Short-term safety and efficacy of intravitreal 0.7-mg dexamethasone implants for pseudophakic cystoid macular edema

To determine the feasibility, safety, and clinical efficacy of intravitreal 0.7-mg dexamethasone implants [Ozurdex] in patients with refractory cystoid macular edema after uncomplicated cataract surgery. In this study, 11 eyes of 11 patients affected by pseudophakic cystoid macular edema refractory to medical treatment were treated with a single intravitreal injection of a dexamethasone implant. Follow-up visits involved Early Treatment Diabetic Retinopathy Study visual acuity testing, optical coherence tomography imaging, and ophthalmoscopic examination. The follow-up period was six months. The mean duration of cystoid macular edema before treatment with Ozurdex was 7.7 months [range, 6-10 months]. The baseline mean best corrected visual acuity [BCVA] was 0.58 +/- 0.17 logarithm of the minimum angle of resolution [logMAR]. The mean BCVA improved to 0.37 +/- 0.16 logMAR [p = 0.008] and 0.20 +/- 0.13 logMAR [p = 0.001] after 1 and 3 months, respectively. At the last follow-up visit [6-month follow-up], the mean BCVA was 0.21 +/- 0.15 logMAR [p = 0.002]. The mean foveal thickness at baseline [513.8 lm, range, 319-720 lm] decreased significantly [308.0 lm; range, 263-423 lm] by the end of the follow-up period [p < 0.0001]. Final foveal thickness was significantly correlated with baseline BCVA [r = 0.57, p = 0.002]. No ocular or systemic adverse events were observed. Short-term results suggest that the intravitreal dexamethasone implant is safe and well tolerated in patients with pseudophakic cystoid macular edema. Treated eyes had revealed a significant improvement in BCVA and decrease in macular thickness by optical coherence tomography

Lymphocytic leukemia presenting as acute Vogt-Koyanagi-Harada disease

Leukemia commonly involves eyes and adnexae. It is unusual, however for leukemia to present with visual complaints. There are only rare case reports of a leukemic patient presenting with bilateral exudative retinal detachment. This report describes a case of bilateral exudative retinal detachment associated with prodromal symptoms simulating the presentation of acute Vogt-Koyanagi-Harada disease that was eventually diagnosed as acute lymphocytic leukemia. There was rapid settling of the exudative detachment and improvement in vision when the patient received chemotherapy. Bilateral exudative retinal detachment associated with neurologic and auditory abnormalities may be a presenting sign of acute lymphocytic leukemia in an otherwise healthy young adult. Clinicians should be aware of the possibility of leukemia in such patients. A simple blood investigation such as complete blood profile confirms the diagnosis