bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electro-Oculographic Abnormality in Eyes with Uveal Melanoma
Authors: Spadea L. , Bianco G. , Magni R. , Rinaldi G. , Ponte F. , Brancato R. , Ravalico G. , Balestrazzi E. 
Published: January 2018

Purpose To seek out correlations between preoperative electro-oculogram (EOG) recordings with different types of uveal melanomas, after surgery. Methods We analysed the EOG recordings of 120 patients with uveal melanomas, histologically verified, 100 in the choroid and 20 in the iris and ciliary body. The EOG data were correlated with the site, size and histological type of the tumor. Results In 100 eyes with choroidal melanoma the Arden Index (AI) was less than in fellow eyes (mean 126.6, SD ± 23.8 and 202.9, SD ± 47.0; p=0.01). The EOG values were not different with respect to the histological type, site and size of tumor. In cases with iris and ciliary body melanomas the AI were not significantly different from the fellow eyes (mean 180.6, SD ± 23.6 and 203.2, SD ± 38.7; p=0.07). Conclusions Since the EOG is abnormal in eyes with choroidal melanoma, it can be considered a powerful auxiliary for diagnosing these tumors.
Conjunctival Ulcer - Mucocutaneous or Ocular Manifestation of Behçet's Disease? a Case Report
Authors: Shenoy R. 
Published: January 2018

Purpose To report the rare occurrence of conjunctival ulceration in a patient with Behcet's disease. Methods Case report. A 35 year old “Behçet's suspect” on azathioprine presented to the ophthalmic emergency room with a painful ulceration involving the inferior palpebral conjunctiva of her left eye. Results The ulcer responded to treatment with topical steroids and healed without scarring. Conclusions Conjunctival ulceration is not a common manifestation of Behcet's disease. Its occurrence during maintenance therapy with azathioprine in a patient with Behcets could be either incidental or indicate inadequate immunosuppression.
Self-Inflicted Repetitive Optic Nerve Injury: A Case Report
Authors: Detry-Morel M. , Philippart P. , Boschi A. , Luts A. 
Published: January 2018

Purpose To describe an obsessive-compulsive patient who developed blindness after self-inflicted repetitive optic nerve injury. Methods Case report. Results A myopic 46-year-old male became blind as a result of intermittent rubbing of his eyes, causing stretching of the optic nerves. Extensive ocular, neurologic and systemic work-ups were negative. Cerebral and orbital MR studies showed severe bilateral optic nerve atrophy. Psychiatric evaluation confirmed obsessive-compulsive personality. Conclusions Self-inflicted optic nerve injury should be included in the differential diagnosis of progressive optic neuropathy in a young adult.
Evaluating the Management of Diabetic Retinopathy in a Teaching Center
Authors: Pharmakakis N.M. , Petropoulos I.K. , Peristeropoulos P.A. , Vantzou C.V. , Koliopoulos J.X. 
Published: January 2018

Purpose To evaluate the efficacy of the management of diabetic retinopathy (DR) in the teaching center of the University Eye Clinic of Patras in Greece. Methods From 1989 to 1999, 302 patients with type I (5.3%) and type II (94.7%) diabetes mellitus (DM) were examined. Standard examination and treatment protocols were employed. Examinations and laser treatment were done by trainee specialists, under the supervision of the head physician (N.Ph), during their rotation in the retina and vitreous disorders outpatient department. Results At baseline examination, 17.9% of the eyes had no DR, 71.7% had nonproliferative DR, and 10.4% had proliferative DR. In 34.4%, no laser treatment followed. The other 65.6% underwent focal and/or grid laser and/or panretinal photocoagulation and/or vitrectomy. At the final examination, DR was still the same in 63.1% of the eyes, progression had occurred in 34.1%, and regression in 2.8%. Type I DM patients' eyes had a higher prevalence of proliferative DR at the final examination than type II DM eyes. There was also a significant correlation between progression of DR and duration of DM, insulin treatment for DM, and elevated glycosylated hemoglobin (HbA1c). Conclusions Having applied standard examination and treatment protocols, the efficacy of the management of our diabetic patients was consistent with international standards, even though patients were treated mostly by doctors in training.
Hyperhomocysteinemia and Retinal Vascular Occlusive Disease
Authors: Abu El-Asrar A.M. , Abdel Gader A.G.M. , Al-Amro S.A. , Al-Attas O.S. 
Published: January 2018

Purpose Elevated plasma homocysteine is an independent risk factor for thrombosis and vascular disease. This prospective study compared plasma total homocysteine levels in patients with retinal vascular occlusive disease and in matched healthy controls. Methods We measured plasma total homocysteine in 56 consecutive patients with recently diagnosed retinal vascular occlusive disease: 36 had central retinal vein occlusion, 12 branch retinal vein occlusion, and 8 retinal artery occlusion, and compared them with 59 age- and sex-matched healthy controls. Homocysteine levels were determined by high-performance liquid chromatography with electrochemical detection. Hyperhomocysteinemia was defined as a plasma homocysteine level above the 95th percentile in the control group (13.6 μmol/L). Results Mean plasma total homocysteine levels were significantly higher in patients than controls (16.1 ± 8.3 vs. 8.96 ± 5.6 μmol/L p<0.001). Mean homocysteine levels were significantly higher in the retinal vein occlusion and retinal artery occlusion groups than the control group (15.3 ± 8.2 and 20.95 ± 6.9 vs 8.96 ± 5.6 μmol/L, p<0.001). Estimates of the relative risk indicated that the risk of hyperhomocysteinemia was significantly higher in patients with retinal vascular occlusive disease than controls. Hyperhomocysteinemia was present in 37 (66.1%) of the 56 patients with retinal vascular occlusive disease but only 2 (3.4%) controls (odds ratio [OR] 47.5, 95% confidence interval [CI] 9.8 - 149.9). Hyperhomocysteinemia was present in 29 (60.4%) of the patients with retinal vein occlusion (OR 43.5, 95% CI 8.77 - 141.93) and in 6 (75%) patients with retinal artery occlusion (OR 85.5, 95% CI 7.49 - 1173.1). Conclusions High plasma homocysteine is a risk factor for retinal vascular occlusive disease so it may be useful to measure homocysteine in the management of these patients. A randomized, controlled trial is required to study the effect of lowering with homocysteine folic acid and other B vitamins on the risk of recurrent vascular occlusion in the same eye or its development in the fellow eye.
Anesthesia through a Novel Retrobulbar Catheter Provides Perioperative Pain Control for 24 h after Pars Plana Vitrectomy
Authors: Jonas J.B. , Jäger M. , Hemmerling T.M. 
Published: January 2018

Purpose The purpose of this study was to assess the retrobulbar catheter technique for perioperative pain control in pars plana vitrectomy. Methods One hundred consecutive pars plana vitrectomies (duration 20–220 minutes) in 88 patients (age range 37–88 years) were performed by the same surgeon under retrobulbar anesthesia using a commercially available retrobulbar needle. Initially, 7 ml of mepivacaine 2% were injected, a 28-gauge flexible catheter was introduced into the retrobulbar space and the needle was withdrawn. The catheter was removed 24 h after surgery. Intra-operatively and postoperatively, the patients were asked to rate pain using a numerical scale from 0 to 10. When pain was more than grade 3, 2 ml of a local anesthetic were re-injected through the catheter. Results A first re-injection was given intraoperatively 53.0 ± 34.6 minutes after the start of surgery during 35/100 procedures, and second and third injections were needed during 12/100 and 4/100 procedures, respectively. The first postoperative re-injection was given 3.9 ± 1.5 hours after the start of surgery in 54 procedures, and second and third injections were carried out in 35/100 and 10/100 procedures respectively. Conclusions The results suggest that a temporary indwelling retrobulbar catheter allows long-lasting titratable local anesthesia during pars plana vitrectomy and titratable postoperative analgesia.
Determination of Optic Cup Depth by Confocal Scanning Laser Tomography
Authors: Budde W.M. , Jonas J.B. , Hayler J.K. , Mardin C.Y. 
Published: January 2018

Purpose To assess whether confocal scanning laser tomography of the optic disc and clinical ophthalmoscopy using stereoscopic optic disc photographs, agree in the evaluation of the deepest part of the optic cup. Patients and Methods The study included 33 eyes of patients with focal normal-pressure glaucoma. Using 15° color stereoscopic optic disc photographs and dividing the optic disc into an upper and a lower half, two trained observers independently established the location of the deepest part of the cup. By selection, the two observers had made congruent judgements for all eyes in the study. All patients also underwent confocal scanning laser tomography of the optic disc using the Heidelberg Retina Tomograph (HRT). The location of the deepest “mean cup depth” was noted. Results The deepest optic cup region based on stereoscopic evaluation of photographs and on scanning laser tomography did not correlate significantly with each other (p=0.18; chi-square test, linear-by-linear association). According to the scanning laser tomography data, the maximal optic cup depths were not correlated with the corresponding locations of maximal visual field defect (p=0.80). Using the stereo photographic data, the locations of maximal optic cup depth and maximal visual field defect were correlated (p=0.006). Conclusions In some glaucomatous eyes, confocal scanning laser tomographic assessment of the location of the deepest optic cup region does not agree with clinical judgement and, in contrast to clinical examination, does not correlate with the location of the maximal visual field defect.
Topical Aminocaproic Acid to Prevent Rebleeding in Cases of Traumatic Hyphema
Authors: Karkhaneh R. , Naeeni M. , Chams H. , Abdollahi M. , Mansouri M.R. 
Published: January 2018

Purpose To determine the effect of topical aminocaproic acid on the incidence of rebleeding after traumatic hyphema. Patients and Methods This randomized double blind clinical trial investigated 132 consecutive cases of traumatic hyphema referred to the emergency room of Farabi Eye Hospital in 1998–1999. The patients were randomly divided into three groups: Group 1 received cycloplegic drops only. Group 2 received cycloplegic drops and 2% carboxy polymethylene (CPM) gel as placebo. Group 3 was treated with cycloplegic drops and 25% aminocaproic acid (ACA) in CPM gel (supplied by Messrs. Sina Darou). All patients were treated for five days on an outpatient basis, with a two-week follow-up. The incidence of rebleeding, time needed for clot absorption, and complications of hyphema were recorded and analyzed using the chi-square and Student's t-tests and logistic regression modeling. Results Rebleeding occurred in 8 eyes of 52 patients in group 1 (15.4%), 7 eyes of the 39 patients in group 2 (17.9%) and 5 eyes of the 41 patients in group 3 (12.2%). This difference was not significant. The time needed for clot absorption in groups 1, 2 and 3 was respectively 9.5±3.9, 9.3±4.2 and 11.15±4.7 days, the difference between group 3 and the other two groups being statistically significant (p<0.04). Conclusions Topical 25% ACA is not effective in reducing the incidence of rebleeding and lengthens the time needed for clot absorption.
Spontaneous Visual Improvement in Pituitary Metastasis
Authors: Berney C. , Borruat F.-X. , De Tribolet N. 
Published: January 2018

Purpose To report spontaneous visual improvement in a patient with unilateral optic neuropathy due to pituitary metastasis. Methods Report of a case. Results A 54-year-old woman with a history of breast carcinoma lost vision in her right eye to 20/70 without any other symptoms. Six days later, vision spontaneously improved to 20/30. A pituitary mass compressing the right intracranial optic nerve was found on magnetic resonance imaging and the diagnosis of metastatic breast carcinoma was confirmed by biopsy. Conclusions Spontaneous visual improvement can occur in the setting of compressive optic neuropathy by a solid mass.
Biopsy of the Conjunctiva in Dry Eye Patients Establishes a Correlation between Squamous Metaplasia and Dry Eye Clinical Severity
Authors: Murube J. , Rivas L. 
Published: January 2018

Purpose The aim of this work was to evaluate the different grades of squamous metaplasia of the conjunctiva during the clinical course of dry eye syndrome, detecting the most characteristic morphological and morphometric changes by biopsy in order to provide a diagnostic classification. Methods The conjunctiva was studied under light microscopy by conventional histological methods and by morphometric analysis in 165 patients and in 33 controls. Patients were classified according to the Schirmer 1 test, break-up time, rose Bengal staining, osmolarity and impression cytology. The epithelium and connective tissue, with their different cells and other structures, were studied. Results The conjunctiva in dry eye patients showed progressive stratification, hyperplasia, hypertrophy and cellular flattening, with loss of goblet cell density and mucous layer. We found five pathological grades of squamous metaplasia and one normal grade. Clear nuclear alterations (indentation and binucleation) were found in the early grades of dry eye syndrome, but pyknotic nuclei and anucleated cells were only seen in the most severe grades. The smallest epithelial cells were found in the control group and their size increased with the severity of the dry eye syndrome From the earliest stages to the most severe cases, increases in cellular separation were observed. There was also an increase in the number of inflammatory cells. Blood and lymphatic vessels showed alterations only in the most severe cases. Conclusions This is the first grading system proposed for biopsy evaluation of the ocular surface in dry eye patients. These morphological and morphometric studies alone were able, even in the earliest phases of dry eye, to detect the squamous metaplasia that progresses from the surface of the epithelium to the connective tissue. This degenerative or adaptative cellular process was characterized mainly by marked increases in the stratification, epithelial cellular size and a general loss of goblet cells.
Changes in Blood Antioxidants and Several Lipid Peroxidation Products in Women with Age-Related Macular Degeneration
Authors: Nowak M. , Świȩtochowska E. , Wielkoszyński T. , Marek B. , Karpe J. , Górski J. , Głogowska-szelαg J. , Kos-kudła B. , Ostrowska Z. 
Published: January 2018

Purpose The aim of this study was to evaluate the ferric reducing ability of plasma (FRAP), selected enzymatic and non-enzymatic components of the antioxidative system, and the intensity of peroxidative processes in the blood of patients with age-related macular degeneration (AMD). Methods In the peripheral blood, we evaluated FRAP; concentrations of vitamins C, A, and E; and of thiols. We assayed the activity of enzymatic components of the antioxidative system-superoxide dismutase, catalase, ceruloplasmin and the concentration of reduced glutathione as an indicator of glutathione peroxidase activity. In order to determine the intensity of lipid peroxidation, we measured the concentrations of malondialdehyde and hydroxyalkenales (MDA-HNA) and conjugated diens (CD). Results We found a significant increase in FRAP in patients with AMD compared with the control group. The average concentrations of vitamins A and C were low and vitamins E and GSH were significantly higher in AMD than in the control group. The activity of almost all the antioxidative enzymes was high. We found a significant increase in MDA-HNA but no difference in CD. Conclusions The significantly higher concentration of lipid peroxidation products in patients with AMD indicates an important pathogenic role of oxido-reduction disturbance. The high FRAP concentration may be one of the protective mechanisms in oxidation stress. The adaptive increase of the antioxidant barrier mostly involves the enzymatic components.
Intravitreal Triamcinolone Acetonide Injection in Blind Painful Eyes
Authors: Rodriguez M.L. , Juarez C.P. , Luna J.D. 
Published: January 2018

Purpose Phthisis bulbi results from different ocular conditions. We evaluated intravitreal triamcinolone acetonide as a treatment option in blind painful eyes. Methods Thirty-one patients with unilateral phthisis were randomly divided into two groups. Group A received 0.3 ml (12.5 mg) triamcinolone acetonide intravitreally and Group B 0.3 ml balanced salt solution after retrobulbar anesthesia. Treatment success was assessed by subjective response to pain and clinically by biomicroscopic evaluation of conjunctival congestion. Tonometry was done before and after treatment. Follow-ups were at 24 hours, 3 weeks, 3 and 6 months, and 1 and 2 years. Results Throughout the two-year follow-up, only two patients in Group A reported pain after the procedure and were retreated, one at week 4 and the other at week 7. Conjunctival congestion was significantly lower in Group A. Two patients with hypotony before treatment had normal tension after triamcinolone. All Group B patients were reinjected with triamcinolone because pain continued after balanced salt solution injection. No severe complications were found. Conclusions Intravitreal triamcinolone acetonide may be effective and safe for treating blind painful eyes.
Goldmann-Favre Vitreoretinal Degeneration
Authors: Batioğ lu F. 
Published: January 2018

Purpose To describe a case of Goldmann-Favre vitreoretinal degeneration with typical clinical findings. Methods The case report of a healthy 47-year-old woman with typical clinical findings of Goldmann-Favre vitreoretinal degeneration is presented. She had complaints of reduced visual acuity and night blindness. Her parents were first cousins. Results Fundus examination revealed annular pigmentary degenerative changes, macular edema, and peripheral retinoschisis in both eyes. Electroretinography results were abnormal. Optical coherence tomography scans revealed hyporeflective spaces in the macular area and irregularities of the chorioretinal complex in the degenerative pigmentary areas. Conclusions Typical fundus findings combined with night blindness and electroretinogram abnormalities permited the diagnosis of Goldmann-Favre vitreoretinal degeneration.
Bilateral Acanthamoeba Keratitis with Late Recurrence of the Infection in a Corneal Graft: A Case Report
Authors: Rama P. , Matuska S. , Viganò M. , Spinelli A. , Paganoni G. , Brancato R. 
Published: January 2018

Purpose To report a case of bilateral Acanthamoeba keratitis with late, atypical recurrence after penetrating keratoplasty à chaud. Methods A 23-year-old contact lens wearer was treated for bilateral Acanthamoeba keratitis and underwent penetrating keratoplasty in the right eye for descemetocele with impending risk of perforation. The postoperative course was uneventful and topical steroids were combined with neomycin and propamidine. Two months after the operation in the right eye the patient presented with active infection in the left eye. One month later recurrence appeared in the right eye, as a central corneal infiltrate in the graft. Results Recurrences in both eyes were successfully treated with a combination of hexamidine and neomycin, and with polyhexamethylene biguanide respectively. The right eye was regrafted three months after the recurrence and penetrating keratoplasty was done two years later in the left eye. Both grafts were successful and remained clear. There has been no further recurrence in the long-term follow-up. Conclusions Recurrence of Acanthamoeba keratitis after penetrating keratoplasty à chaud may occur even several months after the operation and the manifestation may be atypical. Current antiamoebal therapy was effective and regrafting in the quiet eye was successful.
Transient Third Nerve Palsy in a Young Patient with Intracranial Arteriovenous Malformation
Authors: Wu G. , Agrawal A. , Ghanchi F.D. 
Published: January 2018

Purpose To describe a patient with transient third nerve palsy as the possible presenting sign of intracranial arteriovenous malformation. Method Case report. Result A 24-year-old female presented to ophthalmic casualty with sudden onset binocular diplopia and was diagnosed to have right sided partial third nerve palsy. Within 30 hours the third nerve palsy had recovered completely. A MRI scan and subsequent carotid angiogram revealed a large, high flow, trans-cortical Spetzler-Martin grade 4 arteriovenous malformation. The feeder vessel of the AVM originated from the right middle cerebral artery. Superficial venous drainage was via the superficial middle cerebral vein to the right transverse sinus. The deep venous drainage was via thalamostriate veins into markedly dilated internal cerebral vein and vein of Galen (Great cerebral vein). Venous reflux was noted around the midbrain from the vein of Galen. Conclusions Transient third nerve palsy may rarely occur secondary to intracranial arteriovenous malformation. Ophthalmologists should consider neuroimaging in the investigations for transient cases of III nerve palsy in young patients.
Treatment of Blepharospasm with Botulinum Neurotoxin Type A: Long-Term Results
Authors: Calace P. , Cortese G. , Piscopo R. , Della Volpe G. , Gagliardi V. , Magli A. , De Berardinis T. 
Published: January 2018

Purpose To describe the long-term efficacy and side effects of treatment of blepharospasm with botulinum neurotoxin type A (Botox). Methods A total of 178 patients with blepharospasm were treated by injections of botulinum toxin in the Eye Clinic of the University of Naples from 1980 to 2001. The severity of spasm for each patient was graded on a four-point scale. Duration of improvement was assessed and reported in months. Results Of 178 cases, 10 were lost to follow-up; of the remaining patients, 93% reported improvement after treatments. The mean duration of improvement was 3.6 months. Twelve patients (76%) who underwent more than 14 treatments maintained stable relief. Three patients (1.7%) had a total remission of spasms. Side-effects were local; none of the 168 patients experienced any systemic or toxic reaction. Conclusions Botulinum toxin therapy for blepharospasm can provide long-lasting relief and reduction of spasms in the majority of patients. This therapy has the advantages of being safe, simple, and repeatable.
Iris Transillumination Defects in Patients with Primary Open Angle Glaucoma
Authors: Christen R. , Pache M. , Teuchner B. , Meyer P. , Prünte C. , Flammer J. 
Published: January 2018

Purpose To examine the incidence and pattern of iris transillumination defects in patients with primary open angle glaucoma (POAG) with and without vascular dysregulation, in comparison to controls. Methods We prospectively examined 24 patients with POAG (M/F 10:14; mean age 59 ± 14, range 21–76 years) and 23 controls (M/F 10:13; mean age 52 ± 15, range 25–86 years). Vascular dysregulation was presumed if patients had a typical medical history of vasospasm and a pathological result in nailfold capillaroscopy. Iris transillumination defects were visualized by video-taped, digitized diaphanoscopy and assessed by two blinded observers. Results We found significantly more iris transillumination defects in POAG than in controls (54.2% vs. 8.7%; χ2 = 8.85; df = 1; p = 0.002). The defects in POAG showed a characteristic radially-streaked pattern different from those described, for instance, in pigment dispersion syndrome, pseudoexfoliation syndrome, and acute glaucoma. Glaucoma patients with vascular dysregulation had a tendency to a higher incidence of transillumination defects than non-vasospastic patients, though this finding was not significant. Conclusions Patients with POAG have a higher incidence of iris transillumination defects than controls. The underlying mechanisms are not yet clear and call for further investigation.