Consuelo Gutierrez Ortiz

Introduction: Metastatic tumors to the optic disc are a rare event. Infiltration of the optic nerve head is usually a unilateral process with characteristic funduscopic features. Loss of vision is its main symptom. Neuroimaging should be performed in every patient suspected of infiltrative optic neuropathy. The patient should be referred for appropriated chemotherapy for the systemic cancer plus external ocular irradiation. Case Presentation: The case of a 75-year-old man with progressive vision loss in his left eye is presented. Among his medical background a gastric adenocarcinoma (GAC) with multiple liver metastases is highlighted. The exploration showed an optic nerve head invaded by chalky whitish infiltrates, associated to flameshaped hemorrhages along the vascular arcades; the magnetic resonance imaging (MRI) demonstrated signal enhancement of the posterior region of the left ocular globe, affecting the optic nerve head. Orbital radiotherapy was ruled out due to patient’s systemic situation. Discussion: Metastases and optic nerve infiltration should be suspected in every oncologic patient who develops optic neuropathy. Though a rare condition with poor systemic prognosis, patients should be studied and offered orbital radiotherapy in order to stabilize the ocular progression.

Dear editor, we have read with great interest the article of Fernandez-Vigo et al.1 on swept source optical coherence tomography (SS OCT) anterior scleral thickness biometry. In their article, they...

Precis: At 6 months the procedure achieved a 33.89% drop in intraocular pressure (IOP), had an overall success rate of 57.15%, and did not change the best-corrected visual acuity. Achieving 20% from the preoperative value without antiglaucoma treatment and as qualified if that level was achieved with antiglaucoma medications. Preoperative and postoperative factors were evaluated for an association with postoperative success using Kaplan-Meier analysis. Results: A significant reduction in mean IOP from preoperative levels was evident at the end of the follow-up. The overall surgical success rate was 57.15%. On the basis of Kaplan-Meier survival analysis, we found that patients whose IOP on the following day of the procedure was <8 mm Hg had a higher success rate than those whose 1-day postoperative IOP was higher. These patients had a percentage of success of 100%, 84.6%, and 76.9% at 1-, 3-, and 6-month postoperative follow-up, respectively. Conclusion: The IOP level on the first postoperative day could be considered a prognostic indicator of success in needling revision performed in failed NPDS.