Inner limiting Membrane Peel Extends Calcium Imaging of Retinal Ganglion Cell Activity Beyond the Fovea in Non-Human Primate.

High resolution retinal imaging paired with intravitreal injection of a viral vector coding for the calcium indicator GCaMP has enabled visualization of activity dependent calcium changes in retinal ganglion cells (RGCs) at single cell resolution in the living eye. The inner limiting membrane (ILM) is a barrier for viral vectors, restricting transduction to a ring of RGCs serving the fovea in both humans and non-human primates (NHP). We evaluate peeling the ILM prior to intravitreal injection as a strategy to expand calcium imaging beyond the fovea in the NHP eye in vivo.

Steroid Allergy in a Patient With Behçet's Disease.

Immediate hypersensitivity reactions to systemic steroids are reported rarely in the literature. The authors present a case of Behçet's disease-associated panuveitis in a patient with skin test confirmed immunoglobulin E-mediated allergy to methylprednisolone and reported allergic reaction to prednisone. The patient tolerated prednisolone eyedrops for his anterior segment disease, as well as oral prednisolone for systemic therapy.

Spontaneous Resolution of a Choroidal Mass: A Case Series.

Choroidal masses can be of varying etiologies including tumors of benign, primary, and metastatic nature. Herein, we report on 3 cases of well-documented solitary choroidal masses associated with exudative retinal detachments of unclear etiology (despite extensive workup) that resolved spontaneously.

Quantitative Comparison of Fundus Images by 2 Ultra-Widefield Fundus Cameras.

Purpose: To compare the relative number of retinal pixels and retinal area imaged using the Optos P200DTx (Optos PLC) and Zeiss Clarus 500 (Carl Zeiss Meditec AG) ultra-widefield (UWF) fundus cameras.

Design: Single-center retrospective cross-sectional analysis.

Participants: Seventy-eight eyes of 46 patients.

Imaging Transplanted Photoreceptors in Living Nonhuman Primates with Single-Cell Resolution.

Stem cell-based transplantation therapies offer hope for currently untreatable retinal degenerations; however, preclinical progress has been largely confined to rodent models. Here, we describe an experimental platform for accelerating photoreceptor replacement therapy in the nonhuman primate, which has a visual system much more similar to the human. We deployed fluorescence adaptive optics scanning light ophthalmoscopy (FAOSLO) to noninvasively track transplanted photoreceptor precursors over time at cellular resolution in the living macaque.

Cellular-scale evaluation of induced photoreceptor degeneration in the living primate eye.

Progress is needed in developing animal models of photoreceptor degeneration and evaluating such models with longitudinal, noninvasive techniques. We employ confocal scanning laser ophthalmoscopy, optical coherence tomography (OCT) and high-resolution retinal imaging to noninvasively observe the retina of non-human primates with induced photoreceptor degeneration. Photoreceptors were imaged at the single-cell scale in three modalities of adaptive optics scanning light ophthalmoscopy: traditional confocal reflectance, indicative of waveguiding; a non-confocal offset aperture technique visualizing scattered light; and two-photon excited fluorescence, the time-varying signal of which, at 730 nm excitation, is representative of visual cycle function.

In Vivo Adaptive Optics Ophthalmoscopy Correlated with Histopathologic Results in Cancer-Associated Retinopathy.

Purpose: To demonstrate the validity of adaptive optics scanning laser ophthalmoscopy (AOSLO) imaging of the retina in human disease based on clinicopathologic correlation in a patient with cancer-associated retinopathy (CAR).

Design: Case report.

Participant: Sixty-four-year-old man with CAR.

Immunologic factors may play a role in herpes simplex virus 1 reactivation in the brain and retina after influenza vaccination.

Herpes simplex virus 1 (HSV-1) is a nearly ubiquitous human pathogen, remaining dormant in its human host the majority of the time. The interaction between HSV-1 and the immune system represents a complicated balance of power that allows the virus to persist in the host for a lifetime. However, disruptions in the immune system can activate the virus with the potential to cause devastating infections in the central nervous system (CNS).

Central Retinal Artery Occlusion With Subsequent Central Retinal Vein Occlusion in Biopsy-Proven Giant Cell Arteritis.

Central retinal artery occlusion with subsequent central retinal vein occlusion in the same eye is a rare entity. We present a 72-year-old man with biopsy-proven giant cell arteritis who developed bilateral arteritic anterior ischemic optic neuropathy and a left central retinal artery occlusion. Subsequently, he developed a left central retinal vein occlusion within 2 weeks of his initial vision loss.

CRYSTALLINE RETINOPATHY FROM HYPEROXALURIA: LONG-TERM FOLLOW-UP.

Purpose: To report long-term follow-up in a patient with retinal oxalosis from primary hyperoxaluria.

Methods: Retrospective chart review was performed for this patient.

Patients: A 6-year-old girl that presented to our clinic before and after combined kidney/liver transplant.

Focal damage to macaque photoreceptors produces persistent visual loss.

Insertion of light-gated channels into inner retina neurons restores neural light responses, light evoked potentials, visual optomotor responses and visually-guided maze behavior in mice blinded by retinal degeneration. This method of vision restoration bypasses damaged outer retina, providing stimulation directly to retinal ganglion cells in inner retina. The approach is similar to that of electronic visual protheses, but may offer some advantages, such as avoidance of complex surgery and direct targeting of many thousands of neurons.

Migration of intravitreal dexamethasone implant to anterior chamber.

Purpose: To describe two cases of migration of intravitreally injected dexamethasone implant into the anterior chamber.

Methods: Charts were reviewed of two patients who received sustained-release dexamethasone implant intravitreally for chronic intractable cystoid macular edema.

Results: Both patients had pseudophakic cystoid macular edema and a complicated clinical course before receiving the implant.

Esophageal metastasis to the iris effectively palliated using stereotactic body radiation therapy and adjuvant intravitreal chemotherapy: case report and literature review.

We report a case of isolated iris metastasis from esophageal adenocarcinoma that was successfully managed with local application of stereotactic body radiation therapy (SBRT) and adjunctive intravitreal therapy. A 53-year-old man with locally advanced esophageal adenocarcinoma achieved a complete clinical and radiographic response after surgery and chemotherapy. Four months later, he developed headache and decreased vision and was diagnosed with metastasis to the iris by slit-lamp examination.

Infectious endophthalmitis in adult eyes receiving Boston type I keratoprosthesis.

Purpose: To report the clinical characteristics of infectious endophthalmitis after Boston type I keratoprosthesis (K-Pro) implantation.

Design: Retrospective study.

Participants: One hundred forty-one adult eyes receiving a K-Pro at a single institution from May 2004 through July 2008.

Intravitreal injection of AAV2 transduces macaque inner retina.

Purpose: Adeno-associated virus serotype 2 (AAV2) has been shown to be effective in transducing inner retinal neurons after intravitreal injection in several species. However, results in nonprimates may not be predictive of transduction in the human inner retina, because of differences in eye size and the specialized morphology of the high-acuity human fovea. This was a study of inner retina transduction in the macaque, a primate with ocular characteristics most similar to that of humans.

Retinal arteriolar spasm during transient monocular visual loss in eosinophilic vasculitis.

A patient with eosinophilic vasculitis and acquired immunodeficiency syndrome (AIDS) developed episodic transient monocular visual loss. During or immediately after two visual loss episodes, we demonstrated narrowed retinal arterioles, delayed arterial filling time, and segmented retinal venous flow in the affected eye on fundus photography and fluorescein angiography (FA). Such findings have only rarely been reported in patients with transient monocular visual loss in other conditions, probably because the episodes have ended before fundus photography and FA could be performed.

A 9 year-old girl with herpes simplex virus type 2 acute retinal necrosis treated with intravitreal foscarnet.

A 9-year-old girl presented with a 2-week history of redness in the left eye. Examination revealed vitritis, retinal whitening, vasculitis, and optic nerve head edema. Polymerase chain reaction testing of the aqueous fluid revealed herpes simplex virus type 2.

An ultrastructural study of the pathology of the retinal pigment epithelium, Bruch's membrane, and the choriocapillaris in the aged Fischer 344 rat.

Purpose: The neural retinal degeneration in the aging Fischer 344 (F344) rat has been previously characterized. Here we describe the ultrastructural changes that occur in the retinal pigment epithelium (RPE), Bruch's membrane, and choriocapillaris in the periphery of the aged Fischer 344 rat.

Methods: F344 eyes from 24-month-old animals (n = 4 animals, 8 eyes) were fixed and embedded for ultrastructural study.

Use of best and final visual acuity outcomes in ophthalmological research.

Objective: To evaluate how often visual acuity outcomes are reported in the ophthalmological literature as best or final outcomes, despite potential bias with this type of analysis, as compared with interval outcomes, when a specific condition may continue to cause gain or loss of visual acuity beyond the time that the best or final outcome is determined.

Methods: Each article published in the 3 most frequently cited comprehensive clinical ophthalmological journals in the United States from January through December 2000 was reviewed. Clinical studies were identified in which visual acuity was used as an outcome measure.

Late-onset bacteria endophthalmitis following glaucoma drainage implantation.

A clinicopathologic report of late-onset bacterial endophthalmitis 4 years after implantation of a Baerveldt drainage implant is described. An 80-year-old woman with glaucoma presented 8 years after tube shunt implantation with clinical endophthalmitis. During surgical removal of the implant, a small conjunctival buttonhole caused by the suture securing the plate to the sclera was noted to be the only entry site.

Late-onset bacterial endophthalmitis following glaucoma drainage implantation.

Abstract. A clinicopathologic report of late-onset bacterial endophthalmitis 4 years after implantation of a Baerveldt drainage implant is described. An 80-yearold woman with glaucoma presented 8 years after tube shunt implantation with clinical endophthalmitis.