Objective: To compare the results of silicone oil removal (SOR) 2 months after vitrectomy for retinal detachment with delayed removal for 6 months or more. Study: Prospective and retrospective study. Patients and Methods: A total of 32 patients (32 eyes) in the prospective series of early SOR and 19 patients (22 eyes) in the retrospective series of late removal. The two groups were compared as to the condition of the eye at the time of SOR and 6 months following SOR. Results: Patient compliance with the scheduled time for SOR was more in the early removal series. The outcome was comparable in the two groups as to the risk of retinal re-detachment, while cataract, increased intraocular pressure, oil emulsification, keratopathy, and anterior segment inflammation were more frequently encountered at the time of removal in the late removal series, particularly when it was delayed beyond 6 months. Conclusion: A protocol of early removal of silicone oil after 2 months did not increase the risk of re-detachment, and ensured a better compliance of the time of removal. It can be particularly recommended when patients are less likely to comply with a protocol for delayed removal.

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Aims: Our aim is to evaluate the use of BIOM-3 (Oculus, Germany) and 27-gauge Eckardt twin-light chandelier endoillumination (DORC, Netherland) as an alternative to indirect ophthalmoscope. Settings and Design: A prospective, interventional case series study was conducted in T.E.H. (Private Practice), Assiut, Egypt. Subjects and Methods: Twenty patients (Twenty eyes) complaining of primary rhegmatogenous retinal detachment (RRD) with proliferative vitreoretinopathy ≤ Grade B from January 2013 to April 2014. All patients underwent 27-gauge twin-light chandelier endoillumination for retinal break localization. Break localization was followed by cryopexy (Cryomatic Cryo Console, Keeler Ltd., UK) and standard scleral buckling under surgical microscope. Anatomical and functional outcomes were evaluated at the end of 6 months. Results: Anatomical success (attachment of retina) was achieved in 18 (90%) of twenty eyes. All these eyes remained attached at the end of 6 months. Significant improvement in mean best-corrected visual acuity was achieved at the end of 6 months follow-up 0.05 ± 0.46 preoperatively compared with 0.5 ± 0.14 postoperatively (P = 0.023). Conclusion: Twin-light-assisted scleral buckling for primary RRD is a better alternative to classic surgery with indirect ophthalmoscope.

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Background: Insulin has been shown to directly influence retinal blood flow, vascular tone, and angiogenesis, all of which are active aspects of the pathogenesis of diabetic retinopathy (DR). Intensive administration of insulin can increase vascular endothelial growth factor, potentially leading to transient worsening of retinopathy. Aims: The aim of the study is to access the role of serum insulin levels in various stages of DR in type 2 diabetes mellitus (DM). Settings and Design: This was a tertiary care center-based, cross-sectional, case-control, observational study conducted from April 2014 to March 2015. Materials and Methods: A total of 79 patients were divided into groups - controls (No DM), No DR, nonproliferative DR (NPDR), and proliferative DR (PDR). Serum insulin level was compared with severity of DR. Statistical Analysis: Data were summarized and presented as mean ΁ standard error. The variables of the study groups were compared by analysis of variance. For pairwise comparison between the groups, Tukey's test for multiple comparison was used. Results: No significant difference was found between insulin levels in No DM and No DR groups. On the other hand, the difference was statistically significant on comparison between No DM and NPDR (P < 0.001) and also between No DM and PDR (P < 0.05). However, no such difference in insulin level was observed on comparing NPDR and PDR groups. Conclusion: Serum insulin level has an association with the development of retinopathy patients of noninsulin-dependent DM. However, prospective interventional studies are required to establish such role of serum insulin in DR.

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A 25-year-old male presented with blurring of vision of left eye. He was subjected to penetrating injury to right eye 15 years ago. Right eye showed phthisis bulbi. Fine keratic precipitates, mild anterior chamber cells, mild vitreous cells, and multiple elevated macular detachments were detected. Ultrasonography revealed vitritis and thickened choroid. Fluorescein angiography revealed early subretinal hyperfluorescence with late pooling. Optical coherence tomography demonstrated multifocal serous macular detachment.

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Purpose: The purpose of this study was to evaluate the effect of focal double-frequency yttrium-aluminum-garnet (YAG) laser therapy in patients with central serous chorioretinopathy (CSCR) resistant to intravitreal bevacizumab (IVB) injections. Methods: This is a retrospective analysis of 16 eyes of 16 patients with CSCR of >3 months duration who had been previously treated with multiple injections of bevacizumab (average 2.7) with no improvement in best-corrected visual acuity (BCVA). All patients had been treated using multiple spots of focal double-frequency YAG laser over areas of focal and diffuse leak. Spectral domain-optical coherence tomography (SD-OCT) was done a day before laser treatment and at 1, 3, and 6 months after. Fluorescein angiography was done for all patients to locate leakage site before laser treatment. Reduction in subretinal fluid height on SD-OCT was used to measure the response to treatment. Results: Mean age of patients was 37.6 ± 3.9 years. The baseline BCVA was improved significantly (P < 0.001) from 0.39 ± 0.45 logarithm of the minimum angle of resolution (log MAR) to 0.11 ± 0.43, 0.10 ± 0.44, and 0.09 ± 0.45 (log MAR) at 1, 3, and 6 months posttreatment, respectively. The baseline OCT mean central macular thickness decreased significantly (P < 0.001) from 554 ± 45 μm to 285 ± 38 μm, 279 ± 34 μm, 275 ± 33 μm at 1, 3, and 6 months posttreatment, respectively. Conclusion: Focal double-frequency YAG laser therapy improved the BCVA and reduced neurosensory detachment in patients with CSCR resistant to IVB injections.

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