bluuebunny/crossref_metadata_2025_split huggingface dataset:
EN FACE OPTICAL COHERENCE TOMOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF INNER RETINAL DIMPLES AFTER INTERNAL LIMITING MEMBRANE PEELING FOR FULL-THICKNESS MACULAR HOLES
Authors: Navajas Eduardo V. , Schuck Nathan , Govetto Andrea , Akil Handan , Docherty Gavin , Heisler Morgan , Sarunic Marinko V. , Sarraf David 
Published: January 2019

Purpose:
To quantitatively and qualitatively evaluate the microvascular and structural abnormalities associated with inner retinal dimpling after internal limiting membrane peeling for full-thickness macular holes using sequential en face optical coherence tomography (OCT) and OCT angiography.

Methods:
Thirteen eyes of 13 patients with idiopathic full-thickness macular holes were enrolled in the study. Patients were treated with pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. Subjects were evaluated preoperatively and at postoperative Months 1, 3, and 6. At each visit, patients underwent a comprehensive ophthalmologic examination, en face OCT and OCT angiography. The morphology and number and proportionate area of inner retinal dimples were analyzed. Vessel density of the superficial vascular complex at all visits was also measured.

Results:
Inner retinal dimples were identified 1 month after surgery in all cases. The number and proportionate area of inner retinal dimples significantly increased over the follow-up period (P = 0.05). Preoperative vessel density of the superficial vascular complex was 17.9 ± 1.9 and did not change significantly over the follow-up period (P = 0.15).

Conclusion:
Inner retinal dimples are identified with en face OCT as early as the first month after internal limiting membrane peeling for idiopathic full-thickness macular holes and progressively increase in number and proportionate area in the subsequent 3 to 6 months after surgery. This may be the result of progressive deturgescence of the nerve fiber layer in the postoperative period.
STEM CELL THERAPIES, GENE-BASED THERAPIES, OPTOGENETICS, AND RETINAL PROSTHETICS:
Authors: Wood Edward H. , Tang Peter H. , De la Huerta Irina , Korot Edward , Muscat Stephanie , Palanker Daniel A. , Williams George A. 
Published: January 2019

Purpose:
To review and discuss current innovations and future implications of promising biotechnology and biomedical offerings in the field of retina. We focus on therapies that have already emerged as clinical offerings or are poised to do so.

Methods:
Literature review and commentary focusing on stem cell therapies, gene-based therapies, optogenetic therapies, and retinal prosthetic devices.

Results:
The technologies discussed herein are some of the more recent promising biotechnology and biomedical developments within the field of retina. Retinal prosthetic devices and gene-based therapies both have an FDA-approved product for ophthalmology, and many other offerings (including optogenetics) are in the pipeline. Stem cell therapies offer personalized medicine through novel regenerative mechanisms but entail complex ethical and reimbursement challenges.

Conclusion:
Stem cell therapies, gene-based therapies, optogenetics, and retinal prosthetic devices represent a new era of biotechnological and biomedical progress. These bring new ethical, regulatory, care delivery, and reimbursement challenges. By addressing these issues proactively, we may accelerate delivery of care to patients in a safe, efficient, and value-based manner.
AQUEOUS HUMOR CYTOKINES AND THERAPEUTIC CUSTOMIZATION IN NONRESPONDING MACULAR EDEMA SECONDARY TO RETINAL VEIN OCCLUSION
Authors: Modi Aditya , Sharma Karen , Sudhakar Neha Peraka , Yadav Naresh Kumar 
Published: January 2019

Aim:
To report an alternative cytokine-based customized therapeutic approach of macular edema secondary to retinal vein occlusion.

Methods:
A 64-year-old male patient presented with left eye macular edema secondary to central retinal vein occlusion, status after three consecutive anti–vascular endothelial growth factor injections. He was subsequently subjected to aqueous humor cytokine analysis. Vascular endothelial growth factor, interleukin-6 (IL-6), and interleukin-8 (IL-8) concentrations were determined using multiplex bead assay (BD Cytometric Bead Array). Based on the results, intravitreal steroid was administered. Follow-up examination included monitoring corrected distance visual acuity using Snellen's chart, central subfoveal thickness measurement on spectral domain optical coherence tomography (Spectralis, HRA2; Heidelberg engineering, Heidelberg, Germany) and cytokine quantification at the end of one and three months.

Results:
Baseline corrected distance visual acuity was counting fingers at 1 m, which subsequently improved to 6/12 Snellen equivalent 1 month after customized intravitreal therapy. Central subfoveal thickness demonstrated significant reduction from 529 to 253 µm; baseline vascular endothelial growth factor, IL-6, and IL-8 concentration were ascertained to be 29.94, 1.31, and 82.12 pg/mL (picograms/millilitre). One month after intravitreal steroid injection, the IL-8 levels normalized to 13.28 pg/mL. Functional and anatomical improvements were sustained till the last follow-up at 3 months.

Conclusion:
Customized intravitreal treatment provides an objective, alternative, and effective therapeutic approach for macular edema secondary to retinal vein occlusion.
DYNAMIC ECHOGRAPHY OF VARIX OF THE VORTEX VEIN AMPULLA
Authors: de Carlo Talisa E. , Mieler William 
Published: January 2019

Purpose:
To describe four cases of varix of the vortex vein ampulla imaged with dynamic echography.

Methods:
Observational case series of four patients with varix of the vortex vein ampulla diagnosed with ocular examination maneuvers such as digital pressure or Valsalva. Dynamic echography was used to confirm the diagnosis.

Results:
Dynamic echography can quickly and noninvasively show the varix of the vortex vein ampulla disappear with external pressure, or engorge with a Valsalva maneuver or altered gaze directions.

Conclusion:
Dynamic echography is very helpful in the establishment of the diagnosis of varix of the vortex vein ampulla and differentiating this benign condition from other retinal or choroidal abnormalities.
BISPHOSPHONATE-INDUCED BILATERAL ANTERIOR UVEITIS AND CHOROIDAL EFFUSIONS WITH SECONDARY ANGLE CLOSURE
Authors: Thng Zheng Xian , Li Zhenghao Kelvin , Gan Nicola Yi'an 
Published: January 2019

Purpose:
To report a case of bisphosphonate-induced bilateral anterior uveitis and choroidal effusions with secondary angle closure in a 64-year-old female patient.

Methods:
Observational case report.

Results:
A 64-year-old woman with history of scleroderma and antiphospholipid syndrome, presented with bilateral painless blurring of vision after commencement of alendronate. Clinical examination revealed bilateral anterior uveitis and choroidal effusions with resultant secondary angle closure in the left eye. Ultrasound biomicroscopy showed bilateral anteriorly rotated ciliary bodies. There was also a −2D myopic shift in the left eye. On drug cessation, complete resolution was seen within 2 weeks.

Conclusion:
In the absence of other plausible etiologies and with recent commencement of a new drug, we postulate that the anterior uveitis and choroidal effusions are likely due to alendronate. This is further supported by complete resolution of the inflammation and effusions once alendronate was withheld.
TRAUMATIC RETINAL DETACHMENT CAUSED BY NERF GUN SHOT IN A PEDIATRIC PATIENT
Authors: Mandviwala Murtaza M. , Sassani Patrick P. 
Published: January 2019

Purpose:
To present a case of retinal detachment caused by a Nerf-gun shot in a pediatric patient.

Methods:
Single case report.

Results:
A 16-year-old white man presented with a nasal visual field deficit and floaters in his left eye for 1 month after being shot with a foam-ball Nerf gun by a friend. Fundus examination revealed a midperipheral retinal dialysis extending from 1 to 4:30 clock hours with a macula-on retinal detachment and superficial proliferative vitreoretinopathy. He underwent successful 25-gauge pars plana vitrectomy with membrane peel, retinectomy, injection of perfluoron, endolaser, and use of 1,000 centistoke silicone oil for tamponade.

Conclusion:
This is the first reported case of traumatic retinal detachment secondary to a Nerf-gun shot.
ACUTE MYOCARDITIS WITH CARDIOGENIC SHOCK AND MULTIPLE ORGAN FAILURE, FOLLOWED BY BILATERAL PANUVEITIS MASQUERADING AS ENDOGENOUS ENDOPHTHALMITIS, DUE TO TOXOPLASMA GONDII IN AN IMMUNOCOMPETENT PATIENT
Authors: Filipowicz Artur , Coca Mircea N. , Blair Barbra M. , Chang Peter Y. 
Published: January 2019

Purpose:
To report a case of systemic and ocular toxoplasmosis in an immunocompetent patient, who developed myocarditis with resulting cardiogenic shock and multiple organ failure, followed by bilateral panuveitis masquerading as endogenous endophthalmitis.

Methods:
Single case report with images.

Results:
A 59-year-old man with a history of monoclonal gammopathy of undetermined significance and associated scleromyxedema but otherwise immunocompetent was admitted to the intensive care unit for cardiogenic shock and multiple organ failure due to presumed viral myocarditis. After hospital discharge, ophthalmic examination revealed what seemed to be endogenous fungal endophthalmitis in both eyes. The ocular inflammation failed to improve on local and systemic antifungal therapies. After repeated testing and vitrectomy, the causative organism responsible for his intraocular inflammation remained elusive. The patient was then found to have significantly elevated serum titers of anti–Toxoplasma gondii IgG and IgM, followed by an appearance of a focal retinochoroidal lesion more typical of ocular toxoplasmosis. Systemic anti-Toxoplasma therapy led to resolution of intraocular inflammation, and the patient had since fully recovered from the myocarditis and its multiple comorbidities. Of note, myocardial biopsy and polymerase chain reaction testing of aqueous and vitreous fluids were all negative for Toxoplasma.

Conclusion:
Even in an immunocompetent patient, Toxoplasma can result in myocarditis with significant morbidities and even death, and its ocular manifestation may be quite different from the classic focal retinochoroiditis. In addition, polymerase chain reaction analysis of ocular fluids can be unreliable in an immunocompetent host, and thus treatment decision should be guided by clinical history and examination findings.
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY STUDY OF CHOROIDAL NEOVASCULARIZATION ASSOCIATED WITH EARLY-ONSET DRUSEN
Authors: Terao Ryo , Matsuda Aya , Ogawa Asako , Shimizu Kimiko , Azuma Keiko , Inoue Tatsuya , Obata Ryo 
Published: January 2019

Purpose:
To report three middle-aged cases with choroidal neovascularization (CNV) associated with early-onset drusen documented with optical coherence tomography angiography (OCTA).

Methods:
Three patients with bilateral early-onset drusen were referred to our hospital. Fundus examination, fluorescein angiography, indocyanine green angiography, OCTA, and other multimodal imaging were performed.

Results:
Case 1 involved a 47-year-old woman who presented with sudden unilateral anorthopia. She had no previous systemic pathologies. Funduscopic examination and fluorescein angiography revealed bilateral large colloid drusen accompanied by unilateral mild subretinal hemorrhage. Indocyanine green angiography revealed CNV, although it was unclear in fluorescein angiography. Optical coherence tomography angiography also showed interconnecting CNV beneath the retinal pigment epithelium. Case 2 involved a 40-year-old woman with membranoproliferative glomerulonephritis Type 3 who presented with unilateral anorthopia. On fluorescein angiography, cuticular drusen secondary to membranoproliferative glomerulonephritis were seen in both eyes. An interconnecting vascular network was revealed with OCTA and indocyanine green angiography indicating Type 1 CNV in the affected eye. Case 3 involved a 47-year-old man without any medical or family history. Predominant large colloid drusen associated with cuticular drusen were seen in both eyes. Unilateral mild serosanguinous changes were accompanied in the macula, where Type 1 CNV was detected with OCTA.

Conclusion:
All our cases with early-onset drusen showed Type 1 CNV that was detected by indocyanine green angiography or OCTA. Optical coherence tomography angiography has a potential to help noninvasively diagnose CNV in the cases of EOD.
Comparison of Donor Cornea Endothelial Cell Density Determined by Eye Banks and by a Central Reading Center in the Cornea Preservation Time Study
Authors: Benetz Beth Ann , Stoeger Christopher G. , Patel Sanjay V. , O'Brien Robert C. , Szczotka-Flynn Loretta B. , Ayala Allison R. , Maguire Maureen G. , Menegay Harry J. , Bedard Peter , Clover Jameson M. , Gupta Pankaj C. , McCoy Kristen E. , Song Jonathan C. , Lass Jonathan H. ,   on behalf of the Cornea Preservation Time Study Group
Published: January 2019

Purpose:
To evaluate agreement between eye banks (EBs) and a reading center on endothelial cell density (ECD) determinations in the Cornea Preservation Time Study.

Methods:
The Cornea Image Analysis Reading Center (CIARC) performed variable frame image analysis on EB-obtained–preoperative central endothelial images (after lamellar dissection for Descemet stripping automated endothelial keratoplasty by the EBs or before shipping, if surgeon prepared) to determine ECD. The EBs performed their usual method of ECD determination. The CIARC and EBs also provided ECD determinations from screening central endothelial images taken by the EBs during donor evaluation. Two independent masked CIARC readers determined ECD with measurements averaged.

Results:
The mean preoperative ECD was 15 cells/mm2 greater by the EBs than by CIARC (N = 1286, P < 0.001) with 95% limits of agreement of (−644, 675 cells/mm2). The limits of agreement in preoperative ECD were wider in the After-Lamellar-Dissection Group (−687, 683 cells/mm2) than in the Before Shipping Group [(−505, 633 cells/mm2); P = 0.03]. The EBs-determined preoperative ECD was within 10% of the CIARC-determined ECD for 886 (69%) image sets, with 236 (18%) higher by >10% and 164 (13%) lower by >10%. Excellent agreement appeared between the EBs and CIARC when 100–300 cells could be analyzed in contrast to <100 cells (SD = 308 cells/mm2 vs. SD = 603 cells/mm2; P < 0.001).

Conclusions:
The mean ECD by the EBs and CIARC were similar, but there was considerable variability between determinations for individual corneas. Agreement improved between the 2 measurements when more than 100 cells were able to be analyzed.
Feasibility of Intraocular Projection for Treatment of Intractable Corneal Opacity
Authors: Shim Sarah Y. , Gong Songbin , Rosenblatt Mark I. , Palanker Daniel , Al-Qahtani Ahmed , Sun Michael G. , Zhou Qiang , Kanu Levi , Chau Felix , Yu Charles Q. 
Published: January 2019

Abstract:
Despite many decades of research and development, corneal opacity remains a leading cause of reversible blindness worldwide. Corneal transplantation and keratoprosthesis can restore corneal clarity, but both have well-known limitations. High-resolution electronic microdisplays may offer an alternative to traditional methods of treating corneal disease using an intraocular implant to project imagery onto the retina, obviating the need for a clear cornea. In this study, we review previous work and recent technologic developments relevant to the development of such an intraocular projection system.
A Systematic Review and Meta-analysis of Methods for Reducing Local Anesthetic Injection Pain Among Patients Undergoing Periocular Surgery
Authors: Gostimir Mišo , Hussain Ahsen 
Published: January 2019

Purpose:
Various factors help minimize pain during the injection of local anesthetic. The majority of current evidence involves nonspecific injection sites. The objective of this review was to provide a comprehensive summary of all existing evidence for methods used to reduce injection pain specifically in the context of periocular procedures.

Methods:
A literature search of the MEDLINE, EMBASE, and Scopus databases was conducted to identify all relevant experimental and observational studies from 1946 to 2018. Studies were included of patients undergoing periocular surgery under subcutaneous local anesthesia whereby outcomes were reported following a specific intervention intended to help reduce pain. Risk of bias was assessed using recognized tools. A subgroup meta-analysis was performed to indirectly compare pooled intervention-versus-control differences for various pain reduction interventions.

Results:
Following the review of 2089 search results, 23 articles representing 1135 patients were included. The methods assessed in the studies included choice of anesthetic agent, buffering, warming, dilution, needle type, administration of an inhalational anesthetic, application of topical anesthetics, iontophoresis, skin cooling with ice, tactile distraction with vibration, and decreasing the rate of injection.

Conclusions:
Methods demonstrating best efficacy included solution modification (buffering, dilution, warming), skin cooling with ice, vibration, transconjunctival topical anesthetic before injection, and decreased rate of injection. Further study is warranted for modification of equipment factors, topical anesthetics, and strategies to reduce pain because of anesthetic infiltration.
Methotrexate as an Adjuvant in Severe Thyroid Eye Disease: Does It Really Work as a Steroid-Sparing Agent?
Authors: Yong Kai-Ling , Chng Chiaw-Ling , Ming Sie Nicole , Lang Stephanie , Yang Morgan , Looi Audrey , Choo Chai-Teck , Shen Sunny , Seah Lay Leng 
Published: January 2019

Purpose:To compare the efficacy and safety of adjunctive oral methotrexate with intravenous pulsed methylprednisolone against methylprednisolone alone in the treatment of severe thyroid eye disease.Methods:Retrospective review of clinical data of patients with severe sight-threatening thyroid eye disease with compressive optic neuropathy treated with methylprednisolone with and without methotrexate. Eye disease outcome measures (e.g., VISA inflammatory score and vision) at 0, 3, 6, 12, and 18 months were recorded.Results:There were 72 subjects including 33 who had methylprednisolone alone and 39 with methylprednisolone with methotrexate. There were no statistical differences in demographics and baseline measures of disease activity or vision between the 2 treatment groups. No significant statistical differences in the cumulative dosage of methylprednisolone or occurrence of restrictive myopathy, raised intraocular pressure, proptosis, and exposure keratopathy between the groups at 0, 3, 6, 12, and 18 months were found. However, subjects who received methylprednisolone with methotrexate had better visual acuity of more than 2 lines on Snellen chart (p= 0.026) and VISA inflammatory score (p= 0.034) at 3 months, but no differences at 6, 12, and 18 months. Three patients who received methylprednisolone with methotrexate had transient worsening of liver function. No patient developed severe adverse reaction.Conclusions:The results demonstrated improved vision and disease activity at 3 months in the combination treatment group. This may suggest that the addition of methotrexate to methylprednisolone is beneficial for accelerating suppression of disease activity and hastens visual recovery. Addition of methotrexate to methylprednisolone did not reduce the requirement for steroids.
Measurement of the Force Required by Blunt-Tipped Microcannulas to Perforate the Facial Artery
Authors: Ugradar Shoaib , Hoenig Jonathan 
Published: January 2019

Purpose:
To measure the force required by blunt-tipped microcannulas of various sizes to penetrate the wall of the facial artery.

Methods:
Twenty hemifaces of 10 fresh frozen cadavers were dissected to reveal the facial artery from its origin at the external carotid artery until the angular artery was found. On the right side of each cadaver, the facial artery was removed at the nasolabial fold, while arteries on the left were kept in situ, preserved with their fascial attachments. A force-sensitive resistor (Tekscan, Boston, MA, U.S.A.) was used to measure the force required by a syringe attached to 18G, 22G, 23G, 25G, and 27G blunt-tipped microcannulas, to pierce the proximal wall of the facial arteries on the left hemiface at the nasolabial fold. The facial arteries from each right hemiface were pierced by cannulas that were attached to a horizontally mounted microtensile load cell, which included a linear motor (Ibex Engineering, Newbury Park, CA). The force required to perforate the proximal wall of the facial arteries was calculated for each cannula. A 2-tailed t test was used to compare the forces measured by the force-sensitive resistor and the microtensile load cell.

Results:
On force testing, the 18G and 22G cannulas were unable to penetrate the vessel wall in facial arteries that were both: removed from the cadavers and maintained in the cadavers. There was no statistically significant difference between the values obtained by the load motor and the force-sensitive resistor (p = 0.33). The force required to penetrate the proximal wall of the facial artery was: 0.72 kg to 0.81 kg for 23G, 0.43 kg to 0.54 kg for 25G, and 0.23 kg to 0.32 kg for 27G blunt-tipped microcannulas. There was a significant correlation between the gauge of the cannulas and the force required to penetrate the vessel walls (r = −0.970; p = <0.01).

Conclusions:
Blunt-tipped microcannulas smaller than 22G penetrate the facial artery with a low amount of force.
Opioid cessation and chronic pain: perspectives of former opioid users
Authors: Goesling Jenna , DeJonckheere Melissa , Pierce Jennifer , Williams David A. , Brummett Chad M. , Hassett Afton L. , Clauw Daniel J. 
Published: January 2019

Abstract
Current guidelines for addressing opioid cessation in the context of chronic pain management recommend that opioids be discontinued if the risks outweigh the benefits. However, few studies have focused on understanding opioid cessation from the perspective of individuals with chronic pain. This mixed-method study included 49 former opioid users with chronic pain and used quantitative survey data and qualitative focus group data to identify themes pertaining to former opioid user's experience before, during, and after opioid cessation. Participants described several reasons for wanting to stop opioids including lack of efficacy, impact on quality of life, and concerns about addiction. Barriers to cessation included concerns about inadequate pain management and concerns about the impact of stopping opioids on mood. After opioid cessation, the sample was mixed regarding the benefit of cessation. Half of the former opioid users reported their pain to be better or the same after stopping opioids; however, 47% of the sample reported feeling worse pain since stopping their opioids. As the pendulum swings from pain control to drug control, we must ensure that the response to the opioid epidemic does not cause harm to individuals with chronic pain. Novel opioid cessation interventions are needed in combination with methods of addressing individual challenges and barriers to adequate pain relief including access to and provision of nonopioid alternatives for pain management.