Aim:The aim was to study the structural sequelae and refractive outcome after laser treatment for Type 1 prethreshold retinopathy of prematurity (ROP) in Asian Indian eyes.Materials and Methods:A retrospective chart review of infants with Type 1 prethreshold ROP (defined according to the Early Treatment for Retinopathy of Prematurity study) undergoing laser treatment at a tertiary center between January 2004 and December 2008 was done. The 1-year outcome of infants was analyzed.Results:Sixty-nine eyes of 36 infants were included. The mean birth weight was 1121.69 ± 254.81 g and the gestational age was 28.99 ± 2.03 weeks. Sixty-five eyes (94.2%) had zone 2 and 4 (5.8%) had zone 1 disease. Forty-four (63.77%) eyes had stage 2 ROP with plus disease and 25 (36.23%) eyes had prethreshold (fewer than five contiguous or eight cumulative clock hours) stage 3 ROP with plus disease. None of the eyes developed retinal structural sequelae. On cycloplegic retinoscopy, 59.4% eyes had nonsignificant hyperopia [spherical equivalent (SE) ≤ 4 D], 14.5% eyes had no refractive error (SE 0 D), 24.7% eyes had low myopia (SE < 5 D), and 1.4% eyes had high myopia (SE > 5.0 D). Eyes developing myopia were associated with a greater number of clock hours of ROP, greater number of laser spots used, and a longer time to disease regression. Two infants (5.6%) had esotropia and one (2.8%) had exotropia.Conclusion:Asian Indian infants treated for Type 1 prethreshold ROP did not develop retinal structural sequelae. Myopia was seen in nearly one-fourth of the eyes.The risk factors for myopia were a greater number of clock hours of ROP, greater number of laser spots, and a longer time to regression of ROP.

A 43-year-old woman with tubercular choroidal granuloma showed poor response to conventional first-line four-drug antitubercular therapy (ATT) and corticosteroids. A therapeutic trial with intravitreal bevacizumab (1.25 mg in 0.05 mL) injections as an adjunct to ATT and corticosteroids led to a prompt initial regression of granuloma with restoration of visual acuity that was sustained for almost 2 years. A subsequent recurrence of the same lesion with evidence of enhanced vascularity was treated with intravitreal bevacizumab alone, that led to a complete regression of the granuloma with no recurrence until 1 year of follow-up.

Tacrolimus is commonly used as an immunosuppressant in organ transplantation. Although it is well tolerated, visual loss has been known as a rare but serious complication of this drug. We report a woman developing visual complaints while on tacrolimus therapy for nephrotic syndrome. Omission of the drug led to partial visual field recovery. Visual complications in patients receiving tacrolimus should alert the treating physicians for timely discontinuation of the drug.

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