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Eye Diseases - Top 30 Publications

Screening for Diabetic Retinopathy.

Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?

The aims of the study were to develop guidelines for prescribing spectacles for patients with moderate to severe hyperopic amblyopia and to demonstrate how emmetropization progresses.

Sphingosine-1-Phosphate (S1P)-Related Response of Human Conjunctival Fibroblasts After Filtration Surgery for Glaucoma.

To investigate levels of sphingosine-1-phosphate (S1P) in aqueous fluid samples taken before and after filtration surgery and S1P-induced human conjunctival fibroblast (HCF) responses.

Course of Sodium Iodate-Induced Retinal Degeneration in Albino and Pigmented Mice.

To characterize the course of sodium iodate (SI)-induced retinal degeneration in young adult albino and pigmented mice.

Homozygosity Mapping and Genetic Analysis of Autosomal Recessive Retinal Dystrophies in 144 Consanguineous Pakistani Families.

The Pakistan Punjab population has been a rich source for identifying genes causing or contributing to autosomal recessive retinal degenerations (arRD). This study was carried out to delineate the genetic architecture of arRD in the Pakistani population.

Molecular Genetic Analysis of Pakistani Families With Autosomal Recessive Congenital Cataracts by Homozygosity Screening.

To identify the genetic origins of autosomal recessive congenital cataracts (arCC) in the Pakistani population.

Prevalence, Natural Course, and Prognostic Role of Refractile Drusen in Age-Related Macular Degeneration.

To report prevalence, clinical characteristics, and prognostic significance of refractile drusen in eyes with intermediate age-related macular degeneration (AMD).

Measurements of the parapapillary atrophy zones in en face optical coherence tomography images.

To measure the parapapillary atrophy (PPA) area in en face images obtained with swept-source optical coherence tomography (SS-OCT), and to evaluate its relationship to glaucoma, myopia, and age in non-highly myopic subjects.

Active transforming growth factor-β2 in the aqueous humor of posterior polymorphous corneal dystrophy patients.

Posterior polymorphous corneal dystrophy (PPCD) is characterized by abnormal proliferation of corneal endothelial cells. It was shown that TGF-β2 present in aqueous humor (AH) could help maintaining the corneal endothelium in a G1-phase-arrest state. We wanted to determine whether the levels of this protein are changed in AH of PPCD patients.

Goniosynechialysis and Repositioning of Intraocular Lens in a Case of Secondary Angle Closure Glaucoma.

Implanting intraocular lens (IOL) in proper direction is important in cataract surgery to reduce the possibility of undesirable complications. We experienced a case who underwent vitrectomy combined with cataract surgery and developed secondary angle closure glaucoma caused by IOL misdirection. Goniosynechialysis (GSL) and repositioning of IOL successfully ameliorated the high intraocular pressure (IOP).

Elevated C-X-C motif ligand 13 and B-cell-activating factor levels in neuromyelitis optica during remission.

Discovery of specific antibodies against astrocytic water channel aquaporin-4 (AQP4), which is produced by plasma cells, in the serum of neuromyelitis optica (NMO) confirmed the pathogenic role of B cells in NMO. C-X-C motif ligand 13 (CXCL13) and B-cell-activating factor (BAFF) are two crucial factors for antibody production. Relevant studies have focused on the acute phase of NMO. However, CXCL13 and BAFF levels during remission, remain to be elucidated.

Multireceptor fingerprints in progressive supranuclear palsy.

Progressive supranuclear palsy (PSP) with a frontal presentation, characterized by cognitive deficits and behavioral changes, has been recognized as an early clinical picture, distinct from the classical so-called Richardson and parkinsonism presentations. The midcingulate cortex is associated with executive and attention tasks and has consistently been found to be impaired in imaging studies of patients with PSP. The aim of the present study was to determine alterations in neurotransmission underlying the pathophysiology of PSP, as well as their significance for clinically identifiable PSP subgroups.

Ferulic Acid Suppresses Amyloid β Production in the Human Lens Epithelial Cell Stimulated with Hydrogen Peroxide.

It is well known that oxidative stresses induce the production of amyloid β (Aβ) in the brain, lens, and retina, leading to age-related diseases. In the present study, we investigated the effects of ferulic acid on the Aβ levels in H2O2-stimulated human lens epithelial (HLE) SRA 01/04 cells. Three types of Aβ peptides (Aβ1-40, Aβ1-42, and Aβ1-43) were measured by ELISA, and the levels of mRNA for the expressed proteins related to Aβ production (APP, BACE1, and PS proteins) and degradation (ADAM10, NEP, and ECE1 proteins) were determined by quantitative real-time RT-PCR. H2O2 stimulation augmented gene expression of the proteins related to Aβ production, resulting in the production of three types of Aβ peptides. Treatment with 0.1 μM ferulic acid attenuated the augmentations of gene expression and production of the proteins related to the secretion of three types of Aβ peptides in the H2O2-stimulated HLE cells. These results provided evidence of antioxidative functions of ferulic acid for lens epithelial cells.

Relation between macular morphology and treatment frequency during twelve months with ranibizumab for diabetic macular edema.

To investigate whether baseline optical coherence tomography (OCT) parameters can predict the treatment frequency of intravitreal ranibizumab (IVR) injections during the first year in patients with diabetic macular edema (DME) treated with pro re nata (PRN) IVR injections.

Treatment coverage rates for refractive error in the National Eye Health survey.

To present treatment coverage rates and risk factors associated with uncorrected refractive error in Australia.

Blindness enhances auditory obstacle circumvention: Assessing echolocation, sensory substitution, and visual-based navigation.

Performance for an obstacle circumvention task was assessed under conditions of visual, auditory only (using echolocation) and tactile (using a sensory substitution device, SSD) guidance. A Vicon motion capture system was used to measure human movement kinematics objectively. Ten normally sighted participants, 8 blind non-echolocators, and 1 blind expert echolocator navigated around a 0.6 x 2 m obstacle that was varied in position across trials, at the midline of the participant or 25 cm to the right or left. Although visual guidance was the most effective, participants successfully circumvented the obstacle in the majority of trials under auditory or SSD guidance. Using audition, blind non-echolocators navigated more effectively than blindfolded sighted individuals with fewer collisions, lower movement times, fewer velocity corrections and greater obstacle detection ranges. The blind expert echolocator displayed performance similar to or better than that for the other groups using audition, but was comparable to that for the other groups using the SSD. The generally better performance of blind than of sighted participants is consistent with the perceptual enhancement hypothesis that individuals with severe visual deficits develop improved auditory abilities to compensate for visual loss, here shown by faster, more fluid, and more accurate navigation around obstacles using sound.

Postretinal Structure and Function in Severe Congenital Photoreceptor Blindness Caused by Mutations in the GUCY2D Gene.

To examine how severe congenital blindness resulting from mutations of the GUCY2D gene alters brain structure and function, and to relate these findings to the notable preservation of retinal architecture in this form of Leber congenital amaurosis (LCA).

High Mitochondrial DNA Copy Number Is a Protective Factor From Vision Loss in Heteroplasmic Leber's Hereditary Optic Neuropathy (LHON).

Leber's hereditary optic neuropathy (LHON) is a mitochondrial disease that typically causes bilateral blindness in young men. It is characterized by as yet undisclosed genetic and environmental factors affecting the incomplete penetrance.

Calculations of actual corneal astigmatism using total corneal refractive power before and after myopic keratorefractive surgery.

To calculate actual corneal astigmatism using the total corneal refractive astigmatism for the 4-mm apex zone of the Pentacam (TCRP4astig) and keratometric astigmatism (Kastig) before and after photorefractive keratectomy or laser in situ keratomileusis.

Correlation of choroidal thickness and ametropiain young adolescence.

Choroid has been proposed to participate in the regulation of light refraction by changing its thickness. The present study aims to analyze the characteristics of choroidal thickness (CT), and its correlation with refractive error, axial length and age in young ametropia. A total of 51 subjects (102 eyes), aged from 5 to 18 years old (mean age 10.04 ±2.78 years), with ametropia were included in the study. Choroidal imaging was obtained by enhanced depth imaging (EDI) of spectral domain Optical Coherence Tomography (OCT). CT was horizontally measured at 5 locations in across fovea with 1mm interval. We found that the spherical equivalent refractive diopter was from -7.25D to 1.6D (mean, -1.61D±1.82D), the mean axial length was 24.14mm±1.14mm. The closer to the optic disc the thinner the choroid is. CT between fovea and disc showed better correlation with refractive error (p< 0,01), axial length (p<0.01) and age (P<0.05) than those temporal to fovea. Our results indicated that the choroid is least thick around the optic disc. Thickness between fovea and optic disc is significantly associated with refractive error, axial length and age in growing adolescences. This result may help us understand the function of choroid during ametropic progression.

Predicted patient demand for a new delivery system for glaucoma medicine.

Sustained-release drug delivery systems that replace the need for daily glaucoma medications will improve outcomes for those who are nonadherent and reduce the inconvenience of having to take medications on a recurring basis.The objective is to estimate uptake (i.e., demand) for a new technology that delivers sustained-release glaucoma medication and to investigate how uptake varies by product attributes, physician recommendations, peer adoption (i.e., percentage of patients seen in a clinic using the new technology), and patient characteristics.In a web-enabled discrete-choice experiment survey, glaucoma patients in the United States were asked to choose between continuing eye drop use or purchasing the new delivery system. In a cross-sectional web-enabled survey, ophthalmologists were asked their likelihood of recommending the new technology based on product and patient characteristics.Study participants were 500 glaucoma patients who were on topical administration of daily eye drops and 155 ophthalmologists who practice in the US.Main outcomes were predicted uptake for patients and likelihood of recommending a new drug delivery system for ophthalmologists. Logistic models were used to analyze the choice data.Uptake was estimated to be 18% at an annual cost of $1000 and to be 24% when the cost was $500. A physician's recommendation increased uptake by 6% to 12%, whereas an increase in peer adoption from 5% to 50% increased uptake by 3% to 7%. Patients aged ≥ 65 and those with lower income were more likely to remain on eye drops. Physicians were more likely to recommend a product if the interval between administrations is 6 months or longer and when long-term safety and efficacy data are available. They were less likely to recommend it to patients with lower income and no adherence problems.Results suggest a significant interest in an injectable solution or other sustained-release alternatives to daily eye drops. However, in this survey, patient uptake was greatly influenced by out-of-pocket cost and the interval between treatment administrations. Few physicians were willing to recommend sustained-release technology if the treatment interval was less than 3 months.

Retinal microvascular alterations related to diabetes assessed by optical coherence tomography angiography: A cross-sectional analysis.

Fluorescein angiography has been so far the gold-standard test to assess diabetic macular ischemia (DMI), a cause of irreversible visual impairment in diabetic patients. The aim of this study was to investigate foveal avascular zone (FAZ) and perifoveal microcirculation changes in eyes with nonproliferative diabetic retinopathy (NPDR) using optical coherence tomography angiography (OCTA), a new and noninvasive vascular imaging technique.Cross-sectional study including eyes of diabetic patients with NPDR.All patients underwent medical history, best-corrected visual acuity (BCVA) measurement, slit-lamp and fundus examination, multicolor imaging, SD-OCT, and swept-source OCT. OCTA was performed in order to assess macular superficial and deep capillary plexus, and swept-source OCT was performed to evaluate the central choroidal thickness.Fifty-eight eyes of 35 patients with a mean age of 61.8 years (±12.1) with mean HbA1C level of 7.6% (±1.5) were included in this study. Among them, 19 eyes had mild NPDR, 24 eyes had moderate NPDR, and 15 eyes had severe NPDR. There was a significant progression between NPDR stages for FAZ grade (P < 0.0001), surface (P = 0.0036) and perimeter (P = 0.0001), and for superficial capillary plexus nonperfusion index (NPI) (P = 0.0009). Moreover, a significant correlation was found between NPI and BCVA (P = 0.007).OCT angiography is a useful noninvasive tool to explore early phases of diabetic retinopathy, which are not routinely explore with fluorescein angiography and not precisely enough with color photographs. NPI and foveal avascular zone parameters are correlated with glycated hemoglobin in patients with NPDR. If confirmed by further studies, these results could represent a mean to sensibilize diabetic patients to their disease.

Progressive visual disturbance and enlarging prolactinoma caused by melanoma metastasis: A case report and literature review.

Melanoma metastases to the pituitary adenoma (MMPA) are extremely rare, with only 1 reported case. To date, the melanoma metastasis to the existing prolactinoma has not been reported in literatures.

The association between periodontal disease and age-related macular degeneration in the Korea National health and nutrition examination survey: A cross-sectional observational study.

Periodontal disease (PD) is associated with various systemic diseases. We investigated the association between PD and age-related macular degeneration (AMD).For this population-based, cross-sectional study, we enrolled 13,072 adults at least 40 years of age with gradable retinal fundus photographs and community periodontal index (CPI) data from the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2010 and 2012). Participants were divided into a middle age group (age ≤62 years) and old age group (age >62 years). PD was divided into 2 categories of mild and severe. Logistic regression analysis was used to evaluate the association between PD and AMD (early and late).The prevalence of PD and AMD in the study population was 37.4% ± 0.8% and 5.6% ± 0.2%, respectively. Overall, there was no significant difference in the proportion of participants with PD between those with and without AMD. Only participants with AMD in the middle age group had more any PD than those without AMD (P = 0.031). Multivariate logistic regression model after adjusting for all confounding factors showed that PD was not significantly associated with AMD (odds ratio [OR] 1.03, 95% confidence interval [CI] 0.86-1.22). However, according to degree of PD, participants with severe PD in the middle age group were 1.61 times more likely to have AMD (OR 1.61, 95% CI 1.02-2.54).Our data, collected from an Asian population, showed that only severe PD is independently associated with AMD in individuals aged 62 years or younger.

Influence of the lamina cribrosa on the rate of global and localized retinal nerve fiber layer thinning in open-angle glaucoma.

The advent of optical coherence tomography (OCT) imaging allows identification of the structural contribution of the lamina cribrosa (LC) to glaucoma progression. This study aimed to determine the role of various LC features, such as the LC depth (LCD), LC thickness (LCT), and focal LC defects, on the future rate of progressive retinal nerve fiber layer (RNFL) thinning in patients with glaucoma. One hundred eighteen patients with glaucoma who had undergone at least 4 OCT examinations were included. Features of LC, including the LCD, LCT, and presence of focal LC defects, from serial scan of the optic disc using the enhanced depth imaging of Spectralis OCT; were analyzed at baseline. Eyes were classified as those with or without progressive RNFL thinning using the guided progression analysis of Cirrus OCT. Factors associated with the rate of RNFL thinning (linear regression analysis against time for global average, inferior, and superior RNFL thicknesses, μm/year) were evaluated using a general linear model. Greater baseline LCD and thinner baseline LCT were significantly associated with the rate of superior RNFL thinning. Focal LC defects were significantly more frequent in eyes with progressive inferior RNFL thinning (93.8%) and the location of the focal LC defect was only related to the location of progression RNFL thinning in the inferior region (P < 0.001). A deeper and thinner LC was related to the rate of superior RNFL thinning, and the presence of focal LC defects was related to the rate of inferior RNFL thinning.

Impact of intravitreal pharmacotherapies including antivascular endothelial growth factor and corticosteroid agents on diabetic retinopathy.

Diabetic retinopathy is common and increasing in prevalence. Pharmacologic management of diabetic macular edema (DME) has improved tremendously over the last decade with the use of two families of intravitreally administered medications: antivascular endothelial growth factor-specific agents and corticosteroids. Clinical evaluation of these pharmaceuticals has demonstrated that they can have a substantial impact on diabetic retinopathy severity levels and the underlying retinal vasculature itself.

Ocular Emergencies: Red Eye.

"Red eye" is used as a general term to describe irritated or bloodshot eyes. It is a recognizable sign of an acute/chronic, localized/systemic underlying inflammatory condition. Conjunctival injection is most commonly caused by dryness, allergy, visual fatigue, contact lens overwear, and local infections. In some instances, red eye can represent a true ocular emergency that should be treated by an ophthalmologist. A comprehensive assessment of red eye conditions is required to preserve the patients visual function. Severe ocular pain, significant photophobia, decreased vision, and history of ocular trauma are warning signs demanding immediate ophthalmological consultation.

The Hippo signaling pathway: a potential therapeutic target is reversed by a Chinese patent drug in rats with diabetic retinopathy.

The Hippo signaling pathway is reported to be involved in angiogenesis, but the roles of the Hippo pathway in diabetic retinopathy have not been addressed. Fufang Xueshuantong Capsule has been used to treat diabetic retinopathy in China; however, the effect of Fufang Xueshuantong Capsule on the Hippo pathway has not been investigated.

Potential of angiotensin II receptor blockers in the treatment of diabetic retinopathy.

Impairments in renin-angiotensin-aldosterone system during diabetes mellitus, leading to its dysfunction, have been known since a decade. Hyperglycemia induces several pathological alterations which upregulate this system, accounting for overexpression of its downstream signaling molecules, amongst which angiotensin II (Ang II) and aldosterone hold prime pathological notoriety. Although it is well known that elevated plasma levels of Ang II play a crucial role in the pathophysiology of type-II diabetic mellitus, by inducing and aggravating insulin resistance, it is not quite much known that it equally elevates the possibility/risk of development of diabetic complications. Also, amongst the various diabetic complications, the effects of Ang II upregulation are more widely acknowledged in studies concerning the pathophysiology of diabetic nephropathy; however, its role in exacerbating diabetic retinopathy has not received much attention. Ang II, indeed, plays a detrimental role in the progression of diabetic retinopathy by augmenting the principal events involved in its pathogenesis, namely oxidative stress, angiogenesis and inflammation. The utility of angiotensin receptor blockers has shown positive results in research studies and hence, might potentially provide a novel adjuvant therapy for treating this complication and preventing the associated vision-loss in diabetic patients.

Adult-onset hypophosphatemic osteomalacia associated with Sjogren syndrome: Clinical case report.

Hypophosphatemic osteomalacia (HO) is a metabolic bone disease, exhibiting different etiologies such as genetic mutation, tumor induction, dysimmunity, or renal disease. Sjogren's syndrome (SS) is a connective tissue disorder commonly involving exocrine glands; however kidney involvement is also encountered, leading to abnormal phosphorus metabolism, even HO.