Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 6 Articles
Background: To evaluate the treatment with topical 0.05% cyclosporine A (CsA) in patients with subepithelial\r\ncorneal infiltrates (SEI).\r\nMethods: We reviewed 16 patients (22 eyes) before and after the treatment with 0.05% CsA eye drops. All patients\r\nhad been treated previously with topical corticosteroids without any improvement and also they had to stop the\r\nmedication secondary to intraocular pressure elevation. The objective data recorded included best-corrected visual\r\nacuity (BCVA), evaluation of corneal subepithelial infiltrate scores (CSIS), intraocular pressure (IOP) prior to treatment\r\nand the last follow-up visit.\r\nResults: Six males (37.5%) and 10 females (62.5%), mean age of 35.2 Ã?± 16.6 years, were included. The patientsââ?¬â?¢\r\naverage topical CsA use duration was 5.1 Ã?± 3.5 months (1 ââ?¬â?? 13 months). The average follow up time of the patients\r\nwas 9.2 Ã?± 4.7 months (4 ââ?¬â?? 22 months). One patient, although he didnââ?¬â?¢t have a 0 scale of SCIS, did not show up for\r\nfollow up examinations after six months. The mean BCVA (logarithm of the minimum angle of resolution) before\r\nand after the treatment were 0.15 Ã?± 0.15 and 0.07 Ã?± 0.07 respectively, CSIS 1.68 Ã?± 0.89 and 0.23 Ã?± 0.53 respectively,\r\nIOP 18.50 Ã?± 3.82 and 16.86 Ã?± 2.76 mmHg respectively. There were statistically significant improvements in BCVA\r\n(p = 0.002), reduction of CSIS (p = 0.002) and reduction of IOP (p < 0.001) prior to treatment and the last follow-up\r\nvisit. 18 eyes (81.9%) showed clinical improvement and 4 (18.1%) had decreased SEI which did not fully disappear\r\nduring the treatment period. The eyes which reached CSIS score 0 (18 eyes) were treated with CsA for\r\n1 ââ?¬â?? 13 months; while the eyes which had clinical improvement but had not CSIS score 0 (4 eyes) were decided to\r\ndiscontinue of CsA treatment in last follow-up visit. There were recurrences in 2 eyes 3 months after the treatment.\r\nPatients reported reduction in the severity of symptoms after the treatment. Most of the patients reported no\r\nforeign body sensation, glare, or other side effects with topical CsA treatment. Overall, patients noted an\r\nimprovement in vision and satisfaction with topical 0.05% CsA treatment.\r\nConclusions: Topical 0.05% CsA is a safe and effective alternative treatment in patients with SEI who do not\r\nrespond to other treatment modalities or have undesired side effects from topical steroids....
Age related Macular Degeneration (AMD) is the leading cause of irreversible blindness in the elderly. The aim of\r\nthe present study is therefore to explore the relationship between the presence of multiple gene polymorphisms and\r\ntwo distinct advanced ââ?¬Å?dry and wetââ?¬Â phenotypes of AMD, and also to assess gene interactions with the influence of\r\npersonal factors.\r\nSeventy three unrelated participants grouped as 29 wet and 26 dry type AMD patients, and 18 healthy controls.\r\nThey were all genotyped for the multiple gene polymorphisms in 12 different genes. Genotyping was carried out\r\nby reverse hybridization. The data set collected was then analysed by using the Bayesian inference methods and\r\nvisualised by means of the Bayesian Networks.\r\nThe results of all the analyses suggest that (1) PAI-14G/5G and FV G1691A genes have the joint roles in the\r\nseparation of the three groups (wet, dry AMD and control group), (2) both wet and dry AMD can be separated from the\r\ncontrol group by the genes PAI-1 4G/5G, FV G1691A, FXII V34L and PT G20210A, (3) the wet AMD and control group\r\ncan be separated by the combination of the ACE I/D and B Fibrinogen-455 G-A gene polymorphisms, (4) the wet AMD\r\nand control group can be distinguished by the combination of the BMI, MTHFR-C677T and PAI-1genes, (5) there is a\r\ncorrelation between the wet AMD and high BMI (>30kg/m2), (6) the impact of BMI on the disease development seems\r\nonly in question with the connective availability of the genes MTHFR C677T and PAI-1.\r\nIt can be concluded that the combination of the MTHFR C677T and PAI-1 4G/5G gene polymorphisms in the\r\npresence of obesity may increase the risk of wet AMD type. In addition, the results further support a complex interplays\r\namong genetic and environmental factors in the development of different phenotypes...
Purpose: to evaluate the effect of Intravitreal tissue plasminogen activator (r-tPA) injection on improvement\r\nof visual acuity and decreasing the rate of complications in Branch Retinal Vein Occlusion (BRVO) and ischemic\r\nComplications in Retinal Vein Occlusion (CRVO).\r\nMethods: 10 patients with BRVO and 19 patients with ischemic CRVO of recent onset (from 4 to 30 days duration)\r\nand visual acuity of <=20/50 were given 100 microgram of tPA intravitreally. Ischemia was defined as an area of\r\nnonperfusion >=10 DD for CRVO and >=5 DD for BRVO. Follow up schedule contained 6 visits : at the time of injection,\r\nand 1 week,1 month, 2months, 3months, and 6 months after. Fluorescein angiography was performed before injection\r\nand at the end of the study.\r\nResults: In ischemic CRVO group: only one eye (5.6%) developed Iris neovascularization. The mean of baseline\r\nvisual acuity increased from 1.8400 LogMAR to 1.5333 LogMAR at the end of the study (p=0.009). Pearson correlation\r\ncoefficient was +0.874 for initial and final measured BCVAs. 8 patients (44.4%) had doubling of visual angle (0.3\r\nLogMAR increase in BCVA).\r\nIn BRVO group: 3 patients (30%) were classified in the ischemic group and after a complete 6 month follow up none\r\nof the cases (0%) developed retinal neovascularization, vitreous hemorrhage, retinal detachment or endophthalmitis.\r\nThe mean of baseline visual acuity increased from 1.0710 LogMAR to 0.6100 at the end of the study (p=0.001).\r\nDiscussion: Comparison between the results of our study and natural history of RVO indicates that after injection:\r\nThere was doubling of visual angle in about 10% of cases. The rate of Iris neovascularization and neovascular glaucoma\r\nwas decreased to 1/6 of what occurs without treatment.\r\nEndophthalmitis, retinal detachment and vitreous hemorrhage which are known as major complications of this\r\nprocedure did not occur in any of our 29 patients....
Background: To investigate indocyanine green angiography (ICGA) findings in patients with long-standing\r\nVogt-Koyanagi-Harada (VKH) disease and their correlation with disease activity on clinical examination as well as\r\nwith systemic corticosteroid therapy.\r\nMethods: Twenty-eight patients (51 eyes) with long-standing (=6 months from disease onset) VKH disease whose\r\ntreatment was tapered based only in clinical features were prospectively included at a single center in Brazil. All\r\npatients underwent standardized clinical evaluation, which included fundus photography, fluorescein angiography\r\nand ICGA. Clinical disease activity was determined based in the Standardization in Uveitis Nomenclature Working\r\nGroup. Fisher exact test and logistic regression models were used for statistical analysis.\r\nResults: Disease-related choroidal inflammation on ICGA was observed in 72.5% (31 of 51 eyes). Angiographic\r\nfindings suggestive of (choroidal and/or retinal) disease activity were not observed on FA. Clinically active disease\r\nbased on clinical evaluation was observed in 41.2% (21 of 51 eyes). In these 21 eyes, disease-related choroidal\r\ninflammation on ICGA was observed in 76.2% (16 of 21 eyes); in the remaining eyes (without clinical active disease)\r\ndisease-related choroidal inflammation on ICGA was observed in 70.0% (21 of 30 eyes). In respect to systemic\r\ncorticosteroid therapy, 10 patients (18 of 51 eyes) were under treatment with prednisone. In these 10 (18 of 51\r\neyes) patients, disease-related choroidal inflammation on ICGA was observed in 83.3% (15 of 18 eyes); in the\r\nremaining patients (33 of 51 eyes) disease-related choroidal inflammation on ICGA was observed in 66.7%\r\n(22 of 33 eyes).\r\nConclusion: ICGA findings suggestive of disease-related choroidal inflammation were observed in a considerable\r\nproportion of patients with long-standing VKH disease, independent of the inflammatory status of the disease on\r\nclinical examination or current use of systemic corticosteroid. Therefore, the current study reinforces the crucial role\r\nof ICGA to assist the management and treatment of patients with long-standing VKH disease....
Nontraumatic subperiosteal hematoma (NTSOH) has been reported to be associated with systemic coagulopathies.\r\nWe present a 52-year-old female with a history of alcohol use who has recently undergone cataract surgery that\r\ndevelops a postoperative NTSOH. Liver disease-associated thrombocytopenia was diagnosed after the development\r\nof the hematoma....
Background: Cataracts are a common and significant cause of visual impairment globally. We aimed to evaluate\r\nuncorrected distance visual acuity (UDVA) as an outcome in treating astigmatic cataract patients to assist clinicians\r\nor ophthalmologists in their decision making process regarding available interventions.\r\nMethods: Medline, Embase and Evidence Based Reviews were systematically reviewed to identify relevant studies\r\nreporting changes in UDVA, UIVA and UNVA after cataract surgery in presbyopic patients. Strict inclusion/exclusion\r\ncriteria were used to exclude any non-relevant studies. Relevant outcomes (UDVA, UIVA and UNVA) were identified\r\nfrom the studies retrieved through the systematic review process.\r\nResults: The systematic review identified 11 studies which reported UCVA. All 11 studies reported UDVA. Four\r\nbrands of toric intraocular lenses (IOLs) were reported in these studies. All studies identified in the literature search\r\nreported improvements in UDVA following surgical implant of a toric IOL. The largest improvements in VA were\r\nreported using the Human Optics MicroSil toric IOL (0.74 LogMAR, UDVA) and the smallest improvements were also\r\nreported using the Human Optics MicroSil toric IOL (0.23 LogMAR, UDVA) in a different study.\r\nConclusions: The results of this systematic review showed the aggregate of studies reporting a beneficial increase\r\nin UDVA with the use of toric IOLs in cataract patients with astigmatism....
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