1: Eur J Ophthalmol. 2008 Mar-Apr;18(2):320-3. 

Comparison of visual function and ocular hemodynamics between pre- and
post-menopausal women.

Siesky BA, Harris A, Patel C, Klaas CL, Harris M, McCranor LJ, Lauer J, Kaplan
B.

Department of Ophthalmology, Indiana University School of Medicine, Indianapolis
- USA.

PURPOSE. The incidence of eye disease increases with age and can often be linked
to worsening cardiovascular function and increasing intraocular pressure.
Estrogen is known to have vasodilatory effects in the systemic circulation.
Decreased estrogen levels during menopause may therefore complicate or
contribute to ocular pathologies as estrogen receptors are found in both retinal
and choroidal tissue. The purpose of this investigation was to determine the
effects of menopause on visual function and cardiovascular and ocular
hemodynamics. METHODS. Twelve premenopausal and 24 postmenopausal women were
evaluated at the Indiana University School of Medicine during a single study
visit. Vision screening and ocular blood flow evaluations were performed,
including blood pressure, heart rate, visual acuity, contrast sensitivity,
intraocular pressure, and retinal capillary and retrobulbar blood flow imaging.
Vision and ocular hemodynamics were compared using unpaired Student t-tests with
p<0.05 regarded as statistically significant. RESULTS. The premenopausal group
had significantly lower heart rate (-16.1 b/m, p=0.0001) and systolic blood
pressure (-17.7 mmHg, p=0.003) than postmenopausal subjects. Contrast
sensitivity was significantly higher (measured in log units) in premenopausal
women in both the right (0.25, p=0.039; 0.16, p=0.039) and left (0.45, p=0.001;
0.27, p=0.032) eyes at 9 and 18 cycles per degree, respectively. Premenopausal
women also had significantly lower intraocular pressure in both the right (-2.19
mmHg, p=0.024) and left (-1.74 mmHg, p=0.035) eyes. Total ocular perfusion was
not significantly different between groups. CONCLUSIONS. This pilot work
suggests that postmenopausal women have lower contrast sensitivity detection and
elevated intraocular pressures compared to premenopausal women. Premenopausal
women have lower cardiovascular risk factors, while total ocular circulation was
similar to postmenopausal women.

PMID: 18320533 [PubMed - in process]

2: Eur J Ophthalmol. 2008 Mar-Apr;18(2):316-9. 

Optociliary shunt vessels in compressive optic neuropathy by the intracranial
internal carotid artery.

Rebolleda G, Corcostegui J, Arruabarrena C, Martinez San Millan J, Munoz-Negrete
FJ.

Ophthalmology Department, Glaucoma Unit, Hospital Ramon y Cajal, University of
Alcala, Madrid - Spain.

PURPOSE. To report a clinical case of optic nerve compression by supraclinoidal
internal carotid artery associated with optociliary shunt vessels. METHODS. A
78-year-old woman with the clinical triad of left visual loss, ipsilateral optic
disc pallor, and retinochoroidal (optociliary) shunt vessels is reported. She
complained of loss of vision in the left eye of 2 years\'\' duration. RESULTS. A
diffuse depression of the visual field was found in the affected eye. Magnetic
resonance imaging revealed left optic nerve compression by the supraclinoidal
internal carotid artery. CONCLUSIONS. The occurrence of optociliary shunt
vessels, visual loss, and optic atrophy is a nonspecific sign of chronic optic
nerve compression and in some instances may be falsely localized.

PMID: 18320532 [PubMed - in process]

3: Eur J Ophthalmol. 2008 Mar-Apr;18(2):313-5. 

Hepatitis C virus presumably associated bilateral consecutive anterior ischemic
optic neuropathy.

Fodor M, Nagy V, Berta A, Tornai I, Pfliegler G.

Department of Ophthalmology, Medical and Health Sciences Center, Faculty of
Medicine, University of Debrecen, Debrecen - Hungary.

PURPOSE. To report a case of bilateral nonarteritic anterior ischemic optic
neuropathy (NAION) in a hepatitis C (HCV) infected patient and demonstrate the
relationship between HCV and the development of NAION. METHODS. Case report.
RESULTS. A 43-year-old woman with chronic HCV infection and long-term euthyroid
autoimmune thyroiditis suddenly lost vision in her right eye, and 6 months later
in her left eye, due to NAION. Slightly elevated levels of aminotransferases
suggested liver infection activity. Anti-HCV antibody was detected; the genotype
of the virus was 1b and the viral RNA level was 1.8 x 106 IU/mL. Liver biopsy
proved chronic active hepatitis (Ishak score grading: 7, staging: 2). Except for
the elevated levels of antithyroid antibodies and a weak antinuclear factor, the
detailed laboratory examinations (thrombophilia, cryoglobulin, anticardiolipin
antibodies, co-infections) revealed no other abnormalities; a causative
relationship between the underlying chronic hepatitis C and bilateral NAION
therefore seems probable. The patient was treated with pegylated interferon and
ribavirin for 1 year and a sustained viral remission could be achieved. Her
vision has neither improved nor deteriorated further. CONCLUSIONS. This appears
to be the first reported case of bilateral NAION presumably caused by HCV
infection.

PMID: 18320531 [PubMed - in process]

4: Eur J Ophthalmol. 2008 Mar-Apr;18(2):309-12. 

Is there alteration in aortic stiffness in Leber hereditary optic neuropathy?

Nemes A, De Coo IF, Spruijt L, Smeets HJ, Chinnery PF, Soliman OI, Geleijnse ML,
Ten Cate FJ.

Department of Cardiology, Thoraxcentre, Erasmus Medical Center, Rotterdam - The
Netherlands and 2nd Department of Medicine and Cardiology Center, University of
Szeged, Szeged - Hungary.

PURPOSE. Leber hereditary optic neuropathy (LHON) is recognized as the most
common cause of isolated blindness in young men. The current study was designed
to test whether LHON as a mitochondrial disease is associated with vascular
functional alterations characterized by aortic elastic properties during
echocardiography. METHODS. A total of 19 patients with typical features of LHON
aged 42+/-13 years (10 males) were included. Their results were compared to 19
age- and gender-matched healthy controls. Aortic stiffness index was calculated
from the echocardiographically derived aortic diameters and the clinical blood
pressure data. RESULTS. In this patient population, the point mutation was
present in 3460G>A position in five cases, in 11778G>A position in five cases,
and in 14484T>C position in nine patients. Diastolic aortic diameter (26.0+/-2.5
mm vs 28.4+/-4.1 mm, p<0.05) and aortic stiffness index (5.1+/-2.6 vs
12.0+/-7.9, p<0.05) were significantly increased in LHON patients compared to
controls. CONCLUSIONS. Aortic stiffness can be increased in LHON disease, but
further studies are warranted to confirm these findings in a larger LHON patient
population with a more reliable method focusing on the pathophysiologic
background.

PMID: 18320530 [PubMed - in process]

5: Eur J Ophthalmol. 2008 Mar-Apr;18(2):304-8. 

Vitreoretinal surgery for retinal detachment in retinochoroidal colobomata.

Teoh SC, Mayer EJ, Haynes RJ, Grey RH, Dick AD, Markham RH.

The Eye Institute, Tan Tock Seng Hospital - Singapore.

PURPOSE. To report the management and outcome of retinal reattachment surgery in
retinochoroidal coloboma. METHODS. Four patients with retinochoroidal colobomata
presented to the Bristol Eye Hospital (a UK tertiary referral center for
vitreoretinal surgery) with retinal detachment. INTERVENTION. All were type II
colobomatous detachments (three patients with type IIB, one patient with type
IID). All eyes underwent vitrectomy with endolaser and/or cryotherapy and three
eyes underwent scleral buckling. Two eyes had internal tamponade with gas (SF6,
C3F8) while the other two had silicone oil. Endolaser was applied over healthy
retinal pigment epithelium. RESULTS. At last follow-up, all (100%) remained
attached, with no recurrences. Three patients achieved visual acuity of 6/120 or
better and were able to perform satisfactory near work with appropriate
magnifiers. The last patient began with hand movement vision and retained
similar vision but subjectively felt more navigational. CONCLUSIONS. Good
anatomic and functional outcomes can be achieved in this patient group with
combined vitrectomy with or without scleral buckling surgery. Endolaser
retinopexy is effective over healthy RPE at the margin of the coloboma combined
with either gas or oil internal tamponade.

PMID: 18320529 [PubMed - in process]

6: Eur J Ophthalmol. 2008 Mar-Apr;18(2):301-3. 

Spontaneous resolution of vitreomacular traction following ranibizumab
(Lucentis) injection.

Rouvas A, Petrou P, Ladas I, Neamonitou G, Vergados I.

Second Ophthalmology Department, University of Athens, Attikon Hospital, Athens
- Greece.

PURPOSE. Spontaneous resolution of vitreomacular traction syndrome in diabetic
patients is a rare phenomenon that has been poorly described in the literature.
METHODS. Case presentation. RESULTS. The authors present a case of spontaneous
resolution of vitreomacular traction following intravitreal administration of
ranibizumab. CONCLUSIONS. In patients with vitreomacular traction syndrome and
diabetic macular edema, the combination of the possible vitreous liquefaction
and mechanical increase of vitreous volume caused by an intravitreal injection
with a degree of reduction in retinal thickness caused by the effect of vascular
endothelial growth factor inhibition could play a role in the resolution of
vitreomacular traction.

PMID: 18320528 [PubMed - in process]

7: Eur J Ophthalmol. 2008 Mar-Apr;18(2):297-300. 

Single-session photodynamic therapy combined with intravitreal bevacizumab for
neovascular age-related macular degeneration.

Ahmadieh H, Taei R, Soheilian M, Riazi-Esfahani M, Ahadi H.

Ophthalmic Research Center of Shaheed Beheshti Medical University, Labbafinejad
Medical Center, Tehran - Iran.

PURPOSE. To evaluate the efficacy of combined single-session photodynamic
therapy (PDT) and intravitreal bevacizumab (IVB) for treatment of neovascular
age-related macular degeneration (AMD). METHODS. In a prospective interventional
case series, patients with subfoveal choroidal neovascularization (CNV)
underwent PDT followed by 1.25 mg IVB injection. Best-corrected visual acuity
(BCVA) and optical coherence tomography (OCT) measurements were repeated at
6-week intervals and fluorescein angiography was performed after 12 weeks and
when considered necessary thereafter. Repeat injections of IVB were performed
based on fluorescein angiographic evidence of CNV leakage. RESULTS. Fourteen
eyes were included in this study. Mean follow-up was 52.4+/-15.2 weeks (range:
26-74 weeks). Initially, mean BCVA was 0.80+/-0.42 logMAR and mean central
macular thickness (CMT) was 308+/88 micronm. At week 12, BCVA improved to
0.62+/-0.47 logMAR (p=0.006) and CMT reduced to 186+/-53 micronm (p=0.003).
Corresponding results were 0.53+/-0.52 logMAR (p=0.02) and 193+/-78 micronm
(p=0.002) after 24 weeks. A second IVB injection was performed in 13 eyes with a
mean interval of 16.3+/-5.9 weeks. CONCLUSIONS. Combination therapy with
single-session PDT and IVB can improve vision and reduce CMT in neovascular AMD.
Repeat IVB injections may maintain the visual gain from the initial combination
therapy.

PMID: 18320527 [PubMed - in process]

8: Eur J Ophthalmol. 2008 Mar-Apr;18(2):294-6. 

Mycobacterium chelonae keratitis in a patient with Sjogren\'\'s syndrome.

Van Der Beeck MT, Bernards AT, Lapid-Gortzak R.

Department of Medical Microbiology, Center of Infectious Diseases, Leiden
University Medical Center, The Netherlands.

PURPOSE. In this report a case of Mycobacterium chelonae keratitis in a patient
without any previously described risk factors is described. The only risk factor
found was a rheumatoid arthritis related Sjogren\'\'s syndrome. METHODS. Case
report. RESULTS. A 60-year-old woman was referred to the hospital with an
infectious keratitis of the left eye of 3 months duration, unresponsive to
empirical therapy with ofloxacin and tobramycin drops. Her medical history
included a longstanding rheumatoid arthritis and a secondary ocular surface
syndrome. Upon arrival the left eye showed diffuse corneal edema and centrally
several large infiltrates with fluffy edges, surrounded by several smaller
satellite infiltrates. The cornea was scraped for culture and grew M chelonae
and sensitivity testing showed sensitivity to ciprofloxacin, clofazimine, and
clarithromycin. Systemically, ciprofloxacin 750 mg and clarithromycin 500 mg
twice daily were prescribed orally. Topical therapy consisted of topical
erythromycin 10 mg/mL and ofloxacin 3 mg/mL every 2 hours. Treatment was
continued for a total of 10 months during which the infiltrates cleared
completely, but the central cornea remained scarred. CONCLUSIONS. M chelonae can
be a cause of infectious keratitis in patients without known risk factors for
rapidly growing mycobacterium keratitis. Especially in the case of ocular
infections that show no response to regular antibacterial treatment,
mycobacterial infection should be considered. Good communication between the
ophthalmologist and the microbiologist is crucial for a rapid diagnosis.

PMID: 18320526 [PubMed - in process]

9: Eur J Ophthalmol. 2008 Mar-Apr;18(2):290-3. 

Penetrating keratoplasty in a newborn: Case report and analysis of current
surgical trends in Italy.

Ricci B, Coppola G, Capobianco A, Ziccardi L.

Ophthalmology Unit, Association Columbus Clinic, Catholic University, Roma -
Italy.

PURPOSE. The aims of this study were to describe bilateral penetrating
keratoplasty (PK) in a newborn and to analyze the data of PKs performed in Italy
during the 5-year period 1999-2003 in children under 4 years of age. METHODS. A
male newborn had PK at age 3 months and 5 months for near-blindness secondary to
severe congenital corneal clouding in both eyes. The infant\'\'s explanted corneas
were subjected to histochemical and ultrastructural analyses. Data regarding the
number of PKs performed in Italy on 0-4-year-olds were obtained from the Web
site of the Italian Ministry of Health. RESULTS. The postoperative courses were
uncomplicated, and 42 months of follow-up data show bilateral graft transparency
and substantial improvement in visual acuity despite high-grade myopia and
nystagmus. At the ultrastructural level, the main alterations involved the
endothelial cells and Descemet membrane. A total of 45 PKs were performed in
Italy on patients 0-4 years old from 1999 through 2003; only nine involved
babies under 1 year of age. CONCLUSIONS. In babies with congenital corneal
opacities, early PK can reduce severe amblyopia. However, the risk of intra- and
postoperative complications in PK is high. Based on the 42-month follow-up, the
anatomic and functional results achieved in the current patient are satisfactory
despite the presence of nystagmus and postoperative high-grade myopia. This
study shows that PKs are rarely performed, in Italy, in children aged 0-4 years,
and very few are done during the first year of life.

PMID: 18320525 [PubMed - in process]

10: Eur J Ophthalmol. 2008 Mar-Apr;18(2):285-9. 

The importance of cyclotorsional changes in refractive surgery.

Laria C, Gamio S, Prieto-Diaz J, Alio JL, Miranda M, Plech AR.

VISSUM-Instituto Oftalmologico de Alicante, Department of Pediatric
Ophthalmology and Strabismus, Alicante - Spain.

PURPOSE. To provide evidence of the importance of a precise record of torsional
alterations in all patients about to undergo refractive surgery and particularly
in patients with latent strabismus that may become decompensated due to the
dissociation phenomenon produced during different surgical procedures that
result in fixation loss. METHODS. Using 3D-VOG video-oculography, the authors
analyzed the horizontal, vertical, and torsional movements of each eye after
inducing fixation loss in one and both eyes in a patient with well-compensated
dissociated vertical deviation (DVD). As the dissociated techniques, Posner
maneuver and the placing of Bagolini filters with increasing densities by means
of the Bielschowsky phenomenon, both pathognomonic of DVD. RESULTS. The authors
observed not only horizontal and vertical alterations, but also cyclotorsional
alterations which may even exceed 15 degrees depending on the resulting
dissociation component. CONCLUSIONS. In view of the obtained results, the
authors consider it important to conduct a meticulous study of ocular motility
in all patients about to undergo refractive surgery, especially in the case of
high astigmatism to rule out possible latent strabismus that may condition
cyclotorsional alterations important in refractive surgery.

PMID: 18320524 [PubMed - in process]

11: Eur J Ophthalmol. 2008 Mar-Apr;18(2):282-4. 

Congenital ocular motor apraxia.

Goncalves Carrasquinho S, Teixeira S, Cadete A, Bernardo M, Pego P, Prieto I.

Department Paediatric Ophthalmology, Hospital Fernando Fonseca, Lisboa -
Portugal.

PURPOSE. Congenital ocular motor apraxia is a rare disease characterized by
defective or absent voluntary and optically induced horizontal saccadic
movements. Jerky head movements or thrusts on attempted lateral gaze are a
compensatory sign. Most affected children have delayed motor and speech
development. Cases associated with systemic diseases, neurologic maldevelopment,
metabolic deficits, and chromosomal abnormalities have been described. METHODS.
Case report and review of the scientific literature. RESULTS. The authors
describe the ophthalmologic, pediatric, and neurologic evaluations and follow up
of a child with impaired horizontal saccades, jerky head movements, and delayed
motor and speech development. CONCLUSIONS. Congenital ocular motor apraxia is an
uncommon disorder of ocular motility. Even so, ophthalmologists should be aware
of the developmental delay and the other associated conditions, in order to
grant the patients the multidisciplinary assistance they often require.

PMID: 18320523 [PubMed - in process]

12: Eur J Ophthalmol. 2008 Mar-Apr;18(2):278-81. 

Hess Lancaster screen test with the head tilted: A useful test in the diagnosis
of bilateral fourth nerve palsies.

Armesto A, Ugrin MC, Travelletti E, Schlaen A, Piantanida N.

Ophthalmology Department, Hospital de Clinicas, University of Buenos Aires and
Ophthalmology Department, Hospital Aleman, Buenos Aires - Argentina.

PURPOSE. To introduce Hess Lancaster screen test performed with the head tilted
as a new ancillary test to help in the diagnosis of bilateral superior oblique
(SO) nerve paresis. METHODS. Three patients with clinical diagnosis of acquired
bilateral fourth nerve paresis, three with clinical diagnosis of acquired
unilateral fourth nerve paresis, and three normal subjects were tested with Hess
Lancaster test in the nine positions of gaze with their heads straight and with
their heads tilted to each side. Test results were compared and data were
analyzed. RESULTS. Hess Lancaster test of all patients with bilateral SO palsy
performed with their heads straight showed unilateral SO underaction, but when
the test was carried out with the head tilted to each side findings were
positive for ipsilateral SO underaction and ipsilateral hypertropia for both
sides. In those patients with unilateral SO palsy, Lancaster test was positive
for SO underaction when the head was in straight position and when it was tilted
to the side of the paretic muscle, but it was almost normal with the head tilted
to the opposite side. Normal subjects did not show any abnormality regardless of
the head position. CONCLUSIONS. Bilateral SO palsies are sometimes difficult to
diagnose for they might be masked. Hess Lancaster test carried out with the head
tilted to both sides could help in the diagnosis of bilateral SO palsies.

PMID: 18320522 [PubMed - in process]

13: Eur J Ophthalmol. 2008 Mar-Apr;18(2):270-7. 

Prognostic factors associated with outcomes after giant retinal tear management
using perfluorocarbon liquids.

Al-Khairi AM, Al-Kahtani E, Kangave D, Abu El-Asrar AM.

Department of Ophthalmology, College of Medicine, King Saud University, Riyadh -
Saudi Arabia.

PURPOSE. To identify prognostic factors for visual acuity and anatomic outcomes
associated with giant retinal tear management using intraoperative
perfluorocarbon liquids. METHODS. All patients with giant retinal tears without
proliferative vitreoretinopathy (PVR) who underwent management with
intraoperative perfluorocarbon liquids between 1994 and 2005 were reviewed.
RESULTS. The study included 115 patients (117 eyes), 93 (80.9%) males and 22
(19.1%) females, with a mean age of 30.3+/-15.2 years. Mean follow-up period was
29.7+/-26.7 months. Success rate with primary procedure was 78.6%, which
increased to 94% with multiple surgeries. On univariate analysis, factors
significantly associated with final visual acuity better than 20/200 included
phakic/clear lens at presentation (p=0.0113), partial retinal detachment
(p=0.0233), absence of all postoperative complications (p=0.0122), absence of
recurrent retinal detachment (p=0.0406), and absence of postoperative PVR
(p=0.0062). Logistic regression analysis highlighted that phakic/clear lens at
presentation, unfolded flap of the giant tear, absence of postoperative
cataract, and absence of postoperative PVR were associated with final visual
acuity better than 20/200. On univariate analysis, use of gas tamponade was
significantly associated with recurrent retinal detachment (p=0.0190). Logistic
regression analysis highlighted that placement of an encircling scleral buckle
and use of silicone oil tamponade were associated with anatomic reattachment
with primary procedure. CONCLUSIONS. Encircling scleral buckling and silicone
oil tamponade decrease the risk of recurrent retinal detachment.

PMID: 18320521 [PubMed - in process]

14: Eur J Ophthalmol. 2008 Mar-Apr;18(2):263-9. 

Bevacizumab-augmented retinal laser photocoagulation in proliferative diabetic
retinopathy: A randomized double-masked clinical trial.

Mirshahi A, Roohipoor R, Lashay A, Mohammadi SF, Abdoallahi A, Faghihi H.

Eye Research Center, Farabi Eye Hospital, Medical Sciences/University of Tehran,
Tehran - Iran.

PURPOSE. To evaluate the additional therapeutic effect of single intravitreal
bevacizumab injection on standard laser treatment in the management of
proliferative diabetic retinopathy. METHODS. A prospective, fellow-eye sham
controlled clinical trial was conducted on 80 eyes of 40 high-risk
characteristic proliferative diabetic retinopathy type II diabetics. All cases
received standard laser treatment according to Early Treatment Diabetic
Retinopathy Study protocol. Avastinassigned eyes received 1.25 mg intravitreal
bevacizumab (Genentech Inc., San Francisco, CA) on the first session of their
laser treatments. Fluorescein angiography was performed at baseline and at weeks
6 and 16, and proliferative diabetic retinopathy regression was evaluated in a
masked fashion. RESULTS. The median age was 52 years (range: 39-68) and 30% of
the participants were male. All patients were followed for 16 weeks. A total of
87.5% of Avastin-injected eyes and 25% of sham group showed complete regression
at week 6 of follow-up (p<0.005). However, at week 16, PDR recurred in a sizable
number of the Avastin-treated eyes, and the complete regression rate in the two
groups became identical (25%; p=1.000); partial regression rates were 70% vs
65%. In the subgroup of Avastin-treated eyes, multivariate analysis identified
hemoglobin A1c as the strongest predictor of proliferative diabetic retinopathy
recurrence (p=0.033). CONCLUSIONS. Intravitreal bevacizumab remarkably augmented
the short-term response to scatter panretinal laser photocoagulation in
high-risk characteristic proliferative diabetic retinopathy but the effect was
short-lived, as many of the eyes showed rapid recurrence. Alternative dosing
(multiple and/or periodic intravitreal Avastin injections) is recommended for
further evaluation.

PMID: 18320520 [PubMed - in process]

15: Eur J Ophthalmol. 2008 Mar-Apr;18(2):255-62. 

Intracameral Avastin dramatically resolves iris neovascularization and reverses
neovascular glaucoma.

Chalam KV, Gupta SK, Grover S, Brar VS, Agarwal S.

Department of Ophthalmology, University of Florida College of Medicine,
Jacksonville, FL - USA.

PURPOSE. To report the biologic effect of intracameral bevacizumab in patients
with iris neovascularization secondary to proliferative retinal vasculopathies.
METHODS. Sixteen eyes of 15 patients with iris neovascularization associated
with or without neovascular glaucoma secondary to proliferative retinal
vasculopathies received intracameral bevacizumab (1.25 mg). Ophthalmic
evaluations included Snellen visual acuity (VA), complete ophthalmic iris
angiography, and slit lamp photography. Main outcome measure was change in
degree of iris neovascularization. Secondary outcomes included fluorescein iris
angiographic leakage, control of intraocular pressure, and changes in VA.
RESULTS. All patients with neovascularization demonstrated by slit lamp
photography and fluorescein angiography (16/16 eyes) had complete (or at least
partial) reduction in leakage of the neovascularization within 3 weeks after the
injection. Leakage from iris neovascularization resolved in 12 of 16 (75%) eyes.
In two cases recurrent leakage was seen as early as 4 weeks necessitating repeat
injection. Intraocular pressure was controlled with maximum medical therapy in
eight of nine eyes reducing the need for glaucoma surgery. Visual acuity
improved from a median of hand motions to 20/200. CONCLUSIONS. In summary,
intracameral bevacizumab was effective in reversing iris neovascularization in
the majority of patients. It also facilitated intraocular pressure control in
patients with associated glaucoma.

PMID: 18320519 [PubMed - in process]

16: Eur J Ophthalmol. 2008 Mar-Apr;18(2):248-54. 

Retinal photocoagulation for proliferative sickle cell retinopathy: A
prospective clinical trial with new sea fan classification.

Sayag D, Binaghi M, Souied EH, Querques G, Galacteros F, Coscas G, Soubrane G.

Department of Ophthalmology, University of Paris XII, Centre Hospitalier
Intercommunal de Creteil, Creteil - France.

PURPOSE. To compare the clinical outcome of stage III proliferative sickle cell
retinopathy (PSR) treated by peripheral retinal scatter photocoagulation to
natural course disease. METHODS. Long-term follow-up of 101 patients enrolled in
a prospective trial of photocoagulation for PSR has been completed. Among 202
eyes of 101 patients enrolled at the University Eye Clinic of Creteil, 73 eyes
showed a stage III PSR, which the authors further divided into five new grades
(A, B, C, D, E) considering size, hemorrhage, fibrosis, and visible vessels.
Grading was based on a three-mirror fundus examination, 360 degrees color
photographs, and fluorescein angiography. Mean follow- up was 4 years. RESULTS.
Thirty-eight treated eyes and 35 untreated eyes were included in this study. The
evolution was not statistically significant between treated and untreated groups
concerning flat sea fan <1 MPS disc area (grade A) or elevated sea fan with
partial fibrosis (grade C). Progression and regression were compared between the
two groups for grade B, resulting statistically significant (p<0.05). Nine
complications (13%) were observed, which only occurred in untreated patients
with elevated sea fan and hemorrhage (grade B) or complete fibrosed sea fan with
well defined vessels (grade E) (p<0.05). CONCLUSIONS. These data suggest that
patients with grade A or C new sea fan classification should not be initially
treated but observed.

PMID: 18320518 [PubMed - in process]

17: Eur J Ophthalmol. 2008 Mar-Apr;18(2):239-47. 

Correlation of visual function impairment and OCT findings in patients with
Stargardt disease and fundus flavimaculatus.

Querques G, Prato R, Iaculli C, Voigt M, Delle Noci N, Coscas G, Soubrane G,
Souied EH.

Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris
XII, Paris - France and Department of Ophthalmology, Ospedali Riuniti,
University of Foggia, Foggia - Italy.

PURPOSE. To investigate the relationship between morphologic lesions of the
retina and functional abnormalities in patients with Stargardt disease (STGD)
and fundus flavimaculatus (FFM). DESIGN. Case-controlled, prospective,
comparative observational study. METHODS. A complete ophthalmologic examination,
including best-corrected visual acuity (BCVA) and optical coherence tomography
(OCT), was performed in 61 eyes of 32 consecutive patients with STGD/FFM and in
60 eyes of 30 matched healthy control subjects. Furthermore, fundus-related
perimetry was performed in 12 of the affected eyes. RESULTS. The age ranged from
21 to 71 years in STGD/FFM patients and from 21 to 72 years in controls. BCVA
ranged from 20/20 to 20/400 and from 20/20 to 20/32, respectively, in STGD/FFM
patients and in controls. A foveal thinning was found by OCT Stratus in almost
all cases (average 160 micronm) compared with controls (average 210 micronm)
(p<0.001). BCVA impairment significantly correlated to the degree of foveal
thinning (r2=0.16; p=0.0014). Moreover, in STGD/FFM patients the authors
observed two types of hyperreflective deposits which were not correlated with
BCVA impairment or foveal thinning. In addition, fundus-related perimetry
revealed a stable fixation in 8/12 eyes, that was predominantly central in only
4 of these eyes. A smaller degree of foveal thinning correlated to a more stable
fixation (p=0.0108), even if not predominantly central (p=0.0218). CONCLUSIONS.
In this series, lower visual acuity and unstable fixation correlated with a
greater transverse foveal thinning. OCT and fundus-related perimetry may be
useful tools in STGD/FFM patients.

PMID: 18320517 [PubMed - in process]

18: Eur J Ophthalmol. 2008 Mar-Apr;18(2):233-8. 

Atherosclerotic and thrombophilic risk factors in patients with recurrent
central retinal vein occlusion.

Sodi A, Giambene B, Marcucci R, Sofi F, Bolli P, Abbate R, Prisco D, Menchini U.

Department of Oto-Neuro-Ophthalmological Surgical Sciences, Eye Clinic, Firenze
- Italy.

PURPOSE. Atherosclerotic and thrombophilic risk factors may be causes of central
retinal vein occlusion (CRVO). The aim of this study was to evaluate the
prevalence of the aforesaid risk factors in patients with recurrent CRVOs and
patients with a single episode of CRVO. METHODS. Seventeen patients with
recurrent CRVO and 30 with a single episode of CRVO were enrolled. The
atherosclerotic risk factors investigated were hypertension, diabetes, smoking,
and dyslipidemia. Specific laboratory tests for the following thrombophilic
markers were performed: homocystinemia (Hcy), lipoprotein (a), factor VIII,
factor II G20210A and factor V G1691A polymorphisms, lupus anticoagulant,
anticardiolipin antibodies, plasminogen activator inhibitor-1, and deficit of
vitamins B6, B12, and folic acid. A multivariate analysis, adjusted for age,
gender, traditional and thrombophilic risk factors, was performed. Statistical
significance was set at p7 years postsurgery. Group A patients
showed no cells/exudates adhering to the IOL surfaces, no synechiae, minimal (as
compared to Group B) vitreous opacifications, and significantly higher visual
acuity (p=0.024 at the seventh year control). Group A patients reported less
frequent relapses of uveitis postsurgery, but the relevant clinical data did not
allow statistical evaluations. CONCLUSIONS. Total removal of cataract in highly
exudative uveitic eyes, plus anterior vitrectomy and scleral fixation of PC
IOLs, although technically a more demanding surgical procedure, proved tobe safe
and more effective than classical procedures.

PMID: 18320514 [PubMed - in process]

21: Eur J Ophthalmol. 2008 Mar-Apr;18(2):212-9. 

Results of combined phacoemulsification and viscocanalostomy in patients with
cataract and pseudoexfoliative glaucoma.

Hassan KM, Awadalla MA.

Magrabi Eye Center, Riyadh - Saudi Arabia.

PURPOSE. Coexisting pseudoexfoliation glaucoma (PEXG) and cataract represents a
special challenge. Although phacotrabeculectomy is an effective procedure, it
combines the risks of phacoemulsification and trabeculectomy. This study
evaluates phacoviscocanalostomy to manage eyes with PEXG and cataract. METHODS.
We conducted a prospective noncomparative study that included 30 consecutive
eyes of 22 patients with uncontrolled PEXG and cataract. Phacoviscocanalostomy
was performed in all. Success rate based on postoperative intraocular pressure
(IOP) reduction and requirement for topical antiglaucoma medication was
evaluated as the main outcome measure. Visual acuity and complication rates were
secondary outcomes. RESULTS. The mean follow-up was 18.6 months +/- 6.2 (SD)
(range 12 to 36 months). There was statistically significant decrease in mean
IOP from 25.3 +/- 5.2 mmHg preoperatively to 13.5 +/- 6.0 mmHg 1 day after
surgery (p< .05), 12.3 +/- 3.1 mmHg at the final follow-up (p< .05), and at all
evaluations to the last postoperative visit. Only three eyes (10%) required a
single antiglaucoma medication to achieve the target IOP. A complete surgical
success (IOP < 21 mmHg without medication) was achieved in 90%, while a
qualified success (IOP < 21 mmHg with or without glaucoma medication) was
achieved in 100% of cases. Complications included Descemet membrane
microperforations (13.3%), macroperforation (3.3%), zonular dehiscence (6.6%),
and transient postoperative IOP spike (3.3%). CONCLUSIONS. Phacoviscocanalostomy
achieved excellent IOP control and visual acuity improvement in
pseudoexfoliation patients with coexisting cataract and glaucoma. Complication
rate was low and did not affect the surgical outcome.

PMID: 18320513 [PubMed - in process]

22: Eur J Ophthalmol. 2008 Mar-Apr;18(2):205-11. 

Rarebit perimetry and frequency doubling technology in patients with ocular
hypertension.

Corallo G, Iester M, Scotto R, Calabria G, Traverso CE.

Centro di Ricerca Clinica e Laboratorio per il Glaucoma e la Cornea, Department
of Neurological Sciences, Ophthalmology and Genetics, Eye Clinic, University of
Genova, Genova - Italy.

PURPOSE. To test the capability of rarebit perimetry (RP), a recent
non-conventional perimetric technique, in detecting early functional damage in
subjects with ocular hypertension (OHT) and to compare RP findings with those
obtained by frequency-doubling technology (FDT) perimetry. METHODS. Thirty
patients with OHT were matched with 30 healthy subjects. All were tested with RP
and FDT. Frequency-doubling technology mean deviation (MD) and pattern standard
deviation (PSD), as well as RP mean hit rate (MHR), of the two groups were
analyzed. The agreement between the two techniques was tested by Kappa analysis.
RESULTS. In the OHT group the mean (SD) FDT MD was 0.5 (2.1), the mean (SD) FDT
PSD was 4.2 (1.6), and the mean (SD) RP MHR was 81.4 (6.7). In the control
group, corresponding values were mean (SD) FDT MD 1.1 (1.4), mean (SD) FDT PSD
3.0 (0.3), mean (SD) RP MHR 96.2 (2.0). The differences between the two groups
were not significant for the studied indexes. Eleven (36.6%) out of the 30 OHT
eyes had abnormal RP results; 12 (40.0%) eyes had abnormal FDT results. Five
(16.6%) eyes had abnormal RP and FDT findings. Only 1 eye (3.3%) in the control
group had abnormal RP results and 3 eyes (10.0%) had abnormal FDT results. RP
and FDT showed a moderate agreement (Kappa = 0.43; 95% CI: 0.42 to 0.51).
CONCLUSIONS. RP and FDT showed VF defects not shown in standard automated
perimetry in the OHT group. This may be indicative of an increased risk in
developing glaucoma, even if a gold standard for detecting subtle defects is not
currently available. RP has the additional advantage of not requiring any
expensive device to be used. The poor agreement between these techniques in
identifying eyes with early damage warrants further investigations. Large
longitudinal studies are needed before defining the role of RP in early glaucoma
diagnosis.

PMID: 18320512 [PubMed - in process]

23: Eur J Ophthalmol. 2008 Mar-Apr;18(2):199-204. 

Physician attitudes regarding prostaglandin treatment for glaucoma in the United
States and Europe.

Stewart WC, Stewart JA, Nelson LA, Kruft B.

Carolina Eye Institute, University of South Carolina, School of Medicine,
Columbia and PRN Pharmaceutical Research Network, LLC, Dallas - USA.

PURPOSE. To evaluate physician use of prostaglandins (latanoprost, travoprost,
and bimatoprost) in the United States (US) and Europe (EU). METHODS. One
thousand multiple-choice surveys were distributed via e-mail in the US and EU.
RESULTS. The authors received 71 responses (US 40 [8%] and EU 31 [6%]).
Physicians preferred prostaglandin monotherapy (US 39 [98%] and EU 22 [71%],
p=0.003), usually latanoprost (US 32 [80%] and EU 22 [71%], p=0.45). When more
efficacy was required, US physicians would typically switch (23 [58%]) and EU
physicians would add therapy (22 [71%], p=0.007). In both continents 45% of
respondents stated bimatoprost was more efficacious. CONCLUSIONS. US and EU
physicians prefer prostaglandin monotherapy, most commonly latanoprost.
Bimatoprost is often perceived as more effective, but having a higher incidence
of conjunctival hyperemia.

PMID: 18320511 [PubMed - in process]

24: Eur J Ophthalmol. 2008 Mar-Apr;18(2):191-8. 

Combined phacoemulsification and Ahmed valve glaucoma drainage implant: A
retrospective case series.

Nassiri N, Nassiri N, Sadeghi Yarandi S, Mohammadi B, Rahmani L.

Department of Ophthalmology, Imam Hossein Medical Center, Shaheed Beheshti
University of Medical Sciences, Tehran - Iran.

PURPOSE. To report on the efficacy and safety of combined phacoemulsification
and an Ahmed valve glaucoma drainage implant with respect to visual acuity
improvement, intraocular pressure (IOP) control, and requirement for
antiglaucoma medication. METHODS. A retrospective chart review was conducted of
41 eyes (31 patients) with coexisting visually significant cataracts and
uncontrolled glaucoma who had combined phacoemulsification and Ahmed valve
implantation. The outcome measures were: visual acuity, IOP, antiglaucoma
medication requirements, and intra- and post-operative complications. Success
was categorized as absolute (IOP<21 mmHg without the need for antiglaucoma
medication) and relative (IOP<21 mmHg with one or more antiglaucoma
medications). Failure was considered to be an IOP<6 mmHg or IOP>21 mmHg on
maximally tolerated medications or any devastating complication. RESULTS. The
mean patient age was 67.3+/-5.9 years old. The mean visual acuity improved from
0.73+/-0.5 to 0.16+/-0.16 (p=0.000). The mean IOP decreased from 28.2+/-3.1 to
16.8+/-2.1 (p=0.000, 40.4%), while the number of antiglaucoma medication
decreased from 2.6+/-0.66 to 1.2+/-1.4 (p=0.000). The absolute and relative
success rates were 56.1% and 31.7%, respectively; 5 eyes (12.2%) were considered
failures. There were no intraoperative complications; postoperative
complications occurred in 8 eyes (19.5%). A hypertensive phase was detected in
12 (29.3%) eyes. CONCLUSIONS. Combined phacoemulsification and Ahmed valve
glaucoma drainage implantation is a safe and effective alternative to
phacotrabeculectomy in patients with coexisting cataract and refractory
glaucoma.

PMID: 18320510 [PubMed - in process]

25: Eur J Ophthalmol. 2008 Mar-Apr;18(2):182-90. 

Evaluation of threshold estimation and learning effect of two perimetric
strategies, SITA Fast and CLIP, in damaged visual fields.

Capris P, Autuori S, Capris E, Papadia M.

Department of Neurosciences, Ophthalmology and Genetics-Clinica Oculistica,
Department of Health Science Section Biostatistics, University of Genova, Genova
- Italy.

PURPOSE. The threshold estimation, learning effect, and between-algorithm
differences of the Fast Swedish Interactive Thresholding Algorithm (SITA Fast),
of the Humphrey Field Analyzer (HFA), and the Continuous Light Increment
Perimetry (CLIP) strategy of the Oculus Twinfield perimeter were evaluated in
damaged visual fields. METHODS. Twenty-one glaucomatous patients with damaged
visual fields (MD worse than -8 dB) underwent Oculus Full Threshold (FT),
Humphrey FT, SITA Fast, and CLIP 30-2 perimetric examinations. All the tests
were repeated in a second session at least 3 days later. The point-wise
differences in absolute sensitivity and of the total deviation plot values
between FT and fast algorithms, between fast algorithms and the learning effect
were evaluated (Wilcoxon test and Bland-Altman analysis). RESULTS. The average
point-wise sensitivity difference between SITA Fast and HFA FT strategy (0.84
dB) was significantly lower than that found between CLIP and Oculus FT strategy
(1.71 dB). Between-algorithm point-wise differences of the total deviation plot
values of the fast strategies were not significantly different. Learning effect
for SITA Fast (0.67 dB) was higher than that found for CLIP (0.39 dB). Test time
for SITA (367+/-71 sec) and CLIP (453+/-98 sec) were about 55% and 35%,
respectively, shorter (p<0.001) than those found with FT algorithms. The
acceptance for fast algorithms and particularly for CLIP was significantly
better. CONCLUSIONS. The two fast strategies, even though using very different
algorithms, showed good threshold estimation compared to FT strategies with a
consistent time saving in damaged visual fields.

PMID: 18320509 [PubMed - in process]

26: Eur J Ophthalmol. 2008 Mar-Apr;18(2):177-81. 

Effect of pterygium surgery on corneal topography.

Errais K, Bouden J, Mili-Boussen I, Anane R, Beltaif O, Meddeb Ouertani A.

Department of Ophthalmology, Charles Nicolle University Hospital, Tunis -
Tunisia.

PURPOSE. To evaluate the effect of successful pterygium surgery on corneal
topography. METHODS. Computerized corneal topography was performed on 20 eyes
with pterygium before and 3 months after successful excision and
limbo-conjunctival autograft surgery. Corneal shape, corneal spherical power,
simulated keratometric astigmatism, surface regularity index (SRI), and surface
asymmetry index (SAI) were assessed before and after surgery. Pre- and
postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual
acuity (BSCVA), and manifest refraction spherical equivalent (MRSE) were also
evaluated. RESULTS. Changes in corneal shape were mainly a decrease in midline
corneal flattening. Corneal spherical power was 41.65+/-3.29 diopters (D) (mean
+/- SD) preoperatively and 44.58+/-1.55 D postoperatively (p=0.04). Simulated
keratometric astigmatism was 5.47+/-3.45 D preoperatively and 1.79+/-1.52 D
postoperatively (p=0.0005). SRI was 1.39+/-0.93 preoperatively and 1.10+/-0.57
postoperatively (p=0.03). SAI was 1.17+/-1.09 preoperatively and 0.75+/-0.73
postoperatively (p=0.02). UCVA was 0.31+/-0.33 preoperatively and 0.52+/-0.32
postoperatively (p=0.04). BSCVA was 0.73+/-0.20 preoperatively and 0.89+/-0.16
postoperatively (p=0.008). MRSE was -0.54+/-3.29 D preoperatively and
-1.30+/-3.05 D postoperatively (p=0.45). CONCLUSIONS. Corneal topographic
changes caused by the pterygium are almost reversible after surgical treatment.
Successful pterygium surgery significantly reduces topographic astigmatism, SRI,
SAI, and corneal flattening. However, precise prediction of these refractive
changes is not always accurate.

PMID: 18320508 [PubMed - in process]

27: Eur J Ophthalmol. 2008 Mar-Apr;18(2):172-7. 

Color Doppler imaging of retrobulbar hemodynamics in Sturge-Weber
syndrome-associated glaucoma.

Neely D, Harris A, Siesky B, McCranor L, McNulty L, Hynes E, Benzion I.

Department of Ophthalmology, Indiana University School of Medicine, Indianapolis
- USA.

PURPOSE. Sturge-Weber syndrome (SWS) is frequently associated with early onset
glaucoma in the eye on the same side as the facial angioma. The exact cause of
glaucoma in SWS is poorly understood and difficult to treat. The purpose of this
study is to investigate the ocular hemodynamics of children with SWS-associated
glaucoma using color Doppler imaging techniques. METHODS. This is a prospective
study of 10 pediatric patients with unilateral SWS-associated glaucoma. Color
Doppler imaging was used to measure the peak systolic velocity and the end
diastolic velocity of both the ophthalmic and central retinal arteries in the
glaucomatous eye compared to the fellow healthy eye. RESULTS. Twenty eyes of 10
children with SWS (6 boys) with unilateral glaucoma were included in the
prospective study. The mean age of the 10 participants was 5.5 years. When
compared to their contralateral normal eyes, the glaucomatous eyes had greater
CDR (p<0.001) and a myopic shift (p=0.04). No significant differences were found
in the measurements of ocular blood flow velocities of the ophthalmic and
central retinal arteries. CONCLUSIONS. Vascular pathology has been proposed to
play a role in SWS glaucoma etiology. The authors did not find arterial
retrobulbar blood flow differences between the glaucomatous and the fellow
normal eye. Since the primary vascular anomaly in patients with SWS is in the
venous plexus, a bigger prospective trial is warranted in order to better
understand and treat children with SWS glaucoma.

PMID: 18320507 [PubMed - in process]

28: Eur J Ophthalmol. 2008 Mar-Apr;18(2):165-71. 

Exophthalmometry values of Turkish adult population and the effect of age, sex,
refractive status, and Hertel base values on Hertel readings.

Beden U, Ozarslan Y, Ozturk HE, Sonmez B, Erkan D, Oge I.

Ophthalmology Department, Ondokuz Mayis University, Samsun - Turkey.

PURPOSE. To establish normal exophthalmometry values in the adult Turkish
population, and the impact of age, gender, interpupillary distance, Hertel base
selection, and refractive status on globe position. METHODS. Exophthalmometry
measurements and refractive status of 2477 subjects were conducted in one
tertiary and five primary health care centers. Change of globe position by age,
intersex differences in terms of globe position, correlations of Hertel base
with exophthalmometry results, and interpupillary distance (IPD) were evaluated.
Multiple linear regression analysis was performed to test determination effect
of each variable on final Hertel reading. RESULTS. Median Hertel reading was 13
mm, and 95% of the population had an upper limit of 17 mm for both eyes. There
was a negative correlation between spherical equivalent of refractive status and
exophthalmometry results and a weak positive correlation between IPD and
exophthalmometry result. Mean Hertel value was found to decrease significantly
after the third decade. Hertel base value was found to have moderate linear
correlation with Hertel results. A weak correlation was detected with Hertel
base/IPD ratio with final Hertel results. Multiple linear regression analysis
was performed and only 13% and 20% of change in Hertel values bilaterally were
found to be determined by other variables (age, IPD, refractive status, and
Hertel base value) for females and males. CONCLUSIONS. Normative dataset for
exophthalmometry results of the Turkish population is established to be used in
clinical practice and research. Only 13% to 20% of change in Hertel values was
detected to be determined by age, IPD and Hertel base values.

PMID: 18320506 [PubMed - in process]