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Sustained Visual Acuity Loss in the Comparison of Age-Related Macular Degeneration Treatments Trials

from ArchOpht - 01 Aug 14

ImportanceAlthough anti–vascular endothelial growth factor treatment of neovascular age-related macular degeneration (AMD) results in improved vision overall, loss of substantial vision can occur. Understanding the processes that lead to loss of vision may lead to preventive strategies.ObjectiveTo determine the incidence, characteristics, causes, and baseline predictors of sustained visual acuity loss after 2 years of treatment with ranibizumab or bevacizumab for neovascular AMD.Design, Setting,



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Sex- and Age-Specific Prevalence and Incidence Rates of Sight-Threatening Diabetic Retinopathy in Taiwan

from ArchOpht - 01 Aug 14

ImportanceThe prevalence of diabetic retinopathy (DR) is high in individuals with diabetes mellitus. Published estimates for sight-threatening DR (STDR) prevalence range widely. There is a need for precise contemporary estimates of the prevalence and incidence of STDR for providing optimal strategies of clinical management in Taiwan.ObjectiveTo determine the precise contemporary estimates of the prevalence and incidence of STDR in patients with type 2 diabetes mellitus in Taiwan.Design, Setting,



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Correlation Between Clinical Signs and Optical Coherence Tomography With Enhanced Depth Imaging Findings in Patients With Birdshot Chorioretinopathy

from ArchOpht - 01 Aug 14

ImportanceBirdshot chorioretinopathy (BCR) is a bilateral posterior uveitis that typically requires aggressive therapy to prevent loss of vision. Clinical signs of disease activity may be subtle and visual acuity is often preserved despite significant loss of visual function. Optical coherence tomography with enhanced depth imaging (OCT-EDI), a new technology that allows visualization of structures posterior to the retinal pigment epithelium, may be a useful tool to monitor disease activity in t



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Combined Intravitreal Melphalan and Topotecan for Refractory or Recurrent Vitreous Seeding From Retinoblastoma

from ArchOpht - 01 Aug 14

ImportanceDemonstrating the usefulness and complications of multiagent intravitreal chemotherapy is necessary for successful treatment in patients with recalcitrant vitreous seeding of retinoblastoma.ObjectiveTo determine the efficacy and complications of combined intravitreal chemotherapy (melphalan hydrochloride and topotecan hydrochloride) for viable vitreous seeding from retinoblastoma.Design, Setting, and ParticipantsThis retrospective study was conducted in a hospital setting. Trans–pars p



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Pingyangmycin as First-Line Treatment for Low-Flow Orbital or Periorbital Venous Malformations Evaluation of 33 Consecutive Patients

from ArchOpht - 01 Aug 14

ImportanceLow-flow orbital or periorbital venous malformation (OVM) is the most common periorbital vascular lesion that may produce an appearance defect, visual dysfunction, internal hemorrhage, and thrombosis. Intralesional injection of pingyangmycin as a minimally invasive, gentle intervention may have better outcomes in treating low-flow OVMs compared with other currently used methods.ObjectiveTo investigate the efficacy and safety of intralesional injection of pingyangmycin for treatment of



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Lysyl Oxidase–Like 1 Gene in the Reversal of Promoter Risk Allele in Pseudoexfoliation Syndrome

from ArchOpht - 01 Aug 14

ImportanceThis study was necessary to establish the association between common genetic variants in the lysyl oxidase–like 1 (LOXL1) gene with pseudoexfoliation (PEX) syndrome and emphasize the reversal of promoter risk allele in a South Indian population.ObjectiveTo investigate the potential association of genetic variants across the LOXL1 gene in South Indian patients with PEX syndrome and glaucoma.Design, Setting, and ParticipantsA case-control study of individuals from Madurai, India, with PE



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Single vs Multiple Intraocular Pressure Measurements in Glaucoma Surgical Trials

from ArchOpht - 01 Aug 14

ImportanceLittle is known about the necessity of multiple same-day intraocular pressure (IOP) measurements in describing the effect of IOP-lowering surgical procedures, and such evidence could affect surgical trial recruitment and retention of participants.ObjectiveTo determine whether a single IOP measurement might adequately approximate the mean of several measurements in glaucoma surgical trials.Design, Setting, and ParticipantsA prospective, multicenter, interventional cohort from the preran



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Adjustable Nasal Transposition of Split Lateral Rectus Muscle for Third Nerve Palsy

from ArchOpht - 01 Aug 14

ImportanceThird nerve palsy causes disfiguring, incomitant strabismus with limited options for correction.ObjectiveTo evaluate the oculomotor outcomes, anatomical changes, and complications associated with adjustable nasal transposition of the split lateral rectus (LR) muscle, a novel technique for managing strabismus associated with third nerve palsy.Design, Setting, and ParticipantsRetrospective medical record review appraising outcomes of 6 consecutive patients with third nerve palsy who unde



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Mutation in TMEM98 in a Large White Kindred With Autosomal Dominant Nanophthalmos Linked to 17p12-q12

from ArchOpht - 01 Aug 14

ImportanceNanophthalmos is a congenital disorder characterized by small eyes, with the main complications being severe hyperopia and angle-closure glaucoma.ObjectiveTo perform a clinical and genetic investigation of a large white family with autosomal dominant nanophthalmos.Design, Setting, and ParticipantsDetailed clinical evaluation and a genome-wide linkage scan was conducted in the family NNO-SA1. Linkage was evaluated with a 10K single-nucleotide polymorphism array, followed by whole exome



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Two-Year Changes in Refractive Error and Related Biometric Factors in an Adult Chinese Population

from ArchOpht - 01 Aug 14

ImportanceThis article provides, to our knowledge, the first longitudinal population-based data on refractive error (RE) in Chinese persons.ObjectiveTo study cohort effects and changes associated with aging in REs among Chinese adults.Design, Setting, and ParticipantsA 2-year, longitudinal population-based cohort study was conducted in southern China. Participants, identified using cluster random sampling, included residents of Yuexiu District, Guangzhou, China, aged 35 years or older who had un



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Alteration of Tear Mucin 5AC in Office Workers Using Visual Display Terminals The Osaka Study

from ArchOpht - 01 Aug 14

ImportanceThere are limited reports on the relationship between mucin 5AC (MUC5AC) concentrations in tears, working hours, and the frequency of ocular symptoms in visual display terminal (VDT) users. This investigation evaluated these relationships among patients with dry eye disease (DED) and individuals serving as controls.ObjectiveTo determine the relationship between MUC5AC concentration in the tears of VDT users based on the diagnosis of DED and frequency of ocular symptoms.Design, Setting,



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Nonpenetrance of the Most Frequent Autosomal Recessive Leber Congenital Amaurosis Mutation in NMNAT1

from ArchOpht - 01 Aug 14

ImportanceThe NMNAT1 gene was recently found to be mutated in a subset of patients with Leber congenital amaurosis and macular atrophy. The most prevalent NMNAT1 variant was p.Glu257Lys, which was observed in 38 of 106 alleles (35.8%). On the basis of functional assays, it was deemed a severe variant.ObservationsThe p.Glu257Lys variant was 80-fold less frequent in a homozygous state in patients with Leber congenital amaurosis than predicted based on its heterozygosity frequency in the European A



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Bilateral Subfoveal Neurosensory Retinal Detachment Associated With MEK Inhibitor Use for Metastatic Cancer

from ArchOpht - 01 Aug 14

ImportanceBilateral central serous retinopathy–like events have been described in patients receiving drugs that inhibit the mitogen-activated protein kinase enzyme MEK for metastatic cancer. To date, the clinical details of this ocular adverse effect have not been adequately described in the literature. We report on a series of bilateral subfoveal neurosensory retinal detachments in patients with metastatic cancer undergoing systemic therapy with MEK inhibitors enrolled in clinical trials at ou



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Methicillin-Resistant Staphylococcus aureus Dacryoadenitis

from ArchOpht - 01 Aug 14

ImportanceAlthough classically thought to be primarily a nosocomial infection, the incidence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is rising. In this series we report 3 cases of community-acquired MRSA acute dacryoadenitis in adults presenting within a 3-week period.ObservationsAll cases presented with pain and periocular erythema increasing over approximately 1 week. An S-shaped lid deformity was evident, and 2 of the 3 cases demonstrated multiple pustules/abs



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Expansion of Ocular Phenotypic Features Associated With Mutations in ADAMTS18

from ArchOpht - 01 Aug 14

ImportanceWe describe novel ocular phenotypic features caused by mutations in ADAMTS18. The exact role of ADAMTS18 in ocular disease is unclear, and our work further contributes to the understanding of this gene and its protein.ObjectiveTo expand the phenotypic characterization in patients with homozygous mutations in ADAMTS18 and report novel mutational data.Design, Setting, and ParticipantsA case series with genetic investigations was conducted at tertiary referral clinical and university sett



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Use of Topical Ice for Local Anesthesia for Intravitreal Injections

from ArchOpht - 01 Aug 14

Topical anesthetic allergy is a rare but recognized entity for which incidence is difficult to calculate owing to the difference between a perceived and true allergic response. Allergic episodes attributed to topical anesthetics are typically adverse reactions, such as a vasovagal event, rather than the development of hypersensitivity. However, several articles place the likely incidence of topical anesthetic allergy at less than 1% of the general population.





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Accelerometer-Assessed Physical Activity and Diabetic Retinopathy in the United States

from ArchOpht - 01 Aug 14

Hemoglobin A1c (HbA1c) and blood pressure currently represent the only reversible risk factors associated with diabetic retinopathy. Physical activity (PA) is another potential modifiable risk factor for preventing diabetic ocular complications, although studies investigating this association have produced conflicting results. These studies have relied exclusively on self-report to quantify PA, which is prone to considerable error. Herein, we assess whether accelerometer-defined PA is associated



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Squamous Cell Carcinoma With Clear-Cell Features of the Palpebral Conjunctiva

from ArchOpht - 01 Aug 14

The clear-cell variant makes up a distinct minority of squamous cell carcinomas. The microscopic appearance of the clear cells can be difficult to distinguish from those of sebaceous carcinoma cells. Determining the correct diagnosis is of great therapeutic and prognostic significance, as sebaceous cell carcinoma is associated with a poorer prognosis.



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Effect of Topical Rebamipide on Human Conjunctival Goblet Cells

from ArchOpht - 01 Aug 14

The conjunctival epithelium contains mucin-secreting goblet cells, which are essential for maintenance of a healthy ocular surface. It has been demonstrated that topical administration of rebamipide, an antiulcer agent, increases the mucin level of the tear film and improves the ocular surface in dry eye syndrome. Indeed, rebamipide increased the number of goblet cells in rabbit and murine conjunctivas in vivo. Ríos et al demonstrated that rebamipide led to proliferation of cultured rat conjunct



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Adalimumab for Pediatric Sympathetic Ophthalmia

from ArchOpht - 01 Aug 14

Sympathetic ophthalmia (SO) is an autoimmune, bilateral, granulomatous panuveitis occurring after accidental or surgical trauma to the eye. Systemic corticosteroids are first-line therapy for SO, with immunomodulatory therapy used for corticosteroid-sparing immunosuppression and chronic, refractory cases. Biological response modifiers are a class of therapeutics that target specific cytokines mediating inflammation, and tumor necrosis factor a (TNF-a)–antagonist biological response modifiers hav



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Tethered Vitreous Seeds Following Intravitreal Melphalan for Retinoblastoma

from ArchOpht - 01 Aug 14

Placing a needle into an eye with retinoblastoma, whether for diagnostic or therapeutic purposes, has historically been avoided owing to concerns of extraocular spread along the needle track. In the past 3 years, intravitreal injections of melphalan have been used worldwide, with excellent results for vitreous seeding and an exceedingly low risk of extraocular extension. The treatment course involves repetitive puncture sites with approximately 6 to 8 weekly injections and often a concomitant pa



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Sebaceous Carcinoma of the Eyelid and Muir-Torre Syndrome

from ArchOpht - 01 Aug 14

Muir-Torre syndrome (MTS) is a rare autosomal dominantly inherited disease, subtype of Lynch syndrome II, caused by DNA mismatch repair proteins. It is characterized by the association of tumors of the sebaceous glands and/or multiple keratoacanthomas and visceral neoplasia. We report the first case, to our knowledge, of MTS associated with sebaceous carcinoma of the upper eyelid, adrenocortical adenoma, and carcinoma of the colon. We highlight the important role of the ophthalmologist in the po


 

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