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Fuchs Endothelial Corneal Dystrophy A Neurodegenerative Disorder?

from ArchOpht - 01 Apr 14

First described more than a century ago, Fuchs endothelial corneal dystrophy (FECD) is a common disease characterized by progressive loss of endothelial cells, thickening of the Descemet membrane, and deposition of extracellular matrix in the form of guttae. Advanced cases result in corneal edema and vision loss occurring in patients aged 60 years or older.



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Safety and Complications of Ocriplasmin Ocriplasmin, Ocriplasmin; Oh, How Safe Art Thou?

from ArchOpht - 01 Apr 14

Our ability to examine the vitreoretinal interface has been greatly improved by the invention of spectral-domain optical coherence tomography (OCT). It has allowed earlier and more accurate diagnosis of abnormalities of vitreomacular adhesion (VMA) that may contribute to vision loss and may benefit from intervention. While subtle abnormalities of VMA may be observed, symptomatic VMA or that associated with full-thickness macular hole (FTMH) requires surgical intervention. With improvements in vi



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Vision Restoration Training for Glaucoma A Randomized Clinical Trial

from ArchOpht - 01 Apr 14

ImportanceVisual field loss due to retinal damage is considered irreversible, and methods are needed to achieve vision restoration. Behavioral vision training, shown to improve visual fields in hemianopia and optic nerve damage, might comprise such a method.ObjectiveTo determine if behavioral activation of areas of residual vision using daily 1-hour vision restoration training for glaucoma for 3 months improves detection accuracy compared with placebo.Design and SettingProspective, double-blind,



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Effectiveness of Intraocular Pressure–Lowering Medication Determined by Washout

from ArchOpht - 01 Apr 14

ImportanceWhile medication efficacy is well documented in clinical trials, less is known of medication effectiveness in real-world clinical settings.ObjectiveTo assess the effectiveness of intraocular pressure (IOP)–lowering medications in patients with open-angle glaucoma.Design, Setting, and ParticipantsProspective, multicenter, interventional cohort from the prerandomization phase of a randomized clinical trial at multiple ophthalmology clinics. A total of 603 patients (603 eyes) with primary



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Artifacts in Spectral-Domain Optical Coherence Tomography Measurements in Glaucoma

from ArchOpht - 01 Apr 14

ImportanceSpectral-domain optical coherence tomography (SD-OCT) has an integral role in the diagnosis and treatment of glaucoma. Understanding the types of artifacts commonly seen in the imaging of patients being evaluated for glaucoma will help physicians better implement these data in the care of patients.ObjectivesTo determine the frequency and distribution of SD-OCT imaging artifacts in patients being evaluated for glaucoma and to provide examples of common artifacts.Design, Setting, and Par



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Resident-Performed Selective Laser Trabeculoplasty in Patients With Open-Angle Glaucoma

from ArchOpht - 01 Apr 14

ImportanceTo our knowledge, this is the first study to investigate effectiveness and complication rates of resident-performed selective laser trabeculoplasty (SLT).ObjectivesTo evaluate the effectiveness and complications of SLT performed by resident ophthalmologists and to identify predictors for success.Design, Setting, and ParticipantsRetrospective case series of 81 patients with open-angle glaucoma undergoing 110 SLT procedures from November 17, 2009, through December 16, 2011, at the San Fr



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Safety and Effects of the Vector for the Leber Hereditary Optic Neuropathy Gene Therapy Clinical Trial

from ArchOpht - 01 Apr 14

ImportanceWe developed a novel strategy for treatment of Leber hereditary optic neuropathy (LHON) caused by a mutation in the nicotinamide adenine dinucleotide dehydrogenase subunit IV (ND4) mitochondrial gene.ObjectiveTo demonstrate the safety and effects of the gene therapy vector to be used in a proposed gene therapy clinical trial.Design and SettingIn a series of laboratory experiments, we modified the mitochondrial ND4 subunit of complex I in the nuclear genetic code for import into mitocho



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Association of Race/Ethnicity With Visual Outcomes Following Acute Optic Neuritis An Analysis of the Optic Neuritis Treatment Trial

from ArchOpht - 01 Apr 14

ImportanceRetrospective studies have demonstrated disparate outcomes following acute optic neuritis in individuals of African descent compared with individuals of white race/ethnicity. However, published analyses of the prospectively collected Optic Neuritis Treatment Trial (ONTT) data identified no association between worse visual outcomes and black race/ethnicity.ObjectivesTo investigate the associations of age, sex, and race/ethnicity with visual outcomes following acute optic neuritis throug



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Trial End Points and Natural History in Patients With G11778A Leber Hereditary Optic Neuropathy Preparation for Gene Therapy Clinical Trial

from ArchOpht - 01 Apr 14

ImportanceEstablishing the natural history of G11778A Leber hereditary optic neuropathy (LHON) is important to determine the optimal end points to assess the safety and efficacy of a planned gene therapy trial.ObjectiveTo use the results of the present natural history study of patients with G11778A LHON to plan a gene therapy clinical trial that will use allotopic expression by delivering a normal nuclear-encoded ND4 gene into the nuclei of retinal ganglion cells via an adeno-associated virus ve



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Spectral-Domain Optical Coherence Tomography Staging and Autofluorescence Imaging in Achromatopsia

from ArchOpht - 01 Apr 14

ImportanceEvidence is mounting that achromatopsia is a progressive retinal degeneration, and treatments for this condition are on the horizon.ObjectivesTo categorize achromatopsia into clinically identifiable stages using spectral-domain optical coherence tomography and to describe fundus autofluorescence imaging in this condition.Design, Setting, and ParticipantsA prospective observational study was performed between 2010 and 2012 at the Edward S. Harkness Eye Institute, New York-Presbyterian H



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Markers of Inflammation, Oxidative Stress, and Endothelial Dysfunction and the 20-Year Cumulative Incidence of Early Age-Related Macular Degeneration The Beaver Dam Eye Study

from ArchOpht - 01 Apr 14

ImportanceModifying levels of factors associated with age-related macular degeneration (AMD) may decrease the risk for visual impairment in older persons.ObjectiveTo examine the relationships of markers of inflammation, oxidative stress, and endothelial dysfunction to the 20-year cumulative incidence of early AMD.Design, Setting, and ParticipantsThis longitudinal population-based cohort study involved a random sample of 975 persons in the Beaver Dam Eye Study without signs of AMD who participate



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The Effects of Technological Advances on Outcomes for Elderly Persons With Exudative Age-related Macular Degeneration

from ArchOpht - 01 Apr 14

ImportanceExudative age-related macular degeneration (ARMD) is the major cause of blindness among US elderly. Developing effective therapies for this disease has been difficult.ObjectivesTo assess the effects of introducing new therapies for treating exudative ARMD on vision of the affected population and other outcomes among Medicare beneficiaries newly diagnosed as having ARMD.DesignThe study used data from a 5% sample of Medicare claims and enrollment data with a combination of a regression d



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Serum Carboxymethyllysine, an Advanced Glycation End Product, and Age-Related Macular Degeneration The Age, Gene/Environment Susceptibility–Reykjavik Study

from ArchOpht - 01 Apr 14

ImportanceAdvanced glycation end products have been implicated in the pathogenesis of age-related macular degeneration (AMD).ObjectiveTo investigate the relationship between serum carboxymethyllysine (CML), a major circulating advanced glycation end product, and AMD in older adults.Design, Setting, and ParticipantsCross-sectional study of a population-based sample of 4907 older adults (aged =66 years) in the Age, Gene/Environment Susceptibility–Reykjavik Study in Iceland.ExposuresSerum CML and r



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Eye Care Availability and Access Among Individuals With Diabetes, Diabetic Retinopathy, or Age-Related Macular Degeneration

from ArchOpht - 01 Apr 14

ImportanceUnderstanding whether differences in the local availability of eye care professionals are related to differences in realized access to eye care is important for assessing whether and where public health efforts are needed to increase access to eye care professionals.ObjectiveTo examine whether the county-level availability of ophthalmologists and optometrists is associated with measures of realized access to eye care for individuals with diabetes mellitus, diabetic retinopathy, or age-



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Retinoblastoma Incidence Patterns in the US Surveillance, Epidemiology, and End Results Program

from ArchOpht - 01 Apr 14

ImportanceSeveral studies have found no temporal or demographic differences in the incidence of retinoblastoma except for age at diagnosis, whereas other studies have reported variations in incidence by sex and race/ethnicity.ObjectiveTo examine updated US retinoblastoma incidence patterns by sex, age at diagnosis, laterality, race/ethnicity, and year of diagnosis.Design, Setting, and ParticipantsThe Surveillance, Epidemiology, and End Results (SEER) databases were examined for retinoblastoma in



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Acute Panretinal Structural and Functional Abnormalities After Intravitreous Ocriplasmin Injection

from ArchOpht - 01 Apr 14

ImportanceOcriplasmin cleaves fibronectin and laminin, components of the vitreous gel, and is used as a pharmacologic treatment for vitreomacular traction. Laminin is also found throughout multiple retinal layers. Ocriplasmin injection may lead to acute panretinal dysfunction in some eyes, but the mechanism of this toxic reaction has not been described.ObservationsWe evaluated a 63-year-old woman demonstrating acute panretinal dysfunction after intravitreous ocriplasmin injection for a small mac



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Vision Loss After Intravitreal Ocriplasmin Correlation of Spectral-Domain Optical Coherence Tomography and Electroretinography

from ArchOpht - 01 Apr 14

ImportanceClinical trials indicate that visual impairment is significantly greater in patients receiving ocriplasmin than placebo. The mechanism of this symptom has not been explained. We report a patient with persistent darkening of her vision after intravitreal ocriplasmin and describe ancillary testing findings that may yield insights into the effects of ocriplasmin and the cause of this symptom.ObservationsWe describe a 71-year-old woman with symptomatic vitreomacular traction who received i



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“The El Greco Fallacy” Fallacy

from ArchOpht - 01 Apr 14

To what extent does an artist’s work represent his or her perceptual world, and to what extent can attributes of his or her work be ascribed to sensory defects? These issues lie at the center of a conjecture more than a century old, which has been termed the El Greco fallacy. The El Greco fallacy posits that the elongation evident in El Greco’s art reflects an underlying perceptual elongation of objects caused by astigmatism. The “logical” refutation of this theory argues that any perceptual elo



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Midstromal Isolated Bowman Layer Graft for Reduction of Advanced Keratoconus A Technique to Postpone Penetrating or Deep Anterior Lamellar Keratoplasty

from ArchOpht - 01 Apr 14

Midstromal implant of an isolated Bowman layer graft is a new approach to reduce ectasia in eyes with advanced keratoconus. The procedure should postpone penetrating or deep anterior lamellar keratoplasty. Ten eyes of 9 patients with progressive, advanced keratoconus and contact lens intolerance underwent the procedure with no intraoperative adverse events. Throughout the study period, we observed no complications related to stromal dissection and/or the Bowman layer graft. Maximum corneal power




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Disablement-Based Nomenclature for Vision and Function

from ArchOpht - 01 Apr 14

Zhang et al recently reported that visual function loss but not visual acuity was associated with depression. In an accompanying editorial, Morse further described how the loss of functional vision (ie, actual task-related visual performance) leads to depression. The article and editorial raise important questions about the terminology of vision and function.



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Varicella-Zoster Virus Detection in Varicella-Associated Stromal Keratitis

from ArchOpht - 01 Apr 14

Stromal keratitis is a well-known development in herpes zoster ophthalmicus but is uncommonly noted following varicella, the primary infection with varicella-zoster virus. Keratitis typically occurs several weeks to months following varicella and is often described as disciform in nature. We describe a case of varicella-associated stromal keratitis in which the cornea was positive for varicella-zoster virus by polymerase chain reaction (PCR) testing. We believe that this is the first case of var



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Rapid Progression of Uveitis and Alopecia Syphilitica in AIDS

from ArchOpht - 01 Apr 14

There has been recent renewed interest in the ocular manifestations of syphilis, likely owing to the increased prevalence of patients with human immunodeficiency virus (HIV) coinfections in recent years. Ocular complications due to syphilis in these immunocompromised patients have been noted not only to progress faster but also to be more severe. We describe a young man, ultimately diagnosed as having syphilis and AIDS, who presented with florid panuveitis in the setting of progressive, secondar



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JAMA Ophthalmology

from ArchOpht - 01 Apr 14

Mission Statement: To be the indispensable source of ophthalmic knowledge by promptly publishing innovative, clinically relevant research through consistent and authoritative peer review and;thereby, to be the first choice of authors for their important manuscripts.


 

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