Study of macular and optic disk blood flow by angio‐OCT in Glucose‐6‐Phosphate Dehydrogenase (G6PD) deficient men and age‐related G6PD‐normal subjects

Purpose: The reported prevalence of Glucose‐6‐Phosphate Dehydrogenase (G6PD) deficiency in Sardina, Italy, ranges from 8% to 15%. Hemizygous males have totally deficient erythrocytes. Evidence indicates that patients with G6PD deficiency are protected against ischemic heart and cerebrovascular disease, colorectal cancer, retinal vein occlusion, and nonarteritic anterior ischemic optic neuropathy. The purpose of this study was to study the macular and optic disk blood flow by angio‐OCT in G6PD‐deficient men and age‐related G6PD‐normal subjects and ascertain whether, or not, there are statistically significant differences between the two groups Methods: 22 G6PD‐deficient men and 22 perfectly age‐matched G6PD‐normal controls were examined at the Ophthalmology Unit, University of Sassari, Sassari, Italy. A complete review of the medical history and a complete ophthalmological examination, including ETDRS best corrected visual acuity, slit‐lamp biomicroscopy of the anterior segment, applanation tonometry, and fundus examination, was carried out. An HD 6‐mm Angio‐Retina and a 4.5‐mm Angio Disk (RT‐Vue, Optovue XR‐100 with Angio Vue, CA) examination were also performed Results: Only 1 eye per patients was included in the analysis, for a total of 22 eyes in each group. All the exported parameters about retinal and disk flow were evaluated. No statistical differences between the two groups were found, even after controlling for the effects of age, hypertension and hypercholesterolemia (p = 0.9). Conclusions: Results suggest that G6PD‐deficient and G6PD‐normal men have similar macular and optic disk blood flow. Larger scale studies are necessary to confirm these findings

Hepatocellular Carcinoma Metastasis to the Orbit in a Coinfected HIV+ HBV+ Patient Previously Treated with Orthotopic Liver Transplantation: A Case Report

Hepatocellular carcinoma rarely metastasizes to the orbit. We report a 45-year-old male, HBV+, HIV+, with a past history of a liver transplant for ELSD (end-stage liver disease) with hepatocellular carcinoma and recurrent HCC, who presented with proptosis and diplopia of the left eye. CT scans of the head revealed a large, irregular mass in the left orbit causing superior and lateral destruction of the orbital bone. Biopsy specimens of the orbital tumor showed features of metastatic foci of hepatocellular carcinoma. Only 16 other cases of HCC metastasis to the orbit have been described in literature, and this is the first case in a previously transplanted HIV+, HBV+ patient

Glucose-6-phosphate dehydrogenase (G6PD) deficiency and late-stage age-related macular degeneration

Purpose: Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly in Western Countries. Evidence indicates that Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency, a common genetic abnormality, may protect against ischemic heart and cerebrovascular disease, ocular vascular disorders, and colorectal cancer. This study was undertaken to ascertain whether G6PD deficiency may protect against AMD. Materials and Methods: 79 men with late-stage AMD and 79 male, age-matched cataract controls without AMD were recruited in March-December 2016. Smoking status, clinical history, and drug use were recorded. A blood sample was taken from each participant. Complete blood count, hemoglobin, glucose, creatinine, cholesterol, triglycerides, transaminases, bilirubin, and erythrocyte G6PD activity were measured. Stepwise logistic regression was used to investigate the association between G6PD deficiency and AMD. Results: G6PD deficiency was found in 7 (8.9%) AMD patients and 8 (10.1%) controls, a not statistically significant difference. Stepwise logistic regression disclosed that AMD was significantly associated with increased diastolic blood pressure (OR=1.09, 95% CI=1.03-1.15, P=0.02) and LDL-cholesterol (OR=1.02, 95% CI=1.0001-1.03, P=0.049) and lower values of white blood cell (WBC) count (OR=0.71, 95% CI=0.56-0.88, P=0.02) and aspartate aminotransferase (AST) (OR=0.92, 95% CI=0.85-0.99, P=0.044). Conclusion: Results suggest that G6PD deficiency has no protective effect on nor is a risk factor for AMD. Larger studies are necessary to confirm whether increased diastolic blood pressure and LDL-cholesterol and lower values of WBC count and AST are risk factors for AMD

27-gauge vs 25-gauge vitrectomy for different retinal pathologies

Purpose : Microincision vitrectomy surgery has obvious advantages over 20 gauge (20-G) vitrectomy. Some debate still exists if changing from 25-G to 27-G probes may add extra benefits to the procedure rather than burdens. In this retrospective study we compared 27-G with 25-G pars plana vitrectomy (PPV) for different retinal pathologies, in terms of surgery duration, best corrected visual acuity (BCVA), intraoperative and postoperative complications Methods : Twenty eyes of 20 patients (6 male, 14 female; mean age: 48 years old), who underwent 27G (10 eyes) or 25G (10 eyes) PPV for different retinal pathologies, were evaluated. The mean duration for total vitrectomy and for different surgical steps was calculated through a review of surgical videos. BCVA and intraocular pressure (IOP) at 1, 7 and 30 days after surgery were also recorded. Post surgical inflammation was assessed at 1, 7 and 30 days after surgery using an anterior segment inflammation score (range from 0 = no inflammation to 2,5 = severe inflammation). Results : The distribution of retinal pathologies was similar between the two groups: retinal detachment (27G: 2 eyes; 25G: 3 eyes), vitreous haemorrhage (27 G: 3 eyes; 25 G: 2 eyes), epiretinal membranes/macular holes (27 G: 5 eyes; 25 G: 5 eyes). No statistically significant difference was found between 27G and 25G group in terms of mean duration (minutes) of total vitrectomy (10.86 ± 9.5 vs 10.39 ± 6.9; P=0.86), core vitrectomy (6.80 ± 6.54 vs 5.94 ± 2.1; P=0.53), shave vitrectomy (9.1 ± 5.1 vs 9 ± 5; P > 0.99), membrane peeling (7.7 ± 3.5 vs 4.3 ± 0.83; P=0.05) and fluid-air exchange (4.9 ± 5.8 vs 2.8 ± 2.7; P=0.21). No intraoperative complications were reported. Post surgical inflammation score didn’t show significant differences between the 27G and 25G group 1 day after surgery (0.4 ± 0.4 vs 0.37 ± 0.48 respectively; P=0.77). Mean IOP was higher in 25G group than in 27G group at 1 day after vitrectomy (P = 0.1), but no longer at 7 (P = 0.2) and 30 days (P = 0,8). BCVA improved in both groups at 1 month, but only in 25G group the improvement was significant (P = 0.03) Conclusions : Efficacy and safety of 27G system is comparable to 25G system. We didn’t find significant differences in terms of surgery duration, intraoperative and postoperative complications.The difference in final BCVA could be explained by the variability among patients selected

Management of intraoperative complications during scleral buckling surgery

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Rhabdomyosarcoma mimicking lymphangioma : report of three cases

We report three cases of proptosis, in children aged 6, 10 and 12. In all cases the first clinical, radiologic and ultrasonographic diagnosis was lymphangioma, while the final anatomopathological diagnosis was rhabdomyosarcoma. In presence of a rapidly worsening exophthalmos or eyelid swelling in a child, an early diagnosis is very important. Imaging techniques have a very important role in the diagnosis, but are often not conclusive and a excisional biopsy (if feasible) must always be considered

Rabdomyosarcoma mimicking lymphangioma:report of three cases.

We report three cases of proptosis, in children aged 6, 10 and 12, whereby in all cases the first clinical, radiologic and ultrasonographic diagnosis was lymphangioma, while the final anatomopathological diagnosis was rhabdomyosarcoma. In presence of a rapidly worsening exophthalmos or eyelid swelling in a child, an early correct diagnosis is very important. Imaging techniques play a very important role in the diagnosis, but are often inconclusive and an excisional biopsy (if feasible) must always be considered