Journal Contents

Am Jour Ophthalmol
Br J Ophthalmol
Can J Ophthalmol
J Cat Ref Surg
Curr Eye Res
Eur J Ophthalmol
J Glaucoma
JAMA Ophthalmol
Graefes Ophthalmol
Indian J Ophthalmol
Int Ophthalmol Clin
Invest Ophth Vis Sci
Jpn J Ophthalmol
Korean J Ophthal
J Neuroophthalmol
Ophthalmic Epidemiol
Ophthalmic Genet
Ophthal Plast Rec Surg
Ophthalmic Res
Surv Ophthalmol
Ophthalmology Review Journal
Eye[JOUR] Established 1995
1. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.318. [Epub ahead of print]

Minimal incision posterior approach levator plication for aponeurotic ptosis.

Ng DS(1), Chan E(1), Ko ST(1).

Author information: 
(1)Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong.

PurposeTo assess the efficacy and predictability of a minimal incision posterior 
approach levator plication technique for correction of involutional
ptosis.MethodRetrospective chart review of patients with involutional aponeurotic
ptosis underwent minimal incision posterior approach levator plication technique 
between August 2013 and June 2014 by a single surgeon. The upper lid was double
everted, and the conjunctiva and Muller's muscle layers were incised vertically
until the levator aponeurosis could be identified. The incision(s) was similar to
performing incision and curettage of chalazion, except that the site was above
the tarsal plate and extended towards the fornix. Then insertion of aponeurosis
was dissected away from the anterior tarsal surface, and the more superiorly
located levator was plicated on it with double arm suture(s). No tissue was
excised in this procedure. Surgical success was defined as a postoperative margin
reflex distance (MRD)>2 mm and<4.5 mm, interlid height<1 mm and satisfactory
contour.ResultsForty-four lids of 27 patients were included. Preoperative mean
MRD was 0.48 +/- 0.56 mm. Severe ptosis of MRD<1 mm was present in 34/44 patients
(77.3%). The postoperative mean MRD was 2.49 +/- 0.53 mm, and mean improvement
was 2.02 +/- 0.61 mm, which was statistically significant (P<0.001). The overall 
success rate was 38/44 (86.4%).ConclusionsMinimal incision posterior approach to 
levator plication was effective for the correction of aponeurotic ptosis with
moderate to good levator function.Eye advance online publication, 23 January
2015; doi:10.1038/eye.2014.318.

PMID: 25613849   [PubMed - as supplied by publisher]

2. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.335. [Epub ahead of print]

The incidence, embryology, and oculofacial abnormalities associated with eyelid

Smith HB(1), Verity DH(1), Collin JR(1).

Author information: 
(1)Adnexal Service, Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK.

PurposeTo describe a cohort of patients with congenital eyelid coloboma, to
identify associated ocular and craniofacial abnormalities, and to establish any
correlation between the size and location of eyelid colobomas and the presence of
such abnormalities.MethodsAn observational case series of 55 patients with eyelid
coloboma treated by a single surgeon (JROC) between 1985 and 2005.ResultsEyelid
colobomas predominantly affected the upper lids (93%), and were typically
unilateral (76%). About a third (29%) were an isolated finding, with the
remainder associated with other ocular (62%) and/or craniofacial (53%)
abnormalities. Of those with ocular abnormalities; 19 (56%) had conjunctival
traction bands, 16 (47%) choristomas, and 8 (24%) an abnormal globe. Of those
with craniofacial abnormalities; 13 (45%) had Goldenhar Syndrome, 10 (35%)
clefting disorders, and 4 (14%) Fraser Syndrome. Clefting disorders were
typically associated with more severe colobomas and a higher incidence of
conjunctival traction bands, first arch syndromes with smaller colobomas and more
choristomas. Overall large colobomas were significantly associated with the
presence of other craniofacial defects compared with small colobomas (P<0.01,
χ(2)), but coloboma size did not correspond with the presence of other ocular
abnormalities.ConclusionsColoboma size, location, and associations in this series
are consistent with our current understanding of eyelid embryogenesis. It is
likely that those colobomas associated with other craniofacial and ocular
abnormalities are those which result from errors earlier in embryogenesis during 
eyelid specification, growth, and closure, whereas isolated colobomas arise later
during eyelid separation, and after codependent structures have developed.Eye
advance online publication, 23 January 2015; doi:10.1038/eye.2014.335.

PMID: 25613848   [PubMed - as supplied by publisher]

3. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.340. [Epub ahead of print]

Evaluation of retinopathy of prematurity screening in reverse Kangaroo Mother
Care: a pilot study.

Padhi TR(1), Sareen D(1), Pradhan L(2), Jalali S(3), Sutar S(1), Das T(3), Modi
RR(1), Behera UC(1).

Author information: 
(1)Retina-Vitreous Service, LV Prasad Eye Institute, Bhubaneswar, India.
(2)Infosys Pediatric Center, Capital Hospital, Bhubaneswar, India. (3)Srimati
Kanuri Santhamma Center for Vitreoretinal Diseases, LV Prasad Eye Institute,
Hyderabad, India.

PurposeTo evaluate retinopathy of prematurity (ROP) screening practice in reverse
Kangaroo Mother Care (R-KMC) with respect to stress and pain to the
infant.MethodsIn a pilot study we evaluated ROP screening practice in R-KMC in 20
babies at risk of ROP. The R-KMC differed from the conventional KMC with respect 
to the baby position where the baby lay supine on mother's chest. With the mother
lying supine and the baby in R-KMC position, screening examinations were done
with indirect ophthalmoscope. The outcome measures included stress (quantified by
pulse, respiration, and oxygen saturation) and pain to the baby by observing
facial expression (eye squeezing, crying, and brow bulge). The heart rate,
respiratory rate, and SpO2 (%) were compared before and immediately after the
procedure using paired t-test.ResultMean (±SD) gestational age and birth weight
were 30.8±2.3 weeks and 1362.5±253.9 g, respectively. During examination in R-
KMC position 8 babies (40%) were completely relaxed (no eye squeezing and
crying), 10 (50%) were partially relaxed (no brow bulge) and 2 babies (10%) were 
not relaxed. A change in heart and respiration rate both by 10 per minute was
recorded in 12 (60%) and 10 (50%) babies, respectively. Five babies (25%) had
reduction in blood oxygen concentration below 92%. The majority of the mothers
(19 of 20) were relaxed.ConclusionROP screening in R-KMC can be a baby friendly
screening practice with respect to stress and pain to the infant and needs
further evaluation in a larger cohort.Eye advance online publication, 23 January 
2015; doi:10.1038/eye.2014.340.

PMID: 25613847   [PubMed - as supplied by publisher]

4. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.315. [Epub ahead of print]

Subthreshold micropulse yellow laser (577 nm) in chronic central serous
chorioretinopathy: safety profile and treatment outcome.

Yadav NK(1), Jayadev C(1), Mohan A(1), Vijayan P(1), Battu R(1), Dabir S(1),
Shetty B(1), Shetty R(1); Medscape.

Author information: 
(1)Department of Vitreoretina Services, Narayana Nethralaya, Bangalore, India.

PurposeTo assess the safety and efficacy of a single session of subthreshold
micropulse (SM) yellow laser (577 nm) in the treatment of chronic central serous 
chorioretinopathy (CSCR).MethodsThis was a retrospective analysis of 15 eyes of
13 patients with CSCR of >3 months duration who had been treated with SM yellow
laser (577 nm). All patients had been treated using multiple spots of laser with 
a duty cycle of 10% over areas of focal and diffuse leak, as seen on fundus
fluorescein angiography (FFA) and indocyanine green angiography (ICGA). Reduction
in subretinal fluid height on spectral domain optical coherence tomography
(SD-OCT) was used to measure the response to treatment.ResultsThe mean follow-up 
was at 8 weeks (4-19 weeks). All eyes responded to treatment. The mean subretinal
fluid height pre and post treatment was 232 and 49 μm, respectively, showing a
79% average reduction (P<0.001) in fluid height. There was no evidence of retinal
pigment epithelium or retinal damage on SD-OCT, FFA, or fundus autofluorescence. 
Median visual improvement was one line on Snellen's visual acuity chart
(P=0.015). Microperimetry was performed in eight eyes of which six eyes (75%)
showed an improvement in the threshold values post treatment.ConclusionSM yellow 
laser is an effective treatment option for chronic CSCR.Eye advance online
publication, 23 January 2015; doi:10.1038/eye.2014.315.

PMID: 25613846   [PubMed - as supplied by publisher]

5. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.314. [Epub ahead of print]

Intra-familial phenotype variability in patients with Jalili syndrome.

Gerth-Kahlert C(1), Seebauer B(2), Dold S(2), Hanson JV(1), Wildberger H(1),
Spörri A(3), van Waes H(3), Berger W(4).

Author information: 
(1)Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. 
(2)1] Institute of Medical Molecular Genetics, Zurich, Switzerland [2]
Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland.
(3)Clinic of Orthodontics and Paediatric Dentistry, Center of Dental Medicine,
Zurich, Switzerland. (4)1] Institute of Medical Molecular Genetics, Zurich,
Switzerland [2] Neuroscience Center Zurich, University and ETH Zurich, Zurich,
Switzerland [3] Zurich Center for Integrative Human Physiology, University of
Zurich, Zurich, Switzerland.

PMID: 25613845   [PubMed - as supplied by publisher]

6. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.342. [Epub ahead of print]

Outcomes of rectangular 3-snip punctoplasty in acquired punctal stenosis: is
there a need to be minimally invasive?

Ali MJ(1), Ayyar A(1), Naik MN(1).

Author information: 
(1)Dacryology Service, Ophthalmic Plastics Surgery, L.V. Prasad Eye Institute,
Hyderabad, India.

AimTo report the clinical profiles of acquired punctal stenosis and outcomes with
rectangular 3-snip punctoplasty.MethodsRetrospective chart review of all patients
who underwent rectangular 3-snip punctoplasty, over a 3-year period from a single
surgeon's (MJA) database was performed. Data retrieved include demographics,
symptomatology, prior interventions, grades of punctal stenosis, associated
ocular findings, and outcomes. A minimum follow-up of 6 months following
punctoplasty was considered for analysis. Success was defined as clearance of dye
on functional dye disappearance test and resolution of symptoms.ResultsOne
hundred and forty five puncta of 87 eyes of 56 patients were studied. The mean
age at presentations was 52 years. Puncta (71.7%; 104/145) were of grade 2 size. 
Epiphora was the commonest presenting symptom noted in 94.3% (82/87) of the eyes.
At a minimum follow-up of 6 months, complete resolution of symptoms was achieved 
in 74.7% (65/87) of eyes. Eight out of 87 eyes (9.1%) failed to show any
improvement secondary to lacrimal obstructions distal to the puncta. Five out of 
87 (5.7%) eyes showed punctal restenosis whereas 10.3% (9/87) of the eyes had
functional epiphora post punctoplasty.ConclusionPuncta of grade 2 size were the
most common in this series. Although rectangular 3-snip punctoplasty is an
effective and safe procedure for majority of grades 1 and 2 of acquired punctal
stenosis, a higher percentages of functional epiphora and punctal restenosis in
the remaining patients should propel further investigations into developing
nonincisional, minimally invasive alternatives.Eye advance online publication, 23
January 2015; doi:10.1038/eye.2014.342.

PMID: 25613844   [PubMed - as supplied by publisher]

7. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.324. [Epub ahead of print]

Rupture of Descemet's membrane secondary to presumed non-accidental injury.

Bhagat S(1), Mikhail M(1), Boyle N(1).

Author information: 
(1)University Hospital Ayr, Ayr, UK.

PMID: 25613843   [PubMed - as supplied by publisher]

8. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.345. [Epub ahead of print]

Fluorescein angiography and optical coherence tomography in myopic choroidal

Chhablani J(1), Deepa MJ(1), Tyagi M(1), Narayanan R(1), Kozak I(2).

Author information: 
(1)Srimati Kanuri Santhamma Vitreo-Retina Service, L.V. Prasad Eye Institute,
Hyderabad, India. (2)Division of Vitreoretinal Diseases and Surgery, King Khaled 
Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.

PurposeTo assess intra/inter-observer agreement, and diagnostic capabilities of a
color fundus photograph, fundus fluorescein angiography (FFA), and spectral
domain optical coherence tomography (SD-OCT) in making a diagnosis of myopic
choroidal neovascularization (CNV).Patients and methodsTwo masked observers
evaluated FFA and SD-OCT images to identify the presence of myopic CNV in 80
high-myopic eyes of 57 patients. A third masked observer identified CNV on a
color fundus photo. Presence of myopic CNV on a fundus photo was defined as
presence of subretinal hemorrhage, thickening of the retina and/or visible
membrane at the macula. Presence of myopic CNV on FFA was defined as
hyperfluorescence in the early phase with increase in intensity and size in the
late phase; presence of a large irregular lesion; and hypofluorsescence due to
subretinal hemorrhage. Myopic CNV on SD-OCT was defined as the hyper-reflective
lesion with or without intraretinal fluid or subretinal fluid with retinal
thickening.ResultsIntraobserver repeatability on FFA and SD-OCT was 0.54 and
0.44, respectively. Agreement (kappa) between FFA and SD-OCT was 0.38 and 0.3,
respectively. Among 34 eyes, which had the presence of CNV on a color fundus
photo, CNV was diagnosed in 18 (53%) eyes on FFA and in 20 (58.8%) eyes on
SD-OCT. Sensitivity and specificity of FFA was 47 and 80.4%, respectively, and
that of SD-OCT was 58.8 and 86.9%, respectively.ConclusionRepeatability and
reproducibility for diagnosis of myopic CNV was better with FFA compared with
SD-OCT; however, agreement is very poor between FFA and SD-OCT. SD-OCT is
comparatively a better tool to rule out presence of myopic CNV.Eye advance online
publication, 23 January 2015; doi:10.1038/eye.2014.345.

PMID: 25613842   [PubMed - as supplied by publisher]

9. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.341. [Epub ahead of print]

Scleral buckling surgery for rhegmatogenous retinal detachment with subretinal

Ghasemi Falavarjani K(1), Alemzadeh SA(2), Modarres M(1), Parvaresh MM(1),
Hashemi M(1), Naseripour M(1), Nazari Khanamiri H(3), Askari S(2).

Author information: 
(1)Eye Research Center, Eye Department, Rassoul Akram Hospital, Iran University
of Medical Sciences, Tehran, Iran. (2)Medical Student Research Committee, Iran
University of Medical Sciences, Tehran, Iran. (3)USC Eye Institute, Los Angeles, 

PurposeTo evaluate the outcome of scleral buckling surgery in patients with
rhegmatogenous retinal detachment (RRD) with subretinal proliferation.MethodsIn
this retrospective study, a chart review of all patients with RRD associated with
subretinal proliferation who were primarily treated with scleral buckling
procedure, from April 2007 to April 2014, was undertaken. Main outcome measures
were anatomical retinal reattachment and visual acuity.ResultsForty-four eyes of 
43 patients including 24 males and 19 females with a mean age of 26.5±13.1 years 
were evaluated. Immediately after the surgery, retina was reattached in all eyes.
However, five eyes (11.3%) needed additional surgery for retinal redetachment.
Single surgery anatomical success rate was 88.7%. Four eyes (9.1%), needed pars
plana vitrectomy for the treatment of redetachment associated with proliferative 
vitreoretinopathy and scleral buckle revision surgery was successfully performed 
in the other eye. Best corrected visual acuity improved from 1.5±0.9 logMAR
before surgery to 1.1±0.7 logMAR after surgery (P<0.001). An improvement in BCVA 
of >2 lines was found in 23 eyes (52.2%) and worsening of best corrected visual
acuity of >2 lines was observed in 2 eyes (4.5%).ConclusionsScleral buckling
surgery is highly successful in eyes with RRD associated with subretinal
proliferation.Eye advance online publication, 23 January 2015;

PMID: 25613841   [PubMed - as supplied by publisher]

10. Eye (Lond). 2015 Jan 23. doi: 10.1038/eye.2014.336. [Epub ahead of print]

Observing implantable collamer lens dislocation by panoramic ultrasound

Shi M(1), Kong J(1), Li X(1), Yan Q(1), Zhang J(1).

Author information: 
(1)Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical
University, Eye Hospital of China Medical University, The Key Laboratory of Lens 
in Liaoning Province, Shenyang, China.

PurposeObserve the image characteristics and dislocation of implantable collamer 
lenses (ICL) following their use to correct high myopia.MethodsA total of 127
patients (242 eyes); 64 females (50.3%) and 63 males (49.7%) were included in
this retrospective study with ICL V4 implantation and mean spherical equivalent
-9.08±2.04 diopters (D). Panoramic ultrasound biomicroscopy (UBM) was utilized to
observe anterior segment morphology and ICL location at various follow-up periods
(1 week preoperative, followed by 1, 3, 6, and yearly
postoperative).ResultsTwenty-eight ICL eyes (11.2%) were noted to have abnormal
postoperative positioning. The central vault of 12 eyes was too high with ICL
decentration, mean central vault 1.14±0.39 mm; 10 eyes were too low but without
ICL decentration, mean central vault 0.13±0.11 mm. The remaining subjects were
only ICL decentration without abnormal central vault, mean central vault was
0.54±0.28 mm.ConclusionsThis study shows the abnormal characteristics regarding
ICL locations. The ICL dislocation closely correlates with the central vault. The
ICL dislocation is the primary cause of several postoperative complications.
Panoramic UBM is one of the most effective imaging means to observe the ICL
positioning and its stability after implantable surgery.Eye advance online
publication, 23 January 2015; doi:10.1038/eye.2014.336.

PMID: 25613840   [PubMed - as supplied by publisher]

11. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.330. [Epub ahead of print]

Macular and peripapillary retinal nerve fibre layer thickness in patients with
cyanotic congenital heart disease.

de Aguiar Remigio MC(1), Brandt CT(2), Santos CC(3), Arantes TE(1), de Aguiar

Author information: 
(1)Department of Ophthalmology, Fundação Altino Ventura, Recife, Brazil.
(2)Department of Surgery, Universidade Federal de Pernambuco, Recife, Brazil.
(3)Department of Pediatric Cardiology, Instituto de Medicina Integral Prof.
Fernando Figueira, Recife, Brazil. (4)Department of Cardiology, Universidade
Federal de Pernambuco, Recife, Brazil.

PurposeTo evaluate macular and retinal nerve fibre layer (RNFL) measurements in
patients with cyanotic congenital heart disease (cCHD) using spectral domain
optical coherence tomography (OCT).Patients and methodsThirty patients with cCHD 
(18 females and 12 males, mean age 10.9 years) and 60 healthy controls (35
females and 25 males, mean age 11.2 years) underwent complete ophthalmologic
examination and OCT measurements of macular and peripapillary RNFL
thickness.ResultsPatients with cCHD had significantly thinner measurements in all
macular subfields compared with healthy controls (P<0.001). There was no
significant difference in peripapillary RNFL thickness between the two groups,
with the exception of the upper quadrant, for which thickness measurements were
higher in patients with cCHD (P=0.021).ConclusionsPatients with cCHD showed a
significant decrease in macular thickness and a thickened superior quadrant RNFL 
thickness when compared with healthy controls. This may represent the damage
caused by the effect of hypoxia.Eye advance online publication, 16 January 2015; 

PMID: 25592129   [PubMed - as supplied by publisher]

12. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.323. [Epub ahead of print]

Reply: Transient retinal artery occlusion during phacoemulsification cataract

Yusuf IH(1), Fung TH(1), Wasik M(1), Patel CK(1).

Author information: 
(1)The Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Oxford, UK.

PMID: 25592128   [PubMed - as supplied by publisher]

13. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.320. [Epub ahead of print]

Wide-field imaging and OCT vs clinical evaluation of patients referred from
diabetic retinopathy screening.

Manjunath V(1), Papastavrou V(1), Steel DH(2), Menon G(3), Taylor R(4), Peto
T(5), Talks J(1).

Author information: 
(1)Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
(2)Sunderland Eye Infirmary, Sunderland and Institute of Genetic Medicine,
Newcastle Upon Tyne, UK. (3)Frimley Park Hospital, Frimley Park, UK. (4)Newcastle
University, Newcastle upon Tyne, UK. (5)NIHR Biomedical Research Centre at
Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 
London, UK.

PurposeCompare wide-field Optomap imaging and optical coherence tomography (OCT) 
with clinical examination in diabetic retinopathy (DR).MethodsPatients referred
from Diabetic Eye Screening Programmes to three centres underwent dilated
ophthalmoscopy and were assigned a DR grade. Wide-field colour imaging and OCT
were then examined by the same clinician at that visit and a combined grade was
assigned. Independent graders later reviewed the images and assigned an
imaging-only grade. These three grades (clinical, combined, and imaging) were
compared. The method that detected the highest grade of retinopathy, including
neovascularisation, was determined.ResultsTwo thousand and forty eyes of 1023
patients were assessed. Wide-field imaging compared with clinical examination had
a sensitivity and specificity of 73% and 96%, respectively, for detecting
proliferative DR, 84% and 69% for sight-threatening DR, and 64% and 90% for
diabetic macular oedema. Imaging alone found 35 more eyes with new vessels (19%
of eyes with new vessels) and the combined grade found 14 more eyes than clinical
examination alone.ConclusionsAssessment of wide-field images and OCT alone
detected more eyes with higher grades of DR compared with clinical examination
alone or when combined with imaging in a clinical setting. The sensitivity was
not higher as the techniques were not the same, with imaging alone being more
sensitive. Wide-field imaging with OCT could be used to assess referrals from DR 
screening to determine management, to enhance the quality of assessment in
clinics, and to follow-up patients whose DR is above the screening referral
threshold but does not actually require treatment.Eye advance online publication,
16 January 2015; doi:10.1038/eye.2014.320.

PMID: 25592127   [PubMed - as supplied by publisher]

14. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.322. [Epub ahead of print]

Transient retinal artery occlusion during phacoemulsification cataract surgery.

Ahfat FG(1).

Author information: 
(1)Ear and Mouth Unit, Maidstone General Hospital, Maidstone & Tunbridge Wells
NHS Trust, Maidstone, UK.

PMID: 25592126   [PubMed - as supplied by publisher]

15. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.325. [Epub ahead of print]

Retained silicone tip of diamond-dusted membrane scraper during vitrectomy in a
valved cannula system.

Felcida V(1), Kumar N(2), Haynes R(2), Habal S(1), Tyagi AK(1).

Author information: 
(1)Department of Vitreoretinal Surgery, Birmingham & Midland Eye Centre,
Birmingham, UK. (2)Department of Vitreoretinal Surgery, Bristol Eye Hospital,
Bristol, UK.

PurposeTo report a complication of retained silicone tip from a diamond-dusted
membrane scraper (DDMS) that occurred while using a valved cannula vitrectomy
system.MethodRetrospective review of three cases that underwent 23 gauge (G)
sutureless vitrectomy for idiopathic macular hole (cases 1 and 2) and myopic
macular schisis (case 3).ResultsIn all three cases following a standard
vitrectomy, the internal limiting membrane (ILM) peeling was initiated by using a
23G DDMS. During the insertion of the DDMS, the flexible silicone tip of the 23G 
DDMS was detached from the metal shaft and was retained in the 23G valve system
and in case 3, the silicone tip got dislodged from the valve onto the retina.
Subsequent ILM peeling was completed by using an end-gripping forceps. All
underwent intravitreal gas injection at the end. No other complications were
noted.ConclusionThese three cases demonstrate an uncommon complication of
retained silicone tip within the valved cannula vitrectomy system and this
complication should be considered while using flexible instruments in valved
cannula systems.Eye advance online publication, 16 January 2015;

PMID: 25592125   [PubMed - as supplied by publisher]

16. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.326. [Epub ahead of print]

Outcomes following cataract surgery in choroideremia.

Edwards TL(1), Groppe M(1), MacLaren RE(2).

Author information: 
(1)Oxford Eye Hospital and Nuffield Laboratory of Ophthalmology, John Radcliffe
Hospital, Oxford, UK. (2)1] Oxford Eye Hospital and Nuffield Laboratory of
Ophthalmology, John Radcliffe Hospital, Oxford, UK [2] Moorfields Eye Hospital
Foundation Trust, NIHR Ophthalmology Biomedical Research Centre, London, UK.

PurposeTo present a case series of cataract surgery outcomes in choroideremia
eyes with an emphasis on the safety of this common operation in advanced stages
of the disease.MethodsA single centre retrospective interventional case series
comprising six patients with varying degrees of visual loss secondary to
choroideremia underwent cataract surgery at a single tertiary eye hospital. Pre- 
and post-operative best-corrected Snellen visual acuity, spectral domain optical 
coherence tomography (SD-OCT), and slit lamp examination were performed together 
with fundus autofluorescence (FAF) and colour fundus photographs.The prevalence
of intra- or post-operative complications, post-operative visual outcome, and
change in central macular thickness were recorded.ResultsThe pre-operative
best-corrected Snellen visual acuity in the operated eyes ranged from 6/12
(20/40) to PL. All but one patient had either an objective or a subjective
improvement in visual acuity. There was no evidence of retinal phototoxicity or
post-operative cystoid macular oedema (CMO). Three patients developed early
capsular fibrosis.ConclusionsAlthough the residual functioning retina in
choroideremia patients may be potentially vulnerable, this report finds no
evidence of iatrogenic vision loss after uncomplicated cataract surgery. This
suggests that cataract surgery may be performed safely in choroideremia patients,
although a guarded prognosis for visual improvement should be emphasized in the
informed consent.Eye advance online publication, 16 January 2015;

PMID: 25592124   [PubMed - as supplied by publisher]

17. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.296. [Epub ahead of print]

Prevalence and incidence of blindness and other degrees of sight impairment in
patients treated for neovascular age-related macular degeneration in a
well-defined region of the United Kingdom.

Buckle M(1), Lee A(2), Mohamed Q(1), Fletcher E(1), Sallam A(1), Healy R(1),
Stratton I(3), Tufail A(2), Johnston RL(1).

Author information: 
(1)Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust,
Cheltenham Hospital, Cheltenham, UK. (2)Medical Retina Department, Moorfields Eye
Hospital, London, UK. (3)Gloucester Diabetic Retinopathy Research Group,
Cheltenham General Hospital, Cheltenham, UK.

AimsThis study aimed to evaluate the incidence and prevalence of blindness, sight
impairment, and other visual acuity (VA) states in patients receiving ranibizumab
for neovascular age-related macular degeneration (nAMD) in
Gloucestershire.MethodsSerial VA and injection data for all treatment-naive
patients receiving their first intravitreal injections of ranibizumab for nAMD in
the Gloucestershire National Health Service Ophthalmology department between 2008
and 2010 were extracted from an electronic medical record system.ResultsThe
prevalence of blindness (VA in the better-seeing eye ≤25 Early Treatment Diabetic
Retinopathy Study (ETDRS) letters) at the time of first intravitreal injection
was 0.8%, increasing to 3.5% after 3 years. The prevalence of sight impairment
(VA in the better-seeing eye 26-39 ETDRS letters) increased from 4.1% at baseline
to 5.5% after 3 years. The incidence of initiating ranibizumab treatment for nAMD
in people aged ≥50 years in Gloucestershire was 111 people per 100 000 population
in 2009, and 97 people in 2010. The incidence of patients meeting the visual
criteria for blindness and sight impairment registration from treated nAMD in
people aged ≥50 years in Gloucestershire was 3.5 and 9.7 people, respectively per
100 000 population in 2010.ConclusionThis is the first real-world study on the
incidence and prevalence of eligibility for blindness and sight impairment
registration in treated nAMD in the UK based on VA data. The incidence and
prevalence of eligibility for certification of blindness or sight impairment in
patients treated with ranibizumab for nAMD is low in Gloucestershire, with only
3.6% of the incident population progressing to blindness in 2010.Eye advance
online publication, 16 January 2015; doi:10.1038/eye.2014.296.

PMID: 25592123   [PubMed - as supplied by publisher]

18. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.334. [Epub ahead of print]

Ophthalmic and molecular genetic findings in Kniest dysplasia.

Sergouniotis PI(1), Fincham GS(1), McNinch AM(2), Spickett C(3), Poulson AV(1),
Richards AJ(2), Snead MP(1).

Author information: 
(1)Vitreoretinal Service, Addenbrooke's Hospital, Cambridge University NHS
Foundation Trust, Cambridge, UK. (2)1] Vitreoretinal Service, Addenbrooke's
Hospital, Cambridge University NHS Foundation Trust, Cambridge, UK [2] Department
of Pathology, University of Cambridge, Cambridge, UK. (3)Department of Pathology,
University of Cambridge, Cambridge, UK.

PurposeTo study the variability of the ophthalmic phenotype in Kniest dysplasia. 
Kniest dysplasia is an inherited disorder associated with defects in type II
collagen and characterised by short-trunked dwarfism, kyphoscoliosis, and
enlarged joints with restricted mobility. Other features include marked hand
arthropathy, cleft palate, hearing loss, and ocular abnormalities (myopia,
abnormal vitreous, and high risk of developing retinal detachment).MethodsData
from eight unrelated individuals with a clinical and molecular diagnosis of
Kniest dysplasia are reported. Clinical assessment included an audiogram and
ophthalmological examination in all but one patient who died in the immediate
postnatal period. Sanger sequencing of the COL2A1 gene was performed.ResultsSix
of the seven patients tested were high myopes with one patient being an
emmetrope. Bilateral quandratic cataracts and subluxed lenses were noted in one
subject. Variable but abnormal vitreous architecture was observed in all seven
individuals tested. Six of the seven patients had significant hearing impairment 
and five of the seven patients exhibited clefting abnormalities. One patient had 
bilateral retinal detachments in his twenties. Six dominant disease-causing
COL2A1 variants were detected. In three cases, testing of parental samples
revealed that the disease-causing variant was not present in either
parent.ConclusionThe ophthalmic features in Kniest dysplasia are very similar to 
those in other disorders of type II collagen such as Stickler syndrome. It is
likely that different type II collagenopathies have a similar level of ocular
morbidity and regular ophthalmologic examination is recommended. Kniest dysplasia
is associated with heterozygous COL2A1 mutations that are frequently de novo.Eye 
advance online publication, 16 January 2015; doi:10.1038/eye.2014.334.

PMID: 25592122   [PubMed - as supplied by publisher]

19. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.328. [Epub ahead of print]

Unintentional secondary exogenous corticosteroid exposure and central serous

Thinda S(1), Lam K(1), Park SS(1).

Author information: 
(1)Department of Ophthalmology and Vision Science, University of California Davis
Eye Center, Sacramento, CA, USA.

PurposeThe purpose of this study is to describe a possible association between
unintentional secondary exogenous corticosteroid exposure and central serous
chorioretinpathy (CSCR).MethodsA retrospective review of three patients diagnosed
with CSCR in one or both eyes and a history of possible unintentional secondary
corticosteroid exposure. Clinical history, exam findings, optical coherence
tomography, fluorescein angiography, and clinical course were
reviewed.ResultsThree patients, who did not use corticosteroids, reported
suspected unintentional secondary corticosteroid exposure from living with family
members or partners using dermatologic corticosteroid cream and/or inhalers
frequently. Two of the three patients had a history of recurrent CSCR, one
patient involving both eyes. After taking precautions to avoid secondary
corticosteroid exposure, all three patients had complete resolution of CSCR
without further recurrence during follow-up ranging from 2 to 4
years.ConclusionsPatients with CSCR should be queried for both primary and
possible unintentional secondary routes of corticosteroid exposure, which may
contribute to this condition.Eye advance online publication, 16 January 2015;

PMID: 25592121   [PubMed - as supplied by publisher]

20. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.333. [Epub ahead of print]

Acute corneal hydrops in keratoconus: a national prospective study of incidence
and management.

Barsam A(1), Petrushkin H(2), Brennan N(3), Bunce C(2), Xing W(2), Foot B(4),
Tuft S(2).

Author information: 
(1)Department of Ophthalmology, Luton and Dunstable University Hospital, Luton,
UK. (2)Corneal Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
(3)Department of Ophthalmology, Hillingdon Hospital, London, UK. (4)British
Ophthalmic Surveillance Unit, The Royal College of Ophthalmologists, London, UK.

PurposeTo determine incidence and management of acute corneal hydrops in the
UK.MethodsWe used the BOSU report card system to survey cases of acute corneal
hydrops in patients with keratoconus that occurred in the UK between November
2009 and December 2010. Ophthalmologists who reported a case were sent an initial
questionnaire, with a follow-up questionnaire after 6 months. We collected
information on the demographics, complications, changes in visual acuity, and
management. The 2011 National Census was used as a source for population and
ethnicity in the UK.ResultsThere were 73 incident cases of acute corneal hydrops,
with a response to the initial questionnaire for 64 (88%) patients and follow-up 
data at 6 months for 57 (78%) patients. For the 64 confirmed cases the median
(interquartile range) age of onset was 31.9 (23.2, 41.3) years and 48 (75%) of
the cases occurred in males. A total of 42 (66%) patients were white, 14 (22%)
were South Asian, and 7 (11%) were black. The proportion of South Asian and black
patients with acute corneal hydrops was significantly higher than in the general 
population (P<0.001). The minimum estimated annual incidence of acute corneal
hydrops in patients with keratoconus was estimated to be 1.43 (1.10, 1.83) per
1000. At 6 months following acute corneal hydrops a decision to proceed with
keratoplasty had been made for 12 (20.3%) patients.ConclusionsThis is the first
population-based estimate of the incidence of acute corneal hydrops in
keratoconus.Eye advance online publication, 16 January 2015;

PMID: 25592120   [PubMed - as supplied by publisher]

21. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.319. [Epub ahead of print]

Comparison of penetration depth in choroidal imaging using swept source vs
spectral domain optical coherence tomography.

Waldstein SM(1), Faatz H(1), Szimacsek M(1), Glodan AM(1), Podkowinski D(1),
Montuoro A(1), Simader C(1), Gerendas BS(1), Schmidt-Erfurth U(1).

Author information: 
(1)Christian Doppler Laboratory for Ophthalmic Image Analysis, Vienna Reading
Center, Department of Ophthalmology, Medical University of Vienna, Vienna,

PurposeTo compare signal penetration depth and deep structure-visualization of
swept source (SS) and spectral domain (SD)-optical coherence tomography (OCT)
with and without enhanced depth imaging (EDI) and B-scan averaging
modes.MethodsVolume scans were obtained from 20 eyes of healthy volunteers by DRI
OCT-1, Spectralis using EDI and B-scan averaging, and Cirrus HD-OCT. The signal
penetration depth was measured as the distance between the retinal pigment
epithelium and the deepest visible anatomical structure at the foveal center.
Visibility and contrast of the choroidoscleral junction and of vascular details
within the choroid were assessed across the entire volume using an ordinal
scoring scale. Outcome measures were compared using paired t-test and rank-sum
test.ResultsThe mean signal penetration depth was 498±114 μm for Spectralis,
491±85 μm for DRI OCT-1, and 123±65 μm for Cirrus; P=0.9708 Spectralis vs DRI
OCT-1, P<0.0001 Spectralis vs Cirrus, and P<0.0001 DRI OCT-1 vs Cirrus. Mean
ranks for visibility and contrast of the choroidoscleral junction were 3.83 for
Spectralis, 3.98 for DRI OCT-1, and 2.00 for Cirrus; and 3.45 for Spectralis,
2.93 for DRI OCT-1, and 1.58 for Cirrus. Mean ranks for visibility and contrast
of vascular details were 3.73 (Spectralis), 3.70 (DRI OCT-1), and 2.23 (Cirrus); 
and 3.53 (Spectralis), 2.05 (DRI OCT-1), and 1.98 (Cirrus).ConclusionSignal
penetration depths are similar for SS-OCT and SD-OCT using EDI and frame
averaging, and statistically significantly lower without EDI/averaging. Both
SD-OCT using EDI/frame averaging and SS-OCT offer excellent visualization
capabilities for volumetric imaging of the choroidoscleral interface.Eye advance 
online publication, 16 January 2015; doi:10.1038/eye.2014.319.

PMID: 25592119   [PubMed - as supplied by publisher]

22. Eye (Lond). 2015 Jan 16. doi: 10.1038/eye.2014.329. [Epub ahead of print]

Intraocular pharmacokinetics of intravitreal vascular endothelial growth
factor-Trap in a rabbit model.

Park SJ(1), Oh J(2), Kim YK(1), Park JH(1), Park JY(1), Hong HK(1), Park KH(1),
Lee JE(3), Kim HM(3), Chung JY(2), Woo SJ(1).

Author information: 
(1)Department of Ophthalmology, Seoul National University College of Medicine,
Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
(2)Department of Clinical Pharmacology and Therapeutics, Seoul National
University College of Medicine and Bundang Hospital, Seongnam, Republic of Korea.
(3)Graduate School of Medical Science and Engineering, Korea Advanced Institute
of Science and Technology (KAIST), Daejeon, Republic of Korea.

PurposeTo determine intraocular pharmacokinetic properties of intravitreally
injected vascular endothelial growth factor (VEGF)-Trap in a rabbit
model.MethodsVEGF-Trap was intravitreally injected in 18 rabbit eyes. Eyes were
enucleated 1 h and 1, 2, 5, 14, and 30 days after injections and immediately
frozen at -80 °C. Concentration of VEGF-Trap in vitreous, aqueous humor, and
retina/choroid was determined using an indirect enzyme-linked immunosorbent assay
and analyzed to obtain pharmacokinetic properties.ResultsMaximum concentration of
VEGF-Trap was achieved at 1 h in all three tissues. A one-compartment model of
distribution was selected as the final model for all tissues studied. Estimated
half-life of VEGF-Trap in vitreous, aqueous humor, and retinal/choroid was 87.1, 
36.8, and 35.0 h, respectively, and estimated mean residence time was 125.7,
53.1, and 50.5 h, respectively. Area under the curve from time 0 to the end point
was 10009.8, 3945.1, and 1189.3, respectively. Total exposure of the aqueous
humor and retina/choroid to VEGF-Trap was 39.4% and 11.9% of vitreous exposure,
respectively.ConclusionThe vitreous half-life of VEGF-Trap is 3.63 days. This is 
shorter than that of bevacizumab (6.99 days) and longer than that of ranibizumab 
(2.51 days), as shown in studies using the same experimental settings. The
concentration of VEGF-Trap peaked at 1 h after injections in all eye tissues
studied.Eye advance online publication, 16 January 2015;

PMID: 25592118   [PubMed - as supplied by publisher]

23. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.308. [Epub ahead of print]

Patterns of ranibizumab and aflibercept treatment of central retinal vein
occlusion in routine clinical practice in the USA.

Lotery AJ(1), Regnier S(2).

Author information: 
(1)Clinical and Experimental Sciences, Faculty of Medicine, University of
Southampton, Southampton, UK. (2)Novartis Pharma AG, Basel, Switzerland.

BackgroundThe intravitreal anti-vascular endothelial growth factor treatments
ranibizumab and aflibercept have proven efficacy in clinical trials, but their
real world usage in central retinal vein occlusion (CRVO) has not been assessed. 
We therefore evaluated the treatment patterns of both drugs in a US claims
database.MethodsThe IMS Integrated Data Warehouse was used to identify the
patients with CRVO in the USA with claims for ranibizumab or aflibercept between 
24 September 2012 and 31 March 2014 with at least 12 months follow-up. Patients
were required to have had no anti-VEGF treatment code for 6 months before index
('treatment-naive'). Mean numbers of injections and non-injection visits to a
treating physician were compared with patients receiving these
treatments.ResultsPatient characteristics were similar for patients receiving
ranibizumab (n=206) or aflibercept (n=79) at index. The mean (±SD) numbers of
injections received by patients treated with ranibizumab or aflibercept were
4.4±2.8 and 4.7±2.9 (P=0.38), respectively; the total number of patient visits to
their treating physician was 7.3±3.7 and 7.0±2.9 (P=0.52), respectively. For
patients receiving one or more injections (n=238), the mean interval between
injections was 55.1 days (ranibizumab) and 54.2 days (aflibercept;
P=0.44).ConclusionsOur results suggest that, in routine clinical practice,
patients receive a comparable number of injections in the first year of treatment
with ranibizumab or aflibercept. This may have implications for commissioning and
service development of CRVO care pathways.Eye advance online publication, 9
January 2015; doi:10.1038/eye.2014.308.

PMID: 25572584   [PubMed - as supplied by publisher]

24. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.290. [Epub ahead of print]

Reply to: 'Four quadrant sclerotomies for uveal effusion syndrome'

Andrijević Derk B(1), Benčić G(1), Corluka V(2), Zorić Geber M(1), Vatavuk Z(1).

Author information: 
(1)Department of Ophthalmology, University Clinical Centre 'Sestre milosrdnice', 
Zagreb, Croatia. (2)Department of Ophthalmology, General Hospital, Vinkovci,

PMID: 25572583   [PubMed - as supplied by publisher]

25. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.316. [Epub ahead of print]

What information can we give to the patient about the risks of strabismus

Bradbury JA(1).

Author information: 
(1)Eye Department, Bradford Royal Infirmary, Bradford, West Yorkshire, UK.

I hope to report the type, incidence, and clinical outcomes of severe
complications from strabismus surgery in the United Kingdom and to help in the
discussions involved in the consent process. The main part of the talk will
revolve around a BOSU (British Ophthalmic Survey Unit) investigation. Cases were 
identified prospectively between 1 September 2008 and 31 August 2010.
Questionnaire data were requested at the time of the complication recognition and
at 6 months' follow-up. Outcome was graded I-V, with a poor or very poor outcome 
meaning either loss of corrected visual acuity or primary position double vision.
A total of 60 completed reports of adverse events and complications were received
during the study period. During the same time, ∼24 000 strabismus surgeries were 
carried out in the United Kingdom, yielding an overall incidence of 1 in 400
operations (95% binomial confidence, 1 per 333-500 operations). The most commonly
reported complication was perforation of the globe (19 (0.08%)), followed by a
suspected slipped muscle (16 (0.067%)), severe infection (14 (0.06%)), scleritis 
(6 (0.02%)), and lost muscle (5 (0.02%)). Overall, complications were reported in
adults and children in equal numbers; however, scleritis was significantly more
common in adults. A poor or very poor clinical outcome was recorded as 1
operation per 2400. The study limitations are as follows: the denominator was
extrapolated from the number of surgeries in England, and there was an almost
certain underreporting of cases. Complications with the potential for a poor
outcome are relatively common, but the final clinical outcome is good in the
majority of cases.Eye advance online publication, 9 January 2015;

PMID: 25572582   [PubMed - as supplied by publisher]

26. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.303. [Epub ahead of print]

Response to Fu et al.

Morris DS(1), Desai P(2), MacEwen CJ(3).

Author information: 
(1)Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK. (2)Moorfields Eye
Hospital, London, UK. (3)University Department of Ophthalmology, Ninewells
Hospital, Dundee, UK.

PMID: 25572581   [PubMed - as supplied by publisher]

27. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.313. [Epub ahead of print]

Spectrum of morphological and visual changes due to vitreomacular interface
disorders encountered in a large consecutive cohort of patients.

Fusi-Rubiano W(1), Awad M(1), Manjunath R(1), Elaraoud I(1), Narendran N(1), Yang

Author information: 
(1)Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK. (2)1] Royal
Wolverhampton Hospitals NHS Trust, Wolverhampton, UK [2] Faculty of Life and
Health Sciences, Aston University, Birmingham, UK.

AimIdentify the incidence of vitreomacular traction (VMT) and frequency of
reduced vision in the absence of other coexisting macular pathology using a
pragmatic classification system for VMT in a population of patients referred to
the hospital eye service.MethodsA detailed survey of consecutive optical
coherence tomography (OCT) scans was done in a high-throughput ocular imaging
service to ascertain cases of vitreomacular adhesion (VMA) and VMT using a
departmental classification system. Analysis was done on the stages of traction, 
visual acuity, and association with other macular conditions.ResultsIn total,
4384 OCT scan episodes of 2223 patients were performed. Two hundred and fourteen 
eyes had VMA/VMT, with 112 eyes having coexisting macular pathology. Of 102
patients without coexisting pathology, 57 patients had VMT grade between 2 and 8,
with a negative correlation between VMT grade and number of Snellen lines
(r=-0.61717). There was a distinct cutoff in visual function when VMT grade was
higher than 4 with the presence of cysts and sub retinal separation and breaks in
the retinal layers.ConclusionsVMT is a common encounter often associated with
other coexisting macular pathology. We estimated an incidence rate of 0.01% of
VMT cases with reduced vision and without coexisting macular pathology that may
potentially benefit from intervention. Grading of VMT to select eyes with cyst
formation as well as hole formation may be useful for targeting patients who are 
at higher risk of visual loss from VMT.Eye advance online publication, 9 January 
2015; doi:10.1038/eye.2014.313.

PMID: 25572580   [PubMed - as supplied by publisher]

28. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.312. [Epub ahead of print]

The development and evolution of full thickness macular hole in highly myopic

Lin CW(1), Ho TC(1), Yang CM(1).

Author information: 
(1)Department of Ophthalmology, National Taiwan University Hospital, Taipei,

PurposeTo evaluate the morphological changes before and after the formation of a 
full-thickness macular hole (MH) in highly myopic eyes.Patients and
methodsRetrospective observational case series. From 2006 to 2013, clinical
records of patients with MH and high myopia who had optical coherence tomography 
(OCT) before the development of MH were reviewed. All patients had been followed 
for more than 1 year since MH formation to observe the morphological
changes.ResultsTwenty-six eyes of 24 patients were enrolled. The initial OCT
images could be classified into four types: (1) normal foveal depression with
abnormal vitreo-retinal relationship (eight cases), (2) macular schisis without
detachment (six cases), (3) macular schisis with concomitant/subsequent
detachment (nine cases), and (4) macular atrophy with underlying/adjacent scar
(three cases). After MH formation, one case in type 1 and one case in type 4
group developed retinal detachment (RD). In type 2 group, four cases developed RD
at the same time of MH formation. The preexisting detachment in type 3 group
extended in eight cases and improved in one case. Among all the cases, 14 eyes
received vitrectomy and 7 eyes received gas injection. MH sealed in nine eyes
after vitrectomy and four eyes by gas injection.ConclusionThe study revealed four
pathways of MH formation in highly myopic eyes. MH from macular schisis tended to
be associated with detachment. However, the evolution and the results of surgical
intervention were not always predictable.Eye advance online publication, 9
January 2015; doi:10.1038/eye.2014.312.

PMID: 25572579   [PubMed - as supplied by publisher]

29. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.292. [Epub ahead of print]

Cranial nerve palsies in childhood.

Lyons CJ(1), Godoy F(1), ALQahtani E(1).

Author information: 
(1)1] Department of Ophthalmology, BC Children's Hospital, Vancouver, British
Columbia, Canada [2] Department of Ophthalmology and Visual Sciences, University 
of British Columbia, Vancouver, British Columbia, Canada.

We review ocular motor cranial nerve palsies in childhood and highlight many of
the features that differentiate these from their occurrence in adulthood. The
clinical characteristics of cranial nerve palsies in childhood are affected by
the child's impressive ability to repair and regenerate after injury. Thus,
aberrant regeneration is very common after congenital III palsy; Duane syndrome, 
the result of early repair after congenital VI palsy, is invariably associated
with retraction of the globe in adduction related to the innervation of the
lateral rectus by the III nerve causing co-contraction in adduction. Clinical
features that may be of concern in adulthood may not be relevant in childhood;
whereas the presence of mydriasis in III palsy suggests a compressive aetiology
in adults, this is not the case in children. However, the frequency of associated
CNS abnormalities in III palsy and the risk of tumour in VI palsy can be
indications for early neuroimaging depending on presenting features elicited
through a careful history and clinical examination. The latter should include the
neighbouring cranial nerves. We discuss the impact of our evolving knowledge of
congenital cranial dysinnervation syndromes on this field.Eye advance online
publication, 9 January 2015; doi:10.1038/eye.2014.292.

PMID: 25572578   [PubMed - as supplied by publisher]

30. Eye (Lond). 2015 Jan 9. doi: 10.1038/eye.2014.291. [Epub ahead of print]

Four quadrant sclerotomies for uveal effusion syndrome.

Wang BZ(1), Clark B(1), McKelvie P(2), Matthews BJ(1), Buttery RG(1), Chandra

Author information: 
(1)Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia.
(2)Department of Histopathology, St Vincent's Hospital, Fitzroy, VIC, Australia.

PMID: 25572577   [PubMed - as supplied by publisher]