Table of Contents - WOC 2012

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Isotretinoin associated to macular Drusen; chance or causality
Galindo-Ferreiro Alicia (1) , Sanabria_ Ruiz Colmenares M.R (1) , Garcia-Llanes
G (1) , Alvarez-Iscar N (1)
1. Complex Health Care of Palencia
PURPOSE: The Isotretinoin (retinoic 13-cis-acid, Accutane®) is the treatment
of choice for severe acne. Decrease of dark adaptation has been described as
an ocular side effect that alters the visual cycle. CASE REPORT: A 31-year-old
female referred decreased dark adaptation and decreased color vision after
treatment with Isotretinoin. Best corrected visual acuity was 20/20; normal
ocular surface. The fundus showed a symetric puntiform, cuticular drusen in
the near periphery. The angiofluoresceingraphy (AGF) demonstrated abundant
hyperfluorescent points in the early phase, with the typical starred sky image,
OCT drusen in RPE. Humphrey visual field (HVF), Farnsworth test (28 Hue),
electroretinogram and adaptoelectroretinogram were normal. First degree
relatives were examined and none of them presented any similar lesions.
Only her mother presented drusen in posterior pole although less abundant.
Treatment was discontinued. The patient was reviewed after 2, 6 and 12
months. She had the same symptoms and fundus appearance.
Conclusions: Subjective decreased dark adaptation may be permanently
impaired and can be attributed to the toxicity of the drug. Its responsibility for
the presence of fundus drusen is more doubtful, although Isotretinoin, as a
vitamin A isomer, could trigger decompensation of a preexisting condition,
interfering with the RPE and photoreceptor.
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OZURDEX versus intravitreal anti-VEGF for the treatment of macular
edema associated to retinal vein occlusion
Turki Khalil (1) , Yohan Benayoun (1) , Oana Gagos (1) , Adenis Jean Paul (1) ,
Robert Pierre Yves (1)
1. University Hospital
Purpose To report our experience with sustained-release dexamethasone 0.7
mg intravitreal implant (Ozurdex) in retinal vein occlusion with macular edema
and to evaluate its efficiency comparing to ranibizumab. Methods A prospective
study of two groups all presenting macular edema with vein occlusion. Group
one (8 patients) was treated with Ozurdex and second one (14 patients) with
intravitreal ranibizumab. The criteria for retreatment in the second group were
based on best corrected visual acuity and OCT foveal thickness value (average
= 4 injections in 6 months). Data of each group and side effects were noted
at baseline and follow-up (1 week, 1 month, 3 months and 6 months). Results
All eyes in both groups showed OCT evidence of decreased edema following
injection. Forty percent of patients gained 10 letters of best-corrected visual
acuity at 3 months. Results were similar in both groups. Thirty-five percent
of patients in group one experienced a slight increase of ocular pressure.
Conclusions In patients with macular edema in retinal vein occlusion, Ozurdex
may have the same efficiency as intravitreal ranibizumab with a less number
of injections.
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Retinal Pharmacotherapy
Rodrigues Eduardo (1) , Farah Michel (1) , Schachat Andrew (2) , Mieler William (3) ,
Meyer Carsten (1)
1. Vision Institute, Department of Ophthalmology, Federal University of Sao
Paulo
2. Department of Ophthalmology, Cole Eye Institute
3. Department of Ophthalmology and Visual Sciences, University of Illinois
Objective: This course will serve as an overview of how various drugs may
work in the retina. The session will present cutting-edge results of clinical trials
as the CATT, as well as overview the techniques and complications in retinal
pharmacotherapy. The most important drugs available in clinical practice,
Lucentis, Avastin, and Ozurdex, will be presented in detail. At the conclusion,
the attendee will be able to understand the indications, applications and status
of drugs available in retinal pharmacotherapy.
Summary Of Content: The management of retinal diseases has changed in
recent years, as the focus has moved into pharmacologic treatments. There
are currently existing and upcoming drugs being used to treat various retinal
diseases. This course will provide an in-depth knowledge of the drugs in
retinal pharmacotherapy. Audience: General Ophthalmologists and Retinal
Specialists Level: Intermediate to Advance
WOC2012 Abstract Book
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Factors influencing presentation for ROP evaluation to a tertiary
level screening centre
Gopal Devaprasad, Jalali Subhadra Padmaja Kumari rani
1. LV Prasad Eye Institute
: To evaluate the social factors influencing early versus late presentation for
ROP evaluation.
Methods: Prospective cross sectional case control study of babies with
early(before 30 days of life) versus late presentation (after 30 days of life)
for screening of ROP.140 parents in each group were administered an event
survey and responses were evaluated.
Results: Failure to inform parents about timely screening
(64/140,45.7%),unaware of the importance (46/140,32.9%), busy in
events(30/140,21.4%) were causes of late presentation.
Conclusion: Late presentation is primarily due to failure of paediatrician to
inform regarding timely ROP screening and its importance besides parents
pre occupation .Good awareness by the paediatrician and ophthalmologist is
needed to improve the compliance.
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Macular involvement and visual acuity in Behcet›s disease
Shimoda Yukitoshi (1) , Hashimoto Hideaki (1) , Sano Morihiko (1) , Magoori Mikiya
(1) (1)
, Kishi Shoji
1. Department of Ophthalmology, Gunma University School of Medicine
Purpose: To evaluate the macular morphological change and visual acuity in
Behcet›s disease using spectral domain optical choherence tomography (SD-
OCT).
Methods: We retrospectively studied 17 eyes of 12 patients with Behcet›s
disease. During period, 10 eyes had exudative attack in the macula and 15
eyes had remission.
Results: Mean best corrected visual acuity (mBCVA) of the 10 eyes during
attack was 0.20. SD-OCT demonstrated macular edema in 10 eyes (100%),
a serous retinal detachment in 7 eyes (70%), high reflect changes of retina in
6 eyes (60%) and dot reflects of vitreous in 5 eyes (50%). The mean central
foveal thickness (mCFT) was 461?m. During remission, mBCVA of the15 eyes
was 0.41. SD-OCT showed retinal thinning in 9 eyes (60%), disruption of
foveal photoreceptor inner and outer segment (IS/OS) in 7 eyes (47%), defect
of foveal external limited membrane (ELM) in 4 eyes (27%). The mCFT was
194?m. The status of foveal ELM and IS/OS was more correlated with final
BCVA than CFT in 15 eyes during remission.
Conclusion: The main features of macular attack in Behcet›s disease were
macular edema and serous retinal detachment. During remission, foveal ELM
and IS/OS were most predictive factor for visual outcomes.
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Hemodynamics of retinochoroidal circulation in central retinal artery
occlusion
Li Danjie (1) , Kishi Shoji (1)
1. Department of Ophthalmology, Gunma University School of Medicine
Purpose: To evaluate hemodynamics of retinal and choroidal circulation in
central retinal artery occlusion (CRAO) by laser speckle flowgraphy (LSFG)
Methods: We performed laser speckle flowgraphy (LSFG) in four patients with
unilateral CRAO, which measures the index of blood velocity (mean circle blur
rate: MBR) at the optic disc and the central macula. We compared the MBR
values between CRAO and normal fellow eyes at day 3 (2 cases) and day 6
(2 cases) from the onset of decreased vision, and one month later (4 cases).
Results: At initial visit, their visual acuities were 0.01 (2 cases) and 0.03 (2
cases). In macula, the MBR values of CRAO eyes were relatively maintained,
the ratio to normal fellow eyes was 74%(case 1), 94%(case2), 155%(case3)
and 95%(case4), but in optic disc, the MBR values were decreased , 30%,
63%, 56% and 40%. After one month, the visual acuities of two cases had
slightly improved, however, the MBR values of CRAO in areas of optic disc and
macula had not changed.
Conclusions: The circulation of optic disc in CRAO decreased half level of
normal eye or lower. Contrary, circulation of macula, which is mainly supplied
by choroidal circulation, was maintained at normal level.
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