bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Cellular Origins of Heterotopic Ossification
Authors: Kan Lixin , Kessler John A. 
Published: August 2014

Educational Objectives

As a result of reading this article, physicians should be able to:

1.
Update the current knowledge about candidate cell populations as heterotopic ossification (HO) contributors.

2.
Understand the potential limitations of the experimental designs and techniques underlying the identification of putative HO contributors.

3.
Clarify the confusion about the phenotypes of candidate populations in the literature.

4.
Contrast the fundamental cellular differences between HO and normal skeletogenesis to identify potential disease-specific targets.

Heterotopic ossification (HO), acquired or hereditary, is featured by the formation of bone outside of the normal skeleton. Typical acquired HO is a common, debilitating condition associated with traumatic events. Cardiovascular calcification, an atypical form of acquired HO, is prevalent and associated with high rates of cardiovascular mortality. Hereditary HO syndromes, such as fibrodysplasia ossificans progressiva and progressive osseous heteroplasia, are rare, progressive, life-threatening disorders. The cellular origins of HO remain elusive. Some bona fide contributing cell populations have been found through genetic lineage tracing and other experiments in vivo, and various other candidate populations have been proposed. Nevertheless, because of the difficulties in establishing cellular phenotypes in vivo and other confounding factors, the true identities of these populations are still uncertain. This review critically evaluates the accumulating data in the field. The major focus is on the candidate populations that may give rise to osteochondrogenic lineage cells directly, not the populations that may contribute to HO indirectly. This issue is important not solely because of the clinical implications, but also because it highlights the basic biological processes that govern bone formation. [
Orthopedics.
2014; 37(5):329–340.]
Congenital Nasolacrimal Duct Obstruction in Premature Children
Authors: Lorena Silvia Helena Tavares , Silva João Amaro Ferrari , Scarpi Marinho Jorge 
Published: August 2014

Purpose:
To determine the incidence of congenital nasolacrimal duct obstruction (CNLDO) in premature and full-term children.

Methods:
Medical records of 200 premature and 200 full-term children from July 2004 to November 2009 at the Peri-Peri Health Center were retrospectively reviewed. Fifty-three nasolacrimal ducts in 32 premature children (21 patients were bilateral) and 9 nasolacrimal ducts in 7 full-term children (2 patients were bilateral) diagnosed as having CNLDO were retrospectively examined.

Results:

Of the 200 premature children, 32 (16%) had CNLDO compared with 7 (3.5%) of the 200 full-term infants (
P
< .0001). Thirty premature infants and five full-term children underwent conservative treatment. Bilateral obstruction was found in all 3 extremely premature children (gestational age < 28 weeks), in 9 (69.23%) moderately premature children (gestational age of 28 to 31 weeks), in 9 (56.25%) mildly premature children (gestational age of 32 to 36 weeks), and in 2 (28.57%) full-term children (gestational age > 37 weeks).

Conclusions:
This study reported a higher incidence of CNLDO in preterm infants when compared to full-term infants. This might be expected in light of the normal development of the nasolacrimal duct system, the patency of which normally occurs after the preterm infant is born.

[J Pediatr Ophthalmol Strabismus 2013;50(4):239–244.]
Retinoblastoma in Turkey: Results From a Tertiary Care Center in Ankara
Authors: Gündüz Kaan , Köse Kenan , Kurt Rengin Aslihan , Süren Elçin , Taçyildiz Nurdan , Dinçaslan Handan , Ünal Emel , Erden Esra , Heper Aylin Okçu 
Published: August 2014

Purpose:
To evaluate the presentation patterns and results of management of retinoblastoma at a tertiary care center in Ankara, Turkey, with special emphasis on globe conservation rate in unilateral and bilateral intraocular retinoblastoma.

Methods:
Patients were grouped according to the International Classification of Retinoblastoma. For intraocular retinoblastoma, group E and some group D eyes underwent primary enucleation. Secondary enucleation was performed after failure of chemoreduction, focal treatments, external beam radiotherapy (EBRT), and intra-arterial chemotherapy used in various combinations. For extraocular retinoblastoma cases, treatment consisted of enucleation/exenteration or orbital biopsy, high-dose chemotherapy, and EBRT to the orbit and metastatic sites.

Results:
During the study period from October 1998 to May 2010, 165 of 192 (85.9%) patients had intraocular disease and 27 (14.1%) patients had extraocular disease. In total, primary or secondary enucleation was performed in 70 of 94 eyes with unilateral retinoblastoma (74.5%) and in 34 of 142 eyes with bilateral retinoblastoma (23.9%). The overall globe conservation rate was 69.6%. Only one patient in the intraocular retinoblastoma group died of metastatic retinoblastoma to the central nervous system. Twenty of 27 patients (74.1%) with extraocular retinoblastoma were found to have metastasis to the central nervous system, bone, bone marrow, and/or lymph nodes. At a mean follow-up of 28.0 months (median: 12 months; range: 1 to 120 months), survival was 33.3% despite intensive treatment.

Conclusions:
The overall risk of enucleation was 75% in eyes with unilateral retinoblastoma and 24% in eyes with bilateral retinoblastoma. Extraocular retinoblastoma carries a 75% risk of systemic metastasis and 67% risk of death.

[J Pediatr Ophthalmol Strabismus 2013;50(5):296–303.]
Surgical Results of Consecutive Exotropia
Authors: Rajavi Zhale , Feizi Mohadeseh , Mughadasifar Hoosein , Yaseri Mehdi , Haftabadi Narges , Sheibani Kourosh 
Published: August 2014

Purpose:
To determine the success rates of different surgical procedures and the risk factors of surgical failure among patients with consecutive exotropia.

Methods:
Forty patients with exotropia were observed at least 6 weeks after their esotropia surgery. Surgical planning was based on the medial rectus muscle function. Lateral rectus weakening in patients with normal medial rectus function, medial rectus strengthening for patients with limited medial rectus function (−1 to −3), and combined procedure occurred when the correction of each type of surgery was less than the amount of deviation. Postoperatively, patients were divided into success (8 prism diopters [PD] or less) or failure (8 PD or greater) groups. The follow-up period was at least 3 months.

Results:

The mean preoperative exotropia was 29 ± 13 PD, which was reduced to 7 ± 7 PD postoperatively (
P
< .001). Successful results were achieved in 31 patients (77.5%), 17 (81%) in lateral rectus weakening, 10 (83%) in medial rectus strengthening, and 4 (57%) in the combined procedure group. More preoperative exodeviation was observed in the failure group compared to the success group (
P
= .015).The mean dose response was 2.27 ± 0.92 PD/mm in the lateral rectus weakening, 4.25 ± 2.27 PD/mm in the medial rectus strengthening, and 2.31 ± 0.66 PD/mm in the combined procedure groups.

Conclusion:
If the choice of surgical planning is based on medial rectus function and the amount of exodeviation, satisfactory alignment would be achieved in the majority of patients with consecutive exotropia. The preoperative amount of exodeviation was the only risk factor of surgical failure in the study.

[J Pediatr Ophthalmol Strabismus 2013;50(5):274–281.]
Corneal Topography and Corneal Thickness in Children
Authors: Reddy Shailaja P. , Bansal Rasheena , Vaddavalli Pravin K. 
Published: August 2014

Purpose:
To evaluate the corneal topography, thickness, and elevation (anterior and posterior corneal surface) in children.

Methods:
One hundred eyes of 100 patients with a mean ± standard deviation age of 10.6 ± 2.7 years (range: 5 to 15 years) were imaged. The corneal elevation maps were classified into regular ridge, irregular ridge, incomplete ridge, island, and unclassified patterns.

Results:
Mean simulated keratometry (Sim K) astigmatism was −0.69 ± 0.35 diopters (D) with mean maximum and minimum keratometry (K) of 44.26 ± 1.55 and 43.56 ± 1.57 D, respectively. Mean astigmatism and refractive power in the 3- and 5-mm zones was 0.64 ± 0.36, 43.85 ± 1.53 and 0.78 ± 0.5, 43.41 ± 1.48, respectively. The thinnest site on the cornea had an average thickness of 540 ± 34.03 μm. This site was most commonly located in the inferotemporal quadrant in 61% of eyes, followed by the superotemporal quadrant in 31%. Among the nine regions of the cornea evaluated, the central cornea had the lowest average thickness of 540 ± 34.03 μm and the superonasal cornea had the greatest average thickness of 628 ± 38.94 μm. The most common anterior corneal elevation pattern was the incomplete ridge (52%), followed by the island pattern. The incomplete ridge was most commonly observed on the posterior corneal elevation map (35%).

Conclusions:
These results provide normal standards for elevation and curvature topography and corneal thickness in children. These data may prove useful as a reference for future comparative studies of different corneal diseases in children.

[J Pediatr Ophthalmol Strabismus. 2013;50(5):304–310.]
Stereoscopic Visual Acuity in Types of Ametropic Amblyopia in Children
Authors: Li Shanshan , Zou Haidong , Wei Can 
Published: August 2014

Purpose:
To evaluate the presence of stereopsis in children with ametropic amblyopia, including hyperopia, myopia, and astigmatism.

Methods:
A total of 205 children with the average age of 5.2 years were selected, including 65 cases of astigmatic amblyopia, 30 of myopic amblyopia, and 110 of hyperopic amblyopia. The near stereoacuity test (zero disparity stereoacuity, crossed disparity, and uncrossed disparity) and distance stereoacuity test by synoptophore with Yan’s random-dot test in The Examination Chart of Stereoscopic Acuity were performed. Visual acuity was examined with the standard Snellen chart. Distance fusion was determined with the synoptophore. Correlations between amblyopia and stereopsis were performed with logistic procedure.

Results:

Differences between zero disparity stereoacuity of hyperopia, myopia, and astigmatism were statistically significant in children with mild and moderate amblyopia determined by the near stereoacuity test (
P
< .05). Individuals with hyperopia have better central stereopsis and macular stereopsis, whereas children with astigmatism have significantly decreased stereoacuity. No difference was identified between the three types in children with severe amblyopia (
P
> .05). Results of different degrees of amblyopia at distance and near were approximate. In amblyopic eyes, difference between hyperopia, myopia, and astigmatism, determined with synoptophore, was not significant (
P
> .05). The types and degrees of amblyopia were closely related with stereopsis (
P
< .001).

Conclusions:
In mild and moderate amblyopic eyes, children with astigmatism had the worst stereoacuity. This group should pay more attention to visual stimulation training and stereopsis training.

[J Pediatr Ophthalmol Strabismus 2014;51(2):105–110.]
The Importance of Oxygen Control Reaffirmed: Experience of ROP Reduction at a Single Tertiary Care Center
Authors: Nobile Stefano , Gnocchini Francesco , Pantanetti Marco , Battistini Paola , Carnielli Virgilio P. 
Published: August 2014

Purpose:
To report the impact of the adoption of a low oxygen saturation policy on retinopathy of prematurity (ROP) incidence at a single tertiary care center.

Methods:
ROP incidence, procedures for ROP, and neonatal outcome among very low birth weight infants were compared before and after the adoption of a low saturation policy, which took place in 2004. The Mann–Whitney test was performed to look for differences.

Results:

The incidence of severe ROP significantly decreased from 5.3% of live very low birth weight infants between 1999 and 2004 to 1% of live very low birth weight infants between 2005 and 2012 (
P
= .003). The use of laser therapy for severe ROP between the same periods significantly decreased from 6.4% of live very low birth weight infants between 1999 and 2004 to 0.6% of live very low birth weight infants between 2005 and 2012 (
P
= .002). There was also a significant reduction of death or bronchopulmonary dysplasia from 33.8% between 1999 and 2004 to 24.2% between 2005 and 2012 (
P
= .02).

Conclusions:
Trained personnel and low and tailored oxygen saturation intervals for very low birth weight infants could play a pivotal role in reducing the incidence of severe ROP without increasing mortality.

[J Pediatr Ophthalmol Strabismus 2014;51(2):112–115.]
Anterior Segment OCT Imaging After Femtosecond Laser Cataract Surgery
Authors: Nagy Zoltan Z. , Filkorn Tamás , Takács Ágnes I. , Kránitz Kinga , Juhasz Tibor , Donnenfeld Eric , Knorz Michael C. , Alio Jorge L. 
Published: August 2014

PURPOSE:
To report the anterior segment imaging characteristics after femtosecond laser assisted cataract surgery.

METHODS:
Cataract surgery was performed with the LenSx femtosecond laser (Alcon-LenSx Inc., Aliso Viejo, CA) in 40 eyes of 40 patients. The laser was programmed to perform a 4.5-mm capsulorhexis, a cross-pattern fragmentation of the nucleus, a 2.8-mm main incision, and a 1.0-mm side-port incision. The anterior segment was then analyzed using the Visante OCT anterior segment program (Zeiss-Meditec AG, Jena, Germany).

RESULTS:
The preoperatively set treatment parameters correlated well with the achieved results. For the capsulorhexis, the femtosecond laser cut was programmed to start 350 μm behind the anterior lens capsule and OCT measured 377 ± 55.3 μm. Nucleus fragmentation was programmed to start 750 μm in front of the posterior capsule and end 550 μm behind the anterior capsule, and OCT measured 794 ± 111 and 568 ± 147 μm, respectively. The diameter of the capsulorhexis measured by OCT was 4.54 ± 0.2 mm, compared to the 4.5 mm programmed.

CONCLUSIONS:
Anterior segment OCT imaging was able to detect the tissue changes within the lens after femtosecond laser capsulorhexis and nucleus fragmentation. The measured values correlated well with the planned treatment parameters.
Removability of a Small Aperture Intracorneal Inlay for Presbyopia Correction
Authors: Alió Jorge L. , Abbouda Alessandro , Huseynli Samira , Knorz Michael C. , Homs Maria Emilia Mulet , Durrie Daniel S. 
Published: August 2014

PURPOSE:
To evaluate the safety of the corneal inlay removal procedure and the reversibility of visual acuities, corneal topography, and corneal biomicroscopy changes in a series of cases.

METHODS:
Ten cases implanted with one of three versions of the AcuFocus Kamra Inlay (ACI 7000, 7000T, and 7000PDT; AcuFocus, Inc., Irvine, CA) were followed for a minimum of 6 months after corneal inlay removal.

RESULTS:

The reason for removal was related to subjective dissatisfaction with visual symptoms (8 of 10 patients) such as night glare, photophobia, starburst, blurry vision, and halos. One case of removal was related to inadvertent thin flap and the final case was related to insufficient near vision. Mean uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) was 0 ± 0.1 logMAR (Snellen 20/20) and 0.5 ± 0.2 logMAR (Snellen 20/40), respectively, preoperatively and 0.1 ± 0.1 logMAR (Snellen 20/25) and 0.5 ± 0.1 logMAR (Snellen 20/63), respectively, 6 months after corneal inlay removal. Mean corrected distance visual acuity (CDVA) and corrected near visual acuity (CNVA) was 0 ± 0.1 logMAR (Snellen 20/20) and 0 ± 0.1 logMAR (Snellen 20/20), respectively, preoperatively and 0 ± 0.1 logMAR (Snellen 20/20) and 0.1 ± 0.1 logMAR (Snellen 20/25), respectively, 6 months after corneal inlay removal. Mean root mean square (RMS) higher-order aberration (HOA) was 0.50 ± 0.12 (range: 0.30 to 0.70) preoperatively and 0.69 ± 0.14 (range: 0.48 to 0.95) 6 months after corneal inlay removal (
P
< .8). Weak positive correlation was found between Δt Implant-Removal (Δt I-R), RMS spherical, coma, and HOA at 6 months (Δt I-R vs RMS spherical was r = 0.2, r
2
= 0.5,
P
< .7; Δt I-R vs RMS coma was r = 0.8, r
2
= 0.6,
P
< .3; and Δt I-R vs HOA r = 0.8; r
2
= 0.6,
P
< .9).

CONCLUSION:
This study suggests that after removal of the corneal inlay, corneal topography and corneal aberrometry are not permanently affected. In more than 60% of patients, CNVA, CDVA, UNVA, and UDVA were similar to the preoperative value.

[
J Refract Surg.
2013;29(8):550–556.]
Microdistortions in Bowman’s Layer Following Femtosecond Laser Small Incision Lenticule Extraction Observed by Fourier-Domain OCT
Authors: Yao Peijun , Zhao Jing , Li Meiyan , Shen Yang , Dong Zixian , Zhou Xingtao 
Published: August 2014

PURPOSE:
To study microdistortions in Bowman’s layer after femtosecond laser small incision lenticule extraction (SMILE) using Fourier-domain optical coherence tomography (OCT) and to investigate possible sources and potential visual impacts.

METHODS:
A nonrandomized controlled prospective study enrolled 52 eyes of 29 consecutive patients undergoing SMILE, with spherical equivalent of −6.33 ± 1.88 diopters and 4.2 mm superior incision. The micro-distortions in Bowman’s layer were counted at 1 day, 1 week, and 1 month postoperatively and at long-term follow-up. Another 38 eyes of 20 patients undergoing femtosecond laser-assisted LASIK (FS-LASIK) were examined at 1 day and long-term postoperatively as the control group.

RESULTS:
Microdistortions in Bowman’s layer were observed by OCT, with no clinically significant corneal striae under slit-lamp microscopy, in 46 eyes (88.5%) on day 1 after SMILE and in 16 eyes (42.1%) after FS-LASIK, with more in SMILE eyes than in FS-LASIK eyes. The amount decreased at 1 week and then remained stable. There were more microdistortions in the center area than in the periphery in both groups. Microdistortions were more in the inferior than the superior quadrant on the first day after SMILE but there was no difference at long-term follow-up. Microdistortions after SMILE were associated with the refractive lenticule thickness and surgery order but had no significant impact on long-term visual outcomes or wavefront aberrations.

CONCLUSIONS:
Microdistortions in Bowman’s layer after SMILE were associated with the refractive lenticule thickness and surgery order. The microdistortions remained stable after 1 week and had no impact on long-term visual performance.

[
J Refract Surg.
2013;29(10):668–674.]
Normal Values for the Size of a Halo Produced by a Glare Source
Authors: Puell María C. , Pérez-Carrasco María J. , Barrio Ana , Antona Beatriz , Palomo-Alvarez Catalina 
Published: August 2014

PURPOSE:
To determine the size of a halo in the visual field induced by bright light in healthy eyes of all ages using the Vision Monitor (MonCv3; Metrovision, Pérenchies, France) and to assess the repeatability of the method.

METHODS:
Measurements were made in the right eyes of 147 healthy subjects (mean age: 48.2 ± 16.2 years) who were classified into six age groups. Using the Vision Monitor, optotypes of low luminance were presented at a distance of 2.5 m. The visual angle subtended by the radius of the halo was calculated in minutes of arc (arc min). The repeatability of the method was determined in a subset of 37 subjects older than 50 years by calculating the Bland–Altman coefficient of repeatability.

RESULTS:

The mean radius of the halo was 111.6 ± 39.8 arc min. Halo radius started to increase significantly from the age of 50 to 59 years. The relationship between halo radius and age (r = 0.65;
P
< .0001) was described by fitting a power function to the data. Halo size was independent of gender. The coefficient of repeatability of the method was ±44 arc min.

CONCLUSIONS:
Halo size increases with age following a power model. The normal halo size values provided could help clinicians distinguish between normal or abnormal glare problems. The intersession repeatability observed for halo size measurement indicates this method could be useful for assessing visual impairment caused by glare.

[
J Refract Surg.
2013;29(9):618–622.]
Intraoperative, Real-Time Aberrometry During Refractive Cataract Surgery With a Sequentially Shifting Wavefront Device
Authors: Krueger Ronald R. , Shea William , Zhou Yan , Osher Robert , Slade Stephen G. , Chang David F. 
Published: August 2014

PURPOSE:
To introduce a new sequential wavefront device with rapid sampling that can be used as an intraoperative, real-time aberrometer/refractometer for immediate diagnosis and management of refractive outcomes during cataract surgery.

METHODS:
A unique wavefront device uses a rotating prismatic mirror to rapidly shift the incident wavefront emanating from the eye through an aperture for analysis of a sequentially sampled wavefront segment. The sampled segment is then focused onto a quad detector that localizes its angular displacement of the sampled segment’s wavefront gradient. Although the device’s capability is higher for other applications, the wavefront is herein rapidly sampled at 200 Hz (frames/second), with a 2-mm aperture that moves along a 5-mm outer diameter annulus to capture a real-time analysis of refractive error for intraoperative application (ie, an intraoperative wavefront movie). The prototype wavefront device has been miniaturized into a narrow profile attachment that can be fixed to an operating microscope. In pilot analysis, several eyes undergoing cataract surgery were analyzed to determine both the qualitative and quantitative change in refraction with surgical intervention in an effort to document and improve outcomes intraoperatively.

RESULTS:
Clinical application of the device was easily implemented without changing or limiting the working distance, magnification, or illumination of the surgeon’s ergonomics intraoperatively. The real-time wavefront outcome was visualized overlaying a live eye image, presenting the refractive error both qualitatively and quantitatively. Qualitative representation of spherical refractive error was seen as a circle, cylinder as a thin ellipse, and emmetropia as a dot. Localization of lower-order aberrations with a practical sample rate of 200 frames/ second enables a real-time visualization of qualitative refractive data coaxially aligned with the eye image and quantitatively as sphere, cylinder, and axis at the bottom of the screen. Practical evaluation of residual cylinder prior to and during limbal relaxing incision placement, rotational accuracy during toric intraocular lens alignment, and refractive effect of subtle surgical maneuvers were all achieved with this device.

CONCLUSION:
Real-time, intraoperative refraction and visualization is possible with a new sequential wavefront device attached to the operating microscope. The precision and accuracy of intraoperative documentation and refinement of outcomes is likely to be enhanced, making this an important future tool for optimizing cataract surgery outcomes.

[
J Refract Surg.
2013;29(9):630–635.]