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Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity in branch retinal vein occlusion. Methods The prospective comparative nonrandomized clinical interventional study included 28 patients (28 eyes) with branch retinal vein occlusion. The study group consisting of 10 consecutive patients received an intravitreal injection of 20–25 mg of triamcinolone acetonide. The control group including 18 patients did not receive an intravitreal injection. The mean follow-up was 8.7±4.4 months. Results In the study group, mean visual acuity increased significantly ( P =0.02) from 0.27±0.11 preoperatively to a best postoperative visual acuity of 0.45±0.27. Visual acuity measurements determined 1 month after the injection were significantly ( P =0.027) higher than baseline values. Nine (90%) eyes gained in visual acuity, with six (60%) eyes showing an increase in visual acuity of at least two Snellen lines. In the ischaemic subgroup, visual acuity did not change significantly (0.18±0.18 to 0.13±0.04; P =0.66), while, in the nonischaemic subgroup, visual acuity increased significantly ( P =0.012) from the baseline value to the best postoperative measurement (0.29±0.09 to 0.53±0.24). In the control group, baseline visual acuity and best visual acuity during the follow-up did not vary significantly ( P =0.27). Comparing the study and control groups with each other, the gain in visual acuity was significantly higher in the study group at 1 month ( P =0.016) and 2 months ( P =0.012) after baseline. Conclusions Intravitreal injection of triamcinolone acetonide can increase visual acuity in patients with branch retinal vein occlusion.

Aim: To assess the accommodative power of a new foldable monofocal intraocular lens. Method: A prospective randomised non-masked clinical interventional study. The study included 40 patients attending the hospital for cataract surgery and who were randomly distributed into a study group receiving a new foldable monofocal intraocular lens with flexible haptics, and a control group receiving a standard foldable intraocular lens. Mean follow up period was 8.51 (SD 1.34) months (range 4–11 months) Standard cataract surgery consisted of clear cornea incision, capsulorrhexis, phacoemulsification, and intraocular lens implantation, with topical anaesthesia. The main outcome measures were preoperative and postoperative visual acuity for near and distance; range of accommodation; change in anterior chamber depth. Results: In the study group compared with the control group, range of accommodation was significantly (p = 0.01) higher (1.01 (SD 0.4) dioptres versus 0.50 (0.11) dioptres) and change in anterior chamber depth was significantly more pronounced (0.82 (0.30) versus 0.40 (0.32), p = 0.01). Both groups did not vary significantly in best corrected vision (0.94 (0.12) versus 0.93 (0.18); p = 0.74). Conclusion: During a mean follow up period of 8 months after implantation, the new foldable monofocal intraocular lens with flexible haptics showed an accommodative power of about 1 dioptre, which was significantly higher than the accommodative power of a conventional monofocal flexible intraocular lens. The difference in the accommodative power between the two intraocular lenses was paralleled by a difference in the change of the anterior chamber depth.

Purpose To report on the follow-up of patients who received an intravitreal triamcinolone acetonide injection (IVTA) as treatment of exudative age-related macular degeneration. Methods The clinical interventional case-series study included 205 patients (222 eyes) with progressive exudative age-related macular degeneration with subfoveal neovascularization who consecutively received an IVTA of about 20 mg as only therapeutic procedure and for whom follow-up was at least 3 months. Mean follow-up was 10.4±7.1 months (range, 3–35.7 months). Results Visual acuity improved significantly ( P <0.001) from baseline (0.90±0.45 logarithm of the minimum angle of resolution (LogMar)) to a mean minimum of 0.79±0.42 LogMar during follow-up. In 86 (38.7%) eyes and in 55 (24.8%) eyes, best visual acuity increased by at least two and three Snellen lines, respectively. Comparing the measurements at specific postinjection examination dates showed that visual acuity measurements taken at 1, 2, and 3 months after injection were not significantly different from the baseline value. Measurements taken at 6, 9, and 12 months after the injection were significantly ( P <0.001) lower than the measurements at baseline. Mean loss at 6 months was 1.4±3.8 Snellen lines, at 9 months, 2.5±4.6 lines, and at 12 months after the injection, 2.6±4.0 lines. Intraocular pressure increased significantly ( P <0.001) during the first 6 months, and returned to baseline at 9 months after injection. Conclusions Single injection high-dosage IVTA did not show an apparent benefit at 12 months after injection in patients with neovascular age-related macular degeneration.

Comment The data of this study may suggest that the repeated intravitreal injection of about 20 mg of triamcinolone acetonide as treatment of diffuse diabetic macular oedema can be associated with a increase in visual acuity again in those patients who as \"triamcinolone responders\" showed an improvement in visual acuity after a preceding intravitreal injection of triamcinolone acetonide.

Background/aimsProliferative retinopathies remain the most common causes of blindness. Retinal neovascularisation is induced by hypoxic upregulation of angiogenic growth factors, such as vascular endothelial growth factor (VEGF). Thalidomide has been shown to be anti-angiogenic via reduction of VEGF levels. We investigated the effect of intravitreal application of thalidomide on neovascularisation and retinal toxicity in a mouse model of proliferative retinopathy.MethodsC57BL/6J mice were exposed to 75% oxygen from postnatal day (p) 7 to p12. Immediately after transfer to room air at p12, mice received an intravitreal injection of 150 μg/μl thalidomide or control solution. Preretinal neovascularisation was quantified at p17. VEGF levels were assessed in whole retinal lysates at p13 and p17. Retinal toxicity was assessed by measuring retinal layer thickness and by analysing caspase-3 activity and apoptotic cell counts in retinal layers to examine retinal apoptosis.ResultsIntravitreal application of thalidomide significantly reduced preretinal neovascularisation by 62% compared with control treated contralateral eyes (p=0.01). Interestingly, this effect was established without a change in retinal VEGF levels. Intravitreal thalidomide was not toxic, as retinal layer thickness, retinal caspase-3 activity and apoptotic cell counts were unaltered.ConclusionThese data indicate that intravitreal application of thalidomide can be an effective and safe way to treat retinal neovascularisation.

The purpose of this study was to evaluate the subclinical influence of uncomplicated cataract surgery on foveal thickness and volume in the early postoperative period. In a prospective study, 108 eyes were assessed by optical coherence tomography preoperatively and 1 day, 1 week and 4 weeks after uncomplicated small incisional phacoemulsification with endocapsular intraocular lens (IOL) implantation under topical anesthesia. The study included 24 eyes of diabetic patients. Eyes with diseases predisposing them for postoperative macular edema, preexisting macular edema, and eyes that developed cystoid macular edema during follow-up were excluded. Main outcome measures were minimal foveal thickness (MFT) and foveal volume. Secondary outcome measure was VA. Visual acuity (LogMAR) increased significantly (p<0.001) from 0.43+/-0.21 to 0.11+/-0.15 4 weeks after surgery, with a significantly (p=0.001) higher increase in VA for nondiabetic subjects. MFT increased from 183+/-27 mum preoperatively to 191+/-37 mum 4 weeks after surgery (p=0.001), with diabetic patients showing a tendency toward a more pronounced increase in minimal retinal thickness than nondiabetic subjects (p=0.058). One day and 1 week after surgery, MFT measurements were not significantly different from preoperative results. Foveal volume showed a significant increase at 1 week and 4 weeks after surgery (p<0.001), independent of the presence of diabetes (p=0.565). The proportion of patients exhibiting subclinical macular swelling was about 1/5 in the nondiabetic group and 1/3 in the diabetic group. Mean duration of surgery was 11.5+/-6.6 min. Foveal thickness and foveal volume demonstrate a subclinical increase within 4 weeks after uncomplicated cataract surgery in up to 1/3 of the patients. The amount and frequency of early postoperative subclinical retinal thickening was higher than expected.

Background: Intravitreal triamcinolone acetonide has been discussed as treatment for exudative age-related macular degeneration (AMD). Objectives: To give an updated report on repeated intravitreal injections of triamcinolone acetonide (IVTA) for the treatment of exudative AMD. Methods: The case-series study included 24 patients (24 eyes) with progressive exudative AMD who had shown an increase in, or stabilization of, visual acuity after a first IVTA, and who eventually experienced a deterioration of visual acuity. The 24 (6.5%) eyes were selected out of a total group of 369 eyes who had received IVTA for exudative AMD within the last 5 years. All patients of the study received a second IVTA (approximately 20 mg) 3.7–38.5 months after the first injection. Main outcome measure was visual acuity. Results: After the first injection, best corrected visual acuity improved significantly (p = 0.001) from 0.75 ± 0.34 logMAR to a minimum of 0.58 ± 0.30 logMAR during follow-up, with 10 (42%) eyes improving in visual acuity by two or more Snellen lines. Towards the end of follow-up after the first injection, best corrected visual acuity decreased significantly (p = 0.03) compared with the baseline value. After the second injection, visual acuity did not change markedly from baseline to a mean maximal visual acuity during follow-up. Comparing the last postoperative examination at the end of the follow-up after the second IVTA with the preoperative examination, a significantly (p = 0.001) higher number of eyes lost in visual acuity [19 (79%) eyes] than gained in visual acuity [3 (12%) eyes]. Conclusions: In selected eyes with an increase in visual acuity after a first IVTA (20 mg), repeated IVTA temporarily stabilizes visual acuity with a drop in visual acuity towards the end of follow-up.