bluuebunny/crossref_metadata_2025 huggingface dataset:
13th Annual Conference of the UK Evaluation Society: Conference report
Authors: Markiewicz Anne
Published: January 2018

The 13th Annual Conference of the United Kingdom Evaluation Society (UKES), ‘Great Expectations? Meeting the Changing Needs of Stakeholders in Evaluation’, was held in Leeds, England on 22-23 November 2007. This article is a brief report on the conference.
Indigenous Evaluation: A Strategic Objective of the Australasian Evaluation Society
Authors: Wehipeihana Nan
Published: January 2018

In 2003, the Australasian Evaluation Society (AES) Board identified Indigenous evaluation as a strategic objective of the Society. In coming to this decision, the Board signalled that it believed it was important to consider Indigenous evaluation more fully and its potential implications for the AES, its members, and the practice of evaluation.

This article provides brief background information about the factors that gave rise to the emergence of Indigenous evaluation as a strategic objective of the AES, describes the activities and progress for the period 2004-2007, and identifies possible strategies to further progress Indigenous evaluation. It argues that greater engagement on the part of AES members is needed to progress Indigenous evaluation as a strategic objective of the Society; in particular, the need for AES members to consider what Indigenous evaluation means or might mean for the Society and why, if at all, Indigenous evaluation has a place within the AES.

The article is set in the context of my role as a past Executive member of the AES Board, with responsibility to progress Indigenous evaluation as a strategic objective of the Society. As such, it is a personal reflection of that journey to date.
A Constructive Inquiry Approach: Blending Appreciative Inquiry with Traditional Research and Evaluation Methods
Authors: Howieson Jill
Published: January 2018

Evaluating a pioneering dispute resolution program that blended a child protection safety framework with a legal alternative dispute resolution (ADR) model called for an innovative approach. The evaluation method chosen involved blending an Appreciative Inquiry, which focused on the cultural change aspect of the program, with traditional evaluation research methods that enabled assessment of system effectiveness. This mixed approach, called a Constructive Inquiry, enabled the stakeholder partners to achieve the best of many worlds. The Constructive Inquiry provided the partners with an appreciative assessment of their pioneering collaborations, an objective measurement of the effectiveness of their program, and a clearer understanding of the experiences and practice of their professional participants. In addition, this approach provided everyone involved with a richer and deeper understanding of the experience of cultural change and the future pathways that they all needed to tread to consolidate that change. In the future, Constructive Inquiry might offer a useful model for the evaluation of projects with similar parameters.
Editorial
Authors: Alderman Lyn , Clinton Janet , Harvey Graeme
Published: January 2018

For the first edition of the Evaluation Journal of Australasia for 2013, I would like to welcome Associate Professor Janet Clinton and Lyn Alderman as members of the editorial team. Both Janet and Lyn bring a depth of experience, expertise and a great deal of enthusiasm for evaluation and in the continued development of EJA. Currently, Associate Professor Janet Clinton is Director of the Centre for Program Evaluation at the University of Melbourne and Lyn Alderman is the Manager of Academic Quality and Standards at Queensland University of Technology. Lyn is also the Chair of the AES Journal and Publications Working Group.
Editorial
Authors: Alderman Lyn , Clinton Janet , Harvey Graeme
Published: January 2018

This is an exciting time for the Evaluation Journal of Australasia (EJA) as it embarks on a new phase. As we launch a new design and move to an online format, it is our hope that EJA is enhanced as a resource for evaluators and one that supports the growth of evaluation. With a new approach and a contemporary look and feel, we believe that the journal will add value to the profession and the discipline that is evaluation. By promoting research on evaluation and celebrating practice, evaluation in Australasia may flourish.
Towards Gender Equality through Equity in Community-Level Evaluation
Authors: Donnelly John
Published: January 2018

The calls by donors for gender equality to be an outcome of community development projects, locally and internationally, have been a constant for many years. While gender equality is not normally an explicit requirement of community-level evaluations, it should be. However, entrenched social and religious mores and economic systems have most often proved too difficult to change and gender equality remains a challenge.

When it comes to the evaluation of community development projects, most donors and practitioners call for participatory evaluations to ensure that real input into evaluation findings is obtained from those most affected by the development intervention. However, gender equality in evaluation is faced with the same barriers as in development—the gendered barriers to participation.

Gender equality means equal access, equal value, equal numbers and equal rights in participation in the activities. But the barriers to participation are most often the result of the gendered nature of society. These barriers include literacy, time availability, the timing of an activity, public standing and access. Common participatory practices, such as surveys, focus group discussions and positivist approaches, do not break down these barriers. While this situation is very often the case in developing countries, it is also seen as an issue in Australia's multicultural society, in particular among recent refugee groups.

This article highlights that participation, together with gender equity (as distinct from equality), in the design, implementation and monitoring of an evaluation is also a requirement for ensuring gender equality in the outputs of evaluations. The article focuses on the importance of the informants’ understanding of what is being evaluated, and minimising the impact of barriers in ensuring gender equity (that is, fairness of treatment for women and men, according to their respective needs), so that all voices are heard. Tools and approaches that bring fairness and justice to participatory evaluation can help to ensure gender equality in the findings, conclusions and resultant recommendations of communitylevel evaluations.
Letter to the editor: Use of cost–benefit analysis in evaluation
Authors: King Julian
Published: January 2018

I enjoyed reading the article on cost–benefit analysis (CBA) by Liddle, Wright & Koop in the June 2015 issue of the Evaluation Journal of Australasia. As a health economist-turned-evaluator I can vouch for the value of CBA and other economic methods (i.e. cost-effectiveness and cost-utility analysis) in evaluation. For example, understanding the relationship between the resources invested in a program and the consequences of the investment provides a deeper understanding of the program's worth, rather than examining either side of the equation (e.g. the ‘costs’ or ‘benefits’) in isolation.

I also welcome the suggestion by Liddle et al. (2015) that CBA can be used with traditional evaluation approaches, rather than as a replacement for them. However, more guidance is needed for evaluators and economists on how this should be done. To illustrate this point, a few considerations are outlined below. Firstly I will start with the strengths and limitations of CBA, then I will lead on to some considerations about when it might be appropriate to use CBA, when CBA alone might be insufficient to determine the worth of a program, and how CBA might be combined with traditional approaches.
Relevance of cross-cultural understanding for evaluations in development practice
Authors: Rhodes Deborah
Published: January 2018

In the evaluation profession, there is shared agreement that cross-cultural understanding is relevant for those working in communities and countries different from their own. This helps inform the selection of appropriate approaches, tools and processes. Perhaps more importantly, the concept of evaluation itself could be considered through a cross-cultural lens; such consideration may reveal a lack of shared understanding between different cultures. The idea of evaluation reflects values about change, development and risk; knowledge and wisdom; access to information and education; the completion of tasks; and, the maintenance of harmonious relationships. These values are not necessarily shared universally. This article draws links between understanding differences in cultural values and the practice of evaluation in international development—beyond the level of culturally appropriate method selection.

A widely used model for understanding cultural value differences is applied to the concept of evaluation and it raises questions about the idea itself. Notwithstanding this analysis, the article applies the model to practice and considers implications for those involved in commissioning and undertaking evaluations. To maximise relevance of the article for practitioners, a suggested set of skills is provided to support effective cross-cultural evaluation processes. The article brings together learning from multiple disciplines to the practice of cross-cultural evaluation. It is particularly relevant for Australian and New Zealand audiences and those working in Pacific and Asian countries, however, the issues are global. The article also raises some conceptual questions, which are relevant to cross-cultural evaluation practice.
Barrier interactions: The good, the bad and the ugly!
Authors: Loud Marlène Läubli
Published: January 2018

Dr Marlène Läubli Loud was a keynote speaker at the 2015 international Australasian Evaluation Society Conference in Melbourne, Australia. She gave an address reflecting on her own experiences and that of others in managing an internal evaluation unit—particularly noting how boundaries can be overcome to ensure that the commissioning, management and use of evaluation is instrumental. This article provides an overview of Marlène's conference address. While much of the article is grounded in the context of Switzerland, Marlène also shares insights from internal evaluation managers in a range of different settings, and applies these learnings to advance the discipline of evaluation.
‘It Ain't Necessarily so’: Eliciting Hidden Knowledge and the Role of Schemata in Data Collection1
Authors: Roberts David
Published: January 2018

A problem for evaluators and researchers is that what people ‘say’ in an interview context is often different from what they do in the everyday world, in vivo. Elicitation techniques appear to be effective at revealing ‘hidden’ data but the theories about why they do so are inadequate. This paper examines literature from cognitive science, schema and survey research to identify ideas that may help explain why elicitation techniques work and how we can improve their use. The schema concept provides a testable mechanism for how elicitation may function and the conditions under which elicitation might work. It also raises questions for evaluators about the variability of people's responses in different contexts and the influence of the interview context on the results obtained.
Expert Consensus to Examine the Cross-Cultural Utility of Substance Use and Mental Health Assessment Instruments for Use with Indigenous Clients
Authors: Stephens Anne , Bohanna India , Graham Deborah
Published: January 2018

Evaluation of minority-culture specific treatment centres for substance use and mental health is challenging. The challenge is compounded by a paucity of validated instruments for assessing substance use and mental ill health. In the field of Australian Indigenous alcohol and other drug service provision there are few guidelines to determine which instruments should be targets for validation for use with Indigenous clients. As such, reliable, validated, evaluable data on the client population is limited, posing multifaceted concerns for clinicians and service providers as well as evaluators. The aim of this study was to pilot the use of a participatory expert consensus approach to evaluate, rate and select suitable majority-culture substance use and mental health assessment instruments for use with their clients. Eight practitioners of an Indigenous-specific substance misuse residential treatment centre participated. The findings reinforce the value of consensus approaches for stakeholder engagement and to provide a sense of ownership of the results. In this setting, consensus on the implementation of an agreed set of Indigenous-specific and non-Indigenous specific instruments improved the ownership of the instruments by clinicians allowing for the use of valid and/or reliable instruments that also had good face validity. This makes it more probable that reliable client wellbeing data will be collected. This is crucial to program evaluation at a later point in time. This study was a novel approach to generating evidence to inform practice in the absence of normative practice guidelines.
Conscious Perception of Facial Asymmetry in a Unilateral Cleft Lip Model
Authors: Dobbie Allison M. , Ward Ralph C. , Oyer Samuel L. , Overton Lewis J. , Hill Elizabeth G. , Patel Krishna G.
Published: January 2018

Objective:

Lip asymmetry after a unilateral cleft lip repair can be perceived as an unsatisfactory result. The objective of this study is to determine the degree of upper lip asymmetry and/or nasal alar hooding required for recognition of asymmetry in a simulated model of unilateral cleft lip.

Design:

A model of unilateral cleft lip was created using digital morphing software to simulate asymmetries in vermilion height and nasal hooding in photographs of children. Volunteers were shown photographs for different time intervals and with varying degrees of asymmetry. Ability to detect facial asymmetry was recorded and analyzed.

Setting:

This study was conducted by surveying layperson volunteers in public community settings.

Participants:

108 layperson volunteers were randomly surveyed.

Main Outcome Measures:

The primary outcome measure was a reported lip or nose asymmetry by the volunteers. Proportions and corresponding 95% confidence intervals were obtained to estimate the probability of reporting an asymmetry at 3- and 10-second intervals.

Results:

After 3- and 10-second exposure, labial asymmetry was perceived by ≥50% of subjects at 2 mm (62%, P = .001) and 1 mm (89%, P < .0001), respectively. Nasal asymmetry was detected by <50% of subjects at 3 seconds, but ≥50% perceived a 3-mm alteration at 10 seconds (64%, P < .0001). Photographs with combined nasal and labial modification did not lower the threshold for asymmetry perception compared to either deformity alone.

Conclusions:

This study is the first to determine a predictable millimeter threshold for perceived asymmetry in cleft lip deformity using a digital model.
The Influences of Child Intelligibility and Rate on Caregiver Responses to Toddlers With and Without Cleft Palate
Authors: Frey Jennifer R. , Kaiser Ann P. , Scherer Nancy J.
Published: January 2018

Objective:

The purpose of this study was to investigate the influences of child speech intelligibility and rate on caregivers’ linguistic responses.

Design:

This study compared the language use of children with cleft palate with or without cleft lip (CP±L) and their caregivers’ responses. Descriptive analyses of children’s language and caregivers’ responses and a multilevel analysis of caregiver responsivity were conducted to determine whether there were differences in children’s productive language and caregivers’ responses to different types of child utterances.

Setting:

Play-based caregiver-child interactions were video recorded in a clinic setting.

Participants:

Thirty-eight children (19 toddlers with nonsyndromic repaired CP±L and 19 toddlers with typical language development) between 17 and 37 months old and their primary caregivers participated.

Main Outcome Measures:

Child and caregiver measures were obtained from transcribed and coded video recordings and included the rate, total number of words, and number of different words spoken by children and their caregivers, intelligibility of child utterances, and form of caregiver responses.

Results:

Findings from this study suggest caregivers are highly responsive to toddlers’ communication attempts, regardless of the intelligibility of those utterances. However, opportunities to respond were fewer for children with CP±L. Significant differences were observed in children’s intelligibility and productive language and in caregivers’ use of questions in response to unintelligible utterances of children with and without CP±L.

Conclusions:

This study provides information about differences in children with CP±L’s language use and caregivers’ responses to spoken language of toddlers with and without CP±L.
Public School Nursing Practice in the United States
Authors: Willgerodt Mayumi A. , Brock Douglas M. , Maughan Erin D.
Published: January 2018

School nursing practice has changed dramatically over the past 20 years, yet few nationally representative investigations describing the school nursing workforce have been conducted. The National School Nurse Workforce Study describes the demographic and school nursing practice patterns among self-reported public school nurses and the number and full-time equivalent (FTE) positions of all school nurses in the United States. Using a random sample stratified by public/private, region, school level, and urban/rural status from two large national data sets, we report on weighted survey responses of 1,062 public schools. Additional questions were administered to estimate the school nurse population and FTEs. Findings reported illustrate differences by strata in public school nurse demographics, practice patterns, and nursing activities and tasks. We estimate approximately 132,300 self-identified practicing public and private school nurses and 95,800 FTEs of school nurses in the United States. Research, policy, and school nursing practice implications are discussed.
Impact of dosage timing on the bioavailability of oral anticancer medications: Is pre-prandial dosing equivalent to post-prandial dosing
Authors: Yu Guo , Wu Dan-Na , Yu Yichao , Li Guo-Fu , Zhou Hong-Hao
Published: January 2018

Many oral anticancer agents are recommended to be given either at least 1 h before or 2 h after a meal, according to the prescribing information. However, the effect of dosage timing of an oral anticancer agent with reference to food intake on anticancer treatment remains unclear. As shown by the literature survey and labeling analysis for oral anticancer drugs approved by the US Food and Drug Administration from 2010 to 2016, labeling information regarding dosage timing for several anticancer drugs appeared not be optimum, leading to suboptimal bioavailability and plasma drug concentrations. This supports a call to regularly recalibrate the labeling information for dosage timing of oral anticancer medications to minimize the risks of compromised efficacy or unintended toxicities.
Resisting and Redirecting: Agentive Practices Within an African American Parent–Child Dyad During Digital Storytelling
Authors: Lewis Ellison Tisha , Wang Huan
Published: January 2018

This article examines the digital storytelling practices between an African American mother and son. We used agency as a theoretical framework to explore how the two exercised their own power to collaborate on their digital story. As digital technologies became part of their practice, challenges and tensions arose when both participants attempted to override each other’s agency, as demonstrated in their interviews. Data were collected during digital storytelling workshops conducted at a university computer lab, church, and the participants’ home. Using thematic coding, we analyzed audio-recorded interviews to determine the participants’ agency in the context of their digital storytelling activity. We found how a mother and son worked together through resisting and redirecting when creating a digital story, and how their digital storytelling practices displayed evidence of agency. Implications include how familial interactions in digital storytelling practices contribute to the ways agency is conceptualized for families, educators, and researchers.
Effect of Cytokines on Regulation of the Production of Transforming Growth Factor Beta-1 in Cultured Human Tenon's Capsule Fibroblasts
Authors: Denk P.O. , Roth-Eichhorn S. , Gressner A.M. , Knorr M.
Published: January 2018

Purpose

Transforming growth factor-β1 (TGF-β1) is thought to play a pivotal role in the regulation of the wound healing process after glaucoma filtering surgery. The aim of the present study was to investigate whether platelet-derived growth factor isoforms (PDGF-AA, PDGF-BB), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), in-terleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) modulate the production of latent and/or active TGF-β1 by cultured human Tenon's capsule fibroblasts (HTF).

Methods

Human Tenon's capsule fibroblasts were seeded at two different densities (30 cells/mm2 and 150 cells/mm2) and stimulated for five days with PDGF-AA, PDGF-BB, bFGF, EGF, IL-1β and TGF-β1. Control cells were treated with serum-free medium (WM/F12). The concentrations of latent and active TGF-β1 in the medium were determined using an immunoassay before and after activation of TGF-β1 by transient acidification.

Results

The concentration of latent TGF-β1 in conditioned media from HTF seeded at high density (150 cells/mm2) significantly increased after stimulation with 5 ng/ml TGF-β1 (151.5 ± 41.7 pg/ml) or 10 ng/ml IL-1β (45.7 ± 8.1 pg/ml). The concentration of active TGF-β1 in conditioned media also significantly increased after stimulation of HTF with 5 ng/ml TGF-β1 (48.4 ± 27.5 pg/ml).

Conclusions

The present results indicate that TGF-β1 is the most potent inducer of its own synthesis in HTF. Activation of an autocrine TGF-β1 loop may play a role in the wound healing response after glaucoma filtering surgery.
Evaluation of Retinoic Acid Ophthalmic Emulsion in Dry Eye
Authors: Selek H. , Ünlü N. , Orhan M. , Irkeç M.
Published: January 2018

Purpose

An oil in water emulsion of 0.01% all-trans-retinoic acid (tretinoin) was prepared and clinically evaluated in dry eye patients.

Methods

The ophthalmic emulsion consisted of 10% of arachis oil and 90% of the hydro-gel of Carbopol 940. To evaluate retinoic acid emulsion clinically, a placebo-controlled, open-labeled, randomized study was performed with 22 dry-eye patients. Symptoms were recorded before and after the treatments. The Schirmer 112067210001000205l test, measurement of tear film break-up time (BUT), rose Bengal and fluorescein staining of cornea and conjunctiva, and mucus fern test were done.

Results

Retinoic acid did not improve the dryness, photophobia and foreign body sensation more than placebo. Schirmer test and BUT were significantly improved by retinoic acid treatment. Corneal and conjunctival epithelium maintained their characteristics during the use of retinoic acid, as indicated by rose Bengal and fluorescein staining.

Conclusions

Ophthalmic emulsion of retinoic acid can be suggested as a promising approach for the treatment of dry eye.
Circulating Antibodies to Human and Bovine Cornea in Human Keratoplasty
Authors: Robert P.-Y. , Adenis J.-P. , Cogné M. , Drouet M.
Published: January 2018

Purpose

To compare anti-human cornea and anti-bovine cornea serum reactivity in corneal transplantation and pathology.

Methods

We investigated the presence of IgG and IgM antibodies to bovine corneal extract (BCE) and human corneal extract (HCE) by ELISA in 48 healthy adults and in 30 corneal allograft recipients before and after grafting. Baseline levels of antibodies in healthy controls served to establish a positivity threshold. Anti-HLA antibodies were investigated in all patients.

Results

Preoperatively, five and one patient were positive respectively for IgG and IgM anti-BCE; one and ten patients were positive for IgG and IgM anti-HCE. The presence or absence of antibodies was not modified after grafting, and was not associated with rejection. Anti-HCE of the IgM class were more frequent in patients with keratoconus. Two patients had anti-HLA antibodies.

Conclusions

Antibodies to non-HLA corneal antigens are detectable in corneal allograft recipients. Reactions against bovine and human substrates differ in frequency and class. This reactivity is not modified after grafting or rejection, but is increased in corneal disorders, including keratoconus.
Factors Influencing Anatomic and Visual Results in Primary Scleral Buckling
Authors: Ahmadieh H. , Entezari M. , Soheilian M. , Azarmina M. , Dehghan M.H. , Mashayekhi A. , Sajjadi H.
Published: January 2018

Purpose

To identify the factors influencing anatomical and visual results in cases of rhegmatogenous retinal detachment undergoing primary scleral buckling.

Methods

A retrospective study of 233 eyes of 226 patients was done. The data were evaluated by univariate analysis and stepwise logistic regression analysis.

Results

Retinal reattachment was achieved with primary scleral buckling in 197 eyes (84.5%). The extent of retinal detachment, preoperative proliferative vitreoretinopathy (PVR), preoperative visual acuity and relative afferent pupillary defects were identified as influencing anatomical results, by univariate analysis. The predictive roles of extent of retinal detachment (p<0.0001) and preoperative PVR (P=0.0085) were shown to be significant by stepwise logistic regression. As well as the above factors, the patient's age, the duration of symptoms and the status of the macula were predictors of visual results, by univariate analysis. Stepwise logistic regression analysis confirmed the predictive roles of preoperative visual acuity (P < 0.0001) and the extent of retinal detachment (P=0.0089).

Conclusions

Cases with a larger extent of retinal detachment, more advanced preoperative PVR and poorer preoperative visual acuity have less favorable anatomical and functional results.
Analysis of the Pterygium Size Inducing Marked Refractive Astigmatism
Authors: Oner F.H. , Kaderli B. , Durak I. , Cingil G.
Published: January 2018

Purpose

Astigmatic changes induced by the pterygium and their relation to its size and morphology were analysed to establish the critical size for surgery before significant astigmatism occurs.

Materials and Methods

We evaluated the refraction in 148 eyes of 108 adult patients with primary pterygia. We grouped the astigmatic values according to the keratometric results correlating with the maximal length, width and the approximate total area of the pterigium encroaching on the corneal surface.

Results

Pterygia with length or width ≥ 3.00 mm were related to significantly higher astigmatism than other groups (p<0.01). The effect of the pterygium morphology on corneal astigmatism was not significant.

Conclusions

Pterygia exceeding 3.00 mm of length or width should be considered within the limits of surgery.
Brucella Melitensis Dacryoadenitis: A Case Report
Authors: Bekir N. A. , Güngör K. , Namiduru M.
Published: January 2018

Purpose

To present a case of brucellosis-related unilateral dacryoadenitis.

Methods

A 16-year-old boy had unilateral lacrimal gland enlargement, shown by magnetic resonance imaging of the orbits. Clinical findings, tube agglutination, the culture of a lacrimal gland aspirate, and histopathological examination confirmed the diagnosis of brucellosis.

Results

Tube agglutination testing for brucellosis gave a titer of over 1/640. The aspirate from the lacrimal glands grew Brucella melitensis and histopathological findings were consistent with brucellosis.

Conclusions

Dacryoadenitis may occur in the course of systemic brucellosis caused by Brucella melitensis
Merkel Cell Carcinoma of the Eyebrow Extending into the Orbit
Authors: Seiberth V. , Woldt C.
Published: January 2018

Background

Merkel cell carcinoma is a rare and aggressive cutaneous neoplasm with high local recurrence and metastatic rates.

Purpose

To highlight an unusual presentation of a Merkel cell carcinoma.

Case Report

We report a large Merkel cell tumor in an 85-year-old woman. It extended from the eyebrow into the upper nasal orbit posterior to the equator of the eye globe. Local resection resulted in microscopically complete removal of the tumor. During follow-up (20 months) no local recurrence was noticed but there was a metastasis in a lymphatic nodule.

Conclusions

Merkel cell carcinoma often presents in the eyelids and periorbital region. However, extension from the eyebrow deep into the orbit is unusual.
Asteroid Hyalosis
Authors: Yazar Z. , Hanioglu S. , Karakoç G. , Gürsel E.
Published: January 2018

Purpose

This study evaluated ocular and systemic diseases in patients with asteroid hyalosis and compared axial lengths of asteroid hyalosis patients with the normal population.

Methods

The examination of 26 patients with asteroid hyalosis consisted of complete history, complete ocular examination, blood pressure and laboratory studies in order to detect systemic diseases, A and B scan ultrasonography to measure axial lengths and to detect posterior vitreous detachment.

Results

All patients had unilateral asteroid hyalosis; 10 (38.5%) were symptomatic. Eight patients (20.5%) had type II diabetes mellitus, 13 (33.3%) patients had systemic arterial hypertension and 7 (18%) had atherosclerotic heart disease; 5 (12.8%) had hyperlipidemia and 6 (15.4 %) had hypercholesterolemia. Posterior vitreous detachment was found in 3 (11.5%) patients with asteroid hyalosis, and 6 patients in the control group (23.1%) had posterior vitreous detachment (p<0.01). In patients with asteroid hyalosis, the mean axial length difference between two eyes was 0.32 ±0.06, against 0.10 ± 0.02 in the control group (p<0.01).

Conclusion

Asteroid hyalosis may be found together with systemic diseases and such patients must be evaluated systematically for diabetes mellitus, hypertension and hyperlipidemia. Asteroid hyalosis can also cause artefactual lowering of axial length measurement, leading to significant error in calculations of intraocular lens power. This must be kept in mind before cataract surgery.
Isolated Ocular Ischemic Syndrome with no Cerebral Involvement in Common Carotid Artery Occlusion
Authors: Karacostas D. , Terzidou C. , Voutas S. , Rafou J. , Artemis N. , Georgiadis N.
Published: January 2018

Purpose

The ocular ischemic syndrome (OIS) is sometimes a complication of common carotid artery (CCA) occlusion causing complete interruption of blood flow through both the internal and external carotid arteries we investigated a single case of an isolated OIS that remained undiagnosed for two years, because the underlying CCA pathology caused no cerebral involvement.

Case Report

A 57-year-old man presented with subacute painful visual loss in the right eye in a setting of hypertension, smoking and coronary artery disease.

Results

Neurological examination, a brain CT and MRI scan were all normal. Extensive laboratory work-up excluded small artery disease, inflammatory arteritis or cardiac causes of retinal embolism. Ophthalmologic evaluation and fluorescein angiography gave findings consistent with OIS, while vascular ultrasound evaluation and aortic arch angiography verified right CCA occlusion accompanied by an extensive collateral network.

Conclusions

Had this patient been referred sooner for a simple carotid artery work-up, both the CCA occlusion and the OIS could probably had been prevented.
Comparative Efficacy of β-Irradiation and Mitomycin-C in Primary and Recurrent Pterygium
Authors: Şimşek T. , Günalp I. , Atilla H.
Published: January 2018

Purpose

To determine the efficacy and safety of mitomycin-C as adjunctive treatment and to compare this drug with beta irradiation with strontium-90 after surgical excision of primary and recurrent pterygia.

Materials and Methods

The study group consisted of 193 patients with primary and recurrent pterygia who underwent surgical excision with the bare sclera technique. They were divided into two groups according to the type of adjunctive treatment. In group I, 130 patients (141 eyes, 67.8%) were treated with beta irradiation with Sr-90 doses of 1000–7000 cGy. In group II 63 patients (67 eyes, 32.2%) received topical mitomycin-C at a concentration of 0.02% four times daily for one week postoperatively. Recurrence rates, complications and efficacy of these treatments were compared with the chi-square of Fisher's exact test.

Results

The recurrence rates were 6.4% in group I after a mean postoperative follow-up of 89 months and 17.9% in group II after a mean follow-up of 14.9 months. Recurrence rates and complications were higher in group II and the difference was significant (p<0.05, p<0.001). Life-table analysis showed a success rate of 93.6% for Sr-90 and 81.9% for the mitomycin-C, the difference being significant (p<0.005).

Conclusions

Beta irradiation with Sr-90 after surgical excision was more effective than topical mitomycin-C in patients with primary and recurrent pterygium in terms of recurrence rates, and safer in terms of complications.
Methicillin Resistance of Bacteria Isolated from Vitreous Fluid from Patients Undergoing Vitrectomy
Authors: Labit C.M. , Claeys G.W. , Verbraeken H.E. , Verschraegen G.L.
Published: January 2018

Purpose

The aim of this study was to compare the resistance patterns of bacteria in vitreous fluid from patients undergoing vitrectomy for diagnostic reasons, with bacteria of other nosocomial infections.

Methods

Vitreous fluid samples (n=144) were obtained from 133 patients undergoing vitrectomy for endophthalmitis, and 11 for uveitis as suspected endophthalmitis. They were Gram stained and cultured. Antibiotic susceptibility tests were run on all isolates.

Results

Gram stains were positive in 45/144 cases (31%), among which 38/45 (84%) were confirmed by a positive culture. Cultures were positive in 74/144 patients (51%) with mainly coagulase-negative staphylococci (n = 44) and Staphylococcus aureus (n = 13). In 133 patients endophthalmitis occurred after lens implantation (80 cases) and in 53 cases there was another origin (e.g. corneal transplantation, endogenous). In 26/ 80 post-lens implantation infections, culture remained negative; 32 infections occurred with coagulase-negative staphylococci, 10 with Staphylococcus aureus, 9 with streptococci and 3 with Gramnegative bacteria. For endophthalmitis, ophthalmologists in our institution give an intraocular injection of vancomycin and ceftazidim after vitrectomy. Among the 44 isolates of coagulase-negative staphylococci, 12 (27%) were resistant to methicillin. This is in contrast to other hospital-related coagulase-negative staphylococcus infections in general, and the resistance rate is 75% in our hospital. Only 2/13 Staphylococcus aureus isolates were methicillin-resistant.

Conclusions

We conclude that isolates of coagulase-negative staphylococci from vitreous fluid are less resistant to methicillin than those isolated in other nosocomial infections.
Palbebral Anthrax
Authors: Çelebí S. , Aykan Ü. , Alagöz G. , EsmerlíGíl S.
Published: January 2018

Purpose

Anthrax is a rare infection transmitted to humans from animals or animal products. In cutaneous anthrax it may produce lesions of the eyelids which can lead to cicatricial ectropion.

Methods

We examined three women and five men with anthrax of the eyelids. Intravenous penicillin G was used alone as therapy.

Results

All patients presented with a localized itchy erythematous papule of the eyelid. A necrotising ulcer formed in each case, resulting in black eschar. The lesions resolved, with only mild cicatrization of the eyelid in all the patients.

Conclusions

Anthrax is primarily an infectious disease of domestic animals but it is also seen in humans. Eyelids are rarely affected but cutaneous anthrax should be considered in any patient with a painless ulcer or black eschar who has a history of exposure to animals.
Necrotising Fasciitis of the Orbit: Early Recognition and Treatment a Key to Success
Authors: Puri P. , Innes JR.
Published: January 2018

Purpose

To report a case of necrotising fasciitis which was managed successfully with timely intervention.

Case Report

A 77-year-old lady diagnosed as having narcotizing fasciitis of the orbit based on the clinical picture and microbiology report is presented. Early recognition of the condition followed by timely surgical intervention in the form of surgical debridement and subsequent exenteration led to a favorable prognosis.

Discussion

Necrotising fasciitis is a fulminant synergistic infection. It spreads along facial planes causing necrosis of the overlying skin. Management of this condition includes both medical treatment and surgical debridement. Early intervention is of vital importance to save the patient's life as septicemia often leads to death within 24–96 hours.

Conclusions

Early recognition and treatment are the key to successful management of cases with necrotising fasciitis of the orbit.
Optic Nerve Lesion following Neuroborreliosis: A Case Report
Authors: Burkhard C. , Gleichmann M. , Wilhelm H.
Published: January 2018

Purpose

Neuroborreliosis may cause various neuro-ophthalmological complications. We describe a case with a bilateral optic neuropathy.

Case Report

A 58-year-old female developed facial paresis six weeks after an insect bite. One week later she developed bilateral optic disc swelling with haemorrhages and nerve fibre bundle defects in the lower visual field of the left eye. In CSF and serum, raised IgM and IgG titres to Borrelia burgdorferi were found. Systemic antibiotic treatment led to improvement of the vision and facial paresis, but not all visual field defects resolved, probably due to ischemic lesions of the optic disc.

Discussion/Conclusions

In optic nerve lesions due to neuroborreliosis it is difficult to distinguish between inflammatory and ischemic lesions. This patient demonstrated features of an ischemic optic nerve lesion.
Propionibacterium Acnes Endophthalmitis in Ahmed Glaucoma Valve
Authors: Gutiérrez-Díaz E. , Montero-Rodríguez M. , Mencía-Gutiérrez E. , Fernández-González Ma.C. , Pérez-Blázquez E.
Published: January 2018

Purpose

To report a case of Propionibacterium acnes endophthalmitis in a patient with an Ahmed glaucoma valve.

Case Report

A nine-year-old boy with bilateral congenital glaucoma, with an Ahmed glaucoma valve implanted in the left eye, had recurrent conjunctival dehiscence and endophthalmitis.

Results

Vitreous cultures demonstrated the presence of Propionibacterium acnes.

Conclusions

This is the first reported case of Propionibacterium acnes endophthalmitis in an Ahmed glaucoma valve and the second one in a glaucoma drainage device. We strongly recommend using a patch graft to prevent and treat tube exposure. Conjunctival grafts may be useful to close the conjunctiva when there is marked scarring to prevent patch exposure and melting or extrusion.
Causes of Blindness among Adult Jordanians: A Hospital-Based Study
Authors: Al-Bdour M.D. , Al-Till M.I. , Abu-Khader I.B.
Published: January 2018

Purpose

To assess the causes of blindness among adults aged 20 years and over who attended two big general ophthalmic clinics in Jordan.

Patients and Methods

This hospital-based study was undertaken at Jordan University Hospital in Amman (the capital of Jordan) and Princess Basma Teaching Hospital which is affiliated with Jordan University of Science and Technology in Irbid, the third largest city in the country. A total of 2732 patients seen consecutively over 26 months were examined and the ophthalmic findings were recorded. Using standard Snellen charts, subjects were placed in one of three categories according to their best corrected visual acuity: (1) unilateral blindness: less than 6/60 in the worst eye, 6/60 or more in the better eye; (2) moderate bilateral blindness: less than 6/60 in the worst eye, less than 6/60 to 3/60 or more the better eye; and (3) severe bilateral blindness: less than 3/60 in both eyes.

Results

Of the total patients seen, 373 were blind according to the selection criteria. Among 248 patients with unilateral blindness, diabetic retinopathy, cataract and trauma were the leading causes. Among the 81 patients with moderate bilateral blindness, diabetic retinopathy and cataract were the leading causes. Diabetic retinopathy and glaucoma were the leading causes in patients with severe bilateral blindness.

Conclusions

These data could be used in planning blindness prevention and treatment programs while awaiting a national survey on the prevalence and causes of blindness in Jordan.
Comparison of Tear Function Tests and Impression Cytology with the Ocular Findings in Acne Rosacea
Authors: Yaylali V. , Ozyurt C.
Published: January 2018

Purpose

The aim of this study was to determine the correlation between tear function tests and impression cytology results and the clinical findings in ocular rosacea.

Methods

Patients with a histopathologic and clinical diagnosis of acne rosacea were studied. Ocular examination consisted of best-corrected visual acuity measurement, slitlamp examination, tear break-up time (BUT), basal Schirmer test, and rose Bengal staining. Impression cytology was done two days later. Ocular findings and symptoms were checked and scored. Age-matched controls were assessed using the same parameters.

Results

The most frequent symptoms were itching (80%), redness (68%), burning (64%), and photophobia (60%). The most frequent clinical findings were meibomitis (92%), telangiectasis (88%), blepharitis (84%), superficial punctate keratopathy (72%), and hyperemia (60%). Mean tear BUT was 9.6 ± 3.1 (SD) seconds (range 5–17 seconds). Mean Schirmer test measured 11.4 ± 1.6 mm (SD) (range 8–15 mm). Mean rose Bengal staining scored 1.8 ± 0.1. Mean tear BUT, Schirmer test and rose Bengal staining scores were lower in the rosacea group than the control group (p<0.003, p=0.04, p≤0.038, respectively). Staining was pathologic in 18 patients (36%) and the highest staining score was 4. No significant difference was found between the stages of the nasal and temporal conjunctival impression cytologies in each eye, and there was no relationship between impression cytology stages and rose Bengal scores (p>0.05). A significant relation was observed between the stages of impression cytology and the severity of meibomitis (Fisher's test, χ2=9.625, p=0.001). The Schirmer test gave lower results in patients with severe blepharitis (Mann-Whitney U Test, U=180.5, p=0.034).

Conclusions

Early diagnosis prevents serious ocular complications and chronic dry eye in rosacea. We suggest that in addition to tear function tests, rose Bengal staining and impression cytology can be successfully used in the early diagnosis of dry eye and in monitoring medical treatment in ocular rosacea. Meibomian glands play an important role in the pathogenesis of the ocular disease.
Diabetic Retinopathy and HLA Antigens in Type 2 Diabetes Mellitus
Authors: Birinci A. , Birinci H. , Abidinoglu R. , Durupinar B. , Öge Í.
Published: January 2018

Purpose

Diabetic retinopathy is the most common complication of diabetes mellitus. No single predisposing factor has been identified, and genetic factors may play a role in the development of severe retinopathy. In this study, we investigated the association between diabetic retinopathy and HLA antigens in type 2 diabetes mellitus.

Methods

This study was conducted at the retina unit of the Department of Ophthalmology of Ondokuz Mayis University between October 1999 and March 2000, and included 46 diabetics with non-proliferative retinopathy and 30 with proliferative retinopathy, with 30 non-diabetic controls. HLA class I (A, B, C) antigens were studied by Terasaki's microlympho-cytotoxicity test and HLA class II (DR, DQ) typing was carried out using a polymerase chain reaction-sequence specific primer.

Results

HLA-DR4 and DQ8 frequencies were higher in patients with non-proliferative retinopathy than those with proliferative retinopathy, and HLA-DR7 frequency was higher in patients with proliferative retinopathy than non-proliferative cases (p<0.05). No significant differences in HLA antigens were found between patient groups and controls.

Conclusions

The differences in HLA antigen frequencies between patients with and without proliferative retinopathy suggest a genetic contribution to diabetic retinopathy.
A New Case of Acute Idiopathic Frosted Branch Angiitis in Europe
Authors: Huerva V. , Puig T. , Sánchez M.C. , Jurjo C. , Asenjo J.
Published: January 2018

Case Report

A 20-year-old male with no history of any systemic or eye disease developed loss of visual acuity in both eyes. White exudates surrounding the retinal veins from the posterior pole to the periphery, retinal edema and hemorrhages in both eyes were evident on ophthalmoscopy. Fluorescein angiography showed leakage of the dye from the veins and extensive staining of the vein walls. A diagnosis of acute frosted branch angiitis was made. Systemic examination revealed axillary, submandibular and inguinal lymphadenopathies. VCA IgM antibody for Epstein-Barr virus was negative and IgG positive. Biopsy was taken of an axillary lymph node; a non-specific inflammatory reaction was found on anatomopathologic study. The patient was started on 90 mg prednisolone daily. After two weeks retinal vasculitis had improved and the lymphadenopathies soon resolved. Small, hard exudates were present in the posterior pole during absorption of the retinal edema and resolution of the vascular inflammation. Systemic prednisolone were reduced progressively and definitively withdrawn two months later. The patient's visual acuity was 20/25 in both eyes. No fibrotic scar tissue or atrophic lesions were noted in either fundus.

Conclusions

We report a new case of acute frosted branch angiitis with an onset and favorable clinical course similar to previous reports. We found the additional presence of lymphadenopathies but have been unable to establish a possible causal agent. To our knowledge, apart from a recent case of frosted branch angiitis-like response in Greece, the present case is the first reported in western Europe.
Surgical Management of Retinal Detachment with Choroidal Coloboma
Authors: Ünlü N. , Kocaoğ Lan H. , Acar M.A. , Aslan B.S. , Duman S.
Published: January 2018

Purpose

To verify the functional and anatomical results of retinal detachments related to choroidal coloboma.

Methods

Seven eyes with retinal detachment secondary to retinal breaks at the margin of or within a choroidal coloboma were analysed retrospectively.

Results

Scleral buckling was performed in five of the seven eyes; two needed additional pars plana vitrectomy (PPV) with internal tamponade using silicone oil to reattach the retina. In two eyes PPV with internal tamponade using silicone oil or gas was used as a primary procedure. All seven eyes were reattached. Five eyes (71.4%) showed improvement or had visual acuity of 20/400 or better after surgery, but two remained unchanged.

Conclusions

Retinal detachment secondary to choroidal coloboma can be treated successfully by scleral buckling or PPV with internal tamponade.