Morphological integrity of the outer retinal layers and visual prognosis in chronic central serous chorioretinopathy after half-dose photodynamic therapy: a qualitative SD-OCT analysis.

The study aims to investigate the morphological integrity of the outer retinal layers (ORLs) (an ellipsoid layer (EL) + external limiting membrane) and visual prognosis in chronic central serous chorioretinopathy (CSCR) with subretinal fluid (SRF) completely resorbed after half-dose photodynamic therapy (HD PDT) using enhanced-depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT). This retrospective study included 40 eyes of 38 chronic CSCR patients treated with HD PDT between December 2012 and June 2016. However, only 34 eyes (85%) with complete SRF resorption 3 months after HD PDT had their 6th and 12th month data analyzed. Morphological integrity of the ORLs was further analyzed in relation to best-corrected visual acuity (BCVA) and disease duration. Thirty-four eyes of 34 patients (male/female: 82.35/17.65%) with mean age of 49.90 ± 7.80 (32-61) years were studied. The mean logMAR BCVA improved significantly from 0.52 ± 0.31 at baseline to 0.34 ± 0.36 and 0.26 ± 0.26 at the 6th and 12th months after HD PDT, respectively (p < 0.001). The proportion of eyes with completely normal morphological ultrastructural integrity of the ORLs was 44.12% at the 6th month, which increased to 64.71% at the 12th month after HD PDT. However, the EL morphological disruption was associated with significantly lower mean logMAR BCVA 12 months after HD PDT (p = 0.029). The disease duration had no effect on mean logMAR BCVA gain. Even after complete resorption of serous neurosensory retinal detachment after HD PDT in chronic CSCR, the ORLs, especially the EL, may not be anatomically restored. The EL morphological ultrastructural integrity seems to be the most important factor influencing visual prognosis.

Etiological factors in young patients with Retinal Vein Occlusion.

OBJECTIVE: To present the etiological factors of patients with Retinal Vein Occlusion (RVO) under the age of 50 years. METHODS: The study was conducted at Ege University Medicine Faculty Department of Ophthalmology. The clinical records of patients with RVO under the age of 50 seen between January 2014 and March 2018 were analyzed retrospectively. Forty patients comprised the study. Detailed ophthalmologic examination was performed. Past medical history, drug use, thrombophilic features, hyperviscosity syndromes and pathologies that may cause vasculitis were noted. RESULTS: Forty patients, 22 (55%) male and 18 (45%) female, were included. Mean age was 41.6 ± 10.01 years. Mean intraocular pressure and best-corrected visual acuity were 16.8 ± 5.47mmHg and 0.76 ± 0.64 logMAR, respectively. Hyperhomocystenemia (15 patients, 37.5%), Behçet's disease (three patients, 7.5%), diabetes and/or hypertension (16 patients, 40%), methylenetetrahydrofolate reductase gene mutation (11 patients, 27.5%), prothrombin gene mutation (four patients, 10%) and factor V Leiden mutation (five patients, 12.5%) were present among the patients as etiological factor. Multiple etiological factors were detected in 11 (27.5%) patients. Factor V Leiden mutation and methylenetetrahydrofolate reductase gene mutation were detected in one patient (2.5%) with Behçet's disease. Four patients with diabetes and/or hypertension also had hyperhomocystenemia and one of them had additionally prothrombin gene mutation. Two patients with methylenetetrahydrofolate reductase gene mutation also had a factor V Leiden mutation and one of them had additionally a prothrombin gene mutation. Three patients with methylenetetrahydrofolate reductase gene mutation also had hyperhomocystenemia and one patient with prothrombin gene mutation also had methylenetetrahydrofolate reductase gene mutation. CONCLUSIONS: Etiological factors that might result in RVO in young individuals should be investigated in detail. Targeted therapies may help to prevent development of new RVOs and potential vascular problems in other organs.

The Prevalence and Characteristics of Charles Bonnet Syndrome in Turkish Patients with Retinal Disease.

PURPOSE: The aim of this study is to investigate the prevalence and clinical characteristics of Charles Bonnet syndrome (CBS) in a group of Turkish patients with various retinal diseases. METHODS: Two hundred and sixty-four patients with a best-corrected visual acuity of ≤20/40 in the better-seeing eye were asked with a standardized question whether they had symptoms of CBS. If they responded positively, a questionnaire was verbally administered to learn more about the details of the symptoms. RESULTS: There were 125 (47.3%) females and 139 (52.7%) males with a mean age of 72.1 years (range 31-90). Seventeen (6.4%) patients were diagnosed with CBS. Three (17.7%) patients had noncomplex hallucinations and 14 (82.3%) had complex hallucinations. CONCLUSION: CBS is not uncommon in visually impaired patients with retinal disease. Clinicians who care for visually impaired patients should be aware of CBS.

Choroidal malignant melanoma with no extraocular extension presenting as orbital cellulitis.

This report describes a patient with choroidal malignant melanoma presenting as orbital cellulitis without extraocular tumor extension. It is an interventional case report with histopathologic correlation. A 68-year-old male presented with a 3-day history of painful hyperemia and swelling in the right eye. The examination showed edematous eyelids, mechanical ptosis and chemosis with conjunctival injection. B-scan ultrasonography showed a mass with medium level echogenicity that filled the vitreous cavity. Magnetic resonance imaging showed a solid choroidal mass with hemorrhagic and inflammatory changes with no obvious extraocular extension. Due to these suggestive findings of choroidal melanoma the right eye was enucleated. A spindle cell choroidal melanoma including intense pigmentation and necrosis was confirmed by histopathological examination. Although rare; choroidal melanoma may present as orbital cellulitis, particularly when the tumor is necrotic.

A Case of Concurrent Acute Macular Neuroretinopathy and Paracentral Acute Middle Maculopathy Following Pfizer-BioNTech COVID-19 Vaccination.

We present a 65-year-old woman who developed sudden and severe vision loss in her left eye one day after the administration of the second dose of COVID vaccine. The best corrected visual acuity in this eye was 1/10. Diffuse paracentral acute middle maculopathy was detected on spectral domain optical coherence tomography (OCT). OCT angiography images revealed concurrent vascular flow defects consistent with acute macular neuroretinopathy in the deep retinal capillary plexus and choriocapillaris layers. At the end of the six-month follow-up, there was no improvement in visual acuity, and atrophy and thinning developed in all layers of the retina.

Investigation of the choroidal structure in non-neovascular age-related macular degeneration patients with reticular pseudodrusen.

BACKGROUND: This study aimed to compare choroidal thickness, total choroidal area (TCA), luminal area (LA), stromal area (SA) and choroidal vascularity index (CVI) in patients with reticular pseudodrusen (RPD) and drusen. METHODS: A total of 100 eyes of 100 patients with non-neovascular age related macular degeneration (AMD) with five or more medium drusen (63-125 µm) and RPD in two or more quadrants were recruited to the study. 48 eyes of 48 patients with RPD were assigned as Group 1 and 52 eyes of 52 patients with drusen were assigned as Group 2. 40 right eyes of 40 healthy subjects were included as controls. Patients with neovascular AMD or advanced non-neovascular AMD were excluded from the study. After a detailed ophthalmic examination, infrared reflectance images and OCT with enhanced depth imaging mode was obtained from all patients. TCA, SA, LA and CVI were calculated using the Image J program. The data were analyzed for statistics using SPSS software. RESULTS: The female/male ratio was 56/44 in the patient groups and 20/20 in the control group. The mean age was 73.63±6.14 (61-91) years for Group 1 and 69.43± 6.97 (59-87) years for Group 2 (p=0.005). The mean age of Group 3 patients was 71.14±8.17 (60-79) years and was statistically similar to Groups 1 and 2 (p=0.09 and p=0.12, respectively). Choroidal thickness, TCA, SA and LA were significantly lower in Group 1 (p<0.001). CVI and foveal thicknesses were not significantly different between Group 1 and 2 (p=0.214 and p=0.384 respectively). CVI was significantly lower in Group 3 (p<0.01). RPD was most commonly seen in the superior quadrant followed by temporal, nasal, and inferior quadrants. CONCLUSIONS: TCA, SA and LA, which reflect choroidal vasculature, were decreased in patients with RPD. These parameters can help evaluate the pathophysiology of the disease.

Multimodal Imaging of Reticular Pseudodrusen in Turkish Patients.

Objectives: To investigate the presence and prevalence of reticular pseudodrusen (RPD) in patients with age-related macular degeneration using multiple imaging modalities and to compare the sensitivity and specificity of these modalities in the detection of RPD. Materials and Methods: Images from a total of 198 consecutive patients were analyzed prospectively. Color fundus photography, red-free imaging, spectral domain optical coherence tomography (SD-OCT), infrared and blue reflectance (BR) imaging, fundus autofluorescence (FAF), enhanced-depth imaging OCT (EDI-OCT), fundus fluorescein angiography (FFA) and indocyanine green angiography were performed. RPD was diagnosed in the presence of relevant findings in at least two of the imaging methods used. Results: RPD were detected in 149 eyes (37.6%). In the detection of RPD, color fundus photography, red-free photography, SD-OCT, infrared, FAF, BR, and FFA imaging had sensitivity values of 50%, 57.7%, 91.6%, 95%, 74.6%, 65.7%, and 28.2% and specificity values of 99.6%, 100%, 98.4%, 94.6%, 100%, 99.6%, and 69.8%, respectively. Conclusion: Infrared imaging had the highest sensitivity. SD-OCT combined with infrared imaging was the most sensitive imaging technique for detecting RPD. The high specificity of FAF, red-free, and BR imaging may be useful to confirm a diagnosis of RPD.

Expert recommendations for the management of diabetic macular edema with intravitreal dexamethasone implant: A Turkish Delphi study.

PURPOSE: To provide consensus on the clinical use of intravitreal dexamethasone (DEX) implant for the treatment of diabetic macular edema (DME) in Turkey. METHODS: A panel of 22 retina experts prepared 77 statements of recommendation, and 80 retinal specialists practicing in Turkey were chosen to vote either in support or against each one. A Delphi-based method was used through which the ophthalmologists were able to view all of the results anonymously after two rounds and modify their subsequent answers. The survey was conducted via a mini website, and statements without consensus were resent to the specialists with the latest vote results a week later. RESULTS: A total of 72 ophthalmologists answered the first and second round questions. After the first stage, consensus was achieved on 55 of the statements, leaving 22 without agreement. After the second stage, consensus was reached on 11 of the remaining statements. Strong consensus was achieved on statements regarding the etiopathogenesis of DME and the first-line indications and safety of the DEX implant procedure. The panel recommended the use of DEX implant for patients with an arterial thromboembolic event in the last three months and also agreed that pro re nata DEX implant treatment not only provides better outcomes for DME patients but also reduces the treatment burden for those who could not receive an adequate number of anti-vascular endothelial growth factor (VEGF) injections. CONCLUSION: This study provides clinical consensus and recommendations about the use of DEX implant in the clinical practice of DME management in Turkey.

Multimodal Imaging of Pigmented Paravenous Retinochoroidal Atrophy in a Pediatric Patient with Cystoid Macular Edema.

The aim of this case report is to present the multimodal imaging characteristics of pigmented paravenous retinochoroidal atrophy (PPRCA) in a pediatric patient with cystoid macular edema (CME). A 7-year-old girl was admitted to our clinic with complaints of mild blurred vision and poor night vision. Best corrected visual acuity was 10/10 in both eyes. Fundus examination showed atrophic areas around the optic nerve and along the retinal vessels in both eyes. A few small dot-shaped paravenous pigmentations were observed in the mid-peripheral retina. Fundus autofluorescence was consistent with PPRCA. Spectral-domain optical coherence tomography (OCT) revealed the presence of CME and loss of the outer retinal layers outside the macula, with intact retinal layers in the macula. OCT angiography revealed normal choriocapillaris vasculature and flow. The patient was followed up for 6 months but showed no change in CME or clinical appearance. CME without ocular inflammation is an unusual finding of PPRCA and may suggest the involvement of chronic or latent inflammation in the etiology of PPRCA.

Prevalence of Polypoidal Choroidal Vasculopathy in Eyes with Neovascular Age-Related Macular Degeneration Resistant to Intravitreal Anti-VEGF Treatment.

Objectives: To determine the prevalence of polypoidal choroidal vasculopathy (PCV) in intravitreal (IV) anti-vascular endothelial growth factor (anti-VEGF)-resistant neovascular age-related macular degeneration (nvAMD) cases. Materials and Methods: Eyes that were diagnosed as having active and treatment-naive nvAMD in the Ege University Ophthalmology Department, Retina Unit in 2011-2018, were non-responsive to IV anti-VEGF treatment, and for which indocyanine angiography (ICGA) could be obtained were included in the study. Active nvAMD was defined as the presence of fresh hemorrhage on clinical examination or findings of subretinal, intraretinal, or sub-retinal pigment epithelial fluid on spectral domain optical coherence tomography and accompanying fluorescein dye leakage in fluorescein angiography. Eyes that had activation findings despite at least 6 consecutive intravitreal anti-VEGF injections were defined as non-responders and underwent ICGA to assess for PCV. The diagnosis of PCV was based on the Everest II study criterion. Results: A total of 97 eyes of 88 patients were included in the study. Of 88 patients, 44 (50%) were female, 44 (50%) were male, and the mean age was 75.9±8.3 years (range: 59-93). The mean number of anti-VEGF injections until the time of ICGA was 7.3±2.2 (range: 6-15). PCV was detected in 62 eyes (63.9%) on ICGA. Conclusion: The prevalence of PCV is quite high among eyes with IV anti-VEGF treatment-resistant nvAMD in Turkey (63.9%). ICGA evaluation for PCV should be conducted for all nvAMD cases that are non-responsive to IV anti-VEGF treatment, both to shed light on the reason for resistance and to modify treatment as necessary.

Do mydriatics effect serous pigment epithelial detachment elevation? A case report on central serous chorioretinopathy.

This report aimed to determine if pupil-dilating eye drops (mydriatics) affected serous pigment epithelial detachment elevation in an eye with central serous chorioretinopathy using spectral domain-optical coherence tomography. A 47-year-old man presented to our clinic with metamorphopsia in his right eye, which had best corrected visual acuity of 20/20. Spectral domain-optical coherence tomography revealed minimal subretinal fluid and serous pigment epithelial detachment. During the follow-up examination after the final diagnosis of central serous chorioretinopathy and serous pigment epithelial detachment, different pigment epithelial detachment elevations on optical coherence tomography images before and after pupil dilation were found incidentally. These elevations were re-measured separately on different days before and after pupil dilation with 2.5% phenylephrine and 1% tropicamide to determine if this was a mydriatic-induced increase in pigment epithelial detachment elevation, which was eventually found to be the case. Mydriatics appeared to affect pigment epithelial detachment elevation in central serous chorioretinopathy. A thorough consideration of pre-dilation ocular examination and imaging data in central serous chorioretinopathy may be valuable.

Multimodal Imaging Characteristics of Circumscribed Choroidal Hemangioma Accompanying with Central Serous Chorioretinopathy: A Case Report.

A 42-year-old man presented with a temporal visual field defect in his right eye. His history revealed systemic steroid use before onset of his complaints. Multimodal imaging techniques including ultrasonography, fluorescein angiography, indocyanine green angiography, and optical coherence tomography angiography (OCTA) suggested the presence of circumscribed choroidal hemangioma (CCH) accompanying with central serous chorioretinopathy (CSCR) in the right eye, which might have worsened with systemic steroid treatment. CCH may rarely present with accompanying CSCR. Besides, OCTA is a non-invasive reliable method for the diagnosis of CCH in terms of visualizing vascular features of tumor.

Multimodal Imaging Characteristics of Quiescent Type 1 Neovascularization in Best Vitelliform Macular Dystrophy

This case report of a 38-year-old man with bilateral Best vitelliform macular dystrophy (BVMD) presents bilateral quiescent type 1 neovascularizations (NV) detected by optical coherence angiography (OCTA) and their multimodal imaging characteristics. It was emphasized that this kind of quiescent and asymptomatic NV may be present in nearly every stage of BVMD and it was concluded that OCTA is a noninvasive, easy, and rapid method that is superior to other imaging methods in detecting them.

Aflibercept Treatment Results and Association with Baseline Characteristics in Cases of Newly Diagnosed Neovascular Age-Related Macular Degeneration

Objectives: To evaluate functional and anatomical responses to intravitreal aflibercept (IVA) treatment in newly diagnosed and untreated neovascular age-related macular degeneration (nvAMD) cases and to investigate the effect of baseline lesion characteristics on anatomical responses. Materials and Methods: This prospective, cross-sectional study included a series of 139 eyes of 133 patients that were diagnosed with active nvAMD and had not been treated. All eyes were subjected to complete ophthalmological examination, spectral-domain optical coherence tomography and fluorescein angiography, and 42 eyes also underwent indocyanine green angiography. IVA treatment was performed using a "treat and extend" regimen after 3 injections at 4-6 weeks intervals. Anatomical and functional responses at 4 weeks after the last injection were evaluated in eyes that completed 3 injections and the subgroup of eyes that completed 6 IVA injections. The effect of baseline lesion characteristics on IVA treatment results was also investigated. Results: All 139 eyes included in the study received 3 IVA injections (group 1) and 62 received 6 IVA injections. Both groups showed statistically significant improvement in best-corrected visual acuity (p<0.001 for both). The rate of complete response was 54.6% and 58.0% in groups 1 and 2, respectively. In group 1, the presence of pigment epithelial detachment (PED) and serous PED were identified as negative initial factors (p=0.043, p=0.005, respectively). However, none of the baseline characteristics were significantly associated with anatomical response in group 2. Conclusion: In our study, it was determined that successful anatomical and functional results were achieved with 3 and 6 doses of IVA in eyes with newly-diagnosed and untreated nvAMD. Among baseline characteristics, the presence of PED and serous PED in particular were found to be factors affecting treatment response negatively.

Multimodal imaging of a patient with poppers maculopathy.

Objective: To describe the findings and the imaging characteristics of a patient with poppers maculopathy. Methods: The ocular findings were evaluated with fundus autofluorescence imaging, spectral optical coherence tomography and optical coherence tomography angiography. Results: A 36-year-old man presented with a history of blurring vision after using poppers. Best-corrected visual acuity was 0.9 and intraocular pressure was normal in both eyes. Fundus examination revealed hyperreflective appearence at macula with a faint foveolar reflex. Optical coherence tomography revealed focal hyperreflectivity and irregularity of the ellipsoid zone at the fovea. Fundus autofluorescence was normal. Optical Coherence Tomography Angiography revealed no vascular changes. The patient received hyperbaric oxygen therapy for 10 days. After one month VA increased, and OCT improved. Conclusion: Inhalation of poppers may be associated with bilateral vision loss due to the disruption of photoreseptors which is clearly demonstrated with OCT.

An Unusual Case: Self-separation of an Idiopathic Epiretinal Membrane

Self-separation or peeling of an idiopathic epiretinal membrane (ERM) in an eye with partial posterior vitreous detachment (PVD) is a rare event. A 56-year-old woman presented to our clinic with complaints of floaters in her right eye. Best-corrected visual acuity (BCVA) was 9/10 in this eye. Fundus examination and Spectral domain optical coherence tomography (SD-OCT) revealed an idiopathic ERM and Grade 3 PVD in this eye. Four months later, she had complaints of metamorphopsia in her right eye. BCVA was 7/10, while SD-OCT images of the right macula were similar to previous images. One week after the last visit, she presented again due to the sudden disappearance of her metamorphopsia complaints. BCVA had improved to 10/10. Fundus examination demonstrated that the ERM had spontaneously separated from the retinal surface as a flap floating in the vitreous and the foveal contour had returned to normal. The etiologic mechanism may be explained as the contracting forces within an immature ERM being stronger than its adhesion to the retina.

Subgroups and Features of Poor Responders to Anti-Vascular Endothelial Growth Factor Treatment in Eyes with Neovascular Age-Related Macular Degeneration

Objectives: This study aimed to determine the incidence of poor response to intravitreal (IV) anti-VEGF treatment in neovascular age-related macular degeneration (nvAMD) and to define subgroups of poor responders. Materials and Methods: A total of 235 treatment-naive eyes of 202 patients completed this prospective study. Patients younger than 50 years of age and those with a contraindication for anti-VEGF therapy were excluded. All eyes were treated with IV ranibizumab. Poor response was defined as recurrence, persistence, or worsening despite treatment. Poor responders were classified into subgroups based on progression patterns. Results: Of the 235 eyes, 78 (33.2%) showed poor response. Pigment epithelial detachment (PED) and occult choroidal neovascularization (CNV) were more common among poor responders (p<0.001) and 5 subgroups were identified. Conclusion: Poor response to anti-VEGF treatment is not uncommon and occult CNV and PED are frequently seen in these eyes. Various subgroups can be defined based on clinical features.

Optical Coherence Tomography Characteristics of Quiescent Type 1 Neovascularization in Eyes with Nonexudative Age-related Macular Degeneration

Objectives: To describe the lesion characteristics of nonexudative, quiescent, asymptomatic type 1 neovascularization (NV) on B-scan and en face spectral domain optical coherence tomography (SD-OCT) in eyes with nonexudative age-related macular degeneration (AMD). Materials and Methods: In this retrospective, observational, consecutive case series, 27 patients who were already being followed and treated for exudative AMD in one eye were included in the study for their fellow eyes, which were initially nonexudative but developed exudative findings during follow-up. Initial B-scan and en face SD-OCT, fluorescein angiography (FA), and indocyanine green angiography (ICGA) images of these 27 eyes were examined retrospectively. The characteristic B-scan SD-OCT features of type 1 NV in this silent and asymptomatic stage were described. Results: The 27 eyes of 27 patients (13 males and 14 females; mean age 69.5±8.2 years) with nonexudative AMD had a mean best corrected visual acuity (BCVA) of 0.6±0.3 Snellen. Initial B-scan OCT images of all eyes (100%) showed retinal pigment epithelium (RPE) elevations and irregularities caused by a moderately reflective material in the sub-RPE space without fluid accumulation in the intraretinal/subretinal or sub-RPE space. Twenty-four eyes (88.8%) showed sub-RPE hyperreflective lesions consistent with type 1 NV on en face OCT images. While none of the eyes showed signs of type 1 NV in FA, macular plaque was observed in 8 eyes (29.6%) in ICGA. The mean time to onset of exudative findings was 8.3±4.03 months. Conclusion: In eyes with nonexudative AMD, there may be quiescent and asymptomatic type 1 NV lesions which do not yet show exudative changes. This NV has characteristic features on B-scan SD-OCT and can also be detected with en face OCT. Detection and close monitoring of these quiescent and inactive type 1 NV lesions during the asymptomatic, pre-exudative period are important for early treatment.

Vitreomacular Traction and Outer Retinal Structural Changes

In this case report we aimed to present the outer retinal structural changes secondary to vitreomacular traction (VMT). Outer retinal structural changes occurring secondary to VMT due to incomplete posterior vitreous detachment were described retrospectively with spectral-domain optical coherence tomography in 3 eyes of 3 patients. The patients ranged in age from 58 to 65 years and best corrected visual acuity in the 3 eyes was 4/10, 8/10, and 9/10. All of the patients were symptomatic and exhibited outer retinal microholes at the fovea extending from the retinal pigment epithelium to outer limiting membrane, with an overlying operculum on the detached posterior hyaloid membrane over the macula following spontaneous resolution of VMT. In the mean follow-up period of 32 months, the outer retinal microholes decreased in size but did not completely resolve. As demonstrated in these cases, VMT can cause small outer retinal layer defects without signs of full-thickness macular hole. These lesions can cause symptoms and affect visual function, and may be permanent structural changes.

The efficacy of "IOL-Vip Revolution" telescopic intraocular lens in age-related macular degeneration cases with senile cataract.

PURPOSE: To evaluate the efficacy of the IOL-Vip Revolution telescopic intraocular lens in age-related macular degeneration patients. METHODS: A total of 13 eyes of 12 age-related macular degeneration patients with senile cataract were enrolled. Selection of the patients was done by means of a low vision diagnostic and rehabilitative program (IOL-Vip software) that evaluates residual visual function. After standard phacoemulsification surgery, the incision site was enlarged and the IOL-Vip Revolution system was implanted in the capsular bag. The outcome measures were best corrected visual acuity, contrast sensitivity, anterior chamber depth, endothelial cell density, central corneal thickness, and quality-of-life questionnaire. RESULTS: The mean age of the subjects was 72.3 ± 8.5 years. The mean positive power of the intraocular lens was 59 ± 2 D and the negative intraocular lens power was standard (-46 D). Pre- and postoperative best corrected visual acuity were 1.08 ± 0.14 and 0.81 ± 0.16 logMAR in the operated eye and 1.13 ± 0.36 and 1.01 ± 0.40 logMAR in the unoperated eye, respectively. The best corrected visual acuity was increased significantly in both operated and unoperated eyes (p = 0.005 and 0.021, respectively). Quality of life and anterior chamber depth increased significantly (p = 0.018 and 0.008, respectively), while endothelial cell density decreased (p = 0.002). No significant differences were detected in central corneal thickness or contrast sensitivity (p = 0.133 and 0.684, respectively). CONCLUSION: The results showed that IOL-Vip Revolution telescopic intraocular lens is a promising treatment option in age-related macular degeneration patients. The rehabilitation program may have an important role in the restored clinical results, which also provided visual improvement in the unoperated eyes.