bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathological findings after pars plana vitrectomy with a new hypersonic vitrector
Authors: Irion L. , Pastor‐Idoate S. , Bonshek R. , Zambrano I. , Bishop P. , Mironov A. , Carlin P. , Stanga P. 
Published: September 2016

PurposeAssess morphological changes in the retina and optic nerve head (ONH) after pars plana vitrectomy with a new prototype ultrasound‐based hypersonic vitrector (HV).MethodsSix porcine cadaveric eyes, 6 human cadaveric eyes and 14 live porcine eyes underwent pars plana vitrectomy (PPV) using the HV or a pneumatic guillotine vitrector (GV). One extra eye from each porcine group had no procedure done, being used as a control. Eyes were fixed in formalin, examined macroscopically and processed for histological assessment. Microscopic analysis included assessment of any morphological intraocular change especially to the retina and ONH. Comparison was made between non‐vitrectomized (intenal control) and vitrectomized areas, respectively nasal and temporal to ONH .ResultsThere were no macroscopic retinal or ONH defects associated with either HV or GV PPVs. Microscopically, cadaveric human and porcine retinas showed focal vacuolization and fragmentation at the nerve fibre layer and the ganglion cell layer as well as separation of the inner limiting membrane (ILM). Eyes from live swines following PPV with both vitrectors showed ILM fragmentation and separation. There were no differences between the ‘non‐vitrectomized’ nasal (control) and vitrectomized temporal areas of the ONH with HV.ConclusionsMorphological examination of retina and ONH with light microscopy after PPV showed similar features using the HV or the GV. The HV might be a promising new alternative to the currently commercially available GV for PPV.
A link between diabetes mellitus and glaucoma — Danish Nationwide Study
Authors: Horwitz A. , Petrovski B.É. , Petrovski G. , Torp‐Pedersen C. , Kolko M. 
Published: September 2016

PurposeTo determine the effect of anti‐diabetic medication on glaucoma. Furthermore, to investigate if diabetic comorbidities and concomitant medications are associated with glaucoma in patients treated with anti‐diabetic medication.MethodsRetrospective nationwide cohort study, spanning a 16‐year follow‐up period. The National Danish Registry of Medicinal Products Statistics was used to identify all claimed prescriptions for glaucoma medication and anti‐diabetic drugs. Comorbidities with diabetic retinopathy and diabetic nephropathy were identified using the ICD‐10 classification and the Danish National Patient Register.ResultsA total of 6,343,747 individuals in the period 1996–2012 were included. The overall incidence rates of new‐onset glaucoma were 0.07 and 0.36 per 1,000 person‐years for the reference population and for diabetes mellitus, respectively. Patients treated with anti‐diabetic drugs at any time during the study period had a significantly higher overall relative risk of glaucoma (RR = 5.11, p < 0.0001), even when controlling for age, gender, diabetic retinopathies and calendar year‐fixed effects (RR = 2.05, p < 0.0001). For patients treated with anti‐diabetic drugs, we found an increased hazard for development of glaucoma in patients with diabetic retinopathies (HR = 1.40) and joint complications with diabetic retinopathies and diabetic nephropathy (HR = 1.40). Furthermore, we found that concomitant antihypertensive medications were associated with an increased likelihood of glaucoma overall, while treatment with β‐blocker and RAS, in combination, are associated with a significantly lower risk (HR = 0.87).ConclusionsUse of anti‐diabetic drugs is strongly associated with use of anti‐glaucomatous drugs. Diabetic complication as well as concomitant antihypertensive medications affect the risk of glaucoma in patients treated with anti‐diabetic drugs.
Paraneoplastic retinopathy and optic neuropathy with Waldenström Macroglobulinemia
Authors: Ozturk N. , Havelange V. , Draganova D. , Boschi A. 
Published: September 2016

PurposeTo report the clinical, electrophysiologic and immunopatholologic findings in a patient with progressive visual loss due to retinal and optic nerve degeneration associated with a Waldenström's macroglobulinemia (WM).MethodsA 77‐year old man with mild stage WM, complained of progressive bilateral visual loss, with photopsia, intense photophobia and loss of color perception. Patient developed severe legs pain and unsteadiness.Complete ophthalmological, neurological and hematological examinations were realized, and patient followed over a period of 2 years. Immunohistochemical studies to determine the presence of serum antiretinal antibodies were performed.ResultsVisual acuity was gradually reduced to 1/10 RE and 2/10 LE, with a severe loss of color perception. The visual field showed a deep central and peripheral visual loss in both eyes. Optic nerves were pale and excavated, macular remained normal as peripheral retina. Cerebral CT scan did not show anomalies in the brain as in the optic nerves, lumbar puncture was unremarkable. Neurological revealed a rest less leg syndrome. Electroretinogram showed a reduce rod response and a delayed combined and cone response. Hematologic evaluations confirmed the WM and immunohistochemistry showed reactivity of the patient's serum against the photoreceptors.The patient was treated with 4 intravenous infusions of Rituximab, followed 1 month later by 1gr of Methylprednisolone for 3 days. Improvement of central vision (4/10 RE, 6/10 LE) and peripheral visual fields was reported.ConclusionsThe visual loss in this patient is due to a combined dysfunction in the retina and the optic nerve and presumed to result from antibodies IgM‐subtype reacting to proteins in different retinal antigens.
En face OCT of uncomplicated angioid streaks
Authors: Perestrelo S. 
Published: September 2016

PurposeThe Optical Coherence Tomography (OCT) is not a good diagnostic method for uncomplicated angioid streaks. Even the most better resolution imaging forms such as Spectral Domain OCT or Swept Source OCT has no sufficient resolution to distinguish the locations of small splines. The aim of this study is to report the imaging characteristics of uncomplicated angioid streaks using en face Spectral Domain OCT (SD‐OCT).MethodsPatients with uncomplicated angioid streaks were imaged using Spectralis SD‐OCT. A macular cube composed of 248 μm 20° × 15° 19‐line raster scans was obtained. En face SD‐OCT characteristics were evaluated by taking images at the retinal pigment epithelium level taking into account all its thickness.ResultsLarge angioid streaks are visible in en‐face SD‐OCT as a hiporreflective groove structure, representing the pigment epithelium, surrounded by a hiperreflective area that corresponds to its absence.ConclusionsSD‐OCT en face imaging can be used in clinical practice to identify and follow patients with uncomplicated angioid streaks. ‘Follow‐up’ functions of the SD‐OCT may help in the future to better understantd the behavior of these lesions.
The role of anterior segment optical coherence tomography (AS‐OCT) and ultrasound biomicroscopy (UBM) in conjunctival nevi
Authors: Lauwers N. , Janssens K. , Mertens M. , De Keizer R.J.W. , De Groot V. 
Published: September 2016

PurposeTo compare AS‐OCT and UBM in the evaluation of conjunctival nevi.MethodsProspective, observational, non‐randomized trial. We examined 16 eyes of 15 consecutive patients with conjunctival nevi.ResultsThe visualization of the margins of the nevus was categorized as good, fair or poor. There was a good resolution in 100% of anterior margins for both UBM and AS‐OCT cases. On UBM and AS‐OCT the posterior margin had a good or fair resolution in 94 and 88%, respectively. Except for 1 UBM image, all AS‐OCT and UBM images had a good or fair resolution of the lateral margins. Some degree of deep optical shadowing was seen on all AS‐OCT images, but it only hindered good visualization of the posterior margin in 3 cases.AS‐OCT was able to visualize the nevi with a better resolution than UBM. Intrinsic cysts were seen in 6 cases (36%) with UBM and in 13 cases (81%) with AS‐OCT, not necessarily in the same cases.ConclusionsAS‐OCT and UBM have the ability to accurately visualize the anterior and posterior margins of conjunctival nevi although AS‐OCT is more accurate in visualizing details. AS‐OCT is also more patient friendly but it has the disadvantage of deep optical shadowing, especially in thick nevi. We would advise to document conjunctival nevi with photographs and AS‐OCT first and to use UBM only when the nevus is too thick to visualize the posterior margin with AS‐OCT.
Dexamethasone induced glaucoma as part of chemotherapy for lymphoblastic lymphoma and colorectal cancer
Authors: Lockwood A. , Mitchell A. , Lewis K. , Papadopoulos M. , Gray J. , May K. 
Published: September 2016

PurposeTo describe glaucoma in an 11‐year‐old girl and exacerbation of glaucoma in a 59 year old man after high dose oral corticosteroid chemotherapy.MethodsTopical steroids are well known to cause intraocular pressure (IOP) elevation, but oral steroids are less commonly associated. We report 2 cases of significant IOP elevation after high dose dexamethasone treatment as part of chemotherapy for lymphoblastic lymphoma in an eleven‐year old girl, and for metastatic colorectal cancer in a 59‐year old man.ResultsA week after induction with dexamethasone combination chemotherapy an 11‐year old girl presented with headaches, photophobia and blurring of vision. Intraocular pressures were 48 and 52 mmHg in the right and left eye respectively with bilateral arteriolar disc pulsation. Control of IOP was achieved through topical and systemic treatment but requiring renal support after systemic carbonic anhydrase inhibitor use. The second patient was an adult male with preexisting glaucoma controlled medically in the right eye and with an aqueous shunt in the left eye. During the course of chemotherapy with systemic dexamethasone for colorectal cancer he presented to casualty with reduced right vision from 6/12 to 6/60 associated with an IOP of 42 mmHg in the right eye, while the left was 21 mmHg. His right eye required cyclodiode laser for IOP control.ConclusionsThese cases illustrate that high dose systemic dexamethasone treatment for chemotherapy may cause a considerable rise in IOP potentially leading to significant visual loss from glaucoma. This possibility should be anticipated especially in children and in patients with pre existing glaucoma who are at higher risk of steroid responsiveness.
Comparaison of the Plusoptix A12 and the 2WIN with the Retinomax K‐plus 3 in a pediatric population
Authors: Bouvier R. , Heripret A. , Promelle V. , Milazzo S. 
Published: September 2016

PurposeTo compare non‐cycloplegic refractive results obtained with the Plusoptix A12 (Plusoptix, Germany) and the 2WIN (Adaptica, Italia), to Retinomax K‐Plus 3 (Righton, Virginia) in a pediatric cohort.Methods106 eyes of 53 childrens were included prospectively between March 2015 and June 2015. On each eye, no‐cycloplegic refraction was performed with the Plusoptix A12 and the 2WIN, and cycloplegic refraction was performed with the Retinomax K‐Plus 3, which was used as gold‐standard reference method. All data from each device, concerning sphere and cylinder power and axis, were compared to cycloplegic refractive measurements. The measures were considered reliable when the difference on sphere or cylinder power was between −0.5 D and +0.5 D, and when the difference on axis was less than 10°.ResultsThe mean age was 7.3 years (range, 1–17 years). Regarding sphere, measures were reliable in 37.7% for the right eye and 35.8% for the left eye with the Plusoptix A12 and in 35.8% with the 2WIN, regardless the eye. The sphere was underestimated respectively in 59.3 and 57.5%. Regarding the cylinder power, measures were adequate in 66% for the right eye and 69.8% for the left eye with the Plusoptix A12 and in 79.2% for the right eye and 64.2% for the left eye with the 2WIN. Concerning the cylinder axis, values were reliable in 32% for the right eye and 47% for the left eye with Plusoptix A12 and 42% for the right eye and 62% for the left eye with the 2WIN .ConclusionsThe Plusoptix A12 and the 2WIN seem reliable for the evaluation of the cylinder power but not for the axis. These devices trend to underestimate the sphere. These devices can be used for screening of children refractive errors, but can not restitute cyloplegic retinoscopy measurements for prescription of optical corrections.
Warfarin use among wet AMD patients
Authors: Paterno J.J. , Ahola O. , Järvikallio R. , Kiviluoma J. , Turtiainen H. , Vuorinen I. , Kaarniranta K. 
Published: September 2016

PurposeTo evaluate the prevalence of warfarin use among wet AMD patients, and impact on clinical outcome.MethodsA retrospective analysis of patient records was conducted in Kuopio University Hospital, Finland. We obtained best possible medication history of 414 wet AMD patients and 247 controls, aged 60 years or over, and already excluding other causes of macular oedema by ophthalmologist. Controls were patients with glaucoma or age‐related cataract, with no wet AMD. Due missing medication history, 139 wet AMD patients and 71 controls (p = 0.216) were kept out from the study. When possible, we obtained real‐life 2‐year outcome data of wet AMD treatment for the patient's first eye, solely treated with anti‐VEGF pro re nata.ResultsThe study included 276 wet AMD patients (mean age: 79.5 years) and 175 controls (mean age: 75.3 years). A positive warfarin medication history was detected in 57 (20.7%) wet AMD patients, compared to 16 (9.1%) in control group. Crude OR was 2.59 (95% CI 1.43–4.67, p = 0.001). Age‐adjusted OR was 1.92 (95% CI 1.02–3.60, p = 0.018). Treatment outcome data was obtained from 11 patients (mean age: 77.3 years) using warfarin and 54 patients (mean age: 79.1 years) without warfarin medication. Snellen visual acuity didn't differ between these wet AMD groups at the baseline (0.3 vs. 0.2, p = 0.319). After 2‐year follow‐up, no difference was seen in the change of visual acuity (+0.3 vs. +0.3, p = 0.696), or in number of anti‐VEGF injections (7.8 vs. 9.0, p = 0.435) with respect to the use of warfarin.ConclusionsOur study suggest that warfarin use may be more common among wet AMD patients, but it does not have any effect on the outcome of wet AMD treatment. As the study sample is small and wet AMD‐related cardiovascular factors are susceptible to interfere, these initial findings should be verified in a larger prospective study.
Rupture of Descemet's membrane associated with forceps delivery
Authors: Idoate A. , Ascaso F. , Perez D. , Remón L. , Perez I. , Almenara C. , Esteban O. , Martinez M. , Sanchéz J.I. , Berniolles J. , Bartolomé I. 
Published: September 2016

PurposeIn modern medicine forceps‐induced birth trauma to the eye is a rare clinical event. Forceps injury to the cornea occurs during complicated forceps delivery. The break in Descemet's membrane is the most common complication.MethodsInterventional case report showing the rupture of Descemet's membrane due to a complicated forceps delivery.ResultsA 2 days‐old boy was referred for severe and diffuse corneal edema. Medical history was significant for forceps delivery. On examination, he was found to have a rupture of the Descemet's membrane. Conservative treatment and application of hypersomolar solution was decided. Corneal edema was resolved in three months. Actually the cornea remained clear but persists a residual corneal astigmatism of 6D.ConclusionsThe application of the forceps can cause accidental rupture of the cornea at the level of the Descemet's membrane. The edema resolves spontaneously within a few weeks or months eventually leaving the visible edges of the break and a clear cornea. Rupture of Descemet's membrane is not presented as an Ophtalmologic urgency but it′s crucial to follow these patients because failure to intervene leads to amblyopia or ‘lazy eye’.
Choroidal metastasis from thyroid cancer: a case series
Authors: Mamunur R. , Kivela T. 
Published: September 2016

PurposeTo describe the clinical features, treatment, and outcome of primary thyroid cancer patients with choroidal metastases.MethodsA retrospective observational case series of 3 consecutive thyroid cancer patients with choroidal metastasis in the Ocular Oncology Service, Helsinki University Hospital, Finland, from 2009 to 2015.ResultsThe median age at presentation with primary thyroid carcinoma was 45 years. Two primary tumors were medullary and one was a papillary carcinoma. All patients had synchronous metastases to various tissues, and the choroidal metastasis from a papillary carcinoma was the first sign of cancer. The choroidal metastases from the medullary carcinomas developed 4 and 15 years after diagnosis. Two patients had unilateral and one bilateral choroidal metastases. The median tumour height was 1.9 mm and all were 10–12 mm by largest basal diameter. The primary cancer was treated with radiotherapy and thyroidectomy in 2 who also received systemic chemotherapy and sorafenib. The choroidal metastases permanently vanished with 40 Gy external beam radiotherapy. The patient with papillary carcinoma died within 4 months from cerebral metastases, whereas the two with medullary carcinoma survived 34 and 45 months from detection of choroidal metastasis and 7 and 17 years from detection of the primary tumor with synchronous metastases.ConclusionsThe choroid is not a common site for metastatic thyroid carcinoma: to the best of our knowledge, there is only one previous series with three affected patients although in addition there are about 50 single case reports.
Validation of an antiretinal antibody detection strategy for the diagnosis of autoimmune retinopathies
Authors: Draganova D. , Debaugnies F. , Postelmans L. , Caspers L. , Willermain F. , Corazza F. 
Published: September 2016

PurposeAntiretinal antibody (ARA) detection is a key element in the diagnosis of autoimmune retinopathies (AIR). We present the indirect immunofluorescence data from a series of suspected AIR patients and controls.MethodsPrimate retinal sections were incubated with 1:100 diluted sera. Patients with suspected paraneoplasic AIR (pAIR) (n = 13) or non paraneoplasic AIR (npAIR) (n = 15) were included. Diagnosis of AIR was based on a combination of symptoms (visual loss, photopsia, nyctalopia) and signs (decreased visual acuity, reduced visual field, abnormal electroretinography and retinal imaging) in a context of history of cancer or autoimmune disease. 3 control groups were used to define the threshold of positivity: negative: sera from healthy individuals without ophthalmological history (n = 15), pathological: patients with outer retinal inflammation (ORI) (n = 12) and positive: commercial antibodies against recoverin, α‐enolase, IRBP and TRPM‐1. Antinuclear antibodies (ANA) were screened when a nuclear pattern was observed.ResultsAs expected, in sera positive for ANA there was a signal in all nuclear layers, complicating ARA interpretation. ANA positivity was found in 4/15 negative controls, 2/12 ORI, 2/13 pAIR, 7/15 npAIR. In ORI, 1/12 patient had positive ARA. We found ARA respectively in 6/13 pAIR and 4/15 npAIR patients. ARA were localized at the following retinal layers: photoreceptors (PR), external limiting membrane, outer plexiform layer, outer nuclear layer. In pAIR, PR staining was most frequently observed. In contrast, no predominant location was found in npAIR.ConclusionsWe show that ARA detection can help the management of suspected AIR patients but should be integrated in the overall clinical context. Furthermore, we underline the importance of using negative controls and being aware that positive ANA complicate interpretation of results.
Prevention and reversal of selenite‐induced cataracts by N‐acetylcysteine amide in Wistar rats
Authors: Maddirala Y. , Tobwala S. , Karacal H. , Ercall N. 
Published: September 2016

PurposeThe present study sought to evaluate the efficacy of N‐acetylcysteine amide (NACA) eye drops in reversing the cataract formation induced by sodium selenite in male Wistar rat pups.MethodsForty male Wistar rat pups were randomly divided into treatment groups. Cataracts were evaluated at the end of week 2 (postpartum day 14) when the rat pups opened their eyes. NACA eye drops were administered beginning week 3 till the end of week 4 (postpartum days 15–30) and the rats were sacrificed at the end of week 4. Lenses were isolated and examined for oxidative stress parameters such as glutathione, lipid peroxidation, and calcium levels along with the glutathione reductase and thioltransferase enzyme activities. Casein zymography and Western blot of m‐calpain were performed using water soluble fraction of lens proteins.ResultsMorphological examination of the lenses in the NACA‐treated group indicated that NACA was able to reverse the cataract grade. In addition, glutathione (GSH) level, thioltransferase (Ttase) activity, m‐calpain activity, and m‐calpain level (as assessed by Western blot) were all significantly higher in the NACA‐treated group than in the Na2SeO3‐induced cataract group. Furthermore, sodium selenite injected rat pups had significantly higher levels of malondialdehyde (MDA), glutathione reductase (GR) enzyme activity, and calcium levels, which were reduced to control levels upon treatment with NACA.ConclusionsNACA has the potential to significantly improve patient health and the clinical care of cataracts. Further development of pharmacological agents like NACA may eventually help ophthalmologists prevent cataract formation in high‐risk populations and non‐surgically treat early stage cataracts, producing favorable patient outcomes while decreasing medical costs.
Stargardt disease phenotype‐genotype correlation – first results of a Lithuanian cohort study
Authors: Strupaite R. , Cimbalistienė L. , Ambrozaitytė L. , Utkus A. , Asoklis R. 
Published: September 2016

PurposeTo describe the first phenotype‐genotype correlation results of the patients with Stargardt disease in Lithuanian population.MethodsFrom May 2015 till April 2016 a prospective study was performed, 16 patients with Stargardt disease were involved. Ophthalmological examination included best‐corrected visual acuity (BCVA), ophthalmoscopy, fundus photography, fundus autofluorescence (FAF), spectral‐domain optical coherence tomography (SD‐OCT) and specular microscopy. Different DNA variants in several genes have been identified for all patients.ResultsThe age of patients ranged from 18 to 66 years. Initial ophthalmoscopy revealed either no abnormalities or foveal retinal pigment epithelium (RPE) changes, foveal atrophy, atrophic RPE lesions, and/or irregular yellow‐white fundus flecks. Different FAF patterns were observed: central atrophy surrounded by ring of increased AF, irregular hypo/hyper AF or spots of hypo AF in the posterior pole. SD‐OCT revealed photoreceptor damage followed by atrophy of the outer retina, RPE, and choroid. The mean central retinal thickness of the right eye was 96.5 ± 57.004 μm and 110.9245 ± 54.84872 of the left eye. The mean subfoveal choroidal thickness, the endothelial cell count and corneal thickness were also evaluated.ConclusionsThese are the first results of Stargadt disease in Lithuanian population. All patients had a different phenotypic expression. Further investigations conserning individual mutations contribution to phenotype are necessary.