bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrophysiological Approaches for Early Detection of Glaucoma
Authors: Bach M. 
Published: January 2018

Purpose While elevated intraocular pressure (IOP) is a major risk factor for glaucoma, only about 1% of patients with 25 mmHg develop the condition each year. Since a sizeable proportion of the ganglion cells are already lost when the visual field losses are apparent, the aim is to identify patients with elevated IOP in whom glaucoma damage is incipient before visual field changes occur. Methods This report concerns early diagnosis of glaucoma with electrophysiological techniques, rather than with monitoring the disease using various available psychophysical and morphological methods. Visual electrophysiology offers a wide range of tools to assess function layer-by-layer along the visual pathway. Their clinical value for early detection of glaucoma will be discussed. The pattern electroretinogram (PERG), a direct functional indicator of retinal ganglion cell function, is markedly affected by glaucoma, and in longitudinal studies the PERG correctly indicated eyes at risk before manifest glaucoma occurred. Conclusions Consequently, this report will concentrate on the PERG. Less proven, but promising measures like the “photopic negative response”, the motion visually evoked potential (VEP) and the multifocal VEP will also be touched upon.
Evaluation of Glaucomatous Visual Field Loss with Locally Condensed Grids Using Fundus-Oriented Perimetry (FOP)
Authors: Schiefer U. , Malsam A. , Flad M. , Stumpp F. , Dietrich T. J. , Paetzold J. , Vonthein R. , Knorr M. , Denk P.O. 
Published: January 2018

Purpose We compared detection rates of glaucomatous visual field defects (VFDs) between a conventional rectangular stimulus grid and locally condensed test point arrangements in morphologically suspicious regions. Methods Humphrey Field Analyzer model 630 (HFA I, program 30-2 with a rectangular 6° × 6° grid) was used as the conventional perimetric method. Individual local test-point condensation was realized by fundus-oriented perimetry (FOP) on the Tuebingen Computer Campimeter (TCC). Results Of a total of 66 glaucoma patients, or suspected sufferers, 23 showed normal findings and 27 showed pathological findings with both methods. In 15 cases we found normal visual fields in HFA 30-2, whereas FOP revealed early glaucomatous functional damage. Only one case showed pathological HFA results, while FOP was normal. Detection rates of VFDs significantly differed between the two methods (p < 0.001; sign test). Conclusions FOP, using individually condensed test grids, significantly increases detection rates of glaucomatous VFDs in morphologically suspicuous areas compared with a conventional HFA 30-2 technique using equidistant rectangular (6° × 6°) test point arrangements.
Brimonidine (Alphagan®): A Clinical Profile Four Years after Launch
Authors: David R. 
Published: January 2018

The early information on the clinical efficacy, safety, and tolerability of brimonidine 0.2% were obtained from studies that compared brimonidine monotherapy with timolol and betaxolol. These studies showed its intra-ocular pressure lowering efficacy to be comparable with timolol and superior to betaxolol. The data from the timolol studies showed consistent results after four years. These findings have been confirmed by additional studies in the clinical setting. More recently, several clinical trials have been completed investigating the role of brimonidine as adjunctive medication to beta-blockers and as replacement therapy to other intraocular pressure lowering compounds. When added to beta-blockers, brimonidine is superior to dorzolamide, similar in efficacy but better tolerated than pilocarpine, and more predictable than latanoprost. Data from replacement studies have indicated that there may be advantages in replacing rather than adding medications in the treatment of glaucoma.
Corneal Thickness in Trachomatous Dry Eye
Authors: Guzey M. , Satici A. , Karadede S. 
Published: January 2018

Purpose To investigate the effect of severe desiccation on corneal thickness in scarring trachoma by comparing the thickness of normal and trachomatous dry eye corneas. Methods Ultrasonic pachymetry was used to measure the corneal thickness at nine points in the central and peripheral cornea (superior, superonasal, nasal, inferonasal, inferior, inferotemporal, temporal, superotemporal) in 45 eyes of 27 patients with trachomatous dry eye and 54 eyes of 31 normal subjects. Results The average thickness of the nine sites in the central and midperipheral cornea was significantly less in trachomatous dry eyes than normal eyes. The superior cornea was the thickest area in both groups, measuring 574.03 ± 31.62 μm in trachomatous dry eyes and 611.33 ± 34.99 μm in normal eyes (p<0.001). The centre of the cornea was the thinnest, measuring 510.43 ± 32.12 μm in trachomatous dry eyes and 546.27 ± 36.20 μm in normal eyes (p<0.001). Conclusions The thickness of the central and midperipheral cornea was significantly reduced in patients with trachomatous dry eye. The chronic state of severe desiccation, tear film instability and increased immune activation in trachomatous dry eye may contribute to this thinning.(Eur J Ophthalmol 2002; 12: 18–23)
Outcome of Abducens Nerve Paralysis in Patients with Nasopharyngeal Carcinoma
Authors: Ílhan Ö. , Şener E.C. , Özyar E. 
Published: January 2018

Purpose The objective of this study was to investigate the incidence, management and outcome of patients with nasopharyngeal carcinoma (NPC) who developed VIth nerve palsy. Methods Between December 1993 and December 1999, we investigated retrospectively the charts of 166 patients with NPC. Results Twenty-eight of 166 patients (16.8%) had cranial nerve involvement at the time of the diagnosis of NPC. Sixteen (57.2%) were identified as having abducens nerve palsy. In 25% abducens nerve palsy was the presenting symptom. Three patients were able to compensate for their diplopia after prism correction or botulinum toxin-A injection, and six (50%) completely recovered from abducens nerve palsy after either radiotherapy or chemotherapy. Conclusions Abducens is the most common cranial nerve involved in NPC, radiotherapy and or chemotherapy relieves the paralysis in half the patients. Prism correction or botulinum toxin-A injection are effective non-invasive procedures for patients with significant diplopia.
Vitreous Hemorrhage following Phakic Anterior Chamber Intraocular Lens Implantation in Severe Myopia
Authors: Nuzzi G. , Cantù C. 
Published: January 2018

Purpose To describe two cases of vitreous hemorrhage following phakic anterior chamber lens (AC-IOL) implantation in high myopia. Case Report In case 1, hemorrhage developed one month after surgery, without retinal involvement, and visual acuity (VA) resulted 20/200 after pars-plana vitrectomy (PPV). In Case 2, vitreous hemorrhage was complicated by retinal detachment (RD). PPV and silicone oil injection were performed, with AC-IOL removal and cristalline lens extraction. After 2 years the retina was attached and VA was 20/80. Discussion Only few cases of RD, posterior uveitis and endophthalmitis are reported following phakic AC-IOL implant. Vitreous hemorrhage could represent an additional posterior segment complication. Intraoperative manoeuvres, hypotony-induced posterior vitreous detachment and/or peripheral retina traction could play a role in engendering this complication in highly myopic eyes.
Effects of Melatonin, Vitamin E and Octreotide on Lipid Peroxidation during Ischemia-Reperfusion in the Guinea Pig Retina
Authors: Çelebi S. , Dilsiz N. , Yilmaz T. , Kükner A. Sahap 
Published: January 2018

Purpose The purpose of this study is to provide evidence that free radical damage is a component of retinal ischemia-reperfusion (I/R) injury, and to determine whether melatonin, vitamin E and octreotide can protect the retina from this injury. Methods The right eyes of 50 male guinea pigs weighing 500–600 g were used. The animals were randomly assigned to group 1 (control), group 2 (I/R), group 3 (melatonin + I/R), group 4 (vitamin E + I/R) and group 5 (octreotide + I/R). Groups 3, 4 and 5 received four subcutaneous injections with a 6-h interval for a total daily dose of 10 mg/kg melatonin, 150 mg/kg vitamin E and 22 μg/kg octreotide. The first dose of each substance was administered 5 minutes before retinal ischemia, which was induced for 1.5 hours, followed by reperfusion for 24 hours. All three substances were repeated for 6, 12 and 18 hours during reperfusion. The animals were killed at 24 hours of reperfusion. Retinas were isolated and processed for the quantification of malondialdehyde (MDA). Results The compounds had the following relationships: melatonin more than vitamin E more than octreotide in preventing retinal damage by ischemia-reperfusion. All three gave significant protection against the formation of MDA (10.4±2.3, 12.4±2.4, 13.9±1.5 nmol/100 mg tissue wet weight, respectively) compared to the control (3.7±1.3 nmol/100 mg tissue wet weight) and I/R groups (22.7±6.2 nmol/100 mg tissue wet weight). Conclusions This study demonstrates the inhibitory effect of melatonin, vitamin E and octreotide on MDA levels during retinal ischemia-reperfusion injury.
Long-Term Visual Acuity after Argon Green Laser Photocoagulation of Juxtafoveal Choroidal Neovascularization in Highly Myopic Eyes
Authors: Ruiz-Moreno J.M. , Montero J.A. 
Published: January 2018

Purpose To evaluate visual outcomes in patients with high myopia after juxtafoveal choroidal neovascularization (CNV) treated with argon green laser photocoagulation. Patients and Methods We retrospectively analyzed 23 eyes of 21 patients with high myopia (>6.0 diopters and/or axial length >26 mm) with juxta foveal CNV treated with direct Argon green laser photocoagulation. Mean age at diagnosis was 49.08±12.20 years (range, 29 to 71). Mean follow-up was 54.26±26.18 months (range 18 to 96). Results Best corrected visual acuity (BCVA) before treatment was 0.09±0.10 (range, 0.01 to 0.40). Two months after treatment it was 0.14±0.12 (0.01 to 0.6), significant difference (p=0.02, Student's t-test for paired data) and after six months 0.19±0.14 (0.01 to 0.5) (p=0.0002). Mean BCVA decreased with follow-up, to 0.19±0.15 (0.01 to 0.4) after two years, 0.16±0.15 (0.01 to 0.5) after three years and 0.16±0.19 (0.01 to 0.7) after four years, with no significant improvement after the third year (p=0.04). In two cases CNV reappeared. Conclusions Direct argon green laser photocoagulation in high-myopia juxtafoveal CNV can improve BCVA initially for between two and 24 months. The improvement fades with time, and is no longer significant after the third year.
Multifocal Choroiditis after Allogenic Bone Marrow Transplantation
Authors: Alvarez M.T. , Hernáez J.M. , Ciancas E. , Figueroa M.S. 
Published: January 2018

Purpose To describe the clinical manifestations of multifocal choroiditis presumed to be secondary to allogenic bone marrow transplantation after development of self-tolerance to chronic graft-versus-host disease (GVHD). Methods Case report. A 17-year-old male who received an allogenic bone marrow transplant (BMT) from his HLA-identical sister. Results One year after BMT, grade II chronic GVHD developed. Two years later, vision deteriorated to 20/50 R.E. and 20/400 L.E. Ophthalmoscopic examination showed multiple chorioretinal punched-out scars throughout the posterior pole and mid-periphery of both eyes. Fluorescein angiography showed four choroidal neovascular membranes (CNVMs) in the right eye that were surgically removed, and a subfoveal disciform scar in the left eye. Conclusions Multifocal choroiditis is a possible complication related to allogenic BMT. It should be included as a late cause of BMT-associated choroidopathy. Surgical removal of vision-threatening CNVMs is a reasonable approach.
Phacofragmentation without Perfluorocarbon Liquid for Dislocated Crystalline Lenses or Lens Fragments after Phacoemulsification
Authors: Yao K. , Shentu X. , Jiang J. , Du X. 
Published: January 2018

Purpose To evaluate the clinical outcome of vitrectomy with phacofragmentation without perfluorocarbon liquid (PFCL) in the management of dislocation of the crystalline lens, caused by trauma, hereditary disorders, or hypermature cataracts, and lens fragments due to phacoemulsification. Methods A prospective study was conducted to evaluate 30 eyes of 29 patients who had undergone standard pars plana vitrectomy with phacofragmentation without PFCL in the vitreous cavity, for the removal of dislocated crystalline lenses or lens fragments, from January 1998 to July 2000. All cases were followed for more than six months. Results Final best corrected visual acuity of 0.5 or better increased from 0% preoperatively to 36.7% postoperatively, and 0.2 or better rose to 76.7%. The mean IOP was significant reduced, from 26.35 mmHg to 12.75 mmHg. No intraoperative complications occurred. Although two eyes (6.7%) developed retinal detachment, one (3.3%) had cystoid macular edema (CME) and one (3.3%) had a transient intraocular pressure increase (to 25 mmHg) postoperatively, all others had a favorable outcome. Conclusions Standard pars plana vitrectomy with phacofragmentation without PFCL in the vitreous cavity is a safe, simple, and effective method for removing a dislocated crystalline lens or lens fragments, with good visual outcome.
Comparison of Emedastine 0.05% or Nedocromil Sodium 2% Eye Drops and Placebo in Controlling Local Reactions in Subjects with Allergic Conjunctivitis
Authors: Orfeo V. , Vardaro A. , Lena P. , Mensitieri I. , Tracey M. , De Marco R. 
Published: January 2018

Purpose To assess the efficacy of nedocromil sodium 2% eye drops and emedastine difumarate 0.05% eye drops in controlling the ocular allergic reaction induced by conjunctival allergen challenge (CAC). Methods Thirty subjects with a personal history of allergic conjunctivitis were enrolled (first visit). At the second visit each subject randomly received emedastine 0.05% or nedocromil 2% in one eye and placebo in the other eye. Five minutes after the medication the offending allergen was instilled in both eyes. Ocular redness and itching were evaluated according to a standardized scoring system at 3, 10 and 20-minute intervals after instillation of the allergen. After one week (third visit) the whole procedure was repeated using the placebo in the eye used as control during second visit and one of the trial drug that was not used at second visit in the other eye (either emedastine or nedocromil). Results Emedastine 0.05% and nedocromil 2% eye drops were more effective than placebo in controlling ocular redness and itching (p<0.01). Emedastine was more effective (p<0.01) than nedocromil in alleviating redness and itching 3 and 10 minutes after application of the allergen. Conclusions Emedastine 0.05% appeared superior to nedocromil 2% in producing immediate relief when subjects with allergic conjunctivitis were exposed to the offending allergen.
Risk Factors for Anatomical Success and Visual Outcome in Patients Undergoing Silicone Oil Removal
Authors: Jiang F. , Krause M. , Ruprecht K. W. , Hille K. 
Published: January 2018

Purpose To define risk factors for anatomical success and visual outcome in patients undergoing removal of silicone oil. Methods This retrospective study included patients who had silicone oil removed at this hospital between 1996 and 2000. All were followed for at least six months. Patients with recurrent retinal detachment after silicone oil removal were compared with patients without this complication. We also compared patients whose vision improved or stabilized with patients whose vision deteriorated. Risk factors for anatomical success and visual outcome were identified. Results We analysed 94 eyes of 92 patients with silicone oil removal. Nineteen eyes (20%) had recurrent retinal detachment, and in 30 eyes (32%), the vision deteriorated after removal of the oil. Initial vision less than ambulatory vision, initial pathology of giant retinal tears and recurrent retinal detachment, postoperative hypotony and postoperative epiretinal membrane occurred more frequently in eyes with than without recurrent retinal detachment. Pre- and postoperative hypotony, postoperative epiretinal membranes and postoperative recurrent retinal detachment were also more frequent in eyes with deteriorated vision. Conclusions When treating giant retinal tears or recurrent retinal detachments with silicone oil tamponade, surgeons and their patients need to be aware of the higher possibility of unfavorable results, particularly when the initial vision is less than ambulatory vision. The presence of risk factors before and after silicone oil removal should remind surgeons of the higher risk profile of this particular surgery.
Exposure Keratopathy following Phacoemulsification under Local Anaesthesia
Authors: Dinakaran S. 
Published: January 2018

Purpose Report a series of patients with exposure keratopathy following phacoemulsification under local anaesthesia. Methods A case series. Results Four patients were found to have exposure keratopathy within hours after surgery resulting in a visit to the casualty on the day of surgery. Conclusions One should anticipate the possibility of lagophthalmos and assess the blink reflex at the end of surgery. If the reflex is poor, patching the eye or taping the lids should be undertaken to prevent this complication.
Intraoperative Capsular Block Syndrome Masquerading as Expulsive Hemorrhage
Authors: Yip C.-C. , Au Eong K.-G. , Yong V.S.H. 
Published: January 2018

Purpose To describe the clinical features of two cases of intraoperative capsular block syndrome (CBS) mimicking expulsive hemorrhage. Setting The Eye Institute at Tan Tock Seng Hospital, National Healthcare Group, Singapore. Methods Two case reports. Results Two patients underwent phacoemulsification under retrobulbar anesthesia and developed severe globe hardening, shallow anterior chamber (AC) and uveal prolapse intra-operatively after hydrodissection. The AC spontaneously deepened in one patient and the operation was converted to extracapsular cataract surgery on suspicion of CBS with posterior capsule rupture, which was confirmed after nucleus expression; anterior vitrectomy was done and an anterior chamber lens implanted. At the eight post-operative month, his best-corrected visual acuity was 6/24 secondary to an epiretinal membrane in the macula. CBS, however, was not recognized in the other patient and caused posterior lens dislocation during attempted phacoemulsification. This patient underwent vitrectomy, removal of the lens nucleus and insertion of a posterior chamber intraocular lens in the sulcus the next day. His best-corrected visual acuity was 6/9 at the tenth postoperative month. Conclusions Intraoperative CBS may mimic expulsive hemorrhage. Early diagnosis of this condition and proper management optimizes the visual outcome.
Ultrasound Measurement of the Horizontal External Eye Muscles in Patients with Thyroid Disease. is Orbital Involvement Associated with Thyroid Autoantibodies?
Authors: Zimmermann-Belsing T. , Feldt-Rasmussen U. , Fledelius H. 
Published: January 2018

Purpose To describe ophthalmic findings with emphasis on exophthalmometry and ultrasonic assessment of extraocular eye muscle diameter in a consecutive group of females with Graves' disease (GD), compared with healthy controls and patients with other thyroid diseases. We also investigated the relationship with biochemical markers of thyroid autoimmunity such as TSH receptor antibodies (TRAb) and anti-thyroid peroxidase antibodies (anti-TPO). Methods Seventy adult women (age 26–74 years) with various types of thyroid disease consecutively entered the study at a tertiary referral center for thyroid-associated ophthalmopathy (TAO). Twenty-three had long-standing GD with TAO. Clinically, TAO was mainly absent in 22 with newly diagnosed GD and in seven with relapse of GD. Nine with Hashimoto's thyroiditis and nine with multinodular goiter were included for comparison and 18 healthy females served as controls. A full ophthalmic status included B-scan ultrasonic assessment of the four horizontal rectus muscle thicknesses, and a clinical NOSPECS score was attempted for each. Results and Conclusions Besides higher NOSPECS scores, the TAO subgroup had higher exophthalmometry and muscle thickness. The GD groups without significant TAO also scored higher in these ratings compared to controls. Hertel recordings, NOSPECS and muscle thicknesses were all correlated in GD but showed no correlation to thyroid antibodies (TRAb and anti-TPO). Thus, the muscle thickness did not correlate with thyroid autoimmune activity. Nevertheless, we found extraocular muscle assessment useful since a) thicker muscles were usually found in patients with GD, with or without evidence of TAO, and b) other space-occupying orbital lesions could be excluded, thereby reducing the need for the more elaborate imaging techniques (CT, MRI, etc.).
Refractive Lens Exchange for Correction of High Myopia
Authors: Gabrić N. , Dekaris I. , Karaman Ž. 
Published: January 2018

Purpose To evaluate the efficiency and safety of refractive lens exchange for the correction of high myopia. Methods We made a prospective study of the results of refractive lens exchange in 72 eyes that had undergone this surgical procedure between January 1996 and January 2001. Lens extraction by phacoemulsification was done by one surgeon on 34 patients. Follow-up was five months to five years (mean 48 months). The postoperative refractive target was emmetropia or a low degree of myopia. We compared pre- and postoperative uncorrected visual acuity, and preoperative best-corrected visual acuity with postoperative uncorrected visual acuity. Intra- and postoperative complications were recorded. Results In 72.2% of the eyes best-corrected visual acuity (BCVA) was ≥ 0.5 before surgery. Four years after refractive lens exchange, uncorrected visual acuity (UCVA) was ≥ 0.5 in 58.3% of eyes, and the proportion of eyes with BCVA ≥ 0.5 increased to 83.3%. The sphere was fully corrected in 70.8% of cases, remained within 1.0 D of emmetropia in 87.5% and within 2.0 D of emmetropia in 95.8%. Posterior capsule opacification developed in 22 eyes (30.5%)and was treated with neodymium:YAG (Nd:YAG) laser capsulotomy Cystoid macular edema with retinal detachment occurred in one eye. No wound leakage or eye infections were observed during five years' follow-up. Conclusions Refractive lens exchange seems to be an effective alternative for the correction of high myopia, helping people over 40 years of age regain their distant vision.
A Comparison of Endophthalmitis after Phacoemulsification or Extracapsular Cataract Extraction in a Socio-Economically Deprived Environment: A Retrospective Analysis of 2446 Patients
Authors: Kalpadakis P. , Tsinopoulos I. , Rudolph G. , Schebitz K. , Froehlich S.J. 
Published: January 2018

Purpose To assess which cataract operation technique involves least risk of postoperative endophthalmitis, when performed in a population living in poor hygiene conditions. Methods This retrospective clinical study evaluated 2446 cases at the Eye Clinic of the Komotini General Hospital, Greece, between January 1998 and January 2001. Results Endophthalmitis arose in 12/1055 patients (1.13%) after extracapsular cataract extraction (ECCE) and in 8/1391 after phacoemulsification (0.57%). The mean time to onset of endophthalmitis was 23 and 73 days respectively after phacoemulsification and ECCE. This difference was statistically significant. Conclusions Endophthalmitis develops considerably later after ECCE than phacoemulsification. Thus it would appear that hygiene conditions have a stronger effect in patients operated with the ECCE technique. In order to reduce the risk of endophthalmitis after cataract extraction in patients living in substandard conditions, phacoemulsification is proposed as preferable to ECCE.