bluuebunny/crossref_metadata_2025_split huggingface dataset:
Focal Posterior Pole Viral Retinitis
Authors: Hazirolan Diele , Sungur Gulten , Demir Necati , Kasim Remzi , Duman Sunay 
Published: January 2018

Purpose To describe the clinical features of an atypical form of viral retinitis in immunocompetent patients. Methods This was a retrospective noncomparative case series. The charts of 8 patients diagnosed with and treated for focal posterior viral retinitis were reviewed. Clinical and demographic features were evaluated. All the patients had extensive laboratory tests, fundus fluorescein angiography, optical coherence tomography of macula, and polymerase chain reaction of vitreous. Results All the patients were referred to our Uveitis Service from other hospitals, as their uveitis symptoms deteriorated in spite of treatment. The mean age of 4 male and 4 female patients was 32.1 years (range, 22–42 years). The mean follow-up period was 10 months (range, 6–18 months). All of the patients had unilateral disease. Polymerase chain reaction analysis of vitreous specimen was positive for herpes simplex virus-1 in 5 patients and varicella zoster virus in 3 patients. Retinitis resolved after systemic acyclovir treatment in all patients. Conclusions Viral etiology must be borne in mind in the differential diagnosis of atypical retinitis. It can be a milder form of viral retinitis like focal viral retinitis, as mentioned in this study. The prognosis of this disease is better than the other forms of necrotizing retinopathies involving a larger area of retina.
Screening Criteria for Retinopathy of Prematurity in Developing Countries
Authors: Akman Ipek , Demirel Utku , Yenice Özlem , Ilehsoy Hacer , KazokoğLu Haluk , Özek Eren 
Published: January 2018

Purpose Retinopathy of prematurity (ROP) is a serious problem which potentially can lead to blindness. The objective of this study is to detect the incidence of ROP and the number of preterm babies requiring treatment for ROP in our center and to establish the screening criteria for our country. Methods A total of 801 babies with a gestational age less than 37 weeks were screened for ROP. Babies with a gestational age (GA) less than 32 weeks (n=348) were assigned as group 1. Babies with a GA between 32 and 34 weeks (n=335) were assigned as group 2 and between 35 and 37 weeks (n=98) were assigned as group 3. Clinical features and ROP screening results of the cases were documented. Results In group 1, ROP was detected in 176 (50.9%) babies, 41 (11.8%) of whom were treated with laser I cryotherapy. In group 2, 83 (25%) cases of ROP were detected, and 11 of them (3.1%) required therapy. In group 3, 9 (9.1%) infants were diagnosed with ROP, and none of them required treatment. Clinical factors associated with ROP in group 1 were gestational age, birthweight, duration of ventilation, duration of oxygen supplementation, sepsis, and bronchopulmonary dysplasia. Conclusions In developing countries, the criteria for ROP screening programs should be designed according to local conditions. In our country, screening all premature babies with a gestational age less than 34 weeks or a birthweight less than 1850 g appears to be appropriate.
Choroidal Metastasis with Adenocarcinoma of the Lung Treated with Gefitinib
Authors: Inoue Maiko , Watanabe Yoichiro , Yamane Shin , Kobayashi Satoshi , Arakawa Akira , Tsukahara Toshinori , Kaneko Takeshi , Kadonosono Kazuaki 
Published: January 2018

Purpose To report a case of bilateral regression of choroidal metastasis with adenocarcinoma of the lung treated with gefitinib. Methods Retrospective case review of a 68-year-old woman with pulmonary adenocarcinoma with choroidal metastasis who presented with visual loss in the left eye as the initial manifestation. Her visual acuity was 6/6 in the right eye and 6/60 in the left eye before the start of gefitinib administration. Best-corrected visual acuity and spectral-domain optical coherence tomography were compared between baseline and 3 months after treatment. Results Best-corrected visual acuity in the left eye had improved to 6/30 3 months after oral gefitinib. The elevated lesions of the right eye disappeared, with decrease of subretinal fluid and retinal pigment epithelial atrophy. Spectral-domain optical coherence tomography showed that subretinal fluid of the left eye was also reduced. Conclusions Oral gefitinib could be effective for regression of choroidal metastasis in patients with adenocarcinoma of the lung and provides a potential treatment option.
Ocular Neovascularization following Central Retinal Artery Occlusion: Prevalence and Timing of Onset
Authors: Rudkin Adam K. , Lee Andrew W. , Chen Celia S. 
Published: January 2018

Purpose Debate exists in the literature on the prevalence and etiology of neovascularization following central retinal artery occlusion (CRAO). The reported prevalence varies from 2.5% to 31.6%. We conducted a retrospective study to determine the prevalence of ocular neovascularization following acute CRAO in our institution. Methods A retrospective audit of consecutive patients with nonarteritic/thromboembolic CRAO presenting between 1997 and 2009 in a single tertiary teaching hospital. Results Thirty-three patients were identified as having nonarteritic CRAO, and of this cohort 6 patients (18.2%) developed ocular neovascularization. Neovascular glaucoma was present in 5 cases (15.2%); 2 of these presented through an emergency department with painful eyes, both at 16 weeks post CRAO. The other cases of neovascularization were detected on scheduled follow-ups. Mean time from retinal occlusive event to observed neovascularization was 8.5 weeks (range 2–16 weeks). One case of neovascularization was associated with hemodynamically significant ipsilateral carotid stenosis; no patient had proliferative diabetic retinopathy or other causes of neovascularization. Conclusions The prevalence of neovascularization following acute CRAO in our population was 18.2% at an average of 8.5 weeks post CRAO. There was a temporal relationship between the 2 events and no other causes of neovascularization demonstrable in our cohort of patients. There is no consensus on the follow-up regimen post CRAO to detect ocular neovascularization complications. Our study suggests that neovascularization can occur early and regular follow-up especially in the first 4 months is important post CRAO.
Periorbital and Orbital Cellulitis: A 10-Year Review of Hospitalized Children
Authors: Georgakopoulos Constantine D. , Eliopoulou Maria I. , Stasinos Stavros , Exarchou Artemis , Pharmakakis Nikolaos , Varvarigou Anastasia 
Published: January 2018

Purpose Periorbital cellulitis is often difficult to distinguish from orbital cellulitis, which is a potentially lethal infection involving the contents of the orbit. A delay in diagnosis and appropriate treatment may result in serious complications. We studied the predisposing factors, microbiologic data, clinical features, complications, and treatment of periorbital and orbital cellulitis in childhood. Methods Eighty-three medical records of patients (mean age 3.7±3.1 years) admitted to the Department of Pediatrics with a diagnosis of periorbital or orbital cellulitis during the 10-year period January 1997 to December 2007 were retrospectively studied. Results In this series, periorbital cellulitis occurred more frequently (83%) than orbital cellulitis (17%). Of the children with periorbital cellulitis, 85% were younger than 5 years of age, while 62% of the children with orbital cellulitis were older than 5 years of age. The most common predisposing factors in periorbital cellulitis were upper respiratory infection (68%) and trauma to the eyelids (20%), while sinusitis was more frequently associated with orbital cellulitis (79%). Blood and skin cultures were usually negative. The most common isolated pathogens were Staphylococcus aureus, Streptococcus pneumoniae, and Staphylococcus epidermidis. Forty-five of the 83 children were treated with intravenous ceftriaxone + clindamycin (mean duration 8.6±5.5 days). Intravenous antibiotics alone was an effective management in most of the patients, but a small proportion (6%) required surgical intervention. Conclusions Upper respiratory infection and sinusitis are the most important predisposing factors for periocular infection. Streptococcus species are the predominant causative agents. Both diseases can usually be successfully treated with intravenous antibiotics, but some patients may require surgery to control extensive infection.
Unusual Presentation of Giant Cell Angiofibroma of the Eyelids
Authors: Surace Dario , Blandamura Stella , Bernardini Francesco P. , Galan Alessandro , Giudice Giuseppe Lo 
Published: January 2018

Purpose To describe a case of bilateral eyelid-confined giant cell angiofibroma (GCAF) in a patient with a slowly progressive bilateral eyelid swelling. Methods A 40-year-old man with a 5-year history of slowly progressive bilateral eyelid swelling, severe functional impairment, and bilateral cosmetic deformity was studied. An extensive ophthalmologic evaluation, laboratory examinations, and orbital magnetic resonance imaging were carried out. Results Clinical examination showed nonpitting lymphedema affecting both upper and lower eyelids, with orange peel skin. Orbital magnetic resonance imaging revealed diffuse thickening of the preseptal structures in the eyelids without extension to the orbit. Histologic specimen revealed the presence of spindle and multinucleated giant cells surrounding pseudovascular spaces strongly positive to CD34 and vimentin. A diagnosis of GCAF was made and radiation therapy was performed 3 weeks after surgical debulking with partial recovery of visual and anatomic function. Conclusions Giant cell angiofibroma involving the eyelid is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist.
Sequential Anterior Ischemic Optic Neuropathy and Central Retinal Artery and Vein Occlusion after Ranibizumab for Diabetic Macular Edema
Authors: Parodi Maurízio Battaglia , Lacono Pierluigi , Cascavilla Maria Lucia , Zucchiatti Ilana , Kontadakis Dimitris Stelios , Vergallo Stefano , Bandello Francesco 
Published: January 2018

Purpose To describe a rare adverse event characterized by anterior ischemic optic neuropathy (AION) associated with central retinal artery occlusion (CRAO) followed by central retinal vein occlusion (CRVO) secondary to treatment with intravitreal injection of ranibizumab for diabetic macular edema (DME). Methods A patient with DME refractory to focal grid laser photocoagulation in the left eye was prospectively followed and treated with intravitreal injection of ranibizumab. Over a 12-month period and after 4 injections, best-corrected visual acuity (BCVA) improved from 20/63 to 20/50 (Snellen equivalent) and central retinal thickness (CRT) reduced from 551 to 279 μm. In July 2009, BCVA dropped to 20/100 with CRT of 421 μm due to the recurrence of DME and a further injection was administered. Results One month later, the left eye showed a sudden visual acuity loss. Best-corrected visual acuity was 20/400 and the fundus examination revealed a hyperemic and swollen optic disc, with several retinal hemorrhages. Retina at the posterior pole was pale, with attenuation and sheathing of arterial vessels. Fluorescein angiography showed a delayed optic disc and arterial filling with retinal ischemia involving both posterior pole and periphery and confirmed the diagnosis of AION associated with CRAO. One month later, the BCVA decreased to 20/800, and fundus examination evidenced a CRVO with diffuse retinal hemorrhages in the 4 quadrants, congestion, and tortuosity of the retinal veins. Conclusions Although severe ocular adverse events are generally rare, patients receiving intraocular anti-vascular endothelial growth factor injection should be monitored carefully for the development of vascular complications.
Acquired Senile Retinoschisis of the Peripheral Retina Imaged by Spectral Domain Optical Coherence Tomography: A Case Report
Authors: Landa Gennady , Shirkey Belinda L. , Garcia Patricia M.T. , Milman Tatyana , Garcia Julian P.S. , Rosen Richard B. 
Published: January 2018

Purpose We report spectral domain optical coherence tomography findings of the peripheral retina in a patient with senile (acquired) retinoschisis. Methods This is an observational case report. Spectral domain optical coherence tomography was performed to image the peripheral retina at the area of retinoschisis in a 70-year-old man with bilateral inferonasal elevated peripheral retinal lesions. Since the lesions were not entirely transparent and smooth, and demonstrated a certain degree of mobility, the diagnosis of retinal detachment could not be excluded. Results Spectral domain optical coherence tomography scans obtained at the margin of the lesions demonstrated attached retina with a characteristic splitting of the neurosensory retina at the outer plexiform layer and cystic changes in the inner retina. Conclusions Spectral domain optical coherence tomography can assist in the diagnosis of senile (acquired) retinoschisis, particularly in cases where retinal detachment cannot be excluded on clinical examination alone.
Vitrectomy for Treatment of a Lamellar Hole in a Patient with Exudative Macular Degeneration: The Role of Vitreous Traction Elimination
Authors: Theodossiadis Panagiotis , Charonis Alexandros , Panagiotidis Dimithos , Papathanassiou Miltiadis , Petrou Petros 
Published: January 2018

Purpose Lamellar macular hole (LMH) represents a well-defined clinical entity with variable pathophysiologic mechanisms and a controversial therapeutic approach. The purpose of the present work is to present a patient with an epiretinal membrane (ERM)–associated LMH on the background of exudative age-related macular degeneration (AMD) that was successfully managed with pars plana vitrectomy. Methods Interventional case report. Results A 67-year-old man presented with progressive visual loss OS of 5 months’ duration. He was diagnosed with an ERM-associated LMH with coexisting subretinal fluid arising by a neovascular membrane on the background of exudative AMD confirmed with fundus fluorescein angiography. He underwent a 3-port pars plana vitrectomy with ERM–internal limiting membrane peeling and gas tamponade (14% C3F8) for treatment of the LMH and ERM with a view to undergo anti-vascular endothelial growth factor treatment for the exudative AMD. Postoperative optical coherence tomography demonstrated complete closure of the LMH with simultaneous total subretinal fluid absorption that was maintained at the 2-month follow-up period. Conclusions To our knowledge, this is the first report whereby pars plana vitrectomy in a patient with an ERM-associated LMH on the background of exudative AMD resulted in improvement of both clinical entities. The latter strengthens the role of vitreous traction elimination in exudative AMD and highlights the need for further research.
Comparative Study of Mydriasis in Cataract Surgery: Topical versus Mydriasert versus Intracameral Mydriasis in Cataract Surgery
Authors: Morgado Gabriel , Barros Pedro , Martins Joana , Lima André , Martins Neves 
Published: January 2018

Purpose To compare the mydriatic efficacy and cardiovascular safety of the mydriatic options. Methods This was a prospective randomized analysis of 90 eyes submitted to senile cataract surgery. Group A (30 eyes) included topical mydriasis, group B (30 eyes) included mydriasis with the ophthalmic insert (Mydriasert), and group C (30 eyes) included intracameral mydriasis. Measures were mydriasis value before ophthalmic viscoelastic device (OVD) injection and at the end of surgery, blood pressure and heart rate, need for antihypertensive medication, and subjective iris stability. Results Before OVD injection and at the end of surgery, pupillary dilation was 8.1 and 7.0 mm in group A, 8.2 and 7.7 mm in group B, and 6.3 and 6.1 mm in group C, respectively. Mean surgery time was 8.3 min in group A, 8.1 min in group B, and 12.3 min in group C (p<0.05). The mean subjective iris stability score was 8.7/10 in group A, 9.3/10 in group B, and 6.1/10 in group C (p<0.05). Systolic blood pressure was greater than 180 mmHg in 9 (30%) patients in group A, 3 (10%) in group B, and 2 (6.6%) in group C. Antihypertensive medication was administered to 8 (26.6%) cases in group A, 2 (6.6%) in group B, and 0 (0%) in group C (p<0.05). Conclusions The most effective mydriasis was obtained within the Mydriasert group, followed by the topical mydriasis group. From the cardiovascular point of view, intracameral mydriasis was the safest and topical mydriasis the least safe.
Is There Any Difference in Target Intraocular Pressure for Exfoliative Glaucoma Patients with Cardiovascular Disease History?
Authors: Holló Gábor , Cvenkel Barbara , Teus Miguel A. , Irkec Murat T. , Astakhov Yuri S. , Chiselita Dorin , Petkova Nataliya , Liehneová Ivana , Kaluzny Bartlomiej J. , Kóthy Péter , Bozkurt Banu , Akopov Evgeny L , Stewart Jeanette A. , Kristoffersen Michael S. , Kristoffersen Caroline J. , Stewart William C. 
Published: January 2018

Purpose To investigate if patients with exfoliation glaucoma (XFG) with cardiovascular disease (CVD) require different target intraocular pressure (IOP) compared to patients with XFG with no CVD for long-term stability. Methods A retrospective, multicenter, observational cohort analysis included consecutive patients with XFG from 9 European academic centers, with a minimum of 5 years follow-up. Results In 201 patients, there was a statistical difference between progressed and nonprogressed patients in mean (p=0.0049) and peak (p=0.015) IOP, variance of IOP (p=0.028), and number of medicine changes/year (p=0.0037). At a mean IOP ≥22 mmHg, patients progressed in 84% (32/38), between 14 and 21 mmHg in 54% (81/151), and at ≤13 mmHg in 33% (4/12). There was no difference in the rate of progression between groups based on CVD history (p=0.65). However, IOP that allowed ≤50% progression rate for patients with mild or no CVD was ≤20–21 mmHg and ≤18 mmHg for patients with severe disease. Further, at IOP ≥20 mmHg, 8% (1/12) of patients with severe CVD remained stable in contrast to 38% (16/42) of patients with mild and 21% (4/19) with no CVD history (p=0.0093). By multivariant regression analysis of the IOP and CVD measures, mean IOP was a risk factor for progression (p=0.0097). Conclusions Although IOP is the main determinant of progression in XFG under treatment, history of severe CVD should be further investigated as potential risk factor for glaucomatous progression.
Single Needle Revision of Failing Filtration Blebs: A Retrospective Comparative Case Series with 5-Fluorouracil and Mitomycin C
Authors: Palejwala Neal , Ichhpujani Parul , Fakhraie Ghasem , Myers Jonathan S. , Moster Marlene R. , Katz L. Jay 
Published: January 2018

Purpose To assess the success of needling in failed filtration blebs and the potential benefit of using either 5-fluorouracil (5-FU) or mitomycin C (MMC). Methods In this retrospective, comparative observational case series, 107 eyes that underwent needle revision with either 5-FU or MMC between July 2003 and May 2008 at Wills Eye Institute were selected. Exclusion criteria included follow-up less than 1 month and a history of glaucoma drainage device. Intraocular pressure (IOP) and number of glaucoma medications were recorded preoperatively and postoperatively. Success was defined as >20% decrease in IOP if glaucoma medications were resumed or <10% decrease in IOP if medications were not resumed post needling or fewer medications than pre needling. Results Sixty-five patients received 5-FU and 42 patients received MMC for needling. Mean IOP changed from 23.9 mmHg to 13.8 mmHg in the MMC group and from 23.3 mmHg to 13.02 mmHg in the 5-FU group (both p<0.001). Mean glaucoma medications changed from 1.7 to 0.7 in the MMC group and 2.0 to 0.8 in the 5-FU group (both p<0.001) at the end of follow-up. After a mean follow-up of 14.5 months, overall survival was 49.5%. Mean time to failure was 7.7 months. There was a moderately weak association between survival and the immediate postoperative IOP (r=0.262, p=0.01). In comparing MMC and 5-FU, there was no statistically significant difference in survival rate (p=0.267). Conclusions Bleb needling may be a safe and effective means of prolonging bleb survival. The only factor associated with success was the immediate postoperative IOP There was no apparent difference between the use of 5-FU and MMC in this population. A prospective study may provide further confirmation of this finding.
Bone mineral density 10 years after a Zweymüller uncemented stem prosthesis
Authors: Vervest T. M.J.S. , Van Heeswijk W. H.J.C. , Anderson P. G. , Van Limbeek J. 
Published: January 2018

The effect of a Zweymüller uncemented stem prosthesis on the long-term bone remodelling of femoral bone was examined using dual-energy X-ray absorptiometry (DEXA). Thirty-two patients (11 males, 21 females) with a unilateral prosthesis (18 Hochgezogen and 14 Stepless) were scanned at an average of 129.8 months after the initial operation. The average follow-up Harris Hip Score was 93.7: ten patients were classified as Charnley Class A, two patients as class B and 20 patients as class C. The group as a whole showed a moderate activity level and most patients were satisfied with the result of the operation. All stem prostheses were osseo-integrated. The non-operated contralateral femur was used as a control for the bone mineral density (BMD) changes in the femur around the prosthesis. A decrease of bone mineral density on the prosthesis side was found at the region of the calcar femoris, without any clinical decline or any radiographic anomalies.
Primary total hip replacement for acute displaced subcapital femoral fractures with a minimal three-year follow-up
Authors: Sharma S. , Draviraj K.P. , Bhamra M.S. 
Published: January 2018

The aim of the study was to review the results of total hip replacement (THR) in relatively fit and mobile patients with Garden 3 and 4 fractures of the neck of femur. Forty-one patients who underwent THR for displaced intracapsular hip fractures from 1993 to 2001 were reviewed. Only those patients with three years or more follow-up were reviewed. Average follow-up was 5.8 years (3–9.6 years). Complications encountered were: minor wound dehiscence (1), DVT (3), pulmonary embolism (1), dislocation (1), per-operative femur fracture (1), periprosthetic fracture following repeat fall (2), stem loosening (1). Average Harris Hip score at follow-up was 91 (66–100). We recommend total hip replacement as the primary treatment in relatively fit and mobile patients with displaced intracapsular fractures of the hip.
Septic Hip after a Fractured Neck of Femur in a Rheumatoid Patient: A Case Report
Authors: Anwar R. , Cranston C. , Botchu R. , Ravikumar K.J. 
Published: January 2018

A 63-year-old rheumatoid patient presented with severe pain in her left hip without a preceding history of trauma. An initial clinical and radiological examination revealed no “obvious” abnormality and the patient was symptomatically treated. The patient presented again five weeks later as weightbearing became increasingly difficult due to worsening pain. Inflammatory markers were found to be elevated and a repeat radiological examination revealed a displaced un-united fracture of the neck of femur. Isotope imaging suggested increased activity around the hip. A formal arthrotomy revealed pus in the joint. She continued to deteriorate and subsequently died due to sepsis. Spontaneous fractures without any history of trauma have been described in patients with rheumatoid arthritis. The fracture haematoma serves as a good culture medium for micro-organisms in immuno-compromised rheumatoid patients. Any hip pain arising in a rheumatoid patient should be thoroughly investigated and a high index of suspicion is necessary for both sepsis and fracture.