Purpose To determine and validate the diagnostic ability of a linear discriminant function(LDF) based on the retinal nerve fiber layer thickness at each of the 12 clockhour positions obtained using optical coherence tomography for discriminating between healthy eyes and eyes with early glaucomatous visual field loss Methods We prospectively selected 62 consecutive healthy individuals and 73 patients with open‐angle glaucoma to calculate the LDF. Another independent prospective sample of 280 healthy eyes and 302 glaucomatous eyes was used to evaluate the diagnostic accuracy of the LDF Results The proposed function was LDF=15.584 – (12‐ o’clock segment thickness_0.032) – (7‐o’clock segment thickness_0.041) – (3‐o’clock segment thickness[nasal side]_0.121). The greatest area under the receiver operating characteristic curve was observed for our LDF in both populations: 0.962 and 0.922. Our LDF and the average thickness yielded sensitivities of 74.5% and 67.8%, respectively, at a fixed specificity of 95% Conclusion The LDF increased the diagnostic ability of the isolated retinal nerve fiber layer thickness at the 12 clock‐hour positions. Compared with optical coherence tomography–provided parameters, our LDF had the highest sensitivities at 85% and 95% fixed specificities to discriminate between healthy and early glaucomatous eyes

Purpose To report our case report with sustained‐release dexamethasone 0.7 mg intravitreal implant (Ozurdex®; Allergan, Inc., Irvine, CA) in retinal vein occlusion with macular edema. Methods A 67‐years old female patient with recent retinal vein occlusion with macular edema treated with sustained‐release dexamethasone 0.7 mg intravitreal implant was performed. On initial examination, the right best‐corrected visual acuity (BCVA) was 0,3. Right fundoscopy revealed dilatation and tortuosity of the retinal veins and retinal hemorrhage in the superior quadrant of the retina. The fluorescein retinal angiography showed a delay of filling time and spectral domain optical coherence tomography (Spectralis SD‐OCT; Heidelberg Engineering, Heidelberg, Germany) showed macular edema. Results The patient was treated with two intravitreal ranibizumab injections but two moths later the visual acuity was 0,2 and then we treated with sustained‐release dexamethasone 0.7 mg intravitreal implant and six moths later the right BCVA was improved to 0.7. Funduscopy and optical coherence tomography confirmed reduction of edema and tolerability of the implant was assessed. Conclusion The dexamethasone drug delivery system is one of the most recent additions to the armamentarium against macular edema, and is intriguing for its potency, dose consistency, potential for extended duration of action, and favorable safety profile. In patients with macular edema in retinal vein occlusion, sustained‐release dexamethasone 0.7 mg intravitreal implant may be an effective treatment option to control macular edema

Purpose Ectopia lentis is a patology with lens dislocation presumably secondary to zonular fiber weakness. Ectopia lentis can occur in isolation, in association with other ocular disorders or as part of systemic disorder. Marfan´s syndrome and homocystinuria are the most frequent cause of heritable ectopia lentis. Marfan syndrome (MFS) is a hereditary connective tissue disorder. Studies of MFS have established the critical contribution of fibrillin‐1 deficiency to disease progression through altered cell‐matrix interactions and dysregulated TGF‐β signalling. Methods We report four eyes of 4 children aged from 2 years to 4 years with ectopia lentis Both cases showed bilateral and symmetric lens dislocation with low visual acuity. One of the children was diagnosed of Marfan syndrome. Results We practised Twenty three gauge two port pars plana lensectomy without intraocular lenses. Conclusion Pars plana lensectomy is a safe, effective procedure for the management of ectopia lentis. Earlier surgery is indicated to prevent amblyopia and improve visual acuity. Marfan syndrome, homocystinuria, trauma and simple ectopia lentis are the most common caused of pediatric lens subluxation. Ectopia lentis in children continues to be a diagnostic and therapeutic challenge for ophthalmologists. The convencional surgical management of congenital subluxated lenses infrequently associated with a high incidence of complications leading to poor visual prognosis. Surgical intervention is necessary when lens subluxation causes a significant refractive error resulting in amblyopia.

Purpose Ranibizumab is a recombinant, humanized, monoclonal antibody antigen‐binding fragment that neutralizes all biologically active forms of vascular endothelial growth factor (VEGF), and is effectively used in the treatment of neovascular age‐related macular degeneration (AMD). Ocular and systemic side effects may be encountered after its intravitreal injection. We report the importance of provide information for patients about the alarm signs and when to seek urgent attention from their doctor. Methods Prospective, interventional, single case report. A 79‐year‐old male patient controlled to our department for exudative AMD since 1997. The process started in the right eye (RE), which had been treated by argon laser photocoagulation. Twelve years later, visual acuity in his left eye (LE) decreased to 5/10 and ophthalmoscopy showed a subretinal macular haemorrhage corresponding with an occult choroidal neovascular membrane in fluorescein angiography image. In this time, we decided to proceed with intravitreal ranibizumab treatment in the LE. Results Two days following de second injection, the patient is referred to our department for ocular pain with severe episcleral inflammation, located at the injection site. Not visual loss was documented. A good response to topical steroids was obtained, and so, one month later, the third injection is performed with no complications. Conclusion Intravitreal ranibizumab therapy is associated with various complications, the most of which are related with the injection procedure. However ranibizumab´s benefits are greater than its risks, for the treatment of exudative AMD.

Purpose To report our case report with sustained‐release dexamethasone 0.7 mg intravitreal implant (Ozurdex®; Allergan, Inc., Irvine, CA) in retinal vein occlusion with macular edema Methods A 81‐years old male patient with recent retinal vein occlusion with macular edema treated with sustained‐release dexamethasone 0.7 mg intravitreal implant and cataract surgery was performed. On initial examination, the right best‐corrected visual acuity (BCVA) was 0,1. Right fundoscopy revealed retinal hemorrhage in the superior quadrant of the retina. The fluorescein retinal angiography showed a delay of filling time and spectral domain optical coherence tomography (Spectralis SD‐OCT; Heidelberg Engineering, Heidelberg, Germany) showed macular edema 485 μm Results The patient was treated with two dexamethasone 0.7 mg intravitreal implant and cataract surgery in one year. During the first six months after implant the right BCVA was 0,4 and OCT: 294 μm. At six months the macular edema increased 335 μm and we treated with the second implant, the macular edema improved 280μm but not the BCVA and we realized cataract surgery and BCVA was improved to 0.5. Conclusion The dexamethasone drug delivery system is one of the most recent additions to the armamentarium against macular edema, and is intriguing for its potency, dose consistency, potential for extended duration of action, and favorable safety profile but can accelerate cataract surgery.In patients with macular edema in retinal vein occlusion, sustained‐release dexamethasone 0.7 mg intravitreal implant may be an effective treatment option to control macular edema