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Seminars in Ophthalmology

Shaohui Liu, Peter Veldman
Endothelial keratoplasty (EK) has replaced penetrating keratoplasty (PKP) as the preferred surgical therapy for corneal endothelial dysfunction. However, recent nationwide corneal graft registry data showed few advantages to EK relative to PKP with respect to graft survival and visual outcomes. This article compares the published outcomes and complications of EK to those of PKP. EK demonstrates superior spectacle corrected visual outcomes, fast recovery, less graft rejection, and higher patient satisfaction, particularly in studies performed by high-volume surgeons/centers...
October 18, 2016: Seminars in Ophthalmology
Euna B Koo, Aubrey L Gilbert, Deborah K VanderVeen
PURPOSE: Amblyopia is a leading cause of low vision and warrants timely management during childhood. We performed a literature review of the management of amblyopia and potential risk factors for amblyopia. METHODS: Literature review of the management of amblyopia and risk factors for amblyopia. RESULTS: Common amblyopia risk factors include anisometropic or high refractive error, strabismus, cataract, and ptosis. Often a conservative approach with spectacles is enough to prevent amblyopia...
October 17, 2016: Seminars in Ophthalmology
Aditi Gupta, Jerry Cavallerano, Jennifer K Sun, Paolo S Silva
According to current projections, the number of Americans with diabetes mellitus will increase from 27.8 million in 2007 to 60.7 million in 2030. With the increasing gap between demand for eye care and supply of ophthalmologists and optometrists, and the non-uniform distribution of eye care providers in US counties, barriers to eye examinations will likely increase. Telemedicine assessment of diabetic retinal disease through remote retinal imaging and diagnosis has the potential to meet these growing demands...
October 17, 2016: Seminars in Ophthalmology
Rachel M Huckfeldt, Jason Comander
Retinitis pigmentosa is a genetically heterogeneous disorder with an estimated prevalence of one in 4,000 that is classically characterized by the progressive constriction of peripheral vision and a later deterioration of visual acuity. Central vision can be compromised earlier in disease, however, in the approximately 25% of patients that have cystoid macular edema. This poorly understood problem can thus significantly impair patient quality of life, particularly as available treatments have limited efficacy...
October 17, 2016: Seminars in Ophthalmology
Juan C Jiménez-Pérez, Michael K Yoon
Natural killer T-cell lymphoma (NKTCL) is a rare and aggressive condition with a high mortality rate. It is most commonly seen in the nasal sinuses, generally affecting the orbit by direct extension. Primary orbital NKTCL is even more rare, with only a few published cases with occasional secondary nasal involvement. This malignancy can present as a "masquerade syndrome," delaying proper diagnosis and treatment. Biopsy is required for diagnosis, which shows specific histopathological characteristics. Radiation and chemotherapy are the mainstay of treatment...
October 14, 2016: Seminars in Ophthalmology
Aubrey L Gilbert, Euna B Koo, Gena Heidary
Acute acquired comitant esotropia (AACE) is characterized by a sudden-onset eye misalignment with an equal angle of deviation in all fields of gaze. This form of esotropia is distinct from common forms of childhood esotropia, such as infantile esotropia and accommodative esotropia, in the rapid tempo and typically later timing of onset; further, AACE is distinct from restrictive or paretic strabismus, which usually results in an incomitant angle of deviation that varies with the direction of gaze. The underlying etiologies for AACE are broad but, in some cases, it may be associated with significant neurologic disease...
October 11, 2016: Seminars in Ophthalmology
Hala El Rami, Rasha Barham, Jennifer K Sun, Paolo S Silva
Diabetic retinopathy (DR) is the most frequent microvascular complication from diabetes and requires annual screening and at least annual follow-up. A systemic approach to optimize blood glucose and blood pressure may halt progression to severe stages of DR and obviate the need for ocular treatment. Although there is evidence of benefit from fenofibrate or intravitreous antiVEGF treatment for eyes with nonproliferative DR (NPDR), these therapies are not standard care for NPDR at this time. Some patients with severe NPDR, especially those with type 2 diabetes, benefit from early panretinal photocoagulation (PRP)...
October 4, 2016: Seminars in Ophthalmology
Farihah Anwar, Angela Turalba
BACKGROUND: Glaucoma is the second leading cause of blindness in the world. Angle closure glaucoma accounts for 25% of all glaucoma, with Asia having the highest rate. Angle closure is an anatomical variation, making the Inuit, Chinese, and other Asians more susceptible. Current treatments include medical, laser, and surgical modalities. PURPOSE: To identify the current treatment protocols for primary angle closure. DISCUSSION: The current general protocol to treat angle closure is to lower the intraocular pressure with medications and perform laser iridotomy...
September 29, 2016: Seminars in Ophthalmology
Maan Alkharashi, Anne B Fulton
Leber congenital amaurosis (LCA) is a group of severe inherited retinal dystrophies that lead to early childhood blindness. In the last decade, interest in LCA has increased as advances in genetics have been applied to better identify, classify, and treat LCA. To date, 23 LCA genes have been identified. Gene replacement in the RPE65 form of LCA represents a major advance in treatment, although limitations have been recognized. In this article, we review the clinical and genetic features of LCA and evaluate the evidence available for gene therapy in RPE65 disease...
September 29, 2016: Seminars in Ophthalmology
Courtney E Bovee, Louis R Pasquale
Interventions in the treatment of mild to moderate glaucoma have evolved to include a group of procedures collectively named "Minimally Invasive Glaucoma Surgery (MIGS)." These procedures are less invasive than traditional filtering surgery and setons and offer the benefit of an improved side-effect profile. A review of current published literature has shown that these procedures offer lower intraocular pressure, decrease reliance on topical medications, have no negative effect on refractive outcomes, and can be safely done following failed tube surgery...
September 29, 2016: Seminars in Ophthalmology
Shivali A Menda, Todd H Driver, Alexandra E Neiman, Seth Blumberg, Ayman Naseri, Jay M Stewart
OBJECTIVE: Investigate risk factors for unplanned return to the operating room after resident-performed cataract surgery. DESIGN: Retrospective case-control study. SETTING: Institutional. METHODS: Study population: All patients with reoperation within 90 days of resident-performed phacoemulsification were matched to four control eyes which had surgery within 30 days of the reoperation at the same institution. OBSERVATION PROCEDURE: Billing codes were used to identify all patients who underwent resident-performed intended phacoemulsification with intraocular lens placement from January 2005 to December 2010...
September 29, 2016: Seminars in Ophthalmology
Kyung Min Kim, Ungsoo Samuel Kim
PURPOSE: To evaluate the prevalence of aquaporin 4 antibody (AQP4-Ab) in new-onset optic neuritis patients and investigate the characteristics of seropositive patients. METHODS: Thirty-six women and six men with new-onset isolated optic neuritis were included in this study between January 2013 and December 2014. AQP4-Ab was detected and all blood samples were obtained prior to treatment and within one week from attack. The patients were sub-grouped into either a seropositive group or a seronegative group according to AQP4-Ab...
September 26, 2016: Seminars in Ophthalmology
Francisco Pérez Bartolomé, Jose María Martínez de la Casa, Irene Camacho Bosca, Federico Sáenz-Francés, Soledad Aguilar Munoa, Alberto Martín Juan, Julian Garcia-Feijoo
PURPOSE: To examine interrelations between corneal biomechanics, ocular biometric variables and optic disc size (ODS), lamina cribosa depth (LCD) or thickness (LCT) in a healthy population. MATERIAL AND METHODS: In a cross-sectional case-control study, the following measurements were made in 81 eyes of 81 participants: axial length, anterior chamber depth, lens thickness, and central corneal thickness using the optical biometer Lenstar LS900; and corneal hysteresis (CH), corneal resistance factor (CRF), Goldman-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) using the Ocular Response Analyzer...
September 14, 2016: Seminars in Ophthalmology
Muhammed Batur, Abdussamet Batur, Vedat Çilingir, Erbil Seven, Adnan Çinal, Aydin Bora, Tekin Yaşar
PURPOSE: In the present study, we attempted to determine whether ultrasonic elastography (USE) evaluation can be used in a diagnosis of optic neuritis (ON). MATERIALS AND METHODS: Thirteen patients who each had one normal eye and one eye with a diagnosis of ON were included in the study. Ultrasonography (US) and USE examinations were performed on the affected and non-affected eyes of all participants. Optic nerve and adjacent fat tissue regions at the same depth were selected, and USE measurements were obtained...
September 14, 2016: Seminars in Ophthalmology
Jelena Paovic, Predrag Paovic, Vojislav Sredovic, Svetlana Jovanovic
Sarcoidosis is a chronic systemic autoimmune disease which belongs to a group of systemic granulomatous diseases. It can be confirmed through characteristic systemic and ocular manifestations and histological findings. Biopsy is the golden standard for diagnosing sarcoidosis. Ocular sarcoidosis can be confirmed, probable, or possible. Over a two-year period, ocular manifestations were studied on a sample of 52 patients, each followed for four months and diagnosed with some form of systemic sarcoidosis. Most frequent systemic manifestations in patients with ocular sarcoidosis were pulmonary, skin, glandular, and systemic generalized sarcoidosis...
September 14, 2016: Seminars in Ophthalmology
Roberta Lilian Fernandes de Sousa Meneghim, Magda Massae Hata Viveiros, Alicia Galindo-Ferreiro, Carlos Roberto Padovani, Silvana Artioli Schellini
PURPOSE: To evaluate the sequelae due to epidemic viral conjunctivitis (VC) for a possible association with inflammatory trachoma in schoolchildren. METHODS: A cross-sectional survey was performed of 2,093 schoolchildren in public schools in Sao Paulo State, Brazil. The exams were conducted according to the WHO definitions to detect trachoma. We evaluated the prevalence and the association between inflammatory trachoma and sequelae due to VC. RESULTS: The prevalence of inflammatory trachoma in schoolchildren in Botucatu City was 2...
September 14, 2016: Seminars in Ophthalmology
Jin Sun Kim, Hun Lee, Seonghee Choi, Eung Kweon Kim, Kyoung Yul Seo, Tae-Im Kim
PURPOSE: To evaluate changes in the tear film lipid layer thickness (LLT) after cataract surgery and the effects of cataract surgery on dry eye syndrome (DES) and meibomian gland dysfunction (MGD). METHODS: LLT measurements obtained using the LipiView interferometer, tear break-up time (TBUT) measurements, Schirmer's tests, Oxford staining scores, lid margin and meibomian gland findings, and the Ocular Surface Disease Index (OSDI) questionnaire scores were evaluated before and one and three months after cataract surgery...
September 14, 2016: Seminars in Ophthalmology
Pinar Altiaylik Ozer, Emrah Utku Kabatas, Gokce Tasdemir Ertugrul, Bengi Ece Kurtul, Umut Kaygusuz, Selmin Karatayli Ozgursoy
PURPOSE: To investigate types and frequencies of ocular disorders in children with sensorineural hearing loss (SNHL), and to emphasize the importance of ophthalmological examination in these children. METHODS: A retrospective analysis of the examination records of children examined in our instutititon between January 2011 and September 2014 was performed. Ocular disorders of children with SHNL were selectively reviewed. RESULTS: Among 55340 patients, SNHL was present in 110 (0...
September 14, 2016: Seminars in Ophthalmology
Jay Chhablani, Michael Stewart, Remya Paulose, Roberto Gallego-Pinazo, Rosa Dolz-Marco
PURPOSE: To report the ocular findings, systemic hematologic parameters, and treatment outcomes of patients with recurrent central retinal vein occlusions (CRVO). METHODS: A retrospective analysis of eyes that developed recurrent CRVO was performed. Key exclusion criteria were follow-up of less than six months after the recurrence, incomplete documentation, and recurrent macular edema in an eye with a CRVO but without evidence of increased superficial hemorrhage or disc edema (recurrent CRVO)...
September 9, 2016: Seminars in Ophthalmology
Alime Gunes, Funda Yıldırım Bas, Bahriye Arslan, Levent Tok, Özlem Tok, Zeliha Salman
PURPOSE: To assess corneal parameters in constitutional thinness (CT) subjects and to compare them with those of healthy individuals. METHODS: Twenty-four CT subjects (BMI < 18.5 kg/m(2)) and 24 healthy subjects (BMI: 18.5-25 kg/m2) were enrolled in this observational cross-sectional study. All participants were screened for age, gender, and medical history, then underwent a detailed ophthalmological examination. Corneal parameters were evaluated by Scheimpflug imaging...
September 6, 2016: Seminars in Ophthalmology
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