Purpose To evaluate choroidal thickness during childhood using enhanced depth imaging (EDI) spectral‐domain optical coherence tomography (SD‐OCT), and its correlation with age, sex, axial length (AL) and refractive error (RE) Methods Cross‐sectional study in which 93 eyes of 93 healthy children were studied using a 25 A‐scans‐EDI SD‐OCT protocol. Choroidal thickness was segmented manually, and an ETDRS grid was applied to analyze choroidal thickness and volume in each of its nine sectors. Two observers independently studied 30 children to assess repeatability and reproducibility, using intraclass coefficient (ICC). Results We included 50 males and 43 females, with mean age of 9.62±2.89 years, mean refractive error (spherical equivalent) +0.03±2.22D and mean axial length (AL) of 23.19±13mm. Mean subfoveal choroidal thickness (SFCT) and volume was 314.22 ±55.48, and 0.25±0.04m3, respectively. SFCT was significantly thicker in the hyperopic group (AL 22.39±0.83mm). There were no statistically significant differences between myopic (AL 24.33±0.76mm) and emmetropic (AL 23.27±0.54mm) children, as well as between males and females. There was a weak, positive correlation between SFCT and age (r=0.259, p=0.012). Inter and intra‐observer ICC of the nine sector of the ETDRS grid ranged from 0.929‐0.991 and 0.992‐0.998, respectively. Conclusion Pediatric SFCT is greater in hyperopic children. The choroid appears to become thicker with age. Manual choroidal thickness segmentation by EDI SD‐OCT showed a high inter and intra‐observer repeatability

Purpose Adenovirus keratoconjunctivitis (AK)can cause corneal opacities that sometimes remain in time, compromising the vision of the patient. The objetive is to show the different morphologic types of corneal affection as a consequence of AK in patients who have received refractive surgery,and to evaluate the application of refractive keratectomy with excimer laser as a possible treatment of the opacities and visual impairment caused. Methods We analyze three examples of patients with visual impairment caused by corneal opacities secondary to adenovirus keratoconjunctivitis. The first case presents central nummular opacities without refractive history; opacities are treated,by photoablation myopic and associated hyperopic. The second case presents central corneal opacities after adenovirus keratoconjunctivitis, 10 years after PRK practice, causing myopic regression;the visual and refractive result emerges after a new laser photoablation. The third case shows the peculiar corneal fibrosis which appears after AK in a patient who received past LASIK treatment Results In the cases of opacification due to superficial corneal fibrosis, good visual and refractive results are obtained through the use of superficial photoablation with excimer laser, with the associated application of mitomycin C Conclusion The morphology of the lesions observed as a consequence of AK varies in patients with no history of refractive surgery, and in patients with a history of refractive surgery Lasik and surface techniques. Refractive PTK is an alternative to the treatment of opacities in case of suitable corneas

Purpose Choroidal neovascularization associated to ocular toxoplasmosis is a known complication of the disease. The important role that the intravitreal anti‐VEGF therapy plays on the CNV has been well‐established. Also, the efficacy of the treatment in CNV secondary to ocular toxoplasmosis in adult patients it has been long described, however there are not cases reported in young patients. The purpose is to describe the efficacy of intravitreal ranibizumab in CNV secondary to ocular toxoplasmosis in children. Methods We present the case of an 8‐year‐old patient with history of ocular toxoplasmosis comes to the hospital with a sudden loss of visual acuity in the right eye (BCVA: 20/200). The fundoscopy shows an old toxoplasmosis scar associated with new perilesional hemorrhages and macular edema. We confirmed these lesions with a SS‐OCT which demonstrated the subretinal fluid associated with a RPE disruption and foveal fibrosis. CNV presence was suggested due to these retinal changes and we decided to treat with intravitreal injections of ranibizumab and anti‐parasitic treatment. Results After three injections of ranibizumab and 6 months of follow up, all the CNV signs have disapeared and the patient has a good recovery of the visual acuity (BCVA: 20/25). Conclusions Intravitreal ranibizumab may be an effective treatment in CNV secondary to ocular toxoplasmosis also in children. In our case, three injections of ranibizumab controlled the secondary CNV, however it is necessary long‐term studies to determinate the effectivity and frequency of the treatment in these patients.

Purpose To evaluate the age‐related variations of ocular parameters in an emmetropic Spanish healthy population. Methods We investigated 117 eyes of 117 healthy and emmetropic subjects. All patients were evaluated in the Department of Ophthalmology at the “Lozano Blesa” University Clinic Hospital, Zaragoza, Spain, between January and October 2013. Axial length (AL), refractive error (RE), subfoveal choroidal thickness (SCT), foveal thickness (FT) and foveal volume (FV) were measured by using auto‐refractive keratometer, optical biometer and spectral domain optical coherence tomography (SD‐OCT), respectively. Results The mean RE was 0.09 ± 0.97 diopters (range, from ‐1.5 to +1.5 diopters); the mean AL was 23.08 ± 0.90 mm (range, 20.9‐24.5 mm); the mean SCT was 278.9 ± 113.2 µm (range, 57‐ 527 µm), the mean FT was 266.6 ± 21.1 µm (range, 210‐342 µm) and the mean FV was 0.20 ± 0.01 mm3 (range, 0.17‐0.27 mm3). In correlation analysis, from 20 to 89 years, subjects showed a positive and statistically significant correlation between age and RE (r=0.262, p=0.004), a negative and statistically significant correlation between age an AL (r= ‐ 0.198, p=0.045) and a negative correlation between age and SCT ( r= ‐ 0.468, p<0.001). There were no significant correlations between age and FT (r= 0.006 p=0.972), and between age and FV (r= 0.046, p=0.773). Conclusion SCT and AL decreased with aging RE increased with age. No correlation was found between age and either FT or FV.

Purpose Optic disc pit(ODP) is a rare congenital optic disc abnormality characterized by a localized grayish‐white depression usually in the center or inferotemporal part of the optic nerve head. It is generally unilateral (85‐90%) and its prevalence is estimated to be 1 in 11,000. Unless the ODP develops maculopathy, patients remain asymptomatic. Serous macular detachment may occur in up to 50% of cases, leading to significant decrease in visual acuity. Although the pathogenesis of ODP maculopathy is unclear, various theories about its onset have implicated fluid entry either from the vitreous cavity or from leakage of cerebrospinal fluid through the peripapillary subarachnoid space. The aim of this study was to evaluate the source of subretinal fluid under the macula in a patient with ODP Methods Enhanced depth imaging optical coherence tomography(EDI‐OCT) using the stars scan pattern of the Spectralis HRA + OCT (version 1.5.12.0; Heidelberg Engineering) was used Results Horizontal SD‐OCT section revealed a small amount of intraretinal fluid in the outer nuclear layer and a prominent serous macular detachment at the same time but with no relationship with either the vitreous cavity or the subarachnoid space. However, a direct communication between the subretinal space and the peripapillary subarachnoid space through the ODP was demonstrated for the first time by using EDI‐OCT. Conclusion This case supports the theory that the source of serous macular detachment in some ODP cases could be cerebrospinal fluid passing into the retina through the ODP due to an incomplete closure of the embryonic fissure