Outcomes of Combination Systemic and Intravitreal Antiviral Therapy for Acute Retinal Necrosis.

Purpose: Determine the efficacy of combination intravitreal and systemic antiviral therapy for the treatment of acute retinal necrosis (ARN) and risk factors impacting visual acuity (VA) and retinal detachment (RD) outcomes.

Design: Single-center retrospective case series.

Participants: Patients with an ARN diagnosis based on clinical features and polymerase chain reaction confirmation who were treated at a tertiary referral, university-based academic practice.

Formulation of a Peribulbar Block for Prolonged Postoperative Pain Management in Vitreoretinal Surgery: A Randomized Clinical Trial.

Purpose: To evaluate postoperative pain level using a supplemental peribulbar injection at the conclusion of retinal surgery.

Design: Prospective, parallel-assigned, single-masked, randomized clinical trial.

Participants: Fifty-eight patients undergoing scleral buckle, vitrectomy, or combined surgery.

SEVERE PANUVEITIS, RETINAL VASCULITIS, AND OPTIC DISK GRANULOMA SECONDARY TO SARCOIDOSIS.

Purpose: To report a case of panuveitis, retinal vasculitis, and optic disk granuloma due to sarcoidosis.

Methods: Case report and literature review.

Results: A 26-year-old previously healthy African American male presented with four months of gradual progressive visual decline in the right eye.

Vogt-Koyanagi-Harada-like syndrome after CTLA-4 inhibition with ipilimumab for metastatic melanoma.

Cytotoxic T-lymphocyte-associated antigen is a naturally occurring inhibitor of T-cell costimulation. Monoclonal antibody inhibition of cytotoxic T-lymphocyte-associated antigen with ipilimumab blocks this negative regulator of costimulation, promoting T-cell activation and survival, and leads to melanoma regression. Findings of the Vogt-Koyanagi-Harada (VKH) syndrome, an uveomeningitic syndrome that features neurological, auditory, ophthalmologic, and cutaneous involvement because of autoimmune targeting of melanocytic antigen, have rarely been described in association with melanoma immunotherapy.

Fundus autofluorescence features in the inflammatory maculopathies.

Purpose: To describe the fundus autofluorescence (FAF) features of the inflammatory maculopathies and develop a quantification method for FAF analysis.

Methods: This is a retrospective, consecutive case series of patients with inflammatory maculopathies from two tertiary centers. The clinical findings, demographics, and FAF imaging characteristics were reviewed.

Diagnostic vitrectomy for primary intraocular lymphoma: when, why, how?

Primary intraocular lymphoma (PIOL) can present with uveitis, vitritis, or chorioretinal lesions. While fluorescein angiography, fundus autofluorescence, and optical coherence tomography may aid in the diagnosis of PIOL, a definitive diagnosis can only be achieved with tissue analysis. The specimen may be obtained with a vitreous or aqueous tap, however, a diagnostic pars plana vitrectomy with acquisition of diluted and undilated vitreous fluid or a chorioretinal biopsy is preferable.

Chorioretinal folds: associated disorders and a related maculopathy.

Purpose: To describe a series of chorioretinal folds (CRFs) representing a clinical sign that may be associated with multiple systemic, orbital, and ophthalmologic disorders. We report the associations with systemic disease and describe 3 stages of a CRF-related maculopathy.

Design: Observational, retrospective case series.

Combination anti-VEGF and corticosteroid therapy for idiopathic retinal vasculitis, aneurysms, and neuroretinitis syndrome.

Vision loss associated with the idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome most commonly occurs from macular edema or complications related to neovascularization. The authors present a case of advanced IRVAN associated with a massive exudative response characterized by peripheral retinal telangiectasias, exudative retinal detachment, and macular edema with lipid maculopathy. The patient was managed successfully with visual acuity from hand motion to 20/150 using a combination of local corticosteroids, intravitreal bevacizumab, panretinal photocoagulation, and eventually pars plana vitrectomy for progressive vitreomacular traction.

Short-term outcomes of aflibercept for neovascular age-related macular degeneration in eyes previously treated with other vascular endothelial growth factor inhibitors.

Purpose: To report results of aflibercept therapy in eyes with neovascular age-related macular degeneration previously treated with bevacizumab, ranibizumab, or both.

Design: Retrospective, interventional, noncomparative, consecutive case series.

Methods: Ninety-six eyes from 85 patients with neovascular age-related macular degeneration who previously had received bevacizumab, ranibizumab, or both were treated with aflibercept monthly for 3 months followed by a fourth injection within 2 months.

Cystoid macular edema without leakage secondary to nab-Paclitaxel (Abraxane): clinical experience with intravitreal bevacizumab.

Purpose: Cystoid macular edema (CME) is a rarely reported side effect of nanoparticle albumin bound (nab)-paclitaxel therapy-an antimitotic agent used for breast cancer. We describe a patient with bilateral CME secondary to Abraxane that was minimally responsive to intravitreal bevacizumab. To our knowledge, this is the first reported case of the use of intravitreal bevacizumab for this condition.

Retinal metastasis simulating cytomegalovirus retinitis.

A 62-year-old man with lung cancer presented with a 2-week history of decreased vision and clinical features of cytomegalovirus retinitis. The patient was empirically treated for viral retinitis, but microbiological testing of the vitreous fluid was negative. Based on the suspicion for retinal metastasis, the patient underwent pars plana vitrectomy with retinal biopsy.

Multimodality diagnostic imaging in unilateral acute idiopathic maculopathy.

Objective: To describe the clinical features and imaging characteristics in unilateral acute idiopathic maculopathy.

Methods: Retrospective review of 4 patients with a diagnosis of unilateral acute idiopathic maculopathy. Clinical characteristics (age, symptoms, Snellen visual acuity, and funduscopic features) and images from spectral-domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography were analyzed.

Intraoperative microscope-mounted spectral domain optical coherence tomography for evaluation of retinal anatomy during macular surgery.

Objective: To evaluate the use of microscope mounted spectral domain optical coherence tomography (SD-OCT) to detect changes in retinal anatomy during macular surgery.

Design: Retrospective, observational case series.

Participants: We included 25 eyes of 24 consecutive patients who underwent SD-OCT during macular surgery.

Incidence of postvitrectomy macular edema using optical coherence tomography.

Objective: To evaluate the incidence, effect on visual recovery, and predisposing risk factors of postvitrectomy macular edema (ME).

Design: Prospective cohort study.

Participants: One-hundred nine eyes undergoing nonemergent vitrectomy surgery.

Combination intravitreal triamcinolone injection and cryotherapy for exudative retinal detachments in severe Coats disease.

Intravitreal triamcinolone injection effectively reduces subretinal fluid in pediatric patients with exudative retinal detachments in severe Coats disease. However, when combined with cryotherapy, a large percentage of patients develop rhegmatogenous retinal detachments with proliferative vitreoretinopathy.

Topical ketorolac in vitreoretinal surgery: a prospective, randomized, placebo-controlled, double-masked trial.

Objective: To evaluate the effects of topical ketorolac in patients undergoing vitreoretinal surgery.

Methods: One hundred nine patients undergoing vitrectomies were randomized to receive either topical ketorolac tromethamine, 0.4%, or placebo.

Iris hypoplasia and aorticopulmonary septal defect: a neurocristopathy.

Background: Errors in neural crest development are responsible for a number of ocular disorders. In some cases, these ocular abnormalities may be associated with systemic disorders, some of which may be life threatening.

Methods: We reviewed the medical record of 3 children from 2 institutions with a similar constellation of ocular and cardiac abnormalities.