bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contact Transscleral Cyclophotocoagulation with Diode Laser in Refractory Glaucoma
Authors: Brancato R. , Carassa R. G. , Bettin P. , Fiori M. , Trabucchi G. 
Published: April 2018

Objective To evaluate the clinical effectiveness of contact transscleral cyclophotocoagulation (CTCP) with diode laser. Design and Patients Forty-eight seeing eyes and 20 blind and painful eyes of 68 patients suffering from refractory glaucoma were treated using a diode laser (EOS3000, Laser Science) coupled with a 400-μm optic fiber ending in a 3-mm focusing tip. Sixteen to twenty 3.9-J (2.6 W x 1.5 to 2.5 s) laser spots were placed over 360°, 1.5 mm from the corneolimbal junction. Results In the seeing-eye group, the follow-up was 20.7 ± 8.14 months, pre- and posttreat-ment lOPs were 37.1 ± 11.27 and 19.5 ± 8.73 mmHg respectively (p < 0.0001), and success (IOP > 2 and < 21 mmHg) was 70.8%. No significant visual acuity change was found in the successful eyes, whereas a significant visual acuity reduction was found in the unsuccessful cases (p=0.03). In the blind-eye group, the follow-up was 20.5 ± 8.54 months, pre- and post-treatment lOPs were 50.7 ± 15.05 and 20.6 ± 13.99 mmHg respectively (p < 0.0001), and success (remission of pain) was 100%. As for complications, one seeing eye developed a spontaneously-resolved vitreous hemorrhage and one seeing and one blind eye became hypotonic, though no phthysis was observed. No conjunctival or lens damage was detected, and no scleral thinning was revealed by ultrasound biomicroscopy. No case of sympathetic ophthalmia was found. Conclusions Diode laser can be successfully employed for CTCP in refractory glaucoma.
Factors Predisposing to Postoperative Intraocular Inflammation
Authors: Corbett M.C. , Hingorani M. , Boulton J.E. , Shilling J.S. 
Published: April 2018

This prospective study of 123 patients undergoing cataract extraction determined the preoperative and surgical factors predisposing to an exaggerated postoperative inflammatory response. It is important to identify the patients at increased risk of complications requiring additional prophylaxis or more intensive postoperative care, particularly when selecting patients for day case surgery. Previous intraocular inflammation or surgery was the factor most strongly associated with marked inflammation on the first postoperative day (p < 0.01, compared to uncomplicated patients). As a result, patients stayed in hospital an average of one day longer (p < 0.001) and required significantly more steroid drops (p < 0.001). Other factors of significance, but reducing importance were: difficult surgery, non-caucasian race and brown irides. Amongst uncomplicated patients, the difficulty of surgery was most significantly related to a high inflammation score (p < 0.01). Non-caucasian patients stayed in hospital significantly longer than their caucasian counterparts (p < 0.05), and required more steroid drops (p < 0.001). Of caucasian patients, those with brown irides were inpatients for significantly longer than those with blue or hazel (p < 0.05). No other factors studied significantly altered postoperative inflammation: neither the presence of diabetes, nor the technique of cataract extraction.
Morphological and Biochemical Assessment of the Cornea in a Gaucher Disease Carrier with Keratoconus
Authors: Salgado-Borges J. , Silva-Araújo A. , Lemos M.M. , Sá-Miranda M.C. , Abreu-Dias P. , Tavares M.A. 
Published: April 2018

Ocular abnormalities such as corneal opacities and some specific alterations in ocular movements have been described in the neuropathic forms of Gaucher disease. This study was designed to correlate the clinical, morphological and biochemical findings in the corneal button obtained after keratoplasty in a Gaucher disease carrier with keratoconus. Morphologically, the cornea showed keratocytes with marked dilatations of the rough endoplasmic reticulum and intracytoplasmic “dark inclusions”; the acidic lipid profiles presented alterations in the cornea of the Gaucher disease carrier when compared with healthy controls and a clear deficiency in ß-glucosidase activity was detected as well. Our data suggest that the cornea may serve as a good marker of an early target organ in lipid metabolism disorders such as Gaucher's disease.
PERG and P-VEP after Surgical Trabeculectomy in Primary Open-Angle Glaucoma
Authors: Spadea L. , Giuffrè I. , Bianco G. , Balestrazzi E. 
Published: April 2018

Pattern-reversal electroretinograms (PERG) and visual evoked potentials (P-VEP) were measured for 10 eyes from 10 rigorously selected patients with bilateral advanced primary open angle glaucoma (POAG), before and after surgical trabeculectomy. The aim was to establish whether electrofunctional examinations improved after major IOP reduction. Only one eye at random was operated, and the fellow eye was used as control. The aim of this study, using electrofunctional examinations, was to clarify whether ganglion cell damage was reversible after marked reduction of IOP by surgery. The results indicate that glaucomatous damage seems to be irreversible.
Drug Induced Myopia Associated with Treatment for Gynecological Problems
Authors: Grinbaum A. , Ashkenazi I. , Avni I. 
Published: April 2018

We present three cases of women who developed acute transient myopia caused by drugs for gynecological problems. One patient was treated with disothiazide for premenstrual edema. The second had acute cystitis and was treated by sulphonamide and the third developed myopia coincident with metronidazole treatment for trichomonas vaginalis. We followed these patients by A scan ultrasonographic ocular measurements, documenting reduction of the anterior chamber depth combined with lens thickening. The ocular and myopic changes cleared up completely on discontinuation of the causative agent. The possible mechanism is thought to be an allergic reaction to the drug.
The Human Corneal Endothelium after Myopic Excimer Laser Photorefractive Keratectomy. Immediate to One-Month Follow-Up
Authors: Carones F. , Brancato R. , Venturi E. , Vigo L. 
Published: April 2018

Purpose To assess whether excimer laser photorefractive keratectomy for myopia (PRK) induced any changes in the human corneal endothelium in the immediate postoperative period and up to one month after surgery. Methods No-contact wide-field sp>ecular biomicroscopy of the central corneal endothelium was performed on 56 eyes of 56 patients (age 20-54 years, mean 31.3) who underwent photorefractive keratectomy for the correction of myopia ranging between 1.25 and 12.50 D (5.71 ± 2.96 D, mean ± SD). Images of the endothelium were obtained using the NonCon Robo endothelial biomicroscope (Konan, Hyogo, Japan), and processed to calculate the mean cell density (MCD), the coefficient of variation of cell area (CV), and the percentage of hexagonal cells (Hex%). Eyes were evaluated immediately before (preop) and after surgery (day 0), on the first two postoperative days (days 1 and 2), and after one month. Results MCD was 2645 ± 344 cells/mm2 at preop, 2609 ± 293 cells/mm2 on day 0, 2681 ± 320 cells/mm2 on day 1, 2629 ± 305 cells/mm2 on day 2, and 2709 ± 308 cells/mm2 at one month; a significant difference was found only comparing preoperative to one month data (p= 0.009). CV was 31.6 ± 4.7 at preop, 39 ± 7.1 on day 0 (p= 0.000001), 37.1 ± 7.8 on day 1 (p= 0.00005), 43.4 ± 13.1 on day 2 (p= 0.000001), and 34.7 ± 5.8 on one month (p=0.0006). Hex% was 61.9 ± 7.1 at preop, 58 ± 7.3 on day 0 (p= 0.002), 58.5 ± 8.5 on day 1 (p= 0.015), 57.1 ± 8.5 on day 2 (p= 0.00004), and 59.3 ± 7.5 at one month (p= 0.002). No correlations were found between ablation depth and endothelial changes. Conclusions Endothelial cell density was not reduced by PRK in the immediate postoperative period. Changes in morphological indices like CV and Hex% indicate that the photoablation causes some kind of damage to the endothelial cells.
Screening for Tamoxifen Ocular Toxicity: A Prospective Study
Authors: Therssen R. , Jansen E. , Leys A. , Rutten J. , Meyskens J. 
Published: April 2018

Specific ocular complications, namely retinopathy, keratopathy and optic neuritis, have been described in women being treated with tamoxifen for metastatic breast cancer or taking this drug as an adjuvant postoperative therapy. We examined 61 patients who had been using tamoxifen for at least one year, in order to detect the incidence of ocular complications. Two patients had retinopathy after having taken high cumulative doses of tamoxifen. Another had corneal deposits and a fourth had optic neuritis. It thus appears that systematic screening of all symptom-free patients using this drug for metastatic breast cancer is superfluous. However, an ophthalmological assessment every two years or earlier in case of visual complaints for patients taking tamoxifen as an adjuvant therapy remains useful, because the oncological therapy can be adjusted if serious ocular complications arise.
Fluorescence Histochemical Demonstration of Adrenergic Terminations in the Human Choroid
Authors: Nuzzi R. , Guglielmone R. , Grignolo F.M. 
Published: April 2018

With the existing literature on the aspects of anatomic and physiological ocular choroid membrane variables in mind, the authors verify the possibility of applying the methods of Axelsson et al and of Lindvall and Bjorklund, as simplified by Furness and Costa for fluorescent microscopy, to the study of human choroid nerve topographic distribution. The material for the study was obtained from three human eyeballs, two enucleated because of malignant melanoma of the choroid and one because of neoplasia of the ciliary body. A binocular dissecting microscope was used. A fluorescent microscope was used to observe the histological specimens and photographs were taken. The following results are presented and discussed: 1) the fluorescent paravascular nervous fibres and periarterial nervous plexuses divided into preterminal and terminal fibres; 2) in the suprachoroidal layer, there were small groups of polygonal nervous branches with or without this connection; 3) the most intervasal plexus development was in the posterior part of the vascular layer with preterminal and terminal fibres, 4) in the intervascular space, melanocytes and free adrenergic nervous terminations were observed; 5) adrenergic fibres were not observed in the choriocapillaris of the choroid membrane; 6) there were adrenergic neurons in the vascular layer.
Ocular Blood Flow Velocities in Patients with Proliferative Diabetic Retinopathy before and after Scatter Photocoagulation: A Prospective Study
Authors: Mendívil A. , Cuartero V. , Mendívil M.P. 
Published: April 2018

Introduction Color Doppler imaging allows for simultaneous two-dimensional anatomical imaging and Doppler measurement of blood flow velocity. Chemicals are released during the development of a thermal lesion caused by photocoagulation. Methods A prospective study compared ocular blood flow velocities (ophthalmic artery, posterior ciliary arteries, central retinal artery, central retinal vein and vortex veins) before and 30 minutes after the first episode of scatter photocoagulation (650, 0.1 s, 500 micron argon laser) in 25 patients with proliferative diabetic retinopathy, using a color Doppler imaging unit (Toshiba Sonolayer SSA-270 A with a 5.0 MHz PLF-503 ST phased-array scanning head). Results Systolic, diastolic and mean arterial blood flow velocities were higher after photocoagulation than before. There was a significant difference in the ophthalmic artery; diastolic (P<0.01), mean velocity (P<0.05), posterior ciliary arteries; systolic (P<0.01), diastolic (P<0.001), mean velocity (P<0.05), central retinal artery; mean velocity (P<0.05), central retinal vein; systolic (P<0.001) and vortex veins; systolic (P<0.01), diastolic (P<0.01). Ophthalmic artery systolic and end-diastolic velocities declined with age in diabetic patients before scatter photocoagulation; these changes were not significant (systolic: r= −0.33, diastolic: r= −0.30). Discussion During and after thermal lesion caused by photocoagulation, there is a dynamic inflammatory and an autoregulatory response of the retinal circulation, causing changes in the ocular circulation.
Syphilitic Interstitial Keratitis with Bilateral Funnel-Shaped Iridocorneal Adhesions a Case Report
Authors: Ruusuvaara P. , Setälä K. , Kivelä T. 
Published: April 2018

We present the clinical and light microscopic ophthalmological findings in a 60-year-old woman with bilateral, symmetrical, paracentral anterior synechia formation and healed, old, inactive interstitial keratitis, probably secondary to congenital syphilis. The patient underwent ECCE and IOL implantation in the left eye and a triple procedure (corneal transplantation, ECCE and IOL) in the right eye. Gonioscopy, fluorescein angiography and light microscopy of a specimen from the triple procedure revealed a fibrovascular connection between the iris and cornea. The etiology of the funnel-shaped bilateral iridocorneal synechiae is discussed.
Computer Assisted Image Analysis Using the Subtraction Method in Indocyanine Green Angiography
Authors: Miki T. , Shiraki K. , Kohno T. , Moriwaki M. , Obana A. 
Published: April 2018

The choroidal vessels are three dimensionally distributed and very complex in their patterns. They often appear to be overlaid in indocyanine green (ICG) angiograms so it is harder to analyze ICG angiography than fluorescein angiography. When an earlier frame is subtracted from a later frame in a sequence of angiograms, the fluorescence which has increased during the time between the two frames can theoretically be demonstrated. We applied computer-assisted image subtraction methods in selected clinical cases of directly acquired digital ICG angiography to demonstrate how this method works. We used software already installed in an IMAGEnet computer system (Topcon) for image subtraction. We applied the subtraction technique in 18 cases with various diseases. When two images with a time difference of several seconds were subtracted, filling of the choriocapillaris, the neovascularization or the pathological vessels could be observed. When the images had a time difference of several minutes, intrachoroidal dye leakage could be seen more clearly. This method is very helpful for analyzing pathological changes in ICG angiography in clinical cases, when two images are selected appropriately.
Vitreous Changes and Retinal Detachment in Highly Myopic Eyes
Authors: Stirpe M. , Heimann K. 
Published: April 2018

This report on 496 highly myopic eyes that underwent transcleral or vitreoretinal surgery for retinal detachment (RD) focuses particularly on how changes in the vitreous gel and the resulting modifications of the vitreoretinal interface produce typical characteristics and complications. According to the pattern of vitreous modifications the 496 eyes were divided into five groups: 1) eyes with uniform PVD (108 eyes) 2) eyes with PVD spreading towards the upper quadrants (231 eyes) 3) eyes with extensive vitreous liquefaction (EVL) and condensations of the vitreous base (51 eyes) 4) eyes with posterior vitreous lacuna (PVL, 87 eyes) 5) eyes with very limited PVD (19 eyes). Age, degree of myopia, surgical procedures and final results are reported for each group. A strong correlation was observed between vitreous changes and clinical picture of RD especially in the group of PVL and EVL. In the PVL group a higher degree of myopia was found and more pronounced posterior staphyloma. Frequently the posterior hyaloid, in the form of a thin, extremely smooth membrane, was hard to separate from the inner posterior retina during surgery. Posterior retinal breaks, including macular holes, were found in 56% of eyes. The presence of EVL with condensation of the vitreous base was correlated with giant retinal tear (GRT) in 70% of cases (36 of 51 eyes). Sixteen GRT were also found in the group of uniform PVD, but these were less extensive and located more posteriorly than in the EVL group. In the former group there were better surgical results because of a lower incidence of PVR. In 46% of the eyes of our series (group 2), PVD extended mostly in the upper quadrants with no vitreous detachment inferiorly. In these cases there was a clinical appearance of inferior vitreous collapse. These eyes had 92% of peripheral superior retinal breaks. Relapses of RD in this group almost invariably occurred in the inferior quadrants.
Homonymous Bilateral Hemianopsia: Electrophysiological Study of a Case
Authors: Magni R. , Reni G. , Rinaldi G. , Ravalico G. , Brancato R. 
Published: April 2018

Described is a case of bilateral homonymous hemianopsia with macular sparing, resulting from head trauma. The case presented lesions of the occipital visual areas which involved entirely the left hemisphere and only partially the right hemisphere. VEP were obtainable only from electrodes placed on the right hemisphere with both right eye and left eye stimulation. VEP mapping showed that each eye projects macular fibres towards functional areas of the right occipital hemisphere. Electrophysiological examination confirmed objectively and for the first time in man the theory of “double cortical macular representation”. Clinical implications of this finding are discussed.
One Quadrant Sub-Tenon's Capsule Anesthesia in Anterior Segment Surgery
Authors: Kapran Z. , Uyar M. , Eltutar K. , Dinçer N. 
Published: April 2018

Reports of complications associated with local anesthesia in ophthalmic surgery have increased conspicuously in recent years. Sub-Tenon's capsule anesthesia for anterior segment surgery avoids the risks of retrobulbar and peribulbar injections. This study compared sub-Tenon's and retrobulbar anesthesia. Patients undergoing various anterior segment surgery were randomly assigned to sub-Tenon's or retrobulbar anesthesia; 300 were operated with 1-quadrant sub-Tenon's anesthesia (1-QST) and the results were compared with 270 patients operated with retrobulbar anesthesia. Retrobulbar anesthesia consisted of a 2.5 ml injection of a 1: 1 mixture of 2% lidocaine without epinephrine and 0.5% bupivacaine. Sub-Tenon's anesthesia involved direct transconjunctival infiltration of the same local anesthetic directly into the sub-Tenon's space, in the inferior-nasal quadrant, using a blunt 23-gauge cannula. Patients undergoing various anterior segment surgery procedures were randomly assigned to 1-QST or retrobulbar anesthesia; 300 patients were operated with 1-QST and the results were compared with 270 patients operated with retrobulbar anesthesia. Preinjection mean (±SD) IOP were 12.9±3.7 mmHg in the retrobulbar and 13.4±3.2 mmHg in the 1-QST patients. Preoperative intraocular pressures were 8.7±3.0 mmHg in the retrobulbar and 9.2±3.2 mmHg in 1-QST patients. Pre- and postinjection IOP for retrobulbar and 1-QST patients were similar. Pain scores for delivery of the anesthetic, using a numerical rating scale, produced a median score of 1 for 1-QST and 2 for the retrobulbar technique. For the subsequent operative procedure, the median score was 1 for 1-QST and 2 for the retrobulbar patients. Complete akinesia was achieved in 41% with 1-QST and in 69% of retrobulbar patients. 1-QST patients with incomplete akinesia most often had lateral muscle function which did not interfere with the operation. We found the use of a blunt cannula to deliver anesthetic into the sub-Tenon's space as a simple, safe and effective alternative approach to traditional retrobulbar anesthesia in anterior segment surgery.
Reopening of Failed Trabeculectomies with Ab Interno Nd: Yag Laser
Authors: Kandarakis A. , Mitropoulos P. , Angelou M. , Dikidou M. , Amariotakis A. 
Published: April 2018

Purpose To test the efficacy of ab interno Nd:YAG laser in reopening closed trabeculectomies and to specify the factors influencing the success or failure of the revision. Methods 27 patients underwent ab interno revision of their failed trabeculectomies with a Q switched, single-shot Cooper Vision 2500 Nd:YAG laser. The cause of obstruction was iris in 12 patients, transparent membrane in sclerectomy in 8 and fibrosis of the scleral flap in the remaining 7. The pre-laser IOP ranged from 28 to 40 mmHg, the patients’ ages from 42 to 75 years and the time between the trabeculectomy failure and the revision from 3 to 17 months. The total energy given to each eye per session, using a gonioscope, ranged from 30 to 1185 mj. Results Post-laser follow-up ranged from 6 to 32 months. IOP was controlled in 20 of 27 cases. Conclusions We believe that factors influencing the success of the revision are the patient's age, the kind and location of the obstacle and the time elapsed between the failure of the trabeculectomy and the Nd:YAG revision.
Morbidity of Malignant Tumours with Ocular Location in the Bulgarian District of Plovdiv
Authors: Atanassova-Chilova B.K. 
Published: April 2018

Purpose To study the actual and standardized morbidity of malignant tumours with ocular location (per 100,000 inhabitants) over a period of ten years. Methods Retrospective evaluation of the registers of the Plovdiv District Oncology Centre and the Department of Ophthalmology in the Medical University. It includes 698 patients grouped according to the International Classification of Diseases. We used the method of standardization (world standard). Results The highest is the actual and standardized morbidity of carcinoma of the eyelid, followed by eyeball tumours and the lowest is malignant melanoma of the eyelids. The standardized morbidity of eyelid carcinoma is significantly higher for males and the rural population. There is no significant difference between epi- and intrabulbar morbidity (from the group of the tumours affecting the eyeball). The rural population suffers more from epibulbar and the urban population from intrabulbar malignant tumours. Conclusions The morbidity of malignant tumours of the eyes is relatively low but it has clinical importance because these tumors may lead to blindness and death.
Intravitreal and Systemic Foscarnet in the Treatment of Aids-Related Cmv Retinitis
Authors: Tognon M.S. , Turrini B. , Masiero G. , Scaggiante R. , Cadrobbi P. , Baldanti F. , Gerna G. , Secchi A.G. 
Published: April 2018

Cytomegalovirus retinitis is the most frequent ocular opportunistic infection in AIDS patients. Untreated, it is always a progressive and destructive disease of the retina that results in blindness. Specific treatment is therefore mandatory to halt the progression of the retinal lesions. The authors report their experience in the treatment of CMV retinitis with foscarnet in 25 AIDS patients; the drug is an analog of pyrophosphate, virostatic against all herpes-class viruses including CMV. Foscarnet was successful in halting the progression of CMV retinitis during induction treatment (180 mg/kg/day) by either a TID (three times a day) or a BID (twice a day) regimen, and in healing retinal lesions during maintenance (90 mg/kg/day) in 14 out of 19 patients. Five patients had a relapse of retinitis during maintenance. In these patients a brief course of intravitreal foscarnet, in association with the lowest dosage of the drug administered systematically (90 mg/kg/day), was effective in healing the retinal lesions. The main systemic side effects, such as renal impairment and electrolytic disturbances, were observed only during the induction treatment, and only in one case was it necessary to stop the therapy.