Open Ophthalmology Journal最新文献

Objective: It is aimed to determine whether fasting during Ramadan has any significant effect on anterior chamber parameters, visual acuity and intraocular pressures.

Methods: 31 fasting (Group 1) and 30 non-fasting healthy volunteers (Group 2) were enrolled. All cases underwent an ophthalmological examination and anterior segment parameter evaluation (central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), pupil size) with Pentacam before and after the breaking of the Ramadan fast in Group 1, before and after dinner in Group 2.

Results: The mean age was 43.35 ± 13.20 in Group 1, 43.17 ± 12.90 in Group 2 (p= 0.955). No significant difference was detected in any of the parameters in both groups.

Conclusion: There is a need for more detailed and associated studies to understand better about the influence of Ramadan fast on various ocular parameters.

Background: To compare the safety and efficacy between switching to prostaglandin/timolol fixed combination eye drops (PG/timolol FCs) and adding brimonidine to PG analogue monotherapy.

Methods: Eyes of 53 patients with primary open-angle glaucoma or ocular hypertension who were receiving PG analogue monotherapy were included. Participants were randomly divided into two treatment groups: one was prescribed PG/timolol FCs (switched group), and for the other, 0.1% brimonidine was added to the PG analogue (added group). Intraocular pressure (IOP), blood pressure, and pulse rate were measured after 1 and 3 months and compared to baseline values. Participants were also surveyed to determine if they had experienced systemic or topical adverse events at each study visit. IOP changes at 1 and 3 months were compared between groups.

Results: Three months after changing medication, mean IOP was 14.6 ± 2.4 mmHg in the switched group and 13.7 ± 1.8 mmHg in the added group; both were significantly lower than the baseline values (switched group, 16.5 ± 2.7 mmHg; added group, 15.8 ± 2.3 mmHg; both P < 0.001). Neither the mean nor the percentage reductions in IOP were significantly different between groups at 1 and 3 months. In the added group, diastolic blood pressure was lower than that at 1 and 3 months, systolic blood was lower than that at 3 months (P < 0.01). The patients who had experienced systemic or topical adverse events were 53.8% in the added group and 40.7% in the the changed group, which was equivalent between groups (P =0.4142). Three patients (11.5%) in the added group, but none from the switched group, were excluded from analyses because of adverse events (not significant, P = 0.217).

Conclusion: Switching from a PG analogue to PG/timolol FCs or to PG with brimonidine was equally safe (systemically and topically) and effective in reducing IOP. Thus, PG with brimonidine might be appropriate medication in patients who cannot use PG/timolol FCs due to repiratory or circulatory disease.

Background: The diagnosis of plus disease in retinopathy of prematurity (ROP) largely determines the need for treatment; however, this diagnosis is subjective. To make the diagnosis of plus disease more objective, semi-automated computer programs (e.g. ROPtool) have been created to quantify vascular dilation and tortuosity. ROPtool can accurately analyze blood vessels only in images with very good quality, but many still images captured by indirect ophthalmoscopy have insufficient image quality for ROPtool analysis.

Purpose: To evaluate the ability of an image fusion methodology (robust mosaicing) to increase the efficiency and traceability of posterior pole vessel analysis by ROPtool.

Materials and methodology: We retrospectively reviewed video indirect ophthalmoscopy images acquired during routine ROP examinations and selected the best unenhanced still image from the video for each infant. Robust mosaicing was used to create an enhanced mosaic image from the same video for each eye. We evaluated the time required for ROPtool analysis as well as ROPtool's ability to analyze vessels in enhanced vs. unenhanced images.

Results: We included 39 eyes of 39 infants. ROPtool analysis was faster (125 vs. 152 seconds; p=0.02) in enhanced vs. unenhanced images, respectively. ROPtool was able to trace retinal vessels in more quadrants (143/156, 92% vs 115/156, 74%; p=0.16) in enhanced mosaic vs. unenhanced still images, respectively and in more overall (38/39, 97% vs. 34/39, 87%; p=0.07) enhanced mosaic vs. unenhanced still images, respectively.

Conclusion: Retinal image enhancement using robust mosaicing advances efforts to automate grading of posterior pole disease in ROP.

The renin-angiotensin system (RAS), that is known for its role in the regulation of blood pressure as well as in fluid and electrolyte homeostasis, comprises dozens of angiotensin peptides and peptidases and at least six receptors. Six central components constitute the two main axes of the RAS cascade. Angiotensin (1-7), an angiotensin converting enzyme 2 and Mas receptor axis (ACE2-Ang(1-7)-MasR) counterbalances the harmful effects of the angiotensin II, angiotensin converting enzyme 1 and angiotensin II type 1 receptor axis (ACE1-AngII-AT1R) Whereas systemic RAS is an important factor in blood pressure regulation, tissue-specific regulatory system, responsible for long term regional changes, that has been found in various organs. In other words, RAS is not only endocrine but also complicated autocrine system. The human eye has its own intraocular RAS that is present e.g. in the structures involved in aqueous humor dynamics. Local RAS may thus be a target in the development of new anti-glaucomatous drugs. In this review, we first describe the systemic RAS cascade and then the local ocular RAS especially in the anterior part of the eye.

Purpose: The aim was to report the aqueous humor moxifloxacin concentration and proteome profile of an individual with bilateral uveitis-like syndrome with pigment dispersion.

Methods: Multiple reactions monitoring mass spectrometry quantified the aqueous concentration of moxifloxacin in the affected individual. Shotgun proteomic analysis performed via liquid chromatography tandem mass spectrometry (LC-MS/MS) defined the protein profile in the affected individual and unaffected control samples.

Results: Moxifloxacin was present at higher than expected levels in aqueous humor 18 days following oral administration. One-third of the proteins were identified by significantly lower spectral counts in the aqueous of the individual with moxifloxacin associated uveitis compared to the unaffected control.

Conclusion: Moxifloxacin was detected in aqueous humor 18 days following the completion of oral administration. These results suggest that moxifloxacin toxicity may be responsible for the uveitis-like syndrome with pigment dispersion syndrome induced by moxifloxacin therapy.

Purpose: The aim of this study was to report a case of atopic dermatitis showing elevated intraocular pressure (IOP) beyond the baseline levels followed by a modified 360-degree suture trabeculotomy, and to analyze the histological findings in the trabecular meshwork.

Methods: A 40-year-old male suffered from blurred vision in the right eye (OD). He had a medical history of severe atopic dermatitis and intraocular lens implantation OU due to atopic cataract. At the initial presentation, the visual acuity was 0.03, and IOP was 35 mmHg OD. Slit-lamp examination demonstrated corneal epithelial edema OD. Increased IOP was refractory to several topical medications. The patient underwent a modified 360-degree suture trabeculotomy. The visual field defect, however, deteriorated with persistently high IOP. The patient underwent trabeculectomy together with drainage implant surgery. In the outflow routes, although there seemed to be an opening of Schlemm's canal into the anterior chamber, there was no endothelium of the canal in the region of its opening. The fibrotic changes were conspicuous around Schlemm's canal.

Conclusion: The histological results indicated that trabeculotomy might not be an appropriate treatment for patients with atopic glaucoma, possibly because of excessive repair to the newly created uveoscleral outflow in addition to the increased postoperative fibrosis in the trabecular meshwork and Schlemm's canal.

Purpose: To investigate associated systemic diseases, other conditions, visual outcome, ocular complications and treatment in Swedish patients younger than 50 years with central retinal vein occlusion (CRVO) and reviewing the literature.

Methods: Twenty-two patients with CRVO, younger than 50 years, were examined with full-field electroretinography (ERG) within 3 months after a thrombotic event, or were periodically examined and were observed for at least 6 months. In 18 of these patients, the initial retinal ischemia was studied using the cone b-wave implicit time in the 30 Hz flicker ERG. Fifteen patients also underwent fluorescein angiography. Optical coherence tomography (OCT) was performed in 14 patients. The patients studied were divided into two groups, non-ischemic and ischemic, which were compared. All patients underwent ocular and systemic examination, as well as complete screening for thrombophilic risk factors.

Results: Of the 22 patients, 15 had non-ischemic type of CRVO and 7 the ischemic type. Patients with non-ischemic CRVO showed significantly improved visual acuity (VA) at the final examination (p=0.006). Patients with ischemic CRVO showed no significant reduction in VA at the final examination (p=0.225). Systemic hypertension (27% in non-ischemic CRVO and 29% in ischemic CRVO) was the most prevalent systemic risk factor for CRVO. The mean central foveal thickness (CFT) decreased significantly from 402.3±136.2 (µm) at the initial examination to 243.8±48.1 (µm) at the final examination in the non-ischemic group (p=0.005). The mean initial CFT was 444.5±186.1 (µm) in the ischemic CRVO group, which decreased to 211.5±20.2 (µm) at the final visit (p=0.068). Pigment dispersion syndrome (PDS)/pigmentary glaucoma (PG), ocular hypertension and dehydration were equally frequent; four patients each (18%) out of 22. The clinical course of 4 younger patients with PDS/PG are described.

Conclusion: The patients with non-ischemic CRVO showed significantly improved VA and significantly decreased CFT at the final examination. Systemic hypertension was the most prevalent risk factor for CRVO. Younger adults with CRVO also had a high prevalence of PDS/PG, ocular hypertension and dehydration. This study highlights the importance of careful IOP monitoring, and the need to investigate possible PDS/PG and to obtain an accurate history of the patient including alcohol intake and intense exercise.

Background: To evaluate intravitreal injection of expansile sulfur hexafluoride (SF6) as a low cost and effective treatment for symptomatic vitreomacular adhesion (sVMA).

Methods: Retrospective analysis of all patients with sVMA treated with pneumatic vitreolysis using SF6 gas presenting to a clinical practice from January 2005 and June 2013.

Results: Six cases were included in the study. Five patients (83%) experienced complete resolution of the vitreomacular adhesion. One patient had a partial release of the vitreomacular adhesion. Four patients (67%) had a one line improvement in best corrected visual acuity.

Conclusion: Due to its low cost, wide availability, and apparent efficacy, intravitreal injection of expansile SF6 should be investigated further as a possible treatment modality for sVMA.

Background: Anterior lens opacities (ALO) are found in 3-14% of pediatric patients with cataracts. No clear guidelines exist in the management and treatment of these cataracts.

Objective: To evaluate pediatric patients with anterior lens opacities and assess rate of amblyopia and need for surgery over time.

Methods: A retrospective chart review was performed on patients with unilateral and bilateral anterior lens opacities (ALOs) seen between January 2008 and December 2014. Size, location, and type of ALO were noted. Refractive error, necessity for treatment of amblyopia, and interventions were recorded.

Results: A total of 31 patients were included in the study. 17 patients had unilateral ALOs and 14 had bilateral ALOs. The majority of the cataracts (90.3%) were centrally located. The most common type of cataract was the polar type of cataract and the vast majority (48.4%) was < 1mm in size. 38.7% of patients had concurrent ocular conditions and 9.7% had systemic associations. 28.6% of patients with bilateral cataracts and 35.3% of the patients with unilateral cataracts were treated for amblyopia. Three patients required cataract surgery.

Conclusion: About half of anterior lens opacities are less than 1mm in size and the majority are of the polar type. Risk of amblyopia in these patients is higher than in the general population. Anisometropia is the most common cause of amblyopia. Ocular associations are seen at a relatively high frequency and systemic associations can occur but are uncommon. The need for surgical intervention is infrequent; however, growth of ALOs and associated cortical changes may be risk factors for surgery.