bluuebunny/crossref_metadata_2025 huggingface dataset:
Corneal Surface Changes in Thygeson's Superficial Punctate Keratitis: A Clinical and Noncontact Photomicrographic in Vivo Study in the Human Cornea
Authors: Tabery H.M.
Published: January 2018

Purpose

To elucidate mechanisms behind the morphology of Thygeson's superficial punctate keratitis (TSPK).

METHODS

Sixteen patients were examined with the slit lamp and photographed by noncontact photomicrography. The results were compared with morphology of epithelial keratitis in herpes simplex type 1 (HSV1), varicella zoster (VZV), and adenovirus type 8 (Ad8) infections, all previously studied by the same method, and with published histologic findings in TSPK.

Results

In the photographs, the corneal epithelium showed various numbers of abnormal subsurface cells measuring about 10 μm in diameter, present individually, in small groups, or aggregated in larger lesions (coarse lesions with the slit lamp). The surface epithelium was well preserved, except in larger lesions, which showed surface debris. The morphology was unlike HSV1 and VZV epithelial keratitis, but strongly resembled epithelial changes occurring in Ad8 infections on day 5, and later, after the onset of symptoms.

CONCLUSIONS

TSPK shows a more widespread epithelial involvement than suspected with the slit lamp. Its morphology seems to reflect an action of a noxious agent targeted at the deeper epithelial layers, with the appearance of abnormal cells as a result. These might represent invading inflammatory cells, damaged intraepithelial ones, or both. The coarse lesions visualize areas of major involvement showing discernible signs of cell destruction. The similarity to Ad8 keratitis suggests that the source of the noxious agent might be located outside the cornea. The morphology, in conjunction with clinical features, is compatible with an immunologically mediated injury. The etiology remains unknown.
Ultrasound Biomicroscopy Findings in Peripheral Vitreoretinal Toxocariasis
Authors: Cella W. , Ferreira E. , Torigoe A.M.S. , Macchiaverni-filho N. , Balarin V.
Published: January 2018

Purpose

To describe the morphologic alterations in ultrasound biomicroscopy (UBM) present in peripheral vitreoretinal toxocariasis.

METHODS

An observational prospective study of case series. Fifteen eyes of 15 patients with clinical and laboratory diagnosis of peripheral vitreoretinal toxocariasis were enrolled. The patients were submitted to UBM examination of the region corresponding to the pars plana of the affected eye.

Results

The most common morphologic alterations found by UBM in patients with peripheral vitreoretinal toxocariasis were as follows: vitreal membranes (13 cases), toxocara granuloma (11 cases), and pseudocysts (8 cases). Other less frequent findings were thickening of the ciliary body (6 cases), cystic formation (2 cases), peripheral retinal detachment (2 cases), rectification of the iris root (1 case), and posterior synechiae (1 case).

CONCLUSIONS

UBM allows detection of well-defined morphologic alterations associated with peripheral vitreoretinal toxocariasis, being useful to reinforce the clinical diagnosis
Ocular Injuries Secondary to Motor Vehicle Accidents
Authors: Panagiotidis D.N. , Theodossiadis P.G. , Petsias C.B. , Kyriaki T.E. , Marakis T.P. , Friberg T.R. , Moschos M.N.
Published: January 2018

Purpose

Ocular trauma is one of the main causes of visual reduction or loss, particularly in the younger population.

METHODS

In this prospective study the authors included 67 consecutive patients with ocular trauma secondary to motor vehicle accidents who were hospitalized in the Athens University Eye Clinic from September 1993 to December 1996. The mean follow-up time was 31 months, the mean age was 31.7 years, and the ratio between men and women was 2.7:1.

Results

Thirty-two of the accidents (47.76%) took place in populated areas. Among the 67 injured persons, 58 (86.56%) were car passengers, 8 (11.95%) were on motorcycles, and 1 (1.49%) was a pedestrian. Only 3 (5.2%) of the 58 persons injured inside automobiles used safety belts and none of the motorcyclists used crash helmets during the accidents. Fifty-three (79.1%) ocular traumas were penetrating in nature, with glass fragments being the main cause in 36 of them (67.9%). Among the 53 injured persons experiencing penetrating ocular trauma, 49 had a follow-up time of more than 6 months. Twenty of them (40.8%) underwent one surgical procedure, 22 (44.9%) were submitted to two surgical procedures, and the remaining 7 persons (14.3%) needed three or more operations. Eighteen (36.7%) of the 49 patients with penetrating ocular trauma and with 6 months follow-up had a final visual acuity of less than 1/20, 21 (42.9%) had a visual acuity of more than 5/10, and 3 (6.1%) underwent enucleation. Among the 67 patients, 61 had a follow-up time of more than 6 months, regardless of their history of penetrating ocular trauma. Eighteen of them (29.5%) had a final visual acuity of less than 1/20, 8 (13.1%) had a visual acuity between 2/10 and 4/10, and 22 (52.5%) had a visual acuity of more than 5/10.

CONCLUSIONS

Because motor vehicle accidents can cause severe ocular trauma, it would be helpful for drivers to be more careful and aware of motor vehicle regulations. There seems to be a great need of enforcement of seatbelt laws in Greece.
Pigmented Congenital Vitreous Cyst
Authors: Bayraktar Z. , Kapran Z. , Ozdogan S.
Published: January 2018

Purpose

To describe the clinical findings in a case with a typical pigmented congenital vitreous cyst and to discuss its differential diagnosis.

METHODS/CASE REPORT

A 24-year-old woman complaining of floaters and blurring of vision during eye movements in the right eye was examined.

Results

A diagnosis of congenital vitreous cyst was made after detailed viteoretinal examination, B-scan ultrasonography (eye and abdomen), computerized tomography of brain, chest radiogram, serologic tests for Echinococcosis and Cysticercosis in the serum, and complete blood count for eosinophilia. Clinical presentation and the patient's complaints remained unchanged during 3 years of follow-up.

CONCLUSIONS

Congenital vitreous cysts are benign lesions. Differential diagnosis from acquired cysts requires careful clinical examination and appropriate laboratory tests.
Duplication of the Optic Disc: True or Pseudo? A Coloboma or not a Coloboma?
Authors: McLoone E.M. , Buchanan T.A.
Published: January 2018

Purpose

To present an unusual case of optic disc pseudoduplication with colobomata.

METHODS

Clinical evaluation, fundus photography and literature review.

Results

Optic disc duplication is a rare clinical entity.

CONCLUSIONS

We report what we believe to be the first case of pseudoduplication of the optic disc with coexistent bilateral optic disc colobomata.
Retinal Detachment in Focal Dermal Hypoplasia
Authors: Prenner J.L. , Ciaccia S. , Capone A. , Trese M.T.
Published: January 2018

Background

Focal dermal hypoplasia is a systemic disease that includes well recognized ocular abnormalities. Retinal detachment has not previously been reported as a part of this syndrome.

Purpose

To report a case of focal dermal hypoplasia with an associated retinal detachment.

METHODS

Single case report of a child with a colobomatous retinal detachment and the focal dermal hypoplasia syndrome.

CONCLUSIONS

Retinal detachments may occur as part of the focal dermal hypoplasia syndrome. Expanding knowledge of this syndrome may help ophthalmologists diagnose this rare condition.
Effects of Betaxolol and Latanoprost on Ocular Blood flow and Visual Fields in Patients with Primary Open-Angle Glaucoma
Authors: Erkin E.F. , Tarhan S. , Kayikçioğlu Ö.R. , Devecı H. , Güler C. , GÖktan C.
Published: January 2018

Purpose

To evaluate the effects of betaxolol and latanoprost on ocular blood flow and visual fields in patients with primary open-angle glaucoma (POAG) by means of an obseiver-masked, prospective clinical study.

METHODS

Thirty-two patients with newly diagnosed POAG were included in the study. The patients were randomized into two groups. The first group was treated with betaxolol 0.50% twice daily and the second group with latanoprost 0.005% once daily. Baseline and post-treatment examinations on the first and third months of treatment included intraocular pressure (IOP) measurement, automated visual field testing, and ocular blood flow assessment. For evaluation of visual fields, mean defect and pattern standard deviation indices were used. Ocular blood flow was assessed by means of color Doppler imaging of the central retinal artery (CRA) and the temporal short posterior ciliary artery (PCA). For each vessel, peak systolic (PSV) and end-diastolic (EDV) blood flow velocities were measured and resistivity index (RI) calculated.

Results

After exclusion of one noncompliant patient, the study was completed with 31 eyes of 31 patients. Both drugs significantly reduced IOP (p<0.05). The mean IOP lowering effect of latanoprost was significantly higher than that of betaxolol (p=0.03). Visual field indices exhibited no significant changes in either group (p>0.05). There were no significant changes in PSV or EDV measurements of CRA or PCA in either group (p>0.05). RI decreased in both CRA and PCA with both drugs. The mean changes between baseline and 3 month blood flow measurements were not significantly different between betaxolol and latanoprost (p>0.05).

CONCLUSIONS

Over a treatment period of 3 months, both betaxolol and latanoprost tended to improve ocular blood flow without one of them being superior to the other. The results suggest that the direct (non IOP-dependent) influence on ocular circulation is better for betaxolol than for latanoprost. In addition, neither drug caused significant generalized improvements in visual fields during this period.
Indications and Outcome of Carotid Doppler Ultrasound: An Ophthalmic Perspective
Authors: Mukherji S. , Kurli M. , Sandramouli S.
Published: January 2018

Purpose

The purpose of this study was to assess indications and outcome of carotid Doppler ultrasound requested by ophthalmologists from an eye hospital over a period of three years.

METHODS

This retrospective study was designed to analyse data for all patients referred to have carotid Doppler ultrasound from 1999 to 2001. Colour fundus photograph was used to ascertain diagnosis of ocular condition. Detailed case note analysis was done to correlate patient details, indication, results of carotid Doppler, and status of anti-platelet treatment as well as presence of other risk factors.

Results

107 patients were included in the study. 46.7% had normal internal carotid on Doppler while 53.3% patients had stenosis, 22.8% of which were significant. 15 out of 24 patients with retinal artery occlusion had internal carotid artery (ICA) stenosis. 2 out of 6 patients with migraine had significant stenosis. 12 patients had retinal vein occlusion (5 were bilateral), 9 of whom showed ICA stenosis. 14 of 15 patients with retinal emboli had stenosis of ICA. Other diagnoses included anterior ischaemic optic neuropathy, cranial nerve palsy, etc. 42 patients had 1 to 3 risk factors, and 11 patients had more than 3 risk factors. Ophthalmologists started anti-platelet management in 24 patients (42.1%) with some degree of ICA stenosis.

CONCLUSIONS

Approximately 55% of our patients referred for carotid Doppler were positive for ICA stenosis with nearly a fifth of such referrals having more than 70% stenosis, which is considered to be clinically significant. Our results highlight the importance of such referrals for carotid Doppler for various ophthalmic conditions by the ophthalmologists.
Pentoxifylline (PTX) - an Alternative Treatment in Graves' Ophthalmopathy (Inactive Phase): Assessment by a Disease Specific Quality of Life Questionnaire and by Exophthalmometry in a Prospective Randomized Trial
Authors: Finamor F.E. , Martins J.R.M. , Nakanami D. , Paiva E.R. , Manso P.G. , Furlanetto R.P.
Published: January 2018

Purpose

To investigate the effect of pentoxifylline (PTX) in subjects with inactive Graves' ophthalmopathy (GO) through a specific quality of life (QOL) questionnaire and exophthalmometry readings.

Methods

Eighteen females were randomly divided in two groups. Group A (n=9) was treated with PTX 1200 mg orally/day for 6 months. Group B (n=9) received placebo during the initial 6 months and then PTX for another 6 months. Proptosis measurements were carried out every 3 months and a questionnaire graded from 0 to 10 according to the severity of the symptoms was performed at baseline and after placebo and PTX administration.

Results

At baseline, Group A questionnaire score values were 5.5 (median; range 3.5 to 8.0), and 5.0 after 6 months (3.0 to 6.0; p=0.01). In Group B, baseline values were not significantly different after 6 months of placebo: 6.0 (4.5 to 7.0) and 5.5 (4.5 to 7.0), respectively. However, a significant change was observed 6 months after PTX: 4.0 (2.0 to 5.0; p<0.001). Patients in Group A had a progressive improvement of proptosis during PTX: at baseline, 23 mm (median; range 20 to 32); after 3 months, 23 mm (18 to 30; p=0.02); and after 6 months, 23 mm (18 to 30; p=0.005). In Group B, proptosis remained stable during placebo: at baseline, 23 mm (21 to 25); after 3 months, 23 mm (20 to 25); and after 6 months, 23.5 mm (20 to 25). A significant change was observed after 3 and 6 months of PTX: 22 mm (19 to 24; p=0.0006) and 20.8 mm (17 to 25; p=0.0003), respectively.

Conclusions

Pentoxifylline seems to improve the QOL of patients in the inactive phase of GO. The objective findings of the proptosis readings corroborate to suggest that PTX may be an effective and promising drug in the inactive phase of GO.
Diffuse Retinal Pigment Epitheliopathy: Treatment with Laser Photocoagulation
Authors: Ladas I.D. , Rouvas A.A. , Apostolopoulos M. , Brouzas D. , Karagiannis D.A. , Georgalas I. , Baltatzis S.
Published: January 2018

Purpose

To evaluate the effectiveness of laser treatment in eyes with diffuse retinal pigment epitheliopathy (DRPE).

Methods

The authors retrospectively reviewed the medical records of 56 consecutive patients (78 eyes) with DRPE. All eyes were treated with digital fluorescein angiography guided argon green laser photocoagulation, direct on the focal retinal pigment epithelium (RPE) leaks and in a grid pattern to the RPE decompensation areas. A processed digital red-free fundus image including all the important traces on it was used as a guide to the laser treatment. The follow-up period ranged from 6 months to 7 years.

Results

At the end of the follow-up time, 70 (89.7%) eyes showed anatomic improvement with complete or partial resolution of the macular exudative lesions. Visual acuity of less than 20/40 was noted in 60 eyes (76.9%) preoperatively compared with 46 eyes (59.0%) finally (p=0.0252). The visual acuity was improved in 19 eyes (24.4%), stabilized in 51 (65.4%), and reduced in only 8 eyes (10.2%).

Conclusions

In this series of patients with DRPE, the results of laser treatment were uniformly satisfactory producing a gradual resolution of the macular exudative lesions and an improvement or stabilization of the visual acuity.
Reactivation of Ocular Toxoplasmosis in Fellow Unaffected Eye
Authors: Lee M. Seng , Boyce R.L. , Clarke J.R.
Published: January 2018

Purpose

To report a case of reactivation of ocular toxoplasmosis in fellow unaffected eye.

Methods

Case report.

Results

A 15 year old girl, known to have right ocular toxoplasmosis previously, has presented with one week history of sudden left visual deterioration and pan uveitis. Her condition was improved on intensive steroid treatment.

Conclusions

Reactivation of such lesion in fellow unaffected eye is quite rare. Various choices of treatment are available and there are also different techniques to treat. A review of treatment based on this pathology is briefly discussed.
Multifocal Choroiditis - an Unusual Finding in Crohn's Disease
Authors: Vianna R.N.G , Özdal P.Ç. , Deschênes J.
Published: January 2018

Purpose

To report a patient with Crohn's disease and acute decreased vision in one eye secondary to multifocal choroiditis and serous retinal detachment.

Methods

A complete ocular examination, including fluorescein angiography, was performed.

Results

Fundus biomicroscopy disclosed multifocal, deep, discretely elevated yellowish lesions at the posterior pole of the affected eye. Fluorescein angiographic study of these lesions revealed early hypofluorescence followed by late hyperfluorescence. Subtenonian injection of corticosteroids rapidly induced remission of the choroidal lesions.

Conclusions

Chorioretinal involvement in patients with Crohn's disease may or may not be related to reactivation of this disorder. Therefore, even patients without gastrointestinal symptoms who present with posterior segment inflammation must be informed of this. The chorioretinal inflammatory lesions do seem to respond promptly to periocular injection of corticosteroids.
Comparison after 10 Years of Two 100–Patient Cohorts Operated on for Eviscerations or Enucleations
Authors: Genevois O. , Millet P. , Retout A. , Quintyn J.C.
Published: January 2018

Purpose

To compare the indications, surgical techniques, and operative outcome between two 100-patient populations operated on for evisceration or enucleation with a 10-year interval.

Methods

This retrospective study involved 100 patients operated on between 1987 and 1990 (Group 1) compared with another 100 patients operated on between 1996 and 2000 (Group 2). Group 1 included 64 males and 36 females, mean age 49 years; Group 2 included 60 males and 40 females, mean age 53.

Results

In Group 1, 19 eviscerations were performed, versus 55 in Group 2. In both groups, half of the indications for surgery were a painful blind eye. In Group 1, endophthalmia (23%) came second, whereas it was trauma (15%) in Group 2. Sixty-eight patients were implanted in Group 1 (silicone spheres 69%) versus 86 in Group 2 (hydroxyapatite spheres 69%). Twenty spheres (20%) were rejected in Group 1 versus 7% in Group 2.

Discussion and Conclusions

The proportion of eviscerations incr eased in 10 years. The number of endophthalmitis-related operations decreased and trauma-related operations increased. The number of implantations increased with hydroxyapatite as the first choice material instead of silicone. This most likely contributed to reducing the number of rejections.
Infliximab for the Treatment of Posterior Uveitis with Retinal Neovascularization in Behçet Disease
Authors: Giansanti F. , Barbera M.L. , Virgili G. , Pieri B. , Emmi L. , Menchini U.
Published: January 2018

Purpose

To report a case of posterior uveitis with retinal neovascularization in a patient with Behçet disease treated with infliximab.

Methods

A 50-year-old man with a history of recurrent relapses of ocular inflammation despite immunosuppressive therapy developed retinal neovascularization near the optic disk. The patient was treated with infliximab and followed up for 12 months.

Results

Retinal neovascularization regressed 8 months after the first anti–tumor necrosis factor (TNF) treatment and with six infusions of infliximab. The ocular inflammation resolved almost completely.

Conclusions

The result suggests that anti-TNF therapy may be effective in the treatment of retinal neovascularization caused by panuveitis in Behçet disease.
Long-Term Follow-up Outcomes of Nonlaser Intranasal Endoscopic Dacryocystorhinostomy: How Suitable and Useful are Conventional Surgical Instruments?
Authors: Gurler B. , San I.
Published: January 2018

Purpose

To investigate the long-term follow-up outcomes of nonlaser intranasal endoscopic dacryocystorhinostomy (IEDCR) using a nasal endoscope and conventional surgical instruments available in all operating rooms, the advantages of this technique, and the usability and suitability of conventional instruments.

Methods

Twenty-seven IEDCRs were performed in combination with bicanalicular silicone intubation on 24 patients with primary nasolacrimal sac or duct obstruction who had undergone no previous procedures. Ablation of the nasal mucosa was performed with a sickle blade (12 operations) or insulated sickle blade allowing simultaneous intranasal monopolar cauterization (15 operations); a bony window was opened with a drill; and ablation of the medial wall of the lacrimal sac was performed with a sickle blade, Blakesley forceps, and Bellucci ear microscissors. Revision intranasal endoscopic surgery was performed in unsuccessful cases.

Results

Patients were followed up for 35 to 71 months (average 49.3 months). In 7 (25.9%) of the 27 IEDCRs, nasolacrimal obstruction recurred within 3 months. Success rates were as follows: 66.7% (8 operations) for the first 12 operations; 80% (12 operations) for the second 15 operations; and 74.1% overall. There were seven cases of surgical failure; revision surgery was successful in four, increasing the overall success rate to 88.9%.

Conclusions

IEDCR can be performed with acceptable facility with standard conventional surgical instruments (sickle blade, endoscopic forceps, and scissors) and surgical tools (drill, monopolar cautery) found in all operating rooms, and the nonlaser intranasal endoscopic approach may be a reasonable alternative to the laser assisted surgery approach.
Desmoplastic Trichilemmoma: A Rare Tumor of the Eyelid
Authors: Keskinbora K.H. , Buyukbabani N. , Terzi N.
Published: January 2018

Purpose

To report an upper eyelid mass which proved to be a desmoplastic trichilemmoma.

Methods

A 60-year-old man had a slowly enlarging upper eyelid mass. The tumor was excised. The pathologic evaluation of the tumor was centered on the differential diagnosis.

Results

The clinical appearance of this lesion is nonspecific and can simulate a verruca, follicular keratosis, or basal cell carcinoma. Central desmoplasia, outer root sheath differentiation of the tumor cells, and CD34 positivity are the main characteristics that allow differentiation from basal cell carcinoma.

Conclusions

Proper recognition of a benign neoplasm that may be misdiagnosed as basal cell cancer can prevent aggressive surgical treatment.
Photodynamic Therapy with Verteporfin of Choroidal Neovascularization in Angioid Streaks: Conventional versus Early Retreatment
Authors: Ladas I.D. , Georgalas I. , Rouvas A.A. , Gotsis S. , Karagiannis D.A. , Moschos M.
Published: January 2018

Purpose

To evaluate the effectiveness of conventional photodynamic therapy with verteporfin (PDT) in a series of patients with macular choroidal neovascularization (CNV) due to angioid streaks and to compare it to the effectiveness of early PDT retreatment.

Methods

This is a retrospective study of 24 eyes (22 consecutive patients) with subfoveal or juxtafoveal CNV secondary to angioid streaks treated with PDT from September 2000 through February 2003 and that completed at least the first year of follow-up. Until August 2001, retreatments were performed according to the conventional protocol for PDT every 3 months (Group 1, consisting of 11 eyes of 9 patients). After August 2001 (13 more eyes of 13 new patients), retreatments were performed earlier (every 8 weeks) when indicated (Group 2). The follow-up time ranged from 30 to 42 months and from 12 to 30 months in Groups 1 and 2.

Results

At the end of the follow-up, final best-corrected visual acuity decreased in 21 (87.5%), stabilized in 2 (8.3%), and improved in 1 (4.2%) of the total 24 eyes. In all, 19 of the 24 eyes (79.2%) had a final best-corrected visual acuity equal to or less than 20/400. There were not any statistically significant differences in final visual acuity between the two groups.

Conclusions

In this large series of patients with macular CNV secondary to angioid streaks, the functional and the anatomic results of PDT were not satisfactory, even when retreatments were performed earlier than the conventional time of 3 months.
Ocular Manifestations of Congenital Lamellar Ichthyosis
Authors: Singh A. J. , Atkinson P. L.
Published: January 2018

Purpose

To describe the ophthalmic manifestations in a series of children with congenital lamellar ichthyosis. These cases presented with varying types of eyelid abnormality associated with the systemic disease. The clinical features and ophthalmic management were studied.

Methods

The case histories of three children presenting to the oculoplastic clinic were reviewed. All were diagnosed with congenital lamellar ichthyosis and under the care of the Dermatology department. Family history and pedigree analysis was performed to determine mode of genetic inheritance. Ocular examination for visual acuity, eyelid and eyelash malposition, lid function and closure were carried out. Corneal examination including tests for exposure was also done.

Results

All three patients had eyelid position abnormalities from the systemic disease. There was no clinical evidence of conjunctival involvement. One patient required full thickness skin grafts to treat corneal exposure secondary to lower lid ectropion. One had mild lower lid ectropion but without corneal exposure. The third case had the unusual finding of inward turning of the anterior lamella of the upper eyelid with a marked lash ptosis and only mild ectropion of the lower lid.

Conclusions

Congenital lamellar ichthyosis is a heterogeneous disorder with phenotypic variability. The most common eyelid abnormality is cicatricial ectropion of the upper and mainly lower eyelids. Most cases are managed conservatively although in severe cases secondary corneal exposure may require surgical correction. In this condition, to the best of our knowledge, the tendency for the eyelids to turn inwards has not previously been described.
Incomplete Extrusion of an Acrylic Punctum Plug in a Case of Severe Dry Eye Syndrome
Authors: Fasce F. , Brancato R.
Published: January 2018

Purpose

To report a case of extrusion of a new soft punctum plug with thermoexpansion property (Medennium SmartPLUG).

Methods

A soft punctum plug was implanted in a 32-year-old woman with a severe dry eye syndrome in juvenile arthritis.

Results

One week after implant the plug partially extruded outside the punctum. Despite this adverse event, all subjective dry eye symptoms improved.

Conclusions

The peculiarity of this case is the persistence of clinical efficacy of the soft punctum plug even if partially extruded. The patient experienced relief of symptoms that can be compared to the benefits usually obtained with a successfully implanted silicon plug.
Relationship of Symptomatology with Closed Chamber Infrared Thermometry and Humidity in Dry Eyes
Authors: Singh G. , Bhinder H. Singh
Published: January 2018

Purpose

To evaluate the relationship of symptoms of dry eye with closed chamber infrared thermometry and humidity measurements.

Methods

The authors studied 54 patients (108 eyes) with dry eye disorders of different grades of clinical severity (mean age 35.75±14.37 years), 31 cases (62 eyes) with normal eyes (mean age 33.68±14.42 years), and 10 cases (20 eyes) with epidemic conjunctivitis (mean age 33.68±14.42 years). The symptoms and the clinical tests (Schirmer-1 test, fluorescein tear break up time, Lissamine green stain; closed chamber infrared thermometry and humidity) were used to establish the diagnosis of dry eyes. The closed chamber humidity difference was used to classify the groups of dry eye.

Results

The authors noted no temperature difference from closed to open eye position in dry eyes as compared to 0.10±0.00 °C difference in normal eyes and epidemic conjunctivitis. Four groups of cases were identified by difference in values of humidity: Group 1 = <0.9 relative humidity (RH)% to 1 RH%; Group 2 = >1 RH% to 1.5 RH%; Group 3 = >1.5 RH% to 2 RH %; and Group 4 = >2 RH%. The symptomatology was measured in the eyes using Oxford scale (0–4) and correlated with the humidity groups. The grading of symptoms with the humidity showed a statistically significant relationship (p<0.0001) in each group. The severity of the symptoms showed an increase in frequency and severity from Group 1 to Group 4, which was statistically significant (p<0.0001). The mean sum total of global symptomatology score was statistically significant (p<0.0001): 3.43±0.31 in Group 1, 4.65±0.42 in Group 2, 8.56±0.78 in Group 3, and 13.35±1.21 in Group 4. However, total symptomatology score in epidemic conjunctivitis did not show a statistically significant value (p=0.20).

Conclusions

The closed chamber humidity and thermometry measurements showed statistical correlation in all four groups of dry eyes to total mean symptomatology score (p<0.001) and showed an increase in value with increasing severity of symptoms. However, all individual symptoms fail to show any conclusive relationship.
Evaluation of Two Humphrey Perimetry Programs: Full Threshold and SITA Standard Testing Strategy for Learning Effect
Authors: Yenice Ö. , Temel A.
Published: January 2018

Purpose

To compare learning effect of Swedish interactive threshold algorithm (SITA) standard strategy with full threshold testing.

Methods

Thirty-nine medical students with no experience in visual field testing had full threshold (FT) and SITA standard for either right or left eyes. They were chosen in such a way that 20 (Group I) had FT for right and SITA for left eyes and 19 (Group II) had SITA standard for right and FT for left eyes. It was designed to have both strategies on same person whereby eliminating inter-individual variability. Visual field testing was repeated in the same week of the first test on the same subject with the same strategy that was chosen for that eye.

Results

The authors found an improvement in mean deviation (MD) and pattern standard deviation (PSD) of first and second testings correspondingly for FT (MD from –3.04 to –2.55; PSD from –2.60 to –2.29) and SITA standard (MD from –2.86 to –2.20; PSD from 2.25 to 2.10) and changes were statistically significant (p<0.05). To analyze learning effect of visual field testings, we calculated percentage change in MD and PSD for full threshold and SITA standard strategy. The percentage changes in visual field parameters were significantly lower in SITA standard strategy testing for MD (p=0.02) and PSD (p=0.01).

Conclusions

This study shows that a learning effect is present for both strategies and SITA standard may have a reduced learning effect compared to FT.
Ectropion of the Lacrimal Point: The Shoelace Technique
Authors: Adenis J.P. , Grivet D.
Published: January 2018

Purpose

To describe an alternative technique to repair the ectropion of the lacrimal point, either alone or combined with an ectropion related to outer angle laxity.

Methods/Results

After diamond shape resection of the conjunctiva and the retractors, sutures are placed with each bridle interlacing on the posterior portion of the eyelid below the lacrimal point in a shoelace fashion.

Conclusions

The technique combines treatment of hyperlaxity of several anatomic structures in a single operation and has the advantage of reinforcing the Horner muscle, which is essential for the cure of this type of ectropion.
Bilateral Serous Macular Detachment as a Presenting Feature of Acute Lymphoblastic Leukemia
Authors: Malik R. , Shah A. , Greaney M.J. , Dick A.D.
Published: January 2018

Purpose

To report a case of bilateral serous maculopathy as an initial sign of acute lymphoblastic leukaemia in children.

Methods/Results

A 13-year-old girl, who presented with symptoms of visual blurring, was found to have a bilateral serous maculopathy. Haematological abnormalities (thrombocytopenia with a mild lymphocytosis) prompted further investigation. A bone marrow aspirate revealed the presence of leukemic blasts and a diagnosis of acute lymphoblastic leukaemia was made. Her maculopathy completely resolved following systemic chemotherapy.

Conclusions

Prompt recognition of disease led to early systemic treatment and restoration of visual function.
Custom Measurement of Retinal Nerve Fiber Layer Thickness Using STRATUS OCT in Normal Eyes
Authors: Carpineto P. , Ciancaglini M. , Aharrh-Gnama A. , Cirone D. , Mastropasqua L.
Published: January 2018

Purpose

To evaluate variability of retinal nerve fiber layer (RNFL) thickness measurements in normal eyes and their correlation with optic disc diameter by using two different scan options of the ultimate commercial optical coherence tomography (OCT) unit (STRATUS OCT™, Carl Zeiss Meditec, Inc., Dublin, CA).

Methods

In this observational case series and instrument validation study 30 eyes of 30 normal subjects were enrolled. Each eye underwent optic disc vertical diameter measurement by means of both stereoscopic photography and planimetry and OCT; RNFL thickness measurements were performed using OCT. Three repetitions of two series of scans were performed. Each eye was scanned at two different options (RNFL thickness 3.4 and Nerve Head Circle). For each option descriptive statistics, analysis of variance, intraclass correlation coefficients (ICCs), and coefficients of variation (COVs) were calculated. To verify the correlation between the two methods of optic disc diameter assessment and to study the influence of optic disc diameter on RNFL measurement using the two different OCT options, Pearson's correlation coefficients were calculated.

Results

Optic disc diameter length ranged from 1.47 to 2.04 mm (mean 1.709 mm, SD ± 0.147) with stereoscopic photographs, and from 1.47 to 2.02 mm (mean 1.703 mm, SD ± 0.143) with OCT (Pearson correlation coefficient 0.999, p<0.001). Mean RNFL thickness was 89.29 mm (SD ± 10.80 mm) using the RNFL thickness 3.4 scanning option and 89.88 mm (SD ±1.72 mm) using the Nerve Head Circle protocol (Pearson correlation coefficient 0.065, p=0.734). The intersubject variance is higher using the RNFL thickness 3.4 option than using the NHC protocol (sum of square: 10147,60 vs. 257,41) (p<0.001); the intrasubject variance is very similar in the two groups (23,72 vs 23,60) (p=NS). The ICC is 99.89% when using the RNFL thickness 3.4 option, 95.62% with the NHC protocol (p=NS). COVs were 12.10% and 1.91 % by using RNFL thickness 3.4 and Nerve Head Circle option, respectively. Pearson's correlation coefficient was 0.988 (p<0.001) when comparing optic disc diameter and RNFL thickness by using the RNFL thickness 3.4 option and −0.016 (p=0.932) when comparing optic disc diameter and RNFL thickness by using the Nerve Head Circle option.

Conclusions

These results suggest that both scan options give good RNFL thickness measurement reproducibility; the use of the Nerve Head Circle option leads to less interindividual variability and can minimize the effect of differences in optic disc diameter on RNFL thickness measurements in normal subjects.
Protective Effects of Antithrombin III on Retinal Ischemia/Reperfusion Injury in Rats: A Histopathologic Study
Authors: Özden S. , Müftüoğlu S. , Tatlipinar S. , Kaymaz F. , Yildirim C. , Yaylali V. , Özbay D.
Published: January 2018

Purpose

To investigate the effect of antithrombin III (AT III) on retinal ischemia/reperfusion (I/R) injury in rats.

Methods

The study was carried out on 10 Wistar albino rats (20 eyes) and four-vessel occlusion method was employed to induce retinal ischemia in this study. Rats were divided into two groups: Group I (control group, 10 eyes) and Group II (AT III, 10 eyes). In both groups, vertebral arteries were occluded bilaterally an electric needle coagulator under an operating microscope. A total of 48 hours after the initial procedure, the rats were re-anesthetized and both common carotid arteries were clamped to interrupt blood flow. In Group II, rats were injected intravenously with 250 U/kg of AT III 5 minutes before the induction of ischemia. Duration of ischemia was 30 minutes. At the end of this period, clamp was removed for the reperfusion of the eye for 4 hours. Following the reperfusion period, the animals were killed by decapitation. Retinal sections were evaluated under light and electron microscope. The signs of l/R injury at the microscopic level, i.e., cellular degeneration, vacuolization between retinal layers, increase in the retinal thickness due to edema, mononuclear cell infiltration, and apoptotic cells, were recorded for each group.

Results

Retinal sections obtained from the rats in the AT III group revealed a well preserved retinal structure. When average thickness values of the two groups were compared to each other, the difference was significant with respect to inner nuclear and inner plexiform layers indicating increased retinal thickness values in Group I due to tissue edema resulting from l/R injury. Similarly, mononuclear cell infiltration and apoptotic cell counts were found to be significantly higher in control group compared to AT III group showing the inhibitory effect of AT III on leukocyte infiltration and apoptotic cell death in rat retina.

Conclusions

Antithrombin III attenuated l/R injury in rat retina.
Varix of the Vortex Vein Ampulla: A Small Case Series
Authors: Levy J. , Yagev R. , Shelef I. , Lifshitz T.
Published: January 2018

Purpose

To report three cases of varix of the vortex vein ampulla.

Methods

Observational small case series. During 2002, three patients were examined for suspected choroidal melanoma. In all cases, the lesions were located at the equator or the periphery.

Results

The lesions became more prominent when the eyes were positioned in the direction of the lesion, and disappeared when firm pressure by ultrasound probe was applied on the globe, while the eye was in primary position, or fundus was examined with a three-mirror Goldmann contact lens. These dynamic characteristics were also demonstrated by color Doppler imaging.

Conclusions

Varix of the vortex vein ampulla is an extremely rare condition. This diagnosis should be considered when an elevated choroidal lesion disappears when the fundus is examined with contact lens.
Exchange Technique for Opacified Hydrophilic Acrylic Intraocular Lenses
Authors: Voros G.M. , Strong N.P.
Published: January 2018

Purpose

To report an exchange technique for opacified hydrophilic acrylic intraocular lenses (IOLs).

Methods

Twenty patients with two different types of opacified hydrophilic acrylic IOLs underwent IOL exchange by a single surgeon. Circumferential enlargement of the pre-existing capsulorrhexis was a critical step of the procedure, and resulted in expression of the IOL with minimal traction to the capsule. Implantation of an in-the-sulcus IOL followed. Surgical technique, complications, and visual outcome are discussed.

Results

Time from the initial cataract operation varied from 15 to 61 months (mean 30.5), and in all cases marked fibrosis was encountered. Eighteen patients had uncomplicated IOL exchange. Posterior capsule rupture occurred in two cases. Vision improved in 16 cases, remained unchanged in 3 cases, and deteriorated in 1 case.

Conclusions

IOL exchange of opacified hydrophilic acrylic IOLs is a particularly challenging procedure due to extensive fibrosis. Circumferential enlargement of the pre-existing capsulorrhexis significantly facilitates the mobilization of the IOL from its fibrous pocket, with the use of minimal forces. Thus, the risk of zonular dehiscence or posterior capsule rupture is minimized.
Efficacy and Safety of Bimatoprost in Patients with Uncontrolled Glaucoma as Alternative to Filtration Surgery
Authors: Vetrugno M. , Sborgia C. , Balestrazzi E. , Bianchi C. , Caporossi A. , Nardi M. , Rapisarda A. , Tassinari G. , Zeppa L.
Published: January 2018

Purpose

To evaluate the efficacy and safety of bimatoprost 0.03% as an alternative to filtration surgery in patients with uncontrolled glaucoma.

Design

Interventional study.

Methods

A total of 83 consecutive patients (83 eyes) awaiting glaucoma surgery were enrolled in eight ophthalmic centers. Reasons for listing were inadequate intraocular pressure (IOP) control despite medical therapy and documented progression of visual field loss. All patients discontinued the previous treatment and were switched to bimatoprost 0.03% QD (one drop at 9 pm). The primary efficacy outcome was a 20% IOP reduction from baseline at each timepoint. IOP was measured at day 7, day 30, day 60, and day 90 of treatment; less than 20% IOP reduction was considered as a failure.

Results

An IOP reduction of at least 20% was achieved in 74 patients (89.1%) after 7 days and in 64 patients (86.5%) after 30 days. Sixty-two patients (74.6%) maintained IOP readings 20% lower than baseline after 60 and 90 days. In these patients, visual field indices improved in 8 eyes (13%), and remained unchanged in 54 eyes (87%). Ocular side effects were conjunctival injection (15.6%), burning sensation (9.6%), foreign body sensation (4.8%), and eyelash growth (2.4%).

Conclusions

This preliminary study shows that bimatoprost 0.03% could represent a useful therapeutic tool that might defer filtration surgery.
Cerebrospinal Fluid Leakage during Dacryocystorhinostomy in a Patient with Meningoencephalocele
Authors: Bagheri A. , Naghibozakerin J. , Yazdani S.
Published: January 2018

Purpose

To report a rare case of cerebrospinal fluid leakage during dacryocystorhinostomy in a patient with Möbius syndrome and meningoencephalocele and to explain our experience in the management of this complication.

Methods

A 9-year-old girl with a history of surgically repaired fronto-ethmoidal meningoencephalocele and bilateral canthopexy was diagnosed with Möbius syndrome and underwent sequential bilateral dacryocystorhinostomy and silicone intubation because of dysgenesis of the lacrimal drainage pathway.

Results

Both dacryocystorhinostomies resulted in cerebrospinal fluid leakage, which spontaneously ceased with conservative management.

Conclusions

Dacryocystorhinostomy surgery in patients with a history of trauma or surgery or congenital defects around the base of the nose or lacrimal system may rarely result in cerebrospinal fluid leakage; thus an ophthalmologist should be familiar with its management.
Comparison of Failed and Successful Dacryocystorhinostomy by Using Computed Tomographic Dacryocystography Findings
Authors: Gökçek A. , Argin M.A. , Altintas A.K.
Published: January 2018

Purpose

To compare the spiral computed tomographic dacryocystography (CT-DCG) findings of failed and successful dacryocystorhinostomies (DCR) and to detect the possible causes of failure before reoperation.

Methods

Eighteen patients with failed and 15 patients with functional DCR were examined by spiral CT-DCG, a combination of contrast dacryocystography and spiral computed tomography. Radiologists, who were blinded to the clinical status of the patients, measured the diameter of the osteotomy window, evaluated its position relative to the lacrimal sac, and documented any abnormal findings around the osteotomy, which may contribute to the failure of DCR.

Results

Location of the osteotomy window was inappropriate in 83% (15/18) of unsuccessful cases and in 7% (1/15) of successful cases and the difference was statistically significant (p<0.01). Presence of the ethmoid air cells medial to the ostium was detected to have a significantly higher frequency in the unsuccessful DCR group (78%, 14/18) than in the successful group (20%, 3/15) (p<0.01). The antero-posterior diameter of bony ostium was less than 15 mm in 94% (17/18) of failed DCR cases, but in only 60% (9/15) of successful DCR cases, and the difference was statistically significant (p<0.05). Some additional findings that may contribute to the failure were noted in failed cases. There were ethmoid sinusitis in three, concha bullosa in two, nasal polyposis in two, mass in medial canthus in one, and extensive granulation tissue around the rhinostomy in one of the failed cases.

Conclusions

CT-DCG is a valuable imaging tool to evaluate DCR failures before reoperation. In this series, CT-DCG showed that small size and inappropriate position of osteotomy, and also extension of ethmoid air cells medial to the lacrimal sac, were frequently seen causative factors of DCR failure.
Comparison of the Effectiveness of Mitomycin-C and Viscoat on Delayed Adjustable Strabismus Surgery in Rabbits
Authors: Cengiz Y. , Altintas Ö. , Manav Ay G. , Çaglar Y.
Published: January 2018

Purpose

To determine a way to prevent the formation of adhesions and delay the time of suture adjustment in the course of adjustable strabismus surgery, an animal study was performed to assess and compare the effects of mitomycin C (Mit-C) and viscoelastic material Viscoat (sodium hyaluronate 3% and chondroitin sulphate 4%, Alcon, Fort Worth, TX).

Methods

Right eyes of 47 rabbits were divided into three groups. After recession of the superior rectus muscle (SRM), Mit-C was administered beneath and over the SRM in Group M (16 eyes), Viscoat was administered beneath and over SRM in Group V (16 eyes), and ringer lactate was administered in Group C (15 eyes). SRM then recessed 5 mm with adjustable strabismus surgery technique. Animals in each group were subdivided into 1 and 2, where 1 = adjustment 1 week postoperatively and 2 = adjustment 3 weeks postoperatively. Delayed adjustment was performed in M1 group (6 eyes), V1 group (6 eyes), and C1 group (7 eyes) after 1 week; in M2 group (6 eyes), V2 group (6 eyes), and C2 group (6 eyes) after 3 weeks. Histopathologic examinations were performed for the remaining 10 eyes without suture adjustment at the end of first and third weeks after adjustable strabismus surgery. The possible length and the necessary force to adjust and the degree of adhesions were recorded.

Results

When length and strength of the adjustment, adhesions between muscle and sclera, and adhesions between muscle and conjunctiva were taken into consideration, there was no statistically significant difference among M, V, and C groups at postoperative weeks 1 and 3. The force needed for adjustment in M1 group was statistically lower than M2 group.

Conclusions

The intraoperative use of Mit-C (0.4 mg/mL) may decrease adhesion formation in the early postoperative period, especially in the first week. The intraoperative use of Viscoat was not effective in reducing postoperative adhesions and delaying adjustment.
Changes in Intraocular Pressure and Corneal and Retinal Nerve Fiber Layer Thicknesses in Hypothyroidism
Authors: Bahçeci U.A. , Özdek Ş. , Pehlivanli Z. , Yetkin I. , Önol M.
Published: January 2018

Purpose

To evaluate the changes in intraocular pressure (IOP), corneal thickness (CT), and retinal nerve fiber layer thickness (RNFLT) in patients with hypothyroidism before and after treatment.

Methods

A complete ophthalmic examination including visual acuity, IOP, anterior segment, and fundus examination together with CT and RNFLT measurements were performed for each patient with newly diagnosed hypothyroidism, at the initial diagnosis and the third and ninth months of the L-thyroxine treatment. Wilcoxon signed rank test and Spearman's correlation test were used for statistical evaluation of the results.

Results

A total of 56 eyes of 28 patients were included in the study. The mean IOP and CT values were found to decrease with medical treatment (p=0.000). There was no significant change in any of the RNFLT parameters measured with scanning laser Polarimeter after L-thyroxine treatment (Wilcoxon, p>0.05). The change in IOP levels was not correlated with the change in thyroid hormone levels (Spearman's correlation test, p>0.05). The mean increase in serum free T3 and serum free T4 levels and the mean decrease in serum TSH levels at the ninth month of the therapy were found to be correlated with the decrease in CT in the left eyes (Spearman's correlation test, R>0.4 and p<0.05).

Conclusions

Hypothyroidism seems to cause a reversible increase in CT and IOP. IOP changes may be secondary to CT changes. RNFLT parameters measured with scanning laser Polarimeter do not seem to be affected by hypothyroidism. When the CT is taken into account and the IOPs corrected for CT, the prevalence of glaucoma in hypothyroidism may not be as high as previously reported. This issue should be taken into account while assessing glaucoma in patients with hypothyroidism.