 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
   |
 |
Online Advanced Release
Articles appearing in this "Online Advanced Release" section have been peer-reviewed and accepted for publication in the Ophthalmic Surgery, Lasers and Imaging and posted online before print publication. Articles appear on this site after copyediting and author corrections, but before final proofing. The content of the article will usually remain unchanged, and possible further corrections are fairly minor. The final published article will specify the issue and page numbers. Once the final version is available in print, the version posted here will be removed from this site.
PDF files and other links below will open in a new window.
Table of Contents
Efficacy of Different Excimer Laser Techniques in the Management of Recurrent Corneal Erosions
Werner W. Hütz, MD; Oliver Stachs, PhD; Fritz Hengerer, MD; Berthold Eckhardt, MDSubmitted 10/21/09; Accepted 7/20/10; Posted 8/30/10
BACKGROUND AND OBJECTIVE: To investigate the efficacy of two excimer laser techniques for recurrent corneal erosions (RCEs).
PATIENTS AND METHODS: Of 100 patients with RCEs not responding to common treatments, 50 received transepithelial (group 1) and 50 received subepithelial (group 2) treatment of 20 pulses of a 193-nm excimer laser (170 J/cm2). Postoperative follow-up occurred at 4 and 52 weeks. Outcome measures were frequency of RCEs, haze formation, and refractive changes.
RESULTS: At first follow-up, 7 patients (14%) in each group displayed recurrence. At second follow-up, 12 patients in group 1 (24%) and 10 patients in group 2 (20%) had RCE. Follow-up recurrence risk was 6% to 27% in both groups at 4 weeks and 13% to 38% in group 1 and 10% to 34% in group 2 at 52 weeks. The spherical equivalent remained unaffected in group 1, but a statistically significant change was observed in group 2.
CONCLUSION: Excimer laser treatment (transepithelial and subepithelial) of RCEs can be performed successfully on the intact epithelium without adjunct therapy or pain. The transepithelial technique is a simple and relatively painless way to reduce the rate of RCE and is equivalent to the well-established subepithelial treatment.
doi: 10.3928/15428877-20100830-01
[get full text]
Long-Term Monitoring of Age-Related Macular Degeneration With Preferential Hyperacuity Perimetry
Michael Stur, MD; Yair Manor, PhDSubmitted 2/7/09; Accepted 7/6/10; Posted 8/30/10
BACKGROUND AND OBJECTIVE: To estimate the efficacy and usability of preferential hyperacuity perimetry (PHP) for monitoring patients with high-risk intermediate age-related macular degeneration (AMD).
PATIENTS AND METHODS: A long-term, observational, prospective case series of patients with intermediate AMD who underwent fluorescein angiography at recruitment. Eyes were examined every 3 months with PHP, visual acuity, and biomicroscopy. Optical coherence tomography (OCT) imaging was performed when PHP was outside normal limits. In case of suspected findings in OCT, fluorescein angiography was also performed. Patients diagnosed as having choroidal neovascularization (CNV) were offered anti-vascular endothelial growth factor therapy.
RESULTS: Twenty-six eyes (25 patients) were monitored for a mean follow-up period of 600 days. Of the 172 PHP tests done by these 26 eyes with intermediate AMD, 158 were within normal limits yielding a false-positive rate of 8.1%. Three of 4 eyes that converted to CNV had PHP test results outside normal limits before or on the day of diagnosis.
CONCLUSION: PHP is useful for detecting CNV in regularly monitored eyes with intermediate AMD while maintaining a low false-positive rate.
doi: 10.3928/15428877-20100830-05
[get full text]
Gábor Márk Somfai, MD, PhD; Erika Tátrai, MD; Mária Ferencz, MD, PhD; Carmen A. Puliafito, MD, MBA; Delia Cabrera DeBuc, PhDSubmitted 12/9/09; Accepted 6/16/10; Posted 8/30/10
BACKGROUND AND OBJECTIVE: Diabetic macular edema has several patterns on optical coherence tomography. This retrospective study aimed to assess which retinal layers show thickness changes in type 1 diffuse diabetic macular edema with preserved vision.
PATIENTS AND METHODS: Eleven eyes with diffuse diabetic macular edema on optical coherence tomography and eight control eyes with 20/20 best-corrected visual acuity were enrolled. Optical coherence tomography images were segmented using an algorithm of the authors’ design (OCTRIMA): regional thickness data in the central area, pericentral rings, and peripheral rings were obtained for the retinal cellular layers.
RESULTS: The retinal nerve fiber layer showed no changes, the ganglion cell and inner plexiform composite layer and the ganglion cell complex were thicker only in the pericentral regions, and all other layers were thicker in all regions in diffuse diabetic macular edema. Macular thickness was normal in the peripheral region.
CONCLUSION: The results show that the outer retina in the foveal area is the most affected in diffuse diabetic macular edema.
doi: 10.3928/15428877-20100830-04
[get full text]
Nathan M. Radcliffe, MD; Mitra Sehi, PhD; Ira B. Wallace, MD; David S. Greenfield, MD; Theodore Krupin, MD; Robert Ritch, MDSubmitted 12/29/09; Accepted 6/9/10; Posted 8/30/10
BACKGROUND AND OBJECTIVE: To compare agreement of automated alternation flicker and serial stereophotograph inspection for detection of progressive glaucoma.
PATIENTS AND METHODS: Serial photographs of patients with glaucoma with at least 36 months of follow-up and perimetry every 4 months were assessed by four graders using predefined criteria with both flicker and stereophotography. The main outcome measure was progressive neuroretinal rim deterioration as identified by each technique.
RESULTS: Forty eyes (20 patients) were included and 12 eyes progressed with perimetry. Using stereophotography, the overall agreement (kappa ± standard error) was 0.19 ± 0.06 for rim change, 0.78 ± 0.06 for disc hemorrhage, and -0.04 ± 0.06 for vessel movement. Using flicker, the overall agreement was similar for rim change (0.28 ± 0.06; P = .29), worse for disc hemorrhage (0.43 ± 0.06; P < .001), and better for vessel movement (0.22 ± 0.06; P = .002). The agreement between perimetric and disc progression was similar using stereophotography (0.10 ± 0.05) and flicker (0.19 ± 0.05; P = .20).
CONCLUSION: Agreement between flicker and stereophotography was similar.
doi: 10.3928/15428877-20100830-02
[get full text]
Bevacizumab for the Treatment of Pediatric Retinal and Choroidal Diseases
Robert A. Sisk, MD; Audina M. Berrocal, MD; Thomas A. Albini, MD; Timothy G. Murray, MDSubmitted 9/22/09; Accepted 6/9/10; Posted 8/30/10
BACKGROUND AND OBJECTIVE: To determine the efficacy of off-label intravitreal bevacizumab (IVB) for the treatment of pediatric retinal and choroidal vascular diseases.
PATIENTS AND METHODS: Retrospective, noncomparative, open-label, interventional, consecutive case series of all patients younger than 18 years old treated with off-label IVB at a single center from January 1, 2005, to January 1, 2008. Primary outcome measures with best-corrected visual acuity by age-appropriate testing and central macular thickness by time-domain optical coherence tomography.
RESULTS: Thirty-five eyes of 33 patients were treated with IVB alone or in combination with other treatments for choroidal neovascularization, Coats’ disease, familial exudative vitreoretinopathy, and various other indications. IVB was used in 24 eyes to reduce excess retinal fluid and exudation. Mean Snellen visual acuity improved from 20/170 at baseline to 20/100 at 1 month (P = .006), 20/80 at 3 months (P = .006), and 20/50 at 6 months (P = .023). Central macular thickness improved from 356 µm at baseline to 287 µm at 6 months (P = .028). IVB was used in 11 eyes to control peripheral retinal neovascularization and iris rubeosis. Although IVB reduced vascular engorgement, it did not prevent the progression of preretinal tractional forces. Mean visual acuity was maintained at each time point. No systemic or ocular adverse events were directly attributable to IVB in any patient.
CONCLUSION: IVB reduced vascular leakage and temporarily regressed pathologic neovascularization of the choroid, retina, and iris in this series of pediatric patients. Further prospective studies are warranted.
doi: 10.3928/15428877-20100830-03
[get full text]
Amitha Domalpally, MD; Sapna Gangaputra, MD, MPH; Qian Peng, MS; Ronald P. Danis, MDSubmitted 4/16/09; Accepted 11/30/09; Posted 3/30/10
BACKGROUND AND OBJECTIVE: To evaluate and compare the intra-session repeatability of retinal thickness measurements from the Topcon 3D OCT 1000 (Topcon Medical Systems; Paramus, NJ), a spectral-domain optical coherence tomography (SD-OCT) system, with the Stratus (Carl Zeiss Meditec, Inc., Dublin, CA), a time-domain OCT (TD-OCT) system, in eyes with retinal diseases.
PATIENTS AND METHODS: Repeated scans with both SD-OCT and TD-OCT were taken. Thickness measurements from high-quality scans were used to assess repeatability and compare measurements between the two instruments.
RESULTS: Paired scans from 127 eyes were evaluated, of which 63 pairs were of high quality. Coefficients of repeatability and variation for the central subfield were 20.1 µm (2.6%) with SD-OCT and 27.4 µm (4%) with TD-OCT (P = .38). The mean difference in central subfield thickness between the two instruments was 24.5 µm (standard deviation = 20.9).
CONCLUSION: Repeatability of retinal thickness measurements with the Topcon 3D OCT 1000 is comparable to the Stratus. The measurements of the two machines differ significantly and cannot be used interchangeably.
doi: 10.3928/15428877-20100325-01
[get full text]
Get Adobe Reader
The .pdf file requires the Adobe® Acrobat® Reader® software application for reading. The application is available for download at no charge, and is available in various formats (stand alone, plug-in) for most of the major operating systems.
Adobe, the Adobe logo, Acrobat, the Acrobat logo, Reader, and the Reader logo are either registered trademarks or trademarks of Adobe Systems Incorporated in the United States and/or other countries.