bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship of health beliefs and prevention behaviours of Greek individuals with family history of glaucoma
Authors: GOULIA O , ZLATANOS D , GKIKA M , RASOGLOU A
Published: November 2010

Purpose Since glaucoma is a serious, progressive and leading to blindness eye disease, a study based on the Health Belief Model (HBM) scale was conducted, in order to identify the relationship of health beliefs and prevention behaviour among Greek blood relative individuals diagnosed with glaucoma.

Methods A correlation study using the HBM framework was undertaken.498 Greek subjects of both genders, from two urban and two rural health centres with mean age of 46, 86 ± 13,49 years participated in this study. A 15‐item HBM glaucoma questionnaire in Greek language, with responses recorded on 5‐point Likert scale was used as a reserce tool.Data were analyzed using descriptive statistics.

Results Only 42% of the participants were aware of glaucoma complications and its risk factors. However, few subjects practiced preventive measures because of lack of perceived seriousness of glaucoma and lack of perceived susceptibility to complications. There were statistically significant correlations (p<0.05) between prevention behaviours and perceived severity, susceptibility and barriers, between subject’s education level and perceived severity and susceptibility as well as between subject’s angle closure type of glaucoma and severity. There was no significant correlation between health beliefs and gender, occupation, residence or social security status.

Conclusion Lack of information and education about glaucoma was evidenced. Information generated from this social cognition model could be a useful tool to set future educational programs that address those beliefs, attitudes and behaviours so as to promote preventive health behaviour for glaucoma among the relatives and the general population.
Intraocular pressure and associated factors: the central India eye and medical study
Authors: BEUTELSPACHER SC , JONAS JB , NANGIA V , MATIN A , SINHA A , KULKARNI M , BHOJWANI K
Published: November 2010

Purpose To determine intraocular pressure (IOP) range in a rural Indian population and to evaluate existing and identify potential new ocular, medical, and socioeconomic factors associated with IOP.

Methods This is a population‐based study performed in Nagpur in Central India. Single IOP measurement was taken using Goldmann applanation tonometry and population IOP was described using standard descriptive statistics.Over 200 independent variables were entered into logistic regression analysis and variables with significant P‐values (P<0.05) were entered into a multivariable logistic regression analysis.

Results Of 5885 eligible subjects, 9338 eyes of 4686 subjects were included in the study. Mean IOP was 13.6±3.4 mmHg. In multivariate regression analysis, the following factors, with coefficients of determination and P‐values reported in parentesis, were found to be associated with IOP. Ocular factors included higher corneal power (0.12;P=0.004), lower central corneal thickness (0.02;P<0.001), and higher myopic refractive power (‐0.13;P=0.001). Medical factors included diastolic blood pressure (0.05;P<0.001), pulse rate (0.02;P=0.005), and body mass index (0.05;P=0.01).

Conclusion Low mean IOP was found when compared to other epidemiologic studies and this may be explained by the low central corneal thickness found in the study population. Several known ocular and medical factors as well as new socioeconomic factors were found to be associated IOP. Identifying risk factors associated with IOP in different populations may allow clinicians to better define and recognize subgroups of patients at risk for elevated IOP. Newly identified socioeconomic‐IOP associations will need to be validated.
Evaluation of the ICareTM‐one rebound tonometer as a self measuring intraocular pressure device
Authors: MOUSTAKA L , STERGIOPOULOS G , AMARIOTAKIS G , PEPONIS V , PAROIKAKIS E , MITROPOULOS P , PATSEA L , HALKIADAKIS I
Published: November 2010

Purpose To investigate whether the ICare one rebound tonometer (ICRBT) can provide accurate measurements of intraocular pressure (IOP) in the hands of an inexperienced user and to compare ICare measurements with Goldman tonometry (GAT).

Methods A trained examiner instructed each of 60 normal subjects on use of the ICRBT. Each subject then measured his/her own pressure using the ICRBT. Finally, a different examiner, who was masked to the earlier readings, measured IOP by GAT.

Results All of the subjects were able to obtain accurate measurements with ICRBT after three attempts. Mean intraocular pressures (IOPs +/‐ SD) obtained using the two instruments were GAT 16.5 +/‐ 3.7 mmHg; and ICRBT 17.9 +/‐ 3.6 mmHg. The 95% LoA for ICRBT‐GAT were from ‐2,5 to +5.7 mmHg

Conclusion The ICRBT was accurate and reliable in the hands of normal subjects and may be used for self monitoring of IOP.
Mathematical model for biomechanical estimation of the data obtained in ophthalmologic procedures based on the application of a static load to the human eye.
Authors: MOISEEVA IN , LYUBIMOV GA , STEIN AA
Published: November 2010

Purpose To develop a mathematical model that makes it possible to analyze the interaction of various mechanical factors involved in the intraocular pressure formation and to apply it to processing the results of ophthalmologic procedures based on static load application.

Methods The mathematical model that represents the eyeball as an elastic water‐filled shell is constructed. The intraocular volume is regulated by a dynamic balance between the liquid inflow (aqueous humor secretion) and outflow (drainage from the eye through the trabecular meshwork and the uveoscleral pathways) and assumed to be a function of the intraocular pressure and the elastic and geometric characteristics of the system. The effect of the hydrodynamic conditions in the blood vessels and osmotic pressure differences is taken into account.

Results The model was tested, using clinical measurement data, for different hypotheses concerning the dependence of the outflow and inflow resistances on the intraocular pressure, the effect of the plasma proteins on the intraocular pressure formation, etc. Applying the model to processing standard clinical tests, we can obtain an additional parameter characterizing the aqueous humor dynamics.

Conclusion The model developed is a useful tool for analyzing, by comparing with experimental data, a possible role of different mechanisms in mass transfer processes in the eye. In particular, the hydrodynamic in‐ and outflow characteristics can be estimated from the change with time of the tonometric pressure under an applied load. The general form of the model makes it possible to take, if necessary, additional effects into account.
Corneal biomechanical properties associated with glaucoma damage.
Authors: DEL BUEY MA , CRISTOBAL BESCOS JA , ASCASO FJ , LAVILLA L , CASAS P , CRUZ N , RAMIRO P
Published: November 2010

Purpose We measured the impact of corneal hysteresis (CH), a measure of viscous damping in the cornea, and corneal resistance factor (CRF), highly correlated with central corneal thickness (CCT), to determine the effect of the glaucoma damage on these two parameters.

Methods 130 eyes of 65 adult patients were classified into two groups (control group and glaucoma group). Measurements of CH and CRF on the Reichert Ocular Response Analyzer, and measurements of CCT by ultrasonic pachymetry were made. In the glaucoma group we reviewed the chart to determine highest known intraocular pressure (IOP), target IOP, diagnosis, years with glaucoma, cup‐to‐disk ratio (CDR), mean defect (MD), and presence or absence of visual field progression. Statistical analysis was performed using SPSS 15.0 for Windows.

Results Control group (56 eyes): The mean age was 43.29 years (SD 15.35), 26 were male. Glaucoma group (74 eyes): All eyes had a diagnosis of primary open angle glaucoma. The mean age was 56.38 years (SD 13.49), 40 were male. The mean hysteresis in normal eyes was 11.15 (SD 1.37) while in glaucomatous population was 9.71 (SD 1.89). A lower corneal hysteresis value (P<0.05) was associated with glaucomatous eyes with visual field progression, which causes a change in the measured compensated intraocular pressure. No effect on CRF was observed.

Conclusion The biomechanical properties of the cornea are modified according to the pathology. CH is significantly higher in the normal group than in the glaucoma group. In glaucoma group lower CH was associated with progressive field worsening. We found no effect of progressive field worsening on the CRF.
Correlation between visual field index and ganglion cell complex parameters, global loss volume and focal loss volume, measured by RTVueTM OCT: interim analysis
Authors: HAUTENAUVEN F , JANSSEN X , POURJAVAN S
Published: November 2010

Purpose To evaluate the correlation between visual field index (VFI%) and ganglion cell complex (GCC) parameters: global loss volume (GLV%) and focal loss volume (FLV%) in glaucomatous patients.

Methods Prospective study including both eyes of 31 glaucomatous patients with a repeatable abnormal Standard Automated Perimetry (SAP) and a local visual field defect in at least one eye. Visual field (VF) examination was performed using Humphrey SAP. OCT imaging was obtained by an experienced technician and using RTVue Spectral Domain OCT. VFI% from VF examination and GLV% and FLV% from RTVue OCT were taken into account for further statistical analysis. Pearson correlation coefficient was used to assess the correlation between different parameter.

Results The mean age was 56 ± 14 yrs. Only 49 of the total 62 visual fields showed reliable and repeatable defect with an abnormal GHT (Abn VF). These VF were taken into account for the correlation test. The remainders (NL VF) were used as controls. The mean VFI% in Abn VF was 79.8 ± 21%. The mean of GLV% was 6.0 ±4.1 and the mean of FLV % was 19.6±11. The Pearson correlation showed no correlation between VFI% and GLV% (p=0.07). There was a correlation between VFI% and FLV% (p<0.01).

Conclusion To date, in this interim analysis, we found only a correlation between VFI% and FLV%. It might refer that FLV parameter is more influenced by the focal defect in the VF.
Refractory glaucoma secondary to iridocorneal syndrome treated with drainage implant
Authors: JIMENEZ DEL RIO B , IBANEZ ALPERTE J , MATEO OROBIA A , PEREZ GARCIA D , ASCASO PUYUELO FJ , LORAS ALEGRE E , CRISTOBAL BESCOS JA
Published: November 2010

Purpose The iridocorneal endothelial (ICE) syndrome is a rare proliferative corneal endotheliopathy of unknown etiology. Common manifestations include corneal edema,iris stromal abnormalities, peripheral anterior synechiae and glaucoma, which does not usually respond to medical treatment. We want to know what is the most successful surgical practice for the control of intraocular presure (IOP) in these patients.

Methods We presents a case of man of 27 years with ocular hypertension in the right eye (RE) difficult to control for 6 months. AV 8/10 in his RE. Iris atrophy with corectopia, uveal ectropion and peripheral anterior synechiae were observed in RE. Abnormalities of angle and endothelial disruption without corneal edema led to a diagnosis of ICE syndrome. We performed an Ahmed valve implant in that eye. Two months after surgery the IOP remains controlled with topical beta‐blocker.

Results The ICE syndrome is usually unilateral disorder that can develop glaucoma resistant to medical treatment. There is a lack of consensus on the surgical technique of choice. It is described a higher survival rate of valve implants on trabeculectomy at 3 and 5 years as well as higher rates of failure than other glaucoma, due to endothelialization of the fistula. The use of Mitomycin would be indicated in these cases.

Conclusion When is not possible to perform a classical filtering surgery due to angle morphological characteristics, the placement of a valve implant should be considered.
Functional and hemodynamic parameters in glaucoma patients after trabeculectomy
Authors: KAZARYAN AA , MARTINOVA LV , DOYNICHENKO NA
Published: November 2010

Purpose To study a correlation of hemodynamic and electroretinography (ERG) parameters in patients with primary open angle glaucoma (POAG) before and after trabeculectomy.

Methods 29 patients (32 eyes) with early, advanced and late stages of POAG were tested prior to surgery and at 2 months after trabeculectomy. Standard ERG methods and chromatic macular ERG were used. Ocular hemodynamics were evaluated by colour Doppler sonography. Peak systolic velocities (PSV), end‐diastolic velocities (EDV), and resistive indices (RI) of the ophthalmic artery, central retinal artery (CRA) and short posterior ciliary arteries (SPCA) were obtained.

Results After surgery reduction of IOP (62.7%, p≤0.001) revealed a significant increase of amplitude values of OPs and macular ERG (p≤0.05). In early and late stages of POAG there were no significant differences in ocular blood flow parameters before and after trabeculectomy. In advanced stage the PSV and EDV in CRA were increased (p≤0.05). We found a correlation between macular ERG to red stimuli, OPs and blood flow parameters in CRA and SPCA before trabeculectomy. After surgery statistics revealed a correlation only between OPs and PSV in CRA.

Conclusion The functional changes of macular area and inner retina are more common in patients with simultaneous decrease of PSV and EDV in CRA and SPCA. Retinal bioelectric activity in early and advanced stages of POAG is IOP‐dependent, and can be partially restored after IOP reduction. In contrast to ERG, the retinal blood parameters are relatively constant before and after short period of trabeculectomy.
Homocysteine concentration in the aqueous and plasma of patients with exfoliative glaucoma and primary open‐angle glaucoma
Authors: KALTSOS K , MIKROPOULOS D , NASR M , KOLIAKOS G , ZIAKAS N , KONSTAS AGP
Published: November 2010

Purpose To compare the mean homocysteine concentration in aqueous humor and plasma in patients with exfoliation syndrome (XFS), exfoliative glaucoma (XFG), primary open‐angle glaucoma (POAG) and normal controls and to evaluate the role of this biochemical index in the management of glaucoma

Methods Aqueous and blood samples were collected from 30 subjects with XFS, 30 subjects with XFG 30 subjects with POAG and 48 individuals with senile cataract who underwent routine phacoemulsification surgery. The mean homocysteine concentration was determined with the enzyme immunoassay method Axis® FHCY 100

Results The mean concentration of homocysteine was significantly higher in XFG patients in both aqueous (2,89±0,82 μmol/l) and plasma samples (17,51±6,08 μmol/l) compared with normal controls (1,87±0,47 μmol/l in the aqueous and 13,04±3,37 μmol/l in the plasma respectively). Patients with POAG exhibited higher mean homocysteine concentration both in aqueous (2,29±0,43μmol/l) and plasma samples (19,17±2,80 μmol/l) compared with normal controls. No significant differences were detected in homocysteine levels between XFS subjects and normal controls in the aqueous (1,98±0,48 μmol/l), or plasma (14,52±5,47 μmol/l). However, a significantly higher level of homocysteine was detected in the aqueous and plasma of those with XFG compared with the XFS group (<0.05). Hypehomocystenemia was present in 93,3% (28/30) of POAG samples, in 70% (21/30) of XFG samples, in 40% (12/30) of XFS samples, and in 27,1% (13/48) of normal control samples.

Conclusion The study confirms a significantly higher homocysteine level in XFG and POAG, which may represent a modifiable risk factor in the future.
DHA administration protects antioxidant defenses in human retinal pigmented epithelial cells in high concentration glucose
Authors: ARNAL E , JOHNSEN‐SORIANO S , ROMERO FJ
Published: November 2010

Purpose Diabetic retinopathy is a leading cause of visual loss and increased nitric oxide (NO) has been correlated with that. The aim of this study was to evaluate protective properties of Docosahexaenoic acid (DHA) at retinal pigment epithelial (RPE) cells exposed to high glucose concentration.

Methods ARPE‐19 were cultured 4 days with normal blood glucose concentration (5,5 mM D‐glucose), followed by exposure to either normal (5,5 mM) or high (45 mM) concentration of D‐glucose during the next 5 days and DHA was added to the culture medium. Four different study groups were obtained: control group (5,5mM D‐glucose) (C), control+DHA group(5,5 mM D‐glucose+6,7 uM DHA)(CDHA), glucose group (45 mM D‐glucose)(G) and glucose+DHA group (45 mM D‐glucose+ 6,7 uM DHA)(GDHA). At the end of the experiment cells were washed, sonicated and lysed and the homogenates criopreserved. The total antioxidant capacity was measured with a commercial kit (Antioxidant Assay Kit, Cayman) and to measured the total nitrites a commercial kit was used (Parameter, Total Nitrite, R&D Systems).

Results Antioxidant capacity in Ggroup was decreased significantly (0.97±0.10 mM/mg prot) when compared with the Cgroup (1.52±0.09 mM/mg prot). DHA administration reversed this alteration to normal values in the GDHA group (1.41 ± 0.16 mM/mg prot, p< 0.05 vs control). The total nitrites were significantly elevated in Ggroup (1.09±0.35 umol/L/mg prot) when compared to the Cgroup (0.53±0.08 umol/L/mg prot) and DHA administration reversed this alteration to normal values (0.49±0.12 umol/L/mg prot, p< 0.05 vs G).

Conclusion DHA might be useful in protecting diabetic retina, though further studies are needed to better understand this mechanisms.
Lutein bioavailability is matrix‐dependent in powdered dietary supplements
Authors: SCHALCH W , BECK M , ROOS F , ELLIOTT J , ROBERTS R
Published: November 2010

Purpose Lutein (L) and zeaxanthin (Z) are the principal constituents of the macula lutea and have been associated with a reduction of risk for retinal diseases as well as improvements in visual function. Intake of L has also been reported to increase macular pigment levels, which are dependent on the bioavailability of the L source. External factors such as matrix composition and delivery system have a major impact on L absorption. A preliminary study in rats had indicated significant differences between the bioavailability of L formulated employing an alginate coating versus L embedded in a corn starch matrix. In order to evaluate these differences in humans, this comparative PK study was undertaken.

Methods After a baseline period of 3 days, individual plasma responses to single doses of 20 mg unesterified L from product A or B were recorded in a randomized, double‐blind, two‐phase, cross‐over study enrolling 48 volunteers and conducted over 4 weeks for each cross‐over phase. Lutein plasma concentrations were determined by HPLC. Main PK parameters evaluated included the area under the curve, cmax, tmax, and elimination half‐time.

Results A preliminary and blinded analysis showed striking differences, even though only the data of the first 7 out of the enrolled 48 subjects were available at the time of abstract submission. While the plasma level increase was minor with product A, product B almost doubled plasma concentrations on average (p<0.05). One of the seven subjects was a non‐responder to either product, but was still included in this initial analysis.

Conclusion The drastic differences in apparent bioavailability between the two L forms emphasize the importance of matrix characteristics for the bioavailability of xanthophylls such as lutein.

Commercial interest
Differential effect of ischemia, hypoxia, hyperglycaemia and hypoglycaemia on the rat retinal neurotransmittion
Authors: VASILAKI A , GRIVAS V , SOURLAS V , PAPAGEORGIOU E
Published: November 2010

Purpose The time‐dependent effects of glucose and oxygen alterations on retinal neurotransmission, are not fully understood. The purpose of this study was to investigate ex vivo the influence of ischemia, hypoxia, hyper‐ and hypo‐glycaemia on the excitatory and inhibitory rat retinal neurotransmission during the first 70min after an initial insult.

Methods For this purpose, 3H‐D‐Aspartate and 3H‐GABA release as well as choline acetyl‐transferase immunoreactivity (ChAT‐IR) were studied under ischemic (glucose to sucrose replacement and 95%N2/5%CO2 buffering), hypoxic (95%N2/5%CO2 buffering), hypoglycaemic (glucose to sucrose replacement) and hyperglycaemic (30mM glucose) conditions, using an ex vivo rat retinal superfusion system.

Results Compared to normoxic conditions: i) ischemia led to an initial decrease of 3H‐D‐Aspartate release followed ~30min later by a delayed increase that was concurrent with an increase of 3H‐GABA release, ii) hypoxia led to a decrease of 3H‐D‐Aspartate release 8min after the initial insult, followed 20min later by a decrease of 3H‐GABA release, iii) hyperglycaemia led to a brief initial decrease of 3H‐D‐Aspartate release while, iv) hypoglycaemia led to a delayed increase of 3H‐GABA release followed by an increase of 3H‐D‐Aspartate release. ChAT‐IR in INL and GCL layers was minimally affected under hypoxic conditions; it was diminished under either hypoglycaemic or hyperglycaemic conditions, while it was abolished under ischemic conditions.

Conclusion Hypoxia decreases retinal neurotransmission. Glutamatergic excitotoxicity is induced primarily under ischemia and to a lesser degree under hypoglycaemia. The GABA‐release compensatory mechanism is more prominent under ex vivo ischemia.
In vitro evaluation of apoptic effects of single and combined use of alpha tocopherol and current antifıbrotics, in human Tenon’s fibroblast and endothelial cells
Authors: ENGIN KN , YEMISCI B , ERDEM S
Published: November 2010

Purpose Mitomycin‐C, 5‐FU and Paclitaxel are current antifibrotics used to prevent fibrocellular scar formation in ophthalmic surgery but, their side effects on endothelium limits their use. Aside from its antioxidant effects, a‐tocopherol is known to be a neuromediator not only prevents tenon’s fibroblast proliferation, but effects similar pathways with those of other antifibrotics as well. In this study, apoptotic effects of a‐tocopherol and other antifibrotics ‐in concordant doses with their in vivo uses, on human tenon’s fibroblast and endothelial cells were examined in vitro in various combinations.

Methods Effects of antifibrotic agents Paclitaxel, Mitomycin, 5‐FU and a‐tocopherol in primary human tenon’s fibroblast and ECV304 human umblical vein endothelial cell cultures were evaluated in single applications and in combination with a‐tocopherol. Apoptotic (AI) Mitotic indexes (MI)were evaluated. Apoptotic cells were demonstrated immunohistochemically in preperates stained with peroxidase labeled Caspace3, bcl‐2/ bax gene expressions were evaluated with Reverse Transcriptase‐PCR. Apoptosis/Necrosis ratios were evaluated with Annexin/PI.

Results Mitomycin and especially Paclitaxel groups demonstrated a significant AI increase, which were found to be augmented by a‐tocopherol addition, except for a reverse effect for 5‐FU in endothelial cells. Either bcl‐2/bax ratio decrease, or Caspase activity were found only in Mitomycin group. Annexin/PI ratios were also concordant with those results.

Conclusion Single uses of 5‐FU and a‐tocopherol have been found to be safe but less effective. Their combination is found to increase both safety and efficiency.
Vasomotor effect of intravitreal juxta‐arteriolar injection of L‐lactate on the retinal arterioles following acute branch retinal vein occlusion in minipigs
Authors: MENDRINOS E , PETROPOULOS I , MANGIORIS G , TSILIMBARIS MK , PAPADOPOULOU DN , GEKA A , POURNARAS CJ
Published: November 2010

Purpose After branch retinal vein occlusion (BRVO), the retinal territory affected by the occlusion becomes hypoxic and the arterioles crossing this territory are often constricted. The purpose of the current experimental animal study is to investigate the effect of intravitreal juxta‐arteriolar microinjection of L‐lactate on the retinal arteriolar diameter following acute BRVO in minipigs.

Methods Under general anesthesia, 9 eyes of 9 minipigs were evaluated. Argon laser endo‐photocoagulation was used to create BRVO. Two hours after BRVO, an intravitreal juxta‐arteriolar microinjection of 50 µl L‐lacate 1 mM (pH=7.4) was performed. The procedure was recorded in real time and retinal arteriolar diameter changes were measured in vivo using a Retinal Vessel Analyzer.

Results Two hours after BRVO, the retinal arteriolar diameter decreased from 210 ± 16 AU to 183 ± 14 AU in the affected territories (p=0.04). Five minutes following L‐lactate juxta‐arteriolar microinjection, the retinal arteriolar diameter increased to 241 ± 16 AU (p< 0.01). The vasodilatory effect of L‐lactate persisted and remained significant till the end of the study period (243 ± 15 AU at 30 min, p<0.01).

Conclusion We measured a significant vasodilation after intravitreal juxta‐arteriolar L‐lactate microinjection in eyes with experimental BRVO. L‐lactate microinjection can be of potential interest in acute BRVO, reversing the arteriolar vasoconstriction, thus leading to increase of the retinal arteriolar blood flow and possibly to improvement of the retinal cellular function in the occluded territory.
Osmolarity of tears in eyes affected by recurrent herpetic stromal keratitis
Authors: MGARRECH M , SAUER A , KASWIN G , GENDRON G , DE MONCHY I , POGORZALEK N , BOURCIER T , LABETOULLE M
Published: November 2010

Purpose To assess the osmolarity of tears in eyes affected by recurrent herpetic stromal keratitis.

Methods All the patients referred for a recurrent unilateral stromal keratitis infection by either Herpes simplex virus (VZV) or varicella‐zoster virus (VZV). All the patients have been finally tested for dry eye conditions when all clinical signs of ongoing keratitis had resolved. The osmolority was assessed using the TearLab® and then the corneal sensitivity was tested with the Cochet‐Bonnet esthesiometer (Luneau™). Values were compared using non‐parametric tests, and statistical significance was defined as p<0.05 (2‐tailed).

Results Fifteen patients (mean age: 57 years +/‐ 11) were consecutively included in the study. The corneal sensitivity was strongly reduced in the affected side (9g/mm2 +/‐ 3.8) compared to the non‐affected side (0.55g/mm2 +/‐ 0.09, p=0.001). There was a trend (p=0.15) for a lower osmolarity in the affected eye (317.3 mosm/l +/‐ 6.2) compared to the non‐affected eye (321.2 mosm/l +/‐ 9.8), but the difference was not significant due to some affected eyes with high values of osmolarity. Indeed, we observed a relationship (p=0.1 for correlation test) between the loss of corneal sensitivity and the modification of tear osmolarity, with relative hypo‐osmolarity when corneal hyposesthesia was moderate and relative hyperosmolarity when corneal aesthesia was severly impaired.

Conclusion This study suggests that recurrent stromal herpetic keratitis induces first an increase of tears production, as showed by hypo‐osmolarity with moderate relative hypoesthesia, and then a reduction of tears production when corneal sensitivity decreases below a threshold that remains to be more precisely defined.
Two cases of ocular sarcoidosis in which vitreous cytology was useful for supporting diagnosis
Authors: OGATA N , MATSUOKA M , ADACHI Y , NISHIMURA T
Published: November 2010

Purpose To report two cases of uveitis who are lacking the systemic signs were confirmed to be ocular sarcoidosis by vitreous cytology.

Methods Case 1 was a 56‐year‐old man who was referred with blurred vision, and was found to have iridocyclitis, vitreous opacities, and papilledema bilaterally. He received pulsed corticosteroid therapy, however, the vitreous opacities and papilledema were not resolved. The second case was a 77‐year‐old man referred with blurred vision, and both eyes had snowball‐like vitreous opacities and optic nerve papilledema. The ocular findings in both cases strongly suggested sarcoidosis, however the systemic findings did not meet the diagnostic criteria of sarcoidosis. We performed pars plana vitrectomy (PPV) to remove the vitreous opacities, and collected all of the diluted vitreous during PPV and submitted for cytological analyses.

Results Epithelioid cells and multinucleated giant cells, cells pathognomonic of sarcoidosis, were found in the vitreous samples which allowed us to make a diagnosis of sarcoidosis.

Conclusion Vitreous cytology can help in making a diagnosis of ocular sarcoidosis especially in cases of ocular inflammations suggesting sarcoidosis but systemic findings that do not satisfy the diagnostic criteria.
Role of fundus autofluorescence as a inflammatory diagnosis tool in serpiginous choroidopathy
Authors: PORTERO A , CARRENO E , HERRERAS JM , LOPEZ MI , GARCIA C , VALVERDE C , SALA A , VICENTE TIERNO N
Published: November 2010

Purpose Serpiginous choroidopathy (SC) is a severe, progressive, bilateral inflammatory disease which produces a serious visual impairment.The most used tool to determine the activity status is fluorescence angiography (FA), but fundus autofluorescence (FAF) has been proposed as an alternative test. The aim of this study is to correlate the activity status disclosed in FA and FAF, and the variations of FAF images in the evolution of the disease.

Methods Prospective consecutive case series. Patients with SC or serpiginous‐like lesions of the Ocular Immunology Unit of our hospital were included from July 2009 to July 2010. All patients underwent FAF (Spaide Autofluorescence Filters, Topcon TRC 50IX) and FA (Topcon TRC 50IX). The correlation between FAF and FA and the behaviour of the lesions according with FAF patterns was evaluated by two independent observers

Results Nine patients with SC or serpiginous‐like lesions were included. Both eyes were involved in 7 cases. There was a positive correlation between FAF and FA, and also a positive correlation between observers. Attending to the behaviour of the lesions, 3 different patterns of FAF images in SC can be described: Active Inflammatory Status, Inactive Inflammatory Status and Transitional Status.

Conclusion FAF may be used as an useful tool for following up patients with SC. It is possible to keep other invasive techniques, such as FA, for cases with suspicious activity disclosed in FAF.
The association between high‐sensitive c‐reactive protein and retinal hemodynamics in type 1 diabetes patients with non‐proliferative diabetic retinopathy
Authors: PEMP B , GARHOFER G , LASTA M , SCHMIDL D , SCHMETTERER L
Published: November 2010

Purpose There is evidence that low‐grade inflammatory processes play a role in the pathogenesis of microvascular complications in diabetes mellitus. In addition, various studies have shown that retinal vascular reactivity is reduced in diabetes, whereas retinal leukocyte velocity is increased. The aim of the present study was to investigate correlations between levels of the inflammation biomarker C‐reactive protein (CRP) and measures of retinal vascular function and perfusion in type 1 diabetes patients with non‐proliferative diabetic retinopathy.

Methods 25 type 1 diabetes patients with non‐proliferative diabetic retinopathy were included in this cross‐sectional study. Blood samples were collected to measure glucose, HbA1C and blood cell count. Serum CRP was determined by high sensitivity enzyme immunoassay. The reaction of retinal vessel diameters to flickering light was measured using the Retinal Vessel Analyzer. Perifoveal leucocyte blood flow was assessed using the blue‐field entoptic technique.

Results Elevated CRP was found in 12 patients. There was no correlation found between white blood cell velocity or flow and CRP. Flicker‐induced vasodilatation also showed no correlation with CRP levels. However, reactivity of retinal veins was negatively correlated to HbA1C (r = ‐0.4, p = 0.049).

Conclusion The results indicate that in our sample of type 1 diabetes patients with diagnosed non‐proliferative retinopathy, serum levels of CRP, a biomarker for inflammation, are not associated with perifoveal leukocyte blood flow or with retinal vessel reactivity. Further investigations are necessary in larger patient groups and with additional inflammatory markers.
Method for distinguishing small retinal hemorrhages from dust artifacts using HLS color space
Authors: SUZUKI N , YAMANE K
Published: November 2010

Purpose Many ophthalmologists consider it is difficult to distinguish the small retinal hemorrhages of early diabetic retinopathy from dust artifacts on fundus cameras. To distinguish these, we analyzed the HLS color spaces for both findings.

Methods Five patients with diabetic retinopathy had photographs of their fundi taken. Paint Shop Pro v. 8.0 was used to measure HLS color spaces of both hemorrhagic area and the area around hemorrhage in two locations of the photograph. In the darkroom, the experimental devise had four kinds of color papers on its ceiling: red, yellow, brown and black. Ten fragments of house dust on magnifier were each photographed using flash with each color paper. Three kinds of color lighting bulbs were hung from the ceiling without color papers. The ten fragments of house dust on the camera’s object lens were photographed under each color lighting bulb. Paint Shop Pro 8.0 was used to measure the HLS color spaces of dust artifact and the area around the dust artifact.

Results The evaluation space of house dust was calculated using the HLS data obtained from magnifier. The hue was red, −116.6±33.1; black, 52.6±24.8; and yellow, 16.9±4.1. The lightness was black, −24.0±5.1; red, −14.5±2.0; brown, −11.5±2.4; and yellow, −8.3±1.4. The saturation was black, −163.8±84.5 and yellow, 45.6±21.6. The evaluation space of house dust was calculated using the HLS data obtained from the camera’s object lens. The hue was yellow, 7.9±1.7 and red, −3.3±1.4. The lightness was yellow, 10.0±2.3; red, 6.4±1.5; and brown, 5.7±2.6.

Conclusion The lightness of the HLS color space could help to distinguish dust from hemorrhage in all color spectra. However, hue and saturation could only distinguish dust from hemorrhage in some conditions.
Comparative in vitro activity of fluoroquinolones against ocular coagulase‐negative Staphylococcus species: a four‐year study
Authors: CHATZIRALLI I , KANONIDOU E , KANONIDOU C , PAPAZISIS L
Published: November 2010

Purpose The aim of our study was to examine the frequency of gram‐positive isolates from samples taken from patients with keratitis and endophalmitis and the in vitro susceptibility profiles of second‐ (ciprofloxacin), third‐ (levofloxacin) and fourth‐generation fluoroquinolones (moxifloxacin) against the most common of them (coagulase‐negative Staphylococcus species‐CoNs) from 2005 to 2009.

Methods A retrospective audit of the medical records of patients treated for keratitis and endophalmitis in the Department of Ophthalmology, Veroia General Hospital during 2005‐2009 was carried out. Adequate specimens (cornea scrapings, and intraocular fluids) were collected prior to any antibacterial therapy. The minimum inhibitory concentrations for individual isolates were determined by Vitek 2 (Biomerieux, France).

Results Out of 73 ocular isolates for all years of study, 49 (67,12%) were gram‐positive (Staphylococcus spp., Streptococcus spp., Bacillus spp.). CoNs were the most common gram‐positive isolates (n=31, 63,26%). From 2005 to 2008, 100% of CoNs isolates were susceptible to all fluoroquinolones tested. In 2009, both second‐ (ciprofloxacin) and third‐generation fluoroquinolones (levofloxacin) provided coverage for 60% of them. All CoNs ocular pathogens were susceptible to fourth‐generation fluoroquinolones (moxifloxacin) during the study period.

Conclusion CoNs were the most prevalent gram‐positive pathogens identified in keratitis and endophthalmitis cases from 2005 to 2009. No significant change in the frequency of their isolation among the years was observed. The in‐vitro potency of second and third generation fluoroquinolones against CoNs was decreased during the last year of study.
Factors influencing donor cornea utilization in a tertiary care centre: results from 5‐year data
Authors: SANKARAN P , TANDON R
Published: November 2010

Purpose To evaluate utilization of corneal tissue procured by the eye bank of a tertiary care centre in north India, to determine factors that were responsible for labeling corneas unsuitable for transplantation, and to identify methods to improve donor tissue utilization.

Methods We retrospectively reviewed records from our eye bank from May 2005 to April 2010. We compared donor demographics, death‐ enucleation interval, and biologic contamination of utilized and non‐ utilized corneal tissues.

Results 3951 corneas were received during the study period. Of these, 2561 donor corneas (65%) were used for surgical purposes. Of the 1390 corneas not utilized for transplantation, 703 corneas (50.6%) were excluded due to poor tissue quality. Other causes were logistical reasons, such as no suitable recipient, in 267 (19.2%), bacterial growth on culture in128 (9.2%), contraindication in the donor’s medical history in 102(7.3%), and serological results in 83(6%). Mean age of donors in the utilized cornea group was 58.9 years (± 21.57 years) as compared to 67.52 years (± 19.82 years) in the non‐utilized cornea group. The difference was statistically significant (P=0.000). Mean death‐enucleation interval was comparable in the 2 groups (5.38 hours versus 4.62 hours; P=0.54).

Conclusion Increase in age of donors results in poorer tissue quality and emerges as a significant factor in non–utilization of donor corneas for transplantation.
Visual phenotyping at the “Institut Clinique de la Souris”
Authors: ROUX MJ , LUX A , KUBALA E , MEZIANE H
Published: November 2010

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

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

Results To illustrate the possibilities offered by the MCI visual phenotyping platform, we will present results obtained from various projects, as well as the validation of electroretinography protocols to follow dark adaptation and the effect of acute drug injections.

Conclusion In an environment allowing for an in depth phenotyping, from behavior to biochemistry, metabolism and cardiology, the MCI visual phenotyping platform provides a comprehensive set of tests to get the most out of genetically modified mice.
Behçet’s disease
Authors: TUGAL‐TUTKUN I
Published: November 2010

Purpose Patients with Behçet’s disease have recurrent inflammatory attacks in all organ systems involved. Ocular involvement is characterized by nongranulomatous panuveitis and retinal vasculitis with a relapsing and remitting course. The demographic and clinical features of Behçet's uveitis and treatment will be discussed.

Methods Literature review

Results The onset of uveitis is typically in the third or fourth decade of life. Uveitis is more frequent and its course is more severe in male patients. The typical findings of uveitis attacks include anterior chamber cells with or without a hypopyon formation, diffuse vitreous haze, occlusive periphlebitis, retinal infiltrates, and inflammation of the optic disc. In severe attacks, diffuse retinal edema and even a serous retinal detachment may develop. Macular edema is the most common complication. Recurrent attacks lead to permanent loss of useful vision due to optic atrophy, maculopathy, and diffuse atrophy and gliosis of the retina. Fluorescein angiography is the gold standard in monitoring disease activity. Anterior chamber flare measured by laser flare photometry correlates with fluorescein leakage in the posterior segment. Management of Behçet uveitis is based on the rapid control of intraocular inflammation and prevention of recurrences. Corticosteroids are generally used for the treatment of acute attacks. However, patients with posterior segment involvement require long‐term immunomodulatory treatment in order to prevent recurrences. Both azathioprine and cyclosporine have been shown to be effective in controlled trials. Interferon alfa or infliximab is used in resistant cases.

Conclusion Behçets uveitis is resistant to conventional treatment in around 20% of patients. Visual prognosis has improved in recent years with the use of biologic agents
Infectious uveitis (toxoplasmosis, herpes and others)
Authors: KHAIRALLAH M
Published: November 2010

Abstract not provided
Presumed tuberculous uveitis
Authors: ABU EL ASRAR A
Published: November 2010

Abstract not provided
Prediction of metastasis of primary uveal melanoma by the insulin‐like growth factor‐1 receptor
Authors: ALJAMAL R , KIVELÄ T
Published: November 2010

Purpose To study whether immunoreactivity for the insulin‐like growth factor‐1 receptor (IGF‐IRα) independently predicts metastasis of primary uveal melanoma in a consecutive Finnish data set.

Methods Population‐based, retrospective cohort study of 167 choroidal and ciliary body melanomas enucleated from 1972 to 1981 with long‐term survival data. Immunostaining was done by using the avidin‐biotinylated peroxidase complex method, rabbit polyclonal antibodies (N‐20 diluted 1:500) to IGF‐IR and heat pretreatment. Survival was assessed by Cox multivariate regression analysis.

Results The tumour area could be reliably measured from 128 (77%) of the 167 consecutive slides which had a choroidal or ciliary body melanoma. The remaining 39 specimens were technically not satisfactory. No significant associations were observed between IGF‐1R immunopositivity and tumor location (P=0.38), largest basal diameter (LBD) (P=0.62), cell type (P=0.84), tumor pigmentation (P=0.59), presence of tumor‐infiltrating macrophages (P=0.33), mean of the ten largest nucleoli (MLN) (P=0.37), presence of extravascular matrix patterns (P=0.67), and microvascular density (MVD) (P=0.39). Adding IGF‐1R did not improve a multivariate model predicting risk of metastasis from primary ciliary body and choroidal melanoma.

Conclusion The results suggest that immunoreactivity for IGF‐IRα may not independently predict metastasis of primary uveal melanoma. Because old formalin‐fixed, paraffin‐embedded material was studied, partial loss of antigenicity can not be ruled out as a contributing factor.
Multiple evanescent white dot syndrome asociated with neuritis: a case report
Authors: IDOIPE M , GARCIA‐MARTIN E , FUERTES I , FERNANDEZ PEREZ S , PINILLA I , GUERRI MONCLUS N , EGEA ESTOPINAN MC , PRIETO CALVO E , CRUZ N , RUIZ MORENO O
Published: November 2010

Purpose Multiple evanescent white dot syndrome (MEWDS) is included in the “White dots syndroms” group. It is characterized for the presence of small, flat, multifocal, gray‐white lesions ranging in size from 100‐300 µm at external retina or as deep as the retinal pigment epithelium layer. These lesions are found outside the macula in the posterior pole and show a tipical angiography. This disease is self‐limited and treatment is not needed.

Methods CASE REPORT

Results Case report: we report a case of a 28 years old woman with blurred vision in left eye (OS) of acute onset. On examination the best corrected visual acuity OS was 0.8, nor discromatopsy or afferent pupillary defect were present . Visual field was performed, with an enlargement of the blind spot in OS. The anterior segment was unremarkable on slit lamp examination of both eyes. Fundus examination of the left eye revealed multiple yellow white dots scattered around the posterior pole not extending beyond the major vascular arcade. One month latter, visual field was normal, and the white dots have disappeared. The patient have history of 3 anterior neuritis reported in our hospital, with a detailed and exhaustive neurological examination including magnetic resonance imaging, serological test, autoantibodies and spinal tap, with all results in normal limits.

Conclusion MEWDS is a rare entity, of unknown etiology, in which a possible viral origin is postulated that would unleash an immune response. Association with neuritis is not reported. Our patient associates a MEWDS´s case and several of neuritis, what make us think about a common etiopathogenic origin.
Macular pigment measurements
Authors: WOLF S
Published: November 2010

Abstract not provided
The initial consultation: when should non‐organic visual loss be suspected?
Authors: SPILEERS W
Published: November 2010

Purpose When a patient reports visual loss and the doctor can not immediately find the etiology, a non‐organic visual loss has to be excluded.

Methods Different testing methods can be of value in deciding on organic versus non‐organic visual loss: visual acuity and visual field measurements, pupillary reflexes, electrophysiologic testing, imaging techniques, ...

Results The value of these different methods will be discussed and illustrated

Conclusion The investigation of possible non‐organic visual loss is a complex task
The role of electrophysiology
Authors: HOLDER GE
Published: November 2010

Purpose To describe the roles of electrophysiology in patients with medically unexplained visual loss

Methods Standardised full‐field and pattern ERGs and VEPs; additional pattern appearance VEPs to quantify visual system resolution when necessary in patients with suspected non‐organic visual loss.

Results Selected cases will be used to illustrate the roles of electrophysiology. A diagnosis of non‐organic visual loss is confirmed by the demonstration of normal visual system function in the presence of symptoms that suggest otherwise. Patients with optic nerve disease may have a normal fundus appearance, and not all macular dysfunction is associated with an abnormal appearance of the macula; both pattern VEP and pattern ERG are needed in such cases. Further, there are many patients with retinal disease where the fundus appearance may be normal but ERGs are abnormal.

Conclusion Objective functional assessment with electrophysiology is indispensable to the diagnosis and management of patients with medically unexplained visual loss.