Anterior chamber depth measurement in teenagers. Comparison of two techniques

Purpose: The aim of this study is to determine the anterior chamber depth (ACD) in teenagers using two different devices: partial coherence interferometry IOLMaster (Carl Zeiss Meditec) and anterior segment optical coherence tomography (Visante TM OCT, Carl Zeiss Meditec) and to evaluate the degree of agreement between ACD measurements carried out by both instruments. Methods: In this prospective study 68 eyes of 34 emmetropic Caucasic patients (18 girls and 16 boys) were analysed. ACD was measured from the anterior corneal surface to anterior surface of the crystalline lens. For each age the ACD size was calculated and the difference between IOLMaster and Visante-OCT measurements was analy…

Corneal Biomechanics, Retinal Nerve Fiber Layer, and Optic Disc in Children

Purpose. To evaluate the possible associations between corneal biomechanical parameters, optic disc morphology, and retinal nerve fiber layer (RNFL) thickness in healthy white Spanish children. Methods. This cross-sectional study included 100 myopic children and 99 emmetropic children as a control group, ranging in age from 6 to 17 years. The Ocular Response Analyzer was used to measure corneal hysteresis (CH) and corneal resistance factor. The optic disc morphology and RNFL thickness were assessed using posterior segment optical coherence tomography (Cirrus HD-OCT). The axial length was measured using an IOLMaster, whereas the central corneal thickness was measured by anterior segment opti…

Design and Validation of an Expanded Disability Status Scale Model in Multiple Sclerosis.

<b><i>Introduction:</i></b> We aimed to develop and validate an Expanded Disability Status Scale (EDSS) model through clinical, optical coherence tomography (OCT), and magnetic resonance imaging (MRI) measures. <b><i>Methods:</i></b> Sixty-four multiple sclerosis (MS) patients underwent peripapillary retinal nerve fiber layer and segmented macular layers evaluation through OCT (Spectralis, Heidelberg Engineering). Brain parenchymal fraction was quantified through Freesurfer, while cervical spinal cord (SC) volume was assessed manually guided by Spinal Cord Toolbox software analysis. EDSS, neuroradiological, and OCT assessment were carried out …

Impact of Corneoscleral Contact Lens Usage on Corneal Biomechanical Parameters in Keratoconic Eyes

Objective To analyze the changes in corneal biomechanical parameters of keratoconic eyes with and without intracorneal ring segment (ICRS) implants after 1 year of corneoscleral contact lens (CScL) wear. Methods Seventy-four eyes of 74 patients were divided into three groups: healthy subjects (29 eyes, control group), and 2 groups of subjects with keratoconic eyes (one group of 20 eyes with ICRS implants and one of 25 eyes without them), which were fitted with CScL. Corneal hysteresis (CH), corneal resistance factor (CRF), and corneal-compensated intraocular pressure (IOPcc) were evaluated before fitting CScL and after 1 year of CScL wear. In addition, endothelial cell count (ECC) and centr…

Fitting Scleral Lenses Less Than 15 mm in Diameter: A Review of the Literature.

OBJECTIVE To perform a comprehensive review of the current and historical scientific literature on fitting small scleral lenses (diameter <15 mm) and clarifying their advantages and disadvantages, in addition to their clinical applications. METHODS The literature search was performed through PubMed from MEDLINE. RESULTS Eleven studies of case series (258 eyes) were found. Indications were similar to those of larger scleral lenses, 74% for corneal irregularities (mainly keratoconus), whereas 26% for ocular surface diseases. In the studies on cases of irregular corneas, visual acuity improved significantly regarding the values before and after fitting the lenses (mean, 0.4-0.03 logMar, respec…

Anterior Segment Biometry and Their Correlation with Corneal Biomechanics in Caucasian Children.

Purpose: To assess the relationship between the corneal biomechanical parameters and the anterior segment parameters in Caucasian children. Methods: This study included 293 eyes from 293 healthy children aged between 6 and 17 years. Corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated with the Ocular Response Analyzer, axial length (AL) with IOLMaster and the anterior segment with Pentacam. Anterior segment parameters obtained were the following: central corneal thickness (CCT), corneal volume (CV), anterior chamber depth (ACD), anterior chamber volume (ACV) and mean anterior and posterior keratometry. Two multiple linear regression models were constructed to assess th…

Dacriocistitis por Candida Lusitaniae

espanolCaso clinico: Se presenta el caso de una mujer de 60 anos con episodios recurrentes de dacriocistitis aguda derecha que no cedian con tratamiento medico ni tras una dacriocistorrinostomia con intubacion bicanalicular. Presento tambien una dacriocistitis izquierda que requirio una dacriocistorrinostomia. Se tomaron muestras intraoperatorias y en el cultivo aparecio Candida Lusitaniae como germen responsable. Tras tratamiento topico con Anfotericina B, asociado a dacriocistorrinostomia, la clinica desaparecio. Discusion: La dacriocistitis por Candida Lusitaniae es muy rara. Cabria preguntarse si Candida Lusitaniae es el germen primario o la dacriocistitis podria ser por sobreinfeccion …

Corneoscleral contact lenses for visual rehabilitation after keratoplasty surgery.

Abstract Purpose To report the use of corneoscleral lenses (CSL) in keratoconus patients who were unsatisfied with their visual outcomes after keratoplasty surgery. Methods Eleven consecutive cases with unsatisfactory vision with spectacles, due to irregular astigmatism, preferred to try CSL before SL due to handling or economic issues. An eye examination included refraction and visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelial-cell count (ECC) and evaluation of corneal biomechanical parameters (corneal resistance factor, CRF; corneal hysteresis, CH; corneal-compensated intraocular pressure, IOPcc). The fitting process…

Visual quality with corneo-scleral contact lenses after intracorneal ring segment (ICRS) implantation for keratoconus management

Purpose: To evaluate the visual quality results when fitting a corneo-scleral contact lens (CScL) after intracorneal ring segment (ICRS) implantation for keratoconus management. Methods: Twenty-seven eyes of 27 patients with keratoconus underwent ICRS implantation and had CScL fitted as their visual quality was unsatisfactory with their spectacles or contact lenses. Patients received a complete eye examination, refraction and visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelial-cell count, and visual quality assessment using contrast sensitivity and aberrometry tests. A diagnostic trial set was used in the fitting process…

&lt;p&gt;Multimodal Evaluation of Visual Function in Geographic Atrophy versus Normal Eyes&lt;/p&gt;

Purpose To comprehensively evaluate visual function in eyes with geographic atrophy (GA) as compared to normal eyes. Patients and Methods Sixty-three eyes from 63 patients ≥50 years old were recruited for this observational study; 31 were identified as normal macular health eyes and 32 with GA. Visual function was tested with best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), low luminance deficit (LLD), reading speed, macular integrity microperimetry, fixation stability, and contrast sensitivity function (CSF). Anatomic function was evaluated with spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF). Quality of life and vision were a…

Corneo-scleral contact lens in a piggyback system for keratoconus: A case report.

Purpose: We describe a case of fitting a corneo-scleral contact lens with a multi-aspheric geometry design (MAGD CScL) on top of a daily silicone hydrogel lens (piggyback system) for keratoconus management. Methods: A 48-year-old man using soft toric contact lenses required an improvement in the unsatisfactory quality of his vision. He presented with bilateral asymmetric keratoconus with high myopia in the right eye (RE) and severe myopia in the left eye (LE). In addition, he had low vision in his LE because of a maculopathy. He was fitted with MAGD CScL to correct his irregular astigmatism. A diagnostic trial set was used in the fitting process and the patient was assessed according to a s…

Brainstem and cavernous sinus metastases arising from a microcystic adnexal carcinoma of the eyebrow by perineural spreading

Symptomatic accommodative and binocular dysfunctions from the use of flat-panel displays

AIM: To determine the presence of symptomatic accommodative and non-strabismic binocular dysfunctions (ANSBD) in a non-presbyopic population of video display unit (VDU) users with flat-panel displays. METHODS: One hundred and one VDU users, aged between 20 to 34y, initially participated in the study. This study excluded contact-lens wearers and subjects who had undergone refractive surgery or had any systemic or ocular disease. First, subjects were asked about the type and nature of eye symptoms they experienced during VDU use. Then, a thorough eye examination excluded those subjects with a significant uncorrected refractive error or other problem, such as ocular motility disorders, vertica…

Optical Coherence Tomography Characterization of Macular Changes Secondary to Arteriovenous Fistula

Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular systems. These usually produce ocular pain, increased intraocular pressure (IOP), and diplopia. Less frequently, they may cause retinal changes with visual impairment. Our purpose is to illustrate different retinal manifestations of AVF. We report the multimodal imaging study of three cases with retinal changes due to AVF, showing neurosensory retinal detachment, macular oedema, and macular ischemia. In conclusion, AVF may appear with different ophthalmic alterations. While usually increased IOP and diplopia are our main concerns, retinal study is mandatory, since a myriad of morphologic abnormalities…

Blefaritis asociada al tratamiento con Cetuximab en adenocarcinoma colorrectal avanzado

espanolCaso clinico: Mujer de 52 anos diagnosticada de adenocarcinoma colorrectal, remitida a nuestro servicio por presentar tras iniciar tratamiento con Cetuximab reaccion adversa palpebral. Discusion: El Cetuximab es un anticuerpo monoclonal cuya diana es el receptor del factor de crecimiento epidermico. Ha sido incorporado recientemente al tratamiento de tumores, principalmente el cancer colorrectal metastatico y los tumores del area otorrinolaringologica. Su tolerancia es en principio mejor que la de los agentes quimioterapicos clasicos. Sin embargo, no esta exento de efectos secundarios. La toxicidad palpebral asociada a Cetuximab ha sido recientemente descrita, por lo que la patogenia…

Corneo-scleral contact lenses in an uncommon case of keratoconus with high hyperopia and astigmatism

Purpose: To analyse the visual quality achieved by fitting corneo-scleral contact lenses (CScL) in an uncommon case of bilateral keratoconus, high hyperopia and astigmatism. Methods: A 45-year-old man presented for eye examination due to the unsatisfactory quality of his vision wearing soft toric contact lenses. He presented high hyperopia and astigmatism with bilateral keratoconus. He was fitted with CScL to correct his irregular astigmatism and ocular aberrations. A diagnostic trial set was used in the fitting process and he was assessed according to standardised fitting methodology. Visual acuity, corneal topography, biometry and ocular aberrations were evaluated. The follow-up period wa…

Corneal Biomechanical Parameters With Corneoscleral Contact Lenses in Post-Laser In Situ Keratomileusis Eyes

Objective: To evaluate corneal biomechanical parameters wearing corneoscleral contact lenses (CScL) in patients with irregular corneas after laser in situ keratomileusis (LASIK). Methods: Data from patients fitted with CScL because of corneal surface irregularities after complicated LASIK surgery were selected by two eye clinics. Previously and after 1 year of CScL fitting, corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc), and central corneal thickness were evaluated. In addition, visual acuity, subjective comfort, and wearing time CScL were reported. Results: The study comprised 27 eyes. Statistically significant differences were fo…

Granuloma piógeno en tapones lagrimales smart plug

espanolCaso clinico: Mujer de 65 anos, diagnosticada de ojo seco, acude por aparicion de tumoracion en canto interno con sensacion de cuerpo extrano. Tres anos antes se le habian implantado tapones lagrimales SmartPlug en ambos puntos lagrimales inferiores. Se aprecio un granuloma en el punto lagrimal inferior izquierdo que se extirpo. Dos semanas despues presento una recidiva lo que obligo a extraer el implante quedandose desde entonces asintomatica. Discusion: Estamos ante un granuloma piogeno en un implante punctal SMART PLUG, complicacion descrita clasicamente con los implantes de silicona, debido posiblemente a la irritacion cronica de los detritus acumulados. Esta complicacion obliga …

Visual quality with corneo-scleral contact lenses for keratoconus management

Purpose: To assess the visual quality achieved by fitting corneo-scleral contact lenses (CScL) for keratoconus management. Methods: Thirty patients with keratoconus presented to have CScL fitted because of the unsatisfactory visual quality they experienced with their contact lenses or spectacles. The eye examination included visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelialcell count, contrast sensitivity and aberrometry. The fitting process was performed using a diagnostic trial set. Subjective visual quality and comfort, and contact lens wear time were also reported. Patients were monitored for one year. Results: Thr…

Magnetic resonance imaging and optical coherence tomography correlations in multiple sclerosis beyond anatomical landmarks.

Abstract Objective To investigate multiple sclerosis (MS) optical coherence tomography (OCT) cross-sectional correlations with central nervous system (CNS) magnetic resonance imaging (MRI). Material and methods Peripapillary retinal nerve fiber layer (pRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner (INL) and outer nuclear layer (ONL) of 54 relapsing remitting (RRMS) and 38 progressive (PMS, 9 primary and 29 secondary) patients were measured. With less than 3 months brain parenchymal fraction (BPF), spinal cord (SC), total gray matter (GM) and white matter volumes were calculated. Demographical and clinical data was compared according to the history of optic neuritis (H…

Lentes de contato corneoesclerais adaptadas em córneas irregulares após cirurgia LASIK

ABSTRACT Purpose: We aimed to describe the outcomes of corneoscleral contact lens fitting with multi-aspherical geometry designs in patients with irregular corneas after laser-assisted in situ keratomileusis (LASIK). Methods: This was a retrospective series of 18 patients (age, 26-38 years) selected from an eye clinic database. Participants were required to have unsatisfactory visual acuity with their current contact lenses or spectacles after LASIK for myopia correction. All patients were fitted with corneoscleral contact lenses designed to correct corneal surface irregularities. A diagnostic trial set was used for fitting, and assessments were performed according to a standardized methodo…

Metastatic Anterior Chamber Non-Hodgkin Lymphoma in a Patient With Acquired Immunodeficiency Syndrome

Purpose To alert ophthalmologists to the possibility of metastatic anterior chamber intraocular non-Hodgkin lymphoma in patients with acquired immunodeficiency syndrome (AIDS). Methods We examined a 19-year-old man with AIDS who had an anterior uveitis with pseudohypopyon and a history of 2 months of malaise. A specimen of the lesion was obtained with a 25-gauge needle for pathologic examination. RESULTS: Systemic exploration showed hepatomegaly. Abdominal computed tomography showed multiple lesions in the liver and spleen. Fine-needle aspiration disclosed a high-grade non-Hodgkin lymphoma. The result of a fine-needle aspiration obtained from a lesion in the anterior chamber was consistent …

Síndrome de Horner como manifestación de disección carotídea

Caso Clínico: Un varón de 42 años se presenta con ptosis y miosis izquierda después de una historia de cefalea homolateral de 20 días de evolución, que empeora progresivamente durante los últimos días. Una angioresonancia revela disección de la arteria carótida interna. Discusión: El «síndrome de Horner doloroso» destaca como una urgencia médica por posible manifestación de una disección carotídea. Consideramos que el perfecto conocimiento de las urgencias neurooftalmológicas es de gran necesidad para el médico oftalmólogo y que estas requieren una atención multidisciplinaria para asegurar un seguimiento y tratamiento adecuado. Clinical Case: A 42-year-old man presented with ptosis and mios…

Síndrome de Horner como manifestación de disección carotídea

Resumen Caso Clinico Un varon de 42 anos se presenta con ptosis y miosis izquierda despues de una historia de cefalea homolateral de 20 dias de evolucion, que empeora progresivamente durante los ultimos dias. Una angioresonancia revela diseccion de la arteria carotida interna. Discusion El «sindrome de Horner doloroso» destaca como una urgencia medica por posible manifestacion de una diseccion carotidea. Consideramos que el perfecto conocimiento de las urgencias neurooftalmologicas es de gran necesidad para el medico oftalmologo y que estas requieren una atencion multidisciplinaria para asegurar un seguimiento y tratamiento adecuado.

Variations of OCT measurements corrected for the magnification effect according to axial length and refractive error in children

Purpose: The aim of this paper was to examine the distribution of macular, retinal nerve fiber layer (RNFL) thickness and optic disc parameters of myopic and hyperopic eyes in comparison with emmetropic control eyes and to investigate their variation according to axial length (AL) and spherical equivalent (SE) in healthy children. Methods: This study included 293 pairs of eyes of 293 children (145 boys and 148 girls), ranging in age from 6 to 17 years. Subjects were divided according to SE in control (emmetropia, 99 children), myopia (100 children) and hyperopia (94 children) groups and according to axial AL in 68 short ([Formula: see text]22.00[Formula: see text]mm, 68), medium (from [For…

Relationship among Corneal Biomechanics, Refractive Error, and Axial Length

Purpose To evaluate the relationship between different ocular and corneal biomechanical parameters in emmetropic and ametropic healthy white children. Methods This study included 293 eyes of 293 healthy Spanish children (135 boys and 158 girls), ranging in age from 6 to 17 years. Subjects were divided according to the refractive error: control (emmetropia, 99 children), myopia (100 children), and hyperopia (94 children) groups. In all cases, corneal hysteresis (CH) and corneal resistance factor (CRF) were evaluated with the Ocular Response Analyzer system. Axial length (AL) and mean corneal power were also measured by partial coherence interferometry (IOLMaster), and central corneal thickne…

Corneoscleral contact lenses fitting on irregular corneas after laser-assisted in situ keratomileusis

ABSTRACT Purpose: We aimed to describe the outcomes of corneoscleral contact lens fitting with multi-aspherical geometry designs in patients with irregular corneas after laser-assisted in situ keratomileusis (LASIK). Methods: This was a retrospective series of 18 patients (age, 26-38 years) selected from an eye clinic database. Participants were required to have unsatisfactory visual acuity with their current contact lenses or spectacles after LASIK for myopia correction. All patients were fitted with corneoscleral contact lenses designed to correct corneal surface irregularities. A diagnostic trial set was used for fitting, and assessments were performed according to a standardized methodo…