Trabecular micro-bypass implant (iStent®) in a case of bilateral acute depigmentation of the iris / Micro implante trabecular (iStent®) em um caso de despigmentação aguda bilateral da íris

ABSTRACT We report a case of bilateral acute depigmentation of the iris in which satisfactory intraocular pressure control was obtained after resolution of the acute disease with a trabecular implant (iStent®). A 62-year-old woman presented with bilateral simultaneous acute eye pain, photophobia, increased intraocular pressure (34 mmHg), circulating pigment in the anterior chamber, areas of depigmentation in the iris, and posterior synechiae. She had received oral amoxicillin-clavulanate and moxifloxacin for pneumonia 2 months previously. Bilateral acute depigmentation of the iris was suspected as well as a viral etiology. She received oral acetazolamide, aciclovir, and prednisone, besides topical prednisolone, betaxolol, brimonidine, dorzolamide, and atropine. The disease gradually resolved in 4 months but, after 1 year, she developed bilateral cataracts, and still needed three drugs for intraocular pressure control (16/18 mmHg). Cataract-iStent® combined surgery was performed in both eyes. One year after surgery, intraocular pressure was 11/12 mmHg, without medication. iStent® was safe and effective on this secondary glaucoma.

RESUMO Relatamos um caso de despigmentação aguda bilateral da íris, no qual obtivemos adequado controle da pressão intraocular com o implante do iStent®, após resolução da fase aguda da doença. Paciente feminina, 62 anos, atendida com quadro agudo, bilateral e simultâneo de dor ocular, fotofobia, hipertensão ocular (34 mmHg), pigmentos circulantes na câmara anterior, áreas de despigmentação iriana e sinéquias posteriores. Havia recebido amoxicilina-clavulanato e moxifloxacina orais para pneumonia 2 meses antes. Suspeitando-se de despigmentação aguda bilateral da íris ou de etiologia viral, recebeu acetazolamida, aciclovir e prednisona orais, e colírios prednisolona, betaxolol, brimonidina, dorzolamida e atropina. O quadro se resolveu gradualmente em 4 meses, porém, após 1 ano, desenvolveu catarata bilateral e ainda usava 3 colírios hipotensores (pressão intraocular 16/18 mmHg). A cirurgia combinada de catarata-iStent® foi realizada em ambos os olhos. Um ano depois, a pressão intraocular mantinha-se 11/12 mmHg, sem medicação. O iStent® foi seguro e eficaz no controle deste glaucoma secundário.

Síndrome inflamatorio de reconstitución inmunológica (SIRS) en la salud reproductiva / Immune reconstitution inflammatory syndrome (IRIS) in reproductive health

Resumen El embarazo es un proceso que genera grandes cambios inmunitarios en los cuales participan los linfocitos T con respuestas proinflamatorias (Th1/Th17) y antiinflamatorias (Th2/Treg), con la finalidad de mantener el óptimo estado y desarrollo fetal. En la infección por VIH estos ambientes inmunológicos son afectados directamente con el descenso de las células TCD4. El uso de antirretrovirales (ART) ha permitido que las mujeres que viven con VIH puedan disminuir de manera importante la posibilidad de infectar a sus productos con el virus. El embarazo, enfermedades autoinmunes y el uso de ART son factores conocidos para el desarrollo del síndrome inflamatorio de reconstitución inmunológica debido a la recuperación abrupta de la respuesta inmunitaria. En esta revisión describimos parte de estos cambios en el embarazo y puerperio sin patología añadida, además proponemos un posible comportamiento en los perfiles Th1/Th2 en mujeres que viven con VIH que reciben ART y cursan el primer año posparto.

Abstract Pregnancy is a process which generate great immunologic changes with participation of T lymphocytes with inflammatory (Th1/Th17) and anti-inflammatory response (Th2/Treg), with the purpose of maintain the optimum condition and fetal development. In HIV infection this immunological ambient are affected directly due the decrease of T CD4 cells. The use of antiretrovirals (ART) has allowed that women living with HIV can decrease the possibility to infect their newborns with the virus. The pregnancy, autoimmune diseases, and the use of ART are known factors for the progress of immune reconstitution inflammatory syndrome due to the abrupt recovery of immune response. In this review we describe some of these changes during the pregnancy and puerperium without any disease added, furthermore we propose a possible behavior of Th1/Th2 profile in women who live with HIV and receive ART during the first year of postpartum.

Caracterización del implante secundario de una lente intraocular plegable suturada al iris en la afaquia

Objetivo: Caracterizar los resultados refractivos del implante de una lente intraocular plegable de cámara posterior suturada al iris en la afaquia sin o con inadecuado soporte capsular. Métodos: Se realizó un estudio descriptivo, prospectivo y longitudinal, en el que se incluyeron 30 pacientes (30 ojos) seguidos por un período de un año de septiembre de 2019 a septiembre de 2021, después del implante de una lente intraocular de cámara posterior suturada al iris en la afaquia. Se les realizó examen oftalmológico completo y se evaluaron variables como mejor agudeza visual sin corrección, con corrección, resultados refractivos, presión intraocular, astigmatismo inducido, densidad celular y complicaciones. Resultados: La mejor agudeza visual sin corrección en el preoperatorio fue del 93,3 % (<0,1) y con corrección de 0,66, al año del posoperatorio fue de 0,493/0,890, respectivamente. La presión intraocular preoperatoria fue de 20,7 mmHg, y al año 19,7 mmHg. La densidad celular en el preoperatorio fue de 1755,7 cél/mm2 y al año fue de 1363,8 cél/mm2, y en los pacientes bien corregidos al mes del posoperatorio fue de 73,4 % y al año de 70 %. El astigmatismo inducido en el posoperatorio al año fue de -0,51 D. Conclusiones: La agudeza visual sin corrección y con corrección mejoran después del implante de una lente intraocular plegable de cámara posterior suturada al iris en la afaquia sin o con inadecuado soporte capsular. Predominan los pacientes bien corregidos, sin cambios en la presión intraocular y la complicación más frecuente fue el edema corneal.

Objective: To characterize the refractive outcomes of implanting a posterior chamber foldable intraocular lens sutured to the iris in aphakia without or with inadequate capsular support. Methods: A descriptive, prospective and longitudinal study was carried out, including 30 patients (30 eyes) followed up for a period of one year, from September 2019 to September 2021, after being implanted a posterior chamber intraocular lens sutured to the iris in aphakia. Complete ophthalmologic examination was performed and variables were assessed, such as best visual acuity without correction, with correction, refractive results, intraocular pressure, induced astigmatism, cell density and complications. Results: The best visual acuity without correction in the preoperative period was 93.3 % (<0.1) and 0.66 with correction; while one-year postoperative visual acuity was 0.493 and 0.890, respectively. Preoperative intraocular pressure was 20.7 mmHg, while it was 19.7 mmHg at one year. Preoperatively cell density was 1755.7 cells/mm2, and it was 1363.8 cells/mm2 at one year it; while in well-corrected patients, it was 73.4% at one month postoperatively and 70% at one year. Postoperative induced astigmatism at one year was -0.51 D. Conclusions: Both uncorrected and corrected visual acuity improve after implantation of a posterior chamber foldable intraocular lens sutured to the iris in aphakia without or with inadequate capsular support. Well-corrected patients predominate, with no change in intraocular pressure, while the most frequent complication was corneal edema.

Corrección de la afaquia postraumática en niños con lentes plegables suturadas al iris

Objetivo: Caracterizar resultados visuales del implante de lente intraocular plegable de cámara posterior suturada al iris en la afaquia traumática de pacientes pediátricos. Métodos: Se realizó un estudio preexperimental, prospectivo, longitudinal con 17 niños, con seguimiento de un año. Se les realizó examen oftalmológico completo y se evaluaron variables como edad, sexo, lateralidad, mejor agudeza visual sin corrección, con corrección, resultados refractivos, presión intraocular, y complicaciones. Resultados: La edad promedio fue de 13,2 años, masculinos fueron el 64,7 %. La mejor agudeza visual sin corrección en el preoperatorio fue del 47,1 % <0,1 y con corrección de 0,7, al año del posoperatorio fue de 0,43/0,78, respectivamente. La presión intraocular preoperatoria fue de 14,1 mm Hg, y al año 14,71 mm Hg. La densidad celular en el preoperatorio fue de 2559.76 células/mm2 y al año de 2475,88 células/mm2. La hexagonalidad preoperatorio fue del 53,12 % y al año del 56,94 %. El cilindro preoperatorio -1,35 D y el 23,5 % presentó astigmatismo inducido al año del posoperatorio. Conclusiones: La aplicación del implante de lente intraocular plegable de cámara posterior suturada al iris en la afaquia traumática de pacientes pediátricos logra mejorar su agudeza visual y la complicación más frecuente fue el edema corneal.

Objective: To characterize visual outcomes of iris-sutured posterior chamber foldable intraocular lens implantation in traumatic aphakia in pediatric patients. Methods: A pre-experimental, prospective, longitudinal, pre-experimental study was performed with 17 children, with a one-year follow-up. A complete ophthalmologic examination was performed and variables such as age, sex, laterality, best visual acuity without correction, with correction, refractive results, intraocular pressure and complications were evaluated. Results: The average age was 13.2 years, 64.7% were male. The best visual acuity without correction preoperatively was 47.1 % <0.1 and with correction 0.7, one year postoperative visual acuity was 0.43/0.78, respectively. Preoperative intraocular pressure was 14.1 mm Hg, and at one year 14.71 mm Hg. Cell density preoperatively was 2559.76 cells/mm2 and at one year 2475.88 cells/mm2. The preoperative hexagonality was 53.12 % and at one year 56.94 %. Preoperative cylinder -1.35 D and 23.5 % presented induced astigmatism at one year postoperatively. Conclusions: The application of posterior chamber foldable intraocular lens implant sutured to the iris in traumatic aphakia in pediatric patients achieves improved visual acuity and the most frequent complication was corneal edema.

“To Fulfill two needs with one deed”: Iris fixation of intraocular lens using four-throw pupilloplasty

Background: Pupil distortion and aphakia are common complications that follow blunt injury of the eye globe, surgical complications, and iris coloboma. Patients with these two complications complain of severe glare and photophobia even after successful intraocular lens (IOL) implantation like scleral fixation of intraocular lens (SFIOL) due to irregular pupil. To overcome this, we prefer to do pupilloplasty along with IOL implantation. Purpose: In this video, we demonstrate iris fixation of IOL using four?throw pupilloplasty; thus with one surgical technique, both pupilloplasty and iris fixation are done. Synopsis: The technique of an IOL implantation without capsular support can be challenging. There are different techniques, such as iris claw, iris fixation, and scleral fixation. Permanent mydriasis or distorted pupil can be a disabling condition, even after successful vision gain, due to photophobia. So pupilloplasty is nowadays preferred along with IOL implantation. Usually after IOL implantation, iris cerclage or pupilloplasty is done. We combined both steps with one technique: iris fixation with four?throw pupilloplasty. This technique can be used for iris coloboma with weak zonules and surgical iridectomy with aphakia cases where the pupil is irregular. Highlights: The video highlights the steps of four?throw pupilloplasty technique which is also used for fixating the IOL to the iris (iris fixation). This can give an excellent outcome in aphakia with distorted pupil using a single technique approach.

A novel iridoplasty suture technique to repair iris defects and traumatic mydriasis

A new iridoplasty method is described, which uses the U-suture technique to repair traumatic mydriasis and large iris defects. Two 0.9 mm opposing corneal incisions were made. The needle was inserted through the first incision, passed through the iris leaflets, and removed through the second incision. The needle was reinserted through the second incision and removed through the first incision by re-passing the needle through the iris leaflets to form a U-shaped suture. The modified Siepser technique was applied to fix the suture. Thus, with a single knot, the iris leaflets were brought closer (shrinking like a pack), fewer sutures were used and fewer gaps were left. Satisfactory aesthetic and functional results were obtained in all cases in which the technique was applied. There was no suture erosion, hypotonia, iris atrophy, or chronic inflammation during the follow-up.

Bilateral acute depigmentation of the iris determined in two cases after COVID-19 infection

Bilateral acute depigmentation of the iris (BADI) is a rare disease characterized by iris atrophy. Although it can be self-limiting, it is sometimes progressive and can lead to glaucoma and severe vision loss. Two female patients were admitted to our clinic because of a change in iris color following coronavirus disease 2019 (COVID-19) infection. After the exclusion of other etiologies in the eye examination, BADI was diagnosed in both cases. Thus, it was shown that COVID-19 may also be involved in the etiology of BADI.

Single haptic iris fixation of posterior chamber intraocular lens

Single haptic iris fixation technique is used where there is a loss of 6 clock hours anterior capsular support. It helps the anterior segment surgeon to fix the intraocular lens to the iris on the side of absent capsular support and place the other haptic over the capsular support. A 10-0 polypropylene suture on a long-curved needle is only used to take a suture bite on the side of capsule loss. Meticulous automated anterior vitrectomy is done. Then, the suture loop below the iris is taken out and the loops are twirled multiple times around the haptic. The leading haptic is then gently glided behind the iris, and the trailing haptic is gently placed on the other side using forceps. The suture ends are trimmed and internalized into the anterior chamber and then externalized through the paracentesis using a Kuglen hook, and the knot is tied and secured

Improved visibility of illuminated chopper-assisted cataract surgery involving iris challenges

Purpose: The aim of this study was to evaluate the efficacy of the illuminated chopper?assisted cataract surgery in terms of shortening the surgical time and reducing the use of pupil expansion devices in eyes with iris challenges. Methods: This was a retrospective case series of a university hospital. Four hundred forty?three eyes of 433 consecutive patients who underwent illuminated chopper?assisted cataract surgery were included in this study. Cases with preoperative or intraoperative miosis, iris prolapse, and intraoperative floppy iris syndrome were included in the iris challenge group. Use of tamsulosin, iris hooks, pupil size, surgical time, and improved visibility (100/surgical time × pupil size) were compared between eyes with and without iris challenges. Mann–Whitney U test, Pearson’s Chi?square test, and Fisher’s exact test were used for statistical analysis. Results: Of 443 eyes, 66 were included in the iris challenge group (14.9%). Tamsulosin use was more common in patients with iris challenges and iris hooks were used more frequently (9.1% vs. 0%, P < 0.001) in patients with iris challenges than in those without iris challenges. Pupil size was smaller in patients with iris challenges (6.01 vs. 7.64 mm, P < 0.001). However, surgical time was not different (16.9 vs. 16.5 min, P = 0.064) between the two groups. As a result, improved visibility was calculated to be higher in patients with iris challenges (1.05 vs. 0.81, P < 0.001). Conclusion: In terms of surgical time and improved visibility, using the illuminated chopper simplified cataract surgery involving iris challenges. The use of an illuminated chopper is expected to be a good solution for challenging cataract surgeries.

SARS-CoV-2 virus-induced bilateral acute iris transillumination syndrome: The first case series in literature

Inflammatory events with highly variable clinical features have been reported with the coronavirus disease 2019 (COVID-19) pandemic, which has affected the whole world. Only one case of COVID-19–associated bilateral acute iris transillumination (BAIT) syndrome has been reported in the literature. We present a case series in which we hypothesize that the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have a mechanism similar to the common viruses that cause BAIT, the etiology of which is still unknown.

A stitch in time saves my (ne) (vision)

Background: Corneal melt with iris prolapse is a rare complication of autoimmune diseases, especially rheumatoid arthritis. Purpose: To highlight a challenging case of a peripheral ulcerative keratitis (PUK) with corneal melt and iris prolapse in a patient’s only eye. Synopsis: A 56?year?old Asian Indian male presented with blurring of vision in the right eye and was diagnosed with cataract. He was a known type 2 diabetes mellitus and a rheumatoid arthritis patient and was not on treatment. He had been previously diagnosed with PUK in the left eye and was lost to follow?up due to coronavirus disease 2019 (COVID?19) after therapeutic penetrating keratoplasty and lost his vision in that eye. Cataract surgery in the right eye was done under cover of immunosuppression. Subsequently, he developed PUK and was treated with a glue and bandage contact lens. Again, he was lost to follow?up and then presented a few months later with corneal melt with iris prolapse in the right eye. We describe in the video the surgical and medical challenges and successful salvage of both the eyeball and the vision. Highlights: Highlights include the following: 1. A rare case of corneal melt with iris prolapse. 2. Demonstration of surgical technique of patch graft. 3. Anterior segment optical coherence tomography before and after the procedure.

Iridociliary measurements using the Anterion swept-source optical coherence tomography

Purpose: Anterior segment optical coherence tomography (AS?OCT) by a swept source can visualize the ciliary body. The study was performed for analyzing the feasibility of a new swept?source OCT (Anterion) device for measuring iris ciliary sulcus, ciliary body thickness, and iris thickness. Methods: It is a pilot study among 30 normal young participants and hospital employees with their consent. The ciliary body, iris thickness, and ciliary sulcus were measured and compared to the results in the literature. We obtained 28 good?quality results. The main outcome measures were iris thickness (near and away from the pupillary margin), ciliary body thickness, and iridociliary sulcus measurement. Results: The iris thickness 2.5 mm from the pupillary margin was 0.70 ± 0.10 mm in the right eye and 0.68 ± 0.11 in the left eye. Closer to the root, the iris thickness varied from 0.55 ± 0.16 mm (right eye) and 0.57 ± 0.12 (left eye). Ciliary body thickness: Right eye 0.59 ± 0.14mm (28 good images), left eye 0.58 ± 0.13mm; ciliary sulcus (inner angle): right eye 82.65 ± 26.6°, left eye 83.66 ± 30.1°. Conclusion: Anterion OCT is feasible in our setting for various measurements and can provide valuable inputs to ophthalmologists for the treatment of ocular diseases.

Effect of pupil dilation on biometric iris recognition systems for personal authentication

Purpose: To study the effect of pupil dilation on a biometric iris recognition (BIR) system for personal authentication and identification. Methods: A prospective, non?randomized, single?center cohort study was conducted on patients who reported for a routine eye check?up from November 2017 to November 2019 (2 years). An iris scanning device “IRITECH?MK2120U” was used to initially enroll the undilated eyes. Baseline scans were taken after matching with the enrolled database. All eyes were topically dilated and matched again with the enrolled database. The Hamming distance (a measure of disagreement between two iris codes) and recognition status were recorded from the device output, and eyes were evaluated by slit?lamp ophthalmoscopy with special emphasis on pupil shape, size, and texture. Results: All 321 enrolled eyes matched after topical dilation. The pupil size had a significant effect on Hamming distance with a P value <0.05. There were no false matches. A correct recognition rate of 100% was obtained after dilation. No loss of iris texture or pupil shape was observed after dilation. Conclusion: A BIR system is a reliable method for identification and personal authentication after pupil dilation. Topically dilated pupils are not a cause for non?recognition of iris scans.

Picadura de insecto en la córnea, a propósito de un caso

Introducción : Es de vital importancia considerar que la toxina del veneno de la avispa puede ocasionar una reacción violenta que daña la función visual, es por ello que presentamos el siguiente caso relacionado. Cuadro Clínico : Mujer de 32 años con antecedente de picadura de avispa hace 24 horas en ojo derecho; disminución de la agudeza visual, enrojecimiento, lagrimeo, dolor, secreción; agudeza visual de cuenta dedos a 2 metros del ojo derecho y 20/25 ojo izquierdo, con presiones intraoculares de 12 y 13; biomicroscopía hiperemia conjuntival con inyección periciliar 3+, cuerpo extraño en córnea hasta estoma con edema 3+, estrías en la Descemet ojo derecho. Resultados : Se procede a la extracción del cuerpo extraño con previa protección antimicrobiana con antibiótico tobramicina, antiinflamatorio esteroideo prednisolona, hipertónicas y lubricante mixto carboximetilcelulosa y glicerina. A la semana, se observa la formación de una opacidad capsular anterior con signos de atrofia iridiana que empieza a dar un "cambio de color del iris", a las dos semanas se evidencia la dilatación de la vasculatura periciliar, a horas 4, y a las 3 semanas el paciente presenta una agudeza visual de 20/25 ambos ojos, con transparencia corneal, persistencia de la atrofia iridiana y catarata traumática capsular anterior, con remisión de sintomatología en el paciente. Conclusiones : No se sabe el componente exacto del veneno que produce los signos previamente descritos, existen teorías de que puede deberse a un componente con acción parasimpaticomimética, el mismo que se relaciona a otras observaciones clínicas de despigmentación local y heterocromía.

Introduction : It is very important to consider that the toxin present in wasp venom may lead to a severe reaction damaging visual function. This is the reason why we present the following case. Clinical Picture : This is a 32-year-old-female who was bitten by a wasp 24 hours ago in her right eye. She had visual acuity reduction, reddening, tearing, pain, and secretion. Her visual acuity was counting fingers at two-meter distance from her right eye and 20/25 in the left eye. Intraocular pressure was 12 and 13. Biomicroscopy showed conjunctival hiperemia with 3+ periciliary injection. There was a foreign body in the cornea towards the stoma, with 3+ edema. There were striae in the right Descemet. Resultados: We took out the foreign body with previous antimicrobial protection including an antibacterial (tobramycin) and a steroid anti-inflammatory compound (prednisolone). Hypertonic solution and mixed lubricants were also administered, including a mixed lubricant, carboxymethylcellulose, and glycerin. One week afterwards, we observed the formation of an anterior capsular opacity with signs of iris atrophy which led to a 'change of color in the iris'. Two weeks afterwards we observed periciliary vascular dilatation, at 4-hour meridian; and on the third week, the patient had 20/25 visual acuity in both eyes. Her cornea was transparent, there was persistence of iris atrophy, and there was an anterior capsular cataract. Her symptoms subsided. Conclusiones : The exact component of wasp venom leading to the described signs is not known. It has been proposed that it may be a compound with parasympathomimetic action, and this has been related with other clinical observations indicating local depigmentation and heterochromia.

New understandings of the pathogenesis of primary angle-closure glaucoma / 中华实验眼科杂志

Primary angle-closure glaucoma (PACG) is still one of the common blinding eye diseases in China.Because of the irreversibility of the vision loss it caused, the factors affecting the early development of glaucoma are of great concern.The understanding of static anatomic structure of high-risk anterior segment, such as shallow anterior chamber, short axial length, thick iris and large anterior lens cannot fully explain the transformation process of PACG, so the specific role of dynamic changes in the development of glaucoma should be further considered.This article expounded the differences in iris volume and dynamic process of elasticity between normal people and patients with PACG, the incoordination between lens and intraocular structure during eyeball development, the dynamic block and expansion of ciliary body, vitreous and choroid, and the latest research on the relationship between the abnormal ocular nerve and vascular system adjustment and change with the onset of PACG, in order to provide guidance for understanding the pathogenesis of PACG, accurate clinical diagnosis and formulation of treatment strategies.

Plateau iris / 国际眼科杂志(Guoji Yanke Zazhi)

Primary angle closure glaucoma(PACG)is the leading type of glaucoma in Asia, especially in China. PACG still has a high proportion of angle closure after laser peripheral iridectomy(LPI). Plateau iris is one of the non-pupillary blockage factors that cause angle closure. With the wide application of ultrasound biomicroscopy(UBM)in ophthalmology, the understanding of plateau iris has been deepened continually. This paper will elaborate the concept, mechanism, prevalence, relationship with angle closure, diagnostic criteria and the treatment of plateau iris, aiming to have a deeper understanding of the relationship between plateau iris and PACG, and to provide references for the treatment and research of PACG in the future.

Use of antioxidants and time of cold storage: effects over viability parameters and enzymatic levels in semen of rainbow trout (Oncorhynchus mykiss, Walbaum, 1792) / Uso de antioxidantes e tempo de armazenamento a frio: efeitos sobre parâmetros de viabilidade e níveis enzimáticos no sêmen da truta arco-íris (Oncorhynchus mykiss, Walbaum, 1792)

Abstract The cold storage of milt implies potentials alterations in its quality because the storage generates as main process, free radicals that produce spermatozoa membrane lipids damage with the consequent motility and fertilising capacity disruptions. To decrease the damage generated by free radicals the cells have antioxidant defences (proteins, enzymes, and low molecular weight substances). The objective of the present study evaluated the time storage effect and different antioxidants prepared in spermatic diluents on sperm viability of O. mykiss milt stored at 4°C. The two-way ANOVA denoted that the time storage and antioxidant influence have significant effects separated or combined on viability parameters (sperm motility and viability, proteins concentrations and superoxide dismutase enzymatic activity in seminal plasma). In contrast, only the storage time affected the fertilising capacity and catalase enzymatic activity in seminal plasma. The resulting analysis can conclude that the antioxidant presence improves the viability of cold stored milt, especially the transport conditions and the antioxidants allow the fecundity despite motility decrease.

Resumo O armazenamento a frio de leite implica potenciais alterações em sua qualidade, pois gera como processo principal radicais livres que provocam danos aos lipídios da membrana dos espermatozoides, com as consequentes alterações na motilidade e na capacidade de fertilização. Para diminuir os danos causados pelos radicais livres, as células têm defesas antioxidantes (proteínas, enzimas e substâncias de baixo peso molecular). O presente estudo avaliou o efeito do tempo de armazenamento e diferentes antioxidantes preparados em diluentes espermáticos no armazenamento de viabilidade de O. mykiss milt a 4°C. A ANOVA de duas vias denotou que o armazenamento no tempo e a influência antioxidante têm efeitos significativos separados ou combinados nos parâmetros de viabilidade (motilidade espermática, viabilidade espermática, concentrações de proteínas e atividade enzimática da superóxido dismutase no plasma seminal), enquanto apenas o tempo de armazenamento afetou a capacidade de fertilização e atividade enzimática da catalase no plasma seminal. A análise resultante pode concluir que a presença de antioxidante melhora a viabilidade do leite frio, especialmente as condições de transporte, e os antioxidantes permitem a fecundidade apesar da diminuição da motilidade.

Beneath the surface: a case report of metastatic iridociliary ring melanoma treated with pembrolizumab / Abaixo da superfície: relato de caso de melanoma metastático iridociliar em anel tratado com pembrolizumabe

ABSTRACT Iridociliary ring melanoma is an uncommon type of uveal melanoma. Clinical manifestation varies from asymptomatic cases to masquerade syndromes mimicking refractory glaucoma. Treatment options include radiotherapy and enucleation. Management of metastatic uveal melanoma remains discouraging. Novel therapies using immune checkpoint inhibitors are currently under study. We present a case of a 54-year-old Hispanic woman with progressive vision loss due to metastatic ring melanoma with anterior chamber seeding treated with pembrolizumab.

RESUMO O melanoma iridociliar em anel é um tipo incomum de melanoma uveal. As manifestações clínicas variam desde casos assintomáticos até síndromes mascaradas que mimetizam um glaucoma refratário. As opções de tratamento incluem radioterapia e enucleação. O manejo do melanoma uveal metastático continua desanimador. Novas terapias usando inibidores de checkpoint imunológico estão atualmente em estudo. Apresentamos o caso de uma mulher hispânica de 54 anos com perda progressiva da visão por um melanoma metastático em anel, com semeadura de câmara anterior, tratada com pembrolizumabe.

Use of antioxidants and time of cold storage: effects over viability parameters and enzymatic levels in semen of rainbow trout (Oncorhynchus mykiss, Walbaum, 1792) / Uso de antioxidantes e tempo de armazenamento a frio: efeitos sobre parâmetros de viabilidade e níveis enzimáticos no sêmen da truta arco-íris (Oncorhynchus mykiss, Walbaum, 1792)

The cold storage of milt implies potentials alterations in its quality because the storage generates as main process, free radicals that produce spermatozoa membrane lipids damage with the consequent motility and fertilising capacity disruptions. To decrease the damage generated by free radicals the cells have antioxidant defences (proteins, enzymes, and low molecular weight substances). The objective of the present study evaluated the time storage effect and different antioxidants prepared in spermatic diluents on sperm viability of O. mykiss milt stored at 4°C. The two-way ANOVA denoted that the time storage and antioxidant influence have significant effects separated or combined on viability parameters (sperm motility and viability, proteins concentrations and superoxide dismutase enzymatic activity in seminal plasma). In contrast, only the storage time affected the fertilising capacity and catalase enzymatic activity in seminal plasma. The resulting analysis can conclude that the antioxidant presence improves the viability of cold stored milt, especially the transport conditions and the antioxidants allow the fecundity despite motility decrease.

O armazenamento a frio de leite implica potenciais alterações em sua qualidade, pois gera como processo principal radicais livres que provocam danos aos lipídios da membrana dos espermatozoides, com as consequentes alterações na motilidade e na capacidade de fertilização. Para diminuir os danos causados pelos radicais livres, as células têm defesas antioxidantes (proteínas, enzimas e substâncias de baixo peso molecular). O presente estudo avaliou o efeito do tempo de armazenamento e diferentes antioxidantes preparados em diluentes espermáticos no armazenamento de viabilidade de O. mykiss milt a 4°C. A ANOVA de duas vias denotou que o armazenamento no tempo e a influência antioxidante têm efeitos significativos separados ou combinados nos parâmetros de viabilidade (motilidade espermática, viabilidade espermática, concentrações de proteínas e atividade enzimática da superóxido dismutase no plasma seminal), enquanto apenas o tempo de armazenamento afetou a capacidade de fertilização e atividade enzimática da catalase no plasma seminal. A análise resultante pode concluir que a presença de antioxidante melhora a viabilidade do leite frio, especialmente as condições de transporte, e os antioxidantes permitem a fecundidade apesar da diminuição da motilidade.

Use of antioxidants and time of cold storage: effects over viability parameters and enzymatic levels in semen of rainbow trout (Oncorhynchus mykiss, Walbaum, 1792)

Abstract The cold storage of milt implies potentials alterations in its quality because the storage generates as main process, free radicals that produce spermatozoa membrane lipids damage with the consequent motility and fertilising capacity disruptions. To decrease the damage generated by free radicals the cells have antioxidant defences (proteins, enzymes, and low molecular weight substances). The objective of the present study evaluated the time storage effect and different antioxidants prepared in spermatic diluents on sperm viability of O. mykiss milt stored at 4°C. The two-way ANOVA denoted that the time storage and antioxidant influence have significant effects separated or combined on viability parameters (sperm motility and viability, proteins concentrations and superoxide dismutase enzymatic activity in seminal plasma). In contrast, only the storage time affected the fertilising capacity and catalase enzymatic activity in seminal plasma. The resulting analysis can conclude that the antioxidant presence improves the viability of cold stored milt, especially the transport conditions and the antioxidants allow the fecundity despite motility decrease.

Resumo O armazenamento a frio de leite implica potenciais alterações em sua qualidade, pois gera como processo principal radicais livres que provocam danos aos lipídios da membrana dos espermatozoides, com as consequentes alterações na motilidade e na capacidade de fertilização. Para diminuir os danos causados pelos radicais livres, as células têm defesas antioxidantes (proteínas, enzimas e substâncias de baixo peso molecular). O presente estudo avaliou o efeito do tempo de armazenamento e diferentes antioxidantes preparados em diluentes espermáticos no armazenamento de viabilidade de O. mykiss milt a 4°C. A ANOVA de duas vias denotou que o armazenamento no tempo e a influência antioxidante têm efeitos significativos separados ou combinados nos parâmetros de viabilidade (motilidade espermática, viabilidade espermática, concentrações de proteínas e atividade enzimática da superóxido dismutase no plasma seminal), enquanto apenas o tempo de armazenamento afetou a capacidade de fertilização e atividade enzimática da catalase no plasma seminal. A análise resultante pode concluir que a presença de antioxidante melhora a viabilidade do leite frio, especialmente as condições de transporte, e os antioxidantes permitem a fecundidade apesar da diminuição da motilidade.