OPHTHALMOLOGICA

Myopic maculopathy: a review

Research is continuing to shed light on the pathophysiology of myopic choiroidal neovascularisation (CNV), and new treatments are beginning to show promise, according to a review article on the current understanding of the condition. Myopic CNV may account for as much as 62 per cent of CNV occurring in patients younger than 50 years of age. The condition occurs in 5.2 per cent of eyes with an axial length longer than 26.5mm. Highly myopic eyes with lacquer cracks or patchy atrophy close to the fovea have a higher risk of developing CNV. Without treatment, two-thirds to three fourths of eyes with CNV associated with high myopia will have a final visual acuity of 20/200 or worse. Direct thermal laser photocoagulation was for a long time the only treatment available. However, whatever benefit it provides in the short term is lost in the long term through the spread of the laser scar. Recent studies suggest intravitreal anti-VEGF agents may produce a more meaningful benefit. • Silva, Ophthalmologica 2012, DOI: 10.1159/000339893

Continuing improvement in retinal structure and visual function

Patients who undergo surgery for idiopathic epiretinal membrane can continue to have further anatomic recovery of disrupted inner-outer segment junctions and corresponding improvements in vision for two years postoperatively, according to the results of a retrospective study. In 17 patients who underwent transconjunctival 25-gauge surgery, the BCVA at 24 months was significantly better than it was at 12 months (p = 0.018). In addition, the number of eyes with a normal appearing IS/OS junction, assessed by spectraldomain optical coherence tomography, increased from one eye at 12 months to seven eyes at 24 months. Those seven eyes showed significantly greater postoperative improvement in BCVA than the remaining 10 eyes throughout the entire follow-up period. • Inoue et al, DOI: 10.1159/000341606

Intravitreal dexamethasone implant effective in uveitis

Intravitreal dexamethasone implants can bring about a great reduction in the signs and symptoms of severe noninfectious uveitis that is unresponsive to immunosuppressants and periocular corticosteroids, according to a retrospective study. In 12 patients with refractory uveitis who received the implant, best-corrected visual acuity improved from 20/80 to 20/40 and the mean retinal thickness improved from 496 to 226 μm after a mean follow-up of nine months. Adverse events included intraocular pressure elevation in three eyes, vitreous haemorrhage in one eye and subconjunctival haemorrhage in one eye. Three patients reduced the daily systemic corticosteroid dosage after treatment  • Miserocchi et al, Ophthalmologica 2012 DOI: 10.1159/000343060

Indocyanine green toxic when used for chromovitrectomy

Indocyanine green (ICG) will degrade into toxic metabolites even when used at their optimum concentrations with modern endoillumination systems in chromovitrectomy procedures, however brilliant blue G (BBG) and trypan blue (TB), will remain stable, according to the results of an in-vitro study. The study's investigators simulated the illumination intensities and dye concentrations used in chromovitrectomy by irradiating vials containing standardised dilutions of the three dyes at a wavelength of 366 nm with an intensity of 14 μW/cm2 for up to 48 hours. They observed an exponential photolysis of ICG, whereas BBG and TB did not break down. • Brockmann et al, Ophthalmologica 2012, DOI: 10.1159/000341605