FUNCTIONAL AND ANATOMICAL OUTCOMES AFTER SHORT-TERM HEAVY SILICONE OIL ENDOTAMPONADE FOR INFERIOR RHEGMATOGENOUS RETINAL REDETACHMENT, A PILOT STUDY.

PURPOSE: To assess the success of the short-term location of the heavy silicone oil (Densiron 68, HSO) as endotamponade after pars plana vitrectomy (PPV) for rhegmatogenous complex retinal re-detachment (RRD). METHODS: Consecutive, retrospective, nonrandomized, pilot study was conducted. Twenty-two eyes of 22 patients with complex inferior RRD previously tamponade with gas (SF6 or C3F8) or 1000cSt silicon oil (SSO) were selected. All were treated with heavy silicone oil HSO endotamponade, and its removal was performed after 1-month. The main outcomes were best corrected visual acuity (BCVA) and postoperative complications after the heavy silicone oil removal. RESULTS: Of the 22 eyes, 10 were SSO endotamponade, 3 with fluorinated gas 14% C3F8, and 9 with 20% SF6 at first surgery. In all cases, a complex inferior RRD was observed after the first surgery, in 1-3 months after silicone oil removal or gas endotamponade introduction.In ten cases the proliferative vitreoretinopathy PVR (grade B or C 1-3) was found. The main BCVA before HSO removal was 0.55± 0.20 logMAR (range 0.4-0.7) and after the HSO removal, it was 0.32± 0.29 logMAR (0.1-0.4).Among the postoperative complications, only in 4 eyes the macular edema was found (medically resolved), in 4 eyes an increase of intraocular pressure (IOP), and none of these developed the epiretinal membrane (ERM). CONCLUSION: The main purpose of this study is to establish a short-term heavy silicone oil endotamponade in eyes with complex retinal detachment recurrences, reducing the possible postoperative complications and having a better prognosis for visual acuity outcomes.

Short-term peripapillary structural and vascular changes following anti-VEGF vs. Dexamethasone intravitreal therapy in patients with DME.

PURPOSE: To evaluate short-term peripapillary structural and vascular changes in DME after treatment with dexamethasone implant (DEX-I) and anti-VEGFs using OCT-A. METHODS: Sixty-five patients with naïve center-involving DME were enrolled. 33 of sixty five patients (group 1) underwent with single DEX-I 0.7 mg (Ozurdex, Allergan, Inc., USA), 32 of sixty-five (group 2) underwent with intravitreal injection of aflibercept 0.5 mg (Eylea, Bayer, Genentech, San Francisco, USA). The OCT acquisition was completed at the following visits: (i) "T1 visit" corresponding to the intravitreal injection of DEX-I or aflibercept in patients with naïve center-involving DME (ii) "T2 visit" corresponding to the examination performed 2 weeks after intravitreal injection of aflibercept and 1 month after DEX-I. The parameters analyzed were: (i) RPC vasculature density (VD); (ii) peripapillary retinal nerve fiber layer (pRNFL) thickness, and (iii) intraocular pressure (IOP). RESULTS: The RPC analysis showed a VD increase at T2 in both groups, although values did not reach statistical significance (48.12± 4.17 and 49.04 ± 4.23; P = 0.081 in Group 1 and 46.93± 3.16 and 47.17 ± 3.70; P = 0.087 in Group 2). Likewise, the pRNFL thickness and IOP fluctuations did not show statistically significant changes in in both groups among the different study visits. CONCLUSIONS: After intravitreal injection (anti-VEGF or DEX-I), no significant short-term changes were found in peripapillary microvasculature, IOP and pRNFL thickness in diabetic eyes treated with anti-VEGF or DEX-I.