bluuebunny/crossref_metadata_2025 huggingface dataset:
AS‐OCT utility for corneal lacerations in pediatric patients
Authors: Sanchez Marin J.I. , Del Buey M.A. , Pérez Navarro I. , Almenara C. , Martínez V M.E.F.O. , Idoate A. , Berniolles J. , Bartolomé I.
Published: September 2016

Purpose

The purpose is to evaluate the utility of optical coherence tomography anterior segment (AS‐ OCT) through different clinical cases of corneal lacerations. OCT technology will help us to determine the corneal anatomy after trauma and deciding the therapeutic approach, in addition to guiding the prognosis, and evaluating response to treatment.

Methods

We examined the corneal trauma patients with the AS‐OCT performing exploration on the initial visit after trauma, which serves as a reference, and repeated again with the established treatment.

Results

The AS‐OCT provides us a more detailed diagnosis than one realized directly with the slit lamp, especially in pediatric patients, and helps us to determine more accurately the depth and location of the trauma diagnosis, possible presence of foreign bodies and to evaluate the response to treatment.

Conclusions

The AS‐OCT is a useful tool for an accurate diagnosis, especially in pediatric patients, in anterior segment ocular trauma and the evaluation of therapeutic response in these cases.
Iatrogenic Ozurdex® injection into the crystalline lens and surgical management
Authors: Sanchez marin J.I. , Ascaso F. , Pérez Navarro I. , Almenara C. , Martínez V M. , Estebán Floría O. , Idoate A. , Berniolles J. , Bartolomé I.
Published: September 2016

Purpose

Ozurdex® implant is a 700 micrograms implant of Dexamethasone approved for the treatment of macular edema secondary to diabetic retinopathy or retinal vein occlusion. The purpose is to describe the uncommon Ozurdex® injection into the crystalline lens and its management.

Methods

We present the case of a woman diagnosed with cystoid macular edema who underwent intravitreal Ozurdex® injection. During the procedure the implant was accidentally injected into the lens body. We also discuss about the surgical management of this complication.

Results

The patient was scheduled for phacoemulsification surgery of the lens with implantation of a 3‐piece lens into the sulcus because a tear in the posterior capsule was identified during the surgery.

Conclusions

Few problems involving the anterior segment in Ozurdex® implants have been described. However, the injection of the dispositive into the crystalline lens is a rare complication we must take into account. Cataract surgery should be performed as soon as possible and we must keep in mind the posible damage of the structures such as posterior capsule or lens zonules. We recommend the management of these cases with a 3‐pieces IOL into the sulcus.
Retinal nerve fiber layer measurements in multiple sclerosis patients using new Swetpt‐Source Optical coherence tomography Triton device
Authors: Cipres Alastuey M. , Vilades Palomar E. , Garcia Martín E. , Satué M. , Rodrigo M.J. , Obis Alfaro J.
Published: September 2016

Purpose

To evaluate retinal nerve fiber layer (RNFL) thickness measurements changes in multiple sclerosis (MS) patients using Swept‐source optical coherence tomography (SS‐OCT)

Methods

101 healthy and 97 MS eyes were included. All of them underwent retinal evaluation using DRI Triton 3DH wide scan and retinal peripapillary thickness was analyzed: Total retinal thickness, CFNR, GCL+ (ganglion cells layer between CFNR and inner nuclear layer) and GCL++ (from the inner limiting membrane to inner nuclear layer) thickness were evaluated. Comparisons between the two groups were performed using Student's T test

Results

GCL+ showed significant thinning in MS patients compared to controls, in temporal, nasal and superonasal sectors; GCL++ and RNFL thickness were significantly lower in the MS group in all the sectors except nasal; total retinal thickness was lower in MS patients in all sectors. (p < 0.05)

Conclusions

Peripapillary retinal structural alterations can be detected in MS patients using SS‐OCT Triton. Further studies comparing Spectral domain and Swept source OCT are needed to demostrate superior capability of SS‐OCT technology to detect retinal changes in these patients.
SMA+perivascular cells evaluation in VEGF induced blood‐retinal barrier breakdown in rabbit model
Authors: Grillo‐Antonelli S. , Mauro V. , Cimbolini N. , Feraille L. , Elena P.P.
Published: September 2016

Purpose

Diabetic Retinopathy (DR) is one of the hallmark microvascular diseases secondary to diabetes. Endothelial cells and perivascular cells are key players in the pathogenesis. It has been shown that VEGF coordinates interactions between endothelial and perivascular cells. In rodent studies, VEGF injected into the eyes results in vascular retinal permeability with pericyte loss. Immunochemistry used for quantification of perivascular cells is well described for murine species but not for rabbit. The aim of the present study was to evaluate perivascular cell pattern in rabbit induced retinal permeability model.

Methods

Ten pigmented rabbits were induced by intravitreal injection of 500 ng rhVEGF165 into the right eye. At day 2, quantification of vascular leakage was evaluated by fluorometry in both eyes. At day 3, both eye were sampled and fixed. Anti‐ SMA and Isolectin B4 staining was performed on flat‐mounted retina. The evaluation of SMA+cells was performed along the microvasculature.

Results

Area of SMA+cells decreased with distal progression along the arterioles and venules: from 78% to 47% of coverage for arteriolar tree and 69% to 47% for venular tree, less coverage for capillary (30%). Flat‐mounted retina immunostaining analysis revealed that VEGF‐induced treated eyes displayed a remodeling and a loss of the SMA+cells coverage in comparison with left non‐induced eyes: Radial arteriole coverage decreased by 27% (A2) and 23% (A3) in VEGF‐induced eye. Radial venular coverage decreased by 22% (V2) in VEGF‐induced eye. No difference was observed on capillary vessel type with SMA immunolabelling.

Conclusions

This study showed the SMA+cells coverage pattern of retinal microvasculature in rabbit eyes and indicates that VEGF decreased SMA+cells coverage of both arteriolar and venular tree in an induced blood‐retinal barrier breakdown rabbit model.
Thickness of chorioretinal complex in the fovea in teenagers with myopia
Authors: Boychuk I. , Shebil S. , Ivanickaya E.
Published: September 2016

Purpose

To study the features of chorioretinal complex in teenagers with myopia of different degree this work was done.

Methods

Measurement of choroidal layer thickness in the fovea was performed in 27 patients aged 14–16 y.o. (7 with mild degree of myopia, 10 with medial and 10 with high degree) .Visual acuity with correction was (0.8 ± 0.2), refraction (−1 to 7.0) dptr (average (−3.6 ± 0.45) dptr). All patients underwent General ophthalmic observation; the thickness of the choroidal layer was measured by OCT (SPECTRALIS Tracing Laser Tomography, Heidelberg Engineering) according to standard protocols in the fovea in both directions of scan. The value of chorioretinal complex in the fovea was measured from the vertical Hyper‐reflective layer of pigment epithelium to the border connections of the choroidal and sclera tissues.

Results

Data analysis showed significantly greater thickness (198 ± 15.9) μm of chorioretinal complex in fovea in children with mild myopia, than in medial cases (164 ± 17.0) μm, p = 0.02 and myopia of high degree (139 ± 17.0) μm, p = 0.001. It is known that in healthy patients choroidal thickness is 270–350 μm, i.e. in adolescents with myopia choroidal thickness is significantly thinner. We have not found significant differences of choroidal thickness in patients in the fovea when measured in the horizontal and vertical directions of scan (paired t‐test, p = 0.2).

Conclusions

It is established that the thickness of chorioretinal complex in the fovea in adolescents with myopia is significantly thinner compared to healthy. 2. The thickness of chorioretinal complex in the fovea in adolescents with mild myopia significantly thicker than in teenagers with myopia of medial and high degree (p = 0.02, p = 0.001, respectively).
Macular hole angle as a surgery prognostic factor
Authors: Rocha de Sousa A. , Silva M.I. , Morais A.S. , Falcao M. , Falcao‐Reis F.
Published: September 2016

Purpose

To analyze pre‐surgical macular hole (MH) angle measured by spectral domain optical coherence tomography (SD‐OCT) and its influence on anatomical and visual outcomes of macular hole surgery

Methods

A retrospective observational study of 37 eyes, with idiopathic MH, of 37 patients was conducted between 2013 January 1st and 2014 December 31st. Temporal and nasal angles of the macular holes were measured as the angle between RPE and the retinal edge. Angles were measured using a protractor directly on the screen of the SD‐OCT machine. For statistical analysis, the approximate average angle of the macular hole was estimated through the average between the temporal and nasal angle of each eye. Besides medium MH angle, other parameters were considered, including minimum hole diameter; hole base diameter; hole height and presence of cystic edges. Several MH indices, such as Macular Hole Index, Tractional Hole Index and Diameter Hole Index, were calculated. Separate multivariate regressions for the dependent variables final best corrected visual acuity and anatomical closure were performed to analyze their associations with SD‐OCT parameters as independent variables.

Results

Median average angle was 43.5 (35.0–45.5) degrees. Multivariate analysis showed that average angle did not significantly correlated to anatomical closure and final visual acuity, in contrast to hole base diameter and hole height that significantly correlated to final visual acuity.

Conclusions

Our study demonstrates that MH angle did not correlate to anatomical or visual outcome after MH repair surgery.
Comparison of visual and refractive outcomes after implantation of a new diffractive trifocal toric lens, a trifocal lens and a monofocal toric lens
Authors: Marechal M. , Delbarre M. , Berguiga M. , Rambaud C. , Benisty D. , Charpentier S. , Timsit A. , Froussart‐Maille F.
Published: September 2016

Purpose

To evaluate a diffractif trifocal toric intraocular lens (IOL) comparated with a trifocal IOL and a monofocal toric IOL.

Methods

This retrospective comparative study included patients with visually significant cataract or presbyopia who were scheduled for lensectomy and implantation of IOL. They were included in 3 groups according to the IOL implanted: multifocal group, multifocal toric group and toric group. At 1 month postoperatively, visual acuity (VA) at long and near distance, and refractive outcomes were examined.

Results

70 eyes of 45 patients were included. 21 eyes in the multifocal group, 22 in the multifocal toric group, and 27 in the toric group. The mean age of patients was 70.7 years +/− 10.6 (range 52–91 years). Postoperatively, the mean refractive astigmatism decreased to 0.71D, 0.77D and 0.72D respectively in the 3 groups. The distance uncorrected VA was 0.13logMar +/− 0.11 for multifocal group, 0.13logMar +/− 0.16 for multifocal toric group and 0.12logMar +/− 0.11 for toric group. There were no statistically differences between the 3 groups for the uncorrected distance VA, and between multifocal group and multifocal toric group for the uncorrected near VA.

Conclusions

Diffractif trifocal toric IOL provided useful VA at any distance. The addition of a toric surface to the aspheric diffractive multifocal IOL resulted in a comparable visual performance.
A new approach of presbyopia over a myopic population: PresbyLASIK using the myopic SUPRACOR Algorithm (preliminary results about 12 eyes)
Authors: Timsit A. , Delbarre M. , Rambault C. , Marechal M. , Charpentier S. , Benisty D. , Berguiga M. , Froussart‐Maille F.
Published: September 2016

Purpose

The aim of our study was to analyze refractive outcomes and satisfaction after myopic presbyLASIK with induced micro‐monovision (−0.50 D), a new approach of correcting presbyopia among myopic patients.

Methods

This retrospective consecutive cases study included 12 eyes of 9 patients treated for myopia and presbyopia with central presbyLASIK with micro‐monovision using the Technolas 217P excimer laser (Technolas Perfect Vision GmbH, Munich, Germany) between December 2014 and May 2016. Study parameters included uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA), iniitial and final sphere and cylinder, abberrometry, central steep zone, and patient satisfaction.

Results

Patients median age was 50.7 ± 4 years (range: 46–54 years), predominantly females at 78%, with a mean preoperative spherical equivalent of −3.38 [−1.25; −5.25]. Mean postoperative spherical equivalent refraction was 0.18 ± 0.47 diopters (D) for dominant eyes and −0.45 ± 0.46 D for dominated eyes. Mean monocular UDVA was 0.09 ± 0.10 logMAR (Snellen 20/24) at 1 month postoperatively. Mean binocular UDVA was −0.06 ± 0.07 logMAR (Snellen 20/18) at last follow‐up visit. Mean binocular UNVA was 0.18 ± 0.14 logMAR (Parinaud 2). At 1 months, 83.3% of patients achieved 20/20 or better and could read Parinaud 2 binocularly, and 91.6% of patients achieved 20/20 and could read Parinaud 3 binocularly. The mean central steep zone was 1.95 ± 1.00 D. There was no need for retreatment (under/over‐correction) but one eye underwent interface washing with corticoids. Patients were satisfied in 92 and 80% were independent of spectacles at all distances.

Conclusions

Myopic PresbyLASIK is safe and efficacious with postoperative improvement in binocular vision at far, intermediate, and near distances vision, being an attractive alternative to monovision.
Retinal function and morphology in Mitf mutant mice
Authors: Garcia Llorca A. , Gudmundsdóttir Aspelund S. , Ogmundsdóttir M.H. , Steingrimsson E. , Eysteinsson T.
Published: September 2016

Purpose

The Mitf (microphthalmia‐associated transcription factor) gene that is essential for the normal development of the retinal pigment epithelium (RPE). Mutations in this gene can cause hypopigmentation, microphthalmia and blindness. The purpose of this work was to analyze the retinal function and morphology in mice with specific Mitf mutations.

Methods

The following Mitf mutations were used: Mitfmi‐enu122 (398), Mitfmi‐wh/+, Mitfmi‐wh/Mitfmi and wild type (C5BL/6J) mice as a control. Mice were anesthetized by an intraperitoneal injection of 40 mg/kg−1 Ketamine and 4 mg/kg−1 Xylazine. Flash electroretinography (ERG), from mice with pupils dilated, with a corneal electrode and a reference electrode placed in the mouth, was used to determine the role of the MITF protein in retinal function. Histological retinal sections were stained with hematoxylin and eosin.

Results

ERG recordings revealed that only one of the four mutants had any retinal function. The wild type mice had significantly higher mean amplitudes of the photopic a‐waves and scotopic oscillatory potentials than the Mitfmi‐enu122 (398) animals (α = 0.05). Furthermore, Mitfmi‐enu122 (398) had significantly shorter implicit times for the photopic b‐waves and c‐waves. Histology revealed that the RPE layer in the Mitfmi‐enu122 (398) and shows localized thinning of the RPE and their retinas look normal. However, the Mitfmi‐wh/+ showed a profound RPE degeneration and this layer is missing from the Mitfmi‐wh/Mitfmi animals. Furthermore, Mitfmi‐wh/+ and Mitfmi‐wh/Mitfmi have an immense retinal degeneration, lacking the photoreceptor and outer plexiform layers.

Conclusions

This study demonstrates that the Mitf gene has an impact on retinal function in mice, and the morphology of the neuroretina and the RPE.
Histomorphological changes of uveal melanoma (UM) following proton beam therapy (PBR)
Authors: Qureshi S. , Hussain R. , Kalirai H. , Heimann H. , Coupland S.
Published: September 2016

Purpose

PBR is used for the treatment of UM. Little is known about histomorphological alterations in UM following PBR. Our aim was to document these changes.

Methods

Data was obtained for 25 UM enucleation samples following PBR between Jan 2005–Dec 2015. Histological sections were examined for morphological changes affecting tumour cells, its microenvironment and adjacent sclera. Data was analysed using SPSS Software.

Results

730 patients underwent enucleation at the Liverpool Ocular Oncology Centre (646 primary, 84 secondary); 41 underwent enucleation following PBR, of which 25 samples were analysed. Histological examination of tumour type classified 5 UM as epitheloid, 9 spindle, and 11 as mixed. Focal necrosis was seen in 10 cases (41.7%); bizarre mitoses in 5 (20.8%); tumour cell‐ ballooning in 17 (70.8%) and mummification in 12 (50%); and vessel wall‐ thickening in 13 (54.2%) and hyalinization in 15 (62.5%). Prominent tumour infiltrating lymphocytes (TIL's) were noted in 17 UM (70.9%), and tumour‐associated‐macrophages (TAM's) in 15 (62.5%); 19 UM (79.2%) had noticeable degenerative scleral changes. Median time elapsed between PBR and enucleation was 14.5 months (range 7–26). Bivariate analyses demonstrated statistically significant correlations between interval from PBR to enucleation and histological changes (bizarre mitoses (p = 0.035); tumour cell mummification (p = 0.025), nuclear inclusions (p = 0.002); TILs/TAMs (p = 0.022); plasma cells (p = 0.021); and hyalinisation (p = 0.031). UMs enucleated >20 months following PBR were 1.73 times more likely to have inflammation and bizarre mitoses than eyes enucleated within 10 months following PBR (p = 0.041).

Conclusions

The histopathological alterations of UM following PBR are complex, and evolve over time, with increasing degenerative and inflammatory changes. Immunohistochemical and genetic studies are underway.
Comparison of the retinal measurements of standard and neurological SD‐OCT applications in MS patients
Authors: Paterno J.J. , Kaarniranta K.
Published: September 2016

Purpose

In multiple sclerosis (MS), spectral domain optical coherence tomography (SD‐OCT) provides a tool to evaluate structural retinal changes related to MS. Recently, an application dedicated to visualize and quantify changes in MS and other neurodegenerative diseases became commercially available. Unlike the standard SD‐OCT, it is not yet widespread in eye clinics in Finland. Therefore, aim of the present study was determine if correlation exists in the retinal measurements between this and standard SD‐OCT application, using scan pattern presets feasible in monitoring of MS.

Methods

Seven patients (mean age 48.2 ± 12.8 years) with previously diagnosed MS were examined in both eyes with Spectralis SD‐OCT (Heidelberg, Germany) in Kuopio University Hospital, Finland. Retinal nerve fibre layer (RNFL) thickness scans around the peripapillary retina (PPR) were performed with the Nsite Analytics and the standard glaucoma application (Heidelberg). Volumes of the retina and its layers in the 9 macular sectors, as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS), were measured by Heyex Viewing Module software with automated retinal layer segmentation (Heidelberg).

Results

Correlations between the measurements of the Nsite Analytics and the standard application were strong (r > 0.9; p < 0.01) in PPR RNFL thickness and in total macular retinal volume. In part, correlations of retinal layer volumes were weaker. Both applications interpreted the degree of PPR RNFL atrophy in a comparable manner (κ > 0.7; p < 0.01), except the temporal superior sector.

Conclusions

As an accessible alternative, the standard SD‐OCT can be used for measuring retinal changes in MS patients. However, an application actually designed for neurological diseases provides tools to visualize these changes and to evaluate the degree of the thickening of PPR RNFL above normal limits.
Wide‐field autofluorescence and scanning laser ophthalmoscopy: a tool for differential diagnosis of intraocular tumors
Authors: Esposti G. , Denaro R. , Hadjistilianou D. , Chimenti G. , Esposti P.L.
Published: September 2016

Purpose

Fundus autofluorescence is a non invasive technique for evaluation of intrinsic autofluorescence of the tissues within the eye; it is an important diagnostic tool for the assessment of various ocular diseases and also for the differential diagnosis of intraocular tumors. The fundus autofluorescence represents the status of the overlying retinal pigment epithelium (RPE) and the natural activity of the complex RPE‐ photoreceptors.

Methods

We have examined 60 eyes of 60 patients: 40 nevi, 12 melanomas, 6 angiomas, 2 choroidal metastasis from lung cancer. All patients carried out a complete eye examination, an OCT (optical coherence tomography), an autofluorescence using a green wavelenght (532 nm) and a blu wavelenght (488), and a fluorangiography. The number of follow‐up was based on the pathology analyzed.

Results

The autofluorescence is predictable of the nature of the tumor. Whereas the diagnosis of small coroidal melanomas remains controversial, imaging such as OCT and fundus autofluorescence are useful to detect subretinal fluid and lipofuscine. It is an additional useful tool together with OCT, fundus photography, ultrasonography and fluorangiography in making differential diagnosis.

Conclusions

Studying the different characteristics of intraocular tumors at autofluorescence we can have important indications about the nature of the tumor. Some findings are strongly characteristics of certain tumors: a choroidal nevus appears silent at autofluorescence, while melanomas show an area of hypo‐autofluorescence; the gravitation tract is typical of angiomas and metastasis appear as a patchy pattern of hyper‐autofluorescence and hypo‐autofluorescence.
A comparison of visual field testing with a new automated perimeter, the Compass visual field analyser, and the Humphrey visual field analyser
Authors: Fenolland J.R. , Bonnel S. , Rosenberg R. , Sendon D. , Ghazal W. , Giraud J.M. , Renard J.P.
Published: September 2016

Purpose

To compare a new visual field analyser, Compass, that included an eye tracking and scanning ophthalmoloscopy to Humphrey visual field analyser (HFA).

Methods

Prospective cross study design.

Patients were included after a complete examination: all were indemn of ocular disease except glaucoma. Visual acuity was 20/20 for each eye and spherical equivalent ranged from +3 to −3 D.

Patients were randomly assigned to one instrument. HFA was performed with a 24‐2 SITA standard strategy comparable to the Compass 24‐2 ZEST strategy. Both eyes were tested and 30 min after where screened with the other instrument.

MD, PSD and exam duration were compared for both devices using a Wilcoxon signed‐rank test. Agreement was evaluated with a Bland‐Altman graph for each parameter.

Results

The study included 67 eyes of 30 patients. This population was decomposed as: 13 normal eyes, 28 OHT or glaucoma suspect and 26 glaucoma. Patients’ demographics were (mean ± SD): age 66.3 ± 13.0 years, pachymetry 527.6 ± 28.95 μm, axial length 23.73 ± 0.99 mm, spherical equivalent −0.004 ± 1.3 D. 65 HFA vs. 62 compass visual fields were reliable (ns). Mean Deviation was equivalent for HFA and Compass instruments: −1.6 ± 2.6 vs. −1.4 ± 2.8 dB (p = 0.28). Pattern Standard Deviation was significantly higher for the Compass 3.9 ± 2.4 vs. 2.4 ± 1.9 dB for the HFA (p < 0.0001). Examen duration was also longer for the Compass 351 ± 83 s vs. 318 ± 48 s for the HFA (p = 0.0164). Bland Altman plots showed a good agreement between HFA and Compass.

Conclusions

This study shows that MD and failure rate were comparable between both instruments, PSD and examination duration were slightly higher for the Compass. Agreement was good between both instruments.

As most of the patients included had already performed a HFA before, this may explain the duration difference between and should be consider in further explorations.
The predegenerated nerves extract enhances the endogenous neuroprotective system of Retinal Ganglion Cells by modulating of BDNF expression in rat glaucoma model
Authors: Pietrucha‐Dutczak M. , Smędowski A. , Lewin‐Kowalik J.
Published: September 2016

Purpose

To verify impact of the administration of extract from predegenerated rat sciatic nerves on the expression and co‐localization of endogenous BDNF and whether this change promotes survival of RGCs in rat glaucoma model.

Methods

Experimental glaucoma was induced unilaterally (the right eye) based on modified bead model. The left eye served as control. Two, 7, or 14 days following glaucoma induction, nerve extract (PNE groups) or PBS was injected into the vitreous body. Time of exposure of RGCs to the extract was 2, 3, or 4 weeks. Five days before euthanasia, RGCs were labeled by FluoroGold (FG). Number of FG‐positive RGCs was estimated and expression of BDNF was analyzed in immunohistochemistry.

Results

BDNF was highly expressed in inner nuclear layer (INL) and RGC layer in the healthy eye and weakly in RGC layer in glaucoma. Injection of the extract at 14th day following induction of glaucoma and 3‐week‐exposure to the extract resulted in the strongest increase in endogenous BDNF expression in both INL and ONL and weaker in RGC layer what was correlated with the highest RGCs survival (2,943 ± 147 in PNE group vs. 2,212 ± 497 in PBS group; p < 0.05). BDNF expression in RGC layer co‐localized with RGCs markers and glial cells markers (both cells bodies and processes).

Conclusions

The increase in the endogenous BDNF expression is correlated with survival of RGCs and is the highest when the extract is administered 14 days following glaucoma induction acting for 3 weeks.
Nasolacrimal duct reconstitution with radiofrequency: case report
Authors: Carvalho B. , Machado M.A.C. , Ferrari da Silva J.A. , Alonso Garcia E.
Published: September 2016

Purpose

To describe a minimal invasive technique for nasolacrimal duct reconstitution with radiofrequency in a case of lacrimal flow restriction.

Methods

Case report of a 23 years‐old female, with previous history of tearing, swelling, redness and pain over the innermost aspect of the lower eyelid of her right eye (RE). The symptoms started four years ago and sometimes relapses and discharge. The patient denies any other comorbilities, systemic or local complaints or any medication. External examination RE: Milder test +++, BUT inferior to 3’’. LE: Milder test +, BUT inferior to 3’’. Both eyes present inferior punctate keratopathy. It was diagnosed low nasolacrimal obstruction in RE, confirmed with dacriocistography. Treatment option was nasolacrimal duct reconstitution with radiofrequency under sedation and local anesthesia.

Results

The patient was followed for at least one year. She was evaluated for the presence of secretion, epiphora, reflux at compression of the lacrimal sac, placement of silicone tube and Milder test. At postoperative visits, the patient presented positive irrigation with clearance of lacrimal duct.

Conclusions

Reconstitution with radio frequency seems to be a solution to be considered. The presented technique was effective in the treatment of nasolacrimal duct obstruction with a good safety profile, being less invasive when compared with the classic DCR. Prospective, comparative, multicentric studies and larger follow up are still needed.
Correlation of foveal bulge on SD‐OCT and visual acuity in resolved macular edema associated with branch retinal vein occlusion
Authors: Bouraoui R. , Dhouib N. , Bouladi M. , Zerei N. , Maamouri R. , Chaker N. , El Matri L.
Published: September 2016

Purpose

To investigate the correlation between the presence of a bulge in the photoreceptor inner segment/outer segment (IS/OS) line and the best corrected visual acuity (BCVA) in eyes with resolved macular edema associated with branch retinal vein occlusion (BRVO).

Methods

A total of 17 eyes (17 patients) with macular edema associated with BRVO were evaluated. The medical records of patients who had a complete resolution of macular edema with intact IS/OS line in the central fovea on spectral‐domain optical coherence tomography (SD‐OCT) images were retrospectively reviewed. These eyes were classified into those with foveal bulge and those without foveal bulge and the characteristics of the 2 groups were compared.

Results

Twelve eyes (70.5%) had complete resolution of macular edema after a mean follow up of 24.1 months. A foveal bulge was present in 9 of 17 eyes with resolved macular edema. The BCVA was significantly better in eyes with a foveal bulge than in eyes without foveal bulge (p < 0.001). All eyes with foveal bulge had a decimal BCVA less than 0.5 against only 28.6% in eyes without foveal bulge (p = 0.011).

Conclusions

Foveal bulge seems to be frequent in resolved macular edema associated with BRVO. Visual acuity was significantly better in the subgroup with foveal bulge making it a potential good marker of the functional properties of the fovea.
Analysis of SD‐OCT prognostic factors in macular edema associated with retinal vein occlusion
Authors: Bouraoui R. , Bouladi M. , Dhouib N. , Mghaieth F. , Limaiem R. , Chaker N. , El Matri L.
Published: September 2016

Purpose

To identify quantitative and qualitative spectral‐domain optical coherence tomography (SD‐OCT) prognostic factors for visual outcome in patients with macular edema secondary to retinal vein occlusion.

Methods

Fourty one patients (41eyes) with retinal vein occlusion were retrospectively analyzed with SD‐OCT before and after resolution of macular edema. We evaluated the influence of these patterns on visual acuity: central macular thickness, total macular volume (TMV), continuity of the junction between photoreceptor inner and outer segments (IS/OS), of the external limiting membrane (ELM) and of the internal limiting membrane (ILM), and the number of hyperreflective foci.

Results

The logMAR VA was significantly better in eyes with continuous IS/OS line, ELM and ILM (p < 0.001) and in eyes with a lower number of hyperreflective foci (p = 0.032). Visual acuity was also statistically better in patients with a thinner central retinal thickness (p = 0.046) and a less total macular volume (p = 0.023) in patients with BRVO.

Conclusions

SD‐OCT seems to be helpful in predicting visual outcomes in macular edema associated with retinal vein occlusion and shows that outer layers integrity was closely associated with visual prognosis.
Presentation and management of cytomegalovirus retinitis in immunocompromised children
Authors: Denier C. , Robert M. , Adjadj E. , Michel S. , Aymard P.A. , Bremond‐Gignac D.
Published: September 2016

Purpose

Cytomegalovirus retinitis in children is poor known and his management remains controversial. The objective of this study is to provide a precise clinical description and set a treatment protocol for a better management of these patients.

Methods

Retrospective study including all children's eyes with primary immune deficiency (PID) patients with CMV retinitis confirmed by PCR on aqueous humor. The treatment protocol consisted of: an anti‐viral treatment with intravitreal injection (IVT) associated with general treatment. The primary endpoint was the good response to treatment defined by a quantifiable vision at the end of treatment.

Results

Fifteen eyes of 8 children aged 6 months to 10 years were included, of 156 children transplanted for PID. Each eye received 4.7 ± 2.5 IVT of Gancyclovir (12/15) or Foscarnet (3/15). The time between IVT was 4, 8 ± 2 days. A systemic treatment was initiated. Eight eyes were placed in the ‘good recovery’ group (BR) and seven eyes of four patients in the ‘poor recovery’ group (MR). In the BR group's initial involvement was peripheral or sectorial, while in the MR group achievement was broadcast for four eyes or sectoral reached the posterior pole for three eyes. The number of IVT by eye and the time between IVT were not different between the groups as well as systemic therapy. At the end of treatment in the BR group the posterior pole was normal for five eyes or showed a para‐macular scar for three eyes. In the MR group, five eyes showed diffuse fibrosis and two macular scar.

Conclusions

Visual prognosis seems related to the extent of the initial damage, the need for regular checks of the FO in children at risk is paramount. Regarding the treatment protocol, an average of four ganciclovir IVT to two per week without exceeding six IVT, combined with the general treatment appears to be an effective protocol.
Retinal toxicity of intraocular silicone oil: a retrospective study
Authors: Rocha de Sousa A. , Roca A. , Barbosa‐Breda J. , Falcão‐Reis F.
Published: September 2016

Purpose

To determine the relation between the use of silicone oil (SO) as an intraocular tamponade and the incidence of unexplained loss of visual acuity.

Methods

A retrospective study of 175 patients who underwent SO removal at Department of vitreo‐retinal surgery at Centro Hospitalar São João between January 2012 and June 2015.

Results

Nine patients (5.1%) (4 male, 5 female), with a median age of 57 years (range 31–84 years) reported reduction of vision of unexplained cause after SO extractions. The median time of SO fill was 8 months (range 4–21 months). Patients with 2 or more lines of vision loss of unexplained cause after removal of silicone oil (ROSO) showed a mean drop of visual acuity of 0.2. The intraocular pressure (IOP) became elevated in 7 (77.8%) eyes during the follow up period. Only 2.9% of patients who underwent ROSO had cataract as a complication.

Conclusions

There is a 5.1% overall incidence of unexplained loss of vision in eyes following SO removal, with a high rate in women (55.6%). The main complication observed was ocular hypertension.
Wooden projectile caused eye injuries in Finland – Helsinki eye trauma study
Authors: Haavisto A.K. , Sahraravand A. , Leivo T. , Holopainen J.
Published: September 2016

Purpose

To report the current population‐based epidemiology, treatment, use of resources and outcomes of eye injuries caused by sticks, branches and other wooden projectiles in Finland.

Methods

The study included all new patients injured by sticks, branches and other wooden projectiles with ocular or orbital traumas taken into care to the Helsinki University Eye Hospital (population base 1.5 million people) in one year. The follow‐up period was three months.

Results

Sixty‐seven patients with male dominance (76%) were treated because of eye injury from wooden projectiles, compromising 6% of all new eye traumas treated in a one year period. Injury was most likely in spring (36%) and autumn (27%) and at the age of 51–57 years. The most common activity during the accident was playing (27%), forestry (16%) and gardening (15%) and most common diagnose after mild superficial trauma (n = 36, 54%) was contusion (n = 25, 37%), followed by eye lid wound (3), orbital fracture (2) and open globe trauma (1). Seven patients (10%) were estimated to have permanent disability because of lowered visual acuity (3), double vision (2), evisceration (1) and glare due to mydriasis (1), all being adults. Traumas were contusions and one orbital fracture and one open globe trauma caused in variable activities. Twenty five patients (37%) were estimated to need lifelong follow‐up, most (24) because of contusion and one because of open globe trauma. Five of these patients were children age 3–11 years. Most took place during playing (7) or forestry (4). Eleven patients needed major surgeries. The number of outpatient visits was 167 and inpatient days 30.

Conclusions

Wooden projectiles cause serious eye injuries, permanent disability and need for lifelong follow‐up. More precaution should attend for eye protection when playing with sticks and during forestry and gardening.
Pollen count compared with severity of symptoms and signs of dry eye disease in Norway
Authors: Eidet J.R. , Tashbayev B. , Chen X. , Ræder S. , Badian R. , Utheim Ø. , Fostad I.G. , Dartt D.A. , Utheim T.P.
Published: September 2016

Purpose

To investigate whether pollen counts are associated with severity of symptoms and signs of dry eye disease (DED) in Oslo, Norway.

Methods

The mean daily number of birch or grass pollen grains per cubic meter of air (pollen count) in Oslo from 2012 to 2015 between March and September were provided by The Norwegian University of Science and Technology and The Norwegian Asthma‐ and Allergy Association. Four hundred and twelve DED patients that were examined for the first time on the same day as pollen data were available were included. Symptoms of DED were measured by the Ocular Surface Disease Index (OSDI) self‐report questionnaire and signs of DED included measurements of tear osmolarity, tear film break‐up time, blink interval, ocular protection index, Schirmer I, staining, meibum expressibility and meibum quality from the right eye. Symptoms and signs, as well as the composite score for dry eye severity level (DESL), were compared with pollen count using Pearson's and Spearman's correlations, Chi square test and Mann‐Whitney U‐test.

Results

Birch pollen was generally only detectable during April and May, whereas grass pollen was normally detectable during June. Neither birch (rs = −0.13; p = 0.81) nor grass (rs = 0.06; p = 0.38) pollen were associated with symptoms of DED as measured by the OSDI. Except Schemer I test, which surprisingly was negatively related to grass pollen count (rs = −0.15; p = 0.02), neither pollen types correlated with DESL or any signs of DED. Only 5.6% of the patients reported the use of systemic prescription drugs against allergy, thus the weak association between pollen counts and severity of DED appear not to have been confounded by concomitant use of anti‐allergy medications.

Conclusions

The severity of symptoms and signs of DED in Oslo, Norway does not seem to be strongly associated with either birch or grass pollen count.
Novel molecular design of culture substrates with amino acids
Authors: Momtazi L. , Shahdadfar A. , Zell Thime H. , Noer A. , Nilsen O. , Eidet J.R.
Published: September 2016

Purpose

Biocompatible and bioactive substrates are important in tissue engineering. The nature of these substrates can directly influence cellular response, ultimately affecting the rate and quality of new tissue formation. A novel atomic layer deposition/molecular layer deposition (ALD/MLD) technique was used to build cell culture substrates to do a preliminary assessment of this techniques’ potential within ocular surface tissue engineering.

Methods

Organic‐inorganic hybrid substrates were prepared with ALD/MLD, which enables deposition of single molecular layers of compounds in a very controlled manner. The substrates are based on amino acids, including lysine, arginine, glycine and aspartic acid, as organic building blocks and titanium as inorganic building blocks. Human corneal epithelial cells were cultured on the substrates for 7 days. The cells were then stained with Hoechst and imaged at 5× magnification with a fluorescence microscope. The number of cell nuclei per field of view was counted to compare cell density. In parallel, cells were also stained with trypan blue to assess the number of dead cells.

Results

Confluent cultures were obtained on all substrates and most of the cells were alive. Substrates with glycine and titanium oxide yielded the highest cell density (1,031 cells ± 65), whereas substrates with aspartic acid and titanium oxide (689 cells ± 48) gave rise to the least number of cells.

Conclusions

Human corneal epithelial cells can be successfully grown on organic‐inorganic hybrid substrates while retaining high viability. The novel ALD/MLD technique can be used to build biocompatible substrates using molecular design and further studies should be conducted to evaluate if this technique can be used to direct cell and tissue development.
Macroscopic analysis of filtering bleb functionality after XEN Gel Stent implantation with Anterior Segment Optical Coherence Tomography
Authors: Costa L. , Cardigos J. , Crisostomo S. , Anjos R. , Sa Cardoso M. , Gomes T.
Published: September 2016

Purpose

The new approach of Micro invasive Glaucoma Surgery, XEN Gel Stent is made of soft collagen and it is introduced by a corneal incision, trough the anterior chamber angle and it stands under the conjunctiva space.

To study the bleb macroscopic morphology with Anterior Segment Optical Coherence Tomography and correlate it with the clinical evaluation.

Methods

Prospective case‐control study with 10 eyes of 8 patients with the range follow‐up to 6 months after XEN Gel Stent implantation. Two groups were characterized according to the clinical evaluation (Intraocular Pressure, topical treatment or additional procedures, as YAG‐LASER and Needling). Group 1 describes those patients with IOP under 21 mmHg without topical treatment even if it was necessary an additional YAG‐LASER or needling (n = 8). Group 2 was formed with IOP above 21 mmHg or under 21 mmHg with topical treatment (n = 2). The parameters analyzed were the bleb structure (diffuse or cystic), extension (height, width and length), chamber angle aperture and tube extension (anterior chamber and scleral).

Results

The group 1 appears to be with indifferently diffuse or cystic higher extensions of filtering blebs than those in group 2. The structural analysis with OCT was concordant with the macroscopic morphology in slit lamp evaluation. The tube extension in anterior chamber and under conjunctiva and its chamber angle entrance was relatively variable over all patients.

Conclusions

The clinical assessment of the filtering bleb has proved a significant concordance with the filtering bleb macroscopic morphology in the AS‐OCT. Additional longitudinal studies about this topic will be necessary to improve the knowledge and the surgeon's management capabilities.
Symmetric tarsal show is crucial in creating upper eyelid symmetry
Authors: De Groot V.
Published: September 2016

Purpose

To illustrate different causes of upper eyelid asymmetry and to stress that detection of any asymmetry is important in avoiding an unhappy patient.

Methods

Patients want an ‘upper eyelid correction’ and do not know the real cause of the asymmetry, or even did not notice any asymmetry. Different kind of asymmetric appearances of the upper eyelids will be shown and analyzed.

Results

The upper eyelid has several landmarks. Besides the palpebral aperture, the margin pupil distance and lid crease height, also the margin fold distance/tarsal show, the lid fullness and braw distance needs to be described. An asymmetric tarsal show is often perceived as ptosis. Also bony orbit, eye position, orbital fat and braw position are all important factors influencing the final upper eyelid shape. In some conditions a perfect upper eyelid symmetry is very difficult to achieve or sometimes impossible.

Conclusions

Good preoperative assessment is crucial in eyelid surgery, both in primary surgery and in correcting postoperative asymmetry. Good patient counseling is important to create realistic expectations.
OCT spectralis for terrien marginal degeneration diagnosis
Authors: Berniolles J. , Bartolome I. , Idoate A. , sánchez J.I. , Ascaso J. , Esteban O. , Martinez M. , Del buey M.A. , Almenara C. , Pérez I.
Published: September 2016

Purpose

Terrien marginal degeneration is a rare idiopathic form of corneal degeneration that affects peripheral cornea, it occurs at any age and 75% of patients are males. This condition is most commonly bilateral and asymmetric.

Patients are often asymptomatic but they may also complain of irritation of the eye and progressive loss of visual acuity due to oblique astigmatism. Rarely the disease may lead to corneal perforation but may also occur spontaneously or secondary to trauma.

The most important corneal modifications in Terrien marginal degeneration, frequently located superonasaly, are observed in the stroma showing yellow – white opacities composed of lipids with associated vascularization.

Spectral Domain OCT because of its capacities to describe corneal anatomy might be useful in the diagnosis of the Terrien marginal degeneration.

Methods

We present a case of a 75 year old male who was examined and followed during several months in the department of ophthalmology, Lozano Blesa University Clinic Hospital, Zaragoza, Spain, with slit lamp, corneal topographic maps and spectral domain‐ OCT.

Results

SD‐OCT confirmed the peripheral corneal thinning seen with corneal topographic map and slit lamp. It showed intact epithelial and endothelial layers surrounding the stromal cavity formation, and a perforation of the endothelium underneath this cavity.

Conclusions

We point out the utility of spectral domain optical coherence tomography in the diagnosis and follow‐up of cavity formation in the peripheral cornea in Terrien marginal degeneration.
Retinal vessel parameters in obstuctive sleep apnea
Authors: Heitmar R. , Turnbull C. , Blann A. , Stradling J.
Published: September 2016

Purpose

Pilot study to explore retinal vessel parameters, calibres as well as vessel reactivity to flicker light provocation in a group of obstructive sleep apnea (OSA) patients.

Methods

All patients [n = 7] underwent a full eye examination including intraocular pressure measurement, visual field assessment (HFA 30‐2 incl. fovea threshold), ocular coherence tomography (Cirrus 3D, Zeiss: optic nerve head and macula centred), retinal photography, dynamic retinal vessel assessment using flicker light provocation (RVA, IMEDOS) and measurement of systemic blood pressure and oxygenation. Central retinal arterial and venous equivalents (CRAE and CRVE) were calculated using optic nerve head centred retinal photographs according to a standardised method, vessel reactivity to flicker light provocation was quantified by calculating the maximum, minimum and peak arterial and venous diameters following flicker light provocation. All data were compared to a group of age and gender matched patients suffering Diabetes Mellitus (DM).

Results

OSA patients (mean age: 65 +/− 7 years) showed significantly better retinal arterial (2.3%) and venous dilation (3.9%) to flicker light provocation compared to those suffering from DM (0.90% and 3.25% respectively). However, CRAE (156 +/− 19 au) but not CRVE (218 +/− 15 au) of OSA patients was significantly reduced compared to their diabetic counterparts (CRAE: 178 +/− 21 au; CRVE: 213 +/− 19 au).

Conclusions

While OSA patients suffer from endothelial dysfunction, our small sample is a well controlled and motivated group of patients which might in part explain their better dilation capacity. Another explanation might be offered by through vessel calibers: diabetic patients showed markedly larger diameters which could reflect predicated vessels at rest and therefore contribute to a diminished dilatory capacity following flicker light provocation.
The oxygen saturation in retinal arterioles is predictive for the effect of intravitreal anti‐VEGF treatment on diabetic macular edema
Authors: Bek T.
Published: September 2016

It has been shown that the oxygen saturation in retinal vessels is increased in patients with diabetic maculopathy, but the role of this parameter for the effect of anti‐VEGF treatment of the disease is unknown. Therefore, the predictive value of oxygen saturation in larger retinal vessels for the effect of anti‐VEGF treatment of diabetic maculopathy was studied. In 73 eyes from 53 patients with center involving diabetic macular edema the predictive value of oxygen saturation in larger retinal vessels and other risk factors for retinopathy progression as explanatory variables was studied for visual acuity (VA) and central retinal thickness (CRT) after anti‐VEGF treatment as effect variables. Anti‐VEGF treatment induced a significant increase in VA and a signficant decrease in CRT, but no significant changes in the overall oxygen saturation of larger retinal vessels. In a multiple regression model VA and CRT obtained before treatment contributed significantly to predicting the effect of treatment on the same variable. Mean arterial blood pressure and the oxygen saturation in retinal arterioles before treatment contributed signficantly to predicting both VA and CRT after treatment. The oxygen saturation in retinal arterioles is a new parameter that might potentially be included in risk models predicting the effect of anti‐VEGF treatment on diabetic maculopathy.