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摘要:Aim: To study the surgically induced astigmatism (SIA) caused by two different type main incisions in phacoemulsification. Methods: Sixty-eight eyes of 65 patients who underwent phacoemul-sification were randomly divided into two groups according to main incision type: 2.8 mm superior limbal incision (in Group 1) and 2.8 mm upper clear corneal incision (in Group 2). Surgical techniques did not differ between the groups except for the main incisions. All patients received detailed ophthalmological examination in addition to keratometry at the pre- and post-operatively. The preoperative and postoperative astigmatisms were calculated by the vector analysis method and the SIA was compared between the groups. Results: The mean SIA values were 1.3 ± 0.67 D, 0.89 ± 0.47 D, 0.77 ± 37 D in Group 1 and 1.42 ± 0.62 D, 1.15 ± 0.54 D, 0.94 ± 0.47 D in Group 2 on the first day, first week and first month postoperatively, respectively. According to the vector analysis, SIA was less in Group 1 than Group 2; although the difference was not statistically significant (p > 0.05). Conclusion: Although less astigmatism was detected in the superior limbal incision group, this difference was not statistically significant....
摘要: style="font-family:Verdana;color:black;font-size:10pt;">As the prevalence of glaucoma continues to rise, clinicians and researchers are confronted with an age-old problem: how to reduce risk factors and preserve vision in glaucoma. Current management options revolve around a validated paradigm—intraocular pressure reduction. Active investigations to improve drug delivery efficacy and surgical outcomes are flourishing. This article aims to provide the interested readers with a review of recent discoveries in nanobiotechnology for the management of glaucoma. Targeted drug-delivery systems using mesoscale vectors demonstrate promising delivery profiles. The utility of nanoparticulate therapies to support retinal ganglion cell survival is being investigated. Studies to modulate tissue regeneration and remodeling and improve post-trabeculectomy outcomes are underway. Though these modalities promise new avenues to manage glaucoma, immediate market availability is not anticipated soon....
摘要:

style="font-family:Verdana;">Purpose: style="font-family:Verdana;"> To determine the outcome of trabeculectomy in African countries. style="font-family:Verdana;"> Design style="font-family:Verdana;">: style="font-family:Verdana;"> This is a review of literature for trabeculectomy conducted in Africa from 2000 to December 2012. style="font-family:Verdana;"> Methods style="font-family:Verdana;">: style="font-family:Verdana;">We conducted an electronic search from the following databases style="font-family:Verdana;">: style="font-family:Verdana;"> PubMed, Science style="font-family:Verdana;">Direct, Google, and Google scholar websites for the articles of original stud style="font-family:Verdana;">ies on trabeculectomy conducted in Africa. style="font-family:Verdana;">Results style="font-family:Verdana;">: style="font-family:Verdana;"> A total of 109 articles, published from 2000 to December 2012 were retrieved. Only 12 articles met our inclusion criteria and were included in the study. The follow-up duration ranged from 6 months to 60 months. The post-trabeculectomy IOP range was 10 style="font-family:Verdana;">mmHg to 22 style="font-family:Verdana;">mmHg with rates varying from 61.8% to 90%. The visual acuity was unchanged among 19% to 30% of the participants in the last follow-up, style="font-family:Verdana;">and style="font-family:Verdana;">the improvement rate was 36% to 81.5% while those whose condition worsened ranged from 8.9% to 30.8%. The cup-disc ratio was ≤0.5 in 13% and ≥0.8 in 83% of the participants. The failure rate of the c/d ratio was 0.9 and it in style="font-family:Verdana;">creased by 0.027 units. There was a follow-up of only one study on the visual field. style="font-family:Verdana;"> Conclusion style="font-family:Verdana;">: style="font-family:Verdana;"> Trabeculectomy with or without application of antimetabolite appears to be a good way to lowering the IOP in Africa. In addition, the com style="font-family:Verdana;">bined effect of trabeculectomy and cataract surgery produces visual benefits for the patients style="font-family:Verdana;">.

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摘要: class="MsoNormal"> lang="EN-US" style="font-family:Verdana;">Cryogens have been used to freeze living tissue for the purpose of treating benign and malignant lesions. Within the last century, ophthalmologists have found cryotherapy to be useful in treating a variety of ocular patholog lang="EN-US" style="font-family:Verdana;">ies lang="EN-US" style="font-family:Verdana;">. Here, we review the history of cryotherapy, its introduction to the field of ophthalmology, its proposed mechanism of action, and its current applications in treating surface and intraocular eye disease. lang="EN-US">

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摘要:Background/aims: Paediatric outpatients are often dilated with cyclopentolate drops. These cause discomfort and distress, which may impede subsequent examination. We aimed to determine the distress caused by cyclopentolate drops, and other factors in the clinic environment. Methods: Over an 8 week period, questionnaires were issued to guardians of all paediatric outpatients aged under 10 years receiving cyclopentolate. The childrens'distress was graded on a scale of 1 - 10 (1 = no distress, 10 = severe distress). Waiting time and ease of examination were recorded. Data was analysed using Stata statistics, and significant differences were reported at the P < 0.05 level. Results: The 72 children were grouped as under 4 years (n = 43, Group A), aged 4 - 7 years (n = 19, Group B), and aged 7-10 years (n = 10, Group C). Median distress levels at home (baseline), on arrival, on dilation, and on examination were as follows: Group A; 1, 2, 7, 6 respectively; Group B; 1, 1, 6, 2 and Group C; 1, 1, 4.5, 1. All age groups were significantly more distressed on examination compared to baseline. Distress scores on examination were significantly greater for Group A, in keeping with the greatest number of suboptimal examinations. Guardians reported that a prolonged waiting time and bright examination lights also contributed to distress. Conclusions: This study confirms that cyclopentolate causes significant distress in young children, and in 45% of very young children, the examination is difficult. Proxymetacaine prior to cyclopentolate is a possible solution, but other distressing factors should also be addressed for optimal outcomes....
摘要:Purpose: To evaluate the influence of commonly used eye drops on contrast sensitivity (CS). Design: Prospective study. Participants: One hundred twenty volunteers (120) were enrolled. Methods: The CS of ophthalmologically healthy individuals was evaluated at baseline examination before the instillation, 20 and 40 minutes after the instillation of diclofenac sodium and commonly used antiglaucoma eye drops (latanoprost, brimonidine tartrate, combination of dorzolamide hydrochloride and timolol maleate). CS was assessed at 7 spatial frequencies varying from 1.5 c/d to 20 c/d by the use of Mentor B-VAT II-SG video acuity tester. Results: Diclofenac sodium induced a mild, however statistically significant decrease on the CS in 4 out of 30 subjects 20 minutes after instillation at the spatial frequency of 1.5 c/d and 3 c/d (p < 0.05 for both frequencies). Latanoprost induced a decrease in CS in 1 out of 30 subjects and combination of Dorzolamide Hydrochloride and Timolol Maleate in 2 out of 30 at low spatial frequencies (1.5 c/d and 3 c/d) 20 minutes after the instillation and this decrease was not statistically significant for any of these drugs (p > 0.05). Brimonidine tartrate decreased CS in 4 out of 30 subjects 20 minutes after the instillation at a high spatial frequency (20 c/d) yet this decrease was marginally statistically significant (p = 0.057). CS returned to baseline scores 40 minutes after the instillation for all drugs. Conclusions: Diclofenac sodium eye drops had a mild temporal effect on the low spatial frequencies of 1.5 c/d and 3 c/d in some individuals. Latanoprost and dorzolamide/timolol had a non-statistically significant effect on the same spatial frequencies. Brimonidine eye drops had a temporal effect on the high spatial frequency of 20 c/d with marginal statistical significance. The CS scores returned to normal, in all cases, within the next 40 minutes after the instillation. Ophthalmologists should be aware of the fact that some eye drops may have an influence on CS....
摘要:Purpose: To present a patient with bilateral severe and symmetric lower lid lymphedema in the setting of previous neck surgery and chronic psoriasis, and to review the potential relationships of neck surgery, irradiation, psoriasis, and rosacea to chronic lymphedema. Design: Single case report with literature review. Methods: A 60-year-old female with long-standing psoriasis presented with a 2-year history of severe, symmetric bilateral lower eyelid edema that developed after total laryngectomy and selective right neck dissection for recurrent Squamous Cell Carcinoma (SCC). 10 years prior she underwent radiation and radical left neck dissection for metastatic disease. Surgical management entailed transcutaneous debulking of the masses combined with ectropion repair and suture tarsorrhaphy. A comprehensive literature review was performed using Pubmed and Medline. Results: Surgical debulking of the soft tissue masses via a transcutaneous incision resulted in significant improvement in the patient's lymphedema without recurrence at 5 months follow-up. Histopathologic findings were consistent with chronic eyelid lymphedema. Conclusions: Isolated eyelid lymphedema is rare, with many etiologies, and poses a diagnostic challenge. While ophthalmologists are familiar with the ocular manifestations of rosacea such as conjunctivitis or blepharitis, it is important to consider rosacea as an etiology of eyelid lymphedema. Reviewing the history for previous surgery or radiation to the head and neck, or other dermatologic inflammatory disorders is also warranted. Rosaceous lymphedema is typically less severe than in post-surgical/radiation patients, and does not respond well to medical treatment; however, it often shows a favorable response to debulking blepharoplasty surgery, with or without skin grafting. This patient with a history of severe psoriasis and bilateral neck dissections with radiation for SCC also responded well to surgery without recurrence of lymphedema. Therefore, surgical debulking can be considered in these patients with severe eyelid lymphedema as an option to markedly improve visual function and overall cosmetic appearance....
摘要:Purpose: To report a rare case of visual allesthesia in a patient with glioblastoma multiforme. Material - Methods : A 46 year old male presented in emergency ophthalmologic department complaining for difficulties in performing tasks related to color discrimination in his occupation (PC technician). The patient underwent a thorough ophthalmological examination and then he was referred to the neurological department for further evaluation. Results: The patient presented an atypical pattern of color perception disturbance. His best corrected visual acuity decreased progressively during hospitalization. He also experienced visual allesthesia paroxysmally (illusory left homonymous transpositions of subjects viewed in the right homonymous visual field). The visual field evaluation revealed homonymous left hemianopsia. Magnetic resonance imaging revealed glioblastoma multiforme confirmed by biopsy. Conclusions: A thorough ophthalmological and neuro-imaging control is suggested in patients with sudden color perception disturbance. Patients with temporal or occipital cortex damage may experience visual allesthesia....
摘要:Purpose: To report a case of a pediatric corneal limbal dermoid with eyelashes and to describe post-operative changes after excision with reconstruction using amniotic membrane grafting, sutures and fibrinogen-thrombin glue. Case Report: One pediatric patient was identified with a grade II infratemporal corneal-limbal dermoid with conjunctival eyelashes. The dermoid was surgically excised and the cornea reconstructed with amniotic membrane using sutures and fibrinogen/thrombin glue. Preoperative and postoperative measurement of astigmatism, anisometropia and presence of exposure keratopathy were performed....
摘要:The purpose of this study is to report a rare condition of post-varicella disciform keratitis in a 4-year-old child. It is a prospective study of the follow-up of a 4 year-old girl who was diagnosed as post-varicella stromal disciform keratitis related to high serum antibody titers five months after the skin lesions. Rapid response to topical steroids, topical and oral antivirals have been observed in 6 weeks of treatment. There was no recurrence in the 6 months of follow-up. Total resolution of the disciform stromal keratitis in a short period of time was disclosed with an effective treatment of both topical and oral antivirals and topical steroids....
摘要:Background: Many clinical entities manifest early characteristic changes in the fundus of the eye. The value of fundoscopy cannot be overemphasized and every medical doctor is expected to be able to use the ophthalmoscope to detect common pathological changes. However, more often than not fundoscopy is seen as an exclusive specialized skill of the ophthalmologist. Aim: The aim of this study was to evaluate knowledge and practice of fundoscopy among the physicians present at the Ordinary General Meeting of the Nigerian Medical Association (Rivers State branch) held in Port Harcourt on 30th June 2014. Methods: A self administered questionnaire about their knowledge and practice of fundoscopy was administered to 125 medical doctors attending the Ordinary General Meeting of the Nigerian Medical Association (Rivers State branch) held in Port Harcourt on 30th June 2014. Questions asked tested the Knowledge and Practice of the physicians on matters related to fundoscopy. Participants' knowledge and practice were graded as Good for scores of 75% and above, Fair for 50% - 74% score and Poor for scores less than 50%. Respondents' demographic data, responses and corresponding scores were entered into computer software—Scientific Package for Social Sciences (SPSS) version 20 and subsequently analyzed. Results: The study participants were 125 physicians; 86 males and 39 females (M:F = 2.2:1). Twenty-eight percent of the study participants had good knowledge of fundoscopy while only 15% had good practice. Seventy eight physicians representing 62.4% of the participants could correctly refer patients with the need for fundoscopy to an ophthalmologist, whereas 11 (8.8%) worked in facilities without basic instrument for fundoscopy (ophthalmoscope). Conclusion: Our study demonstrates that knowledge and practice of fundoscopy among medical practitioners in Port Harcourt is poor and far from ideal. Therefore, refresher courses emphasizing the acquisition of the skill in fundoscopy and the provision of ophthalmoscopes in our General Practitioners' clinics are necessary....
摘要:Case Presentation: A nine-year-old boy presented to the general ophthalmologist with a several weeks history of redness, photophobia and intermittent foreign body sensation in the right eye. A pigmented lesion with anterior chamber inflammation was noted on examination. B-scan ultrasound was performed and revealed no foreign body. The patient was diagnosed with anterior uveitis, which did not completely respond to treatment. The differential diagnosis was expanded to include peripheral ulcerative keratitis, phlyctenulosis, pigmented neoplasm, and corneal foreign body. Upon referral to a cornea specialist, an exam under anesthesia revealed a large foreign body consistent with a rock fragment in the peripheral cornea, which was subsequently removed without complication. Conclusion: This case highlights an atypical presentation of foreign body as well as a differential diagnosis of pigmented peripheral corneal lesions. Foreign bodies represent the most common cause of urgent ophthalmic evaluation. When evaluating lesions of the cornea, it is imperative to keep an extensive differential diagnosis, giving the potential for severe and rapid development of visually threatening complications....
摘要:

style="font-family:Verdana;">Here we present an unusual case of an epithelial implantation cyst within the orbit which presented 40 years after initial injury from an airgun pellet. A retrospective review of the case was performed. This case highlights the importance of taking a thorough history when assessing adnexal lesions of undetermined origin.

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摘要: style="text-align:justify;"> />

style="text-align:justify;"> style="font-size:10.0pt;font-family:;" "=""> style="font-family:Verdana;">Objectives: To compare ocular surface changes induced via glaucoma treatment in patients using fixed combinations of bimatoprost 0.03%/timolol 0.50%, timolol 0.50% or bimatoprost 0.01% eye drops. Methods: This is a prospective, one center, open-label clinical trial. It was performed on 60 glaucoma patients between 01-01-2012 and 12-31-2012. These patients were randomly divided in three subgroups: bimatoprost 0.03%/timolol 0.50% fixed combination, timolol 0.50% and bimatoprost 0.01%. The Ocular Surface Disease Index (O.S.D.I.) was evaluated in all the glaucomatous patients of the three subgroups at basal time and after 6 and 12 months. All the results were statistically evaluated by Student t-test and one-way ANOVA. The results were considered statistically significant if p < 0.05. Results: All of the patients ended the clinical trial. There was no statistical significant difference between patients treated with the bimatoprost 0.03%/timolol 0.50% fixed combination and timolol 0.50% eye drops alone (p = 0.845). Instead, there was a statistically significant difference between bimatopr style="font-family:Verdana;">ost 0.01% and bimatoprost 0.03%/timolol 0.50% style="font-family:Verdana;">patients (p = 0.05) and between bimatoprost 0.01% and timolol 0.50% eye drops alone (p = 0.049). Conclusions: This is a clinical trial based not on the hypotonising effect of these drugs but on their tolerability. The drug which showed the best tolerability is bimatoprost 0.01%.

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摘要:We hereby described two cases with unilateral Purtscher-like retinopathy. The first case occurred following an uneventful spontaneous vaginal delivery. The second case had no discernable cause despite having meticulous systemic work-up. Both eyes had low presenting visual acuity of hand movements and 20/200 consecutively. We elected to inject 1 mg triamcinolone acetolamide in-travitreally for the treatment. Though, there was some subjective visual and clinical improvement within time in both patients, we were not convinced that intravitreal injection was superior to no treatment approach....
摘要: class="MsoNormal"> lang="EN-US" style="font-family:Verdana;">Background lang="EN-US" style="font-family:Verdana;">: To prospectively evaluate the effect of intravitreal bevacizumab on aqueous levels of interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) in patients with exudative age-related macular degenera lang="EN-US" style="font-family:Verdana;">tion (AMD) and to correlate clinical outcomes of patients and aqueous cytokine levels before and after injection. Methods: The study group consisted of 30 eyes from 30 patients with exudative AMD who underwent intravi lang="EN-US" style="font-family:Verdana;">treal injection of bevacizumab three times at monthly intervals. The aqueous samples prior to the 1st injection (baseline) and 3rd injection were analyzed for VEGF and IL-6 levels, evaluating the effect of 2 doses of intravi lang="EN-US" style="font-family:Verdana;">treal bevacizumab. Study patients were sub-grouped based upon change in central subfield (CSF) macular thickness on SD-OCT, at 8 weeks. Group 1 included patients (n lang="EN-US"> lang="EN-US" style="font-family:Verdana;">= lang="EN-US"> lang="EN-US" style="font-family:Verdana;">14) with a decrease in CSF thickness greater than 10% from the baseline and were categorized to have lang="EN-US" style="font-family:Verdana;">“ lang="EN-US" style="font-family:Verdana;">improved lang="EN-US" style="font-family:Verdana;">” lang="EN-US" style="font-family:Verdana;">. Group 2 included patients (n lang="EN-US"> lang="EN-US" style="font-family:Verdana;">= lang="EN-US"> lang="EN-US" style="font-family:Verdana;">16) who had a decrease in CSF thickness 10% or less and were considered lang="EN-US" style="font-family:Verdana;">“ lang="EN-US" style="font-family:Verdana;">treatment-resistant lang="EN-US" style="font-family:Verdana;">” lang="EN-US" style="font-family:Verdana;">. Results: There was no statistically significant change in aqueous VEGF and IL-6 levels after intravitreal bevacizumab. In sub-group analysis, in both Groups 1 and 2 patients, aqueous IL-6 levels showed a better correlation with CSF thickness on SD-OCT (r lang="EN-US"> lang="EN-US" style="font-family:Verdana;">= lang="EN-US"> lang="EN-US" style="font-family:Verdana;">0.72 and 0.71, respectively). Conclusions: Data from our study suggest that aqueous IL-6 may be an important marker of treatment response or resistance. Future therapeutic strategies may include targeted treatment against both VEGF and IL-6, in patients who do not respond to anti-VEGF treatment alone.

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摘要: class="MsoNormal"> lang="EN-US" style="font-family:Verdana;">Purpose: lang="EN-US"> style="font-family:Verdana;">To assess the primary visual disability in patients with cataract and to evaluate their preference regarding the visual outcome after surgery. style="font-family:Verdana;">Materials and Methods: style="font-family:Verdana;">120 patients (66 male lang="EN-US" style="font-family:Verdana;">s lang="EN-US" style="font-family:Verdana;">, mean age 76.3 years, mean best corrected visual acuity 5.2/10 binocularly) participated. Perception regarding the primary visual disability related to cataract and preference of visual outcome after surgery w lang="EN-US" style="font-family:Verdana;">ere lang="EN-US"> style="font-family:Verdana;"> assessed by a questionnaire. All study procedures adhered to the principles outlined in the Declaration of Helsinki for research involving human subjects, and all participants gave written informed consent before their participation. style="font-family:Verdana;"> Results: style="font-family:Verdana;">74 patients (61.6%) had difficulty in distant vision, 5 (4.2%) in near vision, 17 (14.2%) mentioned blurred vision, 14 (11.7%) difficulty lang="EN-US" style="font-family:Verdana;">in lang="EN-US"> style="font-family:Verdana;">driving especially at night, 7 (5.8%) complained about monocular diplopia and 3 (2.5%) about anisometropia. All mentioned that they preferred to obtain clear distant and near vision after cataract surgery. style="font-family:Verdana;">Conclusions: style="font-family:Verdana;">There was an interesting variety in visual disability related to cataract. The difficulty in distant vision was the primary visual deficit in the majority of the patients and the preference for clear distant and near vision was the desired postoperative visual outcome.

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摘要: class="MsoNormal"> style="font-family:Verdana;" lang="EN-US">A 20-year-old male patient presented at our clinic complaining of strange visual experiences (neither decreased nor blurred) lang="EN-US"> style="font-family:Verdana;" lang="EN-US">and a mild headache while reading. His best corrected visual acuity revealed 20/20 with a fort myo style="font-family:Verdana;" lang="EN-US">pic correction. Intraocular pressures measured with Dynamic Contour Tonometer lang="EN-US"> style="font-family:Verdana;" lang="EN-US">(DCT) lang="EN-US"> style="font-family:Verdana;" lang="EN-US">(Swiss Microtechnol style="font-family:Verdana;" lang="EN-US">ogy AG, lang="EN-US"> style="font-family:Verdana;" lang="EN-US">Port, Switzerland) were 23.3 lang="EN-US"> style="font-family:Verdana;" lang="EN-US">mmHg in the right eye (OD) and 27.4 lang="EN-US"> style="font-family:Verdana;" lang="EN-US">mmHg in the left eye (OS) with cen style="font-family:Verdana;" lang="EN-US">ral corneal thicknesses lang="EN-US"> style="font-family:Verdana;" lang="EN-US">(CCTs) of 588 lang="EN-US"> style="font-family:Verdana;" lang="EN-US">(OD) and 591 lang="EN-US"> style="font-family:Verdana;" lang="EN-US">(OS) microns, respectively. Optic discs were bilateral pale with indistinct and scalloped margins without cupping. Red free photos showed autofluorescence of both optic discs, representative of optic disc drusen. Visual field analysis (VFA) of both eyes revealed sensitivity depression with localized defects consistent with the Optical Coherence Tomography lang="EN-US"> style="font-family:Verdana;" lang="EN-US">(OCT) findings. Optic nerve head drusen (ONHD), myopia and high intraocular pressures (IOPs) style="font-family:Verdana;" lang="EN-US">, style="font-family:Verdana;" lang="EN-US"> may cause ganglion cell damage resulting in RNFL thinning and visual field loss. Because of the difficulty in detecting the exact cause and the extent of the damage, patients with ONHD associated with high IOPs and myopia should be examined closely with serial monitoring using OCT and VFA. lang="EN-US"> style="font-family:Verdana;" lang="EN-US">In case of RNFL thinning and visual field defects, topical antiglaucomatous therapy should also be determined.

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摘要: class="MsoNormal"> style="font-family:Verdana;" lang="EN-GB">Aims: style="font-family:Verdana;" lang="EN-GB"> To assess the levels of hepcidin prohormone (Hep) in aqueous humor and plasma of human eyes with primary open-angle glaucoma (POAG) and to correlate their concentrations with the severity of glaucoma. style="font-family:Verdana;" lang="EN-GB"> Methods: Sixty patients with POAG and forty five patients with senile cataract (control group) were enrolled in the study prospectively. Aqueous humor samples were obtained by paracentesis from glaucoma and cataract patients who were undergoing elective surgery. Aqueous humor and?corresponding plasma samples were analyzed for Hep concentrations by enzyme-linked immunosorbent assay. Results: Hep levels were significantly lower in aqueous humor of POAG patients with respect to the comparative group of cataract patients (P < 0.001). No significant difference in the levels of Hep in plasma of POAG and cataract patients. A positive correlation was found between plasma/aqueous humor Hep concentration in POAG versus the control group (P < 0.001). No significant correlation was found between Hep levels and the severity of visual field loss. Conclusion: Lower levels of aqueous humor Hep may be associated with POAG. In addition, Hep may be useful protein derivatives levels in aqueous humor of POAG patients as a consequence of glaucomatous damage.

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摘要:In contrast to intraocular metastases, orbital metastases are a rare manifestation of systemic malignancies; such orbital metastases account for only 1% - 13% of all orbital tumors. Such tumors grow rapidly; they may undergo necrosis, as the rate of tumor angiogenesis cannot keep pace with the rapidly expanding mass. Here, we report a rare case of an orbital metastasis from a nasopharyngeal carcinoma....
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