bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alterations in Central Retinal Sensitivity after Intravitreal Triamcinolone Injection for Diffuse Diabetic Macular Edema
Authors: Bardak Y. , Çekiç O. , Tiğ U. Şahin , Bardak H. 
Published: January 2018

Purpose To evaluate alterations in central retinal sensitivity following intravitreal triamcinolone injection in patients with diffuse diabetic macular edema that persisted after laser treatment. Methods Fourteen eyes of 14 patients that received 4 mg 0.1 cc intravitreal triamcinolone underwent macular threshold test using computerized visual field analyzer before and after 1, 2, 3, and 5 months of triamcinolone injection. Pre- and postinjection values of total defect depth, total threshold, and best-corrected visual acuity were compared and correlated. Results At the last follow-up, compared to baseline, visual acuity improved from 1.4±0.4 (logMAR, mean ± standard deviation) to 1.0±0.4 (p=0.01). Total defect depth tended to recover from 148±64 dB to 121±48 dB (p=0.12), and total threshold tended to increase from 241±87 dB to 271±68 dB (p=0.16), but these values did not reach significance. There was a significant correlation between baseline and 5 months postinjection values of total defect depth (rho=0.60, p=0.02), and of total threshold of light sensitivity (rho=0.55, p=0.04). Conclusions Best-corrected visual acuity was found improved in patients with diabetic macular edema 5 months after triamcinolone injection. Improvement in central retinal sensitivity did not reach significant level at the last follow-up. Macular threshold test may be a valuable tool in the follow-up of patients with diffuse diabetic macular edema after intravitreal triamcinolone injection.
Radiologic Findings in Infected and Noninfected Scleral Buckles
Authors: Mansour A.M. , Han D.P. , Kim J.E. , Uwaydat S.H. , Sibai A. , Medawar W.A. , Li H.K.-F. , Rjeily J.A. , Salti H.I. , Bashshur Z. , Hourani M. 
Published: January 2018

Purpose To present the radiologic findings in scleral buckle infections and in the early postoperative period after scleral buckling. Methods Retrospective multicenter orbital computed tomography (CT) study of 14 patients and brain magnetic resonance (MR) in one patient with scleral buckle infections, some with the referring diagnosis of endophthalmitis, proliferative vitreoretinopathy, orbital cellulitis, or unilateral headache. The control population consisted of early postoperative prospective CT study of 38 consecutive patients with scleral buckle without clinical infection. Results Diffuse scleral thickening and preseptal soft tissue swelling were noted in acute scleral buckle infections. Scleral thickening decreased radiologically following prompt antibiotic therapy in five patients with acute infections. Silicone sponge had low attenuation without infection and high attenuation with infection. In chronically infected scleral buckle, the sclera was thickened around the buckle, with scleral melt under the buckle. MR showed increased signal intensity in the preseptal region in one patient with chronic fungal infection. In the controls, two had thickening of the sclera without soft tissue swelling. Conclusions CT or MR can assist in the early diagnosis and management of scleral buckle infections.
Vogt-Koyanagi-Harada Disease after Head Trauma
Authors: Accorinti M. , Pirraglia M.P. , Corsi C. , Caggiano C. 
Published: January 2018

Purpose To report two cases of Vogt-Koyanagi-Harada disease after closed head trauma. Methods Case report. Results Two patients, one male and one female, developed headache, dysacusis, vertigo, tinnitus, and hair hypersensitivity shortly after a closed head trauma and, 10 and 18 days later, a bilateral uveitis with papillitis and exudative retinal detachment in one and a bilateral mild uveitis with macular exudative detachment in the other. The ocular lesions resolved with intravenous high-dose steroid therapy, but recurred after reduction of the dosages, requiring further steroid therapy. The course of the disease in both patients, with the appearance of fundus depigmentation and pigment clumping, and the occurrence of a concomitant ocular and auditory relapse in one, were typical of Vogt-Koyanagi-Harada disease. Conclusions Vogt-Koyanagi-Harada disease may appear after a closed head trauma suggesting that even an indirect trauma in melanocyte-containing tissue may induce an inflammatory response within the eye.
Air-Guided Manual Deep Anterior Lamellar Keratoplasty: Long-Term Results and Confocal Microscopic Findings
Authors: Balestrazzi A. , Malandrini A. , Traversi C. , Martone G. , Caporossi A. 
Published: January 2018

Purpose To evaluate the long-term results of air-guided manual deep anterior lamellar keratoplasty (DALK) and to perform confocal microscopy on postoperative DALK corneas. Methods Seven postoperative consecutive DALK corneas were evaluated 1 year after suture removal. All patients underwent a complete ophthalmologic examination evaluating visual acuity, astigmatism, corneal thickness, and endothelial cell count. Confocal microscopy was performed to examine the corneas of the seven eyes and to obtain the measured interface depth. Results Eighteen months after surgery, the mean postoperative uncorrected visual acuity was 20/38 and the mean best-corrected visual acuity was 20/23. Postoperative mean value of residual recipient stroma thickness was 65.57 μm ± 28.74. Conclusions Maximum depth DALK can lead to significant advantages for quality of vision when compared to other types of anterior lamellar keratoplasty. Still, it remains a challenging procedure. These results show that a deep dissection without baring Descemet membrane makes good visual results possible, preventing corneal perforation and conversion to penetrating graft.
Glaucoma Drainage Implants in the Treatment of Refractory Glaucoma in Pediatric Patients
Authors: Autrata R. , Helmanova I. , Oslejskova H. , Vondracek P. , Rehurek J. 
Published: January 2018

Purpose The aim of this study is to report the clinical course, effectiveness, and safety of glaucoma drainage implants (Molteno and Baerveldt devices) in primary and secondary childhood glaucomas refractory to conventional surgical treatments and medical therapy. Methods This retrospective study included 76 children (76 eyes) younger than 18 years who underwent glaucoma drainage device (GDD) implantation in our clinic between 1990 and 2004. The mean age at time of surgery was 6.9±5.3 years (range: 4 months to 17.5 years). Intraocular pressure (IOP), visual acuity, corneal diameter, axial length, intraoperative and postoperative complications, and number of glaucoma medications were evaluated. Criteria for success were defined as IOP between 7 and 22 mmHg with or without glaucoma medications, no further glaucoma surgery, the absence of visually threatening complications, and no loss of light perception. Results were compared for children with primary and secondary glaucomas. The mean follow-up was 7.1±6.5 years (range: 1.6 to 15.2 years). Results Mean preoperative and postoperative IOP was 33.6±11.4 mmHg and 17.1±6.5 mmHg (p<0.001), respectively. Kaplan-Meier survival analysis showed cumulative probability of success: 93% at 6 months, 91% at 1 year, 82% at 2 years, 76% at 3 years, 71% at 4 years, 67% at 5 years, and 65% at 6 years. There was no difference between patients with primary (n=31 eyes) and secondary glaucoma (n=45 eyes) in terms of cumulative success (p=0.186), final IOP, number of medications, or length of follow-up. On average, the GDI surgery was successful for a mean period of 6.7 years. Fourteen eyes of 76 (18.4%) failed: 10 eyes with uncontrolled IOP, 2 eyes with retinal detachment, and 2 eyes with no light perception. Statistical regression model did not show influence of gender and previous surgery. Lower age at the time of surgery was found to be associated with higher probability of treatment failure. Conclusions Molteno and Baerveldt glaucoma drainage implants surgery seems to be safe and effective treatment for primary and secondary pediatric glaucoma refractory to the initial surgical procedure and medical therapy.
Unilateral Vernal Keratoconjunctivitis: A Case Report
Authors: Keklikci U. , Soker S.I. , Cakmak S. Soker , Ozkul S. , Sakalar Y.B. , Unlu K. 
Published: January 2018

Purpose A rare case of unilateral vernal keratoconjunctivitis is presented. Methods A 5-year-old boy had itching, foreign body sensation, redness, and ptosis in his left eye. Impression cytology specimens were taken from both upper eyelid tarsal conjunctiva. Results On slit-lamp biomicroscopy, unilateral cobblestone papillae and a shield ulcer were found in the left eye. On impression cytology examination, there was a significant increase in inflammation, presence of a honeycomb pattern, plasma cells, and mucus strands in the upper tarsal conjunctiva of the specimens. Conclusions Giant papillary conjunctivitis must be considered in differential diagnosis of unilateral vernal conjunctivitis. Impression cytology method may be combined with the clinical findings in vernal keratoconjunctivitis diagnosis.
Peribulbar Tramadol, Clonidine, and Ropivacaine in Blind and Seeing Painful Eyes
Authors: Tarantini A. , Lanzetta P. , Cugini U. 
Published: January 2018

Purpose To report on the treatment of painful eyes by peribulbar injection of tramadol, clonidine, and ropivacaine. Methods The authors treated a 72-year-old woman with chronic prephthisical pain in the left eye secondary to graft rejection after penetrating keratoplasty and an 81-year-old woman with severe ocular pain in her left eye for neovascular glaucoma secondary to an ischemic central vein occlusion. They were treated with a medial canthus injection of tramadol (100 mg/2 mL ampules), clonidine (0.15 mg/1 mL ampules), and 1% ropivacaine. Results Both injections were very well tolerated and neither transient nor lasting complications were reported. Complete pain relief was obtained in both patients within 1 day and was maintained throughout the follow-up (11 months and 7 months). Conclusions Peribulbar tramadol, clonidine, and ropivacaine injection may represent a safe and effective treatment modality in the management of chronic ocular pain.
The Removal of 10/0 Polyester (Mersilene) Sutures after Small Incision Congenital Cataract Surgery
Authors: Bar-Sela S.M. , Spierer O. , Spierer A. 
Published: January 2018

Purpose To evaluate the use of 10/0 polyester (Mersilene) sutures for closure of small corneal incision after congenital cataract surgery. Methods The authors retrospectively reviewed the medical records of 58 cases (42 patients) who underwent congenital cataract extraction and intraocular lens implantation between 1999 and 2004, using Mersilene sutures. An examination looking for suture-related complications and retinoscopy was done 1 week after surgery and then every month for 6 months. The sutures were removed in cases of local tissue reaction, but not due to high postoperative astigmatism. Paired t-test was used to compare patients' age and astigmatism level in those cases who had suture removal (Group 1) as opposed to those who did not (Group 2). Results In 10 cases (17%) corneal vascularization, necessitating suture removal, was found during 6-month follow-up period, without the trigger of loose suture. Patient age was 3.5±3.3 years and 4.4±3.3 years in Groups 1 and 2, respectively. At 1 week postoperatively the astigmatism value was 1.7±1.7 diopter (D) and 2.3±2.2 D in Groups 1 and 2, respectively, and it reduced to 0.9±0.8 in both groups at 6 months postoperatively. One case of endophthalmitis was encountered 2 days after suture removal. Conclusions Removal of Mersilene sutures after congenital cataract surgery is required in cases of corneal vascularization, occurring during the first months postoperatively. Owing to the risk of general anesthesia and infection, suture removal should be considered with caution in cases of postoperative astigmatism.
Hyperthyroidism and Severity of Orbital Disease do not Change the Central Corneal Thickness in Graves' Ophthalmopathy
Authors: Konuk O. , Aktas Z. , Aksoy S. , Onol M. , Unal M. 
Published: January 2018

Purpose To investigate whether the central corneal thickness (CCT) shows alterations in Graves disease and Graves ophthalmopathy (GO) cases according to the disease severity and hormonal status of the patients. Methods A total of 150 patients (62 male, 88 female) with Graves disease and 32 control subjects (11 male, 21 female) were included in the study. The patients were divided into six groups according to the severity of orbital involvement and thyroid hormone status. Best-corrected visual acuity, pupillary responses, color vision, biomicroscopy, CCT, intraocular pressure, and funduscopy were performed, and proptosis was measured with Hertel exophthalmometry in all patients. Results CCT values of patients with Graves disease and patients with GO with hyperthyroid or euthyroid hormonal status showed no statistical difference among themselves and versus control subjects (p>0.05). Conclusions Hyperthyroidism or severity of orbital disease does not affect the CCT.
Unusual Coexistence of Bilateral Keratoconus and Optic Disc Pit: A Case Report
Authors: Fasciani R. , Mosca L. , Giannico M.I. , Legrottaglie E.F. , Balestrazzi E. 
Published: January 2018

Purpose To report the unknown coexistence of bilateral optic disc pit and keratoconus. Methods A 23-year-old man with bilateral keratoconus underwent complete ophthalmology screening, with an unexpected detection of undiagnosed optic disc pit in both eyes. Computerized corneal topography (CT), Orbscan, corneal pachometry, endothelial microscopy, and optical coherence tomography (OCT) examination were performed. Results The corneal CT showed a keratoconus pattern in both eyes, evolved in the right eye with a minimum corneal pachometry of 336 μm in the right eye and 405 μm in the left eye. Mean endothelial cell density was 1937 cells/mm2 in the right eye and 1912 cells/mm2 in the left eye. The OCT scans showed the presence of the disc pit in both eyes with a normal macular thickness and profile in the right eye, and in the left eye an augmented retinal thickness in the nasal macular zone due to retinal oedema and schisis, with an initial detachment of the neuroepithelium in the parapapillary area starting from the optic pit. Conclusions This is the first clinical report of bilateral optic disc pit and keratoconus. Further investigations will be necessary to assess if there is a possible pathogenetic correlation between these two ocular pathologies or if this is an unusual coexistence of separate entities.
Analysis of Progressive Ophthalmic Lesion in a Patient with Subacute Sclerosing Panencephalitis
Authors: Zako M. , Kataoka T. , Ohno-Jinno A. , Inoue Y. , Kondo M. , Iwaki M. 
Published: January 2018

Purpose To evaluate the progressive lesions affecting the visual system in a patient with subacute sclerosing panencephalitis (SSPE). Methods The authors observed a 15-year-old boy with SSPE. Since the diagnosis was made before the appearance of ocular manifestations, the authors recorded the progressive ocular lesions using various ophthalmic examinations. Results The patient showed no ophthalmic abnormalities until he developed a left homonymous hemianopia with sudden bilateral disturbed visual acuity. Severe progressive macular lesions including a pigment epithelial window defect by fluorescein angiography, a marked decrease in foveal thickness by optical coherence tomography, and an extensive disorder mainly specific to cone cells in the central retina by electroretinography were demonstrated. Novel findings such as a transient relative afferent pupillary defect and an anterior uveitis were also observed. Conclusions Analyses over a long period of time showed progressive ophthalmic findings in a patient with SSPE.
Color Doppler Imaging of Retrobulbar Hemodynamics in Sturge-Weber Syndrome-Associated Glaucoma
Authors: Neely D. , Harris A. , Siesky B. , McCranor L. , McNulty L. , Hynes E. , Benzion I. 
Published: January 2018

Purpose Sturge-Weber syndrome (SWS) is frequently associated with early onset glaucoma in the eye on the same side as the facial angioma. The exact cause of glaucoma in SWS is poorly understood and difficult to treat. The purpose of this study is to investigate the ocular hemodynamics of children with SWS-associated glaucoma using color Doppler imaging techniques. Methods This is a prospective study of 10 pediatric patients with unilateral SWS-associated glaucoma. Color Doppler imaging was used to measure the peak systolic velocity and the end diastolic velocity of both the ophthalmic and central retinal arteries in the glaucomatous eye compared to the fellow healthy eye. Results Twenty eyes of 10 children with SWS (6 boys) with unilateral glaucoma were included in the prospective study. The mean age of the 10 participants was 5.5 years. When compared to their contralateral normal eyes, the glaucomatous eyes had greater CDR (p<0.001) and a myopic shift (p=0.04). No significant differences were found in the measurements of ocular blood flow velocities of the ophthalmic and central retinal arteries. Conclusions Vascular pathology has been proposed to play a role in SWS glaucoma etiology. The authors did not find arterial retrobulbar blood flow differences between the glaucomatous and the fellow normal eye. Since the primary vascular anomaly in patients with SWS is in the venous plexus, a bigger prospective trial is warranted in order to better understand and treat children with SWS glaucoma.
Rarebit Perimetry and Frequency Doubling Technology in Patients with Ocular Hypertension
Authors: Corallo G. , Iester M. , Scotto R. , Calabria G. , Traverso C.E. 
Published: January 2018

Purpose To test the capability of rarebit perimetry (RP), a recent non-conventional perimetric technique, in detecting early functional damage in subjects with ocular hypertension (OHT) and to compare RP findings with those obtained by frequency-doubling technology (FDT) perimetry. Methods Thirty patients with OHT were matched with 30 healthy subjects. All were tested with RP and FDT. Frequency-doubling technology mean deviation (MD) and pattern standard deviation (PSD), as well as RP mean hit rate (MHR), of the two groups were analyzed. The agreement between the two techniques was tested by Kappa analysis. Results In the OHT group the mean (SD) FDT MD was 0.5 (2.1), the mean (SD) FDT PSD was 4.2 (1.6), and the mean (SD) RP MHR was 81.4 (6.7). In the control group, corresponding values were mean (SD) FDT MD 1.1 (1.4), mean (SD) FDT PSD 3.0 (0.3), mean (SD) RP MHR 96.2 (2.0). The differences between the two groups were not significant for the studied indexes. Eleven (36.6%) out of the 30 OHT eyes had abnormal RP results; 12 (40.0%) eyes had abnormal FDT results. Five (16.6%) eyes had abnormal RP and FDT findings. Only 1 eye (3.3%) in the control group had abnormal RP results and 3 eyes (10.0%) had abnormal FDT results. RP and FDT showed a moderate agreement (Kappa = 0.43; 95% CI: 0.42 to 0.51). Conclusions RP and FDT showed VF defects not shown in standard automated perimetry in the OHT group. This may be indicative of an increased risk in developing glaucoma, even if a gold standard for detecting subtle defects is not currently available. RP has the additional advantage of not requiring any expensive device to be used. The poor agreement between these techniques in identifying eyes with early damage warrants further investigations. Large longitudinal studies are needed before defining the role of RP in early glaucoma diagnosis.
Results of Combined Phacoemulsification and Viscocanalostomy in Patients with Cataract and Pseudoexfoliative Glaucoma
Authors: Hassan K.M. , Awadalla M.A. 
Published: January 2018

Purpose Coexisting pseudoexfoliation glaucoma (PEXG) and cataract represents a special challenge. Although phacotrabeculectomy is an effective procedure, it combines the risks of phacoemulsification and trabeculectomy. This study evaluates phacoviscocanalostomy to manage eyes with PEXG and cataract. Methods We conducted a prospective noncomparative study that included 30 consecutive eyes of 22 patients with uncontrolled PEXG and cataract. Phacoviscocanalostomy was performed in all. Success rate based on postoperative intraocular pressure (IOP) reduction and requirement for topical antiglaucoma medication was evaluated as the main outcome measure. Visual acuity and complication rates were secondary outcomes. Results The mean follow-up was 18.6 months ± 6.2 (SD) (range 12 to 36 months). There was statistically significant decrease in mean IOP from 25.3 ± 5.2 mmHg preoperatively to 13.5 ± 6.0 mmHg 1 day after surgery (pp< .05), 12.3 ± 3.1 mmHg at the final follow-up (pp< .05), and at all evaluations to the last postoperative visit. Only three eyes (10%) required a single antiglaucoma medication to achieve the target IOP A complete surgical success (IOP p< 21 mmHg without medication) was achieved in 90%, while a qualified success (IOP p< 21 mmHg with or without glaucoma medication) was achieved in 100% of cases. Complications included Descemet membrane microperforations (13.3%), macroperforation (3.3%), zonular dehiscence (6.6%), and transient postoperative IOP spike (3.3%). Conclusions Phacoviscocanalostomy achieved excellent IOP control and visual acuity improvement in pseudoexfoliation patients with coexisting cataract and glaucoma. Complication rate was low and did not affect the surgical outcome.
Association of Plasma Homocysteine and Macular Edema in Type 2 Diabetes Mellitus
Authors: Aydin E. , Demir H.D. , Ozyurt H. , Etikan I. 
Published: January 2018

Purpose The aim of this study was to assess the association of macular edema (ME) with plasma homocysteine, vitamin B6, vitamin B12, and folic acid levels in patients with Type 2 diabetes. Methods Sixty-five diabetic subjects with no retinopathy and nonproliferative diabetic retinopathy (NPDR) (no DR, without ME, with ME: 16, 25, 24, respectively), 28 with proliferative diabetic retinopathy (PDR) (with and without ME: 14, 14, respectively), and 19 healthy subjects as control were recruited in this cross-sectional study Plasma homocysteine, vitamin B12, vitamin B6, and folate levels were determined after 8-hour of fasting for all subjects. The levels of serum homocysteine and vitamin B6 were measured using high performance liquid chromatography (HPLC) with fluorescence detection, and the levels of serum vitamin B12 and folic acid were measured by electrochemiluminescence immunoassay. Results When diabetic groups with ME were compared with diabetic groups without ME for homocysteine, vitamin B12, vitamin B6, and folic acid, the only significant difference was detected in homocysteine levels (p=0.001). There was no significant difference between NPDR with ME group compared with NPDR without ME group and no DR group for plasma homocysteine, vitamin B12, vitamin B6, and folic acid (p=0.200, p=0.660; p=0.999, p=0.678; p=1.0, p=0.248; p=1.0, p=0.982, respectively). On the other hand, when PDR with ME group was compared with PDR without ME group, there was only significant difference in homocysteine levels (p=0.023). Conclusions Mild to moderate elevation of homocysteine may explain the role of vascular dysregulation and endothelial dysfunction in patients with DR. The present study suggests hyperhomocysteinemia may be one of the crucial risk factors for development of ME.