Purpose:  To find the visual and anatomical outcomes of pars plana vitrectomy in cases of refractory diabetic macular edema. Study Design:  Quasi Experimental study. Place and Duration of Study:  Department of Ophthalmology, Lahore General Hospital from January 2013 to April 2019. Material and Methods:  Seventy-six patients between the age of 18 and 60 years of both genders having refractory diabetic macular edema with macular thickness of 400 micrometers or more on OCT were enrolled. Informed consent was taken. Detailed preoperative workup including visual assessment, examination on slit lamp using 90D or 78D lens for assessment of macular edema and OCT was done. Patients underwent pars plana vitrectomy, ERM, and ILM peeling. Visual assessment and macular thickness was recorded 4 weeks after surgery. Results:  This study included 76 patients with the mean age of 48.15 ± 8.16 years. Patients were further categorized according to age into 2 groups. The gender distribution of patients showed that most of the participants were female in this study.  Mean duration of Diabetes Mellitus was 9.95 ± 6.29 years. Most of the patients did not have previous history of laser and only three patients (3.9%) did not receive Intravitreal Anti-VEGF. Mean preoperative visual acuity was 0.44 ± 0.13 while postoperative visual acuity was 0.876 ± 0.18 (P = 0.000). Similarly, significant decrease in macular thickness was observed after the procedure (P = 0.000). Conclusion:  Pars plana vitrectomy, ERM and ILM peeling can be an effective treatment option for refractory diabetic macular edema.

Objective: To study per-papillary retinal nerve fibre layer (pRNFL) and central macular thickness (CMT) changesin adults with hyperopic anisometropic amblyopia using optical coherence tomography. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital, Lahore, Pakistan, from Oct 2019 to Feb 2020. Methodology: In this study 30 adults, 18-40 years of age were included who presented in our clinic with monocular poor vision. They underwent detailed ophthalmic clinical examination: including corrected and uncorrected distance visual acuity, slit lamp bio-microscopy and fundus examination with 90 diopter lens. After fulfilling criteria of anisometropic amblyopia, central maular thickness (CMT) and per-papillary retinal nerve fibre layer (pRNFL) thickness was measured by using RS-3000 SLO, NIDEK Co, Japan spectral domain optical coherence tomography device and compared the central maular thickness (CMT) and per-papillary retinal nerve fibre layer (pRNFL) thickness in amblyopic and fellow eye of same individual. Results: The mean change in per-papillary retinal nerve fibre layer (pRNFL) thickness in amblyopic eyes, 121.48± 4.90 μm and non amblyopic eyes was 112.92 ± 4.72 μm with statistical significance (p<0.001). The mean change in central macular thickness (CMT) in amblyopic eyes was 198.50 ± 5.30 μm and non amblyopic eyes was 206.80 ± 3.11 μm with statistical significance (p<0.001). There was significant increase in per-papillary retinal nerve fibre layer (pRNFL) thickness and significant decrease in central macular thickness (CMT) on comparing the amblyopic and the fellow eyes of the same patients. Conclusion: Central macular thickness (CMT) decreased.........................