Retinoblastoma in the Presence of Persistent Fetal Vasculature.

Purpose: This work aims to report the challenging diagnosis, treatment, and follow-up of a patient with persistent fetal vasculature (PFV) and retinoblastoma (RB). Methods: A 22-month-old boy presented with unilateral RB stage VB in the right eye and PFV in both eyes. The patient was treated with transpupillary laser ablation and systemic chemotherapy. Results: Treatment resulted in complete tumor regression. Two years after the last systemic chemotherapy treatment, magnetic resonance imaging (MRI) showed increased signal intensity with progressive optic nerve enhancement, where intraneural malignancy could not be excluded. Enucleation of the right eye was performed. Histopathologic review showed no residual active malignancy in the enucleated globe. Conclusions: This case demonstrates the importance of a thorough clinical examination to establish the correct diagnosis and to rule out RB before any surgery. This case also highlights the importance of regular follow-ups after tumor regression with full a ophthalmologic examination, B-scan, and periodic MRI.

Case Series: Small Full-thickness Macular Hole Treated with Topical Dorzolamide and Bevacizumab Intravitreal Injections.

SIGNIFICANCE: This article reports two cases reported of combined treatment with topical dorzolamide and intravitreal bevacizumab injections, successfully treating small full-thickness macular hole without the need for traditional macular hole surgery. PURPOSE: This study aimed to report the potential effectiveness of combination treatment with topical dorzolamide and bevacizumab intravitreal injection therapy for small macular holes. CASE REPORTS: Case 1 was a 68-year-old woman presented with distorted and decreased vision in her right eye for 9 months. Fundus examination showed a full-thickness macular hole, which was confirmed with spectral domain optical coherence tomography measuring 96 µm. Treatment with topical dorzolamide and intravitreal bevacizumab 1.25 mg/0.05 mL injections was initiated. Spectral domain optical coherence tomography showed gradual improvement of the full-thickness macular hole with complete hole closure and visual improvement in just 1 month. Case 2 was a 73-year-old woman who presented with distorted and decreased vision in her right eye for 8 months. Fundus examination showed a full-thickness macular hole in the right eye, confirmed with spectral domain optical coherence tomography, measuring 76 µm. Treatment with topical dorzolamide and intravitreal bevacizumab 1.25 mg/0.05 mL injections was initiated. Spectral domain optical coherence tomography showed gradual improvement of the full-thickness macular hole with complete closure at 2 months and improvement in visual acuity. CONCLUSIONS: The combination of topical dorzolamide and bevacizumab intravitreal injection is a reasonable consideration for small macular holes with vascular components before considering surgery. Both cases had early macular closure in less than 3 months.

Anti-VEGF treatment switch in neovascular age-related macular degeneration: a comparison of aflibercept versus ranibizumab after a single-dose switch.

PURPOSE: To determine the effect achieved from a single dose of anti-VEGF treatment switch, in patients with nAMD previously treated with bevacizumab, switched to either aflibercept or ranibizumab, and to compare the response between aflibercept and ranibizumab. METHODS: In retrospective, observational, and comparative study, patients were divided into two groups: Group 1, patients switched to aflibercept; Group 2, patients switched to ranibizumab. Paired samples t test was performed to measure differences in central macular thickness (CMT). To compare whether there were differences between groups mixed-design ANOVA was used. RESULTS: In Group 1, CMT changed from 360.51 to 260.16 µm, presenting a significant mean difference from PreSwitch to PostSwitch of 100.34 µm (p = 0.002, paired samples t test). In Group 2, CMT changed from 366.33 to 260.72 µm, showing a significant difference from PreSwitch to PostSwitch of 105.61 µm (p ≤ 0.000, paired samples t test). The mixed-design ANOVA compared both groups and resulted in a nonsignificant value of 0.90. CONCLUSION: The effect achieved from a single dose in patients switched to aflibercept or ranibizumab reduced significantly CMT measurements. Comparing aflibercept and ranibizumab, the effect appears to be similar in both drugs, in terms of reduction of CMT.