Both groups benefited from macular hole surgery, with significant visual improvement. However, complete closure of the macular hole and visual outcomes after internal limiting membrane removal were less successful in highly myopic eyes.
ABSTRACT.Purpose: To evaluate and compare the 12-month outcomes of two different initial dosing regimens of intravitreal ranibizumab for myopic choroidal neovascularization (CNV). Methods: We retrospectively reviewed the medical records of 46 consecutive, treatment-naive eyes which received intravitreal ranibizumab for subfoveal and juxtafoveal CNV secondary to pathologic myopia with a follow-up of 12 months. Two groups were created according to different initial dosing regimens: group 1 included 25 eyes treated by a single intravitreal injection; group 2 included 21 eyes treated by three consecutive monthly injections. Additional injections were performed if needed. Patients' demographic data, best-corrected visual acuity (BCVA), recurrence of CNV and total number of treatments were recorded and evaluated. Results: There was no significant difference between two groups among baseline demographic data. At 12 months, the mean logMAR BCVA improved from 0.58 to 0.23 in group 1 and from 0.55 to 0.22 in group 2 (both p < 0.001; Wilcoxon signedrank test). The mean logMAR BCVA at 12 months did not differ significantly. The average number of injections was 2.32 (SD 1.22) in group 1 and 3.57 (SD 1.12) in group 2 (p = 0.001; two-tailed t-test). During the follow-up, 17 of 25 eyes in group 1 and 5 of 21 eyes in group 2 received additional injections (p = 0.004). Conclusions: Similar visual improvement was achieved in both groups. Although the eyes with a loading dose of 3 monthly injections required a higher number of total injections over 1 year, there was a much lower rate of retreatment needed.
Patients with extremely high myopia obtained anatomical and functional improvements from MH surgery; inverted ILM flap insertion achieved significantly higher primary success rates in MH closure.
We report a patient with clinical ocular siderosis at the time of presentation but undetectable intraocular foreign body on computed tomography (CT) and ultrasonography. A 24-year-old man suffered from right ocular injury when hammering metal on metal. Slit-lamp examination revealed a small corneal perforating wound and an iris hole, but no intraocular foreign body was found under fundus examination. There was also no evidence of intraocular foreign body on ultrasonography and orbital CT scan. About 1 month later, lens siderosis with cataract formation developed, and the patient received lens extraction with intraocular lens implantation. During the operation, a small (< 1 x 1 x 1 mm in size) intralenticular foreign body of metal material was found and removed. The patient's visual acuity improved from 6/20 to 6/6 on the next day. A patient suspected to have intraocular foreign body should be followed-up closely; it is better to remove the foreign body before siderosis bulbi occurs.
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