Current criteria for amblyopia do not account for difference in visual acuity charts. This prospective observational study analyzed 100 children younger than 10 years treated at a tertiary referral center. Visual acuity was separately tested in each eye using Landolt C and tumbling E charts in a random order. For each chart, receiver operating characteristic curve analysis was performed to determine the best cutoff for visual acuity score. Main outcome measures included the difference in visual acuity scores between the two charts, the feasibility of repeated testing of visual acuity in each eye, and amblyopia cutoff values for each chart. Mean logMAR visual acuity scores obtained by tumbling E chart were significantly better than those obtained by Landolt C chart. For amblyopia, the best cutoff values were < + 0.14 (20/27 Snellen equivalent) for tumbling E chart and < + 0.24 (20/35 Snellen equivalent) for Landolt C chart. For children under 10 years old, visual acuity scores for tumbling E chart were significantly better than those for Landolt C chart. We suggest that amblyopia management in children should account for age and the type of visual acuity chart used.

Ischemic retinopathy characterized by neovascularization could result from several diseases such as proliferative diabetic retinopathy, hypertensive retinopathy, and retinal vein occlusion. However, ocular ischemic conditions caused by polycythemia have rarely been described. We report the first case of polycythemia-related proliferative ischemic retinopathy in a 41-year-old male heavy smoker who had ocular ischemic condition due to secondary polycythemia. He had sudden loss of vision in his right eye vision with vitreous hemorrhage and a tortuous retinal artery. Tracing back to his history, he was a heavy smoker with more than one pack of cigarettes per day for more than 30 years. Laboratory data revealed elevated levels of hemoglobin (17.7 g/dL) and hematocrit (51.6%) without other abnormal findings. We performed retinal photocoagulation on the neovascular areas and the fibrous membrane. Additionally, the patient was advised to quit smoking. Owing to adherence to this treatment, the patient’s vision gradually recovered. Although rare, polycythemia can cause retinal ischemic events and should be considered as a sight-threatening disease. Photocoagulation is effective on the regression of the neovascular lesion. Most importantly, changes in lifestyle together with smoking cessation are effective in managing secondary polycythemia. In conclusion, prevention and cessation of tobacco consumption helps improve vision health.

Purpose: To report a case of cytomegalovirus (CMV) retinitis complicated with ganciclovir-related myelosuppression, which was successfully managed with intravenous (IV) ganciclovir and CMV immunoglobulin (CMVIG) therapy. Methods: Observational case report. Results: A 51-year-old male with follicular type non-Hodgkin lymphoma post hematopoietic stem cell transplantation (HSCT) developed vision-threatening retinitis. polymerase chain reaction (PCR) of the aqueous humour showed positive for CMV. Despite myelosuppression occurred during IV ganciclovir therapy, the retinitis resolved and intraocular CMV viral load significantly improved after CMVIG therapy. Conclusion: Combined IV ganciclovir treatment and CMVIG therapy can significantly improve visual outcome and reduce intraocular CMV viral load in vision-threatening CMV retinitis.

Purpose: To report a unique case of post-cataract surgery endophthalmitis caused by Ceftazidime-resistant Rhizobium radiobacter, successfully managed with timely vitrectomy and intravitreal Levofloxacin Case report: A healthy 73-year-old man underwent phacoemulsification and posterior chamber intraocular lens implantation in his left eye. Postoperative ocular examination (OE) one day after the surgery revealed no specific findings. However, on postoperative day 6, he presented with a painful and red left eye. Diagnosed with postoperative endophthalmitis on day 8 at another hospital, he received IVI of Ceftazidime and Vancomycin before being urgently referred to our hospital on the same day. Early vitrectomy and anterior chamber irrigation were performed timely when he arrived on day 8, with cultures identifying Ceftazidime-resistant Rhizobium radiobacter, sensitive to Levofloxacin. Repeated IVI of Levofloxacin (500 mcg/0.1 ml) ensued on post-cataract operative days 13 and 18. Six months post-cataract surgery, the corrected distance visual acuity of the left eye stabilized at 20/33, and OE remained stable. Conclusion: Early vitrectomy and vitreous culture prove effective in managing postoperative endophthalmitis in drug-resistant Rhizobium radiobacter. IVI of Levofloxacin, though rare, proved to be effective in treating Ceftazidime-resistant and Levofloxacin-sensitive pathogens in our case.