bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertical and Torsional Correction in Congenital Superior Oblique Palsy by Inferior Oblique Recession
Authors: Mataftsi A. , Strickler J. , Klainguti G. 
Published: January 2018

Purpose Inferior oblique recession (Fink's technique) is one of various surgical procedures to manage congenital superior oblique muscle palsy. The authors aimed to determine the effectiveness of this operation in reducing vertical deviation and torsional deviation, and to assess the dose-effect relationship. Methods Fifty-eight patients presenting with unilateral congenital superior oblique palsy had an inferior oblique recession of 6 mm, 8 mm, or 10 mm (16, 35, and 7 patients, respectively). Vertical deviation and torsional deviation were measured before and after surgery by means of the dark red glass dissociation in front of Harms’ tangent screen and the data were analyzed retrospectively. Results A cure rate of 88% was achieved, with no complications, and no overcorrections. For the 34 patients for whom long-term follow-up was possible (mean 2.8 years), final median postoperative vertical deviations and torsional deviations were 0.5° and 0°, respectively both in primary position and in adduction upgaze. Conclusions Inferior oblique weakening by recession proves to be an efficient and safe procedure for congenital superior oblique palsy, and its effect on vertical deviation can be predicted on the extent of recession. The operation can therefore be adapted to the patient, depending on the degree of the preoperative deviation.
When is Isolated Inferior Oblique Muscle Surgery an Appropriate Treatment for Superior Oblique Palsy?
Authors: Hatz K.B. , Brodsky M.C. , Killer H.E. 
Published: January 2018

Purpose To evaluate the efficacy of isolated inferior oblique muscle weakening in the treatment of superior oblique palsy. Methods Forty-seven patients with superior oblique palsy underwent either single-muscle surgery (anteriorization or recession of the inferior oblique muscle) or two-muscle surgery (anteriorization of the inferior oblique muscle combined with recession of the contralateral inferior rectus muscle according to the amount of vertical deviation). In a retrospective non-comparative study the objective surgical effect was calculated as the difference between the deviation at the day before surgery and the deviations 6 weeks and at least 1 year after surgery. Pre- and postoperative sensorimotor status and subjective outcome were evaluated. Results In patients who underwent isolated inferior oblique muscle surgery the mean preoperative vertical deviation decreased from 15±9 (distance)/16±10 (near) prism diopters (PD) (anteriorization) and 7±5 (distance)/9±8 (near) PD (recession) to 4±4 (distance)/4±6 (near) PD (anteriorization) and 2±2 (distance)/2±3 (near) PD (recession) at the 1-year follow-up. In patients who underwent two-muscle surgery the mean vertical deviation decreased from 20±11 (distance)/21±10 (near) PD preoperatively and 6±7 (distance)/6±6 (near) PD at 1-year follow-up. Subjective assessment showed excellent scores among the patients treated with single-muscle surgery and slightly lower but also favorable scores among the patients treated with combined techniques. A direct comparison of the different outcome scores was not possible because of the more difficult initial situation in patients who underwent combined surgery. Conclusions Isolated inferior oblique muscle weakening is an effective treatment option for superior oblique palsy up to 15 PD of vertical deviation in primary position. Two-muscle surgery should be reserved for patients with larger vertical deviations.
Phacoemulsification in Previously Vitrectomized Patients: An Analysis of the Surgical Results in 100 Eyes as well as the Factors Contributing to the Cataract Formation
Authors: Pardo-Muñoz A. , Muriel-Herrero A. , Abraira V. , Muriel A. , Muñoz-Negrete F.J. , Murube J. 
Published: January 2018

Purpose To evaluate the safety and effectiveness of phacoemulsification with clear corneal incision in previously vitrectomized patients as well as factors affecting the development time and type of cataract occurring after pars plana vitrectomy (PPV). Methods The authors conducted a prospective study of 100 consecutive eyes of patients who developed a cataract after PPV. Three groups were established based on the underlying vitreoretinal pathology. The main outcome measurements were intraoperative and postoperative complications and changes in best-corrected visual acuity (BCVA). Results The median interval between PPV and phacoemulsification was 11.5 months. Patients with proliferative diabetic retinopathy required phacoemulsification earlier (p=0.018). Posterior subcapsular cataracts developed more frequently in patients <50 years (73.7%, p=0.000) and affected those who underwent vitrectomy primarily for complicated retinal detachment (48.8%, p=0.046). Intraoperative complications included posterior capsular tears (4%), luxated nucleus into vitreous (2%), and zonular dialysis (5%). Postoperative complications were vitreous hemorrhage (6%), retinalredetachment (4%), pupillary synechiae (6%), ocular hypertension (4%), and Seidel phenomenon (3%). Posterior Nd:YAG laser capsulotomy was required in 44% of eyes. BCVA was improved in 85% of cases at the end of follow-up (median, 15.5 months). Twenty-one patients with one functioning eye (61.9%) demonstrated visual improvement compared with 79 patients with bilateral vision (91.1%; p=0.003). Conclusions The technique allows stable improvement in BCVA through long follow-ups. It is more risky than in nonvitrectomized eyes. The visual results after phacoemulsification in vitrectomized eyes seem to be limited by retinal comorbidity and surgical complications.
Vogt-Koyanagi-Harada Associated with Diabetes Mellitus and Celiac Disease in a 3-Year-Old Girl
Authors: Al Hemidan A. I. , Tabbara K.F. , Althomali T. 
Published: January 2018

Purpose To present a case of Vogt-Koyanagi-Harada (VKH) associated with type I diabetes mellitus and celiac disease in a 3 year old female. Methods We studied a three-year old female who presented with clinical manifestation of VKH and type I Diabetes mellitus and ciliac disease. Results Patient was found to have hyperglycemia with type I diabetes mellitus. Duodenal mucosal biopsy specimen confirmed the diagnosis of celiac disease. Patient's ocular inflammation was treated by topical and systemic corticosteroid and immune-suppressive therapy. Her diabetes mellitus was controlled by insulin and her celiac disease was controlled by gluten-free diet. Conclusions The association of VKH with two autoimmune diseases (celiac disease and type I diabetes mellitus) is rare. This case is, to our knowledge, the youngest patient reported with VKH.
Zyoptix Wavefront-Guided versus Standard Photorefractive Keratectomy (PRK) in Low and Moderate Myopia: Randomized Controlled 6-Month Study
Authors: Mastropasqua L. , Toto L. , Zuppardi E. , Nubile M. , Carpineto P. , Di Nicola M. , Ballone E. 
Published: January 2018

Purpose To evaluate the refractive and aberrometric outcome of wavefront-guided photorefractive keratectomy (PRK) compared to standard PRK in myopic patients. Methods Fifty-six eyes of 56 patients were included in the study and were randomly divided into two groups. The study group consisted of 28 eyes with a mean spherical equivalent (SE) of -2.25±0.76 diopters (D) (range: -1.5 to -3.5 D) treated with wavefront-guided PRK using the Zywave ablation profile and the Bausch & Lomb Technolas 217z excimer laser (Zyoptix system) and the control group included 28 eyes with a SE of-2.35±1.01 D (range: -1.5 to -3.5 D) treated with standard PRK (PlanoScan ablation) using the same laser. A Zywave aberrometer was used to analyze and calculate the root-mean-square (RMS) of total high order aberrations (HOA) and Zernike coefficients of third and fourth order before and after (over a 6-month follow-up period) surgery in both groups. Preoperative and postoperative SE, uncorrected visual acuity (UCVA), and best-corrected visual acuity (BCVA) were evaluated in all cases. Results There was a high correlation between achieved and intended correction. The differences between the two treatment groups were not statistically significant for UCVA, BCVA, or SE cycloplegic refraction. Postoperatively the RMS value of high order aberrations was raised in both groups. At 6-month control, on average it increased by a factor of 1.17 in the Zyoptix PRK group and 1.54 in the PlanoScan PRK group (p=0.22). In the Zyoptix group there was a decrease of coma aberration, while in the PlanoScan group this third order aberration increased. The difference between postoperative and preoperative values between the two groups was statistically significant for coma aberration (p=0.013). No statistically significant difference was observed for spherical-like aberration between the two groups. In the study group eyes with a low amount of preoperative aberrations (HOA RMS lower than the median value; <0.28 μm) showed an increase of HOA RMS while eyes with RMS higher than 0.28 μm showed a decrease (p<0.05). Conclusions Zyoptix wavefront-guided PRK is as safe and efficacious for the correction of myopia and myopic astigmatism as PlanoScan PRK. Moreover this technique induces a smaller increase of third order coma aberration compared to standard PRK. The use of Zyoptix wavefront-guided PRK is particularly indicated in eyes with higher preoperative RMS values.
Central Serous Chorioretinopathy and Helicobacter Pylori
Authors: Cotticelli L. , Borrelli M. , D'alessio A.C. , Menzione M. , Villani A. , Piccolo G. , Montella F. , Iovene M.R. , Romano M. 
Published: January 2018

Purpose This study was designed to evaluate the prevalence of Helicobacter pylori infection in patients with central serous chorioretinopathy (CSC). Methods Retrospective observational case series. A group of 23 patients (22 men and 1 woman, age range 34–62 years, median age 47 years) with diagnosis of CSC, confirmed by fluorescein angiogram, and a control group of 23 consecutive patients (22 men and 1 woman, age range 41–69 years, median age 50 years) referred to our Department for retinal disease other than CSC were studied. Each patient provided peripheral venous blood samples and a stool specimen, which were analyzed at the Department of Gastroenterology and Microbiology at the same university. H. pylori infection was determined by measurement of IgG antibodies to H. pylori and by determination of H. pylori antigens in the stool specimens by enzyme-linked immunosorbent assay technique. Patients were defined as H. pylori infected if both tests were positive. Results The prevalence of H. pylori infection was 78.2% (95% CI, 56%–92%) in CSC patients and 43.5% (95% CI, 23%–65%) in control subjects (p<0.03 by two-tailed Fisher exact test). The odds ratio for CSC associated with H. pylori infection was 4.6 (95% CI 1.28–16.9). Conclusions The results of this study show that the prevalence of H. pylori infection seems to be significantly higher in patients with CSC than in controls. H. pylori infection may represent a risk factor in patients with CSC.
Did the Spectrum of Endophthalmitis Change? A Study Comprising 13 Years Experience with Operative Therapy of Endophthalmitis
Authors: Janknecht P. , Zühlke S. , Hansen L.L. 
Published: January 2018

Purpose The authors wondered whether the spectrum of endophthalmitis and the type of therapy had changed. Methods Files of patients who were operated upon for endophthalmitis between 1988 and 2000 were retrospectively analyzed. They were divided into Group 1 (operated upon 1988 to 1994) and Group 2 (1995 to 2000). Results Group 1 consisted of 83 patients (43.4% female, mean age 63.9 years), Group 2 of 108 (38.9% female, mean age 64.6 years). Bilateral endophthalmitis occurred in 8.4% of Group 1 patients (3.7% of Group 2 patients). Patients in both groups took on average 1.2 drug types against various internal diseases. The mean interval between first symptoms and presentation in the clinic was 45.7 days in Group 1 (19 days in Group 2; difference statistically significant). There were 63% (Group 1) (70% [Group 2]) cases of postoperative endophthalmitis, among them 58% (Group 1) (63% [Group 2]) after cataract extraction, 6% (Group 1) (5% [Group 2]) after glaucoma surgery, 20% (Group 1) (17% [Group 2]) endogenous and 17% (Group 1) (13% [Group 2]) posttraumatic. In Group 2 slightly more Gram-negative bacteria were found. As an initial procedure the following were performed: vitrectomy (70% [Group 1], 88% [Group 2]), removal of crystalline lens (11% [Group 1], 10% [Group 2]), removal of pseudophakos (2% [Group 1], 12% [Group 2]), opening of posterior capsule (1% [Group 1], 9% [Group 2]), and anterior chamber irrigation (36% [Group 1], 43% [Group 2]), often combining procedures. There were significantly more vitrectomies and openings of the posterior capsule in Group 2. Neither the spectrum of secondary and tertiary procedures nor the reasons for such surgery differed in both groups. Neither visual acuity at initial presentation (0.1) nor at final follow-up (0.3) differed between the two groups. The rate of enucleation was less in Group 2 (6% versus 11%) although not statistically significantly. Conclusions In Group 2 there were slightly more Gram-negative bacteria and the time interval between initial symptoms and presentation in the clinic had decreased. This can be interpreted as an increase in the severity of the endophthalmitis cases. The final visual acuity was identical in both groups, the enucleation rate improved.
Choroidopathy with Serous Retinal Detachment in a Patient with Polymyositis
Authors: Hotta K. 
Published: January 2018

Purpose The authors report a unique case of multifocal choroidopathy in association with polymyositis. Methods The clinical presentation, laser treatment, and subsequent changes in ocular findings are described. Results A 65-year-old Japanese man with polymyositis experienced mild acute vision impairment in both eyes during systemic corticosteroid treatment for interstitial pneumonia. Fundus examination revealed a gray-white subretinal exudate with serous retinal detachment. Angiographic examination disclosed partial dilatation of the choroidal vein at the posterior pole and dye leakage points in the retinal pigment epithelium. The patient's left eye developed bullous retinal detachment and multifocal choroidal nodules at the posterior pole during the period of tapering of oral corticosteroid administration. Retinal burns were applied to the dye leakage points in the right eye using an argon laser. Vision in the right eye showed rapid recovery due to regression of the serous retinal detachment. However, in the left eye without retinal burns visual acuity decreased to light perception only even after regression of the bullous retinal detachment and choroidopathy. Conclusions In serous retinal detachment with choroidopathy associated with polymyositis, laser photocoagulation at leakage points may be useful for rapid restoration of vision and for the prevention of permanent severe vision loss.
Photodynamic Therapy in Retinal Angiomatous Proliferation Stage I
Authors: Panagiotidis D. , Karagiannis D.A. , Baltatzis S. 
Published: January 2018

Purpose To report a case of photodynamic therapy (PDT) treatment in an 85-year-old patient with retinal angiomatous proliferation (RAP) stage I. Methods According to Treatment of Age-Related Macular Degeneration with Photodynamic Therapy and Verteporfin in Photodynamic Therapy study guidelines, two sessions of PDT with verteporfin were performed, which was activated by a diode laser light at 690 nm. Results The left eye was treated with PDT because of RAP stage I. Even in the early stage of RAP, PDT treatment did not alter the natural course of the disease. In particular, the lesion evolved towards stage III, being initially in stage I, with the final result of development of retinal pigment epithelial (RPE) tear after the second session of PDT treatment. Conclusions Even in the early stage of RAP, PDT treatment did not alter the natural course of the disease, with the final result of RPE tear after the second session of PDT treatment.
Nd:YAG Laser Membranotomy Treatment of Premacular Hemorrhage in two Children with Hematologic Disease
Authors: Hlozanek M. , Dotrelova D. , Vrabcova T.L. , Osmera J. 
Published: January 2018

Purpose Nd:YAG laser membranotomy is considered a safe treatment of premacular hemorrhage (PMH) in adult patients, enabling rapid enhancement of visual functions. For children, however, pars plana vitrectomy (PPV) performed under general anesthesia has been the accepted treatment. In this report, the authors describe Nd:YAG laser membranotomy (LM) in two children with PMH complicated by hematologic disease. Methods Size of lesions was measured in optic disc diameters (DD). The authors performed three openings in the anterior surface of PMH with immediate intravitreal drainage of blood in both patients. Results Rapid enhancement of visual functions was followed. The authors observed no complications in 1 year of follow-up. Conclusions LM may be a safe method of treatment of PMH in children in selected cases.
Intravitreal Triamcinolone Acetonide in Vogt-Koyanagi-Harada Syndrome
Authors: Karacorlu M. , Karacorlu S. Arf , Ozdemir H. 
Published: January 2018

Purpose To report the results of intravitreal triamcinolone acetonide in two eyes of a patient with Vogt-Koyanagi-Harada syndrome. Methods A 24-year-old woman with Vogt-Koyanagi-Harada syndrome was treated with a single 4-mg dose of intravitreal injection of triamcinolone acetonide in both eyes. Results On the seventh day after injection, visual acuity improved from 20/50 to 20/20 in the right eye and from 20/100 to 20/32 in the left. One month after injection, visual acuity was 20/20 in the right eye and 20/32 in the left, and fluorescein angiography showed that serous detachment had almost completely resorbed. The ocular examination remained stable during the 8-month follow-up period. Conclusions In this study, a prompt improvement in the clinical picture of a patient with Vogt-Koyanagi-Harada syndrome after intravitreal triamcinolone acetonide injection was described. The results suggest that intravitreal triamcinolone acetonide injection may be an additional tool in the treatment of Vogt-Koyanagi-Harada syndrome.
Unilateral Recurrent Acute Retinal Necrosis Syndrome Caused by Cytomegalovirus in an Immune-Competent Adult
Authors: Voros G.M. , Pandit R. , Snow M. , Griffiths P.G. 
Published: January 2018

Purpose To report an immune-competent patient with unilateral recurrent acute retinal necrosis syndrome caused by cytomegalovirus, and to highlight the importance of diagnostic vitreous biopsy and specific antiviral therapy in this condition. Methods Case report. Results A 75-year-old man with good general health had two episodes of acute retinal necrosis syndrome affecting his left eye. Vitreous biopsy was performed in each episode, and polymerase chain reaction analysis on the vitreous specimen was positive for cytomegalovirus and negative for varicella zoster virus and herpes simplex virus 1 and 2. On each occasion, investigations indicated past cytomegalovirus infection but no evidence of a systemic reactivation. No indication of immunodeficiency was found over a 2-year follow-up period. His management, which included systemic and intravitreal antiviral therapy, is discussed. Conclusions To the authors’ knowledge, only two other cases of acute retinal necrosis syndrome caused by cytomegalovirus have been reported previously in immune-competent patients. This case illustrates the importance of vitreous biopsy for viral polymerase chain reaction studies in cases of acute retinal necrosis syndrome, in order to direct appropriate antiviral treatment. It also illustrates the role of an intravitreal antiviral drug that is effective against all three herpetic viruses.
Follow-Up after Intravitreal Triamcinolone Acetonide for Diabetic Macular Edema
Authors: Jonas J.B. , Spandau U.H. , Kamppeter B.A. , Vossmerbaeumer U. , Harder B. 
Published: January 2018

Purpose To report on the follow-up of patients who received an intravitreal high-dosage injection of triamcinolone acetonide (IVTA) as treatment of diffuse diabetic macular edema. Methods The clinical interventional case-series study included 109 eyes (90 patients) with diffuse diabetic macular edema who consecutively received an IVTA of about 20 mg. Mean follow-up was 11.2 ± 6.2 months. Results Visual acuity improved significantly (p<0.001) from 0.89 ± 0.33 logMAR to a best minimum of 0.65 ± 0.35 logMAR. An increase in best visual acuity by at least 1 Snellen line, 2 lines, and 3 lines was found in 91 (83%) eyes, 68 (62%) eyes, and 45 (41%) eyes, espectively Differences in visual acuity between baseline and follow-up examinations were significant for measurements performed at 1 month (p<0.001), 2 months (p<0.001), 3 months (p<0.001), and at 6 months (p=0.001) after the injection. At 9 months after the injection, mean visual acuity regressed significantly so that visual acuity at 9 months (p=0.83) and at 12 months after the injection (p=0.58) compared with baseline values did not differ significantly. Forty-seven (43%) eyes developed a rise in intraocular pressure (pressure >21 mmHg) for 6 to 8 months after the injection. No other severe complications were detected. Conclusions The duration of a visual acuity increase and intraocular pressure rise after high-dosage IVTA in diffuse diabetic macular edema is about 6 to 8 months. Compared with data in the literature, the high-dosage IVTA may not have a markedly higher profile of side effects than low-dosage IVTA.
Pars Plana Vitrectomy and Removal of the Internal Limiting Membrane in Diabetic Macular Edema Unresponsive to Grid Laser Photocoagulation
Authors: Yanyali A , Horozoglu F. , Celik E. , Ercalik Y. , Nohutcu A.F. 
Published: January 2018

Purpose To evaluate the effectiveness of pars plana vitrectomy (PPV) with removal of the internal limiting membrane (ILM) in diabetic patients with macular edema unresponsive to grid laser photocoagulation. Methods In this randomized controlled study, 20 eyes of 10 patients with diabetic macular edema unresponsive to grid laser photocoagulation were evaluated. PPV with ILM removal was performed randomly in one eye each of 10 patients and taken as the study group; the untreated fellow eyes were taken as the control group. Main outcome measures were foveal thickness changes measured with optical coherence tomography and preoperative and postoperative visual acuity. Mann-Whitney U, Wilcoxon, and chi-square tests were used in statistical analysis. Results The mean age of the patients was 61.5±6 years (range 51 to 71). All patients were followed up for 12 months. In the study group, mean foveal thickness was 391.3±91.6 μm preoperatively and 225.5±49.4 μm postoperatively (p=0.009). In the control group, mean foveal thickness was 356.2±140 μm at baseline and 318.4±111.1 μm at 12-month follow-up (p=0.138). Mean decrease in foveal thickness was 165.8±114.8 μm in the study group and 37.8±71.2 μm in the control group (p=0.016). In the study group, best-corrected logMAR visual acuity was 0.71 ±0.43 preoperatively and 0.54±0.45 postoperatively (p=0.125). In the control group, best-corrected logMAR visual acuity was 0.43±0.44 at baseline and 0.59±0.55 at 12-month follow-up (p=0.235). In the study group, visual acuity improved by two or more lines in 4 eyes (40%) and remained stable in 6 eyes (60%). In the control group, visual acuity improved by two or more lines in 1 eye (10%) and decreased by two or more lines in 3 eyes (30%). Conclusions PPV with ILM removal appears to be an effective procedure for reducing diabetic macular edema unresponsive to grid laser photocoagulation. A further study with a large number of patients is required to assess the effectiveness and safety of this procedure.