bluuebunny/crossref_metadata_2025 huggingface dataset:
Fundus Angiography with Fluorescein-Labelled Peptide Fraction from Bovine Factor Viii: Correlation with Histologic Findings
Authors: Piccolino F. Cardillo , Ghiglione D. , Ceppa P. , Villaggio B. , Carli F. , Allegri P. , Bertagno R. , Zingirian M.
Published: April 2018

A peptide fraction (VUEFFE) obtained from bovine factor VIII, with a high affinity for vessel endothelium, was bound to fluorescein and used for angiography in rabbits. Several eyes had undergone laser photocoagulation on the retina. The location of the dye was studied histologically with fluorescence microscopy on the enucleated, freeze-dried eyes. The angiographic and histologic findings were compared with findings obtained using sodium fluorescein. Fluorescein-labelled VUEFFE gave a longer lasting fluorescence of the retinal vessels with histologic evidence of dye deposition on the vessel wall. It also showed marked affinity for the photocoagulated tissues, giving intense and prolonged staining of the laser burns. Possible clinical applications are discussed.
Imipenem Reaches Therapeutic Concentrations in Aqueous Humor, as Determined by Hplc
Authors: Bologna M. , Blasi M.A. , Carlucci G. , Biordi L. , Biordi N. , Balestrazzi E.
Published: April 2018

The majority of ocular infections in the industrialized countries arise after surgical interventions. An appropriate antibacterial prophylaxis is therefore highly desirable in eye surgery. We used high performance liquid chromatography (HPLC) to measure the concentrations reached by imipenem, a modern wide-spectrum beta-lactam antibiotic, in plasma and aqueous humor of 26 patients scheduled for cataract surgery. Even a single 500 mg dose of imipenem achieved therapeutic levels of the molecule for the most common ophthalmic pathogens (1μg/ml or above) in the aqueous humor within one to two hours after administration. This drug may therefore be suitable for antibacterial prophylaxis in eye surgery.
Long-Term Follow-Up of Iodine-125 Brachytherapy for Choroidal Melanomas. Part I: Anatomical Results and Life Expectancy
Authors: Kreissig I. , Rose D. , Jost B.
Published: April 2018

We report a prospective study of 19 choroidal melanomas treated with iodine-125 plaque from 1984 to 1989. The mean tumor height was 5.8 mm, base diameter 11.6 mm, and tumor volume 80 to 510 mm3. The mean radiation dose to tumor apex was 70 Gy and scleral contact dose 355 Gy; tumor base was surrounded by contiguous laser or cryopexy lesions. Follow-up was 27 to 84 months (mean 60 months). All tumors regressed at least 50% in volume with no tumor regrowth within 27 months to 60 months. Late tumor regrowth, localized in the center, occurred in one eye after 65 and another after 69 months. One tumor was successfully replaqued; the other was not re-treated because the patient had had a recent heart attack. In 17 eyes radiation retinopathy developed after 1½ years, the earliest in a diabetic eye. Despite primary recovery of preoperative vision, there was severe deterioration of visual acuity after 4½ years in all the eyes. During follow-up, two patients died due to metastases after 28 and 71 months; one patient is alive with metastases after 17 months. None of the eyes had to be enucleated. There was no incidence of madaurosis, Symblepharon, or dry eye.
Trachoma: Possibilities of Prevention. A Study in the Sultanate of Oman
Authors: Graz B.
Published: April 2018

Using a questionnaire and direct observation, this survey aimed at providing basic information on how to design an effective trachoma prevention campaign. Among the population of rural Oman, the causal relations between Chlamydia conjunctivitis and the later complications, trichiasis, corneal ulcer and eventually blindness, are still widely unknown, so that prevention of contagion seems irrelevant in public opinion. A booklet on the prevention of blindness was very poorly understood, because the population is highly illiterate, and because even the pictures used were not appropriate. Such concepts as contagion and the importance of flies in the spread of diseases appeared to be common in the population surveyed. These ideas could provide a starting point in a picture- and television-based campaign. The results are consistent with theory that the success of a trachoma prevention campaign depends on a thorough knowledge of local sociocultural particularities.
Malignant Melanoma of the Iris a 25-Year Analysis of Danish Cases
Authors: Jensen O.A.
Published: April 2018

This study examined malignant melanoma of the iris in Denmark over a 25-year period on the basis of the files of the Eye Pathology Institute. From 1961 to 1985 a total of 80 cases were found (41 males, 39 females; median age 53 years, range 8 - 83). This means an average of 3.2 cases/year with an average population of 4.9 million. In contrast to malignant melanoma of the choroid, an increase was observed. The reason is not known, although exposure to actinic rays may be a factor. More than a third of cases were close to the pupil, a little less than a third invaded the chamber angle/ciliary body. Ten cases were ring melanomas. Half of the tumours were spindle-celled, a quarter mixed and a few epithelioid or naevoid in cell morphology. Iridectomy was performed in 28 cases, primary enucleation in 27 and secondary enucleation in ten. Iridocyclectomy was performed in 15 cases. All patients could be traced. At the date of follow-up (Dec. 1, 1991) eight had died with metastases; four of these were patients with ring melanoma and four with tumours invading the ciliary body. After iridocyclectomy, only one metastatic death was recorded –- a case of incomplete resection. The grave prognosis of a ring melanoma is highlighted.
Fixation and Central Visual Field after Perifoveal Krypton Laser Treatment of Subfoveal Neovascularizations
Authors: Schneider U. , Kuck H. , Kreissig I.
Published: April 2018

In contrast to focal laser treatment of large subfoveal neovascular membranes, perifoveal laser treatment sparing the central avascular zone can partially retain central macular function in some cases. The anatomical and functional outcome of this technique was analysed in 26 patients with large subfoveal neovascular membranes (0.6 to 3.0 disc diameter) secondary to age-related macular degeneration (24 cases) or presumed ocular histoplasmosis syndrome (two cases). Patients were followed for six to 39 months. Out of 26 patients 21 had a stable dry scar at the last follow-up examination. Central fixation was retained postoperatively in nine out of 13 patients with central fixation prior to laser treatment. Visual acuity was maintained or improved in 19 out of 26 treated eyes. Statpack analysis (Humphrey Field Analyser) of the long-term results of patients with central fixation indicated an increase in the depth of their relative central scotoma not only immediately after laser treatment but also in the first and second postoperative years. This increasing depth of central scotoma subsequently led to a shift of central fixation to a paracentral area in four out of nine patients six to nine months after treatment. Indocyanine-green angiography showed remaining subfoveal choroidal vasculature corresponding to the area of central fixation, as found in fundus microperimetry by scanning laser ophthalmoscope. Perifoveal laser treatment seems to be effective in maintaining some initial macular function for a limited time in selected patients suffering from subfoveal neovascular membranes.
Change of Retinal Correspondence in Monocularly Reduced Intensity of Stimulus
Authors: Deguchi M. , Yokoyama T. , Matsuzaka Y. , Kawanami K. , Hosoi S. , Miki T.
Published: April 2018

We analyzed the retinal correspondence with a phase difference haploscope on reducing the stimulus intensity of a monocular image with a series of neutral density filters. Ninety-one exotropes were examined by this method. Five cases changed from normal to anomalous correspondence when the stimulation of the strabismic eye was reduced. Two cases showed anomalous correspondence without a filter, but normal correspondence with a reduced stimulus of the normal eye. All these seven cases showed normal correspondence with any other test. The results suggest that masked anomalous correspondence becomes manifest in some cases when the strabismic eye is stimulated more intensely than the normal eye. These cases display both normal and anomalous correspondence and this condition may be called dual correspondence.
Lachrymal Concentration of Norfloxacin after a Single Ocular Instillation in Humans
Authors: Drago F. , De Bernardis E.
Published: April 2018

Lachrymal concentrations of the fluoroquinolone norfloxacin were studied in 30 subjects (aged 24-35 years) after a single ocular instillation (0.3% solution, 50 ul) in comparison with ofloxacin instilled at the same dose. Lachrymal levels were measured by high performance liquid chromatography (HPLC). Lachrymal peak levels were comparable 5 min after instillation but norfloxacin appeared to have a longer elimination half-life than ofloxacin. The AUC (area under the curve) for norfloxacin was therefore higher than for ofloxacin (35.9 and 10.7 mg* min/ml, respectively). These data suggest that norfloxacin may have higher corneal retention than ofloxacin, so this antibiotic may be indicated in superficial infections dependent on fluoroquinolone-sensitive bacteria.
Esthesioneuroblastoma: An Atypical Form of Manifestation
Authors: San Leandro L. Vallés , Martínez-Salas I. Arcas , Pérez M.P. Villegas , González J. García , Ramírez A.M. Gómez , Manuel M. Redondo , Ortega A.R. Gutiérrez , Lloret J.B. López , De Imperial J. Miralles
Published: April 2018

Esthesioneuroblastoma is a rare tumor that originates in the olfactory epithelium and can invade the orbit. We report a case in which the first symptom was a post-traumatic paralysis of the IV cranial nerve. Whether the tumor itself or the trauma or a combination of the two factors caused the paralysis is discussed.
Myopia and Stature: Findings in a Population of 106,926 Males
Authors: Rosner M. , Laor A. , Belkin M.
Published: April 2018

We conducted a nation-wide study of the relationship of myopia with height, weight and body-mass index in order to confirm observations that myopic persons are taller than non-myopes. From a review of the data of 106,926, consecutive male military recruits aged 17 to 19 years, we found that myopia is associated neither with higher stature nor with greater weight. Persons with severe myopia were slightly shorter (172.8± 7.1 cm) and weighed less (62.6± 11.0 kg) than those with mild myopia (173.3± 6.9 cm and 63.8± 10.5 kg respectively), while the non-myopes were taller (173.7± 6.7 cm) and heavier (63.9± 10.2 kg) than the myopes (p=0.0001). The mean body-mass index was only slightly smaller among the myopes (21.1± 3.1 kg/m2) than among the non-myopes (21.2± 2.9 kg/m2, p=0.0001).
Pathogenesis of Primary Internal Ophthalmoplegia after Head Injury
Authors: Mariak Z. , Mariak Z. , Lewko J. , Zimnoch L.
Published: April 2018

Primary internal ophthalmoplegia is a rare ocular syndrome after head injury. Its pathogenesis remains unclear and it is only a hypothesis that the pupillomotor fibres on the ventromedial aspect of the oculomotor nerve are slightly contused against the petroclinoid ligament at the moment of impact.

We observed a patient after head injury who presented with a fixed, dilated pupil and died within 15 hours of the accident. The postmortem examination revealed an isolated group of fibres on the medial aspect of her oculomotor nerve, which had been torn out of the midbrain. This suggests an alternative explanation in terms of partial injury to the oculomotor nerve to account for primary internal ophthalmoplegia.
Relapsing Bilateral Uveitis and Papilledema in Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease)
Authors: Pivetti-Pezzi P. , Torce C. , Colabelli-Gisoldi R.A.M. , Vitale A. , Baccari A. , Pacchiarotti A.
Published: April 2018

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) is a non-hereditary histiocytic proliferative disorder affecting young people, with extranodal manifestations in 28-43% of cases. Eye involvement is infrequent. Lymphoproliferation in the soft tissues of the orbit and in the lids has been reported in 12% of cases but intraocular involvement is rare. We describe the case of a 12-year-old boy affected by Rosai-Dorfman disease with bilateral relapsing uveitis and papilledema that appeared four years before the onset of lymphadenopathy.
The Behavior of Two Cell Lines Obtained from Murine (B16-F10) and Human (G-361) Melanomas Implanted into the Eyes of New Zealand White Rabbits, and their Microscopic, Immunohistochemical and Ultrastructural Appearances
Authors: Gonzalez J. Garcia , Redondo M. , Ortega V. Vicente , Vicente J. Rodriguez
Published: April 2018

A transcleral inoculation of 15×106 melanocytes of the B16-F10 and G-361 cell lines was carried out in the anterior chamber of one eye in New Zealand white rabbits. Tumor growth occurred in 24 eyes (77%) of the B16-F10 group and in 22 (73%) of the G-361 group. The tumors of the latter group were mostly amelanic and showed local aggression with ocular perforation and extrascleral growth one month post-implant, while the tumors of the B16-F10 group were intensely pigmented and grew over the iris although they did not perforate the eyeball. Microscopically, the tumors of both groups were of the mixed type, made up of epithelioid and fusiform melanocytes. S-100 protein and Nki C3 monoclonal immunohistochemical techniques showed a positive immunoreaction in all cases of tumor growth. Ultrastructurally, the G-361 melanocytes showed a few melanosomes corresponding to maturity state II and, occasionally, state III, while totally melanized state IV cells predominated in the B16-F10 group. Aberrant melanosomes were common in both groups. The inoculation of 15×106 melanocytes of either cell line was useful to produce ocular melanomas.
Acoustic Transients following Excimer Laser Ablation of the Cornea
Authors: Gobbi P.G. , Carones F. , Brancato R. , Pini R. , Siano S.
Published: April 2018

Pressure transients occurring inside the eyeball as a consequence of excimer laser ablation of the cornea were measured at various distances along the optical axis, on enucleated porcine eyes. Positive (compressive) pressure spikes up to 90 bars were observed, lasting 100 ns, and developing, as they propagated in the eyeball, satellite rarefaction pulses with negative pressure as high as −40 bar. Such rarefaction wavefronts can trigger the formation of cavitation bubbles, in both the anterior and posterior chamber, depending on the ablation geometry. The potential risks associated with these photoacoustic phenomena, particularly for retina and corneal endothelium, are outlined.
Epidemiology of Glaucoma in Northern Europe
Authors: Ringvold A.
Published: April 2018

Purpose

To survey glaucoma epidemiology in Northern Europe.

Results of literature review

Open-angle glaucoma is defined here as the simple and capsular types taken together. On this basis open-angle glaucoma makes up by far the largest group of glaucoma in Northern Europe. These are the target groups of this study, and pigmentary glaucoma is excluded because of the small numbers.

Conclusion

Open-angle glaucoma is less frequent in Southern Sweden and Denmark than in Finland, Middle Sweden, Norway, and Iceland. This may to some extent be explained by the suggested low prevalence of pseudoexfoliation in the southern areas, but other factors are presumed to be of importance as well.
Alteration of Visual Function in Impaired Glucose Tolerance
Authors: Karadeniz S. , Kir N. , Yilmaz M.T. , Öngör E. , Dinççag N. , Başar D. , Akarçay K. , Satman I. , Devrim A.S.
Published: April 2018

People with impaired glucose tolerance are considered to be prone to diabetes. To evaluate their visual function we investigated colour vision with the Farnsworth-Munsell 100 Hue test and contrast sensitivity with Arden's grating cards in people with impaired glucose tolerance (IGT), people with normal glucose tolerance (NGT) and others with type II diabetes (NIDDM). Eyes with low vision or any anterior or posterior segment abnormalities were excluded. Contrast sensitivity and color vision differed significantly between the groups (p<0.01). It thus appears that patients with IGT but without clinical diabetes could be followed up to see whether these alterations have any predictive value for the development of diabetes and diabetic retinopathy.
Review of Experience with Retinopathy of Prematurity from the Pavia Registry (1990-1993)
Authors: Bianchi P.E. , Salati R. , Guagliano R. , Traselli G.P. , Rondini G. , Trimarchi F.
Published: April 2018

In this retrospective study we analysed the prevalence of retino-pathy of prematurity (ROP) and its sequelae in a sample of premature infants with birth weight less than 1500 grams.

From 1 January 1990 to 31 October 1993, we studied 160 surviving premature infants with very low birth weight (< 1.500 g) referred to the Neonatal Intensive Care Unit of the I.R.C.C.S. Policlinico San Matteo, Pavia, Italy. Thirty percent of these infants suffered from ROP, and 13.7%, with severe ROP, underwent cryotherapy. These latter had very-very low birth weight (<1.000 g) and low gestational age (<28 weeks).

Follow-up of 69 infants at 12 months for retinal sequelae, refraction defects, bin-ocular vision and ocular motility impairments gave the following results: 1) strabismus 20.3%; 2) >3D hyperopia 3%; 3) myopia 30.4%; 4) >5D myopia 3.7%. The incidence of refraction and ocular motility anomalies in patients with acute ROP with spontaneous remission was similar to that of unaffected premature infants. Conversely, in the patients treated with cryotherapy the incidence of strabismus and >5D myopia was greater than for untreated infants: 30% vs 15.4% (n.s.) and 14.7% vs 0% (p=0.05), respectively. Cryotherapy was successful in 91.9% of cases and in 37.8% of cases the cicatricial sequelae were limited to peripheral chorioretinal scars.
Instillation of Mitomycin C after Recurrent Pterygium Surgery
Authors: Kraut A. , Drnovšek-Olup B.
Published: April 2018

Purpose

The aim of the study was to evaluate the safety and effectiveness of postoperative instillation of Mitomycin C eye drops in patients with recurrent pterygium.

Methods

Between October 1993 and November 1994, we operated 12 patients with recurrent pterygium using the conjunctival autografting technique, and after the operation patients instilled 0.02% or 0.04% Mitomycin C eye drops two or four times a day for one or two weeks.

Results

Early complications were 2 wound dehiscences, 7 corneal epithelial defects, 5 reported eye discomforts and 2 glaucoma. Late, there were 2 recurrences of pterygium after 6 and 9 months, one simplex glaucoma, one cataract and one alopecia areata.

Conclusions

In cases of aggressive or severe pterygia, postoperative use of Mitomycin C eye-drops appears to be safe, effective and acceptable, but good surgical technique, careful observation and a long follow-up is indispensable for these patients.
Pattern of Anesthetic Diffusion during Peribulbar Infiltration: A Ct Evaluation
Authors: Neuschuler R. , Simonetti C. , Gasparri V. , Cantera E. , Ferone E. , Floris R. , Orlacchio A. , Guinetti C.
Published: April 2018

Purpose

The aim of this study was to evaluate the changes undergone by orbital structures during peribulbar anesthesia.

Methods

CT-thin slices were acquired and 8-9 ml of anesthetic, with a small part of low-density non-ionic water-soluble contrast medium were injected under CT guide once to follow extraconal spreading and diffusion to intraconal structures and above all, the surgically important structures such as recti muscles, orbicular and optic nerve sheath. Conjunctival sack involvement was assessed and conjunctival chemosis was rated. Induced ptosis was evaluated, verifying change before and after eyepressure.

Results

The results help in optimizing anesthetic technique, above all concerning the site, materials and quantity, and suggest the amount of anesthesia could be reduced.

Conclusions

The peribulbar anesthetic technique proved effective and safe for patients.
Prevention and Management of Posterior Capsule Rupture
Authors: Traianidis P. , Sakkias G. , Avramides S.
Published: April 2018

Purpose.

To present the means and technique used in our Department for prevention and management of posterior capsule rupture during planned extracapsular cataract extraction.

Methods.

Prospective analysis of 550 extracapsular cataract operations from October 1993 to March 1994. Our technique (a slight modification of Blumenthal's technique) included a triplanar watertight small scleral incision, a relatively large continuous curvilinear capsulorhexis, or can-opener capsulotomy, nucleus hydrodissection and hydroexpression, use of an anterior chamber maintainer and residual cortex removal through a 10 o'clock side-port corneal incision.

Results.

Best corrected postoperative visual acuity ranged from 7-10/10 in 93.45% of our cases. Posterior capsule rupture with or without vitreous loss occurred in 1.63% and 2.72% of the cases, respectively. These rates are much lower than those, observed, when we used the sclerocorneal incision and nucleus extraction with external pressure. Conclusions. The combination of a triplanar watertight small scleral incision, a relatively large continuous curvilinear capsulorhexis, an anterior chamber maintainer and residual cortex aspiration through the 10 o'clock side-port corneal incision greatly reduced the posterior capsule rupture rate.
Comparative Study of Astigmatism through Superior and Lateral Small Incisions
Authors: Mendívil A.
Published: April 2018

Purpose.

To prospectively compare the clinical results of two cataract surgery procedures through a 4.0-mm incision, differing only in the wound location (superior or lateral).

Methods.

168 eyes with cataract were randomly assigned to either procedure. Except for incision location, surgical methods were identical. Uncorrected visual acuity, keratometry and postoperative astigmatism were analyzed up to six months after surgery.

Results.

Both groups had similar uncorrected visual acuity. Eyes in the superior incision group had significantly larger “against-the-rule” changes than those in the lateral incision group, and differences were significant at all measurement points from one week through six months after surgery. Patients with preoperative “with-the rule” astigmatism had smaller postoperative astigmatism after a superior incision and those with preoperative “against-the rule” astigmatism had less postoperative cylinder after a lateral incision. Differences between these groups were significant.

Conclusions.

Both procedures gave satisfactory clinical results. Postoperative astigmatism could depend on the preoperative astigmatism and the wound location.
Treatment with Bifemelane for Optic Nerve Damage following High Intraocular Pressure in Rat Eyes
Authors: Adachi M. , Takahashi K. , Yuge K. , Nishikawa M. , Miki H. , Uyama M.
Published: April 2018

This study found that pretreatment with 4-(o-benzylphenoxy)-N-methylbuty-lamine hydrochloride (bifemelane hydrochloride, Celeport®) reduced ischemia-reperfusion injury in rat eyes. Bifemelane (25 mg/kg) was injected intraperitoneally 30 minutes before an ischemic insult, then acute ischemia of the retina and optic disc was induced by increasing intraocular pressure to 110 mmHg for 45 minutes. After one week, the axonal count of the optic nerve was investigated using electron microscopy. The control group consisted of vehicle-treated eyes which received normal saline. The axon count was 93.4 ± 7.9 for the bifemelane treated group, and 79.2 ± 6.4 for the controls. The axon count in the treated group was significantly higher. These results suggest that bifemelane, which prevents cerebral nerve cell damage from ischemia, can reduce ischemic retinal nerve cell injury.
Esotropia and Pseudoexotropia in Acute Rop Sequelae: Clinical Features and Suggestions for Treatment
Authors: Bianchi P.E. , Guagliano R. , Salati R. , Traselli G.P. , Trimarchi F.
Published: April 2018

We report five cases with a mixture of esotropia and pseudoexotropia due to macular ectopia related to cicatricial retinopathy of prematurity (ROP). On inspection, the patients, aged from 9 to 28 years, presented a divergence of the eyes and a nasally decentralised corneal light reflex. The cover test showed esodeviation. All the cases presented some clinical features common to congenital strabismus. Fundus examination showed temporal traction of vascular and retinal tissues and macular ectopia, referrable to cicatricial sequelae of spontaneously regressed severe ROP. Treatment is limited to follow-up, with attention being paid to the control of retinal damage rather than to resolving the esthetic defects. Despite cryotherapy, these conditions are increasing with the increase in severe ROP and are now relatively frequent. We suggest that they be carefully identified in order to avoid incorrect orthoptic or surgical treatment.
A New Angiotensin-Ll- Receptor Blocker, Cgp 48933: Local Tolerance and Effect on Intraocular Pressure. A Pilot Study
Authors: Kaiser H.J. , Graf T. , Krejci G. , Mathis G.A. , Jauch A. , Flammer J.
Published: April 2018

CGP 48933, a new angiotensin-ll- receptor antagonist, has been shown to lower intraocular pressure (IOP) in two different rabbit glaucoma models in a dose-dependent manner after local application. As a further step a pilot study was performed in human eyes. The trial consisted of three parts. Parts 1 and 2 comprised a double-masked intraindividual trial between CGP 48933 and its vehicle (saline) in five healthy volunteers (Part 1) and five patients with early stages of primary open-angle glaucoma (Part 2), to assess local tolerance and the effect on IOP. Part 3 was a single-masked intraindividual trial between CGP 48933 and saline, to find the effective dose range of the new compound. Local tolerance was assessed as excellent in all subjects. No conjunctival hyperemia burning or itching occurred. There were no significant changes in IOP from baseline in drug or vehicle-treated eyes. In addition, there was no dose-dependent (200 μg to 1 mg) effect of CGP 48933 on IOP. Systemic blood pressure, heart rate and pupil size did not change during the observation period. Topical application of CGP 48933 in its present formulation is thus not suitable for lowering IOP in humans.
Low-Dosage Mitomycin C as an Adjunct to Trabeculectomy. A Prospective Controlled Study
Authors: Martini E. , Laffi G.L. , Sprovieri C. , Scorolli L.
Published: April 2018

Purpose.

To assess the advantages and adverse effects of intraoperative low-dose Mitomycin C in filtering glaucoma surgery.

Methods.

Sixty eyes of 48 patients undergoing surgery for uncontrolled glaucoma were randomized to two groups: one underwent standard trabeculectomy, the other had trabeculectomy with intraoperative application of 0.1 mg/ml mitomycin C. Follow-up was at least one year.

Results.

The success rate (IOP<18 mmHg) was 96.6% in the mitomycin C group and 73.3% in the control group. Mean IOP at one year of successful cases was 11.1 ± 3.1 mmHg in the mitomycin C group and 16.4 ± 6.1 mmHg in controls (p<0.0001). Two patients in the mitomycin C group (6.6%) and six (20%) in the control group needed antiglaucomatous drugs to keep IOP below 18 mmHg.

Conclusions.

Mitomycin C is a useful adjunct to glaucoma surgery. Adverse effects at the dosage used are mainly due to hypotony and are preventable with two-layer suture. Low-dose mitomycin C may be useful in standard primary trabeculectomy.
Experimental Vitreous Replacement with Perfluorophenanthrene
Authors: Ratiglia R. , Berti E. , Galimberti D. , Bindella A. , Schweizer F. , Marchi L. , Rossi A.
Published: April 2018

Purpose.

We studied the toxicity of perfluorophenanthrene (PFP), used as short-, medium-, or long-term internal tamponading substance, on the rabbit choroid and retina. The aim was the check whether PFP is tolerated as a tamponade in the eye or damages the retina, and if any such damage is due to toxicity or to emulsification which may stimulate phagocytosis.

Methods.

Twenty-four right eyes of rabbits operated by vitrectomy were filled with 0.8–1 ml of PFP as retinal tamponading substance. Twelve eyes were operated by vitrectomy and filled with 0.8–1 ml of balanced salt solution as the control group. Direct and indirect ophthalmoscopy was done on the third and seventh day after surgery, then once a week. Enucleation, with histological and immunohistochemical examination, was done on the second day, then in the first, second, fourth and eighth weeks after surgery.

Results and Conclusions.

Histological examination showed progressive damage of the chorioretinal tissues right from the second week: the chorioretinal structure was completely altered from the eighth week. Immunohistochemical examinations showed that glia cells were involved in the inflammation consequent to internal tamponade with PFP.
Regression and wound Healing after Excimer Laser Prk: A Histopathological Study on Human Corneas
Authors: Lohmann C.P. , Patmore A. , O'Brart D. , Reischl U. , Von Mohrenfels C. Winkler , Marshall J.
Published: April 2018

Background.

The results of excimer laser PRK are promising as more than 80% of eyes with up to −6.0 diopters of attempted correction have refractive results within 1.0 diopter of emmetropia. However, throughout the dioptric range some unexpected results have been observed with individual patients showing an aggressive wound healing response with excessive myopic regression and severe corneal haze. Unfortunately, only limited data are available about the cellular and extracellular responses in human corneas after PRK and this information is important to establish adequate postoperative pharmaceutical treatment.

Methods.

We made a histopathological and immunohistochemical study on 20 human corneal samples from patients with severe corneal haze and myopic regression. The indirect immunofluorescence method was used for demonstration of collagen types I, III, IV laminin, chondroitin sulphate, dermatan sulphate, and keratin.

Results.

All corneal specimens showed a hyperplastic epithelium. Histologically, most samples (16/20) showed mainly a loose lamination of extracellular material which could be identified as collagen type IV. The remaining four samples had newly synthesised collagen type III.

Conclusions

Our histopathological results indicate that corneal wound healing after excimer laser PRK varies among individuals. In some people epithelial basement proteins, such as collagen type IV, are the main wound healing products, whereas in others mainly collagen type III is found postoperatively, which does not effect the synthesis of collagen type IV. This suggests the need for individually-tailored postoperative pharmaceutical treatment regimens.
Diabetic Retinopathy and Cerebral Hemodynamic Impairment in Type II Diabetes
Authors: Lippera S. , Gregorio F. , Ceravolo M.G. , Lagalla G. , Provinciali L.
Published: April 2018

Purpose.

To assess whether a screening method based on transcranial Doppler (TCD) examination could detect signs of brain hemodynamic impairment in non-insulin-dependent diabetic patients with retinal microangiopathy of varying severity, asymptomatic for cerebrovascular diseases.

Methods.

We studied 86 patients stratified according to the presence of proliferative diabetic retinopathy (PDR: 29 cases), background retinopathy (BDR: 32 cases) and no diabetic retinopathy (NDR: 25 patients). TCD was performed to record mean flow velocity and pulsatility index values in the middle cerebral (MCA), anterior cerebral (ACA) and ophthalmic arteries (OA), at rest. It was also employed to evaluate the cerebral vasodilatory response to a breath-holding test: the maximum percentage MCA flow velocity increase during the test was taken as an index of cerebrovascular reactivity. Fifty healthy subjects were studied to establish control values. Analysis of variance was used to test inter-group differences. The regression test was applied to define the relationship between TCD parameters and age and disease duration.

Results.

No significant differences were found between controls and the whole group of patients with respect to TCD parameters. However, subgroup analysis showed PDR patient had a significantly higher pulsatility index and lower cerebrovascular reactivity than BDR and NDR patients. This difference was not explained by the effect of age or disease duration, being greatest in patients under sixty.

Conclusions.

These findings seem to confirm the hypothesis of a silent cerebral microangiopathy affecting diabetic patients, with concomitant signs of microangiopathic damage in other districts.
Hyperopia Correction Using an Erodible Mask Excimer Laser Delivery System Coupled to an Axicon: Preliminary Results
Authors: Brancato R. , Carones F. , Morico A. , Venturi E. , Vigo L. , Spinelli A. , Gobbi P.G.
Published: April 2018

Purpose.

This paper presents the results of the first human trial on the correction of hyperopia using an erodible mask excimer laser delivery system coupled to an axicon.

Methods.

We treated 17 eyes of 17 patients (age range 34–62 years) for the correction of +3.21 ± 1.04 D (range +1.00 to +4.00 D). The hyperopic correction was made using an erodible mask inserted on the laser optical pathway, to produce a circular ablation measuring 6.5 mm in diameter. An axicon was then used to create a blend transition zone from 6.5 mm up to 9.4 mm in diameter. Eyes were evaluated at one, three and six months after surgery.

Results.

Reepithelization was always observed by the fifth postoperative day, despite the large area of deepithelization (diameter 9.5 mm). Mean refractive error one month after treatment was −2.44 ± 1.59 D (range 0.00 to −6.50 D). Five eyes (29.4%) had a best corrected visual acuity loss more than two to three lines; all eyes showed mild annular haze not involving the central part of the cornea. Six months after treatment, mean refractive error was −0.88 ± 0.99 D (range +0.50 to −3.00 D). Compared to preoperative status, 13 eyes (76.5%) showed an improvement in uncorrected distance visual acuity (1–8 lines), and 14 eyes (82.4%) showed an improvement in uncorrected vision at reading distance (3–7 lines). Two eyes (11.7%) showed a best corrected visual acuity loss of two of three lines.

Conclusions.

These preliminary results indicate this approach is effective in reducing hyperopia, while its predictability has still to be proved in a larger treatment group with longer follow-up. A cautious approach to this technique is still advisable, especially for higher hyperopic corrections, in view of the large best corrected visual acuity loss seen in two eyes at six months.
Influence of Optic and Haptic Materials on the Adherence of Staphylococcus Epidermidis to Intraocular Lenses: A Pilot Study
Authors: Prosdocimo G. , Grandesso S. , Amici G.
Published: April 2018

To evaluate in vitro the adherence of Staphylococcus epidermidis to intraocular lenses (IOL) of different optic and haptic materials and design, we used a quantitative cultural method. Polymethylmethacrylate (PMMA), PMMA-prolene, polyHEMA, silicone and surface-modified PMMA (wet and dry) implants were tested.

Adherence differed significantly in the various groups, with the best performance by all-PMMA IOL.
Risk Factors in Ocular Hypertension
Authors: Georgopoulos G. , Andreanos D. , Liokis N. , Papakonstantinou D. , Vergados J. , Theodossiadis G.
Published: April 2018

The aim of the study was to determine whether certain factors are related to an increased risk of developing open-angle glaucoma. A total of 345 untreated glaucoma suspects with intraocular pressure (IOP) ≥ 21 mmHg, cup to disc ratio 0.4 or less and no visual field defects, were followed up for 6 to 8 years (mean 7.3). During the follow-up 71 patients developed established glaucoma and were compared to the remaining 274 patients. The following factors were analysed: age, family history of glaucoma, IOP, Humphrey 30-2 visual fields, optic disc appearance, myopia, exfoliation, arterial hypertension and diabetes. Analysis yielded statistically significant results regarding a number of these factors in the patients who subsequently developed open-angle glaucoma. A significant association with the subsequent development of field loss in ocular hypertension (OHT) included: heredity (p < 0.001), age ≥ 60 years (p = 0.013), axial myopia (0.001 < p < 0.01) and arterial hypertension (p = 0.05). About 20% of patients with ocular hypertension developed glaucoma over a period of seven years. Risk factors such as heredity, age, myopia and arterial hypertension, among others, must be considered in the follow-up of glaucoma suspects.
Optic Disc Measurements with the 78 Diopter Lens, Zeiss 4-Mirror Contact Lens and Computerized Image Analysing System
Authors: Akman A. , Oram O. , Aydin P.
Published: April 2018

We evaluated the 78 diopter (D) lens and Zeiss 4-mirror lens for the measurement of vertical and horizontal optic disc diameters during slit-lamp biomicroscopy and compared the results with the measurements made with the computerized image analysing system (IMAGEnet 640, Topcon, Japan) in 30 eyes of 30 patients. The 78D lens and Zeiss 4-mirror lens measurements both correlated well with the computerized image analysis measurements (r=0.881 for vertical and r=0.895 for horizontal disc diameter measurements with the 78D lens and r=0.883 for vertical and r=0.891 for horizontal disc diameter measurements with the Zeiss 4-mirror lens). The 78D lens measurements overestimated vertical disc diameter by 5.3% and horizontal disc diameter by 4.4%. The Zeiss 4-mirror lens underestimated the vertical disc diameter by 2.4% and horizontal disc diameter by 2.2%. Thus either lens can be used for a quick estimation of the optic disc size, since the results correlate well with the computerized image analysis measurements.
Air Bag-Associated Retinal Tear
Authors: Ruiz-Moreno J.M.
Published: April 2018

We report a case of a patient seen after a minor traffic accident, showing an ocular injury due to the air-bag, with minimal corneal edema and a retinal tear. When faced with the traumatic alterations caused by an inflated air-bag, we recommended detailed exploration of the peripheral retina.
Building the house of evaluation: Reconsidering the blueprints and bricks for knowledge accumulation in evaluation
Authors: Lemire Sebastian , Christie Christina A.
Published: April 2018

The push for evidence-based practice is persistent in the public sector—what counts is what works. One central premise for evidence-based practice is the existence of an evidence base; that is, an accumulated and generalizable body of knowledge. Informed by a recent systematic review, we examine the promises and pitfalls of meta-analysis (the statistical workhorse of systematic reviews) as the primary blueprint for cumulative knowledge building in evaluation. This analysis suggests that the statistical assumptions underlying the meta-analytic framework raise issues that, at least in regards to producing generalizable knowledge, may cut even deeper than is suggested by common criticisms. Advancing beyond meta-analysis, we consider alternative approaches for knowledge building and reflect on the implications of these for individual evaluations.
Evaluating business support measures: The Bayesian Network approach
Authors: Giffoni Francesco , Salini Silvia , Sirtori Emanuela
Published: April 2018

Traditional methods to the evaluation of business support consider the firm as a ‘black box’ and the main interest is to see to what extent a policy has produced the intended effects. The causal mechanisms that explain how certain effects are generated are not discovered. In this article we show the applicability of Bayesian Network Analysis in combination with theory-based evaluation as a new mixed-method approach to reveal the mechanisms, both expected and unknown, which explain the changes in a firm’s behaviour and economic performance due to public support. By combining graphical map analysis with statistical analysis, Bayesian Network Analysis reveals the interdependences between different drivers of change in firms so as to either confirm, deny or better qualify the theory of change of the policy.
On the social construction of democracy: Modal rhetoric in former East & West German journalists’ post-reunification editorials
Authors: Roberts Carl W , Zuell Cornelia , Popping Roel
Published: April 2018

We report differences in political rhetoric within former East- and West-German journalists’ editorials written during the 7 years immediately following reunification. Whereas the former evoked frames inconsistently and disproportionately conveyed citizens’ possibilities during the 1994–1995 provincial, national, and European election period; the latter framed their rhetoric consistently and did so in overwhelmingly political terms. From these findings, we draw inferences on citizens’ mutual interpretations within authoritarian societies (what is permitted) versus functioning democracies (what is legal), suggesting that only the latter affords the basis for the social construction of democracy.
Reconstruction of a Deformed Tumor Based on Fiducial Marker Registration: A Computational Feasibility Study
Authors: Han Ye , Oakley Emily , Shafirstein Gal , Rabin Yoed , Kara Levent Burak
Published: April 2018

Interstitial photodynamic therapy has shown promising results in the treatment of locally advanced head and neck cancer. In this therapy, systemic administration of a light-sensitive drug is followed by insertion of multiple laser fibers to illuminate the tumor and its margins. Image-based pretreatment planning is employed in order to deliver a sufficient light dose to the complex locally advanced head-and-neck cancer anatomy, in order to meet clinical requirements. Unfortunately, the tumor may deform between pretreatment imaging for the purpose of planning and intraoperative imaging when the plan is executed. Tumor deformation may result from the mechanical forces applied by the light fibers and variation of the patient’s posture. Pretreatment planning is frequently done with the assistance of computed tomography or magnetic resonance imaging in an outpatient suite, while treatment monitoring and control typically uses ultrasound imaging due to considerations of costs and availability in the operation room. This article presents a computational method designed to bridge the gap between the 2 imaging events by taking a tumor geometry, reconstructed during preplanning, and by following the displacement of fiducial markers, which are initially placed during the preplanning procedure. The deformed tumor shape is predicted by solving an inverse problem, seeking for the forces that would have resulted in the corresponding fiducial marker displacements. The computational method is studied on spheres of variable sizes and demonstrated on computed tomography reconstructed locally advanced head and neck cancer model. Results of this study demonstrate an average error of less than 1 mm in predicting the deformed tumor shape, where 1 mm is typically the order of uncertainty in distance measurements using magnetic resonance imaging or computed tomography imaging and high-quality ultrasound imaging. This study further demonstrates that the deformed shape can be calculated in a few seconds, making the proposed method clinically relevant.
A Combined Histological, Immunocytochemical and Biochemical Approach in the Evaluation of Estrogen Receptors in Breast Carcinomas
Authors: Pietribiasi Francesca , Gugliotta Patrizia , Racca Silvia , Di Carlo Francesco , Bussolati Gianni
Published: April 2018

Correlation of structural and functional data might lead to better identification of hormone-dependent tumors. Sixty breast cancer specimens, sent to the biochemistry laboratory for estrogen receptor (ER) analysis, were studied here by a combined morpho-functional approach.

Histological examination of needle biopsies on frozen tissue blocks showed that 12 cases (10%) were free of tumor cells; these cases mostly proved ER negative. On the other 48 cases, an immunocytochemical reaction was performed on the biopsy sections with a monoclonal antibody directed against p 29, an estrogen receptor related antigen. The staining values for p 29 and the biochemical ER findings were significantly correlated.

A combined histological, immunocytochemical study seems to offer advantages in the selection of patients for hormonal therapy.
Prostate-Specific Antigen in Prostate Cancer
Authors: Kuriyama Manabu
Published: April 2018

Prostate-specific antigen (PA) has been evaluated clinically as a tumor marker of prostate cancer with the use of enzyme immunoassay (EIA). For serodetection of prostate cancer, PA was assayed in a total of 1,109 sera. From mean ± 3 S.D. of normal controls, upper cut-off values in males were decided as 2.5 and 1.2 ng/ml in Americans and Japanese, respectively. Serum PA values in prostate cancer patients were positive in 78% of Americans and 62% of Japanese. However, in benign prostatic hypertrophy (BPH) cases, a high false positive rate of 41% was observed in Americans. Simultaneous assays of serum PA and PAP showed high sensitivity and specificity in the detection of prostate cancer. This antigen could be used, as well as PAP, for monitoring prostate cancer patients.

Furthermore, serum PA levels prior to treatment may express to some degree the malignant potential of the cancer. These results suggest that PA may be useful as a tumor marker of prostate cancer.
Circulating Ca 15.3 Levels in Breast Cancer. Our Present Experience
Authors: Colomer Ramon , Ruibal Alvaro , Navarro Matilde , Encabo Gloria , Sole Luis Alfonso , Salvador Luis
Published: April 2018

CA 15.3 is an antigen expressed by human breast carcinoma cells, and defined by two monoclonal antibodies, 115D8 and DF3. We used IRMA to determine the circulating serum levels of CA 15.3 in 1178 subjects with breast cancer, non-breast malignancies, benign diseases and controls. A threshold level of 40 U/ml was established with 140 healthy controls and 650 patients with benign diseases (respectively 0% subjects and 1.5% patients had abnormal antigen levels). Elevated CA 15.3 was found in 12 of 184 patients with malignancies different from breast cancer (6.5%), either epithelial carcinomas with distant metastases, mainly in the liver, or primary liver tumors. Breast cancer patients (n=204) were analysed by prior therapy, UICC stage and WHO response to therapy. Eight of 134 (5.9%) patients with stage II or III breast cancer at presentation and no evidence of disease (NED) had elevated CA 15.3. All of 22 patients with stage IV breast cancer not responding to therapy (SD and PD) had antigen levels > 40 U/ml, as did 10 of 34 (29.4%) stage IV patients in objective response (CR+PR). Three of 14 pretreatment patients had abnormal marker levels, and they later proved to have distant metastases. Serum CA 15.3 values were statistically different (p < 0.01) in NED (20.6 ± 11.2 U/ml), CR+PR (33.5 ± 24.0 U/ml), stable disease (98.8 ± 50.4 U/ml) and progressive disease (> 200 U/ml) breast cancer patients. Our results suggest that circulating CA 15.3 antigen levels agree with the stage of breast cancer and with the response to therapy.
Circulating Immunocomplexes in the Diagnosis of Autoimmune and Neoplastic Disorders: New Perspectives
Authors: Grassi Riccardo , Grazzini Giuliano , Sodini Francesca , Ronchi M. Costanza , Nottolini Marinella
Published: April 2018

Two new competitive immunoenzymatic assays (“C.I.C.-conglutinin” and “C.I.C.-C1q“) were employed to evaluate circulating immunocomplexes in 90 patients with a variety of autoimmune and neoplastic disorders. In autoimmune diseases the assays appeared very sensitive and relatively concordant, while in malignancies sensitivity was high with the C.I.C.-conglutinin method but much lower with the C.I.C.-C1q method. The clinical significance of these results is discussed with particular regard to the possibilities of application of the two assays in the diagnostic routine of a general hospital laboratory.