PURPOSE:To report optical coherence tomography angiography (OCTA) characteristics of bilateral MacTel Type 1 with capillary obliteration. METHODS:Color fundus photography, OCTA, fundus fluorescein angiography, fundus autofluorescence. RESULTS:We describe three cases of bilateral MacTel Type 1 with a special emphasis on OCTA characteristics. CONCLUSION:Optical coherence tomography angiography is a noninvasive method to detect capillary telangiectasia and abnormal vascular tortuosity in the superficial capillary plexus and deep capillary plexus. Optical coherence tomography angiography demonstrates that bilateral MacTel Type 1 may have both aneurysmal and occlusive components.

PURPOSE:To study the clinical and microbiological profile of post-cataract surgery endophthalmitis and assess the utility of eubacterium and panfungal polymerase chain reaction (PCR). METHODS:This was a case series of consecutive post-cataract surgery endophthalmitis patients treated at a tertiary care center in eastern India between January 2015 and December 2023. Data on clinical features, investigations, treatment, and outcomes were obtained from medical records. Aqueous or vitreous samples were first analyzed with various stains, including Gram's stain, 10% potassium hydroxide (KOH) mount, Giemsa stain, and Ziehl-Nielsen stain. Further samples were inoculated into cultures. All samples were analyzed with polymerase chain reaction (PCR) to identity eubacterium, panfungal, and Propioniobacterium acnes genomes. Favorable anatomical and functional outcomes were defined as clear media and attached retina and best-corrected visual acuity of 20/200 or better, respectively. The main outcome measure was defined as anatomical and functional outcomes in culture-negative but PCR-positive and negative cases. Chi-square tests were performed for statistical analysis, and a P value of less than 0.05 was considered significant. RESULTS:A total of 132 patients were included. Culture was positive in 51 (38.6%) eyes. Gram-negative bacilli (27; 51.9%) were the predominant microorganisms, with Pseudomonas aeruginosa (11; 21.1%) being the most common isolate. Eubacterium or panfungal PCR were positive in 108 (81.8%) eyes. Among 81 culture-negative patients, 57 had positive PCR results (Group A), and 24 had negative PCR results (Group B). A favorable anatomical outcome was achieved in 51 (76.1%) patients in Group A and 10 (71.4%) in Group B ( P = 0.69). A favorable functional outcome was achieved in 50 (74.6%) patients in Group A and 9 (64.3%) patients in Group B ( P = 0.44). CONCLUSION:PCR positivity was higher than conventional culture. Eubacterium and panfungal PCR help in prompt decision-making in culture-negative endophthalmitis.

We are reporting a case of myopic maculopathy in a 52-year-old man, which showed spontaneous resolution of macular schisis and foveal detachment. Spontaneous resolution has been reported after posterior vitreous detachment (PVD) or rupture of the internal limiting membrane (ILM). It has also been reported in cases where either of these two were absent. Our report adds to the literature that spontaneous resolution can occur in the absence of PVD or ILM rupture.

Scleral bands are an age-old surgical technique used for attaching the detached retina with a rhegmatogenous component. It has been associated with multiple ocular complications. However, anterior migration into the cornea is very rare. We report the unique case of a 17-year-old patient who presented with spontaneous intracorneal migration of the silicon band post-scleral buckling. We demonstrate the utility of anterior segment optical coherence tomography (AS-OCT) in such a scenario demonstrating the extent of the intrusion of the band into the intracorneal tissue. Migrated scleral bands usually need explantation if there is an extrusion or associated retinal detachment, or if the migration has led to an intraocular pressure change or any extraocular motility disturbance causing diplopia. We also narrate the other similar cases of anterior migration of the scleral band in detail.

The utility of multicolor imaging (MCI) has been well evaluated for various retinal disorders like age-related macular degeneration, retinal vascular occlusions, and central serous chorioretinopathy. However, the utility of MCI in endogenous endophthalmitis is very limited. We report a unique case of endogenous endophthalmitis showcasing the utility of MCI in monitoring the response of bacterial colonies to intravitreal antibiotic therapy.

Multicolor (MC) imaging is an innovative pseudocolor fundus imaging modality based on confocal scanning laser ophthalmoscopy. It effectively scans the retina at different depths to create a composite image. The green reflectance image depicts the middle retinal while blue reflectance image provides images of the retinal surface. The infrared reflectance image depicts retinal structures at the level of outer retina and choroid. We systematically analyze published case reports, case series, and original articles on MC imaging where it has helped in discovering additional clinical features of retinal diseases not readily apparent on conventional color fundus photography and played a role in monitoring the response to treatment.

Pigmented paravenous retinochoroidal atrophy (PPRCA) is a non-progressive or slowly progressive bilateral disease.[1] This condition is usually symmetrical and is characterized by pigmentation along the retinal veins, choriocapillary atrophy, and retinal pigment epithelium (RPE) degeneration. It is usually associated with a good visual prognosis.[2] However, the exact cause of this condition is unknown. Case A 39-year-old male complained of a gradual, painless diminution of vision for the past year. He was born out of a third-degree consanguineous marriage with no similar complaints from family members. His best corrected visual acuity was 6/7.5 and 6/6 in the right and left eyes, respectively, with an intra-ocular pressure of 12 mmHg in both eyes. Color vision was normal, and the anterior segment was unremarkable. Posterior segment examination showed both eyes had normal optic discs with peripapillary atrophy. There were multiple radial chorioretinal atrophic patches and pigment clump aggregates progressing centrifugally along the retinal veins [Figs. 1 and 2]. The electroretinogram (ERG) showed low photopic and scotopic responses [Figs. 3 and 4]. Based on the clinical findings and ancillary investigations, which were suggestive of PPRCA, the patient was advised to have a regular ophthalmological evaluation.Figure 1: Montage color fundus image of the right eye depicting multiple radial chorioretinal atrophic patches and pigment clump aggregates progressing centrifugally along the retinal veinsFigure 2: Montage color fundus image of the left eye depicting multiple radial chorioretinal atrophic patches and pigment clump aggregates progressing centrifugally along the retinal veinsFigure 3: Full field ERG showing reduced photopic responsesFigure 4: Full field ERG showing reduced scotopic responsesDiscussion Patients with PPRCA usually remain asymptomatic and are diagnosed on routine examination. The primary involvement in PPRCA is mainly the retinal pigment epithelium, further leading to the involvement of the choroidal vasculature.[3] ERGs disclose abnormal or low-normal rod and cone responses (scotopic and photopic ERG), maximal combined responses, flicker responses, and oscillatory potentials. Reduction in the B-wave amplitude is the most common finding, followed by delayed latency and amplitude reduction in the A-wave.[4] To conclude, PPRCA is a slowly progressive condition that requires no specific treatment. Statement of ethics Written assent for publication (including clinical information and the images) from the patient and consent from the parent have been obtained. All procedures carried out were in accordance with the tenets of the Declaration of Helsinki. Institute Ethics Committee approval is not required for a case report according to Indian Council of Medical Research guidelines. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Astrocytic hamartoma is a benign glial tumor. It may be associated with tuberous sclerosis and can also be found incidentally on retinal examination as an isolated presentation. Here, we describe multimodal imaging characteristics of astrocytic hamartoma in a patient with retinitis pigmentosa. Spectral domain optical coherence tomography of both eyes showed moth-eaten optically empty spaces and hyperreflective dots along with foveal thinning. Multicolor image highlighted mulberry appearance of the lesion with green shift signifying elevated lesion. In infrared reflectance, lesion was hyporeflective with its margins well delineated. Green reflectance and blue reflectance highlighted calcification as multiple hyperreflective dots. Autofluorescence showed typical hyperautofluorescence.

A 17-year-old male complained of gradual painless diminution of vision since childhood. He was born out of a third-degree consanguineous marriage with a history of similar complaints in his brother. His best-corrected visual acuity (BCVA) was 6/18, the intraocular pressure being 16 mmHg in both eyes (OU). Color vision was normal and anterior segment (A/S) unremarkable. Posterior segment (P/S) examination showed both eyes normal optic discs with peripapillary atrophy. The foveal reflex was dull and the retina was attached. There were multiple peripheral chorioretinal atrophic patches progressing toward the posterior pole [Fig. 1]. Optical coherence tomography (OCT) revealed abnormal foveal contour with cystoid macular edema [Fig. 2]. Electroretinogram (ERG) revealed both reduced photopic and scotopic responses with reduced 30 Hz flicker response [Fig. 3]. His systemic evaluation revealed elevated serum ornithine levels. Based on the clinical evidence and ERG, a diagnosis of autosomal recessive gyrate atrophy was made.[1,2] He was advised to consult physician and take an arginine-restricted diet.[3]Figure 1: Montage color fundus images depicting multiple peripheral chorioretinal atrophic patches progressing toward the posterior pole[1 , 3]Figure 2: OCT images with arrows depicting foveal intraretinal cystoid spaces[1]Figure 3: Full field ERG showing both reduced photopic and scotopic responses with reduced 30 Hz flicker response[2]Discussion Gyrate atrophy is an autosomal recessive dystrophy of the choroid and retina that is characterised by the elevateion of plasma ornithine levels due to deficiency in the mitochondrial enzyme Ornithine aminotransferase (OAT).[1] It usually starts presenting by the first or second decade of life and is characterised by the presence of myopia, cataract and multiple peripheral chorioretinal degeneration that gradually progress towards the posterior pole.[1] ERG usually reveals a subnormal 'a' and 'b' wave response initially followed by an undetectable response in advance stage of the disease.[2] The pathogenesis of macular edema in such case might be attributed to the breakdown of blood retinal barrier (BRB) or reducing retinal pigment epithelium (RPE) pump mechanism.[3] Hence, topical carbonic anhydrase inhibitors and non steroidal anti-inflammatory agents can be considered as an adjuvant in treating any associated edema in such disorders.[3] Statement of ethics Written assent for publication (including clinical information and the images) from patient and consent from the parent has been obtained. All procedures carried out were in accordance with the tenets of the Declaration of Helsinki. Institute Ethics Committee approval is not required for a case report according to Indian council of medical research guidelines. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Coloboma is a very rare developmental anomaly. The most common form is retinochoroidal coloboma. Macular coloboma is a very rare occurrence. We describe a rare case of unilateral isolated macular coloboma with full-thickness macular hole.

Oguchi's disease is an unusual form of congenital stationary night blindness with autosomal recessive inheritance. Mizuo-Nakamura phenomenon is classical of Oguchi's disease. Full-field electroretinogram shows absent rod response and essentially normal cone-mediated response. The mixed rod–cone response has a negative configuration with relatively well-preserved oscillatory potentials. It recovers to a near normal level after a long period of dark adaptation. We herein report a case of Oguchi's disease with Mizuo-Nakamura phenomenon.

"Bilateral sub–internal limiting membrane haemorrhage in acute myeloid leukaemia." Clinical and Experimental Optometry, 104(1), pp. 122–123

Retinal astrocytomas (RAs) are benign, glial tumors of the retinal nerve fiber layer that arise from retinal astrocytes. They may be associated with tuberous sclerosis, neurofibromatosis, or can also be found incidentally as an isolated presentation.[1] We herein discuss multicolor imaging (MC) in RA. A 40-year-old female patient came for routine eye check up. Best-corrected visual acuity was 20/20 in both the eyes. The right eye was normal. Fundus examination of the left eye showed creamy white, semi-translucent, well-circumscribed, elevated lesion superior to the optic disc [Fig. 1a]. MC highlighted mulberry appearance of the lesion and green shift corresponding to the entire extent of tumor mass [Fig. 1b]. In infrared reflectance (IR), lesion was hyporeflective with its margins well delineated [Fig. 1c]. Fundus autofluorescence (FAF) showed typical hyperautofluorescence [Fig. 1d]. Green reflectance (GR) [Fig. 2a] and blue reflectance (BR) [Fig. 2b] highlighted calcification as multiple hyperreflective dots. Spectral domain optical coherence tomography (SD-OCT) showed moth-eaten optically empty spaces and area of retinal thickening adjacent to the elevated lesion [Fig. 2c]. Tumor margins were better delineated on MC [Fig. 1b] and IR [Fig. 1c].Figure 1: Color fundus photography of left eye (a) showing creamy white, semi-translucent, well-circumscribed, elevated lesion superior to the optic disc (black arrow). Multicolor imaging (b) highlighted mulberry appearance of the lesion (black arrow) and green shift corresponding to entire extent of tumor mass (arrow heads). In infrared reflectance (c), lesion was hyporeflective with its margins well delineated (arrow heads). Fundus autofluorescence (d) showed typical hyperautofluorescenceFigure 2: Green reflectance (a) and blue reflectance (b) highlighted calcification as multiple hyperreflective dots (red arrows). Spectral domain optical coherence tomography (c) showed moth-eaten optically empty spaces (red arrow) and area of retinal thickening adjacent to the elevated lesion (star)RA should be differentiated from similar looking lesions including choroidal osteoma, optic nerve head drusen, chorioretinitis, retinoblastoma,[2] and Von Hippel angiomas. SD-OCT features described by Shields et al. were gradual dome-shaped elevation with hyperreflectivity, retinal disorganization, and a characteristic moth-eaten appearance.[3] Semenova et al. had described multimodal imaging in RA.[4] In their series, fundus fluorescein angiography was helpful in delineating tumor vascularity and FAF picked up intralesional calcification as hyperautofluorescent spots. MC is a novel innovative noninvasive retinal imaging modality.[5] MC with its component images highlighted extent of the lesion (IR) and internal character like calcification (GR and BR) excellently. Clinicians may consider MC as an additional tool in their imaging armoury to document and monitor RA. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Glaucoma is a progressive optic neuropathy associated with irreversible loss of retinal ganglion cells (RGC). This emblematic localized retinal nerve fiber layer defect (RNFLD) can be the earliest sign to detect the ongoing glaucomatous damage. Slitlamp biomicroscopy [90D & 78D], colour and redfree fundus photography, OCT & HRT are used conventionally for early detection of RNFLD. Multicolour Imaging (MCI) is a new non-invasive retinal imaging modality available in Spectralis platform which simultaneously acquires three reflectance images of the retina using three individual lasers producing a composite image thereby allowing analysis of changes at various levels within the retina. MCI provides sharper image, enables imaging through small pupil and hazy media. Current report describes 2 cases where in MCI proved superior to CFP and conventional redfree photograph in delineating area of RNFLD. This is the first report of MCI in RNFL imaging. The present report highlights the role of MCI in detection of RNFLD.

Purpose: To report the visual outcome in choroidal neovascular membrane developing (CNVM) in eyes with central serous chorioretinopathy (CSCR) with our without prior focal laser. Methods: A retrospective case series of eyes with CNVM secondary to CSCR treated with intravitreal anti-VEGF. Results: Ten eyes of nine patients of CNVM with CSCR who underwent intravitreal anti-VEGF injections were analyzed. Five eyes had CNVM without prior laser photocoagulation, and five eyes developed CNVM after laser photocoagulation for CSCR. Intravitreal injection bevacizumab was given in five eyes and ranibizumab in five eyes. The lasered group had significantly shorter duration of the disease, fewer injections given, and better visual acuity at final follow-up (P < 0.05). None had any recurrences of either CSCR or CNVM until the last follow-up. Conclusion: CNVM in CSCR with prior history of focal laser had better outcome than that developed de novo, without prior history of laser.

A 13-year-old female presented with diminution of vision in both eyes for 3 months following snakebite. Best-corrected visual acuities were hand movement in both eyes. Fundoscopy showed vitreous hemorrhage, and B-scan ultrasonography revealed an underlying tractional retinal detachment (TRD) involving the macula in both eyes. Patient underwent 25-gauge pars plana vitrectomy in conjunction with belt buckling, endolaser, and silicone oil tamponade in the left eye. At 6 weeks postoperatively, best-corrected visual acuity of the left eye was noted to be 20/200 with settled TRD and attached retina. Bilateral proliferative retinopathy with TRD is a hitherto unreported complication of snake bite.

Von Graefe first coined the term ‘central recurrent retinitis’ in 1866 for recurrent serous macular detachment. In 1967, Gass explained the pathogenesis and clinical features and named it central serous choroidopathy (CSC). CSCR typically affects middle-aged men and is characterized by serous neurosensory detachment (NSD) of retina at the posterior pole. Most cases are idiopathic and regress spontaneously within 4 months with good visual recovery. However, a few suffer from persistent or recurrent serous macular detachment leading to progressive visual loss. Advances in indocyanine green angiography (ICGA) and optical coherence tomography (OCT) have led to greater understanding of CSCR. Modifications of photodynamic therapy (PDT) have changed CSCR management. Newer treatments in the form of anti-vascular endothelial growth factor (anti-VEGF) and mineralocorticoid receptor (MR) antagonists appear to be promising, but needs more scientific evidence before incorporating them into regular clinical practice.