bluuebunny/crossref_metadata_2025 huggingface dataset:
Imaging Modalities for Uveal Melanoma
Authors: Mirchia Kanish , Turell Mary E , Singh Arun D ,   Cole Eye Institute, Cleveland Clinic Foundation,   Cole Eye Institute, Cleveland Clinic Foundation,   Cole Eye Institute, Cleveland Clinic Foundation
Published: October 2015

Purpose:To review the spectrum of imaging modalities commonly used in clinical practice for the diagnosis and management of uveal melanoma.Materials and Methods:Review of literature.Results:Various forms of ophthalmic imaging are useful in the characterisation and treatment planning of uveal melanoma. These include digital photography, ultrasonography, angiography and optical coherence tomography. Digital photography is useful for documenting the clinical findings for future comparison and response to treatment. Ultrasonography provides information on tumour biometry, local extension and tumour composition (internal reflectivity). Angiography can be used to assess the degree of tumour vascularity. Newer forms of imaging, including optical coherence tomography (OCT), have excellent resolution and provide detail on surface features.Conclusion:The accuracy of clinical diagnosis of uveal melanoma exceeds 99 % when using currently available imaging modalities. There are advantages and disadvantages to each modality depending on tumour location, size, surface characteristics and internal structure. Ancillary techniques such as computed tomography, magnetic resonance imaging and positron emission tomography may be useful in atypical lesions or in the surveillance for metastatic disease.
Viral Aetiology in Anterior Uveitis – The Tip of an Iceberg?
Authors: Hazirolan Dicle , Pleyer Uwe ,   Senior Resident, Ankara Training and Research Hospital, Ministry of Health, Department of Ophthalmology, Ankara, Turkey,   Professor, Department of Ophthalmology, Charité Hospital, Charité Campus Virchow-Klinikum, Humboldt University, Berlin, Germany
Published: October 2015

Identification of an infectious cause in intraocular inflammation is of crucial importance since their treatment and prognosis differ from non-infectious aetiologies. Herpes simplex and varicella-zoster viruses are well known causes of anterior uveitis. Furthermore, cytomegalovirus (CMV) and rubella virus (RV) are also detected in a significant number of patients. Despite their different aetiology, viral anterior uveitis may have similar features and often presents with unilateral diffuse, fine, stellate keratic precipitates, iris atrophy or ocular hypertension. Viruses are increasingly recognised as aetiology of anterior uveitis that has previously been referred as idiopathic. RV, for example, causes a distinct clinical spectrum of ocular signs and symptoms presenting as Fuch’s uveitis syndrome (FUS) in Europe, strongly suggesting a role in its pathogenesis. Interestingly, CMV may also be involved in the pathogenesis of both FUS and Posner–Schlossman syndrome in particular in the Asian population.
Optical Coherence Tomography Imaging and Quantitative Assessment for Monitoring Dry Age-related Macular Degeneration
Authors: Augustin Albert J ,   Head, Department of Ophthalmology, Staedtisches Klinikum Karlsruhe, Germany
Published: October 2015

The purpose of this article is to show the feasibility of the ‘Advanced [retinal pigment epithelium] RPE analysis’ software tool to measure drusen area and volume as well as the area of geographic atrophy (GA) in patients with dry age-related macular degeneration (AMD). The source data from spectral domain optical coherence tomography (SD-OCT) images obtained from three patients with confirmed dry AMD using Cirrus™ HD-OCT (Carl Zeiss Meditec) were re-evaluated with the new software analysis tool Advanced RPE analysis. The area of GA as well as drusen area and volume were measured and analysis of results were presented along with calculated values in two clearly arranged screens. Changes between visits were easily detectable and could be followed over time. Results correlated well with clinical observation. The conclusion reached was that the new Advanced RPE analysis software allows the automated, objective and quantitative assessment of atrophic lesions and drusen. It thus could prove to be useful in determining disease stages as well as prognosis more precisely, and provides the opportunity to monitor the effectiveness of new therapies in clinical trials.
Treatment of Post-operative Endophthalmitis
Authors: Spadea Leopoldo , Fiasca Arianna ,   University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L’Aquila, Italy,   University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L’Aquila, Italy
Published: October 2015

The rates of post-operative endophthalmitis have been low for many years, but recent reports suggest that this type of ocular infection may be on the rise. Fluctuations in the number of cases appear to correlate with the type of intraocular surgery performed. Post-operative endophthalmitis has been reported as a consequence of nearly every type of ocular surgery, but is most common following cataract surgery. Numerous reports have demonstrated that Gram-positive bacteria cause the vast majority of post-operative endophthalmitis cases. Coagulase-negative staphylococcal isolates are the most common. Most intraocular infections resulting from infection with coagulase-negative staphylococci can be treated with antibiotic and anti-inflammatory agents, resulting in restoration of partial or complete vision. However, the more virulent the bacterial strain, the more devastating the visual outcome. Intraocular infections withStaphyloccus aureus, enterococci,Bacillusor Gram-negative strains are often intractable, and blindness or loss of the eye itself is not uncommon. The therapeutic success of treating post-operative endophthalmitis depends largely on accurate and prompt diagnosis. Antibiotic therapy can be topical, sub-conjunctival, systemic or intravitreal. Vitrectomy must be reserved for patients who present with initial visual acuity of light perception. Only in these cases has vitrectomy been shown to be more advantageous with respect to the intravitreal antibiotic injection.
Toric Intraocular Lens Implants for Astigmatism
Authors: Kuo Irene C , Reviglio Victor E ,   Associate Professor of Ophthalmology, Cornea and Refractive Surgery Services, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, US,   Professor, Pathology Department, Cornea and Anterior Segment Research, Catholic University of Córdoba, School of Medicine, Ophthalmology Service, Córdoba Hospital and Instituto de la Visión Cerro de las Rosas, Sanatorio Allende, Córdoba, Argentina
Published: October 2015

Toric intraocular lenses are available in our surgical armamentarium for use in cataract surgery, refractive lens exchange, phakic lens procedures and multifocal lens procedures. These lens implants enjoy a high level of success in terms of post-operative uncorrected visual acuity, astigmatism correction and safety. With time, toric phakic lens implants, not available worldwide, may gain popularity as more surgeons gain comfort and confidence in offering and performing an elective intraocular procedure.
Current Use of Non-steroidal Anti-inflammatory Drugs in the Treatment of Ocular Inflammation Related to Cataract Surgery
Authors: Donnenfeld Eric ,   Clinical Professor of Ophthalmology, New York University, New York, US
Published: October 2015

Ocular inflammation and pain are a common consequence of cataract surgery, and if left untreated, may lead to extensive ocular damage, resulting in impaired vision as well as decreased satisfaction with the procedure. Effective management of ophthalmic inflammation after surgery is therefore vital. Topical ophthalmic non-steroidal anti-inflammatory drugs (NSAIDs) have become a mainstay of management of ocular pain and inflammation as a result of their anti-inflammatory activity, analgesic property and established safety record. Numerous studies have demonstrated the efficacy of topical NSAIDs in post-operative prevention of ocular inflammation, inhibition of intra-operative miosis, reduction of pain associated with cataract surgery and pre-operative use to prevent cystoid macular oedema. Studies have also indicated that NSAIDs and steroids act synergistically when administered together, and that a combination of steroid and NSAID therapy is recommended to achieve successful outcomes. With appropriate administration, NSAIDs are safe and effective therapeutic agents, which rarely result in serious local and systemic responses.
The Evolution of Retinal Laser Technology and Retinal Photocoagulation as Therapeutic Modality
Authors: Azoulay Kfir , Pianka Pazit , Loewenstein Anat ,   General Manager, Ophthalmology Department, Lumenis, Amsterdam, Netherlands,   Senior Ophthalmologist and Medical Director, Lumenis, Yokneam, Israel,   Vice Dean, Faculty of Medicine and Chairperson, Department of Ophthalmology, Tel Aviv Medical Centre, Tel Aviv, Israel
Published: October 2015

The effect of thermal insult to ocular tissue was first recorded in Western literature over two millennia ago. During the early scientific period and the ensuing eras, our understanding of this phenomenon, as well as our ability to accurately deliver dose-controlled therapeutic thermal energy to retinal tissue, have improved greatly. Since their commercial introduction in 1970, ophthalmic photocoagulation laser systems have been playing a cardinal role in the treatment and/or management of various ocular pathologies, predominantly though not limited to, retinal pathologies. Seminal studies, such as the Diabetic Retinopathy Study (DRS) and Early Treatment Diabetic Retinopathy Study (ETDRS), have solidified the role of such tools in the ophthalmologist’s therapeutic armamentarium; and to this day, as either stand-alone treatment or in combination with pharmacological agents, retinal laser therapy is recognised as the ‘gold standard’ for treating diabetic macular oedema (DME) and proliferative diabetic retinopathy (PDR). The continuous elucidation of the role that the retinal pigmented epithelium (RPE) plays in the emergence of retinal pathologies has prompted researchers and clinicians to further investigate selective RPE treatments – featuring significantly reduced or altogether devoid of collateral thermal damage to inner neural retinal structures with limited regenerative capacity. The convergence of electronic dosimetry, diagnostics imaging and new therapeutic laser modalities into a singular entity may serve as the technological platform for successfully employing such therapies in the near future.
The Role of Glaucoma Drainage Devices in Paediatric Glaucoma
Authors: Díaz Esperanza Gutiérrez , Gutiérrez Enrique Mencía , Palacios Pilar Tejada ,   Head, Glaucoma Unit,   Staff Physician,   Associate Professor and Head of Paediatric Unit, Ophthalmology Department, 12 de Octubre Hospital, Complutense University, Madrid, Spain
Published: October 2015

Glaucoma drainage devices may be indicated in glaucoma associated to complex congenital anomalies or dysgenesis of the anterior segment, secondary glaucomas such as those developed after congenital cataract surgery, severe primary congenital glaucoma after failed angle surgery and in eyes with severe conjunctival scarring. They can be combined with several other procedures, such as cataract extraction, intraocular lens implantation, keratoplasty or pars plana vitrectomy. This procedure may achieve a sustained and prolonged intraocular pressure reduction in children, with early post-operative success as high as 90 %, although it decreases over time, to 40–60 % survival at 4–6 years using the Kaplan-Meier analysis and most children need to reinitiate glaucoma treatment postoperatively. We must bear in mind that complications may occur, especially tube malposition and exposure, and multiple repeated surgeries may be necessary. The advantages and complications should be weighed in each individual case.
Combined Surgery in the Treatment of Patients with Cataract and Primary Open-angle Glaucoma
Authors: Taibbi Giovanni , Vizzeri Gianmarco ,   Glaucoma Research Fellow,   Associate Professor and Glaucoma Specialist, Department of Ophthalmology and Visual Sciences, The University of Texas Medical Branch, Galveston, Texas, US
Published: October 2015

Cataract and glaucoma are the two leading causes of blindness worldwide and frequently co-exist in the ageing population. No uniform recommendations can be proposed when the two conditions are associated. In the presence of a visually significant cataract and uncontrolled glaucoma, clinicians should consider performing combined cataract surgery and trabeculectomy. Numerous phacotrabeculectomy techniques have been proposed. However, in the absence of strong evidence in support of a specific technique, surgeons’ preference and experience may dictate the choice. Unless contraindicated, mitomycin-C should be considered in all combined procedures. In addition, novel and minimally invasive glaucoma surgical procedures, such as ab interno trabeculotomy, have recently emerged and gained in popularity. In general, these procedures have shown the potential to be combined with phacoemulsification to further lower intraocular pressure (IOP) with relatively few post-operative complications. However, available data suggest that these techniques seem unlikely to be able to achieve a degree of IOP reduction comparable with that of trabeculectomy. Rigorous studies are necessary to better understand the long-term efficacy and safety profile of these novel procedures, when performed alone or in combination with cataract surgery.
Macular Pigment Optical Density in Macular Health and Visual Function
Authors: Maci Samanta ,   Senior Manager Europe Scientific Affairs & Technical Services, Kemin Human Nutrition and Health, a Division of Kemin Food, Lisboa, Portugal
Published: October 2015

Extensive research has described the biological and optical characteristics of the macular pigment (MP) and has confirmed its composition and dietary origin. Epidemiological and intervention trials support the protective role of MP in the retina as well as its positive effects on visual function in healthy individuals in addition to patients with age-related macular degeneration (AMD). The amount of MP in the macula can be assessed by measuring a surrogate optical indicator, macular pigment optical density (MPOD). New evidence from recently published clinical trials and a European consensus roundtable have confirmed that MPOD can be increased by increasing the ingestion of lutein and zeaxanthin and that MPOD increase benefits macular health and visual function. On balance, this recent evidence suggests a critical role of MP in eye health as well as the importance of assessing if adequate levels of the dietary macular carotenoids are regularly consumed in order to ensure proper availability for deposition into the macula.
Scanning Laser Ophthalmoscope in the Management of Age-related Macular Degeneration
Authors: Scripsema Nicole K , Rosen and Richard B ,   Retinal Photographer, The Retina Center, Department of Ophthalmology, New York Eye & Ear Infirmary, New York, US,   Medical Student, Department of Ophthalmology, New York Medical College, New York, US,   Vice Chairman, Suregon Director, Chief of Retinal Service and Director of Research, The Retina Center, Department of Ophthalmology, New York Eye & Ear Infirmary, New York, US,   Professor of Ophthalmology, Department of Ophthalmology, New York Medical College, New York, US
Published: October 2015

Recent advances in retinal imaging have improved the evaluation and prognostication of age-related macular degeneration. The development and modification of the scanning laser ophthalmoscope (SLO) has played a pivotal role in our understanding of the disease. SLO has led to improved methods of visualising characteristics of the disease, such as drusen and alterations in autofluorescence, and also provided a platform for the quantification of structural and functional changes occurring as a result of the disease process. This article provides a review of the current literature on the impact and clinical utility of SLO devices for infrared viewing, fundus autofluorescence, microperimetry, and as integraded multimodal imaging systems such as optical coherence tomography and SLO.
Treatment of Post-operative Endophthalmitis
Authors: Spadea Leopoldo , Fiasca Arianna ,   Department of Biotechnological and Applied clinical Sciences, Eye Clinic, University of L’Aquila, L’Aquila, Italy,   Department of Biotechnological and Applied clinical Sciences, Eye Clinic, University of L’Aquila, L’Aquila, Italy
Published: October 2015

The rates of post-operative endophthalmitis have been low for many years, but recent reports suggest that this type of ocular infection may be on the rise. Fluctuations in the number of cases appear to correlate with the type of intraocular surgery performed. Post-operative endophthalmitis has been reported as a consequence of nearly every type of ocular surgery, but is most common following cataract surgery. Numerous reports have demonstrated that Gram-positive bacteria cause the vast majority of post-operative endophthalmitis cases. Coagulase-negative staphylococcal isolates are the most common. Most intraocular infections resulting from infection with coagulase-negative staphylococci can be treated with antibiotic and anti-inflammatory agents, resulting in restoration of partial or complete vision. However, the more virulent the bacterial strain, the more devastating the visual outcome. Intraocular infections withstaphyloccus aureus,enterococci,Bacillusor Gram-negative strains are often intractable, and blindness or loss of the eye itself is not uncommon. The therapeutic success of treating post-operative endophthalmitis depends largely on accurate and prompt diagnosis. Antibiotic therapy can be topical, sub-conjunctival, systemic or intravitreal. Vitrectomy must be reserved for patients who present with initial visual acuity of light perception. Only in these cases has vitrectomy been shown to be more advantageous with respect to the intravitreal antibiotic injection.
The Evolution in Glaucoma Surgery – Latest Advances in Filtration Surgery
Authors: Mountfort Katrina , Liebmann Jeffrey , Weinreb Robert N , Shaarawy Tarek , Traverso Carlo E , Nardi Marco ,   Senior Medical Writer, Touch Medical Communications, London, UK,   Clinical Professor of Ophthalmology, New York University School of Medicine, New York, US,   Chair of the Department of Ophthalmology, Director of the Shiley Eye Center and Director of the Hamilton Glaucoma Center, University of California, San Diego School of Medicine, California, US,   Professor, MSc Head, Glaucoma Sector, Ophthalmology Service, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland,   Director of Eye Clinic, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy,   Professor of Ophthalmology, Department of Neuroscience, University of Pisa, Pisa, Italy
Published: October 2015

In recent years, an increased understanding of intraocular pressure (IOP) has facilitated advances in surgical techniques in the treatment of glaucoma. Although trabeculectomy has been the gold standard of glaucoma surgery for over four decades, new devices have recently been introduced, including the EX-PRESS™ glaucoma filtration device (GFD). An important requirement of any surgical or medical procedure to lower IOP is effectiveness over a 24-hour period, since IOP is at its highest at night. Recent data have demonstrated that the EX-PRESS™ GFD can achieve a similar reduction in IOP to that achieved by trabeculectomy, but with a significantly reduced rate of complications. Following the successful learning of a number of surgical techniques, most of which are currently mastered by the skilled trabeculectomy surgeon, implantation of the Ex-PRESS TM GFD is no more challenging than a traditional trabeculectomy and provides rapid post-operative recovery. Since cost considerations prohibit the use of the EX-PRESS™ GFD in all cases of glaucoma surgery, patient selection is important. It must be stressed, however, that use of the EX-PRESS™ GFD results in reduced indirect costs as a result of its better predictability, shorter operative time and reduced short-term post-operative complications.
Glaucoma Pharmacogenetics
Authors: Mossböck Georg , Faschinger Christoph ,   Department of Ophthalmology, Medical University Graz, Graz, Austria,   Department of Ophthalmology, Medical University Graz, Graz, Austria
Published: October 2015

An individuals’ reaction to a specific drug is influenced by various factors including environmental, systemic and genetic factors. In most cases the reactions of a group of individuals are of the Gaussian type with non- to low responders at the lower end of the curve and high- to ultra-high responders at the upper end of the curve. As these extraordinary reactions to a drug are at least partly genetically determined pharmacogenetics is set to decipher the underlying genetic constitution and to establish an individualised genotype-based drug therapy. Candidate genes in pharmacogenetics include genes of receptors as well as their downstream pathway and genes of drug metabolising or activating enzymes. Most prominent examples from the medical literature are warfarin, clopidogrel and various psychotropic and oncological drugs. Regarding glaucoma therapy studies investigating the role of polymorphisms in the genes of β-adrenergic receptors, the important metabolising enzymeCYP2D6and the prostaglandin F2α receptor have been performed. Results of these studies are presented and an outlook on the role of pharmocogenetics in glaucoma therapy will be provided.
The Role of Femtolaser in Cataract Surgery
Authors: Nagy Zoltan Z ,   Professor of Ophthalmology, Department of Ophthalmology, Semmelweis University, Budapest, Hungary
Published: October 2015

Femtolasers were recently introduced into the surgery of the crystalline lens after having great success in corneal surgery. The most important indications and features are: perfectly centred and sized capsulotomy, liquefaction of softer lenses, fragmentation of harder lenses to help chopping of the cataractous lens without phaco energy, and lastly to create corneal wound in any position and size and also to control pre-operative astigmatism using arcuate incisions in the desired depth within the cornea. As a result of controlled steps in cataract surgery wide acceptance and spread is to be expected.
Pathogenesis of Pseudophakic Cystoid Macular Oedema
Authors: Lobo Conceição ,   Ophthalmologist, Department of Ophthalmology, University Hospital of Coimbra; Principal Investigator, Association for Innovation and Biomedical Research on Light and Image (AIBILI) and Institute of Biomedical Research on Light and Image (IBILI); and Invited Professor of Ophthalmology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Published: October 2015

Cystoid macular oedema (CMO) is a primary cause of reduced vision after cataract surgery even after uneventful surgery. The incidence of clinical CMO following modern cataract surgery is 1.0-2.0 % but the high number of surgeries performed worldwide makes this entity an important problem. Pre-existing conditions such as diabetes and intra-operative complications increase the risk of developing CMO post-operatively. CMO is caused by an accumulation of intra-retinal fluid in the outer plexiform and inner nuclear layers of the retina, as a result of the breakdown of the blood-retinal barrier. The mechanisms that lead to this condition are not completely understood. However, the principal hypothesis is that the surgical procedure is responsible for the release of inflammatory mediators, such as prostaglandins. Optical coherence tomography is at present an extremely useful non-invasive diagnostic tool. Guidelines for the management CMO should be focused essentially on prevention and are based on the principal pathogenetic mechanisms, including the use of anti-inflammatory drugs.
Diode Laser Trabeculoplasty in Patients with Pseudoexfoliative Glaucoma
Authors: Babić Nikola , Miljković Aleksandar , Andreić Veljko ,   Ophthalmologist, Head, Glaucoma Department, Eye Clinic, Clinical Center of Vojvodina, Vojvodina, Serbia and Assistant Professor, Medical Faculty University of Novi Sad, Serbia,   Ophthalmologist, Eye Clinic, Clinical Center of Vojvodina, Vojvodina, Serbia, and Teaching Assistant in Ophthalmology, Medical Faculty University of Novi Sad, Serbia,   Ophthalmologist, Eye Clinic, Clinical Center of Vojvodina, Vojvodina, Serbia
Published: October 2015

Aim:A prospective study was carried out to examine the efficacy of diode laser trabeculoplasty (DLT) in the treatment of pseudoexfoliative glaucoma (XFG).Material and Methods:Laser trabeculoplasty was performed by Zeiss VISULAS 532s diode pumped solid state laser on 69 eyes of 40 patients with XFG and primary open-angle glaucoma. Power of 6001,200 mW was used, with a spot size of 100 microns and a pulse of 0.10 second. One hour before DLT brimonidine 0.1 % was administered and during seven days after the treatment Dexamethasone 1 % was administered. All patients underwent complete ophthalmic evaluation before and at intervals after treatment (seven days, one, three and six months and one year postoperatively). During the follow-up period, patients were treated with the same topical anti-glaucoma medicaments as before diode laser trabeculoplasty.Results:Before treatment in XFG patients mean intraocular pressure (IOP) was 23.7±2.6 mmHg and seven days after DLT it was 16.8 ± 2.1 mmHg that is 26.9 % decrease from the baseline, on day 30 it was 14.3 ± 2.2 mmHg which is 38.3 % decrease from the baseline, after 3 months 13.9 ± 2.4 mmHg (39.0 % decrease from the baseline), after six months 13.8 ± 2.7 mmHg or 39.9 % decrease from the baseline and after one year 15.1 ± 3.1 mmHg that makes 36.3 % decrease from the baseline. No side effects (either objective or subjective) were present in examined patients.Conclusions:There is statistically significant difference between IOP before and after diode laser trabeculoplasty, so it is concluded that diode laser trabeculoplasty is an effective mode of treatment for eyes with open-angle glaucoma especially in patients with XFG.
Twenty-four-hour Blood Pressure Monitoring in Central Serous Chorioretinopathy – A Case-control Study
Authors: Venkatesh Pradeep , Jain Vikas , Garg Satpal ,   Additional Professor, Retina Services,   Resident,   Professor, Retina Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
Published: October 2015

Purpose:A case-control study to explore the diurnal variation of blood pressure (BP) in patients with central serous chorioretinopathy (CSCR).Methods:One-hundred patients (50 cases with central serous chorioretinopathy and 50 age- and sex-matched controls) participated in this study. Twenty-four-hour BP was recorded by auscultatory method using manual standard mercury sphygmomanometer by a single, trained observer. Hypertension was categorised according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VII) classification.Results:Mean systolic BP (SBP) and diastolic BP (DBP) in cases and controls were 123.4 mmHg (range 112.3134.6), 81.72 mmHg (range 73.090.5); 118.33 mmHg (range 108.4128.2); and 77.50 mmHg (range 71.483.6), respectively. The difference in SBP and DBP was statistically significant at p=0.02 for the former and p=0.006 for the latter. The mean difference in maximum and minimum SBP in cases was 18 (±15.81) mmHg versus 9.04 (±3.08) mmHg in controls (p=0.001). Mean difference for DBP in cases was 15.16 (±7.86) mmHg versus 9.16 (±3.68) mmHg in controls (0.001). On the JNC-VII classification scale for hypertension, 66 % of cases were found to be pre-hypertensive (60 %) or hypertensive (6 %). Comparative figures for controls were pre-hypertension (30 %) and hypertension (2 %). The mean SBP and DBP was consistently higher in patients with CSCR compared with controls over the entire 24-hour period. The difference in variation between maximum and minimum SBP and DBP was also found to be statistically significant between the groups.Conclusion:A significant correlation exists between higher values BP and central serous chorioretinopathy. Screening of CSCR patients for pre-hypertension may be useful in decreasing the risk of progression to established hypertension, with its associated risks.
Treatment of Optic Neuritis
Authors: Grzybowski Andrzej , Pieniążek Martyna ,   Head, Department of Ophthalmology, Poznan City Hospital,   Chair of Ophthalmology, University of Warmia and Mazury,   Resident, Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
Published: October 2015

Optic neuritis (ON) is a self-limiting condition caused by inflammation-driven demyelination process affecting the optic nerve. Main clinical features are sudden, unilateral worsening of visual acuity, colour vision disturbance, visual field defects and motion-induced ocular pain. Spontaneous recovery appears usually within up to 8 weeks. It is a frequent initial manifestation of multiple sclerosis. Treatment of optic neuritis remains controversial, although many clinical trials have been conducted to establish firm therapeutic guidelines. The most relevant clinical trial is the Optic Neuritis Treatment Trial (ONTT), proving three days intravenous methylprednisolone therapy is not able to change the long-term prognosis, however improving visual recovery, what became a therapeutic option in monocular patients, patients with significant visual field loss, as well as those with professional requirements of fast visual recovery. The ONTT showed that 15-year risk of developing multiple sclerosis was 50 % regardless of the treatment regimen. Oral corticosteroids are recommended for treatment of acute optic neuritis.
Intraocular Pressure Fluctuation – Assess in Clinical Practice
Authors: Hatanaka Marcelo ,   Head, Glaucoma Service, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
Published: October 2015

Intraocular pressure (IOP) is the main risk factor for the development and progression of glaucoma. Treatment is based on IOP reduction and isolated tonometric readings are usually performed for clinical management of the disease. However, IOP is not a static parameter and varies considerably throughout the day. This variability, or fluctuation, has classically been considered a risk factor for glaucoma. Nevertheless, recent studies demonstrate that pressure peaks are the most relevant IOP parameter for the prediction of visual field progression. The lack of a standard definition of IOP fluctuation compromises its clinical assessment and may explain in part the contradictory results found in the literature. This review will analyse options for IOP fluctuation assessment, their limitations and the impact of this parameter on the management of glaucoma.
Evaluation of Ocular Surface Disease Associated with Glaucoma Patients
Authors: Yuksel Nilay ,   Specialist in Ophthalmology, Kahramanmaras Necip Fazil City Hospital, Kahramanmaras, Turkey
Published: October 2015

The relationship between glaucoma medications and ocular surface disease (OSD) has been investigated for a long time by ophthalmologists. It has been well known that all preservatives used in topical medications have the potential to cause corneal and conjunctival changes, including dry eye. It is important to also consider the toxicity of the active ingredients. Objective tests for evaluating OSD are the Schirmer Test, Tear Break Up Time (TBUT), Fluorescein Clearance Test (FCT), impression cytology, confocal microscopy  the most common subjective test is Ocular Surface Disease Index (OSDI). Adverse effects associated with topical medication may have a negative effect on patient adherence to medical treatment, the patients life quality and the doctorpatient relationship. A favourable adherence to treatment will lead to more effective intraocular pressure (IOP) lowering and resultant decrease of glaucomatous vision loss.
Microstructural Changes in Central Serous Chorioretinopathy Documented by Spectral-domain Optical Coherence Tomography
Authors: Odrobina Dominik , Gozdek Piotr , Maroszyński Mariusz , Laudańska-Olszewska Iwona ,   Ophthalmology Clinic Boni Fratres Lodziensis Lodz, Poland,   Ophthalmology Clinic Boni Fratres Lodziensis Lodz, Poland,   Ophthalmology Clinic Boni Fratres Lodziensis Lodz, Poland,   Ophthalmology Clinic Boni Fratres Lodziensis Lodz, Poland
Published: October 2015

Central serous chorioretinopathy (CSC) was first described more than 140 years ago. Due to the rapid development in modern imaging methods, better understanding of changes occurring in the retina in CSC is possible. Spectral-domain optical coherence tomography (SDOCT) has increased our ability to study this disease, especially microstructural changes during active phase and after resolution of CSC. SD-OCT enables a highly detailedin vivoevaluation of the individual retinal layers especially external limiting membrane (ELM), the inner and outer segments of photoreceptors and changes in retinal pigment epithelium (RPE), which are the most essential and important in described disease. It allows us better understand pathogenesis of CSC.
Rosacea-associated Meibomian Gland Dysfunction – An Epidemiological Perspective
Authors: Viso Eloy , Clemente Millán Alejandro , odríguez-Ares María Teresa ,   Staff Ophthalmologist, Servicio de Oftalmología, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain,   Staff Ophthalmologist, Servicio de Oftalmología, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain,   Professor of Ophthalmology, Servicio de Oftalmología, Hospital Clínico Universitario de Santiago de Compostela and Departamento de Oftalmología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
Published: October 2015

The association between meibomian gland dysfunction (MGD) and rosacea is probably frequently underdiagnosed despite being one of the few associations of MGD that has been corroborated in population-based patients. Its diagnosis is not easy because the ocular signs and symptoms of this type of MGD are non specific and because the cutaneous signs may be minimal or absent; however, it is important because it may be associated with more severe manifestations such as keratitis, as several studies have shown, and a poorer prognosis. For this reason, clinical suspicion should be high especially in cases unresponsive to conservative measures and conventional treatment, and in those with inflammatory complications of the ocular surface.
Diagnosis and Treatment Methods for Ocular Surface Disease in Glaucoma
Authors: M Rossi Gemma C ,   Professor, University Eye Clinic of Pavia and Medical Doctor, Eye Clinic of the IRCCS Policlinico San Matteo Foundation, Pavia, Italy
Published: October 2015

Glaucoma and ocular surface disease (OSD) are often concomitant disorders (OSD is the consequence of a tear film dysfunction that may be due to several conditions). The aims of the paper are to suggest a sequence of diagnostic tests easy to perform in daily practice, both subjective and objective, to detect the onset of the OSD; and, second, to propose how to prevent and, if the case, how to manage the OSD. Briefly, tear film break-up time (TF-BUT) and corneal/conjunctival staining are suggested to detect the main signs of OSD. In terms of therapy, the long-term exposure to benzalkonium chloride (BAK) should be minimised, preferring non-BAK-preserved or BAK-free glaucoma medications, where available, as well as fixed combinations. The treatment of associated diseases of the anterior surface may reduce signs; use of non BAK-preserved tears may reduce symptoms.
Recent Advancements in Vitreoretinal Techniques – A Critical Reappraisal
Authors: Grosso Andrea , Arias Luis , Mariotti Cesare , Faraldi Francesco , Panico Claudio , Figueroa Marta ,   Consultant, Department of Ophthalmology, Torino Eye Hospital and Centre for Macular Research and Allied Diseases, San Mauro, Italy,   Consultant, Head of Retinal Department, Department of Ophthalmology, Bellvitge University Hospital, LHospitalet de Llobregat, Barcelona, Spain,   Associate Professor, Department of Ophthalmology, Polytechnic University of Marche, Ancona, Italy,   Consultant, Vitreo-retinal Service, Department of Ophthalmology, Torino Eye Hospital, Italy,   Director of Eye Trauma Centre, Department of Ophthalmology, Torino Eye Hospital, Italy,   President of Spanish Vitreo Retinal Society, Servicio de Oftalmologia, Ramon y Cajal University Hospital, Madrid, Spain
Published: October 2015

The purpose of this review is to stimulate a debate and doubts about future trends in vitreoretinal surgery and social and economic implications. We want to share with our colleagues the challenges of modern ophthalmic surgery in the era of technocratic medicine with the goal to conjugate the technological progress with economic sustainability and equity of access to health facilities and services. The increased possibilities provided by technology result in an increased responsibility. That is, there is no technological imperative, but technology promotes a moral imperative; in particular, it promotes a moral imperative to proper assessment. We offer a historical and economic reappraisal of recent advancements in vitreoretinal surgery since 2002 to todays state of the art in macular surgery and retinal detachment surgery.
Dry Eye and Clinical Disease of Tear Film – Diagnosis and Management
Authors: Chiva Andreea ,   Senior Clinical Biochemist, Department of Clinical Chemistry, University Emergency Hospital, Bucharest, Romania
Published: October 2015

Dry eye disease (DED) is one of the most frequent conditions in ophthalmology. The early diagnosis and the monitoring of therapy efficacy may help to prevent the severe complications and the impairment of visual function. This article presents the advances in the aetiology and diagnostic procedures of dry eye and clinical disease of tear film with a particular focus on SDS-agarose gel electrophoresis of tear proteins (Hyrys-Hydrasys SEBIA system). The test was used for the first time in the author’s laboratory and demonstrated an important clinical value in ocular and systemic diseases, as well as in high-risk groups for DED. The measurement of many target tear proteins (lactoferrin, lysozyme, albumin, immunoglobulin, proteins 20–60 kDa) in a single analysis using only 5 μl of tears with minimal cost and rapid results are strong arguments for including of SDS-agarose gel electrophoresis of tear proteins in routine test panel for DED.
Intraocular Lens Power Calculation – Still Searching for the Holy Grail
Authors: Hirnschall Nino , Findl Oliver ,   Resident,   Chief of the Institute and Chief of the Department, Vienna Institute for Research in Ocular Surgery (VIROS), Department of Ophthalmology, Hanusch Hospital, Vienna, Austria
Published: October 2015

Since the introduction of optical biometry and modern intraocular lens (IOL) power calculation formulae, the refractive outcome after cataract surgery improved significantly. This is necessary, as patient demand for spectacle independence is increasing. However, especially when it comes to short and long eyes, all formulae have their difficulties in predicting the effective lens position – and, therefore, the post-operative refractive outcome. This review summarises the development of IOL power calculation formulae, explains their basics and presents some alternative calculation methods.
Refractive Lens Exchange
Authors: El-Massry Ahmed , Abdellatif Eiman , El-Massry Mohamed Ahmed ,   Professor of Ophthalmology,   Lecturer of Ophthamology,   Third Year Residence and ICO Fellow, Department of Ophthalmology, Alexandria University, Egypt
Published: October 2015

Refractive lens exchange (RLE) still has a role in young age with anisometropia, or in an eye that is anatomically not suitable for phakic intraocular lens (IOL) implantation or in high hypermetropia. Furthermore, in the presence of water vacuoles in the crystalline lens above the age of 40, it is recommended to perform RLE rather than phakic IOL implantation. Multifocal refractive IOLs are designed with several optical zones on the IOL. Apodised diffractive multifocal IOL has gradual diffractive steps on the IOL implant that create a smooth transition between focal points. RLE is a surgery with the same risks of a cataract surgery. Complications do occur in RLE. The mean incidence of retinal detachment is 1 % while the mean incidence of cystoid macular oedema is 0.1 %. Contraindications include unstable refraction, amblyopia and the presence of certain eye pathologies as age-related macular degeneration, glaucoma, diabetic retinopathy and a high risk of retinal detachment.
Review of Diabetic Retinopathy Screening Methods and Programmes Adopted in Different Parts of the World
Authors: Pieczynski Janusz , Grzybowski Andrzej ,   Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Warszawska, Poland,   The Voivodal Specialistic Hospital, Olsztyn, Zolnierska, Poland,   Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Warszawska, Poland,   Department of Ophthalmology, Poznan City Hospital, Poznan, Poland
Published: October 2015

Introduction:One of most common diabetic complications is diabetic retinopathy (DR). Sight-threatening DR can be avoided when diagnosed early and treated in a timely fashion. The aim of this study is to review current worldwide DR screening programmes and studies.Methods:A PubMed platform search was performed to find clinical trials or studies of current DR screening methods.Results:Direct and indirect ophthalmoscopy is still used, but digital photography of the retina seems to be the most efficient, objective and cost-effective.Conclusions:DR screening programmes are developed all over the world. They help to detect early sight-threatening DR, treat it in a timely fashion and in this fashion help to avoid expensive, advanced treatment or even prevent to develop blindness among working age people.
Assessing Photoreceptor Structure in Macular Hole using Split-detector Adaptive Optics Scanning Light Ophthalmoscopy
Authors: Randerson Edward L , Davis Drew , Higgins Brian , Kim Judy E , Han Dennis P , Connor Thomas B , Wirostko William J , Carroll Joseph ,   Medical Student,   Ophthalmology Resident,   Research Technologist,   Professor of Ophthalmology,   Professor of Ophthalmology,   Associate Professor of Ophthalmology, Medical College of Wisconsin, Department of Ophthalmology, Milwaukee, Wisconsin, US,   Associate Professor of Ophthalmology, Medical College of Wisconsin, Department of Ophthalmology, Milwaukee, Wisconsin, US,   Professor of Ophthalmology
Published: October 2015

Introduction:Macular hole (MH) and vitreomacular traction (VMT) can involve disruption at the level of the photoreceptor interdigitation zone (IZ) and ellipsoid zone (EZ) with optical coherence tomography (OCT). Confocal adaptive optics scanning light ophthalmoscopy (AOSLO) has been used to examine the photoreceptor mosaic following surgical intervention in patients with MH and VMT, showing large ‘dark areas’ devoid of normal waveguiding cones. Using split-detector AOSLO, which allows visualisation of cone photoreceptor inner segments, we examined the macular cone structure in these disruptions.Methods:Seven eyes from six subjects with MH or VMT were imaged with spectral domain OCT (SD-OCT), confocal AOSLO and non-confocal split-detection AOSLO following pars plana vitrectomy (PPV) for MH or intravitreal injection with ocriplasmin for VMT.Results:Split-detector AOSLO imagery revealed remnant inner segment structure within dark areas observed with confocal AOSLO. In addition, split-detector images demonstrated that not all hyperreflective dots in confocal AOSLO images were derived from cones.Conclusion:Split-detector AOSLO provides additional information for these retinal conditions, and is likely to become an invaluable tool for assessing residual cone structure in conditions where disrupted cone structure interferes with the ability to visualise cells with confocal AOSLO.
Sublingual Immunotherapy for Respiratory Allergy
Authors: Calderon Moises A ,   Professor of Internal Medicine and Allergy, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital NHS, London, UK
Published: October 2015

Sublingual allergen immunotherapy (SLIT) is a new alternative for the treatment of respiratory allergy. Strong evidence-based medicine data on clinical efficacy and safety about SLIT support the new standardised products register in Europe and the US. SLIT-tablets significantly reduce nasal and ocular symptoms scores, reduce the use of relief medication and improves quality of life in both adults and children with pollen respiratory allergy. New data support its efficacy and safety for house dust mites (HDM) respiratory allergy.
Epidemiology of Prostate Cancer
Authors: Kumar Ravi J , Barqawi Al Baha , Crawford E David ,   Fellow, Urological Oncology, Member, Cancer Center, and Director, Clinical Cancer Unit, University of Colorado Health Sciences Center,   Fellow, Urological Oncology, Member, Cancer Center, and Director, Clinical Cancer Unit, University of Colorado Health Sciences Center,   Fellow, Urological Oncology, Member, Cancer Center, and Director, Clinical Cancer Unit, University of Colorado Health Sciences Center
Published: October 2015

Prostate cancer is a common condition worldwide. Different geographical regions have varying incidence and mortality.Globally,prostate cancer is the sixth most common cancer,and the third most common cancer in men in developed countries.The risk of prostate cancer is increased by African-American ethnicity,increasing age,positive family history,and other factors such as diet.Nonetheless,the causes of prostate cancer are not well understood compared with other common cancers like lung and breast cancer.The introduction of prostate-specific antigen (PSA) screening made an enormous impact on the incidence of prostate cancer, which increased in the early 1990s and is currently down to pre-PSA screening levels.Screening has caused a change in pattern of disease to an earlier stage but not lower grade.Death rates due to prostate cancer diminished in the 1990s due to a decrease in advanced cases with distant metastasis.
Chemotherapy-induced Nausea and Vomiting
Authors: Nevadunsky Nicole S , Matulonis Ursula A ,   Clinical Fellow, Department of Gynecologic Oncology, Brigham and Women’s Hospital,   Director, Medical Oncology, Department of Oncology, Dana Farber Cancer Institute
Published: October 2015

Nausea and vomiting are commonly observed and feared side effects of chemotherapy. Understanding of the physiological mechanisms of chemotherapy-induced nausea and vomiting (CINV) has led to the development of several classes of anti-emetic, including substance P antagonists, serotonin antagonists, and dopamine antagonists. The newest of these agents include aprepitant and palonosetron, which are very effective in treating emesis in highly emotegenic chemotherapies. Several organizations, including the Multinational Association of Supportive Care in Cancer (MASCC), the National Comprehensive Cancer Network (NCCN), and the American Society of Clinical Oncology (ASCO), have developed guidelines for classification and treatment of CINV. The aim of this article is to summarize current gold standards of anti-emetics and treatment guidelines, as well as introducing innovations such as approaches to breakthrough and refractory nausea and vomiting, alternative therapies, and transdermal delivery systems.