Characteristics of Eyes With CRB1-Associated EOSRD/LCA: Age-Related Changes.

PURPOSE: To evaluate ocular and retinal features of CRB1-associated early onset severe retinal dystrophy/Leber congenital amaurosis (EOSRD/LCA) for age-related changes. DESIGN: Retrospective cohort study. METHODS: Sixteen pediatric patients with biallelic CRB1 EOSRD/LCA who had been followed for up to 18 years were reviewed. Results of comprehensive ophthalmic examinations-including visual acuity, refractive error, dark-adapted visual threshold, Goldmann perimetry, and macular optical coherence tomography (OCT)-were analyzed for significant age-related changes using mixed-effects models. RESULTS: Visual acuity dark-adapted visual sensitivity, and area of seeing visual field (all subnormal from the earliest ages recorded) declined with increasing age. Hyperopia was stable through childhood and adolescence. In CRB1 EOSRD/LCA, OCT extrafoveal inner and outer laminar thicknesses exceeded those in controls but varied little with age, and foveal metrics (depth, breadth, thickness at rim) differed significantly from those in controls, but variations in foveal metrics were not associated with declines in acuity. CONCLUSIONS: From the youngest ages, retinal and visual function is significantly subnormal and becomes progressively compromized. A goal of future therapies should be intervention at young ages, when there is more function to be rescued.

Hydrophilic Lens Opacification after Intravitreal Anti-VEGF Injections: A Case Series.

Our objective in this retrospective case series was to report 4 cases of hydrophilic intraocular lens (IOL) opacifications after repeated intravitreal bevacizumab injections. This is a retrospective analysis of all the cases of IOL opacifications presenting to a tertiary referral ophthalmic center in Beirut between January 2013 and January 2019. Four cases were included in the study, of which one was treated for vitreal hemorrhage, the other for macular edema secondary to wet age-related macular edema, and the rest for macular edema secondary to diabetic retinopathy. The mean age of the patients was 71 years with a male predominance and a mean of 5 injections. The IOL opacifications appeared approximately 24 months after first bevacizumab injection. The opacification could be explained by multiple theories such as a possible anterior or posterior segment subclinical inflammation secondary to intraocular interventions, interaction between the hydrophilic properties of the IOLs and anti-vascular endothelial growth factor injection's content, impurities transmission during injection, or faulty IOL manufacturing.

Corneal Haze Secondary to Corneal Collagen Cross-linking in Keratoconus Patients: Treatment and Outcomes.

PURPOSE: The purpose of this study was to evaluate the outcome of patients presenting with mild-to-moderate corneal haze after undergoing corneal collagen cross-linking (CXL) for keratoconus (KCN) and their response to a proposed standardized topical steroid-based treatment. METHODS: This study included 19 eyes of 14 patients presenting with corneal haze after undergoing CXL for KCN. Corrected distance visual acuity, corneal thickness and Kmax values by Pentacam® Scheimpflug tomography, as well as subjective corneal haze changes were evaluated before and after a topical steroid- and cyclosporine-based treatment. RESULTS: Visual acuity improved after the completion of the treatment by 0.043 logMAR (P = 0.017) and Kmax values decreased by 1.17D (P = 0.0024), while the corneal thinnest pachymetry remained stable. Data collected from the examiner's slit-lamp examination description revealed that seven eyes had a decrease in haze compared to 12 eyes with stable or no changes in the haze. CONCLUSION: Our findings suggest an improvement in visual acuity and possible corneal flattening with decreasing Kmax after the completion of topical steroids with taper course treatment in patients suffering from corneal haze post-CXL. This paper also highlights the importance of postcross-linking anti-inflammatory treatment and close follow-up.