Therapeutic Effect of Diode Laser Photodynamic Therapy with ICG Dye in ARMD: A Case Report

PURPOSE: To evaluate the diode laser photodynamic therapy efficacy on choroidal neovascularization (CNV) in the treatment of three patients with age-related macular degeneration (ARMD). METHODS: The authors selected three patients with ARMD whose vision has decreased due to CNV, and applied diode laser treatment after injecting an indocyanine green (ICG) solution. The patients were followed for at least three months after treatment, and examinations included evaluating vision changes and possible leakage on fluorescein angiography (FAG). RESULTS: The final vision of two patients improved by more than one line on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart after at least three months of follow-up. However, the final vision of the third patient decreased by one line on ETDRS chart. FAG was done in all patients, and in two of the patients, there was no evidence of leakage at the laser-applied site. In the other patient, there was evidence of minimal leakage, with the area of leakage decreasing by more than fifty percent. Side effects of ICG were not found during or after the photodynamic therapy sessions. CONCLUSIONS: The photodynamic usage of ICG treatment of CNV in patients with ARMD, was effective in preventing or improving the visual outcome. Compared to the widely used verteporfin, ICG is more stable and is more cost effective. The authors therefore came to a conclusion that ICG can be very useful in the treatment of CNV. However, further studies are necessary.

Comparative Analysis of Scleral Buckling With or Without Postoperative Photocoagulation

PURPOSE: For the treatment of rhegmatogenous retinal detachment, laser photocoagulation is usually combined with scleral buckling. But laser photocoagulation has high possibility of complications. So, we evaluated the effect of scleral buckling only without laser photocoagulation for the treatment of rhegmatogenous retinal detachment. METHODS: We reviewed pre- and post-operative characteristics of retinal detachment in 31 eyes who had undergone scleral buckling only (group A) and in 33 eyes who had laser photocoagulation after scleral buckling (group B). All the patients had similar preoperative findings and had been followed for 1 year or longer. RESULTS: Anatomic success rate was achieved in 83.9% in group A, 81.8% in group B after primary operation. Functional success rate was achieved in 61.3% in group A, 63.6% in group B. No complications in group A but proliferative vitreoretinopathy (3 eyes) and preretinal membrane (2 eyes) did form in group B. CONCLUSIONS: When the vitreoretinal traction is relieved by scleral buckling, we considered only scleral buckling procedure is the fairly effective procedure for retinal detachment in case of equatorial or peripheral tear and that also decrease the incidence of complication.

Wernicke-Korsakoff Syndrome Associated with Hyperemesis Gravidarum

PURPOSE: The authors hereby describe a case of Wernicke-Korsakoff syndrome with accompanying ocular findings that is caused by hyperernesis gravidarum. METHODS: We experienced a 27-year-old female at 12 weeks of pregnancy, who visited our clinic because of weight loss, gait disturbance, decreased mentality and dizziness after prolonged vomiting for 2 months. Neurological examination demonstrated ataxia of gait and loss of orientation. Ophthalmologic examination showed decreased visual acuity, upbeat nystagmus, diplopia and retinal hemorrhage. RESULTS: We report a relatively rare case of Wernicke-Korsakoff syndrome with ophthalmic symptoms induced by hyperemesis gravidarum. CONCLUSIONS: If a pregnant women has symptoms of severe vomiting along with other ocular findings such as retinal hemorrhage or restricted extraocular movement, one must suspect the diagnosis of Wernicke-Korsakoff syndrome, and should start appropriate treatment immediately.