A 33-Year-Old Man With Hemoptysis and Renal Dysfunction.

CASE PRESENTATION: A 33-year-old man presented with a 10-day history of fever, dry cough, and dyspnea. He reported small amounts of frank hemoptysis that occurred several times a day for the past 3 days and a reduction in urine volume. There was no joint pain, skin rash, muscle weakness, or bleeding symptoms, except for the hemoptysis. He had a medical history of childhood asthma and untreated hypertension for the past 2 years. He had no history of smoking, recent travel, medication use, or occupational inhalation.

Iridotrabecular and Iridocorneal Contact Changes after Cataract Surgery and Endothelial Keratoplasty in Bilateral Iridoschisis.

We report a case of bilateral iridoschisis with corneal oedema and a quantitative evaluation of the changes in iridotrabecular and iridocorneal contact before and after cataract surgery and after Descemet stripping automated endothelial keratoplasty (DSAEK). A 76-year-old woman with iridoschisis and cataracts, previously managed with laser iridotomy, experienced progressive vision loss. The preoperative iridotrabecular contact (ITC) index measured by anterior segment optical coherence tomography was 23.6% in the right eye and 24.4% in the left eye. Preoperative corneal oedema in the right eye was more severe than that in the left eye. Cataract surgery, followed by DSAEK, was performed in the right eye and subsequently in the left eye. Her visual acuity improved postoperatively, and the corneal oedema of both eyes was treated successfully. Moreover, the ITC index improved in both eyes, to 4.7 and 6.9% after cataract surgery and to 0 and 0% after DSAEK in the right and left eyes, respectively. Staged cataract surgery and DSAEK were effective for endothelial decompensation caused by iridoschisis. Additionally, we confirm that iridotrabecular and iridocorneal contacts improved after both surgical procedures not only after cataract surgery but also after DSAEK. This case report showed the clinical usefulness of the ITC index in the detection of changes after different surgical procedures.

Diagnosis of Dry Eye by Tear Meniscus Measurements Using Anterior Segment Swept Source Optical Coherence Tomography.

To evaluate the diagnostic power of tear meniscus measurements using anterior segment swept source optical coherence tomography (SS-OCT) for dry eye and suspected dry eye. Fifty subjects (27 men and 23 women; mean age 43.3 ± 13.7 years), comprising 26 eyes of 26 healthy subjects and 24 eyes of 24 patients with dry eye or suspected dry eye according to Japanese diagnostic criteria, were enrolled at The University of Tokyo Graduate School of Medicine. Subjects underwent SS-OCT, and the central upper and lower tear meniscus heights (TMHs) and areas (TMAs) and the lower tear meniscus volume (TMV) were examined. Intergrader variability and interimage variability, calculated using the pooled coefficient of variation and intraclass correlation coefficient, were used to assess repeatability of measurements in the dry eye group. To diagnose dry eye using tear meniscus measurements by SS-OCT, sensitivity, specificity, and cutoff values of optical coherence tomography (OCT) measurements were determined using receiver operating characteristic analysis. The TMH, TMA, and TMV measured by OCT were significantly lower in the dry eye group than in the control group (P < 0.001). Cutoff values of the lower TMH, TMA, and TMV were 191 µm, 12,360 µm, and 0.0473 mm, respectively. Intergrader repeatability and interimage repeatability, measured as the intraclass correlation coefficient, were >80% for all tear meniscus parameters, with acceptable repeatability. Significant correlations between tear meniscus measurements by OCT and vital staining scores, Schirmer test values, and tear film breakup time were observed (P < 0.05). SS-OCT is a noninvasive and practical method for quantitative evaluation of tear fluid and has the potential for detecting dry eye and suspected dry eye.