Herpes zoster keratitis development after acute retinal necrosis.

PURPOSE: To report a case of herpes zoster keratitis in a patient undergoing treatment for herpetic acute retinal necrosis. METHODS: Case report. RESULTS: A 71 year old male presented with acute retinal necrosis of the left eye due to herpes zoster and was treated with intravitreal foscarnet and oral valcyclovir. He developed a retinal detachment and underwent surgical repair. After four weeks, he developed an ipsilateral herpetic zoster keratitis demonstrated by Rose-Bengal staining that was responsive to topical ganciclovir gel. CONCLUSIONS: This case report describes the unusual development of herpes zoster keratitis after the development of unilateral acute retinal necrosis (ARN) in a patient on antiviral treatment.

Prevalence of outer retinal tubulation after anti-VEGF therapy for age-related macular degeneration.

BACKGROUND AND OBJECTIVE: To assess whether there is a correlation between anti-vascular endothelial growth factor (VEGF) therapy and the incidence of outer retinal tubulation (ORT) in patients with exudative age-related macular degeneration (AMD). PATIENTS AND METHODS: A retrospective review of all patients at the Cole Eye Institute who received anti-VEGF injections for exudative AMD and underwent optical coherence tomography (OCT) evaluation was performed. A total of 543 patients were identified and included in the study. The number of treatments and the change in Snellen visual acuity from the time of diagnosis until the development of ORT were tabulated. RESULTS: Seventy individuals with ORT were identified. The data analyzed showed a wide variation in the number of treatments until the development of ORT and did not show a significant correlation between ORT incidence and decreased visual acuity. CONCLUSION: Although a correlation was found between the increased incidence of ORT and length of anti-VEGF treatment, there was no evidence of decreased visual acuity, which suggests that the ORT might be benign.

Evaluation of choroidal thickness in retinitis pigmentosa using enhanced depth imaging optical coherence tomography.

OBJECTIVE: To describe the choroidal characteristics of patients with retinitis pigmentosa (RP) using enhanced depth imaging (EDI) and spectral domain (SD) optical coherence tomography (OCT). PURPOSE: To investigate the spectral-domain ocular coherence tomography features of the choroid in patients with RP using EDI. METHODS: A prospective, case-control study of 21 patients from the Cole Eye Institute with RP imaged using the Spectralis OCT and an EDI protocol. Submacular choroidal thickness measurements were obtained beneath the fovea and at 500 µm intervals for 2.5 mm nasal and temporal to the centre of the fovea. These measurements were compared to choroidal thickness measurements from 25 healthy age-matched controls with similar refractive error range and no clinical evidence of retinal or glaucomatous disease. Statistical analysis was performed to compare choroidal thickness at each location between the two groups and to correlate choroidal thickness with best-corrected visual acuity and central retinal thickness. RESULTS: Mean ages were 40.6 years for control patients and 45.1 years for RP patients (p>0.05). Mean choroidal thickness measurements were 245.6±103 µm in RP patients and 337.8.2±109 µm in controls (p<0.0001). There was no correlation between subfoveal choroidal thickness and visual acuity or retinal thickness in the RP patients when compared to the control group. CONCLUSIONS: Submacular choroidal thickness, as measured by SD-OCT EDI, is significantly reduced in patients with RP, but did not correlate with visual acuity or retinal thickness in RP patients. Further research is needed to understand better  the pathophysiological significance of the choroidal alterations present in RP.