Enhanced Ectasia Detection Using Corneal Tomography and Biomechanics.

PURPOSE: To test the accuracy of the Tomographic and Biomechanical Index (TBI) for ectasia detection in an independent population from the original study. DESIGN: Retrospective case-control study. METHODS: Subjects: Patients were grouped according to clinical diagnosis including corneal topography (front-surface curvature): Normal group, including 1 eye randomly selected from 312 patients with normal corneas; Keratoconus group, including 1 eye randomly selected from 118 patients with keratoconus; a nonoperated ectatic eye from 57 patients with very asymmetric ectasia (57 eyes, VAE-E group), and the nonoperated fellow eye with normal topography (57 eyes, VAE-NT group). MAIN OUTCOME MEASURES: The ability of TBI to distinguish normal and ectatic corneas; and comparison with other indexes, including the Belin/Ambrósio Deviation Index (BAD-DI) and the Corvis Biomechanical Index (CBI), considering the areas under receiver operating characteristic curves (AUCs). RESULTS: The AUC of the TBI was statistically higher than all other tested parameters (DeLong, P < .001). Considering all cases, the cut-off value of 0.335 for the TBI provided a sensitivity of 94.4% and a specificity of 94.9% (AUC = 0.988; 95% confidence interval [CI] 0.982-0.995). Considering the VAE-NT group, optimized TBI cut-off value of 0.295 provided a sensitivity of 89.5% and a specificity of 91.0% (AUC = 0.960; 95% CI 0.937-0.983). CONCLUSION: The TBI was more accurate than all parameters tested for differentiating normal from ectatic corneas. The TBI may epitomize ectasia susceptibility and distinguish cases with fruste disease from true unilateral cases among the eyes with normal-topography VAE.

Characterization of all Surgical Specimens Provided by a Portuguese Department of Ophthalmology over a 13 Year Period.

INTRODUCTION: We intend to evaluate clinically, topographically and morphologically all surgical specimens sent by the Department of Ophthalmology of Hospital de Braga to the Department of Pathology of the same hospital. MATERIAL AND METHODS: Two hundred and fifty eight surgically obtained specimens, from the Department of Ophthalmology of Hospital de Braga, analyzed in the Department of Pathology, from January 2002 to June 2015, were characterized. Data was arranged according to year, age, sex, topography and morphological diagnosis according to the SNOMED® coding system. RESULTS: Mean age at time of diagnosis was 54.6 years old; 52.3% were male subjects. The number of specimens was relatively stable until the year 2010, with a significant increase between 2011 and 2013. Most specimens sent corresponded to eyelid (54.7%), followed by conjunctiva (26.7%); the most common pathological diagnosis was malignant epithelial lesions (22.48%), followed by melanocytic tumours (22.09%) and benign epithelial lesions (17.05%). DISCUSSION: The results are distinct from previous publications presumably because of differences between the populations submitted to analysis. CONCLUSION: This is the first indexed publication characterizing surgical specimens from a Department of Ophthalmology in Portugal; moreover, it also includes an extensive review of global epidemiological data about ophthalmic surgical specimens.

Introdução: Pretende-se avaliar clínica, topográfica e morfologicamente todos as amostras biológicas enviadas pelo Serviço de Oftalmologia do Hospital de Braga para o Serviço de Anatomia Patológica do mesmo Hospital. Material e Métodos: Duzentas e cinquenta e oito amostras biológicas obtidas cirurgicamente pelo Serviço de Oftalmologia do Hospital de Braga e analisadas pelo Serviço de Anatomia Patológica (Hospital de Braga), no período de janeiro de 2002 a junho de 2015. Os dados foram organizados de acordo com o ano, idade, sexo, topografia e diagnóstico patológico de acordo com sistema de codificação SNOMED®. Resultados: A idade média dos doentes à altura do diagnóstico foi de 54,6 anos, sendo 52,3% destes indivíduos do sexo masculino. O número de amostras oscilou pouco até ao ano 2010, verificando-se um aumento importante entre 2011 e 2013. A maioria das amostras biológicas enviadas foi de pele de pálpebra (54,7%), seguida de conjuntiva (26,7%); os diagnósticos morfológicos mais comuns foram as lesões epiteliais malignas (22,48%), seguido pelos tumores melanocíticos (22,09%) e as lesões epiteliais benignas (17,05%). Discussão: Os resultados são distintos das publicações anteriores, presumivelmente devido a diferenças entre as populações analisadas. Conclusão: Esta é a primeira publicação indexada caracterizando as amostras biológicas de um Serviço de Oftalmologia em Portugal; além disso, inclui uma extensa revisão de dados epidemiológicos sobre amostras biológicas oftalmológicas a nível global.