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A 61-year-old woman is referred for bilateral diabetic macular edema. Her visual acuity is 20/70 in the right eye and 20/50 in the left eye. She presents a macular edema on both eyes. Her diabetes and her blood pressure are well controlled. We note that the decrease in visual acuity occured when the patient began taking rosiglitazone (Avandia) 4 mg per day. Three months after replacing rosiglitazone by gliclazide (Diamicron), the visual acuity of the patient improves to 20/40 in the right eye and 20/30 in the left eye.

To evaluate the safety and efficacy of photodynamic therapy in the management of symptomatic circumscribed choroidal hemangiomas (CCH) with exudative activity.This prospective nonrandomized study included eight patients referred to us for management of CCH with exudative activity. PDT was applied by diode laser (689 nm) with a light dose of 100 J/cm2 and using verteporfin (6 mg/m2) IV bolus injection. The treatment spot diameter accurately corresponded to the tumor basal diameter (TBD).The mean tumor thickness before PDT was 3.3 mm (range, 2.7-7.5 mm) and the mean largest TBD was 6.1 mm (range, 5-12 mm). All patients were managed with a single PDT application. After a mean follow-up of 24.2 months (range, 17-29 months), all CCH (100%) showed regression of tumor thickness and complete resorption of the serous retinal fluid; 87.5% of the patients showed a flat tumor scar. All CCH showed overlying PDT-related retinal pigmented epithelium atrophic changes. No case of retinal vascular occlusion or recurrent leakage was documented. Five patients (62.5%) showed visual improvement, one (12.5%) retained stable vision and two (25%) developed worse vision due to chronic exudation-related RPE changes in one patient and preretinal fibrosis in another.PDT using verteporfin offers a safe and effective therapeutic option to manage CCH. Complete resorption of subretinal fluid is usually associated with visual improvement.

The authors report a case of unilateral chronic epiphora resistant to prolonged topical antibiotic treatment in a 62-year-old woman. Culture yielded some colonies of Actinomyces species. A dacryocystorhinostomy was found to be ineffective. Canaliculotomy with removal of cast resolved the chronic canaliculitis. Histological examination confirmed the diagnosis of solid cast of Actinomyces.

To report the clinical and optical coherence tomography features of spherical deposits associated with recurrent toxoplasmic chorioretinitis.Case report.Atypical, 100 microm to 150 microm, greyish deposits appeared along retinal arteries and veins as well as on the vitreoretinal interface in the macula of a 44-year-old Caucasian woman while she was being treated for recurrent toxoplasmic chorioretinitis with antiparasitic drugs and subconjunctival injection of betamethasone. They disappeared progressively with the systemic use of corticosteroids. Their clinical course was nicely documented by optical coherence tomography.Greyish spherical deposits on the vitreoretinal interface have been previously described as inflammatory reactions in asymptomatic human T-lymphotropic virus type I (HTLV-1) carriers and in patients with HTLV-1-associated uveitis. For the first time, optical coherence tomography (OCT) provided clinical correlation of this unusual presentation of toxoplasmic chorioretinitis.

Retrospective study of 17 patients (30 eyes) with diffuse retinal epitheliopathy followed for at least 5 years. The study is based on clinical data, ophthalmoscopic findings and fluorescein angiograms. The patients (16 men and 1 woman) are all caucasian with a mean age of 43 years. The disease is bilateral in 13 patients. We report an association with systemic corticosteroid treatment after kidney transplantation in 10 cases. Nine patients have arterial hypertension. Two patients are diabetic and 2 present high level of psychological stress. After a mean follow-up of 12 years, a loss of vision of at least 3 lines is noted in 17 eyes. The decrease in vision is related to an enlargement of the pigment epithelium atrophy to the fovea (15 eyes) or with permanent retrofoveolar serous detachment (2 eyes).