bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal Topographic Changes after Scleral Buckling
Authors: Karimian F. , Moradian S. , Yazdani S. , Mashayekhy A. , Anisian A. , Kouhestani N. 
Published: January 2018

Purpose To evaluate corneal topographic changes and induced corneal astigmatism after scleral buckling (SB). Methods This interventional case series includes all patients who had undergone scleral buckling for rhegmatogenous retinal detachment (RRD) during a 1-year period. Patients were divided into four groups according to type and extent of scleral buckling which depended on the discretion of a retina specialist. Videokeratography was performed for all patients preoperatively and repeated 1 and 3 months after SB. Results Thirty-nine eyes of 39 patients (29 male, 74.7%) with mean age of 50.35±20 years (range 13–80) were finally analyzed. There was no statistically significant difference among the groups in terms of preoperative corneal astigmatism, surface regularity index (SRI), surface asymmetry index (SAI), mean keratometry (mean K), and potential visual acuity (P\A). Overall, preoperative mean K was 43.97±1.78 D, which reached 44.2±2.02 D and 43.92±2.16 D 1 and 3 months after the operation. Mean preoperative SRI was 0.58±0.4, which increased to 1.24±1.18 and 1.29±1.13 1 and 3 months after the operation respectively. Mean preoperative SAI was 0.39±0.21, which increased to 0.73±0.37 and 0.75±0.66 1 and 3 months after the procedure. Changes in SAI at 1 and 3 months following SB were significant (p values < 0.001); however, these postoperative values were not significantly different. Mean preoperative PVA was 0.07±0.75 logMAR (equivalent to 20/20) but decreased to 0.24±0.25 (equivalent to 20/30) and 0.27±0.29 (equivalent to 20/40) 1 and 3 months after SB, respectively. Conclusions Significant changes in corneal topographic indices including increases in SRI and SAI and a concomitant decrease in PVA may occur after SB procedures. These induced changes must be considered and appropriately addressed postoperatively to provide the best possible corrected vision.
Toxic Keratolysis from Combined use of Nonsteroid Anti-Inflammatory Drugs and Topical Steroids following Vitreoretinal Surgery
Authors: álvarez M.T. , Figueroa M.S. , Teus M.A. 
Published: January 2018

Purpose To evaluate the corneal complications associated with the combined use of nonsteroid anti-inflammatory drugs (NSAIDs) and topical steroids following vitreoretinal surgery. METHOD. Description of corneal lesions in three patients after vitrectomy with use of topical ketorolac and prednisolone acetate. Results Three eyes of three patients developed an atrophic central corneal ulcer with stromal thinning following a pars plana vitrectomy under local anesthesia. Lesions were asymptomatic and were found during a routine examination 2, 3, and 8 weeks after surgery, respectively. Surgical indications were as follows: a pre-retinal membrane, choroidal neovascularization, and massive uveal effusion following cataract surgery. Topical postoperative treatment was as follows: ketorolac 4 times a day, a combination of prednisolone acetate, polymyxin B, and neomycin 6 times a day, and 1% cyclopentolate 3 times a day. Suspension of ketorolac and ocular occlusion led to the resolution of corneal lesions between 2.5 and 3 months later, yielding a central superficial scarring, which showed no changes after a follow-up of 3 years. Conclusions Toxic keratolysis may appear as a secondary effect of the combined use of topical NSAIDs and steroids following vitreoretinal surgery and must be taken into account in the differential diagnosis of postoperative corneal lesions.
Molluscum Contagiosum in a Patient with no Risk Factors
Authors: Aranda R. Luque , Aranda I. Baquero , Hidalgo C. Salido , Garcia-Campos J. 
Published: January 2018

Purpose To report a case of molluscum contagiosum in a patient with no risk factors. Methods A 38-year-old patient with a tumor located in the lower eyelid that appeared 5 months previously was seen in the authors’ hospital. The lesion had grown slowly and appeared as a crateriform mass with elevated edges. It was surgically excised and the histopathology study confirmed the diagnosis of molluscum contagiosum. Risk factors were absent. Results The histopathologic study confirms the presence of eosinophilic inclusion bodies in the keratinocytes cytoplasm. Conclusions External evaluation of the lower lid lesion did not show the morphologic configuration of a molluscum contagiosum. A virus can be suspected if attention is paid to the margin of the eyelid and the patient's age.
Bilateral Cataract following Lightning Injury
Authors: Gupta A. , Kaliaperumal S. , Sengupta S. , Babu R. 
Published: January 2018

Purpose To report a case of bilateral cataract with posterior vitreous detachment induced by lightning injury. Methods A case report of 30 year old man injured by lightning. Results The patient developed visually significant bilateral cataract after four years of the initial insult on the scalp. The exit wound was noted on the right foot. Fundus evaluation after cataract extraction revealed posterior vitreous detachment. Conclusions Lightning can induce various ocular complications. Decrease in vision due to cataract is usually seen years after the initial lightning injury as the initial changes are in the mid-periphery and often missed in the acute setting. Posterior vitreous detachment induced by lightning can rarely lead to retinal tear formation and subsequently retinal detachment. The severity of entry and exit may not give a true picture of the internal organ damage.
Late Effect of External Eye Irradiation on Choroidal Circulation
Authors: Peiretti E. , Slakter J.S. , Wu S. , Iranmanesh R. , Yannuzzi L.A. 
Published: January 2018

Purpose To report two cases of atypical late onset radiation chorioretinopathy occurring 15 and 25 years post exposure and the indocyanine green (ICG) angiographic findings in these patients. Methods Clinical examination and imaging including fluorescein and ICG angiography were performed. RESULT. Fundus examination of the first patient revealed microangiopathy with intraretinal hemorrhages, lipid exudation, telangiectatic and aneurysmal capillary changes. Indocyanine green angiography showed an apparent chorioretinal anastomosis and delayed perfusion of the choriocapillaris. Fundus examination of the second patient revealed a pigment epithelial detachment and retinal pigment epithelial changes. Indocyanine green angiography showed atypical, tortuous, dilated, choroidal vessels as well as areas of hypoperfusion. Both patients had multiple dot-like hyperfluorescent spots in the midphase of the ICG angiogram. Conclusions External radiation exposure may lead to both retinal and choroidal alterations which may be independent events and which may manifest after a long period of quiescence. Furthermore, ICG angiography appears to be a useful diagnostic tool to study the alterations of the choroid following external eye irradiation.
Necrotic Uveal Melanoma with Orbital Inflammation
Authors: Blasi M.A. , Giammaria D. , Balestrazzi E. 
Published: January 2018

Purpose Extraocular extension of uveal melanoma can be accompanied by proptosis and signs of orbital inflammation but this clinical presentation is an uncommon feature if the tumor is solely intraocular. Methods Case report. Results The authors describe a patient with a medium-sized necrotic uveal melanoma, without extraocular spread, presenting with the clinical picture of orbital cellulitis. Conclusions The ophthalmologist needs to be aware of this uncommon presentation of uveal melanoma, and not assume the presence of proptosis and orbital inflammation as signs of extraocular extension.
Inaccuracy of Diagnosis in a Cohort of Patients on the Waiting List for Dacryocystorhinostomy When the Diagnosis Was Made by Only Syringing the Lacrimal System
Authors: Beigi B. , Uddin J.M. , McMullan T.F.W. , Linardos E. 
Published: January 2018

Purpose Accurate identification of the factors contributing to epiphora is essential in directing appropriate management and treatment strategies. The authors applied a methodical strategy of assessment for epiphora to patients who were already on the waiting list for dacryocystorhinostomy (DCR). The findings were compared to the original findings. Methods Forty-four eyes of 35 patients listed for DCR were re-examined. All canaliculi were examined using four tests: dye disappearance, Jones 1 (dye retrieval), probing using Bowman probes, and syringing of the nasolacrimal duct (NLD) under local anesthesia. Some patients were examined using an endocanalicular mini-endoscope. Patients with NLD obstruction underwent DCR and those with canalicular and NLD stenosis underwent intubation of the lacrimal system-canaliculus, lacrimal sac, and nasolacrimal duct-using silicone stents. The authors refer to this as canaliculodacryocystoplasty (CDCP). The patients were assessed for symptoms of epiphora at 12 months. Forty-four eyes had been listed for DCR. They had been originally diagnosed, by means of lacrimal syringing, as NLD obstruction (24 eyes) or stenosis (12 eyes), and functional blocks (8 eyes). Results Four out of the original 44 planned DCR surgeries were performed after re-evaluation. After re-examination, 28 lacrimal systems were found to have canalicular stenosis, 4 NLD stenosis, 4 NLD obstruction, 4 punctal phimosis, 3 ocular surface disease, and 1 patient was asymptomatic. Twenty-eight lacrimal systems underwent CDCP, 4 underwent DCR, 4 had punctoplasty, and 4 had probing alone. Three had treatment for ocular surface disease and one patient required no treatment. After a follow-up of 12 months, 41 (93%) systems had improvement or were free of their epiphora. Conclusions Syringing of the lacrimal apparatus may result in a high false positive diagnosis of NLD obstruction. Canalicular pathology is not uncommon in this cohort of patients and may be underdiagnosed.
Role of Central Corneal Thickness on Baseline Parameters and Progression of Visual Fields in Open Angle Glaucoma
Authors: Shah H. , Kniestedt C. , Bostrom A. , Stamper R. , Lin S. 
Published: January 2018

Purpose To evaluate the relationship of central corneal thickness (CCT) to baseline visual field parameters and visual field progression in patients with primary open-angle glaucoma (POAG). Methods Charts of consecutive patients with POAG were reviewed to obtain visual field data. Visual field was measured by standard threshold static perimetry. Variables analyzed included mean deviation (MD) and pattern standard deviation (PSD). Results A total of 121 eyes examined over 4 years were evaluated. A significant negative relationship between CCT and PSD (correlation coefficient: −0.02, p<0.05) was found. Analyses comparing CCT to change in PSD and MD (visual field progression) were statistically not significant. Conclusions Patients with thinner corneas initially present with a greater visual field defect, indicating that thin corneas may contribute to advanced glaucomatous damage at the time of diagnosis. However, CCT does not seem to be a significant risk factor for progression of the disease.
Transscleral Red Laser Cyclophotocoagulation for the Treatment of Therapy-Resistant Inflammatory Glaucoma
Authors: Puska P.M. , Tarkkanen A.H.A. 
Published: January 2018

Purpose To evaluate in a retrospective study the long-term usefulness of red 647 nm krypton and 670 nm diode laser for transscleral contact cyclophotocoagulation (CPC) in the treatment of therapy-resistant inflammatory glaucoma. Methods The authors treated 48 eyes of 38 consecutive patients (mean age 36.8 years, range 6–81 years) with therapy-resistant inflammatory glaucoma secondary to chronic uveitis (45/48), chronic scleritis (1/48), or combined scleritis with keratouveitis (2/48) using transscleral red 647 nm Krypton or 670 nm Diode laser. All eyes had failed maximum tolerated medical therapy and 19/48 (40%) eyes also previous antiglaucoma surgery. Laser power at the scleral surface was 0.35 to 0.45 W and the application time 10 seconds each. The follow-up was 42.8± 40.0 (range 2–145) months. Results The mean preoperative intraocular pressure (IOP) of 35.6±8.1 mmHg fell to 6–21 mmHg level in 75% after one or repeated CPC. Among adult patients this was achieved in 85%, among children in 54%. More than one treatment was needed in 52%. No cases of hypotony, phthisis bulbi, or other devastating complications occurred. Conclusions Transscleral CPC using red 647 nm krypton or 670 nm diode laser is an effective and well-tolerated procedure for the treatment of therapy-resistant inflammatory glaucoma in adults. CPC can be considered before incisional antiglaucoma surgery with a shunt or antimetabolites is undertaken
Pupil Size Influence on the Intraocular Performance of the Multifocal AMO-Array Intraocular Lens in Elderly Patients
Authors: Salati C. , Salvetat M.L. , Zeppieri M. , Brusini P. 
Published: January 2018

Purpose To study the relationship between pupil size and AMO-Array multifocal intraocular lens (MIOL) performance in a population of elderly patients. Methods This prospective trial included 62 patients (mean age 76 years; range 70 to 86) undergoing bilateral cataract phacoemulsification and MIOL (AMO-Array SA-40N, Allergan) implantation. Patients were divided into two groups based on preoperative pupil diameter: small pupil group (pupil size of 2.5–2.9 mm; 45 subjects) and large pupil group (pupil size of 3–5 mm; 17 subjects). The analysis included uncorrected (UC) and best-corrected (BC) near and distance visual acuity (VA), spectacle dependence, and photic phenomena complaints (postoperative follow-up 16.6±6.2 months; range 11–26 months). Results Patients in the small pupil group showed postoperatively significantly higher distance UCVA and BCVA, but lower near UCVA compared to those in the large pupil group (Mann-Whitney test, p≤0.02). Patients with small pupils also tended to: be more (not statistically significant) spectacle independent for distance (73.3% versus 47.1%) and spectacle-dependent for near vision (55.6% versus 28.4%); report significantly less photic phenomena complaints (37.8% versus 93.1%, chi-square test, p<0.001); and, more satisfied with the surgery (95.5% versus 76.5%). Posterior capsular opacification (PCO) was observed in 19.4% of the patients. Conclusions Bilateral AMO-Array MIOL implantation in elderly patients seems to be an effective and safe surgical procedure that improves distance and near UCVA, providing spectacle independence in many cases. The use of these MIOLs, however, can induce photic phenomena and cause PCO. Patients with small preoperative pupils (<3 mm) presented less photic phenomena complaints and expressed a higher visual outcome satisfaction after surgery.
Phacoemulsification on Previously Vitrectomized Eyes: Results of a 10-Year Period
Authors: Szijártó Z. , Haszonits B. , Biró Z. , Kovács B. 
Published: January 2018

Purpose To provide an overview of intraoperative and postoperative complications during phacoemulsification cataract surgery and to evaluate the visual results in patients having pars plana vitrectomy (PPV) with 10 years of follow-up. Methods Retrospective evaluation of intraoperative and postoperative complications and postoperative visual results in 134 consecutive patients who underwent phacoemulsification after PPV. Of 11,498 eyes treated with phacoemulsification, 143 (1.2%) had previous PPV during the 10-year period (January 1, 1995-December 31, 2004). A total of 134 eyes were included in this study. Results The phacoemulsification procedure seemed to be difficult where there was a deep or fluctuating anterior chamber (93%) and primary posterior capsule opacification (19%). The most frequent intraoperative complications were posterior capsule rupture (9%) and incomplete capsular rhexis (5%). Postoperative intraocular pressure elevation (7%), retinal detachment (6%), and posterior capsule opacification (8%) occurred most frequently during the mean follow-up period of 18.2 months (1.5–110 months). Best-corrected visual acuity (BCVA) increased two or more Snellen E lines in 55% of the cases or became better than or equal to 0.5 in 10% of the cases. Conclusions Despite the well-known difficulties encountered in vitrectomized eyes such as zonular damage, increased mobility of the lens-iris diaphragm, and altered intraocular fluid dynamics, phacoemulsification proved to be a safe procedure in the hands of experienced surgeons.
Causes of Enucleation in Northern India (1995–2005)
Authors: Bal A. , Mohan H. , Chabbra S. , Sood S. 
Published: January 2018

Purpose There are limited data concerning the reasons for surgical removal of eyeball. The present retrospective study was undertaken to evaluate the frequency of diseases requiring surgical removal of eyeball and to study the histopathologic changes in these specimens. Methods Forty-eight surgical eyeball specimens received between January 1999 and June 2005 were included in the study. Age, sex, and clinical diagnoses were recorded in each case. Specimens were classified on the basis of surgical procedure. Gross and microscopic findings were noted for all the specimens. Results Between January 1995 and June 2005, there were 139,092 outpatients, 6,574 hospital admissions, 12,044 ophthalmic operations, and a total of 48 enucleations in 47 patients. Of these 47 patients, 24 were male and 23 female with almost equal male:female ratio. Right eye was involved in 29 cases while left was involved in 17 cases. Bilateral eye involvement was seen in one case. Surgical specimens included enucleation (28 cases, 58.3%), exenteration (12 cases, 25%), and evisceration (8 cases, 16.6%). On histopathologic examination, the lesions were categorized into two broad groups: neoplastic (8 cases, 16.6%) and non-neoplastic (40 cases, 83.4%). Both groups were further subcategorized and correlated with clinical diagnosis. Conclusions In our setting, non-neoplastic lesions are the main cause of eyeball surgery, as compared to the West, where trauma followed by neoplasms constitute important causes. Pathologic examination of eyeballs is a must for proper postoperative management of the patient.
Contraceptives, Cerebral Vein Thrombosis, and Choked Discs
Authors: Reddy A.R. , Backhouse O.C. 
Published: January 2018

Purpose To raise awareness of the importance of prompt and appropriate imaging in patients presenting with signs and symptoms suggestive of idiopathic intracranial hypertension. Methods Case report with diagnostic tests and discussion of management options. Results A 15-year-old girl presenting with bilateral optic disc swelling was noted to have extensive thrombosis of intracerebral venous sinuses with the clot extending along the internal jugular vein as inferior as the root of the neck demonstrable on magnetic resonance venography. Conclusions Ophthalmologists should be vigilant in obtaining appropriate imaging in cases of optic disc swelling.
An Unusual Cause of Central Retinal Artery Occlusion: Acquired Immunodeficiency Syndrome
Authors: Erdol H. , Turk A. , Caylan R. 
Published: January 2018

Purpose In patients with acquired immunodeficiency syndrome (AIDS), disturbances in the circulation of retinal vessels are mostly encountered at the microvascular level. Rarely observed large retinal vessel occlusions frequently affect retinal veins. Methods A 32-year-old woman was admitted to the authors' clinic with sudden loss of vision. Her clinical and ophthalmologic examinations and laboratory tests were carried out and the results were evaluated. Results The patient's history revealed a diagnosis of AIDS established 5 years ago. Her corrected visual acuity was limited to light perception in the right eye and 20/60 in the left eye. There was afferent pupillary defect in the right eye. Posterior segment examination demonstrated central retinal artery occlusion in the right eye and cotton-wool spots in the left eye. The clinical examination and laboratory test results did not reveal any comorbid disease state that can contribute to this presentation. Conclusions As thrombi may develop in patients with human immunodeficiency virus infection, they should be closely followed up for the development of vasoocclusive disease.
Prospective Randomized Comparison of 1-Day versus 3-Day Application of Topical Levofloxacin in Eliminating Conjunctival Flora
Authors: Ta C.N. , Sinnar S. , He L. , Myung D. , De Kaspar H. Miño 
Published: January 2018

Purpose To compare efficacy of a 1-day versus 3-day application of topical levofloxacin in reducing ocular surface bacteria. Methods In this prospective randomized controlled trial, 100 volunteer patients (50 per group) were assigned to receive topical 0.5% levofloxacin four times daily for 1 day or 3 days. Conjunctival cultures were obtained prior to (T0) and after the application of antibiotics (T1). Additionally, all patients received topical levofloxacin at 5-minute intervals for three applications (T2), followed by two drops of topical 5% povidone-iodine (T3). Conjunctival cultures were obtained at timepoints T2 and T3. Results A 1-day application of topical levofloxacin significantly reduced (p = 0.0004) the number of eyes with positive conjunctival cultures from 41 eyes (82%) to 23 eyes (46%). Similarly, a 3-day application significantly reduced (p = 0.0001) the positive culture rate from 37 eyes (74%) to 17 eyes (34%). Two drops of povidone-iodine further reduced the positive culture rate for both groups to 20% (10 eyes for each group). There was no significant difference in positive culture rate between the 1-day and 3-day groups at T0 (p = 0.4689), T1 (p = 0.3074), T2 (p = 0.6706), or T3 (p = 1.000). Conclusions The application of topical 0.5% levofloxacin for 1 or 3 days significantly reduced the number of eyes with positive conjunctival cultures. The addition of 5% povidone-iodine further eliminated bacteria from the conjunctiva. The application of levofloxacin for 1 day appears to be as effective as a 3-day application.
Methotrexate for Uveitis Associated with Juvenile Idiopathic Arthritis: Value and Requirement for Additional Anti-Inflammatory Medication
Authors: Heiligenhaus A. , Mingels A. , Heinz C. , Ganser G. 
Published: January 2018

Purpose To study the value of methotrexate (MTX) and the requirement for additional anti-inflammatory drugs for the treatment of severe chronic iridocyclitis associated with juvenile idiopathic arthritis (JIA). Methods Institutional study of 35 consecutive patients with JIA started on MTX as the single systemic immunosuppressive drug for the treatment of associated iridocyclitis. The clinical epidemiologic data, course of visual acuity (VA), development of complications, and the need for additional anti-inflammatory drugs were analyzed. Results Mean follow-up with MTX treatment was 27.6 months. Uveitic complications were present in 31 patients before MTX treatment. With MTX, quiescence of uveitis was obtained with (n=21) or without (n=4) additional topical steroids. Additional systemic immunosuppressive drugs were required in another 7 patients: cyclosporine A (n=4), azathioprine (n=1), infliximab (n=1), or etanercept (n=1). Three patients had active uveitis at the end of the follow-up period. During MTX therapy, uveitis first developed in the unaffected fellow eyes in 2 patients, and secondary glaucoma or ocular hypertension occurred in 7 patients. The VA deteriorated in 6, improved in 13, and was stable in the remaining eyes. Conclusions The data suggest that MTX is very effective in controlling inflammation of uveitis in patients with JIA. However, additional topical steroids or systemic immunosuppressive drugs are often required.