These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

Bilateral Simultaneous Stage 1 Macular Hole  

PubMed Central

The authors describe two cases of bilateral simultaneous stage 1 macular hole diagnosed via optical coherence tomography (OCT). Vitreomacular traction, foveal pseudo cysts, and outer retinal changes were present initially. Resolution of the foveal pseudo cysts and outer retinal changes occurred in cases where a complete posterior vitreous detachment was noted. The initial step in the pathogenesis of macular holes is “traction” from the detaching posterior hyaloid. However, there are missing links in the exact inciting events and in the progression of the disease. The development of bilateral stage 1 macular holes simultaneously is unique and interesting because an unknown common inciting factor might be at play in these cases. PMID:23053850

Alwassia, Ahmad A.; Adhi, Mehreen; Duker, Jay S.

2014-01-01

2

Bilateral Macular Hole Following Myopic Photorefractive Keratectomy  

PubMed Central

A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole. PMID:24882962

Shoeibi, Nasser; Abrishami, Majid; Ansari-Astaneh, Mohammad-reza

2014-01-01

3

Bilateral macular hole following myopic photorefractive keratectomy.  

PubMed

A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole. PMID:24882962

Shoeibi, Nasser; Jabbarpoor Bonyadi, Mohammad Hossein; Abrishami, Majid; Ansari-Astaneh, Mohammad-Reza

2014-06-01

4

Bilateral choroidal excavation in best vitelliform macular dystrophy.  

PubMed

Focal choroidal excavation (FCE) has recently been described as one or more localized areas of choroidal excavation on spectral-domain optical coherence tomography (SD-OCT). The authors describe a case of bilateral FCE in Best vitelliform macular dystrophy (VMD). SD-OCT revealed FCE in both eyes characterized by interruption of the internal segment-outer segment junction and the presence of subretinal hyporeflective space. This is the first report describing bilateral FCE in a distinct macular disorder and specifically with VMD. Future investigations are warranted to ascertain the involvement of other macular dystrophies with atrophic evolution and the impact of FCE on the clinical course. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:e8-e10.]. PMID:24512759

Parodi, Maurizio Battaglia; Zucchiatti, Ilaria; Fasce, Francesco; Bandello, Francesco

2014-01-01

5

Bilateral cystoid macular edema with giant retinal achromic patch in a patient with tuberous sclerosis.  

PubMed

Retinal astrocytic hamartoma is the most common retinal finding in tuberous sclerosis and has been reported in association with cystoid macular edema. A retinal achromic patch is the second most common retinal finding in tuberous sclerosis. The authors report the first case of bilateral cystoid macular edema in which one the eyes does not have an identifiable retinal astrocytic hamartoma. They also describe a new retinal finding in tuberous sclerosis termed giant retinal achromic patch. PMID:25423644

Andrews, Laura; Lally, David R; Baumal, Caroline R

2014-01-01

6

Bilateral macular hole formation secondary to sclopetaria caused by shockwaves transmitted by a posterior vector: case report  

PubMed Central

Background Sclopetaria is a rare ophthalmic finding in trauma Case Presentation This is a report of a patient who developed macular holes from sclopetaria induced by indirect trauma. A 22-year-old male, suffered a gunshot wound that passed behind his eyes, resulting in bilateral macular hole formation Conclusion To our knowledge, this is the first reported case in which trauma posterior to the globes caused bilateral macular hole formation PMID:20298610

2010-01-01

7

Bilateral macular edema in a patient treated with tamoxifen: a case report and review of the literature.  

PubMed

We present a case of a 41-year-old female patient with progressive bilateral visual loss. On examination, her best corrected visual acuity (BCVA) in her right eye was 3/10 and her BCVA in her left eye was 2/10. Fundus and optical coherence tomography examination revealed severe bilateral macular edema. She had been diagnosed with breast cancer 6 years ago and was receiving tamoxifen at a dosage of 20 mg/day ever since. Tamoxifen therapy was discontinued, and the patient received 250 mg of acetazolamide three times a day for a period of 1 month. Both foveae regained their normal contour within 2 months, and her vision was restored to 10/10 BCVA 3 months later. To our knowledge, this is the first case reported where bilateral intraretinal macular edema is the only retinal manifestation in a patient on oral tamoxifen. PMID:25606038

Zafeiropoulos, Paraskevas; Nanos, Panagiotis; Tsigkoulis, Evangelos; Stefaniotou, Maria

2014-01-01

8

Bilateral Macular Edema in a Patient Treated with Tamoxifen: A Case Report and Review of the Literature  

PubMed Central

We present a case of a 41-year-old female patient with progressive bilateral visual loss. On examination, her best corrected visual acuity (BCVA) in her right eye was 3/10 and her BCVA in her left eye was 2/10. Fundus and optical coherence tomography examination revealed severe bilateral macular edema. She had been diagnosed with breast cancer 6 years ago and was receiving tamoxifen at a dosage of 20 mg/day ever since. Tamoxifen therapy was discontinued, and the patient received 250 mg of acetazolamide three times a day for a period of 1 month. Both foveae regained their normal contour within 2 months, and her vision was restored to 10/10 BCVA 3 months later. To our knowledge, this is the first case reported where bilateral intraretinal macular edema is the only retinal manifestation in a patient on oral tamoxifen. PMID:25606038

Zafeiropoulos, Paraskevas; Nanos, Panagiotis; Tsigkoulis, Evangelos; Stefaniotou, Maria

2014-01-01

9

Bilateral macular infarction as an ocular manifestation of systemic lupus erythematosus (SLE)  

PubMed Central

We report a rare case of bilateral macular infarction as an ocular presenting sign of systemic lupus erythematosus (SLE). A 29-year-old woman presented to our ophthalmologic clinic with a 1-week history of progressive visual loss in her left eye after she had visited a rheumatologic clinic where SLE was diagnosed. At examination, best-corrected visual acuity (BCVA) of the right eye was 6/6, and for the left was counting fingers. Fundus examination revealed perivascular hard exudates along some branches of vessels in both eyes. After pulse therapy, her BCVA in the right eye declined to 6/30 and in the left improved to 3/60. She was administered sub-Tenon’s injections of triamcinolone acetonide 50 mg/week in both eyes for 3 weeks. Her BCVA improved to 3/6 in her right eye and remained at 3/60 in her left eye. Macular infarction is an uncommon but most severe complication of SLE. Early and regular exam of the fundus in patients with SLE is necessary to avoid progression of severe ocular complications. PMID:25246764

Hu, Chih-Ling; Peng, Kai-Ling

2014-01-01

10

Bilateral macular folds as a diagnostic clue to late-presenting posterior microphthalmos.  

PubMed

Posterior microphthalmos with macular folds is a very uncommon condition. We report such an unusual late-presenting case of posterior microphthalmos where macular folds uncovered the diagnosis and discuss the possibility of worsening of macular folds with advancing age. PMID:23947423

Takkar, Brijesh; Bhatia, Indrish; Chandra, Parijat; Ganguly, Anasua; Azad, Rajvardhan

2014-05-01

11

Bilateral macular haemorrhages secondary to hepatitis-associated aplastic anaemia, treated with Nd:YAG laser posterior hyaloidotomy  

PubMed Central

Hepatitis-associated aplastic anaemia (HAAA) is an uncommon but distinct variant of aplastic anaemia in which pancytopenia and bone marrow failure appears 2–3 months after an acute attack of hepatitis. Although bilateral vision loss may rarely be the initial presentation of aplastic anaemia, no such report is known in HAAA. Here the authors report such a case presenting with large premacular subhyaloid haemorrhages secondary to severe anaemia and thrombocytopenia. Anaemic hypoxic damage to the vessel wall together with increased cardiac output and low platelet counts are interacting causal factors in the development of bleeding. Though these haemorrhages are benign and usually improve spontaneously, the presence of blood may cause permanent macular changes before it resolves. Posterior hyaloidotomy enabled rapid resolution of premacular subhyaloid haemorrhage thereby restoring vision and preventing need for vitreo-retinal surgery. These patients should be advised to refrain from valsalva manoeuvres, ocular rubbing and vigorous exercise to prevent ocular morbidity. PMID:22674943

Ranganath, Akshatha; Mariatos, George; Thakur, Shakti

2011-01-01

12

Optical Coherence Tomography of Bilateral Nanophthalmos with Macular Folds and High Hyperopia  

PubMed Central

Importance. There is a conflict about the content of the macular folds in nanophthalmic eyes in the literature. Our study clearly demonstrated that papillomacular folds seen in nanophthalmos or posterior microphthalmos were only composed of neurosensory retina without involvement of retinal pigment epithelium and choroid. Observations. This is a report of two consecutive nanophthalmic patients with macular folds at Maltepe University School of Medicine, Department of Ophthalmology, from January to June 2012. Anterior segment dimensions were near normal. The axial lengths of the eyes were short with markedly shortened posterior segment. A macular fold extending from the center of the fovea towards the optic nerve head was present in all eyes. Optic coherence tomography clearly demonstrated that folds were only composed of neurosensory retina. Binocular visual acuities and refractive errors of the cases were 0.3, 0.2 and +16.00, +15.75 diopters, respectively. Conclusions and Relevance. Our study proposes a surgical option to treat these folds like serous retinal detachments by showing the true content of the folds, although there is not any surgical operation accepted for this condition yet. Further studies dealing with the surgical interventions of these folds should be performed to support this option. PMID:25197593

Kapran, Ziya; Sencan, Sadik; Uyar, Murat; Cam, Ozlem

2014-01-01

13

Bilateral visual outcomes and service utilization of patients treated for 3 years with ranibizumab for neovascular age-related macular degeneration  

PubMed Central

Background The aim of this study was to describe bilateral visual outcomes and the effect of incomplete follow-up after 3 years of ranibizumab therapy for neovascular age-related macular degeneration. Secondarily, the demands on service provision over a 3-year period were described. Methods Data on visual acuity, hospital visits, and injections were collected over 36 months on consecutive patients commencing treatment over a 9-month period. Visual outcome was determined for 1) all patients, using last observation carried forward for missed visits due to early discontinuation and 2) only those patients completing full 36-month follow-up. Results Over 3 years, 120 patients cumulatively attended hospital for 1,823 noninjection visits and 1,365 injection visits. A visual acuity loss of <15 letters (L) was experienced by 78.2% of patients. For all patients (n=120), there was a mean loss of 1.68 L using last observation carried forward for missing values. Excluding five patients who died and 30 who discontinued follow-up, mean gain was 1.47 L. In bilateral cases, final acuity was on average 9 L better in second eyes compared to first eyes. Also, 91% of better-seeing eyes continued to be the better-seeing eye. Conclusion We have demonstrated our approach to describing the long-term service provision and visual outcomes of ranibizumab therapy for neovascular age-related macular degeneration in a consecutive cohort of patients. Although there was a heavy burden with very frequent injections and clinic visits, patients can expect a good level of visual stability and a very high chance of maintaining their better-seeing eye for up to 3 years. PMID:24748766

Chavan, Randhir; Panneerselvam, Swati; Adhana, Parul; Narendran, Nirodhini; Yang, Yit

2014-01-01

14

Macular Pucker  

MedlinePLUS

... is a macular pucker? A macular pucker is scar tissue that has formed on the eye’s macula, ... retina. As the retina heals itself, the resulting scar tissue can cause a macular pucker. Rarely, a ...

15

Macular telangiectasia type 2  

PubMed Central

Macular telangiectasia type 2 is a bilateral disease of unknown cause with characteristic alterations of the macular capillary network and neurosensory atrophy. Its prevalence may be underestimated and has recently been shown to be as high as 0.1% in persons 40 years and older. Biomicroscopy may show reduced retinal transparency, crystalline deposits, mildly ectatic capillaries, blunted venules, retinal pigment plaques, foveal atrophy, and neovascular complexes. Fluorescein angiography shows telangiectatic capillaries predominantly temporal to the foveola in the early phase and a diffuse hyperfluorescence in the late phase. High-resolution optical coherence tomography (OCT) may reveal disruption of the photoreceptor inner segment–outer segment border, hyporeflective cavities at the level of the inner or outer retina, and atrophy of the retina in later stages. Macular telangiectasia type 2 shows a unique depletion of the macular pigment in the central retina and recent therapeutic trials showed that such depleted areas cannot re-accumulate lutein and zeaxanthin after oral supplementation. There have been various therapeutic approaches with limited or no efficacy. Recent clinical trials with compounds that block vascular endothelial growth factor (VEGF) have established the role of VEGF in the pathophysiology of the disease, but have not shown significant efficacy, at least for the nonneovascular disease stages. Recent progress in structure–function correlation may help to develop surrogate outcome measures for future clinical trials. In this review article, we summarize the current knowledge on macular telangiectasia type 2, including the epidemiology, the genetics, the clinical findings, the staging and the differential diagnosis of the disease. Findings using retinal imaging are discussed, including fluorescein angiography, OCT, adaptive optics imaging, confocal scanning laser ophthalmoscopy, and fundus autofluorescence, as are the findings using visual function testing including visual acuity and fundus-controlled microperimetry. We provide an overview of the therapeutic approaches for both non-neovascular and neovascular disease stages and provide a perspective of future directions including animal models and potential therapeutic approaches. PMID:23219692

Issa, Peter Charbel; Gillies, Mark C.; Chew, Emily Y.; Bird, Alan C.; Heeren, Tjebo F.C.; Peto, Tunde; Holz, Frank G.; Scholl, Hendrik P.N.

2013-01-01

16

Macular Degeneration  

MedlinePLUS

... macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older. It is a disease that destroys your sharp, central vision. You need central vision to see objects clearly ...

17

Visual loss related to macular subretinal fluid and cystoid macular edema in HIV-related optic neuropathy.  

PubMed

Optic nerve involvement may occur in various infectious diseases, but is rarely reported after infection by the human immunodeficiency virus (HIV). We report the atypical case of a 38-year-old patient in whom the presenting features of HIV infection were due to a bilateral optic neuropathy associated with macular subretinal fluid and cystoid macular edema, which responded well to antiretroviral therapy. PMID:22581321

Gautier, David; Rabier, Valérie; Jallet, Ghislaine; Milea, Dan

2012-08-01

18

Pathophysiology of Macular Edema  

Microsoft Academic Search

Macular edema is defined as an accumulation of fluid in the outer plexiform layer and the inner nuclear layer as well as a swelling of Müller cells of the retina. It consists of a localized expansion of the retinal extracellular space (sometimes associated with the intracellular space) in the macular area. Macular edema is a common cause of a sudden

Stefan Scholl; Janna Kirchhof; Albert J. Augustin

2010-01-01

19

Bilateral retinal phototoxic injury during cataract surgery in a child.  

PubMed

The intense illumination of the operating microscope has been implicated in photic retinopathy in patients and in animal studies. We report a case of bilateral macular phototoxicity occurring in an eleven-year-old child who underwent bilateral cataract surgery for radiation cataracts. We are unaware of other reports of retinal toxicity occurring during pediatric cataract surgery. We hypothesize that this child may have been predisposed to macular injury because of previous chemotherapy and radiotherapy exposure. Ophthalmic surgeons should be aware that light toxicity from the operating microscope might also occur in the pediatric population. PMID:15226731

Long, Vernon W; Woodruff, Geoffrey H

2004-06-01

20

Delayed Macular Hole Closure  

PubMed Central

Purpose The presented case raises questions regarding the favorable scheduling of planned postoperative care and the ideal observation interval to decide for reoperations in macular hole surgery. Furthermore a discussion about the use of short- and long-acting gas tamponades in macular hole surgery is encouraged. Methods We present an interventional case report and a short review of the pertinent literature. Results We report a case of spontaneous delayed macular hole closure after vitreoretinal surgery had been performed initially without the expected success. A 73-year-old male Caucasian patient presented at our clinic with a stage 2 macular hole in his left eye. He underwent 23-gauge pars plana vitrectomy and internal limiting membrane peeling with a 20% C2F6-gas tamponade. Sixteen days after the procedure, an OCT scan revealed a persistent stage 2 macular hole, and the patient was scheduled for reoperation. Surprisingly, at the date of planned surgery, which was another 11 days later, the macular hole had resolved spontaneously without any further intervention. Conclusions So far no common opinion exists regarding the use of short- or long-acting gas in macular hole surgery. Our case of delayed macular hole closure after complete resorption of the gas tamponade raises questions about the need and duration of strict prone positioning after surgery. Furthermore short-acting gas might be as efficient as long-acting gas. We suggest to wait with a second intervention at least 4 weeks after the initial surgery, since a delayed macular hole closure is possible. PMID:24847257

Distelmaier, Peter; Meyer, Linda M.; Fischer, Marie T.; Philipp, Sebastian; Paquet, Patrick; Mammen, Antje; Haller, Katharina; Schönfeld, Carl-Ludwig

2014-01-01

21

Posttraumatic Giant Macular Hole  

PubMed Central

Introduction Large macular holes secondary to blunt trauma are sometimes seen in young patients within the spectrum of alterations produced by ocular trauma. Methods Observational case report. A 32-year-old woman who had received a blunt trauma (a blow from a fist) to her right eye 10 years previously had experienced a decrease in visual acuity ever since. Results Clinical photographs, fluorescein angiography and optic coherent tomography images revealed a very large macular hole of approximately 1,920 ?m in diameter. Conclusion This case is an uncommonly large variant of a macular hole secondary to blunt trauma in a young patient. PMID:21941507

Hernandez-Da Mota, Sergio E.

2011-01-01

22

X-82 to Treat Age-related Macular Degeneration  

ClinicalTrials.gov

Age-Related Macular Degeneration (AMD); Macular Degeneration; Exudative Age-related Macular Degeneration; AMD; Macular Degeneration, Age-related, 10; Eye Diseases; Retinal Degeneration; Retinal Diseases

2015-01-21

23

Surgical management of macular holes  

Microsoft Academic Search

Objective: The document describes macular hole surgery and examines the available evidence to address questions about the efficacy of the procedure for different stages of macular hole, complications during and after surgery, and modifications to the technique.

William E Benson; Karen C Cruickshanks; Donald S Fong; George A Williams; Michael A Bloome; Donald Allen Frambach; Allan E Kreiger; Robert P Murphy

2001-01-01

24

[Pseudophakic cystoid macular oedema].  

PubMed

Pseudophakic cystoid macular oedema is still a relevant clinical disease entity although major progress in modern cataract surgery has been made within the last decades. The relevance is attributed to the large number of cases that are performed each year. Even after uneventful surgery, a pseudophakic cystoid macular oedema can develop and may lead to severe and lasting visual impairments. In respect to the pathophysiology, four consecutive steps have to be considered: (i) surgical procedure-related induction and release of various inflammation mediators into the anterior chamber; (ii) removal of the physiological lens barrier between the anterior and posterior segments of the eye, leading consecutively to an increase in diffusion rate in either direction; (iii) local action of the inflammation mediators towards the macular area; and (iv) increased vitreoretinal traction due to the anteriorly oriented drive of the vitreous. To prevent the development of a pseudophakic cystoid macular oedema, systemic and ocular pathologies should be treated consequently prior to surgery. Furthermore, an individual risk profile of each patient needs to be evaluated to define the best pre- and postsurgical medical treatment. A less traumatic surgical approach can help to prevent macular oedema development additionally. The diagnosis is made by performing biomicroscopy, fluorescence angiography and optical coherence tomography as well as by evaluating the patients' major complaints. Standard operation procedures or recommended guidelines by the specialised eye associations to prevent and treat pseudophakic cystoid macular oedema are not available up to date. A synopsis of recommendations in the literature suggests a step-wise treatment regimen, including topical medical treatment on the one hand and a surgical approach on the other hand as well as a combination of both, if needed. Topical medical treatment options include the use of non-steroidal, corticosteroid and/or carbonic anhydrase inhibitor eye drops. Surgical interventions include pars plana vitrectomy. PMID:22422145

Bertelmann, T; Witteborn, M; Mennel, S

2012-08-01

25

Diabetic Macular Edema  

NASA Astrophysics Data System (ADS)

The optical coherence tomography (OCT), a noninvasive and noncontact diagnostic method, was introduced in 1995 for imaging macular diseases. In diabetic macular edema (DME), OCT scans show hyporeflectivity, due to intraretinal and/or subretinal fluid accumulation, related to inner and/or outer blood-retinal barrier breakdown. OCT tomograms may also reveal the presence of hard exudates, as hyperreflective spots with a shadow, in the outer retinal layers, among others. In conclusion, OCT is a particularly valuable diagnostic tool in DME, helpful both in the diagnosis and follow-up procedure.

Lobo, Conceição; Pires, Isabel; Cunha-Vaz, José

26

Bilateral ankle edema with bilateral iritis  

Microsoft Academic Search

I report two patient presented to me with bilateral symmetrical ankle edema and bilateral acute iritis. A 42-year-old female\\u000a of Indian origin and 30-year-old female from Somalia both presented with bilateral acute iritis. In the first patient, bilateral\\u000a ankle edema preceded the onset of bilateral acute iritis. Bilateral ankle edema developed during the course of disease after\\u000a onset of ocular

Sunil Kumar

2007-01-01

27

Treatment of idiopathic macular hole with silicone oil tamponade  

PubMed Central

Purpose We analyzed the anatomical and visual outcomes after surgical treatment of idiopathic macular holes with pars plana vitrectomy, internal limiting membrane (ILM) peeling using Brilliant Blue dye, and silicone oil tamponade without postoperative posturing. Methods This was a retrospective interventional study of 10 eyes in eight patients who underwent surgical treatment of idiopathic macular holes using pars plana vitrectomy, ILM peeling using Brilliant Blue dye, and silicone oil tamponade without postoperative posturing. The preoperative staging of macular holes and postoperative anatomic outcomes were assessed using spectral-domain optical coherence tomography. Results All patients were women with a mean age of 66.86 ± 4.8 years. In two patients, bilateral macular holes were present and both eyes were operated on. Stage 2 macular hole was diagnosed in three eyes, three eyes had stage 3, and four eyes had stage 4 macular holes. Anatomical success and closure of the macular hole was achieved in nine eyes (90%) after one operation. In one eye, the macular hole was closed after reoperation. The preoperative mean best-corrected visual acuity (BCVA) was 0.15 decimal units (0.8 logMAR units). Until the end of the follow-up period, BCVA was 0.25 decimal units (0.6 logMAR units). Visual acuity was improved in seven patients (70%). In two patients (20%), visual acuity remained at the same level, and in one eye (10%), visual acuity decreased. Postoperatively, all patients reported a significant reduction of metamorphopsia. Conclusion Initial results after 20G pars plana vitrectomy with peeling of the ILM, use of dye (Brilliant Blue), and tamponade with silicone oil without postoperative posturing gave good anatomical and functional outcome in terms of visual acuity and reduction of metamorphopsia. Taking into account the age of the patients, this method, which does not require prolonged postoperative face-down posturing, was well tolerated by the patients. Because the anatomical and visual outcome as well as the rate of postoperative complications are comparable to those when gas is used as a tamponading agent, silicone oil tamponade can also be safely used as a first option in surgery of macular holes. However, a longer period of follow-up of the operated eyes, as well as a larger group of operated eyes, will be required to identify long-term outcomes of this surgical treatment. PMID:23055662

Ivanovska-Adjievska, Biljana; Boskurt, Salih; Semiz, Faruk; Yuzer, Hakan; Dimovska-Jordanova, Vesna

2012-01-01

28

Macular Hole after Laser In Situ Keratomileusis in a 26-Year-Old Patient  

PubMed Central

The purpose of this study is to describe the 26-year-old patient with developed macular hole after bilateral laser in situ keratomileusis (LASIK). A macular hole with sharp margins and irregular surface of surrounding retina appeared in the left eye of the female 26-year-old patient two months after LASIK for correction of myopia (followup of 6 months). Although the best corrected visual acuity (BCVA) after LASIK was 1.0, after the macular hole has developed BCVA became 0.5. After surgery, the final visual acuity recovered to 0.7. Macular hole may develop after LASIK for myopia correction due to unknown changes of vitreoretinal interface. Complete informed consent must be obtained from patients with high myopic eyes before LASIK. PMID:23840997

Oshitari, Toshiyuki; Sakurai, Madoka; Baba, Takayuki; Yamamoto, Shuichi

2013-01-01

29

Idiopathic macular hole.  

PubMed

Idiopathic macular hole is a disease that arises from adhesion in the vitreomacular interface and can theoretically be treated by vitrectomy surgery. Surgical techniques include removal of the vitreous with or without simultaneous peeling of the internal limiting membrane (ILM), fluid-air exchange, and gas tamponade. Since the advent of microincision vitrectomy surgery, macular hole surgery has been performed with minimal invasiveness, and significant visual improvement is a common outcome. This chapter describes the pathology of this disease, including presurgical evaluation using optical coherence tomography (OCT), and then shows the fundamental techniques required for the surgery. Also important is the understanding of the postsurgical 'healing' process of the disease, which may confirm the fact that the subjective improvement is closely related to the retinal imaging obtained by OCT. More recent advances are the inverted ILM peeling technique for larger macular holes and 27-gauge vitrectomy that can potentially minimize the surgical invasiveness mainly by smaller wound construction and the reduced volume of irrigation during surgery. PMID:25196764

Oh, Hideyasu

2014-01-01

30

Enhanced visualization of acute macular neuroretinopathy by Heidelberg Retina Tomography.  

PubMed

We report Heidelberg Retina Tomography (HRT) findings in a case of bilateral acute macular neuroretinopathy in a 22-year-old man. In addition to fundus photography, fluorescein and indocyanine green angiography, and visual field testing, HRT scans of the macula were performed early in the disease and at a follow up of 2 months. We found typical paracentral scotomata in visual field testing corresponding to sharply delineated, hyporeflective areas of the macula as visualized in HRT II scans. Those lesions were almost invisible on regular fundus photographs. Angiography results were unremarkable. The lesion size decreased over time. The visibility of the lesions was markedly enhanced by HRT scans, thus the diagnosis and follow up of acute macular neuroretinopathy could be facilitated by this non-invasive imaging technique. PMID:16925709

Mirshahi, Alireza; Scharioth, Gàbor B; Klais, Christina M C; Baatz, Holger

2006-08-01

31

Spontaneous closure of macular hole.  

PubMed

We report a case of spontaneous closure of stage-II macular hole. A 66 years old lady presented with decreased vision in her left eye for the last 3 months. Her vision was 6/18 in right eye and finger counting at 3 feet in left eye. Optical coherence tomography showed stage-II macular hole in left eye. There was attachment of vitreous at the edge of the hole. Minimal hole diameter was 119 ?. Macular hole surgery was planned. During follow-up, hole started closing spontaneously. Nine months later, the hole closed and posterior hyaloid membrane separated from the macula. Visual acuity improved to 6/24. The purpose of this case report is to show that stage-II macular hole may close spontaneously with relief of vitreomacular traction. PMID:24906260

Jamil, Ahmad Zeeshan; Aqil, Amash; Khaliq, Javed; Mirza, Khurram Azam

2014-05-01

32

Macular protection with IOLs  

NASA Astrophysics Data System (ADS)

The clinical outcome within one month after phacoemulsification cataract extraction with implantation of the blue-blocking SN60AT IOL was examined prospectively and compared to a retrospectively examined material of implantations of the equivalent SA30AL without blue-blocker. There was no difference in best corrected visual acuity gain between the two lenses. In addition, the subjective color perception was examined for with a questionnaire after the first implantation of blue-blocking IOL and after the second implantation of blue-blocking IOL. Only one patient noted a changed color perception. There are thus strong theoretical reasons to block blue light in IOLs and no short term clinical inconvenience. But, it remains to be proven in long term follow up studies that the blue-blocking IOL protects against macular degeneration.

Soderberg, Per G.; Lofgren, Stefan; Ayala, Marcelo; Dong, Xiuqin; Kakar, Manoj; Mody, Vino; Meyer, Linda; Laurell, Carl-Gustaf

2004-07-01

33

Bilateral ankle edema with bilateral iritis.  

PubMed

I report two patient presented to me with bilateral symmetrical ankle edema and bilateral acute iritis. A 42-year-old female of Indian origin and 30-year-old female from Somalia both presented with bilateral acute iritis. In the first patient, bilateral ankle edema preceded the onset of bilateral acute iritis. Bilateral ankle edema developed during the course of disease after onset of ocular symptoms in the second patient. Both patients did not suffer any significant ocular problem in the past, and on systemic examination, all clinical parameters were within normal limit. Lacrimal gland and conjunctival nodule biopsy established the final diagnosis of sarcoidosis in both cases, although the chest x-rays were normal. PMID:16633708

Kumar, Sunil

2007-07-01

34

Dietary Modification of Human Macular Pigment Density  

Microsoft Academic Search

Purpose. The retinal carotenoids lutein (L) and zeaxanthin (Z) that form the macular pigment (MP) may help to prevent neovascular age-related macular degeneration. The purpose of this study was to determine whether MP density in the retina could be raised by increasing dietary intake of L and Z from foods. Methods. Macular pigment was measured psychophysically for 13 subjects. Serum

Billy R. Hammond; Elizabeth J. Johnson; Robert M. Russell; Norman I. Krinsky; Kyungjin Yeum; Ross B. Edwards; D. Max Snodderly

35

Spontaneous closure of a fully developed macular hole in a severely myopic eye.  

PubMed

Purpose. Myopic macular holes can be difficult to close with surgery and are frequently associated with retinal detachment. We report on a case of a macular hole in a severely myopic eye that underwent spontaneous closure. Methods. An observational case study. Results. A 55-year-old female was referred to Ophthalmology for a central scotoma and metamorphopsia in the right eye. Visual acuity was 1/20 in both eyes. Fundus examination showed loss of the foveal depression, with a small yellow ring in the center of the fovea in the right eye, and a tilted optic disc and peripapillary staphyloma bilaterally. Spectral domain optical coherence tomography (SD-OCT) revealed a fully developed macular hole with a rim of thickened and slightly elevated retina in the right eye. The patient refused surgery. After 4 years of follow-up, her visual acuity improved to 20/40 in the right eye, and SD-OCT revealed spontaneous sealing of the macular hole without bare retinal pigment epithelium. Conclusions. Myopic macular holes represent a challenge regarding their management, and the prognosis is often poor. PMID:24744932

Bruè, C; Rossiello, I; Guidotti, J M; Mariotti, C

2014-01-01

36

Spontaneous Closure of a Fully Developed Macular Hole in a Severely Myopic Eye  

PubMed Central

Purpose. Myopic macular holes can be difficult to close with surgery and are frequently associated with retinal detachment. We report on a case of a macular hole in a severely myopic eye that underwent spontaneous closure. Methods. An observational case study. Results. A 55-year-old female was referred to Ophthalmology for a central scotoma and metamorphopsia in the right eye. Visual acuity was 1/20 in both eyes. Fundus examination showed loss of the foveal depression, with a small yellow ring in the center of the fovea in the right eye, and a tilted optic disc and peripapillary staphyloma bilaterally. Spectral domain optical coherence tomography (SD-OCT) revealed a fully developed macular hole with a rim of thickened and slightly elevated retina in the right eye. The patient refused surgery. After 4 years of follow-up, her visual acuity improved to 20/40 in the right eye, and SD-OCT revealed spontaneous sealing of the macular hole without bare retinal pigment epithelium. Conclusions. Myopic macular holes represent a challenge regarding their management, and the prognosis is often poor. PMID:24744932

Bruè, C.; Rossiello, I.; Guidotti, J. M.; Mariotti, C.

2014-01-01

37

A case of macular subretinal neovascularisation in chronic uveitis probably caused by sarcoidosis.  

PubMed Central

A 29-year-old-man with a 7-year history of bilateral chronic uveitis developed subretinal neovascularisation in the macular area of his right eye. There was a history suggesting sarcoidosis. Long-term therapy with systemic corticosteroids decreased the activity of the uveitis, and the subretinal neovascularisation changed into a cystic scar. After the systemic corticosteroids were discontinued there was a recurrence of the uveitis but not of the subretinal neovascularisation. Images PMID:6179536

Hoogstede, H A; Copper, A C

1982-01-01

38

Bilateral ovarian carcinoma with bilateral uveal melanoma.  

PubMed Central

A case of bilateral uveal melanoma in a 60-year-old woman in association with primary bilateral ovarian carcinoma is described. This is the first case in which ultrastructural studies have been performed on the ocular tumours. Seven previously described cases are summarised, and the extreme rarity of such reports would suggest that this may indeed be a new syndrome. Images PMID:6704361

Mullaney, J; Mooney, D; O'Connor, M; McDonald, G S

1984-01-01

39

Massive Bilateral Serous Retinal Detachment in a Case of Hypertensive Chorioretinopathy  

PubMed Central

Introduction Systemic high blood pressure is related to a variety of retinal manifestations. We present an atypical case of hypertensive chorioretinopathy with massive bilateral serous retinal detachment. Case Report A 26-year-old male with a genitourinary malformation and secondary grade IV chronic kidney failure as well as high blood pressure complained of acute vision loss. Dilated fundus examination evidenced a bilateral serous retinal detachment with macular involvement. The patient was unresponsive to oral antihypertensive therapy and dialysis treatment. The serous retinal detachment progressively decreased after the restoration of dialysis and antihypertensive therapy. The final visual acuity was 0.50 in both eyes. Discussion In cases of serous macular detachment, it is mandatory to rule out different systemic and ocular diseases. The presence of uncontrolled high blood pressure may produce aggressive bilateral retinal changes, thus hypertension must be under early and strict control in order to improve the visual outcomes. PMID:25120474

Villalba-Pinto, Luis; Hernández-Ortega, M. Ángeles; de los Mozos, F. Javier Lavid; Pascual-Camps, Isabel; Dolz-Marco, Rosa; Arevalo, J. Fernando; Gallego-Pinazo, Roberto

2014-01-01

40

Macular pseudohaemorrhage secondary to Allen Dot artefact.  

PubMed

A 34-year-old highly myopic (-11.00 D) woman presented to eye clinic with a 3?day history of right eye paracentral blurring. Visual acuities were 6/6 bilaterally. Clinical examination was normal. Fundus photography showed the classic appearance of a macular haemorrhage. This is a recognised complication of high myopia and would have accounted for the patient's symptoms. However, further photography showed that the haemorrhage seemed to 'jump' around the fundus and was even present in the fellow eye. The apparent haemorrhage was revealed to be an imaging artefact. The 'Allen Dot' is a 6?mm black mask incorporated into retinal cameras to reduce reflection. Rarely, in highly myopic eyes, optical artefact can result. To the best of our knowledge, we are the first in the literature to report artefacts from the Allen Dot masquerading as ophthalmic disease. This case re-iterates the importance of clinical examination, especially in high myopes, given the current trend towards virtual clinics. PMID:25564595

Michaels, Luke; Alexander, Philip; Newsom, Richard

2015-01-01

41

Macular oedema in idiopathic macular telangiectasia type 1 responsive to aflibercept but not bevacizumab.  

PubMed

We report a patient with macular oedema due to type 1 macular telangiectasia responding to intravitreal aflibercept injection. A 51-year-old man was diagnosed with type 1 idiopathic macular telangiectasia (IMT) in the right eye. The macular oedema was refractory to initial treatment with intravitreal bevacizumab and argon laser photocoagulation. The patient was then treated with intravitreal aflibercept injections, following which the macular oedema was completely resolved and his vision was significantly improved. Intravitreal aflibercept injection appears to improve vision and reduce persistent macular oedema secondary to type 1 IMT and demonstrated promising anatomical and visual outcomes. PMID:25349755

Shibeeb, O'Sam; Vaze, Anagha; Gillies, Mark; Gray, Timothy

2014-01-01

42

Macular Oedema in Idiopathic Macular Telangiectasia Type 1 Responsive to Aflibercept but Not Bevacizumab  

PubMed Central

We report a patient with macular oedema due to type 1 macular telangiectasia responding to intravitreal aflibercept injection. A 51-year-old man was diagnosed with type 1 idiopathic macular telangiectasia (IMT) in the right eye. The macular oedema was refractory to initial treatment with intravitreal bevacizumab and argon laser photocoagulation. The patient was then treated with intravitreal aflibercept injections, following which the macular oedema was completely resolved and his vision was significantly improved. Intravitreal aflibercept injection appears to improve vision and reduce persistent macular oedema secondary to type 1 IMT and demonstrated promising anatomical and visual outcomes. PMID:25349755

Shibeeb, O'Sam; Gillies, Mark; Gray, Timothy

2014-01-01

43

Laser therapy and macular degeneration  

NASA Astrophysics Data System (ADS)

Among macular diseases, choroidal neovascularization (CNV) is one of the most common causes of visual loss, especially in the form associated with age-related macular degeneration and pathologic myopia. Research on these diseases has recently evaluated new treatment modalities that use laser light differently; among these, photodynamic therapy (PDT) has been introduced in the clinical practice, allowing us to expand the possibility of reducing visual loss in patients affected by CNV. With PDT, a photosensitizer (verteporfin, VisudyneTM) is injected intravenously, and it selectively binds to new vessels; low-power laser light exposure then activates the drug, leading to oxidative damage of the endothelium and new vessels thrombosis. Yet, other therapies, such as transpupillary termotherapy, or the use of photocoagulation to cause feeder-vessel occlusion, could proof effective, but they need further investigation.

Menchini, Ugo; Virgili, Gianni; Giansanti, Fabrizio; Giacomelli, Giovanni; Cappelli, Stefania

2001-10-01

44

Idiopathic macular telangiectasia type 2 (idiopathic juxtafoveolar retinal telangiectasis type 2A, Mac Tel 2).  

PubMed

Macular telangiectasia type 2-also known as idiopathic perifoveal telangiectasia and juxtafoveolar retinal telangiectasis type 2A or Mac Tel 2-is an acquired bilateral neurodegenerative macular disease that usually manifests itself during the fourth to sixth decades of life and is characterized by minimal dilatation of the parafoveal capillaries with graying of the retinal area involved, a lack of lipid exudation, right-angled retinal venules, refractile deposits in the superficial retina, hyperplasia of the retinal pigment epithelium, foveal atrophy, and subretinal neovascularization (SRNV). Optical coherence tomography images typically demonstrate intraretinal hyporeflective spaces that are usually not related to retinal thickening or fluorescein leakage. The typical fluorescein angiographic finding is a deep intraretinal hyperfluorescent leakage in the temporal parafoveal area. With time the leakage may involve the whole parafovea, but does not extend to the center of the fovea. Long-term prognosis for central vision is variable and depends on the development of SRNV or macular atrophy. Pathogenesis remains unclear, but Müller cells and macular pigment appear to play a central role. Currently there is no known treatment for the underlying cause of this condition, but treatment of the SRNV may be beneficial. PMID:24160729

Wu, Lihteh; Evans, Teodoro; Arevalo, J Fernando

2013-01-01

45

Macular hole surgery following accidental laser injury with a military rangefinder  

NASA Astrophysics Data System (ADS)

An active duty marine corps service member had bilateral full thickness macular holes induced following accidental Q-switched laser exposure from a hand held Neodymium range finder (ANGVS-5). The right eye had a large hole nasal to the fovea, while the left eye had a much smaller hole closer to the fovea centralis. Over the 18 months following the injury, the left eye demonstrated mild progressive degradation in visual function, but retained 20/20 final visual acuity. In contrast, the hole in the right eye increased in size, developed a localized retinal detachment with cystic changes in the fovea, and had atrophy of the retinal pigment epithelium. Within 6 months after injury, acuity declined to 20/100. Macular hole surgery was performed with a goal of sealing the edges of the hole in order to allow resolution of the localized detachment and cystic changes in the fovea. In spite of surgical techniques that are generally successful in the treatment of macular holes associated with other etiologies, the fundus findings remained unchanged and visual acuity declined to 20/400. To the best of our knowledge, this is the first case report of macular hole surgery for this condition.

Custis, Peter H.; Gagliano, Donald A.; Zwick, Harry; Schuschereba, Steven T.; Regillo, Carl D.

1996-04-01

46

Surgery for full-thickness macular hole in patients with idiopathic macular telangiectasia type 2.  

PubMed

The authors report surgical outcomes of full-thickness macular hole repair in two patients with idiopathic macular telangiectasia in a non-comparative case series. Both patients underwent pars plana vitrectomy with indocyanine green-assisted internal limiting membrane peeling and injection of 16% C(3)F(8) gas. Patients were imaged with optical coherence tomography (OCT) before and after surgery. The first patient demonstrated macular hole closure on examination and OCT with visual improvement from 20/50 preoperatively to 20/30 after macular hole surgery and subsequent cataract surgery. The second patient's hole closed per OCT immediately after surgery but reopened 4 months later, and visual acuity remained 20/70. Macular hole surgery may be an effective treatment in patients with idiopathic macular telangiectasia and full-thickness macular holes and should be further investigated. PMID:21158375

Gregori, Ninel; Flynn, Harry W

2010-01-01

47

Bilateral assymetric epidural hematoma  

PubMed Central

Background: Acute bilateral extradural hematoma is a rare presentation of head trauma injury. In sporadic cases, they represent 0.5–10% of all extradural hematomas. However, higher mortality rates have been reported in previous series. Case Description: The authors described the case of a 28-year-old male presenting head injury, comatose, Glasgow Coma Scale of 6, anisocoric pupils without puppilary light reflex. Computed tomography showed asymmetric bilateral epidural hematomas, effacement of the lateral ventricles and sulci, midline shift and a bilateral skull fracture reaching the vertex. Surgical evacuation was performed with simultaneous hematoma drainage. Patient was discharged on the 29th postoperative day with no neurological deficit. Conclusion: The correct approach on bilateral epidural hematomas depends on the volume, moment of diagnosis, and neurological deficit level. Simultaneous drainage of bilateral hematomas has been demonstrated to be an effective technique for it, which soon decreases the intracranial pressure and promotes an efficient resolution to the neurological damage. PMID:25657867

Pereira, Edmundo Luis Rodrigues; Rodrigues, Daniella Brito; Lima, Lorena Oliveira; Sawada, Luis Armando; Hermes, Mário de Nazareth

2015-01-01

48

Macular Pigment and Lutein Supplementation in Choroideremia  

Microsoft Academic Search

Choroideremia is an incurable X-linked retinal degeneration caused by mutations in the gene encoding Rab escort protein-1. A group of clinically defined and genotyped patients were studied to determine: (1) the degree of rod and cone dysfunction and structural abnormality in the central retina and the level of macular pigment; and (2) the response of macular pigment and foveal vision

Jacque L. Duncan; Tomas S. Aleman; Leigh M. Gardner; Elaine De Castro; Daniel A. Marks; Jessica M. Emmons; Michelle L. Bieber; Janet D. Steinberg; Jean Bennett; Edwin M. Stone; Ian M. MacDonald; Artur V. Cideciyan; Maureen G. Maguire; Samuel G. Jacobson

2002-01-01

49

The genetics of inherited macular dystrophies  

PubMed Central

The aim of this paper is to review current knowledge relating to the monogenic macular dystrophies, with discussion of currently mapped genes, chromosomal loci and genotype-phenotype relationships. Inherited systemic disorders with a macular dystrophy component will not be discussed. PMID:12960208

Michaelides, M; Hunt, D; Moore, A

2003-01-01

50

Iris Color and Macular Pigment Optical Density  

Microsoft Academic Search

The present study was designed to assess the relationship between iris color and macular pigment optical density. Both melanin and carotenoids (responsible for iris color and macular pigment composition, respectively) appear to protect the retina through similar mechanisms and higher concentrations may reduce the incidence of retinal degenerations. To evaluate this relationship, 95 subjects were examined and the following variables

BILLY R. HAMMOND JR.; KENNETH FULD; MAX D. SNODDERLY

1996-01-01

51

Spontaneous closure of traumatic macular hole  

PubMed Central

Macular hole formation is a well-known complication following ocular trauma. Less commonly recognised is the spontaneous closure of such holes. A 27-year-old man presented with a history of blunt trauma to his left eye. Eye evaluation showed conjunctival laceration, diffuse retinal oedema and multiple retinal haemorrhages in that eye. A month later, he developed a full thickness macular hole. Two months later, there was spontaneous complete closure of the full-thickness macular hole in the left eye as confirmed on optical coherence tomography. Spontaneous closure of hole is not uncommon. Observation for a period of up to 12 months is a reasonable management option. Macular hole surgery for traumatic macular holes may be delayed in such cases. PMID:23961017

Sanjay, Srinivasan; Yeo, Tun Kuan; Au Eong, Kah-Guan

2012-01-01

52

Macular telangiectasia type 2 (MacTel) in a 34-year-old patient.  

PubMed

We report macular telangiectasia type 2 (MacTel) in a 34-year-old man, the youngest patient so far published with MacTel type 2. The patient presented with metamorphopsia and impaired reading ability. Diagnosis was based on bilateral abnormal macular autofluorescence, perifoveal telangiectasia with fluorescein angiographic hyperfluorescence without cystoid oedema, a small foveal avascular zone, asymmetric configuration of the foveal pit, disruptions in the inner segment/outer segment layer and hyper-reflective haze and spots in the outer nuclear layer. Although MacTel usually manifests with a slowly progressive decrease in visual acuity in the fifth to seventh decades of life, younger patients may occasionally be diagnosed with the disease. Awareness of subtle signs of the condition is essential for early diagnosis. PMID:25249218

Nicolai, Heleen; Wirix, Mieke; Spielberg, Leigh; Leys, Anita

2014-01-01

53

Macular hole in Behçet's disease  

PubMed Central

Objective: To investigate the clinical features, prevalence, role of surgical intervention and the visual prognosis of macular holes (MH) in patients with Behcet's disease (BD). Materials and Methods: Retrospective study of patients with BD and MH from January 1998 to November 2008. Results: Out of 159 patients, 21 eyes of 17 patients were identified with MH. The mean age was 38.59 (range 23-61) years and the mean follow-up period was 5.1 years (range 13-164 months). The prevalence of MH was 7%. Visual acuity (VA) at the time of presentation ranged from 20/70 to hand-motion. Optical coherence tomography (OCT) findings revealed intraretinal cysts at the edge of the MH. The mean size of MH was 983.6 um; 52% had elevated edges, 43% had flat edges and only one eye (5%) was closed postoperatively. Fluorescein angiography (FA) was consistent with macular ischemia in 76% of the cases. Human leukocyte antigen (HLA) B51 association was found in 14 of the 15 patients investigated. Six patients (out of 17) underwent pars plana vitrectomy. The final VA on their last follow-up ranged from 20/70 to 2/200. Surgical intervention for MH did not result in any visual improvement as compared to non-operated eyes. One patient lost vision completely due to elevated intraocular pressure post vitrectomy and silicon oil tamponade. Conclusions: MH in patients with BD may lead to significant visual disability. Surgical intervention does not seem to have any potential beneficial effect on the VA, probably due to significant macular ischemia and sequelae from the ocular inflammation. PMID:21836340

Al-Dhibi, Hassan; Abouammoh, Marwan; Al-Harthi, Essam; Al-Gaeed, Abdulrahman; Larsson, Jorgen; Abboud, Emad; Chaudhry, Imtiaz

2011-01-01

54

Ranibizumab in diabetic macular edema  

PubMed Central

By 2050 the prevalence of diabetes will more than triple globally, dramatically increasing the societal and financial burden of this disease worldwide. As a consequence of this growth, it is anticipated that there will be a concurrent rise in the numbers of patients with diabetic macular edema (DME), already among the most common causes of severe vision loss worldwide. Recent available therapies for DME target the secreted cytokine, vascular endothelial growth factor (VEGF). This review focuses on the treatment of DME using the first humanized monoclonal antibody targeting VEGF that has been Food and Drug Administration-approved for the use in the eye, ranibizumab (Lucentis®). PMID:24379922

Krispel, Claudia; Rodrigues, Murilo; Xin, Xiaoban; Sodhi, Akrit

2013-01-01

55

Macular full-thickness and lamellar holes in association with type 2 idiopathic macular telangiectasia  

Microsoft Academic Search

PurposeTo describe patients with full-thickness macular holes (FTMHs) and lamellar macular holes (LMHs) in association with type 2 idiopathic macular telangiectasia (type 2 IMT).MethodsSix patients with either FTMH or LMH and type 2 IMT were evaluated by means of optical coherence tomography (OCT) imaging, funduscopy, and fluorescein angiography.ResultsThe age of the examined patients ranged from 57 to 70 years (mean

P Charbel Issa; H P N Scholl; A Gaudric; P Massin; A E Kreiger; S Schwartz; F G Holz

2009-01-01

56

Advances in the management of macular degeneration  

PubMed Central

Current management of age-related macular degeneration (AMD) can be divided into two categories: first, anti-vasoendothelial growth factor (anti-VEGF) injection for wet macular degeneration; second, anti-oxidant vitamins for dry macular degeneration. New therapies are being developed for both of these diseases using novel technologies and different modes of administration. The hope is that some of these therapies will achieve significant improvement to current management and prevent future loss of vision in this devastating eye condition. PMID:24860651

2014-01-01

57

Unilateral Idiopathic Macular Telangiectasia with Choroidal Neovascularization.  

PubMed

A 40-year-old man with decreasing visual acuity in his left eye over 1 year, diagnosed elsewhere as vein occlusion and treated unsuccessfully by systemic steroids was reported. Retrospective analysis of available previous imaging studies was undertaken, and a retrospective diagnosis of idiopathic macular telangiectasia (IMT) was made. Examination revealed subfoveal neovascularization and retinochoroidal anastomosis (RCA) in his left eye with macular edema and exudates surrounding it. The right eye was normal. Current fluorescein angiography (FA) confirmed the presence of choroidal neovascularization and RCA, and optical coherence tomography (OCT) demonstrated cystoid macular edema and subfoveal neovascularization.The patient was diagnosed with unilateral idiopathic macular telangiectasia complicated by subretinal neovascularization. The presences of a choroidal neovascularization process and an RCA have not, to our knowledge, been reported in this type of IMT. PMID:20337307

Mezad-Koursh, Daphna; Zayit-Soudry, Shiri; Barak, Adiel; Loewenstein, Anat

2010-03-01

58

Macular Degeneration Prevention and Risk Factors  

MedlinePLUS

... Individuals with diets high in fat, cholesterol and sugar, and low in antioxidants are more likely to be affected by age-related macular degeneration. Obesity - Overweight individuals are more likely to be affected ...

59

Cystoid macular edema associated with acitretin  

PubMed Central

Summary Cystoid macular edema represents a “final common pathway” response of the retina to a variety of insults. It has been reported in association with vascular problems, inflammatory conditions, inherited diseases, tractional problems, intraocular surgery and medications. We report a case of cystoid macular edema associated with acitretin in a 65-year-old woman and document its resolution with optical coherence tomography (OCT). PMID:24459457

Yap, Joel; Buller, Alex

2013-01-01

60

Bilateral pisotriquetral loose bodies  

PubMed Central

Case reports detailing diagnosis and effective treatment of pisotriquetral loose bodies are scarce. This article describes an even rarer case of bilateral pisotriquetral joint loose bodies, explores the relative diagnostic roles of magnetic resonance imaging versus computed tomography, and outlines effective strategies used for the management of this condition drawn from the literature and our own experience. PMID:22507708

Williams, GR; Holland, P; Beazley, J; Hyder, N

2012-01-01

61

Bilateral clicking ribs.  

PubMed Central

Congenital abnormalities of the ribs, including slipping or clicking rib, are well recognised but rarely give rise to symptoms. Slipping rib has previously been described as a unilateral condition. We report an unusual case of symptomatic bilateral slipping ribs treated successfully by surgery. PMID:2928991

Parry, W; Breckenridge, I; Khalil, Y F

1989-01-01

62

Management of macular epiretinal membrane by vitrectomy and intravitreal triamcinolone  

PubMed Central

A patient underwent successful vitrectomy for macular epiretinal membrane with anatomical and functional improvement. 10 weeks later, there was a recurrence of macular edema with corresponding visual decline. An intravitreal injection of triamcinolone acetonide not only restored the macular anatomy but also improved the visual outcome beyond that achieved after surgery. PMID:23571236

Shukla, Dhananjay

2014-01-01

63

VISUAL OUTCOME CORRELATES WITH INNER MACULAR VOLUME IN EYES WITH SURGICALLY CLOSED MACULAR HOLE  

PubMed Central

Purpose To determine the macular morphologic features that correlate best with visual outcome in eyes with surgically closed idiopathic macular hole. Methods Transversal observational case series of 24 eyes (22 subjects) imaged postoperatively using high-resolution Fourier domain optical coherence tomography (FD-OCT). Total and inner macular volume for central 3 mm area, central foveal thickness, and size of foveal inner segment–outer segment junction abnormality were correlated with best-corrected visual acuity. Microperimetry (MP-1) test was performed in a subset of 18 eyes. Results Mean postoperative best-corrected visual acuity was 20/36 (range, 20/25–20/70). Postoperative follow-up mean was 32.97 ± 24.68 months (range, 5–96 months). Eighteen eyes underwent internal limiting membrane (ILM) peeling. Among FD-OCT parameters, logarithm of the minimum angle of resolution best-corrected visual acuity and mean total microperimetry-1 sensitivity correlated best with inner macular volume in all eyes and ILM-peeled eyes (P < 0.05). Macular surface irregularities were noted in 12 eyes (66.7%) with ILM peeling but in none of the non–ILM-peeled eyes (P = 0.02). No significant correlation was found between microperimetry-1 sensitivity and other FD-OCT parameters. Conclusion Because inner macular volume strongly correlated with visual outcome in eyes with surgically closed macular hole, the possible effect of ILM peeling on visual outcome needs to be further investigated. PMID:23095727

PILLI, SUMAN; ZAWADZKI, ROBERT J.; WERNER, JOHN S.; PARK, SUSANNA S.

2013-01-01

64

Bilateral Mandibular Paramolars  

PubMed Central

ABSTRACT Supernumerary tooth is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. They can cause a variety of complications in the develo­ping dentition. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. Here is the presentation of a case of unusual location of supernumerary teeth located in between mandibular first and second molar region bilaterally. How to cite this article: Dhull KS, Dhull RS, Panda S, Acharya S, Yadav S, Mohanty G. Bilateral Mandibular Paramolars. Int J Clin Pediatr Dent 2014;7(1):40-42. PMID:25206236

Dhull, Rachita Singh; Panda, Swagatika; Acharya, Sonu; Yadav, Shweta; Mohanty, Gatha

2014-01-01

65

Bilateral Sagittal Split Osteotomy  

PubMed Central

The bilateral sagittal split osteotomy is an indispensable tool in the correction of dentofacial abnormalities. The technique has been in practice since the late 1800s, but did not reach widespread acceptance and use until several modifications were described in the 1960s and 1970s. Those modifications came from a desire to make the procedure safer, more reliable, and more predictable with less relapse. Those goals continue to stimulate innovation in the field today and have helped the procedure evolve to be a very dependable, consistent method of correction of many types of malocclusion. The operative surgeon should be well versed in the history, anatomy, technical aspects, and complications of the bilateral sagittal split osteotomy to fully understand the procedure and to counsel the patient. PMID:24872760

Monson, Laura A.

2013-01-01

66

Bilateral sagittal split osteotomy.  

PubMed

The bilateral sagittal split osteotomy is an indispensable tool in the correction of dentofacial abnormalities. The technique has been in practice since the late 1800s, but did not reach widespread acceptance and use until several modifications were described in the 1960s and 1970s. Those modifications came from a desire to make the procedure safer, more reliable, and more predictable with less relapse. Those goals continue to stimulate innovation in the field today and have helped the procedure evolve to be a very dependable, consistent method of correction of many types of malocclusion. The operative surgeon should be well versed in the history, anatomy, technical aspects, and complications of the bilateral sagittal split osteotomy to fully understand the procedure and to counsel the patient. PMID:24872760

Monson, Laura A

2013-08-01

67

Acute serous macular detachment and cystoid macular edema after uncomplicated phacoemulsification using standard dose subconjunctival cefuroxime.  

PubMed

Acute toxic serous macular detachment after cataract surgery is very rare, and has been described previously with the use of high concentrations of intra-cameral cefuroxime. We report a case of serous macular detachment and cystoid macular edema 1 day after uncomplicated phacoemulsification using standard dose subconjunctival cefuroxime at the end of surgery. Our case demonstrates that subconjunctival cefuroxime may cause retinal toxicity in a similar fashion to intra-cameral cefuroxime, possibly due to entry of the drug into the anterior chamber through the section or trans-scleral absorption. To our knowledge, this is the first report of this complication with subconjunctival administration of cefuroxime. PMID:24147948

Kontos, Andreas; Mitry, Danny; Althauser, Susanne; Jain, Saurabh

2014-09-01

68

[Epidemiology and development of macular edema in the diabetic].  

PubMed

Macular edema is the first cause of blindness in diabetics. Macular edema is defined by macular thickening or deposits of hard exudates. On 1000 diabetics examined over 2 years, 60 patients had a macular edema of which we retained 38 cases(54 eyes). All the patients had an ophthalmologic examination with a retinal angiography. Laser photocoagulation with green Argon laser was instituted in 50 eyes. 63% had background rethinopathy. Total or partial regression of the edema happened in 84.4%. Laser photocoagulation decrease by the half vision loss risk. Interest of early detection and treatment to decrease blindness incidence of macular edema in diabetics. PMID:11892440

Zghal-Mokni, I; Jeddi, A; Boujemaa, C; Ben Hadj Alouane, W; Gaigi, S; Ayed, S

2001-12-01

69

Diabetic macular edema: New promising therapies.  

PubMed

The treatment of diabetic macular edema is rapidly evolving. The era of laser therapy is being quickly replaced by an era of pharmacotherapy. Several pharmacotherapies have been recently developed for the treatment of retinal vascular diseases such as diabetic macular edema. Several intravitreal injections or sustained delivery devices have undergone phase 3 testing while others are currently being evaluated. The results of clinical trials have shown the superiority of some of these agents to laser therapy. However, with the availability of several of these newer agents, it may be difficult to individualize treatment options especially those patients respond differently to various therapies. As such, more effort is still needed in order to determine the best treatment regimen for a given patient. In this article, we briefly summarize the major new therapeutic additions for the treatment of diabetic macular edema and allude to some future promising therapies. PMID:24379924

Shamsi, Hanan N Al; Masaud, Jluwi S; Ghazi, Nicola G

2013-12-15

70

Macular Hole Progression following Ocriplasmin Intravitreal Injection  

PubMed Central

Ocriplasmin is a protease which has been approved for the treatment of symptomatic vitreomacular adhesion (VMA). A 63-year-old presented with blurred vision in the left eye and a best corrected visual acuity of 6/18. Optical coherence tomography revealed VMA with an underlying macular hole and she subsequently underwent a left intravitreal ocriplasmin injection. One week after the injection, VMA had been released but with enlargement of the macular hole and a drop in her BCVA to 6/60. This persisted at 1 month after the injection. It is important to warn patients that ocriplasmin may lead to an enlargement of their macular hole with resultant loss in visual acuity.

Casswell, Edward; Fernandez-Sanz, Guillermo; Mitry, Danny; Luk, Sheila; Zakir, Rahila

2014-01-01

71

Macular Hole Progression following Ocriplasmin Intravitreal Injection.  

PubMed

Ocriplasmin is a protease which has been approved for the treatment of symptomatic vitreomacular adhesion (VMA). A 63-year-old presented with blurred vision in the left eye and a best corrected visual acuity of 6/18. Optical coherence tomography revealed VMA with an underlying macular hole and she subsequently underwent a left intravitreal ocriplasmin injection. One week after the injection, VMA had been released but with enlargement of the macular hole and a drop in her BCVA to 6/60. This persisted at 1 month after the injection. It is important to warn patients that ocriplasmin may lead to an enlargement of their macular hole with resultant loss in visual acuity. PMID:25580329

Casswell, Edward; Fernandez-Sanz, Guillermo; Mitry, Danny; Luk, Sheila; Zakir, Rahila

2014-01-01

72

Diabetic macular edema: New promising therapies  

PubMed Central

The treatment of diabetic macular edema is rapidly evolving. The era of laser therapy is being quickly replaced by an era of pharmacotherapy. Several pharmacotherapies have been recently developed for the treatment of retinal vascular diseases such as diabetic macular edema. Several intravitreal injections or sustained delivery devices have undergone phase 3 testing while others are currently being evaluated. The results of clinical trials have shown the superiority of some of these agents to laser therapy. However, with the availability of several of these newer agents, it may be difficult to individualize treatment options especially those patients respond differently to various therapies. As such, more effort is still needed in order to determine the best treatment regimen for a given patient. In this article, we briefly summarize the major new therapeutic additions for the treatment of diabetic macular edema and allude to some future promising therapies. PMID:24379924

Shamsi, Hanan N Al; Masaud, Jluwi S; Ghazi, Nicola G

2013-01-01

73

Bilateral episcleral brachytherapy in simultaneous choroidal melanoma and circumscribed hemangioma  

PubMed Central

Purpose To describe the efficacy of episcleral brachytherapy in a choroidal melanoma and circumscribed hemangioma arising in both eyes of the same patient. Case report We present the case of a 47 year old man who presented decreased visual acuity a few months preceding initial consult. On fundoscopy, he presented a melanotic lesion in the right eye, and a red-orange choroidal mass in the macular area of the left eye. Material and methods B scan-ultrasound, fluorescein, and indocyanine green angiography, confirmed the diagnosis of choroidal melanoma in the right eye, and circumscribed choroidal hemangioma in the left eye. Episcleral brachytherapy with 125I was performed in both eyes consecutively. Results and Conclusions Bilateral episcleral brachytherapy successfully treated both tumors, preserving the eyes and useful visual function. PMID:24474976

Saornil, María Antonia; García-Álvarez, Ciro; Martín, Francisco Lopez-Lara; Frutos-Baraja, Jesus María

2013-01-01

74

Macular pigmentary alterations after repeated viewing of argon laser trabeculoplasty  

NASA Astrophysics Data System (ADS)

We evaluated retinal morphologic and visual functional changes in two individuals accidentally exposed to argon laser 'flashback' from an incorrectly placed laser protective filter while viewing a routine argon laser trabeculoplasty. These exposures, measured in the absence of a patient's eye, are in the region of the maximal permissible exposure. The patients were followed with serial visual function testing, scanning laser ophthalmoscopy (CSLO) and chromatic contrast sensitivity. The first individual received 54 monocular exposures. Acute examination revealed inferior and central Amsler grid abnormalities. These distortions matched the CSLO evidence of pigmentary changes in the corresponding retinal field. Initial contrast sensitivity showed high spatial frequency loss which increased during the ensuring 1.5 months. Chromatic contrast sensitivity revealed high spatial frequency loss for long wavelength test targets and broad spatial frequency loss with short wavelength targets. The second individual received fewer exposures bilaterally. Both eyes showed foveal morphologic alterations with non-selective changes in Moreland anomaloscopic matches, indicative of macular edema. We have shown a correlation between ophthalmoscopic and functional measures of spatial vision. Progressive loss in contrast sensitivity and spatial chromatic functional loss were associated with the more severe exposure while minimal changes were observed with fewer exposures.

Scales, David K.; Zwick, Harry; Lund, David J.; Belkin, Michael; Loveday, J.

1997-05-01

75

Cistoid macular edema as first manifestation of sarcoidosis.  

PubMed

The purpose of this study is to report a case of cystoid macular edema (CME) as a rare first manifestation of ocular sarcoidosis after cataract surgery. A 60-year-old male developed a CME following uneventful phacoemulsification cataract extraction on his left eye. It resolved with conventional medical therapy. One year later the patient was diagnosed with bilateral CME. Oral corticosteroid therapy produced a significant regression. His medical and ocular histories were unremarkable and all tests for etiological diagnosis were negative. There were inflammation recurrences in his left eye, which were also treated with steroids. Optical coherence tomography showed complete resolution of foveal thickening without improvement in vision. Four years later, the patient presented with CME in both eyes. The laboratory tests included high angiotensin-converting enzyme levels and a gallium scan which were also consistent with sarcoidosis. Azathioprine was needed for management of ocular involvement, but it was withheld due to side-effects. At the present time, the CME is controlled with low-dose corticoids. Ocular involvement in sarcoidosis occurs in 20-50 % of patients. CME is not often the initial manifestation of the disease, but ocular sarcoidosis may present with a wide variety of ocular symptoms in all parts of the eye. Therefore, sarcoidosis should be kept in mind when evaluating a patient with ocular inflammation. PMID:24322273

Cabrillo-Estevez, Lucia; de Juan-Marcos, Lourdes; Kyriakou, Danai; Hernández-Galilea, Emiliano

2014-08-01

76

Bilateral Optic Neuropathy with Bilateral Putaminal Lesions: A Case Report.  

PubMed

Bilateral optic neuropathy with bilateral putaminal lesions may be caused by methanol or cyanide poisoning or mitochondrial disorders including Leber hereditary optic neuropathy and Leigh syndrome. We report the case of a 34-year-old Japanese man who developed bilateral visual loss 5 days after the development of gastrointestinal symptoms. Magnetic resonance imaging of the brain on admission revealed high-intensity signal areas in the bilateral putamina on diffusion-weighted and T2-weighted images as well as a high-intensity signal area in the left middle cerebellar peduncle that had been identified 3 years previously. We diagnosed bilateral optic neuropathy with bilateral putaminal lesions caused by preceding infection-triggered demyelination. We administered methylprednisolone, but his vision did not recover. PMID:25052423

Togawa, Jumpei; Ohi, Takekazu

2014-07-23

77

The Intravitreal Autologous Platelet Concentrate Injection as an Adjunct of Vitrectomy for the Treatment of Refractory Macular Holes  

ClinicalTrials.gov

Macular Hole With High Myopia (Spherical Equivalent ? -6.0 Diopters) or,; Large Size Macular Hole (Diameter > 600 Microns) or; Recurred or Failed Macular Hole From Previous Surgery; or Chronic Macular Hole (Symptom Duration > 6 Months)

2014-03-06

78

Age-related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly, and the prevalence of the disease increases exponentially with every decade after age 50 years. It is a multifactorial disease involving a complex interplay of genetic, environmental, metabolic, and functional factors. Besides smoking, hypertension, obesity, and certain dietary habits, a growing body of evidence indicates that inflammation and the immune system may play a key role in the development of the disease. AMD may progress from the early form to the intermediate form and then to the advanced form, where two subtypes exist: the nonneovascular (dry) type and the neovascular (wet) type. The results from the Age-Related Eye Disease Study have shown that for the nonneovascular type of AMD, supplementation with high-dose antioxidants (vitamin C, vitamin E, and ?-carotene) and zinc is recommended for those with the intermediate form of AMD in one or both eyes or with advanced AMD or vision loss due to AMD in one eye. As for the neovascular type of the advanced AMD, the current standard of therapy is intravitreal injections of vascular endothelial growth factor inhibitors. In addition, lifestyle and dietary modifications including improved physical activity, reduced daily sodium intake, and reduced intake of solid fats, added sugars, cholesterol, and refined grain foods are recommended. To date, no study has demonstrated that AMD can be cured or effectively prevented. Clearly, more research is needed to fully understand the pathophysiology as well as to develop prevention and treatment strategies for this devastating disease. PMID:23580402

Cheung, Lily K; Eaton, Angie

2013-08-01

79

Costs and Quality of Life in Diabetic Macular Edema: Canadian Burden of Diabetic Macular Edema Observational Study (C-REALITY)  

PubMed Central

Purpose. To characterize the economic and quality of life burden of diabetic macular edema (DME) in Canadian patients. Patients and Methods. 145 patients with DME were followed for 6 months with monthly telephone interviews and medical chart reviews at months 0, 3, and 6. Visual acuity in the worst-seeing eye was assessed at months 0 and 6. DME-related healthcare costs were determined over 6 months, and vision-related (National Eye Institute Visual Functioning Questionnaire) and generic (EQ-5D) quality of life was assessed at months 0, 3, and 6. Results. Mean age of patients was 63.7 years: 52% were male and 72% had bilateral DME. At baseline, visual acuity was categorized as normal/mild loss for 63.4% of patients, moderate loss for 10.4%, and severe loss/nearly blind for 26.2%. Mean 6-month DME-related costs/patient were as follows: all patients (n = 135), $2,092; normal/mild loss (n = 88), $1,776; moderate loss (n = 13), $1,845; and severe loss/nearly blind (n = 34), $3,007. Composite scores for vision-related quality of life declined with increasing visual acuity loss; generic quality of life scores were highest for moderate loss and lowest for severe loss/nearly blind. Conclusions. DME-related costs in the Canadian healthcare system are substantial. Costs increased and vision-related quality of life declined with increasing visual acuity severity. PMID:24795818

Gonder, John R.; Walker, Valery M.; Barbeau, Martin; Zaour, Nancy; Zachau, Bryan H.; Hartje, James R.; Li, Ruihong

2014-01-01

80

Ischemic Bilateral Opercular Syndrome  

PubMed Central

Opercular syndrome, also known as Foix-Chavany-Marie syndrome, is a paralysis of the facial, pharyngeal, masticatory, tongue, laryngeal, and brachial muscles. It is a rare cortical form of pseudobulbar palsies caused by vascular insults to bilateral operculum. Its clinical presentations include anarthria, weakness of voluntary muscles involving face, tongue, pharynx, larynx, and masticatory muscles. However, autonomic reflexes and emotional activities of these structures are preserved. In the present case, an 81-year-old male presented with acute onset of anarthria with difficulties in chewing, speaking, and swallowing that was diagnosed with opercular syndrome. PMID:23476665

Milanlioglu, Aysel; Ayd?n, Mehmet Nuri; Gökgül, Alper; Hamamc?, Mehmet; Erkuzu, Mehmet Atilla; Tombul, Temel

2013-01-01

81

Bilateral Testicular Epidermoid Cysts  

PubMed Central

Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a correct pre-operative diagnosis on imaging to enable a testis-sparing surgery. PMID:21915385

Loberant, Norman; Bhatt, Shweta; Messing, Edward; Dogra, Vikram S.

2011-01-01

82

Lutein, Zeaxanthin, and the Macular Pigment  

Microsoft Academic Search

The predominant carotenoids of the macular pigment are lutein, zeaxanthin, and meso-zeaxanthin. The regular distribution pattern of these carotenoids within the human macula indicates that their deposition is actively controlled in this tissue. The chemical, structural, and optical characteristics of these carotenoids are described. Evidence for the presence of minor carotenoids in the retina is cited. Studies of the dietary

John T Landrum; Richard A Bone

2001-01-01

83

Driving and Age-Related Macular Degeneration  

PubMed Central

This article reviews the research literature on driving and age-related macular degeneration, which is motivated by the link between driving and the quality of life of older adults and their increased collision rate. It addresses the risk of crashes, driving performance, driving difficulty, self-regulation, and interventions to enhance, safety, and considers directions for future research. PMID:20046818

Owsley, Cynthia; McGwin, Gerald

2009-01-01

84

Genetic susceptibility to age related macular degeneration  

Microsoft Academic Search

Age related macular degeneration (AMD) is the leading cause of visual impairment in the elderly and a major cause of blindness in the developed world. The disease can take two forms, geographic atrophy and choroidal neovascularisation. The pathogenesis of AMD is poorly understood. There are undoubtedly environmental and other risk factors involved and the adverse effect of smoking is well

John R W Yates; Anthony T Moore

2000-01-01

85

Lamellar macular hole after intravitreal ocriplasmin injection.  

PubMed

Intravitreal ocriplasmin was recently approved by the Food and Drug Administration to achieve medical vitreolysis in the setting of vitreomacular adhesion (VMA). We report a case of a 76-year-old woman who developed a lamellar macular hole following treatment with intravitreal ocriplasmin injection for VMA. A pathophysiological mechanism to explain this previously unreported complication of ocriplasmin injection is proposed. PMID:25576512

Chod, Ross Bronson; Goodrich, Clifford; Saxena, Sandeep; Akduman, Levent

2015-01-01

86

Novel Rodent Models for Macular Research  

PubMed Central

Background Many disabling human retinal disorders involve the central retina, particularly the macula. However, the commonly used rodent models in research, mouse and rat, do not possess a macula. The purpose of this study was to identify small laboratory rodents with a significant central region as potential new models for macular research. Methodology/Principal Findings Gerbillus perpallidus, Meriones unguiculatus and Phodopus campbelli, laboratory rodents less commonly used in retinal research, were subjected to confocal scanning laser ophthalmoscopy (cSLO), fluorescein and indocyanine green angiography, and spectral-domain optical coherence tomography (SD-OCT) using standard equipment (Heidelberg Engineering HRA1 and Spectralis™) adapted to small rodent eyes. The existence of a visual streak-like pattern was assessed on the basis of vascular topography, retinal thickness, and the topography of retinal ganglion cells and cone photoreceptors. All three species examined showed evidence of a significant horizontal streak-like specialization. cSLO angiography and retinal wholemounts revealed that superficial retinal blood vessels typically ramify and narrow into a sparse capillary net at the border of the respective area located dorsal to the optic nerve. Similar to the macular region, there was an absence of larger blood vessels in the streak region. Furthermore, the thickness of the photoreceptor layer and the population density of neurons in the ganglion cell layer were markedly increased in the visual streak region. Conclusions/Significance The retinal specializations of Gerbillus perpallidus, Meriones unguiculatus and Phodopus campbelli resemble features of the primate macula. Hence, the rodents reported here may serve to study aspects of macular development and diseases like age-related macular degeneration and diabetic macular edema, and the preclinical assessment of therapeutic strategies. PMID:20976212

Huber, Gesine; Heynen, Severin; Imsand, Coni; vom Hagen, Franziska; Muehlfriedel, Regine; Tanimoto, Naoyuki; Feng, Yuxi; Hammes, Hans-Peter; Grimm, Christian; Peichl, Leo; Seeliger, Mathias W.; Beck, Susanne C.

2010-01-01

87

Microperimetry and optical coherence tomography in a case of traumatic macular hole and associated macular detachment with spontaneous resolution  

PubMed Central

The association of macular detachment with posttraumatic macular hole is a known but rare occurrence. Spontaneously occurring resolution of the detachment and closure of the macular hole has been reported only once in the literature. We describe a similar rare event in a young male, the documentation of which was done serially by microperimetry (MP) and optical coherence tomography (OCT). A 17-year-old male presented with a decrease in vision following a closed globe injury to the left eye. A coexisting macular hole and macular detachment were detected in the affected eye. Serial follow-up with OCT and MP documented complete resolution of the macular hole and the macular detachment within 1 week of presentation. The case highlights that spontaneous resolution of traumatic macular hole and related macular detachment may occur and a waiting period is advisable before undertaking any corrective surgical procedure. The pathophysiologic mechanisms of causation and the resolution of posttraumatic macular hole-related retinal detachment are discussed. PMID:22218253

Aalok, Lalit; Azad, Rajvardhan; Sharma, Yog R; Phuljhele, Swati

2012-01-01

88

Retinal Crystals in Type 2 Idiopathic Macular Telangiectasia  

PubMed Central

Purpose To characterize the phenotype and investigate the associations of intraretinal crystalline deposits in a large cohort of Type 2 Idiopathic Macular Telangiectasia (MacTel) Design Case-control study Participants Patients with and without retinal crystals from the Macular Telangiectasia Project, an international multi-centre prospective study of Type 2 MacTel. Methods Grading of stereoscopic 30° colour fundus (CF), confocal blue light reflectance (CBR), red-free (RF) and infrared (IR) images was performed according to the MacTel Natural History Study protocol and staged using the classification system devised by Gass & Blodi. SD-OCT and adaptive optics imaging were used for a finer analysis of the phenotype. Associations between crystals and other characteristics of the disease as well as potential risk factors were investigated. Main outcome measures Presence of crystals, fundus signs of MacTel, clinical characteristics, presence of potential risk factors of MacTel. Results Out of 443 probands enrolled in the MacTel study, 203 (46%) had crystalline deposits present; 60% of the cases were bilateral at baseline. Eyes with crystals had a mean letter score of 70.7 (SD=15.9) while those without crystals had a mean of 66.5 letters (SD=15.5, p<0.001). Crystals were present at all stages of the disease and showed high reflectivity within a wide wavelength range. They were located at the anterior surface of the nerve fibre layer, arranged along the nerve fibres, within an annular area centred on the fovea. Significant associations of crystalline deposits were found with a loss of retinal transparency, MPOD loss, fluorescein leakage, retinal thickness and a break in the IS/OS junction line. Associations with environmental risk factors were not found. Conclusions Intraretinal crystals are a frequent phenomenon associated with type 2 MacTel, they may appear at all stages and may aid in the early diagnosis of the disease. Their morphology further implicates Müller cells in the pathogenesis of the disease. Insight into their physical and chemical properties may provide clues to the metabolic pathways involved in the pathogenesis of the disease. PMID:21839520

Sallo, Ferenc B; Leung, Irene; Chung, Mina; Wolf-Schnurrbusch, Ute EK; Dubra, Alfredo; Williams, David R; Clemons, Traci; Pauleikhoff, Daniel; Bird, Alan C; Peto, Tunde

2012-01-01

89

Effect of change in macular birefringence imaging protocol on retinal nerve fiber layer thickness parameters using GDx VCC in eyes with macular lesions.  

PubMed

This study evaluates the effect of two macular birefringence protocols (bow-tie retardation and irregular macular scan) using GDx VCC on the retinal nerve fiber layer (RNFL) thickness parameters in normal eyes and eyes with macular lesions. In eyes with macular lesions, the standard protocol led to significant overestimation of RNFL thickness which was normalized using the irregular macular pattern protocol. In eyes with normal macula, absolute RNFL thickness values were higher in irregular macular pattern protocols with the difference being statistically significant for all parameters except for inferior average thickness. This has implications for monitoring glaucoma patients who develop macular lesions during the course of their follow-up. PMID:24469116

Dada, Tanuj; Tinwala, Sana I; Dave, Vivek; Agarwal, Anand; Sharma, Reetika; Wadhwani, Meenakshi

2014-08-01

90

International relations office BILATERAL AGREEMENTS  

E-print Network

International relations office BILATERAL AGREEMENTS UdeM CANDIDATES BILATERAL STUDENT EXCHANGE PROGRAMS APPLICATION FOR PARTICIPATION YEAR 2014-2015 2015-2016 CANDIDATE IDENTIFICATION Last name : ________ Winter semester : (Jan. to April) Number of UdeM credits : ________ Summer semester : (May to Aug

Parrott, Lael

91

Silicosis with bilateral spontaneous pneumothorax  

PubMed Central

Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax. The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature. PMID:20931041

Fotedar, Sanjay; Chaudhary, Dhruva; Singhla, Vikas; Narang, Rajat

2010-01-01

92

Bilateral cholesteatoma and habitual sniffing  

Microsoft Academic Search

Objective: To examine the clinical findings of acquired bilateral cholesteatoma with special reference to incidence of habitual sniffing and sniff-related negative middle ear pressure. Methods: Eighty-eight fresh cases of unilateral cholesteatoma and 33 fresh cases of bilateral cholesteatoma, which were operated on at Department of Otolaryngology, Hyogo College of Medicine, were examined in this study. Responses to a detailed questionnaire

Kojiro Tsuji; Mieko Sone; Masao Kakibuchi; Masafumi Sakagami

2002-01-01

93

Papillary thyroid carcinoma: bilateral choroidal metastases with extrascleral extension.  

PubMed

Here, we present the case of a patient with bilateral choroidal metastases with extraocular extension in one eye. Metastasis of papillary thyroid carcinoma to the uvea is extremely rare, with only 6 patients reported in the literature. A 62-year-old man with a prior history of papillary thyroid carcinoma suffered the rapid loss of vision in his right eye. He had neovascular glaucoma, total retinal detachment, and a solitary choroidal mass. A month later, his left visual acuity also decreased because of a small macular choroidal mass. The right eye was enucleated and a nodular lesion over the sclera representing extraocular extension was observed. This tumor and the intraocular lesion were composed of papillary excrescences and cystic spaces and stained positively for thyroid transcription factor 1 and thyroglobulin, all confirming the diagnosis of metastatic papillary thyroid carcinoma. The tumor in the left eye was successfully treated with diode laser transpupillary thermotherapy. The patient expired within a month as a result of widespread pulmonary metastases. Papillary thyroid carcinoma may metastasize to the uvea bilaterally, cause rapid visual function loss, erode the sclera, and may extend outside the globe similar to choroidal melanoma. This aggressive ocular involvement was associated with a dismal prognosis in our patient. PMID:23730117

Kiratli, Hayyam; Tarlan, Berçin; Söylemezo?lu, Figen

2013-06-01

94

Macular pigment and its contribution to vision.  

PubMed

Three dietary carotenoids, lutein (L), zeaxanthin (Z) and meso-zeaxanthin (MZ) accumulate at the central retina (macula), where they are collectively referred to as macular pigment (MP). MP's pre-receptoral absorption of blue light and consequential attenuation of the effects of chromatic aberration and light scatter are important for optimal visual function. Furthermore, antioxidant activity of MP's constituent carotenoids and the same blue light-filtering properties underlie the rationale for its putative protective role for age-related macular degeneration (AMD). Supplementation with L, Z and MZ augments MP and enhances visual performance in diseased and non-diseased eyes, and may reduce risk of AMD development and/or progression. PMID:23760061

Loskutova, Ekaterina; Nolan, John; Howard, Alan; Beatty, Stephen

2013-06-01

95

Macular Pigment and Its Contribution to Vision  

PubMed Central

Three dietary carotenoids, lutein (L), zeaxanthin (Z) and meso-zeaxanthin (MZ) accumulate at the central retina (macula), where they are collectively referred to as macular pigment (MP). MP’s pre-receptoral absorption of blue light and consequential attenuation of the effects of chromatic aberration and light scatter are important for optimal visual function. Furthermore, antioxidant activity of MP’s constituent carotenoids and the same blue light-filtering properties underlie the rationale for its putative protective role for age-related macular degeneration (AMD). Supplementation with L, Z and MZ augments MP and enhances visual performance in diseased and non-diseased eyes, and may reduce risk of AMD development and/or progression. PMID:23760061

Loskutova, Ekaterina; Nolan, John; Howard, Alan; Beatty, Stephen

2013-01-01

96

Management of pseudophakic cystoid macular edema.  

PubMed

Pseudophakic cystoid macular edema (PCME) is a common complication following cataract surgery. Acute PCME may resolve spontaneously, but some patients will develop chronic macular edema that affects vision and is difficult to treat. This disease was described more than 50 years ago, and there are multiple options for clinical management. We discuss mechanisms, clinical efficacy, and adverse effects of these treatment modalities. Topical non-steroidal anti-inflammatory agents and corticosteroids are widely used and, when combined, may have a synergistic effect. Intravitreal corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents have shown promise when topical medications either fail or have had limited effects. Randomized clinical studies evaluating anti-VEGF agents are needed to fully evaluate benefits and risks. When PCME is either refractory to medical therapy or is associated with significant vitreous involvement, pars plana vitrectomy has been shown to improve outcomes, though it is associated with additional risks. PMID:25438734

Guo, Suqin; Patel, Shriji; Baumrind, Ben; Johnson, Keegan; Levinsohn, Daniel; Marcus, Edward; Tannen, Brad; Roy, Monique; Bhagat, Neelakshi; Zarbin, Marco

2014-09-01

97

Increased resolution macular thickness mapping by OCT.  

PubMed

Optical coherence tomography (OCT) poor mapping resolution has been pointed out as the biggest disadvantage of this technique when compared to others, e.g., retinal thickness analyzer. In this work we were able to solve this problem by developing an atlas of macular thickness of the human retina into which OCT scans were thereafter registered. This atlas is used to allow registering OCT scans from the Fast Macular Protocol, thus bringing OCT scans into the atlas coordinates, therefore correcting for misfixations, while simultaneously allowing to perform OCT inter-scan registration. From this initial registration, we were able to compute a thickness map into which Fast RNFL Protocol scans were merged, thus allowing for increased OCT mapping resolution. PMID:17946646

Bernardes, Rui; Santos, Torcato; Cunha-Vaz, José

2006-01-01

98

Chronic meningitis with intracranial hypertension and bilateral neuroretinitis following Mycoplasma pneumoniae infection.  

PubMed

A previously well 12-year-old boy presented with a 2-week history of headache, nausea, vomiting and left-sided weakness. He subsequently developed meningism, right abducens nerve palsy, persistent papilloedema and reduced visual acuity in association with a bilateral macular star, consistent with neuroretinitis. Cerebrospinal fluid (CSF) examination indicated chronic meningitis and serological testing confirmed recent Mycoplasma pneumoniae infection, although PCR in CSF was negative. He was treated for aseptic meningitis with ceftriaxone, aciclovir, azithromycin and acetazolamide for intracranial hypertension, with gradual improvement in clinical condition and visual acuity over several weeks. This is the first report of M. pneumoniae chronic meningitis further complicated with bilateral neuroretinitis and intracranial hypertension. Evidence of central nervous system inflammation in the absence of direct infection suggests an immune-mediated pathophysiology. Although the use of macrolides with antibiotic and immunomodulatory activity might be beneficial, it was not possible to ascertain whether it influenced clinical recovery in this case. PMID:25538215

Karampatsas, Konstantinos; Patel, Himanshu; Basheer, Sheikh N; Prendergast, Andrew J

2014-01-01

99

Defective Lipid Transport and Biosynthesis in Recessive and Dominant Stargardt Macular Degeneration  

PubMed Central

Stargardt disease is a common inherited macular degeneration characterized by a significant loss in central vision in the first or second decade of life, bilateral atrophic changes in the central retina associated with degeneration of photoreceptors and underlying retinal pigment epithelial cells, and the presence of yellow flecks extending from the macula. Autosomal recessive Stargardt disease, the most common macular dystrophy, is caused by mutations in the gene encoding ABCA4, a photoreceptor ATP binding cassette (ABC) transporter. Biochemical studies together with analysis of abca4 knockout mice and Stargardt patients have implicated ABCA4 as a lipid transporter that facilitates the removal of potentially toxic retinal compounds from photoreceptors following photoexcitation. An autosomal dominant form of Stargardt disease also known as Stargardt-like dystrophy is caused by mutations in a gene encoding ELOVL4, an enzyme that catalyzes the elongation of very long chain fatty acids in photoreceptors and other tissues. This review focuses on the molecular characterization of ABCA4 and ELOVL4 and their role in photoreceptor cell biology and the pathogenesis of Stargardt disease. PMID:20633576

Molday, Robert S.; Zhang, Kang

2010-01-01

100

Macular hole formation in a patient with Irvine-Gass syndrome: coincidence or rare complication?  

PubMed Central

Background Macular edema (ME) is caused by abnormal retinal capillary permeability and has also been described as a postoperative complication of cataract surgery (Irvine-Gass syndrome). Objective To present a patient with Irvine-Gass syndrome in the right eye complicated with a macular hole (MH) in the same eye and possible associations between these two entities. Case report A 72-year-old male with a history of uneventful bilateral cataract surgery was followed-up with biomicroscopy and optical coherence tomography (OCT). Four weeks after cataract surgery oculus dexter (OD), there was progressive visual deterioration (best corrected visual acuity [BCVA]: 0.5). OCT disclosed cystoid ME. A parabulbar triamcinolone injection, dexamethasone 0.1% and ketorolac 0.4% eye drops, both 4 times per day OD were administered. Six weeks later (BCVA OD: 0.2), OCT revealed cystoid ME and full-thickness MH. Conclusion ME secondary to diabetes or central retinal vein occlusion may lead to MH by inducing focal vitreomacular traction and by triggering inflammatory mechanisms which facilitate a marked thinning of the fovea. MH may occur even in cases of pseudophakic ME, representing a rare complication of Irvine-Gass syndrome. PMID:23885166

Moschos, Marilita M; Gatzioufas, Zisis; Rotsos, Tryfon; Symeonidis, Chrysanthos; Song, Xuefei; Seitz, Berthold

2013-01-01

101

PERIFOVEAL VITREOUS DETACHMENT AND ITS MACULAR COMPLICATIONS  

PubMed Central

Purpose To evaluate the vitreoretinal relationship in eyes with idiopathic macular disorders putatively caused by vitreomacular traction associated with early stages of age-related posterior vitreous detachment (PVD). Methods Retrospective observational case series of 43 eyes of 40 patients diagnosed with one of several idiopathic vitreomacular conditions. Included patients had no biomicroscopic evidence for complete PVD on presentation and underwent a specific clinical assessment of the vitreoretinal relationship. Affected eyes were evaluated with slit-lamp biomicroscopy, B-scan ultrasonography, optical coherence tomography, and/or intraoperative examination of the posterior hyaloid. Results By one or more examination techniques, 41 (95.3%) of the 43 study eyes had evidence of vitreous detachment from the perifoveal macular region and the remaining two eyes had complete PVD. When measurable, the size of the vitreomacular adhesion varied by diagnosis. Of 31 eyes with perifoveal vitreous detachment seen in follow-up, only three (9.7%) showed progression to complete PVD over an average preoperative or total follow-up period of 30.0 months (range, 2 to 237 months). Surgical or spontaneous separation of the residual vitreomacular adhesion in 16 eyes was followed in 15 (93.8%) by partial or complete resolution of the symptoms and signs of macular traction. Conclusions Age-related PVD appears to be an insidious, chronic event that begins in the perifoveal macula and evolves over a prolonged period of time prior to vitreopapillary separation. Though usually asymptomatic, its early (perifoveal) stages may be complicated by one of several macular pathologies, determined in part by the size of the residual vitreomacular adhesion. PMID:17057817

Johnson, Mark W

2005-01-01

102

Sex Differences in Macular Pigment Optical Density  

Microsoft Academic Search

Sex differences in macular pigment (MP) optical density (measured psychophysically) were examined. Concentrations of lutein and zeaxanthin (L and Z) (non-separated) and beta-carotene (BC) in the blood were determined using reverse phase high-performance liquid chromatography. Dietary intake of L and Z, BC, fat, and iron were estimated by questionnaire. Males had 38% higher MP density than females (P < 0.001)

BILLY R. HAMMOND; JOANNE CURRAN-CELENTANO; STEPHEN JUDD; KENNETH FULD; NORMAN I. KRINSKY; BILLY R. WOOTEN; D. MAX SNODDERLY

1996-01-01

103

Neovascular Age-Related Macular Degeneration  

Microsoft Academic Search

Purpose: Neovascular age-related macular degeneration (AMD) is a leading cause of blindness, with an increasing incidence as the elderly population expands. Large, multi-center, randomized, clinical trials have been conducted exploring the safety and efficacy of anti-VEGF treatments. This paper aims to discuss the safety and efficacy of pegaptanib, ranibizumab, aflibercept and bevacizumab. New therapeutic agents and treatment strategies are also

Daniele Veritti; Valentina Sarao; Paolo Lanzetta

2012-01-01

104

Macular pigment Raman detector for clinical applications  

PubMed Central

Clinical studies of carotenoid macular pigments (MP) have been limited by the lack of noninvasive, objective instruments. We introduce a novel noninvasive optical instrument, an MP Raman detector, for assessment of the carotenoid status of the human retina in vivo. The instrument uses resonant excitation of carotenoid molecules in the visible wavelength range, and quantitatively measures the highly specific Raman signals that originate from the single- and double-bond stretch vibrations of the ?-conjugated carotenoid molecule’s carbon backbone. The instrument is a robust, compact device and suitable for routine measurements of MP concentrations in a clinical setting. We characterized and tested the instrument in clinical studies of human subjects to validate its function and to begin to establish its role as a possible screening test for macular pathologies. We also show that the MP Raman spectroscopy technology has potential as a novel, highly specific method for rapid screening of carotenoid antioxidant levels in large populations at risk for vision loss from age-related macular degeneration, the leading cause of blindness of the elderly in the developed world. PMID:14715066

Ermakov, Igor; Ermakova, Maia; Gellermann, Werner; Bernstein, Paul S.

2011-01-01

105

Macular Bioaccelerometers on Earth and in Space  

NASA Technical Reports Server (NTRS)

Space flight offers the opportunity to study linear bioaccelerometers (vestibular maculas) in the virtual absence of a primary stimulus, gravitational acceleration. Macular research in space is particularly important to NASA because the bioaccelerometers are proving to be weighted neural networks in which information is distributed for parallel processing. Neural networks are plastic and highly adaptive to new environments. Combined morphological-physiological studies of maculas fixed in space and following flight should reveal macular adaptive responses to microgravity, and their time-course. Ground-based research, already begun, using computer-assisted, 3-dimensional reconstruction of macular terminal fields will lead to development of computer models of functioning maculas. This research should continue in conjunction with physiological studies, including work with multichannel electrodes. The results of such a combined effort could usher in a new era in understanding vestibular function on Earth and in space. They can also provide a rational basis for counter-measures to space motion sickness, which may prove troublesome as space voyager encounter new gravitational fields on planets, or must re-adapt to 1 g upon return to earth.

Ross, M. D.; Cutler, L.; Meyer, G.; Vazin, P.; Lam, T.

1991-01-01

106

Genetic susceptibility to age related macular degeneration  

PubMed Central

Age related macular degeneration (AMD) is the leading cause of visual impairment in the elderly and a major cause of blindness in the developed world. The disease can take two forms, geographic atrophy and choroidal neovascularisation. The pathogenesis of AMD is poorly understood. There are undoubtedly environmental and other risk factors involved and the adverse effect of smoking is well established. Several studies have shown that genetic factors are important but leave uncertainty about the magnitude and nature of the genetic component and whether it varies with the type of AMD. Several hereditary retinal dystrophies show similarities to AMD and these genes are potential candidate susceptibility genes. Particular interest has focused on the ABCR gene which is responsible for autosomal recessive Stargardt macular dystrophy. It has been claimed that heterozygotes for ABCR mutations are predisposed to AMD but the data are conflicting. Studies of the genes responsible for autosomal dominant Sorsby fundus dystrophy, Doyne honeycomb retinal dystrophy, and Best disease have given negative results. In one large AMD family, linkage has been reported to markers in 1q25-q31. Recent data suggest that the ApoE ?4 allele may be associated with reduced risk of AMD. A better understanding of the genetic factors in AMD would contribute to understanding the pathogenesis. If those at risk could be identified it may be possible to modify lifestyle or develop novel therapies in the presymptomatic stage to prevent disease or decrease its severity.???Keywords: age related macular degeneration; genetic susceptibility PMID:10662806

Yates, J.; Moore, A.

2000-01-01

107

Bilateral same-session intravitreal injections of anti-vascular endothelial growth factors  

PubMed Central

AIM To document the indications, safety and possible complications of bilateral same-session intravitreal anti-vascular endothelial growth factor (VEGF) injections performed in the ophthalmic operating room. METHODS A retrospective case series study. Consecutive records of seventy four patients receiving simultaneous bilateral intravitreal injections of either ranibizumab or bevacizumab, between September 2010 and September 2013, were reviewed and the outcomes were assessed. Data collected included number of injections, indications for injections, pre-injection and post-injection visual acuity (VA), pre-injection and post-injection intraocular pressure and ocular and systemic complications/complaints after each injection. RESULTS A total of 342 injections were administered to 74 patients, with a mean of 4.62 injections per patient. Seventy-three patients received bevacizumab (Avastin; Genentech Inc., South San Francisco, California, USA) alone, and only one patient received both bevacizumab and ranibizumab (Lucentis; Genentech Inc.) distributed between the injections. Pre- and post-injection VA follow-up measurements were available for 65 patients. Mean follow up period was 22mo. The indications for initiating therapy were choroidal neovascular membrane from age-related macular degeneration (3 patients) and diabetic macular edema (71 patients). The mean Snellen VA before each injection was 6/22. The next post-injection follow-up mean Snellen VA was 6/20. One patient had a painful, culture-positive endophthalmitis in one eye 3d after bilateral bevacizumab. Another patient had a painless subconjunctival hemorrhage in one eye. No other ocular or systemic adverse side effects/complaints have been registered in this study group. CONCLUSION Bilateral same-session intravitreal injections using a separate povidone-iodine preparation, speculum, needle, and syringe for each eye are well-tolerated. None of the subjects in this study requested to switch to alternating unilateral injections. Proper patient counseling as to the risk of complications with this procedure is necessary.

Abu-Yaghi, Nakhleh E.; Shokry, Ahmed N; Abu-Sbeit, Rami H

2014-01-01

108

A Practical Method for Measuring Macular Pigment Optical Density  

Microsoft Academic Search

PURPOSE. Increasing evidence indicates that the macular pigments (MP) protect the central retina and may retard macular disease. For that reason, a practical method for measuring MP that does not require elaborate optics and can be applied to diverse populations by operators with a modest amount of experience was developed and validated. METHODS. A small tabletop device based on light-emitting

Billy R. Wooten; Billy R. Hammond; Richard I. Land; D. Max Snodderly

1999-01-01

109

Imaging system to assess objectively the optical density of the macular pigment in vivo  

E-print Network

Imaging system to assess objectively the optical density of the macular pigment in vivo Andrew O in combination with various hardware and software tools to assess objectively the macular pigment (MP) optical.52.006201 1. Introduction A. Overview of the Macular Pigment Investigation of the macular pigment (MP

Dainty, Chris

110

Measurement of macular pigment optical density in a healthy chinese population sample  

Technology Transfer Automated Retrieval System (TEKTRAN)

Macular pigment may protect against age-related macular degeneration (AMD) by its capability to absorb blue light and scavenge free radicals. Current information on human macular pigment density has been largely from studies on Caucasians populations. The purpose of this study was to assess macular ...

111

Bilateral internal laryngoceles mimicking asthma  

PubMed Central

Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients. PMID:24174956

Aksoy, Elif A.; Elsürer, Ça?da?; Serin, Gediz M.; Ünal, Ö. Faruk

2013-01-01

112

BILATERAL WASTEWATER LAND TREATMENT RESEARCH  

EPA Science Inventory

Diplomatic relations between the United States and China, established in 1979, opened the door for development of 1985 bilateral environmental research and technology transfer between the USEPA's Robert S. Kerr Environmental Research Laboratory, Ada, Oklahoma, and China's Beijing...

113

Perioperative spontaneous bilateral suprachoroidal hemorrhage  

PubMed Central

Summary Suprachoroidal hemorrhage is a rare condition, occurring most commonly in the perioperative period, although cases of unilateral spontaneous hemorrhages have been reported. We report a case of bilateral spontaneous suprachoroidal hemorrhage and discuss the potential causative factors. PMID:23362387

Haridas, Anjana; Litwin, Andre S.; Coker, Timothy

2011-01-01

114

Visual Field Loss Progression after Macular Hole Surgery  

PubMed Central

Purpose. To report a patient who experienced visual field loss progression after vitrectomy for an idiopathic stage II macular hole. Methods. Case report. A 68-year-old woman, with no history of glaucoma or any neuroophthalmological diseases, underwent a vitrectomy for a macular hole. Results. The patient showed macular hole closure and a resulting central visual acuity of 20/20. However, two months after surgery, she developed an inferotemporal visual field defect. Moreover, seven months after surgery, the patient noticed an enlargement of the temporal blind area: a nearly complete temporal defect was confirmed on visual field testing. Conclusions. Although the beneficial results of successfully treated macular holes are unquestionable, this report raises the possibility that visual field defects following macular hole surgery may be progressive. PMID:20339458

Tosi, Gian Marco; Martone, Gianluca; Balestrazzi, Angelo; Malandrini, Alex; Alegente, Marco; Pichierri, Patrizia

2009-01-01

115

Macular pigment optical density in wet age-related macular degeneration among Indians  

PubMed Central

Purpose To estimate the value of macular pigment optical density (MPOD) in adult south Indian population with wet age-related macular degeneration (AMD). Methods A total of 33 patients with wet AMD and 29 age-matched controls >50 years of age underwent MPOD measurement with the macular densitometer. The patients were also tested for their dietary intake of carotenoids, smoking history, and lifetime UV exposure. Results The mean MPOD values in the Indian population with wet AMD was 0.23 (95% CI: 0.18–0.29) vs control was 0.43 (95% CI: 0.37–0.49), P<0.0001, at 0.5° eccentricity. Ex-smokers had a lower MPOD than non-smokers (0.16 (0.09–0.23) vs 0.28 (0.22–0.34), P=0.026) and the lowest level of carotenoids intake had 48% lower MPOD than the highest level (0.14 (0.08–0.21) vs 0.33 (0.24–0.43), P=0.012). There was no significant age-related decline or gender variation in MPOD. Conclusion This study establishes the MPOD in adult Indian population with wet AMD, with a lack of macular pigment in association with wet AMD. PMID:22627475

Raman, R; Biswas, S; Vaitheeswaran, K; Sharma, T

2012-01-01

116

Macular Pigment and Risk for Age-Related Macular Degeneration in Subjects from a Northern European Population  

Microsoft Academic Search

PURPOSE. Age and advanced disease in the fellow eye are the two most important risk factors for age-related macular degen- eration (AMD). In this study, the authors investigated the rela- tionship between these variables and the optical density of macular pigment (MP) in a group of subjects from a northern European population. METHODS. The optical density of MP was measured

Stephen Beatty; Ian J. Murray; David B. Henson; Dave Carden; Hui-Hiang Koh; Michael E. Boulton

2001-01-01

117

The Impact of Macular Laser Photocoagulation on Contrast Sensitivity Function in Patients with Clinically Significant Macular Edema  

Microsoft Academic Search

Background: Contrast sensitivity is an important aspect of visual function and is even more important for ordinary daily tasks than visual acuity. Contrast sensitivity function may be deteriorated to a significant level in diabetic retinopathy, especially in diabetic macular edema. The objective of this study was to determine the impact of macular laser photocoagulation—as the standard treatment of clinically significant

Mohammad-Sadegh Farahvash; Amir-Hossein Mahmoudi; Mohammad-Mehdi Farahvash; Ali Tabatabaee; Mohammad Riazi; Shiva Mohammadzadeh; Houshang Faghihi; Mehdi Nilli-Ahmadabadi; Ahmad Mirshahi; Reza Karkhaneh; Zahra Aalami-Harandi; Ahmad Javadian; Ali Abdolahi; Alireza Lashey

2008-01-01

118

Episcleral macular buckling for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole  

PubMed Central

AIM To evaluate anatomical and visual outcomes of episcleral macular buckling (EMB) for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole. METHODS Five cases of EMB for initial failure of retinal reattachment after internal limiting membrane (ILM) peeling and silicone oil tamponade caused by myopic macular hole were retrospectively reviewed. A silicone sponge sutured directly across the macular region was performed on the silicone oil filled eyes. Silicone oil was removed no sooner than 1 month post-EMB. The duration of follow-up time after removal of silicone oil was more than 3 months. RESULTS Retinas of five eyes were all reattached at the last follow-up. The postoperative vision ranged from counting fingers to 0.08. CONCLUSION Anatomical results improved after EBM for posterior retinal detachment in silicone oil filled eyes associated with myopic macular hole, which was not evident for visual outcome. PMID:23638417

Tian, Jiao; Tang, Luo-Sheng; Guo, Xiao-Jian; Luo, Yong-Heng

2013-01-01

119

Outcomes of chronic macular hole surgical repair  

PubMed Central

Purpose: To report visual and anatomic outcomes of chronic macular hole surgery, with analysis of pre-operative OCT-based hole size and post-operative closure type. Settings and Design: An IRB-approved, retrospective case series of 26 eyes of 24 patients who underwent surgery for stage 3 or 4 idiopathic chronic macular holes at a tertiary care referral center. Statistical Analysis: Student's t-test. Results: Nineteen of 26 eyes (73%) had visual improvement after surgery on most recent exam. Twenty-one of 26 eyes (81%) achieved anatomic closure; 16 of 26 eyes (62%) achieved type 1, and five of 26 eyes (19%) achieved type 2 closure. Post-operative LogMAR VA for type 1 closure holes (0.49) was significantly greater than for type 2 closure and open holes (1.26, P < 0.003 and 1.10, P < 0.005, respectively), despite similar pre-operative VA (P = 0.51 and 0.68, respectively). Mean pre-operative hole diameter for eyes with type 1 closure, type 2 closure, and holes that remained open were 554, 929, and 1205 microns, respectively. Mean pre-operative hole diameter was significantly larger in eyes that remained open as compared to eyes with type 1 closure (P = 0.015). Conclusion: Vitrectomy to repair chronic macular holes can improve vision and achieve long-term closure. Holes of greater than 3.4 years duration were associated with a greater incidence of remaining open and type 2 closure. Larger holes (mean diameter of 1205 microns) were more likely to remain open after repair. PMID:25116773

Shukla, Shripaad Y; Afshar, Armin R; Kiernan, Daniel F; Hariprasad, Seenu M

2014-01-01

120

Estrogen Antagonist and Development of Macular Hole  

PubMed Central

To describe the clinical and optical coherence tomography (OCT) features of a macular hole (MH) or its precursor lesion in patients treated with systemic antiestrogen agents. We reviewed the medical history of the patient, ophthalmic examination, and both fundus and OCT findings. Three female patients receiving antiestrogen therapy sought treatment for visual disturbance. All of the patients showed foveal cystic changes with outer retinal defect upon OCT. Visual improvement was achieved through surgery for the treatment of MH in two patients. Antiestrogen therapy may result in MH or its precursor lesion, in addition to perifoveal refractile deposits. OCT examination would be helpful for early detection in such cases. PMID:21052512

Chung, Song Ee; Kim, Seong Wook; Chung, Hye Won

2010-01-01

121

Idiopathic macular telangiectasia type 2: ?the progressive vasculopathy.  

PubMed

Purpose. To describe the complete sequence of the progressive vasculopathy in macular telangiectasia type 2.?Methods. This is a report of a case demonstrating the complete vasogenic sequence in macular telangiectasia type 2 over the course of 15 years, and representative images from a collective of 150 patients with macular telangiectasia type 2 employing fundus photography, fluorescein angiography, and optical coherence tomography.?Results. Macular telangiectasia may progress along a predictable vasogenic sequence which consists of nonproliferative stages, characterized by temporal loss of macular luteopigment and inner retinal volume loss in the absence of vascular changes, followed by a progressive proliferative vasculopathy, first involving the deep capillary plexus with eventual extension of the vascular changes circumferentially in the inner retinal capillary plexus. Late proliferative stages may become indistinguishable from advanced neovascular age-related macular degeneration.?Conclusions. While it is rare to observe the complete vasogenic sequence of macular telangiectasia type 2, a classification into nonproliferative and proliferative stages can be established, and may prove helpful as the mechanisms driving the pathogenic process through those stages are identified. PMID:23138663

Engelbert, Michael; Yannuzzi, Lawrence A

2012-11-01

122

Intravitreal Bevacizumab May Increase Diabetic Macular Edema in Eyes with Attached Posterior Vitreous  

PubMed Central

Purpose To report 2 eyes of a patient which developed vitreomacular traction (VMT) 1 month after intravitreal bevacizumab (IVB) injection. Materials and Methods A 45-year-old female with bilateral diffuse diabetic macular edema (DME) received bilateral IVB. Results Her initial visual acuity (VA) was 0.15 and 0.2 in OD and OS, respectively. Central foveal thickness (CFT) was 568 and 662 µm in OD and OS, respectively, without any sign of VMT. Both eyes responded well initially but developed VMT at 1 month. This time, intravitreal triamcinolone (IVTA) injection was performed. One month after IVTA injection, VMT was released and CFT decreased to 163 and 181 µm in OD and OS, respectively. Six months after IVTA injection, CFT was 163 and 153 µm, and VA was 0.7 and 0.9 in OD and OS, respectively. Conclusion In eyes with DME and attached posterior vitreous, VMT may develop after IVB injection and increase edema. IVTA injection might be an option to release VMT before considering vitrectomy. PMID:23467022

Ozsutcu, Mustafa; Gulkilik, Gokhan; Ayintap, Emre; Altinisik, Muhammed; Demirci, Goktug; Aras, Cengiz

2013-01-01

123

Achondroplasia Associated with Bilateral Keratoconus  

PubMed Central

We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE). Right eye (RE) improved to 20/25. The patient underwent penetrating keratoplasty (PKP) in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA) was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out. PMID:23259098

Al Mahmood, Ammar M.; Al Katan, Hind M.; Al Bin Ali, Ghada Y.; Al-Swailem, Samar A.

2012-01-01

124

Macular Hole following Intravitreal Bevacizumab Injection in Choroidal Neovascularization Caused by Age-Related Macular Degeneration  

PubMed Central

This report describes formation of a full-thickness macular hole subsequent to an injection of bevacizumab for the treatment of neovascular AMD. This complication may be caused by focal tractional forces on the retinal surface due to either vitreous incarceration at the injection site or contraction of the choroidal neovascularization membrane. Alternatively, it may be due to a toxic effect of bevacizumab on a previously compromised retina. PMID:21369348

Moisseiev, Elad; Goldstein, Michaela; Loewenstein, Anat; Moisseiev, Joseph

2010-01-01

125

Bilateral breast in brothers - abreast  

PubMed Central

Gynecomastia is a common occurrence in pubertal age group, and is physiological in up to 65 percent of cases. When occurs in the family it should be investigated in order not to miss on a treatable etiology. Two brothers within the same family, presenting with bilateral gynecomastia of different causes and requiring different treatment are presented. PMID:24251182

Shaikh, Altamash Mohammed Yusuf; Yadav, Sameer; Moulick, Nivedita D.

2013-01-01

126

Telepresence index for bilateral teleoperations.  

PubMed

This paper proposes a performance index called telepresence index for bilateral teleoperation, which can be used both for the performance evaluation of bilateral control architectures and for design purposes. This index is intended to represent a comprehensive performance objective consisting of transparency and kinematic correspondence, which are two major performance objectives of bilateral teleoperation. In order to quantify the performance objective, telepresence index has employed the error vector magnitude, which enables a seamless combination of magnitude and phase errors and the accommodation of time delay. In comparison with existing performance indices, it was observed that telepresence index possesses the comprehensiveness of performance objectives, magnitude/phase integrity, and the capacity to include time delay, which the others lack in one way or another. The index was applied to evaluate the performances of two widely known control architectures: PD-type bilateral control and Ueda's ideal control. In all cases, telepresence index has been compared favorably with the other indices in terms of clarity, convenience, and accuracy, thereby demonstrating its superiority. PMID:21824852

Chang, Pyung Hun; Kim, Jonghyun

2012-02-01

127

Bilateral and symmetrical tinea mammae.  

PubMed

Tinea corporis has rarely been reported in some locations such as on the breast skin as unilaterally. Herein, we present a case of bilateral tinea mammae, which has not been reported before in English language literature to our knowledge. PMID:24050298

Yilmaz, Murat; Kavak, Ayse; Yamaner, Nalan Jale

2013-09-01

128

Macular oedema related to idiopathic macular telangiectasia type 1 treated with dexamethasone intravitreal implant (ozurdex).  

PubMed

A 65-year-old female presented with visual disturbance in her right eye lasting for over 2 months. Following investigations, she was diagnosed with MacTel type 1 in the right eye. Visual symptoms were refractory to initial treatment with intravitreal bevacizumab and thereafter intravtireal triamicinolone. The patient was then treated with Ozurdex, following which central macular thickness (CMT) decreased (from 397??m to 286??m) and visual acuity deteriorated (from logMAR 0.48 to 0.59). At 14 weeks posttreatment with Ozurdex, a recurrence of cystoid macular oedema (CMO) was observed. Following a second Ozurdex, visual acuity improved (from logMAR 0.7 to 0.64) and CMT decreased (from 349??m to 279??m). An additional recurrence of CMO was observed at eighteen weeks following the second Ozurdex. Following a third Ozurdex injection visual acuity deteriorated (from logMAR 0.74 to 0.78) and CMT decreased (from 332??m to 279??m). Conclusion. Treatment of macular oedema secondary to MacTel with Ozurdex demonstrated promising anatomical outcomes. However, visual outcomes continued to gradually deteriorate. PMID:25045562

Loutfi, Mohamed; Papathomas, Thomas; Kamal, Ahmed

2014-01-01

129

Macular Oedema Related to Idiopathic Macular Telangiectasia Type 1 Treated with Dexamethasone Intravitreal Implant (Ozurdex)  

PubMed Central

A 65-year-old female presented with visual disturbance in her right eye lasting for over 2 months. Following investigations, she was diagnosed with MacTel type 1 in the right eye. Visual symptoms were refractory to initial treatment with intravitreal bevacizumab and thereafter intravtireal triamicinolone. The patient was then treated with Ozurdex, following which central macular thickness (CMT) decreased (from 397??m to 286??m) and visual acuity deteriorated (from logMAR 0.48 to 0.59). At 14 weeks posttreatment with Ozurdex, a recurrence of cystoid macular oedema (CMO) was observed. Following a second Ozurdex, visual acuity improved (from logMAR 0.7 to 0.64) and CMT decreased (from 349??m to 279??m). An additional recurrence of CMO was observed at eighteen weeks following the second Ozurdex. Following a third Ozurdex injection visual acuity deteriorated (from logMAR 0.74 to 0.78) and CMT decreased (from 332??m to 279??m). Conclusion. Treatment of macular oedema secondary to MacTel with Ozurdex demonstrated promising anatomical outcomes. However, visual outcomes continued to gradually deteriorate. PMID:25045562

Kamal, Ahmed

2014-01-01

130

Laser-induced macular holes demonstrate impaired choroidal perfusion  

NASA Astrophysics Data System (ADS)

Choroidal perfusion was evaluated following the creation of a laser induced macular hole in a nonhuman primate model. Two Rhesus monkeys underwent macular exposures delivered by a Q-switched Nd:YAG laser. The lesions were evaluated with fluorescein angiography and indocyanine green (ICG) angiography . Each lesion produced vitreous hemorrhage and progressed to a full thickness macular hole. ICG angiography revealed no perfusion of the choriocapillaris beneath the lesion centers. Histopathologic evaluation showed replacement of the choriocapillaris with fibroblasts and connective tissue. Nd:YAG, laser-induced macular holes result in long term impairment of choroidal perfusion at the base of the hole due to choroidal scarring and obliteration of the choriocapillaris.

Brown, Jeremiah, Jr.; Allen, Ronald D.; Zwick, Harry; Schuschereba, Steven T.; Lund, David J.; Stuck, Bruce E.

2003-06-01

131

Treatment of cystic macular lesions in hereditary retinal dystrophies.  

PubMed

Cystic macular lesions frequently contribute to impaired visual acuity in hereditary retinal dystrophies. Their pathogenesis varies and is not entirely understood. Carbonic anhydrase inhibitors have proven to be potentially efficacious, although not in all cases. We discuss the various factors and mechanisms implicated in the etiology of cystic macular lesions (anatomical abnormalities, impairment of the blood-retinal barrier, tangential vitreous traction, and mutations in retinoschin, etc.) and the various treatments that have been proposed. PMID:24160730

Salvatore, Serena; Fishman, Gerald A; Genead, Mohamed A

2013-01-01

132

VOIDING DYSFUNCTION AFTER BILATERAL EXTRAVESICAL URETERAL REIMPLANTATION  

Microsoft Academic Search

PurposeVoiding dysfunction has been reported after bilateral extravesical ureteral reimplantation. We evaluate the incidence and duration of voiding dysfunction, and the effects of minimizing surgical dissection in a cohort of children after bilateral extravesical reimplantation.

BETH A. LIPSKI; MICHAEL E. MITCHELL; MARK W. BURNS

1998-01-01

133

Optical coherence tomography imaging of macular oedema.  

PubMed

Macular oedema (ME) occurs in a wide variety of pathological conditions and accounts for different degrees of vision loss. Early detection of ME is therefore critical for diagnosis and therapeutic management. Optical coherence tomography (OCT) is a non-contact, diagnostic method that uses infrared light, which allows the analysis of the retinal structure by means of high-resolution tomographic cross sections. The identification, localisation, quantification and long-term follow-up of fluid collections are the most important capabilities of OCT. Since the introduction of OCT in clinical practice, it has become an invaluable diagnostic tool and different patterns of ME have been reported. The purpose of this manuscript is to review OCT profiles of ME according to the aetiology and describe what has been reported regarding intraretinal features in vivo. PMID:24934220

Trichonas, George; Kaiser, Peter K

2014-07-01

134

Optical coherence tomography imaging of macular oedema  

PubMed Central

Macular oedema (ME) occurs in a wide variety of pathological conditions and accounts for different degrees of vision loss. Early detection of ME is therefore critical for diagnosis and therapeutic management. Optical coherence tomography (OCT) is a non-contact, diagnostic method that uses infrared light, which allows the analysis of the retinal structure by means of high-resolution tomographic cross sections. The identification, localisation, quantification and long-term follow-up of fluid collections are the most important capabilities of OCT. Since the introduction of OCT in clinical practice, it has become an invaluable diagnostic tool and different patterns of ME have been reported. The purpose of this manuscript is to review OCT profiles of ME according to the aetiology and describe what has been reported regarding intraretinal features in vivo. PMID:24934220

Trichonas, George; Kaiser, Peter K

2014-01-01

135

Perceptual learning in patients with macular degeneration  

PubMed Central

Patients with age-related macular degeneration (AMD) or hereditary macular dystrophies (JMD) rely on an efficient use of their peripheral visual field. We trained eight AMD and five JMD patients to perform a texture-discrimination task (TDT) at their preferred retinal locus (PRL) used for fixation. Six training sessions of approximately one hour duration were conducted over a period of approximately 3 weeks. Before, during and after training twelve patients and twelve age-matched controls (the data from two controls had to be discarded later) took part in three functional magnetic resonance imaging (fMRI) sessions to assess training-related changes in the BOLD response in early visual cortex. Patients benefited from the training measurements as indexed by significant decrease (p = 0.001) in the stimulus onset asynchrony (SOA) between the presentation of the texture target on background and the visual mask, and in a significant location specific effect of the PRL with respect to hit rate (p = 0.014). The following trends were observed: (i) improvement in Vernier acuity for an eccentric line-bisection task; (ii) positive correlation between the development of BOLD signals in early visual cortex and initial fixation stability (r = 0.531); (iii) positive correlation between the increase in task performance and initial fixation stability (r = 0.730). The first two trends were non-significant, whereas the third trend was significant at p = 0.014, Bonferroni corrected. Consequently, our exploratory study suggests that training on the TDT can enhance eccentric vision in patients with central vision loss. This enhancement is accompanied by a modest alteration in the BOLD response in early visual cortex. PMID:25368597

Plank, Tina; Rosengarth, Katharina; Schmalhofer, Carolin; Goldhacker, Markus; Brandl-Rühle, Sabine; Greenlee, Mark W.

2014-01-01

136

Acquired, bilateral nevus of Ota-like macules (ABNOM) associated with Ota's nevus: case report.  

PubMed

Ota's nevus is mongolian spot-like macular blue-black or gray-brown patchy pigmentation that most commonly occurs in areas innervated by the first and second division of the trigeminal nerve. Acquired, bilateral nevus of Ota-like macules (ABNOM) is located bilaterally on the face, appears later in life, is blue-brown or slate-gray in color. It is not accompanied by macules on the ocular and mucosal membranes. There is also debate as to whether ABNOM is part of the Ota's nevus spectrum. We report an interesting case of ABNOM associated with Ota's nevus. A 36-yr-old Korean women visited our clinic with dark bluish patch on the right cheek and right conjunctiva since birth. She also had mottled brownish macules on both forehead and both lower eyelids that have developed 3 yr ago. Skin biopsy specimens taken from the right cheek and left forehead all showed scattered, bipolar or irregular melanocytes in the dermis. We diagnosed lesion on the right cheek area as Ota's nevus and those on both forehead and both lower eyelids as ABNOM by clinical and histologic findings. This case may support the view that ABNOM is a separate entity from bilateral Ota's nevus. PMID:15308859

Park, Jung Hun; Lee, Mu Hyoung

2004-08-01

137

Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion  

PubMed Central

Background Central retinal vein occlusion (CRVO) is a common retinal vascular abnormality associated with conditions such as hypertension, diabetes, glaucoma, and a wide variety of hematologic disorders. Macular edema (ME) represents an important vision-threatening complication of CRVO. There is no proven treatment; laser photocoagulation is not effective in treating cystoid macular edema secondary to CRVO. Intravitreal steroids, such as triamcinolone acetonide, have been utilized to treat macular edema stemming from a variety of etiologies and may represent a treatment option for CRVO-ME. Objectives The objective of this review was to explore the effectiveness and safety of intravitreal steroids in the treatment of CRVO-ME. Search strategy We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2008), MEDLINE (January 1950 to November 2008) and EMBASE (January 1980 to November 2008). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 5 November 2008. For all included primary studies, we used The Science Citation Index and manually reviewed reference lists to identify other possible relevant trials. We contacted researchers in the field, currently working on a randomized controlled trial (RCT) on this topic (The Standard Care versus Corticosteroid for Retinal Vein Occlusion - SCORE study), for information on additional current, past, or unpublished trials. Selection criteria We considered RCTs that compared intravitreal steroids of any dosage/duration to observation in the treatment of CRVO-ME for inclusion in this review. We focused on studies that included individuals of any age or gender with unilateral or bilateral disease, with a minimum of six months follow up. Secondarily we considered non-randomized studies with the same criteria for description of evidence, however we did not conduct a separate electronic search for finding all non-randomized studies. Data collection and analysis We found no RCTs that met the inclusion criteria after independent and duplicate review of the search results. Main results We found no relevant RCTs and therefore performed no meta-analysis. Evidence from non-randomized studies is reported in this review. Authors’ conclusions There is inadequate evidence for the use of intravitreal steroids for CRVO-ME due to a paucity of RCTs and well-designed observational studies on the topic; therefore, it is still an experimental procedure. PMID:19160332

Gewaily, Dina; Greenberg, Paul B

2014-01-01

138

Multiresolution Bilateral Filtering for Image Denoising  

PubMed Central

The bilateral filter is a nonlinear filter that does spatial averaging without smoothing edges; it has shown to be an effective image denoising technique. An important issue with the application of the bilateral filter is the selection of the filter parameters, which affect the results significantly. There are two main contributions of this paper. The first contribution is an empirical study of the optimal bilateral filter parameter selection in image denoising applications. The second contribution is an extension of the bilateral filter: multiresolution bilateral filter, where bilateral filtering is applied to the approximation (low-frequency) subbands of a signal decomposed using a wavelet filter bank. The multiresolution bilateral filter is combined with wavelet thresholding to form a new image denoising framework, which turns out to be very effective in eliminating noise in real noisy images. Experimental results with both simulated and real data are provided. PMID:19004705

Zhang, Ming; Gunturk, Bahadir K.

2008-01-01

139

Temporal Macular Thinning Associated With X-Linked Alport Syndrome  

PubMed Central

Importance Optical coherence tomography (OCT) findings of temporal macular thinning are important in the diagnosis and prognosis of X-linked Alport syndrome (XLAS). Objectives To report OCT findings and severity of temporal macular thinning in a cohort with XLAS and to correlate these and other ocular findings with mutation genotype. Design Patients with XLAS underwent genotyping for COL4A5 mutations and complete eye examinations with retinal imaging using spectral domain OCT and fundus photography. Temporal macular thinning was calculated from OCT measurements by comparing the ratio of the retinal thickness of the temporal to the nasal subfields with a published normative database. Setting University departments of ophthalmology and nephrology. Participants Thirty-two patients from 24 families. Main Outcome and Measures Temporal thinning index calculated from spectral domain OCT scans. Results All study patients had a mutation associated with the X-linked COL4A5 gene. Eleven different mutations were identified. Eleven of 32 patients (34%) expressed the L1649R mutation. Of a total of 63 eyes with available OCT scans, 44 (70%) had severe pathological temporal macular thinning. The L1649R mutation was associated with the least amount of severe temporal macular thinning and later onset of renal failure. Conclusions and Relevance Temporal macular thinning is a prominent sign associated with XLAS, suggesting that OCT measurements are essential in the diagnosis and prognosis of the disease. The L1649R mutation in the COL4A5 gene causes a relatively mild form of XLAS characterized by late-onset renal failure and less frequent, severe temporal macular thinning relative to other COL4A5 mutations. The pathological basis for the retinal abnormalities of XLAS remains to be established. PMID:23572034

Ahmed, Faisal; Kamae, Kandon K.; Jones, Denise J.; DeAngelis, Margaret M.; Hageman, Gregory S.; Gregory, Martin C.; Bernstein, Paul S.

2013-01-01

140

Resonance Raman measurement of macular carotenoids in the living human eye  

Microsoft Academic Search

There is growing evidence that high levels of the macular xanthophyll carotenoids lutein and zeaxanthin may be protective against visual loss from age-related macular degeneration. To study this protective effect further, it is important to measure macular carotenoid levels noninvasively in a wide variety of subjects. We have developed and validated resonance Raman spectroscopy as a sensitive and specific objective

Paul S. Bernstein; Da-You Zhao; Mohsen Sharifzadeh; Igor V. Ermakov; Werner Gellermann

2004-01-01

141

Central retinal thickness is positively correlated with macular pigment optical density  

E-print Network

Central retinal thickness is positively correlated with macular pigment optical density S pigment (MP) has been suggested to have a protective role in age-related macular degeneration by reducing was to investigate the relationship between central retinal thickness and macular pigment optical density in a group

142

Color Matching in Diabetes: Optical Density of the Crystalline Lens and Macular Pigments  

E-print Network

Color Matching in Diabetes: Optical Density of the Crystalline Lens and Macular Pigments Nigel lens and macular pigments in a group of patients with diabetes mellitus and compare the results. Wavelengths 420 and 515 nm were chosen, because they are absorbed equally by the macular pigment. To measure

Morland, Antony

143

A 12-Wk Egg Intervention Increases Serum Zeaxanthin and Macular Pigment Optical Density in Women1  

Microsoft Academic Search

Two carotenoids found in egg yolk, lutein and zeaxanthin, accumulate in the macular retina where they may reduce photostress. Increases in serum lutein and zeaxanthin were observed in previous egg interventions, but no study mea- sured macular carotenoids. The objective of this project was to determine whether increased consumption of eggs would increase retinal lutein and zeaxanthin, or macular pigment.

Adam J. Wenzel; Catherine Gerweck; Damian Barbato; Robert J. Nicolosi; Garry J. Handelman; Joanne Curran-Celentano

144

Unilateral Full-thickness Macular Hole Formation Following Low-Energy Nd: Yag Peripheral Iridotomy.  

PubMed

Macular hole formation is a rare complication after YAG peripheral iridotomy. We report a case of post-YAG peripheral iridotomy macular hole in 1 eye of a patient with preexisting vitreomacular adhesion in that eye. Possibly because of the vitreomacular adhesion, a single-shot low-energy YAG laser shot resulted in macular hole formation. PMID:25110955

Sar, Suchanda; Sinha, Sourav; Mitra, Santanu

2014-08-01

145

Macular xanthophylls, lipoprotein-related genes, and age-related macular degeneration.  

PubMed

Plant-based macular xanthophylls (MXs; lutein and zeaxanthin) and the lutein metabolite meso-zeaxanthin are the major constituents of macular pigment, a compound concentrated in retinal areas that are responsible for fine-feature visual sensation. There is an unmet need to examine the genetics of factors influencing regulatory mechanisms and metabolic fates of these 3 MXs because they are linked to processes implicated in the pathogenesis of age-related macular degeneration (AMD). In this work we provide an overview of evidence supporting a molecular basis for AMD-MX associations as they may relate to DNA sequence variation in AMD- and lipoprotein-related genes. We recognize a number of emerging research opportunities, barriers, knowledge gaps, and tools offering promise for meaningful investigation and inference in the field. Overviews on AMD- and high-density lipoprotein (HDL)-related genes encoding receptors, transporters, and enzymes affecting or affected by MXs are followed with information on localization of products from these genes to retinal cell types manifesting AMD-related pathophysiology. Evidence on the relation of each gene or gene product with retinal MX response to nutrient intake is discussed. This information is followed by a review of results from mechanistic studies testing gene-disease relations. We then present findings on relations of AMD with DNA sequence variants in MX-associated genes. Our conclusion is that AMD-associated DNA variants that influence the actions and metabolic fates of HDL system constituents should be examined further for concomitant influence on MX absorption, retinal tissue responses to MX intake, and the capacity to modify MX-associated factors and processes implicated in AMD pathogenesis. PMID:24829491

Koo, Euna; Neuringer, Martha; SanGiovanni, John Paul

2014-05-14

146

Staging of Macular Telangiectasia: Power-Doppler Optical Coherence Tomography and Macular Pigment Optical Density  

PubMed Central

Purpose. Two methods were used to study the stages of macular telangiectasia (MacTel): Power-Doppler optical coherence tomography (PD-OCT), which allows imaging of the retinal circulation in three dimensions, and macular pigment optical density (MPOD), which quantifies the distribution of macular carotenoids. Methods. Among 49 patients with MacTel identified, 12 eyes (6 patients) with MacTel and 7 age-matched control eyes (7 patients) were imaged with a custom-built Fourier-domain OCT instrument to acquire PD-OCT images. MPOD was measured using heterochromatic flicker photometry in 10 eyes (5 patients) with MacTel and compared with 44 age-matched control eyes (44 patients). Clinical staging of MacTel was based on best-corrected visual acuity, fundus biomicroscopy, fluorescein angiography, and OCT. Results. Stage 1 eyes (n = 2) had subtle punctate vascular signal confined to the inner portion of the outer plexiform layer (OPL) on PD-OCT. Stage 2 (n = 2) showed larger oblique vascular signal extending into deeper OPL. Stage 3 (n = 5) had disruption of outer retinal layers with abnormal vasculature extending into the outer nuclear layer. Stage 4 (n = 3) showed diffuse blurring of the retinal layers with vascular channels extending the full thickness of the retina. MPOD values in four eyes with stage 1 or 2 MacTel correlated well with age-matched controls. Six eyes with stage 3 or 4 MacTel had loss of MPOD especially at the fovea. Conclusions. PD-OCT shows penetration of the retinal capillaries into the deeper retinal layers in early stages of MacTel, with full thickness vascular proliferation in advanced disease. MPOD is commonly depleted but may appear normal in early stage MacTel. PMID:23716628

Chin, Eric K.; Kim, Dae Yu; Hunter, Allan A.; Pilli, Suman; Wilson, Machelle; Zawadzki, Robert J.; Werner, John S.; Park, Susanna S.

2013-01-01

147

Age related macular degeneration and visual disability.  

PubMed

Age-related macular degeneration (AMD) is the leading cause of central blindness or low vision among the elderly in industrialized countries. AMD is caused by a combination of genetic and environmental factors. Among modifiable environmental risk factors, cigarette smoking has been associated with both the dry and wet forms of AMD and may increase the likelihood of worsening pre-existing AMD. Despite advances, the treatment of AMD has limitations and affected patients are often referred for low vision rehabilitation to help them cope with their remaining eyesight. The characteristic visual impairment for both forms of AMD is loss of central vision (central scotoma). This loss results in severe difficulties with reading that may be only partly compensated by magnifying glasses or screen-projection devices. The loss of central vision associated with the disease has a profound impact on patient quality of life. With progressive central visual loss, patients lose their ability to perform the more complex activities of daily living. Common vision aids include low vision filters, magnifiers, telescopes and electronic aids. Low vision rehabilitation (LVR) is a new subspecialty emerging from the traditional fields of ophthalmology, optometry, occupational therapy, and sociology, with an ever-increasing impact on the usual concepts of research, education, and services for visually impaired patients. Relatively few ophthalmologists practise LVR and fewer still routinely use prismatic image relocation (IR) in AMD patients. IR is a method of stabilizing oculomotor functions with the purpose of promoting better function of preferred retinal loci (PRLs). The aim of vision rehabilitation therapy consists in the achievement of techniques designed to improve PRL usage. The use of PRLs to compensate for diseased foveae has offered hope to these patients in regaining some function. However, in a recently published meta-analysis, prism spectacles were found to be unlikely to be of substantial benefit in people with age-related macular degeneration. Prescription filters are one of the most beneficial visual aids that people with macular degeneration. In principle, one aims both at reducing short-wavelength light to reduce glare and at identifying light with specific wavelengths (colours) preferred by the patient for viewing. In both instances, such interventions result in apparent improved contrast sensitivity and better visual acuity. Although specific tests are performed to determine the best colour, tint, lens material, and type of frame for the patient's need, no scientific protocol has been developed so far to assist in prescribing tinted or selective transmission lenses . Magnifying optical lenses are available in a wide range of dioptric powers and are made from materials that correct for weight (plastic), thickness (high index), spherical aberrations (aspherical), and variable light intensities (photochromatic). These lenses can be used as loose lenses, mounted on optical frames, or used with a wide variety of attachments. As the dioptric power of plus lenses increases, the viewing distance of the target decreases, hence their usefulness mainly for tasks requiring near resolution acuity, like reading. Magnification can also be achieved with the use of telescopic devices that are built of two or more plus and (or) minus (minifying) optical lenses. Normal resolution acuity levels can be achieved with these devices for all viewing distances. Therefore, all telescopic devices are useful only for stationary patient tasks that do not require mobility and orientation. Electronic magnification has the great advantage over plus lenses of producing an acuity reserve enabling reading skills for almost all levels of visual acuity. The additional benefit provided is preservation of binocularity, even at high levels of visual disparity between the two eyes. Vision rehabilitation can help patients to maximize their remaining vision and adapt to activities of daily living. The support of the patient's social network is critical to patient's well-bei

Christoforidis, John B; Tecce, Nicola; Dell'Omo, Roberto; Mastropasqua, Rodolfo; Verolino, Marco; Costagliola, Ciro

2011-02-01

148

One year follow up of macular translocation with 360 degree retinotomy in patients with age related macular degeneration  

PubMed Central

Aim: To evaluate the benefits of macular translocation with 360 degree retinotomy in patients with exudative age related macular degeneration (ARMD). Methods: A consecutive interventional case series was performed on patients who underwent macular translocation between June 1997 and January 2000 at the department of ophthalmology, University of Aachen, Germany. A retrospective pilot study was set up with a minimum follow up of 12 months in 39 consecutive patients with subfoveal choroidal neovascularisation secondary to ARMD. The surgical technique included pars plana vitrectomy, induction of retinal detachment, 360 degree retinotomy, removal of the choroidal neovascular membranes (CNVM), macular translocation, peripheral laser retinopexy, and silicone oil endotamponade. Results: 18 patients showed predominantly occult CNVM, six patients had predominantly classic CNVM, and 15 showed subretinal haemorrhage. At the 12 month follow up 13 patients (33%) showed an improvement in visual acuity of more than three lines (logMAR scale), 18 patients (46%) retained stable visual acuity with a change of equal or less than three lines (logMAR scale), and eight patients (21%) showed a decrease in visual acuity of more than three lines (logMAR scale). Recurrence of CNVM was observed in three (8%) eyes at 5–11 months postoperatively. Other complications included proliferative vitreoretinopathy with retinal detachment (n=10), peripheral epiretinal membranes (n=9), macular pucker (n=2), corneal decompensation (n=2), and hypotony (n=11). 18 patients (46%) complained about persistent diplopia. Conclusion: Macular translocation surgery is able to maintain or improve distant vision in the majority of patients with exudative ARMD. Proliferative vitreoretinopathy and diplopia are the two major complications. A prospective randomised controlled trial comparing macular translocation with observation for patients with the occult form of exudative ARMD may be justified. PMID:12714406

Abdel-Meguid, A; Lappas, A; Hartmann, K; Auer, F; Schrage, N; Thumann, G; Kirchhof, B

2003-01-01

149

Intravitreal injection of Bevacizumab in diabetic macular edema  

PubMed Central

Objective: To assess the effectiveness of intravitreal injection of Bevacizumab in the treatment of diabetic macular edema. Methods: This case series was conducted at Department of Ophthalmology, Jinnah Post Graduate Medical Centre (JPMC), Karachi. The duration of study was six months from May 26, 2011 to November 25, 2011. The study group comprised of 54 patients of the Diabetic Macular Edema (DME). Intravitreal injection of 1.25 mg of bevacizumab (Avastin) was injected 3.5 mm from the limbus under topical anaesthetic drops. Post procedure follow up was scheduled on 1st post procedure day and after one month. Post procedure Optical Coherence tomography (OCT) was performed in all patients 1 week before and 1st month after 1st injection. The results were statistically analyzed through SPSS 17. Results: Out of the 54 Eyes of 54 Patients who were given the Intravitreal injection of Avastin (Bevacizumab), 43 Eyes (79.6%) showed more than ten percent decrease in macular thickness from pre-injection thickness, 10 Eyes (18.5%) showed less than ten percent decrease and 1 Eye (1.9%) showed increase in macular thickness post operatively after one month. Conclusions: Intravitreal injection of Bevacizumab (Avastin) is effective in the treatment of diabetic macular edema.

Ateeq, Asim; Tahir, Muhammad Ali; Cheema, Alyscia; Dahri, Arif; Tareen, Saifullah

2014-01-01

150

Characteristics of Fixational Eye Movements in People With Macular Disease  

PubMed Central

Purpose. Fixation stability is known to be poor for people with macular disease and has been suggested as a contributing factor for the poor visual performance of these individuals. In this study, we examined the characteristics of the different components of fixational eye movements and determined the component that plays a major role in limiting fixation stability in people with macular disease. Methods. Sixteen observers with macular disease and 14 older adults with normal vision (control observers) monocularly fixated a small cross presented using a Rodenstock scanning laser ophthalmoscope, for trials of 30 seconds. The retinal image and the position of the cross on the retina were recorded digitally. Eye movements were extracted from the recorded videos at a sampling rate of 540 Hz using a cross-correlation technique. A velocity criterion of 8°/s was used to differentiate between slow drifts and microsaccades. Results. Observers with macular disease demonstrated higher fixation instability, larger amplitudes of slow drifts and microsaccades, and lower drift velocities, when compared with older adults with normal vision. The velocity and the rate of microsaccades were comparable between the two groups of observers. Multiple linear regression analysis showed that the amplitude of microsaccades, and to a smaller extent, the amplitude of slow drifts, play a major role in limiting fixation stability. Conclusions. Fixation stability in people with macular disease is primarily limited by the amplitude of microsaccades, implying that rehabilitative strategies targeted at reducing the amplitude of microsaccades should improve fixation stability, and may lead to improved visual functions. PMID:25074769

Kumar, Girish; Chung, Susana T. L.

2014-01-01

151

Efficacy of autologous platelets in macular hole surgery  

PubMed Central

The introduction of optical coherence tomography has allowed accurate measurement of the size of macular holes. A retrospective consecutive review was performed of 21 patients undergoing macular hole repair with vitrectomy, gas tamponade, and autologous platelet injection and we assessed the effect of macular hole parameters on anatomic and functional outcomes. We looked at the demographic features, final visual outcome, and anatomical closure. Twenty-one patients were included in the study. They underwent routine vitrectomy with gas tamponade (C3F8) and injection of autologous platelets. All patients were advised to maintain a facedown posture for 2 weeks. Anatomical closure was confirmed in all cases and 20 out of 21 of patients had improved postoperative visual acuity by two or more lines. In our series, the macular hole dimensions did not have much effect on the final results. The use of autologous platelets and strict facedown posture seems to be the deciding factor in good anatomical and visual outcome irrespective of macular hole dimensions. PMID:23626459

Konstantinidis, Aristeidis; Hero, Mark; Nanos, Panagiotis; Panos, Georgios D

2013-01-01

152

Independent bilateral primary bronchial carcinomas  

PubMed Central

Independent bilateral primary bronchial carcinomas are not common. Since Beyreuther's description in 1924, 16 well-documented cases of independent primary bronchial carcinomas of different histology have been described. From 1965 to 1970, eight cases were seen at the London Chest Hospital. In order to make the diagnosis of a second primary bronchial carcinoma, each tumour should be malignant and neither should be a metastasis from the other. To meet this last criterion, the histopathological features of the two tumours must be different. Many cases have been described in the literature as double primary bronchial carcinomas where the second primary had the same histological features as the first. Images PMID:4327711

Chaudhuri, M. Ray

1971-01-01

153

[Bilateral multilobular cystic adenomatoid malformation].  

PubMed

We reported a case of bilateral and multilobar Congenital Cystic Adenomatoid Malformation (C.C.A.M.) in a four months old child with good clinical results after resections of the lesions. This is a relatively rare form of pulmonary illness. The final prognosis, in those patients, depends on the type of malformation, the presence or absence of fetal hydrops and on the degree of affected lung. There have been reported a few cases of multiple affectation. We will consider the physiopathological aspects of the case, late clinical presentation and treatment and the positive surgical response based in the findings of the functional and anatomic imagen studys. PMID:8679395

Tristán, J U; Gracía Urgellés, X; Wiehoff Neumann, A; Hernández Briz Estévez Rosas, S; Ruiz, M P; Pavcovich Calvo, F M

1995-10-01

154

Bilateral Molariform Mandibular Second Premolars  

PubMed Central

Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots.

Acharya, Sonu; Kumar Mandal, Pradip; Ghosh, Chiranjit

2015-01-01

155

Surgical outcomes of inverted internal limiting membrane flap technique for large macular hole  

PubMed Central

We are presenting the initial results of inverted internal limiting membrane (ILM) flap technique for large macular hole. Five eyes of five patients with large diameter macular hole (>700 ?m) were selected. All patients underwent inverted ILM flap technique for macular hole. Anatomical closure and functional success were achieved in all patients. There was no loss of best-corrected visual acuity in any of the patients. Inverted ILM flap technique in macular hole surgery seems to have a better hole closure rates, especially in large diameter macular holes. Larger case series is required to assess the efficacy and safety of this technique. PMID:24212316

Mahalingam, Prabhushanker; Sambhav, Kumar

2013-01-01

156

Macular hole secondary to toxoplasmic retinochoroiditis.  

PubMed

Ocular toxoplasmosis causes abnormalities in the vitreous that are responsible for several types of well-known complications including retinal detachment and epiretinal membranes. We report on a patient who developed toxoplasmic panuveitis with a full-thickness macular hole (MH) and was successfully treated with vitreoretinal surgery. A 35-year-old Hispanic female presented with a 2-week history of loss of visual acuity and metamorphopsia in her right eye. Funduscopy revealed a typical toxoplasmosis lesion and a MH, which was confirmed by optical coherence tomography. After 8 weeks of medical treatment with sulfamethoxazole (800 mg)/trimethoprim (160 mg) and steroids, the intraocular inflammation was considered inactive. Pars plana vitrectomy with inner limiting membrane peeling and injection of 24 % sulphur hexafluoride gas were performed to treat the MH, without success. Repeat pars plana vitrectomy was then performed with injection of 14 % perfluoropropane (C3F8). Closure of the MH was achieved after this second procedure. Vitreoretinal surgery may be safe and effective for treating MHs secondary to toxoplasmosis lesions, a very uncommon complication of this disease. PMID:23479051

Arana, Begoña; Fonollosa, Alex; Artaraz, Joseba; Martinez-Berriotxoa, Agustin; Martinez-Alday, Nerea

2014-02-01

157

Partial posterior hyaloidectomy for macular disorders  

PubMed Central

Purpose To evaluate the effect of partial posterior hyaloidectomy (PPH) in preventing iatrogenic retinal breaks related to the induction of a posterior vitreous detachment (IPVD) Methods Fifty-nine patients who necessitated IPVD for an epiretinal membrane or macular hole were included in this prospective, interventional case series. Extensive removal of vitreous gel, close to the retina, was conducted before IPVD under 23?G (gauge)-vitrectomy system. The PPH involved the limited extent of IPVD and limited removal of the outermost vitreous cortex to an area slightly beyond the margin of the temporal major vascular arcade. The incidence of retinal breaks related to the surgery was compared with 57 eyes that had undergone conventional 23-G total vitrectomy accompanied by extensive IPVD using ?2-test. Results Patients were followed-up for a mean of 14.3 months (6–30 months) after the surgery. The incidence of peripheral retinal breaks after the PPH was 3.4% (2/59 eyes), which was significantly lower than that in the eyes that underwent conventional 23?G vitrectomy (15.8%, 9/57 eyes, P=0.023) for the same disorders that required an IPVD. No patient complained of postoperative floaters, postoperatively. Conclusions PPH would be an efficient procedure to prevent iatrogenic peripheral retinal breaks related to an IPVD. PMID:23743531

Kim, J H; Kang, S W; Kim, Y T; Kim, S J; Chung, S E

2013-01-01

158

Age-related macular degeneration: choroidal ischaemia?  

PubMed Central

Aim Our aim is to use ultrasound to non-invasively detect differences in choroidal microarchitecture possibly related to ischaemia among normal eyes and those with wet and dry age-related macular degeneration (AMD). Design Prospective case series of subjects with dry AMD, wet AMD and age-matched controls. Methods Digitised 20?MHz B-scan radiofrequency ultrasound data of the region of the macula were segmented to extract the signal from the retina and choroid. This signal was processed by a wavelet transform, and statistical modelling was applied to the wavelet coefficients to examine differences among dry, wet and non-AMD eyes. Receiver operating characteristic (ROC) analysis was used to evaluate a multivariate classifier. Results In the 69 eyes of 52 patients, 18 did not have AMD, 23 had dry AMD and 28 had wet AMD. Multivariate models showed statistically significant differences between groups. Multiclass ROC analysis of the best model showed an excellent volume-under-curve of 0.892±0.17. The classifier is consistent with ischaemia in dry AMD. Conclusions Wavelet augmented ultrasound is sensitive to the organisational elements of choroidal microarchitecture relating to scatter and fluid tissue boundaries such as seen in ischaemia and inflammation, allowing statistically significant differentiation of dry, wet and non-AMD eyes. This study further supports the association of ischaemia with dry AMD and provides a rationale for treating dry AMD with pharmacological agents to increase choroidal perfusion. ClinicalTrials.gov registration NCT00277784. PMID:23740965

Coleman, D Jackson; Silverman, Ronald H; Rondeau, Mark J; Lloyd, Harriet O; Khanifar, Aziz A; Chan, R V Paul

2013-01-01

159

Statistical physics of age related macular degeneration  

NASA Astrophysics Data System (ADS)

Age-related macular degeneration (AMD) is the leading cause of blindness beyond the age of 50 years. The most common pathogenic mechanism that leads to AMD is choroidal neovascularization (CNV). CNV is produced by accumulation of residual material caused by aging of retinal pigment epithelium cells (RPE). The RPE is a phagocytic system that is essential for renewal of photoreceptors (rods and cones). With time, incompletely degraded membrane material builds up in the form of lipofuscin. Lipofuscin is made of free-radical-damaged protein and fat, which forms not only in AMD, but also Alzheimer disease and Parkinson disease. The study of lipofuscin formation and growth is important, because of their association with cellular aging. We introduce a model of non-equilibrium cluster growth and aggregation that we have developed for studying the formation and growth of lipofuscin in the aging RPE. Our results agree with a linear growth of the number of lipofuscin granules with age. We apply the dynamic scaling approach to our model and find excellent data collapse for the cluster size distribution. An unusual feature of our model is that while small particles are removed from the RPE the larger ones become fixed and grow by aggregation.

Family, Fereydoon; Mazzitello, K. I.; Arizmendi, C. M.; Grossniklaus, H. E.

160

Economic Considerations of Macular Edema Therapies  

PubMed Central

Purpose To relate costs and treatment benefits for macular edema due to diabetes (DME) and branch and central retinal vein occlusion (BRVO, CRVO). Design A model of resource utilization, outcomes, and cost effectiveness and utility. Participants none Methods Results from published clinical trials (index studies) of laser, intravitreal corticosteroids, intravitreal anti-vascular endothelial growth factor (VEGF) agents, and vitrectomy trials were used to ascertain visual benefit and clinical protocols. Calculations followed from the costs of one year of treatment for each treatment modality and the visual benefits as ascertained. Main Outcome measures Visual acuity (VA) saved, cost of therapy, cost per line saved, cost per line-year saved, and costs per quality adjusted life years (QALYs). Results The lines saved for DME (0.26 to 2.02), BRVO (0.74 to 4.92), and CRVO (1.2 to 3.75) yielded calculations of costs/line of saved VA for DME ($1329 to 11609), BRVO ($494 to 13039), and CRVO ($704 to 7611), costs/line-year for DME ($60 to 561), BRVO ($25 to 754), and CRVO ($45 to 473), and costs/QALY of $824 to $25566. Conclusion Relative costs and benefits should be considered in perspective when applying and developing treatment strategies. PMID:21507488

Smiddy, William E.

2012-01-01

161

Fundus autofluorescence imaging in age-related macular degeneration.  

PubMed

Abstract Fundus autofluorescence (FAF) is a noninvasive imaging technology that provides information on the distribution of lipofuscin within the retinal pigment epithelial cells. Progressive accumulation of lipofuscin within retinal pigment epithelial cells is involved in the pathogenesis of age-related macular degeneration (AMD). Fundus autofluorescence imaging using a confocal scanning laser ophthalmoscope is a useful technique to identify high-risk characteristics in patients with nonexudative AMD. It gives also some valuable knowledge and clues in differantial diagnosis of exudative age-related macular degeneration. This review comprises an introduction to fundus autofluorescence, a review of FAF imaging in AMD, and the recent classification of geographic atrophy (GA) and early AMD phenotypes by the Fundus Autofluorescence in Age-related Macular Degeneration Study. The association of phenotype and atrophy progression and choroidal neovascularization development are also summarized. PMID:23952079

Bat?o?lu, Figen; Demirel, Sibel; Ozmert, Emin

2015-01-01

162

Spontaneous resolution of macular edema after silicone oil removal  

PubMed Central

AIM To investigate the macular changes in eyes filled with silicone oil (SO) and course of these changes after SO removal. METHODS A retrospective optical coherence tomography scan review was conducted for twenty-four patients who underwent uncomplicated pars plana vitrectomy with SO tamponade for complex retinal detachments were detected with optical coherence tomography before, and one week, one month and three months after SO removal. RESULTS Mean duration of SO tamponade was 3.6±1.0mo (range: 3-7mo). Cystoid macular edema (CME) was detected in 3 eyes before SO removal. Submacular fluid was represented in 1 eye before silicone SO removal. Resolution of CME and submacular fluid was achieved 1mo after SO removal in all eyes. Mean best corrected visual acuity (BCVA) was 1.15±0.65 (range, hand movement to 0.2) before SO removal in the eyes without macular changes. After SO removal, the mean BCVA values at 1wk and 1 and 3mo, and 0.82±0.23, 0.76±0.21, and 0.70±0.19, all of which were significantly better than baseline (P=0.030, 0.017, 0.006 respectively). In the eyes with macular CME and subretinal fluid the mean BCVA was significantly improved at 3mo after SO removal compared with baseline (P=0.037). CONCLUSION Decreased visual acuity in eyes filled with SO could be caused by macular complications due to SO. CME and subretinal fluid may resolve without any additional macular surgery after SO removal.

Karahan, Eyyup; Tuncer, Ibrahim; Zengin, Mehmet Ozgur; Kucukerdonmez, Cem; Kaynak, Suleyman

2014-01-01

163

Sequential bilateral retinal artery occlusion  

PubMed Central

An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old. PMID:24748768

Padrón-Pérez, Noel; Aronés, Janny Rosario; Muñoz, Silvia; Arias-Barquet, Luis; Arruga, Jorge

2014-01-01

164

Fast bilateral filtering using recursive moving sum  

NASA Astrophysics Data System (ADS)

We propose a constant-time algorithm for a bilateral filter. Bilateral filter can be converted into the operation of three-dimensional (3D) convolution. By using recursive moving sum, we can reduce the number of calculations needed to construct a pseudo-Gaussian filter. Applying one-dimensional Gaussian filter to the 3D convolution, we achieved a constant-time bilateral filter. We used a 3-GHz CPU without SIMD instructions, or multi-thread operations. We confirmed our proposed bilateral filter to be processed in constant time. In practical conditions, high PSNR values over 40 dB are obtained.

Igarashi, Masaki; Ikebe, Masayuki; Shimoyama, Sohsuke; Motohisa, Junichi

165

Bilateral eosinophilic mastitis: An uncommon unheard entity.  

PubMed

We are reporting a case of bilateral eosinophilic mastitis which is rare and hardly heard. It is a mimicker of carcinoma breast both clinically & radiologically. A 30 years old non diabetic female presented with bilateral breast lumps with history of rhinitis off & on and peripheral eosinophilia. Mammography was suspicious while ultrasonography was diagnostic of bilateral mastitis. Aspiration cytology exhibited inflammatory lesion rich in eosinophils. Histopathology revealed the diagnosis of eosinophilic mastitis. Eosinophilic infiltration of the breast is a rare manifestation of tissue involvement in peripheral eosinophilia and bilateralism is even rarer. PMID:25171213

Singh, Aminder; Kaur, Pavneet; Sood, Neena; Puri, Harpreet; Garg, Bhavna

2015-01-01

166

Imaging of diabetic retinopathy and diabetic macular edema.  

PubMed

Imaging of the retinal complications of diabetes mellitus is rapidly changing from the emergence of new technology such as optical coherence tomography. In particular, the characterization of diabetic macular edema is much easier for the clinician and there are new, more sensitive clinical research end points. However, our understanding of structure-functional relationships remains suboptimal and the classification of macular edema by optical coherence tomography continues to evolve. The classification of diabetic retinopathy severity continues to rely upon fundus photography, although the transition from film to digital photography presents both challenges and advantages. PMID:21607565

Danis, Ronald P; Hubbard, Larry D

2011-08-01

167

Epiretinal membrane formation associated with idiopathic macular telangiectasia: case report.  

PubMed

A 46-year-old woman complained of blurred and distorted vision in both eyes. Ophthalmic examination showed that visual acuity was 20/200 for the right eye and counting fingers left eye. Fundoscopy revealed perimacular hemorrhages, aneurismal dilatation of the vessels in the posterior pole, and a white and elevated lesion adjacent to vascular changes. We report a case of idiopathic macular telangiectasia and epiretinal membrane that occurs concomitantly. To our knowledge, this is the first report that describes an association between idiopathic macular telangiectasia and epiretinal membrane formation. PMID:25410182

Gomes, Flávia Cid; Felix, João Paulo Fernandes; Nascimento, Maurício Abujamra; Lira, Rodrigo Pessoa Cavalcanti

2014-08-01

168

Resolution of macular edema in idiopathic juxtafoveal telangiectasis using PDT.  

PubMed

A 57-year-old woman was treated by photodynamic therapy for macular edema due to idiopathic juxtafoveal telangiectasis (presumed type 1A) without subretinal neovascularization. Initial visual acuity of the treated eye was 20/200 and it improved to 20/40 by 3 months after the photodynamic therapy session. Visual acuity remained stable 32 months after the treatment. Color photographs and fundus fluorescein angiography before and after photodynamic therapy revealed regression of hemorrhages, exudates, and fluorescein leakage. Photodynamic therapy has long-term benefits for the patient with idiopathic juxtafoveal telangiectasis, presumed type 1A, because it can improve visual acuity and macular edema. PMID:19205501

Kotoula, Maria G; Chatzoulis, Dimitrios Z; Karabatsas, Constantinos H; Tsiloulis, Aristoteles; Tsironi, Evangelia E

2009-01-01

169

Ranibizumab in neovascular age-related macular degeneration.  

PubMed

Neovascular age-related macular degeneration (AMD) is a visually devastating condition resulting from choroidal neovascularization and secondary photoreceptor loss. Ranibizumab and bevacizumab are medications that target vascular endothelial growth factor (VEGF). While other therapies have demonstrated some ability to reduce the risk of losing vision from neovascular AMD, most patients continue to lose some degree of central visual acuity. There is growing evidence that intravitreal administration of ranibizumab and bevacizumab is effective in significantly improving the visual acuity in patients with neovascular age-related macular degeneration. PMID:18046922

Kenneth, T Eng; Kertes, Peter J

2006-01-01

170

Use of antivascular endothelial growth factor for diabetic macular edema  

PubMed Central

Background Diabetic macular edema (DME) is one of the manifestations of diabetic retinopathy leading to loss of central vision and visual acuity. It manifests itself with swelling around the central part of the retina, the area responsible for sharp vision. Current treatment includes laser therapy and intravitreal steroids with preventative measures including diabetes control. No one treatment has guaranteed control of diabetic macular edema which leads to deteriorating visual acuity, function and quality of life in patients. Vascular endothelial growth factor (VEGF) has been shown to be a critical stimulus in the pathogenesis of macular edema secondary to diabetes.1 Antiangiogenic therapy encompassed treatment with anti-VEGF which inhibits VEGF-driven neovascularization hence macular edema leading to decreased visual acuity. Objective For this review, we evaluated the effectiveness of intravitreal anti-VEGF in treating DME. Data sources We identified five trials (n = 525) using electronic databases (Cochrane Central Register of Controlled Trials [Central], Medline®, and Excerpta Medica Database [EMBASE®]) in October 2008, supplemented by hand searching of reference lists, review articles, and conference abstracts. Methods We included all randomized clinical trials (RCTs) evaluating any form of intravitreal anti-VEGF for treating DME. The main outcome factor was change in best-corrected visual acuity and central macular thickness. One author assessed eligibility, methodological quality, and extracted data. Meta analysis was performed when appropriate. Results We included three trials of adequate methodological quality in our meta-analysis. Patients treated with anti-VEGF showed improvement in visual acuity of ?0.17 (95% confidence interval [CI]: ?0.23, ?0.10) and central macular thickness ?84.69 (95% CI: ?117.09, ?52.30). Patients treated with combined anti-VEGF and intravitreal triamcinolone showed improvement of visual acuity of ?0.19 (95% CI: ?0.27, ?0.11) and central macular thickness mean change being –111.20 (95% CI: ?148.13, ?74.28). Conclusions Anti-VEGF has been associated with an improvement in visual acuity and central macular thickness in the analysis, however trial analysis was of a short duration and further research is needed to determine long-term benefits. PMID:20535227

Karim, Rushmia; Tang, Benjamin

2010-01-01

171

Topical Nonsteroidal Anti-Inflammatory Drugs for Macular Edema  

PubMed Central

Nonsteroidal anti-inflammatory drugs (NSAIDs) are nowadays widely used in ophthalmology to reduce eye inflammation, pain, and cystoid macular edema associated with cataract surgery. Recently, new topical NSAIDs have been approved for topical ophthalmic use, allowing for greater drug penetration into the vitreous. Hence, new therapeutic effects can be achieved, such as reduction of exudation secondary to age-related macular degeneration or diabetic maculopathy. We provide an updated review on the clinical use of NSAIDs for retinal diseases, with a focus on the potential future applications. PMID:24227908

Parmeggiani, Francesco; Romano, Mario R.; dell'Omo, Roberto

2013-01-01

172

Spontaneous closure of stage IV idiopathic full-thickness macular hole and late reopening as a lamellar macular hole: a case report  

PubMed Central

Introduction Spontaneous closure of traumatic macular holes is described as a common event in the peer-reviewed literature. However, the spontaneous closure of stage III and IV full-thickness idiopathic macular holes has been reported in less than 15 cases in the literature, this being an extremely rare event, with their reopening being even more infrequent. We report a case of a spontaneous closure of stage IV idiopathic full-thickness macular hole and late reopening as a lamellar macular hole. Case presentation A 67-year-old Spanish man was referred to our hospital with a complaint of decreased vision in his right eye and metamorphopsia for approximately 11?months. He did not report any trauma. Diagnosis was based on fundoscopic and optical coherence tomography. They revealed a stage IV full-thickness idiopathic macular hole and a small epiretinal membrane. Three months later the hole spontaneously closed, and two years later we appreciated its reopening as a lamellar macular hole. Conclusions The contraction of the epiretinal membrane could have contributed to cystic spaces and their fusion, subsequently, to the formation of a lamellar macular hole. To the best of our knowledge this is the first report in the literature of a spontaneously closed full-thickness idiopathic macular hole with reopening as a partial thickness macular defect. PMID:22742449

2012-01-01

173

Comparison of Modified-ETDRS and Mild Macular Grid Laser Photocoagulation Strategies for Diabetic Macular Edema  

PubMed Central

Purpose To compare two laser photocoagulation techniques for treatment of diabetic macular edema (DME): modified-ETDRS direct/grid photocoagulation (mETDRS) and a, potentially milder, but potentially more extensive, mild macular grid (MMG) laser technique in which small mild burns are placed throughout the macula, whether or not edema is present, and microaneurysms are not treated directly. Methods 263 subjects (mean age 59 years) with previously untreated DME were randomly assigned to receive laser photocoagulation by mETDRS (N=162 eyes) or MMG (N=161 eyes) technique. Visual acuity, fundus photographs and OCT measurements were obtained at baseline and after 3.5, 8, and 12 months. Treatment was repeated if DME persisted. Main Outcome Measure Change in OCT measures at 12-months follow up. Results From baseline to 12 months, among eyes with baseline central subfield thickness ? 250 microns, central subfield thickening decreased by an average of 88 microns in the mETDRS group and decreased by 49 microns in the MMG group (adjusted mean difference: 33 microns, 95% confidence interval 5 to 61 microns, P=0.02). Weighted inner zone thickening by OCT decreased by 42 and 28 microns, respectively (adjusted mean difference: 14 microns, 95% confidence interval 1 to 27 microns, P=0.04), maximum retinal thickening (maximum of the central and four inner subfields) decreased by 66 and 39 microns, respectively (adjusted mean difference: 27 microns, 95% confidence interval 6 to 47 microns, P=0.01), and retinal volume decreased by 0.8 and 0.4 mm3, respectively (adjusted mean difference: 0.3 mm3, 95% confidence interval 0.02 to 0.53 mm3, P=0.03). At 12 months, the mean change in visual acuity was 0 letters in the mETDRS group and 2 letters worse in the MMG group (adjusted mean difference: 2 letters, 95% confidence interval ?0.5 to 5 letters, P=0.10). Conclusions At 12 months after treatment, the MMG technique is less effective at reducing OCT measured retinal thickening than the more extensively evaluated current mETDRS laser photocoagulation approach. However, the visual acuity outcome with both approaches is not substantially different. Given these findings a larger long-term trial of the MMG technique is not justified. Application to Clinical Practice Modified ETDRS focal photocoagulation should continue as a standard approach for treating diabetic macular edema. PMID:17420366

2008-01-01

174

Submaximal Expression of the Bilateral Deficit  

ERIC Educational Resources Information Center

Thirty-six participants performed bilateral and unilateral isometric elbow flexion trials at what they perceived to be 100, 75, 50, and 25% of maximal effort. Absolute bilateral deficits ranged from -16% at 25% effort to -10% at 100% effort. The deficit included a component independent of consciousness and a component inversely related to…

McLean, Scott P.; Vint, Peter F.; Stember, Amanda J.

2006-01-01

175

HERITABILITY ESTIMATE FOR BILATERAL OVULATION IN HEIFERS  

Technology Transfer Automated Retrieval System (TEKTRAN)

Recent studies have reported that cows giving birth to twin calves as a result of bilateral ovulations have lower incidences of dystocia and higher calf survival than twins born from the same uterine horn. Therefore, the objective of this study was to determine if bilateral ovulation in heifers is g...

176

Acral osteolysis in bilateral carpal tunnel syndrome  

PubMed Central

Carpal tunnel syndrome is a common neurological condition with rare yet potentially serious cutaneous and skeletal complications. We present a case of mutilating/ulcerating bilateral carpal tunnel syndrome in a 63 year old female. Radiographs showed symmetrical acral osteolysis in the index and middle fingers distal phalanges bilaterally. Carpal tunnel decompressions provided symptomatic relief. PMID:22470585

Khan, Sameer K; Saeed, Iram

2008-01-01

177

Vertigem posicional paroxística benigna bilateral monocanal  

Microsoft Academic Search

Purpose: To determine the prevalence of the simultaneous bilateral involvement of the same semicircular canal in patients with benign paroxysmal positional vertigo (BPPV). Method: Files from 2345 consecutive patients with of BPPV were analyzed. Results: Bilateral monocanal BPPV occurred in 252 (10.9%) patients, with age ranging from 39 to 81 years (average of 59.0 years), prevailing in the feminine gender

Marcela Rosana; Maia da Silveira; Heloísa Helena Caovilla

2007-01-01

178

Bilateral sporadic aniridia: review of management  

PubMed Central

Purpose To report a rare case of bilateral sporadic aniridia in an African child and review the management modalities. Presentation We report a case of bilateral sporadic aniridia with horizontal nystagmus, axial cataract optic disc, and fovea hypoplasia in a 5-year-old female patient. She was managed conservatively. Various modalities of treatment are reviewed. PMID:20957053

Adeoti, Caroline O; Afolabi, Adeyinka A; Ashaye, Adebimpe O; Adeoye, Adenike O

2010-01-01

179

Bilateral cystic nephroma with pleuropulmonary blastoma  

Microsoft Academic Search

Cystic nephroma is a rare benign renal neoplasm that is purely cystic and is lined by an epithelium. Bilateral cystic nephromas are even rarer with only a handful cases reported in the literature. A case of a 2-year-old male child who presented with bilateral renal cystic masses later diagnosed as cystic nephromas is presented here. Ultrasound, CT scan and histopathological

Anand Kumar Bhardwaj; Prem Dass Sharma; Amit Mittal; Akshay Sharma

2011-01-01

180

Spectrum of ABCR gene mutations in autosomal recessive macular dystrophies  

Microsoft Academic Search

Stargardt disease (STGD) and late-onset fundus flavimaculatus (FFM) are autosomal recessive conditions leading to macular degenerations in childhood and adulthood, respectively. Recently, mutations of the photoreceptor cell-specific ATP binding transporter gene (ABCR) have been reported in Stargardt disease. Here, we report on the screening of the whole coding sequence of the ABCR gene in 40 unrelated STGD and 15 FFM

Jean-Michel Rozet; Sylvie Gerber; Eric Souied; Isabelle Perrault; Sophie Châtelin; Imad Ghazi; Corinne Leowski; Jean-Louis Dufier; Arnold Munnich; Josseline Kaplan; J-M Rozet

1998-01-01

181

Genetic factors of age-related macular degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) is a leading cause of blindness in the United States and developed countries. Although the etiology and pathogenesis of AMD remain unknown, a complex interaction of genetic and environmental factors is thought to exist. The incidence and progression of all of the features of AMD are known to increase significantly with age. The tendency for familial

Jingsheng Tuo; Christine M. Bojanowski; Chi-Chao Chan

2004-01-01

182

Nutritional modulation of age-related macular degeneration  

Technology Transfer Automated Retrieval System (TEKTRAN)

Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly worldwide. It affects 30-50 million individuals and clinical hallmarks of AMD are observed in at least one third of persons over the age of 75 in industrialized countries (Gehrs et al., 2006). Costs associated wi...

183

Macular hole in juvenile X-linked retinoschisis  

PubMed Central

An 18 year-old male with no antecedent of trauma, systemic syndrome or myopia was referred for surgical treatment of a full thickness macular hole in the left eye. A more careful inspection revealed discrete foveal cystic changes in the fellow eye and subtle peripheral depigmented retinal pigment epithelial changes in both eyes. A spectral-domain optical coherence tomography (SD-OCT) scan confirmed, in addition to the full thickness macular hole in the left eye, microcystic spaces in the nuclear layers of both retinae. The diagnosis of X-linked retinoschisis was confirmed with a full field electroretinogram displaying the typical negative ERG. Macular holes are uncommon in the young and those complicating X-linked retinoschisis are rare. This report highlights the importance of investigating the presence of a macular hole in a young patient and illustrates the clinical and SD-OCT clues beyond the foveal center which led to the correct diagnosis of X-linked juvenile retinoschisis. PMID:24409088

Al-Swaina, Nayef; Nowilaty, Sawsan R.

2013-01-01

184

Topical indomethacin in the treatment of chronic cystoid macular edema  

Microsoft Academic Search

Eighty percent of 30 eyes with chronic cystoid macular edema (CME) after cataract extraction achieved improved visual acuity of three or more lines when treated with 1% indomethacin eye drops. Of these patients 53% demonstrated an “on\\/off” phenomenon induced by the initiation and cessation of treatment documented by visual acuity measurements and fluorescein angiography. This “on\\/off” phenomenon suggests that there

Michael Peterson; Marc O. Yoshizumi; Robert Hepler; Bartly Mondino; Allan Kreiger

1992-01-01

185

The Evolving Treatment Options for Diabetic Macular Edema  

PubMed Central

Diabetic retinopathy (DR) is the leading cause of vision loss in working-age adults, and diabetic macular edema (DME) is the most common cause of visual impairment in individuals with DR. This review focuses on the pathophysiology, previous treatment paradigms, and emerging treatment options in the management of DME. PMID:24106640

Jain, Atul; Varshney, Neeta; Smith, Colin

2013-01-01

186

Quantitative analysis of macular contraction in idiopathic epiretinal membrane  

PubMed Central

Background We aimed to quantify the displacement of macular capillaries using infrared fundus photographs and image processing software (ImageJ) in patients with idiopathic epiretinal membrane (ERM) who have undergone vitrectomy and to analyze the correlation between vessel displacement and retinal thickness. Methods This prospective study included 16 patients who underwent vitrectomy for idiopathic ERM. Ophthalmic examination and optical coherence tomography (OCT) were performed before and 3 months after surgery. The length of radial vessel segment included in each area (VLA) and the length from the foveola to the vessel branching point (FBL) depending on the superior, inferior, nasal, and temporal areas of the macula were measured using infrared fundus images and image processing software (ImageJ). Preoperative and postoperative parameters were compared and correlations between VLA, FBL, macular thickness, and visual acuity were assessed. Results The VLA of superior, inferior, and temporal areas showed a significant postoperative reduction. VLA differences showed a positive correlation with differences in macular thickness, which corresponded to the superior, inferior, and temporal areas; however, no correlation was observed in the nasal area. The FBL of the superior and inferior areas was significantly increased postoperatively. A positive correlation was observed between FBL differences and macular thickness differences in the superior area. Postoperative change in VLA and FBL did not show a significant correlation with postoperative best corrected visual acuity (BCVA) and BCVA differences. Conclusions Infrared fundus photographs and image processing software can be useful for quantifying progressive changes in retinal surface distortion after surgical removal of ERM. Macular edema and vascular distortion showed significant improvement after surgery. Furthermore, a correlation was observed between topographic and tomographic changes. PMID:24735324

2014-01-01

187

PSEUDOPHAKIC CYSTOID MACULAR EDEMA. ASSESMENT WITH OPTICAL COHERENCE TOMOGRAPHY EDEMA MACULAR QUÍSTICO PSEUDOFÁQUICO. DETECCIÓN MEDIANTE «OPTICAL COHERENCE TOMOGRAPHY  

Microsoft Academic Search

Purpose: To determine the incidence of cystoid macular edema (CME) by means of clinical evalua- tion and subclinical assessment by means of ocular coherence tomography (OCT), and to compare the incidence between diabetic and non-diabetic groups of patients. Methods: Prospective study of 260 consecutive cataract surgeries operated from September 2004 to March 2005. The procedures were performed by means of

TORRÓN-FERNÁNDEZ-BLANCO C; RUIZ-MORENO O; FERRER-NOVELLA E; SÁNCHEZ-CANO A; HONRUBIA-LÓPEZ FM

188

Heterochronic bilateral ectopic pregnancy after ovulation induction*  

PubMed Central

Ectopic pregnancy is identified with the widely-applied assisted reproductive technology (ART). Bilateral ectopic pregnancy is a rare form of ectopic pregnancy which is difficult to be diagnosed at the pre-operation stage. In this paper, we presented an unusual case of heterochronic bilateral ectopic pregnancy after stimulated intrauterine insemination (IUI), where there has been a delay of 22 d between the diagnoses of the two ectopic pregnancies. Literature was reviewed on the occurrence of bilateral ectopic pregnancy during the past four years in the MEDLINE database. We found 16 cases of bilateral ectopic pregnancy reported since 2008, and analyzed the characteristics of those cases of bilateral ectopic pregnancy. We emphasize that ovulation induction and other ARTs may increase the risk of bilateral ectopic pregnancy. Because of the difficulty in identification of bilateral ectopic pregnancy by ultrasonography, the clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operation inspection of both side fallopian tubes in any ectopic pregnancy case. PMID:25091994

Zhu, Bo; Xu, Gu-feng; Liu, Yi-feng; Qu, Fan; Yao, Wei-miao; Zhu, Yi-min; Gao, Hui-juan; Zhang, Dan

2014-01-01

189

Macular Hole Progression after Intravitreal Bevacizumab for Hemicentral Retinal Vein Occlusion  

PubMed Central

Macular edema secondary to retinal vein occlusion is commonly being treated with off-label intravitreal bevacizumab with good outcomes. A significant reduction in macular edema and improvement in visual acuity is seen following such a treatment with no serious adverse effects. In the reported case, a full-thickness macular hole was noticed one month after intravitreal bevacizumab for macular edema secondary to hemicentral retinal vein occlusion. On a detailed review of the pre- and postoptical coherence tomography scans, it was realized that there was a preexisting stage 2-3 macular hole which was masked by the hemorrhages and edema at the fovea and the macular hole had progressed following the injection. PMID:22606470

Nagpal, Manish; Mehta, Vikram; Nagpal, Kamal

2011-01-01

190

Early imaging of a macular hole following vitrectomy with primary silicone oil tamponade  

PubMed Central

Background To describe the morphology of a macular hole in the early postoperative period following vitrectomy with primary silicone oil tamponade. Methods A case report with optical coherence tomography (OCT) scans prior to surgery, at 20 minutes postoperatively and then at 17 hours postoperatively. Results OCT images of a 73-year-old woman with a stage 3 macular hole were obtained. At 20 minutes postoperatively, there was a reduction in intraretinal cysts and a reduction in macular hole size with elevated-open configuration. At 17 hours postoperatively, complete macular hole closure was noted. Conclusion OCT Images of a macular hole in the early postoperative period have been successfully obtained. Macular holes can close within 24 hours postoperatively and show morphological changes that may be predictive of closure within 20 minutes postoperatively. PMID:22140310

Saha, Niladri; Lake, Stewart; Wang, Bob Z

2011-01-01

191

The guided bilateral filter: when the joint/cross bilateral filter becomes robust.  

PubMed

The bilateral filter and its variants, such as the joint/cross bilateral filter, are well-known edge-preserving image smoothing tools used in many applications. The reason of this success is its simple definition and the possibility of many adaptations. The bilateral filter is known to be related to robust estimation. This link is lost by the ad hoc introduction of the guide image in the joint/cross bilateral filter. We here propose a new way to derive the joint/cross bilateral filter as a particular case of a more generic filter, which we name the guided bilateral filter. This new filter is iterative, generic, inherits the robustness properties of the robust bilateral filter, and uses a guide image. The link with robust estimation allows us to relate the filter parameters with the statistics of input images. A scheme based on graduated nonconvexity is proposed, which allows converging to an interesting local minimum even when the cost function is nonconvex. With this scheme, the guided bilateral filter can handle non-Gaussian noise on the image to be filtered. A complementary scheme is also proposed to handle non-Gaussian noise on the guide image even if both are strongly correlated. This allows the guided bilateral filter to handle situations with more noise than the joint/cross bilateral filter can work with and leads to high peak signal-to-noise ratio values as shown experimentally. PMID:25585418

Caraffa, Laurent; Tarel, Jean-Philippe; Charbonnier, Pierre

2015-04-01

192

A longitudinal study of the bilateral benefit in children with bilateral cochlear implants.  

PubMed

Objective: To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization. Design: Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing. Study sample: Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data. Results: For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization. Conclusions: A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience. PMID:25428567

Asp, Filip; Mäki-Torkko, Elina; Karltorp, Eva; Harder, Henrik; Hergils, Leif; Eskilsson, Gunnar; Stenfelt, Stefan

2014-11-27

193

Fibromuscular Dysplasia Presenting with Bilateral Renal Infarction  

SciTech Connect

Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial stenoses, most commonly of the renal and carotid arteries, typically in young women. We report a rare case of bilateral segmental renal infarction secondary to FMD in a young male patient. His initial presentation with loin pain and pyrexia resulted in a delay in the definitive diagnosis of FMD. He was successfully treated with bilateral balloon angioplasty. The delayed diagnosis in this patient until the condition had progressed to bilateral renal infarcts highlights the need for prompt investigation and diagnosis of suspected cases of FMD.

Doody, O., E-mail: orla_doody@hotmail.co [Alfred Hospital, Department of Radiology (Australia); Adam, W. R. [University of Melbourne and Goulburn Valley Health, School of Rural Health (Australia); Foley, P. T.; Lyon, S. M. [Alfred Hospital, Department of Radiology (Australia)

2009-03-15

194

Bilateral pneumothorax after orthognatic surgery  

PubMed Central

Among complications in orthognathic surgery, the insurgence of pneumothorax is very rare. Pneumothorax is the presence of air or gas in the pleural cavity and it is rare complications in the postoperative oral and maxillofacial surgery patient. The clinical results are dependent on the degree of collapse of the lung on the affected side. Pneumothorax can impair oxygenation and/or ventilation. If the pneumothorax is significant, it can cause a shift of the mediastinum and compromise haemodynamic stability. While 10% of pneumothoraces are asymptomatic, patients often complain of acute chest pain and difficulty breathing. There is a reduction in vital capacity, tachycardia, tachypnoea and a decrease in partial pressure of oxygen with an inability to maintain oxygen saturations. We observed this unusual surgical consequence in a 28-year-old female with negative clinical history and instrumental evaluation after Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). No further consequences, no neurological sequelae, no infections and no other osteotomies sequelae were seen. Sudden post-surgical dispnea associated to sub-cutaneous emphysema of the neck and of the thorax must be adequately observed with the aim of monitoring further severe sequelae. The anaesthetic management of the emergency difficult airway in any post-surgical orthognatic treatment can be extremely difficult requiring a multi-disciplinary approach. PMID:23814593

Bertossi, Dario; Malchiodi, Luciano; Turra, Matteo; Bondi, Vincenzo; Albanese, Massimo; Lucchese, Alessandra; Carinci, Francesco; Nocini, Pierfrancesco

2012-01-01

195

Bilateral symmetry across Aphrodite Terra  

NASA Technical Reports Server (NTRS)

There are three main highland areas on Venus: Beta Regio, Ishtar Terra and Aphrodite Terra. The latter is least known and the least mapped, yet existing analyses of Aphrodite Terra based on available Pioneer-Venus orbiter data suggest that it may be the site of extensive rifting. Some of the highest resolution (30 km) PV data (SAR) included most of the western half of Aphrodite Terra. Recent analysis of the SAR data together with Arecibo range-doppler topographic profiling (10 X 100 km horizontal and 10 m vertical resolution) across parts of Aphrodite, further characterized the nature of possible tectonic processes in the equatorial highlands. The existence of distinct topographic and radar morphologic linear discontinuities across the nearly east-west strike of Aphrodite Terra is indicated. Another prominent set of linear features is distinctly parallel to and orthogonal to the ground tracks of the PV spacecraft and are not included because of the possibility that they are artifacts. Study of the northwest trending cross-strike discontinuities (CSD's) and the nature of topographic and morphologic features along their strike suggest the presence of bilateral topographic and morphologic symmetry about the long axis of Aphrodite Terra.

Crumpler, L. S.; Head, J. W.; Campbell, D. B.

1987-01-01

196

Correlation between optical coherence tomography data and biomicroscopic interpretation of idiopathic macular hole  

Microsoft Academic Search

PURPOSE: This study was designed to assess the new clinical information given by optical coherence tomography in patients with idiopathic macular hole.METHODS: Sixty-one consecutive eyes of 47 patients with idiopathic macular hole at different stages of development were studied clinically. Patients with myopia, epiretinal macular membrane, and any other ocular disease were excluded. Best-refracted visual acuity and biomicroscopic fundus examination

Claudio Azzolini; Fabio Patelli; Rosario Brancato

2001-01-01

197

Delayed macular hole formation after demarcation laser photocoagulation for subclinical retinal detachment  

PubMed Central

The purpose of this paper is to report a series of macular holes that developed after demarcation laser photocoagulation for subclinical retinal detachments. This observational case series consists of three eyes from three patients seen between 2005 and 2012. Delayed idiopathic macular hole formation occurred following demarcation laser photocoagulation for subclinical retinal detachment. Demarcation laser photocoagulation of subclinical retinal detachments may predispose to macular hole formation. PMID:24872676

Rusu, Irene M; Zizva, Jessica; Myung, Jane S; Wald, Kenneth

2014-01-01

198

Delayed macular hole formation after demarcation laser photocoagulation for subclinical retinal detachment.  

PubMed

The purpose of this paper is to report a series of macular holes that developed after demarcation laser photocoagulation for subclinical retinal detachments. This observational case series consists of three eyes from three patients seen between 2005 and 2012. Delayed idiopathic macular hole formation occurred following demarcation laser photocoagulation for subclinical retinal detachment. Demarcation laser photocoagulation of subclinical retinal detachments may predispose to macular hole formation. PMID:24872676

Rusu, Irene M; Zizva, Jessica; Myung, Jane S; Wald, Kenneth

2014-01-01

199

Morphology, pathology, and surgery of idiopathic vitreoretinal macular disorders. A review.  

PubMed

Macular pucker, the vitreomacular traction syndrome, and impending macular hole are three idiopathic macular disorders sometimes treated by vitreous surgery. Each condition has distinctive clinical features, pathogenic mechanisms, vitreoretinal anatomy, surgical findings, results, and complications. The clinical and pathologic features of these three conditions are compared based on a series of: (1) 101 idiopathic macular pucker cases for which clinicopathologic correlation with transmission electron microscopy (CPC-EM) was available, (2) 24 cases of the vitreomacular traction syndrome (7 patients with CPC-EM), and (3) 43 cases of impending macular hole (7 patients with CPC-EM). All cases of macular pucker, 16 cases of vitreomacular traction syndrome, and 15 cases of impending macular hole have been reported. The median visual acuity for patients with epiretinal membrane and vitreomacular traction syndrome improved from 20/200 preoperatively to 20/70 and 20/50 postoperatively. Macular holes occurred postoperatively in 11 of 43 patients with impending macular hole. The three conditions must be differentiated clinically so that proper recommendations regarding prognosis and possible surgical management can be made. PMID:2089546

Smiddy, W E; Michels, R G; Green, W R

1990-01-01

200

Bilateral, Zero-Impedance Static Semiconductor Switch  

NASA Technical Reports Server (NTRS)

Static semiconductor switching circuit eliminates the undesirable features of electromechanical relays and conventional semiconductor switching circuits. There is a net zero voltage drop at the terminals and thus a zero impedance for bilateral currents there.

Doughman, C. L.

1968-01-01

201

Preliminary Experience in Treatment of Papillary and Macular Retinoblastoma: Evaluation of Local Control and Local Complications After Treatment With Linear Accelerator-Based Stereotactic Radiotherapy With Micromultileaf Collimator as Second-Line or Salvage Treatment After Chemotherapy  

SciTech Connect

Purpose: To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. Methods and Materials: Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. Results: The median follow-up was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. Conclusions: Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials.

Pica, Alessia, E-mail: Alessia.Pica@chuv.ch [Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Moeckli, Raphael [University Institute for Radiation Physics, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Balmer, Aubin [Department of Radiation Oncology, Jules Gonin Eye Hospital, Lausanne (Switzerland); Beck-Popovic, Maja [Unit of Pediatric Oncology, University of Lausanne, Lausanne (Switzerland); Chollet-Rivier, Madeleine [Department of Anesthesiology, University of Lausanne, Lausanne (Switzerland); Do, Huu-Phuoc [University Institute for Radiation Physics, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Weber, Damien C. [Department of Radiation Oncology, Geneva University Hospital, University of Geneva, Geneva (Switzerland); Munier, Francis L. [Department of Radiation Oncology, Jules Gonin Eye Hospital, Lausanne (Switzerland)

2011-12-01

202

Bilateral ankle pain secondary to sarcoidosis.  

PubMed

Sarcoidosis has been described as a multisystem granulomatous disorder of unknown etiology that usually affects young adults. It can affect the foot and ankle. When erythema nodosum is present, the sarcoidosis usually is characterized by bilateral hilar lymphadenopathy, uveitis, fever, arthralgia, or arthritis. This symptom complex is referred to as Löfgren's syndrome. The author describes a patient who presented with bilateral medial ankle pain secondary to sarcoidosis. PMID:2724109

Julsrud, M

1989-03-01

203

Bilateral hippocampal dysfunction in schizophrenia.  

PubMed

The hippocampus has long been known to be important for memory, with the right hippocampus particularly implicated in nonverbal/visuo-spatial memory and the left in verbal/narrative or episodic memory. Despite this hypothesized lateralized functional difference, there has not been a single task that has been shown to activate both the right and left hippocampi differentially, dissociating the two, using neuroimaging. The transverse patterning (TP) task is a strong candidate for this purpose, as it has been shown in human and nonhuman animal studies to theoretically and empirically depend on the hippocampus. In TP, participants choose between stimuli presented in pairs, with the correct choice being a function of the specific pairing. In this project, TP was used to assess lateralized hippocampal function by varying its dependence on verbal material, with the goal of dissociating the two hippocampi. Magnetoencephalographic (MEG) data were collected while controls performed verbal and nonverbal versions of TP in order to verify and validate lateralized activation within the hippocampi. Schizophrenia patients were evaluated to determine whether they exhibited a lateralized hippocampal deficit. As hypothesized, patients' mean level of behavioral performance was poorer than controls' on both verbal and nonverbal TP. In contrast, patients had no decrement in performance on a verbal and nonverbal non-hippocampal-dependent matched control task. Also, controls but not patients showed more right hippocampal activation during nonverbal TP and more left hippocampal activation during verbal TP. These data demonstrate the capacity to assess lateralized hippocampal function and suggest a bilateral hippocampal behavioral and activation deficit in schizophrenia. PMID:21763438

Hanlon, Faith M; Houck, Jon M; Pyeatt, Clinton J; Lundy, S Laura; Euler, Matthew J; Weisend, Michael P; Thoma, Robert J; Bustillo, Juan R; Miller, Gregory A; Tesche, Claudia D

2011-10-15

204

Bilateral tension pneumothorax related to acupuncture.  

PubMed

We report on a patient with a rare case of bilateral tension pneumothorax that occurred after acupuncture. A 69-year-old large-bodied man, who otherwise had no risk factors for spontaneous pneumothorax, presented with chest pressure, cold sweats and shortness of breath. Immediately after bilateral pneumothorax had been identified on a chest radiograph in the emergency room, his blood pressure and percutaneous oxygen saturation suddenly decreased to 78 mm Hg and 86%, respectively. We confirmed deterioration in his cardiopulmonary status and diagnosed bilateral tension pneumothorax. We punctured his chest bilaterally and inserted chest tubes for drainage. His vital signs promptly recovered. After the bilateral puncture and drainage, we learnt that he had been treated with acupuncture on his upper back. We finally diagnosed a bilateral tension pneumothorax based on the symptoms that appeared 8 h after the acupuncture. Because the patient had no risk factors for spontaneous pneumothorax, no alternative diagnosis was proposed. We recommend that patients receiving acupuncture around the chest wall must be adequately informed of the possibility of complications and expected symptoms, as a definitive diagnosis can be difficult without complete information. PMID:23449179

Tagami, Rumi; Moriya, Takashi; Kinoshita, Kosaku; Tanjoh, Katsuhisa

2013-06-01

205

Anti-VEGF therapy for diabetic macular edema.  

PubMed

Vascular endothelial growth factor (VEGF) plays a pivotal role in the development of diabetic macular edema (DME), the leading cause of vision loss among working-aged individuals. A decade of clinical trials demonstrated that drugs that bind soluble VEGF restore the integrity of the blood-retinal barrier, resolve macular edema, and improve vision in most patients with DME. Four drugs (pegaptanib, ranibizumab, bevacizumab, and aflibercept) effectively treat DME when administered by intravitreal injections. Only ranibizumab has received U.S. Food and Drug Administration (FDA) approval for DME, but bevacizumab is commonly used off-label, and an FDA application for aflibercept is pending. Effective treatment requires repeated injections, although recent data suggest that the treatment burden diminishes after 1 year. Intravitreal therapy is generally safe, although the incidence of systemic thromboembolic events varies among trials. PMID:24919750

Stewart, Michael W

2014-08-01

206

Age-related macular degeneration and the aging eye  

PubMed Central

Age-related macular degeneration (AMD) is an ocular disease that causes damage to the retinal macula, mostly in the elderly. Normal aging processes can lead to structural and blood flow changes that can predispose patients to AMD, although advanced age does not inevitably cause AMD. In this review, we describe changes that occur in the macular structure, such as the retinal pigment epithelium and Bruch’s membrane, with advancing age and in AMD. The role of genetics in AMD and age-related changes in ocular blood flow that may play a role in the pathogenesis of AMD are also discussed. Understanding the pathophysiology of AMD development can help guide future research to further comprehend this disease and to develop better treatments to prevent its irreversible central vision loss in the elderly. PMID:18982917

Ehrlich, Rita; Harris, Alon; Kheradiya, Nisha S; Winston, Diana M; Ciulla, Thomas A; Wirostko, Barbara

2008-01-01

207

Epiretinal macular edema associated with thick epiretinal membranes.  

PubMed

High-resolution imaging with spectral-domain optical coherence tomography has identified an unusual group of epiretinal membranes (ERMs) in the presence of lamellar macular holes. These ERMs are unusually thick. The authors present the case of a patient with age-related macular degeneration who developed edema within a thickened ERM in both eyes after cataract surgery. The edema resolved with anti-vascular endothelial growth factor (VEGF) therapy. The authors propose that the VEGF-responsive fluid within these thick ERMs arose from fibrovascular tissue derived from the retina. Further studies with histopathology will be required to determine whether neovascular tissue is present in all cases of thickened ERMs with epiretinal edema. PMID:24044720

Doshi, Rishi R; Lowrance, Matthew D; Kim, Brian T; Davis, Janet L; Rosenfeld, Philip J

2013-01-01

208

A Novel Episcleral Macular Buckling: Wire-Strengthened Sponge Exoplant for Recurrent Macular Hole and Retinal Detachment in High Myopic Eyes  

PubMed Central

The purpose would be to describe and evaluate a novel technique of episcleral macular buckling in postvitrectomy recurrent macular hole retinal detachment in highly myopic eyes. A 7mm silicone sponge strengthened with a U-shaped 0.5mm orthodontics stainless steel wire fed along its length and hand-bent to produce L-shaped buckle of appropriate shape and length, is used. The episcleral macular buckling has performed on 15 highly myopic eyes (axial length > 30mm) with recurrent macular hole retinal detachment following silicone oil removal. Buckle localization has been performed by manipulating the long arm of the exoplant, under direct internal visualization, scleral marking and suturing. Successful retinal reattachment with improvement in visual acuity achieved in all 15 eyes. Closure of the macular holes was confirmed by Optical Coherence Tomography. The anatomical and functional outcomes of this new technique of macular buckling appears to provide an effective and feasible means of retinal reattachment and hole closure in postvitrectomy recurrent macular hole detachment in highly myopic eyes. PMID:24600635

Mortada, Hassan A.

2013-01-01

209

Geriatric vision loss due to cataracts, macular degeneration, and glaucoma.  

PubMed

The major causes of impaired vision in the elderly population of the United States are cataracts, macular degeneration, and open-angle glaucoma. Cataracts and macular degeneration usually reduce central vision, especially reading and near activities, whereas chronic glaucoma characteristically attacks peripheral vision in a silent way, impacting balance, walking, and driving. Untreated, these visual problems lead to issues with regard to taking medications, keeping track of finances and personal information, walking, watching television, and attending the theater, and often create social isolation. Thus, visually impaired individuals enter nursing homes 3 years earlier, have twice the risk of falling, and have 4× the risk of hip fracture. Consequently, many elderly with low vision exercise greater demands on community services. With the prospect of little improvement and sustained visual loss, in the face of poor tolerance of low-vision services and not accepting magnification as the only way to read, clinical depression is common. In many instances, however, early and accurate diagnosis can result in timely treatment and can preserve quality of life. This review will look at current diagnostic and therapeutic considerations. Currently, about 20.5 million people in the United States have cataracts. The number will reach 30 million by 2020. About 1.75 million Americans currently have some form of macular degeneration, and the number is estimated to increase to 2.95 million in 2020. Approximately 2.2 million Americans have glaucoma, and by 2020 that number is estimated to be close to 3.4 million people. It is projected that by 2030 there will be 72.1 million seniors. With some overlap of the above 3 groups conservatively estimated (if you add the 2030 cataract group to the macular degeneration and glaucoma groups), then about 1 in 2 senior individuals by 2030 may have some significant ocular disease, which could account for about 50% of the healthcare budget for the elderly. PMID:22499498

Eichenbaum, Joseph W

2012-01-01

210

Intraocular lens iris fixation. Clinical and macular OCT outcomes  

PubMed Central

Background To assess the efficacy, clinical outcomes, visual acuity (VA), incidence of adverse effects, and complications of peripheral iris fixation of 3-piece acrylic IOLs in eyes lacking capsular support. Thirteen patients who underwent implantation and peripheral iris fixation of a 3-piece foldable acrylic PC IOL for aphakia in the absence of capsular support were followed after surgery. Clinical outcomes and macular SD-OCT (Cirrus OCT; Carl Zeiss Meditec, Germany) were analyzed. Findings The final CDVA was 20/40 or better in 8 eyes (62%), 20/60 or better in 12 eyes (92%), and one case of 20/80 due to corneal astigmatism and mild persistent edema. No intraoperative complications were reported. There were seven cases of medically controlled ocular hypertension after surgery due to the presence of viscoelastic in the AC. There were no cases of cystoid macular edema, chronic iridocyclitis, IOL subluxation, pigment dispersion, or glaucoma. Macular edema did not develop in any case by means of SD-OCT. Conclusions We think that this technique for iris suture fixation provides safe and effective results. Patients had substantial improvements in UDVA and CDVA. This surgical strategy may be individualized however; age, cornea status, angle structures, iris anatomy, and glaucoma are important considerations in selecting candidates for an appropriate IOL fixation method. PMID:23050659

2012-01-01

211

Nutritional supplements for age-related macular degeneration  

PubMed Central

Purpose of review Age-related macular degeneration, a leading cause of visual loss in older adults, has limited therapeutic options. This review describes the current literature on the role of nutritional supplementation in primary and secondary prevention of AMD. Recent findings Many observational studies have explored the association between diet, nutrient intake, and AMD. In particular, high dietary intakes of omega 3 fatty acids, and macular xanthophylls lutein and zeaxanthin have been associated with a lower risk of prevalent and incident AMD. However, the Age-Related Eye Disease Study (AREDS) is the only large-scale randomized controlled clinical trial to show a 25% beneficial effect of nutritional supplementation in reducing the risk progression to advanced AMD in patients with intermediate AMD or with advanced AMD in one eye at 5 years of follow-up. Based on the results of AREDS, these patients are recommended to take AREDS formulation of vitamins C, E, beta-carotene, and zinc with copper. Summary At the present time, there is insufficient evidence in the literature to recommend routine nutritional supplementation in healthy adults for primary prevention of AMD. However, patients with intermediate risk of AMD or advanced AMD in one eye should consider taking AREDS-type supplements. Observational studies have also suggested benefit from increased dietary intake of macular xanthophylls and omega-3 fatty acids. These are currently being evaluated prospectively in a randomized controlled clinical trial, the Age-Related Eye Disease Study 2 (AREDS2). PMID:20216418

Krishnadev, Nupura; Meleth, Annal D.; Chew, Emily Y.

2010-01-01

212

Retinal layer segmentation of macular OCT images using boundary classification  

PubMed Central

Optical coherence tomography (OCT) has proven to be an essential imaging modality for ophthalmology and is proving to be very important in neurology. OCT enables high resolution imaging of the retina, both at the optic nerve head and the macula. Macular retinal layer thicknesses provide useful diagnostic information and have been shown to correlate well with measures of disease severity in several diseases. Since manual segmentation of these layers is time consuming and prone to bias, automatic segmentation methods are critical for full utilization of this technology. In this work, we build a random forest classifier to segment eight retinal layers in macular cube images acquired by OCT. The random forest classifier learns the boundary pixels between layers, producing an accurate probability map for each boundary, which is then processed to finalize the boundaries. Using this algorithm, we can accurately segment the entire retina contained in the macular cube to an accuracy of at least 4.3 microns for any of the nine boundaries. Experiments were carried out on both healthy and multiple sclerosis subjects, with no difference in the accuracy of our algorithm found between the groups. PMID:23847738

Lang, Andrew; Carass, Aaron; Hauser, Matthew; Sotirchos, Elias S.; Calabresi, Peter A.; Ying, Howard S.; Prince, Jerry L.

2013-01-01

213

Macular Thickness by Age and Gender in Healthy Eyes Using Spectral Domain Optical Coherence Tomography  

PubMed Central

Purpose To determine normal macular thickness and its variation by age and gender in healthy eyes using spectral-domain optical coherence tomography (SD-OCT). Methods In this cross-sectional analysis, two hundred and twenty eyes of 220 healthy subjects underwent raster scanning using Topcon SD-OCT system, at the Department of Ophthalmology, Dow University of Health Sciences and Civil Hospital Karachi, Pakistan. Macular thickness from all 9 regions of the ETDRS map was documented for each subject. Variations in macular thickness measurements by age and gender were determined. Results The 220 subjects had a mean age of 45.3 years (16–80 years). Using the ETDRS map, foveal thickness for all subjects was measured to be 229±20.46 µm. Mean macular thickness for all subjects was 262.8±13.34 µm. Male gender was associated with greater foveal (p<0.0001) and mean macular (p<0.0001) thickness compared to females. There was no association of mean macular thickness (r2?=?0.01; p>0.05) and foveal thickness (r2?=?0.00004; p>0.05) with age. Conclusion We have provided normative data for macular thickness using Topcon SD-OCT system. Our results are comparable to some and vary from other reports using the similar OCT system. Our results suggest that male gender is associated with greater macular thickness, while macular thickness has no association with age in healthy eyes. This is the first normative data for macular thickness from Pakistan; benchmark for diagnosing and monitoring macular pathologies. The values obtained in this study may be useful for comparison with other populations, other SD-OCT systems and future imaging technologies. PMID:22629435

Adhi, Mehreen; Aziz, Sumbul; Muhammad, Kashif; Adhi, Mohammad I.

2012-01-01

214

Fully automated detection of diabetic macular edema and dry age-related macular degeneration from optical coherence tomography images  

PubMed Central

We present a novel fully automated algorithm for the detection of retinal diseases via optical coherence tomography (OCT) imaging. Our algorithm utilizes multiscale histograms of oriented gradient descriptors as feature vectors of a support vector machine based classifier. The spectral domain OCT data sets used for cross-validation consisted of volumetric scans acquired from 45 subjects: 15 normal subjects, 15 patients with dry age-related macular degeneration (AMD), and 15 patients with diabetic macular edema (DME). Our classifier correctly identified 100% of cases with AMD, 100% cases with DME, and 86.67% cases of normal subjects. This algorithm is a potentially impactful tool for the remote diagnosis of ophthalmic diseases. PMID:25360373

Srinivasan, Pratul P.; Kim, Leo A.; Mettu, Priyatham S.; Cousins, Scott W.; Comer, Grant M.; Izatt, Joseph A.; Farsiu, Sina

2014-01-01

215

A One Year Study of the Macular Pigment: The Effect of 140 Days of a Lutein Supplement  

Microsoft Academic Search

A low density of macular pigment may represent a risk factor for age-related macular degeneration (AMD) by permitting greater blue light damage. This study was carried out to determine the effects on macular pigment optical density of dietary supplementation with lutein, one of the pigment constituents. Two subjects consumed lutein esters, equivalent to 30 mg of free lutein per day,

JOHN T LANDRUM; RICHARD A BONE; HILDA JOA; MARK D KILBURN; LINDA L MOORE; KATHLEEN E SPRAGUE

1997-01-01

216

Dietary intake and serum concentrations of lutein and zeaxanthin, but not macular pigment optical density, are related in spouses  

Microsoft Academic Search

Lutein and zeaxanthin, 2 carotenoids obtained from the diet, accumulate in the central retina where they are collectively called macular pigment. Although dietary intake of these carotenoids is directly related to tissue concentration, several factors, such as body mass index, appear to indirectly affect macular pigment concentrations. Individuals who consume similar diets and share factors that affect macular pigment, such

Adam J. Wenzel; Joseph P. Sheehan; Joanne D. Burke; Mark G. Lefsrud; Joanne Curran-Celentano

2007-01-01

217

Comparison of intravitreal bevacizumab with macular photocoagulation for treatment of diabetic macular edema: a systemic review and Meta-analysis  

PubMed Central

AIM To further evaluate the efficacy and safety of intravitreal bevacizumab (IVB) versus macular photocoagulation (MPC) in treatment of diabetic macular edema (DME) by Meta-analysis. METHODS Pertinent publications were identified through systemic searches of PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register up to 30 November, 2013. Changes in central macular thickness (CMT) in µm and best-corrected visual acuity (BCVA) in logMAR equivalents were extracted at 1, 3, 6, 12 and 24mo after initial treatment, and a Meta-analysis was carried out to compare results between groups receiving IVB and MPC. RESULTS Five randomized controlled trial (RCTs) and one high-quality comparative study were identified and included. Our Meta-analysis revealed that both IVB and MPC resulted in the improvements of CMT and BCVA in eyes with DME at 1mo after initial treatment, with IVB being significantly superior to MPC (P=0.01 and 0.02, respectively). The improvements of both measure outcomes at 3, 6, 12 and 24mo after treatment did not vary significantly between the IVB groups and MPC groups (CMT at 3mo, P=0.85; at 6mo, P=0.29; at 12mo, P=0.56; at 24mo, P=0.71; BCVA at 3mo, P=0.31; at 6mo, P= 0.30; at 12mo, P=0.23; at 24mo, P=0.52). However, the number of observed adverse events was low in all studies. CONCLUSION Current evidence shows IVB treatment trends to be more effective in improvements of macular edema and vision in eyes with DME at an earlier follow up (1mo) compared with MPC. At other time, both interventions have comparable efficacy without statistical significances. PMID:25540764

Liu, Xiang-Dong; Zhou, Xiao-Dong; Wang, Zhi; Shen, Hong-Jie

2014-01-01

218

[Triamcinolone acetonide bevacizumab performance in treatment and idiopathic macular spider veins].  

PubMed

This article evaluated the efficacy of intravitrean injection of anti VEGF agents and triamcinolon in the treatment of macular telangiectasis. The patients were followed six months. We practiced fluorescein angiography, optical coherence tomography. We measured the thickening of macular edema and best corrected of visual acuity. PMID:20540378

Cerbulescu, Beatrice; Taina, Ana-Lavinia; Dinita, Monica; Malaeanu, Raluca; Radocea, Robertina; Carstocea, B

2010-01-01

219

The Impact of Macular Laser Photocoagulation on Contrast Sensitivity Function in Patients with Clinically  

Microsoft Academic Search

Background: Contrast sensitivity is an important aspect of visual function and is even more important for ordinary daily tasks than visual acuity. Contrast sensitivity function may be deteriorated to a significant level in diabetic retinopathy, especially in diabetic macular edema. The objective of this study was to determine the impact of macular laser photocoagulation—as the standard treatment of clinically significant

Significant Macular Edema; Mohammad-Sadegh Farahvash; Amir-Hossein Mahmoudi; Mohammad-Mehdi Farahvash; Ali Tabatabaee; Mohammad Riazi; Shiva Mohammadzadeh; Houshang Faghihi; Mehdi Nilli-Ahmadabadi; Ahmad Mirshahi; Reza Karkhaneh; Zahra Aalami-Harandi; Ahmad Javadian; Ali Abdolahi; Alireza Lashey

2008-01-01

220

Macular lutein and zeaxanthin are related to brain lutein and zeaxanthin in primates  

Technology Transfer Automated Retrieval System (TEKTRAN)

The xanthophyll pigments lutein and zeaxanthin cross the blood-retina barrier to preferentially accumulate in the macular region of the neural retina. There they form macular pigment, protecting the retina from blue light damage and oxidative stress. Lutein and zeaxanthin also accumulate in brain t...

221

Comparison of optical coherence tomography models OCT1 and Stratus OCT for macular retinal thickness measurement  

Microsoft Academic Search

Aims: To compare the values measured for retinal macular thickness with the first and last generations of the optical coherence tomograph (OCT1 and Stratus OCT, Zeiss, Humphrey Division).Methods: This was a cohort study. 59 eyes were examined: 17 had a normal macula and 42 had a diabetic macular oedema. In each eye, mean retinal thickness (RT) was measured automatically in

V Pierre-Kahn; R Tadayoni; B Haouchine; P Massin; A Gaudric

2005-01-01

222

Cystoid macular edema associated with juvenile idiopathic arthritis resolved by a dexamethasone intravitreal implant.  

PubMed

Uveitis, glaucoma, and cystoid macular edema frequently develop in patients with juvenile idiopathic arthritis. The authors describe a case of cystoid macular edema associated with juvenile idiopathic arthritis that had not responded to intravitreal triamcinolone acetonide and bevacizumab but improved significantly following intravitreal injection with a dexamethasone 0.7 mg implant. PMID:24811080

Totan, Yüksel; Güler, Emre; Guragaç, Fatma B; Dervisogullari, Mehmet S; Tenlik, Aylin; Hepsen, Ibrahim F

2014-01-01

223

Hemorrhagic Macular Infarction after Intravitreal Bevacizumab for Chronic Multifocal Central Serous Chorioretinopathy  

PubMed Central

We hereby report a case of hemorrhagic macular infarction after intravitreal bevacizumab for chronic multifocal central serous chorioretinopathy (CSC). Issues regarding safety and adverse effects of bevacizumab are discussed. To the best of our knowledge, this is the first reported case of hemorrhagic macular infarction after intravitreal bevacizumab for chronic multifocal CSC. PMID:25126075

Kelkar, Aditya; Gandhi, Poonam; Amoaku, Winfried; Kelkar, Jai; Kelkar, Shreekant; Raut, Priyanka; Shah, Rachana

2014-01-01

224

Macular pigment density measured by autofluorescence spectrometry: comparison with reflectometry and heterochromatic flicker photometry  

Microsoft Academic Search

We present a technique for estimating the density of the human macular pigment noninvasively that takes advantage of the autofluorescence of lipofuscin, which is normally present in the human retinal pigment epi- thelium. By measuring the intensity of fluorescence at 710 nm, where macular pigment has essentially zero absorption, and stimulating the fluorescence with two wavelengths, one well absorbed by

François C. Delori; Douglas G. Goger; Billy R. Hammond; D. Max Snodderly; Stephen A. Burns

2001-01-01

225

Laparoscopic simultaneous bilateral adrenalectomy for testosterone-secreting bilateral adrenal tumors.  

PubMed

Laparoscopic adrenalectomy is widely accepted as a safe and minimally-invasive procedure. Although it is a standard procedure for the surgical treatment of adrenal tumors, its simultaneous use with bilateral adrenalectomy is relatively rare. A 21-year-old woman was referred to Hamamatsu University School of Medicine University Hospital complaining of a deepening voice, hirsutism and secondary amenorrhea. Abdominal computed tomography showed bilateral adrenal tumors, and hormonal examinations showed that the tumors secreted excessive testosterone, resulting in virilizing symptoms. Laparoscopic simultaneous bilateral adrenalectomy was carried out. Postoperatively, serum testosterone levels immediately recovered to within the normal range. Menstruation began the month after the operation, and the hirsutism gradually regressed. This is the third reported case of bilateral virilizing adrenal tumors, and the first to be successfully treated with laparoscopic simultaneous bilateral adrenalectomy. PMID:23601096

Suzuki, Takahisa; Furuse, Hiroshi; Kurita, Yutaka; Ushiyama, Tomomi; Mugiya, Soichi; Ozono, Seiichiro; Oki, Yutaka

2014-01-01

226

Bilateral normal filtering for mesh denoising.  

PubMed

Decoupling local geometric features from the spatial location of a mesh is crucial for feature-preserving mesh denoising. This paper focuses on first order features, i.e., facet normals, and presents a simple yet effective anisotropic mesh denoising framework via normal field denoising. Unlike previous denoising methods based on normal filtering, which process normals defined on the Gauss sphere, our method considers normals as a surface signal defined over the original mesh. This allows the design of a novel bilateral normal filter that depends on both spatial distance and signal distance. Our bilateral filter is a more natural extension of the elegant bilateral filter for image denoising than those used in previous bilateral mesh denoising methods. Besides applying this bilateral normal filter in a local, iterative scheme, as common in most of previous works, we present for the first time a global, noniterative scheme for an isotropic denoising. We show that the former scheme is faster and more effective for denoising extremely noisy meshes while the latter scheme is more robust to irregular surface sampling. We demonstrate that both our feature-preserving schemes generally produce visually and numerically better denoising results than previous methods, especially at challenging regions with sharp features or irregular sampling. PMID:21173457

Zheng, Youyi; Fu, Hongbo; Au, Oscar Kin-Chung; Tai, Chiew-Lan

2011-10-01

227

Intravitreal Injection of Bevacizumab to Treat a Macular Edema Caused by Leber's Miliary Aneurysm  

PubMed Central

Purpose Leber's miliary aneurysm is a variant of Coats’ disease and similar to type 1 idiopathic macular telangiectasia. A recent report showed that an intravitreal injection of bevacizumab (IVB) was effective in an adult patient with type 1 idiopathic macular telangiectasia. We describe our experience with an adult patient with a macular edema caused by Leber's miliary aneurysm, which had not been resolved by prior retinal laser photocoagulation, who underwent IVB. Methods We investigated the ocular characteristics of the patient before and after a single administration of IVB. Results The macular edema had partially improved 1 month after IVB, but then it worsened. We performed laser photocoagulation to treat the aneurysms near the fovea. The macular edema improved, but there was no improvement in visual acuity. Conclusion In this patient, the effect of IVB was limited. PMID:23275795

Takeyama, Masayuki; Iwaki, Masayoshi; Zako, Masahiro

2012-01-01

228

Unilateral recurrent macular hole in a patient with retinitis pigmentosa: a case report  

PubMed Central

Introduction Several macular complications related to abnormalities of the vitreoretinal interface have been classically attributed to retinitis pigmentosa of which cystoid macular edema is the most common. Other less frequent complications are as follows: epiretinal membranes, vitreomacular traction syndrome and macular holes. Case presentation A 64-year-old woman, with the previous diagnosis of retinitis pigmentosa, was referred to our department with a complaint of central visual loss in her left eye for 12?months. A fundoscopy and optical coherence tomography examination revealed the presence of a macular hole more than 500?microns in diameter. The patient underwent 20-gauge pars plana vitrectomy. Closure of the hole was observed after surgery, but reopening occurred at 2?years postoperatively. Conclusion The pathogenesis of macular hole formation in patients with retinitis pigmentosa is unclear. Surgical outcomes may not always be favorable, and the possibility of reopening must be taken into account, even after a long time. PMID:23497416

2013-01-01

229

Bilateral self-inflicted infectious dacryoadenitis.  

PubMed

The aim of this report is to present a case of a patient with bilateral lacrimal gland abscesses in the course of dacryoadenitis. A 45-year-old female patient with a long history of cocaine abuse presented with bilateral bacterial dacryoadenitis and upper lid inflammation with purulent discharge from a palpebral wound of the right upper lid. The diagnosis was confirmed with microbiology culture and an orbital CT scan, which revealed lacrimal gland abscesses. The patient admitted to vigorous eye scratching, which we believe was the mechanism responsible for the process. The infection resolved on targeted antibiotic therapy. This is the first reported case of bilateral infectious dacryoadenitis produced in a self-inflicted mechanism in a cocaine addict. PMID:25208047

Latasiewicz, Marta; Chang-Sotomayor, Meilin; Alonso-Caldarelli, Claudia; Farias-Plazas, Fabian; Leszczynska, Anna; Gonzalez-Candial, Miguel

2014-12-01

230

Bilateral filtering of magnetic resonance phase images.  

PubMed

High-pass filtering is required for the removal of background field inhomogeneities in magnetic resonance phase images. This high-pass filtering smooths across boundaries between areas with large differences in phase. The most prominent boundary is the surface of the brain where areas with large phase values inside the brain are located close to areas outside the brain where the phase is, on average, zero. Cortical areas, which are of great interest in brain MRI, are therefore often degraded by high-pass filtering. Here, we propose the use of the bilateral filter for the high-pass filtering step. The bilateral filter is essentially a Gaussian filter that stops smoothing at boundaries. We show that the bilateral filter improves image quality at the brain's surface, without sacrificing contrast within the brain. PMID:21664782

McPhee, Kelly C; Denk, Christian; Al-Rekabi, Zeinab; Rauscher, Alexander

2011-09-01

231

Bilateral olfactory sensory input enhances chemotaxis behavior.  

PubMed

Neural comparisons of bilateral sensory inputs are essential for visual depth perception and accurate localization of sounds in space. All animals, from single-cell prokaryotes to humans, orient themselves in response to environmental chemical stimuli, but the contribution of spatial integration of neural activity in olfaction remains unclear. We investigated this problem in Drosophila melanogaster larvae. Using high-resolution behavioral analysis, we studied the chemotaxis behavior of larvae with a single functional olfactory neuron on either the left or right side of the head, allowing us to examine unilateral or bilateral olfactory input. We developed new spectroscopic methods to create stable odorant gradients in which odor concentrations were experimentally measured. In these controlled environments, we observed that a single functional neuron provided sufficient information to permit larval chemotaxis. We found additional evidence that the overall accuracy of navigation is enhanced by the increase in the signal-to-noise ratio conferred by bilateral sensory input. PMID:18157126

Louis, Matthieu; Huber, Thomas; Benton, Richard; Sakmar, Thomas P; Vosshall, Leslie B

2008-02-01

232

Bilateral Femoral Neck Fracture-Related Hyperparathyroidism  

PubMed Central

Bilateral femoral neck fracture is not common as unilateral femoral fracture. Femoral neck fracture generally occurs by the high energized traumas. Traffic accidents and fallings are the most common reason for this fracture kind. But suddenly and minor traumatic fractures is not common. Especially, in the hormonal and pathogenic fractures is not common. In this case minor traumatic bilateral femoral fracture is presented. The fracture occurs in the background of critical medical condition by hyperparathyroidism. It can be said chronic hyperparathyroidism conditions must be determined for femoral neck fracture. Because these patients many times fell little disturbed by this fracture, diagnosis can be missed many times.

Ezirmik, Naci; Yildiz, Kadri; Cadirci, Kenan

2011-01-01

233

Spontaneous Bilateral Meningoencephalocoeles of the Temporal Bones  

PubMed Central

Spontaneous tegmen tympani defects are rare with even rarer bilateral cases. The symptoms are nonspecific; hence, a high index of suspicion is required to prevent serious intracranial complications. We present a case of spontaneous bilateral tegmen tympani defects with associated meningoencephalocoeles in a 54-year-old male who presented with the signs and symptoms of severe meningitis. After careful workup which included a lumbar puncture, CT and MRI scans, both defects were repaired using a middle fossa approach. The patient made an uneventful recovery with complete cessation of otorrhoea and improvement in his hearing. PMID:24288640

2013-01-01

234

Isolated Bilateral Congenital Iris Sphincter Agenesis  

PubMed Central

Purpose. We herein report a patient with bilateral congenital total iris sphincter agenesis with no other abnormality detected on systemic examination. Methods. A 24-year-old laborer presented to us for a routine checkup with complaint of photophobia and inability to work under sunlight. Examination revealed bilateral absence of sphincter and 6.5?mm pupil in both eyes in the undilated state. Results. Accommodation was poor in both eyes. Systemic examination was within normal limits. He was prescribed bifocal photochromic glasses for constant wear. Conclusions. Congenital sphincter agenesis can occur in an isolated form without systemic abnormalities which can be managed conservatively. PMID:22606462

Rao, Aparna

2011-01-01

235

Bilateral Metallic Stenting in Malignant Hilar Obstruction  

PubMed Central

Endoscopic palliative biliary drainage is considered as a gold standard treatment in advanced or inoperable hilar cholangiocarcinoma. Also, metal stents are preferred over plastic stents in patients with >3 months life expectancy. However, the endoscopic intervention of advanced hilar obstruction is often more challenging and complex than that of distal malignant biliary obstructions. In this literature review, we describe the issues commonly encountered during endoscopic unilateral (single) versus bilateral (multiple) biliary stenting for malignant hilar obstruction. Also, we provide technical guidance to improve the technical success rates and patient outcomes, focusing on bilateral metallic stenting techniques such as stent-in-stent or side-by-side deployment. PMID:25325005

Moon, Jong Ho; Park, Sang-Heum

2014-01-01

236

Bilateral Hypertrophic Olivary Degeneration in Wilson Disease  

PubMed Central

Hypertrophic olivary degeneration resulting from lesions of the dento-rubro-olivary pathway, also called Guillain-Mollaret-triangle, has been described previously in a number of cases. Reports about bilateral hypertrophic olivary degeneration of the inferior olivary nuclei are very limited, and the magnetic resonance imaging findings of hypertrophic olivary degeneration in Wilson disease have not yet been described to the best of our knowledge. Herein, we present the first report of bilateral hypertrophic olivary degeneration diagnosed by magnetic resonance imaging in a patient suffering from Wilson disease. PMID:23482821

Guenther, Peter; Hoffmann, Karl-Titus

2013-01-01

237

[Bilateral acute depigmentation of the iris syndrome].  

PubMed

Bilateral acute depigmentation of the iris syndrome (BADI syndrome) is a new clinical entity. Young females from 20 to 45 years of age are most commonly affected. It is characterized by bilateral nontransilluminating depigmentation of the iris stroma. During the acute phase, this clinical entity also combines with red painful eye, pigmentation of the trabecular meshwork, anterior chamber flare, circulating pigment, and pigmented deposit on the endothelium cornea. At the acute stage, the symptoms are controlled with topical corticosteroid treatment. The prognosis is good. We report a 41-year-old woman presenting with BADI syndrome. PMID:21531477

Portmann, A; Gueudry, J; Siahmed, K; Muraine, M

2011-05-01

238

Comparison of Macular Thickness in Diabetic Macular Edema Using Spectral-Domain Optical Coherence Tomography and Time-Domain Optical Coherence Tomography  

PubMed Central

Purpose. To compare the macular thicknesses in diabetic macular edema (DME) measured with spectral-domain optical coherence tomography (SD-OCT) and time-domain (TD) OCT. Patients and Methods. The average macular thicknesses of 50 eyes of 29 patients with DME were measured using SD-OCT and TD-OCT. Results. The mean macular thicknesses measured with TD-OCT and SD-OCT were 401.5 ± 117.8??m (mean ± SD) and 446.2 ± 123.5??m, respectively. The macular thicknesses measured with the two devices were well correlated (Pearson's product moment correlation, r = 0.977, P < 0.001). A significant correlation was found between the best-corrected visual acuity and the retinal thickness measured by TD-OCT and SD-OCT (Pearson's product moment correlation, TD-OCT, r = 0.34; P < 0.05; SD-OCT, r = 0.32; P < 0.05). Discussion. The mean macular thickness measured with SD-OCT was about 45??m thicker than that measured with TD-OCT. Attention should be paid when comparing data obtained using different OCT machines. PMID:22315663

Kakinoki, Masashi; Miyake, Taichirou; Sawada, Osamu; Sawada, Tomoko; Kawamura, Hajime; Ohji, Masahito

2012-01-01

239

Foveal atrophy and macular hole formation following intravitreal ranibizumab with/without photodynamic therapy for choroidal neovascularization secondary to age-related macular degeneration  

PubMed Central

Background: To report the occurrence of foveal atrophy and macular hole formation following intravitreal ranibizumab with or without photodynamic therapy for choroidal neovascularization caused by age-related macular degeneration. Methods: This was a retrospective, interventional case series, in which 78 eyes of 76 patients were treated for wet age-related macular degeneration between February 2007 and August 2007. Of these, three eyes developed foveal atrophy following treatment. Two eyes underwent combination photodynamic therapy and intravitreal ranibizumab, and one eye underwent intravitreal ranibizumab alone. One of the two eyes that underwent combination therapy progressed to develop a macular hole. Results: On the first follow-up visit, all three eyes showed thinning of the fovea on optical coherence tomography. Subsequently, treatment was continued with repeat intravitreal ranibizumab injections. At the last follow-up, although choroidal neovascularization regressed in all eyes, extensive foveal atrophy developed in two eyes with macular hole formation in one eye. Conclusion: The possibility of foveal atrophy and macular hole formation must be borne in mind before initiating ranibizumab in combination with or without photodynamic therapy. However, larger studies with longer follow-up are required to understand such adverse effects better. PMID:21383944

Rishi, Pukhraj; Kasinathan, Nachiappan; Sahu, Chinmaya

2011-01-01

240

TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL  

PubMed Central

Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

Mendoza-Ticona, Alberto

2014-01-01

241

Intravitreal bevacizumab for persistent macular edema with proliferative diabetic retinopathy.  

PubMed

To evaluate the effectiveness of an intravitreal bevacizumab injection on retinal neovascularization and diabetic macular edema (DME) refractory to laser photocoagulation therapy. Thirty-four eyes of 22 patients with proliferative diabetic retinopathy and DME refractory to laser photocoagulation therapy received an intravitreal injection of 1.25 mg/0.05 ml of bevazicumab. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), regression of neovascularization over time, and correlation between BCVA and CMT were evaluated. Follow-up visits were at weeks 1, 2 and 4 and months 3 and 6. Mean BCVA was significantly better than baseline only at week 2 (P = 0.036). Mean CMT decreased significantly from baseline at weeks 1, 2, and 4 (P = 0.001). At months 3 and 6, mean CMT increased, albeit insignificantly (P = 0.804 and P = 1.0). The decrease in fluorescein leakage was moderate in all eyes at the end of week 1. At week 2, there was total resolution of fluorescein leakage in 24 (70.5%) eyes and moderate resolution in 10 (29.5%) eyes. At the end of month 3, the fluorescein leakage was fully resolved in 5 (14.7%) eyes, moderately resolved in 24 (70.5%) eyes, and was similar to baseline in 5 (14.7%) eyes. At month 6, the fluorescein leakage was fully resolved in 3 (8.8%) eyes, moderately resolved in 20 (58.8%) eyes, and was similar to baseline in 11 (32.4%) eyes. A moderate but insignificant negative correlation was found between visual acuity and CMT (P > 0.05). Persistence or recurrence of neovascular tissue after panretinal photocoagulation may be attributed to the production of vascular endothelial growth factor by the residual ischemic retina, which also results in persistent or recurrent DME despite macular grid photocoagulation. PMID:20936526

Gulkilik, Gokhan; Taskapili, Muhittin; Kocabora, Selim; Muftuoglu, Gulipek; Demirci, Goktug

2010-12-01

242

Chromatin and transcriptional regulators act in a cascade to establish a bilateral asymmetry of the C. elegans nervous system  

E-print Network

Neuroanatomical bilateral asymmetry is a widespread feature in both vertebrates and invertebrates. Although mostly bilaterally symmetric, the nervous system of Caenorhabditis elegans displays bilateral asymmetry. Bilateral ...

Nakano, Shunji, Ph. D. Massachusetts Institute of Technology

2011-01-01

243

Genetic and Epigenetic Regulation in Age-related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the older population worldwide. While strong genetic risk factors have been associated with AMD etiology, environmental influences through epigenetic regulation are also likely to play a role. Recent advances in epigenetic studies have resulted in the development of numerous epigenetic drugs for the treatment of cancer and inflammation. Here, we review the current literature on the genetic and epigenetic mechanisms of AMD and suggest that understanding the cooperation of epigenetic and genetic mechanisms will greatly advance the clinical management of AMD. PMID:23997991

Wei, Lai; Chen, Ping; Lee, Joo Hyun; Nussenblatt, Robert B.

2013-01-01

244

Inflammation and Macular Oedema after Pars Plana Vitrectomy  

PubMed Central

Cystoid macular oedema (CMO) is a major cause of reduced vision following intraocular surgery. Although the aetiology of CMO is not completely clarified, intraocular inflammation is known to play a major role in its development. The macula may develop cytotoxic oedema when the primary lesion and fluid accumulation occur in the parenchymatous cells (intracellular oedema) or vasogenic oedema when the primary defect occurs in the blood-retinal barrier and leads to extracellular fluid accumulation (extracellular oedema). We report on the mechanisms of CMO formation after pars plana vitrectomy and associated surgical procedures and discuss possible therapeutic approaches. PMID:24288446

Romano, Vito; Angi, Martina; del Grosso, Renata; Romano, Davide; Vinciguerra, Paolo; Romano, Mario R.

2013-01-01

245

Present and Possible Therapies for Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the most common cause of blindness in the elderly population worldwide and is defined as a chronic, progressive disorder characterized by changes occurring within the macula reflective of the ageing process. At present, the prevalence of AMD is currently rising and is estimated to increase by a third by 2020. Although our understanding of the several components underpinning the pathogenesis of this condition has increased significantly, the treatment options for this condition remain substantially limited. In this review, we outline the existing arsenal of therapies available for AMD and discuss the additional role of further novel therapies currently under investigation for this debilitating disease. PMID:25097787

Kamal, Ahmed

2014-01-01

246

Bilateral synergies in foot force production tasks.  

PubMed

We analysed the effects of task symmetry during bilateral accurate force production tasks performed by the two feet. In particular, we tested a hypothesis that bilateral deficit would lead to higher indices of synergies defined as co-varied adjustments in the two forces across trials that reduced total force variability. The subjects produced steady-state force followed by a quick force pulse into the target. The two feet could be acting both into plantar flexion and into dorsiflexion (symmetrical tasks), or in opposite directions (asymmetrical task). We used the framework of the uncontrolled manifold hypothesis to quantify two variance components, one of which did not change total force (V UCM), while the other did (V ORT). Synergy indices during the asymmetrical task were higher than in either symmetrical task. The difference was due to higher V UCM (compared to the symmetrical plantar flexion task) or lower V ORT (compared to the symmetrical dorsiflexion task). The synergy index showed a drop (anticipatory synergy adjustment, ASA) starting 100-150 ms prior to the force pulse initiation. The ASA tended to be shorter and of a smaller magnitude for the asymmetrical task. This is the first demonstration of bilateral synergies during accurate force production by the legs. We conclude that bilateral deficit has no or weak effects on two-leg synergies. The results fit the earlier introduced scheme with two groups of neural variables defining average performance of a redundant system and patterns of co-variation among its elemental variables, respectively. PMID:23568657

Sarabon, Nejc; Markovic, Goran; Mikulic, Pavle; Latash, Mark L

2013-05-01

247

Improving a CAD system using bilateral information  

Microsoft Academic Search

Computer Aided Detection (CAD) mammographic systems are used in medicine to assist radiologists in the evaluation of mammographic images. The aim of this work is to compare the results of a developed single-image CAD system with a new one, dual-image CAD, that adds registration information of bilateral mammographic images in the training step of the former system. The evaluation of

Meritxell Tortajada; Arnau Oliver; Y. Di?ez; R. Marti?; J. C. Vilanova; J. Freixenet

2010-01-01

248

Bilateral breast cancer after cured Hodgkin's disease  

Microsoft Academic Search

Three patients developed bilateral breast cancer at 10 to 24 years after mantle irradiation for locally or systemically advanced Hodgkin's disease (HD). Four of the six cancers in the three patients were detected only by mammography. Pathologically, five of the cancers were intraductal carcinomas (four with an invasive component) with one being a lobular carcinoma. Five of the six lesions

Norwood Anderson; Jacob Lokich

1990-01-01

249

Bilateral Horner's syndrome in cluster type headaches.  

PubMed

A patient with cluster type headaches demonstrated bilateral and alternating ocular sympathetic dysfunction during a spontaneous as well as a nitroglycerin-induced attack. Biochemical evaluation revealed postganglionic pupillary dysfunction on the symptomatic side and preganglionic pupillary dysfunction contralaterally. These findings defy a simple explanation regarding a central or peripheral origin of the oculocephalic sympathetic dysfunction. PMID:8262788

Khurana, R K

1993-09-01

250

Bilateral brain processes for comprehending natural language  

E-print Network

Bilateral brain processes for comprehending natural language Mark Jung-Beeman Department 60208-2710, USA Comprehension of natural language ­ stories, conversa- tions, text ­ is very simple-established facts about the brain; yet, when it comes to comprehending complex, natural language, the right

Jung-Beeman, Mark

251

Bilateral field advantage in visual crowding  

PubMed Central

Thirty randomly oriented T’s were presented in a circle around fixation at an eccentricity of 11 degrees such that each T was crowded by its neighbors. Two locations within the same hemifield (unilateral condition) or one location in each hemifield (bilateral condition) were precued for subsequent probing. Observers were then asked to report the orientation of a target T at one of these locations. A bilateral field advantage was found: target identification was better when the two precued targets were in different hemifields than when they were within the same hemifield. This bilateral advantage was absent when only targets were presented, without any distracters. Further controls showed that this advantage could not be attributed to differences between horizontal and vertical target alignments or to visual field anisotropies. A similar bilateral advantage has been reported for multiple object tracking (Alvarez & Cavanagh, 2005) and other attentional tasks. Our results suggest that crowding also demonstrates separate attentional resources in the left and right hemifields. There was a cost to attending to two targets presented unilaterally over attending to a single target. However, this cost was reduced when the two crowded targets were in separate hemifields. PMID:19362572

Chakravarthi, Ramakrishna; Cavanagh, Patrick

2009-01-01

252

Bilateral Mandibular Supernumerary Canines: A Case Report  

PubMed Central

Supernumerary teeth are defined as the teeth developed in excess of the number found in a normal dentition. Supernumerary canine is an extremely rare finding particularly in the mandible. This case report presents a 25-year-old female patient with the unique feature of bilateral mandibular supplemental supernumerary canines. The patient was non-syndromic without any other supernumerary teeth. PMID:23346342

Abouei Mehrizi, Ehsan; Semyari, Hassan; Eslami Amirabadi, Gholamreza

2010-01-01

253

Experiences with Bilateral Art: A Retrospective Study  

Microsoft Academic Search

Recent advances in neuroscience describe the effect of experience on neural architecture. Paralleling these advances in neuroscience, recent explorations in the field of art therapy speculate on the relationship between specific therapeutic interventions and neuroplasticity, which underlies the changes in neural architecture. One such intervention, bilateral art, purposefully engages both left and right hemispheres of the brain, as well as

Carole M. McNamee

2006-01-01

254

Bilateral integration in the common chemical sense.  

PubMed

Human participants judged the pungency of various concentrations of carbon dioxide presented to one nostril, the other nostril, or both (dichorhinic stimulation). Perceived magnitude grew sharply with concentration over the range explored. The combinatorial rule of bilateral integration followed the Pythagorean theorem: the effective mass in a bilateral stimulus equalled the square root of the sum of squares of the mass entering each nostril. This simple rule implies a possible mutual inhibitory interaction between the two nostrils, but it also implies partial spatial summation of the sensory impact of bilaterally presented concentrations. When persons inhale a relatively strong irritant, such as the higher concentrations used here, they will exhibit a very brief reflex interruption of inhalation. An experiment on the threshold for the reflex implied that it too followed the Pythagorean rule of integration. This occurred for both males and females, though females displayed a lower threshold for the reflex, whether evoked unilaterally or bilaterally. This reflex may hold promise as an objective indicator of functional status of the nasal common chemical sense. PMID:7146140

Garcia Medina, M R; Cain, W S

1982-08-01

255

Macular Hole Surgery in a Patient Who Cannot Maintain Facedown Positioning  

PubMed Central

Aim To present macular hole surgery in a patient who had previously undergone thyroid removal surgery. Material and Methods During thyroid gland removal surgery, the recurrent laryngeal nerves were cut by the surgeon. Therefore, the patient had to have a tracheotomy and because of this unusual situation, the patient could not breathe if lying ‘upside-down’. Complete ophthalmic examination and spectral optical coherence tomography was performed in a 77-year-old woman before and after macular hole surgery. Results The patient was treated by the ‘inverted internal limiting membrane (ILM) flap technique’ with air tamponade for macular hole closure. This technique was described to have very high success rates in large, stage IV macular holes. Postoperatively, lying on her opposite side was advised. However, the macular hole remained open after this approach. Because of this, another approach was undertaken. The ILM flap technique and silicone oil were applied, and the patient was positioned on her opposite side. Silicone oil was removed after 3 months. Eighteen months later, the macular hole remained closed. Visual acuity improved from 10/200 to 20/50. Conclusion This case demonstrates that in an extremely select group of patients, silicone oil combined with the inverted flap technique may be considered for treatment of macular hole. PMID:23467189

Michalewska, Zofia; Nawrocki, Jerzy

2013-01-01

256

Macular Function in Macular Degenerations: Repeatability of Microperimetry as a Potential Outcome Measure for ABCA4-Associated Retinopathy Trials  

PubMed Central

Purpose. To measure macular visual function in patients with unstable fixation, to define the photoreceptor source of this function, and to estimate its test-retest repeatability as a prerequisite to clinical trials. Methods. Patients (n = 38) with ABCA4-associated retinal degeneration (RD) or with retinitis pigmentosa (RP) were studied with retina-tracking microperimetry along the foveo-papillary profile between the fovea and the optic nerve head, and point-by-point test-retest repeatability was estimated. A subset with foveal fixation was also studied with dark-adapted projection perimetry using monochromatic blue and red stimuli along the horizontal meridian. Results. Macular function in ABCA4-RD patients transitioned from lower sensitivity at the parafovea to higher sensitivity in the perifovea. RP patients had the inverse pattern. Red-on-red microperimetric sensitivities successfully avoided ceiling effects and were highly correlated with absolute sensitivities. Point-by-point test-retest limits (95% confidence intervals) were ±4.2 dB; repeatability was not related to mean sensitivity, eccentricity from the fovea, age, fixation location, or instability. Repeatability was also not related to the local slope of sensitivity and was unchanged in the parapapillary retina. Conclusions. Microperimetry allows reliable testing of macular function in RD patients without foveal fixation in longitudinal studies evaluating natural disease progression or efficacy of therapeutic trials. A single estimate of test-retest repeatability can be used to determine significant changes in visual function at individual retinal loci within diseased regions that are homogeneous and those that are heterogeneous and also in transition zones at high risk for disease progression. PMID:22247458

Swider, Malgorzata; Aleman, Tomas S.; Feuer, Willam J.; Schwartz, Sharon B.; Russell, Robert C.; Steinberg, Janet D.; Stone, Edwin M.; Jacobson, Samuel G.

2012-01-01

257

Association of macular pigment optical density with risk factors for wet age-related macular degeneration in the Indian population  

PubMed Central

Purpose To investigate macular pigment optical density (MPOD) in patients with and without wet age-related macular degeneration (AMD) and to elucidate the association between MPOD and the risk factors for AMD in an Indian population. Methods Thirty-three subjects with wet AMD and 29 controls above 50 years old underwent MPOD measurement with the ‘Macular Densitometer'. The subjects were also tested for their smoking history, lifetime ultraviolet (UV) exposure, dietary intake of carotenoids, and body mass index (BMI). Results Smokers had a higher risk for AMD than the non-smokers (P=0.032) and a lower MPOD level than non-smokers (mean (95% CI)) (0.16 (0.09–0.23) vs 0.28 (0.22–0.34), adjusted P=0.026). Subjects with lowest UV exposure had higher MPOD than those with the highest (0.46 (0.38–0.54) vs 0.17 (0.01–0.33), P=0.01). MPOD was significantly lower among those with the lowest quartile of dietary intake of carotenoids (0.14 (0.08–0.21) vs 0.25 (0.13–0.36), P=0.012). Smoking, obesity, and UV index showed an inverse association with the MPOD. Low MPOD, smoking, and UV exposure had 5.11 (1.73–15.08), 3.54 (1.08–11.57), and 5.24 (1.06–25.96) odds for AMD, respectively, whereas higher dietary intake of carotenoids showed a protective effect for AMD. Conclusion We found an inverse association between wet AMD and MPOD. Among the established risk factors of wet AMD, we found an inverse association of smoking, UV index, and obesity with MPOD, whereas a positive association was found between dietary intake of carotenoids and MPOD. PMID:22562185

Raman, R; Biswas, S; Gupta, A; Kulothungan, V; Sharma, T

2012-01-01

258

Sequential Bilateral Cochlear Implantation in a Patient with Bilateral Meniere’s Disease  

PubMed Central

This case study describes a 45 year old female with bilateral, profound sensorineural hearing loss due to Meniere’s disease. She received her first cochlear implant in the right ear in 2008 and the second cochlear implant in the left ear in 2010. The case study examines the enhancement to speech recognition, particularly in noise, provided by bilateral cochlear implants. Speech recognition tests were administered prior to obtaining the second implant and at a number of test intervals following activation of the second device. Speech recognition in quiet and noise as well as localization abilities were assessed in several conditions to determine bilateral benefit and performance differences between ears. The results of the speech recognition testing indicated a substantial improvement in the patient’s ability to understand speech in noise and her ability to localize sound when using bilateral cochlear implants compared to using a unilateral implant or an implant and a hearing aid. In addition, the patient reported considerable improvement in her ability to communicate in daily life when using bilateral implants versus a unilateral implant. This case suggests that cochlear implantation is a viable option for patients who have lost their hearing to Meniere’s disease even when a number of medical treatments and surgical interventions have been performed to control vertigo. In the case presented, bilateral cochlear implantation was necessary for this patient to communicate successfully at home and at work. PMID:22463939

Holden, Laura K.; Neely, J. Gail; Gotter, Brenda D.; Mispagel, Karen M.; Firszt, Jill B.

2012-01-01

259

Morphision: A method for subjective evaluation of metamorphopsia in patients with unilateral macular pathology (i.e., full thickness macular hole and epiretinal membrane)  

PubMed Central

Background: Lack of clinical tests to quantify spatial components of distortion in patients with full thickness macular holes (FTMH) and epiretinal membranes (ERM). Aim: To develop a test for subjective evaluation of visual distortion in the central visual field around fixation in patients with unilateral FTMH or ERM. Settings and Design: Prospective case-control study carried out at tertiary referral center. Materials and Methods: Twenty-five patients with unilateral macular disease (13 macular epiretinal membranes, 12 full-thickness macular holes), and nine controls (without ocular pathology) underwent ophthalmological examination with logMAR ETDRS visual acuity, near vision and contrast sensitivity assessed. Macular optical coherence tomography and metamorphopsia assessment using Morphision test was also carried out. This test consists of a set of modified Amsler charts for detection, identification, and subjective quantification of visual distortion in the central visual field around fixation. Morphision test content and construct validity, and reliability (test-retest method) were evaluated. Sixteen patients completed an unstructured survey on test performance and preference. Results: Every patient with unilateral FTMH or ERM identified a particular chart using Morphision test (content validity). None of the normal subjects without symptoms of metamorphopsia identified any distortion (construct validity). Test-retest showed a 100% consistency for frequency and 67% for amplitude. The mean amplitude difference between measurements was 0.02 degrees (SD = 0.038). The coefficient of repeatability was 0.075. There was a correlation between Morphision amplitude score and visual acuity and contrast sensitivity, individually. Conclusions: Morphision test allowed detection and subjective quantification of metamorphopsia in the clinical setting in our patients with unilateral macular epiretinal membranes and full thickness macular holes. PMID:24008785

Ugarte, Marta; Shunmugam, Manoharan; Laidlaw, D Alistair H; Williamson, Tom H

2013-01-01

260

A randomised controlled feasibility trial of vitrectomy versus laser for diabetic macular oedema  

PubMed Central

Aim: (1) To evaluate whether vitrectomy is preferable to further macular laser in improving visual acuity and resolving retinal thickening in patients with diabetic macular oedema (DMO) despite previous laser and no macular traction. (2) To determine the feasibility of further trials in this population in terms of magnitude of comparative clinical effect, rate of recruitment, and loss to follow up. Methods: A randomised controlled feasibility study. Patients with DMO and a visual acuity of 0.3 logMAR (6/12) or worse after one or more macular laser treatments were randomised on a 1:1 basis to either pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling or further macular laser. Patients with a posterior vitreous detachment, biomicroscopic evidence of retinal traction, or a taut thickened posterior hyaloid (TTPH) were excluded. Primary outcome measures were (1) best corrected logMAR visual acuity, (2) mean central macular thickness on optical coherence tomography, and (3) rate of recruitment and loss to follow up. Analysis was on an intention to treat basis. Results: 19 patients were randomised to PPV and 21 to further macular laser. The mean baseline logMAR visual acuity was 0.65 (SD 0.28) for the group randomised to PPV and 0.60 (0.23) for the group randomised to laser. The mean change in best corrected visual acuity of the vitrectomy group was deterioration by 0.05 logMAR, while in the control group the mean change was an improvement of 0.03 logMAR. The median (interquartile range) baseline central macular thickness was 403 (337, 492) for the group randomised to PPV and 387 (298, 491) for the controls randomised to laser. The median change in central macular thickness from baseline to review in the vitrectomy group was a thinning by 73 ?m (20%) and by 29 ?m (10.7%) in the control laser group. This single centre was able to recruit 40 patients in 18 months with follow up of 82% at 1 year. Conclusion: A randomised controlled trial was found to be potentially feasible in this population, the rate of recruitment was however slow and one in five patients were lost to follow up because of death and ill health. These data provide little evidence in terms of visual acuity and macular thickness of any benefit of vitrectomy over further macular laser in patients with an attached hyaloid, DMO despite previous laser, and no clinically evident macular traction or TTPH. PMID:15615752

Thomas, D; Bunce, C; Moorman, C; Laidlaw, D A H

2005-01-01

261

Microcysts in the inner nuclear layer, a nonspecific SD-OCT sign of cystoid macular edema.  

PubMed

Recently, many authors have propagated the notion that a specific form of "microcystic macular edema" occurs in patients with optic neuritis and optic atrophy of various etiology and is due to retrograde synaptic degeneration. The finding is isolated to the inner nuclear layer on spectral-domain optical coherence tomography in most cases, and is present in a parafoveal, circumferential, and central macular distribution. This perspective critically reviews the evidence and suggests that inner nuclear layer cystoid changes are an early and nonspecific indicator of typical cystoid macular edema of any cause, and that the finding is likely not a distinct entity. PMID:24867911

Sigler, Eric J

2014-05-01

262

Measuring macular pigment optical density in vivo: a review of techniques  

Microsoft Academic Search

Background  Macular pigment has been the focus of much attention in recent years, as a potential modifiable risk factor for age-related\\u000a macular degeneration. This interest has been heightened by the ability to measure macular pigment optical density (MPOD) in\\u000a vivo.\\u000a \\u000a \\u000a \\u000a \\u000a Method  A systematic literature search was undertaken to identify all available papers that have used in vivo MPOD techniques. The\\u000a papers were

Olivia Howells; Frank Eperjesi; Hannah Bartlett

2011-01-01

263

Present and future treatment possibilities in macular degeneration  

NASA Astrophysics Data System (ADS)

Purpose: To discuss present and future treatment possibilities in different types of choroidal neovascularisation. Methods: Presented are angiographic- and OCT-findings in patients with macular degeneration of different origin. Choroidal neovascularisations, which are not likely to respond positively to established procedures like thermal laser coagulation or photodynamic therapy will be discussed. Results and conclusions: Present study-guidelines and new methods of pharmacological intervention are analysed in different patterns of macular degeneration. Conventional laser coagulation in the treatment of classic, extrafoveal CNV and photodynamic therapy of predominantly classic subfoveal CNV still represent a gold standard. There are new recommendations, loosening the tight criteria of the TAP and VIP-guidelines, which cover, for instance, wider visual acuity ranges and the treatment of juxtafoveally located choroidal neovascularisations. Positive findings in literature confirm the role of PDT in pathologic myopia and other non-AMD CNV. Studies about surgical procedures, like macula- or RPE-translocation after surgical removal or thermal laser destruction of the CNV are in progress and are expected to show promising results. Phase II/III studies will soon point out the effect of anti-VEGF agents. The application of intravitreal (triamcinolone) or peribulbar (anecortave acetat) steroids could be useful. The combination with surgical or laser techniques could bring further benefit to the patient.

Fisher, E.; Wegner, A.; Pfeiler, T.; Mertz, M.

2005-11-01

264

Macular lymphocytic arteritis: first clinical presentation with ulcers.  

PubMed

Macular lymphocytic arteritis describes a recently reported entity, clinically characterized by asymptomatic hyperpigmented macules on the lower limbs, without association of systemic diseases. Histopathologically it is characterized by a lymphocytic arteritis with a hyalinized fibrin ring. We report a new case presenting with ulceration, a finding not previously described. A 25-year-old Hispanic woman was evaluated for a 1-year history of a gradually progressive, asymptomatic eruption that begins at level of both knees and progressively affects both legs and feet. She also referred recently appeared ulcers on inner right ankle without previous traumatism. Physical examination revealed multiple fairly well-defined light brown and faint pink patches with petechiae on as well as retiform crusts and livedoid lesions on inner right ankle. Both types of lesions were biopsied showing lymphocytic arteritis with fibrinoid necrosis and thrombus. There were no relevant laboratory alterations. The clinical peculiarity of our case is the clinical image of the lesions mimicking a pigmented purpuric dermatosis and the presence of a non-traumatic ulcer which could be explained because chronic lymphocytic damage may cause ischemic damage. Ulceration in our case supports consideration of macular arteritis as a latent form of cutaneous polyarteritis nodosa. PMID:23384039

Llamas-Velasco, M; García-Martín, P; Sánchez-Pérez, J; Sotomayor, E; Fraga, J; García-Diez, A

2013-04-01

265

Genetic markers and biomarkers for age-related macular degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness in the USA. Although the treatment of AMD has evolved to include laser photocoagulation, photodynamic therapy, surgical macular translocation and antiangiogenesis agents, treatment options for advanced AMD are limited. Furthermore, the dry form of AMD, albeit less devastating than the wet form, has even fewer viable treatment options. This review summarizes the various biomarkers of AMD and analyzes whether or not they may one day be exploited to determine risks of disease onset, measure progression of disease or even assess the effects of treatment of AMD. Potential biomarkers are important to identify since some might be utilized to reflect the disease state of a particular patient and to individualize therapy. Although studies have yielded promising results for nutrient and inflammatory biomarkers, these results have been inconsistent. At present, the best available markers of AMD risk are single nucleotide polymorphisms (SNPs). SNPs in complement factor H (CFH) and PLEKHA1/ARMS2/HtrA1 capture a substantial fraction of AMD risk and permit the identification of individuals at high risk of developing AMD. PMID:17917691

Ross, Robert J; Verma, Varun; Rosenberg, Kevin I; Chan, Chi-Chao; Tuo, Jingsheng

2007-01-01

266

Predicting visual outcomes for macular disease using optical coherence tomography  

PubMed Central

In recent years, the management of macular disease has undergone radical changes, in part because of new therapeutic approaches, but also due to the introduction of a new imaging modality – optical coherence tomography (OCT). The application of OCT imaging has clarified many aspects of chorioretinal disease pathophysiology and elucidated many hitherto unrecognized disease characteristics. From an early stage in its development, OCT has also been revolutionary in attempting to extract clinically useful measurements from image data in an automated fashion. As a result, OCT-derived measurements of retinal thickness have been rapidly embraced in clinical and research settings. However, as knowledge of OCT image analysis has developed, it has become increasingly clear that even accurate measurements of retinal thickness may fail to predict visual outcomes for many diseases. As a result, the focus of much current clinical imaging research is on the identification of other OCT-derived anatomic biomarkers predictive of visual outcomes – such biomarkers could serve as surrogate endpoints in clinical trials and provide prognostic information in clinical practice. In this review, we begin by highlighting the importance of accurate visual function assessment and describing the fundamentals of OCT image evaluation, before describing the current state-of-the-art with regard to predicting visual outcomes, for a variety of macular diseases, using OCT. PMID:23960916

Keane, Pearse A.; Sadda, Srinivas R.

2011-01-01

267

Macular Pigment Optical Density Measured by Heterochromatic Modulation Photometry  

PubMed Central

Purpose To psychophysically determine macular pigment optical density (MPOD) employing the heterochromatic modulation photometry (HMP) paradigm by estimating 460 nm absorption at central and peripheral retinal locations. Methods For the HMP measurements, two lights (B: 460 nm and R: 660 nm) were presented in a test field and were modulated in counterphase at medium or high frequencies. The contrasts of the two lights were varied in tandem to determine flicker detection thresholds. Detection thresholds were measured for different R:B modulation ratios. The modulation ratio with minimal sensitivity (maximal threshold) is the point of equiluminance. Measurements were performed in 25 normal subjects (11 male, 14 female; age: 30±11 years, mean ± sd) using an eight channel LED stimulator with Maxwellian view optics. The results were compared with those from two published techniques – one based on heterochromatic flicker photometry (Macular Densitometer) and the other on fundus reflectometry (MPR). Results We were able to estimate MPOD with HMP using a modified theoretical model that was fitted to the HMP data. The resultant MPODHMP values correlated significantly with the MPODMPR values and with the MPODHFP values obtained at 0.25° and 0.5° retinal eccentricity. Conclusions HMP is a flicker-based method with measurements taken at a constant mean chromaticity and luminance. The data can be well fit by a model that allows all data points to contribute to the photometric equality estimate. Therefore, we think that HMP may be a useful method for MPOD measurements, in basic and clinical vision experiments. PMID:25354049

Huchzermeyer, Cord; Schlomberg, Juliane; Welge-Lüssen, Ulrich; Berendschot, Tos T. J. M.; Pokorny, Joel; Kremers, Jan

2014-01-01

268

Analysis of macular OCT images using deformable registration  

PubMed Central

Optical coherence tomography (OCT) of the macula has become increasingly important in the investigation of retinal pathology. However, deformable image registration, which is used for aligning subjects for pairwise comparisons, population averaging, and atlas label transfer, has not been well–developed and demonstrated on OCT images. In this paper, we present a deformable image registration approach designed specifically for macular OCT images. The approach begins with an initial translation to align the fovea of each subject, followed by a linear rescaling to align the top and bottom retinal boundaries. Finally, the layers within the retina are aligned by a deformable registration using one-dimensional radial basis functions. The algorithm was validated using manual delineations of retinal layers in OCT images from a cohort consisting of healthy controls and patients diagnosed with multiple sclerosis (MS). We show that the algorithm overcomes the shortcomings of existing generic registration methods, which cannot be readily applied to OCT images. A successful deformable image registration algorithm for macular OCT opens up a variety of population based analysis techniques that are regularly used in other imaging modalities, such as spatial normalization, statistical atlas creation, and voxel based morphometry. Examples of these applications are provided to demonstrate the potential benefits such techniques can have on our understanding of retinal disease. In particular, included is a pilot study of localized volumetric changes between healthy controls and MS patients using the proposed registration algorithm. PMID:25071959

Chen, Min; Lang, Andrew; Ying, Howard S.; Calabresi, Peter A.; Prince, Jerry L.; Carass, Aaron

2014-01-01

269

Macular diseases: update on diagnostic and therapeutic techniques  

NASA Astrophysics Data System (ADS)

Purpose of this course is to review the principles that guide the diagnosis and the classification of macular diseases, and the new options available for this purpose. Among new treatments modalities, photodynamic therapy (PDT) has been recently introduced in the clinical practice for treating subfoveal choroidal neovascularization (CNV). In age-related macular degeneration (AMD), eyes in which the classic CNV components covers at least 50% of the entire lesion, called predominantly classic lesions, benefit from a substantial reduction of the rate of moderate visual loss during the first year. Preliminary results in other types of CNV also indicate a possible efficacy. We will present the theoretical basis and mechanisms of action of PDT and then comment on the main results of the TAP study; the preliminary results available from the VIP will also be displayed. Numerous cases treated with PDT, one year after its introduction in the clinical practice, will be shown and discussed. The introduction of PDT has probably reduced the applicability of surgical techniques for treating CNV. Yet, surgeons are developing less invasive techniques to minimize the complications associated with membrane removal and the various types of translocation. This innovation will be illustrated, as well as the criteria for patients selection in the era of PDT.

Fortunato, P.; De Libero, C.; Donati, C.; La Torre, A.

2004-09-01

270

Submacular haemorrhages associated with neovascular age-related macular degeneration.  

PubMed

The exact incidence of submacular haemorrhage (SMH) in patients with neovascular age-related macular degeneration (nAMD) is unknown, and risk factors for its occurrence ill defined. It is known, however, to be a relatively common problem and important because the visual prognosis of these patients is poor. Unfortunately, patients with significant SMH were excluded from all the recent major randomised control trials for nAMD with antivascular endothelial growth factor (VEGF) agents and photodynamic therapy, and as such, the optimum management of patients is uncertain. SMH can present initially or during treatment of nAMD. The location, size, thickness and duration of SMH have an important bearing on treatment and outcomes. Thin or extrafoveal SMH are probably best treated with anti-VEGF agents alone. It has been proposed that patients with moderate-sized SMH, particularly thick haemorrhages, have an improved prognosis with surgical SMH displacement combined with treatment of CNVM if present. SMH drainage, macular translocation and RPE patch grafting are reserved for more severe extensive cases of SMH. Using these techniques, outcomes better than the natural history have been achieved. This review aims to summarise what is known about SMH in nAMD and will discuss a variety of therapeutic interventions. PMID:20813746

Steel, David Henry William; Sandhu, Sukhpal Singh

2011-08-01

271

Anti-VEGF for the Management of Diabetic Macular Edema  

PubMed Central

Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 20 and 60 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significant public health issue. Macular photocoagulation has been the standard treatment for this condition reducing the risk of moderate visual loss by approximately 50%. The role of vascular endothelial growth factor (VEGF) in DR and DME pathogenesis has been demonstrated in recent studies. This review addresses and summarizes data from the clinical trials that investigated anti-VEGF for the management of DME and evaluates their impact on clinical practice. The literature searches were conducted between August and October 2013 in PubMed and Cochrane Library with no date restrictions and went through the most relevant studies on pegaptanib, ranibizumab, bevacizumab, and aflibercept for the management of DME. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an option that must be considered for the treatment of DME. PMID:24741610

Stefanini, Francisco Rosa; Badaró, Emmerson; Falabella, Paulo; Koss, Michael; Farah, Michel Eid; Maia, Maurício

2014-01-01

272

Atypical Cogan's syndrome presenting as bilateral endogenous endophthalmitis.  

PubMed

We report a case of atypical Cogan's syndrome presenting as bilateral endogenous endophthalmitis in a woman with ovarian cancer. A 62-year-old woman with ovarian cancer developed bilateral interstitial keratitis and panuveitis accompanied by bilateral sensorineural hearing loss and chondritis. Auricular cartilage biopsy ruled out relapsing polychondritis and the diagnosis of atypical Cogan's syndrome was set clinically. PMID:22908938

Georgakopoulos, Constantine D; Makri, Olga E; Exarchou, Artemis M; Pharmakakis, Nikolaos

2014-01-01

273

Hardware Implementation of a Bilateral Subtraction Filter  

NASA Technical Reports Server (NTRS)

A bilateral subtraction filter has been implemented as a hardware module in the form of a field-programmable gate array (FPGA). In general, a bilateral subtraction filter is a key subsystem of a high-quality stereoscopic machine vision system that utilizes images that are large and/or dense. Bilateral subtraction filters have been implemented in software on general-purpose computers, but the processing speeds attainable in this way even on computers containing the fastest processors are insufficient for real-time applications. The present FPGA bilateral subtraction filter is intended to accelerate processing to real-time speed and to be a prototype of a link in a stereoscopic-machine- vision processing chain, now under development, that would process large and/or dense images in real time and would be implemented in an FPGA. In terms that are necessarily oversimplified for the sake of brevity, a bilateral subtraction filter is a smoothing, edge-preserving filter for suppressing low-frequency noise. The filter operation amounts to replacing the value for each pixel with a weighted average of the values of that pixel and the neighboring pixels in a predefined neighborhood or window (e.g., a 9 9 window). The filter weights depend partly on pixel values and partly on the window size. The present FPGA implementation of a bilateral subtraction filter utilizes a 9 9 window. This implementation was designed to take advantage of the ability to do many of the component computations in parallel pipelines to enable processing of image data at the rate at which they are generated. The filter can be considered to be divided into the following parts (see figure): a) An image pixel pipeline with a 9 9- pixel window generator, b) An array of processing elements; c) An adder tree; d) A smoothing-and-delaying unit; and e) A subtraction unit. After each 9 9 window is created, the affected pixel data are fed to the processing elements. Each processing element is fed the pixel value for its position in the window as well as the pixel value for the central pixel of the window. The absolute difference between these two pixel values is calculated and used as an address in a lookup table. Each processing element has a lookup table, unique for its position in the window, containing the weight coefficients for the Gaussian function for that position. The pixel value is multiplied by the weight, and the outputs of the processing element are the weight and pixel-value weight product. The products and weights are fed to the adder tree. The sum of the products and the sum of the weights are fed to the divider, which computes the sum of products the sum of weights. The output of the divider is denoted the bilateral smoothed image. The smoothing function is a simple weighted average computed over a 3 3 subwindow centered in the 9 9 window. After smoothing, the image is delayed by an additional amount of time needed to match the processing time for computing the bilateral smoothed image. The bilateral smoothed image is then subtracted from the 3 3 smoothed image to produce the final output. The prototype filter as implemented in a commercially available FPGA processes one pixel per clock cycle. Operation at a clock speed of 66 MHz has been demonstrated, and results of a static timing analysis have been interpreted as suggesting that the clock speed could be increased to as much as 100 MHz.

Huertas, Andres; Watson, Robert; Villalpando, Carlos; Goldberg, Steven

2009-01-01

274

Microcystic macular oedema in multiple sclerosis is associated with disease severity.  

PubMed

Macular oedema typically results from blood-retinal barrier disruption. It has recently been reported that patients with multiple sclerosis treated with FTY-720 (fingolimod) may exhibit macular oedema. Multiple sclerosis is not otherwise thought to be associated with macular oedema except in the context of comorbid clinical uveitis. Despite a lack of myelin, the retina is a site of inflammation and microglial activation in multiple sclerosis and demonstrates significant neuronal and axonal loss. We unexpectedly observed microcystic macular oedema using spectral domain optical coherence tomography in patients with multiple sclerosis who did not have another reason for macular oedema. We therefore evaluated spectral domain optical coherence tomography images in consecutive patients with multiple sclerosis for microcystic macular oedema and examined correlations between macular oedema and visual and ambulatory disability in a cross-sectional analysis. Participants were excluded if there was a comorbidity that could account for the presence of macular oedema, such as uveitis, diabetes or other retinal disease. A microcystic pattern of macular oedema was observed on optical coherence tomography in 15 of 318 (4.7%) patients with multiple sclerosis. No macular oedema was identified in 52 healthy controls assessed over the same period. The microcystic oedema predominantly involved the inner nuclear layer of the retina and tended to occur in small, discrete patches. Patients with multiple sclerosis with microcystic macular oedema had significantly worse disability [median Expanded Disability Score Scale 4 (interquartile range 3-6)] than patients without macular oedema [median Expanded Disability Score Scale 2 (interquartile range 1.5-3.5)], P?=?0.0002. Patients with multiple sclerosis with microcystic macular oedema also had higher Multiple Sclerosis Severity Scores, a measure of disease progression, than those without oedema [median of 6.47 (interquartile range 4.96-7.98) versus 3.65 (interquartile range 1.92-5.87), P?=?0.0009]. Microcystic macular oedema occurred more commonly in eyes with prior optic neuritis than eyes without prior optic neuritis (50 versus 27%) and was associated with lower visual acuity (median logMAR acuity of 0.17 versus -0.1) and a thinner retinal nerve fibre layer. The presence of microcystic macular oedema in multiple sclerosis suggests that there may be breakdown of the blood-retinal barrier and tight junction integrity in a part of the nervous system that lacks myelin. Microcystic macular oedema may also contribute to visual dysfunction beyond that explained by nerve fibre layer loss. Microcystic changes need to be assessed, and potentially adjusted for, in clinical trials that evaluate macular volume as a marker of retinal ganglion cell survival. These findings also have implications for clinical monitoring in patients with multiple sclerosis on sphingosine 1-phosphate receptor modulating agents. PMID:22539259

Gelfand, Jeffrey M; Nolan, Rachel; Schwartz, Daniel M; Graves, Jennifer; Green, Ari J

2012-06-01

275

Anti-vascular endothelial growth factor for macular edema secondary to central retinal vein occlusion  

PubMed Central

Background Central retinal vein occlusion (CRVO) is a common retinal vascular disorder in which macular edema (ME) may develop, with a consequent reduction in visual acuity. The visual prognosis in CRVO-ME is poor in a substantial proportion of patients, especially those with the ischemic subtype, and until recently there has been no treatment of proven benefit. Macular grid laser treatment is ineffective, and whilst a few recent randomized controlled trials (RCTs) suggest short-term gains in visual acuity with intravitreal steroids for patients with non-ischemic CRVO-ME, there is no established treatment for ischemic CRVO-ME. Anti-vascular endothelial growth factor (anti-VEGF) agents have been used to treat ME resulting from a variety of causes and may represent a treatment option for CRVO-ME. Objectives To investigate the effectiveness and safety of intravitreal anti-VEGF agents in the treatment of CRVO-ME. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2010, Issue 8), MEDLINE (January 1950 to August 2010), EMBASE (January 1980 to August 2010), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to August 2010), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (January 1937 to August 2010), OpenSIGLE (January 1950 to August 2010), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) and ClinicalTrials.gov (www.clinicaltrials.gov). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 10 August 2010. Selection criteria We considered RCTs that compared intravitreal anti-VEGF agents of any dose or duration to sham injection or no treatment. We focused on studies that included individuals of any age or gender with unilateral or bilateral disease and a minimum of six months follow up. Secondarily, we considered non-randomized studies with the same criteria, but did not conduct a separate electronic search for these. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Main results We found two RCTs that met the inclusion criteria after independent and duplicate review of the search results. These RCTs utilized different anti-VEGF agents which cannot be assumed to be directly comparable. We, therefore, performed no meta-analysis. Evidence from these trials and from other non-randomized case series is summarized in this review. Authors’ conclusions Ranibizumab and pegaptanib sodium have shown promise in the short-term treatment of non-ischemic CRVO-ME. However, effectiveness and safety data from larger RCTs with follow up beyond six months are not yet available. There are no RCT data on anti-VEGF agents in ischemic CRVO-ME. The use of anti-VEGF agents to treat this condition therefore remains experimental. PMID:20927757

Braithwaite, Tasanee; Nanji, Afshan A; Greenberg, Paul B

2014-01-01

276

Strategy for the Management of Diabetic Macular Edema: The European Vitreo-Retinal Society Macular Edema Study  

PubMed Central

Objective. To compare the efficacy of different therapies in the treatment of diabetic macular edema (DME). Design. Nonrandomized, multicenter clinical study. Participants. 86 retina specialists from 29 countries provided clinical information on 2,603 patients with macular edema including 870 patients with DME. Methods. Reported data included the type and number of treatment(s) performed, the pre- and posttreatment visual acuities, and other clinical findings. The results were analyzed by the French INSEE (National Institute of Statistics and Economic Studies). Main Outcome Measures. Mean change of visual acuity and mean number of treatments performed. Results. The change in visual acuity over time in response to each treatment was plotted in second order polynomial regression trend lines. Intravitreal triamcinolone monotherapy resulted in some improvement in vision. Treatment with threshold or subthreshold grid laser also resulted in minimal vision gain. Anti-VEGF therapy resulted in more significant visual improvement. Treatment with pars plana vitrectomy and internal limiting membrane (ILM) peeling alone resulted in an improvement in vision greater than that observed with anti-VEGF injection alone. In our DME study, treatment with vitrectomy and ILM peeling alone resulted in the better visual improvement compared to other therapies.

Adelman, Ron; Parnes, Aaron; Boscher, Claude; Ducournau, Didier

2015-01-01

277

Silicone Oil Reinjection without Macular Buckling for Treatment of Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal  

PubMed Central

Purpose. To evaluate the efficacy of silicone oil (S.O) reinjection without macular buckling for treatment of recurrent myopic macular hole retinal detachment (MHRD) after silicone oil removal. Methods. A retrospective consecutive interventional study from medical reports on cases of myopic MHRD. Fifty-three eyes of 51 patients underwent silicone oil removal after successful repair of MHRD were reviewed. The main outcomes were the retinal status after silicone oil removal and management of recurrent cases. Results. The rate of recurrent RD (Re RD) after silicone oil removal was 11.3% (6 out of 53 eyes). One case refused any other interference. In the remaining 5 eyes, 4 eyes (80%) could be reattached by S.O re-injection and one eye (20%) developed Re RD after S.O re-injection. Range of followup after management of recurrence was 5–53 months (mean 18.7 months). Conclusions. This case series concluded that the risk factors for recurrent RD after silicone oil removal from cases of myopic MHRD were high myopia, open flat MH, and large posterior staphyloma. Revision of vitrectomy and S.O re-injection can reattach most of recurrent cases. PMID:24672706

Ghoraba, Hammouda Hamdy; Elgouhary, Sameh Mohamed; Mansour, Hosam Osman

2014-01-01

278

Silicone Oil Reinjection without Macular Buckling for Treatment of Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal.  

PubMed

Purpose. To evaluate the efficacy of silicone oil (S.O) reinjection without macular buckling for treatment of recurrent myopic macular hole retinal detachment (MHRD) after silicone oil removal. Methods. A retrospective consecutive interventional study from medical reports on cases of myopic MHRD. Fifty-three eyes of 51 patients underwent silicone oil removal after successful repair of MHRD were reviewed. The main outcomes were the retinal status after silicone oil removal and management of recurrent cases. Results. The rate of recurrent RD (Re RD) after silicone oil removal was 11.3% (6 out of 53 eyes). One case refused any other interference. In the remaining 5 eyes, 4 eyes (80%) could be reattached by S.O re-injection and one eye (20%) developed Re RD after S.O re-injection. Range of followup after management of recurrence was 5-53 months (mean 18.7 months). Conclusions. This case series concluded that the risk factors for recurrent RD after silicone oil removal from cases of myopic MHRD were high myopia, open flat MH, and large posterior staphyloma. Revision of vitrectomy and S.O re-injection can reattach most of recurrent cases. PMID:24672706

Ghoraba, Hammouda Hamdy; Elgouhary, Sameh Mohamed; Mansour, Hosam Osman

2014-01-01

279

Bilateral Nocardia Keratitis after Photorefractive Keratectomy  

PubMed Central

Purpose To report the clinical, confocal scan, and histopathologic features of nocardia keratitis in a patient who developed bilateral infection following photorefractive keratectomy (PRK). Case Report A 23-year-old woman underwent bilateral PRK for low myopia. On postoperative day 3, dense central stromal infiltrates were noticed in both eyes. Empirical antibiotic therapy was initiated which was converted into specific therapy after a definite diagnosis was made based on clinical features and confirmed by confocal scan and histopathologic findings. Clinical and confocal scan features were consistent with the diagnosis of Nocardia keratitis, and topical 2% amikacin eye drops were started. Because of poor response to medical therapy, lamellar keratectomy was performed in both eyes which shortened the treatment course. Histopathologic examination reconfirmed the initial diagnosis. Conclusion Familiarity with clinical and confocal scan features facilitates early diagnosis of Nocardia keratitis leading to proper management and hence a rapid therapeutic response. PMID:23275825

Faramarzi, Amir; Feizi, Sepehr; Javadi, Mohammad-Ali; Rezaei Kanavi, Mozhgan; Yazdizadeh, Forouzan; Moein, Hamid-Reza

2012-01-01

280

Bilateral pneumothorax following a blunt trachea trauma  

PubMed Central

A-13 year old boy had an accident with his bike with a blunt thorax trauma and presented shortly after with facial swelling. Due to respiratory insufficiency, intubation was done during the transport to the clinic. First, a chest radiograph was performed, which showed a unilateral pneumothorax. Later a CT scan revealed bilateral pneumothorax and pneumomediastinum. Bilateral chest tube insertions improved the respiratory situation. Bronchoscopy showed a tracheal lesion two cm posterior to the main carina. After good wound healing, the patient was dismissed after 21 days in good health. Conservative treatment can be recommended in selected patients with a tracheal lesion when having a stable respiratory situation. If the patient does not improve after 48 h or if the clinical condition worsens, surgical management should be considered.

Schwarz, C.; Usemann, J.; Stephan, V.; Kaiser, D.; Rothe, K.; Rückert, J.C.; Neudecker, J.

2013-01-01

281

Bilateral pulmonary sequestration in the elderly adult  

PubMed Central

Pulmonary sequestration (PS) is a rare malformation consisting of aberrant lung tissue which is not affiliated with the normal bronchial system and is fed by an aberrant artery that derives from systemic arteries. However, PS is usually seen unilaterally but, only rarely, it is bilateral. Most patients with PS are diagnosed because of symptoms due to pulmonary infection or cardiac disease, while a small portion of patients are asymptomatic and diagnosed incidentally. In this report, we present an extremely rare case of asymptomatic bilateral PS which was diagnosed at advanced age. To our knowledge, this case represents the oldest patient in the literature, and the second case that was diagnosed in a patient over the age of 50. PMID:23088281

2012-01-01

282

Bilateral Asymmetrical Traumatic Sternoclavicular Joint Dislocations  

PubMed Central

Unilateral and bilateral sternoclavicular joint (SCJ) dislocations are rare injuries. The difficulty in assessing this condition often leads to delay in diagnosis and treatment. We report a rare case of bilateral asymmetrical traumatic SCJ dislocations in a 45-year-old male. The right anterior SCJ dislocation was reduced in the emergency room (ER) and resulted in residual instability. The left posterior SCJ dislocation was asymptomatic and unnoticed for six months. It is important for ER physicians and orthopaedic surgeons to be able identify and treat this condition. All suspected SCJ dislocations should be evaluated by computed tomography (CT) scan for confirmation of the diagnosis and evaluation of both SCJs. Posterior SCJ dislocation is a potentially fatal injury and should not be overlooked due to the presence of other injuries. Surgical intervention is often necessary in acute and old cases. PMID:23275851

Albarrag, Mohammed K.

2012-01-01

283

Multiple osteochondroses of bilateral knee joints  

Microsoft Academic Search

We experienced a patient with a combination of multiple osteochondroses: Blount's disease, bipartite patella, and Sinding-Larsen-Johansson\\u000a disease in the left knee, and a combination of bipartite patella and Osgood-Schlatter disease in the right knee. The patient\\u000a was a healthy, active 12-year-old boy with bilateral knee pain. He had been diagnosed with Blount's disease of the left tibia\\u000a at 2 years

Hiroyuki Segawa; Go Omori; Yoshio Koga

2001-01-01

284

[Case of cystitis glandularis causing bilateral hydronephrosis].  

PubMed

A 38 year-old male was referred to our hospital due to bilateral hydronephrosis. Cystoscopy revealed multiple edematous papillary tumors that exist on the prostatic urethra, bladder neck, trigone, and lateral wall on both sides. He underwent a transurethral resection of bladder tumors. The pathological diagnosis was cystitis glandularis. He was given steroid orally for 6 months and had no sign of recurrence after 2 years. PMID:24187856

Maeda, Motohiro; Hirabayashi, Takaki; Inuzuka, Yoshihiro; Kondo, Atsuya; Tanaka, Kuniaki

2013-09-01

285

Bilateral pregnancy luteoma: a case report.  

PubMed

Pregnancy luteoma is a non-neoplastic lesion of the ovary occurring during pregnancy and is usually discovered incidentally at the time of a cesarean section or during postpartum tubal ligation. An accurate diagnosis is important for the mother and the fetus as it can be confused with ovarian malignancy leading to unnecessary surgery. We report a case of a pregnant female who was discovered to have bilateral enlarged ovaries at the time of emergency cesarean section. PMID:25337317

Nanda, Annu; Gokhale, Uday A; Pillai, G Rajasekharan

2014-09-01

286

Bilateral Pregnancy Luteoma: A Case Report  

PubMed Central

Pregnancy luteoma is a non-neoplastic lesion of the ovary occurring during pregnancy and is usually discovered incidentally at the time of a cesarean section or during postpartum tubal ligation. An accurate diagnosis is important for the mother and the fetus as it can be confused with ovarian malignancy leading to unnecessary surgery. We report a case of a pregnant female who was discovered to have bilateral enlarged ovaries at the time of emergency cesarean section. PMID:25337317

Nanda, Annu; Gokhale, Uday A.; Pillai, G Rajasekharan

2014-01-01

287

Comparison of Spectral/Fourier Domain Optical Coherence Tomography Instruments for Assessment of Normal Macular Thickness  

E-print Network

Purpose: The purpose of this study was to report normal macular thickness measurements and assess reproducibility of retinal thickness measurements acquired by a time-domain optical coherence tomography (OCT) (Stratus, ...

Sull, Alan C.

288

Optical coherence tomography in the preoperative and postoperative management of macular hole and epiretinal membrane  

PubMed Central

Optical coherence tomography (OCT) imaging plays an essential role in the diagnosis and treatment of macular diseases, including those of the vitreomacular interface. OCT enables accurate diagnosis and differentiation of full thickness macular hole, lamellar macular hole and epiretinal membrane, with or without the presence of vitreomacular adhesion. This information enables earlier diagnosis and treatment when necessary, and can guide the choice of therapy. OCT is useful to facilitate discussions with patients and manage the visual expectations. Postoperatively, OCT can be helpful to optimise patient comfort and visual outcomes. As the technology continues to improve, OCT will become increasingly critical for all aspects of care for patients with macular hole and epiretinal membrane. PMID:24627250

Goldberg, Roger A; Waheed, Nadia K; Duker, Jay S

2014-01-01

289

Three Studies Point to Same Risk Gene for Age-Related Macular Degeneration  

MedlinePLUS

... and Jobs Three studies point to same risk gene for age-related macular degeneration Listen NIH-funded ... in Nature Genetics have converged on the same gene as a rare, but powerful risk factor for ...

290

Optical coherence tomography (oct) macular and peripapillary retinal nerve fiber layer measurements and automated visual fields  

Microsoft Academic Search

PurposeTo investigate the structure-function relationship between optical coherence tomography (OCT) macular retinal and peripapillary nerve fiber layer (NFL) thickness and automated visual field (VF) findings.

Gadi Wollstein; Joel S. Schuman; Lori L. Price; Ali Aydin; Siobahn A. Beaton; Paul C. Stark; James G. Fujimoto; Hiroshi Ishikawa

2004-01-01

291

Use of Immunosuppressive Agents for Treatment of Age-related Macular Degeneration (AMD) and Diabetic Retinopathy  

Cancer.gov

The National Eye Institute, Laboratory of Immunology is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize immunosuppressive agents for the treatment of age related macular degeneration.

292

Investigating the genetic and molecular basis of age-related macular degeneration   

E-print Network

Age-related macular degeneration (AMD) is the leading cause of blindness worldwide, affecting an estimated 50 million individuals aged over 65 years. Environmental and genetic risk-factors contribute to the development ...

Stanton, Chloe May

2012-06-30

293

Optical coherence tomography in the preoperative and postoperative management of macular hole and epiretinal membrane.  

PubMed

Optical coherence tomography (OCT) imaging plays an essential role in the diagnosis and treatment of macular diseases, including those of the vitreomacular interface. OCT enables accurate diagnosis and differentiation of full thickness macular hole, lamellar macular hole and epiretinal membrane, with or without the presence of vitreomacular adhesion. This information enables earlier diagnosis and treatment when necessary, and can guide the choice of therapy. OCT is useful to facilitate discussions with patients and manage the visual expectations. Postoperatively, OCT can be helpful to optimise patient comfort and visual outcomes. As the technology continues to improve, OCT will become increasingly critical for all aspects of care for patients with macular hole and epiretinal membrane. PMID:24627250

Goldberg, Roger A; Waheed, Nadia K; Duker, Jay S

2014-07-01

294

Brilliant blue G-assisted peeling of the internal limiting membrane in macular hole surgery  

PubMed Central

Dye-assisted internal limiting membrane (ILM) peeling and gas tamponade is the surgery of choice for idiopathic macular holes. Indocyanine green and trypan blue have been extensively used to stain the ILM. However, the retinal toxicity of indocyanine green and non-uniform staining with trypan blue has necessitated development of newer vital dyes. Brilliant blue G has recently been introduced as one such dye with adequate ILM staining and no reported retinal toxicity. We performed a 23-gauge pars plana vitrectomy with brilliant blue G-assisted ILM peeling in six patients with idiopathic macular holes, to assess the staining characteristics and short-term adverse effects of this dye. Adequate staining assisted in the complete removal of ILM and closure of macular holes in all cases. There was no evidence of intraoperative or postoperative dye-related toxicity. Brilliant blue G appears to be safe dye for ILM staining in macular hole surgery. PMID:21350290

Naithani, Prashant; Vashisht, Naginder; Khanduja, Sumeet; Sinha, Subijay; Garg, Satpal

2011-01-01

295

Bilateral calcaneal stress fractures: a case report.  

PubMed

The majority of plantar heel pain is diagnosed as plantar fasciitis or heel spur syndrome. When history or physical findings are unusual or when routine treatment proves ineffective, one should consider an atypical cause of heel pain. Stress fractures of the calcaneus are a frequently unrecognized source of heel pain. In a normal populat?on, the possibility of calcaneal stress fractures must be borne in mind with patients who have bilateral heel pain. When a stress fracture is considered, clinicans have different imaging options. First of all, x-rays must be used to evaluate for any visible osseous pathology. If plain films are inconclusive, the clinician can proceed with a bone scan or Magnetic Resonance Imaging. In the literature, calcaneal stress fractures are mostly reported in soldiers or athletes, but our case is one of a 44-year-old housewife with bilateral heel pain treated as Achilles tendinitis and plantar faciitis for a long time. Her final diagnosis was bilateral calcaneal fracture by Magnetic Resonance Imaging. PMID:23208939

Imerci, Ahmet; Incesu, Mustafa; Bozoglan, Muhammet; Canbek, Umut; Ursavas, Hüseyin Tamer

2012-01-01

296

Diagnosis and management of bilateral nasolabial cysts  

PubMed Central

Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a “cupping” fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed. PMID:24574670

Parwani, Rajkumar; Parwani, Simran; Wanjari, Sangeeta

2013-01-01

297

Diagnosis and management of bilateral nasolabial cysts.  

PubMed

Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a "cupping" fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed. PMID:24574670

Parwani, Rajkumar; Parwani, Simran; Wanjari, Sangeeta

2013-09-01

298

Bilateral Descemet membrane detachment after canaloplasty.  

PubMed

We report a case of bilateral Descemet membrane detachment (DMD) after canaloplasty in a 70-year-old Portuguese man with primary open-angle glaucoma. The patient developed bilateral DMD immediately following consecutive (1 week apart) canaloplasty surgery in both eyes. Slitlamp biomicroscopy, gonioscopy, and Fourier-domain optical coherence tomography (FD-OCT) findings are described. On postoperative day 1, in both cases, slitlamp biomicroscopy revealed an unscrolled inferonasal DMD and a clear cornea with deep and quiet anterior chambers. Gonioscopy showed an intact, lightly pigmented, and distended trabecular meshwork with no evidence of suture extrusion. High-resolution FD-OCT revealed a widely dilated canal of Schlemm, trabecular distention, and a retrocorneal hyperreflective membrane corresponding to a DMD. At 3 months, the DMD resolved spontaneously in both eyes. Although DMD is a known complication of canaloplasty, the occurrence of bilateral symmetrically located DMDs in our case suggests a possible anatomical predisposition in addition to factors induced by the surgical technique. PMID:20202554

Palmiero, Pat-Michael; Aktas, Zeynep; Lee, Olivia; Tello, Celso; Sbeity, Zaher

2010-03-01

299

Multilateral, regional and bilateral energy trade governance  

SciTech Connect

The current international energy trade governance system is fragmented and multi-layered. Streamlining it for greater legal cohesiveness and international political and economic cooperation would promote global energy security. The current article explores three levels of energy trade governance: multilateral, regional and bilateral. Most energy-rich countries are part of the multilateral trading system, which is institutionalized by the World Trade Organization (WTO). The article analyzes the multilateral energy trade governance system by focusing on the WTO and energy transportation issues. Regionally, the article focuses on five major regional agreements and their energy-related aspects and examines the various causes that explain the proliferation of regional trade agreements, their compatibility with WTO law, and then provides several examples of regional energy trade governance throughout the world. When it comes to bilateral energy trade governance, this article only addresses the European Union’s (EU) bilateral energy trade relations. The article explores ways in which gaps could be filled and overlaps eliminated whilst remaining true to the high-level normative framework, concentrating on those measures that would enhance EU energy security.

Leal-Arcas, Rafael; Grasso, Costantino; Rios, Juan Alemany (Queen Mary Univ. of London (United Kingdom))

2014-12-01

300

Bilateral Kimura's disease of the eyelids.  

PubMed Central

A case of Kimura's disease affecting the eyelids bilaterally is reported in a 5-year-old boy of Afro-Caribbean extraction who has been followed for 12 years with repeat biopsies. He initially presented at 5 years of age with swelling of the left upper eyelid, left cervical lymphadenopathy, and eosinophilia. One year later he developed swelling of the right upper eyelid. There has been no change in the clinical appearance over the next 12 years. Repeated biopsies of the eyelids showed a diffuse inflammatory infiltrate with many eosinophils and lymphocytes. A lymph node biopsy showed reactive lymphoid hyperplasia. Immunohistochemistry using lymphoid markers showed a polyclonal pattern. Kimura's disease is a rare cause of eyelid swelling, particularly at such a young age and with bilateral involvement. This case demonstrates that bilateral orbital lymphoid lesions with cervical node involvement do not always imply lymphoma, but may have a benign pathogenesis. The unusually long follow up in this case confirms an excellent prognosis for Kimura's disease with conservative management. Accurate diagnosis in small orbital biopsies may spare the patient unnecessary radical surgery. Images PMID:1486082

Kennedy, S. M.; Pitts, J. F.; Lee, W. R.; Gibbons, D. C.

1992-01-01

301

High Performance, Three-Dimensional Bilateral Filtering  

SciTech Connect

Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

Bethel, E. Wes

2008-06-05

302

Bilateral elastofibroma dorsi: A case report  

PubMed Central

INTRODUCTION Elastofibroma dorsi(EFD) is slow-growing, benign, soft tissue tumor of unclear pathogenesis, typically located at the subscapular region of elderly people. It may be unilateral or bilateral. As it exhibits benign behavior, it should be surgically removed only in symptomatic patients. Magnetic resonance imaging (MRI) is a useful tool for assessment of EFD and can potentially help avoid the need for unnecessary biopsy and surgery. PRESENTATION OF CASE A 62-year-old woman presented with 2 years complaint of back pain, particularly aggravated with shoulder movements and swelling with bilateral elastofibroma dorsi. Both masses were totally excised with bilateral posterolateral subscapular incision. Symptoms were completely controlled and significant discomfort from the surgical procedure was completely resolved with in a few weeks interval from the operation. DISCUSSION The pathogenesis of the EFD still remains unclear. Elastofibroma dorsi has an unspecific clinical presentation and can be confused with other tumors of the periscapular region Imaging studies are useful for diagnosis. CONCLUSION Elastofibroma dorsi is benign soft tissue tumor mostly observed in the subscapular regions of elderly female patients. The surgery is indicated in symptomatic cases and must be confined to simple excision of the lesion. PMID:25437657

Sarici, Inanc Samil; Basbay, Elif; Mustu, Mehdi; Eskut, Burak; Kala, Ferhat; Agcaoglu, Orhan; Akici, Murat; Ozkurt, Enver

2014-01-01

303

Intravitreal Injection of Dexamethasone Implant and Ranibizumab in Cystoid Macular Edema in the Course of Irvine-Gass Syndrome  

PubMed Central

Purpose To evaluate the efficacy of 2 dexamethasone intravitreal implants and 1 ranibizumab intravitreal injection after a bilateral postoperative complication of cataract surgery as pseudophakic cystoid macular edema. Patients and Methods A 70-year-old male patient with systemic hypertension developed a progressive cystoid macular edema (CME) in both eyes starting between 10 and 20 days after cataract surgery. Two intravitreal dexamethasone implants and 1 ranibizumab injection were administered; first in the right eye (RE) and then in the left eye (LE). The patient was checked for 1 whole week and then once a month for 5 months after the injections. Results One month after the first dexamethasone implant in his RE, the spectral domain optical coherence tomography (SD-OCT) showed a progressive reduction of the foveal thickness until a complete resolution of the CME occurred, which was associated with an improvement of visual acuity. After 3 months, the SD-OCT showed a relapse of the CME, which was then treated with 1 injection of ranibizumab. One month after this injection, there was a complete resolution of the CME. A new CME in his RE was diagnosed 2 months after the last ranibizumab injection; it was treated with a new dexamethasone implant. A complete resolution of the CME was obtained; a normal foveal profile was still present 5 months after the last injection, and the best-corrected visual acuity was 20/20. His LE developed a CME 40 days after surgery. One intravitreal injection of ranibizumab was first administered in his LE, with a complete resolution of the CME at SD-OCT 2 weeks later. As observed in his RE, 40 days after the ranibizumab injection, there was a relapse of the CME that was treated with 1 intravitreal injection of dexamethasone implant. Five months later, the patient showed a worsening of the CME, but it was completely resolved with a second dexamethasone injection. After 3 months, the foveal thickness was back to normal with a BCVA of 20/20. Conclusion Treatment with dexamethasone implants (Ozurdex®) and ranibizumab injections (Lucentis®) induced a progressive reduction of our patient's CME after cataract surgery (Irvine-Gass syndrome) until a complete normal foveal thickness was restored and his visual function was improved despite the order of injections. PMID:25232337

Fenicia, Vito; Balestrieri, Marco; Perdicchi, Andrea; MauriziEnrici, Maurizio; DelleFave, Martina; Recupero, Santi Maria

2014-01-01

304

Optical coherence tomography of cystoid macular edema associated with retinitis pigmentosa  

Microsoft Academic Search

PURPOSE:To detect cystoid macular edema in consecutive eyes with retinitis pigmentosa by means of optical coherence tomography and to study the correlation between cross-sectional structures and angiographic findings in cystoid macular edema.METHODS:In a prospective study, cross-sectional images through the fovea were evaluated by means of optical coherence tomography in 89 phakic eyes of 46 patients with retinitis pigmentosa. Eyes showing

Hirohide Hirakawa; Hiroyuki Iijima; Takashi Gohdo; Shigeo Tsukahara

1999-01-01

305

Macular pigment response to a supplement containing meso-zeaxanthin, lutein and zeaxanthin  

PubMed Central

Background Age-related macular degeneration (AMD) is a disease with multiple risk factors, many of which appear to involve oxidative stress. Macular pigment, with its antioxidant and light-screening properties, is thought to be protective against AMD. A result has been the appearance of dietary supplements containing the macular carotenoids, lutein and zeaxanthin. More recently, a supplement has been marketed containing, in addition, the third major carotenoid of the macular pigment, meso-zeaxanthin. The purpose of the study was to determine the effectiveness of such a supplement in raising macular pigment density in human subjects. Methods A 120 day supplementation study was conducted in which 10 subjects were given gel-caps that provided 20 mg/day of predominantly meso-zeaxanthin, with smaller amounts of lutein and zeaxanthin. A second group of 9 subjects were given gel caps containing a placebo for the same 120 day period. Prior to and during the supplementation period, blood serum samples were analyzed by high performance liquid chromatography for carotenoid content. Similarly, macular pigment optical density was measured by heterochromatic flicker photometry. Differences in response between the supplementation and placebo groups were tested for significance using a student's t-test. Results During supplementation with the carotenoids, blood samples revealed the presence of all three carotenoids. Macular pigment optical density, measured at 460 nm, rose at an average rate of 0.59 ± 0.79 milli-absorbance unit/day in the 10 supplemented subjects. This was significantly different from the placebo group (9 subjects) for whom the average rate was -0.17 ± 0.42 milli-absorbance units/day. Conclusion We have shown for the first time that meso-zeaxanthin is absorbed into the serum following ingestion. The data indicate that a supplement containing predominantly meso-zeaxanthin is generally effective at raising macular pigment density, and may turn out to be a useful addition to the defenses against AMD. PMID:17498306

Bone, Richard A; Landrum, John T; Cao, Yisi; Howard, Alan N; Alvarez-Calderon, Francesca

2007-01-01

306

The Role of Inflammation in the Pathogenesis of Macular Edema Secondary to Retinal Vascular Diseases  

PubMed Central

Macular edema (ME) is a nonspecific sign of numerous retinal vascular diseases. This paper is an updated overview about the role of inflammatory processes in the genesis of both diabetic macular edema (DME) and ME secondary to retinal vein occlusion (RVO). We focus on the inflammatory mediators implicated, the effect of the different intravitreal therapies, the recruitment of leukocytes mediated by adhesion molecules, and the role of retinal Müller glial (RMG) cells. PMID:25152567

Ascaso, Francisco J.

2014-01-01

307

Spontaneous resolution of full-thickness macular hole in retinitis pigmentosa  

PubMed Central

A 57-year-old woman, diagnosed with retinitis pigmentosa and positive family history, was referred to the retinal clinic. Full-thickness macular hole was noted in the right eye with no significant vitreomacular interface abnormalities confirmed at baseline visit with spectral-domain optical coherence tomography scan. Routine follow-up showed spontaneous closure of the full-thickness macular hole with four-letter improvement from baseline visit and remains unchanged with 3 years of follow-up. PMID:22689724

Raja, Muhammad; Goldsmith, Craig; Burton, Benjamin J L

2011-01-01

308

Lack of fibulin-3 causes early aging and herniation, but not macular degeneration in mice  

Microsoft Academic Search

A mutation in the EFEMP1 gene causes Malattia Leventinese, an inherited macular degenerative disease with strong similarities to age-related macular degeneration. EFEMP1 encodes fibulin-3, an extracellular matrix protein of unknown function. To investigate its biological role, the murine Efemp1 gene was inactivated through targeted disruption. Efemp12\\/2 mice exhibited reduced reproductivity, and displayed an early onset of aging-associated phenotypes including reduced

Precious J. McLaughlin; Benjamin Bakall; Jiwon Choi; Zhonglin Liu; Takako Sasaki; Elaine C. Davis; Alan D. Marmorstein; Lihua Y. Marmorstein

2007-01-01

309

Partial-thickness macular hole in vitreomacular traction syndrome: a case report and review of the literature  

PubMed Central

Introduction Vitreomacular traction syndrome has recently been recognized as a distinct clinical condition. It may lead to many complications, such as cystoid macular edema, macular pucker formation, tractional macular detachment, and full-thickness macular hole formation. Case presentation We report a case of vitreomacular traction syndrome with eccentric traction at the macula and a partial-thickness macular hole in a 63-year-old Pakistani Punjabi man. The patient was evaluated using optical coherence tomography, and he underwent a successful pars plana vitrectomy. After the operation, his foveal contour regained normal configuration, and his visual acuity improved from 20/60 to 20/30. Conclusions Pars plana vitrectomy prevents the progression of a partial thickness macular hole in vitreomacular traction syndrome. The relief of traction by vitrectomy restores foveal anatomy and visual acuity in this condition. PMID:20205799

2010-01-01

310

Progression of Geographic Atrophy and Genotype in Age-Related Macular Degeneration  

PubMed Central

Purpose To determine if genotype is associated with rate of growth of geographic atrophy (GA) in eyes with age-related macular degeneration (AMD). Design Prospective analysis of participants in a randomized controlled clinical trial. Participants 114 eyes of 114 participants in the Age-Related Eye Disease Study (AREDS). Methods Fundus photographs from AREDS participants with GA from whom a DNA specimen had been obtained and serial photographs had been taken over a minimum of 2 years were evaluated for progression as determined by change in cumulative area of GA. All fundus photographs were scanned, digitized, and centrally graded longitudinally for area of GA. The relationship of GA progression with previously identified genetic variants associated with AMD was assessed. Main Outcome Measures Genotype frequencies and change in cumulative area of GA. Results The mean growth rate of geographic atrophy for the 114 eyes was 1.79 mm2/year (range= 0.17–4.76 mm2/year). No association between growth rate and genotype was present for variants in the CFH, C2, C3, APOE, and TLR3genes. For the single nucleotide polymorphism (SNP) rs10490924 in LOC387715/ARMS2, there was a significant association of GA growth rate, both adjusted and unadjusted for initial lesion size, with the homozygous risk genotype as compared to the homozygous non-risk genotype (unadjusted p-value = 0.002; Bonferroni corrected p-value = 0.014) and for allelic association(Bonferroni corrected p-value = 0.011). Analyses of other measures of geographic atrophy progression (progression to central GA from extrafoveal GA and development of bilateral GA in those initially with unilateral GA) showed no statistically significant association between progression and the LOC387715/ARMS2/HTRA1 genotype. Conclusion GA growth rates calculated from digitized serial fundus photographs showed no association with variants in the CFH, C2, C3, APOE, and TLR3 genes. There was a nominally statistically significant association with the LOC387715/ARMS2/HTRA1 genotype, although this finding was not supported by analyses of secondary measures of GA progression. Replication in other populations would be needed to establish the existence of an association. PMID:20381870

Klein, Michael L.; Ferris, Frederick L.; Francis, Peter J.; Lindblad, Anne S.; Chew, Emily Y.; Hamon, Sara C.; Ott, Jurg

2009-01-01

311

Visual Acuity is Related to Parafoveal Retinal Thickness in Patients with Retinitis Pigmentosa and Macular Cysts  

PubMed Central

Purpose To quantify the prevalence and effect on visual acuity of macular cysts in a large cohort of patients with retinitis pigmentosa. Methods In 316 patients with typical forms of retinitis pigmentosa, we measured visual acuities with Early Treatment Diabetic Retinopathy Study (ETDRS) charts, detected macular cysts with optical coherence tomography (OCT), and quantified retinal thicknesses by OCT. We used the FREQ, LOGISTIC, and GENMOD procedures of SAS to evaluate possible risk factors for cyst prevalence and the MIXED procedure to quantify the relationships of visual acuity to retinal thickness measured at different locations within the macula. Results We found macular cysts in 28% of the patients, 40% of whom had cysts in only one eye. Macular cysts were seen most often in patients with dominant disease and not at all in patients with X-linked disease (p = 0.006). In eyes with macular cysts, multiple regression analysis revealed that visual acuity was inversely and independently related to retinal thickness at the foveal center (p = 0.038) and within a ring spanning an eccentricity of 5° to 10° from the foveal center (p = 0.004). Conclusions Macular cysts are a common occurrence in retinitis pigmentosa, especially among patients with dominantly-inherited disease. Visual acuity is influenced by edema in the parafovea, as well as in the fovea. PMID:18552390

Brockhurst, Robert J.; Gaudio, Alexander R.; Berson, Eliot L.

2008-01-01

312

OPTICAL COHERENCE TOMOGRAPHY–GUIDED FACEDOWN POSITIONING FOR MACULAR HOLE SURGERY  

PubMed Central

Purpose To use spectral domain optical coherence tomography–guided duration of facedown positioning to study anatomical macular hole closure rates. Methods Retrospective review of patients with macular holes undergoing 23-gauge pars plana vitrectomy and intraocular gas tamponade. Spectral domain optical coherence tomography imaging was done on postoperative Day 1. Patients remained facedown for 2 more days if the macular hole was closed or 6 more days facedown if the macular hole was open or indeterminate. Results There were 8 Stage 2, 12 Stage 3, and 12 Stage 4 macular holes. On postoperative Day 1, 24 holes were closed by spectral domain optical coherence tomography and instructed to remain facedown for two more days. Twenty-three of 24 holes remained closed during the postoperative period. Eight holes were open or indeterminate on postoperative Day 1 and remained facedown for 6 more days. Six of 8 holes (75%) were closed at their last follow-up. The overall closure rate was 29/32 (90.6%). Average follow-up was 334 days. Conclusion Confirming early closure of macular holes with spectral domain optical coherence tomography imaging can serve as an important guide to significantly shorten the duration of prone positioning while maintaining high closure rates. PMID:23343822

SHAH, SUMIT P.; MANJUNATH, VARSHA; ROGERS, ADAM H.; BAUMAL, CAROLINE R.; REICHEL, ELIAS; DUKER, JAY S.

2013-01-01

313

[Treatment of serous macular retinal detachment with antihistamines.  

PubMed

The etiology of retinal detachment in central serous retinopathy (CSR) is unknown; however, three facts are generally accepted: (1) the serous exudate which raises the layers of the receptors/pigment epithelium is formed due to hyperpermeability in the choriocapillaries, (2) patients frequently suffer from headaches and (3) stress promotes the incidence of CSR. A high blood plasma histamine concentration can cause the abovementioned symptoms which suggests that histamine might provoke CSR. Within 1 week after administration of the antihistamine loratadin a considerable reduction in the retinal exudate and restoration of vision were observed. This supports the hypothesis that histamine could be involved in the process of retinal detachment. Further investigations and large scale clinical trials should clarify if this hypothesis can be proved or disproved and whether antihistamines can be used for age-related macular degeneration (AMD). PMID:25278347

Kirschfeld, K

2014-10-01

314

Complement factor H polymorphism in age-related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is a major cause of blindness in the elderly. We report a genome-wide screen of 96 cases and 50 controls for polymorphisms associated with AMD. Among 116,204 single-nucleotide polymorphisms genotyped, an intronic and common variant in the complement factor H gene (CFH) is strongly associated with AMD (nominal P value <10(-7)). In individuals homozygous for the risk allele, the likelihood of AMD is increased by a factor of 7.4 (95% confidence interval 2.9 to 19). Resequencing revealed a polymorphism in linkage disequilibrium with the risk allele representing a tyrosine-histidine change at amino acid 402. This polymorphism is in a region of CFH that binds heparin and C-reactive protein. The CFH gene is located on chromosome 1 in a region repeatedly linked to AMD in family-based studies. PMID:15761122

Klein, Robert J; Zeiss, Caroline; Chew, Emily Y; Tsai, Jen-Yue; Sackler, Richard S; Haynes, Chad; Henning, Alice K; SanGiovanni, John Paul; Mane, Shrikant M; Mayne, Susan T; Bracken, Michael B; Ferris, Frederick L; Ott, Jurg; Barnstable, Colin; Hoh, Josephine

2005-04-15

315

Genetic factors of age-related macular degeneration  

PubMed Central

Age-related macular degeneration (AMD) is a leading cause of blindness in the United States and developed countries. Although the etiology and pathogenesis of AMD remain unknown, a complex interaction of genetic and environmental factors is thought to exist. The incidence and progression of all of the features of AMD are known to increase significantly with age. The tendency for familial aggregation and the findings of gene variation association studies implicate a significant genetic component in the development of AMD. This review summarizes in detail the AMD-related genes identified by studies on genetically engineered and spontaneously gene-mutated (naturally mutated) animals, AMD chromosomal loci identified by linkage studies, AMD-related genes identified through studies of monogenic degenerative retinal diseases, and AMD-related gene variation identified by association studies. PMID:15094132

Tuo, Jingsheng; Bojanowski, Christine M.; Chan, Chi-Chao

2007-01-01

316

AMO Teledioptric System for age-related macular degeneration  

NASA Astrophysics Data System (ADS)

A 2.5 X magnification system consisting of a two-zone intraocular implant and a spectacle was developed, tested, and clinically tried by fifty patients with cataract ad age-related macular degeneration. Optical bench testing results and clinical data confirmed that the field of view of the system was 2.6 times wider than an equivalent external telescope. The study also demonstrated that the implant itself was clinically equivalent to a standard monofocal intraocular lens for cataract. The clinical study indicated that higher magnification without compromising the compactness and optical quality was needed as the disease progressed. Also, a sound vision rehabilitation process is important to provide patients the full benefits of the system.

Chou, Jim-Son; Ting, Albert C.

1994-05-01

317

Age-related macular degeneration – clinical review and genetics update  

PubMed Central

Age-related macular degeneration (AMD) is the leading cause of central vision impairment in persons over the age of 50 years in developed countries. Both genetic and non-genetic (environmental) factors play major roles in AMD etiology, and multiple gene variants and lifestyle factors such as smoking have been associated with the disease. While dissecting the basic etiology of the disease remains a major challenge, current genetic knowledge has provided opportunities for improved risk assessment, molecular diagnosis and clinical testing of genetic variants in AMD treatment and management. This review addresses the potential of translating the wealth of genetic findings for improved risk prediction and therapeutic intervention in AMD patients. Finally, we discuss the recent advancement in genetics and genomics and the future prospective of personalized medicine in AMD patients. PMID:23713713

Ratnapriya, R; Chew, E Y

2013-01-01

318

Cystoid macular edema in a patient with Danon disease  

PubMed Central

To report a patient with Danon retinopathy with cystoid macular edema treated with topical dorzolamide 2% eye drops and oral acetazolamide. A 37-year-old Caucasian man with Danon disease treated with topical and oral carbonic anhydrase inhibitors participated in the study. Examinations performed before and during treatment included visual acuity (VA), spectral-domain optical coherence tomography, and electroretinography. Following total 48 weeks of treatment, VA decreased from 20/30 OD, 20/200 OS, to 20/40 OD, CF OS. The mean central retinal thickness was unchanged from baseline 263 ?m OD, 226 ?m OS, after treatment 283 ?m OD and 202 ?m OS. In our case, carbonic anydrase inhibitors were not effective. However, a general recommendation cannot be given based on a single case. PMID:23571262

Mack, Heather G

2014-01-01

319

Macular function and morphology in acute retinal pigment epithelitis  

PubMed Central

A 20-year-old man applied with vision loss in the left eye. Right eye examination was unremarkable. Best-corrected visual acuity (BCVA) in the left eye was 20/200. Fundus examination revealed a few yellow spots within a round-shaped macular lesion. Autofluorescence imaging showed hyperautofluorescence in the lesion. Central amplitudes in multifocal electroretinogram (mfERG) were depressed. The patient reported a rhinopharyngitis 7–10 days before the visual loss. The patient was diagnosed as acute retinal pigment epithelitis. BCVA improved gradually up to 20/20 in 4 weeks. mfERG amplitudes returned to normal. A slight pigmentary distortion was the only residual fundus finding. PMID:25579361

Gundogan, Fatih C; Diner, Oktay; Tas, Ahmet; Ilhan, Abdullah; Yolcu, Umit

2014-01-01

320

Cystoid macular edema in a patient with Danon disease.  

PubMed

To report a patient with Danon retinopathy with cystoid macular edema treated with topical dorzolamide 2% eye drops and oral acetazolamide. A 37-year-old Caucasian man with Danon disease treated with topical and oral carbonic anhydrase inhibitors participated in the study. Examinations performed before and during treatment included visual acuity (VA), spectral-domain optical coherence tomography, and electroretinography. Following total 48 weeks of treatment, VA decreased from 20/30 OD, 20/200 OS, to 20/40 OD, CF OS. The mean central retinal thickness was unchanged from baseline 263 ?m OD , 226 ?m OS, after treatment 283 ?m OD and 202 ?m OS. In our case, carbonic anydrase inhibitors were not effective. However, a general recommendation cannot be given based on a single case. PMID:23571262

Mack, Heather G

2014-12-01

321

[Age-related macular degeneration (AMD): etiopathogenesis and therapeutic strategies].  

PubMed

Age-related macular degeneration (AMD) is a disease leading to severe visual loss and legal blindness in the population over 60 years of age. Its pathogenesis is likely multifactorial, involving a complex interaction of metabolic, functional, genetic, and environmental factors, and remains poorly understood. For these reasons, currently used therapeutic approaches are insufficiently effective. Although major abnormalities are seen in four functionally interrelated tissues, i.e. photoreceptors, retinal pigment epithelium (RPE), Bruch's membrane, and choriocapillaries, the impairment of RPE cell functions is an early and crucial event in the molecular pathways leading to clinical relevant AMD changes. The RPE progressively degenerates, which results in an irreversible degeneration of photoreceptors. Four processes: lipofuscinogenesis, drusogenesis, inflammation, and neovascularization, specifically contribute to the development of the disease. Two types of AMD are distinguished: the dry and the wet form. This paper briefly describes major molecular and cellular events leading to AMD, and presents currently used and new, forthcoming therapeutic strategies. PMID:17369776

Nowak, Jerzy Z; Bienias, Wojciech

2007-01-01

322

Radiation Therapy for Neovascular Age-related Macular Degeneration  

SciTech Connect

In the enormity of the public health burden imposed by age-related macular degeneration (ARMD), much effort has been directed toward identifying effective and efficient treatments. Currently, anti-vascular endothelial growth factor (VEGF) injections have demonstrated considerably efficacy in treating neovascular ARMD, but patients require frequent treatment to fully benefit. Here, we review the rationale and evidence for radiation therapy of ARMD. The results of early photon external beam radiation therapy are included to provide a framework for the sequential discussion of evidence for the usage of stereotactic radiation therapy, proton therapy, and brachytherapy. The evidence suggests that these 3 modern modalities can provide a dose-dependent benefit in the treatment of ARMD. Most importantly, preliminary data suggest that all 3 can be used in conjunction with anti-VEGF therapeutics, thereby reducing the frequency of anti-VEGF injections required to maintain visual acuity.

Kishan, Amar U. [Harvard Medical School, Boston, Massachusetts (United States)] [Harvard Medical School, Boston, Massachusetts (United States); Modjtahedi, Bobeck S.; Morse, Lawrence S. [Department of Ophthalmology and Vision Sciences, University of California, Davis, Sacramento, California (United States)] [Department of Ophthalmology and Vision Sciences, University of California, Davis, Sacramento, California (United States); Lee, Percy, E-mail: percylee@mednet.ucla.edu [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States)] [Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California (United States)

2013-03-01

323

Macular Hole Formation in Rhegmatogenous Retinal Detachment after Scleral Buckling  

PubMed Central

Purpose To describe early macular hole (MH) development in rhegmatogenous retinal detachment (RRD) after scleral buckling (SB) based on optical coherence tomography (OCT) findings. Methods The medical records and spectral domain OCT images of patients in whom MH developed after RRD repair were evaluated retrospectively. Results A postoperative MH was detected in five eyes that underwent SB during a 6-year period. All had fovea-off RRD without MH at the time of surgery. OCT showed partial loss of the inner retina with a preserved photoreceptor layer in early postoperative days. On average, 7 days (range,5 to 8 days) after surgery, outer retinal tissues disappeared, resulting in the full-thickness MH. Conclusions Serial OCT findings revealed that partial-thickness lamellar holes progressed to full-thickness MHs, which were formed by the degeneration of the outer retina in eyes with preceding loss of the glial cone in the fovea. PMID:25276077

Byon, Ik Soo; Kwon, Han Jo; Park, Gun Hyung; Park, Sung Who

2014-01-01

324

Intravitreal aflibercept for neovascular age-related macular degeneration.  

PubMed

Neovascular age-related macular degeneration (AMD) is the leading cause of legal blindness in patients over the age of 50 in the western world. Intravitreally administered anti-VEGF drugs have been developed to halt neovascular growth in AMD. Randomized trials have demonstrated the excellent safety profile and significant benefit of anti-VEGF therapy in maintaining vision. Aflibercept (Eylea(®); Regeneron, NY, USA) is a soluble decoy receptor against VEGF that offers greater potency and binding affinity than other anti-VEGF drugs. Having received US FDA approval for neovascular AMD in November 2011, aflibercept given every 8 weeks after a loading dose was 'clinically equivalent' and statistically noninferior to the current FDA-approved therapy ranibizumab (Lucentis(®); Genentech, CA, USA), given every 4 weeks. This article discusses the clinical background of AMD, development of aflibercept, results of the clinical trials and the future role of aflibercept in ocular neovascular diseases. PMID:23413903

Xu, David; Kaiser, Peter K

2013-02-01

325

Cost-Effectiveness of Treatment of Diabetic Macular Edema  

PubMed Central

Background Macular edema is the most common cause of visual loss among patients with diabetes. Objective To determine the cost-effectiveness of different treatments of diabetic macular edema (DME). Design Markov model. Data Sources Published literature and expert opinion. Target Population Patients with clinically significant DME. Time Horizon Lifetime. Perspective Societal. Intervention Laser treatment, intraocular injections of triamcinolone or a vascular endothelial growth factor (VEGF) inhibitor, or a combination of both. Outcome Measures Discounted costs, gains in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). Results of Base-Case Analysis All treatments except laser monotherapy substantially reduced costs, and all treatments except triamcinolone monotherapy increased QALYs. Laser treatment plus a VEGF inhibitor achieved the greatest benefit, gaining 0.56 QALYs at a cost of $6975 for an ICER of $12 410 per QALY compared with laser treatment plus triamcinolone. Monotherapy with a VEGF inhibitor achieved similar outcomes to combination therapy with laser treatment plus a VEGF inhibitor. Laser monotherapy and triamcinolone monotherapy were less effective and more costly than combination therapy. Results of Sensitivity Analysis VEGF inhibitor monotherapy was sometimes preferred over laser treatment plus a VEGF inhibitor, depending on the reduction in quality of life with loss of visual acuity. When the VEGF inhibitor bevacizumab was as effective as ranibizumab, it was preferable to because of its lower cost. Limitation Long-term outcome data for treated and untreated diseases are limited. Conclusion The most effective treatment of DME is VEGF inhibitor injections with or without laser treatment. This therapy compares favorably with cost-effective interventions for other conditions. Primary Funding Source Agency for Healthcare Research and Quality. PMID:24573663

Pershing, Suzann; Enns, Eva A.; Matesic, Brian; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

2014-01-01

326

[Modern aspects of diabetic retinopathy and diabetic macular oedema treatment].  

PubMed

Main reasons of eyesight deterioration in diabetic patients are diabetic retinopathy (DR) and diabetic macular oedema (DMO). International multicenter studies have shown that retinal laser coagulation in the event of DMO decreases the risk of eyesight loss in 50%, though only in 16% patients it was also possible to improve their eyesight. Use of vascular endothelial growth factor inhibitor--Ranibizumab--have opened a new era in DMA treatment. It's efficacy and safety have been proven in several international studies. This article contains our own data upon the use of Lucentis in patients with DMO. Intravitreal Luzentis injections and subsequent retinal lasercoagulation in the macular zone were performed on 43 eyes; follow up period--6 months. Additional injections were required in 19 cases, average amount of injections--1,4. Mean corrected visual acuity before the treatment was 0,37 +/- 0,06, after 7 days, 1, 3 and 6 months. - respectively 0,41 +/- 0,06, 0,49 +/- 0,06, 0,51 +/- 0,07 and 0,52 +/- 0,07(p<0,05). Mean retina thickness in central zone was 428 +/- 125 mkm before treatment, 391 +/- 24 mkm 7 days after the last injection 349 +/- 23, 313 +/- 21 and 308 +/- 20 mkm (p<0,05) after 1, 3 and 6 months. In addition to that Luzentis use in preoperative period in patients with non-complicated proliferative DR allowed to decrease the risk of hemorrhagic complications. Thereby, intravitreal injections of Luzentis improve functional result of treatment of patients with DMO, increase efficacy and safety of surgical interventions in patients with complicated forms of proliferating DR. PMID:22550713

Neroev, V V

2012-01-01

327

Fundus autofluorescence imaging of patients with idiopathic macular hole  

PubMed Central

AIM To investigate the role of fundus autofluorescence (FAF) both in the diagnosis and the preoperative and postoperative evaluation of patients with idiopathic macular hole (MH). METHODS Forty eyes of 40 patients diagnosed as idiopathic MH between May 2010 and May 2011 were included in this retrospective study. All patients underwent full ophthalmologic examinations and imagings including fluorescein angiography, fundus autofluorescence (FAF) and optical coherence tomography. Thirty of these patients underwent MH surgery. FAF findings were associated with duration of symptoms, visual acuity at presentation, stage of MH, and postoperative anatomical correction. RESULTS The mean duration of patients' symptoms was 3.8±2.0 (1–9) months. The MH was stage 2 in 4 (10%), stage 3 in 24 (60%) and stage 4 in 12 (30%) eyes. The median preoperative best corrected visual acuity was 20/200 (between 20/800 and 20/100). Twenty-eight of cases (70%) showed a stellate appearance with dark radiating striae. Having a visual acuity ?20/200 was significantly more common in eyes with stellate appearance (P<0.001). The mean duration of symptoms was significantly shorter in eyes with stellate appearance (2.75±0.8 vs 6.33±1.61 months) (P<0.001). The frequency of stage 4 MH was significantly higher in eyes with non-stellate appearance (P<0.001). Anatomical correction of MH was achieved in 91.3% (21/23) of eyes with stellate appearance and 71.4% (5/7) of eyes without this appearance (P=0.225). CONCLUSION Stellate appearance in FAF is associated with earlier stages of macular hole, better visual acuity at presentation, shorter duration of symptoms, thus more favorable prognosis. PMID:24195050

Teke, Mehmet Yasin; Cakar-Ozdal, Pinar; ?en, Emine; Elgin, Ufuk; Nalcac?oglu-Yuksekkaya, Pinar; Ozturk, Faruk

2013-01-01

328

The Value of Measurement of Macular Carotenoid Pigment Optical Densities and Distributions in Age-Related Macular Degeneration and Other Retinal Disorders  

PubMed Central

There is increasing recognition that the optical and antioxidant properties of the xanthophyll carotenoids lutein and zeaxanthin play an important role in maintaining the health and function of the human macula. In this review article, we assess the value of non-invasive quantification of macular pigment levels and distributions to identify individuals potentially at risk for visual disability or catastrophic vision loss from age-related macular degeneration, and we consider the strengths and weaknesses of the diverse measurement methods currently available. PMID:19854211

Bernstein, Paul S.; Delori, François C.; Richer, Stuart; van Kuijk, Frederik J. M.; Wenzel, Adam J.

2009-01-01

329

Mechanism of Highly Synchronized Bilateral Hippocampal Activity  

PubMed Central

In vivo studies of epileptiform discharges in the hippocampi of rodents have shown that bilateral seizure activity can sometimes be synchronized with very small delays (< 2 ms). This observed small time delay of epileptiform activity between the left and right CA3 regions is unexpected given the physiological propagation time across the hemispheres (> 6 ms). The goal of this study is to determine the mechanisms of this tight synchronization with in-vitro electrophysiology techniques and computer simulations. The hypothesis of a common source was first eliminated by using an in-vitro preparation containing both hippocampi with a functional ventral hippocampal commissure (VHC) and no other tissue. Next, the hypothesis that a noisy baseline could mask the underlying synchronous activity between the two hemispheres was ruled out by low noise in-vivo recordings and computer simulation of the noisy environment. Then we built a novel bilateral CA3 model to test the hypothesis that the phenomenon of very small left-to-right propagation delay of seizure activity is a product of epileptic cell network dynamics. We found that the commissural tract connectivity could decrease the delay between seizure events recorded from two sides while the activity propagated longitudinally along the CA3 layer thereby yielding delays much smaller than the propagation time between the two sides. The modeling results indicate that both recurrent and feedforward inhibition were required for shortening the bilateral propagation delay and depended critically on the length of the commissural fiber tract as well as the number of cells involved in seizure generation. These combined modeling/experimental studies indicate that it is possible to explain near perfect synchronization between the two hemispheres by taking into account the structure of the hippocampal network. PMID:24262205

Wang, Y.; Toprani, S.; Tang, Y.; Vrabec, T.; Durand, D.M.

2014-01-01

330

Mechanism of highly synchronized bilateral hippocampal activity.  

PubMed

In vivo studies of epileptiform discharges in the hippocampi of rodents have shown that bilateral seizure activity can sometimes be synchronized with very small delays (<2 ms). This observed small time delay of epileptiform activity between the left and right CA3 regions is unexpected given the physiological propagation time across the hemispheres (>6 ms). The goal of this study is to determine the mechanisms of this tight synchronization with in-vitro electrophysiology techniques and computer simulations. The hypothesis of a common source was first eliminated by using an in-vitro preparation containing both hippocampi with a functional ventral hippocampal commissure (VHC) and no other tissue. Next, the hypothesis that a noisy baseline could mask the underlying synchronous activity between the two hemispheres was ruled out by low noise in-vivo recordings and computer simulation of the noisy environment. Then we built a novel bilateral CA3 model to test the hypothesis that the phenomenon of very small left-to-right propagation delay of seizure activity is a product of epileptic cell network dynamics. We found that the commissural tract connectivity could decrease the delay between seizure events recorded from two sides while the activity propagated longitudinally along the CA3 layer thereby yielding delays much smaller than the propagation time between the two sides. The modeling results indicate that both recurrent and feedforward inhibition were required for shortening the bilateral propagation delay and depended critically on the length of the commissural fiber tract as well as the number of cells involved in seizure generation. These combined modeling/experimental studies indicate that it is possible to explain near perfect synchronization between the two hemispheres by taking into account the structure of the hippocampal network. PMID:24262205

Wang, Y; Toprani, S; Tang, Y; Vrabec, T; Durand, D M

2014-01-01

331

Macular Edema After Cataract Surgery In Eyes Without Pre-operative Central-involved Diabetic Macular Edema  

PubMed Central

Objective To estimate the incidence of central-involved macular edema (ME)16 weeks following cataract surgery in eyes with diabetic retinopathy (DR) without definite central-involved diabetic macular edema (DME) preoperatively. Methods In a multicenter, prospective, observational study, participants (N = 293) with DR without definite OCT central subfield (CSF) thickening underwent cataract surgery. The primary outcome was development of central-involved ME defined as; (1) OCT CSF thickness ? 250?m (time domain) or ? 310?m (spectral domain) with ?1 step increase in logOCT CSF thickness pre-operative to the 16-week visit; (2) ?2-step increase in logOCT CSF pre-operative to 16-week visit; or (3) non-topical treatment for ME received before the 16-week visit with either of the OCT criteria met at the time of treatment. Results Median participant age was 64 years with median visual acuity letter score of 69 (Snellen equivalent 20/40). Forty-four percent of eyes had history of prior treatment for DME. Sixteen weeks postoperatively, central-involved ME was noted in 0% (95%CI: 0-20%) of 17 eyes with no pre-operative DME. Of eyes with non-central involved DME, 10% (95%CI: 5-18%) of 97 eyes without central involved DME and 12% (95%CI: 7-19%) of 147 eyes with possible central involved DME at baseline progressed to central-involved ME. History of DME treatment was significantly associated with central-involved ME development (P<0.001). Conclusion In eyes with DR without concurrent central-involved DME, presence of non-central DME immediately prior to cataract surgery, or history of DME treatment, may increase risk of developing central-involved ME 16 weeks after cataract extraction. PMID:23599174

Baker, Carl W.; Almukhtar, Talat; Bressler, Neil M.; Glassman, Adam R.; Grover, Sandeep; Kim, Stephen J.; Murtha, Timothy J.; Rauser, Michael E.; Stockdale, Cynthia

2014-01-01

332

Bilateral TMJ Involvement in Rheumatoid Arthritis  

PubMed Central

Rheumatoid arthritis (RA) is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ) involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral TMJ involvement with its classical radiographic findings and review literature. PMID:24804125

Ruparelia, Pritesh B.; Shah, Deep S.; Ruparelia, Kosha; Sutaria, Shreyansh P.; Pathak, Deep

2014-01-01

333

Topiramate induced bilateral angle-closure glaucoma.  

PubMed

Topiramate is a sulfamate-substituted monosaccharide and is used as an antiepileptic medication. It can also be used as a prophylactic agent for headache from migraine. The main purpose of this article is to create awareness among medical colleagues regarding severe ophthalmic side effect of topiramate. This is the first reported case of topiramate induced bilateral angle-closure glaucoma in Nepal. This case was managed successfully by discontinuing topiramate and by starting anti-glaucoma medication along with atropine eye drops which were tapered and eventually discontinued. PMID:18604026

Singh, S K; Thapa, S S; Badhu, B P

2007-01-01

334

Progressive bilateral thinning of the parietal bones  

SciTech Connect

Observation of a case of progressive bilateral parietal thinning within a period of 14 years induced us to study skull films of 3 636 consecutive patients. Parietal thinning was found in 86 patients (2.37%). It was more common in women, with a sex ratio of 1:1.9. The mean age of the females was 72 years, and that of the males 63 years. Previous skull films of 25 of these patients were available and showed progression in 10. It is concluded that parietal thinning is a slowly progressive disease of middle-aged and old patients and is not an anatomical variant or congenital dysplasia of the dipole.

Cederlund, C.G.; Andren, L.; Olivecrona, H.

1982-03-01

335

Bilateral Hydronephrosis and Cystitis Resulting from  

PubMed Central

Ketamine associated urinary dysfunction has become increasingly more common worldwide. Point-of-care ultrasound (POCUS) is an established modality for diagnosing hydronephrosis in the emergency department. We describe a case of a young male ketamine abuser with severe urinary urgency and frequency in which POCUS performed by the emergency physician demonstrated bilateral hydronephrosis and a focally thickened irregular shaped bladder. Emergency physicians should consider using POCUS evaluate for hydronephrosis and bladder changes in ketamine abusers with lower urinary tract symptoms. The mainstay of treatment is discontinuing ketamine abuse. PMID:25035738

Abuse, Chronic Ketamine; Tran, Vu Huy; Nelson, Mathew; Nogar, Joshua; Bramante, Robert M.

2014-01-01

336

Bilateral hydronephrosis and cystitis resulting from.  

PubMed

Ketamine associated urinary dysfunction has become increasingly more common worldwide. Point-of-care ultrasound (POCUS) is an established modality for diagnosing hydronephrosis in the emergency department. We describe a case of a young male ketamine abuser with severe urinary urgency and frequency in which POCUS performed by the emergency physician demonstrated bilateral hydronephrosis and a focally thickened irregular shaped bladder. Emergency physicians should consider using POCUS evaluate for hydronephrosis and bladder changes in ketamine abusers with lower urinary tract symptoms. The mainstay of treatment is discontinuing ketamine abuse. PMID:25035738

Abuse, Chronic Ketamine; Tran, Vu Huy; Nelson, Mathew; Nogar, Joshua; Bramante, Robert M

2014-07-01

337

[Congenital bilateral dacryocystitis and craniofacial dysraphia].  

PubMed

It is presented the observation of a child of 8 years old having a bilateral congenital dacryocyst by the absence of the lacrimonasal duct and multiple facial malformations are: telorbitismus, frontal meningocele, some lesions determined by a craniofacial dehiscence (fissura 2-12) with paramedian dysraphia. The affection has been produced by a disturbance of embryogenesis that occurred during the V-VI intrauterine development weeks, by metrorrhagias and repeated hypoxia that determined a disturbance at the level of the welding frontal buds with meningocele, of the olfactive guttier and the mass of the ethmoid with telorbitism and arthresia of the lacrimal duct. PMID:1525141

Cernea, P; Talea, L

1992-01-01

338

Bilateral vertebral artery stenosis present with vertigo  

PubMed Central

Of ischaemic stroke patients, about 25% rise from the posterior or vertebrobasilar system. The ischaemia of vertebral arteries may emerge for different vascular pathological reasons, at different localisations and with different clinical findings. Despite its low morbidity and mortality risk, early diagnosis and treatment is of importance. Vertebrobasilar ischaemia symptoms can be observed clinically such as vertigo, tinnitus, double vision, headache, hypokinesis and hearing disorders, etc. In this article, a 42-year-old stroke patient case is presented, who applied to the emergency service with vertigo and then, was diagnosed with bilateral vertebral artery stenosis by means of cranial MR angiography. PMID:23376658

Kotan, Dilcan; Sayan, Saadet; Acar, Bilgehan Atilgan; Polat, Pinar

2013-01-01

339

Bilateral ossiculoplasty in 1 case of achondroplasia.  

PubMed

Achondroplasia is the most common skeletal dysplasia and it combines various complications with normal longevity. Hearing disturbance due to otitis media or an ossicular anomaly is one of the most common complications. Conductive hearing loss is suggested as the most common form of hearing loss. Temporal bone and middle ear structures are distorted in achondroplasia because of rotational change of the skull base. Authors experienced a case of an achondroplastic patient with bilateral hearing disturbance. We faced making a potential mistake during the previous operation but a favorable postoperative result occurred. Our experience could be helpful to other clinicians who face achondroplastic patients. PMID:24653923

Jung, Jongyoon; Yang, Chulwon; Lee, Sunkyu; Choi, June

2013-12-01

340

Bilateral Ossiculoplasty in 1 Case of Achondroplasia  

PubMed Central

Achondroplasia is the most common skeletal dysplasia and it combines various complications with normal longevity. Hearing disturbance due to otitis media or an ossicular anomaly is one of the most common complications. Conductive hearing loss is suggested as the most common form of hearing loss. Temporal bone and middle ear structures are distorted in achondroplasia because of rotational change of the skull base. Authors experienced a case of an achondroplastic patient with bilateral hearing disturbance. We faced making a potential mistake during the previous operation but a favorable postoperative result occurred. Our experience could be helpful to other clinicians who face achondroplastic patients. PMID:24653923

Jung, Jongyoon; Yang, Chulwon; Lee, Sunkyu

2013-01-01

341

Restoration algorithm for image noise removal using double bilateral filtering  

NASA Astrophysics Data System (ADS)

We propose a double bilateral (DoBi) filter that consists of a classical bilateral filter and a new bilateral filter for image restoration. Bilateral filtering is a simple, noniterative, and effective denoising filter that smooths images while preserving edges by means of a nonlinear combination of adjacent pixel values. A median-metric weighting function is introduced by incorporating a switching median filter into the similarity function. This median-metric component associated with a spatial function constitute the second bilateral filter, which compensates the classical bilateral filter. Moreover, a parameter automation mechanism is proposed to facilitate the restoration procedure. A wide variety of images contaminated by various degrees of Gaussian, impulse, and mixed noise were used to assess the performance of this new restoration algorithm. Experimental results indicated that the DoBi filter outperformed several state-of-the-art methods in both visual image quality and restored signal quantity.

Chang, Herng-Hua; Chu, Woei-Chyn

2012-04-01

342

Multispectral image denoising with optimized vector bilateral filter.  

PubMed

Vector bilateral filtering has been shown to provide good tradeoff between noise removal and edge degradation when applied to multispectral/hyperspectral image denoising. It has also been demonstrated to provide dynamic range enhancement of bands that have impaired signal to noise ratios (SNRs). Typical vector bilateral filtering described in the literature does not use parameters satisfying optimality criteria. We introduce an approach for selection of the parameters of a vector bilateral filter through an optimization procedure rather than by ad hoc means. The approach is based on posing the filtering problem as one of nonlinear estimation and minimization of the Stein's unbiased risk estimate of this nonlinear estimator. Along the way, we provide a plausibility argument through an analytical example as to why vector bilateral filtering outperforms bandwise 2D bilateral filtering in enhancing SNR. Experimental results show that the optimized vector bilateral filter provides improved denoising performance on multispectral images when compared with several other approaches. PMID:24184727

Peng, Honghong; Rao, Raghuveer; Dianat, Sohail A

2014-01-01

343

Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125  

PubMed Central

Background. The risk of ovarian cancer is increased in the association of ovarian tumor, ascites, and hydrothorax with the significant elevated tumor marker CA-125. However, this association can be observed in a rare clinical and benign pathological entity, that is Demons-Meigs' syndrome. Objective. To describe a rare case of Demons-Meigs' syndrome observed in our department. Methods. A black African woman of 35 years old, seventh gravida and fourth parous, underwent a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835?UI/mL) in a pronounced general alteration condition. Results. The postoperative course was uneventful characterized by a complete remission of hydrothorax and ascites with normal level of CA-125 three months after tumor excision. Histology of both masses revealed a bilateral ovarian fibrothecoma, a benign tumor of the ovary, thus confirming the diagnosis of Demons-Meigs' syndrome. Conclusion. The Demons-Meigs syndrome, although it strongly mimics the clinical picture of malignant metastatic ovarian cancer, remains a disease with benign prognosis after surgical tumor resection. This is a rare condition that must be known and recognized by practitioners to avoid unnecessary practices. PMID:23431489

Loué, Védi André Serges; Gbary, Eléonore; Koui, Sylvanus; Akpa, Bédi; Kouassi, Adélaide

2013-01-01

344

Factors predicting outcome of vitrectomy for diabetic macular oedema: results of a prospective study  

PubMed Central

Aim To determine preoperative demographic, clinical, and optical coherence tomography (OCT) factors which might predict the visual and anatomical outcome at 1?year in patients undergoing vitrectomy and inner limiting membrane peel for diabetic macular oedema (DMO). Methods A prospective, interventional case series of 33 patients who completed 1?year follow up. Measurements were taken preoperatively and at 1?year. Outcome measures were logMAR visual acuity (VA) and OCT macular thickness. A priori explanatory variables included baseline presence of clinical and/or OCT signs suggesting macular traction, grade of diabetic maculopathy, posterior vitreous detachment, fluorescein leakage and ischaemia on angiography, presence of subretinal fluid, and peroperative indocyanine green (ICG) use. Results 33 patients completed 1?year follow up. On average VA deteriorated by 0.035 logMAR (p?=?0.40). Macular thickness significantly improved by a mean of 139??m (95% CI; 211 to 67, p<0.001). Patients with evidence of clinical and/or OCT macular traction significantly improved logMAR acuity (logMAR improvement ?=?0.08) compared with patients without traction (logMAR deterioration 0.11, p?=?0.01). Presence of subretinal fluid significantly predicted worse postoperative result (p?=?0.01) Conclusion On average, patients showed a statistically significant improvement in central macular thickness following treatment but a marginal acuity worsening. Presence of subretinal fluid on OCT is hypothesised to be exudative rather than tractional in nature. The visual benefit of vitrectomy for DMO in this study was limited to patients who exhibit signs of macular traction either clinically and/or on OCT. PMID:16361663

Shah, S P; Patel, M; Thomas, D; Aldington, S; Laidlaw, D A H

2006-01-01

345

Bilateral luxatio erecta with greater tuberosity fracture: a case report  

PubMed Central

Bilateral shoulder dislocation with greater tuberosity fracture and luxatio erecta, both are rare by themselves, with only few reports of each. We report an unusual case of posttraumatic bilateral symmetrical shoulder dislocation involving luxatio erecta with greater tuberosity fracture in a young male. To our knowledge, this is the first case of symmetrical bilateral shoulder dislocation with greater tuberosity fracture involving luxatio erecta dislocation from Indian subcontinent.

Saxena, Vikas; Pradhan, Pavan

2013-01-01

346

Pediatric bilateral large concurrent thalamic glioblastoma: An unusual case report  

PubMed Central

Bilateral thalamic tumors are rare. Pediatric bilateral thalamic glioblastomas are even rarer, only five cases reported in the English literature till date. The clinical presentation, natural history, and prognosis of pediatric thalamic tumors are still relatively obscure. In this article, we report an 8-year-old patient with large bilateral thalamic glioblastomas and briefly discuss its clinical presentation, possible modalities of management, and prognosis, in the light of available literature. PMID:24891914

Pandey, Nityanand; Singh, Pankaj Kumar; Mahapatra, Ashok K.; Kakkar, Aanchal; Sharma, Bhawani Shankar

2014-01-01

347

Bilateral congenital cataract with suspected lens-induced granulomatous uveitis.  

PubMed

A healthy newborn baby girl presented with congenital bilateral cataract. Within a few days of presenting she also developed bilateral granulomatous uveitis, a condition generally linked in newborns to congenital infections, most frequently TORCHES syndrome (toxoplasmosis, rubella, cytomegalic inclusion disease, herpesvirus, including Epstein-Barr, syphilis). Extensive investigation did not reveal any underlying etiologic mechanism. Treatment with topical and systemic steroids did not improve the uveitis. However, bilateral lens extraction resulted in a quick resolution of the uveitis. PMID:25262559

Vandenbroucke, Stéphanie; Foets, Beatrijs; Wouters, Carine; Casteels, Ingele

2014-10-01

348

Bilateral angiosarcoma of breast in a young lady.  

PubMed

We report a young lady with bilateral angiosarcoma of breast because of its rarity. A 29 year old unmarried female presented with bilateral breast lump. She underwent bilateral mastectomy with axillary dissection histopathology of which showed low grade angiosarcoma of left breast and high grade angiosarcoma of right breast. CT Thorax revealed right hilar and right mediastenal lymph nodes. She was treated with radiotherapy and chemotherapy postoperatively. PMID:22557784

Roy, Sanjoy; Devleena; Maji, Tapas; Choudhuri, Prabir; Biswas, Jaydip; Lahiri, Debarshi

2011-07-01

349

Bilateral chylothorax: an unusual complication of cervical rib resection.  

PubMed

Bilateral chylothorax is a rare cause of pleural effusions. Here we report an unusual acute presentation of bilateral chylothorax following thoracic outlet surgery. Unique to this case was the disparate characteristics of pleural fluid analyses with an exudate on the left and a transudate on the right. This report describes the recognition and management of bilateral chylothoraces, an uncommon but potentially serious complication of this frequently performed surgical procedure. PMID:25553240

Morjaria, Jaymin B; Aslam, Imran; Johnson, Brian; Greenstone, Michael A; Kastelik, Jack A

2015-01-01

350

A rare case of bilateral sequential spermatocytic seminoma  

PubMed Central

Spermatocytic seminoma (SS) is a rare testicular neoplasm characterized by a palpable, painless, slowly enlarging mass in the testis. Even more rare is a synchronous bilateral presentation. Only eight cases of bilateral SS have been reported in the literature, of which three cases were present with synchronous testis enlargement, and five were sequential. Here, we report an additional case of synchronous bilateral SS and present a comprehensive relevant literature review concerning clinical features, histopathology, and treatment. PMID:23915031

2013-01-01

351

Bilateral chylothorax: an unusual complication of cervical rib resection  

PubMed Central

Bilateral chylothorax is a rare cause of pleural effusions. Here we report an unusual acute presentation of bilateral chylothorax following thoracic outlet surgery. Unique to this case was the disparate characteristics of pleural fluid analyses with an exudate on the left and a transudate on the right. This report describes the recognition and management of bilateral chylothoraces, an uncommon but potentially serious complication of this frequently performed surgical procedure. PMID:25553240

Aslam, Imran; Johnson, Brian; Greenstone, Michael A.; Kastelik, Jack A.

2015-01-01

352

Multiple osteochondroses of bilateral knee joints.  

PubMed

We experienced a patient with a combination of multiple osteochondroses: Blount's disease, bipartite patella, and Sinding-Larsen-Johansson disease in the left knee, and a combination of bipartite patella and Osgood-Schlatter disease in the right knee. The patient was a healthy, active 12-year-old boy with bilateral knee pain. He had been diagnosed with Blount's disease of the left tibia at 2 years of age, and had been treated with open wedge osteotomy. He was diagnosed with bilateral bipartite patellae at the age of 9 years, and was diagnosed with Osgood-Schlatter disease in the right knee and Sinding-Larsen-Johansson disease in the left knee at 10 years of age. The second growth spurt was observed during this period. At 11 years of age, he was diagnosed with an osteochondral fracture of the left lateral femoral condyle and was observed without surgery. This patient showed the sequential appearance of an ossification disorder, probably due to the abnormal response of enchondral ossification to mechanical stress. Overuse in this growth period may have played a role in the development of these osteochondroses. The osteochondral fracture was probably caused by a disruption at one of the weakest parts of the developing skeleton, between the ossification center and the overlying cartilage in the background of an ossification disorder. PMID:11484125

Segawa, H; Omori, G; Koga, Y

2001-01-01

353

Bilateral clavicle osteomyelitis: A case report  

PubMed Central

INTRODUCTION Osteomyelitis of the clavicle is rare. Infection occurs from hematogenous spread or trauma. In adults infection is usually secondary due to an exogenous cause such as open fractures, surgery (iatrogenic) or spread from local tissue with infection. PRESENTATION OF CASE The case is presented here of a 50-year old female with bilateral clavicular fractures, who was operated on with open reduction and internal fixation. At the 6-month follow-up, she had complaints of bilateral osteomyelitis which was successfully treated with resection of the infected segment of the bone, and antibiotic impregnated collagen. DISCUSSION Predisposing factors include diabetes, intravenous drug abuse, tuberculosis or immune suppression. Management involves the removal of bone fixation, debridement of the bone and if there is a defect, coverage with a muscle flap is applied. CONCLUSION In cases of clavicular osteomyelitis where infection continues despite debridement and antibiotic therapy, excision of the sequestered clavicular section is a successful treatment approach and has been seen to improve quality of life without any functional loss. PMID:25460439

Saglam, Fevzi; Saglam, Seymanur; Gulabi, Deniz; Eceviz, Engin; Elmali, Nurzat; Yilmaz, Mustafa

2014-01-01

354

Idiopathic bilateral vestibulopathy: an autoimmune disease?  

PubMed

Bilateral vestibulopathy (BV) is the loss of function of both peripheral labyrinths or of the eighth nerves. Its etiology remains obscure in approximately 20% to 50% of cases (so-called idiopathic bilateral vestibulopathy, IBV). Alternatively, the cause could be viral or vascular; to date, causative gene mutations have not been identified. Other potential disease mechanisms include autoimmune disorders. Antibodies have been detected against inner ear tissue (primarily against vestibular membranous labyrinth). The data suggest that the bulk of anti-labyrinthine autoantibodies may be an epiphenomenon, but a small subgroup of organ-specific autoantibodies may synergize with a cellular response to develop vestibular lesions. The two key symptoms of BV are the following: 1. unsteadiness of gait, particularly in the dark or on uneven ground, and 2. oscillopsia associated with head movements. Episodes of vertigo are reported by patients with IBV, particularly early in the development of vestibular loss. Associated hearing loss seldom occurs in the idiopathic type of this condition. Post-mortem examinations revealed a remarkably selective loss of vestibular hair cells in the vestibular end organs but normal hair cells in the cochlea. The diagnosis is made with a simple bedside test for defective vestibular function. The diagnosis can be confirmed by bithermal caloric testing and pendular body rotation. The therapy is based on steroid treatment, and the early initiation of immunosuppression appears to be essential for therapeutic success. PMID:25173622

Greco, Antonio; De Virgilio, Armando; Gallo, Andrea; Fusconi, Massimo; Ruoppolo, Giovanni; Turchetta, Rosaria; Pagliuca, Giulio; de Vincentiis, Marco

2014-10-01

355

"Mirror-Image" Bilateral Giants: Intracavernous Carotid Artery Aneurysms  

PubMed Central

Summary The literature on the incidence of "mirror image" bilateral giant intracavernous aneurysms, their symptoms and their association with other entities is reviewed, with a brief comment on their evolution and treatment. A case of "mirror image" bilateral giant intracavernous aneurysms in a 76-year-old man who presented a sudden diplopia with pupillary sparing is reported. A CT scan showed parasellar images and dolichomega circle of Willis arteries that enhanced with endovenous contrast. MRI and angiography disclose bilateral aneurysms in detail, associated with an anomalous origin of the left common carotid artery and bilateral renal artery stenosis. PMID:20569579

Díaz, M.B.; Mercado, F.C.; Lemme Plaghos, L.A.

2006-01-01

356

Bilateral aniridia lenticular coloboma and snowflake retinal degeneration.  

PubMed

A 6-year-old boy presented with bilateral aniridia associated with lens coloboma and snowflake retinal degeneration. Ophthalmologic examination revealed bilateral corneal peripheral epithelial thickening and aniridia. Additionally, the patient had lenticular coloboma and snowflake retinal degeneration in both eyes. Intraocular pressure was 22 mm Hg bilaterally. The patient also had pendular nystagmus. Uncorrected visual acuity was counting fingers at 2 meters for both eyes, but improved to 0.2 and 0.05, respectively, with correction. Congenital aniridia has been reported with various ophthalmic pathologies, but this is the first case to display bilateral lenticular coloboma and snowflake retinal degeneration associated with aniridia. PMID:19205498

Doganay, Selim; Emre, Sinan; Firat, Penpegül

2009-01-01

357

Simultaneous bilateral hernia repair. A case against conventional wisdom.  

PubMed Central

The timing of bilateral hernia repair remains controversial. Because of reported high recurrence rates after simultaneous bilateral repair, staged procedures have been suggested. This study determined recurrence and complication rates of unilateral versus simultaneous bilateral repair. Of 659 patients undergoing hernia repair between 1974 and 1980, 333 underwent unilateral repair and 329 had simultaneous bilateral repair. More than 90% of patients were followed until death or a minimum of 60 months (median, 104 months). Perioperative complications were associated with 18% of repairs. More morbidity occurred in the bilateral group. However complication rates for specific events were not significantly different, except for urinary retention, which occurred in 20 patients (6.1%) of the unilateral group and 49 (15%) of the bilateral group (p less than 0.001). Overall 25 recurrences occurred in the unilateral group and 31 in the bilateral group. Recurrence rates at 5 and 9 years were, respectively, 4.8% and 8.8% in the unilateral group and 5.0% and 9.1% in the bilateral group (p = 0.861). These data suggest that simultaneous bilateral inguinal herniorrhaphy does not result in increased rates of most postoperative complications or recurrence when compared with unilateral repair. PMID:1998409

Miller, A R; van Heerden, J A; Naessens, J M; O'Brien, P C

1991-01-01

358

Macular thickness measured by stratus optical coherence tomography in patients with diabetes type 2 and mild nonproliferative retinopathy without clinical evidence of macular edema.  

PubMed

To evaluate macular thickness in eyes with mild nonproliferative diabetic retinopathy (NPDR), patients with diabetes type 2, NPDR level 20 or 35, and without evidence of clinical macular edema underwent best-corrected visual acuity assessment, color fundus photography and Stratus optical coherence tomography. Mean center point thickness (CPT) and mean central subfield (CSF) thickness were compared with those of a healthy control population. 410 eyes/patients aged 61.2 ± 8.3 years, and with glycosylated hemoglobin of 7.9 ± 1.5% were included. Mean CPT and CSF were 186.6 ± 28.4 and 215.2 ± 25 µm, respectively, significantly increased compared to healthy subjects (p < 0.001). CSF thickness was abnormally increased in 17.6% of the patients, with values within the normal range in 79.5%, and abnormally decreased in 2.9%. CPT and CSF thickness were significantly thicker in men. No systemic factors showed a significant association. A significant increase in the macular thickness was found in eyes/patients with mild NPDR without clinical macular edema; however, only 17.6% of the eyes/patients had abnormally increased values and less than 3% abnormally decreased values. PMID:23614970

Pires, Isabel; Santos, Ana Rita; Nunes, Sandrina; Lobo, Conceição

2013-01-01

359

The effects of supplementation with lutein and\\/or zeaxanthin on human macular pigment density and colour vision  

Microsoft Academic Search

Background: Both yellow-blue (YB) discrimination thresholds and macular pigment optical density (MPOD) measurements in the eye exhibit large variability in the normal population. Although it is well established that selective absorption of blue light by the macular pigment (MP) can significantly affect trichromatic colour matches, the extent to which the MP affects colour discrimination (CD) sensitivity remains controversial. Objective: In

Marisa Rodriguez-Carmona; Jessica Kvansakul; J Alister Harlow; Wolfgang Kopcke; Wolfgang Schalch; John L Barbur

2006-01-01

360

Retinal pigment epithelial changes after macular hole surgery with indocyanine green-assisted internal limiting membrane peeling  

Microsoft Academic Search

PURPOSE: To report the results of macular hole surgery using indocyanine green to improve visualization and facilitate peeling of the internal limiting membrane.METHODS: A retrospective noncomparative review of a consecutive series of 22 patients (22 eyes) who underwent macular hole repair using indocyanine green to facilitate visualization of the internal limiting membrane was performed. One patient was excluded because of

Nicholas E Engelbrecht; Jiong Freeman; Paul Sternberg Jr; Thomas M Aaberg Sr; Thomas M Aaberg Jr; Daniel F Martin; Brian D Sippy

2002-01-01

361

Quantitative assessment of macular thickness in normal subjects and patients with diabetic retinopathy by scanning retinal thickness analyser  

Microsoft Academic Search

AIMSTo evaluate the scanning retinal thickness analyser (RTA), a novel non-invasive imaging instrument, in diagnosing and quantitatively characterising diabetic macular oedema, and to investigate the relation between central macula thickness measured by RTA and other clinical examinations.METHODSCentral macular thickness was measured using the RTA in 40 normal subjects and 60 patients with diabetic retinopathy. The reproducibility of the retinal thickness

Yusuke Oshima; Kazuyuki Emi; Shigeki Yamanishi; Masanobu Motokura

1999-01-01

362

Dose-dependent response of serum lutein and macular pigment optical density to supplementation with lutein esters  

Microsoft Academic Search

We conducted a study to determine the effect of different doses of a lutein supplement on serum lutein concentration and macular pigment optical density (MPOD). Lutein is one of the major components of human macular pigment. Eighty-seven subjects received daily doses of 5, 10, or 20mg of lutein, or a placebo, over a 140day period. Serum lutein concentration was determined

Richard A. Bone; John T. Landrum

2010-01-01

363

The association between macular pigment optical density and CFH, ARMS2, C2\\/ BF, and C3 genotype  

Microsoft Academic Search

Age-related macular degeneration (AMD) is the most common cause of blindness in older people in developed countries, and risk for this condition may be classified as genetic or environmental, with an interaction between such factors predisposing to this disease. This study investigated the relationship between AMD risk genes, macular pigment optical density (MPOD), which may protect against AMD, and serum

Edward Loane; John M. Nolan; Gareth J. McKay; Stephen Beatty

364

Macular hole formation, progression, and surgical repair: case series of serial optical coherence tomography and time lapse morphing video study  

PubMed Central

Background To use a new medium to dynamically visualize serial optical coherence tomography (OCT) scans in order to illustrate and elucidate the pathogenesis of idiopathic macular hole formation, progression, and surgical closure. Case Presentations Two patients at the onset of symptoms with early stage macular holes and one patient following repair were followed with serial OCTs. Images centered at the fovea and at the same orientation were digitally exported and morphed into an Audiovisual Interleaving (avi) movie format. Morphing videos from serial OCTs allowed the OCTs to be viewed dynamically. The videos supported anterior-posterior vitreofoveal traction as the initial event in macular hole formation. Progression of the macular hole occurred with increased cystic thickening of the fovea without evidence of further vitreofoveal traction. During cyst formation, the macular hole enlarged as the edges of the hole became elevated from the retinal pigment epithelium (RPE) with an increase in subretinal fluid. Surgical repair of a macular hole revealed initial closure of the macular hole with subsequent reabsorption of the sub-retinal fluid and restoration of the foveal contour. Conclusions Morphing videos from serial OCTs are a useful tool and helped illustrate and support anterior-posterior vitreofoveal traction with subsequent retinal hydration as the pathogenesis of idiopathic macular holes. PMID:20849638

2010-01-01

365

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery  

PubMed Central

Purpose To compare change of macular thickness after uneventful cataract surgery and after cataract surgery complicated with vitreous loss, using optic coherence tomography (OCT). Methods Twenty eyes of 20 patients who underwent cataract surgery complicated with posterior capsular tear participated in this retrospective study (Group 2). The fellow eyes of those patients who underwent uneventful cataract surgery served as the control group (Group 1). Best spectacle-corrected visual acuity (BCVA), refraction, keratometry, axial length measurement, intraocular lens power calculation, intraocular pressure, and biomicroscopic and posterior segment examinations were done preoperatively. BCVA was evaluated at the postoperative 1st day, 1st week, 1st month, and 3rd month. Macular thickness and volumetric measurements with OCT with MM5 protocol were conducted at the postoperative 3rd month. Results Logarithm of the minimum angle of resolution BCVA of Group 1 was significantly better than Group 2 at all intervals (P < 0.05). Foveal, parafoveal (superior and temporal), and perifoveal (superior and temporal) macular thickness measurements were significantly higher in Group 2 at month 3 (P < 0.05). Foveal volume was also significantly higher in Group 2 when compared with Group 1 (P < 0.05). In Group 2, two eyes (10%) were diagnosed with clinically significant cystoid macular edema at the 1-month visit. Conclusion Macular thickness was found to be significantly high in eyes undergoing complicated cataract surgery (with posterior capsular tear) when compared with uneventful cataract surgeries of fellow eyes. PMID:23055671

Akçay, Betül ?lkay Sezgin; Bozkurt, Tahir Kansu; Güney, Esra; Ünlü, Cihan; Erdogan, Gürkan; Akcali, Gülünay; Bayramlar, Huseyin

2012-01-01

366

The effects of intravitreal bevacizumab in infectious and noninfectious uveitic macular edema.  

PubMed

Background/Aims. To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides. Design. Retrospective interventional case series. Methods. A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25?mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted. Results. The mean age of patients was 41 ± 16 years with a mean followup of 4 ± 1 months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet's disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from 0.8 ± 0.8 at baseline to 0.4 ± 0.5 at 1 month and 0.3 ± 0.5 at 3 months (P < 0.002, at 3 months). The mean macular thickness was 430 ± 132??m at baseline. Following IVBI macular thickness improved to 286 ± 93??m at 1 month and to 265 ± 88??m at 3 months of followup (P < 0.001, at 3 months). Conclusion. Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents. PMID:25136452

Al-Dhibi, Hassan; Hamade, Issam H; Al-Halafi, Ali; Barry, Maan; Chacra, Charbel Bou; Gupta, Vishali; Tabbara, Khalid F

2014-01-01

367

Reflection-based imaging of macular pigment distributions in infants and children  

PubMed Central

Abstract. We have developed a reflection-based capability of the RetCam® platform, an FDA-cleared pediatric retinal-imaging instrument, for the purpose of measuring macular pigment levels as well as their spatial distributions in infants and children. Our modifications include narrow-band blue-wavelength excitation of the macular pigment absorption in combination with spectrally selective blue-wavelength readout of the reflection signals received by the instrument’s CCD detector array. Furthermore, an algorithm is developed that allows the computation of optical density maps for the macular pigment relative to peripheral retinal areas. This made it possible for the first time to directly measure macular pigment levels and their spatial features in the developing human retina. In contrast to adults, infants with measurable pigment levels had almost exclusively a narrow, circularly symmetric, pigment distribution. The described methodology holds promise for future investigations into the role of macular pigment in the developing human retina and the effect of dietary interventions in diseases resulting from a lack of normal carotenoid levels. PMID:24196405

Sharifzadeh, Mohsen; Bernstein, Paul S.; Gellermann, Werner

2013-01-01

368

Changes in Central Macular Thickness following Single Session Multispot Panretinal Photocoagulation  

PubMed Central

Purpose. To determine changes in central subfield (CSF) macular thickness and best corrected visual acuity (BCVA) following single session, multispot panretinal photocoagulation (PRP). Methods. Forty eyes of 33 patients with newly diagnosed proliferative diabetic retinopathy were treated with single session, 20-millisecond, multispot PRP. Changes in central macular thickness and BCVA at 4- and 12-week follow-up were compared to baseline measurements. Results. Each eye received a mean (SD) of 2,750 (686.7) laser spots. At 4-week follow-up, there was a statistically significant 24.0??m increase in mean CSF thickness (P = 0.001), with a 17.4??m increase from baseline at 12-week follow-up (P = 0.002). Mean logMAR BCVA increased by 0.05 logMAR units (P = 0.03) at 4-week follow-up. At 12-week follow-up, BCVA had almost returned to normal with only an increase of 0.02 logMAR units compared to baseline (P = 0.39). Macular edema occurred in 2 eyes (5%) at 12-week follow-up. Conclusions. Macular thickening occurs following single session, 20-millisecond, multispot PRP, with a corresponding, mild change in BCVA. However, the incidence of macular edema appears to be low in these patients. Single session, 20-millisecond, multispot PRP appears to be a safe treatment for patients with proliferative diabetic retinopathy.

Watanachai, Nawat; Choovuthayakorn, Janejit; Patikulsila, Direk; Ittipunkul, Nimitr

2015-01-01

369

Spectral domain optical coherence tomography documented rapid resolution of pseudophakic cystoid macular edema with topical difluprednate  

PubMed Central

Introduction Pseudophakic cystoid macular edema is a common cause of poor vision after cataract surgery, and topical corticosteroids and nonsteroidal anti-inflammatory drugs are used for its treatment. We investigated the effectiveness of difluprednate (Durezol®, recently approved by the US Food and Drug Administration) in the treatment of cystoid macular edema, assisted with spectral domain optical coherence tomography (SD-OCT). Case report A 63-year-old African-American woman presented 6 weeks after uneventful cataract surgery in her left eye with decreased vision and associated distortion of the central visual field. Fluorescein angiogram and SD-OCT confirmed pseudophakic cystoid macular edema. Difluprednate was topically administered twice daily and monitored with serial imaging. Resolution was noted after 1 month of topical therapy, with improvement in visual acuity and resolution of distortion. Conclusion Difluprednate is an effective treatment for patients with severe pseudophakic cystoid macular edema. SD-OCT allows the physician to monitor resolution of the macular edema easily. PMID:22291458

Chalam, KV; Khetpal, Vijay; Patel, Chirag J

2012-01-01

370

Lipoxins, resolvins, and protectins in the prevention and treatment of diabetic macular edema and retinopathy.  

PubMed

Diabetic macular edema and retinopathy are low-grade inflammatory conditions. Infusions of antitumor necrosis factor-? (anti-TNF-?) antibody and antivascular endothelial growth factor (anti-VEGF) antibody have been shown to be at least partly effective in the treatment of diabetic macular edema and proliferative diabetic retinopathy. Intravitreal therapy of diabetic macular edema by the anti-TNF-? antibody has been found to produce significant side effects and anti-VEGF therapy to be ineffective. Nevertheless, these studies have indicated that the suppression of TNF-? and other proinflammatory cytokines and VEGF could be of benefit in diabetic macular edema and retinopathy. The retina is rich in polyunsaturated fatty acids, especially in ?-3, and several studies have shown that polyunsaturated fatty acids prevent diabetic retinopathy. Lipoxins, resolvins, and protectins derived from various polyunsaturated fatty acids possess anti-inflammatory actions and suppress the production of interleukin-6, and TNF-? and VEGF have antiangiogenic actions. In view of these evidences, I propose that lipoxins, resolvins, and protectins could be of significant benefit in the prevention and management of diabetic macular edema and retinopathy. PMID:22677359

Das, Undurti N

2013-01-01

371

Treatment and functional outcome of patients with cystoid macular edema: a single-center experience.  

PubMed

The aim of this study was to describe a single-center experience in the treatment and follow-up of cystoid macular edema patients. Clinical records of all patients with cystoid macular edema followed up in the Rheumatologic and Ophthalmological Unit of our center between 1993 and 2013 were retrospectively evaluated. The outcome was assessed by visual acuity and optical coherence tomography status during follow-up. Comparisons were made by Fisher's exact test (p?macular edema. At the end of follow-up, 50 % of patients showed a significant visual loss, while 88 % did not present macular edema. In our small cohort, interferon-? is the most promising drug in contrasting visual acuity loss in cystoid macular edema. Visual prognosis remains severe in these patients. PMID:25028250

Taraborelli, Mara; Cavazzana, Ilaria; Fredi, Micaela; Airò, Paolo; Nascimbeni, Giuseppe; Tincani, Angela; Franceschini, Franco

2014-06-11

372

The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema  

PubMed Central

Background/Aims. To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides. Design. Retrospective interventional case series. Methods. A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25?mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted. Results. The mean age of patients was 41 ± 16 years with a mean followup of 4 ± 1 months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet's disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from 0.8 ± 0.8 at baseline to 0.4 ± 0.5 at 1 month and 0.3 ± 0.5 at 3 months (P < 0.002, at 3 months). The mean macular thickness was 430 ± 132??m at baseline. Following IVBI macular thickness improved to 286 ± 93??m at 1 month and to 265 ± 88??m at 3 months of followup (P < 0.001, at 3 months). Conclusion. Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents. PMID:25136452

Al-Dhibi, Hassan; Hamade, Issam H.; Al-Halafi, Ali; Barry, Maan; Chacra, Charbel Bou; Gupta, Vishali; Tabbara, Khalid F.

2014-01-01

373

Pilot randomised controlled trial of face-down positioning following macular hole surgery  

PubMed Central

Objective This was a pilot randomised controlled trial (RCT) to investigate the effect of post-operative face-down positioning on the outcome of macular hole surgery and to inform the design of a larger definitive study. Methods In all, 30 phakic eyes of 30 subjects with idiopathic full-thickness macular holes underwent vitrectomy with dye-assisted peeling of the ILM and 14% perfluoropropane gas. Subjects were randomly allocated to posture face down for 10 days (posturing group) or to avoid a face-up position only (non-posturing group). The primary outcome was anatomical hole closure. Results Macular holes closed in 14 of 15 eyes (93.3% 95% confidence interval (CI) 68–100%) in the posturing group and in 9 of 15 (60% 95% CI 32–84%) in the non-posturing group. In a subgroup analysis of outcome according to macular hole size, all holes smaller than 400??m closed regardless of posturing (100%). In contrast, holes larger than 400??m closed in 10 of 11 eyes (91% 95% CI 58–99%) in the posturing group and in only 4 of 10 eyes (40% 95% CI 12–74%) in the non-posturing group (Fisher's exact test P=0.02). Conclusion Post-operative face-down positioning may improve the likelihood of macular hole closure, particularly for holes larger than 400??m. These results support the case for a RCT. PMID:21941361

Lange, C A K; Membrey, L; Ahmad, N; Wickham, L; Maclaren, R E; Solebo, L; Xing, W; Bunce, C; Ezra, E; Charteris, D; Aylward, B; Yorston, D; Gregor, Z; Zambarakji, H; Bainbridge, J W

2012-01-01

374

Lamellar macular hole formation following vitrectomy for rhegmatogenous retinal detachment repair  

PubMed Central

Background The purpose of this study was to investigate lamellar macular hole formation in six patients after rhegmatogenous retinal detachment repair. Methods A retrospective review of medical records of patients who underwent primary pars plana vitrectomy for rhegmatogenous retinal detachment repair was performed. Optical coherence tomography characteristics and best-corrected visual acuity were evaluated. Patients who developed lamellar macular hole after pars plana vitrectomy for rhegmatogenous retinal detachment repair were identified. Results A total of 1185 eyes underwent pars plana vitrectomy for retinal detachment between 2004 and 2009. Optical coherence tomography evaluation was available in 450 cases. Six of these cases demonstrated lamellar macular hole formation, which was diagnosed by OCT-3. The mean time from retinal detachment surgery to lamellar hole diagnosis was 4.1 months. The presence of an epiretinal membrane on the surface of the juxtafoveal retina was a common finding in all six patients. Visual acuity was improved after successful retinal reattachment and remained unchanged after lamellar hole formation. Conclusion Lamellar macular holes developing after pars plana vitrectomy is a rare complication. Stability of optical coherence tomography findings and best-corrected visual acuity after lamellar macular hole formation may be observed for at least two years. PMID:22553416

Xirou, Tina; Kidess, Andrej; Kourentis, Christina; Xirou, Vasiliki; Feretis, Elias; Kabanarou, Stamatina A

2012-01-01

375

Occult choroidal neovascularization after successful macular hole surgery treated with ranibizumab  

PubMed Central

Purpose To report on a case that developed an atypical form of occult choroidal neovascularization (CNV) after successful macular hole surgery. Methods Visual acuity change, color fundus photographs, fluorescein and indocyanine green angiograms, and optical coherence tomography results were compared throughout the follow-up duration. Patients A 64-year-old woman with a macular hole in the right eye and drusen in both eyes underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. One month after the operation she developed occult CNV, in which pigment epithelial detachment and fine retinal pigment epithelial (RPE) layer wrinkles were observed under the completely sealed macular hole. After 3-monthly intravitreal injections of ranibizumab, the lesion did not change significantly. Conclusion CNV can develop after otherwise successful macular hole surgery, especially in patients with pre-existing aging changes in the macula, such as drusen. Care should be taken in such patients, to prevent the development of CNV after macular hole surgery. PMID:22927741

Oh, Ha Na; Lee, Joo Eun; Kim, Hyun Woong; Yang, Jae Wook; Yun, Il Han

2012-01-01

376

Race, iris color, and age-related macular degeneration.  

PubMed Central

PURPOSE: While most observers agree that age-related macular degeneration (AMD) is much more common in white persons than in persons of black African ancestry, the influence of iris color has been more controversial. We reexamined relationships between race, iris color, and AMD in a series of patients from our retina clinic. METHODS: We evaluated, in masked fashion, stereoscopic photographs of the retinas and irides in 306 sequential patients 60 years of age or older from our retina clinics. Four readers judged whether AMD was present, absent, or questionable in the retinal photographs and labeled iris color as blue, hazel, or brown. Presence or absence of AMD and presence and severity of the various macular lesions were determined by "majority vote" of the readers. We evaluated inter-rater agreement using the kappa statistic. We compared the prevalence of AMD and of specific AMD lesions as a function of race, sex, and iris color by contingency table analysis. RESULTS: The kappa statistic showed good inter-observer agreement, being 0.466 (P < 10(-6)) for definite or questionable AMD and ranging from 0.185 to 0.522 (P = 0.0047 to P < 10(-6)) for most lesions. We found significantly more AMD in white patients than in black patients (X2 = 27.54, P < 10(-4)). There was no significant difference in AMD prevalence by sex. In white patients, AMD was significantly more prevalent in individuals with blue or hazel irides than in those with brown irides (X2 = 15.04, P = .02). CONCLUSIONS: We confirm previous findings of a higher prevalence of AMD in white persons than in black persons. We also agree with those observers who claim that white subjects with light-colored irides have a higher prevalence of AMD than those with dark-colored irides. We suggest that differences in the association between iris pigmentation and AMD in different studies using different research methods may reflect genetic difference in the groups being studied. PMID:11190014

Frank, R N; Puklin, J E; Stock, C; Canter, L A

2000-01-01

377

Bilateral papillopathy as a presenting sign of pheochromocytoma associated with von Hippel–Lindau disease  

PubMed Central

A 7-year-old girl presented with decreased vision in both eyes for 1 month. Examination showed visual acuity of 20/50 and 20/60, no afferent pupillary defect, cecocentral scotomas, and bilateral optic disc edema with extensive peripapillary and macular exudates. Magnetic resonance imaging showed multiple cortical and subcortical white matter lesions. Both the laboratory workup and the systemic examination were unrevealing. However, on follow-up, the patient showed episodic elevations of blood pressure as high as 240/160. Further workup revealed elevated urine catecholamines and a right supra-adrenal mass proven to be a pheochromocytoma by histopathologic analysis. The paroxysmal hypertension resolved, and the visual acuity, visual fields, fundus exam, and neuroimaging improved. The patient was lost to follow-up until age 18 when she developed shortness of breath and was found to have multiple pulmonary metastases identified as pheochromocytoma by biopsy. Genetic testing identified a 3p25-26 (c.482 G>A) VHL gene chromosomal mutation consistent with von Hippel–Lindau disease genotype. Multiple peripheral retinal vascular dilations and small retinal capillary hemangioblastomas were also found. This case highlights the importance of recognizing the lability of blood pressure often seen with pheochromocytomas, which may mask the underlying cause of hypertensive papillopathy and retinopathy, a diagnosis of low clinical suspicion in the pediatric population. The case also underscores the importance of thorough systemic workup, including genotyping to detect conditions where pheochromocytoma may be the presenting sign of the disease, such as multiple endocrine neoplasia 2A and 2B, von Hippel–Lindau disease, von Recklinghausen disease, tuberous sclerosis, and Sturge–Weber syndrome. PMID:24707167

Shah, Veeral; Zlotcavitch, Leonid; Herro, Angela M; Dubovy, Sander R; Yehoshua, Zohar; Lam, Byron L

2014-01-01

378

Surgical Removal of Retained Subfoveal Perfluorocarbon Liquid through a Therapeutic Macular Hole with Intravitreal PFCL Injection and Gas Tamponade  

PubMed Central

We report two cases of surgical removal of a retained subfoveal perfluorocarbon liquid (PFCL) bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade. Two patients underwent pars plana vitrectomy with PFCL injection for rhegmatogenous retinal detachment. In both cases, a retained subfoveal PFCL bubble was noticed postoperatively by funduscopy and optical coherence tomography. Both patients underwent surgical removal of the subfoveal PFCL through a therapeutic macular hole and gas tamponade. The therapeutic macular holes were completely closed by gas tamponade and the procedure yielded a good visual outcome (best-corrected visual acuity of 20 / 40 in both cases). In one case, additional intravitreal PFCL injection onto the macula reduced the size of the therapeutic macular hole and preserved the retinal structures in the macula. Surgical removal of a retained subfoveal PFCL bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade provides an effective treatment option. PMID:24082781

Kim, Jae Min; Park, Kyu Hyung; Chung, Hum

2013-01-01

379

The Effect of ND:YAG Laser Posterior Capsulotomy Size on Refraction, Intraocular Pressure, and Macular Thickness  

PubMed Central

Purpose. The aim of this study is to examine the influence of capsulotomy size on, spherical equivalent (SE), intraocular pressure (IOP), and macular thickness. Materials and Methods. Sixty-eight patients were examined preoperatively and 1, 4, and 12 weeks after Nd:YAG capsulotomy. Patients were divided into two groups based on the postoperative capsulotomy size. Changes in SE, IOP, and macular thickness were compared between two groups. Results. We found a higher hyperopic shift in large capsulotomy group. In both groups 1 and 2, IOP increased 1 week postoperatively. Intraocular pressure rise in group 2 was higher than in group 1. Both groups had increased macular thickness at 1 week postoperatively. The degree of macular thickening was similar in group 1 and group 2. Comment. Patients who underwent a larger capsulotomy have a higher hyperopic shift and IOP elevation. Rise in macular thickness was similar in large and small capsulotomy groups. PMID:24724016

Karahan, Eyyup; Tuncer, Ibrahim; Zengin, Mehmet Ozgur

2014-01-01

380

A very rare bilateral adrenal tumor.  

PubMed

We report a case of very rare adrenal tumor. A 54-year-old patient was classified as affected by bilateral adrenal incidentaloma that surprisingly, on histology resulted solitary fibrous tumors. Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm. Only five cases of localization of SFT in adrenal gland are reported in the literature, while the frequency of retroperitoneum localization is more frequent, about 30 cases. Immunohistochemically, SFT can be positive for CD34 antigen, vimentin, CD99, and bcl-2 and usually negative for cytokeratins, chromogranin A, NSE, neurofilaments, synoptophysin, and S-100. Surgical excision remains the main treatment in fact the recurrence is locoregional and correlated with positive margins due to incomplete excision, while distant metastases are correlated with atypical or malignant features. PMID:24146413

Toniato, Antonio; Boschin, Isabella Merante; Pelizzo, Maria Rosa

2014-04-01

381

Bilateral mechanical rotational vertebral artery occlusion.  

PubMed

Rotational vertebral artery occlusion, or bow hunter's stroke, is reversible, positional symptomatic vertebrobasilar ischemia. The typical mechanism of action is obstruction of a dominant vertebral artery with contralateral head rotation in the setting of baseline ipsilateral vertebral artery stenosis or occlusion. Here we present a rare case of mechanical occlusion of bilateral patent vertebral arteries manifesting as near syncope with rightward head rotation. Diagnostic cerebral angiography showed dynamic right C5 vertebral occlusion and left C2 vertebral occlusion. The patient underwent right C4/5 transverse process decompression. Postoperative angiogram showed patent flow through the right vertebral artery in neutral position and with head turn with resultant resolution of symptoms. PMID:23465174

Dargon, Phong T; Liang, Conrad W; Kohal, Anmol; Dogan, Aclan; Barnwell, Stanley L; Landry, Gregory J

2013-10-01

382

Bilateral taurodontism in primary dentition with hypodontia  

PubMed Central

Taurodontism is a rare dental anomaly in which there is an enlarged pulp chamber at the expense of roots with apical displacement of the pulpal floor, giving it a rectangular shape. It is caused by the failure of Hertwig's epithelial root sheath to invaginate at the proper horizontal level. Taurodontism has been reported as an intraoral feature of several syndromes like Down syndrome, Klinefelter syndrome, Smith-Magenis syndrome, Hurler syndrome, etc. Association of taurodontism with hypodontia in permanent dentition has also been reported. Taurodontism in primary dentition and its association with hypodontia is very rarely reported in the literature. The present case illustrates bilateral taurodontism of primary mandibular molars with hypodontia in maxilla. PMID:23345504

Surendar, Marappan Natarajan; Pandey, Ramesh Kumar; Khanna, Richa

2013-01-01

383

Spontaneous bilateral internal carotid artery dissection.  

PubMed

Spontaneous internal carotid artery dissection is not an uncommon cause of ischaemic stroke in younger patients, but multiple cervical arterial dissections at presentation are uncommon. Recurrence of dissection in a previously normal artery is common. In this case report we review the history, clinical findings and management of a 42-year-old woman who presented with stroke and Horner syndrome and was found to have spontaneous bilateral internal carotid artery dissection. She was not anticoagulated due to concerns relating to the size of her infarct. She was treated with a combination of aspirin and clopidogrel. We use dual antiplatelets for the management of cervical dissections as a part of the CADISS trial. The patient made good progress with the multidisciplinary team and was discharged on day 22 with support from the community stroke team. PMID:22110554

Ardhalapudi, Srujan; Addy, Victoria; Da Costa, David

2009-01-01

384

Patient with bilateral breast enlargement and hypospadias.  

PubMed

A 20 year old man was admitted in the surgical unit of Dhaka Medical College Hospital on August 2007 presented with Hypospadias & underdeveloped penis from childhood, gradual enlargement of both breasts for the last 10 years, absence of axillary and pubic hair from puberty & painful swelling of both testes for the last 3 years. The patient was regarded as a female upto the age of 10 years. He has got no voice change since puberty. On examination he had average body built, there was bilateral gynaecomastia, hypospadias, rudimentary penis & absence of pubic and axillary hair. His testosterone level, serum prolactin level, serum progesterone level, serum estradiol level was done. Cytology on buccal smear done and ultrasonography revealed no ovary and uterus. Ultimately patient was diagnosed as a case of androgen insensitivity syndrome (AIS). The case is reported for clinical awareness & to share our experience. PMID:19182761

Ali, A A; Ahmed, T; Rashid, M M

2009-01-01

385

Framing effect following bilateral amygdala lesion  

PubMed Central

A paradigmatic example of an emotional bias in decision making is the framing effect, where the manner in which a choice is posed – as a potential loss or a potential gain – systematically biases an ensuing decision. Two fMRI studies have shown that the activation in the amygdala is modulated by the framing effect. Here, contrary to an expectation based on these studies, we show that two patients with Urbach-Wiethe (UW) disease, a rare condition associated with congenital, complete bilateral amygdala degeneration, exhibit an intact framing effect. However, choice preference in these patients did show a qualitatively distinct pattern compared to controls evident in an increased propensity to gamble, indicating that loss of amygdala function does exert an overall influence on risk-taking. These findings suggest either that amygdala does contribute to decision making but does not play a causal role in framing, or that UW is not a pure lesion model of amygdala function. PMID:20227427

Talmi, Deborah; Hurlemann, René; Patin, Alexandra; Dolan, Raymond J.

2010-01-01

386

Bilateralism, multilateralism, and the quest for global free trade  

Microsoft Academic Search

We develop an equilibrium theory of trade agreements in which both the degree and the nature (bilateral or multilateral) of trade liberalization are endogenously determined. To determine whether and how bilateralism matters, we also analyze a scenario where countries pursue trade liberalization on only a multilateral basis. We find that when countries have asymmetric endowments or when governments value producer

Kamal Saggi; Halis Murat Yildiz

2009-01-01

387

Bilateralism, multilateralism, and the quest for global free trade  

Microsoft Academic Search

We develop an equilibrium theory of trade agreements in which both the degree and the nature (bilateral or multilateral) of trade liberalization are endogenously determined. To determine whether and how bilateralism matters, we also analyze a scenario where countries pursue trade liberalization on only a multilateral basis. We find that when countries have asymmetric endowments or when governments value producer

Kamal Saggi; Halis Murat Yildiz

2010-01-01

388

Limb bone bilateral asymmetry: variability and commonality among modern humans  

E-print Network

Limb bone bilateral asymmetry: variability and commonality among modern humans Benjamin M. Auerbach the greatest absolute and directional asymmetry among all populations, with lower asymmetry evident in maximum are unique among primates in the magnitude of di- rectional bilateral asymmetry exhibited in both use

Auerbach, Benjamin M.

389

Bilateral congenital ureteral strictures in a young cat.  

PubMed

An 8-month-old cat was presented with bilateral hydronephrosis. Bilateral ureteral obstructions were identified by diagnostic imaging and confirmed by necropsy. Histopathologic findings revealed polypoid transitional epithelial hyperplasia with chronic lymphoplasmacytic inflammation. This report documents congenital ureteral strictures as a cause of ureteral obstruction in a young cat. PMID:25183890

Lee, Namsoon; Choi, Mihyun; Keh, Seoyeon; Oh, Yein; Seo, Jimin; Choi, Heeyeon; Kim, Hyunwook; Yoon, Junghee

2014-09-01

390

Bilateral Cochlear Implantation in Children: Experiences and Considerations  

ERIC Educational Resources Information Center

Between 2000 and 2006, the University Clinic for Ear Nose and Throat and Communication Disorders in Mainz, Germany, performed 41 bilateral cochlear implantations in children. This article addresses some of the factors to be considered in a decision to bilaterally implant a child, including the age of the child at the first implant, the length of…

Bohnert, Andrea; Spitzlei, Vera; Lippert, Karl L.; Keilmann, Annerose

2006-01-01

391

Co-existent choroidal neovascular membrane and macular hole in pathologic myopia: a long follow-up clinical outcome and literature review  

PubMed Central

Choroidal neovascularization (CNV) is an uncommon complication associated with a macular hole. In this case report of a rare condition, we present a pathologic myopia patient with a co-existent macular hole and choroidal neovascular membrane. The patient was treated with photodynamic therapy for CNV, and then vitreous surgery for the retinal detachment and macular hole. At the end of 4 years follow-up, her visual acuity was improved to 0.1 while the macular hole remained open. Optical coherence tomography is a useful inspection method of the diagnosis of CNV and macular hole. PMID:24392342

Chen, Zhi-Qing; Lin, Ji-Jian; Ye, Pan-Pan; Zhang, Li; Fang, Xiao-Yun

2013-01-01

392

Imaging Polarimetry in Age-Related Macular Degeneration  

PubMed Central

PURPOSE To evaluate the birefringence properties of eyes with age-related macular degeneration (AMD). To compare the information from two techniques—scanning laser polarimetry (GDx) and polarization-sensitive spectral-domain optical coherence tomography (OCT)—and investigate how they complement each other. METHODS The authors prospectively examined the eyes of two healthy subjects and 13 patients with exudative AMD. Using scanning laser polarimetry, they computed phase-retardation maps, average reflectance images, and depolarized light images. To obtain polarimetry information with improved axial resolution, they developed a fiber-based, polarization-sensitive, spectral-domain OCT system and measured the phase retardation associated with birefringence in the same eyes. RESULTS Both GDx and polarization-sensitive spectral-domain optical coherence tomography detected abnormal birefringence at the locus of exudative lesions. Polarization-sensitive, spectral-domain OCT showed that in the old lesions with fibrosis, phase-retardation values were significantly larger than in the new lesions (P = 0.020). Increased scattered light and altered polarization scramble were associated with portions of the lesions. CONCLUSIONS GDx and polarization-sensitive spectral-domain OCT are complementary in probing birefringence properties in exudative AMD. Polarimetry findings in exudative AMD emphasized different features and were related to the progression of the disease, potentially providing a noninvasive tool for microstructure in exudative AMD. PMID:18515594

Miura, Masahiro; Yamanari, Masahiro; Iwasaki, Takuya; Elsner, Ann E.; Makita, Shuichi; Yatagai, Toyohiko; Yasuno, Yoshiaki

2010-01-01

393

Seven new loci associated with age-related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is a common cause of blindness in older individuals. To accelerate the understanding of AMD biology and help design new therapies, we executed a collaborative genome-wide association study, including >17,100 advanced AMD cases and >60,000 controls of European and Asian ancestry. We identified 19 loci associated at P < 5 × 10(-8). These loci show enrichment for genes involved in the regulation of complement activity, lipid metabolism, extracellular matrix remodeling and angiogenesis. Our results include seven loci with associations reaching P < 5 × 10(-8) for the first time, near the genes COL8A1-FILIP1L, IER3-DDR1, SLC16A8, TGFBR1, RAD51B, ADAMTS9 and B3GALTL. A genetic risk score combining SNP genotypes from all loci showed similar ability to distinguish cases and controls in all samples examined. Our findings provide new directions for biological, genetic and therapeutic studies of AMD. PMID:23455636

Fritsche, Lars G; Chen, Wei; Schu, Matthew; Yaspan, Brian L; Yu, Yi; Thorleifsson, Gudmar; Zack, Donald J; Arakawa, Satoshi; Cipriani, Valentina; Ripke, Stephan; Igo, Robert P; Buitendijk, Gabriëlle H S; Sim, Xueling; Weeks, Daniel E; Guymer, Robyn H; Merriam, Joanna E; Francis, Peter J; Hannum, Gregory; Agarwal, Anita; Armbrecht, Ana Maria; Audo, Isabelle; Aung, Tin; Barile, Gaetano R; Benchaboune, Mustapha; Bird, Alan C; Bishop, Paul N; Branham, Kari E; Brooks, Matthew; Brucker, Alexander J; Cade, William H; Cain, Melinda S; Campochiaro, Peter A; Chan, Chi-Chao; Cheng, Ching-Yu; Chew, Emily Y; Chin, Kimberly A; Chowers, Itay; Clayton, David G; Cojocaru, Radu; Conley, Yvette P; Cornes, Belinda K; Daly, Mark J; Dhillon, Baljean; Edwards, Albert O; Evangelou, Evangelos; Fagerness, Jesen; Ferreyra, Henry A; Friedman, James S; Geirsdottir, Asbjorg; George, Ronnie J; Gieger, Christian; Gupta, Neel; Hagstrom, Stephanie A; Harding, Simon P; Haritoglou, Christos; Heckenlively, John R; Holz, Frank G; Hughes, Guy; Ioannidis, John P A; Ishibashi, Tatsuro; Joseph, Peronne; Jun, Gyungah; Kamatani, Yoichiro; Katsanis, Nicholas; N Keilhauer, Claudia; Khan, Jane C; Kim, Ivana K; Kiyohara, Yutaka; Klein, Barbara E K; Klein, Ronald; Kovach, Jaclyn L; Kozak, Igor; Lee, Clara J; Lee, Kristine E; Lichtner, Peter; Lotery, Andrew J; Meitinger, Thomas; Mitchell, Paul; Mohand-Saïd, Saddek; Moore, Anthony T; Morgan, Denise J; Morrison, Margaux A; Myers, Chelsea E; Naj, Adam C; Nakamura, Yusuke; Okada, Yukinori; Orlin, Anton; Ortube, M Carolina; Othman, Mohammad I; Pappas, Chris; Park, Kyu Hyung; Pauer, Gayle J T; Peachey, Neal S; Poch, Olivier; Priya, Rinki Ratna; Reynolds, Robyn; Richardson, Andrea J; Ripp, Raymond; Rudolph, Guenther; Ryu, Euijung; Sahel, José-Alain; Schaumberg, Debra A; Scholl, Hendrik P N; Schwartz, Stephen G; Scott, William K; Shahid, Humma; Sigurdsson, Haraldur; Silvestri, Giuliana; Sivakumaran, Theru A; Smith, R Theodore; Sobrin, Lucia; Souied, Eric H; Stambolian, Dwight E; Stefansson, Hreinn; Sturgill-Short, Gwen M; Takahashi, Atsushi; Tosakulwong, Nirubol; Truitt, Barbara J; Tsironi, Evangelia E; Uitterlinden, André G; van Duijn, Cornelia M; Vijaya, Lingam; Vingerling, Johannes R; Vithana, Eranga N; Webster, Andrew R; Wichmann, H-Erich; Winkler, Thomas W; Wong, Tien Y; Wright, Alan F; Zelenika, Diana; Zhang, Ming; Zhao, Ling; Zhang, Kang; Klein, Michael L; Hageman, Gregory S; Lathrop, G Mark; Stefansson, Kari; Allikmets, Rando; Baird, Paul N; Gorin, Michael B; Wang, Jie Jin; Klaver, Caroline C W; Seddon, Johanna M; Pericak-Vance, Margaret A; Iyengar, Sudha K; Yates, John R W; Swaroop, Anand; Weber, Bernhard H F; Kubo, Michiaki; Deangelis, Margaret M; Léveillard, Thierry; Thorsteinsdottir, Unnur; Haines, Jonathan L; Farrer, Lindsay A; Heid, Iris M; Abecasis, Gonçalo R

2013-04-01

394

Interocular Symmetry in Macular Choroidal Thickness in Children  

PubMed Central

Objective. To report interocular differences in choroidal thickness in children using spectral domain optical coherence tomography (SD-OCT) and correlate findings with biometric data. Methods. This observational cross-sectional study included 91 (182 eyes) healthy children aged 6 to 17 years with no ocular abnormality except refractive error. After a comprehensive eye exam and axial length measurement, high definition macular scans were performed using SD-OCT. Two observers manually measured the choroidal thickness at the foveal center and at 1500?µm nasally, temporally, inferiorly, and superiorly. Interocular differences were computed; correlations with age, gender, refractive error, and axial length were performed. Results. Mean age was 10.40 ± 3.17 years; mean axial length and refractive error values were similar between fellow eyes. There was excellent correlation between the two observers' measurements. No significant interocular differences were observed at any location. There was only a trend for right eyes to have higher values in all thicknesses, except the superior thickness. Most of the choroidal thickness measurements correlated positively with spherical equivalent but not with axial length, age, or gender. Conclusion. Choroidal thickness measurements in children as performed using SD-OCT revealed a high level of interobserver agreement and consistent interocular symmetry. Values correlated positively with spherical equivalent refraction. PMID:25525509

Al-Haddad, Christiane; El Chaar, Lama; Noureddin, Baha'

2014-01-01

395

Mechanism of Inflammation in Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is a multifactorial disease that represents the most common cause of irreversible visual impairment among people over the age of 50 in Europe, the United States, and Australia, accounting for up to 50% of all cases of central blindness. Risk factors of AMD are heterogeneous, mainly including increasing age and different genetic predispositions, together with several environmental/epigenetic factors, that is, cigarette smoking, dietary habits, and phototoxic exposure. In the aging retina, free radicals and oxidized lipoproteins are considered to be major causes of tissue stress resulting in local triggers for parainflammation, a chronic status which contributes to initiation and/or progression of many human neurodegenerative diseases such as AMD. Experimental and clinical evidences strongly indicate the pathogenetic role of immunologic processes in AMD occurrence, consisting of production of inflammatory related molecules, recruitment of macrophages, complement activation, microglial activation and accumulation within those structures that compose an essential area of the retina known as macula lutea. This paper reviews some attractive aspects of the literature about the mechanisms of inflammation in AMD, especially focusing on those findings or arguments more directly translatable to improve the clinical management of patients with AMD and to prevent the severe vision loss caused by this disease. PMID:23209345

Parmeggiani, Francesco; Romano, Mario R.; Costagliola, Ciro; Semeraro, Francesco; Incorvaia, Carlo; D'Angelo, Sergio; Perri, Paolo; De Palma, Paolo; De Nadai, Katia; Sebastiani, Adolfo

2012-01-01

396

Bevacizumab for the management of diabetic macular edema  

PubMed Central

Diabetic retinopathy (DR) is a leading cause of vision loss in the working-age population and is relatedto 1%-5% of cases of blindness worldwide. Diabetic macular edema (DME) is the most frequent cause of DR vision loss and is an important public health problem. Recent studies have implicated vascular endothelial growth factor (VEGF) in DR and DME pathogenesis, as well as provided evidence of the benefits of anti-VEGF agents for the management of such conditions. Despite the benefits of intravitreal ranibizumab injection for the management of DME, the cost-effectiveness of intravitreal bevacizumab therapy has gained increasing interest in the scientific community. This review summarizes the studies examining bevacizumab for the management of DME, focusing on the efficacy and duration of the clinical benefits of decreasing DME and the improvement of best-corrected visual acuity (BCVA). There is strong evidence that intravitreal bevacizumab injection therapy has a good cost-effective profile in the management of DME and may be associated with laser photocoagulation; however, its clinical superiority in terms of the duration of DME regression and the improvement of BCVA compared with intravitreal ranibizumab and other intravitreal anti-VEGF therapies remains unclear and deserves further investigation. PMID:23593532

Stefanini, Francisco Rosa; Arevalo, J Fernando; Maia, Maurício

2013-01-01

397

Ocular surface temperature in age-related macular degeneration.  

PubMed

Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD) eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320). The ocular surface temperature (OST) of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA) test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value?>0.272). OST in AMD patients was significantly lower than in controls (P > 0.05). Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD. PMID:25436140

Sodi, Andrea; Matteoli, Sara; Giacomelli, Giovanni; Finocchio, Lucia; Corvi, Andrea; Menchini, Ugo

2014-01-01

398

Therapeutic Modalities of Exudative Age-related Macular Degeneration  

PubMed Central

Introduction: Age-related macular degeneration (AMD) is a leading cause of irreversible serious vision damage in persons over 50 years of age. In treating AMD many medicaments are applied such as inhibitors of vascular endothelial growth factor (VEGF), have been very carefully included over the last few years after a series of study research. Aims: To analyze the past methods of treatment, discuss emerging therapies which could advance the treatment of exudative AMD. The past anti-VEGF therapies require frequent repetitions of administration, with uncertain visual acuity recovery, as not all patients react to anti-VEGF therapy. Consequently, there is a need to find out additional therapies which could improve the treatment of exudative AMD. The real aim in the treating of AMD is to prevent CNV development. Methods: A survey of the current clinical research and results in the field of the present and future treatments of exudative AMD. Results: There are many areas of research into new methods of the exudative AMD treatment. Conclusion: The future therapies for exudative AMD treatment have a potential not only to reduce the frequency of administration and follow-up visits, but also to improve effects of treatment by targeting additional ways of CNV development, increasing the aptitude of target binding and extending durability of treatment. PMID:25568535

Mavija, Milka; Alimanovic, Emina; Jaksic, Vesna; Kasumovic, Sanja Sefic; Cekic, Sonja; Stamenkovic, Miroslav

2014-01-01

399

Structural Changes in Individual Retinal Layers in Diabetic Macular Edema  

PubMed Central

Optical coherence tomography (OCT) has enabled objective measurement of the total retinal thickness in diabetic macular edema (DME). The central retinal thickness is correlated modestly with visual impairment and changes paradoxically after treatments compared to the visual acuity. This suggests the clinical relevance of the central retinal thickness in DME and the presence of other factors that affect visual disturbance. Recent advances in spectral-domain (SD) OCT have provided better delineation of the structural changes and fine lesions in the individual retinal layers. Cystoid spaces in the inner nuclear layer and outer plexiform layer are related to quantitative and qualitative parameters in fluorescein angiography. OCT often shows vitreoretinal interface abnormalities in eyes with sponge-like retinal swelling. Serous retinal detachment is sometimes accompanied by hyperreflective foci in the subretinal fluid, which exacerbates the pathogenesis at the interface of the photoreceptors and retinal pigment epithelium. Photoreceptor damage at the fovea is thought to be represented by disruption of the external limiting membrane or the junction between the inner and outer segment lines and is correlated with visual impairment. Hyperreflective foci in the outer retinal layers on SD-OCT images, another marker of visual disturbance, are associated with foveal photoreceptor damage. PMID:24073417

Yoshimura, Nagahisa

2013-01-01

400

Age-related macular degeneration: linking clinical presentation to pathology.  

PubMed

Age-related macular degeneration (AMD) is one of the leading causes of blindness worldwide in the elderly population. Optometrists, as primary eye health care providers, require the skills and knowledge to accurately diagnose and manage AMD patients. There is an overwhelming body of research related to the clinical presentation, etiology, epidemiology, and pathology of this disease. Additionally, the evolution of new imaging modalities creates new opportunities to clinically detect and analyze previously uncharacterized and earlier changes in the retina. The challenge for optometrists is to combine all this information into an applicable knowledge base for use in everyday clinical assessment of AMD so that timely and accurate referrals can be made to retinal specialists. This review attempts to address this issue by linking the clinical presentation of AMD with the underlying disease biology. We emphasize the contribution of recent noninvasive imaging technologies to the clinical assessment of early and more advanced AMD including optical coherence tomography, fundus autofluorescence, and infrared reflectance. PMID:24879089

Nivison-Smith, Lisa; Milston, Rebecca; Madigan, Michele; Kalloniatis, Michael

2014-08-01

401

Macular pigment and its contribution to visual performance and experience  

PubMed Central

There is now a consensus, based on histological, biochemical and spectral absorption data, that the yellow colour observed at the macula lutea is a consequence of the selective accumulation of dietary xanthophylls in the central retina of the living eye. Scientific research continues to explore the function(s) of MP in the human retina, with two main hypotheses premised on its putative capacity to (1) protect the retina from (photo)-oxidative damage by means of its optical filtration and/or antioxidant properties, the so-called protective hypothesis and (2) influence the quality of visual performance by means of selective short wavelength light absorption prior to photoreceptor light capture, thereby attenuating the effects of chromatic aberration and light scatter, the so-called acuity and visibility hypotheses. The current epidemic of age-related macular degeneration has directed researchers to investigate the protective hypothesis of MP, while there has been a conspicuous lack of work designed to investigate the role of MP in visual performance. The aim of this review is to present and critically appraise the current literature germane to the contribution of MP, if any, to visual performance and experience.

Loughman, James; Davison, Peter A.; Nolan, John M.; Akkali, Mukunda C.; Beatty, Stephen

2010-01-01

402

Review of nutrient actions on age-related macular degeneration.  

PubMed

The actions of nutrients and related compounds on age-related macular degeneration (AMD) are explained in this review. The findings from 80 studies published since 2003 on the association between diet and supplements in AMD were reviewed. Antioxidants and other nutrients with an effect on AMD susceptibility include carotenoids (lutein and zeaxanthin, ?-carotene), vitamins (vitamin A, E, C, D, B), mineral supplements (zinc, copper, selenium), dietary fatty acids [monounsaturated fatty acids, polyunsaturated fatty acids (PUFA both omega-3 PUFA and omega-6 PUFA), saturated fatty acids and cholesterol], and dietary carbohydrates. The literature revealed that many of these antioxidants and nutrients exert a protective role by functioning synergistically. Specifically, the use of dietary supplements with targeted actions can provide minimal benefits on the onset or progression of AMD; however, this does not appear to be particularly beneficial in healthy people. Furthermore, some supplements or nutrients have demonstrated discordant effects on AMD in some studies. Since intake of dietary supplements, as well as exposure to damaging environmental factors, is largely dependent on population habits (including dietary practices) and geographical localization, an overall healthy diet appears to be the best strategy in reducing the risk of developing AMD. As of now, the precise mechanism of action of certain nutrients in AMD prevention remains unclear. Thus, future studies are required to examine the effects that nutrients have on AMD and to determine which factors are most strongly correlated with reducing the risk of AMD or preventing its progression. PMID:24461310

Zampatti, Stefania; Ricci, Federico; Cusumano, Andrea; Marsella, Luigi Tonino; Novelli, Giuseppe; Giardina, Emiliano

2014-02-01

403

Automatic segmentation of microcystic macular edema in OCT  

PubMed Central

Microcystic macular edema (MME) manifests as small, hyporeflective cystic areas within the retina. For reasons that are still largely unknown, a small proportion of patients with multiple sclerosis (MS) develop MME—predominantly in the inner nuclear layer. These cystoid spaces, denoted pseudocysts, can be imaged using optical coherence tomography (OCT) where they appear as small, discrete, low intensity areas with high contrast to the surrounding tissue. The ability to automatically segment these pseudocysts would enable a more detailed study of MME than has been previously possible. Although larger pseudocysts often appear quite clearly in the OCT images, the multi-frame averaging performed by the Spectralis scanner adds a significant amount of variability to the appearance of smaller pseudocysts. Thus, simple segmentation methods only incorporating intensity information do not perform well. In this work, we propose to use a random forest classifier to classify the MME pixels. An assortment of both intensity and spatial features are used to aid the classification. Using a cross-validation evaluation strategy with manual delineation as ground truth, our method is able to correctly identify 79% of pseudocysts with a precision of 85%. Finally, we constructed a classifier from the output of our algorithm to distinguish clinically identified MME from non-MME subjects yielding an accuracy of 92%. PMID:25657884

Lang, Andrew; Carass, Aaron; Swingle, Emily K.; Al-Louzi, Omar; Bhargava, Pavan; Saidha, Shiv; Ying, Howard S.; Calabresi, Peter A.; Prince, Jerry L.

2014-01-01

404

Automatic segmentation of microcystic macular edema in OCT.  

PubMed

Microcystic macular edema (MME) manifests as small, hyporeflective cystic areas within the retina. For reasons that are still largely unknown, a small proportion of patients with multiple sclerosis (MS) develop MME-predominantly in the inner nuclear layer. These cystoid spaces, denoted pseudocysts, can be imaged using optical coherence tomography (OCT) where they appear as small, discrete, low intensity areas with high contrast to the surrounding tissue. The ability to automatically segment these pseudocysts would enable a more detailed study of MME than has been previously possible. Although larger pseudocysts often appear quite clearly in the OCT images, the multi-frame averaging performed by the Spectralis scanner adds a significant amount of variability to the appearance of smaller pseudocysts. Thus, simple segmentation methods only incorporating intensity information do not perform well. In this work, we propose to use a random forest classifier to classify the MME pixels. An assortment of both intensity and spatial features are used to aid the classification. Using a cross-validation evaluation strategy with manual delineation as ground truth, our method is able to correctly identify 79% of pseudocysts with a precision of 85%. Finally, we constructed a classifier from the output of our algorithm to distinguish clinically identified MME from non-MME subjects yielding an accuracy of 92%. PMID:25657884

Lang, Andrew; Carass, Aaron; Swingle, Emily K; Al-Louzi, Omar; Bhargava, Pavan; Saidha, Shiv; Ying, Howard S; Calabresi, Peter A; Prince, Jerry L

2015-01-01

405

[Age-related macular degeneration--a complex genetic disease].  

PubMed

Age-related macular degeneration (AMD,) is the most common cause of severe visual loss and blindness in the population over 60 years old, especially in the developed world. Two types of AMD are distinguished: the dry (non-exudative or atrophic) and the wet (exudative or neovascular) form. Family and twins studies have shown that the susceptibility for this disease is genetically influenced and the heritability has been estimated to be up to 75%. Until now, many of the candidate-genes associated with AMD have been discovered using studies on genetically engineered and naturally mutated animals, linkage studies, studies of monogenic degenerative retinal diseases and association studies. Recently genes have been described that significantly contribute to the etiopathogenesis of AMD: CFH, PLEKHA1/LOC387715/HTRA1 and C2/BF genes. AMD is considered to be a genetic complex disease in which multiple genes and environmental factors play a role in pathogenesis. Identification of other genes involved in development of AMD will improve our knowledge about new pathways and pathological mechanisms of the disease, as well as avenues for novel more effective treatments. The aim of this article is to survey published data on genetic aspect of AMD, with emphasis of several recently discovered genes described to be particularly important in the pathogenesis of AMD, and /or somehow associated with the occurrence of the disease. PMID:18655465

Antoniak, Katarzyna; Bienias, Wojciech; Nowak, Jerzy Z

2008-01-01

406

Seven New Loci Associated with Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is a common cause of blindness in older individuals. To accelerate understanding of AMD biology and help design new therapies, we executed a collaborative genomewide association study, examining >17,100 advanced AMD cases and >60,000 controls of European and Asian ancestry. We identified 19 genomic loci associated with AMD with p<5×10?8 and enriched for genes involved in regulation of complement activity, lipid metabolism, extracellular matrix remodeling and angiogenesis. Our results include 7 loci reaching p<5×10?8 for the first time, near the genes COL8A1/FILIP1L, IER3/DDR1, SLC16A8, TGFBR1, RAD51B, ADAMTS9/MIR548A2, and B3GALTL. A genetic risk score combining SNPs from all loci displayed similar good ability to distinguish cases and controls in all samples examined. Our findings provide new directions for biological, genetic and therapeutic studies of AMD. PMID:23455636

2013-01-01

407

Aflibercept for the treatment of age-related macular degeneration.  

PubMed

Aflibercept is a novel, recombinant, fusion protein that consists of portions of vascular endothelial growth factor (VEGF) receptor (R) 1 and VEGFR2 extracellular domains fused to the Fc portion of human immunoglobulin G1. It exhibits higher affinity for VEGF-A/-B and binds all the VEGF isoforms (VEGF-B and -C, placental growth factor). The efficacy of aflibercept was assessed in two randomized, double-masked, multicenter, active-controlled, clinical trials in patients with choroidal neovascularization due to exudative age-related macular degeneration (AMD) and compared it's efficacy to ranibizumab, which is already Food and Drug Administration (FDA)-approved for patients with wet AMD. In the two trials known as VIEW 1 and VIEW 2, aflibercept was as effective when dosed as 2 mg every 8 weeks after 3 monthly loading doses compared to monthly ranibizumab. Aflibercept was well tolerated with very rare systemic adverse events, including arterial thromboembolic events (ATEs). The incidence of ATEs was 1.8% during the first year of the clinical trials and included non-fatal strokes, non-fatal myocardial infarction, or death from vascular events or an unknown cause. In November 2011, aflibercept received FDA approval and is currently used in clinical practice for patients with wet AMD. PMID:25135809

Trichonas, George; Kaiser, Peter K

2013-12-01

408

Current therapeutic approaches in neovascular age-related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is the leading eye disease to cause visual impairment in the elderly. Neovascular AMD is a type of advanced AMD that is characterized by pathologic proliferation and leakage of abnormal blood vessels in the eye. While the pathogenesis of neovascular AMD is not completely known, one of the important milestones in neovascular AMD research was the identification of vascular endothelial growth factor (VEGF) as a major stimulus of abnormal angiogenesis that can be targeted for intravitreal treatment. Anti-VEGF therapies that neutralize or block the induction of angiogenesis by VEGF have recently revolutionized the therapeutic approach to neovascular AMD. The scientific literature regarding the efficacy and safety of anti-VEGF treatment has been hugely enriched with results from various recent randomized clinical trials involving the three most commonly utilized anti-VEGF pharmacologic agents--ranibizumab, bevacizumab, and aflibercept. The potential to stop and reverse the progressive loss of vision due to neovascular AMD is evident. Continued investigation into inhibiting VEGF as well as targeting other crucial factors that contribute to neovascular AMD is an active field of research that is expected to accelerate the progress of neovascular AMD therapy. PMID:23819948

Nguyen, Duy H; Luo, Jing; Zhang, Kang; Zhang, Ming

2013-06-01

409

Bilateral psoas and bilateral perinephric abscesses complicating acute pyelonephritis in pregnancy  

PubMed Central

Acute pyelonephritis complicates 1-2% of pregnancies and causes significant maternal and fetal morbidity and mortality. The diagnosis of renal tuberculosis (TB) is often delayed and commonly presents with sterile pyuria or along with other pyogenic organisms. We report a case where the diagnosis of renal TB was missed in a pregnant woman when she presented with acute pyelonephritis, septic shock, and acute renal failure. There was clinical recovery with antibiotics, but bilateral psoas and perinephric abscesses (TB, Enterococcus sp., and E. coli) were diagnosed when she presented with loin pain and palpable left renal angle swelling. Bilateral psoas abscess due to TB in the absence of skeletal TB and human immunodeficiency virus infection is rare. The presentation of renal TB in pregnancy, its complications, and its management are discussed. PMID:23580809

Veerappan, I.; Shanmugam, A.; Kumar, S.; Velayutham, P.

2013-01-01

410

In vivo evidence of epiretinal membrane formation secondary to acute macular microhole after posterior vitreous detachment.  

PubMed

The authors present the case of an idiopathic epiretinal membrane (ERM) secondary to an acute self-repaired macular microhole documented by optical coherence tomography (OCT). A 65-year-old phakic woman presenting with acute onset of light flashes, myodesopsia, and central negative scotoma in the right eye was diagnosed with age-related posterior vitreous detachment. Spectral-domain OCT showed a tiny defect of the outer retina, consistent with the diagnosis of macular microhole, which spontaneously closed after 4 weeks. Six months later, the patient developed a contracting ERM, and her visual acuity significantly worsened. This case represents the first in vivo documentation of retinal pigment epithelium cell migration through a macular microhole, highlighting the importance of OCT in understanding idiopathic ERM pathogenesis. [Ophthalmic Surg Lasers Imaging Retina. 2014;45:596-597.]. PMID:25347828

Furino, Claudio; Cicinelli, Maria Vittoria; Boscia, Francesco; Alessio, Giovanni

2014-11-01

411

Complete bilateral horizontal gaze paralysis disclosing multiple sclerosis  

PubMed Central

Two women presented with bilateral internuclear ophthalmoplegia evolving in a few days to complete bilateral horizontal gaze paralysis. Convergence and vertical eye movements were normal. Cerebral MRI showed a few small white matter lesions in the lateral ventricle regions, and, at the brainstem level, a single, small, bilateral lesion affecting the posterior part of the medial pontine tegmentum and responsible for the clinical syndrome. The condition gradually improved in both patients, following a similar progression as at the onset: improvement first involved the adduction movements in both eyes, whereas bilateral abduction paresis still persisted for a few weeks, before complete recovery of eye movements. Bilateral damage to the medial longitudinal fasciculus and subsequent lateral extent of damage to the region of the two abducens emerging fibres may explain the clinical findings. In both cases, the cause was probably multiple sclerosis.?? PMID:11160480

Milea, D; Napolitano, M; Dechy, H; Le Hoang, P; Delattre, J; Pierrot-Deseillig..., C

2001-01-01

412

Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman  

PubMed Central

Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive) woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days' duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide). Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation. PMID:25580321

Odubamowo, K. H.; Akinpelu, O. M.; Lawal, O. O.; Okolo, C. A.; Odukogbe, A. A.; Adekunle, A. O.

2014-01-01

413

Misdiagnosis of bilateral tubal pregnancy: a case report  

PubMed Central

Introduction The incidence of bilateral tubal pregnancy is rising due to the increase of pelvic inflammatory disease and assisted reproductive techniques. Because the clinical manifestations of bilateral tubal pregnancy are not specific, we often ignore inspection of the other fallopian tube when focusing on the lesions, which may cause misdiagnosis. Case presentation A 33-year-old Chinese woman presented with vaginal bleeding after menopause and with an abnormality found by transvaginal ultrasound scan for which she underwent laparoscopy and salpingectomy. Unfortunately, she had to undergo a repetitive laparoscopic salpingotomy for the other tubal pregnancy due to misdiagnosis of her bilateral tubal pregnancy. Conclusions The incidence of unusual presentations of ectopic pregnancies has risen. Surgeons should always keep in mind the possibility of bilateral tubal pregnancy. An attentive examination of the pelvis, especially the two fallopian tubes, is necessary to avoid missing bilateral tubal pregnancy. PMID:25312677

2014-01-01

414

Interrelationships Between Maternal Carotenoid Status and Newborn Infant Macular Pigment Optical Density and Carotenoid Status  

PubMed Central

Purpose. Deposition of the macular pigment carotenoids lutein and zeaxanthin in the human retina occurs early in life. In this study, we examined the interrelationships of maternal carotenoid status and newborn infant macular pigment levels and systemic carotenoid status. As a secondary measure, we also evaluated the effects of intrauterine growth restriction (IUGR) on carotenoid status in term newborn infants. Methods. We measured mother and infant skin carotenoids using resonance Raman spectroscopy (RRS), serum carotenoids by HPLC, and mother breast milk carotenoids by HPLC. We measured infant macular pigment levels using noninvasive blue light reflectometry. Results. We enrolled 30 healthy term infants, their mothers, and 10 IUGR infants and their mothers. A subset of 16 infants was imaged for macular pigment optical density (MPOD). Infant serum zeaxanthin levels correlated with MPOD (r = 0.68, P = 0.007). Mother serum zeaxanthin levels correlated with infant MPOD (r = 0.59, P = 0.032). Infant and mother serum lutein did not correlate with MPOD. Mother–infant correlations were found for total serum carotenoids (r = 0.42, P = 0.020) and skin carotenoids (r = 0.48, P = 0.001). No difference was seen between IUGR infants and controls in total serum or skin carotenoids. Mothers of IUGR infants had lower total serum carotenoids (P = 0.019) and breast milk carotenoids than controls (P = 0.006). Conclusions. Our findings suggest that maternal zeaxanthin status may play a more important role than lutein status in macular pigment deposition in utero. Controlled trials are needed to determine whether maternal zeaxanthin prenatal supplementation can raise infant macular pigment levels and/or improve ocular function. PMID:23838770

Henriksen, Bradley S.; Chan, Gary; Hoffman, Robert O.; Sharifzadeh, Mohsen; Ermakov, Igor V.; Gellermann, Werner; Bernstein, Paul S.

2013-01-01

415

The Heritability of Macular Response to Supplemental Lutein and Zeaxanthin: A Classic Twin Study  

PubMed Central

Purpose. Antioxidant supplements may reduce age-related macular degeneration (AMD) progression. The macular carotenoids are of particular interest because of their biochemical, optical, and anatomic properties. This classic twin study was designed to determine the heritability of macular pigment (MP) augmentation in response to supplemental lutein (L) and zeaxanthin (Z). Methods. A total of 322 healthy female twin volunteers, aged 16–50 years (mean 40 ± 8.7) was enrolled in a prospective, nonrandomized supplement study. Macular pigment optical density (MPOD) measurements using two techniques (2-wavelength fundus autofluorescence [AF] and heterochromatic flicker photometry [HFP]), and serum concentrations of L and Z, were recorded at baseline, and at 3 and 6 months following daily supplementation with 18 mg L and 2.4 mg Z for a study period of 6 months. Results. At baseline, mean MPOD was 0.44 density units (SD 0.21, range 0.04–1.25) using HFP, and 0.41 density units (SD 0.15) using AF. Serum L and Z levels were raised significantly from baseline following 3 months' supplementation (mean increase 223% and 633%, respectively, P < 0.0001 for both), with no MPOD increase. After 6 months' supplementation, a small increase in MPOD was seen (mean increase 0.025 ± 0.16, P = 0.02, using HFP). Subdivision of baseline MPOD into quartiles revealed that baseline levels made no difference to the treatment effect. Genetic factors explained 27% (95% confidence interval [CI] 7–45) of the variation in MPOD response. Distribution profiles of macular pigment did not change in response to supplementation. Conclusions. MPOD response to supplemental L and Z for a period of 6 months was small (an increase over baseline of 5.7% and 3.7%, measured using HFP and AF, respectively), and was moderately heritable. Further study is indicated to investigate the functional and clinical impact of supplementation with the macular carotenoids. PMID:22700713

Hammond, Christopher J.; Liew, S. H. Melissa; Van Kuijk, Frederik J.; Beatty, Stephen; Nolan, John M.; Spector, Tim D.; Gilbert, Clare E.

2012-01-01

416

Intravitreal triamcinolone injection for chronic diabetic macular oedema with severe hard exudates  

Microsoft Academic Search

Background  The purpose of the study was to determine the efficacy and safety of intravitreal triamcinolone acetonide (TA) in chronic\\u000a diabetic macular oedema with severe hard exudates.\\u000a \\u000a \\u000a \\u000a Methods  This prospective, interventional consecutive case series study consisted of 33 eyes of 28 patients with chronic diabetic macular\\u000a oedema and severe foveal hard exudates who received an intravitreal injection of 4 mg of TA. The

Remzi Avci; Berkant Kaderli

2006-01-01

417

Methods of processing biomedical image of retinal macular region of the eye  

NASA Astrophysics Data System (ADS)

In this paper we report a new method for determination of macular area of the retina obtained by optical coherent tomography (OCT). A novel program of image processing was developed for this purpose. The improved efficiency of proposed tools and it accuracy in the determination of the parameters in the macular area was checked by comparison of results with the standard procedure of processing of the biomedical images of this class. All calculation were obtained from the retina tomograms by using coherent optical topographic scanner STRATUS OCT 3000

Pavlov, S. V.; Vassilenko, V. B.; Vovkotrub, D. V.; Poplavskaya, A. A.; Hotra, O.

2013-01-01

418

Safety and Efficacy of Ranibizumab in Macular Edema following Retinal Vein Occlusion  

PubMed Central

Macular edema is the leading cause of visual impairment in patients with retinal vein occlusion. Limited improvements may be obtained with laser photocoagulation or intravitreal triamcinolone. However, according to the data provided by randomized clinical trials, intravitreal injections of ranibizumab (Lucentis; Genentech, South San Francisco, CA) constitute a new effective and safe option for the management of these vision-threatening diseases. The aim of the present review is to summarize the clinical evidence of ranibizumab for macular edema due to retinal vein occlusions. PMID:23650454

Gallego-Pinazo, Roberto; Dolz-Marco, Rosa; Marín-Lambíes, Cristina; Díaz-Llopis, Manuel

2012-01-01

419

Spontaneous Closure of a Full-Thickness Stage 2 Idiopathic Macular Hole without Posterior Vitreous Detachment  

PubMed Central

Objective We report a 50-year-old female patient with a stage 2 idiopathic macular hole that closed spontaneously. Method The case is presented on the basis of an observational case report. Results The stage 2 idiopathic macular hole closed spontaneously in 6 weeks with a lamellar defect in the outer retina due to the formation of the bridging retinal tissue, but without any evidence of the common mechanisms of spontaneous closure such as posterior vitreous detachment or epiretinal membrane formation. PMID:24348401

Kelkar, Aditya Shreekant; Bhanushali, Devanshi Ramji; Kelkar, Jai Aditya; Shah, Rachana Bharat; Kelkar, Shreekant Bhaskar

2013-01-01

420

Spontaneous resolution of grade 2 macular hole observed with optical coherence tomography  

PubMed Central

A 56-year-old woman presented with decreased vision and metamorphopsia in her left eye for 3 months. She received a diagnosis of stage 2 idiopathic macular hole in her left eye, which was made with a tomographic image of a full-thickness dehiscence of the neurosensory retina at the fovea. The posterior hyaloid membrane was adhering to the edge of the dehiscence. After a 6-month follow-up period, spontaneous resolution of the macular hole was observed with good visual recovery; all of this clearly demonstrated by optical coherence tomography. The posterior hyaloid membrane was fully separated from the fovea with restoration of almost normal foveal contour. PMID:22798094

Shrestha, Sachet Prabhat; Arora, Reema

2010-01-01

421

Vitreo-retinal interface changes on optical coherence tomography in the fellow eyes of patients with macular hole  

PubMed Central

AIM To study the vitreo-retinal interface and macular changes on optical coherence tomography (OCT) in the fellow eyes of patients with macular hole. METHODS Patients with idiopathic macular hole in one or both eyes presented to our institute between January 2003 and December 2009 were evaluated retrospectively. Demographic details, best-corrected visual acuity and vitreo-retinal interface, and macular changes of the fellow eye on OCT were studied. RESULTS Seventy patients underwent OCT of both eyes during the study period. The average age group was 61.96 years and 35 (50%) were females. Among the fellow eyes, normal foveal contour was noted in 36 (51.4%) eyes and 34 (48.6%) eyes were observed to have vitreo-retinal interface changes. Of them, 13 (18.6%) eyes had some stage of full thickness macular hole and 21 (30.0%) eyes had interface changes. There was no statistical correlation between involved eye lesions (P=0.64) or visual acuity (P=0.55) as predictors of development of either fellow eye lesions or poor visual acuity. CONCLUSION There is a significant chance of having vitreo-retinal interface findings in the fellow eyes of patients presenting with macular hole. OCT should be considered in both eyes of patients with macular hole to detect early changes in the fellow eyes, which may require an early intervention. PMID:23991391

Majji, Ajit Babu; Chhablani, Jay Kumar; Bagga, Bupesh

2013-01-01

422

Long-Term Outcome after Vitrectomy for Macular Edema with Retinal Vein Occlusion Dividing into the Occlusion Site  

PubMed Central

Purpose. To investigate the efficacy of treatment for macular edema secondary to retinal vein occlusion (RVO) with vitrectomy. Methods. This retrospective study identified patients with macular edema associated with RVO between January 2004 and April 2006. Inclusion criteria were eyes with (1) preoperative visual acuity (VA) of 20/40 or worse, (2) a central foveal thickness (CFT) greater than 250??m, and (3) vitrectomy with internal limiting membrane and intravitreal triamcinolone acetonide. Each patient had their RVO classified as a major or macular BRVO or hemispheric RVO (HSRVO). Results. Forty-six eyes with major BRVO, 18 eyes with macular BRVO, and 17 eyes with HSRVO were investigated. VA was significantly improved at 24 months after surgery for each group (P < 0.05). Vision in the macular BRVO group 24 months after surgery was significantly better than that in other groups (P < 0.05). For each group, a concomitant reduction of CFT was noted at every time point when compared to preoperative values (P < 0.001). Conclusions. In macular BRVO, the postoperative vision 24 months after surgery was significantly better than the other groups. These findings suggest that additional and earlier treatments might be more important for patients with major BRVO and HSRVO than for those with macular BRVO. PMID:25371814

Iwase, Takeshi; Oveson, Brian C.

2014-01-01

423

Macular hole formation and spontaneous closure after vitrectomy for vitreomacular traction documented in spectral-domain optical coherence tomography  

PubMed Central

Background We present a case of a macular hole formation and its spontaneous closure after vitrectomy for vitreomacular traction. To our knowledge, it is the first description of spontaneous closure of the macular hole after vitrectomy for vitreomacular traction. Case presentation A 78-year-old woman presented decreased visual acuity and metamorphopsia in the right eye due to vitreomacular traction. A vitrectomy with internal limiting membrane peeling and an air tamponade was performed in the right eye. Spectral-domain optical coherence tomography was obtained during all visits. Seven days after the vitrectomy, the spectral-domain optical coherence tomography showed a resolved vitreomacular traction and a full-thickness macular hole. Examination after a further three weeks showed that the full-thickness macular hole had spontaneously closed. 5 months later spectral-domain optical coherence tomography showed a normal foveal contour without intraretinal microcystic spaces and a resolution of the photoreceptor and external limiting membrane elevation. Conclusions While performing a vitrectomy for vitreomacular traction posterior hyaloid membrane creates anterior-posterior traction on the fovea, and, during detachment, retinal layer damage occurs in the macular area and a full-thickness macular hole may develop. Removal of the anterio-posterior vitreous traction may play the main role and may help the spontaneous closure of the macular hole after vitrectomy for vitreomacular traction. PMID:24552161

2014-01-01

424

Genetic risk factors and age-related macular degeneration (AMD)  

PubMed Central

Age related macular degeneration (AMD) is the leading cause of blindness in individuals older than 65 years of age. It is a multifactorial disorder and identification of risk factors enables individuals to make lifestyle choices that may reduce the risk of disease. Collaboration between geneticists, ophthalmologists, and optometrists suggests that genetic risk factors play a more significant role in AMD than previously thought. The most important genes are associated with immune system modulation and the complement system, e.g., complement factor H (CFH), factor B (CFB), factor C3, and serpin peptidase inhibitor (SERPING1). Genes associated with membrane transport, e.g., ATP-binding cassette protein (ABCR) and voltage-dependent calcium channel gamma 3 (CACNG3), the vascular system, e.g., fibroblast growth factor 2 (FGF2), fibulin-5, lysyl oxidase-like gene (LOXL1) and selectin-P (SELP), and with lipid metabolism, e.g., apolipoprotein E (APOE) and hepatic lipase (LIPC) have also been implicated. In addition, several other genes exhibit some statistical association with AMD, e.g., age-related maculopathy susceptibility protein 2 (ARMS2) and DNA excision repair protein gene (ERCC6) but more research is needed to establish their significance. Modifiable risk factors for AMD should be discussed with patients whose lifestyle and/or family history place them in an increased risk category. Furthermore, calculation of AMD risk using current models should be recommended as a tool for patient education. It is likely that AMD management in future will be increasingly influenced by assessment of genetic risk as such screening methods become more widely available.

Mousavi, Maryam; Armstrong, Richard A.

2013-01-01

425

A Model of Best Vitelliform Macular Dystrophy in Rats  

PubMed Central

PURPOSE The VMD2 gene, mutated in Best macular dystrophy (BMD) encodes bestrophin, a 68-kDa basolateral plasma membrane protein expressed in retinal pigment epithelial (RPE) cells. BMD is characterized by a depressed light peak (LP) in the electro-oculogram. Bestrophin is thought to be the Cl channel that generates the LP. The goal was to generate an animal model of BMD and to determine the effects of bestrophin overexpression on the RPE-generated components of the ERG. METHODS Bestrophin or bestrophin mutants (W93C or R218C) were overexpressed in the RPE of rats by injection of replication-defective adenovirus. Immunofluorescence microscopy and ERG recordings were used to study subsequent effects. RESULTS Bestrophin was confined to the basolateral plasma membrane of the RPE. Neither wild-type (wt) nor mutant bestrophin affected the a- or b-waves of the ERG. Wt bestrophin, however, increased the c-wave and fast oscillation (FO), but not the LP. In contrast, both mutants had little or no effect on the c-wave and FO, but did reduce LP amplitude. LP amplitudes across a range of stimuli were not altered by wt bestrophin, though the luminance response function was desensitized. LP response functions were unaffected by bestrophin R218C but were significantly altered by bestrophin W93C. CONCLUSIONS A model of BMD was developed in the present study. Because overexpression of wt bestrophin shifted luminance response but did not alter the range of LP response amplitudes, the authors conclude that the rate-limiting step for generating LP amplitude occurs before activation of bestrophin or that bestrophin does not directly generate the LP conductance. PMID:15452084

Marmorstein, Alan D.; Stanton, J. Brett; Yocom, John; Bakall, Benjamin; Schiavone, Marc T.; Wadelius, Claes; Marmorstein, Lihua Y.; Peachey, Neal S.

2010-01-01

426

Outcomes of Penetrating Keratoplasty for Macular Corneal Dystrophy  

PubMed Central

Purpose To report the outcomes of penetrating keratoplasty (PKP) in patients with macular corneal dystrophy (MCD). Methods This retrospective case series includes consecutive patients with MCD who underwent PKP from 1986 to 2006 with at least 6 months’ follow-up. Main outcome measures included best spectacle-corrected visual acuity (BSCVA), postoperative astigmatism and graft survival. Results Sixty-two eyes of 39 patients with mean age of 34.0±10.5 (range 13–58) years at the time of keratoplasty were included for analysis. After a mean follow-up period of 52.0±47.3 (range 6–190) months, BSCVA improved from 1.4±0.4 logMAR (4/100) preoperatively to 0.2±0.3 logMAR (20/32) at final follow-up (P<0.001).Mean postoperative BSCVA was 0.15±0.40 logMAR in patients (36 eyes) aged less than 35 years at the time of surgery as compared to 0.26±0.25 logMAR in subjects (26 eyes) older than 35 years (P=0.005). Final astigmatism was comparable with different suturing techniques including separate, continuous, and combined sutures (P=0.9). All grafts were clear at final follow-up except a single case of MCD with visually insignificant recurrence.Episodes of immunologic graft rejection occurred in 12 eyes (19.4%) but none led to graft failure. Conclusion PKP for MCD entails favorable outcomes in terms of graft survival and visual improvement. Final visual acuity seems to be better when transplantation is performed before the age of 35 years. PMID:23056668

Karimian, Farid; Baradaran-Rafii, Ali-Reza; Feizi, Sepehr; Zare, Mohammad; Jafarinasab, Mohammad-Reza; Javadi, Mohammad-Ali; Mirdehghan, S. Ali; Einollahi, Bahram

2009-01-01

427

Nutritional Modulation of Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly worldwide. It affects 30–50 million individuals and clinical hallmarks of AMD are observed in at least one third of persons over the age of 75 in industrialized countries (Gehrs et al., 2006). Costs associated with AMD are in excess of $340 billion US (American-Health-Assistance-Foundation, 2012). The majority of AMD patients in the United States are not eligible for clinical treatments (Biarnes et al., 2011; Klein et al., 2011). Preventive interventions through dietary modulation are attractive strategies because many studies suggest a benefit of micro and macronutrients with respect to AMD, as well as other age-related debilities, and with few, if any, adverse effects (Chiu, 2011). Preservation of vision would enhance quality of life for millions of elderly people, and alleviate the personal and public health financial burden of AMD (Frick et al., 2007; Wood et al., 2011). Observational studies indicate that maintaining adequate levels of omega-3 fatty acids (i.e. with 2 servings/wk of fish) or a low glycemic index diet may be particularly beneficial for early AMD and that higher levels of carotenoids may be protective, most probably, against neovascular AMD. Intervention trials are needed to better understand the full effect of these nutrients and/or combinations of nutrients on retinal health. Analyses that describe effects of a nutrient on onset and/or progress of AMD are valuable because they indicate the value of a nutrient to arrest AMD at the early stages. This comprehensive summary provides essential information about the value of nutrients with regard to diminishing risk for onset or progress of AMD and can serve as a guide until data from ongoing intervention trials are available. PMID:22503690

Weikel, Karen A; Taylor, Allen

2012-01-01

428

Bilateral topographic symmetry patterns across Aphrodite Terra, Venus  

NASA Technical Reports Server (NTRS)

Topographic profiles have been obtained across Aphrodite Terra to test for bilateral symmetry of the type associated with thermal boundary layer topography at divergent plate boundaries on earth. In addition to a broad bilateral symmetry at a range of angles across Aphrodite Terra, detailed bilateral symmetry is noted within domains between linear discontinuities in directions parallel to the strike of the discontinuities. The results suggest that western Aphrodite Terra is similar to terrestrial oceanic divergent plate boundary environments, and that the cross-strike discontinuities are analogous to oceanic fracture zones rather than strike-slip faults.

Crumpler, L. S.; Head, James W.

1988-01-01

429

Bilateral Tibial Tubercle Sleeve Fractures in a Skeletally Immature Patient  

PubMed Central

Tibial tubercle sleeve fracture is a rare injury. In concept, it is similar to the patellar sleeve fracture in a skeletally immature patient. We describe a unique case of simultaneous bilateral tibial tubercle sleeve fractures in a 12-year-old boy. Radiographs and MRI confirmed the injury. The patient underwent open surgical repair of bilateral sleeve fractures with suture anchor fixation. At the final followup, 3 years after his initial injury, the patient demonstrated full knee function bilaterally without radiographic evidence of growth disturbances. PMID:23691395

Desai, Rasesh R.; Parikh, Shital N.

2013-01-01

430

[Simultaneous bilateral primary lymphomatous tumors of the testis].  

PubMed

Among the malignant tumours of the gonads, primary lymphoma of the testis represents a rare pathology. It is even more rare to observe this pathology in a bilateral localisation. After a careful evaluation of the cases described in the literature, the authors report a case or primary synchronous and bilateral lymphoma of the testis in a 68-year-old patient; they examine the clinical data and diagnostic methods and analyse the surgical treatment. In conclusion the authors affirm that primary synchronous bilateral lymphoma of the testis represents a rare form of tumour which is burdened by a high mortality rate. PMID:8322114

Vadalà, G; Basile, G; Altamore, S; Mauceri, M; Mangiameli, A; Roveccio, S; Bartoluccio, R

1993-03-01

431

Bilateral transient osteoporosis of the talus in pregnancy.  

PubMed

We present the case of bilateral transient osteoporosis of the talus in pregnancy, which is rarely reported in the medical literature, confirmed by pre- and postpartum MRI.A gravid 33-year-old white female G4P2A1 with bilateral transient osteoporosis of the talus confirmed by magnetic resonance imaging (MRI) is presented. She was conservatively managed and had clinical resolution several weeks postpartum. A follow-up MRI confirmed improvement in bilateral talus consistent with the natural course of transient osteoporosis. PMID:19343470

Daniel, R S; Farrar, E K; Norton, H R; Nussbaum, A I

2009-11-01

432

Anton's Syndrome due to Bilateral Ischemic Occipital Lobe Strokes  

PubMed Central

We present a case of a patient with Anton's syndrome (i.e., visual anosognosia with confabulations), who developed bilateral occipital lobe infarct. Bilateral occipital brain damage results in blindness, and patients start to confabulate to fill in the missing sensory input. In addition, the patient occasionally becomes agitated and talks to himself, which indicates that, besides Anton's syndrome, he might have had Charles Bonnet syndrome, characterized by both visual loss and hallucinations. Anton syndrome, is not so frequent condition and is most commonly caused by ischemic stroke. In this particular case, the patient had successive bilateral occipital ischemia as a result of massive stenoses of head and neck arteries. PMID:25530893

Zuki?, Sanela; Sinanovi?, Osman; Hodži?, Renata; Mujagi?, Svjetlana; Smajlovi?, Edina

2014-01-01

433

Reconstruction of bilateral tendoachilles with fascia lata graft.  

PubMed

A 19 year old male presented with progressive enlargement of both tendoachilles for 2 years and difficulty in walking for 3 months. The neurological history and examination revealed progressive mental deterioration and ataxia. The blood investigation revealed hypercholesterolemia. We report this rare case of cerebrotendinous xanthomatosis with bilateral tendoachilles enlargement, which was treated by excision of bilateral tendoachilles and reconstruction with fascia lata. The American Orthopedic Foot and Ankle Society hindfoot score was 93/100 bilaterally and the subjective evaluation of the patient showed very good results. PMID:24379473

Saxena, Vikas; Pradhan, Pavan; Yadav, Ashok; Nathani, Neeraj

2013-11-01

434

Case report: bilateral ankle pain in an aerobic dancer.  

PubMed

A 32-yr-old female presented to Sports Clinic with bilateral ankle pain and swelling following the initiation of an aerobic dance program 3 months earlier. Physical exam revealed bilateral ankle edema and the recent appearance of discrete tender nodules on her anterior tibias, consistent with erythema nodosum (EN). As part of her evaluation, chest radiographs were performed and demonstrated bilateral hilar adenopathy. This case discusses the evaluation of the patient with joint involvement, EN, and hilar adenopathy. The increased accessibility of sports medicine clinics makes it incumbent on the physician to be familiar with a wide range of differential diagnoses. PMID:1470012

Green, G A; Maltz, B A

1992-12-01

435

Fast bilateral filter with arbitrary range and domain kernels.  

PubMed

In this paper, we present a fast implementation of the bilateral filter with arbitrary range and domain kernels. It is based on the histogram-based fast bilateral filter approximation that uses uniform box as the domain kernel. Instead of using a single box kernel, multiple box kernels are used and optimally combined to approximate an arbitrary domain kernel. The method achieves better approximation of the bilateral filter compared to the single box kernel version with little increase in computational complexity. We also derive the optimal kernel size when a single box kernel is used. PMID:21411406

Gunturk, Bahadir K

2011-09-01

436

Catamenial pneumothorax due to bilateral pulmonary endometriosis.  

PubMed

Co-existence of catamenial pneumothorax and hemoptysis is rare. We present a case of catamenial pneumothorax due to bilateral pulmonary endometriosis in a 45-year-old woman. The patient presented with a 3-year history of intermittent productive cough with blood-tinged sputum, chronic anemia, loss of appetite, and general weakness associated with menstruation. Three years prior to this presentation the patient had undergone a sigmoidectomy as treatment for endometriosis of the sigmoid colon with bleeding. Chest radiographs and computed tomography (CT) scan revealed multiple nodules in both lung parenchyma and recurrent pneumothorax. CT-guided biopsy revealed chronic inflammation of those pulmonary nodules, and laboratory studies disclosed elevated serum levels of carbohydrate antigen 19-9 (CA 19-9) and CA 125. Thoracoscopic wedge resection of the pulmonary nodules was performed, and histopathological examination of the resected nodules revealed endometriosis. At one-year follow-up there was no evidence of recurrence of gastrointestinal bleeding or pneumothorax. PMID:22273501

Fang, Hsin-Yuan; Jan, Chia-Ing; Chen, Chien-Kuang; Chen, William Tzu-Liang

2012-07-01

437

Bilateral Chylhotorax after Falling from Height  

PubMed Central

Chylothorax is accumulation of chyle in the pleural cavity due to disruption of the thoracic duct. The causes can be classified as neoplastic, traumatic (iatrogenic or noniatrogenic), congenital, sporadic, spontaneous, and miscellaneous. A 22-year-old man with no feature in his history and family history was referred to emergency department with the case of falling from height. Abdominal computed tomogram (CT) revealed laceration of liver, grade 5 splenic laceration, fracture of the left acetabulum, and dislocation of the left hip. He was optimized for emergency splenectomy and close left hip reduction. On the 2nd day of the operation, bilateral chylotorax revealed. The treatment depends on its etiology, the amount of drainage, and the clinical picture. Treatment can be classified into 3 categories treatment of the underlying condition, conservative management (such as bed rest, nil by mouth or low fat medium chain triglycerides by mouth and total parenteral nutrition), and surgical management by ligation or clipping of the thoracic duct with open thoracotomy or video-assisted thoracoscopic surgery. The main purpose of surgical treatment is to stop the chylous leak. PMID:25089210

Akpinar, Vildan; Duran, Fulya Yilmaz; Duman, Elif; Özkalkanli, Murat Yasar; Duran, Özgür; Horsanali, Burcu

2014-01-01

438

From bilateral to multi-countries cooperation  

NASA Astrophysics Data System (ADS)

In 2010, the Office for Science and Technology of the French Embassy in Washington DC provided seed funding to enable a new scientific collaboration between the US and France. The work primarily focuses on the understanding of the interaction of particles with the DNA. The National Society of Black Physicists managed the funds. This so-called G4TRAP work is an extension of the ESA-funded G4DNA project that uses the Geant4 Monte Carlo toolkit and is spearheaded by the University of Bordeaux 1 in France. This initiative spawns to new areas (ultrafast lasers, nuclear/high energy physics, radiation biology and space science) and includes US industries, thanks to the interdisciplinary activities needed to advance this project. In addition, the bi-lateral collaboration was expanded to two other countries: Canada and Senegal. Subsequent funding requests were made to US agencies (NSF and DoE) as well as other French programs. More are anticipated that will also include NIH, NASA and the Canadian programs. A review of this multidisciplinary effort will be presented along with the present status on the various aspects of the G4TRAP project.

Gueye, Paul

2011-04-01

439

Long-term follow-up after vitrectomy to treat idiopathic full-thickness macular holes: visual acuity and macular complications  

PubMed Central

Background To assess time-course changes in best-corrected visual acuity (BCVA) up to 5 years after vitrectomy to treat idiopathic full-thickness macular holes (MHs) and identify the relationship of the changes to postoperative complications. Methods Twenty-three consecutive patients with an idiopathic MH underwent vitrectomy without adjuvant treatment. BCVA and complications were assessed postoperatively. Results Twenty-two of 23 (95.7%) MHs closed after the first surgery, with a final anatomic success rate of 100%. The time course of the BCVA was analyzed in 20 cases in which data were obtained for over 5 years. The BCVA improved by 0.43 logarithm of the minimum angle of resolution (logMAR) unit 6 months postoperatively (P < 0.001) and continuously improved by 0.05, 0.06, and 0.07 logMAR units between 6 months and 1 year, 1 year and 3 years (by 0.11 logMAR unit between 6 months and 3 years; P = 0.049), and 3 years and 5 years (P = 0.018) postoperatively, respectively. Macular complications developed in seven (35%) of the 20 cases; the mean BCVA at 5 years in these cases was significantly (P < 0.001) worse than in cases without complications. Conclusion The BCVA might improve gradually for 5 years after vitrectomy to treat MHs. However, the macular complications that can develop postoperatively could limit that possibility. PMID:22927740

Sakaguchi, Hirokazu; Ohji, Masahito; Oshima, Yusuke; Ikuno, Yasushi; Gomi, Fumi; Maeda, Naoyuki; Kamei, Motohiro; Kusaka, Shunji; Nishida, Kohji

2012-01-01

440

Intravitreal Aflibercept Outcomes in Patients with Persistent Macular Exudate Previously Treated with Bevacizumab and/or Ranibizumab for Neovascular Age-Related Macular Degeneration  

PubMed Central

Purpose. To assess whether intravitreal aflibercept (2.0?mg) can effectively reduce persistent macular exudate and enhance visual acuity in ranibizumab (0.5?mg) and/or bevacizumab (1.25?mg) treatment resistant patients with neovascular age-related macular degeneration. Methods. This retrospective study included 47 treatment resistant eyes from 47 patients switched to intravitreal aflibercept injections after receiving a minimum of 3 injections with either ranibizumab or bevacizumab. Snellen visual acuity and optical coherence tomography were assessed just prior to the first injection (baseline) and prior to the fourth injection (final). Additionally, anatomical regions of persistent macular exudate were tracked to determine if these areas yielded varying responses to aflibercept. Results. At baseline, patients had received an average of 11.3 injections with any prior anti-VEGF drug (SD 5.96). For whole group analysis, baseline and final central retinal thickness were 370.57?µm and 295.7?µm (P ? .001), respectively. Baseline and final retinal fluid volumes were 4.81?mm3 and 4.37?mm3 (P ? .001), respectively. Baseline and final logMAR were 0.56 and 0.53 (P = 0.301), respectively. Anatomic location of persistent exudate did not appreciably alter treatment outcome. Conclusion. Central retinal thickness and total retinal fluid volume were reduced in ranibizumab and/or bevacizumab treatment resistant patients following three aflibercept injections. No appreciable change in visual acuity was noted. PMID:25505976

Griffin, David R.; Richmond, Preston P.; Olson, John C.

2014-01-01

441

Fruits and vegetables that are sources for lutein and zeaxanthin: the macular pigment in human eyes  

Microsoft Academic Search

BACKGROUNDIt has been suggested that eating green leafy vegetables, which are rich in lutein and zeaxanthin, may decrease the risk for age related macular degeneration. The goal of this study was to analyse various fruits and vegetables to establish which ones contain lutein and\\/or zeaxanthin and can serve as possible dietary supplements for these carotenoids.METHODSHomogenates of 33 fruits and vegetables,

Olaf Sommerburg; Jan E E Keunen; Alan C Bird; Frederik J G M van Kuijk

1998-01-01

442

Candidate gene study of macular response to supplemental lutein and zeaxanthin.  

PubMed

Supplementation with carotenoids is proposed to protect against age-related macular degeneration. There is, however, considerable variability in retinal macular pigment response, which may be due to underlying genetic variation. The purpose of this study was to determine whether genetic factors, which have been previously associated with cross-sectional macular pigment levels in the retina or serum lutein, also influence response to supplementation. To this end we conducted an association study in 310 subjects from the TwinsUK cohort between variants in 8 candidate genes and serum lutein and retinal macular pigment optical density (MPOD) levels before and after supplementation. Four variants were associated with MPOD response to supplementation (p < 0.05): rs11057841 (SCARB1), rs4926339 (RPE65), rs1929841 (ABCA1) and rs174534 (FADS1). We also confirmed previous associations between rs6564851 near BMCO1 (p < 0.001) and rs11057841 within SCARB1 (p = 0.01) and baseline measures of serum lutein; while the latter was also associated with MPOD response, none of the BMCO1 variants were. Finally, there was evidence for association between variants near RPE65 and ELOVL2 and changes in lutein concentration after supplementation. This study is the first to show association between genetic variants and response to carotenoids supplementation. Our findings suggest an important link between MP response and the biological processes of carotenoids transport and fatty acid metabolism.