Multimodal Imaging Approach in a Patient with Vogt-Koyanagi-Harada-like Syndrome Due to Dabrafenib and Trametinib Use for Cutaneous Melanoma.

PURPOSE: To describe a case of ocular inflammation associated with dabrafenib and trametinib chemotherapy for cutaneous melanoma by using a multimodal image approach. MATERIALS AND METHODS: We report on a 51-year-old woman with Vogt-Koyanagi-Harada-like syndrome, which occurred while she was undergoing treatment with dabrafenib and trametinib for cutaneous melanoma. The patient complained of sudden, bilateral vision loss of 2 days' duration. Anatomical and functional improvement was observed after administration of systemic steroids and cessation of chemotherapy. Later on, 6 weeks after restarting dabrafenib, she had an episode of granulomatous anterior uveitis, which was successfully managed with topical mydriatics and steroids. Strict follow-up with multimodal imaging was performed until recovery. CONCLUSIONS: This report emphasizes the importance of strict ophthalmological follow-up with multimodal imaging in patients receiving dabrafenib and trametinib, and the need for a multidisciplinary approach in the management of ocular inflammation during chemotherapy.

Covid-19 and acute conjunctivitis: Controversial data from a tertiary refferral Italian center.

PURPOSE: Although acute conjunctivitis has been listed from the beginning as a possible sign of COVID-19, the likelihood of this association remains unclear. The aim of this study was to investigate the relationship between COVID-19 and conjunctivitis. METHODS: In this retrospective, observational study, we recruited all patients with signs and symptoms of acute conjunctivitis seen at the Eye Emergency Department (ED), Turin Eye Hospital, between 01/01/2020 and 12/05/2020 and cross-checked our data with the Piedmont Region online COVID-19 registry in the same period. RESULTS: Among 10,065 patients seen at our ED during the timespan considered, 88 underwent a nasopharyngeal swab (NS) for SARS-CoV-2 detection within 4 weeks before/after our examination. On average, NS was performed -0.72 ± 1.8 weeks before/after eye examination. Of the 77 patients with a negative NS, 26 (33.8%) had a diagnosis of acute conjunctivitis, whereas the remaining 51 (66.2%) had other eye disorders. Among the 11 patients with COVID-19, 7 (63,6%) had a diagnosis of acute conjunctivitis. We found a non-statistically significant increase in NS positivity rate (21.2%) among cases examined at our ED for acute conjunctivitis, compared to the NS positivity rate (7.3%) in patients examined for all other eye conditions (p = 0.092). The Odds Ratio of having a positive NS in patients with acute conjunctivitis was 3.43 (95% I.C. = 0.9-12.8, p = 0.06). Considering online-registry data of Turin population during the same time-span, among 2441 positive NS cases only 27 (1.1%) presented with acute conjunctivitis. CONCLUSION: Our results do not reveal a statistically significant correlation between COVID-19 and acute conjunctivitis. SYNOPSIS: The present study analyzes retrospectively data from a tertiary eye referral center to investigate the relationship between COVID-19 infection and conjunctivitis.

The optokinetic response is effective to assess objective visual acuity in patients with cataract and age-related macular degeneration.

PURPOSE: To estimate objective visual acuity in subjects suffering from cataract and age-related macular degeneration via the optokinetic response evoked by a non-conventional induction method (oktotype); in addition, to compare such objective outcome with the subjective acuity based on the ETDRS charts. METHODS: Patients were presented with 13 sequences of symbols arranged horizontally to form a serial pattern, moving from left to right at a constant rate. In each sequence, the size of the stimuli was reduced progressively, while the operator checked for the disappearance of the optokinetic response via a small video camera mounted on the test lens frame. The minimum angular size of the serial pattern able to evoke the optokinetic response (MAER) was referred to as the objective visual acuity of the subject. RESULTS: Correlation between logMAER and logMAR was significant in the cataract and macular degeneration group ([Formula: see text] = 0.70, p < .0001; [Formula: see text] = 0.63, p < .0007). In the two samples, the correspondence between subjective and objective visual acuity (as, respectively, decimal units and arbitrary decimal units) was satisfactory (concordance correlation coefficient: cataract group = 0.91 and AMD group = 0.93). Test-retest reliability of the oktotype was good for the cataract group and moderate for the AMD sample (Κ 0.81 and 0.59, respectively). CONCLUSION: The oktotype seems a promising tool to objectively assess visual acuity in noncooperating subjects with cataract or macular degeneration. Further research on other clinical conditions is needed to clarify the suitability of the procedure in the clinical setting.