Reproducibility of SD-OCT inner macular layer thickness measurements in children with primary congenital glaucoma.

PURPOSE: To examine the reproducibility of spectral domain optical coherence tomography (SD-OCT) segmented ganglion cell complex and circumpapillary retinal nerve fiber layer (cpRNFL) measurements in children with primary congenital glaucoma (PCG) in comparison with healthy children. METHODS: 12 children with PCG (G1) and 24 healthy children (G2) were recruited. The following SD-OCT measurements (Spectralis, Heidelberg Engineering) were made in one eye per child: total macular thickness (MT), thicknesses in several subfields and volumes of the three inner macular layers, macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) and cpRNFL thickness. In a single day, an expert operator obtained 3 circumpapillary and 3 macular measurements in each participant to determine intraoperator variability. Intraoperator repeatability was defined by the coefficient of variation (CoV) and intraclass correlation (ICC). RESULTS: ICC was excellent in both groups for cpRNFL measurements (G1 ICC=0.950 and G2 ICC=0.995) and for MT was excellent in G1 (ICC=0.957) and moderate in G2 (ICC=552). For the inner macular layer measurements, all ICCs were better in PCG group (mRNFL-ICC: 0.915 vs. 0.765; ICC-GCL: 0.584 vs. 0.263 and ICC-IPL: 0.979 vs. 0.742; G1 and G2 respectively). Greater CoV were recorded for macular measurements (from 0.71% to 9.82%) compared to cpRNFL measurements (from 0.52% to 1.50%). CONCLUSION: In children with PCG, Spectralis SD-OCT showed excellent intrasession repeatability for cpRNFL, MT, mRNFL and IPL measurements and moderated for GCL measurements. For all macular measurements, ICC were higher in children with PCG than healthy children.

Comparison of corneal biomechanical properties of patients with dry eye secondary to Sjögren's syndrome and healthy subjects.

PURPOSE: The goal of this study is to determine whether any difference in corneal biomechanical properties exists between Sjögren's syndrome dry eye patients and healthy subjects. METHODS: Thirty-one patients diagnosed with Sjögren's syndrome and associated dry eye manifestations and 44 healthy individuals were included in the study. Ultrasonic pachymetry (UP) was used to measure central corneal thickness (CCT). Corneal biomechanical parameters were obtained using ocular response analyzer (ORA). The main parameters assessed were corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOPg) and corneal compensated IOP (IOPcc). A Student's t-test for independent groups was performed to compare the mean of these variables between both groups. RESULTS: Mean CH values in Sjögren's syndrome and healthy subject eyes were 10.1mmHg and 11.18mmHg respectively, representing a statistically significant difference (P=0.003). No other variable measured differed between cases and controls (P>0.05). Mean CRF values were 9.51mmHg and 10.37mmHg respectively, and mean CCT measured by UP in cases and controls was 527.41µm and 552.51µm respectively. CONCLUSIONS: Sjögren's syndrome can influence corneal biomechanical properties, specifically CH. ORA measurements should be considered of interest in the evaluation of Sjögren syndrome subjects.

Anton-Babinski syndrome, case report. / Ceguera de Anton-Babinski, a propósito de un caso.

CLINICAL CASE: A 22 year-old woman complained about blurred vision after an episode of recovered cardiorespiratory arrest. She had bilateral low visual acuity («count fingers¼) and no ophthalmological or visual pathways changes. She also had an apparent lack of awareness of the deficit. The Magnetic Resonance Imaging (MRI) showed ischaemic changes in both occipital lobes. As a result, she was diagnosed with Anton-Babinski syndrome. DISCUSSION: This is a rare disease that should be suspected in strange or poorly congruent visual loss. It is usually due to an ischaemic injury in this region of brain, manifesting itself with low vision not perceived by the patient (visual confabulation). It can simulate a non-organic visual loss or psychiatric disease.

[Photodynamic therapy in severe chronic central serous chorioretinopaty]. / Terapia fotodinámica en coriorretinopatía serosa central crónica severa.

OBJECTIVE: To determine the efficacy of Photodynamic Therapy (PDT) in chronic Central Serous Chorioretinopathy (CSC). METHODS: Patients diagnosed with chronic CSC, with clinical evidence of activity and treated with Photodynamic Therapy, are included in this report. All were assessed by a complete ophthalmological examination, including assessment of the best corrected visual acuity (BCVA) using an ETDRS chart, fluorescein and indocyanine angiography and optical coherence tomography (OCT). The main objective of the study was to determine the mean visual acuity change. RESULTS: 11 eyes of 11 patients were included in the study, which had a mean follow-up period of 11 months. The mean BCVA increased from 20/76 to 20/64. 35% of eyes improved their BCVA by 2 lines or more, 45% remained stable and 18% lost 2 lines or more. Choroidal hyperpermeability was reduced in every case. Neurosensorial retinal detachment decreased in 80% of cases. Only one eye received a second PDT treatment due to choroidal neovascularization. An increase of atrophy over the Retinal Pigment Epithelium (RPE) was observed in another patient. CONCLUSIONS: PDT can reduce the clinical signs of activity, such as choroidal hyperpermeability or neurosensorial retinal detachment, in patients affected by chronic CSC. However, the increase in visual acuity is variable, probably due to the extent of RPE damage.

[Reduction of corneal permeability in patients treated with HP-guar: a fluorophotometric study]. / Reducción de la permeabilidad corneal en pacientes tratados con HP-guar: estudio fluorofotométrico.

INTRODUCTION: The incidence of dry eye disease, which mainly affects the corneal epithelium, is rising. The main treatment is still the use of artificial tears capable of improving the humidification and lubrication of the corneal epithelium, and avoiding its progressive functional failure. HP-Guar is a new compound used for this purpose. METHODS: We performed a prospective, masked and paired study on the left eye of 10 patients suffering from dry eye disease. Corneal permeability measurements were performed by fluorophotometry after instilling 40 microL of a solution of 2% sodium fluorescein, before and after treatment with the HP-Guar drops. The results were analysed using Wilcoxon test for paired data. RESULTS: A mean decrease in corneal permeability of 45%, after the use of HP-Guar drops was found (p=0.002). CONCLUSIONS: HP-Guar provides a new therapeutic option significantly decreasing corneal epithelial permeability.