Objective. To estimate sensitivity and specificity of several optical coherence tomography (OCT) measurements for detecting retinal thickness changes in patients with relapsing-remitting multiple sclerosis (RRMS), such as macular ganglion cell-inner plexiform layer (GCIPL) thickness measured with Cirrus (OCT) and peripapillary retinal nerve fiber layer (pRNFL) thickness measured with Cirrus and Spectralis OCT. Methods. Seventy patients (140 eyes) with RRMS and seventy matched healthy subjects underwent pRNFL and GCIPL thickness analysis using Cirrus OCT and pRNFL using Spectralis OCT. A prospective, cross-sectional evaluation of sensitivities and specificities was performed using latent class analysis due to the absence of a gold standard. Results. GCIPL measures had higher sensitivity and specificity than temporal pRNFL measures obtained with both OCT devices. Average GCIPL thickness was significantly more sensitive than temporal pRNFL by Cirrus (96.34% versus 58.41%) and minimum GCIPL thickness was significantly more sensitive than temporal pRNFL by Spectralis (96.41% versus 69.69%). Generalised estimating equation analysis revealed that age (P = 0.030), optic neuritis antecedent (P = 0.001), and disease duration (P = 0.002) were significantly associated with abnormal results in average GCIPL thickness. Conclusion. Average and minimum GCIPL measurements had significantly better sensitivity to detect retinal thickness changes in RRMS than temporal pRNFL thickness measured by Cirrus and Spectralis OCT, respectively.

Both RNFL and GCIPL analysis reveal significant thinning in eyes with ONHD directly correlated with drusen severity. In buried ONHD, the abnormality rate was significantly higher with GCIPL compared to RNFL evaluation, suggesting that GCIPL analysis might be an early structural indicator of neuronal loss in the setting of thickened RNFL.

The effect of local and systemic injections of mesenchymal stem cells derived from adipose tissue (AD-MSC) into rabbit models of corneal allograft rejection with either normal-risk or high-risk vascularized corneal beds was investigated. The models we present in this study are more similar to human corneal transplants than previously reported murine models. Our aim was to prevent transplant rejection and increase the length of graft survival. In the normal-risk transplant model, in contrast to our expectations, the injection of AD-MSC into the graft junction during surgery resulted in the induction of increased signs of inflammation such as corneal edema with increased thickness, and a higher level of infiltration of leukocytes. This process led to a lower survival of the graft compared with the sham-treated corneal transplants. In the high-risk transplant model, in which immune ocular privilege was undermined by the induction of neovascularization prior to graft surgery, we found the use of systemic rabbit AD-MSCs prior to surgery, during surgery, and at various time points after surgery resulted in a shorter survival of the graft compared with the non-treated corneal grafts. Based on our results, local or systemic treatment with AD-MSCs to prevent corneal rejection in rabbit corneal models at normal or high risk of rejection does not increase survival but rather can increase inflammation and neovascularization and break the innate ocular immune privilege. This result can be partially explained by the immunomarkers, lack of immunosuppressive ability and immunophenotypical secretion molecules characterization of AD-MSC used in this study. Parameters including the risk of rejection, the inflammatory/vascularization environment, the cell source, the time of injection, the immunosuppression, the number of cells, and the mode of delivery must be established before translating the possible benefits of the use of MSCs in corneal transplants to clinical practice.

PurposeThe purpose of the present study was to analyze in detail the peripapillary area divided into 12 sectors in order to identify the first sector that thins in Alzheimer's disease (AD) patients compared with controls.MethodsA total of 23 mild AD patients and 28 controls were examined. Patients underwent a complete ophthalmologic exam. The peripapillary RNFL thickness parameters evaluated were thickness for each 12‐o'clock hour position with the 3‐o'clock position as nasal, 6‐o'clock position as inferior, 9‐o'clock position as temporal, and 12‐o'clock position as superior. Patients were required to have a visual acuity better than 0.6 and no retinal pathology.ResultsCompared to controls, the eyes of patients with mild‐AD patients showed no statistical difference in peripapillary RNFL thickness (p > 0.05); however, sectors 2, 3, 4, 8, 9, and 11 of the papilla showed thinning, but thickening in sectors 1, 5, 6, 7, and 10.ConclusionsDespite the fact that peripapillary RNFL thickness did not statistically differ in comparison to control eyes, the increase in peripapillary thickness in our mild‐AD patients could correspond to an early neurodegeneration stage and may entail the existence of an inflammatory process that could lead to progressive peripapillary fiber damage.

A 68-year-old Caucasian male was referred for evaluation and follow-up of unilateral glaucoma resistant to control with topical medication. Corrected visual acuity was 20/20 in the right and 20/25 in the left eye. Biomicroscopy was normal and the intraocular pressure (IOP) was 14 mm Hg in the right eye. In the left eye, ciliary injection, a diffuse iris hyperchromia (figure 1A), discrete corneal oedema with the presence of sparse pigment deposits on the endothelium (figure 1B), and mild anterior chamber reaction (+/4+) were observed. The angle was obstructed inferiorly by the pigment deposition, while the parts of the angle that were visible showed increased pigmentation of the trabecular meshwork during gonioscopy. The iris surface was smooth and the crypts were absent. The pupil was round but fixed in medium mydriasis with a posterior synechia seen at 1 h. In addition, the lens had nuclear sclerosis and the IOP was measured at 58 mm Hg. Funduscopy disclosed increased cup-todisc ratio in the left (0.7) compared with the right eye (0.4), but was otherwise unremarkable.The patient's relevant medical history included controlled hypertension and a basal cell carcinoma in the left arm Education group.bmj.com on June 29, 2015 -Published by