Bilateral Myelinated Retinal Nerve Fibers Associated With Bilateral Vitreous Cysts and Solitary Vasoproliferative Tumor: A New Syndrome.

The authors report a case of a 57-year-old male with high myopia, extensive bilateral myelination of the retinal nerve fiber layer, bilateral vitreous cysts, and a solitary vasoproliferative tumor in the right eye. He underwent pars plana vitrectomy and multiple transpupillary thermotherapy treatments for recurrent vitreous hemorrhages and subretinal exudation from the vasoproliferative tumor. To the authors' knowledge, this is the first description of this constellation of findings and suggests this represents a new syndrome. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:356-359.].

Optical Coherence Tomography Angiography Findings in Coats' Disease.

BACKGROUND AND OBJECTIVE: To describe optical coherence tomography angiography (OCTA) findings in patients with unilateral Coats' disease. PATIENTS AND METHODS: Retrospective, observational case series of four patients with unilateral Coats' disease who underwent bilateral OCTA imaging. RESULTS: Bilateral macular OCTA findings of eight eyes are described. An abnormal foveal avascular zone (FAZ) with inner retinal vessels traversing the avascular zone in the superficial capillary plexus was visible on OCTA in the affected eye of all four patients. A similarly abnormal FAZ was noted on OCTA in the clinically normal fellow eye in two of the four patients (50%). CONCLUSION: OCTA may demonstrate an abnormal foveal avascular zone in both the affected eye and the clinically unaffected fellow eye, suggesting widespread pathology of the retinal vasculature in Coats' disease. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:632-635.].

Subconjunctival Bevacizumab for the Treatment of Keratoprosthesis-Associated Cystoid Macular Edema.

The authors present a case of keratoprosthesis-associated cystoid macular edema (CME) responsive to subconjunctival bevacizumab (Avastin; Genentech, South San Francisco, CA). A 40-year-old woman with a history of Stevens-Johnson syndrome (SJS) and Boston keratoprosthesis type I implantation developed CME 10 months after surgery and received sub-Tenon's kenalog with minimal improvement. Sixteen months after surgery, she received a subconjunctival injection of bevacizumab and demonstrated visual and anatomic improvement. Ten weeks later, she received a second subconjunctival injection of bevacizumab for worsening CME and again demonstrated a favorable response. Subconjunctival bevacizumab may be an effective and less-invasive alternative to intravitreal injections for the treatment of postoperative CME.

CHARACTERIZING THE EFFECT OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY ON TREATMENT-NAIVE CHOROIDAL NEOVASCULARIZATION USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

PURPOSE: To use optical coherence tomography angiography (OCTA) to characterize the effects of anti-VEGF injections on treatment-naive choroidal neovascularization (CNV). METHODS: From August 2014 to May 2015, treatment-naive eyes with CNV were scanned using a prototype OCTA system on a commercially available SD-OCT device (Optovue Inc, Fremont, CA). Optical coherence tomography angiography scans were obtained before anti-VEGF injection and at follow-up visits. The CNV area and greatest linear dimension (GLD) were measured along with the maximum retinal pigment epithelial detachment (RPED) height. Changes in subretinal and/or intraretinal fluid were also assessed. RESULTS: Six eyes of six patients with treatment-naive CNV were included. Diagnoses included neovascular age-related macular degeneration, idiopathic polypoidal choroidal vasculopathy, CNV secondary to central serous chorioretinopathy and multifocal choroiditis, and macular telangiectasia Type 2 with subretinal neovascularization. After treatment, all patients with fluid on OCT initially showed a decrease in the amount of fluid. Five of six patients demonstrated decreases in CNV GLD and area with an average reduction of 23.6% and 29.8% respectively. CONCLUSION: Both CNV greatest linear dimension and area measured using OCTA decreased after anti-VEGF treatment in most patients. Optical coherence tomography angiography may be a useful tool for monitoring and quantifying the response of CNV to treatment.

Spectral-domain optical coherence tomography of sympathetic ophthalmia with Dalen-Fuchs nodules.

The authors present a case of sympathetic ophthalmia with Dalen-Fuchs nodules visualized with spectral-domain optical coherence tomography (SD-OCT). An 84-year-old man presented with floaters and decreased vision 25 years after penetrating trauma to the fellow eye. Examination revealed vitritis and subretinal lesions consistent with Dalen-Fuchs nodules. He was diagnosed with sympathetic ophthalmia after a negative systemic work-up. SD-OCT revealed hyper-reflective lesions at the level of the retinal pigment epithelium with disruption of the inner segment/outer segment (IS/OS) junction. Treatment resulted in clinical improvement and disappearance of Dalen-Fuchs nodules on SD-OCT; however, photoreceptor and retinal pigment epithelial disruptions persisted 5 months after treatment was initiated.