Open Access Case study

Remission of Multiple Recurrent Dendriform Keratitis in Herpes Zoster Ophthalmicus after Long-term Oral Acyclovir Therapy

E. W. Chan, S. Sanjay, B. C. Chang

Ophthalmology Research: An International Journal, Page 150-156
DOI: 10.9734/OR/2014/7026

Dendriform keratitis is a recurrent sequelae of herpes zoster ophthalmicus (HZO). A 76-year-old immunocompetent Indian male with HZO developed left eye keratouveitis, uveitic glaucoma and superior orbital fissure syndrome. After treatment with intravenous acyclovir for two weeks, there was resolution of cranial nerve palsies. However, he developed 5 recurrences of dendriform keratitis and uveitis over 4.5 years. The spectrum of corneal epithelial lesions included: lacy branching pseudodendrites without true terminal bulbs, thickened grayish epithelium resembling mucous plaque keratitis, and dot-like epithelial erosions or superficial punctate keratopathy in a linear configuration. Each recurrence resolved with treatment with topical acyclovir and steroids. After the 5th recurrence, oral acyclovir 400 mg twice daily was started and continued for 21 months. Thereafter, he remained recurrence-free for 2 years and 9 months to date. Conclusions: Long-term oral acyclovir may have a prophylactic role against recurrent zoster dendriform keratitis and uveitis, suggesting a need for further studies Epithelial recurrences are characterized by a spectrum of pleomorphic patterns.


Open Access Short Research Article

Fast Eye Movements and Slow Eye Movements in Congenital Neurosensorial Deaf Subjects as Assessed by 2D video-Oculography™

Carlo Aleci, Lorenzo Canavese

Ophthalmology Research: An International Journal, Page 157-164
DOI: 10.9734/OR/2014/8008

Aims:  There is evidence that the deprivation of a sensory system at early developmental stage may lead to a functional change of the remaining one(s). Even if this process has been widely studied, results are still controversial. In particular, the auditory system might affect the oculomotor control, since saccades or fast eye movements (FEMs) and slow eye movements (SEMs) are modulated by the cochleo-vestibular input. It follows that hearing impairment would affect the SEM and saccadic pattern. Therefore, in this study FEMs and SEMs have been evaluated in congenital deaf subjects in order to state whether early auditory deprivation has influence on the oculomotor function.

Study Design: Case-control study.

Place and Duration of Study: Sample: Department of Ophthalmology, University of Turin, duration of the study: 6 months.

Methodology:  20 congenital deaf subjects (12 males, 8 females: age range 7-15 years) and 21 age-matched normal hearing subjects (11 males, 10 females: age range 10-16 years) were recruited. Both groups, who had normal visual acuity, underwent SEM and FEM examination by means of 2D video-oculography. SEM left/right cycle gain and velocity and horizontal/vertical FEM latency, velocity and precision were analysed. Results were then compared in the two samples.

Results:  No substantial differences in SEM and FEM efficiency were found between deaf and normal hearing subjects.

Conclusion: Auditory deprivation does not seem to lead neither to a compensatory enhancement nor to a worsening of the oculomotor function, in contrast to the improvement of peripheral spatial visual attention as reported in literature. We suggest fine ocular movements program, even though strictly influenced by cochleo-vestibular modulation, does not look to be linked to the auditory processing.


Open Access Original Research Article

Multimodal Views of the Human Retina

A. Terry Bahill, Patrick J. Barry

Ophthalmology Research: An International Journal, Page 121-136
DOI: 10.9734/OR/2014/7008

Aims:To show the relationships among subject-reported measures of vision, the view through an ophthalmoscope, the view through a slit lamp, the view through a clinician’s eye, optical coherence tomography (OCT) images, fundus photos, visual field diagrams and Optomap images.

Methodology: Over 1000 clinical ocular measures (taken on one subject over a six-year period of time) were collected, analyzed and summarized. These measures were reduced to 50 images and tables: they were then categorized and filtered, and the essence resulted in the figures contained in this paper.

Results: This paper shows that the retina literature is full of contradictory nomenclature. For example, clinicians use the term fovea to name the 1° diameter disk at the very center of the retina and they use the term macula to name the 5° diameter ring that surrounds it. Whereas, anatomists use the term fovea to name the 5° diameter disk at the center of the retina and they use the term macula to name the 20° diameter ring that surrounds it. This paper demonstrates how the same information appears in the subject’s reports of vision, a facial photograph, an optical coherence tomography image, a fundus photo and a visual field diagram. Finally, it shows how to map information between these views.

Conclusions: The retina-viewing techniques analyzed in this paper can be compared qualitatively, but differences in the techniques preclude precise superposition of the images. A perfect mapping is impossible: because (among other reasons) the algorithms for transforming three-dimensional (3D) shapes into two-dimensional (2D) images are nonlinear and are different for different techniques.


Open Access Original Research Article

Aldose Reductase Inhibitors for Diabetic Cataract: A Study of Disclosure Patterns in Patents and Peer Review Papers

H. A. M. Mucke, E. Mucke, P. M. Mucke

Ophthalmology Research: An International Journal, Page 137-149
DOI: 10.9734/OR/2014/7224

Aims: To investigate, for 13 aldose reductase inhibitors that had been in development for diabetic cataract, whether patent documents could provide earlier dissemination of knowledge to the ophthalmology community than peer review papers.

Methodology: Searches for intellectual property disclosures were conducted in our internal database of ophthalmology patent documents, and were supplemented by online searches in the public Espacenet and Google Patents databases. Searches for peer review papers were performed in Pub Med and Google Scholar, and in our internal database of machine-readable ophthalmology publications.

Results: For sorbinil, tolrestat, fidarestat and GP-1447 patent documents clearly preempted the peer review literature in terms of data-supported information on potential effectiveness in diabetic cataract, typically by 7-17 months. For alrestatin, zenarestat, zopolrestat, indomethacin, and quercitrin academic journals were clearly first to properly report this therapeutic utility, preempting the corresponding patents by 6 months to several years. For ponalrestat, risarestat, epalrestat, and lidorestat claims of utility in diabetic cataract were first made in patent documents, but with insufficient or incomplete support.

Conclusion: Our results suggest that including patent documents in the routine monitoring of newly disclosed knowledge could significantly improve the comprehensiveness of the literature base in ocular pharmacology, and has the potential to alert researchers to emerging drug candidates earlier than reports in the peer review literature.


Open Access Original Research Article

Ocular Manifestations in HIV/AIDS- Prevalence in South India

Vijayalakshmi Valathuru, Chandrakala Kambar, Sankar Kurli, Rajasulochana Pisipati, Savitri Desai

Ophthalmology Research: An International Journal, Page 165-176
DOI: 10.9734/OR/2014/8250

Human immune deficiency virus (HIV) related ocular manifestations may affect 50-75% of HIV infected people worldwide at some point during the course of their illness.

Aim: To estimate the prevalence of Ocular manifestations in HIV patients attending the Anti Retroviral Therapy (ART) centre.

Place and Duration of the Study: ART centre at Government general hospital and Department of Pharmacology, Siddhartha Medical College, Vijayawada, Andhra Pradesh in south India. The study was conducted for six months from January 2010 to June 2010.

Study Design: This was a cross-sectional and observational study done on 1003 patients with or without ocular manifestations.

Methodology: All the patients were examined for anterior and posterior segment by using slit lamp and indirect ophthalmoscopy. Visual acuity was recorded in all patients.

Results: The prevalence of HIV associated ocular diseases was seen in 24.32 % of HIV patients. The most common findings were seen in anterior segment in 157(15.65%) patients followed by posterior segment in 87(8.67%) patients. 8.57% of conjunctival microvasculopathy, 1.59% of uveitis, 1.19% of herpes zoster and 0.89% of xerosis were the most common findings seen in the anterior segment. 2.47% of HIV retinopathy, 0.99% of chorioretinitis, 0.89% of cytomegaloviral retinitis, 0.69% of choroiditis, and 0.69% of optic atrophy were the most common posterior segment findings. Tuberculosis was the main systemic finding seen in 156 patients.

Conclusion: All these ocular findings are directly related to the severity of the clinical stage of the disease and to the severity of immunosupression.