Surgical outcomes of petalloid multilayered inverted internal limiting membrane flaps in extra-large macular holes.

PURPOSE: To analyze the surgical outcomes of petalloid multilayered inverted internal limiting flap using perfluorocarbon liquid (PFCL) in extra-large macular holes (MHs) (minimum linear diameter >550 µm and basal diameter [BD] >1000 µm). METHODS: This was a prospective interventional series of 103 eyes of 99 patients with extra-large MHs which were treated with 25-gauge pars plana vitrectomy, petalloid multilayered inverted internal limiting membrane flaps under PFCL and 15% perfluoropropane (C3F8) gas tamponade. Intraoperative optical coherence tomography (i-OCT) was used to confirm correct positioning of flaps. Follow-up was at 1 week, 1 month, and 3 months postoperatively. RESULTS: Mean age of patients was 58.282 ± 16.3 years. Mean preoperative best corrected visual acuity (BCVA) was logarithm of minimum angle of resolution (logMAR) 1.206 ± 0.384, and the value at the third month was logMAR 0.793 ± 0.337. Mean minimum linear diameter (MLD) was 711.96 ± 270.744 µm. MLD ranged from 557µm (minimum MLD) to 2657 µm (maximum MLD). Mean BD was 1301.165 ± 425.914 µm. Type 1 closure was seen in 92.2% eyes, 5.8% eyes had type 2 closure, and 1.9% eyes had type 3 closure. Eyes with both type 1 closure (P = 0.001) and type 2 closure (P = 0.009) showed a significant improvement in BCVA postoperatively at 3 months. CONCLUSION: Petalloid multilayered inverted internal limiting membrane flap under PFCL technique with adjunctive use of i-OCT showed improved morphological and functional outcomes in the treatment of extra-large MHs. We present here a large series of extra-large MHs, in which a novel technique of petalloid multilayered inverted ILM flaps was used.

Presumed Post-COVID Infection Retinitis - Clinical and Tomographic Features of Retinitis as a Post-COVID Syndrome.

PURPOSE: To study clinical and imaging features of presumed post-COVID infection retinitis. METHOD: Retrospective case series of patients presenting with retinitis lesions with evidence of recent COVID infection. Retinal findings and optical coherence tomography (OCT) features were studied at baseline and follow-ups. RESULTS: Twenty-four eyes of 17 patients were included. Mean age was 36.57 ± 11.78 years. Baseline visual acuity (VA) was log MAR 0.97 ± 0.43. Fundus findings included retinitis patches (n = 24),hard exudates (n = 8), and superficial hemorrhages (n = 16). OCT features included neurosensory detachment (NSD, n = 20), hyperreflective inner layers (n = 24), acute macular neuroretinopathy (AMN, n = 8), hyperreflective foci (n = 20). At final follow-up, VA was logMAR 0.43 ± 0.27. Retinitis patches persisted in four eyes, AMN in three eyes, and NSD in five eyes. Conclusion- Post- COVID infection retinitis adds to existing literature on post COVID syndromes.

Retained sutures in the trachea.

A 57-year-old man was evaluated for mucosal irregularity involving the anterior tracheal wall detected on a routine chest computed tomography scan performed for lung transplant evaluation. He had a history of hypercapneic respiratory failure requiring tracheostomy, yet he had been successfully decannulated several months before presentation. Flexible bronchoscopy revealed retained suture material at the earlier tracheostomy site, which was successfully clipped and removed.

Bronchial mucoepidermoid carcinoma.

We report a case of a minimally fluoro-2-deoxy-D-glucose avid bronchial mucoepidermoid tumor in a young male heavy smoker who presented with hemoptysis and a normal chest x-ray.