bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare case of Arthrographis kalrae keratomycosis in a non-contact lens wearer
Authors: Chow Rhuen Chiou , Chong Soh Yee , Khaw Keat Ween , Yushaniza Yaacob , Kamalden T.A. 
Published: January 2021

Purpose: Keratomycoses secondary to Arthrographis kalrae are rarely reported. Previous cases involved patients with contact lens wear. Herein we report a rare case of severe fungal keratitis due to Arthrographis kalrae in a non-contact lens wearer.Methods: Case report.Results: A 52-year-old male presented with a left paracentral corneal ulcer with stromal infiltrates following contact with a foreign body while riding a motorbike. Initial treatment with intensive topical antibiotic drops failed. Antifungal therapy with hourly topical amphotericin B 0.15% and fluconazole 0.2%, as well as oral fluconazole was initiated. His ulcer progressed rapidly despite aggressive treatment. This led to a small, peripheral corneal perforation which was treated with corneal gluing and bandage contact lens. He also developed secondary glaucoma. Microbiological cultures of his corneal scrapings revealed Arthrographis kalrae. A single dose of subconjunctival amphotericin B 0.015% o.1mL was then given. At two months after presentation, he eventually underwent therapeutic penetrating keratoplasty (PK) for non-resolving keratomycosis. Following PK, he was maintained on topical amphotericin B 0.15%, fluconazole 0.2% and ciprofloxacin 0.3% four-hourly, together with fusidic acid ointment 2% twice daily. The graft failed three months post-transplant, albeit with no evidence of residual or recurrent infection.Conclusion: Arthrographis kalrae-related keratitis may occur in non-contact lens wearer. Management remains clinically challenging because this organism causes severe, rapidly progressive keratitis.
Salzmann nodular degeneration after photorefractive keratectomy for hyperopia
Authors: Prasher Pawan 
Published: January 2021

Purpose: To report a case of bilateral central Salzmann nodular degeneration (SND) after photorefractive keratectomy (PRK) for hyperopia.Methods: Case report.Results: A 47-year-old male presented with complaints of glare and difficulty with night driving. He had undergone PRK for hyperopia (+3.5+1.5x180 in the right eye and +4.5+1.0x180 in the left eye) in both eyes about 15 years back. The early postoperative period was uneventful; however, he started having these symptoms after two to three months. At presentation, uncorrected visual acuity was 20/100 and best corrected visual acuity was 20/30 with +3.5+1.0x180 in both eyes. Slit-lamp examination showed bilateral 1-1.5 mm diameter, bluish white nodular lesions involving the central corneas. There were also prominent paracentral brown pigment ring deposits consistent with pseudo-Fleischer rings in both eyes. Scheimpflug images showed dense hyper-reflective nodules that were associated with elevated anterior corneal surface and measured 290 μm in the right eye and 230 μm in the left eye, along with presence of significant astigmatism (K1- 45.1D, K2- 47.8D right eye and K1- 45.4D, K2- 49.2D left eye). Central pachymetry was 485 μm in the right eye and 464 μm in the left eye.Conclusions: SND is a rare complication of PRK for hyperopia that can lead to suboptimal visual outcome. PRK should be included in the list of etiologies leading to SND.
Purtscher-like retinopathy in a 56-year-old Thai female with anti-glomerular basement membrane glomerulonephritis
Authors: Prakhunhungsit Supalert , Khotcharrat Rossukon 
Published: January 2021

A 56-year-old Thai female was referred to Naresuan university hospital with anemia and pitting edema both legs. She had underlying diseases of hypertension, hypercholesterolemia and chronic renal failure with anemia. Before her referral, she was treated by an internist at a provincial hospital. With deterioration of creatinine level and anemic symptom, she was advised to see a nephrologist for the diagnosis of causative pathology and treatment. The reevaluation of chronic renal failure was done. The results of laboratory investigation were creatinine level of 2.42 mg/dl, blood urea nitrogen (BUN) 44 mg/dl and the urinalysis found microscopic hematuria. Further evaluations for hematuria ; vaginoscopy, cystoscopy and ultrasonography of genitourinary system, were performed consequently but all investigations were unremarkable. Then, renal biopsy was done with the result of anti-glomerular basement membrane glomerulonephritis. The hemodialysis and total plasma exchange were done several times to reduce the antibody of anti glomerular basement membrane level.During her admission, she complained of sudden blurred vision both eyes after the ninth total plasma exchange. She has no previous ocular problems nor physical trauma. The ocular examination showed visual acuity of counting fingers both eyes. Anterior segment was unremarkable for her age. The posterior segments showed retinal thickening around the posterior poles with clear intervening zones both eyes with some intraretinal hemorrhage which was compatible with Purtscher-like retinopathy by clinical. The pathogenesis of Purtscher-like retinopathy was investigated with negative results. The counseling was done and the treatment of observation was chosen by the patient and her family. Then she was discharged and followed up at out patient unit of ophthalmology department, Naresuan university hospital.

Conclusion: The Purtscher-like retinopathy is a rare ocular disease with variable treatment strategies and outcomes. In complicated case without obvious causes, the pathogenesis of the disease should be investigated which directed to the proper treatment and better visual outcome.
Cryo-compression of sclerotomy sites after transconjunctival sutureless vitrectomy
Authors: Lee Ho Young , Lim Sung Hyup , Yun Il Han , Lee Joo Eun 
Published: January 2021

Purpose: Transconjunctival sutureless vitrectomy(TSV) has become more commonly performed, but the incidence of sclerotomy site leakage is becoming an issue. We have developed a new and easy sclerotomy closure technique using cryotherapy, and named it ‘cryo-compression’.Methods: After the removal of the cannula, sclerotomy sites’ cryotherapy was performed with the setting of one cryospot for each site and ten seconds for each spot. After cryotherapy, firm pressure was maintained for more than 30 seconds. Immediately after compression, when any degree of leakage was detected, a single transconjunctival suture with 8-0 vicryl was placed. Postoperatively, topical steroid and antibiotics eyedrops were administrated.Results: Sixteen patients undergoing 23-gauge vitrectomy with this technique were reviewed retrospectively. The postoperative one- and six-hour intraocular pressures (IOPs) were significantly lower than preoperative IOP, but postoperative one-day and one-week IOPs were not different from preoperative IOP. Incidence of hypotony was 12.5% (N = 2/16 eyes) at only one hour but all eyes recovered. Intraoperative suture at sclerotomy sites was placed in eight of the 48 sclerotomies(16.7%) and suture placement was not required postoperatively. No cases of severe intraocular inflammation or endophthalmitis were indentified.Conclusions: Our short-term results are fairly respectable, so we think that the ‘Cryocompression’ technique is helpful to obtain sclerotomy closure in TSV.
Dry eye researchers and their publications in Asia and Europe
Authors: Leong Yuan Yuh , Tong Louis 
Published: January 2021

Dry eye, a visually disabling disease that has been reported to be a major public health issue in many countries, is known to induce a significant decrease in quality of life. In this report, we aim to compile information on the investigators of dry eye that published most frequently in peer reviewed scientific journals and the publications in Asia and Europe.
Anterior segment optical coherence tomography documentation of Reverse Pupillary Block -A case of Pigment Dispersion Syndrome in a 10 year Old Child
Authors: Maheshwari Devendra , Ramakrishnan Renagappa , Pawar Neelam 
Published: January 2021

We report a 10-year-old boy with unusually dense, bilateral central posterior capsule pigmentation associated with the characteristic clinical features of pigment dispersion syndrome, including Krukenberg’s spindle and dense trabecular pigmentation in both eyes. There was no history of trauma , laser or intraocular surgeries . The presence of posterior or backward bowing of iris suggested a reverse pupillary block mechanism of pigment dispersion syndrome. Nd Yag laser peripheral iridotomy was performed in both eyes to relieve reverse pupillary block. Anterior segment optical coherence tomography (AS-OCT) showed reversal of iris concavity after laser iridotomy.
The performances of eye drop instillation in glaucoma patients
Authors: Manassakorn Anita , Tangseepha Yuvaporn 
Published: January 2021

Aim: To evaluate the performances of the patients’ eye drop instillation and estimate the quantity of eye drop needed per month in glaucoma patients. Design: Cross-sectional, observational and questionnaire study. Methods: 137 glaucoma patients who had visual acuity better than 20/200 and had self-administered eye drops ≥ 6 months were included. All patients were informed to apply artificial tears into their eyes. Performances were directly observed and evaluated according to the following criteria: washing hands before application, applying the drops into lower conjunctival fornix, successful instillation on the first attempt, did not contaminate the tip of the bottle with eye and adnexa, and occluded their nasolacrimal duct or closing of the eyelids after application. We also interviewed about the same tasks they always do at home. Nonparametric test were used for analyses. Results: Median (IQR) age of the study population was 68 years (18 – 89). Median (IQR) duration since diagnosis of glaucoma was 48 (6 – 576) months. During direct observation, only 1 patient (0.7%) was able to accomplish all 5 criteria whereas 9 patients (6.6%) could not accomplish any of the criteria. Twenty-nine patients (21.2%) successfully instilled a drop in the lower fornix without touching the ocular adnexa. The overall performance under direct observation was significantly lower than the interview score (p<0.001). Younger patients (<60 years old) had higher performance under direct observation (p = 0.006) and knew the correct techniques during interview session better than the older patients (p = 0.014). Fifty-eight patients (42.4%) used more than 1 drop for each attempt. Number of eye drops used reported by the patients was significantly lower than what was directly observed (p<0.001).Discussion: Performance of self-administered eye drop was very poor. Age affected the ability of eye drop application. Standard technique should be emphasized to improve the performance of the glaucoma treatment and prevent contamination.
Pattern ERG as a predictor in ocular hypertensive
Authors: Dave Paaraj , Jethani Jitendra 
Published: January 2021

Purpose: To report the repeatability of Pattern Electrotretinogram (PERG) and its findings in ocular hypertension (OHT) and normal eyes.Methods: A cross-sectional study where PERG responses were compared between the study group comprising of 80 eyes of 80 patients with intraocular pressure (IOP)>21 mmHg and the control group with 80 eyes of 80 normal individuals (IOP≤21mmHg). The optic disc and the visual fields were normal with a visual acuity of ≥ 0.8 in both groups. PERG was recorded twice for each individual in the control group by a single operator on 2 consecutive days to assess the repeatability.Results: The mean age in the study and control groups was 50.05±10.03 and 54.8±7.66 years(p=0.44) respectively. The mean IOP was 26.55±3.9 mmHg for the study group as opposed to 14.45±2.9 mmHg for the controls (p<0.001). The central corneal thickness and the cup-disc ratio was similar between the groups (p>.05). The P50-N95 amplitude (p=0.01) and the P50 latency (p<0.001) was statistically significantly different between both the groups. The intra-class correlation coefficient (ICC) showed poor agreement for all parameters except for N35-P50 0.8 to 16 degree check size amplitude ratio (PERG ratio).Conclusion: Increase in P50 latency emerges as a new candidate for early glaucoma indicator in addition to reduction in P50-N95 amplitude. PERG parameters suffer from high test-retest variability. Deterioration in PERG recordings should be interpreted with caution. The variability is lesser for the PERG ratio which maybe more meaningful while monitoring for change over time.
Internal carotid artery velocities in patients with unilateral non-arteritic anterior ischemic optic neuropathy
Authors: Reyes Karen Bulan 
Published: January 2021

Objective: This study aims to evaluate and compare the proximal, medial, and distal segments of internal carotid artery (ICA) peak systolic velocities (PSV) in patients with nonarteritic anterior ischemic optic neuropathy (NA-AION) in one eye against the contralateral side with normal eye findings using doppler ultrasound. Methods: This is a single-center, prospective, case control study of five patients with unilateral NA-AION. The peak systolic velocity (PSV) of the proximal, medial, and distal segments of the ICAs on both sides, one side with NA-AION while the contralateral side had normal eye findings, were compared and analyzed. Results: Four females and one male with a mean age of 59 years (SD = 17 years) were included. PSV of the ICA was measured in three segments: Proximal (PICA), Medial (MICA), and Distal (DICA). Mean PSV of eyes with NA-AION was 143cm/sec (SD= 177cm/sec), 159 cm/sec (SD=189 cm/sec), 98 cm/sec (SD=34cm/sec) for PICA, MICA and DICA respectively. Mean PSV of contralateral side without NA-AION was 95cm/sec (SD= 72cm/sec), 101 cm/sec (SD=53cm/sec), 140cm/sec (SD=60 cm/sec) for PICA, MICA and DICA respectively. There was no statistically significant difference between the two groups along the three segments (T-test PICAp=0.369, MICAp=0.402, DICAp=0.112). Conclusion: Mean PSV was higher in eyes with NA-AION at the proximal and medial segments of the ICA, while it was lower at the distal segments compared to the contralateral non-NA-AION side.
Visual outcome and ocular survival in pediatric ocular trauma
Authors: Rao Lavanya G , Bhandary Sulatha V , Addoor Krishna Rao , Singh Aditi , Nair Suma , Binu V.S. 
Published: January 2021

Purpose: Ocular injuries in children are a major under-recognized cause of ocular morbidity and can be prevented by identifying the etiology and implementing measures to prevent these injuries. This study intends to assess the visual outcome and ocular survival in paediatric ocular trauma.
Design: A descriptive study set in a tertiary care teaching hospital in Southern India.
Methods: A total of 56 children less than 18 years of age with ocular trauma during the period August 2010 to August 2012were studied. Injuries were classified as per modified Ocular Trauma Classification System (OTCS). Final visual outcome was assessed at the end of 1, 3, & 6 months.
Results: Of the 56 children assessed 87.5% were that of boys. About 12% were under-fives and almost 66% were in the age range of 5-14 years. And majority (47.45 %) had sustained trauma in the streets. Closed globe injury predominated (69.49%). At presentation, grade I injury noted in 28 eyes (47.45%), grade II in 1 (1.69%), grade III in 3 (5.08%) , grade IV in 8 (13.55%) , PL negative in 3 (5.08 %) and un-cooperative in 16 cases (27.11 %). At six months, good vision noted in 44 eyes (74.6%), moderate in 5 (8.47%), poor vision in 1 (1.69 %), PL negative in 4 (6.77%), un-cooperative 4 cases (6.77%). 4 eyes had phthisis (6.77%) and 1 eye (1.69%) was eviscerated.
Conclusions: Ocular trauma in childhood was more common in the male child, mostly due to road traffic accidents. Ocular trauma being a significant cause of visual loss in childhood, awareness campaigns are necessary.
Clinical and histopathological correlation: A study on 334 eyes with retinoblastoma from Vietnam
Authors: Nguyen Ha Ngan , Pham Van Trong , Hoang Tuan Anh , Pham Van Hong , Nguyen Chung Ngoc , Nguyen Tinh Xuan , Vu Thuy Thi Bich , Conway R.Max 
Published: January 2021

Purpose: To elucidate the clinical features which predict high-risk histopathological factors for subsequent metastatic disease as well as to report the incidence of these high-risk histopathological factors in a cohort of Asian patients with retinoblastoma.
Design: A retrospective and non-randomized sequential cases series.
Methods: A retrospective study was done on 334 eyes with retinoblastoma at Vietnam National Institute of Ophthalmology during a 10 year period (January 2004 – December 2013). All pathology specimens and medical records were reviewed and assessed for invasion and clinical signs.
Results: Among 334 eyes, 225 (67.4%) had high-risk retinoblastoma and 109 (22.6%) had non-high-risk features on histopathology. The high-risk histopathological features included anterior chamber seeding (48.2%), iris infiltration (14.7%), ciliary body involvement (14.1%), massive choroidal invasion (29.9 %), post-laminar optic nerve invasion (21.2%), invasion of optic nerve transection (9.6 %), combined choroidal and optic nerve invasion (9.6 %), scleral invasion (3.3%), and extra-scleral infiltration (11.4%). The significant clinical features in high-risk group versus non-high-risk group included hyphema (19.6% vs 3.7%, p < 0.001), pseudohypopyon (19.1% vs 6.4%, p = 0.001), iris neovascularization (25.3% vs 5.5%, p < 0.001), vitreous seeding (72.4% vs 37.6%, p < 0.001), staphyloma (24% vs 4.6%, p < 0.001) and scleritis (20% vs 3.7%, p < 0.001).
Conclusions: Clinical signs including hyphema, pseudohypopyon, iris neovascularization, vitreous seeding, staphyloma, and scleritis were significantly associated with high-risk features on histopathology. Globe preserving methods should be used with caution in patients with these signs.
Changes in corneal properties and its effect on intraocular pressure measurement following phacoemulsification with intraocular lens implantation with or without trabeculectomy
Authors: Dey Ashim , David RathiniLilian , Asokan Rashima , George Ronnie 
Published: January 2021

Purpose: To evaluate the changes incorneal biomechanical properties and their effect on pre and postoperative differences in IOP measurement by each tonometer
Design: Observational study.
Methods: The study was done in subjects who underwent phacoemulsification with intraocular lens (IOL) implantation (phaco-IOL) and combined phacoemulsification with IOL implantation and trabeculectomy (phaco-trab). IOP was measured by a single trained examiner using rebound tonometer (RBT), Ocular Response Analyzer (ORA), Goldmann applanation tonometer (GAT), dynamic contour tonometer (DCT), and Tono-Pen. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured using ORA, central corneal thickness (CCT) using ultrasonic pachymeter, and corneal curvature (CR) with manual keratometry. All measurements were done one week prior to surgery and after four weeks and six weeks of the two surgeries, respectively. Only the operated eye was included for analysis.
Results: Twenty-nine eyes of 29 normal subjects who underwent phaco-IOL and 23 eyes of 23 glaucoma subjects who underwent phaco-trab were studied. Increase in CCT [10.2 ± 14.86 microns, p = 0.001], decrease in CH [0.82 ± 1.38 mmHg, p = 0.003] and CRF [0.97 ± 1.0 mmHg, p < 0.001] were found post-phaco-IOL, whereas post-phaco-trab decrease in CCT [16.61 ± 15.22 microns, p < 0.001], CRF [2.28 ± 1.93 mmHg, p < 0.001] with increase in CH [0.95 ± 1.89 mmHg, p = 0.03] were noted. Multiple linear regression analysis showed significant associations for change in CH and CRF with change in IOP and not with CCT and CR postoperatively.
Conclusion: Alterations in CH and CRF were associated with changes in IOP measured postoperatively by different tonometers. CH and CRF changes contribute to postoperative changes in measured IOP.
Causes of ocular discomfort in patients of computer vision syndrome coming to a tertiary care centre
Authors: Shahid Erum , Fasih Uzma , Jaffery Asad Raza , Shaikh Arshad 
Published: January 2021

Aim: To document causes of ocular discomfort in patients with computer vision syndrome.
Materials and methods: This study included 150 patients with computer vision syndrome who presented in the Eye Out Patient Department of Abbassi Shaheed Hospital. It was a descriptive cross-sectional study with consecutive sampling technique starting from January 2016 until July 2016. All the patients were above 18 years and working at least three hours per day during the last 1 year. Patients diagnosed with ocular diseases, neurological diseases, using topical or systemic medications, who had ocular surgery and systemic diseases causing dry eyes, who did not give consent, and contact lens users were excluded. Ocular examination was done including refractive errors, slit lamp examination, and tear film breakup time. Data was collected and analysed on Statistical Package for Social Sciences (SPSS) version 21.
Results: This study had 150 individuals, of which 115 (76.2%) were males and 35 (23.2%) were females. Mean age was 32.3 ± 8.8 SD. The most frequent complaint was eye strain in 123 (81.5 %) individuals, followed by blurred vision in 94 (62.3%) individuals; the least common was diplopia in 13 (8.6%) individuals. Mean computer daily use was 5.96 ± 2.819 SD hours and duration of computer use was 10.13 ± 6.371 SD years. Tear film breakup time was less than 10 seconds in 63 (42%) individuals. Statistically significant P value 0.003 was seen between tear film breakup time and daily use in hours.
Conclusion: A frequent cause of ocular discomfort in patients with computer vision syndrome is decreased tear film break up time. Another important cause is uncorrected refractive error, the most common of which is myopia, which should be addressed without delay to reduce ocular discomfort.
Outcomes of coaxial microincision cataract surgery versus conventional phacoemulsification surgery
Authors: Malik Anu , Dethi Smruti Ranjan , Gupta Yogesh Kumar , Gupta Alka 
Published: January 2021

Aim: To compare surgical parameters and visual outcomes of coaxial microincision cataract surgery (MICS) with standard phacoemulsification.
Methods: A prospective randomized study was conducted on 60 eyes of 60 patients with age-related uncomplicated cataract who underwent: standard phacoemulsification surgery (30 eyes) i.e., Group 1, or coaxial MICS (30 eyes) i.e., Group 2. Intraoperative parameters were mean effective phacoemulsification power (EPP), effective phacoemulsification time (EPT), and total volume of balanced salt solution (BSS) used. Best-corrected visual acuity (BCVA) and surgically induced astigmatism (SIA) were evaluated pre- and postoperatively.
Results: Mean BCVA at 6 weeks was 0.04 ± 0.07 in Group 1 and 0.05 ± 0.08 in Group 2. No significant difference was observed in SIA between the two groups. Mean EPT was 29.80 ± 3.67 seconds in Group 1 and 31.93 ± 4.08 seconds in Group 2. The mean total EPP in Group 1 was 35.77 ± 5.17%, whereas it was 33.70 ± 3.05% in Group 2. There was a significant statistical difference between mean EPP and EPT in the two groups. Mean total BSS volume used in Group 1 was 128.83 ± 19.81 ml, whereas it was 139.33 ± 13.57 ml in Group 2.
Conclusion: Although EPT and BSS volume used were significantly higher in coaxial MICS, the postoperative results of the two techniques were comparable.