Palmschulz7976

[Ophthalmic Surg Lasers Imaging Retina. 2020;51732.].Limited information is known about the extent of canthaxanthin crystalline retinopathy on the retinal layers. The authors describe a 51-year-old woman who was taking canthaxanthin for tanning purposes for 7 years. Three years after cessation of this agent, she presented with asymmetric crystalline retinopathy affecting both eyes. buy EGFR-IN-7 She was lost to follow-up, and upon returning 4 years later, the crystalline retinopathy persisted but the number of crystals had decreased. Using swept-source optical coherence tomography, the authors showed that the crystalline retinopathy affected all retinal layers. In addition, retinal pigmented epithelial detachments were present suggesting persistent damage caused by the canthaxanthin. [Ophthalmic Surg Lasers Imaging Retina. 2020;51727-731.].Vitamin A is an important component of the visual cycle, and its deficiency causes a retinal degeneration that may be reversed with retinol supplementation. Here, the authors present a patient with vitamin A deficiency and rod-mediated retinopathy who was found to have multiple anti-retinal antibodies that gradually dissipated after vitamin A supplementation. This interesting case suggests the possibility that the photoreceptor degeneration induced by vitamin A deficiency may lead to transient immune exposure to retinal antigens and development of anti-retinal antibodies. [Ophthalmic Surg Lasers Imaging Retina. 2020;51723-726.].

The management of premacular hemorrhage secondary to non-accidental trauma (NAT) is unclear. The authors describe the outcomes of NAT infants referred for surgical evaluation of premacular hemorrhage.

Retrospective institutional review board-approved case series between 2000 and 2019 of vision-threatening premacular hemorrhage (sub-hyaloid or sub-internal limiting membrane hemorrhage without vitreous hemorrhage) in NAT infants. Time to hemorrhage resolution, vision, and comorbidities were collected.

Thirty-six patients (62 eyes) with mean age of 5.4 months (range 2-10 months) were included. Nine eyes (14.5%) underwent vitrectomy. Median time to hemorrhage resolution by observation was 75 days (interquartile range [IQR] 60-120 days), and time to vitrectomy was 54.5 days (IQR 47.8-58.5 days). Eight eyes (12.9%) had amblyopia, which was not significantly different between groups. Despite hemorrhage clearance, a higher proportion of eyes in the vitrectomy group had pigmentary changes (P = .04) and strabismus (P = .002) at follow-up.

Most cases of NAT-related premacular hemorrhage resolve within 3 months without surgical intervention. Comorbidities may limit visual prognosis. [Ophthalmic Surg Lasers Imaging Retina. 2020;51715-722.].

Most cases of NAT-related premacular hemorrhage resolve within 3 months without surgical intervention. Comorbidities may limit visual prognosis. [Ophthalmic Surg Lasers Imaging Retina. 2020;51715-722.].

To evaluate the association of changes in retinal anatomy and microvasculature with age and sex in cognitively healthy older adults.

Cross-sectional study of cognitively healthy subjects aged 50 years and older who underwent optical coherence tomography angiography (OCTA) to estimate the association between age and sex with ganglion cell layer-inner plexiform layer (GC-IPL); central subfield thickness (CST); subfoveal choroidal thickness (CT); foveal avascular zone (FAZ) size; and superficial (SCP), deep (DCP), and whole capillary plexus (WCP) vessel density (VD) and perfusion density (PD) measured in the ETDRS 3-mm and 6-mm circle and rings.

Among 141 older adults (72.9% female; median age 69 years), 282 eyes were imaged. Females had a greater CT, GC-IPL thickness, and FAZ size and a lower CST than males. After controlling for sex, both CT (P = .001) and GC-IPL thickness (P < .001) decreased with age, whereas FAZ size and CST did not. There was a reduction in VD and PD in SCP, DCP, and WCP with age in the 3-mm circle, 3-mm ring, and 6-mm circle (all P < .05).

There is a significant reduction in both VD and PD, as well as decreased choroidal and GC-IPL thickness associated with aging, even beyond the fifth decade, in cognitively healthy adults. [Ophthalmic Surg Lasers Imaging Retina. 2020;51706-714.].

There is a significant reduction in both VD and PD, as well as decreased choroidal and GC-IPL thickness associated with aging, even beyond the fifth decade, in cognitively healthy adults. [Ophthalmic Surg Lasers Imaging Retina. 2020;51706-714.].

To report a series of exudative retinal detachments (ERDs) following laser photocoagulation for retinopathy of prematurity (ROP).

Retrospective case series.

Eleven eyes of seven infants were identified who developed ERD following laser. Median gestation age was 25 weeks (interquartile range [IQR] 24-27 weeks), and median birth weight was 662 grams (IQR 538-850 grams). Median postmenstrual age at time of laser was 35 weeks (IQR 33-39 weeks). ERD was diagnosed at a median of 7 days (IQR 5-7 days) after laser and was managed with steroids. Bevacizumab was also used for certain cases. Time to resolution ranged from 1 to 5 weeks. Macular pigment changes, atrophy, window defect on fluorescein angiography, and photoreceptor loss on optical coherence tomography were noted in some cases following ERD resolution. Excluding one patient who expired at 3 months, median length of follow-up was 10 years (IQR 9-13.5 years). Overall, only one patient, who presented with less severe ERD, had normal vision.

ERD is an uncommonly reported complication following laser for ROP. Macular changes following ERD resolution may have negative visual consequences. [Ophthalmic Surg Lasers Imaging Retina. 2020;51698-705.].

ERD is an uncommonly reported complication following laser for ROP. Macular changes following ERD resolution may have negative visual consequences. [Ophthalmic Surg Lasers Imaging Retina. 2020;51698-705.].

In 2018, cases of inflammation were reported after intravitreal aflibercept (IVA), which resulted in switches to intravitreal ranibizumab (IVR). The authors' purpose was to evaluate outcomes after switching from IVA to IVR in diabetic macular edema (DME).

Retrospective cohort study. Eyes switched from IVA to IVR for treating DME were included. Data were gathered from three visits before to three visits post-switch. Outcome measures included central subfoveal thickness (CFT) and Snellen visual acuity (VA).

There was a statistically significant increase in CFT at the first visit (325 μm ± 234 μm; P = .006) compared to the switch visit, but no difference later visits (268 μm ± 103 μm; P = .32; 284 μm ± 118 μm; P = .11; n = 54). There was no statistically significant change in mean logarithm of the minimum angle of resolution VA between the switch and later visits (0.43 ± 0.38, P = .95; 0.38 ± 0.30, P = .12; 0.41 ± 0.37, P = .69).

The authors observed transient worsening of macular edema in eyes treated for DME when switched from aflibercept to ranibizumab. [Ophthalmic Surg Lasers Imaging Retina. 2020;51691-697.].

The authors observed transient worsening of macular edema in eyes treated for DME when switched from aflibercept to ranibizumab. [Ophthalmic Surg Lasers Imaging Retina. 2020;51691-697.].

This study aims to characterize check-in kiosk usage within a multidisciplinary ophthalmic clinic.

Chart review of patients aged 18 or older seen at Cole Eye Institute, Cleveland Clinic, from August 1, 2019, to October 31, 2019. Primary endpoint was percentage of patients who used a check-in kiosk. Secondary endpoints were demographic characteristics and visual acuity (VA) of the two groups.

Of 13,752 patients, 3,542 (26%) used a check-in kiosk. Kiosk users were significantly younger than kiosk non-users (median [interquartile range (IQR)] 63.6 [49.4-72.6] vs. 66.6 [55.0-75.4]; P < .0001), had a lower proportion of Medicaid patients (282 [8%] vs. 930 [10%]; P < .0001), and lived in areas with a greater median income (mean [± standard error] $58,421 [± 399) vs. $54,992 [±236]; P < .0001). On average, they also had better VA (mean ETDRS [95% confidence interval] 80.5 [80-80.9] vs. 78.3 [78-78.6]; P < .0001).

Significant demographic and VA differences were observed between kiosk users and non-users and may influence kiosk usage. [Ophthalmic Surg Lasers Imaging Retina. 2020;51684-690.].

Significant demographic and VA differences were observed between kiosk users and non-users and may influence kiosk usage. [Ophthalmic Surg Lasers Imaging Retina. 2020;51684-690.].

To compare the dental and skeletal treatment effects after total arch distalization using modified C-palatal plates (MCPPs) on adolescent patients with hypo- and hyperdivergent Class II malocclusion.

The study group included 40 patients with Class II malocclusion (18 boys and 22 girls, mean age = 12.2 ± 1.4 years) treated with MCPPs. Fixed orthodontic treatment started with the distalizing process in both groups. Participants were divided into hypo- or hyperdivergent groups based on their pretreatment Frankfort mandibular plane angle (FMA) ≤22° or ≥28°, respectively. Pre- and posttreatment lateral cephalograms were digitized, and 23 variables were measured and compared for both groups using paired and independent t-tests.

The hyper- and hypodivergent groups showed 2.7 mm and 4.3 mm of first molar crown distalizing movement, respectively (P < .001). The hypodivergent group had a slight 2.2° crown distal tipping of first molars compared with 0.3° in the hyperdivergent group. After distalization, the FMA increased 3.1° and 0.3°, in the hypodivergent and hyperdivergent groups, respectively (P < .001). SNA decreased in the hypodivergent group, while other skeletal variables presented no statistically significant differences in the changes between the groups.

The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.

The hypodivergent group showed more distal and tipping movement of the maxillary first molar and increased FMA than the hyperdivergent group. Therefore, clinicians must consider vertical facial types when distalizing molars using MCPPs in Class II nonextraction treatment.Easy Street is a fictional place where life is carefree. Many doctors and patients are finding simplified, less demanding treatments more appealing, especially in these infectious times that encourage approaches involving minimal contact. In orthodontics, the move to perform more clear aligner therapy may be a faulty step toward Easy Street. A case is made against further trivialization of our specialty.

To investigate the correspondence between programmed interproximal reduction (p-IPR) and implemented interproximal reduction (i-IPR) in an everyday-practice scenario. The secondary objective was to estimate factors that might influence i-IPR to make the process more efficient.

Fifty patients treated with aligner therapy by six orthodontists were included in this prospective observational study. Impressions were taken at the beginning of treatment and after the first set of aligners. Data on p-IPR, i-IPR and technical aspects of IPR were gathered for 464 teeth. Statistical analyses included the Wilcoxon signed-rank test, Kruskal-Wallis, and multilevel mixed regression.

Mean difference between p-IPR and i-IPR was 0.15 mm (SD 0.14 mm; P = .0001), with lower canines showing the highest discrepancy. Use of burs and measuring gauges resulted in a smaller difference (respectively coeff. 0.09, P = .029; coeff. -0.06, P = .013). IPR was performed more accurately on the mesial surface of teeth than on the distal surface.