SummarySpontaneous absorption of lenses or cataracts is rare. We report a case of bilateral spontaneous lens absorption in a 36-year-old woman for which no cause could be determined despite extensive laboratory testing. Case ReportA 36-year-old female presented at the eye clinic of Queen Elizabeth Hospital, Kota Kinabalu, Malaysia, with a complaint of poor vision in both eyes since childhood. She had not previously seen an ophthalmologist and had no history suggestive of trauma, surgery, red eyes, or pain. No systemic illnesses were reported. She was born at home; no additional birth history was available. Family and social histories were noncontributory.On examination, visual acuity was hand movements in both eyes. Intraocular pressures were 14 mm Hg in the right eye and 17 mm Hg in the left. The eyes were orthophoric, with full extraocular motility. Slit-lamp biomicroscopic examination was remarkable for whitish membranous structures in the anterior chambers of both eyes that appeared to be empty capsular bags located in the lower part of the anterior chambers (Figures 1, 2A, 3A). No residual zonules or signs of inflammation were evident. The pupils were 3-4 mm and reacted to light sluggishly. Both eyes were aphakic; an intact anterior vitreous face was present. The optic discs of both eyes were hypoplastic and pale ( Figures 2B, 3B, 4, 5).The patient was sent for refractive correction, but her vision failed to improve beyond hand movements in both eyes. Her refraction was +10.00 +3.50 × 55 in the right eye and +11.00 +2.50 × 108 in the left. Routine blood tests, including full blood count, fasting blood sugar, erythrocyte sedimentation rate, blood urea, and serum electrolytes and creatinine, were normal. Testing for congenital infections, including toxoplasmosis, rubella, cytomegalovirus, leptospirosis, and herpes simplex virus were also performed and found to be negative. Computed tomography of the brain and orbits with contrast agents revealed no abnormalities.

A 17-year-old young girl was seen by us with complaints of progressive, painless decreasing vision in one eye for the last 4 years. No other supporting history could be elucidated. On examination, a large choroidal mass was found. Since the features were suggestive of malignant melanoma of the choroid, an enucleation of the eye was performed. Subsequently, histopathological examination of the enucleated eye revealed findings consistent with melanocytoma of the choroid. This case is unique in that the patient was of relatively young age and the tumor was huge compared to previous such reports.

Glaucoma is now regarded as a neurodegenerative disorder. A number of theories including the mechanical and vascular models have been used to explain the pathogenesis of glaucoma. However, there is now increasing evidence of biochemical molecules which may play a part in it's causation. These biochemical mechanisms include the role of excitatory aminoacids, caspases, protein kinases, oxygen free radicals, nitric oxide, TNF-alpha, neurotrophins and metalloproteins. This paper reviews these new developments which form the biochemical basis of glaucomatous neural degeneration.How to cite this article: Ahmad SS, Ghani SA, Rajagopal TH. Current Concepts in the Biochemical Mechanisms of Glaucomatous Neurodegeneration. J Current Glau Prac 2013;7(2):49-53.

Objective: To prospectively validate the WINROP (Weight, Insulin-like growth factor 1, Neonatal, Retinopathy of Prematurity) screening algorithm (www.winrop.com) based on longitudinal measurements of neonatal body weights in predicting the development of severe retinopathy of prematurity (ROP) among preterm infants admitted to the neonatal intensive care unit of a tertiary care center in East Malaysia. Methods: All premature infants of less than 32 weeks gestational age (GA) were included in this cohort. Their body weight was measured weekly from birth to 36 weeks postmenstrual age and entered into the computer-based surveillance system: WINROP. Infants were then classified by the system into high- or low-risk alarm group. The retinopathy findings were recorded according to Early Treatment for ROP criteria. However, the screening and management of infants were done according to the recommendations of the Continuous Practice Guidelines, Ministry of Health, Malaysia. The team members involved in screening and those recording the findings were kept blinded from each other. Results: A total of 151 infants with median GA at birth of 30 weeks (interquartile range [IQR] Å} 2.1) and mean birth weight of 1,264 g (standard deviation Å} 271) were analyzed. High-risk alarm was signaled in 85 (56.3%) infants and 9 (6.6%) infants developed type 1 ROP. One infant in the low-risk alarm group developed type 1 ROP requiring laser retinal photocoagulation. The median time lag from the high-risk alarm signal to the development of type 1 ROP was 10.4 (IQR Å} 8.4) weeks. Conclusion: In this cohort, the WINROP algorithm had a sensitivity of 90%, with negative predictive value of 98.5% (95% confidence interval) for detecting infants with type 1 ROP and was able to predict infants with ROP earlier than their due screening date. This study shows that a modified version of the WINROP algorithm aimed at specific populations may improve the outcome of this technique.

The paucity of specific retinal findings associated with disease severity in knowlesi malaria contrasts with the retinopathy of severe adult falciparum malaria with and without coma, suggesting that falciparum-like microvascular sequestration in the brain is not a major component in severe knowlesi malaria pathogenesis.