Optical coherence tomography angiography (OCTA) is a non-invasive angiography type without a contrast agent, which provides a detailed assessment of the retinal and choroidal vasculature and visualization of blood flow by detecting motions of erythrocytes, using serial optical coherence tomography B-scans. As compared to gold standard techniques such as fluorescein and indocyanin-green angiography, OCTA offers two major advantages: no dye is required and depth resolution is required is provided. As such OCTA has the potential to improve our abilities to diagnose and monitor ocular vascular diseases.

Retinoblastoma is the most common intraocular malignancy in childhood. It usually presents before 3 years of age and can be germinal or nongerminal. There has been a paradigm shift in the classification and management of retinoblastoma. This review provide the international retinoblastoma classification, latest classification of vitreous seeds, and current and newer treatment modalities such as intra-arterial and intravitreal chemotherapy.

Purpose: To study the tomographic features of idiopathic polypoidal choroidal vasculopathy (IPCV) diagnosed on indocyanine green (ICG) angiogram using spectral domain optical coherence tomography (SDOCT). Design: This was a retrospective observational case series. Materials and Methods: Spectral domain optical coherence tomography (SD OCT) features of 50 eyes of 50 consecutive patients diagnosed as idiopathic polypoidal choroidal vasculopathy (IPCV) between January 2013 to January 2015 on ICG angiograms were studied. A qualitative analysis based on various tomographic features corresponding to the polypoidal lesions and branching vascular network on Spectrailis OCT was studied. Polyps were localized to subfoveal and juxtafoveal areas. These were later compared with SDOCT features of 15 eyes of 15 consecutive patients newly diagnosed as occult choroidal neovascular membrane (CNVM) on FFA/ICG. Results: Of the 50 eyes, sharp peak pigment epithelial notch (PED) was present in 49 eyes (98%); PED notch in 49 eyes (98%); a visible hyporeflective lumen with hyperreflective lesions adherent to the outer surface of the RPE in 48 eyes (96%), multiple PED in 44 eyes (80%), and diffuse PED in 44 eyes (80%); intraretinal hyperreflective dots representing hard exudates were seen in 44 eyes (88%). Surrounding OCT features such as intraretinal hyperreflective dots represent hard exudates, Cystoid macular edema and subretinal fluid were seen in 44 eyes (88%). Sub-RPE features such as PED with sheaths of internal reflectivity – branching vascular network in 19 eyes (38%) and prominent Bruchs membrane and surfacing of choroidal vessels was seen in 18 eyes (36%). At least 3 of the abovementioned OCT features were seen in all of the eyes diagnosed as PCV. The height of the PED ranged from 138–1300 μ (median = 422.2 μ). Of the 15 eyes, 80% showed presence of FVPED; multiple PED were seen in 33.3%; intraretinal hard exudates in 66.7%, and notch PED in 6.7%. Hyporeflective lumen with hyperreflective lesion under RPE was not seen in any of the eyes. The height of PED ranged from 118–339 μ (median = 164.28 μ). Conclusions: SDOCT-based features mentioned above allows detection of IPCV and differentiate it from occult CNVM. Our results suggest that SDOCT may be a useful noninvasive tool compared to ICG in detecting PCV, especially in places where ICG is not available or is contraindicated.

Purpose: To evaluate the efficacy and optimum timing for resurgery in case of persistent macular hole (MH). Materials and Methods: Nineteen eyes of 19 patients who underwent fluid air exchange with intravitreal C3F8 for persistent MH after vitrectomy + internal limiting membrane peeling + SF6 were included in the study. Best corrected visual acuity (BCVA), optical coherence tomography (OCT) features including base diameter and configuration of MH, and time duration between two surgeries were noted. Results: Patients who underwent resurgery within 3 months of the first surgery had better anatomical closure rate compared to those who underwent resurgery after 3 months (P < 0.05).Significant improvement was seen in BCVA in eyes with closed MH. Eyes having MH with irregular edges on OCT had better anatomical closure rates compared to round edges. Conclusion: Patients undergoing repeat gas injection within 3 months of primary surgery for persistent MH have better anatomical closure rates compared to late intervention (>3 months).

Aim: The aim of this study was to evaluate the safety and efficacy of biosimilar intravitreal ranibizumab (Razumab) for the treatment of chorioretinal vascular diseases such as diabetic macular edema (DME), neovascular age-related macular degeneration (nAMD), and macular edema secondary to retinal vein occlusions (RVOs). Methods: A prospective analysis was performed on consented patients with DME (Group 1), nAMD (Group 2), and macular edema secondary to RVO (Group 3). All patients received Razumab at baseline. Snellen visual acuity assessment, anterior segment and fundus evaluation, fundus photo, and optical coherence tomography imaging were done at days 0, 1, 7, and 30, respectively. The International Society for Clinical Electrophysiology of Vision standard electroretinography (ERG) was performed at baseline and day 30 (23 eyes who could afford the investigation). Primary and secondary outcome measures were safety parameters that included signs of clinical and ERG toxicity and changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT), respectively. Results: One hundred and twenty-three eyes of 95 patients received biosimilar intravitreal ranibizumab injection between November 2015 and April 2016. No serious drug-related ocular or systemic adverse events were identified. Mean pretreatment BCVA was 0.67 ± 0.41 logMAR with CMT 345.90 ± 128.84 μm and postinjection BCVA at day 30 was 0.57 ± 0.37 logMAR with CMT reducing to 287.66 ± 90.28 μm, indicating statistical significance (P = 0.001 and P< 0.0001, respectively) for all groups. Conclusion: The biosimilar intravitreal ranibizumab for DME, nAMD, and macular edema secondary to RVO was tolerated over a month with improvements in BCVA and CMT without detectable ocular and systemic toxicity. While the long-term safety and efficacy remain unknown, these short-term results suggest that biosimilar ranibizumab could become a safe, low-cost therapy for macular diseases.

Purpose: The aim of the study was to analyze the effect of cataract surgery on ocular hypertension and to evaluate if type of surgery changes the postoperative intraocular pressure (IOP) outcome. Materials and Methods: A prospective longitudinal study of sixty patients out of which forty of them underwent phacoemulsification and twenty underwent manual small incision cataract surgery over a period of 2 years from December 2014 to October 2016. Data were entered in Microsoft Excel and analyzed using Strata version 13. We calculated the means and standard deviations for the linear variables and proportions for the categorical variables. The means between two groups were compared using the unpaired t-test (for different groups). The proportions were compared using Chi-square test or Fisher's exact test (for low expected cell counts). We used Mann–Whitney test for comparing the distribution of the variables and Wilcoxon matched-pairs signed-ranks test for equality of matched pairs. Conclusion: In our study, 22.7% fall is noted by the end of 3 months. Pressure-to-depth (IOP/anterior chamber depth) ratio is a valuable prognostic indicator in ocular hypertensives as well to predict postoperative IOP outcome. The type of surgery did not effect the reduction in IOP postsurgery by the end of 3 months.

Aim: The purpose of the study was to determine the role of refractive error as a potential risk factor for macular telangiectasia (MacTel) 2A. Subjects and Methods: The study was designed as a hospital-based retrospective case–control study. One hundred and three age- and sex-matched participants served as controls. The study was conducted over a 3-year period (April 2011–March 2014). The diagnosis of MacTel 2A was based on the classification by Gass JD and Blodi BA with the addition of optical coherence tomography and fundus autofluorescence features. Data from medical records were entered in a standardized pro forma and analyzed. Spherical equivalent (SEq) was calculated using the spherical dioptric power plus half the cylindrical dioptric power. Statistical analysis was performed using SPSS version 20 and statistical package R 1386 3.1.0. Results: The mean refractive error (SEq) of the cases was +0.90D and +1.08D among the controls. The refractive errors ranged from −4.00D to +6.75D among the cases. Binary logistic regression analysis was performed to determine the role of refractive error as a risk factor for MacTel 2A. Emmetropia was taken as the reference category. Hypermetropia had an odds ratio (OR) of 2.50 (P = 0.002). Myopia had an OR of 1.50 (P = 0.29). It was inferred that patients with hypermetropia had a 2.50 times higher risk of developing MacTel 2A, compared to emmetropes. Conclusion: Our study of 103 cases and an equal number of age- and sex-matched controls revealed that hypermetropia was a significant risk factor for the development of MacTel 2A.

Context: Central corneal thickness (CCT) was assumed to be a constant when Goldmann designed his applanation tonometer. Knowledge of the CCT is of importance in the assessment of intraocular pressures (IOPs). Aim: The aim of the study was to examine the association of CCT with ocular, demographic, and metabolic factors such as age, race, gender, smoking, alcoholism, diabetes mellitus, hypertension, obesity, metabolic syndrome, corneal curvature, and axial length. Settings and Design: A cross-sectional study was conducted in 166 patients aged between 30 and 70 years who had presented for routine eye checkup from January 1, 2014, to July 1, 2015, in our Ophthalmology Department. Subjects and Methods: Patient parameters were recorded using an interview schedule, and complete ocular examination, including visual acuity and IOPs, were recorded. CCT was measured using PacScan Plus A-Scan/Pachymeter. Statistical Analysis Used: Mean CCT across different variables were compared using ANOVA and t-test. Further analysis was done using univariate and multivariate analysis. Results: On univariate analysis, it was found that age, presence, and duration of diabetes, elevated fasting blood sugar levels, alcohol consumption, corneal curvature (in diopters), and IOP were associated with CCT. Multivariate analysis showed significant association of CCT with age, duration of diabetes, corneal curvature, and IOP (P < 0.05). Conclusions: From our study, we concluded that CCT was significantly associated with age, duration of diabetes, corneal curvature, and IOP. Duration of diabetes and IOP showed a positive correlation with CCT whereas age and corneal curvature showed a negative correlation.

Patch grafting is a procedure employed to address large corneoscleral perforations or impending ones where tectonic stability of the globe is at stake. It is usually done using corneal trephines, the size of which depends on the largest dimension of corneal pathology, often necessitating a large area of dissection. Instead of trephination to ensure the right fit of the excised tissue, we thought that templates made from surgical drape can serve a similar purpose, which is exemplified in this article.

The purpose of this article is to highlight that cryotherapy is an effective, noninvasive, and simple treatment modality for basal cell carcinoma of the eyelid, especially if the tumor size is small. Cryotherapy is not recommended for basal cell carcinomas of the morphea type; however, the treatment was successful in this patient of ours. We present here a case of morpheaform basal cell carcinoma of the lower eyelid which improved after cryosurgery and showed complete resolution at 5-year follow-up.

Intravitreal cyst is a very rarely reported case in children. Here, we report a case of a 10-year-old male child who presented in outpatient department with a complaint of floater in his right eye which was changing its position with movement of eye but did not increase in size since the past 1 year. Visual acuity was 20/20 in both eyes. On slit-lamp examination, right eye showed a solitary pigmented unilateral freely floating cyst in the vitreous and left eye was normal. The indirect hemagglutination tests of the patient for Echinococcus and cysticercosis were negative. Eosinophilia was not detected in the peripheral blood smear. Based on these findings, the patient was diagnosed as a primary vitreous cyst. The patient had few symptoms, so it was decided to follow the patient without any treatment.

A 41-year-old male with a history of head injury 16 years previously but no visual deficit, presented with reading difficulty. Examination showed disc pallor bilaterally, and perimetry showed the left homonymous hemianopsia. Optical coherence tomography showed a reduction of retinal nerve fiber layer temporally in the right eye and nasally in the left eye correlating with the field defect. Magnetic resonance imaging brain showed atrophy of the right half of chiasma and right optic tract, indicating retrograde degeneration of the right visual pathway.