Characteristics and Prognostic Factors Associated With the Progression of Myopic Traction Maculopathy in Mexican Patients.

Background In this study, the characteristics and prognostic factors associated with the progression of myopic traction maculopathy (MTM) were evaluated in a Mexican population. Methods This is a retrospective observational study that analyzed patients with MTM who underwent optical coherence tomography (OCT). Clinical-ocular information, the MTM classification, and initial and final visual acuity (VA) were recorded. Results In total, 101 eyes of 84 patients (mean age 63.5 ± 10.7 years) were included (88.1% female and 11.9% male). The mean spherical equivalent was -16.8 ± 6.4 D, axial length was 29.6 ± 2.1 mm, and mean initial VA was 0.8 ± 0.5 logMAR. The mean follow-up time was 25.7 ± 27.6 months. The change in final VA from diagnosis to the last follow-up was +0.1 (0.2) (p = 0.001). Overall, 24.8% of patients progressed, 72.3% did not progress, and 3% showed regression. The patient-year progression rate was 0.20 ± 0.44. Factors associated with progression were initial logMAR VA (p= 0.012) and staphyloma (p= 0.001). Conclusions One in four patients with MTM progressed, and the patient-year progression rate was 0.5. The factors associated with disease progression were initial VA and the presence of staphyloma. The characteristics of Mexican patients with MTM are similar to those described in other populations.

Long-term follow-up of a patient with partial optic nerve avulsion associated with submacular hemorrhage who underwent pneumatic displacement.

Purpose: We report the case of a 16-year-old boy with partial optic nerve avulsion (ONA) and submacular hemorrhage (SMH) resulting from blunt ocular trauma who underwent pneumatic displacement and subsequent monitoring with optical coherence tomography (OCT) and fundus photography. Observations: Reduced visual acuity was observed in the right eye at presentation (20/2400). Vitreous hemorrhage, partial ONA, and SMH were observed during dilated fundus examination. SMH was managed via pneumatic displacement. Subsequent examination revealed improvement in the visual acuity of the right eye with a substantial reduction in the subfoveal hemorrhage. Further improvement in visual acuity was observed 6 months after the injury (20/150). A smaller optic nerve head excavation defect, foveal atrophy, and reabsorption of SMH were observed during fundus examination. OCT of the optic nerve revealed that glial growth had covered the avulsion excavation. However, atrophy of the outer retinal layer of the fovea was observed during macular OCT. Conclusions and importance: This case emphasizes the importance of performing multimodal imaging in cases of ONA as it enables the identification of alterations in the retinal layers and optic nerve. The subretinal hemorrhage was displaced from the subfoveal region without any adverse effects.

Microcephaly and Chorioretinopathy Relevance as a Differential Diagnosis.

Microcephaly and chorioretinopathy are genetic disorders that are inherited in an autosomal recessive manner. The most frequent ocular manifestation is the presence of lacunar atrophy in the retina and choroid. The diagnosis of this condition can be challenging as several potential causes and related syndromes need to be ruled out. We present two cases of microcephaly and chorioretinopathy in Mexican patients, their clinical characterization, and discuss the differential diagnoses that should be considered. An 8-year-old girl was examined due to a history of decreased vision in both eyes. Fundus examination showed excavated, well-defined, sectorial, bilateral, and symmetrical areas of chorioretinal atrophy. An 18-year-old male had a history of poor vision since childhood. Previous ophthalmological examinations reported bilateral symmetric chorioretinal atrophy with pigment accumulation. Both patients had a prior diagnosis of microcephaly and language delay. Blood tests and a comprehensive systemic evaluation ruled out intrauterine infections. The electroretinogram showed decreased amplitude and increased implicit time in the photopic and scotopic responses. Genetic tests revealed mutations in the TUBGCP4 gene, leading to a diagnosis of microcephaly and chorioretinopathy. As observed in these cases, there was variability in retinal lesions. The presence of chorioretinal lacunae and genetic testing can help to correctly diagnose this disorder.