Ten years after Baerveldt™ implantation, a woman underwent immunosuppressive therapy for necrotizing scleritis. She subsequently developed symptoms suggestive of endophthalmitis in the setting of tube exposure. Cultures isolated fungal Paraconiothyrium. She underwent two vitrectomies with anterior chamber washouts, Baerveldt™ device removal, and intraocular and systemic antifungal therapy. The endophthalmitis has since resolved.

Purpose: To describe a rare bilateral corneal ring-shaped opacity, not categorized as corneal dystrophy or degeneration occurring without any associated ocular or systemic disease. Methods: Case report and review of the literature. Results: The authors describe the clinical history and examination of an 80 years old man, with an asymptomatic bilateral and symmetrical ring-shaped corneal opacity in the deep stroma of the corneal mid-periphery. The surrounding corneal stroma was clear, and the tear film, epithelium and its basement membrane, Descemet’s membrane and endothelium were normal. This rare corneal anomaly was discovered by chance and its etiology is unknown. Conclusions: These rings may result from deposits of unknown origin or possibly a rare corneal dystrophy.

Purpose: To determine choroidal thickness in preterm children with or without history of Retinopathy of Prematurity (ROP) with spectral domain optical coherence tomography (SD-OCT) system. Methods: In a cross-sectional study, 39 eyes of premature patients (Group 1) and 39 eyes of children with history of ROP (Group 2) between 9 and 17 years old were evaluated with Cirrus Zeiss 500 SD-OCT after cycloplegia. Choroidal thickness was measured from the fovea to 1500µm nasal and temporally with intervals of 500 µm using HD1 line raster program of SD-OCT. Clinical history of gestational age at birth, birth weight, time of oxygen exposure, stage of ROP in maximal severity of acute disease and ROP treatment were inquired. Results: Subfoveal thickness was lower in Group 2 (296,85±60,11µm) than in Group 1 (301,82±30,63µm). The mean choroidal thickness in all retinal tested points was not statistically different between groups. The time of oxygen exposure was the most relevant negative predictor considering choroidal thickness (β=-0,420; p= 0,032). Conclusions: Choroidal thickness can be measured using SD-OCT high definition raster scans in the majority of children. Comparing macular choroidal thickness in both groups, we found that it was thinner nasally, subfoveal and temporally in group 2, with no statistical significance. This can suggest a probable delayed choroidal development in preterm infant due to ROP, which can be attenuated with age.

Purpose: To evaluate the quality, readability and suitability of the information on glaucoma available in Portuguese in the Internet. Study design: Cross-sectional limited survey of internet resources. Methods: We used as keyword “GLAUCOMA” for research on four search engines in the internet. The first 30 sites that appeared on each search engine were recorded and those that appeared at least in two search engines were selected. The Sandvik score, Flesch-Kincaid formula and the Suitability Assessment of Materials (SAM) were used as tools to evaluate quality, readability and suitability, respectively. Results: The information provided on the websites presented moderate quality (mean Sandvik score 7.7 ± 1.4), readability of 16.0 ± 1.7 years of education and were unsuitable (mean SAM score 21.4 ± 6.4 %) for the target audience. Conclusion: Most websites about glaucoma had moderate quality. In order to understand the information, an average of 16 years of formal education was deemed necessary. All websites were unsuitable to the target population. RESUMO Objetivos: Avaliar a qualidade, a apreensibilidade e adequabilidade das informações sobre o glaucoma, em português, disponibilizadas na internet. Desenho do estudo: Estudo transversal sobre sítios na internet. Métodos: Utilizou-se a palavra chave “GLAUCOMA” em quatro buscadores para a pesquisa na internet. Os 30 primeiros sites que apareceram em cada buscador foram registrados e aqueles que apareceram em pelo menos dois buscadores foram incluídos no estudo. Como ferramentas para a avaliação da qualidade, apreensibilidade e adequabilidade foram utilizados o escore de Sandvik, o índice de Flesch-Kincaid e o Suitability Assessment of Materials (SAM), respectivamente. Resultados: A informação disponibilizada nos sites selecionados apresentou qualidade mediana (escore médio de Sandvik 7,7 ± 1,4), apreensibilidade média de 16,0 ± 1,7 anos de escolaridade e foi considerada inadequada para o público-alvo (SAM médio de 21,4 ± 6,4 %). Conclusão: A maioria dos sites na internet sobre glaucoma apresentou qualidade moderada. Para a leitura compreensível da matéria contida nos sites, era necessário que o leitor tivesse pelo menos concluído a terceira série do ensino médio. Todos os sites foram considerados inadequados para a compreensão da informação publicada. Palavras-chave: Glaucoma; informação; internet; Controle de Qualidade; Educação de Pacientes.

Purpose: To determine the incidence of intraretinal hemorrhage in newborns at the Hospital de San José, Bogotá, Colombia from September 2009 to September 2010. Design: Cohort study. Methodology: Live newborns were examined at the San José Hospital for a year (September 2009 to 2010), analyzing neonatal and maternal factors associated with the presence of intraretinal hemorrhages. A simple random cluster sampling was used, excluding newborns with a compromised general status, as well as those whose parents or legal guardians did not sign the informed consent form. Patients with the presence of intraretinal hemorrhages were examined every 2 weeks until resolution was observed. Results: A total of 190 newborns were examined, finding an incidence of intraretinal hemorrhages of 22.6% (95% CI 16.6 to 28.6). Most of the mothers were nulliparous (55.8%) and deliveries were eutocic (65.1%). From newborns with hemorrhages, 81.3% were born at term, and hemorrhages in most patients (93.0%) were resolved by the second week of monitoring. Associations between hemorrhages and cesarean section (RR 0.42, CI 0.22 to 0.79) and episiotomy (RR 1.73, CI 1.02 to 2.94) were observed. Conclusions: Newborns who presented intraretinal hemorrhages were children of nulliparous mothers on whom episiotomy was performed, and some with eutocic and instrumented deliveries. The first two variables had statistical significance for the development of intraretinal hemorrhages.

Prupose: To confirm the microbiological presence of C. trachomatis in indigenous communities of Colombia found to have cases of active trachoma. Method: An ophthalmic evaluation was performed in order to identify the active forms of the disease. Ocular swabs were taken from the conjunctiva and analyzed by real-time PCR “in house” for the detection of C. trachomatis. Positive samples were confirmed with a commercial real time PCR and DNA sequencing. Study Design: Descriptive study. Subjects: Children with active trachoma from different indigenous communities in Vaupés, Colombia. Main outcome measures: Presence of C. trachomatis in conjunctival swab samples. Results: Fifteen clinical cases of active trachoma were identified in children between one and 12 years old. A major proportion of TI was observed, compared with TF and greater bilateral commitment of the disease. Patients were from the indigenous communities of Santa Catalina (73.3%), Pacuativa (20%) and Piramirí (6.7%). The presence of C. trachomatis was confirmed in 3 (20%) patients, by real time PCR technique “in house” and confirmatory, and validated with sequencing. Conclusion: This study confirms the presence of C. trachomatis in cases of active trachoma in indigenous communities of the department of Vaupés, Colombia.

We aimed to summarize the applications, strengths and weaknesses of two anterior segment imaging modalities: the ultrasound biomicroscopy (UBM) and the anterior segment optical coherence tomography (AS-OCT) in the diagnosis and surgical management of glaucoma. This narrative review was based on our clinical experience with these technologies supported on scientific literature review through Medline via PubMed®. The syntax used in the search was “Glaucoma AND Anterior Chamber Angle AND Ultrasound Biomicroscopy OR UBM AND Anterior Segment Optical Coherence Tomography OR AS-OCT”. Publications were selected based on relevance and no redundancy, and authorship from 2007-2014. Additionally, UBM and AS-OCT images were selected from two of the authors’ personal archives to illustrate prevalent glaucoma findings and post-operatory using both technologies. AS-OCT and UBM share overlapping characteristics and are both useful in glaucoma diagnosis and post-operative assessment. However, particular technical features of each will direct the best application to clarify specific glaucoma etiologies, to guide in the most effective management and to explain glaucoma surgical outcomes.