bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epithelial Cell, Keratocyte, and Endothelial Cell Apoptosis in Fuchs' Dystrophy and in Pseudophakic Bullous Keratopathy
Authors: Szentmáry N. , Szende B. , Süveges I. 
Published: January 2018

Purpose To elucidate the pathomechanism of Fuchs' dystrophy and pseudophakic bullous keratopathy (PBK) by examining cell apoptosis in different corneal layers. Methods The authors studied corneal buttons obtained from 21 eyes following central penetrating keratoplasty: 14 corneal buttons (13 patients, age 70.8 ± 10.0 years) with Fuchs' dystrophy, and 7 buttons (7 patients, age 69.6 ± 10.2 years) with PBK. Four buttons from enucleated eyes with choroidal melanoma served as controls. Histologic changes were examined using light microscopy with hematoxylin-eosin (HE) staining. The average numbers of apoptotic cells per field of view (125x magnification) in separate samples of the epithelial, stromal, and endothelial layers were determined using the TUNEL (terminal deoxyri-bonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling) assay. Results In 11 of the Fuchs' dystrophy corneas and 2 of the PBK corneas, apoptotic activity was detected. In the control corneas no apoptotic activity was found. Compared to the controls there was a statistically significant difference in the mean (normalized) apoptotic cell numbers for all three layers (p=0.01 in each case) in the Fuchs' dystrophy corneas, and for the stromal layer (p<0.01) in PBK corneas. The apoptotic cell numbers for the epithelial and endothelial layers of the latter were higher, but the difference was not statistically significant (p=0.07, 0.07). Conclusions Apoptosis may play a role in the pathomechanism of Fuchs' dystrophy and in keratocyte death in corneas with PBK.
Prevalence of Blindness and Visual Impairment among Jordanian Diabetics
Authors: Al-Till M.I. , Al-Bdour M.D. , Ajlouni K.M. 
Published: January 2018

Purpose To investigate the prevalence of blindness and visual impairment among a population of Jordanian diabetics. Methods A total of 986 diabetic patients were fully assessed, including complete history, examination, and laboratory tests. All patients underwent detailed eye examination, which included visual acuity, slit-lamp examination, tonometry, funduscopy, and fundus fluorescein angiography (FFA). Results Of all patients examined, 53.2% were male and 46.8% were female. The mean age and duration of diabetes were 55.3 and 11.9 years. Of all patients, 93.3% had type 2 while 6.7% had type 1 diabetes mellitus (DM). Over half (50.3%) were on oral hypoglycemic agents, 34% on insulin, and 14.5% on both types of treatment, whereas only 1.2% were on diet alone. The mean value for HbA1c was 7.7%. The prevalence of blindness among participants was found to be 7.4%, while 10.1% were visually impaired. Diabetic retinopathy (DR) was present in 64.1%, 37.8% had cataract, and 8.7% had undergone cataract surgery. Using multivariate logistic regression analysis, visual impairment was significantly associated with age, treatment of diabetes, and DR, while only age and retinopathy were significantly related to blindness. Conclusions DM is a common disease in Jordan and DR is highly prevalent among Jordanian diabetics. National screening and educational programs are highly needed to reduce the risk of blindness and visual impairment among diabetic patients.
Clinical Outcome and Subjective Quality of Life after Photodynamic Therapy in Patients with Age-Related Macular Degeneration
Authors: Krummenauer F. , Braun M. , Dick H.B. 
Published: January 2018

Purpose Whereas the efficacy of photodynamic therapy (PDT) in preventing the progression of age-related macular degeneration (ARMD) is established, its effect on quality of life is under discussion. Methods All patients who underwent PDT during 2000 and 2001 at the University Eye Hospital of Mainz were interviewed using a standardized 82-item questionnaire on quality of life and patient satisfaction in ophthalmologic patients. Information was assessed in terms of 82 questions; global scores ranging from 1.0 (optimum self-estimated quality of life) to 4.0 (worst) were derived. Cataract patients' scores were used to characterize the ARMD patients' subjective outcome; the latter were then related to clinical outcome parameters via logistic regressions. Results A total of 84 patients (50% female, median age 77 years) were interviewed, who underwent a median of three PDT interventions. During the period of PDT treatment, their median decrease in visual acuity was 3 lines from 0.125 to 0.063. Patients who reported a subjective increase in visual function during this period showed a median private flexibility score of 1.86; patients with the subjective impression of visual function decrease, a median score of 2.71; the median scores for mobility were 2.00 versus 3.00, for flexibility in reading 1.91 versus 3.64, for psychological stress 1.56 versus 2.25, and for communicational flexibility 1.72 versus 2.25. The difference in reading flexibility was statistically significant (p=0.001) after correction for clinical cofactors. Conclusions The established clinical benefit of PDT treatment concerning its efficacy in ARMD progression prevention coincides with an at least slight subjective benefit in quality of life and patient satisfaction. However, the latter is associated with the patients' subjective impression of visual acuity progression rather than with clinically validated outcome after PDT treatment.
Intravitreal Triamcinolone Acetonide in Refractory Pseudophakic Cystoid Macular Edema: Functional and Anatomic Results
Authors: Boscia F. , Furino C. , Dammacco R. , Ferreri P. , Sborgia L. , Sborgia C. 
Published: January 2018

Purpose To evaluate safety and efficacy of intravitreal triamcinolone acetonide (TAAC) injections in the treatment of refractory pseudophakic cystoid macular edema (CME). Methods Seven eyes of six patients (age range: 50–74) with pseudophakic CME resistant to standard treatment received intravitreal injections of 4 mg of TAAC with all vehicle. Mean preinjection duration of CME was 18.3 months. A mean of 2.1±1.2 (range 1 to 4) treatments were performed in four eyes (57.1%) when visual acuity deteriorated towards baseline levels. Visual acuity assessment, optical coherence tomography (OCT), and fluorescein angiography (FFA) were performed pre- and postoperatively to evaluate results of TAAC injections. Intraocular pressure (IOP) and complications related to treatment were assessed. Results After 11.1±3.9 months, mean best-corrected visual acuity (BCVA) increased (p=0.019) from 20/132 to a best value of 20/38. Mean macular thickness decreased from 517.29±146.98 mm to a best value of 263.71±83.13 mm (p=0.0018). Area of fluorescein leakage decreased (p<0.0001) from 11.84±0.93 mm2 at baseline to a minimal value of 3.86±0.98 mm2. The anatomic and functional improvement appeared after 1 month from the intravitreal injection and persisted through at least 3 months of follow-up. At the end of follow-up BCVA, macular thickness, and area of fluorescein leakage did not differ from baseline. Four eyes (57.1%) developed IOP values higher than 21 mmHg, controlled by topical treatment. Two patients developed an endophthalmitis-like reaction. Conclusions Intravitr eal TAAC was relatively safe and effective in resistant cases of pseudophakic CME with a temporary beneficial effect on visual acuity and macular edema.
Congenital Dacryocystocele with Intranasal Extension
Authors: Teixeira C.C. , Dias R.J. , Falcão-Reis F.M. , Santos M. 
Published: January 2018

Purpose Congenital dacryocystocele is a rare anomaly in the newborn child. The swelling of lachrymal sac is observed by birth and it is associated with obstruction of lachrymal system either above or below lachrymal sac. Methods Diagnosis was made by clinical observation. Some ancillary examinations, such as ultrasonography, tomography, and rhinoscopy, were useful. Results The authors describe the clinical case of a newborn with a unilateral congenital dacryocystocele. This anomaly was successfully treated with probing and marsupialization of the nasal cyst. Conclusions Treatment of this congenital anomaly is by light compressive massage, probing with silicone intubation of lachrymal system to assure prolonged permeability of the system, or with marsupialization of the nasal cyst. In some cases with intranasal extension of dacryocystocele, collaboration with an otolaryngologist may be necessary.
Cytomegalovirus Retinitis in a Patient with Non-Hodgkin's Lymphoma: A Diagnostic Dilemma
Authors: Chawla R. , Venkatesh P. , Garg S.P. , Mandal S. , Tewari H.K. 
Published: January 2018

Purpose Patients with lymphoma can rarely develop cytomegalovirus (CMV) retinitis. Clinically it is difficult to distinguish from intraocular lymphoma. Also, in such cases the CD4+ count may be high. The authors report a rare case of bilateral CMV retinitis in a patient with non-Hodgkin's lymphoma with high CD4+ counts. Methods Observational case report with review of literature. Results CMV retinitis was clinically suspected due to the presence of large areas of retinal necrosis and hemorrhages in one eye and a demarcation line with white mottled retina in the other eye. Other differential diagnoses considered were intraocular lymphomatous infiltration and acute retinal necrosis due to herpes group of viruses. The diagnosis of CMV retinitis was confirmed by polymerase chain reaction performed on vitreous sample. Conclusions CMV retinitis can develop in cases of lymphoma despite high CD4+ counts. An early diagnosis can be established by performing PCR on vitreous biopsy.
Delayed Atrophy of the Retinal Pigment Epithelium after Submacular Surgery
Authors: Maclaren R.E. , Aylward G.W. 
Published: January 2018

Purpose We report a case of delayed atrophy of the retinal pigment epithelium (RPE) eighteen months after apparently successful excision of submacular choroidal new vessels (CNV) in a patient with age-related macular degeneration (AMD). Methods Case report. Results Submacular surgery for CNV was achieved without visible disturbance of the underlying RPE in an 83 year old man diagnosed with AMD. At the time of surgery the CNV displayed clinical features consistent with lying internal to Bruch's membrane (Type 2 configuration). There was no visible RPE defect at the fovea and vision improved during the subsequent 12 months follow-up. Eighteen months later, however, an atrophic central RPE defect appeared, with a similar shape to the CNV originally excised. Conclusions This case demonstrates that submacular CNV with Type 2 configuration can occur in AMD and lead to an initially favourable outcome following submacular surgery. Atrophy of the RPE nevertheless did eventually occur and in a pattern consistent with damage during the original operation. It is important to consider results of longer term follow-up when interpreting success rates for surgery in AMD.
Uncomplicated Phacoemulsification and First-Day Review: The Patient's Perspective
Authors: Kumar A. , Hugkulstone C. E. 
Published: January 2018

Purpose To evaluate patients’ opinions regarding first-day review following uncomplicated phacoemulsification. Methods A prospective questionnaire-based survey was conducted on consecutive patients at the time of listing for day-case phacoemulsification. Data collected included demographic details, proposed anaesthetic technique, first or second eye surgery and postcode. Statistical analysis was undertaken with the unpaired t-test, the χ2-test with Yates’ correction for small numbers or Fisher's exact test, and Kendal's rank correlation, as appropriate. Results 100 patients (59% female; mean age 74.2 (12.6) years) were recruited. 87% preferred to return to hospital for their first-day review. This result was not significantly affected by sex, proposed anaesthetic technique, first eye surgery or postcode area. Only patients Conclusions In this population, patients preferred to return for first-day review following uncomplicated phacoemulsification. There may be some variance in the opinions of surgeons and patients regarding this issue, and the patient's preferences should be taken into account to provide optimum quality of care.
Therapeutic Effects of Laser Photocoagulation and/or Vitrectomy in Eales' Disease
Authors: Dehghan M.H. , Ahmadieh H. , Soheilian M. , Azarmina M. , Mashayekhi A. , Naghibozakerin J. 
Published: January 2018

Purpose To determine visual outcomes and regression of retinal neovascularization following laser photocoagulation and/or vitrectomy in eyes with Eales' disease. Methods In a retrospective noncomparative study, the authors reviewed the existing data of 67 eyes of 54 patients with a diagnosis of Eales' disease who had undergone laser photocoagulation and/or vitrectomy based on their clinical presentations. Main outcome measures were visual acuity changes and regression of retinal neovascularization of the eyes following treatment. Results Both laser therapy and vitrectomy improved visual acuity and induced egression of retinal neovascularization. Forty-three eyes had undergone laser therapy; their rate of visual acuity ≥20/30 improved from 53% before treatment to 60% after treatment. Twenty-four eyes had undergone vitrectomy; rate of visual acuity ≥20/30 improved from 13% before surgery to 38% after surgery. In eyes that had undergone laser therapy, additional laser therapy controlled recurrent neovascularization in 47% of the eyes, but ultimately, 12% of them required vitrectomy. In the primary vitrectomized group, additional required treatment was repeat vitrectomy in 21 %, and/or laser therapy in 29% of the eyes. Conclusions Although laser photocoagulation should be the first line of treatment in Eales' disease, it cannot always induce regression of retinal neovascularization. In such cases vitrectomy may further enhance therapeutic success.
Suspension Made with Amniotic Membrane: Clinical Trial
Authors: Bonci Po. , Bonci Pa. , Lia A. 
Published: January 2018

Purpose To investigate if a suspension made with amniotic membrane could have a beneficial effect on ocular surface diseases. Methods In the Imola branch of the Eye Bank of Emilia Romagna, the authors prepared a suspension containing homogenized amniotic membrane previously conserved at −80 degrees Celsius. Subsequently, the authors gave this preparation to 21 patients: 8 had undergone lamellar keratoplasty, 4 had undergone penetrating keratoplasty, 2 had undergone photorefractive keratectomy with a delay of epithelialization, 3 had neurotrophic corneal ulcers, 2 had corneal burning, 1 had torpid corneal ulcer, and 1 had Sjögren syndrome. Each patient had been treated with conventional therapy for at least, 4 months without any clinical improvement. In this sample of eyes the authors evaluated the transparency and integrity of epithelium before and after the therapy by means of a fluorescein staining test, examining the area of epithelial defect as well as the phlogistic situation and the symptoms referred by patients. Nine eyes from this group of patients were studied by impression cytology before and after 3 months of use of suspension. The follow-up was 5 months of once-weekly visits. Results In all patients, after 15 to 30 days the corneas became negative to fluorescein staining test and the epithelium seemed more complete and regular, there was an evident decrease of phlogistic situation in the conjunctiva, and an improvement of symptoms was referred by patients. The situation was stable during the whole follow-up. No side effects were noted. The impression cytology repeated 3 months after the treatment showed a significant corneal recovery of the cytologic situation with an important decrease of CK19 + cells on the corneal surface. Conclusions This new therapy, which is less traumatic than an implant of amniotic membrane, is safe, and can be repeated for a long period, could help patients with corneal superficial defects.
Frequency of Cataract Surgery after Intravitreal Injection of High-Dosage Triamcinolone Acetonide
Authors: Jonas J.B. , Degenring R. , Vossmerbauemer U. , Kamppeter B. 
Published: January 2018

Purpose To evaluate the frequency of cataract surgery after intravitreal injection of high-dosage triamcinolone acetonide in elderly patients. Methods This clinical interventional case series study included 144 phakic eyes that consecutively received an intravitreal injection of about 20 mg triamcinolone acetonide for diffuse diabetic macular edema (n=42 eyes), exudative age-related macular degeneration (n=98), and branch retinal vein occlusion (n=4). Mean age was 72.3±8.9 years. Mean follow-up was 11.0±6.8 months (median, 8.8 months; range, 3 to 35.5 months). Reinjections were carried out in 12 (8.3%) eyes. Results Cataract surgery was performed in 20 (13.9%) eyes 17.4±9.1 months (median, 12.7 months; range, 8.0 to 35.5 months) after the first intravitreal injection. Out of the 20 eyes undergoing cataract surgery, 19 (95%) eyes had received one intravitreal injection, and 1 (5%) eye had received two previous injections. Conclusions In the elderly population of patients with exudative age-related macular degeneration, diffuse diabetic macular edema, or branch retinal vein occlusion, intravitreal high-dosage injection of triamcinolone acetonide leads to clinically significant cataract with eventual cataract surgery in about 15% to 20% of eyes within about 1 year after the intravitreal injection.
Iatrogenic Horner's Syndrome
Authors: Cavazza S. , Bocciolini C. , Gasparrini E. , Tassinari G. 
Published: January 2018

Purpose To report two cases of Horner's syndrome. One presented after the ablation of a schwannoma of the cervical sympathetic chain, the second after upper thorascopic sympathectomy for primary palmar hyperhidrosis. Methods A 42-year-old man underwent excision of a left neck mass found during routine physical examination. A 20-year-old girl with axillary and palmar hyperhidrosis was treated with cervical sympathectomy. Results In the early postoperative days, miosis, ptosis, anhidrosis, and enophthalmos were observed. Conclusions In the ablation of a schwannoma, postoperative Horner's syndrome is associated with the relationship between nerves and the tumor mass, which makes it impossible to separate them surgically in most cases. In thorascopic sympathectomy, patients should be warned of this complication.
Combined Surgical Ablation and Intravitreal Triamcinolone Acetonide for Retinal Angiomatous Proliferation
Authors: Boscia F. , Furino C. , Prascina F. , Delle Noci N. , Sborgia L. , Sborgia C. 
Published: January 2018

Purpose Neovascular age-related macular degeneration (ARMD) with retinal angiomatous proliferation (RAP) has a poor natural history and the efficacy of any treatment has not yet been established. The authors describe a combined surgical treatment. Methods A 76-year-old woman presented with a best-corrected visual acuity (BCVA) of 20/600 in the right eye and macula with stage 3 RAP as identified by fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). After a standard three-port pars plana core vitrectomy (PPV), endodiathermy of the arteriolar and venous feeder vessels of each lesion was performed, intraretinal RAP feeder vessels were cut with manual vertical intraocular scissors, and 0.1 mL of triamcinolone acetonide (TAAC) was injected intravitreally At 1 and 4 weeks and at the sixth month, the patient underwent a complete eye examination, FA, ICGA, and OCT to assess outcomes and complications. Results Six months later, BCVA was stable at 20/300, intraocular pressure was 15 mmHg, anterior segment and vitreous cavity were clear without evidence of TAAC granules, and retina was attached. FA and ICGA showed a complete occlusion of the RAP and absence of leakage or ischemia and OCT demonstrated decreased macular thickness with resolution of both intraretinal edema and pigment epithelium detachment, and the restoration of the normal macular profile. At the end of follow-up, the authors did not observe any ocular or systemic complication. Conclusions Surgical approach to RAP stage 3 with intravitreal injection of 4 mg of TAAC was safe and anatomically effective.
Effects of Membrane Adhesion Barriers on Wound Healing Reaction after Glaucoma Filtration Surgery: A Comparative Study with Interceed and Seprafilm
Authors: Akyol N. , Aydogan S. , Akpolat N. 
Published: January 2018

Purpose To evaluate and compare the effectiveness of two adhesion barriers, Interceed and Seprafilm, on wound healing reaction after glaucoma filtration surgery. Materials and Methods Full-thickness filtration surgery was carried out on three groups, each containing four rabbits. Interceed and Seprafilm prepared in 3×4 mm dimensions was put on and around scleral opening in Groups 1 and 2, respectively. All groups received tobramycin and dexamethasone drops tid for 14 days. Intraocular pressure (IOP), anterior chamber depth, and bleb appearance were checked on the first, third, seventh, and 14th days. The rabbits were killed on the 14th day and the trabeculectomy area with overlying conjunctiva was excised. The samples were fixed with 10% formalin, buried in paraffin, and stained with hematoxylin and eosin. The surgical site and surrounding subconjunctival area were evaluated histopathologically for cell counts (fibroblast, lymphocyte, eosinophil, and macrophage), presence of edema and foreign body reaction, and potency of the fistula tract. Results Mean IOP at the first and third day examinations was significantly different between groups, but there was no statistically significant difference among the groups with respect to IOP, anterior chamber depth, or bleb appearance at the seventh and 14th days. The groups were similar with respect to number of fibroblasts, eosinophils, and neutrophils. Number of macrophages was significantly increased in Groups 1 and 2 and number of vessels was significantly decreased in Group 1. Conclusions Neither of these two adhesion-preventing substances seems to suppress wound healing reaction after glaucoma filtration surgery. However, a diminished wound healing reaction was expected with a decreased number of vessels, such as in Group 1. Increased number of macrophages in both groups may result in a decreased level of some inflammatory mediators.