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Gazit I, Hecht I, Weiner C, Kotlyar A, Almer Z, Bakshi E, Or L, Volkov H, Feldman B, Maharshak I, Michelson M, Goldenberg-Cohen N, Pras E. Variants in the WDR45 Gene Within the OPA-2 Locus Associate With Isolated X-Linked Optic Atrophy. Invest Ophthalmol Vis Sci 2023; 64:17. [PMID: 37819743 PMCID: PMC10573587 DOI: 10.1167/iovs.64.13.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/14/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose To describe clinical and molecular findings of two families with X-linked optic atrophy and present two new pathogenic variants in the WDR45 gene. Methods Case series and molecular analysis of two families of Jewish Ashkenazi descent with early onset bilateral optic atrophy. Whole-exome sequencing (WES) and bioinformatic analysis were performed, followed by Sanger sequencing and segregation analysis. Results In both families, male siblings (three in family 1, two in family 2) had early-onset isolated bilateral optic atrophy. The sibling's healthy mother (and in the second family also one healthy sister) had a mild presentation, suggesting a carrier state and an X-linked inheritance pattern. All participants were otherwise healthy, apart from mild learning disabilities and autism spectrum disorder in two siblings of the second family. Variants in known optic atrophy genes were excluded. Analysis revealed a point variant in the WDR45 gene-a missense variant in the first family, NM_001029896.2:c.107C>A; NP_001025067.1:p.Pro36His (variant ID: 1704205), and a splice site variant in the second family, NM_001029896.2:c.236-1G>T; NP_009006.2:p.Val80Leu (variant ID: 1704204), located on Xp11.23 (OPA2 locus). Both variants are novel and predicted as pathogenic. In both families, the variant was seen with full segregation with the disease, occurring in all affected male participants and in one allele of the carrier females, as well as none of the healthy participants. Conclusions Among two families with isolated X-linked optic atrophy, molecular analysis revealed novel variants in the WDR45 gene in full segregation with the disease. This gene resides within the OPA2 locus, previously described to associate with X-linked optic atrophy. Taken together, these findings suggest that certain pathogenic variants in the WDR45 gene are associated with isolated X-linked optic atrophy.
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Affiliation(s)
- Inbal Gazit
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idan Hecht
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Matlow's Ophthalmo-genetics Laboratory, Shamir Medical Center, Zerifin, Israel
| | - Chen Weiner
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Matlow's Ophthalmo-genetics Laboratory, Shamir Medical Center, Zerifin, Israel
| | - Alina Kotlyar
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Matlow's Ophthalmo-genetics Laboratory, Shamir Medical Center, Zerifin, Israel
| | - Zina Almer
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
| | - Erez Bakshi
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Or
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadas Volkov
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Barak Feldman
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Idit Maharshak
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel
| | - Marina Michelson
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Medical Genetics, Wolfson Medical Center, Holon, Israel
- The Genetic Institute of Maccabi Health Medicinal Organization, Tel Aviv, Israel
| | - Nitza Goldenberg-Cohen
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel, and the Department of Ophthalmology, Bnai Zion Medical Center, Haifa, Israel
| | - Eran Pras
- Department of Ophthalmology, Shamir Medical Center, Zerifin, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Matlow's Ophthalmo-genetics Laboratory, Shamir Medical Center, Zerifin, Israel
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Ostrovsky M, Rosenblatt A, Iriqat S, Shteiwi A, Sharon Y, Kramer M, Vishnevskia-Dai V, Sar S, Boulos Y, Tomkins-Netzer O, Lavee N, Ben-Arie-Weintrob Y, Pizem H, Hareuveni-Blum T, Schneck M, Gepstein R, Masarwa D, Nakhoul N, Bakshi E, Shulman S, Goldstein M, Ramon D, Anouk M, Habot-Wilner Z. Ocular Behçet Disease-Clinical Manifestations, Treatments and Outcomes According to Age at Disease Onset. Biomedicines 2023; 11:biomedicines11020624. [PMID: 36831160 PMCID: PMC9952940 DOI: 10.3390/biomedicines11020624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/03/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Behçet disease (BD) is a multisystemic disease that commonly involves the eyes. Although it affects patients in all age groups, data on ocular disease by age of onset are limited. This retrospective, multicenter study aimed to compare epidemiology, systemic and ocular manifestations, treatments and outcomes between three age groups: juvenile (<18 years), adult (18-39 years) and late (≥40 years) disease onset. The study included 175 ocular BD patients (303 eyes) from Israel and Palestine: juvenile-onset (n = 25, 14.3%), adult-onset (n = 120, 68.6%) and late-onset (n = 30, 17.1%). Most patients in all groups were male. Systemic manifestations were similar in all groups. Systemic co-morbidities were more common in late-onset patients. Bilateral panuveitis was the most common ocular manifestation in all patients. Non-occlusive retinal vasculitis, peripheral vessel occlusions, cataract and elevated intraocular pressure were found more commonly among juvenile-onset eyes. Anterior uveitis and macular ischemia were most common among late-onset eyes, while branch retinal vein occlusion was most common in adult and late-onset eyes. All patients were treated with corticosteroids. Methotrexate, immunomodulatory combinations and biologic treatments were more commonly used for juvenile-onset patients. All groups had a similar visual outcome. Our study showed that patients with ocular BD have varied ocular manifestations and require different treatments according to age of disease onset, but visual outcome is similar.
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Affiliation(s)
- Michael Ostrovsky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Amir Rosenblatt
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Salam Iriqat
- St. John of Jerusalem Eye Hospital Group, East Jerusalem 91198, Palestine
| | - Abdallah Shteiwi
- St. John of Jerusalem Eye Hospital Group, East Jerusalem 91198, Palestine
| | - Yael Sharon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva 4941492, Israel
| | - Michal Kramer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Department of Ophthalmology, Rabin Medical Center, Petah-Tikva 4941492, Israel
| | - Vicktoria Vishnevskia-Dai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- The Goldschleger Eye Institute, Department of Ophthalmology, Sheba Medical Center, Ramat-Gan 52620, Israel
| | - Shaul Sar
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3436212, Israel
| | - Yosif Boulos
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3436212, Israel
| | - Oren Tomkins-Netzer
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3436212, Israel
| | - Natalie Lavee
- Department of Ophthalmology, HaEmek Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 183411, Israel
| | - Yael Ben-Arie-Weintrob
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3525408, Israel
| | - Hadas Pizem
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 3525408, Israel
| | - Tamar Hareuveni-Blum
- Department of Ophthalmology, Galilee Medical Center, Azrieli Faculty of Medicine, Bar-Ilan University, Galilee 22100, Israel
| | - Marina Schneck
- Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Raz Gepstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Department of Ophthalmology, Meir Medical Center, Kfar Saba 4428164, Israel
| | - Dua Masarwa
- Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba 7830604, Israel
| | - Nakhoul Nakhoul
- Department of Ophthalmology, Baruch Padeh Medical Center, Azrieli Faculty of Medicine, Bar-Ilan University, Galilee 15280, Israel
| | - Erez Bakshi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Department of Ophthalmology, Assaf Harofeh Medical Center, Tzrifin 70300, Israel
| | - Shiri Shulman
- Ophthalmology institute, Assuta Medical Centers, Tel Aviv 6789140, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Michaella Goldstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Dan Ramon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Marina Anouk
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Institute of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Zohar Habot-Wilner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
- Correspondence: ; Tel.: +972-3-6973408
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Ostrovsky M, Ramon D, Iriqat S, Shteiwi A, Sharon Y, Kramer M, Vishnevskia-Dai V, Sar S, Boulos Y, Tomkins-Netzer O, Lavee N, Ben-Arie-Weintrob Y, Pizem H, Hareuveni-Blum T, Schneck M, Gepstein R, Masarwa D, Nakhoul N, Bakshi E, Shulman S, Goldstein M, Anouk M, Rosenblatt A, Habot-Wilner Z. Retinal vascular occlusions in ocular Behçet disease - a comparative analysis. Acta Ophthalmol 2023. [PMID: 36750991 DOI: 10.1111/aos.15645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/08/2023] [Accepted: 01/22/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE The literature on retinal vascular occlusions in Behçet disease (BD) patients is limited. The aim of this study is to thoroughly investigate retinal vascular occlusions among ocular BD patients. METHODS Retrospective, multicentre case-control study. Three-hundred and three eyes of 175 patients with ocular BD, from 13 hospitals in Israel and Palestine, were included. Patients were assigned into two groups according to the presence of retinal vascular occlusion. Epidemiology, systemic and ocular manifestations, treatments and outcomes were compared between the groups and risk factors for retinal vascular occlusions were identified. RESULTS One hundred twenty-five patients (71.4%) were male. The mean age at presentation was 28.2 ± 0.86 years. Retinal vascular occlusions were found in 80 eyes of 54 (30.9%) patients, including branch retinal vein occlusion (51.3%), peripheral vessels occlusions (32.5%), central retinal vein occlusion (13.8%) and arterial occlusions (7.5%). Systemic manifestations were similar among both groups. Anterior uveitis was more common in non-occlusive eyes (p < 0.01). Non-occlusive retinal vasculitis (p = 0.03) and ocular complications were more common in occlusive eyes (p < 0.01). Treatments including mycophenolate mofetil, Infliximab or a combination therapy of anti-metabolite and calcineurin inhibitor were more commonly used by occlusive patients (p < 0.05). Occlusive patients underwent more cataract surgeries (p = 0.03). The occlusive group had worse mean best-corrected visual acuity (BCVA) throughout follow-up (p < 0.01). Risk factors for retinal vascular occlusions included male sex and Jewish ethnicity (p < 0.05). CONCLUSION Retinal vascular occlusions were found in a third of ocular BD patients. Occlusive eyes had a worse prognosis. Risk factors for vascular occlusions were identified.
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Affiliation(s)
| | - Dan Ramon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Salam Iriqat
- St. John of Jerusalem Eye Hospital Group, East Jerusalem, Palestine
| | - Abdallah Shteiwi
- St. John of Jerusalem Eye Hospital Group, East Jerusalem, Palestine
| | - Yael Sharon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Michal Kramer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petah-Tikva, Israel
| | - Vicktoria Vishnevskia-Dai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Goldschleger Eye Institute, Department of Ophthalmology, Sheba Medical Center, Ramat-Gan, Israel
| | - Shaul Sar
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Yosif Boulos
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Oren Tomkins-Netzer
- Department of Ophthalmology, Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Natalie Lavee
- Department of Ophthalmology, HaEmek Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Yael Ben-Arie-Weintrob
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Hadas Pizem
- Department of Ophthalmology, Rambam Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Tamar Hareuveni-Blum
- Department of Ophthalmology, Galilee Medical Center, Azrieli Faculty of Medicine, Bar-Ilan University, Nahariya, Israel
| | - Marina Schneck
- Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Raz Gepstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Dua Masarwa
- Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Nakhoul Nakhoul
- Department of Ophthalmology, Baruch Padeh Medical Center, Azrieli Faculty of Medicine, Bar-Ilan University, Tiberias, Israel
| | - Erez Bakshi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Shiri Shulman
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Michaella Goldstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Marina Anouk
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Amir Rosenblatt
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Zohar Habot-Wilner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Safir M, Hecht I, Ahimor A, Zmujack-Yehiam S, Stein R, Bakshi E, Einan-Lifshitz A, Hartstein ME. The effect of thermo-mechanical device (Tixel) treatment on evaporative dry eye disease - A pilot prospective clinical trial. Cont Lens Anterior Eye 2022; 45:101741. [PMID: 35864019 DOI: 10.1016/j.clae.2022.101741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the effects of treatment with a thermomechanical skin device to the eyelid area on the clinical signs and symptoms of patients who suffer from dry eye disease (DED) secondary to meibomian gland dysfunction (MGD). METHODS Forty patients aged 45 years or older with DED due to MGD were recruited. Both eyes (n = 80) of each patient received three treatments with the Tixel device (Novoxel®, Israel), with each treatment separated by a 2-week period. Treatment was applied across the upper and lower eyelids, with the same intensity, tip protrusion distance, and contact duration. Two additional follow-up visits were performed at 2-week intervals after treatment cessation. DED status was evaluated during each visit via SPEED II questionnaire, tear break-up time (TBUT), corneal staining score (CSS), MGD score, and frequency of lubricant use. Visual acuity (VA) was recorded during first and last visits. RESULTS Mean age was 64.3 ± 12.4 years and 72.5 % (n = 29) were female. 45 % (n = 18) had a history of blepharitis, 12.5 % (n = 5) had chalazia, and 17.5 % (n = 7) suffered from allergic conjunctivitis. Mean follow-up time was 2.1 ± 0.6 months. Comparing the first and last visits, all parameters showed significant improvement after Tixel treatment: mean SPEED II scores (16.5 ± 5.9 to 11.8 ± 6.7, p < 0.001), CSS (2.0 ± 1.3 to 0.5 ± 0.9, p < 0.001), TBUT (2.7 ± 0.8 s to 6.5 ± 2.2 s, p < 0.001), MGD score (2.7 ± 0.5 to 1.2 ± 0.4, p < 0.001), and rate of lubricant use (3.4 ± 2.4 per day to 1.9 ± 2.0, p < 0.001). VA also improved (0.10 ± 0.11 logMAR to 0.08 ± 0.10 logMAR, p < 0.05). No major side effects were observed. CONCLUSIONS In this pilot study Tixel treatment induced significant improvement of signs and symptoms among patients with DED due to MGD. Benefits persisted for at least one month. Further randomized controlled double-blinded studies are needed.
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Affiliation(s)
- Margarita Safir
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Idan Hecht
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Ahimor
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Zmujack-Yehiam
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran Stein
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Erez Bakshi
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Einan-Lifshitz
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Morris E Hartstein
- Ophthalmology Department, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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5
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Habot-Wilner Z, Trivizki O, Goldstein M, Kesler A, Shulman S, Horowitz J, Amer R, David R, Ben-Arie-Weintrob Y, Bakshi E, Almog Y, Sartani G, Vishnevskia-Dai V, Kramer M, Bar A, Kehat R, Ephros M, Giladi M. Cat-scratch disease: ocular manifestations and treatment outcome. Acta Ophthalmol 2018; 96:e524-e532. [PMID: 29504674 DOI: 10.1111/aos.13684] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/26/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE To characterize cat-scratch disease (CSD) ocular manifestations and visual outcome and evaluate the effect of systemic antibiotics and corticosteroids on final visual acuity (VA). METHODS Multicentre retrospective cohort study. Medical records of 86 patients with ocular disease (107 eyes) of 3222 patients identified in a national CSD surveillance study were reviewed. RESULTS Mean age was 35.1 ± 14.2 years. Median follow-up was 20 weeks (range 1-806 weeks). Of 94/107 (88%) eyes with swollen disc, 60 (64%) had neuroretinitis at presentation, 14 (15%) developed neuroretinitis during follow-up, and 20 (21%) were diagnosed with inflammatory disc oedema. Optic nerve head lesion, uveitis, optic neuropathy and retinal vessel occlusion were found in 43 (40%), 38 (36%), 34 (33%) and 8 (7%) eyes, respectively. Good VA (better than 20/40), moderate vision loss (20/40-20/200) and severe vision loss (worse than 20/200) were found in 26/79 (33%), 35/79 (44%) and 18/79 (23%) eyes at baseline and in 63/79 (80%), 11/79 (14%) and 5/79 (6%) eyes at final follow-up, respectively (p < 0.001). Significant VA improvement (defined as improvement of ≥3 Snellen lines at final follow-up compared to baseline) occurred in 12/24 (50%) eyes treated with antibiotics compared with 14/16 (88%) eyes treated with antibiotics and corticosteroids (p = 0.02). Multivariate logistic regression was suggestive of the same association (odds ratio 7.0; 95% CI 1.3-37.7; p = 0.024). CONCLUSION Optic nerve head lesion is a common and unique manifestation of ocular CSD. Most patients improved and had final good VA. Combined antibiotics and corticosteroid treatment was associated with a better visual outcome.
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Affiliation(s)
- Zohar Habot-Wilner
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Omer Trivizki
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Michaella Goldstein
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Anat Kesler
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Shiri Shulman
- Division of Ophthalmology; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Josepha Horowitz
- Department of Ophthalmology; Carmel Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Radgonde Amer
- Department of Ophthalmology; Hadassah Medical Center; The Hebrew University Hadassah Medical School; Jerusalem Israel
| | - Ran David
- Department of Ophthalmology; Hadassah Medical Center; The Hebrew University Hadassah Medical School; Jerusalem Israel
| | - Yael Ben-Arie-Weintrob
- Department of Ophthalmology; Rambam Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Erez Bakshi
- Department of Ophthalmology; Assaf Harofeh Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Yehoshua Almog
- Department of Ophthalmology; Meir Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Gil Sartani
- Department of Ophthalmology; Haemek Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Vicktoria Vishnevskia-Dai
- The Goldschleger Eye Institute; Department of Ophthalmology; Sheba Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Michal Kramer
- Division of Ophthalmology; Rabin Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Asaf Bar
- Department of Ophthalmology; Wolfson Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Rinat Kehat
- Department of Ophthalmology; Bnai Zion Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Moshe Ephros
- Pediatric Infectious Disease Unit; Carmel Medical Center; The Ruth and Bruce Rappaport Faculty of Medicine; Technion; Israel Institute of Technology; Haifa Israel
| | - Michael Giladi
- Infectious Disease Unit and The Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases; Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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6
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Barkana Y, Bakshi E, Goldich Y, Morad Y, Kaplan A, Avni I, Zadok D. Characterization and comparison of the 10-2 SITA-standard and fast algorithms. ScientificWorldJournal 2012; 2012:821802. [PMID: 22654632 PMCID: PMC3354663 DOI: 10.1100/2012/821802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 12/26/2011] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To compare the 10-2 SITA-standard and SITA-fast visual field programs in patients with glaucoma. METHODS We enrolled 26 patients with open angle glaucoma with involvement of at least one paracentral location on 24-2 SITA-standard field test. Each subject performed 10-2 SITA-standard and SITA-fast tests. Within 2 months this sequence of tests was repeated. RESULTS SITA-fast was 30% shorter than SITA-standard (5.5 ± 1.1 vs 7.9 ± 1.1 minutes, P < 0.001). Mean MD was statistically significantly higher for SITA-standard compared with SITA-fast at first visit (Δ = 0.3 dB, P = 0.017) but not second visit. Inter-visit difference in MD or in number of depressed points was not significant for both programs. Bland-Altman analysis showed that clinically significant variations can exist in individual instances between the 2 programs and between repeat tests with the same program. CONCLUSIONS The 10-2 SITA-fast algorithm is significantly shorter than SITA-standard. The two programs have similar long-term variability. Average same-visit between-program and same-program between-visit sensitivity results were similar for the study population, but clinically significant variability was observed for some individual test pairs. Group inter- and intra-program test results may be comparable, but in the management of the individual patient field change should be verified by repeat testing.
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Affiliation(s)
- Yaniv Barkana
- Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin 73000, Israel
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Abstract
ABSTRACT
Purpose
To assess the effect of corneal cross-linking on progressive keratoconus in children.
Method
In this retrospective study we enrolled nine eyes of nine consecutive children aged 11 to 17 years old who underwent corneal riboflavin-UVA induced cross-linking for progressive keratoconus at the Department of Ophthalmology at Assaf Harofeh Medical Center. They were followed for 6 to 24 months (average 16 ± 8.1 months). Evaluated parameters were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, pachymetry, slit lamp examination and corneal topography.
Results
Cross-linking resulted in stability of visual acuity in seven of the nine (77.8%) treated eyes. We found a nonsignificant improvement in UCVA and BSCVA with a small reduction of manifest cylinder. Furthermore, there was an improvement in spherical equivalent that was close to statistical significance (p = 0.07). There was 0.86 D reduction of average Kmax value postoperatively (p = 0.36). Most patients (7 of 9, 77.8%) showed a long-term stability or reduction in Kmax.
Conclusion
In this study, we demonstrated the efficacy of corneal cross-linking in arresting the progression of keratoconus in children. We believe that larger scale studies in this age group should be performed to further establish the relevance of this technique in children.
How to cite this article
Bakshi E, Barkana Y, Goldich Y, Avni I, Zadok D. Corneal Cross-Linking for Progressive Keratoconus in Children Our Experience. Int J Keratoco Ectatic Corneal Dis 2012;1(1):53-56.
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Katzenell U, Bakshi E, Ashkenazi I, Bar-Dayan Y, Yeheskeli E, Eviatar E. A retrospective study of the eligibility for tonsillectomy. Isr Med Assoc J 2010; 12:681-683. [PMID: 21243868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The criteria for tonsillectomy for recurrent tonsillitis were established by prospective studies in the pediatric population and are applied to adults as well. No studies have been conducted to assess whether these guidelines are followed. OBJECTIVES To examine the eligibility for tonsillectomy of tonsillectomized patients who were referred because of recurrent acute tonsillitis. METHODS A retrospective case series in an ambulatory military otolaryngology clinic was conducted, and the medical records of 44 tonsillectomized patients who suffered from throat infections during the year before surgery were analyzed. The number of tonsillar infections that met the referral criteria was counted. RESULTS The average number of throat infections that met the referral criteria was 1.89 per year. The average number of visits to the clinic due to upper respiratory tract infection was 12.92 (range 2-36) per year. The average number of visits for any cause was 45.13 (range 6-64) per year. One patient with eight documented throat infections met the criterion of more than six infections in the last year. CONCLUSION Although the referral criteria were not strictly met, we speculate that surgery was probably beneficial. This study shows that the indications for tonsillectomy referral are not strictly followed, and that new criteria for referral of adults for tonsillectomy need to be established.
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Affiliation(s)
- Udi Katzenell
- Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Zerfin, Israel.
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Bakshi E, Ashkenazi I, Katzenell U, Cohen O, Niv Y, Bar-Dayan Y. Wireless Capsule Endoscopy in Israeli Defense Force: Two Years of Experience. Mil Med 2009; 174:991-5. [DOI: 10.7205/milmed-d-00-3208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Morad Y, Bakshi E, Levin A, Binyamini OG, Zadok D, Avni I, Bar Dayan Y. Screening and treating amblyopia: are we making a difference? Invest Ophthalmol Vis Sci 2007; 48:2084-8. [PMID: 17460264 DOI: 10.1167/iovs.06-0089] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the rate of amblyopia in native Jewish Israelis compared with those who immigrated from the former Soviet Union (U.S.S.R.) after they were 10 years of age. METHODS Health records of all 16-year-old subjects examined in the Israel Defense Forces Recruitment Center between 1998 and 2003 were analyzed. The number of subjects with best corrected visual acuity (BCVA) of 6/12 or less in at least one eye among native Israelis and among those who immigrated to Israel from the U.S.S.R. after they were 10 years of age was determined. Subjects who had any ocular disease except cataract, corneal opacity, strabismus, or ptosis were excluded. RESULTS Of 305,712 subjects examined between 1998 and 2003, 292,255 were enrolled in the study. Of those, 260,186 (89%) were born in Israel and 32,069 (11%) were born in the U.S.S.R. and immigrated to Israel after they were 10 years of age. There were 2565 (0.98%) native Israelis and 483 (1.5%) immigrants who had BCVA of 6/12 or less in at least one eye (chi(2) test, P < 0.00001). The rate of amblyopia among subjects who had refractive errors was 14.6% among immigrants, as opposed to 8.0% among native Israelis (P < 0.0001), whereas amblyopia rates among those with strabismus, cataract, or ptosis were similar in native Israelis and immigrants (34.4%, 38.6%, 12.8% as opposed to 34%, 37.5%, 15.4%, respectively, P = 0.5-0.61). CONCLUSIONS The difference in the rate of refractive amblyopia as opposed to strabismic and deprivation amblyopia may be due to the difference in vision screening methods between both countries.
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Affiliation(s)
- Yair Morad
- Department of Ophthalmology, Assaf Harofeh Medical Center, Tel Aviv University, Zrifin, Israel.
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George J, Harats D, Bakshi E, Adler Y, Levy Y, Gilburd B, Shoenfeld Y. Anti-oxidized low density lipoprotein antibody determination as a predictor of restenosis following percutaneous transluminal coronary angioplasty. Immunol Lett 1999; 68:263-6. [PMID: 10424430 DOI: 10.1016/s0165-2478(99)00050-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Recent data suggests that autoimmune factors play an important role in the pathogenesis of atherosclerosis. In this context several autoantigens have been shown to elicit an immune response that results in accelerated atherosclerotic plaque formation. In the present study, we investigated whether elevated titers of anti-oxidized low density lipoprotein (oxLDL), anticardiolipin and antibodies to beta2-glycoprotein I (beta2GPI) can predict subsequent restenosis in patients undergoing percutaneous transluminal coronary angioplasty (PTCA). A total of 74 consecutive patients (52 males, 22 females) with coronary artery disease were enrolled in the study. All patients underwent successful PTCA prior to which blood was drawn for the antibody analysis. The PTCA was followed by a clinical evaluation. Patients with recurrent chest pains underwent a repeated angiography and 34 of the 74 patients (46%) experienced restenosis. Patients positive for the presence of anti-oxLDL antibodies were more likely to develop restenosis within 6 months when compared with patients with no subsequent restenosis (relative-risk of 1.87; P< 0.05). Presence of anti-oxLDL antibodies was associated with hyperlipidemia (r = 0.25; P < 0.05) but not with other risk factors for atherosclerosis. Positivity for anticardiolipin or anti-beta2GPI antibodies which associate with a prothrombotic state, was not effective in predicting lumen narrowing. Thus, the presence of elevated levels of anti-oxLDL antibodies is associated with a higher risk for coronary restenosis following PTCA.
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Affiliation(s)
- J George
- Department of Medicine B, Sheba Medical Center, Tel-Hasomer, Israel
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George J, Patnaik M, Bakshi E, Levy Y, Ben-David A, Ahmed A, Peter JB, Shoenfeld Y. Hantavirus seropositivity in Israeli patients with renal failure. Viral Immunol 1998; 11:103-8. [PMID: 9765032 DOI: 10.1089/vim.1998.11.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The hantavirus is known to cause hemorraghic fever with renal syndrome (HFRS), which is widely spread in Europe and Asia. Several reports have shown an association of hantavirus antibody titers and the occurrence of renal dysfunction. From these observations, it appears that the virus is widely distributed, and different strains prevail in various areas. In the present work we studied 81 patients with end-stage renal-failure under hemodialysis (HD) treatment, 55 with mild to moderate renal failure, and 50 healthy subjects for the presence of antibodies to Hantaan and Puumala viruses. We found that 12.3% of the hemodialysis patients and 9% of the mild to moderate renal failure patients had elevated IgG anti-body titers to Puumala virus compared with 2% of the controls. IgM antibodies to Puumala virus was principally elevated in patient with chronic renal failure (CRF) not on hemodialysis (14.5%) compared with the hemodialyzed (1.2%) and controls (0%) subjects. Hantaan virus IgG antibodies were detected in 3.7% of the HD patients, 5.5% of the CRF not on HD, and in none of the controls. IgM Hantaan antibodies were found only in the non-HD renal failure patients. None of the sera were found to contain antibodies to phospholipids or single-stranded DNA. These results emphasize the widespread nature of infection with hantaviruses and imply that elaborate testing for these serologies should be performed, especially in patients with unexplained renal failure.
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Affiliation(s)
- J George
- Specialty Laboratories Inc., Santa Monica, California, USA
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Sherer Y, Bakshi E, Rotman P, Levy Y, Shoenfeld Y. Comparative clinical study of cefonicid, chloramphenicol, and penicillin in community-acquired pneumonia. Int J Mol Med 1998; 2:343-8. [PMID: 9855709 DOI: 10.3892/ijmm.2.3.343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Community-acquired pneumonia is one of the most common infectious conditions that require hospitalization. When intravenous treatment is indicated, cefonicid is usually the drug of choice. The aim of this study was to find out if chloramphenicol, which is superior to the standard drugs from a financial point of view, could serve as an equally efficient treatment, especially in the elderly. The outcomes of 3 pneumonia patient groups who were either treated with cefonicid, chloramphenicol or penicillin-G (n = 59, 17, 24, respectively) were retrospectively compared. Data about demographic characteristics of the patients, clinical outcomes, rehospitalization rates, duration of improvement/treatment/ hospitalization and clinical laboratory tests were obtained from each patient's medical records. Only minor differences (even though occasionally significant) were found with respect to rehospitalization and improvement rates, duration of hospitalization, treatment and improvement, death rates and clinical laboratory tests. However, chloramphenicol patients were found to be significantly older than cefonicid patients. Moreover, no bone-marrow suppression was associated with chloramphenicol treatment. All 3 drugs tested seem to have the same efficacy. We conclude that since chloramphenicol is as safe as, and much cheaper than cefonicid, this antibiotic agent is not inferior to the others, its usage in older patients with pneumonia should be considered.
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Affiliation(s)
- Y Sherer
- Department of Medicine 'B' and Research Unit of Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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