A lesion specific to Ebola virus disease showed an anatomical distribution suggesting neuronal transmission.

Purpose To assess the preoperative features of patients with idiopathic macular hole (IMH) and vitreomacular adhesion (VMA) treated with ocriplasmin (OCP) that can predict successful closure. Method Data were prospectively collected on all patients with IMH treated with OCP in three British ophthalmic centres. Several preoperative variables were recorded including the IMH base diameter (BD), minimum linear diameter (MLD), and VMA width measured on spectral domain optical coherence tomography. Several other IMH indices were derived including a 'width factor', defined as the BD minus the MLD in μm. The occurrence of VMA release and hole closure were used as the main outcome measures. Results Thirty-three patients in total with IMH were treated with OCP. Two patients developed rhegmatogenous retinal detachment and were excluded. The mean age of the remaining 31 patients was 71 years, and 71% were female. VMA release occurred in 19 of the 31 (61%) patients and macular hole closure in 11 (35%). Width factor was the most predictive feature for closure on multivariate analysis. The deviance R 2 was 67% (Po0.001). An IMH with a width factor of o60 μm had a 95% certainty of closure, whereas if 4290 μm then there was less than a 5% chance of closure. Neither VMA width nor MLD alone was associated with VMA release or closure. Conclusions Patients with macular holes where the BD was close in size to the MLD had an improved probability of closure than holes with wider base configurations.

Purpose To report near-infrared reflectance (NIR-R), near-infrared autofluorescence (NIR-AF) and blue wave autofluorescence (BW-AF) appearance of choroidal nevi using a confocal scanning laser ophthalmoscope (cSLO). Patients and methods NIR-R, NIR-AF and BW-AF images of choroidal nevi were compared with color fundus photos (CF). Images were graded as hyperreflective if reflectance was much greater than background, hyporeflective if less than background, and isoreflective if the same as the background. Results Forty-two nevi of 39 patients were imaged. When compared with CF, nevi could be identified on 95% (40/42) NIR-R images (95% CI: 83.5-99.3). On NIR-R 71% (30/42) demonstrated hyperreflectance and 24% (10/42) were hyporeflective. Hyperreflectivity was demonstrated in 96% (23/24) of NIR-AF images (95% CI: 79.1-99.9) and 34% (14/41) of BW-AF images (95% CI: 20.0-50.5). On NIR-R, 29/40 (73%) were apparently smaller in comparison with CF and 11/40 (28%) had the same area. A correlation was found between NIR-R and NIR-AF (P = 0.02) but not with BW-AF (P = 0.15). Conclusions Nevi can be visualized well using NIR-R and NIR-AF imaging modalities, but are less frequently visible using BW-AF. These changes may be related to melanin within the choroid or chronic changes of the overlying retinal pigment epithelium.

Phacoemulsification with an intraocular lens implant is a safe and effective means of correction of visual loss from cataract. The high frequency of this procedure world wide means inevitable direct surgical complications will be numerous even though infrequent. The approach to correcting aphakia following complicated cataract surery is dependent on multiple factors including the degree to which the capsular bag is intact and the type of intraocular lens that has been inserted. We discuss several approaches and strategies for managing dropped intraocular lenses, the correction of aphakia and the safety and long-term results of anterior chamber intraocular lens placement.

A 63-year-old woman who had received a previous diagnosis of unilateral normal tension glaucoma presented for follow-up. Diagnosis had been made 2 years before, when she was considered to have a left inferotemporal neuroretinal rim notch with corresponding visual field loss. Visual acuity was 20/20 OU, and intraocular pressure was 14 mm Hg OU. Right optic disc was normal. Left optic disc examination showed an inferotemporal pit with associated retinal nerve fiber layer defect (Figure, A, arrowheads). Optical coher-ence tomography revealed a peripapillary schitic cavity communicating with the pit excavation (Figure , B).Optic disc pits can be associated with separation of inner and outer layers of the peripapillary retina, 1 and optical coherence tomography can help establish the connection between the 2 pathologies. 2,3 Acquired optic disc pits are frequent in normal-tension glaucoma, 4 but peripapillary retinochisis has been described to occur in the absence of optic disc pit formation in glaucoma. 5