Ocular decompression retinopathy following intracameral bevacizumab injection in a case of proliferative diabetic retinopathy with neovascular glaucoma.

A 49-year-old diabetic female was diagnosed to have both eyes proliferative diabetic retinopathy (PDR) and neovascular glaucoma (NVG [rubeosis stage in the right eye and angle-closure stage in the left eye]). The right eye anterior and posterior segment new vessels regressed 2 weeks following intravitreal bevacizumab (IVB) injection. The left eye fundus revealed fibrovascular proliferation (FVP) for which panretinal photocoagulation (PRP) was started and subsequently intracameral bevacizumab (ICB) was injected. Following this intervention, the left eye new vessels of iris regressed but fundus showed multiple peripapillary white-centered intraretinal and subhyaloid hemorrhage suggestive of decompression retinopathy. Ocular decompression retinopathy presents as retinal hemorrhages following the acute lowering of the intraocular pressure (IOP). This case describes the rare occurrence of ocular decompression retinopathy following ICB in a case of PDR with NVG.

Can cryotherapy be used as an adjunct in select cases of recalcitrant endophthalmitis? - A case report.

We report two cases of recalcitrant endophthalmitis, a delayed postoperative fungal endophthalmitis following cataract surgery and an atypical mycobacterial endogenous endophthalmitis associated with infective scleritis. Due to recalcitrant nature of the endophthalmitis, one or more sittings of double freeze and thaw cryotherapy was applied over and adjacent to the infective foci in each case. This cryotherapy was used as an adjunct alongside conventional endophthalmitis management following which resolution of infection was observed in both cases.

Role of PASCAL and optical coherence tomography angiograpgy in the treatment of diffuse unilateral subacute neuroretinitis caused by large live motile worm.

A 46-year-old male presented with best corrected visual acuity (BCVA) of 20/125 in his right eye. Fundus showed disc edema, multiple yellow outer retinal crops, macular edema and a live motile worm in the subretinal space. Diagnosis of diffuse unilateral subacute neuroretinitis (DUSN) was made and pattern scanning laser photocoagulation (PSLP) was performed along with administration of oral albendazole, diethylcarbamazine and corticosteroids. Complete disappearance of the worm was observed at 2 weeks. At last follow up, final BCVA improved to 20/30. Herein, we report role of PSLP in the management of DUSN.

Occlusion of the central retinal artery in Plasmodium falciparum malaria.

A 40-year-old woman presented with sudden painless diminution of vision in left eye. The best corrected visual acuity was 20/20 in the right eye and 20/400 in the left eye. The vision loss occurred 3 days after the onset of fever with chills and rigour. Rapid diagnostic test and peripheral blood smear examination revealed Plasmodium falciparum malaria. The left eye fundus showed a pale disc with marked attenuation of arterioles. A detailed systemic evaluation including cardiovascular, haematological and angiographic assessments was performed which did not reveal any abnormality. A diagnosis of central retinal artery occlusion (CRAO) associated with uncomplicated P. falciparum malaria was made. In this communication, we report that acute loss of vision in a patient with P. falciparum malaria, CRAO needs to be ruled out.

Response to anti-vascular endothelial growth factor of abnormal retinal vascular net in para foveal telangiectasia group II images on optical coherence tomography-angiography.

PURPOSE: To identify optical coherence tomography-angiography (OCT-A) findings to predict treatment response during anti-vascular endothelial growth factor (VEGF) therapy in eyes with para foveal telangiectasia (PFT) group II. METHODS: In this retrospective series, Twelve eyes of seven patients diagnosed with PFT group II without evidence of sub-retinal neovascular membrane (SRNVM) clinically or on spectral domain-OCT (SD-OCT) were included. All patients underwent OCT-A on the Topcon DRI OCT Triton® with 4.5 mm macula scans. The patients with abnormal vascular nets were further classified into type A and B nets and administered intravitreal anti-VEGF therapy. Visual acuity and size of type A and B nets were evaluated pre- and post-injection. Paired t- test and intraclass correlation were used to analyse data. RESULTS: Patients with type A net showed significant improvement in visual acuity (logMAR 0.38, P = 0.0047). The size of type A net showed statistically significant decrease (P = 0.0008) on 6 month follow up. Type B net did not show statistically significant difference in visual acuity or size following anti-VEGF therapy. CONCLUSION: OCT-A plays an important role in early detection of possible neovascular nets (type A), in the absence of obvious SRNVM. Treatment decisions based on OCT-A may be helpful to achieve better visual outcome.

Orbital apex osteodural fistula--An unusual surgical access.

Dural arteriovenous fistulas (DAVFs) are fistulas connecting the branches of dural arteries to dural veins or a venous sinus. Osteodural fistulas are a rare subset of this group of diseases. We wish to report a rare case of an osteodural arteriovenous fistula at the foot of the superior ophthalmic vein (SOV), treatment of which required an unusual surgical approach via the orbit and SOV. Though access for endovascular treatment via the SOV for treatment of caroticocavernous fistulas is reported, the external approach is relatively infrequently performed, outside Europe and the Americas, with this being the first reported procedure from the Indian subcontinent. We wish to explain the steps of this unusual surgical access and highlight the salient precautions and pitfalls in the technique.