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- The Role of Multimodal Approach in the Assessment of Glaucomatous Damage in High MyopesPublication . Baptista, Pedro Manuel; Vieira, Rita; Ferreira, André; Figueiredo, Ana; Sampaio, Isabel; Reis, Rita; Menéres, Maria Joãourpose: To compare the optic disc structure and peripapillary retinal function between high myopes with and without glaucoma and to address the differential role of papillary optical coherence tomography angiography (OCT-A) and circumpapillary microperimetry (cpMP) on the diagnosis and prognosis of this patients. Patients and methods: It is a cross-sectional study including 30 high myopic patients (60 eyes), divided into 15 with (GG) and 15 without glaucoma (NGG). Demographic and clinical data were collected from patient records. Papillary structure (peripapillary retinal nerve fiber layer thickness, ppRNFLTs) and vascularization (small vessel densities, SVD´s) were assessed with SD-OCT (RTVue XR Avanti, with AngioVue system, Optovue®). cpMP was carried out with the MP-3 microperimeter (Nidek®). Results: The GG were older, had lower best-corrected visual acuities and higher intraocular pressures and axial lengths (p<0.001). The GG showed lower values in all ppRNFLTs (p<0.05), lower values in all SVDs (p<0.001), except the SVD-inside disc (p=0.638) and lower retinal sensitivities within all cpMPs (p<0.001). The adjusted analysis computing the best two parameters per exam revealed that the anatomical model including the ppRNFLT-inferior and ppRNFLT-temporal and the vascular model including SVD-inferior and SVD-superior had the best discrimination power between groups, with cross-validated AUROCs of 0.9599 and 0.9921, respectively. Conclusion: Despite the apparent superiority of the papillary vascular study, a multimodal approach including the papillary anatomic and circumpapillary microperimetric assessments can be the new way on the diagnosis and prognosis of glaucoma in high myopia.
- Keratitis by Scopulariopsis brevicaulis Fungus After LASIK – A Case ReportPublication . Baptista, Pedro Manuel; Vieira, Rita; Monteiro, Sílvia; Abreu, Ana Carolina; Gomes, Miguel; Pinto, Maria do CéuPurpose: 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.