bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protective Effects of Antithrombin III on Retinal Ischemia/Reperfusion Injury in Rats: A Histopathologic Study
Authors: Özden S. , Müftüoğlu S. , Tatlipinar S. , Kaymaz F. , Yildirim C. , Yaylali V. , Özbay D. 
Published: January 2018

Purpose To investigate the effect of antithrombin III (AT III) on retinal ischemia/reperfusion (I/R) injury in rats. Methods The study was carried out on 10 Wistar albino rats (20 eyes) and four-vessel occlusion method was employed to induce retinal ischemia in this study. Rats were divided into two groups: Group I (control group, 10 eyes) and Group II (AT III, 10 eyes). In both groups, vertebral arteries were occluded bilaterally an electric needle coagulator under an operating microscope. A total of 48 hours after the initial procedure, the rats were re-anesthetized and both common carotid arteries were clamped to interrupt blood flow. In Group II, rats were injected intravenously with 250 U/kg of AT III 5 minutes before the induction of ischemia. Duration of ischemia was 30 minutes. At the end of this period, clamp was removed for the reperfusion of the eye for 4 hours. Following the reperfusion period, the animals were killed by decapitation. Retinal sections were evaluated under light and electron microscope. The signs of l/R injury at the microscopic level, i.e., cellular degeneration, vacuolization between retinal layers, increase in the retinal thickness due to edema, mononuclear cell infiltration, and apoptotic cells, were recorded for each group. Results Retinal sections obtained from the rats in the AT III group revealed a well preserved retinal structure. When average thickness values of the two groups were compared to each other, the difference was significant with respect to inner nuclear and inner plexiform layers indicating increased retinal thickness values in Group I due to tissue edema resulting from l/R injury. Similarly, mononuclear cell infiltration and apoptotic cell counts were found to be significantly higher in control group compared to AT III group showing the inhibitory effect of AT III on leukocyte infiltration and apoptotic cell death in rat retina. Conclusions Antithrombin III attenuated l/R injury in rat retina.
Varix of the Vortex Vein Ampulla: A Small Case Series
Authors: Levy J. , Yagev R. , Shelef I. , Lifshitz T. 
Published: January 2018

Purpose To report three cases of varix of the vortex vein ampulla. Methods Observational small case series. During 2002, three patients were examined for suspected choroidal melanoma. In all cases, the lesions were located at the equator or the periphery. Results The lesions became more prominent when the eyes were positioned in the direction of the lesion, and disappeared when firm pressure by ultrasound probe was applied on the globe, while the eye was in primary position, or fundus was examined with a three-mirror Goldmann contact lens. These dynamic characteristics were also demonstrated by color Doppler imaging. Conclusions Varix of the vortex vein ampulla is an extremely rare condition. This diagnosis should be considered when an elevated choroidal lesion disappears when the fundus is examined with contact lens.
Exchange Technique for Opacified Hydrophilic Acrylic Intraocular Lenses
Authors: Voros G.M. , Strong N.P. 
Published: January 2018

Purpose To report an exchange technique for opacified hydrophilic acrylic intraocular lenses (IOLs). Methods Twenty patients with two different types of opacified hydrophilic acrylic IOLs underwent IOL exchange by a single surgeon. Circumferential enlargement of the pre-existing capsulorrhexis was a critical step of the procedure, and resulted in expression of the IOL with minimal traction to the capsule. Implantation of an in-the-sulcus IOL followed. Surgical technique, complications, and visual outcome are discussed. Results Time from the initial cataract operation varied from 15 to 61 months (mean 30.5), and in all cases marked fibrosis was encountered. Eighteen patients had uncomplicated IOL exchange. Posterior capsule rupture occurred in two cases. Vision improved in 16 cases, remained unchanged in 3 cases, and deteriorated in 1 case. Conclusions IOL exchange of opacified hydrophilic acrylic IOLs is a particularly challenging procedure due to extensive fibrosis. Circumferential enlargement of the pre-existing capsulorrhexis significantly facilitates the mobilization of the IOL from its fibrous pocket, with the use of minimal forces. Thus, the risk of zonular dehiscence or posterior capsule rupture is minimized.
Efficacy and Safety of Bimatoprost in Patients with Uncontrolled Glaucoma as Alternative to Filtration Surgery
Authors: Vetrugno M. , Sborgia C. , Balestrazzi E. , Bianchi C. , Caporossi A. , Nardi M. , Rapisarda A. , Tassinari G. , Zeppa L. 
Published: January 2018

Purpose To evaluate the efficacy and safety of bimatoprost 0.03% as an alternative to filtration surgery in patients with uncontrolled glaucoma. Design Interventional study. Methods A total of 83 consecutive patients (83 eyes) awaiting glaucoma surgery were enrolled in eight ophthalmic centers. Reasons for listing were inadequate intraocular pressure (IOP) control despite medical therapy and documented progression of visual field loss. All patients discontinued the previous treatment and were switched to bimatoprost 0.03% QD (one drop at 9 pm). The primary efficacy outcome was a 20% IOP reduction from baseline at each timepoint. IOP was measured at day 7, day 30, day 60, and day 90 of treatment; less than 20% IOP reduction was considered as a failure. Results An IOP reduction of at least 20% was achieved in 74 patients (89.1%) after 7 days and in 64 patients (86.5%) after 30 days. Sixty-two patients (74.6%) maintained IOP readings 20% lower than baseline after 60 and 90 days. In these patients, visual field indices improved in 8 eyes (13%), and remained unchanged in 54 eyes (87%). Ocular side effects were conjunctival injection (15.6%), burning sensation (9.6%), foreign body sensation (4.8%), and eyelash growth (2.4%). Conclusions This preliminary study shows that bimatoprost 0.03% could represent a useful therapeutic tool that might defer filtration surgery.
Cerebrospinal Fluid Leakage during Dacryocystorhinostomy in a Patient with Meningoencephalocele
Authors: Bagheri A. , Naghibozakerin J. , Yazdani S. 
Published: January 2018

Purpose To report a rare case of cerebrospinal fluid leakage during dacryocystorhinostomy in a patient with Möbius syndrome and meningoencephalocele and to explain our experience in the management of this complication. Methods A 9-year-old girl with a history of surgically repaired fronto-ethmoidal meningoencephalocele and bilateral canthopexy was diagnosed with Möbius syndrome and underwent sequential bilateral dacryocystorhinostomy and silicone intubation because of dysgenesis of the lacrimal drainage pathway. Results Both dacryocystorhinostomies resulted in cerebrospinal fluid leakage, which spontaneously ceased with conservative management. Conclusions Dacryocystorhinostomy surgery in patients with a history of trauma or surgery or congenital defects around the base of the nose or lacrimal system may rarely result in cerebrospinal fluid leakage; thus an ophthalmologist should be familiar with its management.
Comparison of Failed and Successful Dacryocystorhinostomy by Using Computed Tomographic Dacryocystography Findings
Authors: Gökçek A. , Argin M.A. , Altintas A.K. 
Published: January 2018

Purpose To compare the spiral computed tomographic dacryocystography (CT-DCG) findings of failed and successful dacryocystorhinostomies (DCR) and to detect the possible causes of failure before reoperation. Methods Eighteen patients with failed and 15 patients with functional DCR were examined by spiral CT-DCG, a combination of contrast dacryocystography and spiral computed tomography. Radiologists, who were blinded to the clinical status of the patients, measured the diameter of the osteotomy window, evaluated its position relative to the lacrimal sac, and documented any abnormal findings around the osteotomy, which may contribute to the failure of DCR. Results Location of the osteotomy window was inappropriate in 83% (15/18) of unsuccessful cases and in 7% (1/15) of successful cases and the difference was statistically significant (p<0.01). Presence of the ethmoid air cells medial to the ostium was detected to have a significantly higher frequency in the unsuccessful DCR group (78%, 14/18) than in the successful group (20%, 3/15) (p<0.01). The antero-posterior diameter of bony ostium was less than 15 mm in 94% (17/18) of failed DCR cases, but in only 60% (9/15) of successful DCR cases, and the difference was statistically significant (p<0.05). Some additional findings that may contribute to the failure were noted in failed cases. There were ethmoid sinusitis in three, concha bullosa in two, nasal polyposis in two, mass in medial canthus in one, and extensive granulation tissue around the rhinostomy in one of the failed cases. Conclusions CT-DCG is a valuable imaging tool to evaluate DCR failures before reoperation. In this series, CT-DCG showed that small size and inappropriate position of osteotomy, and also extension of ethmoid air cells medial to the lacrimal sac, were frequently seen causative factors of DCR failure.
Comparison of the Effectiveness of Mitomycin-C and Viscoat on Delayed Adjustable Strabismus Surgery in Rabbits
Authors: Cengiz Y. , Altintas Ö. , Manav Ay G. , Çaglar Y. 
Published: January 2018

Purpose To determine a way to prevent the formation of adhesions and delay the time of suture adjustment in the course of adjustable strabismus surgery, an animal study was performed to assess and compare the effects of mitomycin C (Mit-C) and viscoelastic material Viscoat (sodium hyaluronate 3% and chondroitin sulphate 4%, Alcon, Fort Worth, TX). Methods Right eyes of 47 rabbits were divided into three groups. After recession of the superior rectus muscle (SRM), Mit-C was administered beneath and over the SRM in Group M (16 eyes), Viscoat was administered beneath and over SRM in Group V (16 eyes), and ringer lactate was administered in Group C (15 eyes). SRM then recessed 5 mm with adjustable strabismus surgery technique. Animals in each group were subdivided into 1 and 2, where 1 = adjustment 1 week postoperatively and 2 = adjustment 3 weeks postoperatively. Delayed adjustment was performed in M1 group (6 eyes), V1 group (6 eyes), and C1 group (7 eyes) after 1 week; in M2 group (6 eyes), V2 group (6 eyes), and C2 group (6 eyes) after 3 weeks. Histopathologic examinations were performed for the remaining 10 eyes without suture adjustment at the end of first and third weeks after adjustable strabismus surgery. The possible length and the necessary force to adjust and the degree of adhesions were recorded. Results When length and strength of the adjustment, adhesions between muscle and sclera, and adhesions between muscle and conjunctiva were taken into consideration, there was no statistically significant difference among M, V, and C groups at postoperative weeks 1 and 3. The force needed for adjustment in M1 group was statistically lower than M2 group. Conclusions The intraoperative use of Mit-C (0.4 mg/mL) may decrease adhesion formation in the early postoperative period, especially in the first week. The intraoperative use of Viscoat was not effective in reducing postoperative adhesions and delaying adjustment.
Changes in Intraocular Pressure and Corneal and Retinal Nerve Fiber Layer Thicknesses in Hypothyroidism
Authors: Bahçeci U.A. , Özdek Ş. , Pehlivanli Z. , Yetkin I. , Önol M. 
Published: January 2018

Purpose To evaluate the changes in intraocular pressure (IOP), corneal thickness (CT), and retinal nerve fiber layer thickness (RNFLT) in patients with hypothyroidism before and after treatment. Methods A complete ophthalmic examination including visual acuity, IOP, anterior segment, and fundus examination together with CT and RNFLT measurements were performed for each patient with newly diagnosed hypothyroidism, at the initial diagnosis and the third and ninth months of the L-thyroxine treatment. Wilcoxon signed rank test and Spearman's correlation test were used for statistical evaluation of the results. Results A total of 56 eyes of 28 patients were included in the study. The mean IOP and CT values were found to decrease with medical treatment (p=0.000). There was no significant change in any of the RNFLT parameters measured with scanning laser Polarimeter after L-thyroxine treatment (Wilcoxon, p>0.05). The change in IOP levels was not correlated with the change in thyroid hormone levels (Spearman's correlation test, p>0.05). The mean increase in serum free T3 and serum free T4 levels and the mean decrease in serum TSH levels at the ninth month of the therapy were found to be correlated with the decrease in CT in the left eyes (Spearman's correlation test, R>0.4 and p<0.05). Conclusions Hypothyroidism seems to cause a reversible increase in CT and IOP. IOP changes may be secondary to CT changes. RNFLT parameters measured with scanning laser Polarimeter do not seem to be affected by hypothyroidism. When the CT is taken into account and the IOPs corrected for CT, the prevalence of glaucoma in hypothyroidism may not be as high as previously reported. This issue should be taken into account while assessing glaucoma in patients with hypothyroidism.
High-dose (5000-μg) Intravitreal Ganciclovir Combined with Highly Active Antiretroviral Therapy for Cytomegalovirus Retinitis in HIV-Infected Patients in Venezuela
Authors: Arevalo J.F. , Garcia R.A. , Mendoza A.J. 
Published: January 2018

Purpose To describe the use of high doses of intravitreal ganciclovir combined with highly active antiretroviral therapy (HAART) for the treatment of cytomegalovirus (CMV) retinitis in human immunodeficiency virus (HIV)-infected patients. Methods Thirteen HIV-infected patients (18 eyes) with active CMV retinitis (83.3% in zone 1 and 38.4% resistant) participated in this prospective interventional case series. Patients were treated with high dose intravitreal ganciclovir (5.0 mg/0.1 mL once a week) in combination with HAART therapy. Intravitreal injections were discontinued once CMV retinitis healed if there was a significant increase in CD4+ count (any increase of ≥50 cells/μL to levels over 100 cells/μL sustained for at least 3 months). Mean follow-up was 15.6 months. Main outcome measures included assessment of visual acuity and retinal inflammation (CMV retinitis activity). A matched historical control group of 20 eyes (15 patients) with CMV retinitis treated with systemic ganciclovir (intravenous [induction] and oral [maintenance]) was included. Results Complete regression of the retinitis was obtained with high doses of intravitreal ganciclovir in 88.8% of eyes (two patients died during follow-up) at a mean of 4.5 weeks (2 to 8 weeks). Visual acuity improved two or more lines in 61.1% of eyes. No ganciclovir retinal toxicity was identified. Three eyes presented CMV retinitis reactivation at a mean of 25.6 days after their last injection. Complications (33.3%) included retinal detachment (RD; 3 eyes), immune recovery uveitis (IRU; 2 eyes), and endophthalmitis (1 eye). In our control group complete regression of the retinitis was obtained in 100% of eyes at a mean of 4 weeks (3 to 7 weeks). However, 12 eyes (60%) presented with CMV retinitis relapse at a mean of 29 days (21 to 32 days) after initiating oral ganciclovir (maintenance). Complications included RD (7 eyes, 35%) and IRU (3 eyes, 15%). Severe neutropenia occurred in 2 patients (13%). Conclusions High doses of intravitreal ganciclovir (5.0 mg) once a week in combination with HAART therapy is effective to control CMV retinitis, and may be discontinued after CMV retinitis has healed if immune reconstitution with a significant increase in CD4+ count has occurred.
Identification of XLRS1 Gene Mutation (608C>T) in a Portuguese Family with Juvenile Retinoschisis
Authors: Teixeira C. , Rocha-Sousa A. , Trump D. , Brandäo E. , Falcäo-Reis F. 
Published: January 2018

Purpose To characterize electroretinogram (ERG) and molecular genetic findings in a family with XLRS1 mutation. The authors present two cases of a Portuguese family with juvenile retinoschisis with a mutation in exon 6. Methods Two brothers and their parents, grandmother, and uncle underwent a full ophthalmic examination. The two brothers with ophthalmic disease were evaluated with color fundus photography, fluorescein angiography, optical coherence tomography (OCT), molecular genetic study (Group VI of Retinoschisis Consortium), pattern visual evoked potential (PVEP), and full field ERG. Results Both patients presented funduscopic manifestations of vitreoretinal degeneration. They presented peripheral schisis and retinal detachment. However, foveal schisis had never been observed at funduscopy. A negative ERG was recorded in both. Six months after that, the younger brother showed a typical foveal schisis at fundus examination. A retinoschisis gene (XLRS1) mutation with transition of cytosine by thymine at position 608 (608C>T) had been identified in both. Conclusions Negative ERG is the most secure clinical marker to establish the diagnosis of juvenile retinoschisis. XLRS1 gene 608C>T mutation was described for the first time in a Portuguese family.
Cataract Surgery under Systemic Anticoagulant Therapy with Coumarin
Authors: Jonas J.B. , Pakdaman B. , Sauder G. 
Published: January 2018

Purpose To evaluate clinical outcome of cataract surgery under systemic anticoagulant therapy using coumarin. Methods This clinical interventional comparative nonrandomized study included 441 patients (441 eyes) consecutively undergoing standard phacoemulsification with clear cornea incision and topical anesthesia. The study group consisted of 21 (4.8%) patients for whom systemic coumarin therapy was continued despite surgery. The control group included 420 patients without anticoagulant coumarin therapy prior to surgery. Study group and control group did not vary significantly in age, preoperative visual acuity, axial length, refractive error, preoperative intraocular pressure, or surgeon. Results Frequency of intraoperative or postoperative hemorrhages, intraoperative complications such as posterior capsule rupture, postoperative visual acuity, and intraocular pressure did no vary significantly (p>0.30) between study group and control group. Conclusions For patients under systemic coumarin therapy, the rate of surgical complications may not markedly be increased compared to patients without coumarin therapy, when standard phacoemulsification with clear cornea incisions is performed with topical anesthesia. Systemic coumarin therapy does not have to be stopped prior to cataract surgery.
Phacoemulsification in the Vitreous Cavity for Retained Nuclear Lens Fragments
Authors: Ruiz-Moreno J.M. , Barile S. , Montero J.A. 
Published: January 2018

Purpose To evaluate anatomic and functional results after surgery of retained lens fragments in the vitreous cavity after previous phacoemulsification. Methods The authors studied retrospectively 18 patients who underwent pars plana vitrectomy (PPV) for retained nuclear lens fragments. Patients having only cortical material in the vitreous cavity were excluded. In all cases the nucleus or nuclear fragments were removed after a complete vitrectomy using perfluorocarbon injection in the vitreous cavity, associated with phacoemulsification in the vitreous cavity. The authors used a conventional phaco probe devoid of the silicone sleeve. Time lapse between cataract surgery and vitrectomy varied between 0 and 24 days (mean 8.2 ± 7.4). Follow-up was 33.9 ± 20.6 months (range 4 to 53). Results The mean final best-corrected visual acuity (BCVA) was 20/45 (range 20/400 to 20/20). It was 20/40 or better in 33% of patients, reaching 40% when patients with pevious macular disease were excluded. A total of 61% of patients reached a final BCVA ranging from 20/50 to 20/200. Retinal detachment occurred in one eye and topical medications were necessary to manage intraocular pressure in four cases. Conclusions PPV with intravitreous phacoemulsification is the technique of choice for dislocated nuclei or nuclear fragments in the vitreous cavity.
A Comparison of Travoprost, Latanoprost, and the Fixed Combination of Dorzolamide and Timolol in Patients with Pseudoexfoliation Glaucoma
Authors: Parmaksiz S. , Yüksel N. , Karabas V.L. , Özkan B. , Demirci G. , çaglar Y. 
Published: January 2018

Purpose To compare the intraocular pressure (IOP) lowering effect and safety of latanoprost, travoprost given every evening, and the fixed combination dorzolamide + timolol (DTFC) given twice daily in pseudoexfoliation glaucoma (PXG). Methods This randomized, prospective, investigator-masked study has been conducted with 50 PXG patients. Patients were assigned to one of three groups: travoprost 0.004%, fixed combination of dorzolamide 2%+timolol 0.5%, or latanoprost 0.005% for 6 months. At baseline and 0.5, 1, 2, 3, 4, 5, and 6 months of therapy, IOP (8 am, 10 am, 4 pm), blood pressures, and pulse rates were measured, and ophthalmologic examination was performed. The side effects were recorded at each visit. Results Forty-two of the 50 patients initially enrolled completed this study. Withdrawn patients included one (latanoprost) for lack of efficacy, five (three travoprost, one latanoprost, one DTFC) for adverse events, and two (one latanoprost, one DTFC) for loss of follow-up. Each of the three drugs considerably reduced the IOP in PXG cases throughout the 6 months. Mean IOP reduction at 6 months was –9.3±2.9 mmHg in the travoprost group, -8.2±1.2 mmHg in the latanoprost group, and 11.5±3.3 mmHg in the DTFC group. Comparing the groups, DTFC is more effective than latanoprost and travoprost in lowering IOP (p<0.05). There was no difference between travoprost and latanoprost. The most common treatment-related adverse event was conjunctival hyperemia. Intensity of ocular hyperemia was greater in the travoprost group compared with the latanoprost and DTFC groups (p<0.05). There were no significant effects on systemic safety parameters. Conclusions The results demonstrated that DTFC is more effective in reducing IOP than latanoprost and travoprost. Latanoprost and travoprost had similar ocular hypotensive effects in patients with PXG. All three drugs were well tolerated; there were fewer ocular side effects attributable in the latanoprost group.