Parainfectious optic neuritis is a very rare cause of acute vision loss. We present a case of a 51-year-old man with a recent upper respiratory tract infection, presumably of viral aetiology, who showed up with complains of painless right eye vision loss, followed by the same symptoms on the left eye 3 weeks later. Ophthalmological examination revealed optic disc swelling (sequential in severity) which was confirmed by optic disc imaging. The remaining evaluations (lumbar puncture, MRI, laboratory and genetic testing) were completely normal. Considering a postviral aetiology, 5-day intravenous methylprednisolone treatment was performed. Follow-up examinations revealed slight visual acuity and visual fields recovery, with subsequent optic disc atrophy and microcystic macular oedema, bilaterally. This case illustrates how important a correct clinical history is to guide a correct diagnosis and posterior management.

Purpose: To describe the surgical approach and long-term outcomes of Descemet-stripping automated endothelial keratoplasty (DSAEK) for endothelial failure secondary to phakic intraocular lenses (pIOL). Methods: Retrospective, interventional case series of 18 eyes of 13 patients who developed endothelial failure secondary to pIOL implant. Patients were submitted to pIOL explant and DSAEK for visual rehabilitation, with or without phacoemulsification plus posterior-chamber intraocular lens implant. The minimum follow-up time was 3 years and the main outcome measures were best-corrected visual acuity (BCVA), endothelial cell density (ECD) and percentage of endothelial cell loss (ECL), intraoperative and postoperative complications. Results: Patients’ mean age was 47.44 (7.86) years with a mean follow-up time of 55.61 (14.13) months. Sixteen eyes (88.9%) had an angle-supported pIOL. The mean pIOL implant-to explant time was 8.17 (2.73) years. BCVA improved from 1.00 (0.36) logMAR preoperatively to 0.29 (0.36) logMAR at 1 year of follow-up ( p < 0.001), remaining stable over the entire follow-up period ( p > 0.05). At the last visit, all corneas were clear, with a mean ECD of 724.74 (325.57) cells/mm2. During the follow-up, two eyes (11.1%) required a re-DSAEK due to early graft failure (<3 months). Conclusion: Our outcomes reveal that an individualized and careful approach may result in a stable visual rehabilitation in young patients with corneal decompensation following pIOL implant.

Anterior lenticonus is a characteristic ocular feature of Alport syndrome, leading to progressive vision deterioration. Surgical lens removal may be an option in such cases, and the role of femtosecond laser–assisted cataract surgery (FLACS) has been recently described. Herein, we report the third described case, to our knowledge, of bilateral anterior lenticonus surgically approached through FLACS. A 25-year-old man with X-linked Alport syndrome complained of bilateral progressive vision loss. Ophthalmological evaluation revealed a corrected distance visual acuity of 20/63 in both eyes and bilateral anterior lenticonus associated with anterior polar cataract. FLACS was performed, followed by IOL placement on the capsular bag, without any intraoperative complications. One month postoperatively, uncorrected distance visual acuity was 20/20 in both eyes. Considering these results and the information published so far, this technology might be a good option for these patients.

Purpose The aim of this study was to compare all retinal layers' thickness in full-term and preterm children without retinopathy of prematurity (ROP). Methods Cross-sectional study including two groups of patients: group 1 children with history of preterm gestation without ROP (gestational age < 37 weeks) and group 2 healthy children with history of full-term gestation. All subjects underwent an ophthalmic examination including spectral domain-optical coherence tomography. After automatic retinal segmentation, each retinal layer thickness (eight separate layers and overall thickness) was calculated in all nine Early Treatment Diabetic Retinopathy Study areas. Demographic, systemic, gestational, and birth data were collected. Generalized additive regression models were used to analyze the data. Results Fifty-one children (51 eyes) were recruited, 19 full-term and 32 preterm children, mean age at ophthalmic examination of 10.58 (4.21) and 14.13 (3.16), respectively. In multivariable analysis, the preterm group's retinal thickness was significantly decreased in total retina nasal outer sector, ganglion cell layer (GCL), and inner plexiform layer (IPL), specifically GCL temporal outer (p = 0.010), GCL superior outer (p = 0.009), IPL temporal outer (p = 0.022), and IPL superior outer (p = 0.004), when compared with full-term group. From the variables compared only with birth head circumference that influenced the models, a non-linear association was identified and consequently modeled with splines through a generalized additive model. Conclusion This study suggests that preterm children without ROP have structural retinal alterations, mostly in GCL and IPL in outer areas of the macula. Therefore, it is crucial to question gestational history since these retinal changes may be found later in life leading to useless investigation.