bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systemic Bevacizumab for Retinal Angiomatous Proliferation Associated with Retinal Pigment Epithelial Detachment
Authors: Abi-Ayad N. , Mauget-Faÿsse M. , Amara-Allieu S. , Ardisson P. 
Published: January 2018

Purpose To report the off-label use of systemic bevacizumab in a patient with stage 3 retinal angiomatous proliferation (RAP) associated with a vascularized pigmented epithelium detachment (PED). Methods Interventional case report. Results The patient was treated with systemic bevacizumab after obtaining fully informed consent. At 3 months post-treatment, the authors observed an improvement of one line (seven letters) in visual acuity and total regression of the PED on ocular coherence tomography. No adverse effects were observed. Conclusions Systemic bevacizumab therapy appears to be safe and effective in the treatment of RAP associated with PED during this short follow-up period of 3 months. The authors recommend a large trial with long-term follow-up to confirm the promising results and evaluate the occurrence of adverse effects associated with systemic bevacizumab.
The Costs of Treating Glaucoma with Combinations of Topical Drugs in Spain
Authors: Neymark N. , Buchholz P. , Honrubia F. , Kobelt G. 
Published: January 2018

Purpose This study describes the treatment in ordinary clinical practice in Spain of patients with glaucoma with a two-drug combination therapy. The authors present the treatment outcome as end-of-period intraocular pressure (IOP) and the calculated direct medical costs over a 2-year period. Methods Data were extracted retrospectively from patient charts recording the use of all medical resources related to glaucoma. Costs were estimated using unit costs from public sources (2005). Descriptive cost analysis according to combination treatment at baseline was performed. Results The study included 216 patients from 21 centers. Around half of the patients were started on a β-blocker/prostaglandin analogue combination, while the rest received various other combinations containing either an α2-agonist or a carbonic anhydrase inhibitor. Across the seven groups considered, there was a statistically significant difference in the costs of the least and the two most costly groups, while the confidence intervals were overlapping in all other pairwise comparisons. The least costly drug combination was brimonidine/timolol. Assessing IOP at the end of follow-up, all the groups were equally effective (overlapping confidence intervals). In a multivariate regression analysis, the drug combination did not have an independent, significant impact on total direct medical costs, drug costs, or end-of-period IOP. Significant determinants of these variables were surgical interventions and one or more changes of drug combination during the follow-up. Conclusions Costs are determined by the response to treatment. Inadequate response triggers treatment changes and sometimes eventually surgical interventions, thereby increasing costs significantly.
Octreotide Acetate in Dominant Cystoid Macular Dystrophy
Authors: Hogewind B.F. , Pieters G. , Hoyng C.B. 
Published: January 2018

Purpose Dominant cystoid macular degeneration (DCMD) is an autosomal dominant trait of cystoid macular edema with poor visual prognosis. Until now, no efficient treatments for DCMD have been reported. The authors evaluated a somatostatin-analogue (octreotide acetate) as treatment for DCMD. Methods The authors treated four patients with early DCMD by intramuscular longacting octreotide acetate, 20 mg every 4 weeks for 1 year. In addition to general ophthalmologic examination the authors performed fluorescein angiography (FA) before and after treatment. Results Seven out of eight eyes showed improvement on FA and stabilization of visual acuity. Conclusions Somatostatin-analogues may reduce cystoid edema in DCMD and may thus prevent disease-related visual loss.
Necrotizing Fasciitis of Eyelid Secondary to Parotitis
Authors: Akcay E.K. , Cagil N. , Yulek F. , Anayol M.A. , Cetin H. , Cag Y. , Altintas A.G.K. , Simsek S. 
Published: January 2018

Purpose Evaluation of a patient with necrotizing fasciitis of the eyelid spreading from parotid gland. DESIGN. Interventional case report. Methods The patient admitted with rapidly progressive swelling, redness, and pain of four eyelids, and whole face. Pathogenic microorganism was searched, laboratory tests were evaluated. Intensive medical treatment and necrotic wound debridement was performed. Results The patient had been receiving oral cephalosporin at the time she was referred to our hospital, but her infection had spread rapidly under this treatment. In addition to her eyelid necrosis, septic shock developed within 24 hours. No pathogenic microorganism was detected in cultures. The patient responded to intravenous sulbactam ampicillin, surgical debridement of necrotic wound and supportive medical care. Moderate ptosis was the only complication observed in this patient. Reconstructive surgery was not needed. Conclusions With prompt antibiotic treatment and surgical debridement, cosmetic and functional success may be obtained in necrotizing fasciitis cases rarely seen with parotid gland origin.
Exophthalmometry Values of Turkish Adult Population and the Effect of Age, Sex, Refractive Status, and Hertel Base Values on Hertel Readings
Authors: Beden Ü. , Özarslan Y. , Öztürk H.E. , Sönmez B. , Erkan D. , Öge İ. 
Published: January 2018

Purpose To establish normal exophthalmometry values in the adult Turkish population, and the impact of age, gender, interpupillary distance, Hertel base selection, and refractive status on globe position. Methods Exophthalmometry measurements and refractive status of 2477 subjects were conducted in one tertiary and five primary health care centers. Change of globe position by age, intersex differences in terms of globe position, correlations of Hertel base with exophthalmometry results, and interpupillary distance (IPD) were evaluated. Multiple linear regression analysis was performed to test determination effect of each variable on final Hertel reading. Results Median Hertel reading was 13 mm, and 95% of the population had an upper limit of 17 mm for both eyes. There was a negative correlation between spherical equivalent of refractive status and exophthalmometry results and a weak positive correlation between IPD and exophthalmometry result. Mean Hertel value was found to decrease significantly after the third decade. Hertel base value was found to have moderate linear correlation with Hertel results. A weak correlation was detected with Hertel base/IPD ratio with final Hertel results. Multiple linear regression analysis was performed and only 13% and 20% of change in Hertel values bilaterally were found to be determined by other variables (age, IPD, refractive status, and Hertel base value) for females and males. Conclusions Normative dataset for exophthalmometry results of the Turkish population is established to be used in clinical practice and research. Only 13% to 20% of change in Hertel values was detected to be determined by age, IPD and Hertel base values.
Intracameral Avastin Dramatically Resolves Iris Neovascularization and Reverses Neovascular Glaucoma
Authors: Chalam K.V. , Gupta S.K. , Grover S. , Brar V.S. , Agarwal S. 
Published: January 2018

Purpose To report the biologic effect of intracameral bevacizumab in patients with iris neovascularization secondary to proliferative retinal vasculopathies. Methods Sixteen eyes of 15 patients with iris neovascularization associated with or without neovascular glaucoma secondary to proliferative retinal vasculopathies received intracameral bevacizumab (1.25 mg). Ophthalmic evaluations included Snellen visual acuity (VA), complete ophthalmic examination, fluorescein iris angiography, and slit lamp photography Main outcome measure was change in degree of iris neovascularization. Secondary outcomes included fluorescein iris angiographic leakage, control of intraocular pressure, and changes in VA. Results All patients with neovascularization demonstrated by slit lamp photography and fluorescein angiography (16/16 eyes) had complete (or at least partial) reduction in leakage of the neovascularization within 3 weeks after the injection. Leakage from iris neovascularization resolved in 12 of 16 (75%) eyes. In two cases recurrent leakage was seen as early as 4 weeks necessitating repeat injection. Intraocular pressure was controlled with maximum medical therapy in eight of nine eyes reducing the need for glaucoma surgery. Visual acuity improved from a median of hand motions to 20/200. Conclusions In summary, intracameral bevacizumab was effective in reversing iris neovascularization in the majority of patients. It also facilitated intraocular pressure control in patients with associated glaucoma.
Endothelial Function, Intima-Media Thickness, and Ankle-Brachial Index in Patients with Cataract and Age-Related Macular Degeneration
Authors: Zaliuniene D. , Jasinskas V. , Jurkevicius R. , Gustiene O. , Zaliunas R. 
Published: January 2018

Purpose To evaluate the association between cardiovascular risk factors, including endothelial dysfunction, increased intima-media thickness (IMT) of the carotid arteries, ankle-brachial index (ABI), and age-related macular degeneration (AMD), and cataract. Methods Forty-seven patients with AMD and cataract, 35 with cataract only, and 49 with AMD were included. Carotid ultrasound, ischemia-induced brachial artery reactivity test, and ABI in conjunction with investigation of conventional cardiovascular risk factors were performed. Results Increased levels (more than 1.23 mg/L) of high-sensitivity C-reactive protein (hsCRP) and IMT (more than 0.97 mm) increased prevalence odds for AMD and cataract 3.1 and 3.9 times, respectively. Conclusions Elevated hsCRP or increased IMT of the carotid arteries are associated with comorbid cataract and AMD, whereas there were no reliable differences between groups in respect to endothelial function and ABI.
Five-Year Results of Viscocanalostomy
Authors: David V.P. , Kutty K.G. , Somasundaram N. , Varghese A.M. 
Published: January 2018

Purpose To prospectively study the success rates and complications of viscocanalostomy. Methods Prospective nonrandomized case series of 46 eyes (46 patients) with medically uncon-trolled primary and secondary open angle glaucoma. All patients in the study underwent viscocanalostomy. Control of intraocular pressure was used to measure success. Pre and postoperative glaucoma medications, visual acuity, complications, and adjunctive procedures were recorded. Results At 60 months, qualified success (intraocular pressure below 21 mmHg with glaucoma medication) was achieved in 37 (82%) patients and complete success (intraocular pressure below 21 mmHg without medication) in 25 (54%) patients. Nd:YAG laser goniopuncture was performed in 33 (72%) patients with significant post laser reduction of intraocular pressure. No sight threatening complications were observed in this series. Visual acuity remained unchanged in 33 patients (72%). Conclusions Viscocanalostomy appears to be a safe and effective intraocular pressure lowering procedure in eyes with primary open angle glaucoma and certain types of secondary open angle glaucoma.
Intravitreal Triamcinolone for the Treatment of Refractory Macular Edema in Idiopathic Intermediate or Posterior Uveitis
Authors: Hogewind B.F.T. , Zijlstra C. , Klevering B.J. , Hoyng C.B. 
Published: January 2018

Purpose Cystoid macular edema (CME) is the most significant cause of visual loss associated with idiopathic uveitis. The authors report on the use of intravitreal triamcinolone acetonide (IVTA) in a group of patients with macular edema due to idiopathic intermediate and posterior uveitis. Methods Retrospective, noncomparative, interventional case series. Thirty-three eyes were included with uveitic CME that was refractory to topical steroids, oral prednisone, or a combination thereof. Previous steroid treatment did not result in elevated intraocular pressure (IOP). The eyes received an intravitreal injection with 10 mg triamcinolone acetonide, after best-corrected visual acuity (BCVA) and fluorescein angiography (FA) were assessed. Ophthalmologic examination including FA was regularly performed during a 1-year follow-up period. Results Within 12 weeks after injection of IVTA, 50% of the eyes responded with an improvement in vision of more than two lines and 30% of the eyes reached an IOP of ≥21 mmHg (p<0.01). All eyes with an elevated IOP responded well on topical antiglaucoma medication. After 12 months follow-up 40% of the eyes responded with an improvement in vision of more than two lines and 28% of the affected eyes underwent phacoemulsification during the follow-up. No other complications occurred within a year after the treatment. Conclusions In macular edema due to idiopathic intermediate or posterior uveitis IVTA improves the visual acuity within the first 3 months. However, thereafter the visual acuity decreases again. Cataract and elevated IOP are common side effects.
Ophthalmologic Abnormalities in Long-Chain 3-Hydroxyacyl-Coa Dehydrogenase Deficiency: Presentation of a Long-Term Survivor
Authors: Sturm V. 
Published: January 2018

Purpose Long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency is one of the recently discovered defects of mitochondrial fatty acid beta-oxidation surprisingly associated with ophthalmologic abnormalities. The presentation of a long-term survivor may enlarge the clinical spectrum associated with this disorder. Methods A 12-year retrospective review of the clinical course of a 19-year-old long-term survivor was performed. The author concentrated on characteristic ophthalmologic measures: visual acuity, refraction, ophthalmoscopy, visual fields, and electroretinography Results The author found a milder course than described in the literature, although very few case reports of long-term survivors have been published. The patient developed slower circumscribed atrophy of the choroid, retinal pigment epithelium, and retina. Conclusions Because of therapeutic and prenatal diagnostic opportunities in LCHAD deficiency, it is important to recognize this severe disorder early in its course. This may lead to a milder course and better prognosis due to early dietary therapy.
Comparison of Daytime Efficacy and Safety of Dorzolamide/Timolol Maleate Fixed Combination versus Latanoprost
Authors: Mulaney J. , Sonty S. , Ahmad A. , Stewart J.A. , Stewart W.C. 
Published: January 2018

Purpose To compare the 12-hour efficacy and safety of dorzolamide/timolol fixed combination (DTFC) dosed twice daily versus latanoprost dosed every evening following a timolol run-in in primary open-angle glaucoma patients. Methods Following a 6-week timolol run-in patients were randomized to either DTFC or latanoprost for 6 weeks and then changed to the opposite treatment for 6 weeks. At the end of the run-in, and the end of each treatment period, the intraocular pressure (IOP) was measured every 2 hours between 8:00 AM and 8:00 PM. Results Thirty-one patients completed at least one time point in both treatment periods. Both treatments reduced the IOP for the diurnal curve, and at each time point, from the timolol run-in baseline (p<0.0001). The 12-hour IOP on timolol was 22.1±2.8 mmHg, whereas on DTFC it was 18.1±2.8 and latanoprost 18.3±3.1 mmHg (p=0.4). Further, there was no statistical difference in IOP between treatments at any time point (p≤0.1). There was no statistical difference for any individual adverse event between treatments (p>0.05). Conclusions This study suggests that following a timolol run-in both DTFC and latanoprost provide comparable daytime efficacy and safety.
Four Years Incidence of Diabetic Retinopathy and Effective Factors on its Progression in Type II Diabetes
Authors: Manaviat M.R. , Rashidi M. , Afkhami-Ardekani M. 
Published: January 2018

Purpose To study the 4 years incidence of diabetic retinopathy in patients with type II diabetes and effective factors on its progression. Methods Among diabetic patients referred to Yazd Diabetes Research Center, 120 patients with type II diabetes without diabetic retinopathy were selected. After complete ophthalmic examination, fasting blood sugar (FBS), postprandial blood sugar, triglyceride, and cholesterol were measured and height, weight, and blood pressure (BP) were recorded. Then patients were followed with eye examination yearly for 4 years. Results Four-year cumulative incidence of diabetic retinopathy was 47.5% (95% CI: 38.6–56.4). The retinopathy was mild nonproliferative diabetic retinopathy (NPDR) in 43 (35.8%) whereas 10 (8.3%) patients had moderate NPDR, 3 (2.5%) patients had severe NPDR, and only one patient had proliferative diabetic retinopathy. The incidence of diabetic retinopathy was 5.8% in first year, 20.3% in the second year, 24.4% in the third year, and 7.4% in the fourth year. Duration of diabetes, FBS, and systolic BP had statistically significant relation with grades of diabetic retinopathy. However, there was no significant association between age, sex, body mass index, triglyceride, cholesterol, method of treatment, smoking, and diastolic BP with grades of diabetic retinopathy. Conclusions These data provide 4-year cumulative incidence of diabetic retinopathy in defined type 2 diabetic patients. The present study shows that duration of diabetes, hyperglycemia, and systolic BP appear to be the major factors associated with the development of any level of retinopathy in type 2 diabetic patients.
Can Intravitreal Tissue Plasminogen Activator and SF6 Gas Facilitate Management of Macular Degeneration with Photodynamic Therapy?
Authors: Muqit M.M.K. , Ghanchi F.D. 
Published: January 2018

Purpose To describe the safety and efficacy of intravitreal tissue plasminogen activator (tPA) and sulfur hexafluoride (SF6) gas with sequential photodynamic therapy (PDT) in the management of submacular hemorrhage (SMH) associated with macular degeneration (MD). Methods Consecutive case series of five patients presenting with acute SMH from neovascular MD between May 2004 and January 2006 in a UK Eye Centre. Duration of visual loss was less than 7 weeks. Treatment involved intravitreal injections of tPA, SF6 gas to achieve pneumatic displacement of SMH, and 24 hours prone posturing. Displacement of SMH was assessed by digital photography, and choroidal neovascularization (CNV) was reclassified using angiography. PDT was applied when indicated within 1 to 12 days postoperatively. Results Adequate displacement of SMH allowed visualization of CNV within 24 hours in three of five patients. One patient with large SMH of 7 weeks duration had partial displacement of SMH. Three patients were reclassified with classic CNV after tPA-SF6 injection, and successfully underwent PDT. Conclusions Intravitreal tPA and SF6 assisted pneumatic displacement of SMH is a safe and effective intervention. This technique facilitates more accurate angiographic classification of CNV. PDT may be sequentially and rapidly applied as early as 1 day after injections. The technique may be offered to patients with neovascular MD presenting with acute SMH.
Orbital and Ocular Manifestations of Acute Childhood Leukemia: Clinical and Statistical Analysis of 180 Patients
Authors: Russo V. , Scott I.U. , Querques G. , Stella A. , Barone A. , Delle Noci N. 
Published: January 2018

Purpose To investigate the association between presence of orbital or ocular lesions and type and stage of leukemia and to investigate whether orbital and ocular lesions are significant in predicting leukemia prognosis. Methods The authors evaluated 180 patients with acute childhood leukemia. Lesions associated with leukemia may be classified as specific (due to leukemic infiltration of various ocular tissues), nonspecific (due to one of the secondary complications), or iatrogenic manifestations caused by chemotherapy. Risk-based treatment assignment is based on clinical and laboratory features at diagnosis. Children with presenting white blood cell count below 50,000 mm3 are considered at standard risk for treatment failure, while all others are considered at high risk for treatment failure. Results Specific lesions were noted in 66% of patients with acute myeloid leukemia (AML) and 11.5% patients with acute lymphocytic leukemia (ALL) (p±0.05), and were more severe in patients with high risk leukemia than in patients with standard risk leukemia. Orbital or ocular lesions were noted more commonly in patients with AML (66.6%) compared to patients with ALL (15.1%). In both the AML and ALL groups, there was a higher frequency of leukemic relapses in the bone marrow and/or central nervous system in patients with specific lesions (63.1%) compared to patients with nonspecific lesions (42%), and in patients without orbital or ocular lesions (29.2%) (p±0.05). Conclusions In both the AML and ALL groups, the presence of specific orbital or ocular lesions was associated with a higher frequency of bone marrow relapses and CNS involvement (p±0.05), leading to a lower survival rate.
Ocular Manifestations in a Case of Childhood Cicatricial Pemphigoid
Authors: Iovine A. , Fimiani F , Vassallo P. , Alessio M. , Magli A. 
Published: January 2018

Purpose Cicatricial pemphigoid is a rare chronic autoimmune disease, characterized by progressive alterations on the skin and mucous membranes. Ocular lesions consists of chronic conjunctivitis, progressive subepithelial fibrosis on the conjunctival fornix together with symblepharon formation, obstruction of the Meibomian ducts, sicca syndrome, and occasionally, entropion associated with consequent trichiasis and corneal ulcers. Methods A 9-year-old patient with cicatricial pemphigoid with severe eye involvement came to our observation. A complete anamnesis, ophthalmologic examination, and systemic evaluation, including serum antibody levels evaluation and biopsies of mouth, vulva, parotid, and intestine mucosa, were performed. Results Ocular examination showed blepharospasm, conjunctival hyperemia, symblepharon, total cicatricial corneal leucoma, severe dryness, trichiasis, and eyelid edema. The results of medical and surgical treatment are reported. Conclusions Given the serious clinical picture, possibly due to a late diagnosis, it was not possible to avoid relapse and appearance of new cicatricial adherences for which we considered wait and see the most appropriate approach, protecting the anterior segment of both eyes, sacrificing their function. Further follow-up was not possible as the patient died. An early diagnosis would have had a significant influence on the clinical course and on the response to therapy.
Burn during a Routine Pterygium Excision Operation
Authors: Naftali M. , Jabaly-Habib H. , Mukari A. 
Published: January 2018

Purpose To report a patient who sustained a spark fire burn during a routine pterygium operation. Methods A 40-year-old woman was referred for pterygium excision in her left eye. During the operation a low temperature cautery caused a spark fire that resulted in left eye corneal burn, upper and lower eyelid burns, and melting of eyelashes and eyebrows bilaterally. Results Topical antibiotics and vitamin C followed by topical corticosteroids were given. After 1 week the corneal epithelium healed but a paracentral corneal opacity developed. Two months later on last follow-up visit, a mild diffuse corneal opacity was still seen. The combination of three elements found in most routine (ophthalmologic) surgical fields-an enriched oxygen environment with the high temperature transmitted by the electrocautery in the vicinity of hair-might explain the event. Conclusions Surgeons should try to separate these three elements or eliminate any of them, in order to minimize or prevent such events.