Nanocarriers of nanotechnology in retinal diseases

We are approaching a new era of retinal pharmacotherapy where new drugs are rapidly being worked out for the treatment of posterior-segment disease. Recent development in ocular drug delivery systems research has provided new insights into drug development, and the use of nanoparticles for drug delivery is thus a promising excellent approach for advanced therapy of ocular diseases. The primary goal is to develop a variety of drug delivery systems to complement and further enhance the efficacy of the available new medications. The ideal sustained release technology will provide a high level of safety with continuous release over an extended period of time while maintaining almost total drug bioactivity. The use of nanocarriers, such as cyclodextrin nanoparticle suspension, liposomes, nanospheres and, nanoemulsions for gene therapy of retinal diseases has been highlighted in this review

Chromovitrectomy: update

The basic concept for the application of vital dyes during vitreoretinal surgery is to assist in highlighting preretinal membranes and tissues which are very thin and semitransparent and thus difficult to detect. The vital dyes may be classified according to different criteria, where the most commonly applied includes chemical classification. In ophthalmic surgery, vital dyes are widely used in cataract and vitreoretinal surgery. The vital dyes, indocyanine green, infracyanine green, and brilliant blue stain the internal limiting membrane, and trypan blue and triamcinolone acetonide help to visualize epiretinal membranes and vitreous, respectively. This review exhibits the current literature regarding the properties of vital dyes, techniques of application, indications, and toxicities during vitreoretinal surgery and, also suggests that the field of chromovitrectomy represents an expanding area of research.

Successful treatment of melanocytoma associated choroidal neovascular membrane with intravitreal bevacizumab

Melanocytoma of the optic disc is a benign melanocytic tumour that rarely causes visual impairment. We report a rare case of choroidal neovascularization [CNV] in association with optic disc melanocytoma and its response to intravitreal injection of the anti-vascular endothelial growth factor [VEGF], bevacizumab. The choroidal neovascular membrane regressed following a single intravitreal bevacizumab injection with formation of a scar. CNV associated with optic disc melanocytoma is rare. Intravitreal anti-VEGF treatment may be an effective treatment for CNV associated with optic disc melanocytoma

Visual outcome and complications of pars plana vitrectomy for dislocated intraocular lenses

To report factors predicting the visual outcome and complications in eyes that underwent pars plana vitrectomy [PPV] to manage dislocated intraocular lenses [IOLs]. A retrospective chart review was performed. Clinical data recorded from the patient charts include, demographic, preoperative, intraoperative, and postoperative, with emphasis on visual acuity, interval between IOL dislocation and pars plana vitrectomy, surgical method and complications. Patients with follow-up of less than three months were excluded. Ninety-four patients were identified, 63 males and 31 females. Age ranged from 2 to 85years [mean 52.6]. The range of follow-up was 3 to 108 months [mean +/- SD 19.4 +/- 17.4months]. The final visual acuity was 20/50 or better in 52 [55.3%] eyes. Our analysis indicated that visual rehabilitation with IOL was significantly associated with better visual acuity as compared with eyes that were left aphakic [P=0.0092]. There was a trend toward a better visual outcome when PPV was performed within two weeks from the diagnosis of the dislocated IOL which was associated with good visual outcome [20/200 or better] in 85.7% of eyes compared with 78.8% of eyes. Management of IOL by interofixation was associated in [90.0%] of eyes with good vision [20/200 or better] compared to 76.1% eyes that had exchange of IOL through the limbus. Postoperative complications include cystoid macular edema in 9 [9.6%], glaucoma in 9 [9.6%], bullous keratopathy in 8 [8.5%], retinal detachments in 6 [6.4%] eyes, and relapsing uveitis in 2 [2%]. In this series, the final visual outcomes were improved and the rate of postoperative complications were low. Eyes that were pseudophakic had significantly good visual outcome compared with eyes that were left aphakic. To the best of our knowledge, this may be the largest study on dislocated IOL removal by PPV with good visual results compared to other studies

Retinal detachment after laser In Situ keratomileusis

To report characteristics and outcome of rhegmatogenous retinal detachment [RRD] after laser in situ keratomileusis [LASIK] for myopia. A retrospective chart review of patients who presented with RRD after myopic LASIK over a 10-year period. Fourteen eyes were identified with RRD. Of these, two of 6112 LASIK procedures were from our center. The mean age of patients with RRD was 35.43 years. The mean interval of RRD after LASIK was 37.71 months [range, 4 months to 10 years]. The macula was involved in eight eyes and spared in six eyes. Retinal breaks included a macular hole in two eyes, and giant tear in two eyes. Multiple breaks [>2 breaks] occurred in 6 cases. Pars plana vitrectomy [PPV] was performed in 3 [21.4%] eyes, a scleral buckle [SB] was performed in 4 [28.5%] eyes and 7 [50%] eyes underwent combined PPV and SB. Mean follow-up was 15.18 months [range, 1 month to 7 years]. The retina was successfully attached in all cases. The final visual acuity was 20/40 or better in 7 [50%] eyes, 20/40 to 20/60 in 4 [28.5%] eyes, and 20/200 or less in 3 [21.4%] eyes. Poor visual outcome was secondary to proliferative vitreoretinopathy, epiretinal membrane, macular scar and amblyopia. The prevalence of RRD after LASIK was low at our institute. Anatomical and visual outcomes were acceptable in eyes that were managed promptly. Although there is no cause-effect relationship between LASIK and RRD, a dilated fundus examination is highly recommended before and after LASIK for myopia

Asymptomatic intracameral eyelash: Should we remove it?

We describe a case of an adult male who had a recent non-penetrating injury to the right eye. During routine ophthalmological examination, a faint corneal scar was discovered with an anterior chamber cilium. He recalled a penetrating corneal injury 9 years ago. His affected eye had normal visual acuity without any signs of inflammation or complications caused by the intracameral eyelash. The eye tolerated the anterior chamber eyelash well with no indication for its removal. The risk of intraocular surgery may outweigh the benefits of its removal.