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Iris melanocytoma (IM) is a rare variant of iris nevus with distinctive clinical and histopathological features. A 66-year-old woman, with a history of right eye pigmented iris nevus, presented to us with a recent onset of visual acuity decrease in that eye. She had a melanocytic iris lesion with iridocorneal angle invasion, peripheral corneal adhesion, pupil corectopia, sectorial cataract and high intraocular pressure. Ultrasound biomicroscopy did not exclude malignant transformation, so excisional biopsy was performed revealing the presence of IM without signs of atypia. Subsequently, the patient underwent cataract surgery combined with iridoplasty and later an ab externo trabeculectomy. Most cases of IM remain stable and require no intervention, but in cases of unusual clinical course, with rapid growth or secondary glaucoma, surgical treatment is indicated as a diagnostic and therapeutic measure. This case report highlights the importance of a timely and multidisciplinary ophthalmological approach for a better visual outcome.

Submitted by Maria da Luz Antunes (mluz.antunes@estesl.ipl.pt) on 2021-08-04T14:37:34Z No. of bitstreams: 1 Corneal subbasal nerve plexus evaluation by in vivo confocal microscopy in multiple sclerosis.pdf: 1317032 bytes, checksum: 86be831615d41642d36aa9409b5f2dd8 (MD5) Made available in DSpace on 2021-08-04T14:37:34Z (GMT). No. of bitstreams: 1 Corneal subbasal nerve plexus evaluation by in vivo confocal microscopy in multiple sclerosis.pdf: 1317032 bytes, checksum: 86be831615d41642d36aa9409b5f2dd8 (MD5) Previous issue date: 2021-04 info:eu-repo/semantics/publishedVersion

Sjögren's syndrome (SjS) is characterized by lymphocytic infiltration of exocrine glands, i.e. autoimmune epithelitis. Lymphocytes are central in SjS pathogenesis, with B-cell hyperactivity mediated by T-cells. B-cells are main targets of Epstein-Barr virus (EBV) infection, a frequently-suggested trigger for SjS. We aimed to evaluate how the EBV infection modulates B and T-cell subsets in SjS, including as controls Rheumatoid arthritis patients (RA) and healthy participants (HC). SjS patients presented decreased CXCR5+T-cells, although IL21-secreting Tfh and Tfc cells were increased. Tfc were positively correlated with ESSDAI scores, suggesting their relevant role in SjS pathogenesis. As previously described, SjS patients showed expanded circulating naïve B-cell compartments. SjS patients had a higher incidence of EBV-EA-D-IgG+ antibodies, characteristic of recent EBV-infection/reactivation. SjS patients with past infection or recent infection/reactivation showed increased CXCR3+Th1 and CXCR3+Tfh1 cells compared to those without active infection. SjS patients with a recent infection/reactivation profile presented increased transitional B-cells compared to patients with past infection and increased plasmablasts, compared to those without infection. Our results suggest EBV-infection contributes to B and T-cell differentiation towards the effector phenotypes typical of SjS. Local lymphocyte activation at ectopic germinal centres, mediated by Tfh and Tfc, can be EBV-driven, perpetuating autoimmune epithelitis, which leads to gland destruction in SjS.

Sjögren's Syndrome (SjS) is characterized by lymphocytic infiltration of exocrine glands, i.e. autoimmune epithelitis. Lymphocytes are central in SjS pathogenesis, with B-cell hyperactivity mediated by T-cells. B-cells are main targets of Epstein-Barr virus (EBV) infection, a frequently-suggested trigger for SjS.We aimed to evaluate how the EBV infection modulates B and T-cell subsets in SjS, including as controls Rheumatoid arthritis patients (RA) and healthy participants (HC).SjS patients presented decreased CXCR5+T-cells, although IL21-secreting Tfh and Tfc cells were increased. Tfc were positively correlated with ESSDAI scores, suggesting their relevant role in SjS pathogenesis. As previously described, SjS patients showed expanded circulating naïve B-cell compartments. SjS patients had a higher incidence of EBV-EA-D-IgG+ antibodies, characteristic of recent EBV-infection/reactivation. SjS patients with past infection or recent infection/reactivation showed increased CXCR3+Th1 and CXCR3+Tfh1 cells compared to those without active infection. SjS patients with a recent infection/reactivation profile presented increased transitional B-cells compared to patients with past infection and increased plasmablasts, compared to those without infection.Our results suggest EBV-infection contributes to B and T-cell differentiation towards the effector phenotypes typical of SjS. Local lymphocyte activation at ectopic germinal centres, mediated by Tfh and Tfc, can be EBV-driven, perpetuating autoimmune epithelitis which leads to gland destruction in SjS.

Purpose: To assess and compare corneal sub-basal nerve plexus morphology with circulating lymphocyte subsets, immunologic status and disease activity in Sjögren syndrome (SjS) patients. Methods: Fifty-five SjS patients, 63 Sicca patients (not fulfilling SjS criteria), 18 rheumatoid arthritis (RA) patients and 20 healthy controls (HC) were included. Systemic disease activity in SjS was assessed with the ESSDAI score. Lymphocyte subpopulations were studied with flow cytometry. Corneal confocal microscopy and ImageJ software were used to characterize corneal sub-basal nerve plexus in terms of nerve density (CNFD), length (CNFL) and tortuosity (CNFT). Conventional dry eye tests were also performed. Results: CNFL and CNFD were lower in SjS, Sicca and RA groups, compared to HC (p < 0.001 for both SjS and Sicca); CNFL p = 0.005, CNFD p = 0.018 in RA). CNFT was higher in SjS, followed by Sicca, RA and HC. A negative correlation was found between ESSDAI score and CNFL (r=-0.735, p = 0.012). CNFL correlated negatively with IL21+ CD8+ T cells (r=-0.279, p = 0.039) and a positively with total memory (r = 0.299, p = 0.027), unswitched memory (r = 0.281, p = 0.038) and CD24Hi CD27+ (r = 0.278, p = 0.040) B cells. CNFD showed a tendency to significance in its negative correlation with ESSDAI (r=-0.592, p = 0.071) and in its positive correlation with switched memory B cells (r = 0.644, p = 0.068). Conclusions: This is the first study aiming to correlate ocular findings with lymphocyte subsets in SjS. The associations founded between CNFL and CNFD and disease activity, IL21+ follicular T cells and some B-cell subsets suggest that corneal nerve damage may parallel systemic disease activity and inflammatory cells' dynamics. info:eu-repo/semantics/publishedVersion

PURPOSE To evaluate lower tear meniscus and corneal sub-basal nerve plexus in primary Sjogren's syndrome (pSS) and Sicca syndrome patients. METHODS Cross-sectional study of 116 patients with Sicca syndrome associated with pSS and not associated with Sjogren's syndrome (non-SS Sicca) and 20 normal control subjects. Tear meniscus height and area were measured using anterior segment optical coherence tomography; corneal sub-basal nerve plexus density, length, and tortuosity were evaluated using in vivo confocal microscopy. Data analysis was performed using IBM-SPSS Statistics 24.0. RESULTS Corneal sub-basal nerve plexus density and length were significantly lower, and tortuosity was significantly higher in pSS and non-SS Sicca groups than in normal control subjects (P < 0.001; P = 0.018, respectively). Corneal sub-basal nerve plexus presented a strong association with Schirmer test I and tear breakup time. Cutoff values of sub-basal nerve plexus density (36.5 nerve/mm) and length (12.5 mm/mm) presented 80.2% to 81.9% sensitivity and 85% specificity for detecting Sicca syndrome patients. No significant differences were found between the 3 groups regarding tear meniscus height and area. CONCLUSIONS Corneal sub-basal nerve plexus in vivo confocal microscopy may be a useful tool in the assessment of dry eye disease in Sicca syndrome, complementing the information provided by the conventional modalities used in dry eye disease evaluation.

Background: Follicular T-cells, characterized by the expression of CXCR5, secrete interleukin 21 (IL-21) and help B-cell differentiation in lymphoid follicles. They are also found in circulation and may play a key role in Sjogren’s syndrome’s (pSS) chronic autoimmune epithelitis. Objectives: To characterize circulating follicular helper (Tfh) and cytotoxic (Tfc) T-cells in peripheral blood (PB) from pSS patients, Rheumatoid Arthritis (RA) patients and healthy controls (HC), and to investigate how they correlate with B-cell subsets. We also aimed to explore associations between the Tfh and Tfc cells and clinical and laboratory features of pSS. Methods: PB from 57 pSS patients, 20 RA patients and 24 HC was analysed by flow cytometry to characterize T and B-cell subsets, with CXCR5 defining Tfh and Tfc within CD4 and CD8 T cells, respectively. A stimulation assay was used to assess the production of IL-21 by CD4+ and CD8+ T-cells. Results: Compared to HC, pSS and RA patients presented significantly lower lymphocyte absolute counts (1615 and 1935 cells/μL respectively, compared to 2228 cells/μL in HC, p pSS patients presented lower absolute counts of CXCR5+ Tfh compared to RA (134 vs 181 cells/μL, p=0.038) and HC (134 vs 241 cells/μL, p pSS patients exhibited higher percentages of IL21+CD4 and IL21+CD8 T cells (IL21+CD4 T cells: 12.4% in pSS vs 9.0% in RA, p=0.046; vs 9.7% in HC, p=0.028; IL21+CD8 T cells: 4.1% in pSS vs 2.3% in RA, p=0.001; vs 2.8% in HC, p=0.030). In pSS patients, CXCR5+ Tfh correlated positively with the percentages of plasmablasts (r=0.262 for CD24-CD38++ cells, and r=0.282 for IgM-/+CD38++ cells). IL21+CD8 T cells correlated positively with the Naive/Memory B cells ratio (r=0.323; p=0.014) and negatively with Bm1 memory B cells (r=-0.370; p=0.005). IL21+CD4 T cells behaved similarly, though without statistical significance. Anti-SSA-positive patients (n=38) presented higher CD4+IL21+(13.3 vs 8.5%, p=0.025) and CD8+IL21+ cells percentages (4.4 vs 4.0%, p=0.198) than SSA-negative patients (n=19). Although there were no differences between pSS patients with active (n=27) and inactive disease (n=30), a tendency for positive correlations was found between IL-21+CD4 and IL21+CD8 T-cells and the ESSDAI score (r= 0.229, p=0.086 for CD4, r= 0.223, p=0.096 for CD8). Moreover, ESSDAI correlated positively with the Tfh1/Tfh17 ratio. Conclusion: pSS patients present a profile of circulating Tfh and Tfc distinct from RA and HC, both phenotypically and functionally. Moreover, our data support a crucial role for these cells in B cell development, as they correlate with B cells, in pSS patients, which are known to exhibit a typical circulating B cell compartment. Both Tfc and Tfh cells can be critical for disease pathophysiology and activity, as underlined by the correlations between these cells and ESSDAI scores. Disclosure of Interests: Filipe Barcelos Consultant for: Pfizer; Ely-Lilly, Speakers bureau: Novartis, Catarina Martins: None declared, Ricardo Monteiro: None declared, Carlos Geraldes: None declared, Ana Luisa Papoila: None declared, Joana Cardigos: None declared, Nathalie Madeira: None declared, Nuno Alves: None declared, Jose Vaz-Patto: None declared, Jaime Branco: None declared, Luis Miguel Borrego Grant/research support from: MSD, Consultant for: MSD; Tecnifar, Paid instructor for: MSD; AstraZeneca, Speakers bureau: MSD; Tecnifar; AstraZeneca

Background Some B-cell subsets contribute to the regulation of immune responses, mainly through the secretion of interleukin-10, which suppresses T-helper 1 (Th1) and Th17 cells and induces regulatory T-cells (Tregs). The role of Bregs and Tregs in Sjogren’s syndrome (pSS) pathogenesis is an active field of research. Objectives To evaluate the distribution of regulatory and effector T and B-lymphocytes, in patients with pSS and healthy controls (HC), and the relation between regulatory-like B-cell subsets and the pSS phenotype. Methods Fifty-seven pSS patients (2002 AECG criteria) and 24 HC were included. Circulating T and B-lymphocytes were characterized by flow cytometry and groups were compared. Significance was considered for p Results Compared to HC, pSS patients had lower percentages (16.9 vs 32.0%, p Lower frequencies of CD24hiCD27+ B-cells were found in anti-SSA-positive (n=38) compared to anti-SSA-negative (n=19) patients (15.0 vs 19.6%, p=0.170), as well as lower absolute counts (26 vs 31 cells/μL; p=0.173). Anti-SSA-positive patients presented higher CD24hiCD38hi B-cells percentages (6.2 vs 4.2%; p=0.260) and absolute counts (10 vs 5 cells/μL; p=0.343) compared to anti-SSA-negative patients. Although CD24hiCD27+ B-cells frequencies and absolute counts did not differ between patients with active (n=27) or inactive disease (n=30), (16.9% vs 17.0%, p=0.946; 25 vs 31 cells/μl, p=0.179), patients with higher disease activity (ESSDAI≥5) (n=9) presented lower absolute counts of CD24hiCD27+ B-cells (18 vs 31 cells/μL, p=0.096) and lower CD24hiCD38hi B-cells (4 vs 10 cells/μL, p=0.075), and higher Th1/Breg CD24hiCD27+ ratios, (16.2 vs 9.2, p=0.064). Considering all patients, a negative correlation was found between the ESSDAI score and the absolute numbers of either CD24hiCD27+ B-cells (r= -0.277; p=0.037) and Tregs (r= -0.311; p=0.019). Correlations with ESSDAI was stronger when looking at patients with ESSDAI≥5: for the percentages of CD24hiCD27+ B-cells, r=-0.705, p=0.023; for CD24hiCD27+ B-cells absolute counts, r= -0.644; p=0.045; and for the absolute counts of Tregs, r= -0.862; p=0.001. Using ROC curves to discriminate pSS from HC, better AUCs were obtained for CD24hiCD27+Breg cells (cut-off 34 cells/μL, AUC=0.81), Tregs/CD24hiCD27+Breg ratio (cut-off 1.98, AUC=0.74) and Th1/CD24hiCD27+Breg ratio (cut-off 12.23, AUC=0.70), corresponding to a specificity for pSS of 0.83, 0.75 and 0.70, respectively, and sensitivity of 0.75, 0.72 and 0.67, respectively. In pSS, lower CD24hiCD27+ B-cell counts, as well as higher Tregs/CD24hiCD27+Breg and Th1/CD24hiCD27+Breg ratios, were associated to a higher frequency of autoantibodies and higher gammaglobulin. Conclusion Our findings demonstrated a significant decrease in the Breg-enriched CD24hiCD27+ B-cell subset in pSS, which presented a negative correlation with the disease activity. We have demonstrated significant differences in the CD24hiCD27+ B-cell subset and respective ratios, presenting a good discriminatory capacity compared to HC. Therefore, this subset may have diagnostic utility in pSS, as it may support the presence of immune dysregulation in suspected cases that don’t fulfil the pSS classification criteria. Further studies with increased number of samples and a prospective design are needed to explore this hypothesis. Disclosure of Interests Filipe Barcelos Consultant for: Pfizer; Ely-Lilly, Speakers bureau: Novartis, Catarina Martins: None declared, Carlos Geraldes: None declared, Ana Luisa Papoila: None declared, Joana Cardigos: None declared, Gloria Nunes: None declared, Teresa Lopes: None declared, Nuno Alves: None declared, Jose Vaz-Patto: None declared, Jaime Branco: None declared, Luis Miguel Borrego Grant/research support from: MSD, Consultant for: MSD; Tecnifar, Paid instructor for: MSD; AstraZeneca, Speakers bureau: MSD; Tecnifar; AstraZeneca

Purpose To study structural chorioretinal changes in tamoxifen-treated patients. Methods Cross-sectional case-control study comparing structural chorioretinal aspects in tamoxifen-treated patients and healthy controls. Enhanced depth spectral domain optic coherence tomography with choroidal binarization and optic coherence tomography angiography were performed. Individual retinal layer thickness and chorioretinal vascular components were compared. Subgroup analysis regarding history of chemotherapy was performed. Results Two hundred eyes of 100 TAM-treated patients (Group 1) and 80 eyes of 40 healthy controls (Group 2) were included. Of the 200 spectral domain optic coherence tomography scans from patients, 2 showed structural changes attributable to tamoxifen. Group 1 showed significantly lower values in choroidal parameters and in total retinal, ganglion cell layer, inner plexiform layer, outer nuclear layer, and retinal pigment epithelial thicknesses as well as an increased thickness in the outer plexiform layer. The subgroup not submitted to chemotherapy maintained significant reductions in total retinal thickness, ganglion cell layer, retinal pigment epithelium, outer nuclear layer, outer retinal layer, choroidal parameters, as well as an increased thickness in the outer plexiform layer, in comparison with Group 2. Conclusion Subclinical structural retinal changes could indicate early retinal pigment epithelial and photoreceptor damage. The new finding of choroidal thinning could point toward another important pathophysiologic process in tamoxifen-induced toxicity.

Introduction: Image processing of optical coherence tomography scans through binarization techniques represent a non-invasive way to separately asses and measure choroidal components, in vivo. In this review, we systematically search the scientific literature regarding binarization studies published so far. Methods: A systematic research was conducted at PubMed database, including English literature articles for all of the following terms in various combinations: binarization, choroid/al, enhanced depth spectral domain/swept source optic coherence tomography, and latest publications up to November 2018 were reviewed. Results: Thirty-seven articles were included and analyzed regarding studied disease, binarization method, studied variables, and outcomes. Most of the studies have focused on the more common retinal pathologies, such as age-related macular degeneration, central serous chorioretinopathy and diabetic retinopathy but binarization techniques have also been applied to the study of choroidal characteristics in ocular inflammatory diseases, corneal dystrophies and in postsurgical follow-up. Advantages and disadvantages of binarization techniques are also discussed. Conclusion: Binarization of choroidal images seems to represent a promising approach to study choroid subcomponents in an increasingly detailed manner. info:eu-repo/semantics/publishedVersion

Nanotechnology enabled the development of materials and devices with great utility in different fields of medicine. By using engineered-based nano-devices and structures, human biological systems may be controlled and repaired at a molecular scale, ultimately leading to a biological benefit. In particular, in the field of glaucoma treatment, nanotechnology may, for example, enhance drug residence time on the ocular surface and ocular bioavailability, as well as improve surgical success by both optimizing postoperative scarring and providing a wider safety window. Further studies are still needed to entirely explain the pharmacodynamics of nanotechnology-based therapeutic approaches and prove their biological consequences in human eyes. This review aims to summarize the literature concerning the advances in nanotechnology, specifically regarding ocular devices applied to the treatment of glaucoma. info:eu-repo/semantics/publishedVersion

Background B-cell disturbances are a hallmark of pSS and play a pivotal role in the disease pathogenesis and clinical evolution, and may as well have a potential role in diagnosis. In pSS, an increase of the naive subset and a decrease of memory B-cells have been reported. A decreased frequency of memory cells has also been identified in patients with Sicca syndrome without criteria for pSS. Objectives Our study aims to evaluate the distribution of B-lymphocyte subpopulations in pSS and Sicca patients and to establish cut-off points for pSS classification in relation to healthy controls. Moreover, we aim to evaluate the relation between lymphocyte subpopulations and phenotypic features in pSS. Methods Fifty-seven pSS patients, 68 non-Sjogren Sicca patients and 24 healthy controls were included. Circulating B-cell frequencies were determined by flow cytometry, and the naive and memory (switched and unswitched) subsets were characterised based on surface marker expression of the following monoclonal antibodies: CD19, CD24, CD27, Anti-IgD and Anti-IgM. Kruskal-Wallis test was applied for groups’ comparison. ROC curves were used to establish cut-off points in the B-cells subset levels and to estimate corresponding sensitivity and specificity. Data analysis was performed with R software. Results Absolute numbers of lymphocytes in pSS were lower compared to controls, with Sicca presenting intermediate levels. Significant differences were found between pSS and controls in absolute counts of all memory populations: total memory (TMem) (CD19+CD27+), switched (SwM) (CD19+IgD-CD27+) and unswitched memory (UnSwM) (p Through ROC curves, the B-cell subsets that better discriminate between pSS and controls were TMem and SwM. A cut-off of equal to 58 TMem cells/µl yelded a specificity of 0.88 and a sensitivity of 0.60 for pSS, and was met by 59.6% of pSS, 12.5% of controls and 38.8% of Sicca, and a cut-off of equal to 23.5 SwM cells/µl yelded a specificity of 0.88 and a sensitivity of 0.54 and was met by 54.4% of pSS, 12.5% of controls and 37.3% of Sicca. pSS patients with lower values than the established cut-off points had longer disease duration, higher disease activity (ESSDAI), and were more likely to present auto-antibodies and positive biopsy. Several Sicca patients also presented memory B-cell subsets counts lower than the pSS cut-off, but no consistent differences in clinical profile were identified. Conclusions Decreased numbers of memory B-cell subsets clearly discriminate pSS from healthy controls. Lower memory B-cells counts are associated with more active pSS disease profile. It remains to be clarified whether Sicca patients with decreased memory B-cells represent pSS and if B-cell profiling could help in the diagnosis of pSS. Disclosure of Interest None declared

B-cells play a pivotal role in primary Sjögren's syndrome (pSS) pathogenesis. We aim to (1) evaluate the distribution of B-lymphocyte subpopulations in pSS and Sicca patients, (2) establish cut-off points that discriminate pSS from controls, (3) evaluate the association between memory B-cells and phenotypic features in pSS. We included 57 pSS patients, 68 Sicca and 24 healthy controls. Circulating B-cells were characterized by flow cytometry as naïve and memory subsets and classified from Bm1 to Bm5. Compared to controls, pSS patients had lower percentages (29.5 vs 44.4%) and absolute numbers (47 vs 106 cells/µl) of memory B-cells. Through ROC curves, a cut-off of ≤ 58 total memory B-cells/µl yielded a specificity of 0.88 and a sensitivity of 0.60 for pSS, and was met by 59.6% of pSS patients, 38.8% of Sicca and 12.5% of controls. A cut-off of < 23.5 Switched-memory B-cells/µl yielded a specificity of 0.88 and a sensitivity of 0.54 and was met by 54.4% of pSS patients, 37.3% of Sicca and 12.5% of controls. In pSS, lower total memory B-cells count was associated with longer disease duration (14.3 vs 8.1 years, p = 0.006) and more active disease profile, as evaluated by the European League Against Rheumatism (EULAR) Sjögren's Syndrome Disease Activity Index (ESSDAI) (3.1 vs 1.4, p = 0.043). Decreased numbers of memory B-cells clearly discriminated pSS from controls and can also have prognostic value. It remains to be clarified whether Sicca patients with decreased memory B-cells represent pSS and if B-cell profiling could help in the diagnosis of pSS. info:eu-repo/semantics/publishedVersion

Purpose The differential diagnosis between Irvine-Gass Syndrome (IGS) and Diabetic Macular Edema (DME) is currently established by angiography, which is an invasive and time-consuming tool. The aim of this study is to evaluate differences in optic disc's nerve fiber layer thickness (RNFL) in patients with macular edema associated with IGS and Diabetes Mellitus (DM). Methods Retrospective case control study of 28 eyes of 28 patients with macular edema divided into 2 groups. Group 1 included 14 eyes with IGS diagnosed by clinical and angiographic criteria and group 2 included 14 eyes with cystoid diabetic macular edema (DME) without previous ocular surgery. A control group (group 3) of 14 eyes of 14 healthy patients paired by age and gender were also included. Ophthalmologic examinations included visual acuity (VA) measurements, slit-lamp examination, Goldmann applanation tonometry, Spectral-Domain Optic Coherence Tomography (SD-OCT) and fluorescein angiography. Results Forty two patients (21 females and 21 males), with a mean age of 66.57 ± 10.80 years were included in this study. Optic disc nasal and temporal RNFL thicknesses as well as central macular thickness were significantly higher in group 1 and 2 compared with control group (p

Purpose The choroidal circulation receives nearly 95% of ocular blood flow and it is essential for a normal retinal structure and function. Recently, several clinical studies showed a variation in choroidal thickness (CT) even before the presence of diabetic retinopathy (DR), which the meaning remains uncertain and questionable. Our objective was to analyze and correlate the CT with the disease duration, systemic blood pressure (SBP) and analytic evaluation. Methods Prospective, observational case-control study. A complete ophthalmological examination was performed, including dynamic contour tonometry and axial length. CT was assessed by a non-invasive procedure using an OCT (Spectralis Heidelberg Engineering) with an enhanced depth mode (EDI) at 13 different locations (subfoveal and 3 measurements 500 μm apart in all 4 directions – nasal, temporal, superior and inferior). The SBP was measured and an analytical evaluation was performed, including glycemia, glycosylated hemoglobin – HbA1c, lipid parameters, renal function, ionogram and microalbuminuria. Correlation between variables was explored using Spearman correlations. Results The study included 65 diabetic patients without DR (36 females; mean age 67.23 ± 9.08 years), with an average disease duration of 90.42 ± 81.82 months. The CT didn't showed a correlation with disease duration, SBP, glycemia, HbA1c, renal function, lipid parameters, homocysteinemia, natremia or microalbuminuria. However, the CT was positively correlated with potassium and chlorine serum levels in 5 points, with statistic significance (r between 0.26 and 0.31, p

Purpose Diabetes Mellitus is associated with changes in refractive parameters. Some aspects already studied were the corneal biomechanics and lens thickness. Although, the discussion about anterior chamber angle and depth is still open. The author objective was to analyze and correlate the anterior chamber depth, lens vault and lens thickness with disease duration and metabolic status. Methods Prospective case–control study. The anterior chamber and refractive parameters were studied using the Visante OCT and the differences between diabetic patients with metabolic control and disease stability were determined (group 1), without (group 2) and group-control (3). The metabolic control is based on HbA1c levels. The cut-off considered was 7%. Results A total of 64 patients were evaluated (group 1 – n = 21; group 2 – n = 20; group 3 – n = 23). The mean age was 64.32 ± 7.55 years and approximately 5 years of disease duration. In both groups of diabetic patients we found thicker lens, narrow anterior chamber and higher lens vault compared to control group. There was a difference between diabetic groups exists, but it was not statistically significant. Conclusions The anterior chamber angle and lens vault are influenced by the serum glucose levels. Further studies will be necessary to clarify the physiopathology mechanism responsible for the anterior segment modifications.

Purpose To evaluate the thickness of macular retina and determine which retinal layers are most affected by retrochiasmal visual pathways lesions. Methods Mean retinal thickness utilizing automated intraretinal layer segmentation of spectral domain optical coherence tomography scans was performed in 40 eyes of 40 patients with retrochiasmal visual pathways lesions and compared with 60 eyes of control subjects. Multiple linear regression analysis was used to determine the relationship between retinal thickness and follow-up, age and gender. Results Ganglion cell and inner plexiform layer was thinner in the temporal hemiretina ipsilateral and in the nasal hemiretina contralateral than in healthy controls. The mean thickness was significantly reduced in lesions over 6 months of duration, with no differences in correlations with age or gender. Conclusions This study demonstrate ganglion cell and inner plexiform thinning in the hemimacular area. These results support the concept that transneuronal retrograde degeneration of the retinal ganglion cells can be detected by OCT in humans with retrochiasmal visual pathways lesions. This homonymous hemimacular thinning in OCT represents an imaging biomarker that can be of valu in diagnosis, prognosis and clinical trials of neuroprotectives therapies.

Bilateral orbital metastases restricted to the extraocular muscles (EOMs) are exceedingly rare. We report a case of bilateral extraocular muscle metastases from a small cell lung carcinoma and provide a review of the relevant literature. A 56-year-old smoker presented with proptosis, motility changes, and a relative afferent pupillary defect of the left eye, with a previous history of a small cell lung carcinoma. An orbital computerized tomography scan revealed a mass restricted to the left medial rectus. An incisional biopsy confirmed metastasis. Visual acuity of the left eye decreased rapidly, and right globe proptosis became evident. Orbital magnetic resonance imaging at two months follow-up showed marked left orbital mass enlargement and a new right lateral rectus mass. The patient was maintained on palliative care and died from metastatic disease-related complications. info:eu-repo/semantics/publishedVersion