Prolonged Fecal Shedding of SARS-CoV-2 in Asymptomatic Children with Inborn Errors of Immunity

Journal of Clinical Immunology -     

Application of anterior segment optical coherence tomography in glaucoma

Optical coherence tomography (OCT) is a cross-sectional, three-dimensional, high-resolution imaging modality that uses low coherence interferometry to achieve axial resolution in the range of 3–20 μm. Two OCT platforms have been developed: time domain (TD-OCT) and spectral (or Fourier) domain (SD/FD-OCT). Visante anterior segment OCT (Carl Zeiss Meditec) is a TD-OCT widely used for anterior segment imaging. The SD-OCT systems with both posterior and anterior segment imaging capabilities include the RTVue, iVue (Optovue), the Cirrus (Carl Zeiss Meditec), and the Spectralis (Heidelberg Engineering, Inc.). Each of the SD-OCTs has a wavelength in the range of 820–879 nm. Anterior segment OCT is a non-contact method providing high resolution tomographic cross-sectional imaging of anterior segment structures. Anterior segment OCT provides qualitative and quantitative assessment of the anterior segment structures important to the pathogenesis and the anatomical variations of glaucoma, and the approach to and success of treatment. We summarize the clinical applications of anterior segment OCT in glaucoma.     

Scanning laser polarimetry in glaucoma

Glaucoma is an acquired progressive optic neuropathy which is characterized by changes in the optic nerve head and retinal nerve fiber layer (RNFL). White-on-white perimetry is the gold standard for the diagnosis of glaucoma. However, it can detect defects in the visual field only after the loss of as many as 40% of the ganglion cells. Hence, the measurement of RNFL thickness has come up. Optical coherence tomography and scanning laser polarimetry (SLP) are the techniques that utilize the evaluation of RNFL for the evaluation of glaucoma. SLP provides RNFL thickness measurements based upon the birefringence of the retinal ganglion cell axons. We have reviewed the published literature on the use of SLP in glaucoma. This review elucidates the technological principles, recent developments and the role of SLP in the diagnosis and monitoring of glaucomatous optic neuropathy, in the light of scientific evidence so far.     

Comparative evaluation of TonoPen AVIA,Goldmann applanation tonometry and non-contact tonometry

To compare the tonometric recordings of the Tono-Pen AVIA (TPA) with intraocular pressure (IOP) recordings made with Goldmann applanation tonometry (GAT) and non-contact tonometry (NCT). This prospective, observational, comparative case series consisted of 180 eyes of 180 subjects (50 patients with glaucoma and 130 healthy controls). NCT was performed first, followed by GAT and TPA measurement after a 5-min break. The mean age of the patients enrolled in the study was 43.99 ± 16.67 years. The limits of agreement (confidence interval 95%) as calculated from the Bland–Altman plots for TPA–GAT and TPA–NCT were +8.7 to −7.7 and +8.6 to −9.6 mmHg in glaucoma patients. In healthy subjects these values were +4.8 to −5.1 and +6.2 to −5.2 mmHg, respectively. TPA tends to overestimate IOP compared to GAT at central corneal thickness (CCT) greater than 520 μm and underestimate IOP at CCT less than 510 μm. TPA overestimates IOP in comparison to NCT in subjects with CCT greater than 456 μm. Due to wide limits of agreement, TPA cannot be used interchangeably with GAT and NCT in the serial monitoring of glaucoma patients. Central corneal thickness has a significant influence on the IOP readings measured by Tono-Pen AVIA.     

Effect of change in macular birefringence imaging protocol on retinal nerve fiber layer thickness parameters using GDx VCC in eyes with macular lesions

This study evaluates the effect of two macular birefringence protocols (bow-tie retardation and irregular macular scan) using GDx VCC on the retinal nerve fiber layer (RNFL) thickness parameters in normal eyes and eyes with macular lesions. In eyes with macular lesions, the standard protocol led to significant overestimation of RNFL thickness which was normalized using the irregular macular pattern protocol. In eyes with normal macula, absolute RNFL thickness values were higher in irregular macular pattern protocols with the difference being statistically significant for all parameters except for inferior average thickness. This has implications for monitoring glaucoma patients who develop macular lesions during the course of their follow-up.     

Novel Mutation in a Child with Goltz Syndrome

Goltz syndrome or focal dermal hypoplasia is a rare clinical syndrome presenting with cutaneous, skeletal, dental, ocular, central nervous system and soft-tissue defects. The authors report a female child clinically diagnosed as Goltz syndrome, confirmed to have a novel splice site mutation IVS2 + 1G > A of PORCN gene. Review of the 80 or so pathogenic mutations reported in the literature shows this to be a new mutation.