Sub-retinal drusenoid deposits in human retina: organization and composition.

We demonstrate histologically sub-retinal drusenoid debris in three aged human eyes, two of them affected by age-related maculopathy. By postmortem fundus examination, the lesions were drusen-like, i.e.

Macular holes associated with diabetic tractional retinal detachments.

Background And Objective: Evaluation of surgical treatment of full-thickness macular holes secondary to diabetic tractional retinal detachments was conducted.

Patients And Methods: A retrospective review of medical records, fluorescein angiograms, fundus photographs, optical coherence tomography images, and operative findings of six consecutive patients with full-thickness macular holes and diabetic tractional retinal detachments was completed. Each eye was treated with pars plana vitrectomy, tractional retinal detachment repair, membranectomy, indocyanine green-assisted internal limiting membrane peeling, and intraocular gas tamponade.

Intravitreal bevacizumab (Avastin) prevention of panretinal photocoagulation-induced complications in patients with severe proliferative diabetic retinopathy.

Purpose: To evaluate the efficacy of intravitreal injection of bevacizumab (Avastin) (IVA) in preventing panretinal photocoagulation (PRP)-induced macular thickening and visual dysfunction in eyes with severe proliferative diabetic retinopathy.

Methods: A retrospective review of 60 consecutive eyes (30 patients) with severe proliferative diabetic retinopathy whose visual acuity was 20/30 or better (<0.18 in logarithm of the minimum angle of resolution acuity) and average foveal thickness (FT) was 280 microm or less, and whose retinopathy was bilateral and symmetrical, was performed.

Branch retinal artery occlusion: visual prognosis.

Purpose: To evaluate the visual prognosis in eyes with branch retinal artery occlusion (BRAO).

Design: Retrospective, observational, consecutive case series.

Methods: Retrospective medical record review of 52 consecutive eyes of 52 patients with BRAO seen at two vitreoretinal practices in Birmingham, Alabama.

Incidence of acute onset endophthalmitis following intravitreal bevacizumab (Avastin) injection.

Purpose: To report the incidence of acute endophthalmitis as a complication of intravitreal bevacizumab (Avastin) (IVB) injection in a tertiary vitreoretinal group practice.

Methods: A retrospective chart review of 5,233 consecutive eyes that underwent IVB injection at Retina Consultants of Alabama (RCA) from October 1, 2005, to August 31, 2007, was performed to identify cases of acute endophthalmitis.

Results: During the 23-month study interval, the overall incidence rate of postinjection endophthalmitis was 0.

Prevalence and morphology of druse types in the macula and periphery of eyes with age-related maculopathy.

Purpose: Macular drusen are hallmarks of age-related maculopathy (ARM), but these focal extracellular lesions also appear with age in the peripheral retina. The present study was conducted to determine regional differences in morphology that contribute to the higher vulnerability of the macula to advanced disease.

Methods: Drusen from the macula (n = 133) and periphery (n = 282) were isolated and concentrated from nine ARM-affected eyes.

Intravitreal bevacizumab treatment for radiation macular edema after plaque radiotherapy for choroidal melanoma.

Purpose: To evaluate the effect of intravitreal bevacizumab treatment on patients with macular edema (ME) due to radiation retinopathy after plaque radiotherapy for choroidal melanoma.

Methods: In this retrospective case series, 10 consecutive patients with ME due to radiation retinopathy after plaque radiotherapy for choroidal melanoma were treated with a single intravitreal injection of bevacizumab. Postinjection best-corrected visual acuity (BCVA) and mean foveal thickness measured by ocular coherence tomography were the primary outcome measures.

Trans-luminal nd:YAG laser embolysis for branch retinal artery occlusion.

Purpose: To evaluate the clinical efficacy of transluminal YAG laser embolysis (TYE) for patients with severe vision loss secondary to a newly diagnosed branch retinal artery occlusion (BRAO) with visible emboli.

Methods: Five eyes of five patients with acute, severe vision loss secondary to a branch retinal artery occlusion with visible emboli and retinal whitening were prospectively examined, enrolled, and underwent visual acuity testing, ophthalmic examination, color photography, and fluorescein angiography. Each patient was offered TYE and the potential risks of the treatment were explained.

Distribution and composition of esterified and unesterified cholesterol in extra-macular drusen.

More details about the distribution of esterified and unesterified cholesterol (EC, UC), abundant druse components, would inform models of druse biogenesis and new technologies for ocular imaging. From donors with grossly normal maculas (n=10, 66-86years), whose eyes were preserved in paraformaldehyde within 6h of death, extra-macular drusen encased with retinal pigment epithelium (RPE) were isolated manually. Cryosections of pelleted drusen, stained with filipin for UC and EC, were used to investigate filipin staining patterns within single drusen (n=193) and to quantify fluorescence (n=146).

Preemptive sub-Tenon's anesthesia for pars plana vitrectomy under general anesthesia: is it effective?

Background And Objectives: To determine whether irrigation of the sub-Tenon's space with anesthetic agents during pars plana vitrectomy (PPV) involving general anesthesia decreases postoperative pain, analgesic use, or nausea.

Patients And Methods: A prospective, controlled trial of 46 consecutive patients requesting general anesthesia for PPV who were randomized to receive or not receive a sub-Tenon's space injection prior to surgery. A mixture of 3 mL of 2% lidocaine with hyaluronidase and 3 mL of 0.

Intravitreal injection of bevacizumab (Avastin) as adjunctive treatment of proliferative diabetic retinopathy.

Purpose: To report the use of intravitreal bevacizumab (Avastin) as an adjunctive treatment for proliferative diabetic retinopathy (PDR).

Design: Retrospective case review.

Methods: Institutional review board approval to review patient data was obtained for this retrospective study.

Diabetic vitrectomy: risks, prognosis, future trends.

Purpose Of Review: We review the current standards, risks, prognosis, and indications for diabetic pars plana vitrectomy and consider recent developments in surgical techniques. We also examine surgery's role as a treatment modality for diabetic eye disease among the other accepted and developing treatment options, such as systemic and intravitreal pharmacotherapy.

Recent Findings: Pars plana vitrectomy for diabetic macular edema and for traction retinal detachment is addressed.

Hormonal therapy for acne using oral contraceptive pills.

The etiology of acne vulgaris is multifactorial and complex. The four key factors involved in the development of acne include follicular plugging, inflammation, the presence and activity of Propionibacterium acnes, and sebum. Androgen hormones stimulate the sebaceous gland and promote sebum excretion.

Esterified and unesterified cholesterol in drusen and basal deposits of eyes with age-related maculopathy.

To address the potential for an outer segment (OS) contribution to the sub-retinal pigment epithelium (RPE) lesions of age-related maculopathy (ARM), we quantified esterified and unesterified cholesterol (EC, UC) with the sterol-specific fluorescent probe filipin in cryosections of ARM eyes. Twenty six eyes from 20 donors were preserved <5 hr after death in 4% paraformaldehyde (n = 16) or 2.5% glutaraldehyde/1% paraformaldehyde (n = 10).

Intravitreal concentration and clearance of triamcinolone acetonide in nonvitrectomized human eyes.

Purpose: To determine the intravitreal concentration and clearance of triamcinolone acetonide at various intervals after intravitreal injection into nonvitrectomized eyes.

Methods: Six participants were administered 4 mg (0.1 cc) of triamcinolone acetonide ophthalmic suspension.

Glaucoma risk factor assessment and prevention: lessons from coronary heart disease.

Purpose: To determine whether multivariable risk factor assessment can be as successful in developing disease prevention strategies in patients with ocular hypertension as it has been in patients at risk for coronary heart disease (CHD).

Design: From a literature review of the evolution of the global risk assessment model for CHD, parallels are drawn to the evolution of a global risk assessment methodology for glaucoma.

Methods: This article summarizes the literature on global risk assessment and prevention of CHD in clinical practice, discusses the development of glaucoma risk assessment based on available trial and population data, and reviews the potential for prevention strategies founded on the cardiovascular disease model.

Two neuropharmacological types of rabbit ON-alpha ganglion cells express GABAC receptors.

The major inhibitory neurotransmitters GABA and glycine provide the bulk of input to large-field ganglion cells in the retina. Whole-cell patch-clamp recordings were used to characterize the glycine- and GABA-activated currents for morphologically identified ON-alpha ganglion cells in the rabbit retina. Cells identified as ON-alpha cells by light evoked currents were intracellularly stained and examined by light microscopy which revealed dendritic stratification in the vitreal half of the inner plexiform layer and confirmed their physiological identity.

Basaloid follicular hamartomas associated with autoimmune disease: a possible role for retinoids in therapy.

A basaloid follicular hamartoma (BFH) may be localized or diffuse. It may also be congenital or acquired. Development of diffuse BFHs has been associated with autoimmune disease and with the development of diffuse alopecia.

Synaptic input to the on-off directionally selective ganglion cell in the rabbit retina.

A physiologically identified on-off directionally selective (DS) ganglion cell with its preferred-null axis defined was stained with horseradish peroxidase (HRP) and prepared for electron microscopy. A continuous series of thin sections were used to examine the cell's synaptology. Although the DS cell dendrite received the majority of its synaptic input from a heterogeneous population of amacrine cell processes, a frequently observed synaptic profile consisted of a DS cell dendrite receiving synapses from a cluster of several amacrine cell processes.