Ophthalmology Commons^™

Child Eye Health In Nampula, Mozambique And Ireland, Aoife Phelan

Masters

To examine child eye health, in particular, visual impairment (VI), uncorrected refractive error (URE) and strabismus in two targeted cohorts of children in Mozambique and Ireland.

Ca2+ Diffusion Through Endoplasmic Reticulum Supports Elevated Intraterminal Ca2+ Levels Needed To Sustain Synaptic Release From Rods In Darkness., Minghui Chen, Matthew J. Van Hook, Wallace B. Thoreson

Journal Articles: Ophthalmology

UNLABELLED: In addition to vesicle release at synaptic ribbons, rod photoreceptors are capable of substantial slow release at non-ribbon release sites triggered by Ca(2+)-induced Ca(2+) release (CICR) from intracellular stores. To maintain CICR as rods remain depolarized in darkness, we hypothesized that Ca(2+) released into the cytoplasm from terminal endoplasmic reticulum (ER) can be replenished continuously by ions diffusing within the ER from the soma. We measured [Ca(2+)] changes in cytoplasm and ER of rods from Ambystoma tigrinum retina using various dyes. ER [Ca(2+)] changes were measured by loading ER with fluo-5N and then washing dye from the cytoplasm with …

Gendered Disparities In Quality Of Cataract Surgery In A Marginalised Population In Pakistan: The Karachi Marine Fishing Communities Eye And General Health Survey, Khabir Ahmad, Anthony B Zwi, Daniel J. M. Tarantol, Abdul Qadeem Soomro, Rashid Baig, Iqbal Azam Syed

Department of Surgery Docs

Abstract

BACKGROUND:

Marine fishing communities are among the most marginalised and hard-to-reach groups and have been largely neglected in health research. We examined the quality of cataract surgery and its determinants, with an emphasis on gender, in marine fishing communities in Karachi, Pakistan, using multiple indicators of performance.

METHODS AND FINDINGS:

The Karachi Marine Fishing Communities Eye and General Health Survey was a door-to-door, cross-sectional study conducted between March 2009 and April 2010 in fishing communities living on 7 islands and in coastal areas in Keamari, Karachi, located on the Arabian Sea. A population-based sample of 638 adults, aged ≥ …

Iron Toxicity In The Retina Requires Alu Rna And The Nlrp3 Inflammasome, Bradley D. Gelfand, Charles B. Wright, Younghee Kim, Tetsuhiro Yasuma, Reo Yasuma, Shengjian Li, Benjamin J. Fowler, Ana Bastos-Carvalho, Nagaraj Kerur, Annette Uittenbogaard, Youn Seon Han, Dingyuan Lou, Mark E. Kleinman, W. Hayes Mcdonald, Gabriel Núñez, Philippe Georgel, Joshua L. Dunaief, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Publications

Excess iron induces tissue damage and is implicated in age-related macular degeneration (AMD). Iron toxicity is widely attributed to hydroxyl radical formation through Fenton's reaction. We report that excess iron, but not other Fenton catalytic metals, induces activation of the NLRP3 inflammasome, a pathway also implicated in AMD. Additionally, iron-induced degeneration of the retinal pigmented epithelium (RPE) is suppressed in mice lacking inflammasome components caspase-1/11 or Nlrp3 or by inhibition of caspase-1. Iron overload increases abundance of RNAs transcribed from short interspersed nuclear elements (SINEs): Alu RNAs and the rodent equivalent B1 and B2 RNAs, which are inflammasome agonists. Targeting …

Bilateral Papillitis And Unilateral Focal Chorioretinitis As The Presenting Features Of Syphilis., Christy E. Benson, Mohamed K. Soliman, Alexander Knezevic, Daisy D. Xu, Quan D. Nguyen, Diana V V. Do

Journal Articles: Ophthalmology

BACKGROUND: Syphilis is a multisystem bacterial infection caused by Treponema pallidum. The incidence of infection in the United States has risen by more than 75% since the year 2000, when it was at a low of 2.1 per 100,000 people. Ocular involvement may occur in any stage of infection and may present in a variety of ways, with posterior uveitis being the most common manifestation. We report a case of ocular syphilis infection with an unusual presentation of bilateral non-granulomatous panuveitis with papillitis and unilateral focal chorioretinitis.

FINDINGS: This is a retrospective case report with literature review. A 39-year-old Caucasian …

Management Of Neovascular Age-Related Macular Degeneration: Current State-Of-The-Art Care For Optimizing Visual Outcomes And Therapies In Development., Aniruddha Agarwal, William R. Rhoades, Mostafa Hanout, Mohamed Kamel K. Soliman, Salman Sarwar, Mohammad A. Sadiq, Yasir J. Sepah, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

Contemporary management of neovascular age-related macular degeneration (AMD) has evolved significantly over the last few years. The goal of treatment is shifting from merely salvaging vision to maintaining a high quality of life. There have been significant breakthroughs in the identification of viable drug targets and gene therapies. Imaging tools with near-histological precision have enhanced our knowledge about pathophysiological mechanisms that play a role in vision loss due to AMD. Visual, social, and vocational rehabilitation are all important treatment goals. In this review, evidence from landmark clinical trials is summarized to elucidate the optimum modern-day management of neovascular AMD. Therapeutic …

Lower Macular Pigment Optical Density In Foveal-Involved Glaucoma., James Loughman

Articles

Purpose: To evaluate the relationship between macular pigment optical density (MPOD) and structural parameters of the macula and optic nerve head in glaucomatous eyes.

Entral Corneal Thickness Changes After Phacoemulsification, Tanveer Anjum Chaudhry, Muhammad Hamza, Wajiha Koomal, Khabir Ahmad

Department of Surgery Docs

Purpose: To determine when the mean central corneal thickness (CCT) returns to normal values after uneventful phacoemulsification. Material and Methods: This was a prospective case series. The study was carried out at the Section of Ophthalmology, Department of Surgery, Aga Khan University Hospital, Karachi. Eyes scheduled to undergo phacoemulsification during December 2011 – March 2012 were eligible to be included. Eyes with corneal degenerations, dystrophies or high pre-op astigmatism were excluded. A structured proforma was used to collect data on sociodemographics, comorbids, visual acuity, and CCT before surgery and 1 day, 1 week and 1 month after surgery. Changes in …

Systematic Review And Mixed Treatment Comparison Of Intravitreal Aflibercept With Other Therapies For Diabetic Macular Edema (Dme)., Jean-Francois Korobelnik, Jos Kleijnen, Shona H. Lang, Richard Birnie, Regina M. Leadley, Kate Misso, Gill Worthy, Dominic Muston, Diana V. Do

Journal Articles: Ophthalmology

BACKGROUND: This was an indirect comparison of the effectiveness of intravitreal aflibercept (IVT-AFL) 2 mg every 8 weeks after 5 initial monthly doses (or if different periods, after an initial monthly dosing period) (2q8) and other diabetic macular edema (DME) therapies at doses licensed outside the USA.

METHODS: A comprehensive search was undertaken to source relevant studies. Feasibility networks were prepared to identify viable comparisons of 12-month outcomes between IVT-AFL 2q8 and therapies licensed outside the USA, which were assessed for clinical and statistical homogeneity. Pooled effect sizes (mean difference [MD] and relative risk/risk ratio [RR]) were calculated using fixed- …

Spectral Domain Optical Coherence Tomography Changes Following Intravitreal Dexamethasone Implant, Ozurdex® In Patients With Uveitic Cystoid Macular Edema., Pooja Bansal, Aniruddha Agarwal, Vishali Gupta, Ramandeep Singh, Amod Gupta

Journal Articles: Ophthalmology

PURPOSE: To correlate the structural and functional changes following intravitreal injection of dexamethasone 0.7 mg (Ozurdex®) implant in patients with recalcitrant uveitic cystoid macular edema (CME).

MATERIALS AND METHODS: In a prospective, interventional, nonrandomized study, 30 eyes (27 patients) with uveitic CME received Ozurdex® implant and were followed-up for 24 weeks at periodic intervals to monitor structural alterations seen on spectral domain optical coherence tomography (SD-OCT). The outcome measures included change in central macular thickness (CMT) and best-corrected visual acuity (BCVA) as well as structural alterations seen on OCT such as change in the height of cystoid spaces (CSs) and …

Direct Differentiation Of Adult Ocular Progenitors Into Striatal Dopaminergic Neurons., Iqbal Ahmad, Xing Zhao, Sowmya Parameswaran, Christopher J. Destache, J F. Rodriguez-Sierra, Wallace B. Thoreson, Hiba Ahmad, John Sorrentino, Sudha Balasubramanian

Journal Articles: Ophthalmology

Parkinson's disease, characterized by motor dysfunction due to the loss of nigrostriatal dopaminergic neurons, is one of the most prevalent age-related neurodegenerative disorders. Given there is no current cure, the stem cell approach has emerged as a viable therapeutic option to replace the dopaminergic neurons that are progressively lost to the disease. The success of the approach is likely to depend upon accessible, renewable, immune compatible, and non-tumorigenic sources of neural progenitors from which stable dopaminergic neurons can be generated efficaciously. Here, we demonstrate that neural progenitors derived from limbus, a regenerative and accessible ocular tissue, represent a safe source …

Evaluations Of Refraction Competencies Of Ophthalmic Technicians In Mozambique., James Loughman, Kajal Shah, Kovin Naidoo, Margarida Chagunda

Articles

Purpose: Ophthalmic technicians (OT) work at health facilities in Mozambique and are trained to provide primary and secondary eye care services including basic refraction. This study was designed to assess OT competence and confidence in refraction, and investigate whether an upskilling programme is effective in developing their competence and confidence at refraction. Methods: Thirty-one trainee OTs and 16 qualified OTs were recruited to the study. A background questionnaire was administered to determine the demographic profile of the OTs. A confidence levels questionnaire explored their self-reported skills.

Powerful Anti-Tumor And Anti-Angiogenic Activity Of A New Anti-Vascular Endothelial Growth Factor Receptor 1 Peptide In Colorectal Cancer Models, Valeria Cicatiello, Ivana Apicella, Laura Tudisco, Valeria Tarallo, Luigi Formisano, Annamaria Sandomenico, Younghee Kim, Ana Bastos-Carvalho, Augusto Orlandi, Jayakrishna Ambati, Menotti Ruvo, Roberto Bianco, Sandro De Falco

Ophthalmology and Visual Science Faculty Publications

To assess the therapeutic outcome of selective block of VEGFR1, we have evaluated the activity of a new specific antagonist of VEGFR1, named iVR1 (inhibitor of VEGFR1), in syngenic and xenograft colorectal cancer models, in an artificial model of metastatization, and in laser-induced choroid neovascularization. iVR1 inhibited tumor growth and neoangiogenesis in both models of colorectal cancer, with an extent similar to that of bevacizumab, a monoclonal antibody anti-VEGF-A. It potently inhibited VEGFR1 phosphorylation in vivo, determining a strong inhibition of the recruitment of monocyte-macrophages and of mural cells as confirmed, in vitro, by the ability to inhibit …

Surgical Outcomes Of Sequential Versus Concomitant Glaucoma Drainage Implant And Boston Keratoprosthesis Type 1, Varum Patel, Marlene R. Moster, Louis J. Kishfy, Julian Barkan, Tingting Zhan, Irving M. Raber, Brandon D. Ayers, Michael J. Pro, Michael Waisbourd

Wills Eye Hospital Papers

BACKGROUND

The Boston Keratoprosthesis Type 1 (KPro) is a surgical device used in patients who have failed traditional corneal transplant treatment or are poor candidates for it.¹ Candidates for KPro often have advanced anterior segment disease that predisposes them to developing glaucoma.² As a result, these patients may require both a KPro, to treat their corneal pathology, and a glaucoma drainage implant (GDI), to treat their glaucoma. To date, there have been no long-term studies comparing the order of GDI placement with KPro surgery and how it affects surgical outcomes.

Ocular Complications Of Inflammatory Bowel Disease, Rana Mady, Will Grover, Salim Butrus

Ophthalmology Faculty Publications

No abstract provided.

Assessment Of Changes In Quality Of Life Among Patients In The Save Study - Sirolimus As Therapeutic Approach To Uveitis: A Randomized Study To Assess The Safety And Bioactivity Of Intravitreal And Subconjunctival Injections Of Sirolimus In Patients With Non-Infectious Uveitis., Erin M. Vigil, Yasir J. Sepah, Anthony L. Watters, Mohammad A. Sadiq, Mehreen Ansari, Millena G. Bittencourt, Mohamed A. Ibrahim, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

BACKGROUND: The National Eye Institute 39-Question Visual Function Questionnaire (NEI VFQ-39) is an indicator of vision-related quality of life (QoL). The NEI VFQ-39 is used to assess the QoL in patients with non-infectious posterior uveitis, intermediate uveitis, or panuveitis, treated with subconjunctival (SCJ) or intravitreal (IVT) sirolimus as an immunomodulatory therapeutic (IMT) agent, delivered subconjunctivally (SCJ) or intravitreally (IVT) (the SAVE Study). Thirty subjects with non-infectious uveitis were randomized (SCJ:IVT, 1:1) for a prospective clinical trial. The 39-Question Visual Function Questionnaire (VFQ-39) was administered at baseline (BL), month 6 (M6), and month 12 (M12) visits. The survey measures self-reported vision …

Macular Pigment Optical Density Is Lower In Type 2 Diabetes, Compared With Type 1 Diabetes And Normal Controls., James Loughman, Grainne Scanlon, Paul Connell, Audrey Murphy, Karen O'Conner, Mathew Ratzlaff, Brittany Foerg

Articles

Purpose: This study was designed to investigate the optical density of macular pigment in Type 1 and Type 2 diabetes subjects relative to normal controls

Toll Like Receptor (Tlr) Stimulation For Ocular Angiogenesis And Macular Degeneration, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Patents

Provided are methods and compositions for the treatment or prevention of ocular angiogenesis and neovascularization. Administration of stimulators of the TLR3 and TLR7 receptors, Trif or of IL-10 and IL-12 inhibits ocular angiogenesis. Furthermore, all siRNAs (both targeted and non-targeted) can inhibit ocular angiogenesis.

Self-Perceived Barriers To Eye Care In A Hard-To-Reach Population: The Karachi Marine Fishing Communities Eye And General Health Survey, Khabir Ahmad, Anthony B. Zwi, Daniel J. M. Tarantola, Tanveer Anjum Chaudhry

Department of Surgery Docs

Abstract

Purpose.: We examined self-reported barriers to eye care among marginalized, hard-to-reach fishing communities in Karachi, Pakistan.

Methods.: The Karachi Marine Fishing Communities Eye and General Health Survey was a cross-sectional survey conducted between March 2009 and April 2010 in fishing communities in Keamari, Karachi, located on the coast of the Arabian Sea. Adults aged ≥50 years living on seven islands and coastal areas were interviewed regarding sociodemographic background, experience of eye problems, eye care use, and barriers to access. They also were examined to determine visual acuity with a reduced logMAR chart and underwent a detailed eye examination.

Results.: …

New Best1 Mutations In Autosomal Recessive Bestrophinopathy, A. T. Fung, S. Yzer, N. Goldberg, H. Wang, M. Nissen, A. Giovannini, J. E. Merriam, E. N. Bukanova, L. A. Yannuzzi, R. Allikmets, +2 Additional Authors

Journal Articles

PURPOSE: To report the ocular phenotype in patients with autosomal recessive bestrophinopathy and carriers, and to describe novel BEST1 mutations. METHODS: Patients with clinically suspected and subsequently genetically proven autosomal recessive bestrophinopathy underwent full ophthalmic examination and investigation with fundus autofluorescence imaging, spectral domain optical coherence tomography, electroretinography, and electrooculography. Mutation analysis of the BEST1 gene was performed through direct Sanger sequencing. RESULTS: Five affected patients from four families were identified. Mean age was 16 years (range, 6-42 years). All affected patients presented with reduced visual acuity and bilateral, hyperautofluorescent subretinal yellowish deposits within the posterior pole. Spectral domain optical …

Lifitegrast Ophthalmic Solution 5.0% Versus Placebo For Treatment Of Dry Eye Disease: Results Of The Randomized Phase Iii Opus-2 Study, J. Tauber, P. Karpecki, R. Latkany, J. Luchs, J. Martel, K. Sall, A. Raychaudhuri, V. Smith, C. P. Semba

Journal Articles

PURPOSE: Lifitegrast is an integrin antagonist that decreases T-cell-mediated inflammation associated with dry eye disease (DED). We report the results of OPUS-2, a phase III study evaluating the efficacy and safety of lifitegrast compared with placebo for the treatment of DED. DESIGN: A 12-week, multicenter, randomized, prospective, double-masked, placebo-controlled clinical trial. PARTICIPANTS: Adults aged >/=18 years with use of artificial tears within 30 days, inferior corneal staining score >/=0.5 (0-4 scale), Schirmer tear test (without anesthesia) >/=1 and/=40 (0-100 visual analogue scale [VAS]). METHODS: Subjects were randomized 1:1 after 14-day placebo run-in to lifitegrast ophthalmic solution 5.0% or placebo twice …

Update On Uveitis Management., Vishali Gupta, Quan Dong Nguyen, Manfred Zierhut, Ilknur Tugal-Tutkun

Journal Articles: Ophthalmology

No abstract provided.

Nosocomial Keratitis Caused By Methicillin-Resistant Staphylococcus Aureus: Case Report And Preventative Measures, Puneet S. Braich, Shruti Aggarwal, Sabrina Mukhtar, David Rp Almeida

Ophthalmology Publications

A 47-year-old African-American woman was admitted to the intensive care unit of our community hospital for respiratory failure secondary to severe decompensated heart failure, requiring intubation. In the ensuing days, she developed a methicillin-resistant Staphylococcus aureus (MRSA) infection of the cornea, despite no growth of MRSA in multiple blood, sputum, and urine cultures. This unexpected corneal infection complicated her hospital stay, and increased morbidity and disease-related cost. Risk factors, warning signs, and preventative measures for MRSA keratitis secondary to lagophthalmos (inability to completely close one's eyelids) are outlined in this case report. Implementing simple precautions such as taping eyelids shut …

Relocation Consequences On An Ophthalmology Consultation Service From An Inpatient To Outpatient Facility, Jorawer S. Singh, Vincent M. Imbrogno, Mary K. Howard, Amandip S. Cheema, Ausra D. Selvadurai, Surbhi Bansal

Ophthalmology Publications

Importance

This study shows that relocation of an academic ophthalmology residency program from an inpatient to an outpatient setting in western New York does not affect the consult volume but affects management patterns and follow-up rates.

Objective

To investigate the effects on the ophthalmology consultation service of an academic program with relocation from a Regional Level-1 Trauma center to an outpatient facility.

Design

Consultation notes from 3 years before and 3 years after the University at Buffalo’s (UB) Department of Ophthalmology relocation from a Regional Level-1 Trauma center (Erie County Medical Center) to an outpatient facility (Ross Eye Institute) were …

Prevalence And Factors Predictive Of Intraocular Fungal Infection In Patients With Fungemia At An Academic Urban Tertiary Care Center, Elena Geraymovych, Joseph H. Conduff, Puneet S. Braich, Christopher T. Leffler, Vikram S. Brar

Ophthalmology Publications

Objective

To report the prevalence and to identify factors predictive of intraocular infection in patients with fungemia receiving prophylactic antifungal therapy.

Methods

A retrospective review of patients who received prophylactic antifungal therapy and a dilated fundus examination at an academic urban tertiary care center from 2000 to 2007. Basic demographic information, fungal species grown, antifungal agent(s) used, number of positive blood culture specimens, visual acuity, visual symptoms, and known risks of disseminated candidiasis were noted. Logistic regression analysis was used to determine the factors significantly associated with intraocular fungal infection.

Results

A total of 132 patients with positive fungemia culture …

Infrared Imaging Enhances Retinal Crystals In Bietti’S Crystalline Dystrophy, Vikram S. Brar, William H. Benson

Ophthalmology Publications

Infrared imaging dramatically increased the number of crystalline deposits visualized compared with clinical examination, standard color fundus photography, and red free imaging in patients with Bietti’s crystalline dystrophy. We believe that this imaging modality significantly improves the sensitivity with which these lesions are detected, facilitating earlier diagnosis and may potentially serve as a prognostic indicator when examined over time.

Long-Term (60-Month) Results For The Implantable Miniature Telescope: Efficacy And Safety Outcomes Stratified By Age In Patients With End-Stage Age-Related Macular Degeneration, D. Boyer, K. B. Freund, C. Regillo, M. H. Levy, S. Garg

Journal Articles

BACKGROUND: The purpose of this study was to evaluate the long-term results of an implantable miniature telescope (IMT) in patients with bilateral, end-stage, age-related macular degeneration (AMD). METHODS: A prospective, open-label, multicenter clinical trial with fellow eye controls enrolled 217 patients (mean age 76 years) with AMD and moderate-to-profound bilateral central visual acuity loss (20/80-20/800) resulting from untreatable geographic atrophy, disciform scars, or both. A subgroup analysis was performed with stratification for age (patient age 65 to[group 1; n=70] and patient age >/=75 years [group 2; n=127]), with a comparative evaluation of change in best-corrected distance visual acuity (BCDVA), quality …

Optical Coherence Tomographic Angiography Shows Reduced Deep Capillary Flow In Paracentral Acute Middle Maculopathy, K. K. Dansingani, M. Inoue, M. Engelbert, K. B. Freund

Journal Articles

IntroductionParacentral acute middle maculopathy (PAMM) has been described as an ischemic lesion of the middle retinal layers with a characteristic lamellar hyper-reflective placoid appearance in the acute phase and thinning of the involved retinal layers in the chronic phase. Optical coherence tomographic angiography (OCTA) is a novel and non-invasive technique for imaging retinal capillary vasculature with en face segmentation capabilities.MethodCase series. We describe two patients with PAMM who underwent clinical examination and multimodal imaging including OCTA.ResultsIn the first patient, who presented with PAMM secondary to acute cilioretinal artery occlusion, OCTA demonstrated reduction in flow in the deep capillary plexus (DCP). …

En Face Oct Angiography Demonstrates Flow In Early Type 3 Neovascularization (Retinal Angiomatous Proliferation), K. K. Dansingani, J. Naysan, K. B. Freund

Journal Articles

INTRODUCTION: The characteristics of type 3 neovascularization (NV), also known as retinal angiomatous proliferation, have been well described clinically, as well as with fluorescein angiography (FA), indocyanine green angiography, and optical coherence tomography (OCT). OCT angiography (OCT-A) is a novel and non-invasive technique for imaging retinal microvasculature by detecting changes, with respect to time, in reflectivity related to blood flow. METHOD: In this case series, we describe two patients who presented with type 3 NV and underwent clinical examination and multimodal imaging, including OCT-A. RESULTS: In the first patient, OCT-A demonstrated flow within two separate lesions in the same eye, …

Inner Segment Remodeling And Mitochondrial Translocation In Cone Photoreceptors In Age-Related Macular Degeneration With Outer Retinal Tubulation, K. M. Litts, J. D. Messinger, K. B. Freund, Y. Zhang, C. A. Curcio

Journal Articles

PURPOSE: To quantify impressions of mitochondrial translocation in degenerating cones and to determine the nature of accumulated material in the subretinal space with apparent inner segment (IS)-like features by examining cone IS ultrastructure. METHODS: Human donor eyes with advanced age-related macular degeneration (AMD) were screened for outer retinal tubulation (ORT) in macula-wide, high-resolution digital sections. Degenerating cones inside ORT (ORT cones) and outside ORT (non-ORT cones) from AMD eyes and unaffected cones in age-matched control eyes were imaged using transmission electron microscopy. The distances of mitochondria to the external limiting membrane (ELM), cone IS length, and cone IS width at …