Ophthalmology Commons^™

Improving Function In Age-Related Macular Degeneration: A Randomized Clinical Trial., Barry W. Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E. Leiby, Allen C. Ho, William S. Tasman

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: To compare the efficacy of problem-solving therapy (PST) with supportive therapy (ST) to improve targeted vision function (TVF) in age-related macular degeneration (AMD).

DESIGN: Single-masked, attention-controlled, randomized clinical trial with outcome assessments at 3 months (main trial endpoint) and 6 months (maintenance effects).

PARTICIPANTS: Patients with AMD (n = 241) attending retina practices.

INTERVENTIONS: Whereas PST uses a structured problem-solving approach to reduce vision-related task difficulty, ST is a standardized attention-control treatment.

MAIN OUTCOME MEASURES: We assessed TVF, the 25-item National Eye Institute Vision Function Questionnaire plus Supplement (NEI VFQ), the Activities Inventory (AI), and vision-related quality of life …

Periocular Infantile Haemangioma And The Role Of Propranolol., Tanveer Anjum Chaudhry, Mustafa Kamal, Khabir Ahmad

Department of Surgery Docs

ABSTRACT This case of a four and a half-month-old girl describes periocular infantile haemangioma which was treated successfully with propranolol. She developed a red coloured lesion around the left upper eye lid at one week of age. A gradual increase was noticed in the size of the lesion and by the age of four and a half months, the swelling had increased enough to cover her visual axis, completely occluding her left eye. Oral propranolol therapy was initiated with a daily dosage of 1 mg/kg body weight. The dose was increased gradually, and there was an excellent response to propranolol …

Ultra-Small Rnas As Toll-Like Receptor-3 Antagonists, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Patents

Provided are methods and compositions for the treatment or prevention of macular degeneration or other diseases or disorders associated with activation of TLR3. Administration of double stranded RNAs having a length of 22 nucleotides or less treats or prevents macular degeneration or other diseases or disorders associated with activation of TLR3 due to the ability of the RNAs to bind to but not activate TLR3. Furthermore, all double stranded RNAs (both targeted and non-targeted) of 22 nucleotides or less in length can bind to but not activate TLR3 and thereby treat or prevent such conditions. Also provided of a method …

Horner's Syndrome Secondary To Neuroblastoma, Roberto A. Cruz, T. K. Tran, Nicky R. Holdeman, Christian Cajavilca, Rosa A. Tang

School of Medicine Publications

Horner’s syndrome is classically characterized by a triad of miosis, partial ptosis and anhidrosis. The etiology is due to an interruption in the sympathetic innervation to the eye. A prompt diagnosis is crucial, given that Horner’s syndrome could be a manifestation of a life-threatening condition. A thorough case history and clinical evaluation must be employed to arrive at the diagnosis. An important means for confirming Horner’s syndrome is pharmacological testing, which is also used to localize the level where the sympathetic chain is compromised. Following the diagnosis and localization of the lesion, an algorithm should be followed to determine the …

Visual Outcome Of Cataract Surgery, Farzeen Khalid Hashmi, Qazi Assad Khan, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 – 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract …

Visual Outcome Of Cataract Surgery, Farzeen Khalid Hashmi, Qazi Assad Khan, Tanveer Anjum Chaudhry, Khabir Ahmad

Department of Surgery Docs

The aim of this study was to assess whether the visual outcome of cataract surgery in the institution was in accordance with the World Health Organization recommendations. In this retrospective case series, all patients who underwent cataract surgery by a single surgeon from January 2009 till June 2011 were included. Date were collected from medical records on age, gender, visual acuity and causes of sub-optimal outcome. The main outcome was best-corrected visual acuity in the operated eye, measured 4 – 6 weeks after surgery. Data on visual outcome was grouped using WHO's classification. Of the 495 eyes that underwent cataract …

Withaferin A Effectively Targets Soluble Vimentin In The Glaucoma Filtration Surgical Model Of Fibrosis, Paola Bargagna-Mohan, Sunil P. Deokule, Kyle G. Thompson, John Wizeman, Cidambi Srinivasan, Sunil Vooturi, Uday B. Kompella, Royce Mohan

Ophthalmology and Visual Science Faculty Publications

Withaferin A (WFA) is a natural product that binds to soluble forms of the type III intermediate filament (IF) vimentin. Currently, it is unknown under what pathophysiological contexts vimentin is druggable, as cytoskeltal vimentin-IFs are abundantly expressed. To investigate druggability of vimentin, we exploited rabbit Tenon's capsule fibroblast (RbTCF) cell cultures and the rabbit glaucoma filtration surgical (GFS) model of fibrosis. WFA potently caused G₀/G₁ cell cycle inhibition (IC₅₀ 25 nM) in RbTCFs, downregulating ubiquitin E3 ligase skp2 and inducing p27(Kip1) expression. Transforming growth factor (TGF)-ß-induced myofibroblast transformation caused development of cell spheroids with numerous elongated invadopodia, which WFA blocked …

Reliability And Reproducibility Of Spectral And Time Domain Optical Coherence Tomography Images Before And After Correction For Patients With Age-Related Macular Degeneration., Mohammad A. Sadiq, Aymen Rashid, Roomasa Channa, Elham Hatef, Diana V. Do, Quan Dong Nguyen, Yasir J. Sepah

Journal Articles: Ophthalmology

PURPOSE: To evaluate the reproducibility and reliability of optical coherence tomography scans obtained using the time domain (TD-OCT) Stratus (TM) OCT, and the Spectral Domain (SD-OCT) Spectralis (TM) and Cirrus (TM) OCT devices before and after manual correction in eyes with either Neovascular (NV-AMD) or Non-Neovascular (NNV-AMD) age-related macular degeneration.

DESIGN: Prospective observational study.

SETTING: University-based retina practice.

PATIENTS: Thirty-six patients (50 eyes) with NV-AMD or NNV-AMD.

PROCEDURE: OCT scans were taken simultaneously using one TD-OCT and two SD-OCT devices.

MAIN OUTCOME MEASURES: Macular thickness measurements were assessed before and after correction of the algorithm by constructing Bland-Altman plots for …

Corticosteroids As Adjuvant Therapy For Ocular Toxoplasmosis., Smitha Jasper, Satyanarayana S. Vedula, Sheeja S. John, Saban Horo, Yasir J. Sepah, Quan Dong Nguyen

Journal Articles: Ophthalmology

BACKGROUND: Ocular infestation with Toxoplasma gondii, a parasite, may result in inflammation in the retina, choroid, and uvea and consequently lead to complications such as glaucoma, cataract, and posterior synechiae.

OBJECTIVES: The objective of this systematic review was to assess the effects of adjunctive use of corticosteroids for ocular toxoplasmosis.

SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, (January 1950 to October 2012), EMBASE (January 1980 to October 2012), Latin American and Caribbean …

The Muranga Teleophthalmology Study: Comparison Of Virtual (Teleglaucoma) With In-Person Clinical Assessment To Diagnose Glaucoma, Dan Kiage, Irfan N. Kherani, Stephen Gichuhi, Karim F. Damji, Muindi Nyenze

Internal Medicine, East Africa

Purpose: While the effectiveness of teleophthalmology is generally accepted, its ability to diagnose glaucomatous eye disease remains relatively unknown. This study aimed to compare a web-based teleophthalmology assessment with clinical slit lamp examination to screen for glaucoma among diabetics in a rural African district.

Materials and Methods: Three hundred and nine diabetic patients underwent both the clinical slit lamp examination by a comprehensive ophthalmologist and teleglaucoma (TG) assessment by a glaucoma subspecialist. Both assessments were compared for any focal glaucoma damage; for TG, the quality of photographs was assessed, and vertical cup-to-disk ratio (VCDR) was calculated in a semi-automated manner. …

Lasik In Hyperopic Eyes With Congenital Nystagmus: A Case Report, Sharmeen Akram, Zarksis H, Khabir Ahmad

Department of Surgery Docs

Patients with nystagmus are considered to be poor candidates for laser in situ keratomileusis (LASIK), because they are unable to fixate. This case report presents the first reported use of LASIK surgery with a solid-state laser in hypermetropia and congenital nystagmus. A 23 year old woman with congenital nystagmus had LASIK surgery to correct a refractive error of +2.25/+1.75 90º in the right eye and + 2.00 / +1.75 90º in the left one. Baseline uncorrected visual acuity (UCVA) was 20/200 in both eyes, and best spectacle corrected visual acuity was 20/40 in both the eyes. The procedure was performed …

Ocular Tolerability And Efficacy Of Intravitreal And Subconjunctival Injections Of Sirolimus In Patients With Non-Infectious Uveitis: Primary 6-Month Results Of The Save Study., Quan Dong Nguyen, Mohamed A. Ibrahim, Anthony Watters, Millena Bittencourt, Jithin Yohannan, Yasir J. Sepah, James P. Dunn, Joel Naor, Naveed Shams, Ovais Shaikh, Henry Alexander Leder, Diana V. Do

Journal Articles: Ophthalmology

BACKGROUND: The purpose of this study is to evaluate the ocular tolerability and efficacy of sirolimus administered as subconjunctival or intravitreal injections in patients with non-infectious uveitis. Sirolimus as a Therapeutic Approach for Uveitis (SAVE) is a prospective, randomized, open-label, interventional study. Thirty patients were enrolled and randomized in 1:1 ratio to receive either intravitreal injections of 352 μg sirolimus or subconjunctival injections of 1,320 μg at days 0, 60, and 120, with primary endpoint at month 6.

RESULTS: At month 6, all subjects with active uveitis at baseline showed reduction in vitreous haze of one or more steps. Forty …

Ultra-Wide-Field Retinal Imaging In The Management Of Non-Infectious Retinal Vasculitis., Henry A. Leder, John P. Campbell, Yasir J. Sepah, Theresa Gan, James P. Dunn, Elham Hatef, Brian Cho, Mohamed Ibrahim, Millena Bittencourt, Roomasa Channa, Diana V. Do, Quan Dong Nguyen

Journal Articles: Ophthalmology

BACKGROUND: The purpose of this study is to describe and quantify the benefit of ultra-wide-field imaging and fluorescein angiography (FA) in the management of non-infectious retinal vasculitis. In this prospective observational cohort series, patients with non-infectious retinal vasculitis were evaluated and enrolled by four investigators from the Divisions of Retina and Ocular Immunology at the Wilmer Eye Institute. In each patient, disease activity and the need for management changes were assessed, based on clinical examination with or without standard (60°) imaging and then with the addition of ultra-wide-field pseudo-color scanning laser ophthalmoscope (SLO) images and FA using the Optos ultra-wide-field …

Pterygium Recurrence Related To Its Size And Corneal Involvement, Pir Salim Mahar, Nabeel Manzar

Section of Ophthalmology

Objective: To establish the usefulness of grading system based on the size and extent of corneal involvement in predicting recurrence in patients undergoing primary pterygium excision with intraoperative use of adjunctive topical Mitomycin-C (MMC).
Study Design: A case series.
Place and Duration of Study: Section of Ophthalmology, the Aga Khan University Hospital, Karachi, from 2005 till 2010.
Methodology: One hundred and twenty male patients (120 eyes) underwent surgical removal of pterygium using bare sclera method with MMC in concentration of 0.2 mg/ml (0.02%) with exposure time of 3 minutes. Classification of subjects was done according to the grading of pterygium. …

Lateral Mobility Of L-Type Calcium Channels In Synaptic Terminals Of Retinal Bipolar Cells., Wallace B. Thoreson, Aaron J. Mercer, Karlene M. Cork, Robert J. Szalewski

Journal Articles: Ophthalmology

PURPOSE: Efficient and precise release of glutamate from retinal bipolar cells is ensured by the positioning of L-type Ca(2+) channels close to release sites at the base of the synaptic ribbon. We investigated whether Ca(2+) channels at bipolar cell ribbon synapses are fixed in position or capable of moving in the membrane.

METHODS: We tracked the movements of individual L-type Ca(2+) channels in bipolar cell terminals after labeling channels with quantum dots (QDs) attached to α(2)δ(4) accessory Ca(2+) channel subunits via intermediary antibodies.

RESULTS: We found that individual Ca(2+) channels moved within a confined domain of 0.13-0.15 μm(2) in bipolar …

Characterization Of High-Voltage-Activated Calcium Channels In Retinal Bipolar Cells, Qi Lu

Wayne State University Dissertations

Retinal bipolar cells, conveying visual information from photoreceptors to ganglion cells, segregate visual information into multiple parallel pathways through their diversified cell types and physiological properties. Voltage-gated Ca²⁺ channels could be particularly important underlying the diversified physiological properties of different BCs. In this dissertation, I investigated the high-voltage-activated (HVA) calcium current in retinal bipolar cells in mice. In the first part of my dissertation, I characterized multiple bipolar cell-expressing GFP and/or Cre transgenic mouse lines. In the second part of my dissertation, by performing whole-cell patch-clamp recordings, I examined the electrophysiological properties of HVA calcium currents among CBCs and …

Protein Tyrosine Phosphatase-1b Regulates The Tyrosine Phosphorylation Of The Adapter Grb2-Associated Binder 1 (Gab1) In The Retina, Ammaji Rajala, Ashok K. Dilly, Raju Vs Rajala

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Gab1 (Grb2-associated binder 1) is a key coordinator that belongs to the insulin receptor substrate-1 like family of adaptor molecules and is tyrosine phosphorylated in response to various growth factors, cytokines, and numerous other molecules. Tyrosine phosphorylated Gab1 is able to recruit a number of signaling effectors including PI3K, SHP2 and PLC-γ. In this study, we characterized the localization and regulation of tyrosine phosphorylation of Gab1 in the retina.

Results

Our immuno localization studies suggest that Gab1 is expressed in rod photoreceptor inner segments. We found that hydrogen peroxide activates the tyrosine phosphorylation of Gab1 ex vivo and …

Sequential Bilateral Central Retinal Vein Occlusions In A Cystic Fibrosis Patient With Hyperhomocysteinemia And Hypergamma-Globulinemia, R. Gelman, E. A. Dimango, W. M. Schiff

Journal Articles

PURPOSE: To report a case of sequential bilateral central retinal vein occlusions in a cystic fibrosis patient with hyperhomocysteinemia and hypergamma-globulinemia over 6 years of follow up. METHODS: Observational case report of one patient. RESULTS: A 31 year-old male with a history of cystic fibrosis presented with a central retinal vein occlusion (CRVO) in his left eye, followed by a CRVO in his right eye 4 years later. His medical workup was significant for elevated levels of homocysteine and gamma-globulins, which coincided with initiation of intravenous immunoglobulin (IVIG) proceeding his second CRVO. CONCLUSIONS: We describe a case of sequential bilateral …

Clinical Characteristics And Visual Outcomes In Infectious Scleritis: A Review, Emeline Radhika Ramenaden, Veena Rao Raiji

Ophthalmology Faculty Publications

Infection is a very important but rare cause of scleritis, occurring in about 5%–10% of all patients presenting with scleral inflammation. However, due to the similarity of its presentation, infectious scleritis is often initially managed as autoimmune, potentially further worsening its outcome. The overall visual outcome in infectious scleritis is generally worse than its autoimmune counterparts, perhaps because of the delay in diagnosis or because of the aggressive nature of associated microbes. Thus, there is a definite need for insight into the diagnostic approach and treatment options for this ocular disease process. Several studies and case reports have been published …

Cost-Savings Analysis Of Telemedicine Use For Ophthalmic Screening In A Rural Appalachian Health Clinic, D. Russell Richardson, Russell Fry Ii, Michael Krasnow Do, Phd

Ophthalmology

Life in mountainous, rural areas poses unique obstacles for ophthalmic care--notably, a lack of access to ophthalmologists and cost of care. Using telemedicine as a screening tool addresses both issues for diabetic retinopathy (DR) screening, as fundus photography has been determined to be sensitive and specific when screening for DR.^1,2 The American Diabetes Association places a Grade E recommendation on fundus photography as a screening tool.³ We analyze the financial impact of ophthalmic telemedicine in a mountainous, rural health clinic in West Virginia over a seven year period from 2003-2009. At-risk patients are screened with a fundus camera …