Purpose To examine the three-dimensional foveal cone photoreceptor structure in a patient who had suffered laser pointer induced retinal injury. Methods Patient underwent standard fundus photography and clinical spectral domain optical coherence tomography (SD-OCT) imaging. High-resolution imaging was performed using an Adaptive Optics-OCT-Scanning Laser Ophthalmoscope (AO-OCT-SLO). Results AO imaging revealed loss of inner and outer segments of cone photoreceptors while the anterior retinal layers appeared healthy. Analysis of cone topology showed an increase in Voronoi domain area and a less regular hexagonal packing structure closer to the lesion site. Conclusion Exposure to laser pointer radiation, however brief, can result in damage to the retina. Here, repeated imaging nine months later showed a decrease in the size of the lesions (ranging from 3.7 to 23.9%) compared to the first time point. However, the longer-term prognosis is likely permanent scarring.Purpose To present a case of IRVAN syndrome that was successfully managed with serial intravitreal aflibercept injections. Methods Ophthalmic imaging and visual acuity were used to monitor disease state and track treatment methods in order to determine the most valuable combination of treatment medication and treatment interval. Results 25-year-old woman with IRVAN syndrome status post panretinal photocoagulation of both eyes presented with bilateral cystoid macular edema (CME). We demonstrate successful management of retinal CME associated with idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) syndrome using serial intravitreal aflibercept injections. Conclusion Intravitreal aflibercept has a useful role in managing the potential retinal complications associated with IRVAN syndrome and provides further insight into treatment of the later stages of this rare disease.Purpose To report a case of Coccidioides immitis endophthalmitis with severe vision loss and a return to excellent vision following aggressive intervention. Methods Case report. Results A 41-year-old male with a history of solid organ transplantation who complained of floaters and decreased vision in the setting of disseminated Coccidioides infection was found to have presumed coccidioidal endophthalmitis with visual acuities (VA) of 20/20 in the right eye and 20/200 in the left eye. The patient was managed with intravenous amphotericin B, oral voriconazole, and intravitreal injections of amphotericin B and voriconazole in the left eye every three days. Five weeks after presentation, VA remained 20/20 in the right eye and improved to 20/40 in the left eye. click here The patient was transitioned to twice weekly intravitreal injections and oral voriconazole upon hospital discharge. One week later, vision in the left eye decreased to 20/500 with worsening vitritis, prompting vitrectomy. Vision in the left eye subsequently improved to 20/30. Five weeks later, the patient developed a macula-on inferior rhegmatogenous retinal detachment in the left eye and underwent a second vitrectomy, with scleral buckle, laser, and gas injection. Vision in the left eye returned to 20/25. In total, the patient received 22 amphotericin B and 17 voriconazole intravitreal injections in the left eye with two vitrectomies. Vision in the right eye remained 20/20 throughout his treatment course. At four months after presentation, the patient remained on oral voriconazole with no evidence of active intraocular infection on exam. Conclusions Aggressive medical and surgical management can be successful in ocular conservation and restoration of vision in coccidioidal endophthalmitis. Very mild disease may be conservatively monitored and managed with systemic antifungal therapy alone. In severe disease, early diagnosis and prompt and aggressive use of systemic and intravitreal antifungals may spare panophthalmitis and preserve vision.Purpose To describe a novel clinical and imaging finding in patients with tubercular posterior uveitis. Methods A retrospective review of 3 cases presented at a tertiary referral eye centre in North India between June 2016 to March 2019 was performed. All the patients had received an initial diagnosis of non-infective etiologies (sympathetic ophthalmia, necrotizing scleritis and lymphoma). Fundus photography, fluorescein angiography (FA), fundus autofluorescence (FAF), and enhanced-depth imaging optical coherence tomography (EDI-OCT) were reviewed. Results Three patients (all Asian Indian females aged 18, 49 and 52 years) diagnosed with panuveitis were investigated for various etiologies based on the initial clinical suspicion. During the course of therapy, all the patients developed peripheral yellow sub-retinal pigment epithelim (RPE) deposits (YSRPE) which appeared hypo-autofluorescent on FAF, and initially hypofluorescent with late hyperfluorescence on FA. The patients were subjected to detailed systemic evaluation and laboratory tests. All the patients showed acid fast bacilli on invasive tissue biopsies. After initiation of anti-tubercular therapy, the lesions resolved in all eyes. Conclusions YSRPE deposits represent a novel and important diagnostic sign of tubercular posterior uveitis.Purpose To present a surgical technique and case presentation of internal chandelier-assisted macular buckling for myopic foveoschisis. Methods Review of patient clinical features, visual-acuity and optical coherence tomography (OCT) results following internal chandelier-assisted macular buckling for myopic foveoschisis. Results A 48-year-old highly myopic female (axial length 29.85mm) underwent internal chandelier-assisted macular buckling for myopic foveoschisis with macular detachment. The best-corrected visual acuity improved from 20/150 to 20/40. Post-operative OCT confirmed central buckle positioning and demonstrated resolved foveoschisis and macular detachment. There were no complications. Conclusions Internal chandelier-assisted macular buckling is a valuable tool to optimize buckle position and patient outcomes.Purpose METHODS A 23-gauge-pars plana vitrectomy was performed to remove the subfoveal silicone oil bubble and to treat the RD. Through a mid-peripheral retinal tear, we reached the subfoveal space by extending the RD up to the macular region. We inserted in the subretinal space a Charles cannula protected with a silicone tip to catch and aspirate the bubble. Intra-operative optical coherence tomography successfully guided the surgical maneuvers. Results We achieved the complete removal of the bubble from the subretinal space, and this led to the restoration of the retinal morphology with functional improvement, although the fovea developed an atrophy.