Vitreous tamponades in highly myopic eyes.

The use of endotamponade agents has gained a major role in the management of macular complications of high myopia. Myopic foveoschisis and macular hole are the main macular complication of pathologic myopia, this growing condition that is a main cause of visual loss, especially in patients at a younger age. We discuss the physical properties and advantages and disadvantages of the main ocular tamponade agents used in the treatment of these diseases.

An ultrasound biomicroscopy study after deep sclerectomy with supraciliary implant.

OBJECTIVE: To evaluate patients 24 months after deep sclerectomy (DE) with supraciliary implant, and identify any predictive success factors by examination with ultrasound biomicroscopy (UBM) MATERIAL AND METHODS: This study included 26 eyes of 23 patients evaluated by UBM 24 months after a deep sclerectomy with a supraciliary hema implant. RESULTS: There was a significant reduction in intraocular pressure (IOP), changing from a preoperative mean of 25.6 ± 6.4 mmHg to a postoperative mean of 16.2 ± 3.4 mmHg (P<.001). The number of preoperative glaucoma medications also decreased from 2.5 ± 0.6 drugs per patient to 0.5 ± 0.5 (P<.001). No change was observed in the best-corrected visual acuity. The anatomical characteristics of the surgical area, and its relationship with IOP were examined using UBM. There was no correlation between the level of IOP at the time of UBM and the horizontal (r=-.05: P=.71) and vertical diameter (r=-.1; P=.63), the height (r=.28; P=.25) and the volume of intrascleral space (r=-.08; P=.79), the thickness (r=-.07; P=.73) and the length (r=.39; P=.13) of trabeculo-Descemet's membrane (TDM), the presence of filtering bleb (P=.30) and the hypoechoic area in the supraciliary space (P=.24). CONCLUSIONS: The insertion of a hema implant in the supraciliary space is an effective and safe surgery for patients with open angle glaucoma (OAG). No predictive success factors for supraciliary implant were found using the UBM study.

[Use of intravitreal bevacizumab for the treatment of choroidal neovascularization secondary to choroidal rupture]. / Bevacizumab intravítreo en el tratamiento de la neovascularización subretiniana secundaria a rotura coroidea.

CASE REPORT: A 28 year-old male attended our Emergency Department with a traumatic choroidal rupture and macular haemorrhage. After pneumatic displacement of the haemorrhage with C(3)F(8) and tissue plasminogen activator, the haemorrhage was reabsorbed and visual acuity (VA) improved. Three months later the patient presented with decreased VA and a juxtafoveal choroidal neovascularisation (CNV) that was treated with intravitreal bevacizumab. One year after a single bevacizumab injection the CNV remained inactive, with a final VA of 0.5. DISCUSSION: Intravitreal bevacizumab injection is a new and effective treatment for traumatic CNV. In our patient, in contrast to other aetiologies, the CNV needed no more than one Avastin(®) injection to be inactivated, after one year of follow-up.

Comparison of postoperative intraocular pressure in patients with Densiron-68 vs conventional silicone oil: a case-control study.

UNLABELLED: A solution of perfluorohexyloctane and silicone oil with a specific gravity of 1.06 g/cm(3) (Densiron-68) has similar properties as conventional silicone oil (SO) in terms of the shape of the bubble and its ability to act as an internal tamponade agent. We conducted a case-control study to compare the postoperative intraocular pressure (IOP) in patients treated with Densiron-68 with those treated with SO. METHODS: Seventy-one eyes of 71 patients and 57 eyes of 57 patients who had received Densiron-68 and SO, respectively, were included in our study. Both groups were found to have matched for their preoperative comorbidities (diabetes, glaucoma, phakic status, and refractive errors). IOP at first day, between seventh and fourteenth day, and at 4 week postoperatively was recorded. RESULTS: The mean IOP was higher in patients treated with Densiron-68 at day 1 and between seventh and fourteenth day postoperatively (P=0.05 and 0.01, respectively). By the 4th week, the IOP difference between the two groups was insignificant (P=0.17). The difference in the two groups could still be clinically significant and the raised IOP in Densiron-68 group was more difficult to treat in some cases.On day 1, nine eyes (12.7%) in the Densiron-68 group and two eyes (3.5%) in the SO group had IOP greater than 30 mmHg. At 4 weeks, IOP of more than 30 mmHg was seen in nine eyes (12.7%) in the Densiron-68-treated group and in one eye (1.8%) in the SO group. CONCLUSION: The use of Densiron-68 was associated with a higher IOP in the early postoperative period when compared with SO.

Bilateral ischemic maculopathy in a patient with AIDS.

PURPOSE: To describe ischemic maculopathy as a cause of sudden bilateral decreased vision in a patient with human immunodeficiency virus (HIV) infection. METHODS: A 44-year-old HIV-positive woman presented with bilateral decreased vision and normal examination, except for pale maculae and retinal vascular tortuosity. Fluorescein angiography showed bilateral enlargement of the foveal avascular zone with perifoveal dye leakage. CONCLUSIONS: Ischemic maculopathy is a potential cause of decreased vision in patients with acquired immunodeficiency syndrome, even in patients with immune sustained recovery. This condition can be almost totally reversible, in the absence of other concomitant ocular pathologies.