OSAHS patients showed decreased peripapillary nasal RNFL thickness, and increased ONH area and volume parameters when they were evaluated by OCT. These findings suggest that neuronal degeneration might be present in the retina of OSAHS patients, as previously observed in some neurodegenerative disorders.

In the last decade, we have witnessed substantial progress in our understanding of corneal biomechanics and architecture. It is well known that diabetes is a systemic metabolic disease that causes chronic progressive damage in the main organs of the human body, including the eyeball. Although the main and most widely recognized ocular effect of diabetes is on the retina, the structure of the cornea (the outermost and transparent tissue of the eye) can also be affected by the poor glycemic control characterizing diabetes. The different corneal structures (epithelium, stroma, and endothelium) are affected by specific complications of diabetes. The development of new noninvasive diagnostic technologies has provided a better understanding of corneal tissue modifications. The objective of this review is to describe the advances in the knowledge of the corneal alterations that diabetes can induce.

BackgroundTo assess the retinal sensitivity in obstructive sleep apnea hypopnea syndrome (OSAHS) patients evaluated with standard automated perimetry (SAP). And to correlate the functional SAP results with structural parameters obtained with optical coherence tomography (OCT).MethodsThis prospective, observational, case-control study consisted of 63 eyes of 63 OSAHS patients (mean age 51.7 ± 12.7 years, best corrected visual acuity ≥20/25, refractive error less than three spherical or two cylindrical diopters, and intraocular pressure < 21 mmHg) who were enrolled and compared with 38 eyes of 38 age-matched controls. Peripapillary retinal nerve fiber layer (RNFL) thickness was measured by Stratus OCT and SAP sensitivities and indices were explored with Humphrey Field Analyzer perimeter. Correlations between functional and structural parameters were calculated, as well as the relationship between ophthalmologic and systemic indices in OSAHS patients.ResultsOSAHS patients showed a significant reduction of the sensitivity for superior visual field division (p = 0.034, t-student test). When dividing the OSAHS group in accordance with the severity of the disease, nasal peripapillary RNFL thickness was significantly lower in severe OSAHS than that in controls and mild-moderate cases (p = 0.031 and p = 0.016 respectively, Mann-Whitney U test). There were no differences between groups for SAP parameters.We found no correlation between structural and functional variables. The central visual field sensitivity of the SAP revealed a poor Pearson correlation with the apnea-hipopnea index (0.284, p = 0.024).ConclusionsRetinal sensitivity show minor differences between healthy subjects and OSAHS. Functional deterioration in OSAHS patients is not easy to demonstrate with visual field examination.

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Purpose Obstructive sleep apnea syndrome (OSAS) is a common sleep and breathing disorder characterized by repeated episodes of hypoxemia.OSAS is associated with persistent neurocognitive injury that may be reflected in structural changes in certain brain regions. The aim of this study is to determine the peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness and volume by optical coherence tomography (OCT) in adults with OSAS in order to detect axonal injury in this population. Methods Fourty‐nine eyes corresponding to 26 patients (mean age +/‐ SD: 50.8 +/‐ 12.7 years; range: 14‐75; female/male: 5/21) with newly discovered and previously untreated moderate to severe OSAS (apnea‐hypopnea index >15) were compared by OCT with a control group of twenty‐two eyes corresponding to 14 age‐matched healthy individuals (mean age +/‐ SD: 52.1 +/‐ 15.4 years; range: 14‐74; female/male: 7/7), measuring peripapillary RNFL thickness, macular thickness and volume, and optic nerve head (ONH) parameters. Results OSAS patients revealed a significantly lower RNFL thickness in the nasal part of the optic disc (74.6±13.5 µm, range: 47‐100) compared to controls (83.2±14.7 µm, range: 56‐107) (p=0.015). OSAS patients also showed a decreased macular thickness in the outer nasal ring (250.7±13.6 µm, range: 227‐280) compared to controls (265.5±4.9 µm, range: 265‐272) (p=0.05). Other OCT measurements did not show any differences. Conclusion OSAS was associated with a decreased peripapillary RNFL and macular thickness in the nasal quadrants. Therefore, it might be a biomarker of this disease.

Purpose To evaluate the efficacy and safeness of intraocular injections of Ranibizumab followed by grid photocoagulation in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods Prospective study of 12 eyes with ME secondary to BRVO. Eyes were injected with 0.5 of Ranibizumab at the diagnosis time. Thirty days after the injection grid laser was applied in the area of capillary diffusion. Best corrected visual acuity (BCVA) and macular thickness measured by Cirrus‐HD Optical Coherence Tomography were evaluate, at the time of diagnosis, 1 month after injection an 3, 6, and 12 months after the laser. Results The mean BCVA at diagnosis was 0.34. One month after Ranibizumab BCVA was 0.53. Three,6 and 12 months after the laser the BCVA was 0.56, 0.65 and 0.73. The macular average thickness 1, 3, 6 and 12 months of treatment was 437, 300, 292 and 232 microns respectively. No safety events were found. Conclusion Single intraocular injection of Ranibizumab at the diagnosis of BRVO combined with grid photocoagulation could be an effectiveopton to accelerate visual recovery, improving the quality of life and VA since the first month of treatment.

Retinal findings may change in patients with obstructive sleep apnea syndrome (OSAS). The present study aims to evaluate several retinal findings, such as macula layer thickness, the peripapillary retinal nerve fiber layer, and the optic nerve head in patients with OSAS, using optical coherence tomography (OCT); it also aims to monitor the result of several types of treatment of OSAS with OCT. A prospective comparative study was designed. Patients were recruited at a Sleep Unit of a University Hospital and underwent comprehensive ophthalmological examinations. Following exclusion criteria, fifty-two patients with OSAS were finally included. Patients were examined by OCT twice: once before treatment, and again after six months of treatment. In mild–moderate patients, where retinal swelling had been demonstrated, retinal thicknesses decreased [fovea (p = 0.026), as did inner ring macula (p = 0.007), outer ring macula (p = 0.015), and macular volume (p = 0.015)]. In severe patients, where retinal atrophy had been observed, retinal thickness increased [fovea (p < 0.001)]. No statistically significant differences in efficacy between treatments were demonstrated. In conclusion, OCT can evaluate the retina in patients with OSAS and help to monitor results after treatment. In severe OSAS, retinal thickness increased six months after treatment.

PurposeTo compare dilatation pupil devices implemented on cataract surgery, their advantages and disadvantages.MethodsProspective, interventional study to analyze the following pupil dilatation techniques: iris‐retractor hooks and Morcher‐5s, Perfect‐pupil, Graether, Malyugin and Oasis dilator ring. The following properties were studied: handiness, dilatation obtained, stability, and facility to remove the dilator ring in relation with the form, material, size and length of the necessary incision to proceed with the insertion.ResultsIris‐retractor hooks are the best option in cases of zonular instability and retropulsion syndrome. The principal advantage is their versatility. Dilator‐rings obtained similar results in stability and dilatation. Malyugin and Oasis dilator rings had the best handiness results. Graether and Oasis were the easiest to remove and Morcher and Perfect‐pupil the most complicated.ConclusionsHaving a small pupil is one of the main causes of complications in cataract surgery. There are different surgical devices that allow minimizing intra‐operative risks. Each surgeon needs to select the best option compatible with to his surgical technique. Our study revealed that the most used devices were the iris‐retractor hooks due to the capsular stability that they provides and the Oasis dilator‐ring because of its flexibility and how easy they are to remove.