Six-year incidence of proteinuria in type 1 diabetic African Americans.

Objective: We sought to report the 6-year incidence of proteinuria and associated risk factors in African Americans with type 1 diabetes.

Research Design And Methods: African Americans (n = 483) with type 1 diabetes were reexamined in a 6-year follow-up study. Proteinuria and creatinuria were measured in 4-h timed urine specimens obtained at initial and follow-up visits.

Complications in resident-performed phacoemulsification cataract surgery at New Jersey Medical School.

Aim: To describe the complications related to cataract surgery performed by phacoemulsification technique by third-year ophthalmology residents at New Jersey Medical School, who are trained to perform phacoemulsification without any prior experience with extracapsular extraction.

Design: Retrospective, observational case series.

Methods: A retrospective chart review of 755 patients who underwent cataract surgery by third-year residents between July 2000 and June 2005 at the Institute of Ophthalmology and Visual Science was performed.

Recognition of transorbital intracranial injury.

Eyelid or periocular wounds may be the only initial sign of occult, penetrating intracranial trauma. As in this case, the failure to recognize the injury may contribute to serious and potentially life-threatening complications. The discussion emphasizes that a high degree of suspicion and knowledge of patterns of occult penetrating orbito-cranial injury may help direct appropriate radiological imaging and lead to earlier, accurate diagnosis.

Evolving global risk assessment of ocular hypertension to glaucoma.

Purpose Of Review: To discuss current knowledge of global risk assessment in ocular hypertension.

Recent Findings: The ophthalmologist treating patients with ocular hypertension is frequently faced with the clinical dilemma of which patients to treat and how vigorous treatment should be. The goal of risk assessment for glaucoma is to identify patients at greatest risk for symptomatic vision loss.

Comparison of digital and film stereo photography of the optic nerve in the evaluation of patients with glaucoma.

The aim of this study was to validate a digital simultaneous stereo photography system against film in the assessment of optic nerve head features in patients with glaucoma. Fifteen digital and 15 corresponding film simultaneous stereo photographs (SSP) of the optic nerve from patients with glaucoma were graded by two glaucoma specialists. Assessed parameters included the vertical and horizontal cup-to-disc ratios (VCD and HCD, respectively), and the image quality score (1 = worse, 5 = best) for each image.

A comparison of the effectiveness of four biostains in enhancing visualization of the vitreous.

Purpose: To compare the effectiveness of four biostains in vitreous staining as a means to facilitate clean anterior vitrectomy.

Materials And Methods: Four biostains (fluorescein, indocyanine green, trypan blue, and triamcinolone acetonide) were used to stain the transparent vitreous of human cadaver and monkey cadaver eyes. Results were compared and recorded by digital photography and videography.

Six-year progression of retinopathy and associated risk factors in African American patients with type 1 diabetes mellitus: the New Jersey 725.

Objective: To report the 6-year progression of diabetic retinopathy (DR) and associated risk factors among African American patients with type 1 (insulin-dependent) diabetes mellitus.

Methods: Participants from the New Jersey 725 included 483 African American patients with type 1 diabetes who underwent reexamination as part of a 6-year follow-up. Evaluations included a structured clinical interview, ocular examination, 7 stereoscopic fundus photographs, and blood pressure measurements.

Short-term treatment of cocaine and/or methamphetamine abuse with vigabatrin: ocular safety pilot results.

Objective: To evaluate the ocular safety of short-term use of vigabatrin to treat cocaine and/or methamphetamine addiction.

Methods: Individuals who were actively using cocaine and/or methamphetamine were eligible for enrollment. Enrolled subjects were scheduled for comprehensive eye examinations at the beginning and end of the study.

Patterns of transorbital intracranial injury: a review and comparison of occult and non-occult cases.

The authors present an illustrative case of occult transorbital penetrating intracranial injury in a child, and review the literature concerning patterns of low-velocity, non-projectile injury during the era of modern CT and MRI study. Review of the mechanism of injury and analysis of surface entry site of penetration in 38 cases suggests recurring patterns of injury in occult and non-occult cases. A classification system based on surface entry zone site is applied to these injuries.

Role for surgery as adjuvant therapy in optic nerve sheath meningioma.

Purpose: To describe a role for optic nerve decompression as adjuvant surgical therapy in the management of optic nerve sheath meningioma in patients with severe, progressive visual loss and optic disc edema before or after radiation therapy.

Methods: Interventional case report.

Results: Two patients with unilateral optic nerve sheath meningioma had progressive visual loss (20/200 and no light perception) and disc edema.

Adalimumab-associated optic neuritis.

We present, to our knowledge, the first published cases of optic neuritis associated with adalimumab, a medication in the class of anti-tumor necrosis factor-alpha (TNF-alpha) antagonists. Approved in recent years by the FDA, adalimumab (Humira, Abbott Laboratories; Abbott Park, IL) is a recombinant monoclonal antibody that targets and blocks the physiologic effects of TNF. Other TNF antagonists have had associations with optic neuritis and demyelinating events.

Cataract surgery in the small adult eye.

Microphthalmos is a rare condition that is often associated with several other ocular abnormalities. Given the considerable differences between microphthalmic and anatomically normal eyes, cataract surgery is technically demanding in these patients, and special attention must be given to adequate preoperative planning of these procedures. Furthermore, the unique nature of these surgeries creates a particular subset of intraoperative and postoperative complications.

Vitreous hemorrhage as the initial manifestation of X-linked retinoschisis in a 9-month-old infant.

A 9-month-old infant presented with progressive esotropia, bilateral vitreous hemorrhages, bullous retinoschises, and peripheral retinal detachments. X-linked retinoschisis was diagnosed on the basis of electroretinogram findings. We report a case of vitreous hemorrhage as the initial presentation of X-linked retinoschisis in one of the youngest patients discussed in the literature.

Corneal edema and penetrating keratoplasty after anterior chamber phakic intraocular lens implantation.

Phakic intraocular lens (IOL) implantation is an increasingly popular option in surgical correction of refractive error. To date, reports of long-term morbidity are infrequent in the literature. We encountered 3 patients who experienced corneal decompensation and cataract progression following angle-fixated anterior chamber phakic IOL placement.

Systemic reactions associated with ophthalmic medications.

Although most medications for ophthalmic disease are administered locally, systemic absorption occurs as the drug passes into the nasopharynx by way of the nasolacrimal duct and may lead to a significant exposure. Knowledge of the mechanism of action of the drug, extent of systemic exposure, and its corresponding risks are important factors that must be considered before prescription of any ophthalmic agent. The relative risk in turn depends on the agent prescribed, plasma levels achieved, and individual susceptibility factors.

Retinal pigment epithelium resurfacing of aged submacular human Bruch's membrane.

Purpose: To determine whether cultured fetal human retinal pigment epithelium (RPE) cells can attach and differentiate on submacular Bruch's membrane from donors over age 55.

Methods: Differential debridements of Bruch's membrane were performed to expose three different surfaces: the RPE basement membrane, the superficial inner collagenous layer (ICL) directly below the RPE basement membrane, and the deeper ICL. Approximately 3,146 cells/mm2 were seeded onto these Bruch's membrane explants and cultured for 1 or 7 days.

Impaired RPE survival on aged submacular human Bruch's membrane.

Resurfacing of diseased or iatrogenically damaged Bruch's membrane with healthy retinal pigment epithelium (RPE) has been proposed as adjunctive treatment for age-related macular degeneration (AMD). The purpose of this study was to determine whether cultured fetal human RPE cells can attach and differentiate on aged submacular human Bruch's membrane. Bruch's membrane was debrided to expose native RPE basement membrane, the superficial inner collagenous layer directly below the RPE basement membrane, or the deep inner collagenous layer.

Iris pigment epithelium attachment to aged submacular human Bruch's membrane.

Purpose: To determine whether iris pigment epithelium (IPE) cells can attach to aged submacular human Bruch's membrane and to assess whether IPE cells express the integrin subunits that may be necessary to bind to the known extracellular matrix ligands present in Bruch's membrane.

Methods: IPE cells were seeded onto the RPE basement membrane (RPEbm) or inner collagenous layer (ICL) of aged submacular Bruch's membrane as microaggregates or were expanded in culture until enough cells could be obtained for seeding. Cell morphology and the percentage of cell coverage were determined 1 or 7 days after seeding.

Anterior ischemia after posterior segment surgery.

Anterior segment ischemia is a rare complication of posterior segment surgery with a broad spectrum of presentations. Most frequently, it follows a mild self-limited course. Cases that are more prominent usually result from a co-incidence of precipitating factors.

Use of viscodissection and silicone oil in vitrectomy for severe diabetic retinopathy.

Improvement in surgical techniques has led to improved anatomic and functional success rates following surgery for severe complications of proliferative diabetic retinopathy (PDR). We compared the anatomic and functional outcomes of surgery in a non-randomized, consecutive case series of patients with severe PDR. We found that viscodissection using Healon provides outcomes comparable to conventional pick and scissors dissection.

Pars plana vitrectomy for refractory diabetic macular edema.

Objective: The aim of this study is to describe the results of pars plana vitrectomy (PPV) for refractory diabetic macular edema (DME).

Methods: Review of the relevant peer-reviewed scientific literature identified using Medline.

Main Outcome Measures: The anatomical and functional outcome of surgery.