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ABSTRACT: To determine macular sensitivity and fixation characteristics in patients with unilateral resolved central serous chorioretinopathy (CSC) using fundus-related microperimetry.
We reviewed 15 eyes with resolved CSC and 15 normal healthy eyes that had undergone fundus-related microperimetry. The macular sensitivity was measured using the recently introduced fundus-related microperimeter, MP-1. The best-corrected visual acuity (VA) (BCVA), mean retinal sensitivity in the central 10 degrees (central microperimetry, cMP-1) and in the paracentral 10-20 degrees (paracentral microperimetry, pMP-1), and fixation stability and location were determined and compared with measurements in control eyes.
BCVA at the time of this study was 20/20 in all the affected eyes, and fundus examination and optical coherence tomography findings revealed no serous detachment. Eyes with CSC showed statistically significantly lower cMP-1 sensitivity and lower, but not significantly, pMP-1 sensitivity than control eyes (P<0.001, P=0.11, respectively). Eyes with CSC were not significantly different from control eyes in fixation location (P=1.00) or fixation stability (P=0.91). Fixation location was predominantly central in all eyes with CSC; fixation was stable in 12 (80%) and relatively unstable in 3 (20%).
Our study shows that eyes with resolved CSC can have lower retinal sensitivity in the central macula than control eyes, even after good VA has been obtained.
Eye 03/2008; 22(2):204-8. · 1.85 Impact Factor
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ABSTRACT: To evaluate the effect of intravitreal triamcinolone in eyes with diabetic macular oedema that had no previous laser treatment.
In all, 12 eyes of 12 patients with diabetic retinopathy, aged 47-70 years (mean 59.2), made up the study. All the eyes had persistent diabetic macular oedema despite having received medical treatment for at least 3 months. In this consecutive case series, none of the eyes received previous laser photocoagulation. Intravitreal injection of 0.1 ml (4 mg) triamcinolone acetonide was offered to treat macular oedema. The visual and anatomic responses were observed as well as complications related to the injection procedure and corticosteroid medication.
The follow-up period was between 6 and 10 months (mean 7.9 months) and all eyes completed 6 months of follow-up. Macular oedema was documented for an average of 3.5 months (ranged 3-5 months) before intravitreal corticosteroid injection. Baseline mean central macular thickness was 448.6 microm. At 1 month follow-up, a reduction in mean central macular thickness of 40.8% from 448.6 microm to 265.4 microm was obtained. At 3 and 6 months follow-up, mean central macular thicknesses, were 310 mum and 294.5 mum, respectively. No eyes lost vision at 1 month and 10 eyes (83.2%) showed improvement. At 3 months, no eyes lost vision from baseline and 8 eyes (66.6%) showed improvement. At 6 months, again no eyes lost vision from baseline and 10 eyes (83.2%) maintained improved visual acuity.
Intravitreal triamcinolone is a promising therapeutic method in eyes with diabetic macular oedema without previous application of laser treatment. Further study with longer follow-up and large series is warranted to assess the long-term efficacy and safety and the need for retreatment.
Eye 05/2005; 19(4):382-6. · 1.85 Impact Factor
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ABSTRACT: To investigate the use of silicone oil in the patients who had undergone vitrectomy for the treatment of endophthalmitis associated with retinal detachment.
Six consecutive cases of endophthalmitis associated with retinal detachment were included in the study. The mean age of the 4 males and 2 females was 47.25 +/- 23.76 years. Endophthalmitis associated with retinal detachment occurred following perforating injuries in 4 eyes, pneumatic retinopexy in I eye and cataract surgery complicated with vitreous loss in I eye. Preoperative visual acuity was light perception-only in all eyes. Red reflex was absent in all eyes. All the patients underwent vitreous tapping, encirclement, vitrectomy, liquid-gas exchange, endolaser photocoagulation and silicone oil injection.
Mean follow-up time was 14.3 +/- 7.20 months. The microorganisms that were isolated from the vitreous aspiration were Staphylococcus epidermidis in 3 cases, Staphylococcus aureus in 1 case. Remaining cases were culture negative. Retinal breaks could be found in 4 eyes. Inflammation subsided significantly at 5 days in all cases. Final retinal reattachment and treatment of endophthalmitis was achieved in 5 eyes at the end of follow-up. Final visual acuity was 20/40 in I case, counting finger in 4 cases and no light perception in 1 case. The postoperative complications were optic atrophy in 1 eye, epiretinal membrane in 2 eyes and phitisis bulbi in 1 eye.
Silicone oil, a retinal tamponading agent that has antimicrobial activity, may have benefical effect in the surgical treatment of endophthalmitis associated with retinal detachment.
International Ophthalmology 02/2001; 24(3):147-50.
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Retina 02/2000; 20(5):566-7. · 2.81 Impact Factor
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ABSTRACT: To investigate the changes in tear flow and tear film stability after photorefractive keratectomy (PRK) for myopia.
One eye of 32 patients underwent unilateral PRK procedure for the correction of myopia ranging from -1.50 to -6.00 diopters (D) (mean -3.65 +/- 1.55 D). Schirmer test values and break-up time (BUT) scores were measured 6 weeks after the PRK procedure. Unoperated, contralateral eyes were used as control eyes for each patient. The Schirmer test scores and BUT values were statistically analyzed using independent t test.
The mean Schirmer test value was 14.45 +/- 7.79 mm in the operated eyes. It was 28.83 +/- 5.89 in the control eyes. The decrease in Schirmer test value was statistically significant (t = 8.28, p = 0.0001). The mean BUT scores were 13.19 +/- 5.09 s in the operated eyes and 27.83 +/- 9.31 s in the control eyes. The decrease was statistically significant (t = 7.86, p = 0.0001).
PRK causes a decrease in tear flow and tear film stability that is probably caused by decreased corneal sensation after PRK.
Cornea 08/1999; 18(4):437-9. · 1.73 Impact Factor
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ABSTRACT: To investigate the antimicrobial activity of silicone oil against endophthalmitis-causing agents in vitro.
The antimicrobial activity of silicone oil was tested on Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida albicans, and Aspergillus spp. The bacteria and fungi were separately inoculated into 1,300 centistokes silicone oil. Control inoculations were done in two different media: physiologic saline and brain-heart infusion (BHI) for bacteria and Sabouraud broth and physiologic saline for fungi. From each medium, 0.001-mL samples were taken and plated in Petri dishes. After overnight incubation, colony-forming units (CFUs) were enumerated. Culturing from the initially prepared specimens, incubating overnight, and counting CFUs was repeated until no growth of microorganisms was seen in the silicone oil-containing media. Macroscopic photography of the colonies and light microscopic photography of microorganisms were performed.
All the microorganisms showed an apparent decrease in CFUs, with elimination between 7 and 21 days in silicone oil. Colony-forming units of microorganisms remained stable in physiologic saline during the study, with the exception of gradual decrease in CFUs of S. aureus and S. epidermidis from the beginning of the third day. In BHI and Sabouraud broth, both bacteria and fungi showed a growth pattern that was compatible with the growth curve of microorganisms.
Silicone oil has an antimicrobial activity against S. aureus, S. epidermidis, P. aeruginosa, C. albicans, and Aspergillus spp., which are common endophthalmitis-causing agents.
Retina 02/1999; 19(2):122-6. · 2.81 Impact Factor
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Retina 02/1998; 18(2):176-7. · 2.81 Impact Factor
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ABSTRACT: Gingival hyperplasia may be genetic, may be acquired as a consequence of exposure to drugs and other agents or may appear as part of a more widespread disorder. Five patients who acquired gingival hyperplasia due to amyloidaceous deposits staining only for fibrin are presented. This appears to be a new entity related to ligneous conjunctivitis.
Journal of Oral Pathology and Medicine 03/1997; 26(2):100-4. · 1.63 Impact Factor
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ABSTRACT: To compare the efficacy of argon green and dye yellow photocoagulations, 85 eyes of 85 diabetic patients with diffuse macular edema were included in a prospective randomized clinical trial. One year after treatment, visual acuity was unchanged or better in 85.1% of eyes treated with an argon and 89.5% of eyes treated with a dye laser. A reduction of macular edema was accomplished in 67.3% of eyes in the argon-laser group and in 71.1% of eyes in the dye-laser group. No statistically significant differences were observed between the two groups in regard to visual acuity results or the reduction of macular edema.
Annals of ophthalmology 05/1993; 25(4):138-41. · 0.16 Impact Factor
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ABSTRACT: To report serous macular detachment in two patients with cystoid macular edema (CME) associated with latanoprost.
Two eyes of two patients with CME associated with latanoprost underwent an ophthalmoscopic examination, fluorescein angiography, and optical coherence tomography (OCT).
In both patients, besides CME, OCT showed serous macular detachment composed of retinal elevation over a nonreflective cavity with minimal shadowing of the underlying tissues.
This is the first case report that shows an association between serous macular detachment and CME associated with latanoprost.
European journal of ophthalmology 18(6):1014-6. · 0.96 Impact Factor
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ABSTRACT: To report the results of intravitreal triamcinolone acetonide in two eyes of a patient with Vogt-Koyanagi-Harada syndrome.
A 24-year-old woman with Vogt-Koyanagi-Harada syndrome was treated with a single 4-mg dose of intravitreal injection of triamcinolone acetonide in both eyes.
On the seventh day after injection, visual acuity improved from 20/50 to 20/20 in the right eye and from 20/100 to 20/32 in the left. One month after injection, visual acuity was 20/20 in the right eye and 20/32 in the left, and fluorescein angiography showed that serous detachment had almost completely resorbed. The ocular examination remained stable during the 8-month follow-up period.
In this study, a prompt improvement in the clinical picture of a patient with Vogt-Koyanagi-Harada syndrome after intravitreal triamcinolone acetonide injection was described. The results suggest that intravitreal triamcinolone acetonide injection may be an additional tool in the treatment of Vogt-Koyanagi-Harada syndrome.
European journal of ophthalmology 16(3):481-3. · 0.96 Impact Factor
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ABSTRACT: The purpose of this study was to assess macular function by multifocal electroretinography (mfERG) in eyes with diabetic macular edema (DME) after intravitreal triamcinolone acetonide (IVTA) injection.
Fifteen eyes of 15 patients with DME scheduled for 4 mg IVTA injection were prospectively recruited. The response to treatment was monitored functionally by visual acuity (VA) measurement and mfERG and anatomically by foveal thickness measured by optical coherence tomography (OCT). The first-order kernel P1 mfERG responses from 0 to 7 degrees (central) and 7 to 25 degrees (peripheral) were grouped and analyzed. Changes in functional parameters (VAs and the P1 mfERG response amplitudes and peak latencies) and morphometric parameters (OCT foveal thickness) in eyes with DME 1 and 3 months after IVTA injection were compared with baseline values by Student t test.
The mean baseline logMAR value for VAs of the patients before treatment was 0.49+/-0.26. After treatment, it was 0.27+/-0.23 at 1 month and 0.26+/-0.18 at 3 months, and differences from pretreatment values were significant (for each, p<0.001). There were statistically significant decreases in the mean foveal thickness at 1 and 3 months after treatment compared with pretreatment values (for each, p<0.001). There were also statistically significant increases in the mean P1 response amplitude for both central and peripheral groups at all examinations compared with pretreatment (for each, p<0.001). The mean P1 peak latencies for both the central and peripheral groups were shortened, but not significantly.
As well as the reduction in DME and improvement in VA, IVTA injection improves macular function as assessed by mfERG in diabetic patients.
European journal of ophthalmology 18(4):601-8. · 0.96 Impact Factor
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ABSTRACT: To report the optical coherence tomography (OCT) findings in a 35-year-old man with acute inferior branch retinal artery occlusion.
OCT findings in acute branch retinal artery occlusion were evaluated.
OCT disclosed diffuse thickening of the neurosensory retina in the inferior perifoveolar area. Increased reflectivity was noted in the inner retinal layers rom the surface of the retina to the photoreceptor layers. Decreased reflectivity was observed from the photoreceptor layers and the retinal pigment epithelium secondary to the shadowing effect. Foveolar depression, photoreceptor layer in the fovae, and retinal pigment epithelium underneath the fovea were normal. OCT findings in the superior perifoveolar area were also normal.
In the retinal artery occlusion, denaturation and breakdown of the normally transparent intracellular protein and an increase in the intracellular fluid cause ischemic whitening of the retina. Otherwise there is no retinal thickening secondary to the accumulation of serous fluid escaping from retinal capillaries into the extracellular space. The OCT findings support these descriptions.
European journal of ophthalmology 16(2):352-3. · 0.96 Impact Factor
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ABSTRACT: A 30-year-old male with Marfan syndrome underwent pars plana lensectomy and vitrectomy combined with silicone oil injection for the treatment of retinal detachment with proliferative vitreoretinopathy (PVR). Four months after vitrectomy, the silicone oil was removed using an anterior chamber maintainer (AC) and a self-sealing clear corneal incision at the upper temporal quadrant. Suprachoroidal hemorrhage (SCH) developed at the end of the operation. It was limited to the nasal side of the retina. Suprachoroidal hemorrhage remained to be limited and did not show progression.
Ophthalmic surgery and lasers 31(4):337-9.
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ABSTRACT: To investigate the penetration of cefepime (a fourth generation cephalosporin) into the aqueous humor after single-dose intravenous administration in humans.
Before receiving cataract surgery, 30 patients received randomly 1 g (group 1, 15 patients) and 2 g (group 2, 15 patients) single intravenous injection of cefepime before surgery. Samples of aqueous humor and serum were obtained at 0.5, 1, 2, 4, and 12 hours after injection. Three patients were sampled each time for 1 g and 2 g of cefepime. Samples were assayed for cefepime concentrations with high performance liquid chromatography (HPLC).
All the patients had detectable cefepime in their aqueous humor and serum measurable by HPLC. A mean peak aqueous humor level was 5.16 +/- 0.88 microg/mL in group 1 and 5.87 +/- 1.64 microg/mL in group 2 at 0.5 hour after injection. The mean level of cefepime in aqueous humor decreased after 0.5-hour measurements in both groups and was measured as 0.82 +/- 0.21 microg/mL in group 1 and 2.04 +/- 0.30 microg/mL in group 2 at 12 hours after injection.
Aqueous humor levels of cefepime after single IV injection were above the minimum inhibitory concentration (MIC90) for most ocular pathogens, but the duration of exposure to an antibiotic was not sufficient for therapeutic effect.
Ophthalmic surgery and lasers 32(1):25-9.
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ABSTRACT: PURPOSE: To investigate the changes in tear secretion and tear film stability after excimer laser in situ keratomileusis (LASIK) for high myopia. METHODS: One eye of 28 patients underwent unilateral LASIK for the correction of myopia with spherical equivalent refractions ranging from -6.37 to -18.25 D (mean, -11.98 +/- 3.45 D). Schirmer tear test values without anesthesia at 5 minutes and tear break-up time values were measured 4 weeks after LASIK. Unoperated contralateral eyes were used as a control for each patient. The Schirmer tear test and tear break-up time values were analyzed statistically using the independent t-test. RESULTS: The mean Schirmer tear test value was 16.17 +/- 2.50 mm in the operated eyes and 21.07 +/- 7.03 mm in the unoperated (control) eyes of the same patients (P = .001). The mean tear break-up time value was 21.0 +/- 3.55 seconds in the operated eyes and 21.27 +/- 6.79 seconds in the control eyes (P = .85). CONCLUSION: Tear secretion decreased following LASIK probably due to decrease in corneal sensitivity, but tear film stability appeared unaltered.
Journal of refractive surgery (Thorofare, N.J.: 1995) 16(3):362-4. · 2.54 Impact Factor
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ABSTRACT: To report the clinical characteristics, surgical management and outcome of retinal detachment following laser in situ keratomileusis (LASIK) in myopic patients.
Retrospective review of 10 eyes of 10 myopic patients with retinal detachment who had previously undergone LASIK surgery were analyzed. Included in the study were 7 males and 3 females, aged 22 to 68 years (35.2+/-2.8).
Mean spherical equivalent refraction was -10.51+/-3.90 D (ranging from -6.37 D to -17.00 D) before surgery. The time interval between the LASIK procedure and the development of retinal detachment varied from two months to nine months (5.2 +/- 2.78 months). The number of retinal breaks was one in 7 patients, two in 2 patients and three in 1 patient. The type of retinal breaks included 7 patients with horse shoe tears, 1 patient with a retinal hole, 1 patient with a giant retinal tear, and 1 patient with retinal dialysis. Retinal breaks were located anterior to the equator in 9 patients and posterior to the equator in 1 patient. Retinal reattachment was achieved with one operation in 8 eyes (80%) and the remaining 2 eyes required a second surgery for the reattachment of the retina.
This study suggests the possible association between retinal detachment and LASIK procedure in patients with myopia. Clinicians should be aware of retinal pathology predisposing to retinal detachment in patients undergoing LASIK.
Ophthalmic surgery and lasers 31(2):121-5.
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ABSTRACT: To determine macular sensitivity and fixation characteristics in eyes with central serous chorioretinopathy (CSC) using fundus-related microperimetry.
The authors reviewed 19 eyes with serous elevation within the central 10 degrees due to CSC and 15 normal healthy eyes that had undergone fundus-related microperimetry. The macular sensitivity was measured using the fundus-related microperimeter, MP-1. The bestcorrected visual acuity (BCVA), mean retinal sensitivity in the central 10 degrees (central microperimetry, cMP-1) and in the paracentral 10 degrees to 20 degrees (paracentral microperimetry, pMP-1), and fixation stability and location were determined and compared with that of control eyes.
Eyes with CSC showed significantly lower logMAR BCVA (p<0.001), cMP-1, and pMP-1 sensitivity than control eyes (p<0.001, p<0.01, respectively). Eyes with CSC were not significantly different in fixation location (p=1.00) or fixation stability than control eyes (p=0.45). Fixation location was predominantly central in all eyes with CSC; fixation was stable in 17 (89%) and relatively unstable in 2 (11%).
Eyes with CSC showed significantly lower retinal sensitivity not only at the central but also in the paracentral area. Even with decreased BCVA and retinal sensitivity, our patients showed central and stable fixation in their affected eyes.
European journal of ophthalmology 18(5):799-804. · 0.96 Impact Factor
