Intravitreal antiangiogenic drugs have been used recently to treat subfoveal myopic choroidal neovascularization (CNV) with good results. Several papers have reported on the outcome of intravitreal bevacizumab (IVB) in the short term, but very few have…
Category: Peer-reviewed
Retained Lens Fragments after Cataract Surgery: Outcomes of Same-Day versus Later Pars Plana Vitrectomy – Corrected Proof
Purpose: To compare visual acuity outcomes and adverse events in patients with retained lens fragments who underwent same-day versus later pars plana vitrectomy (PPV).Design: Retrospective, interventional case series.Methods: Single-center study evalua…
Author reply
We appreciate the interest of Heindl et al in our recent article in which we report the presence of ciliary body lymphatics in all melanoma eye cases studied. Our group was the first to identify lymphatics in the ciliary body of the normal human eye. T…
Streptococcal Endophthalmitis in Pediatric Keratoprosthesis
The first Boston type I keratoprosthesis used in a child was reported in 2006. Since then, others have advocated for early and primary keratoprosthesis implantation in young patients.
Scheimpflug Corneal Power Measurements for Intraocular Lens Power Calculation in Cataract Surgery – Corrected Proof
Purpose: To compare the keratometric (K) readings from the Pentacam-HR (High Resolution) unit with the automated K values from the IOLMaster keratometer (KIOLM), and to evaluate them in the commonly used intraocular lens (IOL) power calculation formulas for routine cataract surgery.Design: Prospective, comparative observational study.Methods: setting: Private practice, Lynwood, California. study population: Fifty cataractous eyes scheduled for surgery between July and August 2012. observation procedure: The K readings from the Pentacam-HR unit taken at the 2-, 3-, 4-, and 5-mm zones and the 2-, 3-, 4-, and 5-mm rings, respectively, from 3 different maps: sagittal corneal front (KF), true net power (KTNP), and total refractive power (KRP) are compared with KIOLM. IOL power calculations were performed with each of the 25 sets of K readings. main outcome measures: The IOL prediction median absolute error (MedAE) obtained with each measurement.Results: KF averaged 0.03-0.13 diopter (D) higher than KIOLM (P > .05), KTNP averaged 1.16-1.21 D lower than KIOLM (P > .001), and KRP averaged 0.23-0.72 D lower than KIOLM (P > .001), with large variations in the measurements. The MedAE obtained with the different Pentacam K readings ranged from 0.44-0.64 D vs 0.52 D obtained with KIOLM (P > .05). MedAE was lower in all categories when the pupil was 3 mm or smaller.Conclusion: The Pentacam KF values were the closest to KIOLM and the KF readings from the 2-mm ring yielded the best results for IOL power calculation.
August 2012 Cover Photo Is Not Coats’ Disease
We were interested to see the cover photo on the August 2012 edition of Ophthalmology showing a fluorescein angiogram with findings attributed to macular telangiectasia type 1 (Coats’ disease). The wide field fluorescein angiogram very nicely demonstra…
Prevention of Neovascular Glaucoma
Neovascular glaucoma (NVG) is defined by the occurrence of neovascularization (NV) of the iris and/or anterior chamber angle associated with increased intraocular pressure (IOP). Optic disc changes are not specific and cupping of the optic nerve head i…
期刊一览
Richoz 等人 (p. 1354) 的一项长期随访研究发现角膜胶原交联术 (CXL) 可以有效阻止 LASIK 或准分子激光角膜切削术 (PRK) 术后角膜扩张的进展. 这一方法改善了患者最佳矫正远视力 (CDVA) 及最大K值 (Km…
Molecular Analysis of Uveal Melanoma
Onken et al report a prospective evaluation of a gene expression profiling (GEP)-based assay, designed around 15 genes, that assigns uveal melanoma (UM) to 2 prognostic subgroups: Classes 1 and 2, which respectively are associated with low and high ris…
Adaptive Optics Imaging of Idiopathic Epiretinal Membranes
Idiopathic epiretinal membrane (ERM) is the most common vitreomacular interface pathology in adult population. Prevalence of idiopathic ERM has been estimated to be >10% among those >70 years; its development is usually preceded by posterior vitreous detachment. It is composed of nonvascularized tissue growth along the retinal inner limiting membrane, and many different cellular (hyalocytes, glial cells, fibroblasts) and extracellular components (collagen, fibronectin, neurites) have been identified in immunocytochemical studies.
This Issue At A Glance
Long-term results from a study by Richoz et al (p. 1354) show that corneal collagen cross-linking (CXL) effectively halts the progression of ectasia that has occurred after LASIK or photorefractive keratectomy (PRK). The procedure improves the correcte…
Author reply
We appreciate the opportunity to respond to the letter by Coupland and Damato regarding our 2012 article. Contrary to their claim, the gene expression profile (GEP) prognostic test for uveal melanoma has undergone much greater validation than any other…
Choroidal Thickness Changes After Intravitreal Ranibizumab and Photodynamic Therapy in Recurrent Polypoidal Choroidal Vasculopathy – Corrected Proof
Purpose: To evaluate subfoveal choroidal thickness changes in cases with recurrent polypoidal choroidal vasculopathy (PCV) after combination therapy with intravitreal ranibizumab and photodynamic therapy (PDT).Design: Retrospective observational case series study.Methods: We measured subfoveal choroidal thickness in PCV using optical coherence tomography (OCT) before and after PDT. In recurrent cases, the choroidal thickness was measured at the time of the recurrence. In nonrecurrent cases, choroidal thickness was measured 1 year after PDT.Results: Combination therapy was performed in 27 eyes (27 patients). Polypoidal lesions regressed within 3 months after initial treatment in all eyes. Retreatment was needed in 10 of 27 eyes (37.0%) after more than 3 months of follow-up. In recurrent cases, subfoveal choroid decreased from 188 μm at baseline to 157 μm 3 months after PDT (P < .01); however, choroidal thickness increased to 179 μm with recurrence (P = .54 compared to baseline; average, 8.0 months). In nonrecurrent cases, subfoveal choroid decreased from 257 μm at baseline to 210 μm 3 months after PDT and 212 μm 1 year after PDT (P < .01, respectively).Conclusion: Subfoveal choroidal thickness in PCV at the time of recurrence returned to the baseline level after choroidal thinning as a result of PDT treatment. Choroidal thickness changes after PDT examined using OCT may reflect disease activity in PCV.
Diagnostic Precision of Retinal Nerve Fiber Layer and Macular Thickness Asymmetry Parameters for Identifying Early Primary Open-Angle Glaucoma – Corrected Proof
Purpose: To evaluate the diagnostic capabilities of intereye and intraeye differences in retinal nerve fiber layer (RNFL) thickness and macular thickness for identifying early primary open-angle glaucoma (POAG).Design: Prospective, cross-sectional coho…
Choroideremia: Towards a Therapy – Corrected Proof
Purpose: To review what progress has been made towards the application of ocular gene therapy to prevent progressive vision loss in patients affected by choroideremia.Design: A Perspective based on the collective opinions of researchers and clinician…
Accuracy of Matching Optic Discs with Visual Fields: The European Structure and Function Assessment Trial (ESAFAT) – Corrected Proof
Purpose: To determine the ability of ophthalmologists across Europe to match stereoscopic optic disc photographs to visual fields of varying severity.Design: Evaluation and comparison of 2 diagnostic tests.Participants: A total of 109 of 260 invited ophthalmologists in 11 European countries. These had participated in the previous European Optic Disc Assessment Trial (EODAT), a trial on glaucoma diagnostic accuracy based on optic discs only.Methods: Each participant matched stereo optic disc photographs of 40 healthy and 48 glaucomatous eyes to a visual field chosen from 4 options per disc. The 4 presented visual fields included the corresponding one and 3 other visual fields, varying in severity. The matching accuracy and any inaccuracy per disease severity were calculated. Classification accuracy (as glaucomatous or healthy) was compared with EODAT data. Duplicate slides allowed for the assessment of intraobserver agreement.Main Outcome Measures: Accuracy of matching optic discs with their corresponding visual field and of classifying them as healthy or glaucomatous; intraobserver agreement (κ).Results: The overall accuracy of ophthalmologists for correctly matching stereoscopic optic disc photographs to their visual fields was 58.7%. When incorrectly matched, the observers generally overestimated the visual field severity (P < 0.001), notably in eyes with early glaucoma. The intraobserver agreement was, on average, moderate (0.52).Conclusions: European ophthalmologists correctly matched stereoscopic optic disc photographs to their corresponding visual field in only approximately 59% of cases. In most mismatches, the clinicians overestimated the visual field damage.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
Accuracy of Pupil Assessment for the Detection of Glaucoma: A Systematic Review and Meta-analysis – Corrected Proof
Objective: To assess the accuracy of using pupillary light reflex (PLR) in detecting glaucoma.Clinical Relevance: Glaucoma is a specific disease of the optic nerve and is often more severe in 1 eye. When large enough, this asymmetry in disease severity…
Adoption of Electronic Health Records and Preparations for Demonstrating Meaningful Use: An American Academy of Ophthalmology Survey – Corrected Proof
Objective: To assess the current state of electronic health record (EHR) use by ophthalmologists, including adoption rate, user satisfaction, functionality, benefits, barriers, and knowledge of meaningful use criteria.Design: Population-based, cross-se…
Mitochondrial Retinal Dystrophy Associated with the m.3243A>G Mutation – Corrected Proof
Objective: To describe the spectrum of retinal abnormalities associated with the m.3243A>G mutation in the mitochondrial MTTL1 gene and to analyze putative correlations among the severity of retinal abnormalities, disease severity in other organ systems, and heteroplasmy levels.Design: Observational, cohort-based, cross-sectional study.Participants: Twenty-nine patients carrying the m.3243A>G mutation.Methods: Extensive clinical examinations, including visual acuity testing, indirect ophthalmoscopy, color fundus photography, fundus autofluorescence (FAF), high-resolution optical coherence tomography (OCT), and central visual field analysis. In selected patients, Goldmann perimetry, fluorescein angiography, full-field electroretinography (ERG) and electro-oculography (EOG), and color vision testing were performed. Heteroplasmy levels of the m.3243A>G mutation were measured in leukocytes, urinary epithelial cells (UECs), and buccal mucosa. The Newcastle Mitochondrial Disease Adult Scale (NMDAS) score was measured for all patients.Main Outcome Measures: Age at onset, visual acuity, fundus appearance, FAF, OCT findings, systemic disease features, heteroplasmy levels, and NMDAS scores.Results: Twenty-five of the 29 mutation carriers (86%) had retinal abnormalities that could be classified into 4 grades. Six patients (21%) had grade 1 retinal dystrophy with fine pigment abnormalities that were clearly visible with FAF and fluorescein angiography. Eleven patients (38%) had grade 2 abnormalities that were characterized by yellowish or mildly pigmented deposits in the early stage; in advanced grade 2, these pigment changes encompassed the entire macula and often encircled the optic disc. Six patients (21%) had grade 3 disease in which profound chorioretinal atrophy was present outside the fovea. Two patients (7%) with retinal abnormalities had grade 4 disease, in which the fovea was affected by atrophy, with marked loss of visual acuity. The grade of mitochondrial retinal dystrophy correlated significantly with both age (r = −0.483, P = 0.008) and visual acuity (r = −0.614, P G mutation has specific characteristics that can be classified into 4 grades based on the findings on ophthalmoscopy, FAF, and OCT. However, because the maternal inheritance pattern can be masked and the systemic disease associations can be variable or even absent, the disease may be misdiagnosed.Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.
Risk of Choroidal Neovascularization among the Uveitides – Corrected Proof
Purpose: To evaluate the risk, risk factors, and visual impact of choroidal neovascularization (CNV) in uveitis cases.Design: Retrospective cohort study.Methods: Standardized medical record review at 5 tertiary centers.Results: Among 15 137 uveitic eye…