bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of intravitreal dexamethasone implant (Ozurdex®) in the glycemic control of patients with diabetic macular edema
Authors: Agard E. , El Chehab H. , Malclès A. , Russo A. , Leberre J.P. , Mounier C. , Dot C. 
Published: September 2015

PurposeTo evaluate the effect of intravitreal dexamethasone implant (Ozurdex®) in the glycemic control of patients with diabetic macular edema (DME).MethodsTen patients with DME received an intravitreal injection (IVI) of dexamethasone implant (DXE implant, Ozurdex®). The mean age of patients was 72 years ± 13.3 years (range, 54–78 years). Glycated haemoglobin (HbA1C) was analyzed before and three months after IVI. The real‐time glycemic readings, throughout the day and night, during at least one week, are provided by a new medical device (Dexcom G4® Dexcom, Fr). The primary outcome analysis was the comparison of HbA1C test before and after IVI. Other data included blood glucose average, the percentage of time spent higher, lower and in glycemic target, and standard deviation over the period.ResultsThe mean HbA1C test is 7.2% before IVI and 7.5% after IVI (p = 0.83). Recording of blood glucose was performed on an average of 10 days ± 3. There is no statistical difference for the mean blood glycemic levels before and after IVI. It was 155.4 ± 2323.1 mg/dl before IVI and 163.3 ± 32.8 mg/dl after IVI (p = 0.25). No significant difference was found between extreme values of blood glucose: the mean highest values was 321.1 mg/dl versus 349 mg/dl (p = 0.35), the mean lowest values was 54 mg/dl versus 64.57 mg/dl (p = 0.40).ConclusionsThis new continuous glucose monitoring system is indicated for detecting trends and tracking patterns in patients with diabetes. To our knowledge, this is the first study that analyses the glycemic control in human after DXE implant IVI with a daily continuous glucose monitoring. In this study, the use of intravitreal steroids in diabetic patients doesnâ€™t alter glycemic control or increase blood glucose levels. These preliminary results must be confirmed by further studies with a larger cohort.
Tolerance of Dexamethasone intravitreal implant in GAO patients according to their initial treatment and repeated intravitreal injections
Authors: Vié A.L. , Kodjikian L. , Malcles A. , Agard E. , El Chehab H. , Russo A. , Dot C. 
Published: September 2015

AbstractPurposeTo evaluate the tolerance of dexamethasone intravitreal implant (DEX implant) in patients with history of open‐angle glaucoma (OAG) or ocular hypertension (OHT) according to their initial treatment and the repetition of intravitreal injections (IVI).MethodsWe performed a retrospective two‐center clinical study which included 100 patients treated by DEX implants, divided into one group with OAG or OHT patients (n = 50 patients), and one control group (n = 50 patients) including patients with no history of OHT or GAO, matched by age and pathology. IOP was measured and hypotensive treatments were gathered in all patients respectively at baseline, one week, and each month during six months.ResultsMean age was 71.77 (SD +/‐ 10.5) years old in GAO/OHT group and 70.4 (SD +/‐ 10.7) years old in control group and mean number IVI was respectively 2.2 (1–7) and 2.8 (1–11). After the first injection, 50% of OAG/OHT patients and 42% of the control group increased their IOP more than 6 mmHg (p = 0.42). There was no difference between the IOP responses of patients initially treated with monotherapy and the control group but there was significantly more high responders (+>15 mmHg) in patients initially treated with bi and triple therapy. The proportion of responders increased when patient had more than one injection (64 and 56% respectively in OAG and control group, p = 0.22) and the number of high responders doubled (16% at the first IVI, 32% of multi‐IVI). An increased of hypotensive therapy was required in 54% of OAG/OHT patients versus 38% in control group (p = 0.1).ConclusionsDEX implant is well tolerated for the patients under monotherapy. In contrast Patient under bi or triple therapy were at risk of ocular hypertension and filtering surgery. Repeated IVI increased the risk of ocular hypertension.
Normal tension glaucoma associated with lamina cribrosa defects and complicated of maculopathy: A case report
Authors: Besombes G. , Bachetti P. , Labalette P. , Rouland J.F. 
Published: September 2015

AbstractPurposeEyes with glaucoma often present modification of the lamina cribrosa, including posterior displacement, thinning, defects and pore deformities.MethodsA 40‐year‐old woman with no past medical history have been seen for an acute blurred vision of her left eye 5 days ago. Anamnesis didn't find any family history of glaucoma, but she described a Raynaud phenomenon. Complete ophthalmoscopic examination was performed, with biomicroscopy, fundus imaging, visual field test (Humphrey field analysis 30‐2), optical coherence tomography (OCT) assessment with both Spectralis (Heidelberg) and Cirrus OCT (Carl Zeiss), ultrasonography and fluorescein/infracyanin angiography.ResultsThe maculopathy was characterized by schisis‐like thickening and serous detachment. The presence of lamina cribrosa defects permits anomalous communications between intraocular and extraocular spaces. OCT showed a schisis cavity between the inner and outer retina and a larger outer‐layer retinal detachment. The two were connected by a hole in the outer layer near the fovea. The associated subretinal and intraretinal fluid may derive from cerebrospinal fluid that passes through the opening created by the discontinuity of the lamina cribrosa into the subarachnoidal space. This complication usually occurs in case of congenital optic pit.ConclusionsWe describe the case of a patient with a recent diagnosis of normal tension glaucoma, showing a pit‐like structure within the ONH. We observed focal areas of laminar holes in the superior pole of the optic disc. This location differs from the congenital and acquired optic pits mostly temporally or inferiorly located. Enhanced Depth Imaging OCT of the ONH enables microstructural evaluation of lamina cribrosa defects, especially helpful in case of normal tension glaucoma.
Orbital T‐cell lymphoblastic lymphoma
Authors: Heegaard S. , Stenman L. 
Published: September 2015

PurposeTo present the clinical, pathological and genetic characteristics of a case of primary T‐cell lymphoblastic lymphoma of the orbit.MethodsClinical work‐up and morphological – and immunohistochemical study. Genetic analyses using FISH, DNA sequencing and arrayCGH analysis.ResultsA 22‐year‐old man presented with a 3‐week period of headache, reduced visual acuity and restricted eye movements of the left eye, unresponsive to antibiotic treatment. MRI scan showed large thickening of the extraocular muscles. Biopsies showed infiltration of lymphoma cells in the medial and superior rectus muscle as well as the superior oblique muscle of the left eye.Morphological and immunohistochemical studies of the biopsies showed T‐cell lymphoblastic lymphoma. No major genomic imbalances were detected by high‐resolution arrayCGH. FISH analysis revealed no evidence of chromosomal translocation involving the ETV6 and MLL genes.The patient received chemotherapy according to the high‐risk NOPHO‐protocol as well as a myeloablative allogenic bone marrow transplantation. The patient remains free of lymphoma nine months after the diagnosis, but with loss of visual acuity on his left eye.ConclusionsPrimary T‐cell lymphoblastic lymphoma in the eye region is very rare. It is important to recognize these patients early and think of lymphoma as a differential diagnosis in patients with involvement of the extraocular muscles. This is the first reported case of a T‐cell lymphoblastic lymphoma in the orbit.
Long term outcomes in a real life setting treatment by anti‐vascular endothelial growth factor for wet age‐related macular degeneration
Authors: Haouas M. , Girmens J.F. , Thuret G. , Gain P. , Paques M. , Sahel J.A. 
Published: September 2015

PurposeTo report long‐term visual outcomes for patients receiving a real life setting treatment by anti‐vascular endothelial growth factor (VEGF) for neovascular age‐related macular degeneration (AMD).MethodsRetrospective chart review of 500 patients who received a first anti‐VEGF injection for wet AMD from January 1, 2006 to January 1, 2010 at the Quinze‐Vingts National Hospital (Paris). Patients clinical characteristics, ETDRS letter score at baseline, every years and at the last follow‐up were recorded. The number of injections and the date of the first and last injection were also recorded. The main outcome measure was mean change in letter score at 5, 6 and 7 years from baseline.Results150 eyes of 120 patients with at least 5 years of follow‐up were identified. The eyes non‐selected had an insufficient follow‐up or another macular disease treated by anti‐VEGF. The mean follow‐up was of 77 months. Mean change in letter score at 5, 6 and 7 years was respectively + 2 letters, ‐1 letters and ‐ 4 letters. A vision of 20/40 or better was achieved in 20% of treated eyes. Seventy percent of eyes was untreated since 6 months or more at the last follow‐up. Patients received an average of 4 injections per year.ConclusionsReal life setting treatment of neovascular AMD by anti‐VEGF results in a stabilization of vision at 5 and 6 years of treatment. At the seventh years of follow‐up, visual outcomes tend to be worse. Mean duration of treatment was 46 months, with 70% patient no longer requiring reinjection after a mean of 34 months after initiation. Evolution of treatment settings suggests that visual outcomes would be better for recently diagnosed and treated patients.
Radiation complications, Toxic Tumor Syndrome prevention
Authors: Romanowska Dixon B. , Kubicka‐Trzaska A. , Morawski K. , Bogdali A. , Markiewicz A. 
Published: September 2015

PurposeAfter large melanomas radiotherapy (I‐125, Ru‐106 brachytherapy or proton‐beam) tumor is damaged, which can cause the development of radiation‐induced complications. Large tumor resection under the scleral flap (egzoresection) or during pars plana vitrectomy (endoresection) can prevent Toxic Tumor Syndrome.AimTo present choroidal melanoma endoresections results. Tumors were resected in the Department of Ophthalmology and Ocular Oncology at the University Hospital in Krakow.MethodsThe study included 10 patients with large melanoma located in the posterior pole after the proton beam irradiation. Patients were stratified for resection because of the risk of Toxic Tumor Syndrome. Pars plana vitrectomy and tumor endoresection was performed in all cases with endophotocoagulation and silicone oil endotamponade. ResultsRemoved melanomas were localized predominantly in the posterior pole of the eye, tumor base diameter ranged from 11.3 to 15.2 mm, tumor thickness ranged 5.2 to 9.1 mm. Endoresection was performed 1 to 3 months after proton beam irradiation. Intraoperative complications include minor bleeding occurred in all patients, postoperatively in 1 patient intraocular inflammation (treated with good effect intravitreal injections of steroids) and in 1 case of PVR. There was no recurrence of the neoplasm during the observation period. ConclusionsChoroidal melanoma endoresection should be used in some cases of large tumors localized back to the equator of the eye, mainly in the posterior pole of the eye. This prevents Toxic Tumor Syndrome and tumor recurrence.
Clinical outcome of YAG laser vitreolysis (Ultra Q Reflex®) for the treatment of floaters
Authors: Kim E. , Kim H.K. , Yoo T.Y. 
Published: September 2015

PurposeFloaters are localized vitreous opacities that are products of vitreous degeneration or posterior vitreous detachment (PVD). Usually, observation was the only solution, however some patients are suffered from floaters. This study reports the clinical results of YAG laser vitreolysis for the treatment of floaters.MethodsThe patients with floaters were involved who visited Pureun eye hospital between January and March 2015. The patients were involved who met the following criteria; the floaters caused by localized vitreous opacities or PVD; patients suffered from floaters and strong desire for cure. The patients with diabetic retinopathy, retinal detachment, severe media opacity and young age were excluded. Patients had pre and postoperative examinations including visual acuity, tonometry, wide fundus photography, slit lamp and fundus examination. Patients were examined 1, 4 and 8 weeks after treatment. The floater scores were measured with survey paper for the evaluation of subjective change. The wide fundus photography was used for the objective change.ResultsThe 47 eyes were involved (27 cases:male and 20 cases:female). The mean age was 69.5 ± 14.3. Informed consent was obtained in all cases. The floater scores were significantly improved after treatment (preoperative: 73.6 ± 10.5, postoperative: 8.2 ± 4.6, P < 0.001). The visible floaters disappeared in 43/47 cases (91.5%) in wide fundus photography. There were no significant changes in VA and IOP. Other side effects such as retinal detachment or hemorrhage and cataract were not developed during follow up period.ConclusionsThe clinical outcome of YAG laser vitreolysis using Ultra Q Reflex showed favorable results in subjective and objective measurement. There were no significant complications after procedure. We think YAG laser vitreolysis could be the excellent treatment option for the floaters.
Thermal cataract induced by near infrared radiation (IRR)
Authors: Yu Z. , Schulmeister K. , Talebizadeh N. , Kronschläger M. , Söderberg P. 
Published: September 2015

PurposeTo estimate the threshold radiant exposure for 1090 nm IRR and the time evolution of lens damage; To determine the temperature time evolution in the eye during the previously found threshold exposure, and the associated heat diffusion; To investigate if 1090 nm IRR induces cataract photochemically considering irradiance exposure time reciprocity.MethodsThe 6‐weeks‐old albino rats were anesthetized intraperitoneally, ten min before exposure. The pupils of both eyes were dilated with tropicamide. Five min after pupil dilation, the animals were unilaterally exposed to 1090 nm IRR within the pupil area. Temperature was recorded with thermocouples placed in the selected positions of the eye. At the planned post‐exposure time, the animal was sacrificed and the lenses were extracted for measurements of forward light scattering and macroscopic imaging.ResultsThe in vivo exposure to 197 W/cm2 1090 nm IRR required a minimum 8 s for cataract induction with a delayed onset of approx 16 h. The same radiant exposure was found to cause a temperature increase of 10°C at the limbus and 26°C close to the retina. The in vivo exposure to 96 W/cm2 1090 nm IRR with exposure time up to 1 h resulted in an average temperature elevation of 7°C at the limbus with the cornea humidified and no significant light scattering was induced one week after exposure.ConclusionsAn in vivo exposure to 197 W/cm2 IRR at 1090 nm within the pupil for 8 s induces cataract with a time delay. This threshold exposure causes a temperature rise of 10°C at the anterior segment of the rat eye. IRR at 1090 nm produces thermal cataract, probably by indirect heat conduction from absorption in tissues surrounding the lens. There is no cataract development given that the limbal temperature increase is below 8ºC.
Intra‐ocular pressure spike after Aflibercept and Ranibizumab intravitreal injections
Authors: El Chehab H. , Agard E. , Russo A. , Malcles A. , Dot C. 
Published: September 2015

PurposeSince anti‐VEGFsapproval, intra vitreous injections (IVI) represent a booming therapeutic delivery mode. Immediate ocular hypertension (OHT) induced is known after these IVIs. The purpose of this study is to compare the OHT after Aflibercept and Ranibizumab IVI.MethodsIn this prospective study, we compared 30 patients who received an Aflibercept IVI (0.05 mL) to 30 patients who received Ranibizumab for wet AMD. IVI were performed with a 30G needle pushed to the hilt with an anti‐reflux system. We measured intraocular pressure (IOP) using a portable aplanation tonometer PERKINS MK2 (Haag‐Streit, Koeniz, Switzerland) before injection (T0), immediately after IVI (T1), 5 minutes (T5), 15 minutes (T15) and 45 minutes (T45) after the IVI. IOP were compared by a t‐test.ResultsIn Aflibercept group, at T0, IOP was 13.4 mmHg+1.5. All patients had a significant increase in IOP at T1 (42.7 mmHg+3, p < 0.001). At T5, IOP decreased but was still statistically higher than baseline IOP (23.6 mmHg+3.1, p < 0.001). At T15, IOP returned to normal values but was higher than T0 (16.2mmHG + 2.1, p = 0.009). At T45, IOP was 13 mmHg + 1.2, with no significant difference from baseline (p = 0.65). In Ranibizumab group, baseline IOP was 13.8 mmHg + 1.1. IOP increased at T1 (45.6 mmHg + 2.2, p < 0.001). At T5 and T15, IOP were still higher than baseline (24.6 mmHg + 2.2, p < 0.001 and 17.9 + 1.5, p < 0.001). At T45, IOP was 12.7 mmHg + 1.5, with no significant difference from baseline (p = 0.12). At each time measure, there is no statistically difference between two groups.ConclusionsAflibercept and Ranibizumab IVI induce an IOP spike for a short time. It seems to be equal between the two drugs and essentially related to the injected volume.
Comparison of effective group and refractory group to alternative patch treatment in overcorrected intermittent exotropia
Authors: Lee S.J. , Kim J.Y. , Park J.M. 
Published: September 2015

PurposeTo compare effective group with refractory group to alternative patching alone in patients with overcorrection after surgery for intermittent exotropia (IXT).MethodsMedical records of 53 patients with overcorrection after surgery for IXT were reviewed. Alternative patching was prescribed from postoperative day 1 for patients who had esodeviation ≥18 PD, or esodeviation ≥10 PD after postoperative day 2 weeks. Refractory group was defined as remaining esodeviation ≥10 PD at least 3 months of treatment. Presumed risk factors were investigated.ResultsOf total 53 patients, 30 patients (56.6%) were in effective group and 23 patients (43.4%) were in refractory group. Significant differences were found in gender (Female, Refractory 78.3% vs Effective 46.7%) and preoperative exodeviation at distance (Refractory 27.6 ± 6.5 PD vs Effective 25.8 ± 4.5 PD). Mean starting time of alternative patching in refractory group was later (22.4 ± 25.4 days) than in effective group (10.2 ± 9.6 days). The mean angle of postoperative maximal esodeviation at near was larger in refractory group (−20.0 ± 6.9PD vs −14.7 ± 8.5PD). The mean time of postoperative maximal esodeviation was later in refractory group than in effective group (at distance: 2.3 ± 2.1 months vs 0.3 ± 0.2 months, P < 0.01, at near: 3.4 ± 4.1 months vs 0.4 ± 0.3 months.ConclusionsFemale, large preoperative exodeviation at distance were predisposing factors for refractory to alternative patch treatment in overcorrected IXT. Prescription of alternative patching was late in refractory group. The mean angle of postoperative maximal esodeviation was larger and the mean time of postoperative maximal esodeviation was later in refractory group. Postoperative changes in angle of deviation was significantly larger in refractory group since 1 month.
Spontaneous oscillations in the diameter of retinal arterioles from normal persons decrease with age
Authors: Ragunathan S. , Taborsky J. , Bek T. 
Published: September 2015

PurposeThe retinal vascular system is devoid of autonomic nervous supply, and consequently retinal blood flow is autoregulated. This includes pressure autoregulation, metabolic autoregulation and spontaneous oscillations in the diameter of retinal arterioles, so called vasomotion. It has been shown that vasomotion is impaired in diabetic patients, but it is unknown to what extent vasomotion results in retinal vascular disease should be corrected for age.MethodsForty‐eight normal persons consisting of at least 8 persons within each of the age groups (in years): 20–29, 30–39, 40–49, 50–59 and 60–69 were included. The patients had been examined by video recording of the retinal vessels using the Dynamic Vessel Analyzer, and diameter changes at five different locations on both arterioles and venules were analyzed by Fourier analysis. The power of the oscillations was calculated in five frequency bands defined as: (1) <0.04 Hz the very low frequency (VLF), (2) ≥0.04 and <0.15 Hz as the low frequency (LF), (3) ≥0.15 Hz and <0.4 Hz as high frequency (HF), (4) ≥0.4 and <2 Hz (VHF) normally containing the heart rate, and (5) 2‐12.5 Hz as a ultra high frequency (UHF).ResultsIn all arteriolar segments the power of spontaneous diameter oscillations with high frequencies showed a negative correlation with age, and the correlation was also found for low frequencies 1½ disk diameter from the optic disk (R2 = 0.0038 ± , p < 0.003 for all comparisons).ConclusionsPower analysis of spontaneous diameter changes in retinal arterioles should be corrected for age before results from different patient groups can be compared.
Characteristics of Artifacts Associated with Ultra‐Wide Field Fundus Image
Authors: Oh J.R. , Lee B. , Ahn J. , Kim Y.H. , Kim S.W. 
Published: September 2015

PurposeTo evaluate characteristic of artifacts associated with ultra‐wide field fundus image.MethodsThe retrospective study included 139 eyes of 139 patients who had artifacts in color images using Optomap 200Tx (Optos, DunFermline, UK). The artifact means hyperreflective or hyporeflective shadow due to anterior segment of the eye or vitreous except retina. Types and characteristic of red laser separation, green laser separation and autofluorescence image artifacts within each image were evaluated.ResultsAll image artifacts were categorized into two groups according to the location of artifacts. There were corneal opacity, cataract and posterior capsular opacity in the anterior artifacts group. And there were asteroid hyalosis, posterior vitreous detachment, vitreous opacity and vitreous hemorrhage in the posterior artifacts group. Anterior artifacts were more often hyporeflective in red and green laser separation images (p < 0.001). Posterior artifacts were more often hyperreflective in green laser separation images and hyporeflective in red laser separation images (p < 0.001).ConclusionsUltra‐wide field scanning laser ophthalmoscope images can frequently have various shadows from anterior or posterior lesion of eye. These shadows show a difference in reflectivity depending on their origins. To understand the difference helps interpretation of the fundus images.
Toxoplasma chorioretinitis: value of polymerase chain reaction and intraocular antibody production in a patient with negative anti‐Toxoplasma gondii serology
Authors: Roels D. , Nerinckx F. , Leroy B.P. , Padalko E. , De Schryver I. 
Published: September 2015

Purposereport a case of panuveitis with negative anti‐Toxoplasma gondiiserology, and serologic and PCR analysis of intraocular fluids positive for Toxoplasmosis.MethodsA 29‐year‐old male presented with left panuveitis and no view of the fundus, underwent a diagnostic vitreous biopsy. Work‐up included serology, vitreous PCR and measurement of local antibody production in aqueous humour.ResultsAt presentation, BCVA in the LE was CF at 1 m. The patient described a progressive decline of vision in the LE since 6 months. Examination showed panuveitis with dense vitritis obscuring the fundus. IOP was 29 mmHg. The RE showed a chorioretinal scar located superonasally to the optic disc. Toxoplasma chorioretinitis was suspected, but serology was negative. PCR on a diagnostic vitreous biopsy was positive for T. gondii DNA and negative for Herpes viruses. Treatment with clindamycin and trimethoprim/sulfamethoxazole was initiated. The anti‐T. gondii serology remained negative. The Goldmann‐Witmer coefficient was positive. Also, efficacy of treatment was supportive of a diagnosis of ocular toxoplasmosis.ConclusionsAlthough clinical presentation was suggestive of ocular toxoplasmosis, anti‐T. gondii serology remained negative. In cases with high clinical suspicion of ocular toxoplasmosis, superior diagnostic efficacy is achieved by a combination of serology, PCR techniques and GWC.