Evanescent Snowflake Cataract After Pars Plana Vitrectomy.

This case report discusses the finding of early cataract after pars plana vitrectomy in a patient with a history of rhegmatogenous retinal detachment.

Intraocular Pressure Values using IcareⓇ Rebound Tonometer and Correlation with Postconceptional Age in Premature Infants.

Purpose: This study aimedto determine a normative range of intraocular pressure (IOP) values measured with Icare rebound tonometer in premature infants and evaluate IOP variation over time and its correlation with the progression of postconceptional age (PCA). By doing so, we also evaluated advantages of this IOP-measuring method in this population when compared to more traditional methods. Methods: We conducted a single-center prospective study that included premature infants (gestational age ≤32 weeks) who were admitted to the neonatal intensive care unit (NICU) in Hospital Professor Doutor Fernando Fonseca. The study took place between January and December 2021. IOP was measured using Icare tonometer on the occasion of the first retinopathy of prematurity (ROP) screening requested by the NICU and again after a two-week interval if PCA was still ≤37 weeks. IOP measurements were stopped at 37 weeks or if the infant was discharged. The evaluated outcomes were mean IOP values and their correlation with PCA. Results: Thirty-four eyes of 17 preterm infants with a mean gestational age of 29.4 ± 2.3 weeks and a mean birth weight of 1222.9 ± 361.9 gr were evaluated. The mean IOP registered was 16.1 ± 6.4 mmHg, with a median value of 15.3 mmHg. The top 90th percentile was 22.1 mmHg and the bottom 10th percentile was 9.0 mmHg. The average IOP reduction was 4.8 ± 6.7 mmHg (P = 0.0019) within the two-week interval of PCA. Conclusion: The mean IOP in premature infants was 16.1 ± 6.4 mmHg and this value significantly decreased by 4.8 ± 6.7 mmHg every two weeks of PCA.

Landfill leachate treatment by immediate one-step lime precipitation, carbonation, and phytoremediation fine-tuning.

The high pollutant load of sanitary landfill leachates poses a huge challenge in the search for efficient and environment friendly solutions for their treatment. The objective of this work was to study an integrated solution of environmentally friendly technologies - immediate one-step lime precipitation (IOSLP), carbonation (CB), and phytoremediation (Phyt) - to treat a sanitary landfill leachate. In the leachate sample treatment by IOSLP, the influence of CaO concentration (18.2-33.3 gCaO L-1) and stirring time (2-60 min) on the sludge sedimentability and pollutant removal was studied. Organic load and ammonia nitrogen (AN) removal increases with CaO added, as well as sludge volume. Stirring time has a small influence on organic load and AN removal, presenting a minimum for sludge volume. Thus, the best operational conditions were chosen as 27.6 gCaO L-1, and 40-min stirring time, with 64% chemical oxygen demand (COD) removal. Sludge humidity was 2.1%, making dewatering needless. IOSLP supernatant was submitted to CB by atmospheric CO2, and 100% removals in AN and hardness were attained. Effluents from IOSLP and IOSLP + CB were utilized in Phyt tests, with Vetiver (Chrysopogon zizanioides (L.) Roberty). The best COD removal (37%) during Phyt was attained for the samples treated by IOSLP + CB.

Temporal macular thinning and vessel density correlation in children and young adults with sickle cell disease.

Optical coherence tomography angiography (OCTA) is a recent noninvasive imaging technology that has proved to provide a comprehensive evaluation of retinal vascular abnormalities in adult patients with sickle cell disease (SCD). However, the pediatric population remains less studied. The purpose of this study is to evaluate the correlation between temporal vessel density (VD) in OCTA and temporal macular thinning in optical coherence tomography (OCT) in children and young adults with SCD. We reviewed medical records, OCT and OCTA (Spectralis®) scans from a sample of 32 eyes from 16 patients (7 female + 9 male) under 25 years old. The OCT macular thickness data and OCTA image data were processed using Python 3.9 programming language, and statistical analysis was performed. Pearson Correlation Coefficient between macular thickness and VD for inner and outer temporal areas was 0.47 (p-value = 0.006) and 0.74 (p-value < 0.001), respectively. A t-test was also performed to prove that there is a statistically significant VD difference in patients with higher and lower macular thickness (p < 0.001). These results show that children with outer temporal macular thinning on OCT have lower outer temporal VD on OCTA suggesting that microvascular insults may lead to chronic ischemic changes in the inner retinal layers.

Unilateral leukemic infiltration and acute angle closure as the first sign of B-cell acute lymphoblastic leukemia relapse.

Objective: Unilateral ocular leukemic infiltration with acute angle closure is an infrequent complication of B-cell acute lymphoblastic leukemia (ALL-B). We present a clinical case of leukemic ocular infiltration as the sole manifestation of ALL-B relapse. Methods: Case description Results: A 15-year-old female with a history of acute lymphoblastic leukemia in remission for 2 years and pulmonary tuberculosis treated in the past year presented with ocular redness and decreased visual acuity in the left eye (LE) with 5 days of evolution. Visual acuity was 20/20 in the right eye (RE) and absence of light perception in the left eye (LE). Biomicroscopy of LE showed a small hypopion, anterior chamber cells 4+, vitreous cells 3+, and a large white mass in the vitreous with associated vitreous hemorrhage in organization. In LE fundoscopy, the vitreous mass occupying most of the vitreous cavity and associated hemorrhage prevented retina visualization. B-scan ultrasound showed a multilobulated mass occupying virtually the entire vitreous cavity with associated choroidal detachment. Forty-eight hours later, she developed acute angle closure of LE with an IOP of 55 mmHg. A flow cytometric analysis of the anterior chamber and vitreous showed leukemic tumor cells. The microbiologic exam and PCR for Mycobacterium tuberculosis were negative. No other signs of relapse of the disease were identified after investigation by the oncology department. Rescue treatment of the underlying disease was started, with symptomatic improvement. Conclusion: Leukemic ocular infiltration can be the only manifestation of ALL-B relapse.

Macular Thickness Assessment in Patients with Glaucoma and Its Correlation with Visual Fields.

AIM: To determine the relationship between macular thickness (MT) and visual field (VF) parameters, as well as with changes in the retinal nerve fiber layer (RNFL) thickness in patients with glaucoma and ocular hypertension (OH). MATERIALS AND METHODS: Cross-sectional statistical analysis of spectral domain optical coherence tomography (SD-OCT) compared with several VF parameters (mean defect - MD and loss variance - LV), in a nonrandom sample of 70 eyes from patients with glaucoma or OH. Statistical analysis was performed using Statistical Package for Social Sciences®. The correlation coefficient used was determined by Spearman correlation and the value of p < 0.05 was considered statistically significant. RESULTS: A significant correlation was seen between VF parameters and decrease in MT (MD: r = -0.363, p = 0.002; LV: r=-0.378, p = 0.001). The results were more significant when we compared the LV in the group with average MT 270 to 300 µm (r = -0.413, p = 0.015). Asymmetry between the superior macula and inferior macula correlated with LV (r = 0.432, p = 0.019) in the group with MT < 270 µm. There was also a significant correlation between thinning of superior-temporal and inferior-temporal RNFL and the decrease of the superior and inferior MT respectively (p < 0.001). CONCLUSION: Spectral domain optical coherence tomography measurements of retinal thickness in the macula correlate with VF parameters and RNFL parameters in glaucoma patients. This relationship was first demonstrated with static computerized perimetry made with Octopus 101®. These results can be a valuable aid for evaluating and monitoring of glaucoma patients, establishing a correlation between structure and function. Measurements of retinal thickness in the macula may be an additional instrument for early detection of structural changes and its correlation with functional defects. HOW TO CITE THIS ARTICLE: Mota M, Vaz FT, Ramalho M, Pedrosa C, Lisboa M, Kaku P, Esperancinha F. Macular Thickness Assessment in Patients with Glaucoma and Its Correlation with Visual Fields. J Curr Glaucoma Pract 2016;10(3):85-90.

Secondary pigmentary glaucoma associated with 1-piece foldable intraocular lens in the ciliary sulcus.

UNLABELLED: We report the case of an 83-year-old man who had had cataract surgery in both eyes and was being treated with timolol and dorzolamide in the right eye. Goldmann tonometry was 28 mm Hg in the right eye and 14 mm Hg in the left eye. Biomicroscopy of the right eye revealed pigment dispersion on the corneal endothelium, trabecular meshwork, and intraocular lens (IOL), as well as iris transillumination defects. After pupil dilation, a ciliary sulcus-implanted 1-piece IOL and a ruptured posterior capsule could be seen. Optical coherence tomography showed a diminished nerve fiber layer. Exchange for a 3-piece IOL was performed, but the intraocular pressure (IOP) remained high. For that reason, a trabeculectomy was performed. The final IOP was 12 mm Hg, and the visual fields were stable. This case highlights the importance of IOL choice for sulcus implantation. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.