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Cogan's syndrome (CS) is a rare inflammatory disease characterized by interstitial keratitis or uveitis, vestibular impairment, and progressive hearing loss, commonly bilateral. Although glucocorticoids are fundamental treatment options, in most cases, hearing loss gradually worsens. Herein we report 2 pediatric cases of CS who were treated with corticosteroids and methotrexate. One patient had a cochlear implant, and the hearing of the other patient improved with treatment. Also, a systematic literature review was conducted for articles including pediatric CS patients. In the literature, 34 articles describing 44 pediatric patients with CS were identified. Sudden hearing loss (95.3%) and ocular symptoms (92.5%) were the most common manifestations in these patients. Also, aortic involvement was present in 19.5% of patients in the literature. Otorhinolaryngologists, ophthalmologists, and pediatricians should collaborate to diagnose and manage CS to prevent progressive hearing loss and eye involvement. [ABSTRACT FROM AUTHOR]

Purpose To ascertain the anatomic factors that help achieve non-surgical sealing in full thickness macular hole (FTMH). Methods Retrospective collaborative study of FTMH that closed without surgical intervention. Results A total of 78 patients (mean age 57.9 years) included 18 patients with blunt ocular trauma, 18 patients that received topical or intravitreal therapies and 42 patients with idiopathic FTMH. Mean±SD of the initial corrected visual acuity (VA) in logMAR improved from 0.65±0.54 to 0.34±0.45 (p<0.001) at a mean follow-up of 33.8±37.1 months. FTMH reopened in seven eyes (9.0%) after a mean of 8.6 months. Vitreomacular traction was noted in 12 eyes (15.8%), perifoveal posterior vitreous detachment in 42 (53.8%), foveal epiretinal membrane in 10 (12.8%), cystoid macular oedema (CME) in 49 (62.8%) and subretinal fluid (SRF) in 20 (25.6%). By multivariate analysis, initial VA correlated to the height (p<0.001) and narrowest diameter of the hole (p<0.001) while final VA correlated to the basal diameter (p<0.001). Time for closure of FTMH (median 2.8 months) correlated to the narrowest diameter (p<0.001) and the presence of SRF (p=0.001). Mean time for closure (in months) was 1.6 for eyes with trauma, 4.3 for eyes without trauma but with therapy for CME, 4.4 for eyes without trauma and without therapy in less than 200 µm in size and 24.7 for more than 200 µm. Conclusion Our data suggest an observation period in new onset FTMH for non-surgical closure, in the setting of trauma, treatment of CME and size <200 µm. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Predominantly hemorrhage represents one of the possible manifestations of choroidal neovascularisation (CNV) in eyes with age-related macular degeneration (AMD). The purpose of this study is to evaluate the effecte of ranibizumab treatment in patients with predominantly hemorrhagic CNV secondary to AMD. METHODS: Twenty-five patients with predominantly hemorrhagic choroidal neovascularization due to AMD with at least three ranibizumab injections and followed up for at least 12 months were included in the study. The months of follow-up were recorded (baseline, 3rd, 6th, and 12th months). The change in central macular thickness (CMT) on optical coherence tomography, visual acuity (VA) in ETDRS letters, and lesion size on fundus fluorescein angiography were evaluated. RESULTS: The mean age of the patients was 68.1±5.7 (range: 63-82) years, the mean follow-up was 19.9±14.5 (range: 12-67) months, and the mean number of injections was 4.0±1.4 (range: 3-15). The initial VA was 39.3±17.9 (range: 1-65) letters, CMT was 272.7±104 (range: 164-587) µm, and the initial lesion width was 11.4±10.5 (range: 1.3-45.7) mm2. The VA was 41.4±20.1 (range: 5-75) and 36.9±21.8 (range: 4-80) letters (p=0.150), CMT was 270.7±110 (range: 159-570) and 230.4±108 (range: 109-667) µm (p=0.009) and the lesion width was 10.9±11.5 (range: 1.1-39.7) and 10.4±11.6 (range: 1.2-44.3) mm2 at 6th and 12th month, respectively. No factor was found to be associated with final CMT. CONCLUSION: Although the final visual outcome is limited by the progression of the disease, hemorrhagic lesions treated with ranibizumab have stable anatomical outcome. [ABSTRACT FROM AUTHOR]

Purpose: To develop an algorithm for the diagnosis of Behçet's disease (BD) uveitis based on ocular findings. Methods: Following an initial survey among uveitis experts, we collected multi-center retrospective data on 211 patients with BD uveitis and 207 patients with other uveitides, and identified ocular findings with a high diagnostic odds ratio (DOR). Subsequently, we collected multi-center prospective data on 127 patients with BD uveitis and 322 controls and developed a diagnostic algorithm using Classification and Regression Tree (CART) analysis and expert opinion. Results: We identified 10 items with DOR >5. The items that provided the highest accuracy in CART analysis included superficial retinal infiltrate, signs of occlusive retinal vasculitis, and diffuse retinal capillary leakage as well as the absence of granulomatous anterior uveitis or choroiditis in patients with vitritis. Conclusion: This study provides a diagnostic tree for BD uveitis that needs to be validated in future studies. [ABSTRACT FROM AUTHOR]

Aim: It is to review the clinical features, and surgical, and visual outcomes of rhegmatogenous retinal detachment in a pediatric population. Material and Methods: Medical records of 31 children aged 16 years old or younger with rhegmatogenous retinal detachment were retrospectively analyzed. Cases of acute retinopathy of prematurity were excluded. The data for etiologies, risk factors, prior intraocular surgery, therapeutic approach options, anatomic and functional results were evaluated. Results: Thirty-three eyes of 31 patients with RRD were evaluated. The mean patient age was 11.42±3.82 years (range 3-16). There were 26 (83.9%) males and 5 (16.1%) females. The most common etiology was trauma. At presentation 57.5% of affected eyes (19/33) had a visual acuity worse than 20/400. Preoperative retinal tear was found in 60.6% (20/33) of patients. At initial examination, proliferative vitreoretinopathy was detected in 36.3% (12/33) of patients. The most common primary operation was scleral buckle with subretinal fluid drainage (69.6%, 23/33). Anatomical reattachment was accomplished in 84.8% of cases (28/33). At the final visit, 78.78% of affected eyes (26/33) had a better visual acuity when compared to preoperative examination. In nine of affected eyes (27.27%), visual acuity was 20/200 or better. Mean follow-up time was 37.5 months (range 3-72). Conclusion: In our series, pediatric RRD occurred most commonly in association with trauma. Most eyes were anatomically reattached, and most eyes retained vision of 20/800 or better. Preserving vision in children with RRD is of great importance because of high risk of vision threatening events to the fellow eye. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the anatomical and visual results of intravitreal dexamethasone implant treatment for macular edema secondary to retinal vein occlusion. Materials and Methods: The study included a total of 25 patients undergoing dexamethasone implant for macular edema secondary to retinal vein occlusion. Retrospective evaluation included best corrected visual acuity (BCVA) measured with ETDRS charts and macular thickness using optical coherence tomography (OCT) at each visit. The contrast sensitivity levels of patients were evaluated with Pelli-Robson chart. Results: The mean age of the patients was 59.5±13.3 years (range, 34-84years). The mean follow-up time was14.6 ± 5.5 months (range, 6-27 months) and the mean number of implants was 2.6±1.5 (range,1-6). The increase in the visual acuity according to time was statistically significant (p<0.005). The decrease in macular edema was statistically significant (p<0.005). The initial mean contrast sensitivity before implant was 0.72±0.50 log, and the final mean contrast sensitivity was 1.08±0.46 log (p<0.005). No systemic adverse events were observed in any of the cases. When the ocular adverse effects were assessed, cataract progression was seen in 54.5% and cataract operations were performed on 4 patients (18.1%). The increase in intraocular pressure was statistically significant (p<0.005) and only one patient needed medical treatment. Conclusion: Dexamethasone implant had a positive effect on anatomic and visual results in retinal vein occlusion-associated macular edema but the ideal repeat interval for intravitreal dexamethasone treatment should be shorter than 6 months. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and efficacy of gevokizumab for the treatment of Behçet's disease uveitis in a prospective, open-label, randomized phase 2 trial.Methods: Behçet's disease patients with new acute ocular exacerbation or at risk of exacerbation received 30 or 60 mg gevokizumab every 4 weeks intravenously or subcutaneously, on top of a stable regimen of immunosuppressives and corticosteroids (≤20 mg/day equivalent prednisolone). Patients withdrew in cases of ocular exacerbation.Results: A total of 21 patients were included (17 acute and 4 at-risk; mean duration of uveitis 45.6 ± 37.4 months). There were no serious adverse events related to gevokizumab. Recorded adverse events were mostly associated with exacerbation of uveitis or its complications. Response was evaluated for 14 acute patients and all showed rapid control of acute ocular exacerbation, mostly within 1 week, without any increase in corticosteroid dosage.Conclusions: Gevokizumab was well tolerated and rapidly controlled acute ocular exacerbations of Behçet's disease uveitis without the need for high-dose corticosteroid. [ABSTRACT FROM AUTHOR]

Purpose: To investigate best corrected visual acuity (BCVA), subretinal fluid (SRF) absorption time or ellipsoid zone (EZ) restoration time and various variables in patients with persistent SRF after successful primary repair of rhegmatogenous retinal detachment (RRD)., Methods: This retrospective multicenter study allowed independent analysis of the healing pattern by two observers based on composite of serial cross-sectional macular optical coherence tomography (OCT) scans. Univariate and multivariate analyses were implemented., Results: One hundred and three cases had persistent SRF after pars plana vitrectomy, scleral buckling, or pneumatic retinopexy. By univariate analysis, SRF resolution time correlated positively with the number of retinal breaks ( p  < 0.001) and with increased myopia ( p  = 0.011). Using multivariate analysis, final BCVA (log MAR) correlated positively with age, duration of RRD, initial BCVA (OR = 3.28; [95%CI = 1.44-7.47]; p  = 0.015), and SRF resolution time (OR = 0.46 [95%CI 0.21-1.05]; p  = 0.049). EZ restoration time was longer with increasing number of retinal tears (OR = 0.67; [95%CI 0.29-1.52]; p  = 0.030), worse final BCVA, and presence of macula-off RRD (OR = 0.26; [95%CI 0.08-0.88]; p  = 0.056). SRF resolution time correlated marginally with prone position., Conclusions: Residual posterior SRF is more common in eyes with multiple breaks or in myopic eyes. Final BCVA is better in younger subjects and in eyes with shorter duration of RRD. Persistent SRF is a self-limited disorder with a mean resolution of 11.2 months with good visual prognosis improving from a mean baseline logMAR of 1.08 to 0.25 at one year., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Sarcoidosis, a multisystem disorder of unknown etiology that involves multiple organs, is rare in children. The true incidence and prevalence of childhood sarcoidosis is unknown. As in adults, many children with sarcoidosis may be asymptomatic; the disease may remain undiagnosed. A complete and systematic evaluation of the patient is essential for the sarcoidosis diagnosis in children. Here, we describe a case of 12-year-old female who presented with 2 years history of uveitis and hepatosplenomegaly. A chest computerized tomography revealed scattered peripheral pulmonary nodules and bilateral hiliar lymphadenopathy. Bone marrow aspiration and liver biopsy were not diagnostic. A lung biopsy showed non-necrotizing epithelioid cell granulomas. She was diagnosed with sarcoidosis according to demonstration of granulomatous inflammation and the exclusion of confusable entities