[Visual outcomes of 4 therapeutic approaches for central retinal vein occlusion]

To compare the visual outcomes of four different therapeutic modalities for central retinal vein occlusion [CRVO] with each other and with the natural course of the disease. This study was conducted on 63 eyes of 63 patients including 13 eyes in the radial optic neurotomy [RON] group, 10 eyes in the combined RON and intraocular triamcinolone injection [RON/IOT] group, 12 eyes in the combined internal limiting membrane peeling, RON and IOT [ILMP/RON/IOT] group, 14 eyes in the intravitreal triamcinolone injection [IVT] group and 14 untreated control eyes. All patients were followed for six months. Final best-corrected visual acuity [BCVA] was better in the IVT group as compared to the RON [P=0.037], RON/IOT [P=0.401], ILMP/RON/IOT [P=0.023] and control [P=0.025] groups. However, after adjusting final BCVA for baseline BCVA, only the RON/IOT group showed significant visual improvement after 1 [P= 0.025], 3 [P= 0.023] and 6 [P= 0.054] months as compared to controls. Among the four different approaches evaluated in this study, RON/IOT may entail better visual outcomes in the management of CRVO within six months

Radial Optic Neurotomy with and without Intravitreal Triamcinolone Injection in Central Retinal Vein Occlusion

To evaluate the efficacy of radial optic neurotomy [RON] combined with or without intravitreal triamcinolone acetonid [IVTA] injection in the management of central retinal vein occlusion [CRVO].This non-randomized clinical trial was conducted on 23 patients with CRVO, who underwent RON with or without IVTA injection. Preoperative and postoperative best corrected visual acuity were converted to LogMAR and time to plateau of best corrected visual acuity were evaluated over a 12 months period. The patients included 16 male and 7 female subjects with mean age of 56 +/- 16.8 year [25-72 years]. Mean visual acuity was 1.42 +/- 0.43 LogMAR [20/600] preoperatively, which improved to 1.1 +/- 0.14 LogMAR [20/250] postoperatively. [P< 0.05] At one year, mean visual acuity was 1.56 +/- 0.63 LogMAR in the non-IVTA group and 1.09 +/- 0.37 LogMAR in the IVTA group [P= 0.04]. Vision improved by 3 or more lines in 14 eyes [60.9%]. Overall eyes with combined RON and IVTA injection had better postoperative visual acuity, although it was not statistically significant. Time to plateau of best-corrected visual acuity in eyes that underwent RON combined with 1VTA injection was significantly shorter. The combination of RON and IVTA injection may enhance therapeutic success and cause faster visual rehabilitation than RON alone

[Diagnosis of bacterial endophthalmitis by nested-PCR in comparison with routin microbiological culture]

To ascertain whether the use of nested-PCR [nested polymerase chain reation] technique leads to more rapid and accurate diagnosis of bacterial endophthalmitis. The aqueous humor and vitreous samples of 24 eyes of 24 patients with bacterial endophthalmitis were evaluated by microscopy, diagnostic aerobic culture, and Nested-PCR to detect the infectious agent. Aerobic cultures of the aqueous humor and the vitreous were positive in 1 eye [4%] and 6 eyes [25%], respectively. Using Nested-PCR, an infectious agent was detected in the aqueous humor of 14 eyes [58%] and in the vitreous of 17 eyes [70%]. Nested-PCR for eubacterial genome showed 100% correlation with bacteriologically positive specimens. Eubacterial genome was detected in 11 of 18 bacteriologically negative cultures of the vitreous. Nested-PCR on aqueous humor and vitreous samples is a powerful and reliable tool for the diagnosis of bacterial endophthalmitis particularly in smear and culture negative specimens

[Effect of oral prednisolone on visual outcomes and complications after scleral buckling]

To evaluate the effect of oral prednisolone on visual outcome and complications of scleral buckling [SB] in patients with rhegmatogenous retinal detachment [RRD]. In a randomized double-blind placebo-controlled trial, patients with acute RRD who underwent SB were randomly divided into two groups. Oral prednisolone was administered for the treatment group and placebo for the control group. The two groups were compared for visual acuity [VA] , retinal detachment [RD], cystoid macular edema [CME], and proliferative vitreoretinopathy [PVR]. The trial was performed on 25 patients in the treatment group and 27 patients in the placebo group. Mean preoperative VA [LogMAR] was 1.46 +/- 0.81 overall, including 0.85 +/- 0.62 in location were equal in both group. [P=0.45] Significant PVR was seen in one eye in the treatment group and 3 eyes in the placebo group. [P=0.39]. Postoperative oral prednisolone does not seem to affect visual outcomes and complications of scleral buckling in phakic patients

[Transvitreal optic neurotomy: a new treatment option for centra1 retinal vein occlusion]

Central retinal vein occlusion [CRVO] occurs at the scleral outlet where the optic nerve, central retinal artery, and central retinal vein enter the eye; therefore it may be considered a "compartment syndrome" which is defined as a neurovascular compression within this confined space of scleral outlet resulting in tissue ischemia and dysfunction. Transvitreal optic neurotomy [TON] is a new surgical technique advocated for treatment of CRVO. By this procedure and providing surgical relaxation of the scleral outlet, clearing of macular edema and interaretinal hemorrhage and improved retinal blood flow may reestablish. TON may be a beneficial surgical procedure for patients with sever CRVO via decompressing the scleral outlet and by that affecting the optic nerve and the blood supply. In addition to scleral ring relaxation, other postulated mechanisms of effect in TON include development of opticociliary vessels and increased perfusion into pre-existing opticociliary vessels. Preliminary results of TON for CRVO have demonstrated encouraging results; however these results need to be reconfirmed in a randomized clinical trial