Hip-implant related chorio-retinal cobalt toxicity.

A 39-year-old female with elevated serum cobalt levels from her bilateral hip prostheses presented with a 3-week history of blurred vision in her left eye. Optical coherence tomography revealed patchy degeneration of the photoreceptor-retinal pigment epithelium (RPE) complex. The lesions were hypofluorescent on indocyanine green angiography. We postulate that this is a case of implant-related chorio-retinal cobalt toxicity.

Indocyanine green dye enhanced laser photocoagulation for juxtafoveal choroidal neovascularisation.

PURPOSE: To evaluate the initial results of pilot study of indocyanine green dye enhanced laser photocoagulation for juxtafoveal choroidal neovascularisation (CNV). MATERIALS AND METHODS: The study was conducted on eleven eyes of 11 patients of CNV during the period 2001 and 2002. Two to three minutes after the injection of 5 ml of 25 mgm of indocyanine green (ICG) dye, 810 nm diode laser was used to treat the choroidal neovascular lesions. RESULTS: The age of the patients ranged from 45 to 80 years. All patients completed 12 months of follow-up. Eight eyes (72.7%) had neovascular age related macular degeneration, 2 eyes (18.2%) had myopic CNV and one eye (9.09%) had CNV secondary to angioid streak. The presenting visual acuity was <or=6/60 in seven, 6/36 in one and >or=6/12 in three patients. The final visual acuity at the end of at least 12 months follow-up was 6/12 or better in one eye (9%); 6/18-6/36 in 3 eyes (27.27%) and <or=6/60 in 7 eyes (63.64%). In four patients the vision improved whereas it worsened or remained same in 7 eyes. CONCLUSION: ICG dye enhanced diode laser photocoagulation appears to be a potential option for juxtafoveal CNV.

Visual outcome and electron microscopic features of indocyanine green-assisted internal limiting membrane peeling from macular hole of various aetiologies.

PURPOSE: To describe the visual outcome of internal limiting membrane (ILM) peeling for macular hole of various aetiologies and ultrastructural features of the ILM. MATERIALS AND METHODS: The study was conducted on 40 eyes of 38 patients. Thirty eyes with full thickness macular hole were treated with vitrectomy and removal of ILM. Ten eyes with retinal detachment served as negative controls and these patients underwent vitrectomy and ILM removal. The surgical specimens were examined by transmission electron microscopy. RESULTS: The anatomical success rate of the first operation was 90% in idiopathic and myopic groups, whereas it was 100% in traumatic macular hole group. Visual improvement of (3) two lines was noted in 80% of the cases. Electron microscopy revealed the presence of ILM in all surgical specimens. Proliferation of astrocytes and synthesis of new collagen along the inner surface of ILM was noted in the surgical specimens. CONCLUSION: Our findings suggest that the ILM removal helps in closure of the macular hole and retinal reattachment. Vitrectomy with ILM peeling is a reasonable surgical approach to treat macular holes of idiopathic, myopic and traumatic aetiology.

Role of photodynamic therapy in polypoidal choroidal vasculopathy.

PURPOSE: To evaluate photodynamic Therapy (PDT) with Verteporfin for polypoidal choroidal vasculopathy (PCV) involving the fovea in Indian eyes, through a retrospective interventional case series. MATERIALS AND METHODS: We retrospectively reviewed the records of 9 patients (9 eyes) diagnosed to have PCV with foveal involvement between September 2001 and October 2002. RESULTS: Nine eyes underwent PDT for PCV. Follow-up ranged from 12 to 16 months. Initial visual acuity (VA) ranged from 1/60 to 6/12 and final VA varied from 1/60 to 6/9 at the end of follow-up. VA improved in 4/9 eyes (44.4%) by one line and remained unchanged in 5/9 eyes (55.6%), hence it was considered stabilized in all eyes. No adverse effects or events were observed during or after treatment with verteporfin. CONCLUSION: PDT may be beneficial for PCV with foveal involvement. Its long-term efficacy requires to be evaluated.

The indocyanine green findings in idiopathic uveal effusion syndrome.

We report two cases clinically diagnosed as idiopathic uveal effusion syndrome, where indocyanine green angiogram suggest non-specific choroidal inflammation as the underlying cause. Treatment with non-steroidal anti-inflammatory drugs was beneficial.

Indocyanine green enhanced maculorhexis in macular hole surgery.

PURPOSE: To demonstrate the usefulness of staining the internal limiting membrane (ILM) with a solution of indocyanine green (ICG) to facilitate the removal of ILM in eyes with idiopathic macular hole. METHODS: Eighteen patients underwent vitrectomy with the removal of posterior cortical vitreous, induction of posterior vitreous detachment (PVD), ICG-enhanced removal of the macular ILM, and fluid-gas exchange, followed by facedown positioning. RESULTS: Fifteen (83.33%) of the macular holes were closed at 3 months postoperatively. The visual outcome was relatively better in holes smaller than 400 microns in diameter, as compared to bigger macular holes (more than 400 microns in diameter). Of the 18 eyes, 9 (50%) recorded visual improvement of 2 or more lines over the preoperative level. CONCLUSION: Our results show the safety and usefulness of this technique in visualization of the ILM during macular hole surgery, thereby leading to successful removal of optimal amount of ILM, with minimum damage to the retina.