1: Retina. 2010 Feb 23; [Epub ahead of print] 

HIGH-SPEED, HIGH-RESOLUTION SPECTRAL OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS
AFTER VITRECTOMY WITH INTERNAL LIMITING MEMBRANE PEELING FOR PROLIFERATIVE
VITREORETINOPATHY RETINAL DETACHMENT.

Odrobina DC, Michalewska Z, Michalewski J, Nawrocki J.

From the *Klinika Okulistyczna Jasne Blonia, Lodz, Poland.

PURPOSE:: The purpose of this study was to present the retinal morphology after
silicone oil removal in patients after vitrectomy with internal limiting
membrane peeling and silicone oil tamponade for proliferative vitreoretinopathy
retinal detachment. METHODS:: Nineteen patients after vitrectomy or retinotomy
with internal limiting membrane peeling for proliferative vitreoretinopathy
retinal detachment were included in this study. All patients were interviewed,
and an ophthalmologic examination was performed pre- and postoperatively.
Fifteen months after silicone oil removal, all patients were examined with
spectral optical coherence tomography Copernicus. RESULTS:: Visual acuities
determined at the final follow-up visit were from light perception to 20/40
(mean, 0.11 +/- 0.14). Photoreceptor damage was present in 19 eyes (100%), i.e.,
in all cases. In seven eyes, the defects were in the well-visible,
normal-thickness photoreceptor layer. In the remaining 12 eyes, defects were
found in the thin, atrophic photoreceptor layer. Eyes with a well-visible
photoreceptor layer had better visual acuity after surgery (P = 0.015; t-test).
Cystoid macular edema developed in 9 eyes (47.3%). Retinal nerve fiber layer
defects were found in all 19 eyes (100%). Subretinal fluid was present in 1 eye
(5.2%). No cases of macular pucker were observed during follow-up. CONCLUSION::
Spectral optical coherence tomography Copernicus allows detailed imaging of
retinal microstructure and helps us understand why patients have lowered visual
acuity after successful retinal detachment surgeries. It is suspected that the
absence of macular pucker may be caused by systematic peeling of the internal
limiting membrane during vitrectomy.

PMID: 20182404  [PubMed - as supplied by publisher]

2: Retina. 2010 Feb 23; [Epub ahead of print] 

INTRAVITREAL INJECTION VERSUS SUBTENON INFUSION OF TRIAMCINOLONE ACETONIDE
DURING CATARACT SURGERY IN PATIENTS WITH REFRACTORY DIABETIC MACULAR EDEMA.

Takata C, Messias A, Folgosa MS, Lucena LR, Lucena DR, Scott IU, Jorge R.

From the *Department of Ophthalmology, Otorhinolaryngology and Head and Neck
Surgery, School of Medicine of Ribeirao Preto, USP, Ribeirao Preto, Brazil, and
the daggerDepartments of Ophthalmology and Public Health Sciences, Penn State
College of Medicine, Hershey, Pennsylvania.

PURPOSE:: The purpose of this study was to compare the effectiveness of
intravitreal injection (IVT) versus posterior subtenon infusion (STI) of
triamcinolone acetonide performed during phacoemulsification cataract surgery in
eyes with refractory diffuse diabetic macular edema. METHODS:: Twenty-four eyes
of 24 patients with refractory diffuse diabetic macular edema scheduled to
undergo phacoemulsification cataract surgery were randomly assigned to receive
either a 4-mg IVT (n = 12) or a 40-mg STI (n = 12) of triamcinolone acetonide
during cataract surgery. Comprehensive ophthalmic evaluation, including
best-corrected visual acuity, intraocular pressure, and central macular
thickness measured with optical coherence tomography, was performed at baseline
and at 1, 4, 8 +/- 1, 12 +/- 2, and 24 +/- 2 weeks postoperatively. RESULTS::
Ten patients from the IVT group and 9 patients from the STI group completed the
24-week study visit. Mean baseline best-corrected visual acuity (logarithm of
the minimum angle of resolution) was 20/259 and 20/222 in the IVT and STI
groups, respectively (t = 0.41; P = 0.3407). A significant improvement in
best-corrected visual acuity was observed only in the IVT group at 4 weeks (mean
difference +/- standard error, improved to 20/116; P = 0.0437), 8 weeks (20/110;
P = 0.0355), and 12 weeks (20/121; P = 0.0471) postoperatively. There was no
significant change from baseline in mean intraocular pressure in either group.
Mean +/- standard error baseline central macular thickness was 474.1 +/- 42.4
mum and 490.8 +/- 70.8 mum in the IVT and STI groups, respectively (t = 0.21;P =
0.5807). The central macular thickness reductions after surgery at all study
follow-up visits were significantly greater in the IVT group than in the STI
group (P < 0.05). CONCLUSION:: These data suggest that IVT is more effective
than STI of triamcinolone acetonide for the management of refractory diffuse
diabetic macular edema in eyes undergoing phacoemulsification. Further
investigation of a larger number of patients with longer follow-up is necessary
to confirm these findings.

PMID: 20182403  [PubMed - as supplied by publisher]

3: Retina. 2010 Feb 23; [Epub ahead of print] 

RESULTS OF VITRECTOMY FOR BREAKTHROUGH VITREOUS HEMORRHAGE ASSOCIATED WITH
AGE-RELATED MACULAR DEGENERATION AND POLYPOIDAL CHOROIDAL VASCULOPATHY.

Jung JH, Lee JK, Lee JE, Oum BS.

From the *Department of Ophthalmology, College of Medicine, Pusan National
University, Pusan, Korea; and the daggerMedical Research Institute, Pusan
National University, Pusan, Korea.

PURPOSE:: The purpose of this study was to evaluate the results of vitrectomy in
patients with vitreous hemorrhage associated with age-related macular
degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). METHODS:: A
retrospective review was conducted of consecutive cases of patients undergoing
pars plana vitrectomy for nonclearing vitreous hemorrhage associated with
neovascular AMD or PCV. RESULTS:: Twenty-four eyes of 23 patients were included.
The mean length of time from the onset of vitreous hemorrhage to operation was
4.3 months. Twelve eyes had AMD, and 12 eyes of 11 patients had PCV. Additional
treatments for active choroidal neovascularization or PCV were required in 12
eyes during follow-up. The mean visual acuity improved significantly from a
logarithm of the minimum angle of resolution of 2.79 +/- 0.85 before operation
to 1.61 +/- 0.98 at 2 months after operation (P < 0.001). Visual acuity was
>/=20/200 in 9 eyes (37.5%) at 2 months after operation; 1 eye was in the AMD
group, and the other eyes were in the PCV group. Improvement was more frequently
observed in the PCV group (P = 0.005). CONCLUSION:: In this series, the
functional outcomes of vitrectomy for vitreous hemorrhage associated with AMD
were inferior to outcomes of the PCV group. Vitrectomy is beneficial for
improving visual function in select cases of breakthrough vitreous hemorrhage.

PMID: 20182402  [PubMed - as supplied by publisher]

4: Retina. 2010 Feb 23; [Epub ahead of print] 

VITRECTOMY FOR EXUDATIVE AGERELATED MACULAR DEGENERATION WITH VITREOUS
HEMORRHAGE.

Sakamoto T, Sheu SJ, Arimura N, Sameshima S, Shimura M, Uemura A, Kawano H, Wu
TT, Kubota T, Sohma R, Noda Y.

From the *Department of Ophthalmology, Kagoshima University School of Dental and
Medical Sciences, Kagoshima, Japan, daggerKaohsiung Veterans General Hospital,
School of Medicine, National Yang-Ming University, Taiwan, People's Republic of
China, double daggerNTT Tohoku Hospital, Sendai, Japan, section signKagoshima
City Hospital, Kagoshima, Japan, the paragraph signUniversity of Occupational
and Environmental Health, Kitakyushu, Japan, and the **Department of
Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka,
Japan.

PURPOSE:: The purpose of this study was to study the effect of pars plana
vitrectomy (PPV) for age-related macular degeneration with vitreous hemorrhage
on choroidal neovascularization (CNV). METHODS:: A retrospective interventional
case series in which 92 eyes with age-related macular degeneration with vitreous
hemorrhage that received PPV was studied. Among them, 60 eyes without pre- or
posttreatment other than PPV were selected. Choroidal neovascularization was
expressed as the incidence of bleeding 6 months before and after PPV. The status
of CNV after PPV was compared and classified as worsened, remained, regressed,
disappeared, or unclassified. The influence of posterior vitreous detachment was
examined. RESULTS:: The incidence of bleeding was reduced dramatically after PPV
(1.11 +/- 0.44 in preoperative 6 months vs. 0.03 +/- 0.18 in postoperative 6
months, P < 0.0001). The status of CNV improved in most cases; 40 of 54
classifiable eyes (74.1%) were categorized as "regressed" or "disappeared."
Postoperative visual acuity was significantly better than preoperative visual
acuity (P < 0.0001). The status of CNV subsided more in those eyes without
posterior vitreous detachment than in those with posterior vitreous detachment
(odds ratio, 1.02; 95% confidence interval, -0.01-2.08; P = 0.054). CONCLUSION::
The activity of CNV was reduced after PPV in eyes with age-related macular
degeneration with vitreous hemorrhage. Visual acuity significantly improved,
with only rare severe complications. The involvement of vitreomacular traction
in the pathophysiology of CNV in age-related macular degeneration is possible.

PMID: 20182401  [PubMed - as supplied by publisher]

5: Retina. 2010 Feb;30(2):345-52. 

Lipopolysaccharide-binding protein and soluble CD14 in the vitreous fluid of
patients with proliferative diabetic retinopathy.

Hernandez C, Ortega F, Garcia-Ramirez M, Villarroel M, Casado J, Garcia-Pascual
L, Fernandez-Real JM, Simo R.

CIBERDEM (ISCIII), Universitat Autonoma de Barcelona, Barcelona, Spain.

PURPOSE: The purpose of this study was to compare intravitreous levels of
lipopolysaccharide-binding protein and soluble CD14 (sCD14) between patients
with proliferative diabetic retinopathy (PDR) and nondiabetic subjects. METHODS:
This study included 19 consecutive Type 2 diabetic patients with PDR in whom a
vitrectomy was performed. Sixteen vitreous humors from nondiabetic patients
matched by age, with idiopathic macular holes, were selected from our vitreous
bank and used as a control group. Lipopolysaccharide-binding protein was
assessed by enzyme-linked immunosorbent assay and sCD14 by a solid-phase
enzyme-amplified sensitive immunoassay. RESULTS: Lipopolysaccharide-binding
protein and sCD14 levels were significantly higher in patients with PDR than in
the control group (lipopolysaccharide-binding protein, P < 0.001; sCD14, P <
0.01). After correcting for vitreal proteins, the results remained significantly
higher in patients with PDR. No differences in serum levels were observed, and
we did not find any correlation between serum and vitreous levels. A direct
correlation between lipopolysaccharide-binding protein and sCD14 was detected in
the vitreous fluid (r = 0.57; P < 0.001) but not in the plasma. Finally, a
significant correlation between intravitreal levels of both
lipopolysaccharide-binding protein and sCD14 and interleukin-8 and monocyte
chemotactic protein-1 was also detected. CONCLUSION: Lipopolysaccharide-binding
protein and sCD14 are elevated in the vitreous fluid of patients with PDR and
thus may play a role in the innate immune response triggered by the inflammatory
injury characteristic of PDR.

Publication Types:
    Research Support, Non-U.S. Gov't

PMID: 20175275  [PubMed - in process]

6: Retina. 2010 Feb;30(2):332-8. 

Toxic vitreitis outbreak after intravitreal injection.

Ness T, Feltgen N, Agostini H, Bohringer D, Lubrich B.

University Hospital Freiburg, Eye Hospital, Freiburg, Germany.
thomas.ness@uniklinik-freiburg.de

PURPOSE: To report clinical and epidemiologic findings of 11 patients with
severe intraocular inflammation after intravitreal injection. METHODS: This is a
single-center, retrospective, interventional case series of 11 patients with
severe intraocular inflammation after intravitreal injection at 1 referral
center. The clinical data of all patients (3,357) who underwent intravitreal
injection between February 2007 and February 2008 were analyzed. All incidents
of postoperative intraocular inflammatory reaction were documented. RESULTS:
During the examination period, we identified 11 cases of intraocular
inflammation after intravitreal injection. Only one thereof was infectious
endophthalmitis with retinal abscess. All others were toxic vitreitis. Seven
eyes exhibited hypopyon and five disseminated retinal hemorrhages. The toxic
reaction occurred within 48 hours after injection, whereas in the
endophthalmitis case, it occurred after 72 hours. We believe that the cause of
this reaction was the particular syringe brand used. After changing to another
syringe brand, no further cases of toxic vitreitis occurred during the next 6
months. CONCLUSION: Toxic inflammatory reaction is not only a complication of
cataract surgery, but may also occur after intravitreal injection. A critical
review of all processes involved and materials used would help to prevent
further cases of toxic vitreitis.

PMID: 20175274  [PubMed - in process]

7: Retina. 2010 Feb;30(2):310-6. 

Ocular sarcoidosis misdiagnosed as primary intraocular lymphoma.

Birnbaum AD, Huang W, Sahin O, Tessler HH, Goldstein DA.

Department of Ophthalmology and Visual Sciences, University of Illinois at
Chicago, Chicago, IL 60612, USA. abirnb1@uic.edu

PURPOSE: The purpose of this study was to describe patients initially carrying a
diagnosis of primary intraocular lymphoma who were ultimately diagnosed with
ocular sarcoidosis. METHODS: The medical records of patients evaluated between
1995 and 2007 fitting the criteria described earlier were identified, and
pertinent clinical findings allowing for the diagnosis of sarcoidosis are
described. RESULTS: Nine patients between the ages of 52 and 83 were referred
with a diagnosis of primary intraocular lymphoma but were ultimately diagnosed
with sarcoidosis. The most common clinical signs found in these patients that
are atypical for primary intraocular lymphoma but common in sarcoidosis were
multifocal choroiditis (n = 7) and cystoid macular edema (n = 6). Additional
findings included keratic precipitates, posterior synechiae, and Koeppe nodules.
Chest computerized tomography was consistent with sarcoidosis in seven of eight
tested patients, and five of these patients had normal chest x-rays. Other
findings included elevated angiotensin-converting enzyme and/or lysozyme, and
biopsy revealing noncaseating granulomas. CONCLUSION: Although primary
intraocular lymphoma should always be in the differential diagnosis of older
patients who present with signs of ocular inflammation, ophthalmologists must
also consider other etiologies, including sarcoidosis. A chest computerized
tomography may be helpful in the diagnosis, particularly when laboratory
findings are supportive of sarcoidosis.

PMID: 20175273  [PubMed - in process]

8: Retina. 2010 Feb;30(2):305-9. 

Surgical management of epiretinal membrane in combined hamartomas of the retina
and retinal pigment epithelium.

Zhang X, Dong F, Dai R, Yu W.

Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union
Medical College and Chinese Academy of Medical Sciences, Beijing, China.

PURPOSE: The purpose of this study was to evaluate the surgical outcome of
combined hamartomas of the retina and retinal pigment epithelium in five
patients. METHODS: In this interventional retrospective case series study, five
patients with combined hamartomas of the retina and retinal pigment epithelium
received vitrectomy and epiretinal component peeling. Pre- and postoperative
best-corrected visual acuity, fundus examination, photography and fundus
fluorescein angiography, optical coherence tomography, and B-ultrasound scan
examination were analyzed. RESULTS: The 5 patients were all men, ranging in age
from 6 years to 21 years (mean 12.6 +/- 6.5 years). The lesions were unilateral.
Preoperative best-corrected visual acuity ranged from 20/340 to 20/50 (median
20/200), and postoperative best-corrected visual acuity ranged from 20/340 to
20/30 (median 20/100). Best-corrected visual acuity improved in 3 patients (60%)
after the surgeries and remained unchanged in 2 patients. Epiretinal components
were completely removed, except for a small residual membrane left in two cases.
Tortuosity of the retinal vessels improved in all the cases after the surgeries.
Fundus fluorescein angiography showed reduction in vascular tortuosity and
decrease of dye leakage. Optical coherence tomography demonstrated disappearance
or reduction of high reflectivity of the inner retina and decrease of underlying
retina edema. In two cases, the only complication was temporary ocular
hypertension. CONCLUSION: Selected patients with combined hamartomas of the
retina and retinal pigment epithelium may benefit from surgical management at
the appropriate time.

PMID: 20175272  [PubMed - in process]

9: Retina. 2010 Feb;30(2):275-80. 

Choroidal blood flow after isovolemic hemodilution in an eye with retinal vein
occlusion and the contralateral healthy eye.

Chiquet C, Tonini M, Drillat P, Gaudry VV, Romanet JP, Geiser MH.

Department of Ophthalmology, University Hospital of Grenoble, Joseph Fourier
University, Grenoble, France. cchiquet@chu-grenoble.fr

PURPOSE: To evaluate the effect of hemodilution on subfoveal choroidal blood
flow in the human eye with or without retinal vein occlusion. METHODS: Choroidal
blood flow was measured using laser Doppler flowmetry in 28 patients with
retinal vein occlusion in 1 eye. Isovolemic hemodilution was performed when
hematocrit was >35%. Laser Doppler flowmetry parameters, velocity, volume, and
flow were measured in both eyes in 4 sessions: 1 hour before and 1 hour after
the first hemodilution on Day 1 and Day 7. RESULTS: Hematocrit decreased
significantly by 23.7%, 19.8%, and 16.1% in the first hour, on the first day,
and the seventh day after hemodilution, respectively (P < 0.001). The ocular
perfusion pressure of the healthy eye and the eye with retinal vein occlusion
decreased by 7.7% and 7.2% after 1 hour and by 5.3% and 4.7% 1 day after
hemodilution, respectively (P < 0.01). After hemodilution, subfoveal choroidal
blood velocity, volume, flow, and vascular resistance did not significantly
change in either eye. CONCLUSION: Laser Doppler flowmetry measurement in the
subfoveal choroid is a feasible technique for blood flow assessment in patients
with retinal vein occlusion. A substantial change of hematocrit after isovolemic
hemodilution does not lead to a significant change in choroidal blood flow.
Vascular regulation is expected to keep blood flow constant and needs to be
further explored.

Publication Types:
    Research Support, Non-U.S. Gov't

PMID: 20175271  [PubMed - in process]

10: Retina. 2010 Feb;30(2):260-6. 

NSAIDs in combination therapy for the treatment of chronic pseudophakic cystoid
macular edema.

Warren KA, Bahrani H, Fox JE.

Department of Ophthalmology, University of Kansas School of Medicine, Kansas
City, Kansas, USA. kwarren@warrenretina.com

PURPOSE: The purpose of this study was to evaluate the addition of topical
nonsteroidal antiinflammatory drugs (NSAIDs) to intravitreal corticosteroid and
antivascular endothelial growth factor injections for the treatment of chronic
cystoid macular edema. METHODS: Thirty-nine patients with chronic pseudophakic
cystoid macular edema completed a single-center, randomized, investigator-masked
study. All patients were treated with an intravitreal triamcinolone and
bevacizumab injection at study entry; the bevacizumab injection was repeated at
1 month. To evaluate the effect of adding an NSAID, patients were randomized to
treatment with 1 of 4 topical NSAIDs (diclofenac 0.1%, ketorolac 0.4%, nepafenac
0.1%, and bromfenac 0.09%) or placebo for 16 weeks. RESULTS: At Weeks 12 and 16,
both the nepafenac and bromfenac groups showed a significant reduction in
retinal thickness compared with that in placebo (nepafenac, P = 0.0048,
bromfenac, P = 0.0113). A difference, however, between these 2 NSAID groups was
observed in that only the nepafenac group was able to maintain the demonstrated
retinal thickness decrease at Weeks 12 and 16. The nepafenac group also
experienced a significant improvement in visual acuity at Weeks 12 (P = 0.0084)
and 16 (P = 0.0233). The addition of NSAIDs did not produce an increase in mean
intraocular pressure over the course of therapy. CONCLUSION: Although NSAID
therapy seems to potentiate the improvements produced by corticosteroids and
antivascular endothelial growth factor therapy for chronic pseudophakic cystoid
macular edema, only nepafenac- and bromfenac-treated eyes showed reduced retinal
thickness at 12 weeks and 16 weeks. Furthermore, nepafenac produced a sustained
improvement in visual acuity.

PMID: 20175270  [PubMed - in process]

11: Retina. 2010 Feb 17; [Epub ahead of print] 

PREVALENCE, CLINICAL CHARACTERISTICS, AND CAUSES OF VISION LOSS IN CHILDREN WITH
VOGT-KOYANAGIHARADA DISEASE IN SOUTH INDIA.

Martin TD, Rathinam SR, Cunningham ET Jr.

From the *Department of Ophthalmology, California Pacific Medical Center, San
Francisco, California, the daggerUveitis Service, Aravind Eye Hospital, Madurai,
Tamilnadu, India, and the double daggerDepartment of Ophthalmology, Stanford
University School of Medicine, Stanford, California.

PURPOSE:: The purpose of this study was to describe the prevalence, clinical
characteristics, and causes of vision loss in children with Vogt-Koyanagi-Harada
disease seen at a uveitis referral center in South India. METHODS:: Charts of
patients with Vogt-Koyanagi-Harada disease examined in the uveitis referral
clinic of Aravind Eye Hospital between January 1998 and December 2007 were
reviewed. A subset of patients /=20/40, whereas 13.6% had a final visual
acuity of PMID: 20168275  [PubMed - as supplied by publisher]

12: Retina. 2010 Feb 17; [Epub ahead of print] 

ACCURACY OF RETINOPATHY OF PREMATURITY DIAGNOSIS BY RETINAL FELLOWS.

Paul Chan RV, Williams SL, Yonekawa Y, Weissgold DJ, Lee TC, Chiang MF.

From the *Department of Ophthalmology, Weill Cornell Medical College, New York,
New York, the daggerDepartment of Ophthalmology, Columbia University College of
Physicians and Surgeons, New York, New York, the double daggerRetina Center of
Vermont, Burlington, Vermont, the section signDepartment of Ophthalmology,
Children's Hospital Los Angeles, Los Angeles, California, and the paragraph
signDepartment of Biomedical Informatics, Columbia University College of
Physicians and Surgeons, New York, New York.

PURPOSE:: The purpose of this study was to measure the accuracy of retinopathy
of prematurity (ROP) diagnosis by retinal fellows. METHODS:: An atlas of 804
retinal images was captured from 248 eyes of 67 premature infants with a
wide-angle camera (RetCam-II, Clarity Medical Systems, Pleasanton, CA). Images
were uploaded to a study Web site, from which an expert pediatric retinal
specialist and 7 retinal fellows independently provided a diagnosis (no ROP,
mild ROP, type 2 ROP, or treatment-requiring ROP) for each eye. The sensitivity
and specificity of each retinal fellow were calculated and subsequently compared
with a reference standard of diagnosis by an expert pediatric retinal
specialist. RESULTS:: For detection of type 2 or worse ROP by fellows, mean
(range) sensitivity was 0.751 (0.512-0.953), and specificity was 0.841
(0.707-0.976). For detection of treatment-requiring ROP, mean (range)
sensitivity was 0.914 (0.667-1.000), and specificity was 0.871 (0.678-0.987).
CONCLUSION:: In general, fellows showed high accuracy for detecting ROP.
However, 3 of 7 fellows achieved <80% sensitivity for diagnosis of type 2 or
worse ROP, and 2 of 7 achieved <90% sensitivity for diagnosis of
treatment-requiring ROP. This could lead to undermanagement and undertreatment
of clinically significant disease and raises potential concerns about the
quality of ROP screening examinations performed by less-experienced examiners.

PMID: 20168274  [PubMed - as supplied by publisher]

13: Retina. 2010 Feb 17; [Epub ahead of print] 

BEVACIZUMAB FOR CHOROIDAL NEOVASCULARIZATION RELATED TO INFLAMMATORY DISEASES.

Kramer M, Axer-Siegel R, Jaouni T, Reich E, Hemo I, Priel E, Averbukh E, Ehrlich
R, Chowers I, Weinberger D, Amer R.

From the *Department of Ophthalmology, Rabin Medical Center, Petach Tikva,
Israel, the daggerSackler School of Medicine, Tel Aviv University, Tel Aviv,
Israel, the double daggerDepartment of Ophthalmology, Hadassah, Hebrew
University Medical Center, Jerusalem, Israel. section signHadassah School of
Medicine, Hebrew University, Jerusalem, Israel, and the paragraph signMor
Institute for Medical Diagnosis, Bnei Brak, Israel.

PURPOSE:: The purpose of this study was to report our experience with
intravitreal bevacizumab for inflammation-related choroidal neovascularization
in two tertiary centers. METHODS:: This study was a retrospective analysis of
patients with choroidal neovascularization related to inflammatory diseases,
treated with intravitreal bevacizumab injections (1.25 mg/0.05 mL). RESULTS::
Ten eyes of 10 patients (range, 14-78 years; mean age, 44 years) with underlying
uveitis were treated with intravitreal bevacizumab for inflammation-related
choroidal neovascularization during the period from 2006 to 2008. Mean follow-up
time was 13 +/- 8 months, and the mean number of injections was 2.7 +/- 2.
Resolved leakage on fluorescein angiography and resolution of subretinal fluid
on optical coherence tomography occurred in all patients, with improvement in
visual acuity in 9 of 10 eyes and no change in visual acuity in 1 of 10 eyes.
Seven patients received additional treatment based on the underlying condition.
Mean macular thickness on optical coherence tomography decreased from 394 +/-
116 mum to 254 +/- 52 mum (P < 0.01). Mean visual acuity improved from 0.87 +/-
0.74 logarithm of the minimum angle of resolution to 0.38 +/- 0.63 (P = 0.005).
Seven patients reached a visual acuity of 0.2 logarithm of the minimum angle of
resolution (Snellen 6/9) or better. CONCLUSION:: Intravitreal bevacizumab is an
effective treatment for choroidal neovascularization related to inflammatory
diseases when inflammation is controlled.

PMID: 20168273  [PubMed - as supplied by publisher]

14: Retina. 2010 Feb 17; [Epub ahead of print] 

MICROPERIMETRY AND FUNDUS AUTOFLUORESCENCE IN DIABETIC MACULAR EDEMA:
Subthreshold Micropulse Diode Laser Versus Modified Early Treatment Diabetic
Retinopathy Study Laser Photocoagulation.

Vujosevic S, Bottega E, Casciano M, Pilotto E, Convento E, Midena E.

From the *Fondazione GB Bietti, IRCCS, Rome, Italy, and the daggerDepartment of
Ophthalmology, University of Padova, Padua, Italy. Presented, in part, at
American Academy of Ophthalmology 2008 Annual Meeting, Atlanta, GA, November
8-11, 2008. Free Article no. PA017.

PURPOSE:: The purpose of this study was to evaluate and compare microperimetry
and fundus autofluorescence (FAF) after subthreshold micropulse diode laser
versus modified Early Treatment Diabetic Retinopathy Study photocoagulation for
clinically significant diabetic macular edema. METHODS:: A prospective
randomized clinical trial including 62 eyes (50 patients) with untreated,
center-involving, clinically significant diabetic macular edema was performed.
All patients underwent best-corrected visual acuity determination (logarithm of
the minimum angle of resolution), slit-lamp biomicroscopy, FAF, optical
coherence tomography, microperimetry (macular sensitivity), and fluorescein
angiography before and after treatment. Best-corrected visual acuity, optical
coherence tomography, microperimetry, and FAF were repeated at 1-, 3-, 6-, 9-,
and 12-month follow-up examinations. Fluorescein angiography was performed at
baseline and at 6 and 12 months. RESULTS:: Before treatment, demographic and
macular parameters were not different between the two treatment groups. At 12
months, best-corrected visual acuity remained stable in both groups (P = 0.41
and P = 0.82), mean central retinal thickness decreased in both groups (P =
0.0002 and P < 0.0001), and mean central 4 and 12 degrees retinal sensitivity
increased in the micropulse diode laser group (P = 0.02 and P = 0.0075) and
decreased in the Early Treatment Diabetic Retinopathy Study group (P = 0.2 and P
= 0.0026). There was no significant difference in either best-corrected visual
acuity or central retinal thickness between the 2 treatment groups (P = 0.48 and
P = 0.29), whereas there was a significant difference in 4 and 12 degrees
retinal sensitivity (P = 0.04 and P < 0.0001). Fundus autofluorescence never
changed in the micropulse diode laser group even after retreatment. In the Early
Treatment Diabetic Retinopathy Study group, FAF increased up to 9 months and
decreased in 6 eyes (20%) at 12 months. DISCUSSION:: Micropulse diode laser
seems to be as effective as modified Early Treatment Diabetic Retinopathy Study
laser photocoagulation in the treatment of clinically significant diabetic
macular edema. Micropulse diode laser treatment does not determine any change on
FAF showing (at least) nonclinically visible damage of the retinal pigment
epithelium. Microperimetry data encourage the use of a new, less aggressive
laser therapeutic approach in the treatment of clinically significant diabetic
macular edema.

PMID: 20168272  [PubMed - as supplied by publisher]

15: Retina. 2010 Feb 17; [Epub ahead of print] 

RESULTS OF 1-YEAR FOLLOW-UP EXAMINATIONS AFTER INTRAVITREAL BEVACIZUMAB
ADMINISTRATION FOR IDIOPATHIC CHOROIDAL NEOVASCULARIZATION.

Inoue M, Kadonosono K, Watanabe Y, Sato S, Kobayashi S, Yamane S, Ito R, Arakawa
A.

From the *Department of Ophthalmology, Yokohama City University Medical Center,
Yokohama, Kanagawa, Japan; and the daggerDepartment of Ophthalmology, Seaman's
Insurance Hospital, Yokohama, Kanagawa, Japan.

PURPOSE:: The purpose of this study was to report the results of 1-year
follow-up examinations after intravitreal bevacizumab injection for the
treatment of idiopathic choroidal neovascularization. METHODS:: Seven eyes in 7
patients with idiopathic choroidal neovascularization were intravitreally
injected with 1.25 mg/0.05 mL of bevacizumab. The need for retreatment was
evaluated if spectral-domain optical coherence tomography showed intraretinal
edema or subretinal fluid at the time of a 1-month follow-up examination.
Fluorescein angiography was performed 1 year after the first injection. The
primary outcome measures were best-corrected visual acuity and central foveal
thickness using spectral-domain optical coherence tomography. RESULTS:: All 7
eyes were assessed at a 1-year follow-up examination. The mean number of
injections per eye was 2.7. The mean logarithm of the minimum angle of
resolution best-corrected visual acuity improved significantly from 0.31 +/-
0.29 to 0.15 +/- 0.38 (P < 0.05). The mean central foveal thickness decreased
from 332 +/- 83 mum to 261 +/- 66 mum (P < 0.01). Fluorescein angiography showed
no leakage at 1 year in all eyes. All patients whose best-corrected visual
acuity improved by >/=0.2 logarithm of the minimum angle of resolution had a
visual acuity of >/=20/40 when first injected at baseline. CONCLUSION:: The
intravitreal injection of bevacizumab is effective for stabilizing or improving
vision in patients with idiopathic choroidal neovascularization, as evaluated at
a 1-year follow-up examination. In particular, this treatment may be well
tolerated in patients with a visual acuity of >/=20/40 at baseline. Additional
investigations are needed to assess the long-term safety and the optimal
protocol for intravitreal bevacizumab administration.

PMID: 20168271  [PubMed - as supplied by publisher]

16: Retina. 2010 Feb 17; [Epub ahead of print] 

CYSTOID MACULAR EDEMA WITHOUT MACULAR THICKENING: A Retrospective Optical
Coherence Tomographic Study.

Jun JJ, Duker JS, Baumal CR, McCabe F, Reichel E, Rogers AH, Seddon JM,
Tolentino FI.

From the New England Eye Center, Tufts Medical Center, Tufts University School
of Medicine, Boston, Massachusetts.

BACKGROUND:: This is a retrospective observational case series of 37 eyes of 32
patients meeting the inclusion criteria intended to describe the appearance,
prevalence, and associated risk factors for cystoid macular edema in eyes with
normal foveal thickness and contour as determined by optical coherence
tomography (OCT). METHODS:: A retrospective review of all patients with macular
disease who underwent OCT evaluation at the New England Eye Center from January
to March 2007 and met the study inclusion criteria was performed. Optical
coherence tomography scans were evaluated for the presence of intraretinal
cystic fluid or cystoid macular edema but with normal retinal thickness and
foveal contour. Retinal thickness and contour were evaluated using OCT mapping
software. The main outcome measures were as follows: OCT-defined entity based on
the presence of cystoid spaces within the fovea, "normal" foveal thickness (<252
mum), normal foveal contour, and best-corrected visual acuity on the date of
examination. RESULTS:: Thirty-seven eyes of 32 patients were determined to have
cystoid macular edema with normal foveal thickness and contour on OCT. The
overall prevalence within our patient population was 4.9%. Mean foveal thickness
(standard deviation) for these patients was 201.4 mum (28.9) compared with
normal mean foveal thickness (standard deviation) of 212 mum (20.0). Of the 32
patients, 17 (53.1%) had a primary diagnosis of age-related macular
degeneration. The mean visual acuity (Snellen; logarithm of the minimum angle of
resolution) was 20/80 (0.60). CONCLUSION:: Cystoid macular edema in the setting
of normal foveal thickness and contour as determined by OCT has not been
extensively described. This entity is not pathognomonic of a single diagnosis
and can occur in the setting of several disparate diagnoses as seen in our
cohort. Chief among these were age-related macular degeneration and diabetic
retinopathy. Acute postcataract cystoid macular edema was absent.

PMID: 20168270  [PubMed - as supplied by publisher]

17: Retina. 2010 Feb 17; [Epub ahead of print] 

Diagnostic and Therapeutic Challenges.

Raveesh M, Shanmugam MP, Murray TJ.

PMID: 20168269  [PubMed - as supplied by publisher]

18: Retina. 2010 Feb 17; [Epub ahead of print] 

COMPLIANCE WITH THE AMERICAN ACADEMY OF OPHTHALMOLOGY PREFERRED PRACTICE PATTERN
FOR DIABETIC RETINOPATHY IN A RESIDENT OPHTHALMOLOGY CLINIC.

Tseng VL, Greenberg PB, Scott IU, Anderson KL.

From the *The Summer Research Assistantship Program of the Warren Alpert Medical
School of Brown University, Providence, Rhode Island; the daggerDivision of
Ophthalmology, Rhode Island Hospital and the Warren Alpert Medical School of
Brown University, Providence, Rhode Island; the double daggerOphthalmology
Section, Veterans Affairs Medical Center, Providence, Rhode Island; the section
signDepartments of Ophthalmology and Public Health Sciences, Penn State College
of Medicine, Penn State Eye Center, Hershey, Pennsylvania; and the paragraph
signDepartment of Ophthalmology, The University of Texas Health Science Center
at San Antonio, San Antonio, Texas.

PURPOSE:: The purpose of this study was to evaluate compliance with the American
Academy of Ophthalmology Diabetic Retinopathy (DR) Preferred Practice Pattern
for an initial DR examination in a resident ophthalmology clinic. METHODS::
Adult patients with diabetes were included if seen in the resident ophthalmology
clinic at a Veterans Affairs Medical Center for an initial DR examination
between July 2006 and June 2007. Medical records were reviewed for compliance
with the 29 applicable elements from the American Academy of Ophthalmology DR
Preferred Practice Pattern. RESULTS:: Of 451 diabetic patient visits in the
ophthalmology clinic in the study period, 70 met inclusion criteria. The overall
mean compliance rate was 52%. Compliance was best in the categories of
examination (mean = 87%), diagnosis (mean = 82%), and treatment (mean = 74%).
Compliance was lowest in the categories of medical history (mean = 11%) and
counseling/referral (mean = 34%). CONCLUSION:: Compliance with both practice and
documentation of American Academy of Ophthalmology DR Preferred Practice Pattern
guidelines at a resident ophthalmology clinic should be monitored, especially in
the areas of medical history, patient education, and referrals. A target level
of compliance should be set and maintained in all the DR Preferred Practice
Pattern categories, especially in a teaching hospital where residents are
developing their approach to quality care.

PMID: 20168268  [PubMed - as supplied by publisher]

19: Retina. 2010 Feb 17; [Epub ahead of print] 

SECONDARY MACULAR HOLE FORMATION AFTER VITRECTOMY.

Lee SH, Park KH, Kim JH, Heo JW, Yu HG, Yu YS, Chung H.

From the *Department of Ophthalmology, Seoul National University College of
Medicine, Seoul, Republic of Korea; the daggerSeoul Artificial Eye Center, Seoul
National University Hospital Clinical Research Institute, Seoul, Republic of
Korea; and the double daggerDepartment of Ophthalmology, Seoul National
University Bundang Hospital, Seongnam, Gyunggi-do, Republic of Korea.

PURPOSE:: The purpose of this study was to report the incidence and the
underlying ocular pathology of a macular hole (MH) that develops in
vitrectomized eyes and to evaluate its prognosis. METHODS:: A retrospective
chart review was performed in patients who underwent vitrectomy between March
2004 and June 2009. Cases that developed an MH in vitrectomized eyes were
identified, and the data from all ophthalmology examinations were collected.
Patients with recurrent MHs after the initial MH surgery were excluded.
RESULTS:: We identified 10 cases of secondary MH during a period of 64 months
[incidence, 8 of 3,279 (0.24%)]. Two cases of secondary MHs were not included in
the calculations because the initial vitrectomies were performed before March
2004. The initial vitrectomy was performed on four eyes with vitreous hemorrhage
caused by proliferative diabetic retinopathy, three eyes with retinal detachment
from high myopia, one eye with combined retinal detachment with uveitis, one eye
with rhegmatogenous retinal detachment, and one eye with an epiretinal membrane.
The macular pathology identified before MH formation included cystoid macular
edema in two eyes, epiretinal membrane in four eyes, and no specific lesion in
another four eyes. The secondary MHs were managed by additional vitrectomy,
peeling of the internal limiting membrane, and intravitreal gas tamponade. Nine
of 10 eyes achieved hole closure after the secondary surgery, and 8 eyes
recovered their previous visual acuity; the other 2 eyes had visual loss within
2 Snellen chart lines, and none of the 9 patients had a recurrence during a mean
follow-up of 20.7 months (range, 4-31 months). CONCLUSION:: The development of
secondary MHs after vitrectomy is rare. Pathogenic mechanisms other than
idiopathic MH may be involved in these cases. The anatomical and functional
outcome of the secondary MHs that developed after vitrectomy was good, although
the final visual acuity was dependent on the underlying ocular pathology.

PMID: 20168267  [PubMed - as supplied by publisher]

20: Retina. 2010 Feb 17; [Epub ahead of print] 

Regression of Retinal Neovascularization After Laser Photocoagulation in
Incontinentia Pigmenti.

Ranchod TM, Trese MT.

From the William Beaumont Hospital, Royal Oak, Michigan.

PMID: 20168266  [PubMed - as supplied by publisher]

21: Retina. 2010 Feb;30(2):381-2; author reply 382. 

Re: Must screening examinations for retinopathy of prematurity necessarily be
painful?

Rani PK, Jalali S.

Publication Types:
    Comment
    Letter

PMID: 20142720  [PubMed - in process]

22: Retina. 2010 Feb;30(2):380; author reply 380-1. 

Re: Verteporfin combination regimens in the treatment of neovascular age-related
macular degeneration.

Nelson M.

Publication Types:
    Comment
    Letter

PMID: 20142719  [PubMed - in process]

23: Retina. 2010 Feb;30(2):378-9. 

Enhanced depth imaging spectral-domain optical coherence tomography.

Dell'Omo R, Costagliola C, Di Salvatore F, Cifariello F, Dell'Omo E.

Department of Health Science, University of Molise, Campobasso, Italy.
robdellomo@libero.it

PMID: 20142717  [PubMed - in process]

24: Retina. 2010 Feb;30(2):364-8. 

Diagnostic and therapeutic challenges. Acute onset panuveitis.

Kim BJ, Do DV, Nguyen QD, Arevalo F, Van Gelder RN.

Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore,
Maryland, USA.

PMID: 20142716  [PubMed - in process]

25: Retina. 2010 Feb;30(2):357-63. 

The Malyugin pupil expander in vitreoretinal surgery.

Patel CK.

John Radcliffe Hospital, Oxford Eye Hospital, Oxford, United Kingdom.
ckpatel@btinternet.com

PMID: 20142715  [PubMed - in process]

26: Retina. 2010 Feb;30(2):353-6. 

Injection and suturing technique for scleral fixation foldable lens in the
vitrectomized eye.

Zhang ZD, Shen LJ, Liu XQ, Chen YQ, Qu J.

Department of Retina-Vitreous, Eye Hospital of Wenzhou Medical College, Wenzhou,
Zhe Jiang, People's Republic of China. zzduaneye@hotmail.com

PMID: 20142714  [PubMed - in process]

27: Retina. 2010 Feb;30(2):339-44. 

Correlation of vascular endothelial growth factor with chemokines in the
vitreous in diabetic retinopathy.

Wakabayashi Y, Usui Y, Okunuki Y, Kezuka T, Takeuchi M, Goto H, Iwasaki T.

Department of Ophthalmology, Hachiouji Medical Center of Tokyo Medical
University, Tokyo, Japan. wbaki@tokyo-med.ac.jp

PURPOSE: The purpose of this study was to simultaneously measure the
concentrations of multiple cytokines, including vascular endothelial growth
factor, in the vitreous of patients with diabetic retinopathy and to examine
their relation with clinical findings. METHODS: Vitreous samples from 46 eyes
with diabetic retinopathy and 19 eyes with nondiabetic macular disease
(controls) were used. Nine cytokines were simultaneously measured using a
FACSCalibur flow cytometer. RESULTS: Vascular endothelial growth factor,
interleukin-8, monocyte chemotactic protein-1, interferon-inducible protein-10,
and monokine induced by interferon-gamma were detected in the vitreous samples,
and the concentrations were significantly (P < 0.001) higher in patients with
diabetic retinopathy compared with control subjects. Vascular endothelial growth
factor, interleukin-8, monocyte chemotactic protein-1, and monokine induced by
interferon-gamma concentrations were significantly (P < 0.05) higher in active
retinopathy than in inactive retinopathy. Furthermore, a significant (P < 0.01)
positive correlation was observed between vascular endothelial growth factor
concentration and interleukin-8, monocyte chemotactic protein-1,
interferon-inducible protein-10, or monokine induced by interferon-gamma
concentration in the vitreous. CONCLUSION: Vascular endothelial growth factor,
interleukin-8, monocyte chemotactic protein-1, interferon-inducible protein-10,
and monokine induced by interferon-gamma were expressed at high levels locally
in ocular tissues in diabetic retinopathy, and these cytokines may form a
network and interact to impact the pathogenesis of the disease.

PMID: 20142713  [PubMed - in process]

28: Retina. 2010 Feb;30(2):193-202. 

Morphologic findings in acute central serous chorioretinopathy using spectral
domain-optical coherence tomography with simultaneous angiography.

Shinojima A, Hirose T, Mori R, Kawamura A, Yuzawa M.

Publication Types:
    Editorial

PMID: 20142712  [PubMed - in process]

29: Retina. 2010 Feb 4; [Epub ahead of print] 

An elementary and effective method for silicone oil removal.

Tsui I, Reddy S, Hubschman JP.

From the Retina Division, Jules Stein Eye Institute, Department of
Ophthalmology, David Geffen School of Medicine, University of California, Los
Angeles, California.

PMID: 20139801  [PubMed - as supplied by publisher]

30: Retina. 2010 Feb 4; [Epub ahead of print] 

High-resolution optical coherence tomography shows new aspects of bietti
crystalline retinopathy.

Pennesi ME, Weleber RG.

From the Casey Eye Institute, Department of Ophthalmology, Oregon Health &
Science University, Portland, Oregon.

PMID: 20139800  [PubMed - as supplied by publisher]