Correspondence
Updated review: optical coherence tomography findings of the pachychoroid disease spectrum
The ocular choroid consists of 5 distinct layers: innermost Bruch's membrane, capillaries of the choriocapillaris, Sattler's layer housing medium-sized blood vessels, Haller's layer containing larger-sized vessels, and the suprachoroidal space. Pachychoroid disease spectrum (PDS) was first described by Warrow et al.1 in 2013 as a group of chorioretinal disease entities characterized by a thickened choroid exceeding 300 µm and leading to exudative and neovascular complications. However, improved multimodal imaging, including extended depth imaging optical coherence tomography (EDI-OCT), has helped characterize PDS as a spectrum of ocular phenotypes all sharing 3 common characteristics: engorged Haller's layer vessels, Sattler's layer compression, and choriocapillaris attenuation.Acute orbital myositis preceding vesicular rash eruption in herpes zoster ophthalmicus
Herpes zoster ophthalmicus (HZO) is a common ocular emergency caused by reactivation of the varicella zoster virus (VZV), leading to vesicular rash eruption in the ophthalmic division of the trigeminal nerve (V1). Clinical diagnosis is obtained with V1-distributed dermatomal rashes after a prodromal period of ocular pain, chemosis, visual impairment, diplopia, and ptosis.1 Early recognition of this condition is important for timely medical management to prevent complications such as postherpetic neuralgia (PHN) and blindness.Acute bilateral ophthalmoparesis due to bacterial meningitis in the setting of sphenoid sinusitis
Ophthalmoparesis is characterized as inadequate ocular motility resulting in ocular misalignment causing binocular diplopia.1 This condition may arise from compromise at several possible sites: brainstem, cranial nerves, cavernous sinus, neuromuscular junction, or extraocular muscles.2 Acute isolated bacterial sphenoid sinusitis is an uncommon infection that rarely manifests with visual disturbances.3,4 We present a rare case of acute bilateral ophthalmoparesis in the setting of sphenoid sinusitis due to bacterial meningitis.Inadvertent corneal stromal staining by trypan blue following Descemet's membrane endothelial keratoplasty
Trypan blue is an azo dye solution that effectively stains basement membranes such as the anterior lens capsule and Descemet's membrane.1 In Descemet's membrane endothelial keratoplasty (DMEK), where the host Descemet's membrane and corneal endothelium are initially removed, trypan blue is used to stain the donor graft before injection to provide visibility during the unscrolling process in the anterior chamber. Trypan blue can also be injected after the descemetorrhexis and before graft injection to visualize any irregular tags or retained Descemet's membrane, both of which may increase the risk for graft detachment.
