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Introduction/Background: Hallervorden-Spatz syndrome is an autosomal recessive neurodegenerative disorder with brain iron accumulation. The classical form has a progressive early onset in infancy that results in the presence of extrapyramidal symptoms and retinitis pigmentosa (RP). The clinical symptoms and signs in RP include nyctalopia and peripheral visual field reduction. Cystoid macular oedema (CMO) can occasionally occur in RP. Pathogenesis of CMO remains unclear and no gold-standard treatments or protocols have established yet. Methods: Case report. Patient monitored with OCT imaging and treated with topic brinzolamide 10 mg/ml and topical nepafenac 1 mg/ml. Results: A 10 year-old female, diagnosed with Hallervorden- Spatz disease, was derived to the Ophthalmology service from Paediatrics with a progressive vision loss. During exploration, bestcorrected visual acuity (BCVA) was 0.2 in both eyes. Macular OCT was performed and a bilateral CMO was found. Bone spicule pigmentation was observed in periphery without further pathological findings. She was diagnosed with RP. Topic brinzolamide was prescribed and there was vision improvement with bilateral reduction of the CMO. Two months later, BCVA deteriorated although CMO diminished; treatment with brinzolamide was maintained and a topical non-steroidal anti-inflammatory (nepafenac) was added. After three months of double therapy, her BCVA was 0.9 in both eyes and the CMO had considerably reduced. Two months later, the CMO was prominent again and her BCVA had decreased again. Due to the evolution with topical treatment, the patient was finally derived to a children's referral hospital where she can be treated more aggressively (intravitreal and/or subtenon triamcinolone acetonide injection, intravitreal dexamethasone implant or intravitreal anti-VEGF injection). Conclusions: There is no specific treatment to arrest or reverse the photoreceptor degeneration, but complications can be managed in diverse ways. Since a protocol to treat CMO in RP is lacking, a gradually aggressive treatment steps should be followed. Acknowledgements: To Ana Montoliu Antón, Francisco Ramos Martí, Soledad Peña, María Redón Soriano and especially Luis León Ibáñez. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical outcomes of a refractive multi-segmented continuous transitional focus intraocular lens (IOL), analyzing the potential influence of patient pupil dynamics on these outcomes., Methods: Retrospective consecutive case series study enrolling 40 eyes (20 patients, 47-81 years) implanted with the Precizon Presbyopic IOL (Ophtec BV). The following clinical outcomes were analyzed during a mean follow-up of 12.1 months (2-24 months): visual acuity, refraction, contrast sensitivity (CS) under photopic and mesopic conditions, binocular defocus curve and evaluation of the perception of disturbing visual symptoms with a validated questionnaire., Results: Mean binocular uncorrected distance (UDVA), distance-corrected intermediate (DCIVA), uncorrected near (UNVA) and distance-corrected near visual acuities (DCNVA) were -0.09 ± 0.07, 0.04 ± 0.05, 0.17 ± 0.12, and 0.15 ± 0.10 logMAR, respectively. In the binocular defocus curve, mean distance-corrected visual acuity was over 0.20 logMAR for defocus levels from +1.50 to -3.00 D. No significant correlations of photopic pupil diameter with postoperative visual data were found (-0.165 ≤ r ≤ 0.192, p ≥ 0.235). Moderate correlations of mesopic pupil size were found with visual acuities for the defocus levels of -2.50 ( r  = 0.454, p  = 0.003), -3.00 ( r  = 0.609, p  < 0.001), -3.50 ( r  = 0.519, p  < 0.001), and -4.00 D ( r  = 0.403, p  = 0.010). Only significant differences were found between mesopic and photopic CS for 12 cycles/degree ( p  = 0.010). No cases of severe glare or halos were detected. In contrast, 10% of patients referred the severe perception of starbursts postoperatively. Full spectacle independence was referred by almost all patients (90%)., Conclusions: The IOL demonstrates effective visual restoration at various distances, characterized by high levels of visual quality and minimal dependence on pupil dynamics., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.