Ophthalmology Commons^™

Unilateral Isolated Foveal Hypoplasia, A Jacobson, Thaddeus Wandel, Alan Springer

NYMC Faculty Publications

No abstract provided.

Protection Of Cells From Degeneration And Treatment Of Geographic Atrophy, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Patents

Therapeutic uses P2X₇ inhibition and inhibition of IRAK1 and/or IRAK4, methods protecting a cell, and screening methods for identifying inhibitors are described herein.

Synaptic Ribbon Active Zones In Cone Photoreceptors Operate Independently From One Another., Justin J. Grassmeyer, Wallace B. Thoreson

Journal Articles: Ophthalmology

Cone photoreceptors depolarize in darkness to release glutamate-laden synaptic vesicles. Essential to release is the synaptic ribbon, a structure that helps organize active zones by clustering vesicles near proteins that mediate exocytosis, including voltage-gated Ca(2+) channels. Cone terminals have many ribbon-style active zones at which second-order neurons receive input. We asked whether there are functionally significant differences in local Ca(2+) influx among ribbons in individual cones. We combined confocal Ca(2+) imaging to measure Ca(2+) influx at individual ribbons and patch clamp recordings to record whole-cell ICa in salamander cones. We found that the voltage for half-maximal activation (V50) of whole …

Intravitreal Melphalan For Treatment Of Primary Vitreoretinal Lymphoma: A New Indication For An Old Drug., Carol L. Shields, Kareem Sioufi, Arman Mashayekhi, Jerry A. Shields

Wills Eye Hospital Papers

No abstract provided.

Non-Adherence To Eye Care In People With Diabetes, Ann P. Murchison, Lisa A. Hark, Laura T. Pizzi, Yang Dai, Eileen Mayro, Philip P. Storey, Benjamin E. Leiby, Julia A. Haller

Wills Eye Hospital Papers

Objective Evaluate individual factors that impact adherence to eye care follow-up in patients with diabetes. Design and methods A 4-year retrospective chart review was conducted for 1968 patients with diabetes over age 40 from an urban academic center. Data collected included demographics, insurance, visual acuity, smoking status, medications, dates of dilated fundus examinations (DFE), and reported hemoglobin A1C and blood glucose levels. The primary outcome was timely DFE follow-up adherence following the initial eye exam visit. Results Overall, 41.6% of patients adhered to initial follow-up eye care recommendations. Multivariable analysis demonstrated that patients with severe diabetic retinopathy (DR) were more …

Autoimmune Retinopathy Associated With Systemic Lupus Erythematosus: A Diagnostic Dilemma., Wadakarn Wuthisiri, Yu-Hung Lai, Jenina Capasso, Martin Blidner, David Salz, Erik Kruger, Alex V. Levin

Wills Eye Hospital Papers

Visual loss in systemic lupus erythematosus (SLE) due to autoimmune retinopathy (AIR) is rare and easily misdiagnosed as hydroxychloroquine retinopathy. We report the rare clinical presentation of severe visual loss in a patient with SLE due to nonparaneoplastic AIR as differentiated from hydroxychloroquine toxicity. A 70-year-old female diagnosed and treated for lupus for 17 years and had been taking hydroxychloroquine for 15 years. Over the past 2 years, she developed progressive peripheral visual loss oculus uterque which rapidly advanced in the latter 6 months. Hydroxychloroquine toxicity was initially suspected, but diagnostic testing revealed a retinal degeneration. Antiretinal autoantibody testing using …

More Than Meets The Eye: The Contributions Of John Dalrymple (1803-1852)., Joy Mh Wang, Bryan Edwards, Gabrielle G Tardieu, Marios Loukas, Rod J Oskouian, R Shane Tubbs

Articles, Abstracts, and Reports

Having authored two major ophthalmology textbooks and honored with the eponym, the "Dalrymple sign," many are familiar with the works of Dr. John Dalrymple when it comes to the eye. However, few are aware of his other, numerous and wide-ranging contributions to the fields of science and medicine. In this article, we discuss the life and work of a man dedicated to the pursuit and advancement of knowledge and education.

Corneal Edema And Keratitis Following Selective Laser Trabeculoplasty, E T. Liu, L S. Seery, A Arosemena, Tania Lamba, C J. Chaya

Ophthalmology Faculty Publications

Purpose

To describe three cases of keratitis following Selective Laser Trabeculoplasty(SLT).

Observations

Three females with a history of glaucoma presented with corneal edema, keratitis (endothelial, epithelial) and decreased visual acuity shortly after SLT. There was variable resolution of symptoms after starting treatment with oral antiherpetics and topical steroids.

Conclusions and importance

With the increase in usage of SLT as a treatment for glaucoma and subsequent reports of keratitis, it is imperative for ophthalmic surgeons to be aware of herpes simplex as a possible risk factor. Prompt treatment with antivirals and steroids can potentially prevent scarring and permanent …

An Objective Assessment Of The Variability In Number Of Drops Per Bottle Of Glaucoma Medication, Daniel B. Moore, Judy Beck, Richard J. Kryscio

Ophthalmology and Visual Science Faculty Publications

Background: The purpose of this study is to evaluate the number of eyedrops available per bottle of a variety of commonly prescribed glaucoma medications.

Methods: Six bottles of each glaucoma medication were tested: three each in the vertical and horizontal orientations. Bottles were housed in a customized force gauge apparatus designed to mimic ballpoint fingertip contact with a bottle. At a standard rate, all drops were expressed from each bottle and counted with an automated drop counter. Simultaneously, bottle volume was measured and drop size and number were also estimated. The main outcome measures were: total number of drops, volume …

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 …

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(+/+) …

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 …

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 …