Intravitreal bevacizumab injection and carotid artery stent replacement for neovascular glaucoma in internal carotid artery occlusion

Neovascular glaucoma (NVG) secondary to internal carotid artery (ICA) occlusion is usually resistant to treatment. We report a case of NVG with ICA occlusion improved by intravitreal bevacizumab (IVB) injection and carotid artery stent replacement (CAS), even though we did not perform panretinal photocoagulation. A 67-year-old male with NVG noted visual loss in his left eye. Magnetic resonance angiography showed left ICA occlusion. He was diagnosed with NVG secondary to ICA occlusion. The next day, we carried out IVB injection in his left eye, following which the iris and angle neovascularization regressed, and the intraocular pressure decreased to normal within a day after the injection. CAS was performed on his left ICA at a month post injection. Two months later, we reinjected bevacizumab in his left eye. His condition remained stable with no recurrence over two years. This case indicates that IVB injection and CAS are useful for early-stage NVG secondary to ICA occlusion

Corneal Nerve Fiber Structure, Its Role in Corneal Function, and Its Changes in Corneal Diseases

Recently, in vivo confocal microscopy is used to examine the human corneal nerve fibers morphology. Corneal nerve fiber architecture and its role are studied in healthy and pathological conditions. Corneal nerves of rats were studied by nonspecific acetylcholinesterase (NsAchE) staining. NsAchE-positive subepithelial (stromal) nerve fiber has been found to be insensitive to capsaicin. Besides, NsAchE-negative but capsaicin-sensitive subbasal nerve (leash) fibers formed thick mesh-like structure showing close interconnections and exhibit both isolectin B4- and transient receptor potential vanilloid channel 1- (TRPV1-) positive. TRPV1, TRPV3, TRPA (ankyrin) 1, and TRPM (melastatin) 8 are expressed in corneal nerve fibers. Besides the corneal nerve fibers, the expressions of TRPV (1, 3, and 4), TRPC (canonical) 4, and TRPM8 are demonstrated in the corneal epithelial cell membrane. The realization of the importance of TRP channels acting as polymodal sensors of environmental stresses has identified potential drug targets for corneal disease. The pathophysiological conditions of corneal diseases are associated with disruption of normal tissue innervation, especially capsaicin-sensitive small sensory nerve fibers. The relationships between subbasal corneal nerve fiber morphology and neurotrophic keratopathy in corneal diseases are well studied. The recommended treatment for neurotrophic keratopathy is administration of preservative free eye drops

Disturbances in the ocular surface microbiome by perioperative antimicrobial eye drops

We aimed to elucidate the effects of antimicrobial eye drops used in the perioperative period of ophthalmic surgery on the ocular surface microbiome by metagenomic analysis. Twenty-eight eyes from 15 patients (mean age 74.1 years) with no history of eye drop use within 3 months before cataract surgery were included in this study. Gatifloxacin eye drops were used in all patients in the perioperative period. The antimicrobial eye drops were started 3 days before surgery. They were discontinued after conjunctival sac specimen collection for 2 weeks after the surgery. Conjunctival sac specimens were collected to investigate the alterations in the ocular surface microbiome by meta-16S analysis targeting the V3-V4 region of the bacterial 16S rRNA gene. Principal coordinate analysis showed that the bacterial composition tended to be different before and 2 and 4 weeks after surgery. Individual observations on six eyes showed that the bacterial composition at 12 weeks after surgery was closer to that before surgery than to that at 4 weeks after surgery in two eyes, while the bacterial composition in the remaining four eyes was different at various time points. Before surgery, Firmicutes, Proteobacteria, and Bacteroidetes were predominant; however, 2 weeks after surgery, the proportion of Proteobacteria increased and that of Firmicutes decreased. A similar trend was noticed 4 weeks after surgery, although antibacterial eye drops had been discontinued 2 weeks after surgery. The Shannon–Weaver coefficient showed a decreasing trend at 2-, 4-, and 12-weeks post operation compared to that before operation. The diversity of the microbiome decreased significantly at 2- and 4-weeks after surgery when compared to that before surgery (p < 0.05). The ocular surface microbiome is easily disrupted by antimicrobial eye drops, and it needs recovery time. In such cases, the ocular surface microbiome is presumed to contain many antimicrobial-resistant bacteria. In some cases, it may not recover, and a new microbiome is formed

A Kerato-Epithelin (βig-h3) Mutation in Lattice Corneal Dystrophy Type IIIA

This report covers phase 2 of the IWMI-Tata Water Policy Research Program (ITP) for the period 2006-2010. The major areas of action: Research focusing on water sector issues concerning underprivileged communities and backward regions in the country; Idea-incubation for livelihoods enhancement efforts using water as a central input, supporting the Trust in their water sector partnerships; Dissemination and raising public awareness; Widening the network of research partners; Policy influencing

Comparison of monocular sensitivities measured with and without occlusion using the head-mounted perimeter imo.

PurposeUsing a head-mounted perimeter imo that can measure monocular sensitivity with both eyes open, we investigated the difference between monocular sensitivities measured with and without occlusion of the fellow eye and if the difference was influenced by eccentricity.MethodsUsing the perimeter imo, monocular sensitivities with/without occlusion and binocular sensitivity were measured and compared. Three test conditions for monocular sensitivity without occlusion were: with/without a fusional fixation target, and a binocular random single eye test in which the target was randomly presented to either eye and the examinee was not aware of the tested eye. Within the central 25° visual field (VF), 29 points located at the fovea and on the 45°, 135°, 225°, and 315° meridians with 3° intervals were tested. Differences among the four monocular sensitivities with/without occlusion were further evaluated at the fovea, within and beyond the central 5° VF.ResultsSixteen visually normal volunteers (mean age, 28.6 ± 4.6 years) were included in this study. Except at the fovea, monocular sensitivities measured without occlusion were significantly higher than those with occlusion (P ConclusionsExcept at the fovea, monocular sensitivities measured with and without occlusion significantly differed. This indicates that without occlusion, binocular interaction is activated and affects not only binocular sensitivity but also monocular sensitivity