Joseph J. Tseng

Longer-term Outcomes Of A Prospective Study Of Intravitreal Ranibizumab As A Treatment For Decreased Visual Acuity Secondary To Central Retinal Vein Occlusion

Purpose: To evaluate long-term effectiveness and safety of intravitreal injection of ranibizumab as a potential treatment for decreased visual acuity secondary to central retinal vein occlusion. Methods: In this prospective interventional case series, patients with central retinal vein occlusion were administered intravitreal ranibizumab 0.5 mg at baseline and monthly for 2 additional doses. Thereafter, the patients were given additional ranibizumab if they had macular edema by optical coherence tomography, leakage during fluorescein angiography, or any intraretinal hemorrhage. Results: There were 35 eyes of 35 patients who at baseline had a mean visual acuity of 44.2 Early Treatment Diabetic Retinopathy Study letters and a mean central macular thickness of 638 μm. At 12 months, mean visual acuity of 32 eyes improved by 16.5 letters and macular thickness decreased to 164 μm (P < 0.001 vs. baseline for each). At 24 months, mean visual acuity of 24 eyes improved by 17.8 letters and macular thickness was 263 μm (P < 0.001 vs. baseline for each). Patients received an average of 10.2 injections during the first year and 6.6 injections during the second year. No cases of endophthalmitis, retinal detachment, or neovascularization were observed. Conclusion: Intravitreal ranibizumab caused a significant improvement in visual acuity and central retinal thickness, which persisted for up to 2 years with minimal side effects.

Influence of postoperative lens status on intraocular pressure in proliferative vitreoretinopathy.

PURPOSE To determine the influence of lens status on postoperative intraocular pressure (IOP) in eyes undergoing vitrectomy for repair of recurrent retinal detachment (RD) resulting from proliferative vitreoretinopathy (PVR). DESIGN Retrospective, consecutive, nonrandomized, single-center series. METHODS One hundred and forty-five eyes with recurrent RD resulting from PVR were reviewed retrospectively. In all, 99 eyes underwent relaxing retinotomy at the time of surgery (68.4%). Perfluorocarbon gas (n = 60) or silicone oil (n = 85) were used as postoperative tamponades. For analysis, eyes were subdivided first based on tamponade and retinotomy status. The resultant groups then were divided further by lens status into 2 groups: aphakic eyes (aphakic group) and phakic and pseudophakic eyes (nonaphakic group). RESULTS Surgical reattachment was achieved in all eyes except one. Eyes receiving both silicone oil and relaxing retinotomy had the worst baseline characteristics compared with those receiving other interventions. In this subset of eyes, a significantly lower proportion of hypotony was found in those eyes that were aphakic after surgery when compared with those eyes that were nonaphakic (P = .037). CONCLUSIONS Surgical management of PVR often results in ultimate retinal reattachment. In eyes receiving both relaxing retinotomy and silicone oil, higher IOPs and a lower proportion of hypotony are found where a native lens or intraocular implant is absent. Removal of the lens or intraocular implant may be considered for those eyes at greatest risk of hypotony.

Peculiar manifestation of macular telangiectasia type 2.

PURPOSE The purpose of this study was to report two unusual cases of macular telangiectasia type 2 with pronounced asymmetric clinical presentations. PATIENTS AND METHODS Two patients. Observational case study. RESULTS Two patients presented with acute complaints of decreased vision and metamorphopsia in one eye. Each was found to have unilateral, juxtafoveal, subretinal neovascularization and minimal or no clinical evidence of macular telangiectasia type 2 in the fellow eye. In one patient, clinical and angiographic findings of macular telangiectasia type 2 were observed in the previously unaffected eye 13 years after the initial presentation. CONCLUSION Macular telangiectasia type 2 is a bilateral condition, but in rare cases, significant asymmetry between the two eyes concerning disease severity can occur, potentially delaying diagnosis and management.

A Modified Iris Suture Technique for In-the-bag Intraocular Lens Dislocation.

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