1. Am J Ophthalmol. 2015 Nov 12. pii: S0002-9394(15)00698-4. doi:
10.1016/j.ajo.2015.11.010. [Epub ahead of print]

Effects of Implantable Collamer Lens V4c placement on iridocorneal angle
measurements by Fourier domain optical coherence tomography.

Fernández-Vigo JI(1), Macarro-Merino A(2), Fernández-Vigo C(2), Fernández-Vigo
JÁ(3), Martínez-de-la-Casa JM(4), Fernández-Pérez C(5), García-Feijoó J(4).

Author information: 
(1)Clínico San Carlos University Hospital. Department of Ophthalmology. Instituto
de Investigación Sanitaria San Carlos (IdISSC). Madrid, Spain; Centro
Internacional de Oftalmología Avanzada, Madrid, Spain. Electronic address:
jfvigo@hotmail.com. (2)Centro Internacional de Oftalmología Avanzada, Madrid,
Spain. (3)Centro Internacional de Oftalmología Avanzada, Madrid, Spain;
Department of Ophthalmology, Extremadura University, Badajoz, Spain. (4)Clínico
San Carlos University Hospital. Department of Ophthalmology. Instituto de
Investigación Sanitaria San Carlos (IdISSC). Madrid, Spain. (5)Clínico San Carlos
University Hospital. Department of Preventive Medicine. Instituto de
Investigación sanitaria (IdISSC). Madrid, Spain.

PURPOSE: To assess by Fourier domain optical coherence tomography (FD-OCT)
changes produced in iridocorneal angle measurements in patients undergoing Visian
Implantable Collamer Lens(®) (ICL) V4c (STAAR Surgical AG) placement.
DESIGN: Prospective interventional case series.
METHODS: In 50 eyes of 25 myopic subjects consecutively scheduled for ICL
implant, FD-OCT (RTVue(®), Optovue Inc.) iridocorneal angle measurements were
made before and 1 and 3 months after surgery. Trabecular-iris angle (TIA), and
angle opening distance 500 μm anterior to the scleral spur (AOD500) were compared
among the quadrants nasal, temporal and inferior, and correlations with ocular
variables including lens vault were examined.
RESULTS: Preoperative TIA was 48.7 ±8.7, 48.2 ±8.7, and 48.7 ±9.3 degrees for the
nasal, temporal and inferior quadrants, with no differences (P= 1.000). Following
ICL implant, corresponding values fell to 31.2 ±11.5, 30.0 ±10.7 and 29.7 ±8.1
degrees at 1 month post-surgery, indicating angle narrowing of 34 to 42%, and to 
30.6 ±12.3, 30.1 ±11.9 and 29.8 ±12.3 degrees respectively at 3 months
post-surgery. Angle measurements failed to vary between 1 month and 3 months
post-surgery (P= .481). In 8 eyes, iridotrabecular contact attributable to
surgery was observed. One month after surgery, vault measurements correlated with
TIA (R= -.309; P= .048). Six variables were identified as predictors of TIA at 1 
month post-surgery (R(2)= .907).
CONCLUSIONS: Although considerable angle narrowing was detected 1 month after ICL
V4c implant this narrowing remained stable at 3 months post-surgery. Factors
predictive of TIA could serve to identify suitable candidates for ICL placement.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26582312   [PubMed - as supplied by publisher]


2. Am J Ophthalmol. 2015 Nov 12. pii: S0002-9394(15)00701-1. doi:
10.1016/j.ajo.2015.11.013. [Epub ahead of print]

Inverted internal limiting membrane insertion for macular hole associated retinal
detachment in high myopia.

Chen SN(1), Yang CM(2).

Author information: 
(1)Department of Ophthalmology, Changhua Christian Hospital, No. 135, Nan-Hsiao
St., Changhua City, Taiwan; College of Medicine, Kaohsiung Medical University,
No.100, Shichuan 1(st) Rd., Kaohsiung, Taiwan. (2)Department of Ophthalmology,
National Taiwan University Hospital, No.7, Chongshan South Rd., Taipei, Taiwan;
College of Medicine, National Taiwan University, No. 1, Sec. 1, Jenai Rd.,
Taipei, Taiwan. Electronic address: chungmay@ntu.edu.tw.

PURPOSE: To investigate the surgical outcomes of inverted internal limiting
membrane (ILM) insertion in macular hole (MH)-associated retinal detachment (RD) 
in high myopia.
DESIGN: Retrospective, interventional, consecutive case series.
METHODS: This study was conducted at two medical centers. Consecutive cases of
highly myopic eyes with MH associated RD were included. Forty eyes were divided
into 2 groups; group 1 (20 eyes) received vitrectomy, ILM peeling within the
arcade area and air-fluid exchange, and group 2 (20 eyes) received vitrectomy,
inverted ILM inserted into the macular hole and air-fluid exchange. Optical
coherence tomography was used to observe the closure of macular hole. Corrected
visual acuity (VA) was also recorded. Two-sample t-test and Mann-Whitney U test
were used for statistical analysis to compare difference between the 2 groups.
RESULTS: MH was closed in 35% of the eyes in group 1 and in all eyes in group 2
(p<0.001). Significant improvement in VA in logarithm of minimal angle of
resolution (logMAR) was achieved in both groups. There was no difference in the
initial, final, or improvement of LogMAR VA in the two groups.
CONCLUSION: Inverted ILM insertion into a macular hole effectively helps close
the macular hole in MH-associated RD in high myopia. This may prevent the
possible re-detachment from the MH. A prospective study with a larger number of
cases and longer follow-up may help validate our findings.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26582311   [PubMed - as supplied by publisher]


3. Am J Ophthalmol. 2015 Nov 11. pii: S0002-9394(15)00697-2. doi:
10.1016/j.ajo.2015.11.009. [Epub ahead of print]

Peripheral Cryoablation for Treatment of Active Pars Planitis: Long Term Outcomes
of a Retrospective Study.

Sohn EH(1), Chaon BC(2), Jabs DA(3), Folk JC(2).

Author information: 
(1)Department of Ophthalmology and Visual Sciences, Stephen A. Wynn Institute for
Vision Research, University of Iowa Hospitals and Clinics, Iowa City, IA.
Electronic address: Elliott.Sohn@gmail.com. (2)Department of Ophthalmology and
Visual Sciences, Stephen A. Wynn Institute for Vision Research, University of
Iowa Hospitals and Clinics, Iowa City, IA. (3)Departments of Ophthalmology and
Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Department of
Epidemiology, The Johns Hopkins University Bloomberg School of Public Health.

PURPOSE: To compare the long-term outcomes of peripheral retinal cryoablation to 
conventional treatment for active pars planitis.
DESIGN: Retrospective, interventional, comparative case series.
METHODS: Review at a single institution was conducted to compare the effect of
cryotherapy to eyes with pars planitis to those receiving conventional therapy
(topical, regionally injected or oral corticosteroid therapy). Best-corrected
visual acuity (VA), complications, resolution of cystoid macular edema (CME),
anterior chamber and vitreous inflammation were assessed.
RESULTS: One hundred thirty-six eyes were treated conventionally, 50 eyes were
treated with cryotherapy. Median follow-up was 60.8 months (range 8.1-223.1
months) in the cryotherapy group and 45.0 months (range 3.1-339.0 months) in the 
controls. There were no significant differences in baseline VA, anterior chamber 
and vitreous inflammation, presence of CME, and prior use of regional
corticosteroid injections. VA improved over time in the cryotherapy group (slope 
of -0.0018 logMAR-units-per-month; p=0.023) but declined in the controls (slope
of +0.0011 logMAR-units-per-month; p=0.023). Kaplan-Meier survival estimates
demonstrated faster times to resolution of anterior chamber cell, vitreous cell, 
and CME in the cryotherapy-treated eyes. Hazard ratios of remission (adjusted for
confounding factors) for vitreous cell and CME for those treated with cryotherapy
compared to controls were 4.73 (95% confidence interval 1.63,13.63; p=0.004) and 
6.85 (95% 1.06,44.78; p=0.044), respectively. No ocular complications were
identified in the cryotherapy group.
CONCLUSIONS: These data suggest that peripheral retinal cryoablation therapy is
an effective treatment for active pars planitis and may be better than
conventional regional corticosteroid injections and oral corticosteroid therapy
for induction of remission.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26576712   [PubMed - as supplied by publisher]


4. Am J Ophthalmol. 2015 Dec;160(6):1314-5. doi: 10.1016/j.ajo.2015.09.007.

Reply.

Bruyère E(1), Caillaux V(1), Cohen SY(1), Martiano D(1), Ores R(1), Puche N(1),
Souied EH(1).

Author information: 
(1)Créteil, France.

PMID: 26572728   [PubMed - in process]


5. Am J Ophthalmol. 2015 Dec;160(6):1311. doi: 10.1016/j.ajo.2015.09.013.

Morphology and Vascular Layers of the Choroid in Stargardt Disease Analyzed Using
Spectral-Domain Optical Coherence Tomography.

Huang W(1), Zhang X(1).

Author information: 
(1)Guangzhou, China.

PMID: 26572727   [PubMed - in process]


6. Am J Ophthalmol. 2015 Nov 9. pii: S0002-9394(15)00683-2. doi:
10.1016/j.ajo.2015.10.026. [Epub ahead of print]

Assessing Deep Retinal Capillary Ischemia in Paracentral Acute Middle Maculopathy
by Optical Coherence Tomography Angiography.

Nemiroff J(1), Kuehlewein L(2), Rahimy E(3), Tsui I(1), Doshi R(4), Gaudric A(5),
Gorin MB(1), Sadda S(2), Sarraf D(6).

Author information: 
(1)Stein Eye Institute, David Geffen School of Medicine at University of
California Los Angeles, Los Angeles, California. (2)Institute for Ophthalmic
Research, Center for Ophthalmology, Eberhard Karls University Tuebingen,
Tuebingen, Germany. (3)Retina Service, Wills Eye Hospital, Philadelphia,
Pennsylvania. (4)Kaiser Permenante, Tustin, California. (5)Ophtalmologie, Hopital
Lariboisiere, AP-HP, Université Paris 7 - Sorbonne Paris Cité, Paris, France.
(6)Stein Eye Institute, David Geffen School of Medicine at University of
California Los Angeles, Los Angeles, California; Greater Los Angeles Veterans
Affairs Healthcare Center, Los Angeles, California. Electronic address:
dsarraf@ucla.edu.

PURPOSE: To assess microvascular blood flow of the deep retinal capillary plexus 
in eyes with paracentral acute middle maculopathy using optical coherence
tomography (OCT) angiography.
DESIGN: Retrospective, multicenter, observational case series.
METHODS: Clinical and multimodal imaging findings from 8 patients with
paracentral acute middle maculopathy were reviewed and analyzed. OCT angiography 
scans were analyzed and processed, and vessel density was calculated.
RESULTS: Eight patients (7 male, 1 female, aged 9-82 years) were included. OCT
angiography was obtained at either the acute (4 cases) or old stage (4 cases).
Scans of the deep capillary plexus showed preservation of perfusion in acute
lesions and capillary attenuation in old cases. Cases of central retinal artery
occlusion showed marked loss of the deep capillary plexus. The mean vessel
density of the superficial capillary plexus in normal fellow eyes was 12.8±1.8
mm(-1) versus 12.1±1.9 mm(-1) in eyes with paracentral acute middle maculopathy
(reduction -6.0%, P = 0.08). The mean vessel density of the deep capillary plexus
in normal fellow eyes was 17.5±1.4 mm(-1) versus 14.7±3.5 mm(-1) in eyes with
paracentral acute middle maculopathy (reduction -19.4%, P = 0.04). This
significant difference was representative of the eyes with old lesions.
CONCLUSION: Paracentral acute middle maculopathy lesions correspond to
preservation of perfusion in focal acute lesions and to pruning of the plexus in 
old cases. Cases of central retinal artery occlusion demonstrate marked
hypoperfusion of the deep capillary plexus. Our study further supports an
ischemic pathogenesis of this retinal vasculopathy.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26562176   [PubMed - as supplied by publisher]


7. Am J Ophthalmol. 2015 Nov 8. pii: S0002-9394(15)00685-6. doi:
10.1016/j.ajo.2015.11.004. [Epub ahead of print]

Outcomes of Repeat Keratoplasty for Failed Therapeutic Keratoplasty.

Ramamurthy S(1), Reddy JC(2), Vaddavalli PK(1), Ali MH(3), Garg P(1).

Author information: 
(1)Cornea, Anterior Segment and Refractive Surgery Services, L V Prasad Eye
Institute, Kallam Anji Reddy Campus, Hyderabad. (2)Cornea, Anterior Segment and
Refractive Surgery Services, L V Prasad Eye Institute, Kallam Anji Reddy Campus, 
Hyderabad. Electronic address: drcjagadeeshreddy@yahoo.co.in. (3)Department of
Clinical Epidemiology and Biostatistics, L V Prasad Eye Institute, Hyderabad,
India.

PURPOSE: To analyse clinical outcomes of repeat optical penetrating (PK) or
endothelial keratoplasty (EK) after failed therapeutic keratoplasty (TPK).
DESIGN: Retrospective consecutive, comparative, interventional case series
METHODS: Setting: LV Prasad Eye Institute, Hyderabad, India STUDY POPULATION:
Patients aged >18 years who underwent a repeat PK or EK following a failed TPK
with a follow up of atleast one year were included. Patients with culture
negative ulcers, viral aetiology, co existent ocular surface disease and multiple
grafts were excluded from the study.
INTERVENTION: PK or EK for failed TPK MAIN OUTCOME MEASURE: Corrected distance
visual acuity at one year follow up. Secondary outcome measure: graft clarity.
RESULTS: One-hundred twelve eyes (67-PK, 45-EK) were included in the study. The
PK group had a significantly higher number of cases with high risk features prior
to re-graft. Improvement in visual acuity in each of the types of grafts was
statistically significant (p<0.01) but there was no difference between the two
groups at 1 year post-operatively. A statistically significant proportion of
grafts regained graft clarity after re-grafting in the PK group (p<0.01) but not 
in EK group (p=0.205) at 1-year post operatively. Endothelial rejection rates
were higher in the PK group. Sub-group analysis showed that eyes which had PK or 
EK for failed TPK conducted for aspergillus keratitis showed better outcomes in
terms of graft clarity. Kaplan Maier (KM) survival analysis for graft clarity
showed cumulative survival of 50% at 5 years. The survival using the KM curve was
not statistically different between the two groups (p=0.33).
CONCLUSION: This study shows that visual rehabilitation with relatively good
functional outcomes can be achieved by performing repeat PK or EK in patients
after failed TPK.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26558523   [PubMed - as supplied by publisher]


8. Am J Ophthalmol. 2015 Nov 8. pii: S0002-9394(15)00687-X. doi:
10.1016/j.ajo.2015.11.006. [Epub ahead of print]

Ischemic Injury of the Papillomacular Bundle is a Predictive Marker of Poor
Vision in Eyes with Branch Retinal Artery Occlusion.

Cho KH(1), Ahn SJ(2), Jung CK(3), Han MK(4), Park KH(1), Woo SJ(5).

Author information: 
(1)Department of Ophthalmology, Seoul National University College of Medicine,
Seoul National University Bundang Hospital, Seongnam, South Korea. (2)Department 
of Ophthalmology, Armed Forces Capital Hospital, Seongnam, South Korea.
(3)Department of Radiology, Seoul National University College of Medicine, Seoul 
National University Bundang Hospital, Seongnam, South Korea. (4)Department of
Neurology, Seoul National University College of Medicine, Seoul National
University Bundang Hospital, Seongnam, South Korea. (5)Department of
Ophthalmology, Seoul National University College of Medicine, Seoul National
University Bundang Hospital, Seongnam, South Korea. Electronic address:
sejoon1@snu.ac.kr.

PURPOSE: To propose a novel prognostic feature of spectral domain-optical
coherence tomography (SD-OCT) in macula-involving branch retinal artery occlusion
(BRAO).
DESIGN: Retrospective comparative case study.
METHODS: We analyzed 66 eyes diagnosed with acute BRAO involving the macula from 
our hospital RAO registry. At presentation, a detailed ophthalmic and medical
history was obtained from all patients, and all underwent a comprehensive
ophthalmic evaluation, which included visual acuity examination, fundus
photography, fluorescein angiography, and SD-OCT. This evaluation was performed
at each follow-up visit.
RESULTS: The 66 eyes diagnosed with acute BRAO involving the macula were divided 
into 2 groups according to initial vision: Good Vision (≥ 20/40, 29 eyes, 44%)
and Poor Vision (< 20/40, 37 eyes, 56%). The Poor Vision group was further
divided into Improvement (18 eyes, 27%) and Non-Improvement (19 eyes, 28%)
groups, according to visual recovery at the final examination. Among multiple OCT
parameters, the involvement of papillomacular bundle, but not that of the central
fovea, was consistently observed in the Poor Vision group (P < 0.001) and more
significantly in the Non-Improvement (P < 0.001) group. Papillomacular
bundle-involvement features included signs of inner retinal ischemia, including
inner retinal thickening, inner retinal hyperreflectivity, and loss of
layer-by-layer integrity. Loss of layer-by-layer integrity was seen consistently 
in the Non-Improvement group. Quantitative analysis of inner retinal thickness
also supported this association.
CONCLUSION: In eyes with macula-involving BRAO, ischemic injury of the
papillomacular bundle at the acute stage, as seen on OCT, correlates closely with
poor vision and can explain the poor visual prognosis.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26558522   [PubMed - as supplied by publisher]


9. Am J Ophthalmol. 2015 Nov 7. pii: S0002-9394(15)00689-3. doi:
10.1016/j.ajo.2015.11.008. [Epub ahead of print]

Reliability of Pentacam HR Thickness Maps of the Entire Cornea in Normal, Post-
Laser In Situ Keratomileusis, and Keratoconus Eyes.

Xu Z(1), Peng M(1), Jiang J(1), Yang C(1), Zhu W(1), Lu F(1), Shen M(2).

Author information: 
(1)School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou,
Zhejiang, China. (2)School of Ophthalmology and Optometry, Wenzhou Medical
University, Wenzhou, Zhejiang, China. Electronic address: shenmxiao7@hotmail.com.

PURPOSE: To measure the repeatability and reproducibility of Pentacam HR system
thickness maps for the entire cornea in normal, post-laser in situ keratomileusis
(post-LASIK), and keratoconus (KC) eyes.
DESIGN: Reliability study.
METHODS: Sixty normal subjects (60 eyes), 30 post-LASIK subjects (60 eyes), and
14 KC patients (27 eyes) were imaged with the Pentacam HR system by two
well-trained operators. For pachymetry the cornea was divided into four zones: a 
central zone (2-mm diameter) and concentric pericentral zone (2-5 mm),
transitional zone (5-7 mm), and peripheral zone (7-10 mm). The three concentric
zones were subdivided into eight sectors. Intraobserver repeatability and
interobserver reproducibility of entire corneal thickness maps were tested by the
repeatability and reproducibility coefficients, intraclass correlation
coefficients, coefficient of variation, the 95% limits of agreement.
RESULTS: From central to peripheral zones, the precision of corneal thickness
measurements became gradually smaller. Central zone repeatability and
reproducibility were the best in the normal, post-LASIK, and KC groups. The
peripheral superior sectors showed poorer repeatability and reproducibility for
all subjects. The intraobserver repeatability and interobserver reproducibility
for all zones were ≤19.3 μm, ≤22.1 μm, ≤20.7 μm, in the normal, post-LASIK, and
KC groups respectively. The intraobserver and interobserver coefficients of
variation for all zones were ≤1.3%, ≤1.6%, and ≤1.6% for all three groups.
CONCLUSIONS: Pentacam HR system pachymetry of the entire cornea provided good
precision in normal, post-LASIK, and KC corneas. Thickness measurements in the
peripheral cornea should be interpreted with caution in abnormal corneas after
surgery or with diseases.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26556008   [PubMed - as supplied by publisher]


10. Am J Ophthalmol. 2015 Nov 7. pii: S0002-9394(15)00684-4. doi:
10.1016/j.ajo.2015.11.003. [Epub ahead of print]

Conjunctival Primary Acquired Melanosis: Is It Time for a New Terminology?

Jakobiec FA(1).

Author information: 
(1)David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear
Infirmary and the Department of Ophthalmology, Massachusetts Eye and Ear
Infirmary and Harvard Medical School, Boston, MA. Electronic address:
Fred_Jakobiec@meei.harvard.edu.

PURPOSE: To review the diagnostic categories of a group of conditions referred to
as "primary acquired melanosis."
DESIGN: Literature review on the subject and proposal of an alternative
diagnostic schema with histopathologic and immunohistochemical illustrations.
METHODS: Standard hematoxylin and eosin stained sections and immunohistochemical 
stains for MART-1, HMB-45, micropthalmia-associated transcription factor (MiTF), 
and Ki-67 for calculating the proliferation index are illustrated.
RESULTS: "Melanosis" is an inadequate and misleading term because it does not
distinguish between conjunctival intraepithelial melanin over-production
("hyperpigmentation") and intraepithelial melanocytic proliferation. It is
recommended that "intraepithelial melanocytic proliferation" be adopted for
histopathologic diagnosis. Atypical proliferations are characterized either by
bloated dendritic melanocytes with enlarged cell components (dendrites, cell
bodies and nuclei), or by epithelioid melanocytes without dendrites. Atypical
polygonal or epithelioid pagetoid cells may reach higher levels of the epithelium
beyond the basal layer. Immunohistochemistry defines the degree of melanocytic
proliferation, the cellular shape (dendritic or non-dendritic) (MART-1, HMB-45)
or identifies the melanocytic nuclei (MiTF). Intraepithelial melanocytic
proliferation without atypia represents increased numbers of normal appearing
dendritic melanocytes (hyperplasia or early neoplasia) that generally remain
confined to the basal/basement membrane region. Intraepithelial non-proliferative
melanocytic pigmentation signifies the usually small number of conjunctival basal
dendritic melanocytes that synthesize increased amounts of melanin that is
transferred to surrounding keratinocytes.
CONCLUSION: All pre- and postoperative biopsies of flat conjunctival melanocytic 
disorders should be evaluated immunohistochemically if there is any question
regarding atypicality. This should lead to a clearer microscopic descriptive
diagnosis that is predicated on an analysis of the participating cell types and
their architectural patterns. This approach is conducive to a better appreciation
of features indicating when to intervene therapeutically. An accurate early
diagnosis should forestall unnecessary later surgery.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26556007   [PubMed - as supplied by publisher]


11. Am J Ophthalmol. 2015 Nov 7. pii: S0002-9394(15)00686-8. doi:
10.1016/j.ajo.2015.11.005. [Epub ahead of print]

Fine Needle Aspiration Biopsy in Uveal Melanoma: Technique, Complications, and
Outcomes.

Sellam A(1), Desjardins L(2), Barnhill R(3), Plancher C(4), Asselain B(4),
Savignoni A(5), Pierron G(5), Cassoux N(6).

Author information: 
(1)Department of Ophthalmology, Institut Curie, Paris, France. Electronic
address: alexandresellam@gmail.com. (2)Department of Ophthalmology, Institut
Curie, Paris, France. (3)Department of Pathology, Institut Curie, Paris, France. 
(4)Department of Statistics, Institut Curie, Paris, France. (5)Department of
Genetics, Institut Curie, Paris, France. (6)Department of Ophthalmology, Institut
Curie, Paris, France; University Paris V Descartes.

PURPOSE: To report the technical aspects, complications and outcomes concerning
fine needle aspiration biopsy (FNAB) in uveal melanoma.
DESIGN: Retrospective cohort study.
METHODS: Patients with uveal melanoma who underwent trans-scleral or
trans-vitreal FNAB at an ocular oncology center were retrospectively evaluated.
FNAB was performed if the tumor was more than 5 mm in thickness. Array
comparative genomic hybridization analysis was performed on biopsy samples with
sufficient tissue. The main outcome measures were success (sample that gave a
successful result for biomarker analysis) rate, complications, liver metastasis
and overall survival.
RESULTS: There were 217 (114 males, 52%) consecutive study patients with a mean
age of 56.7 (16 - 84) years. The mean follow-up period was 31 (range 3.6 - 61.3) 
months. Mean tumor thickness was 8.4 (range 5 - 12) mm. The overall success rate 
of the procedure was 169 (77.9%) patients. Thirty one (14.3%) patients
experienced intravitreal hemorrhage of whom 9 (4.1%) required vitreal surgery.
There was no case of endophthalmitis, orbital dissemination, local recurrence or 
rhegmatogenous retinal detachment. Thirty-two (14.7%) patients developed
metastasis during the study of whom 20 (9.2%) died. Of the 169 successful
samples, 53 (31%) patients were classified as low risk, 41 (24%) as intermediate 
risk and 54 (32%) as high risk. Fifteen (9%) patients did not have any detectable
chromosomal abnormality and 6 (4%) could not be classified.
CONCLUSION: FNAB is a relatively safe and successful technique that can be
routinely used to obtain tissue for molecular genomic analysis; such analysis
helps determine the diagnosis and prognosis in uveal melanoma.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26556006   [PubMed - as supplied by publisher]


12. Am J Ophthalmol. 2015 Nov 7. pii: S0002-9394(15)00688-1. doi:
10.1016/j.ajo.2015.11.007. [Epub ahead of print]

Association between Trabecular Meshwork Anteroposterior Length and Anterior
Chamber Angle Width.

Lee RY(1), Lin SC(2), Chen RI(3), Barbosa DT(4), Lin SC(5).

Author information: 
(1)Department of Ophthalmology, University of California, San Francisco,
California, USA; Wake Forest University School of Medicine, Winston-Salem, North 
Carolina, USA. (2)Department of Ophthalmology, University of California, San
Francisco, California, USA. (3)Department of Ophthalmology, University of
California, San Francisco, California, USA; Case Western Reserve University
School of Medicine, Cleveland, Ohio, USA. (4)Department of Ophthalmology,
University of California, San Francisco, California, USA; Department of
Ophthalmology, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
(5)Department of Ophthalmology, University of California, San Francisco,
California, USA. Electronic address: LinS@vision.ucsf.edu.

PURPOSE: To investigate the association between trabecular meshwork
anteroposterior length and anterior chamber angle width in nonglaucomatous
subjects DESIGN: Prospective, cross-sectional study METHODS: Time-domain and
spectral-domain anterior segment optical coherence tomography images for 561 eyes
from 366 nonglaucomatous subjects were analyzed to determine trabecular meshwork 
anteroposterior length and three anterior chamber angle width parameters measured
at different distances from the scleral spur: angle opening distance at 250μm
(AOD250), 500μm (AOD500), and 750μm (AOD750) from the scleral spur;
trabecular-iris space area at 500μm (TISA500) and 750μm (TISA750) from the
scleral spur; angle recess area at 750μm (ARA750) from the scleral spur.
Univariable and multivariable linear mixed-effect regression models, the latter
adjusting age, sex, ethnicity, axial length, and the use of both eyes in the same
subject, were used to evaluate the association between trabecular meshwork
anteroposterior length and anterior chamber angle width parameters.
RESULTS: Mean trabecular meshwork anteroposterior length was 824.86±181.77 μm.
Univariate regression analyses showed a significant positive association between 
trabecular meshwork anteroposterior length and all anterior chamber angle width
parameters: AOD250 (P<0.0001; β =335.13), AOD500 (P<0.0001; β=271.84), AOD750
(P<0.0001; β=202.56), TISA500 (P<0.0001; β=780.78), TISA750 (P<0.0001; β=449.17),
ARA750 (P<0.0001; β=381.39). Multivariate regression analyses showed a
significant positive association between trabecular meshwork anteroposterior
length and all anterior chamber angle width parameters: AOD250 (P=0.005;
β=294.02), AOD500 (P=0.036; β=172.94), AOD750 (P=0.049; β=125.58), TISA500
(P=0.004; β=611.51), TISA750 (P=0.011; β=333.96), ARA750 (P<0.0001; β=309.12).
CONCLUSIONS: Wider anterior chamber angle is associated with greater trabecular
meshwork anteroposterior length.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26556005   [PubMed - as supplied by publisher]


13. Am J Ophthalmol. 2015 Nov 6. pii: S0002-9394(15)00678-9. doi:
10.1016/j.ajo.2015.10.023. [Epub ahead of print]

Visual Acuity Outcomes of the Boston Keratoprosthesis Type 1: Multicenter Study
Results.

Rudnisky CJ(1), Belin MW(2), Guo R(3), Ciolino JB(4); Boston Type 1
Keratoprosthesis Study Group.

Collaborators: Dohlman CH(1), Aquavella J(2), Belin MW(3), Aldave AJ(4), Hannush 
SB(5), Sippel KC(6), Mannis MJ(7), Afshari NA(8), Shen TT(9), Alfonso EC(10),
Macsai MS(11), Tabin G(12), Baratz KH(13), Hemady RK(14), Abad JC(1), Melki
SA(1), Pineda R 2nd(1).

Author information: 
(1)Department of Ophthalmology, University of Alberta, Edmonton, Alberta, Canada.
(2)University of Arizona Department of Ophthalmology & Vision Science, Tucson,
Arizona. (3)Department of Ophthalmology, Massachusetts Eye and Ear Infirmary,
Harvard Medical School, Boston, Massachusetts. (4)Department of Ophthalmology,
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston,
Massachusetts. Electronic address: Joseph_Ciolino@meei.harvard.edu.

PURPOSE: To report logarithm of the minimum angle of resolution (logMAR) visual
outcomes of the Boston Keratoprosthesis Type 1.
DESIGN: Prospective, cohort study.
METHODS: Pre-, intra-, and postoperative parameters of 300 eyes of 300 patients
who underwent implantation of a Boston Keratoprosthesis Type I device between
January 2003 and July 2008 by one of 19 surgeons at 18 medical centers were
collected.
RESULTS: After an average of 17.1 ± 14.8 months, visual acuity improved
significantly (p<0.0001) to a mean final value of 0.89 ± 0.64 (20/150). There
were also significantly fewer eyes with light perception (6.7%; n=19; p<0.0001), 
although 3.1% (n=9) progressed to no light perception. There was no association
between age (p=0.08), gender (p=0.959), operative side (p=0.167), or failure
(p=0.494) and final visual acuity. The median time to achieve 20/200 visual
acuity was 1 month (95% CI 1.0 - 6.0) and it was retained for an average of 47.8 
months. Multivariate analysis, controlling for preoperative visual acuity,
demonstrated two factors associated with final visual outcome: chemical injury
was associated with better final vision (p=0.007), whereas age-related macular
degeneration (p<0.0001) was associated with poorer vision.
CONCLUSIONS: The Boston Keratoprosthesis Type 1 is an effective device for
rehabilitation in advanced ocular surface disease, resulting in a significant
improvement in visual acuity. Eyes achieved a mean value of 20/150 (0.89 ± 0.64
logMAR units) after 6 months and this was relatively stable thereafter. The best 
visual prognosis is observed in chemical injury eyes, whereas the worst prognosis
is in aniridia, although the latter has limited visual potential.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26550696   [PubMed - as supplied by publisher]


14. Am J Ophthalmol. 2015 Nov 5. pii: S0002-9394(15)00680-7. doi:
10.1016/j.ajo.2015.10.025. [Epub ahead of print]

Three Dimensional Enhanced Imaging of Vitreoretinal Interface in Diabetic
Retinopathy Using Swept Source Optical Coherence Tomography.

Adhi M(1), Badaro E(2), Liu JJ(3), Kraus MF(4), Baumal CR(5), Witkin AJ(5),
Hornegger J(4), Fujimoto JG(3), Duker JS(5), Waheed NK(6).

Author information: 
(1)New England Eye Center, Tufts University School of Medicine, Boston, MA;
Departments of Electrical Engineering and Computer Science and Research
Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge,
Massachusetts, USA. (2)Department of Ophthalmology, Federal University of Brazil,
Sao Paulo, Brazil. (3)Departments of Electrical Engineering and Computer Science 
and Research Laboratory of Electronics, Massachusetts Institute of Technology,
Cambridge, Massachusetts, USA. (4)Pattern Recognition Lab and School of Advanced 
Optical Technologies (SAOT), University Erlangen-Nuremberg, Erlangen, Germany.
(5)New England Eye Center, Tufts University School of Medicine, Boston, MA.
(6)New England Eye Center, Tufts University School of Medicine, Boston, MA.
Electronic address: nadiakwaheed@gmail.com.

PURPOSE: To analyze the vitreoretinal interface in diabetic eyes using
three-dimensional wide-field volumes acquired using high-speed, long-wavelength
swept-source optical coherence tomography (SS-OCT).
DESIGN: Prospective cross-sectional study.
METHODS: Fifty-six diabetic patients (88 eyes) and 11 healthy non-diabetic
controls (22 eyes) were recruited. Up to eight SS-OCT volumes were acquired for
each eye. A registration algorithm removed motion artifacts and merged multiple
SS-OCT volumes to improve signal. Vitreous visualization was enhanced using
vitreous windowing method.
RESULTS: Of 88 diabetic eyes, 20 eyes had no retinopathy, 21 eyes had
non-proliferative diabetic retinopathy (NPDR) without macular edema, 20 eyes had 
proliferative diabetic retinopathy (PDR) without macular edema and 27 eyes had
diabetic macular edema (DME) with either NPDR or PDR. Thick posterior hyaloid
relative to healthy non-diabetic controls was observed in 0/20 (0%) diabetic eyes
without retinopathy, 4/21 (19%) eyes with NPDR, 11/20 (55%) eyes with PDR, and
11/27 (41%) eyes with DME (p=0.0001). Vitreoschisis was observed in 6/22 (27%)
healthy non-diabetic eyes, 9/20 (45%) diabetic eyes without retinopathy, 10/21
(48%) eyes with NPDR, 13/20 (65%) eyes with PDR and 17/27 (63%) eyes with DME
(p=0.007). While no healthy non-diabetic controls and diabetic eyes without
retinopathy had adhesions/pegs between detached posterior hyaloid and retina,
1/21 (4%), 11/20 (55%) and 11/27 (41%) eyes with NPDR, PDR and DME respectively
demonstrated this feature (p=0.0001).
CONCLUSION: SS-OCT with motion-correction and vitreous windowing provides
wide-field three-dimensional information of vitreoretinal interface in diabetic
eyes. This may be useful in assessing progression of retinopathy, planning
diabetic vitreous surgery and predicting treatment outcomes.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26548809   [PubMed - as supplied by publisher]


15. Am J Ophthalmol. 2015 Nov 5. pii: S0002-9394(15)00677-7. doi:
10.1016/j.ajo.2015.10.022. [Epub ahead of print]

Rates of Reoperation and Abnormal Binocularity Following Strabismus Surgery in
Children.

Leffler CT(1), Vaziri K(2), Schwartz SG(2), Cavuoto KM(2), McKeown CA(2), Kishor 
KS(2), Janot AC(3).

Author information: 
(1)Department of Ophthalmology, PO Box 980438, Virginia Commonwealth University
Medical Center, Richmond, VA 23298-0438. Electronic address:
chrislefflermd@gmail.com. (2)Bascom Palmer Eye Institute, University of Miami
Miller School of Medicine, 900 N.W. 17th St., Miami, FL 33136. (3)Department of
Ophthalmology, PO Box 980438, Virginia Commonwealth University Medical Center,
Richmond, VA 23298-0438.

PURPOSE: To determine predictors of reoperation and abnormal binocularity
outcomes (including amblyopia and diplopia) following pediatric strabismus
surgery.
DESIGN: Retrospective cross-sectional study.
METHODS: Setting: Review of a national insurance database.
STUDY POPULATION: Children under age 18 years having strabismus procedures
between 2007 and 2013.
INTERVENTIONS: Adjustable or fixed suture strabismus surgery, or botulinum toxin 
injection.
OUTCOME MEASURES: Reoperation or diagnosis of abnormal binocularity in the first 
postoperative year.
RESULTS: Of 11,115 children having strabismus procedures, 851 (7.7%) underwent
reoperation. The reoperation rate was 7.4% for fixed suture surgeries, 9.6% for
adjustable suture surgeries (p=0.18), and 44.9% for botulinum injections
(p<0.001). Age under 2 years was associated with higher reoperation and abnormal 
binocularity rates (p<0.001). For horizontal strabismus, the postoperative
abnormal binocularity rate was 12.8% for fixed suture surgery and 26.5% for
botulinum injection (p=0.005). Reoperation rates tended to be higher with
adjustable sutures (odds ratio [OR] 1.69, 95% confidence interval [CI] 0.94 to
3.03, p=0.08), or botulinum toxin injection (OR 10.36, 95% CI 5.75 to 18.66,
p<0.001) and lower with 3- or 4-muscle surgery (p=0.001). Esotropia, hyperopia,
and botulinum injection were independently associated with higher rates of
postoperative abnormal binocularity (p<=0.005). For vertical surgeries,
predictors of reoperation were adjustable suture use (OR 2.51, p=0.10) and
superior oblique surgery (OR 2.36, p<0.001).
CONCLUSIONS: Adjustable sutures were not associated with a lower reoperation rate
in children. Younger age, esotropia, hyperopia, and botulinum injection were
associated with postoperative abnormal binocularity. Superior oblique surgery and
botulinum injection were associated with higher rates of reoperation.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26548808   [PubMed - as supplied by publisher]


16. Am J Ophthalmol. 2015 Nov 3. pii: S0002-9394(15)00676-5. doi:
10.1016/j.ajo.2015.10.021. [Epub ahead of print]

Effect of photorefractive keratectomy on nystagmus and visual functions in myopic
patients with infantile nystagmus syndrome.

Bagheri A(1), Abbasi H(1), Tavakoli M(2), Baradaran-Rafii A(1), Shaibanizadeh
A(3), Kheiri B(1), Yazdani S(1).

Author information: 
(1)Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences,
Tehran, Iran. (2)Ophthalmic Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran. Electronic address: mehditavakolimd@gmail.com.
(3)Department of audiology, Iran University of Medical Sciences, Tehran, Iran.

PURPOSE: To determine the effect of photorefractive keratectomy (PRK) on
involuntary eye movements, visual acuity and contrast sensitivity in myopic
patients with infantile nystagmus syndrome.
DESIGN: Prospective interventional case series METHODS: This study was conducted 
on patients with infantile nystagmus syndrome and myopia equal or more than -1 D,
who were referred to our clinic over a two-year period. Patients older than 18
years of age with a stable refraction for at least one year who were good
candidates for PRK were included. Complete ophthalmological examinations
including assessment of best corrected visual acuity (BCVA), contrast sensitivity
and videonystagmography were performed for all patients before and 3 months after
surgery.
RESULTS: Twenty-four eyes of 12 patients with mean age of 23±2 years were
enrolled into this study. Spherical equivalent refractive error was -2.82 ± 1.65 
D and -0.26 ± 0.25 D before and after PRK, respectively (P<0.001). Monocular BCVA
improved from 0.36±0.21 to 0.27±0.25 LogMAR and binocular BCVA was improved from 
0.33±0.2 to 0.17±0.16 LogMAR (P˂0.001). Contrast sensitivity significantly
improved at low (p<0.001), intermediate (P<0.001), and high frequencies (P=0.01).
The frequency, amplitude and intensity of nystagmus were significantly decreased 
after PRK (P˂0.001). There was no correlation between the degree of myopia
correction and improvement in sensory and motor indices of nystagmus (P> 0.1,
Spearman correlation coefficient).
CONCLUSION: PRK in patients with infantile nystagmus syndrome and myopia improved
monocular and binocular BCVA and contrast sensitivity. Furthermore, motor indices
of nystagmus (frequency, amplitude and intensity) were significantly improved
after surgery in these patients.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26546564   [PubMed - as supplied by publisher]


17. Am J Ophthalmol. 2015 Nov 3. pii: S0002-9394(15)00675-3. doi:
10.1016/j.ajo.2015.10.020. [Epub ahead of print]

Choroidal line scan measurements in swept-source optical coherence tomography as 
surrogates for volumetric thickness assessment.

Gerendas BS(1), Hecht A(2), Kundi M(3), Waldstein SM(1), Deak G(2), Simader C(4),
Montuoro A(5), Schmidt-Erfurth U(6), Funk M(2).

Author information: 
(1)Christian Doppler Laboratory for Ophthalmic Image Analysis, Medical University
of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Vienna Reading Center,
Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel
18-20, 1090 Vienna, Austria; Department of Ophthalmology, Medical University of
Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria. (2)Department of
Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, 1090
Vienna, Austria. (3)Institute of Environmental Health, Center for Public Health, 
Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
(4)Vienna Reading Center, Department of Ophthalmology, Medical University of
Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria; Department of
Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, 1090
Vienna, Austria. (5)Christian Doppler Laboratory for Ophthalmic Image Analysis,
Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
Vienna Reading Center, Department of Ophthalmology, Medical University of Vienna,
Waehringer Guertel 18-20, 1090 Vienna, Austria. (6)Christian Doppler Laboratory
for Ophthalmic Image Analysis, Medical University of Vienna, Waehringer Guertel
18-20, 1090 Vienna, Austria; Vienna Reading Center, Department of Ophthalmology, 
Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria;
Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel
18-20, 1090 Vienna, Austria. Electronic address:
ursula.schmidt-erfurth@meduniwien.ac.at.

PURPOSE: To compare choroidal thickness of different areas on swept-source
optical coherence tomography (SS-OCT) line and cube scans for their
interchangeable use.
DESIGN: Validity analysis.
METHODS: SS-OCT line and cube scans were obtained from 21 patients with various
choroidal thicknesses. Subfoveal centerpoint choroidal thickness, mean central
millimeter choroidal thickness and mean 6-mm area choroidal thicknesses were
obtained from both eyes by two independent graders in a reading center setting.
Cross-correlations were performed using Passing and Bablok regression models. A
95% confidence interval of slope that included 1 was considered to indicate no
significant difference. Average choroidal thickness of centerpoint, early
treatment diabetic retinopathy study grid subfields and total grid area of 6 mm
on both scans and the correlation between different areas served as main outcome 
measures.
RESULTS: No significant difference between line scans/corresponding subfields of 
cube scans (outer nasal 0.92-1.11, inner nasal 0.88-1.06, central 0.94-1.11,
inner temporal 0.95-1.12, outer temporal 0.93-1.17). No significant difference
between subfoveal centerpoint measurement/mean of choroidal thickness in the
central millimeter of cube scans (0.89-1.08). Significant difference of subfoveal
centerpoint measurement or mean of central millimeter area of cube scans to
entire 6-mm area of cube scans (1.01-1.53 and 1.03-1.38).
CONCLUSIONS: Measurements on a single SS-OCT horizontal line scan can represent
the entire choroid but subfoveal centerpoint measurements are only indicative for
the central millimeter area. There is a consistent overestimation of choroidal
thickness when trying to estimate overall choroidal thickness from any central
measurement.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26546563   [PubMed - as supplied by publisher]


18. Am J Ophthalmol. 2015 Oct 30. pii: S0002-9394(15)00660-1. doi:
10.1016/j.ajo.2015.10.017. [Epub ahead of print]

Graft Failure and Intraocular Pressure Control After Keratoplasty in Iridocorneal
Endothelial Syndrome.

Quek DT(1), Wong CW(1), Wong TT(1), Han M(1), Han SB(2), Htoon HM(1), Ho CL(1),
Tan DT(1), Price FW Jr(3), Price MO(3), Mehta JS(1).

Author information: 
(1)Singapore. (2)Singapore and Seoul, South Korea. (3)Indianapolis, Indiana.

PMID: 26525380   [PubMed - as supplied by publisher]


19. Am J Ophthalmol. 2015 Oct 29. pii: S0002-9394(15)00612-1. doi:
10.1016/j.ajo.2015.10.002. [Epub ahead of print]

Comparison of Contrast Sensitivity and Through Focus in Small-Aperture Inlay,
Accommodating Intraocular Lens, or Multifocal Intraocular Lens Subjects.

Vilupuru S(1), Lin L(1), Pepose JS(2).

Author information: 
(1)Irvine, California. (2)St Louis, Missouri.

PMID: 26522650   [PubMed - as supplied by publisher]


20. Am J Ophthalmol. 2015 Oct 29. pii: S0002-9394(15)00634-0. doi:
10.1016/j.ajo.2015.10.006. [Epub ahead of print]

Prevention of Cystoid Macular Edema After Cataract Surgery in Non-Diabetic and
Diabetic Patients: A Systematic Review and Meta-Analysis.

Wielders LH(1), Lambermont VA(1), Schouten JS(1), van den Biggelaar FJ(1), Worthy
G(2), Simons RW(1), Winkens B(1), Nuijts RM(1).

Author information: 
(1)Maastricht, Netherlands. (2)Escrick, York, United Kingdom.

PMID: 26522649   [PubMed - as supplied by publisher]


21. Am J Ophthalmol. 2015 Nov 13. pii: S0002-9394(15)00674-1. doi:
10.1016/j.ajo.2015.10.019. [Epub ahead of print]

Idiopathic Enlargement of the Extraocular Muscles in Young Patients: A Case
Series.

Sharma A(1), Foster RS(2), Suh DW(3), Smith D(1), Kraft SP(1), Ali A(4).

Author information: 
(1)Department of Ophthalmology and Vision Sciences, The Hospital for Sick
Children and the University of Toronto, Toronto, Canada. (2)Department of
Ophthalmology, Stanford University, Stanford, California. (3)Department of
Ophthalmology and Visual Science, University of Nebraska Medical Center, Omaha,
Nebraska. (4)Department of Ophthalmology and Vision Sciences, The Hospital for
Sick Children and the University of Toronto, Toronto, Canada. Electronic address:
asim.ali@sickkids.ca.

PURPOSE: To describe a case series of enlarged extraocular muscles in young
patients.
DESIGN: Retrospective interventional case series.
METHODS: Study involves 6 young patients who presented with atypical restrictive 
strabismus and reduced eye movements. Examination, neuroimaging, biochemistry
results, and biopsy results are presented. The surgeries are described, and the
follow-up over 1-20 years is presented.
RESULTS: All 6 patients had enlarged extraocular muscles that caused restrictive 
strabismus. The patients had no significant medical history. There was no
identifiable underlying pathology on biochemistry tests or muscle biopsy. Three
of the patients required multiple surgeries.
CONCLUSION: Atypical presentations of strabismus should be investigated for
systemic conditions. Neuroimaging of the orbit and brain and a biopsy of the
affected muscles should be considered. The patients should be counseled that
multiple surgeries may be necessary to improve the strabismus, and it is unlikely
that orthotropia will be attained.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26521716   [PubMed - as supplied by publisher]


22. Am J Ophthalmol. 2015 Oct 30. pii: S0002-9394(15)00673-X. doi:
10.1016/j.ajo.2015.10.018. [Epub ahead of print]

Evaluation of Photoreceptors in Bietti Crystalline Dystrophy with CYP4V2
Mutations Using Adaptive Optics Scanning Laser Ophthalmoscopy.

Miyata M(1), Ooto S(2), Ogino K(2), Gotoh N(2), Morooka S(2), Makiyama Y(2),
Hasegawa T(2), Sugahara M(2), Hata M(2), Yamashiro K(2), Yoshimura N(2).

Author information: 
(1)Department of Ophthalmology and Visual Sciences, Kyoto University Graduate
School of Medicine, Kyoto, Japan. Electronic address: miyatam@kuhp.kyoto-u.ac.jp.
(2)Department of Ophthalmology and Visual Sciences, Kyoto University Graduate
School of Medicine, Kyoto, Japan.

PURPOSE: To evaluate photoreceptors in Bietti crystalline dystrophy patients with
CYP4V2 mutations using high-resolution images of the macula obtained with
adaptive optics scanning laser ophthalmoscopy (AO-SLO).
DESIGN: Prospective observational case series with comparison to healthy
controls.
METHODS: Seven eyes of 7 Bietti crystalline dystrophy patients with CYP4V2
mutations and 12 normal eyes of 12 age- and axial length-matched healthy
volunteers were studied. All participants underwent ophthalmologic examinations
and AO-SLO assessments. All patients underwent spectral-domain optical coherence 
tomography, fundus autofluorescence, Humphrey field analysis, and
electroretinography. AO-SLO images were analyzed 0.5 mm and 1.0 mm from the
center of the fovea in the superior, inferior, nasal, and temporal quadrants.
RESULTS: Mean ± standard deviation cone density (cells/mm(2)) 0.5 mm from the
center of the fovea was 17 209 ± 2276 in patients and 20 493 ± 2758 in controls, 
which was statistically different (P = .001); however, mean cone density 1.0 mm
from the center of the fovea was 15 685 ± 2302 in patients and 15 705 ± 1848 in
controls, which was not statistically different (P = .20). There was no
correlation between cone density and mean deviation measured using a Humphrey
field analysis or visual acuity in patients.
CONCLUSIONS: In Bietti crystalline dystrophy patients with CYP4V2 mutations, cone
density remained for visual dysfunction by evaluation using high-resolution
AO-SLO. These findings support the theory that disorder of the retinal pigment
epithelium and the photoreceptors in the patients are the primary and secondary
pathologic changes, respectively. This is consistent with results from previous
basic studies.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26521715   [PubMed - as supplied by publisher]


23. Am J Ophthalmol. 2015 Oct 28. pii: S0002-9394(15)00643-1. doi:
10.1016/j.ajo.2015.10.015. [Epub ahead of print]

Comparison of Lateral Rectus Muscle Re-recession and Medial Rectus Muscle
Resection for Treatment of Postoperative Exotropia.

Bhambhwani V(1).

Author information: 
(1)New Delhi, India.

PMID: 26520673   [PubMed - as supplied by publisher]


24. Am J Ophthalmol. 2015 Oct 28. pii: S0002-9394(15)00633-9. doi:
10.1016/j.ajo.2015.10.005. [Epub ahead of print]

Prevention of Cystoid Macular Edema After Cataract Surgery in Non-Diabetic and
Diabetic Patients: A Systematic Review and Meta-Analysis.

Kim SJ(1), Jampel H(2).

Author information: 
(1)Nashville, Tennessee. (2)Baltimore, Maryland.

PMID: 26520672   [PubMed - as supplied by publisher]


25. Am J Ophthalmol. 2015 Oct 28. pii: S0002-9394(15)00614-5. doi:
10.1016/j.ajo.2015.10.004. [Epub ahead of print]

Comparison of Contrast Sensitivity and Through Focus in Small-Aperture Inlay,
Accommodating Intraocular Lens, or Multifocal Intraocular Lens Subjects.

Vilupuru S(1), Lin L(1), Pepose JS(2).

Author information: 
(1)Irvine, California. (2)St Louis, Missouri.

PMID: 26520671   [PubMed - as supplied by publisher]


26. Am J Ophthalmol. 2015 Oct 26. pii: S0002-9394(15)00642-X. doi:
10.1016/j.ajo.2015.10.014. [Epub ahead of print]

Comparison of Lateral Rectus Muscle Re-recession and Medial Rectus Muscle
Resection for Treatment of Postoperative Exotropia.

Lueder GT(1), Galli M(1).

Author information: 
(1)St Louis, Missouri.

PMID: 26514396   [PubMed - as supplied by publisher]


27. Am J Ophthalmol. 2015 Oct 26. pii: S0002-9394(15)00659-5. doi:
10.1016/j.ajo.2015.10.016. [Epub ahead of print]

Graft Failure and Intraocular Pressure Control After Keratoplasty in Iridocorneal
Endothelial Syndrome.

Mittal R(1), Senthil S(1).

Author information: 
(1)Hyderabad, India.

PMID: 26514395   [PubMed - as supplied by publisher]


28. Am J Ophthalmol. 2015 Oct 24. pii: S0002-9394(15)00611-X. doi:
10.1016/j.ajo.2015.10.001. [Epub ahead of print]

Comparison of Contrast Sensitivity and Through Focus in Small-Aperture Inlay,
Accommodating Intraocular Lens, or Multifocal Intraocular Lens Subjects.

Garcia-Gonzalez M(1), Teus MA(1).

Author information: 
(1)Madrid, Spain.

PMID: 26507159   [PubMed - as supplied by publisher]


29. Am J Ophthalmol. 2015 Oct 24. pii: S0002-9394(15)00638-8. doi:
10.1016/j.ajo.2015.10.010. [Epub ahead of print]

Validation of Concentric Rings Method as a Topographic Measure of Retinal
Nonperfusion in Ultra-widefield Fluorescein Angiography.

Nicholson L(1), Vazquez-Alfageme C(1), Ramu J(1), Triantafyllopoulou I(1), Patrao
NV(1), Muwas M(1), Islam F(1), Hykin PG(1), Sivaprasad S(1).

Author information: 
(1)London, United Kingdom.

PMID: 26507158   [PubMed - as supplied by publisher]


30. Am J Ophthalmol. 2015 Oct 21. pii: S0002-9394(15)00641-8. doi:
10.1016/j.ajo.2015.10.013. [Epub ahead of print]

Retinal Changes in Pediatric Glaucoma and Nonglaucomatous Optic Atrophy.

Jiramongkolchai K(1), Freedman SF(1), El-Dairi MA(2).

Author information: 
(1)Duke Eye Center, Durham, North Carolina. (2)Duke Eye Center, Durham, North
Carolina. Electronic address: mays.el-dairi@dm.duke.edu.

PURPOSE: To describe the incidence and significance of retinal changes in
pediatric eyes with glaucoma and nonglaucomatous optic atrophy by optical
coherence tomography (OCT).
DESIGN: Retrospective observational case series.
METHODS: OCT scans performed on children with either glaucoma or nonglaucomatous 
optic atrophy were retrospectively reviewed. Excluded were poor-quality scans and
diagnoses of ocular hypertension or glaucoma suspects.
RESULTS: Included were 227 eyes (227 children), 151 with glaucoma and 76 with
nonglaucomatous optic atrophy. Outer retinal changes were present in 20 of 151
glaucoma eyes (13.2%) (12 prior intraocular surgery, 5 uveitis, 3 primary
retinopathy) and 6 of 76 nonglaucomatous optic atrophy eyes (7.9%) (1 retinal
vasculitis, 3 papilledema, 2 infiltrative optic neuropathy). Excluding eyes with 
outer retinal changes, isolated inner nuclear layer (INL) cysts were found in 6
of 131 eyes with glaucoma (4.6%) (3 uveitis, 1 prior hydrocephalus, 1 uveitis and
pars plana vitrectomy, and 1 juvenile open-angle glaucoma) and 21 of 70 eyes with
nonglaucomatous optic atrophy (30%) (5 optic neuritis, 11 anterior visual pathway
tumors, 2 papilledema, 3 other) (P < .0001). Compared to eyes without INL cysts, 
those with INL cysts had thinner average retinal nerve fiber layer (RNFL) (78.2 ±
1.8 μm vs 52.0 ± 4.8 μm, P < .0001) and worse vision (logMAR = 0.33 ± 0.04 vs
0.65 ± 0.09, P < .002).
CONCLUSIONS: INL cysts are more frequent in pediatric nonglaucomatous optic
atrophy than glaucoma; they are associated with worse vision and thinner RNFL.
Outer retinal changes were exclusively seen in pathology that directly affected
the retina. In children, INL cysts and/or outer retinal changes without prior
history of intraocular surgery or uveitis should prompt further evaluation.

Copyright © 2015 Elsevier Inc. All rights reserved.

PMID: 26498891   [PubMed - as supplied by publisher]