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Objective To report cases of acute serous macular detachment and edema after uncomplicated phacoemulsification. Design Retrospective case series. Participants We reviewed the clinical data of 5 patients who developed an acute serous macular detachment and edema after uncomplicated phacoemulsification with intraocular lens implantation by the same expert surgeon and without any complication during surgery. Methods Best corrected visual acuity (BCVA), biomicroscopy, fundus examination, and optical coherence tomography were performed at 1, 3, 7, and 30 postoperative days. Results On the first postoperative day, all eyes had low visual acuity (median 1.0 logMAR) despite normal postoperative appearance of the anterior segment. Optical coherence tomography showed serous macular detachment with intraretinal fluid accumulation. After treatment with oral indomethacin and acetazolamide, at 7 days, intraretinal and subretinal fluid were fully reabsorbed and BCVA improved (at least 0.1 logMAR). In the following 6 months, no eye had recurrence of macular edema. Conclusions Acute serous macular detachment and edema can occur after uncomplicated phacoemulsification. It should be considered in cases of low visual acuity during the early postoperative period.

Purpose: To investigate, with spectral-domain optical coherence tomography, if the preoperative status of the retinal pigment epithelium (RPE) affects the postoperative foveal morphology and visual outcomes in eyes with surgically closed macular holes (MHs). Methods: In 52 eyes with surgically closed MHs, preoperative RPE morphology was evaluated and graded based on the measurement of the largest hyperreflective protrusions above the RPE line. Foveal microstructural features and best-corrected visual acuity (BCVA) were evaluated 12 months after surgery. Results: At 12 months, a significant correlation was found between postoperative degree of integrity of the photoreceptors with preoperative RPE morphology, and base diameter of the hole (p = 0.003 and p = 0.028, respectively); mean BCVA at 12 months in eyes with diffuse RPE alteration was significantly lower than in eyes with small or no RPE alteration (p < 0.05). Conclusions: Preoperative RPE integrity may be indicative of good photoreceptor restoration and visual recovery in patients with surgically closed MHs.

PURPOSE To report the use of bevacizumab in patients with Vogt-Koyanagi-Harada disease and persistent serous retinal detachment during the systemic steroid treatment. METHODS Four patients with bilateral Vogt-Koyanagi-Harada disease with the resolution of ocular inflammation presenting a serous retinal detachment involving the fovea that persisted for at least 1 month, despite systemic corticosteroid treatment, received an intravitreal injection of bevacizumab during the steroid tapering stage. Best-corrected visual acuity, central retinal thickness, and macular sensitivity were evaluated. RESULTS Of 8 eyes, 7 (87%) had complete resolution of subretinal fluid within 1 month following the treatment. After the treatment, the mean best-corrected visual acuity and macular sensitivity improved significantly (P < 0.001, analysis of variance). Compared with baseline, at all measurements, central retinal thickness decreased significantly (P < 0.01, Tukey-Kramer test). At 6 months, a significant correlation was found between best-corrected visual acuity and macular sensitivity in the central 8° (linear regression, r = -0.73; P = 0.03), whereas no correlation was found between central retinal thickness and both best-corrected visual acuity and macular sensitivity. CONCLUSION Intravitreal injection of bevacizumab during the corticosteroid therapy may be a treatment option for patients with decreased visual function because of persistent serous retinal detachment associated with Vogt-Koyanagi-Harada syndrome.

BACKGROUND AND OBJECTIVE: To evaluate the intrasession reproducibility of the peripapillary retinal nerve fiber layer (RNFL) thickness measurements obtained by spectral-domain optical coherence tomography (SD-OCT) in eyes with keratoconus and normal eyes. PATIENTS AND METHODS: Peripapillary RNFL thickness measurements with SD-OCT were repeated three times during the same visit using the eye tracker and retest function in one eye of each participant. Reproducibility was evaluated using within-subject standard deviation (Sw), coefficient of variation (CV), and intraclass correlation coefficient (ICC). RESULTS: For the overall global RNFL thickness, the values of the three parameters were Sw (± 1.96 standard error) 1.43 ± 0.24, CV 1.28%, ICC (95% confidence interval) 0.969 (range: 0.947–0.983) in control eyes and Sw (± 1.96 standard error) from 1.41 ± 0.26 to 1.57 ± 0.34, CV from 1.18% to 1.37%, and ICC (95% confidence interval) from 0.951 (range: 0.909–0.976) to 0.977 (range: 0.938–0.993) in eyes with keratoconus. CONCLUSION: Measurement of peripapillary RNFL thickness by SD-OCT shows a good intrasession reproducibility in eyes with keratoconus.