ika virus (ZIKV) is a neurotropic flavivirus spread to humans by Aedes genus mosquitos. Zika virus was first isolated in the Zika Forest in Uganda in a nonhuman primate in 1947. 1,2 Five years later, Nigeria reported the first cases of ZIKV transmission to humans, and subsequent ZIKV outbreaks have been reported outside Africa. [1][2][3] The first autochthonous case was confirmed in 2015 in Brazil, with a subsequent increase in the number of cases. This event coincided with reports of newborns with microcephaly, congenital malformations, and neurologic syndromes. 1,2 The spread of ZIKV to other parts of Latin America, the Caribbean, and the United States brought epidemiologic concern because of the clinical manifestations, including those associated with congenital Zika syndrome (CZS). [4][5][6] Although microcephaly is considered to be the characteristic feature of CZS, other central nervous system abnormalities and ocular findings have been described as part of this entity. [7][8][9][10] Despite having clinical evidence of the association between CZS and ocular findings, [11][12][13][14][15][16] only a few studies 17,18 have identified the presence of ZIKV in mouse ocular tissues and cultured human cells. Ritter et al 19 described the presence of ZIKV antigen within the neural retina in 1 case of CZS by immunohistochemical analysis, but the histopathologic findings were not described. The only study to date that has provided valuable clinical information regarding the retinal layers affected in CZS in human eyes was performed using optical IMPORTANCE Congenital Zika syndrome (CZS) is known to be associated with severe malformations in newborns. Although microcephaly is the hallmark of this disease, the ocular findings are important given the severe visual impairment that has been observed in these patients. Regardless of the increased number of CZS cases reported, to date, no studies have described the ocular histopathologic findings of this entity.OBJECTIVES To evaluate the presence of Zika virus (ZIKV) antigens and describe the associated ocular histopathologic features of 4 cases of CZS.

Purpose To evaluate the utility of Endothelial/Descemet's membrane complex (En/DM) characteristics in diagnosing corneal graft rejection. Design Diagnostic reliability study. Methods 139 eyes (96 corneal grafts post penetrating keratoplasty or Descemet's stripping automated endothelial keratoplasty: 40 clear, 23 actively rejecting, 24 rejected and 9 non-immunological failed grafts, along with 43 age-matched control eyes) were imaged using high-definition optical coherence tomography. Images were used to describe En/DM and measure central corneal thickness (CCT) and central En/DM thickness (DMT). En/DM rejection index (DRI) was computed to detect the relative En/DM thickening to the entire cornea. Results In actively rejecting grafts, DMT and DRI were significantly greater than controls and clear grafts (28, 17 and 17 μm and 1.5, 1 and 1, respectively; P<0.001). Rejected grafts had the highest DMT and DRI compared to all groups (59 μm and 2.1; P<0.001). DMT and DRI showed excellent accuracy, significantly better than that of CCT, in differentiating actively rejecting from clear grafts (100% and 96% sensitivity; 92.5% and 92.5% specificity), actively rejecting from rejected grafts (88% and 83% sensitivity; 91% and 83% specificity) and non-immunological failed from rejected grafts (100% and 100% sensitivity; 88% and 100% specificity). DMT correlated significantly with rejection severity (P<0.001). Conclusions In corneal grafts, in vivo relative thickening of the En/DM is diagnostic of graft rejection as measured by DMT and DRI. These indices have excellent accuracy, sensitivity and specificity in detecting graft immunological status, superior to CCT. DMT is a quantitative index that correlates accurately with the severity of rejection.

Purpose: To retrospectively describe the clinical characteristics, management, and outcomes of a series of patients with solitary fibrous tumor (SFT) of the orbit and to evaluate signal transducer and activator of transcription 6 (STAT6) as a diagnostic marker. Methods: Review of a retrospective, noncomparative, consecutive series of patients treated at a single institution with a histopathologic diagnosis of SFT. Demographic, clinical, and imaging data were collected, and paraffin-embedded tissue sections were stained to evaluate for the presence of STAT6 and other pertinent markers. Results: Twenty-one patients were identified. Most presented with painless progressive proptosis or eyelid swelling for less than 6 months. Imaging revealed well-circumscribed, firm, variably vascular contrast-enhancing lesions with low to medium reflectivity on ultrasound. Four tumors were histopathologically malignant. All tumors were primarily excised, and 1 patient required exenteration. Two patients were treated with adjuvant radiation therapy. Six patients had recurrent disease of which 3 underwent repeat excision, and 2 were observed. No metastatic disease or attributable deaths were observed. All lesions with available tissue stained positively for both CD34 and STAT6. Conclusion: This is the largest single institution case series of orbital SFT with clinicopathologic correlation and the largest series to confirm the presence of STAT6 in orbital lesions. The management of SFT remains challenging due to unpredictable tumor behavior, and complete excision is the generally recommended treatment. It remains unclear whether a subset of asymptomatic patients with histopathologically benign disease can be durably observed without negative sequelae.

Computed tomography (CT) during arterial portography (CTAP) is an important technique for evaluating the liver before hepatic tumor resection. With this technique, most tumors are of low attenuation cornpared with that of enhancing parenchyma. At times, low-attenuation lesions are encountered that represent perfusion abnormalities rather than tumor deposits. These perfusion abnormalities can be categorized Abbreviation: ClAP = computed tomography during arterial portography Index terms: Computed tomography (CT). preoperative, 76 1. I 2 1 1 #{149} Liver neoplasms. 76 1 .30 #{149} Liver neoplasms. CT.

A 6-day-old female baby with known diagnosis of congenital Zika infection was referred for ophthalmologic examination. The mother (37 years old) was referred for a pruritic rash, conjunctival hyperemia, and malaise at 12 weeks of gestation while still living in Venezuela. Upon arrival to Miami, Zika virus (ZIKV) exposure was confirmed during prenatal screening. At birth, due to the known exposure, a complete congenital ZIKV workup was performed, including brain ultrasound and MRI, which disclosed calcifications in the frontal lobe. Fundus examination revealed a hypopigmented retinal lesion in the left eye that was documented with retinal imaging. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:952-955.].