1: Retina. 2010 Mar 12; [Epub ahead of print] 

Diagnostic and Therapeutic Challenges.

Lima LH, Shakin E, Sen HN, Nussenblatt RB, Yannuzzi LA, Jampol LM, Cunningham
ET.

PMID: 20234333  [PubMed - as supplied by publisher]

2: Retina. 2010 Mar 12; [Epub ahead of print] 

TOWARD EARLIER DETECTION OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO
AGE-RELATED MACULAR DEGENERATION: Multicenter Evaluation of a Preferential
Hyperacuity Perimeter Designed as a Home Device.

Loewenstein A, Ferencz JR, Lang Y, Yeshurun I, Pollack A, Siegal R, Lifshitz T,
Karp J, Roth D, Bronner G, Brown J, Mansour S, Friedman S, Michels M, Johnston
R, Rapp M, Havilio M, Rafaeli O, Manor Y.

From the *Department of Ophthalmology, Tel Aviv Medical Center, Tel-Aviv,
Israel; the daggerMeir Medical Center, Kfar Saba, Israel; double daggerHaEmek
Medical Center, Afula, Israel; section signWolfson Medical Center, Holon,
Israel; paragraph signKaplan Medical Center, Rehovot, Israel; **Rabin Medical
Center, Petah Tikvah, Israel; daggerdaggerSoroka Medical Center, Beer Sheba,
Israel; double daggerdouble daggerMachon Mor, Ramat Gan, Israel; section sign
section signRetina-Vitreous Center, Toms River, New Jersey; paragraph sign
paragraph signFoxman Foxman & Margolis, Retinal and Ophthalmic Consultants,
Northfield, New Jersey; ***Charlotte Eye Ear Nose & Throat Associates,
Charlotte, North Carolina; daggerdaggerdaggerVirginia Retina Center, Leesburg,
Virginia; double daggerdouble daggerdouble daggerCentral Florida Retina
Institute, Lakeland, Florida; section sign section sign section signRetina Care
Specialists, Palm Beach Gardens, Florida; paragraph sign paragraph sign
paragraph signEdina Retina Consultants, Edina, Minnesota; and ****Notal Vision,
Ltd, Tel Aviv, Israel.

PURPOSE:: The primary purpose of this study was to evaluate the ability of a
home device preferential hyperacuity perimeter to discriminate between patients
with choroidal neovascularization (CNV) and intermediate age-related macular
degeneration (AMD), and the secondary purpose was to investigate the dependence
of sensitivity on lesion characteristics. METHODS:: All participants were tested
with the home device in an unsupervised mode. The first part of this work was
retrospective using tests performed by patients with intermediate AMD and newly
diagnosed CNV. In the second part, the classifier was prospectively challenged
with tests performed by patients with intermediate AMD and newly diagnosed CNV.
The dependence of sensitivity on lesion characteristics was estimated with tests
performed by patients with CNV of both parts. RESULTS:: In 66 eyes with CNV and
65 eyes with intermediate AMD, both sensitivity and specificity were 0.85. In
the retrospective part (34 CNV and 43 intermediate AMD), sensitivity and
specificity were 0.85 +/- 0.12 (95% confidence interval) and 0.84 +/- 0.11 (95%
confidence interval), respectively. In the prospective part (32 CNV and 22
intermediate AMD), sensitivity and specificity were 0.84 +/- 0.13 (95%
confidence interval) and 0.86 +/- 0.14 (95% confidence interval), respectively.
Chi-square analysis showed no dependence of sensitivity on type (P = 0.44),
location (P = 0.243), or size (P = 0.73) of the CNV lesions. CONCLUSION:: A home
device preferential hyperacuity perimeter has good sensitivity and specificity
in discriminating between patients with newly diagnosed CNV and intermediate
AMD. Sensitivity is not dependent on lesion characteristics.

PMID: 20234332  [PubMed - as supplied by publisher]

3: Retina. 2010 Mar 10; [Epub ahead of print] 

THE RESULTS OF INTRAVITREAL BEVACIZUMAB INJECTIONS FOR PERSISTENT
NEOVASCULARIZATIONS IN PROLIFERATIVE DIABETIC RETINOPATHY AFTER PHOTOCOAGULATION
THERAPY.

Erdol H, Turk A, Akyol N, Imamoglu HI.

From the Department of Ophthalmology, Karadeniz Technical University, School of
Medicine, Trabzon, Turkey.

PURPOSE:: The purpose of this study was to evaluate the effectiveness of
intravitreal bevacizumab on persistent retinal neovascularizations in
proliferative diabetic retinopathy. METHODS:: Thirty-three eyes of 24 patients
(mean age, 52.75 +/- 8.2 years) with proliferative diabetic retinopathy showing
recurrences or no regressions in neovascularizations were evaluated in this
study. After the intravitreal injection of 1.25 mg/0.05 mL of bevacizumab, the
first examination was performed within 3 days and repeated at 1 week, 1 month, 3
months, and 6 months. In these examinations, localization and dimensions of
neovascularizations were evaluated with red-free photographs and/or fluorescein
angiography. RESULTS:: All patients had type II diabetes for a period of 12 +/-
4.4 years (range, 2-20 years). After a single dose of bevacizumab, complete
resolution rate of neovascularizations was 78.8% at 1 month, 63.6% at 3 months,
and 45.4% at 6 months. When evaluated together with 9 eyes that had a second
injection at 3 months, the complete resolution rate was 60.6% at 6 months. Mean
best-corrected visual acuity and macular volume were 1.06 logarithm of the
minimum angle of resolution (20/225 in Snellen) and 11.65 mm before treatment.
Six months after treatment, these were 0.73 logarithm of the minimum angle of
resolution (20/108 in Snellen) and 8.92 mm (P = 0.048 and 0.003, respectively).
CONCLUSION:: Bevacizumab can be used safely and successfully in patients with
proliferative diabetic retinopathy who do not experience any resolution or
experience recurrences after panretinal photocoagulation.

PMID: 20224478  [PubMed - as supplied by publisher]

4: Retina. 2010 Mar 10; [Epub ahead of print] 

DO PLATELETS HAVE A ROLE IN THE PATHOGENESIS OF AGGRESSIVE POSTERIOR RETINOPATHY
OF PREMATURITY?

Vinekar A, Hegde K, Gilbert C, Braganza S, Pradeep M, Shetty R, Shetty KB.

From the *Department of Pediatric Retina, Narayana Nethralaya Postgraduate
Institute of Ophthalmology, Bangalore, India; the daggerLondon School of Hygiene
and Tropical Medicine, London, UK; and the double daggerDepartment of
Neonatology, MS Ramaiah Medical College and Hospital, Bangalore, India.

PURPOSE:: The purpose of this study was to report the possible role of
thrombocytopenia in the pathogenesis of aggressive posterior retinopathy of
prematurity (APROP). METHODS:: The index case described in this study showed
spontaneous resolution of APROP with plus disease within 3 days of correcting
thrombocytopenia and did not require laser treatment. The retrospective cohort
of nine consecutive Asian Indian infants with APROP with similar stage and plus
disease as the index case was studied. The mean platelet count of these infants
before laser treatment was compared with 21 age- and birth weight-matched
control subjects. Correlation of platelet count with APROP is discussed.
RESULTS:: The mean birth weight of the 10 cases with APROP was 1,030 g (+/-178
g), and the mean period of gestation was 29.4 weeks (+/-2.0 weeks). The mean
platelet count of the cases was 82,870/mm (+/-58,702/mm) and that of the control
subjects was 178,285 +/- 57,051/mm (P = 0.0002). Five of the 10 cases (50%) and
1 of the 21 control subjects (4.8%) had a platelet count of <100,000/mm (P =
0.007). In all, 19.4% of infants had culture-proven sepsis. There was no
correlation between sepsis and thrombocytopenia in our cohort (P = 0.567).
CONCLUSION:: The role of low platelets in the etiopathogenesis of APROP has not
been previously elucidated. Our study shows that a platelet count of <100,000
was associated with severe disease. Recently, platelets have been reported to
play a key role in angiogenic regulatory protein delivery. It is possible that
premature infants who develop retinopathy of prematurity in the setting of low
platelet counts may lack the function of either delivering the optimal level or
incompletely scavenging the excess of vascular endothelial growth factor A
present in APROP. The spontaneous resolution of disease in our index case with
platelet correction alone needs additional studies to correlate the timing and
magnitude of correction that may play a role.

PMID: 20224477  [PubMed - as supplied by publisher]

5: Retina. 2010 Mar 10; [Epub ahead of print] 

AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY.

Drenser KA, Trese MT, Capone A Jr.

From the Associated Retinal Consultants, Royal Oak, Michigan.

PURPOSE:: The purpose of this study was to review the anatomic and function
outcomes of aggressive posterior retinopathy of prematurity occurring at the
authors' institution. METHODS:: This is a retrospective chart review of inborn
infants developing aggressive posterior retinopathy of prematurity from January
2004 through January 2008. Birth histories, interventions, and outcomes were
reviewed. RESULTS:: Twenty-two infants were identified as having aggressive
posterior retinopathy of prematurity. All eyes underwent peripheral laser
ablation. Seven infants (14 eyes) required a second session of laser. Five
infants (eight eyes) progressed to retinal detachment that was successfully
repaired by lens-sparing vitrectomy. Seven eyes developed stage 4a detachments,
and one eye developed a stage 4b detachment. Forty-three eyes (43 of 44)
demonstrated a good anatomic outcome with minimal posterior pole distortion.
CONCLUSION:: The management of aggressive posterior retinopathy of prematurity
requires frequent screening examinations and timely intervention as outlined in
the Early Treatment retinopathy of prematurity study. Eyes progressing to
retinal detachment may still have a good structural outcome with lens-sparing
vitrectomy.

PMID: 20224476  [PubMed - as supplied by publisher]

6: Retina. 2010 Mar 10; [Epub ahead of print] 

TREATMENT OF TYPE 1 RETINOPATHY OF PREMATURITY WITH INTRAVITREAL BEVACIZUMAB
(AVASTIN).

Dorta P, Kychenthal A.

From the Department of Ophthalmology, Hospital de Ninnos Roberto del Rio,
Santiago, Chile.

PURPOSE:: The purpose of this study was to report a noncomparative consecutive
case series of eyes with type 1 retinopathy of prematurity treated only with
intravitreal bevacizumab (Avastin). METHODS:: Twelve consecutive eyes of 7
premature infants, with type 1 retinopathy of prematurity as stated in the
Results of the Early Treatment for Retinopathy of Prematurity Randomized Trial,
were treated with only one intravitreal injection of bevacizumab (0.625 mg).
RetCam pictures were used to document the cases. RESULTS:: Nine eyes had zone I
and 3 eyes had zone II retinopathy of prematurity. The infants weighed between
600 and 1,100 grams (mean, 846.57 g). The gestational age ranged from 23 weeks
to 28 weeks (mean, 25.57 weeks). All eyes showed regression of the disease with
no additional treatment needed. CONCLUSION:: Intravitreal bevacizumab is a
useful therapy for type 1 retinopathy of prematurity. However, additional
studies are needed to define the role of Avastin as the first-line therapy, in
combination, or after the failure of laser photocoagulation.

PMID: 20224475  [PubMed - as supplied by publisher]

7: Retina. 2010 Mar 10; [Epub ahead of print] 

VITRECTOMY AFTER INTRAVITREAL BEVACIZUMAB (AVASTIN) FOR RETINAL DETACHMENT IN
RETINOPATHY OF PREMATURITY.

Kychenthal A, Dorta P.

From the Department of Ophthalmology, Hospital de Ninos Roberto del Rio,
Santiago, Chile.

PURPOSE:: The purpose of this study was to evaluate the feasibility of
performing vitrectomies after using bevacizumab (Avastin, Genentech, San
Francisco, CA) for the management of retinal detachments in retinopathy of
prematurity. METHODS:: Eleven eyes of 8 children with retinopathy of prematurity
retinal detachment that developed despite peripheral ablation with indirect
diode laser were injected with 0.625 mg bevacizumab. Injections were given
through the pars plicata, and the status of the central retinal artery was
checked with indirect ophthalmoscopy. A vitreoretinal surgery was scheduled for
1 week after the Avastin injection. All eyes underwent surgery using 25- or
23-gauge instrumentation. Demographic data, neovascular activity, and the
anatomic status of the retina were evaluated. Systemic and local perioperative
complications were recorded. RESULTS:: The average gestational birth weight was
950 g, and the average gestational age at birth was 25.7 weeks. Although 9 eyes
had stage 4A, 2 had stage 4B retinal detachments. Six eyes had zone II and five
eyes had zone I disease. Bevacizumab was injected at an average postgestational
age of 38 weeks. A notable reduction in the vascular activity could be observed
1 week later when vitrectomy was performed. With a mean follow-up of 8.5 months
(range, 2-13 months), a favorable outcome could be observed in all eyes. Only
one eye with persistent vitreous hemorrhage required reoperation. No
complications attributable to the bevacizumab injections were noted.
CONCLUSION:: These data show that vitrectomy after intravitreal bevacizumab can
be effective in selected cases. The regression of the vascular activity induced
by this drug might contribute to better results in some of these cases. There
were no apparent short-term safety concerns for intravitreal bevacizumab
injections in these babies. However, additional studies are needed to define the
role of bevacizumab as a possible adjuvant in the management of retinopathy of
prematurity retinal detachments.

PMID: 20224474  [PubMed - as supplied by publisher]

8: Retina. 2010 Mar 10; [Epub ahead of print] 

DELAYED PRESENTATION OF CYTOMEGALOVIRUS RETINITIS IN AN INFANT WITH SEVERE
CONGENITAL CYTOMEGALOVIRUS INFECTION.

Coors LE, Spencer R.

From the Texas Retina Associates, Dallas, Texas.

PURPOSE:: The purpose was to study the congenital cytomegalovirus (CMV), which
is the most common cause for congenital infection in the United States,
affecting nearly 40,000 infants per year. There is no widely accepted treatment
protocol for congenital CMV infection despite recent clinical trials with
antiviral medications ganciclovir and valganciclovir. METHODS:: We present a
case report of an infant with severe congenital CMV infection with presentation
of chorioretinitis in both eyes at 5 months of age. RESULTS:: The child did not
receive treatment with ganciclovir during hospitalization after birth despite
severe manifestations of CMV infection. Treatment was again withheld after
diagnosis of retinitis because of immunocompetent status, potential side effects
of ganciclovir treatment, and location of retinitis in the retinal periphery of
both eyes. The retinitis resolved during a period of 3 months. CONCLUSION:: This
case shows that CMV retinitis in infants with congenital CMV infection can be
delayed in presentation and can resolve without treatment. It shows the need for
more consistent monitoring for chorioretinitis in infants with congenital CMV
infection.

PMID: 20224473  [PubMed - as supplied by publisher]

9: Retina. 2010 Mar 10; [Epub ahead of print] 

FUNDUS AUTOFLUORESCENCE, OPTICAL COHERENCE TOMOGRAPHY, AND ELECTRORETINOGRAM
FINDINGS IN CHOROIDAL SCLEROSIS.

Hwang JC, Kim DY, Chou CL, Tsang SH.

From the Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia
University Medical Center, New York, New York.

PURPOSE:: The purpose of this study was to describe fundus autofluorescence
(FAF), optical coherence tomography, and electroretinogram findings in choroidal
sclerosis. METHODS:: This is a retrospective case series. Eight eyes of four
patients with choroidal sclerosis were evaluated with FAF, optical coherence
tomography, and electroretinogram testing. RESULTS:: In all eight eyes, FAF
imaging showed hypofluorescent placoid lesions corresponding to areas of
chorioretinal atrophy seen on stereo biomicroscopy. Prominent hyperfluorescent
linear markings underlying regions of atrophic disease were observed in all
eyes, likely representative of normal choroidal vessel autofluorescence. In two
eyes, FAF showed punctate hypofluorescent lesions in the fovea that were not
visualized on biomicroscopy. In one eye, FAF identified a central island of
preserved retinal pigment epithelium that was not realized on ophthalmoscopic
examination. Optical coherence imaging was significant for loss of choroidal
fine tubular structures, retinal pigment epithelium, and outer nuclear layer in
regions of chorioretinal atrophy. Full-field electroretinogram testing showed
generalized rod-cone dysfunction in all patients with a lower B- to A-wave ratio
in two patients. CONCLUSION:: Fundus autofluorescence and optical coherence
tomography are noninvasive diagnostic adjuncts that can aid in the diagnosis of
choroidal sclerosis. Fundus autofluorescence may be a more sensitive marker of
disease extent and progression than clinical examination alone.
Electroretinogram testing can result in an electronegative maximal response.

PMID: 20224472  [PubMed - as supplied by publisher]

10: Retina. 2010 Mar 10; [Epub ahead of print] 

Fibrin Glue-Assisted Conjunctival Closure in Pars Plana Vitrectomy Where
Conjunctival Closure With a Suture Would Be Difficult.

Choi SH, Lee EK, Nam KY, Kim JY.

From the *Department of Ophthalmology, Chungnam National University College of
Medicine, Daejeon, South Korea; and the daggerResearch Institute for Medical
Science, Chungnam National University, Daejoen, South Korea.

PMID: 20224471  [PubMed - as supplied by publisher]

11: Retina. 2010 Mar 10; [Epub ahead of print] 

EFFECT OF OPERATIVE FIELD IRRIGATION ON INTRAOPERATIVE BACTERIAL CONTAMINATION
AND POSTOPERATIVE ENDOPHTHALMITIS RATES IN 25-GAUGE VITRECTOMY.

Shimada H, Nakashizuka H, Hattori T, Mori R, Mizutani Y, Yuzawa M.

From the Department of Ophthalmology, School of Medicine, Nihon University,
Tokyo, Japan.

PURPOSE:: The purpose of this study was to compare bacterial contamination and
endophthalmitis rates with different irrigation methods in 25-gauge vitrectomy.
METHODS:: A total of 4,347 eyes undergoing 25-gauge vitrectomy were studied
prospectively. Of these, 2,801 eyes were irrigated with infusion fluid (group A)
and 1,546 with 1.25% povidone-iodine (group B) after lid speculum placement.
Bacteriologic culture was performed for 103 eyes in group A and 155 eyes in
group B using the following samples: ocular surface fluid after placement of the
lid speculum (left eye 1), ocular surface fluid after operative field irrigation
(left eye 2), vitreous collected after angled incision made while some
irrigation fluid remains in the conjunctival sac (V1), and vitreous at the
completion of vitrectomy (V2). RESULTS:: The bacterial contamination rate in
left eye 1 did not differ significantly between groups A (5.5%) and B (5.8%).
However, the rates in left eye 2, V1, and V2 were lower in group B (0%, 0%, and
0.6%, respectively) than in group A (2.0%, 1.0%, and 2.0%). Incidences of
endophthalmitis were 0 of 2,801 eyes and 0 of 1,546 eyes in groups A and B,
respectively. CONCLUSION:: After lid speculum placement, ocular surface
contamination occurred in approximately 6% of eyes. Irrigating the operative
field again with 1.25% povidone-iodine and performing sclerotomy with some
povidone-iodine remaining in the conjunctival sac prevented bacterial
contamination of the vitreous.

PMID: 20224470  [PubMed - as supplied by publisher]

12: Retina. 2010 Mar 10; [Epub ahead of print] 

RETINAL FUNCTIONAL CHANGES MEASURED BY MICROPERIMETRY IN NEOVASCULAR AGE-RELATED
MACULAR DEGENERATION TREATED WITH RANIBIZUMAB: 24-Month Results.

Parravano M, Oddone F, Tedeschi M, Chiaravalloti A, Perillo L, Boccassini B,
Varano M.

From the Fondazione G. B. Bietti-IRCCS, Rome, Italy.

PURPOSE:: The purpose of this study was to assess long-term functional and
structural retinal changes in patients with neovascular age-related macular
degeneration treated with intravitreal 0.5 mg ranibizumab. METHODS:: Eighteen
patients with neovascular age-related macular degeneration have been evaluated
in this retrospective 24-month follow-up study. All patients have been treated
with 3 injections of 0.5 mg ranibizumab 1 month apart and retreated according to
predefined criteria. At baseline, all patients were subjected to visual acuity,
fluorescein angiography, MP1 microperimetry, and stratus optical coherence
tomography. Although visual acuity and optical coherence tomography were
repeated 28 +/- 2 days after each injection, MP1 was performed at 6, 12, and 24
months. RESULTS:: Seventeen of 18 and 14 of 18 patients completed 12 and 24
months of follow-up, respectively. Mean retinal sensitivity significantly
improved from 3.89 +/- 3.0 dB to 7.33 +/- 4.11 dB at 24 months (P = 0.024). Mean
visual acuity improved from 48.67 +/- 8.59 to 59.17 +/- 16.45 at 24 months (P =
0.049). Visual acuity improved to >/=15 letters in 33.3% (6 of 18) of patients
and <15 letters in 44.4% (8 of 18); 22.2% (4 of 18) of patients lost <15 letters
at 24 months. Five of 13 patients (38.5%) with either an instable or relatively
instable fixation at baseline showed improvement of fixation stability at 24
months. Central retinal thickness significantly decreased from 310.5 +/- 85.7 to
232.9 +/- 60.1 at 24 months (P = 0.0001). CONCLUSION:: Intravitreal injections
of 0.5 mg ranibizumab determine progressive improvement of retinal sensitivity
until 24 months, although visual acuity levels off after 6 months, suggesting
that microperimetry may give additional information about macular function not
given by visual acuity alone.

PMID: 20224469  [PubMed - as supplied by publisher]

13: Retina. 2010 Mar 10; [Epub ahead of print] 

POSTERIOR UVEAL MELANOMA IN YOUNG PATIENTS TREATED WITH PROTON BEAM THERAPY.

Vavvas D, Kim I, Lane AM, Chaglassian A, Mukai S, Gragoudas E.

From the Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical
School, Boston, Massachusetts.

PURPOSE:: The purpose was to study the clinical profile and prognosis of young
patients with uveal melanoma treated by proton beam irradiation. METHODS:: A
retrospective case-control series was studied. Seventeen patients aged 20
years were treated for posterior uveal melanoma between 1975 and 2004. All
patients were treated with proton beam irradiation at Harvard Cyclotron.
Metastasis and survival of patients were the main outcome measures. RESULTS:: Of
a total of 3,207 patients with uveal melanoma, 17 patients were PMID: 20224468  [PubMed - as supplied by publisher]

14: Retina. 2010 Mar 10; [Epub ahead of print] 

RAPID VISION LOSS ASSOCIATED WITH FLUDARABINE ADMINISTRATION IN THREE PATIENTS.

Bishop RJ, Ding X, Heller CK 3rd, Illei G, Caruso RC, Cunningham D, Pavletic S,
Chan CC.

From the *National Eye Institute, National Institutes of Health, Bethesda,
Maryland; the daggerNational Cancer Institute, National Institutes of Health,
Bethesda, Maryland; the double daggerNational Institute of Dental and
Craniofacial Research and National Institute of Arthritis and Musculoskeletal
and Skin Diseases, National Institutes of Health, Bethesda, Maryland; and
section signOphthalmic Center, Sun Yet-sen University, Guangzhou, China.

PURPOSE:: The purpose of this study was to report the clinical and pathologic
findings of three cases of rapid vision loss associated with fludarabine
toxicity. METHODS:: A retrospective, single-center case series was conducted.
Autopsies of the eyes from three cases were performed. RESULTS:: A 23-year-old
man (Case 1) with systemic lupus erythematosus developed rapid and severe vision
loss, generalized neurologic decline, and eventual death after administration of
fludarabine before stem cell transplantation. A 48-year-old woman (Case 2) and a
60-year-old man (Case 3), both with metastatic melanoma, had similar courses
after receiving fludarabine as part of a preparatory regimen before adoptive
cell therapy. Fundus examination showed punctuate yellow flecks in the macula
after visual decline in two cases. In all three cases, serum antiretinal
antibodies were negative before and after treatment; electrophysiological
testing showed markedly decreased B-waves; and pathologic analysis showed loss
of retinal bipolar and ganglion cells, gliosis within the retina and optic
nerve, and optic nerve atrophy. CONCLUSION:: Fludarabine toxicity can result in
severe vision loss attributable to damage to retinal bipolar and ganglion cells.
Although effective treatments are not known, care should be taken to consider
fludarabine toxicity in patients who present with vision loss approximately 1
month after treatment.

PMID: 20224467  [PubMed - as supplied by publisher]

15: Retina. 2010 Mar 10; [Epub ahead of print] 

RECURRENT HEMOLACRIA: A Sign of Scleral Buckle Infection.

Mukkamala K, Gentile RC, Rao L, Sidoti PA.

From the *Department of Ophthalmology, The New York Eye and Ear Infirmary, New
York, New York; and the daggerDepartment of Ophthalmology, New York Medical
College, Valhalla, New York.

PURPOSE:: The purpose of this study was to report recurrent hemolacria, or
"bloody tears," as a sign of scleral buckle (SB) infection. METHODS:: This is an
interventional case series of three eyes of three patients with hemolacria after
SB placement. RESULTS:: Two men and one woman were treated for recurrent
hemolacria after SB placement for a rhegmatogenous retinal detachment. Two
patients had an encircling silicone sponge placed, one 6 years and the other 3
years before presentation. The third patient had a segmental solid silicone
element placed 3 months before presentation. Two of the patients reported from 6
to 10 episodes of hemolacria occurring for "years" before referral and
diagnosis. In all three patients, hemolacria originated from an occult
conjunctival fistula overlying or adjacent to an exposed SB. Microbiological
cultures grew Staphylococcus aureus in two eyes and polymicrobial growth in the
other. Hemolacria resolved with explantation of the SB in two patients and with
long-term continuous topical antibiotics in the other patient. CONCLUSION::
Hemolacria can be a sign of a SB infection and should raise a high level of
suspicion for the presence of an occult conjunctival fistula with exposure of
the underlying scleral buckling element when frank exposure is not seen.

PMID: 20224466  [PubMed - as supplied by publisher]

16: Retina. 2010 Mar 10; [Epub ahead of print] 

POSITIVE RESPONSE TO INTRAVITREAL RANIBIZUMAB IN THE TREATMENT OF CHOROIDAL
NEOVASCULARIZATION SECONDARY TO PUNCTATE INNER CHOROIDOPATHY.

Menezo V, Cuthbertson F, Susan DM.

From the Oxford Eye Hospital, John Radcliffe Hospital, Headley Way, Oxford, UK.

PURPOSE:: The purpose of the study was to report the use of ranibizumab in
choroidal neovascularization secondary to punctate inner choroidopathy.
METHODS:: This was a retrospective case series. Clinical notes of 10 patients
with choroidal neovascularization secondary to punctate inner choroidopathy were
reviewed (mean age, 40.7 years, age range, 25-58 years). RESULTS:: Previous
therapies included photodynamic therapy, posterior sub-Tenon's triamcinolone,
oral prednisolone, and intravitreal triamcinolone. Ten eyes in 10 patients
underwent a mean of 1.9 +/- 1.3 (+/- standard deviation) injections of
antivascular endothelial growth factor (range, 1-5). All 10 patients had a
follow-up review of at least 6 months (median, 12.5 +/- 9.2 standard deviation;
range, 6-34 months). Nine eyes either maintained or improved vision by at least
1 line on the logarithmic of the minimal angle of resolution calculated
equivalent chart at least 6 months after the start of treatment with
antivascular endothelial growth factor therapy. No ocular or systemic
complications were observed. CONCLUSION:: The role of ranibizumab in choroidal
neovascularization in association with punctate inner choroidopathy has been
shown to be beneficial in this small group in whom improvement or stabilization
of vision was observed in 9 of 10 eyes. Recurrent choroidal neovascularization
can occur in these patients, and additional injections of ranibizumab appear to
be safe and efficacious.

PMID: 20224465  [PubMed - as supplied by publisher]

17: Retina. 2010 Mar 10; [Epub ahead of print] 

SUPRASELECTIVE INJECTION OF INTRAARTERIAL MELPHALAN AS THE PRIMARY TREATMENT FOR
LATE PRESENTATION UNILATERAL MULTIFOCAL STAGE VB RETINOBLASTOMA.

Aziz HA, Boutrid H, Murray TG, Berrocal A, Quintero Wolfe S, Pina Y, Dorfman M,
Moftakhar R, Fernandes CE, Reichbach J, Aziz-Sultan MA.

From the *Bascom Palmer Eye Institute, University of Miami Miller School of
Medicine, Miami, Florida; daggerDepartment of Neuro-radiology/Neurosurgery,
Jackson Memorial Hospital, Miami, Florida; double daggerDepartment of Pediatric
Hematology/Oncology, Jackson Memorial Hospital, Miami, Florida.

PURPOSE:: The purpose of this study was to report a case of a 7-year-old girl
with unilateral, multifocal Reese Ellsworth Stage Vb retinoblastoma who was
successfully treated using intraarterial chemotherapy infusion as the primary
therapy. METHODS:: This is an interventional case report. A 7-year-old girl
presented with advanced unilateral retinoblastoma. The patient received
intraarterial melphalan infusion therapy as the primary treatment. RESULTS::
Complete tumor resolution was seen at 1 month after intraarterial melphalan
infusion. CONCLUSION:: This case of advanced retinoblastoma in a 7-year-old girl
was successfully treated with intraarterial melphalan infusion alone. Treatment
resulted in complete resolution of the tumor 1 month after treatment. In
comparison with systemic chemotherapy, intraarterial melphalan infusion therapy
may be a less toxic and more effective primary treatment option in the future
management of advanced retinoblastoma.

PMID: 20224464  [PubMed - as supplied by publisher]

18: Retina. 2010 Mar 10; [Epub ahead of print] 

PERIPHERAL RETINAL FINDINGS IN HIGHLY MYOPIC CHILDREN 6.00 diopters) who were evaluated for
presumed risk of retinal detachment by either an examination under anesthesia or
office examination by a single retina specialist from January 2001 through
December 2008. Patients with regressed retinopathy of prematurity, retinal
detachment in the fellow eye, or known Stickler syndrome were excluded.
RESULTS:: Fifty-four eyes of 30 patients with high myopia were examined.
Twenty-six eyes of 14 patients were examined under anesthesia because of the
examiner's ability to adequately visualize the peripheral retina during an
office examination. Mean age at examination was 6 +/- 3, 1-10) years. Mean
spherical equivalent refractive error was -13.88 +/- 3.79 (range, -6.00 to
-25.00) diopters. Peripheral retinal findings were identified in 33% of eyes,
the most common being lattice degeneration (20%), white without pressure (11%),
and retinal holes with subretinal fluid (4%). CONCLUSION:: Approximately one
third of highly myopic children in our study showed peripheral retinal findings.
If the peripheral retina is not adequately visualized during an office
evaluation, examination under anesthesia should be considered.

PMID: 20224463  [PubMed - as supplied by publisher]

19: Retina. 2010 Mar 10; [Epub ahead of print] 

EARLY VITRECTOMY EFFECTIVE FOR BILATERAL COMBINED ANTERIOR AND POSTERIOR
PERSISTENT FETAL VASCULATURE SYNDROME.

Walsh MK, Drenser KA, Capone A Jr, Trese MT.

From Associated Retinal Consultants PC, Royal Oak, Michigan.

PURPOSE:: The purpose of this study was to review our surgical experience with
patients with bilateral combined anterior and posterior persistent fetal
vasculature syndrome (PFVS). METHODS:: We retrospectively reviewed the charts of
all patients seen in our tertiary care pediatric retinal practice from 1988 to
2008 with a potential diagnosis of bilateral PFVS with posterior involvement.
Clinical diagnosis required the presence of either bilateral persistent
hyaloidal stalk tissue with retinal involvement or bilateral dense retrolental
fibrovascular plaques (usually with no posterior view preoperatively) without a
family history or genetic testing consistent with Norrie disease or familial
exudative vitreoretinopathy. RESULTS:: Chart review showed 22 vitrectomized
patients with clinical findings consistent with bilateral PFVS with posterior
involvement who did not have a family history or genetic testing consistent with
Norrie disease or familial exudative vitreoretinopathy. All 22 of these patients
with posterior retinal involvement also had anterior findings and thus can be
classified as combined anterior and posterior PFVS. Of the 13 patients with
visual acuity follow-up data, 9 patients (69%) maintained at least light
perception vision in at least 1 eye at last follow-up. Of the 28 operated eyes
in 16 patients with follow-up data, 3 eyes (11%) were phthisical at last
follow-up. CONCLUSION:: Children with bilateral PFVS with posterior retinal
involvement have a dismal visual prognosis if left unoperated. In this
relatively large series of a rare condition, we find that vitrectomy with or
without lensectomy is beneficial in bilateral combined anterior and posterior
PFVS in two regards: maintenance or restoration of vision and avoidance of
phthisis bulbi.

PMID: 20224462  [PubMed - as supplied by publisher]
20: id: 20216297 Error occurred: The following PMID is not available: 20216297 

21: Retina. 2010 Mar;30(3):534-5; author reply 535-6. 

Correspondence.

Williams CJ, Lui WC, Li KK, Wong D, Lo AC.

Publication Types:
    Comment
    Letter

PMID: 20216296  [PubMed - in process]

22: Retina. 2010 Mar;30(3):533; author reply 533-4. 

Correspondence.

Hu YJ, Chen WQ, Hou P.

Publication Types:
    Comment
    Letter

PMID: 20216295  [PubMed - in process]

23: Retina. 2010 Mar;30(3):527-30. 

Diagnostic and therapeutic challenges.

Cohen SY, Levy-Gabriel C, Freund KB, Atebara NH.

PMID: 20216294  [PubMed - in process]

24: Retina. 2010 Mar;30(3):452-8. 

Comparison of laser photocoagulation for diabetic retinopathy using 532-nm
standard laser versus multispot pattern scan laser.

Nagpal M, Marlecha S, Nagpal K.

Retina Foundation, Near Shahibag Underbridge, Shahibag, Ahmedabad, Gujarat,
India 380004. drmanishnagpal@yahoo.com

PURPOSE: The purpose of this study was to compare the efficacy, collateral
damage, and convenience of panretinal photocoagulation for proliferative
diabetic retinopathy or severe nonproliferative diabetic retinopathy using a
532-nm solid-state green laser (GLX) versus a multispot 532-nm pattern scan
laser (PASCAL). METHODS: This study was a prospective randomized clinical trial.
Sixty patients with bilaterally symmetrical proliferative diabetic retinopathy
or severe nonproliferative diabetic retinopathy participated. Each patient
underwent panretinal photocoagulation: one eye with GLX and the other with
PASCAL, two sittings per eye. Grade 3 burns with a 200-mum spot size were placed
with both modalities. The fluence, pain using the visual analog scale, time,
laser spot spread with infrared images, and retinal sensitivity were compared.
RESULTS: Pattern scan laser and GLX required an average fluence of 40.33 vs 191
J/cm(2), respectively. Average time required per sitting was 1.43 minutes with
PASCAL and 4.53 minutes with GLX. Average visual analog scale reading for GLX
was 4.6, whereas that for PASCAL was 0.33. Heidelberg retinal angiography images
showed the spot spread as being 430 versus 310 microm at 3 months with GLX and
PASCAL. The eyes treated with PASCAL showed higher average retinal sensitivity
in the central 15 degrees and 15 degrees to 30 degrees zones (25.08 and 22.08
dB, respectively) than the eyes treated with GLX (23.16 and 17.14 dB),
respectively. CONCLUSION: Pattern scan laser showed lesser collateral damage and
similar regression of retinopathy compared with GLX. Pattern scan laser
treatment was less time consuming and less painful for the patient compared with
GLX.

PMID: 20216293  [PubMed - in process]

25: Retina. 2010 Mar;30(3):447-51. 

Long-term results of vitrectomy without endotamponade in proliferative diabetic
retinopathy with tractional retinal detachment.

Tao Y, Jiang YR, Li XX, Gao L, Jonas JB.

Department of Ophthalmology, People's Hospital, Peking University, Beijing,
China.

PURPOSE: The purpose of this study was to evaluate the long-term results of
vitreoretinal surgery without use of intraocular silicone oil or gas in patients
with proliferative diabetic retinopathy and tractional retinal detachment.
METHODS: A clinical interventional case-series study was conducted of 168 eyes
of 150 patients with diabetic tractional retinal detachment who were
consecutively treated by pars plana vitrectomy without endotamponade during a
study period of 7 years. Per selection criterion, retinal defects did not
develop or were not observed in any of the study participants before or during
surgery. The surgery included pars plana vitrectomy, removal of epiretinal
membranes, and retinal endolaser coagulation. Combined cataract surgery was
performed in 33 eyes (20%). The mean follow-up was 23 + or - 14 months (range,
12-65 months). RESULTS: In 158 eyes (94%), the retina reattached after surgery
and remained attached until the end of follow-up. Subretinal fluid absorbed
completely within 2 months after surgery. Best-corrected visual acuity improved
in 126 eyes (75%) and remained unchanged in 19 eyes (11%). Mean best-corrected
visual acuity improved from 2.22 + or - 1.22 at baseline to 1.24 + or - 1.00 at
final follow-up (P < 0.001). At the end of follow-up, 11 eyes (7%) showed iris
neovascularization, and 9 of these 11 eyes developed iris neovascularization
after surgery. In multivariate logistic regression, the only factor associated
with postoperative rubeosis iridis was preexisting rubeosis iridis (odds ratio,
6.4). CONCLUSION: Vitreoretinal surgery for tractional retinal detachment in
proliferative diabetic retinopathy may not necessarily be combined with an
ocular endotamponade if there were no pre- or intraoperative retinal breaks.

Publication Types:
    Research Support, Non-U.S. Gov't

PMID: 20216292  [PubMed - in process]

26: Retina. 2010 Mar;30(3):383-9. 

Correlation between morphologic features on spectral-domain optical coherence
tomography and angiographic leakage patterns in macular edema.

Brar M, Yuson R, Kozak I, Mojana F, Cheng L, Bartsch DU, Oster SF, Freeman WR.

Department of Ophthalmology, University of California San Diego, Shiley Eye
Center, 0946, Joan and Irwin Jacobs Retina Center, 9415 Campus Point Drive, La
Jolla, CA 92037, USA.

PURPOSE: The purpose of this study was to determine the morphologic patterns of
angiographic macular edema using simultaneous colocalization of fluorescein
angiography and spectral-domain optical coherence tomography (SD-OCT) images in
diabetes, epiretinal membrane, uveitic and pseudophakic cystoid macular edema,
and vein occlusion. METHODS: Eighty-seven consecutive patients (107 eyes) with
macular edema from 5 different etiologies were imaged by simultaneous scanning
laser ophthalmoscopy/OCT to study the morphologic patterns of edema on SD-OCT
and then correlated/colocalized with the fluorescein angiographic patterns of
leakage. Statistical analysis was done to analyze the differences in the
morphologic OCT pattern by different diseases. RESULTS: Spectral-domain OCT
characteristics of macular edema showed a significant difference across
different diseases (P = 0.037). Cystic fluid pockets were found to be more
commonly seen in patients with diabetic macular edema and retinal vein
occlusions, whereas those cases with macular edema secondary to epiretinal
membrane showed noncystic changes on OCT. Seventy of the 107 eyes had diffuse
angiographic leakage, and the remaining 37 eyes had cystoid leakage on
angiography. Of the 70 eyes with diffuse leakage, 24.28% showed microcysts on
SD-OCT in the area of edema, and 70% eyes had diffuse thickening or distorted
architecture without cyst. All 37 eyes with cystoid leakage showed cysts in the
area of edema by SD-OCT. A total of 3.73% of eyes with fluorescein angiographic
leakage had no abnormalities on SD-OCT. CONCLUSION: Eyes with diabetic macular
edema and retinal vein occlusions have a significantly higher incidence of cyst
formation on SD-OCT. There was no correlation between visual acuity and cyst
formation. Diffuse noncystoid angiographic macular edema may show microcysts on
SD-OCT, but diffuse edema is more commonly associated with thickening or
distortion of the retinal layers without cyst formation. Cystoid leakage on
fluorescein angiography is always associated with cystic changes on SD-OCT.

Publication Types:
    Research Support, N.I.H., Extramural

PMID: 20216291  [PubMed - in process]

27: Retina. 2010 Feb 23; [Epub ahead of print] 

HIGH-SPEED, HIGH-RESOLUTION SPECTRAL OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS
AFTER VITRECTOMY WITH INTERNAL LIMITING MEMBRANE PEELING FOR PROLIFERATIVE
VITREORETINOPATHY RETINAL DETACHMENT.

Odrobina DC, Michalewska Z, Michalewski J, Nawrocki J.

From the *Klinika Okulistyczna Jasne Blonia, Lodz, Poland.

PURPOSE:: The purpose of this study was to present the retinal morphology after
silicone oil removal in patients after vitrectomy with internal limiting
membrane peeling and silicone oil tamponade for proliferative vitreoretinopathy
retinal detachment. METHODS:: Nineteen patients after vitrectomy or retinotomy
with internal limiting membrane peeling for proliferative vitreoretinopathy
retinal detachment were included in this study. All patients were interviewed,
and an ophthalmologic examination was performed pre- and postoperatively.
Fifteen months after silicone oil removal, all patients were examined with
spectral optical coherence tomography Copernicus. RESULTS:: Visual acuities
determined at the final follow-up visit were from light perception to 20/40
(mean, 0.11 +/- 0.14). Photoreceptor damage was present in 19 eyes (100%), i.e.,
in all cases. In seven eyes, the defects were in the well-visible,
normal-thickness photoreceptor layer. In the remaining 12 eyes, defects were
found in the thin, atrophic photoreceptor layer. Eyes with a well-visible
photoreceptor layer had better visual acuity after surgery (P = 0.015; t-test).
Cystoid macular edema developed in 9 eyes (47.3%). Retinal nerve fiber layer
defects were found in all 19 eyes (100%). Subretinal fluid was present in 1 eye
(5.2%). No cases of macular pucker were observed during follow-up. CONCLUSION::
Spectral optical coherence tomography Copernicus allows detailed imaging of
retinal microstructure and helps us understand why patients have lowered visual
acuity after successful retinal detachment surgeries. It is suspected that the
absence of macular pucker may be caused by systematic peeling of the internal
limiting membrane during vitrectomy.

PMID: 20182404  [PubMed - as supplied by publisher]

28: Retina. 2010 Feb 23; [Epub ahead of print] 

INTRAVITREAL INJECTION VERSUS SUBTENON INFUSION OF TRIAMCINOLONE ACETONIDE
DURING CATARACT SURGERY IN PATIENTS WITH REFRACTORY DIABETIC MACULAR EDEMA.

Takata C, Messias A, Folgosa MS, Lucena LR, Lucena DR, Scott IU, Jorge R.

From the *Department of Ophthalmology, Otorhinolaryngology and Head and Neck
Surgery, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto, Brazil, and
the daggerDepartments of Ophthalmology and Public Health Sciences, Penn State
College of Medicine, Hershey, Pennsylvania.

PURPOSE:: The purpose of this study was to compare the effectiveness of
intravitreal injection (IVT) versus posterior subtenon infusion (STI) of
triamcinolone acetonide performed during phacoemulsification cataract surgery in
eyes with refractory diffuse diabetic macular edema. METHODS:: Twenty-four eyes
of 24 patients with refractory diffuse diabetic macular edema scheduled to
undergo phacoemulsification cataract surgery were randomly assigned to receive
either a 4-mg IVT (n = 12) or a 40-mg STI (n = 12) of triamcinolone acetonide
during cataract surgery. Comprehensive ophthalmic evaluation, including
best-corrected visual acuity, intraocular pressure, and central macular
thickness measured with optical coherence tomography, was performed at baseline
and at 1, 4, 8 +/- 1, 12 +/- 2, and 24 +/- 2 weeks postoperatively. RESULTS::
Ten patients from the IVT group and 9 patients from the STI group completed the
24-week study visit. Mean baseline best-corrected visual acuity (logarithm of
the minimum angle of resolution) was 20/259 and 20/222 in the IVT and STI
groups, respectively (t = 0.41; P = 0.3407). A significant improvement in
best-corrected visual acuity was observed only in the IVT group at 4 weeks (mean
difference +/- standard error, improved to 20/116; P = 0.0437), 8 weeks (20/110;
P = 0.0355), and 12 weeks (20/121; P = 0.0471) postoperatively. There was no
significant change from baseline in mean intraocular pressure in either group.
Mean +/- standard error baseline central macular thickness was 474.1 +/- 42.4
mum and 490.8 +/- 70.8 mum in the IVT and STI groups, respectively (t = 0.21;P =
0.5807). The central macular thickness reductions after surgery at all study
follow-up visits were significantly greater in the IVT group than in the STI
group (P < 0.05). CONCLUSION:: These data suggest that IVT is more effective
than STI of triamcinolone acetonide for the management of refractory diffuse
diabetic macular edema in eyes undergoing phacoemulsification. Further
investigation of a larger number of patients with longer follow-up is necessary
to confirm these findings.

PMID: 20182403  [PubMed - as supplied by publisher]

29: Retina. 2010 Feb 23; [Epub ahead of print] 

RESULTS OF VITRECTOMY FOR BREAKTHROUGH VITREOUS HEMORRHAGE ASSOCIATED WITH
AGE-RELATED MACULAR DEGENERATION AND POLYPOIDAL CHOROIDAL VASCULOPATHY.

Jung JH, Lee JK, Lee JE, Oum BS.

From the *Department of Ophthalmology, College of Medicine, Pusan National
University, Pusan, Korea; and the daggerMedical Research Institute, Pusan
National University, Pusan, Korea.

PURPOSE:: The purpose of this study was to evaluate the results of vitrectomy in
patients with vitreous hemorrhage associated with age-related macular
degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). METHODS:: A
retrospective review was conducted of consecutive cases of patients undergoing
pars plana vitrectomy for nonclearing vitreous hemorrhage associated with
neovascular AMD or PCV. RESULTS:: Twenty-four eyes of 23 patients were included.
The mean length of time from the onset of vitreous hemorrhage to operation was
4.3 months. Twelve eyes had AMD, and 12 eyes of 11 patients had PCV. Additional
treatments for active choroidal neovascularization or PCV were required in 12
eyes during follow-up. The mean visual acuity improved significantly from a
logarithm of the minimum angle of resolution of 2.79 +/- 0.85 before operation
to 1.61 +/- 0.98 at 2 months after operation (P < 0.001). Visual acuity was
>/=20/200 in 9 eyes (37.5%) at 2 months after operation; 1 eye was in the AMD
group, and the other eyes were in the PCV group. Improvement was more frequently
observed in the PCV group (P = 0.005). CONCLUSION:: In this series, the
functional outcomes of vitrectomy for vitreous hemorrhage associated with AMD
were inferior to outcomes of the PCV group. Vitrectomy is beneficial for
improving visual function in select cases of breakthrough vitreous hemorrhage.

PMID: 20182402  [PubMed - as supplied by publisher]

30: Retina. 2010 Feb 23; [Epub ahead of print] 

VITRECTOMY FOR EXUDATIVE AGERELATED MACULAR DEGENERATION WITH VITREOUS
HEMORRHAGE.

Sakamoto T, Sheu SJ, Arimura N, Sameshima S, Shimura M, Uemura A, Kawano H, Wu
TT, Kubota T, Sohma R, Noda Y.

From the *Department of Ophthalmology, Kagoshima University School of Dental and
Medical Sciences, Kagoshima, Japan, daggerKaohsiung Veterans General Hospital,
School of Medicine, National Yang-Ming University, Taiwan, People's Republic of
China, double daggerNTT Tohoku Hospital, Sendai, Japan, section signKagoshima
City Hospital, Kagoshima, Japan, the paragraph signUniversity of Occupational
and Environmental Health, Kitakyushu, Japan, and the **Department of
Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka,
Japan.

PURPOSE:: The purpose of this study was to study the effect of pars plana
vitrectomy (PPV) for age-related macular degeneration with vitreous hemorrhage
on choroidal neovascularization (CNV). METHODS:: A retrospective interventional
case series in which 92 eyes with age-related macular degeneration with vitreous
hemorrhage that received PPV was studied. Among them, 60 eyes without pre- or
posttreatment other than PPV were selected. Choroidal neovascularization was
expressed as the incidence of bleeding 6 months before and after PPV. The status
of CNV after PPV was compared and classified as worsened, remained, regressed,
disappeared, or unclassified. The influence of posterior vitreous detachment was
examined. RESULTS:: The incidence of bleeding was reduced dramatically after PPV
(1.11 +/- 0.44 in preoperative 6 months vs. 0.03 +/- 0.18 in postoperative 6
months, P < 0.0001). The status of CNV improved in most cases; 40 of 54
classifiable eyes (74.1%) were categorized as "regressed" or "disappeared."
Postoperative visual acuity was significantly better than preoperative visual
acuity (P < 0.0001). The status of CNV subsided more in those eyes without
posterior vitreous detachment than in those with posterior vitreous detachment
(odds ratio, 1.02; 95% confidence interval, -0.01-2.08; P = 0.054). CONCLUSION::
The activity of CNV was reduced after PPV in eyes with age-related macular
degeneration with vitreous hemorrhage. Visual acuity significantly improved,
with only rare severe complications. The involvement of vitreomacular traction
in the pathophysiology of CNV in age-related macular degeneration is possible.

PMID: 20182401  [PubMed - as supplied by publisher]