Total Filling of the Vitreous Cavity With a Cohesive Ophthalmic Viscosurgical Device to Support the Removal of the Intraocular Foreign Body.

PURPOSE: To evaluate the effectiveness of loading the vitreous cavity with a cohesive ophthalmic viscosurgical device in aiding the removal of the posterior segment intraocular foreign body (IOFB). METHODS: Seven consecutive patients underwent a small-gauge vitrectomy due to eye trauma with the IOFB between January 2019 and December 2019. The IOFB removal was initiated after total filling the vitreous cavity with the ophthalmic viscosurgical device (Eyefill C or Bio-Hyalur Plus) to facilitate maneuvering and slow the descent in cases of the unintendedly released IOFBs. The eye examination was performed at presentation and at 1 day, 7 days, 1 month, and 3 months after surgery. The best-corrected visual acuity and intraocular pressure were evaluated. RESULTS: In all eyes, IOFBs were elevated into the center of the vitreous cavity and could be securely gripped while suspended in the ophthalmic viscosurgical device to allow the surgeon for successful and harmless removal. In the 3-month follow-up, the best-corrected visual acuity was 20/20 in 5 patients and 20/25 in 2 patients. In the early postoperative period, the elevation of intraocular pressure did not occur. No patient developed endophthalmitis. CONCLUSION: The authors demonstrated that this uncomplicated technique is an effective surgical option for more reliable removal of posterior segment IOFBs.

Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: An optical coherence tomography angiography study.

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory and demyelinating diseases that commonly manifest with optic neuritis (ON) but differ in the pathogenic mechanism. Although it was shown that retinal vessels might alter in MS and NMOSD, a comparative study has not been reported. This study evaluated the macular vessel density in 40 MS patients, 13 NMOSD patients, and 20 controls using optical coherence tomography angiography. The vessel density of superficial capillary plexus (SCP) was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS-ON, NMOSD-ON) and controls. The density of deep capillary plexus (DCP) was significantly increased in MS+ON and MS-ON eyes compared to healthy eyes. In NMOSD+ON and NMOSD-ON, the DCP did not remarkably differ from the control group. A significant positive correlation was noted between SCP and ganglion cell complex (GCC) thickness in MS+ON, MS-ON, and NMOSD+ON. The DCP did not significantly correlate with GCC thickness, but it increased or decreased with ganglion cell loss in MS and NMOSD, respectively. In conclusion, our findings suggest that the capillary changes in MS patients are secondary to ganglion cells' atrophy, while vasculopathy seems to be a primary process in NMOSD patients.

Differentiation between multiple sclerosis and neuromyelitis optica spectrum disorder using optical coherence tomography angiography.

Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are autoimmune demyelinating diseases of distinct etiology presenting with optic neuritis (ON). This study aimed to identify the macular and peripapillary neurovascular alterations that may facilitate the differentiation between NMOSD and MS eyes using spectral-domain optical coherence tomography (OCT) and OCT angiography (OCTA). A total of 13 NMOSD patients and 40 MS patients were evaluated. After ON, the radial peripapillary capillary (RPC) vessel density was significantly decreased in the superior (S) and inferior (I) sectors in NMOSD compared with MS eyes, whereas in non-ON eyes, the temporal (T) sector of RPC was reduced in MS group. In the ON eyes, the retinal nerve fiber layer in the I and T quadrants was thinner in NMOSD than in MS. Regarding ON and non-ON eyes, the macular capillary plexuses, and the ganglion cell complex thickness did not differ between NMOSD and MS. The ratios, based on the disease-specific intra-eye RPC vessel density reduction pattern, were the best discriminants between NMOSD and MS, i.e., inferior to nasal (I/N) and I/T ratios for ON eyes, and S/T and N/T ratios for non-ON eyes. Our results show that the OCTA-based simple ratios may be useful in distinguishing NMOSD and MS patients.

Optical Coherence Tomography Angiography of Peripapillary Vessel Density in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Comparative Study.

Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are demyelinating diseases of the central nervous system, which differ in the pathogenic mechanism. A common clinical presentation of both conditions is optic neuritis (ON). The study aimed to compare the radial peripapillary capillary (RPC) vessel density in MS and NMOSD patients using optical coherence tomography angiography (OCTA). A total of 40 MS patients, 13 NMOSD patients, and 20 controls were included. The average RPC vessel density was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS-ON, NMOSD-ON) and in MS+ON, MS-ON, NMOSD+ON, and NMOSD-ON compared with the control group. In NMOSD+ON eyes, the vessel density in superior nasal, nasal superior, and inferior sectors was significantly more decreased than in MS+ON eyes. RPC reduction was also observed in inferior nasal and temporal superior sectors in MS-ON eyes compared with NMOSD-ON eyes. In conclusion, our findings indicate that optic neuritis is associated with a more significant RPC vessel density drop in NMOSD than in MS patients, and the predilection to superior and inferior sectors may be useful as a differential diagnostic marker.

Pharmacological Myopia Control Influence on Quality of Life and Psyche among Adolescents.

Myopia is a global problem affecting all aspects of patients' lives. OBJECTIVES: The aim of the study was to evaluate the influence of low dose atropine (LDA) myopia control on the quality of life in patients with myopia. MATERIAL AND METHODS: A self-constructed questionnaire, including eight questions, was distributed among 40 patients. The questionnaire was divided into two subsections: (1) influence of LDA on visual functions and (2) influence of LDA on self-esteem. Answers were collected separately for boys (18 patients) and girls (22 patients) and compared considering spherical equivalent (SE) and myopia progression rate. RESULTS: Girls reported more issues with near activities and pupil size. Boys and girls complained similarly, regarding the sun glare. We found a high level of certainty about the efficacy of LDA therapy among both examined groups and a little improvement in self-esteem. Girls recommended LDA therapy more often than boys, especially when the progression rate was low. There was no statistically significant difference in answer scores between groups with different myopia progression rates for boys. Girls with lower progression rates reported more issues with near work and sun glare and less trust in LDA therapy's effectiveness than girls with a higher progression rate. There was no statistically significant correlation between SE and the total answer score for both genders. CONCLUSIONS: Findings concerning childrens' and adolescents' psyche are a new aspect of myopia control. We prove that patients during pharmacological myopia control did not report significant problems caused by LDA therapy and they were convinced about its efficacy, had greater self-esteem, and recommended it to peers.

Early presentation of sympathetic ophthalmia in optical coherence tomography studies: A case report.

Sympathetic ophthalmia (SO) is often diagnosed when an inflammatory process appears to be advanced. Herein, the authors present the prospective optical coherence tomography (OCT) study of the onset of SO in the sympathizing eye. Prior to any signs of uveitis, we noted the mild disintegration of the retinal pigment epithelium (RPE) layer, the interdigitation zone (IZ), and the ellipsoid zone (EZ). The complete disruption of IZ and EZ was seen 12 weeks later. After 14 weeks, the uveal inflammation was present, and OCT imaging disclosed the formation of nodule-like lesions between the Bruch's membrane and the RPE layer. The histopathological evaluation of the enucleated exciting eye confirmed the diagnosis of SO.

Exclusively ocular and cardiac manifestation of granulomatosis with polyangiitis - a case report.

BACKGROUND: Granulomatosis with polyangiitis (GPA) is an antineutrophil cytoplasmic antibodies (ANCA)-associated necrotizing granulomatous vasculitis that affects small to medium size vessels. While the classical form with renal and respiratory tract involvement is mainly seen, a limited form (i.e., with no renal disease) may also occur. We present an unusual case of GPA manifesting merely as a bilateral ocular involvement and complete heart block. CASE PRESENTATION: We report a case of a 60-year-old male patient with a limited form of GPA who initially presented with bilateral chronic conjunctivitis and complete atrioventricular block. His visual acuity subsequently declined due to progression to bilateral panuveitis with exudative retinal detachment. The laboratory investigation revealed the elevation of acute phase reactants and strongly positive cytoplasmic ANCA (c-ANCA). Despite negative conjunctival and musculocutaneous biopsy results, the positive c-ANCA, and the clinical manifestation, i.e., heart and ocular involvement, led to the diagnosis of GPA. The remission was achieved with cyclophosphamide and methylprednisolone systemic therapy. CONCLUSIONS: A limited form of GPA may be a diagnostic chameleon. Though rare, it is essential to consider even extremely uncommon findings. Our patient is the first case of such a unique demonstration of the limited GPA manifesting as a bilateral ocular involvement and complete heart block.