Ophthalmology Commons^™

Outcomes Of The Second Aqueous Shunt Implant Versus Transscleral Cyclophotocoagulation Treatment Study: A Randomized Comparative Trial, Robert M Feldman, Alice Z Chuang, Steve L Mansberger, Angelo P Tanna, Lauren S Blieden, Nicholas P Bell, Ronald L Gross, Louis R Pasquale, David S Greenfield, Jeffrey M Liebmann, Robert N Weinreb

Faculty, Staff and Student Publications

PRCIS: Short-term overall success rates were high with either SGDD or CPC. However, SGDD was associated with more clinic visits and an increased risk of additional glaucoma surgery. Both treatments were reasonable options for eyes with inadequately controlled IOP after a single GDD.

PURPOSE: The purpose of this study is to compare the implantation of a second glaucoma drainage device (SGDD) and transscleral cyclophotocoagulation (CPC) in eyes with inadequately controlled intraocular pressure (IOP), despite the presence of a preexisting glaucoma drainage device.

METHODS: Patients with inadequately controlled IOP, despite the medical therapy and a preexisting glaucoma drainage device, were enrolled …

Frosted Branch Angiitis After Smallpox Vaccination, Kristen Collister, Sam S Dahr

Faculty, Staff and Student Publications

PURPOSE: To describe a patient presenting with frosted branch angiitis soon after small-pox vaccination.

OBSERVATIONS: Frosted branch angiitis (FBA) is an acute onset retinal vasculitis featuring prominent perivascular sheathing in otherwise healthy individuals. FBA has been associated with noninfectious and infectious etiologies. This report describes a twenty-year-old African American female who developed bilateral frosted branch angiitis one week after small-pox vaccination. At presentation, the patient had bilateral, para-central visual field defects and subjective visual disturbances. On dilated exam, the patient demonstrated diffuse vasculitis bilaterally. The patient's field defects and clinical exam responded dramatically to oral prednisone therapy.

CONCLUSIONS AND IMPORTANCE: …

Fiber Bragg Grating Array For Shape Reconstruction In Structural Elements, Edson A Souza, Leandro C Macedo, Anselmo Frizera, Carlos Marques, Arnaldo Leal-Junior

Faculty, Staff and Student Publications

This paper presents the development, analysis and application of a fiber Bragg grating (FBG) array for two-dimensional (2D) shape reconstruction in a cantilever beam. The structural elements made of Pinus wood and Nylon 6.0 were numerically analyzed using the finite element method for the strain distribution when constant loading is applied at the free end of the beam. In addition, the temperature compensation method is proposed to decouple the temperature cross-sensitivity in the deflection analysis. In this case, the temperature sensitivities of all sensing elements of the 5-FBG array were obtained. An additional FBG was encapsulated in a silicone mold …

Accuracy Of Iol Power Calculation Formulas For Acrysof Sn60wf Versus Tecnis Zcb00 Intraocular Lenses, Cynthia C Jiang, Noah M Hodson, Daniel A Johnson, Ahmad Kheirkhah

Faculty, Staff and Student Publications

PURPOSE: To compare the accuracy of various intraocular lens power formulas for two monofocal hydrophobic foldable lenses, the AcrySof SN60WF and the Tecnis ZCB00.

METHODS: This retrospective study included 409 eyes from 409 patients who underwent uncomplicated cataract surgery (299 eyes with SN60WF and 110 eyes with ZCB00). Biometry was performed for all eyes with an IOLMaster 700. Predicted refraction from five different IOL power formulas (Barrett Universal II, Haigis, Hoffer-Q, Holladay 2, and SRK/T) was compared to postoperative refraction at one to three months for the following axial length strata: short eyes (

RESULTS: In patients with medium eyes, …

Impact Of The Time To Surgery On Visual Outcomes For Rhegmatogenous Retinal Detachment Repair: A Meta-Analysis, Amirthan Sothivannan, Arshia Eshtiaghi, Arjan S. Dhoot, Marko M. Popovic, Sunir J. Garg, Peter J. Kertes, Rajeev H. Muni

Wills Eye Hospital Papers

PURPOSE: To determine the relationship between time from symptom onset or presentation to repair and visual outcomes for macula-on and macula-off rhegmatogenous retinal detachment (RRD).

DESIGN: Meta-analysis.

METHODS: We searched MEDLINE, EMBASE, and Cochrane Library for randomized controlled trials and observational studies comparing best-corrected visual acuity (BCVA) based on time to RRD repair. Study identifiers, baseline characteristics, intervention characteristics, and visual outcomes were extracted. We conducted a random effects meta-analysis. Sensitivity analyses included leave-1-out and influence analyses. Primary outcomes included mean difference (MD) in final BCVA, MD between preoperative and final BCVA (∆BCVA), and relative risk of final BCVA24 hours. …

Barriers To Care For Poststroke Visual Deficits In Alberta, Canada, Kiran Pohar Manhas, Karim F. Damji, Katelyn Brehon, Jennis Jiang, Peter Faris, Fiona Costello

Department of Ophthalmology & Visual Sciences

Poststroke visual impairment (VI) negatively affects rehabilitation potential and quality of life for stroke survivors. In this cross-sectional observational study, stroke survivors and providers were surveyed to quantify perspectives regarding care for poststroke VI in Alberta, Canada (n = 46 survivors; n = 87 providers). Few patients (35%) felt prepared to cope with VI at the time of discharge from acute stroke and inpatient rehabilitation settings. Less than 25% of stroke survivors, and <16% of providers, felt referral processes were adequate. 95.2% of providers and 82% of stroke survivors advocated for a provincial clinical pathway to improve care quality for poststroke VI.

Cytochrome C: A Potential Early Biomarker Of Diabetic Retinopathy, Ileana G. Villarreal

Theses and Dissertations

Diabetic retinopathy is an ocular disease which appears in patients who experience progression of diabetes mellitus over a continuous period. Oftentimes, patients go undiagnosed due to the fact that there is no way to determine when the exact moment a patient develops diabetic retinopathy. Ophthalmologists and other eye specialists diagnose a patient with diabetic retinopathy once the patient begins to show progressed symptoms of the disease. Various experiments have been previously performed to increase our knowledge of the connection of diabetic retinopathy and early biomarkers of the disease. Several studies have determined the effects of diabetic retinopathy and apoptosis with …

Immune Phenotype Of The Cd4+ T Cells In The Aged Lymphoid Organs And Lacrimal Glands, Claudia M Trujillo-Vargas, Kelsey E Mauk, Humberto Hernandez, Rodrigo G De Souza, Zhiyuan Yu, Jeremias G Galletti, Jana Dietrich, Friedrich Paulsen, Cintia S De Paiva

Faculty, Staff and Students Publications

Aging is associated with a massive infiltration of T lymphocytes in the lacrimal gland. Here, we aimed to characterize the immune phenotype of aged CD4+ T cells in this tissue as compared with lymphoid organs. To perform this, we sorted regulatory T cells (Tregs, CD4+CD25+GITR+) and non-Tregs (CD4+CD25negGITRneg) in lymphoid organs from female C57BL/6J mice and subjected these cells to an immunology NanoString® panel. These results were confirmed by flow cytometry, live imaging, and tissue immunostaining in the lacrimal gland. Importantly, effector T helper 1 (Th1) genes were highly upregulated on aged Tregs, including the master regulator Tbx21. Among …

Glucose Uptake By Glut1 In Photoreceptors Is Essential For Outer Segment Renewal And Rod Photoreceptor Survival, Lauren L. Daniele, John Y.S. Han, Ivy S Samuels, Ravikiran Komirisetty, Nikhil Mehta, Jessica L Mccord, Minzhong Yu, Yekai Wang, Kathleen Boesze-Battaglia, Brent A Bell, Jianhai Du, Neal S Peachey, Nancy J. Philp

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Photoreceptors consume glucose supplied by the choriocapillaris to support phototransduction and outer segment (OS) renewal. Reduced glucose supply underlies photoreceptor cell death in inherited retinal degeneration and age-related retinal disease. We have previously shown that restricting glucose transport into the outer retina by conditional deletion of Slc2a1 encoding GLUT1 resulted in photoreceptor loss and impaired OS renewal. However, retinal neurons, glia, and the retinal pigment epithelium play specialized, synergistic roles in metabolite supply and exchange, and the cell-specific map of glucose uptake and utilization in the retina is incomplete. In these studies, we conditionally deleted Slc2a1 in a pan-retinal or …

Management Of The Facial Nerve Following Temporal Bone Ballistic Injury, Anne K. Maxwell, John C. Lemoine, Jacob B. Kahane, Celeste C. Gary

School of Medicine Faculty Publications

Objective: To understand the patterns of temporal bone fracture and facial nerve injury from ballistic trauma. Study Design: Retrospective case series. Methods: Retrospective review of 42 patients evaluated following temporal bone ballistic injury at a single institution, university-based level-one trauma center between 2012 and 2021. Demographics, facial nerve status, CT images, interventions, complications, and outcomes were reviewed. Results: Mean age 30.3 years (range 5–58 years); 79% male. Racial demographics reflected the surrounding community. Seven mortalities occurred. Nineteen patients (54%) demonstrated facial nerve injury. Of those, 13/19 displayed immediate paralysis, 1 delayed, 5 unknown (due to altered mental status). On consultation, …

Paclitaxel And Urolithin A Prevent Histamine-Induced Neurovascular Breakdown Alike, In An, Srijayaprakash Uppada, Dianxiong Zou, Erin M Scott, Gladys Ko, Stephen Pflugfelder, M N V Ravi Kumar, Raghu Ganugula

Faculty, Staff and Students Publications

Neurovascular eye problems are better prevented than managed or treated. Despite growing concern of occurrence in aging populations and development secondary to diseases such as diabetes and hypertension, we currently have very few options to tackle this global problem. Creating effective and high-throughput screening strategies is as important as the intervention itself. Here, we present for the first time a robust ex vivo rat eye model of histamine-induced vascular damage for investigating the therapeutic potential of paclitaxel (PTX) and urolithin A (UA) as alternatives to dexamethasone for preventing vascular damage in the retina. Extensive loss of vascularization and apoptosis were …

Differential Susceptibility Of Retinal Neurons To The Loss Of Mitochondrial Biogenesis Factor Nrf1, Takae Kiyama, Ching-Kang Chen, Annie Zhang, Chai-An Mao

Faculty, Staff and Student Publications

The retina, the accessible part of the central nervous system, has served as a model system to study the relationship between energy utilization and metabolite supply. When the metabolite supply cannot match the energy demand, retinal neurons are at risk of death. As the powerhouse of eukaryotic cells, mitochondria play a pivotal role in generating ATP, produce precursors for macromolecules, maintain the redox homeostasis, and function as waste management centers for various types of metabolic intermediates. Mitochondrial dysfunction has been implicated in the pathologies of a number of degenerative retinal diseases. It is well known that photoreceptors are particularly vulnerable …

In Vivo Determination Of The Human Corneal Elastic Modulus Using Vibrational Optical Coherence Tomography, Marcos A. Crespo, Hiram J. Jimenez, Tanmay Deshmukh, Jose S. Pulido, Ahmed Saeed Saad, Frederick H Silver, Dominick A Benedetto, Christopher J Rapuano, Zeba Syed

Wills Eye Hospital Papers

Purpose: To determine the in vivo elastic modulus of the human cornea using vibrational optical coherence tomography (VOCT).

Methods: Vibrational analysis coupled with optical coherence tomography (OCT) was used to obtain the resonant frequency (RF) and elastic modulus of corneal structural components. VOCT corneal thickness values were measured using OCT images and correlated with corneal thickness determined with Pentacam (Oculus, Wetzlar, Germany). Moduli were obtained at two locations: central cornea (CC) and inferior cornea (IC). Measurements were obtained with and without anesthetic eye drops to assess their effect on the modulus measurements.

Results: VOCT thickness values correlated positively (R2 = …

Impact Of Coronavirus Disease 2019 Restrictions On Retinal Detachment: A Multicenter Experience, Jesse J Jung, Jonathan S Chang, Patrick R Oellers, Mohsin H Ali, Brian K Do, Joseph J Tseng, Roberto Roizenblatt, Rajeev H Muni, Christina Y Weng, Zackery B Oakey, Sean W Tsao, Soraya Rofagha, Xavier Chan, Quan V Hoang

Faculty, Staff and Students Publications

In this retrospective, multicenter study of 261 eyes (259 patients), patients who underwent rhegmatogenous retinal detachment repair during the coronavirus disease 2019 (COVID-19) post-lockdown period experienced an additional 22-day delay, leading to significantly more epiretinal membrane and proliferative vitreoretinopathy and lower single-surgery anatomic success rates. During lockdown, perfluoropropane gas was used more commonly, and pneumatic retinopexy was used more commonly in COVID-19-positive patients.

Nf-Kb (P50/P65)-Mediated Pro-Inflammatory Microrna (Mirna) Signaling In Alzheimer's Disease (Ad), Walter J. Lukiw

School of Medicine Faculty Publications

No abstract provided.

Divergent Outer Retinal Circuits Drive Image And Non-Image Visual Behaviors, Corinne Beier, Ulisse Bocchero, Lior Levy, Zhijing Zhang, Nange Jin, Stephen C Massey, Christophe P Ribelayga, Kirill Martemyanov, Samer Hattar, Johan Pahlberg

Faculty, Staff and Student Publications

Image- and non-image-forming vision are essential for animal behavior. Here we use genetically modified mouse lines to examine retinal circuits driving image- and non-image-functions. We describe the outer retinal circuits underlying the pupillary light response (PLR) and circadian photoentrainment, two non-image-forming behaviors. Rods and cones signal light increments and decrements through the ON and OFF pathways, respectively. We find that the OFF pathway drives image-forming vision but cannot drive circadian photoentrainment or the PLR. Cone light responses drive image formation but fail to drive the PLR. At photopic levels, rods use the primary and secondary rod pathways to drive the …

Functional Attenuation Coefficient Imaging Of Rod Inner Segment: The Shape Of Things To Come, Cole Goodman

Medical Student Research Symposium

Purpose: Dysfunction of mitochondria and their linked processes within the rod cell (i.e., the rod energy-landscape) are leading hypotheses for rod atrophy in retinitis pigmentosa (RP). It remains unclear how to translate the detailed information available from isolated cell / mitochondria studies into how mitochondria are functioning and responding to treatment in vivo. Here we present a new rod energy-landscape biomarker that can help address this problem using a common clinical tool.

Methods: In mice, OCT data was converted into attenuation coefficients (AC) to map the light-scattering of mitochondria within the inner segment (IS), which fills ~75% of its volume …

False-Positive Serum Igm/Igg To Sars-Cov-2 In A Rare Pulmonary Neuroendocrine Carcinoma With Ocular Metastasis: A Case Report, Irandi P. Pratomo, Gatut Priyonugroho, Aris Ramdhani, Dian Zamroni, Thariqah Salamah, Yayi D.B Susanto, Ramdinal A. Zairinal, Annisa N. Witjaksono, Dita Aditianingsih, Jamal Zaini

The New Ropanasuri Journal of Surgery

The Coronavirus disease 2019 (COVID-19) pandemic impacts pulmonary cancer management since it shares similar clinical features and creates fear among patients to visit hospitals due to possible in-hospital disease transmission. We report a patient who presented with a rare case of a pulmonary neuroendocrine tumor with an ocular involvement, which, unfortunately, experienced a delay in diagnostics. The first hospitalization was due to superior vena cava syndrome, pleural and pericardial effusions, and swollen left eye. The patient was diagnosed with pulmonary cancer, released after the symptoms were relieved, and expected to visit a referral hospital for further diagnostics and treatments. The …

Retained Lens Fragment Presenting 32 Years After Cataract Extraction, Thomas Tien, Marcos A Crespo, Tatyana Milman, Zeba Syed

Wills Eye Hospital Papers

Purpose: To report a patient with retained lens material presenting over three decades after initial cataract extraction with fluctuating corneal edema and intraocular inflammation.

Observations: A 66-year-old man presented with a first episode of decreased vision and photophobia 32 years after cataract extraction without intraocular lens implantation in the right eye. Slit lamp examination revealed a tan-colored oblong mass in the inferior angle, in addition to corneal edema and an anterior chamber reaction. The patient was aphakic with traumatic mydriasis, and accordingly it was noted that the mass shifted location between anterior and posterior chambers over subsequent evaluations. The anterior …

Persistent Opioid Use In Cataract Surgery Pain Management And The Role Of Nonopioid Alternatives, Richard S Davidson, Kendall Donaldson, Maggie Jeffries, Sumitra Khandelwal, Michael Raizman, Yasaira Rodriguez Torres, Terry Kim

Faculty, Staff and Students Publications

Cataracts are a leading cause of preventable blindness globally. Although care varies between developing and industrialized countries, surgery is the single effective approach to treating cataracts. From the earliest documented primitive cataract removals to today's advanced techniques, cataract surgery has evolved dramatically. As surgical techniques have developed, so have approaches to surgical pain management. With current cataract surgical procedures and advanced technology, anesthesia and intraoperative pain management have shifted to topical/intracameral anesthetics, with or without low-dose systemic analgesia and anxiolysis. Despite this, pain and discomfort persist in some patients and are underappreciated in modern cataract surgery. Although pain management has …