bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between IOP and biomechanical corneal values obtained by ORA
Authors: LOPEZ DE LA FUENTE C , SANCHEZ‐CANO A , PINILLA I , FUENTES BROTO L , SEGURA CLAVO F
Published: August 2012

Purpose To evaluate the relationship between intraocular pressure (IOP) measurements and corneal biomechanical parameters obtained with Ocular Response Analyser (ORA) in healthy subjects.

Methods Sixty‐five eyes from 65 healthy subjects were prospective and consecutively selected. All of them underwent a full optometric examination, including central corneal thickness (CCT) and IOP measured with ORA: ORA Goldmann‐corrected IOP (IOPg) and ORA corneal resistance‐corrected IOP (IOPcc). Pearson correlation coefficients between IOP values and corneal biomechanics parameters obtained by ORA were also calculated.

Results IOP parameters, evaluated by Pearson correlation coefficients were significantly correlated with p<0.001; r=0.826 for IOPcc‐IOPg. IOPg was linearly associated with corneal resistance factor (CRF; r=0.619) and with CCT (r=0.579). IOPcc had a linear relationship with CH (r=‐0.482); similar results were obtained with CRF and corneal hysteresis (CH; r=0.841), CRF and CCT (r=0.681) or between CH and CCT (r=0.466).

Conclusion IOPcc and IOPg have a positive linear correlation. ORA biomechanics parameters CRF, CH and CCT show also a linear positive relation between them.
To assess the difference in the corneal biomechanical properties in healthy subjects with and without their contact lenses
Authors: DE FAYS A , POURJAVAN S
Published: August 2012

Purpose To assess the difference in the corneal biomechanical properties in healthy subjects with and without their contact lenses.

Methods The study included one eye of 20 healthy subjects who wear monthly, soft contact lenses for a refractive error. The subjects were asked, not to wear their contact lenses during at least 12 hours. The central corneal thickness was measured at least 30 minutes before other examination using an ultrasonic pachymeter. The corneal biomechanical properties and the intraocular pressure (IOP) were measured by ocular response analyzer (ORA). The measurements were repeated immediately with the contact lenses. A student t‐test was used to assess the difference between the measurements with and without contact lenses.

Results The mean corneal hysteresis without and with contact lenses were 10.88 ± 1.8 mmHg (9.6‐13.7 mmHg) and 10.92 ± 1.7 mmHg (8.5‐13.4 mmHg), respectively (p = 0.16). The mean corneal resistance factor was 9.96 ± 1.7 mmHg (7.9‐12.6 mmHg) without contact lenses compared with 9.95 ± 2.1 mmHg (7.6‐12.3 mmHg) with the contact lenses (p= 0.21) There was no significant difference nor in corneal‐compensated IOP neither in Goldmann‐correlated IOP, with or without the contact lenses.

Conclusion Our results suggest that ORA‐generated parameters are not influenced by the contact lens itself. Further longitudinal studies should be performed to establish the eventual changes of the biomechanical parameters with duration of the contact lens wear.
IOP management in glaucoma/OHT following intravitreal anti‐VEGF injections
Authors: ANSARI E
Published: August 2012

Purpose To determine a protocol for IOP management in glaucoma/OHT cases following intravitreal anti‐VEGF injections

Methods Baseline IOP with Icare tonometry, optic disc assessment and automated perimetry IOP post‐injection at 5, 15, 30 and 60min. Standard injection technique.

Results Mean baseline IOP was 16.92 mmHg (SD 4.98, 95% CI 14.95 to 18.88). Thirty minutes post Apraclonidine 1% administration, mean IOP was 15.71 mmHg (SD 4.58, 95% CI 13.74 to 17.67) Paired Student’s t‐test giving a P value of 0.368 indicated that administration of Apraclonidine 1% prior to intravitreal treatment did not cause a statistically significant IOP reduction in patients with ocular hypertension and glaucoma. Immediately post injection, mean IOP was 41.54mm Hg (SD 14.1, 95% CI 37.20 to 45.88). Paired T test results showing a p value < 0.0001 confirmed a statistically significant difference between baseline and immediate post injection IOP. 13 out of 24 (58%) of the study patients required anterior paracentesis post intravitreal injection according to our devised protocol.

Conclusion The authors propose the use of the formulated paracentesis protocol for intraocular management in patients with ocular hypertension and glaucoma receiving intravitreal anti‐VEGF treatment.
Optic disc torsion direction predicts the location of glaucomatous damage in normal tension glaucoma patients with myopia
Authors: LEE K
Published: August 2012

Purpose To characterize optic disc tilt and torsion in normal tension glaucoma(NTG) patients with myopia and evaluate the relationship between optic disc tilt and torsion with the location of visual field(VF) defect

Methods Patients were divided into myopic NTG group (spherical equivalent(SE)≥‐2.0 diopters(D) or axial length(AL)≥24.0 mm) and non‐myopic NTG group (SE<‐0.5 D or AL<24.0 mm). Disc tilt, torsion, and area of peripapillary atrophy(PPA) were measured from disc photographs. Patients were further divided into superior and inferior defect groups according to the location of the VF defect in the pattern deviation map. Logistic regression analysis was used to determine the relationship between tilt ratio, torsion degree, and the VF defect location.

Results Among 225 NTG eyes, 166(73.8%) were myopic eyes. The myopic NTG group was significantly younger(42.85 years) than the non‐myopic NTG group(60.73 years). Disc tilt(45.8%) and torsion(75.9%) were significantly more prevalent in the myopic NTG group. PPA area was larger in the myopic NTG group(P=0.057). VF defect location was significantly different between the two groups, with superior defects more prevalent in the myopic NTG group(69.9%, P<0.001). Torsion degree was significantly different in the superior defect group(18.45 degrees) compared to the inferior defect group(‐3.81 degrees, P = 0.001). Torsion degree was the only factor related to VF defect location in both univariate(P=0.001) and multivariate logistic regression(P=0.014) analysis.

Conclusion Korean NTG patients had a high prevalence of myopia and young age. Optic disc tilt and torsion were highly prevalent in Korean NTG patients with myopia. The direction of the optic disc torsion may predict the location of damage.
Structure–function relationship: assessment of macular ganglion cell complex with FD‐OCT and standard automated perimetry
Authors: EL CHEHAB H , GIRAUD JM , FENOLLAND J , FRANCOZ M , SENDON D , EL ASRI F , MESSAOUDI R , DOT C , MAY F , RENARD JP
Published: August 2012

Purpose This study aims to evaluate relationship might exist between new indices of structural damage provided by FD‐OCT which analyses macular ganglion cell complex (mGCC) and functional indices collected in standard automated perimetry (SAP).

Methods 102 eyes (56 PAOG and 46 control) benefited a SAP(Humphrey SITA‐Standard 24.2, Carl Zeiss Meditec) and an FD‐OCT imaging (RTVue 100, macular grid of 7*7mm, Optovue Inc.). We analyse: MD, PSD and VFI for functional analysis, and focal and global losses (FLV and GLV) of mGCC for macular mapping. Statistical regression analysis was used to assess possible structure‐function relationship.

Results Glaucoma (66.2±3.5y) results report: MD:‐6.25±1.46dB, PSD:5.9±1.1dB, VFI:84±4.7%, FLV:4.84±1.26% and GLV:19.2±2.7%. Controls (61.6±4y) results were: MD:0.36±0.22dB, PSD:1.6 ± 0.1dB, VFI:99±0.5%, FLV:2.04±0.59 and GLV:9.8±2.3%. Structural damage and functional impairment indices may be correlated by linear regression. Correlation is higher in glaucoma group. Strongest relation is between PSD and FLV with determination coefficient (r ²) of 0,63.

Conclusion This study evaluates the possible relationship between new structural and functional parameters in 2 age‐matched groups. Linear correlation, greater in glaucoma group, emphasizes a structure‐function relationship with a highest determination coefficient of 0,63. This correlation is between focal indices of structural and functional damage (PSD and FLV). New FD‐OCT parameters of mGCC provided us a better understanding of glaucoma structural damage. Assessment of structure‐function relationship is improved and we find a higher correlation between focal indices.
Retinal pigmentepithelium (rpe) alterations correspond to retinal nerve fiber layer (rnfl) degeneration in glaucoma
Authors: KERNT M , HUEBERT I , MANN T , NEUBAUER A , HIRNEISS C
Published: August 2012

Purpose A close interaction between neurosensory retina and the retinal pigmentepithelium (RPE) is a prerequisite for normal vision. Glaucomatous damage is characterized by neuroretinal degeneration. As a result, an imbalanced interaction exists. However, there is only limited evidence regarding RPE involvement in glaucoma patients’ eyes. This study investigates the correlation between retinal nerve fiber layer (RNFL) thickness and RPE alterations as detected by widefield fundus autofluorescence (FAF).

Methods Peripapillary RNFL thickness was quantified by optical coherence tomography (OCT). The six corresponding retinal areas were defined by a standardized grid and FAF intensity/irregularities were assessed and correlated to RNFL measurements.

Results 84 glaucomatous eyes were investigated. A correlation between RNFL thickness and standardized FAF in the corresponding topographic retina segments was observed. Correlation coefficients ranged between ‐0.12 to 0.35 and were statistically significant in the temporal inferior central field (r=0.35, p=0.02) and the temporal inferior peripheral field (r=0.31, p=0.04).

Conclusion This study provides early evidence that in glaucoma RNFL degeneration may be accompanied by corresponding RPE alterations
Correlation of various optic nerve head parameters obtained by 3D non‐mydriatic retinal camera and optical coherence tomography (OCT)
Authors: KANG KD , JUNG SH
Published: August 2012

Purpose To evaluate the relationship between various optic nerve head parameters(ONHP) provided by 3D non‐mydriatic retinal camera and OCT. Agreement in assessing the disc damage likelihood scale (DDLS) using 3D monitor between trainees and the validity of the DDLS provided by the integrated algorism of 3D retinal camera were also investigated.

Methods Patients(122 eyes from 82 patients) were categorized as normal, glaucoma suspect and glaucoma groups. Stereoscopic images were taken by 3D non‐mydriatic retinal camera(Nonmyd WX 3D,Kowa company Ltd.,Japan) and various ONHP provided by the instrument were used. To access the agreement in assessing the DDLS between trainees, initially DDLS score was graded using slit lamp by each observer and then each observer was provide with the 3D image of the optic nerve head using 3D monitor and was asked to re‐grade the DDLS according to their findings. OCT was performed to acquire retinal nerve fiber layer analysis and optic nerve head analysis.

Results There was a good correlation between various ONHP obtained by 3D non‐mydriatic retinal camera and OCT. The interobserver agreement of the DDLS evaluated through the 3D monitor was excellent(0.91), whereas the interobserver agreement of the DDLS evaluated clinically by slit lamp was substantial (0.80). The DDLS evaluated by the integrated algorism of 3D non‐mydriatic retinal camera was not itself satisfactory in the diagnosis of glaucoma. ROC curve shoed that DDLS evaluated using 3D monitor had the best predictive power(0.93).

Conclusion ONHP obtained by 3D non‐mydaiatic retinal camera are useful in evaluating patients with glaucoma, however, the integrated algorism of the device to calculate the DDLS needs to be improved.
To assess circumpapillary retinal arteries and veins thickness (cRAT and cRVT) at optic disc (OD) border and correlate them with circumpapillary retinal nerve fiber layer (cRNFL)
Authors: PEREIRA I , WEBER S , HOLZER S , RESCH H , KISS B , FISCHER G , VASS C
Published: August 2012

Purpose To assess circumpapillary retinal arteries and veins thickness (cRAT and cRVT) at optic disc (OD) border and correlate them with circumpapillary Retinal Nerve Fiber Layer (cRNFL).

Methods 123 healthy subjects underwent complete ophthalmologic examination including Cirrus®HD‐OCT and GDx‐ECC® (both Carl Zeiss Meditec Inc.). We used SLO images of HD‐OCT and MATLAB® (Version R2009b, The Mathworks Inc.) to manually identify the OD contour and measure cRAT and cRVT at OD border. cRAT and cRVT data were convolved with a Gaussian window to generate a 64‐sector profile.

Results 123 and 118 subjects showed significant intrasubject correlations between the cRNFL thickness profiles of the GDx‐ECC and cRVT and cRAT profiles, with Rmean 0.68 (0.96 – 0.03) and Rmean 0.65 (0.92 – 0.02). 26 and 24 of 64 plots showed significant intersubject correlation between cRNFL and cRVT and cRAT profiles (Rmax 0.35 and 0.29). For all vessels together intrasubject Rmean was 0.74 (0.40 – 0.96). Intersubject correlation was significant in 33/64 plots (Rmax 0.37).

Conclusion The individual cRVT and cRAT profiles contain approximately 46% of the individual RNFL profile information. Up to 12% of the intersubject variability of cRNFL might be explained by variations of cRVT or cRAT profiles. Analyzing all vessels together performed even slightly better.
Asymmetry in hemifield macular thickness as an indicator of early glaucomatous structural or functional progression
Authors: CHEN Y , KOBAYASHI N , KOBAYASHI K
Published: August 2012

Purpose To evaluate whether asymmetry in macular thickness can serve as an indicator of glaucomatous structural or functional progression utilizing Spectralis spectral domain optical coherence tomography (SD‐OCT).

Methods 31 early glaucoma eyes were evaluated in this study. Average macular thickness maps were acquired by posterior pole analysis of SD‐OCT and Macular thickness asymmetry between superior and inferior hemifield was analyzed. 16 eyes were classified as asymmetric and 15 eyes were classified as symmetric. Average macular thickness and circumpapillary retinal never fiber layer (cRNFL) were measured by SD‐OCT while Visual sensitivity loss was determined by mean deviation (MD) using Humphrey Visual Field Analyzer. All examinations were repeated after 6 months.

Results In asymmetry group, average macular thickness decreased from 280.8±8.2 to 273.3±7.4μm and cRNFL decreased from 80.2±3.4 to 76.8±3.0μm. Both of them became thinner statistically significantly. In symmetry group, neither average macular thickness nor cRNFL had significant change. Visual sensitivity loss did not get significantly worse in each group.

Conclusion Evaluation of asymmetry in macular thickness in early glaucoma eyes may serve as a useful indicator in the progression of glaucomatous changes.
Macular ganglion cell‐Inner plexiform layer thickness measurement and reproducibility with SD‐OCT
Authors: FRANCOZ M , FENOLLAND J , GIRAUD JM , EL CHEHAB H , SENDON D , MESSAOUDI R , MAY F , RENARD JP
Published: August 2012

Purpose To evaluate the macular retinal ganglion cell‐inner plexiform layer (GC‐IPL) thickness with automated detection and analyze the intra and interobservator reproducibility in normal, ocular hypertensive (OHT) and glaucomatous eyes.

Methods A total of 138 eyes were enrolled in 3 goups: normal subjects (n=69), OHT subjects (n=35), and open angle glaucoma subjects (n=34). All patients underwent a complete ocular examination including 24‐2 standard automated perimetry, biometry and pachymetry. Each eye had macular scanning using the Cirrus HD‐OCT (Carl Zeiss Meditec, Dublin, CA, USA), 3 times by each of 2 observators, and the ganglion cell analysis (GCA) algorithm provided parameters as average, minimum and 6 sectoral GC‐IPL thicknesses. The reproducibility was assessed with intraclass correlation coefficient (ICC), coefficient of variation (CV) and test‐retest SD (TRTSD).

Results The mean GC‐IPL thickness was 82.27 ± 7.37 µm, 76.84 ± 7.01 µm and 66.16 ± 11.16 µm in normal, OHT, and glaucoma group respectively. The GC‐IPL thickness was significantly lower in glaucomatous eyes than in normal and OHT eyes (p<0.0001 for all parameters). In the 3 groups ICC ranges were 96.4‐99.9 % and 92.5‐99.8 %, CV ranges were 0.41‐2.24 % and 0.55‐1.67 %, and TRTSD ranges were 0.61‐2.64 µm and 0.83 and 2.22 µm, for respectively the intraobservator and interobservator reproducibility analysis.

Conclusion To our knowledge this is the first study of GCA algorithm in normal, OHT and glaucomatous eyes. A highly satisfactory reproducibility of GC‐IPL thickness measurements using Cirrus HD‐OCT is reported. GC‐IPL thickness might be promising new OCT parameter for glaucoma diagnosis and follow‐up.
Average nerve width measurement obtained by optical coherence tomography and glaucoma
Authors: SHENG‐YAO HSU
Published: August 2012

Purpose This study will investigate the optic nerve head (ONH) using optical coherence tomography (OCT) and analyze the correlations between neuroretinal rim and optic disc‐cup structure in order to apply the finding in glaucoma.

Methods This cross‐sectional study enrolled 157 healthy subjects firstly and analyzed one randomly selected eye in each subject. The measurements for ONH parameters, including neuroretinal rim and optic disc‐cup structure (disc or cup areas and cup‐to‐disc ratios), were taken by a single experienced operator. The associations among neuroretinal rim and optic disc‐cup structure were determined. Independent parameter was further tested in 25 glaucomatous patients.

Results In healthy subjects, average cup‐to‐disc area ratio estimated was 0.2827 ± 0.1134 (95% CI; range, 0.263 to 0.302); rim area (vertical cross section), vertical integrated rim area, horizontal integrated rim width, and rim area positively correlated with disc area (p<0.05); rim area (vertical cross section), average nerve width, and vertical integrated rim area negatively correlated with cup area (p<0.05); and rim area (vertical cross section), average nerve width, vertical integrated rim area, horizontal integrated rim width, and rim area negatively correlated with cup‐to‐disc ratios (p<0.05). In further stepwise regression analysis, average nerve width was not associated with optic disc‐cup structure measurements (p>0.05, F<4.000) in healthy subjects. In glaucomatous patients, average nerve width was positively correlated with the mean deviation (dB) in standard automated perimetry (p<0.001, r=0.709).

Conclusion Average nerve width (the height of the nerve fiber bundle) is an independent rim parameter, and is helpful for the evaluation in glaucoma.
Glaucoma diagnostic accuracy : comparison of RTVue‐100 and Cirrus HD
Authors: FENOLLAND J , GIRAUD JM , EL CHEHAB H , FRANCOZ M , SENDON D , MAY F , RENARD JP
Published: August 2012

Purpose To compare diagnostic performance of peripapillary retinal nerve fiber layer and macular complex acquisitions in both Cirrus HD and RTVue OCTs.

Methods Observational study. 26 control eyes of 13 patients and 29 glaucomatous eyes of 16 patients were included. Inclusion criteria were : VA>20/25, no retinopathy nor maculopathy, spherical equivalent between ‐6 and 4 diopters, no recent ocular surgery. Acquisition protocols were : optic disc cube and 200x200 macular cube for the Cirrus. RNFL parameters and the macular complex (retinal ganglion cell and inner plexiform ie GCA) in 6 zones were studied. With the RTVue:3D optic disc plus ONH map then macular map. RNFL parameters and macular complex (retinal nerve fiber plus retinal ganglion cell plus inner plexiforme ie GCC). Statistical analysis : normal and glaucomatous population were compared with a Mann‐Whitney test. Area under curve (AUC), sensibility and specificity were calculated for each parameters. Agreement between the 2 OCT for the RNFL was evaluated with a Bland Altman plot

Results there was a difference for all the studied parameters between the two populations (u‐test p<0,01). AUC ranges from 0,782 to 0,963. for the Cirrus, the best parameters were GCA inferotemporal (AUC=0,955 Se=88% Sp=91%) and inferior RNFL (AUC=0,963 Se=93 Sp=91%) whereas for the RTVue,it was FLV (AUC=0,942 Se=89%, Sp=92%) and average RNFL (AUC=0,935 Se=85%, Sp=96%). There was no statistical differences when comparing those four AUC. There was a moderate agreement between the RNFL values with a biais of 9 micrometers.

Conclusion There is no difference between GCA (Cirrus) and GCC (RTVue) in diagnostic accuracy for glaucoma. Macular parameters have the same performance than peripapillar parameters.
Scanning laser polarimetry in glaucoma suspects: influence of the lens
Authors: MILANO G , VERTICCHIO VERCELLIN AC , LOMBARDO S , BOSSOLESI L , RAIMONDI M , LANTERI S , ROSSI GCM
Published: August 2012

Purpose to compare scanning laser polarimetry (GDx) variable corneal compensation (VCC) and enhanced corneal compensation (ECC) in glaucoma suspects divided on the basis of lens conditions

Methods 339 eyes of 182 consecutive patients were selected and submitted to complete ophthalmic evaluation, automated perimetry (HFA 24‐2), scanning laser polarimetry of RNFL with GDx VCC and ECC. Patients were divided into 4 groups if pseudophakic (IOL) or with different lens opacities graded according to LOCS‐III (NO/NC 1, 2 or 3). Morphometric parameters as TSNIT average, superior, inferior, nerve fiber indicator(NFI); quality of the image (Q)and typical scan score(TSS) given by the two GDx algorithms were compared applying Wilkoxon signed‐rank test and Lin’s concordance coefficient. Kruskall‐Wallis test was used to compare the 4 groups on the basis of age, intra‐ocular pressure (IOP), perimetric indices as mean defect (MD) and pattern standard deviation (PSD),TSNIT,NFI,Q and TSS

Results IOL group was significantly older, with lower IOP and higher MD as compared to the other groups. ECC gave better quality scans, thinner RNFL and higher NFI as compared to VCC. ECC/VCC outcomes were significantly different and concordance was poor to moderate but slightly better with transparent lens than with cataract (NO/NC3) or IOL. IOL and cataract seemed to affect GDx outcomes especially with VCC

Conclusion different lens conditions seemed to influence laser polarimetry outcomes particularly with VCC. ECC as compared to VCC gave better quality scans, thinner RNFL, higher NFI and was less influenced by lens condition. ECC could possibly better reproduce RNFL thickness, giving a more reliable model of early glaucomatous neuropathy
The influence of TSD (topographic standard deviation) and RH (refference height) test/retest variability upon the test/retest variability of the HRT stereometric parameters
Authors: POPA CHERECHEANU A , DASCALU AM , SERBAN D , STANA D
Published: August 2012

Purpose To investigate the role of TSD and RH inter‐test variability upon the variability of the stereometric parametres.

Methods 204 glaucomatous patients underwent regularly complete ophthalmological follow‐up for 3 years and HRT3 exam (yearly). The exclusion criteria were optic disc or retinal pathology that might interfere with the detection of glaucoma progression, TSD >30μm and progression of glaucomatous defect on optic disc photography or TCA.

Results TSD inter‐test variability <27; no statistically significant correlation between TSD variability and stereometric parameters changes. RH variability ranged between ‐198 and 187. Correlation analyses revealed a linear dependence between the inter‐test variability of RH and stereometric parameters change. The most powerful correlations were observed for: RNFL Thickness (r=0.756, p<0.001), Rim Area (r=0.662, p<0.001), C/D Area Ratio (r=‐0.663, p<0.001). The least correlated were Height Variation Contour (r=0.31) and Cup Shape Measure (r=0.07, p=0.3). When RH variability did not exceed 25μm, the correlations with stereometric parameters change were not statistically significant (for Rim Area, r=0.21, p>0.05, for C/D Area Ratio, r=‐0.13, p=0.22, for RNFL Thickness r=0.06, p=0.52).

Conclusion At TSD <30, the impact of TSD variability upon stereometric parameters changes is of little relevance. For values >25μm, the variability of the RH is a major factor determining test/retest variability for RNFL Thickness, Rim Area, C/D Area, Rim Volume and Linear C/D. Inter‐test variability of RH <25μm is an important criterion for the clinical relevance of stereometric parameters changes.
Combined analysis of five observational studies evaluating the efficacy and tolerability of bimatoprost/timolol fixed combination in patients with primary open‐angle glaucoma or ocular hypertension
Authors: PFENNIGSDORF S , DE JONG L , MAKK S , FOURNICHOT Y , MORGAN‐WARREN RJ , MALTMAN J
Published: August 2012

Purpose To evaluate the efficacy and tolerability of a fixed combination (FC) of bimatoprost 0.3 mg/ml and timolol 5.0 mg/ml (BTFC; Ganfort®) in patients with primary open‐angle glaucoma (POAG) or ocular hypertension (OHT).

Methods This was a combined analysis of five prospective, observational studies involving 5556 patients from 830 centres in Germany, Switzerland, Netherlands, Austria and France. All treatment decisions were at the physician’s discretion.

Results In the study population, 78% had POAG and the remainder had OHT. Patients were monitored for a median of 14 weeks. Overall, 93% (n = 5164) had received prior therapy; 47% receiving timolol. The most frequent reason for switching to BTFC (in 81% of patients with prior therapy) was insufficient intraocular pressure (IOP) control. Over the treatment period, mean IOP decreased from 21.5 to 16.1 mmHg with BTFC (25% reduction). BTFC reduced IOP in patients previously receiving prostaglandin monotherapy, β‐blocker, carbonic anhydrase inhibitor (CAI) and FCs containing a prostaglandin or CAI plus β‐blocker. In categorical analyses, physicians rated BTFC efficacy as ‘very good’ or ‘good’ in 86% of patients. BTFC tolerability was rated ‘very good’ or ‘good’ by 70% of physicians and 65% of patients. Adverse events were recorded for 9.7% (n = 541) of patients: the most common were eye irritation (2.8%) and ocular hyperaemia (2.2%).

Conclusion When used in a real‐life clinical setting, BTFC was well tolerated and effective in the management of POAG and OHT.

Commercial interest
The impact of brimonidine on the loss of retinal nerve fiber layer (RNFL) thickness in glaucoma diabetic patients
Authors: SMEDOWSKI A , WYLEGALA E , ORSKI M , WOJCIK L
Published: August 2012

Purpose Brimonidine has proved protective effects on Retinal Ganglion Cells (in animal researches with intravitreal injection), but when used in topical application, its neuroprotective activity has not been unequivocally confirmed. A trail to evaluate potential neuroprotective effect of brimonidine on RNFL in Glaucoma patients.

Methods After a retrospective analysis of 1800 patients data, we selected 98, who revealed a significant RNFL thickness loss (21 had Diabetes). We compared the rate of RFNL loss between the group of 53 patients (100 eyes) treated with brimonidine and 45 (90 eyes) treated with other drugs.

Results In patients with well‐controlled intraocular pressure (IOP) there is statistically significant relationship between the use of brimonidine and loss of RNFL thickness (p <0.01) and an annual rate of RNFL loss (p=0.01).

Conclusion The potentially neuroprotective effect of brimonidine depends on IOP. The higher than normal IOP will limit this potential effect.
Effectivness of brimonidin and dorsolamid as additional therapy to beta‐blockers‐comparable analysis
Authors: RADUNOVIC M , RADUNOVIC M , RADUNOVIC A , KUJUNDZIC H
Published: August 2012

Purpose The aim of this survey is comparison of brimonidin and dorsolamid effect as an additional therapy for primary open angle glaucoma patients already treated with beta‐blockers.

Methods Primary open angle glaucoma patients treated with beta‐blockers and who had unregulated IOP were divided in two groups: the first one was additionally treated with 0,2% Brimonidin, and the second one with 2% Trusopt. The therapy was administered twice a day to all the patients. IOP and visual field changes and progression were followed up in next six months. Analysis and comparison of IOP and computerised visual field was done after 4, 12, 16 and 24 weeks from the treatment beginning.

Results We have followed up 80 patients in total, 40 in the group treated with 0,2% Brimonidin and 40 in the group treated with 2% Trusopt. 48 patients or 60% were women. We didn’t noticed any significant differences in visual field defects progression during the six months period between these two groups, but middle IOP decrease was 4.2mmHg in the first and 3.0mmHg in the second; that presents high statistical significance. From 15.6% patients (13 in total; 6 in the 0.2% Brimonidin group and 7 in the 2% Trusopt group) with significant visual field defects at the end of study, 85% (11 patients) had those defects already in the first week, at the beginning of additional therapy.

Conclusion There was no statistically significant difference between these two groups in the visual field defects prevention and progression during six months period of treatment. Middle IOP decrease in these two groups was significant. Key words: glaucoma, optic nerve, 0.2% Brimonidin, 2% Dorsolamid, beta‐blockers.
Multiple topical administrations of Ramipril enhance retinal ganglion cell survival after transient retinal ischemia‐reperfusion in rats
Authors: ELENA P , VIAUD‐QUENTRIC K , CHARFEDDINE R , REKIK R
Published: August 2012

Purpose The aim of the present study was to evaluate the protective effects of eye drops the angiotensin‐converting enzyme (ACE) inhibitor ramipril on retinal ganglion cells (RGC) in a model of ischemia‐reperfusion (I/R) injury in pigmented rat retina.

Methods Retinal I/R injury was induced in adult Long Evans rats by vascular ligation of the optic nerve for 45 minutes, after which reperfusion was immediately established. Rats were treated topically with Ramipril 2% or vehicle eyedrops three times before and after ischemia. Intraperitoneal injection of brimonidine (2 mg/kg) was used as reference. Post‐ischemic retinal function was assessed by scotopic electroretinography (ERG) and RGC density by immunofluorescence on retinal flatmounts 8 days after ischemia.

Results In ischemic eyes, no ERG responses could be recorded immediately after reperfusion. They gradually recovered to approximately 75% of baseline 8 days after injury. Recoveries of the b‐wave in the Ramipril‐ and brimonidine groups were better than those in the vehicle group. Severe RGC loss was also observed after I/R injury. However, Ramipril and brimonidine treatments significantly enhanced RGC survival (270.43 ± 87.57 cells/mm2 and 300.65 ± 92.48 cells/mm2), in comparison with the vehicle group (178.42 ± 107.81 cells/mm2).

Conclusion Multiple instillations of ramipril 2% enhanced rat RGC survival and retinal function in the ischemia‐reperfusion injury model. This warrants further evaluation of the neuroprotective properties of ramipril in eye diseases.

Commercial interest
Relative efficacy and safety of preservative‐free latanoprost (T2345) for the treatment of open‐angle glaucoma and ocular hypertension. An adjusted indirect comparison meta‐analysis
Authors: CUCHERAT M , ROULAND JF
Published: August 2012

Purpose Adjusted indirect comparison (AIC) were performed to assess the relative efficacy and tolerability of T2345 compared to the other prostaglandin analogs for the treatment of open‐angle glaucoma (OAG) and ocular hypertension (OH)

Methods We performed a systematic literature review to identify randomized controlled trials evaluating prostaglandin analogs with or without preservative for the treatment of OAG and OH. AIC were conducted using Bucher’s method. The main endpoints was intraocular pressure (IOP) measured at 3 months and hyperhemia or ocular redness

Results Twenty‐one studies were included. No statistically significant difference in IOP were found between T2345 and BAK‐free travoprost (mean difference and 95%CI 0.47 [‐0.58;1.51]), bimatoprost (0.49 [‐0.13;1.10]), bimatoprost 0.01% (0.19 [‐0.69;1.06]), travoprost (.27 [‐0.50;1.03]) and latanoprost (0.40 [‐0.02;0.82]). T2345 was found statistically significantly superior to tafluprost (‐0.90 [‐1.52;‐0.28]). For hyperhemia or ocular redness, T2345 was found statistically significantly superior to BAK‐free travoprost (odds ratio 95% CI 0.30 [0.14;0.61]), bimatoprost (0.18 [0.10;0.33]), bimatoprost 0.01% (0.27 [0.13;0.56]), tafluprost (0.18 [0.05;0.65]), travoprost (0.25 [0.14;0.46]) and latanoprost (0.52 [0.31;0.86])

Conclusion In terms of efficacy on IOP, indirect comparisons never found T2345 statistically significantly inferior to the others. T2345 was found superior to tafluprost and an almost statistically significant trend was found in favor of bimatoprost for IOP. For hyperemia or ocular redness, T2345 latanoprost was statistically significantly superior to all the others

Commercial interest
Safety and efficacy of phacoemulsification and intraocular lens implantation in eyes with end‐stage chronic angle‐closure glaucoma
Authors: KIM S , CHOI HJ
Published: August 2012

Purpose To evaluate surgical outcomes of phacoemulsification and intraocular lens implantation in eyes with end‐stage chronic angle‐closure glaucoma (CACG).

Methods Patients with medically controlled end‐stage CACG (mean deviation, < ‐19 dB) and clinically significant cataracts were enrolled in this prospective observational study. Standard phacoemulsification and intraocular lens implantation were performed. During at least 6 months of follow‐up, changes in visual acuity, intraocular pressure, visual field parameters, and number of antiglaucoma agents used were assessed. Intraoperative and postoperative complications were documented. Multiple regression analysis was performed to identify independent predictors of postoperative visual outcome.

Results Twenty‐two eyes of 19 subjects were enrolled. The mean follow‐up period was 13.7 months (6–27 months). Corrected visual acuity improved from 0.63 ± 0.50 logarithm of the minimum angle of resolution (logMAR) preoperatively to 0.20 ± 0.31 logMAR postoperatively (p < 0.001). Intraocular pressure decreased from 14.05 ± 3.11 mmHg to 10.55 ± 1.79 mmHg (p < 0.001). No change was found in visual field parameters or number of antiglaucoma agents used. During surgery, 2 eyes had zonular dialysis and 1 eye had posterior capsule rupture. After surgery, 1 eye required additional trabeculectomy due to uncontrolled intraocular pressure after phacoemulsification. Preoperative visual acuity and mean sensitivities of 4 central points of the visual field were independent predictors of postoperative visual outcome.

Conclusion Phacoemulsification and intraocular lens implantation was performed safely and effectively in end‐stage CACG eyes with cataracts.
Non penetrating deep sclerectomy versus trabeculectomy in bilateral primary open‐angle glaucoma
Authors: IBANEZ J , PEREZ D , MATEO OROBIA A , ASCASO F , PEIRO C , CRISTOBAL JA
Published: August 2012

Purpose To establish the efficacy and safety of non penetrating deep sclerectomy versus trabeculectomy in primary open‐angle glaucoma.

Methods A Prospective randomized trial of fifteen patients (30 eyes) with bilateral primary open angle glaucoma were included in the study. Eyes were randomly assigned to receive deep sclerectomy in one eye and trabeculectomy in the other eye. Outcome Measures included :mean intraocular pressure (IOP), postoperative medications, visual acuity, success rate, and complications.

Results At 12 months, mean IOP reduction was 11.5 +/‐ 3.5 (sclerectomy) versus 13.2 +/‐ 4,4mmHg (trabeculectomy) (P = 0.12), and an IOP </= 21 mmHg was achieved in 13 (86,6%) and 14 eyes (93.3%) (P = 0.9), respectively. Complications included two (13,3%) flat/shallow anterior chambers and one (6.6%) hypotony (trabeculectomy), whereas internal iris incarceration was encountered in two eyes (13,3%) (sclerectomy).

Conclusion Deep sclerectomy may provide comparable IOP reduction with fewer complications in management of primary open angle glaucoma.
Glaucoma surgery in a patient with prominent episcleral vessels
Authors: PRIETO CALVO E , DE LA MATA G , FERNANDEZ‐PEREZ S , SATUE M , GARCIA‐MARTIN E , BAMBO MP , PEREZ‐OLIVAN S
Published: August 2012

Purpose We report a case of a patient with dilated episcleral veins of unknown etiology and with secondary open angle glaucoma, who developed ciliochoroidal effusion as result of an early glaucoma filtration surgery.

Methods Observational single case report. A 74‐year‐old male patient who had undergone sequential trabeculectomy for his both eyes, postoperatively he presented with redness of both the eyes and choroidal effusion, which was not resolved with conservative management (systemic steroid in tapering dose) or surgery. Slit‐lamp biomicroscopy revealed dilated episcleral veins and the gonioscopy showed open angles with blood in Schlemm’s canal in both eyes.

Results During follow‐up, his intraocular pressure (IOP) remained in high thirties in the left eye (LE) and mid‐twenties in the right eye (RE) despite anti‐glaucoma medications and surgery. Systemic examination was negative for carotid cavernous fistula, low‐grade dural arteriovenous fistula, dysthyroid ophthalmopathy or orbital tumor. The chest X‐ray excluded any tumor at the apex of lung. Finally, the patient was admitted to the hospital for a right congestive heart failure and he was diagnosed with primary pulmonary hypertension (PPH) confirmed by physical examination, electrocardiogram and echocardiogram.

Conclusion Secondary glaucoma related to dilated episcleral veins is difficult to manage medically and surgical complications are also high. The underlying mechanism by which PPH causes uveal effusion is an increased pressure in the superior vena cava transmitted to the ophthalmic veins and choroidal circulation that lead to the excessively dilated and congested episcleral veins observed in our patient.
The morphological changes in the eye tissues during implantation drainages for glaucoma surgery
Authors: GAVRILOVA I , CHUPROV A
Published: August 2012

Purpose to study experimentally the morphological changes in the eye tissues with implantation of different drainages for glaucoma surgery

Methods The experiment was conducted on 15 rabbits (30 eyes) breed «Gray Chinchilla» at the age of 4‐6 months, the weight of 2‐2,5 kg, without signs of ocular pathology. Animals were divided into 3 groups of 5 animals in each group. Deep sclerectomy and implantation of different drainages for glaucoma surgery was performed in all rabbits. Polymer triangular setons by digel were implanted to rabbits of 1 group, perforated drainages from digel ‐ to rabbits of 2 group, lamellar collagen drainages ‐ to rabbits of 3 group. After 6 months the animals were taken out of the experiment. We fixed enucleated rabbit eyes in 10% formalin solution, produced serial sections of thickness 20 microns, stained with hematoxylin ‐ eosin

Results Histological studies of eyes in the late postoperative period showed that the polymer drainages from digel exist in the intraskleral cavity, the collagen drainage completely resorbed. The cavity is formed in the location of any drainage, but in the case of implantation digel drainage it is surrounded by a capsule. However, all drainage cavities is isolated, i.e. no messages subconjuctival or suprachoroidal space

Conclusion Thus, the drainages does not provide enhanced outflow of aqueous humor from the eye through the anastomosis in the late postoperative period. The reason of this is a fibrosis by intraskleral or subconjuktival level
Epidemiology of primary congenital glaucoma: a study lasting 11 years
Authors: AZIZ A , DENIS D , MATONTI F
Published: August 2012

Purpose Primary congenital glaucoma is a rare affection, which could lead to blindness. Till now in France, few epidemiological and clinical data are available. This study aims to determine epidemiological factors found in the children affected by severe primitive congenital glaucoma requiring surgery.

Methods This retrospective study including patients diagnosed for primitive congenital glaucoma was led between January, 2000 and November, 2011 in a department of Pediatric Ophthalmology of the South of France. Studied parameters were: age at the time of diagnosis, gender, presenting signs, hereditary and environmental factors, prematurity and medical histories to determine the epidemiological characteristics of these children.

Results 60 children were included in the study, classified in early congenital glaucoma (n = 26 either 44 %), infantile (n = 24 or 40 %) or late (n = 10 or 16 %) according to the age of diagnosis. The average age of diagnosis was respectively of 3.8, 8 and 35 months. The sex ratio was 1,1 times more boys than girls. The most common presenting signs were megalocornea (65 %), stromal scars (30 %), watering eyes (26 %), photophobia (21 %) or the association of some of these criteria (39 %). A family history of congenital glaucoma in the first degree exists for 14 % of the children and the rate of consanguinity recorded between the parents is 14 %. The rate of prematurity is 12 %. Seven children (12 %) presented a polymalformative syndrome and six patients (15 %) neurological disorders with delay of psychomotor development.

Conclusion This French study led over a long‐term period and on a large cohort shows results comparable to those found in the international literature for similar populations.
Glaucomatous optic neuropathy complicated by pituitary adenoma: case report
Authors: PESCE G , MONTRONE F , VELLA G , GARRIBBA AP
Published: August 2012

Purpose The authors report on a case of Glaucomatous optic neuropathy complicated by pituitary adenoma

Methods Caucasian 54 year old male patient. At the age of 2 divergent strabismus in both eyes and amblyopia in left eye was present; surgical correction for strabismus of both eyes at the age of 7. Since 2000 primary open angle glaucoma in both eyes treated with medical therapy (initially with beta blockers, and later adding carbonic anhydrase inhibitors): mean intraocular pressure of 16 mmHg. Visual field defects typical of glaucomatous optic neuropathy were present and stable over time. The patient underwent surgical removal of cataract in 2007 and 2009 in each respective eye.

Results During 2009 very fast deterioration of the visual field in both eyes (OD>OS) with well‐controlled intra ocular pressure (IOP) with medication. No neurological symptoms associated. Magnetic resonance imaging (MRI) of the brain showed a macro pituitary adenoma compressing the optic chiasm. In 2010 the patient underwent surgical removal of the adenoma.

Conclusion After removal of the pituitary adenoma and decompression of the optic nerve, the visual fields over the past two years have remained stable with the same defects greater in the right eye than in the left eye. However, the visual quality continues to deteriorate possibly due to surgical intrasellar herniation of the optic nerve.
IOP lowering effect of low intensity ultrasound on experimental glaucoma model using microbeads in rats
Authors: KIM C , RHO S , LEE N , LEE C , KIM N , PARK S , CHOI B , CHOI M
Published: August 2012

Purpose To report the intraocular pressure (IOP) lowering effect of low intensity ultrasound (LIUS) on eyes of ocular hypertensive rats.

Methods Continuous radiation of LIUS on ocular hypertensive eyes induced by unilateral microbeads injection was performed. A round plane ultrasound transducer operating at a frequency of 1MHz was utilized to deliver a sonication of 240mW/cm2 in acoustic intensity. LIUS was treated on both eyes of rats (n=5) simultaneously and the IOP measurements of treated group were compared with those of untreated group (n=5).

Results The mean IOPs of LIUS‐treated eyes and un‐treated eyes were 9.4 ± 0.55 mmHg and 9.6 ± 0.55 mmHg, respectively at baseline. After an intracameral injection of microbeads, IOPs were reached to 18.6 ± 4.037 mmHg and 22.8 ± 3.493 mmHg (p=0.580) at 3 days after microbeads injection. Then the IOPs were decreased by 39.47 % and 9.68 % at 1 day after a single sonication.

Conclusion These results showed that continuous low intensity ultrasound suppresses the IOP elevation in experimental glaucoma model using microbeads injection into anterior chamber. By the reason of its non‐invasiveness and repeatability, LIUS could be an alternative method for glaucoma treatment in near future.
Vision quality in population research of children and adolescents in Siemianowice Slaskie (southern Poland)
Authors: MOCKO L , WYLEGALA E , ZAJAC M , JOZWIK A , LEWANDOWSKA M
Published: August 2012

Purpose The aim of this study was to determine the quality of vision, refraction, and aberrations in a group of children and adolescens in selected schools of the city Siemianowice Slaskie (Southern Poland).

Methods Visual quality was evaluated as visual acuity measured with two methods: OPTEC® Vision Tester and FrACT computer programme as well as contrast threshold for 30 arc min size optotypes. Refraction was determined with Topcon KR‐1W aberrometer which enables its measuring with “refractor” method or its calculation from low‐order Zernike aberrations.

Results Totally 556 children aged from 8‐to‐17 years (average age 13.87, standard deviation 2.29), were investigated. Visual acuity varied within great range, but average value remained almost constant on the level slightly better that V = 5/5 (ca. ‐0.06 logMAR) in the group whithout vision problems. In the group of children with detected refraction errors (wearing glasses) average visual acuity decreased by 0.1 log units in every 5 years.There was high correlation between contrast threshold and visual acuity. We noticed an increase in the average spherical error in the amount of –0.5 D in the time interval of about 5 years.

Conclusion Both methods testing visual acuity investigated by the authors are comparable and may be used as screening for children. The FrACT test for screening visual acuity and contrast is a method that would be appropriate to be used in children and teenagers in view of its similarity to computer games and its short time duration. The distribution of visual defects is comparable to that found in other screening tests on the Polish and European populations.
Mesopic pupil amplitude depending on the age and the wavelenght of the stimuli
Authors: LOBATO RINCON LL , NAVARRO VALLS J , NAVARRO BLANCO C , BONNIN ARIAS C , RAMIREZ MERCADO G , SANCHEZ‐RAMOS RODA C
Published: August 2012

Purpose In the present study, values of the phases of pupil light reflex were recorded and analyzed depending on the age, and the spectral content of the incident light, in order to determine changes on the pupil light reflex by means of various types of lights and compare their effects in every sub‐sample and between them.

Methods The sample consists in 30 old subjects and 32 young subjects. To evaluate possible dementia in old subjects, the clock drawing test was applied. The pupillometer used was Power Refractor II, a binocular, infrared based instrument and autorefractometer. Four optical filters were interposed on the flash: a neutral density filter 05, and three interferential filters with peaks of transmission in 450 nm, 510 nm and 600 nm. Our team designed a parser programmed in java that calculates all the variables implicated.

Results In the old age group, the average amplitude were 1.23 ±0.3 mm, 1.03 ± 0.3 mm, 1.11 ± 0.4 mm, and 0.85 ± 0.3 mm for white light, blue monochrome light, green monochrome light and red monochrome light, respectively. In the young age group, the average amplitude to white light was 2.29 ± 0.4 mm, and the average amplitude for blue, green and red monochrome lights were, respectively, 1.91 ± 0.3 mm, 2.04 ± 0.5 mm, and 1.60 ± 0.6 mm. Both groups exhibited a similar behaviour when reactions were compared depending on the different wavelength.

Conclusion Age affects considerably to mesopic pupil amplitudes values provoked for luminous stimuli. Likewise, blue and green monochrome lights bias the response in both groups.