Factors predicting response of pseudophakic cystoid macular edema to topical steroids and nepafenac.

Purpose: The purpose of this study is to determine factors predicting resolution of acute pseudophakic cystoid macular edema (PCME) after 6 weeks of topical prednisolone and nepafenac application. Methods: Case records of patients with a clinical and optical coherence tomography (OCT)-based diagnosis of acute PCME were retrospectively reviewed for best-corrected visual acuity and OCT-based parameters at the time of presentation with PCME. In addition, demographic variables, intraoperative and early postoperative factors, and type of treatment prescribed (tapering vs. nontapering prednisolone, generic vs. branded prednisolone and nepafenac) were recorded from case records for analysis. Complete and any successes were defined and baseline factors predicting complete success at 6 weeks were analyzed. Results: We analyzed 69 eyes of 69 patients out of which complete success with topical medications was seen in 37 eyes (54%) and any success was seen in 55 eyes (80%) at 6 weeks. Multivariable logistic regression showed that eyes with lower vision at presentation had a significantly lower likelihood of experiencing both, complete (odds ratio [OR] = 0.83 with one-line decrement in baseline vision, 95% confidence interval [CI] = 0.61-0.89, P = 0.003) and any success (OR = 0.61, 95% CI = 0.4-0.9, P = 0.007). Baseline OCT thickness did not influence success rates. Conclusion: Topical prednisolone and nepafenac lead to resolution in PCME in half of the eyes at 6 weeks. Baseline vision is the only factor predicting rates of success and PCME resolution with topical medications.

Retained intraocular iron foreign body presenting with acute retinal necrosis.

We report an unusual case of retained metallic intraocular foreign body (IOFB) presenting with acute retinal necrosis (ARN). A healthy young man presented with signs of ARN including hypopyon, dense vitritis, and peripheral retinal necrosis following alleged history of trauma with a high-velocity projectile. After initial management of ARN with systemic antivirals, a retained metallic IOFB was identified and subsequently removed surgically. The patient was followed up for 12 months postoperatively and retained excellent vision without recurrence of the ARN. The diagnosis of an IOFB in a case with associated inflammation can be challenging. A strong clinical suspicion with proper investigations can achieve optimum results.

Retinal Vascular Occlusion Secondary to Retrobulbar Injection: Case Report and Literature Review.

Retrobulbar injection has been widely practiced as a technique of ocular anesthesia for many decades. Nevertheless, the technique is not free from complications. Vascular occlusion secondary to retrobulbar injection is rare but can be vision threatening. We report a case series of two such patients who presented with poor vision following retrobulbar injection. Fundus showed pale retina with cherry red spot suggestive of central retinal artery occlusion in case 1 and pale disc with sclerosed vessels and multiple superficial hemorrhages suggestive of a combined occlusion of retinal artery and vein in case 2. Optical coherence tomography (OCT) showed thickened inner retinal layers with intact outer retinal layers in case 1 and thinning in case 2. We conclude that retrobulbar injections can rarely be associated with dreadful vision-threatening complications like in our patients. We also report the role of OCT in assessing the prognosis following vascular occlusion.

Incidence and risk factors of retinopathy of prematurity in Western India - Report from A Regional Institute of Ophthalmology.

INTRODUCTION: Retinopathy of prematurity is an important cause of childhood blindness amongst premature babies in developing as well as developed world. OBJECTIVES: To report the incidence and risk factors of ROP from a regional institute of Ophthalmology in western India and compare it with the existing scenario. MATERIALS AND METHODS: This was prospective observational study of babies born at <34 weeks of gestational and/or <1700 grams birth weight between January 2012 and October 2013. Birth related information viz. O2 administration was recorded in consultation with a neonatologist and babies were evaluated for the presence of ROP. Multivariable logistic regression was used to identify risk factors for any-ROP and severe-ROP requiring treatment. RESULTS: Out of 280 babies screened, any-ROP was seen 54 babies(19.28%) out of which, severe-ROP was found in 28 babies(10.29%).Likelihood of developing any-ROP increased 3 fold (95%CI=1.1 - 6.5), and severe-ROP by 7 fold (95%CI=1.6 - 27.5), if oxygen therapy as administered. Older gestational age was associated with reduced likelihood of developing severe-ROP (Odds ratio=0.79, 95%CI=0.6 - 0.9) but not any-ROP. Twenty four babies (86%) with severe ROP responded well to laser or Bevacizumab therapy while 4 babies developed retinal detachment. CONCLUSION: This is the first report quoting only incidence and risk factors of ROP from western India. One in 5 babies develop any-ROP similar to that reported across rest of the country. The incidence of severe-ROP requiring treatment appears to be marginally higher, and treatment outcomes in these eyes are similar to that reported in literature.