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Introduction: Despite good refractive results, implantable collamer lens (ICL) implantation may lead to postoperative complications. One indicator of its safety is the vault size. Our purpose was to evaluate the agreement of vault size measurements between the Pentacam®, the Anterion® and the Spectralis®.Methods: Cross-sectional analysis of eyes previously submitted to ICL implantation. Vault size was evaluated with the Pentacam® HR, the Anterion® and the Spectralis® (anterior segment). Secondarily, the anterior chamber depth (ACD) was evaluated with the Pentacam® and the Anterion®. Images of the same patient were performed on the same day, by the same technician. Vault and ACD measurements were performed by two refractive surgeons. Images were randomly divided into three groups and each group was analyzed one week apart, by each observer, with images in a randomized order.Results: Fifty-five eyes (30 patients) were included. The intraclass correlation coefficient (ICC) for absolute agreement and consistency of vault measurements was good to excellent. The vault measurements obtained with Pentacam® were inferior to those obtained with the Anterion® and the Spectralis® (p0.697). The differences in the vault measurements between the Anterion® and the Pentacam® correlated positively with the increase of the vault size in the Anterion® (p, Introdução: Apesar dos bons resultados refrativos, o implante de implantable collamer lens (ICL) pode levar a complicações pós-operatórias. Um indicador da sua segurança é o tamanho do vault. O nosso objetivo foi avaliar a concordância nas medições do vault entre o Pentacam®, o Anterion® e o Spectralis®. Métodos: Análise transversal de olhos previamente submetidos a implante de ICL. O vault foi avaliado com o Pentacam® HR, o Anterion® e o Spectralis® (segmento anterior). Secundariamente, a profundidade da câmara anterior (ACD) foi avaliada com o Pentacam® e o Anterion®. As imagens do mesmo paciente foram realizadas no mesmo dia, pelo mesmo técnico. As medições do vault e da ACD foram realizadas por dois cirurgiões refrativos experientes. As imagens foram divididas aleatoriamente em três grupos e cada grupo foi analisado com uma semana de intervalo, por cada observador, com imagens em ordem aleatória. Resultados: Foram incluídos 55 olhos (30 doentes). O coeficiente de correlação intraclasse (ICC) para a concordância absoluta e a consistência das medições do vault foi bom a excelente. As medições do vault obtidas com Pentacam® foram inferiores às obtidas com o Anterion® e o Spectralis® (p

Purpose: In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Methods: Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. Results: The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). Conclusion: We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact. RESUMO Objetivo: Neste estudo prospectivo, pacientes com acne vulgaris e indivíduos saudáveis do grupo controle foram comparados em relação ao tempo de ruptura do filme lacrimal, taxa de abandono de glândulas meibomianas e parâmetros da câmara anterior, usando o tempo de ruptura do filme lacrimal topográfico não invasivo, meibografia não invasiva e fotografia de Scheimpflug, respectivamente. Métodos: Setenta e três olhos de 73 pacientes com acne vulgaris e 67 olhos de 67 indivíduos saudáveis foram incluídos. Todos os participantes submetidos ao primeiro tempo de ruptura do filme lacrimal não-invasivo e ao tempo médio de ruptura do filme lacrimal não-invasivo foram avaliados pelo uso do tempo de ruptura do filme lacrimal; perda de glândulas meibomianas foram avaliadas por meibografia; os parâmetros da córnea e da câmara anterior foram medidos por fotografia de Scheimpflug; e, finalmente, as queixas oculares subjetivas foram pontuadas com o uso do questionário do Indice de doenças de superfície ocular. Resultados: Os valores do tempo de ruptura do primeiro filme lacrimal não-invasivo do Grupo com acne vulgaris e do Grupo controle foram 4,7 ± 2,8 e 6,4 ± 3,5 segundos, respectivamente, refererindo-se a uma diferença significativa entre os valores dos grupos (p=0,016). Qualitativamente, o número de olhos com ruptura lacrimal a qualquer momento durante o período de medição foi significativamente maior no grupo de pacientes. (p=0,018). No Grupo com acne vulgaris, a perda de glândulas meibomianas nas pálpebras superiores foi de 33,21 ± 15,5% e nas pálpebras inferiores foi de 45,4 ± 14,5%; por outro lado, no Grupo controle foi de 15,7 ± 6,9% e 21 ± 9,7% respectivamente; ambos os casos referem-se a uma diferença significativa entre os grupos (p=0,000). Conclusão: Encontramos estabilidade comprometida do filme lacrimal em pacientes com acne vulgaris. No entanto, o comprometimento foi de grau muito menor, em comparação com a taxa de perda das glândulas meibomianas que desempenham um papel fundamental na estabilidade do filme lacrimal. Esta condição pode ser documentada de forma objetiva - uma metodologia parcialmente sem contato, totalmente não-invasiva e livre de corantes.

An 18-year-old boy presented to our emergency department with a 1-month history of a painful left eye, photophobia, and progressive blurring of vision. His past ocular history included a penetrating left globe injury, surgically repaired 1 year before. Biomicroscopy revealed a scar in the inferior cornea and a huge epithelial iris cyst, reaching the visual axis (Panel A). BCVA of the left eye was 20/320, and intraocular pressure was 20 mmHg. Further investigation, namely ultrasound biomicroscopy (Panel B), and anterior segment-OCT (not shown) supported this diagnosis. Nd: YAG laser cystotomy was performed to rupture the cyst wall and drain its fluid content. Immediate shrinkage of the cyst was seen, but additional follow-up is required to rule out the development of procedure-related complications and cyst recurrence. With the evolution of surgical techniques, posttraumatic iris cysts have become rare entities. Nevertheless, its recognition and management are mandatory for any ophthalmologist.

Introducción: la clínica del cierre angular primario puede variar desde una sospecha de la enfermedad hasta estadios avanzados del daño glaucomatoso, lo que puede provocar ceguera. Objetivo: describir la epidemiología del cierre angular primario en pacientes pinareños, una vez identificadas las variables sociodemográficas y oculares que determinan su forma clínica. Métodos: se realizó un estudio descriptivo transversal en Pinar del Río, en los años 2013 y 2017, el universo estuvo constituidos por 293 casos nuevos con diagnóstico de cierre angular primario en cualquiera de sus formas clínicas. El análisis estadístico se realizó con el programa SPSS. Resultados: la edad media fue 57,69 ± 7,35 años; predominaron las mujeres (89,5 %) y el 77,2 % evidenció una situación de estrés. Los valores promedio de longitud axial y amplitud de cámara anterior fueron 21,89 ± 0,49 mm y 2,65 ± 0,27 mm. El 87,03 % de los ojos mostró ángulo estrecho. La media de la presión intraocular basal fue de 23,86 ± 5,81. Al analizar las variables sociodemográficas y oculares en relación a la forma clínica, se encontró que los factores que la determinan fueron: edad (p

Se ha realizado una revisión bibliográfica del humor acuoso y del lugar de su producción y drenaje, cámara posterior y anterior haciendo un repaso general de la anatomía del globo ocular. También destacamos, sin profundizar en el tema, el glaucoma, patología que puede desarrollarse por anomalía en la formación, circulación o/y reabsorción del HA. El trabajo se ha dividido en varios apartados: en primero lugar comenzamos con Embriología, donde describimos el proceso de formación del globo ocular, dándole más importancia al desarrollo de las cámaras del ojo y las estructuras que están implicadas en la formación, circulación y reabsorción del HA. El siguiente apartado Anatomía, hacemos una visión general de las diferentes estructuras del ojo. A continuación, adentramos en varios apartados donde se focaliza el principal objetivo de la revisión bibliográfica que se ha realizado: cámara posterior y anterior. En la sección de la cámara posterior describimos los procesos ciliares y la formación del HA, añadiendo la velocidad de producción y la supresión de salida del acuoso. En la cámara anterior explicamos el drenaje del HA y sus diferentes vías de evacuación detallando la anatomía de las estructuras del ojo implicadas. También especificamos la fisiopatología y fisiología seguido del ciclo dinámico. Finalmente, el último apartado se habla del Glaucoma, definiendo en que se basa esta enfermedad y en los diferentes tipos de glaucoma se ven afectados por la formación, circulación y reabsorción del humor acuoso. Universidad de Sevilla. Grado en Óptica y Optometría

Purpose: Pharmacological pupillary dilation is performed in comprehensive ophthalmological examinations and before biometric measurements. So far, there is no consensus regarding its impact on biometric measurements. This study’s aim was to investigate the effects of pharmacological pupillary dilation on ocular biometric measurements in healthy children. Methods: This was a prospective, observational, non-randomized study of children (4-18 years of age) who were admitted for routine ophthalmological examination. Biometric measurements were performed, using a non-contact optical biometry device, both before and after pharmacological pupillary dilation with cyclopentolate hydrochloride. Intraocular lens power calculations were performed using Hill-RBF, Barrett, Olsen, Sanders-Retzlaff-Kraff/Theoretical, Holladay, and Hoffer Q formulas. Descriptive statistical analyses were also performed. The Wilcoxon signed-rank test was used to compare measurements before and after pharmacological pupillary dilation. Relationships between variables were analyzed using the Spearman-Brown rank correlation coefficient. Results: The study included 116 eyes of 58 children (mean age, 8.4 ± 0.32 years; 34 girls). Significant changes were observed after pupillary dilation, compared with before pupillary dilation, in terms of anterior chamber depth, aqueous depth, and central corneal and lens thicknesses. No significant change was observed in axial length. Intraocular lens power calculations revealed no significant changes after pupillary dilation in most formulas except for the Olsen formula. The intraocular lens power was significantly inversely correlated with axial length and anterior chamber depth. Conclusions: Pharmacological pupillary dilation in children appeared to have no impact on axial length and intraocular lens power, but caused a significant increase in anterior chamber depth. The difference in anterior chamber depth measurements before and after pupillary dilation could be related to the optical biometry device model used. These outcomes should be considered in intraocular lens power calculations performed using anterior chamber depth parameters. RESUMO Objetivo: A dilatação pupilar farmacológica é realizada em exames oftalmológicos abrangentes e antes das medições biométricas. Até o momento, não há consenso sobre seu impacto nas medições biométricas. O objetivo deste estudo foi investigar os efeitos da dilatação pupilar nas medidas biométricas oculares em crianças saudáveis. Métodos: Estudo prospectivo, observacional e não randomizado de crianças (4-18 anos) que foram admitidas para exame oftalmológico de rotina. As medidas biométricas foram realizadas usando um dispositivo de biometria óptica sem contato, antes e após a dilatação pupilar farmacológica com cloridrato de ciclopentolato. Os cálculos de potência das lentes intraoculares foram realizados utilizando as fórmulas de Hill-RBF, Barrett, Olsen, Sanders-Retzlaff-Kraff/ Teórica, Holladay e Hoffer Q. Análises estatísticas descritivas também foram realizadas. O teste dos postos sinalizados de Wilcoxon foi usado para comparar as medidas antes e após a dilatação pupilar farmacológica. As relações entre as variáveis foram analisadas pelo coeficiente de correlação de Spearman-Brown. Resultados: O estudo incluiu 116 olhos de 58 crianças (idade média de 8,4 ± 0,32 anos; 34 meninas). Alterações significativas foram observadas após a dilatação pupilar, em termos de profundidade da câmara anterior, profundidade do humor aquoso e espessura central da córnea e do cristalino. Nenhuma mudança significativa ocorreu no comprimento axial. Os cálculos de potência da lente intraocular não revelaram alterações significativas após a dilatação pupilar na maioria das fórmulas, com exceção da fórmula Olsen. O poder da lente intraocular foi significativamente inversa correlacionada com o comprimento axial e a profundidade da câmara anterior. Conclusões: A dilatação pupilar farmacológica em crianças parece não ter impacto no comprimento axial e no poder da lente intraocular, mas causou um aumento significativo na profundidade da câmara anterior. A diferença nas medidas da profundidade da câmara anterior antes e após a dilatação pupilar pode estar relacionada ao modelo do dispositivo de biometria óptica utilizado. Tais resultados devem ser considerados nos cálculos de potência da lente intraocular realizados usando parâmetros de profundidade da câmara anterior.

En la actualidad existen numerosos equipos que permiten determinar los valores de espesor, curvatura corneal, amplitud, profundidad y volumen de la cámara anterior como lo es el Pentacam HR; el cual es un equipo capaz de crear una imagen panorámica en tiempo real del segmento anterior y un estudio topográfico-refractivo, arrojando resultados verídicos y confiables por su alta repetividad y reproducibilidad en las medidas (1-10). El objetivo de este estudio fue analizar la relación entre el espesor corneal con la cámara anterior mediante la Pentacam HR, en pacientes atendidos en la clínica de optometría de la Universidad Santo Tomás de febrero de 2009 a diciembre 2018. El estudio empleado fue observacional, descriptivo, corte trasversal, donde se tomaron 604 exámenes arrojados por la Pentacam desde los años nombrados anteriormente sin ninguna intervención al paciente y con el consentimiento informado por parte de la institución. Se analizaron los siguientes parámetros: edad, ángulo, profundidad, volumen de la cámara anterior, espesor corneal y formas topográficas. Luego se tabuló y se analizó la información por medio de análisis estadístico. En los resultados fueron: una mediana de edad de 31 años, en el volumen de 164 mm3, para el ángulo, la profundidad y el espesor fue de 556 µm. La edad y el espesor corneal tanto en mujeres con un total de población de 317 y hombres de 287, se determinó que a mayor edad menor espesor. Este estudio permitió concluir que existe una relación inversamente proporcional entre la edad y el espesor corneal, para la relación entre el ángulo - volumen y el ángulo- profundidad, se evidenció datos estadísticamente significativos presentados en los dos grupos tanto femeninos como masculinos. En el grupo de hombres, se demostró una relación mayor en cuanto al espesor- profundidad como al espesor – ángulo que, en lo encontrado en las mujeres, teniendo en cuenta que la muestra total es más pequeña en el sexo masculino. Con respecto a las formas topográficas la de mayor prevalencia fue en mujeres siendo la forma regular con un 56,04% y el de menor frecuencia fue la forma topográfica irregular con el 51,24% en hombres. Palabras Claves: Espesor Corneal, Cámara anterior. At present there are numerous teams that allow to determine the values of thickness, corneal curvature, amplitude, depth and volume of the anterior chamber such as the Pentacam HR; which is a team capable of creating a panoramic image in real time of the previous segment and a topographic-refractive study, yielding true and reliable results due to its high repeatability and reproducibility in the measurements (1-10). The objective of this study was to analyze the relationship between corneal thickness with the anterior chamber using the Pentacam HR, in patients treated at the optometry clinic of the Santo Tomás University from February 2009 to December 2018. The study used was observational, descriptive, transversal court, where 604 examinations thrown by the Pentacam were taken from the years previously mentioned without any intervention to the patient and with the informed consent of the institution. The following parameters were analyzed: age, angle, depth, anterior chamber volume, corneal thickness and topographic shapes. The information was then tabulated and analyzed by means of statistical analysis. The results were: a median age of 31 years, in the volume of 164 mm3, for the angle, depth and thickness was 556 µm. Age and corneal thickness in both women with a total population of 317 and men of 287, it was determined that the older the lower thickness. This study allowed us to conclude that there is an inversely proportional relationship between age and corneal thickness, for the relationship between angle-volume and angle-depth, statistically significant data presented in both female and male groups was evidenced. In the group of men, a greater relationship was demonstrated in terms of thickness-depth as well as thickness-angle than, as found in women, taking into account that the total sample is smaller in the male sex. With respect to topographic forms, the highest prevalence was in women, being the regular form with 56.04% and the lowest frequency was the irregular topographic form with 51.24% in men. Keywords: Corneal thickness, anterior chamber Especialista de Segmento Anterior y Lentes de Contacto http://www.ustabuca.edu.co/ustabmanga/presentacion Especialización

Introduction: there is currently a tendency toward phacoemulsification in the primary angular closure due to the crucial role of the lens in the pathophysiology of the disease. Objective: to describe the results of phacoemulsification in patients with primary angular closure in Pinar del Río. Method: a prospective longitudinal descriptive study was carried out in Pinar del Río, between January 2013 and December 2015, which included 43 patients with primary angular closure not controlled by laser peripheral iridotomy or medical treatment, who underwent phacoemulsification. Statistical analysis was performed using the SPSS program. Results: mean age was 54.67 ± 4.22 years and 83.7% were women. The mean amplitude value of the anterior chamber was 2.56  0.11 mm increasing to 3.24  0.08 mm (p = 0.006). 93.02% of the eyes showed a narrow angle, and after treatment 83.72% presented a grade 3-4 (p

Purpose: The aim of this study was to evaluate the effect of anterior chamber depth and axial length on clinical performance of the Spot Vision Screener in detecting amblyopia risk factors in children aged 3-10 years. Methods: A total of 300 eyes from 150 patients aged 3-10 years were prospectively tested with Spot Vision Screener (firmware version 3.0.02.32, software version 3.0.04.06) and a standard autorefractometer (Nidek ARK-1). The anterior chamber depth and axial length were measured with an optical biometer (Nidek AL-Scan). The sensitivity and specificity values for detecting significant refractive errors using the referral criteria of the American Association for Pediatric Ophthalmology and Strabismus were determined. Pearson’s correlation analysis was employed to evaluate the relationship between the Spot Vision results and the anterior chamber depth and axial length. Results: Compared with the standard autorefractometer results, the Spot Vision Screener’s sensitivity and specificity was 59% and 94%, respectively. The differences between the cycloplegic autorefractometer and the Spot Vision Screener spherical equivalents were negatively correlated with anterior chamber depth (r=-0.48; p

Intraoperative and postoperative cataract surgery in eyes with anterior megalophthalmos are challenging procedures. Herein we describe the case of a 53-year-old male with anterior megalophthalmos who developed unilateral Urrets-Zavalia Syndrome following cataract surgery. RESUMO O intraoperatório e o pós-operatório de cirurgia de catarata em olhos com megaloftalmo anterior é desafiador. Descrevemos o caso de um homem de 53 anos com megaloftalmo anterior que desenvolveu a Síndrome de Urrets-Zavalia unilateral após cirurgia de catarata.

We describe here a case of a 21-year-old woman who presented with low visual acuity, pain, and hyperemia in the left eye for 45 days. Her eye had extensive corneal infiltrate, with melting and a central perforation that was glued with cyanoacrylate, but with Seidel (+). She underwent tectonic corneal transplantation, and anterior chamber lavage with subconjunctival infiltration with voriconazole, as well as intracameral injections of amphotericin B. Laboratory tests revealed Paecilomyces lilacinus as the infectious agent. The patient was then maintained with oral voriconazole and eye drops for three months, after which the infection was considered cured. However, in the sixth postoperative month she presented with endothelial rejection, and two weeks later signs of recurrence of the fungal infection. She was treated with two further washes of the anterior chamber and subconjunctival injection of voriconazole, followed by intravenous voriconazole that was replaced with drops after ten days. The infection initially worsened, but then regressed, and at last follow-up, the patient was still infection-free.

Acute corneal edema is caused by various factors, with different levels of severity, and various forms of presentation. This paper reports the case of a male patient presenting with acute corneal edema without epithelium compromise, whose clinical picture, ophthalmological examination and additional tests did not reveal its etiology. Also, a review of available literature was conducted looking for all known causes of acute corneal edema, which are classified according to the etiology of the corneal edema into injury or inflammation of the corneal epithelium or stroma, endothelial dysfunction or increase in intraocular pressure. Resumen El edema de córnea es una entidad que se produce por un gran número de causas y tiene diversas formas de presentación y diferentes grados de afección. En este artículo se reporta el caso de un hombre con edema de córnea agudo sin compromiso epitelial, en el que el cuadro clínico, el examen oftalmológico y los estudios de extensión no lograron establecer su etiología. Además, se hace una revisión de la literatura disponible respecto a todas las posibles causas de edema de córnea agudo, agrupándolas en aquellas que ocasionan el edema por lesión o inflamación epitelial o estromal, por disfunción endotelial o por un aumento en la presión intraocular.

Acute corneal edema is caused by various factors, with different levels of severity, and various forms of presentation. This paper reports the case of a male patient presenting with acute corneal edema without epithelium compromise, whose clinical picture, ophthalmological examination and additional tests did not reveal its etiology. Also, a review of available literature was conducted looking for all known causes of acute corneal edema, which are classified according to the etiology of the corneal edema into injury or inflammation of the corneal epithelium or stroma, endothelial dysfunction or increase in intraocular pressure. El edema de córnea es una entidad que se produce por un gran número de causas y tiene diversas formas de presentación y diferentes grados de afección. En este artículo se reporta el caso de un hombre con edema de córnea agudo sin compromiso epitelial, en el que el cuadro clínico, el examen oftalmológico y los estudios de extensión no lograron establecer su etiología. Además, se hace una revisión de la literatura disponible respecto a todas las posibles causas de edema de córnea agudo, agrupándolas en aquellas que ocasionan el edema por lesión o inflamación epitelial o estromal, por disfunción endotelial o por un aumento en la presión intraocular.

OBJECTIVE: Ocular function is fundamental for environmental adaptation and survival capacity. Growth factors are necessary for a mature eyeball, needed for adequate vision. However, the consequences of the deficiency of circulating growth hormone (GH) and its effector insulin-like growth factor I (IGF-I) on the physical aspects of the human eye are still debated. A model of untreated isolated GH deficiency (IGHD), with low but measurable serum GH, may clarify this issue. The aim of this study was to assess the ocular aspects of adult IGHD individuals who have never received GH therapy. DESIGN: Cross sectional study. METHODS: Setting University Hospital, Federal University of Sergipe, Brazil. Patients: Twenty-five adult (13 males, mean age 50.1 years, range 26 to 70 years old) IGHD subjects homozygous for a null mutation (c.57+1G>A) in the GHRH receptor gene, and 28 (15 males, mean age 51.1 years, range 26 to 67 years old) controls were submitted to an endocrine and ophthalmological assessment. Forty-six IGHD and 50 control eyes were studied. Main outcome measures: Visual acuity, intraocular pressure (IOP), refraction (spherical equivalent), ocular axial length (AL), anterior chamber depth (ACD),lens thickness (LT), vitreous depth (VD), mean corneal curvature (CC) and central corneal thickness (CCT). RESULTS: IGHD subjects exhibited unmeasurable serum IGF-I levels, similar visual acuity, intraocular pressure and LT, higher values of spherical equivalent and CC, and lower measures of AL, ACD, VD and CCT in comparison to controls, but within their respective normal ranges. While mean stature in IGHD group was 78 % of the control group, mean head circumference was 92 % and axial AL was 96 %. CONCLUSIONS: These observations suggest mild ocular effects in adult subjects with severe IGF-I deficiency due to non-treated IGHD. OBJETIVO: A função ocular é fundamental para a adaptação ambiental e a capacidade de sobrevivência. Fatores de crescimento são julgados necessáriospara alcançar um globo ocular maduro, e conseqüente visão adequada. No entanto, as consequências da deficiência isoladadohormônio de crescimento circulante (GH) edo seu efetor, o fator de crescimento semelhante à insulina I (IGF-I) nos aspectos físicos do olho humano ainda são debatidas. Um modelo de deficiência isolada de GH não tratada (DIGH) pode esclarecer esta questão. O objetivo deste estudo foi avaliar os aspectos físicos do globo ocular de indivíduos adultos com DIGH que nunca receberam terapia com GH. DESENHO: Estudo transversal. MÉTODOS: Ambiente: Hospital Universitário, Universidade Federal de Sergipe, Brasil. Pacientes: 25 indivíduosadultos (13 homens,com média de idade de 50,1 anos, entre 26 e 70 anos), com DIGH homozigotos para uma mutação nula (c.57 + 1G> A) no gene do receptorGHRH do grupo DIGH e 28 controles (15 homens, com média de idade de 51,1 anos, entre 26 e 67 anos), pareados, foram submetidos à avaliação endócrina e oftalmológica. Principais medidas: acuidade visual(AV), pressão intraocular(PIO),refração (equivalente esférico, EE), comprimento axial ocular (CA), profundidade da câmara anterior(PCA), medida da espessura do cristalino(EC), profundidade do vítreo(PV), curvatura corneana média(CCM) e espessura central corneana(ECC). RESULTADOS:Indivíduos com DIGH apresentaram IGF-I sérico não mensurável, similarAV, PIO e EC, valores mais altos doEEe CCM, e menores valores do CA, PCA, PV e ECC em comparação com os controles, mas dentro das respectivas faixas normais. Enquanto a estaturamédia no grupo DIGH foi de 78% do grupo de controle, a média da circunferência da cabeça foi de 92% e a média docomprimento axial foi de 96%. CONCLUSÃO: Essas observações sugerem efeitos oculares discretosem indivíduos adultos com grave deficiência de IGF-I devido à DIGH não tratada.

OBJECTIVE: Ocular function is fundamental for environmental adaptation and survival capacity. Growth factors are necessary for a mature eyeball, needed for adequate vision. However, the consequences of the deficiency of circulating growth hormone (GH) and its effector insulin-like growth factor I (IGF-I) on the physical aspects of the human eye are still debated. A model of untreated isolated GH deficiency (IGHD), with low but measurable serum GH, may clarify this issue. The aim of this study was to assess the ocular aspects of adult IGHD individuals who have never received GH therapy. DESIGN: Cross sectional study. METHODS: Setting University Hospital, Federal University of Sergipe, Brazil. Patients: Twenty-five adult (13 males, mean age 50.1 years, range 26 to 70 years old) IGHD subjects homozygous for a null mutation (c.57+1G>A) in the GHRH receptor gene, and 28 (15 males, mean age 51.1 years, range 26 to 67 years old) controls were submitted to an endocrine and ophthalmological assessment. Forty-six IGHD and 50 control eyes were studied. Main outcome measures: Visual acuity, intraocular pressure (IOP), refraction (spherical equivalent), ocular axial length (AL), anterior chamber depth (ACD),lens thickness (LT), vitreous depth (VD), mean corneal curvature (CC) and central corneal thickness (CCT). RESULTS: IGHD subjects exhibited unmeasurable serum IGF-I levels, similar visual acuity, intraocular pressure and LT, higher values of spherical equivalent and CC, and lower measures of AL, ACD, VD and CCT in comparison to controls, but within their respective normal ranges. While mean stature in IGHD group was 78 % of the control group, mean head circumference was 92 % and axial AL was 96 %. CONCLUSIONS: These observations suggest mild ocular effects in adult subjects with severe IGF-I deficiency due to non-treated IGHD. OBJETIVO: A função ocular é fundamental para a adaptação ambiental e a capacidade de sobrevivência. Fatores de crescimento são julgados necessáriospara alcançar um globo ocular maduro, e conseqüente visão adequada. No entanto, as consequências da deficiência isoladadohormônio de crescimento circulante (GH) edo seu efetor, o fator de crescimento semelhante à insulina I (IGF-I) nos aspectos físicos do olho humano ainda são debatidas. Um modelo de deficiência isolada de GH não tratada (DIGH) pode esclarecer esta questão. O objetivo deste estudo foi avaliar os aspectos físicos do globo ocular de indivíduos adultos com DIGH que nunca receberam terapia com GH. DESENHO: Estudo transversal. MÉTODOS: Ambiente: Hospital Universitário, Universidade Federal de Sergipe, Brasil. Pacientes: 25 indivíduosadultos (13 homens,com média de idade de 50,1 anos, entre 26 e 70 anos), com DIGH homozigotos para uma mutação nula (c.57 + 1G> A) no gene do receptorGHRH do grupo DIGH e 28 controles (15 homens, com média de idade de 51,1 anos, entre 26 e 67 anos), pareados, foram submetidos à avaliação endócrina e oftalmológica. Principais medidas: acuidade visual(AV), pressão intraocular(PIO),refração (equivalente esférico, EE), comprimento axial ocular (CA), profundidade da câmara anterior(PCA), medida da espessura do cristalino(EC), profundidade do vítreo(PV), curvatura corneana média(CCM) e espessura central corneana(ECC). RESULTADOS:Indivíduos com DIGH apresentaram IGF-I sérico não mensurável, similarAV, PIO e EC, valores mais altos doEEe CCM, e menores valores do CA, PCA, PV e ECC em comparação com os controles, mas dentro das respectivas faixas normais. Enquanto a estaturamédia no grupo DIGH foi de 78% do grupo de controle, a média da circunferência da cabeça foi de 92% e a média docomprimento axial foi de 96%. CONCLUSÃO: Essas observações sugerem efeitos oculares discretosem indivíduos adultos com grave deficiência de IGF-I devido à DIGH não tratada.

Purpose: To study the changes in anterior chamber depth (ACD), anterior chamber angle (ACA), and pupil diameter (PD) during accommodation. Methods: Eighty eyes of 80 subjects, aged 22 to 40 years, were included. The rotating Dual Scheimpflug and a Placido disc system (Galilei G4, Ziemer Ophthalmic Systems AG, Switzerland) was used to measure the changes in ACD, ACA, and PD during accommodation. ACD measurement was taken for the central zone and for 4 more positions, each in different orientation (nasal, superior, temporal and inferior), 4 mm away from the centre. ACA was measured for the whole eye as well for the nasal, superior, temporal, and inferior quadrants. These metrics were obtained for various accommodation stimuli, ranging from +1 D to -4 D in 1-D steps. Results: For a given position, the ACD did not vary significantly with accommodation. For the central ACD, the percentage of relative change between far and near vision was -4.11%. The ACA was significantly lower at the inferior, temporal, and superior positions. There was no change in the ACA of the whole eye and that of the nasal orientation. These two eye metrics were significantly lower in the superior-nasal than in the inferior-temporal region. At each vergence studied, the PD decreased significantly with accommodation. The relative change after the -4 D stimulus was -8.13%. Conclusion: ACA and PD varied significantly with accommodation, whereas no such variation of ACD was observed. Further, the anterior chamber was found to be asymmetrical, with the nasal-superior area becoming significantly shallower than the inferior temporal region. Objetivo: Estudar as mudanças na profundidade da câmara anterior (ACD), ângulo da câmara anterior (ACA) e diâmetro da pupila (PD) durante a acomodação. Métodos: Foram incluídos 80 olhos de 80 indivíduos com idades entre 22 e 40 anos. Um sistema rotacional de Scheimpflug duplo acoplado a um sistema de disco de Placido (Galilei G4, Ziemer Ophthalmic Systems AG, Suíça) foi usado para medir as mudanças na ACD, ACA e PD, durante a acomodação. As medidas da ACD foram consideradas na zona central e em mais 4 posições, cada uma em orientação diferente (nasal, superior, temporal e inferior), a 4 milímetros de distância do centro. O ACA do olho inteiro, assim como nos quadrantes nasal, superior, temporal e inferior foram medidos. Todos estes indicadores foram obtidos por vários estímulos acomodativos, que variaram de +1 D a -4 D em intervalos de 1 D. Resultados: A ACD não variou significativamente com acomodação para qualquer determinada orientação, sendo a percentagem de variação relativa entre longe e visão de perto -4,11% para a ACD central (onde sinal negativo representa uma diminuição na ACD). Em relação ao ACA, este diminuiu significativamente em posições inferiores, temporais e superiores. O ACA total de olho e o ACA nasal não se alterou. Estas duas métricas oculares foram significativamente menores no par nasal-superior do que no temporal-inferior. Finalmente, PD diminuiu significativamente com a acomodação em cada vergência estudada, a mudança relativa após o estímulo de -4 D foi -8,13%. Conclusão: ACA e PD variaram significativamente com a acomodação, enquanto ACD não. Além disso, a câmara anterior se mostrou alterar assimetricamente, com a área nasal-superior se tornando significativamente mais rasa do que a temporal-inferior.

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 analysed using Bland---Altman plot and paired t-test. Results: For all data the mean (SD) anterior chamber depth was 3.56 (0.19) mm with the IOLMaster and 3.65 (0.21) mm with the Visante-OCT. IOLMaster measurements were an average of 0.10 (0.12) mm less than Visante-OCT (paired t-test, p < 0.0001). In our study ACD mean differences (SD) by age obtained had been −0.139 (0.163), −0.044 (0.112), −0.082 (0.054) and −0.105 (0.101) for 13, 14, 15 and 17 respectively. The 13-age group showed the larger standard deviation compared to the other groups. Conclusions: IOLMaster and Visante-OCT are good and useful non-contact methods for measuring ACD in the healthy eyes of teenagers. The measurement differences between two devices were quite small, however, they should take into account in order to calculate the power on intraocular lens. The findings provide more normative date for this age group. © 2012 Spanish General Council of Optometry. Published by Elsevier Espana, S.L. All rights reserved.