bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of the effects of ocular hypotensive drugs on number of neurons in the retinal ganglion layer in a rat experimental glaucoma
Authors: Villena Alicia , Díaz Florentina , Vidal Lourdes , Moreno Mercedes , Garcĺa-Campos Jose , De Vargas Ignacio Pérez
Published: March 2018

Purpose

We investigated the effects of antiglaucomatous drugs on neurons in the retinal ganglion layer (RGL) in an experimental model of elevated intraocular pressure (IOP).

Methods

Three episcleral veins of rats with normal IOP were cauterized. Three months later, we examined the effects on the number of neurons in the RGL as well as in rats submitted to treatment with timolol, latanoprost, or brimonidine. The IOP was measured using a calibrated Tono-Pen XL tonometer before and immediately after cauterization and every 2 weeks for the following 3 months as well as immediately before perfusion.

Results

The IOP was 14.85±0.65 mmHg in the control group, whereas it was 1.25-fold higher (33.5±1.06 mmHg) in the experimental group. After treatment, the IOP returned to baseline levels. The mean number of neurons per mm2 in the RGL was 33% lower in the experimental group (283±10 cells/mm2) compared with the control group (423±11 cells/mm2). In the groups treated with timolol, latanoprost, or brimonidine, the neuronal loss was less (331±10, 360±15, and 333±3 cells/mm2, respectively), although values did not return to baseline levels.

Conclusions

This experimental model provokes an immediate, constant, and prolonged increase in IOP and the application of hypotensive agents affords a certain degree of protection to neurons in the RGL.
Comparison of conventional and torsional mode (OZil) phacoemulsification: randomized prospective clinical study
Authors: Bozkurt Ercüment , Bayraktar Sukru , Yazgan Serpil , Cakir Mehmet , Cekiç Osman , Erdogan Havva , Yilmaz Omer F.
Published: March 2018

Purpose

To compare the amount of intraoperative energy used during conventional and torsional phacoemulsification surgery and investigate the changes in corneal endothelial cell density.

Methods

In this study, a total of 100 eyes in patients with age-related cataract (mean age 68.9 years) were included. Patients were randomly allocated into conventional (group 1) or torsional (OZil, group 2) phacoemulsification. Mean nuclear grade made according to Lens Opacities Classification System II was not different in the 2 groups. Total ultrasound time (USTT), cumulative dissipated energy (CDE), and the percent of total equivalent power in position 3 (%USTEPiP3) were compared between the 2 groups.

Results

There were 47 eyes in group 1 and 53 eyes in group 2. Patient age and sex were matched between the 2 groups (p=0.49, p=0.08). Mean USTT was 1.6±1.1 minutes (m) in group 1 and 1.5 ± 0.9 m in group 2 (p=0.55). Average CDE was 29.9±16.9 in group 1 and 25.2±19.1 in group 2 (p=0.20). Mean %USTEPiP3 was 27.0%±8.5% in group 1; however, it was 22.4%±6.6% in group 2 (p=0.003). At the first postoperative day, mean corneal edema was graded as 0.25±0.5 in group 1 and 0.18 ± 0.4 in group 2 (p=0.47). At the first postoperative week, it was found to be 0.02±0.15 in group 1 and 0.03±0.27 in group 2 (p=0.71). ECD loss was 6.7%±3.3% in group 1 and 4.2%±5.7% in group 2 (p=0.56).

Conclusions

No statistically significant difference was found between conventional and torsional phacoemulsification with respect to USTT and CDE. Torsional mode led to a significant reduction in US power in footswitch position 3. Torsional mode also appears to be associated with less loss of ECD
Optical coherence tomography of macular thickness after biaxial vs coaxial microincision clear corneal cataract surgery
Authors: Kurz Sabine , Krummenauer Frank , Thieme Hagen , Dick H. Burkhard
Published: March 2018

Purpose

To evaluate macular thickness changes after biaxial microincision versus coaxial small incision cataract surgery using optical coherence tomography (OCT).

Methods

This prospective, randomized, marked study comprised 70 patients (70 eyes) undergoing biaxial microincision surgery or conventional coaxial phacoemulsification. Patients were evaluated by Stratus OCT preoperatively and 1 day, 4 weeks, and 8 weeks postoperatively. Best-corrected visual acuity (BCVA), phacoemulsification power, and effective phacoemulsification time (EPT) were evaluated.

Results

In the biaxial group, median foveal thickness changed from 160 μm preoperatively to 168 μm 8 weeks postoperatively (p=0.018), while median macular volume increased from 2.43 mm3 to 2.57 mm3 (p<0.001). In the coaxial group, median foveal thickness increased from 164 μm preoperatively to 170 μm 8 weeks postoperatively (p=0.082), while median macular volume changed from 2.45 mm3 to 2.55 mm3 (p<0.001). No significant differences in the intraindividual increase of foveal thickness and macular volume were found between groups at 8 weeks. A statistically significant difference between groups was found in median foveal thickness at day 1 postoperatively (p=0.027). No significant differences between groups in median macular volume were found at day 1 or at 4 and 8 weeks postoperatively. Median phacoemulsification power was 7.1% and EPT 2.4 seconds in the biaxial group versus 10.6% and 3.2 seconds in the coaxial group (p<0.001 and p=0.078).

Conclusions

No clinically relevant differences in foveal thickness or macular volume were observed after biaxial microincision and coaxial small incision clear corneal cataract surgery. The blood–retinal barrier did not seem to be influenced by either procedure.
Conversion from nonischemic to ischemic retinal vein occlusion: prediction by venous velocity on color Doppler imaging
Authors: Arsene Sophie , Vierron Emilie , Le Lez Marie Laure , Herault Beatrice , Gruel Yves , Pisella Pierre-Jean , Giraudeau Bruno , Tranquart François
Published: March 2018

Purpose

To identify color Doppler imaging (CDI) parameters and other prognostic factors of a conversion from nonischemic to ischemic retinal vein occlusion (RVO) in a large population with a long follow-up.

Methods

This was a retrospective observational study. Data were collected for patients who had been admitted to the ophthalmologic department of the Hospital of Tours because of nonischemic central RVO (CRVO) or branch RVO (BRVO). We analyzed the relation between time until conversion into ischemic RVO and several prognostic factors of conversion, mainly vein velocities as measured by CDI.

Results

Analyses involved 162 patients. One year after inclusion, conversion into ischemic RVO occurred in 25.0% of the 113 CRVO and in 28.6% of the 49 BRVO cases. For CRVO, an increase of the minimal central retinal venous velocity (CRV), measured by CDI before and after treatment by hemodilution, diminished the risk of conversion into an ischemic form (p=0.048). For BRVO, an elevated maximal CRV on diagnosis was a protector (p=0.004). Age was associated with a high risk of ischemic evolution for CRVO (p=0.023) but not BRVO. Initial visual acuity was not associated with the conversion, for BRVO or CRVO. Increased retinal hemorrhages highly increased the risk of conversion both for CRVO (p<0.0001) and BRVO (p=0.010).

Conclusions

Risk of ischemic evolution for BRVO and CRVO treated by isovolemic hemodilution was associated with central venous velocities. CDI might be useful for identifying risk of ischemic conversion and individualizing the follow-up of patients.
Is multifocal ERG a reliable index of macular function after triamcinolone acetonide injection in diffuse diabetic macular edema?
Authors: Durukan Ali Hakan , Memisoglu Serdar , Gundogan Fatih Cakir
Published: March 2018

Purpose

To investigate the changes and the reliability of multifocal electroretinogram (mfERG) after intravitreal triamcinolone acetonide (IVTA) injection in diffuse diabetic macular edema (DDME).

Methods

Twenty-four eyes with DDME were treated with an intravitreal injection of 4 mg of triamcinolone acetonide. Visual acuity (VA), central macular thickness (CMT), mfERG, and intraocular pressures (IOP) were evaluated in the preinjection period and the 15th day, third month, and sixth month after IVTA injection.

Results

Age and gender of the patients were not significantly correlated to logMAR VA (p=0.888 for age, p=0.192 for gender), CMT (p=0.282 for age, p=0.625 for gender), or P1/N1 amplitudes/implicit times in mfERG at baseline (p>0.05 for age and gender). The correlation between logMAR VA and CMT at baseline also was not significant (r=0.069, p=0.750). The VA increased significantly at the 15th day (p<0.001). The VA increase persisted until the third month and decreased to preinjection values at the sixth month (p=0.324). CMT decrease was significant at the 15th day (p=0.012) but insignificant at the third and sixth months (p=1.000 for both). Correlations between logMAR VA change/CMT change at the 15th day were not significant (r=–0.043, p=0.843). Moreover, the correlation of CMT change with P1/N1 amplitude/implicit time changes was not significant (p>0.05 for all).

Conclusions

The positive effect of IVTA injection in DDME is reversible until the sixth month. Monitoring of the improvement in visual function by mfERG is violated possibly by irreversible macular dysfunction due to long duration of macular edema and primary neurophysiologic effects of diabetes on the retina.
Intravitreal bevacizumab combined with panretinal photocoagulation in the treatment of open angle neovascular glaucoma
Authors: Ciftci Suleyman , Sakalar Yildirim Bayezit , Unlu Kaan , Keklikci Ugur , Caca Ihsan , Dogan Eyup
Published: March 2018

Purpose

To evaluate the clinical efficacy of intravitreal bevacizumab (IVB) combined with panretinal photocoagulation in patients with open angle neovascular glaucoma (NVG).

Methods

Nine patients (9 eyes) with NVG participated in this study. Patients received IVB (1.25 mg) as the initial treatment for NVG and were followed up for at least 4 months. IVB was offered as the first treatment of choice to patients with NVG. Panretinal photocoagulation was performed as soon as feasible after the second week and completed in all patients the fourth week after IVB. The main outcome measures are resolution of INV, inhibition of peripheral anterior synechia (PAS), and controllability of intraocular pressure (IOP).

Results

The mean follow-up period was 5.6±1.4 months (range, 4–9 months). The mean IOP before treatment was 35.1±9.7 mmHg (range, 24–56) under medication before IVB treatment. After IVB and after combined treatment, the mean IOP was reduced to 22.8±8.1 mmHg (range, 9–33) and 13.0±4.0 mmHg (range, 7–20), respectively. The mean referral INV was 3.6±0.4 grade (range, 3–4) and reduced to 1.6±0.4 (range 1–2) grade after IVB and 0.6±0.8 (range 0–2) grade after combined therapy. By IVB, combined panretinal photocoagulation recurrence of INV was not observed.

Conclusions

In NVG, IVB treatment can reduce iris and angle neovascularization and inhibits further PAS formation temporarily. Panretinal photocoagulation inhibits neovascularization constantly. Therefore, management of open angle NVG is more feasible with bevacizumab combined with panretinal photocoagulation.
Retinal nerve fiber layer thickness in chronic renal failure without diabetes mellitus
Authors: Demir M. Necati , Ekşioğlu Ümit , Altay Mustafa , Tök Özlem , Yilmaz F. Gül , Acar Mehmet A. , Duranay Murat , Duman Sunay
Published: March 2018

Purpose

To evaluate the retinal nerve fiber layer (RNFL) thickness in patients with chronic renal failure (CRF) without diabetes mellitus by using optical coherence tomography (OCT).

Methods

Sixty-six eyes of 33 patients with CRF were evaluated. Eighteen patients have been treated with hemodialysis (group 1) and 15 patients have been treated with peritoneal dialysis (group 2). The RNFL thicknesses were assessed before and after the hemodialysis in group 1. None of these patients had diabetes mellitus. Forty eyes of 20 age-matched normal control subjects were assessed in group 3. An RNFL thickness protocol was used to acquire circular scans of 3.4 mm in diameter around the optic nerve. For each eye, RNFL thicknesses were evaluated in 4 quadrants. All of the measurements were automatically calculated by the existing OCT software. All normal subjects and CRF patients underwent comprehensive ophthalmologic examination. The mean and quadrantal RNFL thickness values in patients with CRF were compared with the control group.

Results

The mean RNFL thickness values in patients with CRF were statistically significantly lower than the control group. Differences between the RNFL thickness values in group 1 and group 2 and the predialysis and postdialysis measurements were not statistically significant.

Conclusions

The RNFL thickness in CRF without DM, which was measured by OCT-3, was found to be significantly decreased. The presence of CRF can be a source of false positive results and lead to overestimation of glaucomatous optic neuropathy.
Pars plana vitrectomy for vitreoretinal complications of ocular toxoplasmosis
Authors: Adán Alfredo , Giralt Joan , Alvarez Guifré , Alforja Socorro , Burés-Jesltrup Anniken , Casaroli-Marano Ricardo P. , Corcóstegui Borja
Published: March 2018

Purpose

Ocular toxoplasmosis is associated with vitreoretinal complications that can potentially cause severe visual loss. The aim of this study is to report the preoperative, intraoperative, and postoperative outcomes of vitreous surgery in eyes with vitreoretinal complications secondary to ocular toxoplasmosis.

Methods

This retrospective study included 15 eyes of 15 patients (8 men, 7 women; mean age at surgery, 37.2 years, range 18–57 years) who had undergone vitreoretinal surgery for vitreoretinal complications secondary to ocular toxoplasmosis. Visual acuity was compared between the last preoperative visit and the most recent follow-up visit. Intraoperative and postoperative complications were also analyzed.

Results

Indications for surgery were retinal detachment in 8 eyes (53.3%), epiretinal membrane in 2 eyes (13.3%), persistent vitreous opacities in 2 eyes (13.3%), choroidal neovascularization in 1 eye (6.6%), vitreous hemorrhage secondary to vasoproliferative retinal tumor in 1 eye (6.6%), and hemorrhagic vasculitis with premacular hemorrhage in 1 eye (6.6%). At last examination, visual acuity improved in 11 eyes (73.3%) by 2 lines or more. Postoperative events that might be related to the surgery included 1 localized retinal detachment, 2 cataracts, and 1 glaucoma.

Conclusions

Pars plana vitrectomy for treatment of vitreoretinal complications secondary to ocular toxoplasmosis can be safely performed and may result in improved visual acuity.
Endophthalmitis after vitrectomy and vitrectomy combined with phacoemulsification: incidence and visual outcomes
Authors: Wani Vivek B. , Sabti Khalid Al , Kumar Niranjan , Mathew Sebastian , Kandari Jamal Al , Raizada Seemant
Published: March 2018

Purpose

To study the incidence of endophthalmitis after vitrectomy and after combined vitrectomy and phacoemulsification surgery and to report the results of treatment in such cases.

Methods

This is a retrospective, noncomparative, interventional study based at a tertiary ophthalmology center in Kuwait. Cases of vitrectomy only and combined vitrectomy with phacoemulsification surgery performed during the period from January 1, 1997, to December 31, 2007, were included. Patients undergoing vitrectomy for traumatic etiologies and endophthalmitis were excluded. Patients who developed endophthalmitis after vitrectomy were identified and their records were analyzed.

Results

Six patients developed endophthalmitis among 2965 cases of all vitrectomy procedures, resulting in an incidence of 0.20%. The incidence of endophthalmitis was 0.12% for cases undergoing vitrectomy (3 out of 2564 cases) and 0.75% for cases undergoing combined vitrectomy and phacoemulsification surgery (3 out of 401 cases), respectively. Three cases were culture positive. Four cases ended up with final visual acuity of perception of hand movements or worse.

Conclusions

Incidence of endophthalmitis in our series was higher than in other studies. The visual results were poor in 4 out of 6 cases. Earlier diagnosis and more aggressive approach may be needed to improve the results of treatment in these cases.
Pars plana vitrectomy with ILM peeling for macular edema secondary to retinal vein occlusion
Authors: Raszewska-Steglinska Marzena , Gozdek Piotr , Cisiecki Slawomir , Michalewska Zofia , Michalewski Janusz , Nawrocki Jerzy
Published: March 2018

Purpose

To evaluate anatomic and functional results in patients with macular edema in retinal vein occlusion (RVO), treated with pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling, depending on the timing of surgery.

Methods

A total of 35 consecutive patients underwent PPV with ILM peeling. Visual acuity, fluorescein angiography, and optical coherence tomography/spectral optical coherence tomography were performed preoperatively and 6–12 months postoperatively.

Results

Anatomic improvement was achieved in 29 patients (82.9%). In 6 patients, there was no improvement. Central macular thickness decreased in 17 patients (48.6%) with central retinal vein occlusion (CRVO) and in 12 patients (34.3%) with branch retinal vein occlusion (BRVO) (p<0.05). A total of 68% of eyes showed improvement in visual acuity (p<0.05). Visual acuity improved in 14 patients (mean 3.7 Snellen lines) with CRVO and in 10 patients (mean 3.7 Snellen lines) with BRVO. The t test shows no statistically significant difference in visual acuity improvement between ischemic and nonischemic CRVO (p>0.05) or between ischemic and nonischemic BRVO (p>0.05). Better results were observed in patients treated within 1 month of the onset of symptoms than in patients treated after more than 1 month. The difference is statistically significant (t test, p=0.0016).

Conclusions

PPV with ILM peeling may improve anatomic and functional prognosis in patients with macular edema secondary to RVO. Vitrectomy with ILM peeling seems to be beneficial for macular edema secondary to RVO in patients treated within 1 month from the onset of symptoms. PPV with ILM peeling in ischemic RVO and nonischemic RVO improves visual acuity.
Conversion visual loss: a differential diagnosis in infant amblyopia
Authors: Laria Carlos , Pérez Maria Elena , Pérez Eduardo , Piñero David Pablo , Ruiz-Moreno José María , Alió Jorge L.
Published: March 2018

Purpose

To report the first case of amblyopia due to a conversion disorder in a child.

Methods

A 9-year-old girl without allergies or family or personal antecedents of interest presented to our clinic. She manifested a progressive visual loss after an episode of lumbar pain. This progressive loss led the patient in a 6-month period to legal bilateral blindness: visual acuity inferior to 2/20 in both eyes and severe constriction of both visual fields.

Results

Several pathologic processes were discarded by means of multiple explorations and a general multidisciplinary analysis: physical pathology, simulating patient, schizophrenia, and the Briquet syndrome. Finally, she was diagnosed with a conversion somatoform disorder leading to a bilateral blindness. For 6 months, the patient was successfully treated with psychotherapy and a pharmacologic protocol. Total recovery was achieved with final visual acuity of 20/20 in both eyes and normal visual fields.

Conclusions

Conversion disorders should be considered as an additional etiology of visual loss in children. In these cases, the analysis and multidisciplinary treatment is crucial for a successful outcome.
Juvenile xanthogranuloma with bilateral ocular involvement: complete response after treatment with vinblastine: case report
Authors: Pollono Daniel , Galán Marta , Curuchet Adriana , Drut Ricardo , Pollono Agustina , Rodríguez Jacinto
Published: March 2018

Purpose

To present an infant with bilateral ocular and skin involvement by juvenile xanthogranuloma and the results of treatment with vinblastine.

Methods

Analysis of the clinical and histopathologic data and the results of the treatment.

Results

After 14 months' evolution with no response to other treatments, the lesions responded to a course of vinblastine (6 mg/m2/weekly, corrected for weight), which was followed by a maintenance treatment for 52 weeks.

Conclusions

The treatment protocol used in the present case may prove useful for similar patients. We found no other report describing these results.
Mirror image congenital esotropia and concordant hypermetropia in identical twins
Authors: Dirani Mohamed , Schache Maria , Baird Paul N.
Published: March 2018

Purpose

To report the occurrence of mirror image congenital esotropia and concordant hypermetropia in a pair of monozygotic twins.

Methods

A pair of twins was recruited through the Australian Twin Registry. Zygosity was determined by questionnaire, physical appearance, and standard genotyping. Visual acuity was measured using the logMAR chart at 3 m followed by cycloplegic refraction using the Topcon autorefractor.

Results

Twin 1 developed right eye esotropia at 2 years of age with bilateral hypermetropia (right = +5.75 D, left = +5.75 D). Twin 2 developed left eye esotropia at age 2 years with bilateral hypermetropia (right = +6.75, left = +7.50).

Conclusions

We describe the first reported case of mirror image congenital esotropia with concordant hypermetropia in monozygotic twins.
Pseudophakic pseudoexfoliation of an AkreosFit intraocular lens
Authors: Roberts Michael A. , Hawksworth Nicholas R.
Published: March 2018

Purpose

To describe a case of intraocular lens opacification resembling pseudophakic pseudoexfoliation affecting an AkreosFit intraocular lens (IOL).

Methods

Single case analysis.

Results

A patient had IOL opacification resembling pseudophakic pseudoexfoliation.

Conclusions

An 83-year-old woman with normal tension glaucoma was noted to have pseudophakic pseudoexfoliation of an AkreosFit IOL 5 years after uncomplicated phacoemulsification with IOL.
Customized iris clip anterior chamber intraocular lenses designed for iris reconstruction
Authors: Sakellaris Dimitrios , Goossens Carl , Tassignon Marie-José
Published: March 2018

Purpose

To present three cases of partial aniridia reconstructed by a customized polymethylmethacrylate (PMMA) iris print and iris clipped anterior chamber intraocular lens (IOL) (Ophtec BV®).

Methods

In two cases, the partial aniridia was originally caused by an eye trauma leaving one eye phakic and the second eye aphakic but without capsular support, whereas in the third case, surgically induced sectorial iridectomy was justified by a slowly growing cystic iris melanoma.

Results

All three cases showed very good results with useful visual recovery after customized phakic or aphakic iris print, toric or spheric PMMA, anterior chamber iris fixated IOLs.

Conclusions

Customized PMMA iris print and iris clipped anterior chamber IOL is a possible solution to repair aniridia with or without correction of aphakia and corneal astigmatism.
Herpetic keratitis and keratouveitis after mitomycin-C use in glaucoma filtering surgery: a short case series
Authors: Rao Aparna , Tandon Radihika , Sharma Namrata , Sihota Ramanjit , Gupta Viney , Dada Tanuj
Published: March 2018

Purpose

We report 4 eyes of 3 patients with presumed herpetic keratitis/keratouveitis after glaucoma surgery wherein intraoperative mitomycin-C was used.

Methods

Three patients, aged 18–75 years, were found to have unilateral or bilateral herpetic keratitis and/or keratouveitis, 15 days to 2 years after trabeculectomy with mitomycin-C.

Results

All 3 cases healed without any sequelae after 4 to 6 weeks with topical and/or systemic acyclovir. Topical steroids were used in cases with stromal involvement.

Conclusions

Mitomycin-C may predispose/facilitate development of herpetic keratitis/keratouveitis up to 2 years after glaucoma surgery.
Autofluorescence findings in Vogt-Koyanagi-Harada disease
Authors: Ayata Ali , Doğru Salim , Şenol Mehmet Güney , Ünal Melih , Erşanli Dilaver , Bilge Ahmet Hamdi
Published: March 2018

Purpose

To report shortwave autofluorescence (SW-AF) and near infrared autofluorescence (NIR-AF) findings in a case of Vogt-Koyanagi-Harada (VKH) disease.

Methods

A 22-year-old man presented with a 2-week history of headache, moderate hearing loss, discolored hair, and bilateral gradually decreased vision (20/800 bilaterally). Ophthalmologic examinations revealed bilateral granulomatous anterior uveitis and multiple patchy bullous retinal detachments. Fundus fluorescein angiography (FFA), SW-AF, and NIR-AF imaging were performed with a confocal scanning laser ophthalmoscope at the beginning and after resolution. The patient responded well to systemic prednisolone treatment. Visual acuity and hearing loss improved quickly (visual acuity 16/20 bilaterally).

Results

Multilobular dye pooling with a dark rim was observed in serous detached retinal areas on late-phase FFA. These areas were observed as hypoAF in SW-AF and NIR-AF mode due to the blockage. After resolution of serous detachment, numerous hypoAF granular dots were observed scattered over the previously serous detached areas in SW-AF and NIR-AF mode. These hypoAF granular dots were seen as window defect lesion in FFA and interpreted as retinal pigment epithelial damage or atrophy.

Conclusions

SW-AF and NIR-AF imaging confirmed granular retinal pigment epithelium atrophy which corresponds to FFA findings. SW-AF and NIR-AF imaging methods are noninvasive and useful techniques for documentation of fundus changes in VKH disease.
Viscocanalostomy: A Pilot Study
Authors: Carassa R.G. , Bettin P. , Fiori M. , Brancato R.
Published: March 2018

Purpose

Viscocanalostomy is a new, non-penetrating procedure for glaucoma surgery. We started a prospective study to assess the effectiveness and safety of the operation.

Materials and methods

Up to March 1998 we enrolled 33 patients (33 eyes) suffering from glaucoma, uncontrolled despite maximum medical therapy, who underwent viscocanalostomy according to Stegmann's technique. A complete ophthalmological examination was performed the day before surgery and on days 1 and 7 postoperatively. Further visits were scheduled at months 1, 3, 6 and 12.

Results

In four eyes Schlemm's canal was either missed or not deroofed properly, and the procedure was converted into simple trabeculectomy. After a mean follow-up of 3.0±2.6 months (range 1–10), success defined as IOP > 2 and < 21 mmHg with no medication was obtained in 86.2% of the cases (25/29); 23 out of 29 eyes (79.3%) had IOP > 2 and < 16 mmHg. In the 25 successful eyes, mean IOP was 27.7±9.5 mmHg (range 13–48) preoperatively and 12.0±3.0 mmHg (range 7–18) (p<0.0001) at the end of the follow-up period. Mean VA ranged from 0.35±0.34 to 0.32±0.32 (n.s.).

Intraoperative complications included

Descemet rupture (7), with iris plugging in two cases; choroidal deroofing (3), irregular incision of Schlemm's canal (2). Postoperative complications included: self-resolving 2-mm hyphema (4); IOP spike (1); inadvertent filtering bleb (2); hypotony with choroidal detachment for one week (1).

Conclusions

In this short-term study, viscocanalostomy proved effective and safe in lowering IOP in glaucomatous eyes.
The Effect of Betaxolol on Ocular Blood Flow and Visual Fields in Patients with Normotension Glaucoma
Authors: Turaçli M.E. , Özden R.G. , GÜrses M.A.
Published: March 2018

Purpose

This study investigated the effect of ophthalmic betaxolol, a ß, selective adrenoceptor antagonist, on ocular blood flow and visual function in patients with normotension glaucoma (NTG).

Methods

Thirty-six eyes of eighteen patients with NTG, but otherwise free of systemic disease, were included. Blood fibrinogen, sedimentation rates, Goldmann intraocular pressure, Humphrey automated perimetry, and color Doppler imaging were done at baseline and after one year of twice-daily bilateral topical ocular dosing with 0.5% betaxolol HCl.

Results

After treatment, the resistivity index of the ophthalmic artery was significantly reduced, and visual fields were significantly improved. The resistivity indexes of the central retinal artery and posterior ciliary artery were also reduced but did not achieve statistical significance. Intraocular pressure was significantly reduced. There was no change in blood fibrinogen and sedimentation rates.

Conclusions

These findings indicate that long-term treatment with ophthalmic betaxolol improves ocular hemodynamics by lowering the resistivity index of the ophthalmic artery and results in an improvement in the visual fields of patients with NTG. In view of this positive effect on blood flow and visual function, betaxolol is recommended in the management of patients with NTG.
Effects of 0.5% and 0.25% Apraclonidine on Postoperative Intraocular Hypertension after Cataract Extraction
Authors: Simsek S. , Demirok A. , Yasar T. , Çinal A. , Bayram A. , Yilmaz Ö. F.
Published: March 2018

Purpose

We conducted a double-masked, prospective study to evaluate the effect of 0.5% and 0.25% apraclonidine on postoperative intraocular pressure (IOP) in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation.

Methods

Fifty-four patients scheduled for ECCE were randomly divided into three groups of 18. The first group received one drop of 0.50% apraclonidine topically one hour before surgery and immediately after the end of the procedure. The second group received the same regimen but with 0.25% apraclonidine. The third group received artificial tears as the control group. IOP was measured 12 h preoperatively and 6 and 24 h postoperatively. All the measurements were made using the same Goldmann applanation tonometer by the same surgeon who did not know to which group the patient belonged.

Results

Preoperative mean IOP was 13.66 ± 2.76 mmHg in the first group, 14.27 ± 2.24 mmHg in the second and 14.5 ± 1.34 mmHg in the control group. The differences were not significant (p=0.398). Mean IOP at the early postoperative visit (6 h) was significantly lower in the first group (17.44 ± 4.95 mmHg) than the second (21.78 ± 7.19 mmHg) and the control group (24.55 ± 5.65 mmHg) (p<0.001). Mean postoperative IOP at 24 h was again significantly lower in the first group (14.33 ± 3.75 mmHg) than the second (17.11 ± 4.16 mmHg) and the control group (19.61 ± 3.20 mmHg) (p<0.001).

Conclusions

Our findings indicate that topical 0.5% apraclonidine controlled early postoperative intraocular hypertension after cataract extraction without any side effects, while the 0.25% drops were not effective.
Effects of Hypertension on the Retinal Vein Width at the Retinal Arteriovenous Crossings
Authors: Akman A. , Kadayifçilar S. , Aydin P.
Published: March 2018

Purpose

The study was designed to quantify retinal vein width changes at the arterio-venous crossing and to evaluate the effects of hypertension on vein widths at “vein posterior to the artery” (VPA) and “vein anterior to the artery” (VAA) crossings.

Methods

The width of the retinal veins was measured at points before and after the arterio-venous crossings by a computerized image analysis system in ten normal subjects and 35 hypertensive patients. Retinal vein width changes at fixed intervals from the arterio-venous crossing points, both VAA and VPA, were measured as a function of the stage of the hypertensive retinopathy in the subjects.

Results

Mean retinal vein width showed significant (p<0.05) narrowing at VPA crossings at stages 2,3 and 4 of hypertensive retinopathy. For the VAA crossings, there was no significant decrease in the width of the vein at any stage. There was no significant narrowing of the vein at VPA crossings in normal subjects or in stage 0 and stage 1 hypertensive retinopathy patients.

Conclusions

The decrease in the width of the retinal vein in stages 2, 3 and 4 hypertensive retinopathy patients at VPA crossings can cause turbulence in blood flow, leading to intimal damage and occlusion. The absence of narrowing may explain the low incidence of branch retinal vein occlusions at VAA crossings.
Bilateral Retinal Detachment in Marfan's Syndrome
Authors: Dotrelova D.
Published: March 2018

Purpose

Bilateral retinal detachment (RD) in Marfan's syndrome (MS) has a typical preoperative, operative, and post-operative course. This study describes symmetry of retinal tears and bilateral RD surgery in five MS patients over a period of 15 years.

Methods

Six eyes with uncomplicated RD were operated on using the scleral buckling procedure, and four eyes with complicated RD were operated using a pars plana vitrectomy (PPV) and inner retinal tamponade with silicon oil.

Results

Complete retinal reattachment was achieved in seven eyes. Partial anatomical success with attached macula was achieved in one eye. The surgery failed in two eyes. Final visual acuity was between 0.66 and 0.33 in three eyes, and between 0.25 and 0.1 in five; two eyes had no light perception.

Conclusions

The course of the bilateral retinal disease highly correlated with the symmetry of retinal defects.
Ocular and Orbital Complications following the Treatment of Retinoblastoma
Authors: Anteby I. , Ramu N. , Gradstein L. , Miskin H. , Pe'er J. , Benezra D.
Published: March 2018

Purpose

To investigate the ocular and orbital complications observed in children treated for retinoblastoma.

Methods

We retrospectively studied 73 children (39 boys, 34 girls) suffering from retinoblastoma. Thirty-six had bilateral tumor and 37 unilateral disease for a total of 109 eyes affected. The follow-up was 6–180 months (median 36 months). Enucleation was the most common initial treatment approach in the unilateral group, and radiotherapy (by external beam) was the most common initial therapy in the bilateral group. Cryotherapy, photocoagulation, brachytherapy and/or systemic chemotherapy were used as adjuvant treatments when necessary. Ocular complications were recorded at the follow-up examinations.

Results

Cataract developed in 20% of the irradiated eyes. The mean time from irradiation until development of cataract was 28.5 months (6–64 months). Radiation retinopathy developed in 12% and was first detected 11–72 months (mean 37 months) after irradiation therapy. Mild transient keratopathy was observed in all eyes undergoing irradiation, and xerophthalmia in one eye. Complications after enucleation included: marked discharge from the socket (11.0%), extrusion of the implant (9.6%), and contraction of the socket (3.0%). No complications were observed after cryotherapy or laser photocoagulation of the tumor.

Conclusions

Ocular complications after treating children with retinoblastoma are common and may seriously affect the quality of life of children surviving the primary malignancy.
Effect of Nitric Oxide Synthase Inhibition in Experimental Pseudomonas keratitis in Rabbits
Authors: Er H. , Turkoz Y. , Ozerol I.H. , Uzmez E.
Published: March 2018

Purpose

The aim of this study was to assess the efficacy of the nitric oxide synthase inhibitor L-NG-nitro-arginine-methyleser (L-NAME) in the treatment of experimental Pseudomonas keratitis.

Methods

Twelve young New Zealand white rabbits were given intrastromal injections of Pseudomonas aeruginosa strains. Twenty-four hours later, the rabbits were randomly divided into four groups: group 1 was treated with topical 0.3% ciprofloxacin drops and a single subconjunctival injection of L-NAME (150 mg/kg); group 2 received topical 0.3% ciprofloxacin drops alone; group 3 received a single subconjunctival injection of L-NAME alone; group 4, the control group, was treated with topical balanced salt solution (BSS) drops. One drop of either ciprofloxacin of BSS was applied at each treatment interval. Twenty-six hours after the start of treatment, the eyes were examined by slit lamp to assess inflammation. Aqueous humor specimens were collected from each eye to measure the nitric oxide concentration. Corneas were removed to count bacteria results.

Results

Slit lamp examination cell scores were significantly lower for groups 1 and 3 than groups 2 and 4 eyes (p = 0.002 to p = 0.004). No viable bacteria were detected in the corneas of groups 1 and 2. Group 3 corneas had significantly fewer bacteria (6.33 ± 0.42 × 103) than group 4 (5.94 ± 0.16 × 104) (p < 0.05). Nitric oxide levels in the aqueous humor were significantly lower for group 1 eyes than for groups 2, 3, or 4 (p = 0.02, p = 0.01, and p = 0.003, respectively).

Conclusions

We conclude that nitric oxide synthase inhibitors may be a useful adjunct but are not a replacement for traditional antibiotic drop therapy.
Different Therapeutic Approaches and Outcome in the Treatment of Pterygium
Authors: Karabatsas C. H. , Marsh G. W. , Cook A. M. , Cook S. D.
Published: March 2018

Purpose

This study was initiated to investigate the role of different therapeutic modalities in the outcome of the surgical treatment of pterygium.

Methods

The results of treatment of pterygia with a variety of surgical techniques were studied in 56 eyes (49 patients) operated on at Bristol Eye Hospital during a period of five years. The surgical techniques included simple excision; bare sclera; conjunctival autograft; sliding conjunctival flap; lamellar keratoplasty and penetrating keratoplasty. Twelve eyes received additional beta irradiation in a fractionated total dose of 40 Gys.

Results

The incidence of recurrence was 23.2% for the 43 treated primary pterygia, and 23% for the 13 recurrent pterygia. All recurrences occurred between 2.5 and 11 months postoperatively. None of the 11 cases where additional beta irradiation was used showed any recurrence or other complication within the study period. In the recurrent pterygia group, the cases treated with a combination of surgical excision and beta irradiation, showed significantly lower recurrence rate (p<0.001) compared to those cases treated with surgical excision alone.

Conclusions

Beta irradiation as a complement to surgical treatment of pterygium, is successful in treating high risk cases such as reoperations, whereas for the majority of primary pterygia surgical excision alone is adequate. Additionally, follow up of one year will reveal any recurrences.
Intraoperative Application of Mitomycin C in the Surgical Treatment of Pterygium
Authors: Demirok A. , Simsek S. , Çinal A. , Yasar T.
Published: March 2018

Purpose

To investigate the effectiveness of intraoperative mitomycin C in pterygium surgery.

Methods

The effectiveness of intraoperatively administered mitomycin C and the occurrence of postoperative complications were evaluated in 17 patients with two recurrences of pterygium. The authors employed the “bare-sclera technique” and placed a sterile sponge soaked in a 0.02% mitomycin C solution intraoperatively in the episcleral space for 3 minutes. The control group (15 patients) underwent only surgical excision. Patients were followed for 21 to 30 months.

Results

The pterygium recurred in one (5.9%) of the 17 patients in group 1 and in six (40%) of the 15 controls. Statistical analysis using Fisher's exact test showed a significant (p=0.027) reduction of recurrences of pterygium in the group treated intraoperatively with mitomycin C. No serious complications or side effects arose during the follow-up period.

Conclusions

Mitomycin C administered intraoperatively can be considered an effective treatment to improve the success rate after surgical excision.
Clinical Comparison of the Ocular Blood Flow Tonograph and the Goldmann Applanation Tonometer
Authors: Esgin H. , Alimgil M.L. , Erda S.
Published: March 2018

Purpose

To compare the IOP readings of an ocular blood flow (OBF) tonograph (OBF Labs UK Ltd) with Goldmann applanation tonometry.

Methods

194 patients were studied. In group 1, the software version 8.2 of the OBF tonograph was used in 214 eyes of 107 patients and in group 2, the 11.2 version of the tonograph was used in 174 eyes of 87 patients.

Results

We found 63% of the OBF tonograph readings to be within ±2mm Hg of the Goldmann applanation tonometry readings in group 1 and 60% in group 2. In group 1 the correlation coefficient between the readings of the two instruments was 0.71 and 0.82 in group 2. The mean value for the paired differences in group 1 was –1.34±2.75mm Hg overall and –1.04±2.91mm Hg overall in group 2. There was a significant difference between the Goldmann applanation tonometer and OBF tonograph readings in the 8–10mm Hg interval (p<0.001) in group 1, but not in group 2 (p>0.1).

Conclusions

The 11.2 version of the OBF tonograph is more accurate than the 8.2 version and measures IOP in a manner that corresponds well to the Goldmann applanation tonometer in the 8–10mm Hg and 21–29mm Hg intervals. It corresponds fairly well in the 11–20mm Hg interval.
The Effect of 0.25% Apraclonidine in Preventing Intraocular Pressure Elevation after Nd: Yag Laser Posterior Capsulotomy
Authors: Simsek S. , Ertürk H. , Demirok A. , Cinal A. , Yasar T. , Karadenizli C.
Published: March 2018

Purpose

The efficacy and adverse effects of 0.25% apraclonidine on intraocular pressure (IOP) after Nd: YAG laser posterior capsulotomy were investigated, and the results were compared with placebo, 0.50% timolol maleate and 1% apraclonidine.

Methods

Eighty eyes were randomly assigned to four groups of 20 eyes. In a double-masked design, the groups were treated with placebo (group I), 0.50% timolol maleate (group 2), 1% apraclonidine (group 3), 0.25% apraclonidine (group 4) one hour before and five minutes after Nd:YAG laser posterior capsulotomy. IOP was measured by applanation tonometry 1 hour before (baseline IOP) and 1,3, 24 hours after capsulotomy.

Results

The average baseline IOP increased respectively 3.90 ± 5.35, 5.95 ± 5.32, 1.15 ± 3.20 mmHg in the first group 1, 3 and 24 hours post-treatment. There were significant differences between baseline IOP and 1 and 3 hours but not at 24 hours (p=0.004, p=0.001, p=0.13). IOP increased 0.40 ± 4.08, 0.75 ± 5.33, 0.80 ± 6.03 mmHg in the second group at the same times. The differences between the average baseline IOP and the 1, 3 and 24h measurement were not significant (p=0.83, p=0.65, p=0.93). In the third group, IOP decreased 3.70 ± 2.40, 3.30 ± 2.47, 2.65 ± 1.56 mmHg at the measurement times, with significant differences between the average baseline IOP and the 1, 3 and 24 hour measurements (p=0.001, p=0.0001, p=0.01). In the fourth group IOP increased 0.35 ± 3.32 mmHg at 1 hour, but decreased 1.25 ± 3.41, 0.90 ± 2.07 mmHg at 3 and 24 hours. The differences were not significant (p=0.94, p=0.16, p=0.08). When the 0.25% and 1% apraclonidine groups were compared, there were significant differences between the average IOP at 1 hour in both groups but not at 3 and 24 hours (p=0.01, p=0.17, p=0.21). Similarly, there were no significant differences between the average IOP at the same times when the 0.25% apraclonidine group was compared with the timolol group (p=0.30, p=0.08, p=0.16). Some systemic and local side effects were seen in the timolol and 1% apraclonidine groups, but none with 0.25% apraclonidine.

Conclusions

It was concluded that 0.25% apraclonidine is effective in preventing the early elevation of IOP after Nd:YAG laser posterior capsulotomy and may offer an alternative to 0.50% timolol maleate and 1% apraclonidine.
Fixed-Dose Combination of 0.1% Diclofenac plus 0.3% Tobramycin Ophthalmic Solution for Inflammation after Cataract Surgery: A Randomized, Comparative, Active Treatment-Controlled Trial
Authors: Barraquer R.I. , ÁLvarez de Toledo J.P. , Montané D. , Escoto R.M. , Torres C. Garcia , Bennani-Tazzi M.
Published: March 2018

Purpose

To assess the efficacy, tolerance, and ocular tolerability of a fixed-dose combination of 0.1% diclofenac plus 0.3% tobramycin ophthalmic solution compared with 0.1% diclofenac (Voltaren®) and 0.3% tobramycin (Tobrex®) in patients undergoing cataract extraction by either nuclear expression (extracapsular) or ultrasound-assisted aspiration (phacoemulsification) with intraocular lens implantation.

Methods

Eighty-eight patients undergoing cataract extraction with intraocular lens implantation participated in a randomized, parallel, observer-masked trial, in which the clinical usefulness of a fixed-dose combination of 0.1% diclofenac plus 0.3% tobramycin ophthalmic solution, two eyedrops every 6 hours (n=44) was compared with Voltaren® and Tobrex®, one drop of each every 6 hours (n=44) in a 22-day course. Efficacy was assessed from changes of the sum of anterior chamber cell count plus flare, conjunctival hyperemia and edema, and ciliary congestion, by means of slit lamp biomicroscopy on days 1, 7, 14, and 21. Tolerance and ocular tolerability were assessed by recording intraocular pressure (IOP), side effects, and the patient's and investigator's opinions.

Results

Anterior chamber cell count plus flare showed no differences in the two treatment groups at any evaluation point. The study treatment was associated with a significantly higher score for conjuncitval edema on day 1 (p=0.015), conjuncitval hyperemia on day 14 (p=0.009) and anterior chamber cell count on day 21 (p=0.04), but these differences had no clinical relevance. No side effects related to the study treatment were recorded.

Conclusions

Efficacy, tolerance, and ocular tolerability of a fixed-dose combination of 0.1% diclofenac plus 0.3% tobramycin ophthalmic solution were comparable to Voltaren® plus Tobrex® for the control of anterior chamber inflammation after cataract surgery, with the advantage that both active principles are supplied in a single container.
Clinical Consequences of the Use of Highly Purified Silicone Oil: Comparative study of highly and less purified silicone oil
Authors: Pastor J. C. , Zarco J. M. , Del Nozal M.J. , Pampliega A. , Marinero P.
Published: March 2018

Purpose

To compare the ocular toxicity caused by the use of highly purified silicone oil to less purified silicone oil in humans.

Methods

Fifty-six eyes received 2,000 centistokes (cs) purified silicone oil (group 1) and 42 eyes received 2,000 cs fractionated (highly purified) silicone oil (group 2) after pars plana vitrectormy. Follow-up ranged from 6 to 48 months.

Results

Six months after injection, the following complications were found in groups 1 and 2, respectively: ocular hypotension (<13mmHg), 39.3% and 31%, sustained ocular hypertension (>23mmHg), 19.6% and 19%; acute hypertensive peaks (>30mmHg), 23.2% and 11.9%; corneal alterations, 19.6% and 14.3%; emulsification, 1.8% and 2.4%; silicone oil cloudiness, 28.6% and 0%; preretinal reproliferation, 14.3% and 4.8% and total or partial retinal reattachment, 78.6% and 90.5%.

Conclusions

Highly purified silicone oil was better tolerated than the less purified oil and caused fewer complications. Poorly purified silicone oils should be avoided in clinical practice.
Indocyanine Green Angiographic Findings in a Case of Punctate Inner Choroidopathy
Authors: Akman A. , Kadayifçilar S. , Aydin P.
Published: March 2018

Purpose

To report indocyanine green angiographic findings in a case of punctate inner choroidopathy.

Methods

Fundoscopy, fluorescein angiography and indocyanine green angiography were carried out on a 23-year-old woman who presented with features typical of punctate inner choroidopathy.

Results

Fundoscopy showed multiple small yellow lesions in the retinal pigment epithelium and inner choroid in both eyes and a subfoveal choroidal neovascular membrane in the left eye. The lesions showed early hyperfluorescence with mild leakage in the late phases of the fluorescein angiogram. On indocyanine green angiography, the lesions demonstrated obvious hypofluorescence in the early, mid and late phases.

Conclusions

The fluorescein and indocyanine green angiographic findings indicate that punctate inner choroidopathy affects the choriocapillaris as well as the retinal pigment epithelium and photoreceptors. However, it is still not known whether the primary pathology is in the retinal pigment epithelium, the photoreceptors or the choriocapillaris.