bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rare orbital malignancies in xeroderma pigmentosum – a case series and review of literature
Authors: Raza Rizvi Syed Ali , Yusuf Faraz , Amitava A K , Arif S H , Vasenwala M , Mehdi Ghazala 
Published: January 2021

Xeroderma pigmentosum (XP) is a rare genodermatosis, with a defect affecting recovery of ultraviolet-induced damages and characterized by a high rate of malignancies of the exposed skin areas. Inheritance is autosomal recessive and consanguinity of parents is common. We report two siblings with a history of consanguinity having XP with rare orbital malignancies. The first case had orbital amelanotic melanoma and the second case had sebaceous gland carcinoma (SGC) with orbital extension. In this case series, we have discussed and reviewed orbital malignancies in XP with respect to this report and other cases in the literature. Although early detection and treatment of these malignancies will reduce morbidity and mortality, genetic counselling remains the most important protective measures for XP.
Diagnostic value of contrast sensitivity test and conjunctival impression cytology for the detection of sub-clinical vitamin-a deficiency
Authors: Gondhowiardjo Tjahjono Darminto , Andriyani Irma , Gumay S. , Artini Widya , Werdhana R.A. 
Published: January 2021

Purpose: To determine whether or not contrast sensitivity test and conjunctival impression cytology can be used as diagnostic tools to detect sub-clinical vitamin-A deficiency; and if there is a correlation within the two diagnostic methods.Methods: A series of diagnostic studies comprising of contrast sensitivity test, conjunctival impression examination and serum retinol concentration were performed on literate children, six to ten years old, at West Java Elementary School. All subjects underwent a basic eye examination. Sample size, receiver operator curve, negative and positive predictive values, sensitivity and specificity were calculated.Results: A total of 109 subjects out of 154 elementary school children corresponding to the inclusion criteria were included in this study. Forty-four (41.9%) children were detected to have sub-clinical vitamin-A deficiency. The contrast sensitivity test had a sensitivity value of 45.5% and a specificity value of 50.8% with a positive predictive value of 40%. The area under the receiver operator characteristic (ROC) curve was 49.5% (95% CI 38.1%- 60.9%), whereas the conjunctival impression cytology test had a sensitivity value of 90.9%, and a specificity value of 16.4% with a positive predictive value of 43.9%. The ROC area was 56.1% (95% CI 45.0% - 67.1%). Pearson’s analysis showed that there is no correlation between the two diagnostic tools (p 0.538).Conclusion: The results of this study indicated that neither the contrast sensitivity test nor the conjunctival impression cytology was found to be a favorable screening tool to detect sub-clinical vitamin-A deficiency. Moreover, there is no correlation between the two methods.
The role of the TB T-spot test in patients with tubercular retinal vasculitis
Authors: Lee Elin , Sanjay Srinivasan , Teoh Stephen 
Published: January 2021

Purpose: To report tuberculosis (TB) T-spot diagnosis and management of two cases of presumptive tubercular retinal vasculitis in Singapore.Method: Retrospective case reports.Results: Two patients were diagnosed with presumptive TB retinal vasculitis using clinical features, TB T-spot test and ancillary investigations. They were successfully treated with a combination therapy of oral steroids, anti-tuberculosis medications and pan retinal photocoagulation (PRP). Follow-up demonstrated resolution of symptoms and signs with no complications arising from anti-tuberculosis medications.Conclusions: TB retinal vasculitis presents diagnostic and therapeutic challenges. Ocular TB diagnosis is often presumptive, as confirmatory evidence of organisms from the eye has low yield. The results of culture and Mantoux test require a long waiting period. TB T-spot provides rapid results with high sensitivity and specificity, thus holding promise as a diagnostic tool. Management of TB retinal vasculitis is multi-modal and multi-disciplinary requiring oral steroids and pan-retinal photocoagulation by the ophthalmologists and anti-tuberculosis medications by the Physicians.
Outcomes following orbital decompression surgery for dysthyroid optic neuropathy associated with Graves’ ophthalmopathy.
Authors: Ha Jerome How Ing , Leong James , Martin Peter , Ghabrial Raf , Benger Ross 
Published: January 2021

Purpose: To investigate the outcomes of orbital decompression surgery for dysthyroid optic neuropathy associated with severe Graves’ ophthalmopathy. Design: Ten years (2000-2010) retrospective case series.Methods: Thirty-eight orbits (with dysthyroid optic neuropathy) of 119 surgical orbital decompressions. Patients with dysthyroid optic neuropathy associated with Graves’ ophthalmopathy, who underwent orbital decompression surgery at Sydney Eye Hospital (Sydney, Australia), were investigated for outcome measures.Results: Thirty-five orbits were eligible for data analysis. Orbital decompression surgery improved visual acuity in 29 orbits and maintained visual acuity in four orbits. In patients with dysthyroid optic neuropathy, there was a statistically significant mean improvement in visual acuity of 2.8 lines postoperatively (standard deviation = 3.2; 95% confidence interval 3.9 to 1.7, p-value < 0.05). There were no statistically significant differences invisual acuity amongst different combinations of orbital walls being decompressed, with the majority of orbits had the medial orbital wall decompressed. This may reflect the small number of decompressions performed in each subgroup. Orbital decompression surgery reduced proptosis by a mean of 3.2 mm (standard deviation = 2.9; 95% confidence interval -4.32 to -2.07; p-value < 0.05). Medial and lateral orbital walls decompression resulted in the greatest mean reduction in proptosis. There were no severe visual impairment cases postoperatively (VA worse than 6/60). There were two patients with new onset diplopia postoperatively. There were three orbits with bleeding and one orbit with CSF leakage, all without major sequelae postoperatively.Conclusion: Regardless of surgical access, orbital decompression surgery is effective and safe in the management of dysthyroid optic neuropathy and in reducing proptosis in patients with Graves’ ophthalmopathy.
Occupational eye hazard – a case of perforating industrial nail injury to the eye
Authors: Lee Elin , Madhav Wagle Ajeet 
Published: January 2021

Purpose: To report the management and outcome of an unusual case of occupational perforating ocular industrial nail injury involving the posterior pole. Methods: Observational case report. A 48-year-old Chinese male construction worker presented with perforating industrial nail injury.Results: The patient underwent primary globe repair and foreign body removal followed by staged pars plana vitrectomy with endophotocoagulation and cyclopropane gas tamponade for repair of the vitreous incarceration at the posterior exit wound, a subsequent laser retinopexy with silicone oil tamponade for an inferior retinal detachment extending from the perforation site and finally silicone oil removal with a scleral fixated intraocular lens implant. His best-corrected visual acuity improved to 20/100 six months after the initial injury. Conclusion: Perforating ocular injuries involving the posterior pole often present with severe visual impairment and significant management challenges. We report a case of perforating ocular nail injury, which was managed successfully with staged surgical procedures.
Determinants and outcome of periocular dirofilariasis in a cohort of patients with demonstrable live worm from the ocular and adnexal parasitic granulomas
Authors: Prabhu Padma Balagopal , Raju Kuzhupally Vallon 
Published: January 2021

Purpose: We attempt to describe the unique diagnostic features of dirofilariasis affecting the eye, a rare disease caused by the nematode dirofilaria repens. Case report: The cohort includes 5 adult cases of ocular dirofilariasis. Migratory oedema was present in all but one case. The occurrence of the lesions near the medial canthus in all the cases including subconjunctival mass suggests predictable pattern of migration of the worm. Absence of systemic eosinophila and lack of marked eosinophilic infiltration around the parasitic granuloma in histopathology indicates alternative immune response against the parasite. Persistence of live worm despite antihelminthic drugs can be accounted by the presence of a thick capsule which protects the filaria against adulticidal and larvicidal drugs. Surgical exicision was curative in all cases.Conclusion: Our case series points to the importance of having high index of suspicion and early detection of ocular dirofilariasis as it is amenable to simple and effective treatment.
Correlation of refractive error with axial length and corneal topography
Authors: Ruia Surabhi , Kishore Poonam , Singh Vinita , Chaudhary Nitin 
Published: January 2021

Purpose: To collect and analyze normative data about corneal topography and axial length in various refractive errors in Indian population.Design: Cross-sectional observational study. Materials and Method: Three hundred eyes (150 patients) of age group 12-35 yrs were arranged in 5 groups according to refractive status; Group 1 (n=44): myopia of SphericalEquivalent (SE) > 6 D; Group 2 (n=67): myopia of SE >0.5 D to 6 D; Group 3 (n=88): nearly emmetropic of SE -0.5 D to +0.5 D; Group 4 (n=59): hypermetropia of SE >0.5 to 6 D; Group 5 (n=42): hypermetropia of SE > 6 D. Axial length(AL), central radius of curvature of cornea (CR), central power of cornea (CK) , Al/CR ratio for each group were documented . Correlation with SE and among each other was studied. Results: Mean AL (in mm) of myopic patients (n=111) was 24.23 ± 1.34, emmetropic (n=88) 22.62 ± 0.94 and hypermetropics (n=101) 20.73 ±0.94. Mean CR (in mm) of myopic patients was 7.55 ± 0.35, emmetropics was 7.70 ±0.32, and hypermetropes was 7.99 ±0.35. Mean CK (in D) of myopics was 44.86±2.59, emmetropes was 43.91±1.76, and hypermetropes was 42.32±1.89. Mean AL/CR ratio of myopics was 3.22 ± 0.29, emmetropics 2.94± 0.07, and hypermetropics 2.60 ± 0.19. AL was negatively correlated with SE(r=-0.91, p<0.0001) and positively with AL/CR(r=0.88, p<0.0001) and CK (r=0.36, p<0.0001). CR was negatively correlated with AL/CR (r=-0.74, p<0.0001) while positively correlated with SE (r=0.62, p<0.0001). CK showed positive correlation with AL/CR (r=0.75, p<0.0001) while negative correlation with SE (r=-0.61, p<0.0001). AL/CR was negatively correlated withSE(r=-0.95, p<0.0001). Conclusion: This study showed a negative correlation between axial length and refractive error and between AL/CR ratio and refractive error with stronger inverse relationship in hypermetropes than myopes. There was a positive correlation of CR with SE with a weaker direct relationship in myopes than hypermetropes.
Femtosecond laser-assisted anterior lamellar keratoplasty (FSALK) versus microkeratome-assisted anterior lamellar keratoplasty (MALK) for the treatment of anterior corneal dystrophy.
Authors: Almousa Radwan , Daya Sheraz M 
Published: January 2021

Purpose: To compare the visual outcome of femtosecond laser-assisted anterior keratoplasty (FSALK) and microkeratome-assisted anterior lamellar keratoplasty (MALK) in anterior corneal dystrophy. Methods: retrospective comparative chart review of 7 eyes that underwent FSALK and 7 eyes that underwent MALK. The primary outcome was the visual outcome of both procedures. The secondary outcome was the recurrence of the corneal dystrophies.Results: Mean follow-up time was 30±14(7-51) months for the FSALK group and 127±28(80-127) months for the MALK group. In the FSALK group the preoperative best spectacle-corrected visual acuity (BSCVA) improved from 20/63 to 20/25 at 36 months. In the MALK group there was 1 eye with documented BSCVA over 36 months follow-up; it improved from 20/160 preoperatively to 20/32 at 36 months. Uncorrected visual acuity (UCVA) at 36 months improved from 20/100 preoperatively to 20/63 in the FSALK group and from 20/200 preoperatively to 20/63 in the MALK group. Five eyes with Reis-Bucklers showed a clinical recurrence at a mean of 142±13(125-152) months. Two eyes with granular dystrophy showed a clinical recurrence at 23 and 80 months of follow-up. One eye in the MALK group had epithelial ingrowth. One eye in the FSALK group with compromised ocular surface due to 2 previous penetrating keratoplasty, suffered bacterial keratitis that ended up with corneal scarring. Conclusion: Both procedures improve visual outcome for anterior corneal dystrophy. FSALK has theoretical advantages over MALK; however, larger prospective studies are needed to prove this.
Association of PDGFRA gene polymorphisms and early-onset myopia in South Sumatera, Indonesia
Authors: Purwoko Mitayani , Reki Winarto , Winarni Tri Indah 
Published: January 2021

Purpose: Myopia is a refraction error that may caused by corneal curvature (CC) anomaly. Platelet-derived growth factor receptor alpha (PDGFRA) gene was determined to have an effect on CC. The purpose of this study was to find a correlation between single nucleotide polymorphisms (SNP) in PDGFRA gene and early-onset myopia in South Sumatera tribes, a part of Indonesian ethnic group.
Design: Using a random sampling method, population-based, case control study included 100 subjects aged 18-40 years from Palembang, South Sumatera, Indonesia.
Methods: Visual acuity was measured by Snellen chart and CC was measured by manual keratometer. DNA sample from buccal swab was investigated with Amplification Refractory Mutation System (ARMS) PCR and visualized in agarose gel.
Results: Median of CC for the right eye was 7.73 (7.07-8.63) mm and the left eye was 7.73 (7.04-8.69) mm. There was no difference between CC in myopic and normal subjects. Distribution of mutant allele in rs17084051, rs7677751, rs7682912, and rs2114039 were higher in myopic subject compare to those of normal control. Significant association between PDGFRA gene polymorphism and early-onset myopia was found only in rs17084051 (p = 0.009) and rs7677751 (p = 0.001).
Conclusions: Mutant type allele A of rs17084051 and mutant type allele T of rs7677751 of PDGFRA gene polymorphism are associated with early-onset myopia in South Sumatera tribes in this study.
Macular thickness in diabetic retinopathy without clinically significant macular edema
Authors: Rao Krishna , Chandra Ravi , Rao Lavanya , S Shailaja , Hazarika Manali 
Published: January 2021

Aim: To measure macular thickness by optical coherence tomography (OCT) in various grades of diabetic retinopathy with no clinically significant macular edema (CSME) and its comparison with non-diabetics.
Design: Prospective cross–sectional study.
Methods: Macular thickness was measured by OCT in 72 healthy volunteers (107 control eyes), 45 patients with mild and moderate non-proliferative diabetic retinopathy (NPDR) (78 eyes) and 37 patients with severe NPDR and proliferative diabetic retinopathy (PDR) (66 eyes). Patients with diabetic macular edema (DME) as assessed by stereoscopic evaluation or photographs were excluded. One-way ANOVA test to compare the mean thickness and Tukey's test for multiple comparison between groups were used.
Results: Central subfield thickness (CST) was 238.57 ± 25.077 µm, 251.22 ± 24.649 µm, and 270.45 ± 28.956 µm in the three groups respectively. As the severity of retinopathy increased, the macular thickness significantly increased (p = < 0.001) in all the nine zones on OCT. There was a significant increase in CST noted in all the grades of retinopathy when compared with non-diabetics (p = 0.004, p = < 0.0001). No significant difference in macular thickness was noted between genders, irrespective of their groups (p = 0.72), or between the three groups in all the nine zones (p = 0.609).
Conclusion: There is a significant increase in CST in all grades of retinopathy, as well as with increasing severity of retinopathy when compared to non-diabetics. This warrants the need to obtain OCT measurements even in patients with moderate NPDR without CSME to rule out subclinical DME.
Case series of cultivated oral mucosa epithelium transplantation for limbal stem cell failure
Authors: Oh Kah Lay , Zahidin Aida , Md Noh Umi Kalthum , Mohd Khialdin Safinaz , Ooi Ghee Chien , Then Kong Yong 
Published: January 2021

Purpose: To report a case series of seven eyes (six patients) with severe limbal stem cell failure who underwent cultivated oral mucosa epithelium transplantation (COMET) in preparation for corneal transplant surgery and assess the change in visual acuity postoperatively.
Design: Case series.
Methods: A retrospective analysis of an interventional case series of six patients with severe limbal stem cell deficiency who underwent COMET between 2012 and 2015 was performed. Six eyes had COMET followed by corneal transplant, and one eye had corneal transplant preceding COMET. The change in the visual acuity after operation was evaluated.
Results: A total of six patients with seven eyes were studied. All of them had severe ocular surface disease with limbal stem cell deficiency (LSCD) secondary to chemical injury (five eyes), SJS (one eye), and severe ocular rosacea (one eye). Four eyes had improvements in visual acuity, two of which achieved best corrected visual acuity (BCVA) of 6/12.
Conclusion: The use of COMET helps to optimize the ocular surface in severe LSCD for further corneal transplant surgeries. It has helped to improve the graft uptake and subsequent visual improvement, especially in chronic chemical burn cases.
Patient satisfaction of pterygium surgery using fibrin glue versus suture autograft
Authors: Mohamad Noh Nur Reza , Yong Geng-Yi , Lee Siew-Ting , Low Kui-Feng , Pan Shin-Wei 
Published: January 2021

Purpose: To compare pterygium surgery with fibrin glue autografts and sutured autografts in terms of length of surgery time and postoperative patient satisfaction.
Methods: All pterygium operations performed at Sibu Hospital (Sarawak, Malaysia) between October 1, 2012 and September 30, 2013 were included.
Results: Eighty-one cases were included in the study. The fibrin glue group and suture group had 33 and 48 cases, respectively. The mean age of the patients was 50.56 (SD: 7.61). The fibrin glue group had a shorter mean duration of surgery (17.18 minutes, SD: 10.66) compared to the suture group (22.60 minutes, SD: 12.88) (P = 0.05). Patient satisfaction at first week review was 93.9% for the fibrin glue group and 75.0% for the suture group (P = 0.027, OR 5.2 [95%CI: 1.1, 24.9]). Patient satisfaction at sixth week review was 97.0% for the fibrin glue group and 77.1% for the suture group (P = 0.023, OR 9.5 [95%CI: 1.2, 77.8]). There was no serious adverse event in this study population.
Conclusion: Fibrin glue has shorter mean duration of surgery and significantly higher patient satisfaction at first week and sixth week post-pterygium surgery compared to the suture technique.
Ahmad’s modified trabeculectomy technique
Authors: Ahmad Syed Shoeb 
Published: January 2021

Aim or purpose: To present a modified technique of trabeculectomy.
Design: Ahmad’s modified trabeculectomy technique aims to utilize subtle modifications to the classical trabeculectomy technique in order to achieve a better filtering bleb leading to lesser complications.
Methods: Retrospective interventional case series.
Results: Thirty-four patients underwent this surgery. There was a significant difference in the preoperative and postoperative median intraocular pressure (IOP; z = 3.928; p < 0.001). The postoperative IOP (median = 12) was significantly lower than the preoperative IOP (median = 28; interquartile range = 9).
Conclusion: This modification can prove to be an effective method to reduce IOP with minimal complications.
Implantation of ArtificialIris, a CustomFlex® iris prosthesis, in a trauma patient with an Artisan lens
Authors: Doroodgar Farideh , Jabbarvand Mahmoud , Niazi Feazollah , Niazi Sana , Sanginabadi Azad 
Published: January 2021

Purpose: To evaluate probable complications of ArtificialIris implantation with iris-fixated intraocular lens.
Method: Development of photophobia, glare, and psychological strain during face-to-face communication in a 23-year-old man with a widespread traumatic iris defect terminate to make a decision for performing implantation an ArtificialIris (HumanOptics, Erlangen, Germany) under the remnant iris without removing the patient’s existing Artisan lens.
Results: Without any intraoperative or postoperative complications, the patient’s visual acuity increased by one line, the endothelial cell loss was comparable with the cell loss associated with standard cataract surgery, and the anterior chamber depth and anterior chamber anatomy did not change. At the final follow-up examination, the mean intraocular pressure (IOP) did not differ from baseline, and we achieved high level of patient satisfaction and subjective vision improvement. We discuss the particular importance of considering the patient’s expectations, the appropriate measurements, ways to perfect color evaluation, and the types of ArtificialIris products.
Conclusion: The implantation of the ArtificialIris in patients with aphakic iris-supported lenses (i.e., preexisting Artisan lenses) is a feasible approach and a useful option for patients with thin irises and iris hypoplasia who are at risk of subluxation or the dislocation of the PCIOL as well as those with sclerally fixed PCIOLs.
Vision-threatening diabetic retinopathy necessitating vitrectomy in a tertiary care hospital in coastal Karnataka, South India
Authors: Reddy Narasimha Vasista , Kamath Yogish Subraya , Rao Lavanya G. , Rao Krishna Addoor , Shenoy Shailaja Bhat , Bhandary Sulatha V. 
Published: January 2021

Background: The proportion of diabetic patients having vision-threatening diabetic retinopathy and those needing to undergo vitrectomy was documented.
Methods: A cross-sectional observational study was conducted at a tertiary care hospital in coastal Karnataka, South India. All patients with diabetes mellitus visiting the ophthalmology department in the study period were screened for retinopathy, and the data regarding the presence of maculopathy and proliferative retinopathy were included as vision-threatening retinopathy.
Results: Of the 1,435 diabetic patients included, 38.4% had retinopathy changes due to diabetes, with 8.71% having vision-threatening retinopathy and 1.81% needing vitrectomy.
Conclusion: Although the proportion of vision-threatening retinopathy is small, the rapidly increasing diabetic population requires the setting up of more resources for tackling this condition, at least at the tertiary levels of the health-care system. However, considering the increased human and economic resources involved in setting up vitrectomy units, more emphasis on strengthening screening programs for early detection and referral to reduce the progression of retinopathy to advanced stages would be appropriate.