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Clinical Ophthalmology

Daniel Sarezky, Aaishah R Raquib, Joshua L Dunaief, Benjamin J Kim
PURPOSE: Alpha lipoic acid (ALA) is an antioxidant and iron-chelating supplement that has potential benefits for geographic atrophy in dry age-related macular degeneration as well as other eye diseases. The purpose of this study was to determine the tolerability of ALA in the elderly population. PATIENTS AND METHODS: Fifteen subjects, age ≥65 years, took sequential ALA doses of 600, 800, and 1,200 mg. Each dose was taken once daily with a meal for 5 days. After each dose was taken by the subjects for 5 days, the subjects were contacted by phone, a review of systems was performed, and they were asked if they thought they could tolerate taking that dose of ALA for an extended period of time...
2016: Clinical Ophthalmology
Mohamed Omar Yousif
Managing large iridodialysis that may occur during phacoemulsification is challenging. I describe how a procedure to reposit a prolapsed iris while the anterior chamber is markedly inflated by a current of infusion fluid may inadvertently lead to large iridodialysis, and discuss how to avoid such a complication. I describe a fast and efficient technique for managing large iridodialysis both immediately, once it occurs, or as a secondary maneuver. My technique involved fixing the iris periphery back to its root at the anterior chamber angle using 10-0 polypropylene suture with two straight needles introduced directly through the cornea at distant points, and an insulin syringe as a guide track to a point 1...
2016: Clinical Ophthalmology
Kaoru Tounaka-Fujii, Kenya Yuki, Kazuno Negishi, Ikuko Toda, Takayuki Abe, Keisuke Kouyama, Kazuo Tsubota
PURPOSE: The aims of our study were to investigate whether laser in situ keratomileusis (LASIK) improves health-related quality of life (HRQoL) and to identify factors that affect postoperative HRQoL. MATERIALS AND METHODS: A total of 213 Japanese patients who underwent primary LASIK were analyzed in this study. The average age of patients was 35.0±9.4 years. The subjects were asked to answer questions regarding subjective quality of vision, satisfaction, and quality of life (using the Japanese version of 36-Item Short Form Health Survey Version 2) at three time points: before LASIK, 1 month after LASIK, and 6 months after LASIK...
2016: Clinical Ophthalmology
Remya Paulose, Jay Chhablani, Chintan J Dedhia, Michael W Stewart, Ahmad M Mansour
AIM: To report the efficacy of intravitreal ziv-aflibercept injections in eyes with macular edema due to retinal vein occlusions (RVOs). METHODS: Consecutive patients with persistent or recurrent macular edema (central macula thickness >250 μm) due to RVO were enrolled in this prospective study. Study eyes received intravitreal injections of ziv-aflibercept (1.25 mg/0.05 mL) at baseline. Patients were reassessed monthly for 4 months and given additional injections pro re nata for worsening best-corrected visual acuity (BCVA), intraretinal edema or subretinal fluid seen on spectral domain optical coherence tomography, or central macular thickness (CMT) measurements >250 μm...
2016: Clinical Ophthalmology
Fredric J Gross, Debra E Garcia-Zalisnak, Courtney E Bovee, Joy D Strawn
In this randomized prospective study, the cumulative dissipated energy and case time of pop and chop and of traditional four-quadrant divide and conquer in the first 60 cases (in total 120 eyes) of cataract surgery performed by two residents at the Veterans Administration Hospital in Hampton, Virginia, were compared. Overall and individually, the residents had significantly shorter case times and used significantly less cumulative dissipated energy for performing pop and chop than that for divide and conquer technique...
2016: Clinical Ophthalmology
Stefan Pfennigsdorf, Peter Eschstruth, Stefan Häsemeyer, Cord Feuerhake, Gerrett Brief, Ioana Grobeiu, Andrew Shirlaw
PURPOSE: The aim of this study was to evaluate the efficacy and tolerability of, and compliance to, preservative-free (PF), fixed-combination (FC) bimatoprost 0.03%/timolol 0.5% in patients with primary open-angle glaucoma or ocular hypertension in a clinical practice setting. PATIENTS AND METHODS: This open-label study observed patients switched to PF FC bimatoprost 0.03%/timolol 0.5% due to insufficient intraocular pressure (IOP) control on previous therapies...
2016: Clinical Ophthalmology
Rick Potvin, Brent A Kramer, David R Hardten, John P Berdahl
PURPOSE: To analyze intraocular lens (IOL) orientation data from an online toric back-calculator ( for determining if differences were apparent by lens type. METHODS: A retrospective review of toric back-calculations that included IOL identification and intended orientation axis. RESULTS: Of 12,812 total validated calculation records, 8,229 included intended orientation and lens identification data. Of the latter, 5,674 calculations (69%) involved lenses oriented 5° or more from their intended position...
2016: Clinical Ophthalmology
Adel Galal Zaky, Ahmed Tarek Yassin, Saber Hamed El Sayid
OBJECTIVE: To assess the role and diagnostic effectiveness of optical coherence tomography (OCT) and short wave-automated perimetry (SWAP) to distinguish between normal, glaucoma suspects, and surely diagnosed glaucomatous eye. BACKGROUND: Changes in the optic disc and retinal nerve fiber layer (RNFL) often precede the appearance of visual field defect with standard automated perimetry. Unfortunately, RNFL defect can be difficult to identify during clinical examination...
2016: Clinical Ophthalmology
Ama Sadaka, Robert A Sisk, James M Osher, Okan Toygar, Melinda K Duncan, Christopher D Riemann
PURPOSE: The purpose of this study was to evaluate intravitreal methotrexate infusion (IMI) during pars plana vitrectomy (PPV) for retinal detachment in patients with high risk for the development of proliferative vitreoretinopathy (PVR). METHODS: Patients presenting with severe recurrent PVR with tractional retinal detachment and/or a history of severe ocular inflammation were treated with IMI. Clinical outcomes were determined from a retrospective medical chart review...
2016: Clinical Ophthalmology
Adel Galal Zaky, Hesham Mohamed Fouad Elmazar, Mohamed Samy Abd Elaziz
PURPOSE: The purpose of this study was to evaluate the longevity results of modified Hughes procedure in reconstructing large lower eyelid defects. BACKGROUND: The modified Hughes procedure was used to reconstruct large full-thickness lower eyelid defects. Meanwhile, the functional results indicated that ocular surface health in the treated eyes may be affected. PATIENTS AND METHODS: Noncomparative, case series retrospective study was designed after obtaining the approval of the institutional review board at the Ophthalmology Department, Menoufia University, Egypt, where the results of cases who underwent surgery with the modified Hughes procedure during a 7-year interval were evaluated...
2016: Clinical Ophthalmology
Leopoldo Spadea, Emanuele Tonti, Enzo Maria Vingolo
Collagen cross-linking (CXL) is a relatively new conservative approach for progressive corneal ectasia, which is able to strengthen corneal tissue reforming new covalent bonds. Subjective and objective results following this method seem to be promising. In recent years, newer CXL protocols have been developed to perform more effective and less invasive procedures. The increasing diffusion of CXL in the corneal ectatic disease has increased the need to have actual indices regarding the efficacy of the treatment...
2016: Clinical Ophthalmology
Müberra Akdoğan, Yasemin Ustundag-Budak, Kagan Huysal
BACKGROUND: Atherogenic dyslipidemia is particularly common in people with type 2 diabetes (DM2). Platelets from patients with DM2 have increased reactivity and baseline activation. The aim of the present study is to evaluate the relationship between atherogenic index and hematologic inflammatory markers and to evaluate the relationship between these parameters and associated variables in diabetic retinopathy (DR) patients. METHODS: The medical records of all patients admitted to the eye clinic between January and December 2014 were evaluated systematically...
2016: Clinical Ophthalmology
Sarah Cheng, Theodore Leng
BACKGROUND AND OBJECTIVES: A method of identifying retinal vascular microaneurysms (MAs) in nonproliferative diabetic retinopathy (NPDR) using swept-source optical coherence tomography (SS-OCT). PATIENTS AND METHODS: SS-OCT images were acquired in 17 eyes with NPDR using prototype SS-OCT device and fluorescein angiography (FA) images were obtained simultaneously. MAs identified on SS-OCT slabs were correlated to MAs identified on FA. RESULTS: MAs were identified in SS-OCT slabs in 15/17 eyes, resulting in NPDR diagnosis rate of 88%...
2016: Clinical Ophthalmology
Ryan Lee, Sharon Yeo, Han Tun Aung, Louis Tong
BACKGROUND: It is difficult to standardize assessment of dry eye in different clinical settings. Increasingly, tear stability is recognized to be important for the definition and assessment of patients with dry eye. Recently, two commercially available instruments have been made available for objectively measuring noninvasive tear break-up time (NIBUT), as an indicator of tear stability: the Tomey RT-7000 Auto Refractor-Keratometer and Oculus Keratograph (K)5M. We aim to assess the agreement of NIBUT measurements using these modalities...
2016: Clinical Ophthalmology
Hsi-Wei Chung, Lay Leng Seah
PURPOSE: Cosmetic and functional outcomes of frontalis suspension surgery using autologous fascia lata (FL) or silicone rods (SRs) in pediatric congenital ptosis. DESIGN: Retrospective case series. STUDY SUBJECTS: Patients with congenital ptosis, aged 18 years or younger, during the period under study (2005-2011) at the Singapore National Eye Centre. METHODS: Review of case records for functional and cosmetic outcome measures after frontalis suspension surgery using either SRs or autologous FL...
2016: Clinical Ophthalmology
Karel Allegaert
No abstract text is available yet for this article.
2016: Clinical Ophthalmology
Tanner J Ferguson, John P Berdahl, Justin A Schweitzer, Ramu G Sudhagoni
PURPOSE: To evaluate the safety and efficacy of the iStent trabecular microbypass stent in combination with cataract surgery in patients with open-angle glaucoma (OAG). METHODS: Retrospective, consecutive case series from October 2012 to December 2015 with no exclusion criteria. The series comprised of 350 eyes with OAG and cataract. Data were collected both preoperatively and postoperatively at day 1 week 1, months 1, 3, 6, 12, 18, and 24. Data included intraocular pressure (IOP), number of glaucoma medications, visual acuity, the incidence of postoperative IOP pressure spikes of greater than ≥15 mmHg at any time point, and need for additional surgery...
2016: Clinical Ophthalmology
Ling Bei, Iris Lee, Michael S Lee, Greg P Van Stavern, Collin M McClelland
Giant-cell arteritis (GCA) is a visually devastating disease that often progresses to severe bilateral vision loss if untreated. Diagnosis of GCA is made challenging by the protean nature of the disease and the lack of a simple test that is both highly sensitive and specific. Choroidal filling delay on fluorescein angiography (FA) has been touted as a highly characteristic feature of GCA-related vision loss, although knowledge of both the sensitivity and specificity of this finding remains unproven. We report our experience of delayed choroidal filling on FA in a series of seven patients referred to an academic neuro-ophthalmology practice due to concern for GCA...
2016: Clinical Ophthalmology
Lutz E Pillunat, Peter Eschstruth, Stefan Häsemeyer, Ulrich Thelen, Christian Foja, Richard Leaback, Stefan Pfennigsdorf
BACKGROUND: Intraocular pressure (IOP)-lowering medications for primary open-angle glaucoma and ocular hypertension commonly contain preservatives that can cause ocular surface damage in many patients. The purpose of this study was to evaluate the efficacy and tolerability of, and compliance to, preservative-free (PF) bimatoprost 0.03% in patients with primary open-angle glaucoma or ocular hypertension (IOP ≥18 mmHg) in a clinical practice setting. METHODS: This open-label study observed patients who were switched to PF bimatoprost 0...
2016: Clinical Ophthalmology
Paolo Milani, Amedeo Massacesi, Stefania Moschini, Marco Setaccioli, Ennio Bulone, Gemma Tremolada, Stefano Ciaccia, Elena Mantovani, Daniela Morale, Fulvio Bergamini
PURPOSE: To investigate myopic choroidal neovascularization (mCNV) by fluorescein angiography (FA), spectral-domain optical coherence tomography (SD-OCT), near-infrared (NIR) reflectance, and autofluorescence (AF). METHODS: This retrospective study included 65 eyes of 62 Caucasian patients with a mean age of 66.72 years (95% confidence interval [CI] 63-70 years) and a mean refraction of -9.72 diopters (95% CI -8.74 to -10.70 diopters). RESULTS: Most of the mCNV cases were foveal-juxtafoveal (60/65, 92...
2016: Clinical Ophthalmology
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