Showing papers in "journal of current ophthalmology in 2016"
TL;DR: Simultaneous evaluation of BAD_D, 5th order vertical coma aberration, IVA, and ISV, especially when the pattern of the corneal curvature is normal, can detect subclinical keratoconus with high sensitivity and specificity.
Abstract: Purpose
To determine pachymetric, aberrometric, and topometric indices in patients with definite and subclinical keratoconus and the validity of these indices in the diagnosis of keratoconus.
112 citations
TL;DR: Visualization of the peripheral retina using ultra-wide-field imaging improves diagnosis and classification of diabetic retinopathy.
Abstract: Purpose To present an overview on ultra-wide-field imaging in diabetic retinopathy. Methods A comprehensive search of the pubmed database was performed using the search terms of “ultra-wide-field imaging”, “ultra-wide-field fluorescein angiography” and “diabetic retinopathy”. The relevant original articles were reviewed. Results New advances in ultra-wide-field imaging allow for precise measurements of the peripheral retinal lesions. A consistent finding amongst these articles was that ultra-wide-field imaging improved detection of peripheral lesion. There was discordance among the studies, however, on the correlation between peripheral diabetic lesions and diabetic macular edema. Conclusions Visualization of the peripheral retina using ultra-wide-field imaging improves diagnosis and classification of diabetic retinopathy. Additional studies are needed to better define the association of peripheral diabetic lesions with diabetic macular edema.
62 citations
TL;DR: A qualitative approach using semi-structured individual interviews was used to elicit common outdoor difficulties in individuals with visual impairment to show how appropriate urban modification can be very beneficial.
Abstract: Propose
A qualitative approach using semi-structured individual interviews was used to elicit common outdoor difficulties in individuals with visual impairment.
49 citations
TL;DR: Posterior corneal elevation, cornal thickness and high order aberrations are important indices that need to be considered to diagnose different grades of keratoconus.
Abstract: Purpose
To assess the anterior segment parameters of keratoconus (KC) eyes at different stages of the disease by a new Scheimpflug camera combined with Placido disk corneal topography (Sirius, CSO, Italy) in a sample of the Iranian population.
48 citations
TL;DR: Based on the current evidence, intracameral antibiotics seems to be effective in preventing endophthalmitis after cataract surgery.
Abstract: Purpose
To investigate recent evidence in prophylaxis and management of post-cataract surgery endophthalmitis.
47 citations
TL;DR: Using AS-OCT, there was a statistically significant difference in the underlying PAC mechanisms and quantitative AC parameters among the three subtypes of angle closure disease.
Abstract: Purpose To evaluate different mechanisms of primary angle closure (PAC) and to quantify anterior chamber (AC) parameters in different subtypes of angle closure disease using anterior segment optical coherence tomography (AS-OCT). Methods In this prospective study, 115 eyes of 115 patients with angle closure disease were included and categorized into three groups: 1) fellow eyes of acute angle closure (AAC; 40 eyes); 2) primary angle closure glaucoma (PACG; 39 eyes); and 3) primary angle closure suspect (PACS; 36 eyes). Complete ophthalmic examination including gonioscopy, A-scan biometry, and AS-OCT were performed. Based on the AS-OCT images, 4 mechanisms of PAC including pupillary block, plateau iris configuration, thick peripheral iris roll (PIR), and exaggerated lens vault were evaluated. Angle, AC, and lens parameter variables were also evaluated among the three subtypes. Results There was a statistically significant difference in the mechanism of angle closure among the three groups (p = 0.03). While the majority of fellow eyes of AAC and of PACS eyes had pupillary block mechanism (77.5% and 75%, respectively), only 48.7% of PACG eyes had dominant pupillary block mechanism (p = 0.03). The percentage of exaggerated lens vault and plateau iris mechanisms was higher in PACG eyes (25.5% and 15.4%, respectively). Fellow eyes of AAC had the shallowest AC (p = 0.01), greater iris curvature (p = 0.01), and lens vault (p = 0.02) than PACS and PACG eyes. Iris thickness was not significantly different among the three groups (p = 0.45). Conclusion Using AS-OCT, we found that there was a statistically significant difference in the underlying PAC mechanisms and quantitative AC parameters among the three subtypes of angle closure disease.
41 citations
TL;DR: The incidence of trachoma has decreased significantly in the Middle East and North Africa region with implementation of the SAFE (surgery, antibiotics, facial cleanliness, and environmental control) strategy with support from the ITI.
Abstract: Purpose
To review the background, epidemiology and current management of trachoma in endemic areas and worldwide.
38 citations
TL;DR: In this article, age-related changes in corneal viscoelastic properties in healthy individuals were determined by measuring the correlation between age and visco-elastic changes.
Abstract: Purpose
To determine age-related changes in corneal viscoelastic properties in healthy individuals.
36 citations
TL;DR: It can be concluded that systemic hypertension significantly increases the risk of cataract formation in the rat eyes via modulation of the antioxidant defense mechanism and electrolyte homeostasis.
Abstract: Purpose
To evaluate modes of cataractogenesis in the hypertensive state by using different hypertensive animal models, including fructose, cadmium chloride (CdCl2), Nω-nitro-l-arginine methyl ester (l-NAME), and two-kidney, one clip (2K1C) method.
34 citations
TL;DR: An observational cross-sectional study in healthy individuals that evaluated the correlations of corneal viscoelastic properties measured by the Ocular Response Analyzer with central Corneal thickness (CCT) in different age groups concluded that accuracy of CH and CRF is not good enough for using these values as single parameters for ectasia diagnosis.
Abstract: Corneal biomechanics emerged as a very hot topic for research in Ophthalmology.1, 2 In this issue, Sharifipour and coworkers3 present an observational cross-sectional study in healthy individuals that evaluated the correlations of corneal viscoelastic properties measured by the Ocular Response Analyzer (ORA, Reichert, Buffalo, NY) with central corneal thickness (CCT) in different age groups. In this study, corneal hysteresis (CH) and corneal resistance factor (CRF) had a significant negative correlation with age (P < 0.001). Other studies had already demonstrated that CH and CRF have a negative correlation with age and a positive correlation with CCT.4 While statistical methodology was done properly in these studies, it is very important to note that CH and CRF do not express stiffness or the stress–strain behavior of corneal tissue. It is well recognized that corneal stiffness increases with age due to enzymatic pathways such as transglutaminase and lysyl oxidase, generating natural collagen crosslinking.5 In agreement with such concept, Elsheikh and coworkers analyzed human corneal specimens ranging in age between 50 and 95 years with an inflation test, finding a significant increase in stiffness associated with age and also with the load rate.6
The ORA was introduced in 2005 as the first instrument for assessing corneal biomechanics in vivo.7 The ORA is a non-contact tonometer (NCT) that monitors corneal deformation using the infrared reflex of the corneal apex. The applanation is detected as a peak on this reflex and is correlated with the pressure of the air puff. The inward phase (P1) and in the outward phase (P2) applanations are registered. The air puff maximal pressure is related to P1 as the system has an integrated loop to control the pump, which generates a collimated air pulse or puff with a symmetrical configuration. P1 and P2 pressure measurements are the basis for the first generation variables as reported by the original ORA software. The difference between the two pressures is called CH. Hysteresis is derived from the Greek, meaning ‘‘lagging behind’’.8 Corneal resistance factor is also derived from the inward and outward pressure values, based on a formula (P1 – kP2), where k is a constant that was empirically developed to augment the correlation with CCT. The concept was to develop a parameter (CRF) that reflects the resistance to deformation, but this is still related to IOP.7 Shah and coworkers first reported that hysteresis was significantly lower in keratoconic eyes compared to normal eyes.9 However, accuracy of CH and CRF is not good enough for using these values as single parameters for ectasia diagnosis.10 Even though pressure-dependent variables are relatively limited for detecting ectatic corneal disease, low CH is very relevant in glaucoma. CH is associated with optic nerve neuropathy in glaucoma. Interestingly, CH is more strongly associated with glaucoma presence, risk of progression, and effectiveness of glaucoma treatments than CCT.11
Beyond pressure-dependent parameters, different waveform-derived parameters were introduced for characterizing corneal deformation.8, 12, 13 Dupps and coworkers developed parameters related to the intensity of deformation in accordance to the pressure applied, along with other aspects of response and combinations of these variables.14 These parameters were found as better representatives of corneal structure in studies related to the diagnosis of ectatic disease.14, 15 Interestingly, integration of biomechanical data with corneal tomography has been demonstrated to augment accuracy for the identification of milder forms of ectasia.16, 17
The Corvis ST (Oculus, Wetzlar, Germany) was introduced as the second instrument for “in vivo” biomechanical assessment of the cornea. This is also a NCT system with a collimated symmetrical air puff pressure profile. However, unlike the ORA, the Corvis ST produces a consistent air puff maximal pressure for every examination. In addition, it has an ultra-fast Scheimpflug camera that takes 140 frames during the 33 ms of the measurement, which allows for a more detailed evaluation of corneal deformation.18 The Corvis ST provides a set of corneal deformation parameters based on the dynamic inspection of the corneal response.19 Deformation amplitude refers to the movement of the corneal apex in the anterior-posterior direction and is determined as the highest displacement of the apex at the highest concavity moment. Studies involving contact lenses with different material properties mounted on an anterior chamber model with adjusted pressures have demonstrated the impact of the chamber pressure on the deformation response.20 Novel corneal deformation parameters (CDP) were developed to improve ectasia detection.21 The Vinciguerra Screening Report provides these data along with correlations of normality values and biomechanically adjusted intraocular pressure. In addition, the horizontal Scheimpflug image of the undisturbed cornea provides data for calculating the profile or the rate of increase of corneal thickness from the apex towards nasal and temporal sides. In addition, the characterization of the thickness data on the horizontal Scheimpflug image enables the calculation of the Ambrosio Relational Thickness through the horizontal meridian (ARTh).22 ARTh has been combined with the CDP to generate the Corvis Biomechanical Index (CBI) that optimizes accuracy for detecting keratoconus. Vinciguerra and coworkers23 demonstrated that with a cut off of 0.5, CBI was able to correctly identify 98.2% of the keratoconic cases with 100% specificity. Further integration of the Corvis ST and Pentacam has already been tested and also provides the most accurate platform for early ectasia diagnosis. (Integration of corneal tomography and biomechanical parameters for diagnosis of ectatic disease. Ambrosio and coworkers, Poster ESCRS 2015).
Other approaches that combine deformation of the cornea with analysis of high-speed imaging, such as swept-source OCT or supersonic shear-wave imaging technology, have been proposed.8 The Brillouin optical microscopy is another technology that has been proposed to measure in vivo corneal biomechanics through the analysis of light scatter. This technology led to new insights regarding corneal biomechanics in ectatic diseases. Brillouin imaging showed differences between healthy and keratoconic corneas. Interestingly, it revealed that the mechanical weakening is primarily concentrated within the area of the corneal protrusion. Brillouin shift measures outside the protruded or conic area were comparable with that of healthy corneas.24 These findings are in agreement with the concept of focal weakening, starting a biomechanical decompensation cycle as proposed by Roberts.2 We predict fast developments and a bright future for corneal biomechanical assessments for ectasia detection, refining refractive surgery, glaucoma, and other applications for Ophthalmology.
28 citations
TL;DR: Based on the results, I-BiT™ seems to be effective in amblyopia therapy accompanied with patching, and it is recommended to compare I- biT™ alone withPatching in further studies.
Abstract: Purpose To determine the role of Interactive Binocular Treatment (I-BiT™) as a complementary method of patching in amblyopia therapy. Methods In this randomized clinical trial study, 50 unilateral amblyopic children (25 male/25 female) between 3 and 10 years with either best corrected visual acuity (BCVA) ≤20/30 in the amblyopic eye or a difference of BCVA ≥ 2 lines between the two eyes were included. They were randomly classified into the case and control groups (25 in each). Patching was recommended in both groups, and cases also received I-BiT™. Cases were asked to play I-BiT™ games through appropriate glasses with conjugate colored filters. Moving and fixed targets were shown to the amblyopic and non-amblyopic eyes, respectively. Playing games was continued 20 min in each session for 5 days a week within one month (total time: 6.6 h). Patching was continued for one month more in both groups to evaluate the continuous effect of I-BiT™. BCVA was measured at baseline, one month after beginning I-BiT™, and one month after cessation of I-BiT™. Results BCVA of amblyopic eyes in cases and controls were 0.34 ± 0.14 and 0.33 ± 0.17LogMAR at baseline which improved to 0.17 ± 0.14 and 0.26 ± 0.17 at one month, respectively. The difference was significant in each group (p Conclusion Based on our results, I-BiT™ seems to be effective in amblyopia therapy accompanied with patching. We recommend comparing I-BiT™ alone with patching in further studies. ClinicalTrials.gov Identifier: NCT02740725 .
TL;DR: EPO has been used for the treatment of different ophthalmic conditions with promising results and further studies are needed to elaborate the role of EPO in management of ocular diseases.
Abstract: Purpose To review the current literature on ocular application of erythropoietin (EPO). Methods A comprehensive search was performed on Pubmed and Scopus databases. All selected articles were reviewed thoroughly by the authors to review current applications of the EPO in ocular diseases. Results Various aspects of administration of EPO for different ischemic, traumatic, vascular, and degenerative disorders have been explained. The articles are generally preclinical with few small studies reporting clinical outcomes. Conclusion EPO has been used for the treatment of different ophthalmic conditions with promising results. Further studies are needed to elaborate the role of EPO in management of ocular diseases.
TL;DR: Ophthalmology residents in the US express high levels of satisfaction with their residency training programs, and while most programs adequately address most ICO core objectives, certain curriculum modifications should be considered.
Abstract: Purpose
To evaluate the perspective of ophthalmology residents in the US about their residency programs and compare the competency of residency programs to international competency levels set by the International Council of Ophthalmology (ICO).
TL;DR: The results did not show that vitrectomy, membranectomy, and ILM peeling result in significant improvement of BCVA in eyes with refractory DME and non-tractional ERM in spite of central macular thickness reduction.
Abstract: Purpose
To evaluate the efficacy of vitrectomy, membranectomy, and internal limiting membrane (ILM) peeling on macular thickness and best corrected visual acuity (BCVA) in patients with refractory diffuse diabetic macular edema (DME) and non-tractional epiretinal membrane (NT-ERM).
TL;DR: Both SMILE and Q-FS-LASIK resulted in a decrease in CH and the CRF at postoperative 1 day, with the decreases stabilizing after this point and the decreases subsequently stabilized with no further deteriorations compared to postoperative day 1.
Abstract: Purpose The aim of this study was to compare the changes in corneal biomechanical properties following small-incision lenticule extraction (SMILE) versus Q-value–guided femtosecond laser-assisted in situ keratomileusis (Q-FS-LASIK). Methods In this prospective comparative study, patients with a sphere plus cylinder measurement of less than −10.00 D and cylinder measurement of less than −5.00 D were included in the study. A total of 160 patients (160 eyes) with myopia and myopic astigmatism were divided into the two groups, with 80 patients (80 eyes) allocated to SMILE and 80 patients (80 eyes) allocated to Q-FS-LASIK. Corneal hysteresis (CH) and the corneal resistance factor (CRF) were quantitatively assessed using the Ocular Response Analyzer (ORA) preoperatively and at 1 day, 2 weeks, and 1 and 3 months postoperatively. Results Both types of surgery were associated with statistically significant decreases in CH and the CRF at postoperative day 1 (both P 0.05). Both groups showed similar biomechanical changes at each time point (all P > 0.05). Conclusions Both SMILE and Q-FS-LASIK resulted in a decrease in CH and the CRF at postoperative 1 day, with the decreases stabilizing after this point. There were no significant differences between the short term effects of SMILE and Q-FS-LASIK on corneal biomechanical properties.
TL;DR: The findings of nevus psiloliparus, eyelid choristoma and intracranial lipoma were consistent with ECCL, and pediatricians and ophthalmologists should be aware of this condition.
Abstract: Purpose
To report a rare case of encephalocraniocutaneous lipomatosis (ECCL) presented with characteristic multiple organ involvement.
TL;DR: In this study, SDM was more effective than conventional laser photocoagulation in reducing CMT and CMV and improving visual acuity in patients with DME.
Abstract: Purpose The aim of the present study was to investigate the effect of subthreshold diode laser micropulse (SDM) in comparison with conventional laser photocoagulation in the treatment of the diabetic macular edema (DME). Methods Sixty-eight eyes from 68 patients with clinically significant DME were divided randomly into two equal groups. In the first group, SDM photocoagulation was employed, while conventional laser photocoagulation was performed on the eyes of the second group. Central macular thickness (CMT), central macular volume (CMV), and best corrected visual acuity (BCVA) were measured before, 2, and 4 months after intervention, and the results were compared. Results The mean CMT was 357.3 and 354.8 microns before the treatment in Groups 1 and 2, respectively (P = 0.85), and decreased significantly to 344.3 and 349.8 after 4 months, respectively (P = 0.012 and P = 0.049). The changes in the central macular thickness was statistically higher in the first group (P = 0.001). The mean CMV significantly decreased in Group 1 (P = 0.003), but it was similar to pretreatment in Group 2 after 4 months (P = 0.31). The BCVA improved significantly in Group 1 (P Conclusions In this study, SDM was more effective than conventional laser photocoagulation in reducing CMT and CMV and improving visual acuity in patients with DME.
TL;DR: The results of the study showed significant correlations between corneal and refractive astigmatisms and HOA, and no significant correlation between residual astigmatism and Hoa.
Abstract: Purpose
To evaluate the correlation between refractive, corneal, and residual astigmatism and higher order aberrations (HOA) in refractive surgery candidates.
TL;DR: The orbital index of this sample Iranian people is Mesoseme according to the study results, the expected characteristic of the white race, and the right orbits are determined to be larger than the left ones.
Abstract: Purpose
To determine the dimensions of orbital entrance in unaffected bony orbit by computed tomography (CT) in a sample of Iranian population.
TL;DR: The prevalence of ptosis in this study was considerably high and significantly increased with age and in the multiple logistic regression model, ptosis prevalence correlated with older age, diabetes and hypertension.
Abstract: Purpose
To determine upper eyelid ptosis prevalence and some related factors in 44- to 69-year-olds of Shahroud in the north of Iran.
TL;DR: VOPS might be considered a feasible, valid, and reliable assessment method for procedural skills of medical students and residents that can be used as an alternative to the DOPS method, however, VOPS might underestimate DOPS in evaluating surgical skills of residents.
Abstract: Purpose
The efficacy and sufficiency of a healthcare system is directly related to the knowledge and skills of graduates working in the system. In this regard, many different assessment methods have been proposed to evaluate various skills of the learners. Video Observation of Procedural Skills (VOPS) is one newly-proposed method. In this study we aimed to compare the results of the VOPS method with the more commonly used Direct Observation of Procedural Skills (DOPS).
TL;DR: Corneal aberrations remained unchanged 3 months after wearing RGP contact lens, and relationships that remained statistically significant in the multiple model were between baseline central corneal thickness and changes in total higher order aberration and anterior 4th order astigmatism 0°, and between baseline 2nd order astigmaticism 45° and its changes.
Abstract: Purpose
To determine the short-term effect of rigid gas permeable (RGP) contact lenses on corneal aberrations in keratoconic patients
TL;DR: There were a good correlation betweenCorneal topographic pattern and corneal HOAs in normal eyes and results indicate that the corneals values are largely determined by the topographic patterns.
Abstract: Purpose
This study reports the characteristics of corneal higher order aberrations (HOAs) in eyes with normal topographic pattern using the Pentacam scheimpflug system.
TL;DR: This study points towards the simultaneous role of multiple risk factors including sun exposure, hot climate, toxic material exposure, familial transmission, and dry eye in association with pterygium.
Abstract: Purpose
The purpose of this study was to determine the factors associated with Pterygium, utilizing history and examination.
TL;DR: It is indicated that cycloplegic drops caused a statistically significant shift in the “with the rule” and “against therule” astigmatisms, although the oblique astigmatism remained unaffected.
Abstract: Purpose
To determine the effect of the cyclopentolate 1% on the cylindrical and spherical components of the refraction.
TL;DR: This association of Crouzon syndrome with bilateral peripapillary MRNF may lend insight into the developmental control of optic nerve myelination, the pathogenesis of MRNF, and the potential role of growth factors in these processes.
Abstract: Purpose
We present a case of bilateral extensive peripapillary myelinated retinal nerve fibers (MRNF) in an individual with Crouzon syndrome, an inherited form of craniosynostosis caused by overactivation of fibroblast growth factor receptor 2. As a secondary aim, we examine the utility of optical coherence tomography (OCT) angiography for visualization of peripapillary vasculature obscured by myelination on other imaging modalities.
TL;DR: Ophthalmologists should take into account infectious causes of retinal vasculitis before approaching anti-inflammatory or anti-VEGF therapy after a 61-year-old woman with proven CMV retinitis was referred.
Abstract: Purpose To report a case of cytomegalovirus (CMV) retinitis in an immunocompetent adult patient. Methods A 61-year-old woman with proven CMV retinitis and no evidence of HIV or other underlying immunodeficiencies was referred. Results She was referred with history of recent right eye visual loss. In fundus examination, she had signs of retinal vasculitis. After initial examination, she was found to have CMV retinitis documented by polymerase chain reaction (PCR) analysis of vitreous sample. She had neither underlying risk factor in any assessed work-up nor any concomitant disease in 10 months follow-up. She received intravitreal ganciclovir with good response to treatment. Conclusion Ophthalmologists should take into account infectious causes of retinal vasculitis before approaching anti-inflammatory or anti-VEGF therapy.
TL;DR: Miniscleral contact lenses can be considered a safe and effective option in aphakia patients with concurrent corneal scarring secondary to ocular injury for whom surgical intervention would be complicated.
Abstract: Purpose
To evaluate visual results, comfort of use, safety, and efficacy of mini scleral contact lenses in optical management in patients with traumatic aphakia and severe concomitant irido-corneal injury.
TL;DR: Fonto nasal anastomosis restores the anatomy and reduces the chance of recurrence of frontal sinus mucocele and its recurrence in a team of ENT and Ophthalmic orbital surgeons.
Abstract: Purpose
To present a technique to improve the surgical treatment of frontal sinus mucocele and its recurrence.
TL;DR: Almost all the medical journals have included a special section for “Letter to the Editor” or “Correspondence” in order to raise the level of discussion on their publications.
Abstract: Almost all the medical journals have included a special section for “Letter to the Editor” or “Correspondence” in order to raise the level of discussion on their publications. Historically, articles published in this section have consisted of several categories depending on the journal policy: