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Sample records for ophthalmoscopy

  1. Constant training in direct ophthalmoscopy

    Directory of Open Access Journals (Sweden)

    Younan HC

    2017-08-01

    Full Text Available Helen-Cara Younan, Rishi Iyer, Janaki Natasha DesaiFaculty of Medicine, Imperial College London, London, UKWe read with great interest the review by Ricci and Ferraz on the advances in training and practice in ophthalmoscopy simulation.1As final year medical students, we have recently experienced direct ophthalmoscopy teaching and agree with the authors that “simulation is a helpful tool in ophthalmoscopy training”.1 Indeed, in our experience, simulation is useful in teaching a wide variety of clinical skills including venepuncture, intravenous cannulation, and catheterization. We were taught all of these clinical skills in our first clinical year of study through use of simulation models. With regards to our direct ophthalmoscopy teaching, we were first taught to recognize the normal retina and different retinal pathologies using images, before practicing our technique and recognition of those images in a model similar to the THELMA (The Human Eye Learning Model Assistant described by the authors.1However, we feel that the use of simulation models alone is not enough to provide confidence and competency in direct ophthalmoscopy among medical students. The authors conclude that “constant training is a well-known strategy for skill enhancement”,1 and we have found that a lack of constant training in direct ophthalmoscopy is evident. After learning venepuncture, cannulation, and catheterization on the simulation models, we were able to observe doctors performing these skills before performing them on patients either in the wards or in theatre. These are skills that we are constantly trained in across a wide variety of medical and surgical attachments. However, opportunities to observe and practice ophthalmoscopy during our attachments are more limited, and thus we are not continuing to use the skills we learn.Authors' replyLucas Holderegger Ricci,1 Caroline Amaral Ferraz21Department of Ophthalmology, School of Medicine, Laureate

  2. Ophthalmoscopy

    Science.gov (United States)

    ... EA, eds. Duane's Ophthalmology . 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 1, chap 63. Miller ... EA, eds. Duane's Ophthalmology . 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 1, chap 50.

  3. Direct ophthalmoscopy on YouTube

    DEFF Research Database (Denmark)

    Borgersen, Nanna Jo; Henriksen, Mikael Johannes Vuokko; Konge, Lars

    2016-01-01

    by evaluating their content and approach to visualization. METHODS: In order to synthesize main themes and points for direct ophthalmoscopy, we formed a broad panel consisting of a medical student, junior and senior physicians, and took into consideration book chapters targeting medical students and physicians...... in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman's correlation. RESULTS......: We screened 7,640 videos, of which 27 were found eligible for this study. Overall, a median of 12 out of 18 points (interquartile range: 8-14 key points) were covered; no videos covered all of the 18 points assessed. We found the most difficulties in the approach to visualization of how to approach...

  4. Human milk for neonatal pain relief during ophthalmoscopy

    Directory of Open Access Journals (Sweden)

    Laiane Medeiros Ribeiro

    2013-10-01

    Full Text Available Ophthalmoscopy performed for the early diagnosis of retinopathy of prematurity (ROP is painful for preterm infants, thus necessitating interventions for minimizing pain. The present study aimed to establish the effectiveness of human milk, compared with sucrose, for pain relief in premature infants subjected to ophthalmoscopy for the early diagnosis of ROP. This investigation was a pilot, quasi-experimental study conducted with 14 premature infants admitted to the neonatal intensive care unit (NICU of a university hospital. Comparison between the groups did not yield a statistically significant difference relative to the crying time, salivary cortisol, or heart rate (HR. Human milk appears to be as effective as sucrose in relieving acute pain associated with ophthalmoscopy. The study’s limitations included its small sample size and lack of randomization. Experimental investigations with greater sample power should be performed to reinforce the evidence found in the present study.

  5. Unwanted reflections during slit lamp assisted binocular indirect ophthalmoscopy

    Science.gov (United States)

    Sheehan, Matthew; Goncharov, Alexander

    2011-11-01

    Binocular indirect ophthalmoscopy is a routine ophthalmic examination procedure. Two different apparatus setups are commonly employed; the head/spectacle mounted designs of Schepens and slit lamp assisted ophthalmoscopy, both typically performed through a fundus lens of high positive power. It can be difficult for clinicians to avoid unwanted back reflections primarily emanating from the fundus lens and the pre-corneal tear film, particularly when initially learning the skills required to perform the examination. In this investigation the illumination system of a slit lamp was modified to include a variety of obscuration designs optically conjugate to surfaces responsible for creating unwanted reflections. The modified apparatus was then used to perform binocular indirect ophthalmoscopy on an artificial eye and on real eyes. Clinicians used questionnaires to score the appearance of reflections. The mean scores were similar across all trials, including the control unmodified trial, indicating general consensus that the modified illumination system provided no substantial effect on the perception of these unwanted reflections.

  6. Photography or Ophthalmoscopy for Detection of Diabetic Retinopathy?

    NARCIS (Netherlands)

    Leiden, Hendrik A. van; Moll, Annette C.; Dekker, Jacqueline M.; Abramoff, M.D.; Polak, Bettine C.P.

    2003-01-01

    The U.K. National Screening Committee recommended digital fundus photography as the screening method of choice for diabetic retinopathy (DR). However, concerns have been expressed about replacing ophthalmoscopy with slit-lamp biomicroscopy by digital photography. These concerns included the possibil

  7. Critical evaluation of the usability of augmented reality ophthalmoscopy for the training of inexperienced examiners.

    Science.gov (United States)

    Leitritz, Martin A; Ziemssen, Focke; Suesskind, Daniela; Partsch, Michael; Voykov, Bogomil; Bartz-Schmidt, Karl U; Szurman, Gesine B

    2014-04-01

    To measure the value of augmented reality technology usage to teach the medical students performing binocular indirect ophthalmoscopy. Thirty-seven medical students were randomly assigned to the training of binocular indirect ophthalmoscopy either in the conventional way or with augmented reality ophthalmoscopy (ARO). For testing student's skills, they had to examine a real person using a conventional ophthalmoscopy system and draw the optic disk. They also had to fill out a questionnaire. Subjective and objective evaluations were performed. Thirty-seven students were randomly assigned to two groups. Eighteen students were trained with conventional ophthalmoscopy and 19 students with ARO. The questionnaires showed no differences. Performing an objective analysis, the median ophthalmoscopy training score for the conventional ophthalmoscopy group was 1.2 (range, 0.67-2) and showed a significant difference (P < 0.0033) to the ARO group (median 2; range, 0.67-2). The study provides evidence that a single ARO training is efficient to improve ophthalmoscopy skills. As the objective analysis showed, the ARO group had a significantly superior performance. Our study also indicates that subjective evaluation of the fundus drawings without systematic analysis is prone to errors.

  8. Adaptive optics parallel near-confocal scanning ophthalmoscopy.

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    Lu, Jing; Gu, Boyu; Wang, Xiaolin; Zhang, Yuhua

    2016-08-15

    We present an adaptive optics parallel near-confocal scanning ophthalmoscope (AOPCSO) using a digital micromirror device (DMD). The imaging light is modulated to be a line of point sources by the DMD, illuminating the retina simultaneously. By using a high-speed line camera to acquire the image and using adaptive optics to compensate the ocular wave aberration, the AOPCSO can image the living human eye with cellular level resolution at the frame rate of 100 Hz. AOPCSO has been demonstrated with improved spatial resolution in imaging of the living human retina compared with adaptive optics line scan ophthalmoscopy.

  9. Imaging of the optic disk in caring for patients with glaucoma: ophthalmoscopy and photography remain the gold standard.

    Science.gov (United States)

    Spaeth, George L; Reddy, Swathi C

    2014-01-01

    Optic disk imaging is integral to the diagnosis and treatment of patients with glaucoma. We discuss the various forms of imaging the optic nerve, including ophthalmoscopy, photography, and newer imaging modalities, including optical coherence tomography (OCT), confocal scanning laser ophthalmoscopy (HRT), and scanning laser polarimetry (GDx), specifically highlighting their benefits and disadvantages. We argue that ophthalmoscopy and photography remain the gold standard of imaging due to portability, ease of interpretation, and the presence of a large database of images for comparison.

  10. Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists

    Directory of Open Access Journals (Sweden)

    Ricci LH

    2017-06-01

    Full Text Available Lucas Holderegger Ricci,1 Caroline Amaral Ferraz2 1Department of Ophthalmology, School of Medicine, Laureate International Universities, São Paulo (SP, Brazil; 2Department of Ophthalmology, Federal University of São Paulo (UNIFESP, São Paulo (SP, Brazil Objective: To describe and appraise the latest simulation models for direct and indirect ophthalmoscopy as a learning tool in the medical field. Methods: The present review was conducted using four national and international databases – PubMed, Scielo, Medline and Cochrane. Initial set of articles was screened based on title and abstracts, followed by full text analysis. It comprises of articles that were published in the past fifteen years (2002–2017.Results: Eighty-three articles concerning simulation models for medical education were found in national and international databases, with only a few describing important aspects of ophthalmoscopy training and current application of simulation in medical education. After secondary analysis, 38 articles were included.Conclusion: Different ophthalmoscopy simulation models have been described, but only very few studies appraise the effectiveness of each individual model. Comparison studies are still required to determine best approaches for medical education and skill enhancement through simulation models, applied to both medical students as well as young ophthalmologists in training. Keywords: direct ophthalmoscopy, indirect ophthalmoscopy, skills, simulator, simulation models

  11. Simulation models applied to practical learning and skill enhancement in direct and indirect ophthalmoscopy: a review

    Directory of Open Access Journals (Sweden)

    Lucas Holderegger Ricci

    2014-10-01

    Full Text Available The purpose of this review was to analyze and describe simulation methods for practical learning and training of the ophthalmoscopy exam and to organize them into specific topics relative to each principle of operation, while evaluating their preliminary results. A critical review of articles that described and evaluated simulated models for ophthalmoscopy published in the last ten years (2004-2014 was performed. One hundred articles about ophthalmology and simulation were found in national and international periodicals, but only a few discussed the examination of the posterior pole of the eye. For this study, 25 articles were considered; those articles described simulation methods, general concepts, and its actual use in ophthalmoscopy. There were many different simulation methods described, but only few articles proved their efficacy or performed a comparison between models. Review of this topic may give information for the critical analysis of the simulation devices and ideas for the development of new ones.

  12. Comparison of non-mydriatic retinal photography with ophthalmoscopy in 2159 patients: mobile retinal camera study.

    Science.gov (United States)

    Taylor, R; Lovelock, L; Tunbridge, W M; Alberti, K G; Brackenridge, R G; Stephenson, P; Young, E

    1990-01-01

    OBJECTIVE--To determine whether non-mydriatic Polaroid retinal photography was comparable to ophthalmoscopy with mydriasis in routine clinic screening for early, treatable diabetic retinopathy. DESIGN--Prospective study of ophthalmoscopic findings according to retinal camera screening and ophthalmoscopy and outcome of referral to ophthalmologist. SETTING--Outpatient diabetic clinics of three teaching hospitals and three district general hospitals. PATIENTS--2159 Adults selected randomly from the diabetic clinics, excluding only those registered as blind or those in wheelchairs and unable to enter the screening vehicle. MAIN OUTCOME MEASURES--Numbers of patients and eyes correctly identified by each technique as requiring referral with potentially treatable retinopathy (new vessel formation and maculopathy) and congruence in numbers of microaneurysms, haemorrhages, and exudates reported. RESULTS--Camera screening missed two cases of new vessel formation and did not identify a further 12 but indicated a need for referral. Ophthalmoscopy missed five cases of new vessel formation and indicated a need for referral in another four for other reasons. Maculopathy was reported in 147 eyes with camera screening alone and 95 eyes by ophthalmoscopy only (chi 2 = 11.2; p less than 0.001), in 66 and 29 of which respectively maculopathy was subsequently confirmed. Overall, 38 eyes received laser treatment for maculopathy after detection by camera screening compared with 17 after ophthalmoscopic detection (chi 2 = 8.0; p less than 0.01). Camera screening underestimated numbers of microaneurysms (chi 2 = 12.9; p less than 0.001) and haemorrhages (chi 2 = 7.4; p less than 0.01) and ophthalmoscopy underestimated hard exudates (chi 2 = 48.2; p less than 0.001). CONCLUSIONS--Non-mydriatic Polaroid retinal photography is at least as good as ophthalmoscopy with mydriasis in routine diabetic clinics in identifying new vessel formation and absence of retinopathy and is significantly better

  13. Comparison of the diagnostic value of MR imaging and ophthalmoscopy for the staging of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Khurana, Aman; Wan, Wenshuai; Yeom, Kristen [Stanford University, Department of Radiology, Stanford, CA (United States); Eisenhut, Christina A. [Technical University of Munich, Department of Radiology, Munich (Germany); Ebrahimi, Katayoon B. [Johns Hopkins University, Department of Ocular Oncology, Baltimore, MD (United States); Patel, Chirag [University of California Davis, Department of Radiology, Davis, CA (United States); O' Brien, Joan M. [University of Pennsylvania, Department of Ophthalmology, Philadelphia, PA (United States); Daldrup-Link, Heike E. [Stanford University, Department of Radiology, Stanford, CA (United States); Stanford University, Department of Radiology, Pediatric Radiology Section, Lucile Packard Children' s Hospital, Stanford, CA (United States)

    2013-05-15

    To compare the diagnostic value of magnetic resonance (MR) imaging and ophthalmoscopy for staging of retinoblastoma. MR and ophthalmoscopic images of 36 patients who underwent enucleation were evaluated retrospectively following institutional review board approval. Histopathology being the standard of reference, the sensitivity and specificity of both diagnostic modalities were compared regarding growth pattern, iris neoangiogenesis, retinal detachment, vitreous seeds and optic nerve invasion. Data were analysed via McNemar's test. Both investigations showed no significant difference in accuracy for the detection of different tumour growth patterns (P = 0.80). Vitreous seeding detection was superior by ophthalmoscopy (P < 0.001). For prelaminar optic nerve invasion, MR imaging showed similar sensitivity as ophthalmoscopy but increased specificity of 40 % (CI 0.12-0.74) vs. 20 % (0.03-0.56). MR detected optic nerve involvement past the lamina cribrosa with a sensitivity of 80 % (0.28-0.99) and a specificity of 74 % (0.55-0.88). The absence of optic nerve enhancement excluded histopathological infiltration, but the presence of optic nerve enhancement included a high number of false positives (22-24 %). Ophthalmoscopy remains the method of choice for determining extent within the globe while MR imaging is useful for evaluating extraocular tumour extension. Thus, both have their own strengths and contribute uniquely to the staging of retinoblastoma. (orig.)

  14. Ophthalmoscopy for congenital hypertrophy of the retinal pigment epithelium (CHRPE) in patients with sporadic colorectal carcinoma

    DEFF Research Database (Denmark)

    Hartvigsen, A; Myrhøj, T; Bülow, Steffen

    1995-01-01

    In order to investigate the frequency of congenital hypertrophy of the retinal pigment epithelium (CHRPE) in sporadic colorectal cancer, ophthalmoscopy was carried out in 34 patients with colorectal carcinoma without known familial disposition. CHRPE is one of the most frequent extracolonic...

  15. Ophthalmoscopy for congenital hypertrophy of the retinal pigment epithelium (CHRPE) in patients with sporadic colorectal carcinoma

    DEFF Research Database (Denmark)

    Hartvigsen, A; Myrhøj, T; Bülow, Steffen

    1995-01-01

    In order to investigate the frequency of congenital hypertrophy of the retinal pigment epithelium (CHRPE) in sporadic colorectal cancer, ophthalmoscopy was carried out in 34 patients with colorectal carcinoma without known familial disposition. CHRPE is one of the most frequent extracolonic...

  16. Cone structure imaged with adaptive optics scanning laser ophthalmoscopy in eyes with nonneovascular age-related macular degeneration

    National Research Council Canada - National Science Library

    Zayit-Soudry, Shiri; Duncan, Jacque L; Syed, Reema; Menghini, Moreno; Roorda, Austin J

    2013-01-01

    To evaluate cone spacing using adaptive optics scanning laser ophthalmoscopy (AOSLO) in eyes with nonneovascular AMD, and to correlate progression of AOSLO-derived cone measures with standard measures of macular structure...

  17. Comparison between binocular indirect ophthalmoscopy and digital retinography for diabetic retinopathy screening: the multicenter Brazilian Type 1 Diabetes Study

    National Research Council Canada - National Science Library

    Malerbi, Fernando Korn; Morales, Paulo Henrique; Farah, Michel Eid; Drummond, Karla Rezende Guerra; Mattos, Tessa Cerqueira Lemos; Pinheiro, André Araújo; Mallmann, Felipe; Perez, Ricardo Vessoni; Leal, Franz Schubert Lopes; Gomes, Marília Brito; Dib, Sergio Atala

    2015-01-01

    .... Our objective is to compare binocular indirect ophthalmoscopy (BIO) to telemedicine protocols of digital retinography for diabetic retinopathy screening in a large and heterogenous type 1 diabetes population in a developing country...

  18. Ophthalmoscopy simulation: advances in training and practice for medical students and young ophthalmologists

    OpenAIRE

    Ricci LH; Ferraz CA

    2017-01-01

    Lucas Holderegger Ricci,1 Caroline Amaral Ferraz2 1Department of Ophthalmology, School of Medicine, Laureate International Universities, São Paulo (SP), Brazil; 2Department of Ophthalmology, Federal University of São Paulo (UNIFESP), São Paulo (SP), Brazil Objective: To describe and appraise the latest simulation models for direct and indirect ophthalmoscopy as a learning tool in the medical field. Methods: The present review was conducted using four ...

  19. Direct ophthalmoscopy on YouTube: analysis of instructional YouTube videos’ content and approach to visualization

    Science.gov (United States)

    Borgersen, Nanna Jo; Henriksen, Mikael Johannes Vuokko; Konge, Lars; Sørensen, Torben Lykke; Thomsen, Ann Sofia Skou; Subhi, Yousif

    2016-01-01

    Background Direct ophthalmoscopy is well-suited for video-based instruction, particularly if the videos enable the student to see what the examiner sees when performing direct ophthalmoscopy. We evaluated the pedagogical effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization. Methods In order to synthesize main themes and points for direct ophthalmoscopy, we formed a broad panel consisting of a medical student, junior and senior physicians, and took into consideration book chapters targeting medical students and physicians in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman’s correlation. Results We screened 7,640 videos, of which 27 were found eligible for this study. Overall, a median of 12 out of 18 points (interquartile range: 8–14 key points) were covered; no videos covered all of the 18 points assessed. We found the most difficulties in the approach to visualization of how to approach the patient and how to examine the fundus. Time spent on fundus examination correlated with the number of views per week (Spearman’s ρ=0.53; P=0.029). Conclusion Videos may help overcome the pedagogical issues in teaching direct ophthalmoscopy; however, the few available videos on YouTube fail to address this particular issue adequately. There is a need for high-quality videos that include relevant points, provide realistic visualization of the examiner’s view, and give particular emphasis on fundus examination. PMID:27574393

  20. Utilization of scanning laser ophthalmoscopy in laser-induced bilateral human retinal nerve fiber layer damage

    Science.gov (United States)

    Zwick, Harry; Gagliano, Donald A.; Ruiz, S.; Stuck, Bruce E.

    1995-05-01

    In this paper, we describe a military laser accident case where bilateral Q-switched laser exposure resulted in bilateral macular damage with immediate visual acuity loss in one eye (OS) and delayed visual acuity loss in the other exposed eye (OD), where retinal damage appeared more parafoveal. At 6 weeks post exposure, OS had recovered to 20/17 and OD had dropped to 20/100 Snellen activity. Retinal nerve fiber damage was observed in both eyes at this time. Contrast sensitivity measurements made in OS were suppressed across all spatial frequencies, even though Snellen acuity measured in the normal range. More severe high spatial frequency loss in contrast was measured in the right eye as well as low spatial frequency loss. Both OS and OD revealed a parafoveal preferred retinal locus with scanning laser ophthalmoscopy contrast sensitivity measurements, suggesting parafoveal retinal compensatory processes.

  1. Quality and Diagnostic Utility of Mydriatic Smartphone Photography: The Smartphone Ophthalmoscopy Reliability Trial.

    Science.gov (United States)

    Adam, Murtaza K; Brady, Christopher J; Flowers, Alexis M; Juhn, Alexander T; Hsu, Jason; Garg, Sunir J; Murchison, Ann P; Spirn, Marc J

    2015-06-01

    Establish quality and diagnostic utility of mydriatic smartphone ophthalmoscopy (SO) fundus images compared to fundus camera (FC) images. In this prospective, cross-sectional study, 94 consecutive patients in an urban eye emergency department underwent SO and FC fundus imaging via one of three study arms: medical student 1 (MS1), medical student 2 (MS2), and ophthalmology resident (OR). Images of 188 eyes were graded for overall quality by two masked reviewers, and observed critical fundus findings were compared to dilated fundus examination documentation. SO images were higher quality in the OR arm than in the MS1 and MS2 arms (P quality between photographers (all P > .328). In the OR arm, SO images detected 74.3% of critical fundus findings, whereas FC images detected 77.1%. SO produces fundus images approaching the quality and diagnostic utility of traditional FC photographs. Copyright 2015, SLACK Incorporated.

  2. Systematic study of high-frequency ultrasonic transducer design for laser-scanning photoacoustic ophthalmoscopy

    Science.gov (United States)

    Ma, Teng; Zhang, Xiangyang; Chiu, Chi Tat; Chen, Ruimin; Kirk Shung, K.; Zhou, Qifa; Jiao, Shuliang

    2014-01-01

    Abstract. Photoacoustic ophthalmoscopy (PAOM) is a high-resolution in vivo imaging modality that is capable of providing specific optical absorption information for the retina. A high-frequency ultrasonic transducer is one of the key components in PAOM, which is in contact with the eyelid through coupling gel during imaging. The ultrasonic transducer plays a crucial role in determining the image quality affected by parameters such as spatial resolution, signal-to-noise ratio, and field of view. In this paper, we present the results of a systematic study on a high-frequency ultrasonic transducer design for PAOM. The design includes piezoelectric material selection, frequency selection, and the fabrication process. Transducers of various designs were successfully applied for capturing images of biological samples in vivo. The performances of these designs are compared and evaluated. PMID:24441942

  3. Direct ophthalmoscopy on YouTube: analysis of instructional YouTube videos’ content and approach to visualization

    Directory of Open Access Journals (Sweden)

    Borgersen NJ

    2016-08-01

    Full Text Available Nanna Jo Borgersen,1–3 Mikael Johannes Vuokko Henriksen,2,3 Lars Konge,2,3 Torben Lykke Sørensen,1,3 Ann Sofia Skou Thomsen,2–4 Yousif Subhi1,3 1Department of Ophthalmology, Zealand University Hospital, Roskilde, 2Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark, 3Faculty of Health and Medical Sciences, University of Copenhagen, 4Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark Background: Direct ophthalmoscopy is well-suited for video-based instruction, particularly if the videos enable the student to see what the examiner sees when performing direct ophthalmoscopy. We evaluated the pedagogical effectiveness of instructional YouTube videos on direct ophthalmoscopy by evaluating their content and approach to visualization.Methods: In order to synthesize main themes and points for direct ophthalmoscopy, we formed a broad panel consisting of a medical student, junior and senior physicians, and took into consideration book chapters targeting medical students and physicians in general. We then systematically searched YouTube. Two authors reviewed eligible videos to assess eligibility and extract data on video statistics, content, and approach to visualization. Correlations between video statistics and contents were investigated using two-tailed Spearman’s correlation.Results: We screened 7,640 videos, of which 27 were found eligible for this study. Overall, a median of 12 out of 18 points (interquartile range: 8–14 key points were covered; no videos covered all of the 18 points assessed. We found the most difficulties in the approach to visualization of how to approach the patient and how to examine the fundus. Time spent on fundus examination correlated with the number of views per week (Spearman’s ρ=0.53; P=0.029.Conclusion: Videos may help overcome the pedagogical issues in teaching direct ophthalmoscopy; however, the few available videos on You

  4. Time course of the size of the dark area in macular holes by scanning laser ophthalmoscopy.

    Science.gov (United States)

    Akasaka, Y; Nishikawa, S; Tamai, M

    2000-02-01

    To investigate the time course of idiopathic macular hole development by scanning laser ophthalmoscopy (SLO), we examined 28 eyes of 25 patients with macular holes. Cases included four eyes with stage 1-B disease (foveal detachment), 3 with stage 2 (break at the fovea), 13 with stage 3 (full-thickness macular hole), and 8 with stage 4 (hole with pseudo-operculum, posterior vitreous detachment), according to Gass's classification. The diameter of the dark area around the macular holes was recorded by SLO using a helium-neon laser. We compared the percent difference of dark area recorded between initial findings and these after three months. The size of the dark area increased after three months in eyes with stages 1, 2, and 3 disease. The size of the dark area in stage 4 disease decreased after 3 months. In the stage before posterior vitreous detachment (PVD), the dark areas increased. Once PVD occurred, these areas decreased. These findings suggested that the time course of the dark area may be related to the development of PVD.

  5. Monte Carlo investigation on quantifying the retinal pigment epithelium melanin concentration by photoacoustic ophthalmoscopy.

    Science.gov (United States)

    Shu, Xiao; Liu, Wenzhong; Zhang, Hao F

    2015-10-01

    The retinal pigment epithelium (RPE) melanin plays an important role in maintaining normal visual functions. A decrease in the RPE melanin concentration with aging is believed to be associated with several blinding diseases, including age-related macular degeneration. Quantifying the RPE melanin noninvasively is therefore important in evaluating the retinal health and aging conditions. Photoacoustic ophthalmoscopy (PAOM), as an optical absorption-based imaging technology, can potentially be applied to measure variations in the RPE melanin if the relationship between the detected photoacoustic (PA) signal amplitudes and the RPE melanin concentrations can be established. In this work, we tested the feasibility of using PA signals from retinal blood vessels as references to measure RPE melanin variation using Monte Carlo (MC) simulation. The influences from PAOM axial resolution, the depth and diameter of the retinal blood vessel, and the RPE thickness were examined. We proposed a calibration scheme by relating detected PA signals to the RPE melanin concentrations, and we found that the scheme is robust to these tested parameters. This study suggests that PAOM has the capability of quantitatively measuring the RPE melanin in vivo.

  6. Pain and stress assessment after retinopathy of prematurity screening examination: Indirect ophthalmoscopy versus digital retinal imaging

    Directory of Open Access Journals (Sweden)

    Moral-Pumarega M

    2012-08-01

    Full Text Available Abstract Background Increasingly, neonatal clinics seek to minimize painful experiences and stress for premature infants. Fundoscopy performed with a binocular indirect ophthalmoscope is the reference examination technique for screening of retinopathy of prematurity (ROP, and it is associated with pain and stress. Wide-field digital retinal imaging is a recent technique that should be evaluated for minimizing infant pain and stress. Methods The purpose of the study was to assess and compare the impact of using a binocular indirect ophthalmoscope (BIO, or wide-field digital retinal imaging (WFDRI on pain and stress in infants undergoing ROP screening examination. This was a comparative evaluation study of two screening procedures. Ophthalmologic examinations (N = 70 were performed on 24 infants with both BIO and WFDRI. Pain assessments were performed with two specific neonatal scales (Crying, requires oxygen, increased vital signs, expression and sleeplessness, CRIES and, Premature infant pain profile, PIPP just prior to the examination, and 30 seconds, 1 hour, and 24 hours later after ending the examination. Results Changes over time were significantly different between BIO and WFDRI with both scales (PIPP score, p = .007, and CRIES score, p = .001. Median PIPP score (interquartile interval at baseline was 4 (3–5. At 30 seconds the score was 8 (6–9 for BIO and 6 (5–7 for WFDRI, respectively. The increase in PIPP score between baseline and 30 seconds was significantly lower with WFDRI (p = .006. The median increase in CRIES score from baseline to 30 seconds was 1 point lower for WFDRI than for BIO (p  Conclusions A transient short-term pain and stress response occurs with both BIO and WFDRI. Infants examined for screening of ROP with digital retinal imaging present less pain and stress at 30 seconds following completion of the exam when compared with binocular indirect ophthalmoscopy.

  7. Retro-Mode Scanning Laser Ophthalmoscopy Planning for Navigated Macular Laser Photocoagulation in Macular Edema

    Directory of Open Access Journals (Sweden)

    Ernest V. Boiko

    2016-01-01

    Full Text Available Purpose. To compare treatment areas and navigated macular laser photocoagulation (MLP plans suggested by retro-mode scanning laser ophthalmoscopy (RM-SLO image versus optical coherence tomography (OCT central retinal thickness map and treatment planning among retina specialists. Methods. Thirty-nine eyes with diabetic or branch retinal vein occlusion-related ME undergoing navigated MLP with navigated photocoagulator had OCT and RM-SLO taken. OCT map and RM-SLO image were imported to the photocoagulator and aligned onto the retina. Two retina specialists placed laser spot marks separately based on OCT and RM-SLO images in a random fashion. The spots placed by each physician were compared between OCT and RM-SLO and among physicians. The areas of retinal edema on OCT and RM-SLO of the same eye were also compared. Results. The average number of laser spots using RM-SLO and OCT template was 189.6±77.4 and 136.6±46.8, respectively, P=0.003. The average area of edema on RM-SLO image was larger than that on OCT map (14.5±3.9 mm2 versus 10.3±2.8 mm2, P=0.005 because of a larger scanning area. There was narrow variability in treatment planning among retina specialists for both RM-SLO (P=0.13 and OCT (P=0.19. Conclusion. The RM-SLO image superimposed onto the fundus of the same eye can be used to guide MLP with narrow variability in treatment planning among retina specialists. The treatment areas suggested by RM-SLO-guided MLP plans for ME were shown to be larger than those suggested by OCT-guided plans.

  8. Retro-Mode Scanning Laser Ophthalmoscopy Planning for Navigated Macular Laser Photocoagulation in Macular Edema.

    Science.gov (United States)

    Boiko, Ernest V; Maltsev, Dmitrii S

    2016-01-01

    Purpose. To compare treatment areas and navigated macular laser photocoagulation (MLP) plans suggested by retro-mode scanning laser ophthalmoscopy (RM-SLO) image versus optical coherence tomography (OCT) central retinal thickness map and treatment planning among retina specialists. Methods. Thirty-nine eyes with diabetic or branch retinal vein occlusion-related ME undergoing navigated MLP with navigated photocoagulator had OCT and RM-SLO taken. OCT map and RM-SLO image were imported to the photocoagulator and aligned onto the retina. Two retina specialists placed laser spot marks separately based on OCT and RM-SLO images in a random fashion. The spots placed by each physician were compared between OCT and RM-SLO and among physicians. The areas of retinal edema on OCT and RM-SLO of the same eye were also compared. Results. The average number of laser spots using RM-SLO and OCT template was 189.6 ± 77.4 and 136.6 ± 46.8, respectively, P = 0.003. The average area of edema on RM-SLO image was larger than that on OCT map (14.5 ± 3.9 mm(2) versus 10.3 ± 2.8 mm(2), P = 0.005) because of a larger scanning area. There was narrow variability in treatment planning among retina specialists for both RM-SLO (P = 0.13) and OCT (P = 0.19). Conclusion. The RM-SLO image superimposed onto the fundus of the same eye can be used to guide MLP with narrow variability in treatment planning among retina specialists. The treatment areas suggested by RM-SLO-guided MLP plans for ME were shown to be larger than those suggested by OCT-guided plans.

  9. Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children

    Directory of Open Access Journals (Sweden)

    Mihir Kothari

    2012-01-01

    Full Text Available Aim: To describe and compare dynamic distance direct ophthalmoscopy (DDDO with dynamic retinoscopy (DR in assessment of accommodation in children. Materials and Methods: This prospective observational study had four components. Component 1: to understand the characteristic digital images of DDDO. Component 2: to compare DDDO with DR for detection of accommodative defects in children (1-16 years. Component 3: to compare DDDO with DR for the detection of completeness of pharmacologically induced cycloplegia in children (5-16 years and Component 4: to assess which one of the two techniques was more sensitive to detect onset of cycloplegia after instillation of 1% cyclopentolate eye drops. Results: Component 1: image analysis of DDDO on two subjects (7 years and 35 years demonstrated superior pupillary crescent that progressively disappeared with increasing accommodation. Concurrently an inferior crescent appeared that became bigger in size with increasing accommodation. Component 2: the prevalence of defects in accommodation was 3.3% (33/1000 children. Three had unilateral accommodation failure. Sensitivity of DDDO was 94%, specificity 100%, positive predictive value 100%, negative predictive value 99%, and clinical agreement (kappa 0.97. Component 3: in the detection of completeness of pharmacologically induced cycloplegia (n=30, the sensitivity of DDDO was 94%, specificity 96%, positive predictive value 97%, negative predictive value 93% and kappa 0.9. DR had two false positives. DDDO had one false negative. Component 4: DDDO detected onset of pharmacologically induced cycloplegia 5 min earlier than DR (n=5. Conclusion: DDDO is a novel, simple, clinical and reliable method to assess accommodation in young children. This test can assess the accommodative response of both eyes simultaneously.

  10. Comparative study of RetCamRetCam II vs. binocular ophthalmoscopy in a screening program for retinopathy of prematurity.

    Science.gov (United States)

    Tejada-Palacios, P; Zarratea, L; Moral, M; de la Cruz-Bértolo, J

    2015-08-01

    To determine the performance of RetCam vs. binocular ophthalmoscopy (BIO) in a screening program for retinopathy of prematurity (ROP). Observational comparative study with prospective data collection. Examinations with RetCam (n=169) were performed on 83 infants included in a screening program for ROP and stored for analysis at a later stage. An experienced ophthalmologist examined the ocular fundus with binocular indirect ophthalmoscopy (BIO). The RetCam images were assessed for the presence of ROP, zone, grade, and presence of plus disease. RetCam and BIO data were compared by visually to estimate sensitivity, specificity, positive (VPP) and negative (VPN) predictive values. ROP disease was detected in 108 eyes with BIO, and in 74 with RetCam. Out of 306 eyes examined with RetCam, false negative results were found in 34 eyes, with no false positives. Sensitivity of RetCam exam vs. BIO was 0.68, and specificity was 0.99. Positive predictive value was 0.93 and negative predictive value was 0.85. All 34 ROP cases not detected with RetCam were in zone III or outer zone II. They were all mild and regressed spontaneously. No threshold ROP was missed with RetCam. Binocular indirect ophthalmoscopy is the reference method for the diagnosis of ROP. RetCam may be used as an alternative for ROP screening. Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  11. Optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy in retinal nerve fiber layer measurements of glaucoma patients.

    Science.gov (United States)

    Fanihagh, Farsad; Kremmer, Stephan; Anastassiou, Gerasimos; Schallenberg, Maurice

    2015-01-01

    To determine the correlations and strength of association between different imaging systems in analyzing the retinal nerve fiber layer (RNFL) of glaucoma patients: optical coherence tomography (OCT), scanning laser polarimetry (SLP) and confocal scanning laser ophthalmoscopy (CSLO). 114 eyes of patients with moderate open angle glaucoma underwent spectral domain OCT (Topcon SD-OCT 2000 and Zeiss Cirrus HD-OCT), SLP (GDx VCC and GDx Pro) and CSLO (Heidelberg Retina Tomograph, HRT 3). Correlation coefficients were calculated between the structural parameters yielded by these examinations. The quantitative relationship between the measured RNFL thickness globally and for the four regions (superior, inferior, nasal, temporal) were evaluated with different regression models for all used imaging systems. The strongest correlation of RNFL measurements was found between devices using the same technology like GDx VCC and GDx Pro as well as Topcon OCT and Cirrus OCT. In glaucoma patients, the strongest associations (R²) were found between RNFL measurements of the two optical coherence tomography devices Topcon OCT and Cirrus OCT (R² = 0.513) and between GDx VCC and GDx Pro (R² = 0.451). The results of the OCTs and GDX Pro also had a strong quantitative relationship (Topcon OCT R² = 0.339 and Cirrus OCT R² = 0.347). GDx VCC and the OCTs showed a mild to moderate association (Topcon OCT R² = 0.207 and Cirrus OCT R² = 0.258). The confocal scanning laser ophthalmoscopy (HRT 3) had the lowest association to all other devices (Topcon OCT R² = 0.254, Cirrus OCT R² = 0.158, GDx Pro R² = 0.086 and GDx VCC R² = 0.1). The measurements of the RNFL in glaucoma patients reveal a high correlation of OCT and GDx devices because OCTs can measure all major retinal layers and SLP can detect nerve fibers allowing a comparison between the results of this devices. However, CSLO by means of HRT topography can only measure height values of the retinal surface but it cannot distinguish

  12. Assessment of the Optic Disc Morphology Using Spectral-Domain Optical Coherence Tomography and Scanning Laser Ophthalmoscopy

    Directory of Open Access Journals (Sweden)

    Pilar Calvo

    2014-01-01

    Full Text Available Objective. To compare the equivalent optic nerve head (OHN parameters obtained with confocal scanning laser ophthalmoscopy (HRT3 and spectral-domain optical coherence tomography (OCT in healthy and glaucoma patients. Methods. One hundred and eighty-two consecutive healthy subjects and 156 patients with open-angle glaucoma were divided into 2 groups according to intraocular pressure and visual field outcomes. All participants underwent imaging of the ONH with the HRT3 and the Cirrus OCT. The ONH parameters and the receiver operating characteristic (ROC curves were compared between both groups. Results. Mean age did not differ between the normal and glaucoma groups (59.55 ± 9.7 years and 61.05 ± 9.4 years, resp.; P=0.15. Rim area, average cup-to-disc (C/D ratio, vertical C/D ratio, and cup volume were different between both instruments (P<0.001. All equivalent ONH parameters, except disc area, were different between both groups (P<0.001. The best areas under the ROC curve were observed for vertical C/D ratio (0.980 for OCT and 0.942 for HRT3; P=0.11. Sensitivities at 95% fixed-specificities of OCT parameters were higher than those of HRT3. Conclusions. Equivalent ONH parameters of Cirrus OCT and HRT3 are different and cannot be used interchangeably. ONH parameters measured with OCT yielded a slightly better diagnostic performance.

  13. Multimodal swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography at 400 kHz

    Science.gov (United States)

    El-Haddad, Mohamed T.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

    2017-02-01

    Multimodal imaging systems that combine scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) have demonstrated the utility of concurrent en face and volumetric imaging for aiming, eye tracking, bulk motion compensation, mosaicking, and contrast enhancement. However, this additional functionality trades off with increased system complexity and cost because both SLO and OCT generally require dedicated light sources, galvanometer scanners, relay and imaging optics, detectors, and control and digitization electronics. We previously demonstrated multimodal ophthalmic imaging using swept-source spectrally encoded SLO and OCT (SS-SESLO-OCT). Here, we present system enhancements and a new optical design that increase our SS-SESLO-OCT data throughput by >7x and field-of-view (FOV) by >4x. A 200 kHz 1060 nm Axsun swept-source was optically buffered to 400 kHz sweep-rate, and SESLO and OCT were simultaneously digitized on dual input channels of a 4 GS/s digitizer at 1.2 GS/s per channel using a custom k-clock. We show in vivo human imaging of the anterior segment out to the limbus and retinal fundus over a >40° FOV. In addition, nine overlapping volumetric SS-SESLO-OCT volumes were acquired under video-rate SESLO preview and guidance. In post-processing, all nine SESLO images and en face projections of the corresponding OCT volumes were mosaicked to show widefield multimodal fundus imaging with a >80° FOV. Concurrent multimodal SS-SESLO-OCT may have applications in clinical diagnostic imaging by enabling aiming, image registration, and multi-field mosaicking and benefit intraoperative imaging by allowing for real-time surgical feedback, instrument tracking, and overlays of computationally extracted image-based surrogate biomarkers of disease.

  14. Regional Image Features Model for Automatic Classification between Normal and Glaucoma in Fundus and Scanning Laser Ophthalmoscopy (SLO) Images.

    Science.gov (United States)

    Haleem, Muhammad Salman; Han, Liangxiu; Hemert, Jano van; Fleming, Alan; Pasquale, Louis R; Silva, Paolo S; Song, Brian J; Aiello, Lloyd Paul

    2016-06-01

    Glaucoma is one of the leading causes of blindness worldwide. There is no cure for glaucoma but detection at its earliest stage and subsequent treatment can aid patients to prevent blindness. Currently, optic disc and retinal imaging facilitates glaucoma detection but this method requires manual post-imaging modifications that are time-consuming and subjective to image assessment by human observers. Therefore, it is necessary to automate this process. In this work, we have first proposed a novel computer aided approach for automatic glaucoma detection based on Regional Image Features Model (RIFM) which can automatically perform classification between normal and glaucoma images on the basis of regional information. Different from all the existing methods, our approach can extract both geometric (e.g. morphometric properties) and non-geometric based properties (e.g. pixel appearance/intensity values, texture) from images and significantly increase the classification performance. Our proposed approach consists of three new major contributions including automatic localisation of optic disc, automatic segmentation of disc, and classification between normal and glaucoma based on geometric and non-geometric properties of different regions of an image. We have compared our method with existing approaches and tested it on both fundus and Scanning laser ophthalmoscopy (SLO) images. The experimental results show that our proposed approach outperforms the state-of-the-art approaches using either geometric or non-geometric properties. The overall glaucoma classification accuracy for fundus images is 94.4% and accuracy of detection of suspicion of glaucoma in SLO images is 93.9 %.

  15. Assessment of β-zone peripapillary atrophy by optical coherence tomography and scanning laser ophthalmoscopy imaging in glaucoma patients

    Directory of Open Access Journals (Sweden)

    Seidensticker F

    2014-06-01

    Full Text Available Florian Seidensticker,1,* Lukas Reznicek,2,* Thomas Mann,2 Irene Hübert,2 Anselm Kampik,2 Michael Ulbig,2 Christoph Hirneiss,2 Aljoscha S Neubauer,2 Marcus Kernt2 1Department of Ophthalmology, Hannover Medical School, Hannover, Germany; 2Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany  *These authors have contributed equally to this work Purpose: To assess β-zone peripapillary atrophy (β-PPA using spectral domain optical coherence tomography (SD-OCT, scanning laser ophthalmoscopy (SLO, and fundus autofluorescence (FAF imaging in patients with primary open-angle glaucoma with advanced glaucomatous visual field defects. Methods: A consecutive, prospective series of 82 study eyes with primary open-angle glaucoma were included in this study. All study participants underwent a full ophthalmic examination followed by SD-OCT, wide-field SLO, and FAF imaging of the optic nerve head and the peripapillary region. Results: Eighty-four glaucomatous eyes were included in our prospective study. Correlation analyses for horizontally and vertically obtained β-PPA for all three imaging modalities (color SLO, FAF, and SD-OCT revealed highest correlations between FAF and color SLO (Pearson correlation coefficient: 0.904 [P<0.001] for horizontal β-PPA and 0.786 [P<0.001] for vertical β-PPA. Bland–Altman plotting revealed highest agreements between color SLO and FAF, with −2.1 pixels ±1.96 standard deviation (SD for horizontal β-PPA, SD: 10.5 pixels and 2.4 pixels ±1.96 SD for vertical β-PPA. Conclusion: β-PPA can be assessed using en-face SLO and cross-sectional SD-OCT imaging. Correlation analyses revealed highest correlations between color SLO and FAF imaging, while correlations between SLO and SD-OCT were weak. A more precise structural definition of β-PPA is needed. Keywords: fundus autofluorescence, FAF, OCT, SD-OCT, SLO, glaucomatous optic neuropathy

  16. Holographic laser Doppler ophthalmoscopy

    CERN Document Server

    Simonutti, Manuel; Sahel, J A; Gross, Michel; Samson, Benjamin; Magnain, Caroline; Atlan, Michael; 10.1364/OL.35.001941

    2010-01-01

    We report laser Doppler ophthalmoscopic fundus imaging in the rat eye with near-IR heterodyne holography. Sequential sampling of the beat of the reflected radiation against a frequency-shifted optical local oscillator is made onto an array detector. Wide-field maps of fluctuation spectra in the 10 Hz to 25 kHz band exhibit angiographic contrasts in the retinal vascular tree without requirement of an exogenous marker.

  17. Inability to perform posterior segment monitoring by scanning laser ophthalmoscopy or optical coherence tomography with some occlusive intraocular lenses in clinical use.

    Science.gov (United States)

    Yusuf, Imran H; Peirson, Stuart N; Patel, Chetan K

    2012-03-01

    To evaluate whether occlusive intraocular lenses (IOLs) produced by several manufacturers for clinical use equivalently transmit near-infrared (IR) light for scanning laser ophthalmoscopy (SLO) or optical coherence tomography (OCT) imaging. Nuffield Laboratory of Ophthalmology, Oxford University, United Kingdom. Evaluation of diagnostic test or technology. The study evaluated 6 black IOLs of 2 designs: 3 poly(methyl methacrylate) (PMMA) and 3 iris-claw anterior chamber IOLs. Each IOL was placed between a broad-spectrum white light source and a spectroradiometer to generate transmission spectra. Transmission in the near-IR range was examined using an 850 nm light-emitting diode. Scanning laser ophthalmoscopy or OCT imaging using Spectralis spectral-domain SLO or OCT was attempted through occlusive IOLs in a model eye. Artisan iris-claw and MS 612 PMMA occlusive IOLs totally occluded all wavelengths of light, including in the near IR range in which SLO and OCT imaging systems operate. It was not possible to capture SLO or OCT images through the iris-claw and PMMA occlusive IOLs in a model eye. Results suggest the property of near-IR transmission that permits SLO or OCT imaging through occlusive IOLs is restricted to the Morcher range of occlusive IOLs. Patients with non-near IR transmitting IOLs will not be able to receive detailed posterior segment monitoring with SLO or OCT. This finding may have a significant impact on preoperative occlusive IOL selection and the management of current patients with occlusive IOLs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Fluorescent scanning laser ophthalmoscopy for cellular resolution in vivo mouse retinal imaging: benefits and drawbacks of implementing adaptive optics (Conference Presentation)

    Science.gov (United States)

    Zhang, Pengfei; Goswami, Mayank; Pugh, Edward N.; Zawadzki, Robert J.

    2016-03-01

    Scanning Laser Ophthalmoscopy (SLO) is a very important imaging tool in ophthalmology research. By combing with Adaptive Optics (AO) technique, AO-SLO can correct for ocular aberrations resulting in cellular level resolution, allowing longitudinal studies of single cells morphology in the living eyes. The numerical aperture (NA) sets the optical resolution that can be achieve in the "classical" imaging systems. Mouse eye has more than twice NA of the human eye, thus offering theoretically higher resolution. However, in most SLO based imaging systems the imaging beam size at mouse pupil sets the NA of that instrument, while most of the AO-SLO systems use almost the full NA of the mouse eye. In this report, we first simulated the theoretical resolution that can be achieved in vivo for different imaging beam sizes (different NA), assumingtwo cases: no aberrations and aberrations based on published mouse ocular wavefront data. Then we imaged mouse retinas with our custom build SLO system using different beam sizes to compare these results with theory. Further experiments include comparison of the SLO and AO-SLO systems for imaging different type of fluorescently labeled cells (microglia, ganglion, photoreceptors, etc.). By comparing those results and taking into account systems complexity and ease of use, the benefits and drawbacks of two imaging systems will be discussed.

  19. Image-guided feedback for ophthalmic microsurgery using multimodal intraoperative swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography

    Science.gov (United States)

    Li, Jianwei D.; Malone, Joseph D.; El-Haddad, Mohamed T.; Arquitola, Amber M.; Joos, Karen M.; Patel, Shriji N.; Tao, Yuankai K.

    2017-02-01

    Surgical interventions for ocular diseases involve manipulations of semi-transparent structures in the eye, but limited visualization of these tissue layers remains a critical barrier to developing novel surgical techniques and improving clinical outcomes. We addressed limitations in image-guided ophthalmic microsurgery by using microscope-integrated multimodal intraoperative swept-source spectrally encoded scanning laser ophthalmoscopy and optical coherence tomography (iSS-SESLO-OCT). We previously demonstrated in vivo human ophthalmic imaging using SS-SESLO-OCT, which enabled simultaneous acquisition of en face SESLO images with every OCT cross-section. Here, we integrated our new 400 kHz iSS-SESLO-OCT, which used a buffered Axsun 1060 nm swept-source, with a surgical microscope and TrueVision stereoscopic viewing system to provide image-based feedback. In vivo human imaging performance was demonstrated on a healthy volunteer, and simulated surgical maneuvers were performed in ex vivo porcine eyes. Denselysampled static volumes and volumes subsampled at 10 volumes-per-second were used to visualize tissue deformations and surgical dynamics during corneal sweeps, compressions, and dissections, and retinal sweeps, compressions, and elevations. En face SESLO images enabled orientation and co-registration with the widefield surgical microscope view while OCT imaging enabled depth-resolved visualization of surgical instrument positions relative to anatomic structures-of-interest. TrueVision heads-up display allowed for side-by-side viewing of the surgical field with SESLO and OCT previews for real-time feedback, and we demonstrated novel integrated segmentation overlays for augmented-reality surgical guidance. Integration of these complementary imaging modalities may benefit surgical outcomes by enabling real-time intraoperative visualization of surgical plans, instrument positions, tissue deformations, and image-based surrogate biomarkers correlated with completion of

  20. A technique to train new oculomotor behavior in patients with central macular scotomas during reading related tasks using scanning laser ophthalmoscopy: immediate functional benefits and gains retention

    Directory of Open Access Journals (Sweden)

    Lorincz Erika N

    2006-11-01

    procedure for training patients with central field loss using scanning laser ophthalmoscopy. Our initial results on the acquisition of newly self-selected PRLs and the development of new oculomotor behaviors suggest that the procedure aiming primarily at developing an examiner's selected TRL might have initiated a more global functional adaptation process.

  1. Evaluation of baseline structural factors for predicting glaucomatous visual-field progression using optical coherence tomography, scanning laser polarimetry and confocal scanning laser ophthalmoscopy.

    Science.gov (United States)

    Sehi, M; Bhardwaj, N; Chung, Y S; Greenfield, D S

    2012-12-01

    The objective of this study is to assess whether baseline optic nerve head (ONH) topography and retinal nerve fiber layer thickness (RNFLT) are predictive of glaucomatous visual-field progression in glaucoma suspect (GS) and glaucomatous eyes, and to calculate the level of risk associated with each of these parameters. Participants with ≥28 months of follow-up were recruited from the longitudinal Advanced Imaging for Glaucoma Study. All eyes underwent standard automated perimetry (SAP), confocal scanning laser ophthalmoscopy (CSLO), time-domain optical coherence tomography (TDOCT), and scanning laser polarimetry using enhanced corneal compensation (SLPECC) every 6 months. Visual-field progression was assessed using pointwise linear-regression analysis of SAP sensitivity values (progressor) and defined as significant sensitivity loss of >1 dB/year at ≥2 adjacent test locations in the same hemifield at P<0.01. Cox proportional hazard ratios (HR) were calculated to determine the predictive ability of baseline ONH and RNFL parameters for SAP progression using univariate and multivariate models. Seventy-three eyes of 73 patients (43 GS and 30 glaucoma, mean age 63.2±9.5 years) were enrolled (mean follow-up 51.5±11.3 months). Four of 43 GS (9.3%) and 6 of 30 (20%) glaucomatous eyes demonstrated progression. Mean time to progression was 50.8±11.4 months. Using multivariate models, abnormal CSLO temporal-inferior Moorfields classification (HR=3.76, 95% confidence interval (CI): 1.02-6.80, P=0.04), SLPECC inferior RNFLT (per -1 μm, HR=1.38, 95% CI: 1.02-2.2, P=0.02), and TDOCT inferior RNFLT (per -1 μm, HR=1.11, 95% CI: 1.04-1.2, P=0.001) had significant HRs for SAP progression. Abnormal baseline ONH topography and reduced inferior RNFL are predictive of SAP progression in GS and glaucomatous eyes.

  2. In vivowide-field multispectral scanning laser ophthalmoscopy-optical coherence tomography mouse retinal imager: longitudinal imaging of ganglion cells, microglia, and Müller glia, and mapping of the mouse retinal and choroidal vasculature

    Science.gov (United States)

    Zhang, Pengfei; Zam, Azhar; Jian, Yifan; Wang, Xinlei; Li, Yuanpei; Lam, Kit S.; Burns, Marie E.; Sarunic, Marinko V.; Pugh, Edward N., Jr.; Zawadzki, Robert J.

    2015-12-01

    Scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT) provide complementary views of the retina, with the former collecting fluorescence data with good lateral but relatively low-axial resolution, and the latter collecting label-free backscattering data with comparable lateral but much higher axial resolution. To take maximal advantage of the information of both modalities in mouse retinal imaging, we have constructed a compact, four-channel, wide-field (˜50 deg) system that simultaneously acquires and automatically coregisters three channels of confocal SLO and Fourier domain OCT data. The scanner control system allows "zoomed" imaging of a region of interest identified in a wide-field image, providing efficient digital sampling and localization of cellular resolution features in longitudinal imaging of individual mice. The SLO is equipped with a "flip-in" spectrometer that enables spectral "fingerprinting" of fluorochromes. Segmentation of retina layers and en face display facilitate spatial comparison of OCT data with SLO fluorescence patterns. We demonstrate that the system can be used to image an individual retinal ganglion cell over many months, to simultaneously image microglia and Müller glia expressing different fluorochromes, to characterize the distinctive spatial distributions and clearance times of circulating fluorochromes with different molecular sizes, and to produce unequivocal images of the heretofore uncharacterized mouse choroidal vasculature.

  3. Adaptive optics scanning ophthalmoscopy with annular pupils.

    Science.gov (United States)

    Sulai, Yusufu N; Dubra, Alfredo

    2012-07-01

    Annular apodization of the illumination and/or imaging pupils of an adaptive optics scanning light ophthalmoscope (AOSLO) for improving transverse resolution was evaluated using three different normalized inner radii (0.26, 0.39 and 0.52). In vivo imaging of the human photoreceptor mosaic at 0.5 and 10° from fixation indicates that the use of an annular illumination pupil and a circular imaging pupil provides the most benefit of all configurations when using a one Airy disk diameter pinhole, in agreement with the paraxial confocal microscopy theory. Annular illumination pupils with 0.26 and 0.39 normalized inner radii performed best in terms of the narrowing of the autocorrelation central lobe (between 7 and 12%), and the increase in manual and automated photoreceptor counts (8 to 20% more cones and 11 to 29% more rods). It was observed that the use of annular pupils with large inner radii can result in multi-modal cone photoreceptor intensity profiles. The effect of the annular masks on the average photoreceptor intensity is consistent with the Stiles-Crawford effect (SCE). This indicates that combinations of images of the same photoreceptors with different apodization configurations and/or annular masks can be used to distinguish cones from rods, even when the former have complex multi-modal intensity profiles. In addition to narrowing the point spread function transversally, the use of annular apodizing masks also elongates it axially, a fact that can be used for extending the depth of focus of techniques such as adaptive optics optical coherence tomography (AOOCT). Finally, the positive results from this work suggest that annular pupil apodization could be used in refractive or catadioptric adaptive optics ophthalmoscopes to mitigate undesired back-reflections.

  4. Ophthalmoscopy versus non-mydriatic fundus photography in the ...

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... detection of diabetic retinopathy before and after dilatation of th~ pU~i1s in black diabetics was .... patient's retina, the camera also provides excellent material for student education. We are indebted to Mr R. Taylor for taking ...

  5. Closed-loop optical stabilization and digital image registration in adaptive optics scanning light ophthalmoscopy.

    Science.gov (United States)

    Yang, Qiang; Zhang, Jie; Nozato, Koji; Saito, Kenichi; Williams, David R; Roorda, Austin; Rossi, Ethan A

    2014-09-01

    Eye motion is a major impediment to the efficient acquisition of high resolution retinal images with the adaptive optics (AO) scanning light ophthalmoscope (AOSLO). Here we demonstrate a solution to this problem by implementing both optical stabilization and digital image registration in an AOSLO. We replaced the slow scanning mirror with a two-axis tip/tilt mirror for the dual functions of slow scanning and optical stabilization. Closed-loop optical stabilization reduced the amplitude of eye-movement related-image motion by a factor of 10-15. The residual RMS error after optical stabilization alone was on the order of the size of foveal cones: ~1.66-2.56 μm or ~0.34-0.53 arcmin with typical fixational eye motion for normal observers. The full implementation, with real-time digital image registration, corrected the residual eye motion after optical stabilization with an accuracy of ~0.20-0.25 μm or ~0.04-0.05 arcmin RMS, which to our knowledge is more accurate than any method previously reported.

  6. Calibration-free sinusoidal rectification and uniform retinal irradiance in scanning light ophthalmoscopy.

    Science.gov (United States)

    Yang, Qiang; Yin, Lu; Nozato, Koji; Zhang, Jie; Saito, Kenichi; Merigan, William H; Williams, David R; Rossi, Ethan A

    2015-01-01

    Sinusoidal rectification (i.e., desinusoiding) is necessary for scanning imaging systems and is typically achieved by calculating a rectification transform from a calibration image such as a regular grid. This approach is susceptible to error due to electronic or mechanical instability that can alter the phase of the imaging window with respect to the calibration transform. Here, we show a calibration-free rectification method implemented from live video of a scanning light ophthalmoscope (SLO) with or without adaptive optics (AO). This approach, which capitalizes on positional differences in the images obtained in the forward and backward scan directions, dynamically keeps the imaging window in phase with the motion of the sinusoidal resonant scanner, preventing errors from signal drift over time. A benefit of this approach is that it allows the light power across the field-of-view (FOV) to be modulated inversely to achieve uniform irradiance on the retina, a feature desirable for functional imaging methods and light safety in SLOs.

  7. Fluorescence lifetime imaging ophthalmoscopy in type 2 diabetic patients who have no signs of diabetic retinopathy

    Science.gov (United States)

    Schweitzer, Dietrich; Deutsch, Lydia; Klemm, Matthias; Jentsch, Susanne; Hammer, Martin; Peters, Sven; Haueisen, Jens; Müller, Ulrich A.; Dawczynski, Jens

    2015-06-01

    The time-resolved autofluorescence of the eye is used for the detection of metabolic alteration in diabetic patients who have no signs of diabetic retinopathy. One eye from 37 phakic and 11 pseudophakic patients with type 2 diabetes, and one eye from 25 phakic and 23 pseudophakic healthy subjects were included in the study. After a three-exponential fit of the decay of autofluorescence, histograms of lifetimes τi, amplitudes αi, and relative contributions Qi were statistically compared between corresponding groups in two spectral channels (490diabetic patients and age-matched controls (p450 ps, and the shift of τ3 from ˜3000 to 3700 ps in ch1 of diabetic patients when compared with healthy subjects indicate an increased production of free flavin adenine dinucleotide, accumulation of advanced glycation end products (AGE), and, probably, a change from free to protein-bound reduced nicotinamide adenine dinucleotide at the fundus. AGE also accumulated in the crystalline lens.

  8. Diabetic retinopathy : a cost-effectiveness analysis of ophthalmoscopy and photocoagulation

    NARCIS (Netherlands)

    H.H.M. Crijns (Henricus Hubertus Maria)

    1993-01-01

    textabstractWithin twenty years after the onset of diabetes mellitus (DM), the prevalenee of diabetic retinopathy (DR) reaches the following maxima: 98% for IDDM patients (age of onset <30 years); 95% and 72% for insulin taking and not-insulin taking NIDDM patients (age of onset ;:,30 years). At fir

  9. Role of wide-field autofluorescence imaging and scanning laser ophthalmoscopy in differentiation of choroidal pigmented lesions

    Institute of Scientific and Technical Information of China (English)

    Lukas; Reznicek; Carmen; Stumpf; Florian; Seidensticker; Anselm; Kampik; Aljoscha; S; Neubauer; Marcus; Kernt

    2014-01-01

    ·AIM:Toevaluatethe diagnostic properties of wide-field fundus autofluorescence(FAF) scanning laser ophthalmoscope(SLO) imaging for differentiating choroidal pigmented lesions.·METHODS: A consecutive series of 139 patients were included, 101 had established choroidal melanoma with13 untreated lesions and 98 treated with radiotherapy.Thirty-eight had choroidal nevi. All patients underwent a full ophthalmological examination, undilated wide-field imaging, FAF and standardized US examination. FAF images and imaging characteristics from SLO were correlated with the structural findings in the two patient groups.·RESULTS: Mean FAF intensity of melanomas was significantly lower than the FAF of choroidal nevi. Only 1out of 38 included eyes with nevi touched the optic disc compared to 31 out of 101 eyes with melanomas. In 18 out of 101 melanomas subretinal fluid was seen at the pigmented lesion compared to none seen in eyes with confirmed choroidal nevi. In "green laser separation", a trend towards more mixed FAF appearance of melanomas compared to nevi was observed. The mean maximal and minimal transverse and longitudinal diameters of melanomas were significantly higher than those of nevi.·CONCLUSION: Wide-field SLO and FAF imaging may be an appropriate non-invasive diagnostic screening tool to differentiate benign from malign pigmented choroidal lesions.

  10. Nonmydriatic ultra-wide-field scanning laser ophthalmoscopy (Optomap) versus two-field fundus photography in diabetic retinopathy.

    Science.gov (United States)

    Liegl, Raffael; Liegl, Kristine; Ceklic, Lala; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W; Kernt, Marcus; Neubauer, Aljoscha S

    2014-01-01

    The purpose of this study was to investigate the diagnostic properties of a 2-laser wavelength nonmydriatic 200° ultra-wide-field scanning laser ophthalmoscope (SLO) versus mydriatic 2-field 45° color fundus photography (EURODIAB standard) for assessing diabetic retinopathy (DR). A total of 143 consecutive eyes of patients with different levels of DR were graded regarding DR level and macular edema based on 2-field color photographs or 1 Optomap Panoramic 200 SLO image. All SLO images were nonmydriatic and all photographs mydriatic. Grading was performed masked to patient and clinical data. Based on photography, 20 eyes had no DR, 44 had mild, 18 moderate and 42 severe nonproliferative DR, and 19 eyes had proliferative DR. Overall correlation for grading DR level compared to Optomap SLO was moderate with kappa 0.54 (p photography need to be confirmed in further studies.

  11. Assessment of diabetic retinopathy using nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) compared with ETDRS 7-field stereo photography.

    Science.gov (United States)

    Kernt, Marcus; Hadi, Indrawati; Pinter, Florian; Seidensticker, Florian; Hirneiss, Christoph; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W; Neubauer, Aljoscha S

    2012-12-01

    To compare the diagnostic properties of a nonmydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) versus mydriatic Early Treatment of Diabetic Retinopathy Study (ETDRS) 7-field photography for diabetic retinopathy (DR) screening. A consecutive series of 212 eyes of 141 patients with different levels of DR were examined. Grading of DR and clinically significant macular edema (CSME) from mydriatic ETDRS 7-field stereo photography was compared with grading obtained by Optomap Panoramic 200 SLO images. All SLO scans were performed through an undilated pupil, and no additional clinical information was used for evaluation of all images by the two independent, masked, expert graders. Twenty-two eyes from ETDRS 7-field photography and 12 eyes from Optomap were not gradable by at least one grader because of poor image quality. A total of 144 eyes were analyzed regarding DR level and 155 eyes regarding CSME. For ETDRS 7-field photography, 22 eyes (18 for grader 2) had no or mild DR (ETDRS levels ≤ 20) and 117 eyes (111 for grader 2) had no CSME. A highly substantial agreement between both Optomap DR and CSME grading and ETDRS 7-field photography existed with κ = 0.79 for DR and 0.73 for CSME for grader 1, and κ = 0.77 (DR) and 0.77 (CSME) for grader 2. Determination of CSME and grading of DR level from Optomap Panoramic 200 nonmydriatic images show a positive correlation with mydriatic ETDRS 7-field stereo photography. Both techniques are of sufficient quality to assess DR and CSME. Optomap Panoramic 200 images cover a larger retinal area and therefore may offer additional diagnostic properties.

  12. Screening for retinopathy of prematurity-a comparison between binocular indirect ophthalmoscopy and RetCam 120

    Directory of Open Access Journals (Sweden)

    Shah Parag

    2006-01-01

    Full Text Available Aim: To compare the photographic screening for retinopathy of prematurity (ROP using RetCam 120 with binocular indirect ophthalmoscope (BIO, which is the current gold standard. Setting and Design: Prospective, comparative study. Materials and Methods: A total of 87 RetCam examinations were performed on 27 premature babies. They were stored in a separate file after deleting the identifying information. At the same visit using the BIO with scleral depression, an experienced vitreoretinal surgeon evaluated the fundus in detail. A masked examiner then evaluated the RetCam photographs for presence or absence of ROP, the stage and zone of the disease, and the presence or absence of plus disease. These data were then compared with the BIO findings to determine the sensitivity, specificity, and the positive and negative predictive values of the method. Results: ROP was detected in 63 of 87 examinations by BIO and in 56 of 87 RetCam examinations. Nine RetCam examinations were false-negative and two were false-positive. Sensitivity of RetCam was 85.71% (54/63 and specificity was 91.66% (22/24. The positive and negative predictive values were 96.43% and 70.97% respectively. Conclusion: Nine cases having ROP were missed by the RetCam. All these cases were either in zone 3 or the outer part of zone 2, which later regressed. These were missed mostly because of the restricted mobility of the camera head caused by its size and the barrier caused by the lid speculum arms. No case of threshold ROP was missed. RetCam may replace BIO for screening of ROP.

  13. Comparison between Early Treatment Diabetic Retinopathy Study 7-field retinal photos and non-mydriatic, mydriatic and mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy

    DEFF Research Database (Denmark)

    Rasmussen, Malin Lundberg; Broe, Rebecca; Frydkjaer-Olsen, Ulrik;

    2015-01-01

    AIMS: To compare non-mydriatic, mydriatic and steered mydriatic widefield retinal images with mydriatic 7-field Early Treatment Diabetic Retinopathy Study (ETDRS)-standards in grading diabetic retinopathy (DR). METHODS: We examined 95 patients (190 eyes) with type 1 diabetes. A non-mydriatic, a m...

  14. [Diagnostic Precision of the Confocal Scanning Laser Ophthalmoscopy in the Large Optic Disc with Physiological Excavation - a Long-Term Study].

    Science.gov (United States)

    Koch, Eva Charlotte; Plange, Niklas; Fuest, Matthias; Schimitzek, Hannah; Kuerten, David

    2017-07-06

    We repeatedly examined 17 subjects with presumed bilateral physiological excavation labeled as pathological and/or borderline via HRT to verify the diagnosis of physiological cupping or to monitor the long-term progression into normal tension glaucoma. Patients and Methods 17 Subjects with presumed bilateral physiological cupping and large optic discs were included in this long-term follow-up study. All subjects underwent regular detailed ophthalmologic examinations, including intraocular pressure measurement via Goldmann applanation tonometry (GAT), retinal nerve fiber layer imaging via optical coherence tonometry (OCT) and visual field testing and optic disc imaging using the HRT. Glaucomatous progression was identified using the HRT's tools (stereometric trend analysis [STA] and topographic change analysis [TCA]). Results In the initial examination, all 17 subjects were classified as "pathological", by the HRT's Moorfield's Regression Analysis (MRA). Over the observation period of 9.2 ± 5 years, only 1 of the 17 subjects showed an ensured conversion to normal tension glaucoma with glaucomatous visual field defects. The remaining 16 subjects show no visual field defects to date. STA showed significant changes in 3 subjects alone, in 1 subject TCA showed a significant change alone, and in 1 subject both analyses showed a progressive change. Conclusion After 9 years of regular examinations, 16 of the 17 subjects that were classified as "pathological" using MRA showed no glaucomatous visual field defects. In 5 out of these 16 subjects, progressive changes of the optic disc could be recorded via HRT. Therefore, the diagnostic precision of the HRT measurements seems to be limited in patients with large discs and physiological cupping. Georg Thieme Verlag KG Stuttgart · New York.

  15. WAJM 28(3) for printing.pmd

    African Journals Online (AJOL)

    dese

    examination) includes comprehensive adult eye evaluation with ... CS, Contrast Sensitivity; CSLO, Co-focal Scanning Laser Ophthalmoscopy; DCT, Dynamic .... result in a pale optic disc but disc pallor ..... sensitivity of fast blue-yellow and.

  16. Evaluation of Competence of Medical Students in Performing Direct ...

    African Journals Online (AJOL)

    which they underwent a didactic lecture on direct ophthalmoscopy and ... exam. Exclusion criteria. Medical students who failed to meet 75% attendance as ... the Y instructor believes students are motivated to learn willingly without close ...

  17. Photo-induced foveal injury after viewing a solar eclipse.

    Science.gov (United States)

    Källmark, Fredrik P; Ygge, Jan

    2005-10-01

    To study the injury to and possible recovery of the visual function and foveal morphology in patients with photo-induced foveal injury due to watching the solar eclipse of August 11th, 1999 in Stockholm, Sweden. Fifteen patients, all of whom viewed the solar eclipse, were followed for 1 year, during which their visual symptoms were recorded and visual acuity (VA) was tested, and ophthalmoscopy and scanning laser ophthalmoscopy were performed. Photo-induced foveal injury gave rise to subjective visual disturbances, reduced VA and morphological changes in the fovea. Central scotomas could still be seen in all patients 1 year after the foveal injury. Photo-induced foveal injury gave rise to subjective visual disturbances, reduced VA and morphological changes in the fovea. Scanning laser ophthalmoscopy offers the possibility of detailed examination of small retinal lesions, which can sometimes be difficult to localize with ophthalmoscopy.

  18. South African Medical Journal - Vol 78, No 9 (1990)

    African Journals Online (AJOL)

    Detecting asymptomatic coronary artery disease using routine exercise testing and exercise thallium ... Ophthalmoscopy versus non-mydriatic fundus photography in the detection of diabetic retinopathy in black .... Current Issue Atom logo

  19. Screening for diabetic retinopathy: the utility of nonmydriatic retinal photography in Egyptian adults.

    Science.gov (United States)

    Penman, A D; Saaddine, J B; Hegazy, M; Sous, E S; Ali, M A; Brechner, R J; Herman, W H; Engelgau, M M; Klein, R

    1998-09-01

    Although regular screening for diabetic retinopathy with ophthalmoscopy or retinal photography is widely recommended in the United States and Europe, few reports of its use in developing countries are available. We compared the performance of screening by retinal photography with that of indirect ophthalmoscopy by using data from a population-based survey of diabetes and its complications in Egypt. During that project, 427 persons with diabetes underwent an eye examination and fundus photography with a non-mydriatic camera through a dilated pupil. Data from the examinations of the right eye of each patient are presented. Ninety-two (22%) of the 427 retinal photographs were ungradable; in 58 eyes (63%), this was due to media opacity (42 eyes with cataract, 3 with corneal opacity, and 13 with both). Agreement between retinal photography and indirect ophthalmoscopy was poor (kappa = 0.33; 95% CI = 0.27-0.39) and primarily due to the large number of eyes (n = 79) with ungradable photographs that could be graded by ophthalmoscopy. None of these eyes was judged by ophthalmoscopy to have sight-threatening retinopathy. Fifty-four photographs were diagnosed with greater retinopathy than found on ophthalmoscopy. Retinal photography with the nonmydriatic camera through a dilated pupil is a useful method to screen for diabetic retinopathy in most adults in Egypt. However, such screening strategies have limited use in older persons and in persons with corneal disease or cataract.

  20. Névrite optique. Diagnostics différentiels

    DEFF Research Database (Denmark)

    Alphandari, A; Milea, Dan

    2010-01-01

    Optic neuritis is clinically suspected when painful, rapidly progressive central visual loss occurs in a young patient who has a relative afferent pupillary defect. Ophthalmoscopy is normal in the majority of cases but papillitis or optic disc palor can occur. Several other diseases can mimic opt...

  1. Fundus reflectance : historical and present ideas

    NARCIS (Netherlands)

    Berendschot, T.T.J.M.; Delint, P.J.; Norren, D. van

    2003-01-01

    In 1851 Helmholtz introduced the ophthalmoscope. The instrument allowed the observation of light reflected at the fundus. The development of this device was one of the major advancements in ophthalmology. Yet ophthalmoscopy allows only qualitative observation of the eye. Since 1950 attempts were mad

  2. EAMJ Assessment March 10.indd

    African Journals Online (AJOL)

    2010-03-03

    Mar 3, 2010 ... After 20 years, virtually all type 1 and more than. 60% of all type 2 ... be missed on ophthalmoscopy (7) and at least one ... Subjects: Africans aged 20 years and above with newly diagnosed type 2 diabetes mellitus of up ... classification published by WHO (20), while diabetic ... Body mass index, Kgm-2. 23.

  3. Babbage, Charles (1792-1871)

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    Polymath, eleventh Lucasian Professor at Cambridge. Known not only for work on astronomy but also in cryptanalysis, probability, geophysics, altimetry, ophthalmoscopy, statistical linguistics, meteorology, actuarial science, lighthouse technology, the use of tree rings as historic climatic records, magnetism, biology, geology, religion, submarines, politics, economics and mathematics. Most import...

  4. Diagnostic accuracy and use of nonmydriatic ocular fundus photography by emergency physicians: phase II of the FOTO-ED study.

    Science.gov (United States)

    Bruce, Beau B; Thulasi, Praneetha; Fraser, Clare L; Keadey, Matthew T; Ward, Antoinette; Heilpern, Katherine L; Wright, David W; Newman, Nancy J; Biousse, Valérie

    2013-07-01

    During the first phase of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department study, 13% (44/350; 95% confidence interval [CI] 9% to 17%) of patients had an ocular fundus finding, such as papilledema, relevant to their emergency department (ED) management found by nonmydriatic ocular fundus photography reviewed by neuro-ophthalmologists. All of these findings were missed by emergency physicians, who examined only 14% of enrolled patients by direct ophthalmoscopy. In the present study, we evaluate the sensitivity of nonmydriatic ocular fundus photography, an alternative to direct ophthalmoscopy, for relevant findings when photographs are made available for use by emergency physicians during routine clinical care. Three hundred fifty-four patients presenting to our ED with headache, focal neurologic deficit, visual change, or diastolic blood pressure greater than or equal to 120 mm Hg had nonmydriatic fundus photography obtained (Kowa nonmydriatic α-D). Photographs were placed on the electronic medical record for emergency physician review. Identification of relevant findings on photographs by emergency physicians was compared with a reference standard of neuro-ophthalmologist review. Emergency physicians reviewed photographs of 239 patients (68%). Thirty-five patients (10%; 95% CI 7% to 13%) had relevant findings identified by neuro-ophthalmologist review (6 disc edema, 6 grade III/IV hypertensive retinopathy, 7 isolated hemorrhages, 15 optic disc pallor, and 1 retinal vascular occlusion). Emergency physicians identified 16 of 35 relevant findings (sensitivity 46%; 95% CI 29% to 63%) and also identified 289 of 319 normal findings (specificity 91%; 95% CI 87% to 94%). Emergency physicians reported that photographs were helpful for 125 patients (35%). Emergency physicians used nonmydriatic fundus photographs more frequently than they performed direct ophthalmoscopy, and their detection of relevant abnormalities improved. Ocular fundus

  5. The effect of subretinal viscoelastics on the porcine retinal function

    DEFF Research Database (Denmark)

    Sørensen, Nina Fischer; Ejstrup, Rasmus; Svahn, Thøger Frøsig

    2012-01-01

    examined by mfERG. The major component P1 was analyzed statistically. Indirect ophthalmoscopy and bilateral color fundus photography (FP) were performed. Selected animals underwent high-resolution optical coherence tomography (OCT). Examination by ophthalmoscopy and FP showed that the RDs remained detached...... for the 6 weeks of follow-up. The P1 amplitude of the mfERG did not differ significantly between the detached areas, the surrounding attached areas, and the healthy eye (p¿=¿0.25). Similarly, P1 implicit time did not differ between the areas (p¿=¿0.85). The lack of functional consequences of long-term RD...

  6. Evaluation of a simulation tool in ophthalmology: application in teaching funduscopy

    Directory of Open Access Journals (Sweden)

    Joice Elise Androwiki

    2015-02-01

    Full Text Available Purpose: The aim of this study was to evaluate the Eye Retinopathy Trainer® as a teaching tool for direct ophthalmoscopy examination by comparing it with the traditional method using volunteers. Methods: Fourth year medical students received training in direct ophthalmoscopy using a simulation tool and human volunteers. Ninety students were randomized into a Simulation Group or a Control Group by the inclusion or absence of the simulation model in classroom practice. Differences between the groups were analyzed using unpaired Student’s t-test. Results: The Simulation Group was superior to the Control Group, with 51.06% successful in performing fundus examination in both the anatomical model simulation and the human model in comparison with 21.15% in the Control Group. Conclusion: The Eye Retinopathy Trainer® appears to be an effective teaching tool for practice and improvement of ophthalmologic examination among fourth year medical students.

  7. Ocular Fundus Photography as an Educational Tool.

    Science.gov (United States)

    Mackay, Devin D; Garza, Philip S

    2015-10-01

    The proficiency of nonophthalmologists with direct ophthalmoscopy is poor, which has prompted a search for alternative technologies to examine the ocular fundus. Although ocular fundus photography has existed for decades, its use has been traditionally restricted to ophthalmology clinical care settings and textbooks. Recent research has shown a role for nonmydriatic fundus photography in nonophthalmic settings, encouraging more widespread adoption of fundus photography technology. Recent studies have also affirmed the role of fundus photography as an adjunct or alternative to direct ophthalmoscopy in undergraduate medical education. In this review, the authors examine the use of ocular fundus photography as an educational tool and suggest future applications for this important technology. Novel applications of fundus photography as an educational tool have the potential to resurrect the dying art of funduscopy.

  8. ROLLER COASTER RETINOPATHY: CASE REPORT OF SYMPTOMATIC BILATERAL INTRARETINAL HEMORRHAGES AFTER SHAKING INJURY IN AN OTHERWISE HEALTHY ADULT

    OpenAIRE

    Yogin P. Patel; Saraf, Steven S.; Desai, Ankit; Desai, Uday R.

    2016-01-01

    Purpose: Traumatic head injuries not involving the eye have been known to cause retinal injury through multiple mechanisms. Abusive head trauma remains the prototypical example. We propose to demonstrate the first case of bilateral multiple retinal hemorrhages in a young healthy adult related to riding multiple theme park roller coasters. Methods: The patient was evaluated with a complete ophthalmic examination including dilated extended ophthalmoscopy, fluorescein angiography, optical cohere...

  9. Névrite optique. Diagnostics différentiels

    DEFF Research Database (Denmark)

    Alphandari, A; Milea, Dan

    2010-01-01

    Optic neuritis is clinically suspected when painful, rapidly progressive central visual loss occurs in a young patient who has a relative afferent pupillary defect. Ophthalmoscopy is normal in the majority of cases but papillitis or optic disc palor can occur. Several other diseases can mimic optic...... neuritis, such as ophthalmological conditions or other diseases affecting the visual pathways. Their appropriate clinical diagnosis is of paramount importance in order to avoid unnecessary or invasive procedures or treatments....

  10. Wide-angle chromatic aberration corrector for the human eye.

    Science.gov (United States)

    Benny, Yael; Manzanera, Silvestre; Prieto, Pedro M; Ribak, Erez N; Artal, Pablo

    2007-06-01

    The human eye is affected by large chromatic aberration. This may limit vision and makes it difficult to see fine retinal details in ophthalmoscopy. We designed and built a two-triplet system for correcting the average longitudinal chromatic aberration of the eye while keeping a reasonably wide field of view. Measurements in real eyes were conducted to examine the level and optical quality of the correction. We also performed some tests to evaluate the effect of the corrector on visual performance.

  11. MRI and intraocular tamponade media

    Energy Technology Data Exchange (ETDEWEB)

    Manfre, I. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Fabbri, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Avitabile, T. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Biondi, P. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Reibaldi, A. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Pero, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy))

    1993-05-01

    Thirteen patients who underwent surgery for retinal detachment and injection of intraocular tamponade media (silicone oil, flurosilicone oil, or perfluoro-carbon liquid) underwent magnetic resonance imaging (MRI), using spin-echo T1- and T2-weighted images. The ophthalmic tamponade media showed different signal intensity, according to their chemical structure. Unlike ophthalmoscopy or ultrasonography, MRI showed no oil-related artefact, making possible recognition of recurrent retinal detachment. (orig.)

  12. EYESi ophthalmoscope - a simulator for indirect ophthalmoscopic examinations.

    Science.gov (United States)

    Schuppe, Oliver; Wagner, Clemens; Koch, Frank; Männer, Reinhard

    2009-01-01

    We present a training simulator for indirect ophthalmoscopy. An optical tracking system is used to reconstruct the position of a lens mockup and a model of the patient's face. Refraction and illumination are computed in real-time and displayed on a head-mounted display using augmented reality. A case database completes the training system which allows to practise the examination and to study clinical patterns.

  13. OCULAR COLOBAMATA IN A FAMILY

    Directory of Open Access Journals (Sweden)

    Sheetal

    2015-04-01

    Full Text Available AIM: To identify the proportion of cases affected in a family with ocular colobamata . MATERIAL: Ocular colobomata present in a family METHOD: Visual acuity, Slit lamp examination, Ophthalmoscopy, Fundus Photography, B - Scan, Family members were examined. RESULTS: Family showed poor visual acuity, Iris and Choridal Coloboma without optic disc involvement and normal corneal diameter. CONCLUSION: Ocular coloboma occurring in patients of my study is family and genetically determined.

  14. Bloody cerebrospinal fluid: traumatic tap or child abuse?

    Science.gov (United States)

    Apolo, J O

    1987-06-01

    A central nervous system dysfunction of nontraumatic etiology was initially suspected in three cases of shaken baby syndrome. Blood contaminating the cerebrospinal fluid was attributed to a traumatic lumbar puncture. Failure to detect retinal hemorrhages contributed to the misdiagnosis. Emergency physicians must consider the diagnosis of shaken baby syndrome in a critically ill infant with bloody cerebrospinal fluid. Ophthalmoscopy should be done routinely in these patients.

  15. Scleral Buckling with Chandelier Illumination

    OpenAIRE

    Michael I Seider; Riikka E.K Nomides; Paul Hahn; Prithvi Mruthyunjaya; Mahmoud, Tamer H

    2016-01-01

    Scleral buckling is a highly successful technique for the repair of rhegmatogenous retinal detachment that requires intra-operative examination of the retina and treatment of retinal breaks via indirect ophthalmoscopy. Data suggest that scleral buckling likely results in improved outcomes for many patients but is declining in popularity, perhaps because of significant advances in vitrectomy instrumentation and visualization systems. Emerging data suggest that chandelier-assisted scleral buckl...

  16. The use of retinal photography in nonophthalmic settings and its potential for neurology.

    Science.gov (United States)

    Pérez, Mario A; Bruce, Beau B; Newman, Nancy J; Biousse, Valérie

    2012-11-01

    Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and interexamination/intraexamination agreement compared with in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Nonmydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. In addition, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurological, and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings.

  17. The use of retinal photography in non-ophthalmic settings and its potential for neurology

    Science.gov (United States)

    Pérez, Mario A.; Bruce, Beau B.; Newman, Nancy J.; Biousse, Valérie

    2012-01-01

    Background Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Review Summary Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and inter-/intra-examination agreement compared to in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Non-mydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. Additionally, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Conclusion Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurologic and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings. PMID:23114666

  18. Feasibility of Non-Mydriatic Ocular Fundus Photography in the Emergency Department: Phase I of the FOTO-ED Study

    Science.gov (United States)

    Bruce, Beau B.; Lamirel, Cédric; Biousse, Valérie; Ward, Antionette; Heilpern, Katherine L.; Newman, Nancy J.; Wright, David W.

    2011-01-01

    Objectives Examination of the ocular fundus is imperative in many acute medical and neurologic conditions, but direct ophthalmoscopy by non-ophthalmologists is underutilized, poorly performed, and difficult without pharmacologic pupillary dilation. The objective was to examine the feasibility of non-mydriatic fundus photography as a clinical alternative to direct ophthalmoscopy by emergency physicians (EPs). Methods Adult patients presenting to the emergency department (ED) with headache, acute focal neurologic deficit, diastolic blood pressure ≥ 120 mmHg, or acute visual change had ocular fundus photographs taken by nurse practitioners using a non-mydriatic fundus camera. Photographs were reviewed by a neuro-ophthalmologist within 24 hours for findings relevant to acute ED patient care. Nurse practitioners and patients rated ease, comfort, and speed of non-mydriatic fundus photography on a 10-point Likert scale (10 best). Timing of visit and photography were recorded by automated electronic systems. Results Three hundred fifty patients were enrolled. There were 1,734 photographs taken during 230 nurse practitioner shifts. Eighty-three percent of the 350 patients had at least one eye with a high quality photograph, while only 3% of patients had no photographs of diagnostic value. Mean ratings were ≥ 8.7 (standard deviation [SD] ≤ 1.9) for all measures. The median photography session lasted 1.9 minutes (interquartile range [IQR] 1.3 to 2.9 minutes), typically accounting for less that 0.5% of the patient’s total ED visit. Conclusions Non-mydriatic fundus photography taken by nurse practitioners is a feasible alternative to direct ophthalmoscopy in the ED. It is performed well by non-physician staff, is well-received by staff and patients, and requires a trivial amount of time to perform. PMID:21906202

  19. Feasibility of nonmydriatic ocular fundus photography in the emergency department: Phase I of the FOTO-ED study.

    Science.gov (United States)

    Bruce, Beau B; Lamirel, Cédric; Biousse, Valérie; Ward, Antionette; Heilpern, Katherine L; Newman, Nancy J; Wright, David W

    2011-09-01

    Examination of the ocular fundus is imperative in many acute medical and neurologic conditions, but direct ophthalmoscopy by nonophthalmologists is underutilized, poorly performed, and difficult without pharmacologic pupillary dilation. The objective was to examine the feasibility of nonmydriatic fundus photography as a clinical alternative to direct ophthalmoscopy by emergency physicians (EPs). Adult patients presenting to the emergency department (ED) with headache, acute focal neurologic deficit, diastolic blood pressure ≥ 120 mm Hg, or acute visual change had ocular fundus photographs taken by nurse practitioners using a nonmydriatic fundus camera. Photographs were reviewed by a neuroophthalmologist within 24 hours for findings relevant to acute ED patient care. Nurse practitioners and patients rated ease, comfort, and speed of nonmydriatic fundus photography on a 10-point Likert scale (10 best). Timing of visit and photography were recorded by automated electronic systems. A total of 350 patients were enrolled. There were 1,734 photographs taken during 230 nurse practitioner shifts. Eighty-three percent of the 350 patients had at least one eye with a high-quality photograph, while only 3% of patients had no photographs of diagnostic value. Mean ratings were ≥ 8.7 (standard deviation [SD] ≤ 1.9) for all measures. The median photography session lasted 1.9 minutes (interquartile range [IQR] = 1.3 to 2.9 minutes), typically accounting for less that 0.5% of the patient's total ED visit. Nonmydriatic fundus photography taken by nurse practitioners is a feasible alternative to direct ophthalmoscopy in the ED. It is performed well by nonphysician staff, is well-received by staff and patients, and requires a trivial amount of time to perform. © 2011 by the Society for Academic Emergency Medicine.

  20. Determinants of visual acuity outcomes in eyes with neovascular AMD treated with anti-VEGF agents: an instrumental variable analysis of the AURA study.

    Science.gov (United States)

    Holz, F G; Tadayoni, R; Beatty, S; Berger, A R; Cereda, M G; Hykin, P; Staurenghi, G; Wittrup-Jensen, K; Nilsson, J; Kim, K; Sivaprasad, S

    2016-08-01

    PurposeTo identify the strongest variable(s) linked with the number of ranibizumab injections and outcomes in AURA, and to identify ways to improve outcomes using this association.MethodsAURA was a large observational study that monitored visual acuity over a 2-year period in patients with neovascular age-related macular degeneration (AMD) who received ranibizumab injections. Baseline characteristics, resource use, and outcomes were analyzed using an instrumental variable approach and regression analysis.ResultsData were analyzed from 2227 patients enrolled in AURA. Optical coherence tomography (OCT) and ophthalmoscopy were the most common diagnostic tests used, and this combination was the strongest instrumental variable. Use of OCT and ophthalmoscopy affected the number of injections given and resulted in an increase in visual acuity gains from baseline of 17.6 letters in year 1 and 2.5 letters in year 2. Regression models using the instrumental variable (OCT and ophthalmoscopy combined) showed that ≥5.1 (95% CI: 3.3-11.4) ranibizumab injections were needed to maintain visual acuity from baseline to year 1 and ≥8.3 (95% CI: 5.3-18.8) injections were needed to maintain visual acuity from year 1 to year 2. To gain ≥15 letters, ≥7.9 (95% CI: 5.1-17.5) ranibizumab injections would be needed in year 1 and ≥16.1 (95% CI: 10.3-36.4) injections would be needed over 2 years.ConclusionsThese findings highlight the role that regular monitoring plays in guiding neovascular AMD therapy and they showed that the number of ranibizumab injections needed to maintain visual acuity is higher than that administered in AURA.

  1. Optic neuropathy in sheep associated with overdosage of closantel.

    Science.gov (United States)

    Borges, A S; Mendes, L C; de Andrade, A L; Machado, G F; Peiro, J R

    1999-12-01

    This report describes clinical and pathological findings in 2 flocks in Brazil where blindness and deaths in sheep occurred after closantel overdosage. Depression, weakness, and blindness affected 37 animals and 17 died in 2 flocks of 190 animals. Two animals submitted for ophthalmic examination showed no inflammation in the anterior segment of both eyes; posterior segment evaluation by indirect ophthalmoscopy suggested retinal degeneration. One postmortem evaluation local spongy vacuolization was in several regions of the brain and the optical nerves had severe axonal degeneration.

  2. MR imaging findings of retinal hemorrhage in a case of nonaccidental trauma

    Energy Technology Data Exchange (ETDEWEB)

    Altinok, Deniz; Saleem, Sheena; Smith, Wilbur [Children' s Hospital of Michigan, Department of Pediatric Imaging, Detroit, MI (United States); Zhang, Zaixiang [Wayne State University School of Medicine, Department of Radiology, Detroit, MI (United States); Markman, Lisa [Children' s Hospital of Michigan, Child Protection Team, Detroit, MI (United States)

    2009-03-15

    Retinal hemorrhage is a well-recognized manifestation of child abuse found in many babies with shaken baby syndrome. The presence of retinal hemorrhage is generally associated with more severe neurological damage and a worse clinical outcome. MR imaging findings of retinal hemorrhages are not well described in the pediatric literature. We present a 6-month-old boy with new-onset seizures, subdural hemorrhage and bilateral retinal hemorrhages that were detected by MRI and confirmed by indirect ophthalmoscopy. This case demonstrates the MR imaging findings of retinal hemorrhages and the importance of radiologists being able to recognize these specific imaging features. (orig.)

  3. Is Smoking a Risk Factor for Proliferative Diabetic Retinopathy in Type 1 Diabetes?

    DEFF Research Database (Denmark)

    Gaedt Thorlund, Mie; Borg Madsen, Mette; Green, Anders

    2013-01-01

    Aim: The aim was to evaluate if smoking was a risk factor for proliferative retinopathy (PDR) in a 25-year follow-up study. Methods: 201 persons from a population-based cohort of Danish type 1 diabetic patients were examined at baseline and again 25 years later. At both examinations the patients...... were asked about their smoking habits. The level of retinopathy was evaluated by ophthalmoscopy at baseline and by nine 45-degree colour field fundus photos at the follow-up. Results: In multivariate analyses there was a trend that current smokers at baseline were more likely to develop PDR...

  4. [Technical principles of adaptive optics in ophthalmology].

    Science.gov (United States)

    Reiniger, J L; Domdei, N; Holz, F G; Harmening, W M

    2017-02-13

    During the last 25 years ophthalmic imaging has undergone a revolution. This review gives an overview of the possibilities of adaptive optics (AO) for ophthalmic imaging technologies and their development and illustrates that the role of ophthalmic imaging changed from the documentation of obvious abnormalities to the detection of microscopic yet significant conspicuities. This enables earlier and more precise diagnoses. The implementation of AO for imaging systems like fundus cameras, scanning laser ophthalmoscopy and optical coherence tomography has gained in importance. In recent years a couple of companies started developing commercially available AO systems, thus, indicating a future use in clinical routine.

  5. Down's syndrome: a ten-year group study.

    Science.gov (United States)

    Gaynon, M W; Schimek, R A

    1977-12-01

    Thirty individuals with the clinical diagnosis of Down's syndrome received ophthalmologic examination periodically over 10 years at a state school for exceptional children. External examination, retinoscopy, anterior segment evaluation, ophthalmoscopy, and tonometry were usually done. The ages at present range from 10 to 50 years. The sex ratio was 80% male and 20% female. Three subjects died during the course of the study. The most frequent ocular anomalies were oblique fissures, refractive error, blepharoconjunctivitis, epicanthus, and Brushfield's spots. All of these occurred in 50% or more of the subjects.

  6. [Bilateral choroidal osteoma--a case report].

    Science.gov (United States)

    Jędrychowska-Jamborska, Justyna; Kulig-Stochmal, Agnieszka; Markiewicz, Anna; Jakubowska, Barbara; Romanowska-Dixon, Bożena

    2014-01-01

    Choroidal osteoma is a an extremely rare (especially located bilaterally), benign, intraocular tumor, the type of choristoma. It occurs between 2-3 decades of life, women are particularly vulnerable. The main complication in 1/3 cases is a subretinal neovascularization which may cause bleeding. The gradually progressive decalcification develops within the tumour over time, which causes atrophy of the retinal pigment epithelium and Bruch's membrane deformity. The article presents a case of a 26-year-old woman with bilateral choroidal osteoma complicated by subretinal hemorrhage; the diagnosis was based on clinical examination (biomicroscopy and indirect ophthalmoscopy) as well as specialised tests including: ultrasonography, optical coherence tomography, and fluorescein angiography.

  7. Characterization of single-file flow through human retinal parafoveal capillaries using an adaptive optics scanning laser ophthalmoscope.

    Science.gov (United States)

    Tam, Johnny; Tiruveedhula, Pavan; Roorda, Austin

    2011-03-02

    Adaptive Optics Scanning Laser Ophthalmoscopy was used to noninvasively acquire videos of single-file flow through live human retinal parafoveal capillaries. Videos were analyzed offline to investigate capillary flow dynamics. Certain capillaries accounted for a clear majority of leukocyte traffic (Leukocyte-Preferred-Paths, LPPs), while other capillaries primarily featured plasma gap flow (Plasma-Gap-Capillaries, PGCs). LPPs may serve as a protective mechanism to prevent inactivated leukocytes from entering exchange capillaries, and PGCs may serve as relief valves to minimize flow disruption due to the presence of a leukocyte in a neighboring LPP.

  8. Bilateral vision loss in a captive cheetah (Acinonyx jubatus).

    Science.gov (United States)

    Walser-Reinhardt, Ladina; Wernick, Morena B; Hatt, Jean-Michel; Spiess, Bernhard M

    2010-09-01

    The following case report describes a 1-year-old female cheetah (Acinonyx jubatus) with bilateral blindness and unresponsive pupils. For comparison, a second healthy 2.5-year-old male cheetah without visual deficits was also examined. Clinical examination of both animals included biomicroscopy, indirect ophthalmoscopy, tonometry, and electroretinography. The young female cheetah showed no menace response, no direct or indirect pupillary light reflex, and no dazzle reflex in either eye. Fundus lesions, as detected by indirect ophthalmoscopy, are described for the female animal. In both eyes, the fundus color was green/turquoise/yellow with multiple hyperpigmented linear lesions in the tapetal area around the optic nerve. The optic nerve head was dark gray and about half the normal size suggesting bilateral optic nerve hypoplasia and retinal dysplasia or differentially optic nerve atrophy and chorioretinal scarring. The ERG had low amplitudes in the right eye but appeared normal in the left eye compared with the male cheetah. Blood levels did not suggest current taurine deficiency. This is addressed to some degree in the discussion. Bilateral optic nerve hypoplasia or optic nerve atrophy is a rare anomaly in cats and has not yet been described in a cheetah.

  9. Nonmydriatic Ocular Fundus Photography in the Emergency Department: How It Can Benefit Neurologists.

    Science.gov (United States)

    Bruce, Beau B

    2015-10-01

    Examination of the ocular fundus is a critical aspect of the neurologic examination. For example, in patients with headache the ocular fundus examination is needed to uncover "red flags" suggestive of secondary etiologies. However, ocular fundus examination is infrequently and poorly performed in clinical practice. Nonmydriatic ocular fundus photography provides an alternative to direct ophthalmoscopy that has been studied as part of the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) Study. Herein, the results of the FOTO-ED study are reviewed with a particular focus on the study's implications for the acute care of patients presenting with headache and focal neurologic deficits. In headache patients, not only optic disc edema and optic disc pallor were observed as would be expected, but also a large number of abnormalities associated with hypertension. Based upon subjects with focal neurologic deficits, the FOTO-ED study suggests that the ocular fundus examination may assist with the triage of patients presenting with suspected transient ischemic attack. Continued advances in the ease and portability of nonmydriatic fundus photography will hopefully help to restore ocular fundus examination as a routinely performed component of all neurologic examinations.

  10. A New Microsurgical Technique to Correct Retinal Detachment

    Institute of Scientific and Technical Information of China (English)

    Wen Liu; Chunfang Li; Suying Huang; Qichong Wu

    2006-01-01

    Purpose: To evaluate the efficacy of a new technique to repair retinal detachments (RD) under the microscope. Methods: Thirty-six consecutive patients (36 eyes) who presented to our clinic with rhegmatogenous RD without severe proliferative vitreoretinopathy (≤ C1) were included. The sutures for buckling and/or encircling bands were preplaced according to the preoperative location of the breaks using a three-mirror contact lens. Drainage of subretinal fluid, retinal cryotherapy, buckling, locating the retinal breaks, and intravitreal gases injection were performed under surgical microscopy. The surgical effects were compared with those in 37 consecutive patients with rhegmatogenous RD who underwent surgery under binocular indirect ophthalmoscopy.Results: The simultaneous intraoperative observation of fundus details and the sclera through the microscope was excellent in all cases. The effect of retinal cryotherapy was clearly visible. Mild opacity of the refractive media did not interfere with observing cryotherapy and locating the breaks. Retinal reattachment was obtained in31 eyes (86%) during the primary surgery and in three eyes after a second surgery(94% total). The best-corrected visual acuity was <0.1 in 6 eyes (16.7%), 0.1~0.4 in 15 eyes (41.7%) and ≥ 0.5 in 15 eyes (41.7%). The results were similar to that of RD surgery performed under indirect ophthalmoscopy.Conclusions: This microsurgical procedure to correct RD is simple, convenient,reliable, provides an upright image, and facilitates good recovery similar to conventional RD surgery.

  11. Super-Resolution Scanning Laser Microscopy Based on Virtually Structured Detection.

    Science.gov (United States)

    Zhi, Yanan; Wang, Benquan; Yao, Xincheng

    2015-01-01

    Light microscopy plays a key role in biological studies and medical diagnosis. The spatial resolution of conventional optical microscopes is limited to approximately half the wavelength of the illumination light as a result of the diffraction limit. Several approaches-including confocal microscopy, stimulated emission depletion microscopy, stochastic optical reconstruction microscopy, photoactivated localization microscopy, and structured illumination microscopy-have been established to achieve super-resolution imaging. However, none of these methods is suitable for the super-resolution ophthalmoscopy of retinal structures because of laser safety issues and inevitable eye movements. We recently experimentally validated virtually structured detection (VSD) as an alternative strategy to extend the diffraction limit. Without the complexity of structured illumination, VSD provides an easy, low-cost, and phase artifact-free strategy to achieve super-resolution in scanning laser microscopy. In this article we summarize the basic principles of the VSD method, review our demonstrated single-point and line-scan super-resolution systems, and discuss both technical challenges and the potential of VSD-based instrumentation for super-resolution ophthalmoscopy of the retina.

  12. Two siblings with late-onset cone–rod dystrophy and no visible macular degeneration

    Science.gov (United States)

    Sakuramoto, Hiroyuki; Kuniyoshi, Kazuki; Tsunoda, Kazushige; Akahori, Masakazu; Iwata, Takeshi; Shimomura, Yoshikazu

    2013-01-01

    Background We report our findings in two siblings with late-onset cone–rod dystrophy (CRD) with no visible macular degeneration. Cases and methods Case 1 was an 82-year-old man who first noticed a decrease in vision and color blindness in his early seventies. His mother and younger sister also had visual disturbances. His decimal visual acuity was 0.3 in the right eye and 0.2 in the left eye. Ophthalmoscopy showed normal fundi, and fluorescein angiography was also normal in both eyes. The photopic single flash and flicker eletroretinograms (ERGs) were severely attenuated and the scotopic ERGs were slightly reduced in both eyes. Case 2 was the 80-year-old younger sister of Case 1. She first noticed a decline in vision and photophobia in both eyes in her early seventies. Her decimal visual acuity was 0.4 in the right eye and 0.2 in the left eye. Ophthalmoscopy showed mottling of the retinal pigment epithelium in the midperiphery with no visible macular degeneration. The photopic single flash and flicker ERGs were severely attenuated, and the scotopic ERGs were slightly reduced in both eyes. Conclusion These siblings are the oldest reported cases of CRD with no visible macular degeneration. Thus, CRD should be considered in patients with reduced visual acuity, color blindness, and photophobia even if they are older than 70 years. PMID:24039390

  13. Treatment of early complications on eye fundus in patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Iva Akmadža

    2016-09-01

    Full Text Available Early ocular complications in patients with diabetes mellitus (DM mostly refer to non-proliferative diabetic retinopathy (NPDR. Generally speaking, diabetic retinopathy (DR is one of the most common causes of blindness and the most common cause of blindness between the age of 20 and 65. DM is a disease characterized by metabolic disorders of carbohydrates, lipids and proteins. The main characteristic is hyperglycemia, which affects all organs by different pathogenetic pathways. The presence of DR is associated with the duration of DM, glycemic control and blood pressure. DR is a microangiopathy and is diagnosed by simple indirect ophthalmoscopy. It is very important to perform regular eye examinations in patients with DM, whereas DR is usually asymptomatic in the early stage of the disease. Optical coherence tomography (OCT has the great importance in diagnostics of DR. Besides indirect ophthalmoscopy and OCT, fluorescein angiography and ultrasound are also widely used to diagnose DR. The prevention of the disease is most important, which is in domain of internal medicine specialist, diabetologist and general practitioner. Intravitreal anti-vascular endothelial growth factor therapy is the gold standard in treatment of NPDR associated with diabetic macular edema (DME and impaired vision. Intravitreal injections of corticosteroids and laser photocoagulation are also used. The current and future treatment modalities are presented in the text that follows.

  14. [Reliability of retinal imaging screening in retinopathy of prematurity].

    Science.gov (United States)

    Navarro-Blanco, C; Peralta-Calvo, J; Pastora-Salvador, N; Alvarez-Rementería, L; Chamorro, E; Sánchez-Ramos, C

    2014-09-01

    The retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. The advances in neonatal care make the survival of extremely premature infants, who show a greater incidence of the disease, possible. The aim of the study is to evaluate the reliability of ROP screening using retinography imaging with the RetCam 3 wide-angle camera and also study the variability of ROP diagnosis depending on the evaluator. The indirect ophthalmoscopy exam was performed by a Pediatric ROP-Expert Ophthalmologist. The same ophthalmologist and a technician specialized in digital image capture took retinal images using the RetCam 3 wide-angle camera. A total of 30 image sets were analyzed by 3 masked groups: group A (8 ophthalmologists), group B (5 experts in vision), and group C (2 ROP-expert ophthalmologists). According to the diagnosis using indirect ophthalmoscopy, the sensitivity (26-93), Kappa (0.24-0.80), and the percent agreement were statistically significant in group C for the diagnosis of ROP Type 1. In the diagnosis of ROP Type 1+Type 2, Kappa (0.17-0.33) and the percent agreement (58-90) were statistically significant, with higher values in group C. The diagnosis, carried out by ROP-expert ophthalmologists, using the wide-angle camera RetCam 3 has proved to be a reliable method. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  15. Prevalence of diabetic retinopathy in patients assisted by a unit of Family Health Strategy in the city of Ananindeua, Brazil

    Directory of Open Access Journals (Sweden)

    Dyndara Rodrigues Pedrosa

    2012-06-01

    Full Text Available Objective: To identify the prevalence of diabetic retinopathy (DR in patients served by the Family Health Strategy (FHS of Ananindeua, Brazil. Methods: This was a cross-sectional study with 40 patients with diabetes mellitus (DM enrolled in the HIPERDIA program and assisted by the FHS of Ananindeua. Those selected were subjected to a standardized questionnaire at home and answered questions about the knowledge, outcomes and complications of DM and DR, and socioeconomic data. In the next step, a volunteer ophthalmologist performed ophthalmoscopy and found those with DR, who were sent to a specialized center to receive treatment. Of these patients, 9 were excluded because they did not attend the unit to perform ophthalmoscopy. Results: The prevalence of DR was found to be 40.7%; however, 4 patients had impaired their analysis due to the presence of cataracts, so it was only possible to do evaluation in 27. Factors associated with DR, after analysis of the variables were the time to the patients be aware of the diagnosis of DM, type of DM and non-proliferative DR. Conclusion: This pilot study underscores the importance of primary care in monitoring diabetic patients and guidance to the professionals of public health about the need for periodic referral of diabetic patients to ophthalmologists.

  16. Subchronic Inhalation Toxicity Study of n-pentane in Rats.

    Science.gov (United States)

    Kim, Jong-Kyu; Cho, Hae-Won; Han, Jeong-Hee; Lee, Sung-Bae; Chung, Yong-Hyun; Rim, Kyung-Taek; Yang, Jeong-Sun

    2012-09-01

    This study was conducted in order to obtain information concerning the health hazards that may result from a 13 week inhalation exposure of n-pentane in Sprague-Dawley rats. This study was conducted in accordance with the Organization for Economic Co-operation and Development (OECD) guidelines for the testing of chemicals No. 413 'Subchronic inhalation toxicity: 90-day study (as revised in 2009)'. The rats were divided into 4 groups (10 male and 10 female rats in each group), and were exposed to 0, 340, 1,530, and 6,885 ppm n-pentane in each exposure chamber for 6 hour/day, 5 days/week, for 13 weeks. All of the rats were sacrificed at the end of the treatment period. During the test period, clinical signs, mortality, body weights, food consumption, ophthalmoscopy, locomotion activity, urinalysis, hematology, serum biochemistry, gross findings, organ weights, and histopathology were assessed. During the period of testing, there were no treatment related effects on the clinical findings, body weight, food consumption, ophthalmoscopy, urinalysis, hematology, serum biochemistry, gross findings, relative organ weight, and histopathological findings. The no-observable-adverse-effect level (NOAEL) of n-pentane is evaluated as being more than 6,885 ppm (20.3 mg/L) in both male and female rats. n-pentane was not a classified specific target organ toxicity in the globally harmonized classification system (GHS).

  17. Retinal imaging in the twenty-first century: state of the art and future directions.

    Science.gov (United States)

    Keane, Pearse A; Sadda, Srinivas R

    2014-12-01

    Assessment of chorioretinal disease is dependent on the ability to visualize pathologic changes occurring in the posterior segment of the eye using optical instruments, termed ophthalmoscopy. Ophthalmoscopy, in turn, has been enhanced greatly by the development of techniques that allow recording of these changes, termed retinal imaging. As well as documenting pathologic features, retinal and fundal imaging facilitates the identification of morphologic features not visible to the clinician on biomicroscopy. As such, advances in retinal imaging have proven fundamental to many paradigm shifts in our understanding and treatment of ocular disease. In the 1950s, with the advent of electronic flashes and 35-mm cameras, the field of modern fundus photography was born. Similarly, in the 1960s and 1970s, the introduction of fluorescein and indocyanine green angiography revolutionized our ability to assess the integrity of the chorioretinal vasculature. More recently, in the 1990s, the introduction of a wholly new form of noninvasive cross-sectional imaging, optical coherence tomography, has greatly facilitated use of emerging pharmacotherapies in diagnosing and monitoring chorioretinal disease. In this translational science review, we provide an overview of current, state-of-the-art retinal imaging technologies, as well as highlight many emerging imaging technologies that we believe are likely to transform the provision of eye care in the 21st century.

  18. Adaptive optics scanning laser ophthalmoscope imaging: technology update.

    Science.gov (United States)

    Merino, David; Loza-Alvarez, Pablo

    2016-01-01

    Adaptive optics (AO) retinal imaging has become very popular in the past few years, especially within the ophthalmic research community. Several different retinal techniques, such as fundus imaging cameras or optical coherence tomography systems, have been coupled with AO in order to produce impressive images showing individual cell mosaics over different layers of the in vivo human retina. The combination of AO with scanning laser ophthalmoscopy has been extensively used to generate impressive images of the human retina with unprecedented resolution, showing individual photoreceptor cells, retinal pigment epithelium cells, as well as microscopic capillary vessels, or the nerve fiber layer. Over the past few years, the technique has evolved to develop several different applications not only in the clinic but also in different animal models, thanks to technological developments in the field. These developments have specific applications to different fields of investigation, which are not limited to the study of retinal diseases but also to the understanding of the retinal function and vision science. This review is an attempt to summarize these developments in an understandable and brief manner in order to guide the reader into the possibilities that AO scanning laser ophthalmoscopy offers, as well as its limitations, which should be taken into account when planning on using it.

  19. Adaptive optics scanning laser ophthalmoscope imaging: technology update

    Directory of Open Access Journals (Sweden)

    Merino D

    2016-04-01

    Full Text Available David Merino, Pablo Loza-Alvarez The Institute of Photonic Sciences (ICFO, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain Abstract: Adaptive optics (AO retinal imaging has become very popular in the past few years, especially within the ophthalmic research community. Several different retinal techniques, such as fundus imaging cameras or optical coherence tomography systems, have been coupled with AO in order to produce impressive images showing individual cell mosaics over different layers of the in vivo human retina. The combination of AO with scanning laser ophthalmoscopy has been extensively used to generate impressive images of the human retina with unprecedented resolution, showing individual photoreceptor cells, retinal pigment epithelium cells, as well as microscopic capillary vessels, or the nerve fiber layer. Over the past few years, the technique has evolved to develop several different applications not only in the clinic but also in different animal models, thanks to technological developments in the field. These developments have specific applications to different fields of investigation, which are not limited to the study of retinal diseases but also to the understanding of the retinal function and vision science. This review is an attempt to summarize these developments in an understandable and brief manner in order to guide the reader into the possibilities that AO scanning laser ophthalmoscopy offers, as well as its limitations, which should be taken into account when planning on using it. Keywords: high-resolution, in vivo retinal imaging, AOSLO

  20. A CLINICAL STUDY ON INCIDENCE OF RETINOPATHY OF PREMATURITY CHANGES IN PRETERM INFANTS AND ASSOCIATED RISK FACTORS IN A TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Sneha

    2014-03-01

    Full Text Available OBJECTIVE: This is a hospital based, prospective clinical study on incidence of retinopathy of prematurity changes in preterm infants and associated risk factors. METHODS: Neonates with gestational age <37wks and/ or birth weight ≤ 2500gms born over one year period were examined by indirect ophthalmoscopy between 2 to 4 weeks after birth, and followed up till retinal vascularization was complete. Maternal and neonatal risk factors were noted and data analyzed by statistical package SPSS-15. RESULTS: 100 babies were thus examined. The overall incidence of retinopathy of prematurity was 40%, 22%in babies’ ≤34wks of gestation and 52% in babies with a birth weight1500-2000g. Majority were in stage 2. Gestational age (<32weeks, Birth weight (<1500g, RDS, surfactant therapy, PDA were found to be risk factors. CONCLUSION: Meticulous fundus examination with indirect ophthalmoscopy in all preterm babies with gestational age<37weeks and birth weight ≤ 2500gms is essential noninvasive method for early detection of ROP and its progression. Screening should be intensified in the presence of factors like RDS, oxygen administration and presence of PDA

  1. Complement anaphylatoxin receptors C3aR and C5aR are required in the pathogenesis of experimental autoimmune uveitis.

    Science.gov (United States)

    Zhang, Lingjun; Bell, Brent A; Yu, Minzhong; Chan, Chi-Chao; Peachey, Neal S; Fung, John; Zhang, Xiaoming; Caspi, Rachel R; Lin, Feng

    2016-03-01

    Recent studies have suggested that reagents inhibiting complement activation could be effective in treating T cell mediated autoimmune diseases such as autoimmune uveitis. However, the precise role of the complement anaphylatoxin receptors (C3a and C5a receptors) in the pathogenesis of autoimmune uveitis remains elusive and controversial. We induced experimental autoimmune uveitis in mice deficient or sufficient in both C3a and C5a receptors and rigorously compared their retinal phenotype using various imaging techniques, including indirect ophthalmoscopy, confocal scanning laser ophthalmoscopy, spectral domain optical coherence tomography, topical endoscopic fundus imaging, and histopathological analysis. We also assessed retinal function using electroretinography. Moreover, we performed Ag-specific T cell recall assays and T cell adoptive transfer experiments to compare pathogenic T cell activity between wild-type and knockout mice with experimental autoimmune uveitis. These experiments showed that C3a receptor/C5a receptor-deficient mice developed much less severe uveitis than did control mice using all retinal examination methods and that these mice had reduced pathogenic T cell responses. Our data demonstrate that both complement anaphylatoxin receptors are important for the development of experimental autoimmune uveitis, suggesting that targeting these receptors could be a valid approach for treating patients with autoimmune uveitis.

  2. Comparative study of the retinal nerve fibre layer thickness performed with optical coherence tomography and GDx scanning laser polarimetry in patients with primary open-angle glaucoma.

    Science.gov (United States)

    Wasyluk, Jaromir T; Jankowska-Lech, Irmina; Terelak-Borys, Barbara; Grabska-Liberek, Iwona

    2012-03-01

    We compared the parameters of retinal nerve fibre layer in patients with advanced glaucoma with the use of different OCT (Optical Coherence Tomograph) devices in relation to analogical measurements performed with GDx VCC (Nerve Fiber Analyzer with Variable Corneal Compensation) scanning laser polarimetry. Study subjects had advanced primary open-angle glaucoma, previously treated conservatively, diagnosed and confirmed by additional examinations (visual field, ophthalmoscopy of optic nerve, gonioscopy), A total of 10 patients were enrolled (9 women and 1 man), aged 18-70 years of age. Nineteen eyes with advanced glaucomatous neuropathy were examined. 1) Performing a threshold perimetry Octopus, G2 strategy and ophthalmoscopy of optic nerve to confirm the presence of advanced primary open-angle glaucoma; 2) performing a GDx VCC scanning laser polarimetry of retinal nerve fibre layer; 3) measuring the retinal nerve fibre layer thickness with 3 different optical coherence tomographs. The parameters of the retinal nerve fibre layer thickness are highly correlated between the GDx and OCT Stratus and 3D OCT-1000 devices in mean retinal nerve fibre layer thickness, retinal nerve fibre layer thickness in the upper sector, and correlation of NFI (GDx) with mean retinal nerve fibre layer thickness in OCT examinations. Absolute values of the retinal nerve fibre layer thickness (measured in µm) differ significantly between GDx and all OCT devices. Examination with OCT devices is a sensitive diagnostic method of glaucoma, with good correlation with the results of GDx scanning laser polarimetry of the patients.

  3. CORELATION OF DRY EYE STATUS WITH SEVERITY OF DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Tanushree

    2014-11-01

    Full Text Available AIM: To study the correlation of dry eye status with severity of diabetic retinopathy. MATERIALS AND METHODS: SETTINGS AND DESIGN: Prospective study. One hundred patients with diabetes mellitus attending the outpatient and in-patient department, Department of Ophthalmology, K. R. Hospital, Mysore, were included under the study, between the periods from January 2014 to July 2014 (6 months. Informed and written consent was taken from all the patients. After detailed history, all necessary ocular and systemic examination was done. All diabetes mellitus patients were analyzed for dry eye status and presence of diabetic retinopathy changes. Dry eye status was evaluated with Schirmer’s test, Tear film break up time and conjunctival impression cytology. Retinal status evaluation was done by direct ophthalmoscopy, indirect ophthalmoscopy and Slit lamp Biomicroscopy using 78D lens after pupillary dilation. Diabetic retinopathy was graded accordingly to ETDRS classification. STATISTICAL ANALYSIS: All data were analyzed using descriptive statistics and Chi square test and contingency coefficient analysis was applied. RESULTS: A total of 100 diabetes mellitus patients were analyzed. 56 (56% patients had Diabetic retinopathy and 44(44% had normal fundus picture. Out of the 100 diabetes mellitus patients, 36 (36% patients had dry eye. Significant association (P – 0.001 between dry eye and diabetes mellitus was seen. CONCLUSION: Dry eye and diabetes mellitus have a common association. Dry eye is more frequent in diabetes mellitus patients with longer duration and in patients with Diabetic retinopathy.

  4. STUDY OF PATTERN OF VISUAL IMPAIRMENT IN PATIENTS SEEKING VISUAL DISABILITY CERTIFICATE

    Directory of Open Access Journals (Sweden)

    Shubhratha Sathish

    2016-05-01

    Full Text Available PURPOSE To determine the severity and various causes of visual impairment in patients seeking visual disability certificate. METHODS Cross-sectional study of patients seeking visual disability certificate from November 2014 to April 2015 was done. Severity of visual impairment was calculated as per the guidelines of Ministry of Social Justice and Empowerment 1999. Cause was ascertained after detailed examination which included slit-lamp examination, direct ophthalmoscopy, indirect ophthalmoscopy, slit-lamp biomicroscopy with 78D lens, Humphrey visual field analysis wherever necessary. RESULTS Of the 267 patients, category 0-7 (2.62%, category 1-37 (13.85%, category 2-42 (15.73%, category 3-157(58.80%, one eyed- 24 (8.98%. Male preponderance was seen (56.55%. The causes were congenital malformations-78 (29.21%, retinitis pigmentosa- 71 (26.59%, refractive errors with amblyopia-52 (19.47%, corneal opacity related to trauma and infectious keratitis 22(8.23%, glaucoma-14 (5.24%, phthisis bulbi-9 (3.37%, ARMD-3 (1.12%, miscellaneous-9 (3.37%. The causes were preventable in 41.19%. CONCLUSION Most of the patients who sought disability certificate were totally blind. The leading causes for visual impairment were congenital malformations, retinitis pigmentosa and refractive errors with amblyopia. 41.19% patients suffered from visual impairment caused by potentially preventable conditions. The burden of visual impairment can be reduced by taking necessary preventive measures with the leading causes being identified.

  5. Blindness as a sign of proventricular dilatation disease in a grey parrot (Psittacus erithacus erithacus).

    Science.gov (United States)

    Steinmetz, A; Pees, M; Schmidt, V; Weber, M; Krautwald-Junghanns, M-E; Oechtering, G

    2008-12-01

    An approximately eight-year-old female grey parrot (Psittacus erithacus erithacus) was presented with a two months history of blindness. The radiographic examination showed a dilatation of the proventriculus, ventriculus and gut. Ophthalmoscopy and electroretinography revealed degeneration of the retina. A proventricular dilatation disease was suspected. The bird was euthanased because of deteriorating condition and poor prognosis. The pathological examination showed an atrophy of the ventricular muscles and lymphoplasmacytic infiltrates of the myenteric plexus of the proventriculus, ventriculus and gut as well as moderate lymphoplasmacytic infiltrates of the cerebrum with moderate neuronophagia. Lymphoplasmacytic infiltrates in the retina, indicating proventricular dilatation disease, and subsequent retinal degeneration were found. A potential common aetiology for proventricular dilatation disease and blindness is discussed.

  6. Callosal agenesis, chorioretinal lacunae, absence of infantile spasms, and normal development: Aicardi syndrome without epilepsy?

    Science.gov (United States)

    Prats Viñas, Jose Maria; Martinez Gonzalez, María Jesús; Garcia Ribes, Ainhoa; Martinez Gonzalez, Sonia; Martinez Fernandez, Ricardo

    2005-06-01

    Aicardi syndrome is defined by the clinical triad of infantile spasms, agenesis of the corpus callosum, and pathognomonic chorioretinal lacunae. Almost all patients are females with severe cognitive and physical disabilities. All of the cases reported in the literature have had early-onset seizures. Most cases of Aicardi syndrome exhibit very slow development, even when seizures are eventually controlled, and the cases with a relatively favourable outcome are associated with low intelligence quotient levels. A relationship between chorioretinal changes or severity of the agenesis of the corpus callosum and prognosis of Aicardi syndrome has been claimed, but few data are available about the clinical features that can predict clinical outcome. We describe a case of Aicardi syndrome in a female aged 24 months. Magnetic resonance imaging showed complete agenesis of the corpus callosum and ophthalmoscopy revealed chorioretinal lacunae in the left eye. She had never had seizures and her psychomotor and language development were normal for age.

  7. SEPTO-OPTICDYSPLASIA WITH AN ANTERIOR ENCEPHALOCELE AND INTACT SEPTUM PELLUCIDUM: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Z. Razavi

    2008-06-01

    Full Text Available ObjectiveThe diagnosis of de Morsier syndrome or septo-optic dysplasia is made on the basis of the diagnosis of optic nerve hypoplasia. Septo-optic dysplasia is defined by a variable combination of dysgenesis of midline brain structures including optic nerve hypoplasia and hypothalamic-pituitary dysfunction often associated with a wide variety of brain malformations of cortical development.The importance of direct ophthalmoscopy of optic nerve abnormalities is stressed, as well as of magnetic resonance imaging, which has become a guideline in the classification of  this syndrome This article reports a 19-year-old female with bilateral optic nerve  hypoplasia,anterior encephalocele and intact septum pellucidum. She was diagnosed withdiabetes insipidus, short stature and the history of seizure.

  8. Toxicity profiles of subretinal indocyanine green, Brilliant Blue G, and triamcinolone acetonide: a comparative study

    DEFF Research Database (Denmark)

    Ejstrup, Rasmus; Dornonville de la Cour, Morten; Heegaard, Steffen

    2012-01-01

    /ml and triamcinolone acetonide (TA) 13 mg/ml was injected subretinally in 12 vitrectomized pig eyes. At 6 weeks, retinas were examined by multifocal electroretinography (mfERG), ophthalmoscopy, fluorescein angiograpy, histopathology, and apoptosis assay. RESULTS: mfERG responses were significantly lower in ICG......-injected eyes than in healthy fellow eyes (p¿=¿0.039). The ratio between injected eyes and healthy fellow eyes was lower in the ICG group than in the BBG (p¿=¿0.009) and TA group (p¿=¿0.025). No difference between BBG and TA existed. All retinas were reattached, and fluorescein angiographies showed a window...

  9. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-07-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  10. Causes of suboptimal corrected visual acuity following phacoemulsification in a teaching university hospital.

    Science.gov (United States)

    Fathallah, Mohammed; Eltanamly, Rasha M; Saadeldin, Hala; Elnahry, Gehad H

    2017-03-10

    Cataract is the leading cause of reversible blindness in developing countries, with variable visual outcome following surgery. This work aims at assessing the outcomes of cataract surgery at Kasr Al Ainy Hospital and identifying the reasons for borderline and poor outcome in the studied group. A total of 150 eyes of patients with cataract and no other ocular pathology were included in this study. Uncorrected visual acuity (UCVA) and corrected visual acuity (CVA), complete ocular examination using slit-lamp, applanation tonometry, and ophthalmoscopy were performed for all patients. Biometry for intraocular lens power calculation and operative data were recorded. Patients were followed for 6 weeks; UCVA, CVA, and any complications were noted. Mean preoperative CVA was 0.16 ± 0.16 (SD) and mean postoperative CVA was 0.66 ± 0.33 (pteaching hospital where most surgeons were in their learning periods.

  11. Persistent hyperplastic primary vitreous (PHPV) in two Siberian husky dogs.

    Science.gov (United States)

    Ori, J; Yoshikai, T; Yoshimura, S; Takenaka, S

    1998-02-01

    Three eyes in two Siberian husky dogs were clinically diagnosed as persistent hyperplastic primary vitreous (PHPV) by means of ophthalmoscopy and ultrasonography (USG). Examination of mildly affected PHPV eyes with an ophthalmoscope showed the axial part of the posterior capsule to be opaque. The central lesion of the posterior capsule in severely affected eyes had been opaque with many blood vessels. Echographic changes in mild cases of PHPV were outside of the lens, linearly hyperechoic, parallel to the posterior lens capsule. In a severely affected eyeball, funnel-shaped hyperechoic change was noted in the retrolental space. Two months later, phacoemulsification was performed for diagnostic treatment of PHPV since progressive cataract was observed in this eye.

  12. The assessment of visually impaired persons working capacities using electrophysiological and ophthalmic ergonomics methods

    Directory of Open Access Journals (Sweden)

    M. I. Razumovsky

    2014-01-01

    Full Text Available Aim was to analyze working capacities of visually impaired persons by means of complex electrophysiological and ophthalmic ergonomics eye examination.Materials and methods. Standard clinical ophthalmologic examination (visual acuity measurement, refractometry, biomicroscopy, ophthalmoscopy as well as electrophysiological (electrooculography, electrical sensitivity of the eye, critical flicker fusion frequency and ophthalmic ergonomics tests (accommodation measurement, professional testing using automated system «Proftest-1» were performed.Results. Complex electrophysiological and ophthalmic ergonomics tests were performed in 20 visually impaired persons. Their results revealed direct correlation between electrophysiological and ophthalmic ergonomics indices.Conclusion. Working capacities of visually impaired persons can be assessed reliably using complex electrophysiological and ophthalmic ergonomics eye examination only.

  13. [Serous macular detachment associated with circumscribed choroidal hemangioma: a case report].

    Science.gov (United States)

    Munteanu, M; Giuri, Stela; Rosca, C; Boruga, O; Chercota, V; Stanca, H T

    2013-01-01

    Choroidal hemangiomas are benign vascular hamartomas that typically present from second to fourth decade of life, when they can cause visual disturbance due to exudative retinal detachment. They represent uncommon benign choroidal vascular tumors, usually occuring sporadically in the absence of systemic disease. We report the case of a young female patient, presenting a juxtapapillary circumscribed choroidal haemangioma complicated with serous macular detachment. The patient underwent photodynamic therapy with verteporfin (PDT). Systematic follow-up using ophthalmoscopy, ultrasonography, Fluorescein angiography and Indocyanine green angiography was performed. The patient presented regression with flattening of tumour, resolution of the subretinal fluid, and significant improvement of vision. Mostly asymptomatic, the choroidal hemangiomas can be associated with serous retinal detachment, leading to reduced vision and metamorphopsia; in those cases, the long term visual prognosis is poor, even in adequately treated patients. PDT is effective in eliminating the subretinal fluid and improving vision in patients with circumscribed choroidal hemangioma.

  14. Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis.

    Science.gov (United States)

    Molina-Sócola, F E; López-Herrero, F; Medina-Tapia, A; Rueda-Rueda, T; Contreras-Díaz, M; Sánchez-Vicente, J L

    2016-12-07

    A 36 year-old male with a recent HIV diagnosis, presented with loss of vision of his left eye. Ophthalmoscopy revealed a unilateral yellowish placoid lesion in the macula. After fluorescein angiography, optical coherence tomography, optical coherence tomography angiography, syphilis serology, and cerebrospinal fluid results, he was diagnosed with neurosyphilis and syphilitic posterior placoid chorioretinitis. Acute syphilitic posterior placoid chorioretinitis is a rare ocular manifestation of syphilis. All patients with characteristic clinical and angiographic findings of acute syphilitic posterior placoid chorioretinitis should be tested for a neurosyphilis and human immunodeficiency virus co-infection. Early treatment with intravenous penicillin is usually effective with good visual results. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Pharmacokinetics of intravitreal glial cell line-derived neurotrophic factor: experimental studies in pigs

    DEFF Research Database (Denmark)

    Ejstrup, Rasmus; Kiilgaard, J F; Tucker, B A;

    2010-01-01

    The purpose of this study was to establish the intravitreal (ITV) pharmacokinetics of glial cell line-derived neurotrophic factor (GDNF) and observe possible complications after ITV injection. Twenty Danish landrace pigs and 34 eyes were included in the study; 30 were injected with 100 ng of GDNF......, two controls were injected without GDNF, and two received no injection. At post-injection time points of 1, 2, 3, 6 hours (h), 1, 2, 4 or 7 days (d) eyes were enucleated and the ITV concentration of GDNF (cGDNF) was determined by enzyme-linked immunosorbent assay, and activity was tested using...... a retinal ganglion cell line (RGC5) bioassay. Indirect ophthalmoscopy, intraocular pressure assessment, and fundus photography were performed before enucleation. There was initial variability in the cGDNF, but after 24h GDNF was cleared in a monoexponential fashion with a half-life of 37 h (CL 33-43 h...

  16. Prevalence and Causes of Visual Impairment and Blindness among Cocoa Farmers in Ghana.

    Science.gov (United States)

    Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Mashige, Khathutshelo Percy; Osafo-Kwaako, Alfred; Ilechie, Alex Azuka; Abokyi, Samuel

    2017-02-01

    To determine the prevalence and causes of visual impairment and blindness among cocoa farmers in Ghana in order to formulate early intervention strategies. A cross-sectional study using multistage random sampling from four cocoa growing districts in Ghana was conducted from November 2013 to April 2014. A total of 512 cocoa farmers aged 40 years and older were interviewed and examined. The brief interview questionnaire was administered to elicit information on the demographics and socioeconomic details of participants. The examination included assessment of visual acuity (VA), retinoscopy, subjective refraction, direct ophthalmoscopy, slit-lamp biomicroscopy and intraocular pressure (IOP). For quality assurance, a random sample of cocoa farmers were selected and re-examined independently. Moderate to severe visual impairment (VA Ghana is relatively high. The major causes of visual impairment and blindness are largely preventable or treatable, indicating the need for early eye care service interventions.

  17. Photoreceptor cell dysplasia in two Tippler pigeons.

    Science.gov (United States)

    Moore, P A; Munnell, J F; Martin, C L; Prasse, K W; Carmichael, K P

    2004-01-01

    Two 12-week-old Tippler pigeons were evaluated for ocular abnormalities associated with congenital blindness. The pigeons were emaciated and blind. Biomicroscopy and direct and indirect ophthalmoscopy findings of the Tippler pigeons were normal with the exception of partially dilated pupils at rest. Scotopic (blue stimuli) and photopic monocular electroretinograms were extinguished in the blind Tippler pigeons. Histological and electron microscopy studies revealed reduced numbers of rods and cones, and an absence of the double cone complex. The photoreceptor cells' outer segments were absent, and the inner segments were short and broad. The number of cell nuclei in the outer and inner nuclear layers was decreased, and the internal and external plexiform layers were reduced in width. Photoreceptor cell endfeet with developing synaptic ribbons were present in the external plexiform layer. Inflammatory cell and subretinal debris was not seen. The electroretinographic, histopathological, and ultrastructural findings of the blind Tippler pigeons support the diagnosis of a photoreceptor cell dysplasia.

  18. Reliability and Repeatability of Cone Density Measurements in Patients with Congenital Achromatopsia.

    Science.gov (United States)

    Abozaid, Mortada A; Langlo, Christopher S; Dubis, Adam M; Michaelides, Michel; Tarima, Sergey; Carroll, Joseph

    2016-01-01

    Adaptive optics scanning light ophthalmoscopy (AOSLO) allows non-invasive assessment of the cone photoreceptor mosaic. Confocal AOSLO imaging of patients with achromatopsia (ACHM) reveals an altered reflectivity of the remaining cone structure, making identification of the cells more challenging than in normal retinas. Recently, a "split-detector" AOSLO imaging method was shown to enable direct visualization of cone inner segments in patients with ACHM. Several studies have demonstrated gene replacement therapy effective in restoring cone function in animal models of ACHM and human trials have on the horizon, making the ability to reliably assess cone structure increasingly important. Here we sought to examine whether absolute estimates of cone density obtained from split-detector and confocal AOSLO images differed from one another and whether the inter- and intra-observer reliability is significantly different between these modes. These findings provide an important foundation for evaluating the role of these images as tools to assess the efficacy of future gene therapy trials.

  19. Clinical Analysis of Leber's Hereditary Optic Neuropathy Harboring mtDNA Mutation at nt11778

    Institute of Scientific and Technical Information of China (English)

    Xinyu Zhang; Qiang Yu; Qingjiong Zhang; Changxian Yi

    2001-01-01

    Purpose: To improve our diagnostic technique through the analysis of clinical features ofLeber's heredita'y optic neuropathy (LHON) harboring mtDNA point mutation at nt11778. Methods: Detection of nt11778 mutation was performed on 38 patients clinically diagnosed as LHON in our ophthalmic center from year 1998 to 2000. Circumstances of onset and family history were obtained and ophthalmoscopy, fundus fluorescein angiography, visual field and visual evoked potential were performed on all 38 patients. Result: 30 In 38 patients (78.95 % ) harbor nt11778 mutation, including 28 male (93.33%) and 2 female (6.67%). The ratio of affected male to female is 14: 1. Patients harboring nt11778 mutation display typical clinical nanifestations. Ccnclusion: Identification of one of the three LHON specifically associated ntDNA mutations is essential to confirm the diagnosis. Eye Science 2001: 17:31 ~ 34.

  20. Experiment Study of Retinal Ultrastructure after Intravitreal FK506

    Institute of Scientific and Technical Information of China (English)

    Shuangnong Li; Shibo Tang; Wei Li; Dongping Li

    2004-01-01

    Purpose:To investigate the retinal toxicity of FK506 by intravitreal administration.Methods :Twenty-two eyes of 14 New Zealand rabbits were investigated. FK506 at con centrations of 5,25 and 50μg/eye was injected into the vitreous cavitiesrespectively.The control eyes were received mixed solution of balanced salt and ethanol. All eyes were examined by tonometry, slit lamp and indirect ophthalmoscopy preoperatively and post operatively at the 1st, 3rd, 7th, and 14th day respectively. In the final examination, all eyes were enucleated and processed for light and electron microscopy. Conclusion: It is safety with intravitreal FK506. There are no irritation and toxicity to the are proved to be toxic to the retina. Eye Science 2004;20:34-38.

  1. Large intradural craniospinal arachnoid cyst: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Souvagya Panigrahi

    2012-01-01

    Full Text Available Presence of an arachnoid cyst at craniospinal junction is not very common. This is a very rare anatomic site, with only seven other cases reported in the literature. We report a case of large intradural craniospinal arachnoid cyst presenting with obstructive hydrocephalus and cranial nerve palsy. A 39-year-old male presented with 8-month history of neck pain, headache, vomiting, visual disturbances, diminished taste sensation, and numbness of face. He had bilateral papilledema on ophthalmoscopy. Magnetic resonance imaging (MRI revealed a posterior fossa arachnoid cyst extending down to the lower border of C5 vertebra. Posterior decompression was done through C5 laminectomy. He made a full recovery and was asymptomatic at 6-month follow-up examination. The clinical features, diagnosis, and management of these rare craniospinal arachnoid cysts are discussed.

  2. In vivo cellular-resolution retinal imaging in infants and children using an ultracompact handheld probe

    Science.gov (United States)

    Larocca, Francesco; Nankivil, Derek; Dubose, Theodore; Toth, Cynthia A.; Farsiu, Sina; Izatt, Joseph A.

    2016-09-01

    Enabled by adaptive optics, retinal photoreceptor cell imaging is changing our understanding of retinal structure and function, as well as the pathogenesis of numerous ocular diseases. To date, use of this technology has been limited to cooperative adult subjects due to the size, weight and inconvenience of the equipment, thus excluding study of retinal maturation during human development. Here, we report the design and operation of a handheld probe that can perform both scanning laser ophthalmoscopy and optical coherence tomography of the parafoveal photoreceptor structure in infants and children without the need for adaptive optics. The probe, featuring a compact optical design weighing only 94 g, was able to quantify packing densities of parafoveal cone photoreceptors and visualize cross-sectional photoreceptor substructure in children with ages ranging from 14 months to 12 years. The probe will benefit paediatric research by improving the understanding of retinal development, maldevelopment and early onset of disease during human growth.

  3. Validity and cost-effectiveness of methods for screening of primary open angle glaucoma

    Directory of Open Access Journals (Sweden)

    Fröschl, Barbara

    2007-02-01

    Full Text Available Health political background: About 950,000 people are affected by glaucoma in Germany, about 50% of which are undiagnosed. The German Ophthalmological Society and the German Association of Ophthalmologists recommend a screening for glaucoma according to their guidelines. The Federal Joint Committee disapproved a glaucoma-screening program on expense of the compulsory health insurance in 2004. Scientific background: Primary open angle glaucoma is diagnosed by evaluation of the optic disc, the retinal fibre layer and the visual field. The main examinations are ophthalmoscopy, scanning laser polarimetry, confocal scanning laser ophthalmoscopy, retinal thickness analysis and optical coherence tomography. Scotomas are diagnosed by perimetry (standard automated perimetry, short wavelength automated perimetry and frequency doubling perimetry. The intraocular pressure is the most important treatable risk factor and is measured by (contact or non-contact tonometry. Research questions: The aim of this HTA-report is to investigate the diagnostic validity and cost effectiveness of diagnostic techniques or combinations of these methods with respect to the use in a screening setting in Germany. Methods: A systematic literature research was performed in 35 international databases and yielded 2602 articles. Overall 57 publications were included for assessment, according to predefined selection criteria. Results: The 55 medical articles deal mainly with frequency doubling perimetry, confocal scanning laser ophthalmoscopy and scanning laser polarimetry. Few articles cover short wavelength automated perimetry, tonometry and ophalmocopic evaluations by ophthalmologists. The quality of the papers is generally low, as far as the evidence in respect of screening is concerned. No single method exists with both, high sensitivity and high specificity for screening purpose. Data are also not sufficient to recommend combinations of methods. Only two economic models on cost

  4. Comparasion of Optic Nerve Head with Stereophotometric and Scanning Laser Ophthalmoscopic Imaging

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    Serek Tekin

    2016-01-01

    Full Text Available Aim: To compare theevaluation results of two experienced clinicians about examination of optic discs in glaucoma patients and healthy inidividuals by stereophotometry and scanning laser ophthalmoscopy. Material and Method: We studied 116 individuals (217 eyes who were divided as normal, glaucoma and suspected glaucoma in numbers of 54, 42 and 20 respectively. Stereophotometric photographs of optic disc were examined with fundus camera (Zeiss, FF 450 plus. Optic disc was also evaluated with HRT-3 in the same visit. Two experienced clinicians evaluated the cup/disc ratios and whether the optic discs were glaucomatous or not. Evaluation results were analysed and compared with HRT-3 examinations. Results:There were no significant age and gende rdifferences between the groups(p>0.05.Stereophotographic C/D ratio correlations between the clinicians were 0.79 (p

  5. Visualization of chorioretinal vasculature in mice in vivo using a combined OCT/SLO imaging system

    Science.gov (United States)

    Goswami, Mayank; Zhang, Pengfei; Pugh, Edward N.; Zawadzki, Robert J.

    2016-03-01

    Chorioretinal blood vessel morphology in mice is of great interest to researchers studying eye disease mechanisms in animal models. Two leading retinal imaging modalities -- Optical Coherence Tomography (OCT) and Scanning Laser Ophthalmoscopy (SLO) -- have offered much insight into vascular morphology and blood flow. OCT "flow-contrast" methods have provided detailed mapping of vascular morphology with micrometer depth resolution, while OCT Doppler methods have enabled the measurement of local flow velocities. SLO remains indispensable in studying blood leakage, microaneurysms, and the clearance time of contrast agents of different sizes. In this manuscript we present results obtained with a custom OCT/SLO system applied to visualize the chorioretinal vascular morphology of pigmented C57Bl/6J and albino nude (Nu/Nu) mice. Blood perfusion maps of choroidal vessels and choricapillaris created by OCT and SLO are presented, along with detailed evaluation of different OCT imaging parameters, including the use of the scattering contrast agent Intralipid. Future applications are discussed.

  6. Successful medical treatment of an orbital osteoma in a dog.

    Science.gov (United States)

    Grozdanic, Sinisa; Riedesel, Elizabeth A; Ackermann, Mark R

    2013-03-01

    A 6-year-old neutered male German Shepherd-mixed breed with a 2-month history of bilateral conjunctival hyperemia, epiphora, and a firm, slowly progressive swelling of the medial canthal region of the left eye (OS) was examined. Ophthalmic examination OS revealed a firm and smooth mass, extending from the medial canthus toward the medial orbital wall. Indirect ophthalmoscopy revealed indentation of the nasal part OS, which corresponded to the position of the orbital mass. Orbital neoplastic diseases were the main differential considerations. Computerized tomography revealed a bony smooth orbital mass without bone destructive features. Biopsy was performed, and histologic features were suggestive of osteoma. Systemic nonsteroidal anti-inflammatory (NSAID) drugs resulted in complete mass regression and absence of clinical signs for 5 years following initial diagnosis. This report describes the first case of canine orbital osteoma, which was responsive to NSAIDs.

  7. Nevus of Ota: A series of 15 cases

    Directory of Open Access Journals (Sweden)

    Sekar Shanmuga

    2008-01-01

    Full Text Available Background: The nevus of Ota is a dermal nevus characterized by bluish pigmentation in the distribution of the first and the second division of the trigeminal nerve. Aim: Our aim was to study the cutaneous and extracutaneous manifestations of the nevus of Ota. Methods: A total of 15 cases were included in our study. A detailed history, clinical examination along with direct ophthalmoscopy and otoscopy were done for all the cases. Results: Most of the patients (60% had lesions at birth and the majority (86.7 % were females. Five (33.3% patients belonged to Tanino class II. Combined dermal and ocular involvement was observed in 60% of the cases. Conclusion: Tanino class II was the most common type observed in our studies. A few rarer associations such as nevus of Ito and hemangioma were also noted in our patients.

  8. Choroidal metastases in testicular choriocarcinoma, successful treatment with chemo- and radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Guber Ivo

    2011-12-01

    Full Text Available Abstract Background Choriocarcinoma is a very rare cause of ocular metastasis. Only 18 male patients have been reported on, 4 of whom survived, but with significant loss of vision. Case presentation A 26-year-old Caucasian man, suffering from testicular choriocarcinoma with pulmonary, cerebral, renal, hepatic and osseous metastases, underwent left radical orchiectomy. While being treated with chemotherapy, he presented with loss of vision in the left eye. Ophthalmoscopy revealed bilateral non-pigmented, hemorrhagic choroidal tumours, compatible with secondary lesions. Continued chemotherapy and stereotactic radiotherapy of the skull and spine lead to full remission with excellent vision, after more than 4 years of follow up. Conclusion Testicular choriocarcinoma is an exceptional cause of choroidal metastasis, potentially asymptomatic and with specific clinical features. Radiotherapy can complement radical orchiectomy and chemotherapy, to achieve full remission and maintain good vision.

  9. Effects of radiofrequency hyperthermia on the healthy canine cornea

    Energy Technology Data Exchange (ETDEWEB)

    Glaze, M.B.; Turk, M.A.

    1986-04-01

    Radiofrequency hyperthermia was used to induce axial corneal lesions in the eyes of 10 dogs. Clinical observations were continued for up to 6 months, using biomicroscopy and indirect ophthalmoscopy. Eyes were harvested at intervals for light and electron microscopic evaluation. Clinical alterations included immediate corneal opacification and epithelial disruption at the site of electrode contact. Ulcerative keratitis persisted for 4 to 6 days, accompanied by anterior uveitis. Additional corneal changes included stromal thinning, edema, and vascularization. Final evaluation revealed negligible alterations in corneal contour or clarity 6 months after treatment. Microscopically, epithelial and superficial stromal necrosis preceded epithelial loss. Stromal alterations included edema (associated with focal endothelial detachments), vascularization, and inflammatory cell infiltration. Recovery was characterized by keratocytic hyperplasia and hypertrophy, epithelial proliferation, and stromal condensation.

  10. Role of imaging in glaucoma diagnosis and follow-up

    Directory of Open Access Journals (Sweden)

    Vizzeri Gianmarco

    2011-12-01

    Full Text Available The purpose of the review is to provide an update on the role of imaging devices in the diagnosis and follow-up of glaucoma with an emphasis on techniques for detecting glaucomatous progression and the newer spectral domain optical coherence tomography instruments. Imaging instruments provide objective quantitative measures of the optic disc and the retinal nerve fiber layer and are increasingly utilized in clinical practice. This review will summarize the recent enhancements in confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography with an emphasis on how to utilize these techniques to manage glaucoma patients and highlight the strengths and limitations of each technology. In addition, this review will briefly describe the sophisticated data analysis strategies that are now available to detect glaucomatous change overtime.

  11. Scleral Buckling with Chandelier Illumination.

    Science.gov (United States)

    Seider, Michael I; Nomides, Riikka E K; Hahn, Paul; Mruthyunjaya, Prithvi; Mahmoud, Tamer H

    2016-01-01

    Scleral buckling is a highly successful technique for the repair of rhegmatogenous retinal detachment that requires intra-operative examination of the retina and treatment of retinal breaks via indirect ophthalmoscopy. Data suggest that scleral buckling likely results in improved outcomes for many patients but is declining in popularity, perhaps because of significant advances in vitrectomy instrumentation and visualization systems. Emerging data suggest that chandelier-assisted scleral buckling is safe and has many potential advantages over traditional buckling techniques. By combining traditional scleral buckling with contemporary vitreoretinal visualization techniques, chandelier-assistance may increase the popularity of scleral buckling to treat primary rhegmatogenous retinal detachment for surgeons of the next generation, maintaining buckling as an option for appropriate patients in the future.

  12. Scleral buckling with chandelier illumination

    Directory of Open Access Journals (Sweden)

    Michael I Seider

    2016-01-01

    Full Text Available Scleral buckling is a highly successful technique for the repair of rhegmatogenous retinal detachment that requires intra-operative examination of the retina and treatment of retinal breaks via indirect ophthalmoscopy. Data suggest that scleral buckling likely results in improved outcomes for many patients but is declining in popularity, perhaps because of significant advances in vitrectomy instrumentation and visualization systems. Emerging data suggest that chandelier-assisted scleral buckling is safe and has many potential advantages over traditional buckling techniques. By combining traditional scleral buckling with contemporary vitreoretinal visualization techniques, chandelier-assistance may increase the popularity of scleral buckling to treat primary rhegmatogenous retinal detachment for surgeons of the next generation, maintaining buckling as an option for appropriate patients in the future.

  13. Visual function and retinal vessel diameters during hyperthermia in man

    DEFF Research Database (Denmark)

    Jensen, Bettina Hagström; Bram, Thue; Kappelgaard, Per

    2017-01-01

    laser ophthalmoscopy was used to measure retinal trunk vessel diameters. Assessment was made at baseline, during hyperthermia and after cooling. RESULTS: The induction of a mean increase in core body temperature of 1.02°C was associated with a 7.15-mmHg mean reduction in systolic blood pressure (p ... in cling film, tinfoil and warming blankets. Subsequent cooling was achieved by undressing. Flicker sensitivity (critical flicker fusion frequency) was chosen to assess temporal resolution, while the Freiburg Vision Test was used to determine spatial contrast sensitivity at 1.5 cycles per degree. Scanning...... diameters (CI95 0.96-4.94, p cooling. CONCLUSION: Increased core body temperature was accompanied by improved temporal visual resolution and retinal trunk...

  14. The neuro-ophthalmological examination.

    Science.gov (United States)

    Rucker, Janet C; Kennard, Christopher; Leigh, R John

    2011-01-01

    The neuro-ophthalmological examination constitutes one of the most refined and exact components of the clinical examination, often allowing precise diagnosis and formulation of a treatment plan even within the compass of the first visit. This chapter briefly highlights important features in the neuro-ophthalmological history and then presents detailed information on the important components of a comprehensive neuro-ophthalmological examination. Covered examination topics include visual acuity, visual field testing, color vision, external eye exam, pupils, ophthalmoscopy, and eye movements. The final section discusses ancillary tests that supplement the bedside neuro-ophthalmological examination, including formal visual field analysis, electroretinography, fluorescein angiography, ocular coherence tomography, visual-evoked potentials, neuroimaging, and quantitative eye movement recordings. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Central Retinal Artery Occlusion in a Patient with Metabolic Syndrome X

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    Sonja Predrag Cekić

    2010-01-01

    Full Text Available Purpose: To report a case of central retinal artery occlusion (CRAO in a patient with metabolic syndrome X. Case Report: A 64 year-old-man presented with abrupt, painless, and severe loss of vision in his left eye. Indirect ophthalmoscopy disclosed signs compatible with CRAO and laboratory investigations revealed erythrocyte sedimentation rate of 74 mm/h, C-reactive protein (CRP level of 21 mg/l, hyperglycemia, hyperuricemia, hypertriglyceridemia and hypercholesterolemia. Fluorescein angiography and immunological studies excluded other systemic disorders. The patient met the full criteria of the National Cholesterol Education Program for metabolic syndrome X. Conclusion: In addition to different vascular complications such as stroke, and cardiovascular disease, metabolic syndrome X may be associated with retinal vascular occlusions.

  16. Modern technologies for retinal scanning and imaging: an introduction for the biomedical engineer.

    Science.gov (United States)

    Gramatikov, Boris I

    2014-04-29

    This review article is meant to help biomedical engineers and nonphysical scientists better understand the principles of, and the main trends in modern scanning and imaging modalities used in ophthalmology. It is intended to ease the communication between physicists, medical doctors and engineers, and hopefully encourage "classical" biomedical engineers to generate new ideas and to initiate projects in an area which has traditionally been dominated by optical physics. Most of the methods involved are applicable to other areas of biomedical optics and optoelectronics, such as microscopic imaging, spectroscopy, spectral imaging, opto-acoustic tomography, fluorescence imaging etc., all of which are with potential biomedical application. Although all described methods are novel and important, the emphasis of this review has been placed on three technologies introduced in the 1990's and still undergoing vigorous development: Confocal Scanning Laser Ophthalmoscopy, Optical Coherence Tomography, and polarization-sensitive retinal scanning.

  17. ORGANOPROTECTIVE EFFECTS OF BENASEPRIL IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    V. S. Zadionchenko

    2006-01-01

    Full Text Available Aim. To evaluate antihypertensive efficiency of benasepril therapy (Lotensin, Novartis and its effects on microcirculation, endothelium function, system of cytoprotection, ophthalmoscopic and functional characteristics of eye retina in patients with arterial hypertension (AH. Material and methods. 40 patients with AH of 1-3 degree (AH1, AH2, and AH3 were studied. After wash-out period all patients were prescribed benasepril 5-10 mg daily. If necessary, hydrochlorothiazide 12,5 mg daily was added. Treatment lasted during 6 months. Patients were examined at the beginning and at the end of the study. Ambulatory blood pressure (BP monitoring was carried out. Microcirculation was assessed by method of laser Doppler flowmetry. Stable plasma metabolites of nitric oxide (NO were determined by spectral photometry. Cytoprotection was assessed by content of heat shock proteins (HSP70 in leucocytes of peripheral blood. Ophthalmoscopy, color and contrast static campimetry with evaluation of sensory-motor reaction (SMR time in different fields of vision were carried out. Results. Therapy with benasepril allowed to improve daily profile of BP and to reach its target level in all AH patients. Number of patients with spastic type of microcirculation decreased. Functional condition of endothelium improved which revealed in normalization of endothelial production of NO. Therapy with benasepril resulted in intracellular HSP70 level decrease which testified restriction of cellular destruction. The cytoprotective effect of benasepril was stronger in patient with severe AH. Therapy with benasepril resulted in SMR time decrease which signifies its positive influence on retinal blood flow. Evaluation of contrast and color sensitiveness of retina allowed to reveal and quantitatively assess earlier dysfunctions of retinal tissue perfusion, compared to ophthalmoscopy. Conclusion. Benasepril is an efficient antihypertensive drug which improves microcirculation, endothelium

  18. Could Visual Impairment in the Pediatric Age Group Be Reduced?

    Directory of Open Access Journals (Sweden)

    Doğan Ceyhan

    2013-06-01

    Full Text Available Pediatric age is the most important period for preventive eye care services and research. Vision loss in this period could cause a long life without sight and also significant financial and moral losses, in terms of people and society. Rational screening programs may reduce vision loss in childhood and this issue increases the value of the subject. Retinopathy of prematurity, congenital/infantile cataracts and glaucoma, optic nerve and retinal pathologies, refractive errors, amblyopia, and strabismus are the major clinical pictures causing visual loss in childhood. Using the epidemiological data, it could be estimated that every year approximately two to three thousand children suffer an ophthalmologic disease that causes significant visual loss. Regarding the refractive errors and amblyopia, it could be estimated that hundreds of thousands of children need ophthalmological follow-up in the country. For the timely treatment of these pathologies, a couple of short eye examination programs seem more realistic. Childhood vision loss in the country could be reduced, by informing pediatricians and family physicians and by proper guiding of the public opinion. Effective eye screening could be achieved with the implementation of simple methods like red reflex/Brückner test with ophthalmoscopy, or simultaneous (binocular retinoscopy and ophthalmoscopy of both eyes. Screening programs could be spread throughout the country by appropriate training of the physicians in the health institutions of the country. Screening programs will contribute to reduce the rate of visual disability by disseminating ophthalmologic practices throughout the country. (Turk J Ophthalmol 2013; 43: 195-201

  19. High-resolution adaptive optics retinal imaging of cellular structure in choroideremia.

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    Morgan, Jessica I W; Han, Grace; Klinman, Eva; Maguire, William M; Chung, Daniel C; Maguire, Albert M; Bennett, Jean

    2014-09-04

    We characterized retinal structure in patients and carriers of choroideremia using adaptive optics and other high resolution modalities. A total of 57 patients and 18 carriers of choroideremia were imaged using adaptive optics scanning light ophthalmoscopy (AOSLO), optical coherence tomography (OCT), autofluorescence (AF), and scanning light ophthalmoscopy (SLO). Cone density was measured in 59 eyes of 34 patients where the full cone mosaic was observed. The SLO imaging revealed scalloped edges of RPE atrophy and large choroidal vessels. The AF imaging showed hypo-AF in areas of degeneration, while central AF remained present. OCT images showed outer retinal tubulations and thinned RPE/interdigitation layers. The AOSLO imaging revealed the cone mosaic in central relatively intact retina, and cone density was either reduced or normal at 0.5 mm eccentricity. The border of RPE atrophy showed abrupt loss of the cone mosaic at the same location. The AF imaging in comparison with AOSLO showed RPE health may be compromised before cone degeneration. Other disease features, including visualization of choroidal vessels, hyper-reflective clumps of cones, and unique retinal findings, were tabulated to show the frequency of occurrence and model disease progression. The data support the RPE being one primary site of degeneration in patients with choroideremia. Photoreceptors also may degenerate independently. High resolution imaging, particularly AOSLO in combination with OCT, allows single cell analysis of disease in choroideremia. These modalities promise to be useful in monitoring disease progression, and in documenting the efficacy of gene and cell-based therapies for choroideremia and other diseases as these therapies emerge. (ClinicalTrials.gov number, NCT01866371.). Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  20. Two siblings with late-onset cone–rod dystrophy and no visible macular degeneration

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    Sakuramoto H

    2013-08-01

    Full Text Available Hiroyuki Sakuramoto,1 Kazuki Kuniyoshi,1 Kazushige Tsunoda,2 Masakazu Akahori,2 Takeshi Iwata,2 Yoshikazu Shimomura1 1Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka-Sayama City, Osaka, Japan; 2National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan Background: We report our findings in two siblings with late-onset cone–rod dystrophy (CRD with no visible macular degeneration. Cases and methods: Case 1 was an 82-year-old man who first noticed a decrease in vision and color blindness in his early seventies. His mother and younger sister also had visual disturbances. His decimal visual acuity was 0.3 in the right eye and 0.2 in the left eye. Ophthalmoscopy showed normal fundi, and fluorescein angiography was also normal in both eyes. The photopic single flash and flicker eletroretinograms (ERGs were severely attenuated and the scotopic ERGs were slightly reduced in both eyes. Case 2 was the 80-year-old younger sister of Case 1. She first noticed a decline in vision and photophobia in both eyes in her early seventies. Her decimal visual acuity was 0.4 in the right eye and 0.2 in the left eye. Ophthalmoscopy showed mottling of the retinal pigment epithelium in the midperiphery with no visible macular degeneration. The photopic single flash and flicker ERGs were severely attenuated, and the scotopic ERGs were slightly reduced in both eyes. Conclusion: These siblings are the oldest reported cases of CRD with no visible macular degeneration. Thus, CRD should be considered in patients with reduced visual acuity, color blindness, and photophobia even if they are older than 70 years. Keywords: cone–rod dystrophy, peripheral cone dystrophy, occult macular dystrophy, late onset, macular degeneration, negative ERG

  1. CMV retinitis screening and treatment in a resource-poor setting: three-year experience from a primary care HIV/AIDS programme in Myanmar

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    Tun NiNi

    2011-08-01

    Full Text Available Abstract Background Cytomegalovirus retinitis is a neglected disease in resource-poor settings, in part because of the perceived complexity of care and because ophthalmologists are rarely accessible. In this paper, we describe a pilot programme of CMV retinitis management by non-ophthalmologists. The programme consists of systematic screening of all high-risk patients (CD4 3 by AIDS clinicians using indirect ophthalmoscopy, and treatment of all patients with active retinitis by intravitreal injection of ganciclovir. Prior to this programme, CMV retinitis was not routinely examined for, or treated, in Myanmar. Methods This is a retrospective descriptive study. Between November 2006 and July 2009, 17 primary care AIDS clinicians were trained in indirect ophthalmoscopy and diagnosis of CMV retinitis; eight were also trained in intravitreal injection. Evaluation of training by a variety of methods documented high clinical competence. Systematic screening of all high-risk patients (CD4 3 was carried out at five separate AIDS clinics throughout Myanmar. Results A total of 891 new patients (1782 eyes were screened in the primary area (Yangon; the majority of patients were male (64.3%, median age was 32 years, and median CD4 cell count was 38 cells/mm3. CMV retinitis was diagnosed in 24% (211/891 of these patients. Bilateral disease was present in 36% of patients. Patients with active retinitis were treated with weekly intravitreal injection of ganciclovir, with patients typically receiving five to seven injections per eye. A total of 1296 injections were administered. Conclusions A strategy of management of CMV retinitis at the primary care level is feasible in resource-poor settings. With appropriate training and support, CMV retinitis can be diagnosed and treated by AIDS clinicians (non-ophthalmologists, just like other major opportunistic infections.

  2. Safety of iPhone retinal photography.

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    Hong, Sheng Chiong; Wynn-Williams, Giles; Wilson, Graham

    2017-04-01

    With the advancement in mobile technology, smartphone retinal photography is becoming a popular practice. However, there is limited information about the safety of the latest smartphones used for retinal photography. This study aims to determine the photobiological risk of iPhone 6 and iPhone 6 plus when used in conjunction with a 20Diopter condensing lens for retinal photography. iPhone 6 and iPhone 6 plus (Apple, Cupertino, CA) were used in this study. The geometrical setup of the study was similar to the indirect ophthalmoscopy technique. The phone was set up at one end of the bench with its flash turned on at maximal brightness; a 20 Dioptre lens was placed 15 cm away from the phone. The light that passes through the lens was measured with a spectroradiometer and an illuminance probe at the other end to determine the spectral profile, spatial irradiance, radiant power emitted by the phone's flash. Trigonometric and lens formula were applied to determine the field of view and retinal surface in order to determine the weighted retinal irradiance and weighted retinal radiant exposure. Taking ocular transmission and the distribution of the beam's spatial irradiance into account, the weighted retinal irradiance is 1.40 mW/cm(2) and the weighted retinal radiant exposure is 56.25 mJ/cm(2). The peak weighted foveal irradiance is 1.61 mW/cm(2). Our study concluded that the photobiological risk posed by iPhone 6 indirect ophthalmoscopy was at least 1 order of magnitude below the safety limits set by the ISO15004-2.2.

  3. B - SCAN ULTRASONOGRAPHY BEFORE SURGERY I N EYES WITH ADVANCED CATARACTS: A USEFUL PROGNOSTIC TOOL

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    Jatin

    2015-05-01

    Full Text Available BACKGROUND : Ocular ultrasonography is an important tool for evaluating the posterior segment in eyes with opaque media . In cases with dense cataract , where posterior segment evaluation by ophthalmoscopy is not possible , B - scan ultrasonography before surgery can help in surgical planning and guiding the expectations of patients . PURPOSE : To determine the relevance and prevalence of posterior segment abnormalities in patients with dense ca taracts prior to surgery by ultrasonography . DESIGN : Prospective diagnostic study . METHODS : Diagnostic B - scan ultrasound was performed on 158 eyes of 132 patients with dense cataract precluding visualization of fundus on ophthalmoscopy from January 2013 to December 2013 . Patients were divided in two groups , traumatic ( 22 and non - traumatic ( 136 . Patients in the age range of 1 to 79 years of both sexes were included . Detailed history and some basic eye examination techniques , like slit lamp and tonometry we re done . Patients having already posterior segment lesions and those who had previous history of ocular surgery were excluded from the study . RESULTS : 26 ( 16 . 4% patients , out of total 158 patients , had posterior segment lesions . Among traumatic group of 22 patients , 15 ( 68 . 1% had positive posterior segment lesions , while only 11 ( 8% patients in the non - traumatic group of 136 patients had positive posterior segment lesions . Out of the 26 positive cases , retinal detachment was found in 8 ( 5% patients , 7 ( 4 . 4% had posterior vitreous detachment , 7 ( 4 . 4% had vitreous hemorrhage , 2 ( 1 . 26% had retinal detachment with vitreous hemorrhage , 1 ( 0 . 63% had asteroid hyalosis , 1 ( 0 . 63% had intra - ocular foreign body . CONCLUSION : We concluded that B - scan ultrasound has sign ificant importance in the preoperative evaluation of patients with dense cataracts to detect pathologies that may influence the surgical strategy and the postoperative visual prognosis .

  4. A slowly progressive retinopathy in the Shetland Sheepdog.

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    Karlstam, Lena; Hertil, Eva; Zeiss, Caroline; Ropstad, Ernst Otto; Bjerkås, Ellen; Dubielzig, Richard R; Ekesten, Björn

    2011-07-01

    To describe a slowly progressive retinopathy (SPR) in Shetland Sheepdogs. Animals  Forty adult Shetlands Sheepdogs with ophthalmoscopic signs of SPR and six normal Shetland Sheepdogs were included in the study. Ophthalmic examination including slit-lamp biomicroscopy and ophthalmoscopy was performed in all dogs. Electroretinograms and obstacle course-test were performed in 13 affected and 6 normal dogs. The SPR dogs were subdivided into two groups according to their dark-adapted b-wave amplitudes. SPR1-dogs had ophthalmoscopic signs of SPR, but normal dark-adapted b-wave amplitudes. Dogs with both ophthalmoscopic signs and subnormal, dark-adapted b-wave amplitudes were assigned to group SPR2. Eyes from two SPR2 dogs were obtained for microscopic examination. The ophthalmoscopic changes included bilateral, symmetrical, greyish discoloration in the peripheral tapetal fundus with normal or marginally attenuated vessels. Repeated examination showed that the ophthalmoscopic changes slowly spread across the central parts of the tapetal fundus, but did not progress to obvious neuroretinal thinning presenting as tapetal hyper-reflectivity. The dogs did not appear seriously visually impaired. SPR2 showed significantly reduced b-wave amplitudes throughout dark-adaptation. Microscopy showed thinning of the outer nuclear layer and abnormal appearance of rod and cone outer segments. Testing for the progressive rod-cone degeneration ( prcd )-mutation in three dogs with SPR was negative. Slowly progressive retinopathy is a generalized rod-cone degeneration that on ophthalmoscopy looks similar to early stages of progressive retinal atrophy. The ophthalmoscopic findings are slowly progressive without tapetal hyper-reflectivity. Visual impairment is not obvious and the electroretinogram is more subtly altered than in progressive retinal atrophy. The etiology remains unclear. SPR is not caused by the prcd-mutation. © 2011 American College of Veterinary Ophthalmologists.

  5. Alterações retinianas em jovens portadores de anemia falciforme (hemoglobinopatias em hospital universitário no nordeste do Brasil Retinal impairment in young individuals with sickle cell anemia (hemoglobin SS disease in university hospital in Northeastern of Brazil

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    Allisson Mário dos Santos

    2012-10-01

    Full Text Available OBJETIVOS: Descrever e classificar alterações retinianas encontradas em portadores de anemia falciforme com genótipo SS, bem com comparar métodos diagnósticos (mapeamento de retina e angiofluoresceinografia. MÉTODOS: Neste estudo transversal foram avaliados pacientes portadores de anemia falciforme com idade igual ou superior a sete anos. Esses pacientes foram submetidos a mapeamento de retina e angiofluoresceinografia. Os achados do mapeamento de retina foram agrupados em três classes: sem alterações; alterações não proliferativas e alterações proliferativas. Os resultados à angiofluoresceinografia foram classificados de acordo com os estágios de Goldberg, variando de I a V e expressando gradiente crescente de gravidade. RESULTADOS: Foram avaliados 61olhos de 31pacientes. A retinopatia falciforme foi encontrada em 38/61 (62,3% dos olhos examinados. A média de idade do grupo de portadores de retinopatia foi menor que dos pacientes sem retinopatia (14,4 versus 17,4 anos, p=0,04. Observou-se elevada freqüência de retinopatia não proliferativa, especialmente as tortuosidades vasculares (27,9%, seguidas por anastomoses arteriovenosas na periferia da retina (24,6% e oclusões arteriolares (8,2%. Em um olho foi observado neovascularização. Em 16,4% dos olhos obteve-se resultado normal no mapeamento de retina e alterado à angiofluoresceinografia. CONCLUSÕES: As alterações retinianas do tipo não proliferativa são frequentes e precoces nos portadores de anemia falciforme do tipo SS, sendo a angiofluoresceinografia mais sensível no diagnóstico quando comparada ao mapeamento de retina.PURPOSES: To describe and categorize retinal vascular changes in patients with sickle cell anemia, as well as to compare diagnostic methods (indirect ophthalmoscopy and fluorescein angiography. METHODS: Patients with sickle cell anemia over the age of seven were examined. Complete ophthalmologic examination with indirect ophthalmoscopy and

  6. Development and experimental basis of local subretinal technique of xenogenic’s injection stem cells labelled by magnetic perticles

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    Yu. A. Belyy

    2014-10-01

    Full Text Available Purpose: is to develop a technique for local subretinal injection of xenogeneic stem cells labeled with magnetic particles and to prove experimentally its effectiveness.Material and methods: We used a line of stem cells HEK-293 GFP,labeled with magnetic particles. The study was made on 84 eyes of 42 chinchilla rabbits 6 months of age, the weight were from 2.5 to 3.5 kg. All right eyes were experimental (42 eyes and all left eyes (42 eyes were the control group. In the experimental group we used original complex of polymer elastic magnetic implant (PEMI with laser probe and fixed it to the sclera, then we made a median vitrectomy and injected HEK-293 GFP under the retina using a specially designed dispenser. In the control group PEMI was not fixed. We examined animals using biomicroscopy, ophthalmoscopy, ultrasound scanning, optical coherence tomography  OCT, computer tomography (CT, morphological study (cryohistological sections in 1, 3, 5, 7, 14 day and 1 month after surgery.Results: According the results of biomicroscopy in observation periods up to 3 days the vascular injection was visualized in the area operation. According the results of ophthalmoscopy and ultrasound scanning in 1 day the local retinal detachment was visualized in the area of local injection of the stem cells, which was not visualized in terms of further observations. CT helped us to confirm the local place of PEMI fixation. The morphological study results showed that cells were located in the subretinal space up to 14 days in the experimental group, and only up 3 days in the control group.Conclusion: The suggested surgical technique enables to control the injection of cells into the subretinal space, reduces the risk of tissue damage and exit cells in the vitreous space. The suggested methodology allows the fixing of the cellular material in the local place of the injection and enables to predict cells`s movement.

  7. Development and experimental basis of local subretinal technique of xenogenic’s injection stem cells labelled by magnetic perticles

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    Yu. A. Belyy

    2014-01-01

    Full Text Available Purpose: is to develop a technique for local subretinal injection of xenogeneic stem cells labeled with magnetic particles and to prove experimentally its effectiveness.Material and methods: We used a line of stem cells HEK-293 GFP,labeled with magnetic particles. The study was made on 84 eyes of 42 chinchilla rabbits 6 months of age, the weight were from 2.5 to 3.5 kg. All right eyes were experimental (42 eyes and all left eyes (42 eyes were the control group. In the experimental group we used original complex of polymer elastic magnetic implant (PEMI with laser probe and fixed it to the sclera, then we made a median vitrectomy and injected HEK-293 GFP under the retina using a specially designed dispenser. In the control group PEMI was not fixed. We examined animals using biomicroscopy, ophthalmoscopy, ultrasound scanning, optical coherence tomography  OCT, computer tomography (CT, morphological study (cryohistological sections in 1, 3, 5, 7, 14 day and 1 month after surgery.Results: According the results of biomicroscopy in observation periods up to 3 days the vascular injection was visualized in the area operation. According the results of ophthalmoscopy and ultrasound scanning in 1 day the local retinal detachment was visualized in the area of local injection of the stem cells, which was not visualized in terms of further observations. CT helped us to confirm the local place of PEMI fixation. The morphological study results showed that cells were located in the subretinal space up to 14 days in the experimental group, and only up 3 days in the control group.Conclusion: The suggested surgical technique enables to control the injection of cells into the subretinal space, reduces the risk of tissue damage and exit cells in the vitreous space. The suggested methodology allows the fixing of the cellular material in the local place of the injection and enables to predict cells`s movement.

  8. Early retinal inflammatory biomarkers in the middle cerebral artery occlusion model of ischemic stroke

    Science.gov (United States)

    Ritzel, Rodney M.; Pan, Sarah J.; Verma, Rajkumar; Wizeman, John; Crapser, Joshua; Patel, Anita R.; Lieberman, Richard; Mohan, Royce

    2016-01-01

    Purpose The transient middle cerebral artery occlusion (MCAO) model of stroke is one of the most commonly used models to study focal cerebral ischemia. This procedure also results in the simultaneous occlusion of the ophthalmic artery that supplies the retina. Retinal cell death is seen days after reperfusion and leads to functional deficits; however, the mechanism responsible for this injury has not been investigated. Given that the eye may have a unique ocular immune response to an ischemic challenge, this study examined the inflammatory response to retinal ischemia in the MCAO model. Methods Young male C57B/6 mice were subjected to 90-min transient MCAO and were euthanized at several time points up to 7 days. Transcription of inflammatory cytokines was measured with quantitative real-time PCR, and immune cell activation (e.g., phagocytosis) and migration were assessed with ophthalmoscopy and flow cytometry. Results Observation of the affected eye revealed symptoms consistent with Horner’s syndrome. Light ophthalmoscopy confirmed the reduced blood flow of the retinal arteries during occlusion. CX3CR1-GFP reporter mice were then employed to evaluate the extent of the ocular microglia and monocyte activation. A significant increase in green fluorescent protein (GFP)-positive macrophages was seen throughout the ischemic area compared to the sham and contralateral control eyes. RT–PCR revealed enhanced expression of the monocyte chemotactic molecule CCL2 early after reperfusion followed by a delayed increase in the proinflammatory cytokine TNF-α. Further analysis of peripheral leukocyte recruitment by flow cytometry determined that monocytes and neutrophils were the predominant immune cells to infiltrate at 72 h. A transient reduction in retinal microglia numbers was also observed, demonstrating the ischemic sensitivity of these cells. Blood–eye barrier permeability to small and large tracer molecules was increased by 72 h. Retinal microglia exhibited enhanced

  9. Current practices of diagnostic techniques requir- ing the use of ophthalmic drugs among KwaZulu- Natal optometrists*

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    K. P. Mashige

    2009-12-01

    Full Text Available In anendeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as goniosco-py that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55% of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53% were certified in di-agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%, 78 D/90 D lens fundus examination (60%, binocular indirect ophthalmoscopy (84% and gonioscopy (78%. Also, among these certified respondents (62 optometrists, a significant proportion (60% disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61% agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%, agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117, 86% agreed that they were confident about the accuracy of their referrals and less than half (45% disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than

  10. Relevant factors analysis of poor vision after cataract surgery%白内障术后视力低下的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    张秀

    2011-01-01

    目的:了解白内障复明术后效果,探讨引起白内障患者术后视力低下的主要因素.方法:186例(208眼)白内障患者采用超声乳化白内障囊外摘除加人工晶体植入术,术后行直接、间接眼底镜检查,对眼底镜所见无法确诊的病例,则予以眼底荧光血管造影检查.结果:208眼,术后153眼视力恢复,占73.55%,53眼视力低下,占26.45%.其中与手术有关致视力低下32眼,占15.38%,原有眼病所致视力低下21眼,占10.09%.结论:白内障术后视力低下与手术效果、术前原有的眼病和各种各样的病变均有很大的关系.%Objective: To know the effect of the cataract surgery, and to explore the main reason of visual acuity after cataract surgery. Methods: 186 cases of cataract patients (208 eyes) were treated by cataract phaeoemuIsification and ex tracapsular cataract extraction plus intraocular lens implantation, direct, indirect ophthalmoscopy were used alter operation, ophthalmoscopy findings could not be confirmed cases used fundus fluorescein angiography. Results: 153 eyes were visual acuity after surgery (73.55%), 53 eyes were with poor vision (26.45%). 32 eyes were related with the cause of poor vision with surgery (15.38%), 21 eyes were due to low vision of the original eye disease (10.09%). Conclusion: Poor vision after cataract surgery have a great relationship with the surgery, preoperalive eye disease and a variety of existing lesions.

  11. Current practices of diagnostic techniques requiring the use of ophthalmic drugs among KwaZulu- Natal optometrists*

    Directory of Open Access Journals (Sweden)

    K. P. Mashige

    2009-12-01

    Full Text Available In anendeavour to improve the quality of optometric eye care services in South Africa, the scope of practice was expanded to include the use of ocular diagnostic procedures such as gonioscopy that require the use of ophthalmic drugs. The purpose of this study was to assess the practices of specific diagnostic techniques (contact tonometry, 78 D/90 D lens fundus examination, binocular indirect ophthalmoscopy and gonioscopy requiring the use of ophthalmic drugs among optometrists in KwaZulu-Natal (KZN province. These specific techniques are referred to as diagnostic procedures in this article. A questionnaire containing information on demography and practice of these specific techniques was sent to all 213 KwaZulu-Natal registered optometrists who owned private practices. One hundred and thirty two completed questionnaires were received, a response rate of 62%. One hundred and seventeen (55% of the questionnaires were included in the analysis of which 55% of the respondents were females and 45% were males. Sixty two optometrists (53% were certified in di-agnostic procedures but many procedures were not being practiced. These procedures and the percentage respondents were: Contact tonometry (60%, 78 D/90 D lens fundus examination (60%, binocular indirect ophthalmoscopy (84% and gonioscopy (78%. Also, among these certified respondents (62 optometrists, a significant proportion (60% disagreed when asked if they were confident and proficient in performing the relevant diagnostic procedures. Many, (61% agreed that lack of incentives discouraged them from routinely performing the procedures. More than half (58%, agreed that chair time was an important factor in deciding whether or not to perform these diagnostic procedures. Of the total respondents (117, 86% agreed that they were confident about the accuracy of their referrals and less than half (45% disagreed that diagnostic procedures should be the sole responsibility of ophthalmologists. Less than

  12. Combined 20-gauge and 23-gauge pars plana vitrectomy for the management of posteriorly dislocated lens: a case series

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    Pipat Kongsap

    2010-06-01

    Full Text Available Pipat KongsapDepartment of Ophthalmology, Prapokklao Hospital, Chanthaburi, Thailand; Affiliated with the Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandObjective: To present a new surgical approach for the management of posteriorly dislocated lens by using a combination of 20-gauge (20G and 23-gauge (23G pars plana vitrectomy.Design: An interventional case seriesMethods: This technique was performed on six patients (five men, one woman; mean age, 66.67 years; range, 66–72 years. Two 23G trans-conjunctival sclerotomy ports were created for infusion and illumination along with a 20G sclerotomy port for introducing the vitrectomy probe or fragmatome.Results: This procedure was successfully performed on six eyes. On postoperative day one, the media were clear and the retina could be seen by indirect ophthalmoscopy. Hyphema developed in one eye and resolved within a week. There were no observed cases of retinal tear, wound leakage, hypotony, or endophthalmitis. The post-operative follow-up period ranged from three to twelve months (mean, 8.1 months. By the final visit, two patients had achieved a visual acuity of 20/40 or better, three patients, 20/70, and one patient, 20/200.Conclusion: The combination of 20G and 23G pars plana vitrectomy is an efficacious and safe procedure for management of posteriorly dislocated lens.Keywords: lensectomy, fragmatome, sutureless vitrectomy

  13. PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

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    A. Bostak

    2006-11-01

    Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

  14. ROLLER COASTER RETINOPATHY: CASE REPORT OF SYMPTOMATIC BILATERAL INTRARETINAL HEMORRHAGES AFTER SHAKING INJURY IN AN OTHERWISE HEALTHY ADULT.

    Science.gov (United States)

    Patel, Yogin P; Saraf, Steven S; Desai, Ankit; Desai, Uday R

    2016-01-01

    Traumatic head injuries not involving the eye have been known to cause retinal injury through multiple mechanisms. Abusive head trauma remains the prototypical example. We propose to demonstrate the first case of bilateral multiple retinal hemorrhages in a young healthy adult related to riding multiple theme park roller coasters. The patient was evaluated with a complete ophthalmic examination including dilated extended ophthalmoscopy, fluorescein angiography, optical coherence tomography, and fundus photography. The patient was found to have a bilateral symptomatic macular retinopathy characterized by multiple intraretinal hemorrhages. Given the lack of other systemic findings and negative medical workup, her signs and symptoms were thought to be attributed to the same day attendance of a theme park and riding of multiple roller coasters. Theme park roller coasters, as well as other attractions, may affect the eye at the vitreoretinal interface. This type of acceleration-deceleration injury should be considered in the differential of an adolescent or adult patient with retinal hemorrhage in the absence of other pathologic processes to explain clinical findings.

  15. Eye injury treatment in intensive care unit patients

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    L. K. Moshetova

    2015-01-01

    Full Text Available Aim. To describe eye injuries in intensive care unit (ICU patients with multitrauma, to study conjunctival microflora in these patients, and to develop etiologically and pathogenically targeted treatment and prevention of wound complications.Materials and methods. Study group included 50 patients (54 eyes with combined mechanical cerebral and eye injury. All patients underwent possible ophthalmological examination (biomicroscopy, ophthalmoscopy and ocular fundus photographing with portative fundus camera, tonometry, cranial CT and MRT, and bacteriological study of conjunctival smears. Results. Modern methods of ophthalmological examination of ICU patients provided correct diagnosis and prediction of wound healing. Eye injury treatment schedule provided maximum possible results in all ICU patients. Hospitalacquired infection results in asymptomatic dissemination of pathogenic microbes on ocular surface. Conclusions. 14-day topical treatment with antimicrobials, steroids, and NSAIDs reduces posttraumatic inflammation caused by mechanical eye injuries in ICU patients. Bacteriological studies of conjunctival smears demonstrate the presence of pathogenic flora in ICU patients. In these patients, the most effective antibacterial agents are third-generation fluoroquinolones. 

  16. Applying photoacoustics to quantification of melanin concentration in retinal pigment epithelium (Conference Presentation)

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    Shu, Xiao; Zhang, Hao F.; Liu, Wenzhong

    2016-03-01

    The melanin in the retinal pigment epithelium (RPE) protects retina and other ocular tissues by photo-screening and acting as antioxidant and free radical scavenger. It helps maintain normal visual functions since human eye is subjected to lifelong high oxygen stress and photon exposure. Loss of the RPE melanin weakens the protection mechanism and jeopardizes ocular health. Local decrease in the RPE melanin concentration is believed to be both a cause and a sign of early-stage age-related macular degeneration (AMD), the leading blinding disease in developed world. Current technology cannot quantitatively measure the RPE melanin concentration which might be a promising marker in early AMD screening. Photoacoustic ophthalmoscopy (PAOM), as an emerging optical absorption-based imaging technology, can potentially be applied to measure the RPE melanin concentration if the dependence of the detectable photoacoustic (PA) signal amplitudes on the RPE melanin concentrations is verified. In this study, we tested the feasibility of using PA signal ratio from RPE melanin and the nearby retinal blood vessels as an indicator of the RPE melanin variation. A novel whole eye optical model was designed and Monte Carlo modeling of light (MCML) was employed. We examined the influences on quantification from PAOM axial resolution, the depth and diameter of the retinal blood vessel, and the RPE thickness. The results show that the scheme is robust to individual histological and illumination variations. This study suggests that PAOM is capable of quantitatively measuring the RPE melanin concentration in vivo.

  17. Coloboma típico associado à síndrome de clivagem de câmara anterior e microcórnea: descrição de um caso Typical coloboma associated with anterior chamber cleavage syndrome, and microcornea: description of one case

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    Ana Regina Cruz Vlainich

    2004-02-01

    Full Text Available Os autores descrevem associação rara bilateral de coloboma da íris, coróide, retina e cabeça do nervo óptico, microcórnea e deficiência de clivagem de câmara anterior. Fazem também uma abordagem quanto à embriologia e à dificuldade de identificar se a causa da queda contínua e insidiosa da visão é devida ao próprio coloboma ou a outra doença associada, como o glaucoma. Os exames subsidiários disponíveis como campo visual, fundoscopia e tonometria, são de pouca confiabilidade devido ao nistagmo e à baixa acuidade visual.The authors describe a rare association of bilateral typical coloboma, microcornea and anterior chamber cleavage deficience. They also discuss the embriology and the difficulties to identify if the continuous and insidious vision impairment is due to coloboma or to other associated disease, like glaucoma. Supplementary tests, such as visual field, ophthalmoscopy, and tonometry are not reliable because of the presence of nistagmus and low visual acuity.

  18. Immune recovery vitritis

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    Dujić Mirjana

    2007-01-01

    Full Text Available Introduction Immune recovery vitritis (IRV is symptomatic vitritis of > 1+ severity associated with inactive cytomegalovirus (CMV retinitis. It is an opportunistic infection of the eye, in the patients who suffer from AIDS, and is treated with a highly active antiretroviral therapy (HAART. As a result of this therapy, there is an immune reconstitution in the body and inflammation of the vitreous body. Objective The aim of the study was to show the incidence of IRV in patients treated with HAART. Method A retrospective study was conducted in patients who suffered from CMV retinitis. Twenty-one were treated with HAART and had the diagnosis of CMV retinitis, as well. All of them were examined by the same ophthalmologist who peformed slit lamp examination with mydriasis and indirect ophthalmoscopy. Results Nine of 21 patients developed IRV as a complication of HAART, two had cystoid macular edema (CMO. Conclusion CMV retinitis develops when the number of CD4+ T lymphocytes drops below 50/mm3. This results in necrotic retinitis which, if untreated, leads to complete loss of vision. With the introduction of HAART, we learned that the reconstitution of immune status was achieved as well as life expectancy, but there was a dramatic decline in the opportunistic infection, including CMV retinitis, as well. With the immune reconstitution, the inflammation develops in the eye, known as IRV. Sometimes, it is necessary to treat this condition, but in the case of our patients, the inflammation was mild, and no treatment was necessary.

  19. Subacute toxicity evaluation of KR-33493, FAF1 inhibitor for a new anti-parkinson's disease agent, after oral administration in rats and dogs.

    Science.gov (United States)

    Jeong, Jong-Woo; Yu, Changsun; Lee, Jong-Hwa; Moon, Kyoung-Sik; Kim, Eunhee; Yoo, Sung-Eun; Koo, Tae-Sung

    2016-11-01

    KR33493, a newly developed FAS-associated factor 1 (FAF1) inhibitor for Parkinson's disease, is being evaluated in a Phase I clinical trial. In the present study, the subchronic toxicity of KR33493 in Sprague-Dawley (SD) rats and beagle dogs was investigated at various oral doses for 28 and 14 days, respectively. During the study, food consumption, body weights, organ weights, gross findings, and mortality were examined; and ophthalmoscopy, electrocardiography, hematology, serum biochemistry, urinalysis, histopathology, and toxicokinetics were performed. In rats, weight gain decreased in both sexes at 500 mg/kg/day, with no significant differences. In dogs, some significant differences compared with the control were found during the trial; however, at the end of recovery periods, these were no longer observed and there was no dose correlation. Some histopathological findings were observed, but these were considered as incidental changes. Since no other significant changes were observed, doses above 500 and 1000 mg/kg KR33493 in rat and dogs, respectively, caused no observed adverse effects. Therefore, based on these results, the Phase 1 clinical trial for KR33493 was approved by the Korean Food & Drug Administration.

  20. Haptoglobin2-2 phenotype is an additional risk factor of retinopathy in type 2 diabetes mellitus

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    Mukund R Mogarekar

    2013-01-01

    Full Text Available Aims: The aim of this study was to investigate the association between haptoglobin (Hp phenotypes and risk of the development of diabetic retinopathy (DR in patients of type 2 diabetes mellitus. Materials and Methods: This cross-sectional study included 45 normotensive type 2 diabetic patients (duration more than 5 years admitted in the hospital divided into two groups (with and without DR on the basis of fundus examination by direct ophthalmoscopy. Serum samples of all patients were subjected for Hp phenotyping by polyacrylamide gel electrophoresis. Results: DR was associated significantly in diabetic patients with Hp2-2 phenotype (79.31% than diabetic patients with Hp2-1 phenotype (43.75% and Hp2-2 had higher odds ratio (OR for DR in univariate analysis (OR 4.929, [95% confidence interval [CI] (1.297-18.733], P = 0.016 and multivariate analysis (OR 7.704 [95% CI (0.887-66.945], P = 0.064. Furthermore, Hp2-2 was associated significantly with severe forms of DR. Conclusion: Hp2-2 phenotype is associated with susceptibility to DR showing a graded risk relationship to the number of Hp2 alleles. Determination of Hp phenotype may be useful in the risk assessment and management of DR.

  1. Differences of optic disc appearance between normal tension and high tension glaucoma patients

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    Stojčić Milan

    2011-01-01

    Full Text Available Introduction. The term glaucoma is used to cover a wide range of diseases, whose main feature is optic neuropathy. According to the level of intraocular pressure (IOP, the open angle glaucoma is arbitrarily divided into high tension glaucoma (HTG and normal tension glaucoma (NTG. Objective. The aim of this study was to investigate the differences of optic disc cup appearance between patients with NTG and HTG. Methods. Prospective study included 30 patients (60 eyes with NTG and 30 patients (60 eyes with HTG. IOP was measured by Goldmann applanation tonometry. Examination of optic disc head was performed by indirect ophthalmoscopy with Volk 90 D superfield lens through a dilated pupil to observe qualitative and quantitative parameters. Visual fields were examined in all patients with the Octopus program G1, full threshold strategy (Octopus 500 EZ, Interzeag, Switzerland. Results. Vertical form of optic disc cup was present in 11 eyes with NTG (18.3% and three eyes with HTG (5% (p<0.05. A disc with localized tissue loss (polar notching on the inferior pole was observed in eight eyes with NTG (13.3% and in one eye with HTG (1.7% (p<0.01. Uniformly enlarged, round cup was more frequent in patients with HTG than NTG: 93.3% and 68.3% respectively (p<0.05. Conclusion. The perceived differences indicate a complex multifactorial nature of glaucoma disease and a possible existence of two pathophysiological ways of optic disc changes within the same basic disease.

  2. THE EYE — MIRROR OF CARDIOVASCULAR DISORDER. RELATIONSHIP OF THE RETINA FUNCTIONAL STATE AND THE HYPERTENSION SEVERITY

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    V. S. Zadionchenko

    2011-01-01

    Full Text Available Aim. To study the retina state by functional methods in patients with arterial hypertension (HT of various degrees. Material and methods. Patients with uncomplicated HT of 1-3 degrees (n=81 and healthy subjects (n=20 of control group were examined. Routine (direct ophthalmoscopy and functional (evaluation of contrast and color sensitivity of the retina, electroretinography methods were used. Results. Functional retinal changes (reduction in color and contrast sensitivity progressed with increasing HT degree. These changes were located in the area of central retinal artery (paramacular area and area of choroidal blood flow (macular region. Retinal bioelectrical activity disturbance was also found by the electroretinography. Conclusion. The identified functional disorders suggest the retina involvement in the pathological process even in the early HT and may be associated with its severity. It confirms a relationship of HT with disorders of eye as a target organ in HT. Published data and results of our studies can refute the point of view about impossibility of changes assessment on the eye fundus in patients with uncomplicated HT, and indicates that it was premature exclusion of the eye from the list of target organs in HT.

  3. Optical Design and Optimization of Translational Reflective Adaptive Optics Ophthalmoscopes

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    Sulai, Yusufu N. B.

    The retina serves as the primary detector for the biological camera that is the eye. It is composed of numerous classes of neurons and support cells that work together to capture and process an image formed by the eye's optics, which is then transmitted to the brain. Loss of sight due to retinal or neuro-ophthalmic disease can prove devastating to one's quality of life, and the ability to examine the retina in vivo is invaluable in the early detection and monitoring of such diseases. Adaptive optics (AO) ophthalmoscopy is a promising diagnostic tool in early stages of development, still facing significant challenges before it can become a clinical tool. The work in this thesis is a collection of projects with the overarching goal of broadening the scope and applicability of this technology. We begin by providing an optical design approach for AO ophthalmoscopes that reduces the aberrations that degrade the performance of the AO correction. Next, we demonstrate how to further improve image resolution through the use of amplitude pupil apodization and non-common path aberration correction. This is followed by the development of a viewfinder which provides a larger field of view for retinal navigation. Finally, we conclude with the development of an innovative non-confocal light detection scheme which improves the non-invasive visualization of retinal vasculature and reveals the cone photoreceptor inner segments in healthy and diseased eyes.

  4. Ultrasonography-guided scleral buckle retinopexy and cryotherapy: case report Retinopexia com "buckle" escleral e crioterapia guiada por ultrassom: relato de caso

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    Daniel da Rocha Lucena

    2009-04-01

    Full Text Available If the ocular media are clear, indirect binocular ophthalmoscopy allows retinal detachment and retinal tear identification and treatment under direct visualization. However, if opacities are present preventing direct fundus examination, ultrasonography becomes the most important tool for evaluating the posterior segment. In addition, ultrasonography can be useful in retinal tear treatment by guiding cryotherapy. In this article we describe a rhegmatogenous retinal detachment treatment technique applied to a patient with corneal opacity. Cryopexy and circumferential and radial buckle positioning were guided by ultrasonography, resulting in retinal attachment during the 6-month follow-up period.Quando os meios oculares são transparentes, oftalmoscopia binocular indireta permite a identificação de descolamento de retina e roturas, bem como seu tratamento sob visibilização direta. Porém, em olhos que apresentam opacidades de meios impedindo o exame oftalmoscópico, a ultrassonografia constitui o exame mais importante do segmento posterior do olho. Além disso, o tratamento de roturas retinianas também pode ser auxiliado pelo uso desse equipamento, orientando a crioterapia. Neste trabalho será apresentada técnica de tratamento de descolamento de retina regmatogênico, no qual a criopexia e o posicionamento dos "buckles" episclerais circunferencial e radial foram guiados pelo ultrassom em paciente com leucoma corneano. O tratamento resultou em aplicação retiniana durante o seguimento em seis meses.

  5. Evaluation of potential risk factors for development of primary angle-closure glaucoma in Bouviers des Flandres.

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    Dubin, Alexis J; Bentley, Ellison; Buhr, Kevin A; Miller, Paul E

    2017-01-01

    OBJECTIVE To evaluate potential risk factors for development of primary angle-closure glaucoma (PACG) in Bouviers des Flandres. DESIGN Prospective, observational study. ANIMALS 98 Bouviers des Flandres. PROCEDURES All dogs underwent slit-lamp biomicroscopy, indirect ophthalmoscopy, gonioscopy, applanation tonometry, streak retinoscopy, and A-scan, B-scan, and high-resolution ultrasonography. Iridocorneal angles and degree of pectinate ligament dysplasia sheeting were graded, and an angle index was mathematically derived for each eye on the basis of these values. Ciliary clefts evaluated by high-resolution ultrasonography were classified as open, narrow, or closed. Owners were contacted by telephone 7 to 9 years after the initial examination to determine whether dogs had a subsequent diagnosis of PACG. Relationships between previously recorded variables and the development of PACG were evaluated by logistic regression methods. Available pedigrees were reviewed to assess genetic relationships among affected dogs. RESULTS 9 of 92 (9.8%) dogs with follow-up information available developed PACG. An angle index 1 eye, or both findings were 13, 20, and 28 times those for dogs that did not have these findings, respectively. All dogs that developed PACG shared 1 common male sire or grandsire. CONCLUSIONS AND CLINICAL RELEVANCE Several anatomic factors were significant risk factors for development of PACG in this population of dogs. Results also suggested a genetic component for the disease.

  6. Chromatic aberration correction of the human eye for retinal imaging in the near infrared.

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    Fernández, Enrique J; Unterhuber, Angelika; Povazay, Boris; Hermann, Boris; Artal, Pablo; Drexler, Woflgang

    2006-06-26

    An achromatizing lens has been designed for the human eye in the near infrared range, from 700 to 900 nm, for retinal imaging purposes. Analysis of the performance of the lens, including tolerance to misalignments, has been mathematically accomplished by using an existing eye model. The calculations have shown a virtually perfect correction of the ocular longitudinal chromatic aberration, while still keeping a high optical quality. Ocular aberrations in five subjects have been measured with and without the achromatizing lens by using a Hartmann-Shack wavefront sensor and a broad bandwidth femtosecond Ti:sapphire laser in the spectral range of interest with a set of interference filters, studying the benefits and limits in the use of the achromatizing lens. Ocular longitudinal chromatic aberration has been experimentally demonstrated to be fully corrected by the proposed lens, with no induction of any other parasitic aberration. The practical implementation of the achromatizing lens for Ophthalmoscopy, specifically for optical coherence tomography where the use of polychromatic light sources in the near infrared portion of the spectrum is mandatory, has been considered. The potential benefits of using this lens in combination with adaptive optics to achieve a full aberration correction of the human eye for retinal imaging have also been discussed.

  7. Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

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    Rodrigo M. Navarro

    2015-01-01

    Full Text Available Purpose. To determine the efficacy of 23-gauge pars plana vitrectomy (PPV for symptomatic posterior vitreous detachment (PVD on visual acuity (VA and quality after multifocal intraocular lenses (IOLs. Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA, intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25 was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test. Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P=0.017. All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P=0.023, near activities (P=0.043, distance activities (P=0.041, mental health (P=0.011, role difficulties (P=0.042, and driving (P=0.016. Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised.

  8. Refractive Errors in State Junior High School Students in Bandung

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    Sabila Tasyakur Nikmah

    2016-12-01

    Full Text Available Background: Uncorrected refractive error is one of the avoidable causes of vision impairment in children and adults. Vision problem in children has been shown to affect their psychological and academic performance. This study aims at identifying and gaining more insights on the characteristic of the refractive errors in state junior high school students in Bandung to avoid uncorrected refractive errors. Methods: A cross-sectional study was conducted in September–November 2015 in state junior high schools in Bandung, West Java, Indonesia. Sample was selected using multistage random sampling technique. Children were examined using tumbling E examination; then students with visual acuity worse than 6/12 underwent Snellen Chart test, refractometry without pupil dilatation, correction with trial lens, then was followed by direct ophthalmoscopy. Results: From a total of 435 children who completed all the examination, 80 children (18.39% had refractive errors; consisted of 151 eyes (94.38% with myopia and 9 eyes (5.62% with astigmatism. Refractive errors were found to be more common in female children (73.7% than male children (26.3%. Among those with refractive errors, 45 children (56.3% did not use any corrective glasses before the examination. Conclusions: Routine refractive error test in vision screening examination is needed for students. It is equally important to raise more awareness toward eye disease in community.

  9. LONG-TERM OUTCOMES OF RETINAL DEGENERATIVE DISORDER TREATMENT WITH PEPTIDE BIOREGULATORS

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    M. I. Razumovskiy

    2015-01-01

    Full Text Available Aim. To analyze long-term outcomes and efficacy of retinal degeneration treatment with Retinalamin.Patients and methods. Group I included 20 patients (40 eyes with pigmentary retinal dystrophy (15 patients, 30 eyes and retinal abiotrophy (5 patients, 10 eyes who received treatment with Retinalamin for 5‑7 years. Group II included 11 patients (22 eyes with pigmentary retinal dystrophy (9 patients, 18 eyes and retinal abiotrophy (2 patients, 4 eyes who received treatment with Retinalamin for 23‑25 years. Group III (controls included 15 patients (30 eyes with pigmentary retinal dystrophy (11 patients, 22 eyes and retinal abiotrophy (4 patients, 8 eyes who received traditional treatment (vasodilators, angioprotectors, antisclerotic agents, vitamins for 25 years. Standard ophthalmological examination, i.e., visual acuity measurement, visual field test, refractometry, biomicroscopy, ophthalmoscopy, was performed.Results. First course of treatment with Retinalamin improved vision in 58.1 % of retinal degeneration patients. Visual fields improved in 64.5 % of cases. Repeated treatment courses (1‑2 times a year for 23‑25 years preserved residual vision in 55.6 % of patients and object vision in 11.1 % of cases. In retinal abiotrophy patients, residual vision preserved in 100 % of cases.Conclusions. In retinal degenerations, Retinalamin improves vision and visual fields and decreases total area of absolute scotomas even after the first treatment course as well as preserves vision in prolonged use. 

  10. Advanced capabilities of the multimodal adaptive optics imager

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    Hammer, Daniel X.; Ferguson, R. D.; Mujat, Mircea; Biss, David P.; Iftimia, Nicusor V.; Patel, Ankit H.; Plumb, Emily; Campbell, Melanie; Norris, Jennifer L.; Dubra, Alfredo; Chui, Toco Y. P.; Akula, James D.; Fulton, Anne B.

    2011-03-01

    We recently developed several versions of a multimodal adaptive optics (AO) retinal imager, which includes highresolution scanning laser ophthalmoscopy (SLO) and Fourier domain optical coherence tomography (FDOCT) imaging channels as well as an auxiliary wide-field line scanning ophthalmoscope (LSO). Some versions have also been equipped with a fluorescence channel and a retinal tracker. We describe the performance of three key features of the multimodal AO system including: simultaneous SLO/OCT imaging, which allows SLO/OCT co-registration; a small animal imaging port, which adjusts the beam diameter at the pupil from 7.5 to 2.5 mm for use with small animals ubiquitous in biological research or for extended depth-of-focus imaging in humans; and slow scan Doppler flowmetry imaging using the wide field auxiliary LSO imaging channel. The systems are currently deployed in several ophthalmology clinics and research laboratories and several investigations have commenced on patients with a variety of retinal diseases and animals in vision research.

  11. A CLINICAL STUDY OF OCULAR TRAUMA

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    Bharat Kumar

    2015-12-01

    Full Text Available AIM This study is designed to enumerate various causes of ocular trauma, clinical spectrum of presentation and to evaluate the visual outcome after appropriate management. MATERIALS AND METHODS A prospective study was conducted on total of 136 patients from the places in and around Kakinada, East Godavari District of Andhra Pradesh, India. A detailed work up of all patients including slit lamp biomicroscopy, direct, indirect ophthalmoscopy and ultra sonography B scan was done. RESULTS Observations from the study were analyzed, discussed and compared with the existing studies in the literature. Mean age group of patients belong to young adults between 20-30 years (57.9%, males (81% affected more than females. Illiterates, Agricultural labourers, Industrial workers affected more. Road Traffic Accidents (25.73%, industrial injuries (22.05% and agricultural hazards (19.11% being the major cause of unilateral eye injury. Closed globe injuries (80.88% more common than Open globe injuries (19.12. CONCLUTIONS Ophthalmic injuries due to innumerable causes results in various types of ocular trauma, leading to untold misery, visual impairment and economic burden to the family, society and country as a whole. Health education regarding use of preventive measures, seeking early treatment and appropriate rehabilitation are very much recommended to reduce the burden of morbidity due to ocular trauma.

  12. Corneal epithelial bullae after short-term wear of small diameter scleral lenses.

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    Nixon, Alex D; Barr, Joseph T; VanNasdale, Dean A

    2017-04-01

    Complications of scleral lens wear are not well documented or understood. While multiple studies focus on oxygen transmission during scleral lens wear and associated corneal swelling, little is known about the effects of varying scleral lens fitting relationships, especially when there is corneal interaction. Scleral lenses, by convention, are designed to completely clear the corneal surface and rest on the conjunctival and scleral tissue. However, some designs maximize oxygen transmission by reducing the lens diameter, thickness, and recommended corneal clearance.While the modifications increase oxygen transmission in any scleral lens design, they also distribute the lens mass closer to the limbus and make visualization of corneal clearance, especially narrow in the limbal region, more difficult. The sequelae from mechanical interaction between scleral lenses and the ocular surface, in particular the cornea, remain uncertain. This case series will describe corneal epithelial bullae, molding, and epithelial erosions as unintended scleral lens complications. These corneal changes corresponded to areas of contact lens-corneal bearing confirmed utilizing a combined scanning laser ophthalmoscopy (SLO) and anterior segment OCT. This case series will discuss epithelial bullae detection, their etiology, and suggestions for application of this information into scleral lens fitting protocols. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  13. Progress on Developing Adaptive Optics-Optical Coherence Tomography for In Vivo Retinal Imaging: Monitoring and Correction of Eye Motion Artifacts.

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    Zawadzki, Robert J; Capps, Arlie G; Kim, Dae Yu; Panorgias, Athanasios; Stevenson, Scott B; Hamann, Bernd; Werner, John S

    2014-03-01

    Recent progress in retinal image acquisition techniques, including optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO), combined with improved performance of adaptive optics (AO) instrumentation, has resulted in improvement in the quality of in vivo images of cellular structures in the human retina. Here, we present a short review of progress on developing AO-OCT instruments. Despite significant progress in imaging speed and resolution, eye movements present during acquisition of a retinal image with OCT introduce motion artifacts into the image, complicating analysis and registration. This effect is especially pronounced in high-resolution datasets acquired with AO-OCT instruments. Several retinal tracking systems have been introduced to correct retinal motion during data acquisition. We present a method for correcting motion artifacts in AO-OCT volume data after acquisition using simultaneously captured adaptive optics-scanning laser ophthalmoscope (AO-SLO) images. We extract transverse eye motion data from the AO-SLO images, assign a motion adjustment vector to each AO-OCT A-scan, and re-sample from the scattered data back onto a regular grid. The corrected volume data improve the accuracy of quantitative analyses of microscopic structures.

  14. Progress on Developing Adaptive Optics–Optical Coherence Tomography for In Vivo Retinal Imaging: Monitoring and Correction of Eye Motion Artifacts

    Science.gov (United States)

    Zawadzki, Robert J.; Capps, Arlie G.; Kim, Dae Yu; Panorgias, Athanasios; Stevenson, Scott B.; Hamann, Bernd; Werner, John S.

    2014-01-01

    Recent progress in retinal image acquisition techniques, including optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO), combined with improved performance of adaptive optics (AO) instrumentation, has resulted in improvement in the quality of in vivo images of cellular structures in the human retina. Here, we present a short review of progress on developing AO-OCT instruments. Despite significant progress in imaging speed and resolution, eye movements present during acquisition of a retinal image with OCT introduce motion artifacts into the image, complicating analysis and registration. This effect is especially pronounced in high-resolution datasets acquired with AO-OCT instruments. Several retinal tracking systems have been introduced to correct retinal motion during data acquisition. We present a method for correcting motion artifacts in AO-OCT volume data after acquisition using simultaneously captured adaptive optics-scanning laser ophthalmoscope (AO-SLO) images. We extract transverse eye motion data from the AO-SLO images, assign a motion adjustment vector to each AO-OCT A-scan, and re-sample from the scattered data back onto a regular grid. The corrected volume data improve the accuracy of quantitative analyses of microscopic structures. PMID:25544826

  15. Early diagnosis of diabetic retinopathy in primary care

    Science.gov (United States)

    Jimenez-Baez, Maria Valeria; Barcenas-Contreras, Rodolfo; Morales Montoya, Carlos; Espinosa-Garcia, Laura Fatima

    2015-01-01

    Objective: To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2) in Quintana Roo, México. Methods: Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR) in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed. Results: In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women. Conclusions: The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases. PMID:26019380

  16. Antioxidant status of dog aqueous humor after extracapsular lens extraction

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    Barros P.S.M.

    2003-01-01

    Full Text Available We determined the antioxidant status of the aqueous humor after extracapsular lens extraction in 14 mongrel dogs weighing about 10 kg. The animals were examined by slit lamp biomicroscopy, applanation tonometry and indirect ophthalmoscopy. One eye was submitted to conventional extracapsular lens extraction and the other was used as control. Samples of aqueous humor were obtained by anterior chamber paracentesis before and at days 1, 2, 3, 7 and 15 after surgery. Total antioxidant status was determined as the capacity of aqueous humor to inhibit free radical generation by 2,2-azobis(2-amidopropane chlorine. Ascorbic acid concentration was measured by HPLC with UV detection. Protein content was determined with the biuret reagent. Statistical analysis was performed by ANOVA followed by the Tukey-Kramer test. Protein concentration increased from 0.61 to 22 mg/ml 24 h after surgery. These levels were maintained and returned to normal at day 7. Total antioxidant capacity was reduced from 50 to about 30 min until day 3 and at day 7 it was equal to control. Ascorbic acid levels were reduced from 252 to about 110 µM and then returned to control values at day 15. Considering the importance of ascorbic acid concentration in aqueous humor for the maintenance of the antioxidant status of the anterior segment of the eye, the decrease of antioxidant defenses suggests that the surgical procedures promote an oxidative stress condition in the eye.

  17. [Organizational aspect of medical care rendered to children with abnormal refraction under the conditions of school education].

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    Chentsova, O B; Golovanova, T P

    2005-01-01

    The main purpose of the case study was to investigate the efficiency of different-method treatment of children with abnormal refraction. One hundred and fifty children were examined and shared between 3 experimental and one control groups. Routine ophthalmic examination methods were made use of; they are: visometry, autorefractometry, ophthalmobiometry, determination of the scope of relative accommodation, biomicroscopy, ophthalmoscopy; additional examinations, like rheoencephalography and consultation by neurologist, were also used. It was for the first time that the efficiency of infrared pneumomassage and of color-pulse therapy in the treatment of abnormal refraction was dynamically studied under the conditions of school education (vision correction rooms). The amplitude of relative accommodation increased in 71.6% of cases and the acuity of vision--in 78.8% of cases after the main treatment course; the refraction stabilized in 25-30% of cases. The results declined in 25-30% of cases after 3-4 months, therefore, treatment courses need to be repeated 3 times per year. Besides, positive results were obtained in the treatment of abnormal refraction by punctate massage of biologically active points, by general exercise and exercise for eyes as well as by massage of the collar zone and by medicamental therapy. Indications and contraindications were defined for the complex treatment of accommodation cramp and of abnormal refraction.

  18. Webcams as a tool for teaching in Optometry training

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    Gargallo, A.; Arines, J.

    2015-04-01

    Clinical Optometry lab training is devoted to develop the students skills needed in eye healthcare professional practice. Nevertheless, students always find difficulties in the management of some optometric instruments and in the understanding of the evaluation techniques. Moreover, teachers also have problems in explaining the eye evaluation tests or making demonstrations of instruments handling. In order to facilitate the learning process, webcams adapted to the optometric devices represent a helpful and useful tool. In this work we present the use of webcams in some of the most common clinical test in Optometry as ocular refraction, colour vision test, eye health evaluation with slip-lamp, retinoscopy, ophthalmoscopy and contact lens fitting. Our experience shows that with this simple approach we can do things easier: show the instrument handling to all the students at the same time; take pictures or videos of different eye health conditions or exploratory routines for posterior visualization with all the students; recreate visual experience of the patient during optometric exam; simulate colour vision pathologies; increase the interactions between students allowing them to help and correct each other; and also record the final routine exam in order to make possible its revision with the students.

  19. Combination of Intravitreal Ranibizumab and Laser Photocoagulation for Aggressive Posterior Retinopathy of Prematurity

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    Ágata Mota

    2012-04-01

    Full Text Available Purpose: To report on 2 cases of aggressive posterior retinopathy of prematurity (ROP treated with intravitreal ranibizumab (Lucentis® and laser photocoagulation. Methods: Two premature females, born at 25 and 26 weeks’ gestation with a birth weight of 530 and 550 g, respectively, with aggressive posterior ROP received combined treatment with laser photocoagulation and intravitreal ranibizumab (0.3 mg [30 µl] to each eye. Structural outcomes were evaluated by indirect ophthalmoscopy and documented by retinography. Results: An intravitreal injection was made at 34 weeks of postmenstrual age in the first case, followed by laser photocoagulation 1 week later. There was a partial regression of ROP with treatment. Five weeks later, neovascularization regrowth with bleeding in both eyes (intraretinal and subhyaloid occurred and retreatment with combined therapy was performed. In the second case, single therapy with laser photocoagulation was made at 34 weeks of postmenstrual age. In spite of the confluent photocoagulation in the avascular area, progression to 4A ROP stage occurred 1 week later. Both eyes were retreated 1 week later with intravitreal ranibizumab and laser photocoagulation. Treatment resulted in ROP regression in both cases. There were no signs of systemic or ocular adverse side effects. Conclusion: The cases presented show that combination therapy of indirect laser photocoagulation and intravitreal ranibizumab can be effective in the management of aggressive posterior ROP. Further investigation on anti-VEGF safety in premature infants is necessary . Additional studies are needed to define the role of anti-VEGF in ROP treatment.

  20. Investigation of retinal microstructure in healthy eyes and dry age-related macular degeneration using a combined AO-OCT-SLO system

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    Wells-Gray, Elaine M.; Choi, Stacey S.; Ohr, Matthew; Cebulla, Colleen M.; Doble, Nathan

    2017-02-01

    Combined adaptive optics (AO) optical coherence tomography (OCT) scanning laser ophthalmoscopy (SLO) imaging allows simultaneous en face and cross sectional views of the retina. We describe improvements to our AO-OCT-SLO system and highlight its resolution capability and clinical utility by presenting results from 3 control and 4 dry agerelated macular degeneration (AMD) subjects. From a group of subjects with healthy eyes, OCT A-scans were grouped as originating from cones or rods and were averaged. The resulting reflectance profiles were then used to identify the location of cone and rod segments. Results for rods and cones were compared, with the focus on inner segment (IS) and outer segment (OS) structures and where these cells embed into the retinal pigment epithelium (RPE). In the AMD patients, cone IS and OS lengths were measured over and around drusen for two retinal regions (fovea-2° and 2°-4°), and those results were correlated to drusen height. For the fovea-2° region, the drusen height that caused statistically significant shortening of cone ISL and OSL compared to the unaffected adjacent area were 40 μm and 50 μm respectively (p = 0.009, and p region, the equivalent drusen heights that caused significant shortening of segment length were 60 μm for IS (p = 0.017) and 80 μm for OS (p < 0.001)

  1. IMPLANTATION OF POSTERIOR-CHAMBER PHAKIC INTRAOCULAR LENS pIOL-3 IN HIGH MYOPIA (preliminary report

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    G. V. Sorokoletov

    2015-01-01

    Full Text Available Aim. To assess preliminary clinical functional outcomes of phakic intraocular lens pIOL-3 implantation in high myopia.Patients and methods. pIOL-3 was implanted in 6 patients (10 eyes aged 27‑63 with high myopia and no concomitant pathologies. Follow-up period varied from 1 to 12 months. IOL is made of hydrophilic material Contamac CI26 with water content of 26% and refraction index of 1.46. pIOL design (holes in the haptic portions provides its matching to ciliary sulcus size (0.5 mmless than linear size of the sulcus. Preoperative and postoperative examination included visual acuity measurement, biomicroscopy, ophthalmoscopy, visual field test, tonometry, endothelial microscopy, and ultrasound biomicroscopy. Simplicity of surgical technique, adaptability of haptics, and postoperative course were evaluated.Results. Early postoperative period was uncomplicated. Uncorrected (UCVA and best-corrected visual acuity (BCVA improved in the first hours after the surgery. No visual acuity worsening (as compared with preoperative BCVA was observed. Surgical procedure did not affected IOP even despite the absence of basal iridotomy. Maximum endothelial cell loss was less than 5%. No IOL forward «vaulting» was observed.Conclusions. pIOL implantation in high myopia patients is safe and provides maximum visual acuity in the first postoperative hours. Owing to its design this IOL can be implanted into ciliary sulcus (which size is0.5 mmless than IOL diameter without forward «vaulting». 

  2. Optimization of confocal scanning laser ophthalmoscope design.

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    LaRocca, Francesco; Dhalla, Al-Hafeez; Kelly, Michael P; Farsiu, Sina; Izatt, Joseph A

    2013-07-01

    Confocal scanning laser ophthalmoscopy (cSLO) enables high-resolution and high-contrast imaging of the retina by employing spatial filtering for scattered light rejection. However, to obtain optimized image quality, one must design the cSLO around scanner technology limitations and minimize the effects of ocular aberrations and imaging artifacts. We describe a cSLO design methodology resulting in a simple, relatively inexpensive, and compact lens-based cSLO design optimized to balance resolution and throughput for a 20-deg field of view (FOV) with minimal imaging artifacts. We tested the imaging capabilities of our cSLO design with an experimental setup from which we obtained fast and high signal-to-noise ratio (SNR) retinal images. At lower FOVs, we were able to visualize parafoveal cone photoreceptors and nerve fiber bundles even without the use of adaptive optics. Through an experiment comparing our optimized cSLO design to a commercial cSLO system, we show that our design demonstrates a significant improvement in both image quality and resolution.

  3. Lyme disease associated neuroretinitis - Case report.

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    Vanya, Melinda; Fejes, Imre; Jako, Maria; Tula, Areta; Terhes, Gabriella; Janaky, Marta; Bartfai, Gyorgy

    2015-12-01

    We describe a rare case of Lyme disease complicated by unilateral neuroretinitis in the right eye. We report a case of a 27-year-old woman with blurred vision on her right eye. Because of the suspicion of optic neuritis (multiplex sclerosis) neurological examination was ordered. Surprisingly, computer tomography of the brain revealed incomplete empty sella, which generally results not monocular, but bilateral optic nerve swelling. Opthalmological examination (ophthalmoscopy and optical coherence tomography) indicated not only monocular optic nerve, but retinal oedema next to the temporal part of the right optic disk. Visual evoked potentials (VEP) demonstrated no P100 latency delay and mild differences between the amplitudes of the responses of the left and right eye. Optical coherence tomography (OCT) demonstrated the swelling of the optic nerve head and oedematous retina at the temporal part of the disk. Suspicion of an inflammatory cause of visual disturbance blood tests was ordered. Doxycycline treatment was ordered till the result of the blood test arrived. The Western blot and ELISA test were positive for Borrelia burgdorferi sensu lato. Following one week corticosteroide and ceftriaxone treatments, the patient displayed a clinical improvement. Unilateral neuroretinitis with optic disk swelling due to neuroborreliosis is a rare complication and in many cases it is difficult to distinguish between inflammatory and ischemic lesions. Further difficulty in the diagnosis can occur when intracranial alterations such as empty sella is demonstrated by CT examination.

  4. Ocular changes in pregnant Nigerian women.

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    Ebeigbe, J A; Ebeigbe, P N; Ighoroje, Ada

    2012-01-01

    Pregnancy results in a lot of hormonal changes in the body and the eyes are no exception. These ocular changes could be physiologic, pathologic or a modification of a pre-existing condition. The aim of this study was to determine physiologic ocular changes that are associated with pregnancy in healthy Nigerian women. A total of 100 women were followed longitudinally through out the course of their pregnancy and 6 weeks postpartum. The women were recruited at 8 weeks of pregnancy at the anti-natal clinic in the Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Nigeria. The women were aged between 20 and 35 years. Tests carried out included visual acuity, ophthalmoscopy, retinoscopy, and tonometry. The tests were carried out in each of the three trimesters of pregnancy and 6 weeks postpartum. There was a fall in intraocular pressure across the trimesters and this was very significant (Pchanges associated with pregnancy are transient and most tend to resolve postpartum, with values returning to near pre-pregnant state.

  5. Efficacy of intravitreal Ranibizumab injection for choroidal neovascularization secondary to pathologic myopia

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    Li-Hong Cui

    2016-03-01

    Full Text Available AIM:To observe the efficacy and safety of intravitreal Ranibizumab injection in patiens with choroidal neovascularization(CNVsecondary to pathologic myopia.METHODS:In this retrospective and comparative study,24 patients(25 eyeswith CNV secondary to pathologic myopia were enrolled. All patients were assessed by examinations of ETDRS visual acuity chart, preplaced-mirror ophthalmoscopy, fundus fluorescein angiography(FFA, indocyanine green angiography(ICGAand optical coherence tomography(OCT. Patiens received intravitreally injected ranibizumab 0.5mg(0.05mL. Treatments were repeated if the follow-up indicated that it was necessary. The follow-up periods were 4~10mo. Best corrected visual acuity(BCVA, central macular thickness(CMTand leakage of CNV before and after the treatment were compared. RESULTS:No local or systemic complications occurred in any patients during the treatment or follow-up. The average time of injection was 1.52. The mean BCVA was 23.93±12.46 letters before the therapy. In the last follow-up, the mean BCVA was 40.63±7.25 letters, improved by 14.27±9.36 letters and the difference was statically significant(t=5.74, Pt=3.96, PCONCLUSION:Intravitreal ranibizumab injection for CNV secondary to pathologic myopia is safe and effective, and this treatment can improve visual acuity, reduce retina edema and leakage of CNV.

  6. TEAR SUBSTITUTES PREVENT OPHTHALMIC COMPLICATIONS IN INTENSIVE CARE UNIT PATIENTS

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    S. A. Kochergin

    2015-01-01

    Full Text Available Aim. To study the effects of Cationorm for the prevention of ophthalmic complications in intensive care unit (ICU patients and to compare the efficacy of ocular surface lubricants used in ICU. Patients and methods. 50 ICU patients (100 eyes with bilateral lagophthalmos (2 mm or more were enrolled in the study. Study group and control group each included 25 patients (50 eyes who were on deep sedation and ventilator. Before and after the treatment, general examination, biomicroscopy, tonometry, ophthalmoscopy, Schirmer’s test and Norn’s test (with fluorescein were performed. Results. Cationorm significantly improves tear film stability without any corneal epithelial defects (100 % of patients. In 7 controls (14 eyes, 28 %, initial signs of corneal xerosis and exposure keratitis were revealed. Conclusions. ICU patients are at high risk of complications due to hypodynamia and reduced innervation of the eye and its appendages. Bilateral lagophthalmos develops in 16.67 % of ICU patients who are on deep sedation and ventilator (up to 3 days. In the abscence of preventive therapy, lagophthalmos results in complications, i.e., keratitis and, occasionally, corneal ulceration and perforation. ICU patients require ophthalmological examination and tear substitutes. Regular instillations of Cationorm minimize ophthalmic complications due to intensive therapy. Cationorm restores tear firm architectonics and may be considered as a first-line choice for such disorders. 

  7. Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

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    Navarro, Rodrigo M.; Machado, Leonardo M.; Maia, Ossires; Wu, Lihteh; Farah, Michel E.; Magalhaes, Octaviano; Arevalo, J. Fernando; Maia, Mauricio

    2015-01-01

    Purpose. To determine the efficacy of 23-gauge pars plana vitrectomy (PPV) for symptomatic posterior vitreous detachment (PVD) on visual acuity (VA) and quality after multifocal intraocular lenses (IOLs). Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA), intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25) was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test. Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P = 0.017). All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P = 0.023), near activities (P = 0.043), distance activities (P = 0.041), mental health (P = 0.011), role difficulties (P = 0.042), and driving (P = 0.016). Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised. PMID:26504590

  8. Comparison of intravitreal ranibizumab and bevacizumab treatment for retinopathy of prematurity

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    Muhammet Kazim Erol

    2015-12-01

    Full Text Available ABSTRACT Purpose: To compare the efficacy of intravitreal ranibizumab and bevacizumab treatment for type 1 retinopathy of prematurity (ROP. Methods: 36 eyes of 20 patients with type 1 ROP who received anti-vascular endothelial growth factor (anti-VEGF intravitreal injections between August 2011 and February 2013 were retrospectively evaluated. Fifteen eyes of 8 patients received 0.25 mg ranibizumab (group 1, and 21 eyes of 12 patients received 0.625 mg bevacizumab (group 2. Eyes were examined by indirect ophthalmoscopy on the first day, third day, first week, and first month and as required after injections. Laser photocoagulation was performed in cases with progression of ROP. Results: The mean gestation time was 26.2 ± 2.7 weeks in group 1 patients and 27.1 ± 2.5 weeks in group 2 patients. No statistical difference in the time of gestation was observed between the two groups. The mean follow-up period was 20 ± 4.5 months. Laser photocoagulation was performed in 6 of 15 eyes from group 1 and 2 of 21 eyes from group 2. No eyes developed retinal detachment during the follow-up period. Conclusion: Ranibizumab and bevacizumab showed an efficacy in the treatment of type 1 ROP. The incidence of disease relapse was higher in eyes which received ranibizumab. Further randomized, controlled clinical trials are required to compare the efficacy of ranibizumab and bevacizumab.

  9. Leber's hereditary optic neuroretinopathy (LHON) associated with mitochondrial DNA point mutation G11778A in two Croatian families.

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    Martin-Kleiner, Irena; Gabrilovac, Jelka; Bradvica, Mario; Vidović, Tomislav; Cerovski, Branimir; Fumić, Ksenija; Boranić, Milivoj

    2006-03-01

    Leber's hereditary optic neuroretinopathy (LHON) is manifested as a bilateral acute or subacute loss of central vision due to optic atrophy. It is linked to point mutations of mitochondrial DNA, which is inherited maternally. The most common mitochondrial DNA point mutations associated with LHON are G3460A, G11778A and T14484C. These mutations are linked with the defects of subunits of the complex I (NADH-dehydrogenase-ubiquinone reductase) in mitochondria. The G11778A mitochondrial DNA point mutation is manifested by a severe visual impairment. In this paper two Croatian families with the LHON G11778A mutation are presented. Three LHON patients from two families were younger males which had the visual acuity of 0.1 or below, the ophthalmoscopy revealed telangiectatic microangiopathy and papilloedema, while Goldmann kinetic perimetry showed a central scotoma. The mothers and female relatives were LHON mutants without symptoms, whereas their sons suffered from a severe visual impairment. Molecular diagnosis helps to explain the cause of LHON disease.

  10. Reduced bone mineral density and hyaloid vasculature remnants in a consanguineous recessive FEVR family with a mutation in LRP5.

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    Downey, L M; Bottomley, H M; Sheridan, E; Ahmed, M; Gilmour, D F; Inglehearn, C F; Reddy, A; Agrawal, A; Bradbury, J; Toomes, C

    2006-09-01

    Familial exudative vitreoretinopathy (FEVR) is an inherited blinding condition characterised by abnormal development of the retinal vasculature. FEVR has multiple modes of inheritance, and homozygous mutations in LRP5 have recently been reported as underlying the recessive form of this disease. The aim of this study was to examine LRP5 in a consanguineous recessive FEVR family and to clarify the eye and bone phenotype associated with recessive FEVR. All family members were examined by slit lamp biomicroscopy and indirect ophthalmoscopy. Linkage to LRP5 was determined by genotyping microsatellite markers, constructing haplotypes and calculating lod scores. Mutation screening of LRP5 was performed by polymerase chain reaction amplification of genomic DNA followed by direct sequencing. Bone mineral density (BMD) was evaluated in all family members using dual energy x ray absorptiometry (DEXA). The clinical features observed in this family were consistent with a diagnosis of recessive FEVR. A homozygous LRP5 missense mutation, G550R, was identified in all affected individuals and all unaffected family members screened were heterozygous carriers of this mutation. Reduced BMD, hyaloid vasculature remnants, and nystagmus were features of the phenotype. Recessive mutations in LRP5 can cause FEVR with reduced BMD and hyaloid vasculature remnants. Assessment of a patient with a provisional diagnosis of FEVR should therefore include investigation of BMD, with reduced levels suggestive of an underlying LRP5 mutation.

  11. Early diagnosis of diabetic retinopathy in primary care

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    María Valeria Jiménez-Báez

    2015-03-01

    Full Text Available Objective:To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2 in Quintana Roo, México.Methods:Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed.Results:In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women.Conclusions:The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases.

  12. A Portable, Inexpensive, Nonmydriatic Fundus Camera Based on the Raspberry Pi® Computer

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    Bailey Y. Shen

    2017-01-01

    Full Text Available Purpose. Nonmydriatic fundus cameras allow retinal photography without pharmacologic dilation of the pupil. However, currently available nonmydriatic fundus cameras are bulky, not portable, and expensive. Taking advantage of recent advances in mobile technology, we sought to create a nonmydriatic fundus camera that was affordable and could be carried in a white coat pocket. Methods. We built a point-and-shoot prototype camera using a Raspberry Pi computer, an infrared-sensitive camera board, a dual infrared and white light light-emitting diode, a battery, a 5-inch touchscreen liquid crystal display, and a disposable 20-diopter condensing lens. Our prototype camera was based on indirect ophthalmoscopy with both infrared and white lights. Results. The prototype camera measured 133mm×91mm×45mm and weighed 386 grams. The total cost of the components, including the disposable lens, was $185.20. The camera was able to obtain good-quality fundus images without pharmacologic dilation of the pupils. Conclusion. A fully functional, inexpensive, handheld, nonmydriatic fundus camera can be easily assembled from a relatively small number of components. With modest improvements, such a camera could be useful for a variety of healthcare professionals, particularly those who work in settings where a traditional table-mounted nonmydriatic fundus camera would be inconvenient.

  13. A Portable, Inexpensive, Nonmydriatic Fundus Camera Based on the Raspberry Pi® Computer

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    Shen, Bailey Y.

    2017-01-01

    Purpose. Nonmydriatic fundus cameras allow retinal photography without pharmacologic dilation of the pupil. However, currently available nonmydriatic fundus cameras are bulky, not portable, and expensive. Taking advantage of recent advances in mobile technology, we sought to create a nonmydriatic fundus camera that was affordable and could be carried in a white coat pocket. Methods. We built a point-and-shoot prototype camera using a Raspberry Pi computer, an infrared-sensitive camera board, a dual infrared and white light light-emitting diode, a battery, a 5-inch touchscreen liquid crystal display, and a disposable 20-diopter condensing lens. Our prototype camera was based on indirect ophthalmoscopy with both infrared and white lights. Results. The prototype camera measured 133mm × 91mm × 45mm and weighed 386 grams. The total cost of the components, including the disposable lens, was $185.20. The camera was able to obtain good-quality fundus images without pharmacologic dilation of the pupils. Conclusion. A fully functional, inexpensive, handheld, nonmydriatic fundus camera can be easily assembled from a relatively small number of components. With modest improvements, such a camera could be useful for a variety of healthcare professionals, particularly those who work in settings where a traditional table-mounted nonmydriatic fundus camera would be inconvenient.

  14. A Portable, Inexpensive, Nonmydriatic Fundus Camera Based on the Raspberry Pi® Computer.

    Science.gov (United States)

    Shen, Bailey Y; Mukai, Shizuo

    2017-01-01

    Purpose. Nonmydriatic fundus cameras allow retinal photography without pharmacologic dilation of the pupil. However, currently available nonmydriatic fundus cameras are bulky, not portable, and expensive. Taking advantage of recent advances in mobile technology, we sought to create a nonmydriatic fundus camera that was affordable and could be carried in a white coat pocket. Methods. We built a point-and-shoot prototype camera using a Raspberry Pi computer, an infrared-sensitive camera board, a dual infrared and white light light-emitting diode, a battery, a 5-inch touchscreen liquid crystal display, and a disposable 20-diopter condensing lens. Our prototype camera was based on indirect ophthalmoscopy with both infrared and white lights. Results. The prototype camera measured 133mm × 91mm × 45mm and weighed 386 grams. The total cost of the components, including the disposable lens, was $185.20. The camera was able to obtain good-quality fundus images without pharmacologic dilation of the pupils. Conclusion. A fully functional, inexpensive, handheld, nonmydriatic fundus camera can be easily assembled from a relatively small number of components. With modest improvements, such a camera could be useful for a variety of healthcare professionals, particularly those who work in settings where a traditional table-mounted nonmydriatic fundus camera would be inconvenient.

  15. Two Cases of Endogenous Endophthalmitis Caused by Gram-Positive Bacteria with Good Visual Outcome

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    Machiko Itoh

    2010-09-01

    Full Text Available Background: Endogenous endophthalmitis is a rare disease and its visual prognosis is poor. Case Reports: We present two patients, a 60-year-old man and a 53-year-old man, who developed endogenous endophthalmitis caused byGram-positive organismsbut recovered good vision after antibiotics and vitrectomy. Results: The first patient complained of ocular pain and visual decrease in his right eye. Ophthalmoscopy showed inflammation in the anterior chamber and vitreous opacities. Antibiotic was administrated systemically, and blood culture detected Streptococcus anginosus. He underwent successful heart surgery for endocarditis and total dental extraction for severe gingivitis. Vitrectomy was performed 36 days after the onset and vision improved from 0.02 to 0.7. The second patient was referred for acute visual decrease in his left eye. Severe iritis and vitreous opacities were observed, and systemic examination showed acute pyelitis and prostatic abscesses. Blood cultures detected Staphylococcus sp., and systemic antibiotics were given. Vitrectomy was performed 12 days after the onset, and vision improved from 0.06 to 1.2. Conclusions: We conclude that the rapid treatment with systemic antibiotics for the organisms at the primary site, and the vitrectomy, even though delayed, can lead to a good recovery of vision.

  16. Novel molecular imaging approach for subclinical detection of iritis and evaluation of therapeutic success.

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    Xie, Fang; Sun, Dawei; Schering, Alexander; Nakao, Shintaro; Zandi, Souska; Liu, Ping; Hafezi-Moghadam, Ali

    2010-07-01

    There is an urgent need for early diagnosis in medicine, whereupon effective treatments could prevent irreversible tissue damage. Acute anterior chamber inflammation is the most common form of uveitis and a major cause of vision loss. The proximity of the iris vasculature to the light-permeable cornea and its involvement in ocular inflammation make it an ideal target for noninvasive molecular imaging. To accomplish this, carboxylated fluorescent microspheres (MSs) were conjugated with recombinant P-selectin glycoprotein ligand-1 and systemically injected in endotoxin-induced uveitic animals. MS adhesion in the microcirculation of the anterior and posterior chamber was visualized by intravital microscopy and scanning laser ophthalmoscopy. In iritic animals, significantly higher numbers of recombinant P-selectin glycoprotein ligand-1-conjugated MSs adhered to the endothelium (P = 0.03) matching the increase in leukocyte adhesion. Conjugated MSs specifically interacted with firmly adhering leukocytes, allowing quantification of the endogenous immune response. Topical eye drop treatment with dexamethasone (P < 0.01) or cyclosporine A (P < 0.01) significantly lowered MS adhesion in iris vessels. Surprisingly, topical dexamethasone significantly reduced MS interaction in the fundus vessels (P < 0.01), while cyclosporine A did not. In vivo MS accumulation preceded clinical signs of anterior uveitis and leukocyte adhesion in iris vasculature. This work introduces noninvasive subclinical detection of endothelial injury in the iris vasculature, providing a unique opportunity for quantifying vascular injury and immune response in vivo.

  17. Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

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    Shih Hao Wang

    2017-01-01

    Full Text Available A case of choroidal rupture caused by airbag-associated blunt eye trauma and complicated with massive subretinal hemorrhage and vitreous hemorrhage that was successfully treated with intravitreal injection of expansile gas and bevacizumab is presented. A 53-year-old man suffered from loss of vision in his right eye due to blunt eye trauma by a safety airbag after a traffic accident. On initial examination, the patient had no light perception in his right eye. Dilated ophthalmoscopy revealed massive subretinal hemorrhage with macular invasion and faint vitreous hemorrhage. We performed intravitreal injection of pure sulfur hexafluoride twice for displacement, after which visual acuity improved to 0.03. For persistent subretinal hemorrhage and suspicion of choroidal neovascularization (CNV, intravitreal bevacizumab (1.25 mg/0.05 mL injection was administered. After 3 weeks, the visual acuity of his right eye recovered to 0.4. For early-stage choroidal rupture-induced subretinal hemorrhage and complications of suspected CNV, intravitreal injection of expandable gas and intraocular injection of antiangiogenesis drugs seem to be an effective treatment.

  18. Sub-chronic safety evaluation of the ethanol extract of Aralia elata leaves in Beagle dogs.

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    Li, Fengjin; He, Xiaoli; Niu, Wenying; Feng, Yuenan; Bian, Jingqi; Kuang, Haixue; Xiao, Hongbin

    2016-08-01

    Aralia elata Seem. (A. elata) is a traditional Chinese medicine to treat some diseases. This investigation aims to evaluate the pharmaceutical safety of the ethanol extract of A. elata leaves, namely ethanol leaves extract (ELE), in Beagle dogs. In sub-chronic oral toxicity study, dogs were treated with the ELE at doses of 50, 100 and 200 mg/kg for 12 weeks and followed by 4 weeks recovery period. During experimental period, clinical signs, mortality, body temperature, food consumption and body weight were recorded. Analysis of electrocardiogram, urinalysis, ophthalmoscopy, hematology, serum biochemistry, organ weights and histopathology were performed. The results showed that both food consumption and body weight significantly decreased in high-dose group. Treatment-related side effects and mortality were observed in high-dose female dogs. Some parameters showed significant alterations in electrocardiogram, urinalysis, serum biochemistry and relative organ weights. These alterations were not related to dose or consistent across gender, which were ascribed to incidental and biological variability. The findings in this study indicated that the no-observed adverse effect level (NOAEL) of the ELE was 100 mg/kg in dogs and provided a vital reference for selecting a safe application dosage for human consumption.

  19. Retinoblastoma diagnosis: a proposal based on the experience of Centro Infantil Boldrini, Brazil.

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    Palazzi, Maristela A; Stephan, Celso; Brandalise, Silvia R; Aguiar, Simone Dos Santos

    2013-08-01

    Advanced disease is a risk factor for eye loss in patients with retinoblastoma (RB). We still record critical rates of enucleation, especially for unilateral RB due to advanced stages of disease at diagnosis. This retrospective study of 223 RB patient records referred to treatment at Centro Infantil Boldrini, Brazil, between 1978 and 2008, showed that 176 patients (79%) presented intraocular tumors while 47 (21%) already had extraocular involvement. At the time of diagnosis, the age of patients was 26.2 months in the group that had enucleated eyes and 13.7 months in the group that preserved both eyes. Under a multiple logistic regression model, familial history (OR = 0.195; p = .01) and age at diagnosis in months (OR = 1.047; p = .04) were significantly correlated with enucleation. Strategies to early detect RB must be changed in order to offer better chances of ocular preservation with visual function. Authors propose a systematic referral of all children to the ophthalmologist for an indirect ophthalmoscopy once a year in the first two years of life, as a measure to be adopted by all pediatricians in daily routine to early detect the tumor.

  20. Decalcified choroidal osteoma found in the retina

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    Yoshikawa T

    2012-11-01

    Full Text Available Tadanobu Yoshikawa, Kanji TakahashiDepartment of Ophthalmology, Kansai Medical University, Hirakata Hospital, Osaka, JapanAbstract: Choroidal osteoma is a benign tumor of the choroid. Herein, we report a rare case of decalcified choroidal osteoma found in the retina. A 27-year-old woman presented with visual loss. Her best-corrected visual acuity was 20/50 OS. Ophthalmoscopy of the left eye revealed a yellow-white calcified region accompanied by a decalcified region of four disc diameters in size. After 6 years, spectral-domain optical coherence tomography showed a tumor projected strongly upwards from the choroid and partially through the retina with serous retinal detachment, with both a lamellar appearance and mound-like area. The calcified region became more contractive than was observed on the first visit. Conversely, the decalcified region was wider than was observed on the first visit. Her best-corrected visual acuity was 20/400 OS. Choroidal osteoma was worsened by progression of decalcification. The decalcified choroidal osteoma resulted in poor visual acuity, and projected strongly upward from the choroid and into the retina.Keywords: osteoma, decalcification, choroidal osteoma

  1. Lip twitch restraint on rebound tonometry in horses

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    Maria Cristina Caldart de Andrade

    2016-01-01

    Full Text Available ABSTRACT: The purpose of this study was to verify the effect of the upper lip twitch restraint on intraocular pressure (IOP of healthy horses. In this study, forty five Criollo horses, aged between two to 20 years (male or female were evaluated with rebound tonometer, with and without upper lip twitch restraint. A previous ophthalmic examination was performed with Schirmer tear test, fluorescein test, slit lamp biomicroscopy and direct ophthalmoscopy in all horses. Only healthy animals with no ocular findings were used. The order of the IOP measurements (with or without twitch and order of the eye (right or left were randomized. Three measurements of each eye were made and the mean was calculated. Head position was kept above the heart level and no pressure was made over eyelids. At least 10 minutes passed between the evaluations of the same horse. Measurements were made between 3:30 and 5:30pm to avoid circadian fluctuation of intraocular pressure. Statistical analysis was performed with SAS 9.2 software. A Split plot factorial design was used where horses were considered blocks. The mean intraocular pressure values obtained with lip twitch restraint (34.68±6.47mmHg were significantly higher (P<0.05 than those obtained without (29.35±4.08mmHg. There was no relevant statistical difference between right and left eyes. The restraint of horses with upper lip twitch increased equine intraocular pressure measured with the rebound tonometry.

  2. Role of Q-switched ND:YAG laser in nevus of Ota: A study of 25 cases

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    Shivangi Sharma

    2011-01-01

    Full Text Available Background: Nevus of Ota is common condition in Indian patients. The condition is more common in females, with a male-female ratio of 1:4.8. Aim : To evaluate long-term efficacy safety and stability of Q-switched ND:YAG laser in treatment of Nevus of Ota. Design: 6 month follow-up of patients of Nevus of Ota, treated with Q-switched ND:YAG laser Materials and Methods : Twenty-five patients of Nevus of Ota were treated with Q-switched ND:YAG laser for a period of 1 year and 9 months; patient had fitzpatricks skin type 4 and 5; detailed history, clinical examination, ophthalmoscopy, and otoscopy was done in all cases; clinical photographs were taken before and after the completion of treatments. Six-month follow-up was done after the last session. Response to treatment was graded based on physician′s global assessment. Result : More than 70% improvement was seen in 15 patients (60%. Eight patients (32% had moderate and two patients (8% showed mild improvement.

  3. Compass: clinical evaluation of a new instrument for the diagnosis of glaucoma.

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    Luca Rossetti

    Full Text Available To evaluate Compass, a new instrument for glaucoma screening and diagnosis that combines scanning ophthalmoscopy, automated perimetry, and eye tracking.A total of 320 human subjects (200 normal, 120 with glaucoma underwent full ophthalmological evaluation and perimetric evaluation using the Humphrey SITA standard 24° test (HFA, and the Compass test that consisted of a full-threshold program on the central 24° with a photograph of the central 30° of the retina. A subgroup of normal subjects and glaucoma patients underwent a second Compass test during the same day in order to study test-retest variability. After exclusion of 30 patients due to protocol rules, a database was created to compare the Compass to the HFA, and to evaluate retinal image quality and fixation stability.The difference in mean sensitivity between Compass and HFA was -1.02 ± 1.55 dB in normal subjects (p65% of cases; Image-based diagnosis was in accordance with the initial diagnosis in 85% of the subjects.Based on preliminary results, Compass showed useful diagnostic characteristics for the study of glaucoma, and combined morphological information with functional data.

  4. Genetics of Bietti Crystalline Dystrophy.

    Science.gov (United States)

    Ng, Danny S C; Lai, Timothy Y Y; Ng, Tsz Kin; Pang, Chi Pui

    2016-01-01

    Bietti crystalline dystrophy (BCD) is an inherited retinal degenerative disease characterized by crystalline deposits in the retina, followed by progressive atrophy of the retinal pigment epithelium (RPE), choriocapillaris, and photoreceptors. CYP4V2 has been identified as the causative gene for BCD. The CYP4V2 gene belongs to the cytochrome P450 superfamily and encodes for fatty acid ω-hydroxylase of both saturated and unsaturated fatty acids. The CYP4V2 protein is localized most abundantly within the endoplasmic reticulum in the RPE and is postulated to play a role in the physiological lipid recycling system between the RPE and photoreceptors to maintain visual function. Electroretinographic assessments have revealed progressive dysfunction of rod and cone photoreceptors in patients with BCD. Several genotypes have been associated with more severe phenotypes based on clinical and electrophysiological findings. With the advent of multimodal imaging with spectral domain optical coherence tomography, fundus autofluorescence, and adaptive optics scanning laser ophthalmoscopy, more precise delineation of BCD severity and progression is now possible, allowing for the potential future development of targets for gene therapy.

  5. Neuroprotection in a novel mouse model of multiple sclerosis.

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    Katie Lidster

    Full Text Available Multiple sclerosis is an immune-mediated, demyelinating and neurodegenerative disease that currently lacks any neuroprotective treatments. Innovative neuroprotective trial designs are required to hasten the translational process of drug development. An ideal target to monitor the efficacy of strategies aimed at treating multiple sclerosis is the visual system, which is the most accessible part of the human central nervous system. A novel C57BL/6 mouse line was generated that expressed transgenes for a myelin oligodendrocyte glycoprotein-specific T cell receptor and a retinal ganglion cell restricted-Thy1 promoter-controlled cyan fluorescent protein. This model develops spontaneous or induced optic neuritis, in the absence of paralytic disease normally associated with most rodent autoimmune models of multiple sclerosis. Demyelination and neurodegeneration could be monitored longitudinally in the living animal using electrophysiology, visual sensitivity, confocal scanning laser ophthalmoscopy and optical coherence tomography all of which are relevant to human trials. This model offers many advantages, from a 3Rs, economic and scientific perspective, over classical experimental autoimmune encephalomyelitis models that are associated with substantial suffering of animals. Optic neuritis in this model led to inflammatory damage of axons in the optic nerve and subsequent loss of retinal ganglion cells in the retina. This was inhibited by the systemic administration of a sodium channel blocker (oxcarbazepine or intraocular treatment with siRNA targeting caspase-2. These novel approaches have relevance to the future treatment of neurodegeneration of MS, which has so far evaded treatment.

  6. Treatment of retinal detachment due to macular hole in high myopia by vitrectomy with posterior sclera reinforcement

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    Hui-Ru Lin

    2015-05-01

    Full Text Available AIM: To evaluate the efficacy of the method of vitrectomy combined with posterior sclera reinforcement for retinal detachment due to macular hole in high myopia.METHODS: From January 2012 to December 2013, in 45 eyes of 45 high myopic patients with retinal detachment due to macular hole, 28 eyes were in group A of vitrectomy with posterior sclera reinforcement and 17 eyes were in group B of vitrectomy. Preoperative examinations included visual acuity, intraocular pressure, indirect ophthalmoscopy and OCT were performed. In follow-up 6 to 12mo, postoperative examinations of visual acuity, OCT were performed and effects of retinal reattachment and macular hole closure were compared between the two groups. RESULTS:(1Postoperative examinations: visual acuity was 1.19±0.39 in group A and 1.51±0.34 in group B. The differences were statistically significant(PP>0.05.(3The macular hole closure rate was 82% in group A and 53% in group B. The differences were statistically significant(PCONCLUSION: The treatment of vitrectomy with posterior sclera reinforcement is safe and feasible, which could improve visual acuity and increase the rate of macular hole closure in treating retinal detachment due to macular hole in high myopia.

  7. Master slave en-face OCT/SLO

    Science.gov (United States)

    Bradu, Adrian; Kapinchev, Konstantin; Barnes, Frederick; Podoleanu, Adrian

    2015-01-01

    Master Slave optical coherence tomography (MS-OCT) is an OCT method that does not require resampling of data and can be used to deliver en-face images from several depths simultaneously. As the MS-OCT method requires important computational resources, the number of multiple depth en-face images that can be produced in real-time is limited. Here, we demonstrate progress in taking advantage of the parallel processing feature of the MS-OCT technology. Harnessing the capabilities of graphics processing units (GPU)s, information from 384 depth positions is acquired in one raster with real time display of up to 40 en-face OCT images. These exhibit comparable resolution and sensitivity to the images produced using the conventional Fourier domain based method. The GPU facilitates versatile real time selection of parameters, such as the depth positions of the 40 images out of the set of 384 depth locations, as well as their axial resolution. In each updated displayed frame, in parallel with the 40 en-face OCT images, a scanning laser ophthalmoscopy (SLO) lookalike image is presented together with two B-scan OCT images oriented along rectangular directions. The thickness of the SLO lookalike image is dynamically determined by the choice of number of en-face OCT images displayed in the frame and the choice of differential axial distance between them. PMID:26417531

  8. FLIMX: A Software Package to Determine and Analyze the Fluorescence Lifetime in Time-Resolved Fluorescence Data from the Human Eye

    Science.gov (United States)

    Klemm, Matthias; Schweitzer, Dietrich; Peters, Sven; Sauer, Lydia; Hammer, Martin; Haueisen, Jens

    2015-01-01

    Fluorescence lifetime imaging ophthalmoscopy (FLIO) is a new technique for measuring the in vivo autofluorescence intensity decays generated by endogenous fluorophores in the ocular fundus. Here, we present a software package called FLIM eXplorer (FLIMX) for analyzing FLIO data. Specifically, we introduce a new adaptive binning approach as an optimal tradeoff between the spatial resolution and the number of photons required per pixel. We also expand existing decay models (multi-exponential, stretched exponential, spectral global analysis, incomplete decay) to account for the layered structure of the eye and present a method to correct for the influence of the crystalline lens fluorescence on the retina fluorescence. Subsequently, the Holm-Bonferroni method is applied to FLIO measurements to allow for group comparisons between patients and controls on the basis of fluorescence lifetime parameters. The performance of the new approaches was evaluated in five experiments. Specifically, we evaluated static and adaptive binning in a diabetes mellitus patient, we compared the different decay models in a healthy volunteer and performed a group comparison between diabetes patients and controls. An overview of the visualization capabilities and a comparison of static and adaptive binning is shown for a patient with macular hole. FLIMX’s applicability to fluorescence lifetime imaging microscopy is shown in the ganglion cell layer of a porcine retina sample, obtained by a laser scanning microscope using two-photon excitation. PMID:26192624

  9. Optic atrophy, necrotizing anterior scleritis and keratitis presenting in association with Streptococcal Toxic Shock Syndrome: a case report

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    Papageorgiou Konstantinos I

    2008-02-01

    Full Text Available Abstract Introduction We report a case of optic atrophy, necrotizing anterior scleritis and keratitis presenting in a patient with Streptococcal Toxic Shock Syndrome. Case presentation A 43-year-old woman developed streptococcal toxic shock syndrome secondary to septic arthritis of her right ankle. Streptococcus pyogenes (b-haemolyticus Group A was isolated from blood cultures and joint aspirate. She was referred for ophthalmology review as her right eye became injected and the pupil had become unresponsive to light whilst she was in the Intensive Therapy Unit (ITU. The iris appeared atrophic and was mid-dilated with no direct or consensual response to light. Three zones of sub-epithelial opacification where noted in the cornea. There where extensive posterior synechiae. Indirect ophthalmoscopy showed a pale right disc. The vision was reduced to hand movements (HM. A diagnosis of optic atrophy was made secondary to post-streptococcal uveitis. She subsequently developed a necrotizing anterior scleritis. Conclusion This case illustrates a previously unreported association of optic atrophy, necrotizing anterior scleritis and keratitis in a patient with post-streptococcal uveitis. This patient had developed Streptococcal Toxic Shock Syndrome secondary to septic arthritis. We recommend increased awareness of the potential risks of these patients developing severe ocular involvement.

  10. Accidental bilateral Q-switched neodymium laser exposure: treatment and recovery of visual function

    Science.gov (United States)

    Zwick, Harry; Stuck, Bruce E.; Dunlap, Weldon; Scales, David K.; Lund, David J.; Ness, James W.

    1998-05-01

    A 21 year old female was accidentally exposed in both eyes when she looked into the 10 cm exit aperture of a military laser designator emitting 1064 nm q-switched (30 ns) pulses at a 10 pulse per second rate. Steroid therapy (methylprednisolone sodium succinate) was initiated within 6 hours post exposure. Initial ophthalmoscopic observation revealed small contained macular hemorrhages in each eye. Fluorescein angiography (FA) showed minimal leakage. Visual acuity was 20/100 and 20/60 in OD and OS respectively. Contrast sensitivity in both eyes was depressed across all spatial frequencies by more than 1.5 log units. At four weeks post exposure, no significant macular scarring was apparent and visual acuity returned to 20/25 in both eyes. Contrast sensitivity had improved to normal levels with a peak at 3 cycles/degree. At one year post exposure, visual acuity was 20/13 in both eyes and measures of contrast sensitivity were within normal limits. During the course of recovery, the patient's fixation shifted from a slightly superior temporal site back to the central foveal region. The foveal lesion sites were still evident by ophthalmoscopy and Amsler grid measurements but were deemed functional when the patient placed small targets generated by the scanning laser ophthalmoscope in the lesion site for discrimination. This outcome indicates remarkable recovery of visual function and suggests that early administration of steroids may assist in preserving the natural neural recovery process of the photoreceptor matrix by minimizing intraretinal scar formation.

  11. Differential Diagnosis for Multiple Sclerosis-related Optic Neuritis

    Institute of Scientific and Technical Information of China (English)

    Yan Zhang; Xiaolei Liang; Shihui Wei; Hongyang Li

    2015-01-01

    Purpose:.To analyze clinical features and main causes of multiple sclerosis-related optic neuritis (MS-ON), providing evidence for the differential diagnosis of MS-ON. Methods: Clinical data were collected from 527 patients, 123 males and 404 females, diagnosed with MS-ON between June 2008 and June 2013. Visual acuity, optometry, visual field, slit-lamp microscopy, indirect ophthalmoscopy (20D), opti-cal coherence tomography (OCT) and magnetic resonance imaging (MRI) were performed. Venous blood was sampled for detection of autoimmune antibodies and Aquaporin (AQP-4). Results:.Fifty nine cases were diagnosed with neuromyelitis optica-related optic neuritis. (NMO-ON),.27 Sjogren's syn-drome-related optic neuropathy,.22 tumors,.21 anterior is-chemic optic neuropathy, 15 radiation-induced optic neuropa-thy, 14 optic neuropathy-related infection, 17 genetic eye dis-eases and 10 open angle glaucoma. Among168 MS-ON pa-tients undergoing optic nerve MRI,90 cases (53.57%) had a lesion 30 mm in two (1.19%). Conclusion:.MS-ON is more commonly misdiagnosed with NMO-ON and Sjogren's syndrome, when compared to optic neuropathy, tumors and ischemic optic neuropathy.

  12. Precision targeting with a tracking adaptive optics scanning laser ophthalmoscope

    Science.gov (United States)

    Hammer, Daniel X.; Ferguson, R. Daniel; Bigelow, Chad E.; Iftimia, Nicusor V.; Ustun, Teoman E.; Noojin, Gary D.; Stolarski, David J.; Hodnett, Harvey M.; Imholte, Michelle L.; Kumru, Semih S.; McCall, Michelle N.; Toth, Cynthia A.; Rockwell, Benjamin A.

    2006-02-01

    Precise targeting of retinal structures including retinal pigment epithelial cells, feeder vessels, ganglion cells, photoreceptors, and other cells important for light transduction may enable earlier disease intervention with laser therapies and advanced methods for vision studies. A novel imaging system based upon scanning laser ophthalmoscopy (SLO) with adaptive optics (AO) and active image stabilization was designed, developed, and tested in humans and animals. An additional port allows delivery of aberration-corrected therapeutic/stimulus laser sources. The system design includes simultaneous presentation of non-AO, wide-field (~40 deg) and AO, high-magnification (1-2 deg) retinal scans easily positioned anywhere on the retina in a drag-and-drop manner. The AO optical design achieves an error of third generation retinal tracking system achieves a bandwidth of greater than 1 kHz allowing acquisition of stabilized AO images with an accuracy of ~10 μm. Normal adult human volunteers and animals with previously-placed lesions (cynomolgus monkeys) were tested to optimize the tracking instrumentation and to characterize AO imaging performance. Ultrafast laser pulses were delivered to monkeys to characterize the ability to precisely place lesions and stimulus beams. Other advanced features such as real-time image averaging, automatic highresolution mosaic generation, and automatic blink detection and tracking re-lock were also tested. The system has the potential to become an important tool to clinicians and researchers for early detection and treatment of retinal diseases.

  13. Fine needle aspiration biopsy to reestablish cell culture in an animal model of uveal melanoma.

    Science.gov (United States)

    Correa, Zelia Maria da Silva; Marshall, Jean-Claude; Souza Filho, João Pessoa; Odashiro, Alexandre Nakao; Burnier Jr, Miguel Noel

    2009-01-01

    To access the reliability of fine-needle aspiration biopsy in harvesting a sufficient amount of viable melanoma cells to establish a cell culture and maintain a melanoma cell line from an animal model of uveal melanoma. For this study, fifteen male New Zealand albino rabbits had their right eye surgically inoculated with uveal melanoma cell line 92.1. The animals were immunosupressed with cyclosporine A using a dose schedule previously published. The animals were followed for 12 weeks. Intraocular tumor growth was monitored weekly by indirect ophthalmoscopy. After the fourth week, one animal was sacrificed per week preceded by fine-needle aspiration biopsy using a sharp 25-gauge, 1-inch long needle. Two separate aspirates were made from different areas of the tumor. Each aspirate was flushed to a separate cell culture media and sent for cell culture. The cells were frozen after two weeks when there were at least 1 million cells, which is enough to maintain a cell line. Cells were defrosted for HMB-45 immuno-stains to confirm the melanoma origin. Cell growth was observed from the samples harvested from 11 out of the 15 animals inoculated with uveal melanoma. All cell cultures, after defrost, immunoassayed positive for HMB-45. Fine needle aspiration biopsy seems to be a reliable method to harvest cells from solid intraocular melanomas in an animal model, to establish cell culture and to maintain a melanoma cell line.

  14. Eye injury treatment in intensive care unit patients

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    L. K. Moshetova

    2015-03-01

    Full Text Available Aim. To describe eye injuries in intensive care unit (ICU patients with multitrauma, to study conjunctival microflora in these patients, and to develop etiologically and pathogenically targeted treatment and prevention of wound complications.Materials and methods. Study group included 50 patients (54 eyes with combined mechanical cerebral and eye injury. All patients underwent possible ophthalmological examination (biomicroscopy, ophthalmoscopy and ocular fundus photographing with portative fundus camera, tonometry, cranial CT and MRT, and bacteriological study of conjunctival smears. Results. Modern methods of ophthalmological examination of ICU patients provided correct diagnosis and prediction of wound healing. Eye injury treatment schedule provided maximum possible results in all ICU patients. Hospitalacquired infection results in asymptomatic dissemination of pathogenic microbes on ocular surface. Conclusions. 14-day topical treatment with antimicrobials, steroids, and NSAIDs reduces posttraumatic inflammation caused by mechanical eye injuries in ICU patients. Bacteriological studies of conjunctival smears demonstrate the presence of pathogenic flora in ICU patients. In these patients, the most effective antibacterial agents are third-generation fluoroquinolones. 

  15. Quantification and anatomic distribution of choroidal abnormalities in patients with type I neurofibromatosis.

    Science.gov (United States)

    Nakakura, Shunsuke; Shiraki, Kunihiko; Yasunari, Takaharu; Hayashi, Yoko; Ataka, Shinsuke; Kohno, Takeya

    2005-10-01

    Choroidal abnormality manifesting as a bright patchy lesion under infrared monochromatic light has previously been described in neurofibromatosis type I patients in whom the choroid appears normal under conventional ophthalmoscopic examination or on the fluorescein angiogram. We investigated the correlation between patient age and the number of choroidal abnormalities, as well as the anatomic distribution of choroidal abnormalities in the fundus. We examined the fundus of 28 eyes in 14 patients with neurofibromatosis type I. Patients ranged in age from 2 to 38 years and were examined between April 2001 and April 2002 by confocal scanning laser ophthalmoscopy with infrared monochromatic light (780 nm wavelength). We divided the fundus into five regions (one within the retinal vascular arcade and those supero-temporal, infero-temporal, supero-nasal, and infero-nasal to it), and lesions on the border between regions were assigned to the region containing the greater part of the lesion. We studied the total number of choroidal abnormalities and the correlation between the total number and age. A positive correlation was found between the total number of choroidal abnormalities and age (Spearman rank correlation coefficient, r=0.6209, P=0.0178). There was a significantly greater number of choroidal abnormalities in the arcade region than in the other four regions (ANOVA, P<0.001). Choroidal abnormalities tend to increase with age and are most often observed within the vascular arcade.

  16. Intraarterial chemotherapy for kissing macula tumors in retinoblastoma.

    Science.gov (United States)

    Abramson, David H; Marr, Brian P; Brodie, Scott; Dunkel, Ira J; Gobin, Pierre Y

    2012-01-01

    To describe the management of kissing macula retinoblastoma tumors treated with intraarterial chemotherapy. Superselective infusion of chemotherapy (combinations of melphalan, topotecan, and carboplatin) into the ophthalmic artery of children with retinoblastoma who had kissing macula tumors was administered on an outpatient basis. Results were assessed with indirect ophthalmoscopy, RetCam digital photography, B-scan ultrasonography, and electroretinograms. Three children with bilateral retinoblastoma (aged 6.1, 7, and 16 months) and kissing macula tumors in an eye were treated. All children are alive without the need for removal of the eye, systemic chemotherapy, or external beam irradiation. In each case, the kissing tumors retracted, leaving an anatomically normal fovea. Final 30-Hz flicker electroretinograms were 93.9, 65, and 63.9 μV (under anesthesia). There were no significant systemic toxicities. Superselective infusion of chemotherapy by means of the ophthalmic artery of young children with kissing macula tumors resulted in prompt shrinkage of tumors away from the fovea. There were no systemic side effects.

  17. Adaptive optics OCT using 1060nm swept source and dual deformable lenses for human retinal imaging

    Science.gov (United States)

    Jian, Yifan; Lee, Sujin; Cua, Michelle; Miao, Dongkai; Bonora, Stefano; Zawadzki, Robert J.; Sarunic, Marinko V.

    2016-03-01

    Adaptive optics concepts have been applied to the advancement of biological imaging and microscopy. In particular, AO has also been very successfully applied to cellular resolution imaging of the retina, enabling visualization of the characteristic mosaic patterns of the outer retinal layers using flood illumination fundus photography, Scanning Laser Ophthalmoscopy (SLO), and Optical Coherence Tomography (OCT). Despite the high quality of the in vivo images, there has been a limited uptake of AO imaging into the clinical environment. The high resolution afforded by AO comes at the price of limited field of view and specialized equipment. The implementation of a typical adaptive optics imaging system results in a relatively large and complex optical setup. The wavefront measurement is commonly performed using a Hartmann-Shack Wavefront Sensor (HS-WFS) placed at an image plane that is optically conjugated to the eye's pupil. The deformable mirror is also placed at a conjugate plane, relaying the wavefront corrections to the pupil. Due to the sensitivity of the HS-WFS to back-reflections, the imaging system is commonly constructed from spherical mirrors. In this project, we present a novel adaptive optics OCT retinal imaging system with significant potential to overcome many of the barriers to integration with a clinical environment. We describe in detail the implementation of a compact lens based wavefront sensorless adaptive optics (WSAO) 1060nm swept source OCT human retinal imaging system with dual deformable lenses, and present retinal images acquired in vivo from research volunteers.

  18. Retinopathy in severe malaria in Ghanaian children - overlap between fundus changes in cerebral and non-cerebral malaria

    DEFF Research Database (Denmark)

    Essuman, Vera A; Ntim-Amponsah, Christine T; Astrup, Birgitte S

    2010-01-01

    . Secondly, to determine any association between retinopathy and the occurrence of convulsions in patients with CM. Methods and subjects A cross-sectional study of consecutive patients on admission with severe malaria who were assessed for retinal signs, at the Department of Child Health, Korle-Bu Teaching...... Hospital, Accra, from July to August 2002 was done. All children had dilated-fundus examination by direct and indirect ophthalmoscopy. RESULTS: Fifty-eight children aged between six months and nine years were recruited. Twenty six(45%) had CM, 22 with convulsion; 26(45%) had SA and six(10%) had RD. Any...... retinopathy was seen in: CM 19(73%), SA 14(54%), RD 3(50.0%), CM with convulsion 15(68%) and CM without convulsion 4(100%). Comparison between CM versus non-CM groups showed a significant risk relationship between retinal whitening and CM(OR=11.0, CI=2.2- 56.1, p= 0.001). There was no significant association...

  19. Síndrome de Usher: características clínicas Usher's syndrome: clinical characteristics

    Directory of Open Access Journals (Sweden)

    Josilene de Carvalho Soares Liarth

    2002-08-01

    Full Text Available Objetivos: Descrever e analisar as manifestações clínicas da síndrome de Usher bem como, estudar o padrão hereditário da doença nos pacientes examinados. Métodos: Foram estudados quatro pacientes, com diagnóstico de síndrome de Usher, na clínica oftalmológica de um hospital geral universitário, no período de dezembro de 1997 a março de 1999. Os pacientes foram submetidos a exames de acuidade visual, refração, biomicroscopia, oftalmoscopias direta e indireta, tonometria, retinografia, campo visual com perímetro de Goldman e audiometria. Foi desenhado o heredograma da família e realizado anamnese e oftalmoscopia binocular indireta de 63 familiares. Resultados: Dos quatro pacientes com síndrome de Usher, 1 foi do tipo I e 3 do tipo II. A acuidade visual dos pacientes variou de 20/100 a 20/400 e a disacusia de moderada a grave. Todos apresentaram retinose pigmentar típica e campo visual tubular. Não foram detectados outros casos de associação de retinose pigmentar e surdez dentre os familiares examinados. Conclusão: É importante enfatizar ao oftalmologista, o diagnóstico de síndrome de Usher, diante de um caso de retinose pigmentar, chamando atenção para o seu padrão de herança autossômica recessiva, assim como para a orientação ao paciente sobre as manifestações clínicas da doença e importância do acompanhamento oftalmo-otorrinolaringológico.Purpose: To describe and analyze the clinical manifestation of Usher's syndrome and to study their hereditary standard as well. Methods: Four patients with Usher's syndrome were studied at Ophthalmologic Clinic of the Getúlio Vargas Hospital, in Teresina-PI, between December, 1997 and March, 1999. The patients were scheduled for tests of visual acuity, refraction, biomicroscopy, direct and indirect ophthalmoscopy, tonometry, retinography, visual field with Goldman perimeter and audiometry. Family's pedigree was built and an anamnesis and indirect binocular

  20. Efficacy and tolerability of bilateral sustained-release dexamethasone intravitreal implants for the treatment of noninfectious posterior uveitis and macular edema secondary to retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Ryder SJ

    2015-06-01

    Full Text Available Steven J Ryder,1 Danilo Iannetta,1 Swetangi D Bhaleeya,2 Szilárd Kiss1 1Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA; 2Department of Ophthalmology, University of South Florida, Tampa, FL, USA Purpose: To report our experience with bilateral placement of dexamethasone 0.7 mg (DEX sustained-release intravitreal implant in the management of noninfectious posterior uveitis or macular edema secondary to retinal vein occlusion.Methods: A retrospective chart review of patients with bilateral noninfectious posterior uveitis and macular edema secondary to retinal vein occlusion who were treated with DEX intravitreal implant was performed. Ocular side effects such as intraocular pressure (IOP, cataract, and tolerability of bilateral injections was reviewed.Results: Twenty-two eyes of eleven patients treated with a total of 32 DEX implants were included. Ten of eleven patients received bilateral implants due to active noninfectious uveitis while the other demonstrated macular edema in both eyes following separate central retinal vein occlusions. Among the patients with bilateral uveitis, the mean interval between DEX implant in the initial eye and the subsequent DEX in the fellow eye was 15.6 days (range 2–71 days. Seven of the ten patients received the second implant in the fellow eye within 8 days of the initial implantation. None of the patients had bilateral implantations on the same day. Seven eyes required reimplantation for recurrence of inflammation (mean interval between first and repeat implantation was 6.00±2.39 months. Following single or, in the case of the aforementioned seven eyes, repeat DEX implantation, all 20 uveitic eyes demonstrated clinical and/or angiographic evidence of decreased inflammation in the form of reduction in vitreous cells on slit lamp ophthalmoscopy, macular edema on ophthalmoscopy, or optical coherence tomography and/or disc and vascular leakage on fluorescein angiography. The mean

  1. In-vivo imaging of retinal nerve fiber layer vasculature: imaging – histology comparison

    Directory of Open Access Journals (Sweden)

    Libby Richard T

    2009-08-01

    Full Text Available Abstract Background Although it has been suggested that alterations of nerve fiber layer vasculature may be involved in the etiology of eye diseases, including glaucoma, it has not been possible to examine this vasculature in-vivo. This report describes a novel imaging method, fluorescence adaptive optics (FAO scanning laser ophthalmoscopy (SLO, that makes possible for the first time in-vivo imaging of this vasculature in the living macaque, comparing in-vivo and ex-vivo imaging of this vascular bed. Methods We injected sodium fluorescein intravenously in two macaque monkeys while imaging the retina with an FAO-SLO. An argon laser provided the 488 nm excitation source for fluorescence imaging. Reflectance images, obtained simultaneously with near infrared light, permitted precise surface registration of individual frames of the fluorescence imaging. In-vivo imaging was then compared to ex-vivo confocal microscopy of the same tissue. Results Superficial focus (innermost retina at all depths within the NFL revealed a vasculature with extremely long capillaries, thin walls, little variation in caliber and parallel-linked structure oriented parallel to the NFL axons, typical of the radial peripapillary capillaries (RPCs. However, at a deeper focus beneath the NFL, (toward outer retina the polygonal pattern typical of the ganglion cell layer (inner and outer retinal vasculature was seen. These distinguishing patterns were also seen on histological examination of the same retinas. Furthermore, the thickness of the RPC beds and the caliber of individual RPCs determined by imaging closely matched that measured in histological sections. Conclusion This robust method demonstrates in-vivo, high-resolution, confocal imaging of the vasculature through the full thickness of the NFL in the living macaque, in precise agreement with histology. FAO provides a new tool to examine possible primary or secondary role of the nerve fiber layer vasculature in retinal

  2. Adaptive-optics SLO imaging combined with widefield OCT and SLO enables precise 3D localization of fluorescent cells in the mouse retina.

    Science.gov (United States)

    Zawadzki, Robert J; Zhang, Pengfei; Zam, Azhar; Miller, Eric B; Goswami, Mayank; Wang, Xinlei; Jonnal, Ravi S; Lee, Sang-Hyuck; Kim, Dae Yu; Flannery, John G; Werner, John S; Burns, Marie E; Pugh, Edward N

    2015-06-01

    Adaptive optics scanning laser ophthalmoscopy (AO-SLO) has recently been used to achieve exquisite subcellular resolution imaging of the mouse retina. Wavefront sensing-based AO typically restricts the field of view to a few degrees of visual angle. As a consequence the relationship between AO-SLO data and larger scale retinal structures and cellular patterns can be difficult to assess. The retinal vasculature affords a large-scale 3D map on which cells and structures can be located during in vivo imaging. Phase-variance OCT (pv-OCT) can efficiently image the vasculature with near-infrared light in a label-free manner, allowing 3D vascular reconstruction with high precision. We combined widefield pv-OCT and SLO imaging with AO-SLO reflection and fluorescence imaging to localize two types of fluorescent cells within the retinal layers: GFP-expressing microglia, the resident macrophages of the retina, and GFP-expressing cone photoreceptor cells. We describe in detail a reflective afocal AO-SLO retinal imaging system designed for high resolution retinal imaging in mice. The optical performance of this instrument is compared to other state-of-the-art AO-based mouse retinal imaging systems. The spatial and temporal resolution of the new AO instrumentation was characterized with angiography of retinal capillaries, including blood-flow velocity analysis. Depth-resolved AO-SLO fluorescent images of microglia and cone photoreceptors are visualized in parallel with 469 nm and 663 nm reflectance images of the microvasculature and other structures. Additional applications of the new instrumentation are discussed.

  3. An adaptive optics imaging system designed for clinical use.

    Science.gov (United States)

    Zhang, Jie; Yang, Qiang; Saito, Kenichi; Nozato, Koji; Williams, David R; Rossi, Ethan A

    2015-06-01

    Here we demonstrate a new imaging system that addresses several major problems limiting the clinical utility of conventional adaptive optics scanning light ophthalmoscopy (AOSLO), including its small field of view (FOV), reliance on patient fixation for targeting imaging, and substantial post-processing time. We previously showed an efficient image based eye tracking method for real-time optical stabilization and image registration in AOSLO. However, in patients with poor fixation, eye motion causes the FOV to drift substantially, causing this approach to fail. We solve that problem here by tracking eye motion at multiple spatial scales simultaneously by optically and electronically integrating a wide FOV SLO (WFSLO) with an AOSLO. This multi-scale approach, implemented with fast tip/tilt mirrors, has a large stabilization range of ± 5.6°. Our method consists of three stages implemented in parallel: 1) coarse optical stabilization driven by a WFSLO image, 2) fine optical stabilization driven by an AOSLO image, and 3) sub-pixel digital registration of the AOSLO image. We evaluated system performance in normal eyes and diseased eyes with poor fixation. Residual image motion with incremental compensation after each stage was: 1) ~2-3 arc minutes, (arcmin) 2) ~0.5-0.8 arcmin and, 3) ~0.05-0.07 arcmin, for normal eyes. Performance in eyes with poor fixation was: 1) ~3-5 arcmin, 2) ~0.7-1.1 arcmin and 3) ~0.07-0.14 arcmin. We demonstrate that this system is capable of reducing image motion by a factor of ~400, on average. This new optical design provides additional benefits for clinical imaging, including a steering subsystem for AOSLO that can be guided by the WFSLO to target specific regions of interest such as retinal pathology and real-time averaging of registered images to eliminate image post-processing.

  4. Comparative evaluation of diode laser versus argon laser photocoagulation in patients with central serous retinopathy: A pilot, randomized controlled trial [ISRCTN84128484

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    Venkatesh Pradeep

    2004-10-01

    Full Text Available Abstract Background To evaluate the efficacy of diode laser photocoagulation in patients with central serous retinopathy (CSR and to compare it with the effects of argon green laser. Methods Thirty patients with type 1 unilateral CSR were enrolled and evaluated on parameters like best corrected visual acuity (BCVA, direct and indirect ophthalmoscopy, amsler grid for recording scotoma and metamorphopsia, contrast sensitivity using Cambridge low contrast gratings and fluorescein angiography to determine the site of leakage. Patients were randomly assigned into 2 groups according to the statistical random table using sequence generation. In Group 1 (n = 15, diode laser (810 nm photocoagulation was performed at the site of leakage while in Group 2 (n = 15, eyes were treated with argon green laser (514 nm using the same laser parameters. Patients were followed up at 4, 8 and 12 weeks after laser. Results The mean BCVA in group 1 improved from a pre-laser decimal value of 0.29 ± 0.14 to 0.84 ± 0.23 at 4 weeks and 1.06 ± 0.09 at 12 weeks following laser. In group 2, the same improved from 0.32 ± 0.16 to 0.67 ± 0.18 at 4 weeks and 0.98 ± 0.14 at 12 weeks following laser. The improvement in BCVA was significantly better in group 1 (p Conclusion Diode laser may be a better alternative to argon green laser whenever laser treatment becomes indicated in patients with central serous retinopathy in terms of faster visual rehabilitation and better contrast sensitivity. In addition, diode laser also has the well-recognized ergonomic and economic advantages.

  5. Treatment of cytomegalovirus retinitis with an intraocular sustained-release ganciclovir implant

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    Muccioli C.

    2000-01-01

    Full Text Available The objective of this prospective study was to evaluate the efficacy and complications of the use of an intraocular sustained-release ganciclovir implant for the treatment of active cytomegalovirus (CMV retinitis in AIDS patients. Thirty-nine eyes of 26 patients were submitted to ocular surgery. All patients underwent complete ocular examination before and after surgery. The surgical procedure was always done under local anesthesia using the same technique. The mean time for the surgical procedure was 20 min (range, 15 to 30 min. The average follow-up period was 3.7 months. Of all patient, only 4 presented recurrence of retinitis after 8, 8, 9 and 2 months, respectively. Three of them received a successful second implant. All 39 eyes of the 26 patients presented healing of retinitis as shown by clinical improvement evaluated by indirect binocular ophthalmoscopy and retinography. Retinitis healed within a period of 4 to 6 weeks in all patients, with clinical regression signs from the third week on. Six (15.4% eyes developed retinal detachment. None of the patients developed CMV retinitis in the contralateral eye. The intraocular implant proved to be effective in controlling the progression of retinitis for a period of up to 8 months even in patients for whom systemic therapy with either ganciclovir or foscarnet or both had failed. The intraocular sustained-release ganciclovir implant proved to be a safe new procedure for the treatment of CMV retinitis, avoiding the systemic side effects caused by the intravenous medications and improving the quality of life of the patients.

  6. Blockade of Tumor Necrosis Factor-Alpha: A Role for Adalimumab in Neovascular Age-Related Macular Degeneration Refractory to Anti-Angiogenesis Therapy

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    Beatriz Fernández-Vega

    2016-03-01

    Full Text Available Aims: To report a case of wet age-related macular degeneration (wet-AMD refractory to intravitreal anti-vascular endothelial growth factor (anti-VEGF therapy in a patient who showed visual and anatomical improvement and stabilization after starting a subcutaneous treatment course with adalimumab, an anti-tumor necrosis factor-alpha (TNF-α drug, for concomitant Crohn's disease. Methods: Observational case report of a female patient. Ophthalmological evaluation was performed by slit lamp and ophthalmoscopy (posterior pole and anterior segment. Best-corrected visual acuity (BCVA was determined, and imaging was performed by fluorescein angiography, indocyanine green angiography, and optical coherence tomography (OCT. Intravitreal therapies used and treatment with anti-TNF-α were recorded. Results: A 64-year-old woman with wet-AMD was treated with fourteen intravitreal injections of ranibizumab (0.5 mg for a period of 40 months with intervals of 1-6 months. She initially showed a good visual and anatomical response to periodic anti-VEGF treatment but during check visits, anatomical and functional responses deteriorated. At the 40-month follow-up, the patient had developed Crohn's disease, and her rheumatologist started treatment with adalimumab (40 mg subcutaneously every 2 weeks. During the 25 months of treatment with adalimumab, the patient did not require any additional intravitreal anti-VEGF treatments because her BCVA, clinical, and OCT findings improved and remained stable. Conclusions: We described a case of a patient with wet-AMD refractory to anti-VEGF therapy, which clinically benefited from subcutaneous adalimumab therapy. Treatment with subcutaneous anti-TNF-α in combination with anti-VEGF therapy avoids the high cost and risks related to multiple intravitreal anti-VEGF injections with good functional and anatomic outcomes.

  7. Multimodal adaptive optics for depth-enhanced high-resolution ophthalmic imaging

    Science.gov (United States)

    Hammer, Daniel X.; Mujat, Mircea; Iftimia, Nicusor V.; Lue, Niyom; Ferguson, R. Daniel

    2010-02-01

    We developed a multimodal adaptive optics (AO) retinal imager for diagnosis of retinal diseases, including glaucoma, diabetic retinopathy (DR), age-related macular degeneration (AMD), and retinitis pigmentosa (RP). The development represents the first ever high performance AO system constructed that combines AO-corrected scanning laser ophthalmoscopy (SLO) and swept source Fourier domain optical coherence tomography (SSOCT) imaging modes in a single compact clinical prototype platform. The SSOCT channel operates at a wavelength of 1 μm for increased penetration and visualization of the choriocapillaris and choroid, sites of major disease activity for DR and wet AMD. The system is designed to operate on a broad clinical population with a dual deformable mirror (DM) configuration that allows simultaneous low- and high-order aberration correction. The system also includes a wide field line scanning ophthalmoscope (LSO) for initial screening, target identification, and global orientation; an integrated retinal tracker (RT) to stabilize the SLO, OCT, and LSO imaging fields in the presence of rotational eye motion; and a high-resolution LCD-based fixation target for presentation to the subject of stimuli and other visual cues. The system was tested in a limited number of human subjects without retinal disease for performance optimization and validation. The system was able to resolve and quantify cone photoreceptors across the macula to within ~0.5 deg (~100-150 μm) of the fovea, image and delineate ten retinal layers, and penetrate to resolve targets deep into the choroid. In addition to instrument hardware development, analysis algorithms were developed for efficient information extraction from clinical imaging sessions, with functionality including automated image registration, photoreceptor counting, strip and montage stitching, and segmentation. The system provides clinicians and researchers with high-resolution, high performance adaptive optics imaging to help

  8. Cyclopentolate as a cycloplegic drug in determination of refractive error

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    Bolinovska Sofija

    2008-01-01

    Full Text Available Cycloplegia is loss of the power of accommodation with inhibition of a ciliary muscle. We obtain in this way the smallest refraction of the lens and make it possible to determine the presence and size of the particular refractive error in cycloplegia by using cyclopentolate. Cyclopentolate is a synthetic anticholinergic drug and antagonist of the muscarine receptors. If applied in the eye, it blocks the effect of cholinergic stimulation on the sphincter pupillae muscle and ciliary muscle. It provokes severe mydriasis (dilation of the pupil and cycloplegia (paralysis of the accommodation. Cyclopentolate has been used occasionaly in diagnostic purposes: defining ocular refraction and in ophthalmoscopy. This is the prospective study which included 200 children (400 eyes aged 3-18 years, carried out in one ambulatory ophthalmological examination. The results were analysed using standard statistical methods. The most often refractive error in the examined group of children is hyperopia with hyperopic astigmatism, then myopia with myopic astigmatism and mixtus astigmatism are the most often in the oldest group of children. The mean value of corneal astigmatism on the right eye was 1.24 D, on the left eye 1.23 D. Anisometropy was found in 40% children. The presence of myopia, myopic and astigmatism mixtus tended to increase, and hyperopia and hyperopic astigmatism tended to decrease toward older groups of children. Refractive error could result in a poor development of visual acuity, causing amblyopia and strabismus, and because of that represents an important public health problem. As one of amblyogenic risk factors in children, it can be prevented with screening program and appropriate treatment, thus providing prevention of amblyopia as one form of blindness.

  9. Comparison of normotensive and glaucoma simplex patients according to age and sex

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    Stojčić Milan

    2012-01-01

    Full Text Available Introduction. According to the level of intraocular pressure (IOP, open angle glaucoma is divided into high tension glaucoma (HTG and normal tension glaucoma (NTG. Objective. To determine if there are differences in the distribution of patients by age and sex between NTG and HTG. Methods. Our prospective study included 30 patients with NTG and 30 with HTG. A complete eye examination was performed. The examination included measuring of intraocular pressure by Goldmann applanation tonometry, examination of optic disc head by indirect ophthalmoscopy with Volk 90 D lens and visual field examination using the Octopus program. Results. The average damage of visual field in the group of patients with NTG was 8.14±4.43 dB, while in the group with HTG it was 7.40±2.84 dB (p>0.05. The average age of the group of patients with NTG was 66±11.58 years, while among those with HTG the average age was 59.7±11.63 years (p<0.01. Among the patients with NTG there were three times more women than men (χ2=9.124; p<0.01, while in the group of patients with HTG there were more men than women, but without statistically significant difference between the tested groups (χ2=1.851; p>0.05. Conclusion. Open angle glaucoma is a disease of elderly population. According to our results, risk factors for this disease can be age and sex. NTG is more frequently present than HTG among elderly population and females.

  10. Rapid assessment of cataract blindness in an urban district of Gujarat

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    Limburg Hans

    1999-01-01

    Full Text Available Purpose: To estimate the prevalence of bilateral cataract blindness in persons ≥50 years of age in Ahmedabad district, Gujarat. Methods: A total of 1,962 persons ≥50 years of age were examined in clusters of 45 people or less. The survey design used a systematic random cluster sampling. The sample size was calculated assuming a prevalence of bilateral cataract blindness (visual acuity <3/60 of at least 3% and design effect of 1.6, to estimate the actual prevalence of cataract blindness with a sampling error of ≤20 at 80% confidence level. Visual acuity was assessed with glasses, where available, and pinhole was used for visual acuity <6/18. Distant direct ophthalmoscopy in semidark condition with undilated pupil was used to assess the lens status. Results: The age-gender-adjusted prevalence of all blindness was 2.9% in persons ≥50 years of age (6.7% for visual acuity<6/60. The age-gender-adjusted prevalence of bilateral cataract blindness ( visual acuity <3/60 was 1.2% in persons ≥50 years of age. For visual acuity <6/60, the prevalence was 3.1%. The prevalence in females was slightly higher than in males. The prevalence of bilateral and unilateral aphakia and pseudophakia was high. The cataract surgical coverage, an indicator for coverage and service utilization, was 92.9% for persons and 83.1% for eyes. Conclusion: Rapid assessment of cataract blindness in persons ≥50 years of age can be conducted in urban settings with existing resources and at affodable costs, to provide district level data for assessment and monitoring of cataract intervention programs.

  11. Foveal hemorrhage in an eye with foveal hypoplasia associated with albinism

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    Masuda N

    2014-09-01

    Full Text Available Naonori Masuda, Taiji Hasegawa, Mariko Yamashita, Nahoko Ogata Department of Ophthalmology, Nara Medical University, Nara, Japan Abstract: Oculocutaneous albinism is a group of congenital disorders caused by alterations of melanin biosynthesis. We report our findings in a patient with oculocutaneous albinism who presented with foveal hypoplasia and a foveal hemorrhage. A 48-year-old man noted a dark spot in the middle of the visual field of his right eye. He had depigmented skin, white hair, white eyebrows, and white cilia. He also had horizontal nystagmus and depigmented irides. His best-corrected visual acuity was 2/100 with -14.0 diopters in the right eye and 3/100 with -5.0 diopters in the left eye. Ophthalmoscopy showed diffuse depigmentation in both eyes and a foveal hemorrhage in the right eye. Optical coherence tomography showed the absence of a foveal pit in both eyes and a subretinal hyperreflective lesion corresponding to the foveal hemorrhage in the right eye. Fluorescein angiography showed that the retinal and choroidal vessels were relatively hypofluorescent because of the lack of a blocking effect of the pigments in the retinal pigment epithelium. Fluorescein angiography and indocyanine green angiography did not show any evidence of choroidal neovascularization in either eye. The foveal hemorrhage in the right eye spontaneously regressed and finally resolved at 3 months after onset. At the final examination, the patient reported that his vision had recovered. A foveal hemorrhage is a rare condition in an eye with foveal hypoplasia associated with albinism. The hemorrhage may be related to high myopia and also to the hypoplasia of the fovea associated with albinism. Keywords: albinism, foveal hemorrhage, foveal hypoplasia, simple hemorrhage

  12. Clinical profile of uveitis in Hansen’s disease after completion of treatment – A study of 50 cases using Polymerase Chain Reaction (PCR on aqueous humour

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    Radha Annamalai

    2016-05-01

    Full Text Available Chronic low grade anterior uveitis is the commonest cause of blindness in leprosy. It is usually asymptomatic until the late stages and patients seek help only after irreversible visual loss. We analysed patients who had a recurrence of uveitis after completion of treatment with anti-leprosy drugs and had been proven as histopathologically negative. The presence of chronic uveitis, complications and the extent of ocular damage it may cause, can continue even after treatment, emphasising the importance of follow-up, early detection and treatment. This is a prospective cohort study. Ophthalmic evaluation was performed using slit lamp examination, biomicroscopy, indirect ophthalmoscopy, applanation tonometry, corneal sensation and Schirmer’s test. Split skin microscopy was done to confirm the activity of leprosy. In patients with recalcitrant iridocyclitis, anterior chamber paracentesis was performed. The sample was analysed both by smear and polymerase chain reaction. The sequences that were targeted using PCR included genes encoding the DNA of 36-kDa antigen, 18-kDa antigen, 65-kDa antigen and the repetitive sequences among other M. leprae genes. Aqueous aspirate showed copies of mycobacterium leprae DNA in five out of twelve patients with recalcitrant anterior uveitis. Direct smear and staining with Ziehl- Neelson staining for mycobacteria was positive showing both live and dead bacilli. Live bacilli can persist in the aqueous humour even after completion of treatment. In our study this was more frequently observed in tuberculoid leprosy. This is possibly due to an immune mediated response combined with inadequate treatment dose in these patients.

  13. Wavefront sensorless adaptive optics versus sensor-based adaptive optics for in vivo fluorescence retinal imaging (Conference Presentation)

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    Wahl, Daniel J.; Zhang, Pengfei; Jian, Yifan; Bonora, Stefano; Sarunic, Marinko V.; Zawadzki, Robert J.

    2017-02-01

    Adaptive optics (AO) is essential for achieving diffraction limited resolution in large numerical aperture (NA) in-vivo retinal imaging in small animals. Cellular-resolution in-vivo imaging of fluorescently labeled cells is highly desirable for studying pathophysiology in animal models of retina diseases in pre-clinical vision research. Currently, wavefront sensor-based (WFS-based) AO is widely used for retinal imaging and has demonstrated great success. However, the performance can be limited by several factors including common path errors, wavefront reconstruction errors and an ill-defined reference plane on the retina. Wavefront sensorless (WFS-less) AO has the advantage of avoiding these issues at the cost of algorithmic execution time. We have investigated WFS-less AO on a fluorescence scanning laser ophthalmoscopy (fSLO) system that was originally designed for WFS-based AO. The WFS-based AO uses a Shack-Hartmann WFS and a continuous surface deformable mirror in a closed-loop control system to measure and correct for aberrations induced by the mouse eye. The WFS-less AO performs an open-loop modal optimization with an image quality metric. After WFS-less AO aberration correction, the WFS was used as a control of the closed-loop WFS-less AO operation. We can easily switch between WFS-based and WFS-less control of the deformable mirror multiple times within an imaging session for the same mouse. This allows for a direct comparison between these two types of AO correction for fSLO. Our results demonstrate volumetric AO-fSLO imaging of mouse retinal cells labeled with GFP. Most significantly, we have analyzed and compared the aberration correction results for WFS-based and WFS-less AO imaging.

  14. Evaluating outer segment length as a surrogate measure of peak foveal cone density.

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    Wilk, Melissa A; Wilk, Brandon M; Langlo, Christopher S; Cooper, Robert F; Carroll, Joseph

    2017-01-01

    Adaptive optics (AO) imaging tools enable direct visualization of the cone photoreceptor mosaic, which facilitates quantitative measurements such as cone density. However, in many individuals, low image quality or excessive eye movements precludes making such measures. As foveal cone specialization is associated with both increased density and outer segment (OS) elongation, we sought to examine whether OS length could be used as a surrogate measure of foveal cone density. The retinas of 43 subjects (23 normal and 20 albinism; aged 6-67years) were examined. Peak foveal cone density was measured using confocal adaptive optics scanning light ophthalmoscopy (AOSLO), and OS length was measured using optical coherence tomography (OCT) and longitudinal reflectivity profile-based approach. Peak cone density ranged from 29,200 to 214,000cones/mm(2) (111,700±46,300cones/mm(2)); OS length ranged from 26.3 to 54.5μm (40.5±7.7μm). Density was significantly correlated with OS length in albinism (pdensity as a function of OS length was created based on histology and optimized to fit the albinism data. The model includes triangular cone packing, a cylindrical OS with a fixed volume of 136.6μm(3), and a ratio of OS to inner segment width that increased linearly with increasing OS length (R(2)=0.72). Normal subjects showed no apparent relationship between cone density and OS length. In the absence of adequate AOSLO imagery, OS length may be used to estimate cone density in patients with albinism. Whether this relationship exists in other patient populations with foveal hypoplasia (e.g., premature birth, aniridia, isolated foveal hypoplasia) remains to be seen. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. A Study of Factors Related to the Incidence of Cataract in Patients with Non-Insulin Dependent Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    Xiaoping Xia; Xiao Zhang; Haitao Xia

    2001-01-01

    Purpose: To investigate the factors related to the development of cataract in patientswith non-insulin dependent diabetes mellitus(NIDDM).Methods: 792 NIDDM patients received ophthalmologic examinations including visualacuity, external status of the eyes, slit lamp microscopy and ophthalmoscopy. Glucose,urea nitrogen (BUN), creatinine (Cr), urine acid (UA), N-acetyl-β2-D-glucosaminidase(NAG), β2-microglobulin(β2-MG) and serum albumin in blood were quantitativelytested. Glucose, pH value, protein, cells, cast and ketobodies in urine were assayed.Diagnosis of cataract was based on lens opacities classification system Ⅱ. Any patientmeeting "NⅡ", "CⅡ" or "PⅡ" level was diagnosed as cataract.Results: The incidence of cataract in this group of NIDDM was 62.37 % (494/792),which significantly related to the duration of the disease course, but not to the sex of thepatient. The occurrence rate of cataract in patients suffering from NIDDM of less thanfive years duration, from five to ten years, and more than ten years was 49.67 % (228/459), 71.84 % (125/174), and 88.68 % (141/159), respectively. The occurrence ofcataract in patients diagnosed of the disease from five to ten years and more than tenyears was much higher than that of those with the course of the disease less than fiveyears( P < 0.05 and P < 0. 001, respectively) . Rising concentrations of blood ureanitrogen, creatinine, glycosylated hemoglobin HbA1c(G-HbA1c), N-acetyl-β2-D-glucosaminidase(NAG) and β2-microglobulin(β2-MG) indicated malfunction of thekidneys, and the rate of cataract occurrence in these patients was higher.Conclusion: This study indicates that prolongation of the duration of non-insulindependent diabetes mellitus, renal dysfunction, as well as poor blood glucose control,may accelerate the development of cataract.

  16. Effects of short term changes in the blood glucose level on the autofluorescence lifetime of the human retina in healthy volunteers

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    Klemm, Matthias; Nagel, Edgar; Schweitzer, Dietrich; Schramm, Stefan; Haueisen, Jens

    2016-03-01

    Purpose: Fluorescence lifetime imaging ophthalmoscopy (FLIO) provides in vivo metabolic mapping of the ocular fundus. Changes in FLIO have been found in e.g. diabetes patients. The influence of short term metabolic changes caused by blood glucose level changes on is unknown. Aim of this work is the detection of short-term changes in fundus autofluorescence lifetime during an oral glucose tolerance test. Methods: FLIO was performed in 10 healthy volunteers (29+/-4 years, fasting for 12h) using a scanning laser ophthalmoscope (30° fundus, 34μm resolution, excitation with 473nm diode laser with 70 ps pulses at 80 MHz repetition rate, detection in two spectral channels 500-560nm (ch1) and 560-720nm (ch2) using the timecorrelated single photon counting method). The blood glucose level (BGL) was measured by an Accu-Chek® Aviva self-monitoring device. Before and after a glucose drink (300ml solution, containing 75g of glucose (Accu-Chek® Dextrose O.G.T.), BGL and FLIO were measured every 15min. The FLIMX software package was applied to compute the average fluorescence lifetime τ on the inner ring of the ETDRS grid using a modified 3-exponential approach. Results: The results are given as mean +/- standard deviation over all volunteers in ch1. Baseline measurement: BGL: 5.3+/-0.4 mmol/l, τ1: 49+/-6ps. A significant reduction (α=5% Wilcoxon rank-sum test) in τ1 is detected after 15min (BGL: 8.4+/-1.1 mmol/l, τ1: 44+/-5ps) and after 90min (BGL: 6.3+/-1.4 mmol/l, τ1: 41+/-5ps). Results of ch2 show smaller reductions in the fluorescence lifetimes over time.

  17. Distrofia macular cristalina em paciente com síndrome de Sjögren-Larsson: relato de caso Macular crystalline dystrophy in Sjögren-Larsson syndrome: case report

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    David Leonardo Cruvinel Isaac

    2009-04-01

    Full Text Available Apresentação de um caso de distrofia macular cristalina em paciente do sexo feminino com síndrome de Sjögren-Larsson. A doença caracteriza-se pela tríade: ictiose congênita, diplegia ou tetraplegia espástica e retardo mental. Os olhos são acometidos em até 100% dos casos sendo característica a presença de maculopatia cristalina como observado na paciente relatada. À fundoscopia observou-se a presença de depósitos esbranquiçados perifoveais. A tomografia de coerência óptica evidenciou pontos hiper-reflexivos correspondentes aos depósitos intrarretinianos, atrofia macular com redução na espessura macular em ambos os olhos. Os achados relacionados à síndrome, à tomografia de coerência óptica foram apresentados de maneira inédita em nosso meio.Presentation of a case of crystalline macular distrophy diagnosed in a female patient with Sjögren-Larsson syndrome. The disease consists of clinical findings of spastic diplegia or tetraplegia, mental retardation, and congential ichthyosis. The eyes are affected in up to 100% of cases, and crystalline maculopathy is the main finding as described in this case report. On fundus examination multiple white dots were observed at ophthalmoscopy. The optical coherence tomography has shown not only the hipereflexive intraretinal spots but also macular atrophy with macular thickness reduction. The tomographic findings were first described in our country.

  18. The correlation of albuminuria and glomerular filtration rate with diabetic retinopathy in type 2 diabetes%尿白蛋白、肾小球滤过率与2型糖尿病视网膜病变的相关性研究

    Institute of Scientific and Technical Information of China (English)

    蔡芸莹; 马中书; 邱明才

    2012-01-01

    目的 比较T2DM视网膜病变(DR)不同时期,尿蛋白、肾小球滤过率(GFR)变化,寻找早期筛查DR的指标. 方法 采用回顾性病历研究,根据散瞳眼底检查分组,同期测定各组24h尿白蛋白定量,以MDRD公式计算GFR. 结果 与正常眼底组相比,DR组患者的GFR明显减低(P<0.05),且尿白蛋白(UAlb)、GFR均与DR呈显著独立相关(P<0.05). 结论 UAlb、GFR均与DR密切相关,其联合筛查有利于DR早期检出.%Objective To compare changes of urinary albumin and eGFR between different stages of diabetic retinopathy(DR) to look for early screening diabetic retinopathy indicators. Methods The clinical data were analyzed retrospectively. Diabetic retinopathy was assessed by mydriatic ophthalmoscopy. While determinating the urinary albumin quantitative for 24 hours, the estimated glomerular filtration rate(GFR) was measured by MDRD formula Results The levels of GFR were significantly lower in two DR groups than in normal retina group(P< 0. 05). Both urinary albumin(Ualb) and GFR were independently risks for diabetic retinopathy. Conclusion Ualb and GFR are closely associated with diabetic retinopathy. Clinicians need to check both urinary albumin and eGFR to screen for early diabetic retinopathy.

  19. A patient with acute macular neuroretinopathy and central retinal vein occlusion

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    Hirooka K

    2013-07-01

    Full Text Available Kiriko Hirooka,1 Wataru Saito,1,2 Kousuke Noda,1,2 Susumu Ishida1,21Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; 2Department of Ocular Circulation and Metabolism, Hokkaido University Graduate School of Medicine, Sapporo, JapanPurpose: The precise mechanism causing acute macular neuroretinopathy (AMN is still unknown. A recent report suggested that choroidal circulation impairment correlates with its pathogenesis. We report a rare case with simultaneous onset of AMN and central retinal vein occlusion (CRVO, which is a retinal circulation disorder.Methods: Case report.Results: A 44-year-old woman complained of central visual loss of the left eye for the previous 2 weeks. The patient’s visual acuity was 0.5 in the left eye (OS. Fundoscopic examination revealed a wedge-shaped, dark reddish-brown lesion at the macula, and CRVO-like retinal hemorrhages OS. Fluorescein angiography revealed retinal vasculitis and hypofluorescence corresponding to the macular lesion. The patient’s scanning laser ophthalmoscopy infrared imaging result led to a diagnosis of AMN. Two weeks after corticosteroid pulse therapy, her visual acuity improved to 1.2 OS, with improvement of macular findings and Humphrey perimetry. When the dose of oral corticosteroid was decreased, the AMN lesion worsened, with recurrence of retinal hemorrhages. Visual functions improved again after an increased dose of corticosteroid.Conclusion: These results suggest that circulatory disorders almost simultaneously occurred in choroidal and retinal vessels, resulting in the onset of both AMN and CRVO.Keywords: choroidal circulation, optical coherence tomography, retinal circulation, systemic corticosteroid therapy

  20. The Evonik-Mainz-Eye-Care-Study (EMECS: design and execution of the screening investigation.

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    Lorenz Barleon

    Full Text Available To determine if screening for major ophthalmological diseases is feasible within the frame of routine occupational medicine examinations in a large working population.13037 employees of Evonik Industries aged 40 to 65 years were invited to be screened for major ophthalmological diseases (glaucoma, age related macular degeneration and diabetic retinopathy between June 2007 and March 2008 within an extended setting of occupational medicine. Ophthalmological examinations consisted of visual acuity, objective refraction, pachymetry, tonometry, perimetry (frequency doubling technology, confocal scanning laser ophthalmoscopy and digital fundus photography. Participants responded to a questionnaire addressing history of ocular and general diseases and social history.4183 participants (961 female and 3222 male were examined at 13 different sites. Response rates for eligible persons at those sites ranged from 17.9 to 60.5% but were in part limited by availability of examination slots. Average age of participants was 48.4 ± 5.4 years (mean ± SD. 4147 out of 4183 subjects (99.1% had a visual acuity ≥ 0.5 in the better eye and 3665 out of 4183 (87.6% subjects had a visual acuity ≥ 0.8 in the better eye. 1629 participants (38.9% had previously not been seen by an ophthalmologist at all or not within the last three years.This article describes the study design and basic characteristics of study participants within a large occupational medicine based screening study for ophthalmological diseases. Response rates exceeded expectations and were limiting examination capacity. Meaningful data could be obtained for almost all participants. We reached participants who previously had not received ophthalmic care. Thus, ophthalmological screening appears to be feasible within the frame of routine occupational medicine examinations.

  1. Filtering bleb activation in the early post-operative period after fistulizing surgery

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    S. Yu. Petrov

    2014-10-01

    Full Text Available The article presents a case report of a patient with a cystic bleb in the early postoperative period after trabeculectomy. Patient complained of discomfort in a recently (4 weeks operated eye. Medical regimen administered previously had been taken irregularly. Biomicroscopy revealed a high, encapsulated cystic bleb with thin walls and hyperemia. Intraocular pressure at the moment of examination was 27 mmHg. Local hypotensive therapy had been neglected by the patient. A local anti-inflammatory (tobramycin / dexamethasone fixed combination and hypotensive (brimonidine / timolol fixed combination therapy was administered. 24 hours later, when intraocular pressure decreased to 20 mmHg, a needle revision procedure was conducted for partial bleb wall destruction and subconjunctival injection of dexamethasone, fluorouracil and ranibizumab. During the next day examination the bleb was diffuse, with less hyperemia and an abundance of conjunctival microcysts in the central bleb’s zone. Intraocular pressure was 10.2 mmHg. No choroidal detachment was noted during ophthalmoscopy and OCT examination. The patient continued anti-inflammatory therapy. Another needling procedure with the same drug combination was repeated two weeks after due to an increased hyperemia. At the end of the four-week follow-up period the filtering bleb remained diffuse and the intraocular pressure was 13.2 mmHg. Dexamethasone drops were prescribed to be instilled 1‑2 times a day for a month. This case report demonstrates the method of restoring a functioning filtering bleb by the needle revision with antiinflammatory, cytostatic and anti-VEGF therapy for prolonging the hypotensive effect of a trabeculectomy in the presence of wound healing.

  2. Filtering bleb activation in the early post-operative period after fistulizing surgery

    Directory of Open Access Journals (Sweden)

    S. Yu. Petrov

    2014-01-01

    Full Text Available The article presents a case report of a patient with a cystic bleb in the early postoperative period after trabeculectomy. Patient complained of discomfort in a recently (4 weeks operated eye. Medical regimen administered previously had been taken irregularly. Biomicroscopy revealed a high, encapsulated cystic bleb with thin walls and hyperemia. Intraocular pressure at the moment of examination was 27 mmHg. Local hypotensive therapy had been neglected by the patient. A local anti-inflammatory (tobramycin / dexamethasone fixed combination and hypotensive (brimonidine / timolol fixed combination therapy was administered. 24 hours later, when intraocular pressure decreased to 20 mmHg, a needle revision procedure was conducted for partial bleb wall destruction and subconjunctival injection of dexamethasone, fluorouracil and ranibizumab. During the next day examination the bleb was diffuse, with less hyperemia and an abundance of conjunctival microcysts in the central bleb’s zone. Intraocular pressure was 10.2 mmHg. No choroidal detachment was noted during ophthalmoscopy and OCT examination. The patient continued anti-inflammatory therapy. Another needling procedure with the same drug combination was repeated two weeks after due to an increased hyperemia. At the end of the four-week follow-up period the filtering bleb remained diffuse and the intraocular pressure was 13.2 mmHg. Dexamethasone drops were prescribed to be instilled 1‑2 times a day for a month. This case report demonstrates the method of restoring a functioning filtering bleb by the needle revision with antiinflammatory, cytostatic and anti-VEGF therapy for prolonging the hypotensive effect of a trabeculectomy in the presence of wound healing.

  3. Prevalence of retinopathy in Caucasian type 2 diabetic patients from the South of Brazil and relationship with clinical and metabolic factors

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    K.G. Santos

    2005-02-01

    Full Text Available Diabetic retinopathy (DR is a sight-threatening chronic complication of diabetes mellitus and is the leading cause of acquired blindness in adults. In this cross-sectional study, we investigated the prevalence of and the factors associated with DR in an analysis of 210 consecutive and unrelated Brazilian Caucasians with type 2 diabetes mellitus. Retinopathy was evaluated by ophthalmoscopy and/or biomicroscopy through dilated pupils. The relationship between clinical and metabolic variables and the presence of DR was assessed by logistic regression analysis. DR was detected in 99 of the 210 patients (47%. In the univariate logistic regression analyses, male sex, duration of diabetes, body mass index, glycated hemoglobin, C-peptide, LDL cholesterol, smoking, and albumin excretion rate were found to be associated with the presence of DR. However, the multiple logistic regression analysis showed that only duration of diabetes (odds ratio (OR = 1.15, 95% CI = 1.09-1.22; P 100 µg/min (OR = 12.72, 95% CI = 3.89-41.56; P < 0.001 were independently associated with DR. Although DR was found to be frequent among Brazilian type 2 diabetic patients, its prevalence was within the range observed in other Caucasian populations. Our findings emphasize the need for good glycemic control in order to prevent or delay the onset of DR, since the most well-known risk factors for the development of this complication in type 2 diabetes mellitus, such as duration of diabetes, glycated hemoglobin and albumin excretion rate were independently related to DR.

  4. Visual function and cortical organization in carriers of blue cone monochromacy.

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    Rossi, Ethan A; Achtman, Rebecca L; Guidon, Arnaud; Williams, David R; Roorda, Austin; Bavelier, Daphne; Carroll, Joseph

    2013-01-01

    Carriers of blue cone monochromacy have fewer cone photoreceptors than normal. Here we examine how this disruption at the level of the retina affects visual function and cortical organization in these individuals. Visual resolution and contrast sensitivity was measured at the preferred retinal locus of fixation and visual resolution was tested at two eccentric locations (2.5° and 8°) with spectacle correction only. Adaptive optics corrected resolution acuity and cone spacing were simultaneously measured at several locations within the central fovea with adaptive optics scanning laser ophthalmoscopy (AOSLO). Fixation stability was assessed by extracting eye motion data from AOSLO videos. Retinotopic mapping using fMRI was carried out to estimate the area of early cortical regions, including that of the foveal confluence. Without adaptive optics correction, BCM carriers appeared to have normal visual function, with normal contrast sensitivity and visual resolution, but with AO-correction, visual resolution was significantly worse than normal. This resolution deficit is not explained by cone loss alone and is suggestive of an associated loss of retinal ganglion cells. However, despite evidence suggesting a reduction in the number of retinal ganglion cells, retinotopic mapping showed no reduction in the cortical area of the foveal confluence. These results suggest that ganglion cell density may not govern the foveal overrepresentation in the cortex. We propose that it is not the number of afferents, but rather the content of the information relayed to the cortex from the retina across the visual field that governs cortical magnification, as under normal viewing conditions this information is similar in both BCM carriers and normal controls.

  5. Visual function and cortical organization in carriers of blue cone monochromacy.

    Directory of Open Access Journals (Sweden)

    Ethan A Rossi

    Full Text Available Carriers of blue cone monochromacy have fewer cone photoreceptors than normal. Here we examine how this disruption at the level of the retina affects visual function and cortical organization in these individuals. Visual resolution and contrast sensitivity was measured at the preferred retinal locus of fixation and visual resolution was tested at two eccentric locations (2.5° and 8° with spectacle correction only. Adaptive optics corrected resolution acuity and cone spacing were simultaneously measured at several locations within the central fovea with adaptive optics scanning laser ophthalmoscopy (AOSLO. Fixation stability was assessed by extracting eye motion data from AOSLO videos. Retinotopic mapping using fMRI was carried out to estimate the area of early cortical regions, including that of the foveal confluence. Without adaptive optics correction, BCM carriers appeared to have normal visual function, with normal contrast sensitivity and visual resolution, but with AO-correction, visual resolution was significantly worse than normal. This resolution deficit is not explained by cone loss alone and is suggestive of an associated loss of retinal ganglion cells. However, despite evidence suggesting a reduction in the number of retinal ganglion cells, retinotopic mapping showed no reduction in the cortical area of the foveal confluence. These results suggest that ganglion cell density may not govern the foveal overrepresentation in the cortex. We propose that it is not the number of afferents, but rather the content of the information relayed to the cortex from the retina across the visual field that governs cortical magnification, as under normal viewing conditions this information is similar in both BCM carriers and normal controls.

  6. The prevalence of visual impairment and blindness in underserved rural areas: a crucial issue for future.

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    Hashemi, H; Yekta, A; Jafarzadehpur, E; Doostdar, A; Ostadimoghaddam, H; Khabazkhoob, M

    2017-08-01

    PurposeTo determine the prevalence of visual impairment and blindness in underserved Iranian villages and to identify the most common cause of visual impairment and blindness.Patients and methodsMultistage cluster sampling was used to select the participants who were then invited to undergo complete examinations. Optometric examinations including visual acuity, and refraction were performed for all individuals. Ophthalmic examinations included slit-lamp biomicroscopy and ophthalmoscopy. Visual impairment was determined according to the definitions of the WHO and presenting vision.ResultsOf 3851 selected individuals, 3314 (86.5%) participated in the study. After using the exclusion criteria, the present report was prepared based on the data of 3095 participants. The mean age of the participants was 37.6±20.7 years (3-93 years). The prevalence of visual impairment and blindness was 6.43% (95% confidence interval (CI): 3.71-9.14) and 1.18% (95% CI: 0.56-1.79), respectively. The prevalence of visual impairment varied from 0.75% in participants aged less than 5 years to 38.36% in individuals above the age of 70 years. Uncorrected refractive errors and cataract were the first and second leading causes of visual impairment; moreover, cataract and refractive errors were responsible for 35.90 and 20.51% of the cases of blindness, respectively.ConclusionThe prevalence of visual impairment was markedly high in this study. Lack of access to health services was the main reason for the high prevalence of visual impairment in this study. Cataract and refractive errors are responsible for 80% of visual impairments which can be due to poverty in underserved villages.

  7. Consequences of zygote injection and germline transfer of mutant human mitochondrial DNA in mice.

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    Yu, Hong; Koilkonda, Rajeshwari D; Chou, Tsung-Han; Porciatti, Vittorio; Mehta, Arpit; Hentall, Ian D; Chiodo, Vince A; Boye, Sanford L; Hauswirth, William W; Lewin, Alfred S; Guy, John

    2015-10-20

    Considerable evidence supports mutations in mitochondrial genes as the cause of maternally inherited diseases affecting tissues that rely primarily on oxidative energy metabolism, usually the nervous system, the heart, and skeletal muscles. Mitochondrial diseases are diverse, and animal models currently are limited. Here we introduced a mutant human mitochondrial gene responsible for Leber hereditary optic neuropathy (LHON) into the mouse germ line using fluorescence imaging for tissue-specific enrichment in the target retinal ganglion cells. A mitochondria-targeted adeno-associated virus (MTS-AAV) containing the mutant human NADH ubiquinone oxidoreductase subunit 4 (ND4) gene followed by mitochondrial-encoded mCherry was microinjected into zygotes. Female founders with mCherry fluorescence on ophthalmoscopy were backcrossed with normal males for eight generations. Mutant human ND4 DNA was 20% of mouse ND4 and did not integrate into the host genome. Translated human ND4 protein assembled into host respiratory complexes, decreasing respiratory chain function and increasing oxidative stress. Swelling of the optic nerve head was followed by progressive demise of ganglion cells and their axons, the hallmarks of human LHON. Early visual loss that began at 3 mo and progressed to blindness 8 mo after birth was reversed by intraocular injection of MTS-AAV expressing wild-type human ND4. The technology of introducing human mitochondrial genes into the mouse germ line has never been described, to our knowledge, and has implications not only for creating animal models recapitulating the counterpart human disorder but more importantly for reversing the adverse effects of the mutant gene using gene therapy to deliver the wild-type allele.

  8. A cross-sectional survey of optometrists and optometric practices in Ghana.

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    Boadi-Kusi, Samuel Bert; Ntodie, Michael; Mashige, Khathutshelo Percy; Owusu-Ansah, Andrew; Antwi Osei, Kwaku

    2015-09-01

    The study was conducted to profile optometrists and optometric practices in Ghana. An online survey was conducted among 146 optometrists, who were registered with the Ghana Optometric Association (GOA). It included questions on their demographics, equipment, ophthalmic procedures routinely conducted and the barriers to providing a full scope of optometric services. Ninety registered optometrists (62 per cent) responded, their mean age being 28.97 ± 3.36 years. There were more males (68.9 per cent) than females and most had the Doctor of Optometry (OD) degree, the profession's highest degree in Ghana. There were more practitioners in urban centres (71.1 per cent) and most practices had basic optometric instruments, such as direct ophthalmoscopes, slitlamp biomicroscopes and retinoscopes. Many optometrists routinely conducted direct ophthalmoscopy (100 per cent), slitlamp biomicroscopy (87.5 per cent) and contact tonometry (55.7 per cent); however, few provided contact lens (10.2 per cent) and low vision (9.1 per cent) assessments, with 76 per cent stating that it was due to the unavailability of low vision devices, poor sources of contact lenses (27 per cent) and perceived insufficient training (11.2 per cent). Many practitioners (97 per cent) reported the use of diagnostic pharmaceutical agents and therapeutic pharmaceutical agents (96.6 per cent). Most practitioners (52.9 per cent) preferred conferences for the delivery of continuous professional development over publications (26.4 per cent) and internet resources (12.6 per cent). The data elicited in this study provide a basis for addressing the country's unmet eye-care needs and can be used to determine training and support guidelines for the profession. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

  9. Time-Resolved Autofluorescence Imaging of Human Donor Retina Tissue from Donors with Significant Extramacular Drusen

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    Schweitzer, Dietrich; Gaillard, Elizabeth R.; Dillon, James; Mullins, Robert F.; Russell, Stephen; Hoffmann, Birgit; Peters, Sven; Hammer, Martin; Biskup, Christoph

    2012-01-01

    Purpose. Time and spectrally resolved measurements of autofluorescence have the potential to monitor metabolism at the cellular level. Fluorophores that emit with the same fluorescence intensity can be discriminated from each other by decay time of fluorescence intensity after pulsed excitation. We performed time-resolved autofluorescence measurements on fundus samples from a donor with significant extramacular drusen. Methods. Tissue sections from two human donors were prepared and imaged with a laser scanning microscope. The sample was excited with a titanium-sapphire laser, which was tuned to 860 nm, and frequency doubled by a BBO crystal to 430 nm. The repetition rate was 76 MHz and the pulse width was 170 femtoseconds (fs). The time-resolved autofluorescence was recorded simultaneously in 16 spectral channels (445–605 nm) and bi-exponentially fitted. Results. RPE can be discriminated clearly from Bruch's membrane, drusen, and choroidal connective tissue by fluorescence lifetime. In RPE, bright fluorescence of lipofuscin could be detected with a maximum at 510 nm and extending beyond 600 nm. The lifetime was 385 ps. Different types of drusen were found. Most of them did not contain lipofuscin and exhibited a weak fluorescence, with a maximum at 470 nm. The lifetime was 1785 picoseconds (ps). Also, brightly emitting lesions, presumably representing basal laminar deposits, with fluorescence lifetimes longer than those recorded in RPE could be detected. Conclusions. The demonstrated differentiation of fluorescent structures by their fluorescence decay time is important for interpretation of in vivo measurements by the new fluorescence lifetime imaging (FLIM) ophthalmoscopy on healthy subjects as well as on patients. PMID:22511622

  10. Diagnostic fundus autofluorescence patterns in achromatopsia.

    Science.gov (United States)

    Fahim, Abigail T; Khan, Naheed W; Zahid, Sarwar; Schachar, Ira H; Branham, Kari; Kohl, Susanne; Wissinger, Bernd; Elner, Victor M; Heckenlively, John R; Jayasundera, Thiran

    2013-12-01

    To describe the unique diagnostic fundus autofluorescence (FAF) patterns in patients with achromatopsia and the associated findings on optical coherence tomography (OCT). Observational case series. We evaluated 10 patients with achromatopsia by means of best-corrected visual acuity (BCVA), ophthalmoscopy, Goldmann visual field, full-field electroretinography (ffERG), OCT, and FAF photography. FAF patterns were compared with patient age and foveal changes on OCT. Patients fell into two dichotomous age groups at the time of evaluation: six patients ranged from 11 to 23 years of age, and 3 patients ranged from 52 to 63 years of age. All patients had severely reduced photopic ffERG responses, including those exhibiting preserved foveal structure on OCT. The younger patients had absent to mild foveal atrophy on OCT, and four of the six demonstrated foveal and parafoveal hyperfluorescence on FAF. In addition, a 7-month-old child with compound heterozygous mutations in CNGA3 demonstrated similar foveal hyperfluorescence. The older patients demonstrated advanced foveal atrophy and punched-out foveal hypofluorescence with discrete borders on FAF imaging corresponding to the area of outer retinal cavitation on OCT. Foveal hyperfluorescence is an early sign of achromatopsia that can aid in clinical diagnosis. In our cohort, patients with achromatopsia demonstrated age-dependent changes in FAF, which are likely to be progressive and to correlate with foveal atrophy and cavitation on OCT. This finding may be useful in charting the natural course of the disease and in defining a therapeutic window for treatment. Copyright © 2013. Published by Elsevier Inc.

  11. Residual Foveal Cone Structure in CNGB3-Associated Achromatopsia.

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    Langlo, Christopher S; Patterson, Emily J; Higgins, Brian P; Summerfelt, Phyllis; Razeen, Moataz M; Erker, Laura R; Parker, Maria; Collison, Frederick T; Fishman, Gerald A; Kay, Christine N; Zhang, Jing; Weleber, Richard G; Yang, Paul; Wilson, David J; Pennesi, Mark E; Lam, Byron L; Chiang, John; Chulay, Jeffrey D; Dubra, Alfredo; Hauswirth, William W; Carroll, Joseph

    2016-08-01

    Congenital achromatopsia (ACHM) is an autosomal recessive disorder in which cone function is absent or severely reduced. Gene therapy in animal models of ACHM have shown restoration of cone function, though translation of these results to humans relies, in part, on the presence of viable cone photoreceptors at the time of treatment. Here, we characterized residual cone structure in subjects with CNGB3-associated ACHM. High-resolution imaging (optical coherence tomography [OCT] and adaptive optics scanning light ophthalmoscopy [AOSLO]) was performed in 51 subjects with CNGB3-associated ACHM. Peak cone density and inter-cone spacing at the fovea was measured using split-detection AOSLO. Foveal outer nuclear layer thickness was measured in OCT images, and the integrity of the photoreceptor layer was assessed using a previously published OCT grading scheme. Analyzable images of the foveal cones were obtained in 26 of 51 subjects, with nystagmus representing the major obstacle to obtaining high-quality images. Peak foveal cone density ranged from 7,273 to 53,554 cones/mm2, significantly lower than normal (range, 84,733-234,391 cones/mm2), with the remnant cones being either contiguously or sparsely arranged. Peak cone density was correlated with OCT integrity grade; however, there was overlap of the density ranges between OCT grades. The degree of residual foveal cone structure varies greatly among subjects with CNGB3-associated ACHM. Such measurements may be useful in estimating the therapeutic potential of a given retina, providing affected individuals and physicians with valuable information to more accurately assess the risk-benefit ratio as they consider enrolling in experimental gene therapy trials. (www.clinicaltrials.gov, NCT01846052.).

  12. De-warping of images and improved eye tracking for the scanning laser ophthalmoscope.

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    Bedggood, Phillip; Metha, Andrew

    2017-01-01

    A limitation of scanning laser ophthalmoscopy (SLO) is that eye movements during the capture of each frame distort the retinal image. Various sophisticated strategies have been devised to ensure that each acquired frame can be mapped quickly and accurately onto a chosen reference frame, but such methods are blind to distortions in the reference frame itself. Here we explore a method to address this limitation in software, and demonstrate its accuracy. We used high-speed (200 fps), high-resolution (~1 μm), flood-based imaging of the human retina with adaptive optics to obtain "ground truth" information on the retinal image and motion of the eye. This information was used to simulate SLO video sequences at 20 fps, allowing us to compare various methods for eye-motion recovery and subsequent minimization of intra-frame distortion. We show that a) a single frame can be near-perfectly recovered with perfect knowledge of intra-frame eye motion; b) eye motion at a given time point within a frame can be accurately recovered by tracking the same strip of tissue across many frames, due to the stochastic symmetry of fixational eye movements. This approach is similar to, and easily adapted from, previously suggested strip-registration approaches; c) quality of frame recovery decreases with amplitude of eye movements, however, the proposed method is affected less by this than other state-of-the-art methods and so offers even greater advantages when fixation is poor. The new method could easily be integrated into existing image processing software, and we provide an example implementation written in Matlab.

  13. [Ocular manifestations of children living with HIV/AIDS in Kinshasa].

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    Nsiangani, N L; Kaimbo Wa Kaimbo, D; Kapepela, M K

    2013-01-01

    to determine the frequency of ocular manifestations in Congolese children aged 0 to 15 years infected with HIV/AIDS and to identify the predicted clinical and/or biological elements. This was a prospective, descriptive and cross-sectional study performed from November 2010 to April 2011 in five sanitary structures who take care of children infected with HIV/AIDS. During the period of study, one hundred children infected with VIH/AIDS were examined. Seventy- six (76%) of children were under highly active anti-retrovial therapy (HAART). The age of children ranged from 0,5 month to 15 years. Children underwent a routine ophthalmic examination which included measurement of visual acuity, inspection of the adnexa and cornea, slit-lamp examination and dilated ophthalmoscopy. The CD4 lymphocyte count was determined in 88 of them. The frequency of ocular manifestations was 36%. The mean age of children was 8 years (SD: 4.01; range 0,5 month-15 years). The male female sex ratio was 0.8/1. Ocular complaints were present in 22 children (22%). Visual symptoms were most frequent in children with severe decrease of immunity. Of four children identified with a visual handicap, one (1.5%) had blindness and three (4.4%) had visual impairment. All of these four children had a CD4 lymphocyte count less than 15%. Among ocular manifestations, the adnexial manifestations were the most frequent with 18 cases (18%) followed by the posterior segment manifestations with 14 cases (14%) and the neuroophthalmic lesions with 5 cases (5%). This study documented 36% of ocular manifestations; this frequency is comparable with the other African studies. Comparatively to studies conducted in other continents the frequency in African studies is high. This study also showed that the adnexial manifestations are the most frequent ocular findings and that the children with severe decrease of immunity are most exposed to visual troubles that can lead to blindness.

  14. Biocompatible reverse thermal gel sustains the release of intravitreal bevacizumab in vivo.

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    Rauck, Britta M; Friberg, Thomas R; Medina Mendez, Carlos A; Park, Daewon; Shah, Veeral; Bilonick, Richard A; Wang, Yadong

    2014-01-23

    We assessed the in vivo release profile of bevacizumab from and biocompatibility of poly(ethylene glycol)-poly-(serinol hexamethylene urethane), or ESHU, a thermoresponsive hydrogel administered intravitreally for drug delivery. The technical feasibility of injection was assessed quantitatively via mechanical testing. For in vivo studies, New Zealand White rabbit eyes were injected intravitreally with 0.05 mL of either: ESHU dissolved in 25 mg/mL bevacizumab, ESHU dissolved in PBS, or 25 mg/mL bevacizumab. Clinical examination included IOP measurements and examination with indirect ophthalmoscopy for signs of inflammation. Additionally, eyes were examined histologically following euthanasia. To quantify bevacizumab release, aqueous humor samples were obtained via anterior chamber paracentesis and ELISA was used to determine the concentration of drug weekly. In vitro cytotoxicity testing also was performed using bovine corneal endothelial cells. The ESHU was injected easily through a 31-gauge needle, was well tolerated in vivo, and caused minimal cell death in vitro when compared to other common materials, such as silicone oil. The long-term presence of the gel did not affect IOP, and there was no evidence of inflammation histologically or through indirect observation. The ESHU sustained the release of bevacizumab for over 9 weeks and maintained a drug concentration that averaged 4.7 times higher than eyes receiving bolus bevacizumab injections. To our knowledge, this is the first report demonstrating sustained bevacizumab release in vivo from an intravitreally injected hydrogel formulation, suggesting that this delivery system may be a promising candidate for ocular drug delivery.

  15. FUNDUS CHANGES IN PREGNANCY INDUCED HYPERTENSION: A CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Rama Bharathi

    2015-01-01

    Full Text Available PURPOSE: To estimate the prevalence of fundus changes in Pregnancy Induced Hypertension (PIH and to find the correlation of the findings with the levels of hypertension and with the severity of the disease. METHODS: This was a hospital based cross section al study conducted over a period of one year from July 2012 to June 2013. 150 patients with diagnosed PIH and admission into wards at King George Hospital, Visakhapatnam, with 36 weeks period of gestation and above, were included in the study. Those with p re - existing hypertension, coexisting diabetes mellitus, severe anaemia, renal disease and ocular diseases like cataract or corneal opacities were excluded from the study. After taking consent and ocular history, anterior segment was evaluated. Pupils were dilated with 0.5% tropicamide eye drops and fundus examination was done with direct ophthalmoscope. Information like age, para, BP etc., was noted down from case sheets. RESULTS: Total number of patients studied was 150.Mean age was 23.06+ 3.03years. 105 ( 70% were primigravidae and 45(30% were multigravidae. Fundus findings were seen in 35 cases (23.33%. 26 (17.33% had Grade I changes, 1 (0.66% had grade II changes, 6 (3.9% had grade III changes 2 (1.3% had serous retinal detachment/grade - IV. The de gree of retinopathy was correlating with the severity of the disease and levels of hypertension. CONCLUSION: The prevalence of fundus changes in PIH is 23.33%. Most of the fundus changes in PIH are underdiagnosed. Timely ophthalmoscopy should be called for in all cases of PIH as it would affect the decision of induction of delivery, thereby preventing other complications.

  16. Evaluation of the progression rate of atrophy lesions in punctate inner choroidopathy (PIC) based on autofluorescence analysis.

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    Hua, Rui; Liu, Limin; Chen, Lei

    2014-12-01

    To investigate the autofluorescence (AF) characteristics of punctate inner choroidopathy (PIC) and to evaluate the progression rate of retinal pigment epithelium (RPE) atrophy lesions in PIC using confocal scanning laser ophthalmoscopy. Twenty-two eyes of 14 PIC cases and 21 eyes of 21 non-proliferative diabetic retinopathy (NPDR) cases which received retinal coagulation as a control group were enrolled in this study. Enhanced depth imaging optical coherence tomography (EDI-OCT) and AF were recorded from all patients at 18 months follow-up. The RPE atrophy areas of PIC and laser scars in NPDR were analyzed using the Region Finder software of the Heidelberg Eye Explorer. This software allows direct export of AF images from the database and semi-automated detection of atrophic areas by shadow correction, vessel detection, and selection of seed points. At baseline, both hyperfluorescence and hypofluorescence were observed in the lesions of PIC eyes with a focal elevation of RPE and corresponding disruption of the ellipsoid region of the inner segment ellipsoid zone (EZ). In contrast, hypo-AF was detected when there was a lack of RPE. The mean progression rate of RPE atrophy in PIC and NPDR were 3.735 mm(2)/year (0.056-0.545) and 0.127 mm(2)/year (0.015-0.466), respectively. Compared with the atrophy area in the last visit, the progression rate in PIC was significantly greater than that in NPDR (Z=5.615, P<0.0001). The results of AF reflect the status of PIC and the progression rate of RPE atrophy in PIC, which can be used to predict the progress of PIC noninvasively. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Semiautomated image processing method for identification and quantification of geographic atrophy in age-related macular degeneration.

    Science.gov (United States)

    Schmitz-Valckenberg, Steffen; Brinkmann, Christian K; Alten, Florian; Herrmann, Philipp; Stratmann, Nina K; Göbel, Arno P; Fleckenstein, Monika; Diller, Martin; Jaffe, Glenn J; Holz, Frank G

    2011-09-29

    To determine intraobserver and interobserver longitudinal measurement variability of novel semiautomated software for quantification of age-related macular degeneration-associated geographic atrophy (GA) based on confocal scanning laser ophthalmoscopy fundus autofluorescence (FAF) imaging. Three-field FAF (excitation 488 nm, emission 500-700 nm), near-infrared reflectance (820 nm), and blue reflectance (488 nm) images of 30 GA subjects were recorded according to a standardized protocol at baseline after 6 and 12 months. At all visits, the GA area was analyzed on central FAF images by seven independent readers using semiautomated software. The software allows direct export of FAF images from the database and semiautomated detection of atrophic areas by shadow correction, vessel detection, and selection of seed points. The mean size of atrophy at baseline and the mean progression rate were 5.96 mm² (range, 1.80-15.87) and 1.25 mm²/year (0.42-2.93), respectively. Mean difference of interobserver agreement (Bland-Altman statistics) ranged from -0.25 to 0.30 mm² for the baseline visit and from -0.14 to 0.11 mm²/year for the atrophy progression rate. Corresponding reflectance images were helpful for lesion boundary discrimination, particularly for evaluation of foveal GA involvement and when image quality was poor. The new image processing software offers an accurate, reproducible, and time-efficient identification and quantification of outer retinal atrophy and its progression over time. It facilitates measurements both in natural history studies and in interventional trials to evaluate new pharmacologic agents designed to limit GA enlargement.

  18. Comparison of the effectiveness of three retinal camera technologies for malarial retinopathy detection in Malawi

    Science.gov (United States)

    Soliz, Peter; Nemeth, Sheila C.; Barriga, E. Simon; Harding, Simon P.; Lewallen, Susan; Taylor, Terrie E.; MacCormick, Ian J.; Joshi, Vinayak S.

    2016-03-01

    The purpose of this study was to test the suitability of three available camera technologies (desktop, portable, and iphone based) for imaging comatose children who presented with clinical symptoms of malaria. Ultimately, the results of the project would form the basis for a design of a future camera to screen for malaria retinopathy (MR) in a resource challenged environment. The desktop, portable, and i-phone based cameras were represented by the Topcon, Pictor Plus, and Peek cameras, respectively. These cameras were tested on N=23 children presenting with symptoms of cerebral malaria (CM) at a malaria clinic, Queen Elizabeth Teaching Hospital in Malawi, Africa. Each patient was dilated for binocular indirect ophthalmoscopy (BIO) exam by an ophthalmologist followed by imaging with all three cameras. Each of the cases was graded according to an internationally established protocol and compared to the BIO as the clinical ground truth. The reader used three principal retinal lesions as markers for MR: hemorrhages, retinal whitening, and vessel discoloration. The study found that the mid-priced Pictor Plus hand-held camera performed considerably better than the lower price mobile phone-based camera, and slightly the higher priced table top camera. When comparing the readings of digital images against the clinical reference standard (BIO), the Pictor Plus camera had sensitivity and specificity for MR of 100% and 87%, respectively. This compares to a sensitivity and specificity of 87% and 75% for the i-phone based camera and 100% and 75% for the desktop camera. The drawback of all the cameras were their limited field of view which did not allow complete view of the periphery where vessel discoloration occurs most frequently. The consequence was that vessel discoloration was not addressed in this study. None of the cameras offered real-time image quality assessment to ensure high quality images to afford the best possible opportunity for reading by a remotely located

  19. HCN1 Channels Enhance Rod System Responsivity in the Retina under Conditions of Light Exposure.

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    Vithiyanjali Sothilingam

    Full Text Available Vision originates in rods and cones at the outer retina. Already at these early stages, diverse processing schemes shape and enhance image information to permit perception over a wide range of lighting conditions. In this work, we address the role of hyperpolarization-activated and cyclic nucleotide-gated channels 1 (HCN1 in rod photoreceptors for the enhancement of rod system responsivity under conditions of light exposure.To isolate HCN1 channel actions in rod system responses, we generated double mutant mice by crossbreeding Hcn1-/- mice with Cnga3-/- mice in which cones are non-functional. Retinal function in the resulting Hcn1-/- Cnga3-/- animals was followed by means of electroretinography (ERG up to the age of four month. Retinal imaging via scanning laser ophthalmoscopy (SLO and optical coherence tomography (OCT was also performed to exclude potential morphological alterations.This study on Hcn1-/- Cnga3-/- mutant mice complements our previous work on HCN1 channel function in the retina. We show here in a functional rod-only setting that rod responses following bright light exposure terminate without the counteraction of HCN channels much later than normal. The resulting sustained signal elevation does saturate the retinal network due to an intensity-dependent reduction in the dynamic range. In addition, the lack of rapid adaptational feedback modulation of rod photoreceptor output via HCN1 in this double mutant limits the ability to follow repetitive (flicker stimuli, particularly under mesopic conditions.This work corroborates the hypothesis that, in the absence of HCN1-mediated feedback, the amplitude of rod signals remains at high levels for a prolonged period of time, leading to saturation of the retinal pathways. Our results demonstrate the importance of HCN1 channels for regular vision.

  20. Consequences of zygote injection and germline transfer of mutant human mitochondrial DNA in mice

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    Yu, Hong; Koilkonda, Rajeshwari D.; Chou, Tsung-Han; Porciatti, Vittorio; Mehta, Arpit; Hentall, Ian D.; Chiodo, Vince A.; Boye, Sanford L.; Hauswirth, William W.; Lewin, Alfred S.; Guy, John

    2015-01-01

    Considerable evidence supports mutations in mitochondrial genes as the cause of maternally inherited diseases affecting tissues that rely primarily on oxidative energy metabolism, usually the nervous system, the heart, and skeletal muscles. Mitochondrial diseases are diverse, and animal models currently are limited. Here we introduced a mutant human mitochondrial gene responsible for Leber hereditary optic neuropathy (LHON) into the mouse germ line using fluorescence imaging for tissue-specific enrichment in the target retinal ganglion cells. A mitochondria-targeted adeno-associated virus (MTS-AAV) containing the mutant human NADH ubiquinone oxidoreductase subunit 4 (ND4) gene followed by mitochondrial-encoded mCherry was microinjected into zygotes. Female founders with mCherry fluorescence on ophthalmoscopy were backcrossed with normal males for eight generations. Mutant human ND4 DNA was 20% of mouse ND4 and did not integrate into the host genome. Translated human ND4 protein assembled into host respiratory complexes, decreasing respiratory chain function and increasing oxidative stress. Swelling of the optic nerve head was followed by progressive demise of ganglion cells and their axons, the hallmarks of human LHON. Early visual loss that began at 3 mo and progressed to blindness 8 mo after birth was reversed by intraocular injection of MTS-AAV expressing wild-type human ND4. The technology of introducing human mitochondrial genes into the mouse germ line has never been described, to our knowledge, and has implications not only for creating animal models recapitulating the counterpart human disorder but more importantly for reversing the adverse effects of the mutant gene using gene therapy to deliver the wild-type allele. PMID:26438859

  1. A degenerative retinal process in HIV-associated non-infectious retinopathy.

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    Igor Kozak

    Full Text Available HIV retinopathy is the most common non-infectious complication in the eyes of HIV-positive individuals. Oncotic lesions in the retinal nerve fiber layer, referred to as cotton wool spots (CWS, and intraretinal (IR hemorrhages are frequently observed but are not unique to this pathology. HIV-positive patients have impaired color vision and contrast sensitivity, which worsens with age. Evidence of inner-retinal lesions and damage have been documented ophthalmoscopically, however their long term structural effect has not been investigated. It has been hypothesized that they may be partially responsible for loss of visual function and visual field. In this study we utilized clinical data, retinal imaging and transcriptomics approaches to comprehensively interrogate non-infectious HIV retinopathy. The methods employed encompassed clinical examinations, fundus photography, indirect ophthalmoscopy, Farmsworth-Munsell 100 hue discrimination testing and Illumina BeadChip analyses. Here we show that changes in the outer retina, specifically in the retinal pigment epithelium (RPE and photoreceptor outer segments (POS contribute to vision changes in non-infectious HIV retinopathy. We find that in HIV-positive retinae there is an induction of rhodopsin and other transcripts (including PDE6A, PDE6B, PDE6G, CNGA1, CNGB1, CRX, NRL involved in visual transduction, as well as structural components of the rod photoreceptors (ABCA4 and ROM1. This is consistent with an increased rate of renewal of rod outer segments induced via increased phagocytosis by HIV-infected RPE previously reported in culture. Cone-specific transcripts (OPN1SW, OPN1LW, PDE6C, PDE6H and GRK7 are uniformly downregulated in HIV positive retina, likely due to a partial loss of cone photoreceptors. Active cotton wool spots and intraretinal hemorrhages (IRH may not affect photoreceptors directly and the interaction of photoreceptors with the aging RPE may be the key to the progressive vision

  2. Towards a quantitative OCT image analysis.

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    Marina Garcia Garrido

    Full Text Available Optical coherence tomography (OCT is an invaluable diagnostic tool for the detection and follow-up of retinal pathology in patients and experimental disease models. However, as morphological structures and layering in health as well as their alterations in disease are complex, segmentation procedures have not yet reached a satisfactory level of performance. Therefore, raw images and qualitative data are commonly used in clinical and scientific reports. Here, we assess the value of OCT reflectivity profiles as a basis for a quantitative characterization of the retinal status in a cross-species comparative study.Spectral-Domain Optical Coherence Tomography (OCT, confocal Scanning-Laser Ophthalmoscopy (SLO, and Fluorescein Angiography (FA were performed in mice (Mus musculus, gerbils (Gerbillus perpadillus, and cynomolgus monkeys (Macaca fascicularis using the Heidelberg Engineering Spectralis system, and additional SLOs and FAs were obtained with the HRA I (same manufacturer. Reflectivity profiles were extracted from 8-bit greyscale OCT images using the ImageJ software package (http://rsb.info.nih.gov/ij/.Reflectivity profiles obtained from OCT scans of all three animal species correlated well with ex vivo histomorphometric data. Each of the retinal layers showed a typical pattern that varied in relative size and degree of reflectivity across species. In general, plexiform layers showed a higher level of reflectivity than nuclear layers. A comparison of reflectivity profiles from specialized retinal regions (e.g. visual streak in gerbils, fovea in non-human primates with respective regions of human retina revealed multiple similarities. In a model of Retinitis Pigmentosa (RP, the value of reflectivity profiles for the follow-up of therapeutic interventions was demonstrated.OCT reflectivity profiles provide a detailed, quantitative description of retinal layers and structures including specialized retinal regions. Our results highlight the

  3. The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

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    Anand Vinekar

    2014-01-01

    Full Text Available Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP program for retinopathy of prematurity (ROP screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score graded their ability (Level I to III to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple. Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001. Only 0.4% of infants needing treatment were missed.The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001 respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics.

  4. Neurodegeneration severity can be predicted from early microglia alterations monitored in vivo in a mouse model of chronic glaucoma

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    Alejandra Bosco

    2015-05-01

    Full Text Available Microglia serve key homeostatic roles, and respond to neuronal perturbation and decline with a high spatiotemporal resolution. The course of all chronic CNS pathologies is thus paralleled by local microgliosis and microglia activation, which begin at early stages of the disease. However, the possibility of using live monitoring of microglia during early disease progression to predict the severity of neurodegeneration has not been explored. Because the retina allows live tracking of fluorescent microglia in their intact niche, here we investigated their early changes in relation to later optic nerve neurodegeneration. To achieve this, we used the DBA/2J mouse model of inherited glaucoma, which develops progressive retinal ganglion cell degeneration of variable severity during aging, and represents a useful model to study pathogenic mechanisms of retinal ganglion cell decline that are similar to those in human glaucoma. We imaged CX3CR1+/GFP microglial cells in vivo at ages ranging from 1 to 5 months by confocal scanning laser ophthalmoscopy (cSLO and quantified cell density and morphological activation. We detected early microgliosis at the optic nerve head (ONH, where axonopathy first manifests, and could track attenuation of this microgliosis induced by minocycline. We also observed heterogeneous and dynamic patterns of early microglia activation in the retina. When the same animals were aged and analyzed for the severity of optic nerve pathology at 10 months of age, we found a strong correlation with the levels of ONH microgliosis at 3 to 4 months. Our findings indicate that live imaging and monitoring the time course and levels of early retinal microgliosis and microglia activation in glaucoma could serve as indicators of future neurodegeneration severity.

  5. Microangiopathic complications in type 1 diabetes mellitus: differences in severity when isolated or associated with autoimmune polyendocrinopathies

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    Patrícia Teófilo Monteagudo

    Full Text Available CONTEXT: The development and evolution of different chronic diabetic complications may present variations among the different types and conditions of this disease. OBJECTIVE: To evaluate the degree of microangiopathy in Type 1 diabetes mellitus (DM1 associated with autoimmune polyendocrinopathies (OSAD or isolated DM1 (iDM1. PATIENTS: OSAD (n=17 and iDM1 (n=13 were over 15 years old at diagnosis of DM and were matched for diabetes duration (13.9 ± 8.2 and 13.2 ± 5.9 years, respectively and metabolic control (HbA1c: 6.4 ± 1.9 and 6.8 ± 1.4%. MAIN OUTCOME MEASURES: Urinary albumin excretion (UAE; ELISA, the inversion of serum creatinine (1/C level and indirect ophthalmoscopy. RESULTS: Although the prevalence of hypertension was similar in both groups, the OSAD had inferior levels of UAE (7.4 ± 2.5 vs. 17.3 ± 9.2 µg/min; p< 0.05. Nephropathy was detected in 12% of the OSAD (none of them macroproteinuric and in 39% of the iDM1 . The UAE in the iDM1 correlated negatively with 1/C values (r= -0.7, p< 0.005, but the same did not occur in the OSAD (r= 0.2, ns. Among patients with retinopathy, the severe form was found in 29% of the OSAD and in 46% of the iDM1. CONCLUSIONS: OSAD was associated with a lower degree of microangiopathy, in spite of age at diagnosis, duration of diabetes and the metabolic control. In contrast with the iDM1 , the increase in UAE of OSAD was not associated with reductions in GFR.

  6. Implantation of ultrathin, biofunctionalized polyimide membranes into the subretinal space of rats.

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    Julien, Sylvie; Peters, Tobias; Ziemssen, Focke; Arango-Gonzalez, Blanca; Beck, Susanne; Thielecke, Hagen; Büth, Heiko; Van Vlierberghe, Sandra; Sirova, Milada; Rossmann, Pavel; Rihova, Blanka; Schacht, Etienne; Dubruel, Peter; Zrenner, Eberhart; Schraermeyer, Ulrich

    2011-06-01

    Subretinal implants aim to replace the photoreceptor function in patients suffering from degenerative retinal disease by topically applying electrical stimuli in the subretinal space. Critical obstacles in the design of high-resolution subretinal implants include the proximity of stimulating electrodes to the target cells and enabling nutrient flow between the retina and the choroid. The present work evaluates the adhesion, migration and survival of retinal cells on an ultrathin (5 μm), highly porous (Ø 1 μm spaced 3 μm), gelatin-coated polyimide (PI) membrane. The biocompatibility was examined in mice indicating a good tolerance upon subcutaneous implantation with only a mild inflammatory response. In addition, organotypic cultures of rat retina evidenced that the porous membrane allowed the necessary nutrient flow for the retinal cell survival and maintenance. A transscleral implantation technique was applied to position the membrane into the subretinal space of rats. The effect on the obtained retinal integration was investigated in vivo using scanning laser ophthalmoscopy (SLO) and optical coherence tomography (OCT). In 12 out of 18 rat eyes, the implant was successfully placed subretinally. SLO and OCT demonstrated complete retinal attachment and fluorescein angiography showed no retinal vascular abnormalities over and around the implant, immediately after and up to four weeks after the implantation. Histological examination of the eyes showed a close attachment of a thin fibrocyte layer to the implant, the occlusion of the pores by living cells and the survival of some photoreceptors at the implantation site. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Determination of morphological, biometric and biochemical susceptibilities in healthy Eurasier dogs with suspected inherited glaucoma.

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    Boillot, Thomas; Rosolen, Serge G; Dulaurent, Thomas; Goulle, Frédéric; Thomas, Philippe; Isard, Pierre-François; Azoulay, Thierry; Lafarge-Beurlet, Stéphanie; Woods, Mike; Lavillegrand, Sylvie; Ivkovic, Ivana; Neveux, Nathalie; Sahel, José-Alain; Picaud, Serge; Froger, Nicolas

    2014-01-01

    In both humans and dogs, the primary risk factor for glaucoma is high intraocular pressure (IOP), which may be caused by iridocorneal angle (ICA) abnormalities. Oxidative stress has also been implicated in retinal ganglion cell damage associated with glaucoma. A suspected inherited form of glaucoma was recently identified in Eurasier dogs (EDs), a breed for which pedigrees are readily available. Because of difficulties in assessing ICA morphology in dogs with advanced glaucoma, we selected a cohort of apparently healthy dogsfor the investigation of ICA morphological status, IOP and plasma concentrations of oxidative stress biomarkers. We aimed to establish correlations between these factors, to identify predictive markers of glaucoma in this dog breed. A cohort of 28 subjects, volunteered for inclusion by their owners, was selected by veterinary surgeons. These dogs were assigned to four groups: young males, young females (1-3 years old), adult males and adult females (4-8 years old). Ocular examination included ophthalmoscopy, tonometry, gonioscopy, biometry and ultrasound biomicroscopy (UBM), and the evaluation of oxidative stress biomarkers consisting of measurements of plasma glutathione peroxidase (GP) activity and taurine and metabolic precursor (methionine and cysteine) concentrations in plasma. The prevalence of pectinate ligament abnormalities was significantly higher in adult EDs than in young dogs. Moreover, in adult females, high IOP was significantly correlated with a short axial globe length, and a particularly large distance between Schwalbe's line and the anterior lens capsule. GP activity levels were significantly lower in EDs than in a randomized control group of dogs, and plasma taurine concentrations were higher. Hence, ICA abnormalities were associated with weaker antioxidant defenses in EDs, potentially counteracted by higher plasma taurine concentrations. This study suggests that EDs may constitute an appropriate canine model for the

  8. Adaptive Optics Reveals Photoreceptor Abnormalities in Diabetic Macular Ischemia

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    Nesper, Peter L.; Scarinci, Fabio

    2017-01-01

    Diabetic macular ischemia (DMI) is a phenotype of diabetic retinopathy (DR) associated with chronic hypoxia of retinal tissue. The goal of this prospective observational study was to report evidence of photoreceptor abnormalities using adaptive optics scanning laser ophthalmoscopy (AOSLO) in eyes with DR in the setting of deep capillary plexus (DCP) non-perfusion. Eleven eyes from 11 patients (6 women, age 31–68), diagnosed with DR without macular edema, underwent optical coherence tomography angiography (OCTA) and AOSLO imaging. One patient without OCTA imaging underwent fluorescein angiography to characterize the enlargement of the foveal avascular zone. The parameters studied included photoreceptor heterogeneity packing index (HPi) on AOSLO, as well as DCP non-perfusion and vessel density on OCTA. Using AOSLO, OCTA and spectral domain (SD)-OCT, we observed that photoreceptor abnormalities on AOSLO and SD-OCT were found in eyes with non-perfusion of the DCP on OCTA. All eight eyes with DCP non-flow on OCTA showed photoreceptor abnormalities on AOSLO. Six of the eight eyes also had outer retinal abnormalities on SD-OCT. Three eyes with DR and robust capillary perfusion of the DCP had normal photoreceptors on SD-OCT and AOSLO. Compared to eyes with DR without DCP non-flow, the eight eyes with DCP non-flow had significantly lower HPi (P = 0.013) and parafoveal DCP vessel density (P = 0.016). We found a significant correlation between cone HPi and parafoveal DCP vessel density (r = 0.681, P = 0.030). Using a novel approach with AOSLO and OCTA, this study shows an association between capillary non-perfusion of the DCP and abnormalities in the photoreceptor layer in eyes with DR. This observation is important in confirming the significant contribution of the DCP to oxygen requirements of photoreceptors in DMI, while highlighting the ability of AOSLO to detect subtle photoreceptor changes not always visible on SD-OCT. PMID:28068435

  9. Enhanced Visualization of Subtle Outer Retinal Pathology by En Face Optical Coherence Tomography and Correlation with Multi-Modal Imaging

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    Chew, Avenell L.; Lamey, Tina; McLaren, Terri; De Roach, John

    2016-01-01

    Purpose To present en face optical coherence tomography (OCT) images generated by graph-search theory algorithm-based custom software and examine correlation with other imaging modalities. Methods En face OCT images derived from high density OCT volumetric scans of 3 healthy subjects and 4 patients using a custom algorithm (graph-search theory) and commercial software (Heidelberg Eye Explorer software (Heidelberg Engineering)) were compared and correlated with near infrared reflectance, fundus autofluorescence, adaptive optics flood-illumination ophthalmoscopy (AO-FIO) and microperimetry. Results Commercial software was unable to generate accurate en face OCT images in eyes with retinal pigment epithelium (RPE) pathology due to segmentation error at the level of Bruch’s membrane (BM). Accurate segmentation of the basal RPE and BM was achieved using custom software. The en face OCT images from eyes with isolated interdigitation or ellipsoid zone pathology were of similar quality between custom software and Heidelberg Eye Explorer software in the absence of any other significant outer retinal pathology. En face OCT images demonstrated angioid streaks, lesions of acute macular neuroretinopathy, hydroxychloroquine toxicity and Bietti crystalline deposits that correlated with other imaging modalities. Conclusions Graph-search theory algorithm helps to overcome the limitations of outer retinal segmentation inaccuracies in commercial software. En face OCT images can provide detailed topography of the reflectivity within a specific layer of the retina which correlates with other forms of fundus imaging. Our results highlight the need for standardization of image reflectivity to facilitate quantification of en face OCT images and longitudinal analysis. PMID:27959968

  10. Reproducibility of peripapillary retinal nerve fiber layer thickness measurements using Spectral Domain OCT in Brazilian patients

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    Daniela Araújo Toscano

    2012-10-01

    Full Text Available PURPOSE: To evaluate the reproducibility of peripapillary retinal nerve fiber layer (RNFL thickness measurements in normal eyes and eyes with glaucoma using spectral domain optical coherence tomography (SDOCT. METHODS: One eye of 79 normal and 72 glaucoma patients was analyzed. All patients underwent a complete ophthalmological examination, including visual acuity testing; intraocular pressure, slit-lamp examination, indirect ophthalmoscopy; and the glaucoma group underwent achromatic perimetry with the 24-2 SITA Fast Humphrey Field Analyzer. All patients' eyes were scanned using the spectral domain optical coherence tomography - Spectralis® and one of them was chosen randomly. Three consecutive circular B-scan centered at the optic disc were performed in one visit. RESULTS: The intraclass correlation coefficient (ICC, coefficient of variation and test-retest variability for the mean retinal nerve fiber layer thickness were respectively: 0.94, 2.56% and 4.85 µm for the normal group and 0.93, 4.65% and 6.61 µm for the glaucomatous group. The intraclass correlation coefficient for retinal nerve fiber layer thickness in all quadrants were all excellent in both groups, with the superior quadrant having the highest ICCs (0.964 in glaucomatous eyes and nasal quadrant measurements having the lowest (0.800, but still excellent in eyes without glaucoma. The coefficient of variation was between 2.56% - 8.74% and between 4.65% - 11.44% in normal and glaucomatous group respectively. The test-retest variability was between 4.85 µm and 11.51 µm in the normal group and between 6.61 µm and 14.24 µm in the glaucomatous group. The measurements in glaucomatous eyes were more variable than normal eyes. CONCLUSIONS: Spectral domain optical coherence tomography showed excellent reproducibility with regard to retinal nerve fiber layer thickness measurements in normal and glaucomatous eyes.

  11. Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN--DREAMS III: Study design and research methodology

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    Sahu Chinmaya

    2011-03-01

    Full Text Available Abstract Background To describe the methodology of the Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study III, an ongoing epidemiological study to estimate the prevalence of Diabetes and Diabetic Retinopathy in rural population of Kanchipuram and Thiravallur districts of Tamil Nadu, India and to elucidate the clinical, anthropometric, biochemical and genetic risk factors associated with diabetic retinopathy in this rural population. Methods Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study III will be a mobile van based epidemiological study; 11,760 participants aged ≥ 40 years will be recruited from the study areas. Eligible subjects will undergo blood sugar estimation to diagnose Diabetes. Oral Glucose Tolerance Test will be done to conform diabetes. All subjects with diabetes will undergo complete information of knowledge, aptitude and practice of diabetes and diabetic retinopathy, Diet questionnaire, demographic data, socioeconomic status, physical activity, anthropometric measurements, and risk of sleep apnoea. A detailed medical and ocular history, a comprehensive eye examination including refraction, slit lamp biomicroscopy examination, indirect ophthalmoscopy, slit lamp biomicroscopy, digital stereo fundus photography and ultrasound of eye will be done in the mobile van. Blood will be collected for biochemical investigations including blood hemoglobin, glycosylated hemoglobin, lipid profile, urea and creatinine, genetic study. Urine will be collected for microalbuminuria. All fundus photographs will be graded at base hospital. Participants who need treatment will be sent to the base hospital. A computerized database is created for the records. Conclusion The study is expected to provide an estimate of the prevalence of Diabetes and Diabetic Retinopathy and also a better understanding of the genetic, anthropometric and socio-economic risk factors associated with Diabetic

  12. Bedside ROP screening and telemedicine interpretation integrated to a neonatal transport system: Economic aspects and return on investment analysis.

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    Kovács, Gábor; Somogyvári, Zsolt; Maka, Erika; Nagyjánosi, László

    Peter Cerny Ambulance Service - Premature Eye Rescue Program (PCA-PERP) uses digital retinal imaging (DRI) with remote interpretation in bedside ROP screening, which has advantages over binocular indirect ophthalmoscopy (BIO) in screening of premature newborns. We aimed to demonstrate that PCA-PERP provides good value for the money and to model the cost ramifications of a similar newly launched system. As DRI was demonstrated to have high diagnostic performance, only the costs of bedside DRI-based screening were compared to those of traditional transport and BIO-based screening (cost-minimization analysis). The total costs of investment and maintenance were analyzed with micro-costing method. A ten-year analysis time-horizon and service provider's perspective were applied. From the launch of PCA-PERP up to the end of 2014, 3722 bedside examinations were performed in the PCA covered central region of Hungary. From 2009 to 2014, PCA-PERP saved 92,248km and 3633 staff working hours, with an annual nominal cost-savings ranging from 17,435 to 35,140 Euro. The net present value was 127,847 Euro at the end of 2014, with a payback period of 4.1years and an internal rate of return of 20.8%. Our model presented the NPVs of different scenarios with different initial investments, annual number of transports and average transport distances. PCA-PERP as bedside screening with remote interpretation, when compared to a transport-based screening with BIO, produced better cost-savings from the perspective of the service provider and provided a return on initial investment within five years after the project initiation. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Relationship Between Optic Nerve Appearance and Retinal Nerve Fiber Layer Thickness as Explored with Spectral Domain Optical Coherence Tomography

    Science.gov (United States)

    Aleman, Tomas S.; Huang, Jiayan; Garrity, Sean T.; Carter, Stuart B.; Aleman, Wendy D.; Ying, Gui-shuang; Tamhankar, Madhura A.

    2014-01-01

    Purpose To study the relationship between the appearance of the optic nerve and the retinal nerve fiber layer (RNFL) thickness determined by spectral domain optical coherence tomography (OCT). Methods Records from patients with spectral domain-OCT imaging in a neuro-ophthalmology practice were reviewed. Eyes with glaucoma/glaucoma suspicion, macular/optic nerve edema, pseudophakia, and with refractive errors > 6D were excluded. Optic nerve appearance by slit lamp biomicroscopy was related to the RNFL thickness by spectral domain-OCT and to visual field results. Results Ninety-one patients (176 eyes; mean age: 49 ± 15 years) were included. Eighty-three eyes (47%) showed optic nerve pallor; 89 eyes (50.6%) showed RNFL thinning (sectoral or average peripapillary). Average peripapillary RNFL thickness in eyes with pallor (mean ± SD = 76 ± 17 μm) was thinner compared to eyes without pallor (91 ± 14 μm, P < 0.001). Optic nerve pallor predicted RNFL thinning with a sensitivity of 69% and a specificity of 75%. Optic nerve appearance predicted RNFL thinning (with a sensitivity and specificity of 81%) when RNFL had thinned by ∼ 40%. Most patients with pallor had RNFL thinning with (66%) or without (25%) visual field loss; the remainder had normal RNFL and fields (5%) or with visual field abnormalities (4%). Conclusions Optic nerve pallor as a predictor of RNFL thinning showed fair sensitivity and specificity, although it is optimally sensitive/specific only when substantial RNFL loss has occurred. Translational Relevance Finding an acceptable relationship between the optic nerve appearance by ophthalmoscopy and spectral domain-OCT RNFL measures will help the clinician's interpretation of the information provided by this technology, which is gaining momentum in neuro-ophthalmic research. PMID:25374773

  14. Antivascular Endothelial Growth Factor Bevacizumab for Radiation Optic Neuropathy: Secondary to Plaque Radiotherapy

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    Finger, Paul T., E-mail: pfinger@eyecancer.com [New York Eye Cancer Center, New York, NY (United States); Chin, Kimberly J. [New York Eye Cancer Center, New York, NY (United States)

    2012-02-01

    Purpose: To evaluate the intravitreal antivascular endothelial growth factor, bevacizumab, for treatment of radiation optic neuropathy (RON). Methods and Materials: A prospective interventional clinical case series was performed of 14 patients with RON related to plaque radiotherapy for choroidal melanoma. The RON was characterized by optic disc edema, hemorrhages, microangiopathy, and neovascularization. The entry criteria included a subjective or objective loss of vision, coupled with findings of RON. The study subjects received a minimum of two initial injections of intravitreal bevacizumab (1.25 mg in 0.05 mL) every 6-8 weeks. The primary objectives included safety and tolerability. The secondary objectives included the efficacy as measured using the Early Treatment Diabetic Retinopathy Study chart for visual acuity, fundus photography, angiography, and optical coherence tomography/scanning laser ophthalmoscopy. Results: Reductions in optic disc hemorrhage and edema were noted in all patients. The visual acuity was stable or improved in 9 (64%) of the 14 patients. Of the 5 patients who had lost vision, 2 had relatively large posterior tumors, 1 had had the vision decrease because of intraocular hemorrhage, and 1 had developed optic atrophy. The fifth patient who lost vision was noncompliant. No treatment-related ocular or systemic side effects were observed. Conclusions: Intravitreal antivascular endothelial growth factor bevacizumab was tolerated and generally associated with improved vision, reduced papillary hemorrhage, and resolution of optic disc edema. Persistent optic disc neovascularization and fluorescein angiographic leakage were invariably noted. The results of the present study support additional evaluation of antivascular endothelial growth factor medications as treatment of RON.

  15. Ocular abnormalities in atopic dermatitis in Indian patients

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    Kaujalgi Radhika

    2009-01-01

    Full Text Available Background and Aims: Atopic dermatitis (AD is a common skin disease. Long-standing, severe AD with repeated scratching and rubbing of the face, which requires continuous dermatologic care, predisposes the patient to various ocular complications. The knowledge of the frequency and significance of these ocular complications may allow their early diagnosis and treatment. The present study assesses the ocular complications in Indian children suffering from AD. Methods: In order to study the ocular complications in AD, 100 patients (61 male and 39 female between the ages of 1 and 14 years were recruited. All the patients had complete dilated fundus examination with indirect ophthalmoscopy. The lid, conjunctiva and cornea were examined. Also, any evidence of cataract formation and retinal disorders were recorded. Results: The mean age of the children was 5.4 years. Forty-three (43.0% AD patients showed ocular abnormalities in the form of lid and conjunctival changes. Of these, 18 (41.9% patients showed only lid involvement, 16 (37.2% only conjunctival involvement and both conjunctival and lid changes were seen in nine (20.9% patients. Conjunctival changes were mostly in the form of a cobblestone appearance of the papillae, with mild to moderate papillary reaction and papillary hypertrophy. Variables observed to have a significant impact on the development of ocular abnormalities were age more than 5 years, duration of illness> 12 months, positive family history of atopy, presence of palmar hyperlinearity and a combination of both xerosis and Dennie-Morgan fold. Conclusions: The present study is the first of its kind from India to document an association between AD in children and various ocular manifestations. The ocular manifestations observed in our cohort were not associated with significant ocular morbidity or visual impairment possibly because of a less-severe disease in Indians.

  16. Optic neuritis is associated with inner nuclear layer thickening and microcystic macular edema independently of multiple sclerosis.

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    Falko Kaufhold

    Full Text Available BACKGROUND: Microcystic macular edema (MME and inner nuclear layer thickening (INL were described in multiple sclerosis (MS and neuromyelitis optica (NMO patients using optical coherence tomography (OCT. The cause of these findings is currently unknown and a relation to inflammatory or degenerative processes in the optic nerve is discussed. OBJECTIVE: The aim of our study was to investigate whether INL thickening and MME are related to optic neuritis (ON in various neuro-inflammatory disorders causingON: MS, NMO and chronic inflammatory optic neuropathy. METHODS: We retrospectively analyzed data from 216 MS patients, 39 patients with a clinically isolated syndrome, 20 NMO spectrum disorder patients, 9 patients with chronic inflammatory optic neuropathy and 121 healthy subjects. Intra-retinal layer segmentation was performed for the eyes of patients with unilateral ON. Scanning laser ophthalmoscopy (SLO images were reviewed for characteristic ocular fundus changes. RESULTS: Intra-retinal layer segmentation showed that eyes with a history of ON displayed MME independent INL thickening compared to contralateral eyes without previous ON. MME was detected in 22 eyes from 15 patients (5.3% of all screened patients, including 7 patients with bilateral edema. Of these, 21 had a prior history of ON (95%. The SLO images of all 22 MME-affected eyes showed crescent-shaped texture changes which were visible in the perifoveal region. A second grader who was blinded to the results of the OCT classified all SLO images for the presence of these characteristic fundus changes. All MME eyes were correctly classified (sensitivity = 100% with high specificity (95.2%. CONCLUSION: This study shows that both MME and INL thickening occur in various neuro-inflammatory disorders associated with ON. We also demonstrate that detection and analysis of MME by OCT is not limited to B-scans, but also possible using SLO images.

  17. SCREENING FOR GLAUCOMA IN RURAL POPULATION: A HOSPITAL BASED STUDY

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    Rhutuja A

    2015-12-01

    Full Text Available AIM To estimate the prevalence of blindness due to glaucoma in patients aged 40 years and above attending Tertiary Care Hospital. MATERIAL AND METHODS The study was conducted in the Department of Ophthalmology, Mahatma Gandhi Institute of Medical Sciences, Sevagram. Visual acuity, anterior segment examination and anterior chamber depth assessment by slit lamp, digital tension, non-contact tonometry, confrontation field test, fundus examination, direct ophthalmoscopy and fundus imaging was done. Gonioscopy and automated perimetry was done in glaucoma suspects. RESULTS 7600 eyes of 3800 patients were examined, 108 eyes were diagnosed to have glaucoma. Based on the best corrected visual acuity, 15(13.8% eyes and 8(0.22% persons had visual impairment and 33(30.5% eyes and 20(31.7% persons were blind. The prevalence of glaucoma in eyes was 1.42%. The prevalence of blindness due to glaucoma in eyes was 0.43% and person was 0.52%. The prevalence of Primary Open Angle Glaucoma in eyes was 1%, Primary Angle Closure Glaucoma in eyes was 0.15%, Neovascular glaucoma in eyes was 0.07%, Lens Induced Glaucoma in eyes was 0.17% and Pseudoexfoliative Glaucoma in eyes was 0.03%. IOP>20mmHg was present in 50(36.1% glaucomatous eyes, majority of the eyes being in Open Angle Glaucoma 24(31.5% eyes; 58(53.7% glaucomatous eyes had IOP in the range 11-20mmHg, among them 38 eyes were on treatment and 20 eyes were operated. CONCLUSION Being an irreversible disease if diagnosed early, blindness can be avoided. So screening is very important for early diagnosis and their proper management thereon.

  18. Clinical evaluation of Graves ophthalmopathy

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    Janićijević-Petrović Mirjana A.

    2012-01-01

    Full Text Available Introduction. Graves ophthalmopathy is an autoimmune disease, which is the consequence of thyroid dysfunction. Ocular manifestations occur in 50% of patients with Graves disease. The changes occur due to the inflammatory cell infiltration of retrobulbar fat tissue and extraocular muscles. Ultrasonography of eye orbit provides important information about the condition of retrobulbar adipose tissue and the thickness of extraocular muscles. Objective. The aim of our study was to show the clinical significance of orbital ultrasonography in the diagnostics and follow-up of patients with Graves disease. Methods. The authors examined 154 patients with Graves ophthalmopathy at the Clinic of Ophthalmology of the Clinical Centre in Kragujevac during the period 2008–2010. Ophthalmological examination included visual acuity testing (Snellen chart, biomicroscopy and applanation tonometry, direct and indirect ophthalmoscopy, dry eye testing and exophthalmometry (Hertel. Orbital ultrasonography examination and extraorbital muscle measurement was done by ultrasound B-scan. Results. The disease was more frequent in women (79.87% aged from 36–45 years. Most patients had hyperthyreoidism (54.55%. In relation to the duration of the disease, the most frequent clinical signs were bilateral ptosis, conjunctival chemosis and periorbital edema. According to our data the highest number of patients had enlarged medial straight muscle. Conclusion. Graves ophthalmopathy is the most frequent sign of thyroid disease. By orbital ultrasonography we detected extended echogram and measured the thickness of the extraocular muscle. Computerized tomography and magnetic resonance scan were utilized for cases of insufficiently manifested clinical signs of the disease. The advantages of ultrasonography lie in easy handling, patients’ comfort, short time of examination and possibilities of repetition.

  19. Color Doppler imaging features in patients presenting central retinal artery occlusion with and without giant cell arteritis

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    Catalin Jianu Dragos

    2016-01-01

    Full Text Available Introduction. Central retinal artery obstruction (CRAO represents an abrupt diminution of blood flow through the CRA that is severe enough to cause ischemia of the inner retina with permanent unilateral visual loss. We presented the role of color Doppler imaging (CDI of orbital vessels and of extracranial duplex sonography (EDS in the etiological diagnosis of CRAO in two patients with clinical suspicion of unilateral CRAO. Case report. Patients were examined following the protocol which included CDI of orbital vessels and EDS. Both patients had no emboli visible on ophthalmoscopy. The B-scan ultrasound evaluation of the first patient found a small round, moderately reflective echo within the right optic nerve, 1.5 mm behind the optic disc (emboli of cholesterol. CDI of retrobulbar vessels revealed the normal right ophthalmic artery (OA hemodynamic parameters, but the first patient had no arterial flow signal on CDI at the distance of 1.5 mm behind the right optic disc. In contrast, the left eye had the normal aspect on CDI of retrobulbar vessels. The right internal carotid artery EDS identified a severe stenosis at its origin as CRA’s emboli source. The second patient had characteristic CDI findings for giant cell arteritis (GCA with eye involvement: severe diminished blood flow velocities, especially end-diastolic velocities, in both CRAs. Less abnormalities were observed in the posterior ciliary arteries, and in the ophthalmic arteries. The second patient had no systemic symptoms or signs of GCA. Conclusion. In the presented cases, the ultrasound investigation enabled prompt differentiation between central retinal artery occlusion of embolic mechanism and CRAO caused by GCA.

  20. Frequency of choroidal abnormalities in neurofibromatosis type 1.

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    Yasunari, T; Shiraki, K; Hattori, H; Miki, T

    2000-09-16

    Choroidal neurofibromatosis is thought to be a rare form of neurofibromatosis that involves the eyes. The development of infrared light examination with a scanning laser ophthalmoscope (SLO) and indocyanine-green fundus angiography has allowed examination of the choroid. We studied choroidal abnormalities in patients with neurofibromatosis 1 and compared their frequency with that of other ocular abnormalities. We examined 33 eyes of 17 consecutive patients diagnosed with neurofibromatosis 1 by conventional ophthalmoscopy and by non-invasive infrared monochromatic light with confocal SLO. 76 eyes of 39 age-matched controls were examined similarly by confocal SLO. 21 digital fluorescein and indocyanine-green angiographies were obtained from 11 adult patients, and 77 angiograms were obtained from age-matched controls. Infrared monochromatic light examination by confocal SLO showed bright multiple patchy regions at and around the entire posterior pole of all 33 eyes examined. All bright patchy regions seen in adult patients corresponded to hypofluorescent areas on their indocyanine-green angiograms. However, no abnormalities were noted in any patient at corresponding areas under conventional ophthalmoscopic examination or fluorescein angiography. In SLO and indocyanine-green studies, controls and control angiograms showed no choroidal abnormalities. Iris nodules were noted in 25 eyes (76%) of 14 patients (82%) and eyelid neurofibroma in five patients (29%). The bright patchy regions noted under infrared fundus examination and the corresponding hypofluorescent areas seen on indocyanine-green angiograms are probably of choroidal origin. The high frequency (100%) of these abnormalities suggests that the choroid is one of the structures most commonly affected by neurofibromatosis 1.

  1. Determination of morphological, biometric and biochemical susceptibilities in healthy Eurasier dogs with suspected inherited glaucoma.

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    Thomas Boillot

    Full Text Available In both humans and dogs, the primary risk factor for glaucoma is high intraocular pressure (IOP, which may be caused by iridocorneal angle (ICA abnormalities. Oxidative stress has also been implicated in retinal ganglion cell damage associated with glaucoma. A suspected inherited form of glaucoma was recently identified in Eurasier dogs (EDs, a breed for which pedigrees are readily available. Because of difficulties in assessing ICA morphology in dogs with advanced glaucoma, we selected a cohort of apparently healthy dogsfor the investigation of ICA morphological status, IOP and plasma concentrations of oxidative stress biomarkers. We aimed to establish correlations between these factors, to identify predictive markers of glaucoma in this dog breed. A cohort of 28 subjects, volunteered for inclusion by their owners, was selected by veterinary surgeons. These dogs were assigned to four groups: young males, young females (1-3 years old, adult males and adult females (4-8 years old. Ocular examination included ophthalmoscopy, tonometry, gonioscopy, biometry and ultrasound biomicroscopy (UBM, and the evaluation of oxidative stress biomarkers consisting of measurements of plasma glutathione peroxidase (GP activity and taurine and metabolic precursor (methionine and cysteine concentrations in plasma. The prevalence of pectinate ligament abnormalities was significantly higher in adult EDs than in young dogs. Moreover, in adult females, high IOP was significantly correlated with a short axial globe length, and a particularly large distance between Schwalbe's line and the anterior lens capsule. GP activity levels were significantly lower in EDs than in a randomized control group of dogs, and plasma taurine concentrations were higher. Hence, ICA abnormalities were associated with weaker antioxidant defenses in EDs, potentially counteracted by higher plasma taurine concentrations. This study suggests that EDs may constitute an appropriate canine model for

  2. Retinal pathology of pediatric cerebral malaria in Malawi.

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    Valerie A White

    Full Text Available INTRODUCTION: The causes of coma and death in cerebral malaria remain unknown. Malarial retinopathy has been identified as an important clinical sign in the diagnosis and prognosis of cerebral malaria. As part of a larger autopsy study to determine causes of death in children with coma presenting to hospital in Blantyre, Malawi, who were fully evaluated clinically prior to death, we examined the histopathology of eyes of patients who died and underwent autopsy. METHODOLOGY/PRINCIPAL FINDINGS: Children with coma were admitted to the pediatric research ward, classified according to clinical definitions as having cerebral malaria or another cause of coma, evaluated and treated. The eyes were examined by direct and indirect ophthalmoscopy. If a child died and permission was given, a standardized autopsy was carried out. The patient was then assigned an actual cause of death according to the autopsy findings. The eyes were examined pathologically for hemorrhages, cystoid macular edema, parasite sequestration and thrombi. They were stained immunohistochemically for fibrin and CD61 to identify the components of thrombi, beta-amyloid precursor protein to detect axonal damage, for fibrinogen to identify vascular leakage and for glial fibrillary acidic protein to detect gliosis. Sixty-four eyes from 64 patients were examined: 35 with cerebral malaria and 29 with comas of other causes. Cerebral malaria was distinguished by sequestration of parasitized erythrocytes, the presence and severity of retinal hemorrhages, the presence of cystoid macular edema, the occurrence and number of fibrin-platelet thrombi, the presence and amount of axonal damage and vascular leakage. CONCLUSIONS/SIGNIFICANCE: We found significant differences in retinal histopathology between patients who died of cerebral malaria and those with other diagnoses. These histopathological findings offer insights into the etiology of malarial retinopathy and provide a pathological basis for

  3. Five-year change in refraction and its ocular components in the 40- to 64-year-old population of the Shahroud eye cohort study.

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    Hashemi, Hassan; Khabazkhoob, Mehdi; Iribarren, Rafael; Emamian, Mohammad Hassan; Fotouhi, Akbar

    2016-11-01

    To assess 5-year refractive changes and their related factors in the 40- to 64-year-old population of Shahroud, Iran. Prospective cohort study. Of the 5190 participants of Phase I, 4737 participated in Phase II (response rate = 91.3%). Participants were tested by refraction, visual acuity, slit-lamp biomicroscopy, ophthalmoscopy and biometry. Myopia was defined as a spherical equivalent more negative than -0.5 dioptre (D) and hyperopia as a spherical equivalent more positive than +0.5 D. Mean 5-year change in spherical equivalent refraction. The mean 5-year change in spherical equivalent refraction was +0.24 D (95% CI: +0.22 to +0.25). After 5 years, 4.77% (95% CI: 4.08 to 5.46) of subjects developed at least 0.5 D of myopia and 22.27% (95% CI: 20.97 to 23.57) developed at least 0.5 D of hyperopia. Five-year changes in refraction included a hyperopic shift in all age groups. The greatest hyperopic shift was seen in middle-aged women. The greatest loss of lens power was observed in hyperopic women and the least in myopic men. Nuclear cataract was associated with a myopic shift in refraction. The axial length and the corneal power had very small changes during this period. Myopes showed the greatest increase in axial length. Corneal power increased by a very small amount in all refractive groups. The most important biometric index related to hyperopic shifts, which were greater in magnitude in women, was loss of lens power, whereas nuclear cataract was associated with myopic shifts. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  4. Ccl2, Cx3cr1 and Ccl2/Cx3cr1 chemokine deficiencies are not sufficient to cause age-related retinal degeneration.

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    Luhmann, Ulrich F O; Carvalho, Livia S; Robbie, Scott J; Cowing, Jill A; Duran, Yanai; Munro, Peter M G; Bainbridge, James W B; Ali, Robin R

    2013-02-01

    Monocytes, macrophages, dendritic cells and microglia play critical roles in the local immune response to acute and chronic tissue injury and have been implicated in the pathogenesis of age-related macular degeneration. Defects in Ccl2-Ccr2 and Cx3cl1-Cx3cr1 chemokine signalling cause enhanced accumulation of bloated subretinal microglia/macrophages in senescent mice and this phenomenon is reported to result in the acceleration of age-related retinal degeneration. The purpose of this study was to determine whether defects in CCL2-CCR2 and CX3CL1-CX3CR1 signalling pathways, alone or in combination, cause age-dependent retinal degeneration. We tested whether three chemokine knockout mouse lines, Ccl2(-/-), Cx3cr1(-/-) and Ccl2(-/-)/Cx3cr1(-/-), in comparison to age-matched C57Bl/6 control mice show differences in subretinal macrophage accumulation and loss of adjacent photoreceptor cells at 12-14 months of age. All mouse lines are derived from common parental strains and do not carry the homozygous rd8 mutation in the Crb1 gene that has been a major confounding factor in previous reports. We quantified subretinal macrophages by counting autofluorescent lesions in fundus images obtained by scanning laser ophthalmoscopy (AF-SLO) and by immunohistochemistry for Iba1 positive cells. The accumulation of subretinal macrophages was enhanced in Ccl2(-/-), but not in Cx3cr1(-/-) or Ccl2(-/-)/Cx3cr1(-/-) mice. We identified no evidence of retinal degeneration in any of these mouse lines by TUNEL staining or semithin histology. In conclusion, CCL2-CCR2 and/or CX3CL1-CX3CR1 signalling defects may differentially affect the trafficking of microglia and macrophages in the retina during ageing, but do not appear to cause age-related retinal degeneration in mice.

  5. Grade III or Grade IV Hypertensive Retinopathy with Severely Elevated Blood Pressure

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    Amanda D Henderson

    2012-12-01

    Full Text Available Introduction: Hypertensive retinopathy describes a spectrum of retinal changes in patients with elevated blood pressure (BP. It is unknown why some patients are more likely to develop acute ocular end-organ damage than others with similar BP. We examined risk factors for grade III/IV hypertensive retinopathy among patients with hypertensive urgency in the emergency department (ED and compared healthcare utilization and mortality between patients with and without grade III/IV hypertensive retinopathy.Methods: A preplanned subanalysis of patients who presented to a university hospital ED with diastolic BP > 120 mmHg and who enrolled in the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the ED study was performed. Bilateral nonmydriatic ocular fundus photographs, vital signs, and demographics were obtained at presentation. Past medical history, laboratory values, healthcare utilization, and mortality were ascertained from medical record review at least 8 months after initial ED visit.Results: Twenty-one patients with diastolic BP > 120 mmHg, 7 of whom (33% had grade III/IV hypertensive retinopathy, were included. Patients with retinopathy were significantly younger than those without (median 33 vs 50 years, P = 0.02. Mean arterial pressure (165 vs 163 mmHg was essentially equal in the 2 groups. Patients with retinopathy had substantially increased but nonsignificant rates of ED revisit (57% vs 29%, P = 0.35 and hospital admission after ED discharge (43% vs 14%, P = 0.28. One of the patients with retinopathy died, but none without.Conclusion: Younger patients may be at higher risk for grade III/IV hypertensive retinopathy among patients with hypertensive urgency. Chronic compensatory mechanisms may have not yet developed in these younger patients. Alternatively, older patients with retinopathy may be underrepresented secondary to increased mortality among these patients at a younger age (survivorship bias. Further research is needed to

  6. Visual function and retinal vessel diameters during hyperthermia in man.

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    Jensen, Bettina Hagström; Bram, Thue; Kappelgaard, Per; Arvidsson, Henrik; Loskutova, Ekaterina; Munch, Inger Christine; Larsen, Michael

    2016-12-21

    To assess the effect of elevated core body temperature on temporal and spatial contrast sensitivity and retinal vessel diameters. The study included 13 healthy volunteers aged 20-37 years. Core body temperature elevation (target +1.1°C) was induced by wrapping the participants in cling film, tinfoil and warming blankets. Subsequent cooling was achieved by undressing. Flicker sensitivity (critical flicker fusion frequency) was chosen to assess temporal resolution, while the Freiburg Vision Test was used to determine spatial contrast sensitivity at 1.5 cycles per degree. Scanning laser ophthalmoscopy was used to measure retinal trunk vessel diameters. Assessment was made at baseline, during hyperthermia and after cooling. The induction of a mean increase in core body temperature of 1.02°C was associated with a 7.15-mmHg mean reduction in systolic blood pressure (p < 0.01), a 10.6-mmHg mean reduction in diastolic blood pressure (p < 0.01), a mean increase in pulse rate of 36.3 bpm (p < 0.0001), a 2.66% improvement in flicker sensitivity (CI95 1.37-3.94, p < 0.001), a 2.80% increase in retinal artery diameters (CI95 1.09-4.51, p < 0.01) and a 2.95% increase in retinal vein diameters (CI95 0.96-4.94, p < 0.01). There was no detectable effect of temperature on spatial contrast sensitivity. All ocular test parameters returned to baseline levels after cooling. Increased core body temperature was accompanied by improved temporal visual resolution and retinal trunk vessel dilation. The results suggest that hyperthermia is associated with enhanced retinal function and increased retinal metabolism. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Parafoveal retinal cone mosaic imaging in children with ultra-compact switchable SLO/OCT handheld probe (Conference Presentation)

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    LaRocca, Francesco; Nankivil, Derek; DuBose, Theodore B.; Toth, Cynthia A.; Farsiu, Sina; Izatt, Joseph A.

    2016-03-01

    In vivo photoreceptor imaging has enhanced the way vision scientists and ophthalmologists understand the retinal structure, function, and etiology of numerous retinal pathologies. However, the complexity and large footprint of current systems capable of resolving photoreceptors has limited imaging to patients who are able to sit in an upright position and fixate for several minutes. Unfortunately, this excludes an important fraction of patients including bedridden patients, small children, and infants. Here, we show that our dual-modality, high-resolution handheld probe with a weight of only 94 g is capable of visualizing photoreceptors in supine children. Our device utilizes a microelectromechanical systems (MEMS) scanner and a novel telescope design to achieve over an order of magnitude reduction in size compared to similar systems. The probe has a 7° field of view and a lateral resolution of 8 µm. The optical coherence tomography (OCT) system has an axial resolution of 7 µm and a sensitivity of 101 dB. High definition scanning laser ophthalmoscopy (SLO) and OCT images were acquired from children ranging from 14 months to 12 years of age with and without pathology during examination under anesthesia in the operating room. Parafoveal cone imaging was shown using the SLO arm of this device without adaptive optics using a 3° FOV for the first time in children under 4 years old. This work lays the foundation for pediatric research, which will improve understanding of retinal development, maldevelopment and early onset of diseases at the cellular level during the beginning stages of human growth.

  8. Idiopathic horseshoe-like macular tear: a case report

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    Kubota M

    2016-07-01

    Full Text Available Masaomi Kubota,1 Tomohiro Shibata,1 Hisato Gunji,1 Hiroshi Tsuneoka2 1Department of Ophthalmology, The Jikei University School of Medicine Kashiwa Hospital, Chiba, 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan Background: Although a few cases with idiopathic horseshoe-like macular tear have been reported, the mechanism remains unknown and a standard treatment has yet to be determined. Objective: To report the outcome for a patient with idiopathic horseshoe-like macular tear who underwent vitreous surgery. Case report: A 65-year-old man with no previous injury or ophthalmic disease presented with abnormal vision in his left eye. Best-corrected visual acuity was 0.8 in the right and 0.3 in the left, and the relative afferent pupillary defect was negative. Ophthalmoscopy revealed a horseshoe-like tear on the temporal side of the macula in the left eye. The tear size was 0.75 disc diameters (DD. Optical coherence tomography showed that the focal retinal detachment reached the fovea. A few days after the first visit, there was no longer adhesion of the flap of the tear to the retina and the tear size had increased to 1.5 DD. The patient underwent vitreous surgery similar to large macular hole surgery, with the tear closure repaired using the inverted internal limiting membrane flap technique with 20% SF6 gas tamponade. Although the tear decreased to 0.5 DD after the surgery, complete closure of the tear was not achieved. Conclusion: While cases with horseshoe-like macular tear following trauma and branch retinal vein occlusion have been reported, to the best of our knowledge, this is the first reported idiopathic case. In the present case, there was expansion of the tear until the patient actually underwent surgery. If vertical vitreous traction indeed plays a role in horseshoe-like macular tears, this will need to be taken into consideration at the time of the vitreous surgery in these types of cases. Keywords

  9. Vascular changes in the retina in patients with chronic respiratory insufficiency

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    Adžić-Zečević Antoaneta

    2014-01-01

    Full Text Available Background/Aim. Chronic respiratory insufficiency is a pathological state which occurs as a result of respiratory system inability to maintain normal gas exchange between the outside air and circulating blood. For the purposes of human organism’s proper functioning, it is necessary that a certain amount of air in the lungs comes into contact with a certain amount of blood within a unit of time, so that an adequate hemoglobin oxygenation could be achieved. Then, hemoglobin from erythrocytes in the blood supply delivers oxygen to all the tissues and cells of the body including the eye. Direct impact of hypoxemia and hypercapnia on the wall of arterioles, venules and capillaries results in a severe vasodilatation along with the increased permeability of the walls causing clinically evident changes in the retina. The aim of this study was to determine the degree of ocular changes in retina with patients suffering from chronic respiratory insufficiency. Methods. A prospective study was conducted on 80 patients, 40 patients with respiratory failure and 40 patients with chronic obstructive pulmonary disease an and bronchial asthma (the control group. In all the patients direct and indirect ophthalmoscopy and fluoresceine angiography was performed. Clinically visible fundus and retina changes in patients suffering from chronic respiratory failure were categorized as mild (dilatation and retinal veins and arteries tortosion up to the mid-periphery, moderate (retinal hemorrhage and severe (optic nerve edema, macular edema, superficial and deep retinal hemorrhages and venous occlusion. Results. In the patients suffering from respiratory insufficiency the changes in retinal blood vessels were found [in 18 (45% mild, in 13 (32.5% moderate, and in 9 (22% severe], while in the patients with chronic obstructive pulmonary disease and bronchial asthma (without respiratory insufficiency no changes were recognized. Conclusion. The results of this study indicate

  10. Clinical, electroretinographic and histomorphometric evaluation of the retina in sheep with natural scrapie

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    Toutain Pierre-Louis

    2011-06-01

    Full Text Available Abstract Background The retina is part of the diencephalon in a peripheral location and may be involved in prion diseases. Retinal function and structural changes were assessed in naturally scrapie-affected red face Manech ewes presenting the classical signs of the disease, and clinically healthy age-matched subjects for controls. Ophthalmic examination was done prior to electroretinography (ERG, which was carried out under conditions that allowed photopic and scotopic activities to be assessed. Histomorphometry of the inner and outer retinal layers was performed post-mortem, and retinas were also examined for evidence of abnormal prion protein (PrPSc accumulation and glial fibrillary acidic protein (GFAP upregulation as a marker of gliosis. Scrapie status was determined by examination of brain tissue Results Ocular reflexes and ophthalmoscopy did not reveal any difference between scrapie affected and control animals. Although the light-and dark-adapted ERG responses of both rod-and cone-mediated functions had a similar waveform in scrapie-affected and control sheep, a significant reduction in the amplitude of the ERG a-and b-waves was observed in affected animals compared to controls. These functional alterations were correlated with a substantial loss of cells in the outer nuclear layer (ONL, lengthening and disorganization in photoreceptor segments, and substantial reduction in cellularity and thickness of the inner nuclear layer (INL. The degenerative changes in the INL and ONL were most marked in the central and paracentral areas of the scrapie retinas, and were accompanied in all scrapie retinas by PrPSc deposition in the ganglion cell and synaptic layers. GFAP immunoreactivity was mainly increased in the ganglion cell and inner plexiform layers. Conclusions No appreciable fundoscopic changes were observed in the scrapie-affected ewes although reproducible changes in retinal function as measured by ERG were observed in these animals. The

  11. The investigation of prevalence and risk factors of diabetic retinopathy in in-patients with type 2 diabetes mellitus in Jinan city%住院糖尿病人视网膜病变发生率调查及其危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王玉; 范传峰; 舒相汶; 张华; 盛艳娟; 吴昌龙; 谭瑞礼; 张同河

    2009-01-01

    Objective To study clinical epidemioiogy of diabetic retinopathy in-patients with type 2 diabetes mellitus in Jinan city and analyze its related factors.Methods A total of 250 diabetics were investigated in detail by filling informs, ocular examination including ophthalmoscopy and physical examination and laboratory testing.These cases were divided into 2 groups according to their diabetic retinopathy.The relations between diabetic retinopathy and various parameters in two groups were observed and analyzed by statistical methods.Results The prevalence of diabetic retinopathy was 56.4%, and proliferative diabetic retinopathy was 10.8 %.Duration of diabetes, HbA1C, hypertension, hyperlipidemia and early renal damage were the risk factors for diabetic retinopathy.Conclusions The prevalence of diabetic retinopathy was higher in Jinan city. The ocular examination should be strengthened in the patients with longer duration of diabetes or early renal damage. To prevent or reduce the occurrence of diabetic retinopathy, blood pressure, blood glucose and blood lipid should be under good control.%目的 调查济南市住院糖尿病患者中糖尿病视网膜病变的发生率,对其相关的危险因素进行分析.方法 对济南市多家医院的250例住院糖尿病患者进行问卷调查、实验室检查、眼部检查等,并按照国际最新糖尿病视网膜病变分期标准对调查资料进行分析.结果 住院糖尿病患者中糖尿病视网膜病变的发生率为56.4%,其中增殖性糖尿病视网膜病变占10.8%.多因素分析显示其危险因素为高血脂、肾损害、高血压、高糖化血红蛋白和糖尿病病程.结论 济南市住院糖尿病人中糖尿病视网膜病变的发生率较高.应加强对糖尿病病程较长、已出现早期肾损害的患者的随访和治疗,除控制好血糖外,还应重视对其血脂、血压的控制.

  12. Achados oculares em pacientes com mielomeningocele: 72 casos Ocular findings in 72 patients with meningomyelocele

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    Mônica Fialho Cronemberger

    2000-10-01

    Full Text Available Objetivo: Estudar as alterações oculares em pacientes com mielomeningocele. Material e Método: Realizado estudo retrospectivo em 72 pacientes com mielomeningocele, descrevendo as alterações oculares presentes nessa população, além de correlacionar com a presença ou não de hidrocefalia. Resultados: Dos 72 pacientes com mielomeningocele, com idade variando de 5 meses a 18 anos, 64 (88,9% pacientes tinham hidrocefalia. Destes 64 pacientes, 36 (56,3% tinham estrabismo, sendo que 21 (58,3% eram endotrópicos, 13 (36,1% exotrópicos, 1 (2,8% exofórico e 1 (2,8% com estrabismo discinético. Do total dos 72 pacientes estudados 38 (52,8% eram estrábicos. A anisotropia foi encontrada em 16 (22,2% pacientes, sendo que em 14 (87,5% em A e em 2 (12,5% em V. Todos os 16 pacientes com anisotropia apresentavam hidrocefalia. O erro refrativo mais freqüente foi a hipermetropia encontrada em 64 (44,4% olhos. Atrofia óptica foi encontrada em 9 (12,5% pacientes. Conclusão: A mielomeningocele, associada a hidrocefalia, apresenta uma porcentagem de estrabismo maior do que o encontrado na população normal.Purpose: To study ocular findings in patients with meningomyelocele. Methods: A retrospective study of 72 patients with myelomeningocele was performed to evaluate ocular motility disorders, refractive errors and indirect ophthalmoscopy findings. Results: In a group of 72 patients with myelomeningocele, aged 5 month -- 18 years, 64 (88.9% had hydrocephalus. Of this group of 64 patients, 36 (56.3% had strabismus, 21 (58.3% of whom were esotropic, and 13 (36.1% exotropic, 1 (2.8% exophoric and 1 (2.8% presented sometimes esotropia and sometimes exotropia. Of the total of 72 studied patients, 38 (52.8% had strabismus. Anisotropia was found in 16 (22.2% patients, 14 (87.5% with an A pattern and 2 (12.5% with a V pattern. The most frequent refractive error was hyperopia, found in 64 (44.4% eyes. All the 16 patients with anisotropia had hydrocephalus

  13. Interconnection between several eye biomechanical and biometric parameters in children with axial and refractive mild myopia

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    T. Ye. Tsybulskaya

    2016-08-01

    Full Text Available to study the relationship of biometric and biomechanical indicators of corneoscleral capsule of the eye in children with axial and refractive mild myopia. Materials and methods. Axial myopia was diagnosed in 32 children (64 eyes, refractive myopia – 18 (36 eyes. The control group – 16 children without ophthalmic diseases (32 eyes. Eye examination: visometry, automated refractometry, biomicroscopy, ophthalmoscopy, determination of the axial length of the eyeball and corneal hysteresis. Results. Significant differences were determined in the indicators of dioptric power of the cornea: 42.2 dpt in patients with axial and 44.7 dpt with refractive myopia (p<0.05, and also difference between patients with refractive myopia and the control group, in which the diopter power of cornea was 42.6 (p<0.05. There are also significant differences in the indicators of the axial length of eyes between axial and refractive myopia – 24.5±0.64 mm and 23.1±0.43 mm (p<0.05. Significant difference with the control group in the axial length marked only in eyes with axial myopia 22.7±0.33 mm and 24.5±0.64 mm, respectively (p<0.05. Corneal hysteresis determined significantly reduced on eyes with both the axial and refractive myopia, which was significantly lower than in the indicators of emmetropic eyes of the control group 13.7 (p<0.05. Corneal hysteresis is inversely related to the axial length of the eyeball: in patients with axial myopia r -0.32, p<0.05; with refractive myopia r -0.36, p<0.05. Сorrelation between diopter power of cornea and axial length of the eyeball: r -0.53, р<0.05 in eyes with axial myopia and r -0.42, p<0.05 refractive myopia. Comparative analysis showed no significant differences between the corneal hysteresis, the axial length of the eye and the spherical component of myopia. Conclusions. In patients with axial and refractive mild myopia corneal hysteresis is reduced on average in 1.2 and 1.1 times, in comparison with emmetropic

  14. Absence of DJ-1 causes age-related retinal abnormalities in association with increased oxidative stress.

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    Bonilha, Vera L; Bell, Brent A; Rayborn, Mary E; Samuels, Ivy S; King, Anna; Hollyfield, Joe G; Xie, Chengsong; Cai, Huaibin

    2017-03-01

    Oxidative stress alters physiological function in most biological tissues and can lead to cell death. In the retina, oxidative stress initiates a cascade of events leading to focal loss of RPE and photoreceptors, which is thought to be a major contributing factor to geographic atrophy. Despite these implications, the molecular regulation of RPE oxidative stress under normal and pathological conditions remains largely unknown. A better understanding of the mechanisms involved in regulating RPE and photoreceptors oxidative stress response is greatly needed. To this end we evaluated photoreceptor and RPE changes in mice deficient in DJ-1, a protein that is thought to be important in protecting cells from oxidative stress. Young (3 months) and aged (18 months) DJ-1 knockout (DJ-1 KO) and age-matched wild-type mice were examined. In both group of aged mice, scanning laser ophthalmoscopy (SLO) showed the presence of a few autofluorescent foci. The 18 month-old DJ-1 KO retinas were also characterized by a noticeable increase in RPE fluorescence to wild-type. Optical coherence tomography (OCT) imaging demonstrated that all retinal layers were present in the eyes of both DJ-1 KO groups. ERG comparisons showed that older DJ-1 KO mice had reduced sensitivity under dark- and light-adapted conditions compared to age-matched control. Histologically, the RPE contained prominent vacuoles in young DJ-1 KO group with the appearance of enlarged irregularly shaped RPE cells in the older group. These were also evident in OCT and in whole mount RPE/choroid preparations labeled with phalloidin. Photoreceptors in the older DJ-1 KO mice displayed decreased immunoreactivity to rhodopsin and localized reduction in cone markers compared to the wild-type control group. Lower levels of activated Nrf2 were evident in retina/RPE lysates in both young and old DJ-1 KO mouse groups compared to wild-type control levels. Conversely, higher levels of protein carbonyl derivatives and i

  15. Correlation between risk factors during the neonatal period and appearance of retinopathy of prematurity in preterm infants in neonatal intensive care units in Alexandria, Egypt

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    Abdel Hadi AM

    2013-05-01

    Full Text Available Ahmed Mahmoud Abdel Hadi, Islam Shereen HamdyDepartment of Ophthalmology, Alexandria University Hospital, Alexandria, EgyptBackground: This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012.Methods: A prospective cohort study was undertaken in infants weighing < 1250 g and maternal postmenstrual age < 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP. Perinatal variables considered were: birth weight, gestational age, gender, method of ventilation (nasal continuous airway pressure or intermittent mechanical ventilation, packed red blood cell and/or plasma transfusion, occurrence of sepsis, neonatal indirect hyperbilirubinemia, intraventricular hemorrhage, and patent ductus arteriosus. After obtaining informed consent from the parents, infants at risk were examined for ROP using indirect ophthalmoscopy, ie, RetCam II fundus photography.Results: The study included 152 infants of mean gestational age 31.02 weeks and mean birth weight 1.229 kg. Seventy-two cases (47.5% were male and 80 cases (52.5% were female. Of the cases screened, 100 (65.6% had no ROP, 52 had ROP of any stage (34.4%, and 27 (18% had stage 1, five (3.3% had stage 2, 17 (11.5% had stage 3, and three (1.6% had stage 4 disease. No infants had stage 5 ROP. Of all our cases with ROP, 15 (28.6% had prethreshold disease type 1 that required treatment, comprising 9.8% of all cases screened for ROP. Using stepwise logistic regression analysis, all risk factors studied were found to be significantly associated with the development of ROP, except for neonatal indirect hyperbilirubinemia. Severity of ROP was inversely proportional to birth weight and gestational age.Conclusion: ROP occurred in 34.4% of all infants screened in the neonatal intensive

  16. STUDY OF ASSOCIATION OF DIABETIC MACULOPATHY WITH HYPERTENSION

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    Sivaramareddy

    2015-12-01

    Full Text Available BACKGROUND Diabetic retinopathy is a leading cause of blindness in adults and is unique in displaying a uniform epidemiology profile worldwide. Diabetic maculopathy is the most common microvascular complication in diabetes which can produce severe visual loss. Apart from diabetes, a number of systemic factor like hypertension, has an important role in occurrence and progression of DME. Thus control of these factors along with control of blood sugars can prevent or reverse the maculopathy and there by restore the vision of diabetic patients. OBJECTIVE To study the association of diabetic maculopathy with hypertension and to highlight the effect of this factor on onset and/or progression of diabetic maculopathy. METHODS A cross sectional two group comparative study was carried out in 100 diabetic patients with retinopathy more than 18 years attending the department of ophthalmology (Katuri medical college in the period of September 2012 to April 2014. For all patients, visual acuity with Snellen’s chart, slit lamp examination, intraocular pressure by applanation tonometry, fundus examination with direct, indirect ophthalmoscopy and 90D lens was conducted. Patients were divided into 2 groups (group1-Retinopathy with maculopathy and group 2- retinopathy without maculopathy. A detailed history of duration of diabetes, type of treatment, hypertension, taken from the patient. The significance of the hypertension was compared in both the groups involved in the study. RESULTS In the present study of 100 patients diagnosed with diabetic retinopathy, majority were males (54% in study group and 58% in control group by age 51-60 years. There was no significant difference in the age and gender distribution among two groups. Majority of the patients in the both groups were on treatment with anti-hypertensives (64% in the study group and 74% in control group. In this study, the mean value of SBP and DBP were significantly higher in study group compared to

  17. Proliferative vitreo-retinal disorders: experimental models in vivo and in vitro.

    Science.gov (United States)

    Martini, B

    1992-01-01

    The aim of the present thesis was to develop, refine, and assess experimental models for the study of proliferative vitreo-retinal disorders. An intravitreal injection of a colloidal solution of microparticles was used in the primate eye to produce pathologic changes including intraocular cell invasion, cell proliferation, neovascularization, collagen synthesis, and tractional retinal detachment. In a separate primate model for laser-induced subretinal neovascularization, the origin and the occurrence of macrophages was evaluated. Examinations were performed using ophthalmoscopy, slit-lamp microscopy, light microscopy, and transmission electron microscopy. Cell cultures were employed to study the effects of vitreous humor and macrophages on the proliferation of cultured retinal pigment epithelial (RPE) cells and cultured fibroblasts using a Coulter counter. Morphologic changes were documented by phase micrography. A quantitative estimation of the extracellular matrix deposition of fibrous proteins by macrophage-modulated RPE cells as well as by vitreous-modulated RPE cells was done using enzymatic digestion and radioactive labeling techniques. A qualitative analysis of the types of collagen that was deposited in the extracellular matrices by vitreous modulated cultures was also made using indirect immunofluorescence. Using a newly developed RPE cell specific monoclonal antibody, the avidin-biotin-peroxidase labeling technique was finally employed to test the phenotypic epitope expression of macrophage-modulated and non-modulated RPE cells. A new experimental in vivo model for pathologic changes that characterize proliferative vitreo-retinal disorders was developed in the primate eye. In the model for laser-induced subretinal neovascularization, macrophages were shown to be principally recruited from the systemic circulation. Using cell cultures, it was found that both macrophage-conditioned medium and vitreous humor, separately or combined, exert mitogenic effects

  18. Polymerase chain reaction for Mycobacterium tuberculosis DNA detection from ocular fluids in patients with various types of choroiditis in a referral eye center in India

    Science.gov (United States)

    Biswas, Jyotirmay; Kazi, Mohmmad Salman; Agarwal, Vishvesh Ashokkumar; Alam, Md. Shahid; Therese, K Lily

    2016-01-01

    Aims: The aim of this study was to detect Mycobacterium tuberculosis (MTB) DNA with polymerase chain reaction (PCR) in aqueous or vitreous samples of patients suffering from choroiditis presumed to be infectious origin. Settings and Design: Hospital-based, retrospective case–control study. Subjects and Methods: In all, forty eyes of forty patients with choroiditis divided into two groups – Group A (serpiginous-like choroiditis, ampiginous choroiditis, multifocal choroiditis) and Group B (choroidal abscess, miliary tuberculosis (TB), choroidal tubercle) were analyzed retrospectively. In 27 controls (patients without uveitis undergoing phacoemulsification), anterior chamber aspirate was done and sample subjected to real-time PCR. Patients underwent nested PCR for MTB using IS6110 and MPB64 primers from aqueous (n = 39) or vitreous (n = 1). All patients underwent detailed ophthalmological examination by slit-lamp biomicroscopy, fundus examination by indirect ophthalmoscopy, and fundus photograph and fundus fluorescein angiography if required. Statistical Analysis: Positive results of PCR for MTB within the group and between two groups were statistically analyzed using Chi-square test. Results: There were 25 males and 15 females. Mean age at presentation was 34.66 years (range, 14–62). PCR positivity rates were 41.3% (n = 12/29) and 81.82% (n = 9/11) in Groups A and B, respectively. No controls had PCR-positive result. Comparison of PCR positivity rates showed statistically significant difference between Groups A and B (P = 0.028). Systemic TB was detected in 57.14% (n = 12/21) of all PCR-positive cases (Group A - 33.3%, n = 4/12; Group B - 88.9%, n = 8/9). Systemic antitubercular treatment (ATT) for 9 months and oral steroids were successful in resolution of choroiditis in all PCR-positive patients (n = 21) without disease recurrence. Conclusions: Eyes with choroiditis of suspected/presumed tubercular origin should be subjected to PCR for diagnosis of TB and

  19. ROLE OF HIGH RESOLUTION ULTRASONOGRAPHY IN THE EVALUATION OF POSTERIOR SEGMENT LESIONS OF THE EYE

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    Rashmi Nagaraju

    2015-01-01

    of ophthalmoscopic diagnosis with significant difference (p - value < 0.0001. 2 I t is particularly well suited in cases of opaque conducting media when direct ophthalmoscopy is not possible. 3 HRUS is a highly sensitive modality and it can reliably differentiate various ocular detachments, vitreoretinal disorders and neoplastic lesion s with significant accuracy KEYWORDS:Eye; posterior segment; high resolution ultrasound; sonography

  20. Microincisional vitrectomy for retinal detachment in I-125 brachytherapy-treated patients with posterior uveal malignant melanoma

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    Lonngi M

    2013-02-01

    Full Text Available Marcela Lonngi,1 Samuel K Houston,1 Timothy G Murray,1–3 Robert A Sisk,4 Christina L Decatur,1 Milena Cavalcante,1 Arnold M Markoe31Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA; 2Murray Ocular Oncology and Retina, Miami, FL, USA; 3Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA; 4Department of Ophthalmology, Cincinnati Eye Institute, Cincinnati, OH, USAPurpose: To analyze functional and anatomical outcomes following 23/25+ gauge microincisional pars plana vitrectomy surgery (MIVS in patients with radiation-related retinal detachment after successful 125-iodine (I-125 brachytherapy treatment for malignant uveal melanoma.Patients and methods: Retrospective case series of 102 consecutive eyes of 102 patients with history of uveal melanoma treated with I-125 brachytherapy that underwent MIVS at the Bascom Palmer Eye Institute. All cases were evaluated for surgical complications and local tumor control. Extended follow-up included Snellen’s best-corrected visual acuity, intraocular pressure evaluation, quantitative echography, indirect ophthalmoscopy, and fundus imaging with optical coherence tomography/wide-field photography.Results: All patients had radiation-related complications, including retinal detachment (102 eyes, vasculopathy (91 eyes, optic neuropathy (32 eyes, and/or vitreous hemorrhage (8 eyes. Sixty-seven patients had vitreoretinal traction. Average follow-up after MIVS was 19.5 months, and from plaque removal was 57.7 months. Interval from plaque to MIVS was 38.1 months. Initial visual acuity was 20/258, which improved to 20/101 at 1 month, 20/110 at 3 months, 20/116 at 6 months, and 20/113 at 12 months (P < 0.05. No eyes required enucleation. Melanoma-related mortality was 0.9% (1/102. There was no intra- or extraocular tumor dissemination, and no tumor recurrence.Conclusion: MIVS was effective in improving

  1. Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela.

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    Yepez, Juan B; Murati, Felipe A; Pettito, Michele; Peñaranda, Carlos F; de Yepez, Jazmin; Maestre, Gladys; Arevalo, J Fernando

    2017-05-01

    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. To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela. This prospective case series included 43 patients from 2 ophthalmic centers in Colombia and Venezuela who underwent evaluation from October 1, 2015, through June 30, 2016, and were clinically diagnosed with congenital Zika syndrome. Twenty patients were Hispanic; 13, African; 8, white; and 2, Native American. Ophthalmic and systemic evaluations and serologic testing were performed on all infants. Patients underwent external ocular examination and dilated ophthalmoscopy. Serologic testing ruled out toxoplasmosis, rubella, cytomegalovirus, syphilis, and human immunodeficiency virus. Ophthalmic manifestations of congenital Zika syndrome. Of the 43 patients included in this series (28 female and 15 male), the mean (SD) age at examination was 2.1 (1.5) months. The mothers of all the children had no ophthalmic findings and did not report ocular symptoms during pregnancy. All patients had bilateral ophthalmic manifestations. Optic nerve findings included hypoplasia with the double-ring sign, pallor, and increased cup-disc ratio in 5 patients (11.6%). Macular abnormalities included mild to severe pigment mottling in 27 patients (63%) and lacunar maculopathy in 3 (6.9%). Chorioretinal scarring was present in 3 patients (7%). Eleven patients (26%) had a combination of lesions in the posterior pole. Five patients (12%) were

  2. Translimbal laser photocoagulation to the trabecular meshwork as a model of glaucoma in rats.

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    Levkovitch-Verbin, Hana; Quigley, Harry A; Martin, Keith R G; Valenta, Danielle; Baumrind, Lisa A; Pease, Mary Ellen

    2002-02-01

    To develop and characterize a model of pressure-induced optic neuropathy in rats. Experimental glaucoma was induced unilaterally in 174 Wistar rats, using a diode laser with wavelength of 532 nm aimed at the trabecular meshwork and episcleral veins (combination treatment group) or only at the trabecular meshwork (trabecular group) through the external limbus. Intraocular pressure (IOP) was measured by a tonometer in rats under ketamine-xylazine anesthesia. Possible retinal vascular compromise was evaluated by repeated fundus examinations and by histology. The degree of retinal ganglion cell (RGC) loss was assessed by a masked, semiautomated counting of optic nerve axons. Effects of laser treatment on anterior ocular structures and retina were judged by light microscopy. After the laser treatment, IOP was increased in all eyes to higher than the normal mean IOP of 19.4 +/- 2.1 mm Hg (270 eyes). Peak IOP was 49.0 +/- 6.1 mm Hg (n = 108) in the combination group that was treated by a laser setting of 0.7 seconds and 0.4 W and 34.0 +/- 5.7 mm Hg (n = 46) in the trabecular group. Mean IOP after 6 weeks was 25.5 +/- 2.9 mm Hg in glaucomatous eyes in the combination group compared with 22.0 +/- 1.8 mm Hg in the trabecular group. IOP in the glaucomatous eyes was typically higher than in the control eyes for at least 3 weeks. In the combination group, RGC loss was 16.1% +/- 14.4% at 1 week (n = 8, P = 0.01), 59.7% +/- 25.7% at 6 weeks (n = 88, P < 0.001), and 70.9% +/- 23.6% at 9 weeks (n = 12, P < 0.001). The trabecular group had mean axonal loss of 19.1% +/- 14.0% at 3 weeks (n = 9, P = 0.004) and 24.3% +/- 20.2% at 6 weeks (n = 25, P < 0.001), increasing to 48.4% +/- 32.8% at 9 weeks (n = 12, P < 0.001). Laser treatment led to closure of intertrabecular spaces and the major outflow channel. The retina and choroid were normal by ophthalmoscopy at all times after treatment. Light microscopic examination showed only loss of RGCs and their nerve fibers. Increased IOP caused

  3. Evaluating medical students’ proficiency with a handheld ophthalmoscope: a pilot study

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    Gilmour G

    2016-12-01

    Full Text Available Gregory Gilmour,1 James McKivigan2 1Physical Medicine and Rehabilitation, Michigan State University, Lansing, MI, 2School of Physical Therapy, Touro University, Henderson, NV, USA Introduction: Historically, testing medical students’ skills using a handheld ophthalmoscope has been difficult to do objectively. Many programs train students using plastic models of the eye which are a very limited fidelity simulator of a real human eye. This makes it difficult to be sure that actual proficiency is attained given the differences between the various models and actual patients. The purpose of this article is to introduce a method of testing where a medical student must match a patient with his/her fundus photo, ensuring objective evaluation as well as developing skills on real patients which are more likely to transfer into clinical practice directly. Presentation of case: Fundus photos from standardized patients (SPs were obtained using a retinal camera and placed into a grid using proprietary software. Medical students were then asked to examine a SP and attempt to match the patient to his/her fundus photo in the grid. Results: Of the 33 medical students tested, only 10 were able to match the SP’s eye to the correct photo in the grid. The average time to correct selection was 175 seconds, and the successful students rated their confidence level at 27.5% (average. The incorrect selection took less time, averaging 118 seconds, yet yielded a higher student-reported confidence level at 34.8% (average. The only noteworthy predictor of success (p<0.05 was the student’s age (p=0.02. Conclusion: It may be determined that there is an apparent gap in the ophthalmoscopy training of the students tested. It may also be of concern that students who selected the incorrect photo were more confident in their selections than students who chose the correct photo. More training may be necessary to close this gap, and future studies should attempt to establish

  4. Retinal and choroidal oxygen saturation of the optic nerve head in open-angle glaucoma subjects by multispectral imaging.

    Science.gov (United States)

    Li, Gai-Yun; Al-Wesabi, Samer Abdo; Zhang, Hong

    2016-12-01

    The aim of this study was to determine whether differences exist in oxygen supply to the optic nerve head (ONH) from the retinal and choroidal vascular layers in patients with primary open angle glaucoma (POAG) using multispectral imaging (MSI).This ia an observational, cross-sectional study.Multispectral images were acquired from 38 eyes of 19 patients with POAG, and 42 healthy eyes from 21 matched volunteers with Annidis' RHA multispectral digital ophthalmoscopy. Superficial and deeper oxygen saturation of the optic disc was represented by the mean gray scale values on the retinal and choroidal oxy-deoxy maps, respectively. Statistical analysis was performed to detect differences in ONH oxygen saturation between the 2 groups. Oxygen saturation levels in the eyes of POAG patients with severe glaucoma were compared to those of fellow eyes from the same subjects. Linear correlation analysis was performed to assess the association between ONH oxygen saturation and systemic and ocular parameters.No statistical difference was found in retinal and choroidal oxygen saturation between the POAG and control groups. In the glaucoma patients, retinal oxygen saturation was lower for eyes with worse visual fields than in those with good visual fields (t = 4.009, P = 0.001). In POAG patients, retinal oxygen saturation was dependent on mean defect of visual field and retinal nerve fiber layer thickness (RNFLT) (r = 0.511, 0.504, P = 0.001, 0.001, respectively), whereas the choroid vasculature oxygen saturation was inversely related to RNFLT (r = -0.391, P = 0.015). An age-dependent increase in retinal oxygen saturation was found for both the POAG and control groups (r = 0.473, 0.410, P = 0.007, 0.003, respectively).MSI revealed a significant correlation between functional and structural impairments in glaucoma and retinal oxygen saturation. MSI could provide objective assessments of perfusion impairments of the glaucomatous ONH. This is a

  5. Schimmelpenning syndrome: a case report%Schimmelpenning综合征一例

    Institute of Scientific and Technical Information of China (English)

    王焱; 冯广东; 王晶; 陈浩; 张倩; 武新英; 薛昌敖; 方方; 孙建方

    2016-01-01

    A 17-year-old female patient presented with generalized brown verrucous proliferative skin lesions on the right side of the head,face and neck for 17 years.Ophthalmoscopy showed a hard cystic mass in the right lacrimal sac area with absence of right lower lacrimal punctum.Magnetic resonance imaging of the orbit revealed a quasi-circular mass compressing the ethmoid sinus and extraocular muscles in the right lacrimal sac area.Histopathological examination of skin lesions of the head and face revealed epidermal hyperkeratosis,acanthosis,papillomatous hyperplasia in the epidermis,numerous mature or immature sebaceous glands in the dermis,and ectopic apocrine sweat glands in some areas.A pathological diagnosis of naevus sebaceous was made.Verrucous vegetation was observed in the oral mucosa including the right side of the palate and tongue,and orthopanotomography showed poor development of the right side of upper and lower jaw bones as well as alveolar bones.Moreover,there were large areas of coffee-colored patches and brown spots on both upper extremities.The patient had average intelligence and a history of convulsion.She was diagnosed with Schimmelpenning syndrome.Lesions were partially removed by surgical excision.%患者女,17岁,右侧头面颈部泛发性褐色疣状增殖性皮损17年.右眼下睑泪囊区触及一质硬囊性肿物,右下泪小点缺如.眼眶核磁平扫:右眼泪囊区可见一类圆形肿物,压及筛窦及眼外肌.头面部皮损组织病理示:表皮角化过度,棘层增生肥厚,表皮乳头瘤样增生,真皮内可见大量成熟及不成熟的皮脂腺结构,部分见异位的大汗腺,诊断为皮脂腺痣.口腔右侧黏膜,包括右侧上腭及右半舌部见疣状赘生物;口腔全景片示右侧上下颌骨及牙槽骨发育欠佳.此外,双上肢可见大面积咖啡色斑片及褐色斑点.患者智力中等,既往有惊厥史.诊断:Schimmelpenning综合征.经皮肤外科手术后去除部分皮损.

  6. [Comparison of Preferential Hyperacuity Perimeter (PHP) test and Amsler grid test in the diagnosis of different stages of age-related macular degeneration].

    Science.gov (United States)

    Kampmeier, J; Zorn, M M; Lang, G K; Botros, Y T; Lang, G E

    2006-09-01

    Age-related macular degeneration (ARMD) is the leading cause of blindness in people over 65 years of age. A rapid loss of vision occurs especially in cases with choroidal neovascularisation. Early detection of ARMD and timely treatment are mandatory. We have prospectively studied the results of two diagnostic self tests for the early detection of metamorphopsia and scotoma, the PHP test and the Amsler grid test, in different stages of ARMD. Patients with ARMD and best corrected visual acuity of 6/30 or better (Snellen charts) were examined with a standardised protocol, including supervised Amsler grid examination and PHP, a new device for metamorphopsia or scotoma measurement, based on the hyperacuity phenomenon in the central 14 degrees of the visual field. The stages of ARMD were independently graded in a masked fashion by stereoscopic ophthalmoscopy, stereoscopic fundus colour photographs, fluorescein angiography, and OCT. The patients were subdivided into 3 non-neovascular groups [early, late (RPE atrophy > 175 microm) and geographic atrophy], a neovascular group (classic and occult CNV) and an age-matched control group (healthy volunteers). 140 patients, with ages ranging from 50 to 90 years (median 68 years), were included in the study. Best corrected visual acuity ranged from 6/30 to 6/6 with a median of 6/12. 95 patients were diagnosed as non-neovascular ARMD. Thirty eyes had early ARMD (9 were tested positive by the PHP test and 9 by the Amsler grid test), and 50 late ARMD (positive: PHP test 23, Amsler grid test 26). The group with geographic atrophy consisted of 15 eyes (positive: PHP test 13, Amsler grid test 10). Forty-five patients presented with neovascular ARMD (positive: PHP test 38, Amsler grid test 36), 34 volunteers served as control group (positive: PHP test 1, Amsler grid test 5). The PHP and Amsler grid tests revealed comparable results detecting metamorphopsia and scotoma in early ARMD (30 vs. 30 %) and late ARMD (46 vs. 52 %). However, the

  7. A novel smartphone ophthalmic imaging adapter: User feasibility studies in Hyderabad, India

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    Cassie A Ludwig

    2016-01-01

    Full Text Available Aim of Study: To evaluate the ability of ancillary health staff to use a novel smartphone imaging adapter system (EyeGo, now known as Paxos Scope to capture images of sufficient quality to exclude emergent eye findings. Secondary aims were to assess user and patient experiences during image acquisition, interuser reproducibility, and subjective image quality. Materials and Methods: The system captures images using a macro lens and an indirect ophthalmoscopy lens coupled with an iPhone 5S. We conducted a prospective cohort study of 229 consecutive patients presenting to L. V. Prasad Eye Institute, Hyderabad, India. Primary outcome measure was mean photographic quality (FOTO-ED study 1–5 scale, 5 best. 210 patients and eight users completed surveys assessing comfort and ease of use. For 46 patients, two users imaged the same patient's eyes sequentially. For 182 patients, photos taken with the EyeGo system were compared to images taken by existing clinic cameras: a BX 900 slit-lamp with a Canon EOS 40D Digital Camera and an FF 450 plus Fundus Camera with VISUPAC™ Digital Imaging System. Images were graded post hoc by a reviewer blinded to diagnosis. Results: Nine users acquired 719 useable images and 253 videos of 229 patients. Mean image quality was ≥ 4.0/5.0 (able to exclude subtle findings for all users. 8/8 users and 189/210 patients surveyed were comfortable with the EyeGo device on a 5-point Likert scale. For 21 patients imaged with the anterior adapter by two users, a weighted κ of 0.597 (95% confidence interval: 0.389–0.806 indicated moderate reproducibility. High level of agreement between EyeGo and existing clinic cameras (92.6% anterior, 84.4% posterior was found. Conclusion: The novel, ophthalmic imaging system is easily learned by ancillary eye care providers, well tolerated by patients, and captures high-quality images of eye findings.

  8. Retinopathy of prematurity: A study of prevalence and risk factors

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    Abdel H. A. A. Hakeem

    2012-01-01

    Full Text Available Background: Retinopathy of prematurity (ROP is a serious complication of prematurity treatment and can lead to blindness unless recognized and treated early. Objective: The objective was to estimate the prevalence of ROP in preterm infants in the Neonatal Intensive Care Unit (NICU, to identify the risk factors which predispose to ROP, and to assess the outcome of these cases. Materials and Methods: A ROP prospective screening survey was performed enrolling all prematures admitted to the NICU from January 2009 to December 2010, with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less. Infants whose gestational age was >32 weeks or birth weight was >1500 g were included if they were exposed to oxygen therapy for more than 7 days. A total of 172 infants (84 males and 88 females had retinal evaluation by indirect ophthalmoscopy from the fourth postnatal week and followed up periodically. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Infants who progressed to stage 3 ROP were given laser therapy. Results: Out of the studied 172 infants, 33 infants (19.2% developed ROP in one or both eyes; 18 (54.5% cases stage 1, 9 (27.3% cases stage 2, and 6 (18.2% cases stage 3. None of the studied neonates presented ROP at stages 4 or 5. The six cases diagnosed as ROP stage 3 underwent laser ablative therapy. Univariate analysis showed that there was a significant relationship between the occurrence of ROP and gestational age (P = 0.000, sepsis (P = 0.004, oxygen therapy (P = 0.018, and frequency of blood transfusions (P = 0.030. However, an insignificant relationship was found between the occurrence of ROP and sex, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, hypotension, phototherapy, duration of oxygen therapy, mechanical ventilation, and CPAP (all P > 0.05. Gestational age, sepsis, oxygen therapy, and frequency of

  9. Training time and quality of smartphone-based anterior segment screening in rural India.

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    Ludwig, Cassie A; Newsom, Megan R; Jais, Alexandre; Myung, David J; Murthy, Somasheila I; Chang, Robert T

    2017-01-01

    We aimed at evaluating the ability of individuals without ophthalmologic training to quickly capture high-quality images of the cornea by using a smartphone and low-cost anterior segment imaging adapter (the "EyeGo" prototype). Seven volunteers photographed 1,502 anterior segments from 751 high school students in Varni, India, by using an iPhone 5S with an attached EyeGo adapter. Primary outcome measures were median photograph quality of the cornea and anterior segment of the eye (validated Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department [FOTO-ED] study; 1-5 scale; 5, best) and the time required to take each photograph. Volunteers were surveyed on their familiarity with using a smartphone (1-5 scale; 5, very comfortable) and comfort in assessing problems with the eye (1-5 scale; 5, very comfortable). Binomial logistic regression was performed using image quality (low quality: quality: ≥4) as the dependent variable and age, comfort using a smartphone, and comfort in assessing problems with the eye as independent variables. Six of the seven volunteers captured high-quality (median ≥4/5) images with a median time of ≤25 seconds per eye for all the eyes screened. Four of the seven volunteers demonstrated significant reductions in time to acquire photographs (P1=0.01, P5=0.01, P6=0.01, and P7=0.01), and three of the seven volunteers demonstrated significant improvements in the quality of photographs between the first 100 and last 100 eyes screened (P1smartphone (odds ratio [OR] =1.25; 95% CI =1.13 to 1.39) and self-reported comfort diagnosing eye conditions (OR =1.17; 95% CI =1.07 to 1.29) were significantly associated with an ability to take a high-quality image (≥4/5). There was a nonsignificant association between younger age and ability to take a high-quality image. Individuals without ophthalmic training were able to quickly capture a high-quality magnified view of the anterior segment of the eye by using a smartphone with an

  10. Ocular manifestations of rheumatoid arthritis and their correlation with anti-cyclic citrullinated peptide antibodies

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    Vignesh AP

    2015-02-01

    Full Text Available Ammapati Paul Pandian Vignesh, Renuka Srinivasan Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India Purpose: To study the ocular manifestations of rheumatoid arthritis and to correlate the role of anti-cyclic citrullinated peptide antibody (anti-CCP antibody with the ocular manifestations.Methods: Three-hundred and ninety-two eyes of the 196 rheumatoid arthritis patients who attended the ophthalmology outpatient department underwent a detailed ocular examination using slit lamp biomicroscopy and ophthalmoscopy. The tear function of all the patients was assessed using Schirmer’s test, tear film break-up time and ocular surface staining. The anti-CCP antibody titers for all the rheumatoid arthritis patients were estimated using enzyme-linked immunosorbent assay tests.Results: Seventy-seven patients (135 eyes, 39% out of the 196 patients studied had ocular manifestations typical of rheumatoid arthritis. Dry eye was the most common manifestation (28%, 54 patients. Of the patients, 78% was females (60 patients. The mean duration of rheumatoid arthritis in patients with ocular manifestations was 5.4±2.7 years and without ocular manifestations was 2.1±1.6years. Three percent of the patients had episcleritis (six patients. Scleritis was present in 2% of the patients (four patients. Peripheral ulcerative keratitis and sclerosing keratitis was present in 1% of the population each (two patients each. Eighty-five percent (66 patients had bilateral manifestations 15% (eleven patients had unilateral manifestations. There was a strong association between the presence of anti-CCP antibodies and ocular manifestations of rheumatoid arthritis which was shown by the statistically significant P-value of <0.0001.Conclusion: Ocular manifestations are a significant part of the extra-articular manifestation of rheumatoid arthritis. Dry eye was the most common ocular manifestation. There was a

  11. Chemistry and biology of the initial steps in vision: the Friedenwald lecture.

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    Palczewski, Krzysztof

    2014-10-01

    Visual transduction is the process in the eye whereby absorption of light in the retina is translated into electrical signals that ultimately reach the brain. The first challenge presented by visual transduction is to understand its molecular basis. We know that maintenance of vision is a continuous process requiring the activation and subsequent restoration of a vitamin A-derived chromophore through a series of chemical reactions catalyzed by enzymes in the retina and retinal pigment epithelium (RPE). Diverse biochemical approaches that identified key proteins and reactions were essential to achieve a mechanistic understanding of these visual processes. The three-dimensional arrangements of these enzymes' polypeptide chains provide invaluable insights into their mechanisms of action. A wealth of information has already been obtained by solving high-resolution crystal structures of both rhodopsin and the retinoid isomerase from pigment RPE (RPE65). Rhodopsin, which is activated by photoisomerization of its 11-cis-retinylidene chromophore, is a prototypical member of a large family of membrane-bound proteins called G protein-coupled receptors (GPCRs). RPE65 is a retinoid isomerase critical for regeneration of the chromophore. Electron microscopy (EM) and atomic force microscopy have provided insights into how certain proteins are assembled to form much larger structures such as rod photoreceptor cell outer segment membranes. A second challenge of visual transduction is to use this knowledge to devise therapeutic approaches that can prevent or reverse conditions leading to blindness. Imaging modalities like optical coherence tomography (OCT) and scanning laser ophthalmoscopy (SLO) applied to appropriate animal models as well as human retinal imaging have been employed to characterize blinding diseases, monitor their progression, and evaluate the success of therapeutic agents. Lately two-photon (2-PO) imaging, together with biochemical assays, are revealing functional

  12. Microperimetría y tomografía de coherencia óptica en operados por cirugía convencional del desprendimiento de retina Microperimetry and optical coherente tomography in patients operated on by the convencional retinal detachment surgery

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    Roberto Alejandro Guerra García

    2008-12-01

    Full Text Available INTRODUCCIÓN: Se realizó un estudio descriptivo para determinar la agudeza visual, la microperimetría y la tomografía de coherencia óptica en operados por cirugía convencional de desprendimiento de retina regmatógeno, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" desde octubre de 2006 a marzo de 2007. MÉTODOS: Se estudiaron 26 pacientes que acudieron con oftalmoscopia y biomicroscopia normal y una evolución entre tres y seis meses. Se obtuvo mejor agudeza visual corregida, fijación, sensibilidad media, morfología y grosores maculares. RESULTADOS: La agudeza visual media fue de 0,41 y la fijación fue estable en la mayoría de los pacientes, la sensibilidad retiniana promedio fue de 11 decibeles. El hallazgo más frecuente fue el desprendimiento seroso. El grosor macular promedio fue de 246,3 micras. No se encontró relación estadística entre el tiempo de evolución preoperatorio y las características maculares del desprendimiento con respecto a estas pruebas. CONCLUSIONES: El estado funcional y anatómico de la retina no estuvo totalmente recobrado y pudiera ser monitorizado gracias a la microperimetría y la tomografía de coherencia óptica.INTRODUCTION: A descriptive study was made to determine the visual acuity, microperimetry and optical coherence tomography in patients operated on by the conventional rhegmatogenous retinal detachment at "Ramon Pando Ferrer" Cuban Ophthalmologic Institute from October 2006 to March 2007. METHODS: Twenty six patients, who had gone to the hospital with normal values in ophthalmoscopy and biomicroscopy and three-six months of disease development. Better corrected visual acuity, fixation, average sensitivity, morphology and macular thickness were obtained after surgery. RESULTS: Average visual acuity was 0,41 and fixation was stable in most of patients; average retinal sensitivity was 11 decibels. The most frequent finding was serum detachment. Average macular thickness was 246

  13. Podoconiosis, trachomatous trichiasis and cataract in northern Ethiopia: A comparative cross sectional study.

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    Helen Burn

    2017-02-01

    Full Text Available Rural populations in low-income countries commonly suffer from the co-morbidity of neglected tropical diseases (NTDs. Podoconiosis, trachomatous trichiasis (both NTDs and cataract are common causes of morbidity among subsistence farmers in the highlands of northern Ethiopia. We explored whether podoconiosis was associated with cataract or trachomatous trichiasis (TT among this population.A comparative cross-sectional study was conducted in East Gojam region, Amhara, Ethiopia in May 2016. Data were collected from patients previously identified as having podoconiosis and from matched healthy neighbourhood controls. Information on socio-demographic factors, clinical factors and past medical history were collected by an interview-administered questionnaire. Clinical examination involved grading of podoconiosis by examination of both legs, measurement of visual acuity, direct ophthalmoscopy of dilated pupils to grade cataract, and eyelid and corneal examination to grade trachoma. Multiple logistic regression was conducted to estimate independent association and correlates of podoconiosis, TT and cataract.A total of 700 participants were included in this study; 350 podoconiosis patients and 350 healthy neighbourhood controls. The prevalence of TT was higher among podoconiosis patients than controls (65 (18.6% vs 43 (12.3% with an adjusted odds ratio OR 1.57 (95% CI 1.02-2.40, p = 0.04. There was no significant difference in prevalence of cataract between the two populations with an adjusted OR 0.83 (95% CI 0.55-1.25, p = 0.36. Mean best visual acuity was 0.59 (SD 0.06 in podoconiosis cases compared to 0.44 (SD 0.04 in controls, p<0.001. The proportion of patients classified as blind was higher in podoconiosis cases compared with healthy controls; 5.6% vs 2.0%; adjusted OR 2.63 (1.08-6.39, P = 0.03.Individuals with podoconiosis have a higher burden of TT and worse visual acuity than their matched healthy neighbourhood controls. Further research into

  14. Effects of the AMPA antagonist ZK 200775 on visual function: a randomized controlled trial.

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    Richard Bergholz

    Full Text Available BACKGROUND: ZK 200775 is an antagonist at the alpha-Amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA receptor and had earned attention as a possible neuroprotective agent in cerebral ischemia. Probands receiving the agent within phase I trials reported on an alteration of visual perception. In this trial, the effects of ZK 200775 on the visual system were analyzed in detail. METHODOLOGY: In a randomised controlled trial we examined eyes and vision before and after the intravenous administration of two different doses of ZK 200775 and placebo. There were 3 groups of 6 probands each: Group 1 recieved 0.03 mg/kg/h, group 2 0.75 mg/kg/h of ZK 200775, the control group received 0.9% sodium chloride solution. Probands were healthy males aged between 57 and 69 years. The following methods were applied: clinical examination, visual acuity, ophthalmoscopy, colour vision, rod absolute threshold, central visual field, pattern-reversal visual evoked potentials (pVEP, ON-OFF and full-field electroretinogram (ERG. PRINCIPAL FINDINGS: No effect of ZK 200775 was seen on eye position or motility, stereopsis, pupillary function or central visual field testing. Visual acuity and dark vision deteriorated significantly in both treated groups. Color vision was most remarkably impaired. The dark-adapted ERG revealed a reduction of oscillatory potentials (OP and partly of the a- and b-wave, furthermore an alteration of b-wave morphology and an insignificantly elevated b/a-ratio. Cone-ERG modalities showed decreased amplitudes and delayed implicit times. In the ON-OFF ERG the ON-answer amplitudes increased whereas the peak times of the OFF-answer were reduced. The pattern VEP exhibited lower amplitudes and prolonged peak times. CONCLUSIONS: The AMPA receptor blockade led to a strong impairment of typical OFF-pathway functions like color vision and the cone ERG. On the other hand the ON-pathway as measured by dark vision and the scotopic ERG was affected as well

  15. ACUTE CEREBROVASCULAR ACCIDENTS IN PREGNANCY, LABOR AND POSTPARTUM

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    R. R. Arustamyan

    2016-01-01

    Full Text Available Background: Acute cerebrovascular accidents are rare and serious complication of pregnancy, labor and puerperium, leading to an increase in maternal and perinatal morbidity and mortality. More than 12% of maternal mortality is related to stroke. Aim: To assess the impact of pregnancy on the incidence of stroke, as well as the impact of cerebrovascular disorders on pregnancy, labor and puerperium. Materials and methods: We retrospectively and prospectively analyzed the course of pregnancy, labor and puerperium in 136 female patients with strokes of various etiologies. The diagnosis of stroke and cerebrovascular disorders was verified with magnetic resonance imaging, angiography, conventional and multiaxial computerized tomography, ophthalmoscopy, electroencephalography, electrocardiography and echocardiography (trans-thoracic and trans-esophageal, 24-hour blood pressure monitoring and electrocardiogram monitoring, ultrasound assessment of extra and intracranial vasculature with duplex scanning, cerebral angiography and laboratory assessments. Results: The analysis of 92 strokes that occurred during pregnancy, labor and postpartum showed that 38% of the cases (n=35 were caused by various cerebrovascular abnormalities. In 18.5% of the cases (n=17, acute cerebrovascular accidents occurred in patients with preeclampsia/eclampsia. Most often (84.8%, or 78/97 of cases strokes or other cerebrovascular accidents developed in II and III trimesters. The most severe cases were patients with intracranial hemorrhages (n=31. In this group, there were 5  deaths of mothers, 1  antenatal and 1  neonatal fetal deaths. In 90% of these cases (28/31, intracranial hemorrhage in pregnancy was related to manifestation of intracerebral vascular abnormality (arteriovenous malformations, arterial aneurysms, cavernomas. We observed a 4-fold rate of arteriovenous malformation ruptures during pregnancy (21 cases vs. 5. The rates of arterial aneurysm and cavernoma ruptures

  16. Intravitreal bevacizumab combined with plaque brachytherapy reduces melanoma tumor volume and enhances resolution of exudative detachment

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    Houston SK

    2013-01-01

    Full Text Available Samuel K Houston,1 Nisha V Shah,1 Christina Decatur,1 Marcela Lonngi,1 William Feuer,1 Arnold M Markoe,2 Timothy G Murray1–31Department of Ophthalmology, 2Department of Radiation Oncology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 3Murray Ocular Oncology and Retina, Miami, FL, USABackground: The purpose of this study was to evaluate intravitreal bevacizumab as an adjuvant treatment to plaque brachytherapy in the treatment of choroidal melanoma.Methods: This was a retrospective, consecutive study of 124 patients treated from 2007 to 2009 for choroidal melanoma with plaque brachytherapy. Patients were treated with I-125 plaque brachytherapy with 2 mm margins and 85 Gy to the tumor apex. Consecutive patients were injected intravitreally with 2.5 mg/0.1 mL bevacizumab at a site away from the primary tumor and immediately following plaque removal. Choroidal melanomas were observed using indirect ophthalmoscopy, wide-angle photography, and ultrasound. The main outcome measures were tumor volume, resolution of exudative retinal detachment, and visual acuity.Results: One hundred and twenty-four patients met our inclusion criteria and were included in the analysis. The mean patient age was 65.7 years, and the mean apical tumor height was 4.0 ± 2.7 mm and basal diameter was 12.7 ± 3.0 mm. Mean follow-up was 24 months. Prior to treatment, 100% of tumors had exudative retinal detachment, and pretreatment visual acuity was 20/55 (median 20/40. Tumor control was 100%, metastasis was 0% at last follow-up, and 89.8% had complete resolution of exudative retinal detachment, with a mean time to resolution of 3.36 months. At one month, 43% had complete resolution of exudative retinal detachment, which increased to 73% at 4 months. Visual acuity was 20/62 (median 20/40 at 4 months, with stabilization to 20/57 (median 20/40 at 8 months, 20/56 (median 20/30 at 12 months, and 20/68 (median 20/50 at 24 months. Tumor

  17. Ascorbic acid levels of aqueous humor of dogs after experimental phacoemulsification.

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    De Biaggi, Christianni P; Barros, Paulo S M; Silva, Vanessa V; Brooks, Dennis E; Barros, Silvia B M

    2006-01-01

    Phacoemulsification has been successfully employed in humans and animals for lens extraction. This ultrasonic extracapsular surgical technique induces hydroxyl radical formation in the anterior chamber, which accumulates despite irrigation and aspiration. In this paper we determined the total antioxidant status of aqueous humor after phacoemulsification by measuring aqueous humor ascorbic acid levels. Mixed-breed dogs (n = 11; weighing about 10 kg) with normal eyes as determined by slit-lamp biomicroscopy, applanation tonometry, and indirect ophthalmoscopy had phacoemulsification performed in one eye with the other eye used as a control. Samples of aqueous humor were obtained by anterior chamber paracentesis before surgery and at days 1, 2, 3, 7, and 15 after surgery. Total aqueous humor antioxidant status was inferred from the capacity of aqueous humor to inhibit free radical generation by 2,2-azobis (2-amidopropane) chlorine. Ascorbic acid concentrations were measured by high-pressure liquid chromatography with UV detection. Protein content was determined with the biuret reagent. Statistical analysis was performed by anova followed by the paired t-test. Total antioxidant capacity was reduced from 48 to 27 min during the first 24 h with a gradual increase thereafter, remaining statistically lower than the control eye until 7 days postoperatively. Reduced levels of ascorbic acid followed this reduction in antioxidant capacity (from 211 to 99 microm after 24 h), remaining lower than the control eye until 15 days postoperatively. Protein concentration in aqueous humor increased from 0.62 mg/mL to 30.8 mg/mL 24 h after surgery, remaining statistically lower than the control eye until 15 days postoperatively. Paracentesis alone did not significantly alter the parameters measured. These results indicate that after phacoemulsification, the aqueous humor ascorbic acid levels and antioxidant defenses in aqueous humor are reduced, indirectly corroborating free radical

  18. Subtenon Carboplatin in the Management of Intraocular Retinoblastoma

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    Reza Karkhaneh

    2008-12-01

    Full Text Available

    PURPOSE: To evaluate the efficacy of adjuvant subtenon carboplatin in the management of intraocular retinoblastoma. METHODS: This study was conducted as a randomized, double-masked clinical trial. A diagnosis of intraocular retinoblastoma was made based on clinical examination, ultrasonography and orbital CT-scanning. The greatest basal dimension of the tumors was estimated in disc diameter (DD by indirect ophthalmoscopy. Tumor thickness was determined by ultrasonography. Each eye was assigned to one of 10 blocks based on tumor stage (Reese-Ellsworth classification and randomly received systemic chemotherapy alone (control group or systemic chemotherapy plus 20mg subtenon carboplatin (case group. Indirect laser photocoagulation or cryotherapy was performed as additional treatment. RESULTS: The study included 35 tumors in 17 eyes of 14 patients (19 tumors in 8 eyes in the control group and 16 tumors in 9 eyes in the case group. There was 57.22% and 61.73% decrease in tumor thickness in the control and case groups, respectively. This difference was not statistically significant (P=0.12. The decrease in greatest basal tumor dimension in the control group (47.32% was not significantly different from that in the case group (38.80%. One eye (12.5% in the control group and 3 eyes (33.3% in the case group were enucleated. CONCLUSION

  19. Detection of Hydroxychloroquine Retinal Toxicity by Automated Perimetry in 60 Rheumatoid Arthritis Patients with Normal Fundoscopic Findings.

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    Motarjemizadeh, Qader; Aidenloo, Naser Samadi; Abbaszadeh, Mohammad

    2015-06-25

    Hydroxychloroquine (HCQ) is an antimalarial drug used extensively in treatment of autoimmune diseases such as rheumatoid arthritis. Retinal toxicity is the most important side effects of this drug. Even after the drug is discontinued, retinal degeneration from HCQ can continue to progress. Consequently, multiple ophthalmic screening tests have been developed to detect early retinopathy. The aim of the current study was to evaluate the value of central 2-10 perimetry method in early detection of retinal toxicity. This prospective cross-sectional investigation was carried out on 60 rheumatoid arthritis patients, who had been receiving HCQ for at least 6 months and still were on their medication (HCQ intake) at the time of enrollment. An ophthalmologist examined participants using direct and indirect ophthalmoscopy. Visual field testing with automated perimetry technique (central 2-10 perimetry with red target) was performed on all included subjects twice in 6 months interval: The first one at the time of enrollment and the second one 6 months later. Males and females did not show any significant difference in terms of age, duration of therapy, daily and cumulative HCQ dose, anterior or posterior segment abnormalities, hypertension, body mass index, and best corrected visual acuity. Anterior segment was abnormal in 9 individuals including 3 subjects with macular pigmentary changes, 4 individuals with cataract and 2 cases with dry eyes. Moreover, 12 subjects had retinal pigmented epithelium (RPE) in their posterior segments. After 6 months, depressive changes appeared in 12 subjects. Additionally, HCQ therapy worsened significantly the perimetric results of 5 (55.6%) patients with abnormal anterior segment. A same trend was observed in perimetric results of 6 (50.0%) subjects with abnormal posterior segments (P=0.009). The daily dose of HCQ (P=0.035) as well as the cumulative dose of hydroxychloroquine (P=0.021) displayed statistically significant associations with

  20. Causes of blindness in rural Myanmar (Burma: Mount Popa Taung-Kalat Blindness Prevention Project

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    Arie Y Nemet

    2009-07-01

    Full Text Available Arie Y Nemet1, Pinhas Nemet2, Geoff Cohn3, Gina Sutton, Gerald Sutton4, Richard Rawson41Department of Ophthalmology, Sydney Hospital and Sydney Eye Hospital, Sydney, Australia; 2Sackler School of Medicine, Tel-Aviv University, Israel; 3Departments of Ophthalmology, University of New South Wales, Sydney, Australia; 4Department of Ophthalmology, University of Sydney, AustraliaPurpose: This study is a review of the major causes of visual impairment (VI and severe visual impairment/blindness (SVI/BL in Mount Popa Taung-Kalat, a rural region in Myanmar (Burma.Methods: A review of our clinical records of consecutive patients attending clinics was conducted. Participants of all ages (n = 650 of the population of Mount Popa Taung-Kalat and villages in its vicinity underwent ophthalmic interview and a detailed dilated ocular evaluation by trained Australian ophthalmologists and ophthalmic nurses. This evaluation included anterior segment examination with a slit lamp, intraocular pressure recording, and direct or indirect ophthalmoscopy. VI and SVI/BL were defined by the World Health Organization (WHO criteria. Results: Six hundred fifty subjects were screened, with a mean age of 49.0 ± 20.6 years (range, 1–99. One hundred five patients (16.2% were children (ages 1–18. Five hundred thirty-one eyes of the total 1,300 eyes (39.5% had VI/SVI/BL, and 40 eyes of the children (38.1% (average age 15.3 ± 13.3 had VI/SVI/BL. The leading causes of VI/SVI/BL were cataract with 288 cases (54.2%, glaucoma with 84 cases (15.8%, and corneal pathology with 78 cases (14.7%. Of all the VI/SVI/BL cases, 8.4% were preventable, 81.9% were treatable, and total of 90.5% were avoidable.Conclusions: In the current study, cataracts were the major cause of blindness and visual impairment, and most of the ophthalmic pathology causing blindness is avoidable. These results highlight the lack of basic ophthalmologist eye care and optician resources in rural regions in Myanmar

  1. Long-lasting corneal endothelial graft rejection successfully reversed after dexamethasone intravitreal implant

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    Giannaccare G

    2016-07-01

    Full Text Available Giuseppe Giannaccare, Michela Fresina, Alberto Pazzaglia, Piera Versura Ophthalmology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES, Alma Mater Studiorum University of Bologna, Sant’Orsola‑Malpighi Teaching Hospital, Bologna, Italy Abstract: Graft rejection is the most significant complication corneal transplantation and the leading indication for overall corneal transplantation. Corticosteroid therapy represents the mainstay of graft rejection treatment; however, the optimal route of administration of corticosteroid remains uncertain. We report herein for the first time the multimodal imaging of a case of long-lasting corneal endothelial graft rejection successfully reversed 3 months after dexamethasone intravitreal implant. A 29-year-old Asian female presented with a long-lasting corneal endothelial graft rejection in her left phakic eye. She underwent penetrating keratoplasty for advanced keratoconus 24 months before presentation. Hourly dexamethasone eyedrops, daily intravenous methylprednisolone, and one parabulbar injection of methylprednisolone acetate were administered during the 5 days of hospitalization. However, the clinical picture remained approximately unchanged despite therapy. By mutual agreement, we opted for the off-label injection of dexamethasone 0.7 mg intravitreal implant in order to provide therapeutic concentrations of steroid for a period of ~6 months. No other concomitant therapies were prescribed to the patient. Visual acuity measurement, slit lamp biomicroscopy, anterior segment photography, confocal microscopy, anterior segment optical coherence tomography, laser cell flare meter, intraocular pressure measurement, and ophthalmoscopy were performed monthly for the first postoperative 6 months. Three months after injection, both clinical and subclinical signs of rejection disappeared with a full recovery of visual acuity to 20/30 as before the episode. Currently, at the 12-month

  2. Retinopatia da prematuridade limiar em crianças submetidas à terapia com surfactante exógeno endotraqueal Threshold retinopathy of prematurity in children undergoing exogenous endotracheal surfactant therapy

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    Mário Martins dos Santos Motta

    2008-12-01

    Full Text Available OBJETIVO: Estudar a freqüência da retinopatia da prematuridade (ROP em qualquer estadiamento e da retinopatia da prematuridade limiar em prematuros que usaram ou não surfactante endotraqueal, para tratamento da síndrome da membrana hialina e avaliar a resposta dos olhos que necessitaram tratamento de ablação da retina periférica. MÉTODOS: Cento e sessenta e oito prematuros, nascidos com 1.500 gramas ou menos e/ou idade gestacional de 32 semanas ou menos, foram triados para a ROP por avaliação oftalmoscópica. Foram comparados os achados de 40 crianças tratadas pelo surfactante endotraqueal com os de 128 que não precisaram desta terapia. A ablação da retina periférica, com laser ou crioterapia, foi realizada nos pacientes com ROP limiar. Para análise estatística foram usados os testes t de Student, qui-quadrado e Kruskal-Wallis, além do teste exato de Fisher com significância para pOBJECTIVE: To study the frequency of retinopathy of prematurity (ROP in any stage and its threshold form in premature infants, either treated or non-treated with exogenous surfactant to neonatal respiratory distress syndrome, and evaluate the response of eyes with threshold retinopathy to ablation treatment. METHODS: One hundred and sixty eight premature infants who weighed 1500 grams or less and/or who had a gestational age of 32 weeks or less, were screened for ROP by ophthalmoscopy. We compared findings in 40 patients treated with exogenous endotracheal surfactant, with those of 128 patients who did not require such therapy. Ablation of ischaemic peripheral retina, either with laser or cryotherapy, was applied in cases of threshold ROP. For statistical analysis Student's t, qui-square, Kruskal-Wallins and Fisher's exact tests were used, with p value of < 0.05 considered as significant. RESULTS: ROP, in any stage, occurred in 51,2% of children. Threshold ROP, requiring treatment, was found in 12 (7,4% of them and regressed in 9. There was no

  3. 眼科常用影像诊断法对眼部肿瘤的综合诊断作用%Pay attention to the application of image examination on ocular tumor diagnosis

    Institute of Scientific and Technical Information of China (English)

    陈伟; 杨文利

    2013-01-01

    眼部肿瘤是致盲重要的疾病之一,严重者可以危及患者的生命。在眼部肿瘤的诊疗过程中,除眼科常规检查,如裂隙灯显微镜及直接或间接检眼镜检查外,影像学检查也发挥着重要的作用。对于那些屈光间质混浊无法窥清眼底的病例,影像学检查具有举足轻重的作用。因而有必要阐述超声成像、计算机断层成像、核磁共振成像、荧光素眼底血管造影及光学相干断层扫描等影像学诊断技术的研究进展,并分析其在视网膜母细胞瘤、脉络膜黑色素瘤、脉络膜转移癌、脉络膜血管瘤、眶内肿瘤及类瘤病变等疾病中的诊断和鉴别诊断作用,从而为合理选择影像学检查方法提供依据。%Ocular tumor is not only a serious blinding diseases, malignant tumor but also can threaten the patient′s life.In addition to routine eye examination, slit lamp microscope, direct/indirect ophthalmoscopy, the imaging exam plays an important role in the diagnosis and treatment of ocular tumor. For those refractive stromal opacity can′t peep clear cases of fundus, imaging examination plays a decisive role.This paper will present research progress of ultrasound imaging, computed tomography, magnetic resonance imaging, angiography, optical coherence tomography and other diagnostic imaging technology, and analyze the value of those technologies in retinoblastoma, uveal melanoma, choroidal metastasis, choroidal hemangioma, orbital tumor and class neoplasia diagnosis, and provide the basis for reasonable selection of the diagnostic imaging methods.

  4. Sustainable control of onchocerciasis: ocular pathology in onchocerciasis patients treated annually with ivermectin for 23 years: a cohort study.

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    Méba Banla

    Full Text Available The evolution and persistence of ocular pathology was assessed in a cohort of Onchocerca volvulus infected patients treated annually with ivermectin for 23 years. Patients were resident in rural Central and Kara Region of Togo and ocular examinations included testing of visual acuity, slit lamp examination of the anterior eye segment and the eye fundus by ophthalmoscopy. Before ivermectin treatment, vivid O.volvulus microfilariae (MF were observed in the right and left anterior eye chamber in 52% and 42% of patients (n = 82, and dead MF were seen in the right and left cornea in 24% and 15% of cases, respectively. At 23 years post initial treatment (PIT, none of the patients (n = 82 presented with MF in the anterior chamber and cornea. A complete resolution of punctate keratitis (PK lesions without observable corneal scars was present at 23 years PIT (p<0.0001, and sclerosing keratitits (SK lessened by half, but mainly in patients with lesions at early stage of evolution. Early-stage iridocyclitis diminished from 42%(rE and 40%(lE to 13% (rE+lE(p<0.0001, but advanced iridocyclitis augmented (p<0.001 at 23 years PIT compared to before ivermectin. Advanced-stage papillitis and chorioretinitis did not regress, while early-stage papillitis present in 28%(rE and 27%(lE of patients at before ivermectin regressed to 17%(rE and 18%(lE, and early-stage chorioretinitis present in 51%(rE+lE of cases at before ivermectin was observed in 12%(rE and 13%(lE at 23 years PIT (p<0.0001. Thus, regular annual ivermectin treatment eliminated and prevented the migration of O. volvulus microfilariae into the anterior eye chamber and cornea; keratitis punctata lesions resolved completely and early-stage sclerosing keratitits and iridocyclitis regressed, whilst advanced lesions of the anterior and posterior eye segment remained progressive. In conclusion, annual ivermectin treatments may prevent the emergence of ocular pathology in those populations still exposed

  5. Features of YAG-laser treatment of posterior capsule opacification in eyes with intraocular comorbidities ext

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    O. I. Borzunov

    2015-01-01

    Full Text Available Purpose: is to evaluate the effectiveness of YAG laser posterior lens capsule dissection in patients with secondary cataract with concurrent intraocular pathology. Patients and methods: retro- and prospective analysis of the results of the YAG — laser treatment of secondary cataract in the 196 eyes, including the intraocular concomitant pathology (myopia, glaucoma, age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa operated retinal detachment, chronic uveitis in remission, peripheral chorioretinal degeneration. Effectiveness of treatment was evaluated by checking visual acuity and dynamics of complaints as aberration, glare, distortion in the central field of view without proper disease of the macula. Complex preoperative studies included: refractometry, visometry with correction, perimetry, tonometry, biomicroscopy, ophthalmoscopy, ultrasound examination of the eyeball (if necessary. The examination results should demonstrate convincing evidence that posterior capsular opacification is the main reason for the decrease of visual acuity. Results:, Visual acuity, at average increased from 0.4‑0.6 to 0.8‑1.0 in 50 cases after dissection, Visual acuity improved to 2‑3 lines in 66‑4–5, 24‑6‑7 lines in 74 cases. Visual acuity remains the same, but contrast sensitivity was increased in 6 cases. The IOL location after disruption was evaluated by β-scanning and biomicroscopy. In case of the initial correct IOL position in all 195 (100 % cases, there were no dislocation in the postoperative period. Complications that can be identified were single microcraters on the IOL surface in cases of its full contact with the posterior capsule. These injuries did not affect the visual functions.Conclusion: YAG -Laser dissection of secondary cataract is effective, less traumatic, and the optimal treatment of secondary cataract, including patients with concomitant intraocular pathology, and helps to avoid over

  6. Lesiones traumáticas de los anexos y del segmento anterior del ojo en los boxeadores Traumatic lesions of the adnexa and of the anterior segment of the eye in fighters

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    Agustín Fernández Sánchez

    2003-06-01

    Full Text Available Se realizó un estudio retrospectivo con una muestra de 71 boxeadores a los cuales se les examinaron las estructuras de referencia mediante oftalmoscopia directa y biomicroscopia ocular, antes de las 6 horas posteriores al término de sus peleas; donde se obtuvo como resultado que los anexos afectados fueron los párpados con 5 hematomas, 4 edemas y 1 excoriación; y la conjuntiva con 4 hiperemias y 8 hemorragias. En el segmento anterior del ojo sólo se afectó la córnea con 13 lesiones en total, divididas en 10 excoriaciones superficiales y 3 profundas. Las lesiones traumáticas predominantes en los anexos del ojo son las de los párpados y las de la conjuntiva y las del segmento anterior del ojo, las de la córnea. El ojo más afectado fue el izquierdo y las lesiones más frecuentes fueron en las categorías de 13 y 14, 17 y 18 y 19 y 34 años las corneales, las conjuntivales y la de los párpados, respectivamente.A retrospective study was carried out with a sample of 71 fighters, whose reference structures were examined by direct ophthalmoscopy and ocular biomicroscopy within the 6 hours following their fights. As a result, it was observed that the affected adnexa were the eyelids with 5 hematomas, 4 edemas and 1 excoriation; and the conjunctiva with 4 hyperemias and 8 hemorrhages. In the anteriro segment, only the cornea was affected with 13 lesions in all, divided into 10 superficial and 3 deep excoriations.The traumatic lesions prevailing in the adnexa of the eye are those of the eyelids and the conjunctiva, whereas the predominating traumatic lesions of the anterior segment of the eye are those of the cornea. The left eye was the most affected and the most frequent lesions were in the categories 13 and 14, 17 and 18 and 19 and 34 years old in the cornea, the conjunctiva and the eyelids, respectively.

  7. Common ophthalmic problems of urban and rural postmenopausal women in a population sample of Raciborz district, a RAC-OST-POL Study

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    Wojciech Rokicki

    2014-03-01

    Full Text Available Introduction and objective. We wished to establish the prevalence of eye diseases and eye disease risk factors at postmenopausal age and to compare ophthalmic problems in urban and rural areas of Raciborz. Patients and methods. The study was performed in 2010. Out of the whole population of Raciborz, Poland, 10 percent (1750 of women were randomly selected for the reported study. Finally, ocular diseases, ophthalmic agents, health status (physical activity level, body mass index – BMI, reproductive history, the use of psychotropic drugs and hormone replacement therapy – HRT were recorded in 623 women. The women underwent visual acuity test and anterior segment examination, applanation tonometry and indirect ophthalmoscopy. Results. The mean age of the selected patients was 66.01±7.76 years, 275 (44% of them originating from rural and 348 (56% from urban regions. The average woman was obese (BMI=30.54±5.38 kg/m2, with near normal agility and reproductive history of 2.59±1.55 births, 147 (24% subjects remained under regular HRT support. According to the WHO, the visual acuity was classified as normal or near normal in 87.5%, while no blindness was recorded at all. Visual acuity depended, first of all, on lens status and was better among subjects with good agility (R=-0.31, p=0.001. Dry eye prevalence increased significantly over age of 67 years (p=0.000 and HRT seemed to be a dry eye protective factor (p=0.010. Except age, No other risk factors of cataract, other than age, were identified. Normal agility (p=0.003 and HRT (p=0.032 were associated with lower AMD (age-related macular degeneration prevalence rates. The differences between urban and rural participants were presented only in education, reproductive history, hypertension and frequency of ophthalmic examinations. Conclusions. Older adult women living in neighboring urban and rural areas present no differential in ophthalmic health problems.

  8. Epidemiological survey of diabetic retinopathy in Shunyi district of Beijing%北京市顺义区40岁及以上人群糖尿病视网膜病变的流行病学调查

    Institute of Scientific and Technical Information of China (English)

    李炳震; 阴正勤; 马志中; 刘瑜玲; 韩亮; 由德勃; 王婷; 蒋爱民; 降丽娟; 吴丽波; 赵一鸣

    2011-01-01

    Background There are no noticeable symptoms in early stages of diabetic retinopathy(DR)and the detection of presymptomatic DR remains challenging. Therefore, data on the prevalence and progress of DR will help in prevention and treatment programs in China. Objective This study was to survey the prevalence and risk factors of diabetic retinopathy( DR ) in a population aged 40 years or older in the Shunyi district of Beijing city.Methods A cross-sectional study was designed. Cluster sampling was used to randomly select 4167 (91.6%)individuals aged ≥40 years in 24 clusters in the Shunyi district of Beijing city in China. The Questionnaire data,including general information, living habits, present history, past history, family history, education level etc., were obtained from each subjects. The height, body weight and blood pressure were examined, and slit-lamp examination, direct ophthalmoscopy,indirect ophthalmoscopy and nonmydriatic fundus photography were performed during the study duration. Diabetic mellitus (DM)was diagnosed and graded according to the criteria of Early Treatment Diabetic Retinopathy Study Research Group(ETDRS). The associated factors with DR were analyzed byx2 test,trend x2 test,and multivariate Logistic regression analysis. This protocol was approved by the Ethic Committee of Peking University. Informed consent was obtained from each individual prior to the survey. Results A total of 4167 ( 91.6% )individuals were examined from the 4549 samples with a response rate of 86. 4%. This study showed a prevalence of 29. 2% for DR, 5.4% for sight-threatening diabetic retinopathy ( STDR), and 1.3% for prolifrative retinopathy (PDR) in type 2 DM subjects. Of the type 2 DM subjects,0. 4% (4/445)had social blindness( VA<0. 1 ) ,and 6. 3% (28/445) presented with visual impairment (VA < 0. 3 )in bilateral eyes. Univariate Logistic regression analysis indicated that insulin therapy ( P = 0.011 ) and lower body mass index ( BMI, kg/m2 ) ( P = 0. 022

  9. Optic nerve head and fibre layer imaging for diagnosing glaucoma

    Science.gov (United States)

    Michelessi, Manuele; Lucenteforte, Ersilia; Oddone, Francesco; Brazzelli, Miriam; Parravano, Mariacristina; Franchi, Sara; Ng, Sueko M; Virgili, Gianni

    2016-01-01

    Background The diagnosis of glaucoma is traditionally based on the finding of optic nerve head (ONH) damage assessed subjectively by ophthalmoscopy or photography or by corresponding damage to the visual field assessed by automated perimetry, or both. Diagnostic assessments are usually required when ophthalmologists or primary eye care professionals find elevated intraocular pressure (IOP) or a suspect appearance of the ONH. Imaging tests such as confocal scanning laser ophthalmoscopy (HRT), optical coherence tomography (OCT) and scanning laser polarimetry (SLP, as used by the GDx instrument), provide an objective measure of the structural changes of retinal nerve fibre layer (RNFL) thickness and ONH parameters occurring in glaucoma. Objectives To determine the diagnostic accuracy of HRT, OCT and GDx for diagnosing manifest glaucoma by detecting ONH and RNFL damage. Search methods We searched several databases for this review. The most recent searches were on 19 February 2015. Selection criteria We included prospective and retrospective cohort studies and case-control studies that evaluated the accuracy of OCT, HRT or the GDx for diagnosing glaucoma. We excluded population-based screening studies, since we planned to consider studies on self-referred people or participants in whom a risk factor for glaucoma had already been identified in primary care, such as elevated IOP or a family history of glaucoma. We only considered recent commercial versions of the tests: spectral domain OCT, HRT III and GDx VCC or ECC. Data collection and analysis We adopted standard Cochrane methods. We fitted a hierarchical summary ROC (HSROC) model using the METADAS macro in SAS software. After studies were selected, we decided to use 2 × 2 data at 0.95 specificity or closer in meta-analyses, since this was the most commonly-reported level. Main results We included 106 studies in this review, which analysed 16,260 eyes (8353 cases, 7907 controls) in total. Forty studies (5574

  10. 视觉对比敏感度和OCT在焊工体检中的应用%The application of visual contrast sensitivity and OCT in physical examination of welder

    Institute of Scientific and Technical Information of China (English)

    王文英; 冀向宁; 王志学; 王永森

    2015-01-01

    Objective To investigate the application of visual contrast sensitivity (CS) and optical coherence tomography (OCT) in physical examination of welder.Methods This is a cross-sectional study.Eighty-six welding workers who had medical checks in May 2014 in our hospital were the research objects (welder group),and 62 other type workers were the control group.Besides the general medical system examinations,eye examinations had been performed on the crowd including subjective symptoms,visual acuity,ophthalmoscopy,OCT and CS.The eye examination results in two groups were compared by chisquare analysis.The consistency in the results of readme symptoms with the results of visual acuity,ophthalmoscopy,OCT and CS were analysed by Kappa test,and the correlation between the results of OCT and CS were analysed by rank correlation test.Results In welder group,the abnormal rates of the examinations in readme symptoms,vision,ophthalmoscope,CS (6c/d) and OCT were 25.6%,5.8%,2.3%,30.2% and 22.1%.Compared with the results in control group,the differences in the results of symptoms,CS(6c/d) and OCT were statistically significant (x2 =7.412,P =0.007),(x2 =8.982,P =0.003),(x2 =10.533,P =0.001).In welder group,the results of OCT and CS (6c/d) were highly consistent with the results of subjective symptoms (Po =0.919,K =0.776),(Po =0.905,K =0.767).Positive correlation was found out between the results of OCT and the results of CS (6c/d) (C =0.753 、x2 =97.577,P =0.000).Conclusion Obvious retinal light damage exists in part welders.CS and OCT examination can accurately find out this damage respectively from the function and anatomy which are applied to eye examinations in welders.The damage of anatomy may be the cause for the change of the function.%目的 探讨在焊接工人体检中应用视觉对比敏感度(CS)和光学相干断层扫描(OCT)检查的意义.方法 横断面调查研究,以2014年5月在河北省沧州市中心医院体检的某工厂焊接工人86人为研

  11. Estudo histopatológico da retina de coelhos após injeção intravítrea de lidocaína Histopathologic study of the retina in rabbits after intravitreous injection of lidocaine

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    Marcos Antônio Ferreira

    2002-01-01

    injection of 0.5 (group II, 1.0 (group III and 2.0 % (group IV lidocaine in the right eyes and saline solution in the left eyes (group I - control after general anesthesia. Bilateral indirect ophthalmoscopy was performed before the intravitreal injection, during the procedure, one hour postoperative and on days 1, 3, 7 and 15. On the same days one eye of group II, two eyes of group III and one eye of group IV were enucleated and examined under light and transmission electron microscopy. Results: No alterations were found under bilateral indirect ophthalmoscopy before and during the intravitreal injection, but on days 1, 3, 7 and 15 after the procedure the retina showed a whitish aspect, an elevation of the vitreous-retinal interface, retinal edema and virtual condensation ring in all groups. No alterations were found using light and transmission electron microscopy analysis. Conclusion: Intravitreal injection of 0.5, 1.0 and 2.0% lidocaine morphologically showed no toxicity to New Zeland albino rabbit retina, based on light and transmission electron microscopy analysis.

  12. Prevalence of diabetic retinopathy in patients assisted by a unit of Family Health Strategy in the city of Ananindeua, Brazil Prevalencia de la retinopatía diabética en pacientes atendidos por la Estratégia de Salud Familiar en el município de Ananindeua - PA Prevalência de retinopatia diabética em pacientes atendidos pela Estratégia Saúde da Família no município de Ananindeua - PA

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    Dyndara Rodrigues Pedrosa

    2012-09-01

    Full Text Available

    Objective: To identify the prevalence of diabetic retinopathy (DR in patients served by the Family Health Strategy (FHS of Ananindeua, Brazil. Methods: This was a cross-sectional study with 40 patients with diabetes mellitus (DM enrolled in the HIPERDIA program and assisted by the FHS of Ananindeua. Those selected were subjected to a standardized questionnaire at home and answered questions about the knowledge, outcomes and complications of DM and DR, and socioeconomic data. In the next step, a volunteer ophthalmologist performed ophthalmoscopy and found those with DR, who were sent to a specialized center to receive treatment. Of these patients, 9 were excluded because they did not attend the unit to perform ophthalmoscopy. Results: The prevalence of DR was found to be 40.7%; however, 4 patients had impaired their analysis due to the presence of cataracts, so it was only possible to do evaluation in 27. Factors associated with DR, after analysis of the variables were the time to the patients be aware of the diagnosis of DM, type of DM and non-proliferative DR. Conclusion: This pilot study underscores the importance of primary care in monitoring diabetic patients and guidance to the professionals of public health about the need for periodic referral of diabetic patients to ophthalmologists.

    Objetivo: Identificar la prevalencia de la retinopatía diabética (RD en pacientes atendidos por la Estrategia de Salud Familiar del Ananindeua, Pará. Métodos: Este es un estudio de la sección con 40 pacientes con diabetes mellitus (DM inscritos en el programa HIPERDIA y acompañado por ESF del Ananindeua. Los seleccionados fueron

  13. Ophthalmic Diagnostic Tests and Ocular Findings in a Flock of Captive American Flamingos ( Phoenicopterus ruber ruber).

    Science.gov (United States)

    Meekins, Jessica M; Stuckey, Jane Ashley; Carpenter, James W; Armbrust, Laura; Higbie, Christine; Rankin, Amy J

    2015-06-01

    Seventeen adult captive American flamingos ( Phoenicopterus ruber ruber) (34 eyes) underwent a complete ocular examination, including assessment of menace response, pupillary light reflexes, dazzle reflex, palpebral and corneal reflexes, fluorescein staining, slit-lamp biomicroscopy, and direct ophthalmoscopy. Birds were randomly assigned to one of 2 groups for tear production and intraocular pressure measurements. Tear production was measured by modified Schirmer tear test I (n = 9 birds) or phenol red thread test (n = 8 birds), and intraocular pressure was measured indirectly by applanation (Tonopen-XL) (n = 9 birds) or rebound (TonoVet) (n = 8 birds) tonometry. Conjunctival swab samples were taken from one randomly selected eye of all 17 birds to identify surface ocular microbial flora via aerobic bacterial culture. Additionally, 3 of the 17 birds were anesthetized for bilateral B-mode ocular ultrasonography examination to obtain axial globe measurements. Results showed that the menace response and dazzle reflex were absent in all birds. Sixteen of the 17 birds were free of significant ocular disease; a small cataract and pigment on the anterior lens capsule were noted in one eye of one bird. Mean ± SD tear production was 12.3 ± 4.5 mm/min (range, 4-20 mm/min) for modified Schirmer tear test I and 24.2 ± 4.4 mm/15 s (range, 14-30 mm/15 s) for phenol red thread test. Modified Schirmer tear test I measurements were significantly lower than phenol red thread measurements (P < .001). Mean intraocular pressure was 16.1 ± 4.2 mm Hg (range, 7-22 mm Hg) for Tonopen and 9.5 ± 1.7 mm Hg (range, 7-13 mm Hg) for TonoVet. Tonopen measurements were significantly higher than TonoVet measurements (P < .001). An Enterococcus species (9/17 eyes; 53%) and a gram-positive coccus (7/17 eyes; 41%) were the bacteria most commonly isolated from conjunctival swab samples. Mean B-mode ultrasonographic globe measurements of 6 eyes (3 birds) were axial globe length, 13.8 ± 0.16 mm

  14. Características clínicas y evolución de la retinosis pigmentaria en adolescentes Clinical characteristics and evolution of retinitis pigmentosa in adolescents

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    Raisa Hernández Baguer

    2007-12-01

    biomicroscopy and ophthalmoscopy, perimetry and ERG at the beginning, annually and at the end were all examined. Four stagings were set up according to parameters such as visual acuity with correction and CV Results: Males and Caucasians predominated in the 42 studied teenagers. DVP was present in 12 eyes (14.2, crystalline opacities were found in 61 eyes (71.4% mainly in the group II. At the end of the study, according to the visual acuity and CV, 32 adolescents (76,2% did not have progressive evolution of the disease, 5 (11,9% had moderately progressive and 5 (11,9% showed very progressive evolution since there was marked worsening of the visual function. Conclusions: The identified characteristics of retinitis pigmentosa in adolescents were within the three first stagings. Evolution was not progressive for 5 years in most of adolescents from both groups, which led us to consider that the biological changes in this period of life seem to have no influence in the course of retinitis pigmentosa.

  15. Evolução da retinite por citomegalovirus após suspensão de terapia de manutenção em pacientes com recuperação imunológica após HAART Cytomegalovirus retinitis outcome following maintenance therapy discontinuation in patients with immune recovery due to HAART

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    André L. L. Curi

    1999-10-01

    Full Text Available Objetivo: Estabelecer critérios seguros para a suspensão da terapia de manutenção anti-CMV em pacientes que apresentaram recuperação imunológica após o uso da HAART ("Highly Active Antiretroviral therapy". Métodos: Vinte e quatro pacientes que apresentavam retinite por citomegalovirus inativa, carga viral indetectável e contagem de CD4+ > 200 céls./mm³ tiveram a medicação anti-CMV de manutenção suspensa. Os pacientes mantiveram acompanhamento quinzenal por meio de oftalmoscopia indireta a partir da suspensão da terapia até dezembro de 1998. Resultados: Dos 24 pacientes estudados nenhum apresentou reativação ou progressão da retinite. Todos os pacientes mantiveram a contagem de CD4+ > 200 céls/mm³. Apenas um apresentou carga viral de 4000 cópias, os demais mantiveram carga viral indetectável. O acompanhamento médio dos pacientes foi de 10,5 meses. Conclusão: Acreditamos que os parâmetros por nós estabelecidos sejam seguros para a suspensão da terapia de manutenção, porém novos estudos devam ser realizados a fim de estabelecer outros critérios. O exame oftalmológico, a contagem de CD4+ e a carga viral são fundamentais no acompanhamento dos pacientes após a suspensão da terapia específica de manutenção para a retinite por CMV.Purpose: To establish safety parameters for stopping anti-CMV maintenance therapy in patients who had immune recovery after highly active antiretroviral therapy. Methods: The anti-CMV maintenance therapy was stopped in 24 patients who presented with inactive CMV retinitis, CD4+ > 200 cells./mm³ and indetectlabe viral load. The pa-tients were examined every 15 days with indirect ophthal-moscopy after maintenance therapy discontinuation until december 1998. Results: None of the 24 patients presented retinitis reactvation or progression. All of them kept CD4+ counts above 200 cells/mm³. One patient presented a viral load of 4000, the others maintained indetectable viral load. The average

  16. Complicações oculares da terapêutica com a cloroquina e derivados Ocular complications of chloroquine and derivatives therapy

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    Augusto Cézar Lacava

    2010-08-01

    gastrointestinal, nervous and skeletal muscular systems and the skin. Ocular adverse reactions are: photophobia, cornea verticillata, poliosis, cataract, extraocular muscle palsy, anterior uveitis, toxic maculopathy and optical neuritis. PURPOSE: Bibliography review of complications due to the use of chloroquine and its derivatives. To analyze the current practice and propedeutics' evolution. To suggest practical managements for early toxicity signs. METHODS: Bibliographic review through research on MEDLINE, PUBMED, LILACS and SciELO database. DISCUSSION: All exams that can be used to screen ocular adverse reactions are described, such as: complete ophthalmologic exam, with emphasis on biomicroscopy and indirect binocular ophthalmoscopy, computerized visual field, Amsler grid testing and color vision testing, electrophysiological exams, polarimetry and optical coherence tomography. A description of maculopathy is presented, focusing on epidemiology, risk factors, histopathology and propedeutics. Chemical structure and the differences between 4-aminoquinolone derivatives are described. CONCLUSION: All patients using chloroquine and its derivatives must be followed-up and documented since the beginning of the therapy until they reach a cumulative dose above 100 grams. The higher the cumulative dose, the more we must be concerned with patient follow-up.

  17. The relationship of visual prognosis and G11778A point mutation in Leber hereditary optic neuropathy%Leber遗传性视神经病变患者G11778A位点突变与临床预后的关系

    Institute of Scientific and Technical Information of China (English)

    粟小丽; 金学民

    2013-01-01

    背景 Leber遗传性视神经病变是一种典型的母系遗传性疾病,已经发现线粒体的多个突变可以导致该病的发生. 目的 报道2个携带线粒体G11778A位点突变的Leber遗传性视神经病变(LHON)家系及其临床预后. 方法 对在郑州大学第一附属医院眼科收集到的2个LHON家系40人进行家系分析和基因检测.2个家系成员中包括母系成员28人,其中LHON病患者10例,作为研究组,母系男性成员的后代及配偶2例作为对照组.抽取受试者外周血2 ml,常规酚-氯仿-异戊醇法抽提外周血基因组DNA,应用逆转录聚合酶链反应(RT-PCR)扩增目的基因,对受试者基因进行测序,对3个常见突变位点G3460A、G11778A、T14484C进行检测和筛查. 结果 本研究中的2个家系所有母系成员(包括患者)均携带G11778A位点突变,家系内对照者未携带该突变位点.所有的家系成员未携带G3460A和T14484C位点的原发突变.这2个家系中的LHON患者视力均等于或低于0.1,未见有视力自行恢复者. 结论 本研究2个家系患者均携带G11778A点突变,视力预后较差.%Background Leber hereditary optic neuropathy (LHON) is a disease characterized by maternal inheritance.A number of mitochondrial DNA (mtDNA) mutation has been thought to be associated with this disease.Objective This study was to investigate the clinical and molecular genetic properties of LHON in two Chinese families.Methods Forty subjects from two Chinese families with LHON were enrolled in Affiliated First Hospital of Zhengzhou University,including 28 maternal members (10 of these members are LHON and 12 controls from two families.All the participants had a complete ophthalmic examination including visual acuity,direct ophthalmoscopy,color sensation and visual evoked potentials.MtDNA was extract from the whole blood sample of all participants.PCR-DNA sequencing was performed to detect the point mutation of the G11778A,T14484C,and G3462A for each

  18. Estudo experimental da inibição da proliferação vitreorretiniana pelo uso da hiperecina Experimental study of vitreoretinal proliferation inhibition by the use of hypericin

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    Roberto Augusto Fernandes Machado

    2009-10-01

    ophthalmoscopy and digital color retinography. The PVR degree was classified according to Hida (0 to 7. RESULTS: Membranes formation was present in 79% of the eyes; being 100% in the eyes of placebo group and 60% in the eyes of treatment group (hypericin. The comparison between PVR phases averages within the groups showed a statistically significant difference between the two groups, with a p value of 0.0321 for Wilcoxon test. CONCLUSIONS: The trauma model with dispase and retinal diathermy produces vitreoretinal membranes. Hypericin was considered effective in PVR emergence and progression decrease.

  19. PROGRESSION AND OUTCOMES OF UVEITIS IN PATIENTS WITH ANKYLOSING SPONDILITIS

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    A. A. Godzenko

    2014-01-01

    Full Text Available Uveitis is a common extraskeletal manifestation of ankylosing spondylitis (AS occurring in 20–40% of patients. Mostauthors underline a favorable prognosis for AS-associated uveitis.Objective: to study features of clinical picture and progression of AS-associated uveitis and to estimate the occurrence of its complications.Subjects and methods. Across-sectional study of 140 patients (98 males and 42 females with AS, who had at least one uveitis attack over the period of disease and was followed up at V.A. Nasonova Research Institute of Rheumatology during 2008–2012. In addition to standard rheumatologic examination all patients were examined by ophthalmologist. Biomicroscopy, ophthalmoscopy, tonometry, computer-assisted perimetry, ultrasonography (B-scanning of eyes and, if needed, fluorescein angiography and electrophysiological examination of retina were performed. Localization of uveitis, presence of complications affecting vision, total number of uveitis attacks by the moment of examination, mean number of uveitis attacks per year, correlation between the frequency of attacks and complications, presence of other extraskeletal manifestations and peripheral arthritis were assessed. The total number of uveitis attacks was defined from patients' interviews and respective medical documentation. Mean number of uveitis attacks was calculated as ratio of total number of uveitis attacks to the duration of disease for each patient. In the case of more than two attacks per year uveitis progression was consideredrefractory.Results.Mean duration of the disease was 17.7±11.03 years. In 19 patients (14% AS manifested before and in 121 (86% – after the age of 16 years. HLA-B27 was revealed in 135 (96% patients, peripheral arthritis – in 43 (30%, whereas other extraskeletal manifestations – in 46 (32%. Early onset of uveitis in first 10 years of the disease was recorded in 81 (58% patients, after10 years – in 21 (15%. Uveitis was the

  20. Subchronic (13-week) oral toxicity study, preceded by an in utero exposure phase, with arachidonate-enriched triglyceride oil (SUNTGA40S) in rats.

    Science.gov (United States)

    Lina, B A R; Wolterbeek, A P M; Suwa, Y; Fujikawa, S; Ishikura, Y; Tsuda, S; Dohnalek, M

    2006-03-01

    Polyunsaturated fatty acids (PUFAs), such as arachidonic acid (ARA) and docosahexaenoic acid (DHA) are natural constituents found in human milk, fish oil or egg yolk. Until recently, infant formulas, though providing the essential fatty acid precursors for these PUFAs, did not contain preformed ARA or DHA. In this study the safety of SUNTGA40S as source of ARA, not only for use in infant formulas but also for nutritional products or food supplements, was evaluated in a subchronic study in Wistar rats, preceded by a 4-week pretreatment period of parental (F(0)) rats and exposure of the F(0) dams throughout mating, gestation and lactation. SUNTGA40S was administered at dietary levels of 0.5%, 1.5% and 5% (wt/wt) adjusted with corn oil to 5.76% added fat. An additional group received 3.65% (wt/wt) SUNTGA40S in conjunction with 2.11% (wt/wt) high DHA Tuna oil, providing an ARA:DHA ratio of 2.7:1. High-fat and low-fat controls received basal diet with or without 5.76% corn-oil supplement. The content, stability and homogeneous distribution of the test substances in the diet were confirmed under study conditions. The administration of SUNTGA40S, with or without DHA oil, did not affect health, growth, fertility or reproductive performance of the parental rats, nor pup characteristics (condition, weight gain, viability, number per litter or sex ratio). In the subchronic study with the offspring (F(1)) rats, no significant differences were found in condition, neurobehavioural observations, ophthalmoscopy, growth, urinalysis or macroscopic and microscopic findings between the test groups and the low-fat or the high-fat controls. In males of the 5% SUNTGA40S and the SUNTGA40S/DHA group, red blood cell counts, haemoglobin concentration and packed cell volume were lower and reticulocytes were slightly higher than in the high-fat and low-fat control groups. Cholesterol, triglycerides and phospholipids in plasma were lower than in the high-fat controls in both sexes in the 5

  1. Estudo comparativo da flarefotometria em pacientes com melanoma maligno e nevo de coróide Comparative study of flare photometry in patients with choroidal malignant melanoma and choroidal nevus

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    Priscilla Luppi Ballalai

    2002-01-01

    Full Text Available Introdução: Os tumores malignos intra-oculares estão associados com um aumento do "flare" na câmara anterior, causado por uma quebra na barreira hemato-aquosa, que pode ocorrer por vários mecanismos. Estudos utilizando a flarefotometria confirmam o aumento do "flare" em olhos com tumores intra-oculares malignos e benignos. Objetivo: Avaliar a flarefotometria como auxiliar no diagnóstico diferencial de melanoma maligno e nevo de coróide, comparando-se com olhos contralaterais normais. Métodos: Foram avaliados olhos com melanoma maligno e olhos com nevo de coróide diagnosticados por meio de oftalmoscopia indireta e/ou ultra-sonografia. Os olhos normais contralaterais foram utilizados como controles. A flarefotometria foi realizada em todos os pacientes, sob midríase bilateral, utilizando equipamento Laser Flare Meter (FC 500, Kowa. Foram aplicados os testes de Wilcoxon, Mann-Whitney, e Spearman para análise estatística. Resultados: A média da flarefotometria nos olhos com melanoma maligno de coróide foi 17,1 ph/ms e nos olhos normais contralaterais foi 4,06 ph/ms. Nos olhos com nevo de coróide o valor da flarefotometria foi 6,12 ph/ms e nos olhos contralaterais normais foi 4,47 ph/ms. O valor da flarefotometria foi maior nos olhos com melanoma maligno e nevo quando comparado com os olhos contralaterais normais (pIntroduction: Malignant intraocular tumors are associated with an increase in the aqueous flare, caused by alterations of the blood-ocular barriers through various mechanisms. Several studies have demonstrated an ocular flare increase using flare photometry in eyes with benign and malignant tumors. Purpose: To evaluate flare photometry as an adjunct method in the differential diagnosis of choroidal malignant melanoma and choroidal nevus comparing to normal control eyes. Methods: Eyes with melanoma and nevus were diagnosed by indirect binocular ophthalmoscopy and/or ultrasound were evaluated. The fellow normal eyes were used

  2. PATHOGENESIS OF OPTIC DISC EDEMA IN RAISED INTRACRANIAL PRESSURE

    Science.gov (United States)

    Hayreh, Sohan Singh

    2015-01-01

    Optic disc edema in raised intracranial pressure was first described in 1853. Ever since, there has been a plethora of controversial hypotheses to explain its pathogenesis. I have explored the subject comprehensively by doing basic, experimental and clinical studies. My objective was to investigate the fundamentals of the subject, to test the validity of the previous theories, and finally, based on all these studies, to find a logical explanation for the pathogenesis. My studies included the following issues pertinent to the pathogenesis of optic disc edema in raised intracranial pressure: the anatomy and blood supply of the optic nerve, the roles of the sheath of the optic nerve, of the centripetal flow of fluids along the optic nerve, of compression of the central retinal vein, and of acute intracranial hypertension and its associated effects. I found that, contrary to some previous claims, an acute rise of intracranial pressure was not quickly followed by production of optic disc edema. Then, in rhesus monkeys, I produced experimentally chronic intracranial hypertension by slowly increasing in size space-occupying lesions, in different parts of the brain. Those produced raised cerebrospinal fluid pressure (CSFP) and optic disc edema, identical to those seen in patients with elevated CSFP. Having achieved that, I investigated various aspects of optic disc edema by ophthalmoscopy, stereoscopic color fundus photography and fluorescein fundus angiography, and light microscopic, electron microscopic, horseradish peroxidase and axoplasmic transport studies, and evaluated the effect of opening the sheath of the optic nerve on the optic disc edema. This latter study showed that opening the sheath resulted in resolution of optic disc edema on the side of the sheath fenestration, in spite of high intracranial CSFP, proving that a rise of CSFP in the sheath was the essential pre-requisite for the development of optic disc edema. I also investigated optic disc edema with

  3. 糖尿病性视网膜病的危险因素%The Risk Factors of Diabetic Retinopathy

    Institute of Scientific and Technical Information of China (English)

    王永武

    2013-01-01

    Objective To assess the risk factors for retinopathy in patients with type 2 diabetes .Methods 52 patients with type 2 diabetes were enrolled in this study .The diagnosis of diabetic retinopathy was diagnosed by ophthalmoscopy and fundus fluorescein angiography .We collected data on risk factors exposure from questionnaires ,clinical examinations and laboratory measurements ,then conducted a comparision between the diabetic patients with or without diabetic retinopathy .Results The prevalence rate of diabetic retinopathy was 26 .8% .Multivariate logistic regression analysis showed that longer diabetes duration (OR 1 .07 ,95% CI 1 .03 ~ 1 . 11) ,insulin treatment (OR 2 .14 ,95% CI 1 .19 ~ 3 .85) ,nonfasting glucose levels (OR 1 .07 ,95% CI 1 .00 ~ 1 .15) and microal-buminuria (OR 1 .89 ,95% CI 1 .28 ~ 2 .81) were the independent risk factors for the occurrence of diabetic retinopathy in patients with type 2 diabetes .Further analyses showed that even low levels of microalbuminuria were significantly independent related with the risk of diabetic retinopathy .Conclusions Diabetes duration ,insulin treatment ,increased blood glucose levels and presence of mi -croalbuminuria are proved to be associated with retinopathy in patients with type 2 diabetes ,and extremely low levels of microalbu-minuria may be a useful risk predictor for identifying patients with diabetes at high risk of retinopathy .%  目的评估2型糖尿病患者视网膜病的危险因素.方法纳入257例2型糖尿病患者,通过眼底检查以及眼底荧光素造影诊断视网膜病,通过问卷调查、临床检查和实验室化验确定各种危险因素暴露情况,对伴和不伴视网膜病的糖尿病患者进行比较.结果糖尿病性视网膜病的患病率为26.8%.多变量 logistic 回归分析显示,糖尿病病程更长(OR 1.07,95% CI 1.03~1.11)、接受胰岛素治疗(OR 2.14,95% CI 1.19~3.85)、非空腹血糖增高(OR 1.07,95% CI 1.00~1.15)和微量白蛋白尿(OR 1.89,95% CI

  4. Claves para el diagnóstico precoz del glaucoma (Keys to early diagnosis of glaucoma

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    Molleda-Carbonell José Mª

    2009-03-01

    vision from damage caused by glaucoma. Regular glaucoma check-ups include tonometry, gonioscopy and exam of retinal and optic head by ophthalmoscopy. In recent years scanning laser polarimetry (GDx and optical coherence tomography (OCT are unvaluable tools for glaucoma diagnosis and to detect loss of optic nerve fibers before the visual acuity could be altered.

  5. Natural latex graft in lamellar and penetrating sclerectomies in rabbits Enxerto de látex natural na cicatrização de esclerectomias lamelar e penetrante em coelhos

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    Ivia Carmem Talieri

    2009-09-01

    Full Text Available The objective of study was to investigate the effects of natural latex with 0.1% of polylysine on lamellar and penetrating scleroctomies in rabbits. Two groups of twelve rabbits each (lamellar GI and penetrating GII were studied. Scleral square incisions near the limbus were performed on the left eye of each animal. The latex biomembrane was fixed to the recipient sclera and it covered with a conjunctival flap. The clinical evaluations were followed for 60 days. Aplannation tonometry, binocular indirect ophthalmoscopy and slit-lamp biomicroscopy were performed during evaluation. Bright field microscopy and polarization microscopy were employed. Blepharospasm, graft infection, mucoid ocular discharge and chemosis were not observed in either treatment group. The conjunctival hyperemia varied from moderate to hardly noticeable. The postoperative IOP was not statiscally significant, comparing to the preoperative IOP, for GI and GII. The histopathology by polarization microscopy showed that the neoformed tissue was primarily dependent on adjacent vascularized tissues and was constituted by collagen type III. Both groups presented optimum graft adhesion to the receiving sclera. The natural latex biomembrane with 0.1% polylysine constitutes a new alternative for scleral reconstruction. Furthermore, this is a durable material, easy to obtain and manipulate.Este trabalho teve como objetivo investigar os efeitos do látex natural com polilisina a 0,1% na cicatrização de esclerectomias lamelar e penetrante em coelhos. Foram estudados dois grupos de 12 coelhos (GI - lamelar e GII - penetrante. As esclerectomias foram realizadas no olho esquerdo de cada animal. A biomembrana de látex foi fixada à esclera receptora e foi recoberta com conjuntiva bulbar. As avaliações clínicas foram realizadas durante 60 dias. Para tal, empregaram-se a tonometria de aplanação, a oftalmoscopia indireta binocular e a biomicroscopia em lâmpada de fenda. Realizou-se an

  6. A and B mode ultrasonography in preoperative evaluation of lens and posterior segment of dogs eyes with cataract

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    Bianca C. Martins

    2010-02-01

    Full Text Available Ultrasonography of the lens and posterior segment is an indispensable step in the preoperative evaluation of dogs with cataracts, since ophthalmoscopy is not feasible when there is opacification of the lens. This study evaluated the echographic conditions of cataractous lens and fundus of the eye in dogs affected by cataracts. The study was conducted in 30 dogs (56 eyes, 10 males and 20 females, with different types of cataracts at different stages of development. Echography in A and B modes, simultaneously, was carried out for the examination of the lens and posterior segment. The examinations revealed anterior cortical, posterior cortical and nuclear cataract in 12 eyes (21.4%, anterior cortical, posterior cortical, nuclear and posterior capsular in 23 eyes (41%, anterior cortical, posterior cortical and posterior capsular cataract in one eye (1.7%, anterior cortical and nuclear cataract in one eye (1.7%, anterior cortical, nuclear and posterior capsular cataract in five eyes (8.9%, and anterior cortical cataract in seven eyes (12.5%. Abnormal ultrasonographic alterations were observed in the posterior segment in 26 eyes evaluated (46.4%. Vitreal degeneration was detected in 12 eyes (21.4%, images of vitreal exudate or hemorrhage in seven eyes (12.5%, persistence of hyaloid artery in four eyes (7.1% and lens subluxation in three eyes (5.3%. The results obtained reiterate the importance of ultrasonography in canine patients presented for cataract surgery given that alterations of the posterior segment are difficult to identify in a clinical examination when the lens is opacified.A ultrassonografia do segmento posterior do bulbo do olho é etapa indispensável na avaliação de cães com catarata que serão submetidos à facectomia, uma vez que a oftalmoscopia não é factível quando há opacificação da lente, notadamente nas cataratas maduras. Este estudo avaliou as condições ecográficas da lente cataratogênica e do fundo de olho de c

  7. Macular edema in multiple evanescent white dot syndrome Edema macular na síndrome dos múltiplos pontos brancos evanescentes

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    Raul N. G. Vianna

    2010-02-01

    Full Text Available Eletroretinographic findings show that the transient decreased vision seen in patients with the multiple evanescent white dot syndrome (MEWDS is related to metabolic disturbances at the level of the retinal pigment epithelium and photoreceptor complex. In this paper, we present a patient with a typical picture of MEWDS associated to macular edema, which could also be a factor to reduce vision in this disorder. Case report of a 53-year-old woman complaining about unilateral decreased vision of 7 days' duration was sent to our retina clinic. A complete ophthalmic examination was performed as well as fluorescein angiography, indocyanine green angiography, Goldmann visual fields and optical coherence tomography (OCT. Best-corrected visual acuity was 20/40 and 20/20, in the right and left eye respectively. Ophthalmoscopy of the affected eye revealed multiple focal outer retinal gray lesions in the perimacular and peripapillary region. There were several orange puntate lesions in the foveolar region. Fluorescein angiography disclosed faint multiple foci of staining in the perimacular and peripapillary area, and some staining of the optic disc. A discrete hyperfluorescence was also observed in the foveal region. OCT disclosed an increase in foveal thickness (231 µm, approximately 25% thicker than the opposite normal eye (186 µm. Within 3 months her visual acuity had returned to 20/20 and the foveal thickness returned to a normal value (189 ìm. Although the mechanism of transitory blurred vision is not completely elucidated in cases of MEWDS, we suggest that macular edema may play a role.PRPÓSITO: Achados eletroretinográficos revelam que a baixa visual transitória observada em pacientes com a síndrome dos múltiplos e evanescentes pontos brancos na retina (MEWDS está relacionada a distúrbios metabólicos ao nível do epitélio pigmentado da retina e dos fotorreceptores. No presente artigo, nós apresentamos um paciente com um quadro típico de

  8. Frecuencia de maculopatía en pacientes con diabetes mellitus tipo 2: Reporte preliminar Frequency of maculopathy in patients with type 2 diabetes mellitus: A preliminary report

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    Harberth Fernández Leyva

    2002-08-01

    Full Text Available Se realizó un estudio transversal de 542 pacientes con diabetes mellitus tipo 2 (DM2 ICA- reclutados consecutivamente en el Centro de Atención al Diabético. Se les hizo historia clínica completa y examen oftalmológico: biomicroscopia y oftalmoscopia (directa e indirecta y examen con lente de 90 Dp. Se determinó glucemia en ayunas, 2 h después del desayuno y del almuerzo, hemoglobina glucosilada (HbA1 y excreción urinaria de albúmina (EUA. La maculopatía se clasificó en exudativa, edematosa e isquémica, y se relacionó con el sexo, hábito de fumar, tratamientos de la DM, edad actual, edad al comienzo de la enfermedad, presión arterial y las variables bioquímicas: glucemia en ayunas, posprandiales, HbA1 y EUA. Se excluyó la nefropatía clínica (EUA ³ 300 mg/L. Se consideró DM2 de reciente presentación cuando el diagnóstico clínico era menor de 6 meses. Padecían algún tipo de maculopatía 95 (17,5 % pacientes: 49 (9,0 %, formas exudativas; 29 (5,3 %, edematosas y 17 (3,2 %, isquémicas. No se hallaron diferencias significativas con el sexo, hábito de fumar o tratamientos utilizados, al dividirlos según la presencia o no de maculopatía. La duración de la DM fue de 12,4 ± 9,45 años para los pacientes con maculopatía, con diferencia estadísticamente significativa (p A cross-sectional study was conducted among 542 patients with ICA-type 2 diabetes mellitus consecutively recruited at the Diabetic Care Center. A complete medical history and an ophthalmological examination: biomicroscopy and ophthalmoscopy (direct and indirect and examination with lens of 90Dp were made. Fasting glycaemia, 2 hours after breakfast and lunch, glycosilated haemoglobin (HbA1 and urinary albumin excretion (UAE were determined. Maculopathy was classified as exudative, edematous and ischaemic and it was related to sex, smoking habit, treatments of DM, present age, age at the onset of the disease, arterial pressure and biochemical variables, such

  9. A proteinúria como fator de risco para retinopatia diabética Proteinuria as a risk factor for diabetic retinopathy

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    André Moraes Freitas

    2002-01-01

    Full Text Available Introdução: A diabete mélito é doença metabólica complexa que envolve hiperglicemia, doença microvascular (retina e rim e neuropatia. A retinopatia e a nefropatia são importantes causas de cegueira e falência renal respectivamente, e complicações relacionadas à diabete mélito. Objetivo: Determinar a relação entre a presença de proteinúria e nefropatia com a gravidade da retinopatia diabética num estudo transversal de pacientes diabéticos. Métodos: Estudo transversal de pacientes diabéticos, sem tratamento oftalmológico prévio, atendidos em serviço de oftalmologia terciário. Estes pacientes foram submetidos a exame fundoscópico, exames laboratoriais e interrogados quanto ao tempo de duração e o tipo de diabete. Comparados os fatores de risco abordados com os achados fundoscópicos. Na análise dos dados quantitativos foi usado o teste t de Student. Resultados: Estudados 81 pacientes, 28 do sexo masculino, 53 do sexo feminino, 28 com diabete insulino-dependente 53 com diabete não-insulino-dependente. Fatores correlacionados estatisticamente com o grupo com retinopatia diabética mais grave incluem: diabete mélito insulino dependente (alfaIntroduction: Diabetes mellitus is a complex metabolic disease characterized by abnormal insulin secretion, elevated fasting plasma glucose, and a variety of complications in terminal organs. Retinopathy and nephropathy are important causes of blindness and renal failure respectively, and complications related to diabetes mellitus. Purpose: To determine the relationship between the presence of proteinuria and nephropathy and the severity of diabetic retinopathy. Methods: Transversal study of diabetic patients without previous ophthalmologic treatment, seeing at a reference eye clinic. These patients underwent indirect ophthalmoscopy and blood work- up, and were questioned about duration and type of diabetes mellitus. The presence of risk factors were correlated with the fundus

  10. Training time and quality of smartphone-based anterior segment screening in rural India

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    Ludwig CA

    2017-07-01

    Full Text Available Cassie A Ludwig,1 Megan Newsom,1 Alexandre Jais,1 David J Myung,1,2 Somasheila I Murthy,3 Robert T Chang1 1Department of Ophthalmology, The Byers Eye Institute, Stanford University School of Medicine, 2Department of Ophthalmology, VA Palo Alto Health Care System, Palo Alto, CA, USA; 3Cornea and Anterior Segment Service, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, India Objective: We aimed at evaluating the ability of individuals without ophthalmologic training to quickly capture high-quality images of the cornea by using a smartphone and low-cost anterior segment imaging adapter (the “EyeGo” prototype. Methods: Seven volunteers photographed 1,502 anterior segments from 751 high school students in Varni, India, by using an iPhone 5S with an attached EyeGo adapter. Primary outcome measures were median photograph quality of the cornea and anterior segment of the eye (validated Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department [FOTO-ED] study; 1–5 scale; 5, best and the time required to take each photograph. Volunteers were surveyed on their familiarity with using a smartphone (1–5 scale; 5, very comfortable and comfort in assessing problems with the eye (1–5 scale; 5, very comfortable. Binomial logistic regression was performed using image quality (low quality: <4; high quality: ≥4 as the dependent variable and age, comfort using a smartphone, and comfort in assessing problems with the eye as independent variables. Results: Six of the seven volunteers captured high-quality (median ≥4/5 images with a median time of ≤25 seconds per eye for all the eyes screened. Four of the seven volunteers demonstrated significant reductions in time to acquire photographs (P1=0.01, P5=0.01, P6=0.01, and P7=0.01, and three of the seven volunteers demonstrated significant improvements in the quality of photographs between the first 100 and last 100 eyes screened (P1<0.001, P2<0.001, and P6<0.01. Self

  11. CHARACTERISTICS OF LIPID METABOLISM IN PATIENTS WITH TYPE 1 DIABETES, DEPENDING ON THE AVAILABILITY OF DIABETIC MICROANGIOPATHY AND DIET

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    Yu. G. Samoilova

    2014-01-01

    Full Text Available Was investigated 67 children (36 boys and 31 girls in age from 6 to 18 years old, with type 1 diabetes patients who were treated at the Children's Hospital Endocrinology number 1 inTomsk, average age of the boys at the time of the survey amounted to (13.0 ± 0.4 years, girls – (13.5 ± 0.4 years. All children diagnosed with type 1 diabetes were under subcompensation. Clinical evaluation of patients included a medical history, physical examination, evaluation of physical development. A study of lipid profile (high-density lipoprotein (HDL cholesterol, low-density lipoprotein (LDL, cholesterol (TC, triglycerides (TG, atherogenic index. Screening for diabetic retinopathy was performed by examining the fundus by direct ophthalmoscopy after pupil dilation. Diagnosis of diabetic nephropathy, retinopathy performed according to the classification. Patients were divided into groups depending on the presence of complications, and the level of compensation lipid metabolism (children with satisfactory compensation of lipid metabolism (total cholesterol level less than 5.2 mmol / l, children with poor compensation lipid metabolism (total cholesterol above 5.2 mmol / l. Nature of the subjects studied nutrition using  a questionnaire drawn up on the basis of the standard dietary questionnaire program CINDI, allowing to evaluate the eating habits by examining the frequency of intake of various foods, food preferences and priorities. Products, according to the lipid-lowering diet on the recommendations of the European Society for atherosclerosis were combined and divided into groups according to frequency of use: commonly used products, and rarely use the products. Mathematical treatment of the results was performed using the software package Statistica 5.5 for Windows. In the first phase expected to total group performance statistics – the arithmetic mean value M and the error of the mean m, as well as visualization of the distribution of values

  12. 傅里叶域相干光断层扫描在黄斑区视网膜感光细胞层断裂诊断中的应用%Application of FD-OCT for macular retinal photoreceptor cell layer fracture diagnosis

    Institute of Scientific and Technical Information of China (English)

    许雪妹; 乔莉; 乔志燕; 董志军; 孙立男; 郝佳颖

    2014-01-01

    目的:应用傅里叶域相干光断层扫描( Fourier-domain optical coherence tomography ,FD-OCT)对眼底血管造影正常的患者眼底黄斑区进行观察,寻找患者自述视物遮挡的原因。方法:对符合病情的患者询问病史,进行视力检查,裂隙灯眼前节检查,直接(间接)检眼镜检查眼底,眼底照相,眼底血管荧光造影,视野, OCT等检查。结果:7例患者(共9只眼),其中1例机械性外伤,1例日光性损伤,2例激光笔照射,3例电弧光损伤。矫正视力:0.3~1.0之间。5例患者进行FFA,结果正常(其余2例拒绝进行FFA检查),7例患者均进行视野检查,无异常。眼底检查6眼黄斑区有黄色圆形病灶。 FD~OCT检查发现7例患者(9眼)均存在黄斑区IS/OS层及椎体外节与RPE绒毛结合部断裂,形成细小囊腔。结论:FD~OCT能够准确观察到黄斑区微小结构变化,为临床诊断疾病提供重要的诊断依据。%Objective:Using FD-OCT to observe macular area in patients with normal FFA , finding the causes of vision shade Meth-ods:Patients who conformed diagnostic criteria were analyzed .Each subject underwent medical history and visual inspection ,Direct ( indi-rect) ophthalmoscopy slit -lamp examination ,fundus photography,FFA, visual field test ,OCT and so on .Results:7 patients (a total of 9 eyes), 1 case was mechanical trauma , 1 case was actinic damage ,2 cases were laser irradiation , three cases were the arc light injury . Corrected visual acuity:between 0.3 -1.0.5 cases of patients with FFA, were normal (the remaining two cases refused to do FFA checking ) ,the perimetries of all the 7 patients were normal .Fundus examination showed that 6 eyes had yellow circular lesions in macular area .FD-OCT revealed that 7 patients (9 eyes) had macular IS /OS layer and the outer segment of vertebral body seperated from RPE villus junction, and then formed small cysts

  13. Epidemiological investigation of senile high myopia in Shanghai Beixinjing community%上海市北新泾街道老年人高度近视眼的流行病学调查

    Institute of Scientific and Technical Information of China (English)

    谢田华; 樊莹; 邹海东; 黄晓波; 王宁; 张皙; 傅炯; 沈彬杰

    2009-01-01

    Objective To investigate the prevalence of high myopia,the prevalence and risk factors of high myopia associated with chorioretinopathy in residents aged 60 years or over in Beixinjing community, Shanghai, China. Methods A cluster stratified random sampling method was used to screen 4153 people aged 60 and over in Beixinjing community. There were 3851participants in total with a 92.73% response rate. Participants were invited to complete a questionnaire and received a comprehensive eye examination including visual acuity, refraction, slit-lamp microscopic examination, direct ophthalmoscopy and fundus photography and so on. Spherical equivalent (SE) was used to determine the degree of refractive errors. The diagnosis of high myopic chorioretinopathy was made if SE>-6.00 D and myopic ehorioretinal atrophy lesions were presented such as posterior seleral staphyloma, lacquer cracks, Fuchs spot and myopic arc spots. The degree of visual acuity impairment was determined according to the World Health Organization (WHO) classification as low vision (the best corrected visual acuity≥0. 05, but 0.05). Logistic regression analysis showed that there were significant differences in the prevalence of high myopia between people with different age, educational levels and family history (X2= 19.21,32. 08,960. 68; P-6.00 D,眼底表现有后巩膜葡萄肿、漆纹样裂纹、Fuchs斑、近视弧形斑等近视性视网膜脉络膜萎缩病灶则诊断为高度近视眼视网膜脉络膜病变.小孔视力按照WHO视力损伤分级:最佳矫正视力≥0.05但0.05).Logistic回归分析显示,不同年龄、不同文化程度、有无高度近视眼家族史人群的患病率差异均有统计学意义(X2=19.21,32.08,960.68;P<0.01).受检者中,双眼盲29例,单眼盲96例,双眼低视力104例,单眼低视力562例.183例高度近视眼视网膜脉络膜病变患者中,111例存在明显的视力损伤,占60.65%,其中,双眼盲、单眼盲、双眼低视力、单眼

  14. 玻璃体切割联合后巩膜加固术治疗高度近视眼黄斑裂孔性视网膜脱离%Treatment of retinal detachment due to macular hole in high myopia by vitrectomy with posterior sclera reinforcement

    Institute of Scientific and Technical Information of China (English)

    林会儒; 肖静; 刘英杰

    2015-01-01

    • AlM: To evaluate the efficacy of the method of vitrectomy combined with posterior sclera reinforcement for retinal detachment due to macular hole in high myopia. •METHODS:From January 2012 to December 2013, in 45 eyes of 45 high myopic patients with retinal detachment due to macular hole, 28 eyes were in group A of vitrectomy with posterior sclera reinforcement and 17 eyes were in group B of vitrectomy. Preoperative examinations included visual acuity, intraocular pressure, indirect ophthalmoscopy and OCT were performed. ln follow - up 6 to 12mo, postoperative examinations of visual acuity, OCT were performed and effects of retinal reattachment and macular hole closure were compared between the two groups. •RESULTS: ( 1 ) Postoperative examinations: visual acuity was 1. 19±0. 39 in group A and 1. 51±0. 34 in group B. The differences were statistically significant(P0. 05). (3) The macular hole closure rate was 82% in group A and 53% in group B. The differences were statistically significant(P • CONCLUSlON: The treatment of vitrectomy with posterior sclera reinforcement is safe and feasible, which could improve visual acuity and increase the rate of macular hole closure in treating retinal detachment due to macular hole in high myopia.%目的:探讨玻璃体切割联合后巩膜加固治疗高度近视眼黄斑裂孔伴视网膜脱离的方法与疗效。  方法:于2012-01/2013-12间收集高度近视性黄斑裂孔伴视网膜脱离患者45例45眼,分为玻璃体切割内界膜撕除联合后巩膜加固组( A组)28眼和玻璃体切割内界膜撕除组( B组)17眼。术前分别行视力、眼压、间接检眼镜、OCT检查,术后随访6~12mo,行视力、OCT检查,分别对视力、视网膜复位情况、黄斑裂孔闭合情况进行统计比较。  结果:(1)视力检查:术后视力:A 组1.19±0.39, B 组1.51±0.34,二者比较有显著性差异(P  结论:玻璃体切割术联合后巩膜加固术治疗高度近视眼

  15. Ocular lesions in sickle cell disease patients from Bahia, Brazil Lesões oculares em pacientes com doença falciforme da Bahia, Brasil

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    Dayse Cury

    2010-08-01

    Full Text Available OBJECTIVE: The present study aims to describe ocular alterations in sickle cell disease patients in Bahia, a Northeast state, with the highest prevalence of the disease in Brazil. METHODS: We carried out a cross-sectional study in a group of 146 (292 eyes sickle cell disease patients (90 HBSS and 56 HBSC. Ophthalmologic examination including indirect binocular ophthalmoscopy was performed. Examination was completed by fluorescein angiography to detect retinal lesions. RESULTS: The most frequent ocular lesions identified were "vascular tortuosity" and "black sunburst". Proliferative retinopathy was found in 22 (12.2% eyes of HBSS patients and 25 (22.3% eyes of HBSC patients (OR=2.06; CI95%: 1.5-4.06, p=0.022; Its frequency was higher among HBSS patients aged 20-39 years, while in HBSC patients, it peaked after 40 years (35.7% and 42.8% and dropped sharply afterwards. CONCLUSION: Proliferative retinopathy was described as early as 10 years of age in both patients groups. Proliferative sickle retinopathy can result in blindness and the knowledge of the most prevalent ocular alterations and age risk will be important to establish a protocol of ophthalmologic follow-up, in order to prevent a severe visual loss and increase patient's life quality.OBJETIVO: O presente estudo teve como objetivo descrever as alterações oculares em pacientes portadores de doença falciforme, na Bahia, um estado do Nordeste, que tem a maior prevalência da doença no Brasil. MÉTODOS: Nós conduzimos um estudo de corte transversal em um grupo de 146 (292 olhos pacientes com Doença Falciforme (90 HBSS e 56 HBSC. Para exame oftalmológico foi realizada oftalmoscopia binocular indireta complementada pela retinografia fluorescente para detecção de lesões retinianas decorrentes da Doença Falciforme. RESULTADOS: As lesões mais frequentemente encontradas foram o aumento da tortuosidade vascular e "black sumburst" Retinopatia proliferativa foi encontrada em 22 (12,2% olhos

  16. Clinical and brain MRI appearances in neuromyelitis optica%视神经脊髓炎的临床及磁共振成像研究

    Institute of Scientific and Technical Information of China (English)

    张世娟; 王飞; 卢洁; 刘亚欧; 段云云

    2011-01-01

    Objective To explore clinical features, brain magnetic resonance imaging (MRI) findings in neuromyelitis optica (NMO).Methods Twenty patients with NMO proved by clinical history or laboratory examinations were reviewed.Results Thirteen cases initially presented with acute myelitis, 7 cases with optic neuritis.Among all patients, 18 cases had a relapsing form of the disease.The main clinical manifestations included acute vision loss, concentric narrowing visual field or double vision (7 cases), muscle weakness, reduced sensation below the level of lesions, or autonomic dysfunction (13 cases).Ophthalmoscopy showed acute optic neuritis, papilledema (3 cases), retrobulbar optic neuritis (5 cases), or optic atrophy (4 cases).Immunoglobulin IgG-24 synthetic rate rose in 8 patients (8/18), serum NMO-IgG was positive in 6 cases (6/12), and oligoclonal bands (OCB) presented positive in 5 patients (5/18).Seven cases with optic neuritis showed extended P100 latency and (or) poor waveforms differentiation.Brain MRI was positive in 8 patients, and lesions typically localized in hypothalamus, pons, midbrain or periventricle areas.Conclusion Laboratory tests may contribute to the diagnosis and differential diagnosis of NMO.Hypothalamus, brainstem, pons or periventricle lesions, corresponded to high sites of aquaporin 4 (AQP4) in the brain, are typical features of NMO.%目的 探讨视神经脊髓炎临床与MRI表现特点.方法 回顾分析20例经临床或实验室检查明确诊断的视神经脊髓炎患者临床资料,总结其发病特点.结果 视神经脊髓炎多以急性脊髓炎(13例)或视神经炎(7例)为首发症状,复发病程(18例)多见.临床主要表现为急性视力减退、视野呈向心性缩小或复视(7例),以及病灶平面以下运动、感觉和自主神经功能紊乱(13例).部分患者眼底呈急性视神经炎、视乳头水肿(3例),球后视神经炎(5例)或视神经萎缩(4例)变化;视觉诱发电位呈现潜伏期延长、波

  17. Clinical features, histopathological analysis and surgical treatment of a free floating vitreous cyst: a case report Achados clínicos, análise histopatológica e tratamento cirúrgico de cisto livre no vítreo posterior: relato de caso

    Directory of Open Access Journals (Sweden)

    Rodrigo Pessoa Cavalcanti Lira

    2006-10-01

    Full Text Available The authors present a report of a 44-year-old female patient, with complaints of visual disturbances in the left eye. The symptoms were present for at least 5 years and worsened in the last 2 years, impairing her activities. The patient reported perception of a floating circle, which blurred her vision. There was no previous history of trauma, infectious or inflammatory disease. Clinical evaluation included physical examination, laboratory testing, abdominal ultrasonography, thorax X-ray and head tomography. Ophthalmologic examination consisted of visual acuity, motility tests, biomicroscopy, tonometry and indirect ophthalmoscopy. Complementary investigation was done with a and b scan ocular ultrasonography. The chosen therapeutic approach to excise the cyst was pars plana vitrectomy, successfully performed. Anatomopathologic analysis revealed a pigmented vitreous cyst, of possible congenital origin, described as a cystic choristoma from the primitive hyaloid system. Benign evolution, clinical findings and histopathological analysis corroborated the diagnostic hypothesis of a cystic choristoma of the primitive hyaloid system. Surgery (pars plana vitrectomy was successful and the patient returned with visual acuity of 20/20 in both eyes, and with no further complaints.Os autores apresentam relato de um caso de paciente de 44 anos, com história de dificuldade visual no olho esquerdo há 5 anos. A paciente referia a sensação de um círculo flutuando em sua visão. Os sintomas pioraram nos últimos dois anos, prejudicando suas atividades. Não havia história pessoal prévia de trauma ou de doença ocular inflamatória ou infecciosa. A avaliação clínica incluiu o exame físico, exames de laboratório, ultra-sonografia abdominal, radiografia de tórax e tomografia de crânio e o exame oftalmológico consistiu em medida de acuidade visual, testes de mobilidade, biomicroscopia, tonometria e oftalmoscopia indireta. Investigação complementar foi

  18. Transpupillary thermotherapy for central serous chorioretinopathy at central macular region%TTT治疗中心性浆液性脉络膜视网膜病变

    Institute of Scientific and Technical Information of China (English)

    沈伟; 蔡琴华; 丁洁; 李龙标

    2008-01-01

    目的 观察经瞳孔温热疗法(traspupillary thermotherapy,TTT)治疗病变涉及黄斑中心区域的中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)疗效和预后.方法 对病变涉及黄斑中心区域的CSC患者18例18只眼进行TTT治疗,根据病灶大小选择光斑和能量.随访时复查视力、眼底,中心视野及FFA.结果 治疗后患者视力、视野均明显好转,治疗后2月94.44%患者视力提高,平均视力及平均光敏感度(MS)分别为1.07和27.38dB,较TTT前差异有显著性(t=8.43、10.01;P<0.01),FFA示所有病例渗漏均停止,但有2例复发.结论 TTT治疗CSC简单有效,尤其适合病变涉及黄斑中心区域的CSC,无明显并发症.%Objective To investigate the clinical results of transpupillary thermothcrapy for patients with central serous chorioretinopathy (CSC)at central macular region.Methods 18 cases (18 eyes)of CSC at central macular region diagnosed by FFA were treated with a diode laser at 810 nm.Laser parameters were as follow:the diameters of beam spot varied from 800μ m to 2000μ m,the power from 100mW to 260mW,the duration 600s, beam spots from 1 to 2.The visual acuity,ophthalmoscopy,central visual field and FFA were followed up.Results The visual acuity and central visual field were improved after laser treatment.2 months after treatment the visual acuity increased in 17 eyes (94.44%).The average visual acuity and mean sensitivity of 18 eyes were 1.07 and 27.38 dB respectively.The difference was significant (t=8.43,10.01;P<0.01)com-pared with the average visual acuity and mean sensitivity before the treatment.FFA showed that fluorescein leakage stopped in all eyes.But there were 2 recurrent cases during the follow-up time.Conclusions Transpupiilary thermotherapy is one of the effective and secure therapies for CSC especially when the RPE le-sion referred to the central macular region.

  19. Importância da avaliação oftalmológica em recém-natos Importance of the ophthalmological evaluation in newborns

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    Daniel Wasilewski

    2002-01-01

    deviation and direct ophthalmoscopy (red reflex in all patients. Results: Among all examined newborns, 3.75% showed some ocular disease. The most frequent problem was corneal opacity. The ocular diseases were not noticed by pediatricians, neonatologists and parents in fifty-six per cent of the cases presenting some problem. Conclusions: This study showed that many ocular disorders presented at birth are not noticed by pediatricians (56%, which highlights the importance of ophthalmological evaluation in all newborns as a routine examination in the first 48 hours of life.

  20. Injection of human umbilical cord derived mesenchymal stem ceils into the vitreous of rabbits%人脐带间充质干细胞兔眼玻璃体腔注射的安全性研究

    Institute of Scientific and Technical Information of China (English)

    孙国玲; 汪建涛; 孟恒星; 吴建国; 李筱荣

    2009-01-01

    目的 观察人脐带间充质干细胞(hUC-MSCs)兔眼玻璃体腔注射后的生存情况及安全性.方法 27只青紫蓝兔随机分为玻璃体腔注射1、2、4周组,每组9只兔.右眼为hUC-MSCs玻璃体腔注射组(实验组),左眼为培养液玻璃体腔注射组(对照组).注射前后分别采用裂隙灯显微镜进行眼前节检查,间接检眼镜、眼底照相、荧光素眼底血管造影(FFA)进行眼底检查,Tono-pen眼压计测量眼压.体外碳花氰荧光染料CM-Dil荧光标记hUC-MSCs.兔眼玻璃体腔hUC-MSCs注射后4周,共聚焦荧光显微镜下观察hUC-MSCs在体内的存活情况,然后摘除眼球行光学显微镜和透射电子显微镜检查.结果 hUc-MSCs玻璃体腔注射后4周.大量hUC-MSCs仍旧存活于玻璃体腔,结构完整.兔全身情况良好;裂隙灯显微镜检查显示眼前节无明显改变;间接检眼镜和眼底照相检查显示实验眼和对照眼视网膜无明显改变;FFA检查显示注射后1、2、4周视网膜血管无异常荧光和荧光渗漏;注射前后各时间点眼压差异无统计学意义(t=0.125,P>0.05);光学显微镜和透射电子显微镜检查显示兔眼角膜、房角、晶状体、视网膜结构无明显变化.结论 hUC-MSCs在玻璃体腔注射后4周仍存活于体内;hUC-MSCs玻璃体腔注射安全可行.%Objective To observe the survival of human umbilical cord derived mesenchymal stem cells (hUC-MSCs) after injection into the vitreous of rabbits,and the animal safety under those procedures.Methods Twenty-seven pigmented rabbits were randomly divided into 3 groups (intravitreal injection 1 week group,2 weeks group and 4 weeks group),each with 9 rabbits.For each animal the right eye was the experimental eye receiving hUC-MSCs injection,while the left eye was the control eye receiving cuhure medium.The rabbit eyes were examined by slit-lamp microscope,indirect ophthalmoscopy,fundus photography,fundus fluorescence angiography(FFA)and Tono-pen tonometer before and

  1. Clinical features of 32 cases of syphilitic uveitis%梅毒性葡萄膜炎32例临床分析

    Institute of Scientific and Technical Information of China (English)

    朱丽; 宋艳萍; 陈晓; 丁琴; 冯越越; 洪玲; 周和政

    2013-01-01

    Objectives To investigate the clinical characteristics and prognosis of syphilitic uveitis.Methods Clinical charts of 32 syphilitic uveitis patients were retrospectively analyzed.The diagnosis was confirmed by clinical and laboratory tests.There were 32 patients (50 eyes),18 males and 14 females; the ages were from 21 to 62 years ole,with a mean age of 42 years old.Eighteen patients were bilateral.All patients had complete ocular examinations including visual acuity,intraocular pressure,slit lamp biomicroscopy,ophthalmoscopy,fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA).Results Inflammatory cells in the anterior chamber and corneal endothelium were present in 42eyes.Thirty eyes showed congestion and swelling of optic discs.Yellow-white lesions in the posterior pole were present in 18 eyes.No change in 6 eyes.FFA showed staining or hyperfluorescence of optic disc in 32eyes,venous leakage in 34 eyes,and cystoid macular edema in 15 eyes.ICGA showed squamous or disseminative hypofluorescence damages in 26 eyes.All patients were treated with penicillin and glucocorticoids,36 eyes had improved vision and fundus damage had abated.Conclusions Most syphilitic uveitis was panuveitis with retinal vasculitis.The prognosis is good with early diagnosis and timely treatment of this disease.%目的 观察梅毒性葡萄膜炎患者的临床特征及治疗预后.方法 回顾性分析临床及血清学检查确诊的梅毒性葡萄膜炎患者32例50只眼的临床资料.其中,男性18例,女性14例;年龄21~62岁,平均年龄(42.0±10.4)岁;双眼18例;单眼14例.所有患眼行矫正视力、眼压、裂隙灯显微镜检查;行间接检眼镜、眼底彩色照相、荧光素眼底血管造影(FFA)检查47只眼,吲哚青绿血管造影(ICGA)检查44只眼.驱梅治疗后随访3~36个月,中位数14个月.结果 50只眼中,前葡萄膜炎4只眼、全葡萄膜炎38只眼、后葡萄膜炎8只眼,分别占患眼8.0%、76.0%、16.0%.

  2. Clinical characteristics of ocular albinism type 1 in China%中国人眼白化病1型的临床特点观察

    Institute of Scientific and Technical Information of China (English)

    房绍华; 贾小云; 黎仕强; 郭向明

    2012-01-01

    [Objective] To observe the clinical characteristics of ocular albinism type 1 (OA1) in China.[Methods] Sixteen patients with OA1 and eight female carriers (eight OA1 patients and four carriers were from the same family) were enrolled in this study.All subjects were examined for corrected visual acuity,slit-lamp microscopy and GPR143 gene mutation detection.Some subjects also received indirect ophthalmoscopy,photography of anterior segment and ocular fundus,retinoscopy and optical coherence tomography (OCT).Iris pigmentation was divided into type A,B and C according to the above findings.Type A:slight pigmentation; type B:uneven pigmentation; type C:large patch of hypo-pigmentation with hippus.Result The corrected visual acuity of 16 OA1 patients was from 0.1 to 0.3.All the OAI patients have bilateral horizontal nystagmus without strabismus.All eight subjects received retinoscopy have medium to low hypermetropia and astigmatism.Type A,B and C iris pigmentation were found in eight (50.0%),seven (43.7%) and one (6.3%) patients,respectively.Two (25.0%) carriers have Type A iris pigmentation,and other six carriers (75.0%) were normal.There is no typical albinism retinopathy,however macular foveal structures were never found in these patients.Four carriers have fundus striate or uneven hypo-pigmentation.The macular foveal structure of all the carriers was normal.The macular foveal structure was not found in three subjects who underwent examination of OCT.GPR143 gene mutation was found in all the OA1 patients (100.0%) and all the carriers.[Conclusion]s The major clinical characteristics of Chinese OA1 patients are foveal hypoplasia and GPR143 gene mutation.%[目的]观察中国人眼白化病1型(OAI)的临床表现特点.[方法]临床和基因检查确诊的16例OA1患者及8例女性携带者纳入研究.其中8例患者和4例携带者来自同一个家系.所有患者和携带者均进行了矫正视力、详细的裂隙灯显微镜眼前节检查.16例

  3. Surgical outcomes of retinal detachment after phacoemulsification cataract extraction and intraocular lens implantation%超声乳化白内障吸除联合人工晶状体植入手术后视网膜脱离的手术效果

    Institute of Scientific and Technical Information of China (English)

    苗培建; 郑钦象; 吴荣瀚; 郑景伟; 徐明; 李文生

    2012-01-01

    目的 观察超声乳化白内障吸除联合人工晶状体(IOL)植入手术后视网膜脱离(RD)的手术效果.方法 回顾分析超声乳化白内障吸除联合IOL植入手术后发生RD并接受手术治疗的38例患者的临床资料.所有患者手术前常规行视力、裂隙灯显微镜、直接或间接检眼镜、A或B型超声、光相干断层扫描检查确诊.男性21例21只眼,女性17例18只眼.年龄42~83岁,平均年龄(57.4±11.2)岁.9例10只眼合并单纯黄斑裂孔性RD(MHRD).根据RD范围、裂孔位置及大小、增生性玻璃体视网膜病变分级等采取玻璃体切割手术或巩膜环扎手术或玻璃体切割联合巩膜环扎手术;MHRD患眼采用后巩膜加固手术.手术后随访3~26个月,平均随访时间(11.9±6.8)个月.结果 36只眼1次手术后视网膜复位成功,成功率为92.3%.2只眼手术后RD复发并放弃手术;1只眼经3次手术后成功复位.超声乳化白内障吸除联合IOL植入手术后视力和RD手术后末次随访视力对比,视力下降36只眼,占92.3%;不变1只眼,占2.6%;提高2只眼,占5.1%00.结论 超声乳化白内障吸除联合IOL植入手术后RD一次手术复位率高,但视力预后不佳.%Objective To observe surgical outcomes and influencing factors of retinal detachment (RD) after phacoemulsification cataract extraction and intraocular lens (IOL) implantation.Methods The clinical data of 38 patients who underwent retinal detachment after phacoemulsification cataract extraction and intraocular lens implantation were retrospectively analyzed.All patients diagnosed via visual acuity,slitlamp microscopy,direct or indirect ophthalmoscopy,A or B-scan ultrasonography and optical coherence tomography (OCT).There were 21 males (21 eyes) and 17 female (18 eyes).The age was from 42 to 83 years,with the mean of (57.4±11.2) years.There were nine patients (10 eyes) with simple macular hole RD (MHRD).Vitrectomy or scleral buckling or combined vitreetomy

  4. 1型糖尿病患儿全视野闪光视网膜电图反应特征%Features of full field electroretinogram responses in children with early type 1 diabetes

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    白雪晴; 余继锋; 施维; 崔燕辉; 刘雯; 田利荣; 李莉

    2016-01-01

    目的 观察1型糖尿病(T1D)患儿全视野闪光视网膜电图(FF-ERG)反应特征.方法 回顾性临床病例研究.T1D患儿41例(T1D组)及轻度屈光不正儿童25名(对照组)纳入研究.所有T1D患儿视力、屈光度、眼压、裂隙灯显微镜、眼底彩色照相、间接检眼镜及光相干断层扫描检查排除糖尿病视网膜病变.所有受检儿均由同一位有经验的技师进行FF-ERG检查.包括暗适应视杆细胞反应0.01(r-b 0.01)、暗适应最大混合反应3.0(mix-a 3.0、mix-b 3.0)、暗适应最大混合反应10.0 (mix-a 10.0、mix-b 10.0)、暗适应3.0振荡电位2(OP2)、明适应视锥细胞反应3.0(c-a 3.0、c-b 3.0)及30 Hz闪烁光反应(30 HzFP)的振幅、潜伏期.对比分析两组受检儿FF-ERG各反应振幅及潜伏期差异.结果 与对照组比较,T1D组患儿各反应振幅降低,潜伏期延长.两组受检儿各反应振幅比较,除r-b 0.01振幅(t=-0.228,P>0.05)之外,其余各反应振幅之间的差异均有统计学意义(t=-1.664、-3.645、-4.324、-6.123、-5.846、-12.900、-14.400、-5.230,P<0.05).两组受检儿各反应潜伏期比较,mix-b 3.0、mix-b 10.0、c-b 3.0及OP2潜伏期之间的差异有统计学意义(t=5.242、2.879、5.378、3.506,P<0.05);r-b 0.01、mix-a 3.0、mix-a 10.0、c-a 3.0、30 Hz FP潜伏期之间的差异无统计学意义(t=2.331、1.677、0.557、0.840、0.064,P>0.05).结论 TID组患儿较正常儿童FF-ERG反应振幅降低,潜伏期延长.%Objective To observe the features of the full field electroretinogram (FF-ERG) in type 1 diabetes (T1D) children without diabetic retinopathy (DR).Methods Retrospective case study.Forty-one T1D children and 25 age-matched normal controls underwent a complete ophthalmic examination,including best-corrected visual acuity,refraction,intraocular pressure,slit lamp,fundus photography,indirect ophthalmoscopy,and spectral domain optical coherence tomography to exclude DR.All FF-ERG tests were performed by an

  5. Achados oculares em pacientes com mais de 99 anos Ocular findings in patients older than 99 years

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    Marcela Colussi Cypel

    2006-10-01

    desenvolvimento de política específica de saúde ocular. Esse estudo demonstrou idosos com maioria do sexo feminino (83,3%, boa saúde geral (35%, hipertensos (40%, com dificuldade para leitura (55% e com baixa visual em decorrência de degeneração macular relacionada à idade.PURPOSE: To determine vision conditions and ocular findings in patients older than 99 years. METHODS: Patients were recruited by media advertisement and examined at the Vision Institute of UNIFESP. The following examinations were performed: visual acuity, ectoscopy, refraction, biomicroscopy, tear film break-up time, Schirmer basal test, tonometry, direct and indirect ophthalmoscopy. Complementary examinations such as optical coherence tomography were performed when indicated. RESULTS: Thirty patients older than 99 years were identified. Mean age of 101.5±1.8, 25 females and 5 males. Most common systemic disease, according to history, was arterial hypertension. In 11 patients (55%, the best corrected far visual acuity was 20/100 or better. The best corrected near visual acuity was J4 or better also in 55% (11 patients and 63.0% (7 patients of these were the ones that had not been submitted to cataract surgery. The most frequent visual complaint was low vision for reading (55% and other 8 patients (40% reported no disturbance (satisfied with their vision. Lens opacity was present in 9 patients (60% and 8 patients (40% had previous cataract surgery (5 aphakic eyes, 9 pseudophakic eyes. Cataract was identified as important for impairment of vision in 5 patients but only 2 of them wanted to be submitted to surgery. The main cause of visual impairment was age-related macular degeneration, present in all patients, 95% with no exudative form. Vision improved with new refractive prescription in 4 patients. CONCLUSION: Once we understand the needs we can plan specific diagnostic and treatment strategies. This sample showed that most were female (83.3%, with good general health (35%, most with systemic arterial

  6. Tratamento conservador em retinoblastoma intra-ocular Conservative treatment for intraocular retinoblastoma

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    Clélia Maria Erwenne

    2003-12-01

    bilaterais foram conservados 48,9% dos olhos tratados. Entre os unilaterais, para os mesmos estádios obteve-se: I 0/0; II 2/2 (100,0%; III 1/3 (33,3%; IV 1/3 (33,3%; V 0/7 (0%. Considerando-se o total de unilaterais foram conservados 26,6% dos olhos. Não se observou nefro ou ototoxicidade às drogas neste grupo.PURPOSE: To report the results of conservation of the ocular globe after treatment with carboplatin and laser; with or without the use of other forms of local treatment or radiotherapy, if necessary. METHODS: All eyes, initially untreated, were evaluated using indirect ophthalmology under inhalation anesthesia in an outpatient clinic treatment setting. They were categorized according to the Reese-Ellsworth system; thereafter, the patients were evaluated clinically by a pediatric oncologist. The patients received the first cycle of chemotherapy consisting of intravenous carboplatin 200 mg/m², vincristine 1.5 mg/m² and etoposide 150 mg/m², for three days. This was followed by other cycles with intervals of between 21 and 28 days. From 7 to 15 days after the end of the chemotherapy cycle, another indirect ophthalmoscopy under inhalation anesthesia was performed, with documentation of the findings and laser hyperthermia application, using a Diode laser, 810 nm, continuous pulse with a large spot size. The procedure (chemotherapy and laser was repeated until complete cicatrization of all lesions was observed, or until the need for another treatment modality such as radiotherapy or enucleation became apparent. Follow-up examinations every two months during the first year and three months thereafter were done for review and for treatment of recurrent or new lesions. Pediatric oncology follow-up was also done throughout the entire initial assessment and follow-up period. RESULTS: We treated a total of 62 patients with retinoblastoma, of whom 32 were male and 30 female. Fifteen were unilateral and 47 were bilateral with a total of 107 eyes. The mean age was 16.9 months (2

  7. GLAUCOMA FOLLOWING BLUNT TRAUMA : AN EPIDEMIOLOGICAL AND CLINICAL STUDY

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    Purvi R

    2014-03-01

    Full Text Available AIMS: To study the demographic profile, clinical picture, treatment modalities and long term follow up of patients suffering from glaucoma developing after blunt trauma. MATERIALS AND METHODS: This was a prospective study over one year in which 75 eyes, newly diagnosed or referred with post traumatic glaucoma to M & J Institute of Ophthalmology were studied. All cases underwent thorough eye examination. Treatment was individualized and instituted. RESULTS: Patients ranged from 1 - 70 years with 32 patients (42.66% below 30 years of age. 61 patients (81.33% were males. 66.65% were students, laborers or housewives, with laborers topping the charts in vulnerability. In 46 cases (61.33%, left eye was affected, while in 29 pts. (38.66% right eye was affected. In 54.66% of cases, trauma was caused by stone, wooden stick or ball. Others included fist, firecracker, iron rod, handle, belt.16% patients presented with IOP in the normal range, 38 (50.66% patients had IOP in the range of 21-30 mm Hg, whereas 16 (21.33% patients had IOP more than 40 mm Hg. Within 1 week of instituting treatment, 41 (54.66% had IOP ≤ 20 mm Hg and only 3 patients had IOP more than 30 mm Hg. However, 70 (93.33% patients had IOP ≤ 20 mm Hg by the end of 6 months and all the patients were in this range after 6 months. On slit lamp examination, corneal edema, traumatic mydriasis and sphincter tears were seen in 32 patients each. 12 patients had hyphema and 19 patients had lens dislocated either into vitreous or into the anterior chamber. Iridodialysis was seen in 5 patients. Other findings included cataract, posterior synechiae, subluxation of lens and tobacco dusting. 57 (76% patients had vision less than 6/60, however after an interval of more than 6 months, 28 (37% patients had vision less than 3/60. The number of patients having vision ≥ 6/12 rose from 5 at initial presentation to 15 in follow-up more than 6 months. Disc changes could be assessed by ophthalmoscopy in 37

  8. The toxic effect observation of the retina after vitreous chamber injected with PDGFR-α ASODN%PDGFR-αASODN玻璃体内注射对视网膜的毒性作用

    Institute of Scientific and Technical Information of China (English)

    彭燕一; 李光辉; 秦程; 蒋姣姣

    2015-01-01

    目的:探讨PDGFR-αASODN对视网膜的毒性作用.方法:选择健康成年有色家兔24只,随机分为4组,每组6只;4组兔子3组右眼玻璃体分别注射0.1 mL不同浓度的PDGFR-αASODN/lipofectamineTM 2000溶液,另外1组注射0.1 mL平衡盐溶液作为对照组;4组兔子的左眼不注药. 于注药后第1、7、14及28天,对4组兔子的右眼行裂隙灯、间接检眼镜、视网膜电图(ERG)检查;第28天,取4组兔子的眼球,对视网膜组织进行光镜HE、免疫组化及透射电镜的观察. 结果:裂隙灯、间接检眼镜检查,各组在各个检查时间点均未发现异常.ERG b波振幅,实验组与对照组比较差异无显著性.注药后第28天,光镜下HE和免疫组化检查,各组视网膜组织均未发现任何病理变化.注药后第28天电镜检查,D组视网膜感光细胞:部分膜盘间隙扩张,部分膜盘融合,少数细胞核周围间隙略增大,其细胞核形态略不规则. 结论:玻璃体内注射0.1 mL PDGFR-αASODN/lip2000时,PDGFR-αASODN的浓度≤1.5 μmol/L是较为安全的.%Objective To explore the toxic effect of platelet-derived growth factor receptor (PDGFR)-αantisense oligonucleotide (αASODN) on the retina. Methods Twenty-four healthy adult colored rabbits were selected and randomly divided into four groups in six for each group. Intravitreous injections of 0.1ml different density diluents containing PDGFR-αASODN and liposome were performed in the right eyes in 3 groups. The other group was injected with 0.1 mL balanced salt solution (BSS) as the control group. The left eyes of all animals were not rejected. Slit lamp examination, indirect ophthalmoscopy and electroretinogram (ERG) examination were performed at 1, 7, 14 and 28 days after the injection. On the day 28, the right eyes were harvested, and HE、immunohistochemistry and transmission electron microscopy of retinal tissue were performed . Results The slit lamp, indirect ophthalmoscope examination of all groups were normal

  9. Study on the safety of eye anterior tissues during plasmin and hyaluronidase inducing posterior vitreous detachment in pigs%纤溶酶和透明质酸酶在诱导猪玻璃体后脱离中对眼前部组织的安全性研究

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    刘雪霞; 吴海洋; 陶海

    2007-01-01

    目的:研究纤溶酶和透明质酸酶玻璃体内注射诱导猪玻璃体后脱离对眼前部组织的影响,探讨其眼前部组织的安全性.方法:15只健康无眼疾贵州小型香猪,分为A,B,C组,每组5只,每只1眼为实验眼,另1眼为对照眼,实验组与对照组各15眼.实验眼玻璃体内注射酶,A组50U(0.1mL)透明质酸酶,B组0.5U(0.1mL)纤溶酶,C组0.5U(0.05mL)纤溶酶+50U(0.05mL)透明质酸酶,对照眼注射等量BSS液.注射前后分别行裂隙灯显微镜、间接眼底镜、Sch(o)tz眼压计临床检查.7d后摘除眼球,行组织学检查.眼前部组织角膜、虹膜做光镜观察,睫状体、晶状体上皮做透射电镜超微结构的研究.结果:7d后A,B,C组实验眼及各组对照眼无明显眼内炎症反应,术前术后眼压变化差异无统计学意义.实验眼光镜观察角膜、虹膜组织结构无明显异常,电镜观察晶状体、睫状体上皮,细胞形态规则,结构清晰,胞膜完整,周界清楚,连接紧密,对照眼光镜及电镜观察组织结构与实验眼无差异.结论:0.5U纤溶酶和50U透明质酸酶猪玻璃体内注射诱导玻璃体后脱离中安全,无眼前部组织的毒性病理变化.%· AIM: To evaluate the safety of eye anterior tissue when plasmin (Pm) and hyaluronidase (HS) are injected into pigs'vitreouses to induce posterior vitreous detachment(PVD).· METHODS: 15 pigs without ocular diseases were randomly assigned to groups A,B,C (5 in each group). For each pig, one eye was experimental, the other eye was control. The experimental eye received intravitreal injection with enzyme:group A: 50U(0.1mL) HS; group B: 0.5U(0.1mL) Pm; group C: 0.5U(0.05mL) Pm combined with 50U(0.05mL) HS; while the control eye received intravitreal injection with equivalent dose of balanced salt solution (BSS). Postoperative reactions in the eyes were carefully observed by clinical examinations such as slit-lamp microscopy and direct and indirect ophthalmoscopy and measurement of

  10. Analysis on relative factors of the incidence and development diabetic retinopathy%糖尿病视网膜病变发生发展的相关因素分析

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    张建文; 马丽; 马凤仙

    2013-01-01

    可作为DR发生发展的预示指标。%AIM:To investigate the relative factors of the incidence and development of diabetic retinopathy ( DR) . METHODS: The retinopathy of the 631 patients with type 2 diabetes mellitus ( T2DM ) was examined by ophthalmoscopy and fundus fluorescein angiography ( FFA) , and the relative factors which possibly associate with the incidence and development of DR were collected. RESULTS: There were 205 patients with DR, the morbidity rate of DR was 32.5% ( 95%CI:28.82%-36.15%) , the nonproliferative diabetic retinopathy ( NPDR ) and proliferative diabetic retinopathy ( PDR ) were 134 cases occupying 21.2% ( 95%CI: 18.04%-24.44%) and 71 cases occupying 11.3%(95%CI:8.78%-13.72%) of the patients with DR, respectively. Univariate analysis showed that income, living environment, whether treatment by insulin, combined with diabetic nephropathy ( DN) , combined with diabetic peripheral neuropathy ( DPN), hold on exercise, course of diabetes, fasting plasma glucose ( FPG ) , 2 hours'postprandial plasma glucose ( 2hPG ), glycosylated hemoglobin A1c ( HbA1c ), systolic blood pressure ( SBP) , total cholesterol ( TC) , urinary albumin excretion rate (UAER), serum creatinine (SCr), and blood urea nitrogen ( BUN ) were significant different among the patients without DR, the patients with NPDR and the patients with PDR ( P<0.05 or P<0.01 ).Multivariate ordinal Logistic regression analysis showed that the incidence and development of DR increased in patients with longer course of diabetes, high HbA1c, high UAER and without exercise, and decreased in patients without DN and DPN (P<0.05 or P<0.01). CONCLUSION:There was a high morbidity rate of DR in patients with patients with type 2 diabetes.The longer course of diabetes, high HbA1c, and without exercise were the independent development factors of DR, whether combined with DN, combined with DPN and UAER were indices for the incidence and development of DR.

  11. 多发性硬化患者视神经炎发作早期的相干光断层扫描表现%Analysis of optical coherence tomography in early stage of optic neuritis in multiple sclerosis patients

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    程钢炜; 赵家良; 梁珍; 钟勇; 张华; 马建民; 睢瑞芳; 毛进

    2011-01-01

    optic neuritis.The average thickness of RNFL and GCC was measured and a three dimensional image of optic disk was reconstructed using optical coherence tomography (OCT).Results Within the first week of onset,the average thickness of RNFL and G CC of first attack eyes increased 75% and 64%,respectively.The average thickness of RNFL and GCC in relapsed eyes decreased 91.7% and 62.5% respectively.The average thickness of RNFL and G CC of the fellow eyes also increased 60% and 43% respectively,within the first week of onset.More cases of optic disk edema and thickening of RNFL were found by OCT than by direct ophthalmoscopy.Conclusions Different changes of the thickness of RNFL and G CC and morphology of the optic disk were detected during the early stage of the initial attack or relapsed optic neuritis in MS patients.OCT could detect such diffferences.

  12. 闭合性眼外伤致黄斑裂孔的光相干断层扫描图像分析%Analysis of the images of optical cohference tomography in the patients with macular hole caused by closed ocular trauma

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    刘杏; 黄晶晶; 林晓峰; 李梅; 阎宏; 罗益文; 郑小平

    2009-01-01

    Objective To observe the features of the images of optical coherence tomograpy (OCT) in patients with traumatic macular hole (TMH), and detect the clinical significance of OCT. Methods Consecutive 74 patients (74 eyes) diagnosed with TMH by examinations of visual acuity, slit lamp, and direct or indirect ophthalmoscopy underwent optical coherence tomography (OCT), The analysis software of OCT was used to make the quantitative measurements of TMH. And the TMH were classified according to the morphological characteristics of the images of OCT. 50°color fundus photography was performed on the patients after OCT. The relationship of TMH with the average visual acuity, disease duration, average neuroepithelial thickness on the margin of hole, and the base diameter and the apex diameter of macular hole were retrospectively analyzed. Results The characterisctics of the images of 74 cases (74 eyes) of TMH were classified into 5 types: macular holes with symmetric edema of the neurosensory retina at the margin in 27 eyes (36.5%), macular holes with asymmetric edema of the neurosensory retina at the margin in 12 eyes (16.2%), macular hole with full-thickness defect of neurosensory retina without edema or detachment at the margin in 14 eyes (18.9 %), macular hole with localized detachment of the neurosensory retina at the margin without edema in 17 eyes (23.0 %), and macular hole with thinning neurosensory retina in 4 eyes (5. 4 %).There was no significant difference of visual acuity among different types of TMH (F=1. 574, P=0. 191).The visual acuity was positively related with the marginal retinal thickness (r=0. 342, P=0. 003), but not related to age, diameter of macular hole or the disease duration(r value was from-0. 022 to-0. 134, P value was from 0. 863 to 0. 261). The disease duration of Type IV TMH was shorter than that of other TMH types. In the patients with the disease duration over 90 days, Type I TMH was predominant. The average retinal thicknesses at the margin

  13. 11例迟发性视锥细胞营养不良患者的临床特征观察%Clinical features of 11 patients with late-onset cone dystrophy

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    王明扬; 王光璐

    2014-01-01

    Objective To observe the clinical features of late-onset cone dystrophy (LOCD).Methods Eleven patients (15 eyes) of LOCD were enrolled in this study.The patients included 7 males and 4 females.The age was ranged from 50 to 79 years,with a mean age of 60.2 years.There was no obvious photophobia and hemeralopia.The visual acuity was less than or equal to 0.05 in 4 eyes,0.06-0.2 in 5 eyes,0.3-1.0 in 6 eyes.Visual acuity,slit lamp microscope,indirect ophthalmoscopy,flash electroretinogram (FERG) and multifocal electroretinograms (mfERG) were examined for all patients,fundus fluorescein angiography (FFA) for 11 eyes,optical coherence tomography (OCT) and chromoptometry for 6 eyes.Results There were 6 eyes with red/green color blindness,2 eyes with color weakness.Normal fundus was found in 11 eyes,while derangement of macular pigment epithelial in 4 eyes.FFA results showed that there were 5 eyes with normal fundus,4 eyes with blocked fluorescent spots,2 eyes with oval macular atrophy.FERG results showed that in cone response,the amplitude was lower in 6 eyes (including mild decrease in 4 eyes,moderate decrease in 1 eye and severe decrease in 1 eye) ; both in cone and rod response,the amplitude were lower in 9 eyes.mfERG results showed that central part of the cone (less than 7 degree from the center) was damaged in 5 eyes,both central and peripheral part (outside of 7 degree) of the cone were damaged in 10 eyes.OCT results showed that pigment derangement in 3 eyes,fovea was normal in 8 eyes,thinned in 5 eyes (foveal thickness was 83-111 μm).Conclusions The fundus manifestations of LOCD patients are variable,from normal fundus to oval macular atrophy.FERG is abnormal,which mainly in cone response at early stage and both in cone and rod response at late stage.Central part and (or) peripheral part of the cone are abnormal by mfERG.%目的 观察迟发性视锥细胞营养不良(LOCD)患者的临床特征.方法 临床检查确诊的LOCD患者11例15

  14. Técnica para injeção intravítrea de drogas no tratamento de doenças vítreorretinianas Technique of intravitreal drug injection for therapy of vitreoretinal diseases

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    Eduardo Buchele Rodrigues

    2008-12-01

    ós-operatório quando associação de antibióticos com corticosteróides deve ser prescrita por ao menos sete dias. As possíveis complicações da injeção intravítrea incluem descolamento de retina, hemorragia vítrea, catarata, uveíte, hipertensão ocular, ou endoftalmite infecciosa.Intravitreal injections are the standard technique applied in the treatment of some vitreoretinal diseases. In this paper the technique and complications of intravitreal injections are presented. In summary, the procedure involves various consecutive steps. Initially, days before the treatment topical antibiotics and acetazolamide may be prescribed for reduction of the ocular flora and intraocular pressure. Before the injection, the pupil should be dilated and topical anesthesia should be achieved. Injection shall be performed in the operating room under sterile conditions, the surgeon should wear surgical gloves and mask. The eye is then exposed with sterile blepharostat and sterile-drape thereby providing protection of the needle against the contact with contaminated lashes and lids. Injection is done 3.5 mm from the limbus through the pars plana. The needle should be inserted up to 6 mm into the vitreous cavity. Immediately after injection the patient must be examined by indirect ophthalmoscopy to verify central artery perfusion and complications as vitreous hemorrhage. Visual acuity better than light perception should be detected right after injection. If persistent central retinal artery occlusion is diagnosed, anterior chamber paracentesis should be performed. The patient may be discharged with an occlusive patch. Examination at the first postoperative day should exclude various complications such as endophthalmitis, and topical steroid and antibiotics should be prescribed for 7 days. Some complications encountered after intravitreal injections include retinal detachment, vitreous hemorrhage, cataract, uveitis, ocular hypertension, or endophthalmitis.

  15. Clinical characteristics of 254 cases of polypoidal choroidal vasculopathy%254例息肉样脉络膜血管病变的临床特征分析

    Institute of Scientific and Technical Information of China (English)

    陶勇; 侯婧; 黎晓新

    2012-01-01

    Objective To observe the clinical characteristics of polypoidal choroidal vasculopathy (PCV).Methods Two hundreds fifty-four PCV patients (306 eyes) were enrolled in this study.All the patients were examined for corrected visual acuity (BCVA) testing,slit-lamp microscope,indirect ophthalmoscopy,fundus photography,fluorescein angiography,indocyanine green angiography and optic coherence tomography.Results The patients included 152 males (59.8%) and 102 females (40.2%) ; the age was from 38 to 91 years,with a mean age of (65.4±8.9) years.Bilateral lesions were observed in 52 patients (20.5%) and unilateral lesions were observed in 202 patients (79.5%).BCVA varied from nonlight perception to 1.2.BCVA was lower than <0.1 in 167 eyes (54.6%),≥0.1 but <0.3 in 92 eyes(30.1%) and ≥0.3 in 47 eyes (15.4%).Vitreous hemorrhage was observed in 61 eyes (19.9%).In 202 patients with unilateral PCV lesions,drusen can be observed in the contralateral eyes of 68 patients (33.7%),exudative age-related macular degeneration changes in the contralateral eyes of 24 patients (11.9 %),and central serous chorioretinopathy history was positive in the contralateral eyes in nine patients (4.5%).In 306 eyes,there were 43 eyes (14.1%) with high permeable choroid.PCV lesions located at macula area in 199 eyes (65.0%),under the temporal retinal vascular arcade in 49 eyes (16.0%),and peripapillary in 15 eyes (4.9%).PCV lesion formation was single in 110 eyes (35.9%),cluster in 176 eyes (57.5%),string in three eyes (1.0%),branch in four eyes (1.3%),and both single and cluster polyps in 13 eyes (4.2%).There were 125 eyes (40.8%) with sub-neuroretinal fluid,121 eyes (39.5%) with hemorrhagic pigment epithelium detachment,and 73 eyes (22.9%) with serous pigment epithelium detachment.Conclusion PCV patients have higher bilateral incidence and female prevalence,and lower rate of peripapillary lesions.%目的 观察息肉样脉络膜血管

  16. Autofluorescence manifestation in children with hereditary retinal diseases%儿童遗传性视网膜疾病的眼底自身荧光表现

    Institute of Scientific and Technical Information of China (English)

    曹绪胜; 马凯; 纪海霞; 彭晓燕

    2011-01-01

    Objective To observe the autofluorescence (AF) manifestation in children with hereditary retinal diseases. Methods The clinical data of 22 children (aged from 5 to 14 years) with hereditary retinal diseases were retrospectively analyzed. There were 8 children (16 eyes) with Best vitelliform macular dystrophy, 3 children (6 eyes) with Stargardt macular dystrophy, 3 children (6 eyes) with macular cone dystrophy, 5 children (10 eyes) with primary retinitis pigmentosa, and 3 children (6 eyes) with X-linked juvenile retinoschisis. The routine clinical examinations included present history, family history, visual acuity, silt-lamp microscopy, indirect ophthalmoscopy, color fundus photography and fundus autofluorescence angiography (FAF). Some patients received fundus fluorescein angiography (FFA),electroretinogram (ERG), electrooculogram (EOG), and ocular coherence tomography (OCT). The characteristics of AF in all the children were analyzed, and were compared with the images of color fundus and/or FFA. Results Symmetry round macular fluorescent weak or absent area was found in all Stargardt disease and cone dystrophy. Weak AF area with surrounded circular increased AF was found in 2 children (4 eyes) with cone dystrophy and 1 child (2 eyes) with Stargardt macular dystrophy. A central round area with regular or irregular intense AF was observed in Best vitelliform macular dystrophy. RP children showed increased AF out of the macular region. Cellular or granular strong AF was found in the fovea of 3 children (5 eyes) with X-linked juvenile retinoschisis. Conclusion The children with hereditary retinal diseases had special AF changes.%目的 观察儿童遗传性视网膜疾病的眼底自身荧光(FAF)特征.方法 回顾性分析22例临床资料完整、年龄5~14岁之问的遗传性视网膜疾病患儿的FAF检查结果.其中,Best卵黄样病变8例16只眼,Stargardt病3例6只眼,视锥细胞营养不良3例6只眼,原发性视网膜色素变性(RP)5例10只

  17. Incidência e fatores de risco da retinopatia diabética em pacientes do Hospital Universitário Onofre Lopes, Natal-RN Diabetic retinopathy incidence and risk factors in patients of the Onofre Lopes University Hospital, Natal-RN

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    Carlos Alexandre de Amorim Garcia

    2003-06-01

    and risk factors (length of illness and arterial hypertension for diabetic retinopathy in 1002 patients who were submitted to the diabetes program at the Onofre Lopes University Hospital from 1992 to 1995. METHODS: Retrospective study of patients diagnosed with diabetes mellitus referred by the university's diabetes Program to the Retina Department and were submitted to an ophthalmological examination, under the author's supervision, including: measurement of visual acuity, anterior and posterior biomicroscopy, Goldman applanation tonometry, and indirect ophthalmoscopy (tropicamide 1% + phenylephrine 10% and analysis of the patients' records regarding length of disease and clinical arterial hypertension diagnosis. RESULTS: Of 1002 diabetic patients (in 24 fundoscopy was impossible to perform 978 were divided into 4 groups: without diabetic retinopathy, 675 cases (69,01%; with non proliferative diabetic retinopathy, 207 cases (21,16%; with proliferative diabetic retinopathy, 70 cases (7,15%; and photocoagulated patients, 26 cases (2,65%. Of the total, 291 were males (29% and 711 females (71%. These 4 groups were analyzed regarding gender, age, visual acuity, duration of the disease, presence of cataract and systemic hypertension.Concerning the type of diabetes, 95 were type I (9,4%, 870 were type II (86,8%, and in 37 cases (3,7% the type of diabetes was not determined. CONCLUSION: It was shown that the longer patients had the disease, more likely they were to develop diabetic retinopathy and that hypertension systemic did not constitute a risk factor for the decrease of visual acuity in the hypertensive patients.

  18. O diagnóstico do carcinoma metastático de coróide pela biópsia aspirativa com agulha fina (BAAF: relato de caso The diagnosis of metastatic carcinoma of the choroid using fine-needle aspiration biopsy (FNAB: case report

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    Zélia Maria da Silva Corrêa

    2003-01-01

    male, while being treated for a solitary pulmonary condensation, reported sudden loss of vision, pain, discharge and red eye (right eye for 10 days. During the ophthalmic examination a nonregmatogenous retinal detachment as well as multiple choroidal tumors were confirmed by diagnostic ocular ultrasound. Fine-needle aspiration biopsy (FNAB was suggested to diagnose a possible metastatic disease. Fine-needle aspiration biopsy was performed under peribulbar anesthesia with sedation. A transvitreous route was chosen through a sclerotomy 4 mm from the limbus. The procedure was monitored via binocular indirect ophthalmoscopy. Two sample aspirates were obtained from different tumour foci. After fine-needle aspiration biopsy, the aspirates were sent for processing, fixation and stained with Papanicolaou and HE. RESULTS: Cytology confirmed the diagnosis of multiple metastatic tumors. Immunocytochemistry of ocular and lung aspirates revealed a common cell origin by a pankeratin (AE1/AE3 positive test. Regardless of systemic treatment with chemotherapy and improvement of the ocular status, the patient died 4 months after cytological diagnosis of metastatic carcinoma of the choroid. CONCLUSIONS: Fine-needle aspiration biopsy was efficient to diagnose and correlate ocular cytology with the primary tumor by imunohistochemical methods in this case. Fine-needle aspiration biopsy should still be used only in selected cases and further research will be necessary for it to become a standard diagnostic procedure in ophthalmology.

  19. Prevalência da retinopatia diabética em unidade do Programa de Saúde da Família Prevalence of the diabetic retinopathy in a Family's Health Program unity

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    Murielem Fernandes Guedes

    2009-04-01

    Program unity in Parque Prazeres - Campos dos Goytacazes, RJ, and the level of patient's knowledge about diabetes visual impairment. METHODS: Seventy two diabetic patients were selected, but only 46 attended the research. The patients were chosen based on Family's Health Program medical registers. They were submitted to visual acuity examination and afterward to a questionnaire in order to evaluate their knowledge level about visual impairment. Then, they were submitted to a direct fundoscopic examination. Statistical studies were done based on Microsoft Excel and Bioestat 5.0 RESULTS: Diabetic retinopathy prevalence was about 19,5% (CI 95% between 8,1 and 31%; 13% showed non proliferative diabetic retinopathy and 6,5% showed proliferative retinopathy. In accordance with World Health's Organization criteria: 8,5% were considered blind and 8,9% with low vision at the moment of ocular examination. Seventy two percent of patients had previous knowledge that diabetes could cause visual reduction, but 80% didn't know the necessary exams to diagnose it and 65% never were previously submitted to ophthalmoscopy. CONCLUSION: Blindness prevention programs by diabetic retinopathy in Family Health Programs are justified considering that the retinopathy diabetic prevalence in assisted communities could be high, as was in this study. The improvement of patient knowledge about the vision threatening risk and ophthalmological exams can allow a better retinopathy diabetic control.

  20. 合并人免疫缺陷病毒感染的梅毒性葡萄膜视网膜炎的临床表现%Ocular manifestations of syphilitic uveoretinitis in patients co-infected with human immunodeficiency virus

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    张锐; 钱江; 王朱健; 袁一飞

    2015-01-01

    uveoretinitis in patients co-infected with human immunodeficiency virus (HIV).Methods Uveoretinitis patients presenting between January 2008 and December 2014 at Eye and ENT Hospital of Fudan University were collected.Patients were selected with positive serologic tests, including rapid plasma regain titer (RPR) > 1 : 8, treponema pallidum particle agglutination assay (TPPA) and human immunodeficiency virus (HIV).Other causes of uveoretinitis were excluded.Each patient underwent complete ophthalmologic examination including best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, ophthalmoscopy, applanation tonometry and B-scan ultrasonography.Fundus fluorescein angiography were obtained in each case except for patients whose fundus was blurred with dense vitritis.Optical coherence tomography (OCT) was performed in selected patients.Thorough physical examination was performed simultaneously.Results Twenty six patients were included in this study including 24 male (92.3%) and 2 female (7.7%).The mean age at presentation was 39.3±13.2 (range 20 to 63 years).RPR titres ranged from 1:32 to 1:512.There were 49 eyes altogether and ocular involvement was bilateral in 23 patients (88.5%) and unilateral in 3 patients (11.5%).Panuveitis was the most common ophthalmic presentation (n=39, 79.6%).Only two eyes were anterior uveitis (4.1%) and 8 eyes were posterior uveitis (16.3%).Anterior chamber cells+++ and mild to severe vitreous opacities were observed.Sixteen eyes presented with neuroretinitis (32.7%), 27 eyes had vitritis (55.1%), 5 eyes had retinochoroiditis (10.2%), 5 eyes had optic neuritis (10.2%), 5 eyes had retinitis (10.2%) including 2 eyes with necrotizing retinitis (4.1%), 4 eyes had retinal vasculitis (8.2%).Two eyes (11.5%) presented with posterior placoid chorioretinitis (4.1%) and multifocal choroiditis (4.1%).Systemic manifestations were detected.Five patients had a history of skin rash (19.2%), five (19.2%) had genital

  1. [Aiming for zero blindness].

    Science.gov (United States)

    Nakazawa, Toru

    2015-03-01

    chose CHOP as our primary target for drug development. Currently, we are in the process of screening a library of 1274 drugs, all of which are already used in human subjects, for CHOP inhibitors. The last topic of our discussion is future possibilities for glaucoma management. First, we discuss the development of next generation in vivo imaging modalities that allow detailed description of pathomechanisms of this multifactorial disease, glaucoma. The purpose of this research was to improve the efficacy of glaucoma diagnosis and to visualize its pathology at a cellular/molecular level and develop molecule-specific therapies. Currently available visual field tests are subjective, since they rely on a determination of the threshold of light perception, and are affected by poor reproducibility. The current dependence on visual field tests to ascertain the progression of glaucoma is thus a serious limitation on an important task of ophthalmologists. We, therefore, turned our focus to the establishment of an in vivo imaging method to detect dying retinal ganglion cells, which would highlight the pathologic state of glaucoma with high sensitivity. To this end, we used confocal scanning ophthalmoscopy to assess the usefulness of SYTOX Orange as a cell death probe. Our results showed that this probe could reveal dying retinal ganglion cells clearly, quickly and with high sensitivity. We, therefore, believe that the clinical application of probes that can sensitively detect dying retinal ganglion cells is a highly promising approach. This also applies to the use of molecular tools that can provide information on the molecular pathology of glaucoma. Finally, we would like to introduce our national collaborative work on the analysis of "big-data". The project aims to collect as wide a range of data as possible at an unprecedented scale. The data to be registered ranges from basic glaucoma data, such as IOP and visual field test results, to data from the most sophisticated

  2. 北京儿童医院视网膜母细胞瘤3年诊断治疗效果总结%Treatment and short-term effect analysis of retinoblastoma in Beijing Children's Hospital for 3-year results

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    马晓莉; 赵军阳; 金眉; 崔洁; 白大勇; 张大伟; 崔燕辉; 吴倩; 于刚

    2014-01-01

    Objective To establish a multidisciplinary approach to intraocular retinoblastomas (RB) and to diagnose and treat intraocular retinoblastoma (RB) by systemic and local chemotherapy and to evaluate the curative effect of the therapy for preservation of eyes of the RB patients,eye sight,and the improvement of the survival rate.Methods We summarized the data of intraocular RB and reviewed medical records of 127 children (180 eyes) presenting with clinically and/or histologically confirmed RB and treated at Hematology oncology Centre,Beijing Children' s Hospital (BCH) Affiliated to Capital Medical University from Nov.2009 to Nov.2011.Eligible eyes were classified according to the International Intraocular Retinoblastoma Classification (IIRC).Based on modified Canadian RB 2003 protocols,therapeutic modalities were enucleation,local control (810 nm and 532 nm laser therapy,cryotherapy) and chemotherapy.Chemotherapy consisted of vincristine,etoposide,and carboplatin (VEC).All patients were followed up to Dec 31,2012.Cases of enucleation and quality of life of children were collected by follow-up,as well as to assess the efficacy and risk of transfer under the ophthalmoscopy.Results There were 127 patients (180 eyes),68 male and 59 female,with a median age of 17 months (range 2 to 84 months)at initial diagnosis.Seventy-eight patients had unilateral RB,31 eyes of unilateral RB were classified as group E(7 eyes with detached retina),47 eyes as group D (7 eyes with detached retina).Fifty-one had bilateral RB(102 eyes),26 eyes of bilateral RB were classified as group E (5 eyes with detached retina),52 eyes as group D (9 eyes with detached retina),group C,B and A were 11,11 and 2,respectively.With a mean chemotherapy of 5.2 cycles (range 1 to 11),76 eyes were enucleated (42.0%).Thirty-two eyes with advanced intraocular disease were enucleated at the time of presentation.Enucleation were then recommended for 44 of those eyes.Overall,50 eyes (42.3%) were successfully

  3. Clinical effectiveness and safety of domestic 125I plaque irradiation for experimental choroidal melanoma%国产125I巩膜敷贴器治疗兔眼脉络膜黑色素瘤的有效性及安全性研究

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    周金琼; 魏文斌; 李彬; 杨文利; 高飞; 李辽青; 杨承勋; 蔡善钰

    2012-01-01

    Background Choroidal melanoma (CM)is the most common primary intraocular tumor,and brachytherapy is one of the most common therapeutic modality in the treatment of the tumor.However,this irradiation approach has not been evaluated in China. Objective The present study was to analyze the effectiveness and safety of domestic 125I plaque irradiation in the treatment of CM. Methods Forty New Zealand albino rabbits were randomized into 5 groups with 8 rabbits 8 eyes (right eyes) in each group.CM models were established in 16 of 40 New Zealand albino rabbits by implanting the rat B16F10 melanoma cell fragments into the suprachoroidal space of right eyes.After 3 weeks,domestic 125I plaque was fixed at the location of CM in the irradiation group 1,and 8 rabbits with CM served as model control group.The clinical effectiveness of 125I plaque for CM was evaluated based on the fundus examination with indirect ophthalmoscopy,B scan ultrasonography,fundus photographs and color Dopplerimaging.Regarding the safety study,domestic 125I plaque was fixed on the normal right cycs of normal rabbits,while the plaques without 125I seeds were used as the sham group.No intervene was performed in the rabbits of blank group.The number of CD4+,CD8+ T cells in peripheral blood was detected by flow cytometry before plaques implanted and on 3,7,15 and 30 days after the plaque was removed.The animals were sacrificed and the eyes were obtained for histology examination.The use of the experimental animals complied with Statement of ARVO. Results After implantation of B16F10 melanoma cell fragments,CM grew steadily and rapidly with the similar size between irradiation group 1 and model control group ( P =0.550).One week after administration of the treatment,tumor size was(0.31±0.07 )cm in irradiation group 1 and (0.85±0.18 )em in the model control group,with the significant difference between them( P=0.001 ).Two week after application of 125I plaque,the size of tumor was smaller than that before

  4. Comparison of 23G and 20G vitrectomy for treatment of infectious endophthalmitis%20G与23G玻璃体切割手术治疗感染性眼内炎临床效果分析

    Institute of Scientific and Technical Information of China (English)

    周和定; 毛静海

    2012-01-01

    眼,硅油填充率37.14%;23G组1只眼,硅油填充率3.13%.两组硅油填充率比较,差异有统计学意义(x2=11.703,P<0.05).再手术眼共9只眼,均为再次手术行硅油填充,占13.43%.其中,20G组8只眼,再手术率22.86%;23G组1只眼,再手术率3.13%.两组再手术率比较,差异有统计学意义(x2=5.597,P<0.05).再手术眼中,20G组中感染复发1只眼,手术后视网膜脱离7只眼,23G组中感染复发1只眼.手术后两组的视网膜脱离发生率比较,差异有统计学意义(x2=7.147,P<0.05).球结膜瘢痕形成共40只眼,其中,20G组35只眼,占100.00%,均为切口处球结膜维痕形成;23G组5只眼,占15.63%,均为原有外伤所致.结论 20G与23G玻璃体切割手术均能有效控制感染性眼内炎,但是在缩短手术时间、减少再手术率、降低手术后视网膜脱离和瘢痕形成发生率等方面,23G玻璃体切除手术系统有着明显的优势.%Objective To compare the outcomes and safety of 23G and 20G vitrectomy for treatment of infectious endophthalmitis.Methods This was a retrospective case study.Sixty-seven eyes of 67 eyes suffering from infectious endophthalmitis with a history of trauma or intraocular operation history were enrolled in this study.They were diagnosed by the examinations of best corrected visual acuity,intraocular pressures,slit lamp microscope,indirect ophthalmoscopy,B-scan ultrasound and CT.There were 49 males (49 eyes) and 18 females (18 eyes).The patients aged from 18 to 72 years with a mean age of (43±13)years.There were 60 patients (60 eyes) with a history of trauma,7 patients (7 eyes) with intraocular operation history.The patients were enrolled into 20G vitrectomy group (35 patients,35 eyes) before December,2009 and 23G vitrectomy group (32 patients,32 eyes) after January,2010 when 23G vitrectomy system was imported in this hospital.Vitreous purulence was taken in all patients at the beginning of the surgery for bacteria and fungal culture and drug sensitivity

  5. Effects of personalized clinical therapy for polypoidal choroidal vasculopathy%息肉样脉络膜血管病变临床个性化治疗效果评价

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    孙祖华; 林冰; 李英姿; 张逸夔; 黄颖; 周容; 李明翰; 刘晓玲

    2014-01-01

    眼;息肉样病灶伴PED加重3只眼.B组接受检查的10只眼中,息肉样病灶消退3只眼;息肉样病灶减少3只眼;息肉样病灶消退后复发4只眼.C组接受检查的5只眼中,息肉样病灶消退4只眼;息肉样病灶消退后复发1只眼.结论 单纯PDT、PDT联合玻璃体腔注射雷珠单抗或后Tenons囊下注射TA均能不同程度使息肉样病灶消退或渗漏减轻;患眼视力稳定或提高.%Objective To observe the effects of personalized clinical therapy for polypoidal choroidal vasculopathy (PCV).Methods Eighty-six eyes of 79 patients with PCV were enrolled in this study.There were 60 males (65 eyes) and 19 females (21 eyes).The average age was (64.48±13.15) years old.Best corrected visual acuity (BCVA),slit lamp ophthalmoscopy,fundus photography,optical coherence tomography (OCT),fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA) were measured.The average BCVA was 0.19 ± 0..20.There were three groups in this study including photodynamic therapy (PDT) group (group A,45 eyes),PDT and intravitreal ranibizumab injection group (group B,31 eyes),and PDT combined with sub-Tenon's capsule triamcinolone acetonide injection group (group C,10 eyes).Follow up begun at 1 month after the treatment.40 eyes in group A were followed up for 1 to 12 months with the average 3.27 months.28 eyes in group B were followed up for 1 to 36 months with the average 6.68 months.9 eyes in group C were followed up for 1 to 12 months with the average 5.67 months.Patients with recurrent or worsen lesions were followed by FFA or ICGA.Pre-and post-treatment BCVA and retinal thickness of the fovea were comparatively analyzed.Results All eyes (100.0 %) in group A,20 eyes (64.52%) in group B and 9 eyes (90.00%) in group C received treatment only once.The mean BCVA at 1 month after treatment was significantly increased than the pre-treatment BCVA in all 3 groups (t=2.061,3.262,3.258; P<0.05),but no significant difference was found between the 3 groups (t

  6. Effects of exogenous interleukin-2, interleukin-23 on differentiation of IRBP 1-20-specific T cells toward Th1 and Th17 and comparison of the pathogenicity of IRBP 1-20-specific T cells%白细胞介素-2与白细胞介素-23对小鼠类结合蛋白特异性T细胞向Th1、Th17分化的诱导及致病性研究

    Institute of Scientific and Technical Information of China (English)

    李洋; 崔彦; 毕宏生; 王影; 李娇; 王兴荣

    2013-01-01

    Objectives To explore the effects of exogenous interleukin (IL)-2 and IL-23 on differentiation of IRBP 1-20-specific T cells originated from C57BL/6 mouse with experimental autoimmune uveitis (EAU) and to investigate the difference in pathogenicity.Methods Experimental study.Thirty C57BL/6 mice were immunized subcutaneously with 200 μ1 emulsion containing 200 μg interphotoreceptor retinoid-binding protein (IRBP) 1-20 and 0.8 mg mycobacterium tuberculosis in complete Freund's adjuvant,distributed over six spots at the tail base and on the flank.On postimmunization Day 13,spleens and draining lymph nodes were removed from mice,and a part of spleens,as the control group,was reserved for examining the expression of IFN-γ mRNA and IL-17 mRNA by RT-PCR.T cells were isolated from the rest of spleens and lymph nodes by passage through a nylon wool column,and then T cells were stimulated for 48 hours with IRBP 1-20 in the presence of antigen-presenting cell and mouse recombinant cytokine IL-2 or IL-23.The IRBP 1-20-specific T cells were separated by Ficoll gradient centrifugation,the expressions of IFN-γmRNA and IL-17 mRNA were assessed by RT-PCR,and IFN-γand IL-17 in T cells supernatant were detected using a commercial ELISA kit.The T cells were cultured for another 48 hours,and then the proportions of IL-17 + γδ + T cells were analyzed by flow cytometry.EAU models were built in 30 C57BL/6 mice,T cells from which were randomly divided into two groups according to the methods mentioned above:IL-2 group and IL-23 group.Transfer EAU models were built in other 6 mice and divided into two groups,IL-2 group and IL-23 group,by intraperitoneal injection of 3.5 x 106 IRBP-special-T cells from IL-2 group or IL-23 group respectively.Clinical changes were observed by indirect ophthalmoscopy on postimmunization day 3,7,14.For histopathological evaluation,whole eyes were collected on postimmunization day 21.Rank sum test,one-way ANOVA and paired t test were used to analyze the

  7. 玻璃体腔注射抗血管内皮生长因子药物治疗特发性脉络膜新生血管的临床疗效观察%Intravitreal anti-vascular endothelial growth factor in the treatment of idiopathic choroidal neovascularization:a retrospective analysis

    Institute of Scientific and Technical Information of China (English)

    吴秋菊; 钱芳; 刘瑜玲; 赵琳; 陈晓勇; 马志中; 郭彤

    2015-01-01

    Objective To evaluate the efficacy of intravitreal anti-vascular endothelial growth factor ( VEGF) in the treatment of idiopathic neovascularization ( ICNV ) .Methods This retrospective study Involved 40 patients (40 eyes) with ICNV diagnosed based on the results from indirect ophthalmoscopy, fundus fluorescein angiography( FFA) ,ICG angiography ( ICGA) and optical coherence tomography ( OCT) . ICNV was subfoveal in 16 eyes and juxtafoveal in 24 eyes.Patients received 1-4 doses of intravitreal ranibizumab ( n=18 ) or intravitreal bevacizumab ( n=22 ) .Data on the best corrected visual acuity ( BCVA) ,OCT and central retinal thickness ( CRT) after treatment were retrieved and analyzed.Correlations between the post-treatment BCVA and other parameters were tested.Results The average BCVA was (55.3±18.19) prior to treatment and (76.45±13.03) at 6 months after treatment (P0.05),ICNV location (r=0.036, P>0.05),number of anti-VEGF injections (r=0.099,P>0.05) and type of anti-VEGF agent (ranibizumab or bevacizumab,r=0.089,P>0.05).No severe systemic complications were observed during the follow-up period.Conclusion Intravitreal injection of anti-VEGF agents may improve visual acuity and reduce central retinal thickness in patients with ICNV,thus having great therapeutic potential.%目的:观察玻璃体腔注射抗血管内皮生长因子( VEGF)药物治疗特发性脉络膜新生血管( ICNV)的临床效果及影响其预后的相关因素。方法收集2012年1月至2013年6月北京大学第三医院眼科中心40例(40只眼)ICNV患者的临床资料,进行回顾性分析。所有患者经间接检眼镜检查、荧光素眼底血管造影( FFA)检查、吲哚菁绿血管造影( ICGA)检查及光学相干断层扫描( OCT)检查确诊为ICNV。对所有患者行玻璃体腔注射抗VEGF药物进行治疗,注药次数1~4次,平均(2.5±0.72)次。术后患者复诊1次/月,在复诊时经OCT检查发现病变部位仍存