bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal Graft Rejection after Penetrating Keratoplasty for Keratoconus in Turner's Syndrome
Authors: Pinna A. , Salvo M. , Dore S. , Carta F. 
Published: January 2018

Purpose To report a patient with Turner's syndrome who developed graft rejection after penetrating keratoplasty (PK) for keratoconus and to review the ophthalmic literature on the association between keratoconus and Turner's syndrome. Methods A woman with bilateral keratoconus and Turner's syndrome (45,XO) was referred for progressive visual loss in the right eye. Best-corrected visual acuity was 20/400 in the right eye. Slit-lamp examination revealed corneal thinning with ectatic protrusion of the central cornea and Vogt's striae in the right eye. The patient underwent PK in the right eye in January 2001. She developed graft rejection in April 2003 and visual acuity dropped to hand motion. After treatment with topical and systemic steroids and systemic cyclosporine A, visual acuity recovered to 20/80 in July 2003. Results The authors know of only three other reported patients (six eyes) with keratoconus in Turner's syndrome. Five eyes underwent PK with good visual rehabilitation, but one developed immunologic graft rejection 7 years after surgery. On the whole, considering the current report and the other cases described in the literature, graft rejection occurred in 2 out of 6 eyes (33.3%). The graft survival rate was 80% after 2 years and 40% after 7 years. Conclusions The results suggest that grafts for keratoconus in patients with Turner's syndrome might have an increased risk of immunologic rejection. Corneal grafts in Turner's syndrome need to be monitored closely. Early detection of graft rejection and aggressive treatment with topical and systemic steroids and systemic cyclosporine A can save the graft and restore useful vision.
The Clinicopathologic Basis of Graves' Ophthalmopathy: A Review
Authors: Kloprogge S. , Kowal L. , Wall J. , Frauman A.G. 
Published: January 2018

Purpose Graves' ophthalmopathy (GO) is a controversial disease, with disagreement within the medical community regarding its pathogenesis, diagnosis, and treatment. Methods We reviewed recent literature on clinical and pathological aspects of GO from both the endocrinologist's and ophthalmologist's perspective. Results Investigations into the pathogenesis of GO have included possible antigenic targets, orbital cell types, and development of animal models. Diagnosis has been improved recently with new tools and grading systems, but can be complicated by conditions that may simulate one or more of the findings of GO. The new findings of clinical studies also compel practitioners to reassess commonly used GO treatments such as orbital irradiation. Conclusions Improved understanding of the pathogenic mechanisms of GO should hopefully lead to new diagnostic and therapeutic approaches to this problematic condition.
Discrimination between Normal and Glaucomatous Eyes with Scanning Laser Polarimetry and Optic Disc Topography: A Preliminary Report
Authors: Magacho L. , Marcondes A.M. , Costa V.P. 
Published: January 2018

Purpose To test the ability of structural parameters (as measured by scanning laser polarimetry (SLP) software 1.0.12 and confocal scanning laser ophthalmoscopy (CSLO) to discriminate between normal and glaucomatous eyes. Methods A total of 112 patients with primary open-angle glaucoma and 88 normal individuals were enrolled in the study. All individuals underwent a thorough ophthalmic evaluation, a 24–2 full threshold Humphrey visual field, SLP with the GDx, and CSLO with the TOPSS. Patients with marked cataract or low vision were excluded from the study. Cut-off points were selected and receiver operator characteristic (ROC) curves were created for each individual CSLO and SLP parameter. Finally, multivariate discriminant formulas were developed in order to achieve a better sensitivity (Se)/specificity (Sp) ratio for the diagnosis of glaucoma, initially separately for each device, and then combining parameters from CSLO and SLP. Results The mean deviation for the glaucoma group was −10.63 ±7.58 dB. Multivariate discriminant formulas resulted in better sensitivity/specificity ratios than any individual parameter, either for CSLO (Se: 90%; Sp: 81%; accuracy: 86%) or SLP (Se: 87%; Sp: 86%; accuracy: 86%). The multivariate formula combining parameters from both devices resulted in an improvement in the ability to diagnose glaucoma. An area under the ROC curve of 0.97 was obtained, with a sensitivity of 93%, a specificity of 91 %, and an accuracy of 92%. Conclusions The combination of structural parameters derived from CSLO and SLP in a multivariate discriminant formula may enhance the ability to diagnose glaucoma. Further studies investigating a random population are needed in order to test the validity of this formula.
Response Time and Safety Profile of Pulsed Oral Methotrexate Therapy in Idiopathic Retinal Periphlebitis
Authors: Bali T. , Saxena S. , Kumar D. , Nath R. 
Published: January 2018

Purpose To evaluate the response time and safety profile of low-dose oral methotrexate pulsed therapy in idiopathic retinal periphlebitis (Eales' disease). Methods A tertiary care center-based prospective interventional study, based on visual acuity grading, was undertaken. Twenty-one consecutive patients with idiopathic retinal periphlebitis were administered 12.5 mg methotrexate as a single oral dose, once per week for 12 weeks (cumulative dose = 150 mg). Each patient was assessed for change in visual acuity grades. Time of first therapeutic response was also noted. Drug safety was monitored by laboratory tests that included twice-weekly white blood cells and differential counts, twice-weekly platelet counts, and monthly liver function tests. Results Twenty-one eyes were assessed. Mean follow-up period was 6 months. All showed improvement in visual acuity grades. An excel lent visual outcome (6/6 or better) was achieved in 18 (69%) eyes. Time of first therapeutic response varied from 2 to 6 weeks with a majority of eyes (80%) showing response by 4 weeks (median = 3 weeks). All the side effects of methotrexate were mild or moderate in severity and rapidly reversible on dose reduction or discontinuation. No patient had any constitutional symptoms severe enough to necessitate cessation of therapy. Conclusions Low dose oral methotrexate pulse therapy (at a dose of 12.5 mg/week) is clinically effective within 4 weeks, and is associated with an acceptable safety profile.
Visual Phenotype of Multiple Sclerosis in the Afro-Caribbean Population and the Influence of Migration to Metropolitan France
Authors: Merle H. , Smadja D. , Merle S. , Olindo S. , Signate A. , Donnio A. , Richer R. , Bonnan M. , Cabre P. 
Published: January 2018

Purpose To describe the visual phenotype of multiple sclerosis (MS) in the Afro-Caribbean population living in Martinique (French West Indies) and to specify the influence of the migration to metropolitan France on ocular impairment. Design Prospective consecutive observational case series. Methods A complete ophthalmologic examination was performed. Participants. A total of 112 patients of Afro-Caribbean origin with MS satisfying McDonald's diagnostic criteria, divided into 53 cases (47.3%), the non-migrant patients (group NM), who had never left the Caribbean basin, and 59 cases (52.7%), the migrant patients (group M), who had lived in metropolitan France for at least 1 year before age 15. Results MS first manifested as an impairment of the optic nerve in 41 cases (36.6%): 25 cases (47.1%) in group NM and 16 cases (27.1%) in group M. Visual function was recovered in 13/25 cases (52%) in group NM compared to 13/16 cases (81%) in group M. Two-thirds of patients presented with a clinical ocular impairment, which was bilateral in 58.5% of cases in group NM. Fourteen cases (12.5%) met the criteria of neuromyelitis optica, nine cases (17%) in group NM and five cases (8.5%) in group M. In group NM, when the initial visual attack did not regress, the visual Expanded Disability Status Scale (EDSS) score was 5±1.5; 75% of patients had monocular blindness and 50% binocular. Conclusions In the non-migrants (group NM), MS manifested more frequently with an optical neuropathy, the ocular impairment was more severe, and corresponded to neuromyelitis optica in 17% of the cases; a visual presentation and the absence of complete recovery from the first attack represented a factor of poor prognosis. This series is the largest description of the visual phenotype of MS in patients of African origin. The results confirm the preferential impairment of the optic nerve in the black population in the course of the disease. The migration towards an area of high prevalence of MS influences the visual phenotype in terms of a lower incidence and less severe prognosis of ocular impairment.
Spontaneous Fracture of an Implanted Posterior Chamber Intraocular Lens
Authors: Çaça I. , Ünlü K. , Ari S. , Aksit I. 
Published: January 2018

Purpose Spontaneous fracture of an intraocular lens (IOL) haptic is a rare complication of cataract surgery. The authors report a case of spontaneous fracture of an implanted posterior chamber IOL. Case Five years ago, a 12-year-old patient underwent linear lens extraction, posterior capsulotomy, and anterior vitrectomy due to traumatic cataract and received a polymethyl methacrylate (PMMA) biconvex posterior chamber IOL implanted in ciliary sulcus. Five years later, IOL optic was found in anterior chamber with its haptics broken from the optic-haptic junction. Discussion The broken haptic was examined with scanning electron microscopy. The fracture site of the haptic was on the optic-haptic junction. The fractured surface had a regular appearance. Conclusions To our knowledge, this is the fourth report of spontaneous fracture of an implanted posterior chamber IOL.
Immune Recovery Uveitis and Human Leukocyte Antigen Typing: A Report on Four Patients
Authors: Modorati G. , Miserocchi E. , Brancato R. 
Published: January 2018

Purpose To report the typing of human leukocyte antigen (HLA) in four human immunodeficiency virus-positive (HIV) patients with immune recovery uveitis (IRU). Methods The medical history of four consecutive patients who presented at the Ocular Immunology and Uveitis Service (University Hospital San Raffaele, Milan, Italy) with definite diagnosis of IRU is reported. The HLA typing was tested in all patients. Results All patients presented the clinical and ophthalmological characteristics of IRU. The HLA typing analysis showed the presence of HLA B 8–18 in all patients. Conclusions The data obtained from these patients indicate the presence of the same HLA typing (B 8–18). The clinical relevance of such association needs to be further evaluated.
Long-Term Clinical Results of Selective Laser Trabeculoplasty in the Treatment of Primary Open Angle Glaucoma
Authors: Weinand F.S. , Althen F. 
Published: January 2018

Purpose To investigate the long-term efficacy of selective laser trabeculoplasty (SLT) in primary open-angle glaucoma, the authors performed a non-randomized, prospective, non-comparative clinical case series. Methods Fifty-two eyes of 52 patients (19 male, 33 female) with primary open angle glaucoma were treated with SLT. Patients were treated with the Coherent Selecta 7000 (Coherent, Palo Alto, CA, USA) frequency-doubled q-switched Nd:YAG laser (532 nm). A total of approximately 50 non-overlapping spots were placed over 180° of the trabecular meshwork at energy levels ranging from 0.6 to 1.4 mJ per pulse. After surgery, patients were maintained with the drug regimen identical to that before treatment. Results After 1 year the average reduction in intraocular pressure (IOP) from the baseline was 24.3% (6.0 mmHg), after 2 years 27.8% (6.12 mmHg), after 3 years 24.5% (5.53 mmHg), and after 4 years 29.3% (6.33 mmHg). A Kaplan-Meier survival analysis revealed a 1-year success rate of 60%, a 2-year success rate of 53%, a 3-year success rate of 44%, and a 4-year success rate of 44%. Conclusions Despite a declining success rate, SLT is an effective method to lower IOP over an extended period of time.
Hereditary Hyperferritinemia Cataract Syndrome: Ocular, Genetic, and Biochemical Findings
Authors: Ismail A.R. , Lachlan K.L. , Mumford A.D. , Temple I.K. , Hodgkins P.R. 
Published: January 2018

Purpose To describe the cataract morphology and genetic and biochemical findings in a four-generation family with hereditary hyperferritinemia cataract syndrome (HHCS). Methods Family members of the proband with HHCS were investigated. DNA sequencing was carried out to identify the iron responsive element (IRE) of the L-ferritin gene in affected and non-affected family members. Molecular modeling allowed prediction of the structure of the mutant IRE in affected cases. Serum ferritin and transferrin saturation were determined using standard methods. All family members underwent slit lamp examination by an ophthalmologist to document presence of cataract or lens status. Cataract morphology was documented where present. Results This family with HHCS had the genetic heterozygous mutation G32C in the IRE of the L-ferritin mRNA. Lens opacities were detectable in young members of the family, and morphology of cataracts was consistent with previous reports. Biochemical testing demonstrated high serum ferritin levels in affected individuals. Conclusions The morphology of cataracts in HHCS seems to be similar in all cases. In the heterozygous G32C mutation, the age at onset of cataracts is very early. Greater awaeness of this condition among ophthalmologists will lead to effective family counseling of those affected, by genetic testing or simple biochemical tests. Serum ferritin levels can be effectively used to screen for this condition in suspected families.
Sympathetic Ophthalmia in VATER Association Combined with Persisting Hyperplastic Primary Vitreous after Cyclodestructive Procedure
Authors: Jonas J.B. , Back W. , Sauder G. , Jünemann U. , Harder B. , Spandau U.H. 
Published: January 2018

Purpose To report on the occurrence of histology-proven sympathetic ophthalmia in a patient with VATER association and persisting hyperplastic primary vitreous (PHPV) after a cyclodestructive procedure was performed to treat secondary angle-closure glaucoma. Methods The left eye of a 13-year-old boy with VATER association was microphthalmic from birth and had been diagnosed with PHPV at age 1 year. It developed iris neovascularization and secondary angle-closure glaucoma, which was treated by combined cyclocryocoagulation and cyclophotocoagulation. Six weeks later, a bilateral fibrinous iritis developed. Despite intensive topical and systemic steroid treatment, the iritis persisted so that the left blind eye was enucleated. Results Histology of the enucleated eye showed a marked intraocular inflammation with lymphocytes, epithelioid cells, and multinuclear giant cells grouped around remnants of melanin-bearing cells. Conclusions Sympathetic ophthalmia may occur in patients with VATER association and PHPV after a secondary angle-closure glaucoma is treated by a combined cyclocryocoagulation and cyclophotocoagulation.
Burkitt's Lymphoma Presenting as Oculomotor Palsy in an HIV-Positive Patient
Authors: Levy J. , Kratz A. , Lifshitz T. 
Published: January 2018

Purpose To report a case of Burkitt's lymphoma (BL) in an HIV-positive patient presenting as complete third nerve palsy. Methods Interventional case report. A 34-year-old man presented with headache, left eye pain, diplopia, and complete ptosis of several hours’ duration. Left eye examination disclosed complete third nerve palsy with pupillary involvement. Significant hepatomegalia was noted at physical examination and computed tomography (CT) scan of the abdomen showed multiple solid lesions. Results Liver biopsy was consistent with Burkitt's lymphoma. Bone marrow biopsy was normal. Brain imaging was normal. Work-up also revealed positivity for human immunodeficiency virus. Chemotherapy treatment was started. Two months later, ocular motility examination was normal. Conclusions Although BL affects the central nervous system very rarely, BL should be considered in any immunosuppressed patient presenting with diplopia or ophthalmoparesis.
Mikulicz's Disease: A New Perspective and Literature Review
Authors: Lee S. , Tsirbas A. , Mccann J.D. , Goldberg R.A. 
Published: January 2018

Purpose To report the clinical and pathophysiologic features of two patients with Mikulicz's disease and to further characterize recommendations for diagnosis and management with a review of the literature. Methods Retrospective nonrandomized consecutive case series, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA. Results Mikulicz's disease is characterized by symmetric lacrimal, parotid, and submandibular gland enlargement with associated lymphocytic infiltrations. The authors noted two cases of Mikulicz's disease. The diagnosis of Mikulicz's disease was based on the following criteria: 1) symmetric and persistent swelling of the lacrimal glands and either or both of the major salivary glands (parotid and submandibular); and 2) the exclusion of other diseases that may mimic this presentation, such as sarcoidosis, viral infection, or lymphoproliferative disorders. Conclusions Mikulicz's disease is a condition in which there is bilateral lacrimal and salivary gland swelling that is not associated with other systemic conditions. The condition is self-limiting and most often, the diagnosis is a clinical one. Previously, Mikulicz's disease was often considered as a subtype of Sjögren's syndrome (SS). Clinical and immunologic differences between Mikulicz's disease and SS may warrant further consideration of Mikulicz's disease as a specific autoimmune phenomenon separate from SS, and Mikulicz's disease may be amenable to different treatment modalities than those employed in patients with SS.
The Comparison of Eyelash Lengthening Effect of Latanoprost Therapy in Adults and Children
Authors: Elgin U. , Batman A. , Berker N. , Ilhan B. 
Published: January 2018

Purpose To compare the eyelash lengthening effect of latanoprost in adults and children with glaucoma. Methods Twenty eyes of 13 men and 7 women (mean age: 54.9, range 42–69 years) with primary open-angle glaucoma and 20 eyes of 9 boys and 11 girls (mean age: 10.7, range 6–16 years) with glaucoma were included in this prospective study. In 19 children, juvenile glaucoma and in one, pseudophakic glaucoma had been detected. A single eyelash was pulled from the center of the upper eyelid before latanoprost therapy and at the sixth month of therapy, and measured. Results In adult cases, the mean eyelash length was 5.79±0.18 mm (5.5–6.1 mm) at baseline and 6.45±0.21 mm (6.2–6.8 mm) at the sixth month. In children, the mean length was 5.66±0.22 mm (5.3–6.0 mm) at baseline and 6.39±0.37 mm (5.9–6.9 mm) at the sixth month. The mean difference in eyelash lengths at baseline and the sixth month was 0.67±0.09 mm (0.5–0.7 mm) in adults and 0.75±0.25 mm (0.4–1.2 mm) in children. Conclusions The differences in mean eyelash lengths at baseline and at the sixth month of latanoprost therapy were statistically significant in both adults and children (p=0.000). The mean of the difference of the eyelash length in children was higher than in adults but the result was not statistically significant (p=0.678).
Reproducibility of Keratometric Measurements Decreases with Time after Blinking
Authors: Erdélyi B. , Csákány B. , Németh J. 
Published: January 2018

Purpose The reproducibility of keratometry measurements was investigated in relation to the elapsed time after blinking. Methods Thirty ophthalmologically healthy subjects were examined, using a standard corneal topographic instrument (17 women, 13 men, age 25.7±5.6 years). Photographs were taken in series of four: at 5, 15, 30, and 60 seconds after a complete blink. The series was repeated three times in each individual. The main outcome measures were the mean values, the standard deviation, and the reproducibility error of the simulated keratometric values (K1, K2), the surface regularity index (SRI), and the surface asymmetry index (SAI). Results The mean of K1 and K2 values did not change (p=0.684 and p=0.982); however, the measurement error increased significantly for K1 (p=0.007) and for K2 (p=0.038). The mean values of SRI changed significantly (p=0.034) during the 1-minute pause in blinking together with a non-significant change in the standard deviation (p=0.106), without elevation of the measurement error (p=0.619). The elevation of SAI with time was not significant (p=0.093). Conclusions The break-up phenomenon of the tear film at the ocular surface induces significant deterioration of the reliability of keratometric measurements on prolonged gaze without blinking. The created error can exceed 0.6 D, which is unacceptably high in practice. Therefore care should be taken to avoid such circumstances during the examination.
Prophylaxis against Infection in Cataract Surgery: A Survey of Routine Practice
Authors: Ang G.S. , Barras C.W. 
Published: January 2018

Purpose To survey the routine practice of consultant ophthalmic surgeons in the United Kingdom in preventing postoperative endophthalmitis following cataract surgery. Methods This is a cross-sectional questionnaire-based study. A questionnaire was sent to consultant ophthalmic surgeons in university teaching hospital ophthalmology departments in the United Kingdom. Results Questionnaires were sent to 391 consultant ophthalmic surgeons in 36 ophthalmology departments. The response rate was 55.0% (215 responses). Eleven (5.1%) did not perform cataract surgery routinely. Of the remaining 204 respondents, all performed phacoemulsification as routine. A total of 28 (13.7%) reported a 0% rate of postoperative infective endophthalmitis. Preoperative topical antibiotics were routinely prescribed by 12 respondents (5.9%). The most common immediately preoperative measure was the usage of povidone iodine (203 respondents, 99.5%). A total of 19 (9.3%) used an antibiotic infusion during surgery. Postoperative subconjunctival antibiotics were given by 138 (67.6%), most commonly cefuroxime. A total of 33 (16.2%) administered postoperative intracameral antibiotics. A total of 141 (69.1%) prescribed topical antibiotics after surgery, most commonly neomycin. None gave systemic antibiotics routinely pre-or postoperatively. Conclusions The results show a wide variation of prophylactic measures used in the United Kingdom. The routine practices adopted reflect personal preferences, and were not necessarily evidence-based. Further prospective studies are required to provide evidence for the efficacy of these prophylaxis techniques.
Evolution of Retinal Pigment Epithelium Detachment after Photodynamic Therapy for Choroidal Neovascularization in Age-Related Macular Degeneration
Authors: Theodossiadis G.P. , Grigoropoulos V.G. , Emfietzoglou I. , Nikolaidis P. , Panagiotidis D. , Vergados I. , Theodossiadis P.G. 
Published: January 2018

Purpose To report a case of pigment epithelium detachment (PED) which appeared after photodynamic therapy (PDT) and was followed up for 50 months. Methods Case report. Results A 71-year-old woman with occult choroidal neovascular membrane due to age-related macular degeneration (ARMD) developed PED 48 hours after PDT. The patient was studied with fluorescein angiography (FA) and optical coherence tomography (OCT). Fluorescein angiographic evidence of PED remained essentially unchanged during the follow-up period of 50 months. Although OCT initially gave clear evidence of PED, in the last 12 months of follow-up the PED appears to have resolved. Conclusions Photodynamic treatment could be involved in the occurrence of PED in occult choroidal neovascular membrane due to ARMD. In this particular case OCT could be considered since it offers useful information in the pretreatment and the post-treatment follow-up period.