bluuebunny/crossref_metadata_2025 huggingface dataset:
Helping Older Adults Find Meaning and Purpose Through Storytelling
Authors: Scott Katie , DeBrew Jacqueline Kayler
Published: November 2009

The purpose of this article is to describe a storytelling project that was designed to help community-dwelling older adults find meaning and purpose in their lives through reminiscing about the past. The storytelling project was successful not only for the older adults who participated but also for the nursing students, who were given an opportunity to learn about interviewing and communicating with older adults. The value of life review and storytelling as a nursing intervention became evident from this project. When time is taken to listen to the valuable stories and life lessons of the older population, nurses create a better understanding of their patients while their patients recall special memories and feel proud of their lives.
Rest-Activity Patterns in Institutionalized Korean Older Adults with Dementia: A Pilot Study
Authors: Song Yeonsu , Dowling Glenna A. , Wallhagen Margaret I. , Lee Kathryn A. , Strawbridge William J. , Hubbard Erin M.
Published: November 2009

This pilot study examined rest-activity patterns and related factors in institutionalized older adults with dementia in Korea. Twelve individuals, residing in either a nursing home or an assisted living facility, participated in the study. Actigraphic measurements were collected for seven consecutive 24-hour periods to assess rest-activity patterns. The participants' demographic characteristics, cognitive function, problematic behaviors, and light exposure were also assessed. The results indicated the participants experienced sleep disturbances, including multiple awakenings at night and excessive daytime napping. Those in the nursing home had significantly more interdaily stability and less intradaily variability, with higher relative amplitude in their rest-activity rhythms, indicating more stable and stronger rest-activity rhythms than those in the assisted living facility. These findings emphasize the importance of the institutional environment in care planning to improve sleep and rest-activity rhythm for older adults with dementia.
Health Practices of Older Adults in Good Health:
Engagement Is the Key
Authors: Van Leuven Karen A.
Published: November 2009

Using an interpretive, descriptive method, this study investigated the beliefs, values, lifestyles, and health status of adults age 75 and older who identified themselves as healthy, as well as the interactions with and observations of health care personnel who work with them. Staff participants were drawn from medical offices, a skilled nursing facility, and an assisted living site. Older adults who self-identified themselves as healthy (
n
= 14), as well as those who self-identified themselves as being in fair or poor health but were included per staff recommendation (
n
= 4), were recruited from the sites in which these staff worked. They were interviewed about health, health promotion, health care, and lifestyle. Social engagement appeared to be a strong mediating factor against chronic illness.
Intraoperative Adjustable Suture Surgery for Excyclotorsion: A Modification of the Harada-Ito Procedure
Authors: Ameri Ahmad , Anvari Faramarz , Jafari Alireza K. , Ahadzadeghan Iraj , Akbari Mohammad Reza , Rajabi Mohammad Taher
Published: November 2009

This study evaluated the surgical results of intraoperative adjustable tucking of the anterior portion of the superior oblique tendon for treatment of excyclotorsion. Two cases of acquired bilateral superior oblique palsy with symptomatic excyclotorsion and minimal vertical deviation in primary position were considered. Tucking of the anterior one-third of the superior oblique tendon was performed with a nonabsorbable suture. The amount of tuck was adjusted until the fovea was at the level of the superior one-third of the disc through indirect ophthalmoscopy. In the patient with local anesthesia, a double Maddox rod test was used to evaluate subjective cyclotorsion intraoperatively. After surgery, the patients became symptom-free. No regression toward excyclotorsion was noted during 18 months of follow-up. Tucking of the anterior portion of the superior oblique tendon is an effective procedure for improving symptomatic excyclotorsion in patients with bilateral superior oblique palsy without significant vertical deviation in primary position.
[J Pediatr Ophthalmol Strabismus 2009;46:368–371.]
Photodynamic Therapy in von Hippel–Lindau Disease in Children
Authors: Fortunato Michele , Di Pietro Rossana , Gravina Luciano , Maggi Riccardo , Ubaldi Andrea , Vadalà Pasquale
Published: November 2009

Von Hippel–Lindau disease is characterized by retinal hemangiomas that often produce hemorrhages and retinal detachment. A 10-year-old boy with von Hippel–Lindau disease presenting with telangiectasias, endophytic angiomas, and exudative retinal detachment underwent treatment with retrobulbar steroid injection, laser photocoagulation, and photodynamic therapy, which led to improvement of visual acuity.
[J Pediatr Ophthalmol Strabismus 2009;46:376–379.]
Unusual Presentation of Sympathetic Ophthalmia
Authors: Agarwal Manisha , Chaudhary S. P. , Narula Ritesh , Arneja Kapil , Biswas Jyotirmay
Published: November 2009

The authors describe an atypical presentation of sympathetic ophthalmia in a child caused by multiple surgical interventions in the exciting eye. Optical coherence tomography findings were noted. Early diagnosis and management with intravenous methylprednisolone and immunosuppressants helped in salvaging the only seeing eye of the child.
Choroidal Effusion With Serous Retinal Detachment as a Complication of Strabismus Surgery
Authors: Casteels Ingele , Gobin Carl V.
Published: November 2009

A 12-year-old girl was referred because of unilateral visual loss in the right eye 5 days after uneventful strabismus surgery for a divergent squint. She had hypermetropia of +8 diopters and the axial length of both eyes was below normal for that age. Investigation with funduscopy, central visual field examination, optical coherence tomography, and fluorescein angiography revealed choroidal edema in the affected eye. The macular edema responded well to parabulbar and topical steroids and vision recovered completely within 2 weeks. Strabismus surgery in highly hypermetropic eyes with a small axial length can be complicated by choroidal edema.
Comparison of Optic Disc Topography in Non-Glaucomatous Eyes of Children with Juvenile Diabetes Mellitus and Normal Children
Authors: Elgin Ufuk , Cankaya Bülent , Simsek Tulay , Batman Aygen
Published: November 2009

Purpose:

To compare the optic disc topography parameters of children with juvenile diabetes mellitus and normal children using the Heidelberg Retinal Tomograph (HRT III) (Heidelberg Engineering, Heidelberg, Germany).

Methods:

The topographic optic disc parameters (cup volume, cup area, rim volume, rim area, disc area, mean cup-to-disc ratio, and mean cup depth) of 28 non-glaucomatous eyes of 28 children with type 1 diabetes mellitus and 28 eyes of 28 age-matched healthy children were compared using the nonparametric Mann–Whitney
U
test.

Results:

No statistically significant differences were found between cup volume (
P
= .782), cup area (
P
= .878), rim volume (
P
= .853), disc area (
P
= .452), mean cup-to-disc ratio (
P
= .852), and mean cup depth (
P
= .711) of eyes of cases with diabetes mellitus and normal subjects.

Conclusion:

This result suggests that non-glaucomatous eyes of children with type 1 diabetes mellitus and healthy subjects have similar topographic optic disc characteristics.
Anterior Transposition of the Inferior Oblique Muscle in the Treatment of Unilateral Superior Oblique Palsy
Authors: Keskinbora Kadircan H.
Published: November 2009

Purpose:

To determine whether unilateral inferior oblique anterior transposition alone could be an effective procedure for treating superior oblique palsy with inferior oblique overaction.

Methods:

The records of 38 patients who underwent unilateral inferior oblique anterior transposition for unilateral superior oblique palsy with inferior oblique overaction were evaluated. A comprehensive ocular examination including best-corrected visual acuity measurements, ductions, versions, and deviations at near and distance, head tilt test, abnormal head position, dilated fundus examination, and Titmus test was performed prior to and after surgery.

Results:

The mean patient age was 29 years, the mean follow-up was 32 months, the mean preoperative hypertropia in primary position was 14.29 ± 7.7 prism diopters (PD), and the mean inferior oblique overaction was 3.63 ± 0.67. Anterior transposition of the inferior oblique muscle was effective across a wide range of preoperative primary position hypertropia (4 to 35 PD) with a mean reduction in postoperative hypertropia of 12 PD. Inferior oblique overaction was reduced in all patients. No patient demonstrated postoperative primary position hypotropia. Surgery improved stereoacuity nearly two units using the Titmus stereoacuity scale.

Conclusion:

Anterior transposition of the inferior oblique muscle is effective in correcting inferior oblique overaction and primary position hypertropia in the treatment of unilateral superior oblique palsy.
Atropine Treatment of Amblyopia: Is a Swap in Fixation Necessary?
Authors: Leone Josephine , Georgievski Zoran , Koklanis Konstandina
Published: November 2009

Purpose:

To investigate the impact of fixation on vision outcomes in patients with amblyopia undergoing atropine treatment and the validity of the “cyclo-swap test” (CST) as a method of predicting atropine efficacy.

Method:

Sixteen children with amblyopia were included. The initial examination included a vision assessment and CST, in which fixation was assessed at 1/3 m, 6 m, and at distances less than 1/3 m. Children were treated for 10 weeks and reviewed at 5-week intervals with cessation of atropine 4 days prior. Vision and fixation were assessed at the follow-up visits. Children demonstrating no fixation swap initially were additionally observed after 1 week of atropine treatment under maximum cycloplegia.

Results:

Eight children demonstrated a fixation swap (FS group) to the amblyopic eye during the CST at either 1/3 or 6 m, and 8 demonstrated no fixation swap (NFS group). By the end of the 10-week treatment period, both groups demonstrated a mean visual acuity improvement of between 2 and 3 lines (FS = 0.22 log units; NFS = 0.27 log units). Six of the 8 children in the NFS group demonstrated improvement in vision, all of whom also demonstrated a fixation swap at some stage.

Conclusion:

Vision improvement in patients using atropine is likely to be attributable to a fixation swap that occurs during the treatment phase. The CST performed at 1/3 and 6 m has little value in predicting improvements in vision; however, when performed at distances of less than 1/3 m, it may provide valuable clinical information about atropine efficacy.
Bilateral Retinoblastoma Presenting With Unilateral Phthisis
Authors: Maka Erika , Csákány Béla , Tóth Jeannette
Published: November 2009

Phthisis of the eye is an uncommon presenting sign of retinoblastoma. The authors report a case of bilateral retinoblastoma in a 14-month-old girl who presented with phthisis of the left eye. Enucleation of the painful left eye was performed. Spontaneously regressed, mostly calcified retinoblastoma was diagnosed. The patient underwent chemoreduction. Plaque radiotherapy and transpupillary thermotherapy were applied on the right side. Subsequent ophthalmoscopic examination revealed lesions showing “cottage-cheese” regression. Retinoblastoma should be suspected in any child presenting with phthisis bulbi of unknown origin and a detailed examination of the other eye should be performed.
Comparative Study of Unilateral and Bilateral Surgery in Moderate Exotropia
Authors: Menon Vimla , Singla M. Ashok , Saxena Rohit , Phulijele Swati
Published: November 2009

Purpose:

To evaluate the surgical outcome of unilateral versus bilateral rectus recession for the correction of moderate exotropia.

Methods:

This was a prospective study of 20 consecutive cases of intermittent exotropia ranging from 15 to 25 prism diopters (PD) randomized into two groups and operated on by a single surgeon. In the unilateral group, a recession of 7.0 to 7.5 and 8.0 to 8.5 was done for 15 to 20 PD and 21 to 25 PD of exotropia, respectively. In the bilateral group, a recession of 5.0 to 5.5 and 6.0 to 6.5 mm was done for 15 to 20 PD and 21 to 25 PD of exotropia, respectively. Surgical results of both groups were compared 3 months postoperatively.

Results:

The mean age of patients was 8.5 years in the unilateral group and 11 years in the bilateral group. The mean preoperative exotropia was 21.0 ± 3.77 PD in the unilateral group and 22.9 ± 3.03 PD in the bilateral group. The mean postoperative deviation at 3 months was 5.5 ± 4.03 PD in the unilateral group and 2.8 ± 3.91 PD in the bilateral group. Consecutive persistent small-angle esotropia was seen in one patient in the bilateral group. There was no significant incomitance at 3 months in either group.

Conclusion:

Unilateral and bilateral rectus recession are equally effective in mild to moderate exotropia.
Incidence of Retinopathy of Prematurity in a Neonatal Intensive Care Unit in Nepal
Authors: Shrestha Jyoti Baba , Bajimaya Sanyam , Sharma Anand , Shresthal Jeevan , Karmacharya Purna
Published: November 2009

Purpose:

To determine the incidence of retinopathy of prematurity (ROP) in low birth weight premature infants admitted to the neonatal intensive care unit of a children’s hospital in Kathmandu.

Methods:

A hospital-based prospective study was performed in neonates with a gestational age of less than 36 weeks or birth weight of less than 2,000 g during 1 year. Ophthalmologic examination was performed 2 to 4 weeks after birth and patients were observed until the retinal vascularization was complete. ROP was classified using the revised International Classification of Retinopathy of Prematurity.

Results:

A total of 78 infants fulfilled the screening criteria. ROP was detected in 29.5% (n = 23) of neonates. Thirteen infants (16.7%) had stage 1 disease and 5 each (6.4%) were found to have stage 2 and stage 3 ROP. Threshold disease was present in 3.8% (n = 3) of infants with a gestational age of less than 32 weeks and birth weight less than 1,500 g who required laser treatment per Early Treatment of ROP criteria. Low birth weight (
P
< .01) and low gestational age (
P
< .01) were significantly associated with the incidence of ROP.

Conclusion:

Prematurity and low birth weight were found to be major risk factors for ROP. ROP screening should be performed in such infants for early detection because its incidence is likely to increase as more premature infants survive with improved neonatal care.
Pentacam Scheimpflug Evaluation of Corneal Volume After LASIK
Authors: Gadelha P. Diniz Camila M. , Hazarbassanov Rossen M. , Yamazaki Ester , Murata Celina , Mallmann Felipe , Campos Mauro
Published: November 2009

Purpose:

To assess the change in corneal volume and laser ablation volume over time after LASIK using a rotating Scheimpflug camera.

Methods:

Twenty-six patients (49 eyes) underwent LASIK. Pentacam Scheimpflug measurements were performed pre- and postoperatively at 1, 3, 7, 15, and 30 days. Central corneal thickness, total corneal volume (10-mm diameter), and partial corneal volumes (3, 5, and 7 mm) based on the apex of the cornea, were measured. Main outcome measures were differences between pre- and postoperative volume measurements of total and partial corneal regions, volume changes over time postoperatively, and comparison between laser ablation volume and corneal volume.

Results:

A strong linear relationship was noted between spherical equivalent refraction and laser ablation volume (r=−0.931,
P
<.0001). Furthermore, 30 days after LASIK, a strong linear relationship was noted between planned thickness and achieved thickness (r=0.9457,
P
<.001). Corneal volumes for 3-, 5-, and 7-mm diameter regions significantly decreased over time postoperatively (one-way analysis of variance,
P
<.05).

Conclusions:

Alterations in corneal volume correlated with laser ablation volume when the diameter of the region considered was 3, 5, or 7 mm from the corneal apex.
Sequential in Vivo Confocal Microscopy Study of Corneal Wound Healing After Cross-Linking in Patients with Keratoconus
Authors: Croxatto J. Oscar , Tytiun Adriana E. , Argento Carlos J.
Published: November 2009

Purpose:

To evaluate the short- and long-term sequential histological changes of the cornea in vivo after corneal collagen cross-linking (CXL) in patients with keratoconus.

Methods:

Eighteen patients with keratoconus (Amsler-Krumeich classification: stages I, II, and III) underwent CXL with riboflavin/ultraviolet A (UVA) in one eye. The corneas were examined preoperatively and within 5 hours, 7 and 14 days, and 1, 3, 6, 9, 12, 18, 24, and 36 months after the procedure using in vivo confocal microscopy.

Results:

Early changes included edema, superficial nerve loss, cellular modifications, and isolated endothelial damage. At intermediate time points, there was nerve fiber regeneration, increased reflectivity of the extracellular matrix, enlarged keratocytes and extracellular deposits, and remodeling of the endothelial layer (two eyes). At later time points, loss of keratocytes and remodeling of the extracellular deposits were noted.

Conclusions:

Although the cornea has no significant tissue modifications clinically after CXL, this study has shown that corneal wounding by riboflavin/UVA collagen CXL induces cellular wound-healing mechanisms and alters the normal structure and cellularity of the cornea for up to 36 months.
Intraoperative Videokeratography in Penetrating Keratoplasty and Excimer Laser-Assisted Lamellar Keratoplasty for Keratoconus
Authors: Spadea Leopoldo , Fiasca Arianna , Federici Simone
Published: November 2009

Purpose:

To evaluate the usefulness of intraoperative computerized corneal topographic data in excimer laser-assisted lamellar keratoplasty (ELLK) and penetrating keratoplasty (PK).

Methods:

Prospective, comparative, interventional case series. Intra- and postoperative videokeratography (Keratron Scout) evaluation was performed on 30 eyes of 30 consecutive patients affected by keratoconus (16 men and 14 women; mean age 32.63±8.02 years) submitted to ELLK (15 eyes) using 16 interrupted 10-0 nylon stitches or to PK (15 eyes) using a 12-bite 10-0 nylon double-running continuous suture.

Results:

In the ELLK group, the mean intraoperative keratometric astigmatism was 12.06±4.86 diopters (D), which changed to 5.19±2.51 D after topography-guided intraoperative suture adjustment. In the PK group, intraoperative keratometric astigmatism was 10.18±3.88 D, which changed to 3.49±0.41 D. After 24 months (sutures out), the mean videokeratographic keratometric astigmatism was 3.35±1.96 D in the ELLK group and 3.37±0.92 D in the PK group. The Alpins method of vector analysis showed some significant changes especially in the ELLK group.

Conclusions:

In keratoplasty surgery, videokeratography is useful for suture adjustment. In the PK group, using a double-running suture technique, the postoperative astigmatism (after all sutures were removed) was similar to the astigmatism measured intraoperatively by videokeratography.
Prophylactic Treatment of Age-Related Macular Degeneration Report Number 2: 810-Nanometer Laser to Eyes With Drusen: Bilaterally Eligible Patients
Authors: Friberg Thomas R. , Brennen Peter M. , Freeman William R. , Musch David C. ,   the PTAMD Study Group
Published: November 2009

Background and Objective:

To determine the prophylactic and therapeutic value of a single subthreshold 810-nanometer laser treatment in patients with high risk drusen as a manifestation of dry age-related macular degeneration in both eyes.

Patients and Methods:

The Prophylactic Treatment of Age-related Macular Degeneration study enrolled 1,278 eyes of 639 participants who were 50 years or older with at least 5 drusen 63 µm or more in diameter in each eye. Treatment consisted of the placement of an annular grid of 48 extrafoveal, subthreshold 810-nm diode laser applications centered at but sparing the foveola in one eye of each participant, with the fellow eye serving as a control. Development of choroidal neovascularization and change in best-corrected visual acuity were compared between treated and untreated eyes.

Results:

Subthreshold laser treatment did not decrease the incidence of choroidal neovascularization in treated versus untreated eyes. A modest visual acuity benefit in treated eyes was found at 24 months (1.5 letter difference;
P
= .04) and in the treated eyes of participants with a baseline visual acuity between 20/32 and 20/63 (4.0 letter difference;
P
= .0034). However, this treatment effect was not sustained at 3 years.

Conclusion:

A single subthreshold 810-nanometer laser treatment to eyes of participants with bilateral high risk drusen is not an effective prophylactic strategy against choroidal neovascularization.

[Ophthalmic Surg Lasers Imaging 2009;40:530–538.]
Surgical Outcome of Scleral Buckling Compared With Scleral Buckling With Vitrectomy for Treatment of Macula-off Retinal Detachment
Authors: Dayani Pouya N. , Blinder Kevin J. , Shah Gaurav K. , Holekamp Nancy M. , Joseph Daniel P. , Wilson Bradley , Thomas Matthew A. , Grand M. Gilbert
Published: November 2009

Background and Objective:

To compare the surgical outcome of scleral buckling (group 1) versus scleral buckling with pars plana vitrectomy (group 2) for the repair of macula-off rhegmatogenous retinal detachment without proliferative vitreoretinopathy.

Patients and Methods:

A retrospective chart review was performed.

Results:

Eighty-three patients were identified in group 1 and 63 patients in group 2. Presenting visual acuity was 4/200 in group 1 and 3/200 in group 2. Median duration of detachment prior to surgery was 5 days in group 1 and 6 days in group 2. There was no statistical difference in best-corrected (
P
= .59) or most recent (
P
= .75) visual acuity between groups. Median best-corrected visual acuity was 20/30 and median most recent visual acuity was 20/40 in both groups. Significantly more additional procedures were performed in group 1 than in group 2 (21.7% vs 7.9%, respectively;
P
= .024). The final reattachment rate was 96.4% in group 1 and 98.4% in group 2. Proliferative vitreoretinopathy developed in 15.7% of patients in group 1 and 4.8% in group 2 (
P
= .037).

Conclusion:

Visual outcome of scleral buckling is similar to scleral buckling with pars plana vitrectomy for the treatment of macula-off rhegmatogenous retinal detachment in patients without proliferative vitreoretinopathy. Patients undergoing scleral buckling only are at an increased risk of developing proliferative vitreoretinopathy and requiring additional procedures.

[Ophthalmic Surg Lasers Imaging 2009;40:539–547.]
Spectral Domain Optical Coherence Tomography in Diabetic Macular Edema
Authors: Pournaras Jean-Antoine C. , Erginay Ali , Lazrak Zineb , Gaudric Alain , Massin Pascale
Published: November 2009

Background and Objective:

To compare the images obtained from Stratus time domain optical coherence tomography (OCT) (Carl Zeiss Meditec, Inc., Dublin, CA) and Cirrus spectral domain OCT (Cirrus HD-OCT 4000 model; Carl Zeiss Meditec, Inc.) in patients with diabetic macular edema.

Patients and Methods:

This observational retrospective case series was created using the charts of 20 patients with diabetes mellitus diagnosed as having diabetic macular edema. All patients had both Stratus and Cirrus OCT imaging completed on the same day. Qualitative comparisons were performed by two experienced clinicians in an unmasked fashion. Central macular thickness and central foveal thickness were recorded.

Results:

Thirty-six eyes of 20 patients with diabetes mellitus were analyzed. Features such as cystoid spaces, highly reflective lesions, vitreoretinal interface, serous retinal detachment, and photoreceptors inner/outer segments were more often detected with the Cirrus OCT than with the Stratus OCT. Considering the same reference lines for evaluation of central macular thickness and central foveal thickness, the same values were obtained with both devices.

Conclusion:

Cirrus OCT enables easier observation of normal structures and retinal abnormalities than the Status OCT. Furthermore, lesions may be accurately identified and quantified by the Cirrus OCT.

[Ophthalmic Surg Lasers Imaging 2009;40:548–553.]
Photodynamic Therapy With and Without Adjunctive Intravitreal Triamcinolone Acetonide: A Retrospective Comparative Study
Authors: Chan Annie , Blumenkranz Mark S. , Wu Kathy H. C. , Wang Gloria , Berker Nilufer , Parast Layla M. , Sanislo Steven R.
Published: November 2009

Background and Objective:

To compare photodynamic therapy (PDT) with and without adjunctive intravitreal triamcinolone acetonide (IVTA) in the treatment of choroidal neovascularization secondary to age-related macular degeneration.

Patients and Methods:

Sixty-six eyes received PDT with IVTA and 73 eyes received PDT only. Outcome measures included changes in visual acuity and greatest linear dimension (GLD), the presence of angiographic leakage, the re-treatment rate, and adverse events.

Results:

Patients treated with PDT with IVTA had reduced mean GLD compared to patients treated with PDT only at all study time points (3 [
P
= .0049], 6 [
P
= .003], and 12 [
P
= .05] months). Forty-four percent of patients in the PDT with IVTA group and 22% of patients in the PDT only group achieved angiographic closure at 3 months (
P
= .027). There were no significant differences in the final visual acuity outcome or the re-treatment rate between the two groups.

Conclusion:

PDT with IVTA therapy has a favorable outcome on GLD. There is a modest improvement in visual acuity with PDT with IVTA therapy, which diminishes over time.

[Ophthalmic Surg Lasers Imaging 2009;40:561–569.]
Optical Coherence Tomography Predictors of Retinal Pigment Epithelial Tear Following Intravitreal Bevacizumab Injection
Authors: Moroz Iris , Moisseiev Joseph , Alhalel Amir
Published: November 2009

Background and Objective:

To evaluate the ability of optical coherence tomography (OCT) to predict the risk of retinal pigment epithelium (RPE) tear in patients with choroidal neovascular membrane associated with pigment epithelium detachment treated with bevacizumab.

Patients and Methods:

Retrospective observational case series of 24 consecutive patients treated with bevacizumab. All patients had sequential OCT scans performed before treatment and during follow-up. Six patients developed an RPE tear. Eighteen patients served as the non-tear group.

Results:

Wavy RPE indentations or small interruptions and breaks in the elevated RPE were evident in all six patients who developed an RPE tear, whereas only two of the remaining 18 patients had such findings (
P
< .001).

Conclusion:

Indentations or minute interruptions and breaks in the RPE layer seen on OCT were correlated with increased risk of developing an RPE tear in patients with pigment epithelium detachment following treatment with bevacizumab.

[Ophthalmic Surg Lasers Imaging 2009;40:570–575.]
Polypoidal Choroidal Vasculopathy in Taiwanese Patients
Authors: Chang Yo-Chen , Wu Wen-Chuan
Published: November 2009

Background and Objective:

To investigate the incidence of polypoidal choroidal vasculopathy (PCV) in patients with presumed neovascular age-related macular degeneration (AMD) using indocyanine green angiography (ICGA). The efficacy of photodynamic therapy (PDT) with verteporfin in eyes with PCV and neovascular AMD was also evaluated.

Patients and Methods:

The medical records of 100 patients with neovascular AMD diagnosed according to ICGA findings were reviewed. Patients who underwent PDT were scheduled for follow-up appointments every 2 months.

Results:

Forty-nine (49.0%) and 51 (51.0%) patients were diagnosed as having PCV and neovascular AMD, respectively. The mean age of presentation was younger in the PCV group than in the neovascular AMD group (63.6 vs 69.7 years, respectively;
P
= .002). There were 35 men (71.4%) in the PCV group and 37 men (72.5%) in the neovascular AMD group. Seventeen patients (33.3%) with neovascular AMD had bilateral involvement compared with only 4 patients (8.2%) with PCV (
P
= .004). Twenty eyes with PCV and 22 eyes with neovascular AMD received one PDT treatment. After PDT, 10 eyes (50%) with PCV and 11 eyes (50%) with neovascular AMD experienced visual improvement.

Conclusion:

PCV is not uncommon in Taiwanese patients diagnosed as having neovascular AMD by ICGA and these patients have a younger age of onset, male predominance, unilateral involvement, and macular polyps. Both PCV and neovascular AMD can achieve favorable visual improvement following PDT with verteporfin.

[Ophthalmic Surg Lasers Imaging 2009;40:576–581.]
Distinctive Findings in a Patient With Axenfeld–Rieger Syndrome Using High-Resolution AS-OCT
Authors: Wang Dandan , Wang Mei , Console James W. , He Mingguang , Seider Michael I. , Lin Shan C.
Published: November 2009

Some distinct findings of a patient with Axenfeld–Rieger syndrome from the anterior chamber angle images by high-resolution anterior segment optical coherence tomography (AS-OCT) are described. The typical anterior segment anomalies of Axenfeld–Rieger syndrome, including iris atrophy, posterior embryo-toxon, peripheral bridging tissue bands, trabecular meshwork elongation, and high insertion of the iris root into the posterior trabecular meshwork, can be visualized clearly on AS-OCT images. Specifically, the high-resolution mode of the AS-OCT program had improved performance in outlining finer structures such as the distinctive endothelial membrane covering the iris in Axenfeld–Rieger syndrome, which enabled better understanding of the pathophysiology in the patient. The high-resolution imaging and non-contact method of AS-OCT make it an effective and feasible option in the diagnosis and evaluation of Axenfeld–Rieger syndrome.
[Ophthalmic Surg Lasers Imaging 2009;40:589–592.]
Transscleral Diode Laser Cyclophotocoagulation in a Patient With Ocular Cicatricial Pemphigoid
Authors: Moore Sacha P. , Spiteri Anthony , Booth Adam
Published: November 2009

The authors present a case of secondary glaucoma associated with silicone oil in a patient with ocular cicatricial pemphigoid successfully managed with transscleral diode laser cyclophotocoagulation. Six months following treatment, the patient remained satisfied and free of pain, with an intraocular pressure of 24 mm Hg without topical drops or oral acetazolamide. There was no evidence of exacerbation of ocular cicatricial pemphigoid and no adjustment was required to the patient's immunosuppressive therapy. This case suggests that transscleral diode laser cyclophotocoagulation may be safely used to control raised intraocular pressure in patients with ocular cicatricial pemphigoid without causing an exacerbation of the condition.
[Ophthalmic Surg Lasers Imaging 2009;40:593–596.]
Müller Muscle Conjunctival Resection for Blepharoptosis in Patients With Poor to Fair Levator Function
Authors: Georgescu Dan , Epstein Gil , Fountain Tamara , Migliori Michael , Mannor Geva , Weinberg David
Published: November 2009

It has been suggested that Müller muscle conjunctival re-section might not be a good procedure for the treatment of blepharoptosis in patients with less than optimal levator function. This case series includes four eyelids (three patients) that had fair preoperative levator function (4 to 8 mm) and good response to phenylephrine. The mean preoperative levator function was 6.25 mm and the mean amount of resection was 10.25 mm. The mean preoperative marginal reflex distance was −0.50 mm and the mean postoperative marginal reflex distance was 3.38 mm. Müller muscle conjunctival resection may be effective for treating patients with fair levator function and satisfactory response to phenylephrine.
[Ophthalmic Surg Lasers Imaging 2009;40:597–599.]
Posterior Vitreous Contraction After Cerebral Sinus Thrombosis
Authors: Xu Liang , Xie Xi Wei , Jonas Jost B.
Published: November 2009

The authors describe a 34-year-old woman who presented with headaches and marked papilledema after she had been taking oral hormonal therapy for the treatment of dysfunctional uterine bleeding. Neurological examination led to the diagnosis of a cerebral venous sinus thrombosis. After thrombolytic treatment, the headaches vanished and the papilledema in the right eye disappeared. Visual acuity increased to 20/25 in the right eye and 20/32 in the left eye. However, the marked papilledema in the left eye had resulted in a pronounced contraction of the posterior vitreous at the optic nerve head associated with a secondary folding of the macula and subretinal pigmentary irregularities in the foveal region.
[Ophthalmic Surg Lasers Imaging 2009;40:600–601.]
Polarization-Sensitive Optical Coherence Tomography of Necrotizing Scleritis
Authors: Miura Masahiro , Yamanari Masahiro , Iwasaki Takuya , Itoh Masahide , Yatagai Toyohiko , Yasuno Yoshiaki
Published: November 2009

A polarization-sensitive swept-source optical coherence tomography system (central wavelength: 1,310 nm; A-line rate: 20 kHz) was developed to evaluate the three-dimensional structure of the anterior eye segment with the phase retardation associated with the anterior segment birefringence of the eyes. Evaluation of normal eyes and an eye with necrotizing scleritis was performed. In the sclera of the normal eyes, a striking polarization change was observed in the cumulative phase retardation images and the boundary of the sclera could be readily detected. In the eye with necrotizing scleritis, phase retardation at the sclera was low in an extensive area; this implied diffuse destruction of the collagen tissue in the sclera had occurred. Polarization-sensitive optical coherence tomography is useful as a contrast engine of the anterior eye segment and for the evaluation of pathological change in the sclera.
[Ophthalmic Surg Lasers Imaging 2009;40:607–610.]
Viscous Contact Lens System for Vitrectomy
Authors: Reichel Elias , Nguyen Jackie , Graham Ray , Harrington Pete , Andrews Jeff
Published: November 2009

The authors describe a recently developed system for use in vitreoretinal surgery. The system is compatible with a variety of lens choices, including wide-field, equatorial, and high-magnification direct viewing lenses, allowing for visualization of the far peripheral retina and detailed imaging of the macula. Used with auto-clavable lenses, the system achieves high-resolution image quality at a cost-effective price.
[Ophthalmic Surg Lasers Imaging 2009;40:611–612.]
Population identification of common cuttlefish (Sepia officinalis) inferred from genetic, morphometric and cuttlebone chemistry data in the NE Mediterranean Sea
Authors: Turan Cemal , Yaglioglu Deniz
Published: November 2009

The population structures of the common cuttlefish Sepia officinalis from the north-eastern Mediterranean (Antalya and Iskenderun Bays), Aegean (Izmir Bay) and Marmara Seas were analyzed with mtDNA PCR-RFLP, body morphometry and cuttlebone chemistry. Analysis of a ND 5/6 (Nikotin Amid Adenin Dehidrojenaz-5/6) gene segment of mtDNA revealed seven haplotypes from 120 individuals. No haplotype sharing was observed among sampling sites. The average nucleotide divergence between samples was 0.009390, and the highest genetic divergence (0.015279) was observed between the Iskenderun Bay and Marmara Sea samples. The lowest genetic divergence (0.003786) was between the Aegean Sea and Antalya Bay samples. Highly significant differences (P
Rocky intertidal macrobenthic communities across a large-scale estuarine gradient
Authors: Giménez Luis , Borthagaray Ana Inés , Rodríguez Marcel , Brazeiro Alejandro , Carranza Alvar
Published: November 2009

We evaluated relationships between (1) salinity and species richness and (2) frontal zones and community structure for the rocky intertidal macrobenthic community of the Uruguayan coast. A large-scale sampling design (extent ~500 km) covering 9 rocky shores across 3 intertidal levels was performed between September and November 2002. The linear relationship between salinity and species richness (minimum at the freshwater extreme) and the lack of correlation between variation in salinity and richness rejected two previous empirical models, explaining variations in species richness along the salinity gradient. Other factors (e.g. turbidity) may explain this discrepancy. The estuarine front defined two communities—freshwater and estuarine-marine—differing in species composition and richness. The freshwater community was characterised by low richness and few individuals confined to crevices or tide pools, and must be structured by physical processes (e.g. desiccation); the estuarine-marine community, with individuals occupying almost all available substrata, must be structured by both physical and biological processes. A marine front, separating estuarine and marine habitats, had a weak effect on community structure although estuarine and marine assemblages differed according to species characterising different functional groups. We conclude that the position of the estuarine frontal zones is important for explaining large-scale patterns of community structure in the study area.
Phylogenetic analysis of Petaloptoctus (Maldanidae: Polychaeta), with description of a new species from southeastern Brazil
Authors: De Assis José Eriberto , Lindsey Christoffersen Martin , Da Cunha Lana Paulo
Published: November 2009

We used morphological data for a phylogenetic analysis of the genus Petaloptoctus (Maldanidae: Polychaeta). We found three most parsimonious phylogenetic trees with length = 37, CI = 0.89 and RI = 0.92. The genus Petaloproctus is monophyletic, and is supported by a strongly arched prostomium, pinnate capillary setae, and an anal cup with a reduced dorsal border. Our proposal for the systematisation of the subgroups of Petaloproctus is ((P. tenuis (P. terriculus + P. neoborealis)) (P. ornatus (((P. cirratus + P. dentatus) (P. macrodentatus (P. borealis (P. vallejoi n. sp. + P. socialis)))))). We also regard Nicomachinae as a monophyletic group with the following synapomorphies: prostomium short and arched; nuchal grooves short and curved; cephalic plate lost; anal pore opening on margin of anal plate. Monophyly of Micromaldane and Nicomache was also supported in the analysis. Petaloproctus vallejoi n. sp. has 19 setigerous and one asetigerous pre-anal segment. The prostomium is rounded, forming a keel with curved laterals. Nuchal grooves are short and deep, strongly curved outwards. Each neuropodium has one acicular spine on setigers 1-3. The pygidium has a large ventral border, and a reduced dorsal border. The anus is terminal, and close to the margin of the anal plate, surrounded by divergent folds.
Privatisation of water systems: Crime against humanity
Authors: Mobie Titus R. , Masango Maake
Published: November 2009

This article emphasises the importance of water resources, which are vital to the sustenance of life. Water is essential for various reasons: for drinking, for personal hygiene, for cooking, for watering crops, for cleaning our homes etc. One can therefore conclude that, without this vital resource, there is no life. It is for this reason that God, giver of life, gave water as a gift – free – both to humanity and to the rest of creation, so that we may all achieve fullness of life. This article challenges the fact that, because of the insistence of the World Bank and the International Monetary Fund on the privatisation of water supplies where the poorest of the poor are unable to pay, these people are cut off from water supplies and are deprived of the right to the fullness of life. The author emphasises that there is no life without water, that water resources are a gift from the creator and should therefore be made accessible to all, rich and poor alike.
Polycythemia vera and essential thombocythemia - A single institution experience
Authors: Ross Cecil , Rameshkumar Karuna ,   Navya,   Vanamala
Published: November 2009

Background: In myeloproliferative disorders, occurrence of Janus kinase 2 [JAK2] mutation is a significant factor in pathogenesis in polycythemia rubra vera (PRV) and Essential thrombocythemia (ET). We studied the frequency of JAK2 mutation in patients with PRV and ET and to compare clinical and laboratory features of patients positive and negative for mutation. Patients and Methods: Clinical and laboratory features of PRV and ET patients (WHO criteria) from 1997 to 2004 were included. After morphological diagnosis, presence or absence of JAK 2 mutation was done during follow up and follow up details were recorded. Results: A cohort of 39 patients (ET-17, PRV -14, ET- PRV-8) were identified .The mean age of entire cohort was 55.5+14.5 years. Comparison of clinical and laboratory features showed JAK2 positive patients were older by a decade, had higher frequency of splenomegaly and higher values for hemoglobin (16.5+2.6 gm/dl) and neutrophil counts (14.5+4.8 thousand/μl).During the course of follow up (6 to 106 months; mean 25.5+28.6 months) frequency of thrombotic events in both groups (p value >0.05) was same, though time for occurrence for thrombotic event was shorter in JAK 2 positive patients, which is noteworthy. Conclusions: The identification of JAK 2 mutation probably defines a sub entity in ET with aggressive behavior as evidenced by splenomegaly, higher total counts and transformation to PRV (n=6/8). The onset of JAK2 V617F mutation probably heralds progression to PRV.
Chemoradiation in locally advanced cervical cancer : A randomized trial
Authors: Kundu Sayan , Basu S , Acharya S , Dastidar A , Roy A G
Published: November 2009

Background: Radiation with concurrent chemotherapy (weekly cisplatin) is currently standard of care for locally advanced cervical cancer. Gemcitabine, a pyrimidine analogue is a potentially radio-sensitizing drug. We compared cisplatin and gemcitabine in the treatment of locally advanced cervical cancer. Methods: 90 patients with locally advanced squamous cell cancer of the cervix (stage IIB-IVA) were randomized to receive either cisplatin 40mg/m2 weekly or gemcitabine 150 mg/m2 weekly (45 patients in each arm) along with external beam radiation (50Gy in 25# over 5 weeks). This was followed by three insertions of high dose radiation (HDR) intracavitary brachytherapy one week apart. Results: At a median follow up of 13months, 25 (55.56%) patients were in complete response (CR) in the cisplatin arm compared to 22 patients (48.89%) [p=0.67] in gemcitabine arm. 10 patients (22.22%) in cisplatin arm had either died or lost to follow up compared to 11 patients in gemcitabine (24.44%) arm. Nausea/vomiting was higher in cisplatin arm. Diarrhea, skin reaction and hematological toxicity were more in gemcitabine arm. Conclusion: Cisplatin seems to be a better option than gemcitabine when used concurrently with radiation for locally advanced cervical cancer both in terms of response and toxicity.
Squamous cell carcinoma in bladder extrophy
Authors: Haji Altaf Gauhar , Chitrathara K , Sharma Shekhar , Vijaykumar D , Gangadharan V
Published: November 2009

Extrophy of the bladder is a rare congenital anomaly with an incidence of about 1/50000 newborn. Malignant potential of ectopic mucosa is high. Sixty percent of cancers in ectopic bladder occur during fourth and fifth decade of life, majority being adenocarcinoma (95%). Here we report a case of squamous cell carcinoma of ectopic urinary bladder in a 74-year-old male patient. In view of locally advanced disease, he received neoadjuvant chemotherapy with poor response. He underwent total cystectomy with ileal conduit diversion and continues to be alive and disease free at 36 months interval. The case is being reported on account of its rarity. Pertinent literature is being reviewed.
Merkel cell carcinoma of skin
Authors: Janaki M , Koushik Kirthi , Baby Rekha , Kempiah Venkatesh
Published: November 2009

Merkel cell carcinoma is a rare neuroendocrinal tumour of the skin. It is noted for its typical aggressive nature unlike other skin tumours. Because of the rarity, the treatment is not standardised. Radiotherapy in the postoperative setting is effective in improving the loco regional control. A case of merkel cell carcinoma treated with postoperative radiotherapy is reported. Pertinent literature is reviewed.
Uncommon manifestations of acute lymphoblastic leukaemia (ALL)
Authors: Gomber Sunil , Narang Manish , Dhaliwal Upreet
Published: November 2009

Unusual manifestations often lead to misdiagnosis of patients with acute lymphoblastic leukemia (ALL). We describe two children with ALL having unusual associations. The first case presented with pseudohypopyon after 18 months into her maintenance therapy whereas the other case masqueraded as juvenile rheumatoid arthritis at presentation.
Epstein-barr virus in gastric lymphoma- An Indian perspective
Authors: Sood Abhay , Braganza Abhita , Rajalakshmi T
Published: November 2009

Background: Primary Gastric Non- Hodgkin′s Lymphomas (NHL) are being increasingly encountered in the recent years. While the role of Helicobacter pylori (H. pylori) has been explored in its causation, some studies have suggested the role of the Epstein - Barr virus (EBV). However data from India is not readily available and this prompted us to study the morphology of primary gastric NHL, the prevalence of EBV infection in primary Gastric NHL and study its association with H. pylori infection. Materials& Methods: A retrospective study. Sixteen biopsy proven cases of primary gastric NHL were studied. Histologic features were reviewed. Immunohistochemistry for EBV LMP-1 and Modified Giemsa stain to identify Helicobacter pylori were done. Results: There were 10 low-grade and 6 highgrade lymphomas, 15 of them classifiable as Mucosa-associated lymphoid tissue (MALT) type, owing to the presence of lymphoepithelial lesions. 36% of the cases were EBV positive. Only one case showed H. pylori. 4 patients succumbed to the disease, of which 3 were seropositive for HIV. Conclusion: Our pilot study suggests that EBV may have an important role in the pathogenesis of gastric MALT lymphomas. The significance of this association and its prognostic value need to be explored in larger number of patients.
An unusual penile spindle cell malignancy
Authors: Francis Anju , Rajalakshmi T , Garg Isha , Mohanty Suravi , Anuradha A , Rout Pritilata , Mohan A
Published: November 2009

Primary non-epithelial malignancies of the penis are rare. We report a patient with an unusual presentation of an unexpected spindle cell malignancy at this site. A 35- year-old man presented with a mass in the shaft of the penis with inguinal lymphadenopathy. A malignant spindle cell neoplasm was seen involving the corpora, consistent with leiomyosarcoma. Immunohistochemically, the tumour was positive for S100, HMB-45 and negative for SMA. A final diagnosis of amelanotic spindle cell melanoma was made. This case is being presented to reiterate the importance of including melanoma in the differential diagnosis of spindle cell sarcomas at uncommon sites.