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PURPOSE To study the evolution of idiopathic epiretinal membrane (IERM) as examined by optical coherence tomography (OCT) in the 1-mm-diameter circle centered on the fovea. METHODS In a case series study 71 subjects (71 eyes) with idiopathic epiretinal membrane and macular thickness greater than 220-/+10 micro m were evaluated by OCT. The fellow healthy eye of 52 patients was used as the control group. The mean follow-up was 36 months. Measurements of macular thickness at baseline and at the final examination were performed. Best-corrected visual acuity was expressed as the number of letters read on the Early Treatment Diabetic Retinopathy Study chart. RESULTS Within the inner macular central circle of 1 mm diameter the thickness of the fovea increased by an average of 12.29% (p

Although intravitreal ranibizumab represents an established therapeutic approach for exudative age-related macular degeneration (AMD), the possible occurrence of adverse events remains under ongoing research. The purpose of this report is to present an incidence of an extensive submacular hemorrhage after intravitreal ranibizumab administration.Interventional case report.A 72-year-old woman was referred to our retinal department for sudden visual loss in the right eye (RE). She had undergone an intravitreal ranibizumab injection 48 hours prior to her presentation. She had known AMD with a confirmed occult choroidal neovascularization (CNV) for which she had been subjected to a total of 24 intravitreal injections in the RE (with monthly intervals) over the last 2 years. Clinical examination revealed an extensive submacular hemorrhage in the RE.To our knowledge, this is the first report of a submacular hemorrhage soon after ranibizumab administration in a patient with a small occult CNV. Although such a correlation cannot be established, the authors underline the possibility of such an adverse event in patients with small CNVs following a long therapeutic course involving high injection volume.

PURPOSE. To report in a single case the effectiveness of bevacizumab in the treatment of feeder vessels (FVs) of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). METHODS. One patient received intravitreal bevacizumab (Avastin) (1.25 mg) which was repeated 4 weeks after the first intravitreal injection. Fluorescein angiography and optical coherence tomography (OCT) were performed. Visual acuity (VA) was also checked. RESULTS. Occlusion of the FVs was observed 4 weeks after starting treatment. During the follow-up period and in the final examination 13 months after the first injection, the FVs remained occluded. Complete resolution of macular edema and improvement of the VA were noticed after the second bevacizumab intravitreal injection. CONCLUSIONS. This report documents the successful occlusion of FVs of subfoveal neovascularization after two intravitreal bevacizumab injections in a patient who was followed up for 1 year after the occlusion. Further long-term investigation is warranted given the promising 12-month results. (Eur J Ophthalmol 2007; 17: 853-6) K EY WORDS. Age-related macular degeneration, Bevacizumab, Feeder vessel, Fluorescein angiography, Optical coherence tomography, Subfoveal neovascularization

PURPOSE. To report a case of pigment epithelium detachment (PED) which appeared after photodynamic therapy (PDT) and was followed up for 50 months. METHODS. Case report. RESULTS. A 71-year-old woman with occult choroidal neovascular membrane due to age-related macular degeneration (ARMD) developed PED 48 hours after PDT. The patient was studied with fluorescein angiography (FA) and optical coherence tomography (OCT). Fluorescein angiographic evidence of PED remained essentially unchanged during the follow-up period of 50 months. Although OCT initially gave clear evidence of PED, in the last 12 months of follow-up the PED appears to have resolved. CONCLUSIONS. Photodynamic treatment could be involved in the occurrence of PED in occult choroidal neovascular membrane due to ARMD. In this particular case OCT could be considered since it offers useful information in the pretreatment and the post-treatment follow-up period.

Patients with beta-thalassemia may present with an acquired diffuse elastic tissue defect due to degeneration of elastic tissue along with vaso-occlusive findings in the retinal microvasculature. Here we report the case of a patient with granular-like accumulation presenting as black sunburst lesions detected by optical coherence tomography (OCT). A 38-year-old man with beta-thalassemia intermedia associated with angioid streaks complained of deterioration of vision in both eyes. Funduscopic examination revealed small, round, hyperpigmented lesions bilaterally. During the early and late phases of fluorescein angiography, granular hyperfluoresence was present, associated with pigment decompensation and mottled-like hypofluorescence. The main OCT finding was the presence of granuloid-like accumulations at the retinal pigment epithelium level. Granule penetration was also noticed at the photoreceptor layer, while isolated granuloid-like accumulations were found in the inner layers of the macula and choroid. In this case, the new OCT finding was the granular-like hyperpigmented accumulations in the macula located at the level of the retinal pigment epithelium. To the best of our knowledge, our OCT findings show for the first time granuloid-like accumulations representing black sunburst lesions.