bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visual Acuity at 6 Weeks after Small Incision Cataract Surgery and Role of Audit in Predicting Visual Acuity
Authors: Khandekar Rajiv B. , Jain Budhendra K. , Sudhan Anand K. , Pandey Kamta P. 
Published: January 2018

Purpose. We present the best-corrected visual acuity (BCVA) at 6 weeks after small incision cataract surgery (SICS) and review the role of audit in predicting visual acuity (VA). Methods. This was a retrospective data analysis of 14,393 SICS performed during 2007–2008 at a hospital in central India. Ophthalmologists noted preoperative, operative, and postoperative details. The BCVA before and 1 day and 6 weeks after surgery were noted. We identified factors associated with BCVA at 1-day and 6-week follow-up. Results. Six weeks after surgery, 12,522 (87%) and 1473 (10.2%) patients had BCVA ≥6/18 and 6/24–6/60, respectively. Vision improved between 2 follow-ups in 6695 eyes (46.5% (95% confidence interval (CI) 45.7–47.3)), remained the same in 7117 eyes (49.4%), and deteriorated in 544 (3.8%) eyes. BCVA at 6 weeks was negatively associated with blindness (VA <3/60 in the better eye) before surgery (odds ratio (OR) = 0.73, 95% CI 0.58–0.92), surgeon's experience (OR = 0.75, 95% CI 0.71–0.81), and male patients (OR = 0.73, 95% CI 0.67–0.80). BCVA at 6 weeks was positively associated with older age (OR = 1.02, 95% CI 1.01–1.03) and intraoperative complications (OR = 1.44, 95% CI 1.14–1.83). The association of VA <6/60 1 day after surgery with improved vision between the 2 follow-ups was not statistically significant (OR = 0.005, p = 0.98). Conclusions. BCVA at 6 weeks after SICS was ≥6/18 in 87% of operated eyes. By performing surgical audit, one can identify high-risk groups that need proactive subsequent follow-ups.
Contrast Reduction and Reading: Assessment and Reliability with the Reading Explorer Test
Authors: Giacomelli Giovanni , Volpe Roberto , Virgili Gianni , Farini Alessandro , Arrighi Roberto , Tarli-Barbieri Chiara , Mencucci Rita , Menchini Ugo 
Published: January 2018

Purpose. To investigate the reliability of the Reading Explorer (REX) charts and to assess the impact of text contrast reduction (1.5 cycle/degree) on reading speed in subjects with normal and low vision. Methods. Standard visual acuity (ETDRS charts), reading speed (MNread charts), and contrast sensitivity (Pelli-Robson charts) measurements were obtained in 3 groups of subjects stratified by visual acuity level in the better eye from 0.0 to 1.0 logMAR, with intermediate cutoffs at 0.3 and 0.6 logMAR. Measurements of reading speed for decreasing levels of text contrast were obtained with the REX charts using a 1.5 cycle/degree text. Results. Since in many patients with lower vision a plateau of maximum reading speed across different levels of text contrast was not found, reliability indexes were computed for average reading speed and reading contrast threshold. In the group with lower visual acuity, 95% limits of agreement were ±0.134 log word/minute and ±0.175 log contrast sensitivity, suggesting good reliability. The proportion of subjects with a 20% loss of reading speed from 90% to 45% text contrast was estimated to be 1/3 at 0.6 logMAR visual acuity level and 2/3 at 1.0 logMAR. Conclusions. The adverse effect of decreased text contrast, which may be found in ordinary reading material, on the reading performance of subjects with advanced and initial low vision is probably underestimated. The REX test proved to be a reliable investigation tool for this phenomenon.
Aqueous Humor Levels of Vasoactive Molecules Correlate with Vitreous Levels and Macular Edema in Central Retinal Vein Occlusion
Authors: Noma Hidetaka , Funatsu Hideharu , Mimura Tatsuya , Harino Seiyo , Hori Sadao 
Published: January 2018

Purpose. Aqueous levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) are associated with the severity of macular edema in patients with central retinal vein occlusion (CRVO). We investigated whether aqueous and vitreous levels of these molecules were correlated in CRVO patients. Methods. Aqueous and vitreous samples were obtained during cataract surgery and vitreous surgery from 17 patients (17 eyes) with CRVO and macular edema. The levels of VEGF and IL-6 in aqueous humor, vitreous fluid, and plasma were determined by enzyme-linked immunosorbent assay. Results. The aqueous levels of VEGF and IL-6 were significantly correlated with the vitreous levels of these molecules (ρ=0.8799, p=0.0004 and ρ=0.8088, p=0.0012, respectively). Vitreous levels of VEGF and IL-6 were significantly higher in CRVO patients with retinal ischemia than in those without ischemia (p=0.0013 and p=0.0009, respectively), as were the aqueous levels of VEGF and IL-6 (p=0.0026, p=0.0120, respectively). Furthermore, both the aqueous and vitreous levels of VEGF and IL-6 were significantly correlated with the severity of macular edema (ρ=0.7181, p=0.0041; ρ=0.8260, p=0.0010; ρ=0.5564, p=0.0260; and ρ=0.6599, p=0.0039, respectively). Conclusions. Our results suggest that aqueous levels of VEGF and IL-6 may reflect the vitreous levels of these molecules. Measurement of VEGF and IL-6 in the aqueous humor may be clinically useful to assess the severity of macular edema in patients with CRVO.
Pars Plana Vitrectomy Results of Exogenous Endophthalmitis in Children
Authors: Çakir Mehmet , Çekiç Osman , Pekel Gökhan , Yilmaz Ömer F. 
Published: January 2018

Purpose. To identify the etiology, culture results, pars plana vitrectomy results, complications, and visual outcome of exogenous endophthalmitis in children. Methods. Seven eyes of 7 consecutive pediatric patients who were treated and followed up for exogenous endophthalmitis between February 2006 and June 2008 were included in this study. The etiology of endophthalmos was penetrating eye injuries in 4 eyes and intraocular surgery in 3 eyes. Combined pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection were performed on all 7 eyes. Anterior chamber fluid and vitreous cultures were taken from all eyes. The patient files were inspected retrospectively. Results. Mean follow-up time was 10.3 months (4–16 months). Mean age of the patients was 8.5 years (3–14 years). At baseline, visual acuity values of the patients were light perception (n=2), hand movements (n=4), and counting fingers from 1 meter (n=1). At final examination, visual acuity improved in 5 eyes, stayed the same in 1 eye, and decreased in 1 eye. Positive culture results were obtained in 3 eyes: alpha hemolytic Streptococcus (n=2) and coagulase-negative Staphylococcus (n=1). Complications seen after vitreoretinal surgery were transient ocular hypertension, emulsification of silicone oil, phthisis bulbi, and secondary retinal detachment. Conclusions. Early pars plana vitrectomy and intravitreal vancomycin plus ceftazidime injection improved anatomic and functional success in pediatric eyes with exogenous endophthalmitis.
Toxic Anterior Segment Syndrome following Iris-Supported Phakic IOL Implantation with Viscoelastic Multivisc BD
Authors: Kremer Israel , Levinger Eliya , Levinger Samuel 
Published: January 2018

Purpose. To report on the association between Multivisc BD and toxic anterior segment syndrome (TASS) post phakic intraocular lens (IOL) implantation. Methods. Two patients developed severe toxic anterior chamber inflammation following implantation of phakic iris fixated IOL with Multivisc BD viscoelastic. Anterior chamber washout was performed with intracameral antibiotic injection. Local antibiotics were continued until cultures were found to be negative. Thereafter, intensive local and systemic steroids were initiated and gradually tapered down. Results. The inflammatory reaction disappeared completely and the visual acuity improved from hand motion to 6/9 without correction within 1 week. Conclusions. Any viscoelastic material may be contaminated by heat-stable bacterial endotoxic as it is prepared by gene-coded bacteria. It is suggested that Multivisc BD was the etiologic factor of TASS. Refractive surgeons should be aware of this rare complication of phakic IOL implantation whenever they use a new viscoelastic material.
Two Cases of Corneal Perforation after Oral Administration of Nonsteroidal Anti-Inflammatory Drugs: Oral Nsaid-Induced Corneal Damage
Authors: Masuda Ikuya , Matsuo Toshihiko , Okamoto Kazuo , Matsushita Kyoko , Ohtsuki Hiroshi 
Published: January 2018

Purpose. To report 2 cases of corneal perforation associated with the use of oral nonsteroidal anti-inflammatory drugs (NSAIDs). Methods. In a 62-year-old woman and a 79-year-old woman, corneal perforation occurred after 7 days and 5 months of oral NSAIDs administration, respectively. Results. After NSAIDs were discontinued, the cornea epithelialized and the anterior chamber formed within 14 and 10 days, respectively. Conclusions. It is well known that topical NSAIDs cause corneal perforation. Observations in the present cases suggest that the oral administration of NSAIDs may also cause corneal damage, and hence, medical professionals should consider the risk of damage to the cornea when administering these drugs orally.
Retinal Peripapillary Nerve Fiber Layer Thickness in a 13-Year-Old Boy with Neuromyelitis Optica
Authors: Camicione Paola , Fodor Estzer , Pannarello Simona , Barabino Stefano 
Published: January 2018

Purpose. To report changes in retinal nerve fiber layer (RNFL) thickness in a patient with neuromyelitis optica (NMO). Methods. A 13-year-old Caucasian boy presented with reduced visual acuity in both eyes, headache, and neck pain associated with left hand burning sensation. Clinical and laboratory examination, including magnetic resonance imaging (MRI) and optical coherence tomography (OCT), were performed. Results. MRI showed spinal cord abnormality and acute myelitis, but normal optic nerve head. A significant reduction of the average and temporal area RNFL thickness was recorded in both eyes by OCT. Six months after initial steroid treatment, visual acuity and visual field slightly improved, but RNFL thickness was further reduced. Conclusions. RNFL thickness measurement with OCT should be performed not only in adults, but also in young patients in case of suspected NMO to confirm the diagnosis and to monitor the disease.
Repeated Surgery for Acute Acquired Esotropia: Is It Worth the Effort?
Authors: Schöffler Corinna , Sturm Veit 
Published: January 2018

Purpose. Good binocular potential has been a fundamental defining characteristic of acute acquired concomitant esotropia (AACE) type II. The purpose of this study was to ascertain the clinical features and surgical outcome in children with AACE type II who underwent repeated surgery for the sake of binocularity Methods. In 4 children with AACE type II, repeated surgery was performed between 1995 and 2008. These cases are presented with special attention to their long-term follow-up and their binocularity outcome. Results. The final binocularity outcome was high-grade stereopsis (Lang I/II positive) in all 4 cases. The duration from onset of esotropia to the time of regained stereovision was between 20 and 62 months. In one case, high-grade stereoacuity was only achieved after a second surgery. Conclusions. Our findings support the good binocular potential in patients with AACE type II. Despite a complicated course and long-lasting absence of stereovision, all patients eventually regained high-grade stereopsis. Resolutely aiming at realignment seems to be worth the effort.
Reproducibility of OCT/SLO Measurements in Healthy Eyes
Authors: Labiris Georgios , Giarmoukakis Athanassios , Katsanos Andreas , Gkika Maria G. , Fanariotis Michael , Pavlidou Efi , Kozobolis Vassilios P. 
Published: January 2018

Purpose. To determine the reproducibility of optical coherence tomography/scanning laser ophthalmoscope (OCT/SLO) measurements within and between observers and within and between sessions in healthy eyes. Methods. Forty eyes of 40 healthy volunteers recruited from the outpatient service of the Department of Ophthalmology at the University Hospital of Alexandroupolis, Greece, were included. Retinal thickness scans were performed 3 times by two experienced operators within each of 3 sessions, which took place within a month, using the spectral OCT/SLO. The OCT/SLO provides retinal nerve fiber layer (RNFL) thickness and volume measurements and a 3D tomography analysis of optic nerve head. Statistical analysis was conducted using Bland-Altman plots, coefficient of variation (CoV), and intra-class correlation coefficient (ICC). Results. AS shown by the CoV values, RNFL parameters were generally found to have high reproducibility (CoV ranging from 4.3% to 10.9% for both operators), whereas optic disc parameters had scores reaching up to 22.5%. On the other hand, as shown by the ICC values, intraobserver and interobserver reproducibility for the OCT/SLO was high for optic disc parameters but low for RNFL thickness and volume measurements. Interobserver reproducibility was found to be highest for the maximum cup depth parameter and lowest for the superior volume. Bland-Altman plots indicate that bias is minimal for practically all parameters and scatterplot homoscedasticity is high. Conclusions. According to our data, SLO/OCT generally has a good reproducibility profile, as differences between the two operators were small. However, additional studies on the reproducibility of measurements with the OCT/SLO are needed.
Identifying Early Recurrence of Choroidal Neovascularization during Treatment with Ranibizumab using C-Scan
Authors: Siqueira Rubens Camargo , Nogueira Miriam Caparroz 
Published: January 2018

Purpose. To demonstrate a new parameter to identify early recurrence of choroidal neovascularization (CNV) during treatment with ranibizumab using summated en face (C-scan). Methods. Seventeen patients with CNV secondary to age-related macular degeneration were enrolled in this retrospective study. Each patient received ranibizumab administered monthly for 3 months and their progress was monitored at 1 week and then at monthly intervals. RTVue spectral domain optical coherence tomography (OCT) was performed in all patients monthly using summated en face (C-scan) subanalysis and was compared with the standard programs for qualitative analysis (Line Scan) and quantitative analysis (macular thickness-MM5 Scan). Results. We observed during the control examination an increase of hyporeflective area (dark spot) mean early fluid accumulation in the layer corresponding to the outer segment of photoreceptors. We did not observe any morphologic characteristics of recurrence of CNV in the standard SD OCT examination. At this time, no treatment was done. We scheduled a new examination in 30 days. After 30 days, the patients presented initial signs of CNV recurrence, and ranibizumab reinjection was necessary. In all cases, we observed change in the C-scan 30 to 60 days before the recurrence signs in the standard OCT program. Conclusions. The data suggest that summated en face (C-scan) is useful to identify early recurrence of CNV during treatment with ranibizumab. Further studies are required to allow for appropriate clinical use of this new technique.
Foveal Structure Defined by Spectral Domain Optical Coherence Tomography Correlates with Visual Function after Macular Hole Surgery
Authors: Chalam Kakarala V. , Murthy Ravi K. , Gupta Shailesh K. , Brar Vikram S. , Grover Sandeep 
Published: January 2018

Purpose. To study the correlation between final visual acuity after successful anatomic macular hole repair and features on spectral domain optical coherence tomography (SD-OCT). Methods. Retrospective review of charts of patients who underwent macular hole surgery. Data collection included pre- and postoperative best-corrected visual acuity (BCVA), central subfield foveal thickness (CSFT), and presence or absence of inner segment-outer segment (IS-OS) line changes on SD-OCT. Data collected from SD-OCT were correlated with Snellen BCVA, which was converted to logMAR score. Subjects were divided into 2 groups: group I had improvement in BCVA of 2 lines or more and group II improved less than 2 lines or had worsening of BCVA. Results. A total of 35 eyes of 32 patients had successful anatomic closure, which was documented both clinically and on SD-OCT. Mean age of the patients was 74.1 years and 71.2% (23/32) of patients were female. Overall, the mean BCVA changed from 1.01±0.38 preoperatively to 0.89±0.48 postoperatively (p=0.33). Based on the postoperative visual outcome, 16 eyes belonged to group I and 19 eyes belonged to group II. On the SD-OCT, the mean CSFT was 252.7±69.1 μm. No correlation was found between the mean CSFT and BCVA in either group. All the 16 patients in group I had a continuous IS-OS line on SD-OCT at the fovea in contrast to 26.3 % (5/19) of patients in group II (p=0.03). Conclusions. Establishment of continuity of IS-OS line is an important indicator of visual recovery in eyes with successful anatomic closure of macular hole.
Use of Amniotic Membrane Transplantation in Isolated Conjunctival Bowen Disease: A Case Report
Authors: Motolese Ilaria , Mazzera Luigi , Frezzotti Paolo , Motolese Paolo Alfonso , Motolese Eduardo 
Published: January 2018

Purpose. To report a case of isolated conjunctival Bowen disease treated with surgical resection and amniotic membrane transplantation. Methods. Interventional case report. Results. A 70-year-old man was admitted to our clinic with a large conjunctival verrucous plaque well-demarcated in the correspondence of the bulbar conjunctiva in the superior quadrant of the left eye with involved limbal and corneal surface. Ophthalmologic examination on slit-lamp examination and color fundus photographs were carried out before surgery and the results were evaluated. Conclusions. Treatment options and treatment studies of Bowen disease are difficult because there are a variety of different protocols and the success of the management depends on several factors (body site, lesion size, number of lesions, and thickness). In the conjunctival localization of the lesion, amniotic membrane transplantation appears to be a useful therapeutic choice after surgical resection of the lesion used to reconstruct ocular and conjunctival surface.
Branch Retinal Artery Embolization Due to Calcific Aortic Valve Stenosis
Authors: Mannino Giuseppe , Romano Mary , Calanchini Matilde , Mannino Cristina , Cascone Nikhil Carlo 
Published: January 2018

Purpose. Branch retinal artery occlusion caused by calcific embolization secondary to calcific aortic valvulopathy Methods. A 45-year-old woman came to our attention complaining a sudden painless loss of her peripheral superior visual field. Best visual acuity was 20/20. Fundus examination revealed the presence of a retinal arterial embolic occlusion of the inferior branch. Fundus retinography visual field, and fluorescein angiography were performed and medical therapy was started. The echocardiography examination revealed a tricuspid and calcified aortic valve with moderate stenosis and regurgitation. Due to the heart pathology, the patient moved to the cardiosurgery department, where an aortic valve replacement was performed. Results. Four months after cardiac surgery, visual acuity of both eyes was stable (20/20). Fundus examination showed a complete reabsorption of the retinal edema and the resolution of retinal pallor. Fluorescein angiography confirmed the delay of the arterial filling. No retinal ischemia was observed. The visual field examination confirmed the deep scotoma previously registered. Conclusions. Retinal arterial embolization is a rare but potentially devastating complication of calcific aortic stenosis. Initial retinal presentation of calcific aortic stenosis is a rare condition. Keeping in mind that these emboli may be recurrent and potentially bilateral, a sudden onset of visual field defects, especially in young asymptomatic patients, needs immediate diagnosis and consideration of an urgent surgical correction.
Cogan Syndrome: Confocal Microscopy Assessment of Corneal Damage
Authors: Pellistri Isabella , Mora Paolo , Ponzin Diego , Coggiola Andrea , Nubile Mario , Orsoni Jelka G. 
Published: January 2018

Purpose. To perform in vivo assessment of corneal alterations in patients with Cogan syndrome (CS) and to correlate these findings with prior histopathologic descriptions. Methods. Four consecutive patients (8 eyes) presenting with typical CS underwent confocal microscopy examination. At the moment of evaluation, ocular inflammation was quiescent in all the patients. The images were studied singularly, and then compared to those obtained from 5 healthy controls. Statistical analysis was performed with Student t test. Results. All the cases showed multiple brightly reflective deposits in the stroma with moderate reflectivity of the surrounding stromal tissue. The outer corneal layers and the endothelium were spared. In 3/4 of the patients, the nerve fibers of the subepithelial plexus were thin and poorly reflective, with interruptions and lack of the typical branching pattern. No cells different from keratocytes could be detected in either case or control eyes. Corneal vascularization was present in one case. In CS-affected eyes, corneal thickness was 552±62 μm on average, and endothelial cell count was 2466±288 cells/mm2. Statistical significance was not reached compared to the control group. Conclusions. Confocal microscopy was able to provide detailed images of corneal alterations in CS. This confirmed the interstitial nature of the keratitis and showed an excellent accordance with prior histopathologic findings. The absence of inflammatory cell infiltration may be explained by the prolonged control of ocular inflammation in our patients, which may also have limited stimuli for corneal neovascularization.
Anterior Chamber Measurements Taken with Pentacam: An Objective Tool in Laser Iridotomy
Authors: Antoniazzi Elena , Pezzotta Sara , Delfino Alessio , Blanchi Paolo E. 
Published: January 2018

Purpose. Laser iridotomy is the standard first-line intervention in both acute and chronic forms of angle closure because it prevents the recurrence of acute attacks and virtually eliminates the risk of an acute attack in the fellow eye. Pentacam is a new imaging modality which does not require probe contact or an immersion bath. The instrument will allow anterior segment morphology before and after laser peripheral iridotomy (LPI) to be quantified. The aim of the study is to evaluate the objective difference in changes of anterior chamber morphology after LPI with Pentacam. Methods. Twenty eyes with a high risk of angle closure were evaluated with Pentacam rotating Scheimpflug camera before and after LPI. We measured anterior chamber volume, anterior chamber depth, and chamber angle before and after laser treatment. Results. Statistically significant difference before and after LPI was noted in all anterior chamber measurements except central anterior chamber depth. Conclusions. This study confirms previous reports of increased anterior chamber volume and angle after LPI and Pentacam is a good objective instrument to demonstrate the efficacy of LPI.