The Thickness of Each Retinal Layer and Visual Acuity after Vitrectomy in Idiopathic Epiretinal Membrane

PURPOSE: In this study, we evaluated the thickness of each retinal layer using spectral-domain optical coherence tomography (OCT) and investigated the correlation between the thickness of each retinal layer and postoperative visual acuity in eyes with idiopathic epiretinal membrane (ERM). METHODS: This retrospective study included 46 eyes from 46 patients with idiopathic ERM who underwent pars plana vitrectomy. Each retinal layer thickness was measured by spectral-domain OCT before operation and at 1, 3, and 6 months after operation. The thickness of each retinal layer was evaluated in the control group before the operation. We performed an analysis of the changes in thickness of each retinal layer at 6 months after operation and then investigated the correlation between the retinal layer thickness and visual improvement. RESULTS: Preoperatively, the thickness of the retinal nerve fiber layer (RNFL) in the ERM group showed more increased compared with that in the control group, and the thickness of photoreceptors and retinal pigment epithelium were decreased compared to those in the control group. At 6 months after the operation, thickness changes were reduced at the RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), GCL-IPL complex, and outer plexiform layer, while the photoreceptor layer increased compared with the values preoperatively. Differences in the preoperative thickness of GCL between the two groups had a significant correlation with postoperative visual acuity (r = 0.477, p = 0.008). CONCLUSIONS: Differences in preoperative thickness of the GCL between the two groups had a significant correlation with postoperative visual acuity. The greater was the thickness of the GCL, the worse was the visual outcome.

Noninfectious Endophthalmitis after Intravitreal Injection of Aflibercept

PURPOSE: To report a case of noninfectious endophthalmitis after intravitreal injection of aflibercept. CASE SUMMARY: A 67-year-old male patient presented with sudden vision loss 2 days after intravitreal aflibercept injection for neovascular age-related macular degeneration. Mild conjunctival injection and moderate inflammation in the anterior chamber were noted, but he had no ocular pain or hypopyon. The patient was diagnosed with noninfectious endophthalmitis and successfully treated with topical antibiotics and topical steroid eye drops. The infection was apparently cleared at 3 days. At 10 days after the initial presentation, his vision loss resolved completely. CONCLUSIONS: Noninfectious endophthalmitis after intravitreal injection of aflibercept can be treated with topical steroids.

Two Cases of Young Patients with Bilateral Posterior Scleritis Accompanied with Serous Retinal Detachment

PURPOSE: To report 2 young female patients with bilateral posterior scleritis and serous retinal detachment. CASE SUMMARY: An 11-year-old girl (Case 1) and a 16-year-old girl (Case 2) visited our clinic with bilateral ocular pain, redness, and blurred vision. Slit lamp examinations revealed severe bilateral scleral injection and mild anterior chamber reactions. Fundus examinations showed bilateral serous retinal detachments in the macular area. In both patients, diffuse multifocal leaking and pooling were found at the macula in the early and late phase fluorescein angiography, respectively. On the B-mode ultrasounds and orbital images (MRI or CT), scleral thickening with retention of subtenons fluid were found. There were no systemic diseases associated with the conditions. We diagnosed the patients with bilateral posterior scleritis and administered systemic steroids. After systemic steroid treatment, all of the symptoms were alleviated. Three months after the regression, bilateral posterior scleritis recurred in patient 2. Oral cyclosporine 100 mg was additionally prescribed in addition to the previous medications that she had taken during her first treatment. CONCLUSIONS: Two young patients diagnosed with posterior scleritis and serous retinal detachment was treated with systemic steroids. With proper examination and treatment, posterior scleritis can be treated with no complications.

The Clinical Outcomes of 23-Gauge Transconjunctival Sutureless Vitrectomy for Endophthalmitis after Cataract Surgery

PURPOSE: To report the clinical outcomes and utility of 23-gauge (G) transconjunctival sutureless vitrectomy (TSV) in patients with postoperative endophthalmitis following cataract surgery. METHODS: The medical records of 16 patients (17 eyes) who underwent 23-G TSV between January 2008 and December 2009 at Konyang University Hospital due to postoperative endophthalmitis following cataract surgery were retrospectively analyzed. The pre- and post-operative best-corrected visual acuities (BCVA), changes in intraocular pressure, the time from diagnosis to surgery, the intraoperative and postoperative complications, and the average duration of hospitalization were investigated. RESULTS: The mean BCVA significantly improved from log MAR 1.89 +/- 1.03 to log MAR 0.42 +/- 0.82 (p = 0.001), and the mean intraocular pressure changed from 16.1 +/- 4.1 mm Hg at baseline to 16.2 +/- 3.3 mm Hg on the first postoperative day without any significant difference (p = 0.955). In addition, none of the patients required sutures to treat wound leakage or showed hypotony on follow-up observation. The average operation time was 64.7 +/- 22.5 minutes, and the average duration of hospitalization was 5.4 +/- 4.5 days. CONCLUSIONS: The use of 23-G TSV in patients with postoperative endophthalmitis following cataract surgery may offer more convenience for the surgeon and more comfort for the patient. In addition, the patient may return to normal life earlier with a shortened duration of hospitalization.

Visual Acuity and Astigmatism after Simultaneous Surgery for Upper and Lower Eyelid Epiblepharon in Children

PURPOSE: To study the changes in vision and astigmatism in epiblepharon patients undergoing simultaneous surgery for both upper and lower eyelid epiblepharon. METHODS: The study subjects consisted of 40 eyes of 20 patients who underwent surgery for both upper and lower eyelid epiblepharon from March 2007 to December 2008. The patients were divided into groups depending on the degree of corneal erosion. Uncorrected and best corrected vision, refractive error and the degree of corneal erosion were measured before and three months after the surgery. RESULTS: The mean patient age was 7.40 years, and all but three patients showed postoperative grade 0 corneal erosion. Mean uncorrected logMAR visual acuity was 0.44 preoperatively and 0.25 three months after the operation. The mean best corrected logMAR visual acuity was 0.13 preoperatively and 0.04 three months after the operation (p = 0.02, 0.01). Mean astigmatism showed a significant decrease from 1.46 preoperatively to 1.19 three months after surgery (p = 0.03). CONCLUSIONS: After simultaneous surgery for upper and lower eyelid epiblepharon in children, uncorrected and best corrected visual acuity and corneal erosion were all improved. The astigmatism was largely with-the-rule, both before and after surgery.