Current Issue : April - June Volume : 2012 Issue Number : 2 Articles : 8 Articles
Objective: To identify the clinical and pathological predictor factors for the fellow eye affliction (asynchronous \r\nbilateralization) in patients who were initially diagnosed with unilateral retinoblastoma. \r\nMethods: The present study was conducted in the Department of Ophthalmology of the Faculty of Medicine at \r\nZagazig University in Zagazig, Egypt. All patients initially diagnosed with unilateral retinoblastoma from January 2005 to \r\nDecember 2007 were followed up meticulously for at least 32 months for the development of metastatic disease and/or \r\nfellow eye affliction. At pathological examination, all specimens were stained with hematoxylin (HX) and eosin (E). The \r\nspecimens also underwent special immunohistochemical staining for neuron-specific enolase (NSE). Care was given \r\nto detect optic nerve invasion by the tumor, tumor focality, and tumor differentiation during pathological examination. \r\nResults: Only 3 (16.7%) of the 18 patients initially diagnosed with unilateral retinoblastoma developed a fellow \r\neye affliction, asynchronous bilateralization of retinoblastoma, during the follow-up period. The time lapse to fellow eye \r\naffliction ranged from 3 to 14 months. All 3 patients (100%) were diagnosed at less than 12 months of age (mean, 6.3 \r\nmonths; P < 0.001). Only 1 (33.3%) of the 3 patients had a multifocal tumor (P > 0.05). Of the 3 patients, 2 (66.7%) had \r\na positive family history of retinoblastoma (P < 0.05). Optic nerve invasion and poor tumor differentiation were found \r\nin 2 (66.7%) and 1 (33.3%), respectively, of the 3 patients with asynchronous bilateralization. A statistically significant \r\ncorrelation was found between negative NSE staining and asynchronous bilateralization of retinoblastoma (P < 0.05). \r\nConclusions: This study suggests that earlier age at diagnosis (less than 1 year), positive family history, and \r\nnegative immunohistochemical staining with NSE are possible predictor factors for the development of fellow eye \r\naffliction in patients initially diagnosed with unilateral retinoblastoma....
Background: The foveal contour is asymmetrical in the horizontal optical coherence tomographic (OCT) images\r\nin idiopathic macula holes (IMHs) successfully closed by pars plana vitrectomy (PPV). The purpose of this study was\r\nto compare the parafoveal retinal contour after PPV followed by gas tamponade for IMHs to that after vitrectomy for\r\nrhegmatogenous retinal detachment (RRD).\r\nDesign: Retrospective study.\r\nParticipants: Eleven eyes of 11 IMH patients and 10 eyes of 10 RRD patients who underwent PPV.\r\nMethods: The internal limiting membrane (ILM) was stained with indocyanine green and peeled in the IMH group\r\nbut not in the RRD group. The postoperative retinal thickness was measured by spectral-domain OCT.\r\nMain outcome measures: The parafoveal thicknesses of the operated eyes were compared to the corresponding\r\nareas of the fellow un-operated eyes.\r\nResults: In the IMH group, the average postoperative thickness of the temporal sector was 312.6 �µm and that of\r\nthe corresponding area of the fellow eyes was 330.2 �µm (P <0.05). Similarly, the thickness of the nasal sector was\r\n362.6 �µm and that of the fellow eyes was 345.8 �µm (P<0.05). These differences were not observed in the RRD group.\r\nAdditional measurements showed that the inner retinal layer was thinner in the temporal retina and the outer retinal\r\nlayer was thicker in the nasal retina in the IMH group.\r\nConclusions: The postoperative asymmetrical foveal contour was observed in only the IMH group.\r\nthat these alterations were caused by procedures, such as ILM peeling, rather than the gas tamponade....
not available...
Background: Retinitis pigmentosa is characterized by the sequential loss of rod and cone photoreceptors. The\r\npreservation of cones would prevent blindness due to their essential role in human vision. Rod-derived Cone\r\nViability Factor is a thioredoxin-like protein that is secreted by rods and is involved in cone survival. To validate the\r\nactivity of Rod-derived Cone Viability Factors (RdCVFs) as therapeutic agents for treating retinitis Pigmentosa, we\r\nhave developed e-conome, an automated cell counting platform for retinal flat mounts of rodent models of cone\r\ndegeneration. This automated quantification method allows for faster data analysis thereby accelerating\r\ntranslational research.\r\nMethods: An inverted fluorescent microscope, motorized and coupled to a CCD camera records images of cones\r\nlabeled with fluorescent peanut agglutinin lectin on flat-mounted retinas. In an average of 300 fields per retina,\r\nnine Z-planes at magnification X40 are acquired after two-stage autofocus individually for each field. The projection\r\nof the stack of 9 images is subject to a threshold, filtered to exclude aberrant images based on preset variables.\r\nThe cones are identified by treating the resulting image using 13 variables empirically determined. The cone\r\ndensity is calculated over the 300 fields.\r\nResults: The method was validated by comparison to the conventional stereological counting. The decrease in\r\ncone density in rd1 mouse was found to be equivalent to the decrease determined by stereological counting. We\r\nalso studied the spatiotemporal pattern of the degeneration of cones in the rd1 mouse and show that while the\r\nreduction in cone density starts in the central part of the retina, cone degeneration progresses at the same speed\r\nover the whole retinal surface. We finally show that for mice with an inactivation of the Nucleoredoxin-like genes\r\nNxnl1 or Nxnl2 encoding RdCVFs, the loss of cones is more pronounced in the ventral retina.\r\nConclusion: The automated platform e-conome used here for retinal disease is a tool that can broadly accelerate\r\ntranslational research for neurodegenerative diseases....
Implantation of toric intraocular lens (IOL) during cataract surgery in eyes with irregular astigmatism such as keratoconus and pellucid marginal degeneration (PMD) is controversial with uncertainty over possible deterioration in higher order aberrations (HOAs) following surgery. We report a case of success in bilateral implantation of toric intraocular lenses, the Alcon Acrysof�® model SN60T9, in which the HOAs of one of the PMD eyes were documented pre- and post-operatively with the use of a new aberrometer, the Topcon KR-1W. Overall, uncorrected visual acuity, best-corrected visual acuity, total ocular and internal HOAs of the eye were improved after surgery, and the patient gained spectacle-independence and was happy with the outcome....
Recent literature data reported evidence of the visual and/or anatomical benefits of all clinically available anti-VEGF \r\ndrugs for the treatment of macular edema (ME) following Central Retinal Vein Occlusion (CRVO), up to 1-year followup. There are no randomized clinical trial data on anti-VEGF agents in ischemic CRVO-ME and the use of anti-VEGF \r\nagents to treat this condition. \r\nA 73-year old caucasian man, with a medical history of diabetes and systemic hypertension and an ophthalmic \r\nhistory of ischemic CRVO with cystoid macular edema was referred to our division on January 2011. The ophthalmic \r\nexamination showed in right eye a visual acuity of 20/2000, a C2N1 cataract and an exudative macular detachment. \r\nOn February 2011, a 0.5mg ranibizumab intravitreal injection (Lucentis�®\r\n, Novartis, Basel, Switzerland) was carried out \r\nin the right eye. 15 and 25 days later the OCT showed no changes. On March 2011, we performed a 0.3mg pegaptanib \r\nsodium intravitreal injection (Macugen, Eyetech Pharmaceuticals, Inc. and Pfizer Inc, New York, NY) in the right eye\r\nand 15 days later the fluorescein angiography and the OCT examination showed reabsorption of subretinal fluid, \r\ncomplete disappearing of macular detachment and normalization of foveal profile, with a thickness of 240 �µm and visual \r\nacuity of 20/400. Three months later, foveal profile and visual acuity were unchanged.\r\nIn our refractory ischemic CRVO-ME patient, pegaptanib sodium showed prompt clinical response. In some cases, \r\neven if it is selective for the VEGF\r\n165 \r\nisoform only, pegaptanib sodium could represent a further possibility in such a \r\ntherapeutic challenge....
Aphakic glaucoma is the most common long-term complication seen following congenital cataract surgery. It has \na reported incidence of between 15% and 45%. Many risk factors have been identified including microcornea, early \nsurgery, persistent fetal vasculature, congenital rubella syndrome, Lowe syndrome, chronic inflammation and retained \nlens material. Diagnosis is often difficult as the classic signs of congenital glaucoma such as epiphora, blepharospasm \nand buphthalmos are usually absent. Additionally, it is also difficult to perform accurate ocular examinations on \nyoung children and examination under anaesthesia is usually required. Surgical intervention is often required with \nmedical treatment providing adjunctive therapy. Surgical techniques performed include trabeculectomy with or without \nantifibrotic agents, glaucoma drainage devices (valved and non-valved), cyclodestructive procedures, goniotomy \nand trabeculotomy. Trabeculectomy with mitomycin C and glaucoma drainage devices are the two most commonly \nperformed procedures. In spite of considerable advances having been made in the management of aphakic glaucoma, \nit still poses a significant management dilemma. Despite best standard of care two thirds of aphakic children end up \nwith a mean visual acuity of = 20/400....
Purpose: To compare the AcrySof Toric intraocular lens (IOL) and an AcrySof spherical control IOL and to investigate correction capability of the AcrySof Toric IOL in subjects with cataracts and corneal astigmatism.\r\nDesign: Comparative case series.\r\nMethods: This retrospective review of clinical records comprised 98 eyes with 1.5 to 4.5 diopters (D) of preoperative corneal astigmatism who had cataract surgery and AcrySof T3/T4/T5 toric or AcrySof IQ spherical monofocal IOL implantation. Surgically induced astigmatism (SIA) was calculated for eyes with postoperative keratometry results. The main outcome measures include visual acuity outcomes, Residual astigmatism, IOL position, patient-reported spectacle use, and safety.\r\n Results: One year postoperatively, best spectacle-corrected distance visual acuity of 0.8 was 71% (Toric IOL) versus 67% (control IOL). Uncorrected distance visual acuity of 0.8 or better was 62% (Toric IOL) versus 21% (control IOL; P<0.05). Mean absolute residual refractive cylinder was 0.42 D (Toric IOL) versus 1.36D (control IOL; P<0.01). Mean rotation was 3.21Ã?°Ã?±1.25Ã?° (range, 0Ã?°ââ?¬â??20Ã?°) for the Toric IOL. Three-month spectacle freedom was 57.0% (Toric IOL) and 34.1% (control IOL; P<0.01). Complications in both groups were few and were as would be expected with cataract surgery.\r\n Conclusions: The mean refractive astigmatism after cataract surgery in patients with 1.5 D to 4.5 D of corneal astigmatism was significantly lower when a toric IOL was implanted. The safety results, efficacy and rotational stability support the use of the AcrySof Toric IOL for patients with cataracts and high degree of corneal astigmatism....
Loading....