Clinical and Experimental Vision and Eye Research最新文献

{"title":"XEN Gel stent: A Review","authors":"S. Dangda, Maria V. Castanos, Anna Do, Joseph F. Panarelli","doi":"10.15713/ins.clever.25","DOIUrl":"https://doi.org/10.15713/ins.clever.25","url":null,"abstract":"Over the last decade, several new surgical devices and treatment options have been developed for the management of glaucoma. Together, known as micro-invasive glaucoma surgery, they aim to provide a safer approach to glaucoma surgery. Although the early devices were used to either stent or ablate a segment of the trabecular meshwork, newer devices such as the XEN gel stent (Allergan Inc., Dublin, Ireland), offer the possibility of creating a safer, more predictable filtering bleb. Since its FDA approval in 2016, several retrospective case series and prospective studies have highlighted the efficacy of the XEN gel stent with regards IOP lowering and reduction in the need for glaucoma medications. The XEN gel stent has also been shown to have a favorable safety profile in terms of intraoperative and post-operative complications. The major concern is the need for bleb intervention in the form of needling and injection of anti-fibrotic agents. This review focuses to summarize the current knowledge on the XEN gel stent for treatment of various subtypes of glaucoma.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"15 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":"115050368","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":"Novel maneuver for the alleviation of pseudophakic optic capture and consequent pupillary block: A case report and technique","authors":"N. Shilova, Amir Sternfeld, I. Bahar, E. Livny","doi":"10.15713/ins.clever.27","DOIUrl":"https://doi.org/10.15713/ins.clever.27","url":null,"abstract":"Posterior chamber pseudophakic pupillary block (PPB) due to anterior optic capture is a rare condition with possible grave consequences. It can lead to extremely elevated intraocular pressure (IOP) and absence of anterior chamber space which may preclude the use of standard treatment methods. We describe a novel technique for its alleviation. An 80-year-old woman presented to a tertiary medical center with the left pupillary block 3 months after implantation of an intraocular lens (IOL) in the ciliary sulcus and 3 days after routine evaluation for age-related macular degeneration with tropicamide 0.5%. By exerting manual pressure on the corneal surface, the inferior half of the IOL optic was reduced into the posterior chamber, creating sufficient space for immediate Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) peripheral iridotomy. After IOP dropped to 20 mmHg, the upper half of the IOL optic was reduced into the posterior chamber using a Sinskey hook inserted through a single limbal paracentesis, and the anterior chamber was filled with an ophthalmic viscoelastic device. The device was subsequently aspirated and 1% acetylcholine was injected to constrict the pupil above the IOL optic. There were no operative complications. The corneal edema resolved, with normal cupping of the optic nerve head. At 3 months, the IOP was stable at 14–18 mmHg. The maneuver described to allow for laser treatment of PPB is technically simple and non-invasive and was highly successful in an 80-year-old patient. Repositioning the pseudophakic IOL optic may be planned as a subsequent, non-urgent procedure.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"62 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":"121671549","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":"Rectus muscle plication in the treatment of anomalous head position associated with nystagmus","authors":"T. Sauer, F. Velez, S. Pineles","doi":"10.15713/ins.clever.20","DOIUrl":"https://doi.org/10.15713/ins.clever.20","url":null,"abstract":"Introduction: Patients with nystagmus and head turn are traditionally treated by recession and resection of the rectus muscles as described by Kestenbaum and Anderson. Methods: We present a case series of patients with nystagmus and anomalous head position (AHP) who underwent plication – only surgery of the horizontal rectus muscles from March 1, 2014, to June 1, 2015. Results: Plication amounts ranged from 5mm to 7.5 mm on the medial rectus and 7–12 mm on the lateral rectus. Average pre-operative horizontal AHP was 22.5° and post-operative AHP 2.5° (paired Student t-test P = 0.034) and only one patient required a second surgery. Discussion: We found AHP can be effectively treated with plication – only surgery.","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":"116752046","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":"Gentamicin-induced macular toxicity following flanged intraocular lens fixation","authors":"S. Singh, M. Dogra, K. Chandra, M. Dogra","doi":"10.15713/ins.clever.26","DOIUrl":"https://doi.org/10.15713/ins.clever.26","url":null,"abstract":"To report a case of gentamicin-induced macular toxicity following subconjunctival injection of gentamicin after flanged intraocular lens (IOL) fixation. A 54-year-old female presented with poor post-operative visual gain following uncomplicated pars plana vitrectomy with dropped nucleus removal and flanged IOL fixation. Clinical examination revealed a patch of retinal opacification at the posterior pole with surrounding cottonwool spots. Fluorescein angiography demonstrated a sharply demarcated area of retinal ischemia with pruning of the surrounding retinal vessels. The findings were suggestive of gentamicin-induced macular toxicity. A short course of systemic corticosteroids failed to bring about significant improvement and the patient developed retinal atrophy in the area. Subconjunctival antibiotics can gain access into the eye in cases with sutureless transconjunctival flanged IOL fixation. Drugs with known intraocular toxicity such as gentamicin should be avoided in such cases.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"32 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":"132823667","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":"Non-neovascular subretinal fluid secondary to choroidal osteoma controlled with intravitreal aflibercept – A case report","authors":"J. Brody, I. Avisar, Ehud Reich","doi":"10.15713/ins.clever.36","DOIUrl":"https://doi.org/10.15713/ins.clever.36","url":null,"abstract":"The aim of the study was to describe a case of subretinal fluid without neovascularization due to choroidal osteoma that was treated successfully with intravitreal aflibercept. Choroidal osteoma is an ossifying tumor that can cause visual impairment through several pathological mechanisms, including fluid accumulation under the retina, with or without choroidal neovascularization (CNV). We described a young adult man who presented with unilateral visual impairment due to choroidal osteoma without CNV, resistant to bevacizumab intravitreal injections, which showed a marked response to aflibercept. Our experience provides support for the use of aflibercept in the treatment of non-neovascular choroidal osteoma; this is the first report describing this encouraging result. Nevertheless, the current observation merits further research.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"1 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":"127686442","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":"Vogt-Koyanagi-Harada syndrome presenting as bilateral simultaneous acute angle closure","authors":"Swati Singh, S. Kaushik, Savleen Kaur, Ramandeep Singh, S. Pandav","doi":"10.15713/ins.clever.29","DOIUrl":"https://doi.org/10.15713/ins.clever.29","url":null,"abstract":"Presentation of bilateral simultaneous angle closure in a patient must alert one to look beyond the common “knee-jerk” diagnosis of acute primary angle closure (APAC). We describe a case with bilateral simultaneous acute angle closure with signs of anterior chamber inflammation with intraocular pressure of 60 mmHg. Based on the clinical details and ultrasonic findings of peripapillary choroidal thickening and supraciliary fluid, a diagnosis of Vogt-Koyanagi-Harada (VKH) disease was made. Our case highlights that every angle closure is not a primary angle closure requiring laser peripheral iridotomy. Detailed clinical examination with appropriate investigations could prevent misdiagnosis of APAC in VKH.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"35 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131623625","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":"Patterns of macular inner retinal layers involvement in eyes with optic nerve head drusen","authors":"Renata A. S. Modesto, Elson Cabral Velanes Neto, Ricia N. P. Moura, A. L. Scoralick, Michele Ushida, Carolina P B Gracitelli, S. Dorairaj, F. Kanadani, T. Prata, Diego T Dias","doi":"10.15713/ins.clever.33","DOIUrl":"https://doi.org/10.15713/ins.clever.33","url":null,"abstract":"Purpose: The purpose of this study was to investigate the macular inner retinal layers involvement in eyes with optic nerve head drusen (ONHD) using spectral-domain optical coherence tomography (SD-OCT). Methods: An observational case series was carried out. Consecutive patients with ONHD and age-matched healthy individuals were enrolled from a single center. Key exclusion criteria were significant media opacity, best-corrected visual acuity ≤20/40, and the presence of any ocular comorbidity. After inclusion, all patients underwent SDOCT imaging, visual field (VF) testing (standard automated perimetry), and optic disc digital imaging. For SD-OCT, macular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) protocols were obtained. SD-OCT examinations were classified as normal or abnormal (and subsequently as focal or diffuse loss pattern) based on previously described color-coded criteria. Results: A total of 19 eyes with ONHD and 20 control eyes were included in the study. The VF mean deviation for ONHD eyes was −4.6 ± 3.9 dB. Regarding macular inner retinal layers (GCC protocol) analysis in ONHD eyes, nine eyes (47.4%) had significant macular GCC thinning, of which seven presented focal loss pattern and two diffuse loss pattern. Overall, both macular and pRNFL parameters were significantly thinner in eyes with ONHD when compared to healthy controls (P < 0.05). Analyzing the ability of the SD-OCTs normative database to detect abnormalities, 42.1% of the patients were presented abnormalities in both pRNFL and GCC parameters, while only one case presented an SD-OCT abnormality restricted to the macular GCC protocol. Conclusions: Investigating macular inner retinal layers involvement in eyes with ONHD, we found detectable macular damage by SD-OCT in almost half of the cases. In most of these cases, macular damage had a focal loss pattern and was accompanied by concomitant pRNFL thinning.","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":"129043039","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":"Unpredicted eye preference in anisometropic children diagnosed late with amblyopia","authors":"Amir Sternfeld, R. Segal, M. Altman, N. Goldenberg-Cohen","doi":"10.15713/ins.clever.32","DOIUrl":"https://doi.org/10.15713/ins.clever.32","url":null,"abstract":"Background: This study aims to describe a rare phenomenon of anisometropic amblyopia in the emmetropic eye, preferring the hypermetropic eye. Methods: The cohort included all children with anisometropic amblyopia attending a tertiary medical center in 2014–2016 in whom amblyopia was diagnosed in the more emmetropic or myopic eye. The medical records were reviewed for demographic parameters, best-corrected visual acuity (BCVA) for each eye, refraction, treatment, glasses prescription, follow-up, and final BCVA. Results: Four patients, two girls and two boys, met the study criteria. The mean age at diagnosis was 6.8 years (range 4–8 years), and mean follow-up time was 2.6 months (one child was lost to follow-up). Median cycloplegic refraction in the amblyopic (right) eyes was −1.7 sphere (0–[−4.5]) with −0.45 cylinder (0–[−0.75]) in 80°, and in the preferred (non-amblyopic) eyes, +1.75 sphere ([+1]–[+3.25]) with −0.35 cylinder (0–[−0.75]) in 87°. Corresponding mean BCVA values were LogMAR 0.46 (0.3–0.7) and LogMAR 0.02 (0–0.07); mean spherical difference was 4 (1–6.5). None of the children had an additional pathology. Treatment consisted of full cycloplegic spherical refractive correction or the closest possible while maintaining BCVA, with mild modified subjective correction of the cylinder. Patching was also used in three children. Mean BCVA after treatment was 0.20. Conclusion: In rare cases of anisometropia, in which amblyopia is diagnosed late, the eye with hyperopic refraction may be preferred. Clinicians should be alert to this phenomenon as treatment requires some modification of conventional glasses prescription. Further studies are needed to clarify the underlying pathophysiology.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"10 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":"117320752","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":"Evaluation and comparison of the safety profile of topical anti-glaucoma drugs in patients of primary open angle glaucoma or ocular hypertension or normal tension glaucoma","authors":"P. Bhagat, Kinjal Y Trivedi","doi":"10.15713/INS.CLEVER.51","DOIUrl":"https://doi.org/10.15713/INS.CLEVER.51","url":null,"abstract":"Aim: The aim of the the study was to evaluate and to compare the side effects of topical anti-glaucoma drugs in patients of POAG, OHT, ad NTG. Introduction: Topical drugs are the mainstay of glaucoma management but are associated with various adverse effects which can influence compliance and quality of life of the patient. Materials and Methods: We studied 308 eyes of 154 patients above 15 years, having POAG, OHT, or NTG and using at least one anti-glaucoma medication. A structured validated questionnaire was used followed by ocular examination to collect data which were analyzed statistically. Results: Out of 308 eyes of 154 patients, 80.51% patients experienced at least one side effect, more in females. The incidence increased to 72.52%, 92.10%, 91.66%, and 100% among 50–59, 60–69, 70–79, and 80–89 age groups, respectively. TBUT was normal in 62.79% eyes when duration of therapy was ≤ 5 years but not when beyond 11 years and normal only in 34% eyes exposed to benzalkonium chloride. Only 8.45% patients experienced systemic side effects but none required emergency care. Change of therapy due to side effects occurred in 8.11% patients. Conclusion: Topical anti-glaucoma drugs are quite safe but incidence of side effects increases with age, duration of therapy, and number of medications. Although few, they affect the quality of life and compliance potentially limiting success of the treatment. Clinical Significance: Knowledge of side effects helps us in tailoring, monitoring, and revising treatment as necessary, to minimize side effects and maximize outcomes.","PeriodicalId":130091,"journal":{"name":"Clinical and Experimental Vision and Eye Research","volume":"34 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":"131049492","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}