American Journal of Ophthalmology via MedWorm.com

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

(Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We thank Dolz-Marco and associates for their interest in and comments on our recent article on the natural course of adult-onset foveomacular vitelliform dystrophy (AOFVD) by spectral-domain optical coherence tomography. The clinical features of AOFVD were described first by Gass in 1974. The disease then was characterized by a late-onset (between 30 and 50 years of age) solitary, round or oval, elevated, yellow, subretinal lesion of the fovea, ranging from one-third to 1 disk diameter in size and often accompanied by a central pigmented spot. Since 1974, several cases of AOFVD have been reported in multiple clinical series. These series revealed high variability in the appearance and progression of AOFVD, and unfortunately, have generated a number of different terms and abbreviations for ...

Natural Course of Adult-Onset Foveomacular Vitelliform Dystrophy: A Spectral-Domain Optical Coherence Tomography Analysis

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We read with great interest the article by Querques and associates describing progressive stages in patients with presumed adult-onset foveomacular vitelliform dystrophy (AOFVD): vitelliform, pseudohypopyon, vitelliruptive, and atrophic. The authors also noted a significant decrease in visual acuity in eyes showing progression through these stages. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We appreciate the comments of Lee and Cho regarding short-term changes of aqueous inflammatory cytokines after intravitreal bevacizumab (IVB) for diabetic macular edema, and their remarks about possible acute alteration of associated cytokines after IVB are worth considering. (Source: American Journal of Ophthalmology)

Possible Short-term Changes of Aqueous Inflammatory Cytokines After Intravitreal Bevacizumab for Diabetic Macular Edema

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We read with great interest the article by Sohn and associates, “Changes in Aqueous Concentrations of Various Cytokines after Intravitreal Triamcinolone versus Bevacizumb for Diabetic Macular Edema.” They reported that only aqueous vascular endothelial growth factor (VEGF) was decreased significantly after intravitreal bevacizumab (IVB) treatment, but that aqueous levels of interleukin (IL)-6, IL-8, interferon-induced protein-10, monocyte chemotactic protein (MCP)-1, and platelet-derived growth factor-AA were not affected by IVB treatment. Previously, Funk and associates also reported that IVB resulted in a significant decrease of VEGF and that all other cytokines, including IL-8 and MCP-1, were not affected in patients with diabetic macular edema (DME). (Source: American Journal of Op...

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

I thank Drs Kamal and Kumar for their interest in our recently published article. I am pleased to learn that they also found our surgical technique useful in correcting lid margin deformity, lid retraction, and lagophthalmos. Although the proposed surgery starts from lamellar division of the involved eyelid at the grey line and ends with posterior repositioning of the anterior lamella, our splitting of anterior and posterior lamella does not reach the level that they stated, that is, just short of superior fornix. As a matter of fact, ours only reaches the level that is sufficient to allow the anterior lamella to be recessed from the tarsal margin, that is, approximately 3 to 5 mm. They found it beneficial to pass 3 mattress sutures from the conjunctiva toward the skin, presumably in a man...

Oral Mucosal Graft to Correct Lid Margin Pathologic Features in Cicatricial Ocular Surface Diseases

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

The article by Fu and associates evaluating the oral mucosal graft in cicatricial ocular surface reconstruction is very interesting. The lamellar division of the eyelid at the grey line with repositioning is used for corrections of entropion and lid margin keratinization. We also have found the technique very useful for such cases. In addition to the correction of lid margin deformity, the procedure also corrects lid retraction and lagophthalmos. However, the technique at our center differs from that of Fu and associates in the following respects. We carry out the splitting of anterior and posterior lamella just short of superior fornix along with the passage of 3 mattress sutures from the conjunctiva toward the skin. These sutures prevent retraction of the posterior lamella in the postope...

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We thank Drs Singh and Sangwan for their interest in our article, “Use of Infliximab in the Treatment of Peripheral Ulcerative Keratitis in Crohn Disease,” and are heartened that they have found a similar effect of this class of biologic agents for peripheral ulcerative keratitis (PUK) resulting from other causes. (Source: American Journal of Ophthalmology)

Use of Infliximab in the Treatment of Peripheral Ulcerative Keratitis in Crohn Disease

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We read with great interest the article “Use of Infliximab in the Treatment of Peripheral Ulcerative Keratitis in Crohn Disease,” published in August 2011 issue of the Journal. We appreciate the authors for highlighting the importance of biologics and the newer immunosuppressives in the management of peripheral ulcerative keratitis in Crohn disease refractory to conventional immunosuppressive therapy. We also agree with the authors' comments that infliximab similarly may be effective in diseases with similar mechanisms of action like rheumatoid arthritis. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We thank Dr Zhang for his interest in our article. We agree that especially in keratoconic corneas, the thickness of the cornea may be very different on different areas of the cornea, and that is why measurements based on handheld instruments may be demanding. Perhaps optical methods to explore the entire cornea could be better. Yet, during corneal cross-linking (CXL), this is not feasible. Accordingly, we state in the Methods, “Corneal thickness was evaluated preoperatively and postoperatively and during the CXL treatment using an ultrasound pachymeter by measuring the corneal thickness at its thinnest point (based on topography) 5 times and calculating the average of these readings.” Naturally, we are not able to measure the thickness at exactly the thinnest point, but we aimed to do...

Corneal Thickness Change in Eyes Undergoing Corneal Cross-Linking

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

I read with interest the recent work by Holopainen and Krootila and would like to ask the authors to clarify some points about their study and offer comments on their findings. The authors stated in the Methods that the central corneal thickness was recorded. However, the documented results in the Results was the corneal thickness at the thinnest point. The authors should not have neglected this disagreement because the central corneal thickness does not always represent the least value of the corneal thickness in keratoconus. I also note that the population in this study consisted of those with keratoconus and keratectasia and other patients. They might have different responses to corneal cross-linking (CXL), as evidenced by a previous study in which a significant difference in the change...

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We thank Dr Rao for the interest in our article. Dr Rao found it surprising that the mean intraocular pressure (IOP) and range of IOP were not significant risk factors for visual field progression in the primary angle-closure glaucoma subgroup without acute angle closure. Our article actually stated that mean overall IOP was found to be a risk factor for visual field progression, both in univariate and multivariate analyses. We agree that the mean overall IOP in eyes with prior attacks of acute angle closure were probably higher because of acute spikes of IOP. We believed that it would be artificial to disregard the initial IOP and consider only the average and range of the rest of the IOP measurements in the assessment of risk for visual field progression in primary angle-closure glaucoma...

Blindness and Long-term Progression of Visual Field Defects in Chinese Patients With Primary Angle-Closure Glaucoma

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

This study assumes greater importance in trying to identify risk factors for progression in primary angle-closure glaucoma. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

Pointdujour and associates argue that the term Graves orbitopathy (GO) “leads to confusion and misdiagnoses among many medical specialists.” We agree that there are several reasons why the term Graves orbitopathy is not ideal for describing this orbital pathologic condition. GO is the most common extrathyroidal manifestation of Graves disease, and therefore, most patients with GO have associated hyperthyroidism. Experts agree that the prevalence of GO in Graves disease depends on the sensitivity of the testing methodology. Although clinically overt GO is present in 30% of Graves disease patients, extraocular muscle involvement is observed in 91% of these patients when assessed by CT. When patients with euthyroid orbitopathy are evaluated extensively, they often are found to have morpho...

Quality of Life in a German Graves Orbitopathy Population

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We read with great interest the recent report by Ponto and associates describing the quality of life of patients with thyroid orbitopathy in a German population. We would like to point out to the readership our belief that the term Graves orbitopathy, as used in this article and throughout the medical literature, is misleading. The authors describe all patients as having Graves orbitopathy, when in fact 94% of the patients had true Graves disease, and the remaining 6% had either euthyroid orbitopathy or Hashimoto-related orbitopathy. This terminology is widespread in the literature and leads to confusion and misdiagnosis among many medical specialties. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

We appreciate the interest and comments of Gatzioufas and associates concerning our article, “In Vivo Analysis of Stromal Integration of Multilayer Amniotic Membrane Transplantation in Corneal Ulcers,” and for bringing the important point of amniotic membrane transplantation in manifest or suspect herpetic keratitis to the readers' attention. As correctly pointed out by the authors, persistent corneal epithelial defects and sterile corneal ulcers and melting often may be related to the protean clinical expression of herpetic infection of the eye. (Source: American Journal of Ophthalmology)

In Vivo Analysis of Stromal Integration of Multilayer Amniotic Membrane Transplantation in Corneal Ulcers

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

Nubile and associates recently published an interesting study evaluating the integration of amniotic membrane into the corneal stroma after amniotic membrane transplantation for persistent noninfectious corneal ulcers. The authors investigated the integration patterns of amniotic membrane using laser scanning in vivo confocal microscopy and anterior segment optical coherence tomography. They documented that integration of amniotic membrane into the corneal stroma is preceded by epithelialization over the amniotic membrane covering the ulcer and that the integrated amniotic membrane undergoes progressive modifications characterized by early loss of amniotic epithelial cells, changes in fibrillar structure, and repopulation by corneal stroma-derived cells. Moreover, a stable increase in corn...

Reporting Visual Acuities

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

The AJO encourages authors to report the visual acuity in the manuscript using the same nomenclature that was used in gathering the data provided they were recorded in one of the methods listed here. This table of equivalent visual acuities is provided to the readers as an aid to interpret visual acuity findings in familiar units. (Source: American Journal of Ophthalmology)

Time Trends in the Incidence and Causes of Blindness in Israel

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

Conclusions: Contemporary interventions in ophthalmology combined with widely available universal free access to healthcare seem to be effective in causing a major reduction in the incidence of blindness. (Source: American Journal of Ophthalmology)

Incidence of Legal Blindness From Age-Related Macular Degeneration in Denmark: Year 2000 to 2010

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

Conclusion: From 2000 to 2010 the incidence of legal blindness from AMD fell to half the baseline incidence. The bulk of the reduction occurred after the introduction of intravitreally injected inhibitors of vascular endothelial growth factor in 2006. (Source: American Journal of Ophthalmology)

An Outbreak of Streptococcus Endophthalmitis After Intravitreal Injection of Bevacizumab

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

Conclusions: In this outbreak of endophthalmitis after intravitreal bevacizumab injection, Streptococcus mitis/oralis was cultured from the majority of patients and from all unused syringes. Visual outcomes were generally poor. The most likely cause of this outbreak was contamination during syringe preparation by the compounding pharmacy. (Source: American Journal of Ophthalmology)

Avastin Doesn't Blind People, People Blind People

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

Conclusions: Recommendations arising from a root cause analysis of infectious endophthalmitis outbreaks should focus on the procedures used by pharmacies to compound bevacizumab. Microbial contamination of bevacizumab-containing syringes prepared from the same vial of drug can be avoided by using a single vial of bevacizumab for each eye or by following strict adherence to United States Pharmacopoeia Chapter 797 requirements when compounding a single vial of bevacizumab into multiple syringes. (Source: American Journal of Ophthalmology)

Changing Trends of Blindness: The Initial Harvest From Translational Public Health and Clinical Research in Ophthalmology

American Journal of Ophthalmology — Sat, 21 Jan 2012 03:51:05 +0100

All ophthalmologists and vision researchers are aware of the profound adverse effects of blindness on our patients' health and quality of life. From a societal perspective, visual loss comes with an exorbitant price tag, with an estimated global cost of nearly $3 trillion for the 733 million people living with low vision and blindness worldwide. With unceasing population growth and aging demographics, these numbers are expected to spiral upward. In this issue of the Journal, however, contemporary surveillance data from 2 large population-based studies shed some light on our battle against blindness and offer hope that the tide may be turning because of new public health initiatives and novel clinical treatments that have been translated from research in recent years. (Source: American Jour...

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

(Source: American Journal of Ophthalmology)

Announcement

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

The 3rd World Congress on Controversies in Ophthalmology (COPHy), March 22–25, 2012, Istanbul. Website: http://www.comtecmed.com/COPHy/2012/ COPHy Istanbul will be devoted to evidence-based debates and discussions amongst chairpersons, speakers and the audience, all of whom will examine and analyze the most relevant issues raised during the course of 2011 within the field of Ophthalmology. Simultaneous sessions will emphasize controversies within anterior segment, retina, and glaucoma. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

We thank Dr Kamal for his comments on our article and wish to clarify his concerns regarding our study. First, topical antibiotics were included in the postoperative antibiotics regimen, and topical quinolones were used for 1 week. In endonasal dacryocystorhinostomy (DCR) cases, nasal steroids were also used for 2 to 3 weeks. Because it has been reported that prophylactic antibiotics are helpful in terms of surgical outcomes, broad-spectrum antibiotics were used in all patients for 1 week after surgery, and it does not seem inappropriate that we used third-generation cephalosporins, which prophylactically can cover both gram-positive and gram-negative bacteria uniformly in all patients where infection is not established. Also, because the silicone tubes generally were removed a few months...

Clinical Significance of Microbial Growth on the Surfaces of Silicone Tubes Removed From Dacryocystorhinostomy Patients

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

Many surgeons prefer to insert bicanalicular silicone stents during dacryocystorhinostomy (DCR) in cases of canalicular obstruction, previous failed attempt, endonasal DCR, or even in primary cases of nasolacrimal obstruction. A recent article by Kim and associates retrospectively reviewed the clinical significance of microbial growth on the surfaces of silicone tubes removed from DCR patients. The authors concluded that Pseudomonas aeruginosa infection showed significant relation with membranous obstruction of nasal mucosa and prolonged silicone intubation and that the final surgical failure was related significantly with canalicular stenosis, pus discharge at extubation, history of endoscopic revision, and pseudomonal infection. However, the report lacks appropriate methods and adequate ...

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American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

Drs Richoz and Schutz in their letter raise 3 main problems with our article to which I will respond. Concerns were raised regarding the technique that we evaluated because, in their opinion, it is somewhat outdated. The scleral buckling procedure was the only technique used to treat retinal detachment until the development of pneumatic retinopexy and vitrectomy. In a recent study comparing these procedures, scleral buckle was found to be as safe and effective a technique as vitrectomy and had better anatomic results than pneumatic retinopexy. Therefore, we believe that the scleral buckling procedure is a good technique that should be subject to further investigations with the aim of improving its outcomes. (Source: American Journal of Ophthalmology)

Risk Factors for Development of Choroidal Detachment After Scleral Buckling Procedure

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

We read with special interest the article by Auriol and associates describing risk factors for development of choroidal detachment after sclera buckling. Some points need to be addressed. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

The focus of our recent publication was branch facial nerve injury occurring as a result of superficial temporal artery biopsy. In the article, we stressed that the risk of this complication is reduced by obtaining a specimen from the parietal as opposed to the frontal branch of the superficial temporal artery. We mentioned that locating the path of the artery is aided with removal of hair overlying the surgical site. Dastgir and associates advise not removing hair as a slight modification. The neurosurgical literature suggests that shaving hair on the head has little impact on infection risk. In short, we are not opposed to their suggested technique of simply parting the hair along the line of the surgical incision and pasting the hair with antibiotic ointment. One can also use rubber ban...

Facial Nerve Injury: A Complication of Superficial Temporal Artery Biopsy

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

We read with great interest the recent report by Yoon and associates describing 4 patients with iatrogenic facial nerve injury sustained during temporal artery biopsy. They correctly describe the danger zone involving the area traversed by the frontal branch of the superficial temporal artery as being a site where facial nerve injury is possible if careful surgical dissection is not performed. We would like to share our preferred method of temporal artery biopsy that decreases the risk of facial nerve injury and improves the cosmetic appearance of the resultant scar without increasing surgical duration. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

We appreciate the interest and discussion from Drs Chandra and Williamson regarding our recent publication. Overall, their comments complement the findings of our study. The only point of debate, really, is that our study found anticoagulant use to be a risk factor for intraocular (not exclusively vitreous, as they mention) hemorrhage on the first postoperative day. They nicely outline the literature with the findings that publications have appeared on both sides of the argument. The problem, of course, is that all of the studies have different methodologies. None (including our own) have an ideal study design, and published studies defy definitive comparison because of many of the following: the frequency of visually consequential events is low, the proportion of patients with various di...

Hemorrhage With Anticoagulants and Antiplatelets in Vitreoretinal Surgery

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

We read with great interest the article by Oh and associates, which adds further debate to the question of the management of antiplatelet and anticoagulant medication in patients undergoing vitreoretinal surgery. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

We thank Chaurasia and associates for their thoughtful observations and questions regarding our article, “Spontaneous Reattachment of Descemet Stripping Automated Endothelial Keratoplasty Lenticles.” In response to their first comment noting that it would be useful to know the number of absolute lenticle dislocations, our study was an observational study, so absolute numbers of detachments were not collected as a denominator for statistical analysis, although this would have been a useful factor to examine. (Source: American Journal of Ophthalmology)

Spontaneous Reattachment of Descemet Stripping Automated Endothelial Keratoplasty Lenticles

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

We read with interest the article entitled “Spontaneous Reattachment of Descemet Stripping Automated Endothelial Keratoplasty Lenticles,” by Hayes and associates. The authors reviewed a significant number of spontaneously attached Descemet stripping automated endothelial keratoplasty (DSAEK) lenticles and provided information about natural course of graft detachment after DSAEK. We would like to offer some comments and observations. (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Tue, 13 Dec 2011 17:01:31 +0100

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

(Source: American Journal of Ophthalmology)

Radiology of the Orbit and Visual Pathways

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

Media Type: Textbook (Atlas style), Online text Synopsis: The radiology of the orbit and visual pathways is a complex topic and this book offers a simplified description of anatomical pathways and their radiological and pathological correlates. There is a wealth of practical information with well referenced chapters. As a whole, the book is appropriate and very useful to students, clinicians, and surgeons from various disciplines. The online access feature including all illustrations can be found via expertconsult.com which also includes the Medline link to references. (Source: American Journal of Ophthalmology)

Cataract Surgery, 3rd Edition

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

Media Type: Textbook, with DVD, and On-line text (requires activation) Synopsis: Dr Steinert has put together a group of associate editors who are among the great cataract surgeons in the world. Cataract Surgery uses a classic textbook format, supplemented by an included DVD covering dozens of individual clips, with voiceovers by the surgeon, and an on-line version hosted on expertconsult.com which has the entire print content that is searchable. The listing of contributing authors is a veritable “who's who” of international cataract surgeons. Readers will find coverage of virtually every topic from embryology to the most up-to-date techniques. It will be a particularly good reference for anyone early in their training, or a master who teaches cataract surgery. (Source: American Journ...

Reply

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We are grateful for the comments from Pahuja and associates on our article regarding long-term changes in corneal astigmatism with aging after sutureless cataract surgery. Although their comments seem to be theoretically appropriate, some important facts have been overlooked. (Source: American Journal of Ophthalmology)

Long-term Change in Corneal Astigmatism after Sutureless Cataract Surgery

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We read with great interest the article by Hayashi and associates on age-related changes in corneal astigmatism in pseudophakic and phakic patients. Changes in corneal astigmatism with age have been well documented in the literature. Corneal astigmatism changes from with-the-rule astigmatism to against-the-rule astigmatism with age. An interesting aspect is the effect of cataract surgery on this natural shift in astigmatism. The literature in this regard is sparse. The authors herein provide valuable information about the age-related changes in pseudophakic patients in their comparative analysis of long-term change in astigmatism in pseudophakic and phakic patients. It is interesting to note that the change in astigmatism in psuedophakic patients follows the same trend as that in phakic pa...

Reply

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We appreciate Zhang and Hoffman's interest and their valuable comments regarding our article. We accept that the rabbits in our study will still demonstrated an increase in weight. However, to our knowledge, the rabbits that weighed 2.5 kg are approximately 5 months of age. This means that they have reached the sexual maturity period, and therefore, their ocular structure is stable. Just like people in their twenties, although they may have variations in weight with their growth, there is less probability of changes in eyeball morphologic features. In a recent study, it was confirmed that age did not affect central corneal thickness. We also read the article published in the Journal of Cataract and Refractive Surgery that showed the changes in corneal thickness after collagen cross-linking...

Collagen Cross-Linking with Riboflavin in a Femtosecond Laser–Created Pocket in Rabbit Corneas

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We read the recent article titled “Collagen Cross-Linking with Riboflavin in a Femtosecond Laser–Created Pocket in Rabbit Corneas: 6-Month Results” and would like to raise our concerns regarding this animal study. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

Ramasamy and associates raise the question of the management of missing data and censored data, which is an interesting and relevant question. Whereas different hypotheses can be made to address the outcome of transplantation in patients lost to follow-up, it may be better to analyze the data with no hypothesis and to include patients in the analysis for the time they were effectively followed. Results should be presented at a postoperative time consistent with the average follow-up time. This was the reason why we decided to show 36-month results in our paper. If results at a longer postoperative time have to be addressed, then a mathematical model must be used to predict long-term results. (Source: American Journal of Ophthalmology)

Graft Rejection and Graft Failure After Anterior Lamellar Versus Penetrating Keratoplasty

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We read the article by Borderie and associates with great interest. We commend the authors' effort and find their results consistent with available evidence. While it is interesting to know that eyes undergoing anterior lamellar keratoplasty (ALK) had a lower incidence of rejection episodes and irreversible rejection compared to the penetrating keratoplasty (PK) group, could the authors kindly throw some light on the following questions that came up in our discussion? (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We thank Kountouras and associates for their interest in our article. We acknowledge their research on the association of Helicobacter pylori infection with neurodegenerative and other diseases. However, the association between H. pylori infection and glaucoma remains controversial. Specifically, the above association, initially found by Kountouras and associates in a case-control study of 41 glaucoma patients and 30 anemic controls, was not confirmed in an independent study from Canada involving 97 patients and 94 controls and in a more recent study from Israel involving 51 glaucoma patients and 36 controls. Also, in another study from India of 100 glaucoma patients and 50 controls, the mean level of anti-H. pylori immunoglobulin G positivity in the sera was not statistically significantl...

Helicobacter pylori Infection as a Risk Factor for Both Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma in Thessaloniki Eye Study

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

Topouzis and associates' observation that increased intraocular pressure (IOP) was the only risk factor associated with both primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (XFG) in the Thessaloniki Eye Study is interesting because recent evidence indicates that the prevalence of Helicobacter pylori (H. pylori) infection in glaucoma patients of this area is equally high, thereby representing a common denominator underlying both POAG and XFG in Thessaloniki. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We read with appreciation the comments from Cortina and associates in response to our recent article on long-term complications associated with a glaucoma drainage device (GDD) in patients with Boston keratoprosthesis. We were pleased by their interest in our publication, and we acknowledge their contributions to one of the most challenging aspects of keratoprosthesis surgery. (Source: American Journal of Ophthalmology)

Long-term Complications Associated with Glaucoma Drainage Devices and Boston Keratoprosthesis

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

This study is a retrospective cases series that suggests that complications associated with glaucoma drainage devices can cause significant vision loss in keratoprosthesis patients. We agree with the authors in that postoperative glaucoma management is one of the significant challenges that we face in keratoprosthesis surgery and that many patients continue to loose vision despite close monitoring by glaucoma specialists. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We thank Drs Wa and Sebag for their interest in our article, “Safety of Vitrectomy for Floaters.” They question our strategy to perform posterior vitreous detachment (PVD) induction in eyes with an attached posterior vitreous. We documented more retinal breaks in the cases in which PVD was induced during surgery. Because retinal breaks are a prerequisite for the development of a retinal detachment, they argue that it would be safer to refrain from PVD induction in these cases. (Source: American Journal of Ophthalmology)

Safety of Vitrectomy for Floaters

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

In the article by Tan and associates describing the safety of vitrectomy for floaters, the authors analyzed a retrospective case series of vitrectomy in 116 eyes with vitreous floaters to determine the complications and risk profile. In 25.9% of cases, the posterior vitreous cortex was still attached and a posterior vitreous detachment (PVD) was induced during surgery. In these cases, retinal breaks were found in 9 (30%) of 30 cases, whereas in the eyes that did not undergo PVD induction, retinal breaks were found in only 10 (11.6%) of 86 cases. This statistically significant difference brings into question the advisability of PVD induction. Indeed, in a study of retinal breaks after the induction of PVD, Chung and associates found that in vitrectomy for macular pucker, PVD induction was a...

Reply

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We are grateful for the comments on our recent article about learning and fatigue effects in flicker defined form perimetry. Bagnis and associates point out that fatigue effects have been shown for several perimetry techniques such as standard automated perimetry (SAP), short-wavelength automated perimetry (SWAP), frequency doubling technology, Rarebit perimetry, and flicker defined form perimetry. (Source: American Journal of Ophthalmology)

Learning Effect in Perimetry: The Role of Chromatic Discrimination

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We read with interest the article “Learning Curve and Fatigue Effect of Flicker Defined Form Perimetry,” by Lamparter and associates. The authors investigated the learning effect of the relatively new flicker defined form perimetry and found a significant improvement in different perimetric indices between the first 3 tests performed by inexperienced healthy subjects. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We appreciate the opportunity to further discuss our recent report on central macular splaying and outer retinal thinning in asymptomatic sickle cell patients, in particular, to respond to the interest and letter from Minnal and associates, who had concerns about the methodology of the study. (Source: American Journal of Ophthalmology)

Central Macular Splaying and Outer Retinal Thinning in Asymptomatic Sickle Cell Patients by Spectral-Domain Optical Coherence Tomography

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

We read the article by Hoang and associates with great interest. This is the first study using a segmental analysis of the macula to demonstrate thinning by spectral-domain optical coherence tomography (OCT) in asymptomatic female sickle patients. The authors conclude that this patient population has significant central macular thinning and splaying, when compared to healthy, matched control subjects. They suggest that since foveal thinning may be indicative of more global retinal ischemia, the presence of thinning may be a useful screening modality for patients to determine the need for a more thorough examination. (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

AJO History of Ophthalmology Series: Lewis Carroll and Asymmetry

American Journal of Ophthalmology — Tue, 22 Nov 2011 16:29:14 +0100

Charles Dodgeson (1832-1898), whose pen name “Lewis Carroll” became famous for Alice in Wonderland, was evidently fascinated by questions of symmetry and asymmetry. This was notable particularly in Through the Looking Glass, where mirrors, opposites, and chess moves are prominent themes. (Source: American Journal of Ophthalmology)

Tear Dysfunction and the Cornea: LXVIII Edward Jackson Memorial Lecture

American Journal of Ophthalmology — Mon, 24 Oct 2011 04:00:00 +0100

Conclusions: Corneal epithelial disease resulting from tear dysfunction causes eye irritation and decreases visual function. Clinical and basic research has improved understanding of the pathogenesis of tear dysfunction–related corneal epithelial disease, as well as treatment outcomes. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

(Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

Media Type: Textbook, with DVD-ROM Synopsis:In these days of the Internet and unlimited access to information one could easily question the place of textbooks. This volume is an excellent example of the role that textbooks still play, serving as a filter to distill information to its most useful components. (Source: American Journal of Ophthalmology)

Miami to Japan Eye-Care Rescue Mission: Vision Van Helps with Relief Efforts

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

The devastating earthquake of March 11—the biggest disaster of modern Japan—hit the northeastern part of the island nation; the subsequent tsunami struck and destroyed almost all coastal villages and cities, leaving more than 20 000 either dead or missing. The destruction was so severe that communication infrastructures and transportation systems were disabled, leading to challenges for rescue and recovery as well as lack of supplies and gasoline. Thousands of survivors were homeless and without immediate medical care. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We reported that the presence of photoreceptor inner/outer segment (IS/OS) junction was correlated with good visual recovery after MH surgery. Using spectral-domain optical coherence tomography (OCT), we found that the restoration of external limiting membrane (ELM) is closely associated with that of the IS/OS junction. (Source: American Journal of Ophthalmology)

Restoration of Foveal Microstructure After Macular Hole Surgery Accompanied by Change in Foveal Contour?

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

I read with great interest the paper by Ooka and associates, in which they correlated the restored external limiting membrane (ELM) and photoreceptor inner and outer segment (IS/OS) junction after surgery for macular hole (MH). They suggested that the restoration of the ELM was associated closely with that of the IS/OS junction and presented representative cases with serial images from spectral-domain optical coherence tomography examinations showing restoration of the ELM and IS/OS junction. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We read with appreciation the comments from Moussally and associates describing their experience with glaucoma drainage devices (GDD) in patients with Boston keratoprosthesis (KPro), in response to our recent article. We certainly concur with their conclusion that larger studies must be undertaken to investigate further the factors that may be involved in the erosion of GDD in patients with the Boston KPro. (Source: American Journal of Ophthalmology)

Long-term Complications Associated With Glaucoma Drainage Devices and Boston Keratoprosthesis

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

In their recent article, Li and associates evaluate the long-term complications associated with glaucoma drainage devices (GDD) in patients who have undergone Boston type 1 keratoprosthesis (KPro) surgery. The authors speculate an association between the presence of soft contact lenses (SCL) and GDD erosion in this particular population. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We thank Drs Gutman and Shinder for their interest and appreciate their comments about our article. We agree with Drs Gutman and Shinder that excision is not standard practice for sarcoid, or for any other inflammatory orbital or ocular adnexal entity. In our series, we had 8 patients who had well-circumscribed, anteriorly located masses that were treated with what, at operation, appeared to be total excision, or near-total excision. The case that was treated with excision and classified as “stable” in Table 3 and had undergone near-total excision; the residual mass did not show any change during the follow-up. (Source: American Journal of Ophthalmology)

Orbital and Adnexal Involvement in Sarcoidosis: Analysis of Clinical Features and Systemic Disease in 30 Cases

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

Discussion. In Table 3, the authors describe 1 of 8 patients who underwent “excisional biopsy” as being “stable” in follow-up. This terminology is confusing, because after excision, a lesion can be either resolved or recurrent in follow-up, but not “stable.” We remind the readership that an excisional biopsy describes a procedure where the entire pathologic lesion is removed in total, whereas an incisional biopsy describes the removal of a part of the pathologic lesion for diagnostic purposes. We believe that this is an important point because surgical debulking (incisional biopsy) is a treatment option for inflammatory sarcoidosis, whereas complete excision (excisional biopsy) is not standard practice for sarcoid or any other inflammatory orbital or ocular adnexal entity. (Sou...

Reply

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We thank Kekunnaya and associates for their interest in our recently published article, “Biomechanical Analysis of X-Pattern Exotropia.” We do agree with them that X-pattern exotropia may involve a large number of neural and biomechanical parameters that were not modulated systematically in our simulations and that multicenter studies would be necessary to obtain a larger number of patients. But exactly for those reasons we confined our investigation to 2 central questions: (1) What do the best available biomechanical simulations say about existing hypotheses on the causes of X-pattern exotropia? and (2) Is there a simple, biomechanically plausible surgery to treat these patients sufficiently? (Source: American Journal of Ophthalmology)

Biomechanical Analysis of X-Pattern Exotropia

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We congratulate Brandner and associates for their article, “Biomechanical Analysis of X-Pattern Exotropia,” which made for an interesting read. We have the following comments regarding the methodology and interpretation of the results. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We thank Drs Quaranta and Floriani for their interest in our publication. The Low-pressure Glaucoma Treatment Study (LoGTS) is a randomized trial of the effect of brimonidine versus timolol on preserving visual function in patients with low-pressure glaucoma. The LoGTS is an important trial for various reasons. It is the first randomized clinical trial to demonstrate the possibility of a pressure-independent treatment effect in glaucoma. It is also the first prospective randomized clinical trial to compare the impact of topical therapy on visual function by using a trend analysis approach to detect progression. By enrolling patients with very low baseline intraocular pressure (IOP), it demonstrates the power of having an enriched study population that minimizes the impact of IOP on disease...

The Rate of Progression and Ocular Perfusion Pressure in the Low-Pressure Glaucoma Treatment Study

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

The Low-Pressure Glaucoma Treatment Study is the first multicenter, randomized, double-masked, controlled clinical trial comparing the efficacy of topical twice-daily brimonidine tartrate 0.2% and twice-daily timolol maleate 0.5% in reducing intraocular pressure (IOP) to prevent or delay visual field progression in patients with low-pressure glaucoma, more commonly called normal-tension glaucoma (NTG). (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We thank Dr Hwang and associates for their interest in and comments on our article. In our study, we determined the characteristics that were significantly associated with the visual field (VF) defects in highly myopic eyes. We found that significant VF defects were newly developed in 13.2% of the highly myopic eyes after excluding the eyes with any type of myopic macular or peripheral lesions that could cause VF defects. Multiple regression analyses showed that an abrupt change of the scleral curvature was the only factor significantly associated with a progression of the VF defects. (Source: American Journal of Ophthalmology)

Long-term Development of Significant Visual Field Defects in Highly Myopic Eyes

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

We read with great interest the article by Ohno-Matsui and associates describing the visual field (VF) defects in highly myopic eyes. They reported that progressive VF defects were newly developed in 13.2% of the highly myopic eyes and the incidence of VF defects was significantly higher in eyes with an oval optic disc than in eyes with a round optic disc. An abrupt change of the sclera curvature was the only factor correlated with progression of the VF defects. Thus, the authors suggested that stretching and distortion of the retinal nerve fiber layer (RNFL) from an abrupt change of scleral curvature may be the factors associated with VF defects. (Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

Dr Garudadri and associates raise several issues. As described in our baseline and outcomes paper, we anticipated greater dropouts in the brimonidine arm, thus randomizing more patients to brimonidine than timolol. The rate of subjects unable to continue brimonidine 0.2% likely resembles real-world clinical practice. (Source: American Journal of Ophthalmology)

A Randomized Trial of Brimonidine Versus Timolol in Preserving Visual Function: Results From the Low-pressure Glaucoma Treatment Study

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

The Low-Pressure Glaucoma Study by Krupin and associates reported a significantly lower rate of visual field progression in the brimonidine group (9%) compared to the timolol group (39%). They discuss that this could be attributable to an intraocular pressure (IOP)–independent protective effect of brimonidine or a relative harmful effect of timolol. This beneficial effect of brimonidine could have a major impact on how we treat patients with low-pressure glaucoma. We would like to highlight certain aspects of this study that might limit the extrapolation of the results. (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

AJO History of Ophthalmology Series: Antarctic Eye Surgery

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

The first major surgery done in Antarctica was an enucleation, performed during the British Antarctic Expedition of 1907-09 commanded by Sir Ernest Shackleton. Aeneas Mackintosh was the second officer of the ship, the Nimrod. As the crew was unloading supplies, a lifting hook swung across the deck and struck his right eye. The expedition's two surgeons, Eric Marshall and Alistair Mackay, examined him and found the lens on his cheek and a portion of the retina protruding from the laceration. (Source: American Journal of Ophthalmology)

Biopsy of Iris Tumors

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

Two articles from the same institution in this issue of the Journal address the issue of biopsy of iris tumors. The authors of these articles describe the biopsy instrumentation and technique they used and provide summary performance data on their biopsy method. The authors of these articles did not mention their clinical diagnosis or differential diagnosis for the tumors in their series, their clinical diagnostic accuracy, the specific indications for biopsy in each case, or the proportion of patients in whom the results of biopsy altered their subsequent patient management. (Source: American Journal of Ophthalmology)

Prophylaxis for Endophthalmitis Following Intravitreal Injection: Antisepsis and Antibiotics

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

Intravitreal injections have rapidly become one of the most common medical procedures in the United States, with 1 270 836 intravitreal injections performed for Part B Medicare recipients in 2009 (Ross Brechner, personal communication, 2011). Associated endophthalmitis is a rare complication with potentially devastating consequences and a well-documented incidence, occurring after approximately 1 out of 1000 to 5000 injections. (Source: American Journal of Ophthalmology)

Clinical Evidence for Neuroprotection in Glaucoma

American Journal of Ophthalmology — Sun, 23 Oct 2011 05:15:41 +0100

Glaucoma is treated by lowering intraocular pressure (IOP). However, numerous laboratory studies have shown that experimental glaucoma can be helped by therapies that act by mechanisms other than lowering IOP. Such therapies are termed “neuroprotective” because the targets are the neurons affected in glaucomatous optic neuropathy. Until recently there has been no level I evidence that any neuroprotective therapy is effective in patients with glaucoma. With the recent online publication of the results of the Low Pressure Glaucoma Treatment Study (LoGTS), there are now data that the α2 agonist brimonidine, a drug previously shown to be neuroprotective in the laboratory, may also have a beneficial effect on visual function independent of IOP lowering. This commentary analyzes the implica...

Long-term Comparison of Full-Bed Deep Lamellar Keratoplasty With Penetrating Keratoplasty in Treating Corneal Leucoma Caused by Herpes Simplex Keratitis

American Journal of Ophthalmology — Thu, 13 Oct 2011 04:00:00 +0100

Conclusions: Advantages of full-bed DLK over PK are no allograft rejection, longer graft survival, earlier drug withdrawal of topical steroid and oral acyclovir, less recurrence of HSK, and fewer follow-up visits. Full-bed DLK is preferable for treating HSK-induced corneal scarring with relatively healthy endothelium and with no history of perforation. (Source: American Journal of Ophthalmology)

Subconjunctival Bevacizumab Versus Mitomycin C Adjunctive to Trabeculectomy

American Journal of Ophthalmology — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Adjunctive subconjunctival bevacizumab with trabeculectomy is effective in controlling the IOP profile; however, its effect is less prominent than that of MMC. (Source: American Journal of Ophthalmology)

Prediction of Postoperative Eyelid Height After Frontalis Suspension Using Autogenous Fascia Lata for Pediatric Congenital Ptosis

American Journal of Ophthalmology — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Postoperative eyelid height may predicted be more accurately by compensating for anesthesia-induced lagophthalmos and adjusting the palpebral fissure to be larger than the desired eyelid height for patients with more severe ptosis. (Source: American Journal of Ophthalmology)

Vitrectomy and Internal Limiting Membrane Peeling With and Without Gas Tamponade for Myopic Foveoschisis

American Journal of Ophthalmology — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Vitrectomy and ILM peeling without gas tamponade appears to be as effective in the treatment of myopic foveoschisis as vitrectomy with gas tamponade. However, eyes treated with gas tamponade showed more rapid resolution of myopic foveoschisis. (Source: American Journal of Ophthalmology)

Near-Infrared Autofluorescence in Patients With Idiopathic Submacular Choroidal Neovascularization

American Journal of Ophthalmology — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Ring-shaped hyperautofluorescence on IR-AF in the eyes with idiopathic CNV may indicate an involutional process of CNV enveloped by the RPE because its area corresponded to the dark rim on ICGA that reflects regression of idiopathic CNV. IR-AF can be a useful noninvasive adjunctive examination to evaluate the involution of CNV. (Source: American Journal of Ophthalmology)

Vascular Endothelial Growth Factor in Plasma and Vitreous Fluid of Patients with Proliferative Diabetic Retinopathy Patients after Intravitreal Injection of Bevacizumab

American Journal of Ophthalmology — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Vitreous and plasma VEGF levels were increased markedly in patients with PDR. VEGF concentrations in vitreous and plasma were decreased significantly after IVB into PDR eyes, and the effect lasted from 4.4 ± 2.2 days to 34.8 ± 33.7 days after injection. (Source: American Journal of Ophthalmology)

Prevalence, Progression, and Impact of Glaucoma on Vision After Boston Type 1 Keratoprosthesis Surgery

American Journal of Ophthalmology — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Most KPro candidates have glaucoma, which may deteriorate in a subset of patients after surgery. Dramatic VA improvement after KPro surgery does not preclude the need for rigorous monitoring for glaucoma progression. A low threshold should be used to treat suspicion of even slightly elevated intraocular pressure. (Source: American Journal of Ophthalmology)

Ocular Complications of Human Immunodeficiency Virus Infection in Eastern China

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusions: The study shows a high rate of treatable ocular complications among patients with HIV/AIDS in eastern China. HIV/AIDS treatment programs in China must be prepared to identify ocular complications and refer patients to the correct treatment facilities. (Source: American Journal of Ophthalmology)

The Long-Term Survival Analysis of Bilateral Lateral Rectus Recession Versus Unilateral Recession-Resection for Intermittent Exotropia

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusion: Surgical outcomes by 2 years after surgery for intermittent exotropia were not different between the BLR and RR groups. However, final outcomes were better in the BLR group than in the RR group. This may be caused by the difference of recurrence rate over time: continuous recurrence of exotropia occurred in the RR group, while recurrence was low in the BLR group after postoperative 6 months. (Source: American Journal of Ophthalmology)

Intravitreal Bevacizumab for Treatment of Subfoveal Idiopathic Choroidal Neovascularization: Results of a 1-Year Prospective Trial

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusions: Intravitreal bevacizumab is generally well tolerated and improves BCVA in eyes with subfoveal idiopathic CNV over a period of 12 months. Large, randomized, controlled, long-term clinical trials are required to further evaluate the efficacy and optimal strategy of this treatment modality. (Source: American Journal of Ophthalmology)

Characteristic Higher-Order Aberrations of the Anterior and Posterior Corneal Surfaces in 3 Corneal Transplantation Techniques

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusions: Because the refractive indices between the anterior and the posterior surfaces differed greatly, eyes that undergo DSAEK have lower anterior corneal HOAs compared with PK or DALK eyes. However, the anterior and posterior corneal HOAs in DSAEK eyes still were greater than those in control eyes. (Source: American Journal of Ophthalmology)

Clinicopathologic and Immunohistochemical Features of Pigmented Basal Cell Carcinomas of the Eyelids

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusions: Only 1 of 6 lesions was uniformly clinically pigmented, whereas the other 5 were only focally brown-black. The clinical pigmentation was imparted by varying densities and distributions of melanocytes with arborizing dendrites, which were present in all BCCs. Melanophages within the stroma and basaloid cell melanization also contributed to pigmentation. No behavioral or biologic differences in pBCC were documented compared with clinically nonpigmented lesions. (Source: American Journal of Ophthalmology)

Risk Factors for Orbital Exenteration in Periocular Basal Cell Carcinoma

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusions: The need for exenteration for BCC may be significantly higher when the lesion involves a medial canthal location, initial management does not include margin-controlled excision, or pathologic analysis reveals an infiltrative subtype. Margin-controlled excision for periocular BCC and close follow-up after excision for medial canthal BCC may be indicated. (Source: American Journal of Ophthalmology)

Punctal and Canalicular Anatomy: Implications for Canalicular Occlusion in Severe Dry Eye

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Conclusions: Based on microscopic anatomic findings that the lacrimal punctum and the vertical canaliculus are part of the tarsal plate, and that the horizontal canaliculus is surrounded by the Horner muscle, excision of the horizontal canaliculus may be an effective technique to treat patients with severe dry eyes. (Source: American Journal of Ophthalmology)

Recent Statin Use and Cataract Surgery

American Journal of Ophthalmology — Fri, 07 Oct 2011 04:00:00 +0100

Purpose: To investigate whether the statin class of drugs reduces the risk of cataract extraction. Design: Case-control study. Method: setting: Kaiser Permanente Southern California, which provides prepaid healthcare for 3.2 million residents by 6000 physicians. patient population: Eligible patients were those who had 5+ years of continuous enrollment in 2009. Cases were 13 982 patients who underwent cataract surgery in their first eye in 2009. Controls were the 34 049 patients who had an eye examination, but did not undergo cataract surgery or have a diagnosis of cataract in their medical record. observation procedure: The primary source of data to assess cataract surgery, treatment with statins, and other risk factors is the electronic database of Kaiser Permanente. main outcome mea...

American Journal of Ophthalmology — Thu, 29 Sep 2011 17:01:58 +0100

(Source: American Journal of Ophthalmology)

Reply

American Journal of Ophthalmology — Thu, 29 Sep 2011 17:01:58 +0100

The comments of Vinekar and associates are valuable and support much of our approach in the management of retinopathy of prematurity (ROP). We are aware of numerous publications (reviewed recently) that have recognized ROP not as an isolated ocular disease but as a manifestation of systemic problems, to which the developing retina gets exposed in the postnatal and antenatal period. We specifically emphasized only anemia in our paper due to varying and evolving protocols among neonatologists for management of anemia. However, all other systemic factors where there has not been much difficulty in defining protocols with the neonatologists (including thrombocytopenia, sepsis, and chronic lung disease) are actively pursued by us and corrected from the time of first screening. This results in n...

Outcomes of a Protocol-Based Management for Zone 1 Retinopathy of Prematurity: The Indian Twin Cities ROP Screening Program Report Number 2

American Journal of Ophthalmology — Thu, 29 Sep 2011 17:01:58 +0100

Jalali and associates must be congratulated for their prospective series in which they report improved outcomes of laser photoablation for aggressive posterior retinopathy of prematurity (APROP). (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Thu, 29 Sep 2011 17:01:58 +0100

An Assessment of the Health and Economic Burdens of Glaucoma

American Journal of Ophthalmology — Thu, 29 Sep 2011 17:01:58 +0100

Conclusions: Early identification and treatment of patients with glaucoma and those with ocular hypertension at high risk of developing vision loss are likely to reduce an individual's loss of health-related quality of life as well as the personal and societal economic burdens. (Source: American Journal of Ophthalmology)

How the Comparison of Age-related Macular Degeneration Treatments Trial Results Will Impact Clinical Care

American Journal of Ophthalmology — Thu, 29 Sep 2011 17:01:58 +0100

Conclusions: CATT provides the first level I evidence for bevacizumab in a large number of patients with neovascular AMD. The trial supports use of either drug as primary therapy and suggests that modification of monthly dosing regimens is feasible. A difference in cardiovascular safety between the 2 drugs was not apparent on inspection of the supplementary safety data. (Source: American Journal of Ophthalmology)

Panretinal Photocoagulation for Proliferative Diabetic Retinopathy: Pattern Scan Laser Versus Argon Laser

American Journal of Ophthalmology — Tue, 20 Sep 2011 04:00:00 +0100

Conclusions: When using traditional laser settings, PRP performed with the PASCAL is less effective than that performed with traditional argon laser in effecting lasting regression of retinal neovascularization in the setting of previously untreated high-risk PDR. Physicians may need to change treatment parameters when using PASCAL pattern laser therapy for high-risk PDR. (Source: American Journal of Ophthalmology)

Anatomical and Functional Macular Changes After Rhegmatogenous Retinal Detachment With Macula Off

American Journal of Ophthalmology — Tue, 20 Sep 2011 04:00:00 +0100

Conclusions: SD-OCT and microperimetry seem to be appropriate tools to determine the visual and the anatomic recovery of the macula after surgery. (Source: American Journal of Ophthalmology)

Structural and Functional Predictors of Visual Outcome of Epiretinal Membrane Surgery

American Journal of Ophthalmology — Tue, 20 Sep 2011 04:00:00 +0100

Conclusion: Photoreceptor disruption detected by OCT and P1 implicit time delay on mfERG were significant predictors of poor visual recovery after ERM surgery. (Source: American Journal of Ophthalmology)

Serum Concentrations of Bevacizumab (Avastin) and Vascular Endothelial Growth Factor in Infants With Retinopathy of Prematurity

American Journal of Ophthalmology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusions: These results indicate that bevacizumab can escape from the eye into the systemic circulation and reduce the serum level of VEGF in infants with ROP. Continued extensive evaluations of infants are warranted for possible effects after intravitreal bevacizumab in ROP patients. (Source: American Journal of Ophthalmology)

The Effect of Standard and Transepithelial Ultraviolet Collagen Cross-Linking on Human Corneal Nerves: An Ex Vivo Study

American Journal of Ophthalmology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusions: This study highlights the immediate effects of collagen cross-linking on the corneal nerves in an ex vivo model. The absence of subbasal nerves in the early phase of treatment appears to be attributable mainly to mechanical removal of epithelium, rather than ultraviolet light–induced damage. Localized swelling of the stromal nerves was the main difference between the 2 treatment protocols. Further research on laboratory animals would be necessary to verify these changes over a specified time course without the super-addition of postmortem changes. (Source: American Journal of Ophthalmology)

Subfoveal Fluid in Healthy Full-term Newborns Observed by Handheld Spectral-Domain Optical Coherence Tomography

American Journal of Ophthalmology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusions: Some healthy full-term infants have bilateral subfoveal fluid not obvious on dilated retinal examination. This fluid resolves within several months. The visual significance of this finding is unknown, but clinicians should be aware that it is common when evaluating newborn infants for retinal pathologic features using SD OCT. (Source: American Journal of Ophthalmology)

Depression and Visual Functioning in Patients With Ocular Inflammatory Disease

American Journal of Ophthalmology — Thu, 15 Sep 2011 04:00:00 +0100

Conclusions: Depression may be a significant but underrecognized comorbid condition in patients with ocular inflammatory disease. Worse visual function was associated with depression. The authors recommend heightened awareness of potential depression in patients with ocular inflammatory disease. (Source: American Journal of Ophthalmology)

The Value of Tests in the Diagnosis and Management of Glaucoma

American Journal of Ophthalmology — Thu, 15 Sep 2011 04:00:00 +0100

Conclusions: The value of any test is determined by 3 aspects: its context of usage; its comparative worth and to whom its benefit accrues; and how we define historically what we are testing. These multiple factors should be considered in the elaboration of priorities for the development and application of tests in glaucoma. (Source: American Journal of Ophthalmology)

Corneal Hysteresis and Beta-Zone Parapapillary Atrophy

American Journal of Ophthalmology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusions: We found no significant differences in CH between eyes with and without βPPA or between fellow eyes with asymmetric βPPA. (Source: American Journal of Ophthalmology)

Micrometer-Scale Contact Lens Movements Imaged by Ultrahigh-resolution Optical Coherence Tomography

American Journal of Ophthalmology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusions: Ultrahigh-resolution and ultralong-scan-depth OCT can assess micrometer-scale lens movements and ocular surface contours. Both lens design and ocular surface shape affected lens movements. (Source: American Journal of Ophthalmology)

Clinical Significance of Microbial Growth on the Surfaces of Silicone Tubes Removed From Dacryocystorhinostomy Patients

American Journal of Ophthalmology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusions: Various bacterial species were cultured from removed silicone tubes. Although many of them were normal flora, P. aeruginosa infection showed significant relation with membranous obstruction of nasal mucosa, prolonged silicone intubation, and surgical failure. (Source: American Journal of Ophthalmology)

Autofluorescence Imaging and Spectral-Domain Optical Coherence Tomography in Incomplete Congenital Stationary Night Blindness and Comparison With Retinitis Pigmentosa

American Journal of Ophthalmology — Wed, 14 Sep 2011 04:00:00 +0100

Conclusions: CSNB2 patients (X-linked recessive and autosomal recessive) had significantly thinner retinas than myopic controls. However, they demonstrated qualitatively normal SD OCT and FAF images, and therefore can be differentiated from RP patients with these techniques. Although ERG testing remains the gold standard for the diagnosis of these conditions, FAF and SD OCT systems are more widely available to community ophthalmologists, offer shorter acquisition times, and, unlike ERG, can be performed on the same day as the initial clinic visit. Therefore, as a supplement to ERG and genetic testing, we advocate the use of FAF and SD OCT in the examination of patients with CSNB2 and RP. (Source: American Journal of Ophthalmology)

Endogenous Fungal Endophthalmitis: Causative Organisms, Management Strategies, and Visual Acuity Outcomes

American Journal of Ophthalmology — Tue, 13 Sep 2011 04:00:00 +0100

Conclusions: Yeasts were the most common cause of culture-proven unilateral or bilateral endogenous fungal endophthalmitis. Endogenous fungal endophthalmitis generally is associated with poor visual acuity outcomes, especially when caused by molds. Retinal detachment is a frequent occurrence during follow-up. (Source: American Journal of Ophthalmology)

Revisiting Diabetes 2000: Challenges in Establishing Nationwide Diabetic Retinopathy Prevention Programs

American Journal of Ophthalmology — Tue, 13 Sep 2011 04:00:00 +0100

Conclusions: Despite recent efforts to educate both patients and physicians alike about the importance of routine DR screening, the lessons learned from the Diabetes 2000 program illustrate the need for new strategies capable of improving accessibility to high-quality eye care, increasing involvement of primary care physicians in DR screening and encouraging at-risk individuals to seek testing. (Source: American Journal of Ophthalmology)

Retinal Arteriolar Tortuosity is Associated With Retinopathy and Early Kidney Dysfunction in Type 1 Diabetes

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: Greater retinal arteriolar tortuosity was independently associated with retinopathy and early stage of nephropathy in type 1 diabetes. These findings may offer the potential of quantitative measurement of retinal vessel tortuosity for diabetic complication risk assessment. (Source: American Journal of Ophthalmology)

A Free Retinal Pigment Epithelium–Choroid Graft in Patients With Exudative Age-Related Macular Degeneration: Results up to 7 Years

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: RPE-choroid graft transplantation may maintain macular function for up to 7 years after surgery, with relatively low complication and recurrence rates. Retinal sensitivity, BCVA data, and fixation on the graft suggest that the graft, rather than simply the removal of submacular hemorrhage and/or choroidal neovascular membrane, was responsible for the preservation of macular function. This surgery may be an alternative for patients with AMD who cannot undergo other standard treatment. (Source: American Journal of Ophthalmology)

The Diversity of Traction Mechanisms in Myopic Traction Maculopathy

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: The traction mechanisms causing myopic traction maculopathy are diverse. Vitreoretinal surgical repair for this condition is successful when the major traction mechanisms causing tautness of the inner retina are identified and relieved. (Source: American Journal of Ophthalmology)

Treatment of Polypoidal Choroidal Vasculopathy With Photodynamic Therapy Combined With Intravitreal Injections of Ranibizumab

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: PDT combined with ranibizumab led to significant visual recovery in treatment-naïve eyes with PCV, but not in eyes with PCV that had demonstrated recurrence after previous PDT. PDT in combination with ranibizumab still has a risk of the postoperative hemorrhagic complications. (Source: American Journal of Ophthalmology)

Viscocannula-Assisted Reinversion of Implantable Collamer Lens: Comparison of Postoperative Outcomes With the Fellow Eyes

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusion: Intraoperative inversion can occur during insertion of ICL and viscocannula-assisted reinversion can be performed without significant complications. (Source: American Journal of Ophthalmology)

Repeatability and Reproducibility of Biometry and Keratometry Measurements Using a Noncontact Optical Low-Coherence Reflectometer and Keratometer

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: The precision of the measurements obtained by the new optical reflectometer and keratometer is extremely high. (Source: American Journal of Ophthalmology)

A Prospective Study Comparing EndoGlide and Busin Glide Insertion Techniques in Descemet Stripping Endothelial Keratoplasty

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: In conclusion, the new EndoGlide results in significantly less endothelial cell loss than Busin glide donor insertion in DSEK. The visual outcomes and refractive changes were similar in both groups. (Source: American Journal of Ophthalmology)

Organization of the Regenerated Nerves in Human Corneal Grafts

American Journal of Ophthalmology — Mon, 12 Sep 2011 04:00:00 +0100

Conclusions: A persistent anatomic disorganization of the corneal nerves in human grafts was found even 14 years after surgery. This could explain the significant reduction of corneal sensation reported in previous studies. (Source: American Journal of Ophthalmology)

Evaluation of New and Established Age-Related Macular Degeneration Susceptibility Genes in the Women's Health Initiative Sight Exam (WHI-SE) Study

American Journal of Ophthalmology — Fri, 09 Sep 2011 04:00:00 +0100

Conclusion: In this unique national cohort of women, we found associations with established AMD-related genetic factors and the recently reported LIPC gene in the HDL pathway. These findings may help develop novel therapeutic targets to treat or delay the onset of the disease. (Source: American Journal of Ophthalmology)

Significant Correlation Between Visual Acuity and Recovery of Foveal Cone Microstructures After Macular Hole Surgery

American Journal of Ophthalmology — Tue, 30 Aug 2011 04:00:00 +0100

Conclusions: The significant correlation between the BCVA and a distinct or irregular COST line after successful macular hole surgery indicates that the recovery of foveal cone microstructure is associated with good postoperative BCVA. (Source: American Journal of Ophthalmology)

Clinical Features of Congenital Retinal Folds

American Journal of Ophthalmology — Fri, 26 Aug 2011 04:00:00 +0100

Conclusions: These clinical features suggested that most congenital retinal folds may result from insufficient retinal vascular development, as in familial exudative vitreoretinopathy, rather than persistent fetal vasculature. Adequate management of active retinopathy and late-onset complications, especially retinal detachment, is required. (Source: American Journal of Ophthalmology)

Ocular Surface Disease and Quality of Life in Patients With Glaucoma

American Journal of Ophthalmology — Fri, 26 Aug 2011 04:00:00 +0100

Conclusions: OSD is more common in patients with increasing glaucoma severity and is associated with poorer glaucoma-related QoL and higher exposure to BAK. (Source: American Journal of Ophthalmology)

Behçet Disease: Visual Prognosis and Factors Influencing the Development of Visual Loss

American Journal of Ophthalmology — Fri, 26 Aug 2011 04:00:00 +0100

Conclusions: Many patients with ocular Behçet disease still have irreversible visual loss at presentation. However, the visual prognosis is otherwise improved, with a 10-year risk of severe visual loss of 13% in this cohort. The use of biologic agents is associated with a lower risk of severe visual loss at 5 and 10 years. (Source: American Journal of Ophthalmology)

The Effect of Iris-Fixated Foldable Phakic Intraocular Lenses on Retinal Straylight

American Journal of Ophthalmology — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: Retinal straylight was reduced significantly after Artiflex pIOL implantation. Besides age, axial length was the only predictor of preoperative and postoperative straylight values. The increased tissue length light has to pass from cornea to retina, might explain the increase in straylight values in longer eyes. (Source: American Journal of Ophthalmology)

Laser-Assisted In Situ Keratomileusis in High Levels of Myopia With the Amaris Excimer Laser Using Optimized Aspherical Profiles

American Journal of Ophthalmology — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: LASIK for high myopia using optimized aspherical profiles and the Amaris excimer laser is a safe, effective, and predictable procedure. (Source: American Journal of Ophthalmology)

Assessment of Corneal Thickness and Keratocyte Density in a Rabbit Model of Laser In Situ Keratomileusis Using Scanning Laser Confocal Microscopy

American Journal of Ophthalmology — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: There was excellent agreement between ultrasonic and confocal microscopy measurements of corneal thickness. In vivo repeatability of keratocyte density estimation using scanning laser confocal microscopy is comparable with the results of previous reports using tandem-scanning confocal microscopy. Keratocyte density was more varied, but not significantly different, in the anterior-most corneal stroma 6 weeks after a lamellar incision. (Source: American Journal of Ophthalmology)

The Impact of Contact Lens Wear and Visual Display Terminal Work on Ocular Surface and Tear Functions in Office Workers

American Journal of Ophthalmology — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: Office workers who wore CLs and spent more than 4 hours engaged in VDT work had a lower tear meniscus volume with significant dry eye and visual symptoms triggered by environmental factors. (Source: American Journal of Ophthalmology)

Lamellar Keratoplasty and Keratolimbal Allograft for Mustard Gas Keratitis

American Journal of Ophthalmology — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: LKP is an effective method of corneal transplantation in mustard gas victims. When stem cell and corneal transplantation are indicated, the simultaneous approach can yield better results than staged intervention. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:44:00 +0100

(Source: American Journal of Ophthalmology)

Correction

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:44:00 +0100

The Multicenter Uveitis Steroid Treatment Trial Research Group. The Multicenter Uveitis Steroid Treatment Trial: Rationale, Design, and Baseline Characteristics. Am J Ophthalmol 2010;149(4):550–561. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Wed, 24 Aug 2011 19:44:00 +0100

We appreciate the interest by Chang and associates about our recent article published in the journal. The authors also highlight the results of their study. While both studies share the same goal of improving our understanding of optic pathway glioma (OPG) in children, the primary outcome measures and interpretations differed between studies. (Source: American Journal of Ophthalmology)

Retinal Nerve Fiber Layer Thickness in Children With Optic Pathway Gliomas

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:59 +0100

We read with great interest the article by Avery and associates published in the March 2011 issue of the journal. Their well-done prospective optical coherence tomography (OCT) study demonstrated that a decrease in retinal nerve fiber layer (RNFL) thickness was associated with decreased visual acuity in children with optic pathway gliomas (OPGs). We would like to draw your attention to our pilot study on the same subject, published in the December 2010 issue of the Journal of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) and accompanied by an editorial. Our research was also presented at the annual AAPOS meeting in April 2010. The goal of our study was to examine the utility of OCT in the evaluation of neurofibromatosis type 1 (NF-1) subjects with and withou...

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American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:59 +0100

I am happy to respond to Dr Rao regarding our publication. We defined the surgical failure as an intraocular pressure (IOP) of 21 mm Hg or more (criterion A) and an IOP of 18 mm Hg or more (criterion B) with or without medications, which means qualified successes. Because the level at which postoperative IOP medication should be started depends largely on the surgeon, we did not evaluate the complete successes in this study. Although we do not have enough data about the comparison of the complete successes between trabeculotomy versus trabeculectomy, we had collected data regarding the numbers of postoperative medications at 1, 2, 3, 4, and 5 years after the surgery. The mean ± standard deviation numbers of postoperative medications in eyes with steroid-induced glaucoma that underwent tra...

Success Rates of Trabeculotomy for Steroid-Induced Glaucoma: A Comparative, Multicenter, Retrospective Cohort Study

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:59 +0100

It is with great interest that I read the article by Iwao and associates on the success of trabeculotomy in steroid glaucoma. There has been a long-felt need for studies looking at alternatives to trabeculectomy in glaucoma that can minimize surgical complications while providing adequate long-term intraocular pressure (IOP) control. So this multicenter study assumes great importance since it tries to rigorously address the issue of trabeculotomy vs trabeculectomy in steroid glaucoma. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:59 +0100

I am happy to respond to Drs Wei and Razeghinejad regarding our publication. Our data demonstrated that trabeculotomy was significantly more effective for steroid-induced glaucoma than for primary open-angle glaucoma. In the steroid-induced glaucoma group, the surgical success of trabeculotomy was comparable with that of the trabeculectomy group for criterion A (intraocular pressure [IOP] < 21 mm Hg), but was worse than that of trabeculectomy for criterion B (IOP < 18 mm Hg). We did not state that the outcome was better for trabeculotomy than for trabeculectomy in the steroid-induced glaucoma group. (Source: American Journal of Ophthalmology)

Success Rates of Trabeculotomy for Steroid-Induced Glaucoma: A Comparative, Multicenter, Retrospective Cohort Study

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:59 +0100

We read with interest the Iwao and associates' article about steroid-induced glaucoma. The authors stated that the results after trabeculotomy were better than those after trabeculectomy in the steroid-induced glaucoma group. There are some points which need to be addressed. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:58 +0100

We thank Prof Gonzales de la Rosa for the comments regarding our paper. Agreement on issues among different laboratories can sometimes be problematic. When reputable laboratories disagree, it is usually not because one is right and the other is wrong. Rather, it is because there are differences in the manner in which each group views the problem, how they interpret the items under investigation, their prior experience, and the results of other investigators. We believe that our system of evaluating the merit and validity of scientific and clinical research is fair and provides the best current method of determining whether a research project is worthy of publication or not. Additionally, we believe in other factors in conducting research: 1) results by the inventor are usually better than ...

Pulsar Perimetry in the Diagnosis of Early Glaucoma

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:58 +0100

In a recently published article, Zeppieri and associates affirm that Pulsar perimetry shows lower sensitivity than other procedures for the diagnosis of glaucoma in cases where morphologic defect precedes functional defect (glaucomatous optic neuropathy; GON). However, the optic nerve head size of patients in the GON group is clearly larger (2.13 ± 0.46 mm2) than that of normal reference subjects (1.81 ± 0.51 mm2), which raises the suspicion that many patients in the GON group were not in fact glaucomatous. (Source: American Journal of Ophthalmology)

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American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:58 +0100

We appreciate the interest of Dr Sakurada and assoicates in our article. Our study was a screening study for genes significantly associated with age-related macular degeneration (AMD). As Drs Sakurada and Iijima stated, there have been several reports suggesting that pseudoexfoliation syndrome (XFS) could be one of the risk factors for AMD. However, the small sample of our study was a limitation, and we could not exclude the possibility of false positives. (Source: American Journal of Ophthalmology)

Polymorphisms in ARMS2 (LOC387715) and LOXL1 Genes in the Japanese With Age-Related Macular Degeneration

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:57 +0100

We read the article by Fuse and associates with great interest. In their report, a variant (rs1048661, G allele) of lysyl oxidase–like 1 (LOXL1) gene was associated with exudative age-related macular degeneration (AMD), but not with polypoidal choroidal vasculopathy (PCV). The LOXL1 polymorphisms (rs1048661:758G/T and rs3825942:794G/A) have been reported to be associated with pseudoexfoliation syndrome (XFS) through a genome-wide scanning study. However, there have been few reports suggesting that XFS could be one of the risk factors for AMD. (Source: American Journal of Ophthalmology)

Reporting Visual Acuities

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:54 +0100

Intraocular Pressure: Modulation as Treatment for Glaucoma

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:48 +0100

Conclusions: Practitioners should consider whether patients who are progressing at low mean IOP may benefit from having IOP variation reduced. Single elevated measures of IOP may not be an anomaly or may not be related to compliance, but may identify patients who are at high risk for progressive glaucomatous damage, and thus should be monitored more carefully and potentially treated more aggressively. (Source: American Journal of Ophthalmology)

Emerging Evidence Concerning Systemic Safety of Anti-VEGF Agents – Should Ophthalmologists Be Concerned?

American Journal of Ophthalmology — Wed, 24 Aug 2011 19:43:48 +0100

Intraocular injections of anti–vascular endothelial growth factor (VEGF) agents have yielded dramatic improvements in the management of a wide variety of neovascular ocular diseases including age-related macular degeneration (AMD), diabetic retinopathy (DR), retinal vein occlusion, and now even retinopathy of prematurity. These agents have thus become one of the most commonly employed treatments, with 824 525 anti-VEGF intraocular injections given in 2008 in the United States. There are currently 2 widely used agents: ranibizumab (Lucentis), which is FDA-approved, and bevacizumab (Avastin), given off-label. Despite its off-label status, a majority of the intravitreal anti-VEGF injections given in the United States and around the world are for bevacizumab, accounting for 58% of all inject...

Keratocyte Density 3 Months, 15 Months, and 3 Years After Corneal Surface Ablation With Mitomycin C

American Journal of Ophthalmology — Tue, 23 Aug 2011 04:00:00 +0100

Conclusion: Our study suggests that there is a reorganization of the stromal cell population soon after surface ablation with MMC, with a decrease in the stromal bed compensated initially with an increase in the mid and posterior stroma. Corneal cellularity tends to normalize over time, and 3 years postoperatively the mean cell density throughout the cornea seems to maintain normal values. (Source: American Journal of Ophthalmology)

American Journal of Ophthalmology via MedWorm.com

Contents

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Natural Course of Adult-Onset Foveomacular Vitelliform Dystrophy: A Spectral-Domain Optical Coherence Tomography Analysis

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Possible Short-term Changes of Aqueous Inflammatory Cytokines After Intravitreal Bevacizumab for Diabetic Macular Edema

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Oral Mucosal Graft to Correct Lid Margin Pathologic Features in Cicatricial Ocular Surface Diseases

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Use of Infliximab in the Treatment of Peripheral Ulcerative Keratitis in Crohn Disease

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Corneal Thickness Change in Eyes Undergoing Corneal Cross-Linking

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Blindness and Long-term Progression of Visual Field Defects in Chinese Patients With Primary Angle-Closure Glaucoma

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Quality of Life in a German Graves Orbitopathy Population

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In Vivo Analysis of Stromal Integration of Multilayer Amniotic Membrane Transplantation in Corneal Ulcers

Reporting Visual Acuities

Time Trends in the Incidence and Causes of Blindness in Israel

Incidence of Legal Blindness From Age-Related Macular Degeneration in Denmark: Year 2000 to 2010

An Outbreak of Streptococcus Endophthalmitis After Intravitreal Injection of Bevacizumab

Avastin Doesn't Blind People, People Blind People

Changing Trends of Blindness: The Initial Harvest From Translational Public Health and Clinical Research in Ophthalmology

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Announcement

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Clinical Significance of Microbial Growth on the Surfaces of Silicone Tubes Removed From Dacryocystorhinostomy Patients

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Risk Factors for Development of Choroidal Detachment After Scleral Buckling Procedure

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Facial Nerve Injury: A Complication of Superficial Temporal Artery Biopsy

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Hemorrhage With Anticoagulants and Antiplatelets in Vitreoretinal Surgery

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Spontaneous Reattachment of Descemet Stripping Automated Endothelial Keratoplasty Lenticles

Reporting Visual Acuities

Contents

Radiology of the Orbit and Visual Pathways

Cataract Surgery, 3rd Edition

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Long-term Change in Corneal Astigmatism after Sutureless Cataract Surgery

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Collagen Cross-Linking with Riboflavin in a Femtosecond Laser–Created Pocket in Rabbit Corneas

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Graft Rejection and Graft Failure After Anterior Lamellar Versus Penetrating Keratoplasty

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Helicobacter pylori Infection as a Risk Factor for Both Primary Open-Angle Glaucoma and Pseudoexfoliative Glaucoma in Thessaloniki Eye Study

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Long-term Complications Associated with Glaucoma Drainage Devices and Boston Keratoprosthesis

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Safety of Vitrectomy for Floaters

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Learning Effect in Perimetry: The Role of Chromatic Discrimination

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Central Macular Splaying and Outer Retinal Thinning in Asymptomatic Sickle Cell Patients by Spectral-Domain Optical Coherence Tomography

Reporting Visual Acuities

AJO History of Ophthalmology Series: Lewis Carroll and Asymmetry

Tear Dysfunction and the Cornea: LXVIII Edward Jackson Memorial Lecture

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Miami to Japan Eye-Care Rescue Mission: Vision Van Helps with Relief Efforts

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Restoration of Foveal Microstructure After Macular Hole Surgery Accompanied by Change in Foveal Contour?

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Long-term Complications Associated With Glaucoma Drainage Devices and Boston Keratoprosthesis

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Orbital and Adnexal Involvement in Sarcoidosis: Analysis of Clinical Features and Systemic Disease in 30 Cases

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Biomechanical Analysis of X-Pattern Exotropia

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The Rate of Progression and Ocular Perfusion Pressure in the Low-Pressure Glaucoma Treatment Study

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Long-term Development of Significant Visual Field Defects in Highly Myopic Eyes

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A Randomized Trial of Brimonidine Versus Timolol in Preserving Visual Function: Results From the Low-pressure Glaucoma Treatment Study

Reporting Visual Acuities

AJO History of Ophthalmology Series: Antarctic Eye Surgery

Biopsy of Iris Tumors

Prophylaxis for Endophthalmitis Following Intravitreal Injection: Antisepsis and Antibiotics