Difference between both eyes in the calculation of the dioptre power of the intraocular lens in a series of 7994 patients.

PURPOSE: To analyse the distribution of the difference between both eyes in the calculation of the dioptric power of the intraocular lens in a series of 7994 patients and the biometric variables that determine it. METHODS: The data of patients between 3 and 99 years old, residents of the city of Guayaquil and neighbouring sites, who received ocular biometry by partial optical coherence interferometry between 2004 and 2020 were reviewed. Ocular biometrics, including axial length (AL), anterior chamber depth (ACD), and the mean corneal dioptre power (CD), were measured by partial coherence interferometry. Refraction without or with cycloplegia was recorded in spherical equivalent (SE). The Haigis formula from the IOL Master instrument was used to calculate the dioptric power of the intraocular lens in both eyes. RESULTS: Data from the bilateral optical biometry of 7994 patients were analysed. The mean and standard deviation of AL, CD, ACD and dioptre power of the IOL were 23.66 ±â€¯1.25, 43.70 ±â€¯1.49, 3.34 ±â€¯0.40 and +20.46 ±â€¯3.84, respectively. 2538 (31.7%) patients had equal dioptre power of the IOL between both eyes. 3243 (40.6%) patients had a 0.50 D difference; 1162 (14.5%), 1.0 D; 425 (5.3%), 1.5 D. 626 patients (7.8%) had a difference in IOL dioptre of 2 D or more, with a maximum of 24 D. The asymmetry of AL between OU was ≥0.4 mm in 10.49%, while that of CD reached ≥1 D in 1.9%. CONCLUSIONS: 92.16% of patients had a difference within 1.5 D between both eyes in the calculation of the dioptre power of the intraocular lens. In case an eye is programmed in which it is impossible to perform a reliable biometry, either due to trauma or due to white or brunescent cataract, the calculation of the intraocular lens could be done taking as a reference the biometry of the contralateral eye.

Anti-citrullinated protein antibodies and arthritis in Sjögren's syndrome: a systematic review and meta-analysis.

OBJECTIVE: The presence of anti-citrullinated protein antibodies (ACPAs) in primary Sjögren's syndrome (pSS) ranges from 3% to 9.9%; however, there is no agreement about their clinical significance. Our aim was to systematically review the literature regarding the association of arthritis and ACPAs in pSS and their role in the development of rheumatoid arthritis (RA). METHOD: A comprehensive search of MEDLINE, ISI Web of Knowledge, and Cochrane Library from inception until June 2016 was undertaken using the combination of two or three of the keywords: primary Sjögren's syndrome, Sjögren's syndrome, arthritis, synovitis, arthropathy, anti-cyclic citrullinated peptide antibodies, and anti-citrullinated protein antibody - ACPA. No language restriction was used. Studies were included if they: assessed the association of arthritis and ACPAs, had sufficient data to construct a two-by-two table, tested immunoglobulin G ACPA by any method, and included patients with pSS according to a validated set of classification criteria. We used a random effects model and evaluated the heterogeneity and publication bias. RESULTS: Ten studies were included (involving 1322 patients). We found a pooled odds ratio of 4.42 (95% confidence interval 1.15-16.94, p = 0.03). The test for heterogeneity was I2 = 0.87. Publication bias was not observed. Based on data from three studies, 33 of 58 pSS patients with ACPAs (57%) developed RA compared with none of 598 pSS patients with negative ACPA (p < 0.000001). CONCLUSION: Patients with pSS disclosing ACPAs are prone to arthritis as part of the clinical spectrum of the disease, but are also at risk of developing RA.

Clinical and nerve conduction features in Guillain-Barré syndrome associated with Zika virus infection in Cúcuta, Colombia.

BACKGROUND AND PURPOSE: Zika virus (ZIKV) infection has been associated with an increased incidence of Guillain-Barré syndrome (GBS) but the relative frequency of acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and axonal GBS subtypes is controversial. METHODS: Twenty GBS patients diagnosed according to the Brighton criteria during the ZIKV outbreak in Cúcuta, Colombia, were evaluated clinically and electrophysiologically. The electrodiagnosis of GBS subtypes was made according to a recently described criteria set that demonstrated a high diagnostic accuracy on the basis of a single test. The electrophysiological features of 34 Italian AIDP patients were used as control. RESULTS: All patients had symptoms compatible with ZIKV infection before the onset of GBS and ZIKV infection was laboratory confirmed through a plaque reduction neutralization test (PRNT90 ) in 100% of patients. The median time from onset of ZIKV infection symptoms to GBS was 5 days (interquartile range 1-6 days). Cranial nerve palsy was present in 85% of patients (facial palsy in 75%, bulbar nerve involvement in 60%), autonomic dysfunction in 85%, and 50% of patients required invasive mechanical ventilation. AIDP was diagnosed in 70% of patients. 40% of nerves of AIDP patients showed a prevalent distal demyelinating involvement but this pattern was not different from the Italian AIDP patients without ZIKV infection. CONCLUSIONS: Guillain-Barré syndrome associated with ZIKV infection in Cúcuta is characterized by a high frequency of cranial nerve involvement, autonomic dysfunction and requirement of mechanical ventilation indicating an aggressive and severe course. AIDP is the most frequent electrophysiological subtype. Demyelination is prevalent distally but this pattern is not specific for ZIKV infection.