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Purpose To simulate 24-2 visual field (VF) using optical coherence tomographic angiography (OCTA) for glaucoma evaluation. Design Cross-sectional study. Methods One eye each of 39 glaucoma and 31 age-matched normal participants was scanned using 4.5-mm OCTA scans centered on the disc. The peripapillary retinal nerve fiber layer plexus capillary density (NFLP-CD, %area) was measured. The NFLP-CD and 24-2 VF maps were divided into 8 corresponding sectors using an extension of Garway-Heath scheme. Results Sector NFLP-CD was transformed to a logarithmic dB scale and converted to sector simulated VF deviation maps. Comparing simulated and actual 24-2 VF maps, the worst sector was in the same or adjacent location in the same hemisphere 97% of the time. VF mean deviation (VF-MD) was simulated by NFLP mean deviation (NFLP-MD). The differences between NFLP-MD and VF-MD in early, moderate, and severe glaucoma stages were −0.9 ± 2.0, 0.9 ± 2.9, and 5.8 ± 3.2 dB. NFLP-MD had better (P = .015) between-visit reproducibility (0.63 dB pooled standard deviation) than VF-MD (1.03 dB). NFLP-MD had a significantly higher sensitivity than VF-MD (P Conclusions OCTA-based simulated VF agreed well with actual 24-2 VF in terms of both the location and severity of glaucoma damage, with the exception of severe glaucoma in which the simulation tended to underestimate severity. The NFLP-MD had better reproducibility than actual VF-MD and holds promise for improving glaucoma monitoring. The NFLP-MD had better diagnostic accuracy than both VF-MD and overall NFL thickness and may be useful for early glaucoma diagnosis.

PURPOSE: To assess the repeatability and accuracy of corneal astigmatism measurement with a spectral-domain optical coherence tomography (OCT) system (Avanti, Optovue) and compare them with Scheimpflug imaging (Pentacam HR, Oculus) and swept-source optical biometry (IOLMaster 700, Carl Zeiss Mediatec AG). SETTING: Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA DESIGN: Prospective cross-sectional observational study. METHODS: Sixty pseudophakic eyes with monofocal non-toric intraocular lens that previously had refractive surgery were analyzed. To assess accuracy, simulated keratometric (SimK) and net corneal astigmatism, obtained from each device were compared with subjective manifest refraction astigmatism. Repeatability for corneal astigmatism was assessed for OCT and Pentacam HR by the coefficient of repeatability from three repeated measures. RESULTS: Compared to manifest refraction, SimK readings produced with-the-rule (WTR) astigmatic bias which was reduced for net astigmatism for all the three devices. Except for OCT net astigmatism, all instruments significantly overestimated the magnitude of the astigmatism (linear mixed-effects model (LMM), P < .05). OCT net astigmatism showed the highest accuracy for manifest astigmatism prediction with the smaller 95% confidence ellipse for the mean difference vector. OCT net mean absolute difference was 0.57 D, significantly smaller than that of the other modalities (LMM, P

The paper is on intervention of sensitivity training in Human Relationship Management, this is a powerful interference on self-awareness which gives an insight into all aspects of an individual relationship in their personal life as well as professional life. It is an orientation towards group dynamics process by which organizations educate themselves in order to achieve better problemsolving capabilities through healthier human relationship management. This in turn a significant positive change is achieved in the working cordial human relation between members. In this context, IT Organization (Confidential) categorical nominated their staff of various ranks for sensitivity training programme. The findings of 100 respondents are i) null hypothesis is accepted as p is greater than 0.05 which means that there is no association between gender and interpersonal relationship during the sensitivity training. ii) a) If p value < 0.05, reject null hypothesis. The impact of Sensitivity program on conflict management varies at different age groups and b) If p value > 0.05, accept null hypothesis. The impact of Sensitivity program on conflict management is the same at different age groups

� PURPOSE: To evaluate the outcome of pars plana vitrectomy, subretinal tissue plasminogen activator (t-PA) infusion and intraocular gas tamponade with and without postsurgical antivascular endothelial growth factor (VEGF) injection for thick submacular hemorrhage due to exudative age-related macular degeneration (AMD). � DESIGN: Retrospective, comparative, interventional case series. � METHODS: SETTING: 2 retina referral centers. The patient population included 101 eyes of 101 patients with neovascular AMD and thick submacular hemorrhage who underwent surgical displacement of the hemorrhage with or without postoperative anti-VEGF injections. Main outcome measures included degree of blood displacement, best and final postoperative visual acuity (VA), and adverse events. Snellen acuity was converted to logMAR for statistical analysis. � RESULTS: All patients were followed for a minimum of 3 months (mean, 15.3 months, range, 3-70 months). In 83 (82%) of 101 eyes, the procedure resulted in complete hemorrhage displacement from the fovea. Mean preoperative VA was 20/2255 (2.05 logMAR). The acuity significantly improved to 20/893 (1.65 logMAR) at month 1 (P < 0.001) at month 1; 20/678 (1.53 logMAR) at month 3 (P < 0.001), and 20/1150 (1.76 logMAR) at month 12 (P [ 0.002). Best postoperative visual acuity improved by at least 1 line in 83 (82%) of 101 eyes, and 19.6% of eyes gained 3 lines or more at month 3. The visual acuity of the group of eyes that received postoperative anti-VEGF injection (n [ 39) showed greater visual acuity improvement 6 months postoperatively compared to the group of eyes that did not receive postoperative anti-VEGF. Postoperative complications included vitreous hemorrhage in 2 eyes, rhegmatogenous retinal detachment in 4 eyes, and recurrent thick subretinal hemorrhage in 6 eyes. � CONCLUSIONS: Vitrectomy with subretinal t-PA injection and gas tamponade was found to be relatively effective for displacement of thick submacular hemorrhage with a significant improvement in visual acuity. There is a loss of acuity over time; the addition of postoperative anti-VEGF therapy may help maintain the visual

BACKGROUND: The safety and sufficiency of blood supply is dependent on the altruism of healthy donors, to provide blood. These donors get exposed to potential risk of discomfort, complications, and rarely injury from the collection procedure. All medical procedures including blood donation carry some risk of adverse events (AE). Although blood donation is generally safe, approximately of 2-6 % of donors experience complications, mostly mild, that resolve promptly but are still unpleasant for donors, and blood services have an obligation to minimize them. The aim of this study was to estimate the frequency and severity of AE's occurring in whole blood donors, especially in outdoor camps, and to suggest measures to minimize them. MATERIALS AND METHODS: This is a five year retrospective study on whole blood donors (2008-2012). Our blood collection is mainly in camps by voluntary blood donors. Donations in camps: voluntary- 8992(81.2%). Donations in blood bank: voluntary 831(7.53%), replacement 1211(10.97%). RESULTS : Overall 258 adverse events occurred in a total of 11034 donors, resulting in an adverse event rate of 2.33%. Most common AE was pre- syncopal or vasovagal reaction (72.86%). Syncopal minor reactions associated with transient loss of consciousness comprised 14.3%. Severe AE's formed a very small fraction accounting for 1.16%. CONCLUSION: AE analysis helps in identifying the donors at risk and adopting environmentally appropriate measures to reduce risk and improve donor satisfaction .

Adenoid hypertrophy is a normal phenomenon seen in young children. Adenoids may however be of large size or may not reduce in size in adulthood. Large adenoids may cause mouth breathing, overcrowding of teeth or otological symptoms. When adenoids are large and producing these effects, adenoidectomy is necessary. Adenoidectomy immensely benefits such patients but they may still continue to be habitual mouth breathers. This can lead to formation of long narrow face, labially protruded maxillary incisors and class 2 malocclusion. Immediate orthodontic treatment of such patients will improve facial profile and lead to class 1 (Angle) occlusion. We present here a study of 20 patients who were given early orthodontic treatment in postadenoidectomy period as compared to those patients who were not treated by orthodontist.

PURPOSE To report the results of intravitreal use of ranibizumab in a patient with macular edema due to Eales disease. METHOD This was an open-label, Phase 1, 6-month study of the safety and efficacy of intravitreally administered ranibizumab in patients with macular edema due to Eales disease. A single patient was eligible for the study during the 2 years of recruitment. She received 3 monthly intravitreal injections of 0.5 mg of ranibizumab for 3 months. At each of her monthly visits during the 6-month study, she was evaluated with a full ocular examination and optical coherence tomography imaging of the macula. Primary outcome measure was change in optical coherence tomography central subfield thickness at 6 months. RESULTS The central macular thickness as measured on optical coherence tomography reduced from 269 μm at baseline to 186 μm at 3 months. This reduction was transient with subsequent increase to 262 μm at the conclusion of the study at 6 months. CONCLUSION Ranibizumab use led to transient resolution of macular edema at 3 months; however, this reduction in edema was not sustained.

PURPOSE To report a case of recurrent endophthalmitis resulting from Pseudomonas aeruginosa requiring removal of the intraocular lens and lens capsule to eradicate the infection. METHODS Evaluation for management of presumed endophthalmitis after uneventful cataract surgery with intraocular lens implantation. RESULTS Eventual resolution of P. aeruginosa intraocular infection after pars plana vitrectomy 3 times and removal of the intraocular lens and lens capsule with final visual acuity of 20/30. CONCLUSION P. aeruginosa is an aggressive organism that often presents in a fulminant manner, requiring vitrectomy and repeated injections of intravitreal antibiotics. Rarely, the organism can be harbored in the lens capsule, requiring intraocular lens explantation and capsule removal for complete eradication and best visual recovery.

Purpose: To present a series of eyes with multifocal choroiditis and panuveitis (MFC) treated with fluocinolone acetonide intravitreal implants. All eyes developed recurrent choroidal neovascularization (CNV) and were treated with intravitreal bevacizumab or ranibizumab. Methods: Retrospective chart review. Data collected included demographics, details of previous immunosuppressive therapy, preinjection Snellen visual acuity, and central macular thickness measured by optical coherence tomography, total injections administered, and postinjection central macular thickness and visual acuity. Patients were followed up for a minimum of 25 months from the first fluocinolone acetonide implant. Duration from implantation to first injection and complications, including development of cataracts, glaucoma, and recurrent inflammation, were followed. Patients: Three patients treated for MFC at the Casey Eye Institute, a tertiary care referral center at Oregon Health & Science University, from 2005–2008 were studied. All three received fluocinolone acetonide implants and later underwent intravitreal anti–vascular endothelial growth factor (VEGF) therapy for CNV. Results: Preinjection visual acuity in 3 patients was 1.2, 0.54, and 0.48 logarithm of minimal angle of resolution (mean 0.74). Postinjection visual acuity in 3 patients was 1.0, 0.40, and 0.0 logarithm of minimal angle of resolution (mean 0.47). Preinjection central macular thicknesses were 855 μm, 215 μm, and 276 μm (mean 449 μm). Postinjection central macular thicknesses were 220 μm, 190 μm, and 223 μm (mean 211 μm). Anti-VEGF injections did not reactivate inflammation. Advancing cataracts contributed to worsening visual acuity postinjection. The total number of anti-VEGF injections until resolution of intraretinal and subretinal fluid associated with CNV was 6 injections for case 1, 1 for case 2, and 8 for case 3 (mean 5, range 1–8). Conclusion: Intravitreal anti-VEGF therapy was successful in treating recurrent CNV in MFC patients with well-controlled inflammation after insertion of fluocinolone acetonide implants. Anti-VEGF therapy should be considered in treating active CNV in eyes with MFC and quiescent inflammatory disease.

Objective The purpose of this study was to evaluate systemic and ophthalmic features associated with Cytomegalovirus (CMV) retinitis in immunocompetent patients. Design Retrospective chart review. Participants Nine patients with CMV retinitis who were clinically immunocompetent at the time of diagnosis. Methods Retrospective chart review of patients evaluated at the Casey Eye Institute, University of Washington, Bascom Palmer Eye Institute and University of Toronto. IRB approval was obtained. Retrospective chart review of patients evaluated at the Casey Eye Institute, University of Washington, Bascom Palmer Eye Institute and University of Toronto. IRB approval was obtained. Results Seven of the nine patients in our series were 60 years of age or above. Three patients had intravitreal steroid and VEGF inhibitor injections in the preceding year in the affected eye. Five of the nine patients were initially misdiagnosed to have acute retinal necrosis (ARN) for which they were on Valacyclovir for a variable period of time. Seven patients had anterior chamber and eight had vitreous inflammation. Six of the nine patients exhibited vascular attenuation or obliteration. All patients showed improvement in retinitis within weeks following therapy with intravitreal foscarnet and/or ganciclovir and systemic valganciclovir.

To the Editor: Rheumatologists sometimes collaborate with ophthalmologists in the management of patients with ocular inflammatory disease. Corticosteroids are often a valuable component of this management. Ophthalmic complications associated with corticosteroid usage include cataract and glaucoma. Corticosteroids have also been implicated in another important cause of visual loss, central serous retinopathy (CSR)1,2, a disorder characterized by neurosensory detachment of the retina affecting the macula. The combination of CSR, best managed by reduction in corticosteroid dosage, and inflammation usually requiring increased corticosteroid dosage creates a dilemma such that worsening visual acuity should be treated paradoxically with reduction in corticosteroid dosage. A 34-year-old male patient with history of juvenile idiopathic arthritis and uveitis complained of blurred vision in the left eye for 3 days, which was 3 weeks after increasing prednisone dose to 10 mg daily. He was functionally blind in the right eye due to band keratopathy. Vision was 20/25+2 in the left eye. The fundus examination revealed CSR, confirmed by ocular coherence tomography (OCT; Figure 1) and fluorescein … Address correspondence to Dr. S.R Gupta, 3375 SW Terwilliger Blvd., Portland, Oregon 97239; E-mail: seema\_r\_gupta{at}yahoo.com