bluuebunny/crossref_metadata_2025 huggingface dataset:
Photorefractive Keratectomy for Compound Myopic Astigmatism with the MEL-70 G-Scan Excimer Laser
Authors: Roszkowska A.M. , Galasso S. , Meduri A. , De Matteis M. , Ferreri F.M.B.
Published: January 2018

Purpose

To assess the safety, efficacy, predictability and stability of photorefractive keratectomy in compound myopic astigmatism with a moderate and high cylinder component.

Methods

Photorefractive keratectomy was done in 42 eyes with compound myopic astigmatism with the spherocylindrical algorithm of the MEL-70 excimer laser, with wide ablation zones.

Results

Spherical equivalent refraction changed from −4.19±1.65D to −0.05±0.31D, refractive cylinder from −2.01±0.71D to −0.09±0.20D and mean sphere from −3.22±1.76 D to −0.02±0.26D. Mean uncorrected visual acuity rose from 0.12±0.17 to 0.91±0.10. No eye lost lines of spectacle-corrected visual acuity. The safety index was 1.03 and the efficacy index 0.98. Six months from the treatment all eyes were within ±1D, 8.9% of eyes were within 0.50 D and 44% were plano of target refraction. Refractive and topographical stability were achieved between one and three months after treatment. Transient haze was observed between one and three months after PRK.

Conclusions

Photorefractive keratectomy with the MEL-70 excimer laser to correct myopic astigmatism was a safe and effective procedure with good stability at six months' follow-up. Refractive and visual outcome confirmed that excellent predictability can be expected.
Ab-Interno Trabeculo-Canalectomy: Surgical Approach and Histological Examination
Authors: Ferrari E. , Bandello F. , Ortolani F. , Petrelli L. , Marchini M. , Ponzin D.
Published: January 2018

Purpose

To evaluate, on eye bank eyes, a new surgical approach aimed at removing a quadrant of the trabecular meshwork (TM), with an ab interno approach.

Methods

Gonioscopically controlled ab interno removal of the TM was done with a sub-retinal forcep on six human bank eyes. Serial histological sections were obtained from the treated and untreated part of each globe to assess the effect of the technique on intraocular tissues.

Results

Under the gonioscope, the TM was easily removed in strings of varying length. Histological examination showed, unexpectedly, that this resulted in a well-defined deep furrow in the middle of the trabecular region involving both the TM and the inner wall of Schlemm's canal. The operation created a direct communication between the anterior chamber and Schlemm's canal lumen without any evident damage to the outer canal wall and adjacent ocular structures such as the iris base and corneal endothelium.

Conclusions

Our small series on human bank eyes showed that the procedure involves both the TM and the inner wall of Schlemm's canal and is therefore called ab interno trabeculocanalectomy (AITC). The intraoperative findings and the histological evidence are encouraging, and suggest that the procecedure could have potential clinical application.
Scanning Laser Polarimetric Analysis of Retinal Nerve Fiber Layer Thickness in Turkish Patients with Glaucoma and Ocular Hypertension
Authors: Bozkurt B. , Irkeç M. , Karaagaoglu E. , Orhan M.
Published: January 2018

Purpose

To assess the thickness of the retinal nerve fiber layer (RNFL) in patients with different stages of glaucoma, in comparison with ocular hypertensive (OHT) and healthy subjects in a Turkish population.

Methods

Scanning laser polarimetry was done with a GDx Nerve Fiber Analyzer (NFA, GDx version, 1.0.08) on 270 eyes with glaucoma, 52 OHT eyes, and 81 normal eyes. The eyes were classified as having early (146 eyes), moderate (66 eyes) and severe (58 eyes) glaucoma based on the Humphrey Visual Field indices. We compared 14 NFA parameters by analysis of variance (ANOVA) and Scheffe multiple comparison analysis. Receiver operator characteristic curves (ROC) and Fisher linear discriminant analysis (LDF) were used to measure the sensitivity and specificity of the NFA parameters.

Results

Except for symmetry, all NFA parameters showed significant differences between the groups (p<0.05). The eyes with glaucoma had significantly thinner RNFL than healthy eyes (p<0.01). The RNFL retardation measurements of OHT eyes were lower than controls, but higher than the early glaucoma group. The sensitivity and specificity of the GDx System were 87% and 72.8%, respectively. Applying LDF, the group with the highest sensitivity and specificity (85.9% and 74.1%) was determined as inferior ratio, superior/nasal ratio, superior maximum and the Number.

Conclusions

Assessment of RNFL thickness with scanning laser polarimetry can distinguish glaucoma, OHT and normal subjects with relatively high sensitivity and specificity.
Usefulness of Systematic Ophthalmologic Investigations in Neurofibromatosis 1: A Cross-Sectional Study of 211 Patients
Authors: Arigon V. , Binaghi M. , Sabouret C. , Zeller J. , Revuz J. , Soubrane G. , Wolkenstein P.
Published: January 2018

Purpose

To evaluate the usefulness of ophthalmologic examination for diagnosis and for detection of complications in adult patients with neurofibromatosis 1.

Methods

Patients with at least one criterion of neurofibromatosis 1 (excluding ophthalmologic criteria) seen at a referral centre had a systematic ophthalmologic examination including best-corrected visual acuity, slit-lamp examination and dilated funduscopy. The ophthalmologist was unaware of all other anamnestic data.

Results

Patients: 211 patients with NF1 were included (mean age: 32 ± 14 yr.). Ophthalmologic examination in neurofibromatosis 1 patients: Lisch nodules (n = 185) (87.7%); choroidal hamartomas (n = 61) (29%); enlarged corneal nerves (n =1); 3 plexiform neurofibromas (n = 3); symptomatic optic pathway gliomas (n = 5). Diagnostic contribution of presence of Lisch nodules: 6 (3%) of 211 patients. Detection of complications: none.

Conclusions

In adult patients with neurofibromatosis 1, the contribution of ophthalmologic examination to diagnosis and to the detection of complications is low. Ophthalmologic examination should be performed in patients for whom questioning and clinical examination failed to give evidence of NF1 or to determine the NF subtypes.
Response of Retinal Blood Flow to CO2-Breathing in Humans
Authors: Dorner G.T. , Garhoefer G. , Zawinka C. , Kiss B. , Schmetterer L.
Published: January 2018

Purpose

To investigate the effect of systemic hypercapnia on retinal hemodynamics in humans.

Methods

We studied the effect of breathing a mixture of normal air with 5% CO2 for 13 minutes in ten healthy young male volunteers, using the Zeiss retinal vessel analyzer for continuous measurement of retinal vessel diameter and the blue-field entoptic technique to quantify retinal white blood cell flux. In eight other subjects the effect of hypercapnia was measured with the Zeiss retinal vessel analyzer and by laser Doppler velocimetry to establish retinal blood flow velocity.

Results

Retinal arterial and venous vessel diameters increased by a maximum of 4.2% and 3.2%, respectively. Peak effect was observed after 3 minutes of breathing the mixture of normal air with 5% CO2. During hypercapnia red blood cell velocity increased 11.7% and, accordingly, retinal blood flow increased 19.1%. White blood cell density and velocity rose significantly during hypercapnia, resulting in an increase in white blood cell flux (19.2%).

Conclusions

Our data indicate that CO2 induces vasodilation in retinal arteries and retinal veins. Retinal blood flow and perimacular white blood cell flux increased to the same extent in subjects breathing a mixture of normal air with 5% CO2.
Optical Coherence Tomography (OCT) and Angiography in Patients with Angioid Streaks
Authors: Arvas S. , Akar S. , Yolar M. , Yetik H. , Kizilkaya M. , Ozkan S.
Published: January 2018

Purpose

To investigate the retinal and choroidal features of angioid streak by fluorescein angiography (FA), indocyanine green anigography (ICG-A) and optical coherence tomography (OCT).

Methods

We analysed 46 eyes of 23 patients with angioid streaks examined at our retina section between March 1998 and June 2000. Their mean age was 42.8 years (26–61 years). After a routine ophthalmological examination, OCT and simultaneous fluorescein and indocyanine green angiography (FA/ICG-A) were done. Color fundus photographs were also taken.

Results

A peau d'orange appearance and angioid streaks were more numerous and apparent with ICG-A than FA. In two eyes (4.3%), some streaks that were well visualized on FA were not visible on ICG-A. Twenty eyes (43.5%) had macular complications and 26 (56.5%) were normal. Occult choroidal neovascularization (CNV) was diagnosed by ICG-A. Nine eyes had occult, and 11 had classic CNV. Ruptures of Bruch's membrane were hypofluorescent in 20 (43.5%) and hyperfluorescent in 26 eyes (56.5%). Optic disc drusen were detected in both eyes of one patient (4.3%). Localized hyperreflectivity was thought to be due to calcium deposits.

Conclusions

Angioid streaks were visualized more clearly and in larger numbers by ICG-A than FA. However, in some cases streaks that were funduscopically and fluorescein angiogrpahically visible could not be seen by ICG-A. Occult CNV was detected by ICG-A. Some mottled areas were seen and more clearly visualized by ICG-A. Calcium deposits were observed as localized areas of hyperreflectivity on OCT. These findings indicate that fluorescein angiography, ICG-A and optical coherence tomography all provide supportive information for each other and can be used for either diagnosis or follow-up of those patients.
Retinopathy of Prematurity and other Ocular Problems in Premature Infants Weighing less than 1500 g at Birth
Authors: Asproudis I.C. , Andronikou S.K. , Hotoura E.A. , Kalogeropoulos C.D. , Kitsos G.K. , Psilas K.E.
Published: January 2018

Purpose

To estimate the incidence of retinopathy of prematurity and other ocular problems in a population of preterm infants.

Methods

This retrospective study included all infants with gestational age (GA) <32 weeks and birth weight (BW) <1500 g cared for in the neonatal intensive care unit (NICU) over a period of nine years (1992–2000). Ophthalmological examination was started the 4th week of life and included refractive examination, examination of the cornea and funduscopy under mydriasis. An ocular motility test was done after the 2nd month.

Results

The study included 194 infants. Stage I and II retinopathy occurred in 51 infants but regressed spontaneously. Five of the 194 (2.5%) had to undergo cryopexy. Optic disc atrophy was observed in association with peri-intraventricular hemorrhage (PIIVH) (grade IV) in seven infants. Fifteen infants (7.7%) had retinal hemorrhages which were absorbed by three months of age. Almost 20% of the study infants developed high refractive errors and 13.4% strabismus.

Conclusions

Not only retinopathy of prematurity, but other serious ocular problems were observed in this population of preterm infants. The role of PIIVH III-IV in the pathogenesis of certain ocular problems needs further elucidation.
Does Identification of the Causal Organism of Corneal Ulcers Influence the Outcome?
Authors: Pharmakakis N.M. , Andrikopoulos G.K. , Papadopoulos G.E. , Petropoulos I.K. , Kolonitsiou F.I. , Koliopoulos J.X.
Published: January 2018

Purpose

To investigate whether identification of the causal organism in corneal ulcers influences their outcome.

Methods

We retrospectively studied 114 patients, 72 males and 42 females aged 6–89 years, admitted to this eye clinic during the years 1994–2000 on account of an infectious corneal ulcer. Their examination included a detailed history, visual acuity measurement, and biomicroscopy in everyday follow-up. The ulcers were classified according to their severity and outcome. We assessed the cases where cultures had been done, reviewed the results, and searched for a possible correlation between the outcome and the fact of culturing the ulcer and identifying the causal organism.

Results

Of the 114 corneal ulcers studied, 23 were mild, 49 moderate, and 42 severe. Fifty (44%) had not been cultured, but 64 ulcers (56%) had been cultured, with a positive result in 37 cases (58%), Staphylococcus and Pseudomonas species being the most common organisms found. In moderate and severe ulcers, there was a tendency to a higher proportion of successful outcome for cultured ulcers, but with no significant correlation.

Conclusions

Despite a tendency towards favorable results in culture-positive corneal ulcers, the influence of the detection of the organism on their outcome has not been proved. The role of the initial broad-spectrum antibiotic therapy remains important.
Ocular Hypotensive Effects of Cholinergic and Adrenergic Drugs May be Influenced by Prostaglandins E2 in the Human and Rabbit Eye
Authors: Kaplan-Messas A. , Naveh N. , Avni I. , Marshall J.
Published: January 2018

Purpose

Increased PGE2 production by the iris and ciliary body regulate intraocular pressure (IOP) in vivo. Various cholinergic and adrenergic compounds are traditionally used as antiglaucoma drugs, and their effect on IOP reduction is antagonised by cyclooxygenase inhibitors, indicating a role for eicosanoids in their hypotensive activity. One of the most potent antiglaucoma drugs, PG2 alpha (Latanoprost), reduces IOP by increasing uveoscleral outflow and also increases PGE2 production by the iris and ciliary body in vivo. We investigated whether cholinergic and adrenergic antiglaucoma drugs induce the production of prostaglandin E2 (PGE2) in vitro by: 1) the iris-ciliary body (ICB) of rabbits and, 2) irises of glaucoma patients.

Methods

Pilocarpine 2%, epinephrine 1% and echothiophate iodide 0.125% were applied topically to both eyes of Albino rabbits. Control groups were treated with the corresponding vehicles, or untreated completely. Human iris specimens were obtained from nine untreated cataract eyes, and five eyes under antiglaucoma medication undergoing surgery. PGE2 were determined by a radioimmunoassay.

Results

PGE2 production by the ICB of treated rabbits in vitro was twice that of vehicle-treated or untreated rabbit eyes (p< 0.001, for either group). In vitro PGE2 production by treated glaucoma patients' irises was three times higher (p<0.001) than in cataract control patients.

Conclusions

The study found an increase in in vitro production of PGE2 by the irises of eyes treated with cholinergic and adrenergic antiglaucoma medications. This suggests a role for endogenous PG production in the hypotensive effect of both classes of drug.
Vitreoretinal Surgery for Retained Lens Fragments after Phacoemulsification
Authors: Murat Uyar O. , Kapran Z. , Akkan F. , Cilsim S. , Eltutar K.
Published: January 2018

Purpose

To evaluate the prognostic factors, effect of timing and outcomes of vitreoretinal surgery for removal of retained lens fragments after phacoemulsification.

Methods

A retrospective review of 43 eyes of 43 patients who had vitreoretinal surgery for retained lens fragments after phacoemulsification, between January 1998 and November 2000.

Results

Seven of the 43 patients underwent vitrectomy on the same day as cataract surgery, 20 in the first week, and 23 after the first week, with a mean of 14.8 days (0–90). Initial visual acuity was ≤ 20/400 in 27 (75%, n=36) and intraocular pressure (IOP) ≥ 25 mmHg in 22 (61%, n=36) eyes with or without medication. The mean preoperative IOP was 27.4 mmHg. Initial ocular findings included moderate or severe corneal edema in 17 patients (40%), uveitis in 14 (33%), retinal detachment in 1 (2%) and vitreous hemorrhage in 2 (5%). After a mean follow-up of 8.4 months, final best-corrected visual acuity (BCVA) was ≥ 20/40 in 24 patients (56%) and ≤ 20/400 in 7 (16%). Persistent corneal edema (one eye), cystoid macular edema (four eyes), age-related macular degeneration (one eye) and suprachoroidal hemorrhage (one eye) were the causes of BCVA ≤ 20/400. Final mean IOP was 15.2 mmHg and only one case had IOP > 25 mmHg. Uveitis disappeared in all cases (p<0.001), and corneal edema persisted in only one eye. Both the BCVA and IOP differences were significant (p<0.001), but no correlation was found between pre- and postoperative BCVA and IOP as regards vitreoretinal surgery timing, posterior or anterior removal sites and IOL implantation sites or procedures.

Conclusions

Vitreoretinal surgery is effective for removing retained lens fragments after phacoemulsification, lowering the IOP and reducing the uveitic reaction and corneal edema. BCVA ≥ 20/40 can be reached in at least half the patients.
Large Subconjunctival Emphysema Causing Diplopia and Lagophthalmos
Authors: Kaiserman I.
Published: January 2018

Purpose

To describe a patient who developed diplopia, lagophthalmos and exposure keratopathy due to a large subconjunctival emphysema.

Methods

A 24-year-old man sustained an injury in his left eye from a compressed air hose. The patient complained of pain and diplopia. He underwent slit-lamp examination, fundus-copy and computed tomography.

Results

Ophthalmic examination revealed a decrease in vision in the left eye to 0.5, a conjunctival laceration adjacent to the medial limbus, subconjunctival hemorrhage, a large sub-conjunctival emphysema, lagophthalmos, hypertropia and superficial punctate keratopathy. The posterior pole was intact as were the orbital bones. Two weeks after the injury the conjunctival emphysema, diplopia, lagophthalmos and superficial keratopathy resolved, and visual acuity improved to 1.

Conclusions

Large subconjunctival emphysema can result in diplopia, lagophthalmos and exposure keratopathy.
The Anti-Allergic Effects of a Cromolyn Sodium-Chlorpheniramine Combination Compared to Ketotifen in the Conjunctival Allergen Challenge Model
Authors: Leonardi A. , Busca F. , Tavolato M. , Secchi A.G.
Published: January 2018

Purpose

To compare the inhibitory effects of a topical combination product, cromolyn sodium (DSCG) 4% with the antihistamine, chlorpheniramine, with those of topical ketotifen 0.05% on the clinical allergic reaction induced by the conjunctival allergen challenge (CAC).

Methods

Ten allergic but non-active patients were challenged in both eyes with increasing doses of specific allergen to obtain a positive bilateral reaction (visit 1). They were then rechallenged after 1 week to confirm the allergic threshold dose response (visit 2). After 2 weeks, a third CAC was performed bilaterally 30 minutes after topical application of DSCG-chlorpheniramine in one eye and ketotifen in the contralateral eye in a double-masked fashion (visit 3). Clinical signs and symptoms were registered 5, 10, 15, and 20 minutes after challenge using the standard scoring system. Tear cytology was performed 30 minutes after challenge.

Results

Comparing the two drug effects at visit 3, DSCG-chlorpheniramine was shown to be superior to ketotifen at all time points for itching (p<0.01) and at 5 minutes for redness (p<0.01). For the total signs score, DSCG-chlorpheniramine was shown to be superior to ketotifen at all time points (p<0.01), and at 10 and 15 minutes for the total symptoms score (p<0.05). Compared to visit 2, DSCG-chlorpheniramine significantly lowered itching (p<0.001) and redness (p<0.05) at 5, 10, 15, and 20 minutes after challenge. Ketotifen significantly lowered itching at 5 and 10 minutes (p<0.001) and redness at 5, 10, and 15 minutes (p<0.05). Both drugs reduced the total number of cells evaluated by tear cytology during the early-phase reaction (p<0.05).

Conclusions

DSCG-chlorpheniramine was found to be more effective than ketotifen at preventing itching and redness in the CAC model.
Visually Significant Opacification of Hydrophilic Acrylic Intraocular Lenses – A Clinico-Pathological Analysis
Authors: Yong V.K.Y. , Netto P.A. , Heng W.-J. , Yap E.-Y. , Lee H.-M. , Ng M.M.L. , AU Eong K.-G.
Published: January 2018

Purpose

To describe the clinic-pathological analysis of the visually significant opacification of the Cirrus International Hydroflex™ foldable hydrophilic acrylic intraocular lens (IOL) (model SC600-2, Medical Developmental Research Inc., Clearwater, Florida) and to highlight that this IOL is the same model as the Acryflex™ SC600-2 IOL, by the same manufacturer.

Methods

Retrospective review of five eyes of four patients with opacification of their Cirrus International Hydroflex™ foldable hydrophilic acrylic IOLs (model SC600-2) after uncomplicated phacoemulsification and IOL implantation. Two IOLs were explanted from two patients 14 to 24 months after initial implantation. Each explanted lens was divided into equal halves, one half for scanning electron microscopy (SEM) study and the other half for transmission electron microscopy (TEM) examination. SEM and TEM samples were also subjected to energy dispersive X-ray analysis (EDX).

Results

The IOL opacification was detected 14 to 24 months after uncomplicated phacoemulsification and IOL implantation. EDX analysis showed that the crystals contained calcium and phosphorus, presumably calcium phosphate.

Conclusions

The Cirrus Inter national Hydroflex™ foldable hydrophilic acr ylic IOL (model SC600-2) is associated with opacification, that appeared worse centrally than peripherally. This is the same model as the Acryflex™ SC600-2 IOL, made by the same manufacturer. The opacification consists of calcium and phosphate.
Endotoxins in Ophthalmic Viscosurgical Devices
Authors: Burkhard Dick H. , Augustin A.J. , Pakula T. , Pfeiffer N.
Published: January 2018

Purpose

To measure the endotoxin concentration (EC) of 25 commercially available, hyaluronic acid- and hydroxypropylmethylcellulose-based (HPMC) ophthalmic viscosurgical devices (OVDs).

Methods

The in vitro Limulus amebocyte lysate (LAL) assay, which indicates the presence of endotoxins originating from gram-negative bacteria, was used to determine the EC. The procedure was performed according to the European Pharmacopoeia/USP. EC including duplicate determinations, negative controls, dilution series with control standard endotoxin, dilution series with sample extract and positive sample control.

Results

16 OVDs (Amvisc®, Amvisc® Plus, Biolon®, Coatel®, Healon®, Healon® GV, Healon®5, HPMC Ophtal® L, Microvisc®, Microvisc® Plus, Ocucoat®, Provisc®, Rayvisc®, Viscoat®, Visco Shield® 2%, Visko® 1.4%) had an EC under 1.2 endotoxin units/mL, five (Adatocel®, HPMC Ophtal® H, LA Gel®, Viscorneal®, Viscorneal® Plus) had an EC ≥ 1.2 and ≤ 24 EU/ml, and four (Biocorneal®, Dispasan® also named Ophthalin, Dispasan® Plus, Visko® 1%) had an EC of > 24 EU/ml.

Discussion

To avoid viscoelastic-related inflammatory or immunological reactions, the use of pure OVDs is recommended, especially for surgical procedures with an inherent possibility of leaving viscoelastic remnants in the eye (e.g., cataract surgery, viscocanalostomy or penetrating keratoplasty).
Magnetic Resonance Imaging Analysis of Anterior and Posterior Eye Segment Displacement during Ocular Gaze Shifts
Authors: Eter N. , Garbe S. , Pauleit D. , Schüttoff T. , Schüller H.
Published: January 2018

Purpose

To determine the relationship between movements of the posterior and anterior eye segments during arbitrary gaze shifts and to obtain information for monitoring fixation during radiotherapy for ocular diseases.

Methods

We examined eye movements of ten emmetropic volunteers in a 1.5 T magnetic resonance system. Using a T2-weighted ultrafast turbo-spin echo sequence (UTSE), the eyes were examined within 21 seconds. Sagittal and transversal eye slices were obtained in five passages in five gaze directions (straight ahead, 15° above, 15° below, 15° right and 15° left of the primary position). Displacement of the posterior eye segment was analyzed in relation to the movement of the anterior segment in all directions.

Results

The relationship between the movements of the anterior and posterior eye segment was 1:0.8 (± 0.06 SD) during horizontal gaze shifts and 1:1.16 (± 0.11 SD) during vertical gaze shifts.

Conclusions

Magnetic resonance imaging showed that the relationship between anterior and posterior eye segments was different during horizontal and vertical eye movements, indicating the presence of more than one center of rotation. Compared to the anterior eye segment, there was less displacement of the posterior eye segment during horizontal eye movements and more displacement during vertical eye movements.
Bottle-Cork Injury to the Eye: A Review of 13 Cases
Authors: Cavallini G.M. , Lugli N. , Campi L. , Pagliani L. , Saccarola P.
Published: January 2018

Purpose

To analyze the anatomic and functional consequences of wine-cork injury to the eye in relation to the patient's age and the type of cork and wine.

Methods

We retrospectively studied 13 patients, six women and seven men, presenting to our department with bottle-cork injury to the eye between January 1999 and June 2001.

Results

All patients presented with closed-globe injury according to Kuhn et al's classification. All the cases were injured by bottle corks from sparkling wine: white in ten cases and red in three. Mean visual acuity at admission was 20/100 (range, hand motion to 20/20). The most frequent early injury was anterior chamber hyphema (84.6%), followed by corneal injury (62.2%), ocular hypertension (46.1%), lens subluxation (30.8%), traumatic cataract (23.1%), and post-traumatic retinal edema (23.1%). Mean final visual acuity was 20/25; the follow-up ranged from 3 to 29 months, averaging 16.1 months. Late complications were as follows: pupil motility anomalies (38.5%), traumatic cataract (30.8%), iridodialysis (15.4%), traumatic optic neuropathy (7.7%), post-traumatic glaucoma (7.7%), and traumatic maculopathy (15.4%). Surgical treatment was necessary in two cases (15.4%).

Conclusions

Bottle-cork eye injuries account for 10.8% of post-traumatic hospital admissions to our department. Most of them are due to sparkling white wine served at room temperature. There is no correlation between ocular injury and the eye-bottle distance or the type of cork.
The Evaluation of Retinal Nerve Fiber Layer in Pigment Dispersion Syndrome and Pigmentary Glaucoma Using Scanning Laser Polarimetry
Authors: Mocan M.C. , Bozkurt B. , Irkeç M. , Orhan M. , Karabulut E.
Published: January 2018

Purpose

To measure the retinal nerve fiber layer thickness in patients with pigment dispersion syndrome (PDS) using scanning laser polarimetry and to compare these measurements with those of normal subjects and patients with pigmentary glaucoma (PG).

Methods

Age-, sex-, and refractive error-matched subjects – 18 patients with PDS, 18 patients with PG, and 20 healthy subjects – were evaluated by scanning laser polarimetry (Nerve Fiber Analyzer [NFA] GDx). The NFA did not have a compensator for corneal polarization. One randomly selected eye from each patient was included in the statistical analysis. The NFA measurements of patients with PDS and PG and healthy subjects were compared statistically using analysis of variance, Tukey multiple comparisons, chi-square, and independent t-tests.

Results

The mean values for average thickness, superior and inferior maximum, superior and inferior average, ellipse average thickness, and superior integral were found to be lower in the patients with PDS (p<0.02) and PG (p<0.005) compared to the normal subjects. The mean values for maximum modulation, superior ratio, inferior ratio, and superior/nasal ratio in PDS were in between those of the PG and control groups (p>0.05). The ellipse modulation was significantly lower in the PG group when compared to the other two groups (p<0.03).

Conclusions

Retinal nerve fiber loss is present to some extent in patients with PDS and this loss is not age or sex dependent. Parameters of modulation might be more representative of significant damage of the nerve fiber layer.
Neuro-Ophthalmologic Findings in Konzo, an Upper Motor Neuron Disorder in Africa
Authors: Mwanza J.-C.K. , Tshala-Katumbay D. , Kayembe D.L. , Eeg-Olofsson K.E. , Tylleskär T.
Published: January 2018

Purpose

To investigate the neuro-ophthalmological manifestations in konzo, a non-progressive symmetric spastic para/tetraparesis of acute onset associated with consumption of insufficiently processed bitter cassava roots combined with a low protein intake.

Methods

Twenty-one Congolese konzo patients underwent neuro-ophthalmological investigations including visual acuity testing, assessment of light pupillary reflexes, evaluation of ocular motility and deviation, direct ophthalmoscopy, and visual field perimetry. Objective refraction including retinoscopy and keratometry, and slit-lamp biomicroscopy were also done.

Results

Five patients had visual impairment, and 14 had temporal pallor of the optic disc. Fourteen presented visual field defects, the most frequent being concentric constriction and peripheral defects. Overall, 11 subjects had symptoms qualifying for the diagnosis of optic neuropathy. Two had spontaneous pendular nystagmus in primary position of gaze. Visual field defects and pallor of the optic discs were found in mild, moderate and severe forms of konzo. No correlation was found between the severity of the motor disability of konzo and the extent of visual field loss.

Conclusions

Konzo was associated with optic neuropathy and a few patients had nystagmus. Although the etiopathogenesis of this optic neuropathy remains to be elucidated, the symmetry of the involvement suggests a toxic origin. We suggest that cyanide causes the neuro-ophthalmological damage in konzo. However, the optic neuropathy in konzo patients does not resemble the features of the epidemic optic neuropathy in Tanzania, Cuba or Nigeria, Leber's hereditary optic neuropathy, tobacco amblyopia or vitamin B deficiency.
Spatial Perception in Normal and Strabismic Subjects: Role of Stereopsis and Monocular Clues
Authors: Nuzzi G. , Cantù C.
Published: January 2018

Purpose

To evaluate the roles of binocular vision, monocular clues, and experience in spatial perception in a prospective, nonrandomized, case-control study.

Methods

A test was created consisting of three wood blocks arranged along the frontal plane inside Panum area. To produce some degrees of horizontal disparity, blocks were moved along a sagittal plane. Thirteen normal subjects (control group) and 13 nonamblyopic strabismic subjects (study group) were asked to identify, both under binocular and monocular vision, the position of the blocks in a series of 12 randomized presentations (phase I). In phase II of the trial, a letter E in three different sizes, acting as a monocular clue, marked the three blocks. In both phases, the number of correct answers to the test during binocular and monocular vision was recorded.

Results

Binocular normal responses appeared greater than monocular normal responses and strabismic binocular responses in both phases (p<0.001). Binocular strabismic responses and monocular answers of both groups appeared similar.

Conclusions

In our experimental model, spatial orientation of strabismic subjects in binocular vision is substantially identical to that of normal subjects in monocular vision. Monocular clues were used in the same manner in both groups of subjects, and experience seemed to play no role in spatial localization of visual objects.
Impression Cytology of the Conjunctival Epithelium after Antiglaucomatous Treatment with Latanoprost
Authors: Moreno M. , Villena A. , Cabarga C. , Sanchez-Font E. , Garcia-Campos J.
Published: January 2018

Purpose

To study nongoblet and goblet epithelial conjunctival cells after several treatment periods with latanoprost, a prostaglandin analogue.

Methods

Twelve patients (20 eyes) were studied before the onset of treatment and after 1, 3, and 6 months of latanoprost use. Impression cytology was carried out to analyze cellular density and morphologic parameters such as minimum and maximum diameter and area.

Results

Nongoblet epithelium cell density did not change over the treatment period. The density of goblet cells increased after 1 month of use, but returned to initial cell density after longer treatment periods. Nongoblet epithelial cells underwent a significant reduction in size after 1, 3, and 6 months of treatment. In addition, the minimum/maximum diameter ratio suggested that after 1 month there were some changes in shape (a slight elongation) when compared to cells of untreated patients. Nevertheless, after longer treatment periods, the cells regained their original shape. No changes in size were observed in goblet cells, except for a slight decrease in maximum diameter after 6 months of treatment, which suggests that the cells became more rounded.

Conclusions

The density of nongoblet epithelial cells does not change after different treatment periods with latanoprost. However, their size decreases and after short treatment periods their shape also undergoes changes. The density of goblet cells increases after 1 month of treatment, but decreases again after longer periods. Their size does not undergo any modification, although there is a variation in shape after 6 months of treatment.
Intraoperative Biometry for Intraocular Lens (IOL) Power Calculation at Silicone Oil Removal
Authors: El-Baha S.M. , Ei-Samadoni A. , Idris H.F. , Rashad K.M.
Published: January 2018

Purpose

Cataract development is common following retinal detachment surgery that necessitates silicone oil injection. Intraocular lens (IOL) power calculation in the presence of silicone oil is challenging for many reasons. The authors evaluated the accuracy of intraoperative biometry during cataract surgery in silicone-filled eyes.

Methods

Twelve cases of cataract in eyes filled with silicone oil after retinal detachment surgery were included. Preoperatively, keratometric readings were documented. Intraoperative axial length was measured following removal of silicone oil using a sterile probe of the Nidek Echoscan US800 unit. IOL power calculation was computed using the SRK/T formula. This was followed by phacoemulsification and foldable lens implantation. Postoperative refraction allowed evaluation of the accuracy of intraoperative biometry. The predictability of three different formulas was also compared (Holladay, SRK/T, and SRK II).

Results

Seven men and five women with a mean age of 50.2 years were included in the study. The mean postoperative spherical equivalent using the described technique was 6.77 ± 0.43 diopters. SRK/T and Holladay formula had the best predictability for high axial length eyes, whereas the three studied formulas showed no significant differences in predictability in eyes with normal axial length.

Conclusions

Intraoperative biometry proved to have good predictability for the absolute postoperative refractive error in cataract surgery for eyes at the time of silicone oil removal. This predictability was accurate independent of axial length.
Free-Floating Cyst in the Anterior Chamber: Ultrasound Biomicroscopic Reports
Authors: Figus M. , Ferretti C. , Benelli U. , Genovesi-Ebert F. , Nardi M.
Published: January 2018

Purpose

To report a free-floating dislodged pigmented cyst in the anterior chamber and to describe the ultrasound biomicroscopic (UBM) features of the lesion.

Methods

Case report.

Results

A 26-year-old man presented with noise in his left eye in the prone position. Slit-lamp examination revealed a small pigmented mass lesion at the 6 o'clock position in the anterior chamber, slowly moving with changing head postures. UBM revealed an unfixed dislodged pigmented cyst with a thin wall and no internal reflectivity, changing its shape from ovoid to circular. Five years later, the anterior segment does not show any modification and the cyst has not changed in size or appearance.

Conclusions

Cysts of the iris pigment epithelium arise in the posterior iris layer. They may be central, midzonal, peripheral, or dislodged. Dislodged cysts may be repositioned and fixed or free-floating in the vitreous or in the anterior chamber. Surgical removal must be considered only for a rapid enlargement or significant reduction in endothelial cell count. UBM can distinguish solid from cystic lesions, giving detailed information on internal structure, reflectivity, shape, and thickness.
In Vitro Analysis of AcrySof Intraocular Lens Glistening
Authors: Shiba T. , Mitooka K. , Tsuneoka H.
Published: January 2018

Purpose

The authors studied the effects of changes in packaging solution temperature on the development of glistening in acrylic intraocular lenses (AcrySof, Alcon).

Methods

Glistening was examined by slit lamp at each condition. In Experiment 1, Aciy S o f lenses were soaked in physiologic saline adjusted to 15°C and 37°C in an incubator. In Experiment 2, AcrySof lenses were soaked in physiologic saline adjusted to 37°C and 60°C for 5 min, then stored in physiologic saline adjusted to 15°C. In Experiment 3, glistening formation was induced in AcrySof lenses by soaking them in warm water (37°C). The lenses were allowed to dry at 15°C and then soaked in physiologic saline adjusted to 15°C. After storage of dry AcrySof lenses at 37°C in an incubator for 10 months followed by soaking in physiologic saline adjusted to 15°C, glistening formation was evaluated in Experiment 4.

Results

Glistening became observable after 1 month, despite the temperature having been lowered to 15°C. No glistening was observed in the lenses soaked in physiologic saline adjusted to 37°C after 5 min, but glistening was observed 1 month after soaking. When allowed to dry at 15°C, the glistening decreased. After 1 month of soaking at 15°C, glistening was again observable.

Conclusions

AcrySof lenses soaked in warm water for a short time may change characteristics, and therefore, close monitoring of the temperature and time of soaking is necessary to prevent glistening formation.
The Effect of Intraoperative Antibiotics in Irrigating Solutions on Aqueous Humor Contamination and Endophthalmitis after Phacoemulsification Surgery
Authors: Sobaci G. , Tuncer K. , Taş A. , Özyurt M. , Bayer A. , Kutlu U.
Published: January 2018

Purpose

To determine the efficacy of intraoperative antibiotic use in irrigating solutions on aqueous humor contamination during phacoemulsification surgery and to evaluate the corresponding risk of postoperative endophthalmitis.

Methods

644 eyes of 640 patients who underwent phacoemulsification surgery with foldable intraocular lens (IOL) implantation were included in this study. Preoperative conjunctival smears were taken and eyes were allocated to receive irrigating infusion fluid containing either balanced salt solution (BSS)-only (group 1; 322 eyes) or BSS with antibiotics (vancomycin and gentamycin) during surgery (group 2; 322 eyes). Bacterial contamination rates of aqueous humor samples taken in the beginning and at the end of operation were compared. Predictive factors for the development of postoperative endophthalmitis were determined by clinical and microbiologic analyses.

Results

The rates of culture-positivity were similar between group 1 and group 2 for both preoperative conjunctival smears and aqueous samples (p > 0.05). Aqueous samples taken at the end of operation were found to be contaminated in 68 (21.1%) eyes in group 1 and 22 (6.8%) eyes in group 2, and the difference was significant (p = 0.0001; OR = 3.65 (2.1–6.0)). Capsular rupture was associated with higher rate of contamination in both groups (p = 0.0001; OR = 7.7 and p = 0.0001; OR = 8.1). Two eyes in the BSS-only group developed postoperative endophthalmitis and these cases had posterior capsular rupture during the surgery and culture-positivity forstaphylococcus epidermidis throughout the study.

Conclusions

Intraoperative antibiotic irrigation decreases aqueous humor contamination during phacoemulsification. Further studies are warranted to determine the interrelationship between aqueous humor contamination and endophthalmitis in eyes with posterior capsular rupture.
Malondialdehyde and Antioxidant Enzyme Levels in the Aqueous Humor of Rabbits in Endotoxin-Induced Uveitis
Authors: Satici A , Guzey M. , Gurler B. , Vural H. , Gurkan T.
Published: January 2018

Purpose

To investigate the role of oxidative stress in endotoxin-induced uveitis.

Methods

Lipopolysaccharide was injected intravitreally into the right eyes of rabbits. Sterile saline was injected intravitreally into the left eyes as a control. Inflammation was assessed according to clinical score, aqueous humor cell count, and protein levels. Malondialdehyde, superoxide dismutase, glutathione peroxidase, catalase, and nitrite levels were measured in the aqueous humor.

Results

The clinical grade (p<0.01), inflammatory cell count (p<0.001), and protein content (p<0.001) were significantly higher in the aqueous humor of eyes with uveitis than in that of controls. Malondialdehyde (p<0.01) and nitrite (p<0.001) levels in the aqueous humor of eyes with uveitis were significantly higher than in the control group. Superoxide dismutase (p<0.001), glutathione peroxidase (p<0.001), and catalase (p<0.001) levels were significantly lower in the aqueous humor of eyes with uveitis than in that of the controls.

Conclusions

Oxygen free radicals may be implicated as a mediator of inflammation in endotoxin-induced uveitis. The increase in free radicals in the aqueous humor may play a role in the pathogenesis of endotoxin-induced uveitis.
Ocular Complication of Intralesional Corticosteroid Injection of a Chalazion
Authors: Hoşal B.M. , Zilelioğlu G.
Published: January 2018

Purpose

To report a major complication of intralesional corticosteroid injection for the treatment of a chalazion.

Methods

A 28-year-old woman presented with a 4-day history of decreased vision in her left eye that developed after corticosteroid injection to her upper eyelid for the treatment of chalazion. The visual acuity was 20/20 in her right and finger counting in her left eye. Anterior segment examination showed an inferior corneal opacity with positive Seidel test and cataract.

Results

A soft contact lens was applied to cornea and antibiotic therapy was given to prevent endophthalmitis. Cataract was removed by lens aspiration and a posterior chamber intraocular lens was implanted. After surgery, the visual acuity increased to 20/20 in her left eye.

Conclusions

Inadvertent corneal penetration and traumatic cataract are possible and serious complications of intralesional corticosteroid injection.
Endophthalmitis Caused by Mycobacterium Abscessus
Authors: Marín-Casanova P. , Calandria Amiguetti J.L. , GarcíA-Martos P. , Lozano Dominguez C. , Hoyos Sanabria B. , Puerto Alonso J.L. , GarcíA-Tapia A.
Published: January 2018

Purpose

To describe the clinical and laboratory features of a case of endophthalmitis caused by Mycobacterium abscessus in a patient immunocompetent.

Methods

case report. A 65-year-old woman with bilateral cataracts was treated by surgery with phacoemulsification and posterior chamber lens implantation.

Results

The funduscopic examination showed vitreous cells over the optic nerve head, chorioretinal infiltrates, and focal vasculitis. Vitreous humor aspirate disclosed acid-fast bacilli. In the culture on Löwenstein-Jensen medium grew colonies identified as M. abscessus.

Conclusions

M. abscessus is cause of endophthalmitis and crystalline keratopathy. Risk factor include surgical intervention or exogenous contamination. Our patient has no systemic pathology predisposing to the development of endophthalmitis.
Persistency and Clinical Outcomes Associated with Latanoprost and Beta-Blocker Monotherapy: Evidence from a European Retrospective Cohort Study
Authors: Diestelhorst M. , Schaefer C.P. , Beusterien K.M. , Plante K.M. , Fain J.M. , Mozaffari E. , Dhawan R.
Published: January 2018

Purpose

To evaluate persistency (time on initial therapy) and the clinical impact of latanoprost versus beta-blocker monotherapy in treating glaucoma.

Methods

This observational, multicenter, retrospective medical chart review study conducted in four European countries included patients with primary open-angle glaucoma or ocular hypertension who began their first glaucoma treatment with latanoprost or a beta-blocker between November 1996 and November 1998. Persistency and glaucoma-related clinical outcomes data were abstracted for the 2 years following treatment initiation.

Results

In all, 260 patient charts were analyzed (94 latanoprost, 166 beta-blocker). Patients in the latanoprost group stayed on therapy twice as long as those who received a beta-blocker (p<0.0001). After adjusting for baseline characteristics, patients receiving a beta-blocker as initial therapy were 3.8 times more likely to change therapy than those initially treated with latanoprost (p<0.0001). Patients in the latanoprost group also experienced greater mean decreases in intraocular pressure (IOP) than those receiving a beta-blocker (7.4 mmHg versus 4.6 mmHg, respectively; p<0.0001), and fewer had worsened optic nerve head excavation (1.7% versus 14.2%, respectively; p<0.05) by the time of their first therapy change or last study visit, whichever came first.

Conclusions

Over a 2-year period, latanoprost was associated with significantly greater persistency and better clinical IOP outcomes compared with beta-blocker therapy.
Comparative Study of Vitrectomy with and without Vein Decompression for Branch Retinal Vein Occlusion: A Pilot Study
Authors: Figueroa M.S. , Torres R. , Alvarez M.T.
Published: January 2018

Purpose

To report the clinical outcomes in patients undergoing pars plana vitrectomy with and without vein decompression for treatment of branch retinal vein occlusion (BRVO).

METHODS

Thirty-five eyes with macular edema and visual acuity worse than 20/100 secondary to BRVO were prospectively evaluated. Vitrectomy with posterior hyaloid removal and vein decompression at the arteriovenous crossing was performed on 15 eyes (Group 1); consecutively, the same technique without vein decompression was performed on 20 eyes (Group 2). Primary outcome was visual acuity and secondary outcomes were resolution of macular edema and development of neovascularization.

Results

No differences were found between groups in either patient age (p=0.566) or preoperative visual acuity (p=0.505). No differences were found in visual acuity at 3 (p=0.651), 6 (p =0.697), 9 (p =0.763), 12 (p=0.881), or 18 (p=0.748) months. Mean time for macular edema resolution and visual acuity improvement was 9 months in both groups, with a mean improvement of 3.5 ± 2.35 lines in Group 1 and 3.2 ± 2.97 lines in Group 2. No eyes in either group developed new vessels.

CONCLUSIONS

Results suggest that vitrectomy with posterior hyaloid removal without vein decompression can resolve macular edema, improve vision, and prevent development of new vessels in BRVO.
Optical Coherence Tomography and Retinal Thickness Analyzer Features of Spontaneous Resolution of Vitreomacular Traction Syndrome: A Case Report
Authors: Carpineto P. , Ciancaglini M. , Aharrh-gnama A. , Agnifili L. , Mastropasqua L.
Published: January 2018

Purpose

To report optical coherence tomography (OCT) and retinal thickness analyzer (RIA) findings in a case of spontaneous resolution of vitreomacular traction syndrome.

METHODS

Qualitative and quantitative analysis of the macular region was performed with OCT and RTA.

Results

In the left eye of a 34-year-old woman with blurred vision, OCT and RTA examination showed a discrete linear signal anterior to the retina with attachment at the macula and secondary cystoid macular changes. OCT and RTA examination showed an increase in macular thickness (350 μm). Six months later the patient showed a spontaneous complete recovery of visual acuity. Vitreomacular traction and cystoid changes were no longer detectable at OCT and RTA examination; retinal thickness was normal (205 μm) and a posterior vitreous detachment was visible.

CONCLUSIONS

Both OCT and RTA were useful tools for making the diagnosis of vitreomacular traction syndrome and demonstrating the effect of spontaneous vitreomacular traction release with resolution of cystoid macular changes.