PurposeTo describe characteristics of choroidal osteomas (CO), using ocular ultrasound, fluorescein angiography, ultra-widefield retinal imaging, ultra-widefield autofluorescence, optical coherence tomography, enhanced-depth-imaging OCT, and OCT angiography (OCT-A).MethodsRetrospective, observational case series study. Clinical records from patients with diagnosis of CO who underwent complete imaging evaluation were analyzed.ResultsSixteen eyes from 11 patients were included. Mean patient age was 33.4 years (range 20–61), 72.7% were female, 100% were Hispanic, and 54.5% had unilateral CO. Median visual acuity was 20/150 (range 20/20–2000). CO was completely calcified in 25%, partially decalcified in 50%, and decalcified in 25%. Other features included choroidal neovascularization (18.75%), focal choroidal excavation (12.5%), choroidal depression associated to decalcification (18.75%), thinning of outer retina and photoreceptor layers over decalcified tumor (75%). Decreased fluorescence on FAF was observed in decalcified regions while relatively preserved fluorescence was observed in calcified regions.ConclusionsNowadays, diagnostic tests provide important information about each stage of choroidal osteoma. Progressive decalcification of the tumor might have a common pathogenic role for development of FCE or choroidal depression. OCT-A/FA proved to be valuable tools for detection of CNV in patients with CO.

BackgroundTo assess the sensitivity, specificity, positive predictive value and negative predictive value of anterior chamber tap for the diagnosis of bacterial endophthalmitis on a population with high prevalence.MethodsRetrospective, single centre, case series study. We reviewed all medical records with clinical diagnosis of bacterial endophthalmitis in our hospital from January 1st, 2000 to December 31st 2014. From each record, we documented general demographic data, best corrected visual acuity and vitreous and aqueous tap microbiological results. All cases were further divided according to the endophthalmitis aetiology to perform individual calculations of sensitivity, specificity, positive predictive value, negative predictive value, accuracy and prevalence. We used the results of the vitreous tap as the gold standard for diagnosis of bacterial endophthalmitis. We excluded those records in which the aqueous and vitreous samples were not taken simultaneously or had an incomplete microbiological report. Significance were assessed with chi squared statistics, with an alpha value of 0.05 for statistical significance.ResultsA total of 190 cases fulfilled the inclusion/exclusion criteria. Positive culture rate from vitreous samples was 64.74%. Positive culture rate from aqueous sample was 32.11%. Bacteria isolated from aqueous samples matched those isolated from vitreous samples 78.68% of the time. The overall sensitivity was 38.21%, specificity: 75.51%, positive predictive value: 79.66%, negative predictive value: 32.74% (p = 0.08). Subgroup analysis showed that anterior chamber taps in cases of post-surgical endophthalmitis had a moderate to low sensitivity (37.73%), high specificity (93%) and high positive predictive value (95%) (p < 0.04).ConclusionThe sensitivity and specificity of anterior chamber tap are low and should not be used for critical therapeutic decisions in patients with suspected bacterial endophthalmitis. In cases of post-surgical endophthalmitis, the result of an anterior chamber tap could be used for therapeutic guidance, but only in conjunction with clinical presentation and in the absence of a better method for diagnosis.

This is the first analysis involving VEGF polymorphisms and proliferative diabetic retinopathy in a Mexican population. A major finding of the present study is that none of the polymorphisms studied was significantly associated with proliferative retinopathy. Based on these results, we can infer that different populations have different associations for the same polymorphisms.

PurposeTo report the conservative management of a penetrating ocular trauma caused by a nail gun with a six-month follow up.ObservationsA 21 year-old healthy female suffered an ocular penetrating trauma with a nail gun. She presented with a metallic foreign body that partially entered her left eye through the nasal sclera via pars plana, 3 mm posterior to the limbus, but did not reach the retina. Surgical removal of the foreign body and closure of the scleral wound, without vitrectomy, was performed 16 h after the injury. Intravitreal prophylactic antibiotic was administered. Retinal atrophy developed in the areas that had commotio retinae at presentation, but no further complications were observed.Conclusions and importancePars plana vitrectomy may not be necessary in all penetrating ocular traumas with intraocular foreign body, as long as the foreign body is accessible from the exterior of the eye and there are no other conditions (such as vitreous hemorrhage, retinal detachment, endophthalmitis, etc) that are an indication for vitrectomy.

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Purpose: To report the result of the Kirby-Bauer test in bacterial cultures from vitreous samples of patients with postsurgical endophthalmitis, in order to assess the bacterial response to first-line antibiotics like vancomycin and ceftazidime through time.Methods: Retrospective, single center study. We reviewed the medical records of all post-surgical bacterial endophthalmitis cases, from 2009 to 2016. We divided our population into two groups according to the date of diagnosis: group 1 (2009-2012) and group 2 (2013)(2014)(2015)(2016). In each group, we noted the response of the grampositive bacteria to vancomycin and gram-negative bacteria to ceftazidime on the Kirby-Bauer test, as well as to the fourth-generation fluoroquinolones moxifloxacin and gatifloxacin. Nominal variables were assessed by Mann-Whitney test, with an alpha value of 0.05 for statistical significance. Chi-square test was applied to nominal variables as appropriate.Results: Group 1: 46.2% of the gram-positive bacteria were sensitive to vancomycin and 83.4% of the gram-negative bacteria were sensitive to ceftazidime (moxifloxacin: 89.5%, gatifloxacin: 68.4%; p<0.01). Group 2: 47.4% of the gram-positive bacteria were sensitive to vancomycin and 66.7% of the gram-negative bacteria were sensitive to ceftazidime (moxifloxacin: 88%, gatifloxacin: 84%; p<0.01) Conclusion:The result found in this study suggest a possible change in the local sensitivity pattern that might have an impact on the treatment of postsurgical endophthalmitis. Moxifloxacin had higher levels of sensitivity and lower resistance on the Kirby-Bauer test than Vancomycin.

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