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  1. Article ; Online: Tattoo Inflammation and Sarcoid Uveitis.

    de Castro-Abeger, Alexander / Gangaputra, Sapna

    Ophthalmology

    2019  Volume 126, Issue 8, Page(s) 1089

    MeSH term(s) Granuloma/etiology ; Humans ; Male ; Sarcoidosis/complications ; Tattooing ; Uveitis/etiology ; Young Adult
    Language English
    Publishing date 2019-07-20
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 392083-5
    ISSN 1549-4713 ; 0161-6420
    ISSN (online) 1549-4713
    ISSN 0161-6420
    DOI 10.1016/j.ophtha.2019.05.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Effectiveness of a Formal Business of Ophthalmology Course for Trainees

    Siktberg, Jonathan / de Castro-Abeger, Alexander / Berkowitz, Sean T. / Law, Janice C.

    Journal of Academic Ophthalmology

    2023  Volume 15, Issue 01, Page(s) e68–e72

    Abstract: Objective: In medical school and residency training, there is little emphasis on the administrative and business aspects of running a clinical practice as either an employee or a business owner. However, by the first day of practice, young ... ...

    Abstract Objective: In medical school and residency training, there is little emphasis on the administrative and business aspects of running a clinical practice as either an employee or a business owner. However, by the first day of practice, young ophthalmologists need to have a basic understanding of the business of medicine to be successful in clinical practice and to avoid common pitfalls. Areas such as risk management, negotiation, financial health, lawsuits, marketing, coding, and professionalism are particularly important for practicing ophthalmologists to grasp. We instituted a formal practice management course to increase the early exposure of our trainees to the business aspects of ophthalmology.
    Methods: Ophthalmology trainees engaged in 11, 1-hour sessions over 3 weeks during a practice management course covering 10 of the most relevant business topics for early career ophthalmologists. A precourse needs assessment, and a postcourse satisfaction and outcomes survey were administered.
    Results: Of the 24 trainees who completed the presurvey, 96% of respondents had no previous training in contract negotiation, 88% lacked training in lawsuits, and 88% had no training in liability insurance. 96% had no inpatient coding education, and 88% had no outpatient coding training. Seventeen trainees completed the postsurvey, and statistically significant improvements in confidence ratings were found in all domains including coding, malpractice claims, and building a practice. 88% of trainees reported that the course improved their ability to code, and 100% agreed that the course improved their understanding of lawsuits, ability to negotiate a contract, and their understanding of the business of ophthalmology.
    Conclusion: A formal, targeted business of ophthalmology course improved the knowledge of trainees on essential business concepts. This course can serve as a model for other programs looking to meet this educational need.
    Keywords business of ophthalmology ; practice management ; residency education ; malpractice ; negotiation
    Language English
    Publishing date 2023-01-01
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2897840-7
    ISSN 2475-4757 ; 2475-4757
    ISSN (online) 2475-4757
    ISSN 2475-4757
    DOI 10.1055/s-0043-1763514
    Database Thieme publisher's database

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  3. Article ; Online: Case Report: Significant Complications of Cosmetic Iris Implantation.

    Hatcher, Jeremy B / De Castro-Abeger, Alexander / Brown, Eric N / Robinson, Joshua L / Shieh, Christine

    Optometry and vision science : official publication of the American Academy of Optometry

    2021  Volume 98, Issue 8, Page(s) 886–890

    Abstract: Significance: The complications of cosmetic iris implantation may result in irreversible vision loss. Patients who obtain these implants against general medical consensus may present to providers when sequelae develop. In symptomatic patients, providers ...

    Abstract Significance: The complications of cosmetic iris implantation may result in irreversible vision loss. Patients who obtain these implants against general medical consensus may present to providers when sequelae develop. In symptomatic patients, providers must recognize the imminent risk to vision and mitigate further ocular damage.
    Purpose: This is an observational clinical case report of a patient with significant, progressive, vision-threatening ocular pathology from prior cosmetic iris implantation, despite medical and surgical efforts to preserve vision.
    Case report: A 35-year-old HIV-positive man with a history of cosmetic iris implants in India 16 months prior was referred to our center. He had a history of 4 months of steroid-refractory uveitis and secondary glaucoma, with IOP measurements of more than 50 mmHg in the outpatient setting. Slit-lamp examination revealed ciliary flush, pannus formation, corneal edema, and keratic precipitates. Optical coherence tomography suggested possible retinal nerve fiber layer loss in the left eye. He was diagnosed with uveitis and glaucoma, and after a short course of IOP-lowering medication, the implants were removed sequentially. Post-operatively, his course was complicated by IOP elevation, cataract development, and corneal decompensation. This led to bilateral Ahmed tube placement, Descemet's stripping endothelial keratoplasty of the right eye, and pending cataract surgery because of now-dense bilateral cataracts.
    Conclusions: This case emphasizes the vision-threatening dangers of cosmetic iris implantation. It also demonstrates that sequelae may persist and develop despite implant removal and anticipatory management. Providers managing similar patients should carefully monitor for disease progression and maintain a low threshold for referral and/or decisive surgical intervention.
    MeSH term(s) Adult ; Corneal Edema ; Glaucoma/etiology ; Glaucoma/surgery ; Humans ; Intraocular Pressure ; Iris/diagnostic imaging ; Iris/surgery ; Male ; Visual Acuity
    Language English
    Publishing date 2021-08-30
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1001706-9
    ISSN 1538-9235 ; 1040-5488
    ISSN (online) 1538-9235
    ISSN 1040-5488
    DOI 10.1097/OPX.0000000000001752
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Horizontal Transposition of the Vertical Rectus Muscles to Correct a Head Tilt in 5 Patients With Idiopathic Nystagmus Syndrome.

    de Castro-Abeger, Alexander / Benegas, Nancy M / Kushner, Burt / Donahue, Sean P

    American journal of ophthalmology

    2020  Volume 217, Page(s) 68–73

    Abstract: Purpose: Patients with idiopathic nystagmus syndrome often develop an abnormal head position. A horizontal face turn can be treated with the augmented Kestenbaum procedure, while patients with a chin up or chin down position can be treated with surgery ... ...

    Abstract Purpose: Patients with idiopathic nystagmus syndrome often develop an abnormal head position. A horizontal face turn can be treated with the augmented Kestenbaum procedure, while patients with a chin up or chin down position can be treated with surgery on the vertical recti and/or oblique muscles. Although rare, some patients may have a head tilt with no face turn. We report 5 patients who underwent horizontal transposition of the vertical rectus muscles to correct a head tilt.
    Design: Retrospective case series.
    Methods: Five cases from 2 different tertiary referral eye centers and 3 different surgeons were reviewed and analyzed. Surgery for the patients consisted of either a 7-mm or full tendon-width transposition of the vertical rectus muscles of each eye to induce cyclotorsion in the direction of the head tilt. The presenting clinical histories, measurements, and surgical outcomes were reviewed. The primary outcome measure was correction of head tilt.
    Results: Of 5 patients, 2 had previous horizontal face turns that were corrected with an augmented Kestenbaum procedure and later developed a head tilt, while 3 patients presented primarily with a head tilt. Age at surgery ranged from 5 to 8 years. Initial tilts were measured between 20-45°. Surgery was performed bilaterally except in 1 patient with history of morning glory disc anomaly and therefore transposition surgery was only performed on fixating eye for that patient. Postoperatively, 3 of 5 patients had near complete (0-5°) resolution of their tilt. One patient had a persistent 5-degree head tilt and a small chin up that was nullified with vertical prisms in spectacles.
    Conclusion: Transposition of the vertical rectus to induce cyclotorsion in the direction of the head tilt improves abnormal head titling in patients who have idiopathic nystagmus syndrome. This procedure was safely performed in patients with previous augmented Kestenbaum procedures with no incidence of anterior segment ischemia in our cases.
    MeSH term(s) Child ; Child, Preschool ; Female ; Fixation, Ocular ; Head/physiopathology ; Head Movements/physiology ; Humans ; Male ; Nystagmus, Pathologic/physiopathology ; Nystagmus, Pathologic/surgery ; Oculomotor Muscles/physiopathology ; Oculomotor Muscles/surgery ; Ophthalmologic Surgical Procedures/methods ; Postoperative Period ; Posture/physiology ; Retrospective Studies ; Syndrome ; Treatment Outcome ; Visual Acuity
    Language English
    Publishing date 2020-04-30
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80030-2
    ISSN 1879-1891 ; 0002-9394
    ISSN (online) 1879-1891
    ISSN 0002-9394
    DOI 10.1016/j.ajo.2020.04.034
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Connections between intrinsically photosensitive retinal ganglion cells and TBI symptoms.

    Elenberger, Jason / Kim, Bohan / de Castro-Abeger, Alexander / Rex, Tonia S

    Neurology

    2020  Volume 95, Issue 18, Page(s) 826–833

    Abstract: The majority of patients with traumatic brain injury (TBI) are classified as having a mild TBI. Despite being categorized as mild, these individuals report ongoing and complex symptoms, which negatively affect their ability to complete activities of ... ...

    Abstract The majority of patients with traumatic brain injury (TBI) are classified as having a mild TBI. Despite being categorized as mild, these individuals report ongoing and complex symptoms, which negatively affect their ability to complete activities of daily living and overall quality of life. Some of the major symptoms include anxiety, depression, sleep problems, headaches, light sensitivity, and difficulty reading. The root cause for these symptoms is under investigation by many in the field. Of interest, several of these symptoms such as headaches, ocular pain, light sensitivity, and sleep disturbances may overlap and share underlying circuitry influenced by the intrinsically photosensitive retinal ganglion cells (ipRGCs). These cells are light sensing, but non-image forming, and they influence corneal function, pupillary constriction, and circadian rhythm. In this review, we discuss these symptoms and propose a role of the ipRGCs as at least one underlying and unifying cause for such symptoms.
    MeSH term(s) Animals ; Brain Injuries, Traumatic/diagnosis ; Brain Injuries, Traumatic/physiopathology ; Humans ; Photophobia/physiopathology ; Retinal Ganglion Cells/physiology
    Language English
    Publishing date 2020-09-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
    ZDB-ID 207147-2
    ISSN 1526-632X ; 0028-3878
    ISSN (online) 1526-632X
    ISSN 0028-3878
    DOI 10.1212/WNL.0000000000010830
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 374: Show issues

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  6. Article ; Online: Early Ophthalmology Findings in Nonsyndromic Craniosynostosis.

    Tien, Christopher / Johns, Alexis L / Choi, Dylan G / de Castro-Abeger, Alexander / Buswell, Nichole / McComb, J Gordon / Durham, Susan R / Urata, Mark M

    The Journal of craniofacial surgery

    2023  Volume 34, Issue 4, Page(s) 1259–1261

    Abstract: Craniosynostosis (CS) occurs 1 in 2500 births and surgical intervention is indicated partly due to risk for elevated intracranial pressure (EICP). Ophthalmological examinations help identify EICP and additional vision concerns. This study describes ... ...

    Abstract Craniosynostosis (CS) occurs 1 in 2500 births and surgical intervention is indicated partly due to risk for elevated intracranial pressure (EICP). Ophthalmological examinations help identify EICP and additional vision concerns. This study describes preoperative and postoperative ophthalmic findings in CS patients (N=314) from chart review. Patients included nonsyndromic CS: multisuture (6.1%), bicoronal (7.3%), sagittal (41.4%), unicoronal (22.6%), metopic (20.4%), and lambdoidal (2.2%). Preoperative ophthalmology visits were at M =8.9±14.1 months for 36% of patients and surgery was at M =8.3±4.2 months. Postoperative ophthalmology visits were at age M =18.7±12.6 months for 42% with follow-up at M =27.1±15.1 months for 29% of patients. A marker for EICP was found for a patient with isolated sagittal CS. Only a third of patients with unicoronal CS had normal eye exams (30.4%) with hyperopia (38.2%) and anisometropia (16.7%) at higher rates than the general population. Most children with sagittal CS had normal exams (74.2%) with higher than expected hyperopia (10.8%) and exotropia (9.7%). The majority of patients with metopic CS had normal eye exams (84.8%). About half of patients with bicoronal CS had normal eye exams (48.5%) and findings included: exotropia (33.3%), hyperopia (27.3%), astigmatism (6%), and anisometropia (3%). Over half of children with nonsyndromic multisuture CS had normal exams (60.7%) with findings of: hyperopia (7.1%), corneal scarring (7.1%), exotropia (3.6%), anisometropia (3.6%), hypertropia (3.6%), esotropia (3.6%), and keratopathy (3.6%). Given the range of findings, early referral to ophthalmology and ongoing monitoring is recommended as part of CS care.
    MeSH term(s) Child ; Humans ; Infant ; Child, Preschool ; Hyperopia ; Exotropia ; Anisometropia ; Ophthalmology ; Craniosynostoses/diagnosis ; Craniosynostoses/surgery ; Retrospective Studies
    Language English
    Publishing date 2023-04-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1159501-2
    ISSN 1536-3732 ; 1049-2275
    ISSN (online) 1536-3732
    ISSN 1049-2275
    DOI 10.1097/SCS.0000000000009330
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  7. Article ; Online: Optical Coherence Tomography Angiography Compared to Fluorescein Angiography in Branch Retinal Artery Occlusion.

    de Castro-Abeger, Alexander H / de Carlo, Talisa E / Duker, Jay S / Baumal, Caroline R

    Ophthalmic surgery, lasers & imaging retina

    2015  Volume 46, Issue 10, Page(s) 1052–1054

    Abstract: A case of embolic branch retinal artery occlusion (BRAO) was evaluated utilizing both fluorescein angiography (FA) and novel optical coherence topography angiography (OCTA). OCTA demonstrated a well-demarcated area of flow interruption secondary to the ... ...

    Abstract A case of embolic branch retinal artery occlusion (BRAO) was evaluated utilizing both fluorescein angiography (FA) and novel optical coherence topography angiography (OCTA). OCTA demonstrated a well-demarcated area of flow interruption secondary to the retinal artery embolus, as well as capillary nonperfusion in the involved region corresponding to FA findings. Therefore, OCTA can demonstrate vascular features of embolic BRAO correlating to FA findings. In this case, OCTA also revealed an increased perfusion defect in the superficial vascular capillary plexus that was not seen on FA.
    MeSH term(s) Aged ; Angiography ; Embolism/diagnosis ; Embolism/physiopathology ; Fluorescein Angiography ; Humans ; Ischemia/diagnosis ; Male ; Regional Blood Flow ; Retinal Artery/pathology ; Retinal Artery Occlusion/diagnosis ; Retinal Artery Occlusion/physiopathology ; Tomography, Optical Coherence
    Language English
    Publishing date 2015-11
    Publishing country United States
    Document type Case Reports ; Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2701167-7
    ISSN 2325-8179 ; 2325-8160
    ISSN (online) 2325-8179
    ISSN 2325-8160
    DOI 10.3928/23258160-20151027-12
    Database MEDical Literature Analysis and Retrieval System OnLINE

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