Miguel Paciuc-Beja

Enhanced High-Density Line Spectral-Domain Optical Coherence Tomography Imaging of the Vitreoretinal Interface: Description of Selected Cases.

Abstract Purpose: We introduce a new method to observe the morphologic features of the vitreous with spectral-domain optical coherence tomography (SD-OCT) by evaluating and describing the posterior vitreous structure of various selected cases using enhanced high-density (HD) line mode. Methods: This is a descriptive case series of SD-OCT images with enhanced HD line at Denver Health Medical Center, University of Colorado School of Medicine, in 2014. The medical records with ocular images for these patients were analyzed. Results: Enhanced HD line in vitreoretinal mode with SD-OCT offered wide images with well-visible vitreoretinal interface. The posterior precortical vitreous pocket (PPVP), often mistaken as a posterior vitreous detachment on standard retina-based cross line mode, was easily identified. Vitreomacular adhesion and traction, absence or presence of connecting channels between PPVP and Cloquet’s canal, liquefied vitreous lacuna, and emulsified silicone oil droplet-layer could be observed. Conclusions: SD-OCT using enhanced HD line in vitreoretinal mode enables clear visualization of the posterior vitreous structure and often reclassifies patients previously thought to have a posterior vitreous detachment.

Escherichia coli Eyelid Abscess in a Patient with Alcoholic Cirrhosis

Escherichia coli (E. coli) is a rare cause of ocular infections and has not yet been reported as a cause of an ocular abscess. We describe the case of a 47-year-old woman with a history of alcoholic cirrhosis who presented with painful left lower eyelid swelling that did not improve with oral antibiotics. The abscess was drained and cultures were positive for E. coli. Patients with cirrhosis are at increased risk for developing E. coli bacterial infections, but to our knowledge this is the first case of an E. coli eyelid abscess reported in the literature.

Progression of gyrate atrophy measured with ultra-wide-field imaging

Abstract The study aims to determine the progression of gyrate atrophy by measuring the area growth of chorioretinal atrophic lesions using ultra-wide-field images (UWFI). A retrospective, observational, and comparative study was conducted and UWFI (200°) were obtained from two patients with gyrate atrophy at baseline and follow-up. Measurements of atrophy were obtained for three types of lesions: Solitary atrophic lesions (SAL), De novo solitary lesions (DNSL), and peripapillary atrophy (PPA). Comparison of baseline and follow-up was done using t tests. Two patients with gyrate atrophy were included. Patient 1 presented 16 SAL, 5 DNSL, and PPA measured for both eyes (BE). Overall area growth (OAG) for SAL (expressed in decimals) presented a mean of 3.41, σ 3.07. DNSL area for BE presented a mean of 1586.08 P2, σ 1069.55. OAG for PPA presented a mean of 1.21, σ 0.17. Patient 2 presented 5 SAL, no DNSL, and PPA was measured for BE. OAG for SAL presented a mean of 1.58, σ 1.05 (range 1.02–3.47). OAG for PPA presented a mean of 1.05, σ 0.001. Gyrate atrophy progression can be determined by measuring the changes in area using UWFI.

Epiretinal Membrane after Laser In Situ Keratomileusis

Multiple posterior segment complications can occur after LASIK. Posterior vitreous detachment, macular holes, retinal hemorrhages, retinal detachment, and several other complications have been described. A case of posterior vitreous detachment with epiretinal membrane in a young adult after LASIK is reported. LASIK surgeons must be aware of the possibility of posterior segment complications after surgery.

The accuracy of anterior segment optical coherence tomography (AS-OCT) in localizing extraocular rectus muscles insertions

To the Editor: We read with interest Candice Lee Gardemal’s recent Clinical Pearls contribution “Dilating distractions that work” (J AAPOS 2014;18:533).We agree with many of the author’s statements: children dislike eyedrops, the person who instills the drops is always “the bad guy,” distraction is a great solution, and instructing a child to use her hands to hold tissues over her “belly button” to protect it from the drops is a wonderful and humorous distraction. However, we must disagree with the rationale, “that hair will grow in the belly button if the eyedrops get there.” Preschool children are “magical thinkers,” and telling a child this untruth can have longlasting consequences in addition to simply not being honest. Older children may be petrified by imagining the changes in their body image that a hairy navel would produce. As pediatric ophthalmologists, we tend to minimize these important issues in order to move patients through a busy clinic. Child life specialists, employed by most children’s hospitals, are there to assess a child’s psychosocial needs and to help equip children with coping strategies during uncomfortable situations in the hospital and outpatient setting. They typically are willing to observe patient/staff interactions when asked and make recommendations to help a child master his health care experience. We applaud Gardemal for sharing her distraction solution with the journal readership and hope our suggested change in the rationale will make a difficult situation somewhat less disconcerting.