Central serous chorioretinopathy in pregnancy.

Objective: The objective of this work was to present two unusual cases of central serous chorioretinopathy (CSC) and the chosen therapeutic method. Materials and methods: In this article, two cases of CSC in pregnant patients were described. Results: The first case was a 35-year-old patient in the 16th week of pregnancy and the second one was a 26-year-old patient in the 20th week of pregnancy. Due to the contraindications associated to pregnancy, the therapeutic method chosen was subthreshold micropulse laser photocoagulation. The functional and anatomical evolution was very good in both patients. Discussion: In both cases, treatment of the disease was preferred to prevent important photoreceptor losses. After the treatment, very good anatomical and functional results were obtained. Conclusions: The micropulse laser is an effective solution for treating CSC. It is the only safe therapeutic solution during pregnancy. CSC can be associated with pregnancy, without necessarily suggesting pre-eclampsia. Abbreviations: CSC = central serous chorioretinopathy, SRF = subretinal fluid.

Subretinal alteplase injections in massive subretinal hemorrhage due to age-related macular degeneration: A case report series.

This report describes a series of cases with massive subretinal hemorrhage (SRH) due to age-related macular degeneration (AMD) treated by subretinal alteplase injections. In all cases, the surgical technique consisted in 25-gauge pars plana vitrectomy (PPV) and alteplase injection under the retina using a 38-gauge cannula. After the fluid-gas exchange, bevacizumab injection was performed in all patients. Three cases of SRH in which this technique was used, as well as their evolution at one week and one month postoperatively are described. Visual acuity was hand motion in all three cases at presentation. After surgery, a significant anatomical and functional improvement was noted in all cases. One month postoperatively, none of the patients had blood under the macula, and visual acuities significantly improved to 0.8, 0.2 and 0.16 (decimal fraction). A consistent reduction of central retinal thickness was observed on optical coherence tomography (OCT) from the first week postoperatively. No intra and postoperative complications were noted. Subretinal alteplase injection proved as a viable solution in these severe SRH with early presentation. There was no need to change the systemic anticoagulant and antiaggregant therapy. Bevacizumab intravitreal injection at the end of surgery has an important role in preventing further bleeding.

High-resolution imaging of diabetic retinopathy lesions using an adaptive optics retinal camera.

Purpose. Adaptive optics (AO) imaging is a promising high-resolution investigation technique in ophthalmology that can bring new information about the pathophysiology of diabetic retinopathy. Material and methods. Seven patients previously diagnosed with diabetic retinopathy were investigated with optical coherence tomography (OCT) scanning, OCT angiography, fundus photo, and AO retinal camera (rtx1TM, Imagine Eyes, Orsay, France). Results. The red lesions on fundus photos appeared on AO imaging as hyporeflective lesions. OCT angiography helped us to differentiate between microaneurysms and hemorrhages. Hard exudates had a heterogeneous granular appearance. Retinal oedema was proved to have a blurring effect on the AO images. In addition to this, cystic spaces were identified to have a hyporeflective demarcation line. Conclusions. AO imaging is offering a fine documentation of retinal lesions and might become an important instrument for early diagnosis of diabetic retinopathy and for explaining its pathophysiological mechanisms. Abbreviations: AO = adaptive optics, AOO = adaptive optics ophthalmoscopy, SS = swept source, OCT =optical coherence tomography, SLO = scanning laser ophthalmoscope.