Journal of Ophthalmology The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Swept Source Optical Coherence Tomography Angiography for Contact Lens-Related Corneal Vascularization Mon, 26 Sep 2016 11:01:36 +0000 Purpose. To describe a novel technique of adapting a swept-source optical coherence tomography angiography (OCTA) to image corneal vascularization. Methods. In this pilot cross-sectional study, we obtained 3 × 3 mm scans, where 100,000 A-scans are acquired per second with optical axial resolution of 8 μm and lateral resolution of 20 μm. This was performed with manual “XYZ” focus without the anterior segment lens, until the focus of the corneoscleral surface was clearly seen and the vessels of interest were in focus on the corresponding red-free image. En face scans were evaluated based on image quality score and repeatability. Results. We analyzed scans from 10 eyes (10 patients) with corneal vascularization secondary to contact lens use in 4 quadrants, with substantial repeatability of scans in all quadrants (mean image quality score 2.7 ± 0.7; ). There was no significant difference in image quality scores comparing quadrants (superior temporal: 2.9 ± 0.6, superior nasal: 2.8 ± 0.4, inferior temporal: 2.5 ± 0.9, and inferior nasal: 2.4 ± 1.0; ) and able to differentiate deep and superficial corneal vascularization. Conclusion. This early clinical study suggests that the swept-source OCTA used may be useful for examining corneal vascularization, which may have potential for clinical applications such as detecting early limbal stem cell damage. Marcus Ang, Yijun Cai, and Anna C. S. Tan Copyright © 2016 Marcus Ang et al. All rights reserved. A Novel Technique for Conjunctivoplasty in a Rabbit Model: Platelet-Rich Fibrin Membrane Grafting Thu, 22 Sep 2016 16:12:09 +0000 Purpose. To investigate the effect of platelet-rich fibrin (PRF) membrane on wound healing. Methods. Twenty-four right eyes of 24 New Zealand rabbits equally divided into 2 groups for the study design. After the creation of 5 × 5 mm conjunctival damage, it was secured with PRF membrane, which was generated from the rabbit’s whole blood samples in PRF membrane group, whereas damage was left unsutured in the control group. Three animals were sacrificed in each group on the 1st, 3rd, 7th, and 28th postoperative days. Immunohistochemical (IHC) stainings and biomicroscopic evaluation were performed and compared between groups. Results. PRF membrane generated significant expressions of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-), and platelet-derived growth factor (PDGF) in the early postoperative period. However, the IHC evaluation allowed showing the excessive staining at day 28, in control group. Biomicroscopic evaluation revealed complete epithelialization in PRF membrane group, but none of the cases showed complete healing in the control group. Conclusions. This experimental study showed us the beneficial effects of the PRF membrane on conjunctival healing. Besides its chemical effects, it provides mechanical support as a scaffold for the migrating cells that are important for ocular surface regeneration. These overall results encourage us to apply autologous PRF membrane as a growth factor-enriched endogenous scaffold for ocular surface reconstruction. Mehmet Erol Can, Hasan Basri Çakmak, Gamze Dereli Can, Hatice Ünverdi, Yasin Toklu, and Sema Hücemenoğlu Copyright © 2016 Mehmet Erol Can et al. All rights reserved. Clinical Features and Visual Outcomes of Optic Neuritis in Chinese Children Tue, 20 Sep 2016 12:09:20 +0000 Purpose. Although optic neuritis (ON) in children is relatively common, visual outcomes and factors associated with the condition have not been well documented. The aim of this study was to evaluate the clinical features and visual outcomes of ON in Chinese children. Methods. Patients with a first episode of ON at a tertiary neuroophthalmic centre in China were assessed and followed up for at least three months. Visual outcomes and clinical, laboratory, and neuroimaging findings were reviewed. In patients with bilateral ON, only the eyes with worse visual acuity (VA) at presentation were used for statistical analysis. Results. Seventy-six children (76 eyes) with a first episode of ON were included. The mean age was 11.8 years, 60.5% were females, and 48.7% had bilateral involvement. The children were followed up for an average of 18.5 months (age range, 3–48 months). Vision loss at presentation was severe, with VA < 20/200 in 37 eyes (48.7%). At the final visit, 3 (3.9%) eyes had VA of at least 20/20, and 41 (53.9%) eyes had VA of at least 20/40. The final VA in 35 eyes (46.1%) was worse than 20/40. Children aged ≤ 10 years had better predicted visual outcomes when compared to children over 10 years (odds ratio = 2.73, 95% confidential interval: 1.05–7.07, and ). The other features of this cohort, such as sex, experienced bilateral attack, VA at presentation, presence of optic disc edema, systemic diseases, magnetic resonance imaging (MRI) findings, and aquaporin-4 (AQP-4) antibody status, were not significantly correlated with the final visual outcome. Conclusion. The data revealed the clinical characteristics and visual outcomes of ON in Chinese children. ON in children was associated with severe vision loss and relatively good visual recovery. The age at onset could predict the final visual function. Huanfen Zhou, Wei Wang, Quangang Xu, Shaoying Tan, Shuo Zhao, Mo Yang, Chunxia Peng, and Shihui Wei Copyright © 2016 Huanfen Zhou et al. All rights reserved. A Combination of Intrastromal and Intracameral Injections of Amphotericin B in the Treatment of Severe Fungal Keratitis Mon, 19 Sep 2016 13:44:54 +0000 Purpose. To evaluate the efficacy of a combination of intrastromal and intracameral injections of amphotericin B in the treatment of severe recalcitrant fungal keratitis. Methods. Patients with severe fungal keratitis who were resistant to conventional antifungal medical treatments and needed potential surgical intervention were recruited at the First Affiliated Hospital of Fujian Medical University between January 2012 and July 2013. The patients were treated with a combination of intrastromal and intracameral injections of amphotericin B (25 μg/mL and 50 μg/mL, resp.). Selectively repeated injections were performed as necessary. The efficacy, complications, and outcome were evaluated. Results. Nine patients (9 eyes) were involved in this study. All 9 cases responded favorably, and the clinical appearance of serious corneal damage and intraocular extension was resolved after the treatment. Four eyes required only 1 injection, and 5 eyes required repeated injections. Seven corneal ulcers healed with leucoma, and 2 healed with adherent leucoma. All of our cases had a marked increase in the anterior chamber reaction and pain immediately after the injection. There was no obvious clinical evidence of corneal or lenticular toxicity in any patient. Conclusions. A combination of intrastromal and intracameral injections of amphotericin B may be safe and effective for the treatment of severe fungal keratitis that is resistant to conventional therapy. Jianzhang Hu, Jingjin Zhang, Yanling Li, Xiaoli Han, Weidong Zheng, Juan Yang, and Guoxing Xu Copyright © 2016 Jianzhang Hu et al. All rights reserved. Applications of Anterior Segment Optical Coherence Tomography in Cornea and Ocular Surface Diseases Mon, 19 Sep 2016 09:23:45 +0000 Optical coherence tomography (OCT) is a noncontact technology that produces high-resolution cross-sectional images of ocular tissues. Anterior segment OCT (AS-OCT) enables the precise visualization of anterior segment structure; thus, it can be used in various corneal and ocular surface disorders. In this review, the authors will discuss the application of AS-OCT for diagnosis and management of various corneal and ocular surface disorders. Use of AS-OCT for anterior segment surgery and postoperative management will also be discussed. In addition, application of the device for research using human data and animal models will be introduced. Sang Beom Han, Yu-Chi Liu, Karim Mohamed Noriega, and Jodhbir S. Mehta Copyright © 2016 Sang Beom Han et al. All rights reserved. Twelve-Month Follow-Up of Dexamethasone Implants for Macular Edema from Various Diseases in Vitrectomized and Nonvitrectomized Eyes Sun, 18 Sep 2016 11:43:37 +0000 Purpose. To evaluate the best-corrected visual acuity (BCVA), central retinal thickness (CRT), and the number of dexamethasone implants needed to treat cystoid macular edema (CME) from various etiologies over 12 months in vitrectomized and nonvitrectomized eyes. Methods. This multicenter retrospective cohort study included 112 patients with CME secondary to retinal diseases treated pro re nata (PRN) with a 0.7 mg intravitreal dexamethasone implant for 12 months. The BCVA, CRT, adverse events, safety data, and number of implants were recorded. Results. Vitrectomized and nonvitrectomized eyes received means of three implants and one implant, respectively, over 12 months (). The mean BCVA of all patients improved from 0.13 at baseline to 0.33 () 12 months after one (), two (), and three () implants but not four implants (). The mean baseline CRT decreased significantly () from 463 to 254 microns after 12 months with one (), two (), and three () implants but not with four implants (). The anatomic and functional outcomes were not significantly different between vitrectomized and nonvitrectomized eyes. Increased IOP was the most common adverse event (23.2%). Conclusions. Dexamethasone implant administered PRN improved VA and decreased CRT in CME, with possible long-term clinically relevant benefits for treating CME from various etiologies. Vitrectomized eyes needed more implants compared with nonvitrectomized eyes. Eduardo A. Novais, Mauricio Maia, Paulo Augusto de Arruda Mello Filho, João Rafael de Oliveira Dias, José Maurício B. B. Garcia, Gabriel C. de Andrade, Ricardo N. Louzada, Marcos Ávila, André Maia, J. Fernando Arevalo, Lihteh Wu, Maria Berrocal, Emmerson Badaró, and Michel Farah Copyright © 2016 Eduardo A. Novais et al. All rights reserved. Clinical Usefulness of Monitoring Expression Levels of CCL24 (Eotaxin-2) mRNA on the Ocular Surface in Patients with Vernal Keratoconjunctivitis and Atopic Keratoconjunctivitis Sun, 18 Sep 2016 09:44:31 +0000 Purpose. This study aimed to evaluate the clinical efficacy of using expression levels of CCL24 (eotaxin-2) mRNA on the ocular surface as a biomarker in patients with vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). Methods. Eighteen patients with VKC or AKC (VKC/AKC group) and 12 control subjects (control group) were enrolled in this study. The VKC/AKC clinical score was determined by objective findings in patients by using the 5-5-5 exacerbation grading scale. All subjects underwent modified impression cytology and specimens were obtained from the upper tarsal conjunctiva. Expression levels of CCL24 (eotaxin-2) mRNA on the ocular surface were determined using real-time reverse transcription polymerase chain reaction. Results. The VKC group was divided into two subgroups, depending on the clinical score: the active stage subgroup with 100 points or more of clinical scores and the stable stage subgroup with 100 points or less. CCL24 (eotaxin-2) mRNA expression levels in the active VKC/AKC stage subgroup were significantly higher than those in the stable VKC/AKC subgroup and the control group. Clinical scores correlated significantly with CCL24 (eotaxin-2) mRNA expression levels in the VKC group. Conclusions. CCL24 (eotaxin-2) mRNA expression levels on the ocular surface are a useful biomarker for clinical severity of VKC/AKC. Yukiko Shiraki, Jun Shoji, and Noriko Inada Copyright © 2016 Yukiko Shiraki et al. All rights reserved. Reliability of Using Retinal Vascular Fractal Dimension as a Biomarker in the Diabetic Retinopathy Detection Wed, 14 Sep 2016 10:00:39 +0000 The retinal fractal dimension (FD) is a measure of vasculature branching pattern complexity. FD has been considered as a potential biomarker for the detection of several diseases like diabetes and hypertension. However, conflicting findings were found in the reported literature regarding the association between this biomarker and diseases. In this paper, we examine the stability of the FD measurement with respect to (1) different vessel annotations obtained from human observers, (2) automatic segmentation methods, (3) various regions of interest, (4) accuracy of vessel segmentation methods, and (5) different imaging modalities. Our results demonstrate that the relative errors for the measurement of FD are significant and FD varies considerably according to the image quality, modality, and the technique used for measuring it. Automated and semiautomated methods for the measurement of FD are not stable enough, which makes FD a deceptive biomarker in quantitative clinical applications. Fan Huang, Behdad Dashtbozorg, Jiong Zhang, Erik Bekkers, Samaneh Abbasi-Sureshjani, Tos T. J. M. Berendschot, and Bart M. ter Haar Romeny Copyright © 2016 Fan Huang et al. All rights reserved. Corrigendum to “A Review of Collagen Cross-Linking in Cornea and Sclera” Wed, 14 Sep 2016 09:58:15 +0000 Xiao Zhang, Xiang-chen Tao, Jian Zhang, Zhi-wei Li, Yan-yun Xu, Yu-meng Wang, Chun-xiao Zhang, and Guo-ying Mu Copyright © 2016 Xiao Zhang et al. All rights reserved. In Vivo Positional Analysis of Implantable Collamer Lens Using Ultrasound Biomicroscopy Thu, 08 Sep 2016 17:40:22 +0000 Purpose. To evaluate the anterior segment, the anatomical position of the implantable collamer lenses (ICL), and its relationship to adjacent ocular structures using Ultrasound Biomicroscopy (UBM). Methods. In a prospective study, 142 myopic eyes of 93 patients implanted with Visian ICL were subjected to UBM examination between March 2010 and January 2015. The relative position of ICL to the adjacent structure and the overall iris configuration were evaluated. The machine calibers were used to measure the minimum central distance between the ICL and anterior lens capsule (vault) and the vertical central distance between the corneal endothelium and the ICL (E-ICL). Results. The mean ICL vault was  μm. The mean E-ICL was  μm. Contact between ICL and the posterior epithelium of the iris was present in all eyes. The overall iris configuration was flat in 89 eyes. Central anterior convexity was present in 41 eyes and mild peripheral iris bombe in 12 eyes. The haptics could be imaged in the ciliary sulcus in 112 eyes and at least one haptic resting on the lens periphery and zonules in 30 eyes. Conclusion. UBM can provide valuable anatomical information that allows detailed postoperative in vivo assessment of ICL. Ahmed Mohamed Kamal Elshafei, Mahmoud Mohamed Genaidy, and Hossam Mohamed Moharram Copyright © 2016 Ahmed Mohamed Kamal Elshafei et al. All rights reserved. Corneal Epithelial Remodeling and Its Effect on Corneal Asphericity after Transepithelial Photorefractive Keratectomy for Myopia Thu, 08 Sep 2016 06:01:24 +0000 Purpose. To evaluate the changes in epithelial thickness profile following transepithelial photorefractive keratectomy (T-PRK) for myopia and to investigate the effect of epithelial remodeling on corneal asphericity. Methods. Forty-four patients (44 right eyes) who underwent T-PRK were retrospectively evaluated. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones (central, 2 mm; paracentral, 2–5 mm; and mid-peripheral, 5-6 mm) preoperatively and at 1 week and 1, 3, and 6 months postoperatively. The correlation between the changes in corneal epithelial thickness (ΔCET) and postoperative -value changes (ΔQ) was analyzed 6 months postoperatively. Results. Epithelial thickness at 6 months showed a negative meniscus-like lenticular pattern with less central thickening, which increased progressively toward the mid-periphery (, , and  μm at the center, paracenter, and mid-periphery, resp., ). A significant positive relationship was observed between epithelial thickening and ΔQ 6 months postoperatively (, 0.580, and 0.504, resp., ). Conclusions. Significant epithelial thickening was observed after T-PRK and showed a lenticular change with more thickening mid-peripherally, resulting in increased oblateness postoperatively. Epithelial remodeling may modify the epithelial thickness profile after surface ablation refractive surgery for myopia. Jie Hou, Yan Wang, Yulin Lei, Xiuyun Zheng, and Ying Zhang Copyright © 2016 Jie Hou et al. All rights reserved. Comment on “Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer’s Type Dementia” Tue, 06 Sep 2016 13:20:22 +0000 Salih Uzun Copyright © 2016 Salih Uzun. All rights reserved. Evaluation of Anterior Chamber Volume in Cataract Patients with Swept-Source Optical Coherence Tomography Mon, 05 Sep 2016 14:00:24 +0000 Purpose. To evaluate the anterior chamber volume in cataract patients with Swept-Source Optical Coherence Tomography (SS-OCT) and its influencing factors. Methods. Anterior chamber volume of 92 cataract patients was evaluated with SS-OCT in this cross-sectional study. Univariate analyses and multiple linear regression were used to investigate gender, age, operated eye, posterior vitreous detachment, lens opacity grading, and axial length (AXL) related variables capable of influencing the ACV. Results. The average ACV was 139.80 ± 38.21 mm3 (range 59.41 to 254.09 mm3). The average ACV was significantly larger in male patients than in female patients (). ACV was negatively correlated with age and LOCS III cortical (C) grading of the lens (Pearson’s correlation analysis, , , and Spearman’s correlation analysis, , ). ACV was also increased with AXL (Pearson’s correlation analysis, , ). Multiple linear regression showed that, with all of the covariates entered into the model, gender (), age (), LOCS III C grade (), and AXL () were still associated with ACV (). Conclusion. With SS-OCT, we found that, in healthy cataract patients, ACV varied significantly among different subjects. Influencing factors that contribute to reduced ACV were female gender, increased age, LOCS III C grade, and shorter AXL. Wenwen He, Xiangjia Zhu, Don Wolff, Zhennan Zhao, Xinghuai Sun, and Yi Lu Copyright © 2016 Wenwen He et al. All rights reserved. Scleral Buckling for Rhegmatogenous Retinal Detachment Associated with Pars Planitis Mon, 05 Sep 2016 13:34:28 +0000 Purpose. To evaluate the surgical outcome of scleral buckling (SB) in rhegmatogenous retinal detachment (RRD) patients associated with pars planitis. Methods. Retrospective review of RRD patients (32 eyes of pars planitis RRD and 180 eyes of primary RRD) who underwent SB. We compared primary and final anatomical success rates and visual outcomes between two groups. Results. Primary and final anatomical success were achieved in 25 (78.1%) and 31 (96.8%) eyes in the pars planitis RRD group and in 167 eyes (92.7%) and 176 eyes (97.7%) in primary RRD group, respectively. Both groups showed significant visual improvement () and there were no significant differences in final visual acuity. Pars planitis RRD group was associated with higher rate of postoperative proliferative vitreoretinopathy (PVR) development (12.5% versus 2.8%, ). Pars planitis and high myopia were significant preoperative risk factors and pseudophakia was borderline risk for primary anatomical failure after adjusting for various clinical factors. Conclusions. Pars planitis associated RRD showed inferior primary anatomical outcome after SB due to postoperative PVR development. However, final anatomical and visual outcomes were favorable. RRD cases associated with pars planitis, high myopia, and pseudophakia might benefit from different surgical approaches, such as combined vitrectomy and SB. Yong-Kyu Kim, Wontae Yoon, Jae Kyoun Ahn, and Sung Pyo Park Copyright © 2016 Yong-Kyu Kim et al. All rights reserved. Corneal Biomechanical Findings in Contact Lens Induced Corneal Warpage Sun, 04 Sep 2016 13:37:56 +0000 Purpose. To evaluate the difference in biomechanical properties between contact lens induced corneal warpage and normal and keratoconic eyes. Method. Prospective observational case control study, where 94 eyes of 47 warpage suspicious and 46 eyes of 23 keratoconic patients were included. Warpage suspected cases were followed until a definite diagnosis was made (warpage, normal, or keratoconus). Results. 44 eyes of 22 patients had contact lens related corneal warpage. 46 eyes of 23 people were diagnosed as nonwarpage normal eyes. 46 eyes of 23 known keratoconus patients were included for comparison. The mean age of the participants was 23.8 ± 3.8 years, and 66.2% of the subjects were female. The demographic and refractive data were not different between warpage and normal groups but were different in the keratoconus group. The biomechanical properties (corneal hysteresis or CH and corneal resistance factor or CRF) were different with the highest value in the warpage group followed by normal and keratoconus groups. CRF was 10.08 ± 1.75, 9.23 ± 1.22, and 7.38 ± 2.14 and CH was 10.21 ± 1.57, 9.59 ± 1.21, and 8.69 ± 2.34 in the warpage, normal, and keratoconus groups, respectively. Conclusion. Corneal biomechanics may be different in people who develop contact lens induced warpage. Fateme Alipour, Mojgan Letafatnejad, Amir Hooshang Beheshtnejad, Seyed-Farzad Mohammadi, Seyed Reza Ghaffary, Narges Hassanpoor, and Mehdi Yaseri Copyright © 2016 Fateme Alipour et al. All rights reserved. The Intoxication Effects of Methanol and Formic Acid on Rat Retina Function Sun, 04 Sep 2016 06:20:10 +0000 Objective. To explore the potential effects of methanol and its metabolite, formic acid, on rat retina function. Methods. Sprague-Dawley rats were divided into 3- and 7-day groups and a control. Experimental groups were given methanol and the control group were provided saline by gavage. Retinal function of each group was assessed by electroretinogram. Concentrations of methanol and formic acid were detected by GC/HS and HPLC, respectively. Results. The a and b amplitudes of methanol treated groups decreased and latent periods delayed in scotopic and photopic ERG recordings. The summed amplitudes of oscillatory potentials (OPs) of groups B and C decreased and the elapsed time delayed. The amplitudes of OS1, OS3, OS4, and OS5 of group B and OS3, OS4, and OS5 of group C decreased compared with the control group. The IPI1 of group B and IPI1-4 of group C were broader compared with the control group and the IPI1-4 and ET of group B were broader than group C. Conclusions. Both of scotopic and photopic retinal functions were impaired by methanol poisoning, and impairment was more serious in the 7-day than in the 3-day group. OPs, especially later OPs and IPI2, were more sensitive to methanol intoxication than other eletroretinogram subcomponents. Dong-Mei Liu, Shu Zhou, Jie-Min Chen, Shu-Ya Peng, and Wen-Tao Xia Copyright © 2016 Dong-Mei Liu et al. All rights reserved. Comment on “Evaluation of Subfoveal Choroidal Thickness in Internal Carotid Artery Stenosis” Thu, 01 Sep 2016 08:37:57 +0000 Salih Uzun, Yakup Yesilkaya, and Emre Pehlivan Copyright © 2016 Salih Uzun et al. All rights reserved. Effect of Hydroxychloroquine on the Retinal Layers: A Quantitative Evaluation with Spectral-Domain Optical Coherence Tomography Tue, 30 Aug 2016 13:18:44 +0000 Purpose. To evaluate the effect of hydroxychloroquine on retinal pigment epithelium- (RPE-) Bruch’s membrane complex, photoreceptor outer segment, and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods. In this prospective case-control study, 51 eyes of 51 hydroxychloroquine patients and 30 eyes of 30 healthy subjects were included. High-quality images were obtained using a Cirrus HD-OCT with 5-line raster mode; the photoreceptor inner segment (IS) and outer segment (OS), sum of the segments (IS + OS), and RPE-Bruch’s membrane complex were analyzed. Results. The thicknesses of the IS + OS and OS layers were significantly lower in the hydroxychloroquine subjects compared to the control subjects (). RPE-Bruch’s membrane complex thicknesses were significantly higher in the hydroxychloroquine subjects than for those of the control subjects (). The minimum and temporal-inferior macular GCIPL thicknesses were significantly different between the patients with hydroxychloroquine use and the control subjects ( and , resp.). Conclusions. The foveal photoreceptor OS thinning, loss of GCIPL, and RPE-Bruch’s membrane thickening were detected in patients with hydroxychloroquine therapy. This quantitative approach using SD-OCT images may have important implications to use as an early indicator of retinal toxicity without any visible signs of hydroxychloroquine retinopathy. Hasim Uslu, Bulent Gurler, Aydin Yildirim, Mehmet Gurkan Tatar, Feride Aylin Kantarcı, Hasan Goker, Hatice Seval Pehlevan, and Hatice Nur Colak Copyright © 2016 Hasim Uslu et al. All rights reserved. Quantitative Analysis of Lens Nuclear Density Using Optical Coherence Tomography (OCT) with a Liquid Optics Interface: Correlation between OCT Images and LOCS III Grading Mon, 29 Aug 2016 09:50:27 +0000 Purpose. To quantify whole lens and nuclear lens densities using anterior-segment optical coherence tomography (OCT) with a liquid optics interface and evaluate their correlation with Lens Opacities Classification System III (LOCS III) lens grading and corrected distance visual acuity (BCVA). Methods. OCT images of the whole lens and lens nucleus of eyes with age-related nuclear cataract were analyzed using ImageJ software. The lens grade and nuclear density were represented in pixel intensity units (PIU) and correlations between PIU, BCVA, and LOCS III were assessed. Results. Forty-seven eyes were analyzed. The mean whole lens and lens nuclear densities were 26.99 ± 5.23 and 19.43 ± 6.15 PIU, respectively. A positive linear correlation was observed between lens opacities ( = 0.187, ) and nuclear density ( = 0.316, ) obtained from OCT images and LOCS III. Preoperative BCVA and LOCS III were also positively correlated ( = 0.454, ). Conclusions. Whole lens and lens nuclear densities obtained from OCT correlated with LOCS III. Nuclear density showed a higher positive correlation with LOCS III than whole lens density. OCT with a liquid optics interface is a potential quantitative method for lens grading and can aid in monitoring and managing age-related cataracts. You Na Kim, Jin Hyoung Park, and Hungwon Tchah Copyright © 2016 You Na Kim et al. All rights reserved. Evaluation of Anterior Segment’s Structures in Tilted Disc Syndrome Thu, 25 Aug 2016 13:03:54 +0000 Purpose. To evaluate anterior segment’s structures by Pentacam in patients with tilted disc syndrome (TDS). Methods. Group 1 included forty-six eyes of forty-six patients who have the TDS. Group 2 including forty-six eyes of forty-six cases was the control group which was equal to the study group in age, gender, and refraction. A complete ophthalmic examination was performed in both groups. All cases were evaluated by Pentacam. The axial length (AL) of eyes was measured by ultrasound. Quantitative data obtained from these measurements were compared between two groups. Results. There was no statistically significant difference for age, gender, axial length, and spherical equivalent measurements between two groups (, , , and ). There was a statistically significant difference for central corneal thickness (CCT), corneal volume (CV), anterior chamber angle (ACA), and pupil size measurements between two groups (, , , and ). Also, there was no statistically significant difference for anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness (LT) measurements between two groups (, , and ). Conclusion. We determined that CCT was thinner, CV was less, and ACA was narrower in patients with TDS. There are some changes in the anterior segment of the eyes with tilted disc. Ercan Ozsoy, Abuzer Gunduz, Ersin Ersan Demirel, and Tongabay Cumurcu Copyright © 2016 Ercan Ozsoy et al. All rights reserved. Outcomes of Sutureless Iris-Claw Lens Implantation Wed, 24 Aug 2016 17:54:50 +0000 Purpose. To evaluate the indications, refraction, and visual and safety outcomes of iris-claw intraocular lens implanted retropupillary with sutureless technique during primary or secondary operation. Methods. Retrospective study of case series. The Haigis formula was used to calculate intraocular lens power. In all cases the wound was closed without suturing. Results. The study comprised 47 eyes. The mean follow-up time was 15.9 months (SD 12.2). The mean preoperative CDVA was 0.25 (SD 0.21). The final mean CDVA was 0.46 (SD 0.27). No hypotony or need for wound suturing was observed postoperatively. Mean postoperative refractive error was −0.27 Dsph (−3.87 Dsph to +2.85 Dsph; median 0.0, SD 1.28). The mean postoperative astigmatism was −1.82 Dcyl (min −0.25, max −5.5; median −1.25, SD 1.07). Postoperative complications were observed in 10 eyes. The most common complication was ovalization of the iris, which was observed in 8 eyes. The mean operation time was 35.9 min (min 11 min, max 79 min; median 34, SD 15.4). Conclusion. Retropupilary iris-claw intraocular lens (IOL) implantation with sutureless wound closing is an easy and fast method, ensuring good refractive outcome and a low risk of complication. The Haigis formula proved to be predictable in postoperative refraction. Tomasz Choragiewicz, Robert Rejdak, Andrzej Grzybowski, Katarzyna Nowomiejska, Joanna Moneta-Wielgoś, Małgorzata Ozimek, and Anselm G. M. Jünemann Copyright © 2016 Tomasz Choragiewicz et al. All rights reserved. Response to: Comment on “The Effects of Hemodialysis on Tear Osmolarity” Tue, 23 Aug 2016 14:13:00 +0000 Muhittin Taskapili, Kubra Serefoglu Cabuk, Rukiye Aydin, Kursat Atalay, Ahmet Kirgiz, Dede Sit, and Hasan Kayabasi Copyright © 2016 Muhittin Taskapili et al. All rights reserved. Lacrimal Gland, Ocular Surface, and Dry Eye Tue, 23 Aug 2016 09:06:59 +0000 Chuanqing Ding, Edit Tóth-Molnár, Ningli Wang, and Lei Zhou Copyright © 2016 Chuanqing Ding et al. All rights reserved. Effects of Target Size and Test Distance on Stereoacuity Sun, 21 Aug 2016 12:24:48 +0000 Target size and test distance effects on stereoacuity were investigated in 24 subjects using a three-dimensional monitor. Examination 1: Target Size Effects. The test distance was 2.5 m for 0.1°, 0.2°, 0.5°, and 0.9° target sizes; crossed parallax was presented in 22-second units. Average stereoacuity values for 0.1°, 0.2°, 0.5°, and 0.9° target sizes were , , , and seconds, respectively. Stereoacuity was significantly worse with a 0.1° target than with 0.2°, 0.5°, and 0.9° target sizes (, , and , resp.). Examination 2: Test Distance Effects. Test distances of 2.5, 5.0, and 7.5 m were investigated for a 0.5° target size; crossed parallax was presented in 22-second units. Average stereoacuity values at 2.5 m, 5.0 m, and 7.5 m test distances were , , and seconds, respectively. Stereoacuity at a 7.5 m distance was significantly better than at distances of 2.5 m and 5.0 m ( and , resp.). Stereoacuity at a 5.0 m distance was significantly better than at 2.5 m (). Stereoacuity should be estimated by both parallax and other elements, including test distance and target size. Yo Iwata, Fusako Fujimura, Tomoya Handa, Nobuyuki Shoji, and Hitoshi Ishikawa Copyright © 2016 Yo Iwata et al. All rights reserved. Visual Rehabilitation in Combined Surgical Procedures: Bridging Two Eye Poles for Better Vision Thu, 18 Aug 2016 09:28:26 +0000 M. J. Koss, C. Y. Choi, R. R. Krueger, M. Maia, and H. B. Fam Copyright © 2016 M. J. Koss et al. All rights reserved. Corrigendum to “Expression of HGF and c-Met Proteins in Human Keratoconus Corneas” Wed, 17 Aug 2016 12:43:59 +0000 Jingjing You, Li Wen, Athena Roufas, Chris Hodge, Gerard Sutton, and Michele C. Madigan Copyright © 2016 Jingjing You et al. All rights reserved. Intrastromal Injection of Bevacizumab in the Management of Corneal Neovascularization: About 25 Eyes Wed, 17 Aug 2016 09:18:40 +0000 Introduction. Corneal neovessels are a major risk factor for corneal graft rejection, due to the loss of the immune privilege. The purpose of this study is to evaluate the effectiveness of intrastromal injection of bevacizumab in the treatment of corneal neovascularization. Material and Methods. This is a prospective study that included 25 eyes of 22 patients with deep corneal neovessels, treated with intrastromal injections of bevacizumab. Results. The average age of patients was 31 years ranging from 16 to 44 years. The causes of neovascularization were dominated by herpetic keratitis (10 cases). The evolution was marked by complete regress of neovessels in 16 patients, partial regress in 6 cases, and reduced opacity and improved visual acuity in 5 patients. No side effects were noted. Discussion. Short-term results demonstrated the effectiveness of intrastromal injection of bevacizumab in the treatment of corneal neovessels. It may be an option or a complement to other useful treatments in stabilizing or improving vision. Conclusion. Bevacizumab is an effective additional treatment for the improvement of corneal transplants prognosis with preoperative corneal neovascularization. Belghmaidi Sarah, Hajji Ibtissam, Baali Mohammed, Soummane Hasna, and Moutaouakil Abdeljalil Copyright © 2016 Belghmaidi Sarah et al. All rights reserved. Novel Technique of Transepithelial Corneal Cross-Linking Using Iontophoresis in Progressive Keratoconus Mon, 15 Aug 2016 09:05:24 +0000 In this work, the authors presented the techniques and the preliminary results at 6 months of a randomized controlled trial (NCT02117999) comparing a novel transepithelial corneal cross-linking protocol using iontophoresis with the Dresden protocol for the treatment of progressive keratoconus. At 6 months, there was a significant average improvement with an average flattening of the maximum simulated keratometry reading of  D (); in addition, corrected distance visual acuity improved significantly () and spherical equivalent refraction was significantly less myopic () 6 months after transepithelial corneal cross-linking with iontophoresis. The novel protocol using iontophoresis showed comparable results with standard corneal cross-linking to halt progression of keratoconus during 6-month follow-up. Investigation of the long-term RCT outcomes are ongoing to verify the efficacy of this transepithelial corneal cross-linking protocol and to determine if it may be comparable with standard corneal cross-linking in the management of progressive keratoconus. Marco Lombardo, Sebastiano Serrao, Paolo Raffa, Marianna Rosati, and Giuseppe Lombardo Copyright © 2016 Marco Lombardo et al. All rights reserved. Low-Fluence Photodynamic Therapy versus Subthreshold Micropulse Yellow Wavelength Laser in the Treatment of Chronic Central Serous Chorioretinopathy Mon, 15 Aug 2016 07:48:01 +0000 Purpose. To compare the efficacy and safety of subthreshold micropulse yellow wavelength laser (SMYL) and low-fluence photodynamic therapy (PDT) in the treatment of chronic central serous chorioretinopathy (CSC). Methods. Thirty-three eyes of 30 patients with chronic CSC received either PDT (18 eyes) or SMYL (15 eyes) therapy. Best corrected visual acuity (BCVA), subretinal fluid (SRF) height, and central macular thickness (CMT) were evaluated at the baseline visit and one, three, six, nine, and 12 months after the therapy. Results. After 12 months, mean BCVA improved from to ETDRS letters in SMYL group and from to ETDRS letters in PDT group ( and , resp.). Mean CMT decreased from  μm to  μm in the PDT group and from  μm to  μm in the SMYL group ( and , resp.). SRF resolved completely in 72.2% and 80.0% of the eyes in the PDT and SMYL groups, respectively. Mean SRF height decreased from  μm to  μm in the PDT group and from  μm to  μm in the SMYL group ( and , resp.). Conclusions. Subthreshold micropulse yellow wavelength laser seems to be effective in the treatment of chronic CSC without any side effect and results in the resorption of SRF without causing visible retinal scarring. Emin Özmert, Sibel Demirel, Özge Yanık, and Figen Batıoğlu Copyright © 2016 Emin Özmert et al. All rights reserved. How Important Is the Etiology in the Treatment of Epiphora? Wed, 10 Aug 2016 13:14:06 +0000 Purpose. There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients. Materials and Methods. Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination. Results. This study consisted of 163 patients with a mean age of 64.61 ± 16.52 years (range 1–92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years () and six of these had chronic dacryocystitis and one had ectropion. Conclusion. Epiphora not only has a negative impact on patients’ comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied. Mahmut Oğuz Ulusoy, Sertaç Argun Kıvanç, Mehmet Atakan, and Berna Akova-Budak Copyright © 2016 Mahmut Oğuz Ulusoy et al. All rights reserved.