Clinical and Experimental Vision and Eye Research最新文献

{"title":"Incidental findings of multiple air emboli in the brain and orbit","authors":"N. Goldenberg-Cohen, Inbal Man-Peles, Nina Borissovsky","doi":"10.15713/ins.clever.47","DOIUrl":"https://doi.org/10.15713/ins.clever.47","url":null,"abstract":"Bubbles of air are commonly introduced to the circulation in admitted patients. Various causes are related to hospital procedures, but intravenous injections are considered the most common etiology.[1] Usually, it is a clinically insignificant finding with no adverse effects. However, if a large amount of air is introduced, severe complications and even death may occur. Studies estimate that the injection of over 200–300 ml is hazardous and may lead to severe sequelae.[2] While circulating in the respiratory system, the air bubbles are usually absorbed and are asymptomatic. If the bubbles reach the cerebral circulation (through a patent foramen ovale, e.g.), it can cause a cardiorespiratory failure or stroke.[3,4] In these cases, patients may suffer from shortness of breath, confusion, headaches, and loss of consciousness. Here, we present an incidental finding of air bubbles in a brain computed tomography (CT) scan. An 87-year-old female was admitted at postictal state, with fever and urosepsis. Medical history revealed a rapid cognitive decline and physical deterioration following a femur fracture 1 year before admission. She also developed atrial fibrillation and a new convulsive disorder. At admission, she had no shortness of breath, headaches, or visual disturbances. Aortic regurgitation without heart failure was documented. Radiological findings included multiple air bubbles at the right masticator space and two elongated bubbles in the superior ophthalmic vein of the right orbit [Figure 1a and b]. A similar case was previously reported following an intravenous injection in an 83-year-old female.[5] Massive venous air bubbles are not common following intravenous injections, although small bubbles are frequently encountered. Additional etiologies include trauma or catheterization. Risk factors that may be contributed to air embolism, relevant to this case, are venous stasis in the atria due to atrial fibrillation. Breath holding required during injection of contrast agents at CT scans was also suggested to be a risk factor by increasing the intrathoracic pressure.[5] Any patient with a peripheral intravenous catheter is considered at risk. Intensive catheterization and rapid infusion can increase this risk.[4] Here, we describe massive air bubbles found incidentally on a CT scan. The patient did not show adverse sequelae, and the air bubbles resolved spontaneously. Elderly patients, especially","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127502669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal hamartomas respond to everolimus treatment for tuberous sclerosis: A photo essay","authors":"Karin Herscu, R. Cohen, Inbal Man-Peles, S. Michowiz, N. Goldenberg-Cohen","doi":"10.15713/ins.clever.30","DOIUrl":"https://doi.org/10.15713/ins.clever.30","url":null,"abstract":"Background: Tuberous sclerosis is characterized by hamartomas in multiple organs including retinal hamartomas. Everolimus is a novel treatment for tuberous sclerosisrelated lesions. We present a case where everolimus led to lesion shrinkage, the skin tuberomas, as well as the retinal hamartomas, indicating that its effect can be detected, measured, and monitored with an ocular examination. Case Report: We describe a 24-year-old female diagnosed with tuberous sclerosis since birth, with multiorgan involvement. The patients had multiorgan involvement, with angiolipomas of the kidney resistant to treatment. She also underwent subependymal giant cell astrocytoma brain tumor resection. The patient was treated with everolimus after recurrent embolization failed to shrink the renal angiolipomas. The tumors responded well to treatment. Conclusions: Skin lesions disappeared, and fundus photos and repeat retinal optical coherence tomography measurements documented shrinkage of the retinal hamartomas during the 24 months of treatment. We conclude that a simple eye examination can monitor treatment effectiveness.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125892402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flap protection during laser-assisted in situ keratomileusis improves refractive outcomes in high myopic astigmatism","authors":"Nitsan Duvdevan, M. Mimouni, Yuval Dominitz, Tzahi Sela, Gur Munzer, A. Achiron, I. Kaiserman","doi":"10.15713/ins.clever.22","DOIUrl":"https://doi.org/10.15713/ins.clever.22","url":null,"abstract":"Purpose: Subtle irregularities in the corneal flap may affect laser-assisted in situ keratomileusis (LASIK) outcomes. The aim of this study was to evaluate flap protection during ablation in myopic astigmatic patients. Methods: Medical files and corneal topographies of consecutive patients with myopic astigmatism (>2.5 D) that underwent LASIK were retrospectively reviewed. The visual and refractive outcomes with and without flap protection during the procedure were compared. We calculated and compared safety index, efficacy index, index of success (Alpins vector analysis) and ratio between nasal and temporal ablation. Results: We included 57 subjects that fulfilled inclusion criteria. Patients in the flap guarding group were similar to patients in the no-guarding group, in terms of pre-operative parameters and similar treatment zones were used in both groups. Post-operatively, the flap guarding group had a better efficacy index (1.08 ± 0.17 vs. 0.96 ± 0.24, P = 0.04) and index of success (0.16 ± 0.07 vs. 0.23 ± 0.17, P = 0.04). The proportion of subjects with more than double nasal over-ablation ratio (>200%) was significantly lower in the guarding group compared to the no-guarding group (04.2% [1/23] vs. 32.3% [11/34], P = 0.02). No significant differences were found between groups in terms of post-operative safety index, uncorrected visual acuity, best-corrected visual acuity, sphere, cylinder and keratometry. Conclusion: Guarding the flap during high myopic astigmatic LASIK was associated with better visual and refractive outcomes.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134229921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic macular holes – A review of current management strategies","authors":"T. Sela, A. Hadayer, A. Zahavi","doi":"10.15713/ins.clever.34","DOIUrl":"https://doi.org/10.15713/ins.clever.34","url":null,"abstract":"Macular holes (MHs) are retinal defects which involve the center of the anatomical fovea.[1,2] Severity may range from asymptomatic incidentally discovered MHs, to advanced vision-threatening ones.[2,3] MHs are often described according to the extent of retinal layers involvement. Full-thickness MHs (FTMHs) encompass all the layers of the retina from the internal limiting membrane (ILM) to the retinal pigmented epithelium (RPE) [Figure 1].[2] Partialthickness MHs, also termed lamellar holes, involve only the inner retinal layers, while the photoreceptors layer may remain intact [Figure 2].[2,3] Although the majority of cases are idiopathic (>85%), MHs may also be secondary to various conditions, among the most common of which are high myopia and ocular trauma.[2,4,5] Kumawat et al. described in detail other infrequent causes of secondary MHs.[5]","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131706285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine development for glaucoma: From skepticism to certitude","authors":"Rizwana Qadri, R. Sofi, Anoop Sainulabdeen, M. A. Pandit, S. Bhartiya, Mohd Sharique, M. Lone, Ali Mashook, M. Faiq","doi":"10.15713/ins.clever.35","DOIUrl":"https://doi.org/10.15713/ins.clever.35","url":null,"abstract":"Vaccines are conventionally thought to be a strategy to thwart the onset of any disease caused by pathogens. The elementary foundation for this concept is the ability of the immune system to discriminate between what is native to the body and what is foreign. This molecular xenophobia can, in principle, be exploited to prime the body to fight and neutralize any potentially disease-causing organism or moiety. For chronic disorders, preventive measures mediated through immune system modulation have been tried with little success yet the optimism for developing strategies of modulating the immune system is growing day by day as new techniques and animal models are being developed. Given the high prevalence of glaucoma and the ability of glaucoma experts to identify high-risk individuals, preventive regimens, and vaccine-like-substances can be developed to bring down the incidence. In this paper, we will discuss some preliminary efforts of vaccine development in glaucoma. We will also deliberate on the technical difficulties in developing effective vaccines for this disorder. In addition, we will try to identify measures with potential to transform the consistent toil of researchers in this field into an efficacious endeavor. We will attempt to recognize certain plausible methodologies that are likely to take the science of vaccine development for glaucoma (and other neurodegenerative disorders) somewhat nearer to the optimistic frontiers.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"356 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115938144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An alternative endocapsular approach for the management of Argentinean flag capsular tear during cataract surgery","authors":"R. Sella, N. Afshari","doi":"10.15713/ins.clever.37","DOIUrl":"https://doi.org/10.15713/ins.clever.37","url":null,"abstract":"Many techniques are employed to prevent the formation of a radial anterior capsular tear which resembles an Argentinean flag during surgery for the extraction of white mature cataract. We aim to describe an original endocapsular approach to manage this intraoperative complication once it has already occurred, which was employed in four eyes of four patients, all with mature white cataracts prior surgery. Using this technique, without hydrodissection, the surgeon proceeds with phacoemulsification through the slit of the open anterior capsule. The anterior capsule is only manipulated following intraocular lens (IOL) insertion to the capsular bag by creating two symmetric semicircles. In all cases, no posterior capsular tear occurred during surgery, and there were no further intraor post-operative complications. The final best-corrected visual acuity was 20/25 in each case on the 3-month follow-up appointment, and the IOLs were well centered in the capsular bag. capsulorhexis,[1] creating peripheral iridotomies,[8] and capsule milking, as lately described by Chee and Chan.[9] Some surgeons routinely inject intravenous mannitol preoperatively in those cases and/or use viscoelastic agents such as Healon5® intraoperatively (Johnson & Johnson Vision, Santa Ana, CA, USA).[10] Emerging technologies for automated capsulotomy such as the nanopulse capsulotomy (Zepto, Mynosys Cellular Devices, Inc.), and CAPSULaser (Excel-Lens, Inc.) may have a value in preventing this complication, though efficacy is yet to be proven. Nevertheless, and despite the best of efforts, an Argentinean flag sign may still be observed in these complex cases. Once this complication has occurred, it is imperative for the surgeon to meticulously plan the next steps. The main concern is to avoid tear propagation to the posterior capsule, which may lead to capsular or zonular tears, vitreous loss and dropped nucleus, or intraocular lens (IOL).[11] There are, however, no guidelines or explicit recommendations for the management of such complications. We, therefore, report our technique to perform phacoemulsification without hydrodissection through the slit inadvertently created in the anterior capsule. The anterior capsule is only manipulated following IOL insertion to the","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"2 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124263429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroid in central serous chorioretinopathy","authors":"Gideon Nkrumah, J. Chhablani","doi":"10.15713/ins.clever.31","DOIUrl":"https://doi.org/10.15713/ins.clever.31","url":null,"abstract":"","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133662373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental implant causing lateral rectus muscle traumatic laceration","authors":"Y. Vardizer, Shamaly Shamaly, D. Raveh, D. Shamir, Nina Borisovsky, Inbal Man-Peles, N. Goldenberg-Cohen","doi":"10.15713/ins.clever.28","DOIUrl":"https://doi.org/10.15713/ins.clever.28","url":null,"abstract":"Dental implants are often used in maxillofacial surgery. Extraocular muscle (EOM) laceration is a rare complication of the mandibular-zygomatic drilling accidentally penetrating the orbital space. In a single previous report of a lost lacerated lateral rectus muscle post-dental implantation, the muscle was not found, and transposition of the vertical muscles was performed to restore ocular motility partially. Here we present a case of traumatic laceration of the lateral rectus muscle and a successful reconstruction six weeks after injury. Our case demonstrates the EOM laceration was missed on initial radiological assessment, which led to a delayed surgical exploration. Fortunately, the lacerated muscle was re-attached. Botulinum toxin was injected to the antagonist medial rectus muscle in order to improve surgical outcome. Radiological assessment may not be sufficiently sensitive to detect EOM cut. Therefore, surgical exploration should be performed according to clinical suspicion. Even if the surgical procedure is delayed due to hematoma or edema, there is a potential for complete functional recovery.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127150798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viscosealing: A novel technique for port closure in pediatric cataract surgery","authors":"Savleen Kaur, J. Sukhija, Deepak Jugran, J. Ram","doi":"10.15713/ins.clever.23","DOIUrl":"https://doi.org/10.15713/ins.clever.23","url":null,"abstract":"Purpose: The purpose of this study was to evaluate the efficacy and outcome of viscosealing of incisions made during pediatric cataract surgery. Design: This was a prospective case series. Participants: A total of 96 eyes of 65 patients aged <10 years were included. Methods: Analysis of all children with congenital cataract who underwent cataract surgery with intraocular lens implantation and sealing of the side port with 1.45% sodium hyaluronate was done at a tertiary care center. In all the patients’, phacoaspiration with primary posterior capsulorhexis and anterior vitrectomy was done. Results: Mean age at surgery was 42.76 months (3.5 years ± 3.1 years). Complications encountered were irregular pupil in 6 eyes (6.25%), iridolenticular adhesions in 8 eyes (8.3%), and shallow anterior chamber in 6 eyes (6.25%) postoperatively. Most of these complications were seen in children <6 months of age (65.3%). At 3 months postoperatively, the mean spherical equivalent was 1.34 DS ± 2.86 D and mean astigmatism −0.05 ± 1.55 D. Conclusion: Viscosealing is an effective way to close side ports in children above 6 months of age. It does away with suture-related problems and need for the 2nd time general anesthesia.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133738462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained drug delivery platforms – A new era for glaucoma treatment","authors":"Karny Shouchane-Blum, Noa Geffen, A. Zahavi","doi":"10.15713/ins.clever.24","DOIUrl":"https://doi.org/10.15713/ins.clever.24","url":null,"abstract":"Glaucoma is a leading cause of blindness worldwide. Treatment typically consists of the chronic administration of topical eye drops. However, fluctuations in intraocular pressure, local and systemic side effects, and low patient compliance have prompted the development of various sustained drug delivery platforms, both extraocular and intraocular, over the last decade. Some are currently undergoing advanced clinical trials. Extraocular platforms include wearable ocular surface devices (such as ocular insert rings, topical ocular drug delivery devices, gel-forming eye drops, collagen shields, and contact lenses), punctal plugs (such as the OTX-TP and Latanoprost punctal plug delivery system), and subconjunctival injections (such as the Eye-D VS-101, POLAT-001, GB-6249-103, IBI-60089, and dorzolamide-loaded polymer microparticles). Intraocular platforms include mainly intracameral implants (such as the Bimatoprost SR, ENV515 Travoprost XR, iDose, OTX-TIC, PA5108, and DE-117-loaded PLC), although other devices are drawing attention as potential treatment alternatives (such as intravitreal nanosponges and supraciliary implants). The purpose of this review is to describe these emerging sustained drug delivery systems for the treatment of glaucoma and ocular hypertension.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"203 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134274863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}