Category: vitreo-retina

“Chemo-Vitrectomy” for Macular Hole with Ocriplasmin :Case report

AsianOphthalmology Alliance logo
“Chemo-Vitrectomy” for Macular Hole with Ocriplasmin

I am quite fortunate to be able to visit the Tun Hussain Onn National Eye Institute and Hospital, Petaling Jaya, Malaysia at least twice a year. Even more fortunate is the fact that whenever I come, Dr Pall Singh FRCS, FRCOphth, a very senior Vitreo-retina specialist of the hospital, almost always has a new and interesting case to share with me.

This time (Jan 2015) when I met him, he had a case of Idiopathic Macular hole to show me. We all see macular hole cases often enough. What was new was that he had given this case an intra-vitreal injection of Ocriplasmin, a recombinant proteolytic enzyme, 4 days earlier. The vision improved from 6/24 to 6/6P. Sharing the Fundus photo, pre-injection OCT and post-Injection OCT with you. Incredible results !

The injection is quite expensive though. In Malaysia it costs about RM 17,000/- (Approx. USD 4600/-). The patient was so pleased that he got the injection in the other eye as well yesterday. Hopefully he’ll get similar results in the other eye too.

Also sharing a photograph of me with Dr Natarajan Sundaram and Dr Pall Singh….

Thanks dear Dr Pall Singh…


Dr Sarbjit Singh
Consultant Ophthalmologist
Dr Shamsher Singh Eye Hospital
Khanna 141401 Punjab

Treatment of MacularHole with Ocriplasmin



Non-steroidal Anti-Inflammatory Eyedrops Don’t Prevent CME

AsianOphthalmology Alliance logo Nonsteroidal Anti-Inflammatory Eyedrops Don’t Prevent Cystic Macular Edema, Small Study Finds

NEW YORK (Reuters Health) – The nonsteroidal anti-inflammatory eyedrops ketorolac and nepafenac do not prevent cystoid macular edema after phacoemulsification, researchers from Brazil report.
Most patients exhibit inflammation after cataract surgery that requires treatment with an anti-inflammatory eyedrop, typically a steroid, they write in the British Journal of Ophthalmology, online November 10.

Dr. Patrick Frensel Tzelikis from Brasilia Ophthalmologic Hospital in Brasilia and colleagues evaluated the effects of ophthalmic solutions of ketorolac 0.4% and nepafenac 0.1% in preventing cystic macular edema (assessed by optical coherence tomography (OCT)) after phacoemulsification cataract extraction.

Patients were randomly assigned to receive an artificial tear substitute (n=40), ketorolac 0.4% (n=45) or nepafenac 0.1% (n=41). All patients received prednisolone 1% eyedrops on a (more…)


Office-based vitrectomy: proceed with caution

AsianOphthalmology Alliance logo Office-based vitrectomy: proceed with caution

In a pro/con session during AAO 2013 Retina meeting, Thomas M. Aaberg Jr, MD, and Steven T. Charles, MD, argued the merits of office-based vitrectomy.

Rationale for. Primary reasons for making the switch include cost, convenience, and control, Dr. Aaberg said. Proper patient and case selection is essential, he cautioned. With that as the starting point, “In every case we’ve performed, we’ve been able to achieve all of our surgical goals,” he added.

He noted that safety (more…)


FDA accepts Regeneron’s Eylea sBLA for standard review

AsianOphthalmology Alliance logo FDA accepts Regeneron’s Eylea sBLA for standard review

The supplemental Biologics License Application (sBLA) on Eylea intravitreal injection (aflibercept, Regeneron, Tarrytown, N.Y.) for the treatment of diabetic macular edema (DME) has been accepted by the Food and Drug Administration, with a targeted Prescription Drug User Fee Act date of August 18, 2014.

The submission was based on positive data from Regeneron’s VIVID and VISTA studies. Eylea is currently approved in the U.S. for neovascular age-related macular degeneration and for macular edema following central retinal vein occlusion.

EyeWorld Weekly Update


NSAIDs Speed Central Serous Choroidopathy Recovery

AsianOphthalmology Alliance logo NSAIDs Speed Central Serous Choroidopathy Recovery

Patients with central serous choroidopathy treated with nonsteroidal anti-inflammatory drug (NSAID) eyedrops recover faster than when they are not treated, according to a new study.

“We found that we could cut the average time to resolution by 50% with the NSAID eyedrops, which is the way we have been treating patients in our own practice,” said Michael Singer, MD, from Medical Center Ophthalmology in San Antonio.

He presented the results here at the American Academy of Ophthalmology 2013 Annual Meeting.

Central serous choroidopathy is characterized by spontaneous serous detachment of the neurosensory retina in the macular region, with or without retinal pigment epithelium detachment. Its cause is not known, but one theory suggests that increased (more…)


Children Born Prematurely Face Up To A 19 Times Greater Risk Of Retinal Detachment Later In Life

AO Logo Children Born Prematurely Face Up To A 19 Times Greater Risk Of Retinal Detachment Later In Life

First large population-based study investigating long-term risks supports need for ophthalmologic follow-up of children and adults born before 32 weeks of gestation

SAN FRANCISCO – Nov. 7, 2013 – Children born extremely prematurely have up to a 19 times greater risk of retinal detachment later in life than peers born at term, according to a Swedish study published this month in Ophthalmology, the journal of the American Academy of Ophthalmology. In the first large population-based, long-term investigation of the association between preterm birth and later retinal detachment, (more…)


Anti-VEGFs possibly linked to increased heart attack risk

AO LogoAnti-VEGFs possibly linked to increased heart attack risk
This large retrospective study examined health records from Western Australian eye clinics to determine the risk of thromboembolic and gastrointestinal bleeding events in the 12 months after injections of bevacizumab or ranibizumab, compared with photodynamic therapy and untreated community controls. Though all adverse events were rare, anti-VEGF-treated patients were 2.3 times more likely to have a heart attack compared with controls. There was no difference in adverse events between bevacizumab and ranibizumab (1.6 and 2.1 events/100 persons, respectively). It’s unclear if the increased risk is associated with AMD itself or anti-VEGF treatment.

Retina, June 2013


Delayed-onset endophthalmitis associated with better visual outcomes

AO LogoDelayed-onset endophthalmitis associated with better visual outcomes
This large retrospective series included all patients treated for culture-proven endophthalmitis after cataract surgery at a single university center between 2000 and 2009. Patients with delayed-onset endophthalmitis (>6 weeks after surgery) generally presented with better initial visual acuities, had a lower frequency of hypopyon, and better visual outcomes compared to acute-onset patients (≤6 weeks after surgery). Propionibacterium acnes and coagulase-negative Staphylococcus species were the most common organisms cultured in both groups and were associated with the best visual acuity outcomes in both groups.

American Journal of Ophthalmology, March 2012


No-assistant technique for glued IOL (7.05 min Video): Dr Priya Narang

No-assistant technique for glued IOL : Dr Priya Narang MS

An excellent demo video using animation and real surgery videos to explain the tricky concepts in general and the no-assistant technique in particular.


AREDS formula requires tinkering

AO LogoAREDS formula requires tinkering
Five-year results from the AREDS2 study shows that adding lutein and zeaxanthin, and/or omega-3 fatty acids to the original AREDS formula did not further reduce the risk of AMD progression. However, they found some benefit in two subgroups: Subjects who took an AREDS formulation with lutein and zeaxanthin but no beta-carotene cut their risk by about 18 percent, while those who had very little lutein and zeaxanthin in their diets but took an AREDS formulation with lutein and zeaxanthin were about 25 percent less likely to develop advanced AMD compared with participants with similar dietary intake who did not take lutein and zeaxanthin. The authors recommend a new formula consisting of 400 IU of vitamin E, 500 mg vitamin C, 10 mg lutein and 2 mg zeaxanthin, 80 mg zinc and 2 mg copper.

Journal of the American Medical Association, May 5 2013


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