bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral Central Anterior Stromal Opacity of the Cornea: Dystrophy or Degeneration?
Authors: Toker E. , Bavbek T. 
Published: January 2018

Purpose To describe a bilateral, central, oval corneal opacity not resembling any known corneal degeneration or dystrophy. Methods Ophthalmic examination, corneal topography, and pachymetry. Results A 30-year-old woman presented complaining of blurred vision. Biomicroscopic examination revealed bilateral, centrally located, oval, diffuse opacification of the anterior corneal stroma. Corneal topography showed slightly paracentral corneal flattening and irregular astigmatism in both eyes. Pachymetry indicated thinning of the central cornea in the left eye. No evidence of systemic disease was found. Family members had no corneal abnormalities. Conclusions This unusual keratopathy closely resembles climatic proteoglycan stromal keratopathy. However, it is not clear whether the condition should be described as a dystrophy or degeneration.
Effects of Ibopamine Eye Drops on Intraocular Pressure and Aqueous Humor Flow in Healthy Volunteers and Patients with Open-Angle Glaucoma
Authors: Azevedo H. , Ciarniello M.G. , Rosignoli M.T. , Dionisio P. , Cunha-Vaz J. 
Published: January 2018

Purpose On the basis of intraocular pressure measurements and fluorophotometry we assessed the effects of 2% ibopamine eye drops on aqueous humor production in normal and glaucomatous eyes. Methods Thirty subjects (15 healthy volunteers and 15 open-angle glaucoma patients with ocular hypertension) were included in a placebo-controlled study with random assignment of treatment from masked containers. All subjects underwent ophthalmologic examinations and intraocular pressure (IOP) measurements. Fluorophotometry was done in both eyes at baseline (without treatment) and during treatment. Each subject was treated with 1 drop of 2% ibopamine in one eye and 1 drop of placebo in the fellow eye 30 minutes before fluorophotometric scans and every hour after the first instillation (for a total of 4 times). Safety was evaluated by recording adverse events and ocular symptoms and signs. Aqueous humor flow data were analyzed using the paired t-test, comparing ibopamine and placebo-treated eyes. Results No changes in IOP were detected in normal eyes, whereas glaucomatous eyes showed a mean increase of 4 mmHg (95% CI 3.46–4.51) from baseline. The difference in IOP between healthy eyes and those with glaucoma was significant (p<0.0001). In normal eyes and patients with glaucoma ibopamine led to a significant increase in aqueous humor flow compared with placebo-treated eyes (p<0.01). The safety profile of ibopamine was very good. Conclusions The results seem to confirm that ibopamine increases aqueous humor production in normal and glaucomatous eyes, raising IOP only in eyes with glaucoma.
Giant Cell Arteritis Mimicking Idiopathic Orbital Inflammatory Disease
Authors: Islam N. , Asaria R. , Plant G.T. , Hykin P.C. 
Published: January 2018

Purpose To report an unusual presentation of giant cell arteritis, referred from primary care, mimicking orbital apex syndrome. Case Report A 72 year old woman was referred with a two week history of pyrexia, dull right eye ache, 2mm of right proptosis, mild conjunctival chemosis and restriction of right eye movements. Results An erythrocyte sedimentation rate (ESR) was 90 and fluorescein angiography showed almost complete choroidal non-perfusion suggestive of giant cell arteritis. Temporal artery biopsy confirmed the diagnosis. Conclusions Giant cell arteritis (GCA) typically presents with anterior ischemic optic neuropathy (AION), choroidal ischemia, central retinal artery occlusion, infrequently manifesting as an ocular motility problem, but has rarely been known to mimick idiopathic orbital inflammatory disease. Prompt recognition and therapy can minimize the chance of ipsilateral ocular involvement and protect the fellow eye.
Unilateral Purtscher-Like Retinopathy after Weight-Lifting
Authors: Kocak N. , Kaynak S. , Kaynak T. , Oner H.F. , Cingil G. 
Published: January 2018

Purpose To report a case of Purtscher-like retinopathy after weightlifting. Methods A 17-year-old man presented with a sudden visual loss in his left eye after weightlifting two weeks ago. Fundus examination of the left eye showed cotton-wool spots and scattered retinal hemorrhages in the posterior pole. Fluorescein angiography and indocyanine green angiography with a scanning laser ophthalmoscope were performed. Results Angiography showed hypofluorescent areas adjacent to the optic disc and in the posterior pole and partial filling insufficiency in the inferior and inferotemporal branch retinal veins. Complete venous filling was noted in late phases of angiography. Conclusions The pathogenesis of weightlifting suggests the Purtscher-like changes as a result of Valsalva maneuver in our case. To our knowledge, this is the first reported case of Purtscher-like retinipathy associated with weightlifting.
Visual Performance after Congenital Nystagmus Surgery Using Extended Hang Back Recession of the Four Horizontal Rectus Muscles
Authors: Alió J.L. , Chipont E. , Mulet E. , De La Hoz F. 
Published: January 2018

Purpose To evaluate the results of surgical correction of congenital nystagmus based on the use of extensive recessions of the four horizontal rectus muscles. The outcome of this procedure in terms of visual performance of the patients has been analyzed in follow-ups of at least 1 year. Methods Surgery was performed on 42 patients. An extended retroequatorial recession of the four horizontal rectus muscles was performed between 13 and 15 mm from the muscle insertion with hang back sutures in every case. Preoperatively, all cases showed either a horizontal pendular (4 cases) or jerk nystagmus (38 cases). Results After surgery, all cases showed full preservation of ductions in all gaze positions. Torticollis decreased in all cases. Binocular best-corrected vision improved in 19 (45.2%) patients and in the remaining 23 (54.8%) it remained unchanged. Consecutive exotropia was observed postoperatively in 7 patients. A second surgical procedure was performed in 9 cases (21.4%) and a botulinum injection in 3 cases (7%). All cases of diplopia resolved. Patient satisfaction was high in 38 cases (96%). Conclusions Extended recession of horizontal rectus muscles using hang back sutures offers a good option for the surgical correction of sensorial and neuromuscular nystagmus, providing improvement in binocular best-corrected vision in 45% of the patients (21.4% more than 0.2 logMar units), a high satisfaction rate, and few associated complications. In patients with low vision this can be considered a success that may improve quality of life.
Ablation of Vitreous Tissue with a High Repetition Rate Erbium: YAG Laser
Authors: Krause M.H.J. , D'Amico D.J. 
Published: January 2018

Purpose To quantify erbium (Er):YAG laser ablation of vitreous in relation to different pulse repetition rates ≤ 200 Hz, in order to examine the feasibility of laser for removal of vitreous gel (photovitrectomy) in clinically acceptable times. Methods Fresh porcine vitreous samples and saline controls were ablated in air with an Er:YAG laser connected to a sapphire fiber at pulse energies between 1.0 and 21.2 mJ and at pulse repetition rates between 10 and 200 Hz. Net ablation rates were determined by weight measurement. Results Reproducible and constant ablation rates were found for given laser parameters. Net ablation rates increased linearly with pulse repetition rate and nonlinearly with pulse energy. Expanded laser parameter domains permitted vitreous ablation rates as low as 1 μg/s to as high as 1031 μg/s. Ablation rates did not differ significantly between vitreous and saline. Conclusions The study documents clinically useful vitreous ablation rates that scale linearly with high repetition rates of Er:YAG laser, and suggests directions for further development of laser technology for enhanced removal of vitreous and other tissues. However, nonlinear effects of pulse energy also exist, indicating need for careful examination of ablation characteristics in various instruments.
A Preliminary Assessment of Macular Function by MF-ERG in Myopic Eyes with CNV with Complete Response to Photodynamic Therapy
Authors: Moschos M.N. , Panayotidis D. , Moschos M.M. , Bouros Chr. , Theodossiadis P.G. , Theodossiadis G.P. 
Published: January 2018

Purpose To evaluate by multifocal electroretinogram (MF-ERG) macular function before and after photodynamic therapy (PDT) in myopic eyes with choroidal neovascularization (CNV). Patients and Methods Ten eyes with classic subfoveal CNV due to pathologic myopia were studied with MF-ERG before and after PDT in order to evaluate the results of PDT with verteporfin. The post-treatment follow-up was 6 months. Visual acuity testing, ophthalmic examinations, fluorescein and indocyanine green angiograms, and MF-ERG recordings were used to evaluate the results of PDT with verteporfin. The post-treatment period was 6 months. Results Before treatment, the electrical response densities in the foveal and perifoveal areas were apparently decreased in all patients. Six months after treatment, the mean retinal response densities in the same areas were found to be higher than before treatment. Conclusions MF-ERG evaluates objectively the macular function in myopic eyes with CNV. After successful PDT, the electrical activity of the foveal and parafoveal areas is higher than before treatment. This finding postulates the efficacy of PDT in the treatment of CNV.
Ex Vivo Expansion of Corneal Limbal Epithelial/Stem Cells for Corneal Surface Reconstruction
Authors: Ramaesh K. , Dhillon B. 
Published: January 2018

Purpose The management of severe ocular surface disease due to limbal stem cell deficiency has changed dramatically. The concept of limbal stem cells, as the source of corneal epithelium revolutionised the therapeutic approach of ocular surface reconstruction. Deficiency of limbal stem cells results in blinding ocular surface diseases. Grafting viable limbal tissue, from either fellow healthy eye or a donor eye, with the resident stem cell population may replenish limbal stem cells and can restore the corneal surface to normality. Transplanting the limbal tissue can be achieved through a variety of procedures that include cadaveric keratolimbal allograft (KLAL), live or living related conjunctival limbal allograft (lr-CLAL) and limbal autograft. Advances in tissue engineering techniques have offered a viable alternative to overcome the limitation of limbal tissue available for transplantation. Epithelial stem cells harvested from a small limbal biopsy can be expanded in vitro on a suitable carrier and then transplanted to the diseased cornea to successfully restore the corneal surface. This article is a chronological review of the important steps that brought ex vivo expanded stem cell transplantation in ocular, particularly corneal surface reconstruction. Methods The MEDLINE data base was searched for the years 1966–2002, using key words cornea, cell culture, ex-vivo expansion, limbus, stem cell, ocular surface and transplantation. Several articles that were not found by MEDLINE search were taken from references from other articles. Inclusion or exclusion of article was based on the relevance to the subject. Conclusions Corneal epithelial reconstruction with ex vivo expanded limbal cells is a potential tool in ocular surface reconstruction, although the technique is currently investigational. Strategies to achieve conjunctival epithelial restoration and tear film replenishment will allow ophthalmic surgeons to truly reconstruct the ocular surface.
Changes in Tear Protein Pattern after Photorefractive Keratectomy
Authors: Füst Á. , Veres A. , Kiszel P. , Nagy Z.Z. , Cervenak L. , Csákány B. , Maka E. , Süveges I. , Grus F.H. 
Published: January 2018

Purpose Changes in tear protein composition of patients who underwent photorefractive keratectomy (PRK) were analyzed. Methods Tear samples were obtained from 23 eyes of 23 patients immediately before PRK and on the fourth postoperative day with glass capillaries. Tear proteins were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Digital image analysis and evaluation of the densitometric data of the electrophoretic separations were done with BioDoc-Analyze. Results Analysis of discriminance found a significant difference in the protein patterns (p<0.001). This type of analysis of the electrophoretic densitographs uses all peak information simultaneously. A significant decrease (p<0.005) in three of the main protein peaks – lactoferrin, immunoglobulin A heavy chain, and lysozyme – was also found after PRK. Conclusions Excimer laser ablation of the cornea has an acute effect on lacrimal gland protein secretion. Changes in tear composition may lead to feelings of dryness and to a decrease in tear film stability postoperatively.
Peak Pressures: Crossover Study of Timolol and Latanoprost
Authors: Sihota R. , Saxena R. , Agarwal H.C. , Pandey R.M. , Gulati V. 
Published: January 2018

Purpose To compare the diurnal efficacy and action on peak intraocular pressures (IOP) of 0.005% latanoprost and 0.5% timolol as primary therapy in 60 eyes having dark brown irides with primary open angle glaucoma (POAG). Methods A prospective, comparative, observer-masked, crossover, interventional trial including the mean of both eyes of 30 patients with POAG who were randomly started on either latanoprost once daily or timolol twice daily. Three months after treatment with one drug, the second drug was substituted. A masked observer carried out diurnal assessments of IOP before the start of therapy and at 3 and 7 months. The fourth month was the washout period for the first drug. Results The average baseline IOP was 23.36 ± 2.14 mm Hg, which was reduced by 8.8 ± 2.2 mmHg with latanoprost (p<0.01) and by 6.75 ± 1.9 mm Hg with timolol (p=0.01). The reduction was greater for latanoprost (p<0.005). The average peak IOP at baseline was 27.6 ± 2.22 mmHg. The effective fall in IOP at the time of new peaks in subsequent diurnal recordings of IOP compared to the baseline diurnal curve was 8.9 mm Hg with latanoprost (p<0.005) and 5.77 mm Hg with timolol (p<0.01). This difference in IOP reduction between the two drugs was statistically significant (p<0.01). Latanoprost had a lower efficacy in peak IOP reduction in eyes with evening peak of IOP than in those with morning peak (p<0.005). The efficacy of timolol was lower overall compared to latanoprost, but was similar in all circadian rhythms. The shift in timing of IOP peak was greater with latanoprost compared to timolol (4.34 hours vs –0.72 hours, p<0.01). A total of 90% of patients on latanoprost and 33.3% on timolol achieved a reduction of >30% in baseline mean IOP. The average of the trough IOP recorded in each of the individual baseline IOP curves was 19.05 ± 2.05 mm Hg. Conclusions Greater mean and peak IOP reduction was achieved with latanoprost compared to timolol. Dampening of the circadian rhythm was better with latanoprost. Latanoprost appears to be more effective than timolol at all points in time with greater efficacy in eyes with morning peaks compared to evening peaks.
Positive Tensilon Test and Intracranial Tumor: A Case Report
Authors: Gupta M. , Davis H. , Rennie I.G 
Published: January 2018

Purpose To report a case of intracranial tumor in a patient with positive tensilon test. Methods Interventional case report. A 19-year-old male presented with left 6th nerve palsy and had a tensilon test, which was highly positive and was diagnosed as having myasthenia gravis. Results The neurologist scanned the patient, which showed an intracranial tumor in the floor of the temporal fossa on the left side. The patient had surgery and a schwannoma was removed. The VIth nerve palsy did not improve upto two years after surgery. Conclusions A patient with a positive tensilon test can also have an associated intracranial tumor.
Secondary Intraocular Lens (IOL) Implantation: Anterior Chamber versus Scleral Fixation Long-Term Comparative Evaluation
Authors: Dadeya S. , Kumari Sodhi Kamlesh, P. 
Published: January 2018

Purpose To compare the long-term efficacy of a secondarily implanted flexible angle supported anterior chamber (AC) intraocular lens (IOL) with sclerally fixated IOL as a secondary procedure in patients with aphakia. Methods Sixty patients with aphakia were recruited for this study. The patients were randomly divided into two groups: Group I patients underwent secondary implantation with AC IOL (Kelman Z type multiflex Domi classic AC IOL) and Group II patients underwent secondary implantation with scleral fixated IOL (Hanita lens with two eyelets). Postoperatively, the patients were followed up at 1 week, monthly for 6 months, and at twice yearly intervals for 5 years (mean follow-up was 3 years). Results Best-corrected visual acuity of 6/18 or better was achieved in 36.6% (11/30) of patients in Group I and 30% (9/30) of patients in Group II after a mean follow-up of 3 years. The complication rate was higher in Group II as compared to Group I. The authors encountered a total of 23 complications in the sclerally fixated group and 11 in the AC IOL group (p=0.004). Uveitis and ciliary tenderness were the most common complications in Groups I and II, respectively. Conclusions For secondary implantation of IOL in aphakic patients, Kelman Z type multiflex Domi classic AC IOL is a better rehabilitation modality as compared to the scleral fixated Hanita IOL.
Aprotinin Reduces Ischemia-Reperfusion Injury in the Retina of Guinea Pigs
Authors: Yilmaz T. , Kükner A.Ş. , Aydemir O. , Ozercan H.I. , Naziroğlu M. 
Published: January 2018

Purpose The aim of this study was investigate the role of aprotinin on retinal lipid peroxidation and histopathological changes during ischemia/reperfusion (I/R) of guinea pigs. Methods Three groups of seven pigmented guinea pigs each were formed: a control (group 1), ischemia/saline (group 2) and ischemia/aprotinin (group 3). One eye of each animal was selected for histopathological evaluation and the other for biochemical assay. Bilateral pressure-induced retinal ischemia was instigated for 90 min and was followed by 24 hours of reperfusion. Animals in the ischemia/aprotinin and ischemia/saline groups received either 20,000 KIU/kg of aprotinin or saline, repeated four times at 6-hour intervals, with the first dose administered 5 min prior to the ischemic insult. The animals were killed at 24 hours of reperfusion. Retinal malondialdehyde (MDA) levels and the thickness of the inner plexiform layers were measured. Results The level of MDA in group 1 was significantly (p<0.001) lower than the other groups. The mean MDA level in group 2 was significantly (p<0.01) higher than in group 3. The inner plexiform layer in group 1 was significantly (p<0.001) thinner than in the other groups. The mean thickness of the inner plexiform layer in group 2 was significantly (p<0.01) higher than in group 3. Conclusions These data indicate that intraperitoneally administrated aprotinin has a protective effect against I/R injury in the retina of guinea pig as evidenced by reduced retinal MDA level and retinal thickness.
Assessment of Retinal Nerve Fiber Layer Thickness with NFA-GDx following Successful Scleral Buckling Surgery
Authors: Ozdek S. , Lonneville Y. , Onol M. , Gurelik G. , Hasanreisoglu B. 
Published: January 2018

Objective To assess the effect of retinal detachment (RD) on retinal nerve fiber layer (RNFL) thickness by using a scanning laser polarimeter (NFA-GDx) after successful scleral buckling surgery for the treatment of rhegmatogenous RD. Methods Consecutive patients who had successful scleral buckling surgery in one eye were assessed for RNFL thickness by using NFA-GDx prospectively. Fellow healthy eyes of the patients formed the control group. Eyes with RD surgery were compared with the control group with respect to three variables (superior average, inferior average, and average thickness) of NFA-GDx by using two-sampled t-test. Additionally, a possible effect of duration of RD on RNFL thickness was assessed with a correlation test. Results The study group consisted of 16 patients with a mean age of 49.8 years. The mean duration of RD was 28 days. Although the retardation values in operated eyes were less than that of the control eyes, the difference was not statistically significant (p>0.05). However, these three values were seen to increase with increased duration of detachment and this correlation was statistically significant (R>0.5, p<0.03). Conclusion RD seemed to cause minimal or no change in RNFL thickness as determined by GDx variables. The positive correlation between RNFL thickness and duration of RD, however, may be because of the proliferated Müller cells in eyes with RD, which may be responsible for some of the retardation measurements, which may be even more prominent in longstanding RD cases. This needs to be supported by further studies in larger patient groups with longer duration of RD and with histopathologic studies.
Lacquer Crack Formation after Photodynamic Therapy
Authors: Ladas I.D. , Moschos M.M. , Rouvas A.A. , Karagiannis D.A. , Kokolakis S.N. 
Published: January 2018

Purpose To report the occurrence of a lacquer crack after photodynamic therapy (PDT) of choroidal neovascularization (CNV) in a patient with pathologic myopia. Design Interventional case report. Methods PDT was performed with verteporfin, which was activated by a diode laser light at 690 nm. Results The left eye of a 42-year-old woman was treated with PDT because of juxtafoveal CNV caused by pathologic myopia. No lacquer crack was present in the macula on either fluorescein or indocyanine green angiography before treatment. The CNV subsided after treatment. However, a large lacquer crack underlying a subretinal hemorrhage was formatted in the macula of the treated eye soon after PDT. Conclusions Although the chorioretinal damage produced by PDT is minimal, it is enough to create, directly or indirectly, the basis for the formation of a lacquer crack in an eye with pathologic myopia.