. Main outcomes measures were the resolution of neurosensory detachment, best-corrected visual acuity, and findings on fluorescein and indocyanine green angiography. Thirty-three of 40 eyes (82.5%) showed complete absence of subretinal fluid at the macula within 3months following initial intravitreal bevacizumab injection. Eyes exhibiting resolution of subretinal fluid revealed improvement in fluorescein and indocyanine green angiographic findings. The rate of intense hyperfluorescence on indocyanine green angiography was higher in eyes exhibiting resolution of subretinal fluid than eyes exhibiting incomplete absorption of subretinal fluid after intravitreal bevacizumab (72.7 and 28.5%, respectively, p = 0.039). Intravitreal bevacizumab injections generally resulted in anatomic improvement for CSC and may constitute a therapeutic option in CSC. The effect after intravitreal bevacizumab injection for CSC might be related to the hyperfluorescence on indocyanine green angiography.

Vitrectomy for Treatment of a Lamellar Hole in a Patient with Exudative Macular Degeneration: The Role of Vitreous Traction Elimination

Lamellar macular hole (LMH) represents a well-defined clinical entity with variable pathophysiologic mechanisms and a controversial therapeutic approach. The purpose of the present work is to present a patient with an epiretinal membrane (ERM)-associated LMH on the background of exudative age-related macular degeneration (AMD) that was successfully managed with pars plana vitrectomy. Interventional case report. A 67-year-old man presented with progressive visual loss OS of 5 months' duration. He was diagnosed with an ERM-associated LMH with coexisting subretinal fluid arising by a neovascular membrane on the background of exudative AMD confirmed with fundus fluorescein angiography. He underwent a 3-port pars plana vitrectomy with ERM-internal limiting membrane peeling and gas tamponade (14% C3F8) for treatment of the LMH and ERM with a view to undergo anti-vascular endothelial growth factor treatment for the exudative AMD. Postoperative optical coherence tomography demonstrated complete closure of the LMH with simultaneous total subretinal fluid absorption that was maintained at the 2-month follow-up period. To our knowledge, this is the first report whereby pars plana vitrectomy in a patient with an ERM-associated LMH on the background of exudative AMD resulted in improvement of both clinical entities. The latter strengthens the role of vitreous traction elimination in exudative AMD and highlights the need for further research.

Comparative study of patients with central serous chorioretinopathy undergoing focal laser photocoagulation or photodynamic therapy

AimsTo compare clinical outcomes for patients with central serous chorioretinopathy (CSC) undergoing either focal laser photocoagulation or photodynamic therapy (PDT).Methods26 eyes of 26 patients with symptomatic CSC underwent focal laser...