PHOTOBIOMODULATION THERAPY FOR LARGE SOFT DRUSEN AND DRUSENOID PIGMENT EPITHELIAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION: A Single-Center Prospective Pilot Study.

PURPOSE: To evaluate visual acuity and morphologic changes after photobiomodulation (PBM) for patients affected with large soft drusen and/or drusenoid pigment epithelial detachment associated with dry age-related macular degeneration. METHOD: Twenty eyes with large soft drusen and/or drusenoid pigment epithelial detachment age-related macular degeneration were included and treated using the LumiThera Valeda Light Delivery System. All patients underwent two treatments per week for 5 weeks. Outcome measures included best-corrected visual acuity, microperimetry-scotopic testing, drusen volume, central drusen thickness, and quality of life score at baseline and month 6 (M6) follow-up. Data of best-corrected visual acuity, drusen volume, and central drusen thickness were also recorded at week 5 (W5). RESULTS: Best-corrected visual acuity significantly improved at M6 with a mean score gain of 5.5 letters ( P = 0.007). Retinal sensitivity decreased by 0.1 dB ( P = 0.17). The mean fixation stability increased by 0.45% ( P = 0.72). Drusen volume decreased by 0.11 mm 3 ( P = 0.03). Central drusen thickness was reduced by a mean of 17.05 µ m ( P = 0.01). Geographic atrophy area increased by 0.06 mm 2 ( P = 0.01) over a 6-month follow-up, and quality of life score increased by 3,07 points on average ( P = 0.05). One patient presented a drusenoid pigment epithelial detachment rupture at M6 after PBM treatment. CONCLUSION: The visual and anatomical improvements in our patients support previous reports on PBM. PBM may provide a valid therapeutic option for large soft drusen and drusenoid pigment epithelial detachment age-related macular degeneration and may potentially slow the natural course of the disease.

Bilateral Marginal Corneal Infiltrates: A Novel Ocular Manifestation of DRESS Syndrome.

BACKGROUND: Drug reaction with eosinophilia and systemic symptoms, known as DRESS syndrome, is a rare drug induced hypersensitivity reaction syndrome. METHODS: case resport. RESULTS: We describe a patient who presented with acute erythematous rash on her face, fever>38ºC, lymphadenopathy, blood abnormalities, and reaction suspected to be amoxicillin clavulanate-related. The patient also had an associated bilateral redness of the conjunctiva, peripheral corneal infiltrates, and anterior chamber with 3+ cells. CONCLUSION: We describe the first occurrence of bilateral marginal corneal infiltrates and acute anterior uveitis associated with amoxicillin clavulanate-induced DRESS syndrome and discuss its pathogenesis.