bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asymmetric Distribution of Visual Evoked Potentials in Patients with Migraine with Aura during the Interictal Phase
Authors: Coppola G. , Parisi V. , Fiermonte G. , Restuccia R. , Pierelli F. 
Published: January 2018

Purpose One of the most commonly described electrocortical phenomena in patients with migraine is an increased interhemispheric asymmetry, in response to different sensory stimuli. This study aims to evaluate the bioelectrical activity of both occipital cortices in patients with migraine with visual aura (MA) during the interictal period, and its possible relationship with visual symptoms. Methods The authors recorded visual evoked potentials (VEPs) simultaneously from the left (O1) and right (O2) occipital cortices (80% contrast 60′, 30′, 15′, and 7.5' checkerboard stimuli reversed at 2 Hz) in 22 patients with MA and 20 control subjects. The main outcome measure was interhemispheric asymmetry (IA) for both implicit time and amplitude, defined as the difference between the left and right scalp derivation (in absolute values). Results IA was significantly different in patients with MA with respect to controls when employing 60′ (p<0.001) and 15′ (p<0.05) checkerboard stimuli for implicit times, and 60′ (p<0.05) checkerboard stimuli for amplitudes. On the other hand, IA was not statistically different (p>0.05) in patients with MA with respect to controls when employing 30' and 7.5' checkerboards for both implicit times and amplitudes, and 15' checkerboards for amplitudes. No correlations were found between IA and age, onset of disease, attack frequency, or side of headache/aura. Conclusions Patients with MA presented asymmetries in VEP responses not related to visual aura or to headache side during the pain-free phase. These abnormalities may be ascribed to abnormal visual information processing, resulting in a different cortical activation when both foveal and parafoveal stimuli are used.
Rituximab Effectively Reverses Papilledema Associated with Cerebral Venous Sinus Thrombosis in Antiphospholipid Antibody Syndrome
Authors: Chalam K.V. , Gupta S.K. , Agarwal S. 
Published: January 2018

Purpose A case of bilateral papilledema secondary to cerebral venous sinus thrombosis treated with Rituximab, an anti-CD20 monoclonal antibody. Methods A 23 year old obese female with a one week history of blurred vision, headaches and vomiting presented with bilateral papilledema. Her BCVA was 20/50 in right eye and 20/200 in the left eye with severe reduction of visual fields. Laboratory investigations revealed thrombocytopenia, prolonged prothrombin time (not reversed when mixed with normal plasma) and anticardiolipin antibodies. Besides, cerebral angiogram showed presence of cerebral venous thrombosis. The patient was diagnosed to have anti phospholipid antibody syndrome and treated with rituximab I.V. 375 mg/m 2 weekly x 4 doses, acetazolamide 500 mg BID, methyl prednisolone I. V. QID x 4. Results At 1-month, her headaches and vision improved to 20/30 in both eyes with partial resolution of papilledema and complete restoration of visual fields. Nine months later, patient had 20/25 vision in right eye and 20/30 in left eye with complete resolution of papilledema and cerebral sinus thrombosis. Conclusions Rituximab was effective in reversing papilledema and cerebral sinus thrombosis, while preserving the vision in patient with antiphospholipid antibody syndrome. It is efficacious in treating papilledema in patients refractory to treatment with systemic steroids and immunoglobulin, with better clinical compliance and no side effects.
Clinical Features, Complications, and Incidence of Intraoperative Floppy Iris Syndrome in Patients Taking Tamsulosin
Authors: Takmaz T. , Can İ. 
Published: January 2018

Purpose To evaluate the intraoperative findings, complication rates, effect of intracameral adrenaline, and incidence of intraoperative floppy iris syndrome (IFIS) in patients using tamsulosin. Methods In this prospective nonrandomized observational study, 858 eyes of 774 patients who had phacoemulsification between August 2005 and November 2006 were evaluated. Duration and preoperatively discontinuing time of tamsulosin intake were questioned. Preoperative pupil size, intraoperative iris behavior, progressive miosis, adrenalin usage, and complications were recorded. Results The incidence of IFIS was 1.6% and IFIS was seen in 14 of the 18 eyes of patients using tamsulosin (77.8%). One eye had floppy iris only, 2 eyes had floppy iris and intraoperative miosis, 3 eyes had floppy iris and iris prolapse, and 8 eyes had all three signs of IFIS. IFIS was seen in 7 of the 10 eyes where intracameral adrenaline was used, and in 7 of the 8 eyes without adrenaline (p=0.588). Intraoperative miosis was seen only in 3 of the 10 eyes with adrenaline and in 7 of the 8 eyes without adrenaline (p=0.025). Posterior capsule rupture occurred in 1 of the eyes with IFIS and in 5 eyes focal iris stromal atrophy caused by prolapse was seen. Conclusions IFIS occurred in 1.6% of cases having phacoemulsification. Intracameral adrenaline usage did not change the IFIS occurrence rate, but it seemed to be effective in preventing intraoperative miosis. There are still many questions about IFIS, and there is need for future studies strengthening the understanding of IFIS.
Pre- and Postoperative C-Reactive Protein Levels in Patients with Cataract and Age-Related Macular Degeneration
Authors: Zaliuniene D. , Paunksnis A. , Gustiene O. , Brazdzionyte J. , Zaliunas R. 
Published: January 2018

Purpose To assess whether patients with early or intermediate forms of age-related macular degeneration (AMD) benefit from cataract surgery in terms of visual acuity and contrast sensitivity, and to determine the levels of high sensitivity C-reactive protein (hsCRP) as a systemic marker of inflammation before and after cataract surgery in patients with AMD. Methods Three groups of patients (n=132) were studied at baseline and 8–12 weeks later: 1) a study group of patients with AMD who underwent cataract surgery (n=47), 2) a control group of patients without ocular comorbidities who underwent cataract surgery (n=36), and 3) a second control group with AMD and no surgery (n=49). Visual acuity (VA) was obtained by letter charts and expressed as decimal notations ± SD. Contrast sensitivity was measured employing a Ginsburg Box, VSCR-CST-6500. The hsCRP was measured by means of particle enhanced immunonephelometry on a BN Systems. Results Postoperatively in both groups of the operated patients an improvement of VA (0.23±0.17 vs 0.64±0.25 and 0.23±0.18 vs 0.83±0.17, respectively, p<0.0001) and contrast sensitivity (at different spatial frequencies, from 1.5 to 18 cycles/degree, p<0.05) was determined. At baseline, the hsCRP level in Group 1 patients was higher than the level in controls (2.67±2.36 vs 1.67±1.36, p<0.01, or 1.12±0.99 mg/L, p<0.0001, respectively). After 8–12 weeks, the hsCRB level only in Group 1 significantly increased (2.67±2.36 vs 3.74±3.54 mg/L, p<0.05), whereas in the controls it did not change. Conclusions Patients with AMD benefit from cataract surgery, both in terms of VA and contrast sensitivity. The level of hsCRP is significantly higher in patients with AMD and moderate cataract than in patients with one of these eye disorders. The hsCRP only increases after cataract surgery in patients with AMD.
Increased Vascular Endothelial Growth Factor Levels in Aqueous Humor and Serum of Patients with Quiescent Uveitis
Authors: Paroli M.P. , Teodori C. , D'alessandro M. , Mariani P. , Iannucci G. , Paroli M. 
Published: January 2018

Purpose Vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) are angiogenic mediators that share a significant proinflammatory activity. Both substances have been suggested to play a key role in uveitis pathogenesis. The authors analyzed VEGF and IL-8 levels in the aqueous humor and serum of patients with different types of uveitis during a quiet phase of the disease. Methods Thirteen patients with intermediate uveitis, uveitis associated with ankylosing spondylitis, Vogt-Koyanagi-Harada disease, Fuchs uveitis syndrome, idiopathic chronic anterior uveitis, or Behçet disease, as well as 10 normal matched subjects, were included in the study. VEGF and IL-8 concentrations were measured in aqueous humor and serum by enzyme-linked immunosorbent assay. Results VEGF levels were significantly higher in both the aqueous humor and serum of patients with uveitis as compared with controls. IL-8 concentrations in aqueous humor were significantly higher in patients with uveitis with extraocular manifestations than in those with eye-limited disease. Conclusions These findings suggest that VEGF plays a role in uveitis pathogenesis even during inactive disease and that IL-8 levels are significantly influenced by the presence of uveitis-associated extraocular changes.
Extended Silicone Oil Tamponade in Primary Vitrectomy for Complex Retinal Detachment in Proliferative Diabetic Retinopathy: A Long-Term Follow-Up Study
Authors: Shen Yun-Dun , Yang Chung-May 
Published: January 2018

Purpose To investigate long-term anatomic and functional results of extended silicone oil (SO) tamponade in primary vitrectomy for patients with proliferative diabetic retinopathy (PDR) and complex retinal detachment (RD). Methods From January 1999 to June 2005, clinical records of consecutive patients with PDR who underwent primary vitrectomy with extended SO tamponade for complex RD were retrospectively reviewed. Main outcome measures included anatomic outcome, functional outcome, and postoperative complications. Statistical analyses were used to determine factors affecting anatomic and functional outcomes and to evaluate the potential adverse effects on vision from long-term oil tamponade. Results Fifty-four eyes of 45 patients (18 male and 27 female) were included in this series. All patients underwent follow-up ≥12 months (28.2±15.1 months; range: 12 to 69 months). Anatomic success was achieved in 85.2% at the third month postoperatively and 83.3% at last follow-up. Breaks with adjacent unreleased traction was identified as the only variable associated with final anatomic success (OR=0.173, p=0.024). Best-corrected visual acuity (BCVA) improved or remained unchanged in 89% at the third month postoperatively and in 78% at last follow-up. Ambulatory vision was achieved in 41% at the third month postoperative and 44% at last follow-up. Preoperative BCVA was identified as the only variable statistically associated with final BCVA (p<0.001) (multivariate analysis). The change of BCVA from the third month to last follow-up has no correlation with follow-up duration in the 45 eyes with final anatomic success (Pearson correlation coefficient = −0.022, p=0.888). Postoperative complications included peri-silicone oil proliferation in 4 eyes, neovascular glaucoma in 4 eyes, oil migration into anterior chamber in 9 eyes, and pupillary-block induced IOP elevation in 5 eyes. Conclusions Prolonged SO tamponade may provide anatomic success and functional stability after primary diabetic vitrectomy. Significant complications compromising visual prognosis were uncommon with prolonged SO tamponade.
Squamous Cell Carcinoma Presenting as an Orbital Cyst with Radiologic Evidence of Perineural Invasion
Authors: Limawararut V. , Hoyama E. , Selva D. , Davis G. 
Published: January 2018

Purpose To report clinical and radiologic findings of cystic squamous cell carcinoma (SCC) of the orbit with evidence of perineural involvement. Methods Analysis of clinical findings and radiology with a literature review. Results A 66-year-old man with SCC of the forehead 8 years prior presented with paresthesias, diplopia, and proptosis. Magnetic resonance imaging showed a well-defined, cystic mass of the orbit with a single, linear structure running through its center. Lateral orbitotomy revealed a cyst adherent to adjacent periorbita containing viscous, clear, yellow substance and a nerve coursing through the center. Histopathology confirmed poorly differentiated spindle cell carcinoma with positive staining for cytokeratin markers, consistent with SCC. Conclusions Orbital cysts associated with altered sensation are suggestive of SCC with perineural spread, requiring prompt investigation and treatment to minimize morbidity and mortality. The involved nerve may be seen as a single, linear structure within the mass on imaging.
Retinal Pigment Epithelial Tears after Intravitreal Bevacizumab Injection for Predominantly Classic Choroidal Neovascularization
Authors: Arias L. , Caminal J.M. , Rubio M. , Pujol O. , Arruga J. 
Published: January 2018

Purpose To detect retinal pigment epithelium (RPE) tears in predominantly classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) treated with intravitreal bevacizumab injections. Methods Forty consecutive patients with predominantly classic CNV secondary to AMD were treated with 1.25 mg of intravitreal bevacizumab. Patients were evaluated with visual acuity (VA) measured with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography, and fluorescein angiography. Results Three patients developed a RPE tear after the first injection. The first patient had been treated with verteporfin therapy and VA remained unchanged. In the other two cases the CNV was naïve and VA improved since the foveal center was not involved by the tear and macular edema was reduced. Conclusions RPE tears can occur following intravitreal bevacizumab injections in patients with predominantly classic CNV although VA is not always affected.
Evaluation of Transforming Growth Factor and Vascular Endothelial Growth Factor Polymorphisms in Taiwan Chinese Patients with Pterygium
Authors: Bau D.-T. , Chiang C.-C. , Tsai Y.-Y. , Lee C.-C. , Tsai Y. , Lin C.-C. , Tsai C.-H. , Tsai F.-J. 
Published: January 2018

Purpose Pterygium is an invasive and highly vascularized growth, thought to arise from activated and proliferating limbal epithelial stem cells. Epidemiologic studies have found the increase of active angiogenic and epithelial growth factors in pterygia, and implicated that these molecules could be involved directly or indirectly in the pathogenesis of pterygia as causative factors. The aim of this study was to investigate the association of polymorphisms of transforming growth factor (TGF) and vascular endothelial growth factor (VEGF) with pterygium. Methods A total of 133 pterygium patients and 105 volunteers without pterygium were enrolled in this study. Polymerase chain reaction based restriction fragment length polymorphism analysis was used to resolve the TGF-β1–509 and VEGF-460 genotypes. Results There was no significant difference in the allele frequency or genotype of TGF-β1–509 or VEGF-460 between total pterygium and the control group. No interaction between TGF-β1–509 and VEGF-460 was found either. Conclusions These results indicate that TGF-β1–509 and VEGF-460 polymorphisms were not highly associated with the pathology of pterygium. However, it may still be worthwhile to continue to search for angiogenic gene polymorphisms in order to predict the development of pterygium.
Is the PASCAL®-Tonometer Suitable for Measuring Intraocular Pressure in Clinical Routine? Long- and Short-Term Reproducibility of Dynamic Contour Tonometry
Authors: Herdener S. , Hafizovic D. , Pache M. , Lautebach S. , Funk J. 
Published: January 2018

Purpose Dynamic contour tonometry (DCT) is a new technique to measure intraocular pressure (IOP). In several studies no correlation between IOP values and corneal thickness was shown with DCT. This is in contrast to the gold standard, Goldmann applanation tonometry (GAT). The authors evaluated the reproducibility (RP) of DCT compared to GAT, a prerequisite for its introduction into clinical routine. Methods IOP was measured with both DCT and GAT in 50 subjects with normal cornea. To evaluate the short-term RP, four DCT and four GAT measurements were performed at day 1 in a randomized order. Long-term RP was determined by one additional measurement per method at day 2, 5, and 8. Results The short-term RP was defined as the mean value of all standard deviations (SD) of the individual measurements at day 1. Short-term RP was 1.1 mmHg for GAT and 1.2 mmHg for DCT. For long-term reproducibility, mean SD was 1.2 mmHg for GAT and 1.5 mmHg for DCT. Bland-Altman revealed a good agreement of the two methods. However, mean DCT values were on average 0.8±1.1 mmHg higher than GAT values. A significant correlation was observed between GAT and CCT (r2=0.15, p=0.006), but not between DCT and CCT (r2=0.032, p=0.21). Conclusions Short- and long-term reproducibility of DCT is comparable to that of GAT. GAT is more affected by CCT than DCT, measuring higher IOPs in eyes with higher central corneal thickness.
Physician Attitudes regarding Prostaglandin Treatment for Glaucoma in the United States and Europe
Authors: Stewart W.C. , Stewart J.A. , Nelson L.A. , Kruft B. 
Published: January 2018

Purpose To evaluate physician use of prostaglandins (latanoprost, travoprost, and bimatoprost) in the United States (US) and Europe (EU). Methods One thousand multiple-choice surveys were distributed via e-mail in the US and EU. Results The authors received 71 responses (US 40 [8%] and EU 31 [6%]). Physicians preferred prostaglandin monotherapy (US 39 [98%] and EU 22 [71%], p=0.003), usually latanoprost (US 32 [80%] and EU 22 [71%], p=0.45). When more efficacy was required, US physicians would typically switch (23 [58%]) and EU physicians would add therapy (22 [71%], p=0.007). In both continents 45% of respondents stated bimatoprost was more efficacious. Conclusions US and EU physicians prefer prostaglandin monotherapy, most commonly latanoprost. Bimatoprost is often perceived as more effective, but having a higher incidence of conjunctival hyperemia.
The Importance of Cyclotorsional Changes in Refractive Surgery
Authors: Laria C. , Gamio S. , Prieto-Diaz J. , Alió J.L. , Miranda M. , Plech A.R. 
Published: January 2018

Purpose To provide evidence of the importance of a precise record of torsional alterations in all patients about to undergo refractive surgery and particularly in patients with latent strabismus that may become decompensated due to the dissociation phenomenon produced during different surgical procedures that result in fixation loss. Methods Using 3D-VOG video-oculography, the authors analyzed the horizontal, vertical, and torsional movements of each eye after inducing fixation loss in one and both eyes in a patient with well-compensated dissociated vertical deviation (DVD). As the dissociated techniques, the authors used occlusion according to Posner maneuver and the placing of Bagolini filters with increasing densities by means of the Bielschowsky phenomenon, both pathognomonic of DVD. Results The authors observed not only horizontal and vertical alterations, but also cyclotorsional alterations which may even exceed 15° depending on the resulting dissociation component. Conclusions In view of the obtained results, the authors consider it important to conduct a meticulous study of ocular motility in all patients about to undergo refractive surgery, especially in the case of high astigmatism to rule out possible latent strabismus that may condition cyclotorsional alterations important in refractive surgery.
Penetrating Keratoplasty in a Newborn: Case Report and Analysis of Current Surgical Trends in Italy
Authors: Ricci B. , Coppola G. , Capobianco A. , Ziccardi L. 
Published: January 2018

Purpose The aims of this study were to describe bilateral penetrating keratoplasty (PK) in a newborn and to analyze the data of PKs performed in Italy during the 5-year period 1999–2003 in children under 4 years of age. Methods A male newborn had PK at age 3 months and 5 months for near-blindness secondary to severe congenital corneal clouding in both eyes. The infant's explanted corneas were subjected to histochemical and ultrastructural analyses. Data regarding the number of PKs performed in Italy on 0–4-year-olds were obtained from the Web site of the Italian Ministry of Health. Results The postoperative courses were uncomplicated, and 42 months of follow-up data show bilateral graft transparency and substantial improvement in visual acuity despite high-grade myopia and nystagmus. At the ultrastructural level, the main alterations involved the endothelial cells and Descemet membrane. A total of 45 PKs were performed in Italy on patients 0–4 years old from 1999 through 2003; only nine involved babies under 1 year of age. Conclusions In babies with congenital corneal opacities, early PK can reduce severe amblyopia. However, the risk of intra- and postoperative complications in PK is high. Based on the 42-month follow-up, the anatomic and functional results achieved in the current patient are satisfactory despite the presence of nystagmus and postoperative high-grade myopia. This study shows that PKs are rarely performed, in Italy, in children aged 0–4 years, and very few are done during the first year of life.
Is There Alteration in Aortic Stiffness in Leber Hereditary Optic Neuropathy?
Authors: Nemes A. , De Coo I.F.M. , Spruijt L. , Smeets H.J.M. , Chinnery P.F. , Soliman O.I.I. , Geleijnse M.L. , Ten Cate F.J. 
Published: January 2018

Purpose Leber hereditary optic neuropathy (LHON) is recognized as the most common cause of isolated blindness in young men. The current study was designed to test whether LHON as a mitochondrial disease is associated with vascular functional alterations characterized by aortic elastic properties during echocardiography. Methods A total of 19 patients with typical features of LHON aged 42±13 years (10 males) were included. Their results were compared to 19 age- and gender-matched healthy controls. Aortic stiffness index was calculated from the echocardiographically derived aortic diameters and the clinical blood pressure data. Results In this patient population, the point mutation was present in 3460G>A position in five cases, in 11778G>A position in five cases, and in 14484T>C position in nine patients. Diastolic aortic diameter (26.0±2.5 mm vs 28.4±4.1 mm, pp<0.05) and aortic stiffness index (5.1±2.6 vs 12.0±7.9, pp<0.05) were significantly increased in LHON patients compared to controls. Conclusions Aortic stiffness can be increased in LHON disease, but further studies are warranted to confirm these findings in a larger LHON patient population with a more reliable method focusing on the pathophysiologic background.