Introduction: Idiopatic Macular Telangiectasia (IMT) are a rare group of various entities presenting with incompetence, ectasia and/or irregular dilations of the juxtafoveolar capillaries of one or both eyes. Case Report: A 62 year old female with Glaucoma was sent to the Retina Department with a suspected diagnosis of retinal vein occlusion on the left eye (LE). Her best corrected visual acuity (BCVA) was 20/20 in the right eye (RE) and 20/25 in the LE. Slit lamp examination was normal; fundoscopy showed a cup-to-disc relation of 0.6 in the RE with normal macula and a cup-todisc relation of 0.7 in the LE with multiple perifoveal microaneurysms, inferior temporal hard exudates and edema comproved with macular optical coherence tomography; fluorescein angiography revealed an area of hyperfluorescence with juxtafoveolar telangiectatic vessels located inferiorly and temporally to the fovea, with progressive filling and late active leakage in the LE. The diagnosis of IMT type 1 was made and she was treated with a loading dose of intravitreal injections of ranibizumab followed by a fourth injection because of persistent macular edema. One month after, her BCVA was 20/20 in the LE with improvement of macular edema and macular árgon laser photocoagulation was performed. Three months after the laser treatment her LE BCVA was 20/20 with fundoscopy showing small macular hemorrhages and microaneurysms. Conclusion: Macular edema and exudation are the main cause of visual loss in these patients. This case suggests that ranibizumab and laser photocoagulation can be effective in the treatment of type 1 IMT.

Adenoid cystic carcinoma (ACC) of the lacrimal gland is a rare, life-threatening tumor often not diagnosed until advanced stages. This malignancy usually presents with nonspecific symptoms such as periocular pain and non-axial proptosis. We present a case of a 40-year-old female experiencing these symptoms, whose initial lacrimal gland biopsy was consistent with chronic dacryoadenitis. Reappearance and worsening of her symptoms after treatment led to a total dacryoadenectomy, which confirmed the presence of ACC. Close follow up of the clinical signs and imaging in this patient allowed us to suspect and finally diagnose an invasive malignancy that was masquerading as a chronic dacryoadenitis.

Castleman's disease is a rare lymphoproliferative disorder, comprising hyaline vascular elements, and plasma cells, which can be present in unicentric or multicentric forms. This disease rarely involves the orbit/eye globe. We report the case of a 55-year old patient who was found to have a focal lesion in the orbit. Histopathology studies revealed features consistent with Castleman's disease. The patient was treated with surgical resection and radiotherapy and was free of disease recurrence at 16-months follow up.

Purpose: To evaluate if high-resolution adaptive optics confocal scanning laser ophthalmoscopy (AO-SLO) can be used as an adjunct complementary diagnostic tool to spectral domain optical coherent tomography (SD-OCT) in characterizing three macular diseases: cone-rod dystrophy, acute retinal pigment epitheliitis (Krill's disease), and occult macular dystrophy. Methods: As part of a complete clinical examination, each patient was subjected to color fundus pictures, multimodal imaging scans with Heidelberg SpectralisTM and high-resolution retinal images with a custom built adaptive optics scanning laser ophthalmolscope (AO-SLO). The registered AO-SLO images were averaged to improve the signal to noise ratio and used to generate larger photoreceptor mosaics. Results: AO-SLO mosaics for all three conditions showed distinct, characteristic disruptions of the photoreceptors in areas that corresponded to the abnormalities observed on fundus photography and SD-OCT scans. Conclusions: AO-SLO defined fine structural changes associated with retinal pathology at the photoreceptor level that could not be achieved using standard diagnostic methods. A combination of adaptive optics scanning laser ophthalmoscopy (AO-SLO) and SD-OCT provided views of the retina with enhanced lateral and axial resolution. High-resolution, ultra-structural details of the retina may provide additional insights into the disease etiology, progression and management of patients with vision threatening macular diseases.

Purpose: To review standard management of blind painful and non-painful eyes at risk for neovascular glaucoma, and report the management strategies of four cases. Method: Case series and literature review. Patients: The first two cases described are blind, painful eyes secondary to neovascular glaucoma, treated with intracameral bevacizumab injections. The third case, a blind, painful eye with uncontrolled glaucoma in a patient unsatisfied with her eye appearance due to white retained lens material at pupillary margin and a large prominent bleb, was treated with a combination of bleb revision, vitrectomy, lensectomy and endocyclophotocoagulation. The fourth case, a blind, non-painful eye with secondary radiation retinopathy at risk for neovascular glaucoma was treated with laser photocoagulation to prevent neovascular glaucoma and pain. Results: The first two cases of blind, painful eyes with neovascular glaucoma had reduction in neovascularization and pain after intracameral bevacizumab injections and/or laser therapy. The third case had resolution of pain and transient decrease in intraocular pressure after a combined surgery. The blind, non-painful eye in case 4 with a history of radiation retinopathy had stable intrao pressure and no progression to neovascular glaucoma or pain. None of the four cases progressed to enucleation or evisceration. Discussion: Retinal interventional management should be considered in blind painful and non-painful eyes to help control symptoms, treat or prevent progression to neovascular glaucoma and prevention of enucleation or evisceration.

Acknowledgements: This report was made possible with the support of Bayer Healthcare. To guarantee the independence of the report and the working group's conclusions, the content of this report was developed exclusively by the authors, without any influence from Bayer HealthCare, The herein opinions do not reflect Bayer HealthCare's position or opinion. The working group did not receive any honoraria to participate in the development of this report.

Purpose: To present the current state-of-the-art information regarding the properties, indications, surgical techniques, and toxic effects of current and past applications of vital dyes in chromovitrectomy. Design: Critical analysis and surgical perspective of the literature, recent studies and personal contributions. Methods: Review, interpretation, and comments regarding the most relevant experimental as well as clinical studies including the authors' clinical and laboratory research. Results: The evolution of vitreoretinal surgical techniques has been worldwide reported. Chromovitrectomy plays an important hole in these innovations and is very useful to improve the surgical results. There is a consensus that application of vital dyes facilitates the delicate removal of intraocular membranes during vitreoretinal surgery. Controversy still remains around various issues, mainly potential toxicity and safety. The dyes currently used for different steps in chromovitrectomy are: triamcinolone acetonide for vitreous identification; indocyanine green, infracyanine green, and brilliant blue for internal limiting membrane identification and trypan blue for epiretinal membrane identification. The indocyanine green may be toxic for the retinal pigment epithelium if subretinal migration occurs during the surgical procedure. Efforts to avoid subretinal migration of dyes are very important during macular hole surgery. The physiological osmolarity around 270-320mOsm as well as ideal concentrations of the vital dyes during vitreoretinal surgery are important subjects. Conclusions: The state-of-the-art staining-assisted procedures should be performed using concentrations and volumes as low as possible. Triamcinolone acetonide is the ideal dye for vitreous; indocyanine green, infracyanine green and brilliant blue are the ideal dyes for internal limiting membrane; trypan blue is the ideal dye for epiretinal membrane identification.

Primary central nervous system lymphoma is a rare primary brain tumor, accounting for 1% to 3% of all central nervous system malignancies, which may affect the eye in up to a quarter of the cases. Failure to diagnose and treat the ocular component increases morbidity and mortality. Ninety-eight percent of the cases of intraocular lymphomas are non-Hodgkin's B-cell. They may affect both the vitreous and the retina, while secondary invasion from a nodal lymphoma usually affects the uvea. Both forms frequently masquerade as intraocular inflammation. Systemic chemotherapy, alone or in combination with radiotherapy has been used for the treatment of these malignancies. However, when ocular involvement is present, due to the limited penetration through the blood-retina barrier of most of these drugs, adjuvant therapies should be employed. Ocular radiation have been administered in the past, however, due the high rate of recurrences, as well as the commonly seen side effects prompted additional modalities of treatment such intravitreal methotrexate and rituximab. Resumen Los linfomas primarios del sistema nervioso central (SNC) son una causa poco común de tumores cerebrales, constituyendo sólo del 1 al 3% de todas las neoplasias del SNC, pudiendo afectar al ojo en un cuarto de los casos. La falla en el diagnóstico y el tratamiento del componente ocular incrementa la morbilidad y mortalidad de estos pacientes. En el 98% de los casos de linfoma intraocular se trata de un linfoma no Hodgkin de células B. Pueden afectar tanto el vítreo como la retina, mientras que una invasión secundaria a partir de un linfoma nodal puede afectar la úvea. Ambas formas pueden enmascararse como una inflamación intraocular. Quimioterapia sistémica, solo o en combinación con radioterapia ha sido el tratamiento de elección. Sin embargo, si existe un componente ocular, debido a la limitación en la penetración de estos medicamentos a través de la barrera hemato-retiniana, terapia co-adyuvante debe ser considerada. La radiación de los tejidos oculares ha sido empleada en el pasado, no obstante, debido a la alta tasa de recurrencias y a los frecuentes efectos secundarios se han estudiado otras opciones de tratamiento como la inyección intravítrea de metrotexate y rituximab. Palabras clave: Malignidad ocular, linfoma ocular, linfoma del sistema nervioso central, sarcoma de células reticulares, linfomas de células B no Hodgkin, síndromes de enmascaramiento, metrotexate, rituximab.