Complimentary imaging technologies in blunt ocular trauma

We describe complimentary imaging technologies in traumatic chorioretinal injury. Color and fundus autofluorescence [FAF] images were obtained with a non-mydriatic retinal camera. Optical coherence tomography [OCT] helped obtain detailed images of retinal structure. Microperimetry was used to evaluate the visual function. A 40-year-old man sustained blunt ocular trauma with a stone. Color fundus image showed a large chorioretinal scar in the macula. Software filters allowed detailed illustration of extensive macular fibrosis. A 58-year-old man presented with blunt force trauma with a tennis ball. Color fundus imaging showed a crescentric area of macular choroidal rupture with fibrosis. FAF imaging delineated an area of hypofluorescence greater on fundus imaging. OCT showed chorioretinal atrophy in the macula. Microperimetry delineated an absolute scotoma with no response to maximal stimuli. Fundus imaging with digital filters and FAF illustrated the full extent of chorioretinal injury, while OCT and microperimetry corroborated the structure and function correlations.

Pars plana Baerveldt tube insertion with pars plana vitrectomy for refractory glaucoma

Glaucoma drainage implants [GDIs] are used for managing recalcitrant glaucoma and are usually placed in the anterior chamber. This approach may lead to complications such as corneal decompensation, and so a pars plana approach is used in at risk eyes. Aims: To compare functional outcomes and complications of 250 mm 2 and 350 mm 2 pars plana Baerveldt tube insertion with pars plana vitrectomy [PPV] [both 20-and 23-gauge] for managing refractory glaucoma. Settings and Design: A retrospective chart review of 38 patients [39 eyes] undergoing combined PPV-Baerveldt procedure for glaucoma recalcitrant to maximal medical treatment or previous filtering procedures with>6 weeks of follow-up. Main outcome measures were visual acuity, intraocular pressure [IOP], number of glaucoma medications, and postoperative complications. Statistical Analysis Used: A paired 't' test was used to evaluate changes in IOP and glaucoma medications, Fisher's exact test was used to compare complication rates, and Kaplan-Meier survival curves were constructed for comparison of overall outcomes. Mean patient age was 62.2 years. Mean follow-up period was 33.7 months, with 36 [92%] eyes followed for>/=6 months. Mean +/- SD preoperative IOP and number of glaucoma medications were significantly reduced by the combined procedure [P<0.05]. Thirty-five [90%] eyes maintained final IOP between 6 and 21 mmHg. Vision improved by>/=2 lines in 10 [26%] eyes, remained stable in 15 [38%] eyes, and decreased in 14 [36%] eyes. Two [5.1%] eyes developed no light perception vision, with one [2.6%] eye becoming phthisical. Twenty-four [62%] eyes developed complications managed with conservative measures. Five [13%] eyes required>/=1 surgeries within a year of the combined procedure. Pars plana Baerveldt tube implantation with PPV can preserve vision, reduce IOP, and decrease the number of glaucoma medications necessary to achieve target IOP in patients with recalcitrant glaucoma