bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and patient tolerability of preservative‐free latanoprost compared with preservative prostaglandin analogs in patients with ocular hypertension or glaucoma
Authors: El Ameen A. , Vandermeer G. , Pisella P.J.
Published: September 2016

Purpose

The purpose of this study was to compare the local tolerability of the preservative‐free (PF) latanoprost with other preservative prostaglandin analogs (PGA) for the treatment of open‐angle glaucoma and ocular hypertension.

Methods

In this prospective study, until now 125 eyes of 63 patients treated with a PGA monotherapy were included and for 16 of them treatment was switched for PF latanoprost. Ocular subjectve symptoms were evaluated. Non invasive tear break‐up time (NIK BUT), tear meniscus height (TMH), conjunctival hyperemia in Keratograph 5M® and intraocular pressure (IOP) were measured at baseline and 6 months after commencing treatment with PF latanoprost.

Results

Mean conjonctival hyperemia was slightly higher with preservative latanoprost (1.19) and significantly higher with the preservative travoprost (1.34; p = 0.013) and bimatoprost (1.33; p = 0.05) than PF latanoprost (1.06). The two most frequent subjective symptoms (burning upon instillation and conjunctival hyperemia between instillations) were less reported with PF latanoprost than with other preservative PGA. After 6 months of treatment with PF latanoprost, in patients with prior travoprost monotherapy, mean conjonctival hyperemia (1.31 vs. 1.13; p = 0.04) and TMH (0.29 vs. 0.32; p = 0.04) improved significantly. In patients with prior preservative latanoprost monotherapy, TMH improved (0.31 vs. 0.35 p = 0.03). There was no statistical significant difference on IOP at 6 months between PF latanoprost and preservative latanoprost (16.3 ± 3.5 vs. 15.8 ± 3.1 mmHg; p = 0.07) and travoprost (15.8 ± 2.5 vs. 15.5 ± 1.5; p = 0.6).

Conclusions

These preliminary results show that PF latanoprost has better subjective and objective local tolerance than preservative PGA. Switching to PF latanoprost seems to maintain IOP at the same level as preservative PGA but improve ocular surface toxicity.
Unexplained vision loss with intra‐ocular silicone oil tamponade in situ: a case series
Authors: Silvester A. , Cazabon S.
Published: September 2016

Purpose

Silicone oil provides a long‐lasting retinal tamponade which is of particular benefit when attempting to repair complex retinal detachments associated with proliferative retinopathy and giant retinal tears. There have been reports of sudden unexplained visual loss secondary to the use of silicone oil tamponade, often after removal of silicone oil, which is typically severe and permanent. We report a case series of patients who lost vision with silicone oil tamponade in situ.

Methods

Observational report and analysis of three cases of unexplained vision loss with silicone oil tamponade in situ for retinal detachment surgery.

Results

Three cases of unexplained vision loss with silicon oil tamponade were analysed. Two were male and the average age was 55 (51–62 years). 2 cases were macular on retinal detachments. 3 months post operatively, visual acuity was 6/9 in two cases and 6/12 in the third case with silicone oil in situ. Silicone oil 2000cs was used in all cases and the primary success rate was 100%. All had normal intra ocular pressure, fundal examination and optical coherence tomography at 3 months. Loss of vision occurred at 5 months post‐surgery with silicone oil in situ in all three cases. Visual acuities dropped to 6/60, 6/36 and 6/36 respectively. Silicone oil was removed in all cases and visual acuities were 6/36, 6/60 and 2/60 at 1 year following silicon oil removal. Electro‐diagnostic tests confirmed reduced macular function in the affected eyes.

Conclusions

Unexplained vision loss secondary to silicone oil tamponade is severe and permanent. The etiology is still unknown and further work is required to identify the incidence and potential risk factors for this devastating phenomena. A better understanding of this condition would enable us to manage these cases more appropriately and reduce the likelihood of it occurring.
Blepharospams treated with eyelid suspension: long terme follow up and outcomes
Authors: Lathiere T. , Robert P.Y. , Adenis J.P.
Published: September 2016

Purpose

Blepharospasm is defined as a located form of dystonia which is best medically treated with botulinum toxin injections.

Methods

Our study concerned patients suffering from blepharospasm and operated of eyelid suspension because of botulinum toxin insufficiency, and their follow up over many years.

Results

The mean time between blepharospasm diagnostic and surgery was 43.8 months. 76% of patients needed new toxin injections after a mean time of 3.5 months after surgery. A new surgery was performed because of late overcorrection for 28% of patients, with a mean time between the two surgeries of 64 months.

Compared with previous studies, our patients population was similar, the patient rate retreated with toxin was high but lower than the 100% generally described. The long terme re‐operation rate was high in our study. This over‐correction could be linked to a blepharospam decreasing intensity after a many years evolution.

Conclusions

Most patients operated of eyelid suspension for blepharospasm need new botulinum toxin injections but some can be over‐corrected in case of pathology relief after many years of progression.
OPA1 analysis in an international series of probands with bilateral optic atrophy
Authors: Liskova P. , Tesarova M. , Dudakova L. , Stepanka S. , Kolarova H. , Honzik T. , Seto S. , Votruba M.
Published: September 2016

Purpose

To determine the molecular genetic cause in previously unreported probands with optic atrophy from the United Kingdom, Czech Republic and Canada.

Methods

OPA1 coding regions and flanking intronic sequences were screened by direct sequencing in 44 probands referred with a diagnosis of bilateral optic atrophy. Detected rare variants were assessed for pathogenicity by in silico analysis. Segregation of the identified variants was performed in available first degree relatives.

Results

A total of 29 heterozygous mutations evaluated as pathogenic were identified in 42 probands, of these 7 were novel. In two probands only variants of unknown significance were found. 76% of pathogenic mutations observed in 30 (71%) out of 42 probands were evaluated to lead to unstable transcripts resulting in haploinsufficiency. Three probands with the following disease‐causing mutations c.1230 + 1G>A,c.1367G>A and c.2965dup were documented to suffer from hearing loss and/or neurological impairment.

Conclusions

OPA1 gene screening in patients with bilateral optic atrophy is an important part of clinical evaluation as it may establish correct clinical diagnosis. Our study expands the spectrum of OPA1 mutations causing dominant optic atrophy and supports the fact that haploinsufficiency is the most common disease mechanism.
Macular OCT features in eyes with VKH disease
Authors: Diwo E. , Stoykova V. , Massamba N. , Le Hoang P. , Bodaghi B.
Published: September 2016

Purpose

To describe choroidal and retinal patterns evaluated with SD‐OCT in patients with Vogt‐Koyanagi‐Harada (VKH) disease.

Methods

We included all patients with VKH disease according to the international workshop on VKH and referred to Pitie‐Salpetriere Hospital between December 2014 and June 2015, for whom SD‐OCT was performed. Data collection consists of assessing the best corrected visual acuity (BCVA), the dosages of corticosteroids and immunosuppressors as well as the description of retinal and choroidal thickness and architecture.

Results

Thirty eyes of 15 patients, 12 females and 3 males, with an average age of 44.5 years were included. The main uveitis follow‐up was 7.1 years. Two thirds of uveitis cases were chronic. The mean VA was 0.42 logMar. OCT features were macular edema (16.7%), external limiting membrane disruption (36.7%), atrophy of nuclear layers (13.3%), ellipsoid line disruption (36.7%), retinal pigment epithelial hyperplasia and atrophy (26.7% and 16.7%), serous retinal detachment (16.7%), choroidal folds (13.7%), Sattler's and Haller's layers disorganisation (60% and 43%). Retinal and choroidal thicknesses were 259.3 μ and 325.1 μ respectively. The proportion of eyes with ellipsoid disruption, pigment epithelium atrophy and alterations of choroidal layers was more important in the group of eyes with VA superior or equal to 0.4 logMar. Uveitis duration in the first group was superior compared to the second group (5.2 vs. 11.2 years). The degree of inflammation, based on laser flare meter values, was similar.

Conclusions

Severe retinal damages seem not to be so common and are frequently associated with poor visual acuity. Haller and Sattler layers alteration are common in acute and chronic cases of VKH disease. Starting rapidly corticosteroid treatment or/and immunosupressors is necessary to avoid these irreversible damages.
Hyperhomocysteinemia caused chorioretinal vasculopathy in an animal model
Authors: Lee Y.J. , Ke C.Y. , Lin P.K.
Published: September 2016

Purpose

Many reports have suggested that hyperhomocysteinemia is a risk factor for atherosclerosis. Some of the reports further indicated that hyperhomocysteinemia was associated with neural degenerative diseases and even age‐related macular degeneration (AMD). However, the pathogenesis of AMD has not been elucidated clearly yet. We therefore established an animal model to mimic hyperhomocysteinemia status in vivo. Morphological changes of chorioretina, and possibly involved growth factors were investigated in this study.

Methods

The hyperhomocysteinemia animal model was generated by administering various doses of homocysteine via intravenous injection to Sprague‐Dawley rats. Chorioretinal images from the rat models in the different treatment groups were recorded, and fluoresceine angiographies (FAG) were done. Histological examinations of the retina and choroid were also performed. Immunofluorescent studies were used to investigate the expression levels of vascular cell markers and different types of vascular endothelial growth factors (VEGF).

Results

Significantly prominent choroidal vasculatures with congestion and retinal vascular disorders were observed in the chorioretinal images and FAGs of the hyperhomocysteinemic animals. The choroidal capillary plexuses were disclosed expanded and vascular endothelial cells proliferated in the histological examinations. We also found the expressions of VEGF and placental growth factor (PlGF) were both upregulated in the eyes of the animals.

Conclusions

Hyperhomocysteinemia caused choroidal vascular proliferation. VEGF and PlGF might mainly mediate this situation, and PlGF played a key role in that.
Update on IC3D classification
Authors: Nowinska A.
Published: September 2016

The lecture presents clinical, histopathological and genetic information on corneal dystrophies based on 2008 and 2015 International Classification of Corneal Dystrophies (IC3D). Corneal dystrophies are presented chronographically based on new, modified, anatomic classification proposed by the authors of the IC3D Classification. Clinical data of each dystrophy consists of former alternative names and eponyms, onset, course of the disease, signs, symptoms, optical coherence tomography and confocal microcopy analysis results. Genes and mutations linked to each CD would be presented as well as the histopathological data. The lecture also contains the summary of what was changed in the 2015 IC3D compared to the 2008 IC3D Classification.
The marine n−3 PUFA DHA evokes cytoprotection by inducing autophagy and NFE2L2 in human retinal pigment epithelial cells
Authors: Bjorkoy G.
Published: September 2016

Accumulation of misfolded proteins is the hallmark of neurodegenerative diseases. Age‐related macular degeneration (AMD) is a leading cause of central blindness and improved primary prevention and treatment options are needed.

The initial phase of AMD associates with accumulation of intracellular lipofuscin and extracellular protein deposits (drusen). Epidemiological studies have suggested an inverse correlation between dietary intake of marine n−3 polyunsaturated fatty acids (PUFAs) and the risk of AMD. Autophagy is a major cellular mechanism for degradation of damaged intracellular components and has a cytoprotective role. In human retinal pigment epithelial cells we find that the n−3 PUFA docosahexaenoic acid (DHA) induces a transient increase in the oxidative stress response regulator NFE2L2/NRF2. Simultaneously, there is a increase in autophagy of intracellular protein aggregates containing SQSTM1/p62. DHA rescues the cells from arrest induced by misfolded proteins or oxidatives stress in a autophagy and NFR2 dependent manner. These results suggest that DHA both induces endogenous antioxidants and mobilizes selective autophagy to reduce the risk of developing aggregate‐associate diseases like AMD.
Splice‐site mutation in the Bmpr1b gene of the mouse causes optic nerve head dysgenesis and retinal gliosis
Authors: Graw J. , Yan X. , Amarie O.V. , Puk O. , Sabrautzki S. , Klaften M. , Thiele F. , Fuchs H. , Hrabe de Angelis M.
Published: September 2016

Purpose

A novel splice‐site mutation of the Bmpr1b gene was characterized in offspring of N‐ethyl‐N‐nitrosourea (ENU) ‐treated mice; besides irregular limb morphology the mutants show an enlarged optic nerve head.

Methods

Eye development of Bmpr1b mutants was analyzed for Bmp signalling via SMAD1 and 5, and for the expression of PAX2 as a transcription factor important for proper optic nerve head development.

Results

BMP signalling indicated by the presence of phosphorylated SMAD1 and 5 was first observed in a few regions of the developing lens capsule and of the developing retina of mouse embryos at day 11.5 after fertilization. At this stage, no differences in SMAD1/5 phosphorylation have been observed between wild‐type mice and the mutants. However, at the end of embryonic development (E17.5) and in the first days after birth (P7), higher concentrations of phosphorylated SMAD1/5 proteins are found at the optic nerve head region, whereas in the Bmpr1b mutants, the BMP signalling is dramatically reduced indicated by a significant loss of pSMAD1/5 staining. The clear reduction of the pSMAD1/5 in heterozygous and homozygous Bmpr1b mutants leads to a stronger optic disc cupping and to the formation of retinal gliosis indicated by the presence of disorganized and activated astrocytes. Loss of BMP‐mediated signalling in the Bmpr1b mouse mutants is also accompanied by a decrease of Pax2 expression at the optic nerve head region towards the end of embryonic development resulting in an additional line of arguments for the rather specific effect at the optic nerve head.

Conclusions

The T‐G mutation in the splice donor site of exon 10 of the Bmpr1b gene leads to retinal gliosis and hypoplasia of the optic nerve head, which is mainly caused by the repression of BMP‐mediated signalling.
ROP laser treatment based on fluorescein angiography classification
Authors: Guagliano R. , Barillà D. , Bertone C. , Maffia A. , Verticchio Vercellin A.C. , Bianchi P.E.
Published: September 2016

Purpose

To report laser treatment of babies with retinopathy of prematurity (ROP) based on diagnostic signs in the fluorescein angiography images (FA). FA reliability and accuracy were previously demonstrated [EJ opht 2013; 23(6):881–886].

Methods

This is a cross‐sectional study with retrospective diagnostic data from 72 eyes of 36 premature infants (average gestational age: 26 weeks; average birth weight: 742 g) with Type 1 ROP stage 2 evaluated by RetCam3 and FA. RetCam funduscopic images were compared with FA images. A grid with ocular fundus divided into 3 concentric zones (ICROP 1984–87) and into 4 quadrants centered on optic nerve was superimposed on 360° retina photomontages (Photoshop) obtained from the RetCam and FA images. The FA diagnostic signs included leakage, ischemic areas, peripheral plus disease and vascular anomalies. These signs were not detectable in the RetCam images of the same patients. A scoring system was derived considering the presence (1) or absence (0) of the diagnostic signs. The scores of each single sign were summed to obtain a total score for each quadrant. These scores were then summed to get the global score of each eye. Three different fluorangiographic categories were defined in ROP stage 2 (fundoscopic image): mild (score < 4), medium (4 ≤ score ≤ 10) and severe (score > 10).The decision of either laser‐treatment or observation was made based on this FA classification.

Results

58 eyes were classified as severe stage 2, 22 as medium and 14 as mild. Complete (360°) and partial (90° or 180°) laser‐treatments were performed in severe and medium ROP, respectively; for mild ROP closely observation was preferred.

Conclusions

FA classification is a useful tool to detect early signs of ROP progression to threshold disease. It improves treatment timing and extension in order to obtain the best anatomical and functional outcomes.
Spectrum and outcomes of open globe injuries presenting to a tertiary Eye Centre in Singapore
Authors: Goh M.J. , Chaung J. , Koh V. , Sundar G.
Published: September 2016

Purpose

To study the demographics and clinical outcomes of consecutive open globe injuries presenting to a tertiary centre in Singapore.

Methods

Data was prospectively collected for all open globe injuries presenting to a tertiary ophthalmology unit in Singapore between January 2014 and December 2015. Main clinical outcomes were the interval to surgical intervention and visual outcome at 6 months.

Results

We collected 11 cases with a mean duration of follow‐up of 6.5 ± 3.9 months. The mean age was 42.9 ± 22.3 years and 81.8% were male. 10 cases (90.9%) were from industrial accidents and the remaining 1 (9.1%) was due to a fall. Eye protection was worn in only 27.3% (n = 3) of cases. Indications for surgery included penetrating injuries (n = 7), intraocular foreign bodies (IOFB) (n = 3) and globe rupture (n = 1). Nearly all cases (n = 10) sought medical attention within 7.4 ± 5.7 h of the injury, and the mean interval to surgical intervention in these cases was 4.1 ± 2.6 h. The remaining 1 case presented 1 week after the injury, and underwent surgery 5 days after presentation, for a metallic IOFB impacted in the sclera. No cases developed endophthalmitis. The mean number of surgeries required was 1.6 ± 0.7. At presentation, the mean visual acuity (VA) in the affected eye was 2.0 ± 1.1 logMAR and the mean ocular trauma score was 68.7 ± 17.5. There were 8 cases (72.7%) remaining to follow‐up at month 6, with a mean VA of 0.98 ± 1.12 logMAR, and 7 of 8 cases (87.5%) showed improvement in VA compared to presentation.

Conclusions

In our study, open globe injuries in Singapore are quite uncommon, occurred predominantly in males, often secondary to industrial accidents, and use of eye protection was often inadequate. In a tertiary ophthalmology practice, the majority received prompt surgical repair and had improvement in visual acuity at 6 months follow‐up.
Chondro‐keratoprosthesis: an alternative to OOKP?
Authors: Hoffart L. , Guyot L.
Published: September 2016

Purpose

To evaluate the use of cartilage as a potential graft material in order to explore a new approach toward osteo‐odontal tissue replacement in keratoprosthesis surgery

Methods

We describe a modification of the osteo‐odonto‐keratoprosthesis that involves the use of autogenous auricular conchal cartilage graft (ACCG) in 2 patients. In stage 1, ACCG was harvested via a posterior approach. Then, an optical polymethyl‐methacrylate cylinder was embedded into a double‐layered fragment of the conchal cartilage and secured by cyanoacrylate glue. The optical cylinder and cartilage complex were then implanted into the cheek. The stage 2, performed 2–4 months later, involved retrieval of the complex and implantation into the cornea, after reflection of the buccal mucosal flap, corneal trephination, iris and lens removal, and anterior vitrectomy. Cartilage specimens were then processed for histological evaluation after retrieval.

Results

We report 2 cases of chondro‐keratoprosthesis (CKPRO) who underwent surgery with a 9 months follow‐up following a bilateral limbal stem cell deficiency associated with severe corneal changes. On patient 1, vision was improved to 20/100 J6 during the follow‐up. On patient 2, postoperative visual acuity stay limited to LP related to preoperative retinal lesions. During the follow‐up, any postoperative complication as extrusion, epithelial downgrowth, retrocorneal membrane or endophtalmia was observed.

Conclusions

ACCG could be a good alternative to replace osteo‐odontal graft in keratoprosthesis surgery especially in young patients with healthy teeth. ACCG has already been widely used for reconstructive surgery and provides safe and stable support to the optical cylinder. However, further comprehensive studies with larger sample size and longer follow‐up are required.
Nanoparticles for ocular surface drug and gene delivery
Authors: Kompella U.B.
Published: September 2016

Topically applied liquid formulations disappear rapidly from the eye surface due to nasolacrimal drainage. Along with the drop, the drug molecules including small molecules as well as macromolecules such as gene medicines are expected to clear rapidly, depending on their tissue affinity and rate of entry. Nanoparticles offer unique approaches to enhance and sustain ocular drug delivery following topical administration, especially for drug molecules with poor solubility or poor permeability and partitioning in eye tissues. Additionally, drug administration by invasive approaches are also feasible for ocular surface drug and gene delivery. When a drug is administered in its soluble form, it is likely to disappear rapidly from the site of injection. Nanoparticles are useful in such circumstances to sustain drug delivery. This presentation will provide an overview of nanoparticles including those based on pure drug as well as carrier materials for enhancing and sustaining ocular surface drug and gene delivery following topical or invasive administration.
Retinal toxicity by intravitreal liquid perfluorocarbon
Authors: Montero Moreno J.A. , Ruiz‐Moreno J.M. , Fernandez‐Munoz M. , Amat‐Peral P.
Published: September 2016

Purpose

To report retinal changes in a population of patients who had undergone vitreoretinal surgery using liquid perfluorocarbon (LPFC).

Methods

Single centre, retrospective study. The clinical records and images of patients who had undergone vitreoretinal surgery during the 36 months prior to the sanitary alert issued by the Spanish Health Authorities on ALA OCTA LPFC were revised.

Results

Four different brands of LPFC had been used during the 36 months period, including ALA OCTA. 128 patients were identified who had undergone vitreoretinal surgery with LPFC of whom 44 had been treated with ALA OCTA. None of the eyes fulfilled the diagnostic criteria of the sanitary alert issued by the Spanish Health Authorities (no light perception + retinal necrosis + optic disk atrophy). No sign of retinal necrosis or severe ocular inflammation was identified in any of the eyes treated with any of the brands during postoperative follow‐up or at the final visit. Optic disk atrophy was identified in 6 eyes, and limited venous sheathing was observed in one eye treated with ALA OCTA vs. no cases in eyes treated with other brands. SDOCT revealed retinal ganglion cell layer vacuolization in eight eyes and inner nuclear layer vacuolization in five eyes treated with ALA OCTA.

Conclusions

A range of retinal lesions were identified in patients operated on with the aid of LPFC. These changes and lower final visual acuities were more frequently observed but were not exclusive among eyes treated by ALAOCTA LPFC. LPFC toxicity must be carefully evaluated in a case‐by‐case basis in order to elucidate the role of LPFC and other factors involved
Alterations of retinal vessel size after single injection of intravitreal anti‐VEGF for diabetic macular edema
Authors: Akpolat C. , Kurt M. , Cekic O.
Published: September 2016

Purpose

To determine the affect of single injection of intravitreal anti‐vascular endothelial growth factor on the retinal vessel caliber in eyes with diabetic macular edema.

Methods

Overall 32 patients were enrolled in ranibizumab group, 30 patients were included in bevacizumab group. Each of these groups also was divided into two others consisting of study group and control group. The study groups were composed of injected eyes while the non‐injected fellow eyes served as control group. The patients underwent complete ophthalmic examinations including optical coherence tomography and fundus fluorescein angiography. The primary outcome measures were central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE) and artery‐to‐vein ratio (AVR).

Results

In ranibizumab study group (n = 32), pre‐injection mean CRAE (175.42 μm) decreased to 169.01 μm at one week and to 167.47 μm at one month (p < 0.001) while baseline CRVE (235.29 μm) decreased initially to 219.90 μm at one week then to 218.36 μm at one month (p < 0.001). In bevacizumab study group (n = 30), pre‐injection CRAE (150.21 μm) decreased to 146.25 μm at one week and to 145.89 μm at one month (p < 0.001) while baseline CRVE (211.87 μm) decreased initially to 204.59 μm at one week then to 205.24 μm at one month (p < 0.001). Pre‐injection AVR values changed significantly (p = 0.001) at one week and at one month in ranibizumab group, but no significant alteration of AVR was observed in bevacizumab group (p = 0.433). In the control groups of both ranibizumab (n = 32) and bevacizumab (n = 30), none of the three parameters altered throughout the study period compared to the baseline (p > 0.05).

Conclusions

Both ranibizumab and bevacizumab injection significantly constricted retinal vessel diameters in eyes with diabetic macular edema.
Choroidal nevi classification using swept source optical coherence tomography and infrared reflectance patterns at different wavelengths
Authors: Papastefanou V. , Vázquez‐Alfageme C. , Degli‐Esposti S. , Cohen V.M.L. , Patel P. , Sagoo M.S.
Published: September 2016

Purpose

Retrospective observational study attempting a classification of choroidal nevi according to the different reflectivity patterns on SS‐OCT and examining the differences on infrared imaging at two wavelengths (830 and 1050 nm) among categories.

Methods

OCT and infrared images were obtained on 110 clinically diagnosed choroidal nevi from 108 different patients with two different devices: Spectralis SD‐OCT(Heidelberg) at 830 nm and Atlantis DRI SS‐OCT(Topcon) at 1,050 nm. Based on the reflectivity pattern displayed on SS‐OCT, the lesions were classified by a single grader into: Type A (high reflectivity with optical shadowing), type B (medium reflectivity with partial visualization of scleral boundary) and type C (homogeneous hyporeflectivity with visualization of scleral boundary). Infrared images of the lesions at 830 nm (NIR) and 1,050 nm (IR‐SS) were classified into hyper, iso or hyporeflective.

Results

110 choroidal nevi were classified as follows: 51 (46.4%) as type A, 19 (17.3%) as type B and 30 (27.3%) as type C. 10 lesions (9%) did not fall into either category. In type A, 48 lesions (94%) displayed low reflectance on IR‐SS, but hypereflectivity on NIR. In type B 13(68%) were hypereflective on NIR and iso or hyporeflective on IR‐SS. In type C 28 lesions (93%) were iso or highly reflective on IR‐SS and also iso or highly reflective on NIR.

Conclusions

SS‐OCT allows visualization of the choroidal anatomy and characterization of choroidal nevi into three distinct patterns according to the reflectivity displayed. The reflectance pattern on infrared image was drastically different between the two different wavelengths across the OCT patterns. Type A and B showed opposite reflectance patterns between the two devices, while type C displayed similar hypereflectivity.
Evaluation of choroidal changes in patients with ocular toxoplasmosis using spectral domain optical coherence tomography
Authors: Akpolat C. , Murat M. , Celebi N.
Published: September 2016

Purpose

We aimed to examine the choroidal changes in ocular toxoplasmosis with spectral domain optical coherence tomography (SD‐OCT) using the enhanced depth imaging (EDI) mode.

Methods

The clinical and laboratory data and SD‐OCT images of patients with ocular toxoplasmosis admitted to Dicle University Ophthalmology Department were analyzed retrospectively. The demographic properties as well as the outcomes of visual acuity, intraocular pressure, biomicroscopic findings and dilated fundus examination were noted. The patients were categorized into three groups: active toxochorioretinitis (TCR), inactive TCR and healthy controls. EDI‐OCT images of lesions and choroid in the subfoveal region were obtained in patients with active and inactive TCR; while only the EDI‐OCT images of choroids in subfoveal region were obtained in the control group.

Results

A total of 54 subjects were evaluated including 20 individuals in the control group (7 male, 13 female), 10 patients in active TCR group (8 female, 2 male) and 24 patients in inactive TCR group (16 female, 8 male). The study groups were comparable in terms of age, gender and intraocular pressure (p = 0.862, p = 0.682, p = 0.841). The best corrected visual acuity (logMAR) was significant lower in active TCR group compared to controls (p = 0.003). The best corrected visual acuity and average choroid thickness in the subfoveal region were significantly lower in the inactive TCR group compared to control group (p = 0.001). The average choroid thickness in lesion region was found significantly thicker in active disease compared to inactive ocular toxoplasmosis (p = 0.001).

Conclusions

Monitoring of choroid is possible by EDI technique of SD‐OCT. This method is easily applicable and beneficial in the examining of ocular toxoplasmosis.
Impact of intravitreous bevacizumab injections on perceived quality of life in a cohort of patients with exudative age related macular degeneration: real life results at 4 years
Authors: Montero Moreno J.A. , Arnaiz C. , Martinez‐Perez L. , de la Fuente A. , Gonzalez Uruena C.
Published: September 2016

Purpose

To examine the relationship between visual acuity, number of injections performed and Quality of Life (QoL) outcomes in patients with exudative age related macular degeneration (AMD) treated by intravitreal bevacizumab.

Methods

Single centre, prospective study. This is a prospective study that was performed on 59 patients treated by intravitreal bevacizumab for exudative AMD on a treat and extend regime during four years in real life conditions at a public university hospital. Patients were evaluated by best‐corrected visual acuity (BCVA) using early treatment diabetic retinopathy study (ETDRS) charts, posterior biomicroscopy, and spectral domain optical coherence tomography (SDOCT). In order to evaluate perceived visual quality of life the Visual Functioning Questionnaire‐25 (NEI‐VFQ25) was used prior to any visual test at baseline, at month 6, at month 12 and at month 48.

Results

Twenty patients completed the 4 year follow‐up. Mean age at baseline was 78 years (range 55 to 88). At baseline 11 patients showed bilateral disease (16 patients at month 48). The average number of injections performed was 12 (range 0–48). The average number of ETDRS letters read at baseline was 50.6 (range 1–85, SD 27.3) vs. 49.4 (range 1–82, SD 26.0) by the end of the 48‐month period. The average values in NEI‐VFQ25 in Health and Vision items and those related to Difficulty with Activities were 2.9 and 3 at baseline and at 48 months. The average value in Response to Vision Problems items decreased from 4 to 3.

Conclusions

A mild decrease in BCVA was associated with a similar decrease in the perceived quality of life determined by NEI‐VFQ25 in patients with exudative AMD treated by intravitreal bevacizumab after four years treatment on a treat and extend regime.
The effect of systemic alfuzosin hydrochloride on choroidal thickness and pupil diameter sizes
Authors: Doğan M. , Kutluksaman B. , Karalar M.
Published: September 2016

Purpose

To evaluate and investigate the effects of α1‐adrenoceptor antagonist alfuzosin hydrochloride on anterior and posterior segment findings using Sirius Scheimpflug/Placido photography‐based topography system and enhanced depth imaging spectral‐domain optical coherence tomography (EDI‐OCT).

Methods

This prospective study was performed with newly diagnosed benign prostatic hyperplasia, 25 eyes of 25 patients, initiated alfuzosin hydrochloride, were evaluated in this study. Anterior segment and posterior segment findings were noted at baseline, 1st and 3rd month. Results were compared statistically.

Results

The mean subfoveal choroidal thickness 274.05 μm, and the mean 3 mm nasal thickness to the fovea 267.80 and the mean 3 mm temporal thickness to the fovea was 269.10 μm at baseline and they were 275.7 μm, 269.15 μm and 270.85 μm at 1st month and they were 278.10 μm, 271.40 μm and 273.25 μm at 3rd month, (p < 0.05, for all). The mean schirmer test values were 13.75–12.15 and 11.40 mm (respectively, at baseline, 1st and 3rd month) (p < 0.001). Besides, the mean scotopic and photopic pupil diameter values were 7.91 and 4.88 mm at baseline, and they were 7.47 mm and 4.38 mm at 1st month and 6.62–3.55 mm at 3rd month (p < 0.001).

Conclusions

Alfuzosin caused a significant increase in choroidal thickness measurements. It was determined that significant decreases of scothopic and photopic pupil diameter sizes in pupillography, this reductions can be considered that alfuzosin may effect pupil size with blockade α‐adrenoceptors in iris dilator muscle of humans.
Diabetic retinopathy and hearing loss: results from Korean National Health and Nutrition Survey (KHANES V) (2010–2012)
Authors: Shin Y.U. , Cho H. , Lim H.W. , Seong M. , Kang M.H. , Hong E.H. , Chung J.H.
Published: September 2016

Purpose

Microvascular vascular diseases have known as risk factors of hearing loss. There may be a relationship between diabetic retinopathy (DR) and hearing loss based on their vascular etiology. We investigated the association between hearing loss and severity of diabetic retinopathy.

Methods

For this cross‐sectional, population based study, we used data from Korean National Health and Nutrition Survey (2010–2012). We enrolled adults aged 40 years or more with diabetes. The subjects with conductive hearing loss or missing exam data were excluded. Demographic, socioeconomic, general medical data were used for this analysis. We defined hearing loss using puretone average air‐conducted hearing thresholds. DR was divided into no DR, non‐proliferative DR and proliferative DR. Participants were divided into two groups (middle age (≤60) vs. old age groups (>60)). Association between hearing loss and DR was determined using logistic regression analyses.

Results

1045 subjects (n = 411 in middle age group, n = 634 in old age group) were finally enrolled. Overall, a proportion of hearing loss is 57.2% in no DR, 61.4% in NPDR and 85.0% in PDR. Logistic regression model after adjusting age, sex and other confounding factors showed only age (OR, 1.13, 95% CI 1.01–1.16) and sex (male) (OR 2.99, 95% CI 1.49–6.00) were associated with hearing loss. However, in middle age group, age (OR 1.09, 95% CI 1.04–1.15), sex (male) (OR 4.88, 95% CI 2.01–11.90), the presence of PDR (OR 9.63, 95% CI 2.17–42.59) and noise exposure (OR 1.88, 95% CI 1.03–3.29) were associated with hearing loss, while only age (OR 1.21, 95% CI 1.15–1.26) was significant in old age group.

Conclusions

Our study supports a potential role for microvascular diseases in the development of hearing loss especially in middle aged patients. Retinopathy could be window of various other vascular pathologies.
Outbreak of fungal endophthalmits following cataract surgery
Authors: Moon D. , Lee S. , You Y. , Lee D.
Published: September 2016

Purpose

To report clinical features, microbiology, and treatment outcomes of fungal endophthalmitis following cataract surgery.

Methods

The medical and cytopathologic records of all patients treated by the retina specialists at Nune Eye Hospital (Seoul, Korea) between May, 2014 and February, 2016 were retrospectively reviewed.

Results

Total 13cases of 12 patients transfer to our hospital for management of endophthalmitis following cataract surgery at one local clinic between April 8, 2014 and May 15, 2014. A presenting best corrected visual acuity (BCVA) was various (range, hand motion – 20/40). Surgical managements include vitrectomy, capsulectomy, IOL removal and pre and postoperative intravitreal cocktail (vancomycin, ceftadizime with or without dexamethasone and voriconazole) injection were done. Fungal elements of were detected by direct microscopy in all patients. The final visual outcomes were as follows: 10 of 13 cases achieved ≥20/100 which same or better VA than at the first visit. However 3 of 13 cases resulted in poor VA because of enucleated due to uncontrolled inflammation and retinal detachment (RD), macular hole with RD and corneal ulcer in spite of good surgical outcome, respectively.

Conclusions

Fungal endophthalmitis following cataract surgery is rare but could occur. Therefore the possibility of fungal infection should always keep in mind when postoperative intraocular inflammation occurred. Also, fungal endophthalmitis could occur collectively. If fungal endophthalmitis is suspected or diagnosed, surgical management including IOL removal, total capsulectomy and exhaustive anterior vitrectomy should be performed as soon as possible and long term postoperative management including intravitreal injections and systemic treatment of antibacterial and antifungal agents may thought to be helpful in achieving a good visual outcome.
Clinical precision for follow‐up of glaucoma with PIMD‐2 Pi
Authors: Sandberg Melin C. , Malmberg F. , Söderberg P.
Published: September 2016

Purpose

To estimate sources of variation in measurements of the waist of the retinal ganglion cell axons in the optic nerve head (ONH) over 2π, PIMD‐2π, and the consequences for clinical follow‐up.

Methods

The ONH of each of 18 eyes from 18 glaucoma subjects was imaged 3 times with SD‐OCT (Topcon 3D OCT 2000, Japan, protocol 3D‐Disc cube) at 2 separate occasions within 3 months. PIMD‐2π was segmented 3 times with a custom semi‐automatic algorithm. The magnitude of the variation among occasions, volumes and segmentations was estimated with an analysis of variance. The consequences of the estimated sources of variation for clinical follow‐up was finally modelled, assuming a PIMD‐2π loss rate of 10% of baseline and one segmentation of PIMD‐2π. The significance level was set to 0.05.

Results

The variance for volumes was estimated to be on the order of 0.3 of the variance for occasions. The variance for segmentation was negligible compared to the variance for volumes. A significant change of PIMD‐2π from baseline can be detected in 1.5–2 years. Increasing the number of visits per year from 1 to 4 substantially improves the detectability of PIMD‐2π change from baseline. More than 4 visits per year does not improve the detectability further. Increasing the number of volumes per visit does not improve detectability.

Conclusions

Within‐subject morphometric estimation of the waist of the retinal ganglion cell axons in the ONH as PIMD‐2π has potential as a useful estimate for follow‐up of glaucoma.
Management of acute corneal hydrops in keratoconus with pre‐Descemet's membrane sutures
Authors: Brehon A. , Stephan S. , Nguyen Kim P. , Cochereau I. , Gabison E.
Published: September 2016

Purpose

To report three cases of corneal hydrops in patients with keratoconus that were managed with pre‐descemet's membrane (DM) sutures associated with intracameral air injection assisted with the ZEISS RESCAN 700 surgical microscope under general anesthesia to shorten the period of corneal edema, to achieve corneal stability and to reduce the duration of the use of carbonic anhydrase inhibitor.

Methods

The first patient, a 27‐year‐old man affected by a Down's syndrome associated with a bilateral keratoconus presented with corneal hydrops in his right eye resulting from a central vertical tear in DM. Three horizontal pre‐DM sutures were performed. The second patient, a 26‐year‐old man affected by a Down's syndrome associated with a bilateral keratoconus presented with corneal hydrops in his left eye resulting from a central horizontal tear in DM. Five vertical pre‐DM sutures were achieved. The third patient, a 43‐year‐old woman with bilateral keratoconus presented with corneal hydrops in her left eye resulting from a central vertical tear in DM. Four horizontal pre‐DM sutures were achieved.

Results

One month after the pre‐DM sutures, the edema resolved clinically and the pachymetry dramatically decreased on anterior segment OCT. The visual acuity of the Two first patients, while subjectively improved, were not measurable, the third patient visual acuity improved from counting fingers at 1 foot to 1,4logMAR at 20 foots from day one to month six.

Conclusions

Intrastromal pre‐DM sutures and intracameral air injection could promptly restore imperviousness of posterior stroma. This technique seems to be a useful procedure to shorten acute corneal hydrops. This impressive clinical response to stromal sutures led us to hypothesize that the pathogenesis of corneal hydrops may correspond to an acute ‘fracture’ of the corneal stroma secondarily leading to DM tear.
The evaluation of intrastromal MyoRing implantation with corneal collagen cross‐linking in keratoconus treatment
Authors: kazakbaeva G. , Bikbov M. , Usubov E.
Published: September 2016

Purpose

To evaluate functional results of MyoRing implantation with corneal collagen cross‐linking for progressive keratoconus and to find differences in clinical outcomes between the group after Myoring implantation and the group after combined procedure.

Methods

The corneal MyoRing implantation with corneal collagen cross‐linking was performed in 71 eyes with progressive keratoconus of the II‐III disease degree according to the Amsler classification. MyoRings were implanted using a Pocketmaker keratome. Saturation of the cornea was performed with 0.1% riboflavin within 10–15 min. UV irradiation was done after implantation of Myoring for 30 min. Mean thickness of the cornea at the thinnest point was 478 μm. The follow‐up period was 24 months.

Results

UCVA increased from 0.10 ± 0.06 to 0.39 ± 0.21, in the first day after surgery. Refractive power of the cornea decreased from 51.85 ± 5.57 D to 44.55 ± 5.89 D. The spheroeqivalent (SE) preoperatively decreased from −7.79 ± 3.59 D to 0.14 ± 2.92 D. Dynamic observation after 24 months showed stabilization of clinical and functional results. UCVA was 0.50 ± 0.28, Keratometry – 45.53 ± 4.08 D and SE was −1.80 ± 2.98 D.

Conclusions

Combination of CXL and MyoRing implantation can be an effective approach for keratoconus treatment by providing visual rehabilitation. Intrastromal corneal MyoRing implantation with corneal collagen cross‐linking allows correct not only the keratoconus followed ametropia but also to slow down the progression of the disease.
Electric shock‐induced retinal vein occlusion: a propos of two cases
Authors: Ascaso F.J. , Bartolomé I. , Berniolles J. , Esteban O. , Martínez M. , Almenara C. , Sánchez I. , Honrubia A. , Núñez E.
Published: September 2016

Purpose

Ocular damage after electric injury is a rare complication. The most commonly described damages are cataract, papillitis, and more rarely vascular complications. Optic nerve and retina have a low resistance, what can lead easily to their damage, affected by ischemia resulting from coagulation and necrosis from vascular structures.

Methods

We report two cases of middle aged, otherwise healthy men, who suffered an episode of retinal vein occlusion, both occurring following a low‐voltage shock. Both patients came to the Emergency department complaining a decreased visual acuity without any systemic damage due to the electric injury.

Results

Both patients were diagnosed of a retinal vein occlusion and underwent intravitreal therapy with corticosteroids and antiangiogenic drugs. They were followed for 4 and 5 years and kept a visual acuity of 0.2 and 0.8, respectively.

Conclusions

Ophthalmologists should be aware of an infrequent complication such as retinal vein occlusion when receiving a patient who has suffered an electric injury.
The retinal macroglia in hypercholesterolemic rabbits: neuroprotective effect of a non‐lipid‐lowering statin dose
Authors: Fernandez‐Navarro J. , Rojas B. , de Hoz R. , Ramirez A.I. , Gallego B.I. , Salazar J.J. , Triviño A. , Ramirez J.M.
Published: September 2016

Purpose

To evaluate the pleiotropic effects of low‐dose statins in the morphology of retinal macroglia in long‐term hypercholesterolemic rabbits and to quantify treatment‐induced astrocyte changes.

Methods

New Zealand rabbits were split into three groups: Control (G0; n = 10), fed a standard diet; Hypercholesterolemic (G1; n = 8), fed a 0.5% cholesterol‐enriched diet for 8 months; and Statins (G2; n = 8), fed a 0.5% cholesterol‐enriched diet for 8 months together with the administration of fluvastatin sodium or pravastatin sodium at a dose of 2 mg/Kg/day each. Eyes were processed for immunohistochemistry using anti‐GFAP. The retinal area occupied by astrocytes was quantified.

Results

Müller cells and astrocytes were reactive in G1 and G2. In contrast with G1, no GFAP+ Müller cells forming glial scar‐like structures were detected in G2. In comparison with G0: i) the retinal area occupied by astrocytes associated with the nerve bundles was statistically reduced in G1 (p < 0.006); however, no significant changes were observed in G2; and ii) the retinal area occupied by perivascular astrocytes in G1 was significantly reduced (p < 0.003) due to the disappearance of perivascular astrocytes from the vessels, but significantly increased in G2 (p < 0.030), given that perivascular astrocytes did not disappear from the vessels and were reactive.

Conclusions

Despite serum cholesterol values remained unchanged, treatment with low‐dose statins preserved retinal macroglia. The pleiotropic effects of the statins seem to help to prevent astroglial death induced by hypercholesterolemia.
The effect of center shift on the measurement of macular thickness: a spectral domain optical coherence tomography study
Authors: Kim J.Y. , Shin K.S. , Lim H.B. , Shin I.H.
Published: September 2016

Purpose

To evaluate the effect of spectral domain‐optical coherence tomography (SD‐OCT) measurement center shift on the measurement of macular thickness.

Methods

Prospective observational case series. A total of 60 normal eyes of 60 subjects included in the study. SD‐OCT macular scanning (macular cube 512 × 128 scan) was performed twice by an experienced examiner. The average retinal thicknesses of the nine macular sectors as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) were recorded. Each coefficient of repeatability was calculated for the macular thickness measurements of the ETDRS subfields. Thereafter, the measurement center was manually decentered to a seven scan point, each from the central fovea in steps of 58.7 μm horizontally and 47.2 μm vertically. At each shift point, the change in the macular thickness was compared.

Results

When the displacement distance between the measurement center point and the foveal center was within 117.4 μm horizontally and 141.6 μm vertically, the macular thickness measurements did not show any significant differences. However, if the offset of the EDTRS grid center from the anatomic fovea exceeded, we noted that the thickness at the fovea increased and the opposite‐direction region at the inner circle was significantly thinner than the displaced point.

Conclusions

The effect of measurement center shift needs to be considered when analyzing the macular thickness measurements in various ophthalmologic diseases.