The aim of this study was to assess the central macular imaging captured with an optical biometer based on full-eye-length Swept-Source OCT (SS-OCT) scan as a screening strategy for identifying macular diseases in patients scheduled for cataract surgery. 1,114 eyes of 749 consecutive patients underwent a biometrical examination with IOLMaster 700 SS-OCT technology (Carl Zeiss) and conventional Spectral-Domain OCT (SD-OCT) (Spectralis OCT, Heidelberg) device analysis on the same day. Seven examiners graded the scans individually in a full-masked mode. Twenty-five eyes were excluded for media opacities. Among the 1,089 included eyes, statistical analysis revealed a mean Kendall’s Coefficient of 0.83 (range 0.76–0.89). A logistic regression model demonstrated a highly significant correlation (p < 0.001) between the coefficient of concordance and SD-OCT imaging. Intraobserver reproducibility was 0.89 (range 0.86–0.91). Optical biometer SS-OCT scans showed a mean sensitivity of 0.81 and a mean specificity of 0.84. The positive and negative predictive value detected was 0.78 and 0.86, respectively. In order to predict the risk of reduced visual recovery, especially in cases of retinal pathology, optical biometer with SS-OCT scan has proven to be a useful modality for detecting macular structural abnormalities in patients undergoing cataract surgery. Conventional SD-OCT remains mandatory to confirm the presumed diagnosis.

To investigate the antimicrobial activity of a preservative-free 0.6% povidone-iodine eye drop as an antiseptic procedure in decreasing the conjunctival bacterial load in eyes scheduled for intravitreal treatment and to compare its efficacy to the untreated fellow eye used as the control group. Prospective cohort analysis in which 208 patients received preservative-free 0.6% povidone-iodine eye drops three times a day for three days before intravitreal injection. Before and after the prophylactic treatment, a conjunctival swab was collected from both the study eye and the untreated contralateral eye, used as control. The swab was inoculated on different culture media and the colony-forming units were counted. Bacteria and fungi were identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Treatment with 0.6% povidone-iodine eye drops significantly reduced the conjunctival bacterial load from baseline (p < 0.001 for blood agar and p < 0.001 for chocolate agar) with an eradication rate of 80%. The most commonly isolated pathogen at each time-point and in both groups was coagulase-negative Staphylococci, isolated in 84% of the positive cultures. The study provides evidence about the effectiveness of 0.6% povidone-iodine eye drops treatment in reducing the conjunctival bacterial load in eyes scheduled for intravitreal treatment.

Background: Retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) measurements can be influenced by many factors including the presence of concomitant retinal diseases. The aim of this study it to assess the impact of epiretinal membrane (ERM) on RNFL and GCL assessment using optical coherence tomography (OCT). Methods: GCL, peripapillary RNFL (pRNFL), and Bruch’s Membrane Opening Minimum Rim Width (BMO-MRW) thicknesses were analysed using an SD-OCT (Spectralis OCT) in eyes with idiopathic ERM and compared with a control group. Results: 161 eyes were included, 73 eyes in the control group and 88 eyes with idiopathic ERM. The pRNFL analysis revealed a statistically significant difference between the two groups in overall and temporal sector thicknesses. For GCL thickness report, the percentage of scans in which the GCL was erroneously segmented by automatic segmentation was assessed for each eye. A statistically significant difference was found in all sectors (p < 0.001), with the exception of external nasal sector. A statistically significant difference (p < 0.001) in the GCL total volume report was found in ERM group compared to the control group. For MRW at BMO analysis, there was no statistically significant difference in MRW thickness in any sector. Conclusion: In eyes with ERM, the GCL and pRNFL analysis seemed affected by the morphological retinal layers’ modification. MRW-BMO did not appear to be directly affected by the presence of ERM.

conditions) and metabolic acidosis. 1 Indeed, neutrophils can internalize spores and use mechanisms as the respiratory burst to fight infections. 5 In diabetic patients, metabolic acidosis disrupts the ability of transferrin to bind iron, leading to high iron levels in tissues, condition useful for microorganisms to enhance their virulence. 1 Diagnosis of zygomycosis requires the demonstration of the tissue invasion by the hyphae through histopathology and/or culture. 1,2 NMR is more sensitive than X-ray and CT to evidence destruction of bone structures and soft tissues. 6,7 Treatment consists of an aggressive therapy with intravenous liposomal amphotericin-B and surgical debridment of devitalized tissues. 1,2 However, as in our patient, the clinical condition of neutropenic patients, their low performance status and low platelet count, and the presence of multiple mycotic abscesses, might not allow for a radical surgical intervention. In conclusion, rhino-cerebral and/or cutaneous symptomatology in immunosuppressed patients should alert the clinician for a possible zygomycotic infection. Prompt diagnosis and treatment are the main predictive factors of the outcome.

Successful treatment of paediatric glaucoma presents many challenges, with IOP control as the first but not the only priority. In paediatric cases medical therapy may play different roles: it could be an important resource for preparing patients for surgical intervention through clearing cornea, it may help control IOP post-operatively or it may be the initial and often the mainstay pillar for clinical management. Besides inadequate IOP reduction, multiple factors conspire against the success of long term medical therapy in paediatric glaucoma: the difficulties with long term adherence, more than in adults, adequate ascertainment of drug-induced side effects and potential adverse systemic effect of protracted therapy among others. Many medications are available for glaucoma management but many of them still carry a warning that “safety and efficacy in paediatric patients have not been established”. An “Up to date” of medical options for childhood glaucoma is the core aim of this chapter, hoping it could be useful for the daily clinical decision process.