Preoperative aqueous flare is a strong predictive factor for PVR redetachment. The laser flare-cell meter provides a fast and safe tool to accurately identify patients at risk for postoperative PVR, especially when clinical examination did not predict this risk.

Purpose To report the dramatic effect of bolus cyclophosphamide in a severe case of lupus retinopathy. Methods A 31‐year‐old woman with active systemic lupus erythematosus (SLE) consulted for asymmetric rapidly progressive decreased visual acuity (8/10 P2 OD, 1/20 P14 OS). Fundus examination disclosed bilateral macular oedema, numerous peripapillary cotton wool spots and hemorrhages suggestive of the diagnosis of lupus retinopathy. Clinical and biological criteria allowed the diagnosis of severe multi systemic SLE with lupus glomerulonephritis. Treatment based on oral 1mg/kg daily steroids and 6 intravenous cyclophosphamide cures (100mg/m2). Rapid improvement in systemic and biological signs of SLE was observed with parallel disappearance of retinal signs. Full recovery of visual acuity was obtained within 6 months. Results Prevalence of SLE varies between 10 and 50 p 100,000. Presence of ophthalmological manifestations is estimated between 5 and 50% of the patients depending on the series, and the most frequent one is lupus retinopathy. First line treatment is usually based on oral corticosteroids. Immunosuppressive drugs may be used as part of a steroid‐sparing strategy or for resistant forms of the disease. In case of severe acute cases, as in our patient, intensive treatment combining steroids and cyclophophamide cures enables regression of retinal signs and improvement of visual acuity, along with clinical and self‐immune and inflammatory tests. Conclusion In severe forms of SLE a treatment combining cyclophosphamide cures and steroids is mandatory to obtain not only improvement of systemic manifestations but also complete visual recovery.

Purpose To report a case of traumatic macular hole revealing a retinitis pigmentosa. Methods A 33‐year old man without past medical history complained of visual loss after direct trauma of his left eye. Visual acuity was 20/50 RE and 20/400 LE. Anterior chamber examination was normal and fundus examination revealed a large macular hole associated with optic atrophy in his left eye. Right eye funduscopy showed a cystoid macular edema and optic nerve palor (RE). Many pigment deposits were present in retinal mid‐periphery of both eyes. Optical coherence tomography showed cystoid macular edema (517 microns) RE and a large macular hole (3100 microns) LE. Typical visual field defects and extinguished electroretinogram responses confirmed the diagnosis of retinitis pigmentosa. Results Macular diseases are well‐known complications of retinitis pigmentosa, especially macular edema. Vitreomacular tractions, epiretinal membranes and macular holes are less frequent. These complications may be explained by pigment epithelium disorders that may compromise ionic drainage of the retina. Causes of macular hole in retinitis pigmentosa remain uncertain. In our patient, development of a macular hole may be explained by occurrence of trauma in an eye with pre‐existent macular edema secondary to the unknown retinitis pigmentosa. Conclusion Despite macular complications of retinitis pigmentosa are relatively common, a traumatic macular hole as a revealing symptom is exceptional.

Purpose To report 2 cases of ocular inflammation in patients with chronic granulomatous disease (CGD). Methods A 2‐year old boy was referred for red right eye and fever lasting for one month. A granuloma developed in the anterior chamber of his right eye. A CGD was suspected and the X‐chromosom analysis confirmed a mutation in the gp 91 phox (the b subunit of cytochrome b558). Steroids were associated with antifungals and antibiotics and the granuloma disappeared rapidly. The other caseis about a 22‐year‐old womanknown to be a carrier for X‐linked cytochrome b558‐negative CGD. She presented with a red painful right eye. Slit‐lamp examination revealed a nodular scleritisand, funduscopy disclosed chorioretinal granuloma in nasal periphery (RE). A white active but asymptomatic chorioretinal lesion on the temporal part of posterior pole and perivascular retinal scars were found (LE).She was successfully treated with oral prednisone. Results CGD is a rare inherited disorder of phagocytic cells leading to recurrent life‐threatening bacterial and fungal infections, caused by a defect in the nicotinamide adenine dinucleotide phosphate. The most common molecular defect is a mutation in the cytochrome B, b subunit gene located on the X chromosome encoding for gp91. The most frequent ocular manifestations are juxta vascular chorioretinal lesions, keratitis and conjunctivitis. Current therapy for CGD is based on antimicrobial prophylaxis, early and aggressive treatment of infections. Conclusion Ophthalmologists must be aware of the different ocular localisations in CDG that may be the presenting symptoms.

PurposeTo investigate preoperative aqueous flare as a predictive factor for proliferative vitreoretinopathy (PVR) leading to relapse in patients with primary rhegmatogenous retinal detachment repear.MethodsPreoperatively, the aqueous flare of 100 consecutive patients with unilateral rhegmatogenous retinal detachement (RD) was measured with Kowa FM‐500 laser flare‐cell meter. All patients were evaluated at 1 month and 6 months or just after recurence.ResultsTwenty eyes underwent redetachment secondary to PVR developpement. The mean value of flare of patients that redetached was 48.12 pc/ms versus 17.74 pc/ms for those who did well (p = 0.002). We observed that 17/20 recurrences with PVR (85%) and 24/76 that did well (31.6%) had flare greater than 15 pc/ms (p = 0.0355). Moreover in patients without preoperative clinical signs of PVR, the sensitivity of the laser cell flare to predict post operative PVR when flare reached 15 pc/ms was 100% with 77.5% specificity and 31.25% positive predictive value.ConclusionsOur study shows the effectiveness of the laser flare cell meter in detecting eyes at risk of developing post operative PVR leading to recurrences. The laser flare‐cell meter is a non invasive tool that informs the surgeon on the potential severity of the detachment.