bluuebunny/crossref_metadata_2025 huggingface dataset:
Optical Coherence Tomography Evaluation of Macular Edema after Intravitreal Triamcinolone Acetonide in Patients with Parafoveal Telangiectasis
Authors: Cakir M. , Kapran Z. , Basar D. , Utine C.A. , Eroglu F. , Perente I.
Published: January 2018

Purpose

Parafoveal telangiectasis (PT) is a developmental or acquired microvascular abnormality of the macula. Leakage of the abnormal parafoveal capillaries leads to macular edema with subsequent decrease in visual acuity. Intravitreal triamcinolone acetonide is recently widely used in the management of intraocular proliferative, edematous, and neovascular diseases.

Methods

This report presents the evaluation of three cases with PT in whom intravitreal triamcinolone acetonide (IVTA) injection was performed. Fundus fluorescein angiography (FA) and optical coherence tomography (OCT) were used in follow-up of the patients.

Results

Following pars plana intravitreal injection of 4 mg of triamcinolone acetonide, the patients had angiographic improvement of the macular edema and minimal decrease in retinal thickness on OCT, accompanied by improvement in visual acuity and subjective visual assessment.

Conclusions

The results of the present study on parafoveal capillary telangiectasis suggest that the intravitreal injection of triamcinolone acetonide may be a therapeutic option to increase visual acuity and decrease vascular leakage on FA. Following IVTA procedure, follow-up of these patients with both OCT and FA is important for correct clinical evaluation. Future studies on this method seem to be warranted.
Vascular Shunt of the Optic Disc Resembling Neovascularization in a Diabetic patient with Optic Disc Drusen
Authors: Karagiannis D.A. , Sampat V. , Gregor Z.
Published: January 2018

Purpose

To report an insulin-dependent diabetic patient who was referred by the diabetic screening clinic as having proliferative diabetic retinopathy and was found to have bilateral optic disc drusen with optociliary shunt resembling neovascularization on the disc.

Methods

Complete ocular evaluation including a fluorescein angiography was performed.

Results

Fundus examination showed signs of mild nonproliferative diabetic retinopathy in the right eye and the presence of well-defined optic disc drusen in both eyes with a peculiar vascular abnormality resembling neovascularization on the right disc. The central retinal vein pulsation was normal on digital examination. Autofluorescence confirmed the presence of the optic disc drusen in both eyes. Fluorescein angiography showed no leakage from the optociliary shunt. The vascular abnormality has remained stable for 2 years.

Conclusions

This case highlights the correlation of optic disc drusen and optociliary shunts which in diabetic patients can be misdiagnosed as neovascularization.
New Frontiers for the Perioperative Data Method for IOL Calculation following Corneal Refractive Surgeries
Authors: Hamdi I.M. , Artola A. , Alió J.L.
Published: January 2018

Purpose

To evaluate the efficiency of the perioperative data method for intraocular lens (IOL) calculation after correction of myopia and hyperopia with different techniques, including reoperated cases.

Methods

Thirty-five eyes (26 patients) that developed cataract after corneal refractive procedures were evaluated retrospectively They were categorized according to initial error of refraction into myopes and hyperopes and according to types of refractive procedures into ablative, incisional, both, or others. Reoperated cases were also considered. Number of refractive procedures was noted. Time interval between the first procedure and cataract extraction was indicated. Perioperative method was used to calculate the K value. SRK/T formula was used to calculate IOL power. Difference between intended and finally achieved manifest refraction was an indicator for efficiency of the calculation.

Results

Postoperatively, 77.2% of cases had manifest refraction ±1.5 D of intended refraction. There was no difference between myopes and hyperopes in terms of final manifest refraction, best-corrected visual acuity, and difference between intended and finally achieved manifest refraction. Similarly were groups of different types of surgeries. Efficiency of the method decreased with high axial lengths and low IOL powers. Neither the number of refractive surgeries nor time interval between surgeries affected efficiency of the method.

Conclusions

The perioperative data method is equally effective for myopes and hyperopes. The types, numbers of refractive procedures, as well as the time interval between refractive surgery and cataract extraction do not alter the credibility of the method. In high degrees of myopia, the method gives less accurate results.
Long-Term Visual Outcomes of Vitrectomy for Cystoid Macular Edema Due to Nonischemic Central Retinal Vein Occlusion
Authors: Furukawa M. , Kumagai K. , Ogino N. , Uemura A. , Larson E.
Published: January 2018

Purpose

To report the long-term surgical outcome of vitrectomy for cystoid macular edema due to nonischemic central retinal vein occlusion (CRVO)

Methods

A retrospective chart review of 25 consecutive eyes (25 patients) with cystoid macular edema due to nonischemic CRVO treated with vitrectomy was performed. All patients underwent a pars plana vitrectomy with the creation of a posterior vitreous detachment if still attached. Simultaneous phacoemulsification with intraocular lens implantation was also performed in phakic eyes. The main outcome measures were best-corrected visual acuity (BCVA) and changes in macular edema shown by contact-lens biomicroscopy. The mean follow-up time was 49 months (range, 16–108).

Results

The median BCVA before surgery was 0.31 and the median BCVA at last follow-up was 0.67. The BCVA at the last follow-up improved at least two Snellen lines in 17 (68%), remained unchanged in 4 (16%), and worsened in 4 (16%). The BCVA was 20/40 or better in 3 eyes (12%) preoperatively and in 18 eyes (72%) at the last follow-up. During the follow-up, four patients progressed to ischemic CRVO; one of them had neovascular glaucoma requiring surgical intervention.

Conclusions

The data indicate that vitrectomy appears to be a possibly effective treatment in some eyes with cystoid macular edema associated with nonischemic CRVO.
Long-Term Outcome after Conservative Treatment of Indirect Traumatic Optic Neuropathy
Authors: Carta A. , Ferrigno L. , Leaci R. , Kosmarikou A. , Zola E. , Gomarasca S.
Published: January 2018

Purpose

To report the long-term outcome of patients with indirect traumatic optic neuropathy (TON) which showed useful vision for a short period after trauma.

Methods

A cohort of 12 TON patients treated with steroids megadose immediately after trauma was followed every 6 months for an overall period of 5 years. Other than a full neuro-ophthalmologic examination, each visit included quantitative Goldmann perimetry and pattern reversal visual evoked potentials. The results of each examination were compared with the visual function at baseline. The main outcome measures were visual acuity and visual field. Data were analyzed using the Wilcoxon signed-rank test. A p value of less than 0.05 was considered statistically significant.

Results

All patients showed a stable visual function 5 years after optic nerve trauma. There was no difference in visual acuity levels (p=0.65) and no visual field surface area between the visit at baseline and the last follow-up. However, a significant improvement in visual field extension (p=0.036) was observed after perimetry evaluation.

Conclusions

This cohort of patients clearly demonstrates that the residual visual function found in the short term after TON is maintained for at least 5 years. These findings add further important clinical information for patients with TON. Furthermore, these data may be helpful to better quantify morbidity related to optic nerve trauma and its permanent sequelae.
Iris Melanocytoma Mimicking the Cogan-Reese Syndrome with Monocular Pigment Dissemination
Authors: Gutiérrez-Ortiz C. , Pareja J. , Bolívar G. , Cedazo M.T , Busteros J.I. , Teus M.A.
Published: January 2018

Purpose

To report a case of iris melanocytoma mimicking the Cogan-Reese syndrome.

Methods

A 37-year-old woman presented with pigmentary glaucoma in her left eye. There was diffuse pigmentary dispersion in the anterior segment, pedunculated pigmented nodules on the anterior iris surface, mild iris atrophy, and ectropion iridis. Neither intrinsic vasculature nor a sector cataract was found. The angle was open with marked trabecular pigmentation and no anterior synechiae. The intraocular pressure was 30 mm Hg with maximum medical treatment and there was glaucomatous optic atrophy. The differential diagnosis included iris pigmented tumor and iridocorneal endothelial syndrome (Cogan-Reese syndrome). An iris biopsy was performed for diagnostic purposes.

Results

Histologic diagnosis after evaluation of the specimen was iris melanocytoma.

Conclusions

This case presents signs considered quasi-pathognomonic of iridocorneal endothelial syndrome (Cogan-Reese syndrome): glaucoma, mild iris atrophy associated with pedunculated iris nodules, and ectropion iridis. Therefore, iris melanocytoma can present with features that mimic the Cogan-Reese syndrome.
Continuous Full-Time Occlusion of the Sound Eye Vs Full-Time Occlusion of the Sound Eye Periodically Alternating with Occlusion of the Amblyopic Eye in Treatment of Amblyopia: A Prospective Randomized Study
Authors: Stanković B. , Milenković S.
Published: January 2018

Purpose

To compare continuous full-time (24 hours per day) occlusion of the sound eye with full-time occlusion (24 hours per day) of the sound eye 1 day more than the years of age periodically alternating with occlusion of the amblyopic eye for 1 day, as treatments for profound strabismic amblyopia in children older than 5 years.

Methods

A total of 53 patients with visual acuity (VA) of 0.4 and less in the amblyopic eye (tested by crowded Landolt Cs) after previously being provided optimal optical correction were randomly assigned to receive either of the two patching regimens. VA and pattern reversal visual evoked potentials (PVEP) were recorded prospectively at 1-month intervals. Improvement in VA and the reduction in crowding difficulties (CD) were the main outcome measures of the treatment efficiency.

Results

Both treatment modalities were equally effective. Of the 51 subjects who completed the study, 21 (41.2%) were cured whereas 32 (62.7%) attained satisfactory improvement. Recovery of VA was related to age, with cure being obtained in 23.5% (4/17) and satisfactory improvement in 52.9% (9/17) of patients older than 9 years. Larger gain in VA influenced the stability of the vision over time.

Conclusions

It can be concluded that in clinically monitored parameters both treatment modalities were equally effective without any statistical or clinical significance in the observed groups of patients. However, events like the “trade-off” effect, occurrence of occlusion amblyopia, or prolongation of PVEP latency of the sound eye indicate that full-time continuous occlusion possibly presents a more effective form of treatment. (Eur J Ophthalmol 2007; 17: 11–9)
Prevalence and Risk Factors of Lens Opacities in the Elderly in Cuenca, Spain
Authors: Navarro esteban J.J. , Gutiérrez leiva J.A. , Valero caracena N. , Buendía bermejo J. , Calle purón M.E. , Martínez vizcaíno V.J.
Published: January 2018

Purpose

To estimate the prevalence of lens opacities in a group of elderly people and evaluate their relation with diverse risk factors.

Methods

Cross-sectional observational study of the cohort of all persons over the age of 64 years from an urban area and a rural nucleus of the province of Cuenca, Spain. Information on sociodemographic parameters and smoking was compiled using a structured questionnaire. A physical examination was made in which weight, height, and waist circumference were measured, and an ophthalmologic examination was made of visual acuity and lens opacities. Cataracts were classified using the method of the WHO cataract group.

Results

The study included 1155 subjects out of 1435 elderly persons who were invited to participate (response rate 80.5%). The prevalence of cataract in men was 69.2% and in women, 65.5% (p>0.05). The percentage of persons with aphakia/pseudophakia was 17.8% in men and 17.5% in women (p>0.05). In a logistic regression model, age, obesity of more than 35 kg/m2, and low educational level were associated with the presence of cataract or aphakia/pseudophakia.

Conclusions

The prevalence of cataract in people over 64 years is similar to that of other countries, but the prevalence of subjects with previous surgery for cataracts is the highest reported in the literature. Age, body mass index of more than 35 kg/m2, and low educational level were associated with the probability of having cataracts or undergoing surgery for cataracts. (Eur J Ophthalmol 2007; 17: 29–37)
Intraocular Lymphoma Metastasis from Larynx
Authors: Iwase T. , Sugiyama K. , Takahira M. , Uchiyama A.
Published: January 2018

Purpose

To present a rare case of primary larynx diffuse large B cell lymphoma non-Hodgkin's lymphoma (NHL), disseminated to the cerebellum and the intraocular tissue.

Methods

A 69-year-old man noticed blurred vision in both eyes. The vitreous contained infiltrating cells bilaterally, and floating opacities were increased. We performed vitrectomy to recover the vision and diagnose for both eyes.

Results

The authors discovered diffuse large B cell NHL with cytopathologic examination from vitreous specimen in this case, which was identical with diffuse large B cell NHL of the larynx and cerebellum, and therefore could diagnose the intraocular lesion as the metastasis of NHL. Although the vision improved, the patient had remarkable visual disturbance in both eyes at 6 months after surgery because of the chorioretinal lesion. The authors treated by the combined curative chemotherapy and radiotherapy to ocular tissue, since providing sufficient evidence that the chorioretinal lesion was to predict the metastasis of diffuse large B cell NHL. After those treatments, chorioretinal lesions have disappeared in both eyes and the vision has recovered.

Conclusions

Increased attention to the possibility of dissemination of laryngeal NHL to the intraocular tissue is needed. (Eur J Ophthalmol 2007; 17: 133–5)
A Comparison of the Effect of Carbomer-, Cellulose-, and Mineral Oil-Based Artificial Tear Formulations
Authors: Wang I.-J. , Lin I.-C. , Hou Y.-C. , Hu F.-R.
Published: January 2018

Purpose

To compare the efficacy, safety, and local tolerance between carbomer-based artificial tears, cellulose-, and mineral oil-based artificial tears.

Methods

A randomized, open-label, parallel-group comparative 28-day study was designed for 67 patients who were randomized into three treatment groups. Measurements included the scoring of total subjective symptoms and objective signs, Schirmer-Jones test values, and tear break-up time (BUT) at baseline, and after 2 and 4 weeks of treatment. Safety of study treatment was also assessed. Outcomes measured at baseline and 2 and 4 weeks follow-up included the scoring of total subjective symptoms and objective signs, Schirmer-Jones test values, and tear BUT, subjective assessments, and safety.

Results

There were no differences regarding total scores, Schirmer-Jones test, or tear BUT at baseline among these three groups at 2 and 4 weeks. Patients in all three treatment groups experienced a significant improvement from baseline in total scores and Schirmer-Jones test values after treatment. Subjective assessment was better with carbomer-based treatment.

Conclusions

Each artificial tear formulation successfully relieved symptoms and signs of keratoconjunctivitis sicca. The tolerance of carbomer-based artificial tears was comparable to that of cellulose- and mineral oil-based artificial tears. (Eur J Ophthalmol 2007; 17: 151–9)
Sector-Based Analysis of Frequency Doubling Technology Sensitivity and Optic Nerve Head Shape Parameters
Authors: Iester M. , Sangermani C. , De feo F. , Ungaro N. , Cicinelli S. , Tardini M.G. , Calabria G. , Gandolfi S.
Published: January 2018

Purpose

To evaluate which Heidelberg Retina Tomograph (HRT) parameter is the best predictor of frequency doubling technology (FDT) sensitivity by using a sector based analysis between FDT and optic nerve head shape parameters such as cup shape measure (CSM) and rim area (RA), which have been shown to have the best correlation with FDT indices among all the HRT parameters.

Methods

One eye was randomly chosen from 100 patients with primary open angle glaucoma (abnormal visual field and/or abnormal optic nerve and untreated intraocular pressure above 21 mmHg). All the patients were examined with Humphrey field analyzer (HFA), program 24–2, SITA standard, FDT program C 20, and HRT. RA and CSM for the HRT analysis and mean deviation, pattern standard deviation, and the sensitivity of each tested point for the FDT test were considered in this study. All the parameters were calculated as both global and sector measurements. Findings were analyzed using Pearson's correlation coefficient and linear regression model.

Results

Significant (p<0.001) correlation was found between FDT indices and HRT RA and CSM. Significant (p<0.001) sector correlation was found between FDT sensitivity and RA and CSM, but when a linear regression model was applied, RA was the most predictive parameter of FDT. Temporal CSM was more strongly correlated to FDT fovea sensitivity than temporal RA. Furthermore, sector HRT parameters were better correlated to HFA than to FDT.

Conclusions

In this glaucomatous group, cup shape measure and RA were significantly correlated to FDT indices. RA was more predictive of FDT abnormality than CSM in all the considered sectors except in the temporal one. However, HFA was a stronger predictor of HRT parameters than FDT. (Eur J Ophthalmol 2007; 17: 223–9)
Ultrabiomicroscopy (Ubm) in Flap Dislocation following Lasik: A Case Report
Authors: Mannino G. , Perdicchi A. , Medori E.M. , Recupero S.M.
Published: January 2018

Purpose

To describe postoperative laser-assisted in situ keratomileusis (LASIK) flap dislocation occurred after trauma

Methods

Ultrabiomicroscopy (UBM) is used to obtain a high-resolution imaging of the cornea.

Results

The UBM results are presented and compared with histologic and confoscan findings.

Conclusions

The technique is useful and easy to perform, offering more opportunities to study the anatomical changes in LASK flap dislocation occurred after trauma. (Eur J Ophthalmol 2007; 17: 259–61)
Intravitreal Bevacizumab for Neovascular Glaucoma following Central Retinal Artery Occlusion
Authors: Vatavuk Z. , Bencic G. , Mandic Z.
Published: January 2018

Purpose

To report a case of neovascular glaucoma due to central retinal artery occlusion treated with a single intravitreal injection of bevacizumab.

Methods

A 68-year-old patient with a 10-week history of central retinal artery occlusion presented with neovascularization of the iris and the angle and intraocular pressure of 30 mmHg. The patient received a single injection of 1.25 mg bevacizumab in 0.1 mL intravitreally.

Results

Iris and angle neovascularization regressed within 48 hours of the injection. Intraocular pressure dropped from 30 to 15 mmHg, and there was marked improvement in patient comfort. Panretinal photocoagulation was applied 4 weeks after the injection.

Conclusions

Bevacizumab seems to be a useful adjunct to panretinal photocoagulation in the treatment of neovascular glaucoma. (Eur J Ophthalmol 2007; 17: 269–71)
ThinOptX vs AcrySof: Comparison of visual and Refractive Results, Contrast Sensitivity, and the Incidence of Posterior Capsule Opacification
Authors: Kaya V. , Öztürker Z.K. , Öztürker C. , Yaşar Ö. , Sivrikaya H. , AĞCa A. , Yilmaz Ö.F.
Published: January 2018

Purpose.

To evaluate the visual and refractive results, the changes in contrast sensitivity, and the incidence of posterior capsule opacification (PCO) after the implantation of UltraChoice 1.0 ThinOptX (ThinOptX Inc.) intraocular lens (IOL) and conventional acrylic foldable IOL (AcrySof MA30AC).

Methods.

Twenty-five patients were randomized into two groups prospectively. In Group 1, microincisional phacoemulsification and the ThinOptX IOL implantation were applied in one eye, and in Group 2, conventional phacoemulsification and the AcrySof IOL implantation were applied in the fellow eye. Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), surgically induced astigmatism (SIA), contrast sensitivity, and the incidence of PCO were observed in the two groups and comparisons were made.

Results.

Mean follow-up period was 12.8±1.5 months (range 11 to 14 months). In the last follow-up examination, UCVA and BCVA were significantly lower and the PCO scores were significantly higher in Group 1 (p<0.05). Although SIA was lower in Group 1, the difference was not statistically significant. Contrast sensitivity in higher spatial frequencies was significantly lower in Group 1 in the 6th month and 12th month visits. Capsular contraction was seen in 3 eyes (12%) in Group 1 whereas there was no capsular contraction or phimosis in Group 2.

Conclusions.

Long-term evaluation of the ThinOptX IOL concludes with an increased rate of PCO, a diminished resistance to the capsular contraction vs the AcrySof IOL, and a decrease in visual performance. The poor after cataract performance of this rollable lens shows that microphacoemulsification and ThinOptX IOL implantation is not as effective as conventional phacoemulsification and AcrySof IOL implantation in the long term.
Phacoemulsification in Vitrectomized Eyes under Topical Anesthesia
Authors: Zaheer I. , Taylor S.R.J. , Pearson R.V.
Published: January 2018

Purpose.

To study phacoemulsification in vitrectomized eyes under topical anesthesia, assessing anesthetic and intraoperative characteristics and complications.

Methods.

A prospective study was performed on 52 eyes of 51 patients who underwent phacoemulsification of cataract with intraocular lens implantation under topical anesthesia, having previously undergone pars plana vitrectomy. Surgical and anesthetic observations and complications were recorded, as were visual outcomes.

Results.

Ninety-two percent of patients had improved visual acuity postoperatively with only one patient having visual loss as a result of surgery. The most common intraoperative observations were of a deep anterior chamber, posterior capsular plaques, posterior synechiae, and nuclear sclerotic cataracts. Topical anesthesia proved satisfactory in 96%, with only two patients requiring intracameral lignocaine 1%; no patients required conversion to injection anesthesia. There were no major operative or postoperative complications.

Conclusions.

Phacoemulsification in vitrectomized eyes can be challenging, but is visually rewarding. Topical anesthesia proved satisfactory for the vast majority of cases, with none of our patients requiring conversion to injection anesthesia.
Ocular Symptoms and Signs with Preserved and Preservative-Free Glaucoma Medications
Authors: Jaenen N. , Baudouin C. , Pouliquen P. , Manni G. , Figueiredo A. , Zeyen T.
Published: January 2018

Purpose.

To compare the prevalence of side effects between eyedrops with or without preservatives, in terms of subjective symptoms and objective signs in patients with open-angle glaucoma.

Methods.

In a multicenter cross-sectional epidemiologic survey in four European countries, ophthalmologists in private practice enrolled 9658 nonconsecutive patients using preservative (P) or preservative-free (PF) beta-blocking eyedrops between June 1997 and December 2003. Subjective symptoms, conjunctival and palpebral signs, and superficial punctate keratitis were explored before and after a change in therapy. For statistical analysis, a χ2 test was used to calculate the differences in the prevalence of symptoms and signs with or without preservatives.

Results.

A total of 74% of the patients used P, 12% PF, 10% a P-PF combination, and in 4% the type of medication was unknown. Each recorded symptom and all the palpebral, conjunctival, and corneal signs were significantly more frequent (p<0.0001) in the P-group than in the PF-group, such as pain or discomfort during instillation (48 vs 19%), foreign body sensation (42 vs 15%), stinging or burning (48 vs 20%), and dry eye sensation (35 vs 16%). A total of 68% of the patients had a second visit performed, of whom 63% (6083) had been evaluated on treatment difference. A significant decrease (p<0.0001) of all ocular symptoms and signs was observed in patients in whom the preserved eyedrops were diminished in number or altered into preservative free drops.

Conclusions.

Compared to preserved eyedrops, preservative free eyedrops are significantly less associated with ocular symptoms and signs of irritation.
Influence of Deep Scleral Flap Size on Intraocular Pressure after Deep Sclerectomy
Authors: Torres-Suarez E. , Rebolleda G. , Munoz-Negrete F.J. , Cabarga C. , Rivas L.
Published: January 2018

Purpose.

To study the effect of several morphometric characteristics of the deep scleral flap on intraocular pressure (IOP) control after deep sclerectomy.

Methods.

The authors conducted a nonrandomized prospective study of 56 eyes of 51 patients who underwent deep sclerectomy alone or combined with phacoemulsification. A reticulated hyaluronic acid implant was used in all cases. The surface, volume, and weight of the dissected deep scleral flap were measured and recorded. The correlation between these parameters and the postoperative IOP was evaluated at 6 and 12 months postoperatively.

Results.

Forty-nine eyes (87.50%) achieved an IOP of 21 mmHg or less without treatment, and the need for medication was decreased significantly (p<0.001) at 12 months postoperatively. The authors found a significant inverse correlation between the mean postoperative IOP at 6 months and the surface, volume, and weight of the deep scleral flap, but not at 12 months postoperatively.

Conclusions.

Greater weight, surface area, and volume of the deep scleral flap dissected during deep sclerectomy achieve significantly lower postoperative IOPs in the early postoperative period.
Aqueous and Vitreous Penetration of Levofloxacin after Topical and/or Oral Administration
Authors: Sakamoto H. , Sakamoto M. , Hata Y. , Kubota T. , Ishibashi T
Published: January 2018

Purpose.

To investigate the aqueous and vitreous penetration of levofloxacin, the drug was administered topically and/or orally to patients undergoing vitrectomy.

Methods.

Thirty-six patients undergoing initial vitrectomy with phacoemulsification and aspiration (PEA) were enrolled, and were divided randomly into three groups. Group 1 was treated with topical application of levofloxacin (three times on the day before surgery and seven times on the day of surgery), Group 2 received oral administration of levofloxacin (200 mg twice on the day before surgery and 200 mg at 3 hours before surgery), and Group 3 received both topical and oral levofloxacin according to the above schedules. The concentration of levofloxacin was measured in aqueous humor and vitreous fluid samples obtained during surgery.

Results.

In Groups 1, 2, and 3, the mean levofloxacin concentration in aqueous humor was 0.765±0.624 μg/mL, 1.279±0.440 μg/mL, and 1.823±0.490 μg/mL, respectively, while the mean levofloxacin concentration in vitreous fluid was <0.02 μg/mL, 1.455±0.445 μg/mL, and 1.369±0.530 μg/mL, respectively.

Conclusions.

Oral administration of levofloxacin at a dose of 400 mg/day was sufficient for the prophylaxis of ocular infections, because the drug concentrations in both aqueous humor and vitreous fluid were higher than the MIC90 values for major ocular pathogens. Topical application of levofloxacin achieved adequate drug levels in aqueous humor, but not in vitreous fluid, while combined topical and oral administration had an additive effect on the drug concentration in aqueous humor.
Complications of Hydroxyapatite Pegging: Comparison between Polycarbonate and Titanium Peg System
Authors: Salour H. , Eshaghi M. , Abrishami M. , Bagheri A. , Aletaha M.
Published: January 2018

Purpose.

Polycarbonate peg has been customarily used for pegging of hydroxyapatite for years. For better movement, tissue tolerance, and to decrease the complications of pegging, titanium peg system has been used. This study compares the two systems.

Methods.

Complications associated with pegging (polycarbonate: Bio-Eye® or titanium: Dr-Perry new P-K®) were retrospectively reviewed from the charts of 153 patients admitted to the Labbafinejad Medical Center, Tehran, Iran, for over 5 years from 1997 to 2003.

Results.

A total of 153 cases were studied. Ninety-six (62.3%) were male and 57 (37.7%) were female, and the mean age was 27.7 years (6–59 years). In 88 cases pegs were polycarbonate and sleeve system and in 65 cases pegs were titanium. Forty-one (46%) of cases with polycarbonate and 18 (27%) of cases with titanium had at least one or more complications (p=0.018). The most common complications were granulation tissue, discharge, overgrowth of conjunctiva, and peg falling out in 25%, 23%, 13%, and 8% in polycarbonate peg and 15%, 5%, 1.5%, and 0% in titanium peg group. The prevalence of the last three complications was statistically lower in titanium peg compared with polycarbonate. Twenty-five cases (35%) with polycarbonate peg and 5 cases (7.5%) with titanium peg had two or more complications (p=0.03). Peg removal was done in 11 cases of polycarbonate but only two cases of titanium peg in order to treat the complication.

Conclusions.

Both pegging systems had some complications, although these were less severe and prevalent in titanium peg. More studies on complications due to titanium pegs are recommended.
Lattice Corneal Dystrophy Type II: Clinical, Pathologic, and Molecular Study in a Spanish Family
Authors: Huerva V. , Velasco A. , Sánchez M.C. , Mateo A.J. , Matías-Guiu X.
Published: January 2018

Purpose.

To report a family with lattice corneal dystrophy type II (LCD II) associated with systemic amyloidosis type V.

Methods.

A 69-year-old woman presented a LCD II and marked dermachalasis. A lower blepharoplasty was performed. Two years later a penetrating keratoplasty was performed in her left eye. Three children of the patient were studied. Subtle manifestations of LCD were identified in two of them. Pathologic study of the excised skin and corneal button was made. DNA from peripheral blood was obtained, and was subjected to amplification of exon 5 of the gelsolin.

Results.

Pathologic examination of the skin of blepharoplasty specimen demonstrated the presence of amyloid. Microscopic examination of the corneal button showed the presence of amyloid deposits beneath the normal-appearing Bowman layer and also within the stroma. Immunostaining for S-100 protein did not demonstrate a significant relationship between amyloid deposits and corneal nerves. Electron microscopic evaluation demonstrated the presence of amyloid fibrils. No clear relationship was found between amyloid deposits and corneal nerves. These findings confirm LCD type II or Meretoja syndrome. A mutation analysis of the gelsolin gene demonstrated the presence of G to A transition at nucleotide 654. Two children with manifestations of LCD also showed the identical mutation in gelsolin gene.

Conclusions.

A new family with Meretoja syndrome is reported. This is the first documented family with Meretoja syndrome in Spain and in the Mediterranean countries. The molecular study shows the same mutation of reported families from Finland, Japan, the United States, and the United Kingdom.
Macular Sensitivity Change in Multiple Sclerosis followed with Microperimetry
Authors: Romano M.R. , Angi M. , Romano F.
Published: January 2018

Purpose.

To describe the efficacy of MP-1 in detecting early multiple sclerosis (MS) retinal lesions and in monitoring the effectiveness of treatment in terms of changes in macular sensitivity.

Methods.

A 21-year-old woman with MS was referred to us complaining of recurrent episodes of eyesight loss in both eyes. At ophthalmologic examination, best-corrected visual acuity was 20/25 bilaterally; ophthalmoscopy showed bilateral slight optic neuritis without swelling of the disc. Static perimetry of central visual field (30 degrees, by Octopus 101, Haag-Streit AG, Switzerland) and retinal sensitivity of the 12 central degrees (by MP-1 Micro Perimeter, Nidek Inc., Italy) were performed on the patient at that time. The microperimeter (MP-1) showed a loss of sensitivity in the macular region with 0.28±0.9 dB sensitivity in the right eye and 19.42±1.5 dB in the left. The mean fixation stability was 91% considering 2° and 99% considering 4° around the fixation points in the right eye, and 97% in 2° and 100% in 4° central degrees in the left. In the weeks that followed vision continued to get worse in both eyes, so she underwent a steroid therapy with methylprednisolone IV 1000 mg/day for 5 days and 500 mg/day for 3 days.

Results.

After 8 days of therapy the MP-1 showed a significant recovery in the right eye, with mean light sensitivity being 19.61±1.3 dB in the right eye and 20.0±0 dB in the left eye in both macular and peripapillary regions. The mean fixation stability was 100% considering 2° and 100% considering 4° around the fixation points in both eyes.

Conlcusions.

The MP-1 can be an interesting tool for neuro-ophthalmologists as it allows a more precise evaluation of the macular and peripapillary region, which is not easily studied with conventional automated perimetry. In MS, the presence of a subclinical form of optic nerve involvement can be demonstrated in a very early stage, and well followed by the introduction of microperimeter testing in the standard examination protocol.
Curvilinear Streaks in Multifocal Choroiditis
Authors: Matsumoto Y. , Francis J.H. , Yannuzzi L.A.
Published: January 2018

Purpose.

Discreet chorioretinal spots, neovascular maculopathy, peripapillary atrophy and peripheral curvilinear pigmentary-atrophic streaks are characteristic of Multifocal Choroiditis. We report the presence of curvilinear streaks in the posterior pole.

Methods.

Observational series.

Results/Conclusions.

Like chorioretinal discreet spots, peripheral curvilinear atrophic-pigmentary streaks may also appear in the posterior fundus, including the macular region, in Multifocal Choroiditis.
Endogenous Pseudomonas Endophthalmitis in an Immunocompetent Patient
Authors: DÍaz-Valle D. , Del Castillo J.M. Benitez , Aceñero M.J. Fernandez , Santos-Bueso E. , De La Casa J.M. Martinez , Garcia-Sanchez J.
Published: January 2018

Purpose.

To report an unusual case of community-acquired Pseudomonas aeruginosa pneumonia in an immunocompetent host complicated by orbital cellulitis, panophthalmitis, and subcutaneous nodules.

Methods.

An otherwise healthy 47-year-old woman presented with a 24-hour history of fever, cutaneous nodules, right sided pleuritic chest pain, and eyelid edema with severe vision loss in her right eye. A chest X-ray demonstrated a homogeneous infiltrate in the right upper lobe. Ophthalmic examination revealed signs of metastatic orbital cellulitis and panophthalmitis. Culture specimens from blood, sputum, skin, and vitreous showed a significant growth of P. aeruginosa species.

Results.

Intravenous antibiotic therapy led to resolution of the pneumonia, cutaneous nodules, and orbital cellulitis. Despite intravitreal and topical antibiotics, the patient finally required enucleation.

Conclusion

This case represents a rare combination of manifestations in an immunocompetent patient with P. aeruginosa infection. It highlights the accelerated course that may result from P. aeruginosa infection, the difficulties of treatment, and the poor prognosis in the case of eye involvement.
Investigation of Human Papillomavirus and Epstein-Barr Virus DNAs in Pterygium Tissue
Authors: Otlu Baris , Emre Sinan , Turkcuoglu Peykan , Doganay Selim , Durmaz Riza
Published: January 2018

Purpose

Recent studies postulated the presence of a probable relationship between pterygium and neoplasia. This study aimed to investigate the role of two oncogenic viruses, human papillomavirus (HPV) and Epstein-Barr virus (EBV), in the development of conjunctival pterygia.

Methods

Polymerase chain reaction was used to identify the presence of HPV and EBV in 30 primary and 10 recurrent pterygia samples. Twenty conjunctival samples obtained from patients undergoing cataract surgeries were used as the control group. Patient groups had similar sex, race, and age distribution to eliminate bias. For exploration of HPV in groups, two different PCR methods (in-house PCR with two different primer sets and one real-time PCR method) were studied. The presence of EBV was shown by real-time PCR method.

Results

HPV was identified in none of the pterygia and control group patients. However, EBV was detected in 3 out of 30 (10%) primary pterygia patients and in none of the recurrent pterygia and control patients.

Conclusions

Up to now, HPV has been blamed as the major viral pathogen in the etiopathogenesis of pterygium. The current results suggest that EBV may also be involved in the pathogenesis of pterygium, but further larger studies with larger cohorts are required to confirm this hypothesis.
LASIK and PRK in Refractive Accommodative Esotropia: A Retrospective Study on 20 Adolescent and Adult Patients
Authors: Magli Adriano , Iovine Antonello , Gagliardi Vincenzo , Fimiani Francesco , Nucci Paolo
Published: January 2018

Purpose

To evaluate the clinical results obtained with excimer laser treatment of fully refractive accommodative esotropia.

Methods

Fully refractive accommodative esotropia was corrected in 17 patients with laser in situ keratomileusis (LASIK) and in 3 patients with photorefractive keratectomy (PRK). The mean age of the patients at time of refractive surgery was 18.8 years (range 14 to 24 years). All surgical procedures were performed under local anesthesia. The preoperative and postoperative data were retrospectively analyzed with regards to visual acuity, ocular alignment, and stereopsis.

Results

The mean preoperative deviation without correction was 18.1Δ for near vision and 13.7Δ for distance vision. After refractive surgery the mean postoperative deviation was 4Δ esophoria at near, and 2.5Δ of esophoria at distance: 10 patients (50%) showed esophoria for both distance and near vision, 2 patients (10%) esophoria only for near vision, and 8 patients (40%) orthophoria for both distance and near vision. Emmetropia (±1.00 D) was obtained in 97.5% of eyes (39 of 40). The mean correction obtained with excimer laser was +4.62 D (range +2.25 to +7.75, SD 4.52). The preoperative BSCVA was in all eyes greater than or equal to 20/30. There were no significant differences observed between the preoperative and postoperative mean best-corrected visual acuity (p=0.32). There were no complications. The follow-up period lasted a mean of 30.2 months.

Conclusions

The treatment of fully refractive accommodative esotropia with excimer laser was found effective and safe, even in young or adolescent patients. More studies are needed to increase the patient experience and extend the follow-up period in order to evaluate the stability of these results over time.
Pupillometric Characteristics in Patients with Choroidal Neovascularization Due to Age-Related Macular Degeneration
Authors: Brozou Catherine G. , Fotiou Dimitrios , Androudi Sofia , Theodoridou Evelyn , Giantselidis Charalambos , Alexandridis Alexandros , Brazitikos Periklis
Published: January 2018

Purpose

To study the pupillary light reflex in patients with choroidal neovascularization due to age-related macular degeneration (AMD).

Methods

The study included 15 patients with AMD and 15 control subjects. A full recording of the pupil's reaction to light was registered and the following eight parameters were measured and reported: baseline pupil radius (R1), latency (T1), minimum pupil radius (R2), amplitude (AMP), maximum constriction velocity (VCmax), maximum constriction acceleration (AC-max), time for maximum velocity (T2), and time for maximum constriction (T3).

Results

All variables measured presented alterations in the AMD group and a number of them were significantly reduced in the AMD group.

Conclusions

The presence of neovascular AMD significantly affects the pupil's response to light stimulus when compared to normal subjects.
Ultrasonographic Pictures of Intravitreal Triamcinolone Acetonide
Authors: Hosseini Hamid , Anvari-Ardakani Hamid R. , Karanjam Mohammad A. , Farvardin Mohsen , Nowroozizadeh Sarah
Published: January 2018

Purpose

To evaluate ultrasonographic pictures of intravitreal triamcinolone acetonide (IVTA).

Methods

Twenty-eight eyes from 28 patients who needed intravitreal injection of triamcinolone acetonide (4 mg/0.1 mL) were included in this study. A baseline ocular B-scan ultrasound examination was performed in all eyes before IVTA injection. Subsequent examinations were scheduled about 1 hour, 1 day, and 1 week after the injection and thereafter weekly up to complete sonographic disappearance of triamcinolone acetonide. Ultrasonographic pictures of IVTA and disappearance time of the medication were evaluated.

Results

In all the eyes, IVTA was seen as multiple inhomogeneous markedly hyperechoic areas with various size and shape and nonuniform distribution through the vitreous cavity. Common pictures included localized bright hyper-reflective area, diffuse bright point-like echo sources, membranous surfaces, and subhyaloid opacities. IVTA deposited along acoustic interfaces and changed their ultrasonographic characteristics. IVTA facilitated visualization of posterior vitreous surface in seven patients. Opacities due to IVTA gradually cleared over a 3- to 7-week period.

Conclusions

The findings indicate that IVTA has a bright hyper-reflective ultrasonic image and should be considered as a differential diagnosis for vitreous opacity. IVTA can change the ultrasonographic pattern of the vitreous cavity and highlight membranous surfaces.
Intravitreal Bevacizumab as an Adjunct Treatment for Neovascular Glaucoma
Authors: Hasanreisoglu Murat , Weinberger Dov , Mimouni Karin , Luski Moshe , Bourla Dan , Kramer Michal , Robinson Anat , Axer-Siegel Ruth
Published: January 2018

Purpose

To assess the effect of adjunctive intravitreal bevacizumab treatment on neovascular glaucoma (NVG).

Methods

The medical records of all consecutive patients with NVG treated with intravitreal bevacizumab at our center from May 2006 to February 2008 were reviewed. The data collected included background features, findings on full ophthalmologic examination (including visual acuity, gonioscopy, and intraocular pressure), glaucoma medications prescribed, and additional procedures for glaucoma performed before and after bevacizumab injection. The interval between the diagnosis of NVG and intravitreal bevacizumab treatment was calculated.

Results

Eighteen patients (6 male, 12 female; mean age 63±13.2 years) met the study criteria. Causes of NVG were proliferative diabetic retinopathy (n=14), central retinal vein occlusion (n=2), occlusive vasculitis (n=1), and panuveitis (n=1). The mean duration of follow-up was 52 (±12) weeks. Mean intraocular pressure decreased from 32.3 (±4.99) to 18 (±6.1) mmHg (p<0.0001) and mean number of glaucoma medications decreased from 3.16 (±1.2) to 2.55 (±1.46) (p=0.1938). An interval of less than 6 months between the start of bevacizumab treatment and diagnosis was associated with better final visual acuity than delayed treatment (0.82±0.4 logMAR vs 1.88±1.1 logMAR, p=0.002) and a better regression of iris neovascularization (22% vs 89%; p=0.015).

Conclusions

Intravitreal bevacizumab is beneficial for the treatment of anterior segment neovascularization and NVG when used as an adjunct, making the administration of additional treatment for the underlying cause possible. Bevacizumab should be instituted promptly after diagnosis, before irreversible anatomic and functional damage occurs.
In Vivo Characterization of Doxycycline Effects on Tear Metalloproteinases in Patients with Chronic Blepharitis
Authors: Iovieno Alfonso , Lambiase Alessandro , Micera Alessandra , Stampachiacchiere Barbara , Sgrulletta Roberto , Bonini Stefano
Published: January 2018

Purpose

Matrix metalloproteinases (MMPs) have a role in the pathogenesis of rosacea-associated chronic blepharitis. Doxycycline is largely used as a treatment for recalcitrant chronic blepharitis. It has been shown in vitro that doxycycline inhibits MMPs activation. The aim of this study was to investigate in vivo the effect of doxycycline in modulating MMPs in patients with chronic idiopathic blepharitis.

Methods

Eight patients (6 male, 2 female; mean age 45.7±17.5 years) were included in the study. Doxycycline (100 mg) was administered orally, twice a day, for 2 weeks and once a day for an additional 2 weeks. Clinical signs and symptoms were evaluated and scored (0–3) at baseline and after 4 weeks. Total sign (TSS) and total symptom (TSyS) scores were calculated. Tear samples and conjunctival impression cytologies were collected at baseline and after 4 weeks of treatment to evaluate MMP-9 and TIMP-1 expression and activity.

Results

An improvement in TSS (4.5±1.1 vs 2.7±1.5) and TSyS (6.6±1.3 vs. 3.1±1.9) was observed after 4 weeks, with significant amelioration of hyperemia, marginal blepharitis, and superficial punctuate keratopathy. Zymography revealed a decrease of MMP-9 activity after 4 weeks. MMP-9 mRNA and protein levels did not change, while an upregulation of TIMP-1 expression was observed.

Conclusions

This study suggests that 4-week treatment with doxycycline significantly improved symptoms and signs in patients with chronic blepharitis in association with a decrease in MMP-9 activity. Upregulation of TIMP-1 is proposed as a possible mechanism of MMP-9 inactivation. (Eur J Ophthalmol 2009; 19: 708–16)
Evolution of Visual Performance in 250 Eyes Implanted with the Tecnis ZM900 Multifocal IOL
Authors: Palomino Bautista Carlos , Carmona González David , Castillo Gómez Alfredo , Cristóbal Bescos José Angel
Published: January 2018

Purpose

To evaluate visual performance in relation to time after implantation of the multifocal Tecnis intraocular lens (IOL) in patients with cataract.

Methods

This prospective case series involved 250 eyes of 137 patients with cataract aged 68.5±9.9 years. Monocular uncorrected and corrected near visual acuity (NVA and DCNVA) and distance visual acuity (UCVA and BCVA), occurrence of visual symptoms, and patient satisfaction were evaluated at 1–3 days, 30–90 days, and 150–210 days after surgery. Posterior capsule opacification and contrast sensitivity under photopic conditions were also assessed.

Results

At the last follow-up visit, mean NVA and DCNVA was 0.215±0.082 and 0.189±0.045 log-MAR, respectively. The majority of eyes (96.8%) could read J2 without correction, including 83.2% reading J1. With best distance correction, 95.6% of eyes were able to read J1. Mean UCVA and BCVA was 0.144±0.101 and 0.09±0.03 logMAR, including 77.6% and 98.4% of eyes that achieved 20/30 or better, respectively. The majority of patients (>90%) ranked their near, distance, and global vision as good or excellent and 88.4% were free from spectacles. A significant improvement of uncorrected and corrected distance and near VA as well as a decrease in the intensity of subjective photic phenomena was observed over time. At the last follow-up visit, the rate of posterior capsule opacification (grade 1) was 4.4% and mean monocular contrast sensitivity was 1.44±0.26.

Conclusions

The multifocal Tecnis IOL provides excellent near vision and good distance vision in patients with cataract. However, most patients required a neuroadaptation period of approximately 6 months to experience full visual benefits of the lens. (Eur J Ophthalmol 2009; 19: 762–8)