P. Grenga

Visual acuity and contrast sensitivity: AcrySof ReSTOR apodized diffractive versus AcrySof SA60AT monofocal intraocular lenses

PURPOSE: To compare the visual acuity and contrast sensitivity in eyes with the AcrySof ReSTOR multifocal intraocular lens (IOL) (Alcon) and eyes with the monofocal AcrySof SA60AT IOL. SETTING: Policlinico Umberto I, Department of Ophthalmology, Rome, and private clinical practice, Rome, Italy. METHODS: One hundred eyes had phacoemulsification cataract extraction and implantation of a ReSTOR multifocal IOL in the capsular bag. Inclusion criteria were corneal astigmatism less than 1.5 diopters (D), myopia less than 4.0 D, and no associated ocular disease. A complete ophthalmic examination, including uncorrected visual acuity, best spectacle‐corrected visual acuity, and contrast sensitivity, was performed 6 months postoperatively. Results were compared with those in 40 eyes with the AcrySof monofocal IOL single‐piece IOL. RESULTS: In the multifocal group, 90 eyes (90%) had an uncorrected distance visual acuity of 20/25 or better (logMAR <0.10) and an uncorrected near visual acuity at 35 cm of J3 or better (logMAR 0.14). The multifocal group and monofocal group had similar distance uncorrected and best corrected visual acuities; however, the multifocal group had significantly better near uncorrected acuity. The mean contrast sensitivity values were 18.28 dB (static program) and 17.95 dB (dynamic program) in the multifocal group and 19.18 dB (static program) and 21.2 dB (dynamic program) in the monofocal group. CONCLUSIONS: The ReSTOR multifocal IOL provided a satisfactory full range of vision; 92% of the patients achieved total spectacle independence. Contrast sensitivity was lower than with the SA60AT monofocal IOL.

Efficacy of intravitreal triamcinolone acetonide in long standing diabetic macular edema: a microperimetry and optical coherence tomography study.

Purpose: To investigate the efficacy of intravitreal triamcinolone acetonide in patients suffering from diffuse long standing diabetic macular edema, by the assessment of retinal thickness and retinal function by means of optical coherence tomography (OCT) and microperimetry-1. Methods: Twenty eyes received 8 mg in 0.2 mL preservative free intravitreal triamcinolone injection delivered through the pars plana. The best corrected visual acuity (BCVA), foveal thickness, and the average retinal sensitivity of the 45 stimuli were considered in our study. Patients were instructed to attend for OCT and microperimetry-1 follow-up at baseline, 1, 3, and 6. Results: At the baseline, mean macular thickness was 692&mgr; ± 70&mgr;; mean visual acuity was 0.13 ± 0.09. Mean macular sensitivity determined with the microperimetry-1 was 6.85 dB ± 2.1 dB. At the 1 month follow-up, mean OCT macular thickness decreased to 348.28&mgr; ± 132.10&mgr; (P = 0.0001); mean BCVA improved to 0.23 ± 0.15 (P = 0.019); mean retinal sensitivity improved to 8.71 dB ± 2.79 dB (P = 0.03). At the 3 months follow-up, mean OCT macular thickness changed to 363.7&mgr; ± 123.52&mgr; (P = 0.0002); mean BCVA was 0.23 ± 0.15 (P = 0.0024); mean retinal sensitivity 8.54 dB ± 2.78 dB (P = 0.048). Six months after the injection, mean OCT macular thickness was 460.61&mgr; ± 104.9&mgr; (P > 0.05); mean BCVA was 0.15 (P > 0.05); mean retinal sensitivity 7.54 dB ± 2.58 dB (P > 0.05). Conclusion: In our study, we found intravitreal effective in improving BCVA, macular thickness, and retinal sensitivities during the first 3 months. At 6 months, follow-up of the data were not dissimilar to those obtained at baseline. Further investigation is warranted to asses the correlation among daily life visual performance, retinal sensitivities, and macular thickness.

Scleral Ossification in Phthisical Eyes

Heterotopic secondary ossification of the eye usually affects intraocular tissues. Although calcium deposition in the scleral lamellae is not uncommonly observed, bone formation is only rarely associated with chromosomal abnormalities or colobomatous eyes. Herein two cases of both scleral and intraocular ossification in patients with long-standing ocular phthisis are reported. The cases of idiopathic scleral ossification, albeit exceedingly rare, suggest that osteogenic precursor cells may reside in the sclera, as well and though very rarely, these cells can also be stimulated to form heterotopic bone by a traumatic or inflammatory local event.

Vasocentric fascicular uveal melanoma. Incidence and re-appraisal of the histological features

Malignant melanoma of the choroid is the most common intraocular tumour in the adults and usually offers few diagnostic difficulties on both clinical and histological examination. Uveal melanomas are composed of spindle and/or epithelioid cells, usually arranged in compactly woven bundles or distributed in a solid pattern. Far less common is the fascicular type, in which the tumour cells appear to be arranged either in palisades (Verocay-like pattern) or in columns perpendicular to a central blood vessel, the so-called vasocentric pattern. This sub-type of spindle-B cell melanoma was first described by Callender1 2 in 2.6% of 500 uveal melanomas, and an association with higher mortality was noted.1 We describe a case of fascicular malignant choroidal melanoma containing large areas of tumour cells arranged in a peculiar pseudopapillary pattern and discuss some of the cytological and immunohistochemical findings. A 66-year-old woman complaining of progressive visual loss was referred to our Ophthalmologic Department after she was found to have a retinal detachment and a large non-pigmented choroidal tumour in the inferior-temporal quadrant of …