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Publisher: John Wiley and Sons   (Total: 1579 journals)

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Showing 1 - 200 of 1579 Journals sorted alphabetically
Abacus     Hybrid Journal   (Followers: 12, SJR: 0.48, h-index: 22)
About Campus     Hybrid Journal   (Followers: 5)
Academic Emergency Medicine     Hybrid Journal   (Followers: 65, SJR: 1.385, h-index: 91)
Accounting & Finance     Hybrid Journal   (Followers: 46, SJR: 0.547, h-index: 30)
ACEP NOW     Free   (Followers: 1)
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 51, SJR: 1.02, h-index: 88)
Acta Archaeologica     Hybrid Journal   (Followers: 152, SJR: 0.101, h-index: 9)
Acta Geologica Sinica (English Edition)     Hybrid Journal   (Followers: 3, SJR: 0.552, h-index: 41)
Acta Neurologica Scandinavica     Hybrid Journal   (Followers: 5, SJR: 1.203, h-index: 74)
Acta Obstetricia et Gynecologica Scandinavica     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 81)
Acta Ophthalmologica     Hybrid Journal   (Followers: 5, SJR: 0.112, h-index: 1)
Acta Paediatrica     Hybrid Journal   (Followers: 56, SJR: 0.794, h-index: 88)
Acta Physiologica     Hybrid Journal   (Followers: 6, SJR: 1.69, h-index: 88)
Acta Polymerica     Hybrid Journal   (Followers: 9)
Acta Psychiatrica Scandinavica     Hybrid Journal   (Followers: 35, SJR: 2.518, h-index: 113)
Acta Zoologica     Hybrid Journal   (Followers: 6, SJR: 0.459, h-index: 29)
Acute Medicine & Surgery     Hybrid Journal   (Followers: 4)
Addiction     Hybrid Journal   (Followers: 35, SJR: 2.086, h-index: 143)
Addiction Biology     Hybrid Journal   (Followers: 13, SJR: 2.091, h-index: 57)
Adultspan J.     Hybrid Journal   (SJR: 0.127, h-index: 4)
Advanced Energy Materials     Hybrid Journal   (Followers: 26, SJR: 6.411, h-index: 86)
Advanced Engineering Materials     Hybrid Journal   (Followers: 26, SJR: 0.81, h-index: 81)
Advanced Functional Materials     Hybrid Journal   (Followers: 50, SJR: 5.21, h-index: 203)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 13, SJR: 0.232, h-index: 7)
Advanced Materials     Hybrid Journal   (Followers: 259, SJR: 9.021, h-index: 345)
Advanced Materials Interfaces     Hybrid Journal   (Followers: 6, SJR: 1.177, h-index: 10)
Advanced Optical Materials     Hybrid Journal   (Followers: 5, SJR: 2.488, h-index: 21)
Advanced Science     Open Access   (Followers: 5)
Advanced Synthesis & Catalysis     Hybrid Journal   (Followers: 17, SJR: 2.729, h-index: 121)
Advances in Polymer Technology     Hybrid Journal   (Followers: 13, SJR: 0.344, h-index: 31)
Africa Confidential     Hybrid Journal   (Followers: 19)
Africa Research Bulletin: Economic, Financial and Technical Series     Hybrid Journal   (Followers: 12)
Africa Research Bulletin: Political, Social and Cultural Series     Hybrid Journal   (Followers: 9)
African Development Review     Hybrid Journal   (Followers: 34, SJR: 0.275, h-index: 17)
African J. of Ecology     Hybrid Journal   (Followers: 15, SJR: 0.477, h-index: 39)
Aggressive Behavior     Hybrid Journal   (Followers: 15, SJR: 1.391, h-index: 66)
Aging Cell     Open Access   (Followers: 10, SJR: 4.374, h-index: 95)
Agribusiness : an Intl. J.     Hybrid Journal   (Followers: 6, SJR: 0.627, h-index: 14)
Agricultural and Forest Entomology     Hybrid Journal   (Followers: 16, SJR: 0.925, h-index: 43)
Agricultural Economics     Hybrid Journal   (Followers: 45, SJR: 1.099, h-index: 51)
AIChE J.     Hybrid Journal   (Followers: 30, SJR: 1.122, h-index: 120)
Alcoholism and Drug Abuse Weekly     Hybrid Journal   (Followers: 7)
Alcoholism Clinical and Experimental Research     Hybrid Journal   (Followers: 7, SJR: 1.416, h-index: 125)
Alimentary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 33, SJR: 2.833, h-index: 138)
Alimentary Pharmacology & Therapeutics Symposium Series     Hybrid Journal   (Followers: 3)
Allergy     Hybrid Journal   (Followers: 50, SJR: 3.048, h-index: 129)
Alternatives to the High Cost of Litigation     Hybrid Journal   (Followers: 3)
American Anthropologist     Hybrid Journal   (Followers: 140, SJR: 0.951, h-index: 61)
American Business Law J.     Hybrid Journal   (Followers: 24, SJR: 0.205, h-index: 17)
American Ethnologist     Hybrid Journal   (Followers: 90, SJR: 2.325, h-index: 51)
American J. of Economics and Sociology     Hybrid Journal   (Followers: 28, SJR: 0.211, h-index: 26)
American J. of Hematology     Hybrid Journal   (Followers: 33, SJR: 1.761, h-index: 77)
American J. of Human Biology     Hybrid Journal   (Followers: 12, SJR: 1.018, h-index: 58)
American J. of Industrial Medicine     Hybrid Journal   (Followers: 16, SJR: 0.993, h-index: 85)
American J. of Medical Genetics Part A     Hybrid Journal   (Followers: 16, SJR: 1.115, h-index: 61)
American J. of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 4, SJR: 1.771, h-index: 107)
American J. of Medical Genetics Part C: Seminars in Medical Genetics     Partially Free   (Followers: 6, SJR: 2.315, h-index: 79)
American J. of Physical Anthropology     Hybrid Journal   (Followers: 37, SJR: 1.41, h-index: 88)
American J. of Political Science     Hybrid Journal   (Followers: 269, SJR: 5.101, h-index: 114)
American J. of Primatology     Hybrid Journal   (Followers: 15, SJR: 1.197, h-index: 63)
American J. of Reproductive Immunology     Hybrid Journal   (Followers: 3, SJR: 1.347, h-index: 75)
American J. of Transplantation     Hybrid Journal   (Followers: 17, SJR: 2.792, h-index: 140)
American J. on Addictions     Hybrid Journal   (Followers: 9, SJR: 0.843, h-index: 57)
Anaesthesia     Hybrid Journal   (Followers: 130, SJR: 1.404, h-index: 88)
Analyses of Social Issues and Public Policy     Hybrid Journal   (Followers: 10, SJR: 0.397, h-index: 18)
Analytic Philosophy     Hybrid Journal   (Followers: 16)
Anatomia, Histologia, Embryologia: J. of Veterinary Medicine Series C     Hybrid Journal   (Followers: 3, SJR: 0.295, h-index: 27)
Anatomical Sciences Education     Hybrid Journal   (Followers: 1, SJR: 0.633, h-index: 24)
Andrologia     Hybrid Journal   (Followers: 2, SJR: 0.528, h-index: 45)
Andrology     Hybrid Journal   (Followers: 2, SJR: 0.979, h-index: 14)
Angewandte Chemie     Hybrid Journal   (Followers: 168)
Angewandte Chemie Intl. Edition     Hybrid Journal   (Followers: 215, SJR: 6.229, h-index: 397)
Animal Conservation     Hybrid Journal   (Followers: 38, SJR: 1.576, h-index: 62)
Animal Genetics     Hybrid Journal   (Followers: 8, SJR: 0.957, h-index: 67)
Animal Science J.     Hybrid Journal   (Followers: 6, SJR: 0.569, h-index: 24)
Annalen der Physik     Hybrid Journal   (Followers: 5, SJR: 1.46, h-index: 40)
Annals of Anthropological Practice     Partially Free   (Followers: 2, SJR: 0.187, h-index: 5)
Annals of Applied Biology     Hybrid Journal   (Followers: 7, SJR: 0.816, h-index: 56)
Annals of Clinical and Translational Neurology     Open Access   (Followers: 1)
Annals of Human Genetics     Hybrid Journal   (Followers: 9, SJR: 1.191, h-index: 67)
Annals of Neurology     Hybrid Journal   (Followers: 47, SJR: 5.584, h-index: 241)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 2, SJR: 0.531, h-index: 38)
Annals of Public and Cooperative Economics     Hybrid Journal   (Followers: 9, SJR: 0.336, h-index: 23)
Annals of the New York Academy of Sciences     Hybrid Journal   (Followers: 5, SJR: 2.389, h-index: 189)
Annual Bulletin of Historical Literature     Hybrid Journal   (Followers: 13)
Annual Review of Information Science and Technology     Hybrid Journal   (Followers: 14)
Anthropology & Education Quarterly     Hybrid Journal   (Followers: 25, SJR: 0.72, h-index: 31)
Anthropology & Humanism     Hybrid Journal   (Followers: 17, SJR: 0.137, h-index: 3)
Anthropology News     Hybrid Journal   (Followers: 15)
Anthropology of Consciousness     Hybrid Journal   (Followers: 11, SJR: 0.172, h-index: 5)
Anthropology of Work Review     Hybrid Journal   (Followers: 11, SJR: 0.256, h-index: 5)
Anthropology Today     Hybrid Journal   (Followers: 90, SJR: 0.545, h-index: 15)
Antipode     Hybrid Journal   (Followers: 47, SJR: 2.212, h-index: 69)
Anz J. of Surgery     Hybrid Journal   (Followers: 7, SJR: 0.432, h-index: 59)
Anzeiger für Schädlingskunde     Hybrid Journal   (Followers: 1)
Apmis     Hybrid Journal   (Followers: 1, SJR: 0.855, h-index: 73)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 69, SJR: 0.754, h-index: 69)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 7, SJR: 0.632, h-index: 58)
Applied Psychology     Hybrid Journal   (Followers: 177, SJR: 1.023, h-index: 64)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 49, SJR: 0.868, h-index: 13)
Applied Stochastic Models in Business and Industry     Hybrid Journal   (Followers: 5, SJR: 0.613, h-index: 24)
Aquaculture Nutrition     Hybrid Journal   (Followers: 14, SJR: 1.025, h-index: 55)
Aquaculture Research     Hybrid Journal   (Followers: 31, SJR: 0.807, h-index: 60)
Aquatic Conservation Marine and Freshwater Ecosystems     Hybrid Journal   (Followers: 36, SJR: 1.047, h-index: 57)
Arabian Archaeology and Epigraphy     Hybrid Journal   (Followers: 11, SJR: 0.453, h-index: 11)
Archaeological Prospection     Hybrid Journal   (Followers: 12, SJR: 0.922, h-index: 21)
Archaeology in Oceania     Hybrid Journal   (Followers: 13, SJR: 0.745, h-index: 18)
Archaeometry     Hybrid Journal   (Followers: 27, SJR: 0.809, h-index: 48)
Archeological Papers of The American Anthropological Association     Hybrid Journal   (Followers: 15, SJR: 0.156, h-index: 2)
Architectural Design     Hybrid Journal   (Followers: 25, SJR: 0.261, h-index: 9)
Archiv der Pharmazie     Hybrid Journal   (Followers: 4, SJR: 0.628, h-index: 43)
Archives of Drug Information     Hybrid Journal   (Followers: 4)
Archives of Insect Biochemistry and Physiology     Hybrid Journal   (SJR: 0.768, h-index: 54)
Area     Hybrid Journal   (Followers: 12, SJR: 0.938, h-index: 57)
Art History     Hybrid Journal   (Followers: 237, SJR: 0.153, h-index: 13)
Arthritis & Rheumatology     Hybrid Journal   (Followers: 51, SJR: 1.984, h-index: 20)
Arthritis Care & Research     Hybrid Journal   (Followers: 27, SJR: 2.256, h-index: 114)
Artificial Organs     Hybrid Journal   (Followers: 1, SJR: 0.872, h-index: 60)
ASHE Higher Education Reports     Hybrid Journal   (Followers: 14)
Asia & the Pacific Policy Studies     Open Access   (Followers: 15)
Asia Pacific J. of Human Resources     Hybrid Journal   (Followers: 313, SJR: 0.494, h-index: 19)
Asia Pacific Viewpoint     Hybrid Journal   (Followers: 1, SJR: 0.616, h-index: 26)
Asia-Pacific J. of Chemical Engineering     Hybrid Journal   (Followers: 8, SJR: 0.345, h-index: 20)
Asia-pacific J. of Clinical Oncology     Hybrid Journal   (Followers: 6, SJR: 0.554, h-index: 14)
Asia-Pacific J. of Financial Studies     Hybrid Journal   (SJR: 0.241, h-index: 7)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 4, SJR: 0.377, h-index: 7)
Asian Economic J.     Hybrid Journal   (Followers: 8, SJR: 0.234, h-index: 21)
Asian Economic Policy Review     Hybrid Journal   (Followers: 4, SJR: 0.196, h-index: 12)
Asian J. of Control     Hybrid Journal   (SJR: 0.862, h-index: 34)
Asian J. of Endoscopic Surgery     Hybrid Journal   (SJR: 0.394, h-index: 7)
Asian J. of Organic Chemistry     Hybrid Journal   (Followers: 5, SJR: 1.443, h-index: 19)
Asian J. of Social Psychology     Hybrid Journal   (Followers: 5, SJR: 0.665, h-index: 37)
Asian Politics and Policy     Hybrid Journal   (Followers: 12, SJR: 0.207, h-index: 7)
Asian Social Work and Policy Review     Hybrid Journal   (Followers: 5, SJR: 0.318, h-index: 5)
Asian-pacific Economic Literature     Hybrid Journal   (Followers: 5, SJR: 0.168, h-index: 15)
Assessment Update     Hybrid Journal   (Followers: 4)
Astronomische Nachrichten     Hybrid Journal   (Followers: 2, SJR: 0.701, h-index: 40)
Atmospheric Science Letters     Open Access   (Followers: 29, SJR: 1.332, h-index: 27)
Austral Ecology     Hybrid Journal   (Followers: 14, SJR: 1.095, h-index: 66)
Austral Entomology     Hybrid Journal   (Followers: 9, SJR: 0.524, h-index: 28)
Australasian J. of Dermatology     Hybrid Journal   (Followers: 8, SJR: 0.714, h-index: 40)
Australasian J. On Ageing     Hybrid Journal   (Followers: 7, SJR: 0.39, h-index: 22)
Australian & New Zealand J. of Statistics     Hybrid Journal   (Followers: 13, SJR: 0.275, h-index: 28)
Australian Accounting Review     Hybrid Journal   (Followers: 4, SJR: 0.709, h-index: 14)
Australian and New Zealand J. of Family Therapy (ANZJFT)     Hybrid Journal   (Followers: 3, SJR: 0.382, h-index: 12)
Australian and New Zealand J. of Obstetrics and Gynaecology     Hybrid Journal   (Followers: 46, SJR: 0.814, h-index: 49)
Australian and New Zealand J. of Public Health     Hybrid Journal   (Followers: 11, SJR: 0.82, h-index: 62)
Australian Dental J.     Hybrid Journal   (Followers: 7, SJR: 0.482, h-index: 46)
Australian Economic History Review     Hybrid Journal   (Followers: 4, SJR: 0.171, h-index: 12)
Australian Economic Papers     Hybrid Journal   (Followers: 29, SJR: 0.23, h-index: 9)
Australian Economic Review     Hybrid Journal   (Followers: 6, SJR: 0.357, h-index: 21)
Australian Endodontic J.     Hybrid Journal   (Followers: 3, SJR: 0.513, h-index: 24)
Australian J. of Agricultural and Resource Economics     Hybrid Journal   (Followers: 3, SJR: 0.765, h-index: 36)
Australian J. of Grape and Wine Research     Hybrid Journal   (Followers: 5, SJR: 0.879, h-index: 56)
Australian J. of Politics & History     Hybrid Journal   (Followers: 14, SJR: 0.203, h-index: 14)
Australian J. of Psychology     Hybrid Journal   (Followers: 18, SJR: 0.384, h-index: 30)
Australian J. of Public Administration     Hybrid Journal   (Followers: 404, SJR: 0.418, h-index: 29)
Australian J. of Rural Health     Hybrid Journal   (Followers: 5, SJR: 0.43, h-index: 34)
Australian Occupational Therapy J.     Hybrid Journal   (Followers: 71, SJR: 0.59, h-index: 29)
Australian Psychologist     Hybrid Journal   (Followers: 12, SJR: 0.331, h-index: 31)
Australian Veterinary J.     Hybrid Journal   (Followers: 19, SJR: 0.459, h-index: 45)
Autism Research     Hybrid Journal   (Followers: 32, SJR: 2.126, h-index: 39)
Autonomic & Autacoid Pharmacology     Hybrid Journal   (SJR: 0.371, h-index: 29)
Banks in Insurance Report     Hybrid Journal   (Followers: 1)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 10, SJR: 0.539, h-index: 70)
Basic and Applied Pathology     Open Access   (Followers: 2, SJR: 0.113, h-index: 4)
Basin Research     Hybrid Journal   (Followers: 5, SJR: 1.54, h-index: 60)
Bauphysik     Hybrid Journal   (Followers: 2, SJR: 0.194, h-index: 5)
Bauregelliste A, Bauregelliste B Und Liste C     Hybrid Journal  
Bautechnik     Hybrid Journal   (Followers: 1, SJR: 0.321, h-index: 11)
Behavioral Interventions     Hybrid Journal   (Followers: 9, SJR: 0.297, h-index: 23)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 24, SJR: 0.736, h-index: 57)
Berichte Zur Wissenschaftsgeschichte     Hybrid Journal   (Followers: 9, SJR: 0.11, h-index: 5)
Beton- und Stahlbetonbau     Hybrid Journal   (Followers: 2, SJR: 0.493, h-index: 14)
Biochemistry and Molecular Biology Education     Hybrid Journal   (Followers: 6, SJR: 0.311, h-index: 26)
Bioelectromagnetics     Hybrid Journal   (Followers: 1, SJR: 0.568, h-index: 64)
Bioengineering & Translational Medicine     Open Access  
BioEssays     Hybrid Journal   (Followers: 10, SJR: 3.104, h-index: 155)
Bioethics     Hybrid Journal   (Followers: 14, SJR: 0.686, h-index: 39)
Biofuels, Bioproducts and Biorefining     Hybrid Journal   (Followers: 1, SJR: 1.725, h-index: 56)
Biological J. of the Linnean Society     Hybrid Journal   (Followers: 16, SJR: 1.172, h-index: 90)
Biological Reviews     Hybrid Journal   (Followers: 3, SJR: 6.469, h-index: 114)
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 42, SJR: 0.12, h-index: 1)
Biology of the Cell     Full-text available via subscription   (Followers: 9, SJR: 1.812, h-index: 69)
Biomedical Chromatography     Hybrid Journal   (Followers: 6, SJR: 0.572, h-index: 49)
Biometrical J.     Hybrid Journal   (Followers: 5, SJR: 0.784, h-index: 44)
Biometrics     Hybrid Journal   (Followers: 36, SJR: 1.906, h-index: 96)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 10, SJR: 0.715, h-index: 44)
Biopolymers     Hybrid Journal   (Followers: 18, SJR: 1.199, h-index: 104)
Biotechnology and Applied Biochemistry     Hybrid Journal   (Followers: 45, SJR: 0.415, h-index: 55)
Biotechnology and Bioengineering     Hybrid Journal   (Followers: 174, SJR: 1.633, h-index: 146)
Biotechnology J.     Hybrid Journal   (Followers: 14, SJR: 1.185, h-index: 51)
Biotechnology Progress     Hybrid Journal   (Followers: 39, SJR: 0.736, h-index: 101)
Biotropica     Hybrid Journal   (Followers: 20, SJR: 1.374, h-index: 71)
Bipolar Disorders     Hybrid Journal   (Followers: 9, SJR: 2.592, h-index: 100)
Birth     Hybrid Journal   (Followers: 37, SJR: 0.763, h-index: 64)
Birth Defects Research Part A : Clinical and Molecular Teratology     Hybrid Journal   (Followers: 2, SJR: 0.727, h-index: 77)
Birth Defects Research Part B: Developmental and Reproductive Toxicology     Hybrid Journal   (Followers: 5, SJR: 0.468, h-index: 47)
Birth Defects Research Part C : Embryo Today : Reviews     Hybrid Journal   (SJR: 1.513, h-index: 55)
BJOG : An Intl. J. of Obstetrics and Gynaecology     Partially Free   (Followers: 233, SJR: 2.083, h-index: 125)

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Journal Cover Acta Ophthalmologica
  [SJR: 1.473]   [H-I: 38]   [5 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1755-375X - ISSN (Online) 1755-3768
   Published by John Wiley and Sons Homepage  [1579 journals]
  • Simple technique for management of anterior chamber-migrated Ozurdex®
    • Authors: Sung Hoon Lee; Hyungoo Kang, Suk Ho Byeon, Sung Soo Kim, Hyoung Jun Koh, Sung Chul Lee, Min Kim
      PubDate: 2017-10-14T03:06:55.984522-05:
      DOI: 10.1111/aos.13584
  • Changes in thickness of central macula and retinal nerve fibre layer in
           severe hypertensive retinopathy: a 1-year longitudinal study
    • Authors: Han-Min Lee; Woo-Hyuk Lee, Kyong Nam Kim, Young Joon Jo, Jung Yeul Kim
      Abstract: ObjectiveTo analyse the longitudinal changes in the thickness of the central macula and retinal nerve fibre layer (RNFL) in patients with hypertensive retinopathy (HTNR) using spectral-domain optical coherence tomography (SD-OCT).MethodsThis was a prospective cohort study. We studied 18 eyes of patients with HTNR of grade IV who had been followed up for more than 1 year, and 36 normal eyes (without any relevant medical history; the control group). Antihypertensive treatment successfully normalized the blood pressure of HTNR patients. The RNFL thickness and that of the central macula of HTNR patients were measured using a Cirrus HD-OCT instrument, and compared with those of the control group.ResultsAt 12 months of follow-up, the mean thickness of the RNFL and central macula was significantly lower in the HTNR group than in the control group (the RNFL was measured first, and then the central macular thickness (CMT): 77.4 ± 9.1 and 233.8 ± 30.8 μm versus 94.1 ± 7.8 and 256.3 ± 28.1 μm, respectively; p 
      PubDate: 2017-10-04T01:43:29.439739-05:
      DOI: 10.1111/aos.13521
  • Retinal dysfunction characterizes subtypes of dominant optic atrophy
    • Authors: Maria Lucia Cascavilla; Vincenzo Parisi, Giacinto Triolo, Lucia Ziccardi, Enrico Borrelli, Antonio Di Renzo, Nicole Balducci, Costanza Lamperti, Stefania Bianchi Marzoli, Fatima Darvizeh, Alfredo A. Sadun, Valerio Carelli, Francesco Bandello, Piero Barboni
      Abstract: PurposeTo assess preganglionic retinal function using multifocal electroretinogram (mfERG) in patients affected by dominant optic atrophy (DOA) stratified by OPA1 gene mutation.MethodsMultifocal electroretinogram (mfERG) was recorded in 18 DOA patients (DOA group, 35 eyes) and 25 age-matched healthy subjects (control group, 25 eyes). Patients were stratified in two groups based on gene mutation: missense mutation (DOA-M group, 11 eyes) and mutation causing haploinsufficiency (DOA-H group, 24 eyes). The mfERG N1-P1 response amplitude density (RAD) has been evaluated in five annular retinal areas with different eccentricity from the fovea (ring 1: 0–5 degrees, R1; ring 2: 5–10 degrees, R2; ring 3: 10–15 degrees, R3; ring 4: 15–20 degrees, R4; and ring 5: 20–25 degrees, R5) and in eight sectors on the basis of the retinal topography: temporal–superior (TS), temporal–inferior (TI), nasal–superior (NS) and nasal–inferior (NI), temporal (T), superior (S), nasal (N) and inferior (I).ResultsCompared to controls, DOA group revealed a significant reduction in N1-P1 RADs values in R1-R4 rings and in TI, NS and N sectors [analysis of variance (ANOVA), p 
      PubDate: 2017-09-19T08:50:59.369079-05:
      DOI: 10.1111/aos.13557
  • Epiretinal membrane surgery: an analysis of 2-step sequential- or combined
           phacovitrectomy surgery on refraction and macular anatomy in a prospective
    • Authors: Hassan Hamoudi; Ulrik Correll Christensen, Morten La Cour
      Abstract: PurposeTo assess the impact of combined phacoemulsification-vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology.MethodsIn this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subsequent pars plana vitrectomy (PPV) (CAT group), (2) PPV and subsequent cataract surgery (VIT group) or (3) phaco-vitrectomy (COMBI group). Examinations were at baseline, one month after each surgery, and at 3 months and 12 months of follow-up. Primary outcome was the RE (the difference between predicted and achieved spherical equivalent); secondary outcomes were best-corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as>10% increment of central subfield macular thickness (CSMT).ResultsSixty-two eyes were enrolled. The mean RE showed a small myopic shift of −0.36D in all groups 1 month after surgery, decreasing after 12 months to −0.17D. The absolute value of the RE (ARE) ranged 0.49–0.68D after 12 months. In the immediate postoperative period, there was a higher incidence of CME in the CAT group. There was no significant difference in final RE, ARE, BCVA and CSMT between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow-up period.ConclusionSurgery for idiopathic ERM in phakic eyes with either phaco-vitrectomy or sequential surgery are equal approaches with respect to functional- (RE, BCVA) and anatomical outcomes (CME, CSMT). However, if starting with cataract surgery, 17% of the cases may not need subsequent PPV.
      PubDate: 2017-09-19T08:50:21.591505-05:
      DOI: 10.1111/aos.13572
  • Clinical relevance of retinal structure in children with laser-treated
           retinopathy of prematurity versus controls – using optical coherence
    • Authors: Florina Stoica; Adela Chirita-Emandi, Nicoleta Andreescu, Alina Stanciu, Cristian G. Zimbru, Maria Puiu
      Abstract: PurposeWe aimed to assess the macular anatomy using spectral domain optical coherence tomography (SD-OCT), in children born preterm who had laser-treated retinopathy of prematurity (ROP), and to investigate the relationship between structural changes in macula and visual function.MethodsThirty-seven 3–8 years old children were included in the study in two groups: 20 children born preterm [(
      PubDate: 2017-09-19T08:20:34.131545-05:
      DOI: 10.1111/aos.13536
  • Treatment outcomes of ziv-aflibercept for treatment-naïve polypoidal
           choroidal vasculopathy
    • Authors: Errol W. Chan; Mohab Eldeeb, Vishal Govindhari, Chintan Sarvaiya, Alay Banker, Ahmad Mansour, Jay Chhablani
      PubDate: 2017-09-19T08:10:18.701472-05:
      DOI: 10.1111/aos.13533
  • Automated detection of diabetic retinopathy lesions on ultrawidefield
           pseudocolour images
    • Authors: Kang Wang; Chaitra Jayadev, Muneeswar G. Nittala, Swetha B. Velaga, Chaithanya A. Ramachandra, Malavika Bhaskaranand, Sandeep Bhat, Kaushal Solanki, SriniVas R. Sadda
      Abstract: PurposeWe examined the sensitivity and specificity of an automated algorithm for detecting referral-warranted diabetic retinopathy (DR) on Optos ultrawidefield (UWF) pseudocolour images.MethodsPatients with diabetes were recruited for UWF imaging. A total of 383 subjects (754 eyes) were enrolled. Nonproliferative DR graded to be moderate or higher on the 5-level International Clinical Diabetic Retinopathy (ICDR) severity scale was considered as grounds for referral. The software automatically detected DR lesions using the previously trained classifiers and classified each image in the test set as referral-warranted or not warranted. Sensitivity, specificity and the area under the receiver operating curve (AUROC) of the algorithm were computed.ResultsThe automated algorithm achieved a 91.7%/90.3% sensitivity (95% CI 90.1–93.9/80.4–89.4) with a 50.0%/53.6% specificity (95% CI 31.7–72.8/36.5–71.4) for detecting referral-warranted retinopathy at the patient/eye levels, respectively; the AUROC was 0.873/0.851 (95% CI 0.819–0.922/0.804–0.894).ConclusionDiabetic retinopathy (DR) lesions were detected from Optos pseudocolour UWF images using an automated algorithm. Images were classified as referral-warranted DR with a high degree of sensitivity and moderate specificity. Automated analysis of UWF images could be of value in DR screening programmes and could allow for more complete and accurate disease staging.
      PubDate: 2017-09-19T08:05:20.3424-05:00
      DOI: 10.1111/aos.13528
  • Levels of beta-trace protein in optic disc pit with macular detachment
    • Authors: Karim Makdoumi; Torbjörn K. Nilsson, Sven Crafoord
      Abstract: BackgroundTo report beta-trace protein (βTP) levels in the subretinal fluid (SRF) of four patients with a macular detachment associated with optic disc pit (ODP).MethodsFour patients with a serous retinal detachment involving the macula was operated by pars plana vitrectomy (PPV) with C2F6 gas tamponade and peeling of internal limiting membrane (ILM). Patients with a follow-up period exceeding one year postoperatively were included in the study. The SRF was drained using a fine cannula without laser photocoagulation, and the samples were analysed using particle-enhancing nephelometry. The levels of βTP were compared to 20 routine cerebrospinal fluid (CSF) samples.ResultsIn four of the five samples from SRF had relatively low βTP levels, with a mean concentration of 6.6 mg/l (range 2.0 to 23.1 mg/l) compared to 16.0 mg/l (range 6.3-26.8 mg/l) in CSF. The only SRF sample within the range corresponding to normal CSF was the first sample from patient 4, and the analysis of the renewed aspirate during the second operation was 2.8 mg/l. Postoperatively, the regression of SRF was slow, but regression of SRF in the foveal region took place in all cases; however, visual acuity (VA) was improved in only half of the patients.ConclusionThe results from the analysed SRF regarding βTP concentration in these patients indicate that the SRF in ODP is not identical to CSF, as the concentrations of βTP differ.
      PubDate: 2017-09-19T08:00:48.214303-05:
      DOI: 10.1111/aos.13527
  • An 8-year follow-up of anti-vascular endothelial growth factor treatment
           with a treat-and-extend modality for neovascular age-related macular
    • Authors: Karina Berg; Anca B. Roald, Jesintha Navaratnam, Ragnheiður Bragadóttir
      Abstract: PurposeTo investigate long-term visual results of treatment with anti-vascular endothelial growth factor (VEGF) agents for neovascular age-related macular degeneration (nAMD) following a treat-and-extend regimen.MethodsRetrospective review of 155 patients who initiated treatment with bevacizumab for nAMD in one eye. At the final 8-year visit, 40 patients (26%) remained for follow-up. Mean change in best-corrected visual acuity (BCVA) was calculated compared to baseline values.ResultsMean BCVA improved significantly from baseline during the first year of treatment, with −0.11 logMAR units equivalent to 6.1 approximate Early Treatment Diabetic Retinopathy Study (approxETDRS) letters (p = 
      PubDate: 2017-09-19T07:55:20.853516-05:
      DOI: 10.1111/aos.13522
  • Association between CFH, CFB, ARMS2, SERPINF1, VEGFR1 and VEGF
           polymorphisms and anatomical and functional response to ranibizumab
           treatment in neovascular age-related macular degeneration
    • Authors: Estefania Cobos; Sergio Recalde, Jaouad Anter, Maria Hernandez-Sanchez, Carla Barreales, Leticia Olavarrieta, Alicia Valverde, Marta Suarez-Figueroa, Fernando Cruz, Maximino Abraldes, Julian Pérez-Pérez, Patricia Fernández-Robredo, Luis Arias, Alfredo García-Layana
      Abstract: PurposeWe sought to determine if specific genetic single nucleotide polymorphisms (SNPs) influence vascular endothelial growth factor inhibition response to ranibizumab in neovascular age-related macular degeneration (AMD).MethodsA total of 403 Caucasian patients diagnosed with exudative AMD were included. After a three-injection loading phase, a pro re nata regimen was followed. Nine SNPs from six different genes (CFH, CFB, ARMS2, SERPINF1, VEGFR1, VEGF) were genotyped. Non-genetic risk factors (gender, smoking habit and hypertension) were also assessed. Patients were classified as good or poor responders (GR or PR) according to functional (visual acuity), anatomical (foveal thickness measured by OCT) and fluid criteria (fluid/no fluid measured by OCT).ResultsHypertension was the environmental factor with the strongest poor response association with ranibizumab in the anatomical measure after the loading phase (p = 0.0004; OR 3.7; 95% CI, 2.4–5.8) and after 12 months of treatment (p = 10−5; OR 2.3; 95% CI, 1.5–3.4). The genetic variants rs12614 (CFB), rs699947 (VEGFA) and rs7993418 (VEGFR1) predisposed patients to a good response, while rs12603486 and rs1136287 (SERPINF1) were associated with a poor response. The protective genotype of rs800292 variant (CFH) was also associated with a poor anatomical response (p 0.0048).ConclusionAll these data suggest that genetics play an important role in treatment response in AMD patients.
      PubDate: 2017-09-19T07:45:26.605348-05:
      DOI: 10.1111/aos.13519
  • Outcomes of severe uveitic glaucoma treated with Baerveldt implant: can
           blindness be prevented'
    • Authors: Annelie N. Tan; Michiel F. Cornelissen, Carroll A. B. Webers, Roel J. Erckens, Tos T. J. M. Berendschot, Henny J. M. Beckers
      Abstract: PurposeTo evaluate long-term outcomes on efficacy and safety of severe uveitic glaucoma treated with a Baerveldt glaucoma implant (BGI).MethodsA retrospective study of 47 eyes of 47 patients with uveitic glaucoma treated by a BGI between September 2002 and September 2015. Main outcome measures were intraocular pressure (IOP), number of glaucoma medications, course of the uveitis, visual acuity (VA) and complications.ResultsMean IOP dropped from 30.6 ± 8.1 mmHg with 3.6 ± 1.1 glaucoma medications at baseline to 10.6 ± 4.3 mmHg with 1.0 ± 1.3 glaucoma medications after a mean follow-up of 63.6 ± 43.1 months. In the majority of cases, IOP remained stable during follow-up. However, especially in several patients with viral uveitis, episodes with IOP peaks were observed during a flare-up despite a functioning implant. These peaks remained below preoperative levels. During follow-up, 16 patients (34%) experienced a clinically significant VA loss, mainly because of late-stage glaucoma or hypotony maculopathy. Early postoperative complications were transient choroidal effusion (n = 5), shallow/flat anterior chamber (n = 4), hyphaema (n = 2) and suprachoroidal haemorrhage (n = 1). The most important late postoperative complication was hypotony maculopathy (n = 5), three of these in juvenile idiopathic arthritis (JIA) patients.ConclusionThe BGI is an effective and safe treatment for patients with refractive secondary glaucoma due to uveitis. In a majority of patients, VA remains stable and a low and stable IOP is maintained over time with an acceptable number of complications. In particular, patients with viral uveitis and glaucoma should be closely monitored for IOP peaks that may occur during episodes of a flare-up of uveitis, whereas at the other end of the spectrum, patients with JIA seem much more prone to hypotony maculopathy.
      PubDate: 2017-09-18T02:10:22.907242-05:
      DOI: 10.1111/aos.13489
  • Deep capillary plexus impairment in patients with type 1 diabetes
           mellitus with no signs of diabetic retinopathy revealed using optical
           coherence tomography angiography
    • Authors: Fabio Scarinci; Fabiana Picconi, Paola Giorno, Barbara Boccassini, Daniele De Geronimo, Monica Varano, Simona Frontoni, Mariacristina Parravano
      PubDate: 2017-09-09T04:15:25.198284-05:
      DOI: 10.1111/aos.13510
  • Association between mode of delivery and astigmatism in preschool children
    • Authors: Fengyang Liu; Xubo Yang, Angcang Tang, Longqian Liu
      Abstract: PurposeTo determine whether mode of delivery has any impact on astigmatism.MethodsThis case–control study was performed in the Department of Ophthalmology in 2015. Exposure was mode of delivery [vaginal delivery (VD) or caesarean section (CS), which here included both elective and emergency CS]. Outcome was astigmatism (≥2.5 D), which was determined by cycloplegic refraction. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were computed to assess the associations between mode of delivery and astigmatism from logistic regression models.ResultsOf the 659 children studied here (341 boys; mean age, 4.37 years), 440 were born by CS and 219 by VD. The incidence of severe astigmatism (≥2.5 D) in the CS and VD groups was 22.06% and 13.24%, respectively. Children delivered by CS had a 77.9% higher risk of severe astigmatism compared with vaginally delivered children (OR = 1.779; 95% CI, 1.121 to 2.824). After dividing CS into elective CS and emergency CS, children delivered by elective CS had an 87.3% increased risk of severe astigmatism (OR = 1.873; 95% CI, 1.157 to 3.032), but children delivered by emergency CS did not differ from vaginally delivered children. In addition, the children whose mothers had histories of breastfeeding had a 44.6% lower risk of severe astigmatism than children whose mother did not breastfeed them (OR = 0.554, 95% CI, 0.335–0.914).ConclusionBirth by CS, especially elective CS, increases the risk of severe astigmatism (≥2.50 D) in childhood.
      PubDate: 2017-09-09T04:00:32.835947-05:
      DOI: 10.1111/aos.13552
  • Gastric bypass surgery does not increase the risk for sight-threatening
           diabetic retinopathy
    • Authors: Åsa Morén; Magnus Sundbom, Johan Ottosson, Elisabet Granstam
      Abstract: PurposeTo study the occurrence and level of diabetic retinopathy (DRP) before and after planned bariatric surgery and to investigate potential risk factors for deterioration of DRP.MethodsThe Scandinavian Obesity Surgery Registry (SOReg) was used to identify diabetic patients who underwent gastric bypass (GBP) surgery at three centres in Sweden during 2008–2010. Information regarding DRP screening was obtained from ophthalmological patient charts. Patients who had DRP screening before and after GBP surgery were included in the study.ResultsThe survey included 117 patients. Mean age was 50 (SD 10) years, body mass index (BMI) 43 (SD 8) kg/m2 and HbA1c 64 (SD 18) mmol/mol before surgery. One year post-GBP, BMI was reduced to 31 (SD 6) kg/m2. HbA1c was 43 (SD 10) mmol/mol, and in 66% (77/117) treatment for diabetes had been discontinued. Occurrence of DRP before GBP was as follows: no DRP 62%, mild 26%, moderate 10%, severe 0% and proliferative DRP 2%. No significant changes in occurrence of DRP after surgery were observed. Twelve patients (16%) developed mild DRP. In seven patients with pre-existing DRP, deterioration was observed and two of these patients required treatment for sight-threatening DRP. No association between preoperative BMI, HbA1c or reduction in HbA1c and worsening of DRP was found.ConclusionIn a majority of patients, no deterioration of DRP following GBP was observed. Screening for DRP before planned surgery is recommended for all diabetic patients about to undergo bariatric surgery to identify any pre-existing DRP.
      PubDate: 2017-08-31T07:00:39.068798-05:
      DOI: 10.1111/aos.13555
  • Spectacle use after routine cataract surgery: a study from the Swedish
           National Cataract Register
    • Authors: Daniel B. Farhoudi; Anders Behndig, Per Montan, Mats Lundström, Charlotta Zetterström, Maria Kugelberg
      Abstract: PurposeTo explore patients' obtaining and use of spectacles after routine cataract surgery.MethodsThe study included 1329 patients who underwent bilateral surgery with the second eye operated during March 2013 at 38 different clinics in Sweden. Five months after the second-eye surgery, patients completed a five-item questionnaire about their spectacle use preoperatively and postoperatively. The responses were linked to data from the registry on multiple variables including postoperative refraction, age and gender.ResultsOf the 387 patients who were advised by their surgeons to obtain distance spectacles postoperatively, most did so (77.3%, n = 299), while of the 691 patients who were not so advised, most did not obtain spectacles (78.9%, n = 545). Nevertheless, almost 50% of patients with both spherical and cylindrical errors exceeding 1 dioptre (D) did not obtain new distance spectacles postoperatively, while about 25% of patients with bilateral emmetropia (spherical error
      PubDate: 2017-08-31T06:41:08.81245-05:0
      DOI: 10.1111/aos.13554
  • Intravitreal gas for symptomatic vitreomacular adhesion: a synthesis of
           the literature
    • Authors: James E. Neffendorf; Andrew R.H. Simpson, David H.W. Steel, Riti Desai, Dominic A. McHugh, Edward Pringle, Timothy L. Jackson
      Abstract: Symptomatic vitreomacular adhesion (sVMA) is defined as visual loss secondary to foveal damage from vitreomacular traction (VMT) and includes isolated VMT, impending macular hole (MH), and full-thickness MH with persisting vitreous attachment. Management options include pars plana vitrectomy (PPV), intravitreal ocriplasmin, intravitreal gas injection or observation. This synthesis of the literature aimed to assess the safety and efficacy of intravitreal gas for sVMA. Articles describing patients with VMT or MH treated with intravitreal expansile gas were selected by systematic literature review using MEDLINE, EMBASE, and the Cochrane Database of Controlled Trials (CENTRAL) up to September 2016. The main outcomes at 1 month and final review were logarithm of the minimum angle of resolution (logMAR) visual acuity (VA), anatomical success (absence of both VMT and MH, without PPV) and adverse events (AEs). The intended comparator was observation. Nine of 106 identified articles were eligible, and none were randomized controlled trials. The mean VA of 91 eyes improved from 0.55 (Snellen equivalent 6/21) to 0.48 (6/18) logMAR at 1 month and to 0.35 (6/13) logMAR at final review. The mean VA at final review, prior to a vitrectomy, was 0.42 (6/16). Anatomic success was 48% at 1 month and 57% at final review. The reported AEs comprised retinal detachment in two highly myopic eyes. Intravitreal gas injection can relieve sVMA. Larger controlled studies are needed to determine safety and efficacy relative to observation, ocriplasmin, or vitrectomy.
      PubDate: 2017-08-31T06:30:45.486518-05:
      DOI: 10.1111/aos.13547
  • Visual outcomes in patients with neovascular age-related macular
    • Authors: Colin S. Tan; Wei Kiong Ngo, Louis W. Lim
      PubDate: 2017-08-22T07:30:46.677654-05:
      DOI: 10.1111/aos.13540
  • Prominent regression of corneal deposits in Fabry disease 16 years after
           initiation of enzyme replacement therapy
    • Authors: Shizuka Koh; Norio Sakai, Naoyuki Maeda, Kohji Nishida
      PubDate: 2017-08-22T07:30:45.827226-05:
      DOI: 10.1111/aos.13541
  • Ocular findings in patients with microcephaly can suggest presumed
           congenital zika virus infection
    • Authors: Ignasi Jürgens; Amanda Rey
      PubDate: 2017-08-22T07:30:41.828221-05:
      DOI: 10.1111/aos.13548
  • Virtual reality-based proficiency test in direct ophthalmoscopy
    • Authors: Nanna Jo Borgersen; Ann Sofia Skou Thomsen, Lars Konge, Torben Lykke Sørensen, Yousif Subhi
      PubDate: 2017-08-22T07:30:27.2892-05:00
      DOI: 10.1111/aos.13546
  • Ganglion cell layer measurements correlate with disease severity in
           patients with Alzheimer's disease
    • Authors: Jurre den Haan; Lisanne J. Balk, Frank D. Verbraak
      PubDate: 2017-08-22T07:30:23.562552-05:
      DOI: 10.1111/aos.13550
  • The first description of the complete natural history of uveal melanoma by
           two Scottish surgeons, Allan Burns and James Wardrop
    • Authors: Tero T. Kivelä
      Abstract: James Wardrop (1782–1869), a young Scottish surgeon and an early ophthalmologist in Edinburgh, is credited for describing in 1809 retinoblastoma as an entity in his treatise ‘Observations on Fungus Hæmatodes or Soft Cancer’. His treatise also reveals that Allan Burns (1781–1813), another young Scottish surgeon and anatomist, had invited Wardrop to assist in enucleating an eye from a 41-year-old Glasgow woman who, in retrospect, had a uveal melanoma. Her eye had become blind 4 months after symptoms of exudative retinal detachment had appeared, and it had become painful after a further 2–4 months. The tumour eventually perforated the sclera, and she died within a year thereafter of hepatic metastases. Burns and Wardrop went on to publish detailed parallel accounts of the symptoms, signs, ophthalmic pathology and post-mortem findings regarding the primary, recurrent and metastatic tumour. Burns may have performed the post-mortem after exhuming the body, a common occurrence in early 19th Century Scotland, a thriving hub for teaching morbid anatomy to young surgeons at the time.
      PubDate: 2017-08-21T07:40:56.124388-05:
      DOI: 10.1111/aos.13535
  • Visual impairment and blindness in Hungary
    • Authors: Dorottya Szabó; Gábor László Sándor, Gábor Tóth, Anita Pék, Regina Lukács, Irén Szalai, Georgina Zsófia Tóth, András Papp, Zoltán Zsolt Nagy, Hans Limburg, János Németh
      Abstract: AimThe aim of this study was to estimate the prevalence and causes of blindness, severe visual impairment (SVI), moderate visual impairment (MVI), and early visual impairment (EVI) and its causes in an established market economy of Europe.DesignA cross-sectional population-based survey.MethodsA sample size of 3675 was calculated using the standard Rapid Assessment of Avoidable Blindness (RAAB) software in Hungary. A total of 105 clusters of 35 people aged 50 years or older were randomly selected with probability proportionate to size by the Hungarian Central Statistical Office. Households within the clusters were selected using compact segment sampling. Visual acuity (VA) was assessed with a Snellen tumbling E-chart with or without a pinhole in the households.ResultsThe adjusted prevalences of bilateral blindness, SVI, MVI and EVI were 0.9% (95% CI: 0.6–1.2), 0.5% (95% CI: 0.2–0.7), 5.1% (95% CI: 4.3–5.9) and 6.9% (95% CI: 5.9–7.9), respectively. The major causes of blindness in Hungary were age-related macular degeneration (AMD; 27.3%) and other posterior segment diseases (27.3%), cataract (21.2%) and glaucoma (12.1%). Cataract was the main cause of SVI, MVI and EVI. Cataract surgical coverage (CSC) was 90.7%. Of all bilateral blindness in Hungary, 45.5% was considered avoidable.ConclusionThis study proved that RAAB methodology can be successfully conducted in industrialized countries, which often lack reliable epidemiologic data. The prevalence of blindness was relatively low, with AMD and other posterior segment diseases being the leading causes, and cataract is still a significant cause of visual impairment.
      PubDate: 2017-08-21T07:25:47.596711-05:
      DOI: 10.1111/aos.13542
  • Treatment for neovascular age-related macular degeneration in Sweden:
           outcomes at seven years in the Swedish Macula Register
    • Authors: Inger Westborg; Elisabet Granstam, Aldana Rosso, Susanne Albrecht, Niklas Karlsson, Monica Lövestam-Adrian
      Abstract: PurposeTo present Swedish Macula Register (SMR) data regarding treatment of neovascular age-related macular degeneration (AMD) in clinical practice since 2008.MethodsA retrospective register-based study was conducted. Evaluation of baseline demographics, visual outcome and number of injections during this period is presented.ResultsMean age at diagnosis was 79 ± (SD) 8 years; 65% were female. The proportion of patients with
      PubDate: 2017-08-21T07:10:21.471605-05:
      DOI: 10.1111/aos.13539
  • Long-term results of deep sclerectomy in normal-tension glaucoma
    • Authors: Mika Harju; Sakari Suominen, Pasi Allinen, Eija Vesti
      Abstract: PurposeTo study the long-term outcome of deep sclerectomy with and without mitomycin-C (MMC) in patients with normal-tension glaucoma (NTG).MethodsWe prospectively analysed consecutive patients randomized to surgery performed either with (MMC group) or without (non-MMC) MMC. Surgery was considered totally successful if, after surgery, the preoperative intra-ocular pressure (IOP) level was reduced by 25% without medication, and a qualified success if medication was required to achieve the same limits.ResultsA total of 37 patients were enrolled, 15 in the MMC and 22 in the non-MMC group. The median (range) follow-up was 7.9 (1.0–9.0) years, with a drop-out of three (8%) patients. The preoperative IOP was 15 (11–21) mmHg in the MMC and 15 (10–19) mmHg in the non-MMC group. At the last 6- to 9-year follow-up, IOP was significantly reduced to 9 (2–13) mmHg (p = 0.002) and 10 (5–13) mmHg (p 
      PubDate: 2017-08-21T06:45:30.47106-05:0
      DOI: 10.1111/aos.13529
  • Dry eye disease and oxidative stress
    • Authors: Sophia Seen; Louis Tong
      Abstract: Dry eye, an age-related condition, is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear film instability. Environmental factors are also often implicated in dry eye including exposure to pollutants, ultraviolet (UV) radiation and ozone as well as the chronic use of preserved eyedrops such as in the treatment of glaucoma. These factors increase oxidative stress and ocular surface inflammation. Here, we reviewed the cellular, animal and clinical studies that point to the role of oxidative stress in dry eye disease. The biomarkers used to indicate oxidative damage in ocular surface tissues include 8-hydroxy-2 deoxyguanosine (8-OHdG), 4-hydroxynonenal (HNE) and malondialdehyde (MDD). Antioxidative defences in the ocular surface occur in the form of tear proteins such as lactoferrin and S100A proteins, and enzymes such as superoxide dismutase (SOD), peroxidase, catalase and mitochondrial oxidative enzymes. An imbalance between the level of reactive oxygen species (ROS) and the action of protective enzymes will lead to oxidative damage, and possibly inflammation. A small number of interventional studies suggest that oxidative stress may be directly targeted in topical therapy of dry eye treatment. For example, in vitro studies suggest that L-carnitine and pterostilbene, a blueberry component may reduce oxidative stress, and in animal studies, alpha-lipoic acid (ALP) and selenoprotein P may be helpful. Examples of treatments used in clinical trials include vitamin B12 eyedrops and iodide iontophoresis. With recent emphasis on ageing medicine and preventive holistic health, as well as the role of environmental science, research on oxidative stress in the ocular surface is likely to have increasing impact in the coming years.
      PubDate: 2017-08-21T06:22:06.537745-05:
      DOI: 10.1111/aos.13526
  • Prophylactic intravitreal antibiotics reduce the risk of post-traumatic
           endophthalmitis after repair of open globe injuries
    • Authors: Marwan A. Abouammoh; Abdullah Al-Mousa, Mohammad Gogandi, Hani Al-Mezaine, Essam Osman, Abdulrahman M. Alsharidah, Abdullah Al-Kharashi, Ahmed M. Abu El-Asrar
      Abstract: PurposeTo investigate efficacy of prophylactic intravitreal antibiotics in reducing incidence of endophthalmitis after repair of open globe injuries. At King Abdulaziz University Hospital, a standard protocol of intravenous vancomycin and ceftazidime was used in all cases.MethodsCharts of 353 patients who presented between January 2010 and January 2014 with open globe injury were retrospectively reviewed. In addition, the standard protocol in this cohort included prophylactic intravitreal antibiotics in high-risk cases at time of primary repair. High-risk cases were identified based on the presence of one or more of the following risk factors: dirty wound, retained intra-ocular foreign body (IOFB), rural setting, delayed primary repair of>24 hr and ruptured lens capsule. Rate of endophthalmitis in this recent cohort was compared with that of a previous cohort admitted for primary repair between May 1996 and May 2008 (641 patients). In the previous cohort, protocol did not include prophylactic intravitreal antibiotics.ResultsRates of clinically suspected endophthalmitis and culture-positive endophthalmitis were higher in previous cohort (24 of 641 eyes; 3.7% and 12 of 641 eyes; 1.9%, respectively) compared to recent cohort (six of 353 eyes; 1.7% and two of 353 eyes; 0.6%, respectively). In high-risk groups, rates of suspected endophthalmitis and culture-positive endophthalmitis were higher in previous cohort (19 of 345 eyes; 5.5% and 12 of 345 eyes; 3.5%, respectively) compared to the recent cohort (five of 200 eyes; 2.5% and two of 200 eyes; 1.0%, respectively).ConclusionProphylactic intravitreal antibiotics reduce risk of endophthalmitis after repair of open globe injuries.
      PubDate: 2017-08-03T05:10:19.13071-05:0
      DOI: 10.1111/aos.13531
  • The effects of antioxidants on ocular blood flow in patients with glaucoma
    • Authors: Alon Harris; Josh Gross, Nicholas Moore, Thai Do, Amelia Huang, Willy Gama, Brent Siesky
      Abstract: PurposeTo investigate the effects of an antioxidant dietary supplement that includes Ginkgo biloba, on retinal and retrobulbar blood flow in patients with open-angle glaucoma (OAG).MethodsForty-five patients with confirmed OAG were enroled in a randomized, double blinded, placebo-controlled cross-over study. Baseline and postadministration measurements of intraocular pressure (IOP), ocular perfusion pressure (OPP), retrobulbar blood flow, and retinal capillary blood flow were non-invasively measured (ultrasound and laser Doppler modalities, respectively) before and one month after antioxidant nutraceuticals and placebo administration. Changes in measurements between the active supplement and placebo arms were evaluated using paired t-tests, with p 
      PubDate: 2017-08-03T05:00:24.174806-05:
      DOI: 10.1111/aos.13530
  • Ultrawide field scanning laser ophthalmoscopy imaging of lipemia retinalis
    • Authors: Paolo S. Silva; Aditi Gupta, Radwan S. Ajlan, Deborah K. Schlossman, Ann M. Tolson, Jerry D. Cavallerano, Lloyd Paul Aiello
      Abstract: ObjectiveTo describe the characteristic retinal features of lipemia retinalis when using ultrawide field scanning laser ophthalmoscopy.Main PointsWe report a case series of three subjects with ultrawide field retinal images showing cream discoloration of the fundus, light salmon-coloured posterior retinal vessels and greyish pink peripheral vasculature. On green-only imaging, many of the vessels appear light rather than typically dark.ConclusionLipemia retinalis is readily apparent on ultrawide field imaging and illustrates the alterations that systemic diseases may induce in the posterior and peripheral retinal vasculature. Ultrawide field imaging highlights the disparate vascular appearance of the posterior pole and retinal periphery in this condition.
      PubDate: 2017-08-03T04:56:04.065987-05:
      DOI: 10.1111/aos.13525
  • Von Helmholtz's ophthalmometer: historical review and experience with one
           of the last surviving original devices
    • Authors: Daniel Godefrooij; Virgilio Galvis, Alejandro Tello
      Abstract: Hermann von Helmholtz (1821–1894) was one of the most important scientists of the nineteenth century in optics and ophthalmology. One of his significant contributions in the field of vision sciences was the invention of the ophthalmometer in 1850, which was the precursor of the keratometers still used in clinical practice today. However, this development tends to be little recognized, and to be overshadowed by others of the achievements of this singular scientist. This review describes the historical setting behind the von Helmholtz's ophthalmometer and its mechanism. We also describe the modifications that were later made to the design. We report on our experience measuring a living human cornea with one of the last surviving devices in the world. The ophthalmometer by von Helmholtz marked the beginning of an era in the ophthalmology of the late nineteenth century, and although its original design was not broadly used in the clinical practice, and later abandoned, it opened the way for the development of practical systems very similar to the ones that we use even today.
      PubDate: 2017-08-03T04:05:39.538695-05:
      DOI: 10.1111/aos.13493
  • Hyperopia shows the strongest association with LASIK retreatment
    • Authors: Andreas Frings; Elisa Intert, Johannes Steinberg, Vasyl Druchkiv, Stephan J. Linke, Toam Katz
      PubDate: 2017-08-03T02:25:22.426819-05:
      DOI: 10.1111/aos.13486
  • Stroke risk among adult patients with third, fourth or sixth cranial nerve
           palsy: a Nationwide Cohort Study
    • Authors: Tyler Hyungtaek Rim; Jinu Han, Yoon Seong Choi, Taekjune Lee, Sung Soo Kim
      Abstract: PurposeThis study sought to determine whether isolated third, fourth and sixth cranial nerve palsies (NPs) are associated with increased short- and long-term risk of a subsequent stroke.MethodsThis was a nationwide retrospective propensity score-matched cohort study. A cohort of patients with NP (n = 466) and a randomly selected, propensity-matched control cohort (n = 2281) were extracted from the Korean national insurance claim database. Subjects were tracked for 5 years total, subdivided into periods of 0–1 years, 1–3 years and 3–5 years. We assessed the risk of stroke using hazard ratios (HRs) and confidence intervals (CIs) after adjustments using Cox regression at different time intervals.ResultsThe median follow-up was 3.1 years. Stroke developed in 18.9% of the NP cohort and 7.5% of the control cohort. Stroke risk after NP was highest in the first year [14.7 per 100 person-year at 0–1 years (HR = 6.6), 3.1 per 100 person-year at 1–3 years (HR = 1.6) and 4.3 per 100 person-year at 3–5 years (HR = 2.8)]. Each type of NP was also associated with stroke risk: within 0–1 years, stroke risk was increased in third (HR = 7.6), fourth (HR = 6.0) and sixth (HR = 5. 84) NPs. In the 3- to 5-year period, risk was increased in sixth (HR = 4.7) and fourth (HR = 3.3) NPs, but not third (HR = 0.6) NPs.ConclusionPatients in the NP cohort were more likely to have a stroke than those in the matched control cohort; the increased risk was both time- and cranial nerve-dependent.
      PubDate: 2017-08-03T02:20:40.237566-05:
      DOI: 10.1111/aos.13488
  • Ocriplasmin treatment for vitreomacular traction in real life: can the
           indication spectrum be expanded'
    • Authors: Kleanthis Manousaridis; Silvia Peter, Stefan Mennel
      PubDate: 2017-08-03T02:00:37.523073-05:
      DOI: 10.1111/aos.13469
  • Corneal confocal sub-basal nerve plexus evaluation: a review
    • Authors: Joanna Kokot; Adam Wylęgała, Bogumił Wowra, Łukasz Wójcik, Dariusz Dobrowolski, Edward Wylęgała
      Abstract: The aim of this study was to review the most recent data about corneal sub-basal nerve plexus (SNP) evaluated with the use of corneal confocal microscopy (CCM). For this purpose, an electronic search was conducted based on PubMed and Google Scholar and Web of Science databases from 2008 up to the end of 2016. Ninety-eight articles in English were cited, as well as abstracts in other languages, concerning the morphology and function of corneal SNP in various diseases. Changes in corneal SNP as a result of local treatment were also introduced. Figures with scans from confocal microscopy from our Department were included. The main conclusion of this review was that both corneal SNP diminishment and high tortuosity as well as low sensitivity are in principle related to the presence or level of pathology. In addition, increased nerve tortuosity may represent a morphological determinant of nerve regeneration. However, the presented literature shows that SNP changes are not characteristic for one unified corneal pathology; rather, they reflect the non-specific pathological process present in many diseases. Future studies should use automatized biometric software and also examine the effects of new treatments on SNP.
      PubDate: 2017-07-25T06:50:32.367518-05:
      DOI: 10.1111/aos.13518
  • Transplantation of amniotic membrane for choroidal hole to treat
           suprachoroidal silicone oil migration
    • Authors: Dongqing Zhu; Xiaoliang Jin, Jibo Zhou
      PubDate: 2017-07-11T08:07:29.431484-05:
      DOI: 10.1111/aos.13516
  • Measurement centration and zone diameter in anterior, posterior and total
           corneal astigmatism in keratoconus
    • Authors: Anneli Fredriksson; Anders Behndig
      Abstract: PurposeTo investigate the central and paracentral astigmatism and the significance of centration and measurement zone diameter compared to a 3-mm pupil-centred measurement zone in keratoconus and in healthy eyes.MethodsTwenty-eight right eyes from 28 KC patients with an inferotemporal cone were selected according to specified criteria based on Oculus Pentacam HR® measurements and were matched with healthy control eyes. The flat (K1) and steep (K2) keratometry readings were registered from the ‘Total Corneal Refractive Power’ (TCRP) display as well as the anterior and posterior corneal astigmatism displays (ACA and PCA, respectively). Astigmatic power vectors KP0 and KP45 were calculated and analysed for a 6-mm and two 3-mm zones centred on the corneal apex and the pupil, and for 8 paracentral 3-mm zones.ResultsThe astigmatism was generally higher in KC. Many astigmatic values in KC differed between the 3-mm pupil-centred and the 3- and 6-mm apex-centred zones in KC. In the controls, no corresponding differences between measurement zones were seen, apart from PCA, which differed. The magnitude and direction of KP0 and KP45 varied greatly between the paracentral measurements in KC.ConclusionCentration and measurement zone diameter have great impacts on the astigmatic values in KC. A small pupil-centred measurement zone should be considered when evaluating the astigmatism in KC.
      PubDate: 2017-07-10T08:57:03.342677-05:
      DOI: 10.1111/aos.13517
  • Vitrectomy with a modified temporal inverted limiting membrane flap to
           reconstruct the foveolar architecture for macular hole retinal detachment
           in highly myopic eyes
    • Authors: Tzyy-Chang Ho; Allen Ho, Muh-Shy Chen
      Abstract: PurposeWe investigated the surgical results of macular hole retinal detachment (MHRD) with a modified C-shaped temporal inverted internal limiting membrane (ILM) flap to reconstruct the foveolar architecture in highly myopic eyes.MethodsEighteen highly myopic eyes with MHRD in 17 patients who underwent a vitrectomy with a modified C-shaped temporal inverted ILM flap were followed for 12 months. Anatomic outcomes were evaluated by fundus examinations and optical coherence tomography. The preoperative and postoperative best-corrected visual acuities (BCVAs) were compared as functional outcomes.ResultsWomen accounted for 88% of the MHRD patients. The mean age was 60.2 ± 8.2 years. The mean axial length was 29.25 ± 2.10 mm. Type 1 and type 2 MHRD was present in four eyes and 14 eyes, respectively. After a single surgery, the hole was closed in 18 eyes (100%). Retinal attachment was achieved in 95%. Persistent shallow subretinal fluid (SRF) was noted in one case, which was resolved at follow-up. The surgery significantly improved BCVAs (from 1.7 ± 0.6 to 0.72 ± 0.4 logarithm of the minimum angle of resolution units [p 
      PubDate: 2017-07-05T05:27:01.003447-05:
      DOI: 10.1111/aos.13514
  • Vascular and metabolic comorbidities in open-angle glaucoma with low- and
           high-teen intraocular pressure: a cross-sectional study from South Korea
    • Authors: Si Hyung Lee; Gyu Ah Kim, Wonseok Lee, Hyoung Won Bae, Gong Je Seong, Chan Yun Kim
      Abstract: PurposeTo assess the associations between vascular and metabolic comorbidities and the prevalence of open-angle glaucoma (OAG) with low-teen and high-teen intraocular pressure (IOP) in Korea.MethodsCross-sectional data from the Korean National Health and Nutrition Examination Survey from 2008 to 2012 were analysed. Participants diagnosed with OAG with normal IOP were further classified into low-teen IOP (IOP ≤ 15 mmHg) and high-teen IOP (15 mmHg 
      PubDate: 2017-07-05T05:05:21.25253-05:0
      DOI: 10.1111/aos.13487
  • Analysis of KERA in four families with cornea plana identifies two novel
    • Authors: Lubica Dudakova; Jang Hee J. Vercruyssen, Irina Balikova, Lavina Postolache, Bart P. Leroy, Pavlina Skalicka, Petra Liskova
      Abstract: PurposeTo identify the molecular genetic cause in four families of various ethnic backgrounds with cornea plana.MethodsDetailed ophthalmological examination and direct sequencing of the KERA coding region in five patients of Czech and Turkish origin and their available family members.ResultsCompound heterozygosity for a novel missense mutation c.209C>T; p.(Pro70Leu) and a novel splice site mutation c.887-1G>A in KERA were detected in two affected siblings of Czech origin. In silico analysis supported the pathogenicity of both variants. The second proband of Czech origin harboured c.835C>T; p.(Arg279*) in a homozygous state. Homozygous mutations c.740A>G; p.(Asn247Ser) and c.674C>T; p.(Ile225Thr) were identified in the Turkish probands, both born out of consanguineous marriages. Observed ocular phenotypes were typical of cornea plana with the exception of one Czech patient who also had marked thinning and protrusion in the superior part of the left cornea (mean keratometry 47.2 D). No corneal endothelial cell pathology was found by specular microscopy in seven eyes, in three eyes visualization of the posterior corneal surface was unsuccessful.ConclusionKERA mutation c.740A>G has been identified to date in three different populations, which makes it the most frequently occurring mutation in patients with cornea plana. Marked corneal thinning and ectasia are a very rare finding in this disorder and longitudinal follow-up needs to be performed to determine its potential progressive nature.
      PubDate: 2017-07-05T04:46:03.383174-05:
      DOI: 10.1111/aos.13484
  • Factors related to retinal haemorrhage in infants born at high risk
    • Authors: Qinglan Pu; Ping Li, Huiqin Jiang, Hong Wang, Qiaoyun Zhou, Jia Liu, Wenhua Zhong, Huafei Huang
      Abstract: PurposeThis study aims to determine risk factors for retinal haemorrhage (RH) in high-risk infants.MethodsA total of 3123 cases with high-risk pregnancy and/or neonatal asphyxia 72 hr after delivery were enrolled into this study. Fundus examinations were performed on newborns utilizing a wide-angle imaging system (RetCam III). Retinal haemorrhage (RH) was classified into three grades. Maternal, obstetric and neonatal parameters from high-risk infants with RH were compared with parameters from infants without RH.ResultsRetinal haemorrhage (RH) was found in 550 (18%) of 3123 high-risk infants. Retinal haemorrhage (RH) was classified as grade I (39%), grade II (24%) and grade III (37%). Monocular RH occurred in 37% of cases, while the remaining cases were binocular. Moreover, six cases had vitreous haemorrhage. The following parameters correlated (p 
      PubDate: 2017-07-03T07:25:19.849005-05:
      DOI: 10.1111/aos.13515
  • Physical activity and myopia in Danish children—The CHAMPS Eye Study
    • Authors: Kristian Lundberg; Anne Suhr Thykjær, Rasmus Søgaard Hansen, Anders Højslet Vestergaard, Nina Jacobsen, Ernst Goldschmidt, Rodrigo Antunes Lima, Tunde Peto, Niels Wedderkopp, Jakob Grauslund
      Abstract: PurposeTo determine associations between physical activity (PA) and myopia in Danish school children and investigate the prevalence of myopia.MethodsThis is a prospective study with longitudinal data on PA in a Danish child cohort. Physical activity (PA) was measured objectively by repeated ActiGraph accelerometer measurement four times with different intervals (1–2.5 years) at the mean ages 9.7, 11.0, 12.9 and 15.4 years. Mean intensity of PA was estimated as counts/minutes, and time spent in sedentary, light, moderate and vigorous PA was summed using defined cut-off points. The ophthalmologic examination was conducted at the mean age of 15.4 ± 0.7 years and included cycloplegic autorefraction and biometry.ResultsA total of 307 children participated in the Childhood Health, Activity, and Motor Performance School (CHAMPS) Eye Study. The cycloplegic spherical equivalent (SE) was 0.30 ± 1.46 dioptres. The prevalence of myopia was 17.9% (SE ≤−0.5 dioptres). Mean axial length (AL) was 23.5 ± 0.9 mm. For all participants, the overall mean daily distribution of PA was 67.2% in sedentary, 25.6% in light, 4.4% in moderate and 2.9% in vigorous PA. Age- and sex-adjusted linear regression showed no association between PA and SE or AL. In a prospective slope analysis, there was no association between accumulated PA during the 7 years and AL or SE.ConclusionThe prevalence of myopia among Danish children was 17.9%. By logistic regression and slope analysis, we found no association between PA and myopia, in this first of its kind study based on objective and repeated PA data.
      PubDate: 2017-07-03T07:21:27.053656-05:
      DOI: 10.1111/aos.13513
  • Neovascular age-related macular degeneration is associated with cataract
    • Authors: Jau-Der Ho; Sudha Xirasagar, Li-Ting Kao, Herng-Ching Lin
      Abstract: PurposeThis retrospective cohort study examines the association between cataract surgery and neovascular age-related macular degeneration (AMD) during 5-year follow-up using population-based claims data.MethodsWe analysed data sourced from the Taiwan Longitudinal Health Insurance Database 2005. The study included 3465 patients who had undergone cataract operations and did not have a diagnosis of AMD before or on the surgery date (study group), and 10 395 age- and sex-matched comparison patients selected randomly from the remaining patients without an AMD diagnosis before the index date. We tracked the claims of each patient for a 5-year period to identify patients with a subsequent diagnosis of neovascular AMD.ResultsThe incidence rate of neovascular AMD was 0.88 (95% confidence interval (CI): 0.66–1.14) per 1000 person-years among all sampled patients, 1.60 (95% CI: 1.04–2.36) among the cataract surgery patients and 0.64 (95% CI: 0.43–0.91) among comparison patients (p 
      PubDate: 2017-07-03T07:06:52.147308-05:
      DOI: 10.1111/aos.13511
  • Retinal venous pressure is higher than the airway pressure and the
           intraocular pressure during the Valsalva manoeuvre
    • Authors: Richard Stodtmeister; Maria Heyde, Sylvana Georgii, Egbert Matthè, Eberhard Spoerl, Lutz Ernst Pillunat
      Abstract: PurposeThe aims of this prospective experimental study were to explore the influence of the Valsalva manoeuvre (VM) on retinal venous pressure (RVP) in human volunteers in a university setting and to establish correlations for RVP with the increase in airway pressure (∆AirP) and in intraocular pressure (∆IOP).MethodsIn total, 31 healthy young volunteers (age: 24 ± 1.7 years) were investigated. The instruments used included a dynamic contour tonometer, a contact lens dynamometer (Imedos) and an electronic pressure transducer for measuring airway pressure. The following measurements were successively performed in left eyes: tonometry, dynamometry, repeated simultaneous dynamometry and airway pressure measurement during the VM and tonometry during the VM. The pressures obtained during the VM were determined at 10, 20 and 30 seconds after onset of the VM by linear interpolation.ResultsThe pressures (in mmHg) at baseline and during the VM (median and range with outliers) were as follows: ∆AirP: 10 seconds: 10.0 (7.5); 20 seconds: 12.5 (11.0); and 30 seconds: 11.0 (10.0); and RVP: Start: 17.1 (2.4); 10 seconds: 26.0 (7.5); 20 seconds: 25.0 (6.5); and 30 seconds: 24.0 (6.0). During the VM, the RVP was significantly increased compared with the ∆AirP (p = 0.0017). The IOP during the VM was 13.5 (2.7), and the increase in IOP (∆IOP) was 0.8 (5.6).ConclusionDuring the VM, the RVP was increased compared with the ∆AirP. The increase in RVP (∆RVP) was significantly greater than the ∆IOP. During the VM, the calculated retinal perfusion pressure may be more strongly reduced by the ∆RVP than by the ∆IOP. These properties may influence retinal and optic nerve head pathophysiology.
      PubDate: 2017-07-03T06:56:45.169436-05:
      DOI: 10.1111/aos.13485
  • Effect of active evaluation on the detection of negative dysphotopsia
           after sequential cataract surgery: discrepancy between incidences of
           unsolicited and solicited complaints
    • Authors: Natalia Y. Makhotkina; Marjan D. Nijkamp, Tos T.J.M. Berendschot, Bart Borne, Rudy M.M.A. Nuijts
      Abstract: PurposeTo evaluate the incidence of negative dysphotopsia after sequential cataract surgery.MethodsRetrospective cohort study. The incidence of negative dysphotopsia was assessed by retrospective reviewing of medical records and interviews with patients between 2 and 4 months after sequential cataract surgery. Inclusion criteria were uncomplicated surgery, postoperative corrected distance visual acuity (CDVA) ≥20/25 Snellen and the absence of ocular comorbidity. The majority of intra-ocular lens (IOL) implants were one-piece AcrySof SN60WF (161 eyes). Other IOLs (29 eyes) were toric (SN6AT3-6), spherical (SN60AT), three-piece (MN60MA) and multifocal (ReSTOR SN6AD1, PanOptix TFNT00 and Finevision Micro F trifocal).ResultsThe study population was comprised of 95 patients with a mean age of 72 ± 10 years. Unsolicited complaints of negative dysphotopsia were reported by eight patients (8%), and two of them had a resolution of symptoms within 1 month of follow-up. Eighteen patients (19%) reported negative dysphotopsia at the time of the interview. Two patients reported bothersome negative dysphotopsia, and one of them was successfully treated with implantation of a supplementary IOL in the ciliary sulcus. Patients with negative dysphotopsia were younger than patients without dysphotopsia (p = 0.045) and had shorter axial eye length (p = 0.04), a tendency for higher IOL power (p = 0.09) and a higher CDVA (p = 0.001).ConclusionThe incidence of unsolicited negative dysphotopsia after sequential cataract surgery appears to be a substantial underestimation of complaints identified in active interviewing. Although symptoms are not bothersome in the majority of cases, some patients with undiagnosed severe negative dysphotopsia may benefit from reassurance or secondary treatment.
      PubDate: 2017-06-29T07:40:19.62108-05:0
      DOI: 10.1111/aos.13508
  • Predictors of visual outcome in patients operated for craniopharyngioma
           – a Danish national study
    • Authors: Mads Forslund Jacobsen; Ann Sofia Skou Thomsen, Daniella Bach-Holm, Ghazaleh Doroudian, Kamilla Rothe Nissen, Kåre Fugleholm, Lars Poulsgaard, Volkert Siersma, Steffen Heegaard
      Abstract: PurposeCraniopharyngioma often causes visual loss due to the close relation to the anterior visual pathways. This study investigates the incidence and predictors of visual outcomes in patients with craniopharyngioma.MethodsData from sixty-six patients who underwent surgery for craniopharyngioma from 2009 to 2013 in Denmark were reviewed. Primary outcomes were visual acuity (VA) and visual field (VF) defects from pre-and postoperative visits. Secondary outcomes were optic nerve atrophy (OA) and papilledema.ResultsFifty-eight patients were included. The VA of the patients 1-year after surgery improved by −0.16 log(MAR) (95%CI: −0.30 to −0.02; p = 0.0266). Visual field (VF) defects worsened in 17 eyes (30%), remained stable in 21 eyes (37%) and improved in 19 eyes (33%). The presence of papilledema and the absence of OA were significantly correlated with an improvement in VA postoperatively (p = 0.011 and p = 0.011, respectively). Patients undergoing surgery within a week or less after their first ophthalmological examination had a significant improvement in VA (−0.36; 95%CI: −0.62 to −0.09; p = 0.0099). Patients undergoing surgery using a subfrontal approach also showed improvement in VA (p = 0.048). Tumour recurrence had a significantly worse VA outcome (p = 0.0074).ConclusionPatients show a slight improvement in VA 1-year after operation for craniopharyngioma. The presence of papilledema and early surgical intervention is associated with a significant improvement in VA. Early involvement of a dedicated ophthalmologist is recommended to secure an early detection of a visual decline and potential tumour recurrence.
      PubDate: 2017-06-29T07:35:39.188017-05:
      DOI: 10.1111/aos.13483
  • Prevalence and associations of epiretinal membranes in the Australian
           National Eye Health Survey
    • Authors: Stuart Keel; Jing Xie, Joshua Foreman, Peter Wijngaarden, Hugh R. Taylor, Mohamed Dirani
      PubDate: 2017-06-29T06:50:33.820521-05:
      DOI: 10.1111/aos.13386
  • Validation of the CHOP model for detecting severe retinopathy of
           prematurity in a cohort of Colorado infants
    • Authors: Emily A McCourt; Brandie Wagner, Jennifer Jung, Erica Wymore, Jasleen Singh, Robert Enzenauer, Rebecca Braverman, Anne Lynch
      PubDate: 2017-06-27T05:32:32.4107-05:00
      DOI: 10.1111/aos.13506
  • Eplerenone for chronic central serous chorioretinopathy–a randomized
           controlled prospective study
    • Authors: Roy Schwartz; Zohar Habot-Wilner, Michael R. Martinez, Amir Nutman, Dafna Goldenberg, Shai Cohen, Shiri Shulman, Hanan Guzner-Gur, Anat Loewenstein, Michaella Goldstein
      Abstract: PurposeTo evaluate the efficacy and safety of eplerenone for chronic nonresolving central serous chorioretinopathy (CSC).MethodsProspective, double-blind, randomized placebo-controlled study. Nineteen eyes of 17 patients with persistent subretinal fluid (SRF) due to CSC were enrolled and randomized to receive eplerenone 50 mg/day or placebo for 3 months, followed by a 3-month follow-up. The main outcome measure was change in SRF from baseline to 3 months of treatment. Secondary outcomes included change in SRF at any time-point, complete resolution of SRF, improvement in choroidal thickness and change in best-corrected visual acuity (BCVA).ResultsThirteen eyes were treated with eplerenone and six with placebo. Both groups showed reduction in SRF throughout the treatment period, with a significant reduction at months 1, 3 and 5 only in the treatment group. Twenty-three per cent in the treatment group and 30.8% per cent in the placebo group experienced complete resolution of SRF. A significant improvement in BCVA was noted in the placebo group at 4 months, as well as a significant difference in BCVA between groups at 3 months in favour of the placebo group (p = 0.005). There was no significant difference in choroidal thickness in either group throughout the study period. No adverse events related to eplerenone were noted in the treatment group.ConclusionIn this study, eplerenone was not found to be superior to placebo in eyes with chronic CSC.
      PubDate: 2017-06-27T05:22:43.271289-05:
      DOI: 10.1111/aos.13491
  • Enhanced functional properties of human limbal stem cells by inhibition of
           the miR-31/FIH-1/P21 axis
    • Authors: Zhiping Liu; Weijiao Zhan, Minzhi Zeng, Jinghong Chen, Huyong Zou, Zhiqun Min
      Abstract: ObjectiveOn the basis of the functional roles of the embryonic stem cell niche (ESCN) in the human limbal stem cells (LSCs), we proposed to explore the potential roles of microRNAs in regulating the self-renewal and differentiation of LSCs cultured in the ESCN.MethodsThe LSCs were cultured in different media, either in CnT-20 media or in CnT-20 + 20% ES culture supernatant (ESC-CM). The LSCs cultured in ESC-CM were then transfected with microRNA-31 (miR-31) mimic or antago-31. The colony-forming efficiency (CFE) was analysed. Cell cycle, apoptosis, mitochondrial potential and reactive oxygen species were analysed by flow cytometry, and quantitative real-time PCR was used to determine the expression levels of FIH-1, P21, P63, ABCG2, CK3, microRNA-31, microRNA-143, microRNA-145 and microRNA-184. Indirect immunostaining was employed to detect the expression of P63, ABCG2, survivin, connexin-43 and CK3. Western blot was employed to detect the expression of FIH-1, P63, P21, CK3, caspase 3, Tcf4, β-catenin, survivin, GSK3β and pGSK3β.ResultsCompared with cells grown in CnT-20, the level of miR-31 in cells grown in ESC-CM was lower. We investigated the roles that miR-31 and FIH-1 play in regulating the functional properties of LSCs. We used antagomirs (antago) to reduce the level of miR-31 in LSCs. Antago-31 increased FIH-1 levels and significantly reduced P21 expressional level in LSCs compared to irrelevant-antago (Ir-antago) treatment. The downregulation of miR-31 in LSCs promotes the maintenance of stemness.ConclusionES culture supernatant (ESC-CM) regulates the fate of LSCs in part by inhibiting the miR-31/FIH-1/P21 axis. This study may have a high impact on the expansion of LSCs in regenerative medicine, especially for ocular surface reconstruction.
      PubDate: 2017-06-26T07:37:55.123792-05:
      DOI: 10.1111/aos.13503
  • Intra- and interobserver reproducibility of Bruch's membrane opening
           minimum rim width measurements with spectral domain optical coherence
    • Authors: Alexandre S. C. Reis; Camila e S. Zangalli, Ricardo Y. Abe, André L. Silva, Jayme R. Vianna, José Paulo C. Vasconcellos, Vital P. Costa
      Abstract: PurposeTo investigate the reproducibility of Bruch's membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) measurements using spectral domain optical coherence tomography (SD-OCT). Additionally, to investigate the reproducibility of BMO area measurements and fovea to BMO centre (FoBMO) angle.MethodsParticipants were healthy subjects (n = 30) and patients with glaucoma (n = 26). One eye of each participant was scanned to obtain optic nerve head (24 radial B-scans) and peripapillary (one circular B-scan) images by three independent examiners. Additionally, one examiner imaged each participant three times on the same day. Intra- and interobserver reproducibilities were estimated by within-subject standard deviation (SW) and coefficient of variation (COV). Spearman's rank correlation coefficient was used to test the correlation between the magnitude of the parameter and its standard deviation.ResultsThe global BMO-MRW COVs (%) in healthy/glaucoma subjects were 0.87/1.34 and 1.28/3.13 for intra- and interobserver analyses, respectively, and the corresponding global RNFLT figures were 1.50/2.10 and 2.04/2.87. Global mean BMO-MRW and RNFLT showed no correlation with their respective standard deviations. The reproducibilities of BMO area and FoBMO angle were excellent and similar between the groups.ConclusionThe reproducibilities of BMO-MRW, BMO area measurements and FoBMO angle were excellent in both healthy subjects and patients with glaucoma. Bruch's membrane opening minimum rim width (BMO-MRW) reproducibility is comparable to that of RNFLT measurements.
      PubDate: 2017-06-26T07:37:42.628117-05:
      DOI: 10.1111/aos.13464
  • Characteristics of corneal biomechanical responses detected by a
           non-contact scheimpflug-based tonometer in eyes with glaucoma
    • Authors: Younhea Jung; Hae-Young L. Park, Hee Jung Yang, Chan Kee Park
      Abstract: PurposeTo determine the corneal biomechanical properties in eyes with glaucoma using a non-contact Scheimpflug-based tonometer.MethodsCorneal biomechanical responses were examined using a non-contact Scheimpflug-based tonometer. The tonometer parameters of the normal control group (n = 75) were compared with those of the glaucoma group (n = 136), including an analysis of glaucoma subgroups categorized by visual field loss.ResultsAfter adjusting for potential confounding factors, including the intraocular pressure (IOP), central corneal thickness (CCT), age and axial length, the deformation amplitude was smaller in the glaucoma group (1.09 ± 0.02 mm) than in the normal control group (1.12 ± 0.02 mm; p value = 0.031). The deformation amplitude and the deflection amplitude of the severe glaucoma group (1.12 ± 0.02 mm and 0.92 ± 0.01 mm) were significantly greater than that of the early glaucoma group (1.07 ± 0.01 mm and 0.88 ± 0.11 mm, p = 0.006 and p = 0.031), whereas that of the moderate glaucoma group (1.09 ± 0.02 mm and 0.90 ± 0.02 mm) was greater than that of the early glaucoma group, but this difference was not statistically significant. The deformation amplitude showed a negative correlation with the CCT in the normal control group (r = −0.235), with a weaker negative relationship observed in the early glaucoma group (r = −0.099). However, in the moderate and severe glaucoma groups, the deformation amplitude showed a positive relationship with the CCT, showing an inverse relationship. The duration and number of antiglaucomatous eyedrops used had negative correlations with the CCT in eyes with moderate and severe glaucoma.ConclusionOverall, the glaucoma group showed significantly less deformable corneas than did the normal controls, even after adjusting for the IOP, CCT, age and axial length. However, there were also differences according to the severity of glaucoma, where the corneal deformation amplitude was greater in the severe glaucoma group compared to the early glaucoma group. The combined effects of stiffening due to glaucoma and increased viscoelastic properties caused by the chronic use of antiglaucomatous eyedrops may have resulted in the present findings.
      PubDate: 2017-06-21T05:25:23.917571-05:
      DOI: 10.1111/aos.13466
  • A novel double nucleotide variant in the ferritin-L iron-responsive
           element in a Finnish patient with hereditary hyperferritinaemia-cataract
    • Authors: Roosa-Maria Mattila; Annele Sainio, Marketta Järveläinen, Juha Pursiheimo, Hannu Järveläinen
      Abstract: PurposeTo present a novel Finnish double nucleotide variant in the iron-responsive element (IRE) of the ferritin L-chain gene (FTL) leading to hyperferritinaemia-cataract syndrome (HHCS).MethodsGenomic DNA extracted from peripheral blood leucocytes and synthetized with three different primers flanking the IRE in the FTL 5′-untranslated region of the FTL was used in polymerase chain reaction (PCR). Thereafter, Sanger sequencing was performed on the 487-bp and 602-bp PCR amplification products with specific primers to reveal FTL IRE mutations.ResultsA 58-year-old female patient with elevated serum ferritin level (1339 μg/l) was diagnosed with HHCS after extensive workup. Genetic testing identified a novel double point mutation g.48965355G>C (chr19, hg19) and g.48965356G>T (chr19, hg19) in the lower stem region of the IRE canonical structure of the FTL.ConclusionAfter excluding other causes, elevated serum ferritin level in a person with early onset cataract is indicative for HHCS, a genetic disorder caused by mutation in the IRE of the FTL.
      PubDate: 2017-06-21T05:16:03.554016-05:
      DOI: 10.1111/aos.13492
  • Retinal vascular injuries and intravitreal human embryonic stem
           cell-derived haemangioblasts
    • Authors: Jin-Da Wang; Ying An, Jing-Shang Zhang, Xiu-Hua Wan, Wei Zhang, Robert Lanza, Shi-Jiang Lu, Jost B. Jonas, Liang Xu
      Abstract: ObjectiveTo investigate whether intravitreally applied haemangioblasts (HB) derived from human embryonic stem cells (hESCs) are helpful for the repair of vascular damage caused in animals by an oxygen-induced retinopathy (OIR), by an induced diabetic retinopathy (DR) or by an induced retinal ischaemia with subsequent reperfusion.MethodsHuman embryonic stem cell-derived HBs were transplanted intravitreally into C57BL/6J mice (OIR model), into male Wistar rats with an induced DR and into male Wistar rats undergoing induced retinal ischaemia with subsequent reperfusion. Control groups of animals received an intravitreal injection of endothelial cells (ECs) or phosphate-buffered saline (PBS). We examined the vasculature integrity in the mice with OIR, the blood–retina barrier in the rats with induced DR, and retinal thickness and retinal ganglion cell density in retina flat mounts of the rats with the retinal ischaemic–reperfusion retinopathy.ResultsIn the OIR model, the study group versus control groups showed a significantly (p 
      PubDate: 2017-06-21T05:05:55.290801-05:
      DOI: 10.1111/aos.13477
  • Recombinant human serum albumin for corneal preservation
    • Authors: Mohit Parekh; Hossein Elbadawy, Gianni Salvalaio, Marie-Claude Amoureux, Enzo Di Iorio, Denis Fortier, Diego Ponzin, Stefano Ferrari, Alessandro Ruzza
      Abstract: PurposeTo study the performance of a completely synthetic organ culture (OC) preservation system containing recombinant human serum albumin (rHSA) for preservation of human donor corneas.MethodsTwenty-four paired donor corneas were randomly collected, and one cornea from each donor was preserved in synthetic (experimental) and serum-based media (control). The tissues were assessed at day 0; after 6 days of preservation at room temperature (RT) in Cornea Trans® and Cornea Prep II®; after 28 days at 31°C in Cornea Syn® [with rHSA] and Cornea Max® [with foetal calf serum (FCS)] and; 4-day post deswelling in Cornea Trans® and Cornea Jet®. Thickness was determined with optical coherence tomography (OCT) and transparency with a validated, custom device. Morphology, endothelial cell density (ECD) and mortality were observed after treating the tissues with Trypan blue and sucrose. Glucose uptake by the cells was analysed. Data were compared using non-parametric paired Wilcoxon tests with p 
      PubDate: 2017-06-21T04:56:26.246336-05:
      DOI: 10.1111/aos.13498
  • Optical coherence tomography angiography in choroidal haemangioma: small
           case series
    • Authors: Giuseppe Lo Giudice; Anton Giulio Catania, Alessandro Galan
      PubDate: 2017-06-21T04:45:56.454516-05:
      DOI: 10.1111/aos.13512
  • Microalbuminuria is associated with increased choroidal thickness in type
           1 diabetes mellitus patients without diabetic retinopathy
    • Authors: Fernando Korn Malerbi; Caio Vinicius Regatieri, João Roberto Sa, Paulo Henrique Morales, Michel Eid Farah, Sergio Atala Dib
      PubDate: 2017-06-21T04:42:26.611998-05:
      DOI: 10.1111/aos.13462
  • Efficacy of aflibercept for polypoidal choroidal vasculopathy in
    • Authors: Sanaz Shoja Gharehbagh; Yousif Subhi, Torben Lykke Sørensen
      PubDate: 2017-06-21T04:26:50.619529-05:
      DOI: 10.1111/aos.13461
  • Selective laser trabeculoplasty as replacement therapy in medically
           controlled glaucoma patients
    • Authors: Myrjam De Keyser; Maya De Belder, Jonas De Belder, Veva De Groot
      Abstract: PurposeWe examined selective laser trabeculoplasty (SLT) as a replacement therapy for medically controlled open-angle glaucoma (OAG) or ocular hypertensive patients.MethodsA prospective randomized interventional clinical trial on 143 glaucoma patients. Patients were randomized to either receiving SLT or to the control group that continued on pressure lowering medication. Data were recorded 1 hr, 1 week, 1, 3, 6, 12 and 18 months after SLT. Primary outcome was number of medications at 12 and 18 months while maintaining a predetermined target intraocular pressure (IOP).ResultsSelective laser trabeculoplasty (SLT) reduced number of medications from a mean of 1.5 at baseline, to 0.35 after 12 months and 0.29 after 18 months. Meanwhile, SLT achieved more than 20% IOP lowering in 95% of eyes and more than 30% IOP lowering in 86% of eyes after 18 months. Seventy-seven per cent of our eyes no longer needed any medication after SLT at 18 months.ConclusionSelective laser trabeculoplasty (SLT) enabled a reduction in number of medications while maintaining good IOP control. Selective laser trabeculoplasty (SLT) was able to completely replace medical therapy in 77% of eyes after 18 months. Selective laser trabeculoplasty (SLT) as replacement therapy may reduce local and systemic side-effects and prevent adherence issues.
      PubDate: 2017-06-21T04:15:36.560524-05:
      DOI: 10.1111/aos.13509
  • C-Reactive protein and progression of vision loss in retinitis pigmentosa
    • Authors: Yusuke Murakami; Yasuhiro Ikeda, Shunji Nakatake, Kohta Fujiwara, Takashi Tachibana, Noriko Yoshida, Shoji Notomi, Toshio Hisatomi, Shigeo Yoshida, Tatsuro Ishibashi, Koh-Hei Sonoda
      Abstract: PurposeChronic inflammation is involved in retinitis pigmentosa (RP). We demonstrated previously that intraocular inflammatory levels, as measured by slit-lamp ophthalmoscopy or laser flare photometry, are inversely correlated with central visual function in patients with RP. Here, we investigated the relationship between serum high-sensitivity C-reactive protein (hs-CRP) and visual parameters in RP.MethodsWe studied 58 consecutive typical patients with RP
      PubDate: 2017-06-21T04:10:40.315583-05:
      DOI: 10.1111/aos.13502
  • Microstructural changes in the fovea following autologous internal
           limiting membrane transplantation surgery for large macular holes
    • Authors: Seung Min Lee; Han Jo Kwon, Sung Who Park, Ji Eun Lee, Ik Soo Byon
      PubDate: 2017-06-21T04:00:29.349679-05:
      DOI: 10.1111/aos.13504
  • Venous loops: a benign feature of diabetic retinopathy or cause for
    • Authors: Thomas Lee Torp; Tunde Peto, Jakob Grauslund, Søren Leer Blindbæk
      PubDate: 2017-06-21T02:25:24.771725-05:
      DOI: 10.1111/aos.13507
  • Internal cyclopexy for complicated traumatic cyclodialysis cleft
    • Authors: Cong Wang; Xiao-Yan Peng, Qi-Sheng You, Yi Liu, Xiu-Qin Pang, Peng-Fei Zheng, Jost B. Jonas
      Abstract: PurposeTo assess the surgical and functional outcome of internal direct cyclopexy as therapy of complicated traumatic cyclodialysis.MethodsThe single-centre interventional case-series study included eyes with traumatic cyclodialysis who had consecutively been treated. Internal cyclopexy was performed using double-armed sutures introduced into the eye through the pars plana opposite to the cyclodialysis cleft and which were laid parallel to limbus. Additional procedures included cataract surgery, and pars plana vitrectomy. The cyclodialysis was documented upon ultrasound biomicroscopy and gonioscopy.ResultsThe study included 44 patients (44 eyes). The cyclodialysis extended over 4.8 ± 3.2 clock hours of scleral spur circumference (range 1–12 hr, median 4 hr), involving>180° of the scleral spur circumference in 16 eyes (37%) and 360° in 3 eyes (7%). Besides cyclodialysis, additional trauma-related complications included hyphema, iridodialysis, lens dislocation, cataract, vitreous haemorrhage, retinal detachment, suprachoroidal haemorrhage and endophthalmitis. The surgery performed on average at 64 days after the trauma included a mean number of 4.6 ± 1.9 sutures (range: 2–9), with 1.2 sutures per 30° width of cyclodialysis. Mean follow-up was 32 ± 8 weeks (range: 6–51 weeks). Closure of the cyclodialysis was achieved in all 44 eyes, and intraocular pressure (IOP) increased from 8.0 ± 3.4 mmHg (range: 3 21 mmHg) to 14.4 ± 4.0 mmHg (range: 11–21 mmHg). Mean visual acuity (VA) improved from 2.3 ± 1.1 logMAR (range: 0.22–4.0) to 1.2 ± 0.8 logMAR (range 0.3–4.0 logMAR).ConclusionIn conclusion, internal direct cyclopexy is a novel and relatively little invasive surgery technique for the repair of traumatic cyclodialysis.
      PubDate: 2017-06-20T02:35:25.282063-05:
      DOI: 10.1111/aos.13463
  • Two-years results of small-incision lenticule extraction and
           wavefront-guided laser in situ keratomileusis for Myopia
    • Authors: Hidenaga Kobashi; Kazutaka Kamiya, Akihito Igarashi, Masahide Takahashi, Kimiya Shimizu
      Abstract: PurposeTo compare the 2-years visual and refractive outcomes between small-incision lenticule extraction (SMILE) and wavefront-guided laser in situ keratomileusis (LASIK) in eyes with myopia and myopic astigmatism.MethodsOur retrospective case–control study examined 30 eyes of 30 patients with the manifest refraction spherical equivalent (MRSE) of −3.71 ± 1.83 dioptres (D) who underwent SMILE and 30 eyes of 30 patients with MRSE of −3.81 ± 1.40 D who underwent wavefront-guided LASIK. We assessed the 2-years clinical outcomes.ResultsLogarithm of the minimal angle of resolution (LogMAR)-corrected distance visual acuity (CDVA) was −0.23 ± 0.07 in the SMILE group and −0.24 ± 0.07 in the wavefront-guided LASIK group 2 years postoperatively (p = 0.82). Logarithm of the minimal angle of resolution-uncorrected distance visual acuity (UDVA) was −0.18 ± 0.09 and −0.15 ± 0.11 (p = 0.30, respectively). In the SMILE and wavefront-guided LASIK groups 2 years postoperatively, 100% and 73% of eyes, respectively, were within 0.5 D of the prompted MRSE correction (p = 0.005). Changes in the MRSE of −0.10 ± 0.30 D and −0.23 ± 0.51 D occurred from 3 months to 2 years (p = 0.40, respectively). We found a significant correlation between myopic regression and the changes in the keratometric readings from 3 months to 2 years after wavefront-guided LASIK (r = −0.48, p = 0.002), but not after SMILE (r = −0.004, p = 0.90).ConclusionSmall-incision lenticule extraction offers better refractive outcomes than wavefront-guided LASIK during a 2-years follow-up for the correction of myopia and myopic astigmatism.
      PubDate: 2017-06-20T02:28:31.070254-05:
      DOI: 10.1111/aos.13470
  • Aqueous humour concentrations of TGF-β, PLGF and FGF-1 and total retinal
           blood flow in patients with early non-proliferative diabetic retinopathy
    • Authors: Shaolin Du; Lanli Ju, Wenkai Zheng
      PubDate: 2017-06-20T02:25:25.943947-05:
      DOI: 10.1111/aos.13426
  • Comparison of subconjunctival scarring after microincision vitrectomy
           surgery using 20-, 23-, 25- and 27-gauge systems in rabbits
    • Authors: Makoto Gozawa; Yoshihiro Takamura, Seiji Miyake, Kentaro Iwasaki, Shogo Arimura, Yuji Takihara, Masaru Inatani
      Abstract: PurposeTo compare subconjunctival scarring after vitrectomy in rabbit eyes using different gauge systems by analysing anterior segment optical coherence tomography (AS-OCT) images and histological sections.MethodsVitrectomy using 20-, 23-, 25- and 27-gauge systems was performed for rabbits. Anterior segment optical coherence tomography (AS-OCT) images of the incision sites were obtained before and at day 1, 7 and 1 month after surgery. We measured the thickness of conjunctival epithelium, stroma, Tenon's capsule and total conjunctiva of these three layers, then determined the preservation rates of the borderlines between each layer. Surgical invasion was estimated by histological observation.ResultsThe thickness of total conjunctiva, or the thickness of both conjunctival stroma and Tenon's capsule in the 20-gauge group was significantly thicker than that in the 27-gauge group at day 1 and day 7 after surgery. Preservation rates of the conjunctival stroma/Tenon's capsule borderline were significantly lower in the 20-gauge group than in the 25- and 27-gauge groups at day 1, day 7 and 1 month. Preservation rates of the Tenon's capsule/sclera borderline were significantly lower in the 20-gauge group than in the 25- and 27-gauge groups at 1 month. In the 27-gauge group, the number of α-smooth muscle actin-positive fibroblasts was significantly smaller than in the 20-gauge group at day 7.ConclusionBased on the finding of AS-OCT and histology, micro incision vitreous surgery, especially using 27-gauge, contributed to less subconjunctival scarring postoperatively. Therefore, the 27-gauge pars plana vitrectomy (PPV) may be a more effective technique for preserving the structure of conjunctiva.
      PubDate: 2017-06-19T02:07:09.295705-05:
      DOI: 10.1111/aos.13459
  • High-resolution transbulbar ultrasonography helping differentiate
           intracranial hypertension in bilateral optic disc oedema patients
    • Authors: Qian Chen; Weimin Chen, Min Wang, Xinghuai Sun, Yan Sha, Zhenxin Li, Guohong Tian
      Abstract: PurposeThe enlargement of optic nerve sheath diameter (ONSD) has been proven to be related with raised intracranial pressure (ICP). No prospective study has been focused on utilizing retrobulbar ultrasonography in optic disc oedema patient presented to ophthalmologist.MethodsHigh-resolution transbulbar ultrasonography was performed in a cohort of patient presented with bilateral optic disc oedema. The subarachnoid space of optic nerve (SAS), ONSD and optic nerve diameter (OND) was measured prior to other ancillaries including lumbar puncture. Subjects were classified into increased intracranial pressure (IIP) and normal intracranial pressure (NIP) group according to the open cerebrospinal fluid pressure more than 200 mm H20. The SAS, ONSD and OND were compared between groups and with normal control. The sensitivity of SAS or ONSD change for predicating intracranial hypertension was assessed.ResultsA total of 20 IIP, 25 NIP patients and 25 normal controls were evaluated. The mean SAS and ONSD measured in idiopathic intracranial hypertension group was significantly increased than that of NIP and controls (p 
      PubDate: 2017-06-14T20:10:11.115324-05:
      DOI: 10.1111/aos.13473
  • Feasibility study on robot-assisted retinal vascular bypass surgery in an
           ex vivo porcine model
    • Authors: Yi Qi Chen; Ji Wei Tao, Liang Li, Jian Bo Mao, Chen Ting Zhu, Ji Meng Lao, Yang Yang, Li-Jun Shen
      Abstract: PurposeTo describe a new robot-assisted surgical system for retinal vascular bypass surgery (RVBS) and to compare the success rate with freehand RVBS.MethodsA robot-assisted system for retinal microsurgery was constructed to include two independent robotic arms. A 23-gauge light probe and an intraocular forceps were affixed to the arm end effectors to perform the intraocular manipulation. Harvested porcine eyes were introduced to be established animal models of closed-sky eyeballs after that pars plana vitrectomy using temporary keratoprosthesis was performed by a skilful surgeon. Retinal vascular bypass surgery (RVBS) was performed by an inexperienced ophthalmologist to test the ease of use. A stainless steel wire (45-μm pipe diameter) was used as an artificial vessel. Before RVBS, the wires were prepositioned at the retinal surface of the eyes. The Control group (n = 20) underwent freehand RVBS, and the Experimental group (n = 20) underwent robot-assisted RVBS. To create the simulated bypass, the distal end of the wire was inserted into the selected vessel and advanced ~4 mm away from the optic disc. If successful, then the proximal wire end was inserted and advanced ~2 mm towards the optic disc. The difference in the success rate for the freehand and robot-assisted procedures was analysed by the chi-square test.ResultsThe success rate for the freehand RVBS was 5% (1/20 eyes). In contrast, the robot-assisted success rate was 35% (7/20) of eyes (p 
      PubDate: 2017-06-09T02:10:25.212304-05:
      DOI: 10.1111/aos.13457
  • Epidemiology and clinical characteristics of patients hospitalized for
           ocular trauma in South-Central China
    • Authors: Wanpeng Wang; Yalan Zhou, Jun Zeng, Meng Shi, Baihua Chen
      Abstract: PurposeOcular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China.MethodsA retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system.ResultsOf the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0 ± 19.3 years (range from 1 to 87 years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n = 482), followed by the 51- to 60-year age group (16.9%, n = 339). Overall, open-globe injuries had a higher frequency (70.7%, n = 1420) than closed-globe injuries (28.6%, n = 575) and thermal/chemical injuries (0.7%, n = 14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n = 646) followed by rupture (21.5%, n = 432) and an intraocular foreign body (16.2%, n = 325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n = 795), followed by the home (28.4%, n = 570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n = 112, p 
      PubDate: 2017-03-30T01:40:35.478253-05:
      DOI: 10.1111/aos.13438
  • Lens thickness and associated factors in Chinese children: The Shandong
           Children Eye Study
    • Authors: Jian Hua Chen; Wen Jun Jiang, Zhi Yi Sun, Jian Feng Wu, Juan Mei Zhang, Ling Wang, Tai Liang Lu, Wei Sun, Yuan Yuan Hu, Da Dong Guo, Xing Rong Wang, Hong Sheng Bi, Jost B. Jonas
      PubDate: 2017-03-28T06:35:46.907187-05:
      DOI: 10.1111/aos.13431
  • Association between pseudodrusen and delayed patchy choroidal filling
           in the comparison of age-related macular degeneration treatments trials
    • Authors: Qiang Zhou; Ebenezer Daniel, Juan E. Grunwald, Maureen G. Maguire, Dina Y. Gewaily, Daniel F. Martin, Gui-shuang Ying,
      PubDate: 2017-03-08T01:25:28.721552-05:
      DOI: 10.1111/aos.13398
  • Familial vitreous amyloidosis resulting from transthyretin variant
    • Authors: Bing Xie; Shan-jun Cai, Mo Jiang, Hong Li, Gang Su
      PubDate: 2017-03-07T04:05:28.680805-05:
      DOI: 10.1111/aos.13425
  • Surgical management of limbal dermoids: 10-year review
    • Authors: Yong Yao; Ming Zhi Zhang, Vishal Jhanji
      PubDate: 2017-03-07T03:55:35.537211-05:
      DOI: 10.1111/aos.13423
  • Density of the macular and radial peripapillary capillary network measured
           by optical coherence tomography angiography
    • Authors: Qian Wang; Szy Yann Chan, Jing Yan Yang, Bing You, Ya Xing Wang, Jost B. Jonas, Wen Bin Wei
      PubDate: 2017-02-22T22:00:30.694701-05:
      DOI: 10.1111/aos.13331
  • Issue Information
    • Pages: 543 - 546
      PubDate: 2017-08-29T02:17:38.487787-05:
      DOI: 10.1111/aos.13265
  • This issue of ACTA with focus on Chinese ophthalmology
    • Authors: Einar Stefánsson
      Pages: 549 - 550
      PubDate: 2017-08-29T02:17:40.947098-05:
      DOI: 10.1111/aos.13582
  • Time spent in outdoor activities in relation to myopia prevention and
           control: a meta-analysis and systematic review
    • Authors: Shuyu Xiong; Padmaja Sankaridurg, Thomas Naduvilath, Jiajie Zang, Haidong Zou, Jianfeng Zhu, Minzhi Lv, Xiangui He, Xun Xu
      Pages: 551 - 566
      Abstract: Outdoor time is considered to reduce the risk of developing myopia. The purpose is to evaluate the evidence for association between time outdoors and (1) risk of onset of myopia (incident/prevalent myopia); (2) risk of a myopic shift in refractive error and c) risk of progression in myopes only. A systematic review followed by a meta-analysis and a dose–response analysis of relevant evidence from literature was conducted. PubMed, EMBASE and the Cochrane Library were searched for relevant papers. Of the 51 articles with relevant data, 25 were included in the meta-analysis and dose–response analysis. Twenty-three of the 25 articles involved children. Risk ratio (RR) for binary variables and weighted mean difference (WMD) for continuous variables were conducted. Mantel–Haenszel random-effects model was used to pool the data for meta-analysis. Statistical heterogeneity was assessed using the I2 test with I2 ≥ 50% considered to indicate high heterogeneity. Additionally, subgroup analyses (based on participant's age, prevalence of myopia and study type) and sensitivity analyses were conducted. A significant protective effect of outdoor time was found for incident myopia (clinical trials: risk ratio (RR) = 0.536, 95% confidence interval (CI) = 0.338 to 0.850; longitudinal cohort studies: RR = 0.574, 95% CI = 0.395 to 0.834) and prevalent myopia (cross-sectional studies: OR = 0.964, 95% CI = 0.945 to 0.982). With dose–response analysis, an inverse nonlinear relationship was found with increased time outdoors reducing the risk of incident myopia. Also, pooled results from clinical trials indicated that when outdoor time was used as an intervention, there was a reduced myopic shift of −0.30 D (in both myopes and nonmyopes) compared with the control group (WMD = −0.30, 95% CI = −0.18 to −0.41) after 3 years of follow-up. However, when only myopes were considered, dose–response analysis did not find a relationship between time outdoors and myopic progression (R2 = 0.00064). Increased time outdoors is effective in preventing the onset of myopia as well as in slowing the myopic shift in refractive error. But paradoxically, outdoor time was not effective in slowing progression in eyes that were already myopic. Further studies evaluating effect of outdoor in various doses and objective measurements of time outdoors may help improve our understanding of the role played by outdoors in onset and management of myopia.
      PubDate: 2017-03-02T00:06:30.340065-05:
      DOI: 10.1111/aos.13403
  • Assessing oxygen saturation in retinal vessels in high myopia patients
           pre- and post-implantable collamer lens implantation surgery
    • Authors: Pei Chen; Xiaoxiao Cai, Lijun Xu, Jing Zhang, Ying Yang, Qianying Gao, Jian Ge, Keming Yu, Jing Zhuang
      Pages: 576 - 582
      Abstract: PurposeTo determine whether posterior chamber phakic implantable collamer lens (ICL) surgery in high myopia patients impedes oxygen saturation of retinal vessels.MethodsMean oxygen saturation and diameter in retinal blood vessels were measured before and after ICL implantation surgery to correct high myopia refractive errors (i.e. −6.00 to −20.25 dioptres [D]), using an Oxymap T1 retinal oximeter.ResultsIn 17 eyes of 17 patients, the Oxymap T1 retinal oximeter detected a small but significant decrease in oxygen saturation of retinal venules, 1-week postoperatively (compared to preoperative measurements). Moreover, at 1 week after ICL implantation, the diameter of patient retinal vessels had consistently contracted, compared to preoperative measurements. By 1 month after ICL surgery, however, both the oxygen saturation and retinal vessel diameter had returned to preoperative levels. Otherwise, no statistically significant difference in oxygen saturation and diameter of retinal arterioles was found when comparing their measurements before and 1 week after implantation.ConclusionStable levels of oxygen saturation in retinal vessels, as detected by the Oxymap T1 oximeter, show ICL implantation would not leave lasting impact or adverse effects to retina oxygen saturation in high myopia patients.
      PubDate: 2017-02-15T23:15:29.953001-05:
      DOI: 10.1111/aos.13368
  • Preliminary study of a controllable device for subtenon drug infusion in a
           rabbit model
    • Authors: Yiqin Duan; Yezhen Yang, Xuetao Huang, Ding Lin
      Pages: 595 - 601
      Abstract: Background and objectiveConventional methods to treat intraocular diseases are invasive or associated with adverse effects. A minimally invasive means of sustained-release drug delivery to the vitreous is required. This study evaluated a novel device for subtenon drug delivery to the vitreous, relative to a single subconjunctival injection.MethodsSixty adult New Zealand White rabbits were randomly assigned to receive demethylvancomycin (DMV) by continuous subtenon delivery with the flow rate of 0.1 ml/hr for 24 hr, or as a single 0.3 ml subconjunctival injection in the right eyes. Rabbits were killed in subgroups of six at 1, 3, 6, 12 and 24 hr. The DMV concentration of the vitreous humour of the right eye was analysed by high-performance liquid chromatography.ResultsOverall, the vitreous DMV concentration of the subtenon group was significantly higher than that of the subconjunctival group (F = 25.928, p = 0.001). The DMV concentration of the subtenon group was also significantly higher than that of the subconjunctival group at 3, 6, 12 and 24 hr (t = 2.457, 5.064, 3.085, 4.207; p = 0.04, 0.01, 0.018, 0.004, respectively). In the subtenon group, the DMV concentration reached maximum (2.41 ± 0.67 μg/ml) at 6 hr, and at 24 hr was 2.37 ± 1.23 μg/ml. In the subconjunctival group, the DMV concentration reached maximum (0.48 ± 0.27 μg/ml) at 1 hr and declined to 0.09 ± 0.05 μg/ml at 24 hr.ConclusionSubtenon application with this novel minimally invasive design is an effective method for delivering an appropriate drug to the vitreous in a sustained and controllable amount.
      PubDate: 2017-04-09T01:20:36.742799-05:
      DOI: 10.1111/aos.13448
  • Imaging collector channel entrance with a new intraocular micro-probe
           swept-source optical coherence tomography
    • Authors: Chen Xin; Xiaoya Chen, Meng Li, Yan Shi, Huaizhou Wang, Ruikang Wang, Ningli Wang
      Pages: 602 - 607
      Abstract: PurposeTo describe the use of a newly developed side-viewing catheter probe to provide the cross-sectional images of collector channel entrance (CCE), achieved by swept-source optical coherence tomography (SS-OCT).MethodsA side-viewing SS-OCT catheter probe was developed that has a core probe diameter of 0.15 mm and an outer diameter of 0.25 mm, for the purpose of imaging CCEs within eye globe. Cadaver eyes harvested from swine and human were used to demonstrate its feasibility. For porcine eyes, the probe imaged the CCE by accessing the region of the aqueous plexus (AP) as well as along the inner wall (IW) of the trabecular meshwork (TM). For human eyes, the CCE images were captured by placing the probe within the lumen of the Schlemm's canal (SC) and along its IW.ResultsWith the optical coherence tomography (OCT) catheter probe, the CCE is well delineated as optically empty areas within the highly scattering sclera. In porcine eyes, images captured in the region of the AP demonstrate a large cavity with delicate tissue strands around the probe. The CCE can be identified at the outer margin of the AP. When imaged along the IW, the TM is discernable but difficult to be distinguished from the AP. In the human limbal regions, when placed within the lumen of the SC, the catheter probe fully occupies the potential space. TM is highly compact. The CCE can be identified at the outer wall of the SC. When imaged along the IW of TM, the SC and CCE can be identified.ConclusionThe intraocular SS-OCT catheter probe is feasible to provide the CCE images, indicating useful clinical applications to assist glaucoma surgery.
      PubDate: 2017-04-25T04:37:50.59274-05:0
      DOI: 10.1111/aos.13415
  • Peripapillary choroidal vascular layers: the Beijing Eye Study
    • Authors: Jie Xu; Ya Xing Wang, Ran Jiang, Wen Bin Wei, Liang Xu, Jost B. Jonas
      Pages: 619 - 628
      Abstract: PurposeTo assess thickness and associations of the peripapillary choroidal layers.MethodsThe population-based Beijing Eye Study included 3468 participants with an age of 50+ years. Using spectral-domain optical coherence tomography, we measured the large vessel layer (LVL) and small-to-medium vessel layer (SMVL) of the peripapillary choroid in a circular scan with a diameter of 3.4 mm around the optic nerve head centre at eight locations equidistant (45°) to each other. The ratio of SMVL thickness to LVL thickness was calculated.ResultsMeasurements were available for 3000 (86.5%) study participants (mean age: 64.4 ± 9.6 years; range: 50–93 years). SMVL (mean thickness: 31 ± 7 μm; range: 17–70 μm) and LVL (103 ± 48 μm; range: 9–313 μm) were thickest superiorly, followed by the temporal region, nasal region, and inferior region. Thicker SMVL was associated (regression coefficient r: 0.33) with younger age (p 
      PubDate: 2017-03-02T00:25:52.533929-05:
      DOI: 10.1111/aos.13379
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