bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macula off Retinal Detachments. how Long Can They Wait before it is Too Late
Authors: Mowatt L. , Shun-Shin G.A. , Arora S. , Price N. 
Published: January 2018

Purpose To determine the association between the duration of macula off detachment and the visual outcome following corrective surgery. Methods Retrospective review of the medical records of patients who underwent surgery for macula off detachment over a 5 year period (April 1994– March 1999). Results There were 104 patients in the study. Patients with macula off detachments wait a mean of 2.6 weeks (±0.3 SE mean) before presentation and 1.8 weeks (±0.2 SE of mean) thereafter before surgery. The mean duration of detachment prior to surgical repair was 4.2 weeks (±0.3 SE mean). 78% of patients achieved a postoperative improvement in visual acuity. 36.5% achieved functional visual success of 6/12 at 3 months, which increased to 51% at final discharge. There was no significant difference in visual outcomes for patient undergoing internal vs external procedures (p=0.188). The preoperative visual acuity was the most significant predictor of post operative visual acuity (p<0.0005). Less than 40% of macula off detachments of =6 weeks duration will achieve a vision of 6/12 or better compared with 68.2% of patients with macula off detachments of ≤1 week. Conclusions The best mean postoperative vision (LogMAR 0.35) was seen in patients with detachment of <1 week duration. Patients <60 years are more likely to achieve visual improvement despite the duration of the detachment. Macula off detachments of >6 weeks duration have a significantly poor postoperative visual prognosis. Awareness of this visual prognosis can assist in planning the timing of surgery to ensure an acceptable result.
Rhodotorula Rubra Keratitis and Melting after Repeated Penetrating Keratoplasty
Authors: Lifshitz T. , Levy J. 
Published: January 2018

Purpose To describe a rare case of Rhodotorula rubra keratitis in a corneal graft, and to discuss the management of this unusual pathogen. Methods A 78-year-old debilitated man was treated for corneal abscess and descemetocele in his right eye. Urgent penetrating keratoplasty (PKP) with old donor material was performed. The patient underwent a new PKP when appropriate donor cornea was available. The graft was clear after the operation. Corneal cultures were negative. Results One month after the second PKP procedure, deep stromal infiltrate with hypopyon appeared. Cultures grew R. rubra. A third PKP operation was performed. Systemic and topical amphotericin B treatment was started. Six months after the last operation the graft remains clear. Conclusions Rhodotorula keratitis is an extremely rare infection that should be considered in debilitated patients with persistent and progressive corneal infection despite adequate antibiotic therapy.
Ocular Manifestations in Patients with Microscopic Polyangiitis
Authors: Mihara M. , Hayasaka S. , Watanabe K. , Kitagawa K. , Hayasaka Y. 
Published: January 2018

Purpose To describe ocular manifestations in patients with microscopic polyangiitis. Methods Two patients with microscopic polyangiitis complained of ocular symptoms and underwent ophthalmologic examinations. Results An 83-year-old woman (Case 1) was diagnosed with microscopic polyangiitis, according to the general clinical findings and the presence of perinuclear pattern of antineutrophil cytoplasmic antibodies (P-ANCA). She had hypopyon iridocyclitis in the right eye and retinal cotton-wool spots in the left eye. The patient was treated with oral prednisolone and subconjunctival betamethasone. The hypopyon iridocyclitis and retinal cotton-wool spots responded. A 79-year-old man (Case 2) had bilateral scleritis. The diagnosis of microscopic polyangiitis was made based on general clinical findings and the presence of P-ANCA. Scleritis was reduced after corticosteroid treatment. Conclusions Ophthalmologists should be aware that hypopyon iridocyclitis, cotton-wool spot, and scleritis could occur in patients with microscopic polyangiitis.
Optical Coherence Tomography and Fundus Microperimetry Imaging of Spontaneous Closure of Traumatic Macular Hole: A Case Report
Authors: Carpineto P. , Ciancaglini M. , Aharrh-Gnama A. , Agnifili L. , Cerulli A.M. , Cirone D. , Mastropasqua L. 
Published: January 2018

Purpose To report a case of spontaneous closure of traumatic macular hole in a young patient followed using optical coherence tomography (OCT) and fundus microperimetry. Methods/Results In the right eye of a 10-year-old child, a traumatic macular hole was observed to spontaneously resolve 18 weeks after blunt trauma. Initially, visual acuity in the right eye was 20/200 and OCT examination showed a 200üm-diameter full-thickness macular hole with perifoveal edema. Fundus microperimetry examination showed an evident decrease in retinal sensitivity within the macular hole and in the upper macular region where an area of commotio retinae was clearly visible. During follow-up OCT demonstrated the appearance of a band of tissue linking the inferior edge of the hole to the foveal retinal pigment epithelium and at the bottom of the hole the presence of hyperreflective (glial) material. Eighteen weeks after trauma right eye visual acuity had improved to 20/25, OCT examination showed a restored foveal depression, and fundus microperimetry demonstrated an increase in foveal sensitivity. Conclusions Both OCT and fundus microperimetry were useful tools for following the favorable course in a case of spontaneous closure of traumatic macular hole in a young patient. During follow-up OCT examinations were able to demonstrate the course of macular hole closure.
Viscocanalostomy with Mitomycin-C: A Preliminary Study
Authors: Yarangümeli A. , Köz ö. Gürbüz , Alp M.N. , Elhan A.H. , Kural G. 
Published: January 2018

Purpose To compare the results of viscocanalostomy with and without mitomycin-C (MMC). Methods Retrospective results of 15 standard viscocanalostomy (VCO) operations (Group 1) were compared with the prospective results of 15 VCO operations performed with intraoperative adjunctive MMC (Group 2). MMC (0.2 mg/mL) was applied over and under the superficial scleral flap for 3 minutes in Group 2 before the deep flap was prepared. Each patient was followed up for at least 1 year, and results of examinations in the first 12 months were used in the statistical comparison of the two groups. Surgical success was defined as intraocular pressure (IOP) ≤ 18 mmHg. Results Pr eoperative mean intraocular pressures (IOP) in Group 1 and Group 2 wer e 35.3±11.0 and 39.1±8.9, respectively. Mean IOP levels at the 12th month were 14.4±2.6 and 11.9±4.0, respectively, showing a significant decrease in both groups (p<0.001). Postoperative IOP course appeared to be lower in the MMC group, however, the difference was not statistically significant (p=0.554). Complete success rates without medications were 40% in Group 1 and 67% in Group 2. No significant difference was found between the two groups in terms of early and late postoperative complications, pre- and postoperative number of antiglaucoma medications, and surgical success rates at the end of the study period (p>0.05 for all). A significant difference was verified between the two groups of eyes considering the conjunctival bleb types, as low-lying, localized blebs were the most frequent type in Group 1 and thin-walled, avascular blebs were more predominant in the MMC group (p=0.004). Conclusions Intraoperative adjunctive MMC use might improve the long-term results of viscocanalostomy by facilitating subconjunctival filtration and might widen the indication range of the technique.
Effect of Prophylactic Brimonidine on Bleeding Complications after Cataract Surgery
Authors: Desco M C. , Navea A. , Ferrer E. , Menezo J.L. 
Published: January 2018

Purpose To evaluate the effect of prophylactic brimonidine on bleeding complications after cataract surgery. Methods The authors performed a prospective, double-masked, two-surgeon study of 137 patients (137 eyes) who underwent phacoemulsification and intraocular lens implantation with or without prophylactic brimonidine before cataract surgery. The authors also compared the effect of brimonidine among patients with systemic diseases such as diabetes mellitus (types I and II), hypertension, and anticoagulant or antiplatelet treatment. Results Subconjunctival hemorrhage was observed in 73.70% of the patients not treated with brimonidine before surgery and in only 23.75% of the patients who were given prophylactic brimonidine (p<0.001, χ2). The grade of hemorrhage was also statistically significant (p<0.001, Mann-Whitney). No statistically significant difference with regard to the presence of hemorrhage in diabetic patients or in the anticoagulant or antiplatelet treatment group was observed. However, a statistically significant difference (p<0.027, χ2) was found between hypertensive patients treated and not treated with prophylactic brimonidine before cataract surgery. Conclusions This study suggests that brimonidine administered before cataract surgery may significantly reduce subconjunctival hemorrhage in the general population. It has been shown to be beneficial in hypertensive patients. A strong statistical trend, but not significance has been found in diabetic patients or in patients treated with antiplatelet or anticoagulant drugs, but further studies are needed to reach conclusive results.
A Short Duration Transient Ischemia Induces Apoptosis in Retinal Layers: An Experimental Study in Rabbits
Authors: Öz Ö. , Gürelik G. , Akyürek N. , Cinel L. , Hondur A. 
Published: January 2018

Purpose To investigate retinal cell apoptosis in an experimental transient, short duration ocular ischemia model. Methods An experimental ischemia model, which simulates creating temporary high intraocular pressure to control intraocular bleeding during pars plana vitrectomy, was set up. Rabbits were randomly divided into three groups. Group 1 was the control group. In Group 2, intraocular pressure was increased to 97 mmHg for 5 minutes. In Group 3, intraocular pressure was increased to 97 mmHg for 10 minutes. After 24 hours, terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling assay was used to detect retinal apoptosis in rabbit eyes. Only nuclear staining in retinal cells was counted. Results Groups with 5 minutes and 10 minutes of ischemia showed significantly higher amount of ganglion cell layer apoptosis when compared with the control group (p<0.05). Light microscopy and standard hematoxylin-eosin did not show any significant damage in the retina cells. Conclusions Apoptotic cell death in the retinal cell layers occurs in temporary ischemia-reperfusion as early as 5 and 10 minutes duration.
Retinal Nerve Fiber Layer Measured by Heidelberg Retina Tomograph and Nerve Fiber Analyzer
Authors: Iester M. , Mermoud A. 
Published: January 2018

Purpose To compare retinal nerve fiber layer (RNFL) thickness measured by Heidelberg retina tomograph (HRT) and nerve fiber analyzer (GDx). Methods Twenty eyes of 20 consecutive healthy subjects were recruited for this study. Each subject had a normal visual field and a normal optic nerve head, which was assessed by slit-lamp biomicroscopy using a 90° lens. Using the HRT and GDx, RNFL measurement was calculated as for software vs 2.01 and vs 1.0.14, respectively. Retinal nerve fiber layer thickness was evaluated for the entire annulus surface every 5° degrees. RNFL was assessed by HRT and GDx. HRT RNFL measurement was calculated at 0 üm from the edge, while GDx RNFL measurement at 1.75 disc diameter as for software. The difference between the highest points and the deepest points was calculated and compared. Furthermore, because of the possibility of different scales in the two systems, the following ratio was calculated: superior/inferior, superior/temporal, superior/nasal, inferior/temporal, and inferior/nasal. Results When the entire RNFL thickness was considered, a significant (p<0.001) difference was found between the HRT and GDx measurements. A difference of 200 üm was found between the highest and the deepest HRT points while a difference of 40 üm was found between the highest and the deepest GDx points. Conclusions HRT and GDx RNFL measurements were statistically different in each sector. However, ratio parameters showed no difference between the obtained values except for superior/temporal ratio and inferior/temporal ratio.
Early Age-Related Maculopathy and Risk Factors of Cardiovascular Disease in Middle-Aged Lithuanian Urban Population
Authors: Paunksnis A. , Cimbalas A. , Cerniauskiene L.R. , Luksiene D.I. , Margeviciene L. , Domarkiene S. , Tamosiunas A. , Norkus A. 
Published: January 2018

Purpose To assess the prevalence of age-related maculopathy (ARM) in a middle-aged urban population and the relationship between ARM and the main risk factors of cardiovascular disease (CVD). Methods The survey according to the WHO MONICA study protocol was carried out in Kaunas city, Lithuania, from 2001 to 2002. A total of 1403 persons aged 35 to 64 years were screened (626 men and 777 women: response rate 62.4%). Ophthalmologic investigation was performed for 1337 respondents (594 men and 743 women). Analysis of the relationship between ARM and risk factors of CVD was performed in case-control subdivision matching for sex, age, and education level. Results Early ARM was diagnosed in 7.4% of men and 5.4% of women. Rate of current smoking in case and control groups did not differ in men but in case group of women it was greater than in control group. Mean systolic and diastolic blood pressure and body mass index (BMI) in male case group and mean fasting blood glucose concentration in female case group were higher than in corresponding control groups. Frequency of diastolic hypertension (diastolic blood pressure ≥90 mmHg) and obesity (BMI ≥30 kg/m2) in male case group was higher than in control group. ARM was not associated with cholesterol and triglyceride levels in men and women. Conclusions Early ARM in middle-aged Lithuanian urban population was associated with current smoking in women but not in men; it was associated with diastolic blood pressure and BMI in men and with fasting glucose level in women.
Idiopathic Sclerosing Inflammation of the Orbit: A Case of Steroid-Responsive Disease in a Patient with Autoimmune Hemolytic Anemia
Authors: Billing K.J. , Hsuan J.D. , Selva D. 
Published: January 2018

Purpose Idiopathic sclerosing orbital inflammation (ISOI) has been categorized by some authors as a unique clinicopathologic entity, separate from the heterogenous group of disorders known collectively as nonspecific orbital inflammation. Histologic similarity and clinical association with other fibrosclerosing conditions has been shown. The authors present a case of ISOI in conjunction with autoimmune hemolytic anemia. Methods A 59-year-old woman with a history of hemolytic anemia had left upper lid swelling, periocular pain, proptosis, and restriction of ocular motility. Magnetic resonance imaging (MRI) showed a homogenously enhancing lateral orbital mass. Biopsy revealed dense fibrous connective tissue with a paucicellular infiltrate, consistent with ISOI, and treatment with prednisolone 60 mg/day was instituted. Results At 4-week review, the proptosis had settled and the patient regained full range of extraocular movements. At 14 months, the response was sustained and repeat MRI showed a 70% reduction in size of the mass. Conclusions The first known case of ISOI and hemolytic anemia is presented. Despite dense fibrosis histologically, steroid responsiveness can be encountered in cases of ISOI. An early, aggressive approach to management is recommended, and corticosteroids should be considered as a treatment option.
Acute Retinal Necrosis Presenting as Central Retinal Artery Occlusion with Cilioretinal Sparing
Authors: Shah S.P. , Hadid O.H. , Graham E.M. , Stanford M.R. 
Published: January 2018

Purpose To report a case of acute retinal necrosis presenting as central retinal artery occlusion with cilioretinal sparing. Methods Single inter ventional case report. The findings of the ophthalmic examination, MRI, blood parameters, biopsy results and clinical course are reported. Results A forty two year old gentleman reporting sudden loss of sight, ophthalmic examination revealing uveitis, central retinal artery occlusion with cilioretinal sparing and peripheral necrotizing retinitis. Conclusions Central retinal artery occlusion can be an early feature of acute retinal necrosis (ARN).
Central Corneal Thickness in Primary Open Angle Glaucoma, Pseudoexfoliative Glaucoma, Ocular Hypertension, and Normal Population
Authors: Yagci R. , Eksioglu U. , Midillioglu I. , Yalvac I. , Altiparmak E. , Duman S. 
Published: January 2018

Purpose This study was designed to determine the relationship between central corneal thickness (CCT) and intraocular pressure (IOP) measured by applanation tonometer in glaucomatous, ocular hypertensive, and normal eyes. Methods A total of 125 subjects were included in the study. Twenty-six had primary open angle glaucoma (POAG), 25 had pseudoexfoliative glaucoma (PXG), 24 had ocular hypertension (OHT), and 50 of them were normal. IOP values were measured by Goldmann applanation tonometer whereas CCT values were measured by ultrasonic pachymeter. Results CCT values in the OHT group (595.75±22.52 μm) were greater than the CCT values of the POAG group (539.92±21.50 μm), the PXG group (526.28±31.73 μm), and the normal group (533.96±29.25 μm) (p<0.05). Eight patients who were diagnosed with OHT showed IOP values of 21 mm Hg or lower with corrected IOP values according to CCT. Conclusions Increased CCT may lead to falsely high values of IOP measured with Goldmann applanation tonometer. In this study, when IOP values of the OHT group were redefined according to the formulae regarding the CCT, the authors noted that one third of them were normal. Determination of the CCT in OHT cases is crucial since it has great impact on IOP values, measured with applanation tonometer, which is the main parameter in the diagnosis and follow-up of glaucoma.
Safety and Efficacy of Bimatoprost 0.03% versus Timolol Maleate 0.5%/Dorzolamide 2% Fixed Combination
Authors: Day D.G. , Sharpe E.D. , Beischel C.J. , Jenkins J.N. , Stewart J.A. , Stewart W.C. 
Published: January 2018

Purpose To determine the efficacy and safety of bimatoprost given every evening versus the dorzolamide/timolol fixed combination (DTFC) given twice daily in open-angle glaucoma and ocular hypertensive patients. Methods A double-masked, three-center, prospective, randomized, crossover comparison with two 8-week treatment periods following a 4-week medicine free washout period. Diurnal curve intraocular pressures (lOPs) were taken at 08:00 (trough) and 10:00 and 16:00 hours. Results A total of 35 patients were enrolled and 32 completed all evaluations. The diurnal untreated baseline intraocular pressures was 24.8 ± 2.4 mmHg. On the last day of treatment the mean diurnal intraocular pressures was 17.4 ± 2.9 for bimatoprost and 18.1 ± 2.8 mmHg for DTFC (p = 0.35). The individual time points for intraocular pressures were not statistically different between groups. Both groups statistically reduced the intraocular pressures from baseline for each time point and for the diurnal curve (p < 0.05). Regarding ocular safety and tolerability, there was more conjunctival hyperemia with bimatoprost (n = 15) than with DTFC (n = 7, p = 0.013) and more burning and stinging with DTFC (n = 12) than with bimatoprost (n = 0, p = 0.0005). Few systemic adverse events were recorded and there was no statistical difference between groups for any individual event (p > 0.05). Conclusions This study indicates that the intraocular pressures are lowered to a statistically similar amount with DTFC compared to bimatoprost in open-angle glaucoma and ocular hypertensive patients.
Bilateral Lens Subluxation Associated with Atopic Eczema
Authors: Peter N.M. , Nath R. , Tranos P.G. , Teimory M. 
Published: January 2018

Purpose Ectopia lentis remains a therapeutic challenge for ophthalmologists. It classically presents with a preceding history of blunt or penetrating ocular trauma, or it may be associated with other ocular disorders such as congenital glaucoma and aniridia, or concomitant hereditary systemic diseases such as Marfan syndrome and homocystinuria. Methods Case report. Results The authors describe a previously unreported mechanism of ocular trauma associated with continuous eye rubbing, resulting in bilateral recurrent subluxation of both intraocular lens and crystalline lens. Conclusions It is useful for the ophthalmologist to be aware of this uncommon cause of ectopia lentis, since early advice and appropriate medical or surgical intervention may prevent more severe, sight-threatening complications.
Reconstruction of Conjunctiva with Amniotic Membrane after Excision of Large Conjunctival Melanoma: A Long-Term Study
Authors: Dalla Pozza G. , Ghirlando A. , Busato F. , Midena E. 
Published: January 2018

Purpose To evaluate, on a long- term basis, the role of amniotic membrane in the reconstruction of large conjunctival defects after excision of large conjunctival melanoma. Methods Four consecutive patients with diffuse conjunctival melanoma involving both bulbar and palpebral conjunctiva were studied. Conjunctival melanoma was completely excised (with wide clinically disease-free margins) and amniotic membrane immediately sutured to the surrounding conjunctiva and sclera to cover the conjunctival defect. Minimum follow-up was 48 months. Results Successful conjunctival surface reconstruction and physiologic fornical depth were achieved in all patients within 6 weeks. No recurrence of primary melanoma was observed during long-term follow-up. Conclusions Amniotic membrane transplantation is an effective alternative in ocular surface repairing surgery after removal of large conjunctival tumors.
Implantation of Iris Devices in Congenital and Traumatic Aniridias: Surgery Solutions and Complications
Authors: Menezo J.L. , Martínez-Costa R. , Cisneros A. , Desco M.C. 
Published: January 2018

Purpose To show surgical solutions in patients with traumatic and congenital aniridia, to evaluate the clinical improvement of these patients when iris prosthesis are implanted, and to examine safety and complications of these implants in a long-term follow-up. Methods Eight patients were included in this retrospective noncomparative case series. Nine eyes had an artificial iris implantation for traumatic or congenital aniridia. Three eyes received a black diaphragm intraocular lens (IOL) in capsular bag after phacoemulsification. An aniridia prosthesis, sulcus sutured, in front of a previous IOL was implanted in two eyes. A black diaphragm IOL, sulcus sutured, in two eyes; two iris diaphragm rings, in front of the previous IOL, in one eye; and a sector iris prosthesis in front of an IOL in the last eye were implanted. Mean follow-up was 22.5 months (range 16 to 44 months). Results All patients had improved visual acuity (VA) and visual comfort after surgery. The glare disability was subjectively better in all cases. Two patients developed new ocular hypertension after surgery; one of them was controlled by medical treatment and the other needed cyclodiode. Two of the patients with glaucoma preoperatively also needed cyclodiode procedure and one of them an Ahmed valve. Conclusions Several kinds of artificial iris implants are available. In all our patients with aniridia, iris artificial prostheses improved VA and diminished visual discomfort. Glaucoma is the most important complication after artificial iris implant. It is possible to implant the iris prosthesis in the capsular bag, but this requires a large capsulorrhexis and presents a surgical challenge.