bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Phenotype of an Italian Family with a New Mutation in the PRPF8 Gene
Authors: Testa F , Ziviello C. , Rinaldi M. , Rossi S. , Di Iorio V. , Interlandi E. , Ciccodicola A. , Banfi S. , Simonelli F.
Published: January 2018

Purpose

To report the clinical and functional characteristics of an autosomal dominant retinitis pigmentosa (ADRP) family with a novel point mutation (P2301S) in the PRPF8 gene.

Methods

PRPF8 gene analysis and complete ophthalmologic examination in an ADRP family.

Results

Clinical examination revealed the typical RP phenotype in all family members. Electroretinography showed preserved ERG photopic responses. Genetic analysis showed that the P2301S missense mutation segregated with the disease in all subjects.

Conclusions

Unlike previously reported families, the PRPF8 gene mutation in our family is associated with a mild phenotype in which cone function is partially preserved.
Verteporfin Therapy and Triamcinolone Acetonide: Convergent Modes of Action for Treatment of Neovascular Age-Related Macular Degeneration
Authors: Augustin A.J. , Schmidt-Erfurth U.
Published: January 2018

Purpose

Choroidal neovascularization associated with age-related macular degeneration is the primary cause of blindness in the elderly in developed countries, due to a number of pathogenic effects, including angiogenesis, cell-mediated inflammation, leukocyte adhesion and extravasation, and matrix remodeling.

Methods

By producing photochemical effects at the site of target tissue (lesion), photodynamic therapy (PDT) can induce vascular damage and blood flow stasis, leading to occlusion of vascularization and lesion leakage.

Results

PDT with verteporfin (Visudyne, Novartis) has been shown to be safe and effective in reducing the risk of vision loss in patients with classic containing subfoveal CNV and occult with no classic CNV. However, in predominantly occult CNV, the treatment may be most effective in smaller lesions, and less in larger lesions. Most important, visual acuity rarely is improved.

Conclusions

Pilot studies and large case series suggest that a combination of PDT and intravitreal triamcinolone acetonide has the potential to improve visual outcomes and reduce the need for additional treatments. Randomized, prospective clinical trials are underway to confirm the efficacy and safety of this novel treatment modality.
Secondary Management and Outcome of Massive Suprachoroidal Hemorrhage
Authors: Feretis E. , Mourtzoukos S. , Mangouritsas G. , Kabanarou S.A. , Inoba K. , Xirou T.
Published: January 2018

Purpose

To present the results of secondary surgical treatment of five patients with massive suprachoroidal hemorrhage (MSCH), which occurred intraoperatively, postoperatively, or following ocular trauma.

Methods

Five patients presenting with MSCH were included in this study during or after phacoemulsification surgery (1 patient), glaucoma surgery (1 patient), combined glaucoma and phacoemulsification surgery (2 patients), and after traumatic sclera rupture (1 patient). Diagnosis was confirmed by ophthalmoscopy and B-scan ultrasonography. Pre-existing risk factors and distance visual acuity were documented. All cases received medical therapy and underwent secondary surgical intervention with radial sclerotomies combined with vitrectomy, use of perfluorocarbon, and silicone oil. Postoperative assessment included visual acuity measurement, ocular examination, and ultrasonography.

Results

In all cases, anatomic restoration of ocular structures was achieved. Distance visual acuity improved in all cases (preoperative Snellen visual acuity ranged from light perception to hand motions; postoperative Snellen visual acuity ranged from 0.05 to 0.3). The mean follow-up period was 17 months.

Conclusions

In general, despite the advanced surgical techniques, the prognosis of MSCH remains guarded and the visual outcome poor. However, secondary surgical treatment with combined radial sclerotomies and vitrectomy should be considered in order to minimize the damaging effect and maximize the anatomic and functional restoration.
Ocular Involvement in Anti-Epiligrin Cicatricial Pemphigoid
Authors: Nischler C. , Sadler E. , Lazarova Z. , Stoiber J. , Ruckhofer J. , Pohla-Gubo G. , Emberger M. , Bauer J.W. , Grabner G. , Hintner H.
Published: January 2018

Purpose

To report an anti-epiligrin cicatricial pemphigoid (AECP) patient with severe ocular involvement and to provide a practical approach to distinguishing AECP patients from those with other subepidermal blistering diseases.

Methods

Techniques included direct and indirect immunofluorescence microscopy, Western blot and immunoprecipitation studies, as well as interdisciplinary examinations of mucous membranes and skin.

Results

This study describes a patient with clinical features of cicatricial pemphigoid, circulating anti-basement membrane zone IgG antibodies, and subepidermal blisters. Histopathology and immunofluorescence analysis suggested the diagnosis of a cicatricial pemphigoid-like type of epidermolysis bullosa acquisita. However, Western blot and immunoprecipitation studies demonstrated that the patient's serum contained autoantibodies against laminin 5 α3 subunit, leading to the diagnosis of an AECP.

Conclusions

Since patients with AECP have an increased relative risk for malignant tumors, it is important to distinguish this entity within the spectrum of cicatricial pemphigoid patients by additional studies such as Western blot or immunoprecipitation.
Delayed Treatment of Choroidal Melanoma Due to Pregnancy
Authors: Skarmoutsos F , Durnian J.M. , Damato B.E.
Published: January 2018

Purpose

The authors report a 27-year-old woman who presented with a large, choroidal melanoma when she was 28 weeks pregnant. Following detailed discussion with the patient, the decision was made to postpone any surgical treatment until after the birth of her child.

Methods

Case report.

Results

The patient had successful transscleral local resection of the tumor with 6/12 vision 6 months later. Cytogenetic studies showed a low risk of subsequent metastases.

Conclusions

This case illustrates that deferring the treatment of a choroidal melanoma presenting during pregnancy can be a reasonable treatment plan, if the patient is highly motivated to keep the eye.
Optical Coherence Tomography and Focal Electroretinogram Evaluation of Cystoid Macular Edema Secondary to Retinitis Pigmentosa Treated with Intravitreal Triamcinolone: Case Report
Authors: Minnella A.M. , Falsini B. , Bamonte G. , Montrone L. , Petroni S. , Zinzanella G. , Balestrazzi E.
Published: January 2018

Purpose

To assess macular structure and function by optical coherence tomography (OCT) and focal electroretinogram (FERG) before and after intravitreal triamcinolone acetonide (IVTA) administration for cystoid macular edema (CME) in a patient with retinitis pigmentosa (RP).

Methods

A 33-year-old man with RP and refractory bilateral macular edema was treated with IVTA in his left eye and evaluated with visual acuity, OCT, and FERG for 6 months.

Results

Compared to the fellow eye, after IVTA mean retinal thickness significantly decreased, while FERG amplitude and phase did not show significant changes at the end of follow-up. Visual acuity showed a significant tendency to improve.

Conclusions

In this case report, IVTA improved macular anatomy and visual acuity; this result, however, was not associated with a similar electrophysiologic response.
Immunohistochemical Findings in Epiretinal Membrane after Long-Term Silicone Oil Tamponade: Case report
Authors: Carpineto P. , Angelucci D. , Nubile M. , Colasante A. , Di Antonio L. , Ciancaglini M. , Mastropasqua L.
Published: January 2018

Purpose

To report pre- and post-operative macular optical coherence tomography (OCT) and immunohistochemical findings in a case of long-lasting silicone oil tamponade followed by silicone oil removal and epimacular membrane peeling.

Methods

A 69-year-old man with long-standing silicone oil tamponade and an epiretinal membrane at the posterior pole in his right eye (RE) underwent silicone oil/BSS exchange with epiretinal membrane peeling. Preoperatively RE best-corrected visual acuity was 20/200 and macular OCT examination revealed a small increase in foveal thickness (250 μm) with the appearance of a linear hyper-reflective signal at the foveal vitreoretinal interface and a thicker (440 μm) hyperreflective finding causing posterior shadowing at the vitreoretinal interface inferiorly to the fovea. Histopathologic and immunohistochemical study of the specimen including the epiretinal membrane was performed.

Results

Light microscopy revealed extensive rounded empty spaces interpreted as silicone oil bubbles in the preretinal membrane. Macrophages marker (CD68) positive staining cells were found surrounding the empty spaces within the preretinal membrane and several empty spaces were observed intracellularly within macrophage cytoplasm. Thirty days after surgery best-corrected visual acuity was 20/60 and OCT examination showed an evident decrease in foveal thickness (220 μm) with the disappearance of any hyper-reflective signal at the vitreoretinal interface referable to an epiretinal membrane.

Conclusions

The immunohistochemical study showed both silicone oil droplets and macrophagic cells embedded in the epiretinal membrane. Postoperative OCT demonstrated retinal recovery after silicone oil removal and epiretinal membrane peeling, thus justifying an unexpected visual acuity recovery despite the very long term tamponade.
Primary Localized Orbital Amyloidosis: A Case Report
Authors: Di Bari R. , Guerriero S. , Giancipoli G. , Cantatore A. , Sborgia G. , Piscitelli D.
Published: January 2018

Purpose

Amyloidosis refers to a heterogeneous group of disorders associated with deposition of chemically distinct fibril proteins. Isolated orbital amyloidosis is a rare condition and requires systemic examination. The authors report a case of amyloid deposit in the orbit whose systemic investigation has been negative.

Methods

A 64-year-old woman presented to the eye clinic with left-sided orbital mass, mild exophthalmos with downward ocular displacement, and ptosis. The patient presented also visual acuity loss and ocular hypertension. No systemic involvement was noted by systemic workup and it confirmed the primary orbital amyloidosis.

Results

The patient was subject to full clinical examination, laboratory examinations, orbital echography, magnetic resonance imaging and total body computed tomography scans, rectal mucosa, and temporal artery biopsies. It was necessary to exclude systemic amyloidosis. The presence of amyloid deposits was confirmed by biopsy of orbital mass. The chemical nature of deposit was characterized using light microscopy, immunohistochemistry, and electron microscopy.

Conclusions

Orbital amyloidosis is a very rare disease. It should be considered in the diagnosis of patients with ptosis and exophthalmos. The treatment usually consists of surgical removal of the amyloid mass and follow-up for a likely local recurrence. In our case, mass excision determined the decrease of exophthalmos and intraocular pressure.
The Projected Increase in Glaucoma Due to the Aging Population in Austria from 2001 to 2031: Results Based on Data of the Salzburg-Moorfields Collaborative Glaucoma Study
Authors: Hitzl W. , Bunce C. , Reitsamer H.A. , Grabner G. , Hornykewycz K.
Published: January 2018

Purpose

The aim of this study is to present the projected increase in definite primary open angle glaucoma (POAG) and related diseases in Austria from 2001 to 2031.

Methods

The present work is based on two data sources: population projections in Austria and detection rates of the Salzburg-Moorfields Collaborative Glaucoma Study for Austrians in the age groups 40–54 years, 55–69 years, and 70 years and above. The estimates of this glaucoma screening program are based on a total of 3419 subjects. Sensitivity analyses were applied to test the effects of higher and lower sets of prevalence assumptions on the extent of the probable projections.

Results

The number of Austrians with definite POAG, early POAG, POAG suspects, and ocular hypertension (OHT) is expected to increase until 2031 by 0.5%, 43.1%, and 65.6% in the three age groups specified above, respectively. The overall number of Austrians with POAG at the age of 40 or older is estimated to increase from 67,600 in 2001 to 96,400 in 2031. This corresponds to an increase of 42% from 2001 to 2031 (lower scenario: 37%, upper scenario: 47%). Similar increases are expected for individuals with early POAG, POAG suspects, and OHT.

Conclusions

These projections provide an objective basis to estimate the resources that may be needed by health authorities and care providers such as ophthalmologists in the future and should help to design glaucoma blindness prevention programs or screening studies in Austria. The predicted continuous increase of Europe's older population will prove to become a challenge for public health professionals not only for diagnosis and monitoring, but also for the treatment of glaucoma. (Eur J Ophthalmol 2007; 17: 45–52)
Macular Automatic Fundus Perimetry Threshold versus Standard Perimetry Threshold
Authors: Midena E. , Radin P.P. , Convento E. , Cavarzeran F.
Published: January 2018

Purpose

To evaluate if retinal sensitivity threshold obtained with an automatic fundus perimeter may be compared with a standard perimeter retinal threshold.

Methods

Automatic full-threshold fundus perimetry (microperimetry) of the macular area (10° grid, 37 stimulated points) was quantified with a new automatic fundus perimeter (MP1 microperimeter) in nine normal subjects (18 eyes). Retinal threshold was also quantified using an identical grid projected with a standard Octopus 101 perimeter.

Results

Mean threshold registered by MP1 microperimeter was 19.7±0.8 dB (range 16–20 dB; 4.38±0.96 asb, range 4–10 asb) versus 33.1±1.7 dB (range 27–38 dB; 0.53±0.22 asb, range 0.16–2 asb) obtained with Octopus perimeter. Mean SD of intraindividual variation was 0.74 dB in MP1 and 1.51 dB in Octopus. No statistically significant differences were documented between right and left eye with both instruments (p=0.64). No reliable mathematical relationship between retinal thresholds could be obtained with the two perimeters.

Conclusions

Fundus perimetry is a precise, functional fundus-related technique which allows threshold determination at selected retinal points even if fixation is unstable and visual acuity is low. This is beyond the possibility of any static standard perimetry. Normal threshold values obtained with MP1 automatic microperimeter cannot be currently compared with those obtained with standard Octopus perimeter. (Eur J Ophthalmol 2007; 17: 63–8)
The Nature and Frequency of Neovascular Age-Related Macular Degeneration
Authors: Iranmanesh R. , Eandi C.M. , Peiretti E. , Klais C.M. , Garuti S. , Goldberg D.E. , Slakter J.S. , Yannuzzi L.A.
Published: January 2018

Purpose

This study was designed to evaluate the frequency and nature of neovascularization in age-related macular degeneration (ARMD) utilizing the combination of digital imaging techniques, fluorescein angiography (FA), indocyanine green (ICG) angiography, and optical coherence tomography (OCT).

Methods

A complete clinical examination was performed on 100 eyes of 93 consecutive newly diagnosed patients with neovascular ARMD. Digital fluorescein angiography, ICG angiography, and OCT were also used in evaluating those patients. Comparison of the imaging techniques to determine their value in studying the nature of the lesions.

Results

On the basis of existing fluorescein standards, 15 eyes were diagnosed with classic choroidal neovascularization (CNV), 15 with minimally classic CNV, and 70 with occult CNV. ICG angiography was superior for detecting the active vascular component in polypoidal CNV (16 eyes) and retinal angiomatous proliferation (14 eyes). OCT was more sensitive than FA for determining the presence of cystoid macular edema evident in the vast majority of eyes with retinal angiomatous proliferation (RAP).

Conclusions

These results suggest that FA, ICG angiography, and OCT, when used in combination, will assist clinicians in best determining the precise nature of the neovascular process in ARMD. (Eur J Ophthalmol 2007; 17: 75–83)
Clinical Biomicroscopy versus Fluorescein Angiography: Effectiveness and Sensitivity in Detecting Diabetic Retinopathy
Authors: Khalaf S.S. , Al-bdour M.D. , Al-till M.I.
Published: January 2018

Purpose

To compare diagnostic effectiveness and sensitivity of the two methods of screening for diabetic retinopathy.

Methods

Prospective analytic study comparing diabetic retinopathy grading obtained from clinical slit lamp biomicroscopy and fundus fluorescein angiography (FFA). A total of 189 consecutive patients were examined in the ophthalmology department at Jordan University Hospital.

Results

A total of 376 eyes were reviewed by consultant ophthalmologist for diabetic retinopathy grading on FFA. The sensitivity of ophthalmoscopy in diagnosing diabetic retinopathy grading was 91.2%, with a specificity of 97.9%. The degree of agreement kappa was 0.87.

Conclusions

Slit-lamp biomicroscopy is highly sensitive for screening diabetic retinopathy grading in diabetic patients and ophthalmologists do not need to confirm a suspected clinical diagnosis of proliferative diabetic retinopathy using FFA as ophthalmoscopy proved to be comparable to angiography. (Eur J Ophthalmol 2007; 17: 84–8)
Determinants of the Progress of Myopia among Omani School Children: A Historical Cohort Study
Authors: Khandekar R. , Kurup P. , Mohammed A.J.
Published: January 2018

Purpose

This study was conducted in 2002–2003 at selected schools of eight health regions of Oman. The authors present risk factors and predictors of progression of myopia between the 7th and 10th grades.

Methods

This was a historical cohort study. A total of 1304 students in 10th grade, both with and without progression of myopia, were examined by the refractionists. Vision, refraction, and physical measurements of each student were recorded. The health records of all students were reviewed to note the same parameters measured when they were in 7th grade. The odds of progression in height, progression in weight, protein energy malnutrition status, sex, age, history of refractive error in parents and sibling, evidence of trachoma, and allergic conjunctivitis were calculated to associate them to the progression of myopia.

Results

Mean progression of myopia was 0.37 D per year (SD = 0.27D). The mean progression of myopia among students with history of myopia in 7th grade was 0.21 D more than that of students not having myopia in 7th grade (95% CI 0.12–0.29). Multivariate regression analysis suggested that weight of student in the 7th grade (t=-2.2, p=0.031), positive history of myopia in one of the siblings (t=2.44, p=0.015), and myopia in the 7th grade (t=4.56, p<0.001) were associated with the progression of myopia.

Conclusions

Family history of myopia and myopia at younger age were predictors for progressive myopia in teenaged Omani children. However, the role of body mass index at a younger age to predict progressive myopia was not conclusive. (Eur J Ophthalmol 2007; 17: 110–6)
A Successful Alternative: Repair of a Penetrating Limbal Wound by Lamellar Keratoplasty
Authors: Van der meulen I.J.E. , Maillette de buy wenniger-prick L.J.J.M. , Lapid-gortzak R. , Nieuwendaal C.P.
Published: January 2018

Purpose

To report repair of a penetrating limbal wound by lamellar keratoplasty 1 year post-traumatically.

Methods

Interventional case report.

Results

A 5-year-old boy had a self-inflicted injury leading to a limbal penetrating wound. The wound closed spontaneously by prolapsed subconjunctival uveal tissue and no intervention was planned. One year later surgical closure of the defect was necessary, as the amount of prolapsed tissue had increased. After excising the prolapsed tissue the wound was closed with a lamellar corneal graft, resulting in a quiet and stable anterior segment and a best-corrected visual acuity of 20/16.

Conclusions

Lamellar keratoplasty can be a useful technique to repair a limbal penetrating wound. Corneal allografts have adequate tensile strength, low immunogenicity, and are easy to obtain. (Eur J Ophthalmol 2007; 17: 117–20)
Nd:YAG Laser Iridotomy in the Management of Secondary Glaucoma Associated with Behçet's Disease
Authors: Elgin U. , Berker N. , Batman A. , Soykan E.
Published: January 2018

Purpose

To report the outcome of Nd:YAG laser iridotomy in the management of secondary glaucoma associated with Behçet's disease (BD).

Methods

In this prospective study, Nd:YAG laser iridotomy was performed on eyes with secondary angle-closure and pupillary block glaucoma associated with BD. The pretreatment and post-treatment intraocular pressures (IOP) and the number of antiglaucoma medications were compared by Mann-Whitney U test.

Results

The study consisted of 16 eyes of 11 patients (2 female, 9 male, mean age 39.2±8.9 years). Post-treatment follow-up ranged from 6 to 36 months (mean 13.8±8.9). The mean IOP was 21.6±2.5 mmHg on 2.5±0.6 medications before iridotomy. IOP reduced to 17.7±2.5 mmHg on 1±0.6 medications at the first month and 17.1±3.2 mmHg on 1.7±0.9 medications at the sixth month of treatment. The differences between IOP and number of antiglaucoma medications at baseline and at the sixth month of the treatment was statistically significant (p<0.00001). For four eyes trabeculectomy with mitomycin C and for one eye Ahmed valve implantation were performed in the follow-up period.

Conclusions

Nd:YAG laser iridotomy can provide reduction of IOP and the number of antiglaucoma medications in selected cases with secondary glaucoma associated with Behçet's disease. (Eur J Ophthalmol 2007; 17: 191–5)
Retinal Imaging by Spectral Optical Coherence Tomography
Authors: Kałużny J.J. , Szkulmowska A. , Bajraszewski T. , Szkulmowski M. , Kałużny B.J. , Gorczyńska I. , Targowski P. , Wojtkowski M.
Published: January 2018

Purpose

To demonstrate applicability of high speed spectral optical coherence tomography (SOCT) method for imaging retinal pathologies in clinical conditions.

Methods

SOCT was performed in 67 eyes with different macular diseases. Examinations were carried out with the prototype SOCT instrument constructed in the Institute of Physics, Nicolaus Copernicus University, Toruń, Poland. A broadband superluminescent diode was used as a light source.

Results

The disturbances of retinal layer structure concerning mainly outer segments of photoreceptors were observed in case of central serous chorioretinopathy and choroidal neovascularization in age-related macular degeneration. Large drusen were often related to significant changes of outer nuclear layer thickness and reflectivity.

Conclusions

SOCT detects small disturbances of the retinal structure and helps to precisely determine layers involved in different pathologies. (Eur J Ophthalmol 2007; 17: 238–45)
A New Method of Treating Macular Holes
Authors: Alpatov S. , Shchuko A. , Malyshev V.
Published: January 2018

Purpose

To evaluate the effect of pars plana vitrectomy (PPV) combined with joining of the hole edges on the closure of full-thickness macular holes.

Methods

In a prospective consecutive clinical trial, standard PPV with internal limiting membrane (ILM) maculorhexis was performed in 25 eyes from 25 patients with stage 3 or 4 idiopathic macular holes (Group A). The retina was massaged gently around the hole from the periphery to the center in order to approximate the edges as closely as possible. The edges of the macular hole were then joined with forceps and gently pressed together. At the end of surgery, air was used for intravitreal tamponade. Patients were required to remain in a face-down position for 1 day postoperatively. For the comparison, a retrospective analysis of outcomes of surgical treatment of 27 eyes of 27 patients with stage 3 to 4 idiopathic macular hole (Group B), whose surgery included standard three-port PPV, followed with ILM peeling, was performed. The closed macular holes were categorized into two patterns based on optical coherence tomography: flat/closed and flat/open.

Results

The overall closure rate was 92±5.4% over a minimum follow-up period of 6 months in Group A, and 86±6.2% in Group B. Best-corrected visual acuity improved from 0.1±0.014 (ranged from 0.02 to 0.5) before surgery to 0.29±0.03 (ranged from 0.2 to 0.7) after surgery in Group A, and from 0.1±0.05 (ranged from 0.05 to 0.4) before surgery to 0.22±0.04 (ranged from 0.05 to 0.4) after surgery in Group B. No significant difference was found in absolute light sensitivity of macula, intraocular pressure, or lens opacification. A common postoperative complication in Group A was retinal pigment epitheliopathy, which developed in 18 cases (72%).

Conclusions

Mechanical joining and compression of the retinal edges during surgery for stage 3 or 4 idiopathic macular holes appears to yield a promising anatomic and functional result. (Eur J Ophthalmol 2007; 17: 246–51)
Removal of Thelazia Callipaeda from the Subconjunctival Space
Authors: Yagi T. , Sasoh M. , Kawano T. , Ito K. , Uji Y. , Ando K.
Published: January 2018

Purpose

To report the finding of Thelazia callipaeda within the human subconjunctival space.

Methods

An 81-year-old man with a history of traumatic conjunctival laceration that occurred 2 years previously had white worms in the subconjunctival space of his right eye.

Results

Five worms were removed from the subconjunctival space via a local peritomy, since there was no conjunctival laceration noted during the examination. These worms were identified as T callipaeda.

Conclusions

T callipaeda cannot dig holes in the ocular wall due to the lack of hooks or sharp spines within the mouth. Therefore, the authors speculate that these worms entered the subconjunctival space through a conjunctival laceration that had occurred 2 years previously. (Eur J Ophthalmol 2007; 17: 266–8)
Optical Coherence Tomography Study of Vitreoretinal Interface in Full Thickness Macular Hole Associated with Optic Disk Pit Maculopathy
Authors: Theodossiadis P.G. , Grigoropoulos V.G. , Emfietzoglou J. , Nikolaidis P. , Theodossiadis G.P.
Published: January 2018

Purpose

To evaluate by optical coherence tomography (OCT) the vitreous involvement in full thickness macular hole associated with optic disk pit maculopathy.

Methods

Two patients with optic disk pit maculopathy and full thickness macular hole underwent OCT for evaluation of vitreous involvement in the pathogenesis of the disease. Fluorescein angiography and fundus photographs were also performed.

Results

OCT documented the presence of vitreous traction at the edge of the full thickness macular hole in the first case and on the elevated macula in the second case. Partial posterior vitreous detachment was also noticed.

Conclusions

Previously unreported OCT findings such as vitreous traction at the edge of the macular hole and on the elevated macula were found. OCT provided evidence for vitreous participation in full thickness macular hole associated with optic disk pit maculopathy. OCT was also able to show that the full thickness macular hole and optic disk pit maculopathy were probably caused by similar vitreous tractional forces. (Eur J Ophthalmol 2007; 17: 272–6)
Eyeball Muscles’ Diameters versus Volume Estimated by Numerical Image Segmentation
Authors: Majos A. , Grzelak P. , Młynarczyk W. , Stefańczyk L.
Published: January 2018

Purpose.

To determine the clinical usefulness of the numerical segmentation image technique (NSI) in estimating the volume of extraocular muscles and to compare this value to widely used measurements of single diameters of the muscles.

Methods.

Forty-five patients underwent magnetic resonance examinations in 1.5-T scanner. SE T1 sequences in transversal and coronal planes were provided and data were sent to a personal computer, where the degree of exophthalmos, horizontal diameter of medial rectus muscles, and vertical diameter of inferior rectus muscles were determined on the basis of two-dimensional images. The quantity estimation of all eye muscles volumes using NSI application in three-dimensional space was carried out with use of level set segmentation algorithm.

Results.

A strong correlation between the total eye muscle volume and degree of exophthalmos was determined. The usefulness of measuring single diameters for estimating the muscles’ enlargement was confirmed. The difference between a single muscle's volume and its width also was confirmed. Estimates of muscle volume correlate with the degree of exophthalmos more accurately than measurements of single diameters.

Conclusions.

The NSI technique is a clinically useful application, providing objective data calculated individually for each orbit. It allows an objective estimation of the pathologic processes leading to exophthalmos and may be especially helpful in monitoring discrete changes in the muscles volume during treatment.
Is Intracameral Lidocaine Really Effective in Cataract Surgery?
Authors: Välimäki J.O.
Published: January 2018

Purpose.

To evaluate the usefulness of intracameral lidocaine in cataract surgery under topical anesthesia and especially if the patient wanted intravenous sedation preoperatively.

Methods.

In this prospective study 96 patients were randomly assigned to receive 0.5 cc of balanced salt solution (Group 1) or 1% unpreserved lidocaine (Group 2). Patients who wanted sedation received intravenous midazolam hydrochloride. All surgery was done by one surgeon using a clear corneal technique.

Results.

Mean pain scores were 0.73 (of a maximum 3) in Group 1 and 0.54 in Group 2; the difference between groups was not statistically significant. Forty patients in Group 1 (83%) and 44 patients in Group 2 (92%) reported no discomfort or only mild discomfort. The two study groups were comparable in need for intravenous midazolam. Logistic regression analysis showed a significant relationship between pain scores and intravenous sedation (p=0.02) but not with intracameral lidocaine or other tested variables. However, odds ratio for pain increased to 5.1 (95% CI; 1.29–20.41) in participants without intravenous sedation compared to those with sedation.

Conclusions.

The results of the present study suggest that intravenous sedation preoperatively seems to be an important determinant to relieve the sensation of discomfort/pain during small incision cataract surgery, but intracameral lidocaine was shown not to have a clinically useful role.
Anterior Segment Optical Coherence Tomography for Evaluation of Changes in Anterior Chamber Angle and Depth after Intraocular Lens Implantation in Eyes with Glaucoma
Authors: Dawczynski J. , Koenigsdoerffer E. , Augsten R. , Strobel J.
Published: January 2018

Purpose.

To examine anterior chamber depth (ACD) and anterior chamber angle (ACA) in patients with glaucoma after cataract extraction with an anterior optical coherence tomography (OCT) system.

Methods.

A new commercially available 1310 nm infrared light anterior segment OCT system was used for anterior chamber evaluation. Sixty patients (n=20 with primary open angle glaucoma [POAG], n=20 with angle closure glaucoma [ACG], and n=20 with no known glaucoma as control group) with a mean age of 68.8±13.9 years undergoing cataract surgery were enrolled.

Results.

Before cataract surgery, ACD and ACA of the ACG group were significantly lower compared to the POAG and control groups (ACD p<0.005; ACA p<0.005). After cataract extraction, ACD and ACA increased significantly in the ACG group (3.1±0.4 mm vs 1.8±0.2 mm, p<0.005 and 32.3°±7.7° vs 16.0°±4.7°, p<0.005). In the POAG and control groups, ACD and ACA also increased postoperatively, but not as much as in the ACG group. After cataract extraction, IOP decreased significantly in the glaucoma groups (ACG: 15.6±6.1 vs 18.6±5.7 mm Hg, p=0.008; POAG: 16.2±3.4 vs 20.7±8.0 mmHg, p=0.02) and was almost the same in all three groups after surgery (control group after surgery: 15.2±2.8 mmHg).

Conclusions.

Both ACD and ACA increased significantly after cataract extraction and IOL implantation. IOP reduction after surgery was higher in the glaucoma groups compared to the control group.
Extrusion and Infection Incidence in Scleral Buckling Surgery with the use of Silicone Sponge: To Soak or not to Soak? An 11-Year Retrospective Analysis
Authors: Lorenzano D. , Calabrese A. , Fiormonte F.
Published: January 2018

Purpose.

To assess the incidence of extrusion and infections of encircling silicone sponges in scleral buckling surgery for retinal detachment with and without the use of an intraoperative antibiotic soaking procedure.

Methods.

The authors performed a retrospective analysis reviewing the charts of 1127 patients who underwent episcleral buckling surgery operated by the same surgeon in three different institutions during a period of 11 years. The authors reviewed the charts of patients treated with a single episcleral silicone sponge (Labtician®) indentation in three different models. The infection prophylaxis on the operating field was the same in all cases and only since February 1997 was the silicone sponge preoperatively treated with an antibiotic soaking procedure.

Results.

No immediate postoperative infections were reported in the operated eyes. Three eyes had an implant extrusion and in all these cases silicone sponge removal was performed. All three extrusion cases developed when sponge soaking was not adopted.

Conclusions.

The data indicate that the soaking procedure does not decrease extrusion and infection incidence in scleral buckling surgery when both accurate surgical technique and disinfection prophylaxis are performed.
Unilateral Corneal Endothelial Dystrophy and Anterior Keratoconus
Authors: Martone G. , Tommasi C. , Traversi C. , Balestrazzi A. , Berni E. , Nuti E. , Tosi G.M.
Published: January 2018

Purpose.

To describe a case of keratoconus and Fuchs’ corneal endothelial dystrophy in the left eye with no corneal disease in the right eye.

Methods.

A 64-year-old woman presented with visual impairment in her left eye; computer-assisted topographic analysis and specular microscopy were performed in both eyes and left cornea was histopathologically examined.

Results.

Keratoconus was diagnosed by slit-lamp examination, keratometry, and computer-assisted topographic analysis. Corneal endothelial dystrophy was diagnosed on the basis of clinical examination and specular microscopy. Histopathologic examination revealed a stromal degeneration typical of keratoconus and a non-guttae form of endothelial dystrophy.

Conclusions.

This is a rare case of unilateral corneal endothelial dystrophy and keratoconus.
Incidence of Nonarteritic Anterior Ischemic Optic Neuropathy in Adult Chinese: The Beijing Eye Study
Authors: Xu L. , Wang Y. , Jonas J.B.
Published: January 2018

Purpose.

To determine the incidence of optic nerve damage due to nonarteritic anterior ischemic optic neuropathy (NAION) in the adult Chinese population.

Methods.

The Beijing Eye Study, a population-based, longitudinal study which included 4439 subjects (age 40+ years) in 2006, was repeated in 2006. In the follow-up examination, 3169 (71.4%) subjects participated. Optic disc photographs were assessed. Diagnostic criteria for incident NAION were a small optic disc, segmental pallor, and loss of retinal nerve fiber layer and visual field in the follow-up examination, with a normal optic nerve head appearance at baseline.

Results.

New NAION was found in one eye, with an incidence rate of 0.03±0.03% per 5 years (mean ± standard error) (95% confidence interval: −0.03, 0.09), or about 1:16,000 subjects per year.

Conclusions.

Within a 5-year period, new NAION may develop in 1 out of 3200 adult Chinese, or 1:16,000 adult Chinese per year.
Central Corneal Thickness Measurements with Optical Coherence Tomography and Ultrasound Pachymetry in Healthy Subjects and in Patients after Photorefractive Keratectomy
Authors: Schneider Miklos , Borgulya Gabor , Seres Andras , Nagy Zoltan Z. , Nemeth Janos
Published: January 2018

Purpose

To compare central corneal thickness measurements made using two different methods, optical coherence tomography (OCT) and ultrasound pachymetry, applied both in normal eyes and in eyes on which photorefractive keratectomy (PRK) had been performed. A second objective was to assess the intrasession variability of OCT measurements.

Methods

In this prospective study, central corneal thickness was measured in 20 normal subjects (normal group) and in 20 PRK patients using the StratusOCT instrument model 3000 (Carl Zeiss Meditec), and also with an ultrasound pachymeter. Five OCT measurements were performed using the Fast Macular Thickness protocol. Corneal thickness data were obtained with the Scan Profile analysis protocol. The OCT measurement results were compared with the mean value of three ultrasound pachymetry measurements for the same eye.

Results

The pachymetry–OCT correlation coefficients were 0.96 and 0.97 in the normal and PRK groups, respectively (p=0.14). Neither linear regression nor Bland-Altmann analysis revealed any significant systematic measurement error. Intrasession standard deviations in the normal and PRK groups were 4.9 μm and 3.8 μm, respectively.

Conclusions

Noncontact central corneal thickness measurements made using the StratusOCT instrument are accurate and reproducible, both in normal subjects and in post-PRK patients. The instrument system does not need any modifications to correctly detect and measure the center of the cornea.
Comparison of Dose-Related Ocular Side Effects during Systemic Isotretinoin Administration
Authors: Cumurcu Tongabay , Sezer Engin , Kilic Rasit , Bulut Yunus
Published: January 2018

Purpose

To compare the effects of high- (Group 1) and low-dose (Group 2) isotretinoin treatments for acne vulgaris on lacrimal functions and other ocular complications.

Methods

Twenty-six patients receiving high-dose (>0.5 mg/kg per day) systemic isotretinoin treatment and 25 patients treated with low-dose systemic isotretinoin (<0.5 mg/kg per day) underwent complete ophthalmologic assessment of both eyes before treatment, at days 45 and 90 of treatment, and 1 month after the completion of treatment, together with a microbiologic evaluation of conjunctival flora, tear film break-up time (BUT), and anesthetized Schirmer test of the right eye of each patient.

Results

When the results of the anesthetized Schirmer test for Groups 1 and 2 were compared (pretreatment, days 45 and 90 of treatment, and 1 month after treatment), there was no statistically significant difference between the groups (p > 0.05). Although BUT did not differ significantly between the two groups before treatment (p > 0.05), there was a statistically significant decrease in BUT in Group 1 when compared with Group 2 at days 45 and 90 of treatment (p < 0.05). One month after the completion of treatment, there was no difference in BUT between the two groups (p > 0.05). No difference in Staphylococcus aureus colonization was detected between the two groups at days 45 and 90 of treatment (p > 0.05).

Conclusions

During systemic isotretinoin treatment, eye dryness was related to the dose used, at least during the period of treatment. Conversely, the rate of conjunctival S aureus colonization was unrelated to the dose of isotretinoin.
Causes and Treatments of Traumatic Secondary Glaucoma
Authors: Bai Hai-Qing , Yao Lin , Wang DA-BO , Jin Rui , Wang Yun-Xiao
Published: January 2018

Purpose

To study the cause, treatment, and cure of traumatic secondary glaucoma in 103 cases (103 eyes).

Methods

The records of 103 patients (103 eyes) were reviewed. Causes of the high intraocular pressure (IOP) were analyzed according to the time after trauma. Most patients achieved a better visual acuity and ideal IOP after positive medical, neodymium:Yttrium aluminium garnet (Nd:YAG) laser, or surgical treatment. The operations included anterior chamber irrigation, filtering operation combined with mitomycin C, lensectomy, vitrectomy, and combination surgery.

Results

Clinical findings of secondary glaucoma associated with ocular trauma are complex. Causes resulting in high IOP include intraocular bleeding, lens dislocation, phacoanaphylaxis, angle recession, and siderosis. After medical, laser, or surgical treatment, the IOP of most patients could be ideally controlled. After follow-up for half a year, the IOP of 3 cases (2.91%) was below 10 mmHg and 92 (89.32%) cases between 10 and 21 mmHg; only 8 cases (7.77%) still had IOP over 21 mmHg.

Conclusions

In traumatic secondary glaucoma, antiglaucoma medication should be used at the early stage, and surgery should be carried out when medical treatment does not reduce the elevated IOP, or in difficult cases to avoid severe complications. The postoperative IOP of most injured eyes was controlled within the safe range.
Ultrasound Biomicroscopy and Optical Coherence Tomography Imaging of Filtering Blebs after Deep Sclerectomy with New Collagen Implant
Authors: Aptel Florent , Dumas Sophie , Denis Philippe
Published: January 2018

Purpose

To identify the clinical and anatomic characteristics of filtering blebs after glaucoma surgery with a new biodegradable collagen implant, Ologen, using ultrasound biomicroscopy (UBM) and Visante anterior segment optical coherence tomography (OCT).

Methods

The authors conducted a prospective interventional case series in 15 eyes with open-angle glaucoma. The authors performed limbal-based deep sclerectomy with Ologen implantation in the scleral bed. UBM, Visante anterior segment OCT, and a complete ophthalmic examination were performed at each follow-up visit, at 1 day, and 1, 4, and 12 weeks postoperatively.

Results

Intraocular pressure (IOP) was significantly reduced (p<0.001) from a mean preoperative value of 24.2±6.8 mmHg (n=2.82 glaucoma medications) to a mean postoperative value of 8.1±1.2 (n=0), 8.5±1.3 (n=0), 11.7±3.2 (n=0), and 14.2±3.9 mmHg (n=0.33) at 1 day, and 1, 4, and 12 weeks, respectively. Lower IOP correlated with bleb height and low trabeculocorneal membrane thickness (r=0.79, p<0.01, r=0.91, p<0.001) based on UBM examination. Lower IOP correlated with thin bleb wall, large subconjunctival fluid spaces, and low bleb tissue reflectivity (r=0.81, p<0.01, p<0.001, and p<0.001) based on OCT examination. No postoperative complications were reported.

Conclusions

UBM and OCT examinations are useful methods to evaluate outflow mechanisms after glaucoma surgery. Deep sclerectomy with Ologen implantation seems to be an effective and well-tolerated method to reduce IOP.
Intraindividual Comparison of Color Perception and Contrast Sensitivity with and without a Blue Light-Filtering Intraocular Lens
Authors: Eberhard Roman , Roberti Pietro , Prünte Christian
Published: January 2018

Purpose

To investigate color perception and contrast sensitivity with and without additional glare in pseudophakic patients with a conventional intraocular lens (IOL) in one eye and a blue light-filtering IOL in the fellow eye.

Methods

Twenty-three bilaterally pseudophakic patients with a conventional IOL (Acr ySof SA60AT) and a blue light-filtering IOL (AcrySof Natural SN60AT) were tested for intraindividual comparison of visual acuity (ETDRS chart), color perception (Farnsworth-Munsell 100-Hue test), and contrast sensitivity with and without glare (Contrast Sensitivity Pattern Generator). Information about subjective perception was gathered through a questionnaire.

Results

Four patients (17.4%) observed some difference in monocular color perception. Color testing did not show significantly different results for the two IOL types expressed as total error score and segmental error subscores for protan, deutan, and tritan ranges. Regarding contrast sensitivity, 5 patients (21.7%) indicated noticeable difference between the two eyes. Contrast sensitivity testing, however, showed similar curves for the two IOL types with and without additional glare.

Conclusions

Despite some subjective difference in color and contrast perception in a minority of patients, the study did not show significantly different results for the two IOL types.
A Comparison of Retrobulbar Block, Sub-Tenon Block, and Topical Anesthesia during Cataract Surgery
Authors: Ryu Jung-Hee , Kim Minsuk , Bahk Jae-Hyon , Do Sang-Hwan , Cheong Il-Young , Kim Yong-Chul
Published: January 2018

Purpose

This randomized, double-blinded, prospective study was performed to compare the intraoperative hemodynamic variables and the patient-reported outcomes, such as intra- and postoperative analgesia and patient satisfaction, of retrobulbar block, sub-Tenon block, and topical anesthesia during cataract surgery under monitored anesthesia care.

Methods

Eighty-one patients, ASA physical status I–III, undergoing elective cataract surgery under monitored anesthesia care, aged between 43 and 78 years, were randomly assigned to three groups: retrobulbar block (group R), sub-Tenon block (group S), or topical anesthesia (group T). Three minutes after the start of monitored anesthesia care with lidocaine-propofol-remifentanil mixture, an ophthalmologist performed regional anesthesia. Intraoperative hemodynamics, pain score, and patients' satisfaction with the anesthetic experiences were recorded by a study-blinded anesthesiologist.

Results

Mean arterial pressure and heart rate in group R were significantly higher than those in groups S and T during and just after the regional block (p<0.05). Group R required smaller dosage of patient controlled sedation and fewer supplemental bolus doses than groups S and T (p<0.05). On the other hand, group S showed the highest satisfaction scores among the three groups (p<0.05).

Conclusions

Sub-Tenon block seems to be better than retrobulbar block and topical anesthesia in patient satisfaction though adequate analgesia was achieved after retrobulbar block during cataract surgery under monitored anesthesia care.
Bacterial Contamination of Needle Points after Intravitreal Injection
Authors: Nentwich Martin M. , Yactayo-Miranda Yazmin , Weimann Steffen , Fröhlich Stephan , Wolf Armin , Kampik Anselm , De Kaspar Herminia Mino
Published: January 2018

Purpose

Evaluation of the magnitude and pattern of bacterial contamination of needle points with conjunctival bacteria during the intravitreal injection. Analysis of the efficacy of preinjection prophylaxis.

Methods

A total of 550 intravitreal injections were done in 414 patients (n=425 eyes). A total of 289 patients were injected once, while 125 patients received several injections. Before the intravitreal injection in the operation room, the following standard preoperative preparation of the eye–10% povidone iodine scrub on the eyelids, eyelashes and forehead and irrigation of the conjunctival sac with 1% povidone iodine–was carried out. Immediately after the injection, the needle points were rinsed three times in thioglycolate broth, which was cultured at 35°C for 5 days afterwards. As a negative control, 200 sterile unused needle points were treated the same way.

Results

Only 2 out of 550 (0.36%) needle points were contaminated after intravitreal injection. In sensitivity testing, the isolated Staphylococcus epidermidis and Corynebacterium sp did not show multidrug resistance. All 200 unused needle points proved to be sterile after 5 days of cultivation.

Conclusions

Contamination of needle points is minimal after iodine irrigation prophylaxis before intravitreal injection. Therefore, we recommend this prophylaxis technique before intravitreal injections. The low incidence of contaminated needle points, however, shows that there still is a risk of bacteria entering into the eye during injection.