Aim: To investigate the short-term effects of COVID-19 pandemic related unintended treatment lapses on neovascular age related macular degeneration (nAMD) patients. Methods: In this prospective cross-sectional study, 140 patients who had at least one anti-vascular endothelial growth factor (VEGF) injection for nAMD within 12 months before COVID-19 pandemic and who had at least 3 months of unintended lapse for control visits during pandemic were recruited and underwent a detailed opthalmological examination and optical coherence tomography imaging. Results: Of these 140 eyes, 113 (80.7%) were active with presence of either intraretinal and/or subretinal fluid and necessitated intravitreal anti-VEGF injections; and 20 (14.3%) of them complicated with subretinal hemorrhage. The mean interval of clinical visits and intravitreal antiVEGF injections were found to be prolonged during COVID-19 pandemics, which demonstrates a statistically significant lapse for both ( p = 0.001 and p = 0.003 consecutively). The decreased visual acuity due to lapse was positively correlated with number of intravitreal anti-VEGF injections at last 6 months before COVID-19 pandemic ( r = 0.217, p = 0.010) and central subfoveal thickness at first post-COVID-19 visit ( r = 0.175, p = 0.038); and negatively correlated with follow-up duration ( r = −0.231, p = 0.006) and number of control visits ( r = −0.243, p = 0.004). Fifteen (16.9%) of the 89 patients who had drusen in the fellow eye before COVID-19 pandemic evolved to nAMD with an accompanying subretinal and/or intraretinal fluid. Conclusion: Unintended lapses during COVID-19 pandemic resulted with poor functional and structural outcomes for nAMD patients, especially for those at the beginning of the treatment period and who still have an unstable clinical course.

Purpose To evaluate the prevalence of the obstruction of lacrimal drainage system (LDS) in patients with pseudoexfoliation (PXF) syndrome. Materials and Methods This cross-sectional study included 152 eyes of 76 consecutive patients with bilateral PXF syndrome and 170 eyes of 85 age and gender-matched controls. The LDS evaluation was performed based on dye disappearance test, slit-lamp examination, diagnostic probing, and irrigation test. The presence of punctal stenosis and canalicular obstruction were considered as the obstruction of proximal LDS; and complete or incomplete nasolacrimal duct obstruction was considered as obstruction of distal LDS. Demographic characteristics, ophthalmologic findings, and prevalence and site of obstruction of LDS were compared among the groups. Results The prevalence of obstruction of LDS was higher in the PXF syndrome group when compared to controls (21.1% vs 12.2%), but the difference was not statistically significant ( p = 0.061). The obstruction of proximal LDS was found to be more frequent in the PXF syndrome (17.7%) group when compared to controls (10.0%), and this difference was statistically significant ( p = 0.041). There was significantly more punctal stenosis in the PXF syndrome group when compared to controls (15.1% vs 7.6%, p = 0.033). The prevalence of canalicular stenosis and obstruction of distal LDS was similar in the PXF and the control groups ( p = 0.596 and p = 0.741, respectively). Conclusion The prevalence of punctal stenosis was statistically significantly higher in the PXF syndrome group when compared to the controls. This association is probably related to increased local ocular surface inflammation which is triggered by the accumulation of PXF material.

Background An important complication associated with perfluorocarbon liquid (PFCL) use during pars plana vitrectomy (PPV) is its retention in the submacular area. The aim of this study was to present the long-term outcomes of the surgical method used in this study to remove submacular PFCL and to shed light on the advantages and disadvantages compared to other methods. Material and Methods This is a retrospective, single-center, observational study. Patients who underwent surgical intervention due to submacular PFCL were included in this study. The surgical procedural includes internal limiting membrane (ILM) peeling, transretinal aspiration of submacular PCFL with a 25/27-gauge soft-tipped cannula, then perfluoropropane (C3F8) gas tamponade, and facedown positioning for 5 days. The long-term anatomical and functional outcomes were evaluated with an ophthalmological examination and optical coherence tomography (OCT). Outcomes A total of 15 patients with submacular PFCL were included in this study, and the mean age of the patients was 64.33 ± 10.36 years (47 – 83). The localization of submacular PFCL was subfoveal in nine patients (60.00%), non-subfoveal in four patients (26.67%), and both subfoveal and non-subfoveal in two patients (13.33%). The mean time of submacular PFCL diagnosis was 4.86 ± 1.02 weeks (2 – 8) and the mean time of the surgery was 9.80 ± 1.17 weeks (8 – 14). Complete removal of submacular PFCL was achieved in all cases (100%) and no significant treatment-associated complications were observed. The mean follow-up time was 37.60 ± 14.00 months (18 – 60) and the best-corrected visual acuity was significantly improved (p = 0.001). At the end of the follow-up time, prominent ellipsoid zone disruption was observed in six patients (40.00%), while in nine patients (60.00%), there was no prominent ellipsoid zone disruption. Conclusions The surgical procedural for submacular PFCL removal is a reasonable option and improves visual acuity in the long term without any significant treatment-associated complications.