Choroidal neovascularization and MEWDS like reaction in a child: A rare case.

PURPOSE: To report a case of choroidal neovascularization (CNV) associated with Multiple Evanescent White Dot Syndrome (MEWDS) in a child. STUDY DESIGN: Case report. RESULTS: A 13-year-old child visited us with a month-long history of blurred vision in his right eye. His right fundus showed several subretinal white dots and an atrophic macular lesion corresponding to a CNV. Angiography and optical coherence tomography (OCT) were consistent with the diagnosis of MEWDS. The patient's condition poorly improved after an intravitreal injection of anti-vascular endothelial growth factor (anti VEGF) in his right eye. CONCLUSIONS: We reported the case of CNV associated with MEWDS like reaction. The hypothesis of a triggered-MEWDS was highly suspected but no cause was found, which is often the case in paediatric inflammatory eye disorders. Long-term follow-up is needed to judge the evolution.

[Immunosuppressive therapy in severe or chronic pediatric uveitis: Review of the literature]. / Les immunosuppresseurs dans les uvéites pédiatriques sévères ou chroniques : revue de la littérature.

Immunosuppressants are prescribed for pediatric uveitis in cases of severe involvement affecting the prognosis for vision or life, in cases of recurrent or chronic uveitis to achieve corticosteroid sparing, or in cases of corticosteroid resistance. Immunosuppressants used in children include antimetabolites (methotrexate, mycophenolate mofetil, azathioprine), cyclosporine, tacrolimus, and biologics, including infliximab, adalimumab, anakinra, canakinumab, and tocilizumab. The mechanisms of action and indications of the various immunosuppressants are described in this review.

Scleral fixated intraocular lens by a modified technique: Methods and results.

PURPOSE: A certain number of conditions can result in compromised anterior and/or posterior capsular integrity. Several surgical options have been employed for repositioning dislocated intraocular lenses in the absence of adequate capsular support. The purpose of this study is to assess the functional outcomes and complication profile of a modified surgical technique for replacing dislocated intraocular lenses. MATERIAL AND METHODS: All patients who had undergone the modified surgical procedure for dislocated intraocular lenses between 2012 and 2017 were retrospectively reviewed for visual outcomes and complications. Patient demographic characteristics, pre- and postoperative visual acuity, surgical indications, refractive outcomes, intraocular pressure and postoperative complications were recorded and analysed at baseline and at six months, which was the conclusion of the study. We also present our modified surgical technique. RESULTS: Sixty-eight eyes of sixty-eight patients (74% male) were included. Mean age at surgery was 58 years (range 4-89 years). Mean best-corrected visual acuity increased significantly from 0.80 (SD±0.2) LogMar to 0.40 (SD±0.1) LogMar (P<0.005). Median astigmatic error at the conclusion of follow-up remained stable. There were no intraoperative complications and a low postoperative complication rate (10.2%), mainly related to the surgical context. CONCLUSION: Sutureless intrascleral fixation of dislocated intraocular lenses is an option in case of deficient capsular support. Visual outcomes and complication rates are comparable to other case series.

Concentraciones séricas de selenio en recién nacidos / Serum selenium levels in neonates

Antecedentes: A pesar de su creciente importancia en nutrición infantil, los estudios en España sobre los niveles de selenio en recién nacidos son escasos y, a menudo, contradictorios. Objetivos: Establecer unos niveles de normalidad de selenio sérico en neonatos a término sanos de nuestro medio y contribuir al mejor conocimiento de aquellos factores perinatales que influyen sobre éstos. Métodos Determinamos la seleniemia sérica por espectrofotometría de absorción atómica de 247 recién nacidos, distribuidos en 70 a término sanos, 60 a término patológicos, 18 con retraso de crecimiento intrauterino (> 37 semanas y peso al nacimiento < 2.500 g), 44 pretérmino sanos y 55 pretérmino patológicos. Resultados Los a término sanos presentaron concentraciones de selenio séricas superiores a los pretérmino sanos (35,11 6,94 g/l, rango 18,4-48 g/l frente a 28,65 5,95 g/l, rango 15-44,4 g/l; p < 0,001). Los retrasos de crecimiento presentaron valores superiores a los pretérmino sanos (30,80 6,97 g/l, rango 20-45,6 g/l frente a 28,65 5,95 g/l; límites 15-44,4 g/l), pero inferiores a los a término con normopeso al nacimiento (ídem frente a 35,11 6,94 g/l, rango 18,4-48 g/l). Asimismo, los de bajo peso al nacimiento (inferior a 2.500 g) presentaron valores medios inferiores a los neonatos con normopeso (27,98 6,75 g/l, límites, 15-48 g/l frente a 33,09 7,52 g/l, límites, 14,4-48 g/l; p < 0,001). Conclusiones: Prematuridad y bajo peso al nacimiento son los mejores predictores de riesgo de hiposeleniemia neonatal (AU)

[Serum selenium levels in neonates]. / Concentraciones séricas de selenio en recién nacidos.

BACKGROUND: Despite their increasing importance in children's nutrition, studies on selenium levels in neonates in Spain are scarce and often contradictory. OBJECTIVES: To establish the standard serum levels of selenium in healthy full term neonates in our area and to contribute knowledge of the perinatal factors that influence these levels. METHODS: We determined selenium levels in serum by atomic absorption spectrophotometry in 247 neonates: 70 healthy full term neonates, 60 sick full term neonates, 18 neonates with intrauterine growth retardation (> 37 weeks; birthweight < 2500 g), 44 healthy preterm neonates and 55 sick preterm neonates. RESULTS: Healthy full term newborns showed higher serum selenium levels than healthy preterm neonates (35.11 6.94 g/l, range: 18.4-48 g/l versus 28.65 5.95 g/l, range: 15-44.4 g/l, p < 0.001). In the group with intrauterine growth retardation, serum selenium levels were higher than in the healthy preterm group (30.80 6.97 g/l, range: 20-45.6 g/l versus 28.65 5.95 g /L, range: 15-44.4 g/l) but lower than in the full term and normal birthweight group (idem versus 35.11 6.94 g/l, range 18.4-48 g/l). Likewise, the low birthweight group (< 2500 g) showed lower mean serum selenium levels than the normal birthweight group (27.98 6.75 g/l, range 15-48 g/l versus 33.09 7.52 g/l, range 14.4-48 g/l; p < 0.001). CONCLUSIONS: Prematurity and low birthweight are the best predictors for risk of neonatal hyposeleniemia.