3401
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Efficacy and Safety of Various Amphotericin B Concentrations on Candida albicans in Cold Storage Conditions. Cornea 2019; 39:110-117. [DOI: 10.1097/ico.0000000000002019] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3402
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Fayzrakhmanov RR. Anti-VEGF therapy of neovascular age-related macular degeneration: from randomized trials to routine clinical practice. ACTA ACUST UNITED AC 2019. [DOI: 10.21516/2072-0076-2019-12-2-97-105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Antivasoproliferative therapy is a revolutionary trend in the treatment of neovascular age-related macular degeneration (nAMD), as it is aimed at blocking growth factors of the newly formed vessels. Currently, two anti-VEGF drugs are registered for ophthalmological use, and the search for new molecules is only gaining momentum. Studying new approaches to treatment and developing innovative drugs, modern medicine relies on the data from international randomized clinical trials (RCT). The fact that this direction attracts much scientific interest is explained by high reliability of the data obtained with RCTs. However, when analyzing the effectiveness of anti-VEGF therapy in patients with nAMD in routine clinical practice, many ophthalmologists are confronted with discrepancies between the expected morphological and functional results as predicted by RCTs and those obtained in reality. It is thus important to bear in mind that RCTs simply determine how the dynamics of morphofunctional parameters should look like, whilst the ideal result is only achievable through correct implementation of therapeutic strategy in real clinical practice. The results obtained in the practice of any specialist wholly depend on how carefully the prescribed treatment protocols are followed by doctors and patients, how burdensome the treatment is, as well as on the potential of the medication. This literary review offers a comparative analysis of the results achieved by using anti-VEGF drugs (ranibizumab and aflibercept) obtained in key RCTs and in routine clinical treatment of nAMD patients.
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3403
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Shahid E, Shaikh A, Aziz S, Rehman A. Frequency of Ocular Diseases in Infants at a Tertiary Care Hospital. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:287-293. [PMID: 31179661 PMCID: PMC6557792 DOI: 10.3341/kjo.2017.0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/10/2018] [Accepted: 04/19/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine the frequency of ocular diseases in infants visiting the ophthalmology department of a tertiary care hospital. Methods This was a cross-sectional descriptive study conducted in the department of ophthalmology, Abbasi Shaheed Hospital, from January 2015 to May 2016. The study included 377 infants ranging in age from 1 day to less than 1 year who were, selected by a nonprobability consecutive sampling technique. A detailed history was taken, and a complete ocular examination was performed. Descriptive statistics were used to calculate the mean and standard deviation for age. Frequencies were calculated for ocular diseases along with the percentages. Outcome variables included various congenital and acquired diseases such as conjunctivitis, congenital cataract, glaucoma, nasolacrimal duct blockage, squint, trauma, and fundus abnormalities. Results The mean age of infants was 5.0 ± 3.7 months. There were 196 (52%) males and 181 (48%) females. The sample included 330 (87.5%) full term infants. Acquired ocular diseases occurred in 230 (61%) infants; and congenital diseases, in 147 (39%). The most common ocular disease was conjunctivitis, which occurred in 173 (46%) infants, followed by congenital blocked nasolacrimal duct, which occurred in 57 (15 %) infants. Conjunctivitis was more common among neonates than infants. Conclusions Acquired ocular diseases were more common than congenital ocular diseases. The most common ocular pathology was conjunctivitis, followed by congenital nasolacrimal duct obstruction, in infants. Conjunctivitis was more common in neonates than infants.
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Affiliation(s)
- Erum Shahid
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan.
| | - Arshad Shaikh
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
| | - Sina Aziz
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
| | - Atya Rehman
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
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3404
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Dolan H, Li M, Trevena L. Interventions to improve participation in health-care decisions in non-Western countries: A systematic review and narrative synthesis. Health Expect 2019; 22:894-906. [PMID: 31177623 PMCID: PMC6803415 DOI: 10.1111/hex.12933] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/25/2019] [Accepted: 05/23/2019] [Indexed: 01/29/2023] Open
Abstract
Background Patients' participation in medical decision making is an important aspect of patient‐centred care. However, there is often uncertainty about its applicability and feasibility in non‐Western countries. Objective To provide an overview and assessment of interventions that aimed to improve patients' participation in decision making in non‐Western countries. Method Ovid Medline, Embase, Cochrane Central Register of Controlled Trials, CINAHL, Ovid MEDLINE(R) Epub Ahead of Print, In‐Process, Other Non‐Indexed Citations, without Revisions and Daily Update and Database of Abstracts of Reviews of Effects, were searched from respective inception to February 2018. Studies were included if they (a) were randomized controlled trials, before‐and‐after studies and interrupted time series studies; (b) were conducted in non‐Western countries; (c) aimed to improve patients' participation in dyadic decision making; and (d) reported outcomes relevant to patient participation in decision making. Studies were excluded if they included children, were about triadic decision making or solely focused on information provision without reporting outcomes related to patient participation. Narrative synthesis method was used for data analysis and presentation. Results A total of 17 studies, 6 RCTs and 11 non‐RCTs, were included across ten countries. Intervention strategies included patient and/or provider communication skills training, decision aids and a question prompt material. Whilst most of the studies reported increased patient participation, those interventions which had provider or patient training in communication skills were found to be more effective. Conclusion Interventions to improve patient participation, within the context of dyadic decision making, in non‐Western countries can be feasible and effective if communication skills training is provided for health‐care providers and/or patients.
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Affiliation(s)
- Hankiz Dolan
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, The University of Sydney, Sydney, New South Wales, Australia
| | - Mu Li
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyndal Trevena
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, The University of Sydney, Sydney, New South Wales, Australia
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3405
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14th EUNOS Congress: PORTO, PORTUGAL, 16-19 JUNE 2019. Neuroophthalmology 2019; 43:1-221. [PMID: 31528195 PMCID: PMC6736494 DOI: 10.1080/01658107.2019.1608780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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3406
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Tase S, Shimizu T, Hayashi T, Tabuchi H, Niimi K, Mizuki N, Kato N. Descemet's membrane endothelial keratoplasty for pseudoexfoliation syndrome: a case series. BMC Ophthalmol 2019; 19:119. [PMID: 31138243 PMCID: PMC6537358 DOI: 10.1186/s12886-019-1130-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 05/20/2019] [Indexed: 12/11/2022] Open
Abstract
Background To evaluate the clinical outcomes and features of Descemet’s membrane endothelial keratoplasty (DMEK) for eyes with pseudoexfoliation syndrome (PEX). Methods In this retrospective study, 37 DMEK cases were reviewed from available medical records. Patients who exhibited endothelial dysfunction derived from PEX or Fuchs endothelial corneal dystrophy (FECD) and successfully underwent cataract surgery about four weeks before DMEK were enrolled. The best spectacle-corrected visual acuity (BSCVA), central corneal thickness (CCT), endothelial cell density (ECD), and incidence of intra-operative/post-operative complications of DMEK were analyzed. Results This study included 14 eyes of 14 patients (PEX: n = 6, FECD: n = 8). There was no primary graft failure. In the PEX group, BSCVA improved from 0.67 ± 0.28 at the preoperative point to 0.43 ± 0.14 at 1 month, 0.27 ± 0.10 at 3 months, and 0.19 ± 0.08 at 6 months after DMEK. The donor corneal ECD was 2704 ± 225 cells/mm2 at the preoperative point and decreased to 1691 ± 498 cells/mm2 at 1 month, 1425 ± 366 cells/mm2 at 3 months, and 1281 ± 340 cells/mm2 (52.7 ± 11.7% less than ECD of the donor graft) at 6 months after DMEK. None of the patients required rebubbling. When compared with the FECD group, no statistical difference was observed in CCT (p = 0.821); BSCVA (p = 0.001) and the reduction rate of ECD (p = 0.010) were relatively worse. Conclusions DMEK is effective for the treatment of endothelial dysfunction due to PEX. Electronic supplementary material The online version of this article (10.1186/s12886-019-1130-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saho Tase
- Niimi Eye Institute, Hyogo, Japan.,Department of Ophthalmology, Yokohama City University Hospital, Kanagawa, Japan
| | - Toshiki Shimizu
- Department of Ophthalmology, Yokohama City University Hospital, Kanagawa, Japan
| | - Takahiko Hayashi
- Department of Ophthalmology, Yokohama City University Hospital, Kanagawa, Japan. .,Department of Ophthalmology, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuura Higashi, Yokohama, Kanagawa, 236-0037, Japan.
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Hyogo, Japan
| | | | - Nobuhisa Mizuki
- Department of Ophthalmology, Yokohama City University Hospital, Kanagawa, Japan
| | - Naoko Kato
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
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3407
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Hornik B, Duława J. Frailty, Quality of Life, Anxiety, and Other Factors Affecting Adherence to Physical Activity Recommendations by Hemodialysis Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101827. [PMID: 31126041 PMCID: PMC6571908 DOI: 10.3390/ijerph16101827] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/15/2019] [Accepted: 05/16/2019] [Indexed: 02/07/2023]
Abstract
Hemodialysis patients perform little physical activity. We formulated a hypothesis that some factors, i.e., frailty, medical and functional factors, psychological factors, quality of life, awareness of recommendations, and sociodemographic factors influence the decisions of taking up physical activity. This prospective study comprised 72 dialysis patients aged 57.8 ± 16.0 ( x ¯ ± SD; in the range of 19-87 years of age). The following research tools were used: an interview about awareness of the physical activity recommendations, the Canadian Study of Health and Aging Scale (CSHA-CFS), scales for the assessment of functional status, State-Trait Anxiety Inventory (STAI), Acceptance of Illness Scale (AIS), and the questionnaire of Kidney Disease Quality of Life (KDQOL-SF 1.3). The majority of patients diagnosed with frailty did not follow the physical activity recommendations (79.3%). Quality of life was better in active patients compared to inactive patients, especially in the domains of sleep and physical performance. The severity of trait anxiety was significantly higher in patients who did not follow the recommendations compared to patients who adhered to physical activity recommendations (46.0 ± 10.5 vs. 40.0 ± 8.2; p = 0.021 ). The likelihood of adherence decreased by 1% after each subsequent month of dialysis (odds ratio = 0.99; 95% confidence interval = 0.972-0.999; p = 0.047 ). Adherence was most limited by frailty. Adherence to recommendations on physical activity was affected by: motivation, lower levels of trait anxiety, and better quality of life. Age modified the effect of awareness and acceptance of the disease on adherence to physical activity recommendations.
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Affiliation(s)
- Beata Hornik
- Department of Internal Nursing, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | - Jan Duława
- Department of Internal Medicine and Metabolic Diseases, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
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3408
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Emerah SH, Sabry MM, Saad HA, Ghobashy WA. Visual and refractive outcomes of posterior chamber phakic IOL in stable keratoconus. Int J Ophthalmol 2019; 12:840-843. [PMID: 31131246 DOI: 10.18240/ijo.2019.05.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/03/2019] [Indexed: 11/23/2022] Open
Abstract
We evaluated the visual and refractive outcomes after phakic visian toric implantable collamer lens (ICL) insertion in stable keratoconus (KC). This retrospective study investigated toric ICL implantation in 14 eyes of 8 patients with stable KC. After 6mo, the mean uncorrected distance visual acuity improved significantly from 0.77 to 0.15 logMAR. The mean best corrected distance visual acuity (BCDVA) improved from 0.18±0.1 to 0.15±0.1 logMAR. Fifty percent of eyes maintained their preoperative BCDVA; 42.8% gained one line. There was no statistical difference in high order or coma aberration. The mean refractive manifest spherical equivalent (MSE), mean refractive manifest spherical error, mean manifest astigmatism decreased significantly postoperatively. At 6mo postoperatively, our achieved mean spherical equivalent was approximately 74%. No intraoperative or postoperative complications occurred. Toric ICL implantation was effective, predictable and safe to correct refractive error and improve visual acuity in patients with stable KC.
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Affiliation(s)
- Sherif H Emerah
- Ophthalmology Department, Research Institute of Ophthalmology, Giza, Egypt.,Magrabi Eye Hospital, Dubai, UAE
| | - Moataz M Sabry
- Ophthalmology Department, Tanta University, Tanta, Egypt
| | - Hisham A Saad
- Ophthalmology Department, Tanta University, Tanta, Egypt
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3409
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Abstract
Fatigue in radiologists may be responsible for a large number of medical errors. This review describes the latest research on fatigue in radiology. This includes measurement methods, and recent evidence on how fatigue affects accuracy in laboratory test conditions and in clinical practice. The extensive opportunities for future research in the area are explored, including testing interventions to reduce fatigue-related error, and further understanding of which fatigue measures correlate with errors. Finally we explore the possibility of answering these questions using large population-based observational studies and pragmatic integrated randomised controlled trials.
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Affiliation(s)
| | - Chris Stinton
- 1 Warwick Medical School, The University of Warwick , Coventry , England
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3410
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Tavassoli S, Nayar G, Darcy K, Grzeda M, Luck J, Williams OM, Tole D. An 11-year analysis of microbial keratitis in the South West of England using brain-heart infusion broth. Eye (Lond) 2019; 33:1619-1625. [PMID: 31073162 DOI: 10.1038/s41433-019-0463-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/25/2019] [Accepted: 04/22/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aims of this study were to identify the organisms responsible for microbial keratitis, as identified by corneal scrape using brain-heart infusion broth, trends over time and antimicrobial sensitivities, over an 11-year period at two eye units in the South West of England; Bristol Eye Hospital and Royal United Hospital, Bath. METHODS All corneal scrapes performed and sent for microbiological analysis between 4th April 2006 and 31st October 2017 at the two eye units were retrospectively reviewed. First-line treatment was monotherapy with levofloxacin 0.5% and second-line treatment was a combination of cefuroxime 5% and gentamicin 1.5%. Both direct and enrichment cultures were used. RESULTS In total, 2614 corneal scrapes from 2116 patients (1082 female, mean age 47.7 ± 21.2 years) were identified. 38.1% (n = 996) were culture positive and 1195 organisms were cultured. In all, 91.6% were bacteria (69.4% were gram-positive, 30.6% gram-negative). Coagulase-negative Staphylococci (CoNS) were the most commonly cultured organism (n = 430). Pseudomonas aeruginosa was the most commonly identified gram-negative organism (n = 189). In total, 6.9% (n = 83) of organisms cultured were fungi. In all, 1.4% (n = 17) were acanthamoeba. There was no statistically significant trend in the organisms observed over the study period. Sensitivity testing confirmed reasonable sensitivity to the empiric antibiotics used in clinical practice. CONCLUSIONS This is the first report on microbial keratitis trends in the South West of England. Virulent organisms were likely to be detected on direct culture, whereas low virulent organisms such as CoNS were more likely to be detected on enrichment alone. Antibiotic sensitivity testing confirmed fluoroquinolone monotherapy as appropriate first-line treatment.
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Affiliation(s)
- Shokufeh Tavassoli
- Bristol Eye Hospital, Cornea and Refractive Surgery, Bristol, United Kingdom.
| | - Gayathri Nayar
- University Hospitals Bristol and Public Health England Microbiology Laboratory Services Bristol, Bristol, United Kingdom
| | - Kieren Darcy
- Bristol Eye Hospital, Cornea and Refractive Surgery, Bristol, United Kingdom
| | - Mariusz Grzeda
- Bristol Eye Hospital, Cornea and Refractive Surgery, Bristol, United Kingdom
| | - Jon Luck
- Royal United Hospital Bath, Bristol, United Kingdom
| | - O Martin Williams
- University Hospitals Bristol and Public Health England Microbiology Laboratory Services Bristol, Bristol, United Kingdom
| | - Derek Tole
- Bristol Eye Hospital, Cornea and Refractive Surgery, Bristol, United Kingdom
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3411
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Schmidt I, Schlötzer-Schrehardt U, Langenbucher A, Eppig T, Hager T, Zimpfer A, Seitz B. Ultrastructural findings in graft failure after Descemet membrane endothelial keratoplasty (DMEK) and new triple procedure. Medicine (Baltimore) 2019; 98:e15493. [PMID: 31083187 PMCID: PMC6531070 DOI: 10.1097/md.0000000000015493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To investigate factors that influence graft failure after Descemet membrane endothelial keratoplasty (DMEK) based on transmission electron microscopy results.Retrospective observational case series.This single center study included 16 eyes of 16 patients with penetrating keratoplasty (n = 14) or repeat DMEK (n = 2) following graft failure after DMEK. The main outcome measures were ultrastructural changes in the explanted graft on transmission electron microscopy, best-corrected visual acuity, and central corneal thickness.The mean preoperative and postoperative best-corrected visual acuity was 1.01 ± 0.54 logMAR and 0.56 ± 0.37 logMAR. The mean central corneal preoperative and postoperative thickness was 667 ± 187 μm and 511 ± 42 μm. Visual acuity and central corneal thickness improved significantly (P = .001/P = .003) after repeat surgery. Electron microscopy showed that 3 of 14 corneas showed upside down transplantation, and 3 corneas had pigmented cells or pigment granules at the Descemet-stroma interface. Further, 9 of 16 specimens showed a posterior collagenous layer deposited onto the Descemet membrane (average thickness 5.1 ± 6.2 μm; ranged 0.65-20 μm); this did not correlate significantly with the time between the original and repeat keratoplasty. Of 16 original grafts, 7 showed ultrastructural anomalies of the Descemet membrane, but one excised cornea showed no Descemet membrane pathologies.The majority of eyes with graft failure after DMEK showed ultrastructural changes in the Descemet membrane. It is crucial to assess donor tissue quality and to conduct graft marking before surgery to avoid immediate or delayed graft failure after DMEK. Nevertheless, repeat keratoplasty provided significant improvement in central corneal thickness and visual acuity.
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Affiliation(s)
- Isabell Schmidt
- Department of Ophthalmology, Saarland University Medical Center UKS Homburg/Saar
| | | | | | - Timo Eppig
- Institute of Experimental Ophthalmology, Saarland University
| | - Tobias Hager
- Department of Ophthalmology, Saarland University Medical Center UKS Homburg/Saar
| | - Annette Zimpfer
- Department of Pathology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center UKS Homburg/Saar
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3412
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A two-centre validation study of sterility test of corneal storage media with elimination of interfering antimicrobials in compliance with the European Pharmacopoeia. Cell Tissue Bank 2019; 20:275-285. [PMID: 31037539 DOI: 10.1007/s10561-019-09766-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 04/01/2019] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to validate the sterility test of corneal culture and deswelling/transport media using a device for removal of antimicrobials before incubation in BACTEC™ automated system in two Italian Eye Banks. Corneal culture medium, TISSUE-C, and deswelling/transport medium, CARRY-C, were inoculated with 10-100 cfu of six European Pharmacopoeia (EP) reference strains and either treated with medical device RESEP for removal of antimicrobials (RESEP+ group) or left untreated (RESEP- group) before injection into the BACTEC Plus bottles. The same steps were repeated in the absence of inocula with tryptone soy broth samples as negative controls, and the inocula were also directly injected in the BACTEC™ bottles as growth controls. All the samples were incubated in BACTEC™ automated system for 7 days, and the time to detection of microbial growth was recorded automatically. At both the Eye Banks, in the RESEP+ groups, microbial growth was detected in 100% of samples. In the RESEP- group, the method sensitivity ranged from 66.7 ± 21.1 to 88.9 ± 6.4% for TISSUE-C samples while for CARRY-C samples the method sensitivity ranged from 94.5 ± 5.1 to 100%. The method specificity corresponded to 100% for all the groups at both Eye Banks. This two-centre validation study showed that the use of RESEP increased the sensitivity of sterility test using BACTEC™ automated system up to 100% and, consequently, allowed validation of the method for sterility testing of corneal storage and deswelling/transport media according to the EP requirements. The test could not be validated without the use of RESEP.
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3413
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Yamanari M, Uematsu S, Ishihara K, Ikuno Y. Parallel detection of Jones-matrix elements in polarization-sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2019; 10:2318-2336. [PMID: 31149375 PMCID: PMC6524579 DOI: 10.1364/boe.10.002318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/16/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
The polarization properties of a sample can be characterized using a Jones matrix. To measure the Jones matrix without assumptions of the sample, two different incident states of polarization are usually used. This requirement often causes certain drawbacks in polarization-sensitive optical coherence tomography (PS-OCT), e.g., a decrease in the effective A-scan rate or axial depth range, if a multiplexing scheme is used. Because both the A-scan rate and axial depth range are important for clinical applications, including the imaging of an anterior eye segment, a new PS-OCT method that does not have these drawbacks is desired. Here, we present a parallel-detection approach that maintains the same A-scan rate and axial measurement range as conventional OCT. The interferometer consists of fiber-optic components, most of which are polarization-maintaining components with fast-axis blocking free from polarization management. When a parallel detection is implemented using swept-source OCT (SS-OCT), synchronization between the A-scans and synchronization between the detection channels have critical effects on the Jones-matrix measurement. Because it is difficult to achieve perfect synchronization using only hardware, we developed a solution using a numerical correction with signals from a static mirror. Using the developed system, we demonstrate the imaging of an anterior eye segment from the cornea to the back surface of the crystalline lens.
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Affiliation(s)
- Masahiro Yamanari
- Engineering Department, Tomey Corporation, 2-11-33 Noritakeshinmachi, Nishiku, Nagoya, Aichi, 451-0051, Japan
| | - Sato Uematsu
- Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kenji Ishihara
- Engineering Department, Tomey Corporation, 2-11-33 Noritakeshinmachi, Nishiku, Nagoya, Aichi, 451-0051, Japan
| | - Yasushi Ikuno
- Ikuno Eye Center, 2-9-10 3F Juso-Higashi, Yodogawaku, Osaka, Osaka, 532-0023, Japan
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3414
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Thareja T, Kowalski RP, Jhanji V, Kamyar R, Dhaliwal DK. MRSA Keratitis and Conjunctivitis: What Does It Mean Practically? CURRENT OPHTHALMOLOGY REPORTS 2019. [DOI: 10.1007/s40135-019-00206-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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3415
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Keorochana N, Treesit I, Funarunart P. Characteristics and Clinical Outcomes of Hypertensive Anterior Uveitis. Ocul Immunol Inflamm 2019; 28:538-548. [PMID: 31020885 DOI: 10.1080/09273948.2019.1587471] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this article is to determine characteristics and outcome of hypertensive anterior uveitis and prevalence of the Herpesviridae family. Study: Retrospective cohort study. METHODS A total of 64 anterior uveitis participants with increased intraocular pressure and Herpesviridae family polymerase chain reaction (PCR) analysis results were included. RESULTS The prevalence of Herpes family was 53.1% (6.3% for herpes simplex virus, 10.9% for varicella-zoster virus, 34.4% for cytomegalovirus, and 1.6% for Epstein-Barr virus), Posner-Schlossman syndrome 25%, Fuchs uveitis syndrome 7.8%, and idiopathic 14.1%. The recurrence rate was 70.3%. Age in PCR-proven infection group (52.7 ± 15.3) was older than the PCR-negative group (44.4 ± 12.5) (p = 0.021). Glaucoma in PCR-proven infection group (44.1%) was more than in PCR-negative group (16.7%) (p = 0.018). Corneal endothelial cell count in PCR-proven infection group (1879.3 ± 952.3) was lower than in PCR-negative group (2532.9 ± 540.4) (p = 0.004). CONCLUSION Viral infection was found in one half of hypertensive anterior uveitis. The complications of PCR-proven infectious case were more severe than PCR-negative case.
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Affiliation(s)
- Narumon Keorochana
- Ocular inflammatory and Uveitis division, Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao college of Medicine , Bangkok, Thailand
| | - Isaraporn Treesit
- Glaucoma division, Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao college of Medicine , Bangkok, Thailand
| | - Panrapee Funarunart
- Glaucoma division, Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao college of Medicine , Bangkok, Thailand
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3416
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Mieno H, Ueta M, Yamada K, Yamanaka Y, Nakayama T, Watanabe A, Kinoshita S, Sotozono C. Expression of prostaglandin E2 receptor 3 in the eyelid epidermis of patients with Stevens-Johnson syndrome/toxic epidermal necrolysis. Br J Ophthalmol 2019; 104:1022-1027. [DOI: 10.1136/bjophthalmol-2018-313587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/27/2019] [Accepted: 04/03/2019] [Indexed: 11/03/2022]
Abstract
Background/aimsIn a previous genome-wide association study of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) patients we reported the association between SJS/TEN and the prostaglandin E receptor 3 (PTGER3) gene, and that its protein PGE2 receptor 3 (EP3) was markedly downregulated in the conjunctival epithelium of SJS/TEN patients. Here we examined EP3 expression of the eyelid epidermis in SJS/TEN patients with severe ocular complications and investigated the function of EP3.MethodsFor the immunohistochemical study, we obtained eyelid samples from five SJS/TEN patients and five patients without SJS/TEN (control subjects) who were undergoing surgery to treat trichiasis, and investigated the expression of EP3 protein in the epidermis of those samples. To investigate the EP3 function in the human epidermal keratinocytes, we performed ELISA and quantitative reverse transcription polymerase chain reaction, since it is reported that PGE2 suppresses cytokine production via EP3 in human conjunctival epithelium.ResultsThe results of the immunohistochemical study revealed that EP3 expression in the eyelid epidermis of the SJS/TEN patients was the same as that in the controls. PGE2 and a selective EP3 agonist suppressed cytokine production and expression induced by polyinosine-polycytidylic acid stimulation, such as chemokine ligand 5 and chemokine motif ligand 10.ConclusionOur findings revealed that in chronic-phase SJS/TEN, EP3 protein was expressed in the eyelid epidermis and was not downregulated, unlike in conjunctival epithelium, and that PGE2 could suppress cytokine production via EP3 in human epidermal keratinocytes. Thus, EP3 expression in the epidermis might contribute to a silencing of skin inflammation in chronic-phase SJS/TEN.
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3417
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Smith L, Jackson SE, Pardhan S, López-Sánchez GF, Hu L, Cao C, Vancampfort D, Koyanagi A, Stubbs B, Firth J, Yang L. Visual impairment and objectively measured physical activity and sedentary behaviour in US adolescents and adults: a cross-sectional study. BMJ Open 2019; 9:e027267. [PMID: 30987991 PMCID: PMC6500295 DOI: 10.1136/bmjopen-2018-027267] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To compare levels of physical activity and sedentary time in a representative sample of US adolescents and adults with and without visual impairment. DESIGN Cross-sectional analyses were carried out using data from the National Health and Nutrition Examination Survey. PARTICIPANTS The study population consisted of 6001 participants (adolescents n=1766, adults n=4235). The present analysis aggregated data from 2003 to 2004 and 2005-2006. MEASURES Objective physical activity and sedentary behaviour assessment was conducted over 7 days. Distance visual acuity was measured for each eye in all participants 12 years and older. Participants' vision was categorised as: normal vision, uncorrected refractive error, non-refractive visual impairment. We estimated the sex-specific linear associations between presenting vision and objectively measured physical activity and sedentary patterns using adjusted generalised linear models in adolescents and adults. RESULTS AND CONCLUSIONS Adolescents with uncorrected refractive error and non-refractive visual impairment did not accumulate higher levels of sedentary time or lower levels of moderate-to-vigorous physical activity (MVPA) compared with those with normal vision. We observed no association between vision status and accelerometer measured MVPA in adults aged 20-49 years. We observed more time spent sedentary among females 20-49 years old with non-refractive visual impairment compared with those presenting normal vision (mean difference 329.8 min/week, 95% CI: 12.5 to 647.0). Adults 50 years and older with non-refractive visual impairment appeared to accumulate less lifestyle physical activity, particularly in women (mean difference -82.8 min/week, 95% CI: -147.8 to -17.8). Adult women with non-refractive visual impairment have lower levels of lifestyle physical activity and higher levels of sedentary time than those with normal vision. Taken together, these findings highlight the need for interventions to promote physical activity and reduce sedentary time in adult populations with visual impairment, specifically adult women.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Sarah E Jackson
- Deaprtment of Behavioural Science and Health, University College London, London, UK
| | - Shahina Pardhan
- Vision and Eye Research Unit (VERU), School of Medicine, Anglia Ruskin University, Chelmsford, Essex, UK
| | | | - Liang Hu
- Physical Education, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chao Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, USA
- Centre for Public Health Systems Science, Brown School Washington University, St Louis, USA
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, University of Leuven, Leuven, Belgium
- University Psychiatric Centre, KU Leuven, University of Leuven, Leuven, Belgium
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
| | - Joseph Firth
- NICM Health Research Institute, University of Western Sydney, Sydney, Australia
| | - Lin Yang
- Department of Epidemiology, Medical University of Vienna, Austria, Vienna, Austria
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3418
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Evidence for altered neurodevelopment and neurodegeneration in Wolfram syndrome using longitudinal morphometry. Sci Rep 2019; 9:6010. [PMID: 30979932 PMCID: PMC6461605 DOI: 10.1038/s41598-019-42447-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
Wolfram syndrome is a rare disease caused by mutations in the WFS1 gene leading to symptoms in early to mid-childhood. Brain structural abnormalities are present even in young children, but it is not known when these abnormalities arise. Such information is critical in determining optimal outcome measures for clinical trials and in understanding the aberrant neurobiological processes in Wolfram syndrome. Using voxel-wise and regional longitudinal analyses, we compared brain volumes in Wolfram patients (n = 29; ages 5–25 at baseline; mean follow-up = 3.6 years), to age and sex-equivalent controls (n = 52; ages 6–26 at baseline; mean follow-up = 2.0 years). Between groups, white and gray matter volumes were affected differentially during development. Controls had uniformly increasing volume in white matter, whereas the Wolfram group had stable (optic radiations) or decreasing (brainstem, ventral pons) white matter volumes. In gray matter, controls had stable (thalamus, cerebellar cortex) or decreasing volumes (cortex), whereas the Wolfram group had decreased volume in thalamus and cerebellar cortex. These patterns suggest that there may be early, stalled white matter development in Wolfram syndrome, with additional degenerative processes in both white and gray matter. Ideally, animal models could be used to identify the underlying mechanisms and develop specific interventions.
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3419
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Ustaoglu M, Onder F, Karapapak M, Taslidere H, Guven D. Ophthalmic, systemic, and genetic characteristics of patients with Wolfram syndrome. Eur J Ophthalmol 2019; 30:1099-1105. [DOI: 10.1177/1120672119842489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To evaluate the ophthalmic, systemic, and genetic characteristics of patients with Wolfram syndrome. Methods: In total, 13 patients with suspected or clinically diagnosed Wolfram syndrome underwent ophthalmic and systemic examinations and genetic analyses for Wolfram syndrome between August and October 2018. Results: The mean age of the subjects was 24.2 ± 7.1 years, of which 5 (38.5%) subjects were male and 8 (61.5%) were female. The mean best-corrected visual acuity ranged from counting fingers to 20/40, with a mean of 20/250 (1.10 ± 0.69 logarithm of the minimum angle of resolution). Dyschromatopsia was present in all patients (100%). There was a severe decrease in the average peripapillary retinal nerve fiber layer and macular ganglion cell–inner plexiform layer thicknesses (54.7 ± 6.5 and 51.9 ± 4.8 µm, respectively). Optical coherence tomography angiography showed significantly lower whole-image, inside disk, and peripapillary vessel densities in the patients with Wolfram syndrome than in the healthy controls (p < 0.001 for all). All patients who underwent genetic analyses had mutations in the WFS1 gene. Moreover, two novel mutations, p.Met623Trpfs*2 (c.1867delA) and p.Arg611Profs*9 (c.1832_11847del16) at exon 8, were detected. The frequency of systemic findings was as follows: optic atrophy (100%), diabetes mellitus (92.3%), central diabetes insipidus (38.5%), sensorineural hearing loss (38.5%), and presence of urological (30.8%), psychiatric (30.8%), and neurological (23.1%) diseases. Conclusion: Wolfram syndrome is a rare genetic disorder that can be associated with severe ophthalmic and systemic abnormalities. All patients who present with unexplained optic atrophy should be evaluated for Wolfram syndrome, even if they do not have diabetes mellitus because optic atrophy can sometimes manifest before diabetes mellitus.
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Affiliation(s)
- Melih Ustaoglu
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Feyza Onder
- Department of Ophthalmology, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Murat Karapapak
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hasan Taslidere
- Department of Medical Genetics, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Dilek Guven
- Department of Ophthalmology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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3420
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Singh S, Anderson AJ, Downie LE. Insights into Australian optometrists’ knowledge and attitude towards prescribing blue light‐blocking ophthalmic devices. Ophthalmic Physiol Opt 2019; 39:194-204. [DOI: 10.1111/opo.12615] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Sumeer Singh
- Department of Optometry and Vision Sciences The University of Melbourne Parkville Australia
| | - Andrew J Anderson
- Department of Optometry and Vision Sciences The University of Melbourne Parkville Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences The University of Melbourne Parkville Australia
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3421
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Alabi RO, Ansin A, Clover J, Wilkins J, Rao NK, Terry MA, Tran KD, Sales CS. Novel Use of Telemedicine for Corneal Tissue Evaluation in Eye Banking: Establishing a Standardized Approach for the Remote Evaluation of Donor Corneas for Transplantation. Cornea 2019; 38:509-514. [PMID: 30614904 PMCID: PMC6403003 DOI: 10.1097/ico.0000000000001848] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the feasibility of using telemedicine consultations in the evaluation of recovered donor corneas for transplant suitability. METHODS This study aims to establish and test the minimum imaging requirements for telemedical consultations of corneal tissue by remote eye bank medical directors. Digital images from the slit lamp, optical coherence tomography, and/or specular microscope were assembled into telemedical consults and emailed to 4 eye bank medical directors (M.A.T., J.W., C.S.S., N.K.R.). Feedback on the minimum image requirements for each corneal finding was collected. After establishing a standardized imaging and presentation protocol, test cases were presented to the medical directors to examine the validity of these remote consults. To establish a benchmark for the study's parameters, one medical director (J.W.) examined each case in person after his initial remote review. Examiners were masked to each other's responses. RESULTS Minimum image requirements for determination of corneal findings were defined and were specific to each anatomic layer of the cornea (epithelial, stromal, or endothelial). Using a defined set of digital images for a set of common corneal findings, the rate of agreement between remote evaluators, eye bank staff, and the in-person evaluator was 100% (11 of 11 examples). For ambiguous test cases, remote evaluators agreed on 80% of the cases (4 of 5). CONCLUSIONS Results from this pilot study suggest that telemedical review of corneal tissue using high-quality digital images may be adequate for accurate identification of specific corneal findings commonly encountered by eye banks.
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Affiliation(s)
- Rolake O. Alabi
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY
| | - Amy Ansin
- Vision Research Laboratory, Lions VisionGift, Portland, OR
| | - Jameson Clover
- Vision Research Laboratory, Lions VisionGift, Portland, OR
| | | | | | - Mark A. Terry
- Vision Research Laboratory, Lions VisionGift, Portland, OR
- Devers Eye Institute, Portland, OR
| | - Khoa D. Tran
- Vision Research Laboratory, Lions VisionGift, Portland, OR
| | - Christopher S. Sales
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY
- Vision Research Laboratory, Lions VisionGift, Portland, OR
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3422
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Hasan SM, Hammer M, Meller D. Correlation of the Retinal Parapapillary Perfusion and the Retinal Vessel Oxygen Saturation in Glaucoma Patients. ACTA ACUST UNITED AC 2019; 60:1309-1315. [DOI: 10.1167/iovs.18-26099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Somar M. Hasan
- Department of Ophthalmology, Jena University Hospital, Jena, Germany
| | - Martin Hammer
- Department of Ophthalmology, Jena University Hospital, Jena, Germany
| | - Daniel Meller
- Department of Ophthalmology, Jena University Hospital, Jena, Germany
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3423
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Preclinical studies evaluating the effect of semifluorinated alkanes on ocular surface and tear fluid dynamics. Ocul Surf 2019; 17:241-249. [DOI: 10.1016/j.jtos.2019.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/23/2019] [Accepted: 02/25/2019] [Indexed: 12/22/2022]
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3424
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Commensal microflora in human conjunctiva; characteristics of microflora in the patients with chronic ocular graft-versus-host disease. Ocul Surf 2019; 17:265-271. [DOI: 10.1016/j.jtos.2019.02.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 11/19/2022]
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3425
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Simpson MJ. Simulated images of intraocular lens negative dysphotopsia and visual phenomena. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:B44-B51. [PMID: 31044954 DOI: 10.1364/josaa.36.000b44] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/20/2019] [Indexed: 06/09/2023]
Abstract
Simulated images were generated using an extended source to illustrate peripheral dark shadows in pseudophakic eye models. The shadows are a consequence of the intraocular lens being much smaller than the natural crystalline lens, which limits the extent of the focused image. Compensation is made for the cosine intensity falloff due to pupil obliquity, and the images are envisaged as being displayed on polar plots of visual angle corresponding to approximate retinal locations. Additional retinal illumination from light missing the lens reduces the shadow effect as the pupil diameter increases, in agreement with clinical observations. Lenses with two different cross-sectional profiles were evaluated, which both have shadows at about 85°, but with different characteristics. The iris thickness was found to affect the shadows by occluding peripheral rays. Images were also generated for a point source with a 5 mm pupil, where a double image is created for visual angles as low as 50°, which may contribute to visual phenomena at night. This type of modeling may help with patient evaluations and discussions.
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3426
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Efficacy and Safety of Wet Wipes Containing Hy-Ter ® Solution Compared with Standard Care for Bilateral Posterior Blepharitis: A Preliminary Randomized Controlled Study. Ophthalmol Ther 2019; 8:313-321. [PMID: 30929188 PMCID: PMC6513930 DOI: 10.1007/s40123-019-0182-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION A novel treatment for posterior blepharitis which involves the use of disposable wet wipes imbibed with a solution of terpinen-4-ol and hyaluronic acid (Hy-Ter®) as well as aloe, natural anti-inflammatories and antiseptics (Blephapad Combo; Novelty Technology Care, Milan, Italy) has been proposed. The aim of this study was to compare the efficacy and safety of treatment with Blephapad Combo with standard treatment. METHODS We conducted 4-week, open-label, randomized controlled study with a closed sequential design at the Magna Graecia University of Catanzaro, Italy in which patients aged > 40 years with symmetrical bilateral posterior blepharitis were enrolled. Each eye represented a single experimental unit. Patients were randomly assigned using a computer-generated randomization list to apply a reusable heated compress to the eyelid of one eye before cleansing the eyelid with the Blephapad Combo wet wipe (Blephapad Combo treatment arm) or to use the standard treatment of applying a wet and warm gauze to the other eye (standard treatment arm), twice daily for 4 weeks. The primary endpoint was the percentage change from baseline to week 4 in meibomian gland dysfunction (MGD) grading scale scores. RESULTS Eighteen patients (9 men; 9 women) with a mean (± standard deviation) age of 66.9 ± 9.03 years were included in the study. Compared with the eye receiving the standard treatment, treatment with Blephapad Combo appeared to improve the MGD total score after 4 weeks of treatment (mean change from baseline - 29.9 vs. - 38.5%). The assessment of the investigators was that in 11 patients the eye treated with Blephapad Combo showed greater benefit, in two patients the eye treated with the standard treatment showed greater benefit and in four patients there was no difference between treatments. Blephapad Combo was well tolerated, with no serious adverse events (AEs) reported. Minor ocular AEs were reported in 44.4 and 38.9% of patients in the Blephard Combo and standard treatment arms, respectively. CONCLUSIONS Treatment with Blephapad Combo was more effective than the standard treatment in ameliorating MGD in patients with posterior blepharitis. Minor ocular AEs events were equally distributed between the two treatments arms. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03301844.
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3427
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Zhang L, Chen B. Correlation between MTHFR polymorphisms and glaucoma: A meta-analysis. Mol Genet Genomic Med 2019; 7:e00538. [PMID: 30851082 PMCID: PMC6465672 DOI: 10.1002/mgg3.538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/05/2018] [Accepted: 12/02/2018] [Indexed: 12/23/2022] Open
Abstract
Background Whether methylenetetrahydrofolate reductase (MTHFR) polymorphisms are implicated in glaucoma remains controversial. Therefore, we performed this study to better assess the relationship between MTHFR polymorphisms and the likelihood of glaucoma. Methods A systematic research of PubMed, Medline, and Embase was performed to retrieve relevant articles. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results A total of 18 studies with 7,168 participants were analyzed. In overall analyses, a significant association with the likelihood of glaucoma was detected for the rs1801133 polymorphism in dominant (p = 0.04, OR = 0.90, 95%CI 0.81–1.00) and allele (p = 0.02, OR = 0.91, 95%CI 0.84–0.98) comparisons. Further, subgroup analyses by ethnicity revealed that both rs1801131 and rs1801133 polymorphisms were significantly associated with the likelihood of glaucoma in West Asians. However, no positive results were detected for two investigated polymorphisms in East Asians and Caucasians. Conclusion Our findings indicated that rs1801131 and rs1801133 polymorphisms may serve as genetic biomarkers of glaucoma in West Asians.
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Affiliation(s)
- Ling Zhang
- Department of Ophthalmology, People's Hospital of Leshan, Leshan, China
| | - Bin Chen
- Department of Ophthalmology, People's Hospital of Leshan, Leshan, China
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3428
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Prokopiou E, Kolovos P, Kalogerou M, Neokleous A, Nicolaou O, Sokratous K, Kyriacou K, Georgiou T. Omega-3 Fatty Acids Supplementation: Therapeutic Potential in a Mouse Model of Stargardt Disease. Invest Ophthalmol Vis Sci 2019; 59:2757-2767. [PMID: 29860462 DOI: 10.1167/iovs.17-23523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the therapeutic effects of omega-3 (ω3) fatty acids on retinal degeneration in the ABCA4-/- model of Stargardt disease when the blood level of arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratio is between 1 and 1.5. Methods Eight-month-old mice were allocated to three groups: wild type (129S1), ABCA4-/- untreated, and ABCA4-/- ω3 treated. ω3 treatment lasted 3 months and comprised daily gavage administration of EPA and docosahexaenoic acid (DHA). Blood and retinal fatty acid analysis was performed using gas chromatography to adjust the blood AA/EPA ∼1 to 1.5. Eyecups were histologically examined using transmission electron microscopy and confocal microscopy to evaluate lipofuscin granules and the photoreceptor layer. Retinal N-retinylidene-N-retinylethanolamine (A2E), a major component of retinal pigment epithelium lipofuscin, was quantified using liquid chromatography and tandem mass spectrometry, in addition to retinal proteomic analysis to determine changes in inflammatory proteins. Results EPA levels increased and AA levels decreased in the blood and retinas of the treatment group. Significantly less A2E and lipofuscin granules were observed in the treatment group. The thickness of the outer nuclear layer was significantly greater in the treatment group (75.66 ± 4.80 μm) than in the wild-type (61.40 ± 1.84 μm) or untreated ABCA4-/- (56.50 ± 3.24 μm) groups. Proteomic analysis indicated lower levels of complement component 3 (C3) in the treatment group, indicative of lower complement-induced inflammatory response. Conclusions Three months of ω3 supplementation (AA/EPA ∼1-1.5) reduces A2E levels, lipofuscin granules, and C3 levels in the ABCA4-/- mouse model of Stargardt disease, consistent with slowing of the disease.
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Affiliation(s)
| | | | - Maria Kalogerou
- Ophthalmos Research and Educational Institute, Nicosia, Cyprus
| | | | - Orthodoxia Nicolaou
- Department of Electron Microscopy and Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Kleitos Sokratous
- Department of Electron Microscopy and Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus.,Bioinformatics Group, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Kyriacos Kyriacou
- Department of Electron Microscopy and Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Tassos Georgiou
- Ophthalmos Research and Educational Institute, Nicosia, Cyprus
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3429
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Ciocco L, Hassan S, Woreta F, Srikumaran D. Epithelial ingrowth through venting incision into laser-assisted in situ keratomileusis flap interface after descemet stripping automated endothelial keratoplasty. Am J Ophthalmol Case Rep 2019; 13:25-27. [PMID: 30519669 PMCID: PMC6260390 DOI: 10.1016/j.ajoc.2018.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/02/2018] [Accepted: 11/12/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To present a case of epithelial ingrowth into the laser-assisted in situ keratomileusis (LASIK) flap interface after a patient underwent descemet stripping automated endothelial keratoplasty (DSAEK) surgery with venting incisions. OBSERVATIONS We present a case of a 48-year-old man with previous history of LASIK that underwent DSAEK for pseudophakic bullous keratopathy after complicated cataract surgery requiring an intraocular lens (IOL) exchange. The patient developed epithelial ingrowth into the LASIK flap interface from one of the venting incisions. The epithelial ingrowth was observed as it was a small peripheral area that did not affect his visual acuity. CONCLUSIONS AND IMPORTANCE Epithelial ingrowth is a well-described complication following LASIK but has rarely been described to occur after endothelial keratoplasty (EK). Even rarer, are reports of epithelial ingrowth after EK cases that have been found to result from venting incisions. To the authors' knowledge, this is the first case of the ingrowth into a LASIK flap interface occurring after EK through a venting incision. Although it may be an uncommon occurrence in which a patient with a history of LASIK requires EK, surgeons should take extra precautions to avoid this complication.
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Affiliation(s)
- Lindsay Ciocco
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Shahzeb Hassan
- Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Fasika Woreta
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, 21287, USA
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3430
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Gräfe MGO, Gondre M, de Boer JF. Precision analysis and optimization in phase decorrelation OCT velocimetry. BIOMEDICAL OPTICS EXPRESS 2019; 10:1297-1314. [PMID: 30891347 PMCID: PMC6420279 DOI: 10.1364/boe.10.001297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/11/2019] [Accepted: 02/12/2019] [Indexed: 05/13/2023]
Abstract
Quantitative flow velocimetry in Optical Coherence Tomography is used to determine both the axial and lateral flow component at the level of individual voxels. The lateral flow is determined by analyzing the statistical properties of reflected electro-magnetic fields for repeated measurements at (nearly) the same location. The precision or statistical fluctuation of the quantitative velocity estimation depends on the number of repeated measurements and the method to determine quantitative flow velocity. In this paper, both a method to determine quantitative flow velocity and a model for the prediction of the statistical fluctuations of velocity estimations are developed to analyze and optimize the estimation precision for phase-based velocimetry methods. The method and model are validated by phantom measurements in a bulk scattering medium as well as in intralipid solution in a capillary. Based on the model, the number of repeated measurements to achieve a certain velocimetry precision is predicted.
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Affiliation(s)
- Maximilian G. O. Gräfe
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands
| | - Maude Gondre
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands
- Université de Genève, GAP-Biophotonics, Chemin de Pinchat 22, CH-1211 Geneva 4, Switzerland
| | - Johannes F. de Boer
- LaserLaB, Department of Physics and Astronomy, Vrije Universiteit Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands
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3431
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Mun Y, Kim MK, Oh JY. Ten-year analysis of microbiological profile and antibiotic sensitivity for bacterial keratitis in Korea. PLoS One 2019; 14:e0213103. [PMID: 30822325 PMCID: PMC6396910 DOI: 10.1371/journal.pone.0213103] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 02/14/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the risk factors, microbiological profiles, antibiotic susceptibility patterns, and treatment outcome in patients with bacterial keratitis at a Korean tertiary hospital. Methods A retrospective chart review was performed of patients who were diagnosed with infectious keratitis and underwent corneal scrapings for cultures at Seoul National University Hospital between 2007 and 2016. Demographics, clinical characteristics, microbiological data, antibiotic resistance and sensitivity, and treatment outcome were collected. Results Out of 129 scrapings, bacteria were isolated in 101 samples (78.3%). The most frequent isolates were coagulase-negative Staphylococci (CNS) (15.9%), Staphylococcus aureus (12.1%) and Pseudomonas aeruginosa (10.3%). All gram-positive isolates were sensitive to vancomycin, but methicillin resistance was found in 29.4% of CNS and 15.4% of Staphylococcus aureus. All gram-negative isolates were susceptible to ceftazidime and carbapenem while 11.5%, 3.3% and 2.8% of gram-negative isolates were resistant to gentamicin, tobramycin and amikacin, respectively. Ciprofloxacin resistance was observed in 10.3% of gram-positive isolates and 8.8% of gram-negative isolates. No significant changes were observed in profiles of microbial isolates and antibiotic sensitivity over time. Eight eyes of 101 eyes (7.9%) eventually underwent evisceration for infection control. The use of topical glaucoma medication (p = 0.006) and history of ocular surgery (p = 0.019) were significant risk factors related to evisceration. Conclusions CNS, Staphylococcus aureus and Pseudomonas aeruginosa were the most common microorganisms responsible for bacterial keratitis. The duo-therapy using vancomycin and ceftazidime should be considered for empirical treatment until the culture and sensitivity results become available.
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Affiliation(s)
- Yongseok Mun
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Joo Youn Oh
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- * E-mail: ,
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3433
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Hanumunthadu D, Tan ACS, Singh SR, Sahu NK, Chhablani J. Management of chronic central serous chorioretinopathy. Indian J Ophthalmol 2019; 66:1704-1714. [PMID: 30451170 PMCID: PMC6256894 DOI: 10.4103/ijo.ijo_1077_18] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
New treatment modalities for the management of central serous chorioretinopathy (CSC) now exist. While acute CSC generally resolves without the requirement for intervention, chronic CSC has been associated with persistent disruption in visual function. Current treatment approaches include photodynamic therapy, oral aldosterone antagonism and subthreshold multifocal laser. There has also been further investigation into a number of new treatments including antivascular endothelial growth factor treatment. Further investigation using developing optical coherence tomography imaging is helping to determine biomarkers of CSC activity, potential indicators of treatment response and indications of chronicity of disease activity. Further comparative study is required to determine the effectiveness of different forms of treatment in a range of patients with varied demographics, aetiology and chronicity of disease.
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Affiliation(s)
- Daren Hanumunthadu
- Moorfields Eye Hospital National Health Service Foundation Trust, London, UK
| | - Anna C S Tan
- Singapore National Eye Centre; Department of Medical Retina, Singapore Eye Research Institute; Department of Medical Retina, Duke-NUS Medical School, Singapore
| | - Sumit Randhir Singh
- Smt. Kanuri Santhamma Retina Vitreous Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Niroj Kumar Sahu
- Smt. Kanuri Santhamma Retina Vitreous Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Jay Chhablani
- Smt. Kanuri Santhamma Retina Vitreous Centre, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Double-Line Reflection Pattern as a Simple Method to Determine Graft Orientation of Descemet Membrane Endothelial Keratoplasty. Cornea 2019; 38:768-771. [DOI: 10.1097/ico.0000000000001889] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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3435
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Miguel AIM, Silva AB, Azevedo LF. Diagnostic performance of optical coherence tomography angiography in glaucoma: a systematic review and meta-analysis. Br J Ophthalmol 2019; 103:1677-1684. [PMID: 30728123 DOI: 10.1136/bjophthalmol-2018-313461] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/10/2018] [Accepted: 12/31/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Compared with current imaging methods, the diagnostic performance and the advantages and limitations of optical coherence tomography angiography (OCTA) remain unclear. We performed a systematic review and meta-analysis of studies investigating vessel density (VD) in patients with glaucoma using OCTA. METHODS We conducted a literature search on PubMed, Scopus, Web of Science, ISI Conference Proceedings and Google Scholar, along with a manual search, from January 2006 to March 2018. We included prospective studies that used OCTA to compare the VD in glaucomatous eyes with healthy control eyes. RESULTS Of 3045 screened articles, 24 were included in a broad characterisation and 18 in the meta-analysis. We observed a statistically significant reduction in the mean peripapillary VD (MPVD) in glaucoma (MPVD: 57.53%, 95% CI 52.60 to 62.46, p< 0.001) compared with controls (MPVD: 65.47%, 95% CI 59.82 to 71.11; standardised mean difference [SMD], -1.41, 95% CI -1.62 to -1.20, p< 0.001) for 888 glaucomatous and 475 healthy eyes, and also in the mean-whole optic nerve image VD (SMD, -9.63, 95% CI -10.22 to -9.03, p<0.001), mean inside-disc VD (SMD, - 9.51, 95% CI -12.66 to -6.36, p<0.05) and mean parafoveal VD (SMD, -3.92, 95% CI -4.73 to -3.12, p<0.001). Subgroup analyses revealed a significant difference in the MPVD across glaucoma subtypes and OCTA devices. CONCLUSION This suggests the diagnostic utility of OCTA in detecting glaucomatous eyes; however, further longitudinal prospective studies are welcomed to characterise vascular changes in glaucoma.
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Affiliation(s)
- Ana I M Miguel
- Department of Community Medicine, Center for Health Technology and Services Research (CINTESIS), Information and Health Decision Sciences (MEDCIDS), University of Porto, Oporto, Portugal .,Department of Ophthalmology, Polyclinique de la Baie, Avranches, France
| | - André B Silva
- Department of Ophthalmology, Hospital São Teotónio, Viseu, Portugal
| | - Luis F Azevedo
- Department of Community Medicine, Center for Health Technology and Services Research (CINTESIS), Information and Health Decision Sciences (MEDCIDS), University of Porto, Oporto, Portugal
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3436
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Savastano MC, Savastano A, Rizzo S. Pharmacological Adjuncts to Vitrectomy Surgery. Curr Pharm Des 2019; 24:4843-4852. [PMID: 30706802 DOI: 10.2174/1381612825666190130125136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/24/2019] [Indexed: 11/22/2022]
Abstract
Pharmacological adjuncts to vitrectomy surgery are useful tools to better deal with surgery. Their introduction has enriched the therapeutic choice before, during and after operations. Although several classifications could be made to frame adjuncts to vitrectomy, we preferred to divide the pharmacological adjuncts to vitrectomy surgery for therapeutic use in the pre-operatory procedure (neo-adjuvant), for intraoperative use and for post-operatory practice (adjuvant). This type of classification allowed us to explore all the adjuncts based on the timing of their use. The actual interest in vitrectomy surgery is giving rise to considerable interest in new molecules with and without the pharmacological effect that will soon be available for the aid of vitreoretinal surgery.
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Abstract
PURPOSE OF REVIEW It is well known that glaucoma patients are not adherent to their therapeutic regimens. The issue of nonadherence is multifactorial and includes inadequate communication between doctors and patients, resulting in significant costs associated with enhanced disease progression. Therapeutic regimens are risk factors which often influences adherence rates. Thus, alternative treatment modalities, especially those risk factors that do not rely on patients' cooperation, may enable improvements in long-term outcomes of glaucoma in patient. RECENT FINDINGS The studies selected for this review were divided into new medications, especially advancements in pharmaceutical approaches to treat glaucoma and new ways of delivering the medication, new surgical methods, especially minimally invasive surgery methods for glaucoma, and new studies about adherence in glaucoma. SUMMARY Surprisingly, a very few studies on glaucoma medication or surgery addressed the concept of adherence. However, adherence is discussed in studies which consider psychological aspects of patients or communication issues between doctors and patients. Although these studies were performed in clinical settings, the issue of adherence is not addressed; despite it has significant effect on long-term outpatient care. A combination of both aspects, adherence and miscommunication, should be considered in studies.
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3438
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Downie LE, Keller PR, Busija L, Lawrenson JG, Hull CC. Blue-light filtering spectacle lenses for visual performance, sleep, and macular health in adults. Hippokratia 2019. [DOI: 10.1002/14651858.cd013244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Laura E Downie
- The University of Melbourne; Department of Optometry and Vision Sciences; Level 4, Alice Hoy Building Melbourne Victoria Australia 3010
| | - Peter R Keller
- The University of Melbourne; Department of Optometry and Vision Sciences; Level 4, Alice Hoy Building Melbourne Victoria Australia 3010
| | - Ljoudmila Busija
- Monash University; Biostatistics Unit, Department of Epidemiology and Preventive Medicine; Melbourne Victoria Australia 3000
| | - John G Lawrenson
- City University of London; Centre for Applied Vision Research, School of Health Sciences; Northampton Square London UK EC1V 0HB
| | - Christopher C Hull
- City University of London; Centre for Applied Vision Research, School of Health Sciences; Northampton Square London UK EC1V 0HB
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3439
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Menzler J, Neubauer AS, Haritoglou C, Jackson TL. Incidence and prevalence of vitreomacular traction with and without macular hole in Germany. Clin Ophthalmol 2019; 13:177-188. [PMID: 30697035 PMCID: PMC6339449 DOI: 10.2147/opth.s188704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Symptomatic vitreomacular adhesion (sVMA) comprises vitreomacular traction (VMT) and stage 1 and 2 full-thickness macular holes (MHs) associated with vitreomacular adhesion (VMA). We aimed to estimate the incidence and prevalence of sVMA in Germany. MATERIALS AND METHODS A systematic literature review was conducted to identify the incidence and prevalence of sVMA based on international epidemiologic studies, weighted for study size and then averaged across eligible studies. A second systematic review aimed to estimate the proportion of vitrectomy undertaken for sVMA in Germany. This was combined with the reported number of vitrectomies in Germany in 2016 to estimate the number of patients undergoing vitrectomy for sVMA. RESULTS The prevalence of sVMA is 1,365 per 100,000 population, with an incidence of 6.96 per 100,000 per year. For Germany, this translates to 1,119,300 cases, with 5,700 new cases reported annually. Analyzing the national hospital statistics, ~2,300 patients undergo vitrectomy due to sVMA in Germany each year, of which about 1,700 patients have VMT. CONCLUSION Incidence figures, driven by patients presenting to clinic, are much lower than expected based on population-based studies, suggesting that many patients with sVMA exist outside of the clinic system.
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Affiliation(s)
- Jacob Menzler
- Institute for Health- and Pharmacoeconomics/Neubauer Consult, Munich, Germany,
| | - Aljoscha Steffen Neubauer
- Institute for Health- and Pharmacoeconomics/Neubauer Consult, Munich, Germany,
- Private practice, Munich, Germany
| | | | - Timothy L Jackson
- Department of Ophthalmology, Faculty of Life Course Sciences and Medicine, King's College London, London, UK
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3440
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Kulkarni S, Deshpande M. Recent advances in retinal imaging and diagnostics. COMMUNITY EYE HEALTH 2019; 32:S9-S10. [PMID: 32123485 PMCID: PMC7041830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Sucheta Kulkarni
- Director: Clinical services and Head- Retina and ROP services, H. V. Desai Eye Hospital, Pune, India
| | - Madan Deshpande
- Chief Medical Director: H. V. Desai Eye Hospital, Pune, India
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3441
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Esmaeilzadeh H, Farjadian S, Alyasin S, Nemati H, Nabavizadeh H, Esmaeilzadeh E. Epidemiology of Severe Cutaneous Adverse Drug Reaction and Its HLA Association among Pediatrics. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2019; 18:506-522. [PMID: 31089385 PMCID: PMC6487414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Severe cutaneous adverse drug reaction (SCAR) is considered to be a multifactorial drug side effect. This study was designed to investigate the epidemiology and human leukocyte antigen (HLA)-A and -B gene polymorphisms in pediatric patients with SCAR admitted in tertiary referral center, southwestern of Iran from 2013 to 2017. Demographic data, past allergy and autoimmune history, clinical presentations, drugs confirmed to be the cause of SCAR as well as its therapy were reviewed for each patient. HLA-A and -B allele frequencies were determined in 40 of the patients using polymerase chain reaction based on sequence specific primers (PCR-SSP) and compared with 40 healthy individuals as control group. Sixty-one patients with mean age of 6 years old and boy to girl ratio was 1.2/1 in this study. The most common type of SCAR in our patients was Steven Johnson Syndrome (SJS)/Toxic Epidermal Necrosis (TEN) mainly caused by beta-lactam antibiotics. Carbamazepine was the second cause of drug-induced SCAR. Moreover, HLA-A*02:01 and A*51:01 were related to the increased risk of SCAR while A*11:01 seemed to be protective against SCAR. HLA-A*02:01, HLA-A*24:02, and HLA-B*51:01 showed associations to the increased risk of SJS. Based on our results, beta-lactam antibiotics and antiepileptic drugs are the most common causes of severe adverse drug reaction in southwestern Iranian pediatric patients. Moreover, some HLA-A alleles can influence risk of SCAR.
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Affiliation(s)
- Hossein Esmaeilzadeh
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ,Department of Allergy and Clinical Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shirin Farjadian
- Department of Immunology, Shiraz University of Medical Sciences, Shiraz, Iran. ,Corresponding author: E-mail:
| | - Soheila Alyasin
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ,Department of Allergy and Clinical Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hamid Nemati
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hesamodin Nabavizadeh
- Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ,Department of Allergy and Clinical Immunology, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Elmira Esmaeilzadeh
- Department of Internal Medicine, Division of Rheumatology, Shiraz University of Medical Sciences, Shiraz, Iran.
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Dartt DA, Hodges RR, Serhan CN. Immunoresolvent Resolvin D1 Maintains the Health of the Ocular Surface. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1161:13-25. [PMID: 31562618 PMCID: PMC6859005 DOI: 10.1007/978-3-030-21735-8_3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The present review focuses on the role of one of the D-series resolvins (Rv) RvD1 in the regulation of conjunctival goblet cell secretion and its role in ocular surface health. RvD1 is the most thoroughly studied of the specialized proresolution mediators in the goblet cells. The anterior surface of the eye consists of the cornea (the transparent central area) and the conjunctiva (opaque tissue that surrounds the cornea and lines the eyelids). The secretory mucin MUC5AC produced by the conjunctival goblet cells is protective of the ocular surface and especially helps to maintain clear vision through the cornea. In health, a complex neural reflex stimulates goblet cell secretion to maintain an optimum amount of mucin in the tear film. The specialized pro-resolution mediator, D-series resolvin (RvD1) is present in human tears and induces goblet cell mucin secretion. RvD1 interacts with its receptors ALX/FPR2 and GPR32, activates phospholipases C, D, and A2, as well as the EGFR. This stimulation increases the intracellular [Ca2+] and activates extracellular regulated kinase (ERK) 1/2 to cause mucin secretion into the tear film. This mucin secretion protects the ocular surface from the challenges in the external milieu thus maintaining a healthy interface between the eye and the environment. RvD1 forms a second important mechanism along with activation of a neural reflex pathway to regulate goblet cell mucin secretion and protect the ocular surface in health.
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Affiliation(s)
- Darlene A Dartt
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Boston, MA, USA.
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
| | - Robin R Hodges
- Schepens Eye Research Institute/Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Charles N Serhan
- Center for Experimental Therapeutics and Reperfusion Injury, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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3443
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Physical activity, body mass index, and health status among youth with severe visual impairments aged 13–17 years in the United States. Disabil Health J 2019; 12:24-28. [DOI: 10.1016/j.dhjo.2018.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/10/2018] [Accepted: 07/11/2018] [Indexed: 01/22/2023]
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3444
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McClelland JF, Bodle L, Little JA. Investigation of medication adherence and reasons for poor adherence in patients on long-term glaucoma treatment regimes. Patient Prefer Adherence 2019; 13:431-439. [PMID: 31496662 PMCID: PMC6697779 DOI: 10.2147/ppa.s176412] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 12/01/2018] [Indexed: 12/05/2022] Open
Abstract
PURPOSE Long-term treatment adherence for a chronic asymptomatic condition is a demanding task for many patients. Treating progressive glaucoma can also be confounding for physicians, particularly when management relies on assumption of adherence. This study investigated associations between self-reported adherence and frequency of medication changes due to glaucoma progression. METHODS A total of 128 participants with primary open angle glaucoma were recruited from glaucoma clinics in Flinders Eye Center, South Australia, and completed confidential questionnaires. Information was obtained regarding beliefs about glaucoma and their treatment. Adherence was assessed using the four-item Morisky, Green and Levine Medication Adherence Questionnaire (MGL). Medical records were analyzed for the number of medication changes, due to glaucoma progression. RESULTS Adherence to topical glaucoma medication was categorized as 'high' in 41.4% (Morisky, Green and Levine (MGL). Data were analyzed for behaviors affecting adherence, history of adherence, and reasons for changed adherence. Chi-squared test demonstrated that there was no significant association noted between adherence and changes in medication regime (χ2 (2,128)=0.968, P=0.915); however, a significantly lower adherence was detected if participants had difficulties with their drop regime (χ2 (2,128)=7.24, P=0.027) or had help with drop insertion (χ2 (1,128)=9.77, P=0.008). CONCLUSION This study revealed a higher rate of non-adherence than has previously been demonstrated in other studies. This may be attributed to the unique design of the confidential questionnaire and the independent and sympathetic questioning techniques used. Further work to develop a specific glaucoma medication adherence questionnaire would be valuable to enhance glaucoma management.
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Affiliation(s)
- Julie F McClelland
- Vision Science Research Group, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
- Correspondence: Julie F McClelland Vision Science Research Group, Biomedical Sciences Research Institute, Ulster University, Cromore Road, Coleraine, BT52 1SA, UKTel +44 0 287 012 4216Fax +44 0 287 012 4504 Email
| | - Lynne Bodle
- Vision Science Research Group, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Julie-Anne Little
- Vision Science Research Group, Biomedical Sciences Research Institute, Ulster University, Coleraine, UK
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Patil A, Bhavya, Chaudhury S, Srivastava S. Eyeing computer vision syndrome: Awareness, knowledge, and its impact on sleep quality among medical students. Ind Psychiatry J 2019; 28:68-74. [PMID: 31879450 PMCID: PMC6929228 DOI: 10.4103/ipj.ipj_93_18] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/22/2019] [Accepted: 07/11/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Computer vision syndrome (CVS) encompasses a constellation of ocular and extraocular symptoms in computer users who either habitually or compulsively use computers for long periods of time. Electronic devices such as computers, smart phones, and tablets emit blue light (400-490 nm) from their light-emitting diodes and produce electromagnetic fields, both of which interfere with the circadian rhythm. AIM This study aims to assess the awareness, knowledge, and impact on sleep quality of CVS among medical students. MATERIALS AND METHODS This study included 500 medical students. All participants anonymously filled up a pro forma including sociodemographic details and three questionnaires that (a) tested for awareness and knowledge about CVS, (b) tested for CVS, and (c) the Pittsburgh sleep quality index (PSQI), respectively. Data from 463 complete questionnaires were analyzed. RESULTS The mean (±standard deviation) age of the 463 individuals was 19.55 (±1.04) years. The prevalence of CVS was 77.5%. The prevalence was higher in boys (80.23%) compared to girls (75.87%), but the difference was not statistically significant. Only 34.1% of the medical students were aware of CVS. Good knowledge regarding various aspects of CVS was observed in 22.46% individuals, while 53.99% and 23.56% had average and poor knowledge, respectively. Poor sleep quality was present in 75.49% of individuals with CVS compared to 50.96% of students without CVS; the difference was statistically significant (odd's ratio [95% confidence interval]: 0.338 [0.214-0.531]). All the components of PSQI score, except components 1 and 6, had statistically significantly (P < 0.05) higher values in individuals with CVS as compared to individuals without CVS. CONCLUSIONS There is high prevalence but low level of awareness and knowledge about CVS among medical students. CVS is significantly associated with poor sleep quality in medical students.
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Affiliation(s)
- Ashwini Patil
- Department of Physiology, Dr. D.Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Bhavya
- Department of Physiology, Dr. D.Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D.Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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3447
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Rosen DB, Heiland MB, Tingey M, Liu HY, Kang P, Buckner B, Ronquillo YC, Hoopes PC, Moshirfar M. Intraocular Lens Calculation after Refractive Surgery: A Long-Term Retrospective Comparison of Eight Formulas. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2019; 8:121-128. [PMID: 31598512 PMCID: PMC6778468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to compare the accuracy of 8 IOL power calculation formulas for eyes post-refractive surgery. In this Retrospective study, a chart review and data analysis of post-corneal refractive surgery patients who subsequently underwent cataract surgery with IOL implantation in Tertiary surgical center, Draper, UT, USA. The surgery was done in a single surgical center in Draper, UT by one surgeon. The study was approved by the organization's ethics board. The IOL power formulas used were Barrett True K (BTK), Average Pupil Power (APP), Shammas, Haigis, Galilei, Potvin-Hill Pentacam (PVP), OCT and Barrett True K No History (BTKNH). The percent of time each formula was within ±0.5 D and ±0.75 D of refractive prediction error was calculated. Statistical analysis was performed comparing these 8 methodologies at four post-operative follow-up time points and on the summative time points. Mean follow-up time periods were: 4 weeks, 3 months, 6 months, and 12 months. A total of 64 eyes were included in the study. All IOL formulas showed a myopic trend except APP and Shammas, which showed a hyperopic trend. All tests showed a statistically significant mean absolute value difference from zero. OCT, BTKNH, and BTK had consistently high percentages within ±0.5D and ±0.75 D of refractive error. Linear mixed model analysis showed a statistically significant change in predictive value over time for all formulas. Linear mixed model analysis suggests that it is inadequate to evaluate the performance of IOL power formulae in the short term. Longer-term follow-up is needed to determine accuracy as several factors can result in refractive changes greater than 3 months postoperatively. Our analysis did not demonstrate any formula that was clearly superior to the other methods for predicting IOL power at any time point.
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Affiliation(s)
- David B. Rosen
- College of Medicine, University of Arizona, Phoenix, Phoenix, AZ, USA
| | | | - Mitchell Tingey
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA
| | - Harry Y. Liu
- McGovern Medical School, Health Science Center, University of Texas, Houston, TX, USA
| | - Paul Kang
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, USA
| | - Benjamin Buckner
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA
| | | | - Phillip C. Hoopes
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA
| | - Majid Moshirfar
- Hoopes Durrie Rivera Research Center, Hoopes Vision, Draper, UT, USA,John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, School of Medicine, University of Utah Salt Lake City, UT, USA,Utah Lions Eye Bank, Murray, UT, USA
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3448
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Vignola R, Giurgola L, Colabelli Gisoldi RAM, Gaudio M, D'Amato Tóthová J, Pocobelli A. Monitoring the microbial contamination of donor cornea during all preservation phases: A prospective study in the Eye Bank of Rome. Transpl Infect Dis 2018; 21:e13041. [PMID: 30582780 DOI: 10.1111/tid.13041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/16/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND In most European eye banks, human donor corneas are microbiologically tested after storage in organ culture conditions, and the tissues that are free of contamination are distributed for transplantation. In this prospective study, 100 donor corneas were tested for microbial contamination after cold storage, corneal culture and corneal deswelling at the Eye Bank of Rome. METHODS Samples of cold storage medium (EUSOL-C), corneal culture medium (TISSUE-C) and deswelling medium (CARRY-C) were tested after three, seven and one days of corneal storage, respectively. The CARRY-C medium, used to transport the cornea to the operation theatre, was retested 1 day after transplantation. The TISSUE-C and CARRY-C media were also tested after removing antimicrobial and antifungal agents using a dedicated device. RESULTS We found 67% of the EUSOL-C samples were contaminated mainly by Staphylococcus spp, 14% of TISSUE-C media were contaminated by bacteria and fungi and 3% of CARRY-C media by Staphylococcus spp The analysis performed after removing the antimicrobial and antifungal agents showed growth in three additional TISSUE-C samples (S viridans, S haemolyticus and E faecalis) and one CARRY-C (S cerevisiae and P acnes). CONCLUSION Tissue contamination was unexpectedly high on arrival to the eye bank, indicating the need to review and update decontamination procedures during tissue recovery, and renew training for the recovery teams. Storing donor corneas in organ culture conditions significantly reduced the microorganism burden. Using devices to remove antimicrobial and antifungal agents from samples before testing can increase the sensitivity of the standard microbiological method, and thus help further reduce the risk of microbial transmission.
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Affiliation(s)
- Rossella Vignola
- Eye Bank of Rome, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | | | | | - Mariarosa Gaudio
- Clinical Pathology, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | | | - Augusto Pocobelli
- Eye Bank of Rome, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
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3449
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Optical Coherence Tomography-Guided Transepithelial Phototherapeutic Keratectomy for Central Corneal Opacity in the Pediatric Population. J Ophthalmol 2018; 2018:3923617. [PMID: 30671257 PMCID: PMC6323485 DOI: 10.1155/2018/3923617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/30/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To report the outcomes of optical coherence tomography- (OCT-) guided transepithelial phototherapeutic keratectomy (PTK) for central corneal opacity in the pediatric population. Methods The charts of 10 eyes of 8 children aged 9 to 17 with central corneal opacity from various pathologies who underwent a standardized OCT-guided transepithelial PTK technique at a single private practice institution were retrospectively reviewed. The corneal topographic findings, OCT measurements, and visual results with refractive outcomes were analyzed 6 months after the PTK treatment. Results All 10 eyes tolerated the procedure well without any significant intraoperative or postoperative complications. Uncorrected and best spectacle-corrected visual acuity (BSCVA) significantly improved postoperatively (p < 0.0001 and p=0.0045, respectively). The absolute value of spherical equivalent on cycloplegic refraction significantly improved postoperatively as well (p=0.0014), but there were no significant changes in topographic measurements. Seven out of the 10 eyes had complete resolution of the central corneal opacity on OCT imaging. None of the subjects lost any lines of BSCVA and developed recurrence of the corneal opacity from the primary disease condition or required keratoplasty during the follow-up period. Conclusions OCT-guided transepithelial PTK can provide excellent visual outcomes in pediatric patients with central corneal opacities.
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3450
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Bruce G, Tatham AJ. Glaucoma management in primary care: barriers perceived by optometrists in Scotland. Ophthalmic Physiol Opt 2018; 38:629-639. [DOI: 10.1111/opo.12591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/06/2018] [Indexed: 11/26/2022]
Affiliation(s)
| | - Andrew J Tatham
- University of Edinburgh; Edinburgh UK
- Princess Alexandra Eye Pavilion; Edinburgh UK
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