Vitrectomy and tumor endoresection for the diagnosis and treatment of focal nodular retinal gliosis.

We report the case of a 60-year-old woman who presented with metamorphopsia and progressive vision loss in the right eye. Fundus examination revealed an elevated, white-yellow mass in the peripheral inferotemporal retina, with massive retinal exudation, proliferative vitreoretinopathy, and retinal detachment. Pars plana vitrectomy with tumor endoresection was performed, and a complete excisional biopsy of the lesion was obtained by removing the tumor through the anterior chamber. Histopathological analysis of the specimen confirmed a diagnosis of peripheral, focal, nodular retinal gliosis. Postoperatively, visual function improved greatly, with no recurrence of the disease at 12 months' follow-up. Focal nodular retinal gliosis is a rare, non-neoplastic proliferation of retinal glial cells, with a vascular component. In our case, surgical treatment with pars plana vitrectomy facilitated accurate diagnosis and resulted in effective management of the retinal tumor and associated complications.

The effectiveness of phototherapy for surface decontamination against SARS-Cov-2. A systematic review.

COVID-19 appeared in December 2019, needing efforts of science. Besides, a range of light therapies (photodynamic therapy, ultraviolet [UV], laser) has shown scientific alternatives to conventional decontamination therapies. Investigating the efficacy of light-based therapies for environment decontamination against SARS-CoV2, a PRISMA systematic review of Phototherapies against SARS-CoV or MERS-CoV species discussing changes in viral RT-PCR was done. After searching MEDLINE/PubMed, EMBASE, and Literatura Latino-Americana e do Caribe em Ciências da Saúde we have found studies about cell cultures irradiation (18), blood components irradiation (10), N95 masks decontamination (03), inanimate surface decontamination (03), aerosols decontamination (03), hospital rooms irradiation (01) with PDT, LED, and UV therapy. The best quality results showed an effective low time and dose UV irradiation for environments and inanimate surfaces without human persons as long as the devices have safety elements dependent on the surfaces, viral charge, humidity, radiant exposure. To interpersonal contamination in humans, PDT or LED therapy seems very promising and are encouraged.

Copper-Arsenic-Sulfide Thin-Films from Local Raw Materials Deposited via RF Co-Sputtering for Photovoltaics.

The inexorable increase of energy demand and the efficiency bottleneck of monocrystalline silicon solar cell technology is promoting the research and development of alternative photovoltaic materials. Copper-arsenic-sulfide (CAS) compounds are still rather unexplored in the literature, yet they have been regarded as promising candidates for use as p-type absorber in solar cells, owing to their broad raw material availability, suitable bandgap and high absorption coefficient. Here, a comprehensive study is presented on the structural and optoelectronic properties of CAS thin-films deposited via radio-frequency magnetron co-sputtering, using a commercial Cu target together with a Cu-As-S target with material obtained from local resources, specifically from mines in the Portuguese region of the Iberian Pyrite Belt. Raman and X-ray diffraction analysis confirm that the use of two targets results in films with pronounced stoichiometry gradients, suggesting a transition from amorphous CAS compounds to crystalline djurleite (Cu31S16), with the increasing proximity to the Cu target. Resistivity values from 4.7 mΩ·cm to 17.4 Ω·cm are obtained, being the lowest resistive films, those with pronounced sub-bandgap free-carrier absorption. The bandgap values range from 2.20 to 2.65 eV, indicating promising application as wide-bandgap semiconductors in third-generation (e.g., multi-junction) photovoltaic devices.

Microwave versus Conventional Sintering of NiTi Alloys Processed by Mechanical Alloying.

The present study shows a comparison between two sintering processes, microwave and conventional sintering, for the manufacture of NiTi porous specimens starting from powder mixtures of nickel and titanium hydrogenation-dehydrogenation (HDH) milled by mechanical alloying for a short time (25 min). The samples were sintered at 850 °C for 15 min and 120 min, respectively. Both samples exhibited porosity, and the pore size results are within the range of the human bone. The NiTi intermetallic compound (B2, R-phase, and B19') was detected in both sintered samples through X-ray diffraction (XRD) and electron backscattering diffraction (EBSD) on scanning electron microscopic (SEM). Two-step phase transformation occurred in both sintering processes with cooling and heating, the latter occurring with an overlap of the peaks, according to the differential scanning calorimetry (DSC) results. From scanning electron microscopy/electron backscatter diffraction, the R-phase and B2/B19' were detected in microwave and conventional sintering, respectively. The instrumented ultramicrohardness results show the highest elastic work values for the conventionally sintered sample. It was observed throughout this investigation that using mechanical alloying (MA) powders enabled, in both sintering processes, good results, such as intermetallic formation and densification in the range for biomedical applications.

Structural and Optical Characterization of Mechanochemically Synthesized CuSbS2 Compounds.

One of the areas of research on materials for thin-film solar cells focuses on replacing In and Ga with more earth-abundant elements. In that respect, chalcostibite (CuSbS2) is being considered as a promising environmentally friendly and cost-effective photovoltaic absorber material. In the present work, single CuSbS2 phase was synthesized directly by a short-duration (2 h) mechanochemical-synthesis step starting from mixtures of elemental powders. X-ray diffraction analysis of the synthesized CuSbS2 powders revealed a good agreement with the orthorhombic chalcostibite phase, space group Pnma, and a crystallite size of 26 nm. Particle-size characterization revealed a multimodal distribution with a median diameter ranging from of 2.93 µm to 3.10 µm. The thermal stability of the synthesized CuSbS2 powders was evaluated by thermogravimetry and differential thermal analysis. No phase change was observed by heat-treating the mechanochemically synthesized powders at 350 °C for 24 h. By UV-VIS-NIR spectroscopy the optical band gap was determined to be 1.41 eV, suggesting that the mechanochemically synthesized CuSbS2 can be considered suitable to be used as absorber materials. Overall, the results show that the mechanochemical process is a viable route for the synthesis of materials for photovoltaic applications.

Topical Insulin-Utility and Results in Refractory Neurotrophic Keratopathy in Stages 2 and 3.

PURPOSE: The purpose of this study was to evaluate the clinical outcome of patients with refractory neurotrophic keratopathy (NK) in stages 2 and 3 treated with topical insulin. METHODS: Retrospective analysis of eyes with NK in stages 2 and 3 refractory to standard medical and/or surgical treatment which were treated with topical insulin (1 unit per mL). This treatment was applied 4 times per day and was continued until the persistent epithelial defect (PED) or ulcer resolved. The primary outcome of the study was the complete reepithelialization of the PED or persistent ulcer. "Best-corrected visual acuity" pretreatment and posttreatment, "days until complete reepithelialization" data, and anterior segment photographs were obtained. Outcome measures were compared before and after treatment in both groups using paired and independent samples t tests. RESULTS: Twenty-one eyes were included in this study, and 90% achieved complete reepithelialization of the PED and/or persistent ulcer within 7 to 45 days of follow-up. The mean number of days until complete reepithelialization was significantly lower in NK stage 2 (18 ± 9 days) when compared with NK stage 3 (29 ± 11 days) ( P = 0.025). The best-corrected visual acuity improved significantly in both NK stage 2 ( P < 0.001) and NK stage 3 ( P = 0.004). No side effects were reported during the follow-up. CONCLUSIONS: Our results suggest that topical insulin drops may be an effective therapeutic in refractory NK. This therapy may prove extremely useful because of its low cost and high accessibility.

Diplopia After Coronary Revascularization.

Percutaneous coronary intervention is a coronary revascularization procedure that may rarely result in thromboembolic events. Although infrequent, ophthalmological complications of percutaneous interventions include a wide range of clinical presentations, with differing severity and outcomes. In this case report, an 83-year-old woman, with multiple cardiovascular risk factors, presents with horizontal diplopia after a percutaneous transluminal coronary angioplasty. After ophthalmological evaluation and a head computed tomography scan, the diagnosis of isolated ischemic internuclear ophthalmoplegia was established. After six months of follow-up, the patient showed complete recovery of her symptoms and ocular movements. We discuss the post-percutaneous intervention ophthalmic complications that, although uncommon, must be recognized by health care providers.

A intervenção coronária percutânea é um procedimento de revascularização coronária que pode, raramente, resultar em eventos tromboembólicos. Apesar de incomuns, as complicações oftalmológicas da intervenção percutânea incluem um largo espectro de manifestações clínicas com diferentes prognósticos. Reportamos um caso clínico de uma mulher de 83 anos, com múltiplos fatores de risco cardiovascular, que apresenta diplopia horizontal após uma angioplastia coronária percutânea. O diagnóstico de oftalmoplegia internuclear isquémica isolada foi estabelecido após avaliação oftalmológica e realização de tomografia computorizada cranioencefálica. Seis meses após a apresentação, a doente apresentava recuperação completa dos sintomas e dos movimentos oculares. Os autores discutem as complicações oftalmológicas da intervenção percutânea que, apesar de incomuns, devem ser reconhecidas pelos profissionais de saúde.

Treatment of benign eyelid lesions with Nd:YVO laser: a prospective study.

The purpose of this prospective cohort study, including consecutively selected patients, was to evaluate the outcomes of Nd:YVO laser-assisted photocoagulation for the removal of benign eyelid lesions. An emulsion of lidocaine and prilocaine was used for dermal analgesia and subcutaneous injection of 2% lidocaine was performed as needed. Follow-up included two visits, at day 15 and 45 postoperatively, in order to assess time of wound healing, postoperative complications, need for additional treatment, and patient's satisfaction. A total of 101 lesions of 66 patients were included, with a mean age of 55.4 ± 15.3 years. All patients were Caucasian and 62% were female. Papilloma was the most common lesion identified (61%). No major complications were reported during and after the procedure. Complete epithelization occurred in 82% and 100%, at the 15 and 45-day visit, respectively. All patients were satisfied with the cosmetic result. Only one patient was proposed for additional therapy during the follow-up period. In conclusion, this study supports Nd:YVO laser-assisted treatment as an effective and safe alternative to conventional surgery for the removal of benign eyelid lesions. The technique is well accepted, easy to perform, and provides excellent cosmetic and functional results.

Ocular manifestations of intermediate cystinosis: To treat or not to treat?

PURPOSE: To report a case of intermediate cystinosis with an atypical presentation in which a delayed non-treatment decision has been proved right over a large period of time. METHODS: This is a unique case report of a patient who underwent full ophthalmologic evaluations including anterior chamber optical coherence tomography on a regular basis during a 7-year follow-up period. RESULTS: A 30-year-old woman with photophobia was being studied by the Department of Nephrology with a suspicion of Alport syndrome. Slit-lamp examination showed iridescent deposits throughout the corneal anterior stroma and the inferior tarsal conjunctiva bilaterally. Anterior chamber optical coherence tomography showed stromal hyperreflectivity. CTNS gene was found to be positive for c.416C>T (Ser139Phe) mutation. The patient was offered oral and topical cysteamine which was refused. After a period of 5 years of follow-up, general health status remained stable, corneal disease showed no progression and photophobia complaints diminished. However, the patient was advised to start systemic and topical cysteamine because of the unknown development of the disease. CONCLUSION: In this reported case, a delayed non-treatment decision has been proved right contrary to published evidence of active treatment of photophobia. The decision whether to treat or not to treat corneal involvement of the disease is not straightforward. Besides biomicroscopic evaluations, patients' complaints and expectations should be taken into account.

Refractory Myopic Retinal Detachment and Macular Hole Closure with Autologous Neurosensory Retinal Free Flap.

The purpose of this case report is to describe a modified technique involving the use of an autologous neurosensory retinal free flap for closure of a macular hole (MH) during retinal detachment (RD) surgery. A 50-year-old female presented with sudden vision loss (light perception only) and a recurrent myopic RD associated with an MH. An autologous neurosensory retinal free flap was obtained and moved toward the MH. Silicone oil was used as an endotamponade and removed after 6 months. Two months after oil removal visual acuity improved to 20/400 and remained stable thereafter; however, the patient developed central retinal atrophy. One year after surgery the MH was closed and the retina attached. This modified technique with the use of an autologous neurosensory retinal flap provides an alternative approach for recurrent MH in RD procedures.

Tocilizumab in refractory juvenile idiopathic arthritis with associated uveitis: a case report.

INTRODUCTION: We report a 9-year follow-up of a child with refractory juvenile idiopathic arthritis (JIA) with associated uveitis in which tocilizumab proved to be effective in achieving disease control. CASE REPORT: A 16-month child was diagnosed with JIA and at the age of 3 developed bilateral non-granulomatous anterior uveitis. Throughout the follow-up, the patient presented frequent joint and ocular flares. Refractory anterior uveitis and topical corticosteroid therapy resulted in the development of bilateral cataract and high intraocular pressure (IOP). The patient underwent multiple ocular surgeries along with corticosteroids, immunosuppressive therapy with Methotrexate and Adalimumab failing to reach disease control. Only after the introduction of Tocilizumab a lower disease activity was achieved. DISCUSSION: Management of JIA-associated uveitis is challenging and requires a close collaboration between paediatric rheumatologists and ophthalmologists. Clinical remission can be difficult to achieve. However, one should always pursuit JIA inactivity with IOP and inflammation control. This report supports Tocilizumab as a useful therapeutic option for JIA-associated uveitis.

Kaposi's sarcoma of the conjunctiva and the eyelid leads to the diagnosis of human immunodeficiency virus infection - a case report.

BACKGROUND: The purpose of this case report is to describe a conjunctiva and eyelid Kaposi's sarcoma (KS) as the initial manifestation of acquired immunodeficiency syndrome (AIDS), which led to the diagnosis of HIV infection. There are only 3 reported cases of ocular KS as an initial manifestation of HIV infection. CASE PRESENTATION: A 32-year old white man presented to our department with a 1 month history of eye redness. The patient had an enlarged violet-coloured mass on the right superior eyelid which had evolved over the course of 1 week. There was also a mobile bulbar conjunctival lesion with a bright red colour, approximately 5 mm × 5 mm, in the superior temporal quadrant of his left eye. The lesions looked like a chalazion and a subconjunctival haemorrhage, respectivly. Presumed KS diagnosis was confirmed with HIV-1 positive testing and histopathology from tissue biopsy. The patient's CD4 count was 23/mm3 and viral RNA load 427,000/ml. Further systemic evaluation showed a diffuse sarcoma. CONCLUSION: This case report demonstrates the importance of recognizing the ocular manifestations of AIDS in establishing the correct diagnosis of KS and subsequently diagnosing occult HIV infection. Although ocular KS as the initial manifestation of HIV-AIDS is an extremely rare event, a proper diagnosis may contribute to prompt management with personal and social relevance.

Half-dose photodynamic therapy for chronic central serous chorioretinopathy: Efficacy and safety outcomes in real world.

PURPOSE: To have an insight of the outcomes of half-dose photodynamic therapy (PDT) for patients with chronic central serous chorioretinopathy (CSC) in a real world population. MATERIAL AND METHODS: This is a retrospective consecutive case series, one-centre study, with a 12-month follow-up period. RESULTS: The study took into account 15 eyes of 13 patients. All patients were male in gender and only 1 eye belonged to a non-caucasian. The sample mean age was 51,27±11,66 (between 36 and 74 years); mean baseline best-corrected visual acuity (BCVA) was 0,40±0,25 logMAR and central macular thickness (CMT) was 411,40±88,44µm. All patients had subretinal fluid (SRF) and retinal pigment epithelium (RPE) detachment involving the fovea. In a month time, BCVA and CMT had remarkable improvements with only one eye not gaining letters. At 6-month visit, 46,7% of the eyes were provided with additional treatment (intra-vitreal anti-VEGF or PDT). In the final visit no eye had worsened more than 5 letters and 53,3% had a BCVA improvement of at least 5 letters, with only 2 eyes remaining with RPE detachment and SRF. There was a steady regression in CMT throughout the follow-up; 93,3% had CMT under 300µm and CMT mean was 249,93±72,78µm. There were no reported complications. CONCLUSION: These results support PDT as a valuable approach for therapeutic decisions on chronic CSC as well as the need of other add up treatments for a better final outcome. Further evaluations with longer follow-up's should be taken into consideration for safety issues.

Thermal inactivation of the wine spoilage yeasts Dekkera/Brettanomyces.

The heat resistance of three strains of Dekkera/Brettanomyces (Dekkera anomala PYCC 5,153, Dekkera bruxellensis PYCC 4,801 and Dekkera/Brettanomyces 093) was evaluated at different temperatures between 32.5 and 55 degrees C. Thermal inactivation tests were performed in tartrate buffer solution (pH 4.0) and in wines. In the studies employing buffer as the heating menstruum, measurable thermal inactivation began only at temperatures of 50 degrees C. When heating was performed in wine, significant inactivation begins at 35 degrees C. Subsequent thermal inactivation tests were performed in buffer at various levels of pH, ethanol concentration, and various phenolic acids. Results from experiments in buffer with added ethanol suggest that the greater heat sensitivity shown in wines can be largely attributed to ethanol, although potentiation of this effect might be due to the phenolic content, particularly from ferulic acid. In the range of pH values tested (2.5-4.5), this factor had no influence in the heat inactivation kinetics. Relevant data, in the form of D and Z values calculated in the various environments, potentially useful for the establishment of regimes of thermal control of Dekkera/Brettanomyces yeasts in wine and contaminated equipment is presented.