Temporal Side Research Articles

Choroidal thickness in healthy eyes using enhanced depth imaging optical coherence tomography and comparison with cases of retinitis pigmentosa

The goal of this study was to measure by spectral domain optical coherence tomography (SD-OCT) with EDI the choroidal thickness in healthy subjects and to compare these parameters with those of patients with retinitis pigmentosa (RP). Data were obtained from 60 healthy patients without history or family history of retinal or choroidal disease or glaucoma. A case-control study was also conducted on 40 eyes of 20 patients with RP and 40 eyes of 20 healthy refraction- and age-matched controls, selected from among the 60 healthy patients. OCT was used with the EDI protocol. The primary outcome measure was choroidal thickness. Among healthy patients, the overall choroidal thickness was 287.7μm. Mean choroidal thickness was lower on the nasal side (236.6μm at 2000μm from the fovea) compared with the temporal side (262.3μm at 2000μm, P=0.002). It also varied according to age, being highest among 20-29-year-old patients and decreasing thereafter with increasing age. Choroidal thickness was significantly higher in healthy patients than in RP patients, regardless of the location (P<0.001). This observational study confirms that choroidal thickness varies with age and location. It decreases in subjects with RP and is related to worsening of retinal damage, independently of age-related thinning. Further studies are needed to understand whether choroidal vascular alteration is a cause or a consequence of the degenerative pathology.

Résultats anatomiques et fonctionnels de la chirurgie du trou maculaire avec positionnement d’un volet de membrane limitante interne. Retour d’expérience sur 24 cas

To evaluate the anatomical and functional outcomes of macular hole (MH) surgery with a temporal inverted internal limiting membrane (ILM) flap technique. Monocentric retrospective study of 24 patients who were operated on for macular hole between March 2014 and April 2017 at Nancy University Hospital. All patients underwent pars plana vitrectomy with the inverted ILM flap technique. ILM peeling was restricted to the temporal side of the fovea, and the macular hole was then covered with the ILM flap, followed by SF6 tamponnade and first day face-down positioning. The main outcome measures included macular hole closure rate and visual acuity at 1 month postoperatively. Eight men and 16 women of mean age 67.0±5.4 years were included. The mean axial length was 23.5±1.2mm. The mean diameter of the MH was 362±123μm. Closure of the MH was achieved in 23 of 24 eyes (95.8%) after one surgery. The mean BVCA improved significantly from 0.71±0.20 logMar to 0.29±0.22 logMar (P<0.001) at 1 month postoperatively, for a gain of 0.42±0.24 logMar. Macular hole surgery with the inverted ILM flap technique results in good anatomical and functional outcomes, comparable to those obtained with the classic technique with complete ILM peeling.

Ectopic Eyelid Cilia in a 15 years old Girl: A Rare Presentation

Introduction: Eyelashes are unique hair follicles normally found at the eyelid margin. The spectrum of cilial anomalies includes cilial row duplication, agenesis and ectopic placement. Ectopic cilia are the rarest of cilial anomalies.&#x0D; Case Report: A 15 years old girl presented with the complaints of eyeache and headache for three months. She also complained of extra lashes over left upper eyelid with secretion of tears while crying from the area of extra lashes. She was a diagnosed case of epilepsy under treatment for three months.&#x0D; On examination, visual acuity was 6/6p in right eye and 6/6p in left eyewith best corrected visual acuity being 6/6 with -0.25DS in both the eyes. The anterior and posterior segment findings were normal except for presence of extra bunch of cilia on the temporal side of the left upper eyelid two mm above the upperlid crease with dimpling of the underlying skin.&#x0D; Conclusion: Ectopic cilia,a rare congenital condition, is asymptomatic and surgical treatment can be done for cosmetic correction.&#x0D; Keywords: cilia, ectopic, eyelid

EVOLUTION AND PATTERNS OF CHOROIDAL THICKNESS CHANGES IN RHEGMATOGENOUS RETINAL DETACHMENT.

To evaluate the changes in choroidal thickness (CT) before and after a successful pars plana vitrectomy for rhegmatogenous retinal detachment (RD), and to compare the evolution of CT with respect to the extent of RD. Fifty-four patients were divided into three groups: peripheral macula-on RD (>3 mm from the fovea; 14 eyes); paracentral macula-on RD (fovea-sparing; ≤3 mm from the fovea; 14 eyes); and macula-off RD (involving the fovea; 26 eyes). Choroidal thickness was measured at 1 month (M1) and 3 months (M3) postoperatively, preoperatively in macula-on RDs, with enhanced depth imaging optical coherence tomography, from the nasal side (+2.5 mm) to the temporal side (-2.5 mm) of the fovea. In peripheral macula-on RD, the intereye difference in CTs showed thickening throughout follow-up (subfoveally: preoperatively = 19.6% ± 43.9%, M1 = 22.9% ± 27.5%, M3 = 18.2% ± 35.6%). In paracentral macula-on RD, the intereye difference in CTs showed a thinning throughout follow-up (subfoveally: preoperatively = -7.8% ± 21.9%, M1 =-5.5% ± 26.1%, M3 = -9.3% ± 19.4%), as well as in the macula-off RD (subfoveally: M1 = -14.1% ± 18.7%, M3 = -9.9% ± 15%). The extent of RD was related to the evolution of the CT before and after surgery. Further studies are necessary to clarify the relationship between the changes in CT and the effects of circulatory alterations, vitrectomy, and RD.

Compressive Lesions of the Optic Chiasm: Subjective Symptoms and Visual Field Diagnostic Criteria

ABSTRACTWe investigated the diagnostic ability of a new criterion (simple temporal depression) for compressive lesions of the optic chiasm. The subjects were 124 eyes with compressive lesions of the optic chiasm. The controls were 84 eyes. The Humphrey (Carl Zeiss) visual field test was used for visual field testing. The simple temporal depression index was calculated as the ratio of the sums of the thresholds for one line on the nasal side and temporal side of the vertical meridian. The result of new index was 87% sensitivity and 99% specificity. This result suggested that our new criterion will assist the diagnosis in the future.

PEMODELAN DEFORESTASI HUTAN LINDUNG DI INDONESIA MENGGUNAKAN MODEL GEOGRAPHICALLY AND TEMPORALLY WEIGHTED REGRESSION (GTWR)

Regression analysis is a statistical analysis method that is used to modeling the relationship between dependent variables and independent variables. In the linear regression model only produced parameter estimators are globally, so it’s often called global regression. While to analyze spatial data can be used Geographically Weighted Regression (GWR) method. Geographically and Temporally Weighted Regression (GTWR) is the development of GWR model to handle the instability of a data both from the spatial and temporal sides simultaneously. In this GWR modeling the weight function used is a Gaussian Kernel, which requires the bandwidth value as a distance parameter. Optimum bandwidth can be obtained by minimizing the CV (cross validation) coefficient value. By comparing the R-square, Mean Square Error (MSE) and Akaike Information Criterion (AIC) values in both methods, it is known that modeling the level of deforestation in protected forest areas in Indonesia in 2013 through 2016 uses the GTWR method better than global regression. With the R-square value the GTWR model is 25.1%, the MSE value is 0.7833 and AIC value is 349,6917. While the global regression model has R-square value of 15.8%, MSE value of 0.861 and AIC value of 361,3328. Keywords : GWR, GTWR, Bandwidth, Kernel Gaussian

Relative Peripheral Myopia Induced by Fractal Contact Lenses

ABSTRACT Purpose To assess the peripheral refraction induced by Fractal Contact Lenses (FCLs) in myopic eyes by means of a two-dimensional Relative Peripheral Refractive Error (RPRE) map. Materials and Methods This study involved 26 myopic subjects ranging from −0.50 D to −7.00 D. FCLs prototypes were custom-manufactured and characterized. Corneal topographies were taken in order to assess correlations between corneal asphericity and lens decentration. Two-dimensional RPREs were measured with an open-field autorefractor at 67 points, covering the central 60 × 30 degrees of the visual field. The bidimensional RPRE vector components: M, J0 and J45 of the difference between the values obtained with and without the FCLs in the eye were obtained. Additionally, the FCL-induced peripheral refraction in tangential and sagittal planes was computed along the horizontal meridian. Results Induced by the FCLs, significant differences for all vector components were found in the peripheral retina. FCLs were decentered a mean of 0.7 ± 0.19 mm to the temporal cornea. The two-dimensional RPRE maps manifested the FCLs decentration. In particular, M varied asymmetrically between nasal and temporal retina after fitting the FCLs with a significant increment of the myopic shift beyond 10º (p < 0.05). No correlations were found between the amount of lens decentration and the asphericity of the cornea along temporal and nasal sides. However, significant correlations were found between the corneal asphericity and vector components of the RPRE in naked eyes. FCLs produced an increasing myopic shift in tangential and sagittal power errors along the horizontal meridian. Conclusions As predicted by ray-tracing simulations, FCLs fitted in myopic eyes produce a myopic shift of the RPRE. The two-dimensional RPRE maps show information about the lens performance that is hidden in the conventional one-dimensional meridional representations.

Optic disc microvasculature dropout in primary open-angle glaucoma measured with optical coherence tomography angiography.

PurposeTo evaluate microvasculature dropout in the optic disc (Mvd-D) using optical coherence tomography angiography (OCTA) and investigate factors associated with Mvd-D in primary open-angle glaucoma (POAG) eyes.MethodsOne hundred twenty-three eyes of 123 POAG patients were included from the Diagnostic Innovations in Glaucoma Study. The 3.0×3.0-mm optic nerve head OCTA scans were acquired using a spectral-domain OCT instrument. Images with whole-signal-mode were evaluated. Eyes were classified into 3 categories (Mvd-D, pseudo-Mvd-D, and no Mvd-D). Mvd-D and pseudo-Mvd-D had complete loss of OCTA signals on the temporal side of the optic disc on the en face projection image. They were distinguished base on the visualization of the anterior lamina cribrosa in the horizontal B-scans of that area. No Mvd-D was defined when no complete signal loss of OCTA signals was observed. Covariates including focal lamina cribrosa defects assessed by swept-source OCT and microvasculature dropout in the parapapillary region (Mvd-P) were analyzed.ResultsForty-two, 37, and 44 eyes were identified as having Mvd-D, pseudo-Mvd-D, and no Mvd-D, respectively. The eyes with Mvd-D showed significantly lower intraocular pressure, worse visual field mean deviation, larger cup-to-disc ratio, thinner circumpapillary retinal nerve fiber layer (cpRNFL), and lower circumpapillary vessel density within the RNFL than the eyes with pseudo-Mvd-D or the eyes without Mvd-D. Multivariable logistic regression analysis showed significant associations of Mvd-D with larger cup-to-disc ratio (OR, 1.08; P = 0.001), worse visual field mean deviation (OR, 1.09; P = 0.048), higher prevalence of focal lamina cribrosa defect (OR, 9.05; P = 0.002), and higher prevalence of Mvd-P (OR, 10.33; P <0.001).ConclusionsOCTA-derived Mvd-D was strongly associated with the presences of Mvd-P and focal lamina cribrosa defects, and these 3 findings were topographically associated with each other.

Retinal and optic nerve changes in microcephaly: An optical coherence tomography study.

ObjectiveTo investigate the morphology of the retina and optic nerve (ON) in microcephaly.MethodsThis was a prospective case-control study including 27 patients with microcephaly and 27 healthy controls. All participants underwent ophthalmologic examination and handheld optical coherence tomography (OCT) of the macula and ON head. The thickness of individual retinal layers was quantified at the foveal center and the parafovea (1,000 μm nasal and temporal to the fovea). For the ON head, disc diameter, cup diameter, cup-to-disc ratio, cup depth, horizontal rim diameter, rim area, peripapillary retinal thickness, and retinal nerve fiber layer thickness were measured.ResultsSeventy-eight percent of patients had ophthalmologic abnormalities, mainly nystagmus (56%) and strabismus (52%). OCT abnormalities were found in 85% of patients. OCT revealed disruption of the ellipsoid zone, persistent inner retinal layers, and irregular foveal pits. Parafoveal retinal thickness was significantly reduced in patients with microcephaly compared to controls, nasally (307 ± 44 vs 342 ± 19 μm, p = 0.001) and temporally (279 ± 56 vs 325 ± 16 μm, p < 0.001). There was thinning of the ganglion cell layer and the inner segments of the photoreceptors in microcephaly. Total peripapillary retinal thickness was smaller in patients with microcephaly compared to controls for both temporal (275 vs 318 μm, p < 0.001) and nasal sides (239 vs 268 μm, p = 0.013).ConclusionsRetinal and ON anomalies in microcephaly likely reflect retinal cell reduction and lamination alteration due to impaired neurogenic mitosis. OCT allows diagnosis and quantification of retinal and ON changes in microcephaly even if they are not detected on ophthalmoscopy.

Applicability of ISNT Rule Using BMO-MRW to Differentiate Between Healthy and Glaucomatous Eyes.

We evaluated the applicability of the ISNT rule using Bruch's membrane opening minimum rim width (BMO-MRW) in healthy eyes and eyes with normal tension glaucoma (NTG). In total, 124 healthy eyes and 136 NTG eyes were analyzed. Using 2-dimensional disc photographs, neuroretinal rim (NRR) thickness was measured at the superior, inferior, nasal, and temporal sides of the optic disc. Using spectral domain-optical coherence tomography, BMO-MRW was measured at the same regions. We compared the applicability of the ISNT rule in healthy and NTG eyes between these 2 methods. If the NRR was not clearly distinguished on disc photographs, the eye was classified into the "indistinguishable NRR" group and we only tested applicability of the ISNT rule using BMO-MRW. The specificity of "violation of the ISNT rule" for the diagnosis of glaucoma was higher when BMO-MRW was used (66.3%) than using disc photographs (42.2%), whereas the sensitivity did not show a significant difference between the 2 methods (91.7% vs. 86.5%). Compared with eyes with distinguishable NRR (179 eyes), eyes with indistinguishable NRR (81 eyes) had higher axial length, more negative refractive error, and higher tilt ratio (P<0.001). The diagnostic ability of "violation of ISNT rule" using BMO-MRW was not significantly different between eyes with indistinguishable NRR and those with distinguishable NRR (P>0.05). Application of the ISNT rule using BMO-MRW shows superiority in distinguishing between healthy and glaucomatous optic discs compared with disc photographs. The ISNT rule can be applied using BMO-MRW even when NRR is indistinguishable on disc photographs, such as in myopic tilted discs.

Descriptive Study of Conjunctival Cysts: A Rare Complication after Strabismus Surgery.

Aim Conjunctival cyst is one of the uncommon complications of strabismus surgery. It is important for surgeons and patients to be aware of and take precautions to minimize the risk. This study aimed to explore the clinical manifestations, etiology, and prognosis of conjunctival cyst at the operative site after strabismus surgery. Methods The data of 1675 patients were included in our retrospective analysis, who underwent strabismus surgery at the Xiangya Hospital of Central South University between 2010 and 2016. During the postoperative follow-up, conjunctival cyst was found in 7 cases (7 eyes; 0.4% detective rate of all cases). The clinical characteristics, prognosis, and follow-up data were recorded together with the results of pathological and bacteriological tests. Results Seven patients between the age of 3 years 8 months and 39 years, with the mean age of 12.71 years (12.71 ± 12.59, years of age), were included in the study. Strabismus surgery affected 13 recti, 8 medial and 5 lateral recti, and 3 obliques (all inferior oblique). Conjunctival cyst was detected in seven patients between 10 days and 6 months postoperatively (42.57 ± 61.11, detected days). In six cases, the cyst was detected at the nasal (3 cases) or temporal side (other 3 cases), and at the fornix in one case. Four out of 7 patients underwent cyst excision, and methicillin-resistant Staphylococcus aureus (MRSA) was detected in one patient. Conclusions Conjunctival cyst is a rare postoperative complication of strabismus surgery, conjunctival epithelium implantation should be the primary cause, and infection might exaggerate the situation. A longer duration of the surgical procedure could increase the possibility of infection, which could be accompanied with a greater tendency to the occurrence of conjunctival cyst.

Conjunctival Inlapse: Nasal and Temporal Conjuctival Shape Variations associated with Scleral Lens Wear

PURPOSE: This article aims to report a new clinical finding associated with the wear of scleral lenses.&#x0D; METHODS: Non-contact lens wearer subjects were recruited and fitted with large diameter (18 mm) scleral lenses. Lens was randomly filled with non preserved saline or non preserved carboxymethylcellulose-based artificial tears (Refresh Celluvisc, Allergan, Ca). The sinking of the lens on the nasal and temporal sclera was assessed periodically during a total of 6h00 of wear, with the use of anterior segment coherence tomography (OCT- Optovue, Clarion Technologies, Texas). Images were taken every 30 minutes for the first 2h00, then at 4h00 and 6h00 post-insertion.&#x0D; RESULTS: The nasal side sinks significantly more than the temporal side by 23.0±7.3 μm (F(1,12)=10.043; p=0.008; 95%CI:[7.2 ,38.9]). This difference is significant with time (F=8.757; p&lt;0.001) and there is a side effect (F=10.043; p=0.008). The type of solution does not influence the lens behavior (F=0.250; p=0.626). A new clinical finding was revealed during scan analysis. Conjunctival tissue displacement was seen, under the reverse curve of the scleral lens, shortly after insertion. This conjunctival “inlapse” (CI) was sustained over all the wearing hours. On the nasal quadrant, CI was reduced in height and present in only 8/15 subjects while, in the temporal quadrant, 100% of subjects showed an average CI of 38.39 ± 10.43 μm (t(84)=3.68; p=0.0072; 95%CI[17.64, 59.13]) 30 minutes post insertion followed by a non-significant decrease of 1.97 ± 10.34 μm (t(84)=0.19; p=1.00; 95%CI[-22.52,18.58]) between 30 minutes and 6 hours of wear.&#x0D; CONCLUSION: Nasal sinking is more pronounced as compared with temporal lens sinking. This may explain the occurrence of a new clinical phenomenon identified to happen shortly after lens insertion, under the reverse curve of a scleral lens. In fact, CI happens mostly on the temporal quadrant, where more space is available for the conjunctival tissue to move. This finding suggests that conjunctival tissue reacts to scleral lens wear, not only in the inferior quadrant, where conjunctival prolapse is known to occur, but in every other one as well.

Eye wash water flow direction study: an evaluation of the effectiveness of eye wash devices with opposite directional water flow.

IntroductionNew designs of eye wash stations have been developed in which the direction of water flow from the fountain has been reversed, with two water streams originating nasally in both eyes and flowing toward the temporal side of each eye. No study has been done to determine the ideal direction of water flow coming from the eye wash in relation to the eye.Materials and methodsOphthalmic eye examinations were conducted before and after the use of two eye wash stations with opposite water flow directionality. Fluorescein was instilled in both eyes before using an eye wash to measure the effectiveness of the water flow. Subjects were surveyed upon their experiences using the eye washes.ConclusionOphthalmic examination found no significant difference in the efficacy of the eye washes with nasal-to-temporal water flow when compared to temporal-to-nasal water flow direction.

Anatomia Cirúrgica e Classificação das Veias Silvianas

Introdução: O entendimento da anatomia e variações das veias silvianas para o acesso transilviano dos aneurismas intracranianos se torna necessária para evitar complicações como trombose venosa ou contusão cerebral. Nesse sentido os autores realizam um estudo anatômicos das veias silvianas pelo acesso pterional clássico, com a abertura da aracnóide pelo lado frontal. Material e Métodos: De junho de 1994 a dezembro de 2008, 110 pacientes com aneurismas intracranianos foram abordados pela via pterional, dos quais foram analisados 45 hemisférios cerebrais. Resultados: Quinze casos apresentavam predomínio da veia ponte frontobasal e apenas um caso apresentou infarto venoso. Discussão: A abertura da aracnóide pelo lado frontal é mais seguro do que em comparação com a abertura pelo lado temporal. Conclusão: O entendimento anatômico das veias silvianas pode propiciar uma cirurgia mais segura para os aneurismas intracranianos.

Pituitary Tumor Associated with Situs Inversus of the Optic Nerve Head

This report present further developments in a patient with an unusual vas-cular pattern on both optic nerve heads: the trunks of the central retinal vessels appear on the temporal side of the nerve head (situs inversus of the blood vessels of the nerve head). This vascular pattern was also present (to only slightly varying degrees) in all six of his children (two girls and four boys). Twenty-one years after the first presentation of this patient, he de-veloped a non-secretory pituitary tumor. This case suggests that congeni-tal nerve head anomalies may be markers for potential intracranial tumors later in life.

Age-related changes in the peripheral retinal nerve fiber layer thickness.

PurposeThis pilot cross-sectional study aimed to determine age-related changes of the retinal nerve fiber layer (RNFL) thickness in retinal periphery by swept-source optical coherence tomography-based analysis.MethodsForty eyes of 40 healthy subjects were studied in three age groups, group 1 (20–40 years, n=15), group 2 (41–60 years, n=14), and group 3 (≥61 years, n=11). Wide-angle swept-source optical coherence tomography scans, including the optic disc and macula, were montaged with the nasal peripheral optical coherence tomography images acquired with a contralateral gaze. The peripapillary and peripheral RNFL thickness values were obtained for nasal and temporal sides. The ratio of peripheral-to-peripapillary RNFL thickness was also calculated for these sectors.ResultsWe detected a significantly thinner RNFL in older than younger subjects at a distance of 6 mm from the optic disc on nasal and temporal sides (P<0.001). An age-related reduction in peripheral-to-peripapillary RNFL thickness ratios (P<0.001 and P<0.02 for nasal and temporal sides, respectively) was also detected.ConclusionThe age-related decline should be taken into consideration when determining the glaucoma-related alterations in peripheral RNFL thickness. Continued analysis in patients with ocular hypertension and glaucoma should help determine whether RNFL in the periphery with lower nerve tissue reserve might be more susceptible to injury, whether injury to the peripheral RNFL might be easier to detect, and/or whether analysis of the peripheral RNFL thickness could improve clinical diagnosis and follow-up of glaucoma.

Superior cervical gangliectomy induces non-exudative age-related macular degeneration in mice.

ABSTRACTNon-exudative age-related macular degeneration, a prevalent cause of blindness, is a progressive and degenerative disease characterized by alterations in Bruch's membrane, retinal pigment epithelium, and photoreceptors exclusively localized in the macula. Although experimental murine models exist, the vast majority take a long time to develop retinal alterations and, in general, these alterations are ubiquitous, with many resulting from non-eye-specific genetic manipulations; additionally, most do not always reproduce the hallmarks of human age-related macular degeneration. Choroid vessels receive sympathetic innervation from the superior cervical ganglion, which, together with the parasympathetic system, regulates blood flow into the choroid. Choroid blood flow changes have been involved in age-related macular degeneration development and progression. At present, no experimental models take this factor into account. The aim of this work was to analyze the effect of superior cervical gangliectomy (also known as ganglionectomy) on the choroid, Bruch's membrane, retinal pigment epithelium and retina. Adult male C57BL/6J mice underwent unilateral superior cervical gangliectomy and a contralateral sham procedure. Although superior cervical gangliectomy induced ubiquitous choroid and choriocapillaris changes, it induced Bruch's membrane thickening, loss of retinal pigment epithelium melanin content and retinoid isomerohydrolase, the appearance of drusen-like deposits, and retinal pigment epithelium and photoreceptor atrophy, exclusively localized in the temporal side. Moreover, superior cervical gangliectomy provoked a localized increase in retinal pigment epithelium and photoreceptor apoptosis, and a decline in photoreceptor electroretinographic function. Therefore, superior cervical gangliectomy recapitulated the main features of human non-exudative age-related macular degeneration, and could become a new experimental model of dry age-related macular degeneration, and a useful platform for developing new therapies.

A pilot study on clinical efficacy of Agnikarma and Pathyadi decoction (an Ayurvedic formulation) in the management of Ardhavabhedaka (migraine).

Introduction:Ardhavabhedaka described under Shiroroga (disease of the head in Ayurveda) occurs due to vitiation of Tridosha (all of three biological humors). The signs and symptoms of migraine can be correlated with Ardhavabhedaka. Looking to the agony caused during acute episode of migraine and unavailability of specific management and only symptomatic management in conventional medicine this study was conducted. Agnikarma is indicated in severe pain and Pathyadi decoction is indicated in the management of Shiroroga.Aim and Objective:The aim of this study was to evaluate the efficacy of Agnikarma and Pathyadi decoction in the management of Ardhavabhedaka (migraine).Materials and Methods:A total of 15 patients were selected from outpatient department of Ayurveda College. Agnikarma was done on affected temporal side of face, dot type for 1 time, once in a week followed by application of honey–Ghee. Along with this, Pathyadi decoction 40 ml twice a day for 30 days was also given.Results:Statistically highly significant relief (P < 0.001) was noted in headache, photophobia and phonophobia and statistically significant (P < 0.05) relief was noted in vomiting, nausea and vertigo.Conclusion:Agnikarma along with Pathyadi decoction can be considered as an effective line of treatment to manage Ardhavabhedaka (migraine).

Effect of Hemodialysis on Eye Coats, Axial Length, and Ocular Perfusion Pressure in Patients with Chronic Renal Failure.

Purpose To investigate changes in eye coats, axial length, and ocular perfusion pressure (OPP) in hemodialysis (HD) patients with chronic renal failure (CRF). Methods We included HD patients who were diagnosed with CRF in our hospital from January to December 2015. Fifty-two patients met the inclusion criteria; all right eyes were used for observation. Systolic and diastolic blood pressures were recorded to calculate OPP. Approximately 30 minutes before and after HD, we recorded multiple parameters, including lens thickness (LT), axial length of vitreous (VAL), axial length of eye (EAL), ciliary body thickness (CBT), choroidal thickness (CT), and retinal thickness (RT). Results After HD, OPP significantly decreased (P < 0.01, F = 7.023) and CBT became significantly thinner (P < 0.01, t = 3.461). CT was significantly thinner and differed among measurement locations (P < 0.01, t = 6.240; P < 0.01, t = 6.169; P < 0.01, t = 3.405, respectively, fovea, nasal, and temporal side 1500 μm beside the fovea). Further, RT thickened and differed among measurement locations (P < 0.05, t = −2.265; P < 0.05, t = −2.624; P < 0.05, t = −2.220, respectively, fovea, nasal, and temporal side 1500 μm beside fovea), whereas LT, VAL, and EAL significantly increased after HD (P < 0.05, t = −2.076; P < 0.01, t = −3.817; P < 0.01, t = −4.010). Conclusions HD impacts the thickness of the eye coats and VAL, particularly affecting CBT, CT, and RT. OPP transiently decreases during HD, which may contribute to an ischemic state.

Retinal displacement after closure of idiopathic macular hole

Objective: To study the foveal displacement during the closure of idiopathic macular holes (MHs). Methods: Thirty-seven idiopathic MH patients treated by pars plana vitrectomy and internal limiting membrane peeling were studied prospectively. Locations of MH center and foveal pit were measured by optic coherence tomography. Retinal displacement was observed using confocal scanning laser ophthalmoscopy. Results: A total of 40 eyes were included in this study and MHs were closed in 37 eyes (92.5%). The confocal scanning laser ophthalmoscopy showed that all of the retinal capillaries in the superior, inferior, nasal and temporal sides of the MHs moved toward the optic nerve head (ONH). The optic coherence tomography results showed that the mean nasal displacements of foveal pits were (102.9±61.2), (109.6±53.1), and (137.0±52.0) μm at 3, 6 and 12 months, respectively. And the mean vertical displacements were (55.9±49.4), (61.4±57.8) and (67.8±54.3) μm, respectively. Post-operative foveal pits were located in the nasal side of the MH centers. The extension of retina and nasal to the MH were in opposite directions: the nasal hole margin moved toward the MH, but the retina located closer to the ONH moved toward the ONH. The fellow eyes of three patients developed into idiopathic MH during the follow-up period and operations were performed for all of the three patients. Conclusion: Our results showed that center of macula does not move when an idiopathic MH develops, but it moves toward ONH during closure of hole; thus, new fovea is in nasal side of original fovea.