Category: Peer-reviewed

Corneal cross-linking: Intrastromal riboflavin concentration in iontophoresis-assisted imbibition versus traditional and transepithelial techniques – Accepted Manuscript

Abstract: Purpose: The present study aimed at determining differences in riboflavin concentration in the anterior, intermediate and posterior stroma after three corneal cross-linking imbibition techniques (standard Epi-off, Epi-on and Iontophoresis-assisted administration) of 0.1% riboflavin.Design: Experimental laboratory investigation of human cadaver corneas not suitable for transplantation.Methods: 10 corneas underwent imbibition with Epi-on (n=3), Epi-off (n=3), iontophoresis (n=3) and saline exposure (control; n=1). Femtosecond laser was used to produce three 8mm discs of the superficial (0-150μm), intermediate (150-300μm) and deep stroma (>300μm). Riboflavin concentration was measured with High-Performance Liquid Chromatography. The main outcome measure was riboflavin concentration at the three evaluated depths.Results: (Read more...)

Clinic-Based Glaucoma Care in the Era of Surgical Subspecialization – Accepted Manuscript

Abstract: Purpose: To evaluate the impact of surgeon practice profile on clinic-based glaucoma care.Design: Population-based study of glaucoma care patterns in Ontario, Canada from 2000 to 2010.Methods: Using comprehensive physician services data from the Ontario Health Insurance Plan database, ophthalmologists were divided into five surgical practice subgroups. The role of each subgroup in the provision of glaucoma care was evaluated. Consultations and office visits were used to assess non-surgical care, while laser trabeculoplasty procedures were used to assess clinic-based procedural care.Results: Between 2000 and 2010, the population rate of glaucoma consultations and follow up visits provided by ophthalmologists who do (Read more...)

Comparison of refractive stability after non-toric versus toric intraocular lens implantation during cataract surgery – Accepted Manuscript

Abstract: Purpose: To compare refractive state changes in eyes implanted with toric intraocular lenses (IOLs) versus non-toric IOLs, after cataract extraction.Design: Retrospective, comparative.Methods: In a single-institution, 121 eyes underwent phacoemulsification and implantation with either non-toric IOLs (AcrySof® IQ SN60WF) or toric IOLs (AcrySof® Toric IOL). The spherical value, cylindrical value, spherical equivalent (SE) of refractive error, and visual acuity were measured preoperatively and 1, 3, and 6 months after surgery. Main outcome measures were the pattern of changes of spherical, cylindrical, and SE values based on postoperative time, between different IOL types.Results: The groups included patients who underwent surgery with (Read more...)

Comparison of Wide-Field Fluorescein Angiography and Nine-Field Montage Angiography in Uveitis – Accepted Manuscript

Abstract: Purpose: To qualitatively and quantitatively compare Optos© fundus camera fluorescein angiographic images of retinal vascular leakage with 9-field montage Topcon© fluorescein angiography (FA) images in patients with uveitis. We hypothesized that Optos images reveal more leakage in uveitis patients.Design: Retrospective, observational case series.Methods: Images of all uveitis patients imaged with same-sitting Optos FA and 9-field montage FA during a 9 month period at a single institution (52 eyes of 31 patients) were graded for the total area of retinal vascular leakage. The main outcome measure was area of fluorescein leakage.Results: The area of apparent FA leakage was greater in (Read more...)

HLA-DR, DQ Class II DNA Typing in Pediatric Panuveitis and Tubulointerstitial Nephritis and Uveitis (TINU) – Accepted Manuscript

Abstract: Purpose: To describe chorioretinal lesions in pediatric uveitis that are strongly associated with the HLA-DR,DQ Class II type associated with tubulointerstitial nephritis and uveitis (TINU).Design: Retrospective, observational case series.Methods: Results: Fourteen of the 15 patients (93%) with otherwise unexplained pediatric panuveitis typed HLA-DRB1*01-HLA-DQB1*05. Eleven of 15 (73.3%) had bilateral sharply demarcated, usually inferior, 200-300 micron spots of chorioretinal atrophy, and 4 of 15 (27.7%) had bilateral clusters of 500-750 micron poorly defined orange choroidal lesions without overlying atrophy of the retinal pigment epithelium. None had interstitial nephritis. Four of the 6 definite TINU cases had Class II typing and (Read more...)

Lateral Rectus Superior Compartment Palsy – Corrected Proof

Purpose: To employ magnetic resonance imaging (MRI) to seek evidence of compartmental lateral rectus atrophy consistent with a lesion involving selective denervation of only 1 of the 2 neuromuscular compartments of the lateral rectus.Design: Prospective observational case-control series.Methods: At a single institution, surface coil coronal MRI was obtained at 312 μm resolution in quasi-coronal planes 2 mm thick throughout the orbit in 20 normal volunteers and 18 patients with unilateral lateral rectus palsy fixated monocularly on a target placed in central gaze. Maximum cross sections and posterior volumes of the superior and inferior lateral rectus compartments were computed and correlated with clinical (Read more...)

Author Reply – Corrected Proof

Dr Fellman’s thoughtful comments allow for an opportunity to provide clarification with regard to the message conveyed in the editorial, “Things Go Better With Cataract Surgery.” First and foremost, I agree with Dr Fellman that blebless surgery is …

Increased Risk of Parkinson Disease Following a Diagnosis of Neovascular Age-Related Macular Degeneration: A Retrospective Cohort Study – Corrected Proof

Purpose: To investigate the risk for Parkinson disease during a 3-year follow-up period after a diagnosis of neovascular age-related macular degeneration (AMD) using a nationwide population-based dataset in Taiwan.Design: A retrospective matched-cohort study.Methods: We identified 877subjects with neovascular AMD as the study cohort and randomly selected 8770 subjects for a comparison cohort. Each subject was individually followed for a 3-year period to identify those who subsequently developed Parkinson disease. Stratified Cox proportional hazard regressions were performed as a means of comparing the 3-year risk of subsequent Parkinson disease between the study and comparison cohorts.Results: The incidence rate of Parkinson disease (Read more...)

Distribution of Retinal Layer Atrophy in Patients With Parkinson Disease and Association With Disease Severity and Duration – Corrected Proof

Purpose: To evaluate the thickness of the 10 retinal layers in the paramacular area of Parkinson disease patients using a new segmentation technology of optical coherence tomography (OCT) to examine whether the thickness of specific layers predicts neurodegeneration or Parkinson disease severity.Design: Observational prospective study.Methods: Parkinson disease patients (n = 129) and age-matched healthy subjects (n = 129) were enrolled. The Spectralis OCT system was used to automatically segment all retinal layers in a parafoveal scan using the new segmentation application prototype. Mean thickness of each layer was calculated and compared between Parkinson disease patients and healthy subjects, and between Parkinson disease (Read more...)

Atropine for the Treatment of Childhood Myopia: Changes after Stopping Atropine 0.01%, 0.1% and 0.5% – Corrected Proof

Purpose: To study the change in spherical equivalent and other ocular parameters 1 year after stopping the administration of atropine.Design: Prospective randomized double-masked clinical trial.Methods: We assigned 400 myopic children, 6 to 12 years of age, to receive atropine 0.5%, 0.1% or 0.01% for 24 months, after which medication was stopped. Parents and children gave informed consent to participate in the research. Children were reviewed at 26, 32 and 36 months, and changes in cycloplegic spherical equivalent (SE), axial length (AL), visual acuity, pupil size, and accommodation were assessed.Results: Of the children, 356 (89%) entered into the washout phase. At entry, there (Read more...)

Tear Meniscus Dimensions in Tear Dysfunction and Their Correlation With Clinical Parameters – Corrected Proof

Purpose: To evaluate relationships between tear meniscus dimensions and parameters of ocular surface disease in a variety of tear dysfunction conditions.Design: Single-institution prospective observational study.Methods: This study from the Baylor College of Medicine included 128 eyes of 64 subjects. Cross-sectional lower tear meniscus height and tear meniscus area were measured using optical coherence tomography and were compared with tear break-up time (TBUT), corneal staining, conjunctival staining, and an irritation symptom questionnaire (Ocular Surface Disease Index). Study groups included meibomian gland disease (MGD), aqueous tear deficiency (ATD), Sjögren syndrome, non–Sjögren syndrome ATD, and control subjects. Statistical analyses were performed using the (Read more...)

Vitrectomy with Internal Limiting Membrane Peeling versus No Peeling for Idiopathic Full-Thickness Macular Hole – Corrected Proof

Objective: To determine whether internal limiting membrane (ILM) peeling improves anatomic and functional outcomes of full-thickness macular hole (FTMH) surgery when compared with the no-peeling technique.Design: Systematic review and individual participant data (IPD) meta-analysis undertaken under the auspices of the Cochrane Eyes and Vision Group. Only randomized controlled trials (RCTs) were included.Participants and Controls: Patients with idiopathic stage 2, 3, and 4 FTMH undergoing vitrectomy with or without ILM peeling.Intervention: Macular hole surgery, including vitrectomy and gas endotamponade with or without ILM peeling.Main Outcome Measures: Primary outcome was best-corrected distance visual acuity (BCdVA) at 6 months postoperatively. Secondary outcomes were (Read more...)

Defining the Limits of Normal Conjunctival Fornix Anatomy in a Healthy South Asian Population – Corrected Proof

Purpose: Quantifying the extent of conjunctival fibrosis for documentation of progression in conjunctival scarring disease is a clinical challenge. Measurement of forniceal foreshortening facilitates monitoring of these disorders. This study aims (1) to define the limits of the normal human conjunctival fornices and how these alter with age and (2) to provide normative data for upper and lower fornix depths (FDs) and fornix intercanthal distance (FICD) within a healthy South Asian, racially distinct population.Design: Epidemiologic, cross-sectional study.Participants: A total of 240 subjects with national origins from South Asia, with no known ocular history and normal adnexal and conjunctival examination, aged (Read more...)