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Background. To compare the efficacy and safety of a new ocular insert versus conventional mydriasis in cataract surgery. Methods. We selected 70 patients undergoing cataract surgery. Thirty five patients (Group 1) received instillation of mydriatic drops (tropicamide 1%, phenylephrine 10%, and cyclopentolate 1%) prior to surgery, and 35 patients (Group 2) had a Mydriasert insert (Thóa Pharma) (0.28 mg of tropicamide and 5.4 mg of phenylephrine hydrochloride) placed in the inferior fornix. Pupil size before and after surgery, blood pressure, and heart rate were measured. Results. Before surgery, pupil diameter was 9.44 ± 1.17 mm in Group 1 and 9.05 ± 1.54 in Group 2 (P > 0.05). Twenty four hours after surgery, pupil diameter was 5.20 ± 1.54 mm in Group 1 and 3.33 ± 1.15 in Group 2 (P < 0.001). There were no statistically significant differences in blood pressure or heart rate between groups. Conclusions. The effect of the Mydriasert insert was similar to conventional mydriatic agents. Pupil size was restored to normal faster when using the Mydriasert insert compared with conventional mydriatic agents for pupil dilation. [ABSTRACT FROM AUTHOR]

Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidalmetastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis. [ABSTRACT FROM AUTHOR]

Purpose To report the case of a patient with bilateral choroidal mestastases as the first sign of dissemination of cutaneous malignant melanoma. Methods A 47‐year‐old Caucasian male presented to our emergency department with rapid‐onset blurred vision in his right eye (RE). Ophthalmoscopic examination revealed multiple pigmented placoid lesions located in the posterior pole and half periphery of the retina of both eyes and a serous macular detachment in RE. Optical coherence tomography confirmed the macular neurosensory detachment in the RE Since clinical suspicion of choroidal metastases, we referred the patient to the Oncology Department for systematic study. After an exhaustive study, they concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. Results The patient underwent palliative treatment with chemotherapy with improvement of the visual acuity and reduction of the macular neurosensory detachment in the RE. Nevertheless the patient died months later of the diagnosis of cutaneous melanoma dissemination. Conclusion Dissemination of cutaneous melanoma to the choroid is rare and is a major prognostic factor. In general the treatment of ocular metastases is palliative, because the presence of metastases indicates hematogenous spread of tumor. The objectives are therefore to maximize the quality of life and restore or preserve vision. [ABSTRACT FROM AUTHOR]

Purpose To analyze the visual acuity (VA) in the long term in patients with age‐related macular degeneration (ARMD) treated with ranibizumab with persistent subretinal fluid after induction therapy and / or in the follow‐up. Methods A retrospective study of all patients with ARMD treated with ranibizumab between January 2008 and April 2010 with persistent subretinal fluid for at least one year of follow‐up after the induction therapy with ranibizumab. We reviewed the medical records, optical coherence tomography and fluorescein angiography in all patients included in the study. Results 36 eyes of 34 patients were included in the study of a total of 216 patients analyzed. 19 eyes (52.7%) had persistent and 17 (47.2%) recurrent sub‐retinal fluid during the follow‐up (mean 29.06 ± 9.28 months). The initial mean VA was 0.3 ± 0.2, at 3 months 0.43 ± 0.2 and at the end of the follow‐up 0.41 ± 0.22 (p> 0.05). The appearance of bleeding in the relapse was associated with poorer final VA (p = 0.004). There was no significant difference in final VA in the membrane type, lesion size, presence of pigment epithelial detachment or blood before treatment. 18 eyes (50%) remain on treatment with ranibizumab,16 eyes (44%) are observed and 2 patients died. We did not find differences in VA and central macular thickness between both groups. Conclusion The persistence or recurrence of macular subretinal fluid in patients treated with ranibizumab did not significantly lower visual gain obtained after the induction therapy, despite the discontinuation of treatment during the follow‐up. [ABSTRACT FROM AUTHOR]

Purpose Multiple evanescent white dot syndrome (MEWDS) is included in the "White dots syndroms" group. It is characterized for the presence of small, flat, multifocal, gray‐white lesions ranging in size from 100‐300 µm at external retina or as deep as the retinal pigment epithelium layer. These lesions are found outside the macula in the posterior pole and show a tipical angiography. This disease is self‐limited and treatment is not needed. Methods CASE REPORT Results Case report: we report a case of a 28 years old woman with blurred vision in left eye (OS) of acute onset. On examination the best corrected visual acuity OS was 0.8, nor discromatopsy or afferent pupillary defect were present. Visual field was performed, with an enlargement of the blind spot in OS. The anterior segment was unremarkable on slit lamp examination of both eyes. Fundus examination of the left eye revealed multiple yellow white dots scattered around the posterior pole not extending beyond the major vascular arcade. One month latter, visual field was normal, and the white dots have disappeared. The patient have history of 3 anterior neuritis reported in our hospital, with a detailed and exhaustive neurological examination including magnetic resonance imaging, serological test, autoantibodies and spinal tap, with all results in normal limits. Conclusion MEWDS is a rare entity, of unknown etiology, in which a possible viral origin is postulated that would unleash an immune response. Association with neuritis is not reported. Our patient associates a MEWDS´s case and several of neuritis, what make us think about a common etiopathogenic origin. [ABSTRACT FROM AUTHOR]