bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravitreal Triamcinolone Acetonide as Primary Treatment for Diffuse Diabetic Macular Edema: A Prospective Noncomparative Interventional Case Series
Authors: Nicolò M. , Nasciuti F. , Lai S. , Ghiglione D. , Borgia L. , Calabria G. 
Published: January 2018

Purpose To evaluate the efficacy and safety of one intravitreal injection of 25 mg of triamcinolone acetonide as primary treatment for diffuse diabetic macular edema. Methods Intravitreal triamcinolone acetonide injection was performed in 30 eyes with previously untreated diabetic macular edema. The main outcome measures were logMAR visual acuity (VA) and central macular thickness (CMT) at 1, 3, and 6 months. A secondary outcome was intraocular pressure progression. Results Visual acuity results for 30 eyes that had a follow-up of at least 6 months are presented. Twenty of them were followed up to 10.1 ±2.38 months. Preoperatively, VA was 0.54±0.27. At 1, 3, and 6 months follow-up, VA was 0.44±0.29 (p=0.001), 0.43±0.28 (p=0.001), and 0.45±0.29 (p=0.006), respectively. Preoperatively, CMT was 417.3±143.5 μm. At 1, 3, and 6 months follow-up, CMT was 277.3 +74.0 μm (p<0.0001), 279.6±94.4 μm (p<0.0001), and 297.07±114.87 μm (p=0.002), respectively. For the 20 eyes with a follow-up of 10.1±2.38 months, VA was 0.5±0.25 and 0.50±0.32 at baseline and at the last follow-up visit, respectively (p>0.05). Preoperatively, intraocular pressue (IOP) was 15.13±1.48 mmHg. IOP was 18.26±2.71 mmHg, 20.07±4.27 mmHg, and 20.4±6.18 mmHg, at 1, 3, and 6 months, respectively (p<0.0001). Four eyes underwent uncomplicated filtrating surgery for intractable glaucoma. Conclusions Intravitreal triamcinolone as primary treatment effectively increases VA and reduces CMT due to diffuse diabetic macular edema. Longer follow-up and randomized clinical trial are war ranted. Safety results highlight the need to further study the relationship between triamcinolone and intraocular pressure.
Anomalous Vitreoretinal Adhesions in Patients with Exudative Age-Related Macular Degeneration: An OCT Study
Authors: Maftouhi M. Quaranta-El , Mauget-Faÿsse M. 
Published: January 2018

Purpose To analyze the relationship between the retina and the vitreous in patients with exudative age-related macular degeneration (ARMD). Methods Consecutive patients with exudative ARMD, proven by fluorescein angiography, were recruited. Fundus biomicroscopic examination, color and red-free fundus photographs, and serial scans of the macular region using optical coherence tomography (OCT3, Carl Zeiss) were performed before and after photo dynamic therapy (PDT) with verteporfin (Visudyne, Novartis Ophthalmics). Vitreoretinal relationships have been described and compared with fundus photographs and data of fundus biomicroscopy examination. Results Sixty-six eyes of 52 consecutive patients (33 women, 19 men; mean age 75 years, range 64 to 89 years) with exudative ARMD were studied. Analysis of serial OCT scans showed that 13 eyes (20%) did not present any visible vitreous structures. Two eyes (3%) had the appearance of a complete posterior vitreous detachment (PVD). Fifty-one eyes (77%) exhibited some abnormalities of the vitreoretinal interface including 12 eyes with epiretinal membrane and retinal thickening and distortion. Among the 39 eyes examined before and after PDT with Visudyne, only 3 eyes developed a partial vitreous detachment and 1 eye progressed to a complete PVD. Conclusions Eyes with exudative ARMD exhibit a high prevalence of abnormalities of the vitreoretinal interface similar to that observed in many chronic inflammatory diseases. PDT with verteporfin does not modify the observed vitreoretinal adhesions.
Expulsion of a Lacrimal Dacryolith by Sneezing: A Rare Event
Authors: Salam A. , Williams C.P.R. , Manners R.M. 
Published: January 2018

Purpose To describe the case of a man presenting with intermittent epiphora of the right eye and a low grade dacryocystitis due to a dacryolith. Methods/Results He was treated conservatively and was offered a Dacryocystorhinostomy. A few weeks before surgery, he developed swelling and pain over the right medial canthus followed by violent sneezing with spontaneous extrusion of the dacryolith. Discussion The authors propose that the dacryolith fragmented spontaneously and once it reached the nasal cavity, was expelled by violent sneezing to the nostril, a mechanism not previously reported. Conclusions Reformation of dacryolith is a likely possibility, and recurrence of symptoms in such cases may ultimately require a Dacryocystorhinostomy.
Conjunctival Deposits as the First Sign of Systemic Sarcoidosis in a Pediatric Patient
Authors: çaça I. , Ünlü K. , Büyükbayram H. , Ari ş. 
Published: January 2018

Purpose Sarcoidosis is an inflammatory disease of unknown cause, characterized by noncaseating granulomas. In this study, the authors present a sarcoidosis patient without systemic signs diagnosed by histopathologic analysis of conjunctival deposits. Methods A 10-year-old girl had bilateral, focal, multilobular, multiple pale yellow deposits in bulbar conjunctiva for a year. In the patient's biomicroscopic examination, numerous 0.50-to 2-mm diameter pale yellow deposits were determined in both bulbar conjunctivas. The patient had no other systemic or ocular complaints. A conjunctival biopsy was performed. Results The biopsy specimens showed noncaseating granulomas with prominent asteroid bodies. Serum angiotensin-converting enzyme levels were increased in the patient. Conjunctival deposits were the first manifestation of sarcoidosis in the patient and the diagnosis of sarcoidosis was confirmed with a conjunctival biopsy. Conclusions To the authors’ knowledge, this is the second study that reports a sarcoidosis patient with non-systemic involvement diagnosed after histopathologic analysis of conjunctival deposits.
Delayed Onset of Pseudotumor Cerebri Syndrome 7 Years after Starting Human Recombinant Growth Hormone Treatment
Authors: Vischi A. , Guerriero S. , Giancipoli G. , Lorusso V. , Sborgia G. 
Published: January 2018

Purpose To report a case of pseudotumor cerebri (PTC) following treatment with human recombinant growth hormone (GH). Methods A 42-year-old man who developed pseudotumor cerebri 7 years after starting human recombinant GH treatment is presented. Results The patient's medical history was significant for hypophyseal dwarfism with a serious deficit of GH, hypogonadotropic hypogonadism, and hypothyroidism. In 1996 he started taking GH, testosterone, and l-thyroxine. Fundus examination showed disc edema in the left eye. GH was discontinued, and acetazolamide therapy was initiated. At the 3-month follow-up the acuity without correction was patch and the unilateral papilledema had resolved. Conclusions Pseudotumor cerebri or idiopathic intracranial hypertension is an uncommon and complex disorder. The diagnosis is possible when important criteria symptoms and signs are met. Several conditions and risk factors are associated with PTC. The most recently recognized risk factor is GH therapy.
Epstein-Barr Positive T-Cell Lymphoma in the Ocular Region
Authors: Sjö L.D. , Juhl B.R. , Buchwald C. , Prause J.U. , Ralfkiaer E. , Sjö N.C. , Heegaard S. 
Published: January 2018

Purpose To present two cases of rapidly growing tumors in the ocular adnexa. Both tumors were Epstein-Barr virus (EBV) positive peripheral T-cell lymphoma. Methods Case 1 was a 60-year-old man with a non-tender ulcerating tumor involving the lateral third of both upper and lower right eyelid. Case 2 was a 55-year-old man with a swelling of the left eyelid expanding cranially and dislocating the left eye, resulting in proptosis and diplopia. Both patients underwent incisional biopsy that did not disclose the malignant nature of the tumors. Clinical evaluation resulted in suspicion of malignancy and surgical excision was performed. Results The tumors were found to be consistent with EBV-positive peripheral T-cell lymphoma. Conclusions Peripheral T-cell lymphoma is uncommon but a diagnosis to be considered in a patient with a tumorous lesion in the eye region. Furthermore, peripheral T-cell lymphoma may be EBV-positive.
Photorefractive Keratectomy in High Myopic Defects with or without Intraoperative Mitomycin C: 1-Year Results
Authors: Bedei A. , Marabotti A. , Giannecchini I. , Ferretti C. , Montagnani M. , Martinucci C. , Barabesi L. 
Published: January 2018

Purpose To study the results of the prophylactic use of mitomycin C (MMC) to reduce haze formation and refractive regression after excimer laser photorefractive keratectomy (PRK) for high myopic defects (>5 diopters). Methods Prospective, consecutive, observational study. A total of 124 eyes of 62 patients were divided into two groups of 31 patients, 62 eyes each (Groups A and B). Only Group A was treated with MMC 0.02%. The data of the two groups of eyes, related to the best-corrected visual acuity (BCVA), to the difference of refraction pre- and post-treatment, and to the corneal haze, were analyzed through combined permutation tests by using the NPC Test software. Results BCVA of Group A, 1 year after treatment, was better than that of the control Group B (one-sided p value = 0.013): Group A – 3 eyes (4.8%) had a loss of a decimal fraction and no eyes > 1; Group B – 13 eyes (20.9%) had a loss of a decimal fraction and 1 eye (1.6%) of 2. There was a smaller difference between attempted and achieved SE correction in Group A with respect to Group B (one-sided p value = 0.068): Group A – 43 eyes (69.3%) within ± 0.50 D; Group B – 31 eyes (50%) within ± 0.50 D. there was a smaller incidence of corneal haze in the group for which MMC was used (one-sided p value = 0.005). Conclusions In this study, the application of MMC 0.02% solution immediately after PRK produced lower haze rates and had better predictability and improved efficacy 1 year after treatment.
Quantitative Corneal Anatomy in Emmetropic Subjects
Authors: Sanchis-Gimeno J.A. , Herrera M. , Lleó-Pérez A. , Alonso L. , Rahhal M.S. 
Published: January 2018

Purpose Currently there is little information available about the corneal thickness values of healthy emmetropic subjects. Therefore, the authors decided to analyze the corneal thickness in healthy emmetropic subjects. Methods The authors analyzed the difference in thickness values between the thinnest corneal site and the central and paracentral cornea in 124 eyes of 124 healthy emmetropic white subjects. Results The mean difference between the thinnest site of the cornea and the thickness values obtained in the areas analyzed was as follows: 12±6 μm center; 140±19 μm superonasal; 133±23 μm nasal; 117±26 μm inferonasal; 122±19 μm superotemporal; 89±22 μm temporal; and 99±29 μm inferotemporal (p<0.001; one way analysis of variance test). Conclusions In healthy emmetropic white subjects the thinnest site of the cornea is statistically lower than the central and paracentral cornea.
Glaucoma Detection using the GDx Nerve Fiber Analyzer and the Retinal Thickness Analyzer (RTA)
Authors: Hoffmann E.M. , Bowd C. , Klein N. , Stemberger K. , Grus F.H. , Pfeiffer N. 
Published: January 2018

Purpose To compare the ability of the nerve fiber analyzer (GDx) and the retinal thickness analyzer (RTA) to discriminate between glaucomatous and healthy eyes. Methods Thirty-seven glaucoma patients (early to moderate severity) and 34 healthy controls were included. Glaucoma patients were defined as those with two repeatable abnormal visual fields by automated perimetry within 1 year. All subjects were examined with a GDx scanning laser polarimeter and RTA. Twelve GDx retinal nerve fiber layer parameters and 12 RTA optic disk topography parameters were obtained. GDx and RTA measurements were compared between both experimental groups using t-tests. Areas under the receiver operating characteristic curves (AUROC) for discriminating between healthy and glaucomatous eyes using GDx and RTA parameters were calculated and compared, and sensitivities at ≥80% and≥95% specificity were reported. Results Statistically significant differences between glaucomatous and healthy eyes were found for most GDx and RTA parameters. For GDx, the parameter with the largest AUROC for discriminating between healthy and glaucomatous eyes was the number (AUROC = 0.91, sensitivity = 85% at specificity = 84%, sensitivity = 73% at specificity = 95%). For RTA, the parameter with the largest AUROC was mean cup depth (AUROC = 0.79, sensitivity = 61% at specificity = 82%, sensitivity = 33% at specificity = 95%). The AUROC for the GDx number was significantly larger than the AUROC for RTA mean cup depth (p<0.05). Conclusions GDX showed better discrimination and better sensitivities at fixed specificities than RTA. The currently available RTA optic disk analysis software likely cannot replace GDx RNFL analysis software for successful glaucoma diagnosis.
Hyperacute Unilateral Gonococcal Endophthalmitis in an HIV-Infected Man without Genital Infection
Authors: Faggian F. , Azzini A. , Lanzafame M. , Bonora A. , Zorzi A. , Concia E. , Vento S. 
Published: January 2018

Purpose To demonstrate the necessity of obtaining an accurate history from patients presenting abnormal evolution of ophthalmologic diseases. Methods A 42-year-old patient, denying any previous ocular or systemic morbidity, presented with an unusual severe and hyperacute gonococcal endophthalmitis with corneal abscess but no concurrent genitourinary infection. Only after a further interview did the patient reveal his human immunodeficiency virus status and a previous diagnosis of acquired immunodeficiency syndrome. Results Adequate topical and intravenous antibiotic treatment and surgery led to salvage of the eye. Conclusions An accurate history should be obtained by patients with an abnormal course of an ophthalmologic disease, focusing on immunologic deficiencies that can cause extremely serious ophthalmologic complications with ensuing risk of visual impairment or ocular loss (bulbar enucleation).
Radial Keratotomy for the Optical Rehabilitation of Mild to Moderate Keratoconus: More than 5 Years’ Experience
Authors: Utine C.A. , Bayraktar S. , Kaya V. , Kucuksumer Y. , Eren H. , Perente I. , Yilmaz ö.F. 
Published: January 2018

Purpose To present the authors’ long-term experience of radial keratotomy (RK) for the optical rehabilitation of patients with mild to moderate keratoconus – central corneal thickness of greater than 400 μm and without apical scarring. Methods In this observational, noncomparative series of cases, all consecutive patients with mild or moderate keratoconus, treated by RK between 1990 and 2002, with at least 1 year follow-up were included. A total of 170 eyes of 96 patients were investigated. Mean follow-up was 42.08 ± 28.14 months. Visual acuity, refraction, corneal curvature, central corneal thickness, and complications were evaluated. Results In all of the control visits, mean uncorrected and best spectacle corrected visual acuities were better than preoperative values (p<0.0001). Preoperative myopic spherical refraction decreased significantly (p<0.0001), and remained relatively unchanged throughout the follow-up (p=0.43). A small but statistically significant decrease from baseline was observed in astigmatism (p=0.038), which almost disappeared 1 year after the surgery (p=0.47). The surgery produced a statistically significant flattening of the corneal curvature (p<0.0001). Central corneal thickness did not change significantly (p>0.05) in either control visit. In 33 eyes (19.4%), re-deepening of the incisions was required. In 3 eyes (1.8%) penetrating keratoplasty was performed, due to disease progression in 2 eyes (1.2%) and acute traumatic hydrops in 1 eye (0.6%). In 4 eyes (2.2%) microperforation, in 2 eyes (1.2%) macroperforation, in 1 eye (0.6%) infectious keratitis, and in 1 eye (0.6%) hyperopic shift occurred. Conclusions RK surgery was found to be a reasonable option for the rehabilitation of a selected group of keratoconus patients in the early or moderate stages.
Clear Corneal Incision of 2.75 mm for Cataract Surgery Induces Little Change of Astigmatism in Eyes with Low Preoperative Corneal Cylinder
Authors: Giansanti F. , Rapizzi E. , Virgili G. , Mencucci R. , Bini A. , Vannozzi L. , Menchini U. 
Published: January 2018

Purpose To assess the early astigmatic effect induced by 2.75 mm clear cornea incisions with different locations for cataract surgery. Methods A total of 146 eyes of different patients were studied prospectively. Cataract surgery was performed by three surgeons, two using a temporal approach and one using a superior approach. For both approaches, the site of the 2.75 mm incision was allowed to vary slightly according to the characteristics of the eye and orbit. Computerized videokeratography was used to measure corneal astigmatism before surgery and after 1, 4, and 12 weeks. Corneal astigmatism was recorded as cylinder and axis and it was then converted to 2 power vector. Model based prediction and comparisons were made for the most commonly used corneal incision sites: 12 (both eyes), 2 (left eye), and 8 (right eye) o'clock meridian. Results After 3 months the differences in corneal astigmatism (JCC0) between the incisions performed at 12 and 2 o'clock were not statistically significant (-0.08, 95% CI: -0.19, -0.02); the differences in JCC0 between incisions at 12 and 8 o'clock were -0.17 (95% CI: -0.30, -0.05; p<0.01). After 3 months the change in JCC0 for the patients with 0.5 D with-the-rule preoperatively were -0.32 (95% CI: -0.44, 0.21; p<0.01) for incisions at 12; -0.24 (95% CI: -0.36, 0.13; p<0.01) for incisions at 2; and -0.15 (95% CI: -0.27, -0.03; p<0.05) for incisions at 8. After 3 months the changes of JCC0 for the patients with -0.5 D against-the-rule preoperatively were 0.10 (95% CI: 0.04, 0.23) for incision at 12; 0.18 (95% CI: 0.04, 0.32; p<0.05) for incisions at 2; and 0.27 (95% CI: 0.14, 0.40; p<0.01) for incisions at 8 o'clock. The oblique astigmatic vector (JCC45) was very modest in this sample before surgery and underwent minimal and nonsignificant change after it. Conclusions This study has shown that a 2.75 mm clear corneal incision causes a small change of corneal cylinder regardless of incision site.
A Comparison of Morning and Evening Instillation of a Combination Travoprost 0.004%/Timolol 0.5% Ophthalmic Solution
Authors: Denis P. , Andrew R. , Wells D. , Friren B. 
Published: January 2018

Purpose To compare the intraocular pressure lowering efficacy and side effect profile of travoprost 0.004%/timolol 0.5% ophthalmic solution dosed in the morning and evening. Methods This was a multicenter, prospective, randomized, double-masked, parallel group clinical study of 92 patients with open-angle glaucoma (with or without pseudoexfoliative or pigmentary glaucoma) or ocular hypertension. After a washout of existing glaucoma medications, patients were randomly assigned to receive one drop of travoprost 0.004%/timolol 0.5% in the morning or evening for 6 weeks. The main outcome measures were mean intraocular pressure (IOP) assessed at 9 am, 11 am, and 4 pm, and safety variables. Results Travoprost 0.004%/timolol 0.5% ophthalmic solution, dosed in the morning or evening, controlled IOP consistently throughout the day. Mean IOP ranged from 16.5 to 16.7 mmHg in the morning treatment group and from 16.1 to 17.2 mmHg in the evening treatment group. Travoprost 0.004%/timolol 0.5% ophthalmic solution produced statistically significant and clinically relevant reductions in IOP from baseline; mean reductions ranged from approximately 8 to 10 mmHg (32% to 38%). Travoprost 0.004%/timolol 0.5% ophthalmic solution was safe and well tolerated with the most frequently reported adverse event being ocular hyperemia, which occurred in 12.5% of patients in the morning treatment group and 13.6% of patients in the evening treatment group. Conclusions Travoprost 0.004%/timolol 0.5% given once daily, either in the morning or evening, is a safe and effective treatment for open-angle glaucoma and ocular hypertension. It may be beneficial for patients judged to be inadequately controlled on a prostaglandin analogue or ophthalmic beta-blocker alone.
External Trabeculectomy with T-Flux Implant
Authors: Jungkim S. , Gibran S.K. , Khan K. , Murray A. 
Published: January 2018

Purpose To evaluate the efficacy and safety of T-Flux implant in nonpenetrating glaucoma surgery. Methods This clinical interventional case series study included 35 eyes of 35 patients with medically uncontrolled primary open angle glaucoma. External trabeculectomy with T-Flux (ETTF) is a technique of nonpenetrating glaucoma surgery, in which after removing deep scleral tissue and un-roofing the canal of Schlemn (CS) the external trabecular tissue is peeled off to enhance the aqueous drainage without opening the anterior chamber. A non-absorbable T-Flux implant (IOL TECH Laboratories, France) was sutured in deep intrascleral space to keep it patent. Snellen's best-corrected visual acuity, slit lamp biomicroscopy, intraocular pressure (IOP), gonioscopy, funduscopy, and optic disc assessment were performed preoperatively and postoperatively at 1 day, 1 week, and 1, 3, 6, and 12 months. Visual field testing was performed preoperatively and at 6 and 12 months postoperatively. Results For three eyes, surgery was converted to standard trabeculectomy owing to the perforation of trabeculo-Descemet's membrane and iris prolapse and excluded from the study. The results of the remaining 32 eyes were included in the study. Preoperative IOP (mean ± SD) of 32.88 ± 5.7 mmHg decreased to 15.44 ± 1.6 mmHg after 12 months. Ten eyes (28.6%) had microhyphema that resolved spontaneously; 3 eyes (8.6%) had microperforation without iris prolapse so ETTF was proceeded routinely. The preoperative number of antiglaucoma medications per patient reduced from (mean ± SD) 2.74 ± 0.61 to 0.11 ± 0.32 postoperatively at 12 months. Visual acuity and visual fields remained stable. Conclusions ETTF appears to provide significant control of IOP and have low incidence of complications.
Outcomes of Vitreoretinal Surgery for Retinal Detachment after LASIK for Myopia
Authors: Salazar P.F. , Rodriguez F.J. , Medina D.M. , Infante R. , Rodriguez A. 
Published: January 2018

Purpose To report and compare outcomes of vitreoretinal surgery for repair of retinal detachment in myopic patients with and without previous laser-assisted in situ keratomileusis (LASIK). Methods This is a descriptive retrospective observational study with a control group for comparison that consisted of the analysis of clinical and surgical charts of patients who underwent vitreoretinal procedures for retinal detachment at the Fundación Oftalmológica Nacional between January 1995 and December 2002. The authors identified those myopic patients who had previous history of LASIK and an age- and myopia-matched control group without refractive surgery. Results The sample contains 24 myopic eyes of 22 patients with previous LASIK and 23 myopic eyes without previous LASIK in the control group, matched by age and myopia. Mean refractive error was -9.4 D before LASIK for the cases group and -11.2 for the control group. Poor preoperative best-corrected visual acuity was present in 71% of cases and 61% of controls (p=0.489). Macula off retinal detachment was found in 17 eyes in both groups. Five eyes required at least two procedures, achieving 91% (20 eyes) reattachments at the end of follow-up in each group. Final best-corrected visual acuity was better than 20/100 in 15 eyes (62.5%) in the LASIK group and 17 eyes (74 %) in the control group (p=0.659). Conclusions Retinal detachment in patients with previous myopic LASIK has similar characteristics as in myopic patients without refractive surgery. Current vitreoretinal surgery is of good prognosis as the retina was successfully reattached in most cases in both groups.