bluuebunny/crossref_metadata_2025 huggingface dataset:
A Quantitative in vivo Study of Retinal Thickness before and after Laser Treatment for Macular Edema Due to Retinal Vein Occlusion
Authors: De Geronimo F. , Glacet-Bernard A. , Coscas G. , Soubrane G.
Published: January 2018

Purpose

To evaluate quantitatively the effect of grid laser photocoagulation in macular edema due to central and branch retinal vein occlusion, using the retinal thickness analyzer.

Methods

Five patients with cystoid and non-cystoid macular edema were studied before and after argon grid laser treatment. All were examined clinically, with fluorescein angiography, and measurement of retinal thickness. Macular thickness was correlated to visual acuity measured on the ETDRS chart.

Results

Laser-slit images obtained with the retinal thickness analyzer in patients with macular edema disclosed discrete intraretinal changes after photocoagulation. Biomicroscopy and fluorescein angiography were insensitive to these small changes in the retinal thickness. No patient had any change in visual acuity after three months, but the retinal thickness was greater at this interval. The retinal thickening may be explained by a postoperative inflammatory response or by altered retinal blood flow or, in two of the eyes, by the effect of combined peripheral photocoagulation.

Conclusions

The retinal thickness analyzer offers a refined tool for the diagnosis of sub-clinical changes of macular edema in retinal vein occlusion and is therefore also useful for assessing the effects of treatment.
Recurrences of Retinal Detachment after Vitreoretinal Surgery, and Surgical Approach
Authors: Kapran Z. , Uyar O.M. , Kaya V. , Eltutar K.
Published: January 2018

Purpose

To investigate the causes and management of recurrences of complicated retinal detachment after vitreoretinal surgery.

Methods

Vitreoretinal surgery was performed in 61 patients with complicated retinal detachment who were followed up for 4–24 (mean 7) months. Liquid perfluorocarbon (PFC) was used in all 61, silicone oil in 40 and perfluoropropane (C3F8) in 18 patients.

Results

Retinal attachment was achieved in 58 patients (95%) during the first operation. Due to the recurrence of detachment 17 patients (29%) had to be operated for a second, 7 (12%) a third and 4 (7%) a fourth time. Anterior and posterior proliferative vitreoretinopathy, missed tear, retinal incarceration, subretinal membrane and perisilicone proliferation were the factors causing redetachment.

Conclusions

The best anatomical and functional results are obtained by dissection of the anterior membranes. In order to properly remove the retinal periphery the crystalline or intraocular lens should be removed. Comparison of our results with others indicates that anatomical success depends, to a certain extent, on doing only one, radical operation on the pathology that leads to recurrence.
Delayed-Onset Postoperative Endophthalmitis Caused by Hafnia Alvei
Authors: Ruiz-Moreno J.Ma , Alió J.L. , De La Hoz F.
Published: January 2018

Purpose

To identify Hafnia alvei as an etiological factor of delayed-onset endophthalmitis.

Case Report

A 68-year-old woman had uneventful cataract extraction by phacoemulsification with foldable posterior chamber intraocular lens implantation under topical anesthesia in the left eye. Four weeks later, the patient presented anterior uveitis treated by topical corticosteroids. Seven weeks later a posterior uveitis with retinal vasculitis appeared. The patient was treated by systemic and intravitreal corticosteroids without result. Due to the poor course pars plana vitrectomy was done, and a vitreous sample was taken. Microbio-logic examination disclosed Hafnia alvei, gram-negative bacteria rarely isolated from human specimens.

Conclusions

Hafnia alvei should be considered in the etiology of delayed-onset endophthalmitis.
Neuroprotection as a Treatment for Glaucoma: Pharmacological and Immunological Approaches
Authors: Schwartz M.
Published: January 2018

Purpose

Primary open-angle glaucoma is a chronic, progressive optic neuropathy associated with a gradual decline in visual functions, which may lead to blindness.

Methods

In most cases, the optic neuropathy is associated with increased intraocular pressure. However, it is now generally accepted, that normalization of pressure, although necessary, is often not sufficient as a remedial measure. This is because of the existence of additional risk factors, some of which emerge as a consequence of the initial damage. This situation is reminiscent of the response to a traumatic axonal insult: some of the damage is immediate and is caused by the insult itself, while some is secondary and is caused by a deficiency of growth-supportive factors as well as by toxic factors derived from the damaged tissue. Accordingly, we have suggested that glaucoma may be viewed as a neurodegenerative disease and consequently is amenable to any therapeutic intervention applicable to these diseases.

Conclusions

There is evidence that neuroprotection can be achieved both pharmacologically and immunologically. Pharmacological intervention (e.g. by using selective alpha-2 adrenergic receptor agonists) neutralizes some of the effects of the nerve-derived toxic factors and possibly increases the ability of the remaining healthy neurons, at any given time, to cope with the stressful conditions. Immunological intervention boosts the body's own repair mechanisms for counteracting the toxicity of physiological compounds acting as stress signals.
Measuring Structural Changes in the Optic Nerve Head and Retinal Nerve Fibre Layer
Authors: Antón A.
Published: January 2018

Purpose

Assessing structural changes in the optic nerve is fundamental to the diagnosis and follow-up of glaucoma. Many clinical decisions are based on the determination of stability or non-stability of glaucomatous damage. Retinal nerve fibre layer (RNFL) and optic disc photographs are very useful in clinics but their assessment is based on subjective evaluation.

Methods

Confocal scanning laser ophthalmoscope and confocal scanning laser polarimetry are available and allow objective and quantitative analysis of the optic nerve. These instruments are currently being assessed for their use in glaucoma follow-up.

Conclusions

This article summarises their advantages and limitations in performing the difficult task of detecting progression or changes over time.
Increased Corneal Thickness in Active Behçet's Disease
Authors: Evereklioglu C. , Er H.
Published: January 2018

Purpose

To measure central corneal thickness (CCT) in patients with Behçet's disease (BD), particularly in the active disease.

Materials and Methods

We measured CCT by ultrasound pachymetry in 64 patients with Behçet's disease and in 20 healthy controls. Forty-one of the patients with BD had ocular involvement and 23 none; 19 of the 41 with ocular involvement were in an active period and 22 had inactive disease.

Results

The mean CCT in the group with active ocular involvement was significantly higher (589 ± 27 μm) than in the control group (553 ± 21 μm) (p = 0.003), the group with inactive ocular involvement (560 ± 26 μm) (p < 0.001), and the group with no ocular involvement (558 ± 25 μm) (p < 0.001). After appropriate treatment of patients with active ocular involvement, the mean CCT returned nearly to normal (563 ± 20 μm) and the difference from controls was not significant. There was no significant difference for the mean CCT between controls and the patients with no ocular involvement or with inactive ocular involvement.

Conclusions

Behçet's patients with active ocular involvement have a thicker CCT than patients with inactive ocular involvement. There was no difference in CCT between controls and patients with no ocular involvement. The CCT of patients with active ocular involvement returned to nearly normal after treatment. CCT must be taken into account when developing a managing and following approach for Behçet's patients with active ocular involvement.
Long-Term Evaluation of Endothelial Cell Loss after Phacoemulsification
Authors: Lesiewska-Junk H. , Kaluzny J. , Malukiewicz-Wisniewska G.
Published: January 2018

Purpose

To check whether three months' follow-up is sufficient to determine endothelial cell loss after cataract surgery and whether this value depends on preoperative central endothelial cell density.

Methods

A two-year prospective assessment of central endothelial cell density was done in 60 eyes after phacoemulsification. In 30 eyes a 3.5 mm corneal incision closed with a single crossed suture was made, and the other 30 had a 3.5 mm scleral tunnel no-stitch incision. Central endothelial cell density was measured before surgery and 1, 3, 6 months and 2 years after.

Results

The mean rate of endothelial cell loss even two years after surgery was significantly higher than the physiological rate, amounting to 0.9% per year. There was no correlation between preoperative central endothelial cell density and postoperative cell loss.

Conclusions

Even two years' follow-up is not sufficient to establish the total endothelial cell loss after cataract surgery. The amount of cell loss does not depend on the preoperative density.
Group II Phospholipase A2 Content of Tears in Patients with Senile Cataract and Primary Open-Angle Glaucoma
Authors: Aho V. V. , Nevalainen T.J. , Paavilainen V. , Saari K.M.
Published: January 2018

Purpose

To determine the group II phospholipase A2 (PLA2) content of tears in patients with senile cataract or primary open-angle glaucoma (POAG) and to compare it with the PLA2 content of tears in age-matched healthy controls.

Methods

The PLA2 concentration of tears was measured with time-resolved fluoroimmunoassay in 21 patients with senile cataract, 23 patients with POAG and in 40 healthy controls.

Results

The PLA2 content of tears was 38.3 ± 30.1 μg/ml in patients with senile cataract, 32.1 ± 22.3 μg/ml in patients with POAG, and 36.6 ± 31.1 μg/ml in healthy controls. There were no significant differences between the patient and the control groups.

Conclusions

We conclude that neither senile cataract nor POAG has any effect on the PLA2 content of tears.
Non-Penetrating Deep Sclerectomy in Unilateral Open-Angle Glaucoma Secondary to Idiopathic Dilated Episcleral Veins
Authors: Güven D. , Karakurt A. , Ziraman Í. , Hasirípí H.
Published: January 2018

Purpose

To investigate the efficacy of non-penetrating deep sclerectomy (NPDS) in a secondary open-angle glaucoma case due to dilated episcleral veins, on intraocular pressure and retrobulbar hemodynamics.

Methods

NPDS was done on a 32-year-old male unilateral open-angle glaucoma secondary to idiopathic dilated episcleral veins.

Results

Except for hyphema and shallow anterior chamber on the first post-operative day, no other complications were observed. Intraocular pressure was 18–20 mmHg during the first six months, without medication or visual loss. Retrobulbar color Doppler imaging showed normal mean and end-diastolic velocities and pulsatility indices of the posterior ciliary and central retinal arteries at end of the first post-operative year.

Conclusions

NPDS may be an alternative to trabeculectomy in open-angle glaucoma secondary to dilated episcleral veins.
Limbal-Conjunctival Autograft Transplantation for Recurrent Pterygium
Authors: Dekaris I. , Gabrić N. , Karaman Ž. , Mravičić I. , Kaštelan S.
Published: January 2018

Purpose

To assess the usefulness of limbal-conjunctival autograft transplantation (LCAT) for the treatment of recurrent pterygium.

Patients and Methods

Seventeen eyes with advanced recurrent pterygium underwent LCAT. All had already been treated at least twice either by simple excision (n=15) or by conjunctival rotation autograft (n=2). Three eyes (17.65%) had symblepharon at the time of surgery, so LCAT was combined with amniotic membrane transplantation. The autograft was taken from the supero-lateral part of the same eye and transferred to the area where the pterygium had been excised.

Results

During 6–18 months of follow-up no postoperative complications occurred. In 15 eyes (88.24%) no pterygium recurrence was recorded; recurrence occurred in two eyes (11.76%) after 8 and 5 months. In three eyes with a combined symblepharon formation, remission of both pterygium and symblepharon growth was obtained.

Conclusions

LCAT seems to be a promising and safe procedure for recurrent pterygium.
A Simplified Technique for Non-Penetrating Deep Sclerectomy
Authors: Kozlova T. , Zagórski Z.F. , Rakowska E.
Published: January 2018

Purpose

To present a modified technique for non-penetrating deep sclerotomy (NPDS) with limited use of sharp instruments.

Materials and Methods

A special fine spatula is used to separate the Descemet membrane from stromal tissue after preparing superficial and deep scleral flaps and opening the Schlemm's canal. Another specially designed spatula is used to protect the membrane when excising the overlying trabecular and stromal tissue. The other steps of the surgery are identical with the original Kozlov method. The modified surgery was performed by one surgeon experienced in NPDS, and three others starting their transition to this technique under the guidance of the first. Sixty-six patients (66 eyes) with primary open-angle glaucoma (51) or pseudo-exfoliature glaucoma (15) were treated with NPDS.

Results

Two microperforations (3%) of the Descemet membrane were the only intraoperative complications. They did not require iridotomy or any special treatment. In the early postoperative period one 2-mm hyphema was observed, and in five cases there was transient hypotony. In one other case there was a choroidal detachment, which resolved spontaneously in less than two weeks. IOP the day after surgery ranged from 5 to 13 mmHg (mean 9.6) and after one year from 10 to 22 mmHg (mean 14.6). Late complications and IOP control were similar to conventional NPDS.

Conclusions

These procedures performed by one experienced and three inexperienced surgeons gave satisfactory results and the modified method can be recommended for surgeons beginning nonpenetrating glaucoma surgery, and should shorten their learning curve.
Comparison of the Clinical Performance of Healon 5 and Healon in Phacoemulsification
Authors: Cavallini G.M. , Campi L. , Delvecchio G. , Lazzerini A. , Longanesi L.
Published: January 2018

Purpose

Healon 5 is a high-molecular-mass fraction of sodium hyaluronate. Its density endows it with a number of viscoelastic characteristics. In this prospective, randomised clinical study we compared the performance of Healon 5 and Healon in phacoemulsification. SETTING. Institute of Ophthalmology, University of Modena and Reggio Emilia, Italy.

Methods

Two groups of patients underwent phacoemulsification and intraocular lens (IOL) implantation. In the first 27 patients Healon 5 was used as viscoelastic substance during surgery, and in the second 27 Healon was used. The surgeons subjective comments on the performance of these viscoelastic agents were recorded at the different steps of surgery: injection, capsulorhexis, phacoemulsification, IOL implantation, removal of viscoelastic agent and trasparency throughout the operation. The surgeon's overall impression of the viscoelastics during the whole operation was noted. Tonometry and endothelial cell count were performed in all patients before and after operation.

Results

There was no statistical difference between the two groups as regards visual acuity, ocular pressure and endothelial damage. Healon 5 showed excellent ability to maintain the anterior chamber during capsulorhexis, phacoemulsification and IOL implantation. Removal time with Healon 5 was not appreciably longer than Healon.

Conclusions

Healon 5 emerges as a very interesting viscoelastic substance. Visibility is better if the anterior chamber is filled completely. Removal is easier if it is aspirated while moving the irrigation aspiration tip with circular movements over the top and around the border of the IOL.
Posterior Capsular Opacification in Pseudophakic Eyes with a Silicone or Acrylic Intraocular Lens
Authors: Pohjalainen T. , Vesti E. , Uusitalo R.J. , Laatikainen L.
Published: January 2018

Purpose

To compare posterior capsular opacification in eyes with IOL of two different materials - silicone or acrylic.

Methods

Eighty consecutive eyes undergoing cataract surgery were prospectively randomized in two groups, 40 eyes receiving a silicone (SI – 30NB) and 40 eyes an acrylic (Acrysof MA60BM) intraocular lens (IOL). The same surgeon performed phacoemulsification and the intraocular lens (PHACO IOL) operation in all cases. Patients were re-examined on the first postoperative day, after one week, four months, and 1–2.4 years. Seven eyes were lost to late control.

Results

Clinically significant posterior capsular opacification (PCO) (including eyes with capsulotomy already performed) was equally common in both groups; 25% in the silicone group and 19% in the acrylic group (p=0.53). The posterior capsule remained clear in 61% of the silicone and 76% of the acrylic IOL eyes (p=0.18). In the whole study group, 29% of eyes with and 14% without concurrent ocular diseases had significant PCO (p=0.13). In the silicone IOL group, PCO was more common in eyes with concurrent ocular diseases (44%) than eyes without other diseases (10%) (p=0.049). Eyes with acrylic IOL showed no difference in significant PCO, with or without other diseases (18% and 20%, respectively).

Conclusions

In a consecutive series of 80 cataract eyes central PCO was equally common in eyes receiving a silicone or an acrylic IOL. In the silicone IOL group, however, significant PCO was more common if there was concurrent ocular disease, while with the acrylic IOL concurrent ocular disease did not seem to increase the risk of PCO.
Epidemic Endophthalmitis after Cataract Surgery
Authors: Ernest J. , Rejmont L. , Němec P.
Published: January 2018

Purpose

We analyzed the results of pars plana vitrectomy in group of patients with a view to establishing risk factors, optimal therapy, surgical technique and the best timing of the pars plana vitrectomy.

Methods

Eight patients presented features of bacterial endophthalmitis within two days of cataract extraction. We examined the relations between visual outcome and the identity of infecting species, optimal therapy, surgical technique and vitrectomy timing.

Results

Pseudomonas aeruginosa was a pathogenic microbe. Unfortunately the source of infection was not found. The long-term (9–12 months) results are not good. Final visual acuity of all eight patients oscillated between 20/200 and no light perception. Three patients were first treated with intravitreal ATB application and vitrectomy followed with 36 hours lateney. Their final VA was no light perception in two patients and hand motion in one. The outcome was better in five patients operated immediately after the onset of endophthalmitis. Final visual acuity in this group was between hand motion and 20/200.

Conclusions

Visual prognosis in cases of endophthalmitis is closely related to the type of infecting organism, the visual acuity at presentation, and the speed of progression of inflammatory signs. The need for prompt vitrectomy as the only chance of retaining at least basic visual functions is fully demonstrated.
Eye Health Care in Hungary
Authors: Németh J. , Molnár F. , Kocur I.
Published: January 2018

Purpose

To describe eye health-care services provided by in patient Departments of Ophthalmology in Hungary as of 1998.

Methods

A standardised questionnaire was sent to all Hungarian in-patient ophthalmic departments. The response rate was 100%, and data from six university departments and 56 hospitals with ophthalmic units are summarised.

Results

During the 12-month period, a total of 78,008 ophthalmic operations were performed, by 489 ophthalmologists. They worked in 62 in-patient ophthalmic units having a total of 1952 beds. The cataract rate was 3564 operations per million inhabitants; intraocular lens implantation was performed on 97% of the cases. There were 591 corneal transplants, 1698 operations for retinal detachment and 510 vitrectomies for diabetic eye complications.

Conclusions

The level of ophthalmic care in Hungary, judged on the basis of key objective parameters including number of ophthalmic specialists, number of ophthalmic beds, and the rates of surgery, generally conforms to standards prevailing in Western Europe, in spite of financial difficulties and the consequent lack of investment in new equipment and instruments, both major and minor.
Ocular Complications Associated with Brucellosis in an Endemic Area
Authors: Güngör K. , Bekir N.A. , Namiduru M.
Published: January 2018

Purpose

To report the ocular manifestations associated with brucellosis in an endemic area.

Methods

We prospectively evaluated 147 patients with the diagnosis of brucellosis between May 1996 to May 2000 and recorded the ocular and systemic findings. The diagnosis was based on clinical findings, positive serological and bacteriological tests (Brucella agglutination test: over 1/160 titer, blood culture).

Results

Thirty-eight patients (26.0%) with brucellosis had ocular complications: conjunctivitis in 26 (17.7%), anterior uveitis in six (4.1%), posterior uveitis in one (0.7%), dacryoadenitis in two (1.4%), episcleritis in three (2.1%). Three of the seven patients with uveitis had spondylitis associated with brucellosis. Osteoarticular complications in brucellosis were more frequent in the patients with ocular involvement though the difference was not statistically significant compared with patients without ocular involvement.

Conclusions

Ocular manifestations are frequent in brucellosis so an ophthalmologic examination should be routinely performed in patients with brucellosis in endemic areas.
Divergence Insufficiency and Demyelinating Disorder
Authors: Reche Sainz J.A. , Espinet Badia R. , Puig Ganau T.
Published: January 2018

Purpose

To describe a divergence insufficiency in a young woman.

Methods

Case report.

Results

A 38-year-old woman presented with a episode of homonymus horizontal diplopia at distance. She was orthophoric at near but had esotropia at distance. Neurological evaluation was normal but multiple demyelinating lesions were shown in the magnetic resonance scan, with increased intrathecal Ig G production. Double vision improved after corticosteroid mega-doses.

Conclusions

An acute onset of diplopia due to divergence insufficiency in a young adult may be associated with a demyelinating disorder.
Abnormalities of Orbital Volume
Authors: Adenis J.P. , Robert P.Y. , Boncoeur-Martel M.P.
Published: January 2018

New information on the physiopathology and treatment of orbital volumes pathologies is described:

1) In post-enucleation or evisceration socket syndrome placing of synthetic material (HA-TCP) directly in the intraconal orbital fat can correct most of the symptoms. However the best approach is to prevent orbital volume deficiencies during first surgery using an implant large enough to allow a future prosthesis of a volume less than 2 ml. New procedures for placing the implant after enucleation or evisceration are described.

2) In proptosis related to Graves' orbitopathy relative indications are given for orbital decompression by removal of fat or bone.
Fluorescein Dye Disappearance Test in Patients with Different Degrees of Epiphora
Authors: Toprak A.B. , Erkin E.F. , Kayikçioğlu Ö. , Seymenoğlu G. , Güler C. , Unlu H.H.
Published: January 2018

Purpose

To assess the diagnostic efficacy of a modification of the fluorescein dye disappearance test (DDT) in patients with different degrees of epiphora.

Methods

DDT was performed by instilling a drop of 2% fluorescein in the eye. Schirmer tear test strips were placed in the lower conjunctival fornix, after 3 and 10 minutes. The colour dilution on the strips was compared to a scale with known standards and the most closely comparable colour dilution was chosen and recorded as the visual scale test (VST) grade of the strip. The grey-scale value (GV) of each strip was calculated by computer image analysis. The control group comprised 44 patients, mean age 44.8 years (SD 7.5, range 30–60). There were 13 patients in group 1 with moderate epiphora; mean age was 44.2 years (SD 9.5, range 30–60). There were 17 patients in group 2 with severe epiphora; mean age was 48.3 years (SD 7.7, range 37– 60).

Results

VST and GV differed significantly between controls and group 1 patients at 3 minutes (p=0.002, p=0.001), and between controls and group 2 patients at 3 minutes (p<0.001, p<0.001). There was no difference between groups 1 and 2 patients in VST and GV at 3 minutes. The differences were highly significant between controls and group 1 at 10 minutes (p=0.001, p=0.007), and between controls and group 2 at 10 minutes (p<0.001, p<0.001). The differences in GV and VST between groups 1 and 2 were significant at 10 minutes (p=0.026, p=0.018).

Conclusions

This modified DDT permits identification of different degrees of epiphora in a non-invasive manner, it can therefore be used to evaluate the outcome of different treatment strategies.
Posterior Capsule Opacification and Nd:YAG Capsulotomy Rates after Implantation of Silicone, Hydrogel and Soft Acrylic Intraocular Lenses: A Two-year follow-up Study
Authors: Beltrame G. , Salvetat M.L. , Chizzolini M. , Driussi G.B. , Busatto P. , Di Giorgio G. , Barosco F.
Published: January 2018

Purpose

To compare the posterior capsule opacification (PCO) and neodymium:YAG (Nd:YAG) laser posterior capsulotomy rates associated with three different posterior chamber foldable intraocular lenses (IOL).

Methods

We retrospectively evaluated the rates of PCO and Nd:YAG laser capsulotomy in 1150 eyes two years after standard phacoemulsification with a no-stitch 3.5mm clear corneal incision (CCI) and in-the-bag implantation of one of three types of IOL: 190 eyes received a one-piece round-edged hydrogel IOL (Hydroview H60M, Bausch & Lomb); 475 eyes a three-piece round-edged silicone IOL (AMO PhacoFlex SI-40NB, Allergan); 485 eyes a three-piece square-edged soft acrylic lens (AcrySof MA60MA, Alcon).

Results

The PCO and Nd:YAG laser capsulotomy rates were respectively 43.15% and 20.5% in the Hydroview H6OM group, 27.57% and 9.68% in the AMO PhacoFlex SI-4ONB group, 10.5% and 2.47% in the AcrySof MA6OMA group.

Conclusions

PCO and Nd:YAG laser capsulotomy rates were significantly higher in the Hydroview H6OM group and significantly lower with the AcrySof MA6OMA lenses, which combine a bioactive constitutive material with the square-edged optic design.
Posterior Segment Involvement in Ocular Behçet's Disease
Authors: Özdal P.Ç. , Ortaç S. , Taşkintuna I. , Firat E.
Published: January 2018

Purpose

Posterior segment involvement, which can lead to blindness with recurrent inflammatory attacks, has a very important prognostic value in ocular Behçet's disease (BD). This study evaluated the frequency and characteristics of posterior segment involvement and the causes of visual impairment in patients with ocular BD.

Methods

We retrospectively evaluated 257 eyes of the 131 patients who were followed from 1993 to 2001 in the Uveitis and BD division of SSK Ankara Eye Hospital, Turkey.

Results

The mean follow-up was 49.2 ± 27.4 months. Thirty-one of the paients were female (23.6%) and 100 male (76.4%). The mean age was 25.1±7.9. Fundus changes were observed in 213 (82.9%) eyes and were bilateral in 87%, and vitritis was present in 239 (93%) eyes. The most frequent fundus changes were vascular sheathing in 61 eyes (23.7%), optic atrophy in 46 (17.9%), macular edema in 29 (11.3%), retinal hemorrhage in 23 (9%), macular scar in 21 (8.2%), optic disc paleness in 19 (7.4%), retinal edema in 17 (6.6%), branch retinal vein occlusion in 15 (5.8%). The most common fluorescein angiography findings were diffuse vascular leakage in 98 (38%), hyperfluorescence of the optic disc in 38 (14.8%) and hyperfluorescence of the macula in 29 eyes (11.3%). Visual acuity was <1/10 in 85 (33%) of the eyes. Optic atrophy was the main cause (54.1%) of permanent visual impairment.

Conclusions

Posterior segment involvement is the most serious ocular complication of BD, leading to blindness with recurrent attacks. Following patients closely, performing fluorescein angiography in all patients diagnosed as BD even they have no clinical ocular involvement, and early treatment are very important in the prognosis of the disease.
Escherichia Coli Endophthalmitis after Trans-Scleral Resection of Uveal Melanoma
Authors: Balestrazzi A. , Blasi M.A. , Primitivo S. , Balestrazzi E.
Published: January 2018

Purpose

To report a case of Escherichia coli endophthalmitis after trans-scleral resection of an uveal melanoma.

Methods

A large ciliary body melanoma was treated by trans-scleral resection and full-thickness sclerectomy because of epibulbar tumor extrusion, followed by adjuvant ruthenium plaque therapy.

Results

Two months after treatment the patient developed wound dehiscence and consecutive endophthalmitis. Cultures of the involved sclera yielded Escherichia coli. The infection resolved after systemic intravenous ciprofloxacin and ceftriaxone, with aggressive topical ciprofloxacin and tobramycin. Final visual acuity was light perception.

Conclusions

We assume that the ruthenium plaque placed over the scleral patch was responsible for the delay in scleral healing, with consequent wound dehiscence and E. coli endophthalmitis.
Expression of Sox9 and Type IIA Procollagen during Ocular Development and Aging in Transgenic Del1 Mice with a Mutation in the Type II Collagen Gene
Authors: Ihanamäki T. , Säämänen A.-M. , Suominen J. , Pelliniemi L.J. , Harley V. , Vuorio E. , Salminen H.
Published: January 2018

Purpose

To study the expression and distribution of transcription factor Sox9 and type IIA procollagen in the developing and aging eyes of normal and transgenic Del1 mice carrying proa1(II) collagen transgenes with a short deletion mutation, which cause ocular abnormalities in this mouse line.

Methods

The eyes of Del1 mice were studied on embryonic days E14.5, E16.5 and E18.5, and at the ages of 4 and nine months, using their nontransgenic littermates as controls. Sox9 and proa1(IIA) collagen were detected by RNase protection assay and immunohistochemistry.

Results

RNase protection assay revealed Sox9 transcripts in the eyes of Del1 and control mice during development and aging. The mRNA for type IIA procollagen had a similar temporal expression pattern. On embryonic days E14.5, E16.5 and E18.5, Sox9 was located by immunohistochemistry in the nuclei and type IIA procollagen in the extracellular space of the developing retina. During growth and aging, the ocular expression of Sox9 mRNA and the immunohistochemical reaction for Sox9 antibody diminished, concomitant with the reduction in type II procollagen mRNA. However, at the age of nine months, levels of Sox9 and type IIA procollagen mRNAs were higher in the degenerating eyes of Del1 and control mice.

Conclusions

The similarities in the temporo-spatial distribution of Sox9 and type IIA procollagen suggest that this transcription factor is involved in the activation of type II collagen expression in the eye, as has been demonstrated in prechondrogenic mesenchyme and immature cartilage. The increased production of Sox9 and type IIA procollagen in the aging retina and vitreous is analogous to degenerating articular cartilage where attempted tissue repair has also been observed.
Macular Thickness Measured by Optical Coherence Tomography (OCT) in Diabetic Patients
Authors: Lattanzio R. , Brancato R. , Pierro L. , Bandello F. , Iaccheri B. , Fiore T. , Maestranzi G.
Published: January 2018

Purpose

1) To compare macular thickness (MT) by optical coherence tomography (OCT) in diabetics and controls; 2) to assess the relationship between MT and stage of diabetic retinopathy (DR) and macular edema (ME); 3) to quantify MT changes after laser treatment for ME.

Methods

One-hundred and thirty-seven patients with diabetes mellitus (216 eyes) were admitted to the study and examined by stereo-color fundus photos, retinal fluorangiography and OCT. DR was classified as: 1) no DR (46 eyes: 21.3%); 2) background DR (66 eyes: 30.6%); 3) pre-proliferative DR (50 eyes: 23.1%); 4) proliferative DR (54 eyes: 25%). The study group was then divided into three ME groups: 1) no edema (65 eyes: 30.1%); 2) not clinically significant ME (no CSME) (45 eyes: 20.8%); 3) clinically significant macular edema (CSME) (106 eyes: 49.1%). Three-month follow-up tomograms were taken to evaluate eyes laser-treated only for ME. The control group consisted of 50 eyes of 50 non-diabetic, age- and sex-matched subjects.

Results

MT was 369.3±163.2 μm in diabetics and 161.9±12.9 μm in controls (p<0.001). In the four DR groups it was: 1) 211.0±37.6 μm; 2) 370.8±159.6 μm; 3) 419.1±138.2 μm; 4) 456.1±162.0 μm (p<0.001). In the three ME groups, MT was: 1) 227.8±53.4 μm; 2) 321.8±124.2 μm; 3) 476.2±146.6 μm (p<0.001). In the 52 eyes treated with laser photocoagulation of the posterior pole only and with a follow-up > 3 months, MT before and after treatment was 468.2±83. 17 μm and 372.1±120.63 μm.

Conclusions

MT was greater in diabetics than controls and tended to increase with DR and ME severity. OCT is a sensitive technique for detecting early diabetic macular abnormalities and quantifying their reduction after laser treatment.
Our Experience with Perfluorohexyloctane (F6H8) as a Temporary Endotamponade in Vitreoretinal Surgery
Authors: Stefaniotou M.I. , Aspiotis M.V. , Kitsos G.D. , Kalogeropoulos CHR.D. , Asproudis I.C. , Psilas K.G.
Published: January 2018

Purpose

To evaluate the use of F6H8 as a temporary endotamponade for complicated and special cases of retinal detachment instead of silicone oil.

Methods

We have used F6H8 with 14 patients since February 1999. Eight suffered from rhegmatogenous retinal detachment (RRD) with multiple tears located inferiorly. Three presented inferior traction retinal detachment (TRD) under silicone oil, two suffered from ocular trauma with inferior TRD, and one had idiopathic macular hole. The substance was introduced into the eye after pars plana vitrectomy and membrane peeling if needed, and we tried to introduce as much as possible.

Results

With F6H8 the retina was easily reattached in all cases, like with perfluorocarbon liquids. The postoperative view was very good. F6H8 was removed in all cases after 3–8 weeks. Anatomical success was achieved in 12 out of 14 eyes. Two eyes presented severe PVR. F6H8 entered the anterior chamber in 4 cases, but no corneal complications occurred. In one case there was a marked IOP rise due to an anterior block, treated with superior iridotomy. In two cases retinal detachment (RD) occurred in the upper part and was treated with additional surgery, F6H8 removal and silicone oil injection.

Conclusions

F6H8 seems to be a promising tamponade agent for special cases of RD.
Outcomes of Surgical (Pars Plicata and Limbal Lensectomy, Vitrectomy) and Non-surgical Management of Persistent Fetal Vasculature (PFV): An Analysis of 54 Eyes
Authors: Soheilian M. , Vistamehr S. , Rahmani B. , Ahmadieh H. , Azarmina M. , Mashayekhi A. , Sajjadi H. , Dehghan M.H.
Published: January 2018

Purpose

To identify clinical characteristics associated with outcomes of treatment for persistent fetal vasculature (PFV) based on a modified classification.

Methods

In this noncomparative case series, 54 eyes of 47 consecutive patients with PFV managed from 1981 until 1998 at a tertiary eye hospital were reviewed. Pars plicata lensectomy and vitrectomy was performed in 34 eyes and translimbal lensectomy and vitrectomy in five. Fifteen eyes were managed non-surgically. The following outcomes were measured: 1) “Visual improvement”, defined as at least one Zipf's category improvement of best corrected final vision as compared with initial visual acuity, provided that final vision of CSUM (central, steady, unmaintained) equal to 20/100–20/30 was obtained. 2) “Cosmetic acceptability”, defined as the absence of the following: small orbit, externally small appearing eye with microcornea and hypotony, eye deviation more than 35 prism diopters without strabismus surgery and corneal opacity.

Results

Six eyes were inoperable. In 10 out of 33 operated eyes (30.3%) improvement of vision was obtained including four eyes with an anterior form and six eyes with a combined form of PFV. In univariate analysis, factors such as anterior form of PFV, surgery in the combined form and having a normal retina, had a weak association with a higher chance of visual improvement. In multivariate regression analysis the likelihood of unacceptable cosmetic appearance was higher in females than males (OR = 10.5), and in bilateral cases (OR = 7.9). Offspring of consanguineous marriages had more severe forms of PFV.

Conclusions

Although visual potential is limited in PFV, some eyes with an anterior or combined form and normal retina achieved improvement of visual acuity after surgery. However, statistically no single factor except sex and bilateral PFV (for cosmetic unacceptability) reliably predicted the results of treatment. Therapy should be individualized based on clinical findings. Genetic studies in offspring of consanguineous marriages with PFV may prove informative.
Ladies with Leber's Hereditary Optic Neuropathy: An Atypical Disease
Authors: Dandekar S.S. , Graham E.M. , Plant G.T.
Published: January 2018

Purpose

Leber's Hereditary Optic Neuropathy (LHON) is considered to be a disease predominantly affecting young males. The risk of women becoming symptomatic if they are carriers of a primary mutation is 1/5 of that in males. The disease however appears to behave differently in women in some instances. We describe three cases of ladies with LHON and discuss the importance of making the diagnosis.

Case Reports

A 28-year-old female presented with blurring of vision in her left eye with bilateral small hyperemic discs and telangiectatic vessels adjacent to them. DNA analysis confirmed the 11778 mutation and the second eye remains unaffected 10 years later. The second case was 49 years old and presented with bilateral visual loss developing over 3 months. She had no family history of visual loss but had a past history of Wolf Parkinson White syndrome and 3460 mutation was confirmed. The last case was diagnosed with multiple sclerosis at age 24 and went on to develop visual loss with poor recovery. DNA analysis demonstrated the 11778 mutation and confirmed LHON.

Conclusions

All three cases, although not unique, posed considerable diagnostic difficulties over a long period of time. The authors have highlighted important associations of the disease and stress the importance of making the diagnosis in women. They are at increased risk of having affected children, unlike the affected males, especially if they are affected themselves and may wish to seek further genetic advice.
Retinal Vein Occlusion in Lymphomatoid Papulosis
Authors: Ramaesh K. , Monaghan H. , Kemmett D. , Gairns S. , Dhillon B.
Published: January 2018

Purpose

To describe an unusual patient who presented with hemi-retinal vein occlusion and lymphomatoid papulosis (LyP).

Methods

Clinicopathological case study.

Results

A 42 year old female patient presented with blurring of vision in her left eye and a nodular eruption of the skin involving arms, face and torso. She also complained of a non-itchy, blotchy rash on the arms, face and torso lasting for period of three months. Ocular examination showed a left superior hemi-retinal vein occlusion. The nodules resolved spontaneously over a period of two-three weeks leaving a faint scar. Hematological and systemic evaluation for auto-immune disorders, hypercoagulability, systemic malignancy and lymphoma were negative. A biopsy of the skin nodule was performed which showed infiltration of lymphoid blast cells which were CD30 positive. Based on the clinicopathological features a diagnosis of lymphomatoid papulosis (LyP) was made.

Conclusions

Clinical and pathological features of this patient may suggest the retinal vein occlusion may be secondary to LyP.
Ipsilateral Orbital Cavernous Hemangioma and Choroidal Hemangioma
Authors: Kiratli H.
Published: January 2018

Purpose

A unique case of simultaneous ipsilateral choroidal and orbital hemangiomas is described.

Methods

A 71-year-old man was found to have a left orbital intraconal mass while being worked up for intractable headache. He also had a left juxtapapillary choriodal hemangioma which did not cause any leakage to macular area.

Results

The left intraconal tumor was removed by medial transconjunctival orbitotomy. Histopathological examination revealed cavernous hemangioma. The ipsilateral choroidal hemangioma was managed by observation only. During 15 months of follow-up, there has been no growth or accumulation of subretinal fluid.

Conclusions

The occurrence of orbital cavernous and choroidal hemangiomas on the same side suggests common pathogenic derangement acting on two different sites.
New Findings in the Parry-Romberg Syndrome: A Case Report
Authors: Bandello F. , Rosa N. , Ghisolfi F. , Sebastiani A.
Published: January 2018

Purpose

To describe further findings in the Parry-Romberg syndrome that might contribute towards a better understanding of the disease.

Design

Case report.

Methods

The clinical history of a patient with the Parry-Romberg syndrome was studied, and fluorangiography and echography were carried out.

Results

Clinical observation revealed classic hemifacial atrophy; fluorescein angiography showed teleangectases, light staining of the retina, and leakage from the largest teleangectasis and the optic disc vessels; echography showed shrinkage of the eyeball and thinning of the extraocular muscles.

Conclusions

Enophthalmos in this disease is caused not only by progressive fat atrophy but also by shrinkage of the eyeball and thinning of the extraocular muscles; the shrinkage of the eyeball helps explain the presence of choroidal and retinal folding and hyperopia, confirming the primary involvement of connective tissue in this disease.
A Method for Detecting Progression in Glaucoma Patients with Deep, Localized Perimetric Defects
Authors: Corallo G. , Gandolfo E.
Published: January 2018

Purpose

To define a method for early detection of progressive visual field loss, based on monitoring the “healthy” component of the visual field, in glaucoma patients whose perimetric findings show the co-existence of deep scotomata and normal sensitivity areas.

Methods

We reviewed all the “central 30–2 threshold tests” stored in the oldest of our Humphrey perimeters (a 640 VFA model, in use at the Glaucoma Service of the University Eye Clinic of Genoa since 1986). Only the perimetric findings of glaucoma patients with pure, deep, localized defects were collected for this study. In accordance with several inclusion criteria, we could select only 12 series of consecutive examinations (12 eyes of 12 patients). Each series included 12 to 20 examinations and the observation period ranged from 6 years 2 months to 9 years 4 months. Some pre-defined criteria made it possible to separate the defective component of the visual field from the “healthy” one. Then two independent “mean deviations” were calculated, one related to the “healthy” area and one to the defective one.

Results

The mean deviation related to the “healthy” component of the visual field showed very little variation (0.6 to –1.3 dB) in the four series that had no increase in defects, even at the end of the observation period. However, in 7 of the 8 series with a tendency to worsen there was a small inter-test increase (–2.2 to –2.6 dB). This finding anticipated the enlargement of the scotomata, confirmed by subsequent examinations. Only in one series did the increase of the mean deviation related to the “healthy” area coincide in time with the real deterioration of the visual field, rather than anticipating it, but the inter-test interval had by chance been much longer than in the other series. The mean deviation related to the defective areas always showed very large changes in all the series, caused by the high variability of thresholds inside scotomata. This was the explanation for the large variations revealed by the “global” mean deviation too.

Conclusions

Detecting progression is still one of the major problems in evaluating perimetric results. It might be easier to achieve this goal with a method for selectively monitoring light sensitivity inside the “healthy” areas of the visual field.
Retinochoroiditis Associated with Congenital Toxoplasmosis in Children: IgG Antibody Profiles Demonstrating the Synthesis of Local Antibodies
Authors: De Marco R. , Ceccarelli R. , Frulio R. , Palmero C. , Vittone P.
Published: January 2018

Purpose

Retinochoroiditis is generally diagnosed after the first year of life and the association with congenital toxoplasmosis presents a diagnostic dilemma. The detection of local intraocular specific antibodies could be useful for diagnosis.

Methods

We studied six patients (mean age 7±5 years) with retinochoroiditis which appeared after the first year of life. Aqueous and serum were analysed by immunoblotting for anti T. gondii IgG to diagnose toxoplasmosis.

Results

All serum samples were positive only for anti T. gondii IgG. The retinochoroiditis was active in three patients and inactive in the others. Immunoblot analysis of serum and aqueous from the patients with active lesions showed IgG versus the specific antigen of T. gondii. In the patients with inactive lesions the pattern was the same in the two compartments. In active forms, aqueous and serum Western blot patterns differed in proteins lower than 16kDa and higher than 116kDa: in aqueous the findings were typically positive for 30kDa.

Conclusions

Aqueous humour analysis by the Western blot technique may be useful in the diagnosis of congenital toxoplasmosis. In the present small series, we nevertheless detected different patterns for inactive and active retinochoroiditis, confirming the diagnosis in the latter. Aqueous humour paracentesis may be indicated in a child with active retinochoroiditis with unusual clinical features, appearing after the first year of life, and with no clinical or serological evidence of congenital infection.
Protection of the Retina from Ischemia-Reperfusion Injury by L-Carnitine in Guinea Pigs
Authors: Kocer I. , Kulacoglu D. , Altuntas I. , Gundogdu C. , Gullulu G.
Published: January 2018

Purpose

To investigate the efficacy of L-carnitine in preventing retinal injury followed by ischemia-reperfusion.

Methods

The eyes of 34 guinea pigs were used in this experiment. The guinea pigs were divided into two groups: the first group (n= 17) was given L-carnitine intraperitoneally (500mg/kg) and second group (n=17) received the same dose of saline solution. Under general anesthesia, peritomy was performed. Retro-orbital tissues were ligated for 90 minutes and ischemia was induced, followed by 4 hours of reperfusion. One of the enucleated eye was stained with hematoxylin and eosin (H&E) and retinal thicknesses were evaluated. Thiobarbituric acid reactive substances (TBARS) levels were determined in the retina of the other eye.

Results

Mean TBARS levels in retinal tissue were found lower in L-carnitine group (2.77 ± 0.55 μM) than in the control group (6.57 ± 1.19 μM), (p<0.01). On the other hand, mean retinal thickness was found to be increased in the control group (47.47 ± 5.62 μm) when compared to the L-carnitine group (26.52 ± 4.65 μm), (p<0.01). In correlation analysis, significantly positive relationships were found between retinal TBARS level and retinal thickness both in the control and L-carnitine groups (r=0.981, p<0.01 and r= 0.967, p<0.01 respectively).

Conclusions.

L-carnitine is effective in preventing retinal injury followed by ischemia-reperfusion.