BACKGROUND: Toxic anterior segment syndrome (TASS) is a rare, noninfectious inflammation that occurs after anterior segment surgery. We report a case herein that developed presumed atypical late-onset TASS after V4c implantable collamer lens (ICL) implantation surgery.
METHODS: A 26-year-old man underwent ICL implantation surgeries of both eyes on two separate days. The 1-day and 7-day postoperative routine follow-up visits revealed no abnormalities. However, one month after surgery, dense white spots attached to the posterior surface and scattered ones to the anterior surface of ICL in the left eye were noted on anterior segment examination. His uncorrected distance visual acuity (UDVA) was 20/16 in both eyes and the fundus examination was normal. Despite the absence of typical clinical manifestations, late-onset TASS was suspect and intense topical steroid was administered. After 6 weeks of tapering topical steroid therapy, the white spots disappeared and the patient had no subjective complains throughout the treatment period.
CONCLUSIONS: This case suggested that the traditionally considered acute and serious TASS could also present as delayed and insidious onset after ICL implantation surgery. Due to its variabilities, the awareness of TASS should be raised to ophthalmologists and regular follow-up visits should be emphasized to patients. Once TASS was suspected, intensive steroid therapy should be implemented in time.

暂无摘要。

OBJECTIVE: To report the clinical course and compare the utility of Scheimpflug tomography (ST) and anterior segment optical coherence tomography (AS-OCT) for central corneal thickness (CCT) and corneal densitometry (CD) assessment in patients with corneal crystals owing to nephropathic cystinosis.
METHODS: A retrospective chart analysis of three patients with nephropathic cystinosis and the presence of corneal cystine crystals in both eyes was performed. All patients underwent clinical examination and anterior segment photography, ST, and AS-OCT scans. Corneal densitometry was exported from built-in proprietary software for ST and from custom-made validated software for AS-OCT. Anterior segment optical coherence tomography images were rescaled to grayscale units from 0 (maximum transparency) to 100 (minimum transparency) to match built-in ST densitometry readings. Furthermore, the mean pixel intensity, representative of CD, was calculated from the pixels corresponding to the segmented cornea.
RESULTS: All three patients had pathognomonic cystine crystals deposits in the cornea and were treated with cysteamine medications that resulted in clinical improvement. The CCT measured using ST exhibited a range from 560 to 958 μm. Conversely, when assessed with AS-OCT, the CCT varied within the range of 548 to 610 μm. Both examinations could be performed, but in the more severe cases, AS-OCT showed far greater utility to estimate CD. In four of six eyes examined, ST showed disproportionate CCT values, compared with the AS-OCT, whereas reliable CD measurements were only available in AS-OCT.
CONCLUSIONS: The AS-OCT could be considered a baseline ocular measurement in cystinosis and in the evaluation of disease progression and treatment efficacy.

A 24-year-old female patient with photophobia, discoria, redness and dryness in her right eye after intense pulsed light (IPL) therapy applied for posttraumatic subcutaneous hemorrhage received a comprehensive ophthalmic examination including optical coherence tomography (OCT) and OCT angiography of the anterior eye segment. Her best corrected visual acuity was 20/20 in both eyes. Medically induced mydriasis revealed discoria with paresis of pupil dilatator in the left eye (pupil size 4.2 mm and 6.6 mm in the right and left eye, respectively). Anterior segment OCT showed anterior chamber cytosis and increased iris vascularity. The patient was prescribed topical 1.0% tropicamide 2 times per day and 1.0% dexamethasone 4 times per day for two weeks. Examination performed after 3 months showed no restoration of pupil dilatator function in the left eye. The case demonstrates potential ocular complications of IPL therapy, which may include iris burn with iritis and persistent pupil dilatator dysfunction.
Пациентке 24 лет с жалобами на светобоязнь, изменение формы зрачка, покраснение и сухость левого глаза, появившиеся после проведения широкополосной интенсивной фототерапии (intense pulsed light therapy, IPL) по поводу подкожного кровоизлияния левой скуловой области, было выполнено стандартное офтальмологическое исследование, а также оптическая когерентная томография (ОКТ) и ОКТ-ангиография (ОКТ-А) переднего сегмента глаза. Максимальная корригированная острота зрения обоих глаз составляла 1,0. В условиях медикаментозного мидриаза у пациентки определялись дискория и парез дилататора зрачка левого глаза (диаметр зрачка 4,2 и 6,6 мм на левом и правом глазу соответственно). Были обнаружены цитоз во влаге передней камеры по данным ОКТ переднего сегмента и увеличение васкуляризации радужки по данным ОКТ-А. Пациентке были назначены инстилляции тропикамида 1,0% 2 раза в день и дексаметазона 1,0% 4 раза в день в левый глаз на 14 сут. На сроке до 3 мес восстановление функции дилататора зрачка достигнуто не было. Данный случай демонстрирует потенциальные глазные осложнения IPL, включая ожог радужной оболочки с иритом и стойким нарушением функции дилататора зрачка.

BACKGROUND: To report a case of sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) opacification following pars plana vitrectomy surgery using sulfur hexafluoride (SF6) for traumatic lens luxation associated with retinal detachment.
METHODS: A 77-year-old woman was referred to our emergency department after blunt trauma in her right eye. At the ophthalmic evaluation, visual acuity was hand movement, biomicroscopy showed pseudoexfoliation syndrome and a traumatic lens luxation in the vitreous chamber. The patient underwent pars plana vitrectomy, subluxated cataract explantation, and FIL SSF IOL implant. During surgery, an inferior retinal detachment was encountered, requiring 20% SF6 gas tamponade. No adverse events were encountered. One month postoperatively, visual acuity (BCVA) improved to 0,3 logMAR. At the 3-month follow-up, the patient presented with BCVA of 0,5 logMAR, and biomicroscopy showed a minimal IOL opacification. Six months postoperatively, BCVA decreased to 1.0 logMAR, and diffuse, IOL opacification was noted at slit lamp examination. The patient refused any other surgical intervention for IOL exchange.
CONCLUSIONS: Although hydrophilic IOL opacification gas related is known, to the best of our knowledge, this is the first case reported in the literature of FIL SSF IOL opacification after pars plana vitrectomy with gas tamponade for retinal detachment.

暂无摘要。

UNASSIGNED: To highlight the importance of swept-source anterior segment optical coherence tomography (SS-ASOCT) in the peri-surgical management of cataract in uveitis. To describe a case of fibrinoid syndrome in uveitis treated with recombinant tissue plasminogen activator (rtPA).
UNASSIGNED: SS-ASOCT was performed at each follow-up before and after cataract surgery to assess anterior chamber inflammation and assist the clinical management of the patient.
UNASSIGNED: A patient with idiopathic autoimmune uveitis was scheduled for cataract surgery. SS-ASOCT allowed to correctly plan the surgery timing. The patient developed a severe fibrinoid syndrome. Postsurgical SS-ASOCT allowed to distinguish between anterior chamber cells and fibrin thus guiding the timing for rtPA intracameral injection. Visual acuity improved from 20/400 the day after the surgery to 20/40.
UNASSIGNED: SS-ASOCT allowed a precise assessment of the inflammatory components (cellular vs fibrinoid) after cataract surgery. Intracameral rtPA was safe and effective in the treatment fibrinoid syndrome in uveitis.

暂无摘要。

BACKGROUND: PITX3 has been reported to be associated with congenital cataracts, anterior segment mesenchymal dysgenesis, Peters\' anomaly, and microphthalmia. In this case, an infant with unilateral buphthalmos, corneal staphyloma and corneal fistula carrying a variant in PITX3 was reported.
METHODS: We describe a 4-month-old female infant who was referred to our Eye Clinic because of gradual enlargement of the eyeball in the right eye and whitish opacity in both eyes. Buphthalmos with long axial length (22.04 mm), macrocornea with diffuse corneal oedema and opacity (14.50 mm*14.50 mm) and high intraocular pressure (23.78 mmHg) were detected in the right eye. Microphthalmia with short axial length (16.23 mm), microcornea with diffuse corneal oedema and opacity (7.50 mm*6.50 mm) were detected in the left eye. A 360° trabeculotomy was performed for the right eye. However, corneal staphyloma and corneal fistula in the right eye were detected 6 months after the surgery. A variant in exon 4 of PITX3 (c.640_656dup (p. Gly220Profs*95)) was identified in the proband but was not detected in her healthy parents.
CONCLUSIONS: A novel phenotype characterized by unilateral buphthalmos, corneal staphyloma and corneal fistula in an infant were reported to be associated with PITX3 in our study. Our study expands the scope of the clinical heterogeneity of PITX3 variants. It also improves our understanding and increases the attention given to patients with PITX3 variants.

暂无摘要。