bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of the Toric Surgical Marker to Aid in Intraoperative Plaque Placement for the USC Eye Physics Plaques to Treat Uveal Melanoma: A New Surgical Technique
Authors: Berry Jesse L. , Kim Jonathan W. , Jennelle Richard , Astrahan Melvin 
Published: October 2015

BACKGROUND AND OBJECTIVE:
To describe a new surgical technique for intraoperative placement of Eye Physics (EP) plaques for uveal melanoma using a toric marker.

PATIENTS AND METHODS:
A toric marker is designed for cataract surgery to align the axis of astigmatism; its use was modified in this protocol to mark the axis of suture coordinates as calculated by Plaque Simulator (PS) software.

RESULTS:
The toric marker can be used to localize suture coordinates, in degrees, during intraoperative plaque placement. Linear marking using the toric marker decreases potential inaccuracies associated with the surgeon estimating ‘clock-hours’ by dot placement.

CONCLUSION:
Use of the toric marker aided surgical placement of EP plaques. The EP planning protocol is now designed to display the suture coordinates either by clock-hours or degrees, per surgeon preference. Future research is necessary to determine whether routine use of the toric marker improves operative efficiency.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:866–870.]
Image Scaling Difference Between a Confocal Scanning Laser Ophthalmoscope and a Flash Fundus Camera
Authors: Nittala Muneeswar G. , Hariri Amirhossein , Wong Wai T. , Chew Emily Y. , Ferris Frederick L. , Sadda Srinivas R. 
Published: October 2015

BACKGROUND AND OBJECTIVE:
To evaluate scaling and measurement differences between flash and scanning laser fundus images.

PATIENTS AND METHODS:
The authors analyzed fundus autofluorescence images of patients with geographic atrophy secondary to age-related macular degeneration imaged with both 30º confocal scanning laser ophthalmoscope (cSLO) and 50º flash fundus camera (FFC). Multiple vessel-crossing points served as landmarks.

RESULTS:
The mean (± SD; range) scaling factor between cSLO and FFC images (by GRADOR) for the horizontal dimension was 1.217 (± 0.0487; 1.0474-1.272) versus 1.138 (± 0.0311; 1.0841-1.193) for the vertical dimension. The mean percentage difference between horizontal and vertical scaling factors was 7.48 (± 2.29; 2.30–10.70). Refractive error (focus) and aperture size (or field of view of the image) were positively correlated and aspect ratio was negatively correlated with landmark pair measurements.

CONCLUSION:
Inherent image-scaling differences between fundus autofluorescence imaging systems are not restricted to simple pixel-to-millimeter calibration variances, but appear to vary depending on measurement orientation. Differences should be considered when comparing measurements obtained using different imaging systems, particularly for clinical trials.

[
Ophthalmic Surg Lasers Imaging Retina
. 2015;46:872–879.]
Nucleic Acid–Sensing Receptors: Rheostats of Autoimmunity and Autoinflammation
Authors: Sharma Shruti , Fitzgerald Katherine A. , Cancro Michael P. , Marshak-Rothstein Ann 
Published: October 2015

Abstract
Distinct families of germline-encoded pattern recognition receptors can sense both microbial and endogenous nucleic acids. These DNA and RNA sensors include endosomal TLRs and cytosolic sensors upstream of stimulator of type I IFN genes (STING) and MAVS. The existence of overlapping specificities for both foreign and self nucleic acids suggests that, under optimal conditions, the activity of these receptors is finely tuned to effectively mediate host defense yet constrain pathogenic self-reactivity. This equilibrium becomes disrupted with the loss of either TLR9 or STING. To maintain immune protection, this loss can be counterbalanced by the elevated response of an alternative receptor(s). Unfortunately, this adjustment can lead to an increased risk for the development of systemic autoimmunity, as evidenced by the exacerbated clinical disease manifestations of TLR9-deficient and STING-deficient autoimmune-prone mice. These studies underscore the delicate balance normally maintained by tonic signals that prevent unchecked immune responses to nucleic acids released during infections and cellular duress or death.
Effect of Intracameral Triamcinolone Acetonide on Postoperative Intraocular Inflammation in Pediatric Traumatic Cataract
Authors: Mohamed Tarek A. , Soliman Wael , Fathalla Ahmed M. 
Published: October 2015

Purpose To study the effect of a single intracameral injection of triamcinolone acetonide at the end of pediatric traumatic cataract surgery on postoperative inflammation. Methods This prospective interventional study comprised 40 eyes of children with unilateral traumatic cataract. Patients were classified into 2 groups: the study group, in which intraoperative intracameral triamcinolone acetonide (2 mg) was used at the end of surgery; and a control group, which did not receive intracameral triamcinolone acetonide. Results The study group included 20 eyes of patients with an average age of 6 ± 2.8 years. The control group included 20 eyes of patients with an average age of 6 ± 2.1 years. No serious intraoperative complications occurred. In the immediate postoperative period, 3 eyes of the control group (15.0%) developed a fibrinous anterior chamber reaction. None of the study group eyes developed a similar reaction. There were no cases of endophthalmitis. In addition, 3 eyes (15%) in the control group had obscuration of the visual axis at the last follow-up. This complication was not encountered in the study group. Posterior synechiae and cellular deposits were observed in 4 eyes (20%) in the study group and 8 eyes (40%) in the control group at 1 month and at the last follow-up. Conclusions The use of intracameral triamcinolone decreased anterior segment inflammation postoperatively in children who had surgery for traumatic cataract.
Grooved and Nongrooved Clear Corneal Incisions in Phacoemulsification: Permeability Study
Authors: Bergamasco Victor D. , Antunes Victor A.C. , Hida Richard Y. , Malavazzi Gustavo R. 
Published: October 2015

Purpose To detect the inflow of trypan blue through grooved and nongrooved sutureless self-sealing clear corneal incisions at the end of phacoemulsification as compared to a control group. Methods A prospective randomized masked trial considered 52 eyes randomized into 3 groups in which phacoemulsification was performed: group A, nongrooved incisions; group B, grooved incisions; and group C, controls. By the end of each surgery, trypan blue was instilled on the ocular surface in groups A and B and rinsed out after 2 minutes. A sample of the anterior chamber content was collected and analyzed by high-performance liquid chromatography to identify and quantify the trypan blue concentration. The presence of trypan blue was expressed as a specific single peak graphic image. The mean areas of these peaks were used to assess the groups using a nonparametric Mann-Whitney test. Results There was a statistically significant difference between the nongrooved incisions group and the control group (p = 0.0448). No significant difference was observed between group B (grooved incision) and controls (p = 0.1800). Conclusions Trypan blue was detected in the anterior chamber when nongrooved clear corneal incision was used. There was no trypan blue detection in the group with grooved clear corneal main incisions.
Cataract Surgery in Patients with Nanophthalmos: Results and Complications
Authors: Lemos José A. , Rodrigues Pedro , Resende Rui A. , Menezes Carlos , Gonçalves Rita S. , Coelho Pedro 
Published: October 2015

Purpose To evaluate phacoemulsification surgery results and complications in patients with nanophthalmos. Methods The records of 9 patients with nanophthalmos who had cataract surgery from January 2011 through January 2015 were retrospectively reviewed. Nanophthalmos was diagnosed by the presence of an eye with an axial length (AL) less than 20.5 mm. The records were reviewed for ocular diagnosis, keratometry, anterior chamber depth (ACD), AL, ocular surgeries, visual acuity, and complications. Results A total of 14 eyes of 9 patients (8 women, 1 man) with a mean age of 72 years (range 48-86) were reviewed. Mean AL was 18.72 mm and mean ACD was 2.30 mm. Mean preoperative spherical equivalent (+8.55 ± 6.44 diopters (D)) was reduced to +0.30 ± 2.17 D at last follow-up visit. Mean best-corrected visual acuity (BCVA) was +0.68 ± 0.55 logarithm of the minimum angle of resolution (logMAR) preoperatively and improved to +0.55 ± 0.73 logMAR at last follow-up visit. Visual acuity remained stable or improved in 11 eyes. Five eyes did not achieve final BCVA ≥+0.3 logMAR. Complications occurred in 3 eyes (21.4%) and included 1 case of posterior capsule rupture, 1 case of severe iritis and rhegmatogenous retinal detachment 2 weeks postoperatively, and 1 other case of iritis. No postoperative uveal effusion was seen. Conclusions Although phacoemulsification seems to be relatively safe in nanophthalmic eyes, surgeons need to be aware of the challenges of this procedure in these high-risk eyes. Nevertheless, with careful preoperative evaluation and planning, most cases were uncomplicated and resulted in improvement of BCVA.
Improved Outcome after Primary Vitrectomy in Diabetic Patients Treated with Statins
Authors: Tuuminen Raimo , Sahanne Sari , Haukka Jari , Loukovaara Sirpa 
Published: October 2015

Purpose To evaluate the effect of preoperative statin treatment on the outcome of primary vitrectomy in type 1 and 2 diabetic patients. Methods In this open, observational institutional study, a total of 192 eyes of 171 type 1 and 2 adult diabetic patients admitted for primary vitrectomy for management of sight-threatening forms of diabetic retinopathy were divided according to the use of lipid-lowering therapy: those with statin treatment (79 eyes of 73 patients) and those taking no statin medication (113 eyes of 98 patients). One-month best-corrected visual acuity (BCVA) gain and cumulative 12-month revitrectomy frequency were analyzed. Results In multivariate linear regression, diabetic patients with statin treatment had a better 1-month BCVA improvement than did those without statin treatment (absolute difference 0.26, 95% confidence interval [CI] 0.02-0.50, p = 0.028). Subgroup analysis revealed that diabetic patients on statin had better postoperative BCVA improvement when preoperative status included partial or panretinal laser photocoagulation (p = 0.042 and p = 0.049) and anti-vascular endothelial growth factor therapy (p = 0.011). Moreover, diabetic patients with preoperative macular edema (p = 0.009), vitreous hemorrhage (p<0.001), proliferative retinopathy (p<0.001), or tractional retinal detachment (p = 0.010) had better BCVA recovery if receiving statin. In Cox proportional hazards regression model, revitrectomies in our 12-month follow-up were less frequent in diabetic patients on statin treatment (hazard ratio 0.28, 95% CI 0.08-0.93, p = 0.037). Conclusions These data provide novel insight into the potential clinical benefit for patients with sight-threatening diabetic retinopathy undergoing vitrectomy treated with statin.
A Case of Severe Corneal Flattening after Descemet Stripping Endothelial Keratoplasty
Authors: Fernández-López Ester , Miron Alina , Pogorelova Svetlana , Oganesyan Oganes , Baydoun Lamis , Melles Gerrit R.J. 
Published: October 2015

Purpose To report a case of extreme corneal flattening after initially uneventful Descemet stripping endothelial keratoplasty (DSEK). Methods A 76-year-old man underwent uneventful DSEK for pseudophakic bullous keratopathy (PBK) in his left eye. Postoperative evaluations were performed using anterior segment optical coherence tomography and biomicroscopy. Results The DSEK graft showed full adherence to the host stroma. Two weeks after surgery, the transplanted cornea developed pronounced flattening of the central corneal curvature accompanied by graft folds and remained unchanged until the most recent follow-up 20 weeks after surgery. Conclusions Severe corneal flattening may be an undescribed complication occurring after uneventful DSEK, without any concomitant ocular pathology or detectable cause.
Smartphone-Based Fundus Camera Device (MII Ret Cam) and Technique with Ability to Image Peripheral Retina
Authors: Sharma Ashish , Subramaniam Saranya Devi , Ramachandran KI , Lakshmikanthan Chinnasamy , Krishna Soujanya , Sundaramoorthy Selva K. 
Published: October 2015

Purpose To demonstrate an inexpensive smartphone-based fundus camera device (MII Ret Cam) and technique with ability to capture peripheral retinal pictures. Methods A fundus camera was designed in the form of a device that has slots to fit a smartphone (built-in camera and flash) and 20-D lens. With the help of the device and an innovative imaging technique, high-quality fundus videos were taken with easy extraction of images. Results The MII Ret Cam and innovative imaging technique was able to capture high-quality images of peripheral retina such as ora serrata and pars plana apart from central fundus pictures. Conclusions Our smartphone-based fundus camera can help clinicians to monitor diseases affecting both central and peripheral retina. It can help patients understand their disease and clinicians convincing their patients regarding need of treatment especially in cases of peripheral lesions. Imaging peripheral retina has not been demonstrated in existing smartphone-based fundus imaging techniques. The device can also be an inexpensive tool for mass screening.
Study of Spectral-Domain Optical Coherence Tomography in Children: Normal Values and Influence of Age, Sex, and Refractive Status
Authors: Pérez-García Diana , Ibañez-Alperte Juan , Remón León , Cristóbal José Ángel , Sanchez-Cano Ana , Pinilla Isabel 
Published: October 2015

Purpose To establish normal values for retinal nerve fiber layer (RNFL), macular thickness, and macular volume in children using spectral-domain optical coherence tomography (OCT). Methods A descriptive cross-sectional study was performed in healthy children between 3 and 14 years of age. Each child underwent a comprehensive ophthalmic examination that included 3 OCT scans with Spectralis (Heidelberg Engineering, Heidelberg, Germany). All measurements were performed by the same operator, and one eye was randomly selected. The influence of age, sex, and refraction on OCT measurements was analyzed. Results The sample consisted of 162 Caucasian subjects, mean age 8.1 ± 3.03 years. The spherical equivalent was 0.03 ± 0.19 D (range ±4 D, astigmatism <1 D). The average values were 263.69 ± 4.54 µm for central macular thickness, 0.21 ± 0.01 mm3 for central macular volume, and 100.45 ± 1.98 µm for RNFL. A significant correlation between RNFL and spherical equivalent was found for the nasal (p = 0.001), inferior (p = 0.009), and inferior nasal (p = 0.005) sectors. No differences were found with regard to sex (p>0.05). However, central macular thickness and central macular volume were correlated with age (p = 0.027, p = 0.02). Conclusions This study provides reference values for macular thickness, macular volume, and RNFL in healthy children.
Mobile Phones for Retinopathy of Prematurity Screening in Lagos, Nigeria, Sub-Saharan Africa
Authors: Oluleye Tunji S. , Rotimi-Samuel Adekunle , Adenekan Adetunji 
Published: October 2015

Purpose Retinopathy of prematurity (ROP), thought to be rare in Nigeria, sub-Saharan Africa, has been reported in recent studies. Developing cost-effective screening is crucial for detecting retinal changes amenable to treatment. This study describes the use of an iPhone combined with a 20-D lens in screening for ROP in Lagos, Nigeria. Methods The ROP screening program was approved by the Lagos University Teaching Hospital Ethical Committee. Preterm infants with birthweight of less than 1.5 kg or gestational age of less than 32 weeks were screened. In conjunction with the neonatologist, topical tropicamide (0.5%) and phenylephrine (2.5%) was used to dilate the pupils. A pediatric lid speculum was used. Indirect ophthalmoscopy was used to examine the fundus to ensure there were no missed diagnoses. An iPhone 5 with 20-D lens was used to examine the fundus. The App Filmic Pro was launched in the video mode. The camera flash served as the source of illumination. Its intensity was controlled by the app. The 20-D lens was used to capture the image of the retina, which was picked up by the camera system of the mobile phone. Another app, Aviary, was used to edit the picture. Results The images captured by the system were satisfactory for staging and determining the need for treatment. Conclusions An iPhone combined with a 20-D lens appear to be useful in screening for ROP in resource-poor settings. More studies are needed in this area.
Phacoemulsification using a Chisel-Shaped Illuminator: Enhanced Depth Trench, One-Shot Crack, and Phaco Cut
Authors: Wi Jaemin , Seo Hyejin , Lee Jong Yeon , Nam Dong Heun 
Published: October 2015

Purpose To evaluate the efficacy and outcomes of intracameral illuminator-assisted nucleofractis technique in cataract surgery. Methods Since June 2012, this novel technique has been performed in all cataract cases by one surgeon (approximately 300 cases of various densities). Trenching continues until the posterior plate white reflex between an endonucleus and an epinucleus is identified (enhanced depth trench). After trenching, cracking is initiated with minimal separation force, and completion of cracking is confirmed by posterior capsule reflex (one-shot crack). With followability enhanced by an elliptical phaco mode, the divided nucleus is efficiently cut into small fragments by a chisel-shaped illuminator (phaco cut). Results We have not experienced any capsular bag or zonular complications, and the effective phacoemulsification time seemed to be shorter than that with the conventional technique. Conclusions This technique simplifies the complete division of the nucleus, which is the most challenging step in safe and efficient phacoemulsification.
A Novel Technique to Release Sticking Haptic of a Single-Piece Hydrophobic Acrylic IOL using Irrigation-Aspiration Probe
Authors: Khokhar Sudarshan Kumar , Midha Neha , Patil Bharat , Nayak Bhagabat , Simakurthy Sriram 
Published: October 2015

Purpose To describe a novel technique to release sticking haptic of a single-piece hydrophobic acrylic intraocular lens (IOL) using irrigation-aspiration (I/A) probe. Methods In our technique, the I/A probe is introduced into the anterior chamber on Visco mode. Using the aspiration port of the I/A probe, the sticking haptic is held at its tip and suction force is built up until occlusion is noted. Then the haptic is nudged towards the center of the IOL along its curve. After the haptic is free from optic, the suction is released. Results Several techniques have been described to release the sticking haptic such as squeezing the haptic at the site where it sticks to the IOL or using Sinskey hook for releasing the adhesion. These techniques require extra manipulation of the IOL by introduction of surgical instruments. In our technique, we used the I/A probe itself for separating the sticky haptic successfully. Conclusions This technique allows separation of sticking haptic without any extra instrumentation, thus reducing intraocular maneuvering and total surgery time.
Ophthalmic Artery Blood Flow Parameters in Pseudoexfoliation Glaucoma
Authors: Kocaturk Tolga , Isikligil Isil , Uz Burcin , Dayanir Volkan , Dayanir Yelda O. 
Published: October 2015

Purpose To investigate orbital flow parameters of ophthalmic artery (OA) in patients with pseudoexfoliation glaucoma (XFG) by ultrasonography. Methods This case-control study included 38 patients with XFG and 32 healthy control subjects. Color Doppler imaging was performed to evaluate orbital flow parameters of OA. Receiver operating characteristic analyses were performed to define the best cutoff value. Results In the XFG group, decreased peak systolic velocity (p = 0.114), end diastolic velocity (p = 0.002), and increased resistivity index (RI) (p<0.001) at OA compared to healthy controls were observed. A cutoff value 0.72 for OA RI was found to have a sensitivity of 66% and specificity of 94%. Conclusions The results support the findings of increased vascular resistance in OA XFG. High sensitivity and specificity obtained for OA RI may be useful in evaluation of future therapeutic vascular agents.
A Therapeutic Trial of Valganciclovir in Patients with Uveitis and Positive Epstein-Barr virus Early Antigen D IgG Titers
Authors: Boonsopon Sutasinee , Maghsoudlou Armin , Kombo Ninani E. , Foster C. Stephen 
Published: October 2015

Purpose To evaluate the effectiveness of a therapeutic trial of valganciclovir in patients with uveitis with positive Epstein-Barr virus early antigen D immunoglobulin G titers (EBV EA-D). Methods We performed a retrospective chart review of 14 patients at the Massachusetts Eye Research and Surgery Institution who had uveitis with positive EBV EA-D but negative studies for all other causes of uveitis and were treated with valganciclovir 450 mg twice a day or valganciclovir 900 mg twice a day between January 2010 and August 2014. Results Nine of 14 patients, who had presumed EBV reactivation with associated intraocular inflammation, were successfully treated with valganciclovir: 3 of these were treated with valganciclovir 450 mg twice a day and 6 were treated with valganciclovir 900 mg twice a day. Five of 14 patients failed to respond to valganciclovir with persistent inflammation after at least 2 weeks of valganciclovir therapy, and were subsequently treated with immunomodulatory therapy to control inflammation. Conclusions Uveitis can be caused by EBV infection/reactivation. A therapeutic trial with valganciclovir 450 mg twice a day for 1 month in patients with uveitis with positive EBV EA antibody may be beneficial.
Choroidal Thickness in Systemic Arterial Hypertension
Authors: Akay Fahrettin , Gundogan Fatih Cakir , Yolcu Umit , Toyran Sami , Uzun Salih 
Published: October 2015

Purpose To assess choroidal thickness changes in young adults with systemic arterial hypertension. Methods This prospective study comprised 80 hypertensive patients and 80 healthy control subjects. Choroidal thickness was measured with spectral-domain optical coherence tomography (SD-OCT) (RS-3000, Nidek). Choroidal thickness was obtained at the subfovea, 500 µm, 1000 µm, and 1500 µm nasal to the fovea (N500, N1000, N1500) and 500 µm, 1000 µm, and 1500 µm temporal to the fovea (T500, T1000, T1500). Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured with a mercury sphygmomanometer. Only the right eye values were used for statistical comparisons between the groups. Results Mean age was 23.8 ± 2.8 years in hypertensive subjects and 23.5 ± 2.1 years in the control group (p = 0.945). All choroidal thickness measurements (mean choroidal thickness, subfoveal choroidal thickness, all nasal and all temporal choroidal thicknesses) were significantly lower in hypertensive subjects (p<0.001 for subfoveal, N500, T500, T1000, T1500; p = 0.001 for N1000; and p = 0.012 for N1500). The correlations between choroidal thickness measurements and blood pressure (SBP, DBP, MAP) were insignificant (p>0.05 for all correlations). Choroidal thickness measurements were also insignificantly correlated with disease duration (p>0.05 for all correlations). Conclusions The results of this study demonstrated that choroidal thickness decreases in patients with systemic arterial hypertension. This may be caused by arteriolar sclerosis and vascular contraction caused by high intravascular pressure in the choroid.