Photochemical damage occurs after an exposure to high energy radiation within the visible spectrum of light, causing morphological changes in the retina and the formation of superoxide anion. In this study we created a model of phototoxicity in rabbits. Animals were exposed to a light source for 120 minutes and were sacrificed immediately or one week after exposure. Outer nuclear layer and neurosensory retina thickness measurements and photoreceptor counting were performed. Caspase-1 and caspase-3 were assessed by immunohistochemistry. Dihydroethidium was used to evaluate in situ generation of superoxide and thiobarbituric acid reactive substances were measured in retinal homogenates as indicators of lipid peroxidation. The total antioxidant capacity and oxidative ratio were also determined. Retinas from rabbits exposed to light showed higher levels of lipid peroxidation than the unexposed animals and a decrease in outer nuclear layer and neurosensory retina thickness. Our study demonstrates that light damage produces an increase in retinal oxidative stress immediately after light exposure that decreases one week after exposure. However, some morphological alterations appear days after light exposure including apoptotic phenomena. This model may be useful in the future to study the protective effect of antioxidant substances or new intraocular lenses with yellow filters.

We examined the effect of nutritional supplements (modified Age Related Eye Disease Study (AREDS)-II formulation containing vitamins, minerals, lutein, resveratrol, and omega-3 fatty acids) on choroidal neovascularization (CNV). Supplements were administered alone and combined with intravitreal anti-VEGF in an early-CNV (diode laser-induced) murine model. Sixty mice were evenly divided into group V (oral vehicle, intravitreal saline), group S (oral supplement, intravitreal saline), group V + aVEGF (oral vehicle, intravitreal anti-VEGF), and group S + aVEGF (oral supplement, intravitreal anti-VEGF). Vehicle and nutritional supplements were administered daily for 38 days beginning 10 days before laser. Intravitreal injections were administered 48 h after laser. Fluorescein angiography (FA) and flat-mount CD31 staining evaluated leakage and CNV lesion area. Expression of VEGF, MMP-2 and MMP-9 activity, and NLRP3 were evaluated with RT-PCR, zymography, and western-blot. Leakage, CNV size, VEGF gene and protein expression were lower in groups V + aVEGF, S + aVEGF, and S than in V (all p < 0.05). Additionally, MMP-9 gene expression differed between groups S + aVEGF and V (p < 0.05) and MMP-9 activity was lower in S + aVEGF than in V and S (both p < 0.01). Levels of MMP-2 and NLRP3 were not significantly different between groups. Nutritional supplements either alone or combined with anti-VEGF may mitigate CNV development and inhibit retinal disease involving VEGF overexpression and CNV.

for the Biotherapies in Uveitis (BioÚvea) Study Group* Purpose: To study the drug retention rate (DRR), causes, and predictors of discontinuation of adalimumab (ADA) in a real-world uveitis setting.Design: Multicentric, nationwide, registry-based, ambispective, observational study.Participants: Patients treated with ADA for noninfectious uveitis (NIU) in the Biotherapies for Uveitis (BioÚvea) Spanish registry from November 2016 to November 2017.Methods: Demographics, clinical data, timing, and reasons for discontinuation, if occurred, were recorded. The DRR and drug retention time (DRT) were estimated using the KaplaneMeier method. Median follow-up was analyzed by reverse KaplaneMeier. Log-rank test was used for comparisons. Cox proportional-hazards model (PHM) and propensity score matching were used to identify predictors for discontinuation due to inefficacy and adverse events.Main Outcome Measures: Drug retention rate and DRT. Results: A total of 392 patients were analyzed, including 218 women. Median age was 39 (interquartile range, 25) years. Nonanterior uveitis was recorded in 242 patients. Median follow-up was 49.07 (0.97e131.67) months, median DRT (survival) was 69.3 months, and 14 patients were lost to follow-up. The DRR at 6, 12, 24, and 60 months was 92.97%, 87.68%, 76.31%, and 54.28%, respectively. Adalimumab was discontinued in 151 patients. Discontinuation was due to lack or loss of efficacy in 74 patients, adverse event in 34 patients, and sustained quiescence in 25 patients. Recorded adverse events included infections in 10 patients and malignant neoplasms in 3 patients. Concurrent classic immunomodulatory therapy (IMT) was given to 251 patients. We did not find DRT differences regarding the use of concurrent IMT. Adalimumab was prescribed as a second or greater biotherapy line in 76 patients who showed shorter DRT (P ¼ 0.038). Starting ADA in nonbiotherapy-naive patients was a predictor for "discontinuation due to inefficacy," whereas undifferentiated uveitis was a predictor for "discontinuation due to adverse event." Drug retention time was significantly shorter when spared or intensified, mainly due to discontinuation after sustained quiescence.Conclusions: Drug retention rate of ADA in uveitis at 60 months was 54.28%, with a good safety profile. The use of concurrent IMT did not show a significant influence on DRT. The use of ADA as a second or further biotherapy could be predictive for discontinuation due to inefficacy. Undifferentiated uveitis may be prone to premature discontinuation of ADA due to adverse events. Ophthalmology 2020;127:814-825 ª 2019 by the American Academy of Ophthalmology Supplemental material available at www.aaojournal.org.Noninfectious uveitis (NIU) is composed of a large group of diseases that involve the inflammation of the intraocular tissues. 1 Approximately 20% of legal blindness has been attributed to NIU in developed countries. 2,3 The disease usually affects the working-age population, leading to a significant impact on patients' quality of life and welfare. 4,...

RESUMENCaso clínico: Paciente que presenta hemorragia submacular de origen traumático. Se realiza vitrectomía posterior y administración intravítrea de rt-PA y SF 6 . A las cuatro semanas la agudeza visual había pasado de 0,1 a 0,8. El paciente no presentó ninguna complicación derivada del tratamiento con rt-PA Discusión: Debido a que la sangre es tóxica para la retina esperar a su reabsorción espontánea comporta una pobre recuperación visual. El rt-PA administrado junto al SF 6 es útil para el tratamiento de hemorragias submaculares secundarias a degeneración macular asociada a la edad, pero también puede ser útil para la lisis de coágulos hemáticos traumáticos favoreciendo la recuperación de la agudeza visual.Palabras clave: rt-PA, hemorragia submacular, traumatismo ocular, activador tisular del plasminó-geno, sangre subfoveal. COMUNICACIÓN CORTA ABSTRACTCase report: This patient was afflicted by a traumatic submacular hemorrhage. A posterior vitrectomy was performed and intravitreal rt-PA and SF6 were administered. Four weeks later, the visual acuity had increased from 0.1 to 0.8. No complications due to the treatment with rt-PA were reported. Discussion: It is known that waiting for the spontaneous blood removal in such cases results in a poor visual acuity recovery due to a toxic effect of the blood products. Both rt-PA and the SF 6 are useful for the treatment of submacular hemorrhages secondary to age-related macular degeneration, and this case report has shown they are also useful to lyse traumatic blood clots, thus contributing to a better recovery of visual acuity (Arch Soc Esp Oftalmol 2007; 82: 517-520).

RESUMENCaso clínico: Paciente de 63 años que presenta una conjuntivocalasia bilateral con lagrimeo, picor, escozor y retraso en el aclaramiento de fluoresceí-na. Al no observarse mejoría sintomática con el tratamiento tópico, se interviene quirúrgicamente con implante de membrana amniótica sin sutura. Discusión: La conjuntivocalasia es una patología frecuente con síntomas comunes a la sequedad ocular. Cuando no hay respuesta al tratamiento médico se recurre al tratamiento quirúrgico. La técnica descrita por Tseng basada en el implante de membrana amniótica sin sutura resulta muy eficaz en estos casos debido a la poca inflamación que produce permitiendo una rápida recuperación y mejoría sintomática.Palabras clave: Conjuntivocalasia, membrana amniótica, pegamento de fibrinógeno, sequedad ocular, inflamación. COMUNICACIÓN CORTA ABSTRACTCase report: A 63-year-old man with bilateral conjunctivochalasis presented with tearing, irritation, foreign body sensation and a delayed fluorescein clearance test. After no symptomatic improvement with topical treatment, surgery was carried out, with amniotic membrane transplantation and fibrin sealant. Discussion: Conjunctivochalasis is a frequent disorder that shares symptoms with dry eye syndrome. When there is no response to topical treatment, surgical treatment is needed. The surgical technique described by Tseng, and based on amniotic membrane transplantation without suture, resulted in a very useful response, due to less inflammation and a rapid resolution and improvement of symptoms (Arch Soc Esp Oftalmol 2007; 82: 571-574).

RESUMENObjetivo: Comparar la medición de presión intraocular con el tonómetro de Pascal ® en córneas normales frente al tonómetro de Goldmann y al pneumotonómetro. Método: Estudio clínico observacional en el que se han incluido 205 pacientes consecutivos y randomizados que han acudido a la consulta de oftalmología. Se realiza una medición con cada tonómetro en orden aleatorio. Resultados: El Pascal ® , dio una medición de la presión intraocular mayor que la del resto de tonó-metros. Se obtienen diferencias significativas del Pascal ® frente a los otros dos tonómetros (p<0,05). La fiabilidad del Pascal ® fue: fiables en el 27,3% (56 de 205 pacientes), aceptable en el 42% (86 de 205 pacientes) y en el 23,4% (48 de 205 pacientes) inaceptable. En el 7,3% (15 de 205 pacientes) restante no se obtuvo ninguna medición con el tonó-metro de Pascal ® . Al comparar el tonómetro de Pascal ® frente al de Goldmann y al neumotonómetro se observa que el coeficiente de correlación es débil y presenta alta discordancia con el método de BlandAltman. ARTÍCULO ORIGINAL ABSTRACTPurpose: To compare the intraocular pressure measurements as defined by the Pascal ® tonometer, the Goldmann tonometer and the pneumotonometer. Methods: This was an observational clinical study, which included two hundred and five randomly selected subjects recruited from the Ophthalmology Department. The intraocular pressure measurements were performed with each tonometry technique in a randomized order. Results: The Pascal ® 's intraocular pressure measurement was significantly higher than that measured by the other two tonometers (p<0.05). The quality data of Pascal ® was: optimum in 27.3% (56 of 205 patients), acceptable in 42% (86 of 205 patients) and unacceptable in 23.4% (48 of 205 patients). In 7.3% (15 of 205 patients) it was impossible to obtain any measurement using Pascal ® . A weak correlation coefficient between the Pascal ® and the Goldmann, and between Pascal® and the pneumotonometer was found. The Bland-Altman method of measurement using these tonometers showed a high degree of discordance. Conclusion: As reported by others authors, the Pascal ® 's intraocular pressure measurement is higher

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