Central serous chorioretinopathy (CSCR) is a chorioretinal disease characterized by serous detachment of the neurosensory retina, retina pigment epithelium, from the choroid. The disease shows a predilection for middle-aged males and is associated with steroid use, obstructive sleep apnea, pregnancy, and type “A” personality traits.^[1]

How to cite this article: Nkrumah G, Chhablani J. Choroid in central serous chorioretinopathy. Cli Exp Vis Eye Res J 2019;2(2):1-3.

Received: 16-12-2019;

Accepted: 24-12-2019

Background: This study aims to describe a rare phenomenon of anisometropic amblyopia in the emmetropic eye, preferring the hypermetropic eye.

Methods: The cohort included all children with anisometropic amblyopia attending a tertiary medical center in 2014-2016 in whom amblyopia was diagnosed in the more emmetropic or myopic eye. The medical records were reviewed for demographic parameters, best-corrected visual acuity (BCVA) for each eye, refraction, treatment, glasses prescription, follow-up, and final BCVA.

Results: Four patients, two girls and two boys, met the study criteria. The mean age at diagnosis was 6.8 years (range 4-8 years), and mean follow-up time was 2.6 months (one child was lost to follow-up). Median cycloplegic refraction in the amblyopic (right) eyes was -1.7 sphere (0-[-4.5]) with -0.45 cylinder (0-[-0.75]) in 80°, and in the preferred (non-amblyopic) eyes, +1.75 sphere ([+1]-[+3.25]) with -0.35 cylinder (0-[-0.75]) in 87°. Corresponding mean BCVA values were LogMAR 0.46 (0.3-0.7) and LogMAR 0.02 (0-0.07); mean spherical difference was 4 (1-6.5). None of the children had an additional pathology. Treatment consisted of full cycloplegic spherical refractive correction or the closest possible while maintaining BCVA, with mild modified subjective correction of the cylinder. Patching was also used in three children. Mean BCVA after treatment was 0.20.

Conclusion: In rare cases of anisometropia, in which amblyopia is diagnosed late, the eye with hyperopic refraction may be preferred. Clinicians should be alert to this phenomenon as treatment requires some modification of conventional glasses prescription. Further studies are needed to clarify the underlying pathophysiology.

Key words: Amblyopia, anisometropia, hypermetropia, pediatric, preferred eye

How to cite this article: Sternfeld A, Segal R, Altman M, Goldenberg-Cohen N. Unpredicted eye preference in anisometropic children diagnosed late with amblyopia. Cli Exp Vis Eye Res J 2019;2(2): 4-7.

Received: 07-12-2019;

Accepted: 19-12-2019

Purpose: The purpose of this study was to investigate the macular inner retinal layers involvement in eyes with optic nerve head drusen (ONHD) using spectral-domain optical coherence tomography (SD-OCT).

Methods: An observational case series was carried out. Consecutive patients with ONHD and age-matched healthy individuals were enrolled from a single center. Key exclusion criteria were significant media opacity, best-corrected visual acuity ≥20/40, and the presence of any ocular comorbidity. After inclusion, all patients underwent SD-OCT imaging, visual field (VF) testing (standard automated perimetry), and optic disc digital imaging. For SD-OCT, macular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) protocols were obtained. SD-OCT examinations were classified as normal or abnormal (and subsequently as focal or diffuse loss pattern) based on previously described color-coded criteria.

Results: A total of 19 eyes with ONHD and 20 control eyes were included in the study. The VF mean deviation for ONHD eyes was —4.6 ± 3.9 dB. Regarding macular inner retinal layers (GCC protocol) analysis in ONHD eyes, nine eyes (47.4%) had significant macular GCC thinning, of which seven presented focal loss pattern and two diffuse loss pattern. Overall, both macular and pRNFL parameters were significantly thinner in eyes with ONHD when compared to healthy controls (P < 0.05). Analyzing the ability of the SD-OCTs normative database to detect abnormalities, 42.1% of the patients were presented abnormalities in both pRNFL and GCC parameters, while only one case presented an SD-OCT abnormality restricted to the macular GCC protocol.

Conclusions: Investigating macular inner retinal layers involvement in eyes with ONHD, we found detectable macular damage by SD-OCT in almost half of the cases. In most of these cases, macular damage had a focal loss pattern and was accompanied by concomitant pRNFL thinning.

Key words: Glaucoma, macular ganglion cell complex, optical coherence tomography, optic nerve head drusen, peripapillary retinal nerve fiber layer

How to cite this article: Modesto RAS, Neto ECV, Moura RNP, Scoralick ALB, Ushida M, Gracitelli CPB, Dorairaj S, Kanadani FN, Prata TS, Dias DT. Patterns of macular inner retinal layers involvement in eyes with optic nerve head drusen. Cli Exp Vis Eye Res J 2019;2(2):8-12.

Received: 07-10-2019;

Accepted: 16-11-2019

Macular holes (MHs) cause considerable ocular morbidity, reducing visual acuity, and distorting central vision. Idiopathic MHs (IMHs) are the most common subtype of this pathology. Modern treatment options for IMHs include pneumatic vitreolysis, vitrectomy, and chemical vitreolysis. Extensive laboratory and clinical research have led to the development of unique surgical approaches and techniques for each treatment modality offered, thus enabling tailored treatment for individual patients depending on the specific clinical scenario. This review summarized what is known about MHs physiologically and clinically and highlights the experience gained with different treatment modalities. Better understanding of this unique pathology may offer our patients better care and better visual outcomes.

Key words: Idiopathic macular hole, internal limiting membrane, ocriplasmin, pneumatic vitreolysis, vitrectomy

How to cite this article: Sela TC, Hadayer A, Zahavi A. Idiopathic macular holes - A review of current management strategies. Cli Exp Vis Eye Res J 2019;2(2):13-23.

Received: 18-11-2019;

Accepted: 02-12-2019

Vaccines are conventionally thought to be a strategy to thwart the onset of any disease caused by pathogens. The elementary foundation for this concept is the ability of the immune system to discriminate between what is native to the body and what is foreign. This molecular xenophobia can, in principle, be exploited to prime the body to fight and neutralize any potentially disease-causing organism or moiety. For chronic disorders, preventive measures mediated through immune system modulation have been tried with little success yet the optimism for developing strategies of modulating the immune system is growing day by day as new techniques and animal models are being developed. Given the high prevalence of glaucoma and the ability of glaucoma experts to identify high-risk individuals, preventive regimens, and vaccine-like-substances can be developed to bring down the incidence. In this paper, we will discuss some preliminary efforts of vaccine development in glaucoma. We will also deliberate on the technical difficulties in developing effective vaccines for this disorder. In addition, we will try to identify measures with potential to transform the consistent toil of researchers in this field into an efficacious endeavor. We will attempt to recognize certain plausible methodologies that are likely to take the science of vaccine development for glaucoma (and other neurodegenerative disorders) somewhat nearer to the optimistic frontiers.

Key words: Vaccine, Glaucoma, Retina, Alzheimer’s disease, Parkinson’s disease, Neurodegeneration

How to cite this article: Qadri R, Sofi RA, Sainulabdeen A, Pandit MA, Bhartiya S, Sharique M, Lone M, Mashook A, Faiq MA. Vaccine development for glaucoma: From skepticism to certitude. Cli Exp Vis Eye Res J 2019;2(2):24-30.

Received: 30-11-2019;

Accepted: 17-12-2019

The aim of the study was to describe a case of subretinal fluid without neovascularization due to choroidal osteoma that was treated successfully with intravitreal aflibercept. Choroidal osteoma is an ossifying tumor that can cause visual impairment through several pathological mechanisms, including fluid accumulation under the retina, with or without choroidal neovascularization (CNV). We described a young adult man who presented with unilateral visual impairment due to choroidal osteoma without CNV, resistant to bevacizumab intravitreal injections, which showed a marked response to aflibercept. Our experience provides support for the use of aflibercept in the treatment of non-neovascular choroidal osteoma; this is the first report describing this encouraging result. Nevertheless, the current observation merits further research.

Key words: Aflibercept, osteoma, subretinal fluid

How to cite this article: Brody J, Avisar I, Reich E. Nonneovascular subretinal fluid secondary to choroidal osteoma controlled with intravitreal aflibercept - A case report. Cli Exp Vis Eye Res J 2019;2(2):31-33.

Received: 12-10-2019;

Accepted: 23-10-2019

Many techniques are employed to prevent the formation of a radial anterior capsular tear which resembles an Argentinean flag during surgery for the extraction of white mature cataract. We aim to describe an original endocapsular approach to manage this intraoperative complication once it has already occurred, which was employed in four eyes of four patients, all with mature white cataracts prior surgery. Using this technique, without hydrodissection, the surgeon proceeds with phacoemulsification through the slit of the open anterior capsule. The anterior capsule is only manipulated following intraocular lens (IOL) insertion to the capsular bag by creating two symmetric semicircles. In all cases, no posterior capsular tear occurred during surgery, and there were no further intra- or post-operative complications. The final best-corrected visual acuity was 20/25 in each case on the 3-month follow-up appointment, and the IOLs were well centered in the capsular bag.

Key words: Argentinean flag, capsulorhexis tear, mature cataract

How to cite this article: Sella R, Afshari NA. An alternative endocapsular approach for the management of Argentinean flag capsular tear during cataract surgery. Cli Exp Vis Eye Res J 2019;2(2):34-37.

Received: 16-08-2019;

Accepted: 12-10-2019