34 results on '"Mruthyunjaya, Prithvi"'
Search Results
2. Diffuse Choroidal Hemangioma
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Mruthyunjaya, Prithvi, primary
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- 2020
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Catalog
3. Combined Hamartoma of the Retina and Retinal Pigment Epithelium
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Gabr, Hesham, primary and Mruthyunjaya, Prithvi, additional
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- 2020
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4. Choroidal Osteoma
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Mruthyunjaya, Prithvi, primary
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- 2020
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5. Circumscribed Choroidal Hemangioma
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Mruthyunjaya, Prithvi, primary
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- 2020
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6. Contributors
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Ali, Mohsin H., primary, Bleicher, Isaac, additional, Chen, Xi, additional, Dandridge, Alexandria, additional, El-Dairi, Mays, additional, Ely, Amanda, additional, Finn, Avni P., additional, Freedman, Sharon F., additional, Gabr, Hesham, additional, Grewal, Dilraj S., additional, House, Robert J., additional, Hsu, S. Tammy, additional, Kelly, Michael P., additional, Mangalesh, Shwetha, additional, Mruthyunjaya, Prithvi, additional, Ong, Sally S., additional, Rothman, Adam L., additional, Sarin, Neeru, additional, Scott, Adrienne W., additional, Tai, Vincent, additional, Thomas, Akshay, additional, Tian, James, additional, Toth, Cynthia A., additional, Tran-Viet, Du, additional, Vajzovic, Lejla, additional, Viehland, Christian, additional, Winter, Katrina Postell, additional, Yiu, Glenn, additional, Yoon, Steven, additional, and Zhang, Wenlan, additional more...
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- 2020
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7. Choroidal Nevus and Congenital Hypertrophy of the Retinal Pigment Epithelium
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Mruthyunjaya, Prithvi, primary
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- 2020
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8. Retinal Capillary Hemangioblastoma
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Mruthyunjaya, Prithvi, primary
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- 2020
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9. Retinal Astrocytic Hamartoma
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Mruthyunjaya, Prithvi, primary
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- 2020
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10. Central Retinal Vein Occlusion
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Hahn, Paul, primary, Mruthyunjaya, Prithvi, additional, and Fekrat, Sharon, additional
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- 2013
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11. Circumscribed Choroidal Hemangioma
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Day, Shelley, primary and Mruthyunjaya, Prithvi, additional
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- 2013
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12. List of Video Contributors
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Abrams, Gary W., primary, Ai, Everett, additional, Arevalo, J. Fernando, additional, Arumi, Jose Garcia, additional, Aylward, G. William, additional, Bennett, Jean, additional, Binder, Susanne, additional, Castillo, Vicente Martinez, additional, Chang, Stanley, additional, Charles, Martin, additional, Chong, Lawrence P., additional, Claes, Carl, additional, Constable, Ian J., additional, da Cruz, Lyndon, additional, Damato, Bertil E., additional, Fu, Arthur D., additional, Garcia-Valenzuela, Enrique, additional, Gaudric, Alain, additional, Gomes, Andre Vieira, additional, Gonzales, Christine R, additional, Gregor, Zdenek, additional, Gotzaridis, Stratos, additional, Heimann, Heinrich, additional, Holekamp, Nancy M., additional, Hsu, Jason, additional, Humayun, Mark S., additional, Ikuno, Yasushi, additional, Jackson, Timothy L, additional, Jaffe, Glenn J., additional, Johnson, Robert N., additional, Jumper, J. Michael, additional, Kirchhof, Bernd, additional, Kreiger, Allan E, additional, Kwan, Anthony, additional, Lee, Henry C., additional, Lim, Jennifer I., additional, Maguire, Albert M., additional, McDonald, H. Richard, additional, Meier, Petra, additional, van Meurs, Jan C., additional, Morales-Canton, Virgilio, additional, Mruthyunjaya, Prithvi, additional, Nagpal, Manish, additional, Nakashima, Yoshitaka, additional, Nanda, Sumit K., additional, Oshima, Yusuke, additional, Rayes, Ehab N EL, additional, Recchia, Franco M., additional, Rezaei, Kourous A., additional, Rizzo, Stanislao, additional, Rushood, Abdulaziz Adel, additional, Samuel, Michael, additional, Sivagnanavel, V, additional, Sjaarda, Raymond N, additional, de Souza, Eduardo C, additional, Stopa, Marcin, additional, Sullivan, Paul, additional, Terasaki, Hiroko, additional, Thompson, John T., additional, Toth, Cynthia A., additional, Trese, Michael T., additional, Wiedemann, Peter, additional, Witkin, Andre J., additional, and Yoon, Young Hee, additional more...
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- 2013
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13. Contributors
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Abràmoff, Michael, primary, Abrams, Gary W., additional, Agarwal, Anita, additional, Ai, Everett, additional, Aiello, Lloyd M., additional, Aiello, Lloyd Paul, additional, Albert, Daniel M., additional, Aschbrenner, Mathew W., additional, Ávila, Marcos, additional, Aylward, G. William, additional, Bedell, Matthew, additional, Belfort, Rubens, additional, Bennett, Jean, additional, Bergstrom, Chris, additional, Besirli, Cagri G., additional, Bhende, Pramod S., additional, Binder, Susanne, additional, Bird, Alan C., additional, Blodi, Barbara A., additional, Blumenkranz, Mark S., additional, Boldt, H. Culver, additional, Bornfeld, Norbert, additional, Bottoni, Ferdinando, additional, Boulton, Michael E., additional, Bowne, Sara J., additional, Brantley, Milam A., additional, Bressler, Neil M., additional, Bressler, Susan B., additional, Bringmann, Andreas, additional, Brinton, Daniel A., additional, Brown, Gary C., additional, Brown, Justin C., additional, Brunner, Simon, additional, Bush, Ronald A., additional, Cao, Dingcai, additional, Capone, Antonio, additional, Carruthers, David, additional, Cavallerano, Jerry D., additional, Chakravarthy, Usha, additional, Chan, Chi-Chao, additional, Chan, Waiman, additional, Charles, Steven, additional, Charteris, David G., additional, Chen, Dong Feng, additional, Chen, Jeannie, additional, Chen, Youxin, additional, Cheung, Carol Yim Lui, additional, Chew, Emily Y., additional, Chiang, Allen, additional, Chiang, Michael F., additional, Constable, Ian J., additional, Coscas, Gabriel, additional, Cruess, Alan F., additional, Cunningham, Emmett T., additional, Curcio, Christine A., additional, Daiger, Stephen P., additional, Damato, Bertil E., additional, Davis, Janet L., additional, Davis, Matthew D., additional, Day, Shelley, additional, De Potter, Patrick, additional, de Smet, Marc D., additional, Denniston, Alastair K., additional, Dhaliwal, Ranjit S., additional, Ding, Xiaoyan, additional, Do, Diana V., additional, Dou, Guorui, additional, Dunn, William A., additional, Ehlers, Justis P., additional, Engelbert, Michael, additional, Faia, Lisa J., additional, Falsini, Benedetto, additional, Fawzi, Amani A., additional, Fekrat, Sharon, additional, Feldon, Steven E., additional, Fernandes, Rodrigo A. Brant, additional, Ferreyra, Henry A., additional, Ferrington, Deborah A., additional, Ferris, Frederick L., additional, Finger, Paul T., additional, Fisher, Steven K., additional, Fishman, Gerald A., additional, Fleckenstein, Monika, additional, Flynn, Harry W., additional, Fok, Andrew C., additional, Foulds, Wallace S., additional, Freeman, William R., additional, Freton, Aurélien, additional, Friedlander, Martin, additional, Frishman, Laura J., additional, Fu, Arthur D., additional, Garcia Filho, Carlos Alexandre de Amorim, additional, Garcia-Valenzuela, Enrique, additional, Gaudric, Alain, additional, Gayed, Mary, additional, Genead, Mohamed A., additional, Gerding, Heinrich, additional, Giani, Andrea, additional, Goldberg, Morton F., additional, Gombos, Dan S., additional, Gopal, Lingam, additional, Gordon, Caroline, additional, Goto, Hiroshi, additional, Gragoudas, Evangelos S., additional, Grant, Maria B., additional, Green, W. Richard, additional, Gregg, Ronald G., additional, Gregor, Zdenek, additional, Gregori, Giovanni, additional, Gregory-Evans, Kevin, additional, Grob, Seanna, additional, Groenewald, Carl, additional, Grossniklaus, Hans E., additional, Grover, Sandeep, additional, Gullapalli, Vamsi K., additional, Gupta, Aditi, additional, Guthoff, Rudolf F., additional, Hahn, Paul, additional, Haller, Julia A., additional, Harbour, J. William, additional, Haritoglou, Christos, additional, Hartnett, Mary E., additional, Hawkins, Barbara S., additional, He, Shikun, additional, Herwig, Martina C., additional, Heussen, Florian M.A., additional, Hinton, David R., additional, Holz, Frank G., additional, Houston, Samuel K., additional, Hui, Yan-Nian, additional, Humayun, Mark S., additional, Ikuno, Yasushi, additional, Isaac, David, additional, Ishibashi, Tatsuro, additional, Jabs, Douglas A., additional, Jaffe, Glenn J., additional, Jampol, Lee M., additional, Joffe, Leonard, additional, Johnson, Mark, additional, Johnson, Mark W., additional, Johnson, Robert N., additional, Joussen, Antonia M., additional, Julian, Karina, additional, Jumper, J. Michael, additional, Kaiser, Peter K., additional, Kampik, Anselm, additional, Katamay, Robert, additional, Kay, Christine N., additional, Keane, Pearse A., additional, Kenney, M. Cristina, additional, Khaderi, Khizer R., additional, Khodair, Mohamad A., additional, Kim, Ivana K., additional, Kim, Tae Wan, additional, Kirchhof, Bernd, additional, Klein, Barbara E.K., additional, Klein, Ronald, additional, Konstantinidis, Lazaros, additional, Kozak, Igor, additional, Kuppermann, Baruch D., additional, Labriola, Leanne T., additional, Lai, Timothy Y., additional, Lam, Dennis S., additional, Lam, Linda A., additional, Landers, Maurice B., additional, Lane, Anne Marie, additional, Lavik, Erin B., additional, Leary, James F., additional, Lee, Sun Young, additional, Lee, Thomas C., additional, Leung, Loh-Shan B., additional, Lewis, David A., additional, Lewis, Geoffrey P., additional, Leys, Anita, additional, Li, Xiaoxin, additional, Liakopoulos, Sandra, additional, Lin, Chang-Ping, additional, Lin, Phoebe, additional, Liu, David T., additional, London, Nikolas J.S., additional, Lujan, Brandon J., additional, Luo, Yan, additional, Lutty, Gerard A., additional, MacLaren, Robert, additional, Madreperla, Steven, additional, Maguire, Albert M., additional, Mainster, Martin A., additional, Mansfield, Nancy C., additional, Markoe, Arnold M., additional, Marmor, Michael F., additional, Martin, Daniel F., additional, Massey, Stephen C., additional, McCall, Maureen A., additional, McCannel, Tara A., additional, McCutchan, J. Allen, additional, McDonald, H. Richard, additional, Mehta, Milap P., additional, Meier, Petra, additional, Merbs, Shannath, additional, Meredith, Travis A., additional, Meyer, Carsten H., additional, Mieler, William F., additional, Miller, Joan W., additional, Mirza, Rukhsana G., additional, Mitter, Sayak K., additional, Mittra, Robert A., additional, Miyake, Yozo, additional, Montemagno, Carlo, additional, Moshiri, Ala, additional, Mruthyunjaya, Prithvi, additional, Muccioli, Cristina, additional, Mullins, Robert F., additional, Murata, Toshinori, additional, Murphree, A. Linn, additional, Murphy, Robert P., additional, Murray, Philip I., additional, Murray, Timothy G., additional, Nagpal, Manish, additional, Namperumalsamy, Perumalsamy, additional, Nanda, Sumit K., additional, Nguyen, Quan Dong, additional, Nussenblatt, Robert B., additional, Oh, Kean T., additional, Ohji, Masahito, additional, Ohno-Matsui, Kyoko, additional, Palanker, Daniel, additional, Patel, Purnima S., additional, Pavlick, Anna C., additional, Peereboom, David M., additional, Pennesi, Mark E., additional, Pepose, Jay S., additional, Perry, Julian D., additional, Puliafito, Carmen A., additional, Quiram, Polly A., additional, Raman, Rajiv, additional, Ramchandran, Rajeev S., additional, Rao, Haripriya Vittal, additional, Rao, Narsing A., additional, Rao, P. Kumar, additional, Rathinam, Sivakumar R., additional, Recchia, Franco M., additional, Redmond, Kristin J., additional, Reh, Thomas A., additional, Reichenbach, Andreas, additional, Ritch, Robert, additional, Rosenfeld, Philip J., additional, Rubin, Gary S., additional, Ruiz-Garcia, Humberto, additional, Ryan, Stephen J., additional, Sadda, SriniVas R., additional, Sadun, Alfredo A., additional, Sakamoto, Taiji, additional, Sampath, Alapakkam P., additional, Schachat, Andrew P., additional, Schmitz-Valckenberg, Steffen, additional, Schwartz, Stephen G., additional, Scott, Adrienne W., additional, Sebag, Jerry, additional, Seddon, Johanna M., additional, Sen, H. Nida, additional, Sepah, Yasir Jamal, additional, Sharma, Sanjay, additional, Sharma, Tarun, additional, Sheu, Shwu-Jiuan, additional, Shields, Carol L., additional, Shields, Jerry A., additional, Shinoda, Kei, additional, Shukla, Dhananjay, additional, Sieving, Paul A., additional, Silva, Paolo A.S., additional, Silveira, Claudio, additional, Singh, Arun D., additional, Smith, Sylvia B., additional, Smith, Wendy M., additional, Sobrin, Lucia, additional, Sodhi, Akrit, additional, Sohn, Elliott H., additional, Soubrane, Gisèle, additional, Spielberg, Leigh, additional, Srivastava, Sunil K., additional, Stachs, Oliver, additional, Staurenghi, Giovanni, additional, Sternberg, Paul, additional, Stone, Edwin M., additional, Sugino, Ilene K., additional, Sullivan, Lori S., additional, Sullivan, Paul, additional, Sun, Jennifer K., additional, Sunness, Janet S., additional, Tadayoni, Ramin, additional, Tang, Shibo, additional, Terasaki, Hiroko, additional, Thomas, Matthew A., additional, Thompson, John T., additional, Thumann, Gabriele, additional, Toth, Cynthia A., additional, Trese, Michael T., additional, Tsai, Julie H., additional, Turell, Mary E., additional, Turner, Patricia L., additional, Udar, Nitin, additional, Ulrich, J. Niklas, additional, Van Gelder, Russell N., additional, van Meurs, Jan C., additional, Vasconcelos-Santos, Daniel Vítor, additional, Vavvas, Demetrios G., additional, Vemulakonda, G. Atma, additional, Wang, Hao, additional, Wang, Yusheng, additional, Weiland, James D., additional, Weleber, Richard G., additional, Wharam, Moody D., additional, Wickham, Louisa, additional, Wiedemann, Peter, additional, Wiley, Henry E., additional, Wilkinson, C.P., additional, Wilson, David J., additional, Wolfensberger, Thomas J., additional, Wong, David, additional, Wong, Ian Y., additional, Wong, Tien Yin, additional, Wu, David M., additional, Yandiev, Yanors, additional, Yang, Chang-Hao, additional, Yang, Chung-May, additional, Yannuzzi, Lawrence A., additional, Yasuda, Miho, additional, Yeh, Po-Ting, additional, Yehoshua, Zohar, additional, Yiu, Glenn, additional, Yoon, Young Hee, additional, Yu, Hyeong Gon, additional, Yuan, Alex, additional, Zarbin, Marco A., additional, Zhang, Jun Jun, additional, Zhang, Kang, additional, Zhao, Mingwei, additional, and Zhou, Peng, additional more...
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- 2013
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14. Contributors
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Acheson, James F., primary, Adams, G.G.W., additional, Amure, Larry, additional, Andrews, Richard, additional, Barton, Keith, additional, Bates, Adam, additional, Bird, Alan C., additional, Bloom, Jill, additional, Brookes, John, additional, Burton, Ben J.L., additional, Collin, Richard O., additional, Cook, Helen L., additional, Cunningham, Carol, additional, Cruz, Lyndon Da, additional, Dandekar, Samantha, additional, Dart, John K.G., additional, Egan, Catherine, additional, Ehrlich, Daniel P., additional, El-Amir, Ahmed N., additional, Foster, Paul J., additional, Franks, Wendy, additional, Gartry, David, additional, Garway-Heath, Ted, additional, Goh, David, additional, Gregor, Zdenek J., additional, Hardy, Thomas, additional, Hart, Richard H., additional, Henderson, Hugo, additional, Holder, Graham E., additional, Hungerford, John L., additional, Jackson, Timothy L., additional, Jain, Rajni, additional, Khaw, Peng T., additional, Lightman, Susan L., additional, Lim, Natasha, additional, Macalister, Graham, additional, Manzouri, Bita, additional, Martin, Keith, additional, McCarry, Bernadette, additional, McElhatton, Patricia, additional, Merriman, Michael, additional, Michaelides, Michel, additional, Mohammed, Moin, additional, Moore, A.T., additional, Mruthyunjaya, Prithvi, additional, Murdoch, Ian, additional, Nambiar, Anil, additional, Nolan, Winifred, additional, Okhravi, Narciss, additional, Pavesio, Carlos E., additional, Plant, Gordon T., additional, Papadopoulos, Maria, additional, Rai, Poornima, additional, Rajan, Madhavan, additional, Ramchandani, Mahesh, additional, Ramkissoon, Yashin, additional, Restori, Marie, additional, Roberson, Geoff, additional, Rose, Geoffrey E., additional, Sehmi, Kulwant, additional, Siriwardena, Dilani, additional, Sloper, John, additional, Smith, Guy T., additional, Sullivan, Paul M., additional, Timms, Chris, additional, Tufail, Adnan, additional, Uddin, Jimmy, additional, Verity, David H., additional, and Viswanathan, Ananth, additional more...
- Published
- 2008
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15. Central Retinal Vein Occlusion
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Mruthyunjaya, Prithvi, primary and Fekrat, Sharon, additional
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- 2006
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16. Contributors
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Aaberg, Thomas M., primary, Abdel-Rahman, Mohamed H., additional, Abrams, Gary W., additional, Agarwal, Anita, additional, Ai, Everett, additional, Albert, Daniel M., additional, Alexander, Judith, additional, Anand, Rajiv, additional, Anastassiou, Gerasimos, additional, Aylward, G. William, additional, Barazi, Mohammed K., additional, Bingaman, David, additional, Bird, Alan C., additional, Blodi, Barbara A., additional, Blumenkranz, Mark S., additional, Bolling, James P., additional, Bornfeld, Norbert, additional, Bressler, Susan B., additional, Bressler, Neil M., additional, Brinton, Daniel A., additional, Brown, Jeremiah, additional, Brown, Gary C., additional, Brown, Justin C., additional, Buettner, Helmut, additional, de Bustros, Serge, additional, Byrne, Sandra Fraser, additional, Cahill, Mark T., additional, Campochiaro, Peter A., additional, Carr, Ronald E., additional, Chang, Stanley, additional, Charles, Steve, additional, Chen, Jeannie, additional, Chen, Clara A., additional, Chew, Emily Y., additional, Chorich, Louis J., additional, Chow, David R., additional, Ciardella, Antonio P., additional, Ciulla, Thomas A., additional, Coscas, Gabriel J., additional, Cruess, Alan F., additional, da Cruz, Lyndon, additional, Damato, Bertil E., additional, Davidorf, Frederick H., additional, Davis, Matthew D., additional, Davis, Janet L., additional, Deutman, August F., additional, Dhaliwal, Ranjit S., additional, Do, Diana V., additional, Dugel, Pravin U., additional, Earle, John D., additional, Edwards, Albert O., additional, Eliott, Dean, additional, Emerson, Geoffrey G., additional, Fekrat, Sharon, additional, Feldon, Steven E., additional, Ferris, Frederick L., additional, Fine, Stuart L., additional, Finkelstein, Daniel, additional, Fisher, Steven K., additional, Flannery, John, additional, Folk, James C., additional, Foulds, Wallace S., additional, Frank, Robert N., additional, Freeman, William R., additional, Friedlander, Martin, additional, Frishman, Laura J., additional, Fu, Arthur D., additional, Fujii, Gildo Y., additional, Gallemore, Ron P., additional, Garibaldi, Daniel C., additional, Garcia-Valenzuela, Enrique, additional, Gass, J. Donald M., additional, Gautier, Sandrine, additional, Geller, Scott, additional, Goldberg, Morton F., additional, Gonzales, Christine R., additional, Gottlieb, Justin L., additional, Gragoudas, Evangelos S., additional, Green, Ronald L., additional, Green, W. Richard, additional, Gregor, Zdenek J., additional, Gregory-Evans, Kevin, additional, Gross, Nicole E., additional, Gullapalli, Vamsi K., additional, Guyer, David R., additional, Guymer, Robyn, additional, Haller, Julia A., additional, Harbour, J. William, additional, Harlan, Joseph B., additional, Harris, Alon, additional, Hartnett, Mary Elizabeth, additional, Hartzer, Michael K., additional, Hawkins, Barbara S., additional, Heimann, Heinrich, additional, Hinton, David R., additional, Hinz, Brad J., additional, Hoffmann, Stephan, additional, Holekamp, Nancy M., additional, Holland, Gary N., additional, Hoyng, Carel B., additional, Humayun, Mark S., additional, Ikuno, Yasushi, additional, Jabs, Douglas A., additional, Jaffe, Glenn J., additional, Jallet, Valérie, additional, Jampol, Lee M., additional, Joffe, Leonard, additional, Johnson, Robert N., additional, Joseph, Daniel P., additional, de Juan, Eugene, additional, Michael Jumper, J., additional, Kaplan, Henry J., additional, Kelley, James S., additional, Khodair, Mohamad A., additional, Kirchhof, Bernd, additional, Klais, Christina M., additional, Klein, Barbara E.K., additional, Klein, Ronald, additional, Kline, Robert W., additional, Knox, David L., additional, Kosobucki, Brian R., additional, Kreiger, Allan E., additional, Kunimoto, Derek Y., additional, Kwun, Robert Choi, additional, Lakhanpal, Rohit R., additional, Lam, Linda A., additional, Landers, Maurice B., additional, Lane, Anne Marie, additional, Lee, Michael S., additional, Lee, Henry C., additional, Lewis, Hilel, additional, Lewis, Geoffrey P., additional, Lim, Wee-Kiak, additional, Lit, Eugene S., additional, Loewenstein, Anat, additional, Lopez, José Manuel, additional, Lutty, Gerard A., additional, Madreperla, Steven, additional, Maguire, Albert M., additional, Mainster, Martin A., additional, Mansfield, Nancy C., additional, Marmor, Michael F., additional, Martin, Bruce J., additional, Massey, Stephen C., additional, Mavrofrides, Elias C., additional, McCuen, Brooks W., additional, Richard McDonald, H., additional, Meier, Petra, additional, Merbs, Shannath L., additional, Meredith, Travis A., additional, Mieler, William F., additional, Miller, Robert F., additional, Miller, Joan W., additional, Milne, Peter, additional, Mittra, Robert A., additional, Moshfeghi, Darius M., additional, Moshfeghi, Andrew A., additional, Moshiri, Ala, additional, Mruthyunjaya, Prithvi, additional, Murata, Toshinori, additional, Murphree, A. Linn, additional, Murphy, Robert P., additional, Nanda, Sumit K., additional, Nguyen, Quan Dong, additional, Nussenblatt, Robert B., additional, Ober, Michael D., additional, Ober, Richard R., additional, Ogden, Thomas E., additional, Oh, Kean T., additional, Ohji, Masahito, additional, Olsen, Karl R., additional, Palanker, Daniel, additional, Palmer, Earl A., additional, Parel, Jean-Marie, additional, Park, Carl H., additional, Pederson, Jonathan E., additional, Pelzek, Christopher D., additional, Pepose, Jay S., additional, Phelps, Dale L., additional, Phillips, Stephen, additional, Pokorny, Joel, additional, Puliafito, Carmen A., additional, Rao, Narsing A., additional, Kumar Rao, P., additional, Recchia, Franco M., additional, Reh, Thomas A., additional, Robertson, Dennis M., additional, Robertson, Joseph E., additional, Rubin, Gary S., additional, Ryan, Stephen J., additional, Sadda, Srinivas R., additional, Sadun, Alfredo A., additional, Sahel, José Alain, additional, de la Maza, Maite Sainz, additional, Samuel, Michael A., additional, Sanborn, George E., additional, Sarks, John P., additional, Sarks, Shirley H., additional, Schachat, Andrew P., additional, Sebag, J., additional, Seddon, Johanna M., additional, Sharma, Sanjay, additional, Sheffield, Val C., additional, Shields, Carol L., additional, Shields, Jerry A., additional, Singh, Arun, additional, Sjaarda, Raymond N., additional, Slakter, Jason S., additional, Smith, Vivianne C., additional, Smith, Ronald E., additional, Solomon, Sharon D., additional, Soubrane, Gisele, additional, Spencer, Rand, additional, Sternberg, Paul, additional, Stewart, Jay M., additional, Stone, Edwin M., additional, Sugino, Ilene K., additional, Sunness, Janet S., additional, Tano, Yasuo, additional, Tasman, William S., additional, Thomas, Matthew A., additional, Thompson, John T., additional, Thorne, Jennifer E., additional, Thumann, Gabriele, additional, Toth, Cynthia A., additional, Trese, Michael T., additional, Tsai, Linda M., additional, Turner, Patricia L., additional, Tweito, Timothy H., additional, Updike, Paul G., additional, Van Gelder, Russell N., additional, van Lith-Verhoeven, Janneke J.C., additional, Vaudaux, Jean D., additional, Villain, Franck, additional, Vitale, Albert T., additional, Walker, Jonathan D., additional, Walsh, Alexander C., additional, Wang, Hao, additional, Webster, Andrew R., additional, Weiland, James D., additional, Weiter, John J., additional, Weleber, Richard G., additional, Wharam, Moody D., additional, Jeffrey Whitehead, A., additional, Wiedemann, Peter, additional, Wilkinson, C.P., additional, Williams, George A., additional, Willson, James K.V., additional, Wilson, David J., additional, Win, Peter H., additional, Yannuzzi, Lawrence A., additional, Yoon, Young Hee, additional, Young, Tara A., additional, Zarbin, Marco A., additional, and Zhang, Kang, additional more...
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- 2006
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17. An Unusual Pigmented Lesion.
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Thakur S, Guo LY, and Mruthyunjaya P
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- 2025
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18. Ocular Neovascular Conversion and Systemic Bleeding Complications in Patients with Age-Related Macular Degeneration on Anticoagulants.
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Alsoudi AF, Koo E, Wai K, Mruthyunjaya P, and Rahimy E
- Abstract
Purpose: Conversion to neovascular disease in patients with non-neovascular age-related macular degeneration (AMD) initiated on direct oral anticoagulants (DOACs) compared with matched patients treated with warfarin., Design: Retrospective cohort study., Participants: The study included 20 300 patients and 13 387 patients with non-neovascular AMD initiated on DOACs or warfarin, respectively, before propensity score matching (PSM)., Methods: TriNetX was used to identify patients diagnosed with non-neovascular AMD stratified by treatment with DOACs or warfarin with at least 6 months of follow-up. Propensity score matching was performed to control for baseline demographics and medical comorbidities., Main Outcome Measures: Relative risk (RR) of developing neovascular AMD, macular hemorrhage (MH), vitreous hemorrhage (VH), and requiring an ocular intervention (intravitreal anti-VEGF therapy or pars plana vitrectomy [PPV]) within 6 months and 1 year. Patients with chronic atrial fibrillation (AF) on anticoagulation were separately evaluated for the same measures within 5 years after initiating therapy., Results: Treatment with warfarin was associated with a higher risk of developing neovascular AMD at 6 months (RR, 1.24, 95% confidence interval [CI], 1.12-1.39; P < 0.001) and 1 year (RR, 1.26, 95% CI, 1.14-1.40; P < 0.001) when compared with matched patients treated with DOACs. There was an increased risk of requiring intravitreal anti-VEGF therapy (6 months: RR, 1.30; 95% CI, 1.13-1.49; P < 0.001; 1 year: RR, 1.31, 95% CI, 0.72-2.05; P < 0.001) and PPV (6 months: RR, 2.13; 95% CI, 1.16-3.94; P = 0.01; 1 year: RR, 2.29, 95% CI, 1.30-4.05; P = 0.003). Among patients with AMD and AF treated with warfarin, there was an increased risk of ocular complications (neovascular AMD: RR, 1.25; 95% CI, 1.14-1.38; P < 0.001; MH: RR, 1.86; 95% CI, 1.47-2.35; P < 0.001; VH: RR, 2.22; 95% CI, 1.51-3.26; P < 0.001) and need for intravitreal anti-VEGF therapy (RR, 1.34; 95% CI, 1.18-1.52; P < 0.001) over an extended 5-year period. There was no significant difference in the development of major systemic hemorrhagic events between the 2 cohorts over 5 years., Conclusions: Patients with non-neovascular AMD treated with warfarin were more likely to develop neovascular disease and require ocular intervention for hemorrhagic complications when compared with matched patients initiated on DOACs., Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
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- 2024
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19. Association of Cutaneous Keloids, Hypertrophic Scarring, and Fibrosis with Risk of Postoperative Proliferative Vitreoretinopathy.
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Mammo DA, Wai K, Rahimy E, Pan CK, Srivastava SK, and Mruthyunjaya P
- Subjects
- Humans, Female, Male, Retrospective Studies, Middle Aged, Adult, Aged, Risk Factors, Scleral Buckling, Keloid, Vitreoretinopathy, Proliferative surgery, Vitreoretinopathy, Proliferative diagnosis, Vitreoretinopathy, Proliferative etiology, Cicatrix, Hypertrophic etiology, Cicatrix, Hypertrophic epidemiology, Fibrosis, Retinal Detachment surgery, Retinal Detachment diagnosis, Vitrectomy adverse effects, Postoperative Complications
- Abstract
Purpose: To assess an association between cutaneous keloids, hypertrophic scarring, and fibrosis (KHF) and risk of postoperative proliferative vitreoretinopathy (PVR) after rhegmatogenous retinal detachment (RRD) repair., Design: Retrospective, population-based cohort study., Participants: Patients aged ≥ 18 years who underwent initial retinal detachment (RD) repair with pars plana vitrectomy with or without scleral buckle (SB) (Current Procedural Terminology [CPT] 67108), pneumatic retinopexy (67110), and primary SB (67107) from January 1, 2003, to March 1, 2023., Methods: A de-identified electronic health record database through TriNetX, a global health research network, was used to analyze patients. Patients were queried for International Classification of Diseases, 10
th Revision (ICD-10) codes L91.0 (hypertrophic scar) and L90.5 (scar conditions and fibrosis of skin). Frequency of subsequent diagnosis of PVR (H35.2) and CPT codes for secondary surgery including complex RD repair (67113) were determined. Patients with proliferative diabetic retinopathy (PDR) (ICD-10 H10.35/H11.35) were excluded. Descriptive statistics (Z-test) and propensity score matching (PSM) were used to match for age, sex, and race., Main Outcome Measures: Prevalence of H35.2 and CPT 67113 within 180 days after RRD repair in the KHF cohort versus the non-KHF cohort., Results: Among patients with CPT 67108, 1061 in each cohort (KHF and non-KHF) were analyzed after PSM. The mean (standard deviation) age was 60.7 (15.2) years. Within 180 days, 10.1% of patients in the KHF cohort and 3.4% in the non-KHF cohort had a diagnosis of PVR (H35.2) (P < 0.001, odds ratio [OR], 3.2; 95% confidence interval [CI], 2.13-4.71). A total of 8.3% of patients in the KHF cohort and 5.4% of patients in the non-KHF cohort underwent complex RD repair (CPT 67113) (P = 0.008; OR, 3.2; 95% CI, 1.13-2.25). When including all RD repair types (CPT 67108, 67110, 67107), the rate of PVR diagnosis was still significantly greater in the KHF cohort than in the non-KHF cohort (9.0% vs 4.2%, P < 0.01; OR, 2.28; 95% CI, 1.64-3.16)., Conclusions: A dermatologic history of KHF may be a risk factor for PVR after RD repair., Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...- Published
- 2024
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20. Reply.
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Zhang C, Friedman S, Mruthyunjaya P, and Parikh R
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- 2023
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21. The Biosimilar Paradox: How Anti-Vascular Endothelial Growth Factor Biosimilars Could Increase Patient and Overall Health Care Costs.
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Zhang C, Friedman S, Mruthyunjaya P, and Parikh R
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- Aged, Humans, United States, Ranibizumab, Bevacizumab, Angiogenesis Inhibitors therapeutic use, Endothelial Growth Factors, Vascular Endothelial Growth Factor A, Receptors, Vascular Endothelial Growth Factor therapeutic use, Health Care Costs, Recombinant Fusion Proteins therapeutic use, Intravitreal Injections, Biosimilar Pharmaceuticals therapeutic use, Medicare Part B
- Abstract
Purpose: Anti-vascular endothelial growth factor (VEGF) medications for intraocular use are a major and increasing cost, and biosimilars may be a means of reducing the high cost of many biologic medications. However, a bevacizumab biosimilar, which is currently pending Food and Drug Administration (FDA) approval (bevacizumab-vikg), paradoxically may increase the cost burden of intravitreal anti-VEGF agents, because off-label repackaged drugs may no longer be allowed per the Drug Quality and Security Act (DQSA). We aimed to investigate the potential impact of biosimilars on costs in the United States., Design: Cost analysis of anti-VEGF medications., Participants: Medicare data from October 2022 and previously published market share data from 2019., Methods: Average sales prices (ASPs) of ranibizumab, aflibercept, and bevacizumab were calculated from Medicare allowable payments. The ASPs of biosimilars were calculated from wholesale acquisition costs from a representative distributor. The cost of an intraocular bevacizumab formulation is modeled at $500/1.25-mg dose and $900/1.25-mg dose., Main Outcome Measures: Costs of anti-VEGF drugs to Medicare Part B and patients., Results: If an intraocular bevacizumab biosimilar were to be priced at $500, costs to Medicare would increase by $457 million from $3.01 billion to $3.47 billion (15.2% increase). Patient responsibility would increase by $117 million from $768 million to $884 million. Similarly, if intraocular bevacizumab were priced at $900, Medicare costs would increase by $897 million to $3.91 billion (29.8% increase), and patient responsibility would increase by $229 million to $997 million. If bevacizumab were $500/dose, switching all patients currently receiving ranibizumab or aflibercept to respective biosimilars would compensate for only 28.8% of the increased cost. Current prices of ranibizumab and aflibercept biosimilars would have to decrease by an aggregate of 15.7% to $616.80/injection, $1027.97/injection, and $1436.88/injection for ranibizumab 0.3 mg, ranibizumab 0.5 mg, and aflibercept, respectively., Conclusions: An FDA-approved bevacizumab biosimilar for ophthalmic use could increase costs to the health care system and patients, raising concerns for access. This increase would not be offset by ranibizumab and aflibercept biosimilar use at current prices. These data support the need for an exemption of section 503B of the DQSA and continued use of repackaged off-label bevacizumab., Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (Copyright © 2023 American Academy of Ophthalmology. All rights reserved.) more...
- Published
- 2023
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22. Intravitreal Pharmacotherapies for Diabetic Macular Edema: A Report by the American Academy of Ophthalmology.
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Ehlers JP, Yeh S, Maguire MG, Smith JR, Mruthyunjaya P, Jain N, Kim LA, Weng CY, Flaxel CJ, Schoenberger SD, and Kim SJ
- Subjects
- Academies and Institutes standards, Bevacizumab therapeutic use, Databases, Factual, Dexamethasone therapeutic use, Diabetic Retinopathy physiopathology, Drug Therapy, Humans, Intravitreal Injections, Macular Edema physiopathology, Ophthalmology organization & administration, Ranibizumab therapeutic use, Receptors, Vascular Endothelial Growth Factor therapeutic use, Recombinant Fusion Proteins therapeutic use, Technology Assessment, Biomedical, Treatment Outcome, United States, Visual Acuity physiology, Angiogenesis Inhibitors therapeutic use, Diabetic Retinopathy drug therapy, Glucocorticoids therapeutic use, Macular Edema drug therapy, Vascular Endothelial Growth Factor A antagonists & inhibitors
- Abstract
Purpose: To review the evidence on the safety and efficacy of current anti-vascular endothelial growth factor (VEGF) and intravitreal corticosteroid pharmacotherapies for the treatment of diabetic macular edema (DME)., Methods: Literature searches were last conducted on May 13, 2020, in the PubMed database with no date restrictions and limited to articles published in English. The combined searches yielded 230 citations, of which 108 were reviewed in full text. Of these, 31 were deemed appropriate for inclusion in this assessment and were assigned a level of evidence rating by the panel methodologist., Results: Only the 21 articles with level I evidence were included in this assessment. Seventeen articles provided level I evidence for 1 or more anti-VEGF pharmacotherapies, including ranibizumab (14), aflibercept (5), and bevacizumab (2) alone or in combination with other treatments for DME. Level I evidence was identified in 7 articles on intravitreal corticosteroid therapy for treatment of DME: triamcinolone (1), dexamethasone (4), and fluocinolone acetonide (2)., Conclusions: Review of the available literature indicates that intravitreal injections of anti-VEGF agents and corticosteroids are efficacious treatments for DME. Elevated intraocular pressure and cataract progression are important potential complications of corticosteroid therapy. Further evidence is required to assess the comparative efficacy of these therapies. Given the limited high-quality comparative efficacy data, choice of therapy must be individualized for each patient and broad therapeutic access for patients is critical to maximize outcomes., (Copyright © 2021 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2022
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23. Medical Malpractice Lawsuits Involving Ophthalmology Trainees.
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Watane A, Kalavar M, Chen EM, Mruthyunjaya P, Cavuoto KM, Sridhar J, and Parikh R
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- Humans, Ophthalmology legislation & jurisprudence, Education, Medical, Graduate legislation & jurisprudence, Internship and Residency, Malpractice legislation & jurisprudence, Ophthalmology education
- Published
- 2021
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24. Ophthalmic Medication Expenditures and Out-of-Pocket Spending: An Analysis of United States Prescriptions from 2007 through 2016.
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Chen EM, Kombo N, Teng CC, Mruthyunjaya P, Nwanyanwu K, and Parikh R
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- Adolescent, Adult, Cross-Sectional Studies, Eye Diseases economics, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Time Factors, United States, Young Adult, Drug Prescriptions economics, Eye Diseases drug therapy, Health Expenditures statistics & numerical data, Prescription Drugs economics
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Purpose: To estimate temporal trends in total and out-of-pocket (OOP) expenditures for ophthalmic prescription medications among adults in the United States., Design: Retrospective, longitudinal cohort study., Participants: Participants in the 2007 through 2016 Medical Expenditure Panel Survey (MEPS) 18 years of age or older. The MEPS is a nationally representative survey of the noninstitutionalized, civilian United States population., Methods: We estimated trends in national and per capita annual ophthalmic prescription expenditures by pooling data into 2-year cycles and using weighted linear regressions. We also identified characteristics associated with greater total or OOP expenditures with multivariate weighted linear regression. Costs were adjusted to 2016 United States dollars using the gross domestic product price index., Main Outcome Measures: Trends in total and OOP annual expenditures for ophthalmic medications from 2007 through 2016 as well as factors associated with greater expenditures., Results: From 2007 through 2016, 9989 MEPS participants (4.2%) reported ophthalmic medication prescription use. Annual ophthalmic medication use increased from 10.0 to 12.2 million individuals from 2007 and 2008 through 2015 and 2016. In this same period, national expenditures for ophthalmic medications increased from $3.39 billion to $6.08 billion and OOP expenditures decreased from $1.34 to $1.18 billion. Per capita expenditure increased from $338.72 to $499.42 (P < 0.001), and per capita OOP expenditure decreased from $133.48 to $96.67 (P < 0.001) from 2007 and 2008 through 2015 and 2016, respectively. From 2015 through 2016, dry eye (29.5%) and glaucoma (42.7%) medications accounted for 72.2% of all ophthalmic medication expenditures. Patients who were older than 65 years (P < 0.001), uninsured (P < 0.001), and visually impaired (P < 0.001) were significantly more likely to have greater OOP spending on ophthalmic medications., Conclusions: Total ophthalmic medication expenditure in the United States increased significantly over the last decade, whereas OOP expenses decreased. Increases in coverage, copayment assistance, and use of expensive brand drugs may be contributing to these trends. Policy makers and physicians should be aware that rising overall drug expenditures ultimately may increase indirect costs to the patient and offset a decline in OOP prescription drug spending., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2020
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25. The Effect of Anti-Vascular Endothelial Growth Factor Agents on Intraocular Pressure and Glaucoma: A Report by the American Academy of Ophthalmology.
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Hoguet A, Chen PP, Junk AK, Mruthyunjaya P, Nouri-Mahdavi K, Radhakrishnan S, Takusagawa HL, and Chen TC
- Subjects
- Academies and Institutes organization & administration, Databases, Factual, Glaucoma diagnosis, Humans, Intraocular Pressure physiology, Intravitreal Injections, Technology Assessment, Biomedical, United States, Angiogenesis Inhibitors pharmacology, Glaucoma physiopathology, Intraocular Pressure drug effects, Vascular Endothelial Growth Factor A antagonists & inhibitors
- Abstract
Purpose: To assess the effect of intravitreal injections of anti-vascular endothelial growth factor (VEGF) agents on immediate and long-term intraocular pressure (IOP) elevation and glaucoma., Methods: Literature searches of the PubMed and Cochrane databases, last conducted in April 2018, yielded 253 unique citations. Of these, 41 met the inclusion criteria and were rated according to the strength of evidence. Two articles were rated level I, 17 were rated level II, and 15 were rated level III; an additional 7 were excluded because of poor study design and lack of relevance to the topic under evaluation., Results: The studies that reported on short-term IOP elevation (i.e., between 0 and 60 minutes) showed that an immediate increase in IOP is seen in all patients when measured between 0 and 30 minutes of intravitreal injection and that the IOP elevation decreases over time. The data on long-term IOP elevation were mixed; 7 studies reported that between 4% and 15% of patients developed sustained elevation of IOP at 9 to 24 months after injection, whereas 6 studies found no long-term change in IOP from 1 to 36 months after injection. Pretreatment with glaucoma medications, anterior chamber tap, vitreous reflux, longer intervals between injections, and longer axial lengths were associated with lower IOP elevations after injection. Data were mixed on the relationship between IOP increase and the type of intravitreal injection, number of intravitreal injections, preexisting glaucoma, and globe decompression before injection. There were no data on the onset or progression of glaucoma in the studies reviewed in this assessment., Conclusions: Intravitreal injection of anti-VEGF agents results in an immediate and transient increase in IOP. A long-term increase in IOP also may be seen, and further studies are needed to determine at-risk populations. Although there is some suggestion in the literature, there is currently insufficient data to determine the impact of intravitreal anti-VEGF injections on glaucoma progression. Although pretreatment with glaucoma medications, performing anterior chamber paracentesis, or increasing the interval between injections may reduce the impact of transient IOP elevation, the clinical significance and associated risks of these interventions are unknown., (Copyright © 2018 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2019
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26. Association between Tumor Regression Rate and Gene Expression Profile after Iodine 125 Plaque Radiotherapy for Uveal Melanoma.
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Mruthyunjaya P, Seider MI, Stinnett S, and Schefler A
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Fine-Needle, Cohort Studies, Female, Follow-Up Studies, Gene Expression Profiling, Humans, Middle Aged, Retrospective Studies, Uveal Neoplasms pathology, Young Adult, Brachytherapy, Genes, Neoplasm genetics, Iodine Radioisotopes therapeutic use, Neoplasm Proteins genetics, Uveal Neoplasms genetics, Uveal Neoplasms radiotherapy
- Abstract
Purpose: Gene expression profile (GEP) testing segregates uveal melanoma (UM) into 2 main prognostic classes. It is unknown if a greater tumor regression response after iodine 125 (I
125 ) brachytherapy correlates with class 2 GEP status. The purpose of this study was to determine whether there is a significant relationship between the rate of UM height regression and GEP classification testing after I125 plaque brachytherapy., Design: Multicenter, retrospective cohort study., Participants: Adult UM patients treated with I125 plaque brachytherapy who had concurrent tumor biopsy at the time of surgery with a GEP test result from January 1, 2010 through June 30, 2014., Methods: Baseline clinical data and GEP class assignments were obtained. The ultrasonographic tumor height was recorded at baseline and at 3, 6, 9, and 12 months and at the most recent final follow-up visits. Subanalysis of paired cases based on pretreatment ultrasound height was performed. Statistical analysis was performed using Wilcoxon rank-sum tests, the Fisher exact test, and Kaplan-Meier analysis., Main Outcome Measures: Percentage change in tumor height from baseline., Results: A total of 353 patients were included in the study. Median follow-up was 2.1 years (range, 0.5-5.3 years). Gene expression profile status was class 1 in 247 tumors (70%) and class 2 in 106 tumors (30%). Increased patient age, larger tumor dimensions, and greater tumor thickness were associated with class 2 GEP status (P = 0.006, P < 0.001, and P < 0.001, respectively). The percentage reduction in tumor height from baseline was significantly greater in class 1 than class 2 tumors at 3 months (17.5% vs. 11.8%; P = 0.007) and 6 months (26.8% vs. 17.1%; P = 0.007), respectively, but there was no significant difference in reduction between class 1 and 2 tumors at 9 months (P = 0.26) and 12 months (P = 0.57) after treatment. Class 1A and 1B tumors showed similar reduction compared with class 2 tumors (P < 0.05)., Conclusions: Class 1 UM tumors tend to regress more rapidly than class 2 tumors in the first 6 months after plaque radiotherapy. Class 1A and 1B tumors regress at similar rates after plaque radiotherapy., (Copyright © 2017 American Academy of Ophthalmology. All rights reserved.) more...- Published
- 2017
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27. Therapies for Macular Edema Associated with Branch Retinal Vein Occlusion: A Report by the American Academy of Ophthalmology.
- Author
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Ehlers JP, Kim SJ, Yeh S, Thorne JE, Mruthyunjaya P, Schoenberger SD, and Bakri SJ
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- Academies and Institutes, Databases, Factual, Drug Implants, Drug Therapy, Combination, Humans, Intravitreal Injections, Macular Edema etiology, Macular Edema physiopathology, Ophthalmology organization & administration, Retinal Vein Occlusion complications, Retinal Vein Occlusion physiopathology, United States, Visual Acuity, Angiogenesis Inhibitors therapeutic use, Dexamethasone therapeutic use, Macular Edema drug therapy, Retinal Vein Occlusion drug therapy, Technology Assessment, Biomedical
- Abstract
Purpose: To evaluate the available evidence on the ocular safety and efficacy of current therapeutic alternatives for the management of macular edema (ME) secondary to branch retinal vein occlusion (BRVO)., Methods: Literature searches were last conducted on January 31, 2017, in PubMed with no date restrictions and limited to articles published in English, and in the Cochrane Database without language limitations. The searches yielded 321 citations, of which 109 were reviewed in full text and 27 were deemed appropriate for inclusion in this assessment. The panel methodologist assigned ratings to the selected studies according to the level of evidence., Results: Level I evidence was identified in 10 articles that addressed anti-vascular endothelial growth factor (VEGF) pharmacotherapies for ME, including intravitreal bevacizumab (5), aflibercept (2), and ranibizumab (4). Level I evidence was identified in 6 studies that examined intravitreal corticosteroids, including triamcinolone (4) and the dexamethasone implant (2). Level I evidence also was available for the role of macular grid laser photocoagulation (7) and scatter peripheral laser surgery (1). The inclusion of level II and level III studies was limited given the preponderance of level I studies. The number of studies on combination therapy is limited., Conclusions: Current level I evidence suggests that intravitreal pharmacotherapy with anti-VEGF agents is effective and safe for ME secondary to BRVO. Prolonged delay in treatment is associated with less improvement in visual acuity (VA). Level I evidence also indicates that intravitreal corticosteroids are effective and safe for the management of ME associated with BRVO; however, corticosteroids are associated with increased potential ocular side effects (e.g., elevated intraocular pressure, cataracts). Laser photocoagulation remains a safe and effective therapy, but VA results lag behind the results for anti-VEGF therapies., (Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2017
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28. Comparison of Visual Outcomes in Coats' Disease: A 20-Year Experience.
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Ong SS, Buckley EG, McCuen BW 2nd, Jaffe GJ, Postel EA, Mahmoud TH, Stinnett SS, Toth CA, Vajzovic L, and Mruthyunjaya P
- Subjects
- Adolescent, Angiogenesis Inhibitors therapeutic use, Bevacizumab therapeutic use, Child, Child, Preschool, Cohort Studies, Disease Progression, Female, Fluorescein Angiography, Follow-Up Studies, Humans, Infant, Intravitreal Injections, Laser Coagulation, Male, Retinal Telangiectasis diagnosis, Retinal Telangiectasis drug therapy, Retrospective Studies, Vascular Endothelial Growth Factor A antagonists & inhibitors, Retinal Telangiectasis physiopathology, Visual Acuity physiology
- Abstract
Purpose: To report differences in visual acuities among patients with Coats' disease who sought treatment at a tertiary care university-based practice., Design: Single-center retrospective cohort study., Participants: Patients with Coats' disease diagnosed clinically, angiographically, or both from 1995 through 2015., Methods: Patients were divided into 2 groups based on date of presentation: decade 1 (1995-2005) and decade 2 (2006-2015)., Main Outcome Measures: Visual acuity (VA)., Results: Thirty-nine eyes of 39 patients were included with 19 eyes presenting in decade 1 and 20 eyes presenting in decade 2. Three patients demonstrated bilateral disease, but only the worse eye was included for analysis. Forty-seven percent of eyes in decade 1 demonstrated advanced stages of disease (stage 3B or worse) compared with 20% of eyes in decade 2. There was a trend for the mean initial presenting VA (±standard deviation) for decade 1 eyes to be worse (2.05±1.29 logarithm of the minimum angle of resolution [logMAR]) than for decade 2 eyes (1.45±0.99 logMAR; P = 0.1). From initial to final follow-up visit, mean VA also worsened for decade 1 eyes (P = 0.03), but remained stable for decade 2 eyes (P = 1.0). At the end of follow-up, there was a trend for mean VA for decade 1 eyes (2.28±1.17 logMAR) to be worse than for decade 2 eyes (1.60±1.15 logMAR; P = 0.07). Eight eyes were observed initially in decade 1 compared with 1 eye in decade 2, and only 1 of the observed eyes (in decade 2) developed painful glaucoma requiring enucleation. Decade 2 eyes had a higher average number of procedures per eye (6.5±4.9) compared with decade 1 eyes (1.4±1.7; P < 0.001)., Conclusions: The earlier presentation of disease in decade 2 suggests improvements in disease detection over time. Furthermore, there was a trend for eyes to have better final VA in this decade. This is due to a combination of factors, including earlier presentation of disease, fewer eyes being observed without treatment, and eyes, when treated, receiving a higher number of procedures., (Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2017
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29. Anterior Chamber Angle Invasion of Iridociliary Melanoma.
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Walter SD, Cummings TJ, and Mruthyunjaya P
- Subjects
- Aged, Female, Humans, Neoplasm Invasiveness, Tomography, Optical Coherence, Anterior Chamber pathology, Ciliary Body pathology, Iris Neoplasms pathology, Melanoma pathology, Uveal Neoplasms pathology
- Published
- 2017
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30. Diagnosis and Treatment of Acute Retinal Necrosis: A Report by the American Academy of Ophthalmology.
- Author
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Schoenberger SD, Kim SJ, Thorne JE, Mruthyunjaya P, Yeh S, Bakri SJ, and Ehlers JP
- Subjects
- Academies and Institutes, Acyclovir analogs & derivatives, Acyclovir therapeutic use, Antiviral Agents therapeutic use, Aqueous Humor virology, Biomedical Technology standards, DNA, Viral analysis, Eye Infections, Viral diagnosis, Eye Infections, Viral therapy, Foscarnet therapeutic use, Herpes Simplex diagnosis, Herpes Simplex therapy, Herpes Zoster Ophthalmicus diagnosis, Herpes Zoster Ophthalmicus therapy, Herpesvirus 3, Human isolation & purification, Humans, Ophthalmology organization & administration, Polymerase Chain Reaction, Retinal Necrosis Syndrome, Acute virology, Retrospective Studies, Simplexvirus isolation & purification, United States, Valacyclovir, Valine analogs & derivatives, Valine therapeutic use, Vitrectomy, Vitreous Body virology, Retinal Necrosis Syndrome, Acute diagnosis, Retinal Necrosis Syndrome, Acute therapy
- Abstract
Purpose: To evaluate the available evidence in peer-reviewed publications about the diagnosis and treatment of acute retinal necrosis (ARN)., Methods: Literature searches of the PubMed and Cochrane Library databases were last conducted on July 27, 2016. The searches identified 216 unique citations, and 49 articles of possible clinical relevance were reviewed in full text. Of these 49 articles, 27 were deemed sufficiently relevant or of interest, and they were rated according to strength of evidence. An additional 6 articles were identified from the reference lists of these articles and included. All 33 studies were retrospective., Results: Polymerase chain reaction (PCR) testing of aqueous or vitreous humor was positive for herpes simplex virus (HSV) or varicella zoster virus (VZV) in 79% to 100% of cases of suspected ARN. Aqueous and vitreous specimens are both sensitive and specific. There is level II and III evidence supporting the use of intravenous and oral antiviral therapy for the treatment of ARN. Data suggest that equivalent plasma drug levels of acyclovir can be achieved after administration of oral valacyclovir or intravenous acyclovir. There is level II and III evidence suggesting that the combination of intravitreal foscarnet and systemic antiviral therapy may have greater therapeutic efficacy than systemic therapy alone. The effectiveness of prophylactic laser or early pars plana vitrectomy (PPV) in preventing retinal detachment (RD) remains unclear., Conclusions: Polymerase chain reaction testing of ocular fluid is useful in supporting a clinical diagnosis of ARN, but treatment should not be delayed while awaiting PCR results. Initial oral or intravenous antiviral therapy is effective in treating ARN. The adjunctive use of intravitreal foscarnet may be more effective than systemic therapy alone. The role of prophylactic laser retinopexy or early PPV is unknown at this time., (Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2017
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31. Collaborative Ocular Oncology Group report number 1: prospective validation of a multi-gene prognostic assay in uveal melanoma.
- Author
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Onken MD, Worley LA, Char DH, Augsburger JJ, Correa ZM, Nudleman E, Aaberg TM Jr, Altaweel MM, Bardenstein DS, Finger PT, Gallie BL, Harocopos GJ, Hovland PG, McGowan HD, Milman T, Mruthyunjaya P, Simpson ER, Smith ME, Wilson DJ, Wirostko WJ, and Harbour JW more...
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Chromosomes, Human, Pair 3 genetics, Female, Follow-Up Studies, Gene Expression Regulation, Neoplastic physiology, Humans, Male, Melanoma pathology, Middle Aged, Oligonucleotide Array Sequence Analysis, Polymorphism, Single Nucleotide, Prognosis, Prospective Studies, Real-Time Polymerase Chain Reaction, Uveal Neoplasms pathology, Young Adult, Biomarkers, Tumor genetics, Gene Expression Profiling, Melanoma genetics, Uveal Neoplasms genetics
- Abstract
Purpose: This study evaluates the prognostic performance of a 15 gene expression profiling (GEP) assay that assigns primary posterior uveal melanomas to prognostic subgroups: class 1 (low metastatic risk) and class 2 (high metastatic risk)., Design: Prospective, multicenter study., Participants: A total of 459 patients with posterior uveal melanoma were enrolled from 12 independent centers., Testing: Tumors were classified by GEP as class 1 or class 2. The first 260 samples were also analyzed for chromosome 3 status using a single nucleotide polymorphism assay. Net reclassification improvement analysis was performed to compare the prognostic accuracy of GEP with the 7th edition clinical Tumor-Node-Metastasis (TNM) classification and chromosome 3 status., Main Outcome Measures: Patients were managed for their primary tumor and monitored for metastasis., Results: The GEP assay successfully classified 446 of 459 cases (97.2%). The GEP was class 1 in 276 cases (61.9%) and class 2 in 170 cases (38.1%). Median follow-up was 17.4 months (mean, 18.0 months). Metastasis was detected in 3 class 1 cases (1.1%) and 44 class 2 cases (25.9%) (log-rank test, P<10(-14)). Although there was an association between GEP class 2 and monosomy 3 (Fisher exact test, P<0.0001), 54 of 260 tumors (20.8%) were discordant for GEP and chromosome 3 status, among which GEP demonstrated superior prognostic accuracy (log-rank test, P = 0.0001). By using multivariate Cox modeling, GEP class had a stronger independent association with metastasis than any other prognostic factor (P<0.0001). Chromosome 3 status did not contribute additional prognostic information that was independent of GEP (P = 0.2). At 3 years follow-up, the net reclassification improvement of GEP over TNM classification was 0.43 (P = 0.001) and 0.38 (P = 0.004) over chromosome 3 status., Conclusions: The GEP assay had a high technical success rate and was the most accurate prognostic marker among all of the factors analyzed. The GEP provided a highly significant improvement in prognostic accuracy over clinical TNM classification and chromosome 3 status. Chromosome 3 status did not provide prognostic information that was independent of GEP., (Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2012
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32. Optimizing diagnosis and management of nocardia keratitis, scleritis, and endophthalmitis: 11-year microbial and clinical overview.
- Author
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DeCroos FC, Garg P, Reddy AK, Sharma A, Krishnaiah S, Mungale M, and Mruthyunjaya P
- Subjects
- Adult, Diagnosis, Differential, Endophthalmitis microbiology, Endophthalmitis therapy, Eye Infections, Bacterial microbiology, Eye Infections, Bacterial therapy, Female, Follow-Up Studies, Humans, Keratitis microbiology, Keratitis therapy, Male, Nocardia Infections microbiology, Nocardia Infections therapy, Ophthalmologic Surgical Procedures methods, Prognosis, Retrospective Studies, Scleritis microbiology, Scleritis therapy, Time Factors, Anti-Bacterial Agents therapeutic use, Endophthalmitis diagnosis, Eye Infections, Bacterial diagnosis, Keratitis diagnosis, Nocardia isolation & purification, Nocardia Infections diagnosis, Scleritis diagnosis
- Abstract
Objective: To identify clinical factors and microbiological assays that facilitate a rapid diagnosis of Nocardia keratitis, scleritis, and endophthalmitis, and to determine optimal medical and surgical management strategies., Design: Retrospective, consecutive case series., Participants: A total of 111 cases of keratitis, 11 cases of scleritis, and 16 cases of endophthalmitis, all culture-proven Nocardia infections, were identified between January 1999 and January 2010., Intervention: The keratitis cases underwent intensive medical management, and the scleritis and endophthalmitis cases required concurrent surgical intervention for disease control. Corneal and scleral scrapings, as well as undiluted vitreous sample, were submitted for microbiologic evaluation (direct smear and culture)., Main Outcome Measures: Historical points, clinical findings, and microbiologic assays that facilitated a prompt Nocardia diagnosis were identified, and management choices were examined for correlation with final acuity., Results: Ocular exposure to soil or plant matter was a common historical point in cases of Nocardia keratitis (48%) and scleritis (45%), respectively. Nocardia keratitis often (38.7%) presented with "wreath"-shaped anterior stromal infiltrate or infiltrate interspersed with elevated, pinhead-sized, chalky lesions. Most patients with scleritis (63.4%) presented with nodular lesions demonstrating pointed abscesses. Nocardia endophthalmitis typically (75%) presented with endoexudates or nodular exudates surrounding the pupillary border. Gram stain and 1% acid-fast stain enabled prompt diagnosis of Nocardia in 64% and 63% of keratitis cases and 45% and 63% of scleritis cases, respectively. Direct smear was usually not revealing in cases of Nocardia endophthalmitis. Isolates from Nocardia keratitis, scleritis, and endophthalmitis demonstrated 97%, 100%, and 90% susceptibility to amikacin, respectively. Nocardia keratitis resolved with medical therapy alone in 82% of cases. Younger age and better initial acuity correlated with improved final acuity in keratitis cases. Outcomes were poor after Nocardia scleritis and endophthalmitis., Conclusions: Early appropriate treatment often results in visual recovery in eyes with Nocardia keratitis. Despite aggressive and prompt surgical intervention, the prognosis for Nocardia scleritis and endophthalmitis is more guarded. Nocardia isolated from ocular infections demonstrate high levels of susceptibility to amikacin., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article., (Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.) more...
- Published
- 2011
- Full Text
- View/download PDF
33. Change in visual function after macular translocation with 360 degrees retinectomy for neovascular age-related macular degeneration.
- Author
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Mruthyunjaya P, Stinnett SS, and Toth CA
- Subjects
- Aged, Aged, 80 and over, Choroidal Neovascularization etiology, Choroidal Neovascularization physiopathology, Female, Fluorescein Angiography, Follow-Up Studies, Humans, Macular Degeneration complications, Macular Degeneration physiopathology, Male, Postoperative Complications, Prospective Studies, Silicone Oils administration & dosage, Vision Disorders etiology, Choroidal Neovascularization surgery, Macula Lutea transplantation, Macular Degeneration surgery, Vision Disorders physiopathology, Visual Acuity physiology
- Abstract
Objective: To measure the change in vision and visual outcomes at 12 months after macular translocation with 360 degrees retinectomy (MT360) and silicone oil tamponade in patients with bilateral vision loss resulting from subfoveal choroidal neovascular membranes in age-related macular degeneration (AMD)., Design: A prospective, interventional, consecutive, noncomparative case series., Participants: Sixty-four patients with bilateral vision loss resulting from neovascular AMD., Methods: Eligible patients had AMD with subfoveal choroidal neovascularization in the operative eye and a maximum of 6 months of central vision loss. Preoperative and 12-month postoperative evaluations included standardized testing of near and distance acuity and reading speed. Patients underwent MT360 with silicone oil tamponade, followed 2 months later by extraocular muscle surgery and silicone oil removal., Main Outcome Measures: Change in distance acuity, near acuity, and reading speed at 12 months after MT360 compared with those values before surgery., Results: Sixty-one patients were followed up for 12 months. All eyes were translocated successfully. Median distance acuity letter score improved from 62 letters (Snellen equivalent of approximately 20/125) before surgery to 69 letters (approximately 20/80) by 12 months after surgery (P = 0.03). Median near acuity improved from 0.70 logarithm of the minimum angle of resolution (logMAR) units (approximately 20/100) before surgery to 0.44 logMAR units (approximately 20/55) at 12 months (P<0.001). Median reading speed improved from 71 words per minute (wpm) before surgery to 105 wpm at 12 months after surgery (P<0.001). At 12 months, distance acuity improved by 1 or more lines in 32 patients (52%). In patients with either preoperative distance or near acuity of 20/80 or better, 74% and 95% of patients, respectively, remained in this range of acuity. In patients with either preoperative distance or near acuity of worse than 20/80, 40% and 48% of patients, respectively, improved to 20/80 or better. Postoperative retinal detachment developed in 5 patients (8%), with the macula involved in 2 patients, and all retinas were reattached successfully., Conclusions: Macular translocation with 360 degrees retinectomy with silicone oil tamponade is effective in significantly improving visual function in patients with neovascular AMD, as demonstrated by the improvement in distance and near acuity and reading speed at 12 months after surgery in these patients. Although this is a complex surgical intervention, patients with preoperative visual acuity of 20/80 or better at near or distance are highly likely to retain the 20/80 or better acuity at 12 months after surgery. Macular translocation with 360 degrees retinectomy is an effective treatment option for patients with vision loss in their second eye resulting from neovascular AMD. more...
- Published
- 2004
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34. Diagnostic yield of vitrectomy in eyes with suspected posterior segment infection or malignancy.
- Author
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Mruthyunjaya P, Jumper JM, McCallum R, Patel DJ, Cox TA, and Jaffe GJ
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Antibodies analysis, Child, Chronic Disease, Diagnosis, Differential, Diagnostic Techniques, Ophthalmological, Female, Humans, Male, Middle Aged, Polymerase Chain Reaction, Vitreous Body immunology, Eye Diseases diagnosis, Eye Infections diagnosis, Vitrectomy, Vitreous Body microbiology, Vitreous Body pathology
- Abstract
Purpose: To determine the yield of diagnostic pars plana vitrectomy in eyes with suspected posterior segment inflammation or malignancy when clinical examination and systemic laboratory testing did not yield a specific diagnosis., Design: Non-comparative interventional case series, Participants: Eighty-seven consecutive patients (90 eyes) who underwent diagnostic pars plana vitrectomy from 1989 through 1999., Interventions: Vitreous samples were analyzed in a directed manner based on the preoperative clinical examination and systemic laboratory testing., Main Outcome Measures: Diagnosis from each test performed on the vitreous samples., Results: Diagnostic vitrectomy was performed alone in 6 eyes (7%) and as part of a therapeutic procedure in the remaining 84 eyes. The diagnostic tests performed most frequently included cytopathology (83%), microbiologic culture and sensitivity (43%), polymerase chain reaction (PCR) (36%), and intraocular antibody levels for T. canis (14%). Of these, intraocular antibody testing and PCR had the highest positive yield, 46% and 39%, respectively. Overall, directed vitreous analysis identified a specific cause in 35 eyes (39%). Of the 65 cases in which an underlying infection was suspected preoperatively, the procedure yielded a specific diagnosis in 27 (42%). When intraocular malignancy was considered preoperatively (71 eyes), a diagnosis of intraocular lymphoma was obtained in seven (10%). This difference between these diagnostic yields was significant (P = 0.02, Fisher's exact test)., Conclusions: Diagnostic vitrectomy with directed vitreous fluid analysis yields a specific cause and guides subsequent therapy in a high percentage of cases. This procedure is a valuable adjunct in cases that cannot be diagnosed by less invasive methods. more...
- Published
- 2002
- Full Text
- View/download PDF
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