Background:The aim was to make a real-world comparison of the efficacy of ranibizumab, dexamethasone and grid laser treatments in macular oedema due to branch retinal vein occlusion (BRVO). Methods: Forty-four eyes of 44 consecutive patients with macular oedema secondary to BRVO were included. Treatment arms comprised standard care (StCARE, n = 15), intravitreal ranibizumab (RNB, n = 14) and dexamethasone implant (DEX, n = 15). No rescue laser was performed in DEX and RNB groups. Main outcome measures were mean change in visual acuity (VA) and the percentage of patients who gained 10 or more letters from baseline to six months and central retinal thickness (CRT). Results: Improvements in mean logMAR VA (p = 0.642) and letter score from baseline to month 6 were not statistically significantly different in all three groups. Mean follow-up was 13.9 AE 10.7 months in RNB, 11.9 AE 6.3 in DEX and 11.4 AE 6.6 in StCARE. Mean number of injections was 2.4 AE 1.4 (range: 1-6) in RNB and 1.9 AE 0.7 (range: 1-3) in DEX group over the follow-up period. Mean letter gain was 13.5 in DEX (p = 0.067), 7.1 in RNB (p = 0.553) and 4.5 in StCARE (p = 0.362). Mean CRT at baseline was 512.8 μm in DEX, 505.1 μm in RNB and 345.5 μm in the StCARE group. At the last visit, RNB provided the maximum reduction in CRT. Mean CRT decrease was −146.5 μm (28.6 per cent) in DEX, −241.3 μm (47.8 per cent) in RNB and −45.6 μm (13.2 per cent) in StCARE (p = 0.030). A statistically significant intraocular pressure elevation occurred in the DEX group (p = 0.005). Conclusion: Both RNB and DEX provided a significant resolution in macular oedema. Low frequency injections limited the visual gain in ranibizumab therapy. Visual results could be better with higher frequency injections and early start of treatment. Dexamethasone implants may be preferable in terms of visual improvement under low frequency injection conditions. Close follow-up is mandatory for detection of intraocular pressure elevations. Laser monotherapy is not a reasonable first-line option in the era of injection therapies.

Big bubble DALK provides an earlier visual improvement compare to PK. However, visual and topographic outcomes are similar to those in PK at 1y. Postoperative complications including rejection and intraocular pressure elevation are more frequent in PK. DALK is a safer alternative to PK for KC. However, intraoperative perforation of the Descemet's membrane is a significant complication.

Olfactory neuroblastoma (ONB), which is a neuroectodermal tumor of the nasal cavity, is a rare and locally aggressive malignancy that may invade the orbit via local destruction. In this study, we report a patient with proptosis, external ophthalmoplegia, and compressive optic neuropathy caused by ONB. A detailed clinical examination including ocular imaging and histopathological studies were performed. The 62-year-old female patient presented to our clinic with complaints of proptosis and visual deterioration in the left eye. Her complaints started 2 months prior to admission. Visual acuity in the left eye was counting fingers from 2 meters. There was relative afferent pupillary defect. She had 6 mm of proptosis and limitation of motility. Fundus examination was normal in the right eye, but there was a hyperemic disc, and increased vascular tortuosity and dilation of the retinal veins in the left eye. Computerized tomography and magnetic resonance imaging of the brain and orbits demonstrated a large heterogeneous mass in the left superior nasal cavity with extensions into the ethmoidal sinuses as well as into the left orbit, compressing the medial rectus muscle and optic nerve. Endoscopic biopsy of the lesion was consistent with an ONB (Hyams’ grade III). Orbital invasion may occur in patients with ONB. Therefore, it is important to be aware of this malignancy because some patients present with ophthalmic signs such as external ophthalmoplegia, proptosis, or compressive optic neuropathy.