Author: Am J Ophthalmol

Purpose: To evaluate the accuracy of the visual field index (VFI) for the Humphrey Visual Field Analyzer in a population of patients with mild to moderate glaucoma.Design: Retrospective cohort study.Methods: The study included 42 patients (61 eyes) with at least 11 years of follow-up, and annual automated visual fields (VFs). Patients with mean deviations ≤−20 dB were excluded. All unreliable fields were omitted (fixation losses ≥20%, false-positive ≥15%, false-negative ≥33%). The VFs were divided into two 5-year series and the data were analyzed by the new Humphrey Visual Field Analyzer software. Projected VFIs from the first 5 years were compared (Read more...)

Purpose: To analyze the outer retinal and retinal pigment epithelium (RPE) features of reticular pattern dystrophy of the retina using spectral-domain optical coherence tomography (SDOCT).Design: Retrospective observational case series.Methods: Consecu…

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Purpose: To determine the efficacy of 1 intravitreal bevacizumab injection followed by pro re nata (1 + PRN) injection in cases of subfoveal myopic choroidal neovascularization (CNV) and to identify CNV-recurrence–related prognostic factors.Design: Retrospective observational case series.Methods: In total, 103 eyes of 89 consecutive naive patients who had subfoveal myopic CNV and had been followed-up for at least 2 years were included. Of those eyes, 24 had recurrences. The remaining eyes were stable after the initial treatment.Results: The average patient age was 51.1 ± 15.2 years. The average follow-up duration was 44.1 ± 12.7 months. At baseline and at the 1-year, 2-year, (Read more...)

Purpose: To investigate the prevalence and morphologic changes of capsular bag distention syndrome after cataract surgery using the Pentacam and to analyze its clinical characteristics and influencing factors.Design: Retrospective, cross-sectional study.Methods: Clinical records of 239 consecutive patients who underwent cataract surgery were reviewed. Demographic data, use of intraoperative ophthalmic viscosurgical devices, type of intraocular lens implanted, axial length, and white-to-white corneal diameter were recorded. One month after surgery, dilated Scheimpflug imaging was performed. Prevalence, morphologic changes, and characteristic clinical findings of this syndrome were evaluated.Results: Using Scheimpflug imaging, the prevalence of capsular bag distention syndrome was high at 26.8% (64/239), (Read more...)

Purpose: To report experience in the treatment of persistent corneal epithelial defect using overnight wear of a prosthetic device for the ocular surface.Design: Retrospective interventional case series.Methods: A clinical database of patients who underwent prosthetic replacement of the ocular surface ecosystem (PROSE) treatment from March 2003 to August 2008 was searched to identify patients treated for persistent corneal epithelial defect. In early 2003, overnight wear of a PROSE device and addition of commercially available, nonpreserved, topical ophthalmic moxifloxacin to the saline in the device reservoir became standard practice at this center when treating persistent corneal epithelial defect. Medical records were (Read more...)

Purpose: To evaluate the correlation between changes in tear osmolarity, symptoms, and corneal fluorescein staining in patients with dry eye disease (DED).Design: Retrospective, clinic-based cohort study.Methods: In this single-institution study, we reviewed the charts of 186 patients with DED from whom we had data on tear osmolarity, symptoms, and corneal fluorescein staining from 2 separate visits. Main outcomes included the correlation of the changes between the 2 visits for tear osmolarity (TearLab system), symptoms (Ocular Surface Disease Index), and corneal fluorescein staining (modified Oxford scheme). For tear osmolarity and corneal fluorescein staining the scores from the eye with highest readings (Read more...)

Purpose: To determine medical student preferences for learning the ocular fundus examination and to assess their accuracy using different examination modalities.Design: Prospective, randomized study of medical student education approaches.Methods: First-year medical students received training in direct ophthalmoscopy using simulators and human volunteers. Students were randomized to receive vs not receive specific training on interpreting fundus photographs prior to accuracy assessments. Students’ preferences for each of the 3 methods (direct ophthalmoscopy on simulators or human volunteers, or use of fundus photographs) and recognition of normal and abnormal fundus features were assessed.Results: Of 138 first-year medical students, 119 (86%) completed all required (Read more...)

Purpose: To investigate the frequency and types of systemic findings in patients with apparently isolated uveal coloboma.Design: Cross-sectional observational study.Methods: setting: Single-center ophthalmic genetics clinic. study population: Ninety-nine patients with uveal coloboma seen at the National Eye Institute. observational procedure: Results of audiology testing, echocardiogram, brain magnetic resonance imaging, renal ultrasound, and total spine radiographs. main outcome measure: Prevalence of abnormal findings on systemic testing.Results: Uveal coloboma affected only the anterior segment in 8 patients, only the posterior segment in 23 patients, and both anterior and posterior segments in 68 patients. Best-corrected visual acuity (BCVA) of eyes with coloboma was (Read more...)

Purpose: To develop and validate an associative model using pupillography that best discriminates those with and without glaucoma.Design: A prospective case-control study.Methods: We enrolled 148 patients with glaucoma (mean age 67 ± 11) and 71 controls (mean age 60 ± 10) in a clinical setting. This prototype pupillometer is designed to record and analyze pupillary responses at multiple, controlled stimulus intensities while using varied stimulus patterns and colors. We evaluated three approaches: (1) comparing the responses between the two eyes; (2) comparing responses to stimuli between the superonasal and inferonasal fields within each eye; and (3) calculating the absolute pupil response (Read more...)

Purpose: To evaluate the effect of choroidal vascular hyperpermeability, as determined using indocyanine green angiography (ICGA), on the outcome of anti–vascular endothelial growth factor (VEGF) treatment for polypoidal choroidal vasculopathy (PCV).Design: Retrospective comparative series.Methods: Based on the presence of choroidal vascular hyperpermeability on ICGA, 103 eyes (101 patients) with PCV were categorized into 2 subgroups: choroidal vascular hyperpermeability (+) group (41 eyes) and choroidal vascular hyperpermeability (−) group (62 eyes). All subjects were treatment naïve and treated by anti-VEGF with initial 3 loading injections per month, followed by an as-needed reinjection. Best-corrected visual acuity (BCVA) and central macular thickness after (Read more...)

Purpose: To compare accuracy of intraocular lens (IOL) power calculation formulae in infantile eyes with primary IOL implantation.Design: Comparative case series.Methods: The Hoffer Q, Holladay 1, Holladay 2, Sanders-Retzlaff-Kraff (SRK) II, and Sanders-Retzlaff-Kraff theoretic (SRK/T) formulae were used to calculate predicted postoperative refraction for eyes that received primary IOL implantation in the Infant Aphakia Treatment Study. The protocol targeted postoperative hyperopia of +6.0 or +8.0 diopters (D). Eyes were excluded for invalid biometry, lack of refractive data at the specified postoperative visit, diagnosis of glaucoma or suspected glaucoma, or sulcus IOL placement. Actual refraction 1 month after surgery was converted to spherical equivalent (Read more...)

Purpose: To describe the clinical and molecular findings in ten unrelated African American patients with Stargardt disease.Design: Retrospective, observational case series.Methods: We reviewed the clinical histories, examinations, and genotypes of 85 patients with molecular diagnoses of Stargardt disease. Three ABCA4 sequence variations identified exclusively in African Americans were evaluated in 300 African American controls and by in silico analysis.Results: ABCA4 sequence changes were identified in 85 patients from 80 families, of which 11 patients identified themselves as African American. Of these 11 patients, 10 unrelated patients shared 1 of 3 ABCA4 sequence variations: c.3602T>G (p.L1201R); c.3899G>A (p.R1300Q); or c.6320G>A (p.R2107H). The (Read more...)

Purpose: To determine whether Descemet stripping automated endothelial keratoplasty (DSAEK) donor cornea graft thickness impacts measurements of best spectacle-corrected visual acuity (BSCVA), refractive error and intraocular pressure (IOP).Design: Retrospective chart review in a tertiary care center at Duke University Eye Center.Methods: We studied 460 eyes that had undergone DSAEK surgery. They were segregated into three groups based on the thickness of the donor graft: <100 μm (n = 67 eyes); 100–150 μm (n = 316 eyes); and >150 μm (n = 77 eyes). The three graft-thickness groups were assessed at about 6 months postoperatively for measurement of BSCVA, spherical equivalent, and IOP.Results: Baseline demographics were similar in (Read more...)

Purpose: To investigate whether peripapillary choroidal thickness in perimetrically affected eyes of primary open-angle glaucoma (POAG) patients differs from that in perimetrically unaffected fellow eyes and eyes of healthy controls.Design: Retrospective, comparative, cross-sectional study.Methods: Thirty-one POAG patients with unilateral visual field loss and 31 healthy controls were included. Eyes were divided into 3 groups: 31 eyes in group A (eyes with visual field loss), 31 eyes in group B (perimetrically unaffected fellow eyes), and 31 eyes in group C (age- and sex-matched controls). A 360-degree 3.4-mm diameter peripapillary circle scan was performed for retinal nerve fiber layer (RNFL) assessment using (Read more...)

Purpose: To assess the effects of glasses for anisometropia on stereopsis and to determine the factors that affect the level of stereopsis.Design: Retrospective observational case series.Methods: One hundred six nonamblyopic patients who were wearing glasses for anisometropia and 56 who were wearing glasses for isoametropia were enrolled. The levels of stereopsis in the anisometropic patients were divided into normal (≤40 seconds of arc), equivocal (40 < – ≤ 100), and subnormal (100 < – ≤ 400) and compared with those in the isoametropic patients. It was evaluated whether the amount of interocular difference in the lens power of the glasses, the type (Read more...)

Purpose: To determine the clinical outcomes after glued trans-scleral posterior chamber intraocular lens (IOL) exchange for anterior chamber (AC) IOL.Design: Retrospective case series.Methods: Eyes with AC IOL explantation with glued IOL implantation i…

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In their recent article, Constantinou and associates reported clinical outcomes in patients who experienced infectious keratitis after penetrating keratoplasty. Their principal conclusion was that “prolonged use of corticosteroid eye drops is a major…

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We appreciate the interest of Carifi and associates in our recent article. They have raised some excellent points regarding the limitations of our study, some of which we acknowledged in the article. Since our study was retrospective and included patie…

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Purpose: To describe a cohort of patients with Stargardt disease who show a foveal-sparing phenotype.Design: Retrospective case series.Methods: The foveal-sparing phenotype was defined as foveal preservation on autofluorescence imaging, despite a retin…

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The study by Cheng and associates one short-term external buckling with pneumatic retinopexy treating retinal detachment with inferior retinal breaks gives us new insight. Rhegmatogenous retinal detachment (RRD) with inferior breaks usually is a contr…

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