A retrospective analysis of visual function in patients with preoperatively diagnosed myopia, after implantation of Liberty® intraocular lens, including the influence of some factors like a kind of surgery, values of angle alpha and kappa, pupil size, values of higher order aberrations generated by the lens on visual acuity to far and near distances was done. Lens removal and Liberty® implantation was done 47 eyes, including in 13 patients in both eyes. In 7 eyes, it was a toric lens. A mean preoperative value of myopia was -6.72 Dsph. Cataract removal accounted for 55% of all procedures performed, the rest being Refractive Lens Exchange. Preoperative pupil size was between 3.6 and 6,4 mm. The average postoperative visual acuity to far distances was 0.13 (logMar), and to near distances was 0.51 (Snellen). Rare cases of insufficient quality of vision to intermediate distances, when the postoperative pupil size was greater than 4 mm, resolved after increasing light intensity in the room. A bigger values of higher order aberrations corresponded with lower values of preoperative visual acuity to far distances. A bigger values of angle alpha corresponded with lower values of postoperative visual acuity to far distances, which were significantly higher in cataract group. Visual acuity to far distances was also better in eye with bigger pupil size. A specific structure of the lens allows patients to see good to the near distances, even if the light intensity not perfect.
Macular Pigments (MPs), by absorbing potentially toxic short-wavelength (400–500 nm) visible light, provide protection against photo-chemical damage. A new method of MPs levels screening analyzes polarization-dependent absorption of blue light by MPs, which results in the entoptic phenomenon called Haidinger’s Brushes (HB). Subjects identify the direction of rotation of HB when presented with a circular stimulus illuminated with an even intensity of polarized white light in which the electric field vector was rotating either clockwise or anti-clockwise. The examination was performed at baseline and after 3 months of daily intake of 320 mg bilberry extract, from Vaccinium myrtillus L. and standardized to contain more than 36% of anthocyanins (anthocyanosides), in normal subjects and MPs improvement was recorded after 3 months of dietary supplements. The results suggest a challenging role of daily intake of 320 mg bilberry extract in macular pigment density improvement possibly due to a macular protection from oxidative damage by bilberry.
Severe damage of the ocular surface is still one of the leading causes of impaired vision. Next to widely used treatment methods, such as keratoplasty and usage of amniotic membrane, a new approach has been in the focus of the research for the past few years. This review presents possibilities for using nanofibrous materials in the treatment of corneal defects. There is a broad spectrum of natural and synthetic polymers suitable for this purpose. Thanks to their mechanical strength, nanofibrous scaffolds are durable, and due to their high porosity, they promote optimal cell growth and proliferation conditions. Those three-dimensional, thread-like structures can also be used as a drug delivery system for different substances, such as antibiotics or stem cells.
We report the case of a 56 year -old patient, with the notion of a neglected ocular trauma of the right eye 6 years ago, with a progressive decrease in visual acuity for 4 years. The ophthalmological examination of the right eye showed a visual acuity with finger movement, an ocular tone of 15 mmhg with a regressive cataract in the anterior segment with a retracted aspect and an embossed anterior surface. Ocular ultrasound was performed and returned normal. The ophthalmological examination of the left eye did not reveal any abnormality. A phacoemulsification cataract surgery was performed with a good postoperative evolution.
Background Epiretinal membranes in patients with proliferative vitreoretinopathy (PVR) consist of extracellular matrix and a number of cell types including retinal pigment epithelial (RPE) cells and fibroblasts, whose contraction causes retinal detachment. In RPE cells depletion of platelet-derived growth factor (PDGF) receptor (PDGFR)β suppresses vitreous-induced Akt activation, whereas in fibroblasts Akt activation through indirect activation of PDGFRα by growth factors outside the PDGF family (non-PDGFs) plays an essential role in experimental PVR. Whether non-PDGFs in the vitreous, however, were also able to activate PDGFRβ in RPE cells remained elusive. Methods The CRISPR/Cas9 technology was utilized to edit a genomic PDGFRB locus in RPE cells derived from an epiretinal membrane (RPEM) from a patient with PVR, and a retroviral vector was used to express a truncated PDGFRβ short of a PDGF-binding domain in the RPEM cells lacking PDGFRβ. Western blot was employed to analyze expression of PDGFRβ and α-smooth muscle actin, and signaling events (p-PDGFRβ and p-Akt). Cellular assays (proliferation, migration and contraction) were also applied in this study. Results Expression of a truncated PDGFRβ lacking a PDGF-binding domain in the RPEM cells whose PDGFRB gene has been silent using the CRISPR/Cas9 technology restores vitreous-induced Akt activation as well as cell proliferation, epithelial-mesenchymal transition, migration and contraction. In addition, we show that scavenging reactive oxygen species (ROS) with N-acetyl-cysteine and inhibiting Src family kinases (SFKs) with their specific inhibitor SU6656 blunt the vitreous-induced activation of the truncated PDGFRβ and Akt as well as the cellular events related to the PVR pathogenesis. These discoveries suggest that in RPE cells PDGFRβ can be activated indirectly by non-PDGFs in the vitreous via an intracellular pathway of ROS/SFKs to facilitate the development of PVR, thereby providing novel opportunities for PVR therapeutics. Conclusion The data shown here will improve our understanding of the mechanism by which PDGFRβ can be activated by non-PDGFs in the vitreous via an intracellular route of ROS/SFKs and provide a conceptual foundation for preventing PVR by inhibiting PDGFRβ transactivation (ligand-independent activation).
The orbital idiopathic myositis is included in the group of orbital inflammatory pseudotumors. It’s an isolated inflammation, unspecific of orbital muscles. This pathology is rare in Children and it is a source of real diagnosis problems. We report the case of a 10-year-old boy who was hospitalized for bilateral painful exophthalmos. We report the case of a 10-year-old boy who was hospitalized for bilateral exophthalmos of abrupt onset, painful, axial, and non reducible with complete ophthalmoplegia of both eyes. The examination showed a retained Visual Acuity (VA) of 10/10 with a normal Fundus Examination (FO) in both eyes. The inflammatory and thyroid work-up are negative. The orbital tomodensitometry revealed a grade I exophtalmitis and a thickening of external and inferior muscles. The corticotherapy leaded to the decline of exophtalmitis andnormalization of eye movements after 1 month of treatment. The etiologic survey was negative, then the diagnosis of idiopathic myositis was kept. The orbital idiopathic myositis stills an eliminating diagnosis. Faced to a child’s exophtalmitis, other differential diagnosis must be excluded by an advanced etiologic survey.
Corneal hydrops is an aqueous infiltration of the cornea following a breach in the descemet membrane. Its occurrence is a turning point in the evolution of keratoconus. His diagnosis is clinical. Its therapeutic management can be divided into two parts, medical and surgical. This has seen some progress in recent years. We expose during this article the interest of the injection of SF6 gas in the rapid resolution of acute hydrops.
Purpose: To describe the presentation and management of presumed ocular tuberculosis, successfully treated with anti-tubercular therapy alone. Case Report: Presumed tuberculous choroidal granuloma associated with serous retinal detachment healed after initiation of antituberculosis therapy without concomitant corticosteroid therapy. Conclusion: Although corticosteroids are often used as add-on treatment for ocular tuberculosis, selected patients can be treated with anti-tuberculosis therapy alone with close follow-up.
We report the case of a 68-year-old patient, with no particular pathological history, who consulted for a progressive decline in visual acuity over the past 4 years.
Ocular toxocariasis is recognized to be a cause of childhood blindness. It usually results as a sequel of systemic infestation with the second or third stage larva of T. cani (visceral larval migrans). It is an uncommon cause of uveitis that mainly affects younger patients. Inflammation is typically unilateral and presents as either a granuloma in the peripheral or posterior retina or a moderate to severe vitreous inflammation mimicking endophthalmitis. We report two cases of children with ocular toxocariasis with posterior granuloma, negative for specific serodiagnosis. An anterior chamber puncture of the anterior chamber and an ELISA test with homologous antigens of Toxocara canis on the acqueous humor made the diagnosis diagnosis.
Epithelial down growth is a rare and sight-threatening eye condition which can occur after penetrating trauma or any intraocular surgery. Epithelial cells invade the intraocular structures through an incompetent wound and proliferate wildly causing inflammation and multiple damages .We report a case of a 6-year-old patient who presented to the emergency room for a decreased visual acuity, pain over a week in his right eye. Trabeculectomy surgery for congenital glaucoma was performed three years prior and revised with mitomycin C 6 months ago. Slit lamp examination of the affected eye showed conjunctival hyperemia, anterior chamber inflammation, a drawn upwars pupil, in this upper parts we can clearly see a membrane originating from the superior trabeculectomy site with neovascularization on the membrane, a yellow reflect light in pupil area interfering with the fundus examination and highly suggestive of chronic endophthalmitis. Vitreous tap was performed which allowed us to eliminate an infectious origin and revealed the presence of squamous epithelial cells that are not found inside the eye. The diagnose of epithelial down growth resulting to inflammation and vitreous hemorrhage following trabeculectomy was made. Local and general corticotherapy was started. Epithelial down growth treatment is variable, studies showed that patients treated surgically underwent fewer enucleations than those treated medically or not treated.
Purpose: The objective of this meta-analytical study is to consider the impact of the use of VDTs on the onset and/or worsening of the signs and symptoms of dry eye during the COVID-19 pandemic, but also to offer the best solutions to perform the various tasks in daily life in order to safeguard vision, with the aim of promoting a lifestyle that allows you to work and perform different activities more safely and efficiently. Patients should be encouraged to follow proper planning of visits. Methods: Scientific articles chosen by the following inclusion criteria were analyzed: 1) Type of study (Primary); 2) Population (patients suffering from dry eye); 3) Study period (all studies carried out in the period between January 2020 and January 2022); 4) Result variables (correlation between increased use of VDTs during the pandemic and worsening of the symptoms of dry eye syndrome; correlation between autoimmune mechanism from Covid- 19 and etiology of dry eye); 5) Language (English). Results: The results of the various cross-sectional studies, obtained thanks to the administration of an online and anonymous questionnaire, have found a correlation between excessive use of VDTs and the onset of complications related to dry eye syndrome. The results suggest that in university students there is a higher incidence of problems related to dry eyes following the many hours spent in front of a screen to follow the lessons that were proposed to them remotely during the lockdown following the COVID-19 pandemic. Dry eye is the most commonly diagnosed pathology among eye disorders during the lockdown, as people spent much more time locked in the house, even 20-24h in the first months of lockdown in 2020. Conclusions: In conclusion, the analysis of the data shows a correlation between prolonged use of VDTs (exacerbated during the COVID-19 era) and the onset or worsening of dry eye syndrome.
We report the case of an 82-year-old female patient who presented to the ophthalmologic emergency room with decreased visual acuity in the right eye for several years. Ophthalmologic examination of the right eye revealed visual acuity reduced to positive light perception, a clear cornea, a subluxated hypermural cataract inferiorly in the posterior segment (Figure 1), and an ocular tone of 30mmhg. An ocular ultrasound was performed and came back without any abnormalities. The patient was put on hypotonizing therapy. Intracapsular extraction of the cataract with an anterior vitrectomy was performed in the patient with a good postoperative evolution and normalization of the ocular tone.
Conjunctival autograft was now the best method in pterygium operation. An absorbable suture with slipknot was used to fix the grafts of pterygium. A week after the surgery, most of the stitches had disintegrated and fallen out. This easy technique reduces the postoperative pain and the conjunctival reaction in the early postoperative period. It enables the surgeon to eliminate the need for postoperative suture removal, and relieve the patient’s anxiety of removing stitches during the review.
Aim: to evaluate the biometric factors that influence the refraction obtained after simple phacoemulsification using the SRK/T formula. Methods: This is a prospective study of 86 eyes subjected to cataract surgery during a one-year period. The biometric factors evaluated include axial length, keratometry, lens thickness, anterior chamber depth and vitreous depth. The implant calculation formula employed was SRK/T, which is a commonly used method. All patients underwent phacoemulsification and implantation of a foldable intraocular lens into the capsular bag. Refraction was measured 30 days after surgery. Results: the mean axial length was 23.16±0.53mm, mean K1 was 43.5±1.50D, mean K2 was 43±1.63D, mean anterior chamber depth was 3.03mm, mean lens thickness was 3.37mm, mean postoperative target refraction was 0.16±0.377D, and mean postoperative refraction obtained was -0.226±0.625D. Among the eyes, 18.92% had a postoperative refraction within ±0.5D, and a non-target refraction outside ±0.5D was found in 64 eyes. In addition, 30.23% of the eyes had a postoperative refraction within ±0.75D. Conclusion: the SRK/T formula seems to be a dependable method for predicting postoperative refraction following cataract surgery. However, the accuracy of this prediction may be influenced by the axial length of the eye. Higher axial lengths are associated with a greater tendency towards myopia.
While SARS-CoV-2 is a largely respiratory pathogen, it has been reported that the ocular surface may present a significant opportunity for infection either via airborne droplets or by self-contamination via touching an infected surface to the eye. In particular, contaminated contact lenses present a potential vector for microorganism transmission. It is then crucial to demonstrate that contact lens disinfection solutions are effective against the SARS-CoV-2 virus. Here, we applied the International Standards Organization protocol 14729 to assess the antiviral activity of CLEAR CARE® and CLEAR CARE® PLUS, hydrogen peroxide-based contact lens disinfection systems for use with soft contact lenses. Test samples were inoculated with 5.75 log10 TCID50/mL of SARS-CoV-2 and sampled at time zero and then again after the stated disinfection time of 6 hours. Both CLEAR CARE® and CLEAR CARE® PLUS demonstrated a 4.75 log reduction of the SARS-CoV-2 virus after 6 hours. No viable virus was recovered following disinfection with CLEAR CARE® and CLEAR CARE® PLUS. This data indicates the hydrogen peroxide-based contact lens disinfection systems are extremely effective at eliminating SARS-CoV-2, and these systems may provide patients with an effective option for contact lens disinfection in the face of this pandemic.
Myopic maculopathies are the leading cause of visual impairment. Clinically, they are characterized by a decrease in vision, most often at close range, sometimes associated with an impression of distorted vision. Numerous advances have recently been made in the clinical and therapeutic approach to this disease. Modern imaging examinations (optical coherence tomography, digital angiography) allow earlier detection of retinal lesions in myopic patients. A better understanding of the mechanisms leading to this complication may lead to new therapeutic perspectives.
Scleromalacia is a degenerative thinning of scleral tissue. Their general causes are dominated by inflammatory rheumatism and systemic vasculitis. The traumatic cause is very rare. We report a rare case of scleromalacia following a minor trauma with localized hernia of the uveal tissue covered by an intact conjunctiva.
We present a case study of a 41-year-old patient who was admitted to the ophthalmological emergency department complaining of ocular pain and redness following trauma of the right eye. Slit-lamp examination of the right eye revealed visual acuity limited to "counting fingers", diffuse conjunctival hyperemia, anterior dislocation of a clear crystalline lens in the anterior chamber with endothelial contact (Figure 1) , and ocular hypertonia measured at 35 mm Hg. Medical treatment was swiftly initiated, incorporating both local and systemic hypotensive agents. After the eye pressure has been normalized, the patient underwent phacoemulsification lens extraction with anterior vitrectomy. Postoperative outcome was marked by normalization of intraocular pressure and by the absence of optic nerve and corneal endothelial cell damage.
Von Hippel–Lindau disease (VHL), also known as Von Hippel–Lindau syndrome, is a rare genetic disorder with multisystem involvement. It is characterised by the development of multiple vascularised tumours, particularly cerebellar, retinal and/or visceral. The disease can occur at any age and usually starts with retinal hemangioblastomas We report the case of A 17 years old patient with VHL family history who presented with progressive unilateral decrease of visual acuity evolving for 6 months. The fundus examination showed a retinal examination with significant edema. The fluorescein angiography confirmed the diagnosis. The Brain MRI and the abdominal CT scan were normal. The patient had to undergo photocoagulation of the retinal lesions Management of patients with VHL disease often requires a multidisciplinary approach. The role of the ophthalmologist is important in the management of this condition since the ocular involvement may be indicative of the disease.
