To report the surgical outcome and visual rehabilitation of a patient with Fuchs' dystrophy diagnosed with endothelial dysfunction associated with subepithelial and deep corneal scar and advanced cataract, treated with DMEK combined with phacoemulsification and intraocular lens (IOL) implantation, followed by phototherapeutic keratectomy (PTK).

Although the presence of central corneal opacities could limit the visual prognosis, Descemet Membrane Endothelial Keratoplasty (DMEK) was performed and completely resolved corneal edema and opacities on the visual axis. A rigid contact lens fitting was necessary to treat irregular astigmatism postoperatively.

A single case description of a novel surgical treatment using hard palate to correct an upper eyelid deformity after traumatic laceration. The surgical procedure is described with accompanying diagram to illustrate the technique. The eyelid margin was successfully restored with proper anatomical outcome, as seen up to at least eighteen months post-operatively in the presented case. Our technique can be applied to the correction of small eyelid defects in other patients.

A 71-year-old man diabetic and smoker was treated with brachytherapy for a choroidal melanoma. Two years later he developed a radiation optic neuropathy and a contralateral vein occlusion. He received subtenon triamcinolone and then, he underwent a phacoemulsification surgery and one intravitreal injection of antiangiogenic, with functional and anatomical improvement. The radiation optic neuropathy is a chronic progressive vasculopathy induced by supra-threshold doses of ionizing radiation. The risk occurs when the total dose is more than 50 Gy or the daily fraction size exceeds 1,8 Gy. The vein occlusion could be related to risk factors. Several treatments have been used for radation papillopathy. Resumén Varón 71 años diabético y fumador, tratado con braquiterapia por melanoma coroideo. A los dos años presenta una neuropatía óptica por radiación y trombosis venosa contralateral. Se trata con corticodes subtenonianos y posteriormente, se interviene de cataratas y se introduce antiangiogénico intravitreo, con buen resultado. La neuropatía óptica por radiación es una vasculopatía progresiva y crónica secundaria a una radiación ionizante supraumbral. Ocurre cuando la dosis total recibida excede de 50 Gy o la dosis diaria de 1,8 Gy .La trombosis venosa podría estar relaciona con los factores de riesgo existentes. Diferentes tratamientos han sido propuestos para la papilopatía por radiación.

Topiramate is a drug used in the treatment of epilepsy, migraine, bulimia and other pathologies. We report a case of a 40-yearsold woman, presented to the emergency department of ophthalmology with blurred vision in both eyes and bilateral acute angle closure. Her medications included topiramate started 6 days before. Secondary angle closure glaucoma due to topiramate was diagnosed. The medication was discontinued and she was treated with topical antiglaucoma medications, intravenous mannitol and cyclopegics. At the 5-days follow-up visit, vision, intraocular pressure, and angle anatomy had returned to normal. The acute angle-closure glaucoma occurs due to edema of the ciliary body and uveal effusion that produces an anterior motion of the iris-lens diaphragm, with ocular hypertension and acute myopia. Resumen El topiramato es un fármaco usado en epilepsia, migraña, bulimia y otras patologías. En el párrafo siguiente describimos un caso de una mujer de 40 años, que recibía tratamiento con topiramato, que acudió al servicio de urgencias oftalmológicas por disminución de agudeza visual brusca de ambos ojos con cierre angular bilateral. La paciente fue diagnosticada de glaucoma de ángulo cerrado secundario a topiramato. La medicación se suspendió y se trató con medicación antiglaucomatosa tópica, manitol intravenoso y ciclopléjico. A los 5 días, la visión, presión intraocular y anatomía angular habían vuelto a la normalidad. El cierre angular agudo por topiramato se produce debido al edema del cuerpo ciliar y efusión ciliocoroidea que producen un desplazamiento anterior del diafragma iridocristaliniano originando un cierre angular, hipertensión ocular y miopización aguda.

Purpose: To assess the reproducibility of peripapillary retinal nerve fiber layer (RNFL) thickness, measured with Spectralis® OCT, in healthy and glaucomatous subjects, through of inter-examiner variability, intratest and inter-test with and without software of followup. Methods: Cross-sectional and prospective study with 37 controls (63 eyes) and 33 patients with glaucomatous optic neuropathy (55 eyes). Intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated. Results: Low inter-examiner, intra-test and inter-test variability, with ICC>0,75 e CV<10%, in both control group and patients with glaucoma. Conclusions: The Spectralis® OCT shows excellent reproducibility of RNFL measurements, validating it as an useful tool for monitoring the progression of glaucoma. Resumo Objectivos: Avaliar a reprodutibilidade das medições da camada de fibrasnervosas peripapilar (CFN), obtidas com o Spectralis® OCT, em indivíduos saudáveis e com neuropatia óptica glaucomatosa, através da variabilidade inter-examinador, intra-exame e inter-exame com e sem o software de followup. Métodos: Estudo transversal e prospectivo, com 37 controlos (63 olhos) e 33 doentes com neuropatia óptica glaucomatosa (55 olhos). Calculou-se o coeficiente de correlação intraclasse (CCI) e o coeficiente de variação (CV) das medições da CFN. Resultados: Verificou-se baixa variabilidade inter-examinador, intra-exame e inter-exame, com valores de CCI>0,75 e CV<10%, tanto no grupo controlo como no grupo dos doentes com glaucoma. Conclusões: O Spectralis® OCT apresenta uma excelente reprodutibilidade nas medições da CFN, validando-se como uma ferramenta útil para a monitorização da progressão do glaucoma.

Purpose: To further characterize the clinical presentation, diagnosis, and current treatment strategies of IgG4-related ophthalmic disease. Methods: Review and analysis of seven cases orbital inflammatory syndrome found to be biopsy positive for IgG4. Results: We present seven cases of IgG4-related ophthalmic disease, a previously unknown entity that has only recently been identified as a treatable systemic disorder. Management included surgical excision, systemic steroids, steroid-sparing immunosuppression, and radiotherapy. Conclusions: These cases illustrate the importance of including IgG4-related ophthalmic disease in the differential diagnosis of periorbital or orbital masses. Prompt recognition of this entity by clinicians can allow for effective treatment with corticosteroids. Treatment with steroid-sparing immune suppressants and radiotherapy has shown promise in chronic or refractory disease, nonetheless tumor excision may ultimately be necessary.

Allogeneic hematopoietic stem cell transplantation is considered the standard of care for hematological and lymphoid malignancies. One of the complications associated to this therapy is an immunemediated reaction known as graft versus host disease with repercussions towards many organs and tissues. In this article, ocular complications of graft versus host disease will be reviewed.