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Purpose. To report our experiences in patients with age-related macular degeneration (AMD) treated initially with intravitreal ranibizumab and then switched to bevacizumab. Methods. We retrospectively reviewed the records of 7 patients (7 eyes) who were treated with monthly injections of intravitreal ranibizumab and then switched to injections of bevacizumab (every 6 weeks) for six months. The best-corrected visual acuity measurements (BCVA) and optical coherence tomography (OCT) were performed at the baseline examination and then at each visit. The Wilcoxon signed-rank test was used for the statistical analysis. Results. Following three monthly ranibizumab treatments, there was no significant difference in the BCVA, while the foveal retinal thickness (FRT) significantly decreased (P < 0.01). Switching from ranibizumab to bevacizumab resulted in maintenance (57.2%) of the BCVA and a further decrease in the FRT (P < 0.01) after 6 months. Conclusions. Switching to intravitreal bevacizumab may be effective in patients who wish to discontinue intravitreal ranibizumab treatment due to the high cost.

Aim: Infliximab, an anti-tumor necrosis factor (TNF)-α monoclonal antibody, has been reported to be effective in refractory uveoretinitis in Behçet’s disease. Because it has been used clinically for a short time, information on its adverse effects is limited. We report a patient who developed cystoid macular edema (CME) following infliximab use for uveoretinitis associated with Behçet’s disease. Case Report: A 27-year-old man had refractory uveoretinitis and neuro-Behçet’s disease, and intravenous infliximab was administered. Results: One day after infliximab infusion, the patient complained of a decrease in the vision in his left eye. The visual acuity had decreased from 1.2 to 0.5. Daily optical coherence tomographic evaluations showed a progressive worsening of the CME, and fluorescein angiography showed a typical staining with a cystic pattern. Two weeks later, the height of CME appeared to reach a maximum level and thereafter gradually resolved in spite of the continuation of infliximab administration. The visual acuity improved while the patient was treated with repeated subtenon injections of steroids in addition to continuation of infliximab and finally increased from 0.15 to 1.2. Conclusions: Although the mechanism of CME is not known, clinicians should be aware that infliximab therapy might cause a development and worsening of CME. Thus, it is crucial to rule out preexisting abnormalities in the macula prior to commencing infliximab infusion.

Aims: The aim of this study was to evaluate the efficacy of laser photocoagulation for type 1 idiopathic macular telangiectasia (MacTel). Study Design: Retrospective case series Place and Duration of Study: Department of Ophthalmology, Oita University Hospital during the period from 2004 to 2013. Patients and Methods: Six eyes of 6 patients with type 1 MacTel diagnosed consecutively in the Oita University Hospital during the period from 2004 to 2013 were studied. They showed macular edema and their visual acuity were deteriorated due to leakage from the aneurysms. Four patients were male and two were female with an average age of 64 years (range: 41 to 74 years). Informed consent was obtained from each patient and the laser photocoagulation was applied to leaky aneurysms in all eyes. The central macular thickness (CMT) was measured by optical coherence tomography (OCT). Mean follow up period was 44 months (range: 24 - 63 months).  Results: Mean visual acuity significantly increased from logMAR 0.25±0.27 at baseline to logMAR 0.11±0.14 (P<0.05) at the last visit. Visual acuity improved more than 0.2 logMAR in five eyes and was stable (gain or loss of < 0.3 logMAR) in one eye. Mean central macular thickness significantly decreased from 454±181 μm at baseline to 231±67 μm (P<0.05) at the last visit. Macular edema was not detected by OCT inany patients at the last visit. Conclusion: In type I MacTel, laser photocoagulation may achieve a visual improvement and normalize the central macular thickness.

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