bluuebunny/crossref_metadata_2025 huggingface dataset:
Anecortave Acetate for the Treatment of Subfoveal Choroidal Neovascularization Secondary to Age-Related Macular Degeneration
Authors: Schmidt-Erfurth U. , Michels S. , Michels R. , Aue A.
Published: January 2018

Purpose

Anecortave acetate is a novel angiostatic cortisene being evaluated clinically for treatment of exudative age-related macular degeneration (ARMD). A randomized, placebo-controlled, efficacy and safety dose duration study of anecortave acetate for depot suspension (3 mg, 15 mg, 30 mg) in this patient population was completed in June 2003. As part of this trial, 128 patients with subfoveal choroidal neovascularization (CNV) secondary to ARMD were enrolled and treated for up to 2 years by 18 clinical sites in the United States and European Union.

Methods

Study patients were evaluated clinically with detailed ophthalmic examinations, general physical examinations, assessments of best-corrected logMAR visual acuity, and angiographic evaluations. The Digital Angiography Reading Center (New York City, NY) assessed lesion eligibility while the clinical investigators assessed overall patient eligibility prior to treatment. As part of this study, study medication was delivered as a posterior juxtascleral depot using a specially designed curved cannula at 6-month intervals if in the masked investigator's opinion the patient's lesion could benefit from additional treatment.

Results

The 2-year efficacy results of this placebo-controlled study demonstrated that RE-TAANE 15 mg (anecortave acetate for depot suspension) was statistically superior to placebo for stabilization of vision (<3 logMAR line change from baseline) and for inhibition of neovascular lesion growth. There were no serious treatment-related safety issues associated with either the study medication or the procedure for administration.

Conclusions

Anecortave acetate 15 mg for depot suspension is clinically efficacious compared to placebo for treatment of subfoveal exudative ARMD lesions when administered at 6-month intervals as a posterior juxtascleral depot.
Correction of Congenital Entropion of the Lower Eyelid: Incisional versus Rotational Surgery
Authors: Serafino M. , Bottoli A. , Nucci P.
Published: January 2018

Purpose

When, at birth, the eyelid margin is rolled inward against the globe, the condition is referred to as congenital entropion. Upper eyelid involvement is commonly associated with a tarsal abnormality, while lower eyelid entropion is often associated with epiblepharon. Entropion does not resolve spontaneously, and may cause corneal pathology if untreated. The purpose of this study is to compare the two common techniques for the correction of congenital entropion.

Methods

The authors performed a pilot study of 24 consecutive patients with lower bilateral congenital entropion to compare the results of incisional versus rotational surgery.

Results

The rotational procedure was carried out in 14 patients; incisional surgery was performed in 10 patients. Twenty-one patients had good functional and cosmetic results. There were only three case of relapse after 3, 4, and 3 months.

Conclusions

The authors consider both techniques satisfactory, but the procedure of choice, considering the age of the patients and previous studies, remains rotational sutures because of its simplicity, quickness, and low risk of complication.
A Clinical Comparison of Two Formulations of Tobramycin 0.3% Eyedrops in the Treatment of Acute Bacterial Conjunctivitis
Authors: Kernt K. , Martinez M. , Bertin D. , Stroman D. , Cupp G. , Martinez C. , Tirado M. , Guasch J. ,   The International TOBREX2X Group:, Kernt K. , Lizin F. , Cano J. , Wesner M. , Alemany P. , Jungmann P. , Partouche P. , Sitruk A. , Christmann T. , Kandarakis A. , Royo M. , Arias A. , Bacquaert J.P. , Dua H. , Tomazzoli L. , Forsman E. , Gerstenberger A. , Bertel F. , Bouzas E. , Trimarchi F. , Kaye S. , Orsoni G.J. , Klauss V. , Mandel S. , Mortemousque B.
Published: January 2018

Purpose

To compare the safety and efficacy of a new enhanced viscosity ophthalmic formulation of tobramycin, given twice daily (BID), with the existing four times daily (QID) treatment regimen in patients with acute bacterial conjunctivitis.

Methods

This was a 12-day, multicenter, observer-masked, randomized, parallel group study. Patients received one drop of tobramycin 0.3% (3 mg/mL) enhanced viscosity ophthalmic solution BID or tobramycin 0.3% (3 mg/mL) ophthalmic solution QID in the affected eyes for 7 days. The primary efficacy variable was the percentage of patients with sustained cure/presumed bacterial eradication based on clinical judgment at the test-of-cure visit (Day 12). Pretherapy bacterial isolates were obtained and tested for susceptibility to tobramycin by determination of minimum inhibitory concentrations (MIC).

Results

A total of 276 patients were enrolled in the study and 203 of these were culture positive and attended all follow-up examinations. In this group, 98% of those treated with tobramycin enhanced viscosity ophthalmic solution and 99% of those treated with tobramycin 0.3% ophthalmic solution were categorized as having sustained cure/presumed eradication at the test-of-cure visit (p=0.6037). Reported adverse events were not serious, mild to moderate in severity, and generally did not prevent continuation in the study. Several pretreatment pathogens demonstrated tobramycin resistance (MIC > 4 mg/mL). However, therapy with both treatments was effective in the majority of the cases.

Conclusions

Tobramycin enhanced viscosity ophthalmic solution is well tolerated and has equivalent efficacy to the established treatment regimen with a simplified posology. The formulation provides an alternative therapy for acute bacterial conjunctivitis that should improve patient compliance and satisfaction.
Prospective Evaluation of Intravitreal Triamcinolone Acetonide Injection in Macular Edema Associated with Retinal Vascular Disorders
Authors: Tewari H.K. , Sony P. , Chawla R. , Garg S.P. , Venkatesh P.
Published: January 2018

Purpose

To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal vascular disorders.

Methods

This prospective nonrandomized clinical interventional study included 81 eyes (76 patients) comprised of Group I, 57 eyes (51 patients) with diabetic macular edema; Group II, 10 eyes (10 patients) with branch retinal vein occlusion; and Group III, 13 eyes (13 patients) with central retinal vein occlusion. All eyes received an intravitreal injection of 4 mg triamcinolone acetonide (with the solvent) in the operation theater under sterile conditions.

Results

Mean preinjection central macular thickness was 531.84±132 μm in Group I, 458.4±149 μm in Group II, and 750.81±148 μm in Group III. All groups showed a statistically significant decrease in mean central macular thickness at 1 month (300.7±119 μM in Group I, 218.2±99 μm in Group II, and 210.5 ±56 μm in Group III) and 3 months (253.19±109 μm in Group I, 187±47 μm in Group II, and 182±50 μm in Group III) after injection (p<0.05). Mean follow-up was 22±2.4 weeks. Mean visual acuity increased in all three groups (preoperative visual acuity in Group I, 1.2±0.4 logMAR units; Group II, 1.24±0.5 logMAR units; Group III, 1.1 ±0.4 logMAR units; 1 month postinjection in Group I, 0.88±0.3 logMAR units; Group II, 0.67±0.3 logMAR units; Group III, 0.86±0.4 logMAR units; 3 months postinjection in Group I, 0.84±0.4 logMAR units; Group II, 0.59±0.3 logMAR units; Group III, 0.82±0.5 logMAR units) (p<0.05). Forty-one eyes completed 6 months and 20 eyes completed 9 months follow-up. Twelve of 20 (41%) eyes in Group I, 2/6 (33%) eyes in Group II, 3/6 (50%) eyes in Group III, and 8/15 (53%) eyes in Group I, 1/3 (33%) eyes in Group II, and 2/2 (100%) eyes in Group III developed recurrence of macular edema with worsening of visual acuity at 6 and 9 months, respectively. Thirty-three (40.7%) eyes developed IOP elevation (at least one reading > 24 mmHg). One eye developed infective endophthalmitis.

Conclusions

Intravitreal injection of triamcinolone acetonide may be considered as an effective treatment for reducing macular thickening due to diffuse diabetic macular edema, venous occlusion associated macular edema, and may result in increase in visual acuity at least in the short term. Further follow-up and analysis is required to demonstrate its long-term efficacy.
Curvilinear Pigmentary Lesions in a Rod-Cone Dystrophy
Authors: Tamaki Y. , Sawa M. , Yannuzzi L.A.
Published: January 2018

Purpose

To report a peculiar curvilinear pigmentary lesion in the peripheral fundus in a rod-cone dystrophy.

Methods

Observational case report. Fundus examination of a 57-year-old woman who was known to have a generalized rod-cone dystrophy since she was 8 years old.

Results

The peripheral fundus examination revealed a curvilinear lesion which resembles a well-known finding associated with a presumed ocular histoplasmosis syndrome or multifocal choroiditis.

Conclusions

The differential diagnosis of a peculiar curvilinear pigmentary lesion in the peripheral fundus may be expanded to include a generalized rod-cone dystrophy.
Optical Coherence Tomography in Enhanced S-Cone Syndrome: Large Macular Retinoschisis with Disorganized Retinal Lamination
Authors: Hayashi T. , Kitahara K.
Published: January 2018

Purpose

The authors previously reported clinical and molecular features of a boy (at age 17) with enhanced S-cone syndrome (ESCS) who had bilateral cystoid maculopathies. The purpose of the current study was to describe the patient's optical coherence tomography (OCT) findings.

Methods

OCT was performed when the patient was 23 years old.

Results

OCT images revealed formations of single large hyporeflective cystic spaces in the cystoid maculopathies of both eyes. The cystic spaces were much larger than those of previously reported cases. In the temporal region of each cystic space, symmetric disorganized retinal lamination was observed with the retina lacking well-defined and hypoeflective bands of the inner nuclear layer and the outer nuclear layer, which are seen in normal retina. Splitting in the retinal thickness was at the level of the outer retinal layer rather than at the inner retinal layer in both eyes.

Conclusions

Splitting is likely to occur close to the outer plexiform layer in which the cleavage plane of familial juvenile retinoschisis is identified. The unique OCT manifestation of symmetric large macular retinoschisis with disorganized retinal lamination may indicate a severe form of ESCS.
Intraocular Lens Decentration and Posterior Capsule Opacification: Anatomo-Pathologic Findings after Implantation of AMOSI40 IOLs
Authors: Tognetto D. , Sanguinetti G. , Cernobori R. , Basile A. , Ravalico G. , Bussani R. , Silvestri F.
Published: January 2018

Purpose

To evaluate the incidence of intraocular lens (IOL) decentration and posterior capsule opacification (PCO) after implantation of a three-piece posterior chamber silicone IOL in a series of eyes examined postmortem.

Methods

Twenty-three pseudophakic enucleated human cadaver eyes, implanted with AMO SI40NB IOLs after phacoemulsification, were analyzed. Eyes obtained postmortem were sectioned at the equatorial plane and the anterior segment photographed from a posterior view. Location of IOL optic and haptics, type of fixation, and centration of IOL was evaluated. PCO was graded and the presence of Nd:YAG laser posterior capsulotomy was noted.

Results

Mean age at the time of surgery was 77.83 years, mean time since implantation was 18.26 months. In all the eyes examined, IOL haptics were positioned in the capsular bag. Mean decentration was 0.20±0.16 mm. No correlation was found between IOL decentration and time since implantation. The degree of peripheral PCO ranged from none (13.0%) to mild (39.1%) to moderate (26.1%) to severe (21.7%). The degree of central PCO ranged from none (52.2%) to mild (30.4%) to moderate (4.3%). Three patients (13.0%) underwent Nd:YAG laser posterior capsulotomy.

Conclusions

A very good centration can be obtained when silicone AMOSI40NB IOLs are correctly implanted with the haptics inside the capsular bag. About half of the implants showed no central PCO while Nd:YAG laser posterior capsulotomy rates documented a relatively low PCO 18 months after surgery. A careful in the bag haptics placement is needed in order to reduce the IOL decentration and to prevent central PCO.
Narrowing of the Anterior Chamber Angle during Valsalva Maneuver: A Possible Mechanism for Angle Closure
Authors: Sihota R. , Dada T. , Gupta V. , Deepak K.K. , Pandey R.M.
Published: January 2018

Purpose

To evaluate changes at the anterior chamber angle during Valsalva maneuver in eyes suspected to have a primary adult glaucoma.

Methods

Seventy-six consecutive patients underwent recording of applanation tonometry, measurement of the anterior chamber angle recess, angle opening distance, angle recess area, scleral spur-iris root distance, iris thickness, iridociliary angle, ciliary body thickness, anterior chamber depth, and pupil size on ultrasound biomicroscopy before and during the Valsalva maneuver. The Valsalva maneuver was standardized to a pressure of 40 mmHg for 15 seconds, using a manometer.

Results

The mean baseline intraocular pressure changed from 19.5±4.1 mmHg to 29.5±4.8 mmHg during Valsalva (p<0.0001). The anterior chamber angle recess narrowed from 17.9±9.5 to 7.8±9.2 degrees (p=0.0001). The angle recess area diminished from 0.15±0.14 mm2 to 0.14±0.12 mm2 (p=0.03) and the scleral spur to iris distance decreased from 0.19±0.2 mm to 0.16±0.18 mm (p=0.0001). The iridociliary angle narrowed from 72.6±33.5 degrees to 62.5±32.8 degrees (p=0.04). There was a significant increase in the thickness of the ciliary body, from 0.99±0.19 mm to 1.12±0.16 mm (p=0.001) and in iris thickness from 0.47±0.07 mm to 0.55±0.09 mm (p=0.0001). There was no significant change in the angle opening distance, anterior chamber depth, or pupillary diameter. A significant narrowing of the angle to less than 5 degrees was seen in 37 eyes, with iridocorneal apposition present in 28 eyes. After multivariate regression analysis it was found that the baseline ciliary body thickness and angle recess were significant predictors of narrowing of the angle (R2=96.1%).

Conclusions

Significant elevation of the intraocular pressure, narrowing of the anterior chamber angle recess, thickening of the ciliary body, and increase in the iris thickness is seen during the Valsalva maneuver. The Valsalva maneuver may lead to angle closure in eyes anatomically predisposed to primary angle closure glaucoma.
Glutathione S-Transferase M1, T1, and P1 Gene Polymorphism in Exudative Age-Related Macular Degeneration: A Preliminary Report
Authors: Öz Ö. , Ates N. Aras , Tamer L. , Yildirim Ö. , Adigüzel U.
Published: January 2018

Purpose

To elucidate whether the gene polymorphisms of glutathione S-transferase (GST) M1, T1, and PI are associated with the development of exudative age-related macular degeneration.

Methods

The authors genotyped 35 white patients with exudative age-related macular degeneration and 159 healthy controls. Genomic DNA from peripheral blood was examined using polymerase chain reaction and defined for the genetic polymorphisms of GST.

Results

No association was observed between GSTM1, GSTT1, and GSTP1 polymorphisms and age-related macular degeneration risk (p>0.05). The frequencies of the combination of the GSTM1 (null) and GSTP1 (mutant), GSTM1 (null), and GSTT1 (null) genotype polymorphisms in patients with exudative age-related macular degeneration differed greatly from those of the control group (p=0.001 OR [95% CI]: 7.70 [2.28–25.98] and p=0.007 OR [95% CI]: 3.88 [1.51–10.02], respectively).

Conclusions

The present study suggests that the GSTM1 (null) and GSTT1 (null), GSTM1 (null), and GSTP1 (mutant) combinations may be a genetic risk factor for the development of exudative age-related macular degeneration. However, the potential role of GST polymorphisms as a marker of susceptibility to age-related macular degeneration needs further studies in a larger number of patients.
Photodynamic Therapy for Choroidal Neovascularization in Patients with Multifocal Choroiditis and Panuveitis
Authors: Gerth C. , Spital G. , Lommatzsch A. , Heiligenhaus A. , Pauleikhoff D.
Published: January 2018

Purpose

To evaluate the visual benefit of photodynamic therapy (PDT) with verteporfin in patients with choroidal neovascularization (CNV) secondary to multifocal choroiditis and panuveitis over a longer follow-up period.

Methods

A total of 14 eyes of 12 patients (mean age 34 years) with a classic subfoveal CNV (13/14) or juxtafoveal CNV (1/14) were treated with PDT Visual outcome was assessed by best-corrected visual acuity (VA). Morphologic characteristics of CNVs such as localization, size, and activity were monitored by fluorescein angiography.

Results

Patients were followed for 3 to 45 months (mean 23 months). During this period, one to six PDTs (mean 2.4) were performed. At the time of the first PDT no acute inflammation was seen in the affected eyes. Improved or stabilized visual function (VA loss ≤ 2 lines in the Early Treatment Diabetic Retinopathy Study chart) was observed in 71.4% of the eyes. A total of 78% of the eyes showed an inactive scar in the area of CNV after PDT. Treatment failure after PDT occurred due to uninfluenced CNV growth. No further complications were observed.

Conclusions

PDT in subfoveal or juxtafoveal classic CNV secondary to multifocal choroiditis and panuveitis stabilized or improved VA in the majority of patients over a longer follow-up period. No risk factor for failed VA rehabilitation could be defined.
Use of Autologous Plasmin during Vitrectomy for Diabetic Maculopathy
Authors: Sakuma T. , Tanaka M. , Inoue J. , Mizota A. , Souri M. , Ichinose A.
Published: January 2018

Purpose

To evaluate the efficacy of autologous plasmin enzyme as an adjunct to vitrectomy in diabetic macular edema.

Methods

Plasmin derived from autologous blood was injected intravitreally into seven eyes 15 min before vitreous surgery. The development and progression of a posterior vitreous detachment (PVD) was followed, and the time required for vitreous removal was measured. Both pre- and postoperative visual acuities and optical coherence tomography (OCT)-determined macular thickness were measued.

Results

In the seven eyes in which plasmin was used, a PVD developed approximately 5 min after the injection and was confirmed to extend to the far periphery. In all cases, the removal of the vitreous was completed in a shorter time and no complications were observed. A restoration of the shape of the macula was observed in all cases. The visual acuity improved by two or more lines in four eyes, and remained unchanged in the remaining three eyes.

Conclusions

Autologous plasmin alone will create a full PVD, and eliminates the need for a mechanical creation of a PVD. Thus, plasmin is a safe and effective adjunct to vitreous surgery for the treatment of diabetic maculopathy.
Neuro-Ophthalmic Manifestations of Intracranial Cavernous Hemangiomas
Authors: Leibovitch I. , Pakrou D. , Selva D. , Crompton J.
Published: January 2018

PURPOSE:

To describe the neuro-ophthalmic manifestations of patients with intracranial cavernous hemangiomas (cavernomas).

Methods

A retrospective review of all patients with intracranial cavernomas with neuro-ophthalmic manifestations who were treated at the Royal Adelaide Hospital in Australia between 1994 and 2004.

Results

There were nine patients (three men and six women), with a mean age of 39 years (range 22–61). There was one cerebellar lesion, two thalamic, four pontine, one midbrain/pontine, and one midbrain. Ophthalmic presentations included internuclear ophthalmoplegia (one patient), third cranial nerve (CN) palsy (one patient), fourth CN palsy (one patient), and sixth CN palsy (six patients). Three patients underwent extraocular muscle surgery, and six were treated medically or observed. In five patients the diplopia resolved, in three it was only mild, and in one patient no significant change was noted during the follow-up period.

Conclusions

Diplopia is the main neuro-ophthalmic manifestation of intracranial cavernomas. Sixth CN palsy is the most common cause. Neurosurgical or conservative treatment leads to improvement in most cases, and later use of spectacles or extraocular muscle surgery may lead to further improvement.
High Myopia and Congenital Myopathy with Partial Pachygyria in Cutis Laxa Syndrome
Authors: Morava E. , Willemsen M.A. , Wopereis S. , Laak H. Ter , Lefeber D. , Wevers R.A. , Cruysberg J.R.
Published: January 2018

Purpose

Several types of inborn errors of the O-glycan biosynthesis are known, leading to clinically very distinct phenotypes. Children with O-mannosyl glycan biosynthesis defects commonly present as a severe form of congenital muscular dystrophy with decreased alpha-dystroglycan staining, congenital eye anomalies, and brain migration defects. Alpha-dystroglycan is an O-mannosylated glycoprotein with additional mucin type O-glycans.

Methods

Based on overlapping clinical features with O-mannosyl glycan defects, especially with muscle-eye-brain disease, the authors performed a muscle biopsy in a child with severe congenital hypotonia, high myopia, partial pachygyria, mental retardation, cutis laxa, and an inborn error affecting the biosynthesis of both mucin type O-glycans and N-linked glycans.

Results

The histology showed no signs of muscle dystrophy, but a mild myopathy with slight increase in the muscle fiber diameter variability and type I fiber predominance. No significant decrease in the alpha-dystroglycan staining was detected; therefore, in spite of the phenotypic similarities the authors could not confirm the role of abnormal dystroglycan in the etiology of the muscle weakness and the developmental anomalies.

Conclusions

High myopia, muscle weakness, and cortical neuronal migration abnormalities are common in disorders of O-mannosylation and also observed in the authors’ patient. However, compared to the severe generalized defect observed in mannosyl glycan defects, in this child the cerebral white matter and cerebellum were spared, and no muscle dystrophy could be confirmed. This is the first description of high myopia in cutis laxa syndrome in combination with congenital disorders of glycosylation.
Limbal Conjunctival Mini-Autografting for Preventing Recurrence after Pterygium Surgery
Authors: Oguz H. , Kilitcioglu A. , Yasar M.
Published: January 2018

Purpose

The aim of the present study was to evaluate limbal conjunctival mini-autografting procedure based on recurrence rates following pterygium surgery.

Methods

A total of 63 eyes (53 patients) with pterygium, of which 60 were primary and 3 were recurrent, underwent surgery for the removal of pterygia with limbal conjunctival mini-autograft. After the pterygium excision, the limbal portion of the graft was oriented and sutured to the limbus at the recipient bed with the epithelial surface upside. Recurrence was defined as fibrovascular tissue of more than 1 mm over the cornea in the area of previous pterygium excision. The mean follow-up period was 12.5 months (ranging between 6 and 29 months).

Results

The time required for the surgery was approximately 30 minutes (range 20–40 minutes). Recurrence of pterygium was observed in 6 of 63 eyes (9.52%). No eyes with recurrent pterygium developed recurrence postoperatively. There were no severe complications during the operative and postoperative period. Most patients had temporary graft edema, lasting a few days after the operation, and they experienced and complained of foreign body sensations and epiphora.

Conclusions

Limbal conjunctival mini-autografting appears to be an effective procedure for pterygium surgery resulting in a low recurrence rate.
Comparison of the Effect of Sodium Hyaluronate (Ophthalin®) and Hydroxypropylmethylcellulose (HPMC-Ophtal®) on Corneal Endothelium, Central Corneal Thickness, and Intraocular Pressure after Phacoemulsification
Authors: Ray-Chaudhuri N. , Voros G.M. , Sutherland S. , Figueiredo F.C.
Published: January 2018

Purpose

To prospectively evaluate the effects of 2% hydroxypropyl-methylcellulose (HPMC-Ophtal®) and sodium hyaluronate 1% (Ophthalin®) on intraocular pressure, corneal thickness, and endothelial cell loss in small incision cataract surgery with implant. METHODS. A total of 110 patients undergoing routine phacoemulsification with implant received either 2% hydroxypropylmethylcellulose or sodium hyaluronate 1% as ophthalmic viscosurgical device. Pre- and postoperative slit lamp examination, intraocular pressure measurement (preoperatively and at 1–4 hours, 1 day, and 7 days postoperatively), ultrasonic pachymetry (preoperatively and at 1 week, 4–6 weeks, and 12 weeks postoperatively), and corneal endothelial cell count (preoperatively and 12 weeks postoperatively) were performed. Data were analyzed using two-way analysis of variance.

Results

All measurements were comparable between the two groups preoperatively. Intraocular pressure was significantly lower in the Ophthalin® group at 1 day postoperatively, while no significant difference was found between the two groups on the 1–4 hours and 7 days examination. The central corneal thickness was not significantly different between the two groups at any postoperative visit. However, the mean cell density demonstrated a significant fall of 11.76% for Ophthalin® and 4.27% for HPMC-Ophtal® at 12 weeks postoperatively, the difference between the two being significant (p=0.009).

Conclusions

2% Hydroxypropylmethylcellulose, compared with sodium hyaluronate 1%, is superior in protecting the corneal endothelial cells, has the same effect on central corneal thickness, and is associated with slightly higher intraocular pressure 1 day postoperatively. It compares favorably with sodium hyaluronate 1% and can be used as an effective and cheaper alternative in routine small incision cataract surgery with implant.
Diagnostic Accuracy and Reproducibility of Tendency Oriented Perimetry in Glaucoma
Authors: De La Rosa M. Gonzalez , Gonzalez-Hernandez M. , Feijoo J. Garcia , Morales J. , Azuara-Blanco A.
Published: January 2018

Purpose

To evaluate the diagnostic capability of tendency oriented perimetry (TOP) in glaucoma.

Methods

A): The diagnostic accuracy of mean defect (MD), square-root of the loss variance (sLV), and number of pathologic points (NPP) was calculated in 295 normal and 414 glaucoma eyes (179 early, 112 moderate, and 123 advanced) examined with TOP. B): Threshold fluctuation (F) and its relationship with the loss variance (LV) was measured in 34 normal and 33 glaucoma eyes (mean MD=3 dB; SD=3.9) for TOP and for full-threshold perimetry (FT). C): Twenty-eight eyes with stable glaucoma (mean MD=9.5 dB; SD=7.2) were examined six times to quantify LV error. D): TOP and FT were tested with the simulation program PeriSim using different behavior models.

Results

A): The best diagnostic index in early glaucoma (MD<6dB) was sLV(specificity=90.2%, sensitivity=84.9). The three indices had similar precision in moderate and severe glaucoma. B): Threshold fluctuation and sLV were better correlated in TOP (r=0.72, p<0.01) than in FT (r=0.62, p<0.01). For normal subjects, in FT the incidence of F<2 dB was 8.82% and sLV<1.5 dB 5.88%. The same frequencies in TOP were 67.65% and 55.88%. C): Averaging six examinations reduced the sLV value by 22%. D): The threshold estimation error increased 1 dB in TOP in relation to FT for the same patient's behavior, but the error in TOP was lower than in FT when the worst behavior was modeled.

Conclusions

TOP is a good discriminator between glaucoma and normality. Perimetry results overestimate the real sLV value. TOP's high diagnostic ability is probably associated to the algorithm design and to less contaminating influences during the examination.
Surgical Results of Combined Pars Plana Vitrectomy, Phacoemulsification, and Intraocular Lens Implantation for various Vitreoretinal Diseases
Authors: Mochizuki Y. , Kubota T. , Hata Y. , Miyazaki M. , Suyama Y. , Enaida H. , Ueno A. , Ishibashi T.
Published: January 2018

Purpose

To evaluate the results and complications of combined pars plana vitrectomy (PPV), phacoemulsification and aspiration (PEA), and intraocular lens (IOL) implantation.

Methods

A total of 117 eyes from 114 patients who had undergone PPV combined with PEA and IOL implantation were retrospectively analyzed. Combined surgery was performed for a wide variety of vitreoretinal diseases. Intraoperative and postoperative complications were also reviewed.

Results

The postoperative BCVA improved by 2 lines or more in 85 eyes (72.6%). Intraoperative complications consisted of retinal tears in 14 eyes (12.0%) and posterior capsular rupture in 2 eyes (1.7%). Iatrogenic retinal tears occurred more frequently in eyes with a macular hole than in eyes with any other disease (p=0.005, chi-square test). Postoperative complications consisted of posterior capsule opacification (PCO) (21 eyes), transient IOP elevation (29 eyes), vitreous hemorrhage (6 eyes), anterior chamber fibrin exudation (11 eyes), posterior iris synechia (8 eyes), neovascular glaucoma (1 eye), and recurrent retinal detachment (RD) (2 eyes). Fibrin exudation occurred more frequently in eyes with proliferative diabetic retinopathy (PDR) and RD than in eyes with any other disease (p=0.03, chi-square test). PCO occurred more frequently in eyes with PDR than in eyes with any other disease (p=0.03, chi-square test).

Conclusions

The present study suggests that a high success rate can be achieved when recently improved PPV techniques are combined with PEA and IOL implantation. The complications that were observed following this combined treatment varied with respect to the vitreoretinal disease present prior to surgery.
Rufloxacin Eyedrops: Effect of Different Formulations on Ocular Pharmacokinetics in Rabbits
Authors: Burgalassi S. , Cappello B. , Chetoni P. , Iervolino M. , Monti D. , Saettone M.F.
Published: January 2018

Purpose

To evaluate the aqueous humor pharmacokinetics of rufloxacin in rabbits after topical administration of different formulations, and to individuate the ones showing the best pharmacokinetic profile.

Methods

Six formulations were instilled in rabbit eyes: two pH 7.2 suspensions of non-salified rufloxacin base, or zwitterion (RUF), one of which was viscosized with tamarind seed polysaccharide (TSP); two pH 7.2 solutions of RUF obtained using hydroxypropyl-β-cyclodextrin (CD), one of which was viscosized with TSP; and two pH 5.0 solutions of rufloxacin hydrochloride (RUF-HCI), one of which was viscosized with TSP. At different times after administration, samples of aqueous humor were withdrawn and analyzed by high-pressure liquid chromatography. The main pharmacokinetic parameters of RUF in the aqueous humor produced by the different formulations were calculated and statistical differences were assessed.

Results

The best results, in terms of aqueous humor bioavailability, were observed with two TSP-viscosized formulations: a solution of the hydrochloride (TSP/RUF-HCI) and a suspension of the base (TSP/RUF), followed by the non-viscosized solution of RUF-HCI. The formulations containing CD-solubilized RUF were much less effective.

Conclusions

The present data confirm the significant availability-enhancing properties of tamarind seed polysaccharide, and indicate that solubilization of RUF with hydroxypropyl-β-cyclodextrin (CD/RUF) results in decreased drug availability with respect to standard formulations. Two of the TSP-viscosized formulations (RUF suspension and RUF-HCI solution) produced aqueous humor RUF concentrations in the range of activity against Enterobacteriaceae and Pseudomonas aeruginosa, thus warranting further studies on applications of rufloxacin in ocular therapy.
Occurrence of Full-Thickness Macular Hole Complicating Stargardt Disease with ABCR Mutation
Authors: Sodi A. , Bini A. , Passerini I. , Menchini U. , Torricelli F.
Published: January 2018

Purpose

To report an unusual episode of full-thickness macular hole complicating Stargardt disease with an ABCR mutation.

Methods

Case report.

Results

Fundus examination of a 20-year-old healthy man showed typical fundus manifestation with yellowish-round or fish-like flecks associated with vitreous macular adhesion and a round punched-out area in the right eye. Optical coherence tomography (OCT) illustrated a full-thickness macular hole. Molecular genetic examination of the ABCR gene showed two heterozygous missense mutations: R1108C (CGC→TGC) in exon 22 and a splicing mutation IVS6-→1GT – described in the literature in association with Stargardt disease.

Conclusions

Macular hole was once described in other inherited retinal degenerations (Best disease and Bietti crystalline retinopathy). The pathogenesis gives rise to a host of speculations: widespread alteration of the retinal pigment epithelium; inflammatory mechanisms; a minor trauma which might cause subretinal fibrosis. Surgical procedures were not performed on our patient after his ophthalmologic history and findings were considered.
Optical Coherence Tomography Findings in Branch Retinal Artery Occlusion
Authors: Karacorlu M. , Ozdemir H. , Karacorlu S. Arf
Published: January 2018

Purpose

To report the optical coherence tomography (OCT) findings in a 35-year-old man with acute inferior branch retinal artery occlusion.

Methods

OCT findings in acute branch retinal artery occlusion were evaluated.

Results

OCT disclosed diffuse thickening of the neurosensory retina in the inferior perifoveolar area. Increased reflectivity was noted in the inner retinal layers from the surface of the retina to the photoreceptor layers. Decreased reflectivity was observed from the photoreceptor layers and the retinal pigment epithelium secondary to the shadowing effect. Foveolar depression, photoreceptor layer in the fovea, and retinal pigment epithelium underneath the fovea were normal. OCT findings in the superior perifoveolar area were also normal.

Conclusions

In retinal artery occlusion, denaturation and breakdown of the normally transparent intracellular protein and an increase in the intracellular fluid cause ischemic whitening of the retina. Otherwise there is no retinal thickening secondary to the accumulation of serous fluid escaping from retinal capillaries into the extracellular space. The OCT findings support these descriptions.
Effects of Antiglaucoma Drugs GLC756, a Novel Dopamine D2 Agonist and D1 Antagonist, and Timolol on Endotoxin-Induced TNF-Alpha Release in Serum of Rats
Authors: Laengle U.W. , Markstein R. , Schneider V. , Roman D.
Published: January 2018

Purpose

Anti-inflammatory activity of an antiglaucoma drug may be an advantage for long-term treatment of glaucoma since it may reduce the risk of treatment-related inflammatory processes in outer compartments of the eye and probably also prevent or delay progression of glaucomatous retinal neurodegeneration. In this study, the effect of GLC756, a novel mixed dopamine D2 receptor agonist and dopamine D1 receptor antagonist, and timolol on endotoxin-induced cytokine tumor necrosis factor-α (TNF-α) release in serum was examined.

Methods

For endotoxin-induced TNF-α release, 8-week-old Lewis rats were intravenously injected with 160 μg lipopolysaccharide (LPS) from Salmonella typhimurium. GLC756, timolol, or betamethasone were either systemically (1 mg/kg SC for 5 days) or topically (0.4%, 0.5%, and 0.1%, respectively, 20 μL eye drops given 16 times over 48 hours in left and right eye) administered. TNF-α was measured in serum 2 and 48 hours after LPS induction.

Results

A marked TNF-α increase in serum was found 2 hours after LPS induction. Administration of GLC756 and betamethasone, systemically and topically, decreased TNF-α release. However, due to large scattering of mean values only the effect of systemically administered GLC756 was statistically significant. In contrast, timolol increased TNF-α values stronger than LPS alone.

Conclusions

The significant suppression of LPS-induced TNF-α increase by GLC756 suggests an additional anti-inflammatory potential of the dopaminergic compound in the treatment of glaucoma.
In vivo Detection of Monosomy 3 in Eyes with Medium-Sized Uveal Melanoma using Transscleral Fine Needle Aspiration Biopsy
Authors: Midena E. , Bonaldi L. , Parrozzani R. , Tebaldi E. , Boccassini B. , Vujosevic S.
Published: January 2018

Purpose

Cytogenetic prognostication of choroidal melanoma, particularly monosomy 3 detections, is limited to enucleated eyes or resected tumors. The authors developed an in vivo technique to detect monosomy 3 using transscleral fine needle aspiration biopsy (FNAB).

Methods

Eight eyes with medium-sized choroidal melanoma were included in this prospective study. A 25-gauge transscleral FNAB was performed during surgical procedure for brachytherapy, just before applying the radioactive plaque over the tumor base. Sampled material underwent fluorescence in situ hybridization (FISH) with centromeric probes for chromosome 3. Follow-up was >12 months.

Results

Transscleral FNAB yielded sufficient material in 7 of 8 eyes (87.5 %). Five of seven eyes had monosomy 3. No early or late complications were detected.

Conclusions

This study demonstrates that medium choroidal melanomas may be safely sampled by intraoperative transscleral FNAB to detect monosomy 3 in vivo.
Triamcinolone and PDT to Treat Exudative Age-Related Macular Degeneration and Submacular Hemorrhage
Authors: Ruiz-Moreno J.M. , Montero J.A , Barile S.
Published: January 2018

Purpose

To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin and intravitreal injection of triamcinolone to treat choroidal neovascularization (CNV) with flat submacular hemorrhage in age-related macular degeneration (ARMD).

Methods

A prospective, consecutive, noncomparative, interventional case series study was performed at the Instituto Oftalmologico de Alicante, Spain. Ten consecutive eyes from 10 patients with flat submacular hemorrhage secondary to ARMD were treated by PDT followed by intravitreal injection of 19.4±2.1 mg/0.1 mL triamcinolone 5 days later. PDT was repeated if leakage from the CNV appeared on fluorescein angiography (FA) at 3 months follow-up intervals. Main outcome measures were best-corrected visual acuity (BCVA) before and after treatment, post-treatment FA, results, and complications.

Results

Stable or improved BCVA was achieved in seven eyes at 6 months follow-up. Complete absence of leakage in FA was observed in five and in eight eyes at 3 and 6 months follow-up, respectively. Intraocular pressure rose in seven eyes.

Conclusions

PDT followed by intravitreal triamcinolone seems useful to treat CNV with flat submacular hemorrhage in ARMD. However, further studies with longer follow-up and randomized controlled trials are necessary to assess its efficacy in the management of this difficult clinical problem.
Computer-Assisted Image-Guided Orbit Surgery
Authors: Karcioglu Z.A. , Mascott C.R.
Published: January 2018

Purpose

Modern stereotaxy utilizes preoperative computed tomography (CT) and magnetic resonance imaging (MRI) to provide accurate localization information which can be very helpful in orbital surgery. The purpose of this report is to evaluate the usefulness of stereotactic surgery and application of this procedure in the orbit.

Methods

Interventional case series of three patients with orbital tumors. All patients had tumor resection with the utilization of two frameless stereotactic systems: Cygnus™ and Stealth Station™.

Results

The applications of image-guided stereotactic surgery proved to be beneficial in three extensive orbital tumors, including optic nerve glioma, recurrent pleomorphic adenoma of lacrimal gland, and secondary orbital meningioma.

Conclusions

The interactive nature of image guidance can be useful in orbital surgery to orient the surgeon to the exact location within the surgical field and to determine the tumor margins.
Orbital Metastasis from Squamous Cell Carcinoma of the Esophagus
Authors: Aralikatti D.A. , Nylander A.G.E.
Published: January 2018

Purpose

To describe a rare case of orbital metastasis from squamous cell carcinoma of the esophagus.

Methods

A 63-year-old man presented with intermittent left-sided headache. This was initially attributed to angle-closure glaucoma and bilateral peripheral laser iridotomies were performed. One month later, he developed left periorbital swelling. On reviewing the history, it was noted that he had undergone surgery for esophageal carcinoma. CT scan revealed a soft tissue mass in the left orbit, which on biopsy showed histologic features of metastatic squamous cell carcinoma. The patient died before palliative radiotherapy could be completed.

Discussion

Orbital metastasis from esophageal carcinoma is rare. In this case, the possibility of metastasis was overlooked at initial presentation, as there were no clinical signs to suggest it. Regardless of the primary tumor, the prognosis following orbital metastasis is poor.

Conclusions

It is important to consider radiologic investigation when patients with systemic malignancy present with unexplained headache.
Endoscopically assisted Balloon Dacryocystoplasty and Silicone Intubation versus Silicone Intubation Alone in Adults with Incomplete Nasolacrimal Duct Obstruction
Authors: Kashkouli M.B. , Beigi B. , Tarassoly K. , Kempster R.C.
Published: January 2018

Purpose

To compare the success rate of endoscopically assisted balloon daciyocystoplasty (DCP) and silicone intubation (DCP-SI) with endoscopically assisted silicone intubation alone (SI) in adults with incomplete nasolacrimal duct (NLD) obstruction.

Methods

In a retrospective nonrandomized comparative case series, 62 eyes of 55 adult patients with incomplete NLD obstruction underwent endoscopic probing and either SI (n=39 eyes) or DCP-SI (n=23 eyes) under general anesthesia. The last follow-up examination included diagnostic probing and irrigation if there was not success. Success was defined as disappearance of the symptoms and failure as partial improvement or absence of improvement at last follow-up.

Results

Patients ranged from 20 to 85 years of age (mean: 60.93, SD: 15.60). Tubes were removed between 6 and 20 weeks (mean: 7.49, SD: 2.25) postoperatively. Follow-up ranged from 6 to 63 months (mean: 14.60, SD: 10.33). Success rate of the eyes with SI (21/39, 53.84%) and DCP-SI (14/23, 60.86%) were not statistically different (p=0.60). Complications included slight nasal and canalicular bleeding in almost all eyes in both groups which was easily controlled, slit punctum in four eyes with bicanalicular intubation (4/50, 8%), and monocanalicular tube lost in three eyes prematurely.

Conclusions

Success rate of endoscopic DCP-SI had no statistically significant difference from silicone intubation alone in treatment of incomplete NLD obstruction in adults.
Homocysteine Levels in Plasma and Sensorineural Hearing Loss in Patients with Pseudoexfoliation Syndrome
Authors: Ozkan B. Aydoğan , Yüksel N. , Keskin G. , Altintaş Ö. , Karabaş V.L. , Çağlar Y. , Almaç A.
Published: January 2018

Purpose

To determine the incidence and severity of hearing loss in different frequencies in patients with Pseudoexfoliation. Furthermore, possible links between homocysteine and Pseudoexfoliation were evaluated.

Methods

Seventy-five consecutive patients with Pseudoexfoliation and 75 sex- and age-matched subjects without Pseudoexfoliation as control group were included in this prospective case-control study. Pure-tone audiometry was obtained in all subjects in both groups. Blood samples were obtained from 70 patients with Pseudoexfoliation after overnight fasting for levels of homocysteine and analyzed by routine laboratory measurements.

Results

Fifty-two (69%) patients with Pseudoexfoliation and 39 (52%) controls had sensorineural hearing loss in speech frequencies. The difference between Pseudoexfoliation and control group with regard to the frequency of sensorineural hearing loss in speech frequencies was statistically significant (p=0.03). No relationship was found between the degree of glaucomatous damage and hearing threshold variables in the patients with Pseudoexfoliation glaucoma. Plasma homocysteine levels showed no significant difference when patients with Pseudoexfoliation and hearing loss were compared with patients with Pseudoexfoliation and normal hearing threshold (p=0.5). Hyperhomocysteinemia was found in 58% (29/50) of Pseudoexfoliation patients with hearing loss, and 55 % (11/20) of Pseudoexfoliation patients with normal hearing threshold (p=0.8). No statistically significant correlation was found between plasma homocysteine and hearing loss in patients with Pseudoexfoliation.

Conclusions

These findings suggest an association between sensorineural hearing loss and Pseudoexfoliation in patients with Pseudoexfoliation and glaucoma. The severity of hearing loss was not correlated with the degree of glaucomatous damage. There is no association between increased homocysteine levels and hearing loss in patients with Pseudoexfoliation.
Levels of Zinc, Iron, and Copper in Patients with Pseudoexfoliative Cataract
Authors: Cumurcu T. , Mendil D. , Etikan I.
Published: January 2018

Purpose

To investigate the aqueous humor, lens, and serum concentrations of zinc, iron, and copper in patients with pseudoexfoliative cataract and compare with patients who have senile cataract without Pseudoexfoliation.

Methods

Twenty-five patients with pseudoexfoliative cataract and 25 patients with senile cataract as control group were enrolled in the study. Samples from aqueous humor, serum, and lens materials during extracapsular cataract extraction (ECCE) were collected from all patients. The levels of selected trace elements in three samples in all groups were assayed with atomic absorption spectrometry (AAS) and statistical analyses were performed with t-test for independent samples except lens zinc and serum copper levels. The data weren't normally distributed, therefore Mann-Whitney U tesf applied for these parameters.

Results

The zinc and copper levels in aqueous humor of PEX group were significantly higher than those of control group (p<0.001). The iron levels in aqueous humor were not significantly different in PEX group and control group (p=0.252). The copper content of lenses was significantly increased in PEX group compared to control group (p=0.029). The iron and zinc content of lenses had no significant differences between the two groups (p=0.248, p=0.719, respectively). The levels of iron and copper in serum were significantly increased in PEX group compared to control group (p<0.001 and p<0.002, respectively). The zinc level in serum had no significant differences between the two groups (p=0.823, p=0.472, respectively).

Conclusions

Zinc, iron, and especially copper may play a role in PEX syndrome.