AIM: To assess the long term effect of intravitreal triamcinolone acetonide (IVTA) on intraocular pressure (IOP) in patients with macular edema. METHODS: A retrospective case review was performed to identify all patients treated with IVTA at a university based retina practice between March 2003 and January 2004. Baseline IOP was calculated using the mean measurement from three previous visits and changes in IOP were followed after IVTA injection. RESULTS: A total of 35 eyes of 23 patients were identified. Each patient was injected with 0.1ml (4mg) of 40mg/ml triamcinolone acetonide. Responders were defined as mild (elevation 5-10mm Hg), moderate (11-15mm Hg), and severe (over 15mm Hg elevation) elevation in IOP from baseline. 23 of the 35 eyes (66%) were classified as IVTA responders. Mean time to IOP elevation was 42 days. Of those patients with elevated IOP, 15 (65%) required topical hypotensive treatment and one patient required trabeculectomy. Eleven (48%) patients remain on topical therapy and mean time of therapy for all IOP responders was 352 days at last follow up. Nine of ten central retina vein occlusion (CRVO) patients had an elevation in IOP classified as moderate or severe. Mean IOP elevation in the CRVO group was 12.3 mm Hg. CONCLUSIONS: Elevated intraocular pressure is a frequently observed sequela of IVTA treatment and may require long term hypotensive topical medication. Preoperative diagnosis of CRVO has a strong correlation with IOP spikes requiring treatment, an increased number of antiglaucoma medications once therapy is initiated, and in some cases, filtering surgery.

Purpose: to report a case of metastatic sclerochoroidal calcification is a rare ocular entity characterized by yellow-white irregular subretinal lesions. These lesions are caused by the deposition of calcium salts at the level of the sclera and choroid, in patients with abnormal calcium and phosphate metabolism. METHODS: CASE REPORT A 52 year-old asymptomatic woman underwent a routine ophthalmic examination. Past medical history was remarkable for end-stage renal insufficiency on haemodialysis associated with secondary hyperparathyroidism. Visual acuities, anterior segment examination and intraocular pressures were within normal limits. Fundoscopic examination revealed bilateral symmetric subretinal yellow white cluster-like lesions located above the superior vascular arcades. Fluorescein angiography, ultrasonographic and computerized tomography studies were obtained; their results confirmed our clinical diagnosis of metastatic sclerochoroidal calcification. CONCLUSION Sclerochoroidal calcification, a rare and poorly recognized disease with a characteristic pattern, should be included in the differential diagnosis of yellow-white lesions in the retina. A complete anamnesis to rule out possible calcium homeostasis abnormalities can be helpful. BACKGROUND Sclerochoroidal calcification is a rare and often misdiagnosed entity^1,2 characterized by yellow-white irregular subretinal lesions. These lesions are caused by the deposition of calcium salts at the level of the sclera and choroid, and can occur in three varieties according to its origin: metastatic, dystrophic and idiopathic. Even though several cases and series have been reported in the literature,^1-5 it remains poorly recognized and is often misdiagnosed.^2-5 Thus, increased awareness of this diagnosis is warranted.

Purpose: To report the clinical picture and outcome of Behçet’s Disease with hyperprolactinemia. Methods: We report a case of an 18-year-old female who presented with monocular decreased visual acuity two days before. Results: The fundus examination revealed papilitis and mild posterior vitritis OS. Serologic analysis revealed hyperprolactinemia, HLA B51 positive. Brain computed tomography and magnetic resonance imaging excluded intracraneal patology. Vitreous humor Polymerase-Chain-Reaction was negative for common pathogens. Conclusions: This case suggests the role of prolactin in immunoregulation and pathogenesis of Behçet’s Disease. We suggest serum prolactin measu-rement in atypical Behçet’s Disease suspect.

Interferons are glycoproteins that bind to cell-surface receptors and lead to anti-viral, anti-proliferative, and anti-angiogenic properties. Interferons have been used successfully in many different diseases throughout medicine, and recently success has been demonstrated for the treatment of ocular surface neoplasias. Traditional treatment for corneal and conjunctival intraepithelial neoplasia and squamous cell carcinoma includes surgical excision and adjunctive cryotherapy. The use of chemotherapeutic agents, including interferon alfa 2b (IFN a2b), mitomycin C (MMC) and 5-fluorouracil (5-FU), has limited the need for extensive surgical manipulation of the ocular surface and potentially decreases recurrence rates. This article will focus on the use of IFN in the treatment of corneal and conjunctival intraepi-thelial neoplasia and squamous cell carcinoma.

Pterygium is a common benign lesion in countries near the equator due to its association with extensive solar exposure. Other etiologic factors such as human papillomavirus infection are still controversial. Four cases of ocular surface squamous neoplasia initially diagnosed as pterygium are described. Improper specimen handling lead to inadequate therapy and enucleation in three cases. RESUMEN El pterigion, debido a su asociación con exposición solar severa, es una patología benigna frecuente en los países cercanos al ecuador. La presencia de otros factores causales como la infección por papilomavirus humano es aún controversial. Se presentan cuatro casos de neoplasias escamosas de la superficie ocular (NESO) confundidas clínicamente con pterigion, en las cuales el incorrecto manejo del especimen llevó al tratamiento inadecuado y en tres casos, a la pérdida del globo ocular.

Purpose: To demonstrate the use of fibrin glue as an alternative to sutures in the scleral fixation of conjunctival autografts during pterygium surgery. Methods: Review of the literature and description of the authors’ current technique. Conclusion: Fibrin glue appears to be a safe alternative to sutures as a means of fixating conjunctival autografts during pterygium surgery. A theoretical risk exists for the transmission of viral or prion-based diseases however no documented cases of transmission have been reported.

The frontal sling is a surgical technique to correct severe ptosis with minimal or absent elevador muscle function. Despite the development of new synthetic materials, the fascia is still the best alternative. We describe the most used procedures to obtein the fascia and to make the frontal sling. We emphasize the use of the materials and techniques that are available for all the ophthalmologist. RESÚMEN La suspensión al frontal es una técnica para corregir ptosis severas en las que la función del músculo elevador es mínima o nula. A pesar de la aparición de nuevos materiales sintéticos la fascia lata sigue siendo la mejor alternativa. Describimos los procedimientos más usados para extraer la fascia y para realizar la suspensión al frontal, haciendo hincapié en el uso de técnicas y materiales al alcance de todos los oftalmólogos.