Purpose: To determine the peripheral levels of 20 immune mediators in serum samples from patients with birdshot retinochoroidopathy (BSRC).Design: Single-center prospective case-control study.Methods: The serum of 17 BSRC patients during different phases of disease activity and therapy were analyzed with a quantitative multiplex sandwich enzyme-linked immunosorbent assay–based microarray to determine the levels of 20 immune mediators (T cell and proinflammatory). The serum of 12 healthy volunteers was used as controls.Results: Serum levels of interleukin (IL)-21 (P = .0005), IL-23 (P = .0005), and transforming growth factor (TGF)-β1 (P = .0011) were elevated in BSRC patients with active disease naïve to systemic therapy compared with that of controls. There was no significant difference in the serum levels of immune mediators between controls and BSRC patients who had a current or past history of IMT or who were in remission. The levels of IL-21, IL-23, and TGF-β1 were positively correlated (IL-23/IL-21, r = 0.91; TGF-β1/IL-21, r = 0.97; TGF-β1/IL-23, r = 0.87; for all, P < .0001).Conclusions: BSRC patients with active disease naïve to systemic therapy have elevated serum levels of 3 key immune mediators known to promote T helper 17 (Th17) cells in autoimmune disease. Our results suggest that IL-21, IL-23, and TGF-β1 may play an important role in the development of site-specific Th17 cell–mediated inflammation in BSRC, which underscore the importance of systemic therapy and offer new insights into the potential of targeted treatments.
Author: Am J Ophthalmol
Senescent Changes in Cerebrospinal Fluid Circulatory Physiology and Their Role in the Pathogenesis of Normal-tension Glaucoma – Corrected Proof
Purpose: To evaluate the evidence supporting a role for senescent changes in cerebrospinal fluid (CSF) circulatory physiology in the pathogenesis of normal-tension glaucoma (NTG).Design: Literature review and personal perspective of the authors.Methods…
The Association Between Compliance With Recommended Follow-up and Glaucomatous Disease Severity in a County Hospital Population – Corrected Proof
Purpose: To assess the association between insufficient follow-up and clinical parameters such as disease severity and medication use among glaucoma patients at a metropolitan county hospital.Design: Cross-sectional study.Methods: Two-hundred and six p…
Near-infrared and Short-wavelength Autofluorescence in Resolved Central Serous Chorioretinopathy: Association With Outer Retinal Layer Abnormalities – Corrected Proof
Purpose: To evaluate the correlation between changes in fundus autofluorescence (AF) measured using 2 different sources (near-infrared fundus autofluorescence from melanin and short-wavelength fundus autofluorescence from lipofuscin) with changes in spectral-domain optical coherence tomography (SD OCT) and fluorescein angiography in resolved central serous chorioretinopathy (CSC).Design: Retrospective, observational case study.Methods: A total of 91 eyes from 86 patients with a history of resolved CSC and abnormal AF imaging findings were included. In addition to AF, patients were assessed by means of SD OCT and fluorescein angiography. Outer retinal layer alterations in OCT images and abnormalities in fluorescein angiography were analyzed and correlated with the corresponding AF data.Results: All eyes with abnormal near-infrared AF showed a hyperfluorescent angiography window defect in the corresponding area. There was a significant association between the OCT and short-wavelength AF findings. An abnormal short-wavelength AF signal was significantly associated with loss of the ellipsoid portion of the inner segments (EPIS, previously known as the junction between the inner and outer segments of the photoreceptors) on SD OCT (χ2 test; P < .0001). Near-infrared AF could not predict the status of EPIS without the short-wavelength AF image.Conclusions: Outer retinal layer changes in OCT images can be predicted by analyzing both short-wavelength AF and near-infrared AF images. Abnormal changes in the short-wavelength AF image were predictive of EPIS damage.
Why Does the Healthy Cornea Resist Pseudomonas aeruginosa Infection? – Corrected Proof
Purpose: To provide our perspective on why the cornea is resistant to infection based on our research results with Pseudomonas (P) aeruginosa. We focus on our current understanding of the interplay between bacteria, tear fluid, and the corneal epitheli…
Reliability and Validity of an Automated Computerized Visual Acuity and Stereoacuity Test in Children Using an Interactive Video Game – Corrected Proof
Purpose: To evaluate the test-retest reliability and validity of the new automated computerized distance visual acuity and stereoacuity test for children, which uses an interactive video game.Design: Retrospective, observational case series.Methods: A …
Cosmetic Regional Conjunctivectomy With Postoperative Mitomycin C Application With or Without Bevacizumab Injection – Corrected Proof
Purpose: To evaluate the complications of cosmetic wide conjunctivectomy and postoperative topical mitomycin C application with or without bevacizumab injection.Design: Cross-sectional cohort study.Methods: Medical records of 1713 consecutive subjects …
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We thank Parekh and associates for their thoughtful comments and interesting description of a case of blood reflux during cataract surgery 2 years after previous Trabectome surgery. The authors raised several plausible mechanisms for intraoperative blo…
Contents
Intravitreal Bevacizumab for Macular Complications From Retinal Arterial Macroaneurysms
Pichi and associates are to be congratulated for their study on the intravitreal use of bevacizumab for the therapy of retinal macroaneurysms. In their multicenter trial on 38 eyes, Pichi and associates applied bevacizumab intravitreally 3 times and ob…
Delayed-Onset Symptomatic Hyphema After Ab Interno Trabeculotomy Surgery
Recently, the article “Delayed-Onset Symptomatic hyphema after ab interno trabeculotomy surgery” reported that 4.6% of 262 cases demonstrated postoperative spontaneous delayed-onset hyphema after Trabectome surgery. Median time to onset of the hyph…
Reply
We thank Firth and associates for their interest in our article. They suggest that the mechanism behind the change in accommodation during binocular viewing among the patients with intermittent exotropia is the result of convergence accommodation, rath…
Persistent Corneal Edema After Collagen Cross-Linking for Keratoconus
We are intrigued by the case series by Sharma and associates documenting corneal edema after collagen cross-linking. Our group has reported a similar case. An account by Gokhale and 4 cases reported by Koppen and associates constitute other similar rep…
Reply
We thank Vazirani and associates for their interest in our series documenting persistent corneal edema after collagen cross-linking (CXL) for keratoconus. Gokhale was the first to report corneal edema after CXL for keratoconus. Bagga and associates rep…
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We greatly appreciated Dr Jonas’ interest in and comments on our recent study, and we thank him for sharing his experience in the treatment of complicated retinal arterial macroaneurysms with intravitreal bevacizumab. Dr Jonas raises an important point…
Reporting Visual Acuities
The AJO encourages authors to report the visual acuity in the manuscript using the same nomenclature that was used in gathering the data provided they were recorded in one of the methods listed here. This table of equivalent visual acuities is provided…
Binocular Visual Acuity in Intermittent Exotropia: Role of Accommodative Convergence
Ahn and associates presented their findings regarding the level of accommodation, monocularly and binocularly, in patients with intermittent exotropia. They noted that “binocular interaction of visual acuity is associated with accommodative response,…
Comparison and Repeatability of Keratometric and Corneal Power Measurements Obtained by Orbscan II, Pentacam, and Galilei Corneal Tomography Systems – Corrected Proof
Purpose: To assess the repeatability and comparability of corneal power and central corneal thickness (CCT) measurements obtained using Orbscan II (Bausch & Lomb), Pentacam (Oculus), and Galilei (Ziemer) tomographers.Design: Prospective, comparative study.Methods: setting: Departments of Ophthalmology, University of Auckland and Auckland District Health Board, Auckland, New Zealand. study population: Thirty eyes of 30 healthy participants. observations. CCT and corneal power measured using Orbscan II, Pentacam, and Galilei tomography. main outcome measures: Degree of agreement in and repeatability of CCT and corneal power measures.Results: Orbscan II measured significantly lower CCT compared with Pentacam (20 μm; P < .0005) and Galilei (18 μm; P < .0005). The Orbscan II had wide limits of agreement when compared with both the Galilei (−11 to 47 μm) and Pentacam (−88 to 47 μm). For each device, the intraclass correlation coefficient for CCT was higher than 0.9. The coefficient of variation ranged from 0.33% to 0.93%. There was no significant difference in mean steep keratometry or mean flat keratometry between instrument pairs. However, there was poor agreement in flat keratometry and steep keratometry obtained by Orbscan II compared with those obtained by the Galilei and Pentacam.Conclusions: The keratometry and pachymetry measurements obtained by Orbscan II, Pentcam, and Galilei tomographers were sufficiently disparate that the 3 devices could not be considered equivalent. All 3 devices demonstrated a high level of repeatability, although the Galilei exhibited the best repeatability.
Foveal Thickness in Healthy Fellow Eyes of Patients With Unilateral Macular Holes – Corrected Proof
Purpose: To compare the morphologic parameters of ophthalmoscopically and tomographically normal foveae of the fellow eyes of patients with a unilateral macular hole (MH), other unilateral retinal diseases, and healthy eyes.Design: Observational, cross-sectional study.Methods: Of the 849 subjects studied, 183 eyes were excluded because they had an abnormal vitreofoveal interface that might have affected the foveal thickness. The average regional retinal thicknesses of the Early Treatment Diabetic Retinopathy Study sectors determined by spectral-domain optical coherence tomography were compared among 160 patients with MH, 175 patients with epiretinal membrane, 145 patients with retinal vein occlusion, and 186 healthy subjects. The foveal depression was quantified as the foveal pit depth divided by the foveal pit diameter.Results: The fovea (1 mm) and central fovea were significantly thinner in the MH group (243 and 192 μm) than in the other groups (P < .0001). There were no significant differences in the thickness of the fovea and central fovea among the eyes with epiretinal membrane (254 and 203 μm) or retinal vein occlusion (251 and 202 μm) or in the healthy group (254 and 201 μm). The foveal depression was significantly greater in the MH group (0.063) than in the retinal vein occlusion group (0.059) or in the healthy group (0.058; P = .014 and P = .0014, respectively). Multiple regression analyses showed that a thinner fovea and a deeper foveal depression were associated significantly with the presence of MH (P = .0054 to P < .0001).Conclusions: These results suggest that patients with MH have unique foveal morphologic features that predispose them to MH development.
Long-term Botulinum Toxin Treatment of Benign Essential Blepharospasm, Hemifacial Spasm, and Meige Syndrome – Corrected Proof
Purpose: To report the clinical success and incidence of adverse events of repetitive botulinum toxin treatment of 15 years or greater.Design: Retrospective cohort study.Methods: The study sample consisted of 37 patients from a clinical practice, 11 ma…