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1.  Bilateral visual loss due to a giant olfactory meningioma 
Olfactory groove meningiomas can present as large and insidious masses in the anterior cranial base. Due to their location and minimal clinical symptoms, these tumors can go undetected until they have grown extremely large. We present a clinical case and discuss the surgical management of a 63-year-old man who presented for an initial eye examination with bilateral visual loss for over 2 years due to a giant olfactory meningioma encompassing his entire frontal lobe and compressing on his optic nerves.
PMCID: PMC3299556  PMID: 22419855
olfactory groove meningioma; anterior skull base; optic atrophy; bilateral visual loss
2.  Long-Term Visual Outcomes for a Treat and Extend Anti-Vascular Endothelial Growth Factor Regimen in Eyes with Neovascular Age-Related Macular Degeneration 
Journal of Clinical Medicine  2015;4(7):1380-1402.
With the advent of anti-vascular endothelial growth factor (VEGF) therapy, clinicians are now focused on various treatment strategies to better control neovascular age-related macular degeneration (NVAMD), a leading cause of irreversible blindness. Herein, we retrospectively reviewed consecutive patients with treatment-naïve NVAMD initially classified based on fluorescein angiography (FA) alone or with an anatomic classification utilizing both FA and optical coherence tomography (OCT) and correlated long-term visual outcomes of these patients treated with an anti-VEGF Treat-and-Extend Regimen (TER) with baseline characteristics including neovascular phenotype. Overall, 185 patients (210 eyes) were followed over an average of 3.5 years (range 1–6.6) with a retention rate of 62.9%, and visual acuity significantly improved with a TER that required a mean number of 8.3 (±1.6) (± standard deviation) intravitreal anti-VEGF injections/year (range 4–13). The number of injections and the anatomic classification were independent predictors of visual acuity at 6 months, 1, 2, 3 and 4 years. Patients with Type 1 neovascularization had better visual outcomes and received more injections than the other neovascular subtypes. There were no serious adverse events. A TER provided sustained long-term visual gains. Eyes with Type 1 neovascularization had better visual outcomes than those with other neovascular subtypes.
PMCID: PMC4519796
anatomical classification; choroidal neovascularization; fluorescein angiography classification; intravitreal anti-VEGF injections; neovascular age-related macular degeneration; Treat and Extend Regimen
3.  Distracted pedestrian sustains orbital fracture while on cell phone 
Use of cell phones in the general population has become increasingly commonplace. The distracting effects of cell phones among automobile drivers are well established, and legislation prohibits the use of handheld cell phones while driving in several states. Recent research has focused on the similar distracting effects of cell phones in the pedestrian population. In this report, an older gentleman suffered extensive facial trauma requiring surgery as a direct effect of cell phone use at the time the trauma occurred. This case highlights the role that portable electronic devices can play as a cause of ocular trauma.
PMCID: PMC3621686  PMID: 23579597
orbital fracture; ocular trauma; orbital floor fracture; cell phone distraction; pedestrian safety
4.  NAVILAS Laser System Focal Laser Treatment for Diabetic Macular Edema - One Year Results of a Case Series 
To report one year outcomes of focal Navigated Retina Laser Therapy (NAVILAS) for diabetic macular edema (DME).
Retrospective cohort series of 7 diabetic patients treated with NAVILAS focal laser. Statistical analysis included descriptive and continuous variables (Best-corrected logMAR Visual Acuity and time-domain optical coherence tomography (OCT) parameters) which were compared using a non-parametric procedure, the Friedman tests for repeated measures. A p-value of less than 0.05 was considered to denote statistical significance.
diabetic patients (4 male; 3 female) with an average age of 60.8 years (range 48-85 years) were included. All treated eyes were phakic; patients had an average hemoglobin A1C of 9.1 (range 7.8-11.7) at baseline and 8.0 (range 7.4-8.4) at 12 months. Six of the 7 patients had intravitreal bevacizumab injections prior to focal laser treatment with 1 patient having had more than 1 prior injection (total 3). At 12 months, median logMAR improved from 0.695 (± interquartile range 0.574) to 0.477 (± 0.573, p <0.001). OCT median central foveal thickness decreased from 248 (± 112) to 220 µm (± 41, p <0.001); total macular volume decreased from 7.84 (± 0.8) to 7.44 mm3 (± 0.7, p = 0.117); and largest macular subfield thickness decreased from 354 (± 116) to 289 µm (± 42, p <0.001). All patients were treated without complications.
Focal NAVILAS showed to be safe and effective in treating DME with improvement in visual acuity and macular edema on OCT over 12 months in this case series. In clinical practice, combined treatment with focal laser including NAVILAS and anti-vascular endothelial growth factor may provide long-term improvement in DME.
PMCID: PMC3785058  PMID: 24082979
Anti-VEGF; bevacizumab; diabetes; focal laser photocoagulation; macular edema; NAVILAS.
5.  High Definition Spectral Domain Optical Coherence Tomography Findings in Three Patients with Solar Retinopathy and Review of the Literature 
To describe ocular findings in 3 cases of solar retinopathy using high definition, spectral domain optical coherence tomography (SD-OCT) and review the literature for optical coherence tomography (OCT) characteristics associated with worse vision.
Case series and retrospective review of clinical features and Spectralis SD-OCT (Heidelberg Engineering, Vista, California, United States of America). A literature review of OCT findings in cases of solar retinopathy reported on MEDLINE was also performed and analyzed.
Six eyes of 3 patients with solar retinopathy revealed significant foveal pathology. Visual acuity ranged from Snellen 20/30 to 20/50. High definition SD-OCT demonstrated defects at the level of the inner and outer segment junction of the photoreceptors as well as in the inner high reflective layer. There was a significant correlation between chronic disruption of the inner photoreceptor junction with worse vision based on the current case series and literature review.
Screening patients with exposure to central foveal damage from solar retinopathy with high definition SD-OCT improves diagnosis and assessment of photoreceptor damage and vision loss.
PMCID: PMC3394112  PMID: 22798967
Solar retinopathy; fovea; spectral domain optical coherence tomography; Spectralis SD-OCT.
6.  Giant Corneal Keloid: Case Report and Review of the Literature 
Cornea  2010;29(12):1455-1458.
To report a patient with a tumor-like corneal keloid.
Retrospective review of clinical features and histopathologic findings.
A 68-year-old woman with a remote history of an orbital tumor treated with radiation developed a corneal tumor. A biopsy of the tumor showed fibrocellular tissue and her blind, painful eye was enucleated. Pathologic findings in the enucleated eye showed that the corneal mass was consistent with a large keloid.
A corneal keloid may clinically appear as a large corneal tumor.
PMCID: PMC2991373  PMID: 20856108
7.  Presumed Pyogenic Granuloma Associated with Intravitreal Anti-Vascular Endothelial Growth Factor Therapy 
To report a case of a presumed pyogenic granuloma at the site of multiple intravitreal anti-Vascular Endothelial Growth Factor (VEGF) injections. Intravitreal anti-VEGF injections can be complicated by a localized reaction of the conjunctiva.
PMCID: PMC3249641  PMID: 22216076
Ranibizumab (Lucentis); age-related macular degeneration; pyogenic granuloma; nodule; inflammation.

Results 1-7 (7)