bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of diabetic macular edema with micropulse laser therapy
Authors: El Matri K. , Chebbi Z. , Falfoul Y. , Kortli M. , Hassairi A. , Chebil A. , El Matri L.
Published: September 2017

Purpose

The aim of the present study is to investigate the effect of Micropulse Laser Therapy (MP) in the treatment of diabetic macular edema (DME).

Methods

Forty eyes from 25 patients with clinically significant DME were included in the study. We used MP as first‐line therapy in cases of diffuse DME if central macular thickness (CMT) was < 300 μm.

However, if DME was diffuse and CMT was >400 μm, we began anti‐VEGF therapy to reduce CMT and improve vision as quickly as possible.

We started with MP also in patients who refused intravitreal anti‐VEGF injections, whom compromised systemically or those for whom they are not effective.

Best corrected visual acuity (BCVA) and central macular thickness (CMT) were measured before, 3, 6 and 12 months after intervention, and the results were compared.

Results

Mean age of our patients was 60,1 years. Mean BCVA was 0.67 ± 0.37 Logmar before treatment.

After three months of MP, it improved to de 0.55 ± 0.4, p = 0.024. CMT was 511.79 μm, and improved to 481.8 μm (p: 0.055) at 3 month after treatment and to 410 μm at 6 months (p: 0.004) and 257.21 μm at 12 months (p = 0.002).

OCT detected early retinal reflectivity changes after treatment. All patients reported subjective improvement. No adverse events were observed during follow‐up

Conclusions

In this study, MP laser seems to be an effective laser to treat DME.

Its attractive safety profile allows clinicians to offer earlier treatment to prevent tissue damage and the development of visual disability.
Changes in retinal vessel diameters after intravitreal aflibercept in patients with diabetic macular edema
Authors: Blindbæk S.L. , Peto T. , Grauslund J.
Published: September 2017

Purpose

To evaluate changes in retinal vessel diameters after loading doses with intravitreal aflibercept in patients with diabetic macular edema (DME).

Methods

This was a three months prospective, interventional study. We included 17 patients with DME, central retinal thickness >300 μm and no active proliferative diabetic retinopathy. Previous treatment with any intravitreal vascular endothelial growth factor inhibitor was not allowed within 4 months prior to inclusion. All patients received 3 monthly intravitreal injections of aflibercept, and vessel diameters were evaluated at baseline and four weeks after the last injection. Retinal arterial and venous diameters were measured in 50‐degree disc‐centered images using the Oxymap model T1 (Oxymap, Reykjavik, Iceland) as the average diameter of the four major arterioles and venules from the four quadrants. Paired t‐test was used to test for differences in mean oxygen saturations from baseline to follow‐up.

Results

Median age and duration of diabetes were 59.5 and 2.6 years at baseline. Median HbA1c and CRT were 65 mmol/mol and 336 μm, respectively, and 23.5% were women. Venous diameter decreased from baseline to follow‐up (157.9 μm vs. 153.2 μm, p = 0.03), whereas arterial diameter was unchanged (115.4 μm vs. 116.1, p = 0.70).

Conclusions

Retinal venous diameter decreased after treatment with 3 monthly intravitreal injections of aflibercept in patients with DME, whereas no difference was found in the retinal arterial diameter. As previous studies have demonstrated that retinal venules dilate with increasing severity of diabetic retinopathy, our results suggest that treatment with intravitreal aflibercept causes positive changes to retinal vessel geometry.
OCT Angiography in angioid streaks without neovascular complications
Authors: El Matri K. , Falfoul Y. , Hassairi A. , Chebil A. , Ammari M. , El Matri L.
Published: September 2017

Purpose

To describe the features of angioid streaks (AS) without neovascular complications using swept source optical coherence tomography.

Methods

This is a retrospective observational study.

All patients underwent slit‐lamp and fundus examination, fundus photos, swept source optic coherence tomography (SS‐OCT) and OCT angiography (OCT‐A).

Comparisons were made between en face OCT and OCT‐A images.

Results

Seven eyes had AS without neovascular complications, foveola was involved by the streak in 3 eyes of them.

In en face OCT, we found hyper‐reflective points in 5 eyes in the deep plexus (DP), and in 2 eyes in the choriocapillaris (CC) giving a shadow in the level of the choriocapillaris in the corresponding OCT‐A.

In the outer retina (OR), Streaks were detectable in patients having macular involving AS as hyposignal in the OR and the CC.

Also, 5 eyes had CC diffuse rarefaction (CR) that seems more extensive than the masking from the hyper‐reflective material visible in the DP on en face‐OCT.

An irregular vascular network (IVN), different from choroidal neovascularisation (CNV), was detected in 3 eyes with AS involving the macula in the level of the OR and CC. This IVN fills spaces between streaks. On structural OCT, it corresponds to flat elevation of the retinal pigmentary epithelium (RPE) with hyper reflective accumulations between the RPE and the Bruch membrane (BM).

Conclusions

This imaging tool provides new information about AS.

We illustrate different findings including hyper reflective deposits, CR and IVN.

CR suggests early and severe involvement of all the CC.
Clinical significance of subretinal hyper‐reflective material in retinal angiomatous proliferation patients
Authors: Kim J.M. , Lee K.B. , Jung J.J. , Han J.I.
Published: September 2017

Purpose

To evaluate the association of subretinal hyper‐reflective material(SHRM) with visual acuity(VA) in Retinal angiomatous proliferation(RAP) patients treated with anti‐VEGF.

Methods

38 Patients(38 eyes) diagnosed with RAP were included in the study and retrospective chart review was done. Optical coherence tomography(OCT) and VA measurement was conducted at initial diagnosis, 6 months follow up and 12 months follow up. Measurement of SHRM height and width were obtained on each OCT image. Comparison of SHRM existence, height and width with VA was done.

Results

VA after anti‐VEGF treatment was associated with initial VA(p = 0.024) and existence of SHRM(p = 0.045) at baseline, while SHRM height and width were not statistically significant.

Conclusions

Existence of SHRM at baseline and initial VA in RAP patients could be a prediction factor of the final VA treated with anti‐VEGF.
Ocular manifestations associated with takayasu arteritis: a multimodal imaging study
Authors: Chotard G. , Diwo E. , Coscas F. , Saadoun D. , Domont F. , Le Hoang P. , Bodhagi B.
Published: September 2017

Purpose

The goal of this study was to describe ophtalmological features of Takayasu disease on fundus exam, in fluorescein angiography and OCT angiography.

Methods

All patients diagnosed with Takayasu disease and followed in la pitié salpétrière hospital from 2004 to 2016 were restrospectively included. They underwent a complete ophtalmological exam including best correct visual acuity, slit‐lamp biomicroscopy, fundoscopy and multimodality imaging including fluorescein angiography and SD OCT. Most patients underwent OCT angiography.The images were analyzed to evaluate perifoveal anastomotic capillary arcade disruption, capillary perifoveolar density, mivroaneurysms. The foveal avascular zone (FAZ) was measured for superficial (SCP) and deep (DCP) capillary plexus.

Results

26 eyes were included. Most frequent anomalies were retinal microaneurisms (6 patients). Stage I retinopathy was seen in 5 eyes; stage II in 10, stage III in 2 and stage IV in 3 eyes. 14 eyes underwent OCT Angiography. 11 eyes of 6 patients presented with ruptures of the perifoveal anastomotic capillary arcade in SCP. 5 eyes had microaneurysms. 11 eyes of 6 patients had rarefaction of the perifoveolar vascular density in SCP. The average measure of the SCP FAZ was increased to 0.34 mm2 (0.19–0.74) in takayasu patients compared to 0.27 mm2 (0.18–0.33) in the patients with no maculopathy.

Conclusions

Macular abnormalities are uncommon in patients with Takayasu disease as the retinopathy signs are most likely located in the peripheric retina. This study reveals that most of our patients present an enlargement of the FAZ, even in the earliest stages of retinopathy with no macular abnormality on fluorescein angiography. The study finally highlights the relevance of using OCT A to evaluate the macular ischemia as a complement to usual retina global study in fluorescein angiography.
Associations between individual retinal layer thicknesses and diabetic peripheral neuropathy using retinal layer segmentation analysis
Authors: Kim J.H. , Kim J. , Kim H.K. , Lee J. , Kim M. , Kim S.S.
Published: September 2017

Purpose

To evaluate clinical correlations between the thicknesses of individual retinal layers in the foveal area of diabetic patients and the presence of diabetic peripheral neuropathy (DPN).

Methods

This retrospective, observational cross‐sectional study enrolled a total of 120 eyes from 120 patients. The eyes were divided into three groups: normal controls (n = 42 eyes), patients with diabetes mellitus (DM)(n = 42 eyes) but no DPN, and DM patients with DPN (n = 36 eyes). The primary outcome measures were the thickness of all retinal layers in the central 1 mm zone measured by using the segmentation analysis of spectral domain optical coherence tomography (SD‐OCT). Correlations between the thicknesses of the individual retinal layers and the presence of DPN were also analyzed. Logistic regression analyses were used to determine which change of layer thickness had the most significant association with the presence of DPN.

Results

The mean thicknesses and the ratios of retinal nerve fiber layers (RNFLs) to total retina thicknesses in the DPN group were 10.77 ± 1.79 μm and 4.10 ± 0.55 percent (%), significantly lower than those in normal controls and the DM with no DPN group (p = 0.014 and p = 0.001, respectively). Logistic regression analyses also showed the decrease in thicknesses of the RNFLs and the INL are significant factors for predicting a higher risk for DPN development (odds ratio = 7.407 and 1.757; p < 0.001 and p = 0.001, respectively).

Conclusions

A decrease in the RNFL and the INL thickness was significantly associated with presence of DPN. Using SD‐OCT segmentation method, these structural changes could be used as a potential biomarker for early detection of DPN.
Efficacy and safety of primary posterior capsulotomy in combined phaco‐vitrectomy in patients with rhegmatogenous retinal detachment
Authors: Kim J.Y. , Shin Y.I. , Kang T.S.
Published: September 2017

Purpose

To evaluate the efficacy and safety of posterior capsulotomy by analyzing the visual outcomes in patients with rhegmatogenous retinal detachment (RRD), who underwent combined phaco‐vitrectomy.

Methods

A retrospective longitudinal cohort analysis was performed by using data of RRD patients undergoing combined phaco‐vitrectomy. Patients were divided into two groups; Group A (69 patients) with capsulotomy, and Group B (39 patients) without capsulotomy. We reviewed the best‐corrected visual acuity (BCVA), incidence of posterior capsule opacification (PCO), clinical features of RRD, and complications.

Results

The BCVA measured by the LogMAR at initial diagnosis was 0.67 in Group A versus 0.78 in Group B (p = 0.246). The BCVA of Group A was only significantly higher at 12 months (0.21 versus 0.28 [p = 0.013]) after surgery, respectively. In subgroup with macula‐on RRD, Group A exhibited better visual outcomes compared to Group B at 6 (0.17 versus 0.40 [p = 0.037]) and at 12 months (0.17 versus 0.40 [p = 0.030]). The incidence of PCO in Group B was higher than A (28.2% versus 5.8% (p = 0.000)). There were no complications associated with capsulotomy.

Conclusions

A primary posterior capsulotomy during combined phaco‐vitrectomy is the safe and effective procedure in patients with RRD for preventing postoperative PCO.
Microelectrode penetration of the wall of porcine retinal arterioles in vitro results in recordings from several cell types
Authors: Kudryavtseva O. , Aalkjaer C. , Bek T.
Published: September 2017

Purpose

A novel population of perivascular cells (PVC) is located immediately external to the vascular smooth muscle cells of retinal arterioles, express immunoreactivity to the pericyte marker NG2 and give rise to processes that extend into the retina. This suggests that PVCs could play a role in neurovascular coupling. However, the anatomical basis for the connection of PVC processes to the surrounding retina has not been characterized in detail. The aim of the present study was to establish a method for electrophysiological characterization of cells in the perivascular retina for the study of neurovascular coupling.

Methods

First order porcine retinal arterioles with preserved perivascular retinal tissue were mounted in a wire myograph. A glass microelectrode (WPI, USA) with a tip resistance of 30 ‐ 100 MOhm filled with 3M KCl solution was inserted into cells in the perivascular retina using an electronic micromanipulator. The microelectrode was connected to an amplifier (Electrometer 773 Duo, WPI, USA) and the intracellular membrane potential was recorded at resting conditions and after addition of 40mM KCl or solvent.

Results

Recordings from thirty perivascular retinal cells from eight arterioles showed membrane potentials ranging from ‐100 to ‐40 mV (mean ‐68± 3 mV). The most frequent membrane potential was ‐80 mV (30% of the cells). 40mM KCl produced a significant depolarization of the cells of 13 ± 3 mV (p=0.03, n=10), whereas solvent induced no significant change in the membrane potential (p=0.6, n=10).

Conclusions

Cells in the retinal arteriolar wall can be penetrated with microelectrodes for measurement of the membrane potential. The recordings suggest the existence of multiple cell types with distinct membrane potentials. The anatomical basis for these different cell types should be characterized further by intracellular dye injection.
Effect of AVS Retina in a rodent model of retinal ischemia‐reperfusion
Authors: Santonocito M. , La Rosa L.R. , Zappulla C. , Viola S. , Mazzone M.G. , Giuliano F.
Published: September 2017

Purpose

Anti‐VEGF agents currently available for the treatment of Diabetic Retinopathy and Wet Age‐Related Macular Degeneration do not possess a direct effect on inflammation. Our previous findings show that a nutritional supplement formula codenamed AVS is able to inhibit nitric oxide and prostaglandin E2 accumulation by modulating important pro‐inflammatory genes in vitro. Here, we set out to test whether AVS may exert a protective effect in a model of retinal ischemia/reperfusion (IR) damage in rat.

Methods

Brown Norway rats were subjected to retinal IR injury by rising intraocular pressure to 130 mmHg for 60 minutes. Animals were treated once daily by oral gavage with AVS or vehicle (VHC) starting five days before insult and until sacrifice 6 hours (T6 h) or 7 days (T7) after IR. Electroretinograms (ERG) were recorded in unconscious rats before IR (baseline), and then at T3 and T7. Total RNA was extracted from retinas at T6 h to assess the expression of tumor necrosis factor alpha (TNFa) mRNA by Real‐time RT‐PCR.

Results

Retinal ischemia in VHC and AVS groups produced a significant reduction of a‐ and b‐wave amplitudes at T3 when compared with baseline. Notably, a‐ and b‐wave amplitudes reduction observed at T7 in the VHC group was significantly inhibited (p≤0.05) by treatment with AVS. Moreover, the a‐ and b‐wave amplitudes in the AVS group were found not to differ from baseline (p>0.05) while being markedly suppressed in the VHC‐treated rats (p≤0.05). The expression of TNFa was strongly upregulated in the VHC group as assessed in retinas sampled at T6 h. Most importantly, treatment with AVS significantly reduced TNFa expression compared to VHC (p≤0.05).

Conclusions

AVS was found to reduce retinal damage caused by IR favoring its functional recovery possibly by a mechanism involving inhibition of early pro‐inflammatory mediators such as TNFa.
FluoroGold‐labeled organotypic retinal explant culture (FLOREC) for neurodegeneration and neurotoxicity screening studies
Authors: Ajeleti M.O. , Smedowski A. , Maniar R. , Pietrucha‐Dutczak M. , Matuszek I. , Lewin‐Kowalik J.
Published: September 2017

Purpose

To create a fast and reproducible system for retinal drugs toxicity screening.

Methods

In this study, we used retinal explants culture from 4 weeks old Wistar rats (n = 16). First, to determine the effect of FluoroGold (FG) on explants quality, we used 8 animals. FG was injected into midbrain of rats (n = 4) 5 days before euthanasia. Each retina after isolation was divided into 2 parts. In this way, we prepared 16 retinal explants with FG labeling and 16 explants without FG. Explants were cultured in supplemented Neurobasal A medium in Millicell culture inserts. After 7 days of culture, the explants were fixed, stained with ß3‐tubulin and processed for stereology. The culture medium was used to evaluate LDH release. The other group of 8 rats was processed in a similar way, but the culture medium was additionally supplemented with CNTF or toxic concentration of Gentamycin.

Results

We did not observe differences between FG and no‐FG explants for ß3‐tubulin‐positive cell count and LDH release after 7 days of culture. The number of ß3‐tubulin‐positive cells was similar to FG‐labelled cells (57 ± 23; 58 ± 17 cells respectively, p > 0.5). Gentamycin treatment resulted in retinal cell damage expressed in rapid LDH release to culture medium. After 7 days of culture, the levels of LDH in medium increased up to 157 ± 57% and 144 ± 27% when compared to the corresponding LDH levels before Gentamycin exposure in no‐FG (p < 0.05) and FG (p < 0.05) explants respectively. CNTF supplementation minimized the cell damage and the release of LDH was 106 ± 36% and 104 ± 23% when compared to the corresponding LDH levels before Gentamycin exposure in no‐FG (p > 0.5) and FG (p > 0.05) explants respectively.

Conclusions

The FLOREC protocol could be considered as a fast, reproducible and sensitive method to detect neurotoxicity and neuroprotection in the screening studies of the retinal drugs.
Bilateral tacrolimus‐associated optic neuropathy after kidney transplant
Authors: Bartolomé I. , Lopez Sangrós I. , Marco Monzón S. , Martinez Velez M. , Esteban Floria O. , Sanchez Marin J.I. , Idoate Domench A. , Berniolles Alcalde J. , Mateo Gabas J. , Ibañez Alperte J. , Ascaso Puyuelo F.J.
Published: September 2017

Purpose

Tacrolimus is an immunosuppressant drug which is often used after allogenic transplant to prevent organ rejection. It blocks T‐cell development and inhibits cytokine synthesis.

We report the case of a patient who developed bilateral optic neuropathy as a suspected complication of tacrolimus therapy.

Methods

A 75 year‐old man who underwent orthotopic kidney transplant in 2013 was treated with tacrolimus since that moment without toxic blood levels at any moment. He had a history of moderate hypertension but neither other atherosclerotic risk factors nor ophthalmological disease associated. He came to the Emergency department for the first time in 2015, when he noticed sudden blurred vision in his left. His best corrected visual acuity (BCVA) in his left eye was 20/30. Dilated fundus examination revealed hyperemia, haemorrhages and swelling of the disc with distended veins. Visual field analyser showed a superior altitudinal defect in the left eye. Complete blood count, erythrocyte sedimentation and C‐reactive protein were normal. He underwent oral treatment with prednisone 60 mg in descendent pattern. In the follow‐up the visual field worsened, with abolished visual field, BCVA was hand movement at one meter distance and a relative afferent pupillary defect in his right eye was demonstrated. Optic disc showed evidence of atrophy. The right eye examination was unremarkable.

Results

Two years later in 2017 the patient came back to the Emergency department complaining of severe painless visual loss in his left eye. Fundoscopy revealed an optic disc edema with splinter haemorrhages which was confirmed with the OCT where we could see a diffuse edema of the fibre layer.

Conclusions

We should be aware of ophthalmological symptoms in patients who have been receiving therapy with tacrolimus, even in the absence of toxic blood levels of that drug.
Nebivolol acts as a beta3‐adrenergic receptor agonist in a mouse model of oxygen‐induced retinopathy
Authors: Dal Monte M. , Amato R. , Locri F. , Cammalleri M.
Published: September 2017

Purpose

Nebivolol is a β1‐adrenergic receptor (AR) antagonist with vasodilatory properties. Nebivolol, but not the β1‐AR antagonist atenolol, has been found to ameliorate endothelial dysfunction. There is no clear evidence about the molecular target of the vasodilatory action of nebivolol, but several studies seem to indicate that the activation of β3‐ARs may mediate such vasodilation. In the present study, we evaluated the possible activity of nebivolol as β3‐AR agonist in a mouse model of oxygen‐induced retinopathy (OIR) using β1/β2‐AR knockout (KO) mice. These mice are quite resistant to retinal hypoxia, with reduced neovascularization in respect to their wild type (WT) controls.

Methods

The OIR model was established in KO and WT. Nebivolol was subcutaneously administered at 0.1, 1 or 10 mg/kg once daily between PD12 and PD16, before animal sacrifice at PD17. The effects of nebivolol on retinal neovascularization, VEGF levels and nitric oxide (NO) production were assessed by CD31 immunohistochemistry, real time RT‐PCR and ELISA, and the Griess method, respectively.

Results

In OIR, nebivolol minimally affected retinal neovascularization in WT while dose‐dependently induced pathologic angiogenesis in KO mice. In addition, nebivolol dose‐dependently increased VEGF levels in KO. The NO pathway was likely to be involved in the angiogenic effects of nebivolol.

Conclusions

The weak effects of nebivolol in the WT retina indicate that β1‐ and/or β2‐ARs play a pivotal role in retinal angiogenesis and that the angiogenic role of β3‐ARs may be unraveled only in the absence of the two other subtypes and when adequately stimulated. The present study indicates that nebivolol may stimulate β3‐ARs in the mouse retina suggesting this drug as a possible candidate as β3‐AR agonist.
Assessment of endothelial quality of pre‐stripped DMEK grafts prepared using the Muraine technique
Authors: He Z. , Thuret G. , Toubeau D. , Lefevre S. , Gain P. , Muraine M.
Published: September 2017

Purpose

To determine feasibility of shipping of the DMEK grafts that are pre‐stripped in eye bank using the Muraine technique.

Methods

Ten pairs of human corneas were stored in organ culture (OC) for 24±3 days. The mean age of donors was 72±20 years old. For each pair, one cornea was randomized for DMEK preparation using the Muraine technique (Muraine Moria trephine followed by manual dissection on the inverted cornea), the other served as control without dissection. The DMEK grafts of 8 mm in diameter were left attached to the center of the cornea, immersed in the OC medium (without dextran) and shipped to a distant center at room temperature. After 48 hours, the viable endothelial cell density (vECD) was measured with the help of viable cell staining using Calcein‐AM and Hoechst 33342 on entire surface of endothelium. Immunostaining on flat mounted endothelium was used to assess the endothelial pump function (Na+/K+ ATPase, COXIV), the apical (ZO‐1) and basolateral (CD166, N‐CAM) structures of CECs, the roughness of the cleavage between Descemet membrane (DM) and stroma (Collagen I) and the thickness of DMEK grafts.

Results

Before stripping, ECD (classical measurement using a transmitted light microscope) were 2430±175 and 2433±119 cells/mm2 (P=0.9647) in control and DMEK group. After stripping and shipping away, vECD were 2130± 350 and 2190±190 cells/mm2 (P=0.6355). Comparing to controls, no alteration in endothelial pump function, or in characteristic subcellular structures of CECs was noted in DMEK grafts. The thickness of DMEK grafts was 15±2 μm with a smooth cleavage plan.

Conclusions

The technique of Muraine is a good technique for the preparation of DMEK; DMEK grafts attached to the center of the cornea are suitable for long distance shipping.
Is corneal arcus an independent predictor of incident cardiovascular disease?
Authors: Wong M. , Man R. , Gupta P. , Lim S.H. , Lim B. , Sabanayagam C. , Cheng C.Y. , Wong T.Y.
Published: September 2017

Purpose

To examine the longitudinal relationship between baseline corneal arcus (CA) and incident CVD in ethnic Indian and Malay adults in Singapore.

Methods

This was a population‐based cohort study of Malays and Indians aged 40–80 years, with baseline and 6‐year follow‐up visits conducted between 2004–09 and 2010–15, respectively (follow‐up response rate 73.9%). Baseline CA was assessed by ophthalmologists using slit‐lamp biomicroscopy. The main outcome was self‐reported incident CVD, defined as myocardial infarction, angina pectoris or stroke. Multivariable logistic regression models assessed independent associations between baseline CA and incident CVD, adjusting for traditional CVD risk factors including age, gender, cholesterol (total, and HDL cholesterol), hypertension, diabetes and smoking status. We further conducted gender stratified analyses to identify possible effect modifications.

Results

Of the total 3637 participants (overall mean (SD) age; 56 years. (9), 46% male) with available follow‐up data and no baseline history of CVD, 208 (5.72%) incident CVD cases were reported. CA was found to be independently associated with incident CVD (odds ratio [95% confidence interval]: 1.52 [1.07–2.16]) in adjusted models. After gender stratification, associations between CA and incident CVD were found only in men (1.73 [1.12–2.67]) and not in women (1.05 [0.56–1.97]).

Conclusions

CA is associated with incident CVD, independent of traditional CVD risk factors, in ethnic Malay and Indian men. Our finding suggests that male persons with CA should be targeted for CVD risk reduction programs.
Corneal melting and perforation under topical moxifloxacin and tobramycin: case report
Authors: Caspers S. , Noël M. , Le A. , Janssens X. , Willermain F. , Caspers L.
Published: September 2017

Purpose

To describe a case of corneal melting with perforation after treating a corneal abscess with topical moxifloxacin + tobramycin for 2 weeks.

Methods

Retrospective case report.

Results

A 56 year old patient presented 5 weeks after a retinal surgery with a central corneal abscess. Topical tobramycin 0.3% + moxifloxacin 0.5% 1/h + desomedine 1% 8/days was initiated and tapered 3 days later to 1/h, 5/days and 5/days respectively. Four days later a large erosion (3.5 × 3.5 mm) appeared while the abscess had disappeared. Topical tobramycin 5/days and moxifloxacin 3/days were continued for 1 more week when the patient presented to our clinic with a large corneal melting (3 × 2 mm) in a clear cornea that perforated centrally (1 × 1 mm) the next day with Descemet folds, fibrin, anterior cells ++, and, dilated iris vessels and posterior synechiae. Both blood tests and medical history were otherwise unremarkable. Moxifloxacin and tobramycin were discontinued and replaced by preservative free ofloxacin 0.3%1/h tapered quickly, tropicamide 3/days, oral valaciclovir (3 g/day), oral levofloxacin 500 mg/days and therapeutic lens. All cultures for bacteria, virus, amoeba or fungi as well as PCR for HsV1, HsV2 and VZV from corneal smear remained negative. Systemic treatment was consequently stopped, cornea healed quickly and therapeutic lens could be removed after a 3 days. No recurrence has been observed for the next 2 months.

Conclusions

This case suggests that topical moxifloxacin (combined with tobramycin) may inhibit the healing of corneal ulcers and induce a corneal melting leading to perforation.
Analysis of changes in individual retinal layer thickness after cataract surgery using spectral‐domain optical coherence tomography
Authors: KWAK A.Y. , Park S.K. , Kim C.Y.
Published: September 2017

Purpose

To evaluate whether there were significant changes in macular thickness and each retinal layer thickness after cataract surgery using spectral‐domain optical coherence tomography (OCT)

Methods

From February to August 2015, a prospective study of 24 eyes of 14 patients, who underwent cataract surgery was conducted. The thickness of each retinal layer was measured with OCT before and one month after surgery. The changes in OCT signal strength and retinal thickness before and after surgery were compared, and the layers more affected were confirmed. Also, correlation analysis was performed to determine the relationship between changes in signal strength, severity of cataract, and changes in refractive index and retinal thickness.

Results

The mean macular thickness was significantly increased from 263.33 μm to 269.75 μm (p = 0.019). When examining the changes in each retinal layer thickness, there was a significant increase in the thickness of the inner plexiform layer (p = 0.034), outer nuclear layer (p = 0.015) and retinal pigment epithelium (RPE) (p = 0.012). The signal strength of OCT was significantly increased from 28.79 dB to 31.67 dB (p = 0.005), which was significantly correlated with postoperative macular thickness changes (p = 0.046). However, the severity of cataract (p = 0.219) or the change of refractive index (p = 0.098) was not significantly correlated with macular thickness changes.

Conclusions

After cataract surgery, both improvement of signal strength and structural changes of the retina may increase macular thickness. In particular, the thickness of the inner plexiform layer, outer nuclear layer, and retinal pigment epithelial layer increased. Therefore, the thickness of ganglion cell‐inner plexiform layer after cataract surgery may increase, so it should be carefully considered in the assessment of glaucoma progression.
Clinical characteristics of drug induced secondary bilateral acute angle‐closure glaucoma
Authors: Kim J.M. , Lee K.B. , Han J.I. , Jung J.J.
Published: September 2017

Purpose

To describe clinical manifestations, ultrasound biomicroscopy(UBM) findings and treatment outcome of drug induced secondary bilateral acute angle‐closure glaucoma.

Methods

A retrospective chart review of patients diagnosed with drug induced secondary bilateral acute angle‐closure glaucoma from May 2012 to February 2015, was performed.

Results

Seven female patients (14 eyes) were included in the study. 6 patients were taking appetite suppressant to lose weight. 1 patient was taking a cold medicine. The mean age was 30.3 ± 6.6 years old. All the patients complained of decreased visual acuity, and 2 of them complained of ocular pain and a headache, either. UBM revealed supraciliary choroidal effusion causing forward displacement of the lens‐iris diaphragm, which resulted in myopia (‐6.07 ± 2.5 diopter), anterior chamber shallowing, and increased intraocular pressure (31.6 ± 7.0 mmHg on the right eye, 31.86 ± 8.1 mmHg on the left eye by Goldmann applanation tonometer) by angle‐closure. Discontinuation of causative drugs and administration of pressure‐lowering agents led to the resolution of the symptoms. Symptoms improved 7.0 ± 3.9 days after initiation of the treatment, and supracilliary choroidal effusion subsided, which was confirmed by UBM findings. No patients required invasive treatment such as laser iridotomy, or developed glaucomatous optic neuropathy.

Conclusions

Drug induced secondary bilateral acute angle‐closure glaucoma is likely to respond very well to cessation of causative drugs and application of pressure lowering drugs. There were no patients who needed invasive treatment, or developed glaucomatous optic neuropathy.
High‐dose chemotherapy with autologus hematopoeitic stem cell transplantation in relapsing Vitreoretinal Lymphoma, a LOC network study
Authors: Bennedjai A. , Houiller C. , Choquet S. , Cassoux N. , Guesquières H. , Marolleau J.P. , Chabrot C. , Jdid I. , Lejeune C. , Bodaghi B. , Le Hoang P. , Hoang‐Xuan K. , Soussain C. , Touitou V.
Published: September 2017

Purpose

The management of isolated vitreoretinal lymphoma (VRL) remains controversial due to his rarity. The aim of this study was to evaluate the efficiency and safety of high‐dose chemotherapy with autologous hematopoietic stem cell transplantation (HCT‐ASCT) as a treatment of recurrent relapsing VRL.

Methods

We retrospectively studied medical records of patients included in the French LOC network database between 2011 and 2016 with isolated vitreoretinal relapse of either primary vitreoretinal lymphoma or oculocerebral lymphoma treated with HCT‐ASCT. Hematologic, neurologic and ophtalmologic datas were screened.

Results

32 patients (16 F/16 M), all immunocompetent, were included in the study. Median age at HCT‐ASCT was 62 (range 44–73 years). Median Karnofsky Performance status before HCT‐ASCT was 90. At diagnosis, 17/32 had primary vitreoretinous lymphoma (PVRL), 7/32 Primary Central Nervous Cells Lymphoma (PCNCL), 8/32 PVRL and PCNL. Patients had previously received a median number of 1 line of treatment including high‐dose methotrexate before HCT‐ASCT. All patients received a thiotepa‐based HCT. 81% of the patients experienced a complete response. 2 “toxic deaths” occurred. Mean follow‐up was 41.6 months (range: 5–96). 9/32 patients had recurrences. The 5‐years OS was 81%. The 5‐years OS was respectively 91% in the PRVRL groups, 85% in ocular and cerebral group and 64% in PCNCL group. The 5‐years PFS rate was 58%. The 5‐years PFS was respectively 66% in the PRVRL groups, 75% in ocular and cerebral group and 43% in PCNCL group. 4 deaths occurred overall.

Conclusions

Intensive chemotherapy followed by autologous stem cell transplant is an aggressive therapeutic approach but appears to give interesting results especially in young and fit patients with recurrent refractory vitreoretinal lymphoma.
Differential hypoxic response of human choroidal and retinal endothelial cells proposes tissue heterogeneity of ocular angiogenesis
Authors: Andre H. , Mammadzada P. , Gudmundsson J. , Kvanta A.
Published: September 2017

Purpose

To elaborate molecular differences between choroidal and retinal angiogenesis by generating and comparatively analyzing human primary choroidal and retinal endothelial cell (CEC and REC) lines.

Methods

Human CEC and REC were isolated by positive selection and cultured. Characterization was performed by immunostaining for endothelial cell (EC)‐specific markers. Total RNA and protein were extracted from normoxic or hypoxic CEC and REC cultures. qPCR arrays were used to comparatively analyze CEC and REC, and expression differences were calculated by ΔΔCt method. Angiogenesis‐related protein expression differences were investigated by western blot and proteome profiler, and were calculated by densitometry. Functional responses to hypoxia were analyzed by sprouting assay.

Results

Primary human CEC and REC lines stained positively for all EC markers and demonstrated high purity with similar staining and morphology. Under normoxia, CEC showed significantly lower expression levels for cell proliferation and vessel maturation genes and higher expression levels for inflammation‐related genes when compared to REC. In response to hypoxia, CEC and REC displayed differential regulation for a multitude of angiogenesis‐related genes and proteins. Furthermore, within the vascular endothelial growth factor (VEGF) family, CEC showed preferential upregulation for vascular endothelial growth factor A (VEGFA) while REC upregulated placenta growth factor (PlGF) levels. Sprouting was observed in normoxia, and was significantly by hypoxia.

Conclusions

Differential normoxic and hypoxic regulation of angiogenesis‐related factors by CEC and REC outlines tissue heterogeneity of ocular angiogenesis and suggests that tissue specificity should be considered as a novel treatment modality for successfully overcoming choroidal and retinal angiogenic conditions in the clinic.
Thickness mapping of individual retinal layers and sectors by Spectralis SD‐OCT in Autosomal Dominant Optic Atrophy
Authors: Corajevic N. , Larsen M. , Rönnbäck C.
Published: September 2017

Purpose

To assess layer‐ and location‐specific retinal thickness deficits in autosomal dominant optic atrophy (ADOA) on Spectralis SD‐OCT.

Methods

This cross‐sectional study included 41 ADOA patients with OPA1 exon 28 (2826delT) mutation (age, 8.6‐83.5 years; best‐corrected visual acuity (BCVA), 8‐89 ETDRS letters) and 55 mutation‐free first‐degree healthy control relatives (age, 8.9‐68.7 years; BCVA, 80‐99 ETRDS letters). Participants underwent routine examination and OCT with thickness analysis of the total retina, inner retinal layers and outer retinal layers. Individual segmentation was performed of the perifoveal retinal nervefiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer and peripapillary RNFL. Segmentation lines were moved manually to fit optimally with the borders between the layers. Combinations of layers and sectors were tested for their diagnostic significance. Statistical analysis was corrected for age, gender, spherical equivalent, axial length and family clustering in a mixed model analysis.

Results

The perifoveal RNFL, GCL, IPL and the peripapillary RNFL were all significantly thinner in ADOA patients than in healthy controls (p < 0.0001). No statistical difference was found for other layers. The largest deficit was found in the GCL (‐49.9%), and it reached its maximum in the “nasal inner macula” sector with a thickness deficit of ‐63%. Attenuation of the peripapillary RNFL was most prominent temporally to the optic disc (‐58.4%).

Conclusions

In ADOA, retinal ganglion cells are most prominently missing in the nasal perifoveal area of the GCL, which together with the temporal peripapillary RNFL area serves as the strongest diagnostic OCT marker of ADOA.
Swept‐Source OCTutilised to compare the choroidal thickness of the peripapillary area between patients with Parkinson′s disease and healthy subjects
Authors: Obis J. , Garcia‐Martin E. , Satue M. , Rodrigo M.J. , Cipres M. , Vilades E. , Orduna E.
Published: September 2017

Purpose

To evaluate and compare peripapillary choroidal thickness (PPCT) in patients with Parkinson′s disease (PD) and healthy subjects using swept‐source optical coherence tomography (SS‐OCT)

Methods

80 healthy subjects and 40 PD patients were examined using Deep Range Imaging (DRI) OCT Triton. An optic disc 6.0 × 6.0 mm three‐dimensional scan was obtained to measure choroidal thickness. Five concentrical choroidal zones were established and used to compare PPCT between PD patients and healthy subjects: zone 1 corresponded to the optic disc area (thus not measured by the OCT), zones 2 to 5 were progressively farther from the optic disc

Results

PPCT was significantly thicker in PD patients compared to healthy subjects in all the zones (p ≤ 0.0001): 126.89 ± 11.23 μm vs 96.53 ± 9.55 μm in zone 2; 152.75 ± 16.00 vs 121.39 ± 12.10 μm in zone 3; 190.21 ± 12.16 vs 156.69 ± 12.44 μm in zone 4; and 213.21 ± 11.83 vs 186.64 ± 9.47 μm in zone 5. A similar pattern of choroidal thickness was observed both in PD patients and healthy subjects; it was thicker in temporosuperior region, followed by superior, temporal, nasal and inferior regions

Conclusions

PD patients show an increased peripapillary choroidal thickness compared to healthy subjects in all zones. Peripapillary choroidal thickness shows a concentrical pattern both in PD patients and healthy subjects, with increasing thickness moving away from the optic disc. The new SS‐OCT could be useful to evaluate choroidal thickness, and it could be useful in clinical practice.
Choroidal changes in patients with multiple sclerosis
Authors: Rodrigo M.J. , Garcia‐Martin E. , Orduna E. , Obis J. , Cipres M. , Vilades E. , Satue M.
Published: September 2017

Purpose

To evaluate the peripapillar choroidal thickness in patients with multiple sclerosis (MS) and to compare it with age‐ and sex‐ matched healthy controls, using a swept‐source optic coherence tomography (SS‐OCT).

Methods

Fifty‐one right eyes of patients with MS and 102 right eyes of healthy controls were analyzed. A 6X6 mm choroidal cube was scanned using the SS‐OCT Triton device. This OCT showed 676 measurements that were later divided in four zones, from lower to higher choroidal thickness: the zone 1 corresponds to the optic nerve head (no choroidal measurements are given), the zone 2 corresponds to choroidal thickness between 120 and 179 microns, the zone 3 between 180 and 239 microns, and finally the zone 4 corresponds to a thickness higher to 240 microns.

Results

A similar concentric choroidal thickness pattern was observed in MS patients and healthy controls. The choroidal thickness was thicker in the superior region, followed by the temporal, nasal and inferior regions. The farther from the optic nerve, the thicker choroidal tissue was quantified. However, a statistically significant decreased of the peripapillary choroidal thickness in all the concentric zones was observed in patients with MS compared to healthy controls (134.02 ± 16.59 μm in MS group vs 171.56 ± 12.43 μm in the control group in zone 2; 182.23 ± 20.52 vs 219.03 ± 17.99 μm, respectively, in zone 3; and 223.52 ± 10.70 vs 259.99 ± 10.29 μm, respectively, in zone 4; p < 0.0001).

Conclusions

Patients with MS showed thinner peripapillar choroidal thickness compared to healthy controls. The SS‐OCT device could be useful equipment in clinical practice to evaluate the peripapillar choroidal tissue in such patients.
Comparative investigation of compression optic neuropathy of Grvaves orbitopahty (GO) as emergency orbital decompression
Authors: Tagami M. , Kusuhara S. , Azumi A.
Published: September 2017

Purpose

To investigate pre‐operative clinical feature of Compression optic neuropathy of Grvaves orbitopahty(GO), which had necessities of emergency surgery as orbital decompression.

Design

Retrospective,observational,case‐control study.

Methods

Setting single institution. Patient population: Sevanty‐two patients were performed orbital decompression as treatment of proptosis and compression optic neuropathy with GO. Observational procedures: the following were considered potential pre‐operative clinical factors for emergency orbital decompression: patients's sex, patients's age, Disease duration, laterality of GO, laterality of surgery, treatment history of resistance of steroid pulse therapy, thyroid function, visual acuity, existence of central diplopia, asymmetry of proptosis, psychological history,smoking. Main outcome: potential pre‐operative clinical factors for emergency orbital decompression

Results

Women,high age, long Disease duration, laterality of GO, laterality of surgery, treatment history of resistance of steroid pulse therapy, unstable thyroid function, poor visual acuity, existence of centraldiplopia significantly influenced necessities of emergency surgery as orbital decompression(p < .050). The other itmes did not significantly influence necessities of emergency surgery as orbital decompression(p > .050)

Conclusions

This study revealed potential pre‐operative clinical factors of Compression optic neuropathy of Grvaves orbitopahty(GO), which had necessities of emergency surgery as orbital decompression. This results will be helpful and deeply meaningful for physician, managing GO, planning additional surgical options
Clinical features of strabismus and nystagmus in bilateral congenital cataract
Authors: Lee S.J. , Sung Soo H. , Jung Min P.
Published: September 2017

Purpose

The prevalence and clinical features of strabismus and nystagmus, and the factors affecting onset of strabismus and nystagmus were evaluated in the patients with bilateral congenital cataract.

Methods

58 patients, 116 eyes who had lens removal for the treatment of bilateral congenital cataract between January 1999 and January 2011 were evaluated. According to the preoperative and postoperative ocular alignment, patients were divided into 3 groups (Orthotropia/Orthotropia, Orthotropia/Strabismus, and Strabismus/Strabismus). Age at cataract surgery, and associations of nystagmus and primary intraocular lens (IOL) implantation with strabismus were analyzed.

Results

6 patients (10.3%) had strabismus preoperatively and 11 patients (19.0%) developed postoperative strabismus. Thus, total 17 patients (29.3%) had strabismus postoperatively. Exotropia was more common than esotropia both preoperatively and postoperatively. 18 patients (31.0%) had nystagmus postoperatively and sensory nystagmus was the most common type. Of the 18 patients with nystagmus, 10 patients had strabismus and exotropia was more common than esotropia. When there was nystagmus, postoperative visual acuity was poor. In the ortho/strabismus group, age at cataract sugery was significantly younger and postoperative nystagmus was more common and the rate of no primaryIOLimplantation was higher than the other groups.

Conclusions

In patients with bilateral congenital cataracts, exotropia and sensory nystagmus may be common. Age at surgery was earlier, the rate of noIOLimplantation was higher and nystagmus was more common in postoperative strabismus onset group. And if there is nystagmus, poor visual prognosis may be seen. Therefore, careful observation should be needed in these patients.
Treatment with prism glasses for overcorrection after surgery for exotropia in children
Authors: Chang H.R.
Published: September 2017

Purpose

To determine the effect of prism glasses and factors affecting treatment in children wearing prism glasses for overcorrection after surgery for exotropia.

Methods

The medical records of 43 patients who wore prism glasses for overcorrection after exotropia surgery and were followed up more than 1 year were reviewed retrospectively. Patients with overcorrection after surgery for exotropia were treated with occlusion of one eye and correction of hyperopia, and the prism glasses were prescribed if esotropia persists. The strength of prism glasses was adjusted based on alignment. We evaluated the effect of prism glasses according to the starting age of prism glasses, type of surgery, refractive error, occlusion after wearing prism glasses and overcorrection of the strength of prism glasses.

Results

Twenty one patients (48.8%) took off prism glasses. Among 22 patients who still wear prism glasses, the strength of prism was decreasing in 10 patients, maintained in 8 patients and increased in 4 patients. Only 1 patient underwent surgery for consecutive esotropia. In patients who began to wear prism glasses under the age of 10, the rate of took off prism glasses or the rate of decreased in the strength of prism was higher than in patients who began to wear prism glasses aged 10 or older (p=0.007). All patients who underwent unilateral recession and resection took off prism glasses or decreased the strength of prism glasses (p=0.026).

Conclusions

Among 43 patients who needed prism glasses to treat overcorrection after exotropia surgery, 72% took off prism glasses or decreased the strength of prism glasses. Only 1 patient needed second surgery for consecutive esotropia. Treatment with prism glasses for overcorrection after exotropia surgery is very useful and can lower the frequency of second surgery.