No abstract available.
Hepatitis A Antibodies* ; Hepatitis* ; Immunoglobulin M*

PURPOSE: To assess whether a 4 mg/0.05 ml intravitreal triamcinolone acetonide injection can reduce the IOP elevation compared to conventional 4 mg/0.1 ml injection. METHODS: A retrospective case study was performed in 48 patients (48 eyes) who received intravitreal triamcinolone acetonide injection and who had a minimum follow-up time of six months. Patients were randomly assigned to receive 4 mg/0.1 ml or 4 mg/0.05 ml (24 patients in each group). RESULTS: Before injection, mean IOP was 13.8+/-2.2 mmHg and 13.9+/-2.4 mmHg in the 0.1 ml and 0.05 ml group. The difference in IOP elevation between the two groups was statistically significant immediately after injection (P=0.000), one hour after injection (P=0.001), and one day after injection (P=0.000). After injection, the central macular thickness decreased significantly the of two groups. The difference of the central macular thickness decrease between both groups was not statistically significant. CONCLUSIONS: An intravitreal triamcinolone acetonide 4 mg/0.05 ml injection will more quickly reduce the IOP elevation in the early phase compared to 4 mg/0.1 ml injection, while providing a similar effect on the change of central macular thickness.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Retrospective Studies ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To report a rare case of choroidal metastasis from renal cell carcinoma. CASE SUMMARY: A 61-year-old man visited our clinic with the chief complaint of decreased vision in the right eye. Three years earlier, he underwent right nephrectomy due to renal cell carcinoma. Best corrected visual acuity was 0.2 in the right eye and 1.0 in the left eye. Fundoscopic examination of the right eye revealed a yellowish, dome-shaped elevated choroidal mass with serous retinal detachment, measuring 5.0 x 4.0 disc diameter and located lateral to the macular area. Systemic evaluations showed multiple lung and brain metastases. A diagnosis of choroidal metastasis from renal cell carcinoma was made for the right eye, and the patient received local treatments with oral sorafenib therapy, composed of subtenon triamcinolone injection and intravitreal ranibizumab injection. Tumor progression continued, and visual acuity declined to hand motion. Enucleation was recommended, but the patient refused and is on a regular follow-up after transpupillary thermotherapy. CONCLUSIONS: Ocular manifestation may be the initial presenting sign of a recurrent tumor, and an extensive systemic evaluation for metastatic malignancy should be performed. The present example showed a rare case of choroidal metastasis from renal cell carcinoma.
Antibodies, Monoclonal, Humanized ; Brain ; Carcinoma, Renal Cell ; Choroid ; Eye ; Follow-Up Studies ; Hand ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Niacinamide ; Phenylurea Compounds ; Retinal Detachment ; Triamcinolone ; Vision, Ocular ; Visual Acuity ; Ranibizumab

PURPOSE: To evaluate long-term effects and usefulness of combined intravitreal injection of bevacizumab and panretinal photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy. METHODS: The authors retrospectively reviewed the records of 40 patients (40 eyes) with high-risk proliferative diabetic retinopathy who had been treated with PRP alone (laser treatment group, n=20) or intravitreal bevacizumab before PRP (combined treatment group, n=20). Changes in best corrected visual acuity (BCVA), central macular thickness (CMT) and the total area of leakage from active new vessels (NVs) were compared between the groups at one, three, and six months and at one year post-treatment. RESULTS: In the combined treatment group, CMT decreased significantly at one month (p=0.021), and the areas of active NVs decreased significantly at one month (p=0.001) and three months (p=0.014) compared to those of the laser treatment group. However, there were no differences between the two groups after three months. In the combined treatment group, elevated intraocular pressures were found in three cases after one month, and there were vitreous hemorrhages in two cases after three months. CONCLUSIONS: The combined treatment showed significant early improvements in BCVA, CMT, and NVs regression for up to three months. However, long-term follow-up and additional treatment was necessary in the patients with persistent or recurred NVs and macular edema after three months.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Light Coagulation ; Macular Edema ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage ; Bevacizumab

The medial prefrontal cortex (mPFC) has been implicated in the processing of emotionally significant stimuli, particularly the inhibition of inappropriate responses. We examined the role of the mPFC in regulation of fear responses using a differential fear conditioning procedure in which the excitatory conditioned stimulus (CS+) was paired with an aversive footshock and intermixed with the inhibitory conditioned stimulus (CS-). In the first experiment, using rats as subjects, muscimol, a gamma-amino-butyric acid type A (GABAA) receptor agonist, or artificial cerebrospinal fluid (aCSF) was infused intracranially into the mPFC across three conditioning sessions. Twenty-four hours after the last conditioning session, freezing response of the rats was tested in a drug-free state. Neither the muscimol nor the aCSF infusion had any effect on differential responding. In the second experiment, the same experimental procedure was used except that the infusion was made before the testing session rather than the conditioning sessions. The results showed that muscimol infusion impaired differential responding: the level of freezing to CS- was indiscriminable from that to CS+. Taken together, these results suggest that the mPFC is responsible for the regulation of fear response by inhibiting inappropriate fear expressions.
Animals ; Freezing ; Muscimol ; Prefrontal Cortex ; Rats

PURPOSE: To investigate the clinical features of patients with macular edema persisting for three months after a successful vitrectomy and removal of the epiretinal membrane. METHODS: The authors retrospectively reviewed the records of 32 patients (32 eyes) with epiretinal membranes who underwent pars plana vitrectomies and membranectomies from January 2005 to September 2008. The patients selected for the study underwent optical coherence tomography (OCT) which revealed macular edema. Macular edema is defined as central macular thickness measuring over 300 m. Several factors including age, presence of systemic disorders, preoperative visual acuity, surgical technique, preoperative state of the macula, and the response to treatment for macular edema were reviewed. RESULTS: Eight out of 32 eyes (25%) had no improvement of visual acuity after surgery of the epiretinal membrane. Six out of 32 eyes (18.75%) persisted in their macular edema. No common features were detected. All patients showed no improvement of visual acuity after their vitrectomies. Two of the eyes were treated with intravitreal or subtenon triamcinolone injection or non-steroidal anti-inflammatory eye drops. Only one eye (16.7%) achieved visual improvement as of the last follow-up. CONCLUSIONS: Despite a successful vitrectomy and membranectomy, macular edema can remain without any specific cause. Persistantmacular edema appears to be a main cause of poor visual outcome and tends to resist conventional treatment.
Edema ; Epiretinal Membrane ; Eye ; Humans ; Macular Edema ; Ophthalmic Solutions ; Retrospective Studies ; Tomography, Optical Coherence ; Triamcinolone ; Visual Acuity ; Vitrectomy

PURPOSE: To investigate the outcomes of the combined therapy of intravitreal bevacizumab (IVB) and posterior sutbtenon triamconolone acetonide (STTA) injections as compared to single injections of each in patients with diabetic macular edema (DME). METHODS: IVB injection (IVB group), STTA injection (STTA group) and combined therapy injection (combined group) were performed randomly for 90 eyes (83 patients) diagnosed with DME. Changes in central macular thickness (CMT), best corrected visual acuity (BCVA) and intraocular pressure (IOP) were compared among groups prospectively at pre-injection and one, three and six months after injection. RESULTS: Reduction of CMT and improvement of BCVA were maintained for three months after treatment in all groups, but CMT and BCVA deteriorated at six months after treatment. The combined therapy group revealed significant reductions in CMT and improvement of BCVA (p=0.003, p=0.021, respectively) for the first month compared to the single treatment group. Elevated IOPs were found in three cases and there was no endophthalmitis or retinal detachment. CONCLUSIONS: The combined therapy injection showed significant early improvements in CMT and BCVA for one month. Additionally, the combined therapy revealed similar outcomes as compared with each single treatment after three months.
Antibodies, Monoclonal, Humanized ; Endophthalmitis ; Eye ; Humans ; Intraocular Pressure ; Macular Edema ; Prospective Studies ; Retinaldehyde ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab

PURPOSE: Bacillus cereus is an important cause of post-traumatic endophthalmitis. Several different anti-biotics have been used to prevent permanent visual loss. The authors compared the efficacy of intravitreal vancomycin and ciprofloxacin in the treatment of experimental Bacillus cereus endophthalmitis. METHODS: Forty eyes of 20 white rabbits were inoculated with B. cereus organisms. Ten eyes were randomized to receive intravitreal vancomycin (group 1) and 10 eyes ciprofloxacin (group 2) after 12 or 24 hours. Fellow eyes were injected with normal saline as control group. After 48 hours, the eyes were examined and graded for clinical signs of infection and enucleated for histologic examination. RESULTS: There was a statistically significant difference in clinical features between treated groups and control group (p<0.05). There was no significant difference between vancomycin-treated group and ciprofloxacin-treated group. Compared to eyes treated 12 hours after inoculation, eyes treated 24 hours after inoculation showed worse clinical gradings (p<0.05). Histologic examination showed vancomycin or ciprofloxacin-treated groups had significant less inflammation and tissue destruction than control group (p<0.05). There was a statistically significant difference in vitreous and retinal structure between ciprofloxacin-treated after 12 hours inoculation and 24 hours inoculation group (p<0.05). CONCLUSIONS: Ciprofloxacin appeared to be limiting inflammation and tissue destruction in experimental Bacillus endophthalmitis and might effective in substitute vancomycin when necessary.
Bacillus cereus ; Bacillus* ; Ciprofloxacin* ; Endophthalmitis* ; Inflammation ; Rabbits ; Retinaldehyde ; Vancomycin

PURPOSE: To evaluate the safety and effects of intracameral triamcinolone acetonide injection in rabbit corneas. METHODS: Triamcinolone acetonide in the amounts of 0.5, 1, and 2 mg was injected into the anterior chamber of rabbit eyes, and intraocular pressure, corneal thickness, and endothelial cell counts were evaluated on days 1, 3, 7, 14, and 28. Twenty-eight days after triamcinolone acetonide injection, the eyes were enucleated and examined after TUNEL staining. RESULTS: No statistically significant differences were found among control, 0.5, and 1 mg triamcinolone-injected eyes in central corneal thickness, endothelial cell density, pleomorphism, and polymegathism. There was no difference between 2 mg triamcinolone-injected eyes and control eyes for corneal thickness and cell density, but there were statistically significant differences between these two groups for pleomorphism (p<0.05) and polymegathism (p<0.05). CONCLUSIONS: The results of this study suggested that intracameral injections of 0.5~1 mg of triamcinolone acetonide are beneficial and cause no toxic effects on corneas.
Anterior Chamber ; Cell Count ; Cornea ; Endothelial Cells ; Eye ; In Situ Nick-End Labeling ; Intraocular Pressure ; Rabbits ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To evaluate the cause of dark arcuate striae observed in infrared photographs in idiopathic epiretinal membrane (ERM) and macular hole patients after internal limiting membrane (ILM) peeling. METHODS: Forty patients (41 eyes) of idiopathic ERM and macular hole who underwent trans pars plana vitrectomy with ILM peeling and gas tamponade were included in the present study. The best corrected visual acuity (BCVA) was recorded at preoperative and postoperative 6 months. Infrared (IR) photography with spectral domain optical coherence tomography (SD-OCT) were obtained at preoperative and postoperative 1 week, 1 month, 3 months, and 6 months. When abnormal findings were visible on IR photographs, additional SD-OCT was performed at the corresponding sites. RESULTS: Of 40 patients, 4 patients demonstrated dark striae extending from the optic nerve to near macular area in IR photographs at 1 week postoperatively. SD-OCT images of the dark striae region revealed the swelling of retinal nerve fiber layer (RNFL). At postoperative 6 months, however, RNFL swelling previously observed subsided in all 4 cases, while temporal retinal thinning and dimples were observed in 3 cases. The preoperative and postoperative BCVA did not show any statistical difference between the patients with the RNFL swelling and the patients without the swelling. CONCLUSIONS: Swelling of RNFL may occur in idiopathic ERM and macular hole patients after pars plana vitrectomy and ILM peeling, which may present as dark striae in IR photographs.
Epiretinal Membrane ; Humans ; Membranes* ; Nerve Fibers* ; Optic Nerve ; Photography ; Retinal Perforations ; Retinaldehyde* ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy