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Purpose: To evaluate the changes of outer retinal tubulations (ORTs) as seen on spectral-domain optical coherence tomography (SD OCT) in eyes with neovascular age-related macular degeneration (AMD) where treatment was switched from intravitreal ranibizumab to intravitreal aflibercept. Methods: This was a prospective study of eyes diagnosed with neovascular AMD and previously treated with >6 intravitreal ranibizumab injections and switched to aflibercept, conducted at a single centre (Department of Ophthalmology at Pitié Salpetriere Hospital, Paris VI University) from January to July 2015. Before and after treatment was switched from ranibizumab to aflibercept, SD-OCT was used to evaluate the presence of ORTs. Additional assessments in this patient group included best-corrected visual acuity (BCVA), fluorescein angiography (FA), indocyanine green angiography (ICGA). Changes in pigment epithelium detachments (PED), presence of intraretinal cysts, and presence of subretinal fluid (SRF) were also noted. Results: Twenty-four eyes of 24 consecutive patients (15 female/nine male, mean age 70 years) diagnosed with neovascular AMD and previously treated with >6 intravitreal ranibizumab injections and switched to aflibercept were included in the analysis. After receiving aflibercept, patients were followed for a mean of 6.1 months. Prior to treatment switch, 97 % of eyes showed ORTs, while after treatment switch to aflibercept, at the end of the study period, 75 % had ORTs ( p = 0.219). Changes in BCVA (LogMAR) were not statistically significant (1.16 ± 0.44 to 1.18 ± 1.06, p = 0.12), however, a significant reduction in central macular thickness (CMT) (from 406 μm ± 112 to 263 μm ± 68, p = 0.001), PED (from 70.8 % to 41.7 % , p = 0.016), presence of intraretinal cysts (from 83.3 % to 33.3 %, p = 0.002) and SRF (from 91.7 % to 25 %, p = 0.001 ) were noted. Conclusion: After switching from ranibizumab treatment to aflibercept, ORTs remained present in 75 % of eyes, and significant reductions in CMT, PED, and SRF, and presence of intraretinal cysts were observed. [ABSTRACT FROM AUTHOR]

Background: Central retinal vein occlusion (CRVO) leads to poor visual outcome in most eyes. Abnormal hemorheology was suspected to play a major role in its pathogenesis. CRVO treatment is still a matter of debate but several studies have pointed out the efficacy of isovolumic hemodilution. The aim of this study was to assess the feasibility and efficacy of hemodilution using automated erythrocytapheresis in recent-onset CRVO. Methods: In this prospective randomized controlled multicenter study, 61 consecutive CRVO patients were enrolled when they met the following criteria: CRVO lasting for 3 weeks or less, visual acuity ranging from 20/200 to 20/32, age between 18 and 85 years, no diabetes, no uncontrolled systemic hypertension, no antiplatelet or anticoagulant therapy, hematocrit higher than 38%, and signed informed consent. Patients were randomly assigned to the hemodilution group ( n = 31) or to the control group ( n = 30). Hemodilution therapy consisted of one session of erythrocytapheresis on outpatient basis, followed by additional session(s) for 6 weeks if needed. Target hematocrit was 35%. Follow-up was 12 months. Results: No statistical differences in age, associated risk factors, or CRVO characteristics were observed at baseline between both groups. Mean visual acuity was equivalent to 20/80 in the hemodilution group and to 20/63 in the control group (non-significant difference). In the treated group, mean number of hemodilution sessions was 3.3 (range, 1 to 6), and no major side-effects occurred. At the 12-month follow-up visit, 64.5% of the hemodilution group had visual acuity of 20/40 or better compared to 40% of the control group ( p = .048). Visual change was a gain of 1.7 ETDRS line in the hemodilution group versus a loss of 2.3 lines in the control group ( p = .007). There was less conversion into an ischemic form in the hemodilution group (11%) than in the control group (50%, p = .004). Mean final retinal thickness was 289 μm in the hemodilution group versus 401 μm in the control group ( p = .068). Conclusions: This multicenter controlled randomized study demonstrated that automated erythrocytapheresis is a safe and effective tool for performing hemodilution and confirmed that hemodilution therapy can improve the final prognosis of CRVO when applied in the early phase of the disease. [ABSTRACT FROM AUTHOR]

Successful therapy based on the use of interferon-α has been reported in different types of severe chronic uveitis. The immunomodulatory effects of this drug, combined with its antiviral properties seem to contribute to its efficacy in the treatment of different forms of severe and refractory uveitis such as Vogt-Koyanagi-Harada disease, Behçet-associated uveitis, or even human herpes virus 8 (HHV-8) associated uveitis. At the same time, severe ocular complications have been reported in patients treated with interferon-α for chronic viral hepatitis C. Among these complications, six cases of Vogt–Koyanagi–Harada-like disease have been described. We report a small case series of two patients with refractory Vogt–Koyanagi–Harada disease, treated with interferon-α and discuss the potential benefits or detrimental role of interferon therapy in these patients. [ABSTRACT FROM AUTHOR]

Objective To report features of retinal fluorescein (FA) and indocyanine green (ICGA) angiography and optical coherence tomography (OCT) at successive stages of Vogt-Koyanagi-Harada (VKH) disease. Methods FA and ICGA were systematically performed in cases of VKH disease, at admission, 1 month later, and at the end of the follow-up. In addition, the most recent patients underwent OCT. In the follow-up, the clinical evolution and extent of treatment were related to the angiographic and tomographic features. Results FA and ICGA showed a diffuse delayed choroidal perfusion, including a delayed arterial, choriocapillar, and venous filling. This delayed choroidal perfusion involved the posterior pole and the hole periphery. The classically described serous retinal detachments were slowly filled from numerous pin points that could correspond to leakage through areas of damaged retinal pigment epithelium due to the choroidal ischemia. An uneven background choroidal fluorescence visible at the mid phase of ICGA was the result of multiple hypofluorescent round lesions in the choroidal stroma. Choroidal folds appeared hypofluorescent in FA and hyperfluorescent in ICGA. Some of these angiographic findings were present at the very early neurologic stage of the disease. Moreover, under treatment, a persisting altered choroidal perfusion could increase the incidence of retinal detachment relapses. Discussion Various pathological conditions are characterized by choroidal involvement and serous retinal detachment. Angiographical findings may be helpful in the diagnosis. Conclusion FA coupled with ICGA can be an useful tool in the early diagnosis of VKH disease as well as during the tapering of immunosuppressive drugs. [ABSTRACT FROM AUTHOR]

Describes the features of subclinical alveolar lymphocytosis in patients with chronic uveitis. CD4/CD8 lymphocyte ratio; Determination of total cell count in patients; Likelihood of patients with alveolar lymphocytosis to carry the HLA-B51 allele.