Association of Ultra-Widefield Fluorescein Angiography-Identified Retinal Nonperfusion and the Risk of Diabetic Retinopathy Worsening Over Time.

Importance: Presence of predominantly peripheral diabetic retinopathy (DR) lesions on ultra-widefield fluorescein angiography (UWF-FA) was associated with greater risk of DR worsening or treatment over 4 years. Whether baseline retinal nonperfusion assessment is additionally predictive of DR disease worsening is unclear.

Objective: To assess whether the extent and location of retinal nonperfusion identified on UWF-FA are associated with worsening in Diabetic Retinopathy Severity Scale (DRSS) score or DR treatment over time.

Optical Coherence Tomography Angiography Quality Across Three Multicenter Clinical Studies of Diabetic Retinopathy.

Purpose: To explore optical coherence tomography angiography (OCTA) quality and associated factors in multicenter clinical studies.

Methods: OCTA scans were obtained from participants with diabetic retinopathy from three DRCR Retina Network clinical studies using the Optovue AngioVue and ZEISS AngioPlex. Macular (3 × 3 mm and 6 × 6 mm) and optic nerve scans were captured.

Five-Year Outcomes of Ranibizumab With Prompt or Deferred Laser Versus Laser or Triamcinolone Plus Deferred Ranibizumab for Diabetic Macular Edema.

Purpose: To compare long-term vision and anatomic effects of ranibizumab with prompt or deferred laser vs laser or triamcinolone + laser with very deferred ranibizumab in diabetic macular edema (DME).

Design: Randomized clinical trial.

Methods: Eight hundred and twenty-eight study eyes (558 [67%] completed the 5-year visit), at 52 sites, with visual acuity 20/32 to 20/320 and DME involving the central macula were randomly assigned to intravitreous ranibizumab (0.

Randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation.

Purpose: To evaluate 14-week effects of intravitreal ranibizumab or triamcinolone in eyes receiving focal/grid laser for diabetic macular edema and panretinal photocoagulation.

Methods: Three hundred and forty-five eyes with a visual acuity of 20/320 or better, center-involved diabetic macular edema receiving focal/grid laser, and diabetic retinopathy receiving prompt panretinal photocoagulation were randomly assigned to sham (n = 123), 0.5-mg ranibizumab (n = 113) at baseline and 4 weeks, and 4-mg triamcinolone at baseline and sham at 4 weeks (n = 109).

Vitrectomy outcomes in eyes with diabetic macular edema and vitreomacular traction.

Purpose: To evaluate vitrectomy for diabetic macular edema (DME) in eyes with at least moderate vision loss and vitreomacular traction.

Design: Prospective cohort study.

Participants: The primary cohort included 87 eyes with DME and vitreomacular traction based on investigator's evaluation, visual acuity 20/63-20/400, optical coherence tomography (OCT) central subfield >300 microns and no concomitant cataract extraction at the time of vitrectomy.

Risk of endophthalmitis after intravitreal drug injection when topical antibiotics are not required: the diabetic retinopathy clinical research network laser-ranibizumab-triamcinolone clinical trials.

Objective: To report the incidence of endophthalmitis after intravitreal drug injection by means of a standardized procedure that does not require topical antibiotics, sterile gloves, or a sterile drape.

Methods: Intravitreal injections of preservative-free triamcinolone acetonide or ranibizumab were administered in 2 prospective randomized clinical trials performed by the Diabetic Retinopathy Clinical Research Network. The standardized procedure for these trials requires the use of a topical combination product of povidone-iodine, a sterile lid speculum, and topical anesthetic, but does not require the use of topical antibiotics before, on the day of, or after injection.

Magnetic resonance imaging of the collateral ligaments and the anatomic quadrants of the knee.

Injuries to the lateral and medial supporting structures of the knee can be significantly disabling and somewhat difficult to detect and evaluate clinically. An accurate imaging evaluation of these structures requires the use of the appropriate MR imaging sequences and the detailed knowledge of the anatomic structures that are present in these locations. Normal function is dependent on the integrity of the complex functional structures and effective clinical treatment, including surgical repair, of these structures is predicated on an optimal diagnostic evaluation.

Magnetic resonance imaging of the collateral ligaments and the anatomic quadrants of the knee.

Injuries to the lateral and medial supporting structures of the knee can be significantly disabling and somewhat difficult to detect and evaluate clinically. An accurate imaging evaluation of these structures requires the use of the appropriate MR imaging sequences and the detailed knowledge of the anatomic structures that are present in these locations. Normal function is dependent on the integrity of the complex functional structures and effective clinical treatment, including surgical repair, of these structures is predicated on an optimal diagnostic evaluation.

Progression of eIF4e gene amplification and overexpression in benign and malignant tumors of the head and neck.

Background: The overexpression of eukaryotic initiation factor 4E (eIF4E) results in the up-regulation of gene products of mRNAs with long 5' untranslated regions (5' UTRs). The degree of gene amplification increases from the tumor free zone to the tumor core. This led the authors to hypothesize that the degree of eIF4E gene amplification and oncoprotein overexpression is progressive in the cells from normal head and neck tissue, to benign tumors, and eventually to invasive carcinomas (HNCA).

Combined macular hole and cataract surgery.

Purpose: Cataract often develops after macular hole surgery, necessitating cataract surgery. We report a combination of macular hole surgery and cataract surgery on four eyes of four patients.

Methods: Four eyes of four patients had a full-thickness stage III or IV macular hole and some degree of cataract.

Intraoperative fluorescein angiography.

Background: Fluorescein angiography is often beneficial in the evaluation and management of many retinal vascular diseases. However, vitreous blood or opacities may prevent fluorescein studies before pars plana vitrectomy. After vitrectomy, fluorescein angiography may be delayed, creating uncertainty over differentiation of preoperative, intraoperative, and postoperative findings.

Vitreous hemorrhage secondary to age-related macular degeneration.

The clinical features of two patients with vitreous hemorrhage secondary to age-related macular degeneration and the histopathological findings in one of these cases are reported. Twenty additional cases are reviewed and compared with previously reported series. In patients with vitreous hemorrhage secondary to age-related macular degeneration, the appearance of vitreal blood is often preceded by extensive subretinal hemorrhage.

Activation of complement in human serum by some synthetic polymers used for intraocular lenses.

Determination of the potential to activate complement can be used as one criterion in testing the biocompatibility of various synthetic polymers that are utilized in the medical field. Intraocular lenses (IOLs) made of poly(methyl methacrylate) (PMMA) with PMMA loops, poly(hydroxyethyl methacrylate) (PHEMA) lenses, silicone lenses, and PMMA lenses with polypropylene loops were examined in this study. The concentrations of the activation peptides C3a, C4a and C5a were measured by radioimmunoassay (r.

Ptosis following radial keratotomy. Performed using a rigid eyelid speculum.

Seven patients with acquired ptosis and normal levator function following anterior radial keratotomy are presented. Five of these patients then elected to undergo radial keratotomy of the opposite eye, and four had symmetrical lid fissures (mild bilateral ptosis) after bilateral surgery. Ptosis is a well-known complication of cataract extraction, but has not been reported following radial keratotomy.

An analysis of semiflexible, closed-loop anterior chamber intraocular lenses.

We present the pathologic and scanning electron microscopic findings from 44 semiflexible, all polymethylmethacrylate, anterior chamber intraocular lenses (IOLs). These IOLs, which have round, small diameter, closed loops were removed following a variety of complications, including uveitis and/or the uveitis-glaucoma-hyphema syndrome, secondary glaucoma, pseudophakic bullous keratopathy, cystoid macular edema, erosion into uveal tissue (with and without oval pupil), and iris neovascularization. Over 200,000 of these lens styles have been implanted.

A comparison of ciliary sulcus and capsular bag fixation of posterior chamber intraocular lenses.

We compare indications, advantages, and disadvantages of ciliary sulcus and lens capsular bag (lens capsular sac) fixation of posterior chamber intraocular lenses (IOLs). Our findings suggest that, whenever possible, it is efficacious to implant the loops of posterior chamber IOLs within the capsular bag. This positions the lens optic and the supporting loops in the natural anatomical position, sequestered from highly vascular uveal tissue and the blood aqueous barrier.

Choroiditis in infantile periarteritis nodosa.

The ocular pathologic findings were determined in a case of fatal infantile periarteritis nodosa (IPN). To our knowledge, this case is the first histologically documented report of choroidal inflammation associated with this disease. Since the clinical and pathologic findings of IPN and Kawasaki's disease (KD) are identical, these findings should be sought in cases of KD.

Pyogenic granulomas of the cornea.

Pyogenic granulomas are vasoproliferative, inflammatory lesions composed of granulation tissue, which occur on cutaneous or mucosal tissues, often arising secondary to other processes such as trauma or infection. Conjunctival pyogenic granulomas are not rare, but corneal involvement is very unusual and can occasionally lead to problems in the differential diagnosis of corneal masses. We report three cases of pyogenic granuloma involving the cornea.

Complications of intraocular lenses. A historical and histopathological review.

Recent improvements in intraocular lens (IOL) design, manufacturing techniques, and surgical techniques have greatly reduced the incidence of complications following implantation, and many authors now consider IOL implantation to be among the most safe and effective major surgical procedures. However, adverse reactions are still seen--some as late sequelae of earlier IOL designs and implantation techniques and some as sequelae of more recent implantations using "state-of-the-art" lenses and surgical techniques. Complications may be due to various factors, including surgical technique, IOL design, or the inability of some eyes with preexisting disease to tolerate an implant.