1. Eur J Ophthalmol. 2015 Nov 6:0. doi: 10.5301/ejo.5000707. [Epub ahead of print]

Choroidal effusion and suprachoroidal hemorrhage during phacoemulsification:
intraoperative management to prevent expulsive hemorrhage.

Savastano A(1,)(2), Rizzo S(1), Savastano MC(2,)(3), Piccirillo V(4), Forte R(5),
Sbordone S(6), Diurno F(7), Savastano S(2).

Author information: 
(1)Azienda Ospedaliero-Universitaria Careggi, Florence - Italy. (2)Studio Medico 
Associato Savastano, Cassino (Frosinone) - Italy. (3)Università Cattolica del
Sacro Cuore, Policlinico Gemelli, Rome - Italy. (4)S. Maria della Pietà Hospital,
Casoria (Naples) - Italy. (5)Spallanzani Hospital, Frosinone - Italy. (6)Seconda 
Università degli Studi di Napoli (SUN), Naples - Italy. (7)Moscati Hospital,
Anesthesia Department, Aversa (Caserta) - Italy.

PURPOSE: To describe the intraoperative management of choroidal effusion (CE) or 
suprachoroidal hemorrhage (SCH) during cataract surgery with the
phacoemulsification technique.
METHODS: The study is a retrospective interventional study through which we
describe the intraoperative management adopted in 6 cases of CE or SCH during
cataract surgery. The study involved 6,400 eyes (phacoemulsification) in 6 years 
observational time (incidence rate 0.094%). The surgical time at which these
complications happened differed: nucleolus phacoemulsification in 2 eyes, cortex 
removal by bimanual irrigation-aspiration in 3 eyes, and intraocular lens implant
for 1 eye. Once the complication was recognized, each patient was quickly moved
to an extreme reverse Trendelenburg position and pharmacologically treated to
manage high blood pressure, pain, and anxiety (150 mL of an 18% mannitol solution
delivered in rapid infusion intravenously; 1-3 mg intravenous midazolam; 5
nifedipine sublingual drops).
RESULTS: In all the cases reported, the surgery was completed after resolution of
the acute choroidal exudation or SCH. In the follow-up evaluation, the
intraocular pressure was normal at each examination. The visual acuity of the
patients was between 6/7.5 and 5/6 Snellen after 4 weeks. We observed a
statistically significant reduction in endothelial cells in the 2 eyes in which
the CE or SCH happened during the phacoemulsification compared with the other
cases; this finding likely results from mechanical damage (p = 0.04 [95%
confidence interval]).
CONCLUSIONS: Choroidal effusion or SCH can be intraoperatively managed to avoid
expulsive hemorrhage and maintain the possibility of completing the surgery.

PMID: 26559935   [PubMed - as supplied by publisher]


2. Eur J Ophthalmol. 2015 Nov 6:0. doi: 10.5301/ejo.5000708. [Epub ahead of print]

Errors in IOL power study methodology.

Hoffer KJ(1,)(2), Haigis W(3).

Author information: 
(1)Stein Eye Institute, University of California, Los Angles - USA. (2)St. Mary's
Eye Center, Santa Monica, California - USA. (3)Department of Ophthalmology,
University of Würzburg - Germany.

PMID: 26559934   [PubMed - as supplied by publisher]


3. Eur J Ophthalmol. 2015 Nov 6:0. doi: 10.5301/ejo.5000705. [Epub ahead of print]

Epithelial downgrowth after cataract surgery: an atypical presentation with
scleral thinning and massive seeding in anterior chamber.

Scarpa G(1), La Gloria Valerio A(2), Urban F(1), Laurino L(3).

Author information: 
(1)Ophthalmology Unit, Ca'Foncello Hospital, Treviso - Italy. (2)Neuroscience
Department, Ophthalmology Unit, University of Padua, Padua - Italy. (3)Pathology 
Unit, Ca'Foncello Hospital, Treviso - Italy.

PURPOSE: To report an atypical presentation of epithelial downgrowth (ED) after
clear cornea cataract extraction, characterized by mixed clinical expression of
both cystic and diffuse form and massive epithelial debris seeding in anterior
chamber, associated with scleral involvement.
METHODS: In this case report, fine needle anterior chamber aspiration cytology
was performed to identify pathologic tissue invading iris, cornea, and angular
structures. The patient was treated with anterior chamber membrane surgical
excision.
RESULTS: Epithelial downgrowth was identified by cytologic assessment. The
patient was treated with epithelial membrane peeling and scleral defect
conjunctival covering. This conservative surgical approach led to a significant
reduction of ocular pain. During follow-up, residual epithelial tissue was
present in anterior chamber without tendency to regrowth.
CONCLUSIONS: In doubtful cases of ED, histocytopathologic analysis should be
performed without hesitation. Avoiding more invasive procedures, early detection 
and prompt surgical approach can result in improved outcome even in case of
extensive intraocular involvement.

PMID: 26559933   [PubMed - as supplied by publisher]


4. Eur J Ophthalmol. 2015 Nov 2:0. doi: 10.5301/ejo.5000700. [Epub ahead of print]

Estimation of depression prevalence in patients with Stargardt disease using
PHQ-9 and Zung scores.

Moschos MM(1), Nitoda E(1), Lavaris A(1).

Author information: 
(1)1 Department of Ophthalmology, Medical School, National and Kapodistrian
University of Athens, Athens - Greece.

PURPOSE: To evaluate the psychological impact and depression prevalence in
patients with Stargardt disease.
METHODS: We conducted a case-control study including 39 patients with Stargardt
disease and 32 age- and sex-matched healthy controls. All participants underwent 
a complete ophthalmologic examination and completed the Patient Health
Questionnaire-9 (PHQ-9) and the Zung Depression Inventory questionnaire. Results 
were analyzed using IBM SPSS 22.0 software.
RESULTS: The patient group consisted of 19 men and 20 women with mean age of 36.9
± 5.4 years and control group of 19 men and 13 women with mean age of 42.5 ± 10.1
years. The mean values of PHQ-9 and Zung scores for patients and healthy
individuals were 10.9 ± 4.9, 46.7 ± 11.1, 6.7 ± 5.4, and 41.1 ± 8.5,
respectively. There were statistically significant differences between the 2
groups in PHQ-9 scores (independent samples t test: p = 0.001), but not in Zung
scores (Mann-Whitney test: p = 0.053). The PHQ-9 and Zung scores appeared to be
moderately but significantly correlated (Pearson coefficient 0.44, plt;0.0001).
In addition, PHQ-9 score seems to be raised along with age, whereas both scores
are low when best-corrected visual acuity is high.
CONCLUSIONS: Patients with Stargardt disease exhibited more depressive symptoms
compared to healthy individuals according mainly to PHQ-9 scores. Moderate
depression was significantly correlated visual function decline.

PMID: 26541115   [PubMed - as supplied by publisher]


5. Eur J Ophthalmol. 2015 Oct 30:0. doi: 10.5301/ejo.5000695. [Epub ahead of print]

Helicoid peripapillary chorioretinal degeneration complicated by choroidal
neovascularization.

Triantafylla M(1), Panos GD(2), Dardabounis D(1), Nanos P(1), Konstantinidis
A(1).

Author information: 
(1)Department of Ophthalmology, University Hospital of Evros, Alexandroupolis -
Greece. (2)Department of Ophthalmology, Geneva University Hospitals, Faculty of
Medicine, University of Geneva, Geneva - Switzerland.

PURPOSE: Helicoid peripapillary chorioretinal degeneration (HPCD) is a hereditary
disease of the fundus that is characterized by atrophic chorioretinal areas that 
appear early in life and expand gradually from the optic disc towards the macula 
and the periphery.
METHODS: We describe the case of an elderly man with a known diagnosis of HPCD
who developed choroidal neovascular membrane (CNV) in both eyes during the course
of the disease.
RESULTS: The patient was treated with intravitreal injection of ranibizumab, to
which he had excellent response. The CNV subsided with 2 injections in the right 
eye and 1 in the left. Two years after the initial diagnosis of CNV in the right 
eye, visual acuity was 5/10 OD and 9/10 OS.
CONCLUSIONS: Helicoid peripapillary chorioretinal degeneration is rarely
complicated by CNV as the fundus lacks the trigger factors that would sustain
this process. Although rare, HPCD complicated by CNV can be seen bilaterally, but
responds well to few ranibizumab injections.

PMID: 26541114   [PubMed - as supplied by publisher]


6. Eur J Ophthalmol. 2015 Oct 29:0. doi: 10.5301/ejo.5000697. [Epub ahead of print]

Predicting cataract surgery time based on preoperative risk assessment.

Achiron A(1), Haddad F(1), Gerra M(1), Bartov E(1), Burgansky-Eliash Z(1).

Author information: 
(1)Department of Ophthalmology, Edith Wolfson Medical Center, Holon and the
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel.

PURPOSE: Operating room (OR) time is an expensive resource that should be
optimized to reduce costs. Individual preoperative risk parameters (PORS)
assessment may aid in predicting cataract surgery time.
METHODS: Dedicated software was developed and known risk factors for cataract
surgery were integrated into it. Preoperative risk parameters were assigned to
each patient in the preoperative meeting and the risk score was calculated. A
total of 153 patients were divided according to a standard classification into
low-risk group (PORS ≤2) and high-risk group (PORS gt;5). Duration of surgery for
each group was compared by Student t test and linear regression analysis was used
to calculate the relation between change in OR time and change in risk score.
RESULTS: Patients in the high PORS group had longer surgery times when compared
with patients in the low PORS group (37.6 vs 19.6, plt;0.001). Risk scores
positively correlated with surgery time (r = 0.30, plt;0.001). Prediction
equations for the OR time demonstrated for 2 surgeons that every increase in 1
risk point added 2.2 or 3.3 minutes to the OR time. Outliers (more than 1
standard deviation [SD] from each surgeon's surgery mean time) had more than
twice the risk score of cases within 1 SD from the mean.
CONCLUSIONS: The PORS system may be a useful tool for predicting OR time based on
individual patient risk and may improve OR scheduling.

PMID: 26541113   [PubMed - as supplied by publisher]


7. Eur J Ophthalmol. 2015 Oct 30:0. doi: 10.5301/ejo.5000701. [Epub ahead of print]

Bilateral optic disc edema as a presentation of an obstructing spinal
plasmacytoma.

Grixti A(1), Bonello M(2), Silver N(2), Noonan C(1), Ziahosseini K(1).

Author information: 
(1)Department of Ophthalmology, Aintree University Hospitals NHS Foundation
Trust, Liverpool - UK. (2)Department of Neurology, The Walton Centre NHS
Foundation Trust, Liverpool - UK.

PURPOSE: To report a rare case of bilateral optic disc edema as presentation of
an obstructing spinal plasmacytoma.
METHODS: Case report.
RESULTS: A 41-year-old healthy man presented with distortion of his peripheral
vision for 9 months. He denied headaches or neurologic symptoms. Examination
showed bilateral optic disc swelling, radial disc hemorrhages, and absent
spontaneous venous pulsations. Brain magnetic resonance imaging (MRI) and
magnetic resonance venography were unrevealing. Lumbar puncture showed a normal
opening pressure of 19 cm cerebrospinal fluid (CSF). CSF protein was
significantly elevated at 3.22 g/L (0.10-0.45 g/L). Spinal MRI with contrast
revealed a tumor in the T9 vertebral body extending through the disc spaces into 
T8 and T10, compressing the spinal cord. Computed tomography-guided biopsy
confirmed a spinal plasmacytoma. He received radiotherapy to the spine T7-T11 to 
reduce spinal cord compression followed by a 6-month course of chemotherapy with 
dexamethasone, cyclophosphamide, and thalidomide. Disc swelling improved on
starting radiotherapy with complete resolution 8 months posttreatment. MRI spine 
showed reduction of tumor.
CONCLUSIONS: This case highlights the importance of spinal imaging in patients
with normal cranial scans and raised CSF protein levels who lack the typical
idiopathic intracranial hypertension phenotype.

PMID: 26541112   [PubMed - as supplied by publisher]


8. Eur J Ophthalmol. 2015 Oct 30:0. doi: 10.5301/ejo.5000693. [Epub ahead of print]

Long-term anatomical and functional results in patients undergoing observation
for idiopathic nontractional epiretinal membrane.

Rouvas A(1), Chatziralli I(1), Androu A(1), Papakonstantinou S(1), Kouvari MS(1),
Alonistiotis D(1), Theodossiadis P(1).

Author information: 
(1)2 Department of Ophthalmology, Attikon University Hospital, Athens - Greece.

PURPOSE: To evaluate the anatomical and functional course without surgical
intervention in patients with nontractional epiretinal membrane (ERM) using
spectral-domain optical coherence tomography (SD-OCT) in a long-term follow-up of
38.2 ± 30.6 months.
METHODS: Participants were 58 patients with nontractional ERM, which was defined 
as a tear or rip of the ERM in at least one line of OCT scan. All patients were
observed without any surgical intervention. All patients underwent ophthalmologic
examination, including best-corrected visual acuity (BCVA) measurement,
funduscopy, and SD-OCT. Routine follow-up visits were performed every 6 months or
earlier at the discretion of the investigator.
RESULTS: There was no statistically significant difference in BCVA or central
foveal thickness (CFT) at all time points of the follow-up. About 84.4% of
patients presented improvement or stabilization in BCVA at the end of the
follow-up, while 53.4% of patients had a decrease in CFT. All patients had intact
ellipsoid zone and none of them needed surgical intervention at the end of the
follow-up of 38.2 ± 30.6 months.
CONCLUSIONS: In patients with nontractional ERM, BCVA and CFT may remain stable
in a long-term follow-up. Therefore, if ellipsoid zone is intact and there is a
tear or rip of ERM in at least one OCT scan, patients can be monitored and
surgery may be deferred because of high percentage of structural and functional
stability.

PMID: 26541111   [PubMed - as supplied by publisher]


9. Eur J Ophthalmol. 2015 Nov 5:0. doi: 10.5301/ejo.5000696. [Epub ahead of print]

Rotational stability and patient satisfaction after implantation of a new toric
IOL.

Gyöngyössy B(1), Jirak P(2), Schönherr U(1).

Author information: 
(1)Konventhospital der Barmherzigen Brüder, Linz - Austria. (2)Eyelaser, Linz -
Austria.

PURPOSE: To evaluate rotational stability, astigmatism correction, visual
outcomes, and patient satisfaction after implantation of the toric intraocular
lens (IOL) Torica-aA following cataract extraction over a 6-month follow-up
period.
METHODS: This prospective observational study enrolled 40 eyes of 26 patients
presenting with preexisting corneal astigmatism of 1.00 to 2.60 D. The rotational
stability of the IOL was evaluated using retroillumination photographs taken
within 24 hours after surgery and 1 week and 6 months postoperatively. Other main
study outcomes were assessed 6 months postoperatively and included uncorrected
and distance-corrected visual acuities, astigmatism correction, and patient
satisfaction.
RESULTS: Six months postoperatively, mean absolute IOL rotation was 1.99 ± 1.88° 
(range 0.10-7.40°) and secondary repositioning was not required. The IOL rotation
was lt;3° in 85% of eyes, ≤5° in 94% of eyes, and lt;8° in 100% of eyes. Mean
residual refractive cylinder was -0.57 ± 0.34 D. The magnitude of the J0 vector
was significantly decreased postoperatively (plt;0.0001). The mean J45 vector was
close to zero preoperatively and postoperatively (p = 0.27). Mean monocular
uncorrected distance visual acuity (UDVA) was 0.09 ± 0.12 logMAR and 97% of eyes 
achieved UDVA of 20/40 or better including 66% of eyes having 20/25 or better.
The good UDVA resulted in high levels of spectacle independence and patient
satisfaction.
CONCLUSIONS: Implantation of the Torica-aA IOL was safe and effective in reducing
low to moderate preexisting corneal astigmatism and provided good rotational
stability and refractive outcomes, which led to a high degree of patient
satisfaction.

PMID: 26541110   [PubMed - as supplied by publisher]


10. Eur J Ophthalmol. 2015 Oct 31:0. doi: 10.5301/ejo.5000703. [Epub ahead of print]

Influence of hyperopia and amblyopia on choroidal thickness in children.

Öner V(1), Bulut A(1), Büyüktarakçı Ş(1), Kaim M(1).

Author information: 
(1)Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School,
Rize - Turkey.

PURPOSE: To compare subfoveal choroidal thicknesses (ChTs) of anisometropic
hyperopic amblyopic, hyperopic nonamblyopic, and emmetropic control eyes and to
investigate the associations between ChT and ambylopia, spherical equivalent
(SE), and axial length in the pediatric population.
METHODS: Forty-six hyperopic nonamblyopic (hyperopic group), 33 anisometropic
hyperopic amblyopic (amblyopic group), and 42 emmetropic (emmetropic group) eyes 
were enrolled in this cross-sectional comparative study. Enhanced depth imaging
spectral-domain optical coherence tomography was used for quantitative analysis
of subfoveal ChT. ChT was quantified manually as the distance between the
hyperreflective line corresponding to the retinal pigment epithelium and the
chorioscleral interface at the subfoveal area.
RESULTS: The mean age was 10.6 ± 3.3 years (range 5-17) in the hyperopic group,
10.7 ± 3.3 years (range 5-17) in the amblyopic group, and 11.2 ± 3.3 years (range
5-17 years) in the emmetropic group (p = 0.627). The hyperopic and amblyopic
groups had significantly thicker choroid compared to the emmetropic group (p1 =
0.005 and p2 = 0.006, respectively). However, there was no significant difference
between the hyperopic and amblyopic groups concerning subfoveal ChT (p = 0.857). 
In addition, covariance analysis showed that although SE was independently
associated with subfoveal ChT (p = 0.014), amblyopia had no significant
independent effect on subfoveal ChT (p = 0.671). Further, subfoveal ChT had weak 
correlations with the axial length (r = -0.297, p = 0.001) and SE (r = 0.274, p =
0.002).
CONCLUSIONS: Hyperopia was associated with subfoveal ChT, whereas amblyopia had
no independent significant effect on subfoveal ChT in our study population.

PMID: 26541109   [PubMed - as supplied by publisher]


11. Eur J Ophthalmol. 2015 Oct 30:0. doi: 10.5301/ejo.5000690. [Epub ahead of print]

Comparison of astigmatism correction using either peripheral corneal relaxing
incisions or toric intraocular lenses.

Muftuoglu IK(1,)(2), Aydin Akova Y(3), Aksoy S(4), Unsal E(2).

Author information: 
(1)Department of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute,
University of California San Diego, La Jolla, CA - USA. (2)Department of
Ophthalmology, Istanbul Training and Research Hospital, Istanbul - Turkey.
(3)Department of Ophthalmology, Bayındır Kavaklidere Hospital, Ankara - Turkey.
(4)Department of Ophthalmology, Fatih Sultan Mehmet Training and Research
Hospital, Istanbul - Turkey.

PURPOSE: To compare the efficacy and short-term stability of toric intraocular
lenses (tIOL) and peripheral cornea relaxing incisions (PCRI) during
phacoemulsification.
METHODS: Patients with preexisting corneal astigmatism had cataract surgery
either with tIOL (AcrySof Toric) (39 eyes of 35 patients) or standard intraocular
lens (AcrySof) + PCRIs (38 eyes of 33 patients). Patients were retrospectively
evaluated for manifest refraction, corneal topography, and uncorrected and
corrected visual acuities preoperatively and at postoperative 1 and 6 months. The
Alpins vectorial method was used to analyze the target induced astigmatism (TIA) 
and surgically induced astigmatism (SIA), magnitude of error (the difference
between the magnitude of SIA and TIA) (ME), and correction index.
RESULTS: Mean preoperative corneal astigmatism was 2.21 ± 1.32 D in the tIOL
group and 2.24 ± 0.96 D in the PCRI group; the difference was not significant.
The decrease in astigmatism was significant in both groups at last follow-up (64%
tIOL group, 32% PCRI group, plt;0.01, Wilcoxon signed rank test). The mean
remaining refractive astigmatism was significantly higher in the PCRI group than 
in the tIOL group at 1-month (1.42 ± 1.22, 0.89 ± 0.68, respectively) and 6-month
follow-ups (1.75 ± 1.37 D, 0.92 ± 0.72, respectively) (plt;0.01). The mean ME was
significantly lower (-0.35 versus -0.88) with a higher correction index (0.96
versus 0.56) in the tIOL group at 6 months postoperatively.
CONCLUSIONS: Both tIOL implantation and using PCRI were effective methods to
reduce preoperative astigmatism at the time of the cataract surgery. However,
tIOLs provided better remaining astigmatism with a more stable refraction than
PCRI.

PMID: 26541108   [PubMed - as supplied by publisher]


12. Eur J Ophthalmol. 2015 Nov 5:0. doi: 10.5301/ejo.5000704. [Epub ahead of print]

Late opacification of a hydrophilic acrylic intraocular lens in Europe.

Mojzis P(1,)(2), Studeny P(2,)(3), Werner L(4,)(5), Piñero DP(6).

Author information: 
(1)Eye Department, Regional Hospital Havlickuv Brod, Havlickuv Brod, Brod - Czech
Republic. (2)Department of Ophthalmology, Medical Faculty of Charles University, 
Prague - Czech Republic. (3)Teaching Hospital Kralovske Vinohrady, Prague - Czech
Republic. (4)John A. Moran Eye Center, University of Utah, Salt Lake City, UT -
USA. (5)Berlin Eye Research Institute (BERI), Berlin - Germany. (6)Departament de
Optics, Pharmacology and Anatomy, University of Alicante, Alicante - Spain.

PURPOSE: To describe the clinical and microscopic findings in 2 different
patients of 2 cases of late opacification of the hydrophilic acrylic intraocular 
lens (IOL) Ioflex.
METHODS: Two eyes of 2 patients (73 and 74 years old) had an uneventful
phacoemulsification surgery with implantation of the Ioflex IOL (power +21.5 D). 
At 5 years after surgery, a dense IOL opacification was detected in both cases
with significant visual degradation. The IOLs were explanted and analyzed by
microscopy.
RESULTS: In both cases, a satisfactory visual recovery was achieved (corrected
distance visual acuity of 6/9 and 6/12). Microscopic examination of the explanted
IOLs revealed multiple small granules on the surface/subsurface of the lens.
Although histochemical or surface analyses were not performed, the aspect appears
consistent with a process of calcification of this lens design. Other findings
included few surface contaminants, such as fibers, crystals that may correspond
to dry viscoelastic and/or salt solutions, as well as pigments and dust-like
deposits.
CONCLUSIONS: Opacification of the posterior chamber hydrophilic acrylic IOL
Ioflex probably related to calcification can appear several years after its
implantation and requires IOL exchange due to the significant visual loss
induced. More studies are required to understand the causes of this complication.

PMID: 26541107   [PubMed - as supplied by publisher]


13. Eur J Ophthalmol. 2015 Oct 30:0. doi: 10.5301/ejo.5000694. [Epub ahead of print]

Retinal vessel diameter changes in different severities of diabetic retinopathy
by SD-OCT.

Shao Q(1), Heussen FM(2), Ouyang Y(1), Hager A(1).

Author information: 
(1)Charité-Universitätsmedizin Berlin, Department of Ophthalmology, Berlin -
Germany. (2)Department of Ophthalmology, Royal Liverpool University Hospital,
Liverpool - UK.

PURPOSE: To evaluate retinal vessel diameters in relation to different severity
grades of diabetic retinopathy (DR) using spectral-domain optical coherence
tomography (SD-OCT).
METHODS: Patients with varying degrees of nonproliferative DR (NPDR) underwent
circular OCT scans centered on the optic nerve head using a SD-OCT. These cases
were retrospectively reviewed. The presence and severity of DR was assessed using
Early Treatment Diabetic Retinopathy Study protocols. The 5 largest retinal
arterioles and venules were labeled and measured on OCT scans for each patient
according to previously published methods. Vertical vessel inner contour
diameter, vertical vessel outer contour diameter, and reflectance shadowing width
were among the documented parameters.
RESULTS: Of 59 eyes from 45 patients examined, 30 (50.2%) and 29 (49.8%) had mild
and severe NPDR, respectively. Eyes with severe NPDR had narrower mean arteriolar
vertical vessel inner diameter (87.9 ± 10.8 μm), vertical vessel outer diameter
(119.1 ± 9.7 μm), and vessel shadow width (78.8 ± 10.9 μm) than eyes with mild
NPDR (89.8 ± 12.1 μm, 120.9 ± 12.9 μm, 81.3 ± 15.3 μm). However, the differences 
were not statistically significant (p = 0.53, 0.55, 0.47). No correlation was
shown between the severity of NPDR and arteriolar parameters (p = 0.31, 0.59,
0.75). Wider venular diameters were associated with increasing severity of NPDR
(plt;0.001, lt;0.001, 0.007, respectively). The association remained after
multivariate adjustment for age, sex, eye, and cataract surgery (p = 0.04, 0.01, 
0.007, respectively).
CONCLUSIONS: Wider retinal venule diameter was significantly associated with the 
severity of NPDR by SD-OCT-assisted measurement. Prospective studies would be
needed to evaluate whether change in retinal venule could be used as a clinical
indicator of DR progression.

PMID: 26541106   [PubMed - as supplied by publisher]


14. Eur J Ophthalmol. 2015 Oct 30:0. doi: 10.5301/ejo.5000699. [Epub ahead of print]

The status of glaucoma diagnostics and care in Europe in 2015: a European survey.

Holló G(1), Hommer A(2).

Author information: 
(1)Department of Ophthalmology, Semmelweis University, Budapest - Hungary.
(2)Department of Ophthalmology, Hera Hospital, Vienna - Austria.

PURPOSE: To evaluate the current status of glaucoma diagnostics and care in
Europe.
METHODS: A questionnaire addressing glaucoma patient organizations, resident
education, access to an ophthalmologist, use and reimbursement of
techniques/instruments for glaucoma diagnostics and follow-up, prescription
rules, and glaucoma drug reimbursement was sent to all national representatives
of the European Glaucoma Society (EGS) in 2015. The country-specific responses
were analyzed and summarized.
RESULTS: Completed questionnaires were returned for 24 countries. In 2015, a
glaucoma patient organization is functioning in 57% of the respondent countries. 
Waiting time for an ophthalmology resident position varies between ≤6 months and 
gt;2 years. The duration of ophthalmology resident training varies between 3 and 
7 years. Nonemergency access to an ophthalmologist is available directly in 45.8%
and via the general practitioner in 25% of the countries. Disc
photography/imaging is always done during glaucoma diagnostics in 9.5% and for
follow-up in 55.5% of the respondent countries. Initial therapy of glaucoma is
medical in 100% (monotherapy in 91.3%) of the respondent countries. Clinical and 
visual field examination but not disc photography/imaging is reimbursed in 47.5% 
of the countries, while in another 47.5% all examinations are reimbursed.
Dispensing of the prescribed original eyedrops by the pharmacists is mandatory in
43.5% of the countries, while the aut idem rule applies in 52.2%, and the aut
simile rule in 4.3%.
CONCLUSIONS: Diagnostics, treatment, and follow-up of glaucoma remains diverse in
Europe. The differences are due to financial/reimbursement differences. When
reimbursement allows, the EGS Guidelines are followed.

PMID: 26541105   [PubMed - as supplied by publisher]


15. Eur J Ophthalmol. 2015 Nov 6:0. doi: 10.5301/ejo.5000698. [Epub ahead of print]

Anterior corneal surface irregularity after Descemet-stripping endothelial
keratoplasty for bullous keratopathy.

Spadea L(1), Santamaria V(1), Vingolo EM(1), Cagini C(2).

Author information: 
(1)Department of Biotechnology and Medical-Surgical Sciences, "Sapienza"
University of Rome, Rome - Italy. (2)Department of Surgical and Biomedical
Sciences, University of Perugia, Perugia - Italy.

PURPOSE: To evaluate irregularity of the anterior cornea before and after
Descemet stripping endothelial keratoplasty (DSEK) for bullous keratopathy and
its effect on visual acuity.
METHODS: Corneal data were acquired using a topographic unit before and up to 12 
months after DSEK. Anterior corneal elevation data were decomposed into a set of 
Zernike polynomials up to the 8th order within a 6.0-mm diameter region. Total
higher-order aberrations (HOAs) and root mean square from the 3rd to 8th order
were calculated. The effects of anterior surface irregularity on visual acuity
were evaluated.
RESULTS: This clinical study comprised 20 consecutive eyes of 20 patients with
bullous keratopathy. The mean corrected distance visual acuity (CDVA) was 1.00 ± 
0.12 logMAR (SD) preoperatively and 0.24 ± 0.16 logMAR 12 months postoperatively.
Before DSEK, corneas with bullous keratopathy had higher total HOAs compared with
those in controls (plt;0.05). There were no significant differences in anterior
surface HOAs between preoperatively and 12 months (pgt;0.05).
CONCLUSIONS: Postoperative CDVA correlated with irregularity of the corneal
anterior surface. Corneal anterior HOAs are higher in patients with bullous
keratopathy than in controls, and remain higher through 12 months after DSEK. In 
addition to corneal transparency, regularity of the corneal anterior surface is
an important factor in visual acuity after DSEK.

PMID: 26541104   [PubMed - as supplied by publisher]


16. Eur J Ophthalmol. 2015 Oct 31:0. doi: 10.5301/ejo.5000702. [Epub ahead of print]

Big-bubble deep anterior lamellar keratoplasty using central vs peripheral air
injection: a clinical trial.

Feizi S(1), Daryabari SH(1), Najdi D(1), Javadi MA(1,)(2), Karimian F(1,)(2).

Author information: 
(1)Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences,
Tehran - Iran. (2)Central Eye Bank of Iran, Tehran - Iran.

PURPOSE: To compare 2 sites of air injection to achieve Descemet membrane (DM)
detachment in big-bubble deep anterior lamellar keratoplasty (DALK).
METHODS: In this prospective, randomized study, 48 eyes of 48
keratoconus-affected patients who underwent DALK by cornea fellows were enrolled.
Each patient was randomly assigned into one of 2 groups. After trephination to
approximately 80% of the corneal thickness, a 27-G needle was inserted into the
stroma from the trephination site. The needle was moved radially inside the
trephination site and advanced to the central or paracentral cornea in group 1.
In group 2, the needle was inserted into the deep stroma from the trephination
site and advanced into the peripheral cornea to approximately 1.5 mm anterior to 
the limbus. Air was gently injected into the deep stroma until a big bubble was
formed. The rates of DM separation and complications were compared between the 2 
groups.
RESULTS: Big-bubble formation was successful in 79.2% of the eyes in the study
group. A bare DM was achieved by central injection in 68.0% of group 1 and by
peripheral injection in 69.6% of group 2 (p = 0.68). This rate was increased to
80.0% and 78.3% in groups 1 and 2, respectively, after the injection site was
shifted when injections failed. The study groups were comparable in terms of
complications including DM perforation and bubble bursting.
CONCLUSIONS: Both injection sites were equivalent in their rates of big-bubble
formation and complications. Less experienced surgeons are advised to initially
inject air outside the trephination.

PMID: 26541103   [PubMed - as supplied by publisher]


17. Eur J Ophthalmol. 2015 Oct 9;25(6):575. doi: 10.5301/EJO.2015.15172. [Epub ahead 
of print]

Erratum to: Eur J Ophthalmol, 2014; 24: 44-52 and Eur J Ophthalmol. 2012; 22:
175-87.

[No authors listed]

Erratum to: Eur J Ophthalmol. 2014 Jan-Feb;24(1):44-52. doi: 10.5301/ejo.5000335.
Comparison of far and near contrast sensitivity in patients symmetrically
implanted with multifocal and monofocal IOLs. Gil MA, Varon C, Cardona G, Vega F,
Buil JA. PMID: 23813113  [PubMed - indexed for MEDLINE] Eur J Ophthalmol. 2012
Mar-Apr;22(2):175-87. doi: 10.5301/EJO.2011.8371. Visual acuity, contrast
sensitivity, subjective quality of vision, and quality of life with 4 different
multifocal IOLs. Gil MA, Varon C, Roselló N, Cardona G, Buil JA. PMID: 21623590 
[PubMed - indexed for MEDLINE] We inform our readers that the articles above are 
ascribed to the PhD program of the Universitat Autònoma de Barcelona.

PMID: 26511136   [PubMed - as supplied by publisher]