bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regression of Peripapillary Choroidal Neovascularization after Oscillatory Transpupillary Thermotherapy and Anti-VEGF Pharmacotherapy
Authors: Peyman Gholam , Tsipursky Michael , Gohel Parin , Conway Mandi 
Published: October 2010

Purpose We prospectively evaluated a new treatment for recalcitrant choroidal neovascularization (CNV) in 4 patients. We used an infrared laser (810 nm) in oscillatory thermotherapy (OTT) mode combined with indocyanine green (ICG) dye, utilizing the beneficial effect of both thermotherapy and photodynamic therapy We describe preliminary experiences with ICG-assisted OTT (I-OTT) combined with intravitreal bevacizumab/dexamethasone for refractory peripapillary CNV resistant to standard therapy. Methods Clinical examination, funduscopy fluorescein angiography, and optical coherence tomography were performed at baseline and postoperatively. Infrared laser spot size was approximately one-half the lesion size (oscillation 2–3 Hz). Intravitreal injections of bevacizumab (1.25 mg) and dexamethasone (1000 μg) were done during the same visit. Results Mean follow-up was 12.5 months (range 5–17). Mean energy level was 325 mW (range 200–500) in oscillatory mode (2–3 Hz/sec) pre- and post-ICG infusion. Indocyanine green dose was approximately 1 mg/kg (75 mg/patient). All patients had a single treatment. Mean visual acuity improved in 1 patient from 20/60 to 20/30 and remained the same in the other 3 (20/20, 20/40, and 20/400). At final examination, there was no evidence of clinical or angiographic activity of CNV. Conclusions Indocyanine green-assisted OTT has the potential to treat CNV in wet age-related macular degeneration. It may reduce thermal side effects and eliminate or reduce the need for frequent intravitreal treatment. We postulate that l-OTT has a synergistic effect of thermal energy combined with a weak photosensitizer (ICG) applied in an individualized manner, which minimizes thermal damage to retinal and choroidal tissue. Additional anti–vascular endothelial growth factor pharmacotherapy enhances the effect of l-OTT on abnormal new vessels.
Acute Hyperopic Shift in Refraction Associated with Posterior Choroidal Detachment following Phacoemulsification Surgery
Authors: Lee Yin-Yang , Sheu Shwu-Jiuan 
Published: October 2010

Purpose TO describe a patient who presented with hyperopic shift as an initial manifestation of choroidal detachment in the posterior pole following an uneventful phacoemulsification cataract surgery. Methods An 82-year-old woman with preexisting diabetes mellitus and hypertension had bilateral primary angle closure glaucoma on maximal tolerated hypotensive medication. An uneventful phacoemulsification surgery using topical anesthesia was performed in her left eye. Results On the next day, refraction was markedly increased to +7.25 −1.00 × 65 and axial length was reduced from 23.24 mm to 20.13 mm. Funduscopic examination revealed choroidal detachment in the posterior pole without involvement of the peripheral fundus. Axial length increased to 22.19 mm following corticosteroid treatment 1 month later. Six months postoperatively, axial length improved to 22.87 mm with a residual hyperopia of +1.00 −1.00 × 63. Conclusions TO our knowledge, there have been no reports of choroidal detachment in the posterior pole after phacoemulsification. Acute hyperopic shift following phacoemulsification surgery should lead one to suspect a posterior choroidal detachment. Considering axial length and refractive errors along with fundus examination may contribute to a more accurate follow-up.
Validity and Limits of the Rebound Tonometer (ICare®): Clinical Study
Authors: Scuderi Gian Luca , Cascone Nikhil Carlo , Regine Federico , Perdicchi Andrea , Cerulli Angelica , Recupero Santi Maria 
Published: October 2010

Purpose The aim of this study was to evaluate the measurement of intraocular pressure (IOP) using a new induction/impact rebound tonometer (ICare®) compared with Goldmann applanation tonometry (GAT). We also aimed to quantify the systematic and random errors (bias) of the 2 methods, to evaluate the sensitivity and specificity of the ICare® tonometer in identifying patients with 21 mmHg or more measured with the GAT, and to study the influence of corneal thickness on IOP measurement with the 2 tonometers. Methods We compared the IOP values obtained with the 2 instruments in 97 patients. Results Analysis based on the Bland and Altman method revealed that the IOP values recorded with the ICare® tonometer were slightly higher than those obtained with the GAT. The estimated bias for right eye measurements was 0.78 mmHg with 95% limits of agreement ±3.55 mmHg. This overestimation, which is not clinically relevant, was confirmed when we used the IOP values corrected according to central corneal thickness for data analysis. The sensitivity and specificity were 0.90 and 0.95, respectively. Conclusions The ICare® tonometer proved to be comparable with other nonconventional tonometers and can be used by nonophthalmologists and paramedical personnel during screening tests of populations. In addition, the ICare® tonometer could be considered a valid alternative to GAT when GAT is not available.
High-Frequency Ultrasound Biomicroscopy of the Anterior Segment Morphometry before and Immediately after Pars Plana Vitrectomy
Authors: Neudorfer Meira , Oren Nir , Barak Adiel 
Published: October 2010

Purpose TO characterize short-term changes induced by pars plana vitrectomy on anterior segment depth and lens thickness by means of high-frequency ultrasound biomicroscopy. Methods We undertook a prospective case series study on consecutive patients referred for pars plana vitrectomy as the sole procedure in our institution between 2005 and 2007. Twenty-eight eyes of 28 patients undergoing pars plana vitrectomy were studied by ultrasound biomicroscopy. Neither silicone oil nor scleral buckle was used for any of the procedures. Anterior chamber depth and lens thickness were compared before and immediately after surgery, and their results were compared to the postoperative intraocular pressure measurements. Results There was a significant decrease in anterior chamber depth in the study eyes of patients who had undergone gas tamponade (p<0.0001) but not in those who had not undergone gas tamponade. No differences were found between the preoperative and the postoperative lens thickness measurements in any of the patients, nor was there any correlation between anterior chamber depth and increased intraocular pressure. Conclusions Uncomplicated pars plana vitrectomy with gas tamponade can induce short-term changes in anterior chamber depth as measured by morphometry. Surgeons may need to reconsider using gas tamponade at the end of surgery in surgical candidates with shallow anterior chambers.
Oxygen Saturation in Premature Infants at Risk for Threshold Retinopathy of Prematurity
Authors: Thomas William J. , Rauser Michael , Dovich Jesse A. , Dustin Laurie , Flaxel Christina J. 
Published: October 2010

Purpose We aimed to determine if oxygen saturation, desaturations, and saturation variability play a role in progression of retinopathy of prematurity (ROP) and need for laser treatment. Methods This was a retrospective case-control study. We performed chart review of premature infants in a university hospital neonatal intensive care unit consecutively examined for ROP between May 2000 and December 2001. We compared birthweight, postmenstrual age, and oxygen saturation for 3 weeks before laser treatment for threshold ROP in group 1 (n=19) (average weight at treatment 2508 grams) and group 2 (n=18) before they reached 2500 grams. Outcome measures were retinopathy progression and need for treatment. Results Adjusting for birthweight and postmenstrual age, known predictors of ROP progression, we found that babies requiring laser treatment (group 1) had lower average daily oxygen saturation levels in the study period, significantly on 5/20 days (25%). These babies had saturations below 95% on 18/20 days (90%). Babies not requiring laser (group 2) had saturations below 95% on 2/20 days (10%). The last day on which pretreatment saturations differed significantly was 2 days before laser. Group 1 had more desaturations below 80% (6.0±3.2) than group 2 (3.2±1.2), p=0.0002 (independent samples t tests). Saturations varied more for individual group 1 infants. Conclusions Decreased oxygen saturation as early as 3 weeks and as late as 2 days before laser, increased number of desaturations, and saturation variability were seen in babies eventually requiring laser treatment for ROP.
SD OCT Features of Dry Arcuate Longstanding Retinal Folds
Authors: Pierro Luisa , Sadda Srinivas R. , Gagliardi Marco , Mantovani Elena , De Benedetto Umberto , Codenotti Marco , Bandello Francesco 
Published: October 2010

Purpose TO report the spectral domain (SD) findings in a retinal fold secondary to vitrectomy surgery. Methods A 57-year-old man presented 1 month after vitrectomy surgery with gas injection (C3F8 6%) in his left eye for treatment of a macula-on retinal detachment and was noted to have a retinal fold in the superior aspect of the macula. Complete ocular examination, fundus photography, fluorescein angiography, autofluorescence, and SD optical coherence tomography (OCT) were performed. Results Spectral domain OCT revealed a slightly hyperreflective lesion in the outer retina, which occupied a discontinuity in the inner segment-outer segment junction and extended superiorly with apparent indentation of the overlying retinal layers. Conclusions This case illustrates how SD OCT may be useful in describing the morphologic substrate of retinal fold after retinal surgery.
Augmented Medial Rectus Recession, Medial Rectus Recession plus Faden, and Slanted Medial Rectus Recession for Convergence Excess Esotropia
Authors: Khalifa Yasser Mohamed 
Published: October 2010

Purpose TO evaluate the efficacy of 3 different surgical techniques for convergence excess esotropia: augmented medial rectus recession, medial rectus recession plus Faden, and slanted medial rectus recession. Methods Twenty-nine patients with convergence excess esotropia were divided into 3 groups. Group A included 9 patients treated with medial rectus muscle recession augmented with 1–2 mm more of the standard recession. Group B included 10 patients treated with standard recession plus Faden. Group C included 10 patients treated with slanted medial rectus recession. Surgical success was defined as esotropia (ET) 10 prism diopters (à) or less at distance and near with collapse of distance/near disparity. Results Satisfactory alignment with elimination of bifocal correction was noted in group A (66.6%). In groups B and C, the results were 70%. Group A patients had a mean reduction in distance/near disparity from 15.5±1.5Δ preoperatively to 4.7±2.5Δ postoperatively, while in group B the preoperative distance/near disparity was 16.5±1.8Δ and decreased to 3.8±3.1Δ postoperatively, and group C also showed reduction in distance/near disparity from 18.1±1.6Δ preoperatively to 4.5±3.6Δ postoperatively. There were no statistically significant differences among the 3 groups. Conclusions The 3 procedures are effective surgical options to treat convergence excess esotropia with acceptable motor outcomes.
Assessment of Anterior Chamber Inflammation after Intravitreal Bevacizumab Injection in Different Ocular Exudative Diseases
Authors: Yeniad Baris , Ayranci Ozen , Tuncer Samuray , Kir Nur , Ovali Tunc , Tugal-Tutkun Ilknur , Akarcay Koray 
Published: October 2010

Purpose TO investigate the inflammation of the anterior chamber after intravitreal bevacizumab injection in different ocular exudative diseases. Methods The study included 76 eyes from 62 consecutive patients with different ocular exudative diseases. The patients were divided into the 3 following groups: group 1 (nonproliferative diabetic retinopathy), group 2 (choroidal neovascularization secondary to age-related macular degeneration), and group 3 (macular edema with branch or central retinal vein occlusion). The study also included 32 age-matched control patients. Inflammation of the anterior chamber was examined with flare-cell photometry before and after an intravitreal injection of 1.25 mg of bevacizumab. Results There were no statistically significant differences between the measurements at baseline and postoperative day 1, 3, 7, or 30 in any of the groups (p>0.05). Conclusions The extent of inflammation in the anterior chamber did not change after intravitreal bevacizumab injection in patients with nonproliferative diabetic retinopathy, choroidal neovascularization secondary to age-related macular degeneration, or macular edema due to branch or central vein occlusion.
Intrasession, Intersession, and Interexaminer Variabilities of Retinal Nerve Fiber Layer Measurements with Spectral-Domain OCT
Authors: Cremasco Fernanda , Massa Graziela , Vidotti Vanessa Gonçalves , de Carvalho Lupinacci Álvaro Pedroso , Costa Vital Paulino 
Published: October 2010

Purpose TO evaluate the intrasession, intersession, and interexaminer variabilities of retinal nerve fiber layer measurements (RNFL) with spectral-domain optical coherence tomography (OCT). Methods A total of 32 healthy individuals and 34 patients with chronic glaucoma underwent RNFL measurements with the Cirrus HD-OCT Model 4000 (Carl Zeiss Meditec, Dublin, CA, USA) 5 times during the same sitting by one examiner to assess intrasession variability. The same examiner performed RNFL measurements in the same patients on 5 different days to assess intersession variability. A second examiner performed RNFL measurements in the same patients to assess interexaminer variability. The coefficients of variation and intraclass correlation coefficients were obtained for the following parameters: average thickness, quadrant thickness, and Clock hour thickness measurements. Results Intrasession variability: In patients with glaucoma, coefficients of variation ranged from 4.51% to 11.84%. Intraclass correlation coefficients ranged from 0.74 to 0.99. In healthy individuals, coefficients of variation ranged from 2.92% to 6.99%. Intraclass correlation coefficients ranged from 0.89 to 0.98. Intersession variability: In patients with glaucoma, coefficients of variation ranged from 3.68% to 10.50%. Intraclass correlation coefficients ranged from 0.82 to 0.99. In healthy individuals, coefficients of variation ranged from 3.13% to 6.92%. Intraclass correlation coefficients ranged from 0.87 to 0.99. Interexaminer variability: In patients with glaucoma, coefficients of variation ranged from 2.62% to 14.94%. Intraclass correlation coefficients ranged from 0.55 to 0.98. In healthy individuals, coefficients of variation ranged from 2.04% to 7.31%. Intraclass correlation coefficients ranged from 0.86 to 0.98. Conclusions These findings indicate that RNFL measurements with spectral-domain OCT display excellent reproducibility, with low intrasession, intersession, and interexaminer variabilities.
Postural Control in Subjects with Visual Impairment
Authors: Schwesig René , Goldich Yakov , Hahn Ales , Müller Anja , Kohen-Raz Reuven , Kluttig Alexander , Morad Yair 
Published: October 2010

Purpose TO investigate the effect of long-term, not experimentally induced visual impairment on balance, and to clarify which means are used to compensate for this sensory deficit. Methods Posturography was examined in 50 visually impaired subjects (11 with congenital blindness and 39 with acquired visual impairment) and 50 healthy controls. Examination was performed in 4 testing conditions: while standing on firm surface or foam pads (which decreases the somatosensory input) and with open or closed eyes (manipulating visual input). Results Subjects with acquired visual impairment were significantly less stable than controls when tested with open eyes, especially when standing on foam pads, but equal to controls when eyes were closed. Congenitally blind subjects performed equally to normal controls in all test conditions when tested with eyes open, and performed significantly better than controls with eyes closed. In comparison to subjects with acquired visual impairment, the congenitally blind were significantly more stable in all test conditions. Fourier analysis revealed that the visually impaired subjects showed decreased intensity values within the lowest frequency range of 0.1 Hz and below, a range believed to be sensitive to the function of the visual system. Conclusions We have found that vision impairment influenced postural control, especially if acquired and not congenital. The somatosensory and vestibular systems serve as compensatory mechanisms, which is utilized most effectively by the congenitally blind.
Diagnostic Capability of Scanning Laser Polarimetry with and without Enhanced Corneal Compensation and Optical Coherence Tomography
Authors: Benítez-del-Castillo Javier , Martinez Antonio , Regi Teresa 
Published: October 2010

Purpose TO compare the abilities of the current commercially available versions of scanning laser polarimetry (SLP) and optical coherence tomography (OCT), SLP-variable corneal compensation (VCC), SLP–enhanced corneal compensation (ECC), and high-definition (HD) OCT, in discriminating between healthy eyes and those with early-to-moderate glaucomatous visual field loss. Methods Healthy volunteers and patients with glaucoma who met the eligibility criteria were consecutively enrolled in this prospective, cross-sectional, observational study. Subjects underwent complete eye examination, automated perimetry, SLP-ECC, SLP-VCC, and HD-OCT Scanning laser polarimetry parameters were recalculated in 90-degree segments (quadrants) in the calculation circle to be compared. Areas under the receiver operating characteristic curve (AUROCs) were calculated for every parameter in order to compare the ability of each imaging modality to differentiate between normal and glaucomatous eyes. Results Fifty-five normal volunteers (mean age 59.1 years) and 33 patients with glaucoma (mean age 63.8 years) were enrolled. Average visual field mean deviation was −6.69 dB (95% confidence interval −8.07 to −5.31) in the glaucoma group. The largest AUROCs were associated with nerve fiber indicator (0.880 and 0.888) for the SLP-VCC and SLP-ECC, respectively, and with the average thickness in the HD-OCT (0.897). Conclusions The best performing indices for the SLP-VCC, SLP-ECC, and HD OCT gave similar AUROCs, showing moderate diagnostic accuracy in patients with early to moderate glaucoma. Further studies are needed to evaluate the ability of these technologies to discriminate between normal and glaucomatous eyes.
Alagille Syndrome: Clinical and Ocular Pathognomonic Features
Authors: El-Koofy Nehal M. , El-Mahdy Randa , Fahmy Mona E. , El-Hennawy Ahmed , Farag Mohamed Y. , El-Karaksy Hanaa M. 
Published: October 2010

Purpose This study was carried out to determine the frequency of clinical diagnostic criteria in patients with Alagille syndrome (AGS) in comparison to a group of children with cholestasis and histologically proven neonatal hepatitis (NH). The type and frequency of ocular manifestations are highlighted. Methods According to histologic findings on liver biopsy, the 32 patients included in the study were classified into 2 groups: group 1 had paucity of interlobular bile ducts (PILBD) (n=13) and at least 3 of 5 characteristics of AGS and group 2 had NH on liver biopsy (n=19). Results The mean age of patients with AGS was higher than in group 2 (3.9 vs 1.6 years) (p<0.05). Pruritus was a significant symptom in the AGS group (p<0.05). Characteristic fades was detected in 61.5% of the AGS group. None of our patients with AGS had vertebral anomalies. Although cardiac murmurs were heard in 5 patients with AGS, cardiac anomalies were detected in only 3 by echocardiography: pulmonary stenosis in 2 patients and patent foramen ovale in 1. Posterior embryotoxon (PE) was detected in 69.2% of patients with AGS as compared to 10.5% of the NH group. Optic nerve drusen was detected in 91% of patients with AGS as compared to 5.3% of patients with NH. Conclusions Optic nerve drusen was the most common finding in AGS, followed by PE and facial features. Ocular ultrasound needs to be performed in all cholestatic infants with PILBD.
Effects of Osmoprotection on Symptoms, Ocular Surface Damage, and Tear Film Modifications Caused by Glaucoma Therapy
Authors: Monaco Gaspare , Cacioppo Viviana , Consonni Dario , Troiano Pasquale 
Published: October 2010

Purpose TO determine the effects of 2 artificial tear formulas on the ocular surface in patients with glaucoma using topical preserved beta-blockers (BB) or prostaglandins (PG). Methods This was a prospective, comparative, randomized, double-blind study with a crossover design. Twenty patients with dry eye were divided into 2 groups based on glaucoma treatment: BB (10 subjects) or PG (10 subjects). Each group was administered a 4-week course of unpreserved isotonic (300 mOsm/L) solution containing 0.2% sodium hyaluronate (SH) or a preserved isotonic (295–305 mOsm/L) solution containing 0.5% carboxymethylcellulose and 0.9% glycerin as compatible solute (CMCs) administered QID. After a 2-week washout period, the course of treatment was reversed. The primary efficacy criteria consisted of assessing symptoms according to the Ocular Surface Disease Index© (OSDI); the secondary efficacy criteria consisted of evaluating tear film confocal microscopy, central corneal thickness (CCT), and lissamine corneal and conjunctival staining (Oxford Grading System Score [OGSS]). Results Within each group, only CMCs induced a significant improvement in OSDI and OGSS compared to baseline values: OSDI-20.5, p<0.0001; OGSS-0.9, p<0.0001. Tear film confocal microscopy improved after treatment, especially in case of patients who were administered CMCs. No difference in CCT was noticed for any subject. Conclusions This study demonstrates for the first time that the use of concomitant CMCs in the management of glaucoma undergoing treatment with BB or PG may assist in tear film production and could lead to better compliance with intraocular pressure-lowering medication and ultimately better prognosis.
Ocular Decompression Retinopathy after Deep Sclerectomy with Mitomycin C in an Eye with Exfoliation Glaucoma
Authors: Kozobolis Vassilios P. , Kalogianni Eleni , Katsanos Andreas , Dardabounis Doukas , Koukoula Stavrenia , Labiris Georgios 
Published: October 2010

Purpose TO present a case of ocular decompression retinopathy occurring after an uncomplicated nonpenetrating glaucoma procedure (deep sclerectomy with mitomycin C). Methods A 52-year-old man with medically uncontrolled exfoliation glaucoma in the left eye underwent uneventful deep sclerectomy with mitomycin C. The patient had no history or laboratory evidence of any bleeding disorder. Results On the first postoperative day, visual acuity fell from the preoperative level of Snellen 0.2 to hand movement and the intraocular pressure was 5 mmHg. Funduscopy revealed a small intravitreal hemorrhage and multiple, extended retinal hemorrhages in all quadrants of the fundus. After standard postoperative medication with antibiotic/steroid eyedrops, the patient's visual acuity returned to preoperative levels and the retinal hemorrhages were absorbed. Three and a half months postoperatively, the fundus was free of bleedings. Conclusions Although decompression retinopathy has previously been described after penetrating glaucoma surgery, the condition can also occur after uncomplicated deep sclerectomy. Despite the dramatic presentation, the prognosis remains favorable.