bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual Acuity after Vitrectomy and Epiretinal Membrane Peeling with or without Premacular Indocyanine Green Injection
Authors: Koestinger A , Bovey E.H. 
Published: January 2018

Purpose To compare postoperative visual acuity of eyes operated for an epiretinal membrane (ERM), with or without intraoperative intraocular indocyanine green (ICG) injection. Methods Retrospective study of 75 Pseudophakic eyes with epiretinal membrane operated by vitrectomy-peeling. In 20 cases operated in 2001 and 2002 (Group 1), ICG diluted in 5% glucose solution was injected intraoperatively into the vitreous. In another group of 55 cases operated between 1996 and 1999 (Group 2), ICG was not used. Results The mean visual acuity was 0.32+1 and 0.32+2 preoperatively 0.4+2 and 0.5 at 1 month, and 0.63 and 0.63+2 on the final examination in Groups 1 and 2, respectively. Visual acuities were not significantly different between the two groups. Conclusions Premacular injection of ICG during vitrectomy to facilitate epiretinal membrane peeling did not appear to compromise postoperative improvement of visual acuity. However, its use is questioned since it did not yield better postoperative results and because potential toxic adverse reactions could not be excluded by this study.
Subretinal Neovascularization Associated with Retinochoroidal Coloboma
Authors: Takenaka J. , Yamane K. , Minamoto A. , Mishima H.K. , Hayashida H. 
Published: January 2018

Purpose To report a case of subretinal neovascularization associated with retinochoroidal coboma. METHODS AND RESULTS A 44-year-old female presented with metamorphopsia in her right eye for 4 weeks. Funduscopic examination revealed bilateral inferior retinochoroidal coloboma. Fluorescein angiography disclosed foci of subretinal neovascularization at the margin between the colobomatous defect and the normal-appearing retina. Five month later, multiple small areas of subretinal hemorrhages were noted. The hemorrhage was gradually absorbed. Six years after initial presentation, subretinal hemorrhage did not recur and her right VA was 0.2. Conclusions Ophthalmologists should be aware of this rare but important complication of retinochoroidal coloboma.
Brucella Meningitis and Papilledema in a Child
Authors: Levy J. , Shneck M. , Marcus M. , Lifshitz T. 
Published: January 2018

Purpose To report a rare case of Brucella meningitis with papilledema in a child and to discuss the findings of neurobrucellosis in children. Methods A 6-year-old girl was admitted with headache, fever, and vomiting for 1 week. Her family reported intake of raw unpasteurized goat's milk in the past. Meningeal signs were strongly positive. Bilateral moderate optic disc edema with flame-shaped hemorrhages was observed. Results The diagnosis of Brucella infection was established by positive blood culture for Brucella species, serum agglutination titer of antibodies to Brucella >1:160, and positive CSF culture. After treatment consisting of trimethoprim-sulfamethoxazole, rifampin, and doxycycline, the patient's condition gradually improved. One month later, the papilledema disappeared. One year after presentation, the patient remains free of symptoms. Conclusions Brucella meningitis must be ruled out in symptomatic patients reporting ingestion of raw unpasteurized goat's milk. Papilledema is a frequent clinical feature, but irreversible visual impairment is extremely rare.
Mini-Trabeculectomy in Comparison to Conventional Trabeculectomy in Primary Open Angle Glaucoma
Authors: Thimmarayan S.K. , Rao V.A. , Gupta A. 
Published: January 2018

Purpose To evaluate the safety and efficacy of mini-trabeculectomy in comparison to conventional trabeculectomy in primary open angle glaucoma (POAG). Methods A prospective interventional study of mini-trabeculectomy versus conventional trabeculectomy was undertaken on 60 eyes of 54 medically uncontrolled POAG patients requiring glaucoma surgery. They were divided into two groups: Group I underwent mini-trabeculectomy (30 eyes of 26 patients) and Group II underwent conventional trabeculectomy (30 eyes of 28 patients). All patients were followed up for at least 15 months. Statistical analysis was carried using Student's t test and paired t test for quantitative data and Pearson's chi-square test for qualitative data. Results The mean intraocular pressures (IOP) at the end of 15 months of follow-up in Groups I and II were 15.80±4.3 mmHg and 16.13±3.3 mmHg versus mean preoperative IOP of 28.63±2.74 and 28.60±2.44, p<0.0001, respectively. The difference in IOP control was significant only at 6 months of follow up (13.65±3.45 versus 15.98±4.05, p=0.041). The complications and failure were comparatively less in Group I. Conclusions Mini-trabeculectomy is a safe and effective alternative to conventional trabeculectomy in terms of IOP control. A modified tunnel incision employed in mini-trabeculectomy may be responsible for avoiding some of the complications.
Comparison of Topical and Subconjunctival Anesthesia in Intravitreal Injection Administrations
Authors: Kaderli B. , Avci R. 
Published: January 2018

Purpose To compare the effectiveness of topical and subconjunctival anesthesia in intravitreal injection administrations. Methods Twenty-eight patients from a university clinic with bilateral diabetic macular edema were prospectively randomized to receive intravitreal injection of 4 mg triamcinolone under topical anesthesia for one eye and subconjunctival anesthesia for the other eye by using lidocaine 4%. Patients were asked to grade the pain they experienced during administration of both anesthesia and intravitreal injection by using a 4-point pain scale: from 0=no pain to 3=severe pain. Complications that developed during both procedures were recorded. Results The mean pain score experienced during subconjunctival injections was 0.78 ± 0.62, whereas no anesthesia-related pain was reported in the topical group. The mean pain score experienced during intravitreal injection was 1.64±0.67 in the topical and 0.85±0.52 in the subconjunctival group (p<0.001). The mean total pain scores of both procedures were 0.82±0.34 in the topical and 0.82±0.51 in the subconjunctival group (p>0.05). Nine eyes (32%) developed subconjunctival haemorrhage after subconjunctival injection, whereas no anesthesia-related complication developed in the topical group. Subconjunctival haemorrhage was also observed in 5 eyes (18%) in the topical group and in 11 eyes (40%) in the subconjunctival group (p>0.05) after intravitreal injection. Conclusions Although subconjunctival anesthesia provides better pain control during intravitreal injections, its application is more painful and leads to subconjunctival haemorrhage. Moreover, the mean total pain scores are similar in both methods. Therefore, topical anesthesia may be more suitable for daily practice.
Spontaneous Extrusion of a Stainless Steel Glaucoma Drainage Implant (Ex-PRESS)
Authors: Tavolato M. , Babighian S. , Galan A. 
Published: January 2018

Purpose To report a case of spontaneous extrusion of a stainless steel glaucoma drainage implant (Ex-PRESS). Methods An Ex-PRESS was implanted under the conjunctiva in a 76-year-old man with primary open-angle glaucoma. Results Two years after implantation, the Ex-PRESS extruded spontaneously. Despite this adverse event, there was no increase in intraocular pressure. Conclusions This is the first report of spontaneous extrusion of an Ex-PRESS device. Implanting the device under a scleral flap should be considered to avoid adverse events such as extrusion or conjunctival erosion.
Argon Laser Trabeculoplasty in Triamcinolone Acetonide Induced Ocular Hypertension Refractory to Maximal Medical Treatment
Authors: Ricci F. , Missiroli F. , Parravano M. 
Published: January 2018

Purpose To report two cases of intraocular hypertension after intravitreal injection of triamcinolone acetonide (iTAA) that were refractory to maximal medical therapy and were successfully treated with argon laser trabeculoplasty (ALT). Methods Two patients with history of primary open angle glaucoma were treated with intravitreal injection of triamcinolone acetonide for chronic macular edema secondary to branch retinal vein occlusion. Both patients (Case 1 after 2 months and Case 2 after 5 days) developed intraocular hypertension that did not respond to maximal medical therapy. Despite medical therapy, intraocular pressure (IOP) was 45 mmHg in Case 1 and between 34 and 37 mmHg in Case 2. ALT was performed in the inferior 180° angle using the following parameters: 50 μm size, 700 mW, 0.50 sec, 100 spots. Results In both patients IOP returned to normal level a few days after ALT. Conclusions ALT seems to be effective at reducing IOP in patients with intraocular hypertension secondary to iTAA that does not respond to maximal medical treatment.
Bevacizumab for Occult Subfoveal Neovascularization in Age-Related Macular Degeneration
Authors: Jonas J.B. , Harder B. , Spandau U.H. , Kamppeter B.A. , Libondi T. , Sauder G. 
Published: January 2018

Purpose To report on the treatment of exudative age-related macular degeneration by intravitreal bevacizumab (Avastin). Methods A 78-year-old patient experienced a progressive loss of visual acuity in her right eye due to an occult subfoveal neovascular membrane in age-related macular degeneration. She received an intravitreal injection of 1.5 mg bevacizumab. Results Within 4 weeks after the injection, visual acuity improved from 0.40 to 0.60 with complete resolution of subretinal and intraretinal leakage and edema as shown on optical coherence tomography. Pre-existing metamorphopsias disappeared. Intraocular pressure remained in the normal range. During the follow-up, there were no sings of intraocular inflammation or any other intraocular pathology induced by the intravitreal injection. Conclusions Intravitreal bevacizumab may potentially be helpful in the treatment of exudative age-related macular degeneration and may deserve further evaluation.
Clinical Phenotype of an Italian Family with a New Mutation in the PRPF8 Gene
Authors: Testa F , Ziviello C. , Rinaldi M. , Rossi S. , Di Iorio V. , Interlandi E. , Ciccodicola A. , Banfi S. , Simonelli F. 
Published: January 2018

Purpose To report the clinical and functional characteristics of an autosomal dominant retinitis pigmentosa (ADRP) family with a novel point mutation (P2301S) in the PRPF8 gene. Methods PRPF8 gene analysis and complete ophthalmologic examination in an ADRP family. Results Clinical examination revealed the typical RP phenotype in all family members. Electroretinography showed preserved ERG photopic responses. Genetic analysis showed that the P2301S missense mutation segregated with the disease in all subjects. Conclusions Unlike previously reported families, the PRPF8 gene mutation in our family is associated with a mild phenotype in which cone function is partially preserved.
Verteporfin Therapy and Triamcinolone Acetonide: Convergent Modes of Action for Treatment of Neovascular Age-Related Macular Degeneration
Authors: Augustin A.J. , Schmidt-Erfurth U. 
Published: January 2018

Purpose Choroidal neovascularization associated with age-related macular degeneration is the primary cause of blindness in the elderly in developed countries, due to a number of pathogenic effects, including angiogenesis, cell-mediated inflammation, leukocyte adhesion and extravasation, and matrix remodeling. Methods By producing photochemical effects at the site of target tissue (lesion), photodynamic therapy (PDT) can induce vascular damage and blood flow stasis, leading to occlusion of vascularization and lesion leakage. Results PDT with verteporfin (Visudyne, Novartis) has been shown to be safe and effective in reducing the risk of vision loss in patients with classic containing subfoveal CNV and occult with no classic CNV. However, in predominantly occult CNV, the treatment may be most effective in smaller lesions, and less in larger lesions. Most important, visual acuity rarely is improved. Conclusions Pilot studies and large case series suggest that a combination of PDT and intravitreal triamcinolone acetonide has the potential to improve visual outcomes and reduce the need for additional treatments. Randomized, prospective clinical trials are underway to confirm the efficacy and safety of this novel treatment modality.
Secondary Management and Outcome of Massive Suprachoroidal Hemorrhage
Authors: Feretis E. , Mourtzoukos S. , Mangouritsas G. , Kabanarou S.A. , Inoba K. , Xirou T. 
Published: January 2018

Purpose To present the results of secondary surgical treatment of five patients with massive suprachoroidal hemorrhage (MSCH), which occurred intraoperatively, postoperatively, or following ocular trauma. Methods Five patients presenting with MSCH were included in this study during or after phacoemulsification surgery (1 patient), glaucoma surgery (1 patient), combined glaucoma and phacoemulsification surgery (2 patients), and after traumatic sclera rupture (1 patient). Diagnosis was confirmed by ophthalmoscopy and B-scan ultrasonography. Pre-existing risk factors and distance visual acuity were documented. All cases received medical therapy and underwent secondary surgical intervention with radial sclerotomies combined with vitrectomy, use of perfluorocarbon, and silicone oil. Postoperative assessment included visual acuity measurement, ocular examination, and ultrasonography. Results In all cases, anatomic restoration of ocular structures was achieved. Distance visual acuity improved in all cases (preoperative Snellen visual acuity ranged from light perception to hand motions; postoperative Snellen visual acuity ranged from 0.05 to 0.3). The mean follow-up period was 17 months. Conclusions In general, despite the advanced surgical techniques, the prognosis of MSCH remains guarded and the visual outcome poor. However, secondary surgical treatment with combined radial sclerotomies and vitrectomy should be considered in order to minimize the damaging effect and maximize the anatomic and functional restoration.
Ocular Involvement in Anti-Epiligrin Cicatricial Pemphigoid
Authors: Nischler C. , Sadler E. , Lazarova Z. , Stoiber J. , Ruckhofer J. , Pohla-Gubo G. , Emberger M. , Bauer J.W. , Grabner G. , Hintner H. 
Published: January 2018

Purpose To report an anti-epiligrin cicatricial pemphigoid (AECP) patient with severe ocular involvement and to provide a practical approach to distinguishing AECP patients from those with other subepidermal blistering diseases. Methods Techniques included direct and indirect immunofluorescence microscopy, Western blot and immunoprecipitation studies, as well as interdisciplinary examinations of mucous membranes and skin. Results This study describes a patient with clinical features of cicatricial pemphigoid, circulating anti-basement membrane zone IgG antibodies, and subepidermal blisters. Histopathology and immunofluorescence analysis suggested the diagnosis of a cicatricial pemphigoid-like type of epidermolysis bullosa acquisita. However, Western blot and immunoprecipitation studies demonstrated that the patient's serum contained autoantibodies against laminin 5 α3 subunit, leading to the diagnosis of an AECP. Conclusions Since patients with AECP have an increased relative risk for malignant tumors, it is important to distinguish this entity within the spectrum of cicatricial pemphigoid patients by additional studies such as Western blot or immunoprecipitation.
Delayed Treatment of Choroidal Melanoma Due to Pregnancy
Authors: Skarmoutsos F , Durnian J.M. , Damato B.E. 
Published: January 2018

Purpose The authors report a 27-year-old woman who presented with a large, choroidal melanoma when she was 28 weeks pregnant. Following detailed discussion with the patient, the decision was made to postpone any surgical treatment until after the birth of her child. Methods Case report. Results The patient had successful transscleral local resection of the tumor with 6/12 vision 6 months later. Cytogenetic studies showed a low risk of subsequent metastases. Conclusions This case illustrates that deferring the treatment of a choroidal melanoma presenting during pregnancy can be a reasonable treatment plan, if the patient is highly motivated to keep the eye.
Optical Coherence Tomography and Focal Electroretinogram Evaluation of Cystoid Macular Edema Secondary to Retinitis Pigmentosa Treated with Intravitreal Triamcinolone: Case Report
Authors: Minnella A.M. , Falsini B. , Bamonte G. , Montrone L. , Petroni S. , Zinzanella G. , Balestrazzi E. 
Published: January 2018

Purpose To assess macular structure and function by optical coherence tomography (OCT) and focal electroretinogram (FERG) before and after intravitreal triamcinolone acetonide (IVTA) administration for cystoid macular edema (CME) in a patient with retinitis pigmentosa (RP). Methods A 33-year-old man with RP and refractory bilateral macular edema was treated with IVTA in his left eye and evaluated with visual acuity, OCT, and FERG for 6 months. Results Compared to the fellow eye, after IVTA mean retinal thickness significantly decreased, while FERG amplitude and phase did not show significant changes at the end of follow-up. Visual acuity showed a significant tendency to improve. Conclusions In this case report, IVTA improved macular anatomy and visual acuity; this result, however, was not associated with a similar electrophysiologic response.
Immunohistochemical Findings in Epiretinal Membrane after Long-Term Silicone Oil Tamponade: Case report
Authors: Carpineto P. , Angelucci D. , Nubile M. , Colasante A. , Di Antonio L. , Ciancaglini M. , Mastropasqua L. 
Published: January 2018

Purpose To report pre- and post-operative macular optical coherence tomography (OCT) and immunohistochemical findings in a case of long-lasting silicone oil tamponade followed by silicone oil removal and epimacular membrane peeling. Methods A 69-year-old man with long-standing silicone oil tamponade and an epiretinal membrane at the posterior pole in his right eye (RE) underwent silicone oil/BSS exchange with epiretinal membrane peeling. Preoperatively RE best-corrected visual acuity was 20/200 and macular OCT examination revealed a small increase in foveal thickness (250 μm) with the appearance of a linear hyper-reflective signal at the foveal vitreoretinal interface and a thicker (440 μm) hyperreflective finding causing posterior shadowing at the vitreoretinal interface inferiorly to the fovea. Histopathologic and immunohistochemical study of the specimen including the epiretinal membrane was performed. Results Light microscopy revealed extensive rounded empty spaces interpreted as silicone oil bubbles in the preretinal membrane. Macrophages marker (CD68) positive staining cells were found surrounding the empty spaces within the preretinal membrane and several empty spaces were observed intracellularly within macrophage cytoplasm. Thirty days after surgery best-corrected visual acuity was 20/60 and OCT examination showed an evident decrease in foveal thickness (220 μm) with the disappearance of any hyper-reflective signal at the vitreoretinal interface referable to an epiretinal membrane. Conclusions The immunohistochemical study showed both silicone oil droplets and macrophagic cells embedded in the epiretinal membrane. Postoperative OCT demonstrated retinal recovery after silicone oil removal and epiretinal membrane peeling, thus justifying an unexpected visual acuity recovery despite the very long term tamponade.
Primary Localized Orbital Amyloidosis: A Case Report
Authors: Di Bari R. , Guerriero S. , Giancipoli G. , Cantatore A. , Sborgia G. , Piscitelli D. 
Published: January 2018

Purpose Amyloidosis refers to a heterogeneous group of disorders associated with deposition of chemically distinct fibril proteins. Isolated orbital amyloidosis is a rare condition and requires systemic examination. The authors report a case of amyloid deposit in the orbit whose systemic investigation has been negative. Methods A 64-year-old woman presented to the eye clinic with left-sided orbital mass, mild exophthalmos with downward ocular displacement, and ptosis. The patient presented also visual acuity loss and ocular hypertension. No systemic involvement was noted by systemic workup and it confirmed the primary orbital amyloidosis. Results The patient was subject to full clinical examination, laboratory examinations, orbital echography, magnetic resonance imaging and total body computed tomography scans, rectal mucosa, and temporal artery biopsies. It was necessary to exclude systemic amyloidosis. The presence of amyloid deposits was confirmed by biopsy of orbital mass. The chemical nature of deposit was characterized using light microscopy, immunohistochemistry, and electron microscopy. Conclusions Orbital amyloidosis is a very rare disease. It should be considered in the diagnosis of patients with ptosis and exophthalmos. The treatment usually consists of surgical removal of the amyloid mass and follow-up for a likely local recurrence. In our case, mass excision determined the decrease of exophthalmos and intraocular pressure.
The Projected Increase in Glaucoma Due to the Aging Population in Austria from 2001 to 2031: Results Based on Data of the Salzburg-Moorfields Collaborative Glaucoma Study
Authors: Hitzl W. , Bunce C. , Reitsamer H.A. , Grabner G. , Hornykewycz K. 
Published: January 2018

Purpose The aim of this study is to present the projected increase in definite primary open angle glaucoma (POAG) and related diseases in Austria from 2001 to 2031. Methods The present work is based on two data sources: population projections in Austria and detection rates of the Salzburg-Moorfields Collaborative Glaucoma Study for Austrians in the age groups 40–54 years, 55–69 years, and 70 years and above. The estimates of this glaucoma screening program are based on a total of 3419 subjects. Sensitivity analyses were applied to test the effects of higher and lower sets of prevalence assumptions on the extent of the probable projections. Results The number of Austrians with definite POAG, early POAG, POAG suspects, and ocular hypertension (OHT) is expected to increase until 2031 by 0.5%, 43.1%, and 65.6% in the three age groups specified above, respectively. The overall number of Austrians with POAG at the age of 40 or older is estimated to increase from 67,600 in 2001 to 96,400 in 2031. This corresponds to an increase of 42% from 2001 to 2031 (lower scenario: 37%, upper scenario: 47%). Similar increases are expected for individuals with early POAG, POAG suspects, and OHT. Conclusions These projections provide an objective basis to estimate the resources that may be needed by health authorities and care providers such as ophthalmologists in the future and should help to design glaucoma blindness prevention programs or screening studies in Austria. The predicted continuous increase of Europe's older population will prove to become a challenge for public health professionals not only for diagnosis and monitoring, but also for the treatment of glaucoma. (Eur J Ophthalmol 2007; 17: 45–52)