bluuebunny/crossref_metadata_2025 huggingface dataset:
New Forceps and Spatula for Easy Retropupillary Implantation of Iris Claw Lenses in Aphakia: Experience in 4 Years of Use
Authors: Sekundo W.
Published: January 2018

Purpose

Retropupillary implantation of an iris claw lens offers a rapid and atraumatic approach for rehabilitation of aphakic eyes. The difficulty in the implantation process arises because of the possibility of losing the intraocular lens (IOL) into the vitreous cavity and the need to change the hand holding the forceps during the enclavation.

Methods

The new forceps design radically changes the method of grasping an IOL. It contains an extendable supporting plate with a hook-like end. The instrument achieves a horizontal three-point fixation at the edge of the implant in the 6 and 12 o'clock position in order to prevent slippage into the vitreous cavity during the inclination. The supporting plate also has a horizontal mark to facilitate the centration of the IOL behind the pupil level. A long vitreoretinal-type shaft has been turned 90° to exclude the possibility of an accidental release during implantation. A special slender long spatula with an internal twist enables one-hand enclavation through the same side port without the need to change the hand holding the forceps.

Results

The author has implanted over 100 iris claw IOLs during the last 4 years without any intra-or postoperative complications.

Conclusions

The new forceps and spatula enable safe, easy, and rapid implantation of iris claw IOLs into the retropupillary space.
Testing the Reliability of an Eye-Dedicated Triaging System: The Rescue
Authors: Rossi T. , Boccassini B. , Cedrone C. , Iossa M. , Mutolo M.G. , Lesnoni G. , Mutolo P.A.
Published: January 2018

Purpose

To calculate the reliability of an eye-dedicated triaging system named Rome Eye Scoring System for Urgency and Emergency (RESCUE).

Methods

There were four coding parameters: pain, redness, loss of vision, and risk of open globe. Each parameter is assigned a score, the sum of which allows color coding. There were 1000 consecutive patients divided into urgent (U) or non-urgent (NU) based upon diagnosis, need for treatment, hospitalization, and/or follow-up visit. Correlation between RESCUE triage scoring as assigned by the nurse on presentation and urgency as estimated retrospectively was calculated. Accuracy, sensitivity, and specificity have been calculated. False positives (FP) have been defined as patients assigned a RESCUE green or yellow code while retrospectively judged NU and false negatives (FN) have been defined as patients assigned a white code despite being considered U.

Results

Of 1000 patients, 332 (33.2%) were classified as U and 668 (66.8%) NU. The difference in RESCUE scoring between U and NU patients was significant (p<0.001), as well as the correlation between RESCUE scoring and urgency status. Accuracy was 95% with 9.3% FP and 2.7% FN. Sensitivity was 90.7% and specificity 97.2%. Positive predictive value was 94.6%, and negative predictive value was 95.2%. All 32 hospitalized patients and 147/198 (74.2%) patients given a return appointment properly received a yellow or green code.

Conclusions

RESCUE accuracy, sensitivity, and specificity yield encouraging results, confirming the system's ability to properly spot the most urgent cases. The concept of urgency in ophthalmology can be difficult to establish; nonetheless, an eye-dedicated triage can help in properly prioritizing urgent patients.
Macular Involvement in Secondary Systemic Amyloidosis
Authors: Altiparmak U.E. , Köklü B. , Ünlü N. , Yağci R. , Bayrak R. , Gul Yilmaz Çinar F. , Duman S.
Published: January 2018

Purpose

A patient with subretinal and pre-retinal hemorrhage after secondary systemic amyloidosis due to familial Mediterranean fever is presented.

Methods

Case presentation.

Results

A 30-year-old woman with secondary systemic amyloidosis secondary to familial Mediterranean fever presented with painless visual loss in the right eye. The examination demonstrated multiple subretinal and pre-retinal hemorrhages, massive deposits which may represent amyloid material at the left macular region. After 6 months, the hemorrhages disappeared, but deposits persisted.

Conclusions

The macular deposition and hemorrhage is an uncommon manifestation of secondary systemic amyloidosis secondary to familial Mediterranean fever. Further evidence is necessary to understand the nature of these deposits and their relevance to secondary systemic amyloidosis and/or familial Mediterranean fever.
Evaluation of Therapeutic Deep Anterior Lamellar Keratoplasty in Acute Ocular Chemical Burns
Authors: Singh G. , Singh Bhinder H.
Published: January 2018

Purpose

To evaluate the role of deep anterior lamellar keratoplasty (DALK) in acute ocular chemical burns.

Methods

The study was conducted in 50 eyes of 50 patients (24 male, 26 female) with average age of 38.3±14.3 years. DALK in 5 eyes (10%), DALK with quadrant conjunctivo-limbal graft in 25 eyes (50%), and DALK with amniotic membrane in 20 eyes (40%) were performed along with conventional medical therapy. Controls who were matched in all respects (50 eyes) were given medical therapy only as they refused surgical intervention.

Results

Follow-up of cases ranged from 6 to 48 months (mean 21.5±14.18 months). Forty-three eyes (86%) could be restored with clear cornea as compared to 6% in control group. The visual acuity improvement was seen in 100% with good score (0.49±1.46) in DALK group as compared to 18% with low score (0.03±0.01) in control group (p<0.0001). Visual acuity improvement in DALK was 6/12 in 19 eyes (38%), 6/24 in 28 eyes (56%), and 6/36 in 3 eyes (6%) but was 3/60–6/60 in 6 eyes (12%) and finger counting only in 3 eyes (6%) in control group. Eyes with advanced grade II and grade III showed better improvement than those with burns of grade IV (p<0.05). The discomfort was relieved and epithelial healing was achieved immediately in DALK as compared to a prolonged course in control group (p<0.0001). Vascularization presented in 38% in DALK with least score (0.13+0.15) as compared to 100% in control group with high score (2.8±0.30). Perforation of cornea was seen only in 2 cases (4%) in DALK with low score (0.03±0.10) as compared to 88% in control group (1.33±0.20). Symblepharon was seen in 2% in DALK group as compared to 62% in control group.

Conclusions

DALK with and without conjunctival or amniotic membrane transplantation is an effective technique in restoring the integrity of the eye with an excellent graft transparency in 86% and improvement in visual acuity in 100% of the acute chemical burns.
Ultrasound Biomicroscopic Measurement of Anterior Chamber Biometry between before and after Pupil Dilation in Children
Authors: Tsuchiya A.K. , Tanaka K. , Sakurada I. , Oba S. , Mizuki N.
Published: January 2018

Purpose

To evaluate anterior chamber biometry of the eyes of normal children using ultrasound biomicroscopy (UBM) and to evaluate the differences in biometry between children and adults, and before and after pupil dilation in children.

Methods

Anterior chamber depth (ACD) and trabeculariris angle (TIA) were measured in 94 normal children and 15 normal adults using UBM. Before and after pupil dilation were measured in 42 children with emmetropic and hyperopic eyes.

Results

In 66 emmetropic children, ACD and TIA were 2.93±0.18 mm and 34.42±4.02°, respectively. In 28 hyperopic children, ACD and TIA were 2.92±0.21 mm and 35.05±4.42°, respectively. There was no significant difference in anterior chamber biometry associated with the refraction. ACD did not differ between children and adults, but TIA in children was wider than in adults. There was no significant difference in ACD or TIA before versus after pupil dilation in any case.

Conclusions

Anterior chamber biometry in children showed no differences before and after pupil dilation. Also, there was no difference in ACD of children as compared to adults; however, TIA in children was significantly wider than in adults.
A Study on the Awareness of Cataract Disease and Treatment Options in Patients who Need Surgery in a Rural Area of Eastern China
Authors: Zhou J.B. , Guan H.J. , Qu J. , Yang X.J. , Peng D. , Gu H.Y.
Published: January 2018

Purpose

To investigate the awareness of cataract disease and treatment and to determine the major barriers for patients who need cataract treatment in a rural area of eastern China.

Methods

A total of 251 cataract patients were selected by means of eye disease screenings throughout Jiangyan County Questionnaires were administered after the doctor determined that the patient needed cataract surgery The patient's awareness questionnaire was developed by Fletcher and clinically validated at the Aravind Eye Hospital in India.

Results

A total of 89.6% of patients had been aware of their condition for more than 1 year. Only 49.8% of all patients had known for more than 1 year that their eye disease could be treated. The major barriers for those seeking eye treatment included residual functional vision (49.0%), financial problems (36.7%), no demand for the operation (8.8%), and skepticism about the operation (8.8%). Poor vision function grade and female gender were two significant factors associated with a longer awareness (>3 years) of the existence of cataracts. Patients with a history of eye disease and a longer awareness of eye disease were more likely to have known about the potential treatments for a longer period of time (>1 year).

Conclusions

The patients' awareness of the presence of cataract disease and potential treatment were unbalanced. The main treatment barriers were lower demand for vision improvement and financial problems. It is imperative to educate patients on eye health care and to provide low cost, but high quality, cataract surgery to these patients.
Macular Function by Multifocal Electroretinogram in Diabetic Macular Edema after Intravitreal Triamcinolone Acetonide Injection
Authors: Karacorlu M. , Ozdemir H. , Senturk F , Arf Karacorlu S. , Uysal O.
Published: January 2018

Purpose

The purpose of this study was to assess macular function by multifocal electroretinography (mfERG) in eyes with diabetic macular edema (DME) after intravitreal triamcinolone acetonide (IVTA) injection.

Methods

Fifteen eyes of 15 patients with DME scheduled for 4 mg IVTA injection were prospectively recruited. The response to treatment was monitored functionally by visual acuity (VA) measurement and mfERG and anatomically by foveal thickness measured by optical coherence tomography (OCT). The first-order kernel P1 mfERG responses from 0 to 7 degrees (central) and 7 to 25 degrees (peripheral) were grouped and analyzed. Changes in functional parameters (VAs and the P1 mfERG response amplitudes and peak latencies) and morphometric parameters (OCT foveal thickness) in eyes with DME 1 and 3 months after IVTA injection were compared with baseline values by Student t test.

Results

The mean baseline logMAR value for VAs of the patients before treatment was 0.49±0.26. After treatment, it was 0.27±0.23 at 1 month and 0.26±0.18 at 3 months, and differences from pretreatment values were significant (for each, p<0.001). There were statistically significant decreases in the mean foveal thickness at 1 and 3 months after treatment compared with pretreatment values (for each, p±0.001). There were also statistically significant increases in the mean P1 response amplitude for both central and peripheral groups at all examinations compared with pretreatment (for each, p±0.001). The mean P1 peak latencies for both the central and peripheral groups were shortened, but not significantly.

Conclusions

As well as the reduction in DME and improvement in VA, IVTA injection improves macular function as assessed by mfERG in diabetic patients.
Prognostic Prediction Ability of Postoperative Multifocal ERG after Vitrectomy for Diabetic Macular Edema
Authors: Leozappa M. , Micelli Ferrari T. , Grossi T. , Pace V. , Rinaldi M.L. , Battista D. , Micelli Ferrari L.
Published: January 2018

Purpose

Diabetic macular edema (DME) causes visual loss in diabetic patients. Multifocal electroretinograms (mfERGs) have been used to assess macular function pre- and postvitrectomy for DME.

Methods

A standard three-port pars plana vitrectomy with peeling of inner limiting membrane was performed in 25 eyes of 21 patients (13 male, 8 female) with DME. For each patient, visual acuity examination, measure of retinal thickness (using optical coherence tomography), and mfERGs were performed before and 1 week, 1 month, 3 months, and 6 months after vitrectomy.

Results

Mean postoperative visual acuity was significantly improved (p±0.05, t test), with mean increase of 0.17 logMAR units; mean retinal thickness was significantly (p±0.001) decreased after surgery (from 537 μm to 298 μm). The increase of normalized amplitude of central ring was not significant; the mean P1 wave-amplitude increased from 0.33 to 0.40 mV; mean P1 wave-implicit time decreased 2.88 ms. We divided the patients into two groups: Group 1 (13 eyes), in which the visual recovery was less than 0.20 logMAR, and Group 2 (12 eyes), in which the visual recovery was greater than 0.20 logMAR. ERG results were statistically significantly different between the groups (p±0.025), when we consider the response recorded from the central ring. In Group 2 there is a marked reduction in implicit time of both ERGs waves, which was statistically significant for N1 wave (p=0.01). The changes of parameters of mfERG observed 6 months after surgery were consistent with those recorded just 1 week after surgery.

Conclusions

Multifocal electroretinogram can be useful to predict functional prognosis in patients with diabetes who underwent vitrectomy for diabetic macular edema.
Ultrasound Biomicroscopy after Vitrectomy in Eyes with Normal Intraocular Pressure and in Eyes with Chronic Hypotony
Authors: Nehemy M.B. , Zisman M. , Marigo F.A. , Nehemy P.G. , Schachat A.P.
Published: January 2018

Purpose

To analyze the ultrasound biomicroscopy (UBM) features of eyes with chronic hypotony after pars plana vitrectomy (PPV) and compare them with the UBM features of eyes with normal intraocular pressure (IOP) after PPV.

Methods

This comparative (nonrandomized) interventional study included 64 eyes of 64 patients who underwent PPV. Group 1 included 20 eyes with less complex vitreoretinal diseases (VRD) that presented with normal IOP after PPV. Group 2 included 44 eyes with severe proliferative vitreoretinopathy (PVR) managed with PPV and silicone oil tamponade that presented with complete retina reattachment and chronic ocular hypotony. UBM was performed to study the anterior segment, ciliary body (CB), and peripheral retina. The UBM findings of the two groups were compared.

Results

In Group 1, 19/20 eyes presented with no CB alterations detected by UBM. In Group 2, 43/44 eyes presented with CB alterations that included tractional CB detachment (n=16); exudative CB detachment (n=11); tractional CB detachment/CB atrophy (n=7); CB hypotrophy (n=5); tractional CB detachment/exudative CB detachment (n=3); and CB edema (n=1). There was a strong relationship between IOP and CB findings revealed by UBM.

Conclusions

Eyes with hypotony following PPV have CB abnormalities that can be detected by UBM. These CB alterations were not found in eyes with normal IOP after PPV in this series.
Acute Visual Loss and Chorioretinal Infarction after Photodynamic Therapy Combined with Intravitreal Triamcinolone
Authors: Lo Giudice G. , De Belvis V. , Piermarocchi S. , Galan A. , Prosdocimo G.
Published: January 2018

Purpose

To report acute visual loss associated with dynamic vascular changes after photodynamic therapy (PDT) combined with intravitreal triamcinolone (IVTA) for the treatment of occult choroidal neovascularization (CNV).

Methods

An 86-year-old woman complained of visual loss in her left eye. Angiographic examination showed a serous pigment epithelium detachment complicated by CNV. She underwent combined treatment with IVTA (4 mg) followed by standard verteporfin PDT administered after a 5-day interval.

Results

The patient developed vision loss 1 day after PDT. Ophthalmoscopic examination disclosed an acute serous neurosensory retinal detachment. Fluorescein angiography showed a large area of early hypofluorescence in correspondence to and extending beyond the photodynamic spot. Neurosensory retinal vessels involvement with dilation of the retinal arterioles and capillary nonperfuion were also revealed. Indocyanine green angiography showed choroidal infarction within the collateral choroid included in the area of light exposure, with associated nonperfusion of medium and large choroidal vessels being revealed. Five days after PDT, spontaneous severe bleeding with breakthrough into the vitreous occurred, in addition to an RPE tear.

Conclusions

Acute loss of vision associated with vascular changes in retinal and choroidal circulation represents an uncommon but serious complication following combined PDT and IVTA. These risks should be carefully considered in combination therapies.
Vitreous Prolapse through the Scleral Wound in 25-Gauge Transconjunctival Vitrectomy
Authors: Shimada H. , Nakashizuka H. , Hattori T. , Mori R. , Mizutani Y. , Yuzawa M.
Published: January 2018

Purpose

To examine the effectiveness of excising peripheral vitreous until the cannula tip is exposed to prevent vitreous prolapse through the scleral wound in 25-gauge transconjunctival vitrectomy.

Methods

Twenty-five-gauge vitrectomy was performed in 60 consecutive eyes. Peripheral vitrectomy was conducted until the cannula tip was exposed in 30 eyes and with conservation of the vitreous around the cannula in 30 eyes. Vitreous prolapse through the scleral wound was examined using a suction stick.

Results

Vitreous prolapse through the scleral wound was transparent, fine and short, and detectable only with the suction stick. The incidence of vitreous prolapse through the scleral wound was 0% (0 of 30 eyes) when peripheral vitreous was excised until the cannula tip was exposed, and 20% (6 of 30 eyes) when the vitreous around the cannula was conserved, with a significant difference between two groups (p=0.0237). In two of six eyes with vitreous prolapse, the scleral wound was open, but there was no leakage of intraocular fluid and normal ocular pressure was maintained.

Conclusions

If peripheral vitrectomy is performed without excising the vitreous surrounding the cannula, there is a 20% risk of the vitreous prolapsing through the scleral wound. Vitreous prolapse through the scleral wound is difficult to detect because it is transparent, fine and short, and there is no intraocular fluid leakage. Therefore, detecting vitreous prolapse with a suction stick and appropriate intervention are important for preventing endophthalmitis.
Serum Allergen Specific Immunoglobulin E Levels in Patients with Allergic Conjunctivitis
Authors: Kocabeyoglu S. , Bozkurt B. , Bilen O. , Irkec M. , Orhan M.
Published: January 2018

Purpose

To evaluate serum allergen specific immunoglobulin E (IgE) levels in patients with various types of allergic conjunctivitis.

Methods

Twenty-five patients with seasonal allergic conjunctivitis (SAC), 17 patients with perennial allergic conjunctivitis (PAC), and 10 patients with vernal conjunctivitis (VC) were included in the study Specific IgE levels to Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), mixed grass pollens, and animal epithelia were measured using Pharmacia CAP system (Pharmacia Diagnostic AB, Uppsala, Sweden).

Results

The percentage of subjects with specific IgE against Dp and Df was statistically higher in VC (30%) compared to PAC (5.9%) and SAC (0%) (p=0.03). Specific IgE against mixed grass pollens was found in 30% of VC and 40% of SAC, whereas 10% of VC and 8% of SAC patients were found to be hypersensitive to animal epithelia.

Conclusions

Allergic reaction against house dust mites and pollens was common in VC, whereas specific IgE against grass pollens was remarkable in SAC. IgE levels specific to various antigens might be measured by UNICAP system, which is a rapid and practical technology.
Topography-Guided Treatment of Decentered Laser Ablation Using Lasersight's Excimer Laser
Authors: Wu L. , Zhou X. , Ouyang Z. , Weng C. , Chu R.
Published: January 2018

Purpose

To assess the efficacy of topography-guided laser ablation for correction of previously decentered laser ablation using LaserSight's excimer laser.

Methods

Re-treatment was performed to correct decentered ablation using LaserSight's excimer laser for 18 patients who previously underwent LASIK surgery for myopia correction in both eyes. For each patient, only the decentered eye was re-treated while the other asymptomatic eye forms a control group for this study. Measurements were conducted on ablation center, best spectacle-corrected visual acuity (BSCVA), contrast sensitivity and corneal aberrations pre- and post-operatively.

Results

For the retreated 18 eyes, the mean decentration was significantly reduced from 1.32±0.28mm to 0.61±0.23mm post-operatively (t=16.24, p<0.001), and with a significant improvement in mean BSCVA from 0.08±0.09 logMAR to 0.01±0.11 logMAR (t=4.58, p<0.001). The post-operative contrast sensitivity at the spatial frequencies (SF) of 1.00 and 0.70 was significantly improved (p<0.05 for both SFs). Corneal higher-order aberrations (HOAs), including the coma-like aberrations and spherical aberration, were decreased. In comparing the measurements for the retreated group to those for the control group, no significant difference was found either in decentration or in BSCVA, but the contrast sensitivity at 0.70 was lower and the level of corneal aberrations was higher.

Conclusions

Topography-guided ablation with LaserSight excimer laser is effective to correct decentered ablation. However, the re-treated eye is still inferior to the eye with originally centered ablation in corneal optical quality or visual performance.
Effect of Topical Anesthetics on Intraocular Pressure and Pachymetry
Authors: Montero J.A. , Ruiz-Moreno J.M. , Fernandez-Munoz M. , Rodriguez-Palacios M.I.
Published: January 2018

Purpose

The determination of intraocular pressure (IOP) by noncontact tonometry (NCT) has been reported to be affected by central corneal thickness (CCT) and by the instillation of topical anesthetics.

Methods

In order to determine the influence of topical anesthetics on CCT and IOP measured by NCT, 80 eyes from 49 patients were examined before and after the instillation of topical anesthetics.

Results

Average age was 55.3 years (SD 18.4, range 18 to 93). Twenty-eight patients were female and 21 were male. Average basal IOP was 16.1 mmHg (SD 5.2, range 8 to 35.3). IOP was 14.8 mmHg (SD 4.6, 7.4 to 32.4) (p=0.0005, Student t test for paired data) 5 minutes after topical anesthetics instillation. CCT averaged 541 μm (SD 32, range 482 to 604) before topical anesthetic drops and 541 μm (SD 32, 490 to 607, p=0.89, Student t test for paired data) 5 minutes after topical anesthetics instillation.

Conclusions

The study confirms that the instillation of topical anesthetics causes a reduction in IOP. These changes do not seem to be associated with changes in CCT.
Intravitreal Steroid Slow-Release Device Replacing Repeated Intravitreal Triamcinolone Injections for Sympathetic Ophthalmia
Authors: Jonas J.B. , Rensch F.
Published: January 2018

Purpose

To report on the intraocular use of a steroid slow-release device in an attempt to avoid multiple intraocular triamcinolone injections in chronic sympathetic ophthalmia.

Methods

A 47-year-old patient with sympathetic ophthalmia had received 17 intravitreal triamcinolone injections to suppress the uveitis, to increase intraocular pressure, and to reduce systemic anti-inflammatory medication. To avoid the frequent reinjections combined with the temporary reduction in vision and potential risk of infection and a recurrence of sympathetic ophthalmia, a slow-release device of 2.1-mg fluocinolone acetonide was intravitreally implanted.

Results

During the follow-up of 11 months after the procedure, intraocular pressure stabilized at 12 to 18 mmHg and visual acuity at 0.40 to 0.50. The systemic immunosuppressive therapy was stopped, and consequently, the insulin treatment could be halted.

Conclusions

Despite the limitations of a single case report, the results suggest that an intravitreal slow-release device of fluocinolone may be an alternative to repeatedly administered intravitreal triamcinolone injection for the long-term treatment of sympathetic ophthalmia. The intraocular slow-release application of steroids has enabled patients to live free from diabetic treatment and immunosuppressive medication after 21 years of systemic immunosuppressive therapy with secondary Cushing disease including diabetes mellitus and arterial hypertension.
Retinal Pigment Epithelial Marginal Retraction after Photodynamic Therapy for Choroidal Neovascularization in Pathologic Myopia
Authors: Pece A. , Isola V.
Published: January 2018

Purpose

To report the incidence of retinal pigment epithelial (RPE) marginal retraction after verteporfin photodynamic therapy (PDT) for subfoveal choroidal neovascularization (CNV) in pathologic myopia (PM).

Methods

Retrospective review of 236 patients treated with PDT for subfoveal CNV due to PM.

Results

RPE marginal retraction was found in 3 eyes (1.3%), and a decrease of a mean of five lines of vision was reported to occur 10–15 days after treatment. At the end of follow-up two eyes lost three lines and one six lines from baseline.

Conclusions

RPE marginal retraction as an early complication of PDT for subfoveal CNV secondary to PM is rare. The low incidence of this adverse event, however, should not preclude recommendations for PDT in myopic eyes that could benefit from this treatment modality.
The Effect of Pneumatic Trabeculoplasty on Intraocular Pressure: The Results of a 6-Month, Open-Label, Multicenter Study
Authors: Fogagnolo P. , Rossetti L. , Marchini G. , Marraffa M. , Rolando M. , Ciancaglini M. , Calabria G. , Mastropasqua L. , Orzalesi N.
Published: January 2018

Purpose

To evaluate the effects of pneumatic trabeculoplasty (PNT) in ocular hypertension and glaucoma subjects.

Methods

A total of 63 consecutive subjects, either treated (79%) or untreated (21%), with intraocular pressure (IOP) between 20 and 25 mmHg were enrolled; the eye with higher IOP (or, in case of identical IOP, worse visual field) was treated with PNT, with the fellow eye used as control. Subjects underwent a baseline evaluation the day before treatment, two PNT treatments at day 0 and 7, visits at day 1, 8, 14, and at each month until the end of the study, which lasted 6 months. Safety was addressed at all visits; an IOP curve (at 8 and 10 AM, 2 and 4 PM) was obtained at baseline and during monthly visits.

Results

In PNT eyes, baseline IOP was 22.2±1.6 mmHg. Following PNT a statistically significant reduction of IOP occurred at all visits (p<0.0001), with a mean decrease ranging from −2.7±2.5 (-11.9±10.8%) to −3.6±2.6 mmHg (-16.0±11.6%); mean reduction was 12.8±11.5%. Although IOP diminished also in the control eyes after baseline (p<0.05), the change in IOP was significantly higher in PNT group at each visit (p<0.05). Mild side effects were experienced by 76% of subjects and they all resolved without sequelae.

Conclusions

The results suggest the effect of this procedure in reducing IOP in glaucoma and ocular hypertensive subjects.
Nonvisible Subthreshold Micropulse Diode Laser (810 nm) Treatment of Central Serous Chorioretinopathy: A Pilot Study
Authors: Lanzetta P. , Furlan F. , Morgante L. , Veritti D. , Bandello F.
Published: January 2018

Purpose

To verify the efficacy of nonvisible micropulse diode laser irradiation in the treatment of central serous chorioretinopathy (CSC).

Methods

Twenty-two patients with CSC for a total of 24 eyes with a disease duration longer than 3 months were included in a prospective study. Patients underwent Early Treatment Diabetic Retinopathy Study visual acuity (VA) examination, dilated ophthalmoscopy fluorescein angiography and optical coherence tomography before treatment and during follow-up. Treatment with a micropulse diode laser was given with a duty cycle of 15%. Multiple spots were placed over and adjacent to the area of retinal pigment epithelium leak or decompensation.

Results

Mean follow-up was 14 months (range 3–36 months). Powers used ranged from 1 to 2 W (mean 1.35 W). Mean number of spots was 215 (range 90–400). Fourteen eyes were treated once, nine eyes received two to three treatments, and one eye had five treatments during a follow-up of 3 years. Subretinal fluid was resolved or improved in two third of cases 1 month after laser treatment, and in three-quarters at the end of follow-up. Mean retinal thickness was 328 μm, 197 μm, and 168 μm before, 1 month after irradiation, and at the end of follow-up, respectively. No evidence of RPE or retinal changes due to laser treatment were discernible in most of the eyes. Median VA was 20/32 (range 20/100–20/20) before treatment and 20/25 (range 20/200–20/20) at the end of the follow-up.

Conclusions

Nonvisible micropulse diode laser may have efficacy in the treatment of CSC. A randomized study with larger series is needed.
Inferior Sclerotomies without Subretinal Fluid Drainage for Exudative Retinal Detachment in Diffuse Retinal Pigment Epitheliopathy
Authors: Figueroa M.S. , Arruabarrena C. , Sales-Sanz M. , Mingo-Botin D.
Published: January 2018

Purpose

To evaluate the efficacy of inferior sutureless sclerotomies without subretinal fluid drainage for the treatment of bullous exudative retinal detachment secondary to diffuse retinal pigment epitheliopathy.

Methods

A retrospective interventional case series of eyes treated with two inferior postequatorial full-thickness sclerotomies without subretinal fluid drainage. Patients were placed in an upright position 24 hours after surgery. Main outcomes were visual acuity and retinal reattachment rate.

Results

Three eyes with recent diagnoses of diffuse retinal pigment epitheliopathy and bullous inferior retinal detachment were included in the study. In all cases, a very thick sclera was evident during surgery. The day after surgery the retina was completely attached in the three eyes. Preoperative visual acuity was light perception, 20/200, and counting fingers. After surgery, visual acuity improved to 20/200, 20/70, and 20/50, respectively. No intra- or postoperative complications occurred.

Conclusions

The performance of inferior sutureless sclerotomies without a draining procedure in cases of diffuse retinal pigment epitheliopathy with inferior bullous retinal detachment is a simple and effective technique. It achieves retinal reattachment the day after surgery, allowing laser photocoagulation of the leaking lesions disclosed in fluorescein angiography.
An Unusual Optic Disc Neovascularization in a Case of Intermediate Uveitis Associated with Multiple Sclerosis
Authors: Karagiannis D.A. , Ladas I.D.
Published: January 2018

Purpose

To report a case of intermediate uveitis associated with multiple sclerosis (MS) presenting with a complex of an unusual optic disc neovascularization which was treated successfully.

Methods

Interventional case report. Best-corrected visual acuity measurements (BCVA), slit-lamp examination, fundus biomicroscopy and fluorescein angiography (FFA) were performed at baseline examination and during the follow-up period. The patient underwent one injection of intravitreal bevacizumab combined with systemic steroids and panretinal photocoagulation.

Results

A 28-year-old man presented with decreased vision in the right eye (RE) (BCVA 20/40). Compete examination showed a large new vessels complex on the optic disc of the RE protruding into the vitreous, ischemic vasculitis, and snowbanking inferiorly Similar findings but less severe were found in the left eye (LE) with mild vitritis. The RE had also mild, diffuse vitreous hemorrhage. All tests were normal including blood tests, Mantoux, and chest X-ray except brain magnetic resonance imaging which showed three demyelinating lesions. Neurologic evaluation was unremarkable for the first year. The clinical appearance was consistent with intermediate uveitis associated with MS. The patient underwent one injection of intravitreal bevacizumab combined with systemic steroids and panretinal photocoagulation. After 6 months BCVA increased to 20/20 and the neovascular complex became fibrous in RE. The patient, 2 years after treatment, remains stable.

Conclusions

Intermediate uveitis may precede the diagnosis of MS. Intravitreal bevacizumab combined with systemic steroids and panretinal photocoagulation proved successful in the management of this case.
Retinal Detachment Due to a Macular Hole in a Patient with Behçet Disease Treated with Vitrectomy and Silicone Oil Tamponade
Authors: Georgalas I. , Markomichelakis N. , Ladas I.
Published: January 2018

Purpose

A rare case of unilateral retinal detachment due to a macular hole in a patient with Behçet disease is presented.

Methods

Interventional case report.

Results

A 31-year-old man with a 6-year history of Behçet disease presented with a relapse in his disease and received infliximab. Ten days later, as the inflammation subsided, a retinal detachment caused by a macular hole was diagnosed. The patient underwent vitrectomy surgery with internal limiting membrane peeling and silicone oil tamponade. Seven months after the removal of the silicone oil, the macular hole remained closed and the retina attached. Optical coherence tomography was performed before surgery and during the postoperative follow-up period.

Conclusions

Behçet disease could be rarely associated with retinal detachment caused by a macular hole. Macular traction caused by severe recurrent vitritis in combination with the retinochoroidal atrophy due to the relapsing retinitis might be the underlying mechanism of this complication, which to the authors' knowledge has never been reported before.
Disseminated Hydatid Disease in a Child: Albendazole Treatment of Orbital Cyst
Authors: Papathanassiou M. , Petrou P. , Zampeli E. , Vergados I. , Paikos P.
Published: January 2018

Purpose

Orbital hydatid cyst is rare and represents a small percentage of all echinococcal systemic locations. It is usually a primary echinococcosis. A new case of orbital hydatid cyst with asymptomatic coexistent lung and liver cysts is described in a child.

Methods and results

The patient underwent surgical excision of the lung and liver cysts and successful application of albendazole treatment for orbital echinococcal cyst without evidence of recurrence after a 4-year follow-up.

Conclusions

Hydatid cyst should be included in the differential diagnosis of unilateral exophthalmos in patients from countries where echinococcosis is endemic.
Clinical and Microbiological Efficacy of Levofloxacin Administered three Times a Day for the Treatment of Bacterial Conjunctivitis
Authors: Szaflik J. , Szaflik J.P. , Kamińska A. ,   The Levofloxacin Bacterial Conjunctivitis Dosage Study Group, Szaflik Jerzy , Szaflik Jacek P. , Kamińska Anna , Rowiński Mariusz , Kołoziejczyk Wojciech , BełŻecka-Majszyk Agata , Gajda Sebastian , Izdebska Justyna
Published: January 2018

Purpose

This randomized, investigator-masked study aimed to compare the clinical and microbiological effectiveness of three times daily administration of levofloxacin 0.5% eyedrops with the classic, more frequent dosing in patients with bacterial conjunctivitis.

Methods

A total of 120 patients with symptoms of bacterial conjunctivitis were enrolled. The patients were randomly assigned to receive 0.5% levofloxacin eyedrops three times daily to each eye for 5 days (experimental dosage group), or every 2 hours on days 1 and 2, and then every 4 hours on days 3–5 (up to four times per day) (classic dosage group). Ocular symptoms and signs were assessed on day 1, days 3 to 4, and 7 ± 1 visits. Conjunctival cultures were obtained at baseline and final visits. Clinical outcomes were based on resolution of cardinal signs. Microbial outcomes were based on culture results.

Results

Eighty-six patients (41 experimental dosage, 45 classic dosage) were evaluated. There was no difference between the groups in frequency of patients with clinical outcome resolved (85.4% in experimental vs 93.3% in classic dosage group, p=0.3). The microbial eradication rates did not differ statistically between the groups (92.7% vs 95.6%, respectively, p=0.67).

Conclusions

There was no statistically significant difference in the efficacy or safety between the two methods of drug administration. Analysis of the results of compliance supported our conclusion that the less frequent method of dosing of 0.5% levofloxacin eyedrops was more convenient for patients and resulted in better adherence to the drug-dosing scheme
Simultaneous Surgery in Bilateral Congenital Cataract
Authors: Magli A. , Fimiani F. , Passaro V. , Iovine A.
Published: January 2018

Purpose

To assess the efficiency of simultaneous surgery in bilateral congenital cataract not only in patients with a high anesthesiologic risk profile.

Methods

A retrospective study was carried out on 40 bilateral congenital cataract patients (80 eyes) who presented to the outpatient department of pediatric ophthalmology of the University Federico II of Naples in the period from 1990 to 2005. All patients had undergone cataract extraction from both eyes in a single surgical session. Visual rehabilitation was achieved in all patients by corneal lenses; successively 25 patients had a secondary intraocular lens implant in the posterior chamber after a period of 2.5–3 years.

Results

The mean age at cataract surgery was 7 months (1–17 months). Visual acuity (VA) was assessed in 52 eyes: 8 eyes (15%) presented VA <20/200, 21 eyes (41%) showed VA 20/200 < 20/40, 23 eyes (44%) presented VA >20/40. Ocular motility disorders were seen in 28 patients (70%). Eight patients had postoperative complications: the formation of secondary membranes in five patients, and secondary glaucoma in three patients. There were no cases of endophthalmitis.

Conclusions

Simultaneous surgery in bilateral congenital cataract may be taken into consideration not only for patients with a high anesthesiologic risk profile.
Scanning Electron Microscopy and Energy Dispersive Spectroscopy Findings in Explanted Pmma and Hydrophilic Acrylic Intraocular Lenses
Authors: Gungel H.
Published: January 2018

Purpose

To investigate the presence of calcium (Ca) aggregates influencing biocompatibility and the factors that affect calcium accumulation in explanted intraocular lenses (IOL) and to analyze the Ca distribution in an opacified hydrophilic acrylic lens.

Methods

Surface irregularities and aggregates of 13 IOLs were studied with scanning electron microscopy, and their relative concentrations with energy dispersive spectroscopy (EDS). Relationships of distribution between Ca and silicone (Si) and nitrogen (N) and between N and Si and Na, and the influence of Si on Ca accumulation and the effect of differences in lens material on the distribution of N, and the effect of endophthalmitis on the distribution of Ca were evaluated statistically. EDS analyses were performed on the surface and cross-section of the opacified lens.

Results

The statistically significant relationships between the distribution of Ca and N, and between the distribution of N and Na, the significant effect of Si on the Ca accumulation, significant relationship between endophthalmitis and the Ca accumulation in the aggregates were shown. The EDS analysis of the opacified IOL, Ca and P peaks were shown from the whole surface, Ca, O peaks were determined from cross-sections over a 70–80 μm distance.

Conclusions

In the aggregates influencing IOL biocompatibility, presence of proteins was determined to be more important than the presence of Si regarding the distribution of Ca, while the presence of Si affected the accumulation of Ca. Opacification, caused by the Ca accumulation within the lens, was found to result from Ca penetrating from lens pores.
Efficacy of the Fixed Combinations of Bimatoprost or Latanoprost plus Timolol in Patients Uncontrolled with Prostaglandin Monotherapy: A Multicenter, Randomized, Investigator-Masked, Clinical Study
Authors: Centofanti M. , Oddone F. , Vetrugno M. , Manni G. , Fogagnolo P. , Tanga L. , Ferreri P. , Rossetti L.
Published: January 2018

Purpose

To compare the efficacy and tolerability of a once-daily evening dose of bimatoprost/timolol fixed combination (BTFC) with that of a once-daily evening dose of latanoprost/timolol fixed combination (LTFC) in patients not controlled with prostaglandins analogues monotherapy.

Methods

A total of 82 patients on prostaglandin analogues monotherapy were enrolled in this prospective, multicenter, investigator masked, clinical study and were randomized to either BTFC (n=47) or LTFC (n=35) topical therapy once at night for 12 weeks. The primary endpoint of the study was to compare the mean daily intraocular pressure (IOP) reduction from baseline between the two treatment arms. Secondary endpoints included the mean daily IOP at 1 and 3 months compared to baseline and the percentage of patients showing a mean IOP reduction from baseline greater than or equal to 15% or 20%.

Results

Mean IOP at baseline was 22.7±2.0 and 22.1±2.6 mmHg in the BTFC and LTFC groups, respectively (p=0.23). Both treatments were effective in reducing the IOP from baseline. The mean IOP reduction was significantly greater in the BTFC group than in the LTFC group (–21.4% vs −13.7%, p<0.001). A higher percentage of patients in the BTFC group showed a mean IOP reduction from baseline ≥ 15% (72.3% vs 40.0%) and ≥ 20% (61.7% vs 17.1%) compared to patients in the LTFC group.

Conclusions

Both BTFC and LTFC were more effective versus the monotherapy with prostaglandin analogues. BTFC demonstrated higher performance than LTFC in terms of relative IOP reduction.
Nutritional AMD Treatment Phase I (NAT-1): Feasibility of Oral DHA Supplementation in Age-Related Macular Degeneration
Authors: Querques G. , Benlian P. , Chanu B. , Portal C. , Coscas G. , Soubrane G. , Souied E.H.
Published: January 2018

Purpose

To create a pilot study in order to evaluate the feasibility of a prospective case-control study of oral supplementation with fish oil (docosahexaenoic acid [DHA]; eicosapentaenoic acid [EPA]) in a population with age-related macular degeneration (AMD).

Methods

A homogeneous group of 38 patients with drusenoid pigment epithelial detachment in one eye (PED) without choroidal new vessels (CNV) was selected. A complete ophthalmologic examination, and a complete profile of fatty acids in serum (S) and in red blood cell membranes (RBCM), were recorded at day 0 and month 6. In group 1, 22 patients were orally supplemented with EPA (720 mg/day) and DHA (480 mg/day) during 6 months. In group 2, 16 patients were followed as controls. Nutritional recommendations on fish consumption were given to both groups.

Results

In group 1, after 6 months supplementation we observed a significant blood enrichment in EPA (EPA-S: 2.20 vs 0.79, p<0.0001 and EPA-RBCM: 2.24 vs 0.85, p<0.0001) and in DHA (DHA-S: 2.47 vs 1.56, p<0.0001 and DHA-RBCM: 6.47 vs 4.67, p<0.0001). No change was observed in group 2 despite nutritional recommendations. In this short follow-up, no evolution to CNV was noted in either of the two groups. Neither side effects nor dropouts were observed in either of the groups.

Conclusions

This study supports the feasibility of a long-term double-masked prospective case-control study in an AMD population in order to evaluate a potential benefit from oral supplementation with DHA.
Choroidal Neovascularization in Angioid Streaks and Pseudoxanthoma Elasticum: 1 Year Follow-Up
Authors: Schiano Lomoriello D. , Parravano M. , Chiaravalloti A. , Varano M.
Published: January 2018

Purpose

To report the efficacy of intravitreal injection of bevacizumab 1.25 mg (IVB) in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS).

Methods

Case review of two patients with CNV secondary to AS treated with three IVB with a 1-year follow-up.

Results

In both patients after 1 year fluorescein angiography and optical coherence tomography showed complete inactivity of the CNV and the ophthalmologic examination revealed stabilization of the visual acuity.

Conclusions

The IBV appeared to be an effective and safe treatment for CNV secondary to AS resulting in a long-term CNV inactivation. Further long-term studies in this type of lesion are desirable.
The Relationship between Patient Age and Astigmatism Magnitude after Congenital Cataract Surgery
Authors: Bar-Sela Shai M. , Glovinsky Yoseph , Wygnanski-Jaffe Tamara , Spierer Abraham
Published: January 2018

Purpose

To evaluate the magnitude of refractive astigmatism after congenital cataract surgery and to define its correlation with patient age.

Methods

The authors retrospectively reviewed the charts of all pediatric patients who underwent congenital cataract extraction with intraocular lens (IOL) implantation through a 3.0-mm clear corneal incision from 1998 to 2003, and had no suture removal for 5 months afterward. Thirty-four children were included, aged 2 months to 15 years. Refractive astigmatism was assessed manually 1 week, 3 months, and 5 months after surgery by an experienced optometrist. The paired t test was used to compare the magnitude of postoperative astigmatism at different postoperative periods. Spearman correlation was used to determine the correlation between patient age and the postoperative refractive astigmatism.

Results

Mean refractive astigmatism in all patients was 1.8±1.5 diopters (D) at 1 week post-operatively. It significantly decreased to 1.0±0.7 D at 3 months postoperatively (p=0.001), and to 0.8±0.7 D at 5 months postoperatively (p=0.03). The change in astigmatism was significantly greater during the first 3 postoperative months than during the following 2 months (p=0.04). Patient age was significantly correlated with 1 week postoperative astigmatism (Spearman coefficient, r = −0.46; p=0.006) and with 3 months postoperative astigmatism (Spearman coefficient, r =–0.37; p=0.03).

Conclusions

Congenital cataract surgery using a small, clear corneal incision for IOL implantation caused high early postoperative astigmatism, which spontaneously regressed thereafter. Younger patients had higher early postoperative astigmatism.
The ReZoom Multifocal Intraocular Lens: 2-Year Follow-up
Authors: Forte Raimondo , Ursoleo Paolo
Published: January 2018

Purpose

To evaluate distance, intermediate, and near visual acuity and patient satisfaction over a period of 2 years after implantation of the ReZoom multifocal intraocular lens.

Methods

Fifty-five eyes of 35 cataract patients were included in this retrospective study. Only patients with a preoperative photopic pupillary diameter superior to 3 mm were included. Monocular visual acuities and visual symptoms were compared at different time points.

Results

Preoperative mean distance uncorrected visual acuity (UCVA) was 0.5±0.3 LogMAR, uncorrected intermediate visual acuity (UCiVA) at 50 cm was 0.6±0.3 LogMAR, and near un-corrected visual acuity (UNVA) was J7.8±0.6. Mean follow-up was 28.1±7.2 months. At 6 months, UCVA improved to 0.05±0.09 logMAR (p<0.001), UCiVA to 0.08±0.1 LogMAR (p<0.001), and UNVA to J2.4±0.4 (p<0.001). At 24 months, UCVA was 0.04±0.08 LogMAR, UCiVA was 0.07±0.1 LogMAR, and UNVA was J2.3±0.7. No significant differences were observed between the values at 6 months versus 24 months. At the 3-month visit, moderate glare and halo were reported by 10% and 13% of patients, respectively. The occurrence of visual symptoms decreased with time, with only 7% and 5% of patients reporting moderate glare and halo at the last visit, respectively.

Conclusions

The ReZoom lens provides quality vision at all distances. Between 6 and 24 months of follow-up, a further improvement of optical disturbances rather than uncorrected visual acuity may be expected.