Incidental diagnosis of asymptomatic lipaemia retinalis in a patient with uncontrolled type 2 diabetes mellitus: 'white lines'.

A man in his 60s presented for his medical retina clinic appointment, reporting increasing shortness of breath, aches and pains, and increasing insulin requirements during a difficult early lockdown. Wide-field colour fundus imaging (Optos Optomap) and an optical coherence tomography scan (Heidelberg Spectralis) revealed whitened and enlarged hyper-reflective vessels. Retinal colour photography also confirmed a creamy white discolouration of the vessels, which prompted the team to order a lipid profile. The profile showed a raised cholesterol level of 17.5 mmol/L (normal: <4mmol/L) and a marked elevated triglyceride level of 38.41 mmol/L (normal: <1.7 mmol/L).The clinical picture, alongside the biochemical results, suggested a diagnosis of secondary lipaemia retinalis due to poorly controlled diabetes. With aggressive treatment, the patient's biochemistry and vessels returned to baseline.This rare condition should be taken as an indicator of a potential underlying life-threatening medical condition and the role an ophthalmologist has in initiating potential lifesaving intervention.

Retinal Vein Occlusion in a Patient on Dabrafenib and Trametinib Therapy for Metastatic Melanoma.

The purpose of this case report is to highlight the ocular complications of dabrafenib and trametinib treatment. We discuss the case of an 81-year-old female treated with dabrafenib and trametinib for metastatic melanoma, who developed a retinal branch vein occlusion with macular edema in the right eye. The other eye was healthy. The treatment was discontinued and her macular edema was managed with a loading dose of three injections of anti-vascular endothelial growth factor (anti-VEGF) medication with a good response. The use of BRAF and MEK inhibitors is increasingly becoming widespread, and hence it is important to report cases of these adverse effects to achieve earlier diagnoses and initiate fast and effective treatments.

Correlation Between Retrograde Trans-Synaptic Degeneration of Ganglion Cells and Optical Coherence Tomography Angiography Following Ischemic Stroke.

Objective Following nerve injury, the projection of posterior visual pathway lesions into the macular ganglion cell layer (GCL) region indicates retrograde trans-synaptic degeneration (RTSD) as a mechanism of functional damage. Our purpose is to assess GCL damage and the impacts of ischemic brain lesions affecting the visual pathway on macular microvascularization in patients with stroke. Methods In a case-control study, we examined 15 ischemic stroke patients who showed visual field defects and 50 healthy controls using the high-resolution optical coherence tomography (OCT) techniques such as spectral domain-OCT (SD-OCT) to measure retinal nerve fiber layer (RNFL) and GCL thicknesses, and OCT angiography (OCTA) to assess damage to the macular microvasculature. Results In the cases, the correlation was detected among the site of vascular damage, visual field defect, retinal GCL thinning, and normal RNFL thickness. Further observations were significant reductions in macular thickness, GCL thickness, outer retinal layer vascular density, and vascular area in deeper retinal layers (p < 0.05). Conclusion Our findings suggest that ocular microvasculature abnormalities could serve as diagnostic and/or prognostic markers in patients with stroke and support the described use of GCL thickness as an image marker of visual pathway RTSD after brain injury.

Massive application of the SARS-CoV-2 diagnostic test: simulation of its effect on the evolution of the epidemic in Spain.

In Spain, the epidemic curve caused by COVID-19 has reached its peak in the last days of March. The implementation of the blockade derived from the declaration of the state of alarm on 14th March has raised a discussion on how and when to deal with the unblocking. In this paper, we intend to add information that may help by using epidemic simulation techniques with stochastic individual contact models and several extensions.