bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial experience of a nationwide ruthenium‐106 and iodine‐125 ocular brachytherapy service in Ireland
Authors: WALKER C , LANGAN B , HORGAN N , CUNNINGHAM M , GRUNNER E , MCCLEAN B
Published: December 2011

Purpose St. Lukes Hospital, Rathgar, Dublin 6, Ireland has recently implemented an Ocular Brachytherapy Service using both Ruthenium‐106 and Iodine‐125 plaques. This work will summarize the initial experience of the hospital in these treatment modalities and provide information on some of the challenges experienced by a new centre performing this technique. Outline plans for the future of the service will also be presented.

Methods Between September 2010 and June 2011, twenty six patients received a plaque treatment at St. Lukes Hospital. Six of these were Iodine‐125 cases, while twenty used Ruthenium‐106. A multi‐disciplinary pre‐planning procedure using BEBIGs "Plaque Simulator" software identifies treatment durations. This group consists of a Physicist, Consultant Ophthalmologist and a Consultant Radiation Oncologist with the goal of fitting both plaque insertions & removals into designated weekly theatre slots. Following this, a comprehensive plancheck analysis is performed. Post‐treatment, a delivered plan is generated by a Physicist and signed by the clinical team. A yearly delivery of Ruthenium plaques is scheduled; information is given on plaque types, number of uses and plans for Year Two. NPL calibrations were used as a second‐check in Year One with an in‐house method involving a stereotactic diode proposed for Year Two.

Results Nine months into the program, tumour regression in the initial patients is already being observed. Procedures have been streamlined to satisfy designated theatre slots where possible and to maximise throughput of patients. A second‐check calculation procedure for Ruthenium plaques has been devised; however the long‐term plan proposes a greater proportion of Iodine treatments due to the timing flexibility this provides. The in‐house method of calibration shows promise, however further investigations are required before it is suitable for clinical use. This work is ongoing.

Conclusion An Ocular Brachytherapy service has been successfully implemented in St Lukes Hospital that is providing both Ruthenium‐106 and Iodine‐125 treatments to patients across the Republic of Ireland. As the service matures and further intra‐departmental training takes place, the facility will be well prepared to handle both an increase in capacity and complexity while performing treatments to a high standard.
Progression of Electroretinogram Responses in Stargardt‐Fundus Flavimaculatus: A longitudinal study
Authors: FUJINAMI K , MICHAELIDES M , LOIS N , WEBSTER AR , HOLDER GE
Published: December 2011

Purpose To investigate the progression in Stargardt‐fundus flavimaculatus (S‐FFM) by repeated clinical and electrophysiological examination.

Methods A longitudinal study of 59 patients with S‐FFM was undertaken. The mean age at the initial examination was 31.6 years; mean follow‐up interval was 10.5 years. Electrophysiological tests included pattern and full‐field electroretinogram (ffERG); clinical ophthalmic examinations were performed. Patients were classified into 3 groups as previously published (Lois et al, 1999); Group 1 had dysfunction confined to the macula; Group 2 had macular and generalized cone dysfunction; Group 3 had macular, generalized cone and generalized rod dysfunction. Initially, there were 27 patients in Group 1, 16 patients in Group 2, and 16 patients in Group 3. The data obtained at follow‐up were compared with those originally obtained. An amplitude reduction of > 50% or a peak time shift of >3 ms for the 30Hz flicker ERG or bright flash a‐wave were considered clinically significant. Molecular analysis of the ABCA4 gene showed likely disease causing variants in 30/40 patients.

Results During follow‐up, 3/27 patients from Group 1 progressed to Group 2, and 2/27 patients to Group 3. Eight of 16 patients of Group 2 progressed to Group 3. Significant deterioration in ERG was observed 13/59 patients. Electrophysiological progression occurred in 22% of Group 1, 50% of Group 2, and 100% of Group 3.

Conclusion All patients with initial rod involvement demonstrated clinically significant electrophysiological deterioration; only 20% of the patients initially having normal ffERGs showed significant deterioration. These data confirm and elucidate the role of ffERG in the prognosis of patients with S‐FFM.
The importance of dark adapted cone function in ERG interpretation
Authors: HOLDER GE
Published: December 2011

Purpose The ISCEV Standard for ERG does not include a measure of dark‐adapted cone function. Prior to the introduction of the Standard, use of a red flash under dark‐adapted conditions was a well‐recognised part of ERG but its use appears subsequently to have declined. The purpose of the presentation is to demonstrate the importance of the dark‐adapted red flash ERG in clinical ERG interpretation.

Methods Retrospective case based presentation. Use of a red flash under dark adaptation can evoke an ERG in which there the early part of the waveform arises from the dark‐adapted cone system and the latter part of the waveform from the rod system. The intensity of the red stimulus can be adjusted so that the rod‐system derived part of the waveform has an amplitude similar to that of the rod specific ERG b‐wave (DA 0.01).

Results Cases will be shown where use of the dark‐adapted red flash ERG enabled an improved interpretation of the bright flash ERG (DA 11.0). Disorders addressed will include fundus albipunctatus; vitamin A deficiency; RGS9 mutation (“bradyopsia”) and retinitis pigmentosa. An electronegative ERG waveform can occur arising in dark adapted cones, consistent with the so‐called “photopic hill” phenomenon occurring in dark adapted cones exposed by an absence of rod function. The DA 11.0 ERG a‐wave can reach in excess of 150µV under such circumstances, giving the potential for misdiagnosis of a form of inner retinal dysfunction such as may occur in CSNB.

Conclusion The ISCEV Standard ERG waveforms are intended as a minimum data set. Use of a red stimulus under dark adaptation is a valuable addition to that data set and may prevent misinterpretation of the ISCEV Standard ERGs. The decline in the use of this ERG appears unjustified in routine clinical practice.
Colour Vision in Stargardt Disease
Authors: VANDENBROUCKE T , BUYL R , DE ZAEYTIJD J , UVIJLS A , DE BAERE E , LEROY BP
Published: December 2011

Purpose To investigate the type and severity of colour vision deficiencies (CVDs) in Stargardt disease (STD). And, to establish how the degree of CVD relates to best‐corrected visual acuity (BCVA), full field ERG (ffERG) and duration of disease.

Methods A retrospective, cross‐sectional study of 97 patients with a clinical diagnosis of STD included a comprehensive medical history and a full clinical work‐up, with extensive colour vision testing. Eight patients underwent anomaloscopy. ABCA4 was screened in 92 patients.

Results Patients were allocated to 5 BCVA groups and to 3 ffERG groups. Normal colour vision was found in almost 30% of patients. R/G CVDs increased as BCVA declined. More than 50% had a deutan type R/G CVD, although protan R/G CVDs became progressively apparent as BCVA decreased. A predominance of pseudoprotanomaly was evident only on anomaloscopy. Additional Blue/Yellow (B/Y) CVDs were noted in 25% of patients. B/Y CVDs and BCVA higher than 0.75 were seen in adult‐onset STD. CVDs evolve to scotopization in patients with low BCVA and/or longstanding disease. Duration of disease did not correlate well with CVDs. Also, no statistically significant differences in ERG results were found between groups with or without a CVD.

Conclusion Since colour vision function is better correlated to BCVA than either disease duration or ffERG, it is a rather reliable indicator of disease severity. The presence of CVDs may help to establish an early diagnosis of STD.
Herpes simplex virus
Authors: KHAIRALLAH M , ATTIA S , NAHDI I
Published: December 2011

Purpose Herpetic simplex anterior uveitis (HSAU) is a major infectious entity. Prompt diagnosis of HSAU is essential, usually based on typical clinical features. Treatment is based on antivirals and corticosteroids.

Methods Review of clinical features, outcomes, and management of HSAU.

Results HSAU is typically acute and unilateral disease, with patients suffering from blurred vision, photophobia, pain, and redness. Inactive or active corneal involvement is often associated. The corneal sensation can be decreased relative to the controlateral cornea. However corneal involvement can be absent.Inflammation is more often granulomatous, and the typical herpetic keratic precipitates (KPs) are large, flat and usually do not respect the Arlt’s triangle, but tend to accumulate on the central corneal endothelium. Anterior chamber cells and flare of varying degrees of severity, with or without posterior synechiae, are noted. Iris atrophy and pupillary distortion are common. Increased intraocular pressure (IOP) is also frequently observed and is very suggestive. The IOP rise is related to acute trabeculitis. The course tends to be recurrent. Laboratory tests are necessary especially in patients with atypical clinical presentation. Detection of viral DNA in ocular fluids by PCR is the gold standard for the laboratory diagnosis of HSAU. The key to successful treatment of HSAU is the use of topical corticosteroids combined with systemic antivirals for the treatment of recurrences followed by prophylactic antiviral therapy combined with low‐dose corticosteroid drops. Visual prognosis might be good, especially in patients who have only anterior uveitis without corneal desease

Conclusion An increased awareness of the characteristic clinical features and the role of PCR for early diagnosis and appropriate treatment are important.
Cytomegalovirus
Authors: BODAGHI B
Published: December 2011

Cytomegalovirus‐associated anterior uveitis is a recently described entity. Based on the PCR‐analysis of the aqueous humor, the diagnosis may be confirmed in patients with unilateral hypertensive anterior uveitis with mild iris atrophy but without posterior synechiae. Two different subtypes of the disease have been reported so far. It has been shown that more than 50% of cases of Posner‐Schlossman syndrome are CMV‐induced. The type and distribution of keratic precipitates are major clinical elements for the diagnosis of the infection. Interestingly, retinitis has never been described in this group of patients and none of them is immunosuppressed. In Europe, the association of FUuchs heterochromic cyclitis and CMV has not been confirmed. Rarely, PCR tools are insufficient and local antibody production may help diagnostic confirmation. The most important issue remains the therapeutic management of these patients. Specific anti‐CMV drugs have been proposed but the route of administration, the dosages and the duration of therapy remain controversial. Topical anti‐CMV drugs are promising but rarely efficient as an induction regimen. Systemic valganciclovir is highly efficient and proposed for at least 2 months with a close follow‐up to detect any further relapse.
Anterior uveitis with intraocular fluid analysis positive for Rubella virus
Authors: WILLERMAIN F , WENSING B , JUDICE RELVAS L , VIDOVIC VALENTINCIC N , STUNF S , DE GROOT‐MIJNES J , ROTHOVA A , CASPERS L
Published: December 2011

Purpose To compare the clinical characteristics and visual prognosis of patients with anterior uveitis (AU) with intraocular fluid analysis positive for Rubella virus (RV), Herpes Simplex virus (HSV) or Varicella Zoster virus (VZV) in order to discriminate rubella virus AU from herpes virus AU.

Methods Retrospective, observational study.Clinical records of 106 patients with anterior uveitis and positive Polymerase chain reaction and/ or Goldmann‐Witmer coefficients for RV (n=57), HSV (n=39) and VZV (n=10) were analyzed. Demographic constitution, ophthalmological characteristics and visual prognosis were compared.

Results All three types of viral AU were characterized by unilateral involvement (80‐97%). RV‐AU was characterized by younger age at onset and chronic course, and was typically associated with cataract at presentation. Heterochromia was present in 23% of RV‐AU patients. AU associated with HSV or VZV infection occurred characteristically in older patients and frequently followed an acute course. Associated clinical features included conjunctival redness, corneal edema, history of keratitis and development of posterior synechiae. HSV‐AU had more often severe AU whereas the presence of vitritis was more common in RV‐AU and VZV‐AU. The prevalence of documented IOP above 30mm Hg (25‐50%, P=0.06) and development of glaucoma (18‐30%, P=0.687) were similar in all three groups. Retinal scarring was seen in 22% of RV‐AU eyes, 0% HSV‐AU eyes and in 11% of VZV‐AU eyes Visual prognosis was favorable for all three groups.

Conclusion Our results point out clinical differences between RV‐AU, HSV‐AU and VZV‐AU and might be especially of value to ophthalmologists who lack the possibility of intraocular fluids analysis to discriminate rubella virus AU from herpes virus AU.
The Project of “Virus‐induced anterior Uveitis”
Authors: ZIERHUT M
Published: December 2011

Purpose To summarize the clinical signs of virus‐induced anterior uveitis and to compare our understanding with the results of a Symposium recently hold in Berlin, comparing proven to unproven cases of herpes simplex virus (HSV), varicella‐zoster virus (VZV), cytomegalovirus (clinically like Posner‐Schlosman Syndrome), and rubella virus (clinically the picture of Fuchs heterochromic uveitis).

Methods Presentation of typical signs and symptoms of anterior uveitis which may be viral induced. This will include secondary glaucoma, keratitis, iris color changes, synechiae, complications like cataract and macular edema.

Results Typically viral induced anterior uveitis only sometimes leads to posterior synechiae (HSV, VZV), mostly to a mild anterior chamber inflammation, and very rarely to macular edema

Conclusion We plan a worldwide prospective trial for reaching more information about the role of virus in anterior uveitis, with tap of the anterior chamber and evaluation of the antigen and the antibody response.
Extraskeletal chondroma of the palpebral conjunctiva : A case report
Authors: JUNGJIN L , HYOJEONG K , SANGWROUL S
Published: December 2011

Purpose To report one rare case of soft tissue chondroma of palpebral conjunctiva.

Methods A 34‐year‐old female presented with one year history of a slowly enlarging painless mass arising in the left eye. There was no history of trauma or any medical problems. Physical examination revealed a placoid mass of the upper palpebral conjunctiva of the left eye. It was firm, round with 3.0mm diameter and not infiltrative with good‐defined margins.

Results Excisional biopsy revealed a white hard tumor with no pus. Histological examination showed a neoplasm composed pilosebaceous glands and fibrous connective tissue with focal cartilage. The histopathology report was benign chondroma. At one month follow‐up, the patient was asymptomatic without infection and any evidence of recurrence.

Conclusion This is one rare case of chondroma of palpebral conjunctiva. And no other cases were reported before in literature.
Scheimpflug analysis and OCT as new and rapid screening tools in the mouse
Authors: PUK O , FAVOR J , GRAW J
Published: December 2011

Purpose The purpose of this study was the establishment of Scheimpflug imaging and Optical coherence tomography (OCT) in the Vision Screen of the German Mouse Clinic (GMC).

Methods Mouse eyes were analyzed by Scheimpflug imaging, OCT, Slit lamp biomicroscopy, Funduscopy, and Histology.

Results The GMC is a large scale phenotyping center where mouse models for human diseases are analyzed in a standardized way. More than 550 parameters are investigated by mouse researches and clinicians from various fields. The screens in the GMC are designated to 14 different areas including behaviour, neurology, energy metabolism as well as vision and eye development. In our attempt to optimize the Vision Screen, we tested the suitability of Scheimpflug imaging and OCT for high‐throughput investigations of the mouse eye by evaluating data of the inbred lines C57BL/6J (B6) and C3HeB/FeJ (C3H). Both methods confirmed previous findings with well established Slit lamp biomicroscopy, Funduscopy, and Histology. Scheimpflug measurements with non‐anaesthetized 13‐week‐old mice indicated transparent lenses with comparable background densities for both B6 and C3H. Pupil dilating with atropine was necessary to optimize lens imaging. Concerning OCT results, B‐scan images of the C3H fundus proved pigment patches and vessel attenuations that are typical for this inbred line. Moreover, the underlying degeneration of retinal outer plexiform and nuclear layers was successfully visualized. Mouse handling was more time‐consuming compared to Scheimpflug imaging. In particular, mice had to be anaesthetized and mouse eyes required a contact lens.

Conclusion Our data demonstrate that Scheimpflug imaging and OCT represent suitable tools for rapid screening of lens density and fundus morphology in the mouse.
Visual Phenotyping at the “Institut Clinique de la Souris”
Authors: ROUX M
Published: December 2011

Purpose Visual diseases come in many flavors, with a large variety of affected tissues (eye anterior segment, retina, optic nerve, cortex …), ages of onset, rate of progression and causal factors. In Western countries, if the majority of these diseases are now curable, millions of people are still affected by blindness or low vision, as many retinal diseases (age‐related macular degeneration, retinitis pigmentosa, diabetic retinopathy, glaucoma…) still lack efficient treatments. In a facility devoted to mouse phenotyping as the Mouse Clinic Institute (MCI), it is thus of major importance to propose an efficient visual phenotyping platform, to pick up visual defects in screened mutants, to assess the beneficial effects of potential treatments or the eventual adverse effects of drugs targeting the CNS.

Methods Mouse mutant lines from the Eumodic European project, as well as lines from specific academic projects, go through clinical observation (slit lamp, fundus imaging) in the context of a behavioral phenotyping pipeline, or are assessed in more details with angiography, optomotor response, electroretinography, retinal histology and/or immunohistochemistry.

Results To illustrate the possibilities offered by the MCI visual phenotyping platform, we will present results obtained from recent projects, including comparison between C57BL/6J and 6N control mice.

Conclusion In an environment allowing for an in‐depth phenotyping, from behavior to biochemistry, metabolism and cardiology, the MCI visual phenotyping platform provides a comprehensive set of tests to get the most out of genetically modified mice.
Incidence of Eyelid Cancers in Singapore‐ A 13‐year Review
Authors: LIM VSY , AMRITH S
Published: December 2011

Purpose To determine the epidemiology of patients with eyelid malignancies in Singapore from 1996 to 2008

Methods The Singapore Cancer Registry has been collecting epidemiologic data of all cancers seen in Singapore since 1968. The epidemiology of eyelid cancers diagnosed from 1968 to 1995 have previously been reported by Lee et al. The data of all eyelid cancers from 1996 to 2008 was retrieved for analysis. The age standardized incidence rates and age‐specific incidence rates were calculated and the results were compared to the previous study

Results There were a total of 160 male patients (48%) and 173 female patients (52%). The average annual age‐standardised incidence rate among male Singapore residents was 5.2 per 1,000,000 and 5.1 per 1,000,000 among female Singapore residents. Between 1996 to 1998, the average annual rate for females was 6.6 per 1,000,000, compared to 3.9 between 2005 to 2008. The most common cancer was basal cell carcinoma (82%), follwed by sebaceous adenocarcinoma (11%) and squamous cell carcinoma (4%)

Conclusion The annual age‐ standardized incidence rates for male residents have remained relatively stable. The rates for female residents have showed a steady decline over the last 13 years. The rates for males are generally higher than for females. Basal cell carcinoma dominates the incidence trends. These expanded epidemiological characteristics serve to provide ophthalmologists and epidemiologists with a foundation to monitor future disease patterns in Singapore and provide a basis for comparison with other selected populations elsewhere
Treatment of an infantile hemangioma with propanolol
Authors: PEREZ GARCIA D , IBANEZ J , REMON L , RAMIRO P , PEIRO C , PINILLA I , CRISTOBAL JA
Published: December 2011

Purpose Angiomas are common vascular tumors in children. Only 10‐15% should be treated by any vital consequences, functional or aesthetic complications. Classically, oral corticosteroids were the preferred treatment for this type of injury. We present the results obtained after treatment of an eyelid angioma in an infant with oral propranolol.

Methods Infant 6 months old, was referred to our clinic for purple injury which had gradually increased in size, in the right lower eyelid. Underwent imaging studies (MRI), which together with the clinical features led to the diagnosis of eyelid hemangioma without intraorbital extension, so it was decided to start treatment, under pediatric control with 2 mg / kg / day of oral propranolol suspension in two doses.

Results Three months after starting treatment we found a partial regression of the lesion. Complete resolution occurred after 8 months. During this period there were no adverse reactions or complications to treatment with propanolol.

Conclusion Treatment with oral propranolol is currently an effective and safe alternative in the management of infantile hemangiomas.
Chronic ocular surface inflammation and vision quality
Authors: PISELLA PJ
Published: December 2011

Abstract not provided
Treatment and visual outcome in orbital and palpebral hemangiomas of infancy
Authors: PINELLO L , MAZZAROLO M , DE CORTI F , LUZZATTO C
Published: December 2011

Purpose To study the relationship between the location of orbital and palpebral(eyelid)hemangiomas and ocular problems in children and the interventions needed to prevent or reduce the severity of visual impairment.

Methods This study included 12 cases (10 female and 1 male;age range:1 day to 5 months old at first evaluation;mean age 2,5 months)of eyelid and/or orbit hemangiomas gathered over a 6 year period (2005‐2011).Ultrasonography and magnetic resonance imaging(MRI)identified these lesions to be:palpebral in 2 cases, palpebral and orbital involvement in 9 cases.Pediatric and ophthalmological evaluation(orthoptic examination,visual acuity determination with Teller Acuity Cards,refractometry and fundus opthalmoscopy)were performed in all cases.

Results The mean follow‐up was 36 months (range 11‐63 months) Treatments for infants and children with hemangiomas obstructing the visual axis included oral steroid administration(9 cases);in 1 case a surgical treatment was associated.4 cases developed amblyopia and 1 case strabismus.Treatment of early amblyopia through selective patching part‐time patch occlusion of the uninvolved eye and early prescription of astigmatism correction was performed.10 children achieved normal vision at last evaluation.

Conclusion In our study 10 patients treated for visual impairment and available for long‐term follow‐up showed an excellent functional outcome with no residual amblyopia.In most cases,early intervention to address hemangioma‐related visual disturbances can lead to a good functional outcome. Intervention typically involves medical debulking of the hemangioma(using oral steroids)combined with the treatment of early amblyopia through selective patching and/or optical correction with refractive lenses.
Ghrelin expression in the rat’s eye
Authors: ROCHA DE SOUSA AA , PEREIRA‐SILVA P , AZEVEDO‐PINTO S , PINHO S
Published: December 2011

Purpose The purpose of this study was to evaluate the ghrelin’s ocular tissue distribution in the adult rat’s eye and to confirm previously reported data, describing the identification of ghrelin’s mRNA in the iris posterior epithelium and in the ciliary body non pigmented epithelium.

Methods Adult Wistar rats were sacrificed through an intraperitoneal injection of sodium pentobarbital and both eyes were immediately enucleated and processed for cryostat sections and indirect immunofluorescence protocol. Slides were incubated with anti‐ghrelin, anti‐histone H3 (positive control) and with 2% NGS (negative control) at 4ºC for 48 hours and then with secondary antibody containing a fluorescent tag during 1 hour. After incubation slides were examined under a fluorescence microscope.

Results We observed immunolocalization of ghrelin in the rat’s ciliary body epithelium. Its major label was in the inner part of that epithelium facing to the stroma of the ciliary processes. This peptide was not localized in the posterior segment, naamely in the retinal pigmented epithelium.

Conclusion Ghrelin is locally produced in the eye, mainly in the ciliary processes. Based on these findings, we can conclude that this peptide may play a role as a local regulator of the aqueous humor dynamics and ciliary muscle kinetics.
Cystoid macular oedema in a phakic treated with bimatoprost for presumed normal tension glaucoma
Authors: COUTTS SJ , GHAZI‐NOURI S
Published: December 2011

Purpose We report a case of a patient with presumed normal tension glaucoma and cystoid macular oedema induced by treatment with bimatoprost. It has been reported that topical bimatoprost is not associated with structural or clinical macula changes in phakic eyes with glaucoma. In discordance our case is of CMO in a phakic patient treated with bimatoprost.

Methods A 56 year old phakic lady with no previous medical history was started on bimatoprost to both eyes for presumed normal tension glaucoma. An epiretinal membrane was documented pre treatment in the right eye.

Results 14 months after treatment the patient re‐presented with symptoms of distorted vision to the right eye. Fundoscopy showed right eye macular thickening and OCT scan confirmed CMO with a fine epiretinal membrane. The CMO was attributed to bimatoprost which was stopped. 10 months after stopping bimatoprost, OCT showed a flat retina.

Conclusion Bimatoprost, like other topical prostaglandin therapies, can induce CMO. This disturbance is more common in pseudophakics, aphakics and uveitic patients and after rupture of the posterior capsule; all conditions where the blood ocular barrier has been more compromised than in phakic eyes. Similarly an epiretinal membrane may alter the blood retinal barrier and predispose to CMO. To our knowledge, this is the first case of CMO with bimatoprost in a phakic eye and is a caution for its use in patients with ocular co‐morbidity such as ERM.
Axitinib modulates hypoxia‐induced blood–retina barrier permeability and expression of growth factors
Authors: KERNT M , THIELE S , LIEGL RG , HARITOGLOU C , ULBIG MW , KAMPIK A
Published: December 2011

Purpose Hypoxia‐induced breakdown of the inner and outer blood–retina barrier and increased expression of growth factor are closely associated with the development and progression of diabetic macular edema. This study was performed to investigate the effects of the multikinase inhibitor axitinib on hypoxia‐induced increased tissue permeability, vascular endothelial growth factor A (VEGF), and platelet‐derived growth factor (PDGF) expression of human retinal pigment epithelial (RPE) cells and human umbilical vein endothelial cells (HUVECs). In addition, the effects of axitinib on the expression of VEGF receptors 1/2 (VEGFR‐1/2) and PDGF receptor beta (PDGFR‐β) were explored.

Methods Primary human RPE cells and HUVECs were treated with axitinib (0.5 µg/mL). Viability of cells and expression of VEGFR‐1/2 and PDGFR‐β, and their mRNAs, were investigated by reverse transcription‐polymerase chain reaction (RT‐PCR) and immunohistochemistry. Cells were exposed to hypoxia. Viability, tissue permeability, expression, and secretion of VEGF and PDGF were determined by RT‐PCR and enzyme‐linked immunosorbent assays.

Results Treatment with axitinib reduced expression of VEGFR‐1/2 and PDGFR‐β. Hypoxia decreased cell viability and increased tissue permeability, expression, and secretion of VEGF and PDGF. Axitinib significantly reduced hypoxia‐induced overexpression and secretion of the growth factors and tissue permeability.

Conclusion Our in vitro results suggest that axitinib may have promising properties as a potential treatment for diabetic macular edema.
Investigation of the liquid in‐ and outflow parameters of the human eye using a modified strategy of the mechanical loading test
Authors: MOISEEVA IN , LYUBIMOV GA , STEIN AA , IOMDINA EN , NAZARENKO LA
Published: December 2011

Purpose To obtain an additional information about the status of the inflow and outflow systems of the eye from ophthalmologic procedures based on static loading, with further application to diagnostics.

Methods The standard method, based on static load application, for the estimation of parameters characterizing the aqueous humor dynamics was supplemented with an unloading test. After a four‐minute stationary mechanical loading by a Schiøtz tonometer, the load was removed and IOP was measured in a discrete regime for up to 20 min using the same tonometer. Clinical measurements were carried out on glaucoma (13) and non‐glaucoma (4) patients. The data obtained were processed using our mathematical model that represents the eyeball as an elastic water‐filled shell whose inner volume is regulated by dynamic balance between the liquid inflow and outflow and is assumed to be a function of IOP and the elastic and geometric characteristics of the system.

Results The most important result is a strong difference between two characteristic times: the time that characterizes the rate of pressure fall under load and the time that characterizes the rate of pressure recovery after removing the load. The characteristic time is directly related with the outflow facility. The difference varies in different groups of patients. The results can be understood within the assumption of nonlinear IOP dependence of the outflow facility coefficient.

Conclusion The modified mechanical loading test is a useful tool for investigating the biomechanical behavior of glaucoma and non‐glaucoma eyes. Our preliminary results give grounds to expect that the effect revealed may be applied to diagnostics.
Effects of benzalkonium chloride on antigen presenting cells in vitro
Authors: MICHEE S , ROSTENE W , BRIGNOLE‐BAUDOUIN F , BAUDOUIN C , LABBE A
Published: December 2011

Purpose To characterize the phenotype, function and cytokine production of antigen presenting cells (APC) when exposed to the most common preservatives in eye drops, benzalkonium chloride (BAK).

Methods APC were obtained from a human leukemia cell line THP‐1. APC were exposed to 4 concentrations of BAK (10‐5%, 5.10‐5%, 10‐4% and 5.10‐4%) and PBS during 24 hours. Cellular toxicity was evaluated with an annexin V‐PE/7‐AAD double‐staining flow cytometry analysis. Phenotype modification was evaluated by flow cytometry through a panel of cluster of differentiation: CD11b, CD11c, CD33, CD45, CD54 and CD86. Phagocytosis function was analyzed using carboxylate‐modified fluorescent microspheres and quantified by flow cytometry. The cytokine production of APC exposed to BAK was measured in supernatants by a human cytokine array.

Results BAK had almost no cellular toxicity at concentrations below 5.10‐5%. A dose‐dependent cellular toxicity of BAK was observed from 5.10‐5% to 5.10‐4%. At low concentrations, BAK modified the phenotype of APC with an increased expression of CD11b, CD11c, CD54 and CD86, and a decrease of CD33 and CD45. APC phagocytosis function was also increased when exposed to low concentration of BAK. Cytokines in supernatants of APC exposed to 10‐5% BAK during 24 hours revealed decreased levels of IL‐1β and CXCL10, and increased levels of CD40L, CXCL11, G‐CSF, S‐TREM‐1, IL‐17E, IL‐6, IL‐23, IL‐27 and IFN‐γ.

Conclusion The interaction between APC and epithelial conjunctival cells are involved in iatrogenic ocular surface diseases. Low concentrations of BAK could have a stimulating effect on APC, modifying phenotype, function and cytokine production.
Electrophysiological assessment of fundus albipunctatus
Authors: PAWLOWSKI P , SUWALA M , BAKUNOWICZ‐LAZARCZYK A
Published: December 2011

Purpose Fundus Albipunctatus is a congenital, stationary retinal disease with rod system degeneration. The disorder is caused by mutation in the RDH5 gene. It is characterized by impaired night vision and numerous small white‐yellow retinal lesions. Flash ERG reveals severe rod function impairment after usual period of dark‐adaptation, which normalize after prolonged dark adaptation.

Methods A case of a 12‐year‐old female presented with symptoms of poor night vision. The patient underwent the visual acuity, colour vision tests (D15), fundus photography, fluorescein angiography, automated static perimetry. The standard dark adapted electroretinogram (30min) and a prolonged dark adaptated ERG (120 min), photopic ERG and multifocal electroretinogram (mfERG) were performed.

Results Visual acuity of both eyes was not decreased. In the peripheral visual field a concentric restriction was found. Scotopic ERG rod responses (0.009 and 0.017 cd x s /m2) were significantly reduced and a standard ERG response was borderline. Photopic ERG was normal. In the mfERG P1 densities were slightly reduced in the eccentric rings (R4‐R5).

Conclusion The comparison of standard adapted scotopic ERG (30 min) and prolonged dark adapted Scotopic ERG (120 min) is the most useful clinical test in diagnosis and differentation of Fundus Albipunctatus. The mfERG can be helpful in detecting patients suffering from Fundus Albipunctatus with progressive cone dystrophy.
Prevalence of uncorrected refractive errors among schoolchildren In northeast of Iran
Authors: YEKTA AA , KHABAZKHOOB M , AZIZI E , OSTADI MOGHADDAM H , HERAVIAN J , AZIMI A , YEKTA R
Published: December 2011

Purpose To determine the prevalence of uncorrected refractive errors (UCREs) among schoolchildren In northeast of Iran.

Methods In a cross sectional study using random cluster sampling, 2020 schoolchildren 6 to 1 years of age were selected. The participants totaled 1551 (response rate=76.7%), 643 boys and 908 girls of elementary and junior high school students from the schools of northeast of Iran. Refractive errors were measured under cycloplegia. Myopia was defined as a spherical equivalent (SE) of ‐ 0.5 dioptre (D) or worse, hyperopia as a SE of +2.0 D. or more, and astigmatism as cylinder equal to or worse than ‐0.75 D. UCRE was defined as a minimum of 2 lines improvement of visual acuity in the better seeing eye.

Results The prevalence of UCRE was 6.2% ( 95% confidence interval [CI]: 5‐7.4%). UCRE was more in boys than girls (P= 0.068). UCRE was not related to age and parent’s education. Myopia and astigmatism were the most common UCREs respectively. Present and corrected visual acuity was not different in 83.3% of the students. Visual acuity of 3 or more and 4 and more lines increased in 2.5% and 0.8% of the subjects after correcting refractive errors respectively. In 21.1%, 9.5% and 3.2% of the students with old correction, visual acuity of 2 or more, 3 more, 4 or more lines increased after new correction respectively .

Conclusion The results of this study indicated that the prevalence of UCREs in schoolchildren of Iran northeast were similar to the most places of the world . Vision screening and correction refractive errors can prevented from visual impairment in schoolchildren.
How does Bangerter filter affect the normal visual perception?
Authors: LI J , DING Z , DENG D , CHAN YLL , BENJAMIN T , CHEN X , HESS RF , YU M
Published: December 2011

Purpose The Bangerter filter (BF) has become an alternate form of amblyopia patching treatment due to its high social‐psychological compliance and effective therapeutic outcomes. This study aims to investigate the effects of different BF densities on the normal visual system in order to quantify filter densities based on vision perception variables.

Methods Thirty‐two binocularly normal subjects participated in this study. Visual acuity (VA), vernier acuity (VNA) and contrast sensitivity (CS) under spatial frequencies (SF) of 0.5, 1, 2, 5, 10 cyl/deg were measured while the dominant eye was patched with randomly selected BF of densities: 0.8, 0.6, 0.4, 0.2.

Results Mean VA and VNA values under the four BF densities were a) 0.29, 0.30, 0.35, 0.54 logMAR and b) 3.24, 4.81, 5.29, 8.19 min of arc respectively. There was a significant difference (p<0.05) in VA change between BF 0.2 and rest of the density groups. BF 0.8 and 0.2 groups showed a significant VNA change compared to BF 0.6 and 0.4 (p<0.05). There were no significant effects noted in CS at SF of 0.5, 1 and 2 cyl/deg across low to high BF groups (p>0.05). BF 0.2 was the only density that had a significant influence on middle and high SF (5 and 10 cyl/deg) (p<0.05).

Conclusion BF does not alter vision perception abilities in a predictable manner suggested by the manufacturer. Only the high BF density has shown a significant change. Careful attention must be paid on the inconsistencies in low and middle BF densities for the patching treatment.
Bromfenac – a new standard in NSAID efficacy
Authors: FINDL O
Published: December 2011

NSAIDs are increasingly used in ophthalmology to reduce surgically induced miosis and inflammation, and in the prevention and therapy of cystoid macular edema (CME). For the treatment of postoperative inflammation following cataract surgery, bromfenac, a new NSAID, has been studied in several clinical trials in recent years. During our discourse, we will elaborate on the following: ‐ Bromfenac’s mechanism of action ‐ Recent clinical data of pivotal/other bromfenac trials ‐ Bromfenac’s safety, tolerability and use in combination with corticosteroids
From comfort to pain: Neural basis of ocular surface sensations
Authors: BELMONTE C
Published: December 2011

The exposed surface of the eye is richly innervated by sensory nerve fibers originated at trigeminal ganglion neurons. They reach the cornea and bulbar conjunctiva as thin myelinated or unmyelinated nerve fibers lacking of morphological terminal specialization. However, electrophysiological studies have shown that sensory neurons innervating the eye are functionally heterogeneous. Based upon their response to specific stimuli, different functional types of sensory nerve fibers have been identified in the cornea and bulbar conjunctiva. Mechanonociceptor fibers (~20% of the total) react only to mechanical forces; polymodal nociceptor fibers (~70%) respond to mechanical forces but also to heat, exogenous chemical irritants and endogenous inflammatory mediators. Cold‐sensitive fibers (~10‐15%) display an ongoing impulse activity at basal corneal temperatures and increase markedly their firing frequency with moderate cooling. Differences in transduction capacity among ocular sensory fibers are attributable to the variable expression of different types of transduction channels (members of the TRP superfamily, ASICs, 2P domain K channels..) HCN channels and of voltage‐dependent Na+ K+ and Ca2+ channels. Under pathological conditions (inflammation, surgical injury, dryness of the ocular surface) activity of ocular sensory nerve fibers changes markedly as the result of short‐term changes in ion channel expression secondary to local release of inflammatory agents and growth factors, and of long‐lasting modifications in gene expression. This leads to the development of spontaneous activity and of abnormal responsiveness to natural stimuli. Each of the functional types of corneal sensory fibers can be stimulated selectively in humans, using an instrument (the Belmonte esthesiometer) that delivers gas pulses of variable flow at neutral temperature (mechanical stimuli), CO2 concentrations (acidic stimuli) and cooled or warmed air at subthreshold flow levels (cold and heat stimuli) onto the ocular surface. Stimulation of the different functional populations of nerve fibers of the ocular surface evokes a specific quality of sensation that includes a variable component of unpleasantness. The relationship between activation of the different classes of ocular surface sensory fibers under normal and pathological conditions and the quality of the experienced sensation is now being elucidated. In addition to their role in the production of conscious innocuous and noxious sensations referred to the eye surface, sensory fibers appear to play a role in the maintenance of the ocular surface homeostasis, including basal and reflex modulation of tearing and trophic maintenance of corneal and conjunctival tissues. Supported by grants BFU2005‐08741 and CONSOLIDER‐INGENIO 2010 CSD2007‐00023 from the Government of Spain.
Oesophageal electrocardiography in healthy horses
Authors: Verheyen T. , Decloedt A. , De Clercq D. , Sys S. , Van Loon G.
Published: December 2011

Reasons for performing study: In human medicine, oesophageal electrocardiography (ECG) is a well‐established technique that magnifies P waves with respect to the QRS complex.

Objectives: To investigate the feasibility of oesophageal ECG recording in horses and its ability to produce larger P waves compared with base‐apex and unipolar recordings.

Methods: Bipolar and unipolar ECG were performed using oesophageal and surface electrodes. Oesophageal ECG was obtained from 6 different recording configurations at different oesophageal depths. Amplitudes of P, Q, R, S and T waves were measured from 3 different cardiac cycles for each recording configuration and depth.

Results: Oesophageal ECG was feasible in all horses. For all oesophageal recording configurations, significantly larger P waves were recorded from a depth that equalled ‘height of the withers + 10 cm’ (HW+10) than from any other depth. P/QRSmagn, the ratio between the P wave and QRS complex magnitudes, was largest for intraoesophageal recordings with an interelectrode distance of 10 cm, at HW+10, where it was significantly larger than base‐apex and unipolar recordings. Base‐apex recording resulted in significantly smaller P waves than all other recording configurations and significantly smaller P/QRSmagn ratios than all other recording configurations except one combined oesophageal‐surface recording (E/Slow).

Conclusions: Oesophageal ECG recording is feasible in horses and effective in magnifying P wave amplitude.

Potential relevance: The procedure is promising for diagnosis of supraventricular tachydysrhythmias and might be used in electrophysiological studies and for cardiac pacing.
Stifle extension results in differential tensile forces developing between abaxial and axial components of the cranial meniscotibial ligament of the equine medial meniscus: A mechanistic explanation for meniscal tear patterns
Authors: FOWLIE J. G. , ARNOCZKY S. P. , LAVAGNINO M. , STICK J. A.
Published: December 2011

Reason for performing the study: To identify potential functional‐anatomical characteristics of the cranial horn attachment of the medial meniscus (MM) that may help explain the pathogenesis of the common tear patterns that have been reported.

Hypothesis: Full extension of the stifle generates a significant increase in tensile forces within the cranial meniscotibial ligament (CrMTL) of the MM, which may predispose this structure to injury.

Methods: The effect of femorotibial angle (160°, 150°, 140° and 130°) on tensile forces in the axial and abaxial components of the CrMTL was examined in 6 mature cadaver stifles using an implantable force probe. Three additional specimens were used to examine the histological structure of the CrMTL and its connection to the cranial horn of the MM.

Results: Full extension of the stifle (160°) resulted in a significantly greater tensile force in the abaxial component of the CrMTL when compared with the axial component (P = 0.001). The tensile force in the abaxial component of the CrMTL increased significantly between 150° and 160° of stifle extension (P = 0.011). The CrMTL appears to be comprised of 2 functional components, which become more visually distinct as the stifle is extended. Histologically, these components are separated by a cleft of highly vascularised, less organised connective tissue, which becomes less prominent at the junction of the ligament and the cranial horn of the MM.

Conclusion: A 4‐fold difference in the tensile forces in the 2 functional components of the CrMTL of the MM was observed with full extension of the stifle.

Potential relevance: The functional anatomy of the CrMTL may place this region at greater risk of injury during hyperextension of the stifle and, therefore, may provide a mechanistic rationale for the commonly reported meniscal tear patterns in the horse.
SAFE INFANT FEEDING IN LESOTHO IN THE ERA OF HIV/AIDS
Authors: Kroeker Lena , Beckwith Alyx
Published: December 2011

An estimated 160,000 women of childbearing age in Lesotho are HIV positive (UN Children's Fund [UNICEF] 2010). To prevent the transmission of HIV from mother to child (PMTCT), antenatal care clinics test pregnant women for HIV and provide prevention counseling. PMTCT counseling includes information about medication in pregnancy, delivery procedures, and safe infant feeding. Regarding infant feeding, the WHO recommends either exclusive replacement feeding or exclusive breastfeeding; while the culturally normative practice is to combine breast milk with other food for the infant. Mixed feeding, however, increases the likelihood of HIV infection through breast milk. Women must balance the recommendations of healthcare workers with society's norms and the advice of their family, as well as cost and availability. Exclusive replacement feeding is too expensive for most families and against the cultural norm, while exclusive breastfeeding proves difficult to implement because of a lack of understanding of PMTCT recommendations among an infant's multiple caretakers. Collective child care is an important part of social integration and respect for elders makes it difficult for young women to risk conflict by rejecting familial advice for that of healthcare workers. Given these concerns, the authors examine safe infant feeding in the context of Lesotho's HIV epidemic.
“IF I TAKE MY PILLS I’ll GO HUNGRY”: THE CHOICE BETWEEN ECONOMIC SECURITY AND HIV/AIDS TREATMENT IN GRAHAMSTOWN, SOUTH AFRICA
Authors: Jones Chaunetta
Published: December 2011

Based on 14 months of ethnographic research in Grahamstown, South Africa, I argue that economic inequalities and structural barriers have created dire situations in which people living with HIV/AIDS (PLWHA) often are forced to choose between economic security and health security. While the rollout of antiretroviral treatment (ART) has been initiated in various stages throughout the country, the availability of treatment has created unanticipated and adverse responses. Many PLWHA who are too sick to work rely solely on social assistance grants as their only form of income. To qualify for what are locally known as “disability grants,” patients must demonstrate and maintain a CD4 count of 200 or below, which ironically, also is the marker to begin ART. This has created a complex dilemma as patients have begun to modify their adherence to and/or refuse ART to maintain low CD4 counts, in an effort to continue to receive their “disability grant,” thereby sustaining their economic and food security. Future HIV/AIDS programs must develop initiatives that do not conflict with patient treatment and prevention strategies but, rather, provide a holistic approach to economic and health security, particularly in resource‐poor communities.