bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glaucoma among Omani Diabetic Patients: A Cross-Sectional Descriptive Study (Oman Diabetic Eye Study 2002)
Authors: Khandekar R. , Zutshi R. 
Published: January 2018

Purpose/Methods A cross-sectional study was carried out to review the ocular status of 2,063 diabetic patients in Oman. A part of this study is presented to highlight the magnitude and determinants of glaucoma. The study also recommends policies for comprehensive care of glaucoma among diabetic patients. The ocular pressure, disc changes, and field changes were noted by ophthalmologists. The diabetes profile was noted by physicians. Results The rate of glaucoma among diabetic patients was 8.87% (95% CI 8.12 to 9.62). Male diabetic patients had significantly higher rates of glaucoma than female diabetic patients. The rate was significantly higher in higher age groups. The mean ocular pressure in glaucomatous eyes was 28.6 mm Hg. The rate was not significantly different in patients with type I and type II diabetes (RR 1.03 [95% CI 0.61 to 1.79]). The risk of visual disability was higher among diabetic patients with glaucoma than diabetic patients without glaucoma (RR 1.56 [95% CI 1.14 to 2.13]). CONCLUSIONS Ocular pressure measurement could be a simple and reliable first-level screening tool. Diabetic patients with glaucoma should be given special care to reduce visual disability. All patients with diabetes should be thoroughly checked periodically to rule out glaucoma.
Entropion Uveae: Early Sphincter Atrophy, Signposting Primary Angle Closure Glaucoma?
Authors: Sihota R. , Saxena R. , Agarwal H.C. 
Published: January 2018

Purpose An easily recognized clinical marker for early changes of primary angle closure glaucoma (PACG) or eyes predisposed to angle closure is important so that timely laser iridotomy can prevent morbidity. Pupillary ruff changes, specifically appearance of entropion uveae (EU), are frequent in eyes with PACG. Methods Pupillary ruff was examined under magnification and EU, if present, was graded and correlated with gonioscopic grading and presence of peripheral anterior synechiae (PAS) in consecutive patients with primary open angle glaucoma (POAG), non-glaucomatous controls, and PACG of the subacute, acute, chronic symptomatic, and creeping angle closure glaucoma subgroups. Results No POAG eye had an abnormal pupillary ruff. A total of 86.7% of subacute PACG eyes and all eyes with acute and chronic PACG showed some grade of EU. Iridocorneal synechiae were more significantly correlated with EU than goniosynechiae (p<0.001). Meridian of iridocorneal but not iridotrabecular synechiae could be correlated with the meridian of EU. In age-matched patients EU was only present in eyes with steep iris configuration, with significant correlation with narrow angles and goniosynechiae. In the detection of PACG the presence of EU Grade I was 94.9% sensitive and 98.2% specific for PACG eyes compared to the gonioscopic picture of angle closure in occludable angles. Its positive predictive value was 91.4%. Conclusions EU shows significant correlation with narrow angles, steep iris configuration, and PAS. Kinking of radial iris arteries during angle closure probably causes temporary ischemia, especially of end arteries supplying area of the pupil and sphincter pupillae. EU emerges as an easily observed, objective marker for PACG.
Bilateral Congenital Macular Coloboma in a Boy with down Syndrome
Authors: Hayasaka Y. , Hayasaka S. 
Published: January 2018

Purpose To describe macular coloboma in Down syndrome. Methods A 12-year-old boy with Down syndrome underwent ophthalmologic examination. Results The patient had a circumscribed, round defect about 1 disc diameter, with bared sclera at the base and pigment clump at the macula in both fundi. His poor visual acuity was unchanged since childhood. The results of serum IgG and IgM titers for Toxoplasma gondii were negative. Conclusions Congenital macular coloboma associated with Down syndrome, as demonstrated in our patient, may not have occurred by chance.
Cystoid Macular Edema Associated with Latanoprost after Uncomplicated Cataract Surgery
Authors: Altintaş Ö. , Yüksel N. , Karabaş V.L. , Demìrcì G. 
Published: January 2018

Purpose To report clinically symptomatic and angiographically documented cystoid macular edema (CME) associated with the use of latanoprost in two pseudophakic eyes after uncomplicated cataract surgery. Methods Retrospective review of two patients who had history of latanoprost use and uncomplicated cataract surgery and described blurred vision in the first postoperative month. Results Ocular examination revealed CME, which was confirmed by fluorescein angiography. The visual acuities of patients improved and the CME was angiographically resolved after discontinuation of latanoprost and the initiation of nonsteroidal anti-inflammatory eye-drops and oral acetazolamide. Conclusions Until a causal relationship between CME and latanoprost is proved or disproved, caution in its use in pseudophakic patients would be prudent.
Cataract Surgery Combined with Intravitreal Injection of Triamcinolone Acetonide
Authors: Jonas J.B. , Kreissig I. , Budde W.M. , Degenring R.F. 
Published: January 2018

Purpose To evaluate whether the addition of cataract surgery to an intravitreal injection of triamcinolone acetonide markedly increases frequency and spectrum of complications. Methods The comparative nonrandomized clinical interventional investigation included a study group of 60 eyes (56 patients) undergoing cataract surgery and additionally receiving an intravitreal injection of about 20 mg of triamcinolone acetonide and a triamcinolone control group of 290 eyes (262 patients) that consecutively received an intravitreal injection of about 20 mg triamcinolone acetonide without cataract surgery. Reasons for intravitreal injection of triamcinolone acetonide were exudative age-related macular degeneration (n = 228; 65%), diffuse diabetic macular edema (n = 94; 27%), central retinal vein occlusion (n = 17; 5%), and branch retinal vein occlusion (n = 11; 3%). Mean follow-up was 8.6±6.8 months. A second control group included 1068 patients (1068 eyes) who consecutively underwent routine cataract surgery without intravitreal injection. Results Study group and triamcinolone control group did not vary significantly in best visual acuity during follow-up (p=0.08), final visual acuity at the end of follow-up (p=0.30), maximal intraocular pressure during follow-up (p=0.99), frequency of an intraocular pressure higher than 21 mmHg (p=0.66), and intraocular pressure at the end of follow-up (p=0.06). Postoperative infectious endophthalmitis, wound leakage or other corneal wound healing problems, persisting corneal endothelial decompensation, rhegmatogenous retinal detachment, marked postoperative pain, or a clinically significant decentration of the intraocular lens were not observed. Study group and the non-triamcinolone control group did not vary significantly in the rate of posterior lens capsule rupture (p=0.11), postoperative infectious endophthalmitis, and persisting postoperative corneal endothelial decompensation. Conclusions The addition of cataract surgery to an intravitreal injection of triamcinolone acetonide may not markedly increase amount and frequency of side effects and complications of intravitreal triamcinolone acetonide. No safe conclusions can be reached regarding differences in frequency of postoperative infectious endophthalmitis.
Paraneoplastic Optic Neuropathy in a Patient with a Non-Small Cell Lung Carcinoma: A Case Report
Authors: Asproudis I.C. , Nikas A.N. , Psilas K.G. 
Published: January 2018

Purpose To report a case and describe the clinical approach to a patient with a non-small cell lung carcinoma and paraneoplastic optic neuropathy. Methods Case report. Results A 79-year-old woman with known non-small cell lung carcinoma was admitted with a swollen optic disc in the right eye. After detailed clinical, laboratory, and imaging studies, the authors diagnosed paraneoplastic optic neuropathy, excluding other possible diagnosis. Conclusions Paraneoplastic optic neuropathy is a clinical challenge and should be considered as a possible diagnosis in every cancer patient with optic disc edema.
Reproducibility of Optic Nerve Head Measurements Obtained by Optical Coherence Tomography
Authors: Olmedo M. , Cadarso-Suarez C. , Gomez-Ulla F. , Val C. , Fernandez I. 
Published: January 2018

Purpose To evaluate reproducibility of optic nerve head (ONH) morphometry measurements obtained by optical coherence tomography (the fast optical disk protocol of the Zeiss model 3000 OCT system) in normal and glaucomatous eyes. Methods Prospective instrument-evaluation study. ONH measurements for 20 eyes were obtained in eight scan sessions taken during two visits to an ophthalmology clinic (10 normal patients, 10 glaucoma patients, one eye per subject). At every one of the eight sessions for each eye, estimates of eight ONH morphometry variables (see Main outcome measures) were obtained. The first two sessions were performed by two operators, followed by a 30-minute break. The same operators then completed a third and fourth session. This sequence was duplicated on a second visit. Intrasession, intersession, intervisit, and interoperator reproducibility of the eight variables were calculated by the use of a components variance model. Intraclass correlation coefficients (ICC) were used to assess reliability. Results Vertical integrated rim area, horizontal integrated rim area, disk area, cup area, rim area, cup/disk area ratio, cup/disk horizontal ratio, cup/disk vertical ratio. With the exception of the horizontal integrated rim area and rim area in normal subjects, the factor subject was the most important source of variance for all variables. Reliability values as measured by ICC for normal eyes were above 81%, with the exception of measurements of the horizontal integrated rim area (23.1%), rim area (33.3%), and disk area (64.7%). For glaucomatous eyes all values were above 85%, with the exception of the disk area (68.1%). Conclusions ONH measurements obtained using the fast optical disk protocol of the Zeiss 3000 OCT system show good reproducibility, for both normal and glaucomatous eyes.
Prospective Randomized Study Determining Whether a 3-Day Application of Ofloxacin Results in the Selection of Fluoroquinolone-Resistant Coagulase-Negative Staphylococcus
Authors: Ta C.N. , He L. , Nguyen E. , De Kaspar H. Miño 
Published: January 2018

Purpose To determine whether a 3-day application of ofloxacin results in the selection of fluoroquinolone-resistant conjunctival coagulase-negative Staphylococcus. Design. Prospective randomized trial. Methods Patients scheduled for ocular surgery were randomized to a control (89 eyes) or study group (70 eyes). The study group received topical ofloxacin (0.3%) four times a day for 3 days. Conjunctival cultures were obtained at baseline (T0) and after 3 days of ofloxacin (T1). Cultures were also obtained at T0 and T1 for the control group, but these eyes did not receive an antibiotic. Bacteria isolated were identified and antibiotic susceptibility was determined. Results At T0, 53 out of 89 patients (60%) in the control and 48 out of 70 patients (69%) in the study group harbored coagulase-negative Staphylococcus. Among these coagulase-negative Staphylococcus, 12 out of 53 in the control and 11 out of 48 in the study group were resistant to ofloxacin (p>0.9999). At T1, significantly fewer coagulase-negative Staphylococcus (p=0.0003) were isolated from the study group (18 coagulase-negative Staphylococcus), compared the control group (48 coagulase-negative Staphylococcus). Of these, 5 out of 17 coagulase-negative Staphylococcus in the study group and 9 out of 48 coagulase-negative Staphylococcus in the control group were resistant to ofloxacin (p=0.5649). There was no significant difference in the number of coagulase-negative Staphylococcus resistant to ciprofloxacin or norfloxacin in the study group compared to the control group at T1. Conclusions Ofloxacin given four times a day for 3 days does not select out for conjunctival fluoroquinolone-resistant coagulase-negative Staphylococcus.
Allergy and Infections: Long-Term Improvement of Vernal Keratoconjunctivitis following Viral Conjunctivitis
Authors: Sgrulletta R. , Bonini S. , Lambiase A. , Bonini S. 
Published: January 2018

Purpose Vernal keratoconjunctivitis (VKC) is a severe, chronic allergic inflammatory disease of the ocular surface poorly responsive to antiallergic treatments and possibly leading to permanent visual impairment. VKC, because of mast cell, eosinophil, and Th2-type inflammation, polyclonal IgE activation, and tissue remodeling, is considered to be a typical Th2-driven disease. Viral infection stimulates a Th1 type immune response, potentially attenuating allergen-induced inflammation. The purpose of this report is to describe the effect of viral keratoconjunctivitis in a patient with VKC. Methods The authors report on a patient with a severe form of VKC, poorly responsive to antiallergic treatments, who developed a viral keratoconjunctivitis. Signs, symptoms, and cytologic findings were recorded during the 5-year follow-up period. Results The authors observed a prompt and permanent improvement of signs and symptoms of the allergic condition after the viral infection. Conjunctival scraping confirms that the inhibition of the eosinophilic inflammation lasts at least for 5 years. Conclusions In this case, the viral infection seemed to induce a clinical recovery of allergic disease, suggesting that an immune deviation induced by Th1-polarizing agents may revert an ongoing Th2 inflammation.
Impression Cytology of Melanocytic Conjunctival Tumors Using the Biopore Membrane
Authors: Keijser S. , Missotten G.S. , De Wolff-Rouendaal D. , Verbeke S.L.J. , Van Luijk C.M. , Veselic-Charvat M. , De Keizer R.J.W. 
Published: January 2018

Purpose To compare a new Biopore membrane impression cytology method with the routinely used exfoliative cytology in patients with a melanocytic lesion of the conjunctiva. Methods Sixty-eight consecutive patients with a conjunctival melanocytic lesion underwent Biopore membrane impression cytology as well as exfoliative cytology. A histologic sample was also available in 26 cases. All Biopore samples were stained immediately with RAL 555. Both Biopore and exfoliative cytology samples were assessed by two cytopathologists and graded into four different categories of atypia. Results Twenty-three out of 26 Biopores and 20 out of 24 for the exfoliative smears correlated with the corresponding histologic sample. Biopore cytology resulted in higher numbers of cells with a greater density compared to exfoliative cytology. Conclusions Biopore cytology can be used for cytologic sampling of conjunctival melanocytic lesions. Because of the larger amount and higher density of cells obtained with the Biopore membrane, interpretation by a pathologist is easier and faster. Sampling of the fornix, caruncula, and ocular material in children is difficult with the Biopore method, and exfoliative cytology seems to be the favorable test in those situations.
Treatment Carryover Impacts on Effectiveness of Intraocular Pressure Lowering Agents, Estimated by a Discrete Event Simulation Model
Authors: Denis P. , Le Pen C. , Umuhire D. , Berdeaux G. 
Published: January 2018

Purpose To compare the effectiveness of two treatment sequences, latanoprost–latanoprost timolol fixed combination (L-LT) versus travoprost–travoprost timolol fixed combination (T-TT), in the treatment of open-angle glaucoma (OAG) or ocular hypertension (OHT). Methods A discrete event simulation (DES) model was constructed. Patients with either OAG or OHT were treated first-line with a prostaglandin, either latanoprost or travoprost. In case of treatment failure, patients were switched to the specific prostaglandin-timolol sequence LT or TT. Failure was defined as intraocular pressure higher than or equal to 18 mmHg at two visits. Time to failure was estimated from two randomized clinical trials. Log-rank tests were computed. Linear functions after log-log transformation were used to model time to failure. The time horizon of the model was 60 months. Outcomes included treatment failure and disease progression. Sensitivity analyses were performed. Results Latanoprost treatment resulted in more treatment failures than travoprost (p<0.01), and LT more than TT (p<0.01). At 60 months, the probability of starting a third treatment line was 39.2% with L-LT versus 29.9% with T-TT. On average, L-LT patients developed 0.55 new visual field defects versus 0.48 for T-TT patients. The probability of no disease progression at 60 months was 61.4% with L-LT and 65.5% with T-TT. Conclusions Based on randomized clinical trial results and using a DES model, the T-TT sequence was more effective at avoiding starting a third line treatment than the L-LT sequence. T-TT treated patients developed less glaucoma progression.
Prognostic Factors Associated with Outcomes after Giant Retinal Tear Management Using Perfluorocarbon Liquids
Authors: Al-Khairi A.M. , Al-Kahtani E. , Kangave D. , Abu El-Asrar A.M. 
Published: January 2018

Purpose To identify prognostic factors for visual acuity and anatomic outcomes associated with giant retinal tear management using intraoperative perfluorocarbon liquids. Methods All patients with giant retinal tears without proliferative vitreoretinopathy (PVR) who underwent management with intraoperative perfluorocarbon liquids between 1994 and 2005 were re-viewed. Results The study included 115 patients (117 eyes), 93 (80.9%) males and 22 (19.1%) females, with a mean age of 30.3±15.2 years. Mean follow-up period was 29.7±26.7 months. Success rate with primary procedure was 78.6%, which increased to 94% with multiple surgeries. On univariate analysis, factors significantly associated with final visual acuity better than 20/200 included phakic/clear lens at presentation (p=0.0113), partial retinal detachment (p=0.0233), absence of all postoperative complications (p=0.0122), absence of recurrent retinal detachment (p=0.0406), and absence of postoperative PVR (p=0.0062). Logistic regression analysis highlighted that phakic/clear lens at presentation, unfolded flap of the giant tear, absence of postoperative cataract, and absence of post-operative PVR were associated with final visual acuity better than 20/200. On univariate analysis, use of gas tamponade was significantly associated with recurrent retinal detachment (p=0.0190). Logistic regression analysis highlighted that placement of an encircling scleral buckle and use of silicone oil tamponade were associated with anatomic reattachment with primary procedure. Conclusions Encircling scleral buckling and silicone oil tamponade decrease the risk of recurrent retinal detachment.
Comparison of Visual Function and Ocular Hemodynamics between Pre- and Post-Menopausal Women
Authors: Siesky B.A. , Harris A. , Patel C. , Klaas C.L. , Harris M. , McCranor L.J. , Lauer J. , Kaplan B. 
Published: January 2018

Purpose The incidence of eye disease increases with age and can often be linked to worsening cardiovascular function and increasing intraocular pressure. Estrogen is known to have vasodilatory effects in the systemic circulation. Decreased estrogen levels during menopause may therefore complicate or contribute to ocular pathologies as estrogen receptors are found in both retinal and choroidal tissue. The purpose of this investigation was to determine the effects of menopause on visual function and cardiovascular and ocular hemodynamics. Methods Twelve premenopausal and 24 postmenopausal women were evaluated at the Indiana University School of Medicine during a single study visit. Vision screening and ocular blood flow evaluations were performed, including blood pressure, heart rate, visual acuity, contrast sensitivity, intraocular pressure, and retinal capillary and retrobulbar blood flow imaging. Vision and ocular hemodynamics were compared using unpaired Student t-tests with pp<0.05 regarded as statistically significant. Results The premenopausal group had significantly lower heart rate (-16.1 b/m, p=0.0001) and systolic blood pressure (-17.7 mmHg, p=0.003) than postmenopausal subjects. Contrast sensitivity was significantly higher (measured in log units) in premenopausal women in both the right (0.25, p=0.039; 0.16, p=0.039) and left (0.45, p=0.001; 0.27, p=0.032) eyes at 9 and 18 cycles per degree, respectively. Premenopausal women also had significantly lower intraocular pressure in both the right (-2.19 mmHg, p=0.024) and left (-1.74 mmHg, p=0.035) eyes. Total ocular perfusion was not significantly different between groups. Conclusions This pilot work suggests that postmenopausal women have lower contrast sensitivity detection and elevated intraocular pressures compared to premenopausal women. Premenopausal women have lower cardiovascular risk factors, while total ocular circulation was similar to post-menopausal women.
Long-Term Results of a Suture Burial Technique
Authors: Baykara M. , Timucin O.B. 
Published: January 2018

Purpose To report the long-term (minimum 24 months of follow-up) results of a scleral suture fixation technique. Methods Surgical databases from one surgeon were reviewed for consecutive cases from March 2003 to August 2005 in which the scleral suture fixation technique was used and a minimum follow-up of 24 months was completed. In this study, by knotting the suture onto itself, the author has buried the end and the knot of the suture into the sclera for scleral fixation, to stay put within the sclera. Intraoperative technical complications, postoperative visual outcomes, intraocular pressures, and suture-related complications were evaluated for each patient. Results A total of 150 scleral-sutured free suture ends were evaluated after a minimum 24 months of follow-up in 75 eyes of 75 patients. No technical or suture-related complications (suture exposure, irritation, granulomas, giant papillary conjunctivitis, suture abscess) were recorded throughout the follow-up period. Conclusions Long-term follow-up of the suture burial technique - which allows avoidance of scleral incision, flap, or tunnel formation, as well as patch grafts for scleral fixation of intraocular lenses - showed it to be safe and effective.
Confocal Microscopic Evidence of Increased Langerhans Cell Activity after Corneal Metal Foreign Body Removal
Authors: Resch M.D. , Imre L. , Tapasztó B. , Németh J. 
Published: January 2018

Purpose The purpose of the study was to examine the corneal inflammatory reaction and Langerhans cells with confocal microscopy after metal foreign body removal. Methods Corneal metal foreign body was removed from 9 eyes of 9 consecutive patients 12.1±13.6 (4 to 72) hours after superficial angle grinder injury. Both eyes were examined with the Heidelberg Retina Tomograph II (HRT II) Rostock Cornea Module. Morphology and density of epithelium, nerves, metal deposits, keratocytes, endothelium, and Langerhans cells were compared to the uninjured fellow eyes (controls). Results Irregularity and partially missing superficial epithelium was found in all cases. Around the area of injury prolonged basal and wing epithelial cells were found in all eyes. The basal epithelium density is lower than in the control eye (p=0.043). Density of Langerhans cells (68.1±24.2/mm2) was increased in the epithelium, compared to controls (35.2±21.8/mm2, p=0.012). Keratocyte and endothelium densities were not different from that of controls. Some keratocytes showed signs of activation and the inhomogeneous background reflectivity revealed extracellular matrix alterations. Inflammatory reaction was observed up to 260 μm depth. The metal foreign body particles had high reflectivity and irregular edge. Conclusions In vivo confocal microscopy provided additional information to biomicroscopic signs such as epithelial damage and inflammation. It showed the effects of metal foreign bodies in the cornea: nerve damage and Langerhans cell density increase. Langerhans cells seem to play an important role in the inflammatory response after corneal foreign body injuries.