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  • Acosta Beatty posted an update 2 days, 8 hours ago

    A 49- year old immunocompetent male presented with a right flank abscess and was found to have disseminated cryptococcal disease. Treatment was initiated with a one-week intravenous regime of amphotericin B and flucytosine based on recent trial data that this is as effective, and less toxic, than the standard two weeks. After completion of intravenous treatment he was discharged with oral anti-fungals and is making a good recovery with ongoing follow up.[This corrects the article on p. 108 in vol. 7, PMID 29018767.].We report a case of bilateral progressive outer retinal necrosis (PORN) in a patient with acquired immune deficiency syndrome with CD4 count 50 cells/μL. He was treated with standard intravenous and intravitreal antivirals but ultimately developed complications such as retinal detachment and epiretinal membrane. His vision was preserved with early pars plana vitrectomy. This case demonstrates that prompt clinical diagnosis of PORN with its successful medical and surgical management can help prevent progression of this frightening disease.Cyclosporine 0.1% was used in a patient with Lyell syndrome, which had undergone a KeraKlear® keratoprosthesis implant due to the severe ocular involvement to avoid overuse of corticoid agents. To the best of our knowledge, this is the first reported case of cyclosporine 0.1% eye drops to use in Lyell syndrome previously treated with keratoprosthesis implant.Temporal bone fractures are often associated with damage to middle or inner ear structures, facial nerve, and cerebrospinal fluid (CSF) leak, and rarely with abducens nerve palsy. Isolated abducens nerve palsy is not known to occur following temporal bone fracture and is most commonly associated with concurrent facial nerve injury. We report a case of an 11-year-old girl who presented with isolated right abducens nerve palsy following head trauma. The child had incurred injury following a fall from a bicycle. The presence of postauricular ecchymosis was suggestive of possible temporal bone fracture. High-resolution computed tomography scan revealed undisplaced fracture of the right temporal bone at the petrous apex. Identification of temporal bone fracture prompted toward complete neurological and otological evaluation to detect life-threatening complications like CSF otorrhea. The child was managed conservatively with occlusion therapy to alleviate diplopia and showed complete resolution of the nerve palsy after 4 months. Isolated abducens nerve palsy following the temporal bone fracture is a rare finding. Additional clinical findings like postauricular ecchymosis should be looked for, and appropriate otological evaluation sought in such cases.The objective of this study is to report a case of refractory malignant glaucoma post trabeculectomy in vitrectomized eye and review of previous literature in PubMed database. A 63-year-old male encountered malignant glaucoma after trabeculectomy in vitrectomized eye. We had tried vitreous tapping with peripheral iridectomy and vitreous tapping with intracameral injection of room air (Chandler procedure). All of previous procedures were in vain. selleckchem Finally, the yttrium-aluminum-garnet laser membranectomy with zonulectomy was done. The intraocular pressure is within normal range without any topical glaucoma eye drops during 3-year outpatient department regular follow-up. Complete vitrectomy with a patent tunnel from posterior chamber to anterior chamber (iridectomy-zonulectomy) is the effective procedure to manage of malignant-like glaucoma.

    The purpose of this study was to compare intravitreal ziv-aflibercept (IVZ) monotherapy to intravitreal bevacizumab (IVB) monotherapy in patients with exudative age-related macular degeneration (eAMD).

    Patients with treatment-naïve eAMD treated with pro re nata (PRN) monotherapy of IVZ (1.25 mg/0.05 ml) or IVB (1.25 mg/0.05 ml) with a minimum follow-up of 12 months were retrospectively analyzed. Study outcomes included change in best-corrected visual acuity (BCVA), central macular thickness, mean number of injections, and total medication cost in both the groups at 12 months.

    Forty-seven eyes (IVZ, 18/47 [38.3%] and IVB, 29/47 [61.7%]) from 47 treatment-naive patients were included. The change in BCVA for patients receiving IVZ was from 0.61 ± 0.33 logarithm of the minimum angle of resolution (Snellen 20/81; range 20/38-20/174) to 0.45 ± 0.31 (Snellen 20/56; range 20/27-20/115) at 1 year (

    = 0.02). The total number of injections needed to achieve the resolution of intraretinal or subretinal fluid was 2.6 ± 1.4 and 3.5 ± 1.3 for IVZ and IVB, respectively (

    = 0.029). Direct medication cost of IVZ and IVB in our cohort on PRN basis was an average of US$78 (2.6 × US$30) and US$175 (3.5 × US$50), respectively, through 1 year.

    IVZ-PRN monotherapy resulted in improved visual acuity, reduced treatment burden, and reduced direct medication cost in comparison to IVB-PRN monotherapy through 1 year.

    IVZ-PRN monotherapy resulted in improved visual acuity, reduced treatment burden, and reduced direct medication cost in comparison to IVB-PRN monotherapy through 1 year.

    The objective of the study was to investigate possible factors influencing gas fill after microincision vitrectomy surgery (MIVS) combined with fluid-gas exchange.

    This was a retrospective chart review of patients who underwent MIVS combined with fluid-gas exchange (20% C

    F

    ) from February 2017 to December 2017.

    Sixty-one eyes of 58 patients were identified. The mean age was 59.97 ± 9.65 years. The mean gas fill percentage was 76.28% ± 14.29% on day 1, 65.49% ±13.65% on day 3, 60.03% ± 14.53% on day 4, and 43.9% ± 20.88% on day 7 postoperatively. Compared to phakic eyes, eyes that were pseudophakic prior to surgery had a lower gas fill on days 1-3, but the difference did not reach significance on day 3. Eyes that underwent phacovitrectomy had a significantly lower gas fill on days 1-3 than eyes that did not.

    Postoperative pseudophakic status is associated with lower gas fill after MIVS. Adjusted gas fill should be considered in these cases.

    Postoperative pseudophakic status is associated with lower gas fill after MIVS.

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