Optometry and Vision Science (OVS) Announces - April 2015 Supplement






Coming in the April 2015 Supplement Issue of Optometry & Vision Science:

Discovery and Clinical Care

Here are brief highlights.
The online-only copy will be available early-April.
E-Publication Ahead-of-Print now available for all these articles at

Anthony J. Adams, OD, PhD, FAAO

Laser Treatment in ROP Increases Myopia Risk

As is the case in other countries, our authors' study of 105 treated infants, shows that, while laser treatment is needed, myopia risk increases with the treatment in retinopathy of Prematurity ROP in Mainland China. They note that their findings emphasize the need for regular refractive and eye exams following these laser treatments, especially in cases of aggressive posterior ROP patients (APROP).
Vision Side Effect of a Less Toxic Cancer Drug

An oral antineoplastic drug S-1 is a recently developed cancer chemotherapeutic drug. Despite the reported reduced toxicity of S-1 compared to conventional intravenous 5-FU, our authors report a patient who had vision impairing corneal limbal stem cell deficiency while receiving adjuvant chemotherapy with S-1. Our authors feel that their case should raise awareness of this potentially vision threatening side effect of S-1 and the importance of co-management between oncologists and eye care providers.
Pterygia That Don't Adhere?

Pterygia can induce astigmatism, cause discomfort, and are generally seen as a cosmetic disturbance. Surgical excision, with possible recurrence is common.
Rarely, as the authors saw in this case, the pterygium can self-detach from the cornea, resulting in spontaneous resolution. This is counter to our common perception of pterygia attachment and raises provocative mechanistic clinical questions.

OCT, Confocal Microscopy and Gene Sequencing to the Diagnosis Rescue

In one of a dizygotic twin pair with corneal dystrophy of Bowman's layer, OCT and confocal microscopy assisted the gene sequencing revelation of a mutation of a transforming growth factor-β-induced (TGFBI) gene mutation (R124C).

Dual Treatment for Immune-Mediated Dry Eye

New drugs rebamipide and diquafosol eye drops have mucin-inducing and secretion-promotive effects, that are efficacious for dry eye disease. The synergistic effects of dual treatment by these eye drops are thought to be effective for immune-mediated dry eye disease caused by graft-versus-host disease and ocular cicatricial pemphigoid-like disease. The authors believe this is the first report, with accompanying video clip, highlighting the long-term effectiveness of dual treatment by rebamipide and diquafosol, in two cases of immune-mediated dry eye disease.
Avoiding the Wrong Diagnosis

Although rare, nasal chondroma may present as a harmless case of innocuous hypertelorism (an abnormally increased distance between two organs or parts, e.g. the separation of the two eyes).  It is possible for the eyes to be displaced laterally by encroachment into the orbital space by tumor, neural tissue or ethmoid air cells. Our authors report a rare case of a nasal chondroma, confirmed by histopathological examination, which presented as hypertelorism.

Sutureless Artificial Iris Prosthesis in Aniridia Cataract Surgery: a First

Our authors report what they believe is the first case of a bilateral sutureless artificial iris prosthesis used in combination with cataract surgery for congenital aniridia. At the one-year follow-up, they report a successful visual and cosmetic result, significantly reduced subjective complaints of glare and photophobia as well as improved binocular near visual acuity and cosmetic outcome.
Aqueous Humor Ferritin in Rare Cataract Syndrome

The authors use a video clip to accompany their report of a rare case of Hereditary Hyperferritinemia Cataract Syndrome (HHCS), characterized by hyperferritinaemia, but absence of body iron excess, and early onset of bilateral cataracts. Using aqueous humor and lens morphology analysis, they conclude that an elevated aqueous humor ferritin level is involved in the pathogenesis of these bilateral cataracts.

A Rare Intraocular Tumor with Rarer Associated Complications

The authors report a case of a presumed congenital simple hamartoma of the retinal pigment epithelium that presented with secondary macular edema. The edema was believed to be associated with anomalous vascular activity and was treated with an off-label intravitreal bevacizumab injection. Two months later, the patient presented with improved visual acuity and decreased macular edema. The authors believe this is the first documented case of macular edema secondary to vascular activity being associated with this rare lesion.
CNV Associated with Extensive Macular Atrophy and Pseudodrusen

Although the natural course of extensive macular atrophy and pseudodrusen (EMAP) usually leads to the enlargement of the macular atrophy, EMAP can also complicate with bilateral choroidal neovascularization (CNV).The authors made use of fundus autofluorescence, fluorescein angiography, and spectral-domain optical coherence tomography to reveal a disciform scar and extensive macular atrophy associated with a fibrotic juxtafoveal CNV.  Intravitreal bevacizumab helped stop the CNV activity.

The Strange Case of a Spontaneous Fundus Resolution in Syphilis

In this case report, the authors present two unusual cases of acute syphilitic posterior placoid chorioretintis (ASPPC), a rare ocular manifestation of confirmed syphilis. They noted early spontaneous resolution of the fundus and optical coherence tomographic findings during the early clinical course, even before the initiation of treatment.
OCT Reveals Critical Details

Optical coherence tomography (OCT) has allowed optimal visualization and detection of focal choroidal excavation (FCE), a rare choroidal anomaly of the macula. While FCE is detectable by the presence of retinal pigmented epithelium and choroidal abnormalities on funduscopic exam, the true structure is revealed with OCT. Our authors report what they believe is the first case of progression of a conforming FCE to a non-conforming FCE. The implications for this progression are unclear but close monitoring is emphasized since cases of FCE can be associated with central serous chorioretinopathy and choroidal neovascularization.

Optic Disc Drusen Associated with Optic Nerve Tumors

Our authors study a series of cases of optic disc drusen combined with optic nerve tumors. Optic nerve tumors implicate axonal distress and may be the triggering mechanism for optic disc drusen formation.
Clinical Presentation of Pseudo-Abducens Palsy

Pseudo-abducens palsy is a rare neurologic limitation in abduction with an intact abducens nerve. It can be observed when voluntary eye movements show impairment in lateral gaze, yet the vestibulo-ocular reflex (VOR) demonstrates full abduction. The intact VOR (see SDC video) indicates the integrity of the infranuclear abducens nerve, thus suggesting that a pseudo- abducens palsy is likely caused by supranuclear pathology. It must be differentiated from a classic abducens infranuclear palsy.

Successful Management of Hemicrania Continua with Injections

This case report illustrates the rare presentation of Raeder paratrigeminal neuralgia evolving to hemicrania continua and presenting as painful ophthalmoplegia with multiple cranial nerve involvement. This is the first report to successfully utilize onabotulinumA injections for management when indomethacin was not tolerated due to the side effect profile. Given the rarity of both Raeder paratrigeminal neuralgia and hemicrania continua, large-scale, randomized, controlled clinical trials to evaluate the role of prednisone or onabotulinumtoxinA would be challenging; however, this case report supports a positive outcome in indomethacin intolerant cases.