Retinal Capillary Hemangioma Treated with Verteporfin Photodynamic Therapy and Intravitreal Triamcinolone Acetonide

PURPOSE: To report a case of retinal capillary hemangioma treated with verteporfin photodynamic therapy combined with intravitreal triamcinolone acetonide. METHODS: A 15-year-old female presented with metamorphopsia in the left eye for 7 days. Examination showed peripheral endophytic retinal capillary hemangioma, macular edema, and a best-corrected visual acuity of 20/50. The hemangioma and macular edema were treated with verteporfin photodynamic therapy and intravitreal triamcinolone acetonide. RESULTS: After 5 months of follow-up, involution of the hemangioma, reduction of macular edema, decrease of the feeder and draining vessel diameter, and improvement of best-corrected visual acuity to 20/25 was seen. CONCLUSIONS: This verteporfin photodynamic therapy combined with intravitreal triamcinolone acetonide appeared to cause involution of the hemangioma with reduction in macular edema and improvement in visual acuity.

Anterior Lens Capsule Abnormalities in Alport Syndrome

Alport syndrome is a hereditary, progressive disease characterized by progressive nephritis, sensorineural deafness, and ocular abnormalities, including anterior lenticonus. The ultrastructure of the lens capsule abnormalities in Alport syndrome is reported. Four anterior lens capsules from 31-year-old patient and 26-year-old patient with lenticonus who were affected by the Alport syndrome were obtained at capsulectomy. And all four anterior lens capsules were examined by transmission electron microscopy. The histopathologic findings showed that the thickness of the anterior lens capsules was decreased (4~13 micrometer) and that there were many vascular dehiscences localized at the inner part of the lens capsule. There were large numbers of capsular dehiscences containing fibrillar materials and vacuoles. The anterior capsules were clearly fragile in this disease, forming the basis for the progressive lenticonus and anterior polar cataract.

Arteriovenous Adventitial Sheathotomy for the Treatment of Macular Edema Associated with Branch Retinal Vein Occlusion

PURPOSE: To report the arteriovenous (AV) adventitial sheathotomy for the treatment of macular edema associated with branch retinal vein occlusion (BRVO). METHODS: Seven eyes of seven patients with best corrected visual acuity of less than 20/200 secondary to BRVO received pars plana vitrectomy and AV adventitial sheathotomy, and were followed postoperatively for 1, 2, and 4 months. RESULTS: Intraoperative decompression of the AV crossing was achieved in all 7 patients. All patients showed clinical improvement as determined by fundus examination, optical coherent tomography, and fluorescein angiography. Postoperative visual acuity was better in 6 of the 7 patients (86%) with an average of two lines of vision being gained. CONCLUSIONS: AV adventitial sheathotomy may be beneficial for selected patients with poor vision secondary to BRVO.