bluuebunny/crossref_metadata_2025 huggingface dataset:
Causes of Blindness in Southwestern Nigeria: A General Hospital Clinic Study
Authors: Oluleye T.S. , Ajaiyeoba A.I. , Akinwale M.O. , Olusanya B.A.
Published: January 2018

Purpose

This hospital-based study was carried out to assess the common causes of blindness in Ibadan, the largest city in the southwestern part of Nigeria, and to strengthen the primary eye care approach to control and reduction of cases of blindness in the community.

Methods

Following Hospital Ethical Board approval and informed consent of participants, a prospective study was performed in which 1,544 consecutive patients with bilateral or unilateral blindness seen between January and December 2003 at the Ring Road State Hospital, Ibadan, Nigeria, were evaluated for causes of blindness. Visual acuity was measured with an illuminated Snellen chart placed 6 meters away from the participants. This was followed by pen torch examination and dilated funduscopy with a direct ophthalmoscope. Friedman field analyzer was used to measure visual field. Patients with corrected visual acuity of less than 3/60 in the better eye or with visual field of less than 10 degrees from fixation were considered blind according to the World Health Organization criteria.

Results

The 1,544 patients had a mean age of 53.5 years (range, 4 to 96 years); 858 (56%) were male and 686 (44%) were female. Blindness was bilateral in 471 (30%) patients and unilateral in 1,073 (70%). When those persons with unilateral and bilateral blindness were grouped together, individuals within the 60 to 79 years age bracket were 667 (44%) and constituted the largest group of all blind persons. The leading causes of bilateral blindness were cataract, 171 (36%); glaucoma, 138 (29%); and optic atrophy, 21 (4%). The most common causes of unilateral blindness were cataract, 446 (41%); glaucoma, 213 (20%); and those referable to trauma, 116 (11%).

Conclusions

Cataract and glaucoma are the main causes of bilateral and uniocular blindness in the study area.
Progressive Severe Visual Loss after Long-Term Withdrawal from Thioridazine Treatment
Authors: Chaudhry I.A. , Shamsi F.A. , Weitzman M. L.
Published: January 2018

Purpose

To report advanced thioridazine-induced retinopathy in a 50-year-old woman with evidence of progressive severe loss of vision over 30 years after withdrawal from thioridazine treatment.

Methods

The ocular fundus examination revealed areas of retinal pigment epithelium (RPE) clumping as well as generalized atrophy of the RPE and choroid. The patient experienced visual loss to the level of no light perception in both eyes despite the fact that the funduscopic appearances of her optic nerves and retinal vasculature remained relatively normal.

Conclusions

This case demonstrates that severe progressive visual loss can occur several years after the cessation of chronic thioridazine treatment.
Clinical Evaluation of the Neuroprotective Effect of α-Tocopherol against Glaucomatous Damage
Authors: Engin K.N. , Engin G. , Kucuksahin H. , Oncu M. , Engin G. , Guvener B.
Published: January 2018

Purpose

To evaluate the vasoregulatory effect of antioxidant α-tocopherol on retina via protein kinase C pathway.

Methods

Thirty glaucomatous patients (60 eyes) were included in this study. The patients were divided into three groups. For patients in Group A, tocopherol was not supplemented in their therapy. Patients in Groups B and C received 300 and 600 mg/day of oral α-tocopherol acetate, respectively. The ultimate blood tocopherol levels were confirmed via high-performance liquid chromatography assay. Progression of the disease for each subject was monitored via visual field measurements and color Doppler imaging of ophthalmic and posterior ciliary arteries at the beginning and at the 6th and 12th months of this study.

Results

The average differences between the pulsatility indexes (PI) and resistivity indexes (RI) of both ophthalmic arteries (OA) and posterior ciliary arteries (PCA) of Groups B and C were significantly lower than those of Group A at months 6 and 12. In trial groups, RI decreases observed in PCAs at months 6 and 12 and PI decreases observed in OAs at the 6th month were statistically significant. Differences of mean deviations with visual fields in Groups B and C were highly significantly lower than that of Group A.

Conclusions

α-Tocopherol deserves attention beyond its antioxidant properties for protecting retina from glaucomatous damage.
Health Care Supply for Cataract in Austrian Public and Private Hospitals
Authors: Barbieri V. , Schmid E. , Ulmer H. , Pfeiffer K.P.
Published: January 2018

Purpose

This study aims to explain spatial variability or cataract and cataract surgery in Austria. The effect of the availability of health care services on spatial variation is investigated.

Methods

A retrospective study, using routine hospital data from all Austrian public and private hospitals. Calculation of age- and gender-standardized hospitalization ratios (SHR) for all 121 Austrian districts. Poisson regression for age-specific relative risks was performed.

Results

The authors found high regional variability between districts and significant differences in the hospitalization rates of cataract disease and extraction between men and women. There was a significant correlation between standardized hospitalization ratios for districts and the availability of hospitals with departments of ophthalmology. There was a significant difference in length of stay for patients with cataract surgery between public and private hospitals.

Conclusions

Use of routine hospital data in geographic analysis allows large regional studies on health care supply for cataract surgery. Differences in the supply by hospitals between districts depend on the availability of hospitals with departments of ophthalmology. The overall demand for cataract surgery in Austria finds its proper supply in many Austrian regions, but needs further development.
Relation between Cataract and Metabolic Syndrome and Its Components
Authors: Paunksnis A. , Bojarskiene F. , Cimbalas A. , Cerniauskiene L.R. , Luksiene D.I. , Tamosiunas A.
Published: January 2018

Purpose

To estimate the prevalence of cataract in the middle-aged urban population and the relation between cataract and metabolic syndrome and metabolic syndrome components.

Methods

The survey was carried out in Kaunas City, Lithuania, from 2001 to 2002, according to WHO MONICA study protocol. The ophthalmologic investigation was performed for 1282 respondents (573 men and 709 women) aged 35–64 years. Cataract was defined at slit lamp using LOCS III method. Metabolic syndrome was defined by ATP III criteria.

Results

Cataract was found in 17.6% of men and 19.0% of women (p>0.05). Metabolic syndrome was detected in 19.5% of men and 25.7% of women (p<0.05). After distribution of persons into 10-year age groups (35–44, 45–54, 55–64), the prevalence of cataract and metabolic syndrome among men and women significantly increased with age. A relation between cataract and metabolic syndrome was found for men aged 55–64 years and for women aged 45–64 years: the prevalence of cataract in men with metabolic syndrome was 1.3 times higher (43.8% vs 32.9%; OR=1.59 [95% CI, 0.77–3.26]) and in women with metabolic syndrome 1.4 times higher (31.8% vs. 22.6%; OR=1.60 [95% CI, 1.03–2.49]) than in persons of the same age and sex without metabolic syndrome. For men aged 4–64 years cataract was significantly related to central obesity (OR=1.80 [95% CI, 1.01–3.20]) and for women aged 45–64 years cataract was significantly related to higher arterial pressure (OR=1.98 [95% CI, 1.21–3.25]), central obesity (OR=1.54 [95% CI, 1.01–2.35]), and elevated level of serum triglycerides (OR=1.86 [95% CI, 1.20–2.90]).

Conclusions

The results of this study show that the prevalence of cataract in urban women 45–64 years of age with metabolic syndrome was significantly higher than in women of this age without metabolic syndrome.
The Diagnostic Contribution of Indocyanine Green to Fluorescein Angiography in Fellow Drusen Eyes of Patients with Wet Age-Related Macular Degeneration
Authors: Landa G. , Springer A. , Bukelman A. , Pollack A.
Published: January 2018

Purpose

To assess the contribution of indocyanine green angiography (ICGA) to fluorescein angiography (FA) in evaluating fellow drusen eyes of patients with wet age-related macular degeneration (AMD) in the other eye.

Methods

The records of paired FA and ICGA of patients with dry AMD in one eye and wet AMD in the other eye were retrospectively reviewed. Based on color fundus photographs, drusen were graded to low, moderate, or high grade of severity on FA. The FA and ICGA findings were compared.

Results

Fifty-two pairs of eyes were included. Fluorescein angiography showed drusen of low severity in 11 (21.2%) eyes, of moderate severity in 31 (59.6%), and of high severity in 10 (19.2%). Leakage on both FA and ICGA was not demonstrated in any case of drusen of low or moderate severity. Only in 2 out of 10 eyes from the high severity group, 3.8% of the eyes of the whole study population, did ICGA reveal occult choroidal neovascularization (CNV) that was not observed on FA.

Conclusions

In selected eyes with drusen of high grade severity, ICGA may detect occult CNV, unrecognized clinically or by FA. ICGA had a small contribution to the diagnosis of occult CNV in fellow drusen eyes with any degree of severity.
Visual Function after Implantation of Aniridia Intraocular Lens for Traumatic Aniridia in Vitrectomized Eye
Authors: Moghimi S. , Esfahani M. Riazi , Maghsoudipour M.
Published: January 2018

Purpose

To evaluate the efficacy and safety of aniridia posterior chamber intraocular lens (PCIOL) in traumatic aniridia and aphakia in vitrectomized eyes.

Methods

Four aphakic patients with traumatic aniridia and previous pars plana vitrectomy (PPV) due to posterior segment trauma enrolled in the study, and had secondary implantation of an aniridia PCIOL. Two patients were men and two women with mean age of 39.25 years. Complete ophthalmic examinations, including preoperative and postoperative visual acuity in dark and light, glare disability, visual function (using VF-9 questions modified from VF-14), stereopsis, and contrast sensitivity in 3, 6, 12, and 18 cycle per degree frequencies, were done for all patients. Postoperative intraocular pressure (IOP), IOL centration, and intraocular inflammation were monitored. Mean follow-up was 12.25 months (range 7 to 15 months).

Results

Visual acuity improved in all four patients, especially in the light. Glare was subjectively reduced in all of them. Stereopsis was measurable in three of them postoperatively. Contrast sensitivity improved in all patients, especially in brightness and lower frequencies. All four eyes had improved VF-9. All eyes achieved the desired anatomic results. Two cases developed elevated IOP early after surgery. In one eye, IOP elevation was transient and controlled with antiglaucoma medication, but the other eye, which had secondary glaucoma from previous trauma, required cyclophotocoagulation for the IOP to be controlled. No patient developed chronic uveitis or redetachment.

Conclusions

The aniridia PCIOL can overcome aphakia, reduce glare, and increase visual function, contrast sensitivity, and stereopsis in vitrectomized eyes with traumatic aniridia. Although this kind of IOL appears safe, some disadvantages are secondary glaucoma and reduced visibility of peripheral fundus, and caution should be used in its implantation until more patients with longer follow-up are studied.
A Case of Retinal Detachment in Retinitis Pigmentosa
Authors: Demir M.N. , Ünlü N. , Yalniz Z. , Acar M.A. , Örnek F.
Published: January 2018

Purpose

To report case of retinitis pigmentosa in association with rhegmatogenous retinal detachment.

Methods

An eight year old boy complained of a sudden visual loss. The patient had night blindness, bone spicule-like hyperpigmentation, pale optic disc in both eyes, and the retina was totally detached in the right eye.

Results

He was initially treated with conventional scleral buckling surgery, then pars plana vitrectomy with silicone tamponade was performed and retinal reattachment was established. After the phacoemulsification combined with silicone oil removal the final visual acuity of counting fingers was obtained.

Conclusions

The association of retinitis pigmentosa and rhegmatogenous retinal detachment is uncommon in young patients.
Prognostic Value of Gonioscopy after Deep Sclerectomy
Authors: Moreno-Montañés J. , Rebolleda G. , Muñoz-Negrete F.J.
Published: January 2018

Purpose

To ascertain gonioscopic characteristics and identify prognostic indicators related to intraocular pressure (IOP) after deep sclerectomy (DS).

Methods

A transversal, prospective, and nonselected study was performed in 106 eyes (95 patients) after DS. Three surgeons performed all the surgeries and the gonioscopic examination, using the same protocol including 13 gonioscopic data. These data were evaluated for an association with postoperative IOP and time after surgery.

Results

A subscleral space was found in 91 eyes (85.8%), with visualization of the line of scleral flap in 48 eyes (45.3%). The trabeculo-Descemet membrane (TDM) was transparent in 46 eyes (43.4%), opaque in 4 cases, and pigmented in 18 eyes. This TDM was broken using Nd:YAG laser goniopuncture in 38 eyes (35.8%). Thin vessels around TDM were found in 58 eyes (54.7%), and blood remained in 25 eyes (23.5%). Gonioscopic variables significantly positively related with postoperative IOP were as follows: presence of subscleral space, scleral flap line view, and a Schwalbe line depressed. A narrow anterior chamber angle and iris synechia in TDM had a statistically significant negative effect on the postoperative IOP control. Similarly, eyes requiring Nd:YAG goniopuncture had a worse IOP control. The frequency of eyes with visible subscleral space and transparent TDM decreases with time after surgery (p=0.001).

Conclusions

A visible subscleral space was a gonioscopic sign positively related to IOP control after surgery, although it decreased with follow-up. Eyes with goniopuncture, postoperative narrow angle, and iris synechia had worse postoperative IOP control. Although new vessels in TDM were a common finding after DS, the authors did not find any association with postoperative IOP.
Intrascleral-Fixated Intraocular Lenses for Aphakic Correction in the Absence of Capsular Support
Authors: Aznabayev R.A. , Zaidullin I.S. , Absalyamov M.S.H.
Published: January 2018

Purpose

To present results of experience with the authors' technique for intrascleral fixation of intraocular lenses for the correction of aphakia in the absence of capsular support.

Methods

Eleven patients (four children and seven adults) underwent surgery with the use of the method proposed by the authors (11 operations). The patients ranged in age from 11 to 75 years. The equatorial remnants in the lower segment of the capsular bag were revealed in 5 patients (45.5%). Absence of the capsular bag was observed in 6 patients (54.5%).

Results

During long-term follow-up evaluation, visual acuity without correction (mean 0.33±0.05) corresponded to the preoperative corrected one. Better visual acuity outcome of 0.41±0.06 was achieved with added correction. With intrascleral fixation, a mean refractive error of 1.48±0.39 D should be taken into account when calculating intraocular lens power with use of the SRK II formula.

Conclusions

The results indicate that posterior chamber intraocular lens implantation with intrascleral fixation of haptics is a safe and effective technique for aphakic correction in the absence of capsular support and the presence of its defects. The technique used in the present study offers safety and stability of the intraocular lens position.
Long-Term Outcomes of Heavy Silicone Oil Tamponade for Complicated Retinal Detachment
Authors: Berker N. , Batman C. , Ozdamar Y. , Eranđl S. , Aslan O. , Zđlelđoglu O.
Published: January 2018

Purpose

To assess the long-term success rates and complications of heavy silicone oil tamponade (Oxane HD) in the management of complicated retinal detachment with proliferative vitreoretinopathy (PVR).

Methods

Twenty-one eyes of 21 patients with complicated retinal detachment and PVR were included in this study. Vitreoretinal surgery with heavy silicone oil (Oxane HD) tamponade was performed in all patients. Heavy silicone oil was injected by perfluorocarbon liquid-air-silicone oil exchange, and was removed after 3 months. The main outcomes of the surgery including the success and complication rates were evaluated during the mean follow-up period of 11.4±0.88 months. Wilcoxon signed ranks test was used for statistical analysis of visual acuity changes. The outcomes of our study were compared with those of the previous studies.

Results

All eyes had complicated retinal detachment with PVR Grade C3 or worse. Retinal detachment was rhegmatogenous in 6 eyes, secondary to previous detachment surgery in 11 eyes, secondary to proliferative diabetic retinopathy in 3 eyes, and secondary to perforating eye injury in 1 eye. The overall anatomic success rate was 80.9% at the end of the follow-up period. The overall visual success rate was 42.8%, with no statistically significant difference from baseline (p>0.05). Postoperative complications included severe reproliferation (4 eyes), intraocular pressure rise (3 eyes), anterior dislocation of silicone oil (2 eyes), posterior subcapsular cataract formation (4 eyes), vitreous hemorrhage (1 eye), rubeosis iridis (3 eyes), optic atrophy (1 eye), and ocular pain and photophobia (21 eyes).

Conclusions

According to the results of this study, vitreoretinal surgery with temporary heavy silicone oil tamponade appears to increase the anatomic success rates with minimal complication rate in cases with complicated retinal detachment and PVR.
Incidence of Ocular Pathologies in Italian Children with down Syndrome
Authors: Fimiani F. , Iovine A. , Carelli R. , Pansini M. , Sebastio G. , Magli A.
Published: January 2018

Purpose

This study identifies the incidence of primary ocular pathologies in a population of Italian children with Down syndrome.

Methods

A total of 157 Italian children with Down syndrome, age between 1 month and 18 years, were screened between February 2005 and October 2006. The ophthalmologic evaluation included a global inspection of orbit and bulbus oculi, evaluation of ocular motility and visual acuity, slit lamp biomicroscopy, cycloplegic skiascopy, tonometry, and indirect ophthalmoscopy.

Results

The overall incidence of ocular abnormalities was epicanthal fold (132 patients, 84%), hyperopia (93 patients, 59%), astigmatism (44 patients, 28%), myopia (14 patients, 9%), strabismus (56 patients, 36%, 45 cases of esotropia and 11 cases of exotropia), congenital nasolacrimal duct obstruction (35 patients, 22%), cataract (18 patients, 11%), nystagmus (9 patients, 6%), blepharitis and conjunctivitis (6 patients, 4%), and retinal anomalies (10 patients, 6%). Unlike previous reports in patients with Down syndrome, no congenital glaucoma, keratoconus, or Brushfield spots were observed.

Conclusions

Compared to other studies in patients with Down syndrome, we observed a higher incidence of hyperopia and a lower incidence of myopia. The incidence of nystagmus, blepharitis, and conjunctivitis was less than that reported in other studies, while strabismus, especially exotropia (20%), had a high incidence in our cohort. We also frequently observed obstruction of the nasolacrimal duct (22%), but no keratoconus or glaucoma.
25-Gauge Peripheral Iridectomy during Vitrectomy
Authors: Shimada H. , Nakashizuka H. , Hattori T. , Mori R. , Mizutani Y. , Yuzawa M.
Published: January 2018

Purpose

To report peripheral iridectomy using a 25-gauge vitreous cutter in a 42-year-old man with pupillary block due to adhesion of the internal iris surface to the continuous circular capsulorhexis.

Methods

A corneal opening was made at 10 o'clock during vitrectomy. A 25-gauge vitreous cutter was inserted into the anterior chamber with the port facing downward, and peripheral iridectomy at the 12 o'clock position was performed. The vitreous cutter was set at a cutting speed of 2500 cpm and the aspiration pressure at 600 mmHg.

Results

A 25-gauge vitreous cutter with a fine shaft could easily be inserted into the peripheral anterior chamber, and there was no contact with the corneal endothelium even when the anterior chamber became shallow in association with iridectomy. In this patient, pupillary block resolved with peripheral iridectomy, and ocular pressure was also controlled.

Conclusions

25-Gauge peripheral iridectomy is a simple technique that permits iridectomy of appropriate size at any desirable location.
Presumed Infective Meningoencephalitis Complicated by Bilateral Optic Neuritis
Authors: Gore D.M. , Hildebrand G.D. , Sekhri R. , Nicolaides P. , Leitch J.
Published: January 2018

Purpose

To report a case of presumed infective meningoencephalitis complicated by bilateral optic neuritis.

Methods

Interventional case report.

Results

A 7-year-old Pakistani girl presented with fever and multiple right-sided focal seizures. Despite empirical treatment with antibiotic, anti-viral and anti-tuberculous therapy for presumed infective meningoencephalitis, she further deteriorated, developing altered consciousness, hemiplegia and severe, bilateral optic neuritis. No infectious agent could be identified. Following the addition of high dose systemic corticosteroid therapy, her optic nerve function in both eyes began to recover. At 3-month follow-up, the hemiplegia had completely resolved, and visual acuity was 6/6 bilaterally with normal pupillary responses.

Conclusions

This case demonstrates that meningoencephalitis of presumed infective origin may be complicated by acute, severe, bilateral optic neuritis, the latter often mediating profound visual loss. In the setting of rapidly deteriorating vision, aggressive corticosteroid treatment, with antimicrobial cover, albeit unproven, remains the mainstay of treatment.
Demographic and Clinical Factors associated with Brimonidine-Induced Ocular Allergy
Authors: Manni G.
Published: January 2018

Purpose.

Ocular allergy induced by brimonidine tartrate 0.2% is a common adverse event that is associated with poor compliance and therefore treatment failure. The authors investigated the demographic and clinical characteristics associated with development of this allergy.

Methods.

In total, 133 patients with ocular hypertension or open angle glaucoma and treated with brimonidine tartrate 0.2% were retrospectively divided into two groups: allergic and nonallergic to brimonidine tartrate 0.2%. Demographic, local, and systemic ocular variables were compared in the two groups.

Results.

Altogether, 13.5% of patients (18 of 133) developed brimonidine ocular allergy, generally within 2 weeks of beginning treatment (mean time 14.8±17.9 days). Compared with the nonallergic group, the allergic group was significantly more likely to have a history of ocular allergy to eyedrops (p=0.048) and to topical beta blockers (p=0.019). Moreover, the allergic group showed decreased tear film production (p=0.044).

Conclusions.

Patients with a history of eyedrop allergy or with reduced tear film production are more likely to develop brimonidine-associated allergy. Brimonidine may therefore not be suitable for patients with a history of allergy.
In Vivo Confocal Microscopy of Corneal Grafts Shortly after Penetrating Keratoplasty
Authors: Szaflik J.P. , Kamińska A. , Udziela M. , Szaflik J.
Published: January 2018

Purpose

To describe the microstructural status of corneal grafts shortly after penetrating keratoplasty (PK) and to evaluate the efficacy and safety of confocal microscopy in examining corneal grafts at that time.

Methods

A confocal microscope with a 40x front lens was used to examine corneal grafts in 32 patients (32 eyes) 4 days after PK. Images were analyzed, and endothelial cell density counts were compared with presurgical, eye bank values determined by specular microscopy.

Results

Microstructural alterations of the graft included epithelial and stromal edema, epithelial degeneration in both superficial and basal cell layers, dark stromal striae, activated keratocytes, and needle-like structures in the stroma. Descemet membrane folds were visible in 31 of 32 grafts; in 1 graft, the dense stromal edema did not allow imaging of posterior layers. Stromal nerve fibers were imaged in 28 grafts (88%). Endothelial cell density ranged from 1666 to 2548 cells/mm2 (mean±SD, 2125±283 cells/mm2); perioperative endothelial cell density loss varied from 0% to 29% (mean, 12%). No adverse reactions or signs of worsening of clinical condition were observed after the examination.

Conclusions

White light scanning slit confocal microscopy permits imaging of a graft's microstructure (including epithelium and stromal layers), as well as calculation of endothelium cell density, as soon as 4 days after PK. The most frequently observed morphologic alterations of corneal grafts shortly after PK include epithelial and stromal edema, epithelial degeneration, stromal striae, and Descemet membrane folds. Stromal nerves can still be seen in the graft 4 days after PK.
Assessment of the Contribution of Insulin-like Growth Factor I Receptor 3174 G→A Polymorphism to the Progression of Advanced Retinopathy of Prematurity
Authors: Shastry B.S.
Published: January 2018

Purpose

Retinopathy of prematurity (ROP) is a leading cause of blindness in children with short gestational age and low birthweight. The condition can cause abnormal vessel development that can lead to retinal detachment and blindness. It has been recently reported that a low level of insulin-like growth factor I (IGF-I) is associated with ROP. However, the most prevalent polymorphism of IGF-I receptor (IGF-IR 3174 G→A) that was reported to be producing low level of IGF-I was not found to be associated with ROP in a certain population. In order to reproduce this data in a different cohort and to learn more about the contribution of IGF-IR polymorphism to ROP, the authors hypothesized that it is possible that such a polymorphism would occur more frequently in a different cohort of infants with advanced ROP than those children with mild or no disease.

Methods

For genetic analysis, eligible patients were selected consecutively by experienced pediatric ophthalmologists and leukocyte DNA from affected (n=52) and normal patients (n=33) were amplified by polymerase chain reaction. The amplified products were subjected to restriction enzyme digestion with 10 units of MnlI enzyme. The digested products were analyzed by polyacrylamide gel electrophoresis followed by ethidium bromide staining to visualize the restriction fragment length polymorphism.

Results

The analysis suggests that there is no statistically significant difference in allelic frequency of the most prevalent IGF-IR gene polymorphism between normal subjects and patients with ROP in this cohort. The G→A polymorphism did not occur more frequently in patients with ROP.

Conclusions

The results do not support the association of the most prevalent IGF-IR gene polymorphism and the risk of advanced ROP in a different cohort, confirming the earlier report.
Retinal Angiomatous Proliferation Reactivation 6 Months after High-Dose Intravitreal Acetonide Triamcinolone and Photodynamic Therapy
Authors: Reche-Frutos J. , Calvo-Gonzalez C. , Donate-Lopez J. , Garcia-Feijoo J. , Saenz-Frances F. , Fernandez-Perez C. , Garcia-Sanchez J.
Published: January 2018

Purpose

To describe the incidence of retinal angiomatous proliferation (RAP) reactivation after combined treatment with a high-dose intravitreal triamcinolone acetonide (IVTA) and photodynamic therapy (PDT) at 1-year follow-up.

Methods

All patients had undergone a full ophthalmic examination. High-dose IVTA (20 mg) was injected via pars plana. Four to 7 days later, PDT was delivered.

Results

Fourteen eyes of 13 patients were included. Eight lesions (57%) reopened and needed retreatment with combined therapy at 6 months follow-up. At 1-year follow up, the lesion was obliterated in nine cases (64.2%) and best-corrected visual acuity improved from 0.87 logMar (range, 0.7–1) to 0.79 logMar (range, 0.5–1).

Conclusions

Combined therapy using high-dose IVTA and PDT is beneficial in stabilizing RAP. However, a high incidence of RAP reactivation has been observed at 6 months, even with a high-dose IVTA injection.
Intravitreal Bevacizumab for Adult-Onset Vitelliform Dystrophy: A Case Report
Authors: Montero J.A. , Ruiz-Moreno J.M. , De La Vega C.
Published: January 2018

Purpose

Adult-onset foveomacular vitelliform dystrophy (AFVD) is often misdiagnosed as occult choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). The authors report the anatomic and functional outcome of intravitreal bevacizumab in a case of AFVD associated with a suspected occult CNV.

Methods

Prospective, interventional, single case report. One female patient with decreased visual acuity (VA) and metamorphopsia secondary to AFVD received one single intravitreal injection of bevacizumab 1.25 mg.

Results

The patient reported unchanged VA and decreased metamorphopsia 6 weeks after the injection. Fluorescein angiography (FA) and optical coherence tomography (OCT) showed progressive decrease of subretinal fluid until complete disappearance. VA, OCT, and FA remained unchanged during 10 months follow-up.

Conclusions

Intravitreal bevacizumab showed a morphologic improvement and stable VA in a patient with AFVD. Further case series are required to confirm this observation.
Intravitreal Ranibizumab in a Patient with Choroidal Neovascularization Secondary to Multiple Evanescent White Dot Syndrome
Authors: Rouvas A.A. , Ladas I.D. , Papakostas T.D. , Moschos M.M. , Vergados I.
Published: January 2018

Purpose

To report the effect of a single intravitreal injection of ranibizumab in a patient with choroidal neovascularization (CNV) secondary to multiple evanescent white dot syndrome (MEWDS).

Methods

A 65-year-old woman with visual acuity (VA) 20/40, mild vitreous inflammation, optic disc edema, and white deep retinal round lesions in the right eye underwent fluorescein angiography, indocyanine green angiography, and optical coherence tomography. The diagnosis of MEWDS with peripapillary CNV was made and a single injection of ranibizumab (0.5 mg) was administered.

Results

At the 6-month follow-up visit, the VA in the right eye was 20/20, the CNV completely regressed, and the MEWDS findings disappeared.

Conclusions

Intravitreal ranibizumab appears to be a safe and effective treatment option in cases of CNV secondary to MEWDS, resulting in fast resolution of the macular edema and regression of the CNV. On the other hand, it is unclear whether the administration of ranibizumab contributed to a prompt regression of MEWDS.
Correlates of Vitamin a Deficiency among Indian Rural Preschool-Age Children
Authors: Pal R. , Sagar V.
Published: January 2018

Purpose

In India, 52,000 children go blind every year on account of vitamin A deficiency. The purpose of the study was determine the correlates of vitamin A deficiency among 4,205 preschool-age children.

Methods

Case-control study in Bihta Primary Health Center area, Bihar, India. Main outcome measures were dietary habits, maternal literacy, and birth order.

Results

Vitamin A deficiency was found to be significantly higher (p<0.01) in children on a vegetarian diet (7.14%) (OR 5.32). Children born to a literate mother had a prevalence of only 1.35% in relation to a corresponding value of 4.11% in children born to illiterate mothers (p<0.01) (OR 3.15). Birth order of preschool-age children was significantly related to vitamin A deficiency. In birth order less than or equal to three, the prevalence was 2.81%, in comparison to those with birth order four or more, in whom the magnitude was significantly higher (p<0.01) at 5.61% (OR 2.08).
Refractive Errors and Binocular Dysfunctions in a Population of University Students
Authors: Risovic D.J. , Misailovic K.R. , Eric-Marinkovic J.M. , Kosanovic-Jakovic N.G. , Milenkovic S.M. , Petrovic L.Z.
Published: January 2018

Purpose

This clinical study was performed to determine the presence of refractive errors and binocular dysfunctions in a population of university students.

Methods

Refraction and binocular function were evaluated in a young patient population (230 students and 234 nonstudent subjects, aged 18–27 years). Distance visual acuity (DVA) and near visual acuity (NVA), refraction, cover test (CT), ocular motility, near-point of convergence, horizontal phoria measurement by Maddox wing, negative and positive vergence amplitude in prism diopters, fusion amplitude in synoptophore, as well as stereoacuity (Titmus test) were tested.

Results

Emmetropia was the most frequent refractive status in our student and nonstudent groups (78.7%). Myopia was the most frequent refractive disorder in the whole population (13.1%). Myopia and hypermetropia were significantly more frequent in the students than in nonstudents (X2emp 47.55). Exophoria is significantly more frequent in myopic subjects. Vergence amplitude (t test 0.000) and fusion amplitude (t test 0.005) show significantly lower values in student population. Results of Titmus test in the student group is significantly worse than in the nonstudent group (t test 0.000). Maddox wing resulted in significantly higher degree of heterophoria in the student population (t test 0.000). Myopic subjects, in the student group (t test 0.002) as well as in the nonstudent group (t test 0.001), show significantly better results in Titmus test.

Conclusions

High near visual demand could be the most important factor for higher incidence of myopia, worse convergence and fusion amplitude, higher degree of exophoria, and worse results in Titmus test in the student population.
Tear Concentrations of Azithromycin following Topical Administration of a Single Dose of Azithromycin 0.5%, 1.0%, and 1.5% Eyedrops (T1225) in Healthy Volunteers
Authors: Chiambaretta F. , Garraffo R. , Elena P.P. , Pouliquen P. , Delval L. , Rigal D. , Dubray C. , Goldschmidt P. , Tabbara K. , Cochereau I.
Published: January 2018

Purpose

To evaluate azithromycin tear concentrations after one drop of T1225 0.5%, 1.0%, and 1.5% eyedrops.

Methods

In this randomized, double-masked study, 91 healthy volunteers received one drop into each eye of T1225 0.5% (n=23), T1225 1.0% (n=38), or T1225 1.5% (n=38). Azithromycin tear concentrations were measured by HPLC-MS at seven time points for 24 hours. Tolerability was evaluated.

Results

T1225 1.0% and 1.5% had similar pharmacokinetic profiles. After a post-instillation peak (167 to 178 mg/L after 10 minutes), mean concentrations remained above 7 mg/L for 24 hours (except for T1225 1% at H24). A delayed increase of the azithromycin mean tear concentration might be explained by the known late azithromycin release from tissues after storage in cells. Areas under inhibitory curve (AUICs) of T1225 1.0% and 1.5% were higher than AUICs of T1225 0.5% and ranged between 47 and 90. The three T1225 concentrations were safe for the ocular surface.

Conclusions

Once daily instillation of T1225 1.0% and 1.5% was shown to reach an AUIC markedly above the required threshold for an antibacterial activity against Gram-positive bacteria (25–35). These results suggest that a BID instillation is more likely to ensure antimicrobial activity against Gram-negative bacteria (threshold >100).
Relationship between Central Corneal Thickness and Parameters of Optic Nerve Head Topography in Healthy Subjects
Authors: Cankaya A.B. , Elgin U. , Batman A. , Acaroglu G.
Published: January 2018

Purpose

To investigate the relationship between central corneal thickness (CCT) and topographic parameters of optic nerve head (ONH) in healthy eyes.

Methods

Right eyes of 208 healthy subjects between 40 and 59 years of age with refractive error less than 1 D were enrolled in this cross-sectional study. Ultrasonic pachymeter was used to measure CCT, and the ONH parameters were obtained by using confocal scanning laser ophthalmoscope. Relationship of various topographic parameters to age and sex were also investigated. For statistical analysis Student t test, analysis of variance, Pearson and Spearman test, and partial correlation coefficients were used.

Results

Mean CCT of subjects was 540.71±35.53 μm (462–621 μm), and the mean disc area was 2.37±0.44 mm2 (1.28–3.66 mm2). CCT showed negative correlations to disc area, rim area, rim volume, and retinal nerve fiber layer (RNFL) area. These correlations were found to be stronger in females. Negative correlations were demonstrated between age and the mean cup depth, maximum cup depth, RNFL thickness, and RNFL cross sectional area. Women had lesser rim volumes, but bigger cup to disk (C/D) area and linear C/D ratios compared to those of men.

Conclusions

In addition to its effect in the accuracy of intraocular pressure measurements, CCT has a structural relationship with the ONH in healthy nonglaucomatous eyes. Therefore, its effect on disc area might be especially important to explain the structural strength of the ONH in the pathogenesis of glaucoma.
Evaluation of the Acoustic Function in Pseudoexfoliation Syndrome and Exfoliation Glaucoma: Audiometric and Tympanometric Findings
Authors: Detorakis E.T. , Chrysochoou F. , Paliobei V. , Konstas A.G. , Daniilidis V. , Balatsouras D. , Kefalidis G. , Kozobolis V.P.
Published: January 2018

Purpose

Previous studies have reported increased audiometric thresholds in patients with pseudoexfoliation syndrome (XFS), compared with normative data. This study examines mean audiometric thresholds and tympanometric peak values in patients with XFS and in a control group.

Methods

This is a prospective, nonrandomized control case study. Patients with XFS in one or both eyes constituted the study group (SG). Patients without XFS in either eye constituted the control group (CG). Patients with a history of conditions affecting hearing function were excluded. The SG and the CG included 54 and 48 patients, respectively. Pure tone hearing thresholds levels were measured at 0.25, 1, 2, 3, and 8 kHz. Tympanometric peak values were also recorded. Differences in audiometric mean threshold values and tympanometric peak values between SG and CG, as well as between glaucomatous and nonglaucomatous eyes, were examined.

Results

Bone and air audiometric thresholds were significantly increased in SG for 3 kHz and 8 kHz but not for 0.25 kHz, 1 kHz, and 2 kHz. Tympanometric peak values were significantly lower in SG compared with CG. In SG, glaucomatous patients had significantly higher air-conduction thresholds for 3 kHz and 8 kHz. Differences in bone and air audiometric findings as well as tympanometric findings between glaucomatous and nonglaucomatous patients were statistically not significant in CG.

Conclusions

The results agree with previous reports on sensorineural hearing loss in XFS. The reduced tympanometric peak values in SG imply impairment in the elastic properties of the middle ear in XFS. The findings provide additional evidence for the systemic nature of XFS.
Intraocular Pressure Changes after Clear Corneal Phacoemulsification in Nonglaucomatous Pseudoexfoliation Syndrome
Authors: Cimetta D.J. , Cimetta A.C.
Published: January 2018

Purpose

To present a prospective, nonrandomized study of intraocular pressure (IOP) after clear corneal phacoemulsification in eyes with pseudoexfoliation (PEX) syndrome.

Methods

A PEX group of 39 consecutive open angle, nonglaucomatous eyes with cataract in PEX syndrome, and a control group of 40 consecutive open angle, nonglaucomatous eyes with cataract, were operated on by the same surgeon (D.J.C.), using a standard phaco technique along with bimanual anterior epithelial cells aspiration and, in the PEX group, a bimanual anterior capsule PEX material aspiration. The mean diurnal Goldmann tonometer IOP was calculated preoperatively, after 3 and 6 months and 1 year.

Results

The PEX group preoperative mean IOP was 18.3 mmHg, with a maximum of 24 and a minimum of 11 mmHg. Three months postoperatively a mean IOP change of −3.7 mmHg was found (p<0.0001), with a maximum IOP change of −10 mmHg. Six months and 1 year postoperatively the mean IOP change was −3.7 (p<0.0001) and −3.5 mmHg (p<0.0001), respectively. The control group preoperative mean IOP was 13.9 mmHg, with a maximum of 18 and a minimum of 10 mmHg. Three months postoperatively a mean IOP change of −0.9 mmHg was found (p=0.028), with a maximum IOP change of −3 mmHg. Six months and 1 year postoperatively the mean IOP change was −1.4 (p<0.001) and −0.48 mmHg (p=0.11), respectively.

Conclusions

Phacoemulsification with anterior capsule PEX material aspiration significantly reduced the mean diurnal IOP in the PEX group lasting 1 year postoperatively.
Retinal Concentration and Protective Effect against Retinal Ischemia of Nilvadipine in Rats
Authors: Uemura A. , Mizota A.
Published: January 2018

Purpose

Several calcium entry blockers have neuroprotective effects on cellular damage in the brain induced by ischemia. The purpose of this study was to determine whether nilvadipine (NID) crosses the blood–retinal barrier, and if so, whether it can then protect the photoreceptors against retinal ischemia-reperfusion injury.

Methods

Rats received an intramuscular injection of 1 mg/kg of NID and nifedipine (NIF), and the retinal and serum concentrations were measured. Ischemia was induced by raising the intraocular pressure for 45 minutes. Twenty-four hours after the reperfusion, the number of TUNEL positive cells and retinal ganglion cells (RGCs) were counted, and the thickness of the retina was measured.

Results

After 60 minutes, the concentration of NID, but not NIF, was higher in retina than in the serum. The number of TUNEL-positive cells was fewer and the reduction in the number of RGCs and the thickness of retina was less in the eyes that had received NID than controls.

Conclusions

The findings show that NID has high permeability to retina compared with NIF, which has less fat solubility than NID, and neuroprotective effect to retinal cells. NID might be useful for the treatment of glaucoma or other retinal diseases that have some relation to apoptosis.
Ocular Findings in Low Birthweight and Premature Babies in the First Year: Do We Need to Screen?
Authors: Cosgrave E. , Scott C. , Goble R.
Published: January 2018

Purpose

There is no standardized approach for the ophthalmic care follow-up of children screened for retinopathy of prematurity (ROP). The authors report the ocular findings at 12 months in preterm and low birthweight babies screened for ROP over a 5-year period (1998–2003).

Methods

The case notes of 211 babies were retrospectively reviewed for birth details, maternal details, presence of ROP, and findings at follow-up screening which included visual acuity, refraction at 12 months, presence of squint, and any other ocular problems.

Results

At 1 year follow-up, 16.6% of ROP positive children failed a screening visit because of squint (6.66%), refractive error (6.66%), and optic nerve abnormalities (3.33%). At 1 year follow-up, 10% of ROP negative children had failed a screening visit because of squint (3.75 %), refractive error (3.75%), and other pathology (2.5%).

Conclusions

The authors recommend screening all babies with ROP at 12 months to identify amblyogenic factors such as squint and refractive error. Parents of infants who do not develop ROP should be advised of the increased risk of visual problems in their children and to have their child examined in the preschool period.
Intravitreal Pegaptanib Sodium for Irvine-Gass Syndrome
Authors: Querques G. , Iaculli C. , Delle Noci N.
Published: January 2018

Purpose

To report the novel use of intravitreal pegaptanib sodium for the treatment of refractory cystoid macular edema (CME) following cataract extraction.

Methods

A 72-year-old man presented with decreased visual acuity in his right eye 8 months after uncomplicated phacoemulsification cataract extraction and intraocular lens implantation. His best-corrected visual acuity (BCVA) was 20/125 in the affected eye, and fundus examination revealed CME despite 6 months of oral and topical indomethacin therapy. Fluorescein angiography (FA) showed leakage in the central region with no signs of neovascularization, and optical coherence tomography (OCT) confirmed the diagnosis with thickening of the fovea. Because of his history of glaucoma, the patient chose to be treated with intravitreal pegaptanib sodium 0.3 mg.

Results

At the 1-week follow-up, BCVA was 20/25, and the FA and OCT revealed almost total resolution of the CME with no adverse sequelae. Six months postinjection, the patient's BCVA remained 20/25 with no recurrence of CME. Perimetry revealed a stable fixation within 4° with slight reduction of sensitivity.

Conclusions

Vascular endothelial growth factor inhibition with intravitreal pegaptanib sodium appears to be of benefit in the treatment of chronic refractory CME with improvement of visual acuity. Studies evaluating pegaptanib's use in this setting with long-term follow-up are warranted to confirm its efficacy and safety.
The Role of Nystagmus in Silicone Oil Emulsification after Pars Plana Vitrectomy and Silicone Oil Injection for Complex Retinal Detachment
Authors: Yilmaz T. , Güler M.
Published: January 2018

Purpose

The purpose of this study was to determine whether nystagmus has a role in silicone oil emulsification after pars plana vitrectomy and silicone oil injection for complex retinal detachment.

Methods

A retrospective review was conducted of the clinical and operative records of eight eyes with nystagmus that underwent pars plana vitrectomy and silicone oil injection for repair of retinal detachment associated with proliferative vitreoretinopathy. Three male (37.5%) and 5 female (62.5%) patients were included in this study. The mean age was 36.4 years (range, 19 to 54 years) and the mean follow-up time was 18.3 months (range, 5 to 49 months).

Results

Three eyes underwent combined lensectomy and vitrectomy. During the initial postoperative period, retinal attachment was obtained in 6 (75%) patients. Two of eight eyes required further surgery. Silicone oil emulsification occurred in all eyes to different degrees in the 1- to 3-month postoperative period. No inverse hypopyon was observed in any of patients. Three of eight eyes developed open angle glaucoma due to silicone oil emulsification before the silicone oil removal. In these patients, intraocular pressure was controlled successfully by medical therapy. Silicone oil removal was performed before the planned time because of early emulsification. After the removal of silicone oil, two of three eyes had established open angle glaucoma and medical therapy was maintained. After the removal of silicone oil, recurrent retinal detachment developed in two eyes and one of them developed phthisis bulbi.

Conclusions

Silicone oil emulsification may develop earlier than expected in patients with nystagmus who underwent pars plana vitrectomy combined with silicone oil injection.