PhysEmp :: Medicine :: Medical Specialties :: Ophthalmology (86)

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U.S. News and World Report-Ranked ‘America’s Top Hospitals’, Major Southwest Metro, #5224 :: Arizona :: Timeline Recruiting
Replete with natural wonders, history & culture, this region has been romancing people with its Old West charm for decades. Residents can also enjoy regional wine & cuisine, and explore a variety of
Detroit Suburb, $200K + potential, Partnership, #3430 :: Michigan :: Timeline Recruiting
Join a dedicated team looking for a partner. The groups founder will be retiring soon and they would like to bring on someone who has aspirations to become a partner after 2 years. The group has a
Ophthalmology Opportunity just East of Champaign, :: Illinois :: Enterprise Medical Service
Well established multi-specialty group in college community in central Illinois in need of Ophthalmologist with Glaucoma fellowship. Financial package to include attractive base guarantee, signing bonus,

Archives of Ophthalmology current issue

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Prediction of Functional Loss in Glaucoma From Progressive Optic Disc Damage [Clinical Sciences]
Medeiros, F. A., Alencar, L. M., Zangwill, L. M., Bowd, C., Sample, P. A., Weinreb, R. N. Objective  To evaluate the ability of progressive optic disc damage detected by assessment of longitudinal stereophotographs to predict future development of functional loss in those with suspected glaucoma. Methods  The study included 639 eyes of 407 patients with suspected glaucoma followed up for an average of 8.0 years with annual standard automated perimetry visual field and optic disc stereophotographs. All patients had normal and reliable standard automated perimetry results at baseline. Conversion to glaucoma was defined as development of 3 consecutive abnormal visual fields during follow-up. Presence of progressive optic disc damage was evaluated by grading longitudinally acquired simultaneous stereophotographs. Other predictive factors included age, intraocular pressure, central corneal thickness, pattern standard deviation, and baseline stereophotograph grading. Hazard ratios for predicting visual field loss were obtained by extended Cox models, with optic disc progression as a time-dependent covariate. Predictive accuracy was evaluated using a modified R2 index. Results  Progressive optic disc damage had a hazard ratio of 25.8 (95% confidence interval, 16.0-41.7) and was the most important risk factor for development of visual field loss with an R2 of 79%. The R2s for other predictive factors ranged from 6% to 26%. Conclusions  Presence of progressive optic disc damage on stereophotographs was a highly predictive factor for future development of functional loss in glaucoma. These findings suggest the importance of careful monitoring of the optic disc appearance and a potential role for longitudinal assessment of the optic disc as an end point in clinical trials and as a reference for evaluation of diagnostic tests in glaucoma.
Intraoperative and Postoperative Effects of Corneal Collagen Cross-linking on Progressive Keratoconus [Clinical Sciences]
Vinciguerra, P., Albe, E., Trazza, S., Seiler, T., Epstein, D. Objectives  To report intraoperative and 24-month refractive, topographic, tomographic, and aberrometric outcomes after corneal collagen cross-linking in progressive advanced keratoconus. Methods  Prospective, nonrandomized single-center clinical study involving 28 eyes. Main outcome measures included uncorrected and best spectacle-corrected visual acuities, sphere and cylinder refraction, topography, tomography, aberrometry, and endothelial cell count evaluated at baseline and follow-up at 1, 3, 6, 12, and 24 months after treatment. Topography was also recorded intraoperatively. Results  Two years after treatment, mean baseline uncorrected and best spectacle-corrected visual acuities improved significantly (P = .048 and <.001, respectively) and mean spherical equivalent refraction decreased significantly (P = .03). Mean baseline flattest and steepest meridians on simulated keratometry, simulated keratometry average, mean average pupillary power, and apical keratometry all decreased significantly (P < .03). Deterioration of the Klyce indices was observed in the untreated contralateral eyes but not in treated eyes. Total corneal wavefront aberrations Z0 (piston), Z2 (defocus), and Z7 (III coma) decreased significantly (P ≤ .046). Mean 12-month baseline pupil center pachymetry and total corneal volume decreased significantly (P = .045). Endothelial cell counts did not change significantly (P = .13). Conclusions  Two years postoperatively, corneal collagen cross-linking appears to be effective in improving uncorrected and best spectacle-corrected visual acuities in eyes with progressive keratoconus by significantly reducing corneal average pupillary power, apical keratometry, and total corneal wavefront aberrations.

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