This multicenter study confirms that the Working Formulation is a reliable and valid, repeatable system for dividing metastatic uveal melanoma into distinct prognostic subgroups, especially for stage-specific reporting of survival in prospective clinical trials.

Purpose. The aim of this study was to evaluate pressure increases after intravitreal injections (IVI) and the interest in using prophylactic pressure-lowering medications. 
Methods. This was a prospective study of 250 anti-vascular endothelial growth factor IVI (ranibizumab) divided into 5 groups of 50 IVI (group 1: no intraocular pressure [IOP]-lowering medication; group 2: apraclonidine 1%; group 3: acetazolamide; group 4: fixed association brimonidine + timolol; group 5: fixed association dorzolamide + timolol). The IOP was measured before, immediately after (T1), 15 minutes after (T15), and 45 minutes after (T45) the IVI using a tonometer. The data were analyzed by analysis of variance followed by a Bonferroni as post hoc test if necessary.
Results. The mean IOP peak in group 1 was 46.4±10 mmHg at T1, 21.7±10.2 mmHg at T15, and 15.4±8.6 mmHg at T45. It was not correlated with axial length (r=0.04, p=0.81) or lens status (phakic vs pseudophakic: p=0.88). A mild but significant correlation was found with age (r=0.36, p=0.006). Topical medications produced a significant reduction of IOP at every time point, of around 9 mmHg at T1. The reduction in IOP obtained with acetazolamide was not significant at T1 (-1.6 mmHg, p=0.12), but became significant at T15 and T45 (p=0.011 and p=0.015). 
Conclusions. Intraocular pressure spike was high but transient. Topical medications, however, produced a significant reduction in IOP spike as well as in the duration of the increased pressure. It would be advisable to prevent this IOP spike, especially when procedures are repeated, notably in patients with glaucoma.

No abstract

Purpose To evaluate ocular phototoxicity in mountaineer guide in Chamonix, France, exposed to altitude characterized by increased ultraviolet (UV) radiation. Methods 96 guides working and 90 subjects living in plains, older than 50 years, replied to a questionnaire assessing altitude exposure and wearing protective eyewear. We performed slit lamp examination after pupil dilatation, retinal photography (Topcon) and crystalline lens density analysis (Oculyzer®, Alcon). Student t‐test was used to compare the groups and logistic regression to evaluate risks factors in guides group. Results Guides mean age was 59.8years and 59.1 for control (p=0.39). Guides developed more chronic blepharitis (52.1% vs. 10.6%, p<0.01), pterygium (8.9% vs. 0%, p<0.01), pinguecula (58.3% vs. 21.7%, p<0.001). Their corneal break up time was shorter (4.5secs vs. 7secs, p<0.01). Guides presented more cortical cataract (p<0.01) and cataract surgery (p=0.01). Only 61.5% guides had normal ocular fundus vs. 81.1% in control group (p<0.01). They developed more drusenoid deposit (27.2% vs. 15.6%, p<0.01). Guides group analysis showed that exposure superior to 3000m is risk factor to develop anterior cortical cataract (OR=1.16, p<0.01). Exposition to snow increases risk of maculopathy (OR=1.9, p<0.01). Questionnaire reveals discontinuous eye protection in medium altitude. Wearing ski mask reduces cataract, age related maculopathy and chronic blepharitis risk. Conclusion Ocular findings highlight the higher incidence of ocular surface pathology, anterior cortical lens opacities and drunenoid deposits. This data emphasize the potential deleterious role of UVs and importance to wear sunglasses even in low to medium altitude but also when climbing.