Ophthalmology Commons^™

Ophthalmic Manifestations Of Congenital Zika Syndrome In Colombia And Venezuela, Juan B. Yepez, Felipe A. Murati, Michele Petitto, Carlos F. Peñaranda, J. Fernando Arevalo, Gladys E. Maestre

School of Medicine Publications

IMPORTANCE The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed.

OBJECTIVE To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela.

DESIGN, …

Loss Of Displaced Starburst Amacrine Cells In A Rat Glaucoma Model, C A. Cooley-Themm, Q Ameel, David M. Linn, Cindy L. Linn

Peer Reviewed Articles

Acetylcholine (ACh) release by starburst amacrine cells (SACs) has been implicated in the production of retinal waves during early retinal development. Inhibitory gamma-aminobutyric acid (GABA) release by SACs is known to be involved in directional selectivity in the mature retina. However, the role of SAC release of ACh in the adult developed mammalian retina is not entirely understood. Some evidence suggests a neuroprotective effect on retinal ganglion cells (RGCs) acting through alpha7 nicotinic acetylcholine receptors (nAChRs) present in RGCs. If ACh released by SACs is neuroprotective to RGCs, it would follow that this cholinergic transmission might be compromised in glaucoma …

Latanoprost And Timolol In Hydrogel Soft Drug-Dispensing Contact Lenses: A Comparative Analysis, Neha Potdar

Virginias Collegiate Honors Council Conference

Glaucoma patients only can instill glaucoma eye drops. This results in 1-7% absorption of the medication. Surveys show that patients forget to take their medication and have difficulty inserting their eye drops. Researchers at the Massachusetts Eye and Ear Infirmary have developed latanoprost drug-dispensing hydrogel soft contact lenses that dispense the drug to help facilitate the process. However, some glaucoma patients do not respond to latanoprost because they have uveitic glaucoma or do not want to experience latanoprost’s ocular side effects. Patients need an alternative which can be inserted into these contact lenses. Another commonly used glaucoma drug is timolol …

Medical Resource Utilization Of Outpatient Care For Children With Neurofibromatosis Type 1, Rabia Idrees, Michael Fisher, Rachel Hachen, Brian Callaghan, Robert A. Avery

GW Research Days 2016 - 2020

Background:

Neurofibromatosis Type 1 (NF1) is an autosomal dominant syndrome with manifestations affecting the central nervous system, musculoskeletal system, peripheral nervous system, and cognitive/behavioral functions. Many of these manifestations persist throughout life and require medical/surgical interventions.

The resource utilization and economic burden of caring for children with NF1 is unknown. Prior research has inherent selection bias and does not accurately reflect the incidence/resource utilization of morbidities. In order to identify which disease manifestations are in the most need of improved clinical algorithms and novel therapeutics, the frequency/type of resources utilized (i.e., diagnostic imaging and specialty visits) must be determined.

The …

Perioperative Vision Loss In Cervical Spinal Surgery., Brandon C Gabel, Arthur Lam, Jens R Chapman, Rod J Oskouian, Ahmad Nassr, Bradford L Currier, Arjun S Sebastian, Paul M Arnold, Steven Hamilton, Michael G Fehlings, Thomas E Mroz, K Daniel Riew

Articles, Abstracts, and Reports

STUDY DESIGN: Retrospective multicenter case series.

OBJECTIVE: To assess the rate of perioperative vision loss following cervical spinal surgery.

METHODS: Medical records for 17 625 patients from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network who received cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, inclusive, were reviewed to identify occurrences of vision loss following surgery.

RESULTS: Of the 17 625 patients in the registry, there were 13 946 patients assessed for the complication of blindness. There were 9591 cases that involved only anterior surgical approaches; the remaining …

GabaB Receptor Attenuation Of GabaA Currents In Neurons Of The Mammalian Central Nervous System, Wen Shen, Changlong Nan, Peter T. Nelson, Harris Ripps, Malcolm M. Slaughter

Pathology and Laboratory Medicine Faculty Publications

Ionotropic receptors are tightly regulated by second messenger systems and are often present along with their metabotropic counterparts on a neuron's plasma membrane. This leads to the hypothesis that the two receptor subtypes can interact, and indeed this has been observed in excitatory glutamate and inhibitory GABA receptors. In both systems the metabotropic pathway augments the ionotropic receptor response. However, we have found that the metabotropic GABA_B receptor can suppress the ionotropic GABA_A receptor current, in both the in vitro mouse retina and in human amygdala membrane fractions. Expression of amygdala membrane microdomains in Xenopus oocytes by microtransplantation …

Management Of Giant Retinal Tear Detachments, Maria H. Berrocal, Megan Chenworth, Luis A. Acaba

Student Papers, Posters & Projects

Giant retinal tears (GRTs) are full-thickness circumferential tears of more than 90 degrees of the retina that are associated with vitreous detachment. They are related to ocular trauma, high myopia, aphakia, pseudophakia, genetic mutations involving collagen and young age. GRTs comprise 1.5% of all rhegmatogenous retinal detachments and the average age of incidence is 42 years. GRTs are more common in males, as 72% of all cases occur in males. The incidence of GRTs in the general population is estimated to be 0.05 per 100,000 individuals. Common techniques used in the management of GRTs include fluid-air exchange, pneumatic retinopexy, scleral …

Phosphorylation Of Prb: Mechanism For Rb Pathway Inactivation In Mycn-Amplified Retinoblastoma., Kathryn G. Ewens, Tricia R. Bhatti, Kimberly A. Moran, Jennifer Richards-Yutz, Carol L. Shields, Ralph C. Eagle Jr., Arupa Ganguly

Wills Eye Hospital Papers

A small, but unique subgroup of retinoblastoma has been identified with no detectable mutation in the retinoblastoma gene (RB1) and with high levels of MYCN gene amplification. This manuscript investigated alternate pathways of inactivating pRb, the encoded protein in these tumors. We analyzed the mutation status of the RB1 gene and MYCN copy number in a series of 245 unilateral retinoblastomas, and the phosphorylation status of pRb in a subset of five tumors using immunohistochemistry. There were 203 tumors with two mutations in RB1 (RB1(-/-) , 83%), 29 with one (RB1(+/-) , 12%) and 13 with no detectable mutations (RB1(+/+) …

Functional Outcomes Of The Low Vision Depression Prevention Trial In Age-Related Macular Degeneration., Ashley D. Deemer, Robert W. Massof, Barry W. Rovner, Robin J. Casten, Catherine V. Piersol

Department of Psychiatry and Human Behavior Faculty Papers

Purpose: To compare the efficacy of behavioral activation (BA) plus low vision rehabilitation with an occupational therapist (OT-LVR) with supportive therapy (ST) on visual function in patients with age-related macular degeneration (AMD).

Methods: Single-masked, attention-controlled, randomized clinical trial with AMD patients with subsyndromal depressive symptoms (n = 188). All subjects had two outpatient low vision rehabilitation optometry visits, then were randomized to in-home BA + OT-LVR or ST. Behavioral activation is a structured behavioral treatment aiming to increase adaptive behaviors and achieve valued goals. Supportive therapy is a nondirective, psychological treatment that provides emotional support and controls for attention. Functional …

Stones, Bones, Groans, Thrones, And Psychiatric Overtones: Systemic Associations Of Sclerochoroidal Calcification., Jordan A Sugarman, Alexzandra M Douglass, Emil Anthony T. Say, Carol L. Shields

Wills Eye Hospital Papers

Sclerochoroidal calcification (SCC) is a frequent masquerader of choroidal melanoma with important systemic associations such as hyperparathyroidism and parathyroid adenoma. Herein, we describe a case of a 67-year-old male who presented with an amelanotic choroidal lesion in the right eye (OD) and a history of kidney stones. Ultrasonography showed the lesion to be flat and calcified OD. Incidentally, a subclinical calcified plaque was also found in the fellow eye. Optical coherence tomography showed an elevated suprachoroidal mass in a table mountain configuration OD and flat configuration left eye, consistent with type 4 and type 1 SCC. The patient was referred …

Serum Hypercoagulability States In Coats' Disease., Fariba Ghassemi, Carol L. Shields, Masoumeh Mohebbi, Mehdi Nili Ahmadabadi, Fatemeh Morsali, Siamak Sabour

Wills Eye Hospital Papers

PURPOSE: The purpose of this study was to investigate the serum hypercoagulability state and common viral and protozoan infections in Coats' disease versus a normal control group.

MATERIALS AND METHODS: In this comparative case series, 22 consecutive patients with Coats' disease and 19 non-Coats' patients undergoing lensectomy for congenital, traumatic, or senile cataract between January 2011 and June 2014 were included. Laboratory data for hypercoagulability states and common viral and protozoan infections were investigated.

RESULTS: The mean age for the Coats' group was 14.5 years (median 8 years, range: 2 months to 59 years), and for the control group it …

Association Of Intraocular Pressure With Human Immunodeficiency Virus, Matthew T. Young, Rakhi T. Melvani, Faraaz A. Khan, Puneet S. Braich, Surbhi Bansal

Ophthalmology Publications

PURPOSE: Prior studies have shown an association between human immunodeficiency virus (HIV) and reduced intraocular pressures (IOP). The purpose of this study was to determine if patients with HIV on highly active antiretroviral therapy (HAART) had any difference in their IOP compared with patients without HIV or with HIV who are not on HAART.

DESIGN: Retrospective cross-sectional study.

METHODS: We included 400 patients from our academic eye center between 2000 and 2016. Group 1 (G1) consisted of patients with HIV on HAART (n = 176), Group 2 (G2) consisted of patients with HIV who were not on HAART (n = …

Antibiotic Prophylaxis In Orbital Fractures., Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz

Ophthalmology Faculty Publications

Purpose:

To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection.

Design:

Retrospective cohort study.

Participants:

All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics.

Main Outcome Measures:

Development of orbital infection.

Results:

One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria. No orbital infections were documented. Twenty subjects (12%) received no prophylactic antibiotic, and two (1%) received only one dose of antibiotics pre-operatively for surgery. For primary antibiotic, 136 subjects (79%) received oral antibiotics, and 14 (8%) received …

Recent Advances In The Management And Understanding Of Diabetic Retinopathy, Matthew Powers, Margaret Greven, Robert Kleinman, Quan D. Nguyen, Diana V. Do

Journal Articles: Ophthalmology

Despite recent advances in the diagnosis and treatment of diabetic retinopathy, this complication remains a steadfast challenge to patients and physicians. This review summarizes recent progress in the diagnosis and management of diabetic retinopathy, including automated screening, optical coherence tomography, control of systemic risk factors, surgical techniques, laser treatment, and pharmaceutical treatment, including vascular endothelial growth factor inhibitors. Recent advances in pharmaceutical treatments, in particular, hold strong promise of halting and sometimes reversing the disease process. Clinicians nevertheless must remain vigilant in their efforts to diagnose and treat this disease early in its course.

Role Of Myo/Nog Cells In Neuroprotection: Evidence From The Light Damaged Retina., Alice Brandli, Jacquelyn Gerhart, Christopher K Sutera, Sivaraman Purushothuman, Mindy George-Weinstein, Jonathan Stone, Arturo Bravo Nuevo

PCOM Scholarly Works

PURPOSE: To identify Myo/Nog cells in the adult retina and test their role in protecting retinal photoreceptors from light damage.

METHODS: Light damage was induced by exposing albino rats raised in dim cyclic light to 1000 lux light for 24 hours. In one group of rats, Myo/Nog cells were purified from rat brain tissue by magnetic cell sorting following binding of the G8 monoclonal antibody (mAb). These cells were injected into the vitreous humour of the eye within 2 hours following bright light exposure. Retinal function was assessed using full-field, flash electroretinogram (ERG) before and after treatment. The numbers of …

Selective Fusion Of Structural And Functional Data For Improved Glaucoma Detection, Paul Y. Kim, Khan M. Iftekharuddin, Pinakin G. Davey, Gabor Holló, Martha Tóth, Anita Garas, Edward A. Essock

Electrical & Computer Engineering Faculty Publications

This work proposes novel selective feature fusion of structural and functional data for improved glaucoma detection. The structural data such as retinal nerve fiber layer (RNFL) thickness measurement acquired by scanning laser polarimetry (SLP) is fused with the functional visual field (VF) measurement recorded from the standard automated perimetry (SAP) test. The proposed selective feature fusion exploits correspondence between structural and functional data obtained over multiple sectors. The correlation coefficients for corresponding structural-function sector pairs are used as weights in subsequent feature selection. The sectors are ranked according to the correlation coefficients and the first four highly ranked sectors are …

Advancing Vibrational Spectroscopy For Cellular And Sub Cellular Analysis: Raman Spectroscopy As An In Vitro Chemotherapeutic Screeening And Assessment Protocol, Zeineb Farhane

Doctoral

Vibrational spectroscopy, including Raman micro-spectroscopy, has attracted considerable attention over the last few years, as a powerful, non-invasive tool for clinical applications, especially in cancer diagnosis, in vivo and ex vivo. As a molecular fingerprinting technique with optical resolution, Raman micro-spectroscopy is able to monitor biochemical processes, drug uptake, efficacy and mode of action and mechanisms of interaction of chemotherapeutic drugs at a subcellular level. In vitro applications may be more strategically achievable, and can help guide drug design and discovery, and eventually evaluate To this end, different lung cell lines were used and Raman micro-spectroscopy was coupled to valuable …

Optometric Case Finding For Glaucoma In Ireland: An Investigation Of Current Practice Patterns., Catriona Barrett

Doctoral

Optometrists play a vital role in the detection of glaucoma, a leading cause of irreversible blindness. As population screening for glaucoma is neither cost effective nor viable, glaucoma is primarily detected through opportunistic case-finding during routine eye examinations. The present study provides new insight into optometrists’ practice patterns for glaucoma detection in Ireland. Chapters 3 and 4 report on a national survey. The results show that optometrists are well equipped to carry out the traditional glaucoma case finding triad. However, moving towards enhanced services such as monitoring glaucoma suspects or ocular hypertension cases would require some investment in equipment and …

Bowled Over By Cricket: Impact Of Tape-Ball Injuries On The Eyes, Salman Naveed Sadiq, Azam Ali, Bushra Usmani, Khabir Ahmed

Department of Surgery Docs

Abstract

PURPOSE:

The aim of this study was to describe the type and severity of tape-ball cricket-related eye injuries seen at a tertiary care hospital.

DESIGN:

A descriptive case series.

METHODS:

This study included all cases of tape-ball cricket-related eye injuries presenting to the Section of Ophthalmology, Aga Khan University Hospital, Karachi, from January 2014 to January 2015.

RESULTS:

A total of 20 patients with tape-ball cricket-related eye injuries were treated during this period. The right eye was involved in most (14/20) of the cases. The commonest presenting symptoms included reduced/blurred vision, ocular pain, redness, and floaters. Sixty percent (12/20) …

Association Between Age-Related Macular Degeneration And Sleep-Disordered Breathing, Jeffrey A. Nau

Walden Dissertations and Doctoral Studies

Age-related macular degeneration (AMD) is a chronic, irreversible disease that robs individuals of vision, quality of life, and independence. It is the leading cause of blindness in industrialized countries. Sleep-disordered breathing (SDB) is a condition characterized by repeated episodes of apnea and/or hypopnea, insomnia, short sleep duration, and/or sleep disturbances (snoring, gasping, etc.). Because SDB has been shown to cause chronic hypoxia resulting in oxidative stress on the retina, it has been proposed that SDB may be associated with AMD. Based on the life course theory of chronic disease, this quantitative, cross-sectional study used data from the 2005-2008 National Health …