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Purpose: To report a rare case of atopic keratoconjunctivitis (AKC) presenting with bilateral corneal panni associated with limbal inclusion cysts in the left eye., Materials & Methods: Retrospective case report., Results: A 19-year-old female with AKC presented with bilateral corneal panni and limbal inclusion cysts in the left eye. Anterior segment swept-source optical coherence tomography showed bilateral hyperreflective epicorneal membrane and a lobulated cystic lesion in the left eye. Ultrasound biomicroscopy demonstrated a dense membrane overriding the cornea in both eyes and hyporeflective spaces separated by medium reflective septa in the cyst. The patient underwent excision of the limbal inclusion cyst and pannus in the left eye. Histopathological examination revealed subepithelial cystic lesion surrounded by non-keratinizing epithelium; areas of acanthosis, hyperkeratosis, parakeratosis, and hyperplasia in the epithelium of the pannus; as well as inflammation, fibrosis, and increase in vascularization in the stroma., Conclusion: To our knowledge, this is the first case of corneal pannus associated with limbal inclusion cysts in AKC. Surgical excision was done to establish the diagnosis as well as to improve vision in our case.

Purpose: To describe the epidemiological and clinical features and course of patients with posterior scleritis (PS)., Methods: This retrospective, cross-sectional consecutive case series analyzed the medical records of 16 patients diagnosed with PS., Results: Female gender and unilateral involvement were dominant. Blurred vision (84.21%) and ocular pain (78.95%) were the most common presenting complaints. Serous retinal detachment was the most common ocular finding (84.21%), followed by optic disc swelling (42.11%). Increased scleral thickness was observed in all patients, although a T-sign was detected 8 of 19 eyes (42.1%). Recurrence occured in 5 of 19 eyes in mean 30.2 ± 34.7 months. Central macular thickness, choroidal thickness, and retinal nerve fiber layer thickness were reduced with treatment at final examination significantly ( p  = .005, .002, and .002, respectively)., Conclusions: PS should be considered in patients presenting with unilateral ocular pain and decreased vision. Not only USG findings but also OCT findings are very useful in the follow-up of treatment response.

Purpose: We conducted a systematic search of literature to understand the various methods of imaging of the ciliary body., Methods: PubMed, Science Direct, Cochrane Library and Google Scholar were searched comprehensively and systematically to find studies related to the various modalities of ciliary body imaging., Results: The various ciliary body parameters that have been described are Ciliary body thickness, Ciliary body length, ciliary muscle thickness, ciliary process length, ciliary muscle length, ciliary muscle anterior length, trabecular ciliary process distance and Iris ciliary process distance. The various angles which have been measured, which mostly have a significance in Primary angle closure glaucoma (PACG) are Iris ciliary angle, Trabecular ciliary angle, scleral ciliary process angle. Various authors have defined them in various ways with subtle differences. Plateau iris and PACG mechanisms, not forgetting malignant glaucoma are better understood with imaging of the ciliary body using the ultrasound biomicroscopy (UBM). The anterior segment optical coherence tomography (ASOCT) imaging of the ciliary body has been described albeit with its own disadvantages. A few other fields dependant on the importance of ciliary body imaging are intravitreal injections, pars plana vitrectomy, measurements for implantable collamer lens (ICL) and of utmost importance, the differentiating features of ciliary body masses., Conclusion: The UBM is still preferred over the ASOCT for imaging of the ciliary body. A lot of lacunae of knowledge still exists and consensus has to be reached on defining all the parameters universally. Future studies will be able to shed more light on the role of the ciliary body in the many ocular disorders mentioned in this review.

Purpose : The authors report a38-year-old woman with primary Sjögren's syndrome who initially showed recurrent blurred vision caused by uveal effusion syndrome and later developed dry mouth, dry eyes, and arthralgia. During the 5-year-course of disease, the patient's 3-time-onset was all manifested as blurred vision after decreased immunity. Despite the initial absence of sufficient immunological evidence, the final presence of positive serum anti-SS-A, rheumatoid factors, ANA, and inflammatory findings in minor salivary gland biopsy indicated primary Sjögren's syndrome. Methods : Retrospective review of a case note. Conclusions : The manifestation of UES requires further exploration of its real pathogenesis, and the possibility of systemic disease should never be excluded.

Purpose : To explore the performance of ultrasound biomicroscopy (UBM) and color Doppler flow imaging (CDFI) in the diagnosis of primary lacrimal canaliculitis. Methods : Subjects with relevant symptoms of canaliculitis were prospectively recruited. UBM and CDFI were performed for presumptive diagnosis. Microbiology and histopathology were performed for definitive diagnosis. Results : A total of 37 cases were recruited, including 25 cases of canaliculitis and 12 cases of non-canaliculitis. Pathogens were isolated in 13 canaliculitis cases, and the leading pathogens were Actinomyces (4 cases) and Streptococcus (4 cases). UBM and CDFI identified 24 canaliculitis cases (sensitivity = 96%) and 11 non-canaliculitis cases (specificity = 92%). The predictive factors for canaliculitis were lumen wall thickness >0.25 mm ( P = .019) and intracanalicular concretions ( P = .010). Other typical features were enlarged lumen (2.16 ± 0.25 mm) and hot-wheel sign-on CDFI (84%). These image findings were congruent with histopathologic changes. Conclusion : Ultrasonography is a valuable tool to assist the diagnosis of canaliculitis.(Clinical trial registration number: ChiCTR1900025411).

Purpose : The purpose of this report is to present an extremely rare case of endogenous Listeria monocytogenes endophthalmitis. Methods : A 72-year-old woman was diagnosed with endogenous endophthalmitis. Listeria monocytogenes was identified by culture of aqueous humor. Multiple investigations could not reveal any source of infection. An overview of other published cases is presented and a standardized treatment protocol is suggested. Results : Treatment consisted of topical therapy with antibiotics, corticosteroids, cycloplegics, and intraocular pressure-lowering agents, four intravitreal injections of vancomycin, an anterior chamber washout, intravenous amoxicillin, and eventually a pars plana vitrectomy. The inflammation subsided and the patient was discharged with a best-corrected visual acuity of 20/40. Conclusion : Our study emphasizes the importance of adequate microbiological testing and initiating appropriate treatment early in the management of endogenous endophthalmitis.

Purpose : We aim to look at the complications encountered by a cohort of pediatric uveitis patients from north India. Methods : Retrospectively, complications seen in patients younger than 16 years diagnosed with uveitis between January 2006 to March 2015 were noted. Results : Data of 104 children, with a mean follow-up of 3.40 ± 2.34 years was studied. Cataract (n = 42, 24.00%), band-shaped keratopathy (n = 32, 18.29%) and Glaucoma/OHT (n = 11, 6.29%) were most encountered complications at presentation. Glaucoma/OHT (29.71%; n = 52), cataract (18.86%; n = 33) and maculopathy (n=12;6.86%) were the most common complications at follow up. Maculopathy (35%) and Glaucoma/OHT (20%) were the most common causes of visual acuity ≤3/60. Conclusions : Cataract is the most critical complication in children with uveitis at presentation and raised intraocular pressure occurs at follow-up, perhaps attributed to the treatment. Maculopathy is the most common cause of blindness in these children.

With modern technology and peri-op antibiotic use, postoperative endophthalmitis is uncommon to modern cataract surgery, and its recurrence even more unusual. Enterococcal faecalis endophthalmitis is an acute type of endophthalmitis that is not only rare, but can be recurrent, and has a poor functional prognosis [1]. Since the disease is refractory to conventional therapy, this paper details our experience with treating the disease given the current lack of standard care both medically and surgically.

Purpose : To analyze the abnormalities of foveal microvasculature in patients with systemic lupus erythematosus (SLE). Methods : A cross-sectional study of 41 eyes of patients diagnosed with SLE and 40 eyes of healthy controls. Sections measuring 6 mm×6 mm centered on the fovea were obtained using optical coherence tomography angiography (OCTA). Results : The area and perimeter of foveal avascular zone (FAZ) in SLE patients were greater than those in controls (both p < .05). The parafoveal vessel densities in the deep capillary plexus (DCP) of SLE patients were significantly decreased than those in controls ( p < .001). There was a negative correlation between SLE disease activity index and parafoveal vessel density in DCP ( p < .05). Conclusion : Enlargement of the FAZ and decline of the parafoveal vessel density of DCP were revealed by OCTA in patients with SLE. Moreover, a negative correlation between parafoveal vessel density in DCP and disease activity index was detected in SLE patients.

Purpose: To report the ultrasound biomicroscopic features of normal lower eyelid structures., Methods: Thirty lower eyelids of fifteen healthy adults were randomized and prospectively subjected to Ultrasound Biomicroscopy (Quantel Aviso with 50 MHz transducer) by two independent observers (an ophthalmologist and an optometrist). The measurements were performed in upgaze, with the probe perpendicular to the lower eyelid margin in the mid-pupillary line, two limbal lines, and two canthal lines. The tarsus, orbicularis, capsulopalpebral fascia, and retractor-conjunctiva complex were assessed for two parameters: echogenicity (hyper/hypoechoic) and measurement in millimeters., Results: Mean age was 25 years (range 20-39 years), 15 (50%) were right lower eyelids and 8 were males. The first layer, skin-orbicularis complex appeared hyperechoic. The second layer was hypoechoic band which represents the tarsal plate superiorly and capsulopalpebral fascia inferiorly. This was noted to be continuous and of almost uniform thickness in the normal eyelids. The glandular structure of meibomian glands was identified in 100% cases. The hyperechoic layer below the capsulopalpebral fascia is the retractor-conjunctiva complex. The mean thickness of pretarsal and pre-septal orbicularis was 0.68 ± 0.18 mm and 0.89 ± 0.16 mm, respectively. The tarsal plate measured 0.57 ± 0.12 mm, capsulopalpebral fascia 0.42 ± 0.13 mm and the retractor-conjunctiva complex 0.79 ± 0.18 mm. On Bland-Altman analysis, the majority of the measurements had mean agreements between -0.14 mm and +0.12 mm. Anatomical differentiation was not useful in the canthal region., Conclusion: Echogenicity and thickness of normal lower eyelid structures as measured by UBM are reported. The test is non-invasive, with a good inter-observer agreement.

Purpose: Our purpose is to report a patient with primary unilateral ciliary body marginal zone lymphoma who initially presented with hemorrhagic hypopyon., Methods: Retrospective review of the clinical, imaging, and immunohistopathological features of the case was performed., Results: A 59-year-old man was referred with right anterior uveitis of unknown etiology which was unresponsive to systemic treatment. Slit-lamp biomicroscopy showed normotensive hemorrhagic hypopyon in that eye. Anterior segment ultrasound biomicroscopy revealed an iridociliary mass lesion. Because an anterior chamber paracentesis was noncontributory, a diagnostic cyclectomy was performed. Histopathological evaluation showed that the neoplastic cells were positive for CD20, lambda light chain, and BCL 2. BCL 6, CD10, CD5, SOX11, kappa, and Cyclin D1 stains were negative. The final diagnosis was extranodal marginal zone lymphoma of the ciliary body., Conclusions: Although rare, ciliary lymphoma may be a cause of intractable anterior uveitis. Repeat biopsies could be carried out when there is a high level of clinical suspicion.

Purpose : To describe the clinical course and management of anterior uveitis complicated by ocular hypotony associated with Hodgkin lymphoma. Design : Case report. Methods : Chart and multimodal imaging review, including ultrasound biomicroscopy, widefield fundus pictures, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography. Results : A 44-year-old female with progressive visual deterioration and history of low-grade fever developed bilateral granulomatous anterior uveitis complicated by severe hypotony maculopathy, not improving with systemic and topical steroids. After starting ibopamine 2% eye drops, ocular hypotony progressively resolved with visual recovery. Histologic examination of a biopsied enlarged lymph node of the neck revealed the presence of Hodgkin lymphoma, for which the patient underwent systemic chemotherapy. Conclusion : Severe hypotony maculopathy complicating anterior uveitis can be associated with Hodgkin lymphoma. Topical ipobamine 2% was safe and effective in the treatment of ocular hypotony in this case.

Ocular tuberculosis can manifest in a wide variety of clinical presentations. The prevalence is higher in endemic areas as a cause of granulomatous uveitis. While posterior segment manifestations are well known, anterior segment granulomas alone are relatively rare. We report two cases of unilateral iris granulomata in two young patients who presented with decreased vision and redness and were found to have well-circumscribed iris granulomas. Both underwent systemic evaluation and had a negative Mantoux test. Biopsy pathology of the lesions revealed granulomatous inflammation but were negative for PCR, staining, and culture for TB. One patient turned out to have multiple pulmonary lesions. The ocular condition initially worsened with steroid therapy alone and improved and resolved completely after starting a 9 months course of anti-tubercular therapy (ATT).

Canaliculops is a non-inflammatory dilatation of the canaliculus which can be secondary to trauma, punctal agenesis, herpetic infections or chronic drug use. This condition can affect either canaliculi and has shown female preponderance. Treatment described so far has consisted of cyst marsupialization with no literature on the post-operative epiphora in these cases. We describe two cases of canaliculops with punctal agenesis where we have tried to establish lacrimal patency.

Background: To evaluate the risk factors associated with failure to correct hypotony using direct cyclopexy in patients with traumatic cyclodialysis cleft., Methods: In a series of 116 patients with traumatic cyclodialysis who underwent direct cyclopexy at Zhongshan Ophthalmic Center from January 2008 to August 2018, the clinical correlation between the risk factors and failure of the operation were retrospectively studied, after adjusting for other potential confounders., Results: The curative ratio after one procedure was 82.76%, whereas 20 (17.24%) eyes experienced treatment failure after the first surgery. The degree of anterior chamber angle closure was significantly wider in patients with a failed first surgery than in patients for whom one procedure was a success ( p = .046). The risk of failure to achieve closure increased as the angle-closure exceeded 5 clock hour (odds ratio, 10.39; 95% confidence interval, 1.75-61.72; p = .010). An analysis of the recurrent position indicated that an angle closure exceeding 5 clock hour may impede accurate cleft location and is thus associated with an increased risk of failure to correct hypotony., Conclusion: Exceeding the threshold of 5 clock hour in anterior chamber angle closure may impede accurate cleft location and, thus, present a higher risk of failure to correct hypotony using direct cyclopexy. These patients may need injection of a viscoelastic agent into the anterior chamber by paracentesis to deepen the anterior chamber and to delineate the clefts using gonioscopy pre- or intraoperatively.

Purpose: To investigate the clinical features and efficacy of lens surgery in patients with lens subluxation misdiagnosed as primary angle-closure glaucoma., Methods: In total, 2054 inpatients with primary angle-closure glaucoma were consecutively recruited. Eighty-five of the patients were rediagnosed as lens subluxation following ultrasound biomicroscopy after hospitalization. Lens surgeries were performed in all patients, and 35 had a follow-up of at least 12 months. Risk factors of postoperative intraocular pressure control were identified with multivariate logistic regression analysis., Results: Eighty-five inpatients (4.1%, 85/2054) with lens subluxation were misdiagnosed as primary angle-closure glaucoma, of which 71.8% (2.97% of all cases, 61 out of 2054 subjects) had ocular blunt trauma and 18.8% (0.78% of all cases, 16 out of 2054 subjects) had spontaneous dislocation. Lens surgery significantly decreased the intraocular pressure and improved best-corrected visual acuity, meanwhile increased the anterior chamber depth (all P < 0.001). Postoperatively, the intraocular pressure was controlled with antiglaucomatous eye drops administration in 17 eyes, in which greater range of preoperative angle closure and zonular dialysis, and longer operation time delay were detected. Risk factors for poor postoperative IOP control were more quadrants of angle closure (P = 0.038) and operation time delay (P = 0.045)., Conclusion: Lens subluxation was the major cause of the misdiagnosed cases as primary angle-closure glaucoma. Misdiagnosed patients could benefit from the lens surgery, while more angle-closure quadrants and operation time delay indicated worse postoperative intraocular pressure control.

Background: Oculodentodigitaldysplasia (ODDD; MIM no. 164200) is a rare hereditary disorder caused by mutations in the gene GJA1.Ocular disorders included microcornea, cornea opacity and glaucoma. However, few studies described fundus findings., Materials and Methods: Ophthalmic examination included visual acuity measurement, intraocular pressure (IOP) measurements, slit-lamp biomicroscopy, B-scan ultrasonography, Ultrasound biomicroscopy (UBM), spectral-domain optical coherence tomography (SD-OCT), ERG and retcam fluorescein angiogram. In addition, blood samples were taken from this patient for mutation analyze of GJA1., Result: The ophthalmic features of this patient were microcornea, cornea opacity, glaucoma as expected. Interestingly, the patient had a normal axial length with refractive status of emmetropia, but extremely retinal dysplasia and severe choroid thinning was noted. Flash electroretinogram (ERG) was extinguished in both eyes. This study identified a novel mutation c.91A>T in the GJA1 gene associated with fundus abnormalities. Bioinformatics and structural modeling suggested the mutation to be pathogenic., Conclusion: Our research expanded not only the mutation spectrum, but also the clinical characteristics of ODDD. To the best of our knowledge, this is the first report on anatomical and functional chorioretinal changes in ODDD patients. These novel ocular features highlight the importance of fundus morphological and functional evaluation in ODDD., Abbreviations: ODDD: oculodentodigital dysplasia; OCT: optical coherence tomography; ERG: electroretinogram; TACT: teller acuity card test; UBM: ultrasound biomicroscopy; MW: molecular weights; AL: axial length; Cx43: connexin 43; RPE: retinal pigment epithelium; RGCs: retinal ganglion cells; FEVR: familial exudative vitreoretinopathy; ROP: retinopathy of prematurity.

Introduction: Postoperative capsular bag distension syndrome (CBDS) is a rare complication of cataract surgery which might occur in the early postoperative period, as well as several years after uncomplicated surgery. The aim of this study was to review the current evidence on postoperative capsular bag distension syndrome. Material and Methods : PubMed and Web of Science were used for literature search. Results : The typical presentation involves deterioration in visual acuity, unexpected myopic shift or less frequently hyperopia. In eyes with clear capsular fluid and no posterior capsule opacification, usually in the late postoperative period, CBDS can be asymptomatic. Risk factors for developing CBDS include retained ophthalmic viscoelastic device, inadequate subincisional cortex cleaning, apposition between the intraocular lens (IOL) and the capsular bag, postoperative inflammation and IOL sequestration with Propionibacterium acnes . Visualization of the CBDS can be aided with Scheimpflug imaging, ultrasound biomicroscopy, and particularly anterior-segment optical coherence tomography. Conclusion: Nd:YAG posterior capsulotomy, and in some cases anterior capsulotomy, is accepted as a standard and effective CBDS treatment. Surgical approach could be beneficial in cases suspected of Propionibacterium acnes presence or when it is impossible to perform Nd:YAG posterior capsulotomy.

Purpose: To report the occurrence and management of secondary choroidal infiltration in two retinoblastoma (rb) patients., Methods: Fundus examination and imaging with spectral domain optical coherence tomography (SD-OCT), B-scan ultrasonography (B-scan), and ultrasound biomicroscopy (UBM)., Results: Case 1: A 19-month-old girl with multifocal unilateral group B rb pretreated with intravenous chemotherapy (IVC) was referred for further management. At 3.5 years of age, routine 3-Tesla magnetic resonance imaging (3T-MRI) revealed an asymptomatic pinealoblastoma that underwent resection and adjuvant intensive IVC. Concomitant ophthalmic follow-up revealed a recurrence 8.3 × 2.8 mm at the posterior pole nasally to the optic disc on B-scan, localized within the choroid on SD-OCT and 3T-MRI. With high dose IVC ongoing, total regression of the choroidal mass was confirmed on SD-OCT already after 3 weeks. At 6-month follow-up, choroidal and pineal tumors were in complete remission. Sadly, the child died of intravascular disseminated coagulation-like disease after the 5th IVC. Case 2: A heavily pretreated 20-month-old girl with bilateral rb was referred for persistent vitreous seeding in her remaining eye (OD). Three months after intravitreal chemotherapy and chemothermotherapy, a hemorrhagic mass was observed inferior to the primary tumor. Two weeks later, an underlying peripheral choroidal mass 16 × 6 mm was documented by UBM and confirmed by 3T-MRI. Complete resolution was achieved 3 weeks after combined intra-arterial chemotherapy (IAC) of melphalan-topotecan. No recurrence or metastasis was observed at 34-month follow-up., Conclusion: Isolated massive choroidal invasion can be treated conservatively with IVC or IAC in selected cases. SD-OCT, UBM, and B-scan ultrasonography are instrumental in the detection and follow-up of choroidal lesions.

Purpose: Our aim was to examine the associations between the cornea morphological parameters, endothelial cell density, and anterior chamber measurements., Methods: This observational study included 50 eyes of 50 healthy volunteers. The thicknesses of corneal epithelium, Bowman's layer, stroma, Descemet's membrane-endothelium complex, and pre-ocular tear film were measured by means of anterior segment optical coherence tomography. The keratometry (K), corneal volume (CV), corneal optical densitometry (COD), iridocorneal angle (ICA), anterior chamber depth (ACD), and anterior chamber volume (ACV) measurements were taken by the Scheimpflug anterior segment imaging. The corneal endothelial cell density and percentage of hexagonality were measured by specular microscopy., Results: The COD was only correlated with the thickness of Bowman's layer (r = -0.30, p = 0.035). The hexagonal endothelial cell percentage was correlated with the thickness of the pre-ocular tear film (r = -0.50, p < 0.001), ACD (r = 0.40, p = 0.004), and ACV (r = 0.34, p = 0.015). The corneal epithelium thickness was associated with the ACD (r = 0.30, p = 0.034), ACV (r = 0.34, p = 0.018), K-flat (r = -0.35, p = 0.013), and K-steep (r = -0.29, p = 0.038) readings., Conclusions: The anterior chamber morphological parameters (i.e., ACV, ACD) were significantly positively correlated with the hexagonal endothelial cell percentage and corneal epithelium thickness in healthy adults.

Purpose: To report a case of circumferential neuroepithelial cyst of the ciliary body presenting with pigment dispersion (PD) and ocular hypertension., Case Report: 48-year-old female patient presented with a complaint of pain in the left eye. On examination, visual acuity of the left eye was 0.9, and the intraocular pressure was 48 mmHg. Biomicroscopic anterior segment examination of the left eye revealed 4+ pigmented cells in the anterior chamber. Active PD from the pupillary region at 11 o'clock was noticed at the time of the examination. Ultrasound biomicroscopy demonstrated 360º cystic lesions of the ciliary body in the left eye. The patient was diagnosed as neuroepithelial cyst of the ciliary body., Conclusion: Our case is unique as it is the first case of circumferential neuroepithelial ciliary body cyst presenting with acute PD and ocular hypertension.

Purpose: To characterize the clinical features of scleritis in Chinese patients., Methods: The history, demographics, ocular findings, auxiliary examination findings, complications, systemic diseases and therapeutic effects were analyzed retrospectively., Results: The study included 124 male and 169 female patients with scleritis. Anterior and posterior scleritis were, respectively, found in 243 and 42 patients. The other eight patients had both anterior and posterior involvement. The mean age of scleritis onset was 39.4 years. Systemic diseases associated with scleritis mainly included rheumatoid arthritis (RA) (4.4%), ankylosing spondylitis (AS) (3.4%), and tuberculosis (1.7%). Anterior uveitis (23.7%), complicated cataract (16.7%), and intraocular hypertension (12.6%) were common complications of scleritis. Scleritis was controlled in 94.6% of the patients treated with corticosteroids combined with immunosuppressive agents., Conclusions: Diffuse anterior scleritis was the most common scleritis entity in China. RA and AS were relatively common diseases associated with scleritis. Corticosteroids combined with immunosuppressive agents effectively controlled the disease.

Purpose: To analyze the safety and efficacy of sustained-release intravitreal dexamethasone implant (Ozurdex) in management of TB-associated multifocal serpiginoid choroiditis (MSC)., Methods: Retrospective review of TB-associated MSC patients, treated with anti-TB therapy (ATT) and adjunctive intravitreal Ozurdex., Results: Nine eyes of six patients were included. Four patients required Ozurdex implant for progressive or new lesions following ATT and two for additional systemic contraindications to corticosteroids - hyperglycemia and uncontrolled hypertension, respectively. The mean time to resolution was 9.17 ± 7.71 weeks. The mean follow-up post-injection was 13.11 ± 6.05 months (median 12 months [range 6-24.5 months]). Only one of nine eyes developed recurrent MSC lesions and this was attributed to possible autoimmune etiology. Two eyes (22.2%) developed steroid-induced glaucoma - one required implant removal., Conclusions: Sustained-release intravitreal dexamethasone is a safe and efficacious adjunctive anti-inflammatory therapy for TB-associated MSC patients with contraindication for systemic corticosteroids or requiring supplemental anti-inflammatory therapy.

Chikungunya virus (CHIKV) is an RNA virus transmitted by Aedes mosquitoes. The clinical manifestations include fever, arthralgia, rash, and other atypical clinical findings including ocular lesions. We report the case of a 57-year-old man with meningoencephalitis and anterior uveitis due to CHIKV. The patient had developed bilateral anterior uveitis with iris atrophy and a cotton wool spot on the left eye, and his serum, urine, saliva, and cerebrospinal fluid were positive for CHIKV by RT-PCR. The spectrum of the ophthalmologic manifestations and its pathophysiology in cases of CHIKV infections needs to be better understood. Additional studies examining the ocular lesions caused by CHIKV could improve the therapeutic goals of reducing the morbidity and sequels.

Purpose: To report the findings in a patient with congenital primary aphakia, a rare disease known to be caused by mutations in the FOXE3 gene., Methods: The clinical appearances and visual functions of the patient were determined from the medical records. Genetic analyses were performed to search for mutations in the FOXE3 gene by Sanger sequencing and whole exome sequencing., Results: The 2-month-old male patient first presented with bilateral congenital aphakia associated with microphthalmia, corneal opacity, and dysplasia of the anterior segment. At the age of 2-years, his visual acuity in the left eye was 20/1000 at 30 cm, he was able to discriminate red, blue, and yellow light stimuli, and a b-wave was recorded by scotopic combined rod-cone electroretinograms. The right eye became blind during the follow-up period. No mutation in the FOXE3 gene was detected., Conclusion: Although congenital aphakia is known to be caused by mutations in the FOXE3 gene, the results of lack of coding mutation in this patient suggests a possible genetic heterogeneity of the disease.

Background: To test whether biodegradable curcumin-loaded scleral plug is a promising choice for treating posterior ocular diseases, the study investigated the in vitro release profile of the scleral plug and its safety in vivo., Methods: Scleral plugs containing 0.5 mg, 1.0 mg and 1.5 mg curcumin were synthesized by a compression-sintering method. These scleral plugs were placed in tubes containing balanced salt solution (BSS) buffer, which was replaced by fresh buffer daily. The curcumin concentration in the removed aliquot was tested daily for 14 days using high-performance liquid chromatography (HPLC). In the study, 44 rabbits were randomly divided into four groups: control, 0.5 mg, 1.0 mg and 1.5 mg curcumin groups. The scleral plug was trans-scleral fixed in the right eye of the rabbits in the three curcumin-treated groups. The control rabbits only received sclerotomy. The treated rabbit eyes were examined by a slit-lamp biomicroscope, an indirect ophthalmoscope and electroretinogram (ERG), and subjected to histological analysis., Results: The concentration of the 1.5 mg curcumin-loaded scleral plug was higher than 15 μg/ml for consecutive 14 days in vitro. The in vivo experiments revealed intraocular pressure, a-wave and b-wave amplitudes of ERG, and conjunctival reaction degree were not significantly different between the four groups. Retinal structure was normal in the curcumin-treated groups. The sclerotomy wound healed after the plug was completely degraded. Anterior chamber reaction or complications were not observed., Conclusion: The study suggests that curcumin-loaded scleral plug could sustain high concentration of curcumin in vitro and is safe in vivo. It might be a promising alternative choice for the treatment of posterior ocular diseases.

Purpose: To assess 24-hour fluctuations in Schlemm's canal (SC) parameters (cross-sectional area, perimeter) and intraocular pressure (IOP) and the relationship between these fluctuations in healthy individuals., Methods: SC and IOP were examined in 29 participants at 2:30, 5:30, 11:30, 17:30, and 23:30 within one day. The superior, inferior, nasal, and temporal SC quadrants were evaluated using 80-MHz ultrasound biomicroscopy., Results: SC parameters and IOP fluctuated significantly within 24 hours (all P < 0.05). After age, gender, axial length, and central corneal thickness were adjusted, compared with the baseline (23:30) value, the change in SC cross-sectional area was negatively associated with the change in IOP at 2:30, 5:30, 11:30, and 17:30 (β = -0.072[-0.094, -0.049], -0.070[-0.102, -0.038], -0.046[-0.079, -0.013], and -0.033[-0.062, -0.004], respectively; P < 0.001, < 0.001, = 0.009, and = 0.028, respectively). The nasal (175.6 ± 36.0 pixels) and inferior (174.8 ± 36.0 pixels) SC cross-sectional areas were significantly larger than the superior area (156.2 ± 27.1 pixels) (P = 0.018 and 0.048, respectively) at 23:30. The observable SC proportion did not change among the quadrants or measurement time points (all P > 0.05)., Conclusions: SC cross-sectional area fluctuated throughout the day and was negatively associated with changes in IOP.

Anterior uveitis is the most common group of uveitis worldwide, with a diverse spectrum ranging from autoimmune and infectious to masquerade etiologies. Elucidation of the underlying etiology may be challenging, but it remains important, especially for recurrent uveitis. Multimodal imaging has improved our understanding and management of many posterior uveitis and panuveitis. Similarly, a wide variety of anterior segment ophthalmic imaging techniques are available to allow the monitoring of the structural changes that may develop during anterior uveitis. These include anterior segment photography, specular microscopy, in vivo confocal microscopy, anterior segment optical coherence tomography (AS-OCT), ultrasound biomicroscopy (UBM), laser flare photometry, and less commonly used techniques such as anterior segment fluorescein and indocyanine green angiography, iris autofluorescence, and infrared imaging. This review recapitulates the past and recent application of these ophthalmic imaging modalities to the diagnosis and management of anterior uveitis.

Purpose: To compare the efficacy of bevacizumab over mitomycin C (MMC) modulated trabeculectomy in cases of primary open angle glaucoma (POAG)., Method: In this prospective randomized controlled study, 80 eyes of 80 patients with uncontrolled POAG or intolerant to antiglaucoma medications were randomized to two groups: Group 1 (n = 40) patients underwent trabeculectomy modulated with MMC (0.2 mg/ml), whereas Group 2 (n = 40) patients underwent trabeculectomy modulated with bevacizumab (1.25 mg/0.05 ml). The outcome measures were best corrected visual acuity (BCVA), intraocular pressure (IOP), number of glaucoma medications and bleb morphological features based on Moorfields Bleb Grading System (MBGS). All patients were followed up for one year post trabeculectomy., Results: The mean preoperative IOP in the bevacizumab group improved from 22.41 ±1.08 mm Hg with 3.2 ± 0.9 glaucoma medications to 13.68 ± 0.79 mm Hg with 0.11 ± 0.32 glaucoma medications at one year (P < 0.001). The mean preoperative IOP in the MMC group improved from 22.64 ± 0.90 mm Hg with 3.1 ± 0.8 glaucoma medications to 13.84 ± 0.73 mm Hg with 0.17 ± 0.38 glaucoma medications at one year (P < 0.001). IOP was comparable between two groups at one year (P = 0.43). No significant differences were found in bleb morphological features based on MBGS regarding central bleb area, peripheral bleb area, height and central vascularity between the two groups at six months and one year. However, there was a statistically significant difference in peripheral bleb vascularity and peripheral non-bleb vascularity with bevacizumab group exhibiting a low degree of vascularity at one year (P = 0.029 and 0.004, respectively)., Conclusion: Adjunctive bevacizumab in trabeculectomy is effective and comparable to MMC for controlling IOP in POAG patients for the first year.

Purpose: To describe the genotype and phenotype of patients with autosomal recessive bestrophinopathy (ARB), and heterozygous carriers., Methods: The members of three unrelated ARB families were investigated. Molecular genetic analysis was performed on 11 members of these families. Ten members were examined clinically; including visual acuity, slit-lamp examination, biomicroscopy, fundus photography, and Goldmann applanation tonometry. Measurements were also made of the anterior chamber depth and axial length, and optical coherence tomography (OCT), electrooculography (EOG), and full-field electroretinography (full-field ERG) were performed. Multifocal electroretinography (mfERG) was performed on eight members of these families., Results: Two novel combinations of missense mutations in the BEST1 gene were identified: p.R141H/p.M325T in three patients with ARB in two unrelated Norwegian families, and p.R141H/p.I201T was found in an ARB patient in a Swedish family. All four patients with ARB had clinical and electrophysiological features of ARB. All the heterozygous carriers of the p.R141H mutation were clinically normal, and showed normal OCT, EOG and full-field ERG findings, but had mildly abnormal mfERG results. Only one heterozygous carrier of the p.M325T mutation was studied and he was clinically normal, showing normal OCT and full-field ERG results, but subnormal EOG and mfERG findings. The heterozygous carrier of the p.I201T mutation was clinically normal, showing normal OCT, EOG and full-field ERG results, but subnormal mfERG results., Conclusions: We have shown that the two novel combinations of compound heterozygous mutations p.R141H/p.M325T and p.R141H/p.I201T in the BEST1 gene can also lead to the ARB phenotype.

Aim and Scope: To address the role of interferon-induced protein of 10 kDa (IP-10) in the course of corneal neovascularization (CrNV) in a mouse model of experimental corneal neovascularization., Material and Method: BALB/c mice that were 7- to 8-week-old male were included in the study. Corneal injury was induced by NaOH. Mice were randomly divided into 2 groups of IP-10 and vehicle. The alkali-treated eyes received 5 μl of 5 μg/ml IP-10 dissolved in 0.2% sodium hyaluronate for IP-10-treated group, or 5 μl of 0.2% sodium hyaluronate for vehicle-treated group twice a day for 7 days immediately after the alkali injury. 2 weeks after alkali injury, corneas were removed and used for whole mount CD31 staining. The percentages of neovascularization on corneal photographs were examined with digital image analysis. In other experiments, at indicated time intervals, the corneas were removed. Angiogenic factor expression in the early phase after injury was quantified by real-time PCR and western blot. The VEGF expression in macrophages infiltrating into burned corneas was examined by Flow cytometry (FCM) and immunofluorescence. Tube formation and cell proliferation of human retinal endothelial cells (HRECs) were detected after being stimulated with IP-10 in vitro., Results: The mRNA and protein expression of IP-10 and C-X-C motif chemokine receptor 3 (CXCR3) was augmented after the alkali injury (p < 0.05). Compared with vehicle-treated mice, IP-10-treated mice exhibited reduced CrNV 2 weeks after injury, as evidenced by diminished CD31-positive areas (p < 0.05). Concomitantly, the intracorneal mRNA and protein expression enhancement of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) was lower in IP-10-treated mice than in vehicle-treated mice after injury (p < 0.05). Moreover, IP-10 inhibited HREC tube formation and proliferation in vitro., Conclusion: IP-10-treated mice exhibited reduced alkali-induced CrNV through decreasing intracorneal VEGF and bFGF expression, and inhibiting endothelial cell proliferation and tube formation.

Purpose: To investigate the change in pre- and post-dilation anterior segment parameters and intraocular pressure (IOP) of patients with and without pseudoexfoliation, after topical application of phenylephrine HCl 10% and tropicamide 1%., Materials and Methods: Totally 129 eyes of 129 patients were included in the study. Of the 129 eyes; 31 had pseudoexfoliation syndrome (PXS), 37 had pseudoexfoliation glaucoma (PXG), 31 eyes were the fellow eyes of subjects with unilateral pseudoexfoliation syndrome (subclinical PXS) and 30 eyes were the eyes of subjects without PXS (controls). Patients underwent Pentacam analysis and IOP measurement before and after dilation. The changes in IOP, anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), central corneal thickness (CCT) and pupillary diameter (PD) were investigated 30 min after the application of mydriatic agents., Results: The mean change of IOP in eyes with PXS, in eyes with PXG, in eyes with subclinical PXS and eyes of control subjects were 1.45 ± 2.03 mmhg, 0.27 ± 2.25 mmhg, -0.35 ± 1.58 mmHg and -1.06 ± 1.59mmHg, respectively. Post-dilation IOP values were lower (p = 0.001) in eyes of controls but higher (p < 0.001) in eyes of PXS than the pre-dilation levels. All patients exhibited statistically significant increase in ACD, ACV and PD after the dilation procedure (p < 0.001). Additionally, post dilation CCT values were significantly lower than pre-dilation values in all groups; the difference was statistically significant only for eyes with PXG, eyes with subclinical PXS and eyes of controls., Conclusion: Eyes with PXS had a higher tendency of IOP elevation after pupillary dilation. Eyes with subclinical PXS, however, exhibited a minor increase in IOP, reflecting the asymmetrical character of the disease. Anti-glaucoma medications may have blunted any IOP elevation induced by pupillary dilation in eyes with PXG.

Purpose: To study the relationship between phacoemulsification-related changes and the baseline parameters of the anterior chamber., Setting: Military Institute of Medicine, Warsaw, Medical University of Lublin, Medical University of Bialystok., Material and Methods: The study included 228 patients. Anterior chamber depth (ACD), trabecular-iris angle (TIA), central lens thickness (CLT) and axial length of the eye (AXL) were determined prior to and 6 months after surgery. These measurements were used to calculate the ACD(index) describing the degree of postoperative changes in the anterior chamber. K-means clustering, multiple regression and neural networks were used for the analysis., Results: Cataract surgery was reflected by changes in ACD and TIA. The character of changes was described by ACD(index) (p < 0.05). Mean ACD0 was 2.51 ± 0.45 mm and increased to 3.84 ± 0.35 mm (p < 0.05), whereas mean TIA0 was 22.84 ± 7.43° and increased to 30.97 ± 7.99° (p < 0.05). ΔACD and ΔTIA were determined on the basis of baseline parameters defined by ACD(index), characterizing the structural type of the eye. The variability of ACD(index) explained 42.65% of variance in ΔACD and ΔTIA. The quality of network for validation and test samples was from 0.72 to 0.83., Conclusions: Cataract surgery-related changes in ACD and TIA are determined by the type of the eye. Although the linear model of the relationship between baseline parameters of the eye and their postoperative changes is correct, it does not explain the degree of the latter phenomenon. Preoperative consideration of other parameters characterizing anatomical relationships of the eye would enable the prediction of phacoemulsification-related changes in the anterior segment.

Purpose: To study the efficacy of ultrasound biomicroscopy (UBM) in assessment of extraocular muscle insertion sites after strabismus surgery., Methods: This double masked prospective interventional study included 16 eyes of 15 patients with deviation <60 prism diopters (PD) who underwent primary horizontal strabismus surgery. Preoperative muscle insertion was measured by UBM and compared with measurements done intraoperatively by surgical caliper. Both measurements by surgical caliper were taken intraoperatively before and after performing the planned repositioning of the muscle insertion. Postoperatively muscle insertion was remeasured by UBM and compared with the presumed muscle insertion after surgery. Clinically limits of agreement of ±1 mm were taken as acceptable., Results: Mean age of patients was 21±3 years (range 16-28 years). Preoperative average distance of the medial rectus (MR) from limbus was 5.3±0.3 mm (4.9-5.9 mm) by the UBM and 5.6±0.3 (5-6 mm) by surgical caliper (p=0.05). For lateral rectus (LR), UBM measurements from the limbus were 6.8±0.7 mm (5.9-8.3 mm) and 7.1±0.4 mm (6.5-8 mm) by calipers (p=0.067). Post-op UBM at 3 months could visualize new muscle insertion for all operated MR muscles (i.e., 100% of cases) and for LR muscles in only 50% of cases. However, accuracy could be achieved only in 78.6% of cases for MR muscle and for LR in 62.5% of cases (among LR muscles that were visible post-op). Maximum distance posterior to the limbus that the UBM was able to detect MR was 11.2 mm and for LR was 13.5 mm., Conclusion: UBM does not detect the new position of LR with any consistency postoperatively. Even after detection of muscle, the new insertion is only within ±1 mm of the actual muscle insertion in 62.5% of the cases. Hence it is not a reliable tool for planning resurgery.

Purpose: To evaluate the influence that the origin of incisional vitreous incarceration may have on the presence of postoperative conjunctival blebs over sclerotomies after transconjunctival sutureless vitrectomy (TSV). Blebs are formed by incisional leakage due to incompetent closure., Methods: Twenty-three-gauge TSV was performed in 83 cadaveric pig eyes. Once each vitrectomy was finished, ultrasound biomicroscopy (UBM) was used to assess the presence of postoperative conjunctival blebs over the sclerotomy sites, as well as the existence of vitreous incarcerated in incisions. Vitreous strands may come from the perisclerotomy area, running parallel to the sclera toward the inner hole of the sclerotomies, or may radiate from the core of the vitreous cavity., Results: Vitreous entrapment was found in 73.9% of the sclerotomies; 43.4% of the incisions showed vitreous strands coming parallel to the sclera (12.9% of them showed conjunctival bleb), 19.7% of the wounds presented vitreous aiming toward the core of the vitreous cavity (2% of them had conjunctival bleb) and 10.8% of the entrances presented both vitreous incarceration sources (none of them showed bleb). Incisions with vitreous entrapment parallel to the sclera were associated with a significantly greater sclerotomy leakage rate., Conclusions: Sclerotomies with vitreous incarceration coming from the core of the vitreous cavity showed a greater incisional closure competency than that observed in incisions with vitreous entrapment coming from the pericannular area; if these results were confirmed in humans, different postoperative suture rates may be expected on sclerotomies according to the vitrectomy degree performed in different areas of the vitreous cavity.

Purpose: To compare the corneal biomechanical properties of rheumatoid arthritis (RA) patients with those of healthy controls., Methods: Measurements of 39 eyes of 39 RA patients (patient group) were compared with those of 55 eyes of 55 healthy controls (control group). Corneal hysteresis (CH), corneal resistance factor (CRF), intraocular pressure (IOP), and corneal-compensated IOP (IOPcc) were obtained for each subject by the ocular response analyzer (ORA). Corneal thickness (CCT) was measured by ultrasonic pachymeter., Results: CH and CRF were significantly lower in the patient group than in the control group (p1 = 0.002, p2 = 0.019, respectively). The patient group had significantly higher IOPcc values than the control group (p = 0.024). There was no significant differences between the groups concerning CCT and IOP., Conclusions: RA patients had lower CH and CRF, but higher IOPcc values than healthy controls. RA should be considered when the corneal biomechanical properties measured by the ORA are used for diagnoses or therapies.

Purpose: To investigate and compare the efficacy of autologous serum eye drops with amniotic membrane transplantation in eyes with neurotrophic corneal ulcers., Methods: In this retrospective study, 42 eyes of 42 patients (30 females and 12 males) with neurotrophic corneal ulcers were included and divided into group I (n = 20) who were treated with autologous serum eye drops and group II (n = 22) who underwent amniotic membrane transplantation. The epithelial healing time and best corrected visual acuity were performed before and after treatments., Results: In group I, the mean age was 57.1 ± 10.1 years; and at the end of 6.7 ± 2.05 months follow up, 14 (70%) of 20 eyes healed completely with a minimal scarring and vascularization. Two patients had persistent epithelial defects, four patients healed incomplete because of deep stromal ulcers in eyes with post-herpes neurotrophic ulcers. In group II, the mean age was 58.7 ± 14.7 years. Seventeen eyes (72.7%) of 22 patients healed completely and there was no recurrence in these patients at the 6.8 ± 3.9 months follow-up period. Two incomplete healed patients had persistent epithelial defects caused by HSV and the other three patients had deep stromal ulcers caused by the abuse of topical anesthetics. The mean epithelialization time was 22.1 ± 8.0 days in group I and 20.0 ± 4.64 days in group II. In group I, best corrected visual acuity improved in 18 of 20 (90%) eyes and 17 of 22 (77.2%) eyes in group II., Conclusions: Both autologous serum eye drops and amniotic membrane transplantation are effective for eyes with neurotrophic corneal ulcers because of many epitheliotrophic factors. Also, we observed that multilayered amniotic membrane transplantation is more effective than autologous serum in deep corneal ulcers with postherpes neurotrophic keratitis in our cases.

Purpose: To report on severe HLA B27-associated anterior uveitis complicated by vitritis, hypotony, and serous retinal detachment., Methods: Retrospective case series., Results: Five patients with HLA B27-associated uveitis presented with an acute anterior uveitis complicated by vitritis, hypotony, serous retinal detachment, and ciliochoroidal effusion. Two patients had previously acute anterior uveitis and two suffered from HLA B27-associated systemic disease. Laboratory and imaging examinations did not reveal another cause of uveitis. Despite the aggressive treatment a prolonged and slow recovery followed. Four patients developed macular edema and one additional patient developed a macular pucker. Finally, 3 eyes improved, 2 eyes developed atrophy, and 1 was lost at 4-month follow-up with visual acuity of hand movements., Conclusions: The authors conclude that severe uveitis with a serous retinal detachment might develop in HLA B27-positive patients and may be complicated by protracted hypotony, macular edema, and poor visual outcome.

The use of nanoparticles in consumer products increases their prevalence in the environment and the potential risk to human health. Although recent studies have shown in vivo and in vitro toxicity of titanium dioxide nanoparticles (nano-TiO2), a more detailed view of the underlying mechanisms of this response needs to be established. Here, the effects of nano-TiO2 on the DNA damage response and DNA replication dynamics were investigated in human dermal fibroblasts. Specifically, the relationship between nano-TiO2 and the DNA damage response pathways regulated by ATM/Chk2 and ATR/Chk1 was examined. The results show increased phosphorylation of H2AX, ATM, and Chk2 after exposure. In addition, nano-TiO2 inhibited the overall rate of DNA synthesis and frequency of replicon initiation events in DNA-combed fibres. Taken together, these results demonstrate that exposure to nano-TiO2 activates the ATM/Chk2 DNA damage response pathway.

Purpose: To report the clinical features of Vogt-Koyanagi-Harada syndrome presented with bilateral acute angle closure glaucoma in 4 Chinese patients., Methods: The medical records were retrospectively reviewed., Results: Visual acuity ranged from counting fingers before the eye to 6/30. Intraocular pressure ranged from 22.2 to 29.7 mmHg with or without anterior chamber inflammation. Mild vitritis and massive exudative retinal detachment were seen. B scan and fundus fluorescein angiography supported the diagnosis. After corticosteroid treatment, the increased intraocular pressure was resolved with deepened anterior chamber and open angle. Inflammation was controlled and visual acuity was improved., Conclusions: Bilateral acute angle closure glaucoma could be the initial symptom of Vogt-Koyanagi-Harada syndrome. Mild increased intraocular pressure in association with moderate to severe visual disturbance in both eyes is an important sign of this diagnosis. Careful fundus examination and B scan are helpful in diagnosis.

Spontaneous posterior capsule rupture is a very rare entity and its association with lens-nucleus dislocation even more. Herein we report such a case of spontaneous posterior capsule rupture with lens dislocation in a case of Pseudoexfoliation Syndrome.

Anterior segment imaging allows objective assessment of the anterior segment of the eye, particularly the anterior chamber angle. Both qualitative and quantitative analyses are possible and aid in detecting and managing closed-angle and open-angle mechanisms in various forms of glaucoma. This review focuses primarily on anterior segment optical coherence tomography and ultrasound biomicroscopy, with emphasis on principles of technology, commercially available devices, and clinical applications in glaucoma with potential advantages and disadvantages of each technology.

Purpose: The purpose of this paper is to describe ophthalmic findings in a family with isolated ectopia lentis (EL) caused by a specific FBN1 mutation., Methods: Detailed family histories and clinical data were recorded for six isolated EL patients of 11 family members. The ophthalmological and systematic examinations were performed on patients and unaffected members of the investigated family. The detailed ocular examinations included visual acuity, anterior chamber depth, pupil size, lens location, optometry, central corneal thickness, keratometry, slitlamp examination, fundus examination, axial length, ocular B-ultrasound, gonioscope checking, ultrasound biomicroscopy (UBM) and intraocular pressure (IOP; Goldmann applanation tonometer). Systematic examinations included the measurement of echocardiogram, height, arm span, skull, face, jaw, tooth, breast bone, spinal column, and skin. Genomic DNA was extracted using the phenol-chloroform extraction method for all subjects, and sequencing was carried out on an ABI Prism 3730 Genetic Analyzer., Results: A heterozygous mutation, c.184C>T (p.Arg62Cys) in exon 2 of FBN1 was identified in all affected members but was not found in any unaffected member of the family. Our study presented detailed clinical manifestations, including some novel ophthalmic findings, such as pupillary abnormality, different types of glaucoma, and progressive hyperopia., Conclusions: Ophthalmic findings and the p.Arg62Cys mutation of FBN1 gene were reported in a family with early-onset isolated ectopia lentis.

Purpose: To evaluate the influence of the cannula removal maneuver on the postoperative incisional vitreous incarceration using an experimental model of vitrectomized eye., Methods: Prospective, experimental, randomized and observer-masked experimental study in which 23-gauge transconjunctival sutureless vitrectomy was performed through oblique sclerotomies in cadaveric pig eyes. Once the vitrectomy was finished, one of the superior cannulas was removed with the light probe introduced through it, and the other cannula was extracted with the cannula plug inserted. Postoperative incisional vitreous incarceration was evaluated by ultrasound biomicroscopy (UBM)., Results: 60 eyes included. Considering the 60 superior sclerotomies whose cannulas were extracted with the light pipe inserted, vitreous incarceration was observed in 35% of them. On the other hand, 71.6% of the incisions whose cannulas were removed with the cannula plug inserted showed vitreous incarceration (p = 0.00013)., Conclusions: Interposing the light probe through the cannula when it is removed seems to reduce the postoperative wound vitreous incarceration rate in our experimental model.

Ocular imaging technologies continue to evolve and play increasingly important roles in both the diagnosis and management of corneal pathology. In addition to improved documentation of exam findings using increasingly better resolution photographs, newer modalities, including specular and confocal microscopy, can facilitate diagnosis by imaging single cell layers within the cornea. Anterior segment optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) can image structures in the cornea and anterior segment which may not otherwise be visible. This is particularly useful in patients with opaque corneas. The ability to topographically map the cornea allows for more accurate pre- and post-operative planning, especially in patients with corneal ectasia. As these technologies develop, their use in specific patient populations, such as children, must be optimized. In this report, we provide an updated analysis of selected imaging modalities used in the diagnosis and management of pediatric corneal pathology.

Anterior segment imaging modalities including anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) are increasingly widespread, and can quantify several parameters of the anterior segment, such as anterior chamber depth and angle anatomy. These parameters are important to assess, particularly in patients with forms of narrow angle glaucoma. In many cases of open and narrow angle glaucoma, cataract extraction has been shown to result in favorable modification of these parameters, and a lasting decrease in intraocular pressure. Anterior segment imaging has the ability to enable the development of predictive models regarding the potential intraocular pressure lowering effect of cataract extraction in a given individual.