Background and Objective: Optical coherence tomography (OCT) plays a crucial role in guiding the treatment and establishing the prognosis of diabetic macular edema (DME). We aimed to determine which OCT biomarkers respond better to intravitreal triamcinolone acetonide (IVTA) switch after antivascular endothelial growth factor (anti-VEGF) treatment poor response. Materials and Methods: Fifty-eight eyes with DME, submitted to IVTA switch, were included in this retrospective study. OCT biomarkers and best-corrected visual acuity (VA) were assessed, before and after treatment with a mean follow-up of 2.9 months. Results: IVTA switch resulted in improved VA, central foveal thickness (CFT), and macular volume. Intraretinal cysts decreased or disappeared completely (P = 0.007) in 84.2% of the eyes, as well as the hyperreflective foci (P = 0.004) and the subretinal fluid (P = 0.02). Conclusion: We show that IVTA switch is an effective rescue therapy in anti-VEGF therapy refractory DME. OCT plays an important role in selecting the most appropriate treatment, namely between anti-VEGF and steroids.

Roth spots can occur as ophthalmological manifestations of systemic pathologies that compromise the retinal capillary endothelium. A case report of retinopathy due to hemolytic anemia secondary to Epstein–Barr virus is presented. Given the clinical picture, several differential diagnoses were initially considered causing Roth spots that is why a brief review of the literature is carried out to raise awareness of the diverse pathologies that can be associated with the presence of Roth spots to provide timely referrals.

The aim of this article was to report a well-documented case of anterior uveitis as the first manifestation of COVID-19. A 27-year-old male patient sought assistance at our emergency room complaining of bilateral painful conjuntival redness associated with photophobia for 3 weeks. These symptoms were followed by fever and chills, with a positive polymerase chain reaction for COVID-19. While his systemic symptoms improved, the ocular complaints remained. A complete panel for uveitis were performed, with negative results, except for COVID-19. The outbreak of COVID-19 in 2020 has several implications in our society. Previous reports described ocular manifestations of this condition. The ophthalmologists should be aware of the possibility of COVID-19 when facing a patient with red eye.

Takayasu's arteritis (TKA) is a chronic, granulomatous, systemic vasculitis affecting the aorta and its branches. Ocular manifestations in patients with TKA play an important role in determining the visual prognosis. We describe a case of a young female with complaints of painless, progressive loss of vision in both eyes for 6 months who was clinically diagnosed with TKA. Her laboratory and radiological investigations confirmed the diagnosis. She had a bilateral cataract and operated for cataract in the right eye with guarded visual prognosis. This case report highlights the importance of creating awareness among ophthalmologists for early diagnosis and multidisciplinary management in cases of TKA for the prevention of blindness.

The authors report a case of a 68-year-old woman who developed hypotony and a narrow anterior chamber after an Ex-Press shunt implant. After resolution, tube was obstructed by iris hanging to the end of the shunt, which was liberated using Nd:YAG laser. We discuss our results compared with others shown in the literature. Resumen Los autores reportan el caso de un paciente femenino de 68 años que cursó con hipotonía y cámara plana en el postoperatorio de un implante Ex-Press. Tras resolverse el cuadro se observó obstrucción de la luz de entrada del implante por iris, el cuál fue liberado por medio de YAG laser. Reportamos nuestros resultados y discutimos los casos que se abordaron de manera similar en la literatura.

Orbital metastases are a rare manifestation of systemic malignancies, most commonly originating from the breast or lung in adults. Not infrequently there is not any diagnosis of cancer at the time of presentation with orbital metastatic disease. This is a case of a 62-year-old man whose initial presentation of metastatic small cell lung cancer was left upper lid ptosis and hypoglobus.

Introduction Combined hamartoma of the retina and of the retinal pigment epithelium are extremely rare benign tumors distinguished by retinal pigment epithelium (RPE) and glial tissue proliferation, provoking severe peripapillary and retinal distortion. There is no established management for combined hamartoma of the retina and of the retinal pigment epithelium. Case Reports A 46-year-old male and a 35-year-old female, diagnosed as having a combined hamartoma of the retina and retinal pigment epithelium were observed for four years. One of them was treated with pars plana vitrectomy due to large associated epiretinal membrane (ERM), and the other patient declined surgery. Initially, the evolution was satisfactory in the patient who underwent vitreoretinal surgery, with anatomic improvement and visual acuity stabilization. However, four years later, he complained of visual loss, presenting severe macular distortion, and, consequently, decrease in visual acuity. The patient who preferred a conservative management, showed no funduscopic changes during the follow-up. Conclusion Vitreoretinal surgery for combined hamartoma of the retina and retinal pigment epithelium may improve retinal architecture and visual acuity, but in the long-term functional recovery is frequently not possible, leading to a decrease in VA. We can conclude that the evolution of this pathology can be similar in both cases treated with vitreoretinal surgery and in cases without surgery. Therefore, conservative management may be adopted. A larger number of cases are required to be studied to confirm our clinical observations.

Purpose: We report a case of ocular surface squamous neoplasia In a child with xeroderma pigmentosum, treated with excisional biopsy and cryotherapy, in which a map biopsy of noncontiguous conjunctiva was performed to assess the status of the ocular surface. Methods: Case report of patient managed by the Cornea & External Disease service at University of California, Davis Eye Center. Results: Clinical and histopathologic findings of the specimens including p53 staining are described. Conclusion: Scattered ocular surface abnormalities were found in our patient and this may predispose these patients to future recurrences in areas that are not necessarily contiguous with the primary lesion. This finding confirms the need for close follow-up and raises the possibility of adjunctive topical chemotherapy use even for primary lesions in this high-risk patient group.

We present a case of Stevens-Johnson Syndrome in a 8-year-old boy caused by the intake of barbiturates prescribed for seizures without previous neurological history. This muco-cutaneous syndrome produces severe lesions in the conjunctival mucosa causing blindness in some cases. The boy was treated with autologous serum eye drops soon after hospital discharge for toxic epidermal necrolysis. He demonstrated improving corneo-conjunctival epithelization, diminishing neovascularization and avoidance of the formation of new conjunctival synechiae. Here we demonstrate one of the indications of autologous serum eye drops in the alteration of the ocular surface. RESUMEN Presentamos un caso de Síndrome de Stevens-Johnson en un niño de 8 años de edad, causado por la ingesta de barbitúricos prescriptos por crisis convulsivas sin antecedente neurológico previo. Este síndrome muco-cutáneo causa severas lesiones en la mucosa conjuntival, llegando incluso a la ceguera en algunos casos. El niño fue tratado con gotas de suero autólogo en ambos ojos tan pronto fue dado de alta del hospital donde estuvo internado por la epidermolisis necrótica, mejorando la epitelización córneo conjuntival, disminuyendo la neovascularización corneal y evitando la formación de nuevas sinequias conjuntivales. El niño pudo terminar el año escolar. En esta comunicación enfatizamos las indicaciones del suero autólogo en las alteraciones de la superficie ocular.

Purpose: To report a case of spontaneous globe luxation in a 4-year old with unknown cause. Methods: Case Report. Results: The patient underwent globe restitution using topical anesthesia, and no visual complications were associated with the procedure. Post procedure CT scan revealed normal orbital structures and contents. Conclusion: Spontaneous globe luxation is a rare entity, generally associated to thyroid orbitopathy or floppy eyelid syndrome and shallow orbits. Techniques to manage this dramatic event range from bare manual restitution or the same technique aided by paper clip to lateral tarsorrhaphy.