ABSTRACT.Purpose: To investigate the coexistence of ocular microvascular and systemic macrovascular abnormalities in early stage, newly diagnosed and previously untreated normal tension glaucoma patients (NTG). Methods: Retinal vascular reactivity to flickering light was assessed in 19 NTG and 28 age-matched controls by means of dynamic retinal vessel analysis (IMEDOS GmbH, Jena, Germany). Using a newly developed computational model, the entire dynamic vascular response profile to flicker light was imaged and used for analysis. In addition, assessments of carotid intima-media thickness (IMT) and pulse wave analysis (PWA) were conducted on all participants, along with blood pressure (BP) measurements and blood analyses for lipid metabolism markers. Conclusions: Early stage, newly diagnosed, NTG patients showed signs of subclinical vascular abnormalities at both macro-and micro-vascular levels, highlighting the need to consider multi-level circulation-related pathologies in the development and progression of this type of glaucoma.

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BackgroundTo report a case of metastatic hepatocholangiocarcinoma to the vitreous and retina.Case presentationA 70-year-old male, who was recently diagnosed with hepatocholangiocarcinoma, was complaining of floaters in his right eye over the past 5 months and was referred to the Liverpool Ocular Oncology Centre. On presentation, his visual acuity in the right eye was 6/24. Fundus exam revealed a whitish, unilateral, full-thickness retinal lesion at the inferotemporal arcade of his right eye, with vitreous infiltration and subretinal fluid. The patient underwent 25G pars plana vitrectomy with biopsy, resection of the lesion and intravitreal bevacizumab injection. Histopathology testing of the surgical specimens confirmed the diagnosis of metastatic carcinoma to the eye. Two months postoperatively his visual acuity had improved to 6/7.5 and there was no sign of active disease in his right eye, while 9 months postoperatively his visual acuity decreased to 6/9.5 due to developing nuclear sclerotic cataract in his right eye.ConclusionThe current report presents the first case of a hepatocholangiocarcinoma metastasis to the vitreous and retina.

Imaging in diabetic retinopathy (DR) has developed over the years and the advantages are multifold. Various imaging modalities are currently available, which is of great diagnostic and prognostic value in the management of DR. Optical coherence tomography (OCT) has revolutionized the management of diabetic maculopathy. OCT has now become indispensable for initiating and assessing diabetic macular oedema (DMO) while on treatment with intravitreal injections. Recent introduction of optical coherence tomography angiography (OCTA) has significantly reduced the need for fundus fluorescein angiography (FFA) for macular ischaemia and proliferative retinopathy. Ultra-wide field (UWF) imaging modalities for colour fundus and UWF FFA are very useful to document and assess overall retinal state highlighting the periphery. Bscan ultrasonography of the fundus is an useful tool to assess retinal status in proliferative DR with vitreous haemorrhage.

We aimed to create a collaborative data sharing project between two NHS trusts to improve attendance and access to diabetic retinopathy screening in individuals with severe mental illness (SMI). MethodsThe eligible patient lists were analysed before and after interventions to assess their effectiveness over two data runs. ResultsScreening attendance rates increased by 31% and 25% in the data runs; a significant number of patients (15%) who were screened required onward referral to hospital eye services. Patient registrations increased from 35% to 86% for previously not registered individuals. Inpatients were around 50% more likely to get screened and registered than community patients. ConclusionInformation sharing and collaborative working between services can improve patient health outcomes, increasing the number of eligible individuals with SMI registered and improving attendance. The project shows the potential for future data sharing collaborations, highlighting the need for further improvement, development and investment.

The complexity of retinal structure reflects on the difficulty to describe its composite cell interactions and the pathways involved. Microglial cells are the main responsible cell-type for the modulation of immune responses to inflammatory stimuli that occur in the retina in diabetes. The majority of studies on retinal inflammation in diabetic retinopathy in the literature use rodent microglial lines, because of the scarce availability of human cell sources. We carried out a detailed characterization of a