Frosted branch angiitis following corneal tear repair.

We report a patient who developed frosted branch angiitis (FBA) and was diagnosed 1 month after the penetrating eye injury (PEI) repair. A 31-year-old male with no systemic comorbidities presented with defective vision following trauma to his left eye while cutting wood. His best-corrected visual acuity (BCVA) was 20/200. Anterior segment examinations showed a zone I full-thickness corneal tear with iris tissue incarceration. There was no clinical evidence of intraocular foreign body (IOFB) or endophthalmitis. He underwent PEI repair with iris abscission on the same day with intracameral moxifloxacin injection. His BCVA on postoperative day 45 was 20/200. Examination showed a resolving vitreous hemorrhage, venous tortuosity, and retinal perivascular infiltration affecting the venules from the posterior pole up to the periphery. He was treated with oral and topical steroids. The clinical signs resolved completely and BCVA improved to 20/20 after 1 month of treatment. FBA can complicate the recovery of eyes after PEI repair, even in the absence of endophthalmitis or sympathetic ophthalmia. A thorough search for IOFB or its tell-tale signs should be done in such eyes.

Abnormal Retinal Vasculature in a Young Child: A Diagnostic Dilemma.

Aim: To report the case of a young child who presented with sudden visual loss and characteristic abnormal retinal vasculature.Design: Case ReportMethods: A 13-year-old Indian boy presented with sudden visual loss in the left eye (20/1200) for 1 month, associated with recent-onset of seizures. Ocular examination showed a relative afferent pupillary defect, neovascularization of iris, absence of retinal vasculature beyond second branching, and arterio-venous shunts at the junction of vascular and avascular retina. Fundus fluorescein angiography showed delayed arm-to-retina time, leading edge of fluorescein dye in arteries and peripheral capillary non-perfusion areas.Peripheral pulses were absent and carotid doppler showed bilateral carotid artery occlusion (left one being worse affected), suggestive of Takayasu's arteritis (TA). Despite being started on immunotherapy, he lost complete vision in the left eye.Conclusion: TA may present initially to ophthalmologists, who need to maintain a high index of suspicion for early diagnosis and management of this life-threatening disease.

Comparison of platelet-rich plasma and inverted internal limiting membrane flap for the management of large macular holes: A pilot study.

Purpose: To compare the safety and efficacy of 25-gauge pars plana vitrectomy (PPV) with either platelet-rich plasma (PRP) or inverted internal limiting membrane (ILM) flap for the treatment of large macular hole. Methods: Pseudophakic patients with idiopathic macular holes with a minimum diameter (MD) of 600-1500 µm were randomized into two groups (30 patients each): 25-gauge PPV with either inverted ILM flap (group A) or PRP (group B). Results: Mean MD in groups A and B were 803.33 ± 120.65 µm and 784.73 ± 120.10 µm, respectively (P = 0.552). Mean base diameter in groups A and B was 1395.17 ± 240.57 µm and 1486.90 ± 281.61 µm, respectively (P = 0.180). The median presenting best-corrected visual acuity (BCVA) was logMAR 0.78 (range 0.78-1.00) and logMAR 0.78 (Range 0.60-1.00) in groups A and B, respectively (P = 0.103). Anatomical closure was achieved in 90% (n = 27/30) and 93.3% (n = 28/30) eyes in groups A and B, respectively (P = 0.158). Type 1 closure was achieved in 76.7% (n = 23/30) and 83.3% (n = 25/30) eyes in groups A and B, respectively. Median BCVA at postoperative 3-month in groups A and B was logMAR 0.60 (range 0.48-0.60) and logMAR 0.60 (range 0.48-0.78), respectively (P = 0.312). The average visual improvement was 2.0 and 2.5 early treatment diabetic retinopathy study (ETDRS) lines in groups A and B, respectively (P = 0.339). None of the patients developed postoperative exaggerated inflammatory reactions. Conclusion: Using platelets for the treatment of large macular holes is as safe and effective as an inverted ILM flap.

Rare cause of floaters: A motile live worm in vitreous cavity.

Ocular filariasis commonly presents as subconjunctival or eyelid nodules. We report a rare case of a live, motile worm causing floaters. The worm was isolated from the vitreous cavity and revealed to be Dirofilaria repens. Correct recognition of the worm is necessary as human dirofilariasis does not present as microfilaremia and does not require systemic therapy; in contrast to other causes of ocular filariasis, which require systemic therapy. As ophthalmologist may be the first physician to encounter such patients, a high index of suspicion is required for timely and adequate management.

Comparison of Surgical Performance of Internal Limiting Membrane Peeling Using a 3-D Visualization System With Conventional Microscope.

BACKGROUND AND OBJECTIVE: To compare the surgical performance of internal limiting membrane (ILM) peeling in idiopathic macular hole using a digitally assisted vitreoretinal system (DAVS) and an analog microscope (AM). PATIENTS AND METHODS: Patients were operated on using an AM (Group A) and a DAVS (Group B). The data analyzed included surgical time required to complete ILM peeling, number of attempts to create ILM flap and complete ILM peeling, and intraoperative complications. RESULTS: Each group included 20 patients. The average surgical time for ILM peeling in groups A and B was 123.05 seconds ± 42.23 seconds and 142.35 seconds ± 31.49 seconds, respectively (P = .109). The mean number of surgical attempts to create the ILM flap was 1.05 ± 0.22 and 1.70 ± 1.22 respectively (P = .008). The mean number of surgical attempts to complete ILM peeling was 22.85 ± 9.95 and 27.20 ± 7.16, respectively (P = .121). Retinal touch occurred in one and three patients, respectively (P = .534). CONCLUSIONS: DAVS provides similar surgical performance to AM; however, the creation of ILM flap is difficult with DAVS compared to AM. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:941-945.].