A 25-year-old woman presented with blurry vision, headache, nausea, and syncope. Humphrey visual field testing revealed bitemporal defects, but magnetic resonance imaging was negative for chiasmal pathology. Macular optical coherence tomography showed focal parafoveal disruption of the photoreceptor inner segment/outer segment junction and infrared imaging showed hyporeflective macular lesions in both eyes. Our case demonstrates a diagnosis of acute macular neuroretinopathy that presented with bitemporal visual field defects. To our knowledge, bitemporal visual field loss, mimicking chiasmal pathology, has not been reported previously in association with acute macular neuroretinopathy.

Resumen La enfermedad de Best es una distrofia macular que se caracteriza por un acúmulo de lipofuscina sobre el epitelio pigmentario de la retina. Existen cinco estadios diferentes basados en el examen del fondo de ojo incluyendo la neovascularización coroidea. Describimos el caso de un varón de 59 años que acude al servicio de oftalmología por disminución de agudeza visual en ambos ojos. El examen del fondo de ojo reveló lesiones viteliformes en ambas máculas. La angiofluorescinografía mostró una membrana neovascular coroidea en el ojo izquierdo. Confirmando el electrooculograma la enfermedad de Best. La aparición de neovascularización coroidea en la enfermedad de Best es una complicación infrecuente que puede ocurrir en etapas tardías. Las opciones terapéuticas más efectivas son la terapia antiangiogénica y la terapia fotodinámica con veteporfirina. Palabras clave: Enfermedad de Best; neovascularización coroidea; Ranibizumab inyección intravítrea. Abstract Best's Disease is a macular dystrophy characterized by a lipofuscin accumulation on the retinal pigment epithelium. Five stages have been described based on fundus examination, including choroidal neovascularization. We report a case of a 59-years-old male, presented to the Department of Opthalmology with visual loss in both eyes. Fundus examination revealed vitelliform lesions in both maculas. Fluorescein angiography showed a choroidal neovascularization in the left eye. The electrooculogram confirmed the diagnosis of Best's disease. Choroidal neovascularization is a rare complication of Best's Disease in late stages. The most effective therapeutic options are photodynamic therapy with veteporfirin and antiangiogenic therapy

Relapsing Polychondritis (RP) is a rare, recurrent and autoimmune multisystem disorder affecting cartilaginous structures, such as auricles, joints, nasal septum, larynx and tracheobronchial tree. Ocular manifestations may be observed in 42,3-65% of cases. Episcleritis and scleritis are the most common findings. However, RP is frequently misdiagnosed, leading to potentially severe, debilitating and, sometimes, fatal disease. There is no established standardized therapeutic protocol for RP. Current medical therapy is largely empiric and based on case reports. The aim of this paper is to document one case of ocular involvement in RP disease, emphasizing clinical and imaging findings that can help to establish an early diagnosis.

Secondary injuries caused by lightning strikes are not frequent; however, survivors have important sequel in organs and tissues. We describe two cases. The first one with lightning-induced maculopathy and the other case involving lens damage. This paper discusses factors that determine the extent of injuries and review the management for each one. The study and data collection complained with local legislation and with the principles of the Declaration of Helsinki.

Purpose: Normal-tension glaucoma has been associated with systemic vascular diseases such as peripheral vasospasm. This study aims to evaluate the influence of peripheral vasospasm on the thickness of the retinal nerve fiber layer (RNFL) in Raynaud's disease (RD), and the correlation between global RNFL and peripheral microcirculation features in RD patients. Methods: Observational cross-sectional study of 18 patients (35 eyes) with a diagnosis of RD followed in our clinic, and 20 healthy controls (39 eyes). RNFL parameters were obtained using spectral domain optical coherence tomography (SD-OCT Spectralis®, Heidelberg). Global and sectorial peripapillary RNFL thickness were registered. Age, gender, refractive error, best-corrected visual acuity and intraocular pressure were determined, and slit-lamp biomicroscopy and fundus examination were performed. Nailfold videocapillaroscopy (NC) was performed in the RD group to characterize capillary morphology and blood flow. Mann-Whitney and Fisher's exact tests were used for statistical analysis. Statistical significance level was set at p<0.05 (two-sided). Results: There was no significant difference in the global RNFL between RD patients and the control group (p=0.35). The presence of avascular areas in NC was associated with a lower global RNFL thickness (p=0.026). Conclusion: The association between avascular areas in NC and the lower global RNFL thickness in RD patients suggests that systemic vasospasm severity may be related to optic nerve damage propensity. Therefore, its presence in NC may identify RD patients at risk for optic nerve head damage. A larger sample with a long-term study is needed to support the clinical and therapeutic implications of our findings.

Purpose: To compare biometrical measurements performed with the new IOLMaster-700 (Carl Zeiss Meditec AG, Jena, Germany) from those obtained with the Aladdin (Topcon, Tokyo, Japan). Methods: A prospective, cross-sectional, observational, comparative study was proposed. Twenty-four eyes were assessed using two biometry devices. Measurements of axial length (AL), anterior chamber depth (ACD), mean keratometry (KM), flattest (Kf) and steepest keratometry (Ks) and white-to-white (WTW) were done with both devices in a random order. Results: No statistically significant differences (p>0.05) between the two biometry were found for AL (24.22±0.92mm [range 22.66 to 26.09 mm] with IOL Master and 24.22±0.91mm [range 22.65 to 26.09 mm] with the Aladdin), ACD (3.59±0.26mm [range 3.05 to 4.11 mm] with IOL Master and 3.42±0.60mm [range 3.05 to 4.02 mm] with the Aladdin) and Kf (42.43±1.21 D [range 40.55 to 45.15 D] with IOL Master and 42.41±1.25 D [range 40.66 to 45.36 D] with the Aladdin). In Km (42.99±1.23 D [range 41.07 to 45.31 D] with IOL Master and 42.90±1.27 D [range 41.06 to 45.55 D] with the Aladdin), Ks (43.55±1.38 D [range 41.20 to 46.57 D] with IOL Master and 43.40±1.42 D [range 41.21 to 46.62 D] with the Aladdin) and WTW (12.32±0.40mm [range 11.6 to 13.1 mm] with IOL Master and 12.03±0.36 mm [range 11.46 to 12.87 mm] with the Aladdin), there was a statistical difference. Conclusions: Measurements with the new IOLMaster-700 correlated well with those obtained with the Aladdin in patients with clear lens; although a statistical difference was found in KM, Ks and WTW. This difference was not clinically significant.

Introduction: Trabeculectomies are amongst the most common surgical procedures to lower intraocular pressure (IOP). Scleral flap dimensions are a key factor in influencing aqueous outflow and subsequent IOP reduction, especially in the early postoperative period. Despite the substantial diversity of scleral flap shapes that is used in practice, there is little information comparing outcomes between them. In this study, we review the literature on the uses and outcomes of various scleral flap shapes. Methods: A literature review was performed using the databases: MEDLINE, SCOPUS, and Web of Science. Search terms for relevant studies included the following: trabeculectomy AND (square OR triang* OR rectang* OR polygon* OR arc OR shape) AND flap. Results: Our initial literature search revealed 71 unique articles, six of which met our inclusion and exclusion criteria and were reviewed. Four articles reported the use of triangular flaps, one rectangular flap, one square flap, and two arc-shaped flaps. The data from each article were reviewed for the following:

1. Surgical technique;
2. Early postoperative intraocular pressure reduction;
3. Final postoperative intraocular pressure reduction;
4. Postoperative complications.

Conclusions: A myriad of scleral flap shapes is utilized in surgical practice. Essentially all of the trabeculectomy procedures, regardless of scleral flap shape, achieved substantial reductions in IOP with similar success rates. However, due to the variability in surgical technique and lack of direct comparison, we cannot definitively conclude or deny that one flap shape is superior to another. We believe our review provides the most comprehensive analysis of scleral flap shape to date and highlights its importance in regulating aqueous flow, especially in the early postoperative period.