bluuebunny/crossref_metadata_2025 huggingface dataset:
Undercorrection of refractive error and cognitive function. The Beijing Eye Study 2011
Authors: SCHMIDBAUER M
Published: August 2012

Purpose To assess whether ocular parameters are associated with the level of cognitive function.

Methods The Beijing Eye Study is a population‐based study performed in rural and urban regions of Greater Beijing. The study included 3469 individuals (56.6%) women) with a mean age of 64.6+/‐9.8 years (range: 50‐93 years). A detailed ophthalmic and medical examination was performed. The cognitive function score was measured by the MMSE (mini mental state examination) scale.

Results Cognitive function measurements were available for 3127 (90.1%) study participants (56.5%) women). The mean cognitive function score was 26.3+/‐3.7 (median: 27; range: 2‐30). In multivariate analysis, after adjustment for older age (P<0.001; standardized coefficient beta:0.14), male gender (P=0.003;beta:0.06), urban region of habitation (P=0.005;beta:0.07), lower body height (P=0.001;beta:0.07), lower level of education (P<0.001;beta:0.56), type of occupation (P=0.004;beta:0.08), higher score of psychic depression (P<0.001;beta:0.06), lower self‐reported history of cardiovascular disorder (P=0.02;beta:0.07), decreasing cognitive function score was significantly associated with lower BCVA (P<0.001;beta:0.11), higher amount of undercorrection of refractive error (P=0.004;beta:0.04) and non‐wearing of glasses (P<0.001;beta:0.09).

Conclusion After adjustment for systemic parameters and BCVA, the cognitive score was significantly higher in subjects wearing glasses and simultaneously, in subjects with less undercorrection of their refractive error. Although the longitudinal cause‐effect relationship could not be addressed in this cross‐sectional study, the results are in agreement with that correction of refractive errors may be useful to reduce the risk of cognitive under‐functioning.
Fish‐eye disease with retinal involvement associated with mutation in the LCAT gene
Authors: BOUTBOUL S , BORDERIE V , LAROCHE L
Published: August 2012

Purpose A 38‐year‐old Egyptian man was referred to our department due to bilateral loss of vision over a six‐year period.Slit lamp examination revealed extensive bilateral corneal opacitiesBlood analysis revealed lipid metabolism abnormalities with a lack of plasma alpha‐lecithin:cholesterol acyltransferase (LCAT) (high‐density) activity

Methods We used PCR to amplify, to sequence and to determine the genotype of the LCAT gene. Direct sequencing of the six exons of the gene (figure 2) revealed a new homozygous mutation in exon 1 confirming the diagnosis of Fish Eye Disease ( FED). This new homozygous mutation caused a C‐to‐T transition, resulting in a substitution of a leucine by a proline at position 34 of the protein.

Results We performed a penetrating keratoplasty on right eye in december 2004. Despite a clear graft with normal anterior segment and normal fundoscopy, the patient did not recover significant visual acuity from the graft. His visual acuity was 20/100 on right eye . Visual Evoked potential and neuroimaging was normal, but electroretinography revealed a bilateral maculopathy.

Conclusion Similarly to what occurs in cornea ,retinal deposits could explain the macular involvement we have discovered in Fish eye disease. Full‐thickness corneal transplantation should be performed in cases of severe corneal opacification with impaired vision, but success of keratoplasty could be limited by visual impairement due to retinal degeneration. The indication for perforating keratoplasty has to be thought very carefully in these multimorbid patients.
Relationship between visual acuity and other optical parameters in no presbyopic eyes
Authors: SEGURA CALVO F , SANCHEZ‐CANO A , LOPEZ DE LA FUENTE C , FUENTES BROTO L , PINILLA I
Published: August 2012

Purpose To study the relationship between visual acuity (VA) and fluctuation of accommodation and aberrometric data in a population of no presbyopic eyes.

Methods Forty‐two no presbyopic eyes with natural pupil and scotopic lighting conditions were involved in the study. Subjects were studied with an autorefractor to determine the refraction and accommodation fluctuations, a ray tracing aberrometer to measure the refraction as well as aberrometric data, and a system to generate charts and determine the subjective refraction and the AV. The equipments were calibrated with an artificial eye before the tests were done. The subjects were divided in several subgroups of 1) subjective refraction (≥|‐0.50|D or <|‐0.50|D); 2) fluctuation of accommodation (≤0.1D or >0.1D) and 3) RMS of different high order (HO) aberrations: 3a) RMS of HO total (≤0.25µm or >0.25µm), 3b) RMS of spherical aberration (≤0.15µm or >0.15µm), 3c) RMS of coma (≤0.15µm or >0.15µm) and 2d) RMS of trefoil (≤0.15µm or >0.15µm)

Results The mean value for VA was 1.28 and 0.16 D for fluctuations of accommodation. No significant differences among fluctuations of accommodation and VA were found in any group. We found normal values about RMS of HO (0.34 μm), RMS of coma (0.19 μm), RMS of trefoil (0.17 μm) and spherical aberration (0.11 μm). No differences between RMS and VA were found in any group. A moderate correlation (R2=0.19) between the VA and the spherical aberration was observed.

Conclusion The values of fluctuation of accommodation and aberrometric data were within normal ranges reported in the literature. Differences between VA and other optical parameters were not found.
The effect of simplified and traditional chinese character on accommodative reponses in myopes and emmtropes
Authors: XU D , XIN W
Published: August 2012

Purpose This study investigated the effect of simplified and traditional chinese character on accommodative lag, accommodation microfluctuation, near work‐induced transient myopia (NITM) during the near task as well as the subsequent decay time. We aimed to analyze if the traditional Chinese character had the trend of inducing the myopia progress.

Methods Young adults were classified into emmetropes and myopes . Two size (12pt,8pt) and two type (simplified and traditional chinese character) were used to give four different reading targets on computer screen. It was presented in random order at 25 cm and was read for 5min. For each target, accommodation response , accommodation microfluctuation NITM and its decay were measured using the free space Grand‐Seiko auto‐refractor.

Results For myopic subjects, accommodation microfluctuation was greater for traditional chinese character 0.35±0.17 D than for simplified chinese character: 0.29 ±0.11 D, (p=0.017) ,NITM was larger for traditional chinese traditional character 0.61±0.34 D than for simplified chinese character 0.53±0.33 D,p=0.028, however there was no difference in emmetropic subjects. Myopes had larger accommodation microfluctuation 0.35±0.17 D than emmetrope 0.24±0.11 D p=0.02,myopes had greater NITM0.61±0.34 D than emmetropes 0.42±0.25 D P=0.013. For all targets, The accommodative lag of myopes is 0.74±0.32 D while the emmetropes 0.53±0.35 D P=0.000 ;The decay time for myopes was15.88±19.53 seconds while the emmetropes 9.04±12.62 seconds P=0.012.

Conclusion The study showed that compare to the simplified Chinese character, the traditional chinese character had significant effect on myopic subjects, it may be more susceptible of inducing the myopia progress.
Evaluation of magnitude and phase of sweep‐visual evoked potentials
Authors: CHARLIER J , CABON M , ZANLONGHI X , DEFOORT‐DHELLEMMES S
Published: August 2012

Purpose Sweep visual evoked potentials (SVEP) are frequently used for the assessment of visual acuity. Several studies have shown the presence in a significant number of subjects of a reduction of the response amplitude (“notch”) at intermediate spatial frequencies. The purpose of this study was to evaluate if this reduction of amplitude was related to a change in phase of the response.

Methods SVEP records from 16 subjects presenting a notch were analyzed. The sweeps were performed with a checkerboard pattern reversing at a frequency of 12 Hz. The duration of the sweep was 12 seconds and a Fourier analysis was performed over a sliding time window. A vector average was calculated over the different sweeps recorded from each subject and the resulting magnitude and phase were plotted for the 2nd (12Hz) harmonic.

Results The amplitude notch was found between 1.5 and 3 CPD. It was systematically correlated with a discontinuity of phase, typically constant for spatial frequency below the notch and increasing at a constant rate above that frequency. A numerical simulation pas performed to evaluate the effect of phase changes and demonstrated that a discontinuity of phase can produce a transient reduction in the measurement of magnitude similar to the notch found in the responses of some subjects.

Conclusion This result gives a new possible interpretation for the notch found in SVEP responses of some subjects. It may help understand underlying physiological mechanisms. It also suggests that new algorithms taking into account phase changes may be more appropriate to analyze SVEP responses.

Commercial interest
Comparison of visual evoked potentials between premature and full‐term childrens
Authors: HAN SJ , JEON SY
Published: August 2012

Purpose To evaluate the correlation of visual evoked potential(VEP) abnormalities with prematurity, presence of brain lesion, brain lesion localization, especially visual cortex in children under five.

Methods We evaluated VEP responses in children under five, and compare the responses according to prematurity, presence of brain lesion, and brain lesion localization. We divided the subjects into two groups, which the visual pathway involvement (retina, optic nerve, optic chiasm, lateral geniculate body, optic radiation, visual cortex) group, and non‐involvement group. The VEP responses were classified into 3 scores, Score 0: normal waveform and normal latency, Score 1: mildly or moderately attenuated waveform or delayed latency, Score 2: severely attenuated waveform or no response.

Results Subjects were 58 children, 16 premature(25 weeks ~ 38 weeks), and 42 full‐term children. In premature children, 5 out of 16 had visual pathway involvement, and 12 out of 32 had it in full‐term children. In full‐term children, higher score was seen in visual pathway involvement group. On the other hand, in premature children, there was no significant difference of score between visual pathway involvement group and non‐involvement group.

Conclusion In full‐term children, the incidence of VEP abnormality seems to be higher in case of visual pathway involvement. In premature children, the VEP abnormality is vulnerable although there is no visual pathway involvement.
Functional activity of retinal neurons and Muller cells in idiopathic full‐thickness macular holes
Authors: ZUEVA M , NEROEV V , TSAPENKO I , BYCHKOV P , SARYGINA O
Published: August 2012

Purpose To determine the changes of neurons and Muller cells functional activity in idiopathic macular holes (MH).

Methods 7 patients (59‐70years) with a full‐thickness MH (3rd stage by Gass, 6‐8 months duration) were examined. Optical coherent tomography (Stratus3000 OCT, Carl Zeiss) used to detect the maximum size of the MH, total macular volume (TMV) and foveal thickness (FT). The central and general macular sensitivity (Sc within 3° from the fixation point, and Sg) were tested with microperimetry (macula 12°, MP1 Nidek). The cone ERG, photopic flicker ERGs (FERG) at 8.3, 10, 12, 30Hz were recorded (RETIport/scan21, Roland Consult), and glial indices were calculated as the ratio of amplitudes of the ERG b‐wave and every FERG.

Results The best corrected visual acuity was 0.23±0.09, FT=345±12μ; TMV=7.3±0.1mm3; the maximum hole size 581±62μ. Sc =7.9±1.1dB; Sg=12.2±1.3dB. In MH, a moderate reduction of a‐ and b‐wave amplitudes was noted up to 67% and 88.3% of the norm. The b/a ratio was to 50% higher than in control, reflecting a violations in the outer/post‐receptor retina interface. The amplitude of 24Hz‐FERG (but not the 8.3‐12Hz FERG) showed a sharp reduction (up to 31.4%), indicating to a drastic violation of the bipolar cell activity. The less significant depression in the single‐flash ERG b‐wave may reflect the compensatory hyperactivity of Muller cells, which masks the true reduction of bipolar cells activity. Glial indices increased more than two times at 24Hz, testifying a violation of cone bipolar and Muller cells interaction.

Conclusion MH is associated with the reduction in the function of photoreceptor and bipolar cells, sharp increase in Muller cell activity and interaction of cone bipolar and Muller cells.
New clinical measure to assess the visual awareness in peripheral field loss (PFL)
Authors: ALSHAGHTHRAH A , DICKINSON C , MURRAY I
Published: August 2012

Purpose Individuals with PFL have problems moving about, and there are some optical aids that are proposed to enhance mobility performance. However, currently the efficacy of these aids cannot be determined without extended wear. This study aims to design a new clinical measure to assess the visual awareness in PFL patients, so that this new test could be used to determine the efficacy of optical aids in a clinical setting

Methods PFL was simulated using goggles in 50 normally‐sighted subjects. The simulated field of view (FoV) was varied from 5° to 20°. In the new test, observers were asked to search for a stimulus in a 60° field of view and the detection time (DT) & detection efficiency (DE) (DE is the Inter‐quartile range of the DT responses at each eccentricity for every subject) were measured. Head and eye movements were allowed and the presentation time was unlimited. Clinical validity was investigated by correlating the DT and DE scores with the percentage preferred walking speed (PPWS) and the number of collisions on an indoor mobility course

Results The DT and DE scores were inversely correlated with the FoV (r=‐0.60; p<0.0001, for both of them). These scores varied linearly with eccentricity. The DE was inversely correlated with the PPWS (r=‐0.50; p<0.0001) and positively with the collisions score on the indoor mobility course (r=0.50; p<0.0001)

Conclusion The awareness test was sensitive to FoV and stimulus eccentricity. The test results have good correlation with mobility course scores which indicates that the new test is valid. The test is unique, quick, and simple to deliver. The new visual awareness test could be a valuable tool to test the efficacy of optical aids that are intended to enhance mobility performance in PFL patients.
Normal aging: capturing changes in contrast acuity at low light levels
Authors: GILLESPIE‐GALLERY H , KONSTANTAKOPOULOU E , BARBUR JL
Published: August 2012

Purpose Visual tasks that require discrimination of fine spatial detail become a challenge to older subjects, particularly when the light level is low. This worsening of vision is increased further when diseases of the eye are also involved, and these effects are difficult to separate. An index to describe the health of the retina (HRindex) by capturing how contrast acuity (CA) worsens as a function of light level is introduced and the statistical limits of variability established in normal eyes.

Methods CA thresholds were measured at five light levels (in the rage 0.12 to 34 cd/m^2) in 80 subjects, aged 18‐80 years using the CA assessment test (ASEM, 74, 551‐559, 2003). Long wavelength light was used to minimise variability. Stimuli were presented at 0 and ±4 degrees. Pupil size was measured throughout and used to calculate subject‐specific retinal illuminances. The measurements were carried out binocularly and monocularly and in addition to clinical examination, a number of filters were also used to screen for normal eyes.

Results The HRindex was calculated for each subject using a method similar to that developed to investigate changes in colour vision (JOSA, 29 (2):27‐35, 2012). Limits for CA have been established for normal eyes. The effects of aging were examined as well as differences between binocular and monocular thresholds and retinal location.

Conclusion The results show that when appropriate screening for normal vision is applied the HRindex becomes largely independent of age. The new approach and the limits of normal vision obtained in this study make it possible to screen for early‐stage, subclinical retinal disease using CA assessment.
Colour vision losses in diabetes in the absence of proliferative retinopathy
Authors: BARBUR JL , ANSARI I , CANNING C
Published: August 2012

Purpose There are over 30 published studies evaluating colour vision in diabetes. The evidence is, however, not consistent – the predictive accuracy of the studies does not support the use of colour vision as a screening test for diabetic retinopathy (Health Technol Assess, 13 (60), 2009). The CAD colour vision test (Expert Rev.Ophthalmol. 6(4):409‐420, 2011) addresses some of the major flaws in clinical colour testing. This poster reports the application of the CAD test to 214 diabetic patients.

Methods A consecutive series of diabetics attending a diabetes center in Abu Dhabi were invited to participate in the study. Inclusion criteria were a best corrected visual acuity of 6/18 or better, no more than moderate non‐proliferative retinopathy or moderate maculopathy and no co‐existing glaucoma. Patients had a full eye examination (including colour photography and macular OCT), a full assessment of their diabetes and the CAD colour test.

Results Age‐corrected binocular colour threshold limits were employed to screen for normal colour vision. Abnormal colour vision was noted in 80% of Arab and 67% of non Arabs. This did not correlate with duration of diabetes, age, HBA1C, body mass index, visual acuity or central retinal thickness.

Conclusion Colour vision is abnormal in the large majority of the study population. The severity of colour vision loss is not correlated with age or gender of the patients, duration or severity of diabetes, current diabetic control, or central macular thickness. These findings suggest the existence of early retinal changes in diabetes that affect specifically colour vision and occur independently of factors such as those causing macula edema.
The dynamics of molecular markers expression of blood lymphocytes activating at patients with an uveal melanoma at the different types of treatment
Authors: VELICHKO LN , MALETSKIY AP , VIT VV , CHEBOTARYOV YEP
Published: August 2012

Purpose To study the dynamics of molecular markers expression of blood lymphocytes activating at patients with the uveal melanoma at the different types of treatment.

Methods Research was conducted in the dynamics at patients (n=67) in age 63,4±5,7 years old with the uveal melanoma at the different types of treatment. The photocoagulation was conducted in the first group (n=42), the enucleation was in the second group (n=19), the combine therapy (photocoagulation + brachytherapy) was in the third group (n=6). The level of molecular markers expression of lymphocytes activating was determined by the gistoimmunocitochemical method through the monoclonal antibodies (CD7, CD25, CD38, CD45, CD54, CD150 and CD95). The estimation of statistical meaningfulness of distinctions was executed by Mann‐Whitney and Wilcoxon tests.

Results Аfter the photocoagulation at patients with uveal melanoma was marked the reliable increase of molecular markers of lymphocytes activating (CD7, CD38, CD150 and CD95) as compared to indexes at the beginning of treatment. After the enucleation the level of molecular markers of lymphocytes activating (CD7 and CD95) was for certain increased as compared to the initial level. The combine therapy (photocoagulation + brachytherapy) was accompanied the reliable increase of activating markers (CD7, CD25, CD38, CD45, CD54, CD150 and CD95).

Conclusion The highest level of the immune system activating is marked at the combine treatment. Less expressed activating at the enucleation and photocoagulation.
Diagnosis of Herpetic Uveitis is Aided by Confocal Microscopy with the HRT RCM
Authors: KNOLL A , POSTOLE S , MACKENSEN F
Published: August 2012

Purpose Herpetic uveitis (HU) is a frequent infectious cause of anterior uveitis. A definite diagnosis can be obtained by anterior chamber puncture and PCR, an invasive procedure not all patients consent to. We hypothesized that patients with HU typically have high amounts of dendritiform inflammatory cells (DCs) in their corneal subepithelial nerve plexus (SNP),which are detectable by in vivo confocal microscopy and distinguish HU from other uveitis types.

Methods Patients with clinical suspicion of HU without keratitis and patients with Fuchs Uveitis Syndrome (FUS) were imaged with the Rostock Cornea Module attachment on the HRT III (HRT‐RCM)(Heidelberg Engineering) on both eyes. DCs in the SNP were counted by two observers using a cell counting software. Means of the cell counts were used for analysis. Diagnosis of HU was confirmed by anterior chamber puncture or by clinical improvement due to Acyclovir therapy. Statistical significance was assessed with a Kruskal‐Wallis or a Mann Whitney U test,when appropriate.

Results Patients with HU showed significantly higher amounts of DCs in their affected eyes (93.3±10.6 cells/mm2, Mean±SEM, n=10) but also in their unaffected eyes (59±25 cells/mm2, n=7), than patients with FUS, who had an average DC‐density of 46.4±10.4 cells/mm2(n=15) in their affected and 21±6 cells/mm2(n=15) in their unaffected eyes.

Conclusion High amounts of DCs in the corneal SNP were a typical finding in herpetic AU. Much lower numbers of DCs were present in FUS, a clinical similar uveitis type presumably also of viral origin. Imaging corneas of patients with clinical suspicion of HU with the HRT‐RCM is a non‐invasive, low risk technique which can be a useful addition in distinguishing HU from other anterior uveitis aetiologi
Syphilitic uveitis: Vilnius region perspetive: 6 case reports
Authors: STECH S , STRUPAITE R , KARALIUTE Z , CIMBALAS A , SVEIKATIENE J , ASOKLIS R
Published: August 2012

Purpose To examine the clinical manifestations of syphilitic uveitis in Vilnius region population over four years and review trends in incidence

Methods A retrospective case series of 6 patients (8 eyes) with syphilitic uveitis who were managed in Vilnius region between 2009 and 2012

Results Between 2009 and 2012 were 6 patients (mean age 42,67 years, range 28 ‐ 66) all of them with positive Treponema Pallidum Chemiluminescent Immunoassay (CLIA) and negative Human Immunodeficiency Virus (HIV) serology. Venereal Disease Research Labarotory (VDRL) and/or Treponema Pallidum Heamaglutination Assay (TPHA) and/or non – reactive Rapid Plasma Reagin (RPR) were obtained in all 6 patients. Posterior uveitis was the commonest presenting finding (5/8 eyes), panuveitis was seen in 3 eyes at presentation. Posterior uveitis manifests as chorioretinitis with or without vitritis, optic neuritis, neuroretinitis. Panuveitis – granulomatous anterior uveitis, neuroretinitis, vitritis. One patient with bilateral involvement, had rare symptom – syphilitic roseola of the iris. Five patients were treated with intravenal benzylpenicilin and one – oral cefriaxone

Conclusion Ocular syphilis presented most frequently as posterior segment inflammation. An increasing trend in the number of cases of ocular syphilis in the past four years was observed in Vilnius region population
Evaluation of the early diagnosis of uveitis toxoplasma using only western blot
Authors: BECCAT S , WALLON M , SEVE P , PEYRON F , KODJIKIAN L
Published: August 2012

Purpose The aim of this study is to evaluate which methods, between the Goldmann‐Witmer coefficient (GWC) and immunoblotting (IB), in aqueous humor samples, can be sufficient, associated with clinical findings, to diagnosis ocular toxoplasmosis, in running practice, especially in the first three weeks.

Methods Ocular Toxoplasmosis (OT) is one of the most frequent causes of posterior uveitis. The diagnosis of toxoplasmic retinochoroiditis is based upon ophthalmoscopic findings and can often allow the clinician to start specific treatment when needed. But in most cases, laboratory tests are required to confirm the etiology, especially when other diseases are suspected and cannot be ruled out by the lonely clinical findings. Thirty patients with ocular toxoplasmosis and 36 patients with other ocular inflammatory diseases were analyzed by these two methods.

Results The GWC was significant (GWC > 3) in 57.9% patients presenting OT. IB was positive in 85.3% of samples. The combination of these two methods increases the sensitivity to 89.2%. Based upon the interval between symptom onset and paracentesis, IB has a greater sensitivity than GWC when sample of aqueous humor (AH) was taken in the first three weeks (78.6% verus 35.7%).

Conclusion IB seems to be more useful than the GWC if only one of these methods can be perform and especially in the first three weeks. On top of that, IB is easier to perform and require a smaller sample.
Serratamolide as a novel hemolytic factor produced by Serratia marcescens
Authors: SHANKS RM , STELLA N , LAHR R , WANG S , KOWALSKI R , LIU X
Published: August 2012

Purpose The Serratia marcescens bacterium causes vision‐threatening keratitis, life‐threatening hospital acquired infections and contaminates contact lens cases. The goal of this study was to identify a hemolytic factor produced by keratitis isolates and laboratory strains of S. marcescens.

Methods Hemolysis was measured using sheep and mouse erythrocytes. S. marcescens was mutated with a mariner transposon. Hemolysin defective mutants were isolated on blood agar plates. Transposon insertion sites were mapped by marker rescue and sequencing. Complementation analysis was performed with plasmids. Serratamolide was extracted with ethyl acetate and purified by preparative HPLC and verified as pure with high‐resolution mass spectroscopy (HR‐MS) and 1H NMR analysis. Cytotoxicity to human airway and ocular epithelial cells was performed using Alamar Blue viability dye. The presence of swrW in ocular isolates was determined using PCR.

Results Mutation of the swrW gene conferred a hemolysis defect that was complemented by the wild‐type swrW gene on a plasmid. The SwrW protein catalyzes production of the cyclic lipopeptide serratamolide. Purified serratamolide was hemolytic to mammalian erythrocytes, and cytotoxic to human airway and ocular cells in vitro. The swrW gene was found in the majority of contact‐lens associated keratitis isolates.

Conclusion Serratamolide is a novel hemolysin produced by S. marcescens ocular isolates and may contribute to the ability of contact lens associated bacteria to cause infections.
Ocular granuloma, uveitis and X‐linked chronic granulomatous disease
Authors: KURUN S , ANGIOI K , LOCATELLI A , TERRADA C , BODAGHI B
Published: August 2012

Purpose To report 2 cases of ocular inflammation in patients with chronic granulomatous disease (CGD).

Methods A 2‐year old boy was referred for red right eye and fever lasting for one month. A granuloma developed in the anterior chamber of his right eye. A CGD was suspected and the X‐chromosom analysis confirmed a mutation in the gp 91 phox (the b subunit of cytochrome b558). Steroids were associated with antifungals and antibiotics and the granuloma disappeared rapidly. The other caseis about a 22‐year‐old womanknown to be a carrier for X‐linked cytochrome b558‐negative CGD. She presented with a red painful right eye. Slit‐lamp examination revealed a nodular scleritisand, funduscopy disclosed chorioretinal granuloma in nasal periphery (RE). A white active but asymptomatic chorioretinal lesion on the temporal part of posterior pole and perivascular retinal scars were found (LE).She was successfully treated with oral prednisone.

Results CGD is a rare inherited disorder of phagocytic cells leading to recurrent life‐threatening bacterial and fungal infections, caused by a defect in the nicotinamide adenine dinucleotide phosphate. The most common molecular defect is a mutation in the cytochrome B, b subunit gene located on the X chromosome encoding for gp91. The most frequent ocular manifestations are juxta vascular chorioretinal lesions, keratitis and conjunctivitis. Current therapy for CGD is based on antimicrobial prophylaxis, early and aggressive treatment of infections.

Conclusion Ophthalmologists must be aware of the different ocular localisations in CDG that may be the presenting symptoms.
Iritis and angle closure glaucoma caused by caterpillar hairs
Authors: BLASETTI F , TARALLO S , DORE S , PINNA A
Published: August 2012

Purpose To report on a child presenting with iritis and angle closure glaucoma caused by caterpillar hairs.

Methods A 12‐year‐old girl complained of sudden pain and visual loss in her left eye while she was playing in a pinewood. Two hours later, she developed maculo‐papular rash on her limbs. On examination, left visual acuity was 1/10. The affected eye showed conjunctival hyperemia, corneal edema, anterior chamber flare (4+ cells). Corneal staining with fluorescein disclosed diffuse superficial punctate keratopathy. Left IOP was 55 mm Hg. Visante OCT of the affected eye showed a thin, translucent, linear foreign body into the cornea and anterior chamber up to the irido‐corneal angle. Topical steroids, antibiotics, cycloplegics, hypotensive eyedrops, and intravenous mannitol were given.

Results Inspection of the place where the girl was playing revealed the presence of numerous processionary pine caterpillars. On the basis of this finding and the clinical data, a diagnosis of iritis and angle closure glaucoma caused by caterpillar hairs was made. After 3 days’ treatment, corneal edema and anterior chamber inflammation resolved, IOP returned to normal, and visual acuity was 10/10 again. However, a small iris cyst was still visible on OCT scans.

Conclusion Ocular lesions caused by caterpillar hairs are uncommon. Ophthalmologists should be aware that intense iritis with angle closure glaucoma may be the result of the penetration of caterpillar hairs into the eye. OCT scans may be important to confirm the diagnosis.
Uveitis and ocular wall granulomas associated with brimonidine treatment
Authors: LABALETTE P , MAURAGE CA
Published: August 2012

Purpose Anterior granulomatous uveitis has been recently reported as a side effect of chronic topical use of brimonidine tartrate. Clinical features of eight patients with brimonidine induced uveitis and ocular wall granulomas are here described.

Methods Medical history, ocular features, progress of events, pathological aspect, and clinical evolution of all patients were analyzed. For each patient, the search of systemic sarcoidosis was performed including angiotensin converting enzyme dosage, chest computed tomography and accessory salivary gland biopsy.

Results Three women and five men with a mean age of 68 years (varying from 50 to 83 year‐old). All patients presented with glaucoma and two patients had a previous history of unilateral uveitis before treatment with brimonidine. Two patients receiving unilateral treatment had unilateral disease whereas patients receiving bilateral treatment had bilateral disease. At the time of diagnosis, the mean duration of treatment with brimonidine was 18.5 months. Epithelioid granulomatous lesions infiltrated conjunctiva and/or episclera. Remission was obtained after a 4 to 6 weeks of withdrawal. Uveitis and ocular surface inflammation flared up when treatment was tapered. Unfortunately, brimonidine was later reintroduced in one patient and diffuse granulomatous lesions recurred

Conclusion Brimonidine associated uveitis arises after sustained treatment in susceptible patients. Coexisting granulomatous anterior uveitis and ocular wall granulomas in patient treated by brimonidine eyedrops should evoke a drug induced disease. Treatment withdrawal leads to resolution of added inflammation with return to the basal state. Reexposure to brimonidine induce recurrence of uveitis after several months of exposure.
Protective effects of Crepidiastrum denticulatum on oxidative stress‐induced retinal degeneration
Authors: JUNG SH , AHN HR , LEE HJ , KIM CY , KANG KD , NHO CW
Published: August 2012

Purpose This study was to determine whether Crepidiastrum denticulatum, is effective at blunting the negative influence of 1‐buthionine‐(S,R)‐sulfoximine (BSO, 0.5 mM) plus glutamate (10 mM) in transformed retinal ganglion cells (RGC‐5) and of N‐methyl‐D‐aspartate (NMDA) to the rat retina.

Methods RGC‐5 cells in culture were given negative insult such as BSO plus glutamate for 24 hours, after which cell survival were tested. Reactive oxygen species (ROS) quantification was performed by 2΄,7΄‐dichlorodihydrofluorescein diacetate and dihydroethidium. Apoptotic cell death was measured by propidium iodide (PI)/Hoechst 33342 double staining and western blot analysis. NMDA‐induced retinal damage in vivo was tested by hematoxylin‐eosin staining and terminal deoxynucleotidyl transferase‐mediated dUTP nick‐end labelling (TUNEL) staining. The lipid peroxidation was tested by amount of formation for thiobarbituric acid reactive species.

Results The ethanol extract of C. denticulatum (EECD) significantly attenuated RGC‐5 cells death caused by BSO plus glutamate. Treatment of the RGC‐5 cells with EECD reduced the ROS caused by various radical species such as H2O2, OH• or O2•‐. The up (cleaved PARP and cleaved caspase‐3) and down (Bcl‐2) regulations of apoptotic proteins caused by BSO plus glutamate were significantly blunted by EECD. EECD protected the negative influence of NMDA on the retinas of rats of the thinning of the inner plexiform layer (IPL) and of the increased TUNEL in positive ganglion cells in the ganglion cell layer. Chlorogenic acid and 3,5‐dicaffeoylquinic acid were found to be major components of EECD.

Conclusion EECD could be promoted as a potential neuroprotective agent for glaucoma against oxidative stress.
Effects of low intensity ultrasound (LIUS) on the macular degeneration model in vitro
Authors: KIM NK , KIM CY , CHOI MJ , RHO S , PARK S , CHOI BH
Published: August 2012

Purpose The retinal pigment epithelium (RPE) is compose of monolayer of tightly connected pigmented cells and supports the function of the normal vision function. Structural deformation and/or inflammation in RPE are commonly accompanied with and in many cases severely aggravate macular degeneration. We have reported previously low‐intensity ultrasound (LIUS) of less than 1 mW/cm^2 shows cyto‐protective and anti‐inflammatory effects on chondrocytes and cartilage tissue under pathologic environments. The aim of this study is to investigate the effects of LIUS on RPE cells in macular degeneration models in vitro.

Methods ARPE‐19 cells were grown on a plastic dish or permeable transwell inserts and were treated with various damaging agents such as PlGF (an agonist of VEGF receptor), NaCN and H2O2. Then, cells were untreated or treated with varying intensities of LIUS with a maximum of 200 mW/cm^2 once for 20 min a day. Viability of cells was examined with Wst‐1 and TUNEL assays. Permeability of the cell monolayer on transwell membrane was tested by trans‐epithelial electrical resistance (TEER) system. JC‐1 staining was also performed to measure mitochondrial activity in cells.

Results Cell damaging agents increased cell death and permeability of cell monolayer in a dose‐dependent dose manner. LIUS treatment significantly reduced both of the cell death and permeability. Changes in the mitochondrial membrane potential were also decreased by LIUS.

Conclusion This study demonstrated that LIUS inhibits cell death of ARPE‐19 by various pathologic stresses, thereby might be a promising treatment for RPE under macular degeneration.
Hypoxia stimulates the synthesis and release of Brain Natriuretic Peptide (BNP) in RPE cells
Authors: ARJAMAA O , AALTONEN V
Published: August 2012

Purpose Blood flow and oxygen availability of the retina are modulated by locally produced peptides that also can change the function of neurons. The natriuretic peptide system has been isolated and characterized in human retina and these peptides localize in retinal pigment epithelium (RPE) cells. A high concentration of natriuretic peptides has been previously measured from the vitreous of patients suffering of proliferative diabetic retinopathy (PDR). However, the stimulus to which the natriuretic peptide system responds in PDR has remained unknown. We hypothesized that hypoxic conditions will increase the synthesis and release of Brain Natriutretic peptide (BNP) from human RPE cell culture.

Methods Human RPE cell were exposed to hypoxia for several hours. Samples were collected at time intervals and analyzed for BNP peptide and for BNP mRNA. A simultaneous measurement of VEGF served as a positive control.

Results In hypoxic conditions RPE cells secreted statistically significant amounts of BNP.

Conclusion These findings characterize for the first time a stimulus for the natriuretic peptide system in the retina and explain previous clinical findings. Thus, the measurement of natriuretic peptides from the vitreous may guide the treatment of the intraocular diseases in which the retina is suffering from hypoxia.
Flicker‐induced retinal vasodilatation is not dependent on complement factor H polymorphism in healthy young subjects
Authors: NAPORA KJ , TOLD R , PALKOVITS S , KAYA S , BOLTZ A , SCHMIDL D , WERKMEISTER R , GARHöFER G , SCHMETTERER L
Published: August 2012

Purpose We have previously shown that choroidal blood flow regulation in healthy subjects is abnormal in carriers of the CC allele at rs1061170, a complement factor H polymorphism that is closely related to the risk of age‐related macular degeneration. This is compatible with data in complement factor H deficient mice showing abnormal choroidal and retinal vasculature associated with endothelial damage. In the present study we hypothesized that the carriers of CC at rs1061170, which have an increased risk of AMD, already show abnormal retinal blood flow regulation at ages below 35 years.

Methods A total of 99 healthy subjects (aged between 19 and 35 years) were included in this study. Flicker‐induced retinal vasodilatation was investigated in arteries and veins using the dynamic vessel analyzer (DVA) and genotyping at rs1061170 was performed.

Results Out of the 99 subjects 18 were homocygous for the CC allele, 50 were homocygous for the TT allele and 31 subjects were heterocygous. The response in retinal arteries (p=0.376) and retinal veins (p=0.617) to flicker stimulation was similar between the three studied groups. In addition, the baseline diameters of retinal arteries (p=0.619) and veins (p=0.471) was also comparable between the groups.

Conclusion Our data indicate that healthy young carriers of the CC allele at rs1061170 do not show abnormal flicker‐induced vasodilatation in the retina. This is in contrast to our previous results in the choroid, where these individuals have abnormal blood flow regulation. Whether this is due to the differences in vasculature or the difference in the stimulus is unclear.
How much flicker is enough?
Authors: HEITMAR R , SUMMERS RJ
Published: August 2012

Purpose To assess the impact of flicker length on retinal vessel dilation.

Methods Seven healthy individuals underwent manual shygmomanometry, non‐contact tonometry (Keeler Pulsair, UK) and dynamic retinal diameter measurements using the retinal vessel analyser (ImedosSystems, Germnay). In order to evaluate the influence of flicker length on vessel dilation each subject was measured with 5 protocols of varying flicker length. Protocols consisted all of 50 second baseline measurements followed by 3 cycles of either 5 sec, 7 sec, 10 sec or 20 sec flicker provocation and 80 second recovery, whereas the fifth protocol consisted of 50 sec baseline, 50 sec flicker provocation and 120 sec recovery (single cycle). All protocols were administered on the same day but in random order with a minimum of 5‐10 minutes recovery between protocols.

Results Most of the flicker induced dilation (~85%) is reached within the first 7 to 10sec post provocation start independent of flicker length. Any additional flicker provocation does not significantly increase arterial dilation (ANOVA p>0.05). However, venous dilation does increase with increasing flicker lengths but at a slower rate compared to the initial ten seconds.

Conclusion Through administering the different protocols it becomes apparent that the vessel dilation due to flicker light provocation is a two stage process: the first being the immediate reaction to accommodate increased metabolic demand and the second being the maintenance reaction to address prolonged demand. This two stage process could be useful in assessing patients with various ocular and systemic vascular insufficiencies and potentially be a more useful marker than the absolute dilatory response.
The influence of age on retinal vessel oxygenation
Authors: HEITMAR R , CUBBIDGE R
Published: August 2012

Purpose To validate weather regional differences in retinal vessel oxygenation depend on age.

Methods Fifty three healthy individuals (age range 19‐61 years; mean age 35 (SD 11) years) underwent manual sphygmomanometry, non‐contact tonometry (Keeler Pulsair, UK) and retinal vessel oxygen saturation measurements using dual wavelength oximetry (ImedosSystems, Germany). In order to analyse regional saturation differences, all vessels were grouped according to their location into major superior and inferior artery and vein as well as into macula and peripheral feeders (MF and PF respectively for arteries) and macula and peripheral drainers (MD and MF respectively for veins).

Results Multiple regression analysis revealed no influence of age, blood pressure (SBP: 116 (13)mmHg, DBP:73 (11)mmHg) and intraocular pressure (12 (3)mmHg) upon arterial and venous oxygen saturation measurements (p>0.05). Superior and inferior MF, PF, MD and PD were comparable (MF: 97 (9)% and 97 (8)%, p=0.955; PF: 92 (11)% and 91 (9)%, p=0.607; MD: 87 (14)% and 85 (13)%, p=0.594; PD: 61 (14)% and 58 (16)%, p=0.381). MF and PF were significantly different in the superior and inferior retina (p=0.006 and p=0.0002) as were MD compared to PD (p<0.0001 and p<0.0001).

Conclusion Regional variations in oxygen saturation of retinal arterioles and venules are independent of age, blood pressure and intraocular pressure.
Correcting influence of arsenic mineral water on structural characteristic of the retina of rat eyes in model chronic immobilization‐emotional stress
Authors: GUSHCHA S , NASIBULLIN BA , YAROSHENKO NA , ZOLOTARYOVA TA
Published: August 2012

Purpose To study influence arsenic mineral water (AMW) on possible structural variations in retina to rat eyes with model of chronic immobilization‐emotional stress (CIES), strengthened by situational factors.

Methods Experience has realized on 30 white rat‐males which were divided into three groups: І – control group (10 rats). ІІ group — comparison group — 10 rats with model of CIES. ІІІ group — experimental group — 10 rats with model of CIES which had an easy access to drinking AMW.

Results Model of CIES at rats is accompanied with change of a retina of an eye which appear in stretching and non‐uniformity of cells in ganglionary layer; the centers of merge internal and external mesh layers. Vessels a part spasmed, are expanded by a part. The described variations appear for 15 day of supervision, become expressed and diffusive for 30 day.

Conclusion At rats with model of CIES had an easy access to drinking AMW, the picture of change in eye retina conforms to the above‐stated description of results of experience of 15 day.
Galenic and analytic development of Tacrolimus 0.06% eye drops
Authors: GAUTHIER AS , RIVAL B , SAHLER J , FAGNONI‐LEGAT C , GUILLAUME YVES , LIMAT S , DELBOSC B
Published: August 2012

Purpose The administration of topical tacrolimus (FK506) eye drops or ointment is used in treating corneal immune pathologies and in the prevention of the high‐risk corneal graft rejection. The purpose of this study is to develop a new well‐tolerated formulation of tacrolimus 0,06% eye drops. Procedure and the preparation are presented and discussed.

Methods Tacrolimus monohydrate powder and virgin castor oil are used in this new formulation. The manufacturing process guarantees the product sterility. Analytical validation of the assay by high‐performance liquid chromatography allows precise control of the concentration of tacrolimus.

Results The manufacturing and packaging of these eye drops provide good product stability. The concentration of tacrolimus 0.06% was maintained for 28 days, and no mycological or bacteriological contamination was found. Eye drop can be conserved close and exposed to the light during three months after production.

Conclusion Tolerance studies are currently being carried out.
Effects of Irifrin 2,5% on the disturbances pupillary‐accommodative system in patients
Authors: BUSHUYEVA N , MALIEVA O
Published: August 2012

Purpose The disturbances of pupillary‐accommodative system in раtients include astenopia, decreasing of visual acuity, headache. The aim of the study was to conduct investigation of direct and consensual pupillary reactions on the flashlight, accommodative‐convergence reaction on a fixed object with the help of elaborated pupillography device before and after instillation of Irifrin 2,5% in both eyes

Methods Irifrin 2,5% was applied for diagnoses and treatment of pupillary‐ accommodative system disturbances in 34 раtients aged 7–13 with myopia and hypermetropia. Vision acuity, reserves of accommodation, autorefractometry, pupillography of direct, consensual, pupillary‐ accommodative reactions before and after instillation of Irifrin 2,5% in both eyes were studied. Balance of autonomic nervous system was appreciated by Cerdo index: positive (+) means the prevalence of simpatic; negative (‐) means the prevalence of parasimpatic. It was estimated by following formula: Cerdo index = (1‐D/P)  100 D – diastolic blood pressure; P – number of heart systoles per min; For treatment one drop of Irifrin 2,5% was used once before sleeping in the both eyes during one month.

Results Irifrin 2,5% was effective for treatment in all patients with disturbances of accommodation, who had sympathycotonic autonomic balance. During one month after treatment visual acuity increased and normal pupillary‐ accommodative reactions normalized, astenopia and headache disappeared.

Conclusion Irifrin 2,5% was effective for diagnoses and treatment of pupillary‐ accommodative system disturbances in раtients. Irifrin 2,5% instillations is recommended for treatment 3‐4 times a year.
Digital analysis of the changes in carcinomatous conjunctiva using Aperio nuclear v9 algorithm
Authors: ASOKLIS R , PAULAVICIENE R , PETROSKA D
Published: August 2012

Purpose To analyze and evaluate biological and morphometrical changes and differences of healthy and carcinomatous conjunctiva using Aperio nuclear v9 algorithm.

Methods A pilot study for the objective evaluation of carcinomatous conjunctiva in 6 cases. There were analyzed 6 excised conjunctival tumors specimens from 6 patients (6 eyes). Medium age of the patients was 68 years. There were two males and four females. In 3 patients (3 eyes) conjunctival tumor was excised, cryoaplication and amniotic membrane transplantation was performed. In 3 patients excisional biopsy was performed without additional surgical manipulations. Conjunctival specimens were stained with hematoxilin and eosin. Immunohistochemical (IHC) staining with a proliferation marker of cells Ki‐67 was performed for all specimens. Digital slides of the IHC of Ki‐67 from these biopsies were obtained by Aperio ScanScope GL. Aperio Nuclear V9 algorithm was applied to assay proliferation indices (PI) of nuclei stained with Ki‐67 and size of all nuclei in both abnormal and normal conjunctiva.

Results There were analyzed from 1585 till 5020 malignant and 242‐714 normal cells. PI of Ki‐67 ≥19% (range 19.3‐62.1%) was found in carcinomatous conjunctiva comparing with normal conjunctiva PI ≤13.5% (range 1.9‐21.6%) in the same patients. No significant difference was found between nucleus size in pathological (mean 41 µm2, range 33‐64 µm2) and normal conjunctiva (mean 35.5 µm2, range 34‐36 µm2).

Conclusion Aperio nuclear algorithm can be used for carcinomatous and healthy conjunctiva analysis. Further studies of the malignant and healthy eye tissues using larger cohort are required.