bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnification Requirement after Photodynamic Therapy with Verteporfin for Subfoveal Predominantly Classic Choroidal Neovascularization due to Age-Related Macular Degeneration
Authors: Thoelen A.M. , Bernasconi P.P. , Buser F. , Fierz A.B. , Messmer E.P. 
Published: January 2018

Purpose To prospectively assess the magnification requirement after repeat photodynamic therapy (PDT) with verteporfin in patients with predominantly classic subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Methods A total of 103 patients were treated for the first time with PDT between November 1999 and September 2002. These patients were followed up at 3-month intervals for a minimum of 12 months. In addition to the usual investigations undertaken during PDT therapy, the magnification requirement was determined, under standardized conditions, using the SZB test developed by the Swiss Central Association for Blindness. Results A stable lesion with a stable magnification requirement was achieved in 86 (83.5%) patients; these patients were followed up for 24.8 months (range 12 to 36 months). At the time of the last follow-up examination, the magnification requirement compared with baseline was <3 log units higher in 46 patients (53.5%) and ≥3 log units higher in the remaining 40 patients (46.5%). Seventy-four (86%) of these 86 patients had a magnification requirement of ≤8x. Stability was not achieved in 17 (16.5%) patients; up to the last examination these patients had been followed up for 12 to 30 months (mean 20.8). At the time of the most recent examination, 7 (41.2%) patients had a higher magnification requirement of <3 log units while 10 (58.8%) had changed by ≥3 log units. Sixteen patients (94%) had a magnification requirement of ≤8x. Conclusions PDT with verteporfin helps achieve stability without severe impairment in reading ability in most patients with predominantly classic subfoveal CNV due to AMD.
Efficacy of Autologous Plasmin for Idiopathic Macular Hole Surgery
Authors: Sakuma T. , Tanaka M. , Inoue J. , Mizota A. , Souri M. , Ichinose A. 
Published: January 2018

Purpose To determine whether a single intravitreal injection of autologous plasmin or a combination of plasmin and intraocular gas without peeling the internal limiting membrane (ILM) will close idiopathic macular holes. Methods Eight eyes of seven patients with an idiopathic macular hole were studied. The degree of posterior vitreous detachment (PVD), vitreal liquefaction, closure of the macular hole, visual acuity, and complications following intravitreal plasmin or plasmin with gas were investigated. The removed ILM was examined by electron microscopy. Results A PVD was created in seven out of eight eyes exposed to plasmin or plasmin with gas, however, the macular hole was not closed by either. Closure occurred in two eyes using conventional vitrectomy after the plasmin with gas injection, but peeling the ILM was required in the remaining six eyes. Vitreal fibers and glial cells were not observed on the vitreal surface of the extracted ILM. Conclusions A PVD was created safely and reliably although closure of the macular hole did not occur with either plasmin or with plasmin and gas injection. However, vitreous surgery became easier, and it required a shorter time to close the macular hole with intravitreal plasmin.
First Genetic Analysis of Lattice Corneal Dystrophy Type I in a Family from Bulgaria
Authors: Capoluongo E. , De benedetti G. , Concolino P. , Sepe M. , Ambu R. , Faa G. , Sciandra F. , Santonocito C. , D'alberto A. , Caselli M. , Brancaccio A. 
Published: January 2018

Purpose To report a new family belonging to a previously non-investigated geographic area with a rare form of lattice corneal dystrophy (LCD). Methods Detailed ophthalmologic analysis was carried out on a Bulgarian woman, enrolled for perforating keratoplasty. In order to obtain a final diagnosis both histology and genetic analysis were performed. Results Upon transplantation, histologic analysis of the dystrophic cornea revealed the typical staining pattern and amyloid deposits of lattice corneal dystrophies. Genetic analysis of the subject and her daughter confirmed the presence of an autosomal dominant R124C mutation within exon 4 of the BIGH3 gene, encoding for keratoepithelin, while showing no abnormalities in her son. Conclusions The identification of this mutation allows the unambiguous classification of this corneal dystrophy as LCD type I. A first case of LCD I in a family from Eastern Europe could help to better clarify the molecular epidemiology of the disease.
Branch Retinal Artery Occlusion Combined with Branch Retinal Vein Occlusion in a patient with Hepatitis C Treated with Interferon and Ribavirin
Authors: Nicolò M. , Artioli S. , La mattina G.C. , Ghiglione D. , Calabria G. 
Published: January 2018

Purpose To report a case of a combined branch retinal artery and vein occlusion in a patient with hepatitis C treated with interferon and ribavirin. Methods A 29-year-old man with a 1-week history of sudden visual field defect and decrease of central visual acuity was examined. Results Ophthalmoscopy and fluorescein angiography demonstrated an ischemic whitening of the inferior hemi-retina involving part of the macular region, numerous intraretinal hemorrhages, and a significant delay in arterial and vein filling of the dye. Conclusions The findings of a retinopathy associated with interferon and ribavirin treatment of hepatitis C are important. The symptomatic permanent visual field defect and decrease of central visual acuity developing following a branch retinal artery and vein occlusion event emphasizes the need for careful and regular ocular monitoring of patients receiving interferon for hepatitis C.
Photodynamic Therapy with Verteporfin in the Treatment of Exudative Idiopathic Polypoidal Choroidal Vasculopathy
Authors: Mauget-Faÿsse M. , Maftouhi M. Quaranta-El , De La Marnièrre E. , Leys A. 
Published: January 2018

Purpose To determine the safety and efficacy of photodynamic therapy with verteporfin (V-PDT) in the treatment of exudative idiopathic polypoidal choroidal vasculopathy (IPCV) lesions that were not suitable for laser photocoagulation. Methods This was a prospective, open label study in two centers involving 30 consecutive patients (31 eyes) diagnosed with exudative IPCV using fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). All patients underwent complete ophthalmologic examination including best-corrected visual acuity (VA) measurement, contrast sensitivity (CS) testing, FA, ICGA, and OCT. OCT was used to assess the stage of the polypoidal dilations (active or scarred) and the evolution of the signs associated with exudation. Study patients were treated with V-PDT and followed up at 6 weeks and 3, 6, and 12 months. Re-treatment was applied, at an interval of 3 months, until there was an absence of leakage on FA and hyperfluorescence on ICGA. Results Thirty eyes (29 patients) completed the 12 months post-treatment visit and were retained for further analysis. The mean number of V-PDT treatments was 2.5 (SD 1.1). At 12 months post-treatment, the mean foveal thickness had significantly (p<0.03) decreased to 224 (SD 104) μm from the baseline 292 (SD 124) μm while the mean VA had significantly (p<0.02) improved to 0.50 (SD 0.38) from the baseline 0.38 (SD 0.24). Serous detachment of the macula completely resolved in 83.3% of the eyes while 73.3% of the polypoidal dilations were occluded at 12 months. Conclusions The results suggest that V-PDT is effective and relatively safe in treating exudative IPCV.
Diabetic Blindness Significantly Reduced in the Warmia and Mazury Region of Poland: Saint Vincent Declaration Targets Achieved
Authors: Bandurska-Stankiewicz E. , Wiatr D. 
Published: January 2018

Purpose The authors’ aim was to verify if the targets of the Saint Vincent Declaration concerning the reduction of diabetes-related blindness in the Warmia and Mazury Region, Poland, had been achieved. Methods A register of World Health Organization-defined blindness due to diabetes was conducted in the Warmia and Mazury Region between 1989 and 2004. The incidence rate of blindness as the number of new cases/100,000 diabetic population/year and 100,000 total population/year was estimated for three subperiods differing in political-economic system and diabetologic care delivery: 1989–1994, 1995–1999, and 2000–2004. Results The major cause of blindness among diabetic patients was diabetic eye disease (97%). Out of 70 patients with Type 1 diabetes, 53% lost vision due to proliferative diabetologic vitreoretinopathy 20% due to neovascularization with glaucoma, while clinically significant macula edema and cataract associated with proliferative diabetologic vitreoretinopathy or clinically significant macula edema predominated in 210 patients with Type 2 diabetes. The incidence rate of blindness due to diabetes in the diabetic population ranged from 102.4/100,000 (confidence interval [CI]: 65.7–139.0) to 13.3/100,000 (3.8–24.9). The incidence rate of blindness due to Type 1 diabetes ranged from 1.3/100,000 (CI: 0.5–2.2) to 0.1/100,000 (CI: −0.1–0.4). The incidence rate of blindness due to Type 2 diabetes was variable in the first subperiod, and it next decreased by 19% each year from 3.9/100,000 (CI: 2.5–5.3) to 0.7/100,000 (CI: 0.1–1.2); p<0.001. Conclusions The Saint Vincent Declaration target of reducing diabetes-related blindness by one third appears to have been achieved in the Warmia and Mazury Region.
Changing Patterns of Ocular Manifestations in HIV Seropositive Patients Treated with HAART
Authors: Accorinti M. , Pirraglia M.P. , Corradi R. , Corsi C. , Fabiani C. , Pivetti-Pezzi P. 
Published: January 2018

Purpose To report the changing patterns of ocular manifestations in human immunodeficiency virus (HIV) seropositive patients treated with highly active antiretroviral therapy (HAART). Methods The clinical charts of HIV seropositive patients, 735 examined from 1997 to 2003 and treated with HAART for at least 2 months (Group 1), and 838 untreated examined from 1988 to 1995 (Group 2), were reviewed to assess the frequency of ocular manifestations. Results HIV- related retinal microangiopathy and opportunistic retinal infections (cytomegalovirus retinitis and toxoplasmic retinochoroiditis) were significantly higher in Group 2 than 1 (p<0.0001), while in patients treated with HAART a statistically significant increase in the frequency of chalazion (p<0.0001), diabetic and hypertensive retinopathy (p<0.0001), lipid arc of the cornea (p<0.0001), cataract and glaucoma (p<0.0001), and uveitis (p=0.026) was observed. Conclusions HAART therapy has induced a dramatic decrease in the incidence of HIV-related microangiopathy and opportunistic retinal infection and the occurrence of new lesions related both to the metabolic alterations induced by HAART and to immune reconstitution, such as uveitis.
Spontaneous Separation in Idiopathic Vitreomacular Traction Syndrome Associated with Contralateral Full-Thickness Macular Hole
Authors: Rodríguez A. , Infante R. , Rodríguez F.J. , Valencia M. 
Published: January 2018

Purpose Vitreomacular traction syndrome (VMTS) and full-thickness macular hole are two different well-known entities that on follow-up may be subjected to clinical modifications. Precisely, a spontaneous separation of idiopathic VMTS occurred in three eyes of three patients relieving in addition traction of the posterior hyaloid that had led also to a focal macular pigment epithelium detachment (RPE). An association to a full-thickness macular hole was observed in the contralateral eye of one of the patients. Methods This is a retrospective study of three patients evaluated with fluorescein angiography and documented with optical coherence tomography using the Stratus (OCT) model 3000, with scans analysis and protocols analysis, measuring the size and shape of vitreomacular adhesions, macular thickness changes before and after the spontaneous separation of the fractional posterior hyaloid adhesion. In addition, the vitreous was evaluated with contact lens slit lamp biomicroscopy and ultrasound. The associated contralateral macular hole in one of the patients was surgically treated. Results Two of the three eyes with spontaneous separation of the VMTS recovered 20/25 central visual acuity; the other eye maintained the initial 20/50 visual acuity. The treated macular hole recovered 20/100 corrected visual acuity. Conclusions Spontaneous separation of posterior hyaloid is a possible outcome during follow-up of idiopathic VMTS that can be well evaluated and documented with OCT while macular fluorescein angiography may be silent in cases like these presently reported. Central vision recovery can be excellent following the spontaneous separation, which releases anterior-posterior traction including on the retinal pigment epithelium and decreases macular thickness as measured with OCT. Therefore, regarding management, the indication for vitrectomy should be delayed awaiting the spontaneous release of vitreomacular traction in 4 to 6 months. The association between idiopathic VMTS in one eye and full-thickness macular hole in the opposite eye of one patient is an important pathophysiologic consideration.
Keratoconus Associated with Corneal Macular Dystrophy: In vivo Confocal Microscopic Evaluation
Authors: Balestrazzi A. , Martone G. , Traversi C. , Haka G. , Toti P. , Caporossi A. 
Published: January 2018

Purpose The authors present a case, studied through in vivo confocal microscopy, of concomitant keratoconus and macular corneal dystrophy (MCD). Methods A 29-year-old man underwent a penetrating keratoplasty in the right eye in May 2005. Confocal microscopy was performed to examine the cornea of the right eye. Results A diagnosis of concomitant keratoconus and MCD was suspected, due to the simultaneous findings of corneal ectasia and stromal opacities. Conclusions In this case, using in vivo confocal microscopy, morphologic changes were detected in many corneal layers and compared with the histopathologic findings. The morphologic alterations were found mainly in the area of the cornea apex.
Sequential Descemet's Membrane Detachments and Intraocular Lens Haze Secondary to SF6 or C3F8
Authors: Saeed M.U. , Singh A.J. , Morrell A.J. 
Published: January 2018

Purpose To report an unusual complication of treatment in the case of a Descemet's membrane detachment. Methods Observational case report. Results A 79-year-old woman presented for elective cataract surgery. Ocular risk factors identified preoperatively included moderately shallow anterior chambers bilaterally, previously treated with bilateral YAG peripheral iridotomies. After a clear corneal section during phacoemulsification, large Descemet's tears on introducing the micro finger and phaco probe were noticed. Conversion to an extracapsular technique was necessary because of poor view. Similar peroperative Descemet's detachments were noticed in the contralateral eye during phacoemulsification by a senior surgeon a year later. Postoperatively, the Descemet's detachments were managed by intracameral SF6 and later C3F8 gas. A few weeks later, a fine haze was noticed under the anterior surface of the intraocular lens (IOL). Corneal edema persisted and corneal decompensation ensued. Both eyes needed penetrating keratoplasties. The right eye needed an IOL exchange due to IOL haze. Conclusions In this case the SF6 or C3F8 gas may have produced the unexpected effect of an anterior IOL haze. The mechanism of this phenomenon is unknown. To the knowledge of the authors, this effect has not been observed previously with SF6 or C3F8 gas. This haze was visually significant and required an IOL exchange. To the knowledge of the authors this is the first report of this nature. The authors advise caution when using intracameral SF6 or C3F8 gas for repair of Descemet's membrane detachment with this type of IOL.
Bilateral Ischemic Maculopathy in a Patient with Aids
Authors: Romano M.R. , Valldeperas X. , Romano F. 
Published: January 2018

Purpose To describe ischemic maculopathy as a cause of sudden bilateral decreased vision in a patient with human immunodeficiency virus (HIV) infection. Methods A 44-year-old HIV-positive woman presented with bilateral decreased vision and normal examination, except for pale maculae and retinal vascular tortuosity. Fluorescein angiography showed bilateral enlargement of the foveal avascular zone with perifoveal dye leakage. Conclusions Ischemic maculopathy is a potential cause of decreased vision in patients with acquired immunodeficiency syndrome, even in patients with immune sustained recovery. This condition can be almost totally reversible, in the absence of other concomitant ocular pathologies.
Fundus Autofluorescence Imaging Findings in Retinal Pigment Epithelial Tear
Authors: Karadimas P. , Paleokastritis G.P. , Bouzas E.A. 
Published: January 2018

Purpose Retinal pigment epithelial (RPE) tear is a clinical and angiographic entity, which usually occurs in association with pigment epithelial detachments (PED), in the context of neovascular age-related macular degeneration (ARMD). The recording of fundus autofluorescence (FAF) has been introduced as a technique of retinal imaging, allowing the in vivo assessment of the integrity of RPE. The authors describe the FAF imaging findings in a patient with RPE tear. Methods Observational case report. Results A 70-year-old woman developed RPE tear after the application of photodynamic therapy for choroidal neovascularization associated with PED. The diagnosis of the RPE tear was confirmed by fluorescein angiography (FA) and indocyanine green angiography (ICGA). FAF imaging revealed absence of autofluorescence at the area which was denuded of RPE, while at the area where the RPE was rolled, a heterogeneous signal of FAF was recorded. The intensity of the signal in that area was, on average, not different from the normal background FAF signal expected in an unaffected RPE/photoreceptor complex. Conclusion The authors report the FAF imaging findings in a patient with RPE tear. These findings can be interpreted from the ability of FAF imaging to access in vivo the integrity of RPE, and correlate well with the histopathology of this clinical entity. FAF imaging, as a fast and noninvasive technique, may be a useful modality, alternative to FA and ICGA, in the diagnosis and evaluation of such cases. Moreover, it may contribute to a more detailed phenotyping of the various clinical pictures associated with neovascular ARMD.
Retinal Pigment Epithelial Tear following Intravitreal Injection of Bevacizumab (Avastin)
Authors: Nicolò M. , Ghiglione D. , Calabria G. 
Published: January 2018

Purpose To report one case of retinal pigment epithelium tear following intravitreal bevacizumab injection for neovascular age-related macular degeneration. Methods A 59-year-old patient presented with occult choroidal neovascularization associated with a serous pigment epithelial detachment secondary to age-related macular degeneration. The patient was treated with an intravitreal injection of bevacizumab. Results The patient developed a retinal pigment epithelium tear 60 days following the intravitreal injection. Conclusions This report describes the development of retinal pigment epithelium tear after intravitreal bevacizumab injection. Future studies should be performed to evaluate which subtypes of lesions are most susceptible to this potential devastating visual complication.
Successful Management of Melanocytoma-Associated Choroidal Neovascularization with Photodynamic Therapy
Authors: Chalam K.V. , Gupta S.K. , Shah G.Y. , Agarwal S. 
Published: January 2018

Purpose To report the efficacy of photodynamic therapy in treatment of choroidal neovascular membrane (CNV) associated with melanocytoma of the optic disc. Methods A middle-aged man with visual acuity of 20/200 in right eye was treated with photodynamic therapy for juxtafoveal classic CNV overlying the papillomacular bundle. CNV was secondary to ocular melanocytoma, a rare event. Results At the 6-month follow-up, a scarred CNV with final visual acuity of 20/30 was noted clinically and angiographically Tomography revealed high reflective scar tissue with flat macula and microperimetry showed restoration of retinal sensitivity over the papillomacular bundle. Conclusions Photodynamic therapy effectively resolved CNV that involved papillomacular bundle (secondary to melanocytoma) and restored retinal function in papillomacular bundle.
The Effects of Artificial Tear Application on Contrast Sensitivity in Dry and Normal Eyes
Authors: Akin T. , Karadayi K. , Aykan U. , Certel I. , Bilge A. Hamdi 
Published: January 2018

Purpose To investigate the effects of artificial tear application on contrast sensitivity in dry and normal eyes. Methods A total of 55 patients with normal (10/10) corrected or uncorrected visual acuity referring to GATA Gulhane Military Medical Academy Haydarpasa Ophthalmology Outpatient Clinic were evaluated in regard to dry eye diagnostic criteria, and assigned into the dry eye group (Group 1; 35 patients) and the control group (Group 2; 20 patients). All patients were given a contrast sensitivity testing at low and high spatial frequencies using the gradual contrast sensitivity chart before and at 5 minutes after application of artificial tears, and the two groups were compared. Wilcoxon test was used in statistical analysis, accepting a p value of <0.05 as significant. Results In the dry eye group, there was a statistically significant increase in contrast sensitivity scores both at low and high frequencies after application of artificial tears (p<0.05). In the control group, although there was a significant increase in low frequency scores after artificial tear application (p< 0.05), there was not a significant change in high frequency scores (p>0.05). Conclusions The decreased contrast sensitivity in dry eyes improves with application of artificial tears. Therefore, the impeded quality of vision seen in dry eye patients could be restored closer to normal with artificial tear therapy. Besides, contrast sensitivity testing could be used in the follow-up of artificial tear therapy.
Rheumatoid Keratolysis: A Series of 40 Eyes
Authors: Malik R. , Culinane A.B. , Tole D.M. , Cook S.D. 
Published: January 2018

Purpose Rheumatoid keratolysis (RK) is a rare but a serious cause of ocular morbidity in rheumatoid patients. The aim of this study was to analyze the presenting features, the subsequent treatment, and the outcome of patients with RK in the authors’ department. Methods A retrospective study was undertaken of all patients with a diagnosis of RK at Bristol Eye Hospital between January 1987 and June 2002. Results Forty eyes of 38 patients were identified in total. The mean age at presentation was 70 years. The mean duration of rheumatoid arthritis at presentation was 15 years. Most (22, 55%) ulcers were peripheral. Three patients (8%) developed RK within a month of cataract surgery. Out of the 19 patients who did not have a further RK, 11 were immunosuppressed. A total of 37 grafts were performed on 26 eyes. Twenty-two grafts (59%) failed. Immunosuppression increased the chance of anatomical success following penetrating keratoplasty. Infection was identified as a cause of graft failure for immunosuppressed patients in the postoperative period. Nine patients had reversible side effects from immunosuppressant treatment. Four eyes (10%) had to be surgically removed and a further 10 (25%) had severe visual loss (visual acuity less than 6/60). Eleven of the 38 patients subsequently died (29% mortality). Conclusions Although the visual prognosis is often poor, surgical preservation of the eye can be achieved by penetrating keratoplasty and systemic immunosuppression. With careful observation and regular monitoring, immunosuppressive medication appears to be safely tolerated in this group of patients.