Macrophakia: The characterization of a novel lens condition.

Purpose: To present a novel characterization of a lens condition termed macrophakia which includes large or proportionally large lenses with shallow anterior chamber dimensions that are statistically deviant of a normal population. Observations: We identified five eyes from three cases to have significantly large lens parameters and small anterior chamber depths. In all five eyes, the anterior chamber depth was less than 2 mm and the anterior chamber depth to lens thickness ratio was two standard deviations outside the normative range of lens and chamber measurements. These large lenses were all observed in the absence of typical pathology and other biometric abnormalities. Conclusions and importance: A novel lens characterization termed macrophakia is proposed to describe large or proportionately large lenses. Naming this condition is clinically relevant and will enhance cataract evaluations and patient education.

A case of JOAG in a patient with Rett syndrome.

Purpose: In this report, we describe a case of juvenile open angle glaucoma in a patient with Rett syndrome. Observations: A 39- year-old white woman with a notable history of Rett syndrome was referred to our center with a ten-year diagnosis of juvenile open angle glaucoma. Initial exam was notable for complete cupping of the optic nerve. Upon follow up visits, intraocular pressures were elevated and remained refractory to multiple therapies, including SLT and pressure-lowering drops. Medical management was continued due to the risk of surgery and limited visual potential. Because it was declared that patient did not have substantial feedback to visual stimuli and did not exhibit any signs of pain, conservative management with drops was continued. Conclusion and importance: This is the first report of a patient with concurrent Rett syndrome and juvenile open angle glaucoma, thus expanding on the literature of an ocular manifestation occurring presumably coincidentally with this disorder.

Bromo-lactamization of isoxazole via neighboring group participation: toward spiro-isoxazoline γ- and δ-lactams.

Spiro-heterocycles containing natural products and synthetic analogues have a broader biomedicinal application due to their rigid 3D conformation and structural implications. In this context, constructing spiro-isoxazoline systems have continued our interest in natural products and synthetic units to investigate their novel biological activities. Herein, a bromo-lactamization mediated neighboring group participation approach has been utilized on various isoxazole-amides to construct an array of spiro-isoxazoline-lactams. The easy synthesis with diverse functionalization in the periphery of a novel 3D framework could be interesting for biomedical investigation.