bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of macular edema in vein occlusion
Authors: CREUZOT C
Published: December 2011

Purpose Recent multicenter trials provided us with interesting results of macular edema linked to vein occlusion. Until now, the standard of care treatment of macular edema due to branch vein occlusion remained grid laser in contrast with central vein occlusion where the absence of treatment was still recommended. ,

Methods SCORE, GENEVA, BRAVO and CRUISE studies recently provided us with the following results: SCORE study found triamcinolone to be interesting to treat macular edema due to central vein occlusion but not from branch occlusion. GENEVA study assessed the effect of a delivery system of dexamethasone to treat macular edema due to venous occlusion whatever the clinical form with an improvement of visual acuity. CRUISE and BRAVO studies assessed the effect of ranubizumab which was found to improve the visual acuity of macular edema due to either central or branch vein occlusions. GALLILEO and COPERNICUS reported recent results with another antiangiogenic agents with interesting results but still unpublished.

Results At this stage, to treat macula edema in vein occlusion, we have to consider the characteristics of the patients to decide which treatment should be used: lens status, increased ocular pressure, delay before treatment of the disease, clinical form of vein occlusion as well as the predictable acceptance of repeated injections by the patients.

Conclusion There is an urgent need for comparative studies but these studies should consider separately branch and central vein occlusions.

Commercial interest
Peripapillary retinal nerve fiber layer thickness measurement with 3 Spectral Domain OCT devices
Authors: FENOLLAND JR , GIRAUD JM , MOUINGA A , SENDON D , ELASRI F , MAY F , RENARD JP
Published: December 2011

Purpose To compare peripapillary retinal nerve fiber layer (pRNFL) thickness measurement using 3 Spectral Domain OCTs (SD‐OCT) in normal and glaucomatous patients

Methods Observational case series. 145 eyes of 78 patients underwent a complete examination and a standard automated perimetry followed by pRNFL OCT evaluation with the RTVue OCT (Optovue), the 3D‐OCT 2000 (Topcon) and the Spectralis (Heidelberg). Each patient was scanned by the same well‐trained examiner. pRNFL measurements were comparated across the 3 devices using repeated measures analysis of variance (ANOVA) and multiple comparaison t‐tests with Bonferroni adjustements. Bland‐Altman plots were constructed to assess the level of agreement between each pair of OCTs.

Results The study included 66 normal eyes, 24 ocular hypertension, 10 preperimetric, 23 mild, 14 moderate and 8 severe glaucomas. Overall pRNFL thickness mean was greatest on the Topcon (96,2±14,9), intermediate on the RTVue (93,8±16,5) and lowest on the Spectralis (84,5±18,5). The ANOVA test demonstrated a mean thickness difference (overall, superior, inferior, nasal and temporal) between the 3 OCTs (p<0,05). On the multiple comparaisons t‐test, the Topcon and RTvue were not significantly differents. The bland Altman plots show a moderate agreement but a good correlation between the 3 OCTs. The thinner were the RNFL thickness, the greater were the differences between the devices.

Conclusion This study proved that there were differences in the thickness measurements and a moderate agreement between the 3 devices. SD‐OCT are not interchangeable and the patient's follow up should be done on the same device.
The Bestrophinopathies
Authors: LEROY BP
Published: December 2011

Purpose To describe the phenotypes of conditions due to mutations in BEST1, the gene encoding bestrophin‐1.

Methods A case presentation format will be used to illustrate the phenotypes and genotypes of the different bestrophinopathies, with special attention to both the clinical and electrophysiological features that distinguish one phenotype from the other, and those they have in common. In addition, the different BEST1 genotypes will be discussed.

Results The phenotypes of Best vitelliform macular dystrophy (BVMD), autosomal dominant vitreoretinochoroidopathy (ADVIRC), and autosomal recessive bestrophinopathy (ARB) are very different as far as their clinical phenotypes are concerned. Nevertheless at the electrophysiological level, they share an abnormal electro‐oculography (EOG) as a common feature. Electroretinography is normal in BVMD, whereas a rod‐cone dystrophy is evident in the later stages of disease of ADVIRC and ARB. The BEST1 genotypes differ in that BVMD is due to a heterozygous missense mutation in BEST1, ADVIRC is due to interaction of several bestrophin protein isoforms, and ARB is probably the null phenotype.

Conclusion The phenotypes of the bestrophinopathies are diverse, although they share an abnormal EOG as the common feature. The specific genotypes are also different, leading to different molecular pathogenetic mechanisms.
Gene Therapy & Pharmacotherapy for Inherited Retinal Disease: Current Status
Authors: HAMEL C
Published: December 2011

Purpose To describe the rationale for gene therapy and pharmacological treatments in retinal dystrophies, and to show a few examples of the undergoing trials.

Methods Gene therapy can be applied to complement (in loss‐of‐function mutation) or to suppress (in gain‐of‐function mutation) a mutated gene, in order to correct the specific defect linked to this gene. Gene therapy can also be used to in situ produce a protein whose properties will modify the course of the disease. In a similar way, pharmacological drugs can supplement the metabolic defect linked to a specific gene, or can facilitate photoreceptor survival and/or function whatever the genetic defect.

Results Conditions (photoreceptor dysfunction and degeneration, rate of degeneration, stage at disease diagnosis) to which gene therapy can be applied will be reviewed. Retinal dystrophies linked to RPE65 mutations provide good examples of both gene therapy by complementation and pharmacological therapy by supplementation. Gene repair is a promising approach to reverse mutations into the correct sequence. Rapid descriptions of ongoing trials for congenital achromatopsia, Stargardt disease and retinitis pigmentosa will be showed.

Conclusion Future developments of therapeutic interventions will depend on accurate molecular diagnosis, knowledge of pathophysiological mechanisms and improvement in drug ocular delivery.
The immunology of allergic ocular surface disease
Authors: LEONARDI A
Published: December 2011

Purpose The conjunctiva is normally exposed to picogram quantities of environmental allergens such as pollens, dust mite fecal particles, animal dander and other proteins. When deposited on the mucosa, these antigens are processed by Langerhans cells or other antigen‐presenting cells (APC) in the mucosal epithelium, bind to the antigen recognition site of major histocompatibility complex (MHC) class II molecules, and present to naive CD4+ lymphocytes at some unknown location that could be the local draining lymph nodes.

Methods The concentration and distribution of inflammatory mediators or inhibitors in the tear fluid have been extensively used in ocular allergy to find either a ‘disease marker’, to better understand the immune mechanisms involved in the ocular surface inflammation, or to identify potential targets for therapeutic interventions.

Results TMultiple mediators, cytokines, chemokines, receptors, proteases, growth factors, intracellular signals, regulatory and inhibitory pathways, and other unknown factors and pathways are differently expressed, ultimately resulting in the many clinical manifestations of ocular allergic disease.

Conclusion A better understanding of the mechanisms involved in ocular surface immunity is necessary for identifying new classification criteria and new therapeutic strategies.
Caspase‐3 expression in rat lens after in vivo exposure to UVR‐300 nm
Authors: TALEBI ZADEH N , GALICHANIN K , HALLBÖÖK F , SÖDERBERG P
Published: December 2011

Purpose To determine the evolution of active caspase‐3 protein expression in albino rat lens after in vivo exposure to low dose UVR‐300 nm by immunohistochemistry.

Methods Altogether, 10 Sprague Dawley rats were unilaterally exposed in vivo to 1 kJ/m2 UVR‐300 nm for 15 minutes. At 0.5, 3, 7 and 24 hours after UVR exposure, exposed and contralateral non‐exposed lenses were removed and processed for immunohistochemistry. Three midsagittal sections per lens were stained. Active caspase‐3 labeling was counted and recorded three times in each section.

Results Caspase‐3 expression was higher in exposed than in contralateral non‐exposed eyes (expressed as a 95% confidence interval for the mean CI[Mean difference] 0.95 = 13.6 ±0.5). The mean difference between exposed and contralateral non‐exposed lenses was (CI[Mean difference] 0.95) 13.1 ±9.0, 14.3 ±5.6, 18.4 ±1.9 and 8.8 ±7.2 for the 0.5, 3, 7 and 24 hours groups, respectively. There was no difference in expression of caspase‐3 between the 0.5 and 24 hours groups (CI[Mean difference] 0.95 = 4.3 ±7.0). There was a difference between the 3 hours and 7 hours groups (CI[Mean difference] 0.95 = 4.14±2.03). There was a difference when comparing the 0.5 and 24 hours groups versus the 3 and 7 hours groups (CI[Mean difference] 0.95 = 6.21±4.05).

Conclusion Expression of caspase‐3 in eye lens increases after UVR exposure. There is a peak of expression between 3 and 7 hours after exposure.
Why electrophysiology in children?
Authors: HOLDER GE
Published: December 2011

After a description of the appropriate techniques, the presentation will use a case based approach to describe the value of electrophysiological assessment in the diagnosis and management of paediatric patients.
Pros of treatment of NA‐ION
Authors: LEE A
Published: December 2011

Purpose To define the indications for steroids in NAION

Methods Case based learning, evidence based practice

Results Steroids have been shown to be possibly beneficial in NAION in a patient choice methodology study Steroids have an unproven but biologically plausible mechanism of action in NAION

Conclusion Until a randomized, prospective clinical trial is performed, steroids may be considered as a potential treatment option for NAION in selected cases
Cons of treatment of NA‐ION
Authors: GRZYBOWSKI A
Published: December 2011

Purpose To discuss benefits and risks of steroids use in NAION.

Methods Analysis of evidence based studies.

Results There are no first class evidence based studies confirming that the use of steroids in NAION is of benefit. There are few case series and case reports suggesting the benefit of oral or intravitreal steroids use. These studies, however, have several limitations. Moreover, steroids have many adverse effects, what is especially important in elderly patients with co‐existing diseases, the typical profile of NAION patients.

Conclusion There is no effective therapy for NAION supported by first class evidence based study. The use of steroids should be critically analyzed in the context of their possible adverse effects.
Why pulley surgery in strabismus?
Authors: BREMOND‐GIGNAC D
Published: December 2011

The recent innovations in the comprehension of orbital anatomy and extraocular muscles allow a better reflection about practical strabismus surgery. Trochlea anatomy for superior oblique muscle is well defined but Miller in 1987 in monkeys and Demer in 1994 first described functional pulleys for rectus extraocular muscles. These pulleys are based on connective tissue sleeves of collagen, elastin and smooth muscle that surround and stabilize the posterior extraocular muscles paths within the bony orbit. Imaging of the orbit is required to the understanding of variable effect on binocular alignment in strabismus. Different data can be obtained from the MRI as lateral rectus path lengths from orbital apex to first globe conta
Evolution of protein concentration in the rat lens after in vivo exposure to close‐to‐threshold dose ultraviolet radiation
Authors: JING W , ZHANG J , LÖFGREN S , GALICHANIN K , ZALEBIZADEH N , YU Z , SÖDERBERG P
Published: December 2011

Purpose To investigate the short term cataract development and protein concentration in the rat lens after in vivo close‐to‐threshold dose exposure to ultraviolet radiation (UVR) around 300 nm.

Methods Three groups of 10 Sprague Dawley rats were unilaterally exposed to 8 kJ/m2 UVR‐300 nm for 15 minutes, and a forth group of 10 rats was kept without UVR exposure as non‐exposed control animals. The exposed animals were sacrificed at 1, 3 and 7 days after exposure. Both lenses from all animals were extracted and photographed and the intensity of forward light scattering was measured quantitatively. Whole lens was homogenized and protein concentration was determined spectrophotometrically.

Results All exposed lenses developed cataract. Lens light scattering increased throughout 7 days after UVR exposure. The difference of protein concentration between exposed lens and contralateral non‐exposed lens was slightly decreased at 1 day after exposure and then gradually normalized back to baseline within 7 day after exposure.

Conclusion The in vivo close‐to‐threshold dose UVR induced cataract and protein changes are not paralleled. The altered protein concentration is normalized within 7 days after ultraviolet irradiation.
Your second best glaucoma‐friend, function testing
Authors: VISWANATHAN A
Published: December 2011

Accurate and reliable assessment of the results of automated perimetry are of primary importance in the management of glaucoma, both for diagnosis and for the measurement of progression. This aspect of the Course, designed for young ophthalmologists, will give specific, practical guidance on how to derive the maximum amount of useful information from a single visual field test result or from a longitudinal series of results. A simple mnemonic will be described to ensure that no important elements of the analysis are missed.
Your third best glaucoma‐friend, structure evaluation
Authors: SUNARIC MEGEVAND G
Published: December 2011

Glaucoma is characterized by structural changes of the optic nerve and the retinal nerve fibre layer (RNFL) and corresponding functional alterations. Although the glaucoma specialist still depends upon direct fundus examination to assess structural damage, the last ten years has seen the emergence of a variety of new technologies for objective and non‐invasive measurement of structural changes. During the course will be discussed the most important parameters for direct fundoscopic analysis of the optic nerve head and RNFL as well as the principals of the 3 most used imaging devices HRT, GDX, OCT.
Establishment of a lens epithelial cell line from cataract dog
Authors: OCHIAI H
Published: December 2011

Purpose The aim of this study is to establish a lens epithelial cells (LECs) line originated from cataract dog.

Methods Anterior capsulorrhexis specimen from a dog (8‐year‐old male Wire Fox Terrier) naturally developing mature cataracts was obtained prior to routine phacoemulsification cataract extraction. The primary lens epithelial cells were transfected with the expression plasmid DNA encoding replication origin defective simian virus 40 (SV40) large T antigen and then cloned a colony by using glass syrinder.

Results The primary cells proliferated to confluent until three passages. However, the immortalized cells remained proliferative, and this cloned cell line, termed as cdLEC, grew well and could be propagated over 200 times by splitting at 1:20. Functional analysis of Na‐dependent vitamin C transporter (SVCT) indicated that the Km value toward ascorbic acid (vitamin C) was 19.9 + 2.8 M, and RT‐PCR analysis showed that SVCT2 was observed in this cell line while SVCT1 was not, which was the characteristic of LECs. Western blot analysis and cyto‐immunochemistry indicated immortalized cells produced a protein with a molecular weight of 25 kDa, which reacted with an antibody to B‐crystallin within the whole cytosol.

Conclusion These results indicate that cdLEC may provide a useful in vitro system for the study of path‐physiology of canine cataract.
Tips and tricks in grossing and processing ophthalmic specimens
Authors: COUPLAND SE
Published: December 2011

Purpose Ophthalmic specimens range in size and degree of complexity. The diagnostic work‐up of ocular ophthalmic biopsies and larger specimens demands close collaboration between the clinician, the pathologist and other specialties, including the plastic surgeon, head‐and‐neck surgeon as well as the microbiologist.

Methods Documentation of all relevant clinical information in the pathology request form as well as timely discussions between the various specialists (for example, telephone communications just before a biopsy is performed) are essential components of the diagnostic pathway, prior to specimen arrival in the diagnostic laboratory.

Results The laboratory itself should be equipped with experienced technical staff familiar with the specimen protocols, a pathologist with expertise in ocular pathology/fluid samples, and also be supported with a wide range of investigations, including molecular diagnostic techniques.

Conclusion In this way, the yield from these samples can be optimized to reach an unequivocal diagnosis, rapid communication to the clinician, and timely instigation of therapy. Guidelines for these steps are provided.
Overview of eyelid and conjunctival tumours
Authors: LOEFFLER K
Published: December 2011

Abstract not provided
Overview of orbital tumours
Authors: HEEGAARD S
Published: December 2011

Abstract not provided
Incorporation of cytogenetic and molecular techniques in ocular pathology
Authors: COUPLAND SE
Published: December 2011

Purpose The roles of molecular techniques in ocular pathology are four‐fold: a) Understanding disease pathogenesis; b) diagnosis; c) prognosis; and d) predicting therapy response.

Methods Examples of recent developments in molecular pathology in understanding the pathogenesis of tumours include the sonic hedgehog pathway in BCC; polyomavirus MCPyV in Merkel cell carcinoma; microsatellite instability in sebaceous carcinoma; fusion oncogenes in adenoid cystic carcinoma and mucoepidermoid carcinoma; and A20 gene deletions in conjunctival MALT lymphoma. Molecular techniques, such as IgH‐PCR and TCR‐PCR, are required regularly for the confirmation of the diagnosis of ocular B‐ and T‐cell lymphomas, respectively. In particular, IgH‐PCR is required to provide supportive evidence for the diagnosis of vitreoretinal lymphoma, when evaluating a diagnostic vitrectomy or a subretinal aspirate/chorioretinal biopsy.

Results The main example in ocular oncology where molecular techniques are used for prognostication is uveal melanoma. The presence of monosomy 3 and polysomy 8 was initially detected using FISH. Techniques, which provide more detailed information, such as MLPA, aCGH, and GEP, have been introduced in various ocular oncology centres, with the molecular genetic data being incorporated with clinical and histomorphological features to provide individualized prognostic curves.

Conclusion Advances have been made in some other malignancies in predicting tumour response to therapy. For many ocular malignancies, such a “magic bullet” has not yet been found; however, the principles of predicting “responders” and “non‐responders” and the potential targets will be discussed.
Cadmium, copper and lead in cataractous and normal dog lenses
Authors: DODI PL , QUINTAVALLA F
Published: December 2011

Purpose This study aims to determine the concentrations of cadmium (Cd), copper (Cu) and lead (Pb) in cataractous and normal dog lens. The possible role of these elements in cataractogenesis has been suggested by reports in humans.

Methods 14 cataracts dogs lenses and a control group of 6 normal clear dogs lenses of different breeds and sex living in same area have been examined. The average ages of the cataractous group are 9.6+/‐4,6 years old, while the control group are 4,8+/‐2,9 years old. Cataractous lenses were classified as mature. Removed lenses were placed into cleaned PVC tubes and kept frozen below ‐20°C before being assayed. Cd, Cu and Pb levels of the samples were determined with a Perkin‐Elmer atomic absorption spectrophotometer equipped with graphite furnace system using a standard addition technique. The concentrations were calculated in terms of mg/kg dry tissue weight. Statistical method used was Student t test.

Results Cataractous lenses: Cd 0,081+/‐0,046; Cu 2,9+/‐1,5; Pb <0,05. Normal lenses: Cd 0,062+/‐0,035; Cu 3,6+/‐3,8; Pb <0,05. No significant differences in Cd, Cu and Pb concentrations related to age and sex have been found at the comparison of normal versus cataractous lens

Conclusion In humans and animals the most likely origin of Cd, Cu and Pb is from environmental contamination. The results suggest that the low concentrations of these heavy metals in cataractous lens in dogs can be related to the fact that: a) dogs have a shorter lifespam than men; b) these elements are not widely spread in the Italian environment; c) the pattern of absorption and storage of these elements could vary among different species.
The modern management of ocular surface burns
Authors: GICQUEL JJ
Published: December 2011

Ocular surface burns can be due to the exposition to chemical agents, extreme temperatures or ultraviolet, infrared or ionising radiations. Alkali burns differ from acid burns by the fact that they deeply penetrate in the anterior segment and so are particularly severe. Initial clinical examination (with the help of classifications) tells us how to adapt the treatment and gives us the prognosis. The 4 Grades Ropper‐Hall’s classification has been replaced by the more precise 6 Grades Dua’s one. Surgical treatment aiming to restoring a proper corneal epithelium has improved the prognosis of severe cases. It can address the acute (Amniotic Membrane Transplantation, Sequential Sectorial Epitheliectomies) or the late stage of the disease (Limbal Stem Cell (LSC) Transplantation / in or ex vivo expansion). In all cases, an optimal control of the ocular surface inflammation is essential to the LSC survival.
How Anterior Segment Imaging help in the management of ocular surface cicatrizing diseases
Authors: NUBILE M
Published: December 2011

Abstract not provided
The Amniotic Membrane in conjunctival cicatrizing diseases
Authors: DUA H
Published: December 2011

Abstract not provided
Unilateral pediatric cataract of uncertain cause
Authors: PARK JH , LEE JJ , SONG SW
Published: December 2011

Purpose To report the surgical results of unilateral pediatric cataract of uncertain cause and find out factors related to better outcome.

Methods We reviewed the medical records of 39 patients who underwent surgery for unilateral pediatric cataracts of no known cause. All patients underwent primary Intraocular lens implantation, and postoperatively, they were treated for amblyopia with glasses or monocular patch. Postoperative final visual acuity levels greater than 20/30 were considered ‘good’. Statistical analysis was carried out to determine factors affecting surgical outcome.

Results The mean age was 5.9 ± 1.8 years (range 2.6 to 9.2) at the time of surgery. The mean final postoperative visual acuity was 0.47 ± 0.54 logMAR (range 0.00 to 2.00). In all, 46.2% (18 of 39) achieved a ‘good’ visual acuity. The ‘good’ visual acuity was significantly associated with better preoperative visual acuity, smaller amount of preoperative refractive error, smaller amount of preoperative refractive error difference between the operated eye and the fellow eye, and absence of strabismus (p = 0.002, 0.010, 0.008, and 0.014 respectively). Only preoperative visual acuity was significant in the multivariate analysis (p = 0.028). The preoperative visual acuity of 20/160 or better was found to increase the chance of achieving ‘good’ visual acuity by 8.66‐fold (95% CI 1.26 to 59.38).

Conclusion Preoperative visual acuity is the most important prognostic indicator for surgical outcome of unilateral pediatric cataract of uncertain cause.
Management of IOLs in pediatric cataracts
Authors: DEL BUEY MA , CRISTOBAL JA , REMON L , LAVILLA L , MINGUEZ E , ASCASO J , CASAS P , JIMENEZ B , PALOMINO C
Published: December 2011

Purpose To describe the different possibilities of treatment in pediatric cataract with IOL implantation; analyzing the type of IOL, the position of the haptics AND optic.

Methods Children of different ages underwent cataract extraction with intraocular lens implantation. We analyzed age of detection, age at surgery, cooperation of the patients, uni or bilaterality, presence of associated ocular abnormalities. Postoperatively we studied the evolution of the ocular inflamation during the first weeks, avoiding synechiae and membranes formation using oral prednisolone. Also we studied the visual recovery of the pseudophakic eye trying to avoid ambliopya by oclussion therapy of the fellow eye (in case of monocular cataract).

Results We obtained our best results by implanting an IOL always if possible, unless there is associated ocular pathology (microphthalmos, iris abnormalities,...). Our choice: In children under 2 years of age monofocal "3 pieces" IOL with haptics in sulcus and the optic in the bag or luxated into the vitreous (power undercorrected in 20%). In children between 2 and 4 years of age "3 pieces" IOL in the bag or with the optic into the vitreous. In older children with good preoperative biometric evaluation and good cooperation, specially in monocular developmental cataract, a great option is the use of multifocal IOLs to improve binocularity.

Conclusion In our experience, the best option to manage with pediatric cataract is to implant an IOL after cataract extraction, unless the presence of associated ocular abnormalities make it inadvisable . Visual recovery will be faster than in pediatric aphakic eyes and less "hard". Controversy still persists about the appropiate power of the IOL and how to calculate it.
Outcomes of phacoemulsification and intraocular lens implantation in cataracts secondary to uveitis
Authors: JIMENEZ DEL RIO B , PEREZ GARCIA D , RAMIRO P , IBANEZ J , PINILLA I , MINGUEZ E , CRISTOBAL JA
Published: December 2011

Purpose Cataract is a common complication of uveitis. Development of cataract depends on factors such as severity or chronicity of the process, steroid treatment and posterior irido crystalline synechiae formation. The aim of our study was to evaluate the results of phacoemulsification and intraocular lens(IOL) implantation in patients with cataracts secondary to uveitis.

Methods We conducted a retrospective observational study of cataract surgeries secondary to uveitis after 3 months of no inflammation. Phacoemulsification and IOL implantation were performed between january of 2004 and 2010. Studied variables were sex, age, type of uveitis, visual acuity before and after surgery, uveitis sequelae and surgical complications.

Results We studied 32 eyes of 21 patients (12 women and 9 men). The average age was 49.19+/‐15.4 years. Average preoperative best corrected visual acuity was 0.24+/‐0.1 while the final best corrected visual acuity was 0.75+/‐0.2. The most common inflammatory process was idiopathic anterior uveitis.Other inflammation processes were Fuchs heterochromic cyclitis or pars planitis. There was no postoperative recurrence of uveitis in 29 eyes(90.6%) during the first month. The most frequent early postoperative complication was corneal edema and the late one was iris atrophy due to pupillary distention. Posterior capsule opacification appeared in 21 cases(66%) during the first six months after surgery. In 79% of patients achieved a final visual acuity from 0.6 to 0.9.

Conclusion Phacoemulsification with IOL implantation is, at this moment,the chosen surgical technique in most postuveítis cataract because it causes less inflammation and provides good visual results.
A comparison of remaining refractive error after cataract surgery using different monofocal intraocular lenses
Authors: STRATOS A , PEPONIS V , DRAKOS E , HALKIADAKIS I , SKOURIOTIS S , PARIKAKIS EA , KARAGIANNIS D , MITROPOULOS P
Published: December 2011

Purpose The aim of this study was to evaluate the refractive outcomes following cataract surgery using single‐piece and three‐piece monofocal intraocular lenses (IOLs).

Methods In this retrospective study 114 eyes were enrolled. Monofocal single‐piece IOLs were used in group I (Quatrix/Croma., Austria, 61 eyes) and group II (Acrysof IQ /Alcon Laboratories Inc., Texas, 29 eyes) while three‐piece IOLs were implanted in group III (Mediconsult A85UV/Mediconsult Intraocular., Germany, 24 eyes). The main clinical outcome parameter evaluated was the remaining spherical equivalent refraction (Remaining SER: post‐op SER – target refraction). Kruskal‐Wallis non‐parametric ANOVA statistic test was used for data analysis.

Results The mean target refraction was ‐0.52D (SD 0.34). The mean remaining SER in group I, [Iota][Iota] and III was +0.46D (SD 0.93), +0.25D (SD 0.61) and ‐0.29D (SD 0.97) respectively. Kruskal‐Wallis H test showed that there was a statistically significant difference in the residual refractive error among the different IOL implants (H (2) =11.255, P=.004).

Conclusion According to statistics, single‐piece IOL implants Quatrix and AcrySof IQ induced a slight hyperopic shift whereas the refractive outcomes of three‐piece implants (Mediconsult A85UV) concurred with the preoperative target. Future prospective studies and a larger number of cases are needed to verify the aforementioned results.
Evaluation of posterior capsule opacification after cataract surgery using Liquifaction Method
Authors: KALFERTOVA M , BUROVA M , NEKOLOVA J , JIRASKOVA N , ROZSIVAL P
Published: December 2011

Purpose Posterior capsule opacification (PCO) is still one of the most common complication following cataract surgery with IOL implantation. We evaluate the extent of PCO after cataract surgery ‐ torsional phacoemulsification and Liquifaction method removal of the epithelial cells (right eye) and torsional phacoemulsification (left eye). For PCO quantification we use two types of software.

Methods In our prospective clinical study we examine patients 3, 6, 12 and 24 months after surgery, digital retroillumination photographs of the anterior segment, pachymetry, endothelial cell count (ECC) and best corrected visual acuity (BCVA) are obtained For evaluation of PCO we use EPCO 2000 software (Evaluation of Posterior Capsule Opacification) and OSCA software (Open‐Access Systematic Capsule Assessment).

Results The BCVA two years postoperatively is 0.896 ± 0.13 (right eye), 0.883 ± 0.16 (left eye). Nd‐YAG laser capsulotomy one year after surgery underwent one patient (both eyes) and one patient two years postoperatively (right eye). EPCO results ‐ right eye: 0.260 ± 0.198 (3M); 0.259 ± 0.173 (6M); 0.308 ± 0.19 (12M); 0.419 ± 0.252 (24M), left eye: 0.279 ± 0.170 (3M); 0.280 ± 0.153 (6M); 0.333 ± 0.197 (12M); 0.480 ± 0.313 (24M) OSCA results ‐ right eye: 0.599 ± 0.240 (3M); 0.605 ± 0.333 (6M); 0.598 ± 0.256 (12M); 0.655 ± 0.402 (24M), left eye: 0.627 ± 0.403 (3M); 0.635 ± 0.360 (6M); 0.629 ± 0.328 (12M); 0.654 ± 0.452 (24M).

Conclusion The Liquifaction method is save for occular tissue. One year after surgery most cases of PCO is graded as minimal. Supported in part by Charles University Grant Agency, No. 103809
Light transmission of the human lens and its relation with aging
Authors: FELIPE MARCET A , ARTIGAS VERDE JM , NAVEA TEJERINA A , FANDINO A , ARTIGAS C , GARCIA‐DOMENE MC
Published: December 2011

Purpose To determine the visible light transmission of the human crystalline lens of persons of different ages, using both solar and incandescent illumination.

Methods The spectral transmission of lens was measured by using the Perkin‐Elmer 800 UV/VIS spectrophotometer. With these data we calculated the percentage of visible light transmission for solar illumination, simulated by the CIE D65 illuminant, and for incandescent illumination (A illuminant).

Results The total amount of visible light transmitted by nine crystalline lenses is represented as a function of age: with solar illumination and with incandescent illumination and the comparison between both illuminants.In general, the amount of visible light transmitted by the crystalline decreases with age and, in relative values, this transmission is higher with incandescent illumination (between 2 and 8% higher) than with solar illumination.

Conclusion In general, total transmission of visible light decreases greatly with age.Nonetheless, the case of the transmission of a crystalline lens of a 50‐year‐old being much lower than that of a 64‐year‐old has been reported, which indicates that some of the factors that determine the darkening of the crystalline lens may act more intensely in some people than in others. Moreover, a slight improvement in visible light transmission was observed when incandescent light was used instead of solar light. This is because the crystalline lens yellows with age and as incandescent light is basically yellow, it is almost wholly transmitted. However, as solar light is tremendously intense, the absolute amount of light that reaches the retina is always much greater with solar rather than with incandescent illumination.
Age‐induced change in the color of the human crystalline lens
Authors: ARTIGAS VERDE JM , FELIPE MARCET A , NAVEA A , FANDINO A , ARTIGAS C , DIEZ‐AJENJO A
Published: December 2011

Purpose To determine the chromatic coordinates of different human crystalline lenses to analyze the age‐induced change in the color of the crystalline.

Methods The spectral transmission of nine human crystalline lenses of different ages were measured by using a Perkin‐Elmer 800 UV/VIS spectrophotometer. Using these data we calculated the chromatic coordinates of each crystalline lens for both solar and incandescent illumination. The study adheres to the tenets of the Declaration of Helsinki for Research Including Human Subjects and was approved by the Institutional Review Board.

Results The results show a greater saturation of color with the increase of age. In principle, the change tends towards yellow, although for ages of over 70 years it veers more towards orange colors. All the crystalline lenses were more yellow and saturated under incandescent illumination.

Conclusion At the beginning, a young crystalline lens is transparent and its chromatic coordinates practically coincide with those corresponding to solar light. As age increases, the crystalline lens yellows. On the basis of the results obtained, it cannot be claimed that the more yellow a crystalline lens is, the older it is. Our results show that between 40 and 67 years the chromatic coordinates are quite similar, especially under incandescent illumination. However, total transmission of light is more important for vision than the color of the lens and we have found that the age‐induced changes in these two parameters do not always coincide. All this shows that the different factors that influence yellowing of the crystalline lens do not act in the same way on everyone and that crystalline opacification does not depend solely on aging.
Ocular phototoxicity and altitude among mountaineer guides
Authors: EL CHEHAB H , BLEIN JP , HERRY JP , GIRAUD JM , LE CORRE A , CHAVE N , RACTMADOUX G , SWALDUZ B , MOURGUES G , DOT C
Published: December 2011

Purpose To evaluate ocular phototoxicity in mountaineer guide in Chamonix, France, exposed to altitude characterized by increased ultraviolet (UV) radiation.

Methods 96 guides working and 90 subjects living in plains, older than 50 years, replied to a questionnaire assessing altitude exposure and wearing protective eyewear. We performed slit lamp examination after pupil dilatation, retinal photography (Topcon) and crystalline lens density analysis (Oculyzer®, Alcon). Student t‐test was used to compare the groups and logistic regression to evaluate risks factors in guides group.

Results Guides mean age was 59.8years and 59.1 for control (p=0.39). Guides developed more chronic blepharitis (52.1% vs. 10.6%, p<0.01), pterygium (8.9% vs. 0%, p<0.01), pinguecula (58.3% vs. 21.7%, p<0.001). Their corneal break up time was shorter (4.5secs vs. 7secs, p<0.01). Guides presented more cortical cataract (p<0.01) and cataract surgery (p=0.01). Only 61.5% guides had normal ocular fundus vs. 81.1% in control group (p<0.01). They developed more drusenoid deposit (27.2% vs. 15.6%, p<0.01). Guides group analysis showed that exposure superior to 3000m is risk factor to develop anterior cortical cataract (OR=1.16, p<0.01). Exposition to snow increases risk of maculopathy (OR=1.9, p<0.01). Questionnaire reveals discontinuous eye protection in medium altitude. Wearing ski mask reduces cataract, age related maculopathy and chronic blepharitis risk.

Conclusion Ocular findings highlight the higher incidence of ocular surface pathology, anterior cortical lens opacities and drunenoid deposits. This data emphasize the potential deleterious role of UVs and importance to wear sunglasses even in low to medium altitude but also when climbing.
The ‐1562C/T MMP‐9 and the ‐511C/T IL‐1β gene polymorphisms in primary open‐angle glaucoma patients
Authors: MAJSTEREK I , MARKIEWICZ L , PRZYBYLOWSKA K , GACEK M , WASZCZYK M , UDZIELA M , SZAFLIK JP , SZAFLIK J
Published: December 2011

Purpose Matrix metalloproteases (MMPs) play a role in the remodeling of extracellular matrix components (ECM) and the development of primary open‐angle glaucoma (POAG). Interleukin 1 (IL‐1β) is considered as MMP’s transcription upregulating factor. The aim of this study was to evaluate an association of the ‐1562C/T MMP‐9 and the ‐511C/T IL‐1β gene polymorphisms with a risk of POAG in a Polish population.

Methods DNA samples obtained from 196 POAG patients (mean age 70 ± 14) and 256 control subjects (mean age 67 ± 16) were analyzed by restriction fragment length polymorphism of polymerase chain reaction (PCR‐RFLP).

Results The comparison of genotypes distributions showed that the ‐1562C/T genotype (OR 1.69, 95% CI 1.10 ‐ 2.58; P = 0.015) and the T allele (OR 1.57, 95% CI 1.10 ‐ 2.26; P = 0.014) of MMP‐9 exhibit a significant increase of the frequency in POAG patients as compared to healthy controls. A statistically significant increase of the frequency was also found for the ‐511T/T genotype (OR 2.35, 95% CI 1.23‐4.51; P = 0.009) and the T allele (OR 1.40, 95% CI 1.06‐1.85; P = 0.017) of IL‐1β in POAG patients. The analysis of gene‐gene interactions of MMP‐9 and IL‐1β showed a statistically significant increase of the frequency of the C/T‐C/T (OR 2.27, 95% CI 1.25‐4.10; P = 0.006) and the C/C‐T/T (OR 2.23, 95% CI 1.05‐4.71; P = 0.033) genotypes in POAG patients group.

Conclusion In conclusion, we suggest that MMP‐9 and IL‐1β gene polymorphisms may be associated with an increased risk of POAG in a Polish population. This work was supported by grants N N402 375838 and N N402 248936 from Polish Ministry of Science and Higher Education.
Multiple mtDNA deletions in Kearns‐Sayre syndrome associated with macular dystrophy
Authors: ASCASO FJ , LOPEZ‐GALLARDO E , DEL PRADO E , RUIZ‐PESINI E , DEL BUEY MA , CRISTOBAL JA , SOUSA R , MONTOYA J
Published: December 2011

Purpose Kearns‐Sayre syndrome (KSS) is a rare disorder resulting from a mitochondrial dysfunction. Classical triad includes chronic progressive external ophthalmoplegia (CPEO), tapetoretinal degeneration and complete heart block. A 48‐year‐old woman with a clinically and histopathologically confirmed KSS developed a maculopathy resembling an adult‐onset vitelliform macular dystrophy in her right eye.

Methods The patient underwent optical coherence tomography (OCT), fluorescein angiography (FA),electroretinogram (ERG), electrooculogram (EOG), visually evoked cortical potentials (VEP)and muscle enzymes determination. A sartorius muscle biopsy was performed. DNA was submitted to Southern blot analysis.

Results The foveal vitelliform lesion remained hypofluorescent because the accumulation of vitelliform material blocks fluorescence. OCT revealed a retinal pigment epithelium (RPE)detachment in the right macula. ERG, EOG and VEP were normal. Serum lactate value was 3.3 mg/dL (normal: 0.63‐2.44). Muscle enzymes were normal. Muscle biopsy demonstrated "ragged red fibres" on Gomori‐trichome staining. On electron microscopy abnormal aggregation of large and atypical mitochondria were observed. DNA analysis identified the presence of multiple deletions in the mtDNA of a muscle sample, with the common deletion of 4977 bp the most abundant.

Conclusion The retina, in particular RPE, is highly vulnerable to mtDNA defects and decreased oxidative phosphorylation. This is the first report associating KSS to multiple mtDNA deletions and there have been no previous reports of such macular lesion occurring in association with KSS.Ohthalmologists should be aware of the mitochondrial ocular myopathies.
Retinal dystrophy with macular hyperpigmentation in long chain 3‐hydroxy‐acyl‐coa dehydrogenase (lchad) deficiency
Authors: PEIRO C , PINILLA I , PEIRO B , JIMENEZ B , RAMIRO P , CASAS P , PEREZ‐GARCIA D , IBANEZ J , AVENTIN MP , CABEZON L
Published: December 2011

Purpose LCHAD deficiency is an autosomal recessive inheritance metabolic disorder associated with myopathy, cardiomyopathy, hypoglycaemia, neuropathy and retinal changes as retinitis pigmentosa. It is also related to sudden death. The purpose of this study is to present a case of LCHAD deficiency associated with retinal pigmentary changes.

Methods A 3 year‐olds children diagnosed of LCHAD deficiency was examined. Parents were consanguineous. He had several hospitalizations related to hypotonia and lethargia.

Results Fundoscopy examination showed a retinal dystrophy with macular hyperpigmentation and pigmented aggregations and hypopigmentation changes. Both parents and one brother were examined showing no changes in their retinal aspect.

Conclusion Retinal dystrophy in children can be related to metabolic disorders. LCHAD deficiency should always be discarded.
Frequency of anisocoria in patients with astenopia
Authors: BOYCHUK IM , KHRAMENKO NI , BUSHUYEVA NN
Published: December 2011

Purpose Anisocoria ‐ an unequal size of pupils. According to literary data, almost 10 % of the healthy population has a difference in diameter of pupils no more than 1 mm in photopic conditions of illumination and in 20 % of cases – in mezopic. Differential diagnostics of physiological and pathological anisocoria frequently causes certain difficulty and in this question the essential help is rendered by modern diagnostic methods of research, including computer pupillography which allow evaluating objectively pupil sizes and its changes on different stimuli.To reveal if anisocoria in patients with astenopia can be found and what kind of anisocoria it is.

Methods 91 patient at the age 7 ‐ 23 y.o. were observed. They had astenopia complaints; some of them had pupil unequal size, no somatic pathology. Pupillography was done by elaborated pupillography devise, blood circulation of the brain was defined by method of computer reoencephalography .

Results 13 % (12) of observed patients had anisocoria. During direct, consensual and accommodative reaction asymmetry of pupil’s square have increased on 45,5 %, 51% and 67 % accordingly. Volume of blood supplement in internal carotids had increased values in average on 65 % from age norms. Marked asymmetry was found between right and left a. carotid internal which reached 50 % at 9 patients, and at 3 to 70 % in the given pool.

Conclusion Anisocoria was revealed in 13% of patients with astenopia. Patients who had anisocoria, astenopia and accommodative dysfunction had functional disorders of brain blood circulation.
Clinical and Molecular Genetic Aspects of Optic Nerve Hypoplasia
Authors: TRABOULSI E
Published: December 2011

Optic Nerve Hypoplasia is one of the leading causes of childhood blindness in the USA, with estimated incidence of 1/10,000 live births. It is characterized by a subnormal number of optic nerve axons with preserved blood vessels and glial tissue support. It is congenital and non‐progressive. The speaker will present clinical data on More than 100 patients from a pediatric clinic and will review the associated neurological and systemic problems in these patients. A review of underlying molecular genetic, pathogenetic mechanisms and environmental factors will also be given. Optic nerve hypoplasia is an important cause of irreversible blindness. It is undoubtedly a heterogeneous group of conditions. Environmental causes play an important role in its etiology and associated conditions are numerous. Endocrinologic complications are treatable and neurological problems need to be identified and addressed. Studies are underway to identify genetic causes and to provide guidelines for prevention and management.
Abnormalities of optical coherence tomography and visual evoked potentials in patients with chiasmal compression syndrome
Authors: WASIK M , PILECKI W
Published: December 2011

Purpose To report abnormalities of retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) and visual evoked potentials (VEP) in patients with compressive chiasmal tumors confirmed on MRI examination.

Methods 22 eyes of 12 patients with parasellar tumors causing chiasmal compression syndrome were included to the study and compared to 59 eyes of 30 healthy patients. Exclusion criteria were any other ophthalmic or general condition that can affect both VEP and OCT measurements. All patients underwent MRI of the head to confirm the diagnosis, retinal nerve fiber thickness measurements with OCT and visual evoked potentials examination.

Results Average RNFL thickness in patients with chiasmal compression (OD=96,06 ± 14,2µm, OS=92,4 ± 10,2µm) was significantly lower (p=0.016 and p=0.005) than in normal eyes (OD=104,7 ± 10µm, OS=104,5 ± 15µm respectively). It was noticed also reduced RNFL thickness in nasal quadrants. Visual evoked potentials showed mean P100 latency prolongation in examined patients (OD=112 ± 8,7ms and OS=108,4 ± 7,4ms), which was statistically significant (p<0.001 and p=0.001 respectively) in comparison to control group (103,1± 4,5ms and 102,5 ± 4,2ms respectively).

Conclusion In patients with compressive chiasmal syndrome both RNFL thickness measurements with OCT and visual evoked potentials were significantly changed. These methods provide useful information in the diagnosis of chiasmal lesions.
Study of retinal nerve fiber layer in obstructive sleep apnea syndrome patients
Authors: FERRANDEZ ARENAS B , CALVO P , GIL‐ARRIBAS L , GÜERRI N , OTIN S , ALTEMIR I , GARCIA E , FERRERAS A
Published: December 2011

Purpose To evaluate the peripapillary retinal nerve fiber layer (RNFL) thickness obtained with spectral‐domain optical coherence tomography (OCT) in obstructive sleep apnea syndrome (OSA) patients, as a biological marker of neuronal damage.

Methods Sixty‐four OSA patients and one hundred twenty‐nine healthy controls were prospectively selected. Only one eye per subject was randomly chosen. AOS patients were classified in three groups according to apnea/hipopnea index: mild, moderate and severe. All participants had intraocular pressure less than 21 mmHg and performed at least a reliable standard automated perimetry (SAP). Peripapillary RNFL thicknesses were measured with Cirrus OCT (Carl Zeiss Meditec, Dublin, Ca). After checking for a normal distribution of variables, differences between both groups were tested by Student t test.

Results Age was 50.6 ± 9.3 years in control eyes and 47.8 ± 11.5 years in AOS patients (p = 0.09). Mean deviation of SAP was ‐0.50 ± 1.0 dB and ‐1.4± 2.3 dB, in control and AOS patients, respectively (p<0.001). Pattern standard deviation and Visual Field Index (VFI) of SAP were also different between both groups. The RNFL thickness at 7 o’clock position and the average RNFL thickness had lower thicknesses in AOS patients compared to healthy individuals

Conclusion OCT detected a mild reduction of RNFL thickness in AOS patients compared with healthy subjects. Visual field indices were also different between both groups.