bluuebunny/crossref_metadata_2025 huggingface dataset:
Controlled pupilar miosis to improve mesopic visual function in drivers over 40 years old
Authors: NAVARRO VALLS J , RAMIREZ‐MERCADO G , PEREZ‐CARRASCO MJ , LOBATO‐RINCON LL , CHAMORRO E , SANCHEZ‐RAMOS C
Published: August 2012

Purpose To evaluate the influence of a diffuse illumination device located outside the field of vision that provokes a controlled pupillar miosis, on the visual acuity and contrast sensitivity in drivers tested in mesopic conditions

Methods Cross‐sectional prospective observational study in which visual Acuity 100% and 20% contrast by ETDRS Test (VA100 and VA20) and Contrast Sensitivity by Pelli‐Robson Test (CS) were evaluated in 39 drivers individuals under 40 years old and 30 drivers over 40. The study was carried out in a simulated setting for night driving with and without the interposition of the diffuse illumination device

Results In individuals aged over 40 years, an statistically significant improvement of visual function was exhibit. Baseline visual acuity and contrast sensitivity scores were: VA100=0.02±0.18logMAR, VA20=0.21±0.2logMAR, and CS=0.62±0.32, whereas values for the interposition of diffuse illumination device were: VA100=‐0.03±0.14logMAR(p=0.02), VA20=0.19±0.17logMAR(p=0.3), and CS=0.76±0.33(p=0.0003). On the other hand, in drivers aged under 40, statistically significance was not found. In this condition, baseline visual function was: VA100=‐0.1±0.11logMAR, VA20=0.13±0.19logMAR, and CS=1.06±0.2, whereas the interposition of the mentioned system showed the following values: VA100=0.01±0.09logMAR(p=0.9), VA20=0.09±0.14logMAR(p=0.3), and CS=1.08±0.16(p=0.6)

Conclusion Using diffuse illumination device in the interior of the vehicle, provides significant improvement in both high contrast visual acuity and contrast sensitivity in the group older than 40 years
Changes in contrast sensitivity perception due to protector screens for welding tasks: conventional protective optical filter vs novel protective optical filter of selective absorbance
Authors: BONNIN ARIAS C , AGUIRRE‐VILACORO V , CHAMORRO E , LOBATO‐RINCON LL , LANGA‐MORAGA A , NAVARRO‐VALLS J , SANCHEZ‐RAMOS C
Published: August 2012

Purpose To evaluate differences in contrast sensitivity perception in central visual field using protective optic filters for welding tasks. Two interposed filters are compared: a conventional protective optical filter and a new protective optical filter with selective absorption designed by University Complutense of Madrid (UCM).

Methods 36 people of working‐age were included in a cross‐sectional prospective observational study. Contrast sensitivity threshold in central visual field was evaluated using FDT Perimeter, C‐20 procedure (Humphrey systems, USA). Three conditions were set: a) without optical filters; b) with an interposition of conventional protective optical filter for welding (shade 2.5) and c) with an interposition of a novel protective optical filter of selective absorbance that fully blocks the short wavelength light and minimally attenuates the remaining bands of the visible spectrum.

Results Contrast sensitivity in all visual field areas evaluated diminished 91‐98% with the conventional protective optical filters. UCM optical filters provoked a low‐level decrease in contrast sensitivity (9‐19%). Mean contrast sensitivity thresholds were 29.5±5dB, 25.5±4dB, 1.8±2dB in conditions a, b and c respectively

Conclusion Conventional optical filters resulted in drastically diminished contrast sensitivity. UCM optical filter minimally diminish the visual function, allowing a suitable visibility and also maintaining an appropriate level of protection against phototoxic damage.
Morphometrical indices in acquired myopia
Authors: BOYCHUK IRYNA , GORBATUK TL
Published: August 2012

Purpose On an etiology myopia can be congenital and acquired (school myopia), and on character of development – stable and progressing. According to experimental works (Ai L, Li J, Guan H, Wildsoet CF,2009, Nickla DL, Wildsoet CF, Troilo D., 2002) it is known, that the thickness of a retina varies at eyeball growth, and also at defocus change. The probability of myopia growth in each patient remains difficult to predict. The purpose was to reveal differences in patients with acquired myopia and divide them on studied indices

Methods A child of 7‐15 years old (53) with myopia were observed, a criterion of inclusion in research was acquired myopia. Parameters which were studied: visual acuity, refraction, axis length of an eye, accommodation reserves, intraocular pressure, retina layer thickness and peripapillary fiber layer thickness, optic nerve disk indices by optical coherent tomography under standard protocols by SOCT Copernicus, Optopol Technology Sp.z o.o., Poland

Results Optimum points of division of acquired myopia on stable and progressing were established by ROC analysis. The discriminate analysis with high reliability has shown, that the progressing form of myopia will be observed in children with average thickness in a zone 3mm more than 246,3mk , with a refraction more than 4,5 dptr and axes more than 25,3mm (Р=0,0001). Fisher's discriminating functions are defined and the equations for definition of the stable and progressing forms of acquired myopia are offered. Effect of classification is 80,3%.

Conclusion Results have allowed to offer model of classification for the stable and progressing forms of myopia on morfometric indices, axis length and refraction in patients with acquired myopia
Spatial tuning affects diagnostic efficacy of pseudoisochromatic plates
Authors: KRASTEL H , KALTAKJI F , LEERS S , JERCHEL N , JONAS JB
Published: August 2012

Purpose To demonstrate that the diagnostic efficacy of pseudoisochromatic plates is reduced by oversized and by undersized angles of observation.

Methods Pseudoisochromatic “C” and “E” plates accounting for equal demands on color vision in repeated exams were presented to 7 daltonian and 10 normal observers. An illuminant D 65 source (Unity Color Light2go) rendered 170 cd/m2 of luminance. The standard viewing time was 3 s, the viewing angles were 33.4°, 7.4° and 1.8°.

Results Daltonians failed to recognize the plates at 7.4° of visual angle which correspondes to the recommended standard viewing distance. At a viewing angle of 33.4° the plates were recognized by 4 of 7 Daltonians. At a viewing angle of 1.8° the plates were recognized by 3 of 7 Daltonians. With 1.8° of viewing angle, normal observers claimed fusion of i) those various pseudoisochromatic picture elements which are on the red side of yellow, and of ii) those various elements which are on the green side.

Conclusion A standardized observation distance (0,7 m) is necessary for pseudoisochromatic plates, as recommended by Ishihara and Velhagen. At small viewing angle, antagonistic processing of colored picture elements is impaired, causing loss of optotype camouflage. At large viewing angle, individual elements may activate weak color opponent mechanisms in a daltonian retina where green cones or red cones are scarce but not entirely lacking. Poster visitors may observe spatial tuning within their own color vision.

Commercial interest
Vision in subjects with hyperawareness of afterimages and “visual snow”
Authors: ALISSA R , BI W , BESSERO AC , PLANT G , BARBUR JL
Published: August 2012

Purpose Some patients complain of persisting visual noise, often described as “visual snow” (VS) and / or prolonged afterimages, but show no obvious clinical abnormalities. The purpose of this study was to examine the extent to which the processing of different stimulus attributes remains normal in VS patients.

Methods Seven VS patients and nine control subjects were examined. Advanced vision and optometric tests were used to assess visual acuity (VA), red / green (RG) and yellow / blue (YB) colour sensitivity, rapid flicker sensitivity, chromatic afterimage strength and duration and pupil response amplitudes and latencies to chromatic stimuli.

Results The VS patients exhibited normal VA, colour and rapid flicker sensitivity and chromatic afterimage strength. Both controls and four of the VS patients exhibited pupil constrictions to the onset of the coloured stimulus, followed by recovery during the stimulus and a further constriction at stimulus offset, normally attributed to perception of chromatic afterimages (Prog.Brain Res. 144:243‐259, 2004). The pupil responses in three of the VS patients lacked the rapid recovery phase following the initial constriction to stimulus onset.

Conclusion The absence of recovery following the initial constriction of the pupil in three of the VS patients deviates from normal responses and suggests the presence of a more sustained retinal afferent signal that drives the pupil response. The latter may be linked to differences in retinal processing of visual signals that cause the perception of visual snow when the coloured stimulus is viewed against a uniform background.
Detection of colour signals in objects defined by luminance contrast
Authors: HICKEY J , RODRIGUEZ‐CARMONA M , BARBUR JL
Published: August 2012

Purpose The aim was to compare chromatic detection thresholds using two methods that are often employed to isolate the use of colour signals: a. Colour thresholds measured in dynamic luminance contrast (LC) noise when a spatially structured object is defined only by colour signals b. Thresholds for detection of colour changes in objects defined by luminance contrast (i.e., the luminance pedestal (LP) technique that is often used in visual psychophysics to isolate the use of colour signals) Earlier findings in patients with cerebral achromatopsia (Proc.R.Soc.Lond.B. 258 :327‐334 (1994)) suggest that different neural mechanisms handle the use of colour signals in the two conditions. It is therefore of interest to establish whether the corresponding colour thresholds in (a) and (b) are also different in normal subjects.

Methods Colour detection thresholds were measured using both LP and LC noise methods for discrete LP contrast levels and background luminances. The same four‐alternative, forced‐choice staircase procedure was used to measure thresholds for every combination of target and background luminance.

Results The amplitude of dynamic LC noise does not affect colour thresholds. In general, technique (a) yields smaller thresholds when compared to the LP technique (b) for all pedestal LC levels and background luminances. Negative luminance contrast pedestals yield increased colour thresholds for both the red/green and yellow/blue axes.

Conclusion When chromatic signals are added to objects defined by negative luminance contrast, the corresponding colour thresholds are no longer processed independently and increase monotonically with luminance contrast.
Normal range of Cambridge low contrast grating test: a population based study
Authors: OSTADIMOGHADDAM H , YEKTA AA , HERAVIAN J , AZIMI A , KHABAZKHOOB M , MOHAMMADIAN M
Published: August 2012

Purpose To determine the normal range of contrast sensitivity in a representative sample of the population of Mashhad, Iran, and its determinants

Methods In this report, Contrast Sensitivity (CS)c data of 2449 out of 3213 selected individuals was analyzed. CS was determined using Cambridge low contrast squarewave grating and to evaluate its determinants, age, gender, Visual Acuity (VA) and Spherical Equivalent (SE) were analyzed.

Results The mean age of the participants was 29.1±17.3 years (range: 4‐89 years) and 66.4% of them were female. The score of CS for the right and the left eye and its binocular score were 239.6±233.3, 234.6±228.6 and 310.9±249.0 cps, respectively. Multiple linear regression showed that CS significantly correlated with age (β=‐1.1,P<0.001), gender (β=‐40.1, P<0.001), LogMAR BCVA (β=‐165.4, P<0.001) and SE(β=10.2, P<0.001)

Conclusion Since our study was population‐based, normal range of Cambridge low contrast grating test can be used as a reference guide in a general population. Our findings can be used in both research and clinic, especially evaluation of the results of refractive surgeries. However, in clinical evaluations, it should be noted that the mean CS is lower in older, myopic individuals who have a lower BCVA.
Evidence of neuroplasticity in the human visual cortex following beneficial anti‐VEGF treatment in exudative age‐related macular degeneration
Authors: VOTTONEN P , PÄÄKKÖNEN A , TARKKA I , KAARNIRANTA K
Published: August 2012

Purpose Anti‐vascular endothelial growth factor (VEGF) agents have been shown to improve visual acuity and prevent vision loss in exudative age‐related macular degeneration (AMD). As the vision improves relatively quickly in response to intravitreal injections, we wanted to know whether this improvement is reflected in electrophysiolocal markers of visual cortical processing.

Methods Our interventional case series included 6 elderly patients who underwent injection treatment to the affected eye. Their visual acuity, tomographic images of retinal thickness and visual evoked potentials (VEP) were assessed before of the treatment and six weeks after the last injection.

Results All patients showed improved visual acuity and reduced retinal fluid after the treatment. All but one patient showed increased VEP P100 component amplitudes and/or shortened latencies in the treated eye. These VEP changes were consistent with improved vision while the untreated eyes showed no changes.

Conclusion Our results indicate that anti‐VEGF injections improved visual function of the treated eyes both in the level of the retina and in level of visual cortical processing.
Cytokines in patients with HLA‐B27 + acute anterior uveitis
Authors: JAKOB E , UMANSKY L , BECKHOVE P , MACKENSEN F
Published: August 2012

Purpose In this study, we assessed 27 different cytokines in peripheral blood of patients with HLA‐B27 + acute anterior uveitis (AAU), the most common form of immune‐mediated uveitis. Goal of the study was to determine if cytokine levels in peripheral blood are associated with disease activity in AAU. 

Methods Blood samples were collected from 14 consecutive patients with AAU in active and inactive disease phase (2 samples per patient at different time points) and from 14 age and gender matched controls. Patients with systemic treatment were not included. Samples were stored at ‐20 °C. Subjects were evaluated for cytokines in peripheral blood by Bio‐Plex Pro Human Cytokine 27‐Plex Panel. Percentages of each cytokine were compared for patients with active vs inactive disease and to age and gender matched group of healthy controls. IRB approval has been obtained.

Results Comparing active to inactive disease status we found signifficantly higher levels in 12 of the 27 accessed cytokines in active disease compared to inactive. In active status, we found significantly higher levels of Il‐1b,IL‐1ra, IL‐5, IL‐6, IL‐7, IL‐9, IL‐1o, IL‐17 and IFN‐g. Interestingly, we did not see a significant difference in levels of IL‐2 and TNF alpha. In all but one tested cytokine (IL‐6), there was no significant difference between samples of patients in inactive disease and controls.

Conclusion Results show that there are significant differences in serum levels of many different cytokines in patients with active and inactive AAU.
Oxidative stress activates NLRP3 inflammasomes in ARPE‐19 cells
Authors: LAAKSO N , KINNUNEN K , SALMINEN A , KAARNIRANTA K , KAUPPINEN A
Published: August 2012

Purpose Oxidative stress, which refers to cellular damage caused by reactive oxygen species (ROS), contributes to many age‐related diseases, including age‐related macular degeneration (AMD). Retinal pigment epithelial (RPE) cells must endure a high level of oxidative stress because of their high oxygen consumption, high levels of polyunsaturated lipids, and the long periods of exposure to light. Inflammation plays a major role in the pathogenesis of age‐related macular degeneration (AMD). Oxidative stress is known to activate inflammasomes, intracellular protein complexes which assemble to process the precursors of interleukin (IL)‐1beta and IL‐18 to mature and secreted cytokines by caspase‐1. In the present study, we have studied the presence of inflammasome platforms in ARPE‐19 cells.

Methods After the cell exposures, ELISA and qPCR methods were used to examine the inflammasomal activity.

Results In order to activate TLR pathway and NF‐kappaB signaling for inducing the production of the IL‐1beta and IL‐18 precursors, the cells were stimulated with LPS. Thereafter, 4‐hydroxynonenal (HNE) was used to provide the second signal needed for the inflammasome activation. Using the qPCR method, we showed the inflammasome receptor component to be the NACHT, LRR and PYD domains‐containing protein 3 (NLRP3).

Conclusion Our data indicate that oxidative stress is able to activate NLRP3 inflammasomes in human ARPE‐19 cells.
An antimicrobial peptide can enhance the activity of a fluoroquinolone in reducing the colony counts of fluoroquinolone‐resistant MRSA in the NZW rabbit keratitis model
Authors: ROMANOWSKI E , YATES K , MAH F , GORDON Y , KOWALSKI R
Published: August 2012

Purpose Future therapy of ocular infections may depend on enhancing current drugs if no new drugs are developed. We tested whether an antimicrobial peptide, Nisin (NIS) could enhance the activity of ciprofloxacin (CIP) in a NZW rabbit keratitis model.

Methods A total of 48 rabbits were inoculated intrastromally in both eyes with ~1000 CFU of fluoroquinolone and methicillin‐resistant Staphylococcus aureus. After 4 h, the rabbits were divided equally into 4 treatment groups: 1) 0.075% NIS; 2) 0.3% CIP; 3) 0.075% NIS + 0.3% CIP; 4) PBS. Topical treatment was instilled in both eyes every 15 min for 5 hours. One hour after treatment the corneas were harvested, homogenized, and processed for colony counts. Colony counts were Log10 transformed and analyzed using ANOVA. The data is expressed as mean ± sd Log10 CFU/ml.

Results CIP alone (6.76 ± 0.35) demonstrated no difference in colony counts compared to PBS (6.87 ± 0.30) (p>0.05). NIS alone (4.90 ± 1.84) significantly decreased colony counts compared to PBS and CIP (p<0.05). NIS + CIP (3.84 ± 2.01) significantly decreased colony counts compared to NIS alone, CIP alone, and PBS (p<0.05).

Conclusion Combination therapy with 0.075% NIS and 0.3% CIP significantly decreased colony counts compared to PBS and either drug alone. This study provides “proof of principle” that in vivo enhancement of antibiotics can be achieved and may be evaluated using a rabbit model.

Commercial interest
HSV1‐specific meganuclease may reduce ocular infection in a mouse model of herpes keratitis
Authors: LABETOULLE M , GABISON E , ROUSSEAU A , HUOT N , CHAPELLIER B , GAILLEDRAT M , ERGANI A
Published: August 2012

Purpose Current anti‐viral treatments of Herpes simplex virus type 1 (HSV1) inhibit the viral replication but do not impair the latent form of the virus. This could be addressed by rare cutting endonucleases, such as meganucleases. The aim of this study was to demonstrate the antiviral activity of a HSV1‐specific meganuclease in a mouse model of herpes keratitis.

Methods Three weeks after bilateral subconjunctival inoculation of recombinant associated‐adenovirus (rAAV) encoding either a HSV1‐specific meganuclease or a reporter gene (GFP), both cornea of mice were inoculated with a wild‐type HSV1 strain. Mice were sacrificed 6 or 28 days later and corneas were analyzed for the presence of HSV1 genome and viral transcripts.

Results At 6 dpi, there was no clinical difference in the rate of acute herpetic keratitis, but the amounts of viral products were lower in mice treated with meganuclease‐encoding rAAV. At 28 dpi (stage of HSV1 latency), the rate of clear cornea was more important in the mice treated with meganuclease (p = 0.03), and the amounts of viral genome and transcripts were significantly less important (p<0.01.

Conclusion The transduction of HSV1‐specific meganucleases in the ocular tissues by means of a subconjunctival inoculation of r‐AAV is associated with an improvement of corneal recovery, and a reduction in the viral load and replication in the cornea. These results suggest that specific meganucleases could be qualified as a new class of antiviral agent, with the potential to address replicative as well as latent viral DNA.

Commercial interest
Regulation of immune response in post‐operative endophthalmitis
Authors: SAUER A , CREUZOT‐GARCHER C , CHIQUET C , BERROD JP , SALEH M , GAUCHER D , CANDOLFI E , PREVOST G , BOURCIER T
Published: August 2012

Purpose Endophthalmitis is the most feared complication of all ophthalmologic surgeries. The aim of our study is to study the immune response in aqueous humor of infected patients.

Methods In a prospective and multicenter study, clinical datas and aqueous humors of patients with endophthalmitis and control (cataract surgery) were collected. Multiplex immunoassay was done in order to define cytokines patterns. Two‐way ANOVA test was realized for each inflammatory marker to determine any difference between infected and control patients. Pearson linear regression was done to analyse correlation between clinical datas and cytokines levels.

Results Aqueous humor was sampled in 49 patients with endophthalmitis and 88 controls. Microbial identification was obtained in 67% of cases. Endophthalmitis was leading to high levels of cytokines and chemokines of the Th1, Th17 and Treg ways. Moreover, very high levels of VEGF were noted in aqueous humors of patients with endophthalmitis as compared to the control. Better visual acuity after one year of evolution was correlated with decreased levels of IL‐8, MCP‐1 and VEGF.

Conclusion Th1 and Th17 cells may play an important anti‐infectious role in modulating pathogen proliferation in infected eyes. But this huge inflammatory response may be responsible for retinal destruction as a collateral effect. Moreover, pro‐angiogenic factors are secreted in infected eyes. Antagonism of TH17 and anti‐angiogenic drugs could be a way to limit ocular lesion and may open new therapeutic approach associated with antibiotics therapy.
Lattice dystrophy complicated by Cryptococcus curvatus infection
Authors: IRION L , MORGAN S , KOERNER R , JOHNSON E
Published: August 2012

Purpose To present a novel case of Cryptococcus curvatus (CC) keratitis in a patient with Lattice dystrophy (LD).

Methods A 57 year old lady with a family history of LD had a right re‐graft for suspected recurrent lattice dystrophy. Her initial penetrating keratoplasty (PK) was in 2004 after which she kept good vision. 5 years later she developed a small ulcer caused by presumable Candida which healed completely following topical miconazole and short course of oral fluconazole. In 6 months she developed gutter, increasing astigmatism, recurrent erosions without inflammation and progressive peripheral opacities leading to a 2nd PK.

Results Histology of the 2nd PK revealed amyloid deposits in both host and graft elements confirming recurrent LD. In addition the graft contained numerous yeasts within epithelium and stroma along scars from previous PK. The capsulated fungi were seen on PAS, grocott and mucicarmine stains. No inflammatory response was associated with the fungi. Microbiology confirmed these as (CC). On review of findings from initial infection, it seemed that Cryptococcus instead of Candida was indeed the causative agent of her previous ulcer. Interestingly, she had no history of local trauma prior to her first corneal ulceration and there was never evidence of infection elsewhere. Unfortunately, 2 years after the 2nd PK the graft developed new opacities that lead to a 3rd PK which revealed recurrent (CC) keratitis again without any inflammatory response. The left eye also had a corneal graft in 2009 given her underlying LD and mercifully has never been infected.

Conclusion To our knowledge Cryptococcus curvatus keratitis was never described in English literature.In fact, it seems that this is the first description of ocular infection by this species.
Use of tuf PCR for staphylococcal and streptococcal genus detection in endophthalmitis
Authors: CORNUT PL , BOISSET S , BENITO Y , BURILLON C , ETIENNE J , MAURIN M , CHIQUET C , VANDENESCH F
Published: August 2012

Purpose This study reports the contribution of specific conventional PCR of the Staphylococcus and Streptococcus genera followed by sequencing for the microbiological diagnosis of endophthalmitis.

Methods Specific PCR assays targeting the tuf gene of the Staphylococcus and Streptococcus genera were performed in addition to the reference techniques (conventional culture and panbacterial PCR) on samples of aqueous humor and/or vitreous in patients with acute post operative endophthalmitis when Staphylococcus or Streptococcus had been identified using reference methods or no identification had been possible.

Results Out of the 125 samples analyzed (60 aqueous humor and 65 vitreous of 85 patients) , the culture was positive in 61 cases (48.8%) and panbacterial PCR was positive in 78 cases (62.4%). By combining culture and panbacterial PCR bacterial identification was obtained in 94 of the 125 samples (75.2%, 72 Staphylococcus, 22 Streptococcus). Staphylococcus‐specific PCR was positive in 72 out of the 103 samples tested and allowed 8 additionnal identifications. The Streptococcus‐specific PCR was positive in 13 cases. The Streptococcus‐specific PCR provided no additional diagnosis to the pan‐bacterial PCR. By adding Staphylococcus and Streptococcus tuf specific PCR to the reference methods, bacterial identification was obtained in 102 of the 125 samples (81.6%, 80 Staphylococcus, 22 Streptococcus).

Conclusion The Staphylococcus‐ and Streptococcus‐specific techniques used in this study were complementary to the panbacterial PCR techniques and improved sensitivity in the identification of Staphylococcus and better identification of the species with sequencing.
Successful management of recurrent Acanthamoeba keratitis using topical and systemic miltefosine
Authors: BARISANI‐ASENBAUER T , WALOCHNIK J , MEJDOUBI L , BINDER S
Published: August 2012

Purpose Acanthamoebae are ubiquitous free‐living amoebae. As facultative pathogens, they are the causative agents of Acanthamoeba keratitis (AK), a sight‐threatening ocular surface infection. AK can have a favorable prognosis when diagnosed and treated early in the disease course but available treatment options can remain ineffective even when started early.

Methods Case presentation

Results AK can have a favorable prognosis when diagnosed and treated early in the disease course but available treatment options can remain ineffective even when started early. We present a case of AK that was successfully treated with topical and systemic miltefosine after showing sight‐threatening recurrences under recommended therapy including a combination of propamidine 0.1%, miconazole nitrate 1%, neomycin, diamide and cationic antiseptics over a 12 months period.

Conclusion In previous studies, miltefosine (hexadecylphosphocholine), an alkylphosphocholine, approved for the oral and topical treatment of leishmaniasis, proved to be highly active against Acanthamoeba in vitro [Walochnik et al. 2002]. This has been confirmed by several other studies [e.g. Schuster et al. 2006, McBride et al. 2007, Walochnik et al. 2009, Polat et al.2012].
Efficacity and safety of TNF alpha blockers in patients with Behçet’s disease uveitis
Authors: GUINDOLET D , SAADOUN D , CASSOUX N , FARDEAU C , TOUITOU V , LEHOANG P , BODAGHI B
Published: August 2012

Purpose To determine the efficacy and safety of infliximab, an anti‐TNF alpha antibody, in patients with severe and sight‐threatening uveitis associated with Behçet's disease.

Methods Retrospective, single center study on 11 cases of panuveitis due to Behçet's disease managed between July 2001 and November 2011. Patients were treated with infliximab at a dose of 5 mg/kg intravenously. Efficacy was monitored by complete clinical examination, fluorescein angiography and OCT. The general tolerance was evaluated by a regular clinical and biological analysis.

Results Infliximab was used in 11 patients with a mean age of 32.7 years [20.9‐45.7]. Nine patients with panuveitis and retinal vasculitis were resistant or intolerant to immunosuppressors [average 2.1; 0‐4]. Mean duration of uveitis before the use of infliximab was 6.4 years [0.03‐10.8]. Infliximab has been used as long‐term treatment in 6 patients. The mean duration of treatment was 25.59 months [1.96‐82.96] with a mean follow up of 42.32 months [1.38‐114.2] and a mean of 17 infusions administered [2‐52]. Infliximab was efficient in all cases, with rapid regression (after 1‐2 injection) of intraocular inflammation. The average dose of corticosteroids was reduced from 40mg/d to 23.6mg/d (p=0.019). Pneumonitis and optic neuropathy occurred respectively in one case.

Conclusion Infliximab has a rapid and powerful but suspensive effect in severe ocular Behçet's disease. It can be used either as first‐line before the switch to other immunosuppressors or as a new strategy in severe cases resisting to other drugs, such as azathioprine or interferon alpha.
Supplement enriched in antioxidants protects the retina from light‐induced damage
Authors: RANCHON‐COLE I , RAMCHANI BEN OTMAN K , CERCY C , REBIKA H , DOLY M
Published: August 2012

Purpose To evaluate the effect of the dietary supplement Nutrof‐Total, enriched in antioxidants and fish oil, on retinal fatty acid composition and its potential neuroprotective effect.

Methods Six‐7 weeks old Sprague Dawley rats were not treated or administrated orally daily with 0,2 ml of water or Nutrof‐Total for a period of 10 days. Then, they were sacrificed for fatty acid analysis on plasmas and retinas or they were exposed to bright cyclic light for one week. At the end of light exposure, electroretinograms are recorded and animal are sacrificed for histologic analysis and apoptotic cells detection.

Results One week of Nutrof‐Total treatment induced a significant increase of EPA, DPA and DHA in the plasma to respectively 163%, 133% and 19%. In the retina, there is also a significant increase of EPA and DPA but not of DHA and LNA is significantly decreased. In parallel, there is a reduced level of omega‐6 fatty acid in plasma and retina. In untreated animal, bright‐cyclic light induced a reduction of the ONL thickness, an increased in apoptotic cells leading to a reduction of retinal function. Animals treated with Nutrof‐total for 10 days before and during the bright cyclic light have a preserved retinal structure, a reduced number of apoptotic cells and a preserved retinal function.

Conclusion Nutrof‐Total can protect the retina from light‐induced retinal damage. Nutrof‐Total may be beneficial in preventing the toxic effect of light on the retina.

Commercial interest
Effects of intravitreal injection of anti‐TNFα and anti‐VEGF in experimental branch retinal vein occlusion in rats
Authors: ANDRIANAKI A , GILODI N , CONTI A , POURNARAS CJ
Published: August 2012

Purpose To investigate the effect of intravitreal injection of anti‐TNFα and anti‐VEGF antibodies on the inner blood retinal barrier (iBRB) in a rat model of experimental branch retinal vein occlusion (BRVO). Claudin‐5, a tight junction protein seen in the retinal vascular wall was examined in order to evaluate the iBRB integrity.

Methods BRVO was induced in the right eye of Long Evans rats, using laser photocoagulation. The left eye served as control. The intravitreal injection with either anti‐TNFα or anti‐VEGF was performed in the right eye of each animal, 6 hours after BRVO. Two days after laser application, animals were sacrificed and retinas were harvested. The expression and distribution of claudin‐5 were examined by immunofluorescent staining of flat‐mounts under confocal microscopy.

Results Confocal micrographs showed that claudin‐5 is specifically expressed on the cell boundaries of retinal vessels. Two days after laser induced BRVO, the distribution of claudin‐5 in retinal veins of non‐treated rats was weaker, rougher and less linear compared to the images seen in control animals. The staining of claudin‐5 in retinal veins of rats treated with anti‐VEGF or anti‐TNFα was stronger, more linear and uniform.

Conclusion The anti‐TNFα and anti‐VEGF drugs seem to partially restore the integrity of the iBRB which may contribute to the reduction of macular edema. Ongoing experiments using RT‐PCR will determine the effect of those drugs in the expression of genes that influence the development of macular edema after BRVO.
Examination of between eye retinal oxygenation saturation in the peri‐papillary region
Authors: CUBBIDGE R , VEKRIA P , KALITZEOS A , HEITMAR R
Published: August 2012

Purpose To measure the inter‐ocular agreement of retinal vessel oxygen saturation in the peripapillary retina of healthy individuals.

Methods Twelve otherwise healthy individuals (mean age 36.5 (SD 10.5)) underwent dual wavelength retinal oximetry (ImedosSystems, Germany), non‐contact tonometry (Keeler Pulsair, UK) and manual shygomanometry in both eyes on the same day. For analyses purposes the major branches of the central retinal artery and vein crossing through a circular segment located one half disc diameter (DD) away from the optic nerve head (ONH) and 1DD in width were selected from 3 consecutively taken images. Arterial and venular oxygen saturation was then used to calculate the arterio‐venous oxygen saturation difference.

Results Arterio‐venous difference of peri‐papillary retinal vessel oxygen saturation showed good inter‐ocular agreement and no dependence on age, blood pressure or intraocular pressure (Right eye 37 (7)% and left eye 38 (5) %, r=0.71).

Conclusion There is good inter‐ocular agreement of peri‐papillary retinal oxygenation parameters in healthy individuals.
Blindness due to mistake of antituberculosis treatment
Authors: ROBERT PY , YAYA G , YASSAMINA S , MGBALI J , GINOUX J
Published: August 2012

Purpose Antituberculosis drugs such as Ethambutol and Isoniazid may induce toxic optic neuropathy, that has lead to recommendations on the follow‐up of patients under antituberculosis treatment. In Central African Republic, as in many countries where tuberculosis is endemic, this affection may also develop as an opportunist illness of AIDS. Treatment with antituberculosis drugs is often long, and the incidence of ocular toxicity increase.

Methods Since 1998, we noticed an increasing number of bilateral blindness in the population of patients treated by Ethambutol in our outpatient practice. We report here 10 from 23 clinical cases of visual impairment, observed in ophthalmological service of Bangui Teaching National Hospital Center.

Results Two patients received the recommended dose (25mg/Kg/day) throughout the treatment. The others have found themselves in overdose because of a loss of weight. Visual symptoms begin on the average during the 3rd month of treatment. Three patients had a visual improvement, 3 others a stabilization of vision, and the remaining 4 a worsening of vision.

Conclusion We raise from this series a necessary awareness for patients, prescribers and the practitioners in charge of the National program for Tuberculosis Control, on importance of the ocular toxicity of antituberculosis drugs. Yet efficient and extensively used, these drugs require special clinical and biologic balance before every prescription, and close ophthalmologic survey throughout the treatment.
Damage of tolerance to glucose (TG) is the predecessor of insular diabetes (ID) and is accompanied by different metabolic changes, which need all‐round research
Authors: GUSHCHA S , BABOV KD , YAROSHENKO NA
Published: August 2012

Purpose To research changes of water‐electrolytic exchange (WEE) in lens and liquid of anterior chamber of eye of rats with latent changes of carbohydrate metabolism.

Methods White rats Wistar were taken once subcutaneous introduction of alloxan solution in dose 0,075 g/kg.

Results After 14 days in lens and liquid of anterior chamber of eye rats was discovered increase concentration of K+ and decrease concentration of Na+. At the same time content of total tissue water in lens was reduced. Basal level of glucose in blood on an empty stomach was normal. At testing TG was revealed increase of glucose level during 3 hours.

Conclusion It was determined in initial stage of ID genesis have occurred changes of water‐electrolytic exchange (WEE). The received results expand concept about pathogenetic mechanisms of ID genesis and may be used in researching of correct influence of natural medical factors (mineral waters, for example).
Sunglasses with wide temples and thick frame severely constrict temporal visual field extent
Authors: DENION E , DUGUE AE , AUGY S , COFFIN‐PICHONNET S , MOURIAUX F
Published: August 2012

Purpose To compare the impact of two types of sunglasses on visual field and glare: one (“thick sunglasses”) with a thick plastic frame and wide temples, and one (“thin sunglasses”) with a thin metal frame and thin temples.

Methods Using the Goldmann perimeter, visual field surfaces (cm2) were calculated as projections on a 30 cm virtual cupola. A V4 test object was used, from seen to unseen, in 15 healthy volunteers in the primary position of gaze (“base visual field”), then allowing eye motion (“eye motion visual field”) without glasses, then with “thin sunglasses”, followed by “thick sunglasses”. Visual field surface area differences superior to the 14% reproducibility error of the method and having a p‐value inferior to 5% were considered significant. A glare test was done using a surgical lighting system pointed at the eye(s) at different incidence angles.

Results No significant “base visual field” nor “eye motion visual field” surface area variation were noted comparing tests done without glasses and with the “thin sunglasses”. In contrast, a 22% “eye motion visual field” surface area decrease (p‐value = 2.7.10‐13) was noted comparing tests done without glasses and with “thick sunglasses”. This decrease was most severe in the temporal quadrant (‐33%; p‐value = 6.3.10‐20). All subjects reported less lateral glare with the “thick sunglasses” than with the “thin sunglasses” (p‐value = 6.10‐5).

Conclusion The better protection from lateral glare offered by “thick sunglasses” is offset by a severe temporal “eye motion visual field” surface area constriction.
Antitumor evaluation of the new Bcl‐2/Bcl‐xl inhibitor S44563 in primary human uveal melanoma xenografts
Authors: NEMATI F , DE MONTRION C , SASTRE X , KRAUS BERTHIER L , BESNIARD A , DE PLATER L , LOCKHART BP , DESJARDINS L , MARIANI P , PIPERNO‐NEUMANN S , DEPIL S , DECAUDIN D
Published: August 2012

Purpose Nearly half of primary Uveal melanoma (UM) metastasizes in liver, but there are currently no effective therapies. Human UM are characterized by a high expression of Bcl‐2, ranging between 50% and 100%. This observation has been confirmed in our panel of 16 human UM xenografts obtained from patient’s tumors (Némati et al, CCR 2010). We have investigated the efficacy of the new Bcl‐2/Bcl‐XL inhibitor S44563 on 4 primary human UM xenografts.

Methods Four well characterized primary human UM xenografts were used. S44563 (50 or 100 mg/kg, days 1‐5/8‐12/22‐26/29‐33) was administered IP alone or combined with fotemustine, concomitantly (15 or 30 mg/kg days 1 and 22), or after chemotherapy (100 mg/kg, days 43‐47/50‐54/64‐68/71‐75). Tumor Growth Inhibition (TGI) was calculated to measure the efficiency of drugs. Bcl‐2, Bcl‐XL, and Mcl‐1 expressions were determined by immunohistochemistry (IHC).

Results S44563 administered alone induced a moderate TGI of about 50% in 1 model (MP41). When combined S44563 to fotemustine, we observed a synergistic activity in 2 models (MP77 and MM66), without impact on the proportion of complete remission. Finally, when S44563 was concomitantly and/or administered after fotemustine, we found a delay of tumor growth in 2 among the 3 tested xenografts (MP77, and MM26). IHC analyses showed that Bcl‐2, Bcl‐XL, and Mcl‐1 expressions were not modified after S44563 administration.

Conclusion We have shown that S44563 increased the efficacy of chemotherapy in concomitant combination or after fotemustine. Such preliminary results underline the therapeutic potential of this new Bcl‐2/Bcl‐xl inhibitor in human UM.
Retinoblastoma – risk factors and quality of life
Authors: BOGDANICI T , ROMEEN A , COSTIN D , BOGDANICI C
Published: August 2012

Purpose Evaluation of influence of medium factors in children with retinoblastoma and quality of life after treatment.

Methods Retrospective study for 84 eyes treated for retinoblastoma (Rb) in Ophthalmological Department, Hospital “Prof. Dr. Nicolae Oblu” Iasi. Clinical parameters studied: age of diagnosis, adjuvant factors (hypoxia, pregnancy hemorrhages, congenital rubella, ionizing radiation, endocrinological disease of mother) and hereditary factors. Statistical evaluation: program SPSS 16.0, test Mann‐Whitney, Kruskal‐Wallis were used.

Results Between 1953 and 2010 in Ophthalmological Clinic were treated 702 eyes tumors and 77 were diagnosticated with Rb. Unilateral cases were 70 cases and 7 cases bilateral Rb. Hypoxia were at 24,7% Rb versus 4,8% children without Rb (cwRb) – risk factor 2,609. Hemorrhages during pregnancy were 27% in mother with children with Rb versus mothers with cwRb – risk factor 1,735. Mother inflammations were registrated at 39% children with Rb versus 17% cwRb – risk factor 2,025. Congenital rubella was at 15,6% children with Rb versus 5,5% cwRb – risk factor 1,943. Endocrinological diseases of mothers were 26% versus 7,9% ‐ risk factor 2,222. Ionizing radiations were found in 81,8% children with Rb versus cwRb – risk factor 8,312. All cases were treated with radical surgery – enucleation associated with chemotherapy.

Conclusion Ionizing radiation is the highest risk factor (Iasi is 500 km near Chernobyl) especially during 1986‐ 1991. The majority of cases were very late diagnosticated and treatment was for all cases enucleation. Quality of life is poor because of radical treatment and esthetic reasons.
Acute dacryoadenitis as atypical presentation in Sjögren Syndrome
Authors: SATUE M , GARCIA‐MARTIN E , BAMBO M , PRIETO E , DE LA MATA G , FERNANDEZ‐PEREZ S
Published: August 2012

Purpose To present a case report of a patient with acute dacryoadenitis as an atypical clinical presentation of Sjögren Syndrome.

Methods A 37‐year‐old female developed acute left dacryoadenitis with poor response to oral corticosteroids. She had no history of any other clinical symptoms. During the following weeks she developed cervical lymphadenopathies, arthralgia and mild asthenia. Complete blood analysis, imaging diagnostic techniques, C‐reactive protein (CRP) and autoimmunity tests showed normal results, but high levels of anti‐Ro antibodies were found, suggesting Sjögren Syndrome (SS) as the etiopathological cause.

Results All symptoms and clinical findings improved after successive treatment with intravenous corticosteroids, hydroxychloroquine and azathioprine. At the present moment the patient remains stable using maintenance treatment with immunosuppressive drugs.

Conclusion Chronic destruction of the lacrimal gland is the most common cause of dry eye and ocular symptoms in SS. Acute dacryoadinitis is considered an atypical manifestation of this syndrome. Classical systemic corticosteroids treatment for SS usually needs association of immunosuppressive drugs, including biological treatments as a recent new option to control the disease progression and inflammatory activity. Topic cyclosporine and pilocarpine have reported benefits for severe xerophthalmia in recent medical trials.
Ophthalmological symptoms in carotid‐cavernous sinus fistulas
Authors: DO TN , BOIVIN FAURE L , HOUDART E , CHAPOT R , ADENIS JP , ROBERT PY
Published: August 2012

Purpose This study was designed to compare ophthalmological symptoms of dural fistulas (DF) and carotid‐cavernous direct fistulas (CCF), before and after endovascular treatment, and to find out risk factors for ophthalmological sequelae.

Methods We retrospectively studied 44 patients suffering from cavernous sinus fistulas with ophthalmologic symptoms, held in Lariboisière Hospital in Paris and Dupuytren Hospital in Limoges over 8 years. 24 patients had DF, 20 patients had CCF. 2 patients had spontaneous disappearance of the fistula, and 4 patients after non‐invasive treatment. The remaining 40 patients underwent endovascular treatment, until complete exclusion of the fistula (33 had a single treatment, and 5 had to be retreated)

Results The main pre‐treatment symptoms were proptosis (n=38), episcleral venous congestion (n=31), oculomotor palsy (n=28), visual loss (n=20), glaucoma (n=17) and controlateral ocular symptoms (n=11). Thrill and murmur were more frequent in CCF (6 and 12) than in DF (0 and 5) (p<0,05). In patients with DF, the average age was greater (p<0,005) and glaucoma was more frequent (p=0,005). 14 patients had ophthalmological sequelae, oculomotor palsies in most cases (n=8). Ophthalmological sequelae were more frequent in patients with pre‐treatment visual impairement (p<0,05).

Conclusion The risk of ophthalmological sequelae was higher in patients with pre‐treatment visual impairment, and lower in patients with complete anatomical cure of the fistula. 68% of patients had no ophthalmological sequelae after endovascular treatment, and 93,2% had no ophthlmological sequelae after specific additional medical treatment.
The human fovea revisited‐a proposed new strategy based on neural connectivity for analysis of retinal images
Authors: SJÖSTRAND J , POPOVIC Z
Published: August 2012

Purpose To present a model useful for analysis of images of central retina based on functional connectivity between outer retina with its photoreceptors and retinal ganglion cells (RGC) of the inner retina. In addition, to evaluate the nomenclature and to propose clinically relevant definitions of the fovea and surrounding zones based on neural connectivity, function and development.

Methods Published measurements of radial displacement of inner retina relative to outer retina were used to determine the area of RGC corresponding to central photoreceptors. A model of central retina with displaced outer and inner retinal zones was constructed based on data from histological reports and data from recent studies with non‐invasive imaging studies, the convention of the ETDRS study, and psychophysical studies.

Results A model is presented where functional relationships within the retina are based on neural connectivity, i.e the radial displacement of RGC and synaptically connected cones. The statement by S. Polyak (1941) that "the entire inner foveal excavation corresponds to a small central region" of photoreceptors is confirmed. The model indicates that the template for analysis should be separate for outer and inner retina in order to mirror corresponding areas and functional relationships. Based on the model we propose a template relevant for clinical analysis of images of the outer retina mainly based on anatomical nomenclature and partly adapted according to the ETDRS convention.

Conclusion A model of the central retina based on neural connectivity is recommended as a frame for analysis of corresponding but displaced zones of the central retina.Templates for analysis of zones of cones and RGC are proposed.