Photodynamic Therapy and Focal Laser Photocoagulation in Chronic Central Serous Chorioretinopathy

PURPOSE: The aim of this study was to compare the treatment efficacy of photodynamic therapy (PDT) and focal laser photocoagulation in chronic central serous chorio retinopathy (CSC). METHODS: A retrospective study in a clinical practice setting including 40 eyes of 40 patients with chronic CSC which were treated with PDT or focal laser photocoagulation were recruited in this study from March 2011 to December 2013. Mean change in best corrected visual acuity (BCVA), presence or absence of resolution of subretinal fluid (SRF) and pigment epithelial detachment (PED), recurrence rate, and complications were analyzed. RESULTS: PDT was performed in 23 eyes of 23 patients and focal laser photocoagulation was performed in 17 eyes of 17 patients, and all patients were followed up for more than six months. Location of leakage point and appearance of leakage showed no statistically significant difference between the two groups. Both groups showed significant improvement in BCVA at one month and six months after the treatment; however, there was no statistically significant difference in BCVA improvement between the two groups. In both groups, SRF and PED were partially or completely resolved. Resolution of SRF was better in the PDT group at one month after the treatment; however, no statistically significant difference in the resolution period was observed between the two groups. None of the patients experienced adverse events in the PDT group, but one patient developed choroidal neovascularization after treatment in the focal laser photocoagulation group. Two patients showed recurrence in the PDT group and needed retreatment. CONCLUSIONS: Both treatments are beneficial in patients with chronic CSC. Focal laser photocoagulation can be a good treatment option in terms of cost-effectiveness and convenience.

Centeral Retinal Artery Occlusion after Viterctomy with Gas Tamponade for Retinal Detachment: A Case Report / 계명의대학술지

To introduce a case of Centeral Retinal Artery Occlusion in Gas Tamponade State after Viterctomy for the treatment of Retinal Detachment. A 47-year-old male patient with histories of LASEK surgery 15 years ago and cataract surgery 8 years ago visited our clinic with complaints of sudden visual disturbance in his right eye. He was diagnosed as regmatgenous retinal detachment and underwent pars plana vitrectomy, endolaser photocoagulation, 14% C3F8 gas tamponade, and subtenon triamcinolone injection. After the surgery, the retina was well attached and the visual acuity was improved from finger count 30cm at post-operative day 1 to 0.08 after the 2 weeks of surgery. Intraocular pressure was maintained 20~25 mmHg by Brimonidine/timolol eye drop treatment. The best corrected visual acuity was reduced to hand motion at post-operative day 15. Retinal arteriol attenuation and pale optic disc with 1/3 gas filled vitreous cavity was identified at post-operative day 30. Post-operative 2 years, visual acuity was non light perception with severe narrowing of arteriole and diffuse retinal pigment epithelial atrophy; no retinal vascular flow was observed on fluorescein angiography. Gas tamponade state after viterctomy for the treatment of retinal detachment at high myopia may be risk factors of central retinal artery occlusion.

Comparison of Surgical Outcomes in Patients with Small Refractive Error and Intermittent Exotropia

PURPOSE: To identify differences in the refractive error of postoperative intermittent exotropia patients. METHODS: A total of 71 patients who had an average refractive error of 2 D and a follow-up of more than 6 months after unilateral recession-resection (R&R) for intermittent exotropia were included in this study. Patients were divided into 3 groups according to their refractive error: Group 1, or =+1.0 D. The amounts of deviation 1 day after surgery and 6 months after surgery were evaluated. RESULTS: Out of the 71 total patients included in this study, group 1 included 20 patients, group 2 included 39, and group 3 included 12. The average refractive error in groups 1, 2, and 3 was -2.2 +/- 0.9 D, 0.0 +/- 0.4 D and +1.9 +/- 0.9 D, respectively. The angle of deviation 1 day after surgery was measured in the 3 groups; A result labeled '+' was considered to be exodeviation and a result labeled '-' was considered to be esodeviation. The angle of deviation results for groups 1, 2, and 3 one day after surgery were -6.7 +/- 6.0 PD, -7.5 +/- 5.8 PD and -7.3 +/- 5.9 PD (p = 0.937), respectively, and the results 6 months after surgery were +2.2 +/- 4.3 PD, +4.7 +/- 5.9 PD and +1.8 +/- 2.8 PD (p = 0.076), respectively. Among the 3 groups, no statistically significant difference was observed in postoperative angle of deviation after 6 months. CONCLUSIONS: In basic intermittent exotropia patients with an average refractive error of 2 D, the amount of refractive error makes no difference in strabismus surgical outcomes.