Vitrectomy for posterior segment intraocular foreign bodies, visual and anatomical outcomes

To evaluate the visual and anatomic results and determine the prognostic factors after pars plana vitrectomy and posterior segment intraocular foreign body [IOFB] removal. This retrospective study reviews the patients' charts of 48 consecutive patients with posterior segment IOFB who underwent pars plana vitrectomy and IOFB removal over a 4-year period, recently. Association between visual outcome and various preoperative, operative, and postoperative variables was statistically analyzed. Data were analyzed with the paired t-test and the chi square test. Statistical significance was indicated by P < 0.05. The mean interval between the time of injury and IOFB removal was 24 +/- 43.1 days and 27 [53%] eyes underwent IOFB removal within 7 days of the injury. Nine [19.1%] patients achieved a visual acuity of 20/40 or better. An improvement of visual acuity of at least three lines occurred in 21 [44.6%] eyes and the vision remained unchanged in 15 [31.9%] eyes. Postoperative retinal detachment occurred in five [10.6%] eyes. Visual improvement was more likely to occur in eyes with lower levels of presenting visual acuity [P = 0.2]. Visual improvement was not associated with an entry site and IOFB location, lens injury, time to surgery, and pre- and post-operative retinal detachment. At the end of follow up, anatomical success was achieved in 97.9% of eyes. High anatomical success could be achieved after the removal of posterior segment IOFBs by vitrectomy, despite a delay in surgery. Poor visual outcome may be mainly due to the initial ocular injury

Intravitreal bevacizumab for pseudophakic cystoid macular edema; a systematic review

Cystoid macular edema [CME] is a major cause of decreased vision after complicated or uncomplicated cataract surgery. This paper reviews the use of intravitreal bevacizumab [IVB] injection for treatment of pseudophakic CME. In a literature search of all articles available on Medline and Scopus databases, 11 studies including one prospective and 4 retrospective studies, 4 case reports, one letter to editor and one review article were identified. All articles except one, reported the use of IVB for chronic CME unresponsive to at least one conventional treatment modality. The level of evidence for all studies was categorized as low or very low. Although intravitreal bevacizumab might be effective for many cases of pseudophakic CME, its use should be reserved for eyes unresponsive to conventional treatment modalities.

Correlation between retinal nerve fiber layer thickness by optical coherence tomography and perimetric parameters in optic atrophy

To investigate the correlation between retinal nerve fiber layer [RNFL] thickness determined by optical coherence tomography [OCT] and visual field [VF] parameters in patients with optic atrophy. This study was performed on 35 eyes of 28 patients with optic atrophy. RNFL thickness was measured by OCT [Carl Zeiss, Jena, Germany] and automated perimetry was performed using the Humphrey Field Analyzer [Carl Zeiss, Jena, Germany]. The correlation between RNFL thickness and VF parameters was evaluated. Mean global RNFL thickness was 44.9 +/- 27.5] which was significantly correlated with mean deviation score on automated perimetry [r=0.493, P=0.003]; however, no significant correlation was observed between visual field pattern standard deviation and the corresponding quadrantic RNFL thickness. In a similar manner, no significant association was found between visual acuity and RNLF thickness. Mean global RNFL thickness as determined by OCT seems to be correlated with VF defect depth as represented by the mean deviation score on Humphrey VF testing. OCT may be used as an objective diagnostic tool in the evaluation of patients with optic atrophy

Two different doses of intravitreal bevacizumab for treatment of choroidal neovascularization associated with age-related macular degeneration

To compare the efficacy and safety of 1.25 mg versus 2.5 mg intravitreal bevacizumab [IVB] for treatment of choroidal neovascularization [CNV] associated with age-related macular degeneration [AMD]. In this randomized clinical trial, consecutive patients with active CNV associated with AMD received 1.25 mg or 2.5 mg IVB. Best corrected visual acuity [BCVA], foveal thickness and side effects of therapy were evaluated one and three months after intervention. Overall 86 subjects were enrolled and completed the scheduled follow-up. Forty seven and 39 patients received 1.25 and 2.5 mg IVB respectively. The study groups were balanced in terms of baseline characteristics such as age, BCVA and foveal thickness. Mean improvement in BCVA was 0.06 +/- 0.3 logMAR in the 1.25 mg group and 0.07 +/- 0.34 logMAR in the 2.5 mg group [P=0.9]. Mean decrease in foveal thickness was 49 +/- 36 micro m in the 1.25 mg group and 65 +/- 31micro m in the 2.5 mg group [P=0.6]. Three cases of vitreous reaction and one case of massive subretinal hemorrhage were observed in the 2.5 mg group. Double dose [2.5 mg] IVB does not seem to be more effective than regular dose [1.25 mg] injections for treatment of CNV due to AMD and may lead to more complications