bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phakic Iris-Claw IOL Implantation, with Bursa Technique, through a Self-Sealing Scleral Tunnel and without Iridotomy or Iridectomy
Authors: Ozcetin H. , Baykara M. , Ozmen A.T. , Yalcinbayir O. 
Published: January 2018

Purpose To present a novel technique for the implantation of phakic iris-claw intraocular lenses (IOL) in highly myopic cases. Methods Twelve cases, under the age of 40, with high myopia were included in this retrospective study. The mean follow-up span was 14.4±5.8 months. Phakic iris-claw IOL implantation was performed, through a 5.5 or 6.5 mm self sealing scleral tunnel with Bursa technique. No suturing and opening a peripheral iridectomy or iridotomy was required in our study. Pre- and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected visual acuity, best-corrected visual acuity (BCVA), induced astigmatism, and intraocular pressure (IOP) assessments. Results All eyes gained one to nine lines of BCVA of the Snellen chart. The vector analysis revealed an induced astigmatism of 0.63 D. No significant IOP change was detected throughout the follow-up. Conclusions The data suggest that nonfoldable iris fixated phakic IOL implantation, through a self-sealing incision with Bursa technique, is safe and requires no iridectomy or iridotomy in cases with deep anterior chambers.
Abuse of Vasoconstrictive Eyedrops Mimicking an Ocular Pemphigoid
Authors: Tappeiner C. , Sarra G.-M. , Abegg M. 
Published: January 2018

Purpose To describe conjunctival histopathologic alterations induced by excessive chronic astringent use. Methods Report of a case with clinical picture, epicutane test results, histologic workup of conjunctival biopsy using conventional staining, and immunohistochemical markers. Results A 45-year-old man using a phenylephrine preparation hourly for years presented with grotesque eye redness, fornix shortening, and scarring of puncta lacrimalia. Direct and indirect immunofluorescence were negative for ocular pemphigoid. Histology revealed signs of chronic inflammation and neovascularization in the conjunctiva. Symptoms resolved after cessation of therapy. Conclusions Chronic abuse of decongestant eyedrops can produce a clinical picture resembling an ocular pemphigoid. Histology suggests that late onset immunoreaction and chronic vasoconstriction cause chronic inflammation and neovascularization, respectively.
Is Microbiological Analysis of Donor Cornea Transport Culture Media Necessary?
Authors: Cornish K.S. , Ramamurthi S. , Butcher I. , Ramaesh K. 
Published: January 2018

Purpose To investigate microbial contamination of the transport medium. Examination of corneoscleral rims is not included in this series. Methods Transport media of 63 consecutive grafts done at Tennent Institute of Ophthalmology, Glasgow, were collected for microbial examination. Results None of the culture plates showed any growth after prolonged culture, and microscopy was negative in 100% of cases. Conclusions Routine culture of transport media may not be necessary.
Cataract Development in a Young Patient with Lathosterolosis: A Clinicopathologic Case Report
Authors: Cavallini G.M. , Masini C. , Chiesi C. , Campi L. , Rivasi F. , Ferrari P. 
Published: January 2018

Purpose To report a unique case of cataract in a young patient with lathosterolosis, a singular defect of cholesterol biosynthesis, and to report the clinical results and histopathologic findings after cataract surgery. Methods A 7-year-old patient with lathosterolosis, a rare defect of cholesterol biosynthesis, presented with a complex phenotype, including severe mental retardation, liver disease, multiple congenital anomalies, and bilateral posterior subcapsular cataracts. After a severe metabolic decompensation, a worsening in the lens opacity of the left eye occurred. The authors thus performed cataract surgery and made a histopathologic analysis of aspirated lenticular samples. The following examinations were performed at 1 day, 1 week, 3 months, 6 months, 12 months, and 24 months: refraction, biomicroscopy, and fundus evaluation. Visual acuity was not assessable due to lack of patient collaboration. The postoperative follow-up period was 24 months. Results Histopathologic findings on lenticular fragments revealed the presence of fibers disposed in a honeycomb, samples with homogeneous eosinophilic lens fibers, and other fragments characterized by bulgy elements referable to cortical fibers with degenerative characteristics. After surgery, biomicroscopic evaluation revealed no significant inflammation and good intraocular lens centration at the various control visits. No intraoperative or postoperative complications occurred. No posterior capsule opacification occurred 2 years after surgery. Conclusions Lathosterolosis may lead to dysmetabolic cataract development; this unique case of cataract in such a patient has been successfully managed with surgery. Clinical results were excellent, and no complications occurred either intra- or postoperatively.
In vivo Laser Confocal Microscopic Findings in Patients with Epithelial Basement Membrane Dystrophy
Authors: Bozkurt Banu , Irkec Murat 
Published: January 2018

Purpose To evaluate the corneal characteristics of patients with epithelial basement membrane dystrophy (EBMD) using an in vivo laser confocal microscope, Heidelberg Retina Tomograph II, Rostock Cornea Module (HRT II RCM). Methods Sixteen women and 13 men who were diagnosed with or suspected to have EBMD were included in the study. The mean age of the patients was 56.4±17.2 years within a range of 25 to 81 years. Nine patients (31%) had a history of recurrent corneal erosions and 3 patients had been misdiagnosed with herpetic epithelial keratitis. The remaining 17 patients were asymptomatic and EBMD was diagnosed incidentally during routine eye examinations. Results Confocal microscopy revealed highly reflective tissue in various configurations within the intermediate and basal epithelial cell layers corresponding to the abnormal basement membrane extending into the epithelium. There were thin, parallel hyperreflective lines and high contrast round lesions in sizes ranging between 10 and 250 μm within the epithelium. Basal epithelial cells around the abnormal basement membrane and cysts seemed to be highly distorted. In two subjects with bleb-like disorder, the authors observed circular or oval hyporeflective areas with a diameter ranging between 40 and 100 μm at the level of basal epithelium and the Bowman layer, accompanied by hyperreflective, linear structures extending into the epithelium. Conclusions EBMD is most commonly asymptomatic and undiagnosed; however, it might be associated with recurrent corneal erosions and lead to severe complications after LASIK surgery. The confocal images are highly characteristic for EBMD; therefore, confocal microscopy seems to be a valuable tool in the diagnosis of EBMD.
Corneal Endothelium in Patients with Diabetes Mellitus: A Historical Cohort Study
Authors: Shenoy Radha , Khandekar Rajeev , Bialasiewicz Alexander A. , Muniri Abdullah Al 
Published: January 2018

Purpose Retinopathy is the major cause of ocular morbidity in patients with diabetes mellitus. Chronic hyperglycemia spares no organ and can affect the morphology and function of the various corneal layers, compromising its transparency. This study was conducted to associate the status of corneal endothelium to diabetes mellitus (DM) and identify risk factors of compromised corneal endothelium. Methods A total of 220 eyes of randomly selected patients (110 diabetic and 110 nondiabetic) were subjected to detailed slitlamp and fundus evaluation. Corneal endothelial status was evaluated using the Nidek® Confoscan 2. Cell density, percentage polymegathism, and pleomorphism were calculated. The findings in diabetic patients were compared to those without disease. The outcome was correlated to diabetic retinopathy (DR). The effects of hypertension, hyperlipidemia, age, gender, type, duration, glycemic control, and grades of DR was also considered. Results The mean corneal endothelial cell density was −175 cells/mm2 (95% CI −317 to −33 cells/mm2) less in eyes of diabetic patients. The number of endothelial cells with polymegathism was significantly greater among eyes of diabetic patients. There were less corneal endothelial cells with pleomorphism in nondiabetic patients. Polymegathism and pleomorphism of corneal endothelial cells seems to be positively associated with DM type II. Cell density was significantly lower in eyes with DR than those without DR. Conclusions Corneal endothelium in diabetic patients seems to be compromised. Evaluation of corneal endothelium should be part of protocol for eye care of diabetic patients.
Fundus Findings in Spontaneous Subarachnoid Hemorrhage and their Correlation with Neurologic Characteristics
Authors: Entezari Morteza , Azhari Shirzad , Ramezani Alireza 
Published: January 2018

Purpose To determine the incidence of fundus findings in spontaneous subarachnoid hemorrhage (SAH) and their correlation with neurologic characteristics. Methods In a prospective case series, 202 eyes of 101 patients with SAH were evaluated from September 2003 to September 2006. The incidence of fundus findings was detected and correlated with gender, age, consciousness state, Fisher score, site and number of aneurysms, laterality of aneurysms, aneurysmal rebleeding, and mortality rate. Results Fifty (49.5%) patients had normal and 51 (50.5%) patients had abnormal funduscopic examination. Of all eyes, disc swelling in 85 (42.1%), retinal hemorrhage in 51 (25.2%), subhyaloid hemorrhage in 6 (3%), and vitreous hemorrhage in 3 (1.5%) eyes were detected. No relation was found between gender, age, Fisher score, number of aneurysms, laterality of aneurysms, aneurysmal rebleeding, and mortality rate and fundus findings. However, a correlation was observed between consciousness state and retinal hemorrhage (p=0.002) and disc swelling (p=0.002), and also between the anterior communicating artery location of aneurysm and retinal hemorrhage (p=0.017) and any kind of fundus findings (p=0.007). Conclusions Fundus findings including hemorrhage and disc swelling are common in patients with SAH and are related to the consciousness state and anterior communicating artery location of aneurysm.
Early Stage Ethambutol Optic Neuropathy: Retinal Nerve Fiber Layer and Optical Coherence Tomography
Authors: Kim Ungsoo , Hwang Jeong-Min 
Published: January 2018

Purpose To evaluate retinal nerve fiber layer (RNFL) thickness with optical coherence tomography (OCT) in early stage ethambutol optic neuropathy. Methods The RNFL thickness of 20 eyes of 10 patients who developed optic neuropathy after taking ethambutol and visited within 6 months after onset were analyzed and compared with those of 54 eyes of 29 healthy age-matched controls. The mean age was 67.40±10.25 years for the patients with toxic optic neuropathy and 66.78±10.60 for the control group (p=0.948). A full ophthalmologic examination including RNFL evaluation with fast RNFL thickness (3.4) scanning using a Stratus OCT (Carl Zeiss Meditec, Dublin, CA) was performed. Results RNFL thicknesses associated with early ethambutol optic neuropathy were as follows: temporal 75.35±15.77 μm, superior 124.05±24.62 μm, nasal 75.15±24.23 μm, inferior 127.60±22.91 μm, and the average was 100.83±16.56 μm. There was no significant difference between the RNFL thickness of the patients with the early stage of ethambutol optic neuropathy and those of the control group. The thickness of RNFL was greater in the temporal quadrant than the nasal quadrant, although not statistically significant. Conclusions RNFL thickness associated with ethambutol optic neuropathy during the early stages was not different from the controls. Although not statistically significant, the relative thickening of temporal RNFL in our patients might represent a mild swelling of the papillomacular bundle.
The prevalence of anisometropia aniso-astigmatism and amblyopia in neurofibromatosis type 1
Authors: Ardagil Aylin , Yaylali Sevil A. , Erbil Hasan H. , Olgun Ali , Aslan Zeki I. , Dolar Ayse 
Published: January 2018

Purpose The purpose of this study was to document the prevalence of anisometropia, anisoastigmatism, and anisometropic amblyopia in patients with neurofibromatosis-1 (NF1) and to compare it with that in age- and sex-matched controls. Methods Fifty patients with NF1 and 150 age- and sex-matched controls were examined in this study. Cycloplegic autorefraction was attempted on all patients <16 years old and without cycloplegia on patients >16 years old. Anisometropia was defined as absolute interocular difference of spherical equivalent more than or equal to 1 D. Aniso-astigmatism was defined as interocular difference of refractive astigmatism of more than or equal to 1 D. Amblyopia was defined as two-line decrease in Snellen acuity between the two eyes. Results The overall prevalence of anisometropia, aniso-astigmatism, and amblyopia in patients with NF1 was 16%, 20%, and 10%, respectively, and they were all significantly higher than in the controls. The amblyopia was either moderate or severe in nature and all affected patients had significant astigmatism (>2.5 D) in the amblyopic eye. Conclusions NF1 is a risk factor for anisometropia, aniso-astigmatism, and aniso-astigmatic amblyopia and screening patients with NF1 for refractive errors before age 3 will help to detect patients at risk of amblyopia and give them proper treatment.
Choroidal Nonperfusion with Significant Subretinal Exudation after PDT of Predominantly Classic CNV: An OCT and FFA Study
Authors: Jalil Assad , Mercieca Karl , Chaudhry Nadia L. , Stanga Paulo Eduardo 
Published: January 2018

Purpose Despite the increasing use of antivascular endothelial growth factors (anti-VEGF), photodynamic therapy (PDT) with Verteporfin® is still considered the gold standard treatment of subfoveal and juxtafoveal classic choroidal neovascularization (CNV). Methods Case report. Results The authors report a case of a 72-year-old man who developed choroidal nonperfusion and significant subretinal fluid formation with associated severe visual loss following PDT of predominantly classic juxtafoveal CNV. Conclusions Although reported separately, these two complications have not been previously reported to occur in association after PDT treatment of classic CNV and may represent exaggeration of normal events occurring after PDT.
Heidelberg Retina Flowmeter Parameters at the Papilla in Healthy Subjects
Authors: Griesser S.M. , Lietz A. , Orgül S. , Schötzau A. , Hendrickson P. , Flammer J. , Haefliger I.O. 
Published: January 2018

Purpose To assess the Heidelberg Retina Flowmeter (HRF) parameters “volume”, “flow”, and “velocity”, at the papilla in healthy subjects. Methods HRF measurements were taken at the papilla (5° × 20°), superficially at level of the retina and at the bottom of the excavation. The effect of increasing frame size (1×1 to 50×50 pixels) on HRF values was assessed in ten subjects. HRF parameters were calculated (50×50 pixels) for 150 eyes of 150 subjects. To assess short-term reliability, measurements were repeated five times in ten subjects. Results With 50×50 pixels the location of the frame had no influence on HRF values. Reliability was > 90%. Values were significantly higher (p<0.001) in the superficial than in the deeper papillary layers. The correlation between HRF parameters was good (r2>0.85). Conclusions A low magnification (5°×20°) and a 50×50 frame allows a global assessment of HRF parameters at the papilla with high reliability. In healthy eyes, the HRF values are influenced by the level where measurements are made at the papilla. This might be of importance in glaucoma patients with excavated papilla.
Indocyanine Green Angiography of Optic Nerve Head Melanocytoma
Authors: Kadayifcilar S. , Akman A. , Aydin P. 
Published: January 2018

Purpose To determine the features of fluorescein and indocyanine green angiography of melanocytoma. Methods Fluorescein and indocyanine green angiography is used to assess an optic nerve head melanocytoma in a 45-year-old female. Results Fluorescein angiography revealed increased vascularity on the surface, with staining around the lesion in the late stages. The lesion was hypofluorescent in all stages of indocyanine green angiography. Conclusions Indocyanine green angiography is helpful in identifying the benign nature of the lesion by showing hypofluorescence, indicating lack of vascularity in the tumor.
A New Parameter for Assessing the Thickness of the Retinal Nerve Fiber Layer for Glaucoma Diagnosis
Authors: Kogure S. , Iijima H. , Tsukahara S. 
Published: January 2018

Purpose To investigate a new method for assessing the thickness of the retinal nerve fiber layer thickness (NFLT) for glaucoma diagnosis, using scanning laser polarimetry. Material and Methods Thirty eyes of thirty patients with ocular hypertension or glaucoma were examined using a scanning laser polarimeter. NFLT was measured in each of four 90-degree quadrants; superior (S), temporal (T), inferior (I) and nasal (N) along 1.5-disc diameters concentric from the disc margin. The new parameters S-N (meaning the thickness of the superior nerve fiber layer over the nasal one) etc. were compared with the conventional parameters (S, S/N, etc.). The correlations between these parameters and the mean threshold of the associated visual field test points were included in the comparison. Results The total thickness (sum of S, I, N and T), N and T did not correlate to the visual field, but S and I did. The new parameters were well correlated to the visual field, S-N giving the best correlation coefficient (rs=0.782, p<0.0001), and sensitivity and specificity (the area under the receiver operating characteristic curves was 0.91). Conclusions The nasal NFLT was the smallest part of individual variation and glaucomatous damage. The new parameters, based on the nasal NFLT, were good evaluators of the changes in glaucoma.
Aqueous Flare Intensity in Relation to Different Stages of Diabetic Retinopathy
Authors: Zaczek A. , Hallnäs K. , Zetterström C. 
Published: January 2018

Purpose To compare laser flare intensity in patients wilh diabetes mellitus (DM) type I and type II to different stages of diabetic retinopathy (DR) and controls. Methods This study comprised 88 consecutive patients with DM type I and 40 controls in the same age range, divided into two age groups: 20–34 years and 35–50 years; 108 consecutive patients with DM type II and 32 controls were also divided into two age groups: 45–59 years and 60–75 years. Patients with glaucoma, exfoliation syndrome, media opacities, uveitis, within 96 hours after laser photocoagulation, treatment with topical and systemic drugs which can affect aqueous protein concentration, were excluded. One eye was randomly selected from each diabetic patient and control. Flare intensity was measured with a laser flare meter without mydriatic drops, and was then correlated with the stages of DR within each age group. Results Eyes with advanced DR, such as moderate-severe, severe non-proliferative DR and proliferative DR (PDR), had significantly higher flare intensity than controls and eyes without retinopathy in all age groups (p<0.05). Flare intensity values were similar for controls and eyes with mild-moderate DR in all age groups except the older patients with DM type II, particularly those with clinically significant macular edema (CSME) (p<0.05). Eyes with regressed proliferative DR and no indication for laser photocoagulation had significantly lower flare values than eyes with an indication for therapy (p<0.05). Eyes with iris rubeosis (IR) had significantly higher flare than those without IR (p<0.05). Flare values were significantly correlated with the duration of diabetes in DM types I and II (p<0.05). Conclusions Flare intensity was increased in eyes with mild-moderate DR with CSME, and in eyes with advanced and severe stages of DR. Aqueous flare was related to the duration of diabetes.
Norrie Disease and Exudative Vitreoretinopathy in Families with Affected Female Carriers
Authors: Shastry B.S. , Hiraoka M. , Trese D.C. , Trese M.T. 
Published: January 2018

Purpose Norrie disease (ND) is a rare X-linked recessive disorder characterized by congenital blindness, which is often associated with sensorineural hearing loss and mental retardation. X-linked familial exudative vitreoretinopathy (FEVR) is a hereditary disorder characterized by an abnormality of the peripheral retina and is not associated with systemic diseases. X-linked recessive disorders generally do not affect females. Here we show that female carriers can be associated with manifestation of an X-linked disorder. Methods A four-generation family with an affected female, and a history of congenital blindness and hearing loss, was identified through the pro-band. A second family, with a full-term female infant, was evaluated through ophthalmic examinations and found to exhibit ocular features, such as retinal folds, retinal detachment and peripheral exudates. Peripheral blood specimens were collected from several affected and unaffected family members. DNA was extracted and analyzed by single-strand conformation polymorphism (SS-CP) following polymerase chain reaction (PCR) amplification of the exons of the Norrie disease gene. The amplified products were sequenced by the dideoxy chain termination method. Results In an X-linked four-generation family, a novel missense (A118D) mutation in the third exon of the Norrie disease gene, was identified. The mutation was transmitted through three generations and cosegregated with the disease. The affected maternal grandmother and the unaffected mother carried the same mutation in one of their alleles. In an unrelated sporadic family, a heterozygous missense mutation (C96Y) was identified in the third exon of the Norrie disease gene in an affected individual. Analysis of exon-1 and 2 of the Norrie disease gene did not reveal any additional sequence alterations in these families. The mutations were not detected in the unaffected family members and the 116 normal unrelated controls, suggesting that they are likely to be the pathogenic mutations. Conclusions The results further strengthen the proposal that X-linked disorders can occur in female carriers, due likely to an unfavorable X-inactivation.