PurposeTo report the clinical data and visual outcomes after treatment of patients with dysthyroid optic neuropathy (DON).MethodsWe retrospectively reviewed the medical records and orbital images of 40 patients (65 eyes) with DON and analyzed the visual outcomes after treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression.ResultsThe study included 21 men and 19 women, with 10 (25%) being diabetic patients. Visual field test results revealed defects in 88.7% of DON eyes; afferent pupillary defects in 63.2%; reduced color vision in 78.5%; and abnormal visual evoked potentials in 84%. Orbital imaging showed moderate to severe apical crowding in 95% of the orbits and intracranial fat prolapse in 24.2%. Median best corrected visual acuity improved from 0.4 to 1.0 after one year of treatment (p < 0.001). We noted more improvement in vision with the use of decompressive surgery than with non-surgical methods (p < 0.05). Recurrences occurred in 7 patients who had not received orbital radiotherapy.ConclusionsVisual field defects and apical crowding seen on orbital imaging were the most sensitive indicators for the detection of DON. Treatment with intravenous steroids pulse therapy, radiotherapy and orbital decompression effectively improved visual outcomes in cases of DON.

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Purpose:To report a case of noninfectious endophthalmitis after intravitreal injection of aflibercept. Case summary: A 67-year-old male patient presented with sudden vision loss 2 days after intravitreal aflibercept injection for neovascular age-related macular degeneration. Mild conjunctival injection and moderate inflammation in the anterior chamber were noted, but he had no ocular pain or hypopyon. The patient was diagnosed with noninfectious endophthalmitis and successfully treated with topical antibiotics and topical steroid eye drops. The infection was apparently cleared at 3 days. At 10 days after the initial presentation, his vision loss resolved completely.