Ophthalmology Commons^™

Cost-Effectiveness Analysis Of Ocriplasmin Versus Watchful Waiting For Treatment Of Symptomatic Vitreomacular Adhesion In The Us, Arshad M Khanani, Pravin U Dugel, Julia A Haller, Alan L Wagner, Benedicte Lescrauwaet, Ralph Schmidt, Craig Bennison

Wills Eye Hospital Papers

Aim: Evaluate the cost-effectiveness of ocriplasmin in symptomatic vitreomacular adhesion (VMA) with or without full-thickness macular hole ≤400 μm versus standard of care.

Methods: A state-transition model simulated a cohort through disease health states; assignment of utilities to health states reflected the distribution of visual acuity. Efficacy of ocriplasmin was derived from logistic regression models using Ocriplasmin for Treatment for Symptomatic Vitreomacular Adhesion Including Macular Hole trial data. Model inputs were extracted from Phase III trials and published literature. The analysis was conducted from a US Medicare perspective.

Results: Lifetime incremental cost-effectiveness ratio was US$4887 per quality-adjusted life year gained …

Cystoid Macular Edema In A Child., Jordan Hamburger, Xiaolu Yang, Carol L Shields

Wills Eye Hospital Papers

N/A

Pilomatrix Carcinoma Of The Lacrimal Caruncle: A Case Report., Ibrahim Inan Harbiyeli, Altan A Ozcan, Arbil Acıkalin, Emine Ciloglu, Carol L Shields

Wills Eye Hospital Papers

A 45-year-old man presented with a 3-month history of a mass located in the caruncle of his right eye. An incisional biopsy had been performed one month prior by another specialist, and the histopathology report showed basal cell carcinoma. The mass was completely excised with a 2 mm safety margin, and the large conjunctival defect was reconstructed with one sheet of amniotic membrane allograft. A histological diagnosis of pilomatrix carcinoma was established. To prevent recurrence after surgery, we added bevacizumab (25 mg/mL, 1.25 mg/mL per drop) eye drops four times per day for three months. At the one-year follow-up, the …

Methods Of Administering Igg1 Antibodies And Methods Of Suppressing Angiogenesis, Jayakrishna Ambati, Sandro De Falco

Ophthalmology and Visual Science Faculty Patents

A method of suppressing angiogenesis involves administering to a subject an isolated Fc fragment of an IgG1 antibody, or an IgG1 antibody.

Diagnostic Criteria For Detection Of Retinal Nerve Fibre Layer Thickness And Neuroretinal Rim Width Abnormalities In Glaucoma, Feihui Zheng, Marco Yu, Christopher Kai-Shun Leung

Faculty, Staff and Student Publications

BACKGROUND/AIMS: Although measurements of the Bruch's membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) with optical coherence tomography (OCT) have been widely adopted in the diagnostic evaluation of glaucoma, there is no consensus on the diagnostic criteria to define BMO-MRW and RNFLT abnormalities. This study investigated the sensitivities and specificities of different diagnostic criteria based on the OCT classification reports for detection of glaucoma.

METHODS: 340 eyes of 137 patients with glaucoma and 87 healthy individuals, all with axial length ≤26mm, had global and sectoral BMO-MRW and RNFLT measured with Spectralis OCT (Heidelberg Engineering). Six …

Doctor, I'M Seeing Two Of Everything., Alex Davis, Christopher M Lloyd

Ambulatory and Primary Care Articles

Acute diplopia is a rare chief complaint with a broad differential diagnosis; key historical and physical characteristics aid with emergency management. This case report discusses the important findings, imaging, and multidisciplinary interaction between emergency medicine, ophthalmology, and neurology regarding the approach to addressing acute painless vertical diplopia. A 51-year-old male presented to the emergency department (ED), reporting that he was seeing 'two of everything,' since awakening. Although the patient had a history of ischemic stroke, he had never experienced this sensation of diplopia. His ED workup was essentially unremarkable; he was admitted for evaluation of the possibilities of a fourth …

Living With Covid-19: A Perspective From New York Area Ophthalmology Residency Program Directors At The Epicenter Of The Pandemic, Rw Chen, A Abazari, S Dhar, Dr Fredrick, Ib Friedman, Lr Dagi Glass, As Khouri, Et Kim, J. Laudi, J Winokur, +6 Additional Authors

Journal Articles

No abstract provided.

Long-Term Effect Of Intraocular Lens Vs Contact Lens Correction On Visual Acuity After Cataract Surgery During Infancy: A Randomized Clinical Trial, S. R. Lambert, G. Cotsonis, L. Dubois, A. Nizam, S. J. Kruger, E. E. Hartmann, D. R. Weakley, C. Drews-Botsch

Journal Articles

© 2020 American Medical Association. All rights reserved. Importance: Although intraocular lenses (IOLs) are often implanted in children, little is known whether primary IOL implantation or aphakia and contact lens correction results in better long-term visual outcomes after unilateral cataract surgery during infancy. Objective: To compare long-term visual outcomes with contact lens vs IOL correction following unilateral cataract surgery during infancy. Design, Setting, and Participants: This multicenter randomized clinical trial enrolled 114 infants with a unilateral congenital cataract who underwent cataract surgery with or without primary IOL implantation between 1 and 6 months of age. Data on long-term visual outcomes …

Nr2e3 Is A Genetic Modifier That Rescues Retinal Degeneration And Promotes Homeostasis In Multiple Models Of Retinitis Pigmentosa, Sujun Li, Shyamtanu Datta, Emily Brabbit, Zoe Love, Victoria Woytowicz, Kyle Flattery, Jessica Capri, Katie Yao, Siqi Wu, Michael Imboden, Arun Upadhyay, Rasappa Arumugham, Wallace B. Thoreson, Margaret M Deangelis, Neena B. Haider

Journal Articles: Ophthalmology

Recent advances in viral vector engineering, as well as an increased understanding of the cellular and molecular mechanism of retinal diseases, have led to the development of novel gene therapy approaches. Furthermore, ease of accessibility and ocular immune privilege makes the retina an ideal target for gene therapies. In this study, the nuclear hormone receptor gene Nr2e3 was evaluated for efficacy as broad-spectrum therapy to attenuate early to intermediate stages of retinal degeneration in five unique mouse models of retinitis pigmentosa (RP). RP is a group of heterogenic inherited retinal diseases associated with over 150 gene mutations, affecting over 1.5 …

Ocular Findings In The 16p11.2 Microdeletion Syndrome: A Case Report And Literature Review, Cybil S. Stingl, Colleen Jackson-Cook, Natario L. Couser

Ophthalmology Publications

The recurrent 16p11.2 microdeletion is characterized by developmental delays and a wide spectrum of congenital anomalies. It has been well reported that individuals with this ∼593-kb interstitial deletion have an increased susceptibility toward the autism spectrum disorder (ASD). Abnormalities of the eye and ocular adnexa are also commonly associated findings seen in individuals with the 16p11.2 microdeletion syndrome, although these ophthalmic manifestations have not been well characterized. We conducted an extensive literature review to highlight the eye features in patients with the 16p11.2 microdeletion syndrome and describe a 5-year-old boy with the syndrome. The boy initially presented with intellectual disability, …

Oculodentodigital Dysplasia: A Case Report And Major Review Of The Eye And Ocular Adnexa Features Of 295 Reported Cases, Virang Kumar, Natario L. Couser, Arti Pandya

Ophthalmology Publications

Oculodentodigital dysplasia (ODDD) is a rare genetic disorder associated with a characteristic craniofacial profile with variable dental, limb, eye, and ocular adnexa abnormalities. We performed an extensive literature review to highlight key eye features in patients with ODDD and report a new case of a female patient with a heterozygous missense GJA1 mutation (c.65G>A, p.G22E) and clinical features consistent with the condition. Our patient presented with multiple congenital anomalies including syndactyly, microphthalmia, microcornea, retrognathia, and a small nose with hypoplastic alae and prominent columella; in addition, an omphalocele defect was present, which has not been reported in previous cases. …

Relationship Between Nerve Fiber Layer Hemorrhages And Outcomes In Central Retinal Vein Occlusion, A. Au, A. Hilely, J. Scharf, F. Gunnemann, D. Wang, I. Chehaibou, C. Iovino, C. Grondin, L. A. Yannuzzi, D. Sarraf, +31 Additional Authors

Journal Articles

Copyright 2020 The Authors PURPOSE. To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. METHODS. Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. RESULTS. 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 …

Consensus Nomenclature For Reporting Neovascular Age-Related Macular Degeneration Data: Consensus On Neovascular Age-Related Macular Degeneration Nomenclature Study Group, R. F. Spaide, G. J. Jaffe, D. Sarraf, K. B. Freund, S. R. Sadda, G. Staurenghi, N. K. Waheed, U. Chakravarthy, L. A. Yannuzzi, J. Fujimoto, +25 Additional Authors

Journal Articles

© 2019 American Academy of Ophthalmology Purpose: To establish a process to evaluate and standardize a state-of-the-art nomenclature for reporting neovascular age-related macular degeneration (AMD) data. Design: Consensus meeting. Participants: An international panel of retina specialists, imaging and image reading center experts, and ocular pathologists. Methods: During several meetings organized under the auspices of the Macula Society, an international study group discussed and codified a set nomenclature framework for classifying the subtypes of neovascular AMD and associated lesion components. Main Outcome Measures: A consensus classification of neovascular AMD. Results: The study group created a standardized working definition of AMD. The …

Rapid Keratitis And Perforation After Corneal Collagen Cross-Linking, M. Schear, A. Ragam, J. Seedor, I. Udell, C. Shih

Journal Articles

© 2020 Purpose: To describe a case of rapid keratitis and corneal perforation after epithelium off collagen cross-linking. Observations: We report a case of a 17-year-old male who underwent collagen cross-linking with the protocol and device approved by the United States Food and Drug Administration (FDA) that developed a corneal infiltrate 3 days after the procedure. He later developed corneal thinning and perforation on day 5 requiring the use of cyanoacrylate glue and a Kontur lens. Despite initial improvement in the infiltrate with fortified antibiotics he later had leakage of aqueous around the glue and a flat chamber requiring an …

Effects Of Corneal Transplant On Rates Of Retinal Detachment, Daniel S. Mackinnon, Zeba A. Syed, Md, Durga Borkar, Hannah Levin

Phase 1

Introduction: Corneal transplant remains the gold standard treatment for irreversible corneal damage. The purpose of this study is to evaluate retinal detachment rates and clinical outcomes after penetrating keratoplasty (PK) and endothelial keratoplasty (EK). We hypothesized that corneal transplants would increase the rate of RD.

Methods: This retrospective cohort study utilized corneal transplant data from all surgical visits from PK or EK between April 1, 2012 and August 31, 2018. Individual charts were reviewed from patients who had a subsequent retinal detachment. Incidence of retinal detachment following PK or EK was the main outcome measured.

Results: A total of …

The Efficacy And Safety Profile Of Netarsudil 0.02% In Glaucoma Treatment: Real-World Outcomes, Eric Shiuey, Ms, Melih Ustaoglu, Md, Carina Sanvicente, Md, Reza Razeghinejad, Md, L. Jay Katz, Md, Jonathan Myers, Md, Daniel Lee, Md

Phase 1

Introduction: More effective glaucoma medications are necessary as medication intolerance and non-adherence remain problematic. Netarsudil is a newly FDA-approved Rho kinase inhibitor. We hypothesize that netarsudil will safely reduce intraocular pressure (IOP) compared to baseline even while other glaucoma medications are used.

Methods: This retrospective observational study was conducted on glaucoma patients seen at the Wills Eye Hospital Glaucoma Service who received netarsudil 0.02% between March and September of 2018. Intraocular pressure (IOP, via Goldmann applanation tonometry) and best corrected visual acuity (BCVA, via Snellen visual acuity charts) comparisons between baseline and 1- and 3-month follow-up visits were performed …

Conjunctival Melanoma: Features Based On The Fitzpatrick Skin Type (Fst) In 540 Patients At A Single Ocular Oncology Center, Sunihidi Ramesh, Antonio Yaghy, Lauren A. Dalvin, Sara E. Lally, Jerry A. Shields, Carol L. Shields

Phase 1

Background: The Fitzpatrick skin type (FST) is a classification system for skin pigmentation that has been used to stratify risk for cutaneous melanoma; however, it has not yet been explored in the context of conjunctival melanoma. Herein, we examine FST and its association with the clinical features of conjunctival melanoma.

Methods: A retrospective review was conducted on 540 medical records of patients with pathologic diagnosis of conjunctival melanoma. The patients were categorized according to the FST classification based on their external facial photographs at presentation. This includes: Type I (white skin color), Type II (fair skin color), Type III (average …

Microbial Keratitis After Penetrating And Endothelial Keratoplasty, Nicolas Dohse, Turner D. Wibbelsman, Sara Rapuano, Kristin Hammersmith, Parveen Nagra, Christopher Rapuano, Zeba A. Syed

Phase 1

Introduction: The purpose of this study is to review the incidence, risk factors, and outcomes of bacterial and fungal keratitis after penetrating keratoplasty (PK) and endothelial keratoplasty (EK).

Methods: The medical records at Wills Eye Hospital were reviewed for all cases of confirmed microbial keratitis following PK or EK performed between May 1, 2007 and September 1, 2018. Charts were examined to obtain demographic information, past ocular history, details of the microbial keratitis, and graft outcomes.

Results:A total of 2100 transplants (1269 PK and 831 EK) were performed in 1864 eyes of 1601 patients. The incidence of microbial …

Optimisation Of The Performance Of Holographic Beam-Shaping Diffractive Diffusers Through Refinement Of The Recording Process, Cara Jones, Suzanne Martin, Sanjay Keshri, Dervil Cody, Kevin Murphy

Conference Papers

Optical diffusers have uses in laser applications and machine vision. Typical fabrication at a commercial level requires master production and the stamping/copying of individual elements at scale. This expensive, indirect process inhibits custom diffusers at reasonable cost. Previously the authors published a novel, direct, single beam method of recording customizable and controllable volume holographic diffusers by manipulating laser speckle and recording the pattern in photopolymer. This method allows for beam-shaping to produce diffusion patterns of various sizes and shapes. In this work, the direct method of recording controllable holographic diffusers is refined to improve diffuser performance (i.e., a decrease in …

Myo/Nog Cells Are Nonprofessional Phagocytes, Jacquelyn Gerhart, Lindsay Gugerty, Paul Lecker, Fathma Abdalla, Mark Martin, Olivia Gerhart, Colby Gerhart, Karanveer Johal, Jake Bernstein, John Spikes, Keith Mathers, Arturo Bravo Nuevo, Mindy George-Weinstein

PCOM Scholarly Works

Myo/Nog cells were discovered in the chick embryo epiblast. Their expression of MyoD reflects a commitment to the skeletal muscle lineage and capacity to differentiate into myofibroblasts. Release of Noggin by Myo/Nog cells is essential for normal morphogenesis. Myo/Nog cells rapidly respond to wounding in the skin and eyes. In this report, we present evidence suggesting that Myo/Nog cells phagocytose tattoo ink in tissue sections of human skin and engulf cell corpses in cultures of anterior human lens tissue and magnetic beads injected into the anterior chamber of mice in vivo. Myo/Nog cells are distinct from macrophages in the skin …