bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Oral Magnesium Therapy on Visual Field and Ocular Blood Flow in Normotensive Glaucoma
Authors: Aydin Bahri , Önol Merih , Hondur Ahmet , Kaya Mehmet , Özdemir Hakan , Cengel Atiye , Hasanreisoglu Berati
Published: January 2018

Purpose

To evaluate the effect of oral magnesium therapy on ocular blood flow and visual field perimetry indices in patients with normotensive glaucoma (NTG).

Methods

Fifteen patients with NTG (study group) received 300 mg oral magnesium citrate for 1 month, while 15 patients with NTG (control group) received no treatment. Blood magnesium level measurement, visual field analysis, and color Doppler imaging of the orbital vessels were done before treatment and at 1 month.

Results

In the study group, mean deviation improved from −3.7±1.9 (mean ± standard deviation) at baseline to −2.5±1.8 at 1 month (p<0.05), and pattern standard deviation improved from 3.6±2.3 at baseline to 2.8±2.6 at 1 month (p<0.05). Color Doppler imaging indices did not change after magnesium therapy.

Conclusions

Oral magnesium therapy may provide improvement in the visual field, but does not seem to affect ocular blood flow in patients with NTG. Other mechanism than increased ocular blood flow may be responsible for the improvement in the visual field with oral magnesium therapy.
Retinal Nerve Fiber Layer Thickness in Patients with Exfoliation, Exfoliative Glaucoma, and Primary Open Angle Glaucoma
Authors: Kozobolis Vassilios P. , Glynatsis Mikes , Labiris Georgios , Katsanos Andreas , Fanariotis Michael , Koukoula Stavrenia , Alvanos Stratos , Toufexis George
Published: January 2018

Purpose

T ev lu te the retin I nerve fi er I yer (RNFL) pr file f he Ithy ntr Is, pers ns with exf - li ti n syndr me (XFS), nd p tients with exf li ti n gl u m (XFG) nd prim ry pen ngle gl u - m (POAG).

Methods

One eye fr m e h f 269 p rti ip nts w s n lyzed. Fifty eyes were n rm I, 45 eyes h d XFS, 89 eyes h d POAG, nd 89 h d XFG. Gl u m p tients were divided rding t the severity f the dise se int mild nd dv n ed gr ups. All p rti ip nts underwent im ging with the GDx-VCC devi e. Me surements f the p r meters TSNIT ver ge, TSNIT SD, nd nerve fi er indi t r (NFI) were perf rmed. P I rimetri RNFL thi kness v lues were mp red y me ns f B nferr ni- rre - ted t-tests.

Results

Reg rding ntr I nd gl u m gr ups, st tisti lly signifi nt differen es were identified in II GDx p r meters. RNFL thi kness v lues f the ntr I gr up differed signifi ntly fr m the v lues f the XFS gr up. There w s n st tisti lly signifi nt differen e etween RNFL thi kness v lues f r the mild POAG nd mild XFG gr ups rf rthe dv n ed POAG nd dv n ed XFG gr ups.

Conclusions

P I rimetry-determined RNFL in eyes with XFS is thinner th n th t f he Ithy eyes. N differen es in RNFL thi kness were f und when eyes with POAG nd XFG f simil r seventy were mp red.
Comparison of Advanced Visual Field Defects Measured with the Tübingen Mobile Campimeter and the Octopus 101 Perimeter
Authors: Bruckmann Anna , Volpe Nicholas J. , Paetzold Jens , Vonthein Reinhard , Schiefer Ulrich
Published: January 2018

Purpose

To compare the results of advanced visual field defects (VFD) measured with the conventional reference perimeter Octopus 101 (O-101) and the new portable Tübingen Mobile Campimeter (TMC).

Methods

Thirty-seven subjects (18 to 75 years), 13 with advanced arcuate scotomas, 12 with VFD respecting vertical meridians, 6 with concentric constriction and 6 healthy controls were included. First examination was with O-101: grid 30°-NO, 192 stimuli, 10 cd/m2 background luminance, stimulus size: Goldmann III (26’); second examination was with TMC: 84 stimuli (subset of grid 30°-NO), stimulus size 34’, stimulus luminance 320–370 cd/m2, background luminance 8–20 cd/m2. Point-wise accuracy (proportion of concordant locations), sensitivity, and specificity were estimated into 95% confidence intervals (CI) by averaging individual logits. Examination durations were compared.

Results

TMC results are highly concordant with O-101 results for all defect classes. For the entire sample, the percentage of discordant points (perceived with TMC but not with O-101) among all discordant points was 35% (CI: 30% to 40%). Analyzed by VFD pattern, accuracy was highest in healthy controls scotomas (97.9%; CI: 97% to 98.5%) and lowest in arcuate scotomas (80.6 %; CI: 77.3% to 83.5%). Sensitivity was highest in concentric constriction (94.5%; CI: 82.9% to 98.4%) and lowest in healthy controls (59.1%; CI: 26.3% to 85.3%). Specificity was highest in healthy controls (98.1%; CI: 96.6% to 98.9%) and lowest in concentric constriction (77.4%; CI: 62.1% to 87.7%). Mean examination time was 4.6 minutes (TMC) and 9.8 minutes (O-101).

Conclusions

The results indicate that the TMC is a feasible device for detection of VFD.
Retinal Nerve Fiber Layer Thickness and Spatial and Temporal Contrast Sensitivity in Multiple Sclerosis
Authors: Merle Harold , Olindo Stéphane , Donnio Angélique , Beral Laurence , Richer Raymond , Smadja Didier , Cabre Philippe
Published: January 2018

Purpose

To measure peripapillary retinal nerve fiber layer (RNFL) thickness and spatial and temporal contrast sensitivity in multiple sclerosis (MS) taking into account previous history of optic neuropathy (ON).

Methods

Thirty patients (60 eyes) with relapsing-remitting MS were selected (MS group). The MS ON group was composed of 31 eyes with previous history of optic neuropathy and the MS non-ON group of 29 eyes was without previous history of optic neuropathy. Thickness of the RNFL was measured with optical coherence tomography (OCT) with the Stratus OCT. As for sensitivity to spatial contrast, we used Pelli-Robson and Sloan charts. Sensitivity to temporal contrast was explored using frequency doubling technology perimetry (FDTP).

Results

The average thickness of RNFL in the MS, MS ON, MS non-ON, and control groups were 88.2±18.9 μm, 80.81±18.4 μm, 96.7±15.8 μm, and 106±12.2 μm, respectively. The spatial contrast vision and FDTP results were less in the MS non-ON group than in the control group. The average thickness of RNFL correlated to the scores of spatial and temporal contrast vision.

Conclusions

MS is accompanied by visual function alteration even in the absence of acute optic neuropathy. The important correlation between functional and anatomic aspect confirms the value of OCT to appreciate the subclinical involvement of the optic nerve. Associated with tests exploring visual function, the OCT could reveal itself pertinent in evaluation of the different therapeutics used in MS ON.
Vitreoretinal Dysplasia Masquerading as Peters’ Anomaly
Authors: Martinet Virginie , Dureau Pascal , Bergès Olivier , Caputo Georges
Published: January 2018

Purpose

Vitreoretinal dysplasia is characterized by a congenital bilateral nonattachment of the retina. In some cases, anteroposition of the iris and lens can lead to corneolenticular contact and corneal opacity, masquerading as Peters’ anomaly. We report 3 cases of vitreoretinal dysplasia initially diagnosed as Peters’ anomaly.

Methods

Case report.

Results

Case 1: In a 3-year-old boy with bilateral corneal opacities, high frequency ultrasound showed iridolenticular adherences as in Peters’ anomaly, but color Doppler imaging of the posterior pole revealed a bilateral total retinal detachment. Case 2: In an 18-month-old boy with bilateral corneal opacity and dense cataract, ultrasound revealed a shallow anterior chamber and bilateral vitreous hemorrhage with retinal detachment. Case 3: In a 6-month-old girl with bilateral central corneal opacity, shallow anterior chamber, iridocorneal synechiae, and a cataract, ultrasound revealed a total retinal detachment in the right eye, and was uncertain in the left eye. Corneal transplantation was attempted in the left eye, but a retinal detachment was discovered peroperatively There were associated central nervous system anomalies.

Conclusions

Vitreoretinal dysplasia is a potentially evolving disease and can lead to anterior chamber thinning, corneal opacity, and secondary glaucoma. Anterior and posterior segment ultrasound is essential to fix the correct diagnosis and prognosis.
Proliferative Vitreoretinopathy in a Child with Visceral Leishmaniasis
Authors: Salvanos Panagiotis , Kabanarou Stamatina A. , Xirou Tina , Kourentis Christina , Feretis Elias
Published: January 2018

Purpose

We present a rare case of ocular leishmaniasis complicated by proliferative vitreoretinopathy in a child with active visceral leishmaniasis.

Methods

A 10-year-old boy with active visceral leishmaniasis presented with a 5- day history of redness, photophobia, and blurred vision in his left eye. Visual acuity was measured and the child had a complete ocular examination.

Results

Snellen best-corrected visual acuity (BCVA) was 10/10 in the right eye and 7/10 in the left eye at presentation. Ophthalmic examination of the right eye was normal but the left eye showed clinical signs of panuveitis. Laboratory investigations were negative. Treatment with systemic and local steroids was initiated and clinical improvement achieved. Eight months later, the patient had a relapse of systemic and ocular disease with severe panuveitis in both eyes. A combined tractional–rhegmatogenous retinal detachment was present in the left eye. Pars plana vitrectomy was undertaken in the left eye and the patient was started on systemic and local steroid treatment. Retinal reattachment was achieved postoperatively but visual acuity in the left eye remained poor.

Conclusions

Early diagnosis, prompt systemic and ocular treatment, as well as close ophthalmic examination are essential in such cases.
Isolated Unilateral Abducens Cranial Nerve Palsy: A Rare Presentation of Pituitary Apoplexy
Authors: Matti Albert I. , Rudkin Adam K. , Lee Andrew W. , Chen Celia S.
Published: January 2018

Purpose

To describe a rare presentation of pituitary apoplexy as unilateral abducens nerve palsy demonstrating the various presentations of the condition.

Methods

Case report.

Results

A 48-year-old man presented with isolated right abducens nerve palsy. Magnetic resonance imaging showed a large pituitary macroadenoma with evidence of recent bleed into the right cavernous sinus and surrounding the right internal carotid artery.

Conclusions

Pituitary apoplexy may present subtly with an isolated sixth nerve palsy but the condition is critical and high index of suspicion needs to be governed.
A Rare Case Report of Loa Loa Ocular Filariasis
Authors: Aiello Francesco , Palma Stefano , Varesi Chiara , Cerulli Angelica , Valente Rosanna , Aiello Luigi
Published: January 2018

Purpose

We report a case of ocular worm treated surgically and confirmed by microbiological identification.

Methods

A 33-year-old Swiss woman presented to the ophthalmic unit, complaining of pain and foreign body sensation in the left eye. Slit-lamp examination disclosed a subconjunctival amber-colored cord in the conjunctival fornix. Presentation, clinical and histopathologic evaluation, and treatment are described.

Results

At the time of surgery, an alive and still intact worm was extracted through conjunctival incision. Histopathology confirmed the presence of filariasis.

Conclusions

As the flow of immigrants from endemic areas to Europe increases, ocular manifestation of loiasis is becoming more frequent and ophthalmologists need to be aware of this diagnosis.
Visual Acuity at 6 Weeks after Small Incision Cataract Surgery and Role of Audit in Predicting Visual Acuity
Authors: Khandekar Rajiv B. , Jain Budhendra K. , Sudhan Anand K. , Pandey Kamta P.
Published: January 2018

Purpose.

We present the best-corrected visual acuity (BCVA) at 6 weeks after small incision cataract surgery (SICS) and review the role of audit in predicting visual acuity (VA).

Methods.

This was a retrospective data analysis of 14,393 SICS performed during 2007–2008 at a hospital in central India. Ophthalmologists noted preoperative, operative, and postoperative details. The BCVA before and 1 day and 6 weeks after surgery were noted. We identified factors associated with BCVA at 1-day and 6-week follow-up.

Results.

Six weeks after surgery, 12,522 (87%) and 1473 (10.2%) patients had BCVA ≥6/18 and 6/24–6/60, respectively. Vision improved between 2 follow-ups in 6695 eyes (46.5% (95% confidence interval (CI) 45.7–47.3)), remained the same in 7117 eyes (49.4%), and deteriorated in 544 (3.8%) eyes. BCVA at 6 weeks was negatively associated with blindness (VA <3/60 in the better eye) before surgery (odds ratio (OR) = 0.73, 95% CI 0.58–0.92), surgeon's experience (OR = 0.75, 95% CI 0.71–0.81), and male patients (OR = 0.73, 95% CI 0.67–0.80). BCVA at 6 weeks was positively associated with older age (OR = 1.02, 95% CI 1.01–1.03) and intraoperative complications (OR = 1.44, 95% CI 1.14–1.83). The association of VA <6/60 1 day after surgery with improved vision between the 2 follow-ups was not statistically significant (OR = 0.005, p = 0.98).

Conclusions.

BCVA at 6 weeks after SICS was ≥6/18 in 87% of operated eyes. By performing surgical audit, one can identify high-risk groups that need proactive subsequent follow-ups.
Contrast Reduction and Reading: Assessment and Reliability with the Reading Explorer Test
Authors: Giacomelli Giovanni , Volpe Roberto , Virgili Gianni , Farini Alessandro , Arrighi Roberto , Tarli-Barbieri Chiara , Mencucci Rita , Menchini Ugo
Published: January 2018

Purpose.

To investigate the reliability of the Reading Explorer (REX) charts and to assess the impact of text contrast reduction (1.5 cycle/degree) on reading speed in subjects with normal and low vision.

Methods.

Standard visual acuity (ETDRS charts), reading speed (MNread charts), and contrast sensitivity (Pelli-Robson charts) measurements were obtained in 3 groups of subjects stratified by visual acuity level in the better eye from 0.0 to 1.0 logMAR, with intermediate cutoffs at 0.3 and 0.6 logMAR. Measurements of reading speed for decreasing levels of text contrast were obtained with the REX charts using a 1.5 cycle/degree text.

Results.

Since in many patients with lower vision a plateau of maximum reading speed across different levels of text contrast was not found, reliability indexes were computed for average reading speed and reading contrast threshold. In the group with lower visual acuity, 95% limits of agreement were ±0.134 log word/minute and ±0.175 log contrast sensitivity, suggesting good reliability. The proportion of subjects with a 20% loss of reading speed from 90% to 45% text contrast was estimated to be 1/3 at 0.6 logMAR visual acuity level and 2/3 at 1.0 logMAR.

Conclusions.

The adverse effect of decreased text contrast, which may be found in ordinary reading material, on the reading performance of subjects with advanced and initial low vision is probably underestimated. The REX test proved to be a reliable investigation tool for this phenomenon.
Aqueous Humor Levels of Vasoactive Molecules Correlate with Vitreous Levels and Macular Edema in Central Retinal Vein Occlusion
Authors: Noma Hidetaka , Funatsu Hideharu , Mimura Tatsuya , Harino Seiyo , Hori Sadao
Published: January 2018

Purpose.

Aqueous levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) are associated with the severity of macular edema in patients with central retinal vein occlusion (CRVO). We investigated whether aqueous and vitreous levels of these molecules were correlated in CRVO patients.

Methods.

Aqueous and vitreous samples were obtained during cataract surgery and vitreous surgery from 17 patients (17 eyes) with CRVO and macular edema. The levels of VEGF and IL-6 in aqueous humor, vitreous fluid, and plasma were determined by enzyme-linked immunosorbent assay.

Results.

The aqueous levels of VEGF and IL-6 were significantly correlated with the vitreous levels of these molecules (ρ=0.8799, p=0.0004 and ρ=0.8088, p=0.0012, respectively). Vitreous levels of VEGF and IL-6 were significantly higher in CRVO patients with retinal ischemia than in those without ischemia (p=0.0013 and p=0.0009, respectively), as were the aqueous levels of VEGF and IL-6 (p=0.0026, p=0.0120, respectively). Furthermore, both the aqueous and vitreous levels of VEGF and IL-6 were significantly correlated with the severity of macular edema (ρ=0.7181, p=0.0041; ρ=0.8260, p=0.0010; ρ=0.5564, p=0.0260; and ρ=0.6599, p=0.0039, respectively).

Conclusions.

Our results suggest that aqueous levels of VEGF and IL-6 may reflect the vitreous levels of these molecules. Measurement of VEGF and IL-6 in the aqueous humor may be clinically useful to assess the severity of macular edema in patients with CRVO.
Pars Plana Vitrectomy Results of Exogenous Endophthalmitis in Children
Authors: Çakir Mehmet , Çekiç Osman , Pekel Gökhan , Yilmaz Ömer F.
Published: January 2018

Purpose.

To identify the etiology, culture results, pars plana vitrectomy results, complications, and visual outcome of exogenous endophthalmitis in children.

Methods.

Seven eyes of 7 consecutive pediatric patients who were treated and followed up for exogenous endophthalmitis between February 2006 and June 2008 were included in this study. The etiology of endophthalmos was penetrating eye injuries in 4 eyes and intraocular surgery in 3 eyes. Combined pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection were performed on all 7 eyes. Anterior chamber fluid and vitreous cultures were taken from all eyes. The patient files were inspected retrospectively.

Results.

Mean follow-up time was 10.3 months (4–16 months). Mean age of the patients was 8.5 years (3–14 years). At baseline, visual acuity values of the patients were light perception (n=2), hand movements (n=4), and counting fingers from 1 meter (n=1). At final examination, visual acuity improved in 5 eyes, stayed the same in 1 eye, and decreased in 1 eye. Positive culture results were obtained in 3 eyes: alpha hemolytic Streptococcus (n=2) and coagulase-negative Staphylococcus (n=1). Complications seen after vitreoretinal surgery were transient ocular hypertension, emulsification of silicone oil, phthisis bulbi, and secondary retinal detachment.

Conclusions.

Early pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection improved anatomic and functional success in pediatric eyes with exogenous endophthalmitis.
Toxic Anterior Segment Syndrome following Iris-Supported Phakic IOL Implantation with Viscoelastic Multivisc BD
Authors: Kremer Israel , Levinger Eliya , Levinger Samuel
Published: January 2018

Purpose.

To report on the association between Multivisc BD and toxic anterior segment syndrome (TASS) post phakic intraocular lens (IOL) implantation.

Methods.

Two patients developed severe toxic anterior chamber inflammation following implantation of phakic iris fixated IOL with Multivisc BD viscoelastic. Anterior chamber washout was performed with intracameral antibiotic injection. Local antibiotics were continued until cultures were found to be negative. Thereafter, intensive local and systemic steroids were initiated and gradually tapered down.

Results.

The inflammatory reaction disappeared completely and the visual acuity improved from hand motion to 6/9 without correction within 1 week.

Conclusions.

Any viscoelastic material may be contaminated by heat-stable bacterial endotoxic as it is prepared by gene-coded bacteria. It is suggested that Multivisc BD was the etiologic factor of TASS. Refractive surgeons should be aware of this rare complication of phakic IOL implantation whenever they use a new viscoelastic material.
Two Cases of Corneal Perforation after Oral Administration of Nonsteroidal Anti-Inflammatory Drugs: Oral Nsaid-Induced Corneal Damage
Authors: Masuda Ikuya , Matsuo Toshihiko , Okamoto Kazuo , Matsushita Kyoko , Ohtsuki Hiroshi
Published: January 2018

Purpose.

To report 2 cases of corneal perforation associated with the use of oral nonsteroidal anti-inflammatory drugs (NSAIDs).

Methods.

In a 62-year-old woman and a 79-year-old woman, corneal perforation occurred after 7 days and 5 months of oral NSAIDs administration, respectively.

Results.

After NSAIDs were discontinued, the cornea epithelialized and the anterior chamber formed within 14 and 10 days, respectively.

Conclusions.

It is well known that topical NSAIDs cause corneal perforation. Observations in the present cases suggest that the oral administration of NSAIDs may also cause corneal damage, and hence, medical professionals should consider the risk of damage to the cornea when administering these drugs orally.
Retinal Peripapillary Nerve Fiber Layer Thickness in a 13-Year-Old Boy with Neuromyelitis Optica
Authors: Camicione Paola , Fodor Estzer , Pannarello Simona , Barabino Stefano
Published: January 2018

Purpose.

To report changes in retinal nerve fiber layer (RNFL) thickness in a patient with neuromyelitis optica (NMO).

Methods.

A 13-year-old Caucasian boy presented with reduced visual acuity in both eyes, headache, and neck pain associated with left hand burning sensation. Clinical and laboratory examination, including magnetic resonance imaging (MRI) and optical coherence tomography (OCT), were performed.

Results.

MRI showed spinal cord abnormality and acute myelitis, but normal optic nerve head. A significant reduction of the average and temporal area RNFL thickness was recorded in both eyes by OCT. Six months after initial steroid treatment, visual acuity and visual field slightly improved, but RNFL thickness was further reduced.

Conclusions.

RNFL thickness measurement with OCT should be performed not only in adults, but also in young patients in case of suspected NMO to confirm the diagnosis and to monitor the disease.
Repeated Surgery for Acute Acquired Esotropia: Is It Worth the Effort?
Authors: Schöffler Corinna , Sturm Veit
Published: January 2018

Purpose.

Good binocular potential has been a fundamental defining characteristic of acute acquired concomitant esotropia (AACE) type II. The purpose of this study was to ascertain the clinical features and surgical outcome in children with AACE type II who underwent repeated surgery for the sake of binocularity

Methods.

In 4 children with AACE type II, repeated surgery was performed between 1995 and 2008. These cases are presented with special attention to their long-term follow-up and their binocularity outcome.

Results.

The final binocularity outcome was high-grade stereopsis (Lang I/II positive) in all 4 cases. The duration from onset of esotropia to the time of regained stereovision was between 20 and 62 months. In one case, high-grade stereoacuity was only achieved after a second surgery.

Conclusions.

Our findings support the good binocular potential in patients with AACE type II. Despite a complicated course and long-lasting absence of stereovision, all patients eventually regained high-grade stereopsis. Resolutely aiming at realignment seems to be worth the effort.
Reproducibility of OCT/SLO Measurements in Healthy Eyes
Authors: Labiris Georgios , Giarmoukakis Athanassios , Katsanos Andreas , Gkika Maria G. , Fanariotis Michael , Pavlidou Efi , Kozobolis Vassilios P.
Published: January 2018

Purpose.

To determine the reproducibility of optical coherence tomography/scanning laser ophthalmoscope (OCT/SLO) measurements within and between observers and within and between sessions in healthy eyes.

Methods.

Forty eyes of 40 healthy volunteers recruited from the outpatient service of the Department of Ophthalmology at the University Hospital of Alexandroupolis, Greece, were included. Retinal thickness scans were performed 3 times by two experienced operators within each of 3 sessions, which took place within a month, using the spectral OCT/SLO. The OCT/SLO provides retinal nerve fiber layer (RNFL) thickness and volume measurements and a 3D tomography analysis of optic nerve head. Statistical analysis was conducted using Bland-Altman plots, coefficient of variation (CoV), and intra-class correlation coefficient (ICC).

Results.

AS shown by the CoV values, RNFL parameters were generally found to have high reproducibility (CoV ranging from 4.3% to 10.9% for both operators), whereas optic disc parameters had scores reaching up to 22.5%. On the other hand, as shown by the ICC values, intraobserver and interobserver reproducibility for the OCT/SLO was high for optic disc parameters but low for RNFL thickness and volume measurements. Interobserver reproducibility was found to be highest for the maximum cup depth parameter and lowest for the superior volume. Bland-Altman plots indicate that bias is minimal for practically all parameters and scatterplot homoscedasticity is high.

Conclusions.

According to our data, SLO/OCT generally has a good reproducibility profile, as differences between the two operators were small. However, additional studies on the reproducibility of measurements with the OCT/SLO are needed.
Identifying Early Recurrence of Choroidal Neovascularization during Treatment with Ranibizumab using C-Scan
Authors: Siqueira Rubens Camargo , Nogueira Miriam Caparroz
Published: January 2018

Purpose.

To demonstrate a new parameter to identify early recurrence of choroidal neovascularization (CNV) during treatment with ranibizumab using summated en face (C-scan).

Methods.

Seventeen patients with CNV secondary to age-related macular degeneration were enrolled in this retrospective study. Each patient received ranibizumab administered monthly for 3 months and their progress was monitored at 1 week and then at monthly intervals. RTVue spectral domain optical coherence tomography (OCT) was performed in all patients monthly using summated en face (C-scan) subanalysis and was compared with the standard programs for qualitative analysis (Line Scan) and quantitative analysis (macular thickness-MM5 Scan).

Results.

We observed during the control examination an increase of hyporeflective area (dark spot) mean early fluid accumulation in the layer corresponding to the outer segment of photoreceptors. We did not observe any morphologic characteristics of recurrence of CNV in the standard SD OCT examination. At this time, no treatment was done. We scheduled a new examination in 30 days. After 30 days, the patients presented initial signs of CNV recurrence, and ranibizumab reinjection was necessary. In all cases, we observed change in the C-scan 30 to 60 days before the recurrence signs in the standard OCT program.

Conclusions.

The data suggest that summated en face (C-scan) is useful to identify early recurrence of CNV during treatment with ranibizumab. Further studies are required to allow for appropriate clinical use of this new technique.
Foveal Structure Defined by Spectral Domain Optical Coherence Tomography Correlates with Visual Function after Macular Hole Surgery
Authors: Chalam Kakarala V. , Murthy Ravi K. , Gupta Shailesh K. , Brar Vikram S. , Grover Sandeep
Published: January 2018

Purpose.

To study the correlation between final visual acuity after successful anatomic macular hole repair and features on spectral domain optical coherence tomography (SD-OCT).

Methods.

Retrospective review of charts of patients who underwent macular hole surgery. Data collection included pre- and postoperative best-corrected visual acuity (BCVA), central subfield foveal thickness (CSFT), and presence or absence of inner segment-outer segment (IS-OS) line changes on SD-OCT. Data collected from SD-OCT were correlated with Snellen BCVA, which was converted to logMAR score. Subjects were divided into 2 groups: group I had improvement in BCVA of 2 lines or more and group II improved less than 2 lines or had worsening of BCVA.

Results.

A total of 35 eyes of 32 patients had successful anatomic closure, which was documented both clinically and on SD-OCT. Mean age of the patients was 74.1 years and 71.2% (23/32) of patients were female. Overall, the mean BCVA changed from 1.01±0.38 preoperatively to 0.89±0.48 postoperatively (p=0.33). Based on the postoperative visual outcome, 16 eyes belonged to group I and 19 eyes belonged to group II. On the SD-OCT, the mean CSFT was 252.7±69.1 μm. No correlation was found between the mean CSFT and BCVA in either group. All the 16 patients in group I had a continuous IS-OS line on SD-OCT at the fovea in contrast to 26.3 % (5/19) of patients in group II (p=0.03).

Conclusions.

Establishment of continuity of IS-OS line is an important indicator of visual recovery in eyes with successful anatomic closure of macular hole.
Use of Amniotic Membrane Transplantation in Isolated Conjunctival Bowen Disease: A Case Report
Authors: Motolese Ilaria , Mazzera Luigi , Frezzotti Paolo , Motolese Paolo Alfonso , Motolese Eduardo
Published: January 2018

Purpose.

To report a case of isolated conjunctival Bowen disease treated with surgical resection and amniotic membrane transplantation.

Methods.

Interventional case report.

Results.

A 70-year-old man was admitted to our clinic with a large conjunctival verrucous plaque well-demarcated in the correspondence of the bulbar conjunctiva in the superior quadrant of the left eye with involved limbal and corneal surface. Ophthalmologic examination on slit-lamp examination and color fundus photographs were carried out before surgery and the results were evaluated.

Conclusions.

Treatment options and treatment studies of Bowen disease are difficult because there are a variety of different protocols and the success of the management depends on several factors (body site, lesion size, number of lesions, and thickness). In the conjunctival localization of the lesion, amniotic membrane transplantation appears to be a useful therapeutic choice after surgical resection of the lesion used to reconstruct ocular and conjunctival surface.
Branch Retinal Artery Embolization Due to Calcific Aortic Valve Stenosis
Authors: Mannino Giuseppe , Romano Mary , Calanchini Matilde , Mannino Cristina , Cascone Nikhil Carlo
Published: January 2018

Purpose.

Branch retinal artery occlusion caused by calcific embolization secondary to calcific aortic valvulopathy

Methods.

A 45-year-old woman came to our attention complaining a sudden painless loss of her peripheral superior visual field. Best visual acuity was 20/20. Fundus examination revealed the presence of a retinal arterial embolic occlusion of the inferior branch. Fundus retinography visual field, and fluorescein angiography were performed and medical therapy was started. The echocardiography examination revealed a tricuspid and calcified aortic valve with moderate stenosis and regurgitation. Due to the heart pathology, the patient moved to the cardiosurgery department, where an aortic valve replacement was performed.

Results.

Four months after cardiac surgery, visual acuity of both eyes was stable (20/20). Fundus examination showed a complete reabsorption of the retinal edema and the resolution of retinal pallor. Fluorescein angiography confirmed the delay of the arterial filling. No retinal ischemia was observed. The visual field examination confirmed the deep scotoma previously registered.

Conclusions.

Retinal arterial embolization is a rare but potentially devastating complication of calcific aortic stenosis. Initial retinal presentation of calcific aortic stenosis is a rare condition. Keeping in mind that these emboli may be recurrent and potentially bilateral, a sudden onset of visual field defects, especially in young asymptomatic patients, needs immediate diagnosis and consideration of an urgent surgical correction.
Cogan Syndrome: Confocal Microscopy Assessment of Corneal Damage
Authors: Pellistri Isabella , Mora Paolo , Ponzin Diego , Coggiola Andrea , Nubile Mario , Orsoni Jelka G.
Published: January 2018

Purpose.

To perform in vivo assessment of corneal alterations in patients with Cogan syndrome (CS) and to correlate these findings with prior histopathologic descriptions.

Methods.

Four consecutive patients (8 eyes) presenting with typical CS underwent confocal microscopy examination. At the moment of evaluation, ocular inflammation was quiescent in all the patients. The images were studied singularly, and then compared to those obtained from 5 healthy controls. Statistical analysis was performed with Student t test.

Results.

All the cases showed multiple brightly reflective deposits in the stroma with moderate reflectivity of the surrounding stromal tissue. The outer corneal layers and the endothelium were spared. In 3/4 of the patients, the nerve fibers of the subepithelial plexus were thin and poorly reflective, with interruptions and lack of the typical branching pattern. No cells different from keratocytes could be detected in either case or control eyes. Corneal vascularization was present in one case. In CS-affected eyes, corneal thickness was 552±62 μm on average, and endothelial cell count was 2466±288 cells/mm2. Statistical significance was not reached compared to the control group.

Conclusions.

Confocal microscopy was able to provide detailed images of corneal alterations in CS. This confirmed the interstitial nature of the keratitis and showed an excellent accordance with prior histopathologic findings. The absence of inflammatory cell infiltration may be explained by the prolonged control of ocular inflammation in our patients, which may also have limited stimuli for corneal neovascularization.
Anterior Chamber Measurements Taken with Pentacam: An Objective Tool in Laser Iridotomy
Authors: Antoniazzi Elena , Pezzotta Sara , Delfino Alessio , Blanchi Paolo E.
Published: January 2018

Purpose.

Laser iridotomy is the standard first-line intervention in both acute and chronic forms of angle closure because it prevents the recurrence of acute attacks and virtually eliminates the risk of an acute attack in the fellow eye. Pentacam is a new imaging modality which does not require probe contact or an immersion bath. The instrument will allow anterior segment morphology before and after laser peripheral iridotomy (LPI) to be quantified. The aim of the study is to evaluate the objective difference in changes of anterior chamber morphology after LPI with Pentacam.

Methods.

Twenty eyes with a high risk of angle closure were evaluated with Pentacam rotating Scheimpflug camera before and after LPI. We measured anterior chamber volume, anterior chamber depth, and chamber angle before and after laser treatment.

Results.

Statistically significant difference before and after LPI was noted in all anterior chamber measurements except central anterior chamber depth.

Conclusions.

This study confirms previous reports of increased anterior chamber volume and angle after LPI and Pentacam is a good objective instrument to demonstrate the efficacy of LPI.
Assessment of Anterior Chamber Angle Using Visante OCT, Slit-Lamp OCT, and Pentacam
Authors: Dinc Umut A. , Oncel Banu , Gorgun Ebru , Yalvac Llgaz S.
Published: January 2018

Purpose.

To assess and compare the anterior chamber angle (ACA) by different anterior segment imaging techniques.

Methods.

Forty healthy eyes of 40 normal subjects were recruited and 3 consecutive measurements of ACA were determined prospectively utilizing Visante optical coherence tomography (OCT), slit-lamp OCT (SL-OCT), and Pentacam. Statistical significance of interdevice differences between measurements was evaluated by Wilcoxon signed rank test and Bland-Altman analysis. The repeatability of 3 consecutive measurements was analyzed by repeated measured analysis of variance.

Results.

Mean nasal and temporal ACA were detected as 31.2±8.7 and 32.1±8.5 degrees by Visante OCT; 41.6±5.9 and 41.8±5.2 degrees by Pentacam; and 42.9±10.0 and 43.3±10.1 degrees by SL-OCT. All devices displayed a high intrasession repeatability (Scheffe multiple comparison, p>0.05). ACA detected by Visante OCT were found significantly different from ACA calculated by Pentacam and SL-OCT (p<0.05). On the other hand, ACA data obtained by Pentacam and SL-OCT were found to be statistically similar (p>0.05).

Conclusions.

Although noncontact ACA measurements using all modalities were easy to handle and demonstrated good repeatability in healthy participants, the tested devices were not regarded as comparable. Hence, the clinician should take the different modalities into consideration during ACA assessment using various devices.
Learning Effect of Humphrey Matrix Frequency Doubling Technology Perimetry in Patients with Open-Angle Glaucoma
Authors: De Tarso Pierre-Filho Paulo , Gomes Paulo R.P. , Pierre Éarika T.L. , Pierre Leandro M.
Published: January 2018

Purpose.

To evaluate the learning effect of frequency doubling technology (FDT) perimetry using the Humphrey Matrix perimeter in patients with open-angle glaucoma with no perimetric experience.

Methods.

One eye each of 30 glaucoma patients who had no history of visual field testing underwent 3 Matrix tests using 24–2 program with full-threshold strategy. The parameters investigated to detect learning effect were test duration, reliability indexes, mean deviation (MD), pattern standard deviation (PSD), and the number of points with a p of <5% and <1% in the total and pattern deviation maps.

Results.

MD showed a larger defect at the first test (-13.64 ± 1.63 dB) than at the second (-12.68 ± 1.45 dB) and third (-11.69 ± 1.48 dB) tests (p<0.05). A statistically significant reduction (p<0.05) in the number of points with a p <5% and <1% in the total deviation map was observed when repeating the examination. The values of test duration, PSD, fixation losses, false-positive rate, false-negative rate, and number of points with a p <5% and <1% in the pattern deviation map were not changed significantly (p>0.05).

Conclusions.

Humphrey Matrix FDT perimetry showed a statistically significant learning effect on MD and the number of significantly depressed points of the total deviation map in glaucoma patients with no perimetric experience. It is probably necessary to obtain at least 3 repetitions to rule out the presence of a learning effect in such patients before providing useful results.
Surgical Treatment of Esotropia Associated with High Myopia: Unilateral versus Bilateral Surgery
Authors: Morad Yair , Pras Eran , Goldich Yakov , Barkana Yaniv , Zadok David , Hartstein Morris
Published: January 2018

Purpose.

To compare unilateral versus bilateral surgical treatment of esotropia associated with high myopia.

Methods.

This retrospective study comprised patients who underwent surgery for esotropia with high myopia performed by the first author (Y.M.) between 2003 and 2008. Surgical results and complications were compared between patients who underwent unilateral versus bilateral surgery.

Results.

Nine patients were identified with average age of 44.9 years (range 8–70 years). All had bilateral high myopia (average −13.35 D, range −9.00 to −17.50 D) and esotropia of 20–75 diopters, together with hypotropia in 5 cases. Bilateral displacement of the lateral rectus inferiorly and superior rectus medially was demonstrated in each patient by computed tomography scan of the orbits and by observation during surgery. Five patients underwent bilateral surgery and 4 underwent unilateral surgery. After an average follow-up of 29 months (range 4–47 months), 4/5 patients who underwent bilateral myopexy achieved good results with postoperative esotropia of less than 8 diopters, as opposed to 2/4 patients who underwent unilateral surgery. No complications were noted.

Conclusions.

Bilateral superior and lateral rectus myopexy is the preferred method of surgical correction of esotropia associated with high myopia. Additional unilateral or bilateral medial rectus recession is probably not indicated in most cases. Patients who prefer unilateral surgery can benefit from unilateral superior and lateral rectus myopexy together with medial rectus recession. This unilateral approach may yield good results particularly in young patients without markedly restricted and tight extraocular muscles.
Molecular Identification of Adenoviral Conjunctivitis in Turkey
Authors: Yağci Ramazan , Akçali Alper , YağCi Server , Konno Tsunetada , Ishiko Hiroaki , Duman Sunay , Özkaya Etem
Published: January 2018

Purpose.

The aim of the study was isolation of adenoviruses by cell culture and identification using polymerase chain reaction (PCR) and phylogenetic analyses in patients clinically diagnosed with viral conjunctivitis in Ankara, Turkey.

Methods.

Conjunctival swabs from 34 patients with acute conjunctivitis were tested using cell culture isolation and PCR for adenovirus detection. PCR-positive samples were sequenced and typed.

Results.

The positive results of adenovirus were 26.5% (9 of 34) by the PCR method and 20.6% by culture isolation. Nine samples positive at PCR were identified by phylogenetic analyses as human adenovirus 8 (HAdV-8) (4 of 9), HAdV-3 (3 of 9), HAdV-4 (1 of 9), and HAdV-B (1 of 9).

Conclusions.

Our study showed types of adenoviruses in patients with ocular infection that occurred in this region of Turkey for the first time. Furthermore, sequence-based typing method is an efficient, accurate, and rapid means of diagnosis and typing of the adenovirus and has significant clinical and epidemiologic implications. HAdV-8 was major type for acute conjunctivitis in Ankara, Turkey. Further studies are required to reveal the major types of HAdVs that cause ocular diseases in this region of the world.
Phacoemulsification after Deep Anterior Lamellar Keratoplasty
Authors: Leccisotti Antonio , Islam Tahmina , Mcgilligan Victoria E. , Moore Tara C.B.
Published: January 2018

Purpose.

To evaluate the results of phacoemulsification and intraocular lens implantation after deep anterior lamellar keratoplasty (DALK).

Methods.

Retrospective, consecutive, noncomparative, single-surgeon series.

Results.

Sixteen eyes of 16 patients were included (mean age: 51 years). Five eyes had phacoemulsification because of cataract, and 11 eyes for myopic refractive lens exchange. No intraoperative or postoperative complications were noted. Mean spherical equivalent (SE) improved from −8.69 D (SD 3.74) to −0.97 D (SD 1.13). Mean preoperative defocus equivalent (DE) improved from 10.32 D (SD 4.04) to 2.57 D (SD 0.92). Mean preoperative best spectacle-corrected visual acuity improved from 0.48 logMAR (SD 0.60) to 0.13 D (SD 0.005). Mean postoperative uncorrected visual acuity was 0.675 logMAR (SD 0.252). Safety index was 2.33, efficacy index was 0.70, and endothelial cell loss was not significant.

Conclusions.

Phacoemulsification can provide safe and predictable visual rehabilitation for cataract and refractive errors resulting after DALK.
Rarebit Perimetry in the Evaluation of Visual Field Defects in Idiopathic Intracranial Hypertension
Authors: Çelebisoy Nese , Öztürk Taylan , Köse Timur
Published: January 2018

Purpose.

Rarebit perimetry (RBP) is a new perimetric technique that has been reported as a sensitive test for the evaluation of the neural structure of the visual system. The aim of this study was to compare RBP with standard automated perimetry in detecting the visual field defects of patients with idiopathic intracranial hypertension (IIH).

Methods.

Twenty-five patients with IIH and 16 healthy controls were considered. Visual fields were analyzed with Marco automated static perimeter with threshold and central 30–2 programs (MP 30–2) and rarebit perimetry. A visual field was classified into 3 zones for both tests as central, paracentral, and peripheral zones. Mean sensitivity (MS) recorded by the MP 30–2 was compared with the mean hit rate (MHR) recorded by RBP for each zone.

Results.

MS recorded by MP 30–2 and MHR recorded by RBP for each zone were significantly lower in the IIH group than in healthy control eyes (p<0.001). Good correlation was present between the visual fields recorded by both tests. Although the sensitivity and specificity values for each zone were lower in the RBP group than the MP 30–2 group, RBP was found to be efficient to differentiate between the visual fields of normal and IIH-Affected eyes. The average RBP test duration was significantly shorter than the MP 30–2 test duration (p<0.001).

Conclusions.

RBP is a rapid, comfortable, and widely accessible perimetric test giving reliable results in detecting visual field defects in IIH.
Detecting Retinal Vigabatrin Toxicity in Patients with Partial Symptomatic or Cryptogenic Epilepsy
Authors: Akçakaya Aylin Ardagil , Gökçeer Sevda , Erbil Hasan H. , Işik Nihal , Özdöker Levent , Salar Senem , Aykan Fatma , Aydin TuğRul , Yaylali Sevil Ah , Kesim Özlem
Published: January 2018

Purpose.

Detecting retinal vigabatrin toxicity in patients with partial symptomatic or cryptogenic epilepsy can be challenging because of preexisting visual field defects secondary to a structural abnormality in the brain or lack of collaboration. The aim of this study was to measure the retinal nerve fiber layer thickness (RNFLT) with optic coherence tomography (OCT), as well as contrast sensitivity, color vision, and perimetry, in patients with partial symptomatic or cryptogenic epilepsy on vigabatrin, and to determine the efficacy of these tests as markers of vigabatrin-related retinal damage in these subgroups of epileptic patients.

Methods.

The study involved 38 patients with either partial symptomatic or cryptogenic epilepsy and 16 healthy individuals comprising the control group. At the time of the study, 14 of the patients were using vigabatrin, 10 were receiving sodium valproate monotherapy, and 14 were on carbamazepine monotherapy. All the participants underwent RNFLT imaging with OCT, contrast sensitivity, color discrimination assessment, and perimetry.

Results.

The average 360° RNFLT of the vigabatrin group was significantly lower when compared to the other groups. The average RNFLT of all quadrants except the temporal one in the vigabatrin group was also significantly reduced. There was no difference in the mean deviation, contrast sensitivity, and color discrimination between the study groups, but they were all significantly lower than the control group.

Conclusions.

RNFLT measurement with OCT can efficiently identify vigabatrin toxicity in patients with partial symptomatic and cryptogenic epilepsy. Perimetry, contrast sensitivity, and color discrimination assessment might be inconclusive in these particular subgroups of epileptic patients.
Work-Related Eye Injury: The Main Cause of Ocular Trauma in Iran
Authors: Mansouri Mohammad Reza , Hosseini Mona , Mohebi Masoumeh , Alipour Fateme , Mehrdad Ramin
Published: January 2018

Purpose.

Occupational eye injuries are among the major causes of ocular trauma and can cause severe visual impairment, with even minor injuries incurring considerable financial costs due to work absenteeism. This study was designed to evaluate the epidemiology of eye trauma and the role of occupational injuries at Farabi Eye Hospital, which is the largest eye hospital in Iran.

Methods.

In this prospective, cross-sectional study, 822 eyes from 768 trauma patients presenting to Farabi Eye Hospital were enrolled in the study. The Birmingham Eye Trauma Terminology System and the United States Eye Injury Registry model were adopted as the basis for the study questionnaire. The questionnaires were completed through in-person interviews and comprehensive ocular examinations.

Results.

The mean age of ocular trauma patients was 31.11 years, and 685 (89.2%) patients were male. Of all eye injuries, 73.7% were work-related. Only 2.2% of the patients were wearing safety goggles at the time of injury. History of previous eye trauma was positive in 44.3% of cases. An Ocular Trauma Score 3 or more was present in 4% of patients.

Conclusions.

Work-related eye trauma is the major cause of eye injury in Iran and most often occurs as a result of the lack of proper eye protection. Most work-related eye injury patients are young men.