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Radiation dose to the eye lens is a crucial issue for interventional cardiologists (ICs) who are exposed during the procedures they perform. This paper presents a retrospective assessment of the cumulative eye lens doses of ICs enrolled in the O'CLOC study for Occupational Cataracts and Lens Opacities in interventional Cardiology. Information on the workload in the catheterisation laboratory, radiation protection equipment, eye lens dose per procedure and dose reduction factors associated with eye-protective equipment were considered. For the 129 ICs at an average age of 51 who had worked for an average period of 22 years, the estimated cumulative eye lens dose ranged from 25 mSv to more than 1600 mSv; the mean±SD was 423±359 mSv. After several years of practice, without eye protection, ICs may exceed the new ICRP lifetime eye dose threshold of 500 mSv and be at high risk of developing early radiation-induced cataracts. Radiation protection equipment can reduce these doses and should be used routinely. [ABSTRACT FROM PUBLISHER]

Background: Irradiation of intraocular tumors requires dedicated techniques, such as brachytherapy with (106)Ru plaques. The currently available treatment planning system relies on the assumption that the eye is a homogeneous water sphere and on simplified radiation transport physics. However, accurate dose distributions and their assessment demand better models for both the eye and the physics.Methods: The Monte Carlo code PENELOPE, conveniently adapted to simulate the beta decay of (106)Ru over (106)Rh into (106)Pd, was used to simulate radiation transport based on a computerized tomography scan of a patient's eye. A detailed geometrical description of two plaques (models CCA and CCB) from the manufacturer BEBIG was embedded in the computerized tomography scan.Results: The simulations were firstly validated by comparison with experimental results in a water phantom. Dose maps were computed for three plaque locations on the eyeball. From these maps, isodose curves and cumulative dose-volume histograms in the eye and for the structures at risk were assessed. For example, it was observed that a 4-mm anterior displacement with respect to a posterior placement of a CCA plaque for treating a posterior tumor would reduce from 40 to 0% the volume of the optic disc receiving more than 80 Gy. Such a small difference in anatomical position leads to a change in the dose that is crucial for side effects, especially with respect to visual acuity. The radiation oncologist has to bring these large changes in absorbed dose in the structures at risk to the attention of the surgeon, especially when the plaque has to be positioned close to relevant tissues.Conclusion: The detailed geometry of an eye plaque in computerized and segmented tomography of a realistic patient phantom was simulated accurately. Dose-volume histograms for relevant anatomical structures of the eye and the orbit were obtained with unprecedented accuracy. This represents an important step toward an optimized brachytherapy treatment of ocular tumors. [ABSTRACT FROM AUTHOR]

The article discusses various platforms for optical coherence tomography (OCT) and advantages of each. It offers brief information on OCT devices including the Bioptigen Envisu Spectral Domain Ophthalmic Imaging System (SDOIS), Carl Zeiss Cirrus HD-OCT, and Heidelberg Spectralis OCT. Galucoma detection with OCT imaging is discussed and role of standard OCT protocols is highlighted. Use of intraoperative and perioperative OCT imaging is explained in detail along with development of OCT imaging.

Abstract: Imaging is a beneficial aid to the oculoplastic surgeon especially in orbital and lacrimal disorders when the pathology is not visible from outside. It is a powerful tool that may be benefited in not only diagnosis but also management and follow-up. The most common imaging modalities required are CT and MRI, with CT being more frequently ordered by oculoplastic surgeons. Improvements in technology enabled the acquisition times to shorten incredibly. Radiologists can now obtain images with superb resolution, and isolate the site and tissue of interest from other structures with special techniques. Better contrast agents and 3D imaging capabilities make complicated cases easier to identify. Color Doppler imaging is becoming more popular both for research and clinical purposes. Magnetic resonance angiography (MRA) added so much to the vascular system imaging recently. Although angiography is still the gold standard, new software and techniques rendered MRA as valuable as angiography in most circumstances. Stereotactic navigation, although in use for a long time, recently became the focus of interest for the oculoplastic surgeon especially in orbital decompressions. Improvements in radiology and nuclear medicine techniques of lacrimal drainage system imaging provided more detailed analysis of the system. [Copyright &y& Elsevier]

Purpose: The aim was to evaluate the test-retest variation of macular thickness measurements using the Heidelberg Retina Tomograph (HRT3) Retina Module and compare it with the Stratus optical coherence tomography (OCT). As no normative data has been published for the HRT Retina Module, a secondary purpose was to obtain reference values for this technique. Methods: Thirty healthy subjects and nine patients with macular oedema were examined. The healthy subjects underwent five examinations by two experienced examiners at two different occasions. The patients with maculopathy were examined twice by one examiner on one occasion. All measurements were made with both the HRT3 and the Stratus OCT and the macular thickness measurements were used for calculations of the test-retest variation. Results: In healthy subjects the coefficient of variation (CV) ranged from 4.5 to 8.8 per cent with the HRT3 and from 0.6 to 1.5 per cent with the Stratus OCT. In the nine patients with macular oedema, the HRT CV ranged from 7.9 to16.6 per cent and for OCT from 1.1 to 2.5 per cent. The intra-class correlation in the central area for intra-observer/intra-visit in healthy subjects was 0.78 with the HRT3 and 0.93 with the Stratus OCT. Corresponding values for the patients with macular oedema were 0.64 with the HRT3 and 1.0 with the Stratus OCT. Mean macular thickness was significantly larger in all areas measured with the HRT3 compared with the Stratus OCT. No significant correlations were found between the thickness values from the different instruments. Conclusion: In this study, macular thickness was measured with two different techniques. The HRT3 showed lower repeatability and reproducibility as well as a higher CV compared with the Stratus OCT in both healthy subjects and patients with macular oedema. This difference might be of clinical relevance, even though the nine patients with maculopathy in the current study showed abnormal results with both methods. [ABSTRACT FROM AUTHOR]

Background: The clinical response to retinopathy of prematurity (ROP) treatment is currently assessed subjectively. This study aims to quantify treatment response objectively by assessing changes in digital images of posterior pole retinal vessel width and tortuosity. Methods: Images of 30 right eyes with type 1 ROP obtained at up to three time points were analyzed: before treatment (T = 0) and 1 (T = 1) and/or 2 weeks (T = 2) after treatment. Width and tortuosity of retinal vessels were analyzed from digital images using computer-assisted image analysis software. Results: Vessel width decreased by 20% (P < 0.004) within the first week and remained stable by the second week after laser treatment. Vessel tortuosity did not significantly change by the first week but decreased 27% (P < 0.01) by second week. Conclusions: Vessel width appears to decrease dramatic within the first week, whereas the regression of tortuosity follows a slower course. [Copyright &y& Elsevier]

Purpose: To present the clinical findings, orbital imaging, and intraoperative findings of patients with inferior rectus muscle underaction and to determine whether specific findings can help discern the underlying cause. Methods: A retrospective observational study was performed on patients presenting with isolated inferior rectus muscle underaction between January 2007 and October 2011. Patient history, ocular motility, fundus torsion, Lancaster red–green plots, and radiographic findings were analyzed. For patients who had surgery, intraoperative findings also were considered. Results: A total of 28 patients with inferior rectus muscle underaction were identified. Of these, 13 (46%) presented with inferior rectus muscle underaction after orbital trauma; 25 (89%) showed no increase in hypertropia >4Δ on head tilt to either side. Fundus intorsion was present in all patients. Of 15 patients evaluated by Lancaster red–green testing, 12 (80%) showed subjective intorsion. Twenty patients underwent orbital imaging via computed tomography or magnetic resonance imaging, and the results in 8 (40%) revealed obvious changes in the inferior rectus muscle. Nineteen patients underwent surgery; intraoperatively, the muscle appeared grossly normal in 8 patients (42%) and showed posterior muscle slippage in 4 (26%). Less common findings included stretched scar formation, flap tear, missing tissue, extensive muscle adhesions, or inability to identify the muscle. Conclusions: Clinical findings in patients with inferior rectus muscle underaction are not sufficiently different to identify the cause, and orbital imaging identified a specific abnormality in only 40% of cases.▪ [Copyright &y& Elsevier]

Purpose: To evaluate the etiological factors, diagnosis, follow-up and treatment procedures in cases of orbital cellulitis. Material and Method: A retrospective review was performed on medical records of patients with orbital cellulitis treated between 2009 and 2011 in our clinic. The patients were studied for age, ophthalmologic examination features, laboratory and radiology results, treatment modalities and the response to these treatments. Results: Eleven patients (7 male, 4 female) having an average age of 9.7 years (6 months-25 years) participated in the study. All patients had eyelid oedema, hyperemia and ocular pain; with chemosis in 3, gaze restriction in 6, relative afferent pupillary defect and proptosis in 4 cases. Orbital cellulitis was observed to occur secondary to paranasal sinusitis in 10 patients (90.9%) and 1 patient had only history of superior respiratory tract infection. Sinus infection was localized in ethmoid and maxillary sinuses in all except one case. Laboratory tests showed leukocytosis in 8 patients. Surgical drainage was performed in 7 of 8 patients with abscess formation observed with radiological imaging. The remainder of the patients were followed with sole medical treatment. All patients recovered without any vision loss or life-threatening complication. Discussion: Orbital cellulitis cases must be followed with radiologic imaging for any complication that may occur and patients with abscess should be evaluated for surgical drainage besides antimicrobial treatment.(Turk J Ophthalmol 2012; 42: 284-7) [ABSTRACT FROM AUTHOR]

Treatment of Graves’ orbitopathy (GO) is better performed through a multidisciplinary approach. Euthyroidism should be promptly restored. Antithyroid drug and thyroidectomy are not disease-modifying treatments, whereas radioiodine may be associated with worsening of GO. This risk is eliminated by glucocorticoid prophylaxis. Treatments for GO differ depending on its severity and activity. Mild forms should be treated with local measures. In addition a course of selenium may be beneficial. Glucocorticoids (oral or intravenous) represent the main treatment of moderate-to-severe GO, the intravenous route being more effective. Weekly pulses of methylprednisolone are used and the cumulative dose should not exceed 8 g. Severe adverse events have been reported, particularly with higher doses. Orbital radiotherapy can be used either alone or associated with glucocorticoids. In very severe sight-threatening GO high dose intravenous glucocorticoid should be the initial treatment, orbital decompression being considered in nonresponding patients. Rehabilitative surgery should be deferred until GO becomes inactive. [ABSTRACT FROM AUTHOR]

Abstract: Ocular melanomas comprise uveal and conjunctival sub-types, which are very different from each other. A large majority of uveal melanomas involve the choroid, with less than 10% being confined to the ciliary body and iris. They tend to metastasize haematogenously, almost always involving the liver. Therapeutic methods include various forms of radiotherapy, surgical resection and phototherapy, which are often used in combination. Conjunctival melanomas show many similarities to their cutaneous counterparts, often metastasizing by lymphatic spread. Treatment consists of excision of invasive melanoma with adjunctive radiotherapy and/or cryotherapy and topical chemotherapy for intra-epithelial disease. The management of patients with ocular melanomas demands a good understanding of the pathology of these tumours. Pathological examination of the tumour indicates the prognosis and hence the need for further investigation and treatment. The scope of the pathologist is enhanced thanks to advances in molecular biology. [Copyright &y& Elsevier]

Dose conversion coefficients for the lens of the human eye have been calculated for neutron exposure at energies from 1×10−9 to 20 MeV and several standard orientations: anterior-to-posterior, rotational and right lateral. MCNPX version 2.6.0, a Monte Carlo-based particle transport package, was used to determine the energy deposited in the lens of the eye. The human eyeball model was updated by partitioning the lens into sensitive and insensitive volumes as the anterior portion (sensitive volume) of the lens being more radiosensitive and prone to cataract formation. The updated eye model was used with the adult UF-ORNL mathematical phantom in the MCNPX transport calculations. [ABSTRACT FROM PUBLISHER]

Irradiation by long-term ultraviolet (UV) A initiates the induction of photoaging. However, the mechanisms responsible for the structural changes of skin induced by UVA irradiation of the eye are still unknown. Male hairless mice were used in this study. The eye or dorsal skin was locally exposed to UVA after covering the remaining body surface with aluminum foil at a dose of 110 kJ/m using a FL20SBLB-A lamp for 60 days. The plasma α-melanocyte stimulating hormone (α-MSH), nitrogen oxides (NO/NO), tumor necrosis factor-α (TNF-α), and the prostaglandin E (PGE) content all increased after UVA irradiation. The levels of NO/NO, TNF-α, and PGE also increased more after UVA skin irradiation than after UVA eye irradiation. However, the level of α-MSH increased more by eye irradiation than skin irradiation. In addition, UVA irradiation of the eye and dorsal skin increased the number of mast cells and fibroblasts. Furthermore, the expression of the melanocortin-1 receptor (MC1R) was increased on the fibroblast surface by UVA irradiation of the eye. These results indicate that the signal evoked by UVA irradiation of the eye, through the hypothalamo-pituitary proopiomelanocortin system, up-regulated the production of α-MSH. This hormone controls the collagen generation from fibroblasts, thus suggesting that photoaging was induced by UVA irradiation of the eye. [ABSTRACT FROM AUTHOR]

Background: The CorneaL GrAft Thickness Evaluation (COLGATE) system was recently developed to facilitate the evaluation of corneal graft thickness from OCT images. Graft thickness measurement can be a surrogate indicator for detecting graft failure or success. The purpose of this study was to determine the reproducibility of the COLGATE system in measuring DSAEK graft area between two observers. Methods: This was a prospective case series in which 50 anterior segment OCT images of patients who had undergone DSAEK in either eye were analysed. Two observers (MW, AC) independently obtained the image analysis for the graft area using both semi automated and automated method. One week later, each observer repeated the analysis for the same set of images. Bland-Altman analysis was performed to analyze inter and intra observer agreement. Results: There was strong intraobserver correlation between the 2 semi automated readings obtained by both observers. (r= 0.936 and r = 0.962). Intraobserver ICC for observer 1 was 0.936 (95% CI 0.890 to 0.963) and 0.967 (95% CI 0.942 to 0.981) for observer 2. Likewise, there was also strong interobserver correlation (r= 0.913 and r = 0.969). The interobserver ICC for the first measurements was 0.911 (95% CI 0.849 to 0.949) and 0.968 (95% CI 0.945 to 0.982) for the second. There was statistical difference between the automatic and the semi automated readings for both observers (p= 0.006, p = 0.003). The automatic readings gave consistently higher values than the semi automated readings especially in thin grafts. Conclusion: The analysis from the COLGATE programme can be reproducible between different observers. Care must be taken when interpreting the automated analysis as they tend to over estimate measurements. [ABSTRACT FROM AUTHOR]

Background: To assess repeatability of the Zhongshan Assessment Program (ZAP) software measurement of Anterior Segment Optical Coherence Tomography (ASOCT) images and correlate with graft trephine diameter following Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) Methods: Retrospectively evaluated interventional case series. 121 consecutive eyes undergoing DSAEK over a 26 month period underwent ASOCT imaging 1month after their surgery. ASOCT images were processed using ZAP software which measured the graft and cornea parameters including anterior and posterior graft arc length and cord length, posterior cornea arc length (PCAL) and anterior chamber width. Results: The graft measurements showed good repeatability on ASOCT using ZAP with high intra class coefficient and small variation in the coefficient of variation. On ASOCT, the mean recipient PCAL was 12.99+/?0.69mm and the anterior chamber width was 11.16+/?0.57mm. The mean Graft anterior arc length was 9.69+/?0.66mm and the mean Graft anterior cord length was 8.92+/?2.94mm. The mean graft posterior arc length was 9.24+/?0.75mm and the mean graft posterior cord length was 8.15+/?0.57mm. Graft posterior arc length (rho=0.788, p< 0.001) correlated best with intra-operative graft trephine diameter. The mean ratio of posterior graft arc length to PCAL was 0.712 +/? 0.056. Conclusions: We have validated the repeatability of the ZAP software for DSAEK graft measurements from ASOCT images and shown that the graft arc length parameters calculated from the ASOCT images correlate well with the intra-operative graft trephine diameter. This software may help surgeons determine the optimal DSAEK graft size based on pre-operative ASOCT measurements of the recipient eye. [ABSTRACT FROM AUTHOR]

Abstract: This study presents a high spatial resolution dosimetry system for quality assurance of I-125 eye plaques. The system is based on a silicon pixelated detector and is capable of deriving 3D dose distributions. A simple design was implemented, incorporating a movable eye plaque in a small water phantom above the silicon Medipix2 detector. It is designed for obtaining 2D dose distributions at different depths in water, for subsequent 3D dose mapping. The effect of backscattering in a medium placed behind the Medipix2 to simulate surrounding tissue has been studied in terms of dose distribution. Additionally, two modes of acquisition, event counting mode and the more complex time-over-threshold mode, were compared to the TG-43 protocol for the determination of their suitability for dosimetry. [Copyright &y& Elsevier]

Purpose: To compare the pterygium recurrence rates after treatment with two different β-radiation doses. Methods and Materials: A total of 84 patients with a mean age of 63.0 ± 10.3 years (men, 48 eyes, and women, 47 eyes) and initially treated with β-radiation after pterygium excision were recruited. The mean follow-up period was 49.9 ± 51.3 months. The patients were assigned to two dose groups: a high-dose (40 Gy) or a low-dose (20 Gy) group. The statistical significance of differences in patient age, pterygium size, and interval between surgery and radiotherapy were analyzed in the 20-Gy group using the Cox proportional hazard model at p < .05. Results: The high- and low-dose groups included 28 and 67 eyes, respectively. Pterygia recurred in 11 eyes, all in the low-dose group. The interval between surgery and radiotherapy was not a significant predictor of recurrence. Smaller pterygia had a lower risk of recurrence than pterygia that had encroached the pupillary area (pterygium located within one-third of the corneal radius from the limbus, corrected hazard ratio [HR], 0.069; 95% confidence interval [CI], 0.006–0.766; p = .030; pterygium extending beyond one-third of the corneal radius, corrected HR, 0.188; 95% CI, 0.018–0.696; p = 0.019; and pterygium reaching the pupillary area, corrected HR, 0.184; 95% CI, 0.036–0.929; p = .040). Older age was marginally significant as a negative predictor of recurrence (HR, 0.943; 95% CI, 0.887–1.003; p = .061). No scleromalacia developed during the follow-up period. Conclusions: β-Radiation at 40 Gy was more efficacious than at 20 Gy in preventing pterygium recurrence without scleromalacia development, particularly for large-size pterygia and those in young patients. [Copyright &y& Elsevier]

Purpose: To evaluate postoperative outcome and recurrence rate after primary pterygium excision using preoperative Mitomycin C (MMC) injection versus limbal conjunctival autograft transplantation (LCAT). Methods: Ninety-one eyes with primary pterygium were divided into 2 groups. Group A eyes (included 48 eyes) were operated upon with pterygium excision 1 month after subpterygial injection of MMC 0.015%. Group B eyes (included 43 eyes) were operated upon with pterygium excision followed by LCAT technique. Pterygium regrowth over the cornea for 1 mm or more was considered as a recurrence. Results: The follow-up period was 24 months. In group A, reported recurrence was found in 2 (4.2%) eyes with a complication rate of 16.80%. While in group B, recurrence was reported in 4 (9.3%) eyes with a complication rate of 11.63%. No serious postoperative complications were reported. There was no statistically significant difference between the 2 groups regarding the recurrence rate as well as the complication rate. Conclusion: Both techniques used in the current study proved to be effective in reducing the recurrence rate after excision of primary nasal pterygium with minimal postoperative complications. Preoperative MMC injection was technically easier, with shorter operative and preservation of healthy conjunctiva. However, LCAT is a one-stage procedure and independent from adjunctive pharmacological or radiation therapies with their hazards. [ABSTRACT FROM AUTHOR]

Idiopathic orbital pseudotumour (IOP) is a benign inflammatory condition usually confined to the orbit. This may involve single or multiple intraorbital structures. Extraorbital extension can also occur. The imaging appearances often mimic other orbital diseases. Both computed tomography (CT) and magnetic resonance imaging (MRI) are frequently used to investigate orbital diseases, and it is important for radiologists to be aware of the variety of imaging appearances that occur in IOP. We present the imaging appearances in histopathologically confirmed cases of IOP and discuss the clinical features, natural history, and differential diagnosis of this condition. [Copyright &y& Elsevier]

Abstract: Orbital infiltration with bilateral proptosis has been observed in 2% cases of acute or chronic lymphatic leukaemia . In contrast myelogenous leukaemia only very rarely gives rise to extra ocular muscle infiltration . We report an unusual case of acute myelocytic leukaemia in 10-year-old male child presenting with acute bilateral proptosis as its sole manifestation to an ENT surgeon and also describe characteristic radiological features. [Copyright &y& Elsevier]

Abstract: This study aims to describe the epidemiology of ocular burns and related injuries due to fireworks during the Aidil Fitri celebration on the East Coast of the Peninsular Malaysia. A prospective analysis of all patients with ocular burns and related injuries due to fireworks attended three tertiary hospitals in East Coast of Peninsular Malaysia during Aidil Fitri, which was from 10 September to 17 October 2008. We observed the demographic and injury characteristics, extent of the injuries and presenting visual symptoms. Thirty patients with 34 eyes with ocular burns and related injuries were identified. Patients ranged between 2 and 43 years of age. 70.00% of the patients were 12 years old and below. Of the 30 patients, 29 (96.67%) were male and the left eye was affected in 14 (46.70%). Thermal injuries accounted for 60.0% of the injuries whereas 40.0% were due to exploding firework. Burns to the eyelid and cornea (35.29%) were the most common injuries noted. Fifteen patients (50%) were bystanders whilst a majority of patients (96.67%) had no eye protection. At presentation, 15 (44.12%) eyes had a visual acuity of 6/6 to 6/9 in the injured eyes, while 3 out of 34 eyes (8.82%) had vision acuity 6/60 or worse. In conclusion, fireworks cause serious preventable ocular burns and related injuries especially in children who are the most affected age group. It affects mainly eyelid and anterior segment structures which result in moderate visual loss on presentation. Health education, public awareness and tighter legislation are essential preventive measures to limit the effect of fireworks to the public. [Copyright &y& Elsevier]

OBJECTIVE: The present study proposes the evaluation of the depth-dose profiles and the spatial distribution of radiation dose for ocular proton beam radiotherapy protocols, based on computer simulations in nuclear codes and an eye model discretized into voxels. MATERIALS AND METHODS: The employed computational tools were Geant4 (GEometry ANd Tracking) Toolkit and SISCODES (Sistema Computacional para Dosimetria em Radioterapia - Computer System for Dosimetry in Radiotherapy). Geant4 is a toolkit for simulating the passage of particles through the matter, based on Monte Carlo method. Computer simulations of proton therapy were performed based on preexisting facilities. RESULTS: Simulation data were integrated into SISCODES on the eye's model generating spatial dose distributions. Dose depth profiles reproducing the pure and modulated Bragg peaks are presented. Relevant aspects of proton beam radiotherapy planning are considered such as material absorber, modulation, collimator dimensions, incident proton energy and isodose generation. CONCLUSION: The conclusion is that proton therapy when properly modulated and directed can reproduce the ideal conditions for the dose deposition in the treatment of ocular tumors. [ABSTRACT FROM AUTHOR]

Abstract: The proton radiotherapy facility for the eye melanoma treatment is under development at the Henryk Niewodniczański Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN) in Krakow. The facility uses protons, accelerated by the AIC-144 isochronous cyclotron up to the energy of 60MeV. The infrastructure and all necessary equipment have been already installed. The paper describes the present status of the facility, gives results of the preliminary beam measurements and shows future perspectives. [Copyright &y& Elsevier]

Abstract: The analysis of eye movements has proven to be valuable in both clinical work and research as well as in other fields besides medicine. The detection of saccadic eye movements and the extraction of related saccade parameters, such as maximum angular velocity, amplitude, and duration, are usually performed during the analysis of electro-oculographic (EOG) signals. This article considers a saccade detection method that is based on the constant false alarm rate technique, in which the detection sensitivity is continuously adjusted on the basis of the observed signal in order to keep the number of false alarms constant. The method is computationally efficient, it can operate autonomously without user intervention, and it is capable of detecting saccades in a sequential fashion. Therefore, the method finds potential use in applications that require automated analysis of electro-oculographic signals. Because of the constant false alarm rate property, the method can also perform in situations where ideal measurement conditions cannot be guaranteed and noise presents a considerable problem. [Copyright &y& Elsevier]

Abstract: Objective: The contamination of muscle and eye artifacts during an ictal period of the EEG significantly distorts source estimation algorithms. Recent blind source separation (BSS) techniques based on canonical correlation (BSS-CCA) and independent component analysis with spatial constraints (SCICA) have shown much promise in the removal of these artifacts. In this study we want to use BSS-CCA and SCICA as a preprocessing step before the source estimation during the ictal period. Methods: Both the contaminated and cleaned ictal EEG were subjected to the RAP-MUSIC algorithm. This is a multiple dipole source estimation technique based on the separation of the EEG in signal and noise subspace. The source estimates were compared with the subtracted ictal SPECT (iSPECT) coregistered to magnetic resonance imaging (SISCOM) by means of the euclidean distance between the iSPECT activations and the dipole location estimates. SISCOM results in an image denoting the ictal onset zone with a propagation. Results: We applied the artifact removal and the source estimation on 8 patients. Qualitatively, we can see that 5 out of 8 patients show an improvement of the dipoles. The dipoles are nearer to or have tighter clusters near the iSPECT activation. From the median of the distance measure, we could appreciate that 5 out of 8 patients show improvement. Conclusions: The results show that BSS-CCA and SCICA can be applied to remove artifacts, but the results should be interpreted with care. The results of the source estimation can be misleading due to excessive noise or modeling errors. Therefore, the accuracy of the source estimation can be increased by preprocessing the ictal EEG segment by BSS-CCA and SCICA. Significance: This is a pilot study where EEG source localization in the presurgical evaluation can be made more reliable, if preprocessing techniques such as BSS-CCA and SCICA are used prior to EEG source analysis on ictal episodes. [Copyright &y& Elsevier]

Medical records of two patients treated for radiation retinopathy in our clinic were evaluated retrospectively to assess the efficacy of various intravitreal injections. Age of the patients was 28 and 53. The time interval between radiotherapy and radiation retinopathy was 3 years in the first patient and one year in the second. First patient received no prior treatment. Second patient had a history of left vitrectomy for a presumed diagnosis of retinal vein occlusion at another institute. First patient's visual acuity was 2/10 in the right eye and 4/10 in the left eye while second petient's visual acuity was counting fingers at 2 meters in the right eye and counting fingers at 4 meters in the left eye. Their posterior segment examinations revealed changes compatible with radiation retinopathy. There was no retinal or disc neovascularization. Second patient had also signs of optic neuropathy in the left eye. Both patients had multiple intravitreal injections of triamcinolone acetonide, bevacizumab and pegaptanib sodium. Early after injections visual acuity and clinic manifestations became slightly better but re-injections deemed necessary due to recurrent macular oedema. There is no consensus on treatment of radiation retinopathy but intravitreal injections may limit the damage and have a role in the treatment of macular oedema due to radiation retinopathy. [ABSTRACT FROM AUTHOR]

The section presents several articles related to glaucoma published in various medical journals. These include the agreement among clinicians in establishing glaucomatous progression using the Heidelberg retina tomography, a placebo-controlled three-year study of a blocker on visual field and ocular circulation in glaucoma with low-normal pressure, and the measurement of Goldmann applanation tonometer calibration error.

Simple Summary: Retrograde degeneration of the eye's retinal ganglion cells, causing visual loss and even blindness, is a feared consequence of optic pathway gliomas. Optical coherence tomography (OCT) is a patient-friendly, high-resolution imaging technique enabling objective measurements of the integrity of the retinal ganglion cell layer. Children with optic pathway glioma unable to complete formal visual field testing and/or reliable visual acuity testing, may undergo OCT, providing objective information about visual loss and potential clinical progression. By combining visual functional measurements with OCT findings, the clinical examination will be safer and more reliable. By improving the clinical follow-up of the tumor, the treatment choices can be optimized thereby preventing further visual loss and, in the worst case, blindness. This study investigates whether optical coherence tomography (OCT) could add useful information in the examination of children with optic pathway glioma (OPG) at high risk of developing vision loss. For this purpose, the relationship between ganglion cell-inner plexiform layer (GC-IPL) thickness and visual function, evaluated with tests of visual acuity (VA) and visual field (VF), as well as tumor site according to magnetic resonance imaging (MRI), were examined in a geographically defined group of children with OPG. Methods: Children aged <18 years with OPG underwent ophthalmic examination including VA, VF (Zeiss HFA perimetry) and OCT imaging (Zeiss Cirrus HD-OCT). Results: Out of 51 patients included, 45 provided 77 eyes with MRI-verified OPG, and 19 patients provided 25 eyes without OPG. Significant correlations were found between GC-IPL, VF and VA (p < 0.001). The GC-IPL pattern loss corresponded in 95% to VF defects and in 92% to MRI findings. Conclusions: Our study indicates that GC-IPL measures could serve as an early marker of vision-threatening changes related to OPG and as a valuable link between MRI and visual function tests. Thinning of GC-IPL and differences in topography between eyes are strong indicators of and predictive of vision loss related to OPG. [ABSTRACT FROM AUTHOR]

The article reports on the case of a 56-year-old woman with retinoblastoma treated with radiation in the right eye and was presented with a progressively enlarging lesion in the macula associated with subretinal fluid. A vacular lesion with prominent saccular dilations were revealed after observation. Results indicate the presence of complications of rubeosis and atypical polypoidal neovascularization from radiation retinopathy.

Copyright of Canadian Journal of Ophthalmology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Purpose: To describe two cases of arachnoid cyst that altered the bony orbit. Methods: Case report. Results: Cases of unilateral arachnoid cyst are described in two men, both over the age of 60. The patients were evaluated with computed tomography (CT) scans and in each, an arachnoid cyst in the middle cranial fossa caused bone remodeling with exophthalmos in one. These patients were followed clinically and radiographically over a number of years with no change. Conclusion: Arachnoid cysts in the middle cranial fossa have the potential to result in clinically significant proptosis due to bone remodeling of orbital walls. Patients with unexplained proptosis should be evaluated with CT scans to establish the presence of bone remodeling and an arachnoid cyst, which can be confirmed with T2-weighted magnetic resonance imaging (MRI). [ABSTRACT FROM AUTHOR]

: PurposeTo introduce a noninvasive eye fixation and computer-aided eye monitoring system for linear accelerator-based stereotactic radiotherapy for uveal melanoma.: Methods and materialsAt the Department of Radiotherapy and Radiobiology, University of Vienna, stereotactic radiotherapy is offered to patients with uveal melanoma considered unsuitable for 106Ru brachytherapy or local resection. For the present feasibility study, 8 patients were carefully selected according to their ability to fixate a small light source with the diseased eye and whether they had a rather small head to meet the limited geometric space available. A polymethyl methacrylate tube was attached to a stereotactic mask system in craniocaudal orientation supporting a 45° mirror, which was placed in front of the diseased eye. At the other end of the tube, the patient was given a small fixation light, and a small camera was positioned beneath, which was shielded for use during MRI. A computer interface calculated and visualized the spatial difference of the actual and a given reference pupil position, which was defined before CT scanning, during the MRI sequences, and during treatment delivery at the linear accelerator.: ResultsThe described system can be attached to a conventional stereotactic mask system with minor modifications. Because of the large distance between the eye and the fixation light, the optical fixation system was well tolerated by all patients, and a stable position of the eye was obtained. The camera system can be used during CT and MRI without interference. Absorption of the 6-MV photon beam by the mirror and the polymethyl methacrylate tube was negligible. The computer interface designed to determine the pupil position uses an image-processing algorithm that correlates a template of the reference image with the actual image of the eye. Provided sufficient illumination of the pupil, the correlation function showed a pronounced minimum at the reference position. The precision of the algorithm was tested by phantom measurements. For a given 1 mm or 2 mm displacement, the interface reported a mean shift of 0.96 ± 0.18 mm or 2.07 ± 0.11 mm, respectively.: ConclusionThe results of this study demonstrated the feasibility of a new optical fixation system for linear accelerator-based stereotaxis. The artifact-free application of the camera system during image acquisition and irradiation and the use of the computer interface, which automatically monitored eye movements with submillimeter precision, provided large improvements compared with existing techniques. Given well-defined interruption criteria and accelerated image processing, the described system has a high potential to perform automatically gated treatment beam delivery in the near future. [Copyright &y& Elsevier]

An algorithm for estimating the corneal limbus from videokeratoscopic images is proposed. After the image is transformed to a polar grid, a novel edge-detection procedure, suitable for the detection of the soft edge produced by the limbus, is used to locate the limbus. Outliers due to the eyelids, eyelashes, and videokeratoscopic rings are removed by taking advantage of the approximate circularity of the cornea. An ellipse which minimizes the sum of the squared algebraic errors is fitted to the remaining edge points. Comparisons between the proposed algorithm, a manual computer-based technique and an algorithm which uses conventional edge-detection techniques demonstrate the accuracy of the proposed algorithm. [ABSTRACT FROM AUTHOR]

Some publications have shown that Hp(0.07) or even Hp(10) can be used as good operational quantities for X-rays in view of difficulties with Hp(3). With increasing awareness, there is tendency to use whatever dosimeter is available with correction factor to estimate eye lens dose. The best position for an eye lens dosimeter has been reported to be at the side of the head nearest to the radiation source, close to the eye. Recent studies have reported eye doses with cone beam CT (CBCT) both for patients and staff, and there are many papers reporting eye lens doses to staff in nuclear medicine. To minimise the dose to eyes, the user can take advantage of a feature of CBCT of projections acquired over an angular span of 180° plus cone angle of the X-ray tube and with tube under scan arcs. [ABSTRACT FROM AUTHOR]

Studies the relationships between visual scanning patterns, pupillary response, and the clinical diagnosis of mammographic experts. Uses of an inexpensive and unobtrusive eye-tracking system; Why the eye-tracking system was used; Examinations of mammograms in association with breast cancer; Conclusion reached.

Evaluates the degree of lacrimal duct occlusion following implantation of an intracanalicular plug. Complications of canaliculitis and dacryocystitis; Use of dacryoscintigraphy (DSG) to evaluate the degree of occlusion of the lacrimal flow; Efficacy of DSG.

Recently, the International Commission on Radiological Protection has reviewed epidemiological evidences suggesting that there were tissue reaction effects in the eye lens below the previously considered absorbed dose threshold. A new statement related to the eye lens was issued that changed the absorbed dose threshold and reduced the dose limits for occupationally exposed persons. As consequence, some planned exposures require eye lens dosimetry and a debate was raised on the adequacy of the dosimetric quantity and on its method of measurement. The aim of this work was to study the methodology for calibrating the EYE-D TM holder with a TLD-100H Harshaw chip detector and to determine its angular and energy dependences in terms of personal dose equivalent, H p (3). [ABSTRACT FROM AUTHOR]

Orbital malignancy can mimic thyroid associated orbitopathy (TAO) due to overlap of clinical and radiographic findings, which include proptosis, extraocular muscle (EOM) enlargement on imaging, and EOM restriction with diplopia. We report a case of primary orbital liposarcoma masquerading as TAO which required exenteration. [ABSTRACT FROM AUTHOR]

In this case report a 20-year-old patient who had primary scleral reparation after perforating trauma to the right eye is presented. During the follow-up period a traumatic macular hole was detected. After one month, the macular hole was seen to have spontaneously closed and this was shown with optical coherence tomography. [ABSTRACT FROM AUTHOR]

Suprachoroidal hemorrhages are one of the most devastating complications of intraocular surgeries. Here we present a patient who developed "delayed suprachoroidal hemorrhage" after an uncomplicated scleral fixation intraocular lens implantation surgery and we discuss treatment options in this type of hemorrhages. An aphakic 65 years old male patient developed a sudden loss of vision 3 days after the secondary IOL implantation surgery. In B mode ultrasonography of the eye, massive hemorrhagic choroidal detachment was detected. Resorption of the hemorrhage started 10 days after topical and systemic corticosteroid and topical cycloplegin drops. Prognosis in delayed suprachoroidal hemorrhages usually depends on the intensity, localization and the duration of the hemorrhage. In this case because the patient responded well to the conservative treatment after the tenth day, we did not plan any surgical approaches. Following with conservative therapy will decrease any further surgical treatments in particular group of patients. [ABSTRACT FROM AUTHOR]

A 26-year-old woman presented with a painful skin eruption which led to the diagnosis of acute myeloid leukemia. During chemotherapy, she developed an unusual orbital inflammation. Careful observation of the clinical course, computed tomography, and orbital biopsy were necessary to establish the diagnosis of dacryoadenitis associated with subcutaneous Sweet's syndrome. The skin eruption and the dacryoadenitis resolved rapidly with corticosteroid therapy. This is the first report of dacryoadenitis in the course of subcutaneous Sweet's syndrome. [ABSTRACT FROM AUTHOR]

A 17-year-old boy presented with a left upper lid swelling, headaches and diplopia. An orbital computerized tomography (CT) scan showed a mass in the left lacrimal fossa eroding bone and extending into the temporalis fossa and intracranially. An urgent biopsy without curettage was carried out and showed Langerhans cell histiocytosis. He was otherwise well and no other lesion was found. He was therefore observed and reviewed regularly. During follow-up it was noted that the mass was reducing in size. Five months after the initial biopsy a further procedure, involving curettage and an intralesional steroid, was carried out at a tertiary referral center. Histology of the material obtained showed no remaining evidence of Langerhans cell histiocytosis. Spontaneous resolution of orbital Langerhans cell histiocytosis has been described clinically and radiologically. This is the first case of spontaneous resolution to be confirmed histiologically. [ABSTRACT FROM AUTHOR]

Glaucoma is an eye disease that damages the optic nerve and can lead to irreversible loss of peripheral vision gradually and even blindness without treatment. Thus, diagnosing glaucoma in the early stage is essential for treatment. In this paper, an automatic method for early glaucoma screening is proposed. The proposed method combines structural parameters and textural features extracted from enhanced depth imaging optical coherence tomography (EDI-OCT) images and fundus images. The method first segments anterior the lamina cribrosa surface (ALCS) based on region-aware strategy and residual U-Net and then extracts structural features of the lamina cribrosa, such as lamina cribrosa depth and deformation of lamina cribrosa. In fundus images, scanning lines based on disc center and brightness reduction are used for optic disc segmentation and brightness compensation is utilized for segmenting the optic cup. Afterward, the cup-to-disc ratio (CDR) and textural features are extracted from fundus images. Hybrid features are used for training and classification to screen glaucoma by gcForest in the early stage. The proposed method has given exceptional results with 96.88% accuracy and 91.67% sensitivity. [ABSTRACT FROM AUTHOR]

Sub-inner limiting membrane (ILM) hemorrhage is a rare presenting feature of dengue maculopathy. A 24-year-old man in active military service who was recently treated for dengue hemorrhagic fever presented with sub-ILM bleeding in right eye (dominant eye) with profound diminution of vision. Spectral domain optical coherence tomography and fundus fluorescein angiography confirmed sub- ILM hemorrhage with no evidence of vasculitis/venous occlusion or neovascularization. He refused active surgical management by pars plana vitrectomy and was treated with pneumatic tamponade of C3F8 (100%) gas with prone positioning in order to achieve faster visual recovery. He responded well to treatment with complete visual recovery in 1 week. This case report documents for the first time treatment of sub-ILM hemorrhage in the premacular area with pneumatic tamponade in prone position leading to rapid and complete visual recovery in a patient with dengue maculopathy. This novel approach can be employed for patients who are ineligible for more active surgical management. [ABSTRACT FROM AUTHOR]