Seminars in ophthalmology

Publisher: Taylor & Francis

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  • Impact factor
    1.09
  • 5-year impact
    0.00
  • Cited half-life
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  • Other titles
    Seminars in ophthalmology (Online)
  • ISSN
    1744-5205
  • OCLC
    49941701
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

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Taylor & Francis

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Publications in this journal

  • Seminars in ophthalmology 06/2014;
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    ABSTRACT: Abstract An unruptured giant intracranial aneurysm of the internal carotid artery may tend to present with late ocular symptoms. This is the case of a 58-year-old female patient with a giant unruptured aneurysm of the right internal carotid artery. The patient presented with exclusively progressive reduction of visual acuity and visual field defects due to the mass effect of the growing aneurysm. The rupture of the aneurysm occurred before planned treatment. Clinical suspicion and timely recognition as well as prompt treatment play an important role in the final outcome of the management of giant unruptured intracerebral aneurysms.
    Seminars in ophthalmology 05/2014;
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    ABSTRACT: Abstract The aim of this study was to compare morphologic, electrophysiologic, and visual function parameters in non-glaucomatous cupping of prematurity to those of controls. Twenty children (7 to 18 years) with non-glaucomatous cupping of prematurity were prospectively recruited, along with 20 controls. Visual function parameters, retinal nerve fiber layer (RNFL) thickness, and visual evoked potentials (VEP) parameters were measured. RNFL thickness was reduced in children with non-glaucomatous cupping of prematurity compared with controls. VEP P100 amplitude was significantly lower in children with non-glaucomatous cupping of prematurity than in the control group. Kinetic perimetry visual fields were normal in all but one patient. Static perimetry revealed increased overall pattern defect in children with non-glaucomatous cupping of prematurity compared with controls. Despite these morphological, electrophysiological, and subtle visual field defects, many other visual function parameters, such as visual acuity, color vision, and contrast sensitivity, appear similar to normal controls.
    Seminars in ophthalmology 05/2014;
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    ABSTRACT: Abstract Objectives: To show normative data of optic discs and the mechanism of glaucoma in people with myopia. Design: Cross-sectional study. Participants: This study investigated 89 Korean adults with myopia but without glaucoma. Methods: Patients were divided into three groups according to the refractive error: low, moderate, and high; and axial length: normal or below normal length, moderately long, and extremely long. Optic disc variables were obtained by confocal scanning laser ophthalmoscope and compared among groups. Results: The optic disc parameters have a correlation between the refractive error and the optic disc parameters such as average depth, volume below, and half-depth volume. Those parameters also decreased as the axial length increased. The thickness of the volume above decreased significantly as the axial length increased, but a similar relationship was not evident with the refractive error change. In addition, the optic disc parameters were analyzed with respect to the 12 clockwise directions. Conclusions: Analyses of optic disc parameters provided by TopSS™ revealed the height of the disc decreased as the myopic refractive error and/or axial length increased. The RNFL bundle became compacted in the thinner disc of the myopic population. This could be an explanation for the fragility of the RNFL in the myopic population. The 12 radial section analyses revealed the shallow cupping at the temporal side in the high-myopic, very-long-axis group. The neuroretinal rim (NRR) height significantly decreased at the superior and inferior sides. These findings suggest that the RNFL bundle should be under high mechanical strain in these sectors.
    Seminars in ophthalmology 05/2014;
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    ABSTRACT: Abstract Purpose: To characterize the prevalence of refractive error and amblyopia among three- to six-year-old children during the period from 2002 to 2011. Methods: About 31,400 children annually (from 16,592 to 40,816) during the period from 2002 to 2011 were enrolled. The preschool vision screening was performed by the Korean Foundation for the Prevention of Blindness (KFPB) annually during a period that extended from March to September. We reviewed the KFPB annual report about the home vision-screening test as performed during the period from 2002 to 2011. Changes in the prevalence and types of refractive error, strabismus, and amblyopia that manifested throughout this period were analyzed. Results: The prevalence of refractive errors ranged from 1.10% in 2002 to 0.42% in 2011. The prevalence of hyperopia and myopia changed little throughout the 10-year study period. Myopia and hyperopia were equally common among the population examined (χ(2)-test, p = 0.137). The prevalence of anisometropia decreased over time. The annual prevalence of amblyopia ranged from 0.39% to 0.06%, while the overall prevalence of amblyopia dropped from 0.25% in 2002 to 0.06% in 2011. The prevalence of strabismus was highest in 2006 (0.30%) and had decreased by 0.06% in 2011. The type of strabismus showed no significant difference over time (χ(2)-test, p = 0.579). Conclusions: The prevalence of amblyopia, refractive error, anisometropia, and strabismus was lower in 2011 than in early 2000. The prevalence of hyperopia and myopia as well as strabismus remained similar throughout the study period.
    Seminars in ophthalmology 05/2014;
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    ABSTRACT: Abstract Introduction: Previous cross-sectional studies suggested that plasma total homocysteine (tHcy) is associated with retinopathy in patients with type 1 diabetes (T1DM) only in cases of impaired renal function. The objective of this study was to examine whether there is an independent relationship between tHcy and retinopathy in normoalbuminuric T1DM patients with normal estimated glomerular filtration rate (eGFR). Methods: The study included 163 normoalbuminuric patients with T1DM and normal renal function (eGFR >60 ≤ 125 ml min(-1) 1.73 m(-2)). Urinary albumin excretion rate (UAE) was measured from at least two 24 h urine samples. Photodocumented retinopathy status was made according to the EURODIAB protocol. tHcy level was measured with the chemiluminescent immunoassay. Results: Retinopathy was present in 48% of normoalbuminuric patients. Patients with retinopathy were older (49 vs 42 years, p = 0.001), had higher systolic blood pressure (130 vs 120 mmHg, p = 0.001), triglycerides (0.89 vs 0.77 mmol/L, p = 0.01), tHcy (9.8 vs 9.1 µmol/L, p = 0.04), and lower eGFR (100 vs 106 ml min(-1) 1.73 m(-2), p = 0.03). In multivariate logistic regression analysis, after adjustment for variables that reached statistical significance in the univariate analysis, only tHcy was significantly associated with a risk of retinopathy in our subjects (p = 0.02), with odds ratios of 1.02 to 1.43. Conclusion: These data suggest that tHcy is independently associated with retinopathy in normoalbuminuric T1DM with normal eGFR. The mechanisms relating tHcy and retinopathy in T1DM are not clear. Prospectives studies are needed to confirm whether higher tHcy in normoalbuminuric T1DM patients has predictive value for development of retinopathy.
    Seminars in ophthalmology 05/2014;
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    ABSTRACT: Abstract Purpose: To compare the ability of the glaucoma probability score (GPS) and Moorfields regression analysis (MRA) using the Heidelberg Retina Tomograph (HRT) 3 to detect glaucoma in high myopia. Methods: Fifty-five eyes of highly myopic subjects (study group) and 139 eyes of non-highly myopic subjects (control group) were included. HRT images were obtained from all enrolled eyes, and agreement between GPS and MRA in all subjects, the study group, and the control group was established. Diagnostic performances of GPS and MRA were evaluated by including borderline classifications, either as test negatives (most specific criteria) or as test positives (least specific criteria). Results: The agreement between GPS and MRA in all enrolled eyes, the study group, and the control group was κ = 0.56, 0.50, and 0.58, respectively. In the study group, the AUC was 0.728 for GPS and 0.694 for MRA. In the control group, the AUC was 0.751 for GPS and 0.777 for MRA. With the most specific criteria, GPS showed 80.0% sensitivity and 60.0% specificity in the study group, and MRA showed 76.0% sensitivity and 63.3% specificity in the study group. With the least specific criteria, GPS showed 96.0% sensitivity and 40.0% specificity in the study group, and MRA showed 84.0% sensitivity and 40.0% specificity in the study group. Conclusions: In high myopia, GPS showed a high level of sensitivity with maintenance of specificity, compared with MRA using HRT 3. In addition, GPS had higher diagnostic performance than MRA in high myopia; however, there was no statistical difference between the AUC of GPS and MRA.
    Seminars in ophthalmology 04/2014;
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    ABSTRACT: Abstract In the United States, 5.5 million people over the age of 40 meet criteria for visual impairment (VI). They often suffer significant psychosocial and health consequences, including reduced quality of life and depression, which can be persistent and difficult to treat. Additionally, VI may increase the risk of suicide. We report a case of a patient with age-related macular degeneration (ARMD) and suicidal ideation. While this link is reasonable, there are no prior cases of suicidality among patients with ARMD. Moreover, the literature is silent regarding proper approaches to diagnosing and managing suicidality among patients with VI, especially ARMD.
    Seminars in ophthalmology 04/2014;
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    ABSTRACT: ABSTRACT Congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) is a rare tumor speculated to arise from the retinal pigment epithelium (RPE). A case of CSHRPE is presented herein along with the related literature. A healthy 20-year-old Middle-Eastern man was evaluated for an asymptomatic retinal lesion found on routine examination of his left eye. Fluorescein angiogram, spectral domain optical coherence tomography, and A and B scan ultrasonography confirmed the suspected clinical diagnosis. For the first time high-definition OCT images are shown, which have an RPE origin for this tumor.
    Seminars in ophthalmology 04/2014;
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    ABSTRACT: Abstract Background: To examine the efficacy and safety of combined phaco-trabeculectomy in patients with cataract and controlled, open-angle advanced glaucoma and to identify preoperative predictive factors of postoperative glaucoma course. Setting: Departments of Ophthalmology, University of Athens, and General Hospital of Lamia, Greece. Methods: Prospective, interventional, parallel, cluster (units = examinations), randomized clinical study. 60 patients with visually significant cataract, visual field Mean Deviation (MD) worse than -15.0 dB, and preoperative intraocular pressure (IOP), controlled (consistently below 22 mmHg) on topical medications and with no previous ocular surgery, were randomly allocated (1:1) to phacoemulsification alone or phaco-trabeculectomy group. Intention-to-treat analysis was performed to compare the postoperative outcome and adjusted multivariate longitudinal linear regression analysis was performed to identify predictive factors of the main outcome measures, with postoperative visual field MD change up to two years postoperatively. Participant recruiters and data collectors were masked to group assignment. Results: 31 and 29 patients were randomized to phacoemulsification alone and phaco-trabeculectomy groups, respectively. Patients assigned to the phaco-trabeculectomy group experienced a 1.7 mmHg [95% CI:-3.1 to -0.23] reduction in IOP, a 1.4 dB [95% CI: -0.17 to 2.96] improvement in visual fields MD, a 0.6 [95% CI: -1.2 to -0.05] reduction in the number of glaucoma medications needed postoperatively, while the visual acuity improvement was similar between the two groups. Best predictors for visual field MD: degree of nuclear sclerosis, relative afferent pupilary defect (RAPD), preoperative MD deviation from -19.0dB and preoperative cup-disc ratio deviation from 0.9. The phacoemulsification group experienced more IOP spikes (>25 mmHg) with Odds Ratio (OR) of 0.34 [95% CI: 0.11-1.02]. No patient lost light perception. Conclusion: Phaco-trabeculectomy in advanced, controlled, open-angle glaucoma patients with cataract results in better postoperative visual field MD with no major adverse events.
    Seminars in ophthalmology 03/2014;
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    ABSTRACT: Abstract Corticosteroids play an important role in the therapeutic approach to vitreoretinal disease. The Ozurdex® implant (DEX Implant 0.7 mg, Ozurdex®, Allergan Inc., Irvine, CA, USA) offers sustained release of dexamethasone in the vitreous cavity, and this novel drug delivery system has proven useful both in improving clinical outcomes and in reducing injection burden. While the Food and Drug Administration approves the use of the DEX implant in retinal vein occlusions and non-infectious posterior uveitis, its utilization continues to expand in its breadth of diversity across myriad vitreoretinal conditions. Additionally, modified injection techniques are evolving to improve the safety profile of the DEX implant in eyes that are often considered to have relative contraindications to its use, further extending its application. This review aims to evaluate the evidence supporting the expanding indications and injection techniques of the DEX sustained-release implant in vitreoretinal disease, and explores potential future indications for its use. Arenas for future research are also identified to further elucidate the precise role of the DEX implant in our current treatment model. Increased awareness of effective and safe uses of the DEX implant can refine our therapeutic approach to vitreoretinal disease and ultimately improve patient outcomes.
    Seminars in ophthalmology 03/2014;
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    ABSTRACT: Abstract Purpose: To report the efficacy of additional glaucoma drainage device (GDD) insertion in eyes with refractory glaucoma and which have a failed primary GDD. Methods: We conducted a non-comparative, retrospective study on eight eyes of eight patients who had a failed primary GDD and received an additional GDD in the same eye. Intraocular pressure (IOP), visual acuity (VA), the number of anti-glaucomatous medications, and complications were analyzed during the most recent office visit. Success was defined as an IOP between 6 and 21 mmHg and a 20% decrease in IOP after additional GDD insertion, with or without anti-glaucomatous medication. Results: The mean decrease in IOP at the final follow-up was 19.3 mmHg (56.1%). The mean number of anti-glaucomatous medications used at the final follow-up (2.38) was significantly less than the preoperative mean (3.50). Seven patients achieved the criteria for success, whereas one patient had an unsuccessful outcome because of corneal graft failure after additional GDD insertion. Conclusions: We showed that after the failure of a primary GDD, an additional GDD offered favorable IOP control and stable VA. In agreement with a review of previous literature, GDD insertion is the best option for treating refractory glaucoma, even in patients with a failed primary GDD.
    Seminars in ophthalmology 03/2014;
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    ABSTRACT: Abstract Aim: To investigate the role of some variables, including allergy and autoimmunity, in the pathogenesis of vernal keratoconjunctivitis (VKC). The VKC is a chronic and often severe form of bilateral keratoconjunctivitis. Usually, it begins during the first decade and disappears during the end of the second decade of life. Materials and methods: 26 patients with VKC were selected. The diagnosis was performed by the ophthalmologist through a score based on ocular signs and subjective symptoms before and after administration of 1% cyclosporine A (Cy) eyedrops. Each variable was graded: 0 = absent; 1 = mild; 2 = moderate; 3 = severe. Patients with a total score ≥7 were included in the study. Blood samples were collected at the initial time for the determination of autoimmunity by total IgE and antinuclear antibodies (ANA). A Skin Prick Test (SPT) was performed on each patient to common inhalants and food allergens. Results: 53.8% of the children resulted atopic. The most important allergens were house dust mites and grasses. 46.1% of the patients showed total IgE >100 UI/ml and 30.8% had ANA positivity at the first determination. The photophobia occurred in 42.3% of children, most frequently with respect to other symptoms like secretion or tearing (30.8%), foreign body sensation (15.4%), itching and conjunctival hyperemia (11.5%). Conclusions: Fortunately all children improved their symptoms after Cy eyedrop therapy. Moreover, there was an elevated percentage (30.8%) of children with ANA positivity compared with the values in the general pediatric population. Despite the fact that it is a non-specific autoantibody, its high presence in a population of children with VKC may have an important role in clarifying etiopathogenesis and chronic inflammation.
    Seminars in ophthalmology 02/2014;
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    ABSTRACT: Abstract Background: To report a rare case of eyelid eccrine porocarcinoma and compare this to previous documented cases in the literature. Main Observations: We report a case of an 86-year-old man who presented with three months' history of irritation in the right eye, who was found to have an irregular nodule on lower eyelid, which was later diagnosed as eccrine porocarcinoma (EPC). The lesion was excised and the defect repaired with Hughes flap. A computerized tomography (CT) scan of the head, neck, and chest showed no metastasis and no lymphadenopathy. There was no evidence of recurrence after 18 months of follow-up. Conclusion: To date, there have been only six cases of eyelid EPC reported in the literature. EPC has significant risk of recurrence and metastases after local excision. It is therefore important to consider it in the differential diagnosis of malignant eyelid tumour. A histological diagnosis should prompt wide margin excision, assessment of the patient for regional lymph node involvement, and imaging for metastatic disease.
    Seminars in ophthalmology 02/2014;
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    ABSTRACT: Abstract Objective: To investigate the effects of corneal epithelium on corneal curvature in patients with keratoconus. Design: This is a prospective, nonrandomized study. Participants: Fifty-nine eyes of 47 patients diagnosed as keratoconus and for whom corneal collagen crosslinking (CXL) was recruited in this study. Methods: This study is a single-center clinical trial. Pregnancy, lactation, connective tissue disease, corneal thickness below 350 μm, severe dry eyes, or scar of corneal surgery were exclusion criteria. Before and during CXL procedure after removing the corneal epithelium, maximum values of corneal apical curvature, simulated keratometry 1 (Sim-K1), simulated keratometry 2 (Sim-K2), temporal and inferior curvature values, all of which are 1.5 mm from the corneal center, were calculated. These values before and after removal of epithelium were compared statistically. Results: Mean age of patients was 23.30 ± 5.5 (12-38) years. Twenty-eight (59%) were male while 19 (41%) were female. Mean values measured before and after removing the corneal epithelium were: apical curvature; 59.19 ± 7.2 (47.06-82.40) diopter (D) and 61.70 ± 8.8 (49.19-92.66) D (p = 0.001), SimK1; 47.57 ± 4.3 (39.14-64.57) D and 48.23 ± 4.3 (41.89-66.70) D (p = 0.001), SimK2; 52.04 ± 5.3 (43.56-69.34) D and 53.34 ± 5.6 (43.73-70.89) D (p = 0.001), inferior curvature; 53,85 ± 5.2 (43.47-76.56) D and 55.05 ± 5.8 (44.56-81.93) D (p = 0.002), temporal curvature 49.49 ± 5.1 (41.50-71.03) D and 51.53 ± 5.4 (41.58-73.34) D (p = 0.001), respectively. Conclusions: In keratoconus patients during CXL treatment, after removing the corneal epithelium, more steepness is detected in the curvature of the steeper area of the cornea. When evaluating patients with keratoconus, the masking effect of corneal epithelium on values of curvature should be taken into consideration.
    Seminars in ophthalmology 02/2014;
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    ABSTRACT: Abstract Post-traumatic endophthalmitis comprises 25-30% of all endophthalmitis cases. Post-traumatic endophthalmitis is an important clinical condition that may have serious anatomical and functional consequences. The type of pathogenic microorganism, nature of the injury, the presence of a foreign body, and the geographical region in which the trauma occurred are all important factors influencing both treatment and prognosis. Unlike postoperative endophthalmitis, there is not a confirmed treatment protocol recommended by the Endophthalmitis-Vitrectomy Study Group in traumatic cases. In this study, we examine the incidence, risk factors, diagnosis, microbiological features, and treatment principles of post-traumatic endophthalmitis in order to guide clinicians who often encounter eye trauma related to this potential complication.
    Seminars in ophthalmology 02/2014;
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    ABSTRACT: Abstract In neurobrucellosis, even though meningitis is encountered frequently, chronic intracranial hypertension is a rare manifestation. Early diagnosis and treatment is very important for the prevention of permanent visual loss secondary to poststasis optic atrophy in these cases. We report a case that presented with permanent visual loss secondary to intracranial hypertension in neurobrucellosis. Our goal is to draw attention to the consideration of neurobrucellosis in cases with papilla stasis, even in the absence of neurological findings in endemic areas.
    Seminars in ophthalmology 02/2014;
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    ABSTRACT: Abstract We present a case of retained intraocular lens (IOL) haptic segment in the anterior chamber, diagnosed seven months following a reportedly uneventful cataract surgery due to manifestation of inferior corneal edema. Specular microscopy revealed low endothelial counts of 513/mm(2). Upon diagnosis, prompt surgical removal of the IOL haptic segment resulted in rapid resolution of the corneal edema within a week. Despite the clearing of the cornea, no improvement in the visual acuity occurred and cystoid macular edema was diagnosed and treated with topical anti-inflammatory agents and two intra-vitreal anti-VEGF injections, followed by complete resolution of ocular findings and improvement of the visual acuity.
    Seminars in ophthalmology 02/2014;

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