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Publisher: John Wiley and Sons   (Total: 1582 journals)

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Showing 1 - 200 of 1583 Journals sorted alphabetically
Abacus     Hybrid Journal   (Followers: 11, SJR: 0.48, h-index: 22)
About Campus     Hybrid Journal   (Followers: 5)
Academic Emergency Medicine     Hybrid Journal   (Followers: 53, SJR: 1.385, h-index: 91)
Accounting & Finance     Hybrid Journal   (Followers: 43, SJR: 0.547, h-index: 30)
ACEP NOW     Free  
Acta Anaesthesiologica Scandinavica     Hybrid Journal   (Followers: 50, SJR: 1.02, h-index: 88)
Acta Archaeologica     Hybrid Journal   (Followers: 132, 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: 54, SJR: 0.794, h-index: 88)
Acta Physiologica     Hybrid Journal   (Followers: 7, 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: 5, SJR: 0.459, h-index: 29)
Acute Medicine & Surgery     Hybrid Journal   (Followers: 2)
Addiction     Hybrid Journal   (Followers: 32, SJR: 2.086, h-index: 143)
Addiction Biology     Hybrid Journal   (Followers: 12, SJR: 2.091, h-index: 57)
Adultspan J.     Hybrid Journal   (SJR: 0.127, h-index: 4)
Advanced Energy Materials     Hybrid Journal   (Followers: 24, SJR: 6.411, h-index: 86)
Advanced Engineering Materials     Hybrid Journal   (Followers: 25, SJR: 0.81, h-index: 81)
Advanced Functional Materials     Hybrid Journal   (Followers: 47, SJR: 5.21, h-index: 203)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 13, SJR: 0.232, h-index: 7)
Advanced Materials     Hybrid Journal   (Followers: 246, 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: 4, SJR: 2.488, h-index: 21)
Advanced Science     Open Access   (Followers: 4)
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: 33, SJR: 0.275, h-index: 17)
African J. of Ecology     Hybrid Journal   (Followers: 14, SJR: 0.477, h-index: 39)
Aggressive Behavior     Hybrid Journal   (Followers: 15, SJR: 1.391, h-index: 66)
Aging Cell     Open Access   (Followers: 9, 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: 14, SJR: 0.925, h-index: 43)
Agricultural Economics     Hybrid Journal   (Followers: 44, SJR: 1.099, h-index: 51)
AIChE J.     Hybrid Journal   (Followers: 28, 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: 126, 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: 89, 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: 30, 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: 15, SJR: 1.115, h-index: 61)
American J. of Medical Genetics Part B: Neuropsychiatric Genetics     Hybrid Journal   (Followers: 3, SJR: 1.771, h-index: 107)
American J. of Medical Genetics Part C: Seminars in Medical Genetics     Partially Free   (Followers: 5, SJR: 2.315, h-index: 79)
American J. of Orthopsychiatry     Hybrid Journal   (Followers: 4, SJR: 0.756, h-index: 69)
American J. of Physical Anthropology     Hybrid Journal   (Followers: 35, SJR: 1.41, h-index: 88)
American J. of Political Science     Hybrid Journal   (Followers: 234, SJR: 5.101, h-index: 114)
American J. of Primatology     Hybrid Journal   (Followers: 14, 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: 15, SJR: 2.792, h-index: 140)
American J. on Addictions     Hybrid Journal   (Followers: 9, SJR: 0.843, h-index: 57)
Anaesthesia     Hybrid Journal   (Followers: 115, SJR: 1.404, h-index: 88)
Analyses of Social Issues and Public Policy     Hybrid Journal   (Followers: 11, SJR: 0.397, h-index: 18)
Analytic Philosophy     Hybrid Journal   (Followers: 15)
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: 152)
Angewandte Chemie Intl. Edition     Hybrid Journal   (Followers: 203, SJR: 6.229, h-index: 397)
Animal Conservation     Hybrid Journal   (Followers: 34, SJR: 1.576, h-index: 62)
Animal Genetics     Hybrid Journal   (Followers: 8, SJR: 0.957, h-index: 67)
Animal Science J.     Hybrid Journal   (Followers: 5, 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: 8, 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: 42, 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: 12)
Annual Review of Information Science and Technology     Hybrid Journal   (Followers: 14)
Anthropology & Education Quarterly     Hybrid Journal   (Followers: 24, SJR: 0.72, h-index: 31)
Anthropology & Humanism     Hybrid Journal   (Followers: 16, SJR: 0.137, h-index: 3)
Anthropology News     Hybrid Journal   (Followers: 14)
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: 93, SJR: 0.545, h-index: 15)
Antipode     Hybrid Journal   (Followers: 45, SJR: 2.212, h-index: 69)
Anz J. of Surgery     Hybrid Journal   (Followers: 6, 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: 66, SJR: 0.754, h-index: 69)
Applied Organometallic Chemistry     Hybrid Journal   (Followers: 6, SJR: 0.632, h-index: 58)
Applied Psychology     Hybrid Journal   (Followers: 126, SJR: 1.023, h-index: 64)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 47, 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: 13, 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: 34, 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: 14, SJR: 0.156, h-index: 2)
Architectural Design     Hybrid Journal   (Followers: 24, 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: 201, SJR: 0.153, h-index: 13)
Arthritis & Rheumatology     Hybrid Journal   (Followers: 48, SJR: 1.984, h-index: 20)
Arthritis Care & Research     Hybrid Journal   (Followers: 26, 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: 13)
Asia & the Pacific Policy Studies     Open Access   (Followers: 15)
Asia Pacific J. of Human Resources     Hybrid Journal   (Followers: 316, SJR: 0.494, h-index: 19)
Asia Pacific Viewpoint     Hybrid Journal   (SJR: 0.616, h-index: 26)
Asia-Pacific J. of Chemical Engineering     Hybrid Journal   (Followers: 7, 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: 3, 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: 3, 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: 4, 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: 13, 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: 12, SJR: 1.095, h-index: 66)
Austral Entomology     Hybrid Journal   (Followers: 10, SJR: 0.524, h-index: 28)
Australasian J. of Dermatology     Hybrid Journal   (Followers: 7, 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: 3, 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: 42, 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: 6, 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: 21, 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: 13, SJR: 0.203, h-index: 14)
Australian J. of Psychology     Hybrid Journal   (Followers: 16, SJR: 0.384, h-index: 30)
Australian J. of Public Administration     Hybrid Journal   (Followers: 380, SJR: 0.418, h-index: 29)
Australian J. of Rural Health     Hybrid Journal   (Followers: 4, SJR: 0.43, h-index: 34)
Australian Occupational Therapy J.     Hybrid Journal   (Followers: 64, SJR: 0.59, h-index: 29)
Australian Psychologist     Hybrid Journal   (Followers: 11, SJR: 0.331, h-index: 31)
Australian Veterinary J.     Hybrid Journal   (Followers: 19, SJR: 0.459, h-index: 45)
Autism Research     Hybrid Journal   (Followers: 31, 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: 9, 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: 3, 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: 7, SJR: 0.297, h-index: 23)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 21, 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: 14, SJR: 1.172, h-index: 90)
Biological Reviews     Hybrid Journal   (Followers: 2, SJR: 6.469, h-index: 114)
Biologie in Unserer Zeit (Biuz)     Hybrid Journal   (Followers: 44, 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: 37, 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: 134, SJR: 1.633, h-index: 146)
Biotechnology J.     Hybrid Journal   (Followers: 13, SJR: 1.185, h-index: 51)
Biotechnology Progress     Hybrid Journal   (Followers: 39, SJR: 0.736, h-index: 101)
Biotropica     Hybrid Journal   (Followers: 17, SJR: 1.374, h-index: 71)
Bipolar Disorders     Hybrid Journal   (Followers: 10, SJR: 2.592, h-index: 100)
Birth     Hybrid Journal   (Followers: 33, 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)

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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  [1582 journals]
  • Ophthalmic nepafenac use in the Netherlands and Denmark
    • Authors: Andrea V Margulis; Eline Houben, Jesper Hallas, Jetty A Overbeek, Anton Pottegård, Tobias Torp-Pedersen, Susana Perez-Gutthann, Alejandro Arana
      Abstract: PurposeTo describe nepafenac use in the Netherlands and Denmark with reference to its approved indications. For context, we also describe the use of ketorolac and diclofenac.MethodsWe identified users in the PHARMO Database Network (the Netherlands, 2008–2013) and the Danish national health registers (Denmark, 1994–2014). We described prevalence of cataract surgery and duration of use in patients with cataract surgery with and without diabetes.ResultsIn the Netherlands, 9530 nepafenac users (mean age, 71 years; 60% women) contributed 12 691 therapy episodes, of which 21% had a recently recorded cataract surgery. Of 2266 episodes in adult non-diabetic patients with cataract surgery, 60% had one bottle dispensed (treatment duration ≤21 days). Of 441 episodes in adult diabetic patients with cataract surgery, 90% had up to two bottles dispensed (≤60 days).Denmark had 60 403 nepafenac users (mean age, 72 years; 58% women) and 73 648 episodes (41% had recorded cataract surgery). Of 26 649 nepafenac episodes in adult non-diabetic patients with cataract surgery, 92% had one bottle dispensed. Of 3801 episodes in adult diabetic patients with cataract surgery, 99.8% had up to two bottles dispensed.Use patterns of nepafenac, ketorolac and diclofenac were roughly similar in the Netherlands, but not in Denmark.ConclusionLess than half of therapy episodes were related to cataract surgery; around 90% of episodes with surgery were within the approved duration. Underrecording of ophthalmic conditions and procedures was a challenge in this study.
      PubDate: 2017-05-10T23:30:26.963776-05:
      DOI: 10.1111/aos.13468
  • Anisometropia of spherical equivalent and astigmatism among myopes: a
           23-year follow-up study of prevalence and changes from childhood to
    • Authors: Olavi Pärssinen; Markku Kauppinen
      Abstract: PurposeTo study anisometropia of spherical equivalent and astigmatism from the onset of myopia at school age to adulthood.MethodsA total of 240 myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983–1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Examinations with subjective cyclopedic refraction were repeated 3 years later (follow-up 1) for 238 subjects and thereafter at the mean ages of 23.2 (follow-up 2) and 33.9 years (follow-up 3) for 178 and 134 subjects. After exclusions, the 102 subjects who attended all three follow-ups were included in the analyses. Corneal refractive power and astigmatism and anterior chamber depth was measured with Pentacam topography and axial length with IOL master at study end. Prevalence and changes in anisometropia of spherical equivalent (AnisoSE) and astigmatism (AnisoAST) and their relationships with refractive and axial measures were studied.ResultsMean (±SD) of spherical equivalent (SE), AnisoSE and AnisoAST increased from baseline to follow-up end from −1.44 ± 0.57 D to −5.11 ± 2.23 D, from 0.28 ± 0.30 D to 0.68 ± 0.69 D and from 0.14 ± 0.18 D to 0.37 ± 0.36 D, respectively. Prevalence of AnioSE, ≥1 D, increased from 5% to 22.6% throughout follow-up. Higher AnisoSE was associated with SE in the less myopic eye at baseline and at follow-up 1, and with SE in the more myopic eye in follow-ups 2 and 3 in adulthood. At study end, AnisoSE was associated with the interocular difference in axial length (AL) (r = 0.612, p 
      PubDate: 2017-05-08T07:25:30.473219-05:
      DOI: 10.1111/aos.13405
  • Corneal endothelial cell loss and corneal biomechanical characteristics
           after two-step sequential or combined phaco-vitrectomy surgery for
           idiopathic epiretinal membrane
    • Authors: Hassan Hamoudi; Ulrik Correll Christensen, Morten La Cour
      Abstract: PurposeTo assess the impact of sequential and combined surgery [cataract surgery and 23-gauge pars plana vitrectomy (PPV) with peeling] on corneal endothelium cell density (CED) and corneal biomechanical characteristics.MethodsPhakic eyes with epiretinal membrane (ERM) were prospectively allocated to (i) cataract surgery and subsequent PPV (CAT group), (ii) PPV and subsequent cataract surgery (VIT group) or (iii) phacovitrectomy (COMBI group). Eyes were examined at baseline, 1 month after each surgery, and at 3 and 12 months follow-up. Corneal endothelium cell density (CED) was assessed with non-contact specular microscopy. Pachymetry [central cornea thickness (CCT)], keratometry and cornea volume (CV) were measured with Pentacam Scheimpflug camera. Primary outcome was change in CED after 12 months; secondary outcomes were changes in CCT and CV after 12 months.ResultsSixty-two eyes were enrolled and allocated to the three groups. The mean preoperative CED was 2776, 2794 and 2653 cells/mm2, which decreased significantly at 12 months by 15.3, 20.0 and 19.3% in the CAT, VIT and COMBI group. There was no significant difference in percentage cell loss between the groups at final follow-up. The CED decreased significantly after cataract surgery, but was unaffected by PPV. Central cornea thickness (CCT) increased by 10 μm (p = 0.005) and CV by 1.38 mm3 (2.3%, p 
      PubDate: 2017-05-08T07:00:37.696685-05:
      DOI: 10.1111/aos.13474
  • Optical coherence tomography morphology and evolution in cblC
           disease-related maculopathy in a case series of very young patients
    • Authors: Giacomo M. Bacci; Maria A. Donati, Elisabetta Pasquini, Francis Munier, Catia Cavicchi, Amelia Morrone, Andrea Sodi, Vittoria Murro, Nuria Garcia Segarra, Claudio Defilippi, Leonardo Bussolin, Roberto Caputo
      Abstract: PurposeTo describe the retinal structure of a group of patients affected by methylmalonic aciduria with homocystinuria cblC type, caused by mutations in the MMACHC gene, using spectral domain optical coherence tomography (SD-OCT).MethodsYoung patients (n = 11, age 0–74 months) with cblC disease, detected by newborn screening or clinically diagnosed within 40 days of life, underwent molecular analysis and complete ophthalmic examination, including fundus photography and SD-OCT. In one case, we also performed fluorescein angiography (FA) and standard electroretinography (ERG).ResultsMolecular analysis of the MMACHC gene fully confirmed cblC disease in nine of 11 patients. Two patients harboured only a single heterozygous pathogenic MMACHC mutation and large unbalanced rearrangements were excluded by array-CGH analysis in both. All patients except two showed a bilateral maculopathy. In general, retinal changes were first observed before one year of age and progressed to a well-established maculopathy. Measurable visual acuities ranged from normal vision, in keeping with age, to bilateral, severe impairment of central vision. Nystagmus was present in six patients. Spectral domain optical coherence tomography (SD-OCT) showed macular thinning with severe alterations in outer, and partial sparing of inner, retinal layers.ConclusionPatients affected by cblC disease may frequently show an early onset maculopathy with variable ophthalmoscopic appearance. Spectral domain optical coherence tomography (SD-OCT) broadens the knowledge of subtle retinal alterations during the disease's progression and helps to shed light on the pathological mechanism of maculopathy development.
      PubDate: 2017-05-08T06:45:41.326963-05:
      DOI: 10.1111/aos.13441
  • Dynamics of big bubble formation in deep anterior lamellar keratoplasty by
           the big bubble technique: in vitro studies
    • Authors: Harminder S Dua; Lana A Faraj, Mohamed B Kenawy, Saief AlTaan, Mohamed S Elalfy, Tarek Katamish, Dalia G Said
      Abstract: PurposeTo examine the movement of air injected in the cornea in simulated deep anterior lamellar keratoplasty (DALK), from the needle tip to the formation of different types of big bubbles (BB) and to ascertain how air travels through the stroma and pre-Descemet's layer [Dua's layer (PDL)] to create a type-1 (air between PDL and deep stroma) and type-2BB (air between PDL and Descemet's membrane).MethodsAir was injected in 57 sclerocorneal discs and the passage recorded. Leaking points and sites of commencement of type-1 and type-2BB were examined by scanning electron microscopy. Stromal distribution of air pockets was studied by light microscopy. Uninjected corneas served as controls.ResultsInjected air followed a consistent pattern, initially as radial tracks to the limbus, then as circumferential bands along the limbus and finally centripetally to create predominantly a type-1BB. Type-2BB started at the periphery, by air emerging through clusters of tiny fenestrations discovered in the periphery of PDL. Fifteen to 20 such clusters were also seen in control samples on either side of the Descemet's attachment. Type-1BB was formed by air emerging through wide spaces between lamellae of deep stroma. Histologically, the circumferential band revealed an aggregation of air pockets in the mid-stroma.ConclusionThe consistent pattern of passage of air is indicative of the architecture and microanatomy of the corneal stroma where collagen lamellae are orthogonally arranged centrally and as a circular annulus at the periphery. The novel peripheral fenestrations explain the peripheral commencement of a type-2BB and the escape of air into the anterior chamber during DALK.
      PubDate: 2017-05-08T06:25:45.499897-05:
      DOI: 10.1111/aos.13460
  • Influence of scanning area on choroidal vascularity index measurement
           using optical coherence tomography
    • Authors: Rupesh Agrawal; Xin Wei, Abhilash Goud, Kiran Kumar Vupparaboina, Soumya Jana, Jay Chhablani
      Abstract: PurposeRecently, choroidal vascularity index (CVI) is proposed as a novel tool to evaluate the choroidal vasculature. In this study, we investigate the impact of scanning area on CVI measurement using spectral-domain optical coherence tomography (SD-OCT).MethodsSpectral-domain optical coherence tomography (SD-OCT) using enhanced depth imaging mode was performed in 30 eyes from 15 normal subjects. Three scanning areas were compared: dingle foveal scan; central macular scans [scan passing through central 1000 microns circle on Early Treatment Diabetic Retinopathy Study (ETDRS) grid, inner circle]; and total macular cube scans. Binarization of OCT B-scans and segmentation of the binarized choroid layer were achieved using a previously reported validated automated software. Choroidal vascularity index (CVI) percentage was calculated. Degree of agreement among foveal, central macular and total macular CVI was assessed using intraclass correlation coefficient (ICC) and was plotted using Bland–Altman plot.ResultsThe mean CVI in subfoveal, central macular and total macular scans was 49.95 ± 4.84%, 50.00 ± 4.68% and 51.10 ± 4.63%, respectively. Intraclass correlation coefficient (ICC) was more than 0.8 for all three comparisons [subfoveal versus central macular CVI, ICC = 0.92 (95% CI: 0.84–0.96); central macular versus total macular CVI, ICC = 0.90 (95% CI: 0.82–0.96); subfoveal versus total macular CVI, ICC = 0.92 (95% CI: 0.85–0.95)]. No significant differences in variance (all p > 0.05) were noted among CVI measured from the three scanning areas.ConclusionChoroidal vascularity index (CVI) measurements were highly reproducible using subfoveal, central and total macular scans in healthy individuals. Single foveal scan choroidal vascularity represents total macular choroidal vascularity in healthy population.
      PubDate: 2017-05-04T02:35:26.734447-05:
      DOI: 10.1111/aos.13442
  • Systemic intravenous abciximab: a novel treatment for acute central
           retinal artery occlusion'
    • Authors: José Ferreira Mendes; José Amorim, Gil Calvão-Santos
      PubDate: 2017-05-04T02:20:24.422142-05:
      DOI: 10.1111/aos.13446
  • Visual outcomes of polypoidal choroidal vasculopathy treated with
           intravitreal ranibizumab with or without photodynamic therapy
    • Authors: Colin S. Tan; Wei Kiong Ngo, Louis W. Lim
      PubDate: 2017-04-29T04:39:53.654973-05:
      DOI: 10.1111/aos.13467
  • The effect of canaloplasty with suprachoroidal drainage combined with
           cataract surgery – 1-year results
    • Authors: Anna-Maria Seuthe; Kai Januschowski, Siegfried Mariacher, Martina Ebner, Natalia Opitz, Peter Szurman, Karl Boden
      Abstract: PurposeThe purpose of this study was to investigate the safety and efficacy of phacocanaloplasty with suprachoroidal drainage (PCscD) and to compare its intraocular pressure (IOP)-lowering and drug-sparing effect to canaloplasty with suprachoroidal drainage (CscD).MethodsThe study retrospective interventional study included patients with open-angle glaucoma or secondary forms of glaucoma who underwent either CscD or PCscD between the year 2011 and 2014 in Knappschaft Eye Clinic Sulzbach. Primary end-points were IOP reduction and the number of IOP-lowering medication after 12 months. Secondary end-points were intraoperative and postoperative complications.ResultsA total of 328 eyes were included, 193 were treated with CscD and 135 underwent PCscD. Canaloplasty with scD achieved an IOP reduction of 37.0% (from 20.9 ± 3.6 mmHg to 13.2 ± 2.6 mmHg) after 1 year, whereas PCscD showed a significant higher reduction of 47.4% (from 23.2 ± 5.1 mmHg to 12.2 ± 1.7 mmHg). Reduction in IOP-lowering medication was higher after PCscD (from 3.6 ± 0.6 to 0.2 ± 0.5) than after CscD (from 3.5 ± 0.8 to 0.7 ± 1.0). Twelve months after surgery 55.5% in the CscD group and 80.2% in the PCscD group were free of IOP-lowering medication. In both groups, no severe or sight-threatening complications occurred.ConclusionCombining cataract surgery and CscD achieves a higher IOP reduction, and patients postoperatively need less IOP-lowering medication than after CscD alone.
      PubDate: 2017-04-27T11:37:42.658616-05:
      DOI: 10.1111/aos.13393
  • Antiretinal antibodies in central serous chorioretinopathy: prevalence and
           clinical implications
    • Authors: Josianne C. E. M. Berge; Elon H. C. Dijk, Marco W. J. Schreurs, Jacolien Vermeer, Camiel J. F. Boon, Aniki Rothova
      Abstract: PurposeTo investigate the possible role of autoimmune reactions directed against retinal tissue in central serous chorioretinopathy (CSC), by analysing the presence of serum antiretinal antibodies (ARAs) and establishing their clinical relevance.MethodsSixty-three patients with CSC were included, and clinical characteristics were collected. Serum samples of all patients with CSC, 101 uveitis patients and 60 healthy donors were analysed for the presence of ARAs by indirect immunofluorescence. Furthermore, all CSC serum samples were analysed on Western blot. Correlations between laboratory findings and clinical features of CSC were determined by logistic regression.ResultsAntiretinal antibodies (ARAs) were present in 54% of the patients with CSC, in 46% of uveitis patients (p = 0.153) and in 17% of healthy controls (p 
      PubDate: 2017-04-26T06:25:30.536892-05:
      DOI: 10.1111/aos.13445
  • Intraocular pressure following intrastromal corneal ring segments
    • Authors: Paula Arribas-Pardo; Carmen Mendez-Hernandez, Ricardo Cuiña-Sardiña, Jose Manuel Benitez-del-Castillo, Julian Garcia-Feijoo
      PubDate: 2017-04-26T06:10:30.828355-05:
      DOI: 10.1111/aos.13454
  • Optical coherence tomography evaluation of patients with macula-off
           retinal detachment after different postoperative posturing: a randomized
           pilot study
    • Authors: Enrico Peiretti; Francesco Nasini, Elisa Buschini, Giulia Caminiti, Sarit Y. Lesnik Oberstein, Alissa Willig, Heico M. Bijl, Marco Mura
      Abstract: PurposeTo assess the presence of outer and inner retinal folds (RFs) and drop-out of the ellipsoid zone (EZ) occurring after surgical repair of macula-off rhegmatogenous retinal detachment (RRD) with different postoperative posture and preoperative use of adjuvant perfluorocarbon liquid (PFCO).MethodsIn this prospective study, 56 eyes of 56 consecutive patients affected by RRD were subjected to 23- or 25-gauge pars plana vitrectomy (PPV). The patients were randomized in four groups (14 prone 5 hr without PFCO, 14 supine 5 hr without PFCO, 14 prone 5 hr with PFCO and 14 supine 5 hr with PFCO) and followed up with spectral domain optical coherence tomography (SD-OCT).ResultsSpectral domain optical coherence tomography (SD-OCT) was recorded before surgery, at days 30 and 90 to detect the presence of outer RFs, inner RFs and drop-out of EZ and to follow their variation over time. No statistical significance was found in our groups for outer RFs, inner RFs, drop-out of EZ formation and evolution. The postoperative best-corrected visual acuity (BCVA) improved in all groups (mean preoperative BCVA 1.47 logMar ± 0.19, mean postoperative BCVA 0.27 logMar ± 0.11, p 
      PubDate: 2017-04-26T06:02:17.446092-05:
      DOI: 10.1111/aos.13397
  • Prognostic impact of chromosomal aberrations and GNAQ, GNA11 and BAP1
           mutations in uveal melanoma
    • Authors: Kjersti M. Staby; Karsten Gravdal, Sverre J. Mørk, Steffen Heegaard, Olav K. Vintermyr, Jørgen Krohn
      Abstract: PurposeTo evaluate clinico-pathological and molecular prognostic factors in a well-defined series of posterior uveal melanoma (UM) with focus on chromosomal aberrations and mutations in the GNAQ, GNA11 and BRCA1-associated protein 1 (BAP1) genes.MethodsFormalin-fixed paraffin-embedded (FFPE) tissue samples were obtained from 50 consecutive eyes enucleated for UM between 1993 and 2005. The material was tested for loss of chromosome 3 and gain of chromosome 8q gene signatures by selective molecular gene markers using multiplex ligation-dependent probe amplification (MLPA), and for DNA mutations in the GNAQ, GNA11 and BAP1 genes.ResultsAfter a mean follow-up of 83 months (range, 8–205 months), 21 patients had died of metastatic UM and 16 patients of other causes. Tumour diameter, ciliary body involvement, mixed/epithelioid cell types, mitotic index, Ki-67 proliferation index, loss of chromosome 3 and gain of chromosome 8q showed statistically significant associations with metastatic disease. There were no significant differences in the prevalence of GNAQ and GNA11 mutations between patients with or without metastatic disease. Mutational analysis of the BAP1 gene was performed in 32 primary UM and in five UM liver metastases. Nine different BAP1 missense mutations were identified. BAP1 mutations were not more common in metastasizing than in nonmetastasizing UM.ConclusionThe molecular gene markers showing loss of chromosome 3 and gain of 8q gene signatures were associated with an increased risk of metastatic disease. BRCA1-associated protein 1 (BAP1) gene mutation status had no prognostic significance. The frequency and spectrum of BAP1 mutations in UM may be more dependent on ethnicity and demographic variables than hitherto considered.
      PubDate: 2017-04-26T03:35:58.26382-05:0
      DOI: 10.1111/aos.13452
  • Prevalence and risk factors for diabetic retinopathy in 17 152 patients
           from the island of Funen, Denmark
    • Authors: Morten B. Larsen; Jan Erik Henriksen, Jakob Grauslund, Tunde Peto
      Abstract: PurposeThis study aims to estimate the prevalence and risk factors of diabetic retinopathy (DR) in patients enrolled in a large Danish quality-assuring database for diabetes: the Funen Diabetes Database (FDDB).MethodsAll patients with type 1 (T1DM) and type 2 DM (T2DM) diabetes mellitus (DM) were included in a cross-sectional study. The level of DR per patient was determined based on the eye with highest level of DR. All ocular and non-ocular data were extracted at the latest examination that corresponded to the most recent DR-grading data.ResultsData from 17 152 patients were analysed; 83.1% had T2DM. Prevalence of DR was 23.8% (T1DM: 54.3%, T2DM: 21.2%). T1/T2DM patients were statistically significantly different regarding age, duration of diabetes, BMI, systolic blood pressure (BP), cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, s-creatinine and u-albumin (p 
      PubDate: 2017-04-26T02:16:44.250352-05:
      DOI: 10.1111/aos.13449
  • A comparison between patients with epiphora and cataract of the activity
           limitations they experience in daily life due to their visual disability
    • Authors: Elin Bohman; Maria Wyon, Mats Lundström, Eva Dafgård Kopp
      Abstract: PurposeThe objective of this study was to compare patients with epiphora and cataract in terms of the activity limitations they experience in daily life due to their visual disability and to validate the use of the Catquest-9SF questionnaire for epiphora patients.MethodsSeventy-two consecutively encountered adult patients with confirmed lacrimal obstruction and listed for dacryocystorhinostomy (DCR) or lacrimal intubation at the St. Erik Eye Hospital, Stockholm, Sweden, completed the Catquest-9SF questionnaire, which measures activity limitations in daily life due to visual disability. The psychometric qualities of the Catquest-9SF results obtained from this group of patients were evaluated by Rasch analysis. Rasch analysis was further employed to convert the ordinal raw data to a Rasch score for comparison with the preoperative scores of patients registered in the Swedish National Cataract Register (NCR) during March 2013.ResultsThe Catquest-9SF exhibited good psychometric qualities when investigating epiphora patients, with the exception of a misfit for Item 4, the item regarding facial recognition. On the Rasch scale (−5.43 = no activity limitations to +5.01 = severe activity limitations), the mean score for epiphora patients was −0.82 while for patients listed for 1st eye and 2nd eye cataract surgery it was −0.17 and −0.76, respectively. An equivalence test confirmed that the reported visual disability of epiphora patients was not significantly different from visual disability reported by patients waiting for 2nd eye cataract surgery.ConclusionThe Catquest-9SF is a valid measure of visual disability in patients with epiphora. Epiphora patients experience visual disability to the same degree as patients awaiting 2nd eye cataract surgery.
      PubDate: 2017-04-26T01:50:48.543682-05:
      DOI: 10.1111/aos.13447
  • Topical antibiotics and intravitreal injections
    • Authors: Alex P. Hunyor; Rohan Merani, Archie Darbar, Jean-François Korobelnik, Paolo Lanzetta, Annabelle A. Okada
      Abstract: There is increasing evidence that topical antibiotics, given before and/or after intravitreal injections, are ineffective in preventing endophthalmitis and are possibly harmful. In addition to the lack of efficacy and increased development of resistant organisms, the use of topical antibiotics adds significantly to the cost of delivering intravitreal therapy. Despite this, in many countries, it is still common practice to use pre- and/or postinjection topical antibiotics. This review outlines the general principles of effective antibiotic prophylaxis, and the evidence regarding topical antibiotic use as a prophylactic measure for endophthalmitis following intravitreal injections. A key distinguishing feature of intravitreal injections from most other invasive procedures is the fact that they are often repeated on multiple occasions to the same eye. Given the lack of evidence to support topical antibiotics as an effective method of prophylaxis for postinjection endophthalmitis, it appears that more widespread education of ophthalmologists is required to avoid continued inappropriate use. Revision of drug labels in some jurisdictions, and amendment of local/professional society guidelines, may be required to assist in achieving this goal. Emphasis should be placed on antisepsis and aseptic technique, which are the major proven methods of endophthalmitis prevention, rather than antibiotics.
      PubDate: 2017-04-25T04:46:37.759621-05:
      DOI: 10.1111/aos.13417
  • 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
      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
  • Can the SENSIMED Triggerfish® lens data be used as an accurate measure of
           intraocular pressure?
    • Authors: Parveen Vitish-Sharma; Austin G. Acheson, Richard Stead, John Sharp, Ali Abbas, Marta Hovan, Charles Maxwell-Armstrong, Boliang Guo, Anthony J. King
      Abstract: PurposeThe SENSIMED Triggerfish® contact lens sensor (CLS) has an embedded micro-sensor that captures spontaneous circumferential changes at the corneoscleral junction and transmits them via an antenna to a device where these measurements are stored. During laparoscopic colorectal surgery, patients are placed in Trendelenburg position which has been shown to increase intraocular pressure (IOP). Laparoscopic colorectal surgery requires both pneumoperitoneum and Trendelenburg positioning; therefore, IOP can vary significantly. We aimed to assess whether circumferential changes in the corneoscleral area can be correlated to IOP changes measured using Tono-pen® XL applanation tonometer during laparoscopic colorectal surgery.MethodPatients undergoing laparoscopic colorectal resections were included. On the day of surgery, baseline IOP was taken and the SENSIMED Triggerfish® CLS was then set up in one eye of the patient. During surgery (whilst under general anaesthetic), IOP measurements were taken in the contralateral eye using a Tono-pen® XL applanation tonometer every hour and any time the table was moved to record the fluctuations of IOP during surgery and any association with position change. The timings of these readings were documented.ResultsTwenty patients were included in this study (six males, 14 females). Average age was 64.6 years (SD = 16.3). The fluctuation in IOP measured in the reference eye ranged between 6.3 and 46.7 mmHg. The mean correlation coefficient between CLS output measurements and these IOP measurements was r = 0.291 (95% CI).ConclusionOur results showed a weak correlation between the SENSIMED Triggerfish® CLS data output and IOP measurements taken using the Tono-pen® XL applanation tonometer.
      PubDate: 2017-04-09T02:10:27.91942-05:0
      DOI: 10.1111/aos.13456
  • The aetiology of uveitis in Suriname
    • Authors: Sayad Bhikhie; Janna Minderhoud, Anne-Marie T. Bueno de Mesquita-Voigt, Aniki Rothova, Anjo Riemens
      PubDate: 2017-04-09T01:55:26.253923-05:
      DOI: 10.1111/aos.13455
  • Fundus imaging in newborn children with wide-field scanning laser
    • Authors: Vigdis Magnusdottir; Wouter B. Vehmeijer, Thorunn S. Eliasdottir, Sveinn H. Hardarson, Nicoline E. Schalij-Delfos, Einar Stefánsson
      Abstract: PurposeCurrent fundus imaging in newborn babies requires mydriatics, eye specula and corneal contact. We propose that a scanning laser ophthalmoscope (SLO) allows ultra wide-field imaging with reduced stress for the child.MethodsThis prospective observational single centre study was conducted in Landspítali, University Hospital, Reykjavik, Iceland. In this study, a noncontact wide-field SLO (Optomap 200Tx) was used to image the retina in healthy full-term newborns without the use of mydriatics or eye specula. The child was held by one of the parents, while one of the researchers supported the child's head in front of the SLO camera for alignment and opened the eye with either a finger or a cotton tip.ResultsFifty-nine participants were recruited (34 females). The mean age was 16 days, and the mean gestational age was 40 ± 1 weeks at the time of imaging. Ultra-wide-field (200°) images were obtained of 44 participants. Twenty-seven participants (61%) had at least one ultra wide-field image with the optic disc and vessel segments in all quadrants of the fundus visible and in focus. No retinal pathology was found in the participants with the exception of one participant with small retinal haemorrhages.ConclusionScanning laser ophthalmoscope (SLO) ultra-wide-field fundus imaging is feasible in healthy full-term newborns without corneal contact, eye speculum or mydriatics. This approach could be an improvement for retinal imaging in newborn infants. Eye movement of the infant, whether asleep or awake, influenced which part of the fundus was captured, but focus and image quality were generally good.
      PubDate: 2017-04-09T01:45:36.497041-05:
      DOI: 10.1111/aos.13453
  • Differential expression and localization of human tissue inhibitors of
           metalloproteinases in proliferative diabetic retinopathy
    • Authors: Ahmed M. Abu El-Asrar; Ajmal Ahmad, Emilie Bittoun, Mohammad Mairaj Siddiquei, Ghulam Mohammad, Ahmed Mousa, Gert De Hertogh, Ghislain Opdenakker
      Abstract: PurposeTissue inhibitors of metalloproteinases (TIMPs) block the catalysis by matrix metalloproteinases (MMPs) and have additional biologic activities, including regulation of cell growth and differentiation, apoptosis, angiogenesis and oncogenesis. We investigated the expression levels of all the four human TIMPs and correlated these levels with those of MMP-9 and vascular endothelial growth factor (VEGF) in proliferative diabetic retinopathy (PDR).MethodsVitreous samples from 38 PDR and 21 nondiabetic control patients and epiretinal membranes from 14 patients with PDR and 10 patients with proliferative vitreoretinopathy (PVR) were studied by enzyme-linked immunosorbent assay, Western blot analysis and immunohistochemistry.ResultsTissue inhibitor of metalloproteinases-1, TIMP-4, MMP-9 and VEGF levels were significantly higher in vitreous samples from PDR patients than in nondiabetic controls (p 
      PubDate: 2017-04-09T01:35:44.82652-05:0
      DOI: 10.1111/aos.13451
  • Preliminary study of a controllable device for subtenon drug infusion in a
           rabbit model
    • Authors: Yiqin Duan; Yezhen Yang, Xuetao Huang, Ding Lin
      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
  • Factors affecting signal strength in spectral-domain optical coherence
    • Authors: Ryan Lee; Yih-Chung Tham, Carol Y. Cheung, Elizabeth Sidhartha, Rosalynn Grace Siantar, Sing-Hui Lim, Tien Yin Wong, Ching-Yu Cheng
      Abstract: PurposeTo identify ocular factors that affect signal strength in spectral-domain optical coherence tomography (SD-OCT).MethodsData from 1312 participants of the population-based Singapore Malay Eye Study-2 (SiMES-2) were included in the analysis. All participants underwent standardized ophthalmic examination, including measurements of best-corrected visual acuity (BCVA), refractive error, axial length, corneal curvature and presence of cataracts. Optic disc and macular cube scans were acquired using the Cirrus HD-OCT (software version 6.0, Carl Zeiss Meditec, Dublin, CA, USA). Signal strength of the optical coherence tomography (OCT) scan was recorded for each study eye. Multivariable linear regression analyses were performed to evaluate the associations between ocular factors and signal strength of the OCT scans.Results: The mean (±SD) age of our study participants was 61 ± 9 years, and 44.6% were male. Mean optic disc scan signal strength was 7.90 ± 1.25, range = 0–10, while mean macular scan signal strength was 8.80 ± 1.27, range = 0–10. In multivariable regression analyses, poorer signal strength in optic disc and macular cube scans was each associated with older age (per decade, β = −0.373, p 
      PubDate: 2017-04-09T01:00:25.695588-05:
      DOI: 10.1111/aos.13443
  • Topographic analysis of eyelid position using digital image processing
    • Authors: Yeoun Sook Chun; Hong Hyun Park, In Ki Park, Nam Ju Moon, Sang Joon Park, Jeong Kyu Lee
      Abstract: PurposeTo propose a novel analysis technique for objective quantification of topographic eyelid position with an algorithmatically calculated scheme and to determine its feasibility.MethodsOne hundred normal eyelids from 100 patients were segmented using a graph cut algorithm, and 11 shape features of eyelids were semi-automatically quantified using in-house software. To evaluate the intra- and inter-examiner reliability of this software, intra-class correlation coefficients (ICCs) were used. To evaluate the diagnostic value of this scheme, the correlations between semi-automatic and manual measurements of margin reflex distance 1 (MRD1) and margin reflex distance 2 (MRD2) were analysed using a Bland–Altman analysis. To determine the degree of agreement according to manual MRD length, the relationship between the variance of semi-automatic measurements and the manual measurements was evaluated using linear regression.ResultsIntra- and inter-examiner reliability were excellent, with ICCs ranging from 0.913 to 0.980 in 11 shape features including MRD1, MRD2, palpebral fissure, lid perimeter, upper and lower lid lengths, roundness, total area, and medial, central, and lateral areas. The correlations between semi-automatic and manual MRDs were also excellent, with better correlation in MRD1 than in MRD2 (R = 0.893 and 0.823, respectively). In addition, significant positive relationships were observed between the variance and the length of MRD1 and 2; the longer the MRD length, the more the variance.ConclusionThe proposed novel optimized integrative scheme, which is shown to have high repeatability and reproducibility, is useful for topographic analysis of eyelid position.
      PubDate: 2017-04-09T00:35:30.254519-05:
      DOI: 10.1111/aos.13437
  • Choroidal vascular changes in age-related macular degeneration
    • Authors: Lilian Hui Li Koh; Rupesh Agrawal, Neha Khandelwal, Labishetty Sai Charan, Jay Chhablani
      Abstract: PurposeTo assess the choroidal vascular changes using choroidal vascularity index (CVI) in patients with age-related macular degeneration (AMD) compared to controls.MethodsEnhanced depth imaging (EDI) optical coherence tomography (OCT) scans of 64 patients with unilateral or bilateral AMD were obtained. Images with a poorly demarcated choroidal–scleral interface (CSI) were excluded from the analysis. Foveal scans of 63 AMD eyes and 35 ‘normal fellow’ eyes were analysed. Images of 30 eyes from 18 age-matched healthy subjects were included as controls. Choroidal vascularity index (CVI) was derived from binarization of EDI OCT images, using fiji software.ResultsThe mean age was 56.50 ± 5.50 years for AMD patients and 52.25 ± 6.75 years for controls. All patients were treatment naïve. Subfoveal choroidal thickness (SFCT) in AMD, ‘normal fellow’ eyes and controls was 314.02 ± 78.80 μm, 300.88 ± 53.85 μm and 278.5 ± 65.31 μm, respectively. Choroidal vascularity index (CVI) in AMD, ‘normal fellow’ eyes and controls was 64.04 ± 2.43%, 64.66 ± 2.25% and 66.07 ± 1.72%, respectively. Choroidal vascularity index (CVI) of both AMD and ‘normal fellow’ eyes was significantly lower compared to controls (p 
      PubDate: 2017-04-09T00:20:32.712506-05:
      DOI: 10.1111/aos.13399
  • Nitric oxide in the pathophysiology of retinopathy: evidences from
           preclinical and clinical researches
    • Authors: Radka Opatrilova; Peter Kubatka, Martin Caprnda, Dietrich Büsselberg, Vladimir Krasnik, Pavol Vesely, Sandeep Saxena, Surabhi Ruia, Ioana Mozos, Luis Rodrigo, Peter Kruzliak, Katia Goncalves Santos
      Abstract: Retinopathy is the leading cause of blindness and visual disability in working-aged people. The pathogenesis of retinopathy is an actual and still open query. Alterations contributing to oxidative and nitrosative stress, including elevated nitric oxide and superoxide production, changes in the expression of different isoforms of nitric oxide synthase or endogenous antioxidant system, have been implicated in the mechanisms how this ocular disease develops. In addition, it was documented that renin–angiotensin system has been implicated in the progression of retinopathy. Based on comprehensive preclinical and clinical researches in this area, the role of above-mentioned factors in the pathogenesis of diabetic retinopathy, hypertensive retinopathy and ischaemic proliferative retinopathy is reviewed in this study. Moreover, the genetic susceptibility factors involved in the development of the retinopathy and possible strategies that utilize antioxidants as additive therapy are also highlighted here.
      PubDate: 2017-04-08T23:40:31.284243-05:
      DOI: 10.1111/aos.13384
  • Clinical impact of inflammation in dry eye disease: proceedings of the
           ODISSEY group meeting
    • Authors: Christophe Baudouin; Murat Irkeç, Elisabeth M. Messmer, José M. Benítez-del-Castillo, Stefano Bonini, Francisco C. Figueiredo, Gerd Geerling, Marc Labetoulle, Michael Lemp, Maurizio Rolando, Gysbert Van Setten, Pasquale Aragona,
      Abstract: Dry eye disease (DED) is a common, multifactorial ocular condition with major impact on vision and quality of life. It is now well recognized that the pathophysiology of chronic DED can include a cycle of inflammation involving both innate and adaptive immune responses. Recently, in vitro/in vivo models have been used to obtain a better understanding of DED-related inflammatory processes at molecular/cellular levels although they do not truly reproduce the complex and chronic hallmarks of human DED. In clinical DED research, advanced techniques such as impression cytology, conjunctival biopsy, in vivo confocal microscopy and multiplex tear analyses have allowed an improved assessment of inflammation in DED patients. This was supported by the identification of reliable inflammatory markers including matrix metalloproteinase-9, human leucocyte antigen-DR or intercellular adhesion molecule-1 in tears and impression cytology samples. One of the current therapeutic strategies focuses on breaking the inflammatory cycle perpetuating the ocular surface disease, and preclinical/clinical research has led to the development of promising anti-inflammatory compounds. For instance, cyclosporine, already approved in the United States, has recently been authorized in Europe to treat DED associated with severe keratitis. In addition, other agents such as corticosteroids, doxycycline and essential fatty acids, through their anti-inflammatory properties, show encouraging results. We now have a clearer understanding of the inflammatory processes involved in DED, and there is hope that the still emerging preclinical/clinical findings will be translated into new and highly effective therapies for patients in the near future.
      PubDate: 2017-04-08T02:56:19.240983-05:
      DOI: 10.1111/aos.13436
  • Incidence of secondary glaucoma after treatment of uveal melanoma with
           robotic radiosurgery versus brachytherapy
    • Authors: Jakob Siedlecki; Veronika Reiterer, Simon Leicht, Paul Foerster, Karsten Kortüm, Ulrich Schaller, Siegfried Priglinger, Christoph Fuerweger, Alexander Muacevic, Kirsten Eibl-Lindner
      Abstract: PurposeDifferent modalities of radiation therapy nowadays allow for effective treatment of uveal melanoma combined with the advantage of eye preservation. However, this advantage can secondarily be impaired by radiation-related side effects. After local recurrence, secondary glaucoma (SG) has been described as second most frequent complication leading to need of enucleation. This study compares the incidence of SG after conventional Ruthenium (Ru)-106 brachytherapy (BT) versus CyberKnife robotic radiosurgery (RRS) which has been gaining importance lately as an efficient treatment option offering improved patient comfort.MethodsMedical records of all patients diagnosed with uveal melanoma in the Eye Clinic of the Ludwig-Maximilians-University Munich between 2007 and 2013 were reviewed. A total of 268 eyes of 268 patients treated with Ru-106 BT or CyberKnife-RRS as monotherapy were entered in this retrospective cohort study. Incidence of SG was correlated with treatment modality and baseline tumour characteristics.ResultsFifty-three patients (19.8%) developed SG. At 5 years, SG was significantly more frequent after RRS (46.7%) than BT (11.1%); however, tumour thickness (maximum apical height) as a marker of tumour progress was more pronounced in the RRS group. Subgroup analysis of 178 patients for tumours amenable to both BT and RRS (thickness ≤6 mm) revealed comparable results at 3 years (RRS: 13.8 versus BT: 11.2%), but a trend towards increased incidence after RRS beyond year three. However, this difference was not significant at 5 years (28.2% versus 11.2%, p = 0.138). Tumour thickness was significantly associated with incidence of SG.ConclusionIn tumours ≤6 mm thickness, RRS and BT seem to offer a comparable safety profile in terms of SG. Beyond year three, SG was tendentially, but not significantly more frequent after RRS. Increasing tumour thickness is associated with risk of SG.
      PubDate: 2017-04-07T05:13:27.756852-05:
      DOI: 10.1111/aos.13418
  • Cytoarchitecture of epithelial inflammatory infiltration indicates the
           aetiology of infectious keratitis
    • Authors: Adrian Smedowski; Dorota Tarnawska, Michal Orski, Ewa Wroblewska-Czajka, Kai Kaarniranta, Pasquale Aragona, Edward Wylegala
      Abstract: PurposeTo analyse cytological features of corneal epithelium in infectious keratitis.MethodsOne hundred and eighteen patients (53 males and 65 females) diagnosed with acute stage of infectious keratitis (45 viral, 40 bacterial, 23 fungal, 10 Acanthamoeba keratitis) were included in study. We performed retrospective analysis of bright and blue-light slit-lamp photographs and in vivo corneal confocal microscopy scans of the corneal epithelium from five corneal regions (superior, inferior, temporal, nasal and central). Density, morphology of inflammatory cells and their relation to epithelial structures, as well as density of nerve fibres, were evaluated in relation to the keratitis aetiology.ResultsWe characterized five morphological types of inflammatory cells forming infiltration. Cell and nerve fibre densities showed significant differences between groups, and the most intense inflammatory infiltration was associated with fungal then bacterial, viral and Acanthamoeba keratitis. Additionally, differences in aetiology-specific ratio of round/non-round inflammatory cells were observed.ConclusionConfocal microscopy analysis in infectious keratitis of various aetiologies revealed quantitative and qualitative differences in inflammatory cell infiltration expressed in different ratio of round/non-round inflammatory cells. In vivo microscopic analysis of both the corneal epithelial layer cytopathology and the cytology of inflammatory infiltration provides a fast and specific differentiation of keratitis aetiology that may increase the accuracy in the selection of the initial treatment.
      PubDate: 2017-04-03T00:40:31.101654-05:
      DOI: 10.1111/aos.13363
  • Additive effects and safety of fixed combination therapy with 1%
           brinzolamide and 0.5% timolol versus 1% dorzolamide and 0.5% timolol in
           prostaglandin-treated glaucoma patients
    • Authors: Makoto Aihara; Misato Adachi, Hiroshi Matsuo, Tetsuya Togano, Takeo Fukuchi, Noriyuki Sasaki,
      Abstract: PurposeTo compare the additive effects and safety of 1% brinzolamide/0.5% timolol fixed combination (BTFC) versus the low-dose regimen of 1% dorzolamide/0.5% timolol fixed combination (DTFC) in patients with open-angle glaucoma and ocular hypertension (OAG/OH) following treatment with prostaglandin analogues (PGAs).MethodsA prospective, randomized, double-masked, multicentre, parallel-group and active-controlled study included 201 Japanese OAG/OH patients who had been treated with PGA. Efficacy was assessed as the change in intra-ocular pressure (IOP) from baseline after weeks 4 and 8. Safety was assessed with adverse event rates, ocular discomfort score, blur scale, blood pressure and heart rates, best-corrected visual acuity (BCVA) and slit lamp examinations.ResultsIntra-ocular pressure (IOP) change from baseline at 9 AM/11 AM pooled over the 8 weeks was −3.3/−3.3 mmHg in the BTFC group and −2.9/−3.4 mmHg in the DTFC group, demonstrating non-inferiority of BTFC to DTFC. Ocular irritation was frequently seen in DTFC group. Although blurred vision was frequently seen in BTFC group, it was transient and blurring became the equivalent 3 min after instillation between two groups. No noteworthy issue was observed in other safety outcome.ConclusionNon-inferiority of BTFC to DTFC in IOP reduction was demonstrated after adding onto PGA therapy in Japanese OAG/OH patients. Although the score of blurred vision was transiently higher in BTFC than DTFC, treatment difference decreased and disappeared with time. Thus, BTFC can be considered as a safe and effective agent for glaucoma treatment.
      PubDate: 2017-04-03T00:05:24.557264-05:
      DOI: 10.1111/aos.13401
  • Visual impairment certification due to diabetic retinopathy in North and
           Eastern Devon
    • Authors: Siying Lin; Bhaskar Gupta, Natalee James, Roland H. Ling
      Abstract: PurposeTo determine certifications of visual impairment (CVIs) due to diabetic retinopathy (DR) in a region that has operated diabetic screening since 1992.MethodsA retrospective review of all CVIs due to DR was conducted, with mid-year population estimates and a diabetes prevalence model used to determine the annual incidence of certification from 2010 to 2013. For 2013, CVIs due to DR were also compared to all CVIs in the region.ResultsThe total number of certifications due to DR was 75; 52 were sight impaired (SI) and 23 severely sight impaired (SSI) certifications; 25% of patients had type 1, and 75% had type 2 diabetes mellitus. The mean age at time of CVI was 65.5 years. The mean duration of known diabetes was 22.0 years. The incidence of CVI due to DR ranged from 30.8 to 77.4 per million population per year between 2010 and 2013. The incidence of CVI in the diabetic population was estimated at 0.47 to 1.21 per 1000 patients per year with diabetes for 2010–2013. In 2013, DR was a main or contributing cause in 4.3% of all CVIs, but did not contribute to any SSI certifications in the working age population.ConclusionThe incidence of CVI due to DR was comparable to that reported in other regions. Nationwide, DR was the second most common cause of blindness in working age adults, but did not contribute to any SSI certifications in our population. Our results are consistent with the success of a long-standing retinal screening programme.
      PubDate: 2017-04-01T01:05:26.155893-05:
      DOI: 10.1111/aos.13400
  • One-year treatment outcomes of ziv-aflibercept for treatment-naïve
           macular oedema in branch retinal vein occlusion
    • Authors: Errol W. Chan; Mohab Eldeeb, Chintan J. Dedhia, Ahmad Mansour, Jay Chhablani
      PubDate: 2017-03-31T23:55:26.016785-05:
      DOI: 10.1111/aos.13432
  • The effect of cataract surgery and IOL implantation on the magnification
           of a fundus photograph: a pilot study
    • Authors: Laura Knaapi; Tuomo Lehtonen, Eija Vesti
      Abstract: PurposeThe goal was to determine the effect of cataract surgery-induced change in ametropia and anterior chamber depth on the magnification of a fundus photograph.MethodsFundus photographs were taken from 11 subjects undergoing cataract surgery and intraocular lens (IOL) implantation before and after surgery with a telecentric Zeiss and Topcon fundus cameras. The distance between two distinct fundus landmarks, i.e. two crossings of retinal vessels, was measured before and after surgery, and the results were compared to axial length and surgery-induced change in ametropia and anterior chamber depth. In addition, the change in the conversion factor of Topcon fundus camera was calculated and its correlation to axial length, change in ametropia and anterior chamber depth was analysed. Further, the change in the mathematical location of P′, i.e. the second principal point of the eye in the formula of Bennett et al. (1994), was calculated.ResultsCataract surgery and IOL implantation did not significantly influence the magnification of a fundus photograph taken with a telecentric Zeiss or Topcon fundus camera even when ametropia changed markedly. Axial length and anterior chamber depth did not correlate with change in the magnification of a fundus photograph. The average change in the mathematical location P′ due to surgery was −39.4%, SD 0.33.ConclusionFundus photographs taken with a telecentric Zeiss or Topcon fundus camera can be reliably used to follow the size of fundus landmarks even if ametropia and anterior chamber depth are changed after cataract surgery and IOL implantation.
      PubDate: 2017-03-31T23:40:27.580756-05:
      DOI: 10.1111/aos.13435
  • Visual and health outcomes, measured with the activity inventory and the
           EQ-5D, in visual impairment
    • Authors: Antonio Filipe Macedo; Pedro Lima Ramos, Laura Hernandez-Moreno, Joana Cima, António M. G. Baptista, Ana Patricia Marques, Robert Massof, Rui Santana
      Abstract: PurposeGeneric instruments to assess health utilities can be used to express the burden of health problems in widely used indexes. That is in contrast with what can be obtained with condition-specific instruments, outcomes are very specific and difficult to compare across conditions. The purpose of this study was to assess health and visual outcomes and its determinants in patients with visual impairment (VI) using the EQ-5D-3L and the Activity Inventory (AI).MethodsParticipants were recruited in different hospitals during the PCVIP-study. A total of 134 patients with acuity 0.30 logMAR or less in the better eye were interviewed. The AI includes 46 goals split between three objectives: social functioning, recreation and daily living, and was used to measure visual ability. The EQ-5D consists of five questions covering one domain each and was used to provide a measure of health states. Responses to each domain were combined to produce a single individual index.ResultsThe AI and the EQ-5D-3L showed enough discriminatory power between VI levels (p 
      PubDate: 2017-03-30T06:00:40.721371-05:
      DOI: 10.1111/aos.13430
  • Efficacy of nutritional supplementation with omega-3 and omega-6 fatty
           acids in dry eye syndrome: a systematic review of randomized clinical
    • Authors: Ignacio Molina-Leyva; Alejandro Molina-Leyva, Aurora Bueno-Cavanillas
      Abstract: PurposeTo critically appraise scientific evidence regarding the efficacy of nutritional supplementation with omega-3 and omega-6 fatty acids for the treatment of dry eye syndrome (DES).MethodsA systematic review of randomized clinical trials was performed. Two independent reviewers selected and analysed the scientific papers that met inclusion and exclusion criteria. Objective and subjective efficacy outcomes were assessed.ResultsThe trials involved a total of 2591 patients in fifteen independent studies. All studies were published between 2005 and 2015. The supplements used were mostly omega-3 and omega-6 in different proportions. Subjective improvement was measured using mainly Ocular Surface Disease Index (OSDI) test and Dry Eye Severity Score (DESS) test: significant differences in favour of the experimental group were found in seven of the studies. The objective amelioration was assessed by lacrimal function parameters: Tear break-up time (TBUT) significantly increased in nine studies and Schirmer's test in four studies.ConclusionWe observed a discrete improvement in the parameters of tear function. Scientific evidence is not strong enough to systematically recommend the use of omega-3 and omega-6 fatty acids as a standalone treatment of DES independently from its aetiology. However, they could be considered as an effective alternative to topical treatment in patients with DES secondary to certain pathologies.
      PubDate: 2017-03-30T04:20:38.160798-05:
      DOI: 10.1111/aos.13428
  • Is there inter-procedural transfer of skills in intraocular surgery? A
           randomized controlled trial
    • Authors: Ann Sofia Skou Thomsen; Jens Folke Kiilgaard, Morten Cour, Ryan Brydges, Lars Konge
      Abstract: PurposeTo investigate how experience in simulated cataract surgery impacts and transfers to the learning curves for novices in vitreoretinal surgery.MethodsTwelve ophthalmology residents without previous experience in intraocular surgery were randomized to (1) intensive training in cataract surgery on a virtual-reality simulator until passing a test with predefined validity evidence (cataract trainees) or to (2) no cataract surgery training (novices). Possible skill transfer was assessed using a test consisting of all 11 vitreoretinal modules on the EyeSi virtual-reality simulator. All participants repeated the test of vitreoretinal surgical skills until their performance curve plateaued. Three experienced vitreoretinal surgeons also performed the test to establish validity evidence. Analysis with independent samples t-tests was performed.ResultsThe vitreoretinal test on the EyeSi simulator demonstrated evidence of validity, given statistically significant differences in mean test scores for the first repetition; experienced surgeons scored higher than novices (p = 0.023) and cataract trainees (p = 0.003). Internal consistency for the 11 modules of the test was acceptable (Cronbach's α = 0.73). Our findings did not indicate a transfer effect with no significant differences found between cataract trainees and novices in their starting scores (mean ± SD 381 ± 129 points versus 455 ± 82 points, p = 0.262), time to reach maximum performance level (10.7 ± 3.0 hr versus 8.7 ± 2.8 hr, p = 0.265), or maximum scores (785 ± 162 points versus 805 ± 73 points, p = 0.791).ConclusionPretraining in cataract surgery did not demonstrate any measurable effect on vitreoretinal procedural performance. The results of this study indicate that we should not anticipate extensive transfer of surgical skills when planning training programmes in intraocular surgery.
      PubDate: 2017-03-30T03:59:14.220734-05:
      DOI: 10.1111/aos.13434
  • Glistenings, anterior/posterior capsular opacification and incidence of
           Nd:YAG laser treatments with two aspheric hydrophobic acrylic intraocular
           lenses – a long-term intra-individual study
    • Authors: Björn Johansson
      Abstract: PurposeTo compare two hydrophobic acrylic intraocular lenses (IOLs) regarding long-term anterior/posterior capsular opacification (ACO/PCO) development and need for neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser treatment due to visually disturbing PCO, and to study development of glistenings in the IOL materials.MethodsIn a prospective, randomized, intra-individual, comparative trial, 50 cataract patients received either an AcrySof IQ® SN60WF (Alcon, Fort Worth, TX, USA) or a Tecnis® ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA) IOL in the first operated eye, and the second eye received the IOL type not implanted in the first eye. Anterior/posterior capsular opacification (ACO/PCO) and fibrosis were monitored with slit-lamp photography and semi-automated digital analysis 2 and 3 years postoperatively. Glistenings were semi-quantitatively assessed in slit-lamp photographs. Nd:YAG laser treatment for visually disturbing PCO was monitored.ResultsVisual outcomes were similar for the two IOLs. Anterior capsular fibrosis and/or opacification developed more often in SN60WF eyes. Mean PCO area percentage was larger in ZCB00 eyes 3 years after surgery, but severity score did not differ with statistical significance between the two IOLs. Six ZCB00 eyes and 2 SN60WF eyes underwent Nd:YAG laser treatment during a mean of 4 years 8 months after surgery. This difference was not statistically significant. A high amount of glistenings developed in most SN60WF IOLs, while only few ZCB00 IOLs displayed a low degree of glistenings.ConclusionVisual outcomes, PCO development over time and need for Nd:YAG laser treatment were similar for the two IOLs. Anterior capsule fibrosis/contraction and glistenings were more pronounced with the SN60WF IOL.
      PubDate: 2017-03-30T02:35:37.463443-05:
      DOI: 10.1111/aos.13444
  • 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
  • Patients’ maximum acceptable waiting time for cataract surgery: a
           comparison at two time-points 7 years apart
    • Authors: Birgit Weingessel; Michael Wahl, Pia V. Vécsei-Marlovits
      Abstract: PurposeTo evaluate the maximum acceptable waiting time (MAWT) of cataract patients and assess the determinants of their perception of MAWT at two time-points 7 years apart.MethodsIn 2007 (prior to the transformation of our cataract service to a day case unit) and 2014, 500 consecutive patients with cataract were asked to fill in a preoperative questionnaire addressing their MAWT to undergo cataract surgery. The patients’ visual impairment (VF-14 score), education and social status were evaluated.ResultsThe mean MAWT was 3.2 months in both periods, whereas the actual waiting time decreased significantly by 1.7 months (p 
      PubDate: 2017-03-30T01:07:50.689839-05:
      DOI: 10.1111/aos.13439
  • Diurnal expression of proteins in the retina of the blind cone-rod
           homeobox (Crx−/−) mouse and the 129/Sv mouse: a proteomic study
    • Authors: Morten Møller; Martin Fredensborg Rath, Maja Ludvigsen, Bent Honoré, Henrik Vorum
      Abstract: PurposeThe vertebrate retina contains a circadian clock participating in adaptations to day and night vision. This peripheral clock is independent of the master clock in the suprachiasmatic nucleus (SCN). The retinal clock is located in several cell types, including the photoreceptors. To investigate the role of the circadian clock of the photoreceptor cells in regulation of retinal protein rhythms, we analysed diurnal protein expression in the photoreceptor-deficient cone-rod homeobox knockout mouse (Crx−/−) and the 129/Sv mouse.Methods2D gels were made from retinal homogenates of 129/Sv and Crx−/− mice killed at midday and midnight. Stained gels were analysed by use of PDQuest 2D gel analysis software. After trypsin digestion of differential expressed spots, the proteins were identified by LC-MS/MS using a nano-liquid chromatograph connected to a Q-TOF Premier mass spectrometer. These data were used to search the SWISS-PROT database.ResultsBoth the retinae of the control and the Crx−/− mice exhibited diurnal proteins rhythms. As expected, proteins involved in phototransduction were not detected in the Crx−/− mouse; in this phenotype, however, proteins from spots showing diurnal rhythms were specifically identified as enzymes involved in glucose metabolism, Krebs cycle, and mitochondrial enzymes. Data are available via ProteomeXchange with identifier PXD005556.ConclusionWe show diurnal protein rhythms in the retina of a mouse lacking the rods and cones. The diurnal protein rhythms in this genotype, lacking the circadian clock of the photoreceptors, might be caused by a circadian clock in other retinal cell types or a direct light input to the retina.
      PubDate: 2017-03-28T07:00:29.996442-05:
      DOI: 10.1111/aos.13429
  • 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
  • Treatment of adenoviral keratoconjunctivitis with a combination of
           povidone-iodine 1.0% and dexamethasone 0.1% drops: a clinical prospective
           controlled randomized study
    • Authors: Natalya Kovalyuk; Igor Kaiserman, Michael Mimouni, Ornit Cohen, Shmuel Levartovsky, Hilda Sherbany, Michal Mandelboim
      Abstract: PurposeTo determine the efficacy of combination povidone-iodine (PVP-I) 1.0% eyedrops and dexamethasone 0.1% eyedrops in the treatment of adenoviral keratoconjunctivitis.Materials and methodsIn a prospective, randomized, controlled, double-blinded clinical trial patients with recent adenoviral keratoconjunctivitis (diagnosed clinically and confirmed by PCR), we randomly divided into three treatment groups: study group – received PVP-I 1.0% and dexamethasone 0.1%, control 1 group – received dexamethasone 0.1% and control 2 group – received lubricating eyedrops (hypromellose 0.3%). The treatment was administered four times a day in each group. All patients were examined and filled a questionnaire before treatment and on the 3rd, 5th and 7th days of treatment.ResultsWe included in the study 78 eyes (26 in each group). Adenovirus type 8 was the most common pathogen (83% of cases). The fastest improvement in patients red eyes, discharge, superficial punctate keratitis and pseudomembranes was observed in the study group (p 
      PubDate: 2017-03-25T00:20:35.819042-05:
      DOI: 10.1111/aos.13416
  • Factors influencing the contamination rate of human organ-cultured corneas
    • Authors: Daniel Röck; Johanna Wude, Karl U. Bartz-Schmidt, Efdal Yoeruek, Sebastian Thaler, Tobias Röck
      Abstract: PurposeTo assess the influence of donor, environment and storage factors on the contamination rate of organ-cultured corneas, to consider the microbiological species causing corneal contamination and to investigate the corresponding sensitivities.MethodsData from 1340 consecutive donor corneas were analysed retrospectively. Logistic regression analysis was used to assess the influence of different factors on the contamination rate of organ-cultured corneas for transplantation.ResultsThe mean annual contamination rate was 1.8 ± 0.4% (range: 1.3–2.1%); 50% contaminations were of fungal origin with exclusively Candida species, and 50% contaminations were of bacterial origin with Staphylococcus species being predominant. The cause of donor death including infection and multiple organ dysfunction syndrome increased the risk of bacterial or fungal contamination during organ culture (p = 0.007 and p = 0.014, respectively). Differentiating between septic and aseptic donors showed an increased risk of contamination for septic donors (p = 0.0020). Mean monthly temperature including warmer months increased the risk of contamination significantly (p = 0.0031). Sex, donor age, death to enucleation, death to corneoscleral disc excision and storage time did not increase the risk of contamination significantly.ConclusionThe genesis of microbial contamination in organ-cultured donor corneas seems to be multifactorial. The main source of fungal or bacterial contamination could be resident species from the skin flora. The rate of microbial contamination in organ-cultured donor corneas seems to be dependent on the cause of donor death and mean monthly temperature.
      PubDate: 2017-03-21T02:01:24.864585-05:
      DOI: 10.1111/aos.13375
  • Monitoring retinoschisis and non-acute retinal detachment by optical
           coherence tomography: morphologic aspects and clinical impact
    • Authors: Katharina Eibenberger; Stefan Sacu, Sandra Rezar-Dreindl, Julia Pöcksteiner, Michael Georgopoulos, Ursula Schmidt-Erfurth
      Abstract: PurposeTo differentiate retinoschisis (RS) from non-acute retinal detachment (naRD) in clinical routine using optical coherence tomography (OCT), describe unique morphological OCT characteristics and monitor disease progression.MethodsThis prospective, observational study included 64 eyes of 44 patients with either RS or naRD. Patients were examined clinically and using Heidelberg Spectralis OCT®, Topcon DRI OCT® and Cirrus HRA-OCT® over 2 years with follow-up at 1, 3, 6, 12 and 24 months. Main outcomes were typical morphologic findings of RS and naRD described in OCT. Progression was monitored using Spectralis OCT® follow-up mapping and an eye-tracking method.ResultsForty-seven eyes were diagnosed with RS and 17 with naRD. Optical coherence tomography (OCT) provided a definite diagnosis in four eyes diagnosed clinically as uncertain. Seventy-seven percentage of eyes with RS were atrophic in the inner leaf (IL), whereas 41% with naRD showed cystoid alteration. A discontinuation of the IL clinically observed as an inner-layer break (ILB) could be imaged. We described a tissue retraction within the outer leaf (OL), which corresponded to outer-layer breaks (OLBs) in clinical examinations in nine eyes (19%).ConclusionOptical coherence tomography (OCT) is a reliable method to differentiate and monitor RS from naRD. Morphological characteristics, including ILB and OLB, could be accurately illustrated in RS.
      PubDate: 2017-03-21T01:16:21.455595-05:
      DOI: 10.1111/aos.13424
  • Monitoring daily intraocular pressure fluctuations with self-tonometry in
           healthy subjects
    • Authors: Laurence Quérat; Enping Chen
      Abstract: PurposeTo evaluate the accuracy of the intraocular pressure (IOP) measured by healthy subjects with icare® Home and to observe the IOP fluctuation and pattern of IOP fluctuation in healthy subjects over three consecutive days.MethodsSixty healthy subjects were recruited to the study. IOP was measured by the subjects themselves and by study staff using icare® Home tonometers on visits 1 and 2, as well as by study staff using Goldmann applanation tonometry (GAT). Furthermore, the subjects measured their IOP at home for three consecutive days.ResultsTwenty-three per cent of the study eyes were excluded in the statistical analysis due to dropout or non-compliance to the schedule. Approximately 70% of the icare® Home measurements were within 3 mmHg of the GAT measurements. Ten to 16% of the study eyes had IOP peaks outside office hours. Sixty-three per cent of the study eyes had different IOP patterns on consecutive days.ConclusionRebound self-tonometry appears to be accurate and could be used to monitor short- and long-term IOP variations. The difference between IOP patterns on consecutive days raises questions as to the certainty of a single IOP measurement as a measure of treatment effect.
      PubDate: 2017-03-14T05:05:31.507625-05:
      DOI: 10.1111/aos.13389
  • Choroideremia: melanopsin-mediated postillumination pupil relaxation is
           abnormally slow
    • Authors: Shakoor Ba-Ali; Søren Kirchhoff Christensen, Birgit Sander, Thomas Rosenberg, Michael Larsen, Henrik Lund-Andersen
      Abstract: PurposeTo investigate the rod–cone and melanopsin pupillary light response (PLR) pathways in choroideremia.MethodsEight patients with choroideremia and 18 healthy age-matched controls underwent chromatic pupillometry by applying blue (463 nm) and red light (643 nm) at 100 lux intensity to the right eye while recording pupil diameters. Absolute baseline pupil size (mm), normalized maximal pupil constriction and the early and late postillumination pupillary dilation, from 0 to 10 seconds and 10 to 30 seconds after the end of illumination, respectively, were determined. Postillumination responses to blue light were considered to be primarily driven by melanopsin activation of the intrinsic photosensitive retinal ganglion cells.ResultsBaseline pupil diameters were comparable in patients with choroideremia and control subjects (p = 0.48). The maximum pupil constriction in patients with choroideremia was severely weakened in red light but only mildly weakened in blue light (p 
      PubDate: 2017-03-08T04:35:27.782914-05:
      DOI: 10.1111/aos.13394
  • NLRP3 inflammasome activation is associated with proliferative diabetic
    • Authors: Sirpa Loukovaara; Niina Piippo, Kati Kinnunen, Maria Hytti, Kai Kaarniranta, Anu Kauppinen
      Abstract: PurposeInnate immunity and dysregulation of inflammatory processes play a role in vascular diseases like atherosclerosis or diabetes. Nucleotide-binding domain and Leucine-rich repeat Receptor containing a Pyrin domain 3 (NLRP3) inflammasomes are pro-inflammatory signalling complexes that were found in 2002. In addition to pathogens and other extracellular threats, they can be activated by various endogenous danger signals. The purpose of this study was to find out whether NLRP3 activation occurs in patients with sight-threatening forms of diabetic retinopathy (DR).MethodsInflammasome components NLRP3 and caspase-1, inflammasome-related pro-inflammatory cytokines IL-1β and IL-18, vascular endothelial growth factor (VEGF), acute-phase cytokines TNF-α and IL-6, as well as adaptive immunity-related cytokine interferon gamma (IFN-γ) were measured from the vitreous samples of 15 non-proliferative diabetic retinopathy (non-PDR) and 23 proliferative diabetic retinopathy (PDR) patients using the enzyme-linked immunosorbent assay (ELISA) method. The adaptor protein apoptosis-associated speck-like protein containing a CARD (ASC) was determined using the Western blot technique.ResultsInflammasome components were present in the vitreous of DR patients. Along with VEGF, the levels of caspase-1 and IL-18 were significantly increased, especially in PDR eyes. Interestingly, clearly higher levels of NLRP3 were found in the PDR eyes with tractional retinal detachment (TRD) than from PDR eyes with fully attached retina. There were no significant differences in the amounts of IL-1β, TNF-α, IL-6, and IFN-γ that were detectable in the vitreous of both non-PDR and PDR patients.ConclusionOur results suggest that NLRP3 inflammasome activation can be associated especially with the pathogenesis of PDR. The lack of differences in TNF-α, IL-6, and IFN-γ also alludes that acute inflammation or T-cell-mediated responses do not dominate in PDR pathogenesis.
      PubDate: 2017-03-08T04:15:25.641168-05:
      DOI: 10.1111/aos.13427
  • Reduced anterior chamber contamination by frequent surface irrigation with
           diluted iodine solutions during cataract surgery
    • Authors: Hiroyuki Shimada; Shinji Arai, Hiroyuki Nakashizuka, Takayuki Hattori, Mitsuko Yuzawa
      Abstract: PurposeTo verify that ocular surface irrigation with 0.025% povidone–iodine (PI) or 0.0025% polyvinyl alcohol–iodine (PAI) during cataract surgery minimizes bacterial contamination of the anterior chamber.MethodsThe study was a prospective, interventional case series. First, the bactericidal effect of PI or PAI against Staphylococcus aureus was evaluated in vitro. Next, in 400 eyes undergoing cataract surgery, the ocular surface was irrigated every 20 seconds during surgery with balanced salt solution (BSS; 200 eyes) or BSS containing 0.025% PI (100 eyes) or 0.0025% PAI (100 eyes). At the completion of surgery, anterior chamber fluid was cultured bacteriologically. Visual acuity (VA) and corneal endothelial cell density were measured before and 7 days after surgery.ResultsA marked bactericidal effect was observed when S. aureus was directly exposed for 15 seconds to 0.01% PI or 0.001% PAI diluted in BSS. When the two solutions were stored at room temperature, bactericidal effect did not attenuate after 60 min. The bacterial detection rate at the completion of surgery was significantly reduced in 0.025% PI (0%, 0/100 eyes) or 0.0025% PAI group (0%, 0/100 eyes) compared to BSS group (5%, 10/200 eyes) (p = 0.0340). No differences in postoperative visual acuity and postoperative corneal endothelial cell density were observed between three groups.ConclusionIn cataract surgery, irrigation every 20 seconds of the operative field with 0.025% PI or 0.0025% PAI, both of which contain 0.0025% available iodine concentration, achieved a very low bacterial contamination rate in the anterior chamber.
      PubDate: 2017-03-08T02:30:30.412185-05:
      DOI: 10.1111/aos.13390
  • 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
  • Plasma long-chain omega-3 polyunsaturated fatty acids and macular pigment
           in subjects with family history of age-related macular degeneration: the
           Limpia Study
    • Authors: Bénédicte M. J. Merle; Benjamin Buaud, Jean-François Korobelnik, Alain Bron, Marie-Noëlle Delyfer, Marie-Bénédicte Rougier, Hélène Savel, Carole Vaysse, Catherine Creuzot-Garcher, Cécile Delcourt
      Abstract: PurposeIn numerous epidemiological studies, omega-3 polyunsaturated fatty acids (PUFAs) have been associated with a decreased risk of age-related macular degeneration (AMD). Beyond their structural, functional and neuroprotective roles, omega-3 PUFAs may favour the retinal accumulation of lutein and zeaxanthin and thus increase macular pigment optical density (MPOD). We examined the associations of MPOD with plasma omega-3 PUFAs in subjects with family history of AMD.MethodsThe Limpia study is a double-blind, placebo-controlled, prospective randomized clinical trial performed in 120 subjects. Subjects with at least one parent treated for neovascular AMD, aged 40–70, with a best corrected visual acuity (BCVA)>20/25, free of late AMD and other major eye conditions and with no use of supplement containing lutein or zeaxanthin the preceding year were recruited in Bordeaux and Dijon, France. At baseline, MPOD within 1° of eccentricity was measured by modified Heidelberg retinal analyser (Heidelberg, Germany) and plasma omega-3 PUFAs by gas chromatography. Medical history and lifestyle data were collected from a standardized questionnaire. Associations of MPOD with plasma omega-3 PUFAs were assessed at the baseline examination, using mixed linear models adjusted for age, gender, centre, body mass index, smoking, plasma high-density lipoprotein (HDL) cholesterol and lutein+zeaxanthin.ResultsAfter multivariate adjustment, high MPOD was significantly associated with higher level of plasma docosapentaenoic acid (DPA) (β = 0.029, 95% CI: 0.003, 0.055; p = 0.03). Plasma alpha linolenic, eicosapentaenoic and docosahexaenoic acids were not significantly associated with MPOD.ConclusionIn the Limpia study, high MPOD within 1° was significantly associated with higher plasma levels of omega-3 DPA.
      PubDate: 2017-03-08T00:55:52.122862-05:
      DOI: 10.1111/aos.13408
  • Dissecting microRNA dysregulation in age-related macular degeneration: new
           targets for eye gene therapy
    • Authors: Anne Louise Askou; Sidsel Alsing, Andreas Holmgaard, Toke Bek, Thomas J. Corydon
      Abstract: MicroRNAs (miRNAs) are key regulators of gene expression in humans. Overexpression or depletion of individual miRNAs is associated with human disease. Current knowledge suggests that the retina is influenced by miRNAs and that dysregulation of miRNAs as well as alterations in components of the miRNA biogenesis machinery are involved in retinal diseases, including age-related macular degeneration (AMD). Furthermore, recent studies have indicated that the vitreous has a specific panel of circulating miRNAs and that this panel varies according to the specific pathological stress experienced by the retinal cells. MicroRNA (miRNA) profiling indicates subtype-specific miRNA profiles for late-stage AMD highlighting the importance of proper miRNA regulation in AMD. This review will describe the function of important miRNAs involved in inflammation, oxidative stress and pathological neovascularization, the key molecular mechanisms leading to AMD, and focus on dysregulated miRNAs as potential therapeutic targets in AMD.
      PubDate: 2017-03-07T23:20:25.927641-05:
      DOI: 10.1111/aos.13407
  • Reduced number of relapses of human leucocyte antigen-B27-associated
           uveitis during pregnancy
    • Authors: Fleurieke H. Verhagen; Arthur M. Braakenburg, Tessa Kremer, Julia Drylewicz, Aniki Rothova, Joke H. Boer
      PubDate: 2017-03-07T07:10:37.694373-05:
      DOI: 10.1111/aos.13387
  • 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
  • Two-year results of microcatheter-assisted trabeculotomy in paediatric
           glaucoma: a randomized controlled study
    • Authors: Yasmine El Sayed; Ghada Gawdat
      Abstract: PurposeTo compare the outcomes of microcatheter-assisted circumferential trabeculotomy to standard rigid probe trabeculotomy in childhood glaucomas.MethodsEyes of children requiring trabeculotomy for primary congenital or secondary paediatric glaucoma were randomized to undergo either trabeculotomy using the Glaucolight illuminated microcatheter, or a rigid probe trabeculotomy. Complete success was defined as an intraocular pressure (IOP) of
      PubDate: 2017-03-07T03:45:47.363045-05:
      DOI: 10.1111/aos.13414
  • Macular cystic changes as predictive factor for the recurrence of macular
           oedema in branch retinal vein occlusion
    • Authors: Eric Tilgner; Maiara Dalcegio Favretto, Maria Tuisl, Peter Wiedemann, Matus Rehak
      Abstract: AimTo evaluate the role of small cystic macular changes as a prognostic factor for the recurrence of macular oedema (ME) in patients with branch retinal vein occlusion (BRVO) treated with anti-VEGF drugs.MethodsWe performed retrospective chart analysis of 116 patients treated with intravitreal injection of ranibizumab (IVR) or bevacizumab (IVB) for ME secondary to BRVO. At the baseline and monthly follow-up visits over a period of 12 months, a comprehensive ophthalmologic examination including best-corrected visual acuity (BCVA) and volume scan of macula using Spectral domain optical coherence tomography (SD-OCT) were performed. Patients without ME (CRT
      PubDate: 2017-03-07T02:35:29.295013-05:
      DOI: 10.1111/aos.13396
  • The influence of donor factors on corneal organ culture contamination
    • Authors: Anja K. Gruenert; Katja Rosenbaum, Gerd Geerling, Thomas A. Fuchsluger
      Abstract: PurposeTo evaluate the contamination rate and the corresponding spectrum of microbes and to identify donor risk factors for corneal organ culture contaminations.MethodsA total of 3306 organ-cultured donor corneas were included in the study. We performed a retrospective database analysis to evaluate donor factors such as gender, age, death-to-explantation interval (DEI), procurement site and cause of death and to determine their influence on donor cornea contaminations. Odds ratios (ORs) were calculated for each factor.ResultsThe overall contamination rate was 7.8% (n = 259). Younger donor age (OR: 2.2, p = 0.003, chi-squared test), a DEI of more than 24 hr (OR: 1.6, p 
      PubDate: 2017-03-07T02:00:31.051295-05:
      DOI: 10.1111/aos.13402
  • Serum from plasma rich in growth factors regenerates rabbit corneas by
           promoting cell proliferation, migration, differentiation, adhesion and
           limbal stemness
    • Authors: Jaime Etxebarria; Sara Sanz-Lázaro, Raquel Hernáez-Moya, Vanesa Freire, Juan A. Durán, María–Celia Morales, Noelia Andollo
      Abstract: PurposeTo evaluate the regenerating potential and the mechanisms through which the autologous serum derived from plasma rich in growth factors (s-PRGF) favours corneal wound healing in vitro and in vivo.MethodsWe compared the effect of various concentrations of s-PRGF versus fetal bovine serum (FBS) and control treatment in rabbit primary corneal epithelial and stromal cells and wounded rabbit corneas. Cell proliferation was measured using an enzymatic colorimetric assay. In vitro and in vivo wound-healing progression was assessed by image-analysis software. Migration and invasion were evaluated using transfilter assays. Histological structure was analysed in stained sections. Protein expression was evaluated by immunohistochemistry.Resultss-PRGF promoted the robust proliferation of epithelial cultures at any concentration, similar to FBS. Likewise, s-PRGF and FBS produced similar re-epithelialization rates in in vitro wound-healing assays. In vivo, s-PRGF treatment accelerated corneal wound healing in comparison with control treatment. This difference was significant only for 100% s-PRGF treatment in our healthy rabbit model. Histological analysis confirmed normal epithelialization in all cases. Immunohistochemistry showed a higher expression of cytokeratins 3/76 and 15, zonula occludens-1 and alpha-smooth muscle actin proteins as a function of s-PRGF concentration. Notably, keratocyte density in the anterior third of the stroma increased with increase in s-PRGF concentration, suggesting an in vivo chemotactic effect of s-PRGF on keratocytes that was further confirmed in vitro.Conclusions-PRGF promotes proliferation and migration and influences limbal stemness, adhesion and fibrosis during corneal healing.
      PubDate: 2017-03-07T01:35:45.119128-05:
      DOI: 10.1111/aos.13371
  • Aqueous chlorhexidine is an effective alternative to povidone–iodine for
           intravitreal injection prophylaxis
    • Authors: Carmen L. Oakley; Brendan J. Vote
      PubDate: 2017-03-06T01:50:41.614694-05:
      DOI: 10.1111/aos.13340
  • Changes in lipidomic profile of aqueous humour in Fuchs endothelial
    • Authors: Javier Cabrerizo; Javier Aritz Urcola, Elena Vecino, Gerrit Melles
      Abstract: PurposeTo identify and determine differences in lipid profile of aqueous humour (AH) in patients with Fuchs endothelial corneal dystrophy (FECD).MethodsLipidomic profile of eight AH samples of FECD patients and 10 control samples was analysed. Patients with previous history of anterior segment surgery, anterior segment pathology or intraocular injections were excluded. Topical ocular medications within the last 6 months were reported. Aqueous humour (AH) was obtained during the first step of Descemet membrane endothelial keratoplasty in FECD patients and during refractive lensectomy in the control group. Lipidomic ultra-performance liquid chromatography mass spectrometry was used to perform an optimal profiling of glycerolipids, sterol lipids, sphingolipids and glycerophospholipids. Metabolite extraction was accomplished by fractionating the samples into pools of species with similar physicochemical properties.ResultsThe levels of 27 of 110 lipids change significantly in the AH of FECD eyes when compared to control samples. The concentration of most diacylglycerophosphocholines and 1-ether, 2-acylglycerophosphocholines increases in the AH of FECD eyes when compared to healthy controls. In addition, eight sphingomyelins and up to two long-chain highly unsaturated cholesteryl esters present higher levels in FECD samples when compared to controls.ConclusionThe lipid composition of AH in FECD patients differs from that of healthy subjects. Those changes may reflect oxidative stress-related changes in the lipid metabolism of the corneal endothelial cells in FECD.
      PubDate: 2017-03-04T02:40:29.361491-05:
      DOI: 10.1111/aos.13374
  • Issue Information
    • Pages: 221 - 224
      PubDate: 2017-04-12T04:35:21.679026-05:
      DOI: 10.1111/aos.13262
  • This issue of ACTA
    • Authors: Einar Stefánsson
      Pages: 227 - 228
      PubDate: 2017-04-12T04:35:23.103024-05:
      DOI: 10.1111/aos.13458
  • Robot-assisted retinal vein cannulation in an in vivo porcine retinal
           vein occlusion model
    • Authors: Koen Willekens; Andy Gijbels, Laurent Schoevaerdts, Laure Esteveny, Tom Janssens, Bart Jonckx, Jean H. M. Feyen, Caroline Meers, Dominiek Reynaerts, Emmanuel Vander Poorten, Peter Stalmans
      Pages: 270 - 275
      Abstract: PurposeTo evaluate the feasibility of robot-assisted retinal vein cannulation for retinal vein occlusion.MethodsProspective experimental study performed in in vivo porcine eyes. A standard three port pars plana vitrectomy was followed by laser-induced branch retinal vein occlusion. Consequently, a retinal vein cannulation with the help of a surgical robot and a microneedle was performed. Complete success was defined as a stable intravenous position of the needle tip confirmed by blood washout for at least 3 min. Secondary outcomes were the occurrence of intra-operative complications and technical failures.ResultsCannulation was successful in 15 of 18 eyes with a complete success rate (duration of infusion of more than 3 min) of 73% after exclusion of two eyes from analysis due to failure in establishing a blood clot. There were no technical failures regarding the robotic device. The intravessel injections of ocriplasmin in two of two eyes led to a clot dissolution. In a subset of five eyes, a second cannulation attempt at the border of the optic disc resulted in a stable intravessel position and infusion during 362 (±138) seconds.ConclusionRobot-assisted retinal vein cannulation with prolonged infusion time is technically feasible. Human experiments are required to analyse the clinical benefit of this new therapy.
      PubDate: 2017-01-13T02:06:06.753734-05:
      DOI: 10.1111/aos.13358
  • Authors reply to: toric intraocular lens implantation in children with
    • Authors: Jagat Ram
      PubDate: 2016-12-14T05:15:32.608907-05:
      DOI: 10.1111/aos.13366
  • Genotype and Phenotype in an unusual form of
           Laurence–Moon–Bardet–Biedl syndrome
    • Authors: Christina Kamme; Anja Kathrin Mayer, Tim M. Strom, Sten Andréasson, Nicole Weisschuh
      PubDate: 2016-11-23T06:05:34.016614-05:
      DOI: 10.1111/aos.13293
  • Correlation of vitamin D levels with tear film stability and secretion in
           patients with dry eye syndrome
    • Authors: Ki Won Jin; Jin Woo Ro, Young Joo Shin, Joon Young Hyon, Won Ryang Wee, Shin Goo Park
      Abstract: PurposeTo investigate tear film stability and secretion according to serum 25-hydroxyvitamin D3 [25(OH)D] levels in dry eye patients.MethodsIn this retrospective observational study, the medical charts of 92 patients who visited the Department of Ophthalmology at Hallym University Kangnam Sacred Heart Hospital from April to August 2015 were reviewed. Serum 25(OH)D levels were measured. Subjects were divided into three groups according to serum 25(OH)D levels: sufficient, inadequate or deficient group. Eye discomfort was measured by ocular surface disease index (OSDI). Tear break-up time (TBUT), fluorescein staining score and Schirmer's tear secretion test were measured.ResultsThe mean age was 53.38 ± 13.69 years. Mean serum 25(OH)D level was 14.41 ± 5.98 ng/ml. Tear break-up time (TBUT) and tear secretion were positively correlated with serum 25(OH)D levels (r = 0.389, p = 0.001; and r = 0.428, p 
      PubDate: 2016-11-22T08:05:30.293058-05:
      DOI: 10.1111/aos.13241
  • Toric intraocular lens implantation in children with developmental
           cataract and preexisting corneal astigmatism
    • Authors: Haisong Chen; Jiawei Wang
      PubDate: 2016-11-19T02:35:20.792898-05:
      DOI: 10.1111/aos.13312
  • A minimally invasive adjustable-depth blunt injector for delivery of
           pharmaceuticals into the posterior pole
    • Authors: Ygal Rotenstreich; Adi Tzameret, Sapir E. Kalish, Ettel Bubis, Michael Belkin, Iris Moroz, Mordechai Rosner, Itay Levy, Shlomo Margel, Ifat Sher
      Abstract: PurposeTo investigate the feasibility and safety of a novel minimally invasive adjustable-depth blunt injector for pharmaceuticals delivery into the posterior segment.MethodsIndocyanine green (ICG), sodium fluorescein and iron oxide nanoparticles (IONPs) were injected using the new injector into the extravascular spaces of the choroid (EVSC) compartment of rabbits and cadaver pig eyes. Spectral domain optical coherence tomography (SD-OCT), fundus imaging and histology analysis were performed for assessment of injection safety and efficacy.ResultsIndocyanine green, fluorescein and IONPs were detected across the EVSC in rabbit eyes, covering over 80 per cent of the posterior eye surface. Injected IONPs were retained in the EVSC for at least 2 weeks following injection. No retinal detachment, choroidal haemorrhage or inflammation was detected in any of the injected eyes. In cadaver pig eyes, ICG was detected across the EVSC.ConclusionsThis novel minimally invasive delivery system may be used to safely deliver large volumes of pharmaceuticals into a new treatment reservoir compartment – the EVSC which can serve as a depot, in close proximity to the retina, covering most of the surface of the back of the eye without insertion of surgical instruments under the central retina. This system is predicted to enhance the therapeutic effect of treatments for posterior eye disorders.
      PubDate: 2016-10-25T01:15:31.639626-05:
      DOI: 10.1111/aos.13238
  • Cataract surgery affects the pupil size and pupil constrictions, but not
           the late post-illumination pupil response
    • Authors: Shakoor Ba-Ali; Henrik Lund-Andersen, Adam Elias Brøndsted
      PubDate: 2016-10-25T00:21:00.894564-05:
      DOI: 10.1111/aos.13291
  • Analysis of the impact of allergy and atopy on new onset of uveitis
    • Authors: Rafael S. Grajewski; Niusha Barahmand Pour, Katja Burian, Albert Caramoy, Bernd Kirchhof, Claus Cursiefen, Ludwig M. Heindl
      Abstract: PurposeThe inappropriate immune response to harmless foreign and self-antigens is a common feature of allergy, atopy and autoimmune disease. The influence of environmental factors in the initiation of autoimmunity is not well understood. It is conceivable that immune responses to allergens may also serve as a trigger of bystander immune reactions, including autoimmunity such as uveitis. Therefore, we wanted to investigate the prevalence of allergies and atopy in patients with different types of uveitis in comparison to a control cohort.MethodsIn total, 530 consecutive patients with new-onset anterior, intermediate, posterior and panuveitis were compared to a non-uveitis control cohort consisting of 1.060 consecutive new-referral patients who attended our specialized outpatient clinics for other reasons than uveitis. Allergy and atopy status as well as demographic data (age, gender and ethnicity) were obtained by standardized interviewer-assisted questionnaires.ResultsUveitis case cohort and control cohort did not differ significantly in the allergy status (p = 0.910), such as the history of pollen allergy (p = 0.671), history of drug allergy (p = 0.920), history of food allergy (p = 0.941), history of house dust mite allergy (p = 0.197) or history of other allergens (p = 0.593), nor in the atopy status (p = 0.802), such as the history of atopic dermatitis (p = 0.365), history of asthma (p = 0.430) or history of allergic rhinitis (p = 0.115).ConclusionsOur results argue against a substantial influence of allergies and atopy on the onset of uveitis.
      PubDate: 2016-09-29T07:02:04.175322-05:
      DOI: 10.1111/aos.13239
  • Detection of Kayser–Fleischer ring using Scheimpflug imaging
    • Authors: Niklas Telinius; Peter Ott, Jesper Hjortdal
      PubDate: 2016-09-29T05:11:07.536119-05:
      DOI: 10.1111/aos.13271
  • Anterior lens epithelium in cataract patients with retinitis pigmentosa
           – scanning and transmission electron microscopy study
    • Authors: Sofija Andjelic; Kazimir Drašlar, Anastazija Hvala, Marko Hawlina
      Abstract: PurposeIn retinitis pigmentosa (RP) patients, relatively minor lens opacity in central part of posterior pole of the lens may cause disproportionate functional symptoms requiring cataract operation. To investigate the possible structural reasons for this opacity development, we studied the structure of the lens epithelium of patients with RP.MethodsThe anterior lens capsule (aLC: basement membrane and associated lens epithelial cells, LECs) was obtained from cataract surgery and prepared for scanning and transmission electron microscopy (SEM and TEM).ResultsBoth SEM and TEM show a number of abnormal features in the anterior lens epithelium of cataract patients with RP. The abnormalities appear mainly as holes, thinning and degradation of the epithelium, with the dimensions from
      PubDate: 2016-09-28T06:42:42.353351-05:
      DOI: 10.1111/aos.13250
  • Ring-shaped dysphotopsia associated with posterior chamber phakic
           implantable collamer lenses with a central hole
    • Authors: Youngsub Eom; Dae Wook Kim, Dongok Ryu, Jun-Heon Kim, Seul Ki Yang, Jong Suk Song, Sug-Whan Kim, Hyo Myung Kim
      Abstract: PurposeTo evaluate the incidence of central hole-induced ring-shaped dysphotopsia after posterior chamber phakic implantable collamer lens (ICL) with central hole (hole ICL) implantation and to investigate the causes of central hole-induced dysphotopsia.MethodsThe clinical study enrolled 29 eyes of 15 consecutive myopic patients implanted with hole ICL. The incidence of ring-shaped dysphotopsia after hole ICL implantation was evaluated. In the experimental simulation study, non-sequential ray tracing was used to construct myopic human eye models with hole ICL and ICL without a central hole (conventional ICL). Simulated retinal images measured in log-scale irradiance were compared between the two ICLs for an extended Lambertian light-emitting disc object 20 cm in diameter placed 2 m from the corneal vertex. To investigate the causes of hole-induced dysphotopsia, a series of retinal images were simulated using point sources at infinity with well-defined field angles (0 to −20°) and multiple ICL models.ResultsOf 29 eyes, 15 experienced ring-shaped dysphotopsia after hole ICL implantation. The simulation study using an extended Lambertian source showed that hole ICL-evoked ring-shaped dysphotopsia was formed at a retinal field angle of ±40°. Component-level analysis using a well-defined off-axis point source from infinity revealed that ring-shaped dysphotopsia was generated by stray light refraction from the inner wall of the hole and the posterior ICL surface.ConclusionHole ICL-evoked ring-shaped dysphotopsia was related to light refraction at the central hole structure. Surgeons are advised to explain to patients the possibility of ring-shaped dysphotopsia after hole ICL implantation.
      PubDate: 2016-09-28T06:16:11.854632-05:
      DOI: 10.1111/aos.13248
  • Aqueous humour concentrations of TGF-β, PLGF and FGF-1 and total retinal
           blood flow in patients with early non-proliferative diabetic retinopathy
    • Authors: Lee-Anne Khuu; Faryan Tayyari, Jeremy M. Sivak, John G. Flanagan, Shaun Singer, Michael H. Brent, David Huang, Ou Tan, Christopher Hudson
      Abstract: PurposeTo correlate angiogenic cytokines in the aqueous humour with total retinal blood flow in subjects with type 2 diabetes with non-proliferative diabetic retinopathy (NPDR).MethodsA total of 17 controls and 16 NPDR patients were recruited into the study. Aqueous humour was collected at the start of cataract surgery to assess the concentration of 14 angiogenic cytokines. Aqueous humour was analysed using the suspension array method. Six images were acquired to assess total retinal blood flow (TRBF) using the prototype RTVue™ Doppler Fourier domain optical coherence tomography (Doppler FD-OCT) (Optovue, Inc., Fremont, CA) using a double circular scan protocol, 1 month postsurgery. At the same visit, forearm blood was collected to determine glycosylated haemoglobin (A1c).ResultsTransforming growth factor beta (TGF-β1, TGF-β2) and PLGF were increased while FGF-1 was reduced in NPDR compared to controls (Bonferroni corrected, p 
      PubDate: 2016-09-28T05:55:46.16704-05:0
      DOI: 10.1111/aos.13230
  • Genome sequencing identifies a large deletion at 13q32.1 as the cause of
           microcoria and childhood-onset glaucoma
    • Authors: Panagiotis I Sergouniotis; Jamie M Ellingford, James O'Sullivan, Cecilia H Fenerty, Graeme C Black
      PubDate: 2016-09-28T05:42:07.63062-05:0
      DOI: 10.1111/aos.13246
  • Surgical outcomes of lamellar macular holes with and without lamellar
           hole-associated epiretinal proliferation
    • Authors: Jaesang Ko; Gyu Ah Kim, Sung Chul Lee, Jihwan Lee, Hyoung Jun Koh, Sung Soo Kim, Suk Ho Byeon, Christopher Seungkyu Lee
      Abstract: PurposeTo report the clinical findings and surgical outcomes of lamellar macular holes (LMHs) with and without lamellar hole-associated epiretinal proliferation (LHEP).MethodsA retrospective review was performed of 73 eyes of 73 patients who underwent vitrectomy for LMH. Patients were grouped according to the presence of LHEP on preoperative spectral-domain optical coherence tomography (SD-OCT). Postoperative best-corrected visual acuity (BCVA) and OCT features were compared between LMH patients with and without LHEP.ResultsLamellar hole-associated epiretinal proliferation (LHEP) was found in 15 of 73 eyes with LMHs (20.5%). The mean age was 65.0 years. The mean follow-up duration was 21.5 months. Preoperatively, eyes with LHEP were characterized by a greater hole diameter (p = 0.007), thinner fovea (p = 0.002) and greater incidence of outer retinal disruption (p 
      PubDate: 2016-09-20T07:05:25.2456-05:00
      DOI: 10.1111/aos.13245
  • Elevated intraocular pressure increases melatonin levels in the aqueous
    • Authors: Hanan Alkozi; Juan Sánchez-Naves, Maria Jesús Perez Lara, Gonzalo Carracedo, Begoña Fonseca, Alejandro Martinez-Aguila, Jesús Pintor
      Abstract: PurposeTo study the levels of melatonin in the aqueous humour of normotensive and hypertensive intraocular pressure (IOP) patients and to compare them to an animal model of glaucoma.MethodsA total of 37 eyes of 37 patients who underwent cataract surgery were included in the study and were divided into normotensive patients, with IOP below 21 mmHg (n = 23), and hypertensive patients, with IOP > 21 mmHg (n = 14). Glaucomatous DBA/2J (n = 6) and control C57BL/6J (n = 6) mice presenting 3 and 12 months of age for each strain were also used. Human and mice aqueous humours were aspirated using a 30-gauge Rycroft cannula on a tuberculin syringe and further processed to quantify melatonin by high-performance liquid chromatography analysis.ResultsMelatonin levels in normotensive patients (IOP below 21 mmHg) presented values as medians (first quartile; third quartile) of 14.62 (5.38;37.99) ng/ml (n = 23), while hypertensive patients (IOP above 21 mmHg) showed melatonin concentrations of 46.63 (10.28; 167.28) ng/ml (n = 14; p 
      PubDate: 2016-09-06T00:40:29.183372-05:
      DOI: 10.1111/aos.13253
  • Intraocular lens dislocation in pseudoexfoliation: a systematic review and
    • Authors: Pedro Vazquez-Ferreiro; Francisco J. Carrera-Hueso, Narjis Fikri-Benbrahim, Lidia Barreiro-Rodriguez, Marta Diaz-Rey, María Auxiliadora Ramón Barrios
      Abstract: PurposeTo evaluate the impact of pseudoexfoliation syndrome on intraocular lens (IOL) dislocation after phacoemulsification cataract surgery and explore possible associations related to surgical technique.MethodsWe systematically searched the MEDLINE, Embase, Web of Science, Cochrane, and Lilacs databases and grey literature sources and identified (on March 1, 2016) 14 cohort and case–control studies comparing IOL dislocation in patients with and without pseudoexfoliation syndrome who had undergone phacoemulsification. Study quality was assessed using the STROBE scale. An inverse-variance fixed-effects model was used to calculate weighted odds ratios (ORs) and 95% confidence intervals (CI).ResultsThe pooled analysis yielded an OR of 6.02 (95% CI: 3.7, 9.79) for IOL dislocation in patients with pseudoexfoliation, and similarly, high ORs were detected for both early and late (3 months after surgery) dislocation (OR 5.26; 95% CI: 1.05; 26.32 versus OR 6.02; 95% CI: 3.67; 10.17). No significant associations were detected when the results were stratified by year, incision size or use of hooks or retractors.ConclusionsPatients with pseudoexfoliation syndrome have a high risk of late IOL dislocation after phacoemulsification cataract surgery, and this risk may be related to the use of large incisions and hooks or retractors.
      PubDate: 2016-08-29T07:05:43.501419-05:
      DOI: 10.1111/aos.13234
  • Role of artificial tears in reducing the recurrence of pterygium after
           surgery: a prospective randomized controlled trial
    • Authors: Kosol Kampitak; Wichai Leelawongtawun, Supinda Leeamornsiri, Wannisa Suphachearaphan
      Abstract: PurposeTo determine whether artificial tears can reduce recurrence of pterygium after surgery.MethodsA total of 128 primary pterygium cases after excision were randomized into two groups according to postoperative drugs: 64 cases received topical dexamethasone (control group), and 64 cases received topical dexamethasone and hydroxypropyl methylcellulose (treatment group). The pterygium was removed with amniotic membrane graft technique in all cases. Recurrence was observed within 6 months after surgery, and survival analysis was used to evaluate the difference between groups.ResultsThere were no significant differences in age and gender of patients, size of pterygium, Schirmer's test results and tear breakup time between both groups (p > 0.05). Recurrence rate in the treatment group (16%) was significantly less than the control group (33%), p = 0.018 (log-rank test).ConclusionUsing artificial tears as an adjunctive drug could lower pterygium recurrence after excision.
      PubDate: 2016-08-13T00:51:26.151325-05:
      DOI: 10.1111/aos.13176
  • Evaluation of circumferential angle closure using iridotrabecular contact
           index after laser iridotomy by swept-source optical coherence tomography
    • Authors: Hyun-kyung Cho; Dongsub Ahn, Changwon Kee
      Abstract: PurposeTo investigate the quantitative changes of circumferential angle closure after laser iridotomy (LI) using the iridotrabecular contact (ITC) index by Swept-Source optical coherence tomography (OCT).MethodsIn this prospective observational study conducted in a hospital setting, 42 eyes of 36 patients (five males, 31 females) who underwent LI were included. The mean age was 65.00 ± 8.13 years old and the diagnosis included primary angle closure (PAC, 21 eyes), PAC suspect (16 eyes) and PAC glaucoma (five eyes). Optical coherence tomography (OCT) images were obtained pre-LI and at 1 week post-LI. In each image frame, the scleral spur (SS) and the ITC end-point were marked, from which the ITC index was calculated as a percentage of the angle closure across 360°. Measurements inspected before and after LI included: central anterior chamber depth (ACD), anterior chamber volume (ACV), lens vault (LV), nasal and temporal angle opening distance (AOD), angle recess area (ARA), trabecular-iris space area (TISA), trabecular-iris angle (TIA) at 500 μm and 750 μm from the SS and intraocular pressure (IOP).ResultsThe ITC index and IOP decreased significantly after LI from 71.52 ± 26.29 to 35.31 ± 27.19 and from 20.64 ± 12.72 mmHg to 14.02 ± 3.49 mmHg, respectively (p 
      PubDate: 2016-08-13T00:25:31.222022-05:
      DOI: 10.1111/aos.13190
  • Surgical responses and outcomes of bilateral lateral rectus recession in
           exotropia with cerebral palsy
    • Authors: Dae Joong Ma; Hee Kyung Yang, Jeong-Min Hwang
      Abstract: PurposeTo determine surgical responses and outcomes of bilateral lateral rectus (BLR) recession in exotropes with cerebral palsy (CP) and to compare the results with exotropes without CP.MethodsForty-one exotropes with CP and 82 age- and type (intermittent or constant)-matched exotropes without CP who underwent BLR recession by one surgeon (J-M.H.) were evaluated. Main outcome measures were surgical responses, factors affecting surgical response, success rates, cumulative probabilities of success and recurrence, and drifts of ocular alignment towards exodeviation after surgery (exodrift).ResultsThe surgical responses of BLR recession were not significantly different between both groups (p = 0.136). After a mean follow-up period of 2 years, success rates showed no significant difference between the two groups (p = 1.000). The cumulative probabilities of success and recurrence were not significantly different between the two groups (p = 0.770 and 0.754, respectively). The rate of recurrence per person-year during follow-up was 16.7% in patients with CP and 20.2% in patients without CP. The amount of exodrift showed no significant difference between both groups (p = 0.118).ConclusionsExotropes with CP showed a similar surgical response, an amount of exodrift, cumulative success and recurrence rates after BLR recession compared to exotropes without CP.
      PubDate: 2016-07-16T00:10:29.076673-05:
      DOI: 10.1111/aos.13158
  • Povidone-iodine is still a premium antiseptic measure in ocular surgery
    • Authors: Andrzej Grzybowski; Piotr Brona
      PubDate: 2016-06-08T05:01:22.857476-05:
      DOI: 10.1111/aos.13144
  • Refining the definition of the choroidal–scleral interface
    • Authors: Preeti Gupta; Carol Y. Cheung
      PubDate: 2016-05-27T06:51:23.736545-05:
      DOI: 10.1111/aos.13101
  • Alzheimer's disease and glaucoma: can glymphatic system dysfunction
           underlie their comorbidity?
    • Authors: Peter Wostyn; Veva De Groot, Debby Van Dam, Kurt Audenaert, Hanspeter Esriel Killer, Peter Paul De Deyn
      PubDate: 2016-04-29T04:51:25.095482-05:
      DOI: 10.1111/aos.13068
  • Injection scheme for intravitreal bevacizumab therapy for macular oedema
           due to central retinal vein occlusion: results of a multicentre study
    • Authors: Gesine B. Szurman; Kai Januschowski, Peter Szurman, Nicolas Feltgen, Bernhard Spitzer, Amelie Pielen, Matus Rehak, Georg Spital, Spyridon Dimopoulos, , Carsten H. Meyer
      PubDate: 2016-02-01T06:35:18.384435-05:
      DOI: 10.1111/aos.12976
  • Reticular pseudodrusen characterization by retromode imaging
    • Authors: Mariacristina Parravano; Lea Querques, Antonluca Boninfante, Paola Giorno, Monica Varano, Francesco Bandello, Giuseppe Querques
      PubDate: 2016-01-27T08:17:37.685601-05:
      DOI: 10.1111/aos.12948
  • Cross-linking in children with keratoconus: a systematic review and
    • Authors: Lisa McAnena; Frank Doyle, Michael O'Keefe
      Pages: 229 - 239
      Abstract: Keratoconus can behave more aggressively in pediatric than in adult patients. We systematically reviewed the literature to determine the effectiveness of corneal collagen cross-linking (CXL) in children. For this study, MEDLINE® and Cochrane databases were searched for all studies examining the effects of standard, trans-epithelial or accelerated CXL protocols in patients age 18 years or younger. Primary outcomes were; uncorrected visual acuity (UCVA) and maximum keratometry (Kmax) and secondary outcomes were; best-corrected visual acuity (BCVA), mean refractive spherical equivalent (MRSE), central corneal thickness (CCT) and endothelial cell density (ECD). Standardized mean differences (SMD) and 95% confidence intervals were calculated, comparing baseline values with those at 6, 12 and 24 months. A total of 13 papers, published between May 2011 and December 2014 examining 490 eyes of 401 patients with a mean age of 15.25 (±1.5) years, were included in the qualitative analysis in this review. Nine papers were included in the meta-analysis, showing significant improvement in UCVA and BCVA and stable Kmax at 12 months, and stable UCVA, improved BCVA and improved Kmax at 24 months in the standard protocol group UCVA, BCVA and KMax were stable at 12 months in the trans-epithelial group. Mean refractive spherical equivalent (MRSE), CCT and ECD remained stable in both groups. In conclusion it was found that standard CXL may be effective in halting progression of keratoconus in pediatric patients at 1 year. However, larger, more long-term studies are required to ascertain its effectiveness.
      PubDate: 2016-09-28T06:45:54.724344-05:
      DOI: 10.1111/aos.13224
  • The intronic ABCA4 c.5461-10T>C variant, frequently seen in patients with
           Stargardt disease, causes splice defects and reduced ABCA4 protein level
    • Authors: Ingvild Aukrust; Ragnhild W. Jansson, Cecilie Bredrup, Hilde E. Rusaas, Siren Berland, Agnete Jørgensen, Marte G. Haug, Eyvind Rødahl, Gunnar Houge, Per M. Knappskog
      Pages: 240 - 246
      Abstract: PurposeDespite being the third most common ABCA4 variant observed in patients with Stargardt disease, the functional effect of the intronic ABCA4 variant c.5461-10T>C is unknown. The purpose of this study was to investigate the molecular effect of this variant.MethodsFibroblast samples from patients carrying the ABCA4 variant c.5461-10T>C were analysed by isolating total RNA, followed by real-time polymerase chain reaction (RT-PCR) using specific primers spanning the variant. For detection of ABCA4 protein, fibroblast samples were lysed and analysed by SDS-PAGE followed by immunoblotting using a monoclonal ABCA4 antibody.ResultsThe ABCA4 variant c.5461-10T>C causes a splicing defect resulting in the reduction of full-length mRNA in fibroblasts from patients and the presence of alternatively spliced mRNAs where exon 39–40 is skipped. A reduced level of full-length ABCA4 protein is observed compared to controls not carrying the variant.ConclusionsThis study describes the functional effect and the molecular mechanism of the pathogenic ABCA4 variant c.5461-10T>C. The variant is functionally important as it leads to splicing defects and a reduced level of ABCA4 protein.
      PubDate: 2016-10-24T04:20:44.879103-05:
      DOI: 10.1111/aos.13273
  • Primary rhegmatogenous retinal detachment – surgical methods and
           anatomical outcome
    • Authors: Marta Haugstad; Stefan Moosmayer, Ragnheiður Bragadόttir
      Pages: 247 - 251
      Abstract: PurposeThe aim of the study was to evaluate the anatomical success of surgical management of primary rhegmatogenous retinal detachment (RRD) and to compare the anatomical outcomes from different surgical techniques.MethodsDuring 2012, 517 consecutive eyes (514 patients) were operated by 11 surgeons at the Department of Ophthalmology, Oslo University Hospital. Patient records were retrospectively analysed with no exclusions. Main outcome measures were primary and final anatomical success. Primary anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations excluded. Final anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations included.ResultsIncidence of RRD was 18.6 eyes per 100 000 person-years. The macula was detached in 50.5% of the eyes at baseline. Of 517 operated eyes, 317 (61.3%) underwent pars plana vitrectomy (PPV), 23 (4.5%) pars plana vitrectomy together with a scleral buckle (PPV-SB), 175 (33.9%) scleral buckle (SB) surgery and two (0.4%) pneumatic retinopexy (PR). Primary anatomical success was 89.0% in the PPV group, 87.0% in the PPV-SB group and 85.7% in the SB group. Final anatomical success was 98.1% in the PPV group, 100% in the PPV-SB group and 99.4% in the SB group. Factors which were correlated to the redetachment were detachment of more than 6 clock hours (p = 0.003) and visual acuity (VA) on Snellen chart
      PubDate: 2016-11-18T07:00:25.361709-05:
      DOI: 10.1111/aos.13295
  • Reduced metabolic function and structural alterations in inherited retinal
           dystrophies: investigating the effect of peripapillary vessel oxygen
           saturation and vascular diameter on the retinal nerve fibre layer
    • Authors: Rossiana I. Bojinova; Cengiz Türksever, Andreas Schötzau, Christophe Valmaggia, Daniel F. Schorderet, Margarita G. Todorova
      Pages: 252 - 261
      Abstract: PurposeTo evaluate the relationship between the peripapillary metabolic alterations [retinal vessel Oximetry (RO)] and the structural findings [retinal vessel diameter and retinal nerve fibre layer thickness (RNFL)] in patients with inherited retinal dystrophies (IRD).MethodsPatients with IRD [24 patients with rod-cone dystrophy (RCD), 15 patients with cone-rod dystrophy, 13 patients with inherited maculopathy] and 18 age-matched controls, who underwent RO imaging and spectral domain optical coherence tomography, were included. The average and quadrant oxygen saturation in all four major peripapillary retinal arterioles (A-SO2) and venules (V-SO2) were measured, and their difference (A-V SO2) was calculated. The corresponding retinal vessel diameter of these arterioles (D-A) and venules (D-V) was measured. The data were compared to the peripapillary RNFL thickness within the IRD subgroups and to the data obtained in the controls.ResultsIn general, patients with IRD had higher average V-SO2 values when compared to controls (p ≤ 0.029). Rod-cone dystrophy (RCD) patients differed from controls, but also from patients with other IRDs, when the average and quadrant oxygen saturation values (A-SO2 and V-SO2) were evaluated (p ≤ 0.026). Within the RCD group, the correlations of RNFL thickness to V-SO2, A-V SO2, D-A and D-V were significant (p ≤ 0.030), thus indicating a different relationship between the RNFL thickness and the examined parameters, when compared to the other groups.ConclusionIt becomes evident from our combined metabolic–structural approach that a prediction model, to identify which individual is at risk of developing a photoreceptor degeneration of RCD type, can be proposed. It will take into account the peripapillary retinal oxygen saturation, the retinal vessel diameter and the RNFL thickness values.
      PubDate: 2016-09-29T06:11:41.755452-05:
      DOI: 10.1111/aos.13247
  • Macular thickness in healthy eyes of adults (N = 4508) and relation to
           sex, age and refraction: the Tromsø Eye Study (2007–2008)
    • Authors: Therese Hanno; Anette C. Lade, Ellisiv B. Mathiesen, Tunde Peto, Inger Njølstad, Geir Bertelsen
      Pages: 262 - 269
      Abstract: PurposeTo provide sex-stratified normative data on retinal thickness and study the relationship with sex, age and refractive status.MethodsPopulation-based study including 2617 women and 1891 men, aged 38–87 (mean 61 ± 8) years, without diabetes, glaucoma and retinal diseases, and spherical equivalent refraction (SER) within ±6 dioptres. Retinal thickness was measured with optical coherence tomography (spectral domain Cirrus HD-OCT).ResultsWomen had thinner retina than men. Retinal thickness was significantly associated with refraction, where mean change in retinal thickness per 1 D increase in SER was −1.3 (0.2) μm in the fovea, 0.7 (0.1) μm in the pericentral ring and 1.4 (0.1) μm in the peripheral ring. In the fovea, there was a non-monotonic curved relationship between retinal thickness and age in both sexes with a maximum at about 60 years (p 
      PubDate: 2016-12-18T06:45:28.548436-05:
      DOI: 10.1111/aos.13337
  • Prevalence of posterior vitreous detachment in glaucoma patients and
    • Authors: Christoph Schwab; Wilfried Glatz, Bernd Schmidt, Ewald Lindner, Karl Oettl, Regina Riedl, Andreas Wedrich, Domagoj Ivastinovic, Michaela Velikay-Parel, Georg Mossboeck
      Pages: 276 - 280
      Abstract: PurposeTo evaluate the impact of oxidative stress – present in glaucoma – on the vitreous. We therefore compare the presence of early and late stages of posterior vitreous detachment (PVD) between patients with glaucoma and controls.MethodsThe vitreous state was evaluated by the combination of optical coherence tomography and ultrasound. The main outcome was the vitreous state classified into ‘no PVD’, ‘initial PVD’ and ‘advanced PVD’.ResultsWe evaluated the vitreous state in 48 patients with glaucoma (age: mean 66.5 ± 11.9 years; visual field deviation: mean 10.4 ± 6.8 dB) and compared the results with 101 previously investigated controls (age: mean 73.6 ± 9.3 years). After one-to-one matching on age and sex, ordinal logistic regression revealed that patients with glaucoma were significantly more likely to exhibit advanced PVD stages compared to non-glaucoma patients (OR 2.60, 95% confidence interval: 1.06–6.36, p = 0.037).ConclusionOur results suggest that the presence or absence of PVD might be a valuable hint for diagnosing glaucoma – however, further research is needed to determine whether PVD can be used to supplement current glaucoma screening guidelines.
      PubDate: 2016-12-14T05:05:28.618969-05:
      DOI: 10.1111/aos.13339
  • Detection of glaucoma progression by perimetry and optic disc photography
           at different stages of the disease: results from the Early Manifest
           Glaucoma Trial
    • Authors: HannaMaria Öhnell; Anders Heijl, Harald Anderson, Boel Bengtsson
      Pages: 281 - 287
      Abstract: PurposeTo compare the earliest detection of progression in visual fields and monoscopic optic disc photographs at different stages of manifest glaucoma.MethodsThis study evaluated 306 eyes in 249 patients with manifest open-angle glaucoma included in the Early Manifest Glaucoma Trial (EMGT). All patients in the trial were followed up regularly by standard automated perimetry and monoscopic optic disc photography, and the median follow-up time was 8 years. Progression was assessed in series of optic disc photographs and in series of visual fields using glaucoma change probability maps and the predefined EMGT progression criterion. The proportion of progressions detected first in visual fields and the proportion detected first in optic disc photographs were compared at different stages of glaucoma severity defined by the perimetric mean deviation (MD) of the baseline visual field.ResultsAssessment of 210 eyes with early visual field loss, 83 eyes with moderate field loss, and 13 eyes with advanced field loss showed that, among the eyes exhibiting progression, the progression was detected first in the visual field in 80%, 79% and 100%, respectively. The predominance of visual field progressions at all stages was still apparent when using narrower (3-dB) MD intervals for staging.ConclusionIn the EMGT material on eyes with manifest open-angle glaucoma, the initial progression was detected much more often in the visual field series than in the optic disc photographs at all stages of disease.
      PubDate: 2016-10-25T01:05:44.713164-05:
      DOI: 10.1111/aos.13290
  • Ocular traumas in working age adults in Finland – Helsinki Ocular
           Trauma Study
    • Authors: Ahmad Sahraravand; Anna-Kaisa Haavisto, Juha M. Holopainen, Tiina Leivo
      Pages: 288 - 294
      Abstract: PurposeTo describe epidemiology, causes, treatments and outcomes of ocular injuries in adults aged 17 to 60 in southern Finland.MethodsAll new ocular trauma patients admitted to the Helsinki University Eye Hospital (HUEH), during 1 year in 2011–2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3 months.ResultsThe incidence for ocular injury was 88/100 000/year. From 831 trauma patients, 80% were men, 34% were work-related injuries, and 11% were assaults. Most of the injuries were minor traumas (54%). Contusions (22.5%) and chemical injuries and burns (13%) were common. Fractures (5%), lid wounds (3%), open globe injuries (OGI, 2%) and optic nerve injuries (0.5%) were rare. The main causes of ocular injury were superficial foreign bodies (33%), chemicals (13%), body parts (13%) and sports equipment (10%). The most dangerous objects were needles, stones, pellet guns, tools and guns. No patient with OGI used protective eyewear. All OGI and most of contusions needed a lifelong follow-up. Permanent impairment (73 patients, 9%) was caused most often by body parts, sports equipment and work tools.ConclusionA typical ocular trauma patient was a man aged 31–45 with a minor trauma caused by a foreign body at work and a final visual acuity of 20/20. Most common serious injuries were contusion, OGI or fracture at home or at work and were caused by a body part, sport equipment or work tool. Factors causing common and serious eye injuries provide the targets for protective measures.
      PubDate: 2016-12-09T07:27:06.930059-05:
      DOI: 10.1111/aos.13313
  • Histological and clinical evaluation of the hard palate mucous membrane
           graft for treatment of lower eyelid retraction
    • Authors: Sofie D.H. Larsen; Steffen Heegaard, Peter B. Toft
      Pages: 295 - 298
      Abstract: PurposeTo evaluate the histological appearances of the epithelial cells and the clinical effect of the hard palate mucous membrane (HPM) graft for the treatment of lower eyelid retraction (LER).MethodsThis was a follow-up study involving 15 patients, with a total of 16 eyes operated. Five patients had LER as a result of Graves' ophthalmopathy and/or inferior rectus recession, six patients because of wearing an eye prosthesis, two patients because of previous tumour excision, one patient because of proptosis due to sphenoid wing meningioma and one patient because of previous lower eyelid blepharoplasty. Three imprint biopsies were taken from each patient, one from the tarsal conjunctiva in the healthy eye, one from the graft in the operated eye and one from unoperated hard palate. The inferior scleral show was measured on pre- and postoperative photographs and related to the horizontal corneal diameter.ResultsMedian follow-up time was 21.2 [range 4.5–87.9] months. Imprints from the graft and the hard palate showed equally large epithelial cells; imprints from conjunctiva showed small epithelial cells. The mean (±SD) scleral show was 0.12 ± 0.09 cornea diameter before surgery and 0.0003 ± 0.08 cornea diameter at invited follow-up (p 
      PubDate: 2016-12-20T05:21:32.103161-05:
      DOI: 10.1111/aos.13321
  • Lacrimal gland ductal carcinomas: Clinical, Morphological and Genetic
           characterization and implications for targeted treatment
    • Authors: Simon Andreasen; Morten Grauslund, Steffen Heegaard
      Pages: 299 - 306
      Abstract: PurposeDuctal carcinomas (DCs) of the lacrimal gland are very rare but aggressive malignancies. We investigated DC of the lacrimal gland for potentially clinically actionable targets in the search for new therapeutic options.MethodsCase 1: A 77-year-old man, presented with diplopia and xerophtalmia; case 2: A 53-year-old man, presented with headache, proptosis and chemosis and case 3: A 73-year-old man, presenting with chemosis and a corneal abscess. All three cases were characterized morphologically including immunohistochemistry and genetically with fluorescence in situ hybridization (FISH) and one case with next-generation sequencing (NGS) of cancer relevant genes.ResultsCases 1 and 3 were composed of large, rounded, irregular cystic nodules of carcinoma cells with prominent central comedonecrosis, whereas case 2 had a scirrhous morphology. High expression of CK7, CK19, EMA, p53 and HER2 was characteristic for all three tumours. Androgen receptor was intensely positive in case 1, in scattered cells in case 2 and negative in case 3, whereas oestrogen and progesterone receptor were consistently negative. Genetically, a hemizygous deletion and a point mutation in PTEN were identified in case 1, whereas HER2 amplification was found in cases 2 and 3.ConclusionThis study identified a spectrum of genetic events and pattern of protein expression in DC of the lacrimal gland similar to a subset of carcinomas of the breast and ductal carcinomas of the salivary glands. For therapeutic purposes, aberrations in several components of especially the HER2 signalling pathway could alleviate the effect of HER2-directed therapy illustrating an inadequacy of isolated HER2 testing.
      PubDate: 2016-11-03T04:04:08.397717-05:
      DOI: 10.1111/aos.13310
  • High correlation between performance on a virtual-reality simulator and
           real-life cataract surgery
    • Authors: Ann Sofia Skou Thomsen; Phillip Smith, Yousif Subhi, Morten la Cour, Lilian Tang, George M. Saleh, Lars Konge
      Pages: 307 - 311
      Abstract: PurposeTo investigate the correlation in performance of cataract surgery between a virtual-reality simulator and real-life surgery using two objective assessment tools with evidence of validity.MethodsCataract surgeons with varying levels of experience were included in the study. All participants performed and videorecorded three standard cataract surgeries before completing a proficiency-based test on the EyeSi virtual-reality simulator. Standard cataract surgeries were defined as: (1) surgery performed under local anaesthesia, (2) patient age >60 years, and (3) visual acuity >1/60 preoperatively. A motion-tracking score was calculated by multiplying average path length and average number of movements from the three real-life surgical videos of full procedures. The EyeSi test consisted of five abstract and two procedural modules: intracapsular navigation, antitremor training, intracapsular antitremor training, forceps training, bimanual training, capsulorhexis and phaco divide and conquer.ResultsEleven surgeons were enrolled. After a designated warm-up period, the proficiency-based test on the EyeSi simulator was strongly correlated to real-life performance measured by motion-tracking software of cataract surgical videos with a Pearson correlation coefficient of −0.70 (p = 0.017).ConclusionPerformance on the EyeSi simulator is significantly and highly correlated to real-life surgical performance. However, it is recommended that performance assessments are made using multiple data sources.
      PubDate: 2016-09-29T07:06:00.598655-05:
      DOI: 10.1111/aos.13275
  • Validation, test–retest reliability and norm scores for the Dutch
    • Authors: Martijn S. Visser; Myrthe Dieleman, Stijn Klijn, Reinier Timman, Mats Lundström, Jan J. V. Busschbach, Nicolaas J. Reus
      Pages: 312 - 319
      Abstract: PurposeThe Catquest-9SF questionnaire is a unidimensional, reliable, valid and short patient-reported outcome measure for quantifying benefits in visual functioning from cataract surgery. Our aim was to develop a formal Dutch translation, calculate norm scores, assess its validity and test–retest reliability and provide an easy way for use in clinical practice.MethodsTranslation of the questionnaire was performed according to guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Catquest-9SF was obtained in 657 patients pre- and postcataract surgery. We applied Rasch and classical analyses to determine the questionnaire performance with characteristics such as unidimensionality, reliability, separation and differential item functioning. Test–retest reliability was assessed in another group of 145 patients. A cut-off value to discriminate between people with and without cataract, norm scores and a reliable change index (RCI) were calculated using data from a sample of 916 ‘healthy’ persons from the normal population.ResultsThe Dutch Catquest-9SF was unidimensional, and both person and item reliability were high; 0.87 and 0.99, respectively. Cronbach's alpha was 0.94, test–retest reliability was 0.85 and the intraclass correlation coefficient was 0.93. Catquest-9SF showed to be responsive to the effect of cataract surgery (effect size = 1.27; p 
      PubDate: 2016-10-24T04:25:44.329264-05:
      DOI: 10.1111/aos.13287
  • Multiple imaging modalities for the detection of optic nerve head drusen:
           Is echography still mandatory?
    • Authors: Albert Caramoy; Lisa Engel, Konrad R. Koch, Bernd Kirchhof, Claus Cursiefen, Ludwig M. Heindl
      Pages: 320 - 323
      PubDate: 2016-09-29T07:02:11.730102-05:
      DOI: 10.1111/aos.13225
  • Quantification of fluid resorption from diabetic macular oedema with
           foveal serous detachment after dexamethasone intravitreal implant
           (Ozurdex®) in a pregnant diabetic
    • Authors: Delila Hodzic-Hadzibegovic; Shakoor Ba-Ali, Marianne Valerius, Henrik Lund-Andersen
      Pages: 324 - 325
      Abstract: PurposeTo quantify the fluid resorption from the centre of the fovea in a pregnant woman with diabetic macular oedema by daily optical coherence tomography (OCT) measurements after the administration of intravitreal dexamethasone implant (Ozurdex®).MethodsA 36-year-old pregnant woman with type 1 diabetes for 33 years presented with diabetic macular oedema with foveal serous detachment and symptomatic vision loss at 16 gestational weeks. Best-corrected visual acuity (BCVA) in Snellen notation and central retinal volume assessed by optical coherence tomography (OCT, Topcon Corporation) were measured almost on a daily basis the first five weeks after implantation and then 2–3 times per month until childbirth.ResultsThe pretreatment BCVA was 0.6/1.0, and pretreatment central retinal volume was 0.32 mm3. Near elimination of the oedema was achieved 3 days after treatment. One week after treatment, BCVA improved to preconception level, and full regression of the oedema was achieved. The rate of fluid resorption from the centre of the fovea was highest 3 days after treatment 0.00139 μL/hr and decreasing to 0.00065 μL/hr 1 week after treatment.ConclusionIntravitreal dexamethasone implant Ozurdex reduces promptly central retinal volume in diabetic macular oedema involving the centre of the fovea in pregnancy with highest rate of fluid resorption 3 days after treatment initiation.
      PubDate: 2016-10-24T23:45:51.068082-05:
      DOI: 10.1111/aos.13282
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