bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary sources of PM2.5 organic aerosol in an industrial Mediterranean city, Marseille
Authors: El Haddad I. , Marchand N. , Wortham H. , Piot C. , Besombes J.-L. , Cozic J. , Chauvel C. , Armengaud A. , Robin D. , Jaffrezo J.-L.
Published: November 2010

Abstract. Marseille, the most important port of the Mediterranean Sea, represents a challenging case study for source apportionment exercises, combining an active photochemistry and multiple emission sources, including fugitive emissions from industrial sources and shipping. This paper presents a Chemical Mass Balance (CMB) approach based on organic markers and metals to apportion the primary sources of organic aerosol in Marseille, with a special focus on industrial emissions. Overall, the CMB model accounts for the major primary anthropogenic sources including motor vehicles, biomass burning, and the aggregate emissions from three industrial processes (HFO combustion/shipping, coke production and steel manufacturing) as well as some primary biogenic emissions. This source apportionment exercise is well corroborated by 14C measurements. Primary OC estimated by the CMB accounts on average for 22% and is dominated by the vehicular emissions that contribute on average for 17% of OC mass concentration (17% of PM2.5). Even though, industrial emissions contribute for only 2.3% of the total OC (7% of PM2.5), they are associated with ultrafine particles (Dp<80 nm) and high concentrations of Polycyclic Aromatic Hydrocarbons (PAH) and heavy metals such as Pb, Ni and V. On one hand, given that industrial emissions governed key primary markers, their omission would lead to substantial uncertainties in the CMB analysis performed in areas heavily impacted by such sources, hindering accurate estimation of non-industrial primary sources and secondary sources. This result implies that CMB modelling should not be a straightforward exercise and one have to carefully investigate the marker behaviours and trends beforehand, especially in complex environments such as Marseille. On the other hand, being associated with bursts of submicron particles and carcinogenic and mutagenic components such as PAH, these emissions are most likely related with acute health outcomes and should be regulated despite their small contributions to OC. Another important result is the fact that 78% of OC mass cannot be attributed to the major primary sources and thus remains un-apportioned. We have consequently critically investigated the uncertainties underlying our CMB apportionments. While we have provided some evidence for photochemical decay of hopanes, this decay does not appear to significantly alter the CMB estimates of the total primary OC. Sampling artefacts and unaccounted primary sources also appear to marginally influence the amount of un-apportioned OC. Therefore, this significant amount of un-apportioned OC is mostly attributed to secondary organic carbon that appears to be the major component of OC, during the whole period of study.
Assessment of Central Corneal Thickness Using OCT, Ultrasound, Optical Low Coherence Reflectometry and Scheimpflug Pachymetry
Authors: Beutelspacher Sven C. , Serbecic Nermin , Scheuerle Alexander F.
Published: October 2010

Purpose

Accurate measurement of central corneal thickness (CCT) is essential in refractive surgery and advanced glaucoma diagnostics. The gold standard for pachymetry is full-contact ultrasound-based pachymetry. As this method is associated with potential sources of error, noncontact methods have been introduced. The aim of this study was to compare CCT results measured using 4 different techniques.

Methods

In this analysis of 20 patients (40 eyes) at the University Eye Hospital Heidelberg, Germany, we compared a slit-lamp-mounted optical coherence tomography (OCT) system (SL-OCT, Heidelberg Engineering, Heidelberg, Germany), conventional ultrasound pachymetry (IOPac, Heidelberg Engineering), optical low coherence reflectometry (OLCR, Haag-Streit, Germany), and scanning-slit pachymetry (Orbscan).

Results

Comparison among the 4 groups did not show significant differences, except the comparison of OLCR to Orbscan; the mean was significantly different (p=0.0247) and the Orbscan detected slightly thicker values than the other methods.

Conclusions

Orbscan, SL-OCT, and OLCR provide non-touch technology, without the need for local anesthesia, and limiting the risk of infection or artifacts. Extreme care must be used interpreting the results obtained from Orbscan, as this technique may overestimate the CCT significantly.
Reproducibility of Ocular Biometry with a New Noncontact Optical Low-Coherence Reflectometer in Children
Authors: Şahin Aísun , Gürsoy Hüseyin , Başmak Hikmet , Yildirim Nilgün , Usalp Zuhat , Çolak Ertuğrul
Published: October 2010

Purpose

TO evaluate the reproducibility of Lenstar in the pediatric population.

Methods

Three consecutive measurements per eye by 2 ophthalmologists with a total of 6 measurements per eye were performed using Lenstar. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), and corneal curvatures (K1 and K2) were measured for right and left eyes in 154 school-age children. Right and left eyes were analyzed separately. Each optical parameter obtained by 2 examiners was compared by paired samples t test. Intraobserver and interobserver correlation coefficients (r) were calculated for each variable. Significance was attributed when p<0.05.

Results

Measurements could be performed in 152 of the children included. The mean measurements were not different statistically except for left AL (23.22±0.81 vs 23.21 ±0.82 mm; p=0.014), left CCT (548.5±32.3 vs 548.0±32.7 μm; p=0.013), and right ACD (3.19±0.25 vs 3.19±0.25 mm; p=0.033). Intraobserver r values were all above 0.957 except for left LT (r=0.786) for examiner 2. Interobserver r values were all above 0.979.

Conclusions

Although statistical significance was obtained in some variables, they were clinically negligible. The intraobserver and interobserver relation coefficients were very high for all optical parameters including the r value for left LT for examiner 2 (r=0.786). Lenstar is a highly reproducible, user independent, and tolerable instrument for ocular biometry in the pediatric population, with no anesthesia or discomfort.
Prophylactic Intravitreal Bevacizumab for Diabetic Macular Edema (thickening) after Cataract Surgery: Prospective Randomized Study
Authors: Fard Masoud Aghsaei , Abyane Alireza Yazdanei , Malihi Mehrdad
Published: October 2010

Purpose

TO determine the role of intravitreal bevacizumab injected at the time of cataract surgery on postoperative increase of retinal thickness in patients with diabetic retinopathy.

Methods

Patients were randomized to a standardized procedure of phacoemulsification with intraocular lens implantation alone (control group; 30 eyes) or to receive 1.25 mg intravitreal bevacizumab at the end of surgery (IVB group; 31 eyes). Efficacy measures included best-corrected visual acuity (BCVA) testing, optical coherence tomography (OCT), and ophthalmoscopic examination at each postoperative visit during a 6-month follow-up.

Results

There were no significant differences in central macular thickness, BCVA, or systemic condition between the control and IVB groups at baseline. One month after surgery, the control group showed a significant increase in central macular thickness, whereas the bevacizumab group did not show an increase. After 6 months, there was no significant difference in macular thickness and postoperative visual acuity between the 2 groups.

Conclusions

Intravitreal administration of 1.25 mg bevacizumab at the time of cataract surgery is effective just for the short term and 6-month results are the same as the control group.
National Survey of Day-Case Vitreoretinal Surgery in the United Kingdom
Authors: Hussain Rumana , Matare Taurai , Zambarakji Hadi
Published: October 2010

Introduction

Day-case surgery has become uniformly accepted in ophthalmology for most procedures but not for complex, lengthy ones, including vitreoretinal surgery. There is a need for uniform practice that is not only financially and resource efficient, but also convenient for patients.

Purpose

TO describe current practice patterns of day-case vitreoretinal (DCVR) surgery in the United Kingdom.

Methods

A 16-part e-mail questionnaire was sent to UK vitreoretinal consultants, with day-case surgery defined as patients admitted and discharged following surgery on the same day. The questionnaire was sent to all consultant members of the Britain and Eire Association of Vitreoretinal Surgeons using the e-mail address beavrs@yahoogroups.com to increase the response rate.

Results

The overall response rate was 41%. Of 55 responders, 9% do not undertake DCVR surgery, but 61% perform DCVR surgery in >75% of patients. Of all undertaking DCVR surgery, 85% of responders discharge patients home and 13% to a hostel. A total of 76% of responders use local/sub-Tenon anesthesia in >50% of patients undergoing DCVR surgery. A total of 15% of responders were not in favor of DCVR surgery. Common reasons for not undertaking DCVR surgery were significant traveling distances for patients, patient choice, and the need for support during posturing.

Conclusions

The practice of DCVR surgery across the United Kingdom is variable and is influenced by local factors, patient factors, and surgeon views. There is a lack of guidelines to help decision-making. Common standards are required to maximize clinical outcomes and patient satisfaction, as well as reduce the cost burden of hospital admissions.
Experimental Femtosecond Laser-Assisted Nanosurgery of Anterior Lens Capsule
Authors: Toropygin Sergey G. , Krause Matthias , Akkaya Asim , Riemann Iris , Seitz Berthold , Mestres Pedro , Ruprecht Klaus W. , Troeber Leonie , Gatzioufas Zisis , König Karsten
Published: October 2010

Purpose

TO investigate femtosecond laser-assisted nanosurgery of the anterior lens capsule in a prospective in vitro study.

Methods

Eight anterior lens capsules obtained during conventional phaco surgery were irradiated with a nonamplified 80-MHz near-infrared 800-nm titanium:sapphire femtosecond laser. Line intratissue laser cuts were examined by femtosecond multiphoton laser scanning microscopy (MLSM) and transmission electron microscopy (TEM).

Results

Speed parameters of the laser beam, laser ablation time, and pulse power determined the width of the lesions, which ranged from 220±40 nm (SD) to 1.49±0.15 μm. Both MLSM and TEM revealed minimal collateral alterations in the tissue surrounding the laser cuts.

Conclusions

Nonamplified near-infrared femtosecond laser pulses at low pulse energies may be a promising strategy for precise noncontact nanosurgery of the anterior lens capsule with minimal collateral damage to surrounding tissue. High-resolution MLSM offers 3-dimensional, noninvasive, non-destructive imaging at submicrometer resolution within seconds before and after ablation.
Interface Corneal Stromal Irregularities after Flap Creation using Femtosecond Laser
Authors: Kymionis George D. , Kounis George A. , Grentzelos Michael A. , Panagopoulou Sophia I. , Kandarakis Stylianos A. , Krasia Maria S.
Published: October 2010

Purpose

TO report a case of interface corneal stromal irregularities after flap creation with the advanced IntraLase femtosecond (150 Hz) laser system (Abbott Medical Optics, Inc.).

Methods

Case report.

Results

An 18-year-old man underwent bilateral laser in situ keratomileusis (LASIK) using the IntraLase femtosecond laser to create 110–μm flaps. The procedure was uneventful in the left eye. In the right eye, after flap lifting a central irregular stromal interface was noted. The created flap was thicker than expected (139 μm) as measured intraoperatively with ultrasound pachymetry. The excimer laser ablation procedure was performed and the flap was repositioned. On the first postoperative day and during the 6-month follow-up period, uncorrected distance visual acuity was 20/20 in both eyes.

Conclusions

Interface corneal stromal irregularities may occur after femtosecond corneal flap creation during LASIK.
Evaluation of Corneal Biomechanical Properties with the Reichert Ocular Response Analyzer
Authors: Detry-Morel Michèle , Jamart Jacques , Pourjavan Saveh
Published: October 2010

Purpose

TO compare corneal hysteresis (CH) and corneal resistance factor (CRF) measured with the Ocular Response Analyzer (ORA) in patients with primary open-angle glaucoma (POAG), patients with ocular hypertension (OHT), and normal subjects (NL); and to assess correlations of CH and CRF with corneal-compensated intraocular pressure (IOPcc), Goldmann applanation tonometry (GAT), glaucoma type, central corneal thickness (CCT), previous filtering procedure, and antiglaucoma medications.

Methods

A total of 108 POAG, 22 OHT, and 24 NL were enrolled in this observational study Goldmann applanation tonometry and ORA were performed in a randomized sequence followed by pachymetry One eye per subject was selected at random for analysis. Chi-square, Wilcoxon, and Kruskal-Wallis tests were used for comparison and Spearman coefficient for assessing correlations.

Results

Mean CH and CRF were significantly lower in POAG than in OHT and NL. Ocular Response Analyzer IOPcc overestimated IOP compared to GAT only in POAG. This difference increased with higher GAT. Goldmann applanation tonometry and IOPcc were correlated. Corneal hysteresis was negatively correlated with age in POAG. Corneal resistance factor and CH were positively correlated with CCT in POAG and OHT. Unlike CRF, CH was not correlated with GAT in POAG and OHT. Corneal-compensated intraocular pressure was not correlated with CCT. Difference between GAT and IOPcc was not CCT dependent. Corneal hysteresis and CRF were comparable in POAG and NTG, un-changed after filtering procedure. Corneal hysteresis was not altered by topical medications. Corneal resistance factor was significantly lower in treated eyes and those receiving prostaglandin analogues with no correlation with the treatment duration.

Conclusions

Patients with glaucoma seem to have distinctive corneal biomechanical properties compared to OHT and NL. They may be influenced by many other unknown subparameters.
Polypoidal Choroidal Vasculopathy and Macroaneurysm: Respective Roles of Scanning Laser Ophthalmoscopy-Indocyanine Green Angiography and Optical Coherence Tomography
Authors: Coscas Florence , Coscas Gabriel , Souïed Eric
Published: October 2010

Purpose

TO report on a patient with exudative age-related macular degeneration, polypoidal choroidal vasculopathy, and macroaneurysm.

Methods

Scanning laser ophthalmoscopy (SLO)-indocyanine green angiography (ICGA) demonstrated the coexistence of several lesions in the same patient. Optical coherence tomography (OCT) combined with ICGA defined the nature of the lesions and the severity of the exudative phenomena.

Results

The eye tracking system ensured precise follow-up of the course of the lesions on both ICGA and spectral domain (SD) OCT. Image correlation provided a precise diagnosis, defining the indications for local and systemic therapy.

Conclusions

In this patient with multiple lesions, only correlation of clinical examinations and SLO-ICG and SD-OCT imaging allowed a complete assessment with the proposal of a coherent and effective treatment plan.
Refractive Lens Exchange with Acri.LISA Bifocal Intraocular Lens Implantation
Authors: Alfonso José F. , Fernández-Vega Luis , Baamonde Begoña , Orti Susana , Montés-Micó Robert
Published: October 2010

Purpose

TO assess efficacy, safety, and predictability after refractive lens exchange (RLE) in patients who had bilateral implantation of an Acri.LISA 366D diffractive bifocal intraocular lens (IOL).

Methods

Sixty-six eyes of 33 consecutive patients were examined after RLE who had bilateral implantation of an Acri.LISA bifocal 366D IOL. Eyes were divided into myopic and hyperopic groups. Monocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCVA), uncorrected distance near visual acuity, and best distance-corrected near visual acuity (BCNVA) were recorded preoperatively and 6 months after surgery.

Results

Efficacy indexes were 0.73 for myopic and 0.85 for hyperopic eyes at 6 months postoperatively. For the myopic group, 2 eyes lost 1 line, 4 eyes gained 1 line, and 6 eyes gained ≥2 lines; for the hyperopic group, 11 eyes lost 1 line, 8 eyes gained 1 line, and 7 eyes gained 2 lines. Safety indexes were 1.07 and 1.03 for myopic and hyperopic eyes, respectively. Safety indexes at near were 1.03 for myopic and 1.00 for hyperopic eyes. Efficacy indexes at near were 1.00 for myopic and 0.99 for hyperopic eyes.

Conclusions

Bilateral implantation of an Acri.LISA 366D bifocal IOL after RLE is an effective procedure for correcting ametropia and presbyopia.
Posterior Hyaloid Peeling in Advanced Stages of Aggressive Posterior ROP
Authors: Ecsedy Monika , Recsan Zsuzsa
Published: October 2010

Purpose

TO evaluate the indications and timing of surgical intervention on eyes with aggressive posterior retinopathy of prematurity (ROP).

Methods

Retrospective review of a consecutive case series of 9 eyes of 7 children, with aggressive posterior ROP, who underwent early lens-sparing vitrectomy. Preoperative retinal and vitreal features, intraoperative and postoperative complications, postoperative anatomic status, and fixation behavior 1 year after surgery were investigated.

Results

Vitreous hemorrhage and recurrence of plus disease with retinal detachment were the main indications for surgery. Vitrectomy was performed from the 37th to the 44th postmenstrual week (mean 40th week). In 7 eyes, vitrectomy could stop the disease progression. In all of these cases, posterior hyaloid could be peeled together with the proliferative tissue.

Conclusions

Lens-sparing vitrectomy with posterior hyaloid peeling at early postmenstrual ages (37–40 postmenstrual weeks) seems to be advantageous in infants with aggressive posterior ROP. The formation of a gliotic membrane growing ahead to the posterior surface of the lens resulted in unfavorable outcomes in our cases.
The Efficacy of Vertical Rectus Transposition and Its Modalities in Patients with Abducens Nerve Palsy
Authors: Nowakowska Olimpia , Loba Piotr , Broniarczyk-Loba Anna
Published: October 2010

Purpose

Patients with VIth nerve palsy that does not resolve within 6 months should undergo surgery. The most common procedure used in such cases is transposition of a whole or a part of a vertical rectus muscle combined or not with a resection of the lateral rectus muscle. Commonly, a simultaneous recession of medial rectus muscle with or without prior injection of botulinum toxin is performed. The aim of our study was to evaluate the results of vertical rectus transposition performed in patients with abducens nerve palsy.

Methods

Nine cases of abducens nerve palsy ware retrospectively analyzed. All patients underwent full ophthalmic and orthoptic examination before and after surgery. All patients underwent vertical rectus muscle transposition to the lateral rectus insertion in the affected eye. Additional procedures included Jensen procedure, botulinum toxin injection, resection of the lateral rectus, recession of the medial rectus on the same side with or without adjustable sutures, and Foster modification of lateral rectus posterior fixation.

Results

In all cases, we found a varying degree of postoperative improvement. There was a significant reduction in the strabismus angle for distance and near, increase in abduction of the affected eye, and broadening of the field of binocular single vision.

Conclusions

The vertical rectus muscle transposition technique is a safe and successful method of treatment in abducens nerve palsy. Its use together with additional procedures and modifications allows one to achieve orthophoria, improvement of abduction, and larger field of binocular single vision.
Regression of Peripapillary Choroidal Neovascularization after Oscillatory Transpupillary Thermotherapy and Anti-VEGF Pharmacotherapy
Authors: Peyman Gholam , Tsipursky Michael , Gohel Parin , Conway Mandi
Published: October 2010

Purpose

We prospectively evaluated a new treatment for recalcitrant choroidal neovascularization (CNV) in 4 patients. We used an infrared laser (810 nm) in oscillatory thermotherapy (OTT) mode combined with indocyanine green (ICG) dye, utilizing the beneficial effect of both thermotherapy and photodynamic therapy We describe preliminary experiences with ICG-assisted OTT (I-OTT) combined with intravitreal bevacizumab/dexamethasone for refractory peripapillary CNV resistant to standard therapy.

Methods

Clinical examination, funduscopy fluorescein angiography, and optical coherence tomography were performed at baseline and postoperatively. Infrared laser spot size was approximately one-half the lesion size (oscillation 2–3 Hz). Intravitreal injections of bevacizumab (1.25 mg) and dexamethasone (1000 μg) were done during the same visit.

Results

Mean follow-up was 12.5 months (range 5–17). Mean energy level was 325 mW (range 200–500) in oscillatory mode (2–3 Hz/sec) pre- and post-ICG infusion. Indocyanine green dose was approximately 1 mg/kg (75 mg/patient). All patients had a single treatment. Mean visual acuity improved in 1 patient from 20/60 to 20/30 and remained the same in the other 3 (20/20, 20/40, and 20/400). At final examination, there was no evidence of clinical or angiographic activity of CNV.

Conclusions

Indocyanine green-assisted OTT has the potential to treat CNV in wet age-related macular degeneration. It may reduce thermal side effects and eliminate or reduce the need for frequent intravitreal treatment. We postulate that l-OTT has a synergistic effect of thermal energy combined with a weak photosensitizer (ICG) applied in an individualized manner, which minimizes thermal damage to retinal and choroidal tissue. Additional anti–vascular endothelial growth factor pharmacotherapy enhances the effect of l-OTT on abnormal new vessels.
Acute Hyperopic Shift in Refraction Associated with Posterior Choroidal Detachment following Phacoemulsification Surgery
Authors: Lee Yin-Yang , Sheu Shwu-Jiuan
Published: October 2010

Purpose

TO describe a patient who presented with hyperopic shift as an initial manifestation of choroidal detachment in the posterior pole following an uneventful phacoemulsification cataract surgery.

Methods

An 82-year-old woman with preexisting diabetes mellitus and hypertension had bilateral primary angle closure glaucoma on maximal tolerated hypotensive medication. An uneventful phacoemulsification surgery using topical anesthesia was performed in her left eye.

Results

On the next day, refraction was markedly increased to +7.25 −1.00 × 65 and axial length was reduced from 23.24 mm to 20.13 mm. Funduscopic examination revealed choroidal detachment in the posterior pole without involvement of the peripheral fundus. Axial length increased to 22.19 mm following corticosteroid treatment 1 month later. Six months postoperatively, axial length improved to 22.87 mm with a residual hyperopia of +1.00 −1.00 × 63.

Conclusions

TO our knowledge, there have been no reports of choroidal detachment in the posterior pole after phacoemulsification. Acute hyperopic shift following phacoemulsification surgery should lead one to suspect a posterior choroidal detachment. Considering axial length and refractive errors along with fundus examination may contribute to a more accurate follow-up.
Validity and Limits of the Rebound Tonometer (ICare®): Clinical Study
Authors: Scuderi Gian Luca , Cascone Nikhil Carlo , Regine Federico , Perdicchi Andrea , Cerulli Angelica , Recupero Santi Maria
Published: October 2010

Purpose

The aim of this study was to evaluate the measurement of intraocular pressure (IOP) using a new induction/impact rebound tonometer (ICare®) compared with Goldmann applanation tonometry (GAT). We also aimed to quantify the systematic and random errors (bias) of the 2 methods, to evaluate the sensitivity and specificity of the ICare® tonometer in identifying patients with 21 mmHg or more measured with the GAT, and to study the influence of corneal thickness on IOP measurement with the 2 tonometers.

Methods

We compared the IOP values obtained with the 2 instruments in 97 patients.

Results

Analysis based on the Bland and Altman method revealed that the IOP values recorded with the ICare® tonometer were slightly higher than those obtained with the GAT. The estimated bias for right eye measurements was 0.78 mmHg with 95% limits of agreement ±3.55 mmHg. This overestimation, which is not clinically relevant, was confirmed when we used the IOP values corrected according to central corneal thickness for data analysis. The sensitivity and specificity were 0.90 and 0.95, respectively.

Conclusions

The ICare® tonometer proved to be comparable with other nonconventional tonometers and can be used by nonophthalmologists and paramedical personnel during screening tests of populations. In addition, the ICare® tonometer could be considered a valid alternative to GAT when GAT is not available.
High-Frequency Ultrasound Biomicroscopy of the Anterior Segment Morphometry before and Immediately after Pars Plana Vitrectomy
Authors: Neudorfer Meira , Oren Nir , Barak Adiel
Published: October 2010

Purpose

TO characterize short-term changes induced by pars plana vitrectomy on anterior segment depth and lens thickness by means of high-frequency ultrasound biomicroscopy.

Methods

We undertook a prospective case series study on consecutive patients referred for pars plana vitrectomy as the sole procedure in our institution between 2005 and 2007. Twenty-eight eyes of 28 patients undergoing pars plana vitrectomy were studied by ultrasound biomicroscopy. Neither silicone oil nor scleral buckle was used for any of the procedures. Anterior chamber depth and lens thickness were compared before and immediately after surgery, and their results were compared to the postoperative intraocular pressure measurements.

Results

There was a significant decrease in anterior chamber depth in the study eyes of patients who had undergone gas tamponade (p<0.0001) but not in those who had not undergone gas tamponade. No differences were found between the preoperative and the postoperative lens thickness measurements in any of the patients, nor was there any correlation between anterior chamber depth and increased intraocular pressure.

Conclusions

Uncomplicated pars plana vitrectomy with gas tamponade can induce short-term changes in anterior chamber depth as measured by morphometry. Surgeons may need to reconsider using gas tamponade at the end of surgery in surgical candidates with shallow anterior chambers.
Oxygen Saturation in Premature Infants at Risk for Threshold Retinopathy of Prematurity
Authors: Thomas William J. , Rauser Michael , Dovich Jesse A. , Dustin Laurie , Flaxel Christina J.
Published: October 2010

Purpose

We aimed to determine if oxygen saturation, desaturations, and saturation variability play a role in progression of retinopathy of prematurity (ROP) and need for laser treatment.

Methods

This was a retrospective case-control study. We performed chart review of premature infants in a university hospital neonatal intensive care unit consecutively examined for ROP between May 2000 and December 2001. We compared birthweight, postmenstrual age, and oxygen saturation for 3 weeks before laser treatment for threshold ROP in group 1 (n=19) (average weight at treatment 2508 grams) and group 2 (n=18) before they reached 2500 grams. Outcome measures were retinopathy progression and need for treatment.

Results

Adjusting for birthweight and postmenstrual age, known predictors of ROP progression, we found that babies requiring laser treatment (group 1) had lower average daily oxygen saturation levels in the study period, significantly on 5/20 days (25%). These babies had saturations below 95% on 18/20 days (90%). Babies not requiring laser (group 2) had saturations below 95% on 2/20 days (10%). The last day on which pretreatment saturations differed significantly was 2 days before laser. Group 1 had more desaturations below 80% (6.0±3.2) than group 2 (3.2±1.2), p=0.0002 (independent samples t tests). Saturations varied more for individual group 1 infants.

Conclusions

Decreased oxygen saturation as early as 3 weeks and as late as 2 days before laser, increased number of desaturations, and saturation variability were seen in babies eventually requiring laser treatment for ROP.
SD OCT Features of Dry Arcuate Longstanding Retinal Folds
Authors: Pierro Luisa , Sadda Srinivas R. , Gagliardi Marco , Mantovani Elena , De Benedetto Umberto , Codenotti Marco , Bandello Francesco
Published: October 2010

Purpose

TO report the spectral domain (SD) findings in a retinal fold secondary to vitrectomy surgery.

Methods

A 57-year-old man presented 1 month after vitrectomy surgery with gas injection (C3F8 6%) in his left eye for treatment of a macula-on retinal detachment and was noted to have a retinal fold in the superior aspect of the macula. Complete ocular examination, fundus photography, fluorescein angiography, autofluorescence, and SD optical coherence tomography (OCT) were performed.

Results

Spectral domain OCT revealed a slightly hyperreflective lesion in the outer retina, which occupied a discontinuity in the inner segment-outer segment junction and extended superiorly with apparent indentation of the overlying retinal layers.

Conclusions

This case illustrates how SD OCT may be useful in describing the morphologic substrate of retinal fold after retinal surgery.
Augmented Medial Rectus Recession, Medial Rectus Recession plus Faden, and Slanted Medial Rectus Recession for Convergence Excess Esotropia
Authors: Khalifa Yasser Mohamed
Published: October 2010

Purpose

TO evaluate the efficacy of 3 different surgical techniques for convergence excess esotropia: augmented medial rectus recession, medial rectus recession plus Faden, and slanted medial rectus recession.

Methods

Twenty-nine patients with convergence excess esotropia were divided into 3 groups. Group A included 9 patients treated with medial rectus muscle recession augmented with 1–2 mm more of the standard recession. Group B included 10 patients treated with standard recession plus Faden. Group C included 10 patients treated with slanted medial rectus recession. Surgical success was defined as esotropia (ET) 10 prism diopters (à) or less at distance and near with collapse of distance/near disparity.

Results

Satisfactory alignment with elimination of bifocal correction was noted in group A (66.6%). In groups B and C, the results were 70%. Group A patients had a mean reduction in distance/near disparity from 15.5±1.5Δ preoperatively to 4.7±2.5Δ postoperatively, while in group B the preoperative distance/near disparity was 16.5±1.8Δ and decreased to 3.8±3.1Δ postoperatively, and group C also showed reduction in distance/near disparity from 18.1±1.6Δ preoperatively to 4.5±3.6Δ postoperatively. There were no statistically significant differences among the 3 groups.

Conclusions

The 3 procedures are effective surgical options to treat convergence excess esotropia with acceptable motor outcomes.
Assessment of Anterior Chamber Inflammation after Intravitreal Bevacizumab Injection in Different Ocular Exudative Diseases
Authors: Yeniad Baris , Ayranci Ozen , Tuncer Samuray , Kir Nur , Ovali Tunc , Tugal-Tutkun Ilknur , Akarcay Koray
Published: October 2010

Purpose

TO investigate the inflammation of the anterior chamber after intravitreal bevacizumab injection in different ocular exudative diseases.

Methods

The study included 76 eyes from 62 consecutive patients with different ocular exudative diseases. The patients were divided into the 3 following groups: group 1 (nonproliferative diabetic retinopathy), group 2 (choroidal neovascularization secondary to age-related macular degeneration), and group 3 (macular edema with branch or central retinal vein occlusion). The study also included 32 age-matched control patients. Inflammation of the anterior chamber was examined with flare-cell photometry before and after an intravitreal injection of 1.25 mg of bevacizumab.

Results

There were no statistically significant differences between the measurements at baseline and postoperative day 1, 3, 7, or 30 in any of the groups (p>0.05).

Conclusions

The extent of inflammation in the anterior chamber did not change after intravitreal bevacizumab injection in patients with nonproliferative diabetic retinopathy, choroidal neovascularization secondary to age-related macular degeneration, or macular edema due to branch or central vein occlusion.
Intrasession, Intersession, and Interexaminer Variabilities of Retinal Nerve Fiber Layer Measurements with Spectral-Domain OCT
Authors: Cremasco Fernanda , Massa Graziela , Vidotti Vanessa Gonçalves , de Carvalho Lupinacci Álvaro Pedroso , Costa Vital Paulino
Published: October 2010

Purpose

TO evaluate the intrasession, intersession, and interexaminer variabilities of retinal nerve fiber layer measurements (RNFL) with spectral-domain optical coherence tomography (OCT).

Methods

A total of 32 healthy individuals and 34 patients with chronic glaucoma underwent RNFL measurements with the Cirrus HD-OCT Model 4000 (Carl Zeiss Meditec, Dublin, CA, USA) 5 times during the same sitting by one examiner to assess intrasession variability. The same examiner performed RNFL measurements in the same patients on 5 different days to assess intersession variability. A second examiner performed RNFL measurements in the same patients to assess interexaminer variability. The coefficients of variation and intraclass correlation coefficients were obtained for the following parameters: average thickness, quadrant thickness, and Clock hour thickness measurements.

Results

Intrasession variability: In patients with glaucoma, coefficients of variation ranged from 4.51% to 11.84%. Intraclass correlation coefficients ranged from 0.74 to 0.99. In healthy individuals, coefficients of variation ranged from 2.92% to 6.99%. Intraclass correlation coefficients ranged from 0.89 to 0.98. Intersession variability: In patients with glaucoma, coefficients of variation ranged from 3.68% to 10.50%. Intraclass correlation coefficients ranged from 0.82 to 0.99. In healthy individuals, coefficients of variation ranged from 3.13% to 6.92%. Intraclass correlation coefficients ranged from 0.87 to 0.99. Interexaminer variability: In patients with glaucoma, coefficients of variation ranged from 2.62% to 14.94%. Intraclass correlation coefficients ranged from 0.55 to 0.98. In healthy individuals, coefficients of variation ranged from 2.04% to 7.31%. Intraclass correlation coefficients ranged from 0.86 to 0.98.

Conclusions

These findings indicate that RNFL measurements with spectral-domain OCT display excellent reproducibility, with low intrasession, intersession, and interexaminer variabilities.
Postural Control in Subjects with Visual Impairment
Authors: Schwesig René , Goldich Yakov , Hahn Ales , Müller Anja , Kohen-Raz Reuven , Kluttig Alexander , Morad Yair
Published: October 2010

Purpose

TO investigate the effect of long-term, not experimentally induced visual impairment on balance, and to clarify which means are used to compensate for this sensory deficit.

Methods

Posturography was examined in 50 visually impaired subjects (11 with congenital blindness and 39 with acquired visual impairment) and 50 healthy controls. Examination was performed in 4 testing conditions: while standing on firm surface or foam pads (which decreases the somatosensory input) and with open or closed eyes (manipulating visual input).

Results

Subjects with acquired visual impairment were significantly less stable than controls when tested with open eyes, especially when standing on foam pads, but equal to controls when eyes were closed. Congenitally blind subjects performed equally to normal controls in all test conditions when tested with eyes open, and performed significantly better than controls with eyes closed. In comparison to subjects with acquired visual impairment, the congenitally blind were significantly more stable in all test conditions. Fourier analysis revealed that the visually impaired subjects showed decreased intensity values within the lowest frequency range of 0.1 Hz and below, a range believed to be sensitive to the function of the visual system.

Conclusions

We have found that vision impairment influenced postural control, especially if acquired and not congenital. The somatosensory and vestibular systems serve as compensatory mechanisms, which is utilized most effectively by the congenitally blind.
Diagnostic Capability of Scanning Laser Polarimetry with and without Enhanced Corneal Compensation and Optical Coherence Tomography
Authors: Benítez-del-Castillo Javier , Martinez Antonio , Regi Teresa
Published: October 2010

Purpose

TO compare the abilities of the current commercially available versions of scanning laser polarimetry (SLP) and optical coherence tomography (OCT), SLP-variable corneal compensation (VCC), SLP–enhanced corneal compensation (ECC), and high-definition (HD) OCT, in discriminating between healthy eyes and those with early-to-moderate glaucomatous visual field loss.

Methods

Healthy volunteers and patients with glaucoma who met the eligibility criteria were consecutively enrolled in this prospective, cross-sectional, observational study. Subjects underwent complete eye examination, automated perimetry, SLP-ECC, SLP-VCC, and HD-OCT Scanning laser polarimetry parameters were recalculated in 90-degree segments (quadrants) in the calculation circle to be compared. Areas under the receiver operating characteristic curve (AUROCs) were calculated for every parameter in order to compare the ability of each imaging modality to differentiate between normal and glaucomatous eyes.

Results

Fifty-five normal volunteers (mean age 59.1 years) and 33 patients with glaucoma (mean age 63.8 years) were enrolled. Average visual field mean deviation was −6.69 dB (95% confidence interval −8.07 to −5.31) in the glaucoma group. The largest AUROCs were associated with nerve fiber indicator (0.880 and 0.888) for the SLP-VCC and SLP-ECC, respectively, and with the average thickness in the HD-OCT (0.897).

Conclusions

The best performing indices for the SLP-VCC, SLP-ECC, and HD OCT gave similar AUROCs, showing moderate diagnostic accuracy in patients with early to moderate glaucoma. Further studies are needed to evaluate the ability of these technologies to discriminate between normal and glaucomatous eyes.
Alagille Syndrome: Clinical and Ocular Pathognomonic Features
Authors: El-Koofy Nehal M. , El-Mahdy Randa , Fahmy Mona E. , El-Hennawy Ahmed , Farag Mohamed Y. , El-Karaksy Hanaa M.
Published: October 2010

Purpose

This study was carried out to determine the frequency of clinical diagnostic criteria in patients with Alagille syndrome (AGS) in comparison to a group of children with cholestasis and histologically proven neonatal hepatitis (NH). The type and frequency of ocular manifestations are highlighted.

Methods

According to histologic findings on liver biopsy, the 32 patients included in the study were classified into 2 groups: group 1 had paucity of interlobular bile ducts (PILBD) (n=13) and at least 3 of 5 characteristics of AGS and group 2 had NH on liver biopsy (n=19).

Results

The mean age of patients with AGS was higher than in group 2 (3.9 vs 1.6 years) (p<0.05). Pruritus was a significant symptom in the AGS group (p<0.05). Characteristic fades was detected in 61.5% of the AGS group. None of our patients with AGS had vertebral anomalies. Although cardiac murmurs were heard in 5 patients with AGS, cardiac anomalies were detected in only 3 by echocardiography: pulmonary stenosis in 2 patients and patent foramen ovale in 1. Posterior embryotoxon (PE) was detected in 69.2% of patients with AGS as compared to 10.5% of the NH group. Optic nerve drusen was detected in 91% of patients with AGS as compared to 5.3% of patients with NH.

Conclusions

Optic nerve drusen was the most common finding in AGS, followed by PE and facial features. Ocular ultrasound needs to be performed in all cholestatic infants with PILBD.
Effects of Osmoprotection on Symptoms, Ocular Surface Damage, and Tear Film Modifications Caused by Glaucoma Therapy
Authors: Monaco Gaspare , Cacioppo Viviana , Consonni Dario , Troiano Pasquale
Published: October 2010

Purpose

TO determine the effects of 2 artificial tear formulas on the ocular surface in patients with glaucoma using topical preserved beta-blockers (BB) or prostaglandins (PG).

Methods

This was a prospective, comparative, randomized, double-blind study with a crossover design. Twenty patients with dry eye were divided into 2 groups based on glaucoma treatment: BB (10 subjects) or PG (10 subjects). Each group was administered a 4-week course of unpreserved isotonic (300 mOsm/L) solution containing 0.2% sodium hyaluronate (SH) or a preserved isotonic (295–305 mOsm/L) solution containing 0.5% carboxymethylcellulose and 0.9% glycerin as compatible solute (CMCs) administered QID. After a 2-week washout period, the course of treatment was reversed. The primary efficacy criteria consisted of assessing symptoms according to the Ocular Surface Disease Index© (OSDI); the secondary efficacy criteria consisted of evaluating tear film confocal microscopy, central corneal thickness (CCT), and lissamine corneal and conjunctival staining (Oxford Grading System Score [OGSS]).

Results

Within each group, only CMCs induced a significant improvement in OSDI and OGSS compared to baseline values: OSDI-20.5, p<0.0001; OGSS-0.9, p<0.0001. Tear film confocal microscopy improved after treatment, especially in case of patients who were administered CMCs. No difference in CCT was noticed for any subject.

Conclusions

This study demonstrates for the first time that the use of concomitant CMCs in the management of glaucoma undergoing treatment with BB or PG may assist in tear film production and could lead to better compliance with intraocular pressure-lowering medication and ultimately better prognosis.
Ocular Decompression Retinopathy after Deep Sclerectomy with Mitomycin C in an Eye with Exfoliation Glaucoma
Authors: Kozobolis Vassilios P. , Kalogianni Eleni , Katsanos Andreas , Dardabounis Doukas , Koukoula Stavrenia , Labiris Georgios
Published: October 2010

Purpose

TO present a case of ocular decompression retinopathy occurring after an uncomplicated nonpenetrating glaucoma procedure (deep sclerectomy with mitomycin C).

Methods

A 52-year-old man with medically uncontrolled exfoliation glaucoma in the left eye underwent uneventful deep sclerectomy with mitomycin C. The patient had no history or laboratory evidence of any bleeding disorder.

Results

On the first postoperative day, visual acuity fell from the preoperative level of Snellen 0.2 to hand movement and the intraocular pressure was 5 mmHg. Funduscopy revealed a small intravitreal hemorrhage and multiple, extended retinal hemorrhages in all quadrants of the fundus. After standard postoperative medication with antibiotic/steroid eyedrops, the patient's visual acuity returned to preoperative levels and the retinal hemorrhages were absorbed. Three and a half months postoperatively, the fundus was free of bleedings.

Conclusions

Although decompression retinopathy has previously been described after penetrating glaucoma surgery, the condition can also occur after uncomplicated deep sclerectomy. Despite the dramatic presentation, the prognosis remains favorable.
Outcomes of Vitreoretinal Surgery in Patients with Closed-Globe Injury
Authors: Erdurman Cuneyt F. , Ceylan Melih O. , Acikel Cengiz Han , Durukan Hakan A. , Mumcuoglu Tarkan
Published: October 2010

Purpose

TO evaluate the clinical features, visual outcomes, and prognostic factors in patients who underwent vitreoretinal surgery after closed-globe injury.

Methods

Retrospective review of patients with closed-globe injuries who underwent vitreoretinal surgery between January 2003 and December 2007.

Results

The study cohort included 46 eyes from 46 patients who underwent vitreoretinal surgery for posterior segment injury. Retinal detachment was the most frequent indication for the surgery, in 33 eyes (72%). After surgery, final visual acuity of 20/400 or better was achieved in 35 eyes (76%), while 11 eyes (24%) had visual acuity less than 20/400 (poor visual outcome). The most frequent reason for poor outcome was proliferative vitreoretinopathy (PVR) (6 eyes), followed by macular complications (3 eyes) and optic atrophy (2 eyes). Two cases with PVR became phthisical following repeated vitreoretinal procedures and also lost light perception. Prognostic factors associated with poor outcomes included delayed presentation, presenting visual acuity of less than 20/400, the presence of initial macular detachment, and the need for additional surgical intervention (p<0.05). No statistical difference was found in final visual acuity between eyes with or without retinal detachment (p>0.05). Also, the presence of damage to the anterior segment was not significantly associated with poor visual outcome (p>0.05).

Conclusions

In patients with posterior segment pathology caused by closed-globe trauma, retinal detachment was the most common reason for vitreoretinal surgery and PVR was the main cause of surgical failure. The poor visual outcomes associated with delayed presentation suggest that patients need to be referred for further management.
Conventional Surgery for Complicated Retinal Detachment in Silicone Oil-Filled Eyes
Authors: Acar Mehmet A. , Ünlü Nurten , Hazirolan Dicle , Demir M. Necati , Üney Güner Ö. , Örnek Firdevs
Published: October 2010

Purpose

TO evaluate the anatomic and functional outcomes of conventional surgery in silicone oil (SO)-filled eyes with complicated retinal detachment (RD).

Methods

The records of patients who underwent scleral buckling surgery for complex RD in SO-filled eyes were retrospectively reviewed. Conventional RD surgery involved a 2.5-mm encircling band, 6-mm silicone strip for the inferior quadrants or local sponge implant, subretinal fluid (SRF) drainage, and/or SO aspiration with a 27-G needle. Cryotherapy and/or laser photocoagulation was applied around the tears and 360° of the peripheral retina.

Results

In all, 4 of the cases had retinal breaks in the lower quadrants, 1 of which had a macular hole; recurrence was due to proliferative vitreoretinopathy (PVR) in the 3 other cases. Three cases were treated with external SRF drainage, 3 cases with SO aspiration, and 1 case with both external drainage and SO aspiration. The retina was attached at the last follow-up visit in 6 (85.7%) of the 7 eyes. One of the cases required secondary vitreoretinal surgery for recurrent RD due to PVR and still had SO tamponade at last follow-up visit. Mean follow-up period was 17.28 ± 8.64 months. Mean logMAR visual acuity was 1.47 ± 0.47 preoperatively and 1.4 ± 0.97 postoperatively.

Conclusions

Inferior RD in eyes treated with silicone oil tamponade, with or without a retinal break, can be treated with scleral buckling surgery, external SRF drainage, and/or pars plana SO aspiration with satisfactory functional and anatomic outcomes in selected complicated RD cases.