Author: Ophthalmology

Rheumatoid Arthritis–Associated Corneal Ulceration: Mortality and Graft Survival

Purpose:
To investigate mortality and graft survival in patients undergoing penetrating keratoplasty (PKP) for rheumatoid arthritis–associated corneal ulceration (RACU), Fuchs’ endothelial dystrophy (FED), and pseudophakic bullous keratopathy (PBK).

Design:
Case-control study.

Participants and Controls:
Patients listed on the UK Transplant Registry who had undergone a PKP for RACU, FED, or PBK between January 4, 1999, and January 4, 2006. Comparative standardized mortality ratios (SMRs) and causes of death were obtained from the Office for National Statistics.

Methods:
Outcome data were collected from the UK Ocular Tissue National Transplant database and (Read more...)

Predictors of Matching in an Ophthalmology Residency Program

Purpose:
To examine the characteristics of US medical students applying for ophthalmology residency and to determine the predictors of matching.

Design:
A retrospective case series.

Participants:
A total of 3435 medical students from the United States who applied to an ophthalmology residency program from 2003 to 2008 were included.

Methods:
Matched and unmatched applicants were compared and stratified by predictor variables, including United States Medical Licensing Examination (USMLE) Step 1 score, Alpha Omega Alpha (AOA) status, medical school reputation, and medical school geographic region. Differences in proportions were analyzed using (Read more...)

Effect of Lateral Decubitus Position on Intraocular Pressure in Glaucoma Patients with Asymmetric Visual Field Loss

Purpose:
To investigate the effect of the lateral decubitus position (LDP) on intraocular pressure (IOP) in glaucoma patients with asymmetric visual field loss.

Design:
Prospective, cross-sectional study.

Participants:
Ninety-eight eyes of 49 consecutive bilateral glaucoma patients with asymmetric visual field loss, divided into better eye and worse eye groups for calculation of mean deviation.

Methods:
Intraocular pressure was measured using a Goldmann applanation tonometer and rebound tonometer (Icare PRO; Icare Finland Oy, Helsinki, Finland) in each of the following positions: sitting, supine, right LDP, and left LDP. Visual field was (Read more...)

Investigation of the Human Anterior Segment in Normal Chinese Subjects Using a Dual Scheimpflug Analyzer

Purpose:
To investigate anterior segment parameters in normal Chinese subjects and study factors influencing these parameters, such as age, gender, and laterality.

Design:
A prospective observational case series.

Participants:
A total of 291 normal subjects (582 eyes) were included.

Methods:
The anterior segment data were determined with a dual Scheimpflug analyzer.

Main Outcome Measures:
The corneal thinnest-point thickness (CTPT), corneal thinnest-point distribution (CTPD), central corneal thickness (CCT), corneal thickness (CT) in the central 10 mm diameter, pupil diameter (PD), pupil center distribution (PCD), anterior chamber depth (ACD), and anterior chamber (Read more...)

The Use of Peer Optic Nerve Photographs for Teaching Direct Ophthalmoscopy

Objective:
To use a novel teaching exercise to encourage students to practice ophthalmoscopy and to measure the learning effect both subjectively and objectively.

Design:
Comparative case series.

Participants:
One hundred thirty-one fourth-year medical students on their 1-week ophthalmology rotations with 89 in the experimental group and 42 in the control group.

Methods:
Those in the experimental group had 1 eye dilated and their optic nerve photographed on the first day. The next day, these students received an unlabeled optic nerve photograph belonging to 1 of their peers (typically 8–10 per (Read more...)

Retinal Ganglion Cell Count Estimates Associated with Early Development of Visual Field Defects in Glaucoma

Purpose:
To estimate retinal ganglion cell (RGC) losses associated with the earliest development of visual field defects in glaucoma.

Design:
Observational cohort study.

Participants:
The study group included 53 eyes of 53 patients with suspected glaucoma who were followed as part of the Diagnostic Innovations in Glaucoma (DIGS) study. These eyes had normal standard automated perimetry (SAP) visual fields at baseline and developed repeatable (3 consecutive) abnormal test results during a median follow-up of 6.7 years. An age-matched control group of 124 eyes of 124 healthy subjects recruited from the (Read more...)

A Novel Cyclosporine A Drug-Delivery System for Prevention of Human Corneal Rejection after High-risk Keratoplasty: A Clinical Study

Purpose:
To evaluate the efficacy of a novel cyclosporine A (CsA) drug-delivery system (DDS) in the anterior chamber for suppressing the occurrence of rejection and improving the survival of corneal allografts after high-risk keratoplasty.

Design:
Single-center, noncomparative case series.

Participants:
Ninety-two eyes of 92 patients with corneal blindness who required corneal transplantation at Shandong Eye Institute from May 2003 to June 2011.

Methods:
The CsA DDS was implanted into the anterior chamber during high-risk keratoplasty, and subsequent therapeutic effects were evaluated.

Main Outcome Measures:
Occurrence and reversal of graft rejection (Read more...)

Surgical Outcomes of Medial Rectus Recession in Esotropia with Cerebral Palsy

Purpose:
To determine the outcome of a reduced amount of medial rectus (MR) muscle recession in esotropes with cerebral palsy (CP) and to compare the surgical response with that of normal controls.

Design:
Retrospective cohort study.

Participants:
Thirty esotropes with CP and 60 age-matched esotropes without CP who underwent a unilateral or bilateral MR muscle recession.

Methods:
The surgical amount of MR muscle recession was reduced by 1 mm per muscle in patients with CP.

Main Outcome Measures:
Success rates, surgical response, cumulative probabilities of success, and factors affecting surgical (Read more...)

Reversal of Lamina Cribrosa Displacement after Intraocular Pressure Reduction in Open-Angle Glaucoma

Purpose:
To compare the change in lamina cribrosa (LC) displacement in response to intraocular pressure (IOP) lowering in patients with open-angle glaucoma (OAG) using spectral-domain optical coherence tomography (SD-OCT).

Design:
Observational case series.

Participants:
One hundred eyes of 100 patients with OAG in whom IOP at the follow-up examination had decreased by at least 20% compared with the baseline IOP.

Methods:
Serial horizontal B-scan images of the optic nerve head (ONH) were obtained from each eye using enhanced depth imaging SD-OCT. Approximately 65 B-scans covering the optic discs were obtained (Read more...)

Null CYP1B1 Genotypes in Primary Congenital and Nondominant Juvenile Glaucoma

Purpose:
To assess the mutation spectrum, enzymatic activity, and phenotypic features associated with CYP1B1 genotypes in primary congenital glaucoma (PCG) and nondominant juvenile glaucoma (ndJG).

Design:
CYP1B1 genotyping, segregation analysis, and functional evaluation of mutations in a cohort of patients.

Participants:
A total of 177 probands clinically diagnosed with PCG (161) or ndJG (16).

Methods:
Automatic DNA sequencing of the promoter (−1 to −867) and the 3 CYP1B1 exons. CYP1B1 enzymatic activity was evaluated using an ethoxyresorufin O-deethylation assay in transfected HEK-293T cells.

Main Outcome Measures:
Screening and functional evaluation (Read more...)