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Terminology of persistent diabetic macular edema has been initially reserved to cases unresponsive to conventional laser photocoagulation according to ETDRS criteria. While knowledge about pathophysiology of macular edema evolved and new drugs became available, the terminology of persistent diabetic macular edema expanded to include resistance to most current therapies. The purpose of this paper is to review medical and surgical options in the treatment of such difficult cases according to literature data and personal experience.

To assess the anatomical and functional results after intravitreal bevacizumab administration in choroidal neovascularization (CNV) due to angioid streaks; To assess the safety and results stability;Prospective, nonrandomized, interventional case study on choroidal neovascularization due to angioid streaks treated with intravitreal bevacizumab (AVASTIN). Intravitreal injection was repeated, if needed, at 4-6 weeks until leakage stopped. In all cases fluorescein angiograms and Spectral 3D OCTs were performed. Visual acuity was measured with ETDRS optotype. Cases were followed-up at least 6 months. Statistical analysis was performed using ANOVA and Wilcoxon tests.8 cases with CNV associated to angioid streaks were evaluated between January 2007 and January 2013. Mean age of patients in the study was 52,36 +/- 4,33 years (ranging 42-64 years). The mean number of intravitreal injections was 4.64 +/- 0,42 (ranging between 3-8 injections). Mean visual acuity improved significantly in all cases after 3 intravitreal injections with a gain of more than 15 letters in 6 out of 8 cases (75%). OCT confirmed reduced depth of lesion and also a reduced lesion volume after treatment. No major local or systemic side-effects were noted. At 6 months follow-up the CNV reoccurred in 5 out of 8 cases (62.5%) requiring additional treatment. 3 out of 8 cases finally lost more than 5 letters due to subretinal fibrosis.These results confirm the efficacy and safety of intravitreal bevacizumab in controlling the CNV due to angioid streaks. High recurrence rate and quick lesion progression to subretinal fibrosis might be responsible for long-term poor functional results in this type of CNVs. More cases are needed for validation.

We present a case report of a 27 years old pacient with central retinal vein occlussion and macular edema. The pacient has a significant reduction of the macular aedema with complete recovery of vision after the treatment.

To asses the anatomical and functional results after intravitreal bevacizumab administration in choroidal neovascularization secondary to pathologic myopia; To asses the safety and results stability;Prospective, interventional case study of 18 eyes with choroidal neovascularization secondary to pathologic myopia treated with 1.25 mg. intravitreal bevacizumab (AVASTIN). Intravitreal injection was repeated, if needed, at 4-6 weeks until leakage stopped. In all cases fluorescein angiograms and Spectral 3D OCTs were performed. Visual acuity was measured with ETDRS optotype. Cases were followed-up at least 6 months. Statistical analysis was performed using ANOVA and Wilcoxon tests.Mean age of patients in the study was 43.86%--6.32 years (ranging 24-62 years). The mean number of intravitreal injections was 2.62%--0.53 (ranging between 1 - 4 injections). Mean visual acuity improved in all cases. An increase of more than 15 letters was noted in 44.44.% of the cases. OCT confirmed a reduced depth of lesion and also a reduced lesion volume after treatment. No major local or systemic side-effects were noted. At 6 months follow-up the choroidal neovascularization reappeared in 5 cases (27.77%) requiring additional treatment.These results confirm the efficacy and safety of intravitreal bevacizumab in controlling the choroidal neovascularization secondary to pathologic myopia. More than 40% of the cases regained at least 3 lines in ETDRS chart but a recurrence was noted in 27.77% of the cases at 6 months.

We present the case of a 48 year old man who was admitted for the decreased visual acuity of the left eye for about 20 years, when a left sided facial trauma had occured. Clinical examination and lab exams revealed the cause of this change: ocular contusive posttraumatic status for about 20 years (anamnestic), iridodialysis, corectopie, traumatic cataract, PVR, tractional retinal detachment. Surgical treatment was warranted. We performed cataract extraction, posterior vitrectomy with laser fotocoagulation and injection of silicon oil 1000. We followed the pacient's post-operative evolution and we extracted of the silicone oil six months later. The evolution was favorable.

Neovascular glaucoma management is divided into preventive and curative procedures.Pre vention therapy consists of the treatment of the common underlying causes of the disease (ie diabetic retinopathy, ischemic central retinal vein occlusion and ocular ischemic syndrome) as well as the less frequent causes attributed to ocular radiation, ocular tumors, uveitis and other miscellaneous condi tions.Curative therapy includes both the neovascularization treatment and the treatment of the in creased intraocular pressure.lntravitreal Bevacizumab injection enables us to block up the neovascular trigger preparing thereby the pacient to a complement of panretinal photocoagulation or surgical treatment. Since Bevacizumab injection activity is transient, the retinal ischemia treatment by panretinal photocoagulation is mandeited in order to avoid neovascular recurrence.Short term efficacy of Bevacizumab injection is obvious with a constant, marked and swift intraocular pressure lowering espe cially in less severe and/or early forms of the disorder. In more advanced stages of neovascular glaucoma after closing the chamber angle by peripheric anterior synechiae the outcomes of this treatment are inconstant, most of cases necessitating the resorting to surgery (trabeculectomy with antifi brosis drugs or glaucoma drainage implants).

Behçet's Disease is a chronic, systemic, relapsing disease, an occlusive vasculitis which is immune complex mediated. Ocular involvement is usually bilateral, often asymmetric, associated with the loss of visual functions. This case presentation is a way to reveal an uncommon debut and evolution of the pathology using diagnostic criteria for Behçet's Disease.

The aim of antiangiogenic agents in the treatment of age related senile macular degeneration is to destroy coroidian neoformation vessels by minimally affecting the central vision. We present a case of important central vision recovery after 3 intravitreal injections of Avastin. The therapeutic decision and patient monitoring have been made using imaging studies, such as OCT and AFG. A modern therapeutic approach of neovascular forms of age related macular degeneration, backed up by AFG and OCT is a modern treatment method of this disabling illness which brings patients optimal functional and structural improvement.

To assess the efficacy and safety of intravitreal triamcinolone acetonide in diabetic macular oedema.prospective study; 76 patients, 102 eyes; preoperative assessment: visual acuity, intraocular pressure, fundus biomicroscopy fluoresceine angiography, sometimes OCT; postoperative assessment: visual acuity, intraocular pressure, fundus biomicroscopy, fluoresceine angiography, sometimes OCT.Visual acuity improvement in 42% cases; subjective improvement of visual acuity in 72% of casesTriamcinolon acetonide may play a role in treatment of diabetic macular oedema.

This report presents the results of a study on 34 patients with neovascular glaucoma. We analyse the difficulties and the results of the management of this severe form of glaucoma.

Macular edema is the first cause of visual impairment in diabetic patient. This paper is a retrospective evaluation of a group of patients with diabetic retinopathy and macular edema, treated with intravitreal Avastin (Bevacizumab) injection. The patients have been monitored mainly by assessing the evolution of visual acuity and macular thickness (OCT), after treatment, and the results have been compared with preexisting literature data.

Angiogenesis, fundamental process that consists in the formation of new vessels, is essential physiologically in the tissue maintenance and of the homeostasis, having in this sense a few positive and negative regulators. Vascular endothelial growth factor and other angiogenical proteins play a major role in the ocular and general angiogenesis. The solid tumors need new vessels in order to survive and grow, therefore the anti-angiogenic agents can represent important instruments in the ocular oncological therapy The intravitreal administration of the anti-VEGF agents delay the growth of the intraocular tumors, decreases the odds of their methastasis at distance, increases the therapeutical effects of the conservative treatment by irradiation and can limit the ocular complications of radiotherapy.

The purpose of our study is to analyze the outcome of traumatic endophthalmitis, as revealed by our own experience.We conducted a clinical retrospective study including all the consecutive cases with traumatic endophthalmitis that have been hospitalized in the University Ophthalmology Department from Cluj-Napoca (Romania), for a 28 months period of time (September the 1st 2007 - December the 31st 2009).The overall incidence of traumatic endophthalmitis has been 4.76% (5 out of 105 open globe injuries). The presence of an Intra Ocular Foreign Body has been associated with the highest risk of endophthalmitis (8%), followed by the penetrating ocular injuries (6.52%). We performed posterior vitrectomy combined with intravitreal antibiotic and steroid injections in 4 of the 5 traumatic endophthalmities (80%). Injection alone of the above mentioned drugs has been indicated in one early traumatic endophthalmitis (20%), with immediate positive response and the complete recovery of the visual acuity. The technical features of the posterior vitrectomy in the infected eyes are discussed, in comparison with the other clinical conditions in which it is indicated. Our results prove the achievement of visual acuities better than 20/40 in 80% of the post-traumatic endophthalmitis eyes. The failure in one case is explained mainly by the delayed vitrectomy (48 hours from the debut), but also by the circumstances of trauma (soil contamination, in a rural setting).Immediate action in traumatic endophthalmitis is crucial for the final visual prognosis.