bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stability of Silicone Band Frontalis Suspension for the Treatment of Severe Unilateral Upper Eyelid Ptosis in Infants
Authors: Fogagnolo P. , Serafino M. , Nucci P. 
Published: January 2018

Purpose To address the efficacy, safety, and stability of frontalis suspension of the upper eyelid with a silicone band for the treatment of severe congenital ptosis in infants. Methods Data from 22 pediatric patients undergoing unilateral frontalis suspension with silicone band were retrospectively reviewed with a follow-up ranging from 18 to 30 months. The margin-reflex distance (MRD) and the corneal staining had been evaluated at each pre- and postoperative visit. Data were analyzed by analysis of variance and t test for paired data. Results MRD was absent before surgery in all cases: it ranged from −1 mm to −4 mm (-2.4±0.8 mm). Immediately after surgery, it increased to 2.9±0.3 mm, and then progressively reduced by 0.6 mm within the first 3 months (p=0.001); a further reduction of 0.2 mm, occurring between 3 and 12 months after surgery, was not statistically significant. After the 12-month visit, no changes in MRD were found at follow-up for any patient. Corneal staining, which was present in five patients over the first 2 postoperative weeks, recovered without sequelae. Complications occurred in three eyes: overcorrection and corneal ulcer in one case requiring removal of the silicone band, one granuloma, and one extrusion of the silicone band from the upper frontal incision. Conclusions During the study period, the frontalis suspension with a silicone band was an effective and safe procedure. MRD values were stable between month 3 and the end of follow-up, although this series does not preclude the possible occurrence of blepharoptosis at longer time intervals.
A European Perspective on Costs and Cost Effectiveness of Ophthalmic Combinations in the Treatment of Open-Angle Glaucoma
Authors: Hommer A. , Thygesen J. , Ferreras A. , Wickstrøm J. , Friis M.M. , Buchholz P. , Walt J.G. 
Published: January 2018

Purpose Efficacy, safety, and cost implications are important considerations when choosing an ophthalmic treatment. Fixed-combination glaucoma medications containing brimonidine 0.2% and timolol 0.5%, or dorzolamide 2% and timolol 0.5%, were compared with brimonidine 0.2% and dorzolamide 2% that were used as adjunctive therapy to timolol 0.5%. Methods A literature review was conducted to determine the outcome parameters of intraocular pressure reduction and tolerability after 3 months of use of brimonidine or dorzolamide, each together with timolol as a fixed-combination or in concomitant therapy. Modelled cost-minimization and cost-effectiveness analyses were performed to investigate the economic consequences of ophthalmic therapy with brimonidine, dorzolamide, and timolol from a societal perspective. Results The literature review found that brimonidine and dorzolamide used as fixed combinations with timolol as well as in adjunctive therapy to timolol were equally effective and safe. Furthermore, in the European countries studied, the fixed combination of brimonidine/timolol represented a less costly option when compared to the fixed combination of dorzolamide/timolol evaluated over both a 3-month and a 12-month horizon. Conclusions Brimonidine used as a fixed-combination therapy with timolol provided better cost value than dorzolamide/timolol in all the countries studied. For most countries, the fixed combination of brimonidine and timolol also provided better cost value than adjunctive therapy with brimonidine, which was more cost effective than adjunctive therapy with dorzolamide.
The Role of Advanced Oxidation Protein Products and Total Thiols in Diabetic Retinopathy
Authors: Baskol G. , Gumus K. , Oner A. , Arda H. , Karakucuk S. 
Published: January 2018

Purpose This study aimed to investigate the role of protein peroxidation by detecting the serum levels of advanced oxidation protein products (AOPP), a novel marker for the degree of oxidative damage to proteins, and total thiol as a marker of antioxidant status in diabetic patients with or without diabetic retinopathy (DR) and to compare the results with those of control subjects. Methods The study groups consisted of two separate subgroups: 1) 37 patients (14 male, 23 female) with noninsulin-dependent diabetes mellitus (NIDDM) showing diabetic retinopathy (DR) and 2) 20 patients with NIDDM and without any signs of DR (9 male, 11 female); 26 healthy non-diabetic control subjects (15 male, 11 female) were selected from the patients attending our department for refractive disorders. Venous blood samples of all participants were collected in the morning after an overnight fast, and serum samples stored at −70°C until assay for AOPP, and total thiol. Results AOPP levels were significantly higher in diabetic patients with (210.9±73.0 μmol/L) or without DR (222.7±94.4 μmol/L) when compared to those of controls (152.4±72.04 μmol/L) (p=0.004). Even though the difference was not statistically significant (p=0.095), total thiol levels in cases with DR (278.7±139.1 μmol/L) were lower than those without DR (334.0±129.4 μmol/L) and controls (353.2±145.6 μmol/L). Correlation tests did not reveal any association between these parameters and age, sex, or duration of DM. Conclusions The present study suggests that increased protein oxidation may contribute to the pathogenesis of DR.
OCT-Guided Photodynamic Therapy for Angiographic Occult CNV in Pathologic Myopia
Authors: Milani P. , Pierro L. , Scialdone A. 
Published: January 2018

Purpose Pathologic myopia (PM) is frequently complicated by choroidal neovascularization (CNV). Diagnosis is mainly clinical and angiographic but in recent years optical coherence tomography (OCT) has been noted to add important information. The authors report on the successfully OCT-guided photodynamic therapy (PDT) of an angiographic occult CNV complicating PM. Methods Observational case report. Fluorescein angiography with a confocal SLO (HRA, Heidelberg Engineering, Germany) and OCT Stratus (Carl Zeiss Meditec, Inc.) imaging were used for diagnosis and monitoring of the CNV. Standard PDT was performed. Results A highly myopic 17-year-old girl complained of a drop in visual acuity (VA) in left eye (LE), dating back a few weeks. Her best-corrected (BC) VA was 20/40 in the LE, with some metamorphopsia. No hemorrhage or evident signs of CNV were visible either at fundus or at dynamic fluorescein angiography. OCT scans indicated a slight elevation of the RPE-choriocapillary complex with rarefaction of neuroretinal tissue that has been interpreted as CNV. PDT was then performed. LE BCVA had improved to 20/25, metamorphopsias disappeared, and at OCT examination no retinal morphologic modification was evident. Nine months later, BCVA and ophthalmoscopy are still stable. Conclusions In this case, OCT was the fundamental tool for the correct diagnosis and post-therapy monitoring of CNV-complicated PM. The CNV, not clearly detectable using angiographic imaging, was treated with PDT, and results in terms of VA and anatomic resolution were good.
Modifying the Position of Cataract Incisions in Triple Procedure
Authors: Baykara M. , Uçan G. 
Published: January 2018

Purpose The authors present a surgical technique for enhancing the visualization of the lens capsule by lamellar corneal dissection and performing phacoemulsification through the partially trephined recipient bed in eyes undergoing penetrating keratoplasty combined with cataract surgery. Methods First, the cornea was thinned by lamellar dissection in 11 patients undergoing triple procedure (penetrating keratoplasty phacoemulsification, and intraocular lens implantation). After continuous curvilinear capsulorhexis (CCC) was performed in the closed system, phacoemulsification was carried out through the incisions that were created on the partially trephined recipient bed. The trephination was completed by excising the remaining corneal tissue and intraocular lens was implanted. At the end of the surgery, donor cornea was sutured into the recipient bed. Results The cataract surgery was performed in a closed system and the cataract incision places were removed at the end of the surgery; therefore both CCC and phacoemulsification could be completed easily without any intraoperative complication in 11 eyes of 11 patients. Conclusions Phacoemulsification, through the recipient bed that is thinned by lamellar dissection, could be safely performed in a short time, under good view of the lens.
Congenital Cataract Extraction with Primary Aphakia and Secondary Intraocular Lens Implantation in the Posterior Chamber
Authors: Magli A. , Fimiani F. , Bruzzese D. , Carelli R. , Giani U. , Iovine A. 
Published: January 2018

Purpose To evaluate visual outcomes, eye movement abnormalities, and postoperative complications after secondary posterior chamber intraocular lens (IOL) implantation in aphakic children who had initial LAC correction. Methods A retrospective study was carried out on 53 patients (94 eyes). Following aphakic surgery and LAC correction the patients received secondary IOL implantation in the posterior chamber. Special attention was paid to factors that may have influenced their visual outcomes, such as eye movement abnormalities, cataract unilaterality, and cataract density. Results No association was found between age at surgery and the onset of strabismus (p=0.611) or with visual acuity (p=0.086). However, unilaterality and total cataract density were found to have a negative association with poor vision (p<0.001). Strabismus and nystagmus were found to have a statistically significant negative association with visual acuity (p=0.002). Posterior capsule opacification occurred in six eyes of five patients following cataract extraction; IOL dislocation occurred in four eyes after IOL intraocular implantation, and secondary glaucoma occurred in one eye. Conclusions IOL implantation before 12 months of age may be useful in unilateral cataract; in bilateral cataract, simultaneous surgical aphakia, LAC correction, and then IOL implantation at 2.5–3 years of age, together with anti-amblyopic therapy when strabismus or asymmetric cataract density occur, are efficient methods to obtain visual recovery. Extraocular muscle surgery may be required to correct strabismus.
Age-Related Maculopathy and Diabetes
Authors: Borrone R. , Saravia M. , Bar D. 
Published: January 2018

Purpose To compare the prevalence of age-related maculopathy (ARM) in a sample of diabetic patients with the general population. Methods Binocular indirect ophthalmoscopy, biomicroscopy, and fluorescein angiography. Retrospective prevalence study; descriptive-observational case-control type. Two different groups were analyzed from a sample of 1000 consecutive files of diabetic patients: 1) 65 to 74 years old (n = 263) and 2) 75 years and older (n = 199). Prevalence was compared to that of the general population in a control group and the following epidemiologic studies: Beaver Dam Eye Study, Framingham Eye Study, Blue Mountains Study, and Rotterdam Eye Study. Results In diabetic patients aged 75 or older, prevalence of ARM was as follows: early lesions 2.51% (5/199), late lesions (ARMD) 2.51% (5/199). In comparison, the risk in patients 75 or older is as follows: control group (ARMD): OR 4.79, 95% CI 1.778–12.033, p (Fisher) 0.0005; Beaver Dam Eye Study (ARMD): OR 2.93, 95% CI 1.152–7.450, p (Fisher): 0; Blue Mountains Eye Study (ARMD): OR 3.06, 95% CI 1.208–7.754, p (Fisher): 0; Framingham Eye Study (ARM): OR 6.73, 95% CI 3.041–14.880, p (Fisher): 0; Rotterdam Eye Study: p (Fisher) 0.133. Conclusions 1) A lower prevalence of ARM was found in the sample of diabetic patients aged 75 or older than in the general population (with the exception of the Rotterdam study). 2) Prevalence of ARM was even lower in diabetic patients presenting diabetic retinopathy, whether or not they had been treated with photocoagulation. 3) In diabetic patients, the exudative form was more frequent than the atrophic form, in an inverse ratio to that of the general population.
Verteporfin Photodynamic Therapy for Subfoveal Choroidal Neovascularization in Pathologic Myopia: A 12-Month Retrospective Review
Authors: Costagliola C. , Campa C. , Incorvaia C. , Parmeggiani F. , Menzione M. , Della Corte M. , Rinaldi M. , Romano M. , Semeraro F. 
Published: January 2018

Purpose To evaluate the visual outcome of patients with subfoveal choroidal neovascularization (CNV) secondary to pathologic myopia treated with verteporfin photodynamic therapy (PDT-V) and to verify the predictive role of visual and angiographic parameters. Methods This is a retrospective, interventional, consecutive case series study of subjects with subfoveal CNV secondary to pathologic myopia. All patients received PDT-V according to VIP guidelines. A complete ophthalmologic evaluation was performed on all patients and included best-corrected visual acuity (BCVA), fundus examination, and fluorescein angiography (FA, IMAGEnet System, Topcon Corp., Japan). CNV size (mm2) was directly measured on the early phase of the angiogram using the software included with the IMAGEnet package. All checks were scheduled at 3-month intervals for a period of 1 year. A review of medical and angiographic records was performed and assessed throughout a 12-month follow-up period. Results A total of 62 patients (62 eyes) were examined. Best-corrected visual acuity (BCVA) moderately decreased without reaching a statistically noticeable level throughout the follow-up; reduction in lesion size reached a significant level at the second checkup. A significant correlation between higher baseline BCVA and better final visual outcome was detected. Conclusions Standardized PDT-V minimizes central vision deterioration in patients with CNV secondary to pathologic myopia. Better BCVA at presentation represents a good predictive sign.
Causes of Blindness at Nkhoma Eye Hospital, Malawi
Authors: Sherwin J.C. , Dean W.H. , Metcalfe N.H. 
Published: January 2018

Purpose The majority of blindness in Sub-Saharan Africa is treatable. This hospital-based study was undertaken in order to investigate the etiology of blindness at Nkhoma Eye Hospital, Malawi. Methods One ophthalmologist examined 2082 consecutive new patients who presented to the outpatient department at Nkhoma Eye Hospital, Malawi in 2006. Data recorded included age, sex, visual acuity and diagnosis. Patients were classified as blind if their best corrected visual acuity was <3/60 in one eye (unilateral) or two eyes (bilateral). Results The most common diagnosis in new outpatients was cataract (52.8%), followed by glaucoma (8.1%), corneal pathology (7.2%), uveitis (4.5%) and maculopathy (3.2%). There were 742 (35.6%) patients with unilateral blindness and 331 (15.9%) patients with bilateral blindness. Unilateral blindness was present in 37.4% of males and 26.5% of females. The most common causes of unilateral blindness were lens pathology (57.8%), followed by glaucoma (12.1%), corneal pathology (10.0%) and uveitis (6.1%). Bilateral blindness was present in 12.5% of males and 16.8% of females respectively. The most common causes of bilateral blindness were lens pathology (54.4%), followed by glaucoma (19.9%), retinopathy (3.6%), maculopathy (3.6%), uveitis (3.6%) and corneal pathology (3.3%). Conclusions Cataract is the most common cause of blindness in Nkhoma. Resultantly cataract management is preferentially targeted in the Nkhoma VISION2020 Programme. Training of auxiliary eye personnel in cataract diagnosis and surgery may assist in this approach.
Changes of Vascular Endothelial Growth Factor after Vitrectomy for Macular Edema Secondary to Retinal Vein Occlusion
Authors: Noma H. , Funatsu H. , Mimura T. , Hori S. 
Published: January 2018

Purpose To examine whether vitrectomy combined with retinal photocoagulation reduces the vitreous level of vascular endothelial growth factor (VEGF) in patients with macular edema associated with retinal vein occlusion (RVO). Methods The authors measured VEGF levels in vitreous samples from four eyes of four patients with RVO during vitrectomy and fluid samples obtained during revitrectomy 3 to 9 months postoperatively for complications: an epiretinal membrane in two patients, macular holes in one patient, and vitreous hemorrhage in one patient. During vitrectomy, retinal photocoagulation was performed on the ischemic region of the retina in all cases (mean of 510 shots). Results In four eyes with RVO, there was a difference in the vitreous VEGF levels between the vitreous samples obtained during vitrectomy (mean of 2692 pg/mL, range of 15.6–9040 pg/mL) and the fluid samples obtained at the time of revitrectomy (mean of 947 pg/mL, range of 15.6–3430 pg/mL). Conclusions The results suggest that the vitreous levels of VEGF may be reduced by vitrectomy combined with retinal photocoagulation for macular edema with RVO. It may be important to reduce the vitreous levels of VEGF by vitrectomy and retinal photocoagulation for ischemic retina in macular edema with RVO.
Early Results of Modified Nonpenetrating Deep Sclerectomy and Phacoemulsification in the Treatment of Open Angle Glaucoma and Cataract
Authors: Yuen N.S.Y. 
Published: January 2018

Purpose To study the outcome and control of intraocular pressure (IOP) of a combined modified nonpenetrating deep sclerectomy (NPDS) without use of implants and phacoemulsification in patients with primary open angle glaucoma (POAG) and cataract. Methods Prospective series of 14 eyes in 14 patients with medically uncontrolled POAG and cataract with significant visual impairment undergoing a modified NPDS and phacoemulsification. The surgery was designed to utilize all four mechanisms of outflow track of aqueous of NPDS without the use of scleral implant and a standardized postoperative management and early Nd:YAG laser goniopuncture at 4 weeks. All patients underwent clinical assessment before and after surgery at day 1, day 7, weeks 2, 3, and 4, and then at 2, 3, and 6 months postoperation. Surgical outcome was assessed in terms of IOP, visual acuity, and the incidence of complications. Results IOP decreased significantly from a preoperative value of 21.71±3.81 mmHg (mean ± SD) to a postoperative value of 13.14±3.73 mmHg (mean ± SD) (p<0.05, paired t test) at 6 months. The number of antiglaucoma eyedrops needed for control of IOP decreased from 3.28±0.91 to zero after operation at 6 months follow-up. The change in IOP pre and post laser goniopuncture was noted with no complication or fluctuation in anterior chamber depth. Visual acuity ranged from finger counting to 6/18 with Snellen chart at 6 meters preoperatively to 6/36 to 6/9 postoperatively. There were no intraoperative complications. There was one recessed conjunctival wound at 1 week. No other postoperative complication was noted. Conclusions Modified NPDS without scleral implant with early Nd:YAG laser goniopuncture and phacoemulsification for treatment of patients with POAG and cataract is a safe and effective procedure with complete success at 6 months.
Oxidative DNA Damage in Retinopathy of Prematurity
Authors: Ates O. , Alp H.H. , Caner I. , Yildirim A. , Tastekin A. , Kocer I. , Baykal O. 
Published: January 2018

Purpose This study examines the levels of oxidative damage in patients with retinopathy of prematurity (ROP). Methods Fifty patients were recruited with a birthweight below 1500 g or gestational age below 32 weeks. The cases were classified into those who developed ROP (n=25) and those without ROP (n=25). The authors obtained blood and urine samples from each infant, for measuring 8-hydroxy 2-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) levels, at the time of the first examination at 4–6 postnatal weeks. Results A significant difference was observed in leukocyte and urine 8-OHdG levels in patients with ROP compared to those without ROP (p<0.001 for both). Similarly, a significant difference was observed in plasma and urine MDA levels in patients with ROP compared to those without ROP (p<0.001 for both). In addition, significant correlations were found between levels of 8-OHdG in leukocyte DNA and plasma MDA (r=0.859, p<0.001), and between levels of urine 8-OHdG excretion and urine MDA (r=0.563, p<0.001). Conclusions 8-OHdG in leukocyte DNA and urine levels in premature infants can be useful as an indicator for ROP screening.
Hypoxia Tolerance and Retinal Vein Occlusion: A Pilot Evaluation
Authors: Mauget-Faÿsse M. , Germain-Pastene M. 
Published: January 2018

Purpose To determine if hypoxia tolerance in patients with retinal vein occlusion (RVO) following exposure to transient hypoxia is different from the hypoxia tolerance of healthy patients without retinal vein occlusion. Methods Consecutive patients presenting with RVO following exposure to transient hypoxia (Group I) were compared with healthy subjects (Group II). In addition to cardiovascular and plasma tests, functional respiratory evaluation was performed at rest and during exercise at both normal oxygen levels (21% O2) and in hypoxia (11.6% O2). We used the Wilcoxon test for statistical analysis. Results Both groups of eight males had similar mean ages: Group I, 47.5 years and Group II, 53 years. In Group I, three patients had glucose or lipid abnormalities, one had hypertension, and one minor thalassanemia. In Group II, one patient had hypertension. At rest in hypoxia, the oxyhemoglobinic desaturation was significantly different (p=0.03) in Group I in comparison with Group II (-13.8 versus −9.3). At exercise in hypoxia, the oxyhemoglobinic desaturation was similar in both groups but there was a statistically significant increase in both systolic (189 versus 155 mmHg; p=0.01) and diastolic (94 versus 77 mmHg; p=0.03) blood pressure in Group I. Ventilation rate and increased heart rate during hypoxia were higher in Group I compared with Group II but were not statistically significant. Conclusions In our pilot study, patients with RVO following exposure to transient hypoxia demonstrated intolerance to hypoxia and were significantly different from healthy subjects in their response to hypoxia. A larger study is required to confirm these preliminary results.
Nonpenetrating Glaucoma Surgery with Goniosynechiolysis ab Interno: A Surgical Technique
Authors: Mirshahi A. , Scharioth G.B. 
Published: January 2018

Purpose To present a surgical technique for treatment of peripheral anterior synechiae (PAS or goniosynechiae) at the operative field during nonpenetrating glaucoma surgery. Methods After usual preparation of a superficial and a deep scleral flap with externalization of the Schlemm's canal and peeling the juxtacanalicular trabecular meshwork, the goniosynechia is transected by a spatula introduced to the anterior chamber through a paracentesis. A Descemet's window provides full visual control at the peripheral cornea at the basis of the superficial scleral flap. Results With this surgical technique, selective treatment of goniosynechiae is possible exactly at the area where creation of low outflow resistance is intended by the surgeon during nonpenetrating glaucoma surgery. Conclusions This technique enables the surgeon to perform nonpenetrating glaucoma surgery even in the presence of peripheral anterior synechiae.