Analysis of the Changes in Retinal Thickness in Eyes Undergoing Vitrectomy with Silicone Oil Tamponade

Purpose@#To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. @*Methods@#This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. @*Results@#The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. @*Conclusions@#Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.

Analysis of the Changes in Retinal Thickness in Eyes Undergoing Vitrectomy with Silicone Oil Tamponade

Purpose@#To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. @*Methods@#This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. @*Results@#The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. @*Conclusions@#Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.

Optic Neuropathy after Taking Linezolid

PURPOSE@#We report a case of optic neuropathy in a patient who was treated with pre-extensively drug-resistant tuberculosis(pre-XDR TB) treatment with linezolid.CASE SUMMARY: A 61-year-old male patient with no other underlying disease was diagnosed with pre-XDR Tb 6 months before and took the TB drug at another hospital. Ethambolol was not prescribed because it was resistant from the beginning of TB treatment. Threrefore, linezolid was included for treatment of pre-XDR TB. The patient's best corrected visual acuity was 20/400 in both eyes at the time of outpatient visit. In Ishihara color vision test, both eyes showed complete color blindness. There was no detectable relative afferent pupillary defect, and fundus examination showed hyperemic optic discs and visual field examination showed both central visual field defects. Linezolid induced optic neuropathy was suspected, the drug was discontinued. After one month, the patient's best corrected visual acuity recovered to 20/20 in both eyes, and visual field and color vision returned to normal at 3 months.@*CONCLUSIONS@#Linezolid is a broad spectrum antibiotic and is a useful drug for the treatment of broad-spectrum tuberculosis. However, since long-term use may cause optic neuropathy, the possibility of optic neuropathy should always be considered. If optic neuropathy is suspected, prompt drug withdrawal is required and reversible clinical changes can be expected.

A Case of Spontaneous Recovery of an Iris Cyst in a Patient with Peritoneal Tuberculosis

PURPOSE: We report a case of spontaneous recovery of an iris cyst with only tuberculosis medication and conservative eye drops when uveitis and angle closure occurred because of a cyst in a patient with peritoneal tuberculosis. CASE SUMMARY: A 49-year-old female who was diagnosed with iritis and treated with steroid eye drops visited our clinic because of decreased visual acuity 1 month prior. There were anterior chamber inflammation cells and an iris cyst completely obstructing the anterior chamber at 12 o'clock. At the time, the patient had been diagnosed with peritoneal tuberculosis in the Department of Internal Medicine and Gynecology and had been treated with surgery and medication. The patient had no past history of glaucoma, but when the iris cyst developed, the intraocular pressure increased to 29 mmHg and anterior inflammatory cells were seen in the range of +1 to +2. The primary lesion of tuberculosis improved and the iris cyst disappeared with treatments involving medication for tuberculosis, steroid eye drops, and glaucoma eye drops, without invasive treatments such as alcohol curettage, laser treatment, or cyst resection. CONCLUSIONS: If an iris cyst is a new lesion of the eye, it is necessary to identify the pattern and cause of the iris cyst first, and if a secondary benign iris cyst is suspected, the primary treatment of the causative disease is necessary rather than prompt invasive treatment.

A Case of Central Serous Chorioretinopathy after Tadalafil Treatment

PURPOSE: To describe a patient who presented with central serous chorioretinopathy after 2 months of tadalafil administration without any other underlying disease or medication. CASE SUMMARY: A 49-year-old male patient was transferred from a local clinic with metamorphopsia and decreased visual acuity in the right eye. His visual acuity was 6/20 in the right eye and 18/20 in the left eye. The fundus examination showed a large serous detachment between the superior and inferior blood vessel arcades in the right retina. In his medical history, he used tadalafil three times a week for 2 months. His medication was then stopped, and a follow-up examination was scheduled. After 2 months, a fundus examination showed resolution of the subretinal fluid, and his corrected visual acuity recovered to 20/20. CONCLUSIONS: Tadalafil (Cialis®) is a phosphodiesterase (PDE)-5 inhibitor and predominantly prescribed for the treatment of erectile dysfunction. PDE–5 inhibitors may be potent vasodilators in the retina and choroid, and may induce choroidal vessel engorgement leading to leakage across the retinal pigment epithelium and accumulation of subretinal fluid in selected patients. When making a diagnosis as central serous chorioretinopathy, the physician should confirm the causative drugs that are easy to miss, by performing a thorough review of the patient's medical history and promptly terminating the causative drugs.

Optical Coherence Tomography Angiography According to Severity of Diabetic Retinopathy

PURPOSE: To evaluate the extent of macular microvascular changes in diabetic retinopathy according to progression of diabetic retinopathy using optical coherence tomography angiography (OCTA). METHODS: We retrospectively analyzed 46 diabetic patients and 10 normal patients who underwent OCTA. Diabetic patients were classified as mild, moderate, severe non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) according to international clinical diabetic retinopathy severity classification fundus findings. OCTA was performed on a 3 × 3 mm region centered on the fovea and parafoveal areas to measure the width of the fovea avascular zone (FAZ) of the superficial and deep capillary plexuses. RESULTS: Among the control group, NPDR, and PDR, the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the FAZ increased with progression of diabetic retinopathy. In the SCP (p<0.001) and DCP (p<0.001), there was a significant difference in size between the NPDR and PDR groups. In the NPDR group, there were meaningful differences in SCP (p=0.011) and DCP (p=0.038) size between the moderate and severe NPDR groups. CONCLUSIONS: In this study, OCTA was used to measure the FAZ, and we aimed to determine if there was a significant difference in FAZ between the NPDR and the PDR groups and between the moderate and severe NPDR groups in terms of the degree of progression of diabetic retinopathy. The results suggest that the size of the FAZ could be a marker of progression of diabetic retinopathy, and noninvasive OCTA can be used to confirm such progression.