Ocular biometry in dense cataracts: Comparison of partial-coherence interferometry, swept-source optical coherence tomography and immersion ultrasound.

PURPOSE: To assess the axial length (AL) measurement failure rate using partial-coherence interferometry (PCI) and swept-source optical coherence tomography (SS-OCT) in dense cataracts. As a secondary outcome, the SS-OCT biometry was compared to immersion ultrasound. METHODS: This is a prospective cross-sectional and comparative study. Seventy eyes from 70 patients with dense cataracts were enrolled in this study. Dense cataract was defined according to the Lens Opacities Classification System III (LOCS III) scores equal to or more than NO4, NC4, C4, and P3. The failure rate of AL measurement was evaluated using PCI and SS-OCT. Anterior chamber depth (ACD), lens thickness (LT), and AL measurements obtained by SS-OCT were compared with IUS. RESULTS: AL measurement failure rate with PCI was 68.57% and 21.43% with SS-OCT (P = 0.007). AL measurement was achieved in 69.23% of NO4, 66.6% of P3, and 15.3% of mixed cataracts using PCI, while SS-OCT was achieved in 100% of NO4, NO5, P3, and P5 and 76.9% of mixed cataracts. Cortical cataracts alone did not influence AL measurement. Biometric data of ACD, LT, and AL were statistically different comparing US and SS-OCT with a good correlation of AL. CONCLUSION: SS-OCT significantly improves the rate of successful AL measurements when compared to PCI in dense cataracts. The LOCS III clinical cut-off for the use of SS-OCT ocular biometry may well be up to P4 and NO5.

A Proposed Method to Quantify Vitreous Hemorrhage by Ultrasound.

PURPOSE: To propose a method for quantification of vitreous hemorrhages (VH) termed minimum image gain (MIG). Therefore, to obtain MIG measurements in patients with VH and to compare them to normal controls; to compare results between graders; and to obtain and compare MIG from two different ultrasound systems. METHODS: Retrospective and cross-sectional, observational, and comparative study performed in two parts: Part 1) Retrospective comparison of MIG in VH vs controls by two experienced graders, with intra/inter-observer variability: MIG technique is described. MIG is performed retrospectively in two groups, VH patients and normal controls. Groups are compared with independent samples t-test. Intra- and interobserver variability between graders was obtained. Part 2) Cross-sectional analysis of variability from nonexperienced graders and with different ultrasound systems: MIG is performed in cross-sectional measurements of VH patients, by two unexperienced graders, and with two ultrasound systems. Interobserver variability and Bland-Altman plot with levels of agreement (LoA) were obtained. RESULTS: Part 1: 50 patients with VH resulted in mean MIG: 52.8 dB; 34 controls resulted in mean MIG: 77.97 dB. Independent samples t-test resulted in a statistical significant difference. Intra- and inter-observer variability resulted in an almost perfect agreement between experienced graders. Part 2: 63 patients with VH, mean MIG: 56.19 dB. Inter-observer variability resulted in a very high agreement between unexperienced observers. LoA resulted in a statistical difference between the two ultrasound systems. CONCLUSION: MIG may provide an objective and reproducible way to quantify vitreous hemorrhage density and potentially any vitreous humor opacity. Agreement is high even with unexperienced graders. However, the two ultrasound systems analyzed may not be interchangeable.

Echographic findings in the late stages of Vogt-Koyanagi-Harada disease in mexican population / Resultados ecográficos nas fases atrasadas da doença de Vogt-Koyanagi-Harada na população mexicana

Purpose: To correlate clinical findings of Vogt-Koyanagi-Harada disease with standardized echography findings in a cross-sectional, descriptive and observational study. Methods: Patients with Vogt-Koyanagi-Harada disease in the convalescent and recurrence phases were evaluated with standardized ocular echography. Eyes with opaque media were excluded. Clinical findings were correlated with echographic data. Results: Thirty-seven eyes of 25 patients were included. Best corrected visual acuity was in average 20/100 (0.70 logMAR). Clinical findings included: sunset glow fundus (92%), pigment migration (92%), nummular chorioretinal depigmented scars (68%) and subretinal fibrosis (64.8%). Standardized echography was able to recognize all the cases with subretinal fibrosis (n=24) described clinically. Standardized echography showed a 100% sensitivity and specificity of finding subretinal fibrosis. Subretinal fibrosis in patients with Vogt-Koyanagi-Harada represents a risk factor for low vision. In our patients’ eyes, presence of subretinal fibrosis had a 2.5 time relative risk of having a visual acuity equal or worst to 20/70. Conclusions: Standardized echography represents a useful tool in patients with VKH in the chronic (convalescence and recurrence) phase of the disease. Subretinal fibrosis, a sight threatening complication in the convalescence and recurrent phases of Vogt-Koyanagi-Harada, can be diagnosed with ocular echography, with characteristic images. Knowledge of these images can be useful in cases with opaque media and bilateral anterior segment granulomatous inflammatory disease. .

Objetivo: Correlacionar achados clínicos da síndrome de Vogt-Koyanagi-Harada com resultados ecográficos padronizado da doença em um estudo transversal, descritivo e observacional. Métodos: Pacientes com a doença de Vogt-Koyanagi-Harada, o convalescente e recorrência em fases padronizadas foram avaliados com ecografia ocular. Olhos com material opaco foram excluídos. Achados clínicos foram correlacionados com dados ecográficos. Resultados: Um total de 25 pacientes e trinta e sete olhos foram incluídos no estudo. A acuidade visual (AV) 20/100 foi em média 0.70 logMAR. Os achados clínicos incluídos: sunset glow fundus (92%), pigmento migração (92%), numular despigmentado cicatrizes coriorretinianas (68%) e fibrose sub-retiniana (64,8%). A ecografia padronizada foi capaz de reconhecer todos os casos de fibrose sub-retiniana (n= 24) descrito clinicamente. A ecografia revelou um padrão 100% de sensibilidade e especificidade do diagnóstico fibrose sub-retiniana. Sub-retiniana em pacientes com fibrose Vogt-Koyanagi-Harada representa um fator de risco para a baixa visão. Em nossos pacientes olhos, presença de fibrose subretiniana tinham um risco relativo 2,5 hora de ter uma acuidade visual igual ou pior para 20/70. Conclusão: Ecografia padronizadarepresenta uma ferramenta útil em pacientes portadores da doença na fase crônica (convalescença, e recidiva). Fibrose sub-retiniana, uma visão ameaçadora e complicação na convalescença e recorrentes nas fases da Síndrome de Vogt-Koyanagi- Harada, podem ser diagnosticados com ecografia ocular, com imagens características. O conhecimento dessas imagens pode ser útil em casos com material opaco e segmento anterior bilateral da doença inflamatória granulomatosa. .

Ciliary body leiomyoma: case report.

A 41-year-old female complained of impaired vision on her left eye in the past year. Her visual acuity was 20/20 on the right eye and 20/50 on the left eye. In her left eye, there was an ill-defined, irregularly pigmented, orange lesion at 7 o'clock meridian behind the iris. Standardized ultrasound A-scan and B-scan revealed a large, rounded ciliary body lesion with inner homogeneous structure, medium internal reflectivity and positive vascularity. Under the ultrasonographic diagnosis of leiomyoma, iridocyclectomy was performed. Histopathologic examination revealed ciliary body leiomyoma.

Distrofia miotómica de Steinert: Presentación de tres casos / Steinert miotonic dystrophy: Report of three cases

La distrofia miotónica de Steinert, es la más frecuente de las miopatías hereditarias y se distingue de otras distrofias musculares por acompañarse de cambios distróficos en otros órganos y tejidos. En esta entidad se presentan múltiples alteraciones oculares como blefaritis seborréica, ptosis miogénica, queratitis sicca, distrofias corneales, cataratas, hipotensión ocular y cambios pigmentarios a nivel de retina. Se presentan 3 casos

Amiloidosis de la glándula lagrimal. Reporte de un caso / Lacrimal gland amyloidosis. Case report

La amiloidosis representa un espectro de alteraciones que afecta a órganos y sistemas; la fisiopatología involucra una vía metabólica común que resulta en un depósito de proteínas en los tejidos o en múltiple órganos y sistemas. Se presenta el caso de un paciente femenino con una masa blanda en reborde orbitario superior izquierdo, bien delimitada, móvil, con diagnóstico clínico de dacrioadenitis. Se inició tratamiento con prednisolona y sulfas en gotas y ungüento, además de antibiótico por vía oral, sin mostrar cambios en la evolución clínica. Se realizó estudio de ultrasonido ocular y orbitario AO con un equipo Biovisión B-scan-S, observando la presencia de una masa sólida, bien definida, localizada a la glándula lagrimal y con extensión a la porción superior de órbita izquierda. El modo A estandarizado reveló una estructura interna regular y alta reflectividad. El estudio histopatológico reportó una tinción positiva al Rojo Congo y birrefringencia a la luz polarizada con diagnóstico de amiloidosis de la glándula lagrimal. Aunque la amiloidosis de la glándula lagrimal es rara, el estudio de ultrasonido es un método útil en el diagnóstico, aun sin signos clínicos de amiloidosis

Ultrasonido biomicroscópico. Hallazgos en queratomileusis miópica (Lasik) / Ultrasonic biomicroscopic findings in miopic keratomileusis (Lasik)

En la actualidad una de las cirugías más populares para miopía alta es el procedimiento de Lasik, en la cual, la capa de Bowman es preservada. Nosotros estudiamos 9 ojos de 8 pacientes con ultrasonido biomicroscópico a quienes se les realizó la técnica de Lasik. Todos los pacientes fueron mayores de 20 años de edad, con un equivalente esférico promedio de -9.69 dioptrías. A la exploración con ultrasonido biomicroscópico las características de la córnea fueron similares tanto en el examen pre y postoperatorio, el grosor corneal promedio preoperatorio fue de 562 micras y en el post operatorio de 470 micras, la profundidad de la cámara anterior no presentó cambios significativos. La profundiad de la ablación promedio calculada en el preoperatorio fue de 90 micras y en post operatorio fue de 74 micras

Consideraciones de la respuesta inmunológica ocular en la cisticercosis: reporte de dos casos / Immunologic responses in ocular cysticercosis: report of 2 cases

Se presentan 2 casos clínicos de cisticercosis ocular en donde se empleó diagnóstico inmunológico con la prueba de ELISA, la cual resultó altamente positiva en el humor acuoso de ambos pacientes, pero en sólo uno positiva en el suero