Hegazy, A. I., R. H. Zedan, T. A. Macky, and S. M. Esmat, "Retinal ganglion cell complex changes using spectral domain optical coherence tomography in diabetic patients without retinopathy.", International journal of ophthalmology, vol. 10, issue 3, pp. 427-433, 2017. Abstractrg.pdf

AIM: To assess the ganglion cell complex (GCC) thickness in diabetic eyes without retinopathy.

METHODS: Two groups included 45 diabetic eyes without retinopathy and 21 non diabetic eyes. All subjects underwent full medical and ophthalmological history, full ophthalmological examination, measuring GCC thickness and central foveal thickness (CFT) using the RTVue® spectral domain-optical coherence tomography (SD-OCT), and HbA1C level.

RESULTS: GCC focal loss volume (FLV%) was significantly more in diabetic eyes (22.2% below normal) than normal eyes (P=0.024). No statistically significant difference was found between the diabetic group and the control group regarding GCC global loss volume (GLV%) (P=0.160). CFT was positively correlated to the average, superior and inferior GCC (P=0.001, 0.000 and 0.001 respectively) and negatively correlated to GLV% and FLV% (P=0.002 and 0.031 respectively) in diabetic eyes. C/D ratio in diabetic eyes was negatively correlated to average, superior and inferior GCC (P=0.015, 0.007 and 0.017 respectively). The FLV% was negatively correlated to the refraction and level of HbA1c (P=0.019 and 0.013 respectively) and positively correlated to the best corrected visual acuity (BCVA) in logMAR in diabetic group (P=0.004).

CONCLUSION: Significant GCC thinning in diabetes predates retinal vasculopathy, which is mainly focal rather than diffuse. It has no preference to either the superior or inferior halves of the macula. Increase of myopic error is significantly accompanied with increased focal GCC loss. GCC loss is accompanied with increased C/D ratio in diabetic eyes.

Eissa, M. G. A. M., M. A. S. E. Abdelhakim, T. A. Macky, M. M. Khafagy, and H. A. Mortada, "Functional and structural outcomes of ILM peeling in uncomplicated macula-off RRD using microperimetry & en-face OCT.", Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2018 Jan 03. Abstract

PURPOSE: To investigate functional and structural outcomes of internal limiting membrane (ILM) peeling during primary vitrectomy for uncomplicated macula-off rhegmatogenous retinal detachment (RRD).

METHODS: In this prospective interventional randomized comparative study, 43 eyes (43 patients) were randomly divided into group A (20), and group B (23), with and without ILM peeling respectively. Patients were evaluated clinically, and by spectral-domain optical coherence tomography (SD-OCT) and microperimetry (MP) following silicone oil removal. Main outcome measures were functional-MP (mean and foveal retinal sensitivity; MRS, FRS) and best-corrected visual acuity (BCVA)-and anatomical-en-face image analysis (retinal dimples), and SD-OCT changes [epiretinal membrane (ERM), subretinal fluid (SRF), ellipsoid zone disruption, central subfoveal thickness (CSFT), and foveal contour].

RESULTS: All eyes achieved complete postoperative attachment with mean BCVA 1.0 ± 0.4 logMAR (6/60) in group A, and 0.4 ± 0.4 logMAR (6/15) in group B (p < 0.001). MRS and FRS were significantly higher in group B (p = 0.037 and 0.036 respectively). En-face OCT showed retinal dimples in all patients in group A (29.17 ± 7.67 dimples), compared to none in group B (p = 0.007). ERM did not develop in any eye in group A, while it developed in 17.4% of eyes in group B (p = 0.05).

CONCLUSION: Although ILM peeling prevented ERM, it resulted in poorer visual outcome in these uncomplicated RRD cases, and might be better reserved only for complicated cases.

Mahgoub, M. M., and T. A. Macky, "El efecto de la panfotocoagulación con láser en edema macular diabético con el fotocoagulador Pascal® versus el láser de argón convencional.", Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde, vol. 238 Suppl 1, pp. 16-20, 2017 07 11. Abstractls.pdf

Objetivo: El objetivo de este estudio fue comparar el efecto de la panfotocoagulación (PFC) en el edema macular diabético (EMD) en pacientes con retinopatía diabética proliferativa (RDP) con el fotocoagulador Pascal® (FP) vs. un fotocoagulador con láser de argón convencional (FLAC). Métodos: Se aleatorizó el uso de FP o FLAC en ochenta ojos con RDP y EMD con afectación central de la mácula. Ambos grupos tuvieron una evaluación de base de mejor agudeza visual corregida y fueron examinados con tomografía de coherencia óptica y angiografía con fluoresceína. Resultados: El número medio de disparos de láser en los grupos de FP y FLAC fue 1.726,10 y 752,00 en la sesión 1 y 1.589,00 y 830,00 (p < 0,001) en la sesión 2, respectivamente. El grosor foveal central (GFC) medio antes de comenzar el estudio fue 306 ± 100 y 314 ± 98 en los grupos de FP y FLAC, respectivamente. A las 8 semanas, el GFC medio fue 332 ± 116 y 347 ± 111 en los grupos de FP y FLAC, respectivamente (p > 0,05). La MAVC media fue similar durante el periodo de estudio y no hubo ninguna diferencia significativa entre los grupos (p > 0,05). Conclusiones: El FP y el FLAC mostraron efectos similares en el EMD en ojos con RDP y fueron igualmente seguros sin un aumento significativo del GFC.

Pandey, S. K., B. Cochener, D. J. Apple, J. Colin, L. Werner, R. Bougaran, R. H. Trivedi, T. A. Macky, and A. M. Izak, "Intracapsular ring sustained 5-fluorouracil delivery system for the prevention of posterior capsule opacification in rabbits: a histological study.", Journal of cataract and refractive surgery, vol. 28, issue 1, pp. 139-48, 2002 Jan. Abstract

PURPOSE: To evaluate the efficacy of an intracapsular ring releasing 5-fluorouracil (5-FU) in preventing posterior capsule opacification (PCO) in rabbit eyes.

SETTING: Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA, and Chu Morvan, Department d'Ophtalmologie, University of Brest, France.

METHODS: Seventeen rabbits were divided into 3 groups: Group 1, 6 rabbits (6 eyes), had phacoemulsification only (control group); Group 2, 6 rabbits (6 eyes), had phacoemulsification with implantation of an open-loop hydrogel intracapsular ring; Group 3, 5 rabbits (5 eyes), had phacoemulsification with implantation of a ring with sustained release of 0.25 microg/h of 5-FU for 9 days. All eyes were followed for 8 weeks before enucleation. Capsular bag shrinkage and the position of the intracapsular ring were assessed, and central and peripheral PCO was evaluated for intensity and area by stereomicroscopy from a posterior (Miyake-Apple) view. The residual equatorial lens epithelial cells (LECs) were counted by the same observer in histological sections. Transmission electron microscopy (TEM) of the cornea, capsular bag, and retina was done to evaluate the toxicity of 5-FU.

RESULTS: No significant difference was seen in the degree of capsular bag shrinkage in the 3 groups. The intracapsular ring was decentered in 2 eyes (1 each in Groups 2 and 3). There was a statistically significant difference (P <.05, Student t test) between Group 1 and Groups 2 and 3 in the area and intensity of central PCO. There was no difference between Groups 2 and 3 in the intensity of central PCO. No evidence of 5-FU toxicity to intraocular structures (cornea, capsular bag, and retina) was demonstrated on TEM analysis.

CONCLUSION: Implantation of an intracapsular ring may prevent central PCO after cataract surgery by mechanically blocking LEC migration toward the central visual axis. The potential pharmacological effect of 5-FU in PCO prevention was not demonstrated.

Werner, L., D. J. Apple, A. M. Izak, S. K. Pandey, R. H. Trivedi, and T. A. Macky, "Phakic anterior chamber intraocular lenses.", International ophthalmology clinics, vol. 41, issue 3, pp. 133-52, 2001 Summer.
Roig-Melo, E. A., T. A. Macky, M. L. Heredia-Elizondo, and D. V. Alfaro, "Progressive outer retinal necrosis syndrome: successful treatment with a new combination of antiviral drugs.", European journal of ophthalmology, vol. 11, issue 2, pp. 200-2, 2001 Apr-Jun. Abstract

PURPOSE: To describe a case of progressive outer retinal necrosis syndrome, successfully treated with a new combination of antiviral drugs.

METHODS: The patient was treated with a combined therapy of antiviral drugs that includes: intravenous acyclovir 10 mg/kg, three intravitreal injections of foscarnet (1200 microg) and a ganciclovir implant in the right eye.

RESULTS: The progressive outer retinal necrosis appeared to response dramatically with the combination of antiviral agents used over a period of 2 weeks with a final visual acuity of 20/80 at 3 months of follow up.

CONCLUSIONS: Intravitreal foscarnet combined with i.v. acyclovir and ganciclovir implant may represent an effective alternative treatment for PORN.

Macky, T. A., S. K. Pandey, L. Werner, R. H. Trivedi, A. M. Izak, and D. J. Apple, "Anterior capsule opacification.", International ophthalmology clinics, vol. 41, issue 3, pp. 17-31, 2001 Summer.
Trivedi, R. H., A. M. Izak, L. Werner, T. A. Macky, S. K. Pandey, and D. J. Apple, "Interlenticular opacification of piggyback intraocular lenses.", International ophthalmology clinics, vol. 41, issue 3, pp. 47-62, 2001 Summer.
Izak, A. M., L. Werner, S. K. Pandey, T. A. Macky, R. H. Trivedi, and D. J. Apple, "Calcification on the surface of the Bausch & Lomb Hydroview intraocular lens.", International ophthalmology clinics, vol. 41, issue 3, pp. 63-77, 2001 Summer.
Macky, T. A., R. H. Trivedi, L. Werner, S. K. Pandey, A. M. Izak, and D. J. Apple, "Degeneration of ultraviolet absorber material and calcium deposits within the optic of a hydrophilic intraocular lens.", International ophthalmology clinics, vol. 41, issue 3, pp. 79-90, 2001 Summer.