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Survey of Ophthalmology

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https://www.readbyqxmd.com/read/29024675/tempo-ral-was-the-heart-of-the-matter
#1
Francesco Pellegrini, Daniele Cirone, Piernicola Machin, Rod Foroozan
A 71-year-old woman was admitted with fever, headache and weight loss associated with elevated inflammatory markers. She developed acute bilateral ophthalmoplegia and asymmetrical ptosis rapidly followed by anterior ischemic optic neuropathy. Although the first temporal artery biopsy (TAB) was negative, contralateral TAB revealed features consistent with giant cell arteritis. Even while under steroid therapy, the patient died a few days later from myocardial infarction. Acute bilateral complete ophthalmoplegia is a rare presentation of a limited number of possible diseases...
October 9, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/29024674/optic-nerve-head-problem
#2
Rohan Verma, Kevin C Chen, Hema L Ramkumar, Michael H Goldbaum, Carol L Shields
A 68-year-old woman with a recent history of blurring in the left eye had undergone mastectomy for breast cancer twenty years ago. A series of bone metastases started five years after her diagnosis. Examination of the optic nerve head of the left eye revealed an isolated epipapillary mass. Indocyanine green angiography displayed vessels within the mass, and fluorescein angiography demonstrated hyperfluorescence of the mass from vascular leakage plus lobular spots of blocked fluorescence. B-scan ultrasound revealed a hyperechoic elevated nodular mass on the optic disc...
October 9, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/29024673/not-the-usual-suspect
#3
Andrew G Lee, Jonathan D Shader, Aroucha Vickers, Orlando M Diaz, Jurij R Bilyk
An 82-year-old woman presented with right-sided proptosis, chemosis, and a supraorbital bruit. A dural carotid-cavernous fistula (CCF) was suspected, but catheter angiography revealed an intraorbital inferior ophthalmic vein arteriovenous fistula (AVF) supplied by the right ophthalmic artery and infraorbital branch of the internal maxillary artery. A primary orbital AVF can mimic the clinical and radiographic features of the more common CCF.
October 9, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28987614/restorative-retinal-laser-therapy-present-state-and-future-directions
#4
REVIEW
Jay Chhablani, Young Jung Roh, Andrew I Jobling, Erica L Fletcher, Jia Jia Lek, Pooja Bansal, Robyn Guymer, Jeffrey K Luttrull
Because of complications and side effects, conventional laser therapy has taken a back seat to drugs in the treatment of macular diseases. Despite this, research on new laser modalities remains active. In particular, various approaches are being pursued to preserve and improve retinal structure and function. These include micropulsing, various exposure titration algorithms and real-time temperature feedback control of short pulse continuous wave lasers, and ultra-short pulse nanosecond lasers. Some of these approaches are at the pre-clinical stage of development, while others are available for clinical use...
October 4, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28987613/treatment-of-cystoid-macular-edema-secondary-to-retinitis-pigmentosa-a-systematic-review
#5
REVIEW
Malini Bakthavatchalam, Frank H P Lai, Shi Song Rong, Danny S Ng, Marten E Brelen
There are various treatments for cystoid macular edema (CME) secondary to retinitis pigmentosa (RP); however, the evidence for these treatments has not been previously systematically reviewed. Our review that includes 23 studies shows that oral carbonic anhydrase inhibitors (CAI) (including acetazolamide, methazolamide) and topical CAI (dorzolamide and brinzolamide) are effective first line treatments. In patients unresponsive to CAI treatment, intravitreal steroids (triamcinolone acetonide and sustained-release dexamethasone implant), oral corticosteroid (Deflazacort), intravitreal anti-vascular endothelial growth factor agents (ranibizumab and bevacizumab), grid laser photocoagulation, pars plana vitrectomy, or ketorolac were also effective in improving CME secondary to RP...
October 4, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28986312/bilateral-upper-and-lower-eyelid-margin-swelling-and-madarosis-due-to-lymphoma
#6
Huy V Nguyen, Frederick A Jakobiec, Fouad R Zakka, Michael K Yoon
Over a 2 year period a 32-year-old woman developed swellings of all 4 eyelid margins accompanied by complete loss of eyelashes. An inflammatory dermatologic condition was considered the most likely cause. A full thickness right lower eyelid biopsy revealed a multinodular lymphoid tumor at the eyelid margin which immunophenotypically and genetically was diagnosed as an extranodal marginal zone lymphoma. The mode of presentation of the disease was considered to be most unusual, as was its B cell lineage, since the majority of primary cutaneous lymphomas are of T-cell origin...
October 3, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28986311/glaucoma-and-the-brain-trans-synaptic-degeneration-structural-change-and-implications-for-neuroprotection
#7
REVIEW
Mitchell Lawlor, Helen Danesh-Meyer, Leonard A Levin, Indran Davagnanam, Enrico De Vita, Gordon T Plant
A recent hypothesis to enter the literature suggests that glaucoma is a neuro-degenerative disease. The basis for this has been the finding of central nervous system (CNS) changes in glaucoma patients on histology and neuro-imaging. It is known that retinal ganglion cell (RGC) pathology of any cause leads to anterograde and retrograde RGC degeneration, as well as trans-synaptic (trans-neuronal) anterograde degeneration. Trans-synaptic degeneration has been demonstrated in a range of optic neuropathies including optic nerve transection, optic neuritis, and hereditary optic neuropathies...
October 3, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28941765/a-review-of-teaching-methods-and-outcomes-of-resident-phacoemulsification
#8
Kevin Kaplowitz, Mohammad Yazdanie, Azin Abazari
Cataract surgery with phacoemulsification is a challenging procedure for surgeons in training to learn to perform safely, efficiently, and effectively. We review the auxiliary learning tools outside the operating room that residency programs have incorporated into their curriculum to improve surgical skills, including wet lab and surgical simulators. We then discuss different methods of teaching cataract surgery in the operating room. Our goal is to define a learning curve for cataract surgery. We demonstrate that complication rates decline significantly after a resident performs an average of 70 cases...
September 20, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28935121/treatment-of-acute-ocular-chemical-burns
#9
REVIEW
Namrata Sharma, Manpreet Kaur, Tushar Agarwal, Virender S Sangwan, Rasik B Vajpayee
Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5% to 22.1% of ocular injuries. Immediate copious irrigation is universally recommended in acute ocular burns to remove the offending agent and minimize damage. Conventional medical therapy consists of the use of agents that promote epithelialization, minimize inflammation, and prevent cicatricial complications. Biological fluids such as autologous serum, umbilical cord blood serum, platelet-rich plasma, and amniotic membrane suspension are a rich source of growth factors and promote healing when used as adjuncts to conventional therapy...
September 18, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28923583/sunlight-and-ultraviolet-radiation-pertinent-retinal-implications-current-management
#10
REVIEW
Tedi Begaj, Shlomit Schaal
Unprotected and prolonged exposure to ultraviolet (UV) light from sunlight, lasers, and arc welding leads to outer retinal damage. The photoreceptors and retinal pigment epithelium located in the posterior pole are particularly susceptible to this radiation. Classically known as solar retinopathy, this disorder frequently affects young individuals who have clear lenses and a propensity toward observing solar eclipses. Various imaging techniques aid the clinician in diagnosis, even if patients cannot recall an exposure event...
September 16, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28923582/glaucoma-following-corneal-replacement
#11
REVIEW
Monika Baltaziak, Hall F Chew, Dominik W Podbielski, Iqbal Ike K Ahmed
Glaucoma is a well-known complication following corneal transplantation surgery. Traditional corneal transplantation surgery, specifically penetrating keratoplasty (PK), has been slowly replaced by the advent of new corneal transplantation procedures: primarily lamellar keratoplasties. There has also been an emergence of keratoprosthesis implants for eyes that are high risk of failure with PK. Consequently, there are different rates of glaucoma, pathogenesis, and potential treatment in the form of medical, laser or surgical therapy...
September 16, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28923585/the-genetics-of-congenital-aniridia-a-guide-for-the-ophthalmologist
#12
Erlend S Landsend, Øygunn A Utheim, Hilde R Pedersen, Neil Lagali, Rigmor C Baraas, Tor P Utheim
Congenital aniridia is a rare panocular disease caused by fundamental disturbances in the development of the eye, characterized primarily by hypoplasia of the iris and the retinal fovea. Severe secondary complications such as keratopathy, cataract, and glaucoma are common and often lead to considerable visual impairment or blindness. Many complications in aniridia patients are difficult to treat and present a challenge for the ophthalmologist. Increasingly, associated non-ocular features of the disease are also being recognised...
September 15, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28923584/seeing-the-difference-painless-progressive-vision-loss-in-a-vasculopath
#13
Jenny L Lauschke, Katherine Masselos, Jennifer Sandbach, Clare L Fraser
A 78-year-old Caucasian man with significant vascular disease reported sudden onset of worsened vision during a routine wound-care appointment for non-healing necrotic leg ulcers. He described painless blurring of vision with grey scotomas in his RE, his only well-seeing eye, following trauma to the LE as a child. He presented with retinal ischemia, a cotton-wool spot and optic nerve swelling. Temporal artery biopsy showed myxoid degeneration and extensive calcium deposition which also was shown on imaging throughout his carotid and vertebral arterial system, the clinical picture of calciphylaxis...
September 15, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28887138/-the-role-of-phacoemulsification-in-glaucoma-therapy-a-systematic-review-and-meta-analysis
#14
REVIEW
Marisse Masis, Patrick J Mineault, Eileen Phan, Shan C Lin
Cataract extraction is a safe and effective surgery that has been performed in its modern form for several decades. Many studies have noted that cataract extraction could also have a clinically significant role in the control of co-morbid glaucoma. Lens extraction decreases the pressure within the eye, and intraocular pressure is the only controllable risk factor in glaucoma proven to be effective. A systematic analysis of current evidence is needed to establish strong practice patterns and identify areas where further research is required...
September 5, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28882598/iris-cysts-a-comprehensive-review-on-diagnosis-and-treatment
#15
REVIEW
Ilias Georgalas, Petros Petrou, Dimitrios Papaconstantinou, Dimitrios Brouzas, Chrysanthi Koutsandrea, Menelaos Kanakis
Iris cysts, both primary and secondary, are a diagnostic and a treatment challenge. Primary cysts arise either from the iris pigment epithelium or the iris stroma. Posterior pigment epithelial cysts are subdivided according to their location as central, midzonal and peripheral. Iris stromal cysts are classified either as congenital or acquired. Free floating cysts are usually dislodged pigment epithelial cysts. Secondary cysts are classified according to the underlying cause as implantation cysts, drug-induced, uveitic, tumor-induced, parasitic, or as cysts associated with systemic disorders...
September 4, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28882597/the-acute-and-chronic-effects-of-intravitreal-anti-vascular-endothelial-growth-factor-injections-on-intraocular-pressure-a-review
#16
REVIEW
Peter Bracha, Nicholas A Moore, Thomas A Ciulla, Darrell WuDunn, Louis B Cantor
The acute and chronic effects of repeated intravitreal anti-vascular endothelial growth factor (VEGF) injections on intraocular pressure (IOP) have not been fully characterized and the development of sustained ocular hypertension could adversely affect patients who are at risk of glaucomatous optic neuropathy. As expected, volume-driven, acute ocular hypertension immediately follows intravitreal injection, but this pressure elevation is generally transient and well-tolerated. Several medications have been investigated to limit acute ocular hypertension following anti-VEGF therapy, but the benefits of pretreatment are not conclusive...
September 4, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28860081/clinical-decision-making-heuristics-and-cognitive-biases-for-the-ophthalmologist
#17
REVIEW
Ahsen Hussain, James Oestreicher
Diagnostic errors have a significant impact on health care outcomes and patient care. The underlying causes and development of diagnostic error are complex with flaws in health care systems, as well as human error, playing a role. Cognitive biases and a failure of decision-making shortcuts (heuristics) are human factors that can compromise the diagnostic process. We describe these mechanisms, their role with the clinician, and provide clinical scenarios to highlight the various points at which biases may emerge...
August 30, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28837797/ocular-adnexal-lymphoma-dissimilar-to-systemic-lymphoma
#18
Tal J Rubinstein, Hassan A Aziz, Claudine Bellerive, Bryan S Sires, Andrew W Hing, Gabriel Habermehl, Eric Hsi, Arun D Singh
Ocular adnexal lymphoma (OAL) and intraocular lymphoma, whether occurring simultaneously or sequentially, are often similar to associated systemic lymphoma. We describe 4 cases of OAL or intraocular lymphoma with dissimilar systemic lymphoma. Two of the cases represent Richter transformation of chronic lymphocytic leukemia/small cell lymphoma (CLL/SLL) into diffuse large B-cell lymphoma (DLBCL). The third patient developed conjunctival extranodal marginal zone lymphoma (EMZL) following treatment for Hodgkin lymphoma...
August 21, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28818456/response-to-the-letter-to-the-editor-fresnel-prism-intraocular-lens-and-scharioth-macula-lens
#19
LETTER
Boon Lin Teh, Roly Megaw, Shyamanga Borooah, Baljean Dhillon
No abstract text is available yet for this article.
August 15, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28807797/fresnel-prism-intraocular-lens-and-scharioth-macula-lens
#20
LETTER
Andrzej Grzybowski, Weronika Wasińska-Borowiec
No abstract text is available yet for this article.
August 12, 2017: Survey of Ophthalmology
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