bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior Movement of the Crystalline Lens in the Process of Accommodation in Children
Authors: Kaluzny B.J. 
Published: January 2018

Purpose To investigate changes of crystalline lens position during accommodation in children with emmetropia, myopia, and hyperopia. Methods A total of 188 children (372 eyes) from 4 to 19 years old (mean age 11.3±4.43) with cycloplegic refractive error within a range +9.00 D to −9.00 D were enrolled. After a general ophthalmic examination, ultrasound biometry was performed, with the eye at a maximal accommodative effort. Cycloplegia was induced by triple installation of 1% tropicamide drops and 30 minutes later the biometric examination was repeated. Results In emmetropic eyes in the process of accommodation, the anterior pole of the crystalline lens moved forward by 0.144±0.14 mm (p ≤ 0.001); the position of the posterior pole did not change. In myopic eyes, the anterior pole moved forward by 0.071±0.13 mm (p≤0.001) and the posterior pole moved backward by 0.039±0.10 mm (p=0.003). In hyperopic eyes, the whole lens translocated anteriorly: anterior pole moved forward by 0.242±0.16 mm (p≤ 0.001) and posterior pole moved forward by 0.036±0.09 mm (p≤0.001). Differences among emmetropia, myopia, and hyperopia were statistically significant. Forward movement of the posterior pole correlated with a low axial length of the eye, and also with plus refractive error and with a smaller accommodative increase of lens thickness. Conclusions In children, accommodative changes of the crystalline lens position depend on refractive status.
Comparison of Sulcus Implantation of Single-Piece Hydrophilic Foldable Acrylic and Polymethylmethacrylate Intraocular Lenses in Eyes with Posterior Capsule Tear during Phacoemulsification Surgery
Authors: Taskapili M. , Gulkilik G. , Kocabora M.S. , Ozsutcu M. , Yilmazli C. , Kaya G. , Kucuksahin H. 
Published: January 2018

Purpose To compare the results of sulcus implantation of acrylic and poly(methylmethacrylate) (PMMA) intraocular lens (IOL) in eyes with posterior capsule tear during phacoemulsification surgery. Methods In all eyes a posterior capsule tear developed during phacoemulsification surgery and an IOL to the ciliary sulcus was implanted primarily. A total of 89 eyes of 88 patients received hydrophilic foldable acrylic IOL (acrylic group). A total of 72 eyes of 72 patients received PMMA IOL (PMMA group). The mean age was 67.1 years and 68.1 years and postoperative follow-up period was 19.2 months and 17.9 months in acrylic and PMMA groups, respectively. Results Temporary corneal edema appeared in 33 eyes and 26 eyes, elevation of intraocular pressure in 17 eyes and 12 eyes, anterior chamber inflammatory reaction in 5 eyes and 5 eyes, clinical cystoid macular edema in 7 eyes and 12 eyes, and decentered IOL in 4 eyes and 3 eyes in acrylic and PMMA groups, respectively. Late postoperative endophthalmitis developed in two eyes of the PMMA group. Rhegmatogenous retinal detachment developed in one eye in each group. Final best-corrected visual acuities were 5/10 and above in 73 eyes (82.02%) in the acrylic group and 5/10 and above in 42 eyes (58.33%) in the PMMA group. Postoperative final induced astigmatism was 0.5±0.5 D (SD) in the acrylic group and 1.11±0.65 D (SD) in the PMMA group (p=0.0001) (independent samples t-test). Conclusions Increased astigmatism is more frequently seen in the PMMA group. The implantation of foldable acrylic IOL in the sulcus after posterior capsule tear maintains the advantages of small incision surgery.
Intravitreal Bevacizumab (Avastin) as Primary Treatment for Myopic Choroidal Neovascularization
Authors: Mandal S. , Venkatesh P. , Sampangi R. , Garg S. 
Published: January 2018

Purpose To evaluate the short-term efficacy and safety of intravitreal bevacizumab in myopic choroidal neovascularization (mCNV). Methods In this noncomparative, consecutive, interventional case series, 12 eyes of 11 patients with mCNV without any previous treatment were included. Patients received intravitreal bevacizumab (1.25 mg/0.05 mL) at baseline and at 4 weeks interval, if optical coherence tomography (OCT) showed presence of intraretinal edema, subretinal fluid, and/or pigment epithelial detachment. Patients were followed up for a minimum of 6 months and changes in best-corrected visual acuity, central macular thickness (CMT) on OCT, angiographic characteristics, and complications were assessed. Results The mean refractive error was −11.25 diopters. At 6 months the mean best-corrected visual acuity (BCVA) improved from 20/235 (median 20/235) to 20/71 (median 20/80) (p=0.01). The mean CMT was reduced from 403 μm (median 365 μm) to 229 μm (median 239 μm) (p=0.002). At final visit 9 eyes (75%) had an improvement of BCVA of three lines or more, and only 1 eye (8%) lost two lines. No significant ocular or untoward systemic side effects were observed. Conclusions In this small series short-term results suggest that intravitreal bevacizumab (1.25 mg/0.05 mL) is safe, effective, and well tolerated in patients with choroidal neovascularization due to high myopia. Further evaluation in large series with longer follow-up is needed to confirm long-term efficacy and safety in such cases.
Ophthalmologic Findings in Infants after an Apparent Life-Threatening Event
Authors: Altman R.L. , Forman S. , Brand D.A. 
Published: January 2018

Purpose An apparent life-threatening event (ALTE) refers to the sudden occurrence in an infant of a breathing abnormality, color change, or alteration in muscle tone or mental status. The finding of retinal hemorrhage in an infant who has experienced an ALTE strongly suggests the possibility of shaken baby syndrome. Previous ALTE studies have reported the frequency of this specific ocular abnormality but have not reported other ocular findings and their possible diagnostic significance. Methods This study reviews ophthalmologic findings from a series of 120 patients with ALTE who underwent eye examinations as part of their inpatient evaluation. Details of the history, physical examination, diagnostic testing, and discharge diagnosis were abstracted from the medical record while the patient was in the hospital. Results Ten patients (8.3%) had positive findings, including retinal hemorrhages in four of the six patients with shaken baby syndrome, the only ophthalmologic finding that helped establish the cause of an ALTE. Conclusions Since the funduscopic examination can help identify child abuse as the cause of an apparent life-threatening event, ophthalmologists play a critical role in the early evaluation of infants who have experienced such an event.
Comparison of BD Multivisc™ with the Soft Shell Technique in Cases with Hard Lens Nucleus and Fuchs Endothelial Dystrophy
Authors: Fasce F. , Spinelli A. , Bolognesi G. , Rossi M. , Gemma M. 
Published: January 2018

Purpose To compare the efficacy of 2.5% sodium hyaluronate (BD Multivisc™) with the soft shell technique in reducing corneal endothelial cell damage during cataract phacoemulsification in patients with hard lens nucleus (3+) and cornea guttata. Methods Thirty patients (37 eyes) scheduled for cataract surgery at Department of Ophthalmology and Visual Sciences, University Hospital San Raffaele, Milano, Italy. Thirty-seven eyes (randomly divided into Groups A and B) with hard lens nucleus (grade 3 or higher) and cornea guttata had phacoemulsification using the soft shell technique (Group A) with Biolon® (sodium hyaluronate 1%) and Viscoat® (sodium hyaluronate 3%-chondroitin sulfate 4%) or with BD Multivisc™ alone (Group B). Patients were evaluated preoperatively and after 1, 15, 90, and 180 days, checked for best-corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness, and corneal endothelial density. Stop and chop phacoemulsification technique, with burst mode (Alcon Legacy 20000, Advantec), was performed. Results There were no significant differences between the two groups at 3 and 6 months in BCVA, IOP, corneal thickness, or endothelial cell density. The increase of central corneal thickness (preoperative: Group A 584±30 μm, Group B 573±30 μm; postoperative at 90 days: Group A 593±38 μm, Group B 577±25 μm) was not significant. Endothelial cell loss was similar in both groups. Conclusions The results suggest that the soft shell technique (Biolon®, Viscoat®) and 2.5% sodium hyaluronate (BD Multivisc™) are both effective in protecting the corneal endothelium in Fuchs dystrophy during phacoemulsification in patients with hard lens nucleus.
One-Year Results of Photodynamic Therapy for Small Predominantly Classic Choroidal Neovascular Membranes Secondary to Age-Related Macular Degeneration
Authors: Doyle E. , Khanwala M. , Shah S.P. , Ong D.G. , Casswell A.G. 
Published: January 2018

Purpose To determine the visual and angiographic outcomes of patients with small predominantly classic choroidal neovascular membranes (CNV) undergoing photodynamic therapy (PDT). Methods The subjects were a cohort of patients with age-related predominantly classic CNV with lesion size of greatest linear diameter of 2000 μm or less treated with PDT Lesion size and visual acuity were recorded at baseline and at 3-month intervals. Visual treatment failure was defined as either loss of at least 15 letters or visual acuity less than 35 letters on a modified Early Treatment Diabetic Retinopathy Study chart. Lesion treatment failure was defined as increase in greatest linear diameter (GLD) of at least 500 μm. Results Twenty-five eyes of 25 patients were included. Visual treatment failure occurred in 16 and mean visual acuity dropped from 58 letters to 34 letters (p<0.0001). In 11 of these patients this occurred within the first 3 months. Lesion treatment failure occurred in 18 patients. Mean GLD increased from 1331 to 2935 μm (p<0.0001). Early growth of the lesion was associated with poor visual outcome with growth in GLD in the first 3 months of 310 μm in patients without eventual visual treatment failure and 1131 μm in patients with eventual visual failure (p=0.027). Conclusions Small predominantly classic lesions commonly cause visual deterioration if treated with PDT alone. In the first year over 50% may lose at least 15 letters or drop below 35 letters, with most visual loss occurring in the first 3 months. Visual loss is associated with early lesion growth.
Depth of Focus: Clinical Manifestation
Authors: Sergienko N.M. , Tutchenko N.N 
Published: January 2018

Purpose To assess depth of focus on the basis of measurements of the point spread function, which involve Stiles and Crawford phenomenon. Setting Department of Ophthalmology of National Academy of Postgraduate Education. Methods Gullstrand's schematic eye parameters and data of subjective measurement of size of diffusion circles were used for calculation of depth of focus. Data of 1171 eyes with visual acuity 1.0–2.0 were included in the study. Results Under condition of visual acuity 1.5 data of the depth of focus were 0.38 D, 0.64 D, and 1.92 D for pupil diameter 5.0 mm, 3.0 mm, and 1.0 mm, respectively. Visual acuity 1.0 is characterized by larger value and visual acuity 2.0 by lesser value of the depth of focus. Conclusions Depth of focus and normal levels of visual acuity have a close relation: the higher the visual acuity, the smaller the depth of focus.
Release Hallucinations and Visual Loss as First Manifestations of Postoperative Unilateral Blindness
Authors: Montero J.A. , Ruiz-Moreno J.M. , Galindo A. , Fernandez-Muñoz M. 
Published: January 2018

Purpose Release hallucinations (RH) with insight into the unreality of the hallucination have been reported in association with severe vision loss. Postoperative blindness following nonocular surgery may appear associated with central retinal artery occlusion (CRAO) caused by incorrect head positioning during surgery, intraoperative hypotension, and atherosclerosis. RH may initially mask the loss of vision. Methods Case report. Results A 27-year-old woman who had undergone lumbar spinal surgery for right L4-L5 discal herniation developed left eye visual loss and complex visual hallucinations immediately after surgery. Her symptoms were initially considered hallucinations related to the anesthesia and not taken into consideration until 4 days later. Ophthalmic examination disclosed CRAO probably caused by ocular compression during surgery. Optic nerve atrophy appeared during the following 6 years. Conclusions Doctors and auxiliary personnel should be aware that visual hallucinations may be a sign of actual vision damage.
Simultaneous Bilateral Retinal Detachment following Coronary Artery Bypass Graft: Case Report
Authors: Ceruti P. , Tosi R. , Marchini G. 
Published: January 2018

Purpose To present an unusual case of simultaneous bilateral retinal detachment (RD) following a coronary artery bypass graft in a patient with acute myocardial infarction (AMI). Methods A 78-year-old man was first seen for bilateral sudden visual loss after surgical treatment of AMI. The patient underwent ultrasound biomicroscopy (UBM) and ocular B-scan echographic examination. Results The ocular assessment showed a bilateral seclusion of the pupil with bombé of the iris, an anterior chamber without cells or flare, and hypotonia. The evaluation of the visual acuity revealed no light perception in the right eye (RE) and uncertain light perception in the left eye (LE). The UBM analysis of the anterior segment confirmed the presence of bilateral pupillary block due to the seclusion of the pupil and a peripheral serous choroidal detachment involving the RE. The echographic B-scan analysis of the posterior segment showed a bilateral closed funnel-shaped RD and confirmed the presence of the peripheral flat serous choroidal detachment in RE. Conclusions The cause for simultaneous bilateral RD remained unclear. It may have been a consequence of a persistent choroidal detachment with multiple swelling and “kissing” of retinal surface. The increased venous pressure caused by congestive heart failure due to AMI could have caused a bilateral uveal effusion. Alternatively, the absence of retinal tears, the presence of a closed funnel-shaped morphology, and seclusion of the pupils allowed us to suspect an exudative pathogenetic mechanism due to a previous unrecognized ocular inflammatory state.
Cyclooxygenase-2 Expression in Primary and Recurrent Pterygium
Authors: Adiguzel U. , Karabacak T. , Sari A. , Oz O. , Cinel L. 
Published: January 2018

Purpose Pterygium is a proliferative, inflammatory, and invasive ocular surface disease associated with excessive ultraviolet radiation exposure and has several tumor-like characteristics. Cyclooxygenase-2 (COX-2) is an inducible enzyme and recently increased expression of the enzyme was found in many cancers and premalign lesions. This study was conducted to identify the COX-2 expression in pterygium tissues. Methods Immunohistochemical staining using a primary antibody for COX-2 was performed on 30 specimens with primary pterygium (20 pterygium without recurrence and 10 pterygium which recurred during a 12-month follow-up), 11 specimens with recurrent pterygium, and 8 specimens of conjunctival tumor. As a control we used 10 specimens of normal conjunctiva. Extent and intensity of cytoplasmic and membranous staining in epithelial cells were evaluated. Results Higher expression of COX-2 was detected in conjunctival tumor (87.5%) specimens and recurrent pterygium specimens (72.7%) compared to the both normal conjunctiva (30%) and primary pterygium without recurrence (30%). COX-2 expression in primary pterygium tissues with recurrence (60%) was not different from primary pterygium without recurrence (p=0.114) and recurrent pterygium (p=0.537). However, recurrent pterygium tissues were found to express higher COX-2 than primary pterygium without recurrence (p=0.022). Conclusions COX-2 expression is increased in recurrent pterygium tissues and COX-2 expression may be a marker for the prediction of recurrence.
Prevalence of Diplopia Related to Cataract Surgery among Cases of Diplopia
Authors: Karagiannis D. , Chatzistefanou K. , Damanakis A. 
Published: January 2018

Purpose To evaluate the prevalence of diplopia in Greece after cataract surgery among diplopia cases. Methods The authors retrospectively reviewed the medical records of 571 patients with diplopia over an 8-year period in order to evaluate the prevalence of diplopia related to cataract surgery. The surgical and anesthetic records were also reviewed. All patients had full orthoptic assessment including prisms with cover test in all gaze positions. The chi-square and cross-tabulation statistical tests were used for statistical analysis. Results Thirty-nine cases (6.8%) were having persistent diplopia related to cataract surgery. Type of anesthesia was peribulbar. Hyaluronidase was not used. Thirteen patients were men and 26 were women. Left eyes were involved in 22 cases (56.4%), right in 17 cases (43.6%). Mean age was 72.5 years. Patients were divided into four groups. Group 1 consisted of 29 patients related to surgical trauma due to anesthesia. Group 2 consisted of 7 patients related to pre-existing disorders. Group 3 consisted of 2 patients related to aniseikonia or anisometropia. Group 4 with 1 patient related to macular pathology. Vertical diplopia was mostly noted (28 cases). Twenty-nine patients were corrected with prisms, 9 needed strabismus surgery, and 1 needed both surgery and prisms. Conclusions Cataract surgery is not a common cause of persistent diplopia. However, this report highlights that prevalence of diplopia related to cataract is high among cases of diplopia in general, with diplopia being mostly vertical (p=0.001), affecting females (p=0.006), and being more common in left eyes, although results did not reach statistical significance (p=0.133).
The Effect of Complement Factor H Y402H Polymorphism on the Outcome of Photodynamic Therapy in Age-related Macular Degeneration
Authors: Seitsonen S.P. , Järvelä I.E. , Meri S. , Tommila P.V. , Ranta P.H. , Immonen I.J. 
Published: January 2018

Purpose Photodynamic therapy (PDT) has been widely used in the treatment of age-related macular degeneration (AMD). The complement cascade has an important role in the tissue reactions occurring after PDT. The Y402H polymorphism of the complement factor H (CFH) gene has been identified as a risk factor for AMD. Since CFH is central in the regulation of the complement system the authors wanted to analyze whether the CFH Y402H polymorphism modifies the PDT outcome in AMD. Methods A total of 88 patients having been treated with PDT and without further scheduled PDT sessions were analyzed. Depending on the situation at their final PDT session the patients were classified retrospectively as PDT-responders or PDT-nonresponders. All patients were genotyped for the CFH Y402H polymorphism. Results The proportion of PDT-responders was 18/26 (69.2%) in patients homozygous for the CFH Y402H risk allele, 34/50 (68.0%) in heterozygous, and 7/12 (58.3%) in patients with the normal genotype (p=0.520). The median number of PDT treatments of the PDT-responders was three for all the genotypes. Conclusions The dysfunction of the CFH related to the risk of AMD and caused by the Y402H polymorphism does not modify the outcome of PDT. Genotyping for CFH Y402H cannot be used to select patients for this treatment.
Phenotypic Intrafamilial Variability Associated with S212G Mutation in the RDS/Peripherin Gene
Authors: Passerini I. , Sodi A. , Giambene B. , Menchini U. , Torricelli F. 
Published: January 2018

Purpose To describe an Italian family in which two separate phenotypes (retinitis pigmentosa and adult onset vitelliform macular dystrophy) are associated with an identical mutation (S212G) in the peripherin/RDS gene. This mutation has already been reported in patients with retinitis pigmentosa, but it has never been previously detected in association with adult onset vitelliform macular dystrophy. Methods A 38-year-old woman complained of bilateral mild metamorphopsias and on ophthalmologic examination she showed the clinical phenotype of adult onset vitelliform macular dystrophy. Her 62-year-old mother was clinically diagnosed with a retinitis pigmentosa, with a severe clinical course. Results In both patients, molecular genetic analysis revealed a 874A→G transition in the exon 2 of the RDS gene leading to the amino acid change of S212G. Conclusions Peripherin/RDS S212G mutation may have damaging effects on the formation and stability of the photoreceptors' disk structure and may be associated with different clinical phenotypes, even in the same family. Intrafamilial phenotypic variability has been reported for other RDS mutations; this supports the possible influence of modifier genes or environmental factors in the clinical expression of RDS gene variants. Moreover, it suggests that in patients with retinal degeneration and peripherin/RDS mutation, caution should be taken both in using molecular genetic results to predict the clinical course of the disease and in offering genetic counseling.
Minimally Invasive Pterygium Surgery: A New Approach for Prevention of Recurrence
Authors: Bozkir N. , Yilmaz S. , Maden A. 
Published: January 2018

Purpose To introduce a novel approach for pterygium excision, to report recurrence rates, and to compare with conjunctival autografting. DESIGN. A comparative, prospective clinical case series design was used. Methods The study population consisted of 155 patients with unilateral primary or recurrent pterygia. All patients underwent pterygium excision, either by conventional conjunctival autografting (Group A) or by the minimally invasive pterygium excision (MIPE) technique (Group B). The new technique involves making a limbal incision of the conjunctiva through the body of pterygium, removing the head of the pterygium by blunt dissection, keeping the adjacent Tenon capsule intact, and performing a small conjunctival autograft to cover the epithelial defect. The recurrence rate of each technique was compared statistically. Results There were 84 patients in Group A and 71 patients in Group B. The recurrence rates were 18% at 1 year after surgery in the conjunctival autografting technique and 4.2% in the MIPE technique. The MIPE technique had significantly lower recurrence rates compared with conjunctival autografting technique (p<0.0001). Conclusions The MIPE technique had lower recurrence rate and fewer postoperative complications than the conjunctival autografting technique. Preserving the Tenon capsule and minimizing conjunctival excision in pterygium surgery does not appear to increase the recurrence rate in the 1-year period. However, the effectiveness of this technique in preventing recurrences needs to be proven with more than 1-year results, which we plan to report in the future.
Early and Late Endophthalmitis following Trabeculectomy in a Chinese Population
Authors: Kuang T.-M. , Lin Y.-C. , Jui-Ling Liu C. , Hsu W.-M. , Chou C.-K. 
Published: January 2018

Purpose To investigate the rate of bleb-related endophthalmitis over 5 years in a Chinese population. Methods Retrospective chart review. Results Of 988 trabeculectomies performed over 5 years, one case (0.1%) developed early endophthalmitis caused by Morganella morganii, which was rarely reported in the literature. Six cases (0.6%) developed late-onset endophthalmitis. Mitomycin C significantly increased the risk of late-onset endophthalmitis (p=0.0002). Conclusions Physicians should weigh the benefits against the risks of mitomycin C application in performing trabeculectomies.