bluuebunny/crossref_metadata_2025 huggingface dataset:
Central Retinal Vein Occlusion and Sudden Deafness: A Possible Common Pathogenesis
Authors: Glacet-Bernard A. , Roquet W. , Coste A. , Peynègre R. , Coscas G. , Soubrane G.
Published: January 2018

Case Report

A 31-year-old woman complained of blurred vision in the right eye due to a well-perfused central retinal vein occlusion (CRVO) and two months later, of sudden deafness (SD) in her right ear. Her visual acuity and hearing recovered almost completely within a few months. Medical evaluation disclosed the combination of slight coagulation abnormalities (moderate decrease in protein S, slightly elevated lipoprotein (a)), and elevated fibrinogen, with plasma hyperviscosity.

Discussion

The occurrence of CRVO then SD suggests that the same underlying conditions can be considered as risk factors for both diseases and shows up some similarities in the pathogenesis of these acute impairments of microvascular blood flow in the retina and the cochlea.
Progressive Outer Retinal Necrosis Syndrome: Successful Treatment with a New Combination of Antiviral Drugs
Authors: Roig-Melo E.A. , Macky T.A. , Heredia-Elizondo M.L. , Virgil Alfaro D.
Published: January 2018

Purpose

To describe a case of progressive outer retinal necrosis syndrome, successfully treated with a new combination of antiviral drugs.

Methods

The patient was treated with a combined therapy of antiviral drugs that includes: intravenous acyclovir 10 mg/kg, three intravitreal injections of foscarnet (1200 μg) and a ganciclovir implant in the right eye.

Results

The progressive outer retinal necrosis appeared to response dramatically with the combination of antiviral agents used over a period of 2 weeks with a final visual acuity of 20/80 at 3 months of follow up.

Conclusions

Intravitreal foscarnet combined with IV acyclovir and ganciclovir implant may represent an effective alternative treatment for PORN.
Soft Tissue Conjunctivo-Rhinostomy
Authors: Murube J. , Rojo P. , Chenzhuo L.
Published: January 2018

Purpose

To evaluate the results of implantation of a tubular prosthesis between the medial palpebral canthus and the nasal fossa, through the soft tissues of the face, in cases of irrecuperable damage of the lacrimal canaliculi.

Material and Methods

Fifty eyes with canalicular destruction were operated, placing a silicone and Pyrex tubular prosthesis between the lacrimal caruncle and the nasal vestibulum, running almost vertically through the soft tissues of the face, without osteal perforation.

Results

Lacrimal flow was restored in 47 cases. There were three cases of dislocation of the prosthesis, three infections and five papillomata.

Conclusions

Vertical conjunctivo-rhinostomy without osteal perforation is an easy and efficient solution for irrecuperable occluded canaliculi.
Candida Keratitis in a Patient with Candidiasis of the Fingernails
Authors: Jradeh E.F. , Al-Kharashi S.A. , Tabbara K.F.
Published: January 2018

Purpose

To report a case of Candida keratitis following penetrating keratoplasty in a patient with Candidiasis of the fingernails.

Case Report

An 80 year-old male presented with recurrent Candida keratitis following penetrating keratoplasty. Patient was found to have evidence of Candidiasis of the fingernails.

Comment

Candidiasis of the fingernails have led to recurrent fungal keratitis following penetrating keratoplasty. Cultures grew Candida albicans. Preoperative recognition, prompt and appropriate therapy of foci of infection may prevent Candida keratitis following penetrating keratoplasty.
Transretinal Feeder Vessel Ligature in von Hippel-Lindau Disease
Authors: Farah M.E. , Uno F. , Höfling-Lima A.L. , Morales P.H. , Costa R.A. , Cardillo J.A.
Published: January 2018

Purpose

To present a new technique called transretinal feeder vessel ligature for the treatment of retinal angiomas.

Methods

Case report of a patient with peripheral retinal angiomas previously treated unsuccessfully with photocoagulation who responded to this new, alternative surgical treatment.

Results

The retinal angiomas decreased in size although two new feeder vessels appeared and the lesions showed a regression pattern after additional laser therapy over the vascular tumors.

Conclusions

A transretinal feeder vessel ligature in association with vitrectomy and photocoagulation may be useful for some advanced or non-responsive cases of retinal angiomas.
Alpha-2 Adrenergic Receptor Agonists are Neuroprotective in Experimental Models of Glaucoma
Authors: Wheeler L.A. , Woldemussie E.
Published: January 2018

Purpose

The glaucomas are characterized by chronic progressive ganglion cell loss over many years. A drug with neuroprotective activity should increase the resistance of retinal ganglion cells (RGC) to chronic stress or injury and therefore enhance survival. Brimonidine is a highly selective and potent alpha-2 adrenergic receptor agonist, which lowers intra-ocular pressure (IOP) and is neuroprotective. Immunohistochemistry data have shown that the specific receptor targets, the alpha-2 receptors, are located in the inner retina.

Methods

Brimonidine 0.1 mg/kg given intraperitoneally promoted RGC survival compared with vehicle using the optic nerve crush model even when administered up to 24 hours before injury. Using the chronic ocular hypertensive rat model, brimonidine 1 mg/kg/day (with osmotic pump) significantly prevented the loss of RGCs when compared with vehicle or timolol. This ability was due to the neuroprotective action of brimonidine, since it did not affect IOP. In addition, brimonidine 0.1 mg/day reached concentrations in the retina of Sprague-Dawley rats within 30 minutes of injection, which was sufficient to activate the alpha-2 receptor (≥ 2 nM) and maintained these concentrations for 6 hours.

Conclusions

Having demonstrated that: a. the specific receptor target of brimonidine is located in the retina, which is important for optic neuroprotection, b. the agent shows neuroprotective ability in animal models, c. pharmacological concentrations of the drug can be reached in the retina, clinical trial has been initiated to determine whether brimonidine is neuroprotective in patients with nonarteritic ischaemic optic neuropathy.
Brimonidine's Neuroprotective Effects against Transient Ischaemia-Induced Retinal Ganglion Cell Death
Authors: Vidal-Sanz M. , Lafuente M.P. , Mayor-Torroglosa S. , Aguilera M.E. , De Imperial J. Miralles , Villegas-Pérez M.P.
Published: January 2018

Purpose

Brimonidine is a lowering pressure agent currently used in glaucoma. This chronic degenerative condition is characterised by neuronal death, and an agent which offers neuroprotection may slow down or impede the progression of neuronal cell death.

Methods

The effects of brimonidine (BMD) on the short- and long-term survival of retinal ganglion cells (RGCs) after transient retinal ischaemia are reported here using a rat model. The fluorescent tracer Fluorogold (FG) was applied to both superior colliculi to retrogradely label RGCs. A ninety-minute period of ischaemia was induced and densities of surviving RGCs were estimated over time by counting FG-labelled RGCs in 12 standard regions of each retina.

Results

Seven days after inducing transient ischaemia, there was loss of approximately half of the RGC population. Topical pre-treatment with 0.1% or 0.5% BMD prevented ischaemia-induced RGC death.

Conclusions

These results indicate that optimal neuroprotective effects against the early loss of RGCs are seen with 0.1% or 0.5% BMD. Ischaemia-induced RGC loss continued between day 7 and day 21 in the vehicle treated groups and amounted to approximately 25% of the RGC population. Topical pre-treatment with 0.1% or 0.5% BMD was also effective in reducing the slow loss of RGCs.
Decreased Nitric Oxide Production in Primary Open-Angle Glaucoma
Authors: Doganay S. , Evereklioglu C. , Turkoz Y. , Er H.
Published: January 2018

Purpose

Raised intraocular pressure (IOP) is the major risk factor responsible for optic nerve damage in primary open-angle glaucoma (POAG). The trabecular meshwork acts as a valve in aqueous outflow and relaxes with nitric oxide (NO) agonists. Since NO is synthesized by endothelium and smooth muscle elsewhere in the body, this study investigated the NO levels in the aqueous humor of patients with POAG compared with cataract patients.

Materials and Methods

Aqueous humor samples were taken by paracentesis from 16 consecutive patients with POAG (9 male and 7 female; mean age 69.0 ± 3.4 yrs) and 14 age and sex-matched controls with cataract (8 male and 6 female; mean age 66.7 ± 4.1 yrs) during elective surgery. As an indicator for NO, aqueous total nitrite levels (end - product of NO) were measured by Greiss reaction. The Mann-Whitney U test was used for statistical analysis and P <0.05 was considered significant.

Results

The mean age and sex in two groups were comparable. The mean aqueous humor NO levels were significantly (P = 0.001) lower in patients with glaucoma (72.72 ± 11.21 μmol/L) than in patients with cataract and no glaucoma (86.92 ± 11.23 μmol/L).

Conclusions

Decreased NO production in patients with POAG indicates that NO-producing cells may be lost as the disease progresses. The control of NO levels in the eye might be a therapeutic target in glaucoma.
Bilateral Central Serous Chorioretinopathy in a Patient Treated with Systemic Cortico-Steroids for Non-Hodgkin Lymphoma
Authors: Bandello F. , Incorvaia C. , Rosa N. , Parmeggiani F. , Costagliola C. , Sebastiani A.
Published: January 2018

Purpose

To describe the concomitant occurrence of systemic cortico-steroid treatment and the development of bilateral central serous chorioretinopathy (CSC), which promptly regressed after the reduction of the drug dosage, up to its scheduled withdrawal.

Methods

Case report.

Results

A 46-year-old white male, with a history of monolateral CSC, had a non-Hodgkin lymphoma on his right cheek. Soon after surgical excision of the tumoral lesion, he received a standard post-operative regimen of decreasing intramuscular betamethasone for 25 days, followed by 10 day's withdrawal, then cycles of intravenous cyclophosphamide and vincristine, followed by 7-day oral prednisone, repeated monthly for three months. Fluorescein angiographies at the end of the first oral cortico-steroid cycle and before starting the second, documented the occurrence of bilateral CSC and its regression, which were chronologically related respectively to the cortico-steroid administration and withdrawal.

Conclusions

This case further demonstrates that systemic cortico-steroids can be responsible for the occurrence of CSC. The patient's history should always be checked for any previous CSC episodes. In these subjects, periodical ophthalmoscopic examination is essential to discover early or asymptomatic steroid-related CSC patterns, to prevent complications of the disease.
Inadvertent Intravitreal Gentamicin Injection
Authors: Burgansky Z. , Rock T. , Bartov E.
Published: January 2018

Purpose

To describe the management and consequences of an accidental injection of gentamicin in the vitreous.

Methods

A retinal detachment developed in a 70-year-old male. During a vitrectomy operation, gentamicin (20mg) was accidentally injected in to the eye. The surgeon immediately began vigorous lavage of the vitreal cavity with balanced salt solution.

Results

No toxic signs appeared after the operation, despite the devastating consequences described in previous reports.

Conclusions

The immediate vigorous lavage may have reduced the concentration of the toxic material and its consequences.
Effect of Intravenous Droperidol on Intraocular Pressure and Retrobulbar Hemodynamics
Authors: Harris A. , Zalish M. , Kagemann L. , Siesky B. , Migliardi R. , Garzozi H.J.
Published: January 2018

Purpose

Topically-applied dopamine antagonists reduce intraocular pressure (IOP) and increase retinal blood flow in animal models. We examined the acute effects of intravenous infusion of a dopamine blocker (droperidol) on these parameters in healthy humans.

Methods

Sixteen subjects free from ocular or systemic disease (mean age 33 ± 10 yrs) received either 5 mg iv droperidol over 5 minutes, or iv saline placebo in double-masked fashion. IOP was determined 30 and 60 minutes later, while color Doppler imaging was used to determine flow velocities in the ophthalmic, central retinal, and nasal and temporal posterior ciliary arteries 60 minutes after drug infusion.

Results

30 minutes after drug infusion, IOP was reduced 6.0 mmHg as compared with baseline (p<0.001); after 60 minutes, IOP remained reduced by 3.7 mmHg (p<0.001). Placebo had no effect on IOP. While droperidol slightly elevated blood pressure and increased the calculated ocular perfusion pressure, the drug reduced visual acuity and contrast sensitivity (p<0.05). Droperidol elevated peak systolic velocity in the central retinal and nasal posterior ciliary arteries, without changing end-diastolic velocity or the resistance index in either of these vessels. Droperidol had no effect on flow velocities in the ophthalmic artery or the temporal posterior ciliary artery.

Conclusions

The rapid and marked ocular hypotension resulting from intravenous droperidol suggests that this agent may prove useful in the management of acute ocular hypertension. The retrobulbar changes consequent to the ocular tension reduction likely represent autoregulatory responses to altered ocular perfusion pressure.
A Case of Lichen Planus-Lupus Erythematosus Overlap Syndrome with Eyelid Involvement
Authors: Tursen U. , Oz O. , Íkizoglu G. , Kaya T.I. , Dusmez D.
Published: January 2018

Purpose

To report a case of lichen planus-lupus erythematosus overlap syndrome with eyelid involvement. Lichen planus and lupus erythematosus infrequently coexist in the same patients. Ocular involvement has rarely been reported for both diseases.

Case Report

We describe a case of lichen planus-lupus erythematosus overlap syndrome with eyelid involvement. Histopathologic and immunofluorescent studies were done on buccal, lip, left conjunctival, malar, auricular and scalp lesions. The immunopathologic features of the conjunctiva, buccal mucosa and lip were consistent with lichen planus, while those of the malar, auricular and scalp lesions favoured lupus erythematosus.

Results

The patient was successfully treated with hydroxychloroquine 200 mg/day and all lesions responded to therapy within weeks.

Conclusions

This is a rare example of two coexisting autoimmune disease entities: lichen planus of the oral mucosa, lip, eyelid and discoid lupus erythematosus of the skin. To our knowledge, this is the first reported case of lichen planus-lupus erythematosus overlap syndrome with eyelid involvement.
Progressive External Ophthalmoplegia: A Paraneoplastic Manifestation of Lymphoma
Authors: Ascaso F.J. , Torres M. , Bergua J.M. , Alvarez R. , Cristóbal J.A.
Published: January 2018

Purpose

Paraneoplastic neurological syndromes are well-known sequelae of some malignancies. To our knowledge, a syndrome mimicking progressive external ophthalmoplegia had never been reported preceding the diagnosis of a lymphoma.

Case Report

A 63-year-old man developed progressive external ophthalmoplegia, without any other neurological symptoms, as the initial manifestation of a follicular lymphoma grade III. The ophthalmoplegia resolved after two cycles of combination chemotherapy.

Conclusions

The ophthalmologist, when confronted with a progressive extemal ophthalmoplegia, should consider a neurological paraneoplastic syndrome associated with a tumor as a possible diagnosis.
Management of Incontinentia Pigmenti: A Case of Monolateral Pre-Retinal Fibrovascular Proliferations Adjacent to Snail-Track Degeneration Areas
Authors: Bandello F. , Incorvaia C. , Parmeggiani F. , D'Angelo S. , Costagliola C. , Sebastiani A.
Published: January 2018

Purpose

To report a case of monolateral pre-retinal fibrovascular proliferations in a young adult woman, who had suffered from incontinentia pigmenti (IP) during her first month of life.

Methods

Case report.

Results

Circumscribed pre-retinal fibrovascular proliferations, adjacent to a mid-peripheral area of snail track degeneration, were occasionally diagnosed in the left eye of an asymptomatic 18-year-old white female. Careful ocular examination did not reveal any cause of the monolateral vascular abnormalities observed in the posterior segment. A detailed medical history brought to light that the patient has suffered infantile IP, like four other females in her family. The patient did not present any evident malformation of teeth, nails, skeleton or hair. A cytogenetic linkage study documented a chromosomal aberration in the Xq28 band, which confirmed the diagnosis of familial IP (type 2). The fluorescein angiography findings clearly illustrated the minimal retinal involvement in the course of IP.

Conclusions

This case shows that a wide range of etiologies must be considered in patients presenting monolateral pre-retinal fibrovascular proliferations. To correctly manage these uncommon, inherited or acquired, retinal diseases it is better to do a mid-term follow-up, rather than operate immediately, and this enabled us to observe the natural course of the lesion, while awaiting a definitive diagnosis.
Eyelid Verrucous Carcinoma
Authors: Monescillo J. , Mencía-Gutiérrez E. , Gutiérrez-Díaz E. , Santos-Bríz A. , Rodríguez-Peralto J.L.
Published: January 2018

Purpose

To report a case of verrucous carcinoma (VC) that presented as an eyelid mass on the right eye.

Case Report

A 66-year-old man developed a slow-growing eyelid lesion on the lateral can-thus of the right eye. The tumor was firm, well-defined, sessile, acuminate, and exuded foul-smelling fluid.

Results

Excisional biopsy revealed a VC. The patient remains asymptomatic.

Conclusions

VCs are extremely rare eyelid tumors. This clinicopathological entity is a low-grade variant of squamous cell carcinoma that occurs mainly in the intraoral, genitogluteal, and plantar areas. A role of human papillomavirus (HPV) in these tumors has been recently identified. VCs characteristically show locally aggresive growth. This is the second case reported in the literature on the eyelid. VC should be considered in the differential diagnosis of eyelid tumors.
The Protective Effects of Melatonin, Vitamin E and Octreotide on Retinal Edema during Ischemia-Reperfusion in the Guinea Pig Retina
Authors: Yilmaz T. , Çelebi S. , Kükner A.Ş.
Published: January 2018

Purpose

The purpose of this study is to provide evidence that free radical damage is a component of retinal ischemia-reperfusion (I/R) injury, and to determine whether melatonin, vitamin E and octreotide can protect retina from this injury.

Methods

The right eyes of 50 male guinea pigs weighing 500–600 g were used. The animals were randomly assigned to group 1 (control), group 2 (I/R), group 3 (melatonin + I/R), group 4 (vitamin E + I/R) and group 5 (octreotide + I/R). Groups 3, 4 and 5 received four subcutaneous injections at six-hour intervals for total dosage of 10 mg/kg melatonin, 150 mg/kg vitamin E and 22 μg/kg octreotide respectively. The first dose of each substance was administered 5 minutes before retinal ischemia. Retinal ischemia was induced for 1.5 hours, then followed by reperfusion for 24 hours. Infections of all three substances were repeated at 6, 12 and 18 hours during reperfusion. The animals were killed at 24 hours of reperfusion. Sagittal sections of 4 μm were cut and stained with hematoxylin and eosin for light microscopic evaluation. The average thickness (edema) of the inner plexiform layer for each eye was measured in sagittal sections near the optic nerve and expressed in microns.

Results

The efficacy of each compound had the following relationships: melatonin>vitamin E>octreotide in preventing retinal damage by ischemia-reperfusion. The mean thickness of the inner plexiform layer was 13.3 ± 0.8 μm, 25.9 ± 2.0 μm, 20.0 ± 0.7 μm, 21.6 ± 0.7 μm, 23.9 ± 0.8 μm respectively in the control, I/R, I/R plus melatonin, I/R plus vitamin E and I/R plus octreotide groups. The thickness of the inner plexiform layer in group 1 (control) was significantly less than the other groups (p<0.001). The inner plexiform layer was thicker in the I/R group than with I/R plus melatonin, I/R plus vitamin E and I/R plus octreotide (all p <0.01). The inner plexiform layer was thicker in the I/R plus octreotide group than the I/R plus vitamin E and I/R plus melatonin groups both (p<0.05). Compared to the I/R plus melatonin group, the inner plexiform layer was significantly thicker in the I/R plus vitamin E group (p<0.05).

Conclusions

This study demonstrates a protective effect of melatonin, vitamin E and octreotide on the retina during retinal ischemia-reperfusion injury.
Selective Photocoagulation in Coats' Disease: Ten-year Follow-up
Authors: Nucci P. , Bandello F. , Serafino M. , Wilson M.E.
Published: January 2018

Purpose

The diagnostic hallmark of Coats' disease is development of “light bulb” telangiectasis in the retinal periphery, leading to posterior pole intraretinal and subretinal exudation. Even after complete obliteration of all abnormal vessels and resorption of all exudates, follow-up examinations are mandatory for several years.

Methods

We retrospectively analyzed the charts, pictures and/or fluorescein angiographies of a series of 32 consecutive patients, in which the diagnosis of Coats' disease was made. All patients underwent selective photocoagulation of the telangiectasis using a yellow-dye laser. Efficacy of treatment was monitored with drawings and/or fluorescein angiographies.

Results

All our patients had unilateral disease, with macular involvement and exudative retinal detachment. Visual acuity improved in one patient, decreased from light perception to blindness in another, and was unchanged in the remainder.

Conclusions

This is the first report of anatomical benefits from treatment with a yellow-dye laser (i.e., selective photocoagulation without cryotherapy or drainage) despite the presence of a severe form of Coats' disease. Our young Coats' patients responded quickly to treatment. With successful obliteration of the abnormal vasculature, exudates began to absorb in about 4 to 8 weeks although, in some cases, 10 to 12 months were needed to obtain resolution of the exudative detachment. Poor visual outcome of 20/100 or worse was common. In Coats' patients, the key issue is continuous control and long-term follow-up.
Comparative Analysis of the Effects of Dorzolamide and Latanoprost on Ocular Hemodynamics in Normal Tension Glaucoma Patients
Authors: Harris A. , Migliardi R. , Rechtman E. , Cole C.N. , Yee A.B. , Garzozi H.J.
Published: January 2018

Purpose

To compare the effects of latanoprost (Xalatan®) and dorzolamide (Trusopt®) on ocular hemodynamics in normal-tension glaucoma patients.

Methods

A randomized, single-masked, parallel design study was conducted. After a 4 - week washout period, 20 normal tension glaucoma patients, recruited from a single university-based ophthalmology clinic, received either latanoprost once daily or dorzolamide 3 times daily for 4 weeks. The subjects were examined at baseline and post-treatment. Outcome measures included heart rate (HR), blood pressure (BP), logMar visual acuity (VA), contrast sensitivity (CS), intraocular pressure (IOP), color Doppler imaging (CDI), and fluorescein angiography with the Rodenstock scanning laser ophthalmoscope (SLO). CDI measurements of the retrobulbar vessels included peak systolic velocity, end diastolic velocity, and the calculated resistance index. Arterio-venous passage time (AVP) in the superior and inferior temporal retina was calculated from the SLO angiograms.

Results

Neither dorzolamide nor latanoprost had any statistically significantly effect on HR or BP. Both drugs significantly lowered IOP without altering calculated ocular perfusion pressure (p<0.05). There was no statistically significant difference in any CDI measurement. Dorzolamide significantly decreased AVP time in the superior retina (p=0.011), while latanoprost did not (p=0.62).

Conclusions

Dorzolamide, unlike latanoprost, significantly reduced AVP times in the superior temporal retina in normal tension glaucoma (NTG) patients.
Intraocular Hemorrhage after Systemic Thrombolytic Therapy in a Patient with Exudative Macular Degeneration
Authors: Djalilian A.R. , Cantrill H.C. , Samuelson T.W.
Published: January 2018

Purpose

To report a hemorrhagic complication from thrombolytic therapy in a patient with exudative macular degeneration

Case Report

A 75 year old patient with exudative macular degeneration developed pain and loss of vision in the left eye shortly after receiving tissue plasminogen activator (t-PA) for a myocardial infarction. Examination revealed the patient to be in angle closure. A CT scan revealed the etiology of the angle closure to be a dense vitreous hemorrhage pushing the iris-lens diaphragm forward. Intraocular pressure was treated successfully, but the final visual acuity was only light perception

Conclusions

Thrombolytic therapy can lead to devastating intraocular hemorrhages. The presence of exudative macular degeneration may potentially increase the risk of developing such complications.
Liposarcoma Metastatic to the Orbit
Authors: Tehrani A-HY. , Heegaard S. , Prause JU. , Fledelius HC. , Daugaard S.
Published: January 2018

Purpose

To describe a patient with liposarcoma metastatic to the left orbit.

Methods

A 72-year-old man was admitted with diplopia and proptosis of the left eye. Previously, a retroperitoneal liposarcoma had been surgically removed followed by postoperative radiation. Visual acuity was normal. There was proptosis of the left eye, increased retrobulbar resistance and reduced mobility. Trans-septal orbital biopsies showed liposarcoma. The patient was initially treated with prednisolone and later received radio- and chemotherapy. Despite treatment he lost vision of the left eye and died a few months later.

Results

Histological examination of the orbital tumor revealed a spindle-cell liposarcoma similar to the primary tumor of the retroperitoneum.

Conclusions

Liposarcoma metastatic to the orbit is rare, but should be suspected in a patient with proptosis caused by a space-occupying lesion and a history of liposarcoma.
Complications of Laser in Situ Keratomileusis (LASIK)
Authors: Tabbara K.F. , El-Sheikh H.F. , Vera-Cristo C.L.
Published: January 2018

Purpose

To report major complications associated with laser in situ keratomileusis (LASIK).

Methods

Twenty-four eyes of 23 patients who underwent LASIK in different centers in Saudi Arabia were included. There were 9 women and 14 men. The age range was from 20 to 65 years. Nineteen of the 23 patients had been referred to the Eye Center for management. All patients had a complete ophthalmologic examination, refraction, corneal topography and pachymetry.

Results

The 24 eyes of 23 patients had complications consequent to LASIK. Thirteen were intraoperative complications, and 11 postoperative. Ten (44%) of the 23 cases were related to the corneal flap, two (9%) with intraocular perforation with the microkeratome. Three (13%) had photoablation-related complications. Postoperative complications included three (13%) cases of infections, four (17%) stromal-interface related problems, one (5%) who developed interface vascularization, and one (5%) with non-ischemic central retinal vein occlusion.

Conclusions

Although LASIK is a safe and effective procedure, a small number of patients may suffer serious complications that can even lead to visual loss. The procedure must be carefully performed by qualified surgeons.
Prevention of Posterior Capsule Opacification Using Capsular Tension Ring for Zonular Defects in Cataract Surgery
Authors: D'Eliseo D. , Pastena B. , Longanesi L. , Grisanti F. , Negrini V.
Published: January 2018

Purpose

To evaluate the incidence of secondary cataract in phacoemulsification and intraocular lens implantation using a capsular tension ring in case of zonular dehiscence.

Methods

Phacoemulsification using a double capsular tension ring and intraocular lens implantation was done in 65 eyes with cataract and severe zonular weakness. One year after surgery capsular opacities and fibrosis were detected in a double-blind examination. The results were compared with a control group of 36 eyes that did not have a capsular tension ring but had similar surgery.

Results

In the group with the capsular tension ring and implantation 7.7% of patients had moderate or severe posterior capsule opacification, compared with 36.1% in the control group.

Conclusions

Capsular tension rings may influence the formation of capsule opacification.
Ocular Findings in Cerebro-Oculo-Facial-Skeletal Syndrome (Pena-Shokeir-II Syndrome)
Authors: Jonas J.B. , Mayer U. , Budde W.M.
Published: January 2018

Purpose

To report the ocular findings in cerebro-oculo-facial-skeletal syndrome or Pena-Shokeir-II syndrome.

Methods

Case report.

Results

A five-month-old male infant presented with bilateral posterior polar cataract, microphthalmos, nystagmus, and marked non-glaucomatous optic nerve atrophy. Systemic abnormalities such as microcephaly, micrognathia, flexion contractures of the elbows and knees, hypotonic musculature, and failure to thrive, with pronounced statomotor retardation, led to the diagnosis of cerebro-oculo-facial-skeletal syndrome or Pena-Shokeir-II syndrome. Cataract surgery did not improve the poor visual performance.

Conclusions

Cerebro-oculo-facial-skeletal syndrome (Pena-Shokeir-II syndrome) should be included in the differential diagnosis of bilateral microphthalmos, congenital cataract, nystagmus, and pronounced optic nerve atrophy, and cataract surgery does not markedly improve vision.
Peripheral Vasospasm and Nocturnal Blood Pressure Dipping - Two Distinct Risk Factors for Glaucomatous Damage?
Authors: Pache M. , Dubler B. , Flammer J.
Published: January 2018

Purpose

To evaluate the relationship between peripheral vasospasm and circadian blood pressure rhythm in patients with primary open angle glaucoma (POAG).

Methods

Nail-fold capillaroscopy, combined with a cold provocation test, and 24-hour blood pressure monitoring was carried out in 130 patients with POAG (M:F 58:72; mean age 60 ± 14 years), 99 with high-tension glaucoma (HTG) and 31 with normal-tension glaucoma (NTG). Peripheral blood flow parameters were compared for patients with a nocturnal fall in mean systemic blood pressure (MBP) of less than 10% (non-dippers), patients with a nighttime MBP fall of 10–20% (dippers), and patients with a nighttime MBP fall of more than 20% (over-dippers).

Results

Patients with POAG showed a significantly lower blood flow velocity both at baseline (p <0.01) and after cold provocation (p <0.02) and a significantly higher percentage of cold-induced blood-flow standstill (p <0.0001) in the nail-fold capillaroscopy than normal controls. The numbers of non-dippers (50), dippers (66) and over-dippers (14) did not differ between the HTG and NTG group. There were no significant differences between non-dippers, dippers, and over-dippers in peripheral blood flow parameters.

Conclusions

Our findings indicate that vasospasm and low blood pressure may be distinct risk factors for glaucomatous damage. It also appears that screening for vascular dysregulation and systemic hypotension should not be restricted to NTG patients alone.
Trans-Orbital Intra-Cranial Air Gun Injury
Authors: Gilmour D.F. , Ramaesh K. , Fleck B.W.
Published: January 2018

Purpose

To describe a case of trans-orbital intra-cranial air gun injury with a discussion on air gun related morbidity and mortality.

Methods

Case report and literature review.

Results

The air gun pellet travelled through the orbit without penetrating the globe. It passed into the middle cranial fossa through the superior orbital fissure and lodged in the temporal lobe. The patient was managed conservatively with antibiotics and antiepilectis.

Conclusions

Air gun design has changed in recent years resulting in an increased morbidity and mortality. Stricter legislation on the sale and use of these weapons needs to be implemented.
Closed Chamber Thermometry and Humidity Measurements in Normal and Dry Eye Patients: A Pilot Study
Authors: Singh G. , Bhinder H.S.
Published: January 2018

Purpose

To verify the diagnostic value of closed chamber thermometry and humidity measurement in normal and dry eye patients.

Methods

In 20 patients (40 eyes) with dry eye and 20 normal sex- and age-matched controls (40 eyes), aged from 11 to 61 years (mean 37.52 yrs, standard deviation, (SD) 14.81) temperature was measured by infrared thermometry and humidity measured in a closed chamber 15 mm from the cornea. The temperature reading in °C and humidity in % (RH) were noted on closing and then opening the eye for five seconds.

Results

The temperature rose significantly, by 0.11°C ± 0.02, between the closed and open eye positions (p<0.000) in normal eyes, but there was no change in dry eyes. The humidity in normal eyes in the closed position was 49.50 ± 4.67% and 50.03 ± 4.65% in the open position (p<0.00001). Humidity in the closed and open positions in dry eyes was 52.77 ± 7.13% and 53.59 ± 6.75% (p<0.00000). The difference between closed and open dry eyes was 1.25 ± 0.40%, compared to 0.54 ± 0.20% in normal controls (p<0.005). No relationship was found with age or sex.

Conclusions

Thermometry and humidity measurements in a dry eye patient had a 100% diagnostic value. The reading of no change in thermometry and more than 1% change in humidity were highly diagnostic of dry eyes.
Ultrasound Biomicroscopy in Lens “Coloboma”
Authors: Agarwal T. , Saxena R. , Vajpayee R.B.
Published: January 2018

Purpose

To study the morphology of the Lens “Coloboma” using the technique of ultrasound biomicroscopy.

Methods

We used the Paradigm 40 Ultrasound biomicroscope to study the morphology of the lens “Coloboma”.

Results

Ultrasound biomicroscopy of the lens “Coloboma” revealed a greatly increased sphericity of the lens and the deficiency of zonules in the “colobomatous” area.

Conclusions

Ultrasound biomicroscopy has helped in elucidating the pathology of the lens “Coloboma”.
Traumatic Eye Injuries Due to Large Unusual Foreign Bodies: A Singapore Case Series
Authors: Pan J.C.H. , Yap E.Y. , Yip C.C.
Published: January 2018

Purpose

Traumatic eye injuries due to large foreign bodies (FB) are rare. The visual prognosis is often poor in these cases because of severe ocular damage. Staged surgical procedures with eventual enucleation or evisceration are often indicated.

Methods

Case series.

Results

The authors describe two patients with eye injury due to large FB with visual acuity of no light perception at presentation. Both had initial repair of the ocular injuries and removal of the FB. One patient with an intraocular FB eventually underwent enucleation; the other, with intraorbital FB, had evisceration as a secondary procedure. Orbital implantations were done in both. Neither of the patients had developed sympathetic ophthalmia at the last review.

Conclusions

The visual outcome of eye injuries due to large FB is poor. Both enucleation and evisceration can be performed with low risk of sympathetic ophthalmia. Prevention remains the best approach to such devastating injuries.
Transpupillary Thermotherapy of Juxtafoveal Recurrent Choroidal Neovascularization
Authors: Cardillo Piccolino F. , Eandi C.M. , Ventre L. , Rigault De La Longrais R.C. , Grignolo F.M.
Published: January 2018

Purpose

To evaluate the effectiveness of low power transpupillary thermotherapy (TTT) in treating juxtafoveal recurrent choroidal neovascularization (CNV) after laser photocoagulation in patients with age-related macular degeneration (ARMD).

Methods

Eight eyes of eight patients with ARMD and juxtafoveal recurrent CNV were treated with low power TTT, delivered using an 810-nm diode laser with 350 mW, 2.0 mm spot, and 1-minute duration. Visual acuity (VA) ranged from 20/100 to 20/50. Treatment effect was evaluated by fluorescein angiography, indocyanine green angiography, and VA measurements (Early Treatment Diabetic Retinopathy Study) at 1-week, 2-week, and monthly follow-up visits.

Results

NO retinal damage was visible ophthalmoscopically during treatment. At the first follow-up visit, seven eyes had obliteration of CNV and one eye required a second TTT application. VA was unchanged in six eyes, improved in one eye, and worsened in one eye. Recurrences occurred in all eyes between 1 and 7 months after TTT and were treated with photodynamic therapy (PDT). More than two PDT treatments were performed in each eye in the year after recurrence.

Conclusions

LOW power TTT is as able to close juxtafoveal recurrent CNV as is high power conventional laser photocoagulation but does not prevent recurrences. Further intervention with TTT in order to treat recurrences is under investigation.
Bilateral Detachment of the Macular Neuroepithelium in a Patient with Klinefelter Syndrome
Authors: Van Haarlem J. , Cruysberg J.R.M. , Deutman A.F.
Published: January 2018

Purpose

To describe the occurrence of atypical, bilateral detachment of the macular neuroepithelium and Klinefelter syndrome in a young patient.

Methods

Case report.

Results

A 20-year-old male of Chinese origin with karyotype 47,XXY presented with bilateral central neurosensory retinal detachment. There was spontaneous improvement.

Conclusions

An atypical form of detachment of the macular neuroepithelium was seen in a young patient with Klinefelter syndrome. The pathophysiological mechanism is not clear. The possibility of a hormonal imbalance is discussed. A differential diagnostic consideration is central serous chorioretinopathy and a mild form of Vogt-Koyanagi-Harada syndrome. This case is of interest because of the rarity of association between Klinefelter syndrome and chorioretinal abnormalities.
Rieger Anomaly with Bilateral Choroidal Osteoma: Coincidence or Association?
Authors: Erkiliç K. , Özkiriş A. , Evereklioglu C. , Dogan H.
Published: January 2018

Purpose

To report a case of Rieger anomaly associated with bilateral choroidal osteoma. CASE. An 18-year-old woman presented with corectopia, iridocorneal adhesions, and stromal hypoplasia of the iris, and was diagnosed with Rieger anomaly.

Results

Fundus examination revealed bilateral yellowish-orange, placoid degenerative fundus lesions with pseudopod-like edges associated with the areas of retinal pigment epithelium atrophy, indicating choroidal osteoma. Fundus fluorescein angiography showed bilateral early patchy and late diffuse hyperfluorescence. B-scan echography revealed placoid lesion at the posterior ocular coats characterized by localized areas of high ultrasound reflectivity with a corresponding retrobulbar orbital shadowing. This indicated a dense calcium foreign body. In addition, computed tomography of the orbit demonstrated bilateral plate-like thickening with calcification of the choroid that was isodense with the normal skeletal bone.

Conclusions

Although Rieger anomaly is classically known as a disease of the anterior segment of the eye, choroidal osteoma may be a posterior segment finding of the disease that has not previously been reported.
The Effect of Capsulorhexis Size on Development of Posterior Capsule Opacification: Small (4.5 to 5.0 mm) versus Large (6.0 to 7.0 mm)
Authors: Aykan Ü. , Bílge A.H. , Karadayi K. , Akin T.
Published: January 2018

Purpose

The most common surgically related cause of reduced vision after extracapsular cataract extraction is posterior capsule opacification (PCO), which occurs in up to 50% of eyes following cataract extraction. This study examined whether small capsulorhexes of 4.5 to 5.0 mm, which lie completely on the 5.5 mm intraocular lens (IOL), and large capsulorhexes of 6.0 to 7.0 mm, which lie completely off the lens optic, are effective in preventing PCO development.

Methods

In this prospective study, 496 eyes of 367 patients underwent standardized phacoemulsification with capsulorhexis and capsular bag foldable acrylic IOL implantation. The patients were randomly assigned to receive either a small capsulorhexis of 4.5 to 5 mm to lie completely on the IOL optic or a large capsulorhexis of 6 to 7 mm to lie completely off the lens optic. Retroillumination photographs were taken at 6 months and then yearly.

Results

Throughout the follow-up, there was less PCO in the small capsulorhexis group than in the large capsulorhexis group.

Conclusions

Small capsulorhexes were associated with less wrinkling of the posterior capsule and less PCO than were large capsulorhexes. PCO after IOL implantation has a multi-factored pathogenesis. Small (4.5 to 5.0 mm) capsulorhexis and capsular bag implantation of 5.5 mm acrylic IOL are likely to reduce the PCO incidence when compared with the 6.0 to 7.0 mm capsulorhexis. The significance of the IOL optic diameter in association with the capsulorhexis size should also be documented by further studies.
Optic Nerve Alterations in Apolipoprotein E Deficient Mice
Authors: Lopez-Sanchez E. , Frances-Muñoz E. , Diez-Juan A. , Andres V. , Menezo J.L. , Pinazo-Duran M.D.
Published: January 2018

Purpose

To study the morphologic characteristics of the optic nerve (ON) by using an experimental model of knockout mice for expression of the ApoE gene

Methods

Eyeballs with the retrobulbar ON attached were obtained from 24-week-old mice. Using morphologic and morphometric techniques and light and transmission electron microscopy, the ON characteristics were determined in three groups of mice: 1) wild type mice as the controls (CG; n=15), 2) knockout mice for the ApoE gene (ApoE-G; n=15), and 3) knockout mice for the ApoE gene that were fed a cholesterol-supplemented diet (ApoED-G; n=15).

Results

The ON cross-sectional area was significantly higher in the ApoE-G than in the CG (p<0.001) mice, whereas no significant changes were noticed between the ApoE-G and ApoED-G mice. Significant differences were noticed between those groups regarding the myelination index. Higher density of intraaxonal degeneration and myelin sheath alterations were found in both ApoE groups in respect to the CG.

Conclusions

These results suggest that ApoE knockout mice have changes in ON morphology and myelination.
Successful Surgical Repair and Good Visual Outcome of a Recurrent Macular Hole of Seven Years Duration
Authors: Oz O. , Akduman L.
Published: January 2018

Purpose

To report anatomical closure and visual improvement in a patient with seven-year history of recurrent macular hole.

Methods

A 68-year-old woman underwent vitrectomy and silicone oil tamponade for a seven-year old recurrent macular hole.

Results

Macular hole closed and visual acuity improved form 20/400 to 20/60 at 12 months follow-up.

Conclusions

The eyes with very-long standing macular holes may be considered for surgery. Predictors of successful visual outcome after surgery in very-long standing macular holes should be studied in larger series.
Effect of Brimonidine on Intraocular Pressure in Normal Tension Glaucoma: A Short Term Clinical Trial
Authors: Gandolfi S.A. , Cimino L. , Mora P.
Published: January 2018

Purpose

To evaluate the efficacy and safety of 0.2% brimonidine eye drops given twice daily in normal tension glaucoma.

Patients and Methods

Sixteen consecutive patients fulfilling eligibility criteria (glaucomatous optic neuropathy associated with visual field defect in at least one eye, intraocular pressure (IOP) = 18 mmHg (average of the two highest readings of the round-the-clock curve, including one reading at midnight in supine position), no prior glaucoma therapy, angle wide open, visual acuity 20/40 or better) were enrolled in this prospective, randomized, placebo-controlled clinical trial with crossover design, lasting 30 days for each treatment phase plus 15-day washout in between. Main outcome was IOP (average of the two highest readings of the round-the-clock curve).

Results

Mean IOP was significantly reduced by brimonidine (from 17.1 ± 0.7 mm Hg to 13.9 ± 2.2 mmHg, p<0.001 (paired Student t-test)). At the end of the 30-day brimonidine phase, 4 of 16 subjects showed a ≥30% IOP decrease over baseline.

Conclusions

In the short term, 0.2% brimonidine eye drops can induce a significant IOP decrease in eyes with normal tension glaucoma.
Prognosis of Juvenile Rheumatoid Arthritis-Associated Uveitis
Authors: Paroli M.P. , Speranza S. , Marino M. , Pirraglia M.P. , Pivetti-Pezzi P.
Published: January 2018

Purpose

To evaluate the clinical characteristics and the visual prognosis of uveitis in juvenile rheumatoid arthritis (JRA).

Methods

The authors examined 63 patients with uveitis and JRA observed from January 1985 to December 2000. The following characteristics of each patient were considered: age at first visit, age at onset of uveitis and arthritis, sex, laterality and localization of uveitis, ocular complications, antinuclear antibody (ANA) and human leukocyte antigen (HLA) DR11 positivity, and follow-up. A retrospective study on mid-time visual outcome and ocular complications was performed on 42 patients with more than 12 months of follow-up.

Results

A total of 76.2% of the patients were female, with a mean age of 8.1 years. Chronic anterior uveitis was bilateral in 77.8% of the cases and unilateral in 22.2%. Arthritis was oligoarticular at onset in 87.3% of cases, and polyarticular in 12.7%. Mean age at arthritis onset was 4.5 years and mean age at uveitis onset was 5.4 years. ANA were positive in 92% of cases and HLA DR11 was present in 36 of the 43 patients tested (83.7%). Among the 42 patients with more than 12 months of follow-up, ocular complications occurred in 90.5% of cases and the most frequent were cataract (64.4% of eyes) and band keratopathy (59.2% of eyes). Secondary glaucoma (25% of eyes) was associated with the worst visual prognosis. A total of 64.5% of eyes maintained a visual acuity between 20/33 and 20/20 at the end of the follow-up.

Conclusions

Visual prognosis of uveitis associated with JRA is improving, owing to earlier diagnosis and intensive treatment. Ocular complications occurred frequently in patients with uveitis and JRA but they did not seem to seriously affect the final visual outcome. The authors did not observe any correlation between prognosis and sex, age at the onset of uveitis or arthritis, pattern of arthritis, or positivity for ANA or HLA DR11. In a percentage of cases, uveitis may develop before arthritis or years after the onset of arthritis; therefore, continuous ophthalmologic examinations are needed in young people with JRA.
Diabetes Mellitus: A Risk Factor Affecting Visual Outcome in Branch Retinal Vein Occlusion
Authors: Swart J. , Reichert-Thoen J.W. , Suttorp-Schulten M.S. , Van Rens G.H. , Polak B.C.
Published: January 2018

Purpose

The prognosis of visual acuity (VA) after branch retinal vein occlusion (BRVO) in patients with diabetes mellitus is unknown compared to the VA in non-diabetic patients with BRVO. The aim of this study was to evaluate the visual outcome of BRVO in diabetic and non-diabetic patients.

Methods

A retrospective case-control study of diabetic and non-diabetic patients with BRVO was performed. VA and commonly known risk factors and complications of BRVO were compared in a follow-up period of at least 1 year.

Results

A total of 28 eyes of patients with diabetes and 49 eyes of non-diabetic patients with BRVO were included. One year after BRVO, the VA in the patients with diabetes decreased significantly more than that of the non-diabetic patients. During the second year after BRVO, the VA did not change significantly in either group. BRVO in patients with diabetes occurs at an earlier age. Diabetic patients needed more outpatient visits.

Conclusions

The VA 1 year after BRVO in patients with diabetes is worse compared to the VA in patients without diabetes. The VA stabilizes 1 year after onset in both groups. Diabetic patients tend to need more frequent follow-up in order to treat the sequelae of BRVO.