Lenticular Opacities Research Articles

Oxymatrine impedes the progression of endotoxin-induced glaucoma via redox system modulations.

This study aimed to provide irrefutable evidence of the preventive effects of oxymatine (OMT) on a model of endotoxin induced glaucoma in Wistar rats which can be attributed to its anti-inflammatory, antioxidant, and TNF-α antagonistic properties. To assess the impact of OMT on uveitic glaucoma, the normal group received 100 μLdistilled water topically for 15 days, while the glaucoma control group was induced with uveitic glaucoma by applying 10 μLof 10 μg/mLlipopolysaccharide (LPS) topically for 3 consecutive days. The treatment groups were then given OMT solution at a volume of 50 μLwith varying doses of 0.25%, 0.5%, and 1% once a day via topical administration for 15 days. In addition, as a standard, the animals were also given 100 μLof 1% dorzolamide topically for 15 days. All ophthalmic dosing was carried out by pulling the lower eye-lid of the experimental animals and administration of the respective solutions. The study uses cutting-edge real-time imaging of the retinal vasculature in anesthetized animals, postsacrifice lenticular picturization and biochemical evidence to support the changes in the retinal layers. LPS induced animals demonstrated increased IOP, disrupted antioxidant systems, massive lipid damage, enhanced TNF-α activity and changes in intracellular ATPase and ionic activities. The damaged retinal vasculature and lenticular opacification further supported the biochemical evidence. However, using OMT at a 1% dosage effectively enhanced the antioxidant levels, regulated intracellular ion concentration and ATPases, decreased TNF-α activity, and counteracted mechanobiological changes in the visual front and retina. Moreover, OMT can successfully normalize intraocular pressure, making it a highly beneficial treatment option for glaucoma.

Mining and analysis of adverse event signals of Cariprazine based on the real-world data of FAERS database

ObjectiveThis study aims to analyze the adverse events (AEs) of Cariprazine based on the FAERS database, providing evidence for its safety surveillance. MethodsFor signal quantification of Cariprazine-related AEs, we used disproportionality analysis including the Ratio of Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS) algorithms. ResultsWe selected Cariprazine-related AE reports from the FAERS database from the fourth quarter of 2015 to the first quarter of 2023, and performed a detailed data analysis. Out of a total of 12,278,580 case reports, 3659 were found to be directly related to Cariprazine. We identified 140 Preferred Terms (PT) to describe these AEs, finding that they involved 27 organ systems. Specifically, AEs related to eye disorders such as Cataract cortical, Cataract nuclear, Accommodation disorder, Lenticular opacities, Oculogyric crisis, Dyschromatopsia were not explicitly mentioned in the drug's leaflet, indicating the presence of new ADR signals. ConclusionAnalysis of the FAERS database identified AEs associated with Cariprazine, notably in eye disorders not previously documented in the drug's official leaflet. These findings emphasize the need for continuous post-market surveillance and awareness among healthcare professionals regarding potential new ADR signals.

Bilateral dense coin-like lenticular opacities in an infant

A 6-month-old child with impaired vision was taken to a tertiary care hospital. Ocular examination revealed no abnormalities, but under anesthesia, ultrasonic biomicroscopy (UBM) found small, white, and dense lenticular opacities, which were further confirmed on the intraoperative clinical examination. The morphology of these coin-like opacities was distinct from previously described pediatric cataracts, being larger than those in cataract pulverulenta and thinner than “ant-eggs.” The child underwent lens aspiration, anterior vitrectomy, and intraocular lens (IOL) insertion. Understanding the unique morphology of this cataract may contribute to improved management of similar cases and deepen our knowledge of lens embryology and etiopathogenesis of cataract.

Cataracta octopoda: Complex anterior pyramidal and sutural cataract simulating an octopus configuration

A middle aged man presented with glare in right eye. On slit lamp examination, he had lenticular opacity in both eyes emanating from central suture with pyramidal projection above the anterior capsular surface with radiating spokes simulating an octopus like configuration which was confirmed on anterior segment tomography. Hence we describe a special entity cataracta octopoda which is a combination of anterior pyramidal and sutural cataract. Posterior segment evaluation was unremarkable. His low vision was attributable to amblyopia developed due to lenticular opacity. However cataract surgery was offered to him in both eyes primarily to treat glare as well as an added benefit of improving some vision due to the aberrated lens with central opacity. He had gained few lines of vision with resolution of glare symptoms.

Nanophthalmos in a case of Alport syndrome: A unique presentation

A 20-year-old male having a positive family history of Alport syndrome presented to us with bilateral sensorineural hearing loss, hematuria, anterior central lenticular opacity in the right eye (RE), and anterior lenticonus in the left eye (LE). The patient had high hyperopia of +10 and +11 Diopter sphere in RE and LE, respectively. The anterior chambers (AC) were shallow (peripheral AC depth, Van Herick grade 1 and 0) with occludable angles on gonioscopy in both eyes (BE), which led us to suspicion of nanophthalmos. The axial length of ~15.35 mm and retinal–choroidal–scleral thickness of ≥2.20 mm in BE, on B scan, confirmed the diagnosis of nanophthalmos. We report this unique case presenting with phenotypes of two genetically diverse disorders, which, to our knowledge, has never been reported before.

Quiescent caterpillar hair: A rare cause of localised lenticular opacity formation.

To report a rare case of a 65 year old patient with a single caterpillar hair with localised lenticular opacity around it and no active inflammation. A single quiescent caterpillar hair embedded in the anterior lens capsule causing localised cataract around it. There was no other sign of ocular toxicosis and the patient was unaware of the presence of this intraocular foreign body. Caterpillar hair (also known as setae) are a common cause of ophthalmia nodosa. These setae can penetrate intraocularly with ease to cause various forms of ocular toxicosis ranging from conjunctivitis, keratitis, pars planitis, chorioretinitis to even severe vitritis warranting enucleation. As per our knowledge and experience, no case of caterpillar hair without inflammation has been reported till date. We hereby report a rare case of a 65 year old patient with a single caterpillar hair embedded in the anterior lens capsule causing localised cataract around it without any active inflammation. In our opinion, if the eye is quiescent, the patient should be kept on close and long term follow-up and active intervention can be undertaken at the first instance of inflammation or if cataract progresses.

Burden of ocular abnormalities in patients with beta thalassaemia: a cross-sectional study

IntroductionIn Pakistan, the reported carrier rate of thalassaemia is estimated to be 5%–8% with 5000 new patients diagnosed every year. Several known systemic complications of beta thalassaemia major have been...

Successful Surgical Removal of the Crystalline Lenses in a Black-Necked Swan (Cygnus melancoryphus).

A captive-bred, adult, male, black-necked swan (Cygnus melancoryphus) was presented for evaluation of apparent vision loss due to cataract formation of an unknown duration. The animal was having difficulty navigating its enclosure, and lenticular opacities had been previously noted in both eyes. On examination, bilateral hypermature cataracts were diagnosed. Following preoperative diagnostic testing, surgical removal of the crystalline lenses in both eyes was performed using minor modifications of standard techniques. Follow-up examination and behavioral observation at 60 days postsurgery indicated that vision had been successfully restored without complications. We conclude that successful surgical removal of cataracts is possible in this species using modifications of standard techniques.

Intrastromal keratopigmentation: a boon for unsightly corneal scars.

The aim of this study was to improve cosmesis in patients with corneal opacity (CO) using newer organic micronized pigments. Settings: Tertiary Care eye center, Design: Retrospective study. Patients with unsightly corneal scars not suitable for keratoplasty, eccentric corneal opacity not requiring keratoplasty, or lenticular opacity/anterior or posterior capsular opacities in non-seeing eyes. Micronized organic pigment was used for keratopigmentation by the intrastromal pocket technique (ISPT) in deep corneal opacities and lenticular opacities, whereas the intrastromal needle puncture technique (ISNT) was used in superficial opacities or corneoiridic scars. The records of 463 patients were reviewed and analyzed for the duration of the past 7years. Two hundred and ninety-three (63.2%) patients underwent ISNT, eight underwent combined technique, and the rest underwent ISPT. The postoperative follow-up period showed more watering and redness in the needle puncture technique (p > 0.001), which resolved in 70.4% of patients by the end of 4weeks. Repeat procedures were required in 5.3% of the patients with ISNT. The patient's satisfaction grading showed excellent levels in 375 (80.9%) patients, 45 (9.7%) had good satisfaction levels, and the rest had average satisfaction levels. Intrastromal keratopigmentation is a boon for unsightly corneal scars and gives respite to the patients from the social stigma.

Study of Comparison of Effect and Complications of Intravitreal Triamcinolone Injection of 1 mg, 2 mg and 4 mg in Macular Edema of Vascular Origin

Introduction: The present study aimed to compare the efficacy and safety of different doses (1 mg, 2 mg and 4 mg) of triamcinolone acetonide (IVTA) in treatment of eyes with macular edema of vascular origin. Methods: Using simple random sampling among patients attending our tertiary healthcare referral centre, 60 patients fulfilling selection criteria were divided into 3 groups and were followed up for a period of 16 weeks. Following IVTA injections of different doses, patients were observed for changes in best-corrected visual acuity (BCVA), central foveal thickness (CFT) on optical coherence tomography (OCT), intraocular pressure (IOP) and cataract occurrence/ progression in all three groups at 1 week , 4 weeks, 12 weeks and 16 weeks. Results: Following IVTA injection in all three groups (1 mg, 2 mg and 4 mg), mean BCVA improved from baseline but no statistically significant difference was observed in mean BCVA at different follow ups between the three groups. Mean CFT significantly improved from baseline in all three groups but no statistically significant difference was observed at different follow ups between groups. Mean IOP increased from baseline in all three groups but no statistically significant difference was observed among groups at different follow ups. Anti glaucoma treatment was required at end of 16 weeks postoperatively in 0, 1 and 3 eyes receiving 1 mg, 2 mg and 4 mg IVTA respectively. Lenticular changes at the end of 16 weeks postoperatively were found in 0, 1 and 2 eyes with 1 mg, 2 mg and 4 mg IVTA respectively. Conclusion: 4 mg dose of IVTA improves the functional and anatomical outcome in macular edema of vascular origin in most patients followed by 2 mg dose. 1 mg and 2 mg dose of IVTA has less incidence of steroid induced elevation of IOP and lenticular opacity development or progression. Further large scale studies are recommended to compare the effectiveness and safety of different doses of IVTA. Keywords: Triamcinolone Acetonide, Macular edema, diabetic retinopathy, retinal vein occlusion

Study of comparison of effect and complications of intravitreal triamcinolone injection of 1 mg, 2 mg and 4 mg in macular edema of vascular origin

Introduction: The present study aimed to compare the efficacy and safety of different doses (1 mg, 2 mg and 4 mg) of triamcinolone acetonide (IVTA) in treatment of eyes with macular edema of vascular origin.Methods: Using simple random sampling among patients attending our tertiary healthcare referral centre, 60 patients fulfilling selection criteria were divided into 3 groups and were followed up for a period of 16 weeks. Following IVTA injections of different doses, patients were observed for changes in best-corrected visual acuity (BCVA), central foveal thickness (CFT) on optical coherence tomography (OCT), intraocular pressure (IOP) and cataract occurrence/ progression in all three groups at 1 week , 4 weeks, 12 weeks and 16 weeks. Results: Following IVTA injection in all three groups (1 mg, 2 mg and 4 mg), mean BCVA improvedfrom baseline but no statistically significant difference was observed in mean BCVA at different follow ups betweenthe three groups. Mean CFT significantly improved from baseline in all threegroups but no statistically significant difference was observed at different follow ups between groups. MeanIOP increasedfrom baseline in all three groupsbut no statistically significant difference was observed among groups at different follow ups. Anti glaucoma treatment was required at end of 16 weeks postoperatively in 0, 1 and 3 eyes receiving 1 mg, 2 mg and 4 mg IVTA respectively. Lenticular changes at the end of 16 weeks postoperatively were found in 0, 1 and 2 eyes with 1 mg, 2 mg and 4 mg IVTA respectively.Conclusion: 4 mg dose of IVTA improves the functional and anatomical outcome in macular edema of vascular origin in most patients followed by 2 mg dose. 1 mg and 2 mg dose of IVTA has less incidence of steroid induced elevation of IOP and lenticular opacity development or progression. Further large scale studies are recommended to compare the effectiveness and safety of different doses of IVTA. Keywords: Triamcinolone Acetonide, Macular edema, diabetic retinopathy, retinal vein occlusion

An illustration of ocular toxoplasmosis with consequent lenticular opacities and asteroid hyalosis

Inactive ocular toxoplasmosis (OT) is not confined to immunocompromised patients but is also common in immunocompetent patients. It could result in a loss of vision, asteroid hyalosis, lenticular opacity and peripheral chorioretinal scar. More often than not, misdiagnosing the lesion may occur because of the lack of presenting symptoms. Therefore, this article aims to highlight OT and its consequences, emphasising the approach that must be followed to diagnose and manage the disease optimally. This case report is about a 24-year-old woman who had blurred vision in her left eye from the age of 9 years. After dilation for fundus examination and taking the patient for retinal imaging, the fundus showed a clearly defined pigmented chorioretinal scar on the temporal side of the macula.Contribution: As the disease has the ability for retinal complications, documenting any progressive developments of the disease is essential to manage the patient better.

Association of Common and Rare Genetic Variation in the 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Gene and Cataract Risk.

BackgroundResults from animal models and observational studies have raised concerns regarding the potential cataractogenic effects of statin treatment. We investigated whether common and rare genetic variants in HMGCR are associated with cataract risk, to gauge the likely long‐term effects of statin treatment on lenticular opacities.Methods and ResultsWe used genotyping data and exome sequencing data of unrelated European individuals in the UK Biobank to test the association between genetically proxied inhibition of HMGCR and cataract risk. First, we constructed an HMGCR genetic score consisting of 5 common variants weighted by their association with low‐density lipoprotein cholesterol. Second, we analyzed exome sequencing data to identify carriers of predicted loss‐of‐function mutations in HMGCR. Common and rare variants in aggregate were then tested for association with cataract and cataract surgery. In an analysis of >402 000 individuals, a 38.7 mg/dL (1 mmol/L) reduction in low‐density lipoprotein C by the HMGCR genetic score was associated with higher risk for cataract (odds ratio, 1.14 [95% CI, 1.00–1.39], P=0.045) and cataract surgery (odds ratio, 1.25 [95% CI, 1.06–1.48], P=0.009). Among 169 172 individuals with HMGCR sequencing data, we identified 32 participants (0.02%), who carried a rare HMGCR predicted loss‐of‐function variant. Compared with noncarriers, heterozygous carriers of HMGCR predicted loss‐of‐function had a higher risk of developing cataract (odds ratio, 4.54 [95% CI, 1.96–10.53], P=0.001) and cataract surgery (odds ratio, 5.27 [95% CI, 2.27–12.25], P=5.37×10−4). In exploratory analyses, we found no significant association between genetically proxied inhibition of PCSK9, NPC1L1, or circulating low‐density lipoprotein cholesterol levels (P>0.05 for all) and cataract risk.ConclusionsWe found that genetically proxied inhibition of the HMGCR gene mimicking long‐term statin treatment associated with higher risk of cataract. Clinical trials with longer follow‐up are needed to confirm these findings.

Computer‐aided diagnosis of cataract severity using retinal fundus images and deep learning

AbstractCataracts are lenticular opacities that can appear in different parts of the lens in the eye and are a leading cause of blindness globally. Accurate detection and early‐stage diagnosis can prevent the cataract and improve the quality of life for cataract patients. However, clinical cataract detection and grading require the expertise of trained eye specialists, which may impede everyone's early intervention due to the underlying expenses. This article proposed a computer aid diagnosis method for cataract detection, which also grades the severity of cataracts from fundus retinal images such as normal, mild, moderate, and severe. The proposed method uses a hybrid approach in which various pre‐trained convolutional neural networks (AlexNet, VGGNet, ResNet) with transfer learning are used to extract features. These feature vectors of each network individually and in the fused form are applied on the support vector machine classifiers for 4‐stage cataract classification. This architecture also takes advantage of ensemble learning by applying a majority voting scheme on the predictions of these SVM classifiers. The fundus cataract images are obtained from several open‐access datasets and arranged into 4‐classes with the assistance of an eye specialist. Since all the collected images are not suitable for diagnosis, an image quality selection module is included with this method to determine the quality of fundus images. The proposed method achieved 96.25% 4‐class classification accuracy. According to the experimental results, the proposed method is effective for cataract classification and outperforms conventional methods.

Refractive Error in a Chinese Population with Type 2 Diabetes: A Report from the Fushun Diabetic Retinopathy Cohort Study

ABSTRACT Purpose To describe the prevalence and risk factors for refractive errors in a northeastern Chinese population with type 2 diabetes. Methods Subjects (age ≥30 years) from a community-based study, the Fushun Diabetic Retinopathy Cohort Study, were enrolled. All subjects underwent comprehensive ocular examinations, including autorefraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) of the right eye <−0.5 diopter (D), <−5.0D, and >0.5D, respectively. Astigmatism was defined as cylinder <−0.5D in a minus cylinder prescription. Anisometropia was defined as a difference of SE >1.0D between two eyes. Results A total of 1929 participants (790 males, 41.0%) were enrolled. The age and gender standardized prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia were 43.1% (95% confidence interval [CI]: 40.9%–45.3%), 8.5% (95% CI: 7.3%–9.8%), 21.5% (95% CI: 19.7%–23.4%), 61.0% (95% CI: 58.9%–63.2%), and 17.2% (95% CI: 15.5%–18.9%), respectively. Advancing age was associated with a higher frequency of hyperopia, astigmatism, and anisometropia, as opposed to a lower frequency of myopia. Female (adjusted odds ratio [aOR], 1.27; 95% CI, 1.02–1.57) participants, higher intraocular pressure (aOR, 1.03; 95% CI, 1.00–1.07), and lenticular opacity (aOR, 1.53; 95% CI, 1.20–1.94) were also found to be associated with myopia. Long duration of diabetes (>15 years) was found to be a significant factor for astigmatism (aOR, 1.62; 95% CI, 1.15–2.27) and anisometropia (aOR, 1.87; 95% CI, 1.29–2.71). Conclusion Nearly two-thirds of participants with type 2 diabetes had a refractive error. Age is a common factor with different types of refractive errors.

Rhegmatogenous retinal detachment in Coats\u2019 disease: a case report

BackgroundCoats’ disease was originally defined as a unilateral idiopathic exudative retinopathy in young males, characterized by abnormal retinal vascular telangiectasia with intraretinal and subretinal lipid exudation. The retinal detachment is usually exudative. Herein, we describe a case of rhegmatogenous retinal detachment with detectable retinal break in a patient with Coats’ disease.Case presentationA 15-year-old Indo-Aryan male patient presented with sudden painless diminution of vision in his right eye of 4 days duration. Upon examination, the anterior segment in both eyes and left fundus was within normal limits. Dilated fundus evaluation of the right eye revealed telangiectasia of the retinal vessels, with subretinal exudation in superotemporal and superonasal quadrants and presence of subretinal fluid in the superotemporal area extending into fovea. There was also presence of single flap horseshoe tear in the superotemporal quadrant at around the 10 o’clock position in the equatorial region, with no secondary changes. The retina was reattached with encircling band buckle combined with vitrectomy and silicon oil tamponade. Seven months post vitrectomy, lenticular opacification developed, for which he underwent silicon oil removal, along with lens aspiration and implantation of foldable intraocular lens. Over the period of 1 year, his best corrected visual acuity improved from 6/60 to 6/18 in the affected eye at the last follow-up visit. The recovery was uneventful following the subsequent surgery.ConclusionCoats’ disease has a remarkable diversity in clinical presentation and morphology. The disease can also present with an underlying break, which may not be attributed to any iatrogenic modality. The treatment modalities in coats’ disease should be tailored individually due to the low incidence of the disease and the great variation in severity upon presentation. Prompt management restores the best possible anatomical outcome and maintains good vision.

Topical Administration of ACE Inhibitor Interrupts the Progression of Cataract in Two Kidney One Clip Induced Hypertensive Cataract Model

ABSTRACTPurposePreviously, we assessed that hypertension increases cataractogenesis. In the present study, we evaluated the effect of oral and topical administration of enalapril on two kidney one clip (2K1C)-induced hypertensive cataract model by evaluating the biochemical alteration of lenticular antioxidants, ionic content, ATPase activity, protein content and careful examination of the lenticular opacity.Materials and MethodAnimals were divided into normal and hypertensive animals. Hypertensive animals were divided into hypertensive control group (0.3% CMC), enalapril (oral) treatment group (20 mg/kg/day; p.o), and enalapril (topical) treatment group (0.1% w/v on the eye cornea) for a period of twelve weeks. During experimental study blood pressure, heart rate and morphology of the eyes were monitored biweekly. After twelve weeks, lenses were photographed and various catractogenic biochemical parameters were assessed.ResultsEnalapril (oral) treatment conserved the blood pressure (systolic and diastolic), restored the level of antioxidants, restored the lipid peroxidation marker, nitrite content, ionic content, ATPase function, protein content, and thus delayed the cataract formation. While, enalapril (topical) treatment exhibited anti-cataract effect without affecting the systolic and diastolic blood pressure that could be by restoring the antioxidant level, maintaining the ionic balance, balancing the protein levels, and by inhibiting the upregulated ocular renin angiotensin system. The overall results suggest that enalapril (topical) treatment showed conspicuous effect than enalapril (oral) treatment in adjourning the cataract formation.ConclusionBased on the results, it may be concluded that upregulated ocular RAS by increasing oxidative stress and by misbalancing the lenticular ionic and protein content may lead to cataract formation in hypertensive condition.

Establishing a novel lens opacities classification system based on ultrasound biomicroscopy (UBM) for pediatric cataracts: reliability and availability.

This study sought to develop and validate a lens opacities classification system based on ultrasound biomicroscopy (UBM) imaging to grade pediatric cataracts. The study was conducted at Guangzhou Children's Hospital, Guangzhou Women and Children's Medical Center. UBM images of patients at the hospital from September 2013 to November 2014 were used in this study. We summarized the characteristics of lenticular opacification in each of the following 4 zones: the anterior capsule (A); the cortex (C); the nucleus (N); and the posterior capsule (P). The UBM data and intraoperative videos were compared, and sensitivity, specificity, accuracy, and positive and negative predictive values were determined for our Lens Opacities Classification System based on UBM for Pediatric Cataracts (LOCS-UP) detection. Two physicians classified pediatric cataracts (anterior capsule, cortex, and posterior capsule) by extracting 146 images from the UBM database. Patients' data were recorded to calculate the kappa coefficients. The LOCS-UP was developed. Under this standard, all types of pediatric cataracts can be classified and acquired a code by the LOCS-UP. The LOCS-UP had the highest sensitivity (100%) and specificity (98.96%) in naming the anterior capsule and the lowest sensitivity (50%) and specificity (89.59%) in naming the posterior capsule. Its consistency at naming the anterior capsule was satisfactory (Kappa coefficient: 0.70), and it was also able to name the nucleus, cortex, and posterior capsule (0.56, 0.58, and 0.48, respectively). LOCS-UP could name pediatric cataracts by providing an unique digital encoding, which could reflect characteristics exactly for different local lens anomalies to all kinds of pediatric cataract patients. This method provides detailed and accurate information about Patients' lenses.

Clinical outcomes in post-epikeratophakic eyes after removal of epikeratoplasty lenticule

BackgroundAssessment of the optical outcome and adverse events in post-epikeratopathic eyes after removal of the epikeratoplasty lenticule (EKPL).MethodsThis was a retrospective case-series study of patients who underwent EKPL removal between 2002 and 2020. Ten eyes were included in the analysis. We compared the clinical characteristics of the patients before surgery, 6 months after surgery, before lenticular removal, and after removal, and reported optical or ocular surface complications.ResultsWe removed EKPL due to the lenticular opacity in five eyes (50%), intraocular lens (IOL) insertion (n = 4, 40%) after cataract surgery (n = 3) or in aphakic eyes (n = 1), and lenticule-induced irregular astigmatism in one eye (10%). After EKPL removal, the mean refractive power of the cornea (Km) revealed a tendency to increase. Out of nine cases, six cases showed corneal steepening and three cases revealed corneal flattening. When the keratometric readings of pre-epikeratoplasty and post-lenticular removal were compared within the same case, the average difference was 5.1 D ± 4.0 (n = 8). Complications were observed in 3 of 10 cases (excessive corneal flatness, ectatic change, and abnormal epithelial cell ingrowth) after removal.ConclusionsThe surgeon should expect the corneal refractive power to steepen or flatten in some cases with abnormal astigmatism and irregularity. Epikeratophakic eyes may exhibit serious ectatic changes, and abnormal epithelial cell ingrowth after removal of epikeratophakic lenticules.

Lipemic aqueous humor and suspected xanthomas associated with primary hypertriglyceridemia in a cat

AbstractA 1‐year‐old, male neutered, European Shorthair cat presented for bilateral lipemic aqueous humour and mildly increased intraocular pressure in the left eye. Laboratory evaluations showed hypertriglyceridemia and elevation of alpha‐1‐globulins and serum amyloid‐A. The initial treatment plan consisted of topical flurbiprofen, tobramycin‐dexamethasone, dorzolamide and low‐fat diet. Lipemic aqueous resolved within 72 hours without recurrence. Presumed lipemic droplets were observed in the vitreous. Two months after the initial diagnosis the cat returned with dermatological changes, consisting of pale pink papules and erosions on the neck and ear pinna with pruritus. Cytology of these lesions was consistent with cutaneous xanthoma. A primary familial hypertriglyceridemia was confirmed by exclusion on the basis of normal abdominal ultrasound, urine test and repeated blood work after the change of the diet. The xanthomas resolved two weeks after further restriction of the diet. At 74‐weeks after initial presentation posterior subcapsular lenticular opacities appeared in both eyes.