bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reposition of a Misaligned Zeiss AT TORBI 709M® Intraocular Lens 15 Months after Implantation
Authors: Brandlhuber Ulrich , Haritoglou Christos , Kreutzer Thomas C. , Kook Daniel 
Published: May 2014

Purpose To report the treatment of a patient with a misaligned intraocular lens (IOL). Methods We describe a case of a misaligned bitoric single-piece, plate haptic IOL (AT TORBI 709M®, Carl Zeiss Meditec AG, Jena, Germany) 15 months after uneventful phacoemulsification and IOL implantation in the capsular bag. Keratoconus with partly regular astigmatism was preexisting. Results Thorough examination showed a misalignment of the bitoric IOL of 25 degrees, explaining the patient's symptoms (monocular diplopia). Despite capsular fibrosis, surgical revision with IOL rotation was advised and could be performed without major difficulty. A follow-up visit showed a corrected distance visual acuity of 16/20 and a correctly aligned toric IOL. Conclusions A long preceding operation should not detain the surgical revision of a misaligned toric IOL in the capsular bag.
Effect of Prophylactic Medication and Influence of Vitreous Reflux in Pressure Rise after Intravitreal Injections of Anti-VEGF Drugs
Authors: Carnota-Méndez Pablo , Méndez-Vázquez Carlos , Otero-Villar Jaime , Saavedra-Pazos José Antonio 
Published: May 2014

Purpose To assess the efficacy of a hypotensive prophylactic medication in preventing intraocular pressure (IOP) changes after intravitreal injections, and the effect of occurrence of vitreous reflux on the variation of IOP. Methods A total of 141 intravitreal injections of anti-vascular endothelial growth factor drugs (0.05 mL) were randomly distributed into 2 groups: in group 1 (n = 77), no prophylactic IOP-lowering medication was used; in group 2 (n = 64), a fixed combination of brimonidine and timolol was instilled 5 minutes before the injection. The IOP was measured before and 1, 15, and 30 minutes after the injection. The presence of vitreous reflux was recorded. Results Despite significantly reducing the IOP by ~3 mm Hg, prophylactic medication did not prevent a transient IOP rise. A total of 22.7% of injections showed vitreous reflux, and those patients experienced much lower initial spikes. Indeed, only 6.5% out of 77 injections above 30 mm Hg within 1 minute after injection showed vitreous reflux. Only one case showed an IOP >30 mm Hg at 15 minutes, and none at 30 minutes postinjection. The IOP normalization rates over time were similar in all groups within 15 minutes. Conclusions Prophylactic medication instilled 5 minutes before the injection was not effective in preventing a pressure rise after intravitreal injections. Vitreous reflux decreased significantly the spike figures compared to injections with no reflux.
Homozygous c.1937+1G>A Splice-Site Variant of the ABCA4 gene is Associated with Stargardt Disease
Authors: Eandi Chiara M. , Grignolo Federico M. , Passerini Ilaria , Marchese Cristiana 
Published: May 2014

Purpose To report the phenotype of homozygous ABCA4 c.1937+1G>A splice-site variant associated with Stargardt disease. Methods Two siblings, a 10-year-old boy and a 32-year-old woman, born from consanguineous parents, presented with central vision loss and macular pigmentary atrophic changes suggestive of Stargardt disease. After genetic counselling, ABCA4 gene analysis was performed. Results The 2 siblings affected were shown to be homozygous for the c.1937+1G>A splice junction variant of the ABCA4 gene. Both parents were heterozygous for the same mutation; they were asymptomatic and the fundus examination revealed a normal appearance. Conclusions Thus far, ABCA4 c.1937+1G>A splice-site variant was shown to cause retinitis pigmentosa when in hemizygosity and Stargardt disease when present on one allele. In this family two sibs homozygous for the ABCA4 c.1937+1G>A splice-site variant have a less severe phenotype of Stargardt disease. This observation provides useful information for the diagnosis and counseling of patients with this ABCA4 variant.
Management of Recurrent Corneal Ulcers: Use of Amniotic Membrane
Authors: Ricciardelli Gabriella , Ceccuzzi Roberto , Raneri Marco , Scalisi Antonino , Bianchi Paolo E. 
Published: May 2014

Purpose Amniotic membrane (AM), or amnion, is a thin membrane on the inner side of the fetal placenta; it completely surrounds the embryo/fetus and delimits the amniotic cavity, which is filled by amniotic liquid. In recent years, the structure and function of the amnion have been investigated due to its pluripotent properties, which are an attractive source for tissue transplantation and reconstructive surgery. The pioneering use of AM in skin transplantation by Davis dates back to 1910; in 1913, Sabella and Stern employed it in the treatment of burns and superficial scars. Certain characteristics make the AM ideally suited to its application in ocular surface reconstruction. It can be easily obtained and its availability is nearly unlimited. We report a case of AM transplantation to treat ocular surface abnormality. Methods A 28-year-old man came to our attention for persistent foreign body feeling and pain in his right eye. Because of progressive clinical worsening, we decided to perform surgical apposition of AM. Results Clinical and instrumental follow-up was conducted with periodic complete checkups. At 1 year follow-up, best-corrected visual acuity was 4/10. Conclusions Characteristics of AM make it potentially useful to treat ocular surface abnormalities.
Optical Coherence Tomography Characteristics of the Iris in Cogan-Reese Syndrome
Authors: Holló Gábor , Naghizadeh Farzaneh 
Published: May 2014

Purpose To describe the characteristic optical coherence tomography (OCT) findings of the iris in Cogan-Reese syndrome. Methods A 63-year-old woman was referred for consultation due to diffuse pigmentation of the iris and elevated intraocular pressure (IOP) in the left eye. The clinical examination revealed Cogan-Reese syndrome with pedunculated iris outcroppings on the entire iris surface, and no peripheral anterior synechia. The right eye was normal with normal IOP. Results Imaging the left iris with the CAM-L cornea lens adapter of the Optovue Fourier-domain OCT (RTVue-OCT) showed a folded iris surface, an increased total iris thickness, and an increased distance between the anterior and posterior iris layers, compared to those of the healthy right eye. Conclusions Traction by the pathological endothelial cell layer that covers the iris surface in Cogan-Reese syndrome causes characteristic OCT signs in the iris. Detection of the folded iris surface, increase of iris thickness, and increase of the distance between the anterior and posterior iris layers with RTVue-OCT anterior segment examination may promote the correct diagnosis and may help the clinician to discriminate Cogan-Reese syndrome from true iris nevi or iris melanoma.
Vascularization of Conjunctival Autografts in Pterygium Surgery: Comparison of Fibrin Glue with Sutures
Authors: Küçükerdönmez Cem , Karalezli Aylin , Zengin Mehmet Ozgur , Akova Yonca Aydin 
Published: May 2014

Purpose To monitor the development of graft vascularization after pterygium excision with conjunctival autograft transplantation (CAT) using indocyanine green angiography (ICGA) and to compare the graft vascularization between 2 different fixation techniques (fibrin glue and sutures). Methods A total of 26 eyes of 26 patients with primary pterygium were randomly assigned after pterygium excision as having either fibrin glue (13 eyes) or Vicryl sutures (13 eyes) for CAT. Anterior segment ICGA findings were evaluated postoperatively at 1, 7, and 15 days and the percentages of graft vascularization in both groups were compared using pixel analysis software program. Results The mean ± SD age of patients in the suture and fibrin glue groups was 52.1 ± 12.7 years and 57.1 ± 9.82 years, respectively. There was no statistically significant difference between the groups regarding age, sex, or follow-up (p<0.05 for all). Also, the mean intraoperative defect size was not significantly different between the groups, which was measured as 20.11 ± 10.44 mm2 in the suture group and 23.44 ± 12.34 mm2 in the fibrin glue group (p = 0.343). The mean percentage of vascularized graft area at postoperative day 1 and 7 was 18.1 ± 7.8% and 25.3 ± 8.6% in the suture group and 34.8 ± 10.2% and 66.1 ± 17.8% in the fibrin glue group. The difference between the groups was statistically significant (p<0.01 for both). At postoperative day 15, all grafts were 100% perfused in both groups. Conclusions Fibrin glue fixation of conjunctival autografts led to more vascularization in the early postoperative period than suture fixated grafts, which in turn may have significance in terms of graft health and pterygium recurrence.
Comparison of Intralesional Corticosteroid and Propranolol Treatment of Periorbital Infantile Hemangiomas: An Outcome Study of 61 Cases
Authors: Hoornweg Marije J. , Saeed Peerooz , Tanck Michael W.T. , Hage J. Joris , Coumou Adriaan D. , Van Der Horst Chantal M.A.M. 
Published: May 2014

Purpose To compare intralesional corticosteroid (IC) injections with oral propranolol in children with periorbital infantile hemangioma (IH). Methods Children were diagnosed with IH and treated with IC (n = 29) or propranolol (n = 14). In cases in which no further improvement was seen, treatment was stopped and the outcome measured. Type, duration, and complications of treatment and supportive or additional therapies were scored, along with outcomes of visual measurements, at the start and end of therapy. Results Twenty-one of the 29 children (72%) treated with IC injections were given a second injection and 16 (55%) were given more than two. Median duration of IC therapy was 15.9 months (interquartile range (IQR) 10.28), compared with 6.5 months (IQR 4.87) for propranolol (p<0.001). The complications reported after IC injections were bleeding (n = 9) and ulceration (n = 7). No complications were noted in the propranolol group. Additional therapy consisting of oral prednisolone therapy was applied in one child from the steroid-treated group. The levels of amblyopia and the median absolute improvement did not significantly differ between the groups. Conclusions The IC injections and oral propranolol medication equally improved amblyopia in children with IH of the periorbital and cheek region; however, propranolol was associated with fewer complications and additional or supportive treatment was not indicated. We prefer oral propranolol medication over IC injections in cases in which IH threatens to hamper visual acuity.
Open-Globe Injuries at An Emergency Department in Porto, Portugal: Clinical Features and Prognostic Factors
Authors: Teixeira Sérgio M. , Bastos Ricardo R. , Falcão Manuel S. , Falcão-Reis Fernando M. , Rocha-Sousa Amândio A. 
Published: May 2014

Purpose To describe the epidemiology, characteristics, surgical management, functional outcome, and prognostic factors of open-globe injuries requiring surgical treatment. Methods A retrospective review of 180 patients who underwent surgical repair of an open-globe injury at the ophthalmology emergency department of the Hospital S. João (Porto-Portugal) was performed. Prognostic factors for no light perception and for poor vision (visual acuity < 3/10) in patients who retained vision after surgical treatment were determined. Results We observed a different age distribution between male and female ocular trauma (143 patients were men, with a mean age of 46.4 years, while the mean age for women was 70.9 years). Domestic accidents were the most frequent context of trauma (44.4%). However, work accidents constituted the principal context of trauma among men. Initial visual acuity, concomitant adnexa lesion, associated nonocular trauma, and intentionally caused trauma were predictors of no vision at the end of the follow-up. Older age, lens damage, and retinal detachment were predictors of poor vision in patients with retained visual acuity. Vitreous hemorrhage, posterior segment lesion, and simultaneous lesion of anterior and posterior segment anticipated both no vision and poor vision. Isolated anterior segment lesion was associated with vision survival and good vision (≥ 3/10). Conclusions The prognostic factors identified in this study may aid the process of decision-making in 2 crucial moments: at the initial approach and during the follow-up of patients with vision survival after open-globe injuries.
Changes in the Etiology of Endophthalmitis from 2003 to 2010 in a Large Tertiary Medical Center
Authors: Kessner Rivka , Golan Shani , Barak Adiel 
Published: May 2014

Purpose To ascertain the leading causes of endophthalmitis at the Tel Aviv Medical Center between 2003 and 2010. Methods The design of the study is retrospective chart review. The medical records of all patients diagnosed with endophthalmitis in our center between 2003 and 2010 were reviewed for visual acuity and results of ophthalmologic examination at admission, treatment, complications, laboratory investigations, and final visual results. The etiologies of endophthalmitis after cataract surgery were compared for each year from 2003 to 2010, and after intravitreal (IVT) injection from 2006 to 2010. Results Eighty patients were diagnosed with endophthalmitis between 2003 and 2010: 46 male and 34 female, average age 70.7 years. A total of 27.5% were treated with IVT antibiotic injection only and 68.8% needed pars plana vitrectomy. Final visual acuity was better than counting fingers in 56.3% of cases. Surgery was almost the sole cause of endophthalmitis until 2005, when IVT injection became an important etiology. The incidence of postcataract endophthalmitis decreased significantly after 2007 and that following IVT injection decreased significantly after 2008. Conclusions The leading etiology of endophthalmitis changed from postoperative endophthalmitis to endophthalmitis after IVT injection from 2003 to 2010, and the incidence of the infection as a complication of those procedures decreased.
Accidental Foveal Photocoagulation Secondary to Alexandrite Laser
Authors: Anaya-Alaminos Roberto , Muñoz-Ávila José I. , González-Gallardo María C. , Mora-Horna Eduardo R. , García-Serrano José L. , Ramírez-Garrido María V. 
Published: May 2014

Purpose In recent years, we have seen an increase in the use of laser systems in the field of aesthetics (mainly depigmentation and hair removal). Alexandrite laser is the most widely used. Methods Case report. Results We describe a case of retinal injury (foveal photocoagulation) directly related to an alexandrite laser hair removal procedure. Conclusions Hair removal by laser systems is a fast and efficient method. The use of lasers without adequate protective measures or by unqualified personnel increases the risk of ocular adverse effects.
Intravitreal Dexamethasone Implant for Acute Exudative Polymorphous Vitelliform Maculopathy
Authors: Scupola Andrea , Abed Edoardo , Sammarco Maria Grazia , Traina Salvatore , Villano Antonio , Grimaldi Gabriela , Blasi Maria Antonietta 
Published: May 2014

Purpose Acute exudative polymorphous vitelliform maculopathy is a rare retinal disease characterized by bilateral serous macular detachment and subretinal accumulation of yellowish deposits resembling Best dystrophy lesions. Corticosteroid systemic therapy has been used empirically in the attempt to treat this retinal disorder with mixed results. Thus, the benefit of corticosteroid remains undetermined. To our knowledge, we report the first case of acute exudative polymorphous vitelliform maculopathy (AEPVM) treated in one eye with intravitreal dexamethasone implant (Ozurdex; Allergan, Inc., Irvine, California, USA). Methods A 28-year-old man with AEPVM underwent intravitreal dexamethasone implantation in the left eye. Results Compared with the fellow eye, intravitreal dexamethasone implant did not significantly modify the clinical course of the disease. No implant-related complication was experienced during follow-up. Conclusions The lack of response to intravitreal dexamethasone seems to suggest that corticosteroids may be ineffective for the treatment of AEPVM.
Retinal and Choroidal Thickness Changes after Single Anti-VEGF Injection in Neovascular Age-related Macular Degeneration: Ranibizumab vs Bevacizumab
Authors: Sizmaz Selcuk , Kucukerdonmez Cem , Kal Ali , Pinarci Eylem Yaman , Canan Handan , Yilmaz Gürsel 
Published: May 2014

Purpose To evaluate and compare the effects of single intravitreal injection of ranibizumab and bevacizumab on central retinal and choroidal thickness in patients with neovascular age-related macular degeneration (AMD). Methods Forty eyes of 40 patients with neovascular AMD that underwent intravitreal injection of vascular endothelial growth factor inhibitors (anti-VEGFs) were included. Patients were randomized into 2 groups: 20 eyes received ranibizumab and 20 eyes received bevacizumab injection. Central retinal and choroidal thicknesses of all eyes at baseline and 1 month postinjection scans were measured with Fourier-domain optical coherence tomography (OCT). Student t test and Mann-Whitney U test were used to compare the data. Results The mean central retinal thickness (CRT) showed significant decrease after single injection of ranibizumab (from 345.0 μm to 253.5 μm, p<0.01) and bevacizumab (from 329.5 μm to 251.0 μm, p<0.01) at the first month, respectively. There was no significant difference regarding the CRT change between groups (p = 0.39). The mean choroidal thickness decreased from 158.6 μm (115-317) to 155.5 μm (111-322) in the ranibizumab group and from 211.5 μm (143-284) to 201.5 μm (93-338) in bevacizumab group. The decrease was not significant between groups (p = 0.35). Conclusions Intravitreal injection of both ranibizumab and bevacizumab provided a significant decrease in CRT; however, the agents caused no significant change in choroidal thickness. Additionally, no difference between ranibizumab versus bevacizumab was observed related to macular edema inhibition.
Epiphora as the Presenting Sign of Relapsed Non-Hodgkin Lymphoma in a Child with Bruton Agammaglobulinemia
Authors: Gokce Gokcen , Ceylan Osman Melih , Uysal Yusuf , Yildizoglu Uzeyir , Atas Erman , Kurt Bulent 
Published: May 2014

Purpose Primary or secondary infiltration of the lacrimal drainage system by a lymphoid neoplasm is rare in children. Primary immunodeficiencies are characterized by occurrence of unusual malignancies at unexpected locations in the pediatric age group. Methods Case report. Results A 12-year-old boy with a history of Bruton agammaglobulinemia and non-Hodgkin lymphoma (NHL) that primarily originated in the perianal region was referred to our oculoplastics department for persistent epiphora. Computed tomography scan and nasal endoscopy revealed relapse of NHL in the inferior portion of the nasolacrimal duct. Complete remission was achieved with chemotherapy. Conclusions Epiphora could be the initial manifestation of a relapse or a recurrence of an underlying malignancy in the pediatric population with predisposing immunodeficiency.
Assessment and in vitro Experiment of Artificial Anal Sphincter System based on Rebuilding the Rectal Sensation Function
Authors: Zan Peng , Liu Jinding , Jiang Enyu , Wang Hua 
Published: May 2014

In this paper, a novel artificial anal sphincter (AAS) system based on rebuilding the rectal sensation function is proposed to treat human fecal incontinence. The executive mechanism of the traditional AAS system was redesigned and integrated for a simpler structure and better durability. The novel executive mechanism uses a sandwich structure to simulate the basic function of the natural human anal sphincter. To rebuild the lost rectal sensation function caused by fecal incontinence, we propose a novel method for rebuilding the rectal sensation function based on an Optimal Wavelet Packet Basis (OWPB) using the Davies-Bouldin (DB) index and a support vector machine (SVM). OWPB using a DB index is used for feature vector extraction, while a SVM is adopted for pattern recognition. Furthermore, an in vitro experiment with the AAS system based on rectal sensation function rebuilding was carried out. Experimental results indicate that the novel executive mechanism can simulate the basic function of the natural human anal sphincter, and the proposed method is quite effective for rebuilding rectal sensation in patients.
Elevated Resistin Levels are Associated with Inflammation in Hemodialysis Patients with Failed Renal Allografts
Authors: Akagun Tulin , Caliskan Yasar , Yazici Halil , Ozkok Abdullah , Telci Aysegul , Turkmen Aydin , Yildiz Alaattin , Sever Mehmet Sukru 
Published: May 2014

Background Resistin is an adipocytokine, associated with insulin resistance and inflammation. The aim of this study is to evaluate the levels of serum resistin levels and other markers of inflammation in hemodialysis (HD) patients with failed renal allografts. Methods Sixty-nine HD patients with failed renal allografts and 98 never transplanted (naive) HD patients and also 21 healthy controls were included in the study. Serum levels of various biochemical parameters as well as resistin, IL-6, TNF-α and hs-CRP as biochemical markers of inflammation, were measured. Results Serum resistin levels in patients with failed renal allografts (4.80 ± 2.06 ng/mL) were significantly higher than those of the naive HD patients (3.44 ± 1.48 ng/mL) and healthy controls (0.95 ± 0.38 ng/mL; p<0.001). Patients with failed transplants were also characterized by higher TNF-alpha levels (96.8 ± 131.3 pg/mL vs. 40.9 ± 25.4 pg/mL; p<0.001) and IL-6 levels (83.9 ± 150.9 pg/mL vs. 14.6 ± 14.4 pg/mL; p<0.001) as compared to naive HD patients. Serum hs-CRP levels in patients with failed renal allografts (9.33 ± 11.86 mg/L) were significantly higher than those of the naive HD patients (1.26 ± 1.71 mg/L) and healthy controls (2.12 ± 1.82 mg/L; p<0.001). Serum albumin levels in patients with failed transplants (3.84 ± 0.47 g/dL) were lower as compared to never transplanted HD patients (4.13 ± 0.33 g/dL) and healthy controls (4.53 ± 0.40 g/dL; p<0.001). There was a positive correlation between serum resistin and TNF-alpha levels (r = 0.486, p<0.001). Conclusions Serum resistin levels are increased in HD patients with failed renal allografts very probably reflecting an allograft-induced chronic inflammatory state.