bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic Polymorphism of HLA DR in a Scottish Population of Patients with Pars Planitis
Authors: Greiner K.H. , Wilson D.W.L. , Thomson J. , Kilmartin D.J. , Urbaniak S.J. , Forrester J.V.
Published: January 2018

Purpose

Human leucocyte antigen (HLA) class II influences the immunological susceptibility for a variety of diseases including many types of non-infectious intraocular inflammation. Previous studies on North American patients with pars planitis, a subtype of intermediate uveitis, reported an increased prevalence of HLA DR15 in this population. In contrast, two European studies could not find an association between HLA DR2 or its allelic subtype DR15 and various forms of intermediate uveitis. We therefore investigated the genotype frequency of HLA DR alleles in a Scottish population of patients with typical pars planitis.

Methods

Twenty patients with pars planitis were identified from the uveitis database of Grampian Universitiy Hospitals. Only patients with bilateral vitritis and snowbanks in at least one eye in the absence of systemic disease were included in the study. Fifteen patients and 34 healthy controls underwent HLA DR genotyping for all DRB genes using PCR sequence specific primers.

Results

HLA DR15 was found in 13% of patients with pars planitis and in 24% of controls. There was no statistically significant difference between these two groups. Furthermore, the frequencies of HLA DR 1, 3–14, and 16 did not differ significantly between patients and controls.

Conclusions

There appears to be no association between the occurrence of pars planitis and the HLA DR15 or other known HLA DR genotypes in Scottish patients. However, the small sample size limits the power of this study.
Intravitreal Triamcinolone Acetonide as an Additional Tool in Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy
Authors: Jonas J.B. , SÖfker A. , Degenring R.
Published: January 2018

Purpose

To evaluate the safety and efficacy of intravitreal injections of crystalline triamcinolone acetonide as an adjunctive procedure in pars plana vitrectomy for proliferative diabetic retinopathy.

Methods

This nonrandomized comparative study included 30 patients (32 eyes) who underwent standardized pars plana vitrectomy for treatment of proliferative diabetic retinopathy and who received an intravitreal injection of 25 mg triamcinolone acetonide at the end of surgery. Mean follow-up time was 5.60 ± 5.14 months. The study group was compared with a control group (32 eyes) matched with the study group for preoperative and intraoperative parameters and who underwent pars plana vitrectomy for proliferative diabetic retinopathy without intravitreal injection of triamcinolone acetonide.

Results

The study group and the control group did not vary significantly in frequency of postoperative retinal detachment, re-pars plana vitrectomy, or postoperative enucleation or phthisis bulbi, or in best postoperative visual acuity, visual acuity at end of the study, or gain in visual acuity.

Conclusions

In this pilot study, the study group with pars plana vitrectomy and intravitreal triamcinolone acetonide injection compared with the nonrandomized control group without intravitreal triamcinolone acetonide injection did not show a higher than usual rate of postoperative complications. As a corollary, however, the data do not suggest the adjunct use of 25 mg intravitreal triamcinolone acetonide combined with pars plana vitrectomy as treatment of proliferative diabetic retinopathy.
Eyelid Phakomatous Choristoma
Authors: Mencía-Gutiérrez E. , Gutiérrez-Díaz E. , Ricoy J.R. , Sarmiento-Torres B.
Published: January 2018

Purpose

To report a case of congenital phakomatous choristoma (PC) of the eyelid, a rare tumor of lenticular anlage in the subcutaneous tissue and dermis.

Case

A boy had a mass in the right lower eyelid near the inner canthus at birth. At age 10 months, the tumor was excised.

Results

The tumor cells showed intense immunoreactivity positive for S-100 protein, vimentin, and periodic acid-Schiff. Keratin markers, epithelial membrane antigen, glial fibrillary acidic protein, muscle specific actin, and epithelial membrane antigen were negative. The histopathologic features were consistent with those of a PC.

Conclusions

This histopathologic and immunoreactivity study supports the proposal that PC is a rare entity of lenticular anlage origin. Only 18 such cases have been described previously.
Luxated Intraocular Lens Fixation Using Anterior Chamber Slipknot of the Haptic to the Sclera: A Simple Procedure to Fixate Intraocular Lens to the Sclera
Authors: Micelli Ferrari T. , Cardascia N. , Furino C. , Recchimurzo N. , Boscia F. , Sborgia L.
Published: January 2018

Purpose

To describe a technique for suturing a luxated intraocular lens (IOL) in the vitreous cavity directly to the ciliary sulcus using intraocular slipknot without IOL extraction.

Design

Noncomparative interventional case series.

Materials and Methods

A three-port vitrectomy was performed in all cases. According to the Lewis procedure, two scleral flaps and relative sclerectomies were performed at 3 and 9 o'clock position. IOL was rescued from vitreous cavity by means of perfluorocarbon and stabilized in anterior chamber by intravitreal forceps. Corneal endothelium was preserved by a dispersive ophthalmic viscosurgical device coating. Double armed 10–0 polypropylene was introduced into the vitreous cavity through the 9 o'clock sclerotomy incision and both the needles were passed out of the eye by the 3-o'clock position sclerotomy, guided by a bent 27-gauge needle 1.5 mm from the limbus. Hooking the slipknot around the haptics of the IOL in the anterior chamber by means of vitreous forceps, the 10–0 polypropylene was pulled so that the IOL haptic was fixated onto the sulcus. The same procedure was used to fixate the opposite haptic to the ciliary sulcus at the opposite position.

Results

In all four cases, the IOL fixated stably and remained well positioned. No significant intraoperative or postoperative complications occurred.

Conclusions

This technique enables secure fixation of the luxated IOL in the vitreous without extracting it.
Effectiveness and Tolerance of Piroxicam 0.5% and Diclofenac Sodium 0.1% in Controlling Inflammation after Cataract Surgery
Authors: Scuderi B. , Driussi G.B. , Chizzolini M. , Salvetat M.L. , Beltrame G.
Published: January 2018

Purpose

To compare the efficacy and tolerance of piroxicam 0.5% ophthalmic solution and diclofenac sodium 0.1% ophthalmic solution in controlling inflammation after phacoemulsification and intraocular lens (IOL) implantation.

Setting

Ophthalmological Department, San Donà di Piave Hospital, Venice, Italy.

Materials and Methods

Forty consecutive patients – 18 men and 22 women – between 55 and 85 years of age (mean age, 75.1 ± 7.12 years) who were scheduled for cataract extraction with phacoemulsification and IOL implantation were randomized to receive 0.5% piroxicam ophthalmic solution (piroxicam group, 20 patients) or 0.1% diclofenac sodium ophthalmic solution (diclofenac group, 20 patients) for 1 month postoperatively. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) measurements and slit-lamp bio-microscopy for the evaluation of corneal edema, Descemet membrane folds, Tyndall, and cells in the anterior chamber were carried out in all patients 1 day, 4 days, and 1 month postoperatively. Subjective symptoms after the nonsteroidal anti-inflammatory drug (NSAID) ophthalmic solution instillation were assessed using a questionnaire.

Results

There were no significant differences between the two groups in postoperative IOP, BCVA, anterior chamber flare and cell levels, corneal edema, or Descemet membrane folds. Ocular discomfort, evaluated as burning or stinging sensation after NSAID ophthalmic solution instillation, was significantly more frequent and intense in the diclofenac-treated eyes. Two eyes in the diclofenac group had a mild transient punctate keratitis.

Conclusions

These results suggest that piroxicam is as effective as diclofenac sodium in preventing inflammation after cataract surgery with IOL implantation, and its better tolerance and safety can provide higher patient compliance.
Visual Performance in Specific Syndromes Associated with Intellectual Disability
Authors: Van Splunder J. , Stilma J.S. , Evenhuis H.M.
Published: January 2018

Purpose

To report visual performance in adults with specific causes of intellectual disability (ID) and to compare the test results to published reports.

Methods

In a large-scale multicenter epidemiologic study of sensory impairments in 1598 adults with ID, the authors performed ocular assessments in 1539 persons. They compared the test results of those with five specific genetic disorders (Angelman syndrome, Prader-Willi syndrome, fragile X syndrome, Williams-Beuren syndrome, and tuberous sclerosis).

Results

An overrepresentation of strabismus, low vision, and refractive errors was found. Apart from fragile X syndrome and Prader-Willi syndrome (with in general mild to moderate ID), the other syndrome groups contained one or more subjects with visual impairment or blindness. A number of them had never been seen by an ophthalmologist.

Conclusions

The authors confirm a number of ocular features previously reported by other studies and suggest some additional ocular features. They found increased frequencies of treatable ophthalmologic conditions in the subgroups. Because reliable ocular assessment is feasible for 85% of persons with ID, the results are an incentive to address visual functioning in people with ID in order to correct ocular problems and maximize their possibilities.
Eight-Year Follow-Up of Axenfeld-Rieger Syndrome with Turner Syndrome
Authors: Koçak-Midillioglu I. , Karadeniz N. , Yalvaç I. , Koçak-Altintas A.G. , Duman S.
Published: January 2018

Purpose

To report a case of Turner syndrome associated with iridogoniodysgenesis accompanied by somatic malformations.

Methods

A 29-year-old woman underwent complete ophthalmologic and general examination. Incomplete development of the angle with iris stromal hypoplasia and prominent posterior embryotoxon with iris adhesions were noted. Disc drusen was confirmed by ultrasonography. Visual fields were normal other than bilateral enlargement of blind spot. Intraocular pressure was under 21 mm Hg during 8 years of follow-up without medication. The patient had atrial septal defect, sensorineural hearing loss, polycystic ovaries, hirsutism, glomerulosclerosis, dental anomalies, and low intelligence. A chromosome analysis revealed that she had mosaic Turner syndrome with a 45,X/46,XX karyotype.

Conclusions

Few reported cases in the literature describe the coexistence of Axenfeld-Rieger syndrome and Turner syndrome mosaicism. Somatic and anterior chamber malformations in this patient represent a developmental disorder of the neural crest. General examination and chromosomal analysis are indicated in patients presenting with anterior chamber dysgenesis.
Sympathetic Ophthalmia Associated with Ocular and Cerebral Vasculitis: An Angiographic and Radiologic Study
Authors: Kadayifçilar S. , Irkeç M. , Eldem B.
Published: January 2018

Purpose

To describe a case of sympathetic ophthalmia (SO) associated with ocular and cerebral vasculitis.

Methods

The authors report a 38-year-old woman who presented with bilateral uveitis 7 years after a penetrating trauma to the right eye. Ocular examination included fundus fluorescein and indocyanine green angiography. Medical history disclosed an episode of dysarthria and right-sided weakness.

Results

Anterior uveitis was present in the previously injured pseudophakic right eye, which harbored a piece of glass stuck in the lower temporal iris. In the left eye, vitreal inflammation with retinal sheathing and subretinal lesions was predominant. Besides retinal vasculitis, fundus angiography showed choroidal vasculitis. Neurologic studies were compatible with cerebral vasculitis.

Conclusions

In SO, choroidal vasculitis that is invisible clinically can be demonstrated angiographically. Although rare, inflammation can also affect the nervous system.
Tear and Serum Eosinophil Cationic Protein Levels in Seasonal Allergic Conjunctivitis
Authors: Acar N. , Toker E. , Kazokoğlu H.
Published: January 2018

Background/Purpose

Eosinophil cationic protein (ECP) levels in tear fluid and sera of patients with seasonal allergic conjunctivitis (SAC) were measured to assess local and systemic eosinophilic activity in SAC. The correlation between ECP levels and disease activity was evaluated.

Methods

Tears and sera were collected from 21 patients with SAC and 13 healthy control subjects. ECP levels in tears and sera were measured before and 4 weeks after treatment with 0.1% lodoxamide eyedrops. Clinical signs and symptoms of SAC were scored and the correlation of ECP levels with the clinical scores was evaluated.

Results

Tear and serum levels of ECP were significantly increased (p=0.01, p=0.02, respectively) in patients with SAC compared with the control subjects, but ECP levels were not correlated with the severity of the disease. Following treatment with topical 0.1% lodoxamide eyedrops, the mean level of ECP in tears decreased significantly (p=0.02), whereas no significant change was observed in serum ECP levels. Furthermore, a significant decrease in clinical signs and symptoms scores was found after treatment (both p<0.0001).

Conclusions

Increased serum and tear ECP levels in patients with SAC confirms that both local and systemic eosinophil activation occurs in SAC. However, clinical signs and symptoms of SAC were not found to be correlated with the degree of eosinophilic activity. Thus ECP does not seem to have an important role in clinical manifestations of SAC.
Laser-Assisted Subepithelial Keratectomy (LASEK) without Alcohol versus Photorefractive Keratectomy (PRK)
Authors: Leccisotti A.
Published: January 2018

Purpose

To evaluate epithelial healing and visual outcome after laser-assisted subepithelial keratectomy (LASEK) without alcohol de-epithelialization and to compare this technique to photorefractive keratectomy (PRK) in myopia.

Methods

In a series of 1953 patients undergoing bilateral myopic PRK, an epithelial flap could be obtained by manual de-epithelialization in the left eye of 56 patients without alcohol exposure. The right eye was treated by PRK and the left by LASEK (i.e., repositioning the viable flap after surface ablation). The two eyes were compared in terms of pain, uncorrected visual acuity (UCVA) in decimals, correction achieved, and haze. The epithelial healing pattern was assessed in the LASEK eyes.

Results

The flap remained viable, showing a peripheral junction, in 25 eyes (45%). Pain was higher in the PRK eye in 11/56 patients (20%), higher in the LASEK eye in 23/56 patients (41%), and the same in both eyes in 22/56 patients (39%). UCVA at one week was slightly better in the LASEK eyes (median 0.7 versus 0.6, p=0.002 with Wilcoxon test), but was the same in PRK and LASEK eyes after 1 month (median 0.9 in both). Median haze at 6 months was 0.5 in the PRK eyes and 0 in the LASEK eyes (Wilcoxon p=0.007). Median postoperative defocus equivalent at 9 months was 0.5 diopters in both the PRK and the LASEK eyes.

Conclusion

Although our study might have selected patients with loose epithelium, LASEK performed by manual de-epithelialization in the absence of alcohol exposure is not less painful than PRK, even in case of flap survival. Visual recovery speed, as well as haze, is slightly better than in PRK, although the difference is clinically negligible.
Eye Injuries in Childhood: A Retrospective Investigation of 88 Cases from 1988 to 2000
Authors: Tomazzoli L. , Renzi G. , Mansoldo C.
Published: January 2018

Purpose

To assess the frequency, causes, mechanisms, and functional outcomes of eye injuries in childhood.

Methods

A retrospective analysis of the hospital files of patients younger than 12 years admitted to the Institute of Ophthalmology of Verona University for eye injuries from January 1, 1988, to December 31, 2000.

Results

Eighty-eight cases of eye injuries (69 [78%] boys, 19 [22%] girls) were identified. The mean age at admission was 7.2 years. The most frequent causes of eye injuries were domestic accidents in patients younger than 6 years (25%) and accidents at play in those older than 6 years (35%). Scissors were the most frequent causative agents in children under 6 and toys, stones, and ball injuries in those over 6. Diagnoses, therapies implemented, ocular complications, and outcomes are reported.

Conclusions

The major causes of eye injuries in childhood are preventable; thus more adequate adult supervision and educational and legislative measures are necessary and useful in order to reduce prevalence and morbidity of these accidents.
Subfoveal Choroidal Neovascularization in a Patient with Pre-Existing Pseudomacular Hole
Authors: Borgia L. , Badalà F.
Published: January 2018

Purpose

To report concomitant use of fluorescein angiography (FA) and optical coherence tomography (OCT) in a case of pre-existing pseudomacular hole (PMH) and macular choroidal neovascularization (CNV) treated with photodynamic therapy (PDT).

Methods

Case report.

Results

A 63-year-old man who received laser treatment for branch retinal vein occlusion in 1993 developed an asymptomatic macular epiretinal membrane 2 years later. In 2001, the patient complained of metamorphopsia. Biomicroscopy showed a PMH, confirmed by OCT. One year later, metamorphopsia suddenly increased and visual acuity dropped from 20/20 to 20/70. FA and OCT revealed subfoveal occult CNV. PDT was successfully performed. FA and OCT were essential diagnostic tools during the follow-up.

Conclusions

The case presented stresses the importance of different tools for accurate diagnosis and proper follow-up of macular diseases.
Intraocular Pressure, Quality of Block, and Degree of Pain Associated with Ropivacaine in Peribulbar Block: A Comparative Randomized Study with Bupivacaine-Lidocaine Mixture
Authors: Özcan A.A. , Özdemir N. , Günes Y. , Bozkurt A. , Yagmur M. , Alparslan Z.N.
Published: January 2018

Purpose

To compare the effects of ropivacaine and bupivacaine-lidocaine combination on intraocular pressure, quality of block, and degree of postoperative pain in peribulbar block.

Methods

The study group involved 32 patients undergoing elective cataract surgery under peribulbar block. Patients were divided into two groups according to the local anesthetic used: Group 1 (n=16), ropivacaine 0.75%; and Group 2 (n=16), bupivacaine 0.5%-lidocaine 2% mixture. Intraocular pressure was measured at four time points: before block (control), 1 min after block, 5 min after block, and 15 min after block with Tonopen. Quality of block was evaluated using a three-point scoring system based on the reduction of globe motility. Patients were asked their degree of intraoperative pain by using a five-point verbal rating score after the surgery.

Results

Mean values of intraocular pressure after block were significantly lower in Group 1 in comparison to Group 2 (p<0.05, Mann Whitney test). The quality of block was better in Group 2, and the degree of postoperative pain was lower in Group 1 (p<0.05, Mann-Whitney test).

Conclusions

Ropivacaine used in peribulbar block is better than bupivacaine-lidocaine mixture under the same standard conditions in terms of reducing intraocular pressure and postoperative pain in intraocular surgery.
Retinal Periphlebitis Resembling Frosted Branch Angiitis with Nonperfused Central Retinal Vein Occlusion
Authors: Abu El-Asrar A.M. , Al-Obeidan S.A. , Abdel Gader A.G.M.
Published: January 2018

Purpose

To report the unusual association between severe retinal periphlebitis resembling frosted branch angiitis and nonperfused central retinal vein occlusion (CRVO).

Methods

Observational case reports.

Results

Patient 1 was a 28-year-old man who presented with extensive sheathing involving all retinal veins in one eye followed by nonperfused CRVO. Twenty-seven months after initial presentation, he developed perfused CRVO in the other eye followed by periphlebitis that progressed into nonperfused CRVO. Patient 2 was a 47-year-old man who presented with unilateral severe retinal periphlebitis associated with nonperfused CRVO. Despite systemic administration of corticosteroid therapy, rubeosis iridis developed in both patients and neovascular glaucoma developed in Patient 1 despite full panretinal photocoagulation. Extensive systemic workup and coagulation studies were unremarkable except for the presence of antiphospholipid antibodies in both patients and elevated plasma homocysteine level in Patient 2.

Conclusions

Severe retinal periphlebitis complicated by nonperfused CRVO is associated with poor visual outcome despite appropriate medical and surgical treatment.
Neuroprotection as a Treatment for Glaucoma: Pharmacological and Immunological Approaches
Authors: Schwartz M.
Published: January 2018

Primary open-angle glaucoma is a chronic, progressive optic neuropathy associated with a gradual decline in visual function, which may lead to blindness. In most cases, the optic neuropathy is associated with increased intraocular pressure. It is now generally accepted, however, that normalization of pressure, although necessary, is often not-sufficient as a remedial measure. This is because of the existence of additional factors, some of which emerge as a consequence of the initial damage. This situation is reminiscent of the response to a traumatic axonal insult, in which some of the damage is immediate and is caused by the insult itself, and some is secondary and is caused by a deficiency of growth-supportive factors as well as by toxic factors derived from the damaged tissue. Accordingly, the author has suggested that glaucoma may be viewed as a neurodegenerative disease and consequently amenable to any therapeutic intervention applicable to neurodegenerative diseases. There is evidence that neuroprotection can be achieved both pharmacologically and immunologically. Pharmacologic intervention neutralizes some of the effects of the nerve-derived toxic factors and possibly increases the ability of the remaining healthy neurons, at any given time, to cope with the stressful conditions. Immunologic intervention boosts the body's repair mechanisms for counteracting the toxicity of physiologic compounds acting as stress signals.
Pharmacological Strategies to Block Rod Photoreceptor Apoptosis Caused by Calcium Overload: A Mechanistic Target-Site Approach to Neuroprotection
Authors: Fox D.A. , Poblenz A.T. , He L. , Harris J.B. , Medrano C.J.
Published: January 2018

Purpose

Photoreceptor apoptosis and resultant visual deficits occur in humans and animals with inherited, and disease-, injury- and chemical-induced retinal degeneration. Our aims were three-fold: 1) to determine the kinetics of rod apoptosis and Ca2+ overload in Pde6brd1 mice and developmentally lead-exposed rats, 2) to establish a pathophysiologically-relevant model of Ca2+ overload/rod-selective apoptosis in isolated rat retina and 3) to examine different mechanistic based neuroprotective strategies that would abrogate or mollify rod Ca2+ overload/apoptosis.

Methods

Retinal morphometry and elemental calcium content ([Ca]) determined the kinetics of rod apoptosis and Ca2+ overload. A multiparametric analysis of apoptosis including rod [Ca], a live/dead assay, rod oxygen consumption, cytochrome c immunoblots and caspase assays was combined with pharmacological studies of an isolated rat retinal model of rod-selective Ca2+ overload/apoptosis.

Results

Ca2+ overload preceded rod apoptosis in mice and rats, although the extent and kinetics in each differed significantly. The isolated rat model of rod Ca2+ overload/apoptosis showed that blockade of Ca2+ entry through rod cGMP-activated channels with L-cis diltiazem was partially neuroprotective, whereas blockade of Ca2+ entry into rods through L-type Ca2+ channels with D-cis diltiazem or verapamil provided no protection. Inhibition of the mitochondrial Na+/Ca2+ exchanger with D-cis diltiazem provided no protection. CsA and NIM811, mitochondrial permeability transition pore (mPTP) inhibitors, blocked all Ca2+-induced apoptosis, whereas the caspase-3 inhibitor DEVD-fmk only blocked the downstream cytochrome c-induced apoptosis.

Conclusions

The successful pharmacological neuroprotective strategies for rod Ca2+ overload/apoptosis targeted the rod cGMP-activated channels or mPTP, but not the rod L-type Ca2+ channels.
Clinical and Economic Impacts of Latanoprost 0.005% in First-Line Treatment of Open-Angle Glaucoma and Ocular Hypertension in France
Authors: Bernard L.M. , Althin R. , Dhawan R. , Grima D.T. , Lam A. , Aballéa S.
Published: January 2018

Purpose

To assess the cost-effectiveness of treatment strategies that utilize first-line latanoprost compared to those based on initial beta-blocker therapy in patients with open-angle glaucoma (OAG) or ocular hypertension (OH) in France.

Methods

The study was based on a decision-analytic model that was populated with data from a retrospective chart review. A hypothetical cohort of patients newly diagnosed with OAG and/or OH was assessed over a period of 2 and 3 years. For each treatment strategy 10,000 patients were assumed.

Results

First-line latanoprost therapy was significantly more effective than initial treatment with a beta-blocker, providing more days of intraocular pressure (IOP) control primarily due to its longer time until initial treatment failure. Latanoprost's higher acquisition cost was largely offset by reductions in costs associated with surgical procedures. The additional cost for latanoprost was estimated at approximately € 41 and € 27 over 2 and 3 years, respectively. The incremental cost per day of IOP control when latanoprost was used as first-line strategy compared to the first-line beta-blocker strategy was € 0.82 and € 0.36 over 2 and 3 years, respectively.

Conclusions

These results provide compelling evidence that first-line latanoprost therapy can provide superior clinical outcomes at a small additional cost in actual clinical practice.
Posterior Chamber Lens Implantation Techniques in Posterior Capsular Rupture
Authors: Yilmaz A. , Başer Z. , Sefi yurdakul N. , Maden A.
Published: January 2018

Purpose

To evaluate posterior chamber lens implantation techniques and their results in patients in whom posterior capsular rupture and zonular dialysis arose during cataract operation.

METHODS

Forty-three cataractous eyes of 43 consecutive patients with complicated cataract operations such as posterior capsular rupture or zonular dialysis were accepted into this prospective study between November 1999 and January 2001. Intraocular lens implantation to ciliary sulcus was achieved without sutures in 19 cases (Group 1), with one suture from 12 o'clock quadrant in 14 cases (Group 2), and with two sutures from 3 to 9 o'clock quadrants in 10 cases (Group 3). Patients were followed up for 3 months after operation and evaluated for best-corrected visual acuity, refractive astigmatism, corneal edema, anterior chamber depth and inflammation, synechia at angle, intraocular pressure, lens tilt and decentration, intraocular hemorrhage, cystoid macular edema, and retinal detachment.

Results

There was no difference among groups in best-corrected visual acuity, refractive astigmatism, corneal edema, anterior chamber depth and inflammation, intraocular pressure, lens tilt and decentration, cystoid macular edema, or retinal detachment. Anterior chamber and vitreous hemorrhage and peripheral anterior synechia were significantly higher in Group 3 when compared with Group 1 (p=0.009, p=0.009, and p=0.004).

CONCLUSIONS

In all cases with posterior capsular rupture and zonular dialysis, different posterior chamber lens implantation techniques could be performed, beginning with the least invasive procedure suitable for the conditions with the least complications.
Axial Length, Refractive Error, and Keratometry in Patients with Branch Retinal Vein Occlusion
Authors: Goldstein M. , Leibovitch I. , Varssano D. , Rothkoff L. , Feitt N. , Loewenstein A.
Published: January 2018

Purpose

To evaluate ocular parameters that may predispose to the development of branch retinal vein occlusion (BRVO).

METHODS

This prospective study included patients with unilateral BRVO evaluated in the authors' clinic. The mean period from the acute phase was 2.29 ±1.57 years (range 1–6 years). All patients underwent a complete ophthalmologic examination including subjective refraction, axial length measurements, and keratometry readings. The fellow eye served as a control in each patient. The variables of interest were compared between the affected eye and the fellow eye using the parametric t-test and the nonparametric Wilcoxon test.

Results

Twenty-four consecutive patients (14 women, 10 men, mean age 62.4 years) were included in the study. The mean axial length in the affected eye was significantly shorter compared to the mean fellow eye length. No difference was found between the two eyes in mean subjective refraction or mean keratometry readings.

CONCLUSIONS

The authors found that eyes with BRVO have a shorter axial length compared to the fellow eye in the same patient.
Endogenous Group G Streptococcus Endophthalmitis following a Dental Procedure
Authors: Ziakas N.G. , Tzetzi D. , Boboridis K. , Georgiadis N.S.
Published: January 2018

Purpose

To report a case of bilateral endogenous endophthalmitis due to group G Streptococcus after a dental procedure.

METHODS

Case report of a 69-year-old woman who presented with pain, decreased vision, bilateral uveitis, and a unilateral hypopyon 1 week after treatment for an abscessed tooth.

Results

Bilateral endophthalmitis was diagnosed, and group G Streptococcus was cultured from the vitreous samples.

CONCLUSIONS

To our knowledge, this is the second reported case of endogenous endophthalmitis following a dental procedure. Furthermore, it was due to group G Streptococcus, which is a rare cause of this condition.
Correlating Intraocular Pressure, Blood Pressure, and Heart Rate Changes after Jogging
Authors: Karabatakis V.E. , Natsis K.I. , Chatzi balis T.E. , Lake S.L. , Bisbas I.T. , Kallinderis K.A. , Stangos N.T.
Published: January 2018

Purpose

To examine the effects of jogging on intraocular pressure (IOP), blood pressure (BP), and heart rate (HR).

METHODS

Twenty-nine healthy individuals-25 athletes and 4 untrained-were studied. IOP, systolic and diastolic BP, and HR were measured before and just after 20 minutes of jogging (submaximal - 70% - aerobic exercise).

Results

IOP decreased after jogging. Only three individuals had unchanged IOP in one eye and one individual in both eyes. The IOP decrease (1 to 8 mmHg) was statistically significant (p<0.001). BP increased after jogging (systolic: 0 to 60 mmHg, statistically significant changes, p<0.001; diastolic: 0 to 15 mmHg, statistically significant changes, p<0.001). HR increased as well (15 to 80 pulses/min, statistically significant changes, p<0.001). However, there were individuals who presented a significant decrease of IOP and a mild BP rise and vice versa, and also individuals with mild IOP decrease and significant HR change and vice versa. The statistical analysis clearly showed that there are no linear quantitative correlations between BP or HR changes and IOP changes.

CONCLUSIONS

IOP decreases after jogging. Changes in BP and HR values have no linear quantitative correlation with IOP decrease.
Vitrectomy Results for Diffuse Diabetic Macular Edema with and without Inner Limiting Membrane Removal
Authors: Stefaniotou M. , Aspiotis M. , Kalogeropoulos C. , Christodoulou A. , Psylla M. , Ioachim E. , Alamanos I. , Psilas K.
Published: January 2018

Purpose

To determine whether vitrectomy for diffuse diabetic macular edema with and without internal limiting membrane (ILM) peeling is equally effective in reducing edema.

METHODS

The authors retrospectively analyzed the surgical outcomes in 73 eyes of 52 patients with diffuse diabetic macular edema. Eighteen eyes (Group A) underwent three-port pars plana vitrectomy with posterior hyaloid membrane (PHM) removal, while 55 eyes (Group B) had pars plana vitrectomy with additional ILM peeling after PHM removal. RESULTS. Intraoperatively the posterior hyaloid was found to be attached to the macula in all eyes. In Group A, macular edema resolved completely in 8 eyes (44.4%) with improvement of visual acuity (VA). In Group B, VA improved in 38 eyes (69.1%) with complete resolution of edema. The results of this study indicated that vitrectomy effectively reduced macular edema but eyes with ILM peeling (Group B) presented better results than those without ILM peeling. Another important factor related to the outcome seems to be the level of glycosylated hemoglobin (HbA1c).

CONCLUSIONS

In eyes with diffuse diabetic macular edema vitrectomy seems to be effective, but additional ILM peeling presented better results.
Choroidal Neovascularization in Myopic Eyes after Phakic Refractive Lens and Iris-Claw Lens Implantation
Authors: Ruiz-moreno J.M. , Tavolato M. , Montero J.A. , Alio J.L.
Published: January 2018

Purpose

To describe the appearance of choroidal neovascularization (CNV) in two myopic patients after implantation of a phakic refractive lens (PRL) and an iris-claw lens.

METHODS

A PRL was implanted in the left eye of a 35-year-old myopic man. Five weeks later, he reported decreased best-corrected visual acuity (BCVA). Fluorescein angiography revealed juxtafoveal CNV. Photodynamic therapy with Visudyne (PDT) was successfully performed, achieving closure of the membrane. BCVA was 20/40 3 months afterwards. An iris-claw lens was implanted in the left eye of a 24-year-old myopic man. BCVA after surgery was 20/40 (SE -0.75). Three years later subfoveal CNV was diagnosed. PDT was performed, achieving complete closure of CNV. BCVA was 20/100 3 months after treatment.

CONCLUSIONS

The appearance of CNV in myopic eyes corrected by phakic intraocular lens implantation is a possible complication that must be considered.
Visual Recognition Time in Strabismus: Small-Angle versus Large-Angle Deviation
Authors: Schiavi C. , Bolzani R. , Benassi M.G. , Bellusci C. , Campos E.C.
Published: January 2018

Purpose

To measure the possible differences in monocular detection time of a threshold visual acuity stimulus (recognition time [RT]) between patients with small-angle and large-angle strabismus.

METHODS

Ten patients with free alternating esotropia were tested (10 to 18 years old): five with small-angle esotropia (≤7°), five with large-angle esotropia (15° to 20°). Six age-matched normal subjects served as controls. The RT of the threshold stimulus was measured in both eyes sequentially for stimuli presented in the center of a computer monitor (RT 1). Moreover, we measured the time necessary for identifying the same threshold visual acuity stimulus generated on the computer screen in the moment in which fixation is taken up by one eye after occlusion of the second eye (RT 2). Using the same setting, RT was also measured monocularly in all strabismic and normal subjects who were originally looking at a luminous fixation point positioned horizontally at 6.5 and 15 degrees from the center of the monitor (RT 3).

Results

The multivariate analysis of variance for repeated measures indicated that there was no statistical difference in RT 1 between groups. The mean RT2 was significantly longer (p<0.001) in large-angle strabismic eyes when compared with that of normal control eyes. The mean RT 2 in small-angle strabismic eyes did not differ significantly from that of normal eyes. Finally, RT 3 (both at 6.5° and 15° of eccentricity) did not show any significant difference in the three different study groups.

CONCLUSIONS

The authors hypothesized that alternating strabismus patients may have a significant advantage in maintaining a small-angle deviation, as a large-angle deviation would require longer RT in the moment the deviated eye takes up fixation. It can be speculated that the extension of re-fixation movement, obviously shorter in small-angle strabismus patients, is the main factor responsible for longer RT occurring in large-angle strabismus patients.
A New Staging System for Idiopathic Retinal Periphlebitis
Authors: Saxena S. , Kumar D.
Published: January 2018

Purpose

To develop and standardize a universally acceptable new staging system for idiopathic retinal periphlebitis (Eales disease).

METHODS

A new staging system was established and standardized based on standard terminology and features. Idiopathic retinal periphlebitis was classified as peripheral and central types. Peripheral disease consisted of four stages. Stage 1 is periphlebitis of small (1a) and large (1b) caliber vessels with superficial retinal hemorrhages. Stage 2a denotes capillary nonperfusion and 2b neovascularization elsewhere/of the disc. Stage 3a is classified as fibrovascular proliferation and 3b vitreous hemorrhage. Stage 4a is traction/combined rhegmatogenous retinal detachment whereas 4b is rubeosis iridis, neovascular glaucoma, complicated cataract, and optic atrophy. A total of 253 cases of idiopathic retinal periphlebitis (mean age, 24.7 ± 4.7years, all male) presenting at this tertiary care center were classified prospectively according to the new staging system, by two independent observers (inter-observer correlation = 0.7).

Results

The new staging system was consistent, simple, and easy to recall. Peripheral and central types of idiopathic retinal periphlebitis were found in 94.07% and 5.93% of cases, respectively. The new staging system also defined the severity of the disease. Vitreous hemorrhage was found to be the commonest presenting feature (51.68%), whereas traction/combined rhegmatogenous detachment was found in 5.88% of cases.

CONCLUSIONS

The new staging system is useful in classifying and assessing the severity of disease. Management strategy can also be defined according to the stage of the disease. It is designed to promote the use of standard assessment with applications to clinical management and research.
Choroidal Neovascularization after Laser in Situ Keratomileusis in a Patient with Presumed Ocular Histoplasmosis Syndrome
Authors: Fedorovich I. , Mehr D.S. , Oz O. , Akduman L.
Published: January 2018

Purpose

A 44-year-old patient with presumed ocular histoplasmosis syndrome (POHS) who developed a choroidal neovascularmembrane (CNV) after laser in situ keratomileusis (LASIK) surgery is presented.

METHODS

A 44-year-old male patient with moderate myopia and POHS who underwent LASIK surgery complained of distorted vision after the procedure. He had a quiet POHS lesion prior to refractive surgery. Fundus examination and fluorescein angiography revealed subfoveal CNV after the LASIK surgery. He underwent 2 sessions of photodynamic therapy (PDT).

Results

Subfoveal CNV involuted after PDT and his vision improved from 20/300 to 20/25 at 13 months follow-up.

CONCLUSIONS

CNV can be triggered by LASIK surgery in patients with POHS. Those patients should be made aware of and closely followed up postoperatively for this complication.
Intravitreal Triamcinolone Acetonide: Valuation of Retinal Thickness Changes Measured by Optical Coherence Tomography in Diffuse Diabetic Macular Edema
Authors: Ferrari T. Micelli , Sborgia L. , Furino C. , Cardascia N. , Ferreri P. , Besozzi G. , Sborgia C.
Published: January 2018

Purpose

The authors studied the efficacy of intravitreal triamcinolone acetonide in a case series of patients with diffuse diabetic macular edema without evidence of vitreous-macular traction refractory to laser photocoagulation.

Methods

Six eyes with clinically diffuse diabetic macular edema that failed to respond to at least two previous sessions of laser photocoagulation were included. The mean age of selected patients was 72.5 ± 13.8 years, with a preoperative best-corrected visual acuity reduced to 1.48 ± 0.18 logMar and a mean baseline intraocular pressure (IOP) of 15.17 ± 2.64 mmHg. The authors also studied macular thickness measured by optical coherence tomography (OCT 2000 scanner, Humphrey Instruments, San Leandro, CA) – in the preoperative period it was 640.8 ± 171.1 μm – and the fluorangiographic (Heidelberg Retina Angiograph, Heidelberg Engineering GmbH, Heidelberg, Germany) patterns, which showed pooling in tardy phases and leakage. Mean follow-up was 4 months.

Results

In each patient the authors observed a significant improvement, both functionally and anatomically. Mean best-corrected visual acuity increased in the postoperative period to 0.94 ± 0.53 logMar. No patient showed decline of visual acuity at the end of follow-up. Base line macular thickness was reduced in the postoperative period to 312.2 ± 157.65 μm measured by OCT and fluorangiographic patterns showed a reduction of pooling and of leakage. The most common complications described in the literature were not observed and the increase of mean IOP in the postoperative period to 18.76 ± 5.72 mmHg was not significant.

Conclusions

Intravitreal triamcinolone acetonide may decrease macular edema and improve visual acuity in eyes with diffuse diabetic macular edema.
Tubulointerstitial Nephritis and Uveitis Syndrome (TINU Syndrome) with Unilateral Neuroretinitis: A Case Report
Authors: Lecleire-Collet A. , Villeroy F. , Vasseneix C. , Landthaler G. , Brasseur G.
Published: January 2018

Purpose

To report a case of tubulointerstitial nephritis and uveitis syndrome (TINU syndrome) with unusual unilateral neuroretinitis.

Methods

An 11-year-old girl who developed anterior uveitis 3 months after acute tubulointerstitial nephritis, without any etiologic factors for either nephritis or uveitis, is presented.

Results

Several days after the anterior uveitis, the patient presented with unilateral optic disk edema associated with a serous retinal detachment of the posterior pole, never previously described in TINU syndrome, leading to the formation of perifoveal intraretinal exudates.

Conclusions

In spite of these posterior lesions, clinical course confirmed the previously reported favorable visual outcome of TINU syndrome treated with corticosteroids. It appeared that ocular impairment in TINU syndrome could be more diffuse and more extensive than previously described. As well as the whole uveal tract, the retina and the optic nerve may also be the ocular targets of the idiopathic inflammatory response in TINU syndrome.
Intraocular Astrocytoma without Phacomatosis
Authors: Ředinová M. , Baráková D. , Šach J. , Kuchynka P.
Published: January 2018

Purpose

Astrocytic tumors occur in the retina or in the optic disc usually as a part of tuberous sclerosis complex or other phacomatosis and their isolated occurrence is rare. The authors present two adult patients in whom the diagnosis of intraocular astrocytoma was established but no signs of phacomatosis were revealed.
Impact of Preoperative Testing on Ophthalmologic and Systemic Outcomes in Cataract Surgery
Authors: Cavallini G.M. , Saccarola P. , D'Amico R. , Gasparin A. , Campi L.
Published: January 2018

Purpose

To evaluate the incidence of ophthalmologic and systemic complications in patients who undergo cataract surgery without preoperative tests compared to subjects undergoing cataract surgery preceded by preoperative tests.

Methods

The randomized controlled study included 1276 consecutive patients admitted to the Institute of Ophthalmology of the University of Modena and Reggio Emilia for cataract surgery. The patients were randomly divided into two groups: 638 were assigned not to undergo preoperative evaluation based on routine medical tests and electrocardiograms; the other 638 underwent preoperative evaluation based on said tests. Ophthalmologic and systemic complications were assessed intraoperatively and 1 month after surgery.

Results

Eleven intraoperative complications occurred in the group without preoperative tests and eight in the group with preoperative tests; at 1 month six complications were recorded in the group without tests and five in the group with tests. Systemic adverse events occurred intraoperatively in four patients, whereas no systemic adverse event was recorded at 1 month in either group. No statistically significant differences were observed between the two groups.

Conclusions

The findings of this study have broad applicability, because the sample is representative of the population existing in numerous social and healthcare settings; they are of value for administrative purposes, because they may be taken as reference in resource allocation plans; and they have medicolegal implications, as the resulting conduct of healthcare providers is supported by a rigorous scientific study.
Intraocular Pressure Variability in the Anesthetized Rat: A Spectral Analysis
Authors: Marques-Neves C. , Martins-Baptista A. , Boto J.P. , Delgado E. , Silva-Carvalho L. , Rocha I.
Published: January 2018

Purpose

Intraocular pressure (IOP) is a measure of the balance between the inflow and outflow of the aqueous humor, being in close relationship with the venous ocular blood flow. But the influence of the autonomic nervous system upon this variable is not well understood. One of the most frequently used mathematical tools for the evaluation of the autonomic nervous system in the frequency domain is the fast Fourier algorithm (FFT) applied to the analysis of heart rate (HR) and arterial blood pressure (BP). For these variables, a power spectrum has been built showing the major bands: very low frequency, lower frequency, and higher frequency (HF). The range of these bands depends on the animal species. In this study, the authors used FFT to analyze the variability of IOP in anesthetized rats.

Methods

BP and electrocardiogram were acquired at 2 KHz in all animals before and following muscle blockade and artificial ventilation at the same frequency as the spontaneous ventilation. Also, in this last condition, IOP was recorded before and after the application of atropine in the eye.

Results

Results show three bands in the IOP spectrum, a similar profile to those observed in the HR and BP spectra, with HF band modified after atropine application

Discussion

The discussion calls attention to the influence of the autonomic nervous system on IOP and suggests the possibility of clinical application of this methodology on diagnosis and therapeutic efficacy.
Screening for Glaucoma in a General Population with the Non-Mydriatic Fundus Camera and the Frequency Doubling Perimeter
Authors: Detry-Morel M. , Zeyen T. , Kestelyn P. , Collignon J. , Goethals M. ,   Belgian Glaucoma Society
Published: January 2018

Purpose

To evaluate the usefulness of non-mydriatic fundus camera (NMFu-camera) and frequency doubling perimeter (FDP) for detecting glaucoma in a general population.

Methods

This prospective observational multicenter study consisted in screening for glaucoma in the populations of three Belgian cities. Intraocular pressure (IOP) was measured with non-contact pneumo-tonometer (NCT) and applanation tonometry (AT) if NCT IOP was ≥17 mmHg. Visual field was screened with FDP (C-20-5) and digitized optic disc photographs (ODPs) were taken with NMFu-camera. FDP was considered abnormal if at least one defective point was found. ODPs were graded as normal or glaucomatous by consensus of three glaucoma specialists. Optic disc and visual field results were matched per eye. Subjects with known ocular hypertension and/or treated primary open angle glaucoma were excluded from the analysis.

Results

A total of 1620 subjects were included in the study. Their mean age was 63.2 years. AT IOP was >21 mmHg in 8.2%. A total of 98.1% of ODPs could be interpreted. Glaucomatous optic discs were detected in 3.5% of the subjects. In this group only 24% had an AT IOP ≥22 mmHg. FDP was abnormal in 44.5%. The sensitivity and specificity of FDP to identify patients with an optic disc graded as glaucomatous were 58.6% and 64.3% respectively.

Conclusions

The combined use of the NMFu-camera and the FDP is a feasible method for an initial glaucoma mass screening. NMFu-camera may be a useful and quick method to screen for glaucomatous damage in a community. FDP in screening strategy was revealed to be not sensitive enough when setting the cut-off value at one defective test location. IOP measurements were confirmed to be a poor tool to detect glaucomatous damage.