Month: September 2013

Macular Ganglion Cell/Inner Plexiform Layer Measurements by Spectral Domain Optical Coherence Tomography for Detection of Early Glaucoma and Comparison to Retinal Nerve Fiber Layer Measurements – Corrected Proof

Purpose: To evaluate the performance of ganglion cell layer/inner plexiform layer (GCL/IPL) measurements with spectral-domain optical coherence tomography (Cirrus HD-OCT) for detection of early glaucoma and to compare results to retinal nerve fiber layer (RNFL) measurements.Design: Cross-sectional prospective diagnostic study.Methods: We enrolled 99 subjects, including 59 eyes with glaucoma (47 subjects) (mean deviation >−6.0 dB) and 91 normal eyes (52 subjects). Patients underwent biometry and peripapillary and macular OCT imaging. Performance of the GCL/IPL and RNFL algorithms was evaluated with area under receiver operating characteristic curves (AUC), likelihood ratios, and sensitivities/specificities adjusting for covariates. Combination of best parameters was explored.Results: (Read more...)

Demographic Patterns and Treatment Outcomes of Patients With Recurrent Corneal Erosions Related to Trauma and Epithelial and Bowman Layer Disorders – Corrected Proof

Purpose: To evaluate demographics and outcomes of patients with recurrent corneal erosions related to trauma and epithelial and Bowman layer disorders.Design: Retrospective case series.Methods: setting: Wills Eye Institute, Philadelphia, Pennsylvania. study population: Two hundred seventy-two eyes (230 patients) presenting between 2008 and 2011 with recurrent corneal erosions related to trauma and epithelial and Bowman layer disorders. procedure: Conservative management, diamond burr polishing, excimer laser phototherapeutic keratectomy (PTK), and epithelial debridement alone. main outcome measure: Recurrence of erosions, more than 6 weeks after commencing treatment.Results: Mean age was 46.5 ± 14.6 (2-85) years. Female subjects accounted for 53% of patients and 18.3% (Read more...)

CNV recurs up to 6 years after PDT, anti-VEGF injections

Myopic choroidal neovascularization recurred in almost half of patients who underwent photodynamic therapy with or without intravitreal injections of anti-VEGF agents, according to a study.“Presence of lacquer crack, absence of dark rim and prior photodynamic therapy are risk factors for long-term recurrence of myopic choroidal neovascularization after treatment,” the study authors said.

BLOG: $1 million mistake? Not for ophthalmologists

The title of a recent CBS article certainly grabbed my attention, “$1 Million Mistake: Becoming a Doctor” With a title like that I just had to click on the link to read the article.It turns out that a recent survey of physicians showed that most were dissatisfied with their jobs and most would not choose to go into medicine if they were able to do it all again. That comes as a surprise to me since just about every ophthalmologist I meet enjoys helping patients and performing ocular surgery. Sure, (Read more...)

Pharmacogenetic Associations with Vascular Endothelial Growth Factor Inhibition in Participants with Neovascular Age-Related Macular Degeneration in the IVAN Study – Corrected Proof

Purpose: To determine if prespecified genetic polymorphisms influence responsiveness to vascular endothelial growth factor (VEGF) inhibition in neovascular age-related macular degeneration (nAMD). The objectives were to replicate 3 reported pharmacogen…

The Association between Scholarly Impact and National Institutes of Health Funding in Ophthalmology – Corrected Proof

Objective: To examine whether there is an association between scholarly impact, as measured by the h-index, academic rank, and National Institutes of Health (NIH) awards in academic ophthalmology.Design: Retrospective analysis of NIH RePORTER and Scopus databases.Participants: Not applicable.Methods: Five hundred seventy-three NIH awards to 391 primary investigators (PIs) in ophthalmology departments were examined. Grant recipients were organized by academic rank, obtained from online listings, and h-index, calculated using the Scopus database. Non–NIH-funded faculty from 20 randomly chosen academic ophthalmology departments also were organized by rank and h-index for comparison with their NIH-funded colleagues.Main Outcome Measures: Scholarly impact, as measured by (Read more...)

Trabeculectomy in the 21st Century: A Multicenter Analysis – Corrected Proof

Objective: To evaluate the efficacy and safety of current trabeculectomy surgery in the United Kingdom.Design: Cross-sectional, multicenter, retrospective follow-up.Participants: A total of 428 eyes of 395 patients.Methods: Consecutive trabeculectomy cases with open-angle glaucoma and no previous incisional glaucoma surgery from 9 glaucoma units were evaluated retrospectively. Follow-up was a minimum of 2 years.Main Outcome Measures: Surgical success, intraocular pressure (IOP), visual acuity, complications, and interventions. Success was stratified according to IOP, use of hypotensive medications, bleb needling, and resuturing/revision for hypotony. Reoperation for glaucoma and loss of perception of light were classified as failures.Results: Antifibrotics were used in 400 cases (Read more...)

Randomized Trial of Multifocal Intraocular Lenses versus Monovision after Bilateral Cataract Surgery – Corrected Proof

Objective: To compare spectacle independence in patients randomized to receive bilateral multifocal intraocular lenses (IOLs) or monofocal IOLs with the powers adjusted to produce monovision.Design: Randomized, multicenter clinical trial.Participants: A total of 212 patients with bilateral, visually significant cataract.Methods: Before bilateral sequential cataract surgery, patients were randomized (allocation ratio 1:1) to receive bilateral Tecnis ZM900 diffractive multifocal lenses (Abbott Medical Optics, Santa Ana, CA) or Akreos AO monofocal lenses (Bausch & Lomb, Rochester, NY) with the powers adjusted to target −1.25 diopters (D) monovision. Outcomes were assessed 4 months after the second eye underwent operation.Main Outcome Measures: The primary outcome was (Read more...)

Effectiveness of Nonpharmacologic Treatments for Acute Seasonal Allergic Conjunctivitis – Corrected Proof

Objective: To investigate whether artificial tears and cold compress alone or in combination provide a treatment benefit and whether they were as effective as or could enhance topical antiallergic medication.Design: Randomized, masked clinical trial.Participants: Eighteen subjects (mean age, 29.5±11.0 years) allergic to grass pollen.Intervention: Controlled exposure to grass pollen using an environmental chamber to stimulate an ocular allergic reaction followed by application of artificial tears (ATs), 5 minutes of cold compress (CC), ATs combined with CC, or no treatment applied at each separate visit in random order. A subset of 11 subjects also had epinastine hydrochloride (EH) applied alone and (Read more...)