Outcomes of 23- and 25-gauge transconjunctival sutureless vitrectomies for dislocated intraocular lenses

Purpose

To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs).

Design

Retrospective, non-consecutive, comparative, interventional case series.

Participants

Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments.

Methods

The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued.

Results

Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9).

Conclusions

25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.

     

Changes in intraocular pressure during cardiopulmonary bypass

Purpose

The aim of the present study was to investigate the changes in intraocular pressures (IOP) in patients who underwent pulsatile and non-pulsatile cardiopulmonary bypass (CPB).

Methods

A total of 42 patients operated for elective coronary bypass surgery (CABG) on CPB were randomly allocated to pulsatile (Group P) and non-pulsatile (Group N) groups. Pulsatile flow was applied to Group P patients during crops-clamp period. The IOP measurements were made before and after the induction of anesthesia, before the onset of CPB, on the 5th, 15th, 30th, 45th, and 60th min of CPB, after CPB and at the end of the operation. The results of repetitive measurements were analyzed at different intervals and in two groups.

Results

The second IOP measurements of right and left eyes displayed statistically significant decreases from the baseline level [11.9 ± 2.9 (p = 0.0001) and 12.5 ± 3.2 (p = 0.0001), respectively]. The significant decrease in the IOP values persisted in the repeated measurements except for the 5th min of CPB values [17.0 ± 3.5 (p = 0.346) and 16.7 ± 3.6 (p = 0.399)]. Comparison of two groups demonstrated significant differences at pre-CPB (right 12.8 ± 2.3 vs. 10.8 ± 2.4; p = 0.013 and left 13.3 ± 2.4 vs. 11.5 ± 2.5; p = 0.023), and 5th min of CPB measurements (right 18.5 ± 3.1 vs. 15.9 ± 3.4; p = 0.015; left 18.2 ± 3.0 vs. 15.7 ± 3.6; p = 0.019).

Conclusion

We noted a steady decrease in repeated IOP measurements except for the transient increase in CPB values on 5th min. The IOP values were higher in pulsatile CPB group in pre-CPB and 5th min of CPB measurements; however, the difference was not significant in the repeated measurements.

     

Visual consequences of electronic reader use: a pilot study

Background

With the increasing prevalence of electronic readers (e-readers) for vocational and professional uses, it is important to discover if there are visual consequences in the use of these products. There are no studies in the literature quantifying the incidence or severity of eyestrain, nor are there clinical characteristics that may predispose to these symptoms with e-reader use.

Purpose

The primary objective of this pilot study was to assess the degree of eyestrain associated with e-reader use compared to traditional paper format. The secondary outcomes of this study were to assess the rate of eyestrain associated with e-reader use and identify any clinical characteristics that may be associated with the development of eyestrain.

Methods

Forty-four students were randomly assigned to study (e-reader iPAD) and control (print) groups. Participant posture, luminosity of the room, and reading distance from reading device were measured during a 1-h session for both groups. At the end of the session, questionnaires were administered to determine symptoms.

Results

Significantly higher rates of eyestrain (p = 0.008) and irritation (p = 0.011) were found among the iPAD study group as compared to the print ‘control’ group. The study group was also 4.9 times more likely to report severe eyestrain (95 % CI [1.4, 16.9]). No clinical characteristics predisposing to eyestrain could be identified.

Conclusions

These findings conclude that reading on e-readers may induce increased levels of irritation and eyestrain. Predisposing factors, etiology, and potential remedial interventions remain to be determined.

     

The association of <Emphasis Type="Italic">Helicobacter pylori</Emphasis> with choroidal and retinal nerve fiber layer thickness

Purpose

To investigate the effect of Helicobacter pylori (H. pylori) infection on choroidal thickness (CT) and retinal nerve fiber layer thickness (RNFLT).

Methods

The study included 25 patients with H. pylori infection and 25 healthy individuals as the control group. Helicobacter pylori patients were classified as the pre-treatment (Group 1; n: 25) and the post-treatment (Group 2; n: 25). RNFLT and CT were measured before and after treatment of H. pylori infection, using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The axial length and intraocular pressure were also measured.

Results

The mean subfoveal CT was 320.96 ± 29.15 μm in Group 1 and 287.48 ± 49.17 in the control group (p = 0.007), while the mean subfoveal CT did not show any difference between Group 2 and the control group (p > 0.05). No statistically significant difference was determined between the H. pylori patients and the control group in respect of RNFLT values (p > 0.05).

Conclusions

CT increases during H. pylori infection and returns to the normal range within 6 weeks of treatment. RNFLT does not show any change during H. pylori infection. The data related to the subfoveal CT may be useful in understanding the pathogenesis of central serous chorioretinopathy developing in H. pylori patients.

     

Evaluation of the effect of daily activities on intraocular pressure in healthy people: is the 20 mmHg border safe?

Purpose

The aim of this prospective study was to evaluate the intraocular pressure (IOP) variations during daily activities such as reading, speaking and carrying in regard to investigating whether an elevation or decrease exists.

Subjects and methods

Forty-four eyes of 44 healthy subjects were evaluated. The IOP was measured in relaxation and after reading, speaking and carrying a shopping bag for 5 min on different days, respectively. The subjects rested for 15 min between the activities. Mean initial IOP levels were compared with mean IOP levels after reading, speaking and carrying a shopping bag with paired t test. A p value of 0.05 was considered as statistically significant.

Results

We observed no changes in mean IOP after reading (p = 0.188). Mean IOP was increased after speaking and carrying compared with mean basic IOP (p = 0.001 and p = 0.001, very significant, respectively). The mean IOP began to decrease 15 min after speaking and carrying and came back to the baseline values one hour later.

Conclusions

The IOP is not stable during daily activities. Simple actions such as carrying or speaking have an increasing effect on IOP. This should be taken into consideration in glaucoma patients during control measurements, especially in patients in whom the IOP was near to the 20 mmHg border.

     

Outcomes of Ahmed glaucoma valve implantation for steroid-induced elevated intraocular pressure in patients with retinitis pigmentosa

Purpose

To evaluate the outcomes of Ahmed glaucoma valve (AGV) in the management of elevated intraocular pressure (IOP) secondary to steroid use for macular edema in patients with retinitis pigmentosa (RP).

Methods

A total of nine eyes of five patients were evaluated retrospectively. Complete success was defined as IOP ≤ 21 mmHg without glaucoma medications, while qualified success was defined as IOP ≤ 21 mmHg with glaucoma medications.

Results

Mean age at surgery was 25.0 ± 8.3 years, and mean follow-up time was 38.4 ± 13.2 months. Mean IOP was 41.0 ± 8.3 mmHg preoperatively, 9.4 ± 3.5 mmHg at first week (p = 0.008), 13.1 ± 3.6 mmHg at first month (p = 0.008), 14.8 ± 4.1 mmHg at 6th month (p = 0.008), 11.7 ± 2.6 mmHg at 12th month (p = 0.008), 12.4 ± 2.9 mmHg at 24th month (p = 0.008), 12.6 ± 3.6 mmHg at 36th month (p = 0.043) and 12.8 ± 4.2 mmHg at 48th month (p = 0.068) postoperatively. The mean number of topical anti-glaucomatous medications decreased from 2.8 ± 0.4 preoperatively to 0.4 ± 0.9 postoperatively (p = 0.007). Complete success was obtained in 7 (77%) eyes, and qualified success in 2 (23%) eyes. No failure was detected.

Conclusions

AGV implantation can be considered as an alternative and safe option in the management of resistant, elevated IOP secondary to steroid treatment for macular edema in patients with RP.

     

Assessing posterior ocular structures in β-thalassemia minor

Purpose

The aim of this study was to investigate the effect of β-thalassemia minor on choroidal, macular, and peripapillary retinal nerve fiber layer thickness.

Methods

To form the sample, we recruited 40 patients with β-thalassemia minor and 44 healthy participants. We used spectral-domain optical coherence tomography to take all measurements of ocular thickness, as well as measured intraocular pressure, axial length, and central corneal thickness. We later analyzed correlations of hemoglobin levels with ocular parameters.

Results

A statistically significant difference emerged between patients with β-thalassemia minor and the healthy controls in terms of mean values of subfoveal, nasal, and temporal choroidal thickness (p = 0.001, p = 0.016, and p = 0.010, respectively). Except for central macular thickness, differences in paracentral macular thicknesses between the groups were also significant (superior: p < 0.001, inferior: p = 0.007, temporal: p = 0.001, and nasal: p = 0.005). Also, no statistically significant differences were noted for retinal nerve fiber layer thickness between two groups.

Conclusion

Mean values of subfoveal, nasal, temporal choroidal, and macular thickness for the four quadrants were significantly lower in patients with β-thalassemia minor than in healthy controls.

     

Isoflurane and ketamine:xylazine differentially affect intraocular pressure-associated scotopic threshold responses in Sprague-Dawley rats

Purpose

Amplitudes of electroretinograms (ERG) are enhanced during acute, moderate elevation of intraocular pressure (IOP) in rats anaesthetised with isoflurane. As anaesthetics alone are known to affect ERG amplitudes, the present study compares the effects of inhalant isoflurane and injected ketamine:xylazine on the scotopic threshold response (STR) in rats with moderate IOP elevation.

Methods

Isoflurane-anaesthetised (n = 9) and ketamine:xylazine-anaesthetised (n = 6) rats underwent acute unilateral IOP elevation using a vascular loop anterior to the equator of the right eye. STRs to a luminance series (subthreshold to ?3.04 log scotopic cd s/m²) were recorded from each eye of Sprague-Dawley rats before, during, and after IOP elevation.

Results

Positive STR (pSTR) amplitudes for all conditions were significantly smaller (p = 0.0001) for isoflurane- than for ketamine:xylazine-anaesthetised rats. In addition, ketamine:xylazine was associated with a progressive increase in pSTR amplitudes over time (p = 0.0028). IOP elevation was associated with an increase in pSTR amplitude (both anaesthetics p < 0.0001). The absolute interocular differences in IOP-associated enhancement of pSTR amplitudes for ketamine:xylazine and isoflurane were similar (66.3 ± 35.5 vs. 54.2 ± 24.1 µV, respectively). However, the fold increase in amplitude during IOP elevation was significantly higher in the isoflurane- than in the ketamine:xylazine-anaesthetised rats (16.8 ± 29.7x vs. 2.1 ± 2.7x, respectively, p = 0.0004).

Conclusions

The anaesthetics differentially affect the STRs in the rat model with markedly reduced amplitudes with isoflurane compared to ketamine:xylazine. However, the IOP-associated enhancement is of similar absolute magnitude for the two anaesthetics, suggesting that IOP stress and anaesthetic effects operate on separate retinal mechanisms.

     

Alterations in corneal epithelial thickness in patients with congenital myogenic eyelid ptosis

Purpose

To evaluate whether the corneal epithelial thickness (CET) maps obtained by optical coherence tomography (OCT) of the congenital myogenic eyelid ptosis differ from controls.

Methods

CET maps of 13 patients with congenital myogenic eyelid ptosis (m/f = 9/4; mean age 20.5 ± 7.5) and randomly selected one eye of 13 controls (m/f = 7/6; mean age 21.5 ± 6.5) were investigated. Three pachymetry scans of each eye were performed by OCT (RTVue-XR, Optovue Inc., USA), and the scan with the highest signal strength index was selected for the analysis.

Results

In ptosis group: Minimum corneal epithelial thickness was thinner (p = 0.029), standard deviation of thickness was higher (p = 0.039), the negative of min–max values were higher (p = 0.007). This difference was originating from the significant thinness of the superior sectors (S, SN, ST) of the corneal epithelium than the inferior counterparts (I, IT, IN) (p = 0.001, p = 0.017, p = 0.002), respectively. There was no difference regarding total corneal thickness measurements.

Conclusions

The mechanic effects of ptotic eyelid to the ocular surface may reshape the corneal epithelium, which can be objectively detected by OCT.

     

Evaluation of optic disc,retinal nerve fiber and macular ganglion cell layers in pediatric diabetes

Purpose

Our aim was to compare optic disc parameters, retinal nerve fiber (RNFL) and macular ganglion cell layers between children and adolescents with diabetes mellitus (type 1) and healthy controls.

Methods

Sixty-three eyes of 63 pediatric diabetic patients without diabetic retinopathy and 44 eyes of 44 healthy controls were included in this cross-sectional and comparative study. Diabetic and control groups were similar in the aspect of age, gender and refractive error. Measurements of optic disc parameters (i.e., rim area, disc area, cup-to-disc ratio, cup volume), thickness of RNFL and macular ganglion cell—inner plexiform layers (GCL + IPL) were taken with the spectral domain optical coherence tomography.

Results

There were not statistically significant differences between the diabetic patients and healthy controls in terms of intraocular pressure (p = 0.14), retinal nerve fiber layer thickness (p = 0.61), rim area (p = 0.92), disc area (p = 0.10), vertical cup-to-disc ratio (p = 0.16), cup volume (p = 0.13), and average macular GCL + IPL thickness (p = 0.43). On the other hand, binocular RNFL thickness symmetry percentage was statistically significantly different in the diabetic and control groups (p = 0.01).

Conclusion

Diabetic children and adolescents without diabetic retinopathy have more binocular RNFL thickness asymmetry compared to healthy controls.

     

Topical nonsteroidal anti-inflammatory drugs as adjuvant therapy in the prevention of macular edema after cataract surgery

Purpose

The purpose of the study was to assess adjuvant treatment with topical nonsteroidal anti-inflammatory drugs (NSAIDs) (0.9 % bromfenac, 0.1 % nepafenac, 0.5 % indomethacin, or 0.1 % diclofenac) in addition to topical steroidal treatment with 0.1 % dexamethasone and 0.3 % netilmicin for prevention of cystoid macular edema (CME) after uneventful small incision cataract extraction with foldable intraocular lens (IOL) implantation.

Setting

Institute of Ophthalmology, Department of Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Aldo Moro University, Policlinico Consorziale di Bari, Bari, Italy.

Design

A retrospective 6-month single center study.

Methods

Patients were divided into groups according to treatment with topical drugs for 2 weeks, after phacoemulsification with foldable IOL implantation. CME incidence was evaluated by assessing retinal foveal thickness changes using spectral domain optical coherence tomography. All patients were treated with a fixed combination of dexamethasone and netilmicin, and some patients were additionally treated with NSAIDs (bromfenac, nepafenac, indomethacin, or diclofenac).

Results

Fourteen patients were treated with bromfenac, 15 with nepafenac, 12 with indomethacin, and 14 with diclofenac; ten patients were treated with dexamethasone and netilmicin alone. At the end of the follow-up, macular thickness, evaluated at 1-week post-surgery, was reduced only in the group treated with nepafenac (?1.3 %, p = 0.048), was increased in the group treated with dexamethasone and netilmicin alone (+4.3 %, p = 0.04), and did not change in the groups treated with bromfenac (?1.1 %, p = 0.3), indomethacin (+0.1 %, p = 0.19), or diclofenac (+1.2 %, p = 0.74). There were no side effects in any group.

Conclusions

Topical treatment with nepafenac, bromfenac, and indomethacin enhanced the efficacy of steroids to reduce postoperative macular edema. Diclofenac did not improve steroids efficacy.

     

Relationship between intraocular pressure,anterior chamber depth and lens thickness in primary open-angle glaucoma patients

Introduction

To investigate the relationship between intraocular pressure (IOP), anterior chamber depth (ACD) and lens thickness (LT) in primary open-angle glaucoma (POAG) patients and compare with age- and sex-matched controls.

Methods

A cross-sectional analytical study of 62 newly diagnosed POAG patients compared with 62 age- and sex-matched control subjects in a tertiary eye clinic. Socio-demographic data and ocular examinations were documented. IOP was measured using the Goldmann applanation tonometer. LT and ACD were measured using A-scan ultrasonography and the IOLMaster, respectively. Data were analyzed using SPSS version 19.0 and level of significance set at p value <0.05.

Results

In the glaucoma group and control groups, respectively, mean age was 60.3 ± 8.9 and 58.5 ± 8.1 years (p = 0.234), mean IOP was 28.27 ± 7.88 and 14.47 ± 2.60 mmHg (p < 0.001), mean ACD was 3.12 ± 0.27 and 3.15 ± 0.24 mm (p = 0.514), mean LT was 4.24 ± 0.46 and 4.23 ± 0.45 mm (p = 0.903), and mean ACD was shallower in females (p = 0.034) and (p = 0.001). In the glaucoma group, there was a positive correlation between IOP and ACD (r = 0.022, p = 0.864), but a negative correlation between IOP and LT (r = ?0.04, p = 0.758) and ACD and LT (r = ?0.058, p = 0.657). In the control group, there was a positive correlation between IOP and ACD (r = 0.141, p = 0.275), IOP and LT (r = 0.031, p = 0.811) and ACD and LT (r = 0.016, p = 0.901).

Conclusion

ACD is shallower in females. There is no significant correlation between IOP and ACD or between IOP and LT in POAG as well as normal individuals.

     

<Emphasis Type="Italic">MTHFR</Emphasis> and <Emphasis Type="Italic">MTHFD1</Emphasis> gene polymorphisms are not associated with pseudoexfoliation syndrome in South Indian population

Purpose

Pseudoexfoliation syndrome (PEX) is a late onset disorder of extracellular matrix turnover, associated systemically with cardiovascular and cerebrovascular disease. To evaluate the suggested association of polymorphisms of homocysteine metabolism genes MTHFR (rs1801131, rs1801133) and MTHFD1 (rs8006686) with PEX.

Methods

A case–control association study was undertaken, comprising a total of 1472 individuals including 860 unrelated PEX cases and 612 ethnic-matched cataract controls (CC). All the study subjects were genotyped for three SNPs using the TaqMan allelic discrimination assay. Association and statistical analysis were performed with PLINK 1.07 and STATA 11.1.

Results

Among the three SNPs genotyped, MTHFR polymorphisms did not exhibit significant association with PEX (rs1801131; p = 0.549, rs1801133; p = 0.408). The intronic SNP rs8006686 showed nearly significant association (p = 0.069), and however did not remain significant after Bonferroni correction.

Conclusion

Our study suggests no significant genetic association of MTHFR (rs1801131, rs1801133) and MTHFD1 (rs8006686) polymorphisms in South Indian PEX patients.

     

Is keratoconus more severe in pediatric population?

Purpose

To compare the ophthalmic parameters and the severity of keratoconus (KC) in pediatrics and adults at the time of initial diagnosis in an Iranian population.

Methods

KC was diagnosed via slit-lamp examination and Pentacam imaging. In a retrospective observational study, consecutive patients were divided into two groups of pediatrics (<18 years old) and adults (>18 years old). Topographic, keratometric, and tomographic parameters, and severity of KC at the time of diagnosis were compared in both groups. Severity of KC was classified according to Amsler–Krumeich classification.

Results

One hundred fifty-eight eyes of 158 pediatric patients and 343 eyes of 343 adults with KC were studied. The mean ages of the pediatric and adult patients were 15 ± 1.9 and 22 ± 1.9 years, respectively (p < 0.001). The results revealed that pediatric patients had significantly higher values of anterior and posterior mean, flat and steep keratometry, astigmatism, and maximum elevation and significantly lower central and thinnest corneal thickness (p < 0.05). No significant difference was found regarding sphere, cylinder, manifest refraction spherical equivalent, and uncorrected and best-spectacle corrected visual acuity between the groups (p > 0.05). Pediatric patients had a significantly more severe KC than adult patients according to Amsler–Krumeich classification (p = 0.001).

Conclusion

Our findings suggest that KC is more severe in pediatrics, hence the fact that they should be closely monitored and intensively treated.

     

Relationships between vitreous levels of soluble receptor for advanced glycation end products (sRAGE) and renal function in patients with diabetic retinopathy

Purpose

We investigated the relationship between vitreous levels of soluble receptor for advanced glycation end products (sRAGE) and vascular endothelial growth factor (VEGF) and renal function, and correlations between vitreous sRAGE levels and proliferative diabetic retinopathy (PDR) activity.

Methods

We examined 33 eyes from 33 patients with diabetes mellitus who underwent a vitrectomy (eight patients in the non-PDR [NPDR] group and 25 in the PDR group). Serum creatinine levels and estimated glomerular filtration rate (eGFR) were measured and classified according to the chronic kidney disease (CKD)-staging method. Enzyme-linked immunosorbent assay (ELISA) was performed to quantify vitreous sRAGE and VEGF levels.

Results

Vitreous sRAGE levels were significantly higher in PDR group compared to NPDR group (p = 0.00003). Vitreous sRAGE levels were significantly higher in patients with CKD stage 5 (end-stage renal failure or hemodialysis) than in patients with CKD stage 1 or 2 (p < 0.01) and 3 or 4 (p < 0.05), and were significantly correlated with eGFR (r = ? 0.490, p = 0.007) and creatinine levels (r = 0.484, p = 0.006). Within the PDR group, patients with low (<27 pg/mL) sRAGE levels required repeat vitreous surgeries for early postoperative vitreous hemorrhage significantly more frequently than those with high (≥27 pg/mL) sRAGE levels (p = 0.0067).

Conclusions

Vitreous sRAGE levels were significantly correlated with renal function, and low vitreous sRAGE levels in patients with PDR were associated with postoperative vitreous hemorrhage. Vitreous sRAGE may be a useful biomarker for renal dysfunction associated with diabetic retinopathy.

     

Effect of nepafenac on the foveal profile of glaucomatous patients undergoing phacoemulsification

Purpose

Retrospective, pilot study to determine whether nepafenac treatment pre- and postcataract surgery in glaucoma patients using topical hypotensive agents minimized cystoid macular edema by comparing pre- and postsurgical foveal characteristics, as in some cases these agents cannot be withdrawn and, hypothetically, their inflammatory effect on the fovea could be neutralized by the addition of nepafenac.

Methods

Patients were divided into two subgroups depending on whether or not topical nepafenac was added to the surgical protocol (NEP = nepafenac group and nNEP = non nepafenac group). All had undergone phacoemulsification and data on pre- and postoperative macular status were recorded.

Results

In the nNEP group, there was a significant increase in foveal thickness (FT) in the first month postoperative visit with respect to the preoperative status (p = 0.006), and this situation did not change at the third postoperative month (p = 0.9411). In the NEP group, the increase in FT was not significant at the first month after surgery (p = 0.056) nor at the final visit (p = 0.268), in contrast to the nNEP group.

Conclusion

This study of the possible prophylactic effect of nepafenac on postoperative macular edema supports the results of other studies that confirm subclinical edema post phacoemulsification, and found a significantly lower gradient in the increase in FT in patients treated pre- and postoperatively with nepafenac.

     

Comparison of serum thiol–disulphide homeostasis and total antioxidant–oxidant levels between exudative age-related macular degeneration patients and healthy subjects

Purpose

The purpose of the study was to calculate serum total oxidant status (TOS), total antioxidant status (TAS), and dynamic thiol–disulphide (T-D) homeostasis in patients with age-related macular degeneration (AMD), and compare the results with healthy individuals.

Methods

Thirty-three exudative AMD patients and 33 healthy controls were included in this case–control study. Participants’ serum TAS and TOS levels were measured. In addition, total thiol (TT), native thiol (NT), and disulphide (DS) concentrations were assessed using a novel automated method of measurement.

Results

In comparison with the control group, serum TAS, TT, and NT levels were found to be significantly lower (p < 0.0001, p = 0.004, p = 0.003, respectively) and TOS levels were detected higher (p = 0.032) in AMD patients. Serum DS levels were elevated in the AMD patient group, but the difference was not statistically significant (p = 0.219). DS/TT and DS/NT ratios were significantly higher (p = 0.012, p = 0.013, respectively) in AMD patients. A positive correlation was found between TT and NT (p < 0.0001) in AMD group.

Conclusions

Serum TOS levels are higher, TAS levels are lower, and the T-D balance is shifted to the DS bond side in AMD patients. These results suggest that increased oxidative stress and decreased antioxidant levels may play a role in AMD progression. Further studies are needed to confirm the pathophysiologic role of T-D homeostasis in AMD.

     

Impact of laser pulse duration on the reduction of intraocular pressure during selective laser trabeculoplasty

Purpose

To evaluate the efficacy of selective laser trabeculoplasty (SLT) to lower intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG), normal tension glaucoma (NTG) or ocular hypertension (OHT), when performed with laser pulse duration of 1 ns compared with standard 3–5 ns.

Methods

Bilateral SLT with a 532 nm Q-switched neodymium-doped yttrium aluminium garnet laser was conducted in 30 patients (60 eyes) with POAG (n = 5), NTG (n = 2) or OHT (n = 23). Pulse duration was 1 ns in the right eye (30 eyes; cases) and 3–5 ns in all left eyes (controls). Main outcome measures were IOP at 1 h, 1 day, 8 weeks and 6 months, and the rate of adverse ocular tissue reactions in all eyes.

Results

Mean 1 ns and 3–5 ns SLT IOPs were 24.1 and 24.3 mmHg, respectively, at baseline. No statistically significant difference in mean 1 ns and 3–5 ns SLT IOP was observed at 1 h (P = 0.761), 1 day (P = 0.758), 8 weeks (P = 0.352) and 6 months postoperatively (P = 0.879). No significant difference in postoperative anterior chamber inflammation was observed between the eyes (P = 0.529). Treatment with both laser pulse durations resulted in minor ultrastructural changes in the drainage angle.

Conclusions

SLT performed with a 1 ns laser pulse duration does not appear to be inferior to SLT performed with the standard 3–5 ns duration at lowering IOP in treatment-naïve patients with POAG, NTG or OHT.

     

Methicillin resistance and biofilm production of <Emphasis Type="Italic">Staphylococcus epidermidis</Emphasis> isolates from infectious and normal flora conjunctiva

Purpose

Coagulase-negative staphylococci have been reported to be the most frequent cause of bacterial postoperative endophthalmitis. Biofilm formation is the major virulence factor of Staphylococcus epidermidis and is often associated with methicillin resistance. This study aims at evaluating the presence of biofilm-producing and methicillin resistance genes (mecA) in S. epidermidis.

Methods

S. epidermidis isolated from clinically infected sites (group 1) and from normal human conjunctiva (group 2) were studied. All the isolates were tested for their ability to produce biofilm by the conventional Christensen´s method and the presence of mecA by PCR using the 22-mer oligonucleotides as primers.

Results

In total 20 isolates from group 1 and 22 from group 2 were studied. Biofilm and mecA were detected in 15 (75 %) and in 14 (70 %) in group 1 as compared to 8 (36.3 %) and 4 (18.2 %) in group 2 (p = 0.016). Simultaneously, biofilm production and presence of mecA genes were observed in 13/20 (65.0 %) in group 1, and 4/22 (18.2 %) in group 2 (p = 0.002). Multi-resistance was observed in 55 % in group 1 and 9 % in group 2 (p = 0.002); 57 % of the biofilm-producing strains was multi-resistant in contrast to none of the non-producing strains. In all multi-resistant strains, biofilm production was seen.

Conclusions

Biofilm formation capacity was widely distributed, particularly among mecA (+) S. epidermidis strains, which also displayed a high diversity of antibiotic resistance profiles.

     

The effectiveness of disc synoptoscope on patients with abnormal binocular vision: a prospective cohort study

Purpose

We performed a prospective cohort study to evaluate the effectiveness of disc synoptoscope on binocularity in patients with abnormal binocular vision.

Methods

39 eligible subjects were recruited for visual therapy with disc synoptoscope in treatment group and 38 were just observed as control.

Results

Simultaneous perception in treatment group was better than controls at 6-month visit (p < 0.05). Fusional amplitude improved in treatment group but decreased in control group at 3- and 6-months visits (p < 0.001). Near and distance stereopsis in treatment group were better than controls at 3- and 6-months (p < 0.05). The improvements of monocular and binocular acuity in treatment group were better than controls at 3- and 6-months (p < 0.05). Postoperative recurrence rate in treatment group was lower than controls (p < 0.05).

Conclusion

Visual therapy with disc synoptoscope is effective in improving short-term binocular vision for the patients with abnormal binocular vision; disc synoptoscope could serve as an effective home-based visual therapy instrument.