David K Wallace, Don L Bremer, William V Good, Rae Fellows, C Gail Summers, Betty Tung, Robert J Hardy
{"title":"Correlation of recognition visual acuity with posterior retinal structure in advanced retinopathy of prematurity.","authors":"David K Wallace, Don L Bremer, William V Good, Rae Fellows, C Gail Summers, Betty Tung, Robert J Hardy","doi":"10.1001/archophthalmol.2012.2118","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.2118","url":null,"abstract":"<p><p>OBJECTIVE To compare Early Treatment Diabetic Retinopathy Study visual acuity outcome with retinal structural outcome at the 6-year follow-up examination of infants randomized in the Early Treatment for Retinopathy of Prematurity study. METHODS We compared the results in 606 eyes of subjects in whom both functional (visual acuity) and retinal structural assessments were obtained at age 6 years. Visual acuity assessments were performed by masked testers, and retinal examinations were performed by certified ophthalmologists. MAIN OUTCOME MEASURES Visual acuity and retinal structure at age 6 years. RESULTS Concordant outcomes occurred in 462 eyes (76.2%): 402 eyes had favorable functional and structural outcomes and 60 eyes had unfavorable functional and structural outcomes. Discordant outcomes occurred in 92 eyes (15.2%): 86 eyes had unfavorable functional and favorable structural outcomes and 6 eyes had favorable functional and unfavorable structural outcomes. Of the 86 eyes with unfavorable functional and favorable structural outcomes, 43 had optic atrophy (23 eyes) and/or retinal abnormalities that were less severe than those considered to be unfavorable (32 eyes). In 52 eyes (8.6%), retinal structure could not be assessed or the visual acuity was untestable. CONCLUSION Posterior pole appearance correlates well with visual acuity in 6-year-old infants with a history of advanced retinopathy of prematurity. APPLICATION TO CLINICAL PRACTICE When the retinal structure is normal but visual acuity is poor in infants with a history of severe retinopathy of prematurity, other diagnoses such as optic atrophy and cortical visual impairment could at least partially account for the discrepancy. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00027222.</p>","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1512-6"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.2118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30833811","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}
Kaweh Mansouri, Felipe A Medeiros, Ali Tafreshi, Robert N Weinreb
{"title":"Continuous 24-hour monitoring of intraocular pressure patterns with a contact lens sensor: safety, tolerability, and reproducibility in patients with glaucoma.","authors":"Kaweh Mansouri, Felipe A Medeiros, Ali Tafreshi, Robert N Weinreb","doi":"10.1001/archophthalmol.2012.2280","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.2280","url":null,"abstract":"<p><p>OBJECTIVE To examine the safety, tolerability, and reproducibility of intraocular pressure (IOP) patterns during repeated continuous 24-hour IOP monitoring with a contact lens sensor. METHODS Forty patients suspected of having glaucoma (n = 21) or with established glaucoma (n = 19) were studied. Patients participated in two 24-hour IOP monitoring sessions (S1 and S2) at a 1-week interval (SENSIMED Triggerfish CLS; Sensimed AG). Patients pursued daily activities, and sleep behavior was not controlled. Incidence of adverse events and tolerability (visual analog scale score) were assessed. Reproducibility of signal patterns was assessed using Pearson correlations. RESULTS The mean (SD) age of the patients was 55.5 (15.7) years, and 60% were male. Main adverse events were blurred vision (82%), conjunctival hyperemia (80%), and superficial punctate keratitis (15%). The mean (SD) visual analog scale score was 27.2 (18.5) mm in S1 and 23.8 (18.7) mm in S2 (P = .22). Overall correlation between the 2 sessions was 0.59 (0.51 for no glaucoma medication and 0.63 for glaucoma medication) (P = .12). Mean (SD) positive linear slopes of the sensor signal from wake to 2 hours into sleep were detected in both sessions for the no glaucoma medication group (S1: 0.40 [0.34], P < .001; S2: 0.33 [0.30], P < .01) but not for the glaucoma medication group (S1: 0.24 [0.60], P = .06; S2: 0.40 [0.40], P < .001). CONCLUSIONS Repeated use of the contact lens sensor demonstrated good safety and tolerability. The recorded IOP patterns showed fair to good reproducibility, suggesting that data from continuous 24-hour IOP monitoring may be useful in the management of patients with glaucoma. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01319617.</p>","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1534-9"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.2280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30834196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ingrid U Scott, Paul C Vanveldhuisen, Neal L Oden, Michael S Ip, Amitha Domalpally, Bernard H Doft, Michael J Elman, Barbara A Blodi
{"title":"Baseline characteristics and response to treatment of participants with hemiretinal compared with branch retinal or central retinal vein occlusion in the standard care vs corticosteroid for retinal vein occlusion (SCORE) study: SCORE study report 14.","authors":"Ingrid U Scott, Paul C Vanveldhuisen, Neal L Oden, Michael S Ip, Amitha Domalpally, Bernard H Doft, Michael J Elman, Barbara A Blodi","doi":"10.1001/archophthalmol.2012.2728","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.2728","url":null,"abstract":"<p><strong>Objective: </strong>To compare baseline characteristics and treatment response of participants with hemiretinal vein occlusion (HRVO) with those of participants with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO) in the Standard Care vs COrticosteroid for REtinal Vein Occlusion (SCORE) Study.</p><p><strong>Methods: </strong>Eyes were randomized to standard care, 1 mg intravitreal triamcinolone acetonide, or 4 mg intravitreal triamcinolone acetonide. Standard care was observation in the SCORE-CRVO trial and grid photocoagulation in the SCORE-BRVO trial. The HRVO eyes were enrolled in the SCORE-BRVO trial. Baseline characteristics, changes in visual acuity and center point thickness, safety outcomes, and number of treatments were compared among HRVO, BRVO, and CRVO participants.</p><p><strong>Results: </strong>At baseline, HRVO eyes were intermediate between BRVO and CRVO eyes in area of retinal thickening, area of fluorescein leakage, visual acuity, and center point thickness. No differences in visual acuity change from baseline to 1 year were noted between standard care groups for HRVO and BRVO. Within triamcinolone-treated eyes, HRVO eyes did not differ from BRVO eyes in visual acuity change, but HRVO eyes fared better than CRVO eyes. There were no differences in center point thickness change between standard care groups for HRVO and BRVO, nor were there differences across the 3 disease entities for triamcinolone-treated eyes. There were no differences in frequency of protocol treatments and adverse events.</p><p><strong>Conclusions: </strong>The HRVO participants were similar to BRVO and CRVO participants regarding most demographic characteristics, with fundus findings intermediate between BRVO and CRVO. In the SCORE Study, HRVO was treated as BRVO; HRVO eyes responded to treatment similarly to BRVO eyes, and there was no difference among the 3 disease entities in frequency of protocol treatments and adverse events.</p><p><strong>Trial registration: </strong>clinicaltrials.gov Identifier: NCT00105027.</p>","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1517-24"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.2728","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31113943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chromoblastomycosis of the conjunctiva mimicking melanoma of the ciliary body.","authors":"Anh Q Bui, Edgar M Espana, Curtis E Margo","doi":"10.1001/archophthalmol.2012.1573","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.1573","url":null,"abstract":"Yeaney) and Flaum Eye Institute (Dr Hindman), University of Rochester School of Medicine and Dentistry, Rochester, New York. Correspondence: Dr Hindman, Flaum Eye Institute, 601 Elmwood Ave, Box 659, Rochester, NY 14642 (holly _hindman@urmc.rochester.edu). Author Contributions: Dr Hindman had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Conflict of Interest Disclosures: None reported. Funding/Support: This work was supported by grant K23EY019353 from the National Eye Institute, National Institutes of Health. Additional Contributions: Flaum Eye Institute’s Diagnostic Imaging Service obtained the clinical images.","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1615-7"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.1573","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31114958","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":"OCT appearances in acute solar retinopathy.","authors":"Sarah Levy, Leo Sheck, Stephen Guest","doi":"10.1001/archophthalmol.2012.714","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.714","url":null,"abstract":"A patient presented with acute solar retinopathy after gazing directly at the sun. Best-corrected visual acuities were 6/12 and 6/18 in the left and right eyes, respectively. Optical coherence tomography (OCT) demonstrates full-thickness hyperreflective areas (A and B) corresponding to the hypopigmented areas observed on examination (C and D). At 3 months follow-up, the patient’s vision had improved to 6/9 in both eyes. The hypopigmented areas on the maculae had faded (E and F), and OCT shows hyporeflectivity in the outer retinal layers (G and H).","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1540"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.714","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31113945","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":"Treatment of oxidative stress with chelation therapy.","authors":"Marco Zarbin","doi":"10.1001/jamaophthalmol.2013.1306","DOIUrl":"https://doi.org/10.1001/jamaophthalmol.2013.1306","url":null,"abstract":"mentosa. Hahn et al 1 have documented higher iron levels in eyes of patients with age-related macular degeneration than in eyes of age-matched controls (particularly chelatable iron deposition in the retinal pigment epithelium and Bruch membrane). Because iron catalyzes the Fenton reaction (which produces hydroxyl radical), these results may mean that ironmediated oxidative stress contributes to retinal degeneration in age-related macular degeneration. Furthermore, mice deficient in the ferroxidases ceruloplasmin and hephaestin accumulate iron in the retina and subsequently have retinal degeneration with features of age-related macular degeneration. 2,3 In these mice, iron chelation with the orally absorbed and cellpermeant iron chelator deferiprone (Ferriprox) ameliorated oxidative stress and protected against iron overload–induced retinal degeneration. 4 Because other investigators showed that the iron chelator deferoxamine can protect against retinal light damage and retinal ischemia reperfusion injury, Hadziahmetovicetal 5 decidedtotesttherecentlyUSFoodandDrug Administration–approved drug deferiprone because it is orally absorbed and has not been associated with retinal toxic effects in patients or mice. In the current issue of Translational Vision Science & Technology, Hadziahmetovic and colleagues report the ability of deferiprone to preventretinaldegenerationin2distinctpreclinicalmodels: sodium iodate (NaIO3)–induced retinal degeneration and the rd6 mouse. Sodium iodate is a retinotoxin, anditssystemicadministrationrelativelyselectivelydamagesretinalpigmentepitheliumandphotoreceptors.The rd6mutationaffectstheMfrpgene,afrizzled-relatedgene expressed in the retinal pigment epithelium. Mice homozygous for this mutation have an early-onset, slowly progressive loss of photoreceptors. Theinvestigatorsfoundthatsystemicpretreatmentand concomitant treatment with deferiprone modestly improved photoreceptor survival and markedly improved retinal pigment epithelium survival in the NaIO3model. Deferiprone also modestly improved photoreceptor survivalinrd6mice.Whatisthemechanismbywhichdeferiprone exerts these effects? The investigators found that deferiprone diminished NaIO3-induced upregulation of antioxidantandcomplementgenes(C3)causedbyNaIO3. Deferiprone also protected against NaIO3-induced reduction in the levels of visual cycle genesRhoandRpe65, consistent with retinal protection. These and other findings indicate that deferiprone reduces oxidative stress. The finding that deferiprone treatment ameliorated hereditary retinal degeneration due to the rd6 mutation in B6.C3Ga-Mfrprd6/J mutant mice is consistent with the previous work of Obolensky et al, 6 who found that deferoxamine provides functional and structural retina rescueintherd10mousemodelofretinitispigmentosa.Presumably, amelioration of oxidative stress also reduces photoreceptor damage in these models of human retinitis pigmentosa. 7 The dose of deferiprone used in this study is about 3-fol","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1597-8"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaophthalmol.2013.1306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31234007","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":"Use of autologous serum eyedrops for the treatment of ocular surface disease: first US experience in a large population as an insurance-covered benefit.","authors":"Cyril A Dalmon, Naveen S Chandra, Bennie H Jeng","doi":"10.1001/archophthalmol.2012.1652","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.1652","url":null,"abstract":"A utologous serum eyedrops (ASEs) were first reported in the treatment of ocular disease in 1975 and have since been investigated in numerous ocular surface disorders. There are few studies from the United States, yet we know anecdotally that ASEs are used in tertiary care centers across the country. The lack of publicity about ASEs in the United States is, in large part, owing to unique barriers in implementing serum eyedrops as a standard treatment modality: laboratories must follow a manufacturing protocol in compliance with regulatory measures, patients must undergo phlebotomy, and patients must cover the cost. We report here a retrospective review of the first experience with ASEs in a large US patient population as an insurancecovered benefit. We conducted a retrospective record review of all Kaiser Permanente Northern California (KPNC) members (population base of 3.2 million) who began treatment with ASEs for various ocular surface disorders from July 1, 2009, to June 30, 2010, by 11 KPNC cornea specialists. This study population represented all patients who received ASEs for the first time during the initial year in which ASEs were a covered benefit. The serum was collected at approved KPNC laboratories and prepared by Leiter’s Compounding Pharmacy, San Jose, California. Institutional review board approval was granted by KPNC and the University of California, San Francisco Committee on Human Research. Of the 103 patients treated during the study period, 18 were excluded because of prior use of ASEs and 12 were excluded for insufficient medical records, leaving 73 patients included in the study. There were 55 women and 18 men, with a mean age of 65 years. Sixtynine patients received ASEs at a concentration of 100%. While many diseases were treated with ASEs, the leading indication for use was dry eye (Table). Among these patients with dry eye, who were typically recalcitrant to other treatments and often had concurrent indications, we identified 30 patients who had a follow-up visit within 90 days of initiating treatment with ASEs. In this group, 16 patients at the first follow-up visit and 11 at the last visit reported an improvement in symptoms with ASEs (average duration of treatment with ASEs, 8.8 months). Improved corneal staining was noted in 12 of these patients at the follow-up visit and in 13 at the last visit with ASEs. Additionally, topical lubrication use in this group decreased from 25 patients at the initial visit to 15 patients at the follow-up, and topical steroid use decreased from 10 patients to 5 patients (Figure). Seven of the 10 patients with persistent epithelial defects healed with the use of ASEs. The defect had been present for an average of 63 days prior to starting ASEs, and they healed within an average of 42 days. Of the 3 patients whose conditions did not resolve, 2 had perforation during the study period and 1 was lost to followup. We did not find a correlation between the duration of the defect prior to use ","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1612-3"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.1652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31111181","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}
Nandini Venkateswaran, Gabrielle A Yeaney, Holly B Hindman
{"title":"Epithelial downgrowth: an atypical clinicopathological case report.","authors":"Nandini Venkateswaran, Gabrielle A Yeaney, Holly B Hindman","doi":"10.1001/archophthalmol.2012.2475","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.2475","url":null,"abstract":"To The Editor Epithelial downgrowth is a rare but grave complication of intraocular surgery,1,2 that typically presents as epithelial sheets, cysts, or pearls1,2,3,4. Prognosis is poor as incursion of epithelial cells onto anterior chamber structures can result in corneal decompensation, refractory glaucoma, and visual deficits2. Treatment options include enucleation, surgical excision, irradiation, cryotherapy, cautery, laser coagulation, vitrectomy and injections of antimetabolites1,2,3,4,5. The present report describes a case in which epithelial downgrowth presented as an amorphous anterior chamber cellular aggregate, was diagnosed by anterior chamber tap and specular microscopy, and was treated successfully with 5-Fluorouracil.","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1613-5"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.2475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31114957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susan Lewallen, Claudia Perez-Straziota, Van Lansingh, Hans Limburg, Juan Carlos Silva
{"title":"Variation in cataract surgery needs in latin america.","authors":"Susan Lewallen, Claudia Perez-Straziota, Van Lansingh, Hans Limburg, Juan Carlos Silva","doi":"10.1001/archophthalmol.2012.2147","DOIUrl":"https://doi.org/10.1001/archophthalmol.2012.2147","url":null,"abstract":"<p><p>OBJECTIVE To estimate and compare the incidence of operable cataract and the desired cataract surgery rates required to eliminate cataract-related visual impairment in several Latin American settings. METHODS We obtained raw data on age-specific cataract prevalence from standardized population-based surveys. We used the data in a previously described model to estimate the incidence of operable cataract at 11 sites in 10 countries across Latin America. Age-specific incidence rates were then multiplied by corresponding population data to calculate the desired cataract surgery rates needed to eliminate cataract-related visual impairment in eyes in each country. Age-standardized incidence was also calculated to explore potential non-age-related differences in incidence among the countries. RESULTS The desired cataract surgery rates ranged from 3441 to 8935 in the 11 sites. Much of the variation was owing to differing age structures, but there may be important variation in age-specific incidence rates as well. CONCLUSIONS Age structure has a major effect on the number of cataract surgeries needed in different countries of Latin America, and it is essential to consider this when planning cataract surgical services. Potential differences in non-age-related risk factors for cataract among different populations also deserve further study.</p>","PeriodicalId":8303,"journal":{"name":"Archives of ophthalmology","volume":"130 12","pages":"1575-8"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archophthalmol.2012.2147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30835197","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}