bluuebunny/crossref_metadata_2025 huggingface dataset:
Herpetic Optic Neuritis Associated with Herpetic Keratitis
Authors: Sáenz-Francés F. , Calvo-González C. , Jiménez-Santos M. , Méndez-Hernández C. , Fernandez-Vidal A.M. , Martínez-De-La-Casa J.M. , García-Sánchez J. , García-Feijoó J.
Published: January 2018

Purpose

To report a case of herpetic optic neuritis associated with herpetic keratitis.

Methods

A 65 year old woman presented with oedema in the nasal sector of his right papilla. Blood biochemistry, a haemogram, erythrocyte sedimentation rate and C-reactive protein were all normal. The patient was diagnosed as having a non-arteritic anterior ischaemic optic neuropathy. One week later slit lamp examination showed diffuse stromal corneal oedema and a dendritic lesion in the nasal zone of the corneal epithelium.

Results

Serology for varicela-zoster virus was positive. Treatment was started with valacyclovir given orally and topical acyclovir ointment. A week later, the optic disc swelling and corneal lesions had resolved.

Conclusions

The precise mechanism through which the papilla and cornea were successively affected in our patient is unclear but the sensitive innervation of both these structures is provided by the nasal branch of the nasociliary nerve and the spread of herpes via this nerve could affect both sites.
A Comparison of the Polypropylene Plate Ahmed™ Glaucoma Valve to the Silicone Plate Ahmed™ Glaucoma Flexible Valve
Authors: Hinkle D.M. , Zurakowski D. , Ayyala R.S.
Published: January 2018

Purpose

To compare surgical outcomes following implantation of the polypropylene plate Ahmed glaucoma valve (AGV) (S-2) and the newer silicone plate AGV (FP-7) with minimum 12 months follow-up in patients with intractable glaucoma.

Methods

Retrospective chart review of 25 eyes of 22 patients who underwent FP-7 and 26 eyes of 22 patients who underwent S-2 AGV implantation by a single surgeon. Main outcome measures included surgical outcomes in terms of intraocular pressure (IOP) control, hypertensive phase, and postoperative complications.

Results

There were no significant differences in diagnoses, pre- and postoperative IOP, pre- and postoperative visual acuities at all time points, and in the number of pre- and postoperative medications between the groups. Significant IOP reductions occurred after FP-7 implantation (29.6 ± 13.1 to 12.1 ± 3.4, p < 0.001) and S-2 implantation (31.4 ± 11.7 to 16.1 ± 5.7, p < 0.001). The FP-7 group had a statistically lower IOP compared to the S-2 group at 6 (p<0.05), 9 (p<0.01), and 12 months (p<0.01). There was no significant difference in the hypertensive phase between the two groups (p=0.41).

Conclusions

FP-7 model silicone plate AGV resulted in lower IOP compared to the older S-2 polypropylene plate AGV at 1 year. This may suggest that the plate material may influence clinical outcome.
Ocular Surface Temperature in Central Retinal Vein Occlusion: Preliminary Data
Authors: Sodi A. , Giambene B. , Falaschi G. , Caputo R. , Innocenti B. , Corvi A. , Menchini U.
Published: January 2018

Purpose

To compare ocular surface temperature (OST) measures in patients with central retinal vein occlusion (CRVO) and controls.

Methods

Thirty-six patients with unilateral CRVO and 54 healthy volunteers were included in the study. OST was evaluated by infrared thermography.

Results

In CRVO eyes and in fellow, nonaffected eyes, OST values were lower than in controls (p<0.05). Ischemic CRVO eyes showed lower temperatures than nonischemic ones.

Conclusions

Infrared thermography may be helpful in the management of patients with CRVO.
Visual Recovery after Scleral Buckling for Macula-Off Retinal Detachments: An Optical Coherence Tomography Study
Authors: Cavallini G.M. , Masini C. , Volante V. , Pupino A. , Campi L. , Pelloni S.
Published: January 2018

Purpose

To assess the postoperative macular reattachment through OCT3 in eyes treated with episcleral surgery due to macula-off rhegmatogenous retinal detachment, as well as to verify if there is a statistically relevant relation between the persistence of a subfoveal detachment and poor postoperative functional recovery.

Methods

Twelve eyes of 12 patients who underwent episcleral surgery due to macula-off rhegmatogenous retinal detachment were enrolled and examined in a prospective study. Exclusion criteria were the following: traumatic retinal detachments, detachment relapses, macular holes, amblyopia, and grade B proliferative vitreoretinopathy or higher. The time period from the onset of subjective symptoms of retinal detachment to retinal surgery ranged from 3 to 7 days. All patients were evaluated in the preoperative and the postoperative period (after 1, 3, and 6 months) through measurement of visual acuity by ETDRS charts, fundus photographs, and macular tomography with OCT3. The postoperative tomography outcomes and the visual acuity were statistically examined using the Mann-Whitney U-test.

Results

One month after surgery, despite the macular reattachment assessable ophthalmoscopically and through fundus photographs, the OCT examination showed macular subretinal fluid persistence in 66.6% of cases. After 3 and 6 months, the persistence of such foveal detachment was respectively observed in 41.6% and in 33.3% of cases. Moreover, the macular subretinal fluid persistence in the postoperative period showed a statistically significant relation with poor functional recovery.

Conclusions

Delayed or incomplete visual recovery after episcleral surgery for macula-off retinal detachment may be related to macular subretinal fluid persistence, assessable with tomography and not visible ophthalmoscopically.
The Effect of Levodopa and Dopamine Agonists on Optic Nerve Head in Parkinson Disease
Authors: Yavas G.F. , Yilmaz Ö. , Küsbeci T. , Öztürk F.
Published: January 2018

Purpose

To evaluate the effects of levodopa and dopamine agonists on retinal nerve fiber layer using scanning laser ophthalmoscope.

Methods

Forty-four patients with the diagnosis of Parkinson disease and receiving levodopa or dopamine agonist monotherapy were included in this prospective study. The control group consisted of 21 normal cases. The optic nerve head images were taken with Heidelberg Retina Tomograph; rim area, rim volume, mean retinal nerve fiber layer thickness, and the results of Moorfields regression analysis were calculated. The measurement results were evaluated with Kruskal Wallis test and Mann-Whitney U-test.

Results

There was no significant difference in mean age among groups (p=0.093). Retinal nerve fiber layer was measured to be significantly decreased in cases with Parkinson disease (p=0.004) while rim area and rim volume did not show a significant change (p=0.224, p=0.804 respectively). Rim area, rim volume, and retinal nerve fiber layer were significantly greater in the group treated with levodopa while it was the thinnest in the group receiving dopamine agonists.

Conclusions

Levodopa can have a protective affect to retinal nerve fiber layer in Parkinson disease compared to dopamine agonists.
Does Compliance with Amblyopia Management Improve following Supervised Occlusion Treatment?
Authors: El-Ghrably I.A. , Longville D. , Gnanaraj L.
Published: January 2018

Purpose

To demonstrate improvement in compliance following supervised occlusion therapy for amblyopia in children who had failed to respond to outpatient treatment.

Methods

Retrospective review of the visual outcome of 30 children who were admitted to an ophthalmology ward for 1-day intensive supervised occlusion. These children had documented poor compliance and previously failed to respond to the outpatient occlusion treatment. During their stay a trained ophthalmology nurse educated parents regarding amblyopia and the benefits of occlusion therapy. Visual acuity (VA) of the amblyopic and fellow eyes was recorded on admission, discharge, and at each subsequent visit. The compliance was recorded from parent's history and also indirectly by noticing improvement in vision.

Results

The mean supervised occlusion was 7.4 hours (range 4–12 hours). The compliance with occlusion therapy improved in 23 children (77%) after discharge. The mean duration of occlusion after discharge improved to 4 hours (range 1–12 hours). The mean follow-up was 18 months (range 4–24 months). Though there was no dramatic improvement in VA at discharge there was a statistically significant improvement in VA between admission and last recorded VA (p<0.0001). Of the 23 children who were compliant with occlusion following discharge, 21 (91%) gained at least one line of acuity in their amblyopic eye on the last assessment of their VA and five of them achieved 6/12. Of the seven children who did not comply with occlusion following discharge, only one patient gained one line improvement in his amblyopic eye.

Conclusions

This study shows that supervised occlusion treatment and parental education was effective in children who had initially failed traditional outpatient treatment.
Asymmetric Distribution of Visual Evoked Potentials in Patients with Migraine with Aura during the Interictal Phase
Authors: Coppola G. , Parisi V. , Fiermonte G. , Restuccia R. , Pierelli F.
Published: January 2018

Purpose

One of the most commonly described electrocortical phenomena in patients with migraine is an increased interhemispheric asymmetry, in response to different sensory stimuli. This study aims to evaluate the bioelectrical activity of both occipital cortices in patients with migraine with visual aura (MA) during the interictal period, and its possible relationship with visual symptoms.

Methods

The authors recorded visual evoked potentials (VEPs) simultaneously from the left (O1) and right (O2) occipital cortices (80% contrast 60′, 30′, 15′, and 7.5' checkerboard stimuli reversed at 2 Hz) in 22 patients with MA and 20 control subjects. The main outcome measure was interhemispheric asymmetry (IA) for both implicit time and amplitude, defined as the difference between the left and right scalp derivation (in absolute values).

Results

IA was significantly different in patients with MA with respect to controls when employing 60′ (p<0.001) and 15′ (p<0.05) checkerboard stimuli for implicit times, and 60′ (p<0.05) checkerboard stimuli for amplitudes. On the other hand, IA was not statistically different (p>0.05) in patients with MA with respect to controls when employing 30' and 7.5' checkerboards for both implicit times and amplitudes, and 15' checkerboards for amplitudes. No correlations were found between IA and age, onset of disease, attack frequency, or side of headache/aura.

Conclusions

Patients with MA presented asymmetries in VEP responses not related to visual aura or to headache side during the pain-free phase. These abnormalities may be ascribed to abnormal visual information processing, resulting in a different cortical activation when both foveal and parafoveal stimuli are used.
Rituximab Effectively Reverses Papilledema Associated with Cerebral Venous Sinus Thrombosis in Antiphospholipid Antibody Syndrome
Authors: Chalam K.V. , Gupta S.K. , Agarwal S.
Published: January 2018

Purpose

A case of bilateral papilledema secondary to cerebral venous sinus thrombosis treated with Rituximab, an anti-CD20 monoclonal antibody.

Methods

A 23 year old obese female with a one week history of blurred vision, headaches and vomiting presented with bilateral papilledema. Her BCVA was 20/50 in right eye and 20/200 in the left eye with severe reduction of visual fields. Laboratory investigations revealed thrombocytopenia, prolonged prothrombin time (not reversed when mixed with normal plasma) and anticardiolipin antibodies. Besides, cerebral angiogram showed presence of cerebral venous thrombosis. The patient was diagnosed to have anti phospholipid antibody syndrome and treated with rituximab I.V. 375 mg/m 2 weekly x 4 doses, acetazolamide 500 mg BID, methyl prednisolone I. V. QID x 4.

Results

At 1-month, her headaches and vision improved to 20/30 in both eyes with partial resolution of papilledema and complete restoration of visual fields. Nine months later, patient had 20/25 vision in right eye and 20/30 in left eye with complete resolution of papilledema and cerebral sinus thrombosis.

Conclusions

Rituximab was effective in reversing papilledema and cerebral sinus thrombosis, while preserving the vision in patient with antiphospholipid antibody syndrome. It is efficacious in treating papilledema in patients refractory to treatment with systemic steroids and immunoglobulin, with better clinical compliance and no side effects.
Combination Products Today: An Update on a New Fixed Combination
Authors: Bossowska I.
Published: January 2018

Combigan® is a fixed combination made up of brimonidine tartrate (0.2%) and timolol (0.5%, as maleate), two commonly used intraocular pressure (IOP)-lowering agents with complementary mechanisms of action. This paper describes Combigan safety and efficacy studies undertaken for US and European regulatory approval. The studies show that Combigan produces no unexpected adverse effects and that the fixed combination has non-inferiority to the unfixed combination of the same two agents. Phase III trials in the United States and Europe have demonstrated that Combigan lowers IOP more effectively than either of the two agents alone. Allergic conjunctivitis seems to occur less frequently (half the incidence) with Combigan than with brimonidine (Alphagan®) alone. Overall, Combigan shows similar efficacy and safety to concomitant brimonidine and timolol, and superior efficacy to either agent alone, with a favorable benefit-to-risk ratio.
Ocular Surface Assessment of Glaucoma Drug Tolerance
Authors: Baudouin C.
Published: January 2018

Glaucoma topical treatments may cause mild to very severe damage to the ocular surface. Treatments induce both allergic and nonallergic inflammation, and the complex interaction between the two mechanisms varies according to the number of eyedrops used. Their toxicity is mainly associated with the preservatives used in the preparations, rather than the drugs themselves. The lower the exposure of an eye to preservatives, the less the inflammation at the ocular surface. Fixed combinations contain less preservative than the two component agents used separately, and are less likely to induce an inflammatory reaction. In addition, timolol seems to confer a protective effect against the toxicity of the preservative benzalkonium chloride.
Clinical Features, Complications, and Incidence of Intraoperative Floppy Iris Syndrome in Patients Taking Tamsulosin
Authors: Takmaz T. , Can İ.
Published: January 2018

Purpose

To evaluate the intraoperative findings, complication rates, effect of intracameral adrenaline, and incidence of intraoperative floppy iris syndrome (IFIS) in patients using tamsulosin.

Methods

In this prospective nonrandomized observational study, 858 eyes of 774 patients who had phacoemulsification between August 2005 and November 2006 were evaluated. Duration and preoperatively discontinuing time of tamsulosin intake were questioned. Preoperative pupil size, intraoperative iris behavior, progressive miosis, adrenalin usage, and complications were recorded.

Results

The incidence of IFIS was 1.6% and IFIS was seen in 14 of the 18 eyes of patients using tamsulosin (77.8%). One eye had floppy iris only, 2 eyes had floppy iris and intraoperative miosis, 3 eyes had floppy iris and iris prolapse, and 8 eyes had all three signs of IFIS. IFIS was seen in 7 of the 10 eyes where intracameral adrenaline was used, and in 7 of the 8 eyes without adrenaline (p=0.588). Intraoperative miosis was seen only in 3 of the 10 eyes with adrenaline and in 7 of the 8 eyes without adrenaline (p=0.025). Posterior capsule rupture occurred in 1 of the eyes with IFIS and in 5 eyes focal iris stromal atrophy caused by prolapse was seen.

Conclusions

IFIS occurred in 1.6% of cases having phacoemulsification. Intracameral adrenaline usage did not change the IFIS occurrence rate, but it seemed to be effective in preventing intraoperative miosis. There are still many questions about IFIS, and there is need for future studies strengthening the understanding of IFIS.
Pre- and Postoperative C-Reactive Protein Levels in Patients with Cataract and Age-Related Macular Degeneration
Authors: Zaliuniene D. , Paunksnis A. , Gustiene O. , Brazdzionyte J. , Zaliunas R.
Published: January 2018

Purpose

To assess whether patients with early or intermediate forms of age-related macular degeneration (AMD) benefit from cataract surgery in terms of visual acuity and contrast sensitivity, and to determine the levels of high sensitivity C-reactive protein (hsCRP) as a systemic marker of inflammation before and after cataract surgery in patients with AMD.

Methods

Three groups of patients (n=132) were studied at baseline and 8–12 weeks later: 1) a study group of patients with AMD who underwent cataract surgery (n=47), 2) a control group of patients without ocular comorbidities who underwent cataract surgery (n=36), and 3) a second control group with AMD and no surgery (n=49). Visual acuity (VA) was obtained by letter charts and expressed as decimal notations ± SD. Contrast sensitivity was measured employing a Ginsburg Box, VSCR-CST-6500. The hsCRP was measured by means of particle enhanced immunonephelometry on a BN Systems.

Results

Postoperatively in both groups of the operated patients an improvement of VA (0.23±0.17 vs 0.64±0.25 and 0.23±0.18 vs 0.83±0.17, respectively, p<0.0001) and contrast sensitivity (at different spatial frequencies, from 1.5 to 18 cycles/degree, p<0.05) was determined. At baseline, the hsCRP level in Group 1 patients was higher than the level in controls (2.67±2.36 vs 1.67±1.36, p<0.01, or 1.12±0.99 mg/L, p<0.0001, respectively). After 8–12 weeks, the hsCRB level only in Group 1 significantly increased (2.67±2.36 vs 3.74±3.54 mg/L, p<0.05), whereas in the controls it did not change.

Conclusions

Patients with AMD benefit from cataract surgery, both in terms of VA and contrast sensitivity. The level of hsCRP is significantly higher in patients with AMD and moderate cataract than in patients with one of these eye disorders. The hsCRP only increases after cataract surgery in patients with AMD.
Increased Vascular Endothelial Growth Factor Levels in Aqueous Humor and Serum of Patients with Quiescent Uveitis
Authors: Paroli M.P. , Teodori C. , D'alessandro M. , Mariani P. , Iannucci G. , Paroli M.
Published: January 2018

Purpose

Vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) are angiogenic mediators that share a significant proinflammatory activity. Both substances have been suggested to play a key role in uveitis pathogenesis. The authors analyzed VEGF and IL-8 levels in the aqueous humor and serum of patients with different types of uveitis during a quiet phase of the disease.

Methods

Thirteen patients with intermediate uveitis, uveitis associated with ankylosing spondylitis, Vogt-Koyanagi-Harada disease, Fuchs uveitis syndrome, idiopathic chronic anterior uveitis, or Behçet disease, as well as 10 normal matched subjects, were included in the study. VEGF and IL-8 concentrations were measured in aqueous humor and serum by enzyme-linked immunosorbent assay.

Results

VEGF levels were significantly higher in both the aqueous humor and serum of patients with uveitis as compared with controls. IL-8 concentrations in aqueous humor were significantly higher in patients with uveitis with extraocular manifestations than in those with eye-limited disease.

Conclusions

These findings suggest that VEGF plays a role in uveitis pathogenesis even during inactive disease and that IL-8 levels are significantly influenced by the presence of uveitis-associated extraocular changes.
Extended Silicone Oil Tamponade in Primary Vitrectomy for Complex Retinal Detachment in Proliferative Diabetic Retinopathy: A Long-Term Follow-Up Study
Authors: Shen Yun-Dun , Yang Chung-May
Published: January 2018

Purpose

To investigate long-term anatomic and functional results of extended silicone oil (SO) tamponade in primary vitrectomy for patients with proliferative diabetic retinopathy (PDR) and complex retinal detachment (RD).

Methods

From January 1999 to June 2005, clinical records of consecutive patients with PDR who underwent primary vitrectomy with extended SO tamponade for complex RD were retrospectively reviewed. Main outcome measures included anatomic outcome, functional outcome, and postoperative complications. Statistical analyses were used to determine factors affecting anatomic and functional outcomes and to evaluate the potential adverse effects on vision from long-term oil tamponade.

Results

Fifty-four eyes of 45 patients (18 male and 27 female) were included in this series. All patients underwent follow-up ≥12 months (28.2±15.1 months; range: 12 to 69 months). Anatomic success was achieved in 85.2% at the third month postoperatively and 83.3% at last follow-up. Breaks with adjacent unreleased traction was identified as the only variable associated with final anatomic success (OR=0.173, p=0.024). Best-corrected visual acuity (BCVA) improved or remained unchanged in 89% at the third month postoperatively and in 78% at last follow-up. Ambulatory vision was achieved in 41% at the third month postoperative and 44% at last follow-up. Preoperative BCVA was identified as the only variable statistically associated with final BCVA (p<0.001) (multivariate analysis). The change of BCVA from the third month to last follow-up has no correlation with follow-up duration in the 45 eyes with final anatomic success (Pearson correlation coefficient = −0.022, p=0.888). Postoperative complications included peri-silicone oil proliferation in 4 eyes, neovascular glaucoma in 4 eyes, oil migration into anterior chamber in 9 eyes, and pupillary-block induced IOP elevation in 5 eyes.

Conclusions

Prolonged SO tamponade may provide anatomic success and functional stability after primary diabetic vitrectomy. Significant complications compromising visual prognosis were uncommon with prolonged SO tamponade.
Squamous Cell Carcinoma Presenting as an Orbital Cyst with Radiologic Evidence of Perineural Invasion
Authors: Limawararut V. , Hoyama E. , Selva D. , Davis G.
Published: January 2018

Purpose

To report clinical and radiologic findings of cystic squamous cell carcinoma (SCC) of the orbit with evidence of perineural involvement.

Methods

Analysis of clinical findings and radiology with a literature review.

Results

A 66-year-old man with SCC of the forehead 8 years prior presented with paresthesias, diplopia, and proptosis. Magnetic resonance imaging showed a well-defined, cystic mass of the orbit with a single, linear structure running through its center. Lateral orbitotomy revealed a cyst adherent to adjacent periorbita containing viscous, clear, yellow substance and a nerve coursing through the center. Histopathology confirmed poorly differentiated spindle cell carcinoma with positive staining for cytokeratin markers, consistent with SCC.

Conclusions

Orbital cysts associated with altered sensation are suggestive of SCC with perineural spread, requiring prompt investigation and treatment to minimize morbidity and mortality. The involved nerve may be seen as a single, linear structure within the mass on imaging.
Retinal Pigment Epithelial Tears after Intravitreal Bevacizumab Injection for Predominantly Classic Choroidal Neovascularization
Authors: Arias L. , Caminal J.M. , Rubio M. , Pujol O. , Arruga J.
Published: January 2018

Purpose

To detect retinal pigment epithelium (RPE) tears in predominantly classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) treated with intravitreal bevacizumab injections.

Methods

Forty consecutive patients with predominantly classic CNV secondary to AMD were treated with 1.25 mg of intravitreal bevacizumab. Patients were evaluated with visual acuity (VA) measured with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography, and fluorescein angiography.

Results

Three patients developed a RPE tear after the first injection. The first patient had been treated with verteporfin therapy and VA remained unchanged. In the other two cases the CNV was naïve and VA improved since the foveal center was not involved by the tear and macular edema was reduced.

Conclusions

RPE tears can occur following intravitreal bevacizumab injections in patients with predominantly classic CNV although VA is not always affected.
Evaluation of Transforming Growth Factor and Vascular Endothelial Growth Factor Polymorphisms in Taiwan Chinese Patients with Pterygium
Authors: Bau D.-T. , Chiang C.-C. , Tsai Y.-Y. , Lee C.-C. , Tsai Y. , Lin C.-C. , Tsai C.-H. , Tsai F.-J.
Published: January 2018

Purpose

Pterygium is an invasive and highly vascularized growth, thought to arise from activated and proliferating limbal epithelial stem cells. Epidemiologic studies have found the increase of active angiogenic and epithelial growth factors in pterygia, and implicated that these molecules could be involved directly or indirectly in the pathogenesis of pterygia as causative factors. The aim of this study was to investigate the association of polymorphisms of transforming growth factor (TGF) and vascular endothelial growth factor (VEGF) with pterygium.

Methods

A total of 133 pterygium patients and 105 volunteers without pterygium were enrolled in this study. Polymerase chain reaction based restriction fragment length polymorphism analysis was used to resolve the TGF-β1–509 and VEGF-460 genotypes.

Results

There was no significant difference in the allele frequency or genotype of TGF-β1–509 or VEGF-460 between total pterygium and the control group. No interaction between TGF-β1–509 and VEGF-460 was found either.

Conclusions

These results indicate that TGF-β1–509 and VEGF-460 polymorphisms were not highly associated with the pathology of pterygium. However, it may still be worthwhile to continue to search for angiogenic gene polymorphisms in order to predict the development of pterygium.
Is the PASCAL®-Tonometer Suitable for Measuring Intraocular Pressure in Clinical Routine? Long- and Short-Term Reproducibility of Dynamic Contour Tonometry
Authors: Herdener S. , Hafizovic D. , Pache M. , Lautebach S. , Funk J.
Published: January 2018

Purpose

Dynamic contour tonometry (DCT) is a new technique to measure intraocular pressure (IOP). In several studies no correlation between IOP values and corneal thickness was shown with DCT. This is in contrast to the gold standard, Goldmann applanation tonometry (GAT). The authors evaluated the reproducibility (RP) of DCT compared to GAT, a prerequisite for its introduction into clinical routine.

Methods

IOP was measured with both DCT and GAT in 50 subjects with normal cornea. To evaluate the short-term RP, four DCT and four GAT measurements were performed at day 1 in a randomized order. Long-term RP was determined by one additional measurement per method at day 2, 5, and 8.

Results

The short-term RP was defined as the mean value of all standard deviations (SD) of the individual measurements at day 1. Short-term RP was 1.1 mmHg for GAT and 1.2 mmHg for DCT. For long-term reproducibility, mean SD was 1.2 mmHg for GAT and 1.5 mmHg for DCT. Bland-Altman revealed a good agreement of the two methods. However, mean DCT values were on average 0.8±1.1 mmHg higher than GAT values. A significant correlation was observed between GAT and CCT (r2=0.15, p=0.006), but not between DCT and CCT (r2=0.032, p=0.21).

Conclusions

Short- and long-term reproducibility of DCT is comparable to that of GAT. GAT is more affected by CCT than DCT, measuring higher IOPs in eyes with higher central corneal thickness.
Physician Attitudes regarding Prostaglandin Treatment for Glaucoma in the United States and Europe
Authors: Stewart W.C. , Stewart J.A. , Nelson L.A. , Kruft B.
Published: January 2018

Purpose

To evaluate physician use of prostaglandins (latanoprost, travoprost, and bimatoprost) in the United States (US) and Europe (EU).

Methods

One thousand multiple-choice surveys were distributed via e-mail in the US and EU.

Results

The authors received 71 responses (US 40 [8%] and EU 31 [6%]). Physicians preferred prostaglandin monotherapy (US 39 [98%] and EU 22 [71%], p=0.003), usually latanoprost (US 32 [80%] and EU 22 [71%], p=0.45). When more efficacy was required, US physicians would typically switch (23 [58%]) and EU physicians would add therapy (22 [71%], p=0.007). In both continents 45% of respondents stated bimatoprost was more efficacious.

Conclusions

US and EU physicians prefer prostaglandin monotherapy, most commonly latanoprost. Bimatoprost is often perceived as more effective, but having a higher incidence of conjunctival hyperemia.
The Importance of Cyclotorsional Changes in Refractive Surgery
Authors: Laria C. , Gamio S. , Prieto-Diaz J. , Alió J.L. , Miranda M. , Plech A.R.
Published: January 2018

Purpose

To provide evidence of the importance of a precise record of torsional alterations in all patients about to undergo refractive surgery and particularly in patients with latent strabismus that may become decompensated due to the dissociation phenomenon produced during different surgical procedures that result in fixation loss.

Methods

Using 3D-VOG video-oculography, the authors analyzed the horizontal, vertical, and torsional movements of each eye after inducing fixation loss in one and both eyes in a patient with well-compensated dissociated vertical deviation (DVD). As the dissociated techniques, the authors used occlusion according to Posner maneuver and the placing of Bagolini filters with increasing densities by means of the Bielschowsky phenomenon, both pathognomonic of DVD.

Results

The authors observed not only horizontal and vertical alterations, but also cyclotorsional alterations which may even exceed 15° depending on the resulting dissociation component.

Conclusions

In view of the obtained results, the authors consider it important to conduct a meticulous study of ocular motility in all patients about to undergo refractive surgery, especially in the case of high astigmatism to rule out possible latent strabismus that may condition cyclotorsional alterations important in refractive surgery.
Penetrating Keratoplasty in a Newborn: Case Report and Analysis of Current Surgical Trends in Italy
Authors: Ricci B. , Coppola G. , Capobianco A. , Ziccardi L.
Published: January 2018

Purpose

The aims of this study were to describe bilateral penetrating keratoplasty (PK) in a newborn and to analyze the data of PKs performed in Italy during the 5-year period 1999–2003 in children under 4 years of age.

Methods

A male newborn had PK at age 3 months and 5 months for near-blindness secondary to severe congenital corneal clouding in both eyes. The infant's explanted corneas were subjected to histochemical and ultrastructural analyses. Data regarding the number of PKs performed in Italy on 0–4-year-olds were obtained from the Web site of the Italian Ministry of Health.

Results

The postoperative courses were uncomplicated, and 42 months of follow-up data show bilateral graft transparency and substantial improvement in visual acuity despite high-grade myopia and nystagmus. At the ultrastructural level, the main alterations involved the endothelial cells and Descemet membrane. A total of 45 PKs were performed in Italy on patients 0–4 years old from 1999 through 2003; only nine involved babies under 1 year of age.

Conclusions

In babies with congenital corneal opacities, early PK can reduce severe amblyopia. However, the risk of intra- and postoperative complications in PK is high. Based on the 42-month follow-up, the anatomic and functional results achieved in the current patient are satisfactory despite the presence of nystagmus and postoperative high-grade myopia. This study shows that PKs are rarely performed, in Italy, in children aged 0–4 years, and very few are done during the first year of life.
Is There Alteration in Aortic Stiffness in Leber Hereditary Optic Neuropathy?
Authors: Nemes A. , De Coo I.F.M. , Spruijt L. , Smeets H.J.M. , Chinnery P.F. , Soliman O.I.I. , Geleijnse M.L. , Ten Cate F.J.
Published: January 2018

Purpose

Leber hereditary optic neuropathy (LHON) is recognized as the most common cause of isolated blindness in young men. The current study was designed to test whether LHON as a mitochondrial disease is associated with vascular functional alterations characterized by aortic elastic properties during echocardiography.

Methods

A total of 19 patients with typical features of LHON aged 42±13 years (10 males) were included. Their results were compared to 19 age- and gender-matched healthy controls. Aortic stiffness index was calculated from the echocardiographically derived aortic diameters and the clinical blood pressure data.

Results

In this patient population, the point mutation was present in 3460G>A position in five cases, in 11778G>A position in five cases, and in 14484T>C position in nine patients. Diastolic aortic diameter (26.0±2.5 mm vs 28.4±4.1 mm, pp<0.05) and aortic stiffness index (5.1±2.6 vs 12.0±7.9, pp<0.05) were significantly increased in LHON patients compared to controls.

Conclusions

Aortic stiffness can be increased in LHON disease, but further studies are warranted to confirm these findings in a larger LHON patient population with a more reliable method focusing on the pathophysiologic background.
Comparison of Clinical Results between Heparin Surface Modified Hydrophilic Acrylic and Hydrophobic Acrylic Intraocular Lens
Authors: Kang S. , Kim M.-J. , Park S.-H. , Joo C.-K.
Published: January 2018

Purpose

To compare the clinical results of heparin surface modified (HSM) hydrophilic acrylic intraocular lens (IOL) with those of hydrophobic acrylic IOL.

Methods

One hundred patients with cataract were randomized to receive one of acrylic foldable IOLs after phacoemulsification: HSM hydrophilic acrylic IOL (n=50) BioVue3® (BioVue, OII, Ontario, CA, USA) and hydrophobic acrylic IOL (n=50) Sensar® (AR40e, AMO, Santa Ana, CA, USA). Best-corrected visual acuity and refractive error were measured at 1 week, 2 months, 6 months and 12 months after surgery in both IOL groups. To assess posterior capsular opacification (PCO), digital retroillumination image of posterior capsule was analyzed at 12 months using POCOman software.

Results

Best-corrected visual acuity (log MAR) was 0.032±0.082 in BioVue3® group and 0.034±0.077 in Sensar® group at 12 months. There was no statistically significant difference between the two groups (p=0.554). Refractive error was −0.247±0.821 diopter in BioVue3® group and −0.264±0.808 diopter in Sensar® group at 12 months. There was no statistically significant difference of refractive error between the two groups (p=0.909). At 12 months, BioVue3® IOL group had a lower percentage area and severity of PCO than Sensar® group. However, it was not statistically significant (p=0.349, p=0.288). No Nd:YAG capsulotomy was performed in BioVue3® group while it was required in two eyes (4.0%) in Sensar® group.

Conclusions

There was no statistically significant difference of postoperative visual acuity, refractive error and degree of PCO between HSM hydrophilic acrylic IOL and hydrophobic acrylic IOL.
Primary Phacoemulsification and Aspiration Combined with 25-Gauge Single-Port Vitrectomy for Management of Acute Angle Closure
Authors: Miura S. , Ieki Y , Ogino K. , Tanaka Y
Published: January 2018

Purpose

To describe a technique using phacoemulsification and aspiration (PEA) combined with 25-gauge single-port vitrectomy as a primary treatment for acute angle closure (AAC).

Methods

Seventeen consecutive cases of AAC were treated with 1) transconjunctival limited single-port vitrectomy with a 25-gauge vitrector and 2) transcorneal PEA and cortex removal followed by implantation of foldable intraocular lenses (IOL).

Results

Intraocular pressure (IOP) control was achieved in all 17 eyes examined. Mean preoperative IOP was 51.8±13.1 mmHg, and mean IOP on postoperative day 1 was 18.3±8.5 mmHg. Additional anti-glaucoma surgery was necessary in one eye. IOL could not be implanted because of zonular dialysis in one eye. Postoperative complications were seen in three cases (one retinal hemorrhage and two papilledema).

Conclusions

The PEA procedure is efficient as a primary treatment of AAC. Single-port vitrectomy with a 25-gauge vitrector facilitated PEA and IOL implantation.
Incomplete Posterior Hyaloid Detachment after Intravitreal Pegaptanib Injection in Diabetic Macular Edema
Authors: Montero J.A. , Ruiz-Moreno J.M. , De La Vega C.
Published: January 2018

Purpose

Posterior hyaloid adherences play a role in the pathogenesis of diabetic macular edema (DME). Intravitreal antivascular endothelial growth factor (VEGF) drugs are presently being used to treat DME. The authors report one case of incomplete posterior hyaloid detachment (PHD) following intravitreal pegaptanib to treat DME. This case shows a combined mechanism of DME resolution by anti VEGF and PHD.

Methods

Prospective, interventional, single case report. One male patient with bilateral DME was treated by intravitreal pegaptanib in his right eye every 6 weeks for 6 months (five injections) and followed for 42 months.

Results

Central macular thickness decreased from 511 to 376 μm at month 4 in the treated eye and remained within 10% of this value during follow-up. The posterior hyaloid became taut and partially detached after the third injection and was almost completely detached 1 year later. Visual acuity remained unchanged in both eyes during follow-up.

Conclusions

PHD may play an important role in cases where macular thickness is successfully reduced or better acuity is achieved after intravitreal injections.
Metastatic Renal Cell Carcinoma Presenting as a Circumscribed Orbital Mass
Authors: Mudiyanselage S.Y. , Prabhakaran V.C. , Davis G.J. , Selva D.
Published: January 2018

Purpose

To report a case of renal cell carcinoma presenting as a well-circumscribed orbital tumor.

Methods

Retrospective interventional case report.

Results

A 60-year-old woman presented with proptosis of the left eye. Imaging showed a well circumscribed tumor in the region of the medial rectus muscle. Excision biopsy revealed a diagnosis of metastatic renal cell carcinoma that was confirmed on abdominal imaging.

Conclusions

Renal cell carcinoma can rarely present as a well-circumscribed orbital mass and should be included in the differential diagnosis of such lesions.
Strabismus in Developmental Cataract
Authors: Magli A. , Iovine A. , Bruzzese D. , Giani U. , Fimiani F.
Published: January 2018

Purpose

To evaluate the presence of strabismus in patients with developmental cataract rendered pseudophakic and how this influences their visual acuity.

Methods

A retrospective study was carried out on 113 patients with developmental cataract who came under the authors' observation at the outpatient department of the Pediatric Ophthalmology Unit of the University of Federico II of Naples from 1990 to 2005. All patients were followed up for a long period (mean 62 months, range 36–144 months). Age at diagnosis, sex, laterality, age at cataract extraction, morphology, and cataract density were all considered as possible factors associated with strabismus. Visual acuity and ocular motility before and after cataract extraction surgery were especially noted. Statistical evaluation was performed using t-test, Chisquare test, and Fisher exact test.

Results

Out of the 113 patients a total of 181 eyes were affected: 68 patients (60%) presented bilateral cataract, 45 patients (40%) monolateral cataract. Strabismus was present in 39 patients (34%) before cataract surgery. Age at cataract diagnosis, age at surgery, sex, and cataract morphology were not found to be statistically associated with strabismus. However, laterality was found to be statistically associated with the onset of strabismus. Cataract density was found to be statistically associated with poor vision. Patients with strabismus presented a non statistically significant lower visual acuity.

Conclusions

Strabismus has a greater incidence in developmental cataract compared to the general population, and can influence visual acuity, especially in monolateral and total cataracts. Intraocular lens implants produced satisfactory visual rehabilitation.
Loxosceles Reclusa Bite to the Eyelid
Authors: Keklikci U. , Akdeniz S. , Sakalar Y.B. , Cakmak S.S. , Unlu K.
Published: January 2018

Purpose

The authors report a case of Loxosceles reclusa infestation on the eyelid.

Methods

The specimen collected by swabbing the lesions with gauze was tested by using a venom-specific enzyme-linked immunosorbent assay Loxosceles venom was detected in specimen. The patient was managed with conservative therapy that included saline compresses and ocular lubrication.

Results

The case presented with severe edema and necrosis on the left upper eyelid. On laboratory examination, a significant left shift of white blood cell count was detected. Although residual scar of the eyelid and punctate epitheliopathy on the inferior of cornea was detected, vision was not impaired.

Conclusions

Supportive therapy may be reasonable treatment for Loxosceles reclusa infestation on the eyelids. The presence of venom proteins detected with an enzyme-linked immunosorbent assay technique is beneficial for supporting the diagnosis of Loxosceles envenomatio.
Short-Term Anatomic Effect of Ranibizumab for Polypoidal Choroidal Vasculopathy
Authors: Reche-Frutos J. , Calvo-Gonzalez C. , Donate-Lopez J. , Garcia-Feijoo J. , Leila M. , Garcia-Sanchez J.
Published: January 2018

Purpose

To assess the short-term anatomic effect of intravitreal ranibizumab for polypoidal choroidal vasculopathy.

Methods

All patients had undergone a full ophthalmic examination. A monthly injection of ranibizumab was performed for 3 months. Indocyanine angiography (ICG) and optical coherence tomography (OCT) were performed 1 month after the third-month ranibizumab injection.

Results

Polyps disappeared on ICG angiography in 9 out of 13 lesions (69.2%). Retinal thickness diminished significantly on OCT (p=0.02). In our series we noticed a significant reduction of the percentage of patients presenting with subretinal fluid (p=0.02) and pigment epithelium detachment between the initial and final visits (0.016). In addition, we noticed that BCVA increased significantly (p 0.02).

Conclusions

Monthly intravitreal injection of ranibizumab for 3 months has a short-term beneficial anatomic effect.
Amniotic Membrane Transplantation in Severe Ocular Surface Disorders
Authors: Kaup M. , Redbrake C. , Plange N. , Arend K.O. , Remky A.
Published: January 2018

Purpose

Amniotic membrane transplantation is currently being used as an alternative approach to treat severe corneal surface disorders refractory to medical therapy. The authors report complications of corneal surface disorders after successful amniotic membrane transplantation.

Methods

Case series.

Results

Twenty-eight patients with corneal surface disorders due to severe chemical burns, corneal ulceration, or persistent epithelium defects were treated with amniotic membrane transplantation. Four of these patients showed a spontaneous perforation and three patients developed a descemetocele within 6 weeks after the amniotic membrane transplantation.

Conclusions

In this case series, descemetocele and corneal perforation occurred in 25% of the patients after amniotic membrane transplantation. This might be due to the severity of the underlying disease or to the impact of amniotic membrane on corneal fibroblasts and collagenases. The risk of corneal thinning and perforation should be considered in the decision of treatment with amnion and follow-up regimen.
Comparison of Higher Order Aberrations with Spherical and Aspheric Iols Compared to Normal Phakic Eyes
Authors: Rękas M. , Krix-Jachym K. , Żelichowska B.
Published: January 2018

Purpose

To compare higher order aberrations (HOA) in AcrySof SN60AT and Acrysof IQ SN60WF intraocular lenses (IOLs) and natural crystalline lenses in an age-matched population.

Methods

Sixty-nine eyes of 55 patients were examined. Group I included AcrySof spheric lenses, group II AcrySof aspheric lenses, and group III included patients with the natural crystalline lens. The HOA data were obtained with a LADARWave aberrometer (Alcon Inc.). Analysis was based on the RMS of coma, spherical aberrations (SA), and HOA. Statistical comparisons were performed with Kruskal Wallis variance analysis.

Results

In the case of coma, there were statistically significant differences between spheric and aspheric AcrySof (p<0.005) and between spheric AcrySof and natural crystalline lenses (p<0.005). The differences between aspheric AcrySof and natural crystalline lens group were not significant (p>0.05). SA were significantly different between spheric and aspheric AcrySof group, and spheric AcrySof and natural crystalline lens group (p<0.005), as well as between aspheric AcrySof and natural crystalline lens group (p<0.05). In case of HOA no significant differences were observed between aspheric AcrySof and natural crystalline lens group (p>0.05), but differences between groups AcrySof spheric and aspheric, and spheric AcrySof and natural crystalline lens, showed high significance (p<0.005).

Conclusions

The AcrySof Natural IQ aspheric model SN60WF IOL did not change the optical quality of vision compared to a healthy population of 60–80 years of age. The AcrySof Natural model SN60AT spherical IOL resulted in higher HOAs relative to both the natural crystalline lens population and eyes after aspheric AcrySof IQ model SN60WF IOL implantation.
Macular Sensitivity in Eyes with Central Serous Chorioretinopathy
Authors: Ozdemir H. , Senturk F. , Karacorlu M. , Arf Karacorlu S. , Uysal O.
Published: January 2018

Purpose

To determine macular sensitivity and fixation characteristics in eyes with central serous chorioretinopathy (CSC) using fundus-related microperimetry.

Methods

The authors reviewed 19 eyes with serous elevation within the central 10° due to CSC and 15 normal healthy eyes that had undergone fundus-related microperimetry. The macular sensitivity was measured using the fundus-related microperimeter, MP-1. The best-corrected visual acuity (BCVA), mean retinal sensitivity in the central 10° (central microperimetry, cMP-1) and in the paracentral 10° to 20° (paracentral microperimetry, pMP-1), and fixation stability and location were determined and compared with that of control eyes.

Results

Eyes with CSC showed significantly lower logMAR BCVA (p<0.001), cMP-1, and pMP-1 sensitivity than control eyes (p<0.001, p<0.01, respectively). Eyes with CSC were not significantly different in fixation location (p=1.00) or fixation stability than control eyes (p=0.45). Fixation location was predominantly central in all eyes with CSC; fixation was stable in 17 (89%) and relatively unstable in 2 (11%).

Conclusions

Eyes with CSC showed significantly lower retinal sensitivity not only at the central but also in the paracentral area. Even with decreased BCVA and retinal sensitivity, our patients showed central and stable fixation in their affected eyes.