A step forward in sustainable pesticide production from Amphidinium carterae biomass via photobioreactor cultivation with urea as a nitrogen source

This study addresses the problem of replacing nitrate and ammonium with urea as a greener nitrogen source in the mass cultivation of the microalga Amphidinium carterae for the development of amphidinol-based phytosanitary products. To solve this problem, a nuclear magnetic resonance assisted investigation evaluated the effect of nitrogen sources on growth and metabolic profiles in photobioreactors. Urea-fed cultures exhibited growth kinetics comparable to nitrate-fed cultures (µmax = 0.30 day-1, Pbmax = 43 mgL-1day-1). Urea-fed cultures had protein, lipid, and carbohydrate contents of 39.5%, 14.5%, and 42.4%, respectively, while nitrate-fed cultures had 27.9 %, 17.5% and 48.1%, respectively. Metabolomics revealed nitrogen source-dependent metabotypes and a correlation between amphidinols and polyunsaturated fatty acids. The amphidinol-to-nitrogen yield coefficient in urea-fed cultures (135 mg/g) was approximately 2.5 times higher than in nitrate-fed cultures. The potent antiphytopathogenic activity exhibited by extracts from urea-fed cultures underscores the potential of urea as a sustainable nitrogen source in microalgae-based biorefineries.

Comparison of Color Fundus Photography and Multicolor Fundus Imaging for Detection of Lesions in Diabetic Retinopathy and Retinal Vein Occlusion

Purpose

To evaluate the agreement between conventional fundus photography (CFP) and multicolor fundus imaging (MFI) for the detection of lesions of diabetic retinopathy (DR) and retinal vein occlusion (RVO).

Methods

Cross-sectional analysis of eyes with DR or RVO who underwent CFP and MFI. All images were independently analyzed by two observers (O1 and O2), and the evaluated lesions were classified as "present" or "absent". Then, a paired comparison between both exams of the same eye was performed, to assess which made it easier to detect the lesions.

Results

Considering DR, the agreement was substantial for cotton wool spots and photocoagulation scars for both observers (O1: κ=0.75 and κ=0.67; O2: κ=0.71 and κ=0.64, respectively) and for hard exudates for O1 (κ=0.80). These lesions were detected more frequently on MFI. Regarding RVO, the agreement was considered substantial for venous sheathing by O1 (κ=0.64) and moderate for optociliary shunts by O2 (κ=0.60). Optociliary shunts were detected more frequently in CPF by both observers and venous sheathing on MFI by O1. For microaneurysms, retinal hemorrhages, retinal neovascularization, and proliferative membranes, in DR, and retinal hemorrhages, venous engorgement, and retinal neovascularization in RVO, the agreement was almost perfect (κ>0.82). In the paired analysis, both observers considered that, in DR, microaneurysms and retinal hemorrhages were easier to detect on CFP and that retinal neovascularization, cotton wool spots, and photocoagulation scars were easier to identify on MFI. Regarding RVO, optocilliary shunts were easier to identify on CFP and venous engorgement on MFI.

Conclusion

The agreement of MFI and CFP was substantial to almost perfect for most lesions. MFI seems better to detect cotton wool spots and photocoagulations scars in DR and venous sheathing in RVO. Optocilliary shunts seem easier to detect on CFP.

Application of optical coherence tomography angiography for microvascular changes in patients treated with hydroxychloroquine: a systematic review and meta-analysis

BACKGROUND

Retinal toxicity with long-term hydroxychloroquine (HCQ) treatment is a major concern. This systematic review aims to assess the application of optical coherence tomography angiography (OCTA) to detect microvascular alterations in patients under HCQ.

METHODS

PubMed, Scopus, Web of Science, and Cochrane Library databases were systematically searched until January 14, 2023. Studies using OCTA as a primary diagnostic method to evaluate the macular microvasculature of HCQ users were included. Primary outcomes were macular vessel density (VD) and foveal avascular zone (FAZ) at the superficial (SCP) and deep (DCP) capillary plexus. Meta-analysis was performed using a random-effects model.

RESULTS

Of 211 screened abstracts, 13 were found eligible, enrolling 989 eyes from 778 patients. High-risk patients due to longer duration of treatment presented lower VD in the retinal microvasculature than those with low-risk in SCP (P = 0.02 in fovea; P = 0.004 in parafovea) and in DCP (P = 0.007 in fovea; P = 0.01 in parafovea). When compared with healthy controls, HCQ users had lower VD in both plexus-no quantitative synthesis was presented.

CONCLUSIONS

Microvascular changes were found in autoimmune patients under HCQ treatment without any documented retinopathy. However, the evidence produced so far does not allow to draw conclusion concerning the effect of drug as studies were not controlled for disease duration.

Retinal Changes After COVID-19 Infection and COVID-19 Vaccination

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease was first reported in 2019 and was initially associated with respiratory pathology. With the improvement of knowledge about this disease, it was noticed that, among other symptoms, some patients presented visual acuity changes associated with retinal vascular changes, mainly associated with thrombotic phenomena. Later, with the development of vaccines against SARS-CoV-2 disease, cases of visual acuity alterations secondary to thrombotic phenomena were also reported.

Case Presentation

In this article, a series of clinical cases with retinal vascular alterations after COVID-19 infection and vaccination are described.

Conclusion

COVID-19 infection and vaccination increase the risk of retinal vascular events. The purpose of this article is to present a set of clinical cases with various manifestations of vascular changes in the retina associated with COVID-19 infection and COVID-19 vaccination observed in the Department of Ophthalmology of Centro Hospitalar Universitário de Santo António, in Porto, Portugal.

ACUTE MACULAR NEURORETINOPATHY FOLLOWING SARS-CoV-2 VACCINATION

PURPOSE

To report a case of acute macular neuroretinopathy (AMN) following SARS-CoV-2 vaccination.

METHODS

Case report.

RESULTS

An otherwise healthy 28-year-old white woman presented to an ophthalmology department with complaints of black paracentral vision scotomata on both eyes that appeared 2 days after receiving the first dose of Vaxzevria vaccine. Fundus examination revealed bilateral red brown petaloid lesions around the fovea. On spectral domain optical coherence tomography, a hyperreflective plaque between the outer plexiform and outer nuclear layers along with disruption of ellipsoid zone/interdigitation zone was observed. A diagnosis of AMN was made.

CONCLUSION

AMN may be an extremely rare adverse event of SARS-COV-2 vaccination, especially in patients with other risk factors.

SYNOPSIS

An otherwise healthy 28-year-old white woman was diagnosed with AMN 2 days after SARS-CoV-2 vaccination.

Refractive Management of Surgical-Induced Presbyopia in a Young Patient with Vision-Related Quality of Life Complaints: A Case Report

Visual difficulties can negatively impact life quality. Our purpose was to report the refractive surgical planning and outcomes of a young patient with mixed astigmatism and phacoemulsification-induced presbyopia due to congenital cataracts who was unsatisfied with her vision-related quality of life. A 32-year-old woman, submitted to phacoemulsification with implantation of a monofocal intraocular lens (IOL) and Nd:YAG laser posterior capsulotomy 3 years before, due to congenital cataracts, was referred to the Refractive Surgery Unit of Centro Hospitalar Universitário de Santo António. She had mixed astigmatism (+1.00-4.00 × 10° in the right eye [RE] and +0.50-1.75 × 180° in the left eye [LE]) and surgical-induced presbyopia, was intolerant to contact lenses, and felt that her vision significantly impaired her life quality. A trifocal Sulcoflex® (Rayner) IOL was implanted to correct the spherical and near refractive errors. In a second surgical time, a photorefractive keratectomy was performed to correct the residual astigmatism (-3.50 × 10° in the RE and -1.50 × 170° in the LE). In the last visit, distance and near uncorrected visual acuity were 20/20 (Snellen) and Jaeger 1, respectively, in both eyes, and the patient was very satisfied. When assessing the surgical options of young, working-age patients, clinicians should, when possible, consider alternative solutions to monofocal IOLs. In this patient, the combination of corneal and intraocular procedures allowed the correction of both the distance and near refractive errors, with a subsequent significant improvement in the patient's quality of life.

Posterior capsular rupture during cataract surgery in eyes treated previously with intravitreal injections

Introduction: Intravitreal injections are currently the most common intraocular surgical procedure worldwide. Some studies have reported a higher risk of intraoperative complications, namely posterior capsular rupture (PCR), during cataract surgery. The aim of this retrospective and observational study, conducted at Department of Ophthalmology, Centro Hospitalar Universitário do Porto, was to assess the risk of posterior capsular rupture (PCR) during cataract surgery in eyes previously treated with intravitreal injections (IVI) with antivascular endothelial growth factor (anti-VEGF) and/or corticosteroids. Methods: Eyes undergoing cataract surgery between June 2019 and May 2021. Combined surgeries, such as glaucoma surgery and pars plana vitrectomy (PPV) were excluded. The occurrence of PCR during cataract surgery in treated and previously untreated eyes with IVI was analyzed. Results: A total of 5813 cataract surgeries were analyzed; 4.1% of the cases had previously undergone IVI. The PCR rate in cataract surgery was 1.8%: 6.7% in eyes previously treated with IVI and 1.6% without previous IVI (OR=4.5, 95% CI: 2.6-7.7, p<0.001). The combined therapy (anti-VEGF with corticosteroids) presents a higher risk compared to the two therapies alone as monotherapy (OR=11.6, 95% CI: 4.7-28.5, p<0.001), as well as treated eyes treated with ≥10 IVI (OR=2.1, 95% CI: 0.8-6.1, p=0.144) and a time interval between the last IVI and cataract surgery was ≤6 months (OR=1.9, 95% CI: 0.6-6.1, p=0.296). Discussion/Conclusion: These results demonstrate that eyes that require IV treatment prior to cataract surgery are at increased risk of CPA during cataract surgery, and careful assessment of the characteristics of the cataract and posterior capsule is critical.

Quality of Vision After LASIK, PRK and FemtoLASIK: An Analysis Using the Double Pass Imaging System HD AnalyzerTM®

Purpose

Analyze and compare the quality of vision of Photorefractive keratectomy (PRK), LASER in situ keratomileusis with mechanical microkeratome (LASIK) and femtosecond-assisted LASIK (FS-LASIK) using the double-pass imaging system HD AnalyzerTM^®.

Setting

Ophthalmology department of Centro Hospitalar Universitário do Porto (CHUPorto).

Design

Retrospective, non-randomized, single center study.

Methods

Analysis of three equivalent groups of patients submitted to PRK, LASIK and FS-LASIK at our department. The objective quality of vision assessment included the objective scatter index (OSI), the modular transfer function cutoff frequency (MTF) and the predicted visual acuity within the 100% (PVA), 20% (PVA20) and 9% contrast levels (PVA9) that were evaluated at baseline, 1st week, 1 and 6 months after surgery.

Results

118 eyes were included: 40 underwent LASIK, 43 FS-LASIK and 35 PRK. The mean age was 30.6±4.6 years old and 56% were female. There was a significant impact concerning the type of procedure in the objective quality of vision analysis (Repeated measures ANOVA): the FS-LASIK group showed lower OSI values overtime [F(1,2)=4.566, p=0.012, OSI 0.83±0.53 (FS-LASIK) vs 0.87±0.47 (PRK) and 1.21±1.44 (LASIK)], higher MTF values [F(1,2)=6.569, p=0.002, MTF 40.17±8.33 vs 32.37±11.4 (PRK) and 30.26±10.28 (LASIK)], higher PVA 100% [F(1,2)=10.871, p<0.001], PVA 20% [F(1,2)=9.737, p<0.001] and PVA 9% [F(1,2)=6.335), p=0.003].

Conclusion

In our study, FS-LASIK showed an excellent optical performance through the HD AnalyzerTM technology, with significantly lower OSI and higher MTF, PVA100, PVA20 and PVA9 values. According to our results, this procedure seems to be superior to PRK and LASIK regarding visual quality objective parameters.

Sleep disturbances, circadian activity, and nocturnal light exposure characterize high risk for and current depression in adolescence

Study Objectives

Major depressive disorder (MDD) in adolescence is associated with irregularities in circadian rhythms and sleep. The characterization of such impairment may be critical to design effective interventions to prevent development of depression among adolescents. This study aimed to examine self-reported and actimetry-based circadian rhythms and sleep–wake behavior associated with current MDD and high risk (HR) for MDD among adolescents.

Methods

Ninety-six adolescents who took part in the IDEA-RiSCo study were recruited using an empirically developed depression-risk stratification method: 26 classified as low risk (LR), 31 as HR, and 39 as a current depressive episode (MDD). We collected self-report data on insomnia, chronotype, sleep schedule, sleep hygiene as well as objective data on sleep, rest-activity, and light exposure rhythms using actimetry for 10 days.

Results

Adolescents with MDD exhibited more severe insomnia, shorter sleep duration, higher social jetlag (SJL), lower relative amplitude (RA) of activity, and higher exposure to artificial light at night (ALAN) compared with the other groups. They also presented poorer sleep hygiene compared with the LR group. The HR group also showed higher insomnia, lower RA, higher exposure to ALAN, and higher SJL compared with the LR group.

Conclusions

HR adolescents shared sleep and rhythm alterations with the MDD group, which may constitute early signs of depression, suggesting that preventive strategies targeting sleep should be examined in future studies. Furthermore, we highlight that actimetry-based parameters of motor activity (particularly RA) and light exposure are promising constructs to be explored as tools for assessment of depression in adolescence.

Refractive Surgery for Older Children and Adults with Accommodative Esotropia: A Systematic Review

INTRODUCTION

Accommodative esotropia (AET) is characterized by an esodeviation of the eyes due to uncorrected hyperopia, deficient fusional divergence, or high accommodative convergence. Decreasing hyperopia would reduce accommodative convergence and strabismus. We sought to review the existing evidence regarding the outcomes of refractive surgery in patients with AET.

METHODS

A four-database search (Pubmed, ISI Web of Science, Cochrane, and Scopus) was performed from inception to March 2021 using the following MeSH terms: ("Refractive Surgical Procedures" OR "Keratomileusis, Laser In Situ" OR "Photorefractive Keratectomy" OR "Lens Implantation, Intraocular") AND ("Esotropia" OR "Accommodative Esotropia" OR "Refractive Esotropia" OR "Accommodative Strabismus"). No meta-analysis was performed due to studies' heterogeneity.

RESULTS

Twenty-eight studies including 22 case series enrolling 378 patients and 6 case reports enrolling 8 patients were selected among 185 original abstracts. In the case series, a total of 378 patients (726 eyes) were recruited with an age range of 8-52 years. All studies reported mean follow-up periods of at least 12 months. Photorefractive keratectomy was performed in 7 studies, laser-assisted in situ keratomileusis in 9 studies, laser-assisted sub-epithelial keratectomy was reported in 1 study, and 3 studies implanted intraocular lenses, including iris-fixated and collamer. Considering the adult patients with a preoperative corrected esodeviation ≤10 prism diopters (PD) (n = 129), all but 5 (3.9%) presented orthophoria or ≤10PD after refractive surgery. All children but 4 (4.5%) ended up with an esodeviation ≤10PD after surgery with those exceptions being in the range of 11-15PD. Six case reports were included in this review, comprising a total of 8 patients (16 eyes) with an age range of 7-34 years and a follow-up range of 4-48 months. Six case reports were included in this review, comprising a total of 8 patients (16 eyes) with an age range of 7-34 years and a follow-up range of 4-48 months.

CONCLUSION

Evidence produced so far points out that refractive surgery may be an alternative for spectacle correction for adults with AET ≤10PD. There is not enough evidence to recommend its use for patients under 18 years of age. The safety and predictability of these procedures for this purpose remains unclear as the selection criteria used for these patients are much different than the usual indications and there are no studies with long-term follow-up.

An integrated approach for the efficient separation of specialty compounds from biomass of the marine microalgae Amphidinium carterae

An amphidinol-prioritized fractioning approach was for the first time developed to isolate multiple specialty metabolites such as amphidinols, carotenoids and fatty acids using the biomass of the marine microalgae Amphidinium carterae. The biomass was produced in a raceway photobioreactor and the exhausted culture media were reused, thus fulfilling sustainability criteria employing a circular economy concept. The integrated bioactive compounds-targeted approach presented here consisted of four steps with which recovery percentages of carotenoids, fatty acids and amphidinols of 97%, 82% and 99 %, respectively, were achieved. The proposed process was proved to be a better extraction system for this microalga than another based on a sequential gradient partition with water and four water-immiscible organic solvents (hexane, carbon tetrachloride, dichloromethane and n-butanol). The proposed process could be scaled-up as a commercial solid-phase extraction technology well-established for industrial bioprocesses.

Choroidal neovascularization secondary to pathological myopia-macular Bruch membrane defects as prognostic factor to anti-VEGF treatment

PURPOSE

To evaluate the prevalence and visual outcomes of macular Bruch membrane (BM) defects in patients treated with anti-vascular endothelial growth factors (VEGF) for choroidal neovascularization secondary to pathological myopia (mCNV).

METHODS

Single-center retrospective observational case series of 68 eyes from 62 patients with mCNV treated with one anti-VEGF injection followed by a pro re nata (1 + PRN) regimen. A minimum follow-up of 6 months was defined. Chorioretinal atrophy was assessed by fundus examination, fluorescein angiography, and SD-OCT.

RESULTS

Median follow-up was 28.5 (range 6-89) months with a median number of 5 anti-VEGF injections. At baseline, 27.9% of eyes had macular BM defects increasing to 36.8% during follow-up (p<0.001). Eyes without macular BM defects at the baseline had higher BCVA at the last observation than patients with BM defects (p=0.003). An increase of 5 or more ETDRS letters was more frequent in eyes without BM defects (p=0.001). At the end of follow-up, mCNV-related macular atrophy was present in 44.1%; out of which, 83.3% presented macular BM defects (p<0.001). Eyes with mCNV-related macular atrophy without BM defects had a significant increase of best-corrected visual acuity compared with eyes with mCNV-related macular atrophy and BM defect (p=0.002).

CONCLUSIONS

Macular Bruch membrane defects are often seen in mCNV and have a significant impact in visual acuity and prognosis. Eyes with macular BM defects have a poorer response and worse visual outcomes after anti-VEGF therapy.

Fluocinolone Acetonide 0.19 mg Implant in Patients with Cystoid Macular Edema Due To Irvine-Gass Syndrome

Background

Cystoid macular edema (CME) due to Irvine–Gass syndrome (IGS) is one of the common causes of painless visual impairment post-cataract extraction. The treatment of recurrent cases remains unstandardized.

Objective

To evaluate the effectiveness and safety of fluocinolone acetonide intravitreal implant (0.2 µg/day; ILUVIEN^®) in the off-label treatment of recurrent CME due to IGS.

Methods

Retrospective 36-month case series in the Ophthalmology Department of Centro Hospitalar Universitário do Porto, Portugal. Consecutive eyes of patients with recurrent cystoid macular edema due to Irvine–Gass syndrome who underwent a single intravitreal injection of fluocinolone acetonide intravitreal implant were included. Best-corrected visual acuity (logMAR), central macular thickness (µm) and safety (intraocular pressure, mmHg) at baseline and at 6, 12, 24 and 36 months post-administration of the fluocinolone acetonide intravitreal implant were recorded.

Results

Five eyes from three patients were included. The duration of cystoid macular edema was 67.8±25.9 months and all five eyes received more than 2 intravitreal injections of a corticosteroid (triamcinolone and/or dexamethasone implant) prior to fluocinolone acetonide intravitreal implantation. At baseline (median – interquartile range), best-corrected visual acuity was 0.3–0.3; central macular thickness was 492.0–38.0; and intraocular pressure was 16.0–0. By Month 36, best-corrected visual acuity was 0.4 −0.3; central macular thickness was reduced to 369.0–324.0 and intraocular pressure was 17.0–3.0. Four of five eyes had increased intraocular pressure and were managed with intraocular pressure-lowering eye drops.

Conclusion

We report improved functional and anatomical outcomes after treatment with fluocinolone acetonide intravitreal implant, indicating its use as a therapeutic alternative in recurrent cases of cystoid macular edema due to Irvine–Gass syndrome. Additionally, in eyes with suboptimal response to intravitreal therapies, fluocinolone acetonide intravitreal implant may provide longer recurrence-free periods with reduced treatment burden.

The Role of Corneal Biomechanics in the Assessment of Ectasia Susceptibility Before Laser Vision Correction

Purpose

To describe the tomographic and corneal biomechanical status of a sample of eyes excluded from LVC and to present the differences in biomechanical behavior in relation to cutoffs of clinical- and tomography-based screening methods used in clinical practice.

Patients and Methods

Observational cross-sectional study including 61 eyes from 32 consecutive patients who were excluded from LVC in our department. Clinical and demographic data were collected from the patients’ clinical records. Tomographic data was assessed with a Scheimpflug camera (Pentacam, OCULUS^®). Ablation depth (µm) and residual stromal bed (µm) were calculated by the WaveLight^® EX500 laser system software (Alcon, EUA). The corneal biomechanical assessment was made through ultra-high speed Scheimpflug imaging during noncontact tonometry (Corvis ST, OCULUS^®). Several ectasia risk scores were analyzed.

Results

Mean age was 31.0±6 years old and mean manifest spherical equivalent was −2.01 ± 2.3D. Belin–Ambrósio deviation index was the tomographic parameter with higher proportion of eyes within the ectasia high risk interval. In the biomechanical assessment, more than 95% of eyes met the criteria for ectasia susceptibility in four of the first generation and in two of the second generation parameters. In a cutoff based comparative analysis, eyes with Kmax ≥45.5 D, eyes with VCOMA <0 and eyes with ARTmax ≤350 presented significantly softer corneal biomechanical behavior.

Conclusion

The majority of eyes excluded from LVC in the present study met the criteria for ectasia susceptibility in several biomechanical parameters, validating the clinical and tomographic based screening prior to LVC in our center. Differences found in the biomechanical assessment regarding cutoffs used in clinical practice highlight its differential role in characterizing risk profile of these patients. Tomography should not be overlooked and the integration of all data, including treatment-related parameters, can be the future of risk ectasia screening prior LVC.

Keratitis by Scopulariopsis brevicaulis Fungus After LASIK - A Case Report

Purpose

To describe a rare case of an interface filamentous fungal keratitis and its successful clinical approach and management.

Patients and Methods

Retrospective case report. Analysis of the patient’s clinical records.

Results

A healthy 30-year-old woman presenting with complaints of blurred vision, photophobia and intense pain, was previously diagnosed with a suspected unilateral diffuse lamellar keratitis after laser in situ keratomileusis surgery, and accordingly treated with a scheme of oral and subconjunctival corticosteroids. Due to worsening of symptoms, the patient was later referred to our ophthalmology department. Upon examination, a corneal infiltration was observed and a fungal infection was suspected. Treatment with fortified Voriconazole (1%) was initiated and both topical and oral corticosteroids were tapered. The infiltrate resolved after 6 weeks of antifungal topical treatment. Scopulariopsis brevicaulis was isolated on culture media. At the end of follow-up, the uncorrected distance visual acuity was 20/20 with mild scarring.

Conclusion

Scopulariopsis brevicaulis can be associated with post-laser in situ keratomileusis interface infection. A quick intervention may dictate a good outcome, when combining early suspicion and microbiological diagnosis, and an appropriate conservative management. Furthermore, Voriconazole seems to be effective and safe in the treatment of such cases.

Visian® ICLV4c™ and Artiflex®: Comparative Analysis with the HD AnalyserTM and Integration with Subjective Performance and Anatomical Parameters

Purpose

To analyze and compare the mid-term objective and subjective performance of two phakic intraocular lenses (PIOLs) – Visian^® ICL™ V4c and Artiflex^® and to correlate those results with anatomical parameters.

Patients and Methods

Observational retrospective study including thirty patients (15 for each PIOL) randomly selected from those who underwent bilateral implantation of one of the PIOLs (60 eyes were analysed). Uncorrected and corrected distance visual acuities (UDVA and CDVA), anterior chamber structural parameters, and corneal endothelial cells density and morphology were evaluated. Quality of vision was assessed both subjectively with a questionnaire, and objectively using a double-pass technology optical quality analysis system.

Results

At the end of follow-up the Artiflex^® group showed better UDVA (0.95±0.11 vs 0.99±0.05, p=0.027) and higher proportion of eyes reaching at least 20/20 (28/30 vs 18/30, p=0.005). Excellent and similar objective scatter index (1.79±0.9 vs 2.14±1.6, p=0.306) and modular transfer function cutoff frequency (26.91±9.2 vs 26.51±11.9, p=0.784) results were achieved in the HD Analyzer^® and the questionnaire showed comparable high Satisfaction (55.7±3.5 vs 54.3±5.4, p=0.386) and low Dysphotopsia Scores (3.1±1.8 vs 2.1±2.2, p=0.213). The ICL group showed inferior anterior chamber volume (p<0.001), and angle (p<0.001) and superior pupillary diameter (p=0.007). Minimum follow-up was 24 months.

Conclusion

Both the Visian^® ICLV4c™ and the Artiflex^® showed excellent optical performance through the HD Analyzer^TM technology, translated in high patient satisfaction. Overall, both PIOLs showed similar safety, predictability, stability and effectiveness of for the reduction of high sphero-cylindrical refractive errors, despite better UDVA results with the Artiflex^®.

Improved extraction of bioactive compounds from biomass of the marine dinoflagellate microalga Amphidinium carterae

The extraction of three families of compounds (carotenoids, fatty acids and amphidinols) from the biomass of two strains of Amphidinium carterae (ACRN03 and Dn241EHU) was improved by tuning cell disruption and solvent extraction operations. The extraction of carotenoids was evaluated using alkaline saponification (0%-60% KOH d.w.) at different temperatures (25-80 °C). High levels of carotenoids were obtained at 60 °C using freeze-dried biomass, not subjected to cell disruption methods. The ACRN03 strain required 20% KOH whereas the Dn241EHU strain did not require saponification since carotenoid degradation was observed. The extraction efficiencies were determined with a wide range of pure solvents and mixtures thereof. Two empirical non-linear equations were used to correlate extraction percentages for each family of compounds with the Hildebrand solubility parameter (δ_T) and the polarity index of the solvents (PI). Thresholds of δ_T and PI of around 20 MPa^1/2 and 6, respectively, were determined for the extraction of amphidinols, consistent with antiproliferative activity measurements.

Macular edema secondary to retinal vein occlusion in a real-life setting: a multicenter, nationwide, 3-year follow-up study

PURPOSE

To evaluate the presence of macular edema secondary to retinal vein occlusion (RVO)-both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO)-3 years after diagnosis in patients who underwent intravitreal therapy and to identify potential prognostic factors and biomarkers of persistent macular edema.

METHODS

National multicenter, observational, exploratory, retrospective cohort study of 104 consecutive patients with macular edema secondary to RVO diagnosed from January 2014 to December 2015 with minimum 3-year follow-up time. Data analyzed included best-corrected visual acuity (BCVA), clinical and demographic data, and spectral domain optical coherence tomography parameters.

RESULTS

At final observation, median baseline central retinal thickness significantly improved from baseline 538 to 290 μm (p < 0.001) and complete macular edema resolution was achieved in 51.0% of patients (56.3% and 42.5% in BRVO and CRVO patients, respectively). BCVA also improved (p < 0.01). Logistic regression analysis revealed a relationship between recurrence of macular edema and disorganization of retinal inner layers (DRIL) at baseline (odds ratio = 2.88; p = 0.013).

CONCLUSION

Good long-term anatomical and functional outcomes are achieved with intravitreal treatments in RVO patients. Anatomical success and visual gains seen in the first year were maintained throughout the entire follow-up, though DRIL is a major risk factor for recurrence.

A temporary corneal ectasia following airbag trauma

Purpose

To report a case of a temporary corneal ectasia induced by airbag trauma.

Observations

A patient who suffered a road traffic accident with deployment of the frontal airbag and presented a corneal ectasia in both eyes after 3 months, without changes in visual acuity. After 9 months, he presented a significantly improvement, achieving his basal parameters in pentacam.

Conclusions and importance

This is a rare case of corneal ectasia induced by airbag trauma that spontaneously reverted and it can emphasize the viscoelastic properties of the human cornea.

The use of selected phytochemicals with EDTA against Escherichia coli and Staphylococcus epidermidis single- and dual-species biofilms

The aim of this study was the development of a novel and effective antibacterial formulation combining selected phytochemical compounds (quercetin, cuminaldehyde, indole-3-carbinol and vanillic acid) with ethylenediaminetetraacetic acid (EDTA), an aminopolycarboxylic acid. The antibacterial activity of the combinations was evaluated against Escherichia coli and Staphylococcus epidermidis in planktonic and sessile states as single and dual species. The compounds when applied individually demonstrated modest antibacterial activity. Nevertheless, synergy was observed when EDTA was combined with the selected phytochemicals, particularly with cuminaldehyde and indole-3-carbinol. These combinations were evaluated against single- and dual-species biofilms. An inactivation of 100% was obtained for almost all the biofilms, with E. coli biofilms showing the highest resistance. This study allowed the discovery of novel formulations of phytochemical compounds with antibacterial activity against E. coli and S. epidermidis single- and dual-species biofilms at concentrations close to the minimum bactericidal concentration. SIGNIFICANCE AND IMPACT OF THE STUDY: The synergistic combinations of EDTA and cuminaldehyde or indole-3-carbinol were effective against single- and dual-species E. coli and S. epidermidis planktonic cells and biofilms. The overall results highlight the role of phytochemical products as a green and sustainable source of antimicrobial potentiators to control bacteria in both planktonic and sessile states.

Implantation of intracorneal ring segments in pediatric patients: long-term follow-up

Purpose

To analyze the long-term outcomes of intracorneal ring segments (ICRS) implantation for keratoconus management in pediatric patients.

Methods

Retrospective case series review of the long-term (>5 years) outcomes of Intacs^® ICRS implantation for keratoconus in pediatric patients (age <18 years old at the time of surgery) between January 2008 and December 2011 at Ophthalmology Department of Hospital de Santo António. Demographic data, follow-up time, preoperative and postoperative uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) in decimal scale, and corneal topography were evaluated. Statistical analysis was done using SPSS for windows (version 24). Significance was set at p<0.0125.

Results

Fourteen eyes of 14 patients, with a mean age of 15.36 years (range 10-18 years), were included in this study. All patients had been diagnosed with keratoconus with reported progression in the 6 months prior to surgery. Follow-up time was 6.36±0.97 years. UCVA and BCVA improved after ICRS implantation (p<0.0125). Keratometry (K) minimum (Kmin) and K maximum (Kmax) decreased after surgery (p<0.0125). During follow-up, UCVA, BCVA, Kmin, and Kmax values ranged, showing a tendency to worsen at the end of follow-up. However, statistically significant differences were not observed.

Conclusion

ICRS implantation showed good visual and topographic results in pediatric patients. Long-term follow-up suggests that, despite ICRS implantation, there is still progression of keratoconus. To the best of our knowledge, there are no reports regarding the long-term efficacy of ICRS implantation in pediatric patients.