Vitreous hyper-reflective dots in pseudophakic cystoid macular edema assessed with optical coherence tomography.

PURPOSE: This study compares the presence of vitreous hyper-reflective dots (VHDs) detected with optical coherence tomography (OCT) between eyes with pseudophakic cystoid macular edema (CME) and those with no CME after cataract surgery. In addition, we evaluated the impact of VHDs on the responsiveness of pseudophakic CME to cortisone treatment. SETTING: Department of Ophthalmology, Medical University of Graz, Austria. DESIGN: Retrospective, monocenter case-controlled study. METHODS: Inclusion criteria for the study group and the control group were CME and no CME within 12 weeks following uneventful phacoemulsification in otherwise healthy eyes, respectively. VHDs (number and size) and the macular thickness were assessed with OCT. Furthermore, the number of peribulbar or intravitreal steroid injections was assessed. RESULTS: A total of 284 eyes from 267 patients were analyzed, among which 119 met the inclusion criteria for the study (n = 63) and the control group (n = 56). VHDs were observed in 54 (85.7%) study eyes and 21 (37.5%, p = 0.013) control eyes. The number of VHDs was 3.9±3.4 in the study group and 0.7±1 in the control group (p<0.001). The size of the VHDs was 33.5±9.1 µm and 36.6±17.9 µm in the study and control groups, respectively (p = 0.978). Overall, the number of VHDs correlated with central subfield thickness (r = 0.584, p<0.001), cube volume (r = 0.525, p<0.001), and postoperative best-corrected visual acuity (BCVA) (r = -0.563, p<0.001). The number of VHDs did not correlate with the frequency of peribulbar or intravitreal steroid injections. CONCLUSION: VHDs occurred more often in eyes with CME than in eyes without CME following cataract surgery. In addition, the number of VHDs had an impact on the extent of macular thickening and subsequently postoperative BCVA. No correlation was found between the number of VHDs and the frequency of required peribulbar or intravitreal steroid injections.

Ocular trauma scores in paediatric open globe injuries.

BACKGROUND/AIMS: To assess the predictive value and the applicability of Ocular Trauma Score (OTS) for paediatric injuries. METHODS: Retrospective case series of 71 open globe injuries in children less than 18 years of age with a minimum follow-up period of 1 year. The variables of the OTS, the Paediatric Penetrating OTS (POTS), lens injuries and anterior versus posterior segment injuries were analysed for their predictive values in terms of visual outcome. The applicability and the predictive values of OTS and POTS as a whole were then evaluated. RESULTS: Initial visual acuities, retinal detachments, wound locations (p<0.001 each), lens injuries (p=0.001), posterior segment injuries (p=0.002), traumatic cataracts (p=0.010), hyphaema (p=0.011) and vitreous haemorrhages (p=0.026) had significant impacts on visual outcome. The application of OTS proved difficult, as the presence of a mild degree of a relative afferent pupillary defect (RAPD) could not accurately be evaluated in all of our patients. Calculating the OTS without evaluation of RAPD renders it easily applicable for the initial examinations while remaining significantly prognostic (p<0.001). The predictions of the POTS correlated with the actual final visual acuities (p<0.001), but several POTS variables (ie, iris prolapse, age, organic injuries and delay of surgery >48 h) had only limited impacts on visual outcome. CONCLUSIONS: The OTS has a high predictive value for visual outcome after open globe injuries in children, even without evaluation of RAPD.