Posterior subtenon injection of tricinalone acetonide for cystoids diabetic macular edema

To assess the efficacy and safety of posterior subtenon triamcinolone acetonide injection for the treatment of diabetic cystoids macular edema. This prospective, randomized comparative trial included diabetic patients with cystoids macular edema involving 79 eyes. Forty one eyes were randomly given posterior subtenon triamcinolone acetonide injection while the remaining 38 eyes served as a control group. The eligibility criteria for this study included patients with clinically and angiographically detectable cystoids macular edema during the past six months, glycosylated hemomglobin not more than 8.5% and history of previous laser treatment not earlier than three months. All eyes of posterior subtenon triamcinolone acetonide injection group received 40 mg of triamcinalone acetonide through a superotemporal approach in the outpatient clinic. After injection, the visual and anatomical responses were observed at weeks 1, 3, 6, 8, 12, 16, 20 and 24. Intraocular pressure, incidence or reinjection and complications were also noted. At one week after injection, all injected eyes showed significant visual acuity improvement form baseline measurements [p<0.001] and 88% of them showed clinical serous macular edema regression. The most significant improvement in logarithm of the minimum angle of resolution visual acuity was noted at month two post injection. During the next four months a gradual increase in logarithm of the minimum angle of resolution acuity was noted. Comparison between the two groups, showed significant difference of mean study visits. After injection, recurrence of cystoids macular edema was noted in nine eyes [22%] at a mean time of 5.25 +/- 0.71 months. Two eyes [4.9%] developed rise of intraocular pressure [>20mmHg] at the first week post injection and were treated with antiglaucoma drugs for a mean time of 5.5 +/- 1.41 months. Another two eyes had localized subconjunctival hemorrhage at the site of injection. Posterior subtenon triamcinolone acetonide injection of 40 mg triamcinolone acetonide through a superotemporal approach appears to be safe and effective for short-term management of diabetic cystoid macular edema

case of Von Hippel-Lindau disease with exudative maculopathy

Von Hippel-Lindau [VHL] disease is a rare multisystem familial tumor syndrome of autosomal dominant inheritance. Hallmark lesions include retinal, cerebellum and spinal cord hemangioblastomas, renal cell carcinomas, adrenal pheochromocytomas, angiomatous or cystic lesions of the kidneys, pancreas, and epididymis. We report a case of VHL disease in a 26-year-old patient who presented with exudative macular edema. Ocular and systemic studies revealed the presence of retinal and central nervous system hemangioblastomas, adrenal pheochromocytoma, multiple pancreatic, and kidney cysts. The retinal angiomas were successfully treated with argon laser photocoagulation and cryotherapy

Diclofenac sodium for the treatment of ocular contusion with microhyphema

In this study, the effectiveness of topical diclofenac sodium has been investigated in the treatment of microhyphema. A total of 62 patients with traumatic microhyphema were enrolled in a prospective, randomized, double-masked, placebo-controlled clinical study. Of these, 32 were given diclofenac eye drops, while 30 received a placebo. All were observed daily until there was complete recovery. One drop of diclofenac sodium or a placebo was applied four times a day. The efficacy evaluation was based on the measurement of visual acuity, slit-lamp assessment of anterior chamber cells and flare and duration of treatment. Diclofenac sodium was statistically favored over the placebo in flare and cell score. The duration of treatment of the diclofenac group was significantly shorter than the placebo group. Visual acuity of diclofenac sodium recipients was significantly better than the placebo recipients from the third to the sixth day of treatment. No statistical difference in final visual acuity was found between the two groups [P>0.05]. The research indicated that diclofenac sodium reduces microhyphema effectively and more quickly than the placebo, leading to early rehabilitation of patients following ocular contusion