bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of gap junction proteins in primary fiber cell elongation
Authors: GRAW J , PUK O , HORSCH M , BECKERS J
Published: September 2008

Purpose During lens development, the elongation of primary fiber cells is the first crucial step after formation of the lens vesicle. According to characterized mouse mutants, this step depends on the activity of at least three genes: Maf, Pparbp and Gjf1, which we reported recently to encode a new connexin. In all these mutants, lens development is inhibited because the primary fiber cells do not elongate and the secondary fiber cells cannot form properly. The Gjf1 gene is altered in the mouse mutant Aey12 being characterized by microphthalmia, frequently associated with cataracts.

Methods To identify downstream targets of Gjf1, we performed expression profiling in Gjf1Aey12 mouse embryos at 10.5 days of development.

Results At this stage, the lens placode is beginning to form the lens vesicle and histological and morphological differences between wild‐type and mutant eyes are not yet obvious. We assumed that differences in gene expression might precede the morphological Aey12 phenotype. 31 genes were identified as up‐regulated. Among them, Fhod1 shows the highest level of induction; it encodes a Formin homology‐2 domain encoding protein. Another interesting up‐regulated gene is Rai16 (coding for the retinoic acid induced protein 16) providing a new link between lens development and retinoic acid signaling.

Conclusion Since retinoic acid was shown recently to be necessary for lens differentiation in quails (Maden et al., 2007), the analysis of our Aey12 mutant might contribute to a better understanding of the role of retinoic acid and connexins during early lens development in mammals.
Cholesterol oxides, signal transduction and cell dysfunction in the lens: a bizarre love triangle
Authors: PEREIRA P , FERNANDES AF , FERREIRA J , BRITO A , GIRAO H
Published: September 2008

Purpose Cholesterol oxides was implicated in the development of cataract. The purpose of this study is to elucidate the molecular mechanisms underlying cholesterol oxide‐induced cell dysfunction in the lens.

Methods Lens epithelial cells (LEC) were incubated with 7‐ketocholesterol (7‐KC) and 25‐hydroxycholesterol (25‐OH). The effects of cholesterol oxides on cytoskeleton were evaluated by immunofluorescence microscopy. Activation of p38 MAPK and Akt was detected by Western Blot. LC3 processing was detected by Western Blot and immunofluorescence confocal microscopy and autophagy was assessed by the LC3 I/LC3 II ratio.

Results Cells treated with 25‐OH show increased migration and formation of lamellipodia. These effects are reversed by inhibitors of PI3K and p38 MAPK. Consistently, 25‐OH induces activation of Akt and p38 MAPK in LEC. On the other hand, treatment of LEC with 7‐KC decreases Akt levels and up‐regulates autophagy. The increase in autophagy following treatment with 7‐KC is prevented by overexpressing a constitutive active Akt. Chemical inhibition of PI3K or overexpression of a dominant negative Akt also leads to stimulation of autophagy.

Conclusion 7‐KC stimulates autophagy in LEC by promoting degradation of Akt and activation of mTOR. The two different cholesterol oxides (7‐KC, 25‐OH) have opposite effects in the regulation of Akt, resulting in increased autophagy (7‐KC) and increased cell migration (25‐OH). Accumulation of cholesterol oxides in lens may thus account for loss of cell transparency by interfering with cell migration and by deregulating autophagy in LEC. Supported by FCT grants POCI/SAU‐MMO/57216/2004 and POCI/SAU‐OBS/57772/2004.
Functional correlates of abnormally increased annular fundus autofluorescence in different retinal dystrophies
Authors: ROBSON AG , MICHAELIDES M , SAIHAN Z , BIRD AC , FITZKE F , HOLDER GE , MOORE AT , WEBSTER AR
Published: September 2008

Purpose To examine the functional significance and stability of annular fundus autofluorescence (AF) abnormalities in patients with different retinal dystrophies.

Methods One hundred patients were ascertained who had a parafoveal ring of high density AF. Seventy five had a clinical diagnosis of retinitis pigmentosa (RP) or Usher syndrome with good visual acuity; 20 of 75 had serial AF imaging. Twenty five others included cases of cone or cone‐rod dystrophy (GUCA1A, RPGR, RIMS1) and “cone dystrophy with supernormal rod ERG” (KCNV2). International‐standard full‐field and pattern ERG (PERG) testing was performed. Some patients underwent fine matrix mapping (FMM).

Results Results: a) The AF ring radius correlated positively with PERG P50 in non‐syndromic RP (R=0.79, p<0.0005, N=50) and in Usher syndrome (r=0.77, p<0.0005, N=25). The ring encircled areas of preserved photopic function. Serial AF revealed progressive ring constriction in 10 of 20 cases. b) In the 25 patients with cone or cone‐rod dystrophy, AF rings resembled those seen in RP or encircled areas of central atrophy. There was an inverse relationship between P50 and ring size in those with detectable PERGs. High density arcs corresponded with gradients of sensitivity change. There was evidence of AF ring expansion in some cases.

Conclusion Conclusions: Parafoveal rings of high density autofluorescence are non‐specific manifestations of retinal dysfunction associated with gradients of sensitivity change. High density rings progressively constrict in a high proportion of patients with RP and good visual acuity. Progressive ring expansion may occur in different forms of cone and cone‐rod dystrophy.
Improving the diagnostic potential of the photopic electroretinogram (ERG) with refined mathematical tools
Authors: LACHAPELLE P , JAUFFRET C , GARON ML , MIKULA M , MYSORE N , RACINE J
Published: September 2008

Purpose Examine if the use of refined mathematical tools increases the understanding and diagnostic potential of the photopic ERGs.

Methods Analyses were performed on normal and pathological photopic ERGs (background of 30 cd.m‐2; flash intensities ranging from ‐0.8 to 2.84 log cd.sec.m‐2 in 15 steps; n>100). Mathematical instruments included: 1‐ the Continuous Wavelet Transform (CWT)2‐ The Reiman Integrator and 3‐ the Photopic Hill Gaussian:Logistic ratio [GL=Gb/(Gb+Vbmax)]claimed to weight the contribution of the OFF and ON pathways to the photopic ERG.

Results 1‐ CWT revealed 3 distinct frequency domains within the 10‐50 msec poststimulus time interval, namely: 20‐40 Hz, 90‐150 Hz and 200‐300 Hz that appeared to be independently modulated by flash intensity and/or pathology. 2‐ Integration of the OPs accurately reconstructed the broadband ERGs (r>0.90), irrespective of CWT. 3‐ In our cohort of RP patients (n=50), the GL ratio was 0.43 ±0.23, compared to 0.60±0.08 in normal (p<.05).

Conclusion 1‐CWT dissects the ERG into its primary components, a method that should allow a more accurate quantification of ERG responses. 2‐ Strong evidence supports the concept that the b‐wave results from the integration of the OPs. The value of the integration constant (1 sec) is close to the time constant of the Muller cell membrane suggesting that the latter could be at the origin of this integration. 3‐The broader GL distribution obtained from our RP cohort suggests that in some the OFF retinal pathway is primarily affected while in others the ON is. It remains to be determined if the latter represents two stages of the same disease process or two different disease paths. Supported by CIHR and Réseau Vision.
Erg explorer: a software for post‐processing, analysing, and reporting of electrophysiological data
Authors: STRASSER T , WILKE R , MESSIAS A , ZRENNER E
Published: September 2008

Purpose For clinical routine and clinical trials it is important to provide structured, consistent reports of electrophysiological data. Also, there is the need for further processing of raw data. Moreover, the connectivity to different electrophysiological systems is a major requirement. We will present a system that is capable of reading raw data, evaluate and process it, to present it in a graphical report and to make it available for data management systems or statistical software packages.

Methods The application is based on Java Enterprise Edition. Algorithms can easily be added by dropping a new plug‐in into the system. Algorithms like FFT, frequency filters, curve fitting, detrending, intensity‐/response‐function, a‐wave slope detection, and SNR estimation are implemented. The application allows a flexible design of reports based on customizable templates. Templates according for ISCEV standards are included. It also allows exporting data into different formats including Excel or CSV. Currently we are providing an interface for the Espion E2 system, interfaces for LKC UTAS and Roland Consult Reti‐port are being developed.

Results The use of open source frameworks allows for easy adaptation of new algorithms for post‐processing electrophysiological data, the integration of new standards, outstanding reporting features and interfaces to existing devices or applications.

Conclusion The application is successfully used in routine clinical examinations. Further features are also currently being developed, like the integration of additional electrophysiological systems and the implementation of new algorithms, e. g. wavelet analysis and noise estimation. An auxiliary accomplishment may be the establishment of a DICOM standard.
Protection of the photoreceptors in ROP (retinopathy of prematurity)
Authors: FULTON AB , HANSEN RM , AKULA JD , MOSKOWITZ A , HARRIS M
Published: September 2008

Purpose Interventions with putative protective effects on the immature photoreceptors are part of the clinical care of preterm infants. In rat models of ROP, the early status of the photoreceptors predicts ROP outcome, and modification of the energy demands of the developing photoreceptors affects ROP outcome. In prematurely born subjects with thoroughly documented newborn care, we studied the relation of photoreceptor status and ROP outcome.

Methods Retinal function and vasculature were characterized at pre‐ and post‐term ages. Parameters of phototransduction and of post‐receptor activity were derived from ERG a‐ and b‐waves. The integrated curvature of the arterioles was used to quantify the retinal vasculature. The main newborn interventions, including oxygen limits, were categorized.

Results In infancy, the small ERG responses reflected immaturity of the photoreceptors and differed significantly between those who developed ROP and those who did not. The higher the integrated curvature the more severe the ROP. The magnitude of the ERG abnormalities varied significantly with the severity of ROP and integrated curvature. The putatively protective clinical interventions were significantly associated with better photoreceptor function and better ROP outcome.

Conclusion Protecting the immature photoreceptors appears to improve ROP outcome. Future interventions that target the photoreceptors may prevent ROP.
Bilateral visual loss and paraplegy in a patient with metastaic carcinoma of stomach
Authors: PAJTLER A , SEGA S , ZGONC V , ROS‐OPASKAR T , HAWLINA M
Published: September 2008

Purpose We present a case report of bilateral visual loss and paraplegy in patient with metastatic carcinoma of stomach.

Methods 64‐year old male presented with painless visual loss on right eye, and one week later, he was blind on both eyes with no light perception and amaurotic pupils. One year earlier he was diagnosed with primary metastatic carcinoma of stomach and was treated by Xeloda and Docetaxel. Fundi revealed bilateral hyperemic disc oedema. Solu‐Medrol 1 g i.v. for three days had no effect.

Results CT and MRI of brain showed no lesion that would explain his visual loss. Scotopic and photopic electroretinography was normal.Visual evoked potentials (VEP) on flash stimulation were nonrecordable. Specific onco‐neurologic antibodies in CSF and serum were negative:anti‐Ri(ANNA‐2),anti‐Yo,anti‐CV2(CRMP5),anti‐amphiphysin,anti‐Mal,anti‐Hu(ANNA‐1),anti‐Ma2(Ta‐). One month after onset of blindness, he had acute neurological deterioration with paresis of left leg and retention of urine which was diagnosed as Brown‐Sequard syndrome. MRI of spinal chord showed intramedular lesion between Th 6‐10. Oligoclonal bands in serum and CSF were identical, indicating systemic inflammation. Serum was sent for testing NMO‐IgG,but results are in process. Patient was restarted on high doses of Solu‐Medrol i.v. Slight improvement of vision was noted after few days of therapy, and flash‐evoked VEP was barely detectable. The discs were no longer swollen and appeared pale.

Conclusion This unusual case of bilateral blindness due to optic neuropathy might be linked to atypical presentation of neuromyelitis optica or to paraneoplastic optic neuropathy caused by yet unknown antigen.
Modulation of wound healing after glaucoma surgery
Authors: VAN BERGEN T
Published: September 2008

Abstract not provided
Anti‐PLGF, a safer alternative to anti‐VEGF in the treatment of AMD?
Authors: VAN DE VEIRE S
Published: September 2008

Abstract not provided
Efficacy and safety of a 3 day treatment using azithromycin 1.5% in purulent bacterial conjunctivitis
Authors: COCHEREAU I
Published: September 2008

Abstract not provided
Guidelines for managing post operative inflammation using topical steroids or NSAIDs
Authors: HERBORT C
Published: September 2008

Abstract not provided
Third nerve palsies without pupil involvment can still be surgical
Authors: SKINNER KC , MERRICK CD , HOXHA A , RIZAL E
Published: September 2008

Purpose To emphasise the importance of maintaining a high index of suspicion of a surgical cause of a partial third nerve palsy even when pupil is not involved. To highlight an unusual presentation of a pituitary tumour.

Methods Case Report

Results A 15 year old presented to the emergency department one evening after noticing he had a "droopy eyelid". He reported being under a lot of stress whilst revising for exams and described some occasional mild tension type headaches. Of note two weeks before this presentation he had "fainted" in the school playground, it had felt that this episode required no further investigation at the time. There was no other history ellicited. Also of note was that he denied any diplopia or visual symptoms. On presentation, he had a right sided partial ptosis. Visual acuity was normal. Both eyes were normal. On examintion of the ocular movements he had diplopia on upgaze especially in abduction. He had no past ocular or medical history. Goldmann fields were normal. When he was seen it was noted thet he was over 6 feet tall yet his parents were of average height. On discussing the case with radiologists and paediatricains great emphasis was placed by them on the lack of pupil involvement, it was then assumed therefore that it would be unlikely that there would be any brain lesion. However, he did go on to have an MRI scan the next day which revealed a large pituitary mass which protruded laterally hence the third nerve involvment. As of when this abstract was submitted he is awaiting neurosurgical work up.

Conclusion Importance of high index of suspicion of surgical cause of third nerve palsyy depsite pupil involvement. To Highlight an unusual presentation of pituitary tumour
Pupil light reflexes mediated by outer retinal versus inner retinal photoreceptors in normal subjects and patients with neuroretinal visual loss
Authors: KAWASAKI A , ANDERSON SC , KARDON RH
Published: September 2008

Purpose This study was designed to translate recently published physiological behavior of the melanopsin‐expressing retinal ganglion cells to the clinical setting.

Methods 43 normal eyes were tested by recording the pupil light reflex to a Ganzfeld red (620nm+/‐20nm) and blue (480nm+/‐20nm) light stimulus at 3 light intensities (1, 10, and 100 cd/m2) under mesopic conditions. The pupil responses of the normal subjects were compared to patients with outer retinal disease and patients with optic nerve damage.

Results In normal eyes at lower intensities, blue light evoked much greater pupil responses compared to red light when matched for photopic luminance. A disparity between the transient and sustained pupil contractions was greatest at the lowest light intensity and decreased with increasing light intensity. Patients with primarily rod dysfunction showed reduced pupil responses to low intensity blue light stimulation.. A patient with genetically confirmed achromatopsia showed selective reduction of the pupil response to high intensity red light stimulation. Patients with optic neuropathy tended to have reduced pupil responses to all light conditions.

Conclusion Pupil responses that differ as a function of light intensity and wavelength support the hypothesis that selected stimulus conditions can produce pupil responses that may reflect phototransduction mediated by either rods, cones, or intrinsic activation of melanopsin‐expressing retinal ganglion cells. The pupil light reflex may be used to differentiate diseases affecting either the outer or inner retina.
Genetic determinants of abnormal eye movements
Authors: LEROY BP
Published: September 2008

Purpose To describe the phenotypes and genotypes of genetically determined disease leading to nystagmus.

Methods A case presentation format will be used to illustrate different genetically determined conditions leading to nystagmus. Both clinical and electrophysiological phenotypes as well as genotypes will be discussed.

Results Phenotypes and genotypes of genetically determined nystagmus are very different. An important distinction to be made is the one between stationary and progressive diseases. Indeed, such distinction is important as the visual outcome varies considerably between those different conditions.

Conclusion Very diverse conditions may give rise to genetically determined nystagmus. Genetics and visual electrophysiology allows an important distinction between progressive and stationary conditions.
The neurological approach to ocular instability
Authors: MILEA D
Published: September 2008

Purpose Several neurological conditions can cause acquired instable eyes, nystagmus being certainly the most common finding in this setting.

Methods Nystagmus is an involuntary repetitive to‐and‐fro movement of the eyes, initiated by a slow ocular drift. The slow phase can be followed by a rapid return (in jerk nystagmus) or a repetitive slow phase only (pendular nystagmus).

Results A simple diagnostic algorithm of neurological nystagmus and other causes of ocular instability will be presented.

Conclusion Neurological nystagmus is only one of the aspects of acquired instable fixation. A precise clinical description of nystagmus is conditioning the subsequent diagnostic and management algorithm.
The role of electrophysiology
Authors: HOLDER GE
Published: September 2008

Abstract not provided
Structure of the lid margin in laboratory animals
Authors: KNOP N , KNOP E
Published: September 2008

Purpose The eye lid margin is of great importance for the spreading and the limitation of the tears. The so called lid wiper which is a specialized zone at the inner lid border directly apposed to the corneal surface for spreading the preocular tear film has, at present, only been described for the human conjunctiva. We have investigated common laboratory animals (rat and rabbit) for the presence of such a zone.

Methods Conjunctival whole‐mount specimens and total bulbi were investigated by serial section histology in ten rats (DA and Lewis) and in ten rabbits (NZW and Chinchilla).

Results The stratified squamous keratinised epidermis of the free lid margin showed a sharp transition with loss of the keratin layer at the level of the meibomian glands. Close to the inner lid border it was replaced by a small zone of an optically denser epithelium covered by para‐keratinised cells. This area represented the mucocutaneous junction (MCJ) equivalent to the line of Marx in the human.The MCJ rapidly transformed into a thickened 8‐12 cell layered stratified epithelium of that formed a cushion‐like epithelial elevation, reclined sharply towards the inner lid border and hence formed a typically relatively sharp lip‐like edge. The lid‐wiper epithelium showed species‐specific differences in morphology (cuboidal with goblet cells in the rabbit versus squamous without goblet cells in the rat) but it extended all along the lid margin in both species.

Conclusion At the inner border of the upper and lower lid of rat and rabbit, several zones of different morphology occur similar to the human including a lid‐wiper structure. Since lid wiper epitheliopathy was shown as a sensitive early indicator for human dry eye syndrome its investigation may be useful for future research in dry eye models of laboratory animals.
Compartmental factors influencing tear film osmolarity
Authors: BRON AJ , TIFFANY JM , GAFFNEY EA
Published: September 2008

Purpose To illustrate how compartmental factors could influence the distribution of tear osmolarity at the ocular surface in normals and dry eye.

Methods Mathematical modelling using parameters in the literature.

Results Tear film hyperosmolarity is a final common pathway causing ocular surface damage in dry eye. Modelling predicts that tear osmolarity is higher in the tear film than the meniscus, which may influence the distribution of ocular surface damage and the initiation of symptoms caused by hyperosmolarity. Once tear film break up occurs within the blink interval it is likely that this differential is amplified locally. The model allows the effect of compartmental factors on tear osmolarity to be addressed, including: regional differences in air flow and surface temperature, variations in ambient temperature and humidity, imperfect tear mixing, differential corneal and conjunctival exposure and individual differences in reflex tear flow, evaporation rate and blink interval. We hypothesise that interactions between these factors determine the dry eye phenotype in an individual. Additional considerations suggest that events at the ocular surface differ in aqueous‐deficient and evaporative dry eye.

Conclusion Hyperosmolarity at the ocular surface is affected by multiple factors, each of which may make different contributions to distribution and severity of surface damage in a given individual. This may determine the phenotype, frequency and severity of dry eye in a population.
Lid wiper epitheliopathy, ocular surface and tear film in symptomatic contact lens wearers
Authors: PULT H , PURSLOW C , MURPHY PJ , BERRY M
Published: September 2008

Purpose Lid wiper epitheliopathy (LWE) as well as lid parallel conjunctival folds (LIPCOF) are related to dry eye symptoms in contact lens weares and are thought to be caused by mechanical forces during blinking. This study investigates whether any correlations are detectable between LWE and LIPCOF and the ocular surface and tear film in soft contact lens wearers.

Methods 38 subjects were classified asymptomatic and 23 symptomatic by the Contact Lens Dry Eye Questionnaire. Pre‐lens break‐up time, ocular hyperaemia, corneal staining, LWE and LIPCOF were assessed in the right eyes of 61 (23 males, 38 females; mean age = 32.1 ±11.4yrs) experienced lens wearers. Pre‐ocular fluid was sampled using Schirmer strips pressed onto the temporal conjunctiva, and from harvested contact lenses. Mucins were assessed in dot‐blots and in Western blots after electrophoresis on 1% agarose or 4‐12% NuPAGE Gels.

Results LWE and LIPCOF were significantly increased in the symptomatic group (p<0.03). Significant correlations were found between LWE and both temporal LIPCOF (r=0.67, p<0.001), and nasal LIPCOF (r=0.39, p<0.001), and between LWE and bulbar hyperaemia (r=0.28, p<0.001). MUC5AC reactivity was significantly decreased in symptomatics (p=0.050). MUC4 was negatively correlated to temporal LIPCOF and LWE (r=‐0.47 and ‐0.46; p<0.01), MUC16 and MUC5AC correlated with corneal staining (0.36<r<0.53;p<0.04)

Conclusion Symptomatic contact lens wearers exhibit significantly more LWE and LIPCOF, and decreased MUC5AC reactivity. Decreased mucins are associated with LWE and LIPCOF severity. Correlations between LWE and LIPCOF may reflect their common frictional origin. Increased friction might follow from insufficient mucins at the ocular surface.
Genetic epidemiology in age‐related cataract research
Authors: GRAW J , KLOPP N , ILLIG T , WELZL G , HOLLE R , WICHMANN HE , MEISINGER C
Published: September 2008

Purpose Age‐related cataracts are the major cause of blindness worldwide. However, the contribution of genetics to their etiology is largely unknown. In contrast, the congenital and juvenile forms of cataracts are mainly caused by de‐novo or hereditary mutations leading to severe changes in the structure and/or function of the corresponding proteins – as it is obvious from the dominant mode of inheritance of most of the mutations. In addition to rare mutations, these cataract‐causing genes have also polymorphic sites in their regulatory and coding sequences (single nucleotide polymorphisms, SNPs); they might contribute to minor changes in the structure and/or function of the corresponding proteins. These alterations could be cataractogenic per se (in a mild form) or they might lead to an increased sensitivity of the proteins to environmental stress.

Methods In a new population‐based study in Augsburg (Germany), which will be finished in summer 2008, ~3000 probands have been asked for cataracts; the answers are being validated and further specified by the treating ophthalmologists.

Results 16 SNPs from known cataract causing genes (coding for crystallins, connexins and transcription factors) have been identified to be informative without violation of the Hardy‐Weinberg equilibrium. They will be tested with respect to their association with age‐related cataracts by logistic regression allowing for adjustment with respect to age, gender and other confounding effects.

Conclusion The results will be presented and discussed.
Genetics in exfoliation syndrome and age‐related cataract
Authors: JONASSON F
Published: September 2008

Purpose To describe the recent discovery of the association of Lysyl Oxidase Like 1 (LOXL1) gene polymorphisms with exfoliation syndrome as well as similar study on age‐related cataract.

Methods For phenotyping of exfoliation syndrome (XFS) and exfoliation glaucoma (XFG) peripheral band and/or central shield of exfoliative material on the anterior lens capsule was required and in case of glaucoma glaucomatous optic neuropathy. For phenotyping we excluded all exfoliation suspects. The phenotyping of cataract included cortical and nuclear cataract by type and grade using the Japanese Co‐operative Cataract Epidemiology Study Group system. Our genome wide association study on open angle glaucoma included XFG. For both studies we used the Illumina 300 chip including over 300,000 single – nucleotide polymorphisms (SNP´s).

Results When we had done 195 open angle glaucoma cases high genome wide significance was achieved on chromosome 15q24.1 in the LOXL 1 gene, later identified to be confined to XFG only. Combined, the identified DNA sequence variants explained 99% of the population attributable risk for exfoliation glaucoma. Having done 234 cases of age‐related cataract we still have not achieved a high genome wide significance although there was a modest signal associated with the LOXL1 polymorphisms.

Conclusion Exfoliation glaucoma and age‐related cataract have in twin studies both been found to have strong hereditary components. We did discover a major genetic risk factor for XFG/XFS, have however, so far, been unable to identify a highly significant single nucleotide polymorphism for age‐related cataract. The risk factors for cataract may include many modest genetic risk factors together with environmental risk factors.
Multivitamin‐mineral supplementation and age‐related cataract. The Italian‐American controlled clinical trial
Authors: MARAINI G
Published: September 2008

Purpose To evaluate if a multivitamin‐mineral supplement at RDI dosage can prevent incidence and progression of age‐related cataract.

Methods Randomized, double blind, single centre clinical trial. 1020 participants of Italian descent living in Parma, 55 to 75 years old, were assigned to placebo or to a daily tablet of Centrum. Lens status was assessed at baseline and at yearly follow‐up visits by lens photography.Primary outcome was a prespecified increase from baseline in N, C, or PSC opacity grades or cataract surgery. Secondary outcomes were increase in type‐specific opacity grades, cataract surgery, and visual acuity loss > 15 letters.

Results After an average follow‐up of 9 +‐ 2.4 years there was a decrease in total lens events in participants assigned to Centrum (HR 0.82, 95% CI 0.68‐0.98, P = 0.03). Nuclear events were significantly less common (HR 0.66, 95% CI 0.50‐0.88, P = 0.004) and PSC events significantly more common (HR 2.00, 95% CI 1.35‐2.98, P =< 0.001) in participants taking Centrum. No statistically significant treatment effects were seen for cortical opacities, moderate visual acuity loss, or cataract surgery.

Conclusion Lens events were less common in participants who took Centrum, but treatment had opposite effects on the development or progression of N and PSC opacities. This and the absence of effect on a functional outcome does not allow us to recommend the use of RDI nutritional supplement to affect the risk of cataract development (Ophthalmology 115;599,2008).
Mathematical models of intraocular pressure measurements and ocular rigidity
Authors: KOTLIAR K , KOSHITS IN , LANZL IM
Published: September 2008

The term ocular rigidity is widely used in ophthalmology. Generally it is assumed as a measurable physical parameter related to biomechanical properties of the whole eye globe. Formulas for clinical tonometry and tonography methods include the concept of ocular rigidity. Unfortunately ocular rigidity represents an elusive concept that means many things to many people. First of all, there is no consensual view on ocular rigidity in ophthalmology. The most of the formulas for ocular rigidity are based on discrete or continuous tonometric measurements in living or enucleated human eyes. Surprisingly ocular rigidity is measured in different units and has a different meaning by different authors. Finally, there is no clear consent between biomechanical engineers and ophthalmologists on the concept of ocular rigidity. In biomechanics parameters for the elasticity and viscoelasticity are accepted, which represent mechanical properties of a tissue an can consider its morphology. These are for example: Young’s moduli of the sclera, Poisson’s ratios of the cornea etc. Ophthalmological concepts on ocular rigidity are based on the consideration, that biomechanical properties of the corneoscleral shell are involved in the pressure‐volume relationship of the eye globe. Ocular rigidity defined in such a way climes to describe the total response of the eye without detailed considerations on its morphologic and material properties. In the proposed review several formulations of ocular rigidity are analysed and classified. It is attempted to link these conceptions with each other.
Assessment of ocular responce analyzer advantages for IOP measurements in children with progressive myopia
Authors: IOMDINA E , IVASHCHENKO ZH , TARUTTA E , EREMINA M
Published: September 2008

Purpose To study IOP in children with progressive myopia and myopic adults 4‐9 years after photorefractive keratectomy (PRK) using ORA (Reichert) and to assess the influence of corneoscleral biomechanics on IOP measurement results.

Methods Corneal‐compensated IOP (IOPcc), corneal hysteresis (CH), factor of corneal resistivity (FCR), IOP by Goldman (IOPG), corneal thickness and axial length were measured in 34 children (75 eyes) with low (27 eyes), moderate (31 eyes) and high (17 eyes) progressive myopia and 8 patients (16 eyes) with emmetropia or low hyperopia aged 7‐17, and 17 adults (28 eyes) with moderate and high myopia 6.5±0.2 years after PRK and 8 adults (16 eyes) of the same age (36.6±2.0 years) and myopia degree who had no refractive surgery.

Results An insignificant (within the age norm) relative increase of IOPcc has been detected in children with moderate (17.6±0.7 mmHg) and high myopia (17.8±0.8 mmHg) as compared with low myopia (16.4±0.6). Values of IOPcc seem to provide a more exact reflection of the ophthalmic tonus in myopic eyes than IOPG. CH proved to be lower in moderate (10.9±0.3 mmHg) and high myopia (10.7±0.4 mmHg) than in low myopia (11.2±0.3 mmHg) and emmetropia (12.4±0.7 mmHg), while FCR remains practically unchanged. So, CH is related to biomechanical properties of sclera. In the late period after PRK, IOPcc (14.9±0.4 mmHg) and FCR (8.9±0.2 mmHg) are lower than without refractive surgery (resp. 18.4±0.8 and 10.5±0.4 mmHg), while CH shows an identical drop in both cases (resp. 9.4±0.2 and 9.8±0.4 mmHg) compared to norm, which testifies to surgically induced biomechanical changes of the cornea.

Conclusion ORA reduces the impact of corneoscleral biomechanical properties on IOP measurements.
The estimation of intraocular pressure after refractive surgery. Statistical and simulation data
Authors: BAUER SM , KACHANOV AB , SEMENOV BN
Published: September 2008

Purpose To estimate the change in intraocular pressure (IOP) measured by either Maklakov tonometer or by Goldmann tonometer after refractive surgery for myopia and hypermetropia. In contrast to Goldmann tonometer, which measures the IOP by estimating the force needed to apply for prescribed deformation of the cornea, with Maklakov tonometer IOP is measured by estimating the diameter of the circular contact area of the cornea and the flat bottom of a tonometer.

Methods Numerical simulations have been carried out using finite element package ANSYS. The eye shell is modeled as two joint shells (cornea and sclera) with different mechanical properties. The results of mechanical simulation and statistical data were compared. For statistics the measurements of IOP were made for both eyes of 110 patients before and one month after corneal refractive surgery

Results Applanation tonometry after refractive surgery for both myopia and hypermetropia shows reduction of IOP, since in both cases the bending stiffness of the cornea decreases. For some parameters of refractive surgery for myopia (with decreasing corneal thickness less than 0.1 mm) the reduction of IOP is correlated with central corneal thickness. But in general the current model predicts nonlinear relations between new central corneal thickness and IOP reading

Conclusion All parameters of refractive surgery (the depth, the width and the place of ablation, the thickness of flap for Lasik surgery) have an effect on IOP reading obtained with both Goldmann and Maklakov tonometry. The results obtained by Goldmann tonometer are significantly more sensitive to all parameters of refractive surgery than those found with the Maklakov tonometer with load 10 g.
The mechanical response of lamina cribrosa to the elevated intraocular pressure
Authors: VORONKOVA E
Published: September 2008

Purpose To consider the different mechanical aspects of the development of glaucomatous atrophy of the optic nerve fibres.

Methods The Lamina Cribrosa (LC) is modelled as a continuous anisotropic plate with radial and angular nonuniformity. The solutions for LC with different degrees of nonuniformity can help reveal the structure of the LC, for which the glaucomatous damage is most probable to develop. In the second model, LC is assumed to be of multilayer shell of revolution with elastic ties between the layers. The varying of the LC strain of the optic nerve disk after decompression surgeries due to a dissection of the sclera channel paries is analyzed. The nonlinear shell theory is used to analyze deformations of the LC.

Results The calculations of the stresses and deformations in the LC show that the shear deformation of the vertical element of the LC could cause the atrophy of the optic nerve fibres. Buckling in the nonaxisymmetric state in the neighborhood of the edge could also cause edemas at the periphery of the LC and the atrophy of the optic nerve fibres. It is shown, that after decompression surgeries the shape of the LC deflection becomes more shallow, its relative value decreases, as a result of the sclera refinement. However the absolute LC deflection increases.

Conclusion All considered models confirm the mechanical genesis of glaucoma and help to evaluate the deflection of LC in normal state and after decompression surgeries.
The role of supranational societies in education
Authors: SPIVEY B
Published: September 2008

Abstract not provided
Future strategies of EBO
Authors: HAWLINA M
Published: September 2008

Abstract not provided
New strategies of SOE uniting the european national societies
Authors: SEREGARD S
Published: September 2008

Abstract not provided
Multifocal ERG and OCT in unexplained visual loss
Authors: BASTOS A , NOGUEIRA V , FERREIRA A , CRAVO I , NOVAIS M , CAMPOS F , PINTO F , CASTANHEIRA‐DINIS A , MONTEIRO‐GRILLO M
Published: September 2008

Purpose To determine the value of multifocal ERG (mfERG) and optical coherence tomography (OCT) in the evaluation of patients with unexplained visual loss.

Methods mfERG and macular OCT were obtained from six patients with unexplained visual loss (normal ophthalmoscopy, fluorescein angiography, full‐field ERG and brain CT scan) and four age and sex matched controls.

Results Patients BCVA ranged from 20/32 to 20/125. When comparing to controls, patients showed significantly depressed mfERG amplitudes in rings R1 (121.7 vs 64.8; p 0.01) and R2 (42.6 vs 19.5; p 0.02). Foveal thickness, as measured by macular OCT, was also reduced, although not significantly (p 0.1).

Conclusion Multifocal ERG allowed localization of the visual dysfunction to the central macula, in cases with hitherto unexplained visual loss.
Objective assessment of chromatic and achromatic pattern adaptation reveals the temporal response properties of different visual pathways
Authors: ROBSON AG , KULIKOWSKI JJ
Published: September 2008

Purpose To investigate the temporal response properties of magnocellular, parvocellular and koniocellular pathways using contrast increment/decrement visual evoked potentials (VEPs).

Methods Static achromatic and isoluminant chromatic gratings were generated on a monitor (Michelson contrast 0.05 to 0.6). Chromatic gratings were modulated along R/G or subject‐specific tritanopic confusion axes, established using a minimum distinct border criterion. Isoluminance was determined using minimum flicker photometry for a 1‐degree field. Achromatic and chromatic VEPs were recorded to contrast increments and decrements of 0.1 superimposed on the static gratings. Field size for Tritan gratings was restricted to 3‐degrees to minimize the effects of luteal pigment.

Results Achromatic increment/decrement VEPs were positive in polarity and largely unaffected by high levels of static contrast at low spatial frequencies. Responses to finer achromatic gratings showed marked attenuation as static contrast was increased. Chromatic VEPs to R/G or Tritan chromatic contrast increments were of negative polarity and showed progressive attenuation as static contrast was increased. Chromatic contrast decrement VEPs were of positive polarity and less sensitive to pattern adaptation.

Conclusion The relative contribution of sustained and transient response mechanisms to achromatic processing is spatial‐frequency dependent. Chromatic contrast increment VEPs are highly sensitive to pattern adaptation consistent with high stimulus selectivity and the sustained temporal response properties of the parvocellular and koniocellular pathways.
Pupil reactions in children with strabismic amblyopia in dependence of deviation value
Authors: BOYCHUK IM , BUSHUEVA NN , ROMANENKO DV , SLOBODYANIK SB
Published: September 2008

Purpose To reveal the difference between pupil reactions in amblyopic children with and without menifest deviation

Methods 51 patient with amblyopia aged 7‐12 y.o. were examined on the elaborated upillography device. There were 22% with amblyopia of high degree (average visual acuity and 64% of low and 14% of middle degree. Children had hypermetropic refraction;central monocular fixation in 27,eccentric in 18 cases. 32% of cildren had strabismus of different kind others had no manifest deviation (68%). The changes of pupil parameters during investigation of direct and consensual reaction on flashlight test and accommodative‐convergence response were conducted. With the help of elaborated device and corresponding software for pupillography method and STATISTICA for Windows 98.

Results The significant difference was found in groups with and without manifest strabismus during direct fleshligh, the amplitude was larger in those who had manifest viation. The amplitudes of pupil constriction in consensual reaction on flesh light test were also larger in amblyopic patients without deviation, P<0,05. Latencies of pupil striction was almost equal on both eyes in patients without deviation but were significantly different in those, who had manifest deviation. After accommodative‐convergence response average value of pupil recovery was larger in patients without deviation in comparison with.

Conclusion Patients without manifest deviation have disorders in reaction of pupil to direct flesh light test and accommodative response on the near object. Patients with deviation have consensual pupil reaction disorders that indicate on involvement of afferent but and efferent pathways of eye motility in such cases.
Accommodation insufficiency in children: are exercises better than reading glasses?
Authors: WAHLBERG M , CARLSSON R
Published: September 2008

Purpose Purpose: The aim of the present study is to investigate which mode of therapy is the most effective in the treatment of accommodative insufficiency (AI). The two methods compared was plus lens (+1.00D) reading addition (PLRA) or spherical flipper (± 1.50D).

Methods Methods: Twenty four subjects (mean age 10.3 years, 2.5 SD) participated. All subjects were diagnosed with AI. Ten subjects were treated with PRLA and 9, out of 14, subjects completed spherical flipper treatment. The treatment time was 8 weeks.

Results Results: There was a statistical significant improvement in the accommodative amplitude with both regimes of treatment. However, accommodation did not reach normal values after only 8 weeks of treatment. The analysis between the two therapies did not reveal any statistical significant difference although spherical flipper treatment was found to have an overall larger effect.

Conclusion Conclusions: The results of the present study show that both methods improve accommodative amplitude but there were no significant difference between the two methods.
Towards a blood test for diabetic retinopathy
Authors: SHALCHI Z , BUTT A , SMITH S , POWRIE J , JANIKOUN S , SWAMINATHAN R
Published: September 2008

Purpose Diabetic retinopathy (DR) is the leading cause of blindness among adults of working age in the UK. Early detection and appropriate management can prevent severe visual loss in 95% of cases. However, current screening methods are costly and suffer from subjective grading. Nucleic acids have been shown to circulate in plasma, with levels raised in conditions of cell death such as cancer and trauma. This study aimed to quantify circulatory retinal‐specific nucleic acids, and to evaluate potential for their use in the assessment of DR.

Methods Diabetic patients (n = 106) and healthy controls (n = 24) were recruited from the Diabetes and Ophthalmology departments at St Thomas’ Hospital. RNA was extracted from whole blood, with quantitative real‐time RT‐PCR used to quantify mRNA levels for rhodopsin and RPE65, two proteins expressed exclusively in the retina. Beta‐actin mRNA was used for normalisation.

Results Rhodopsin, RPE65 and beta‐actin mRNA were detected in 100% of subjects. Circulating rhodopsin and RPE65 mRNA levels were higher in diabetic patients than healthy individuals (p < 0.02). Circulating rhodopsin mRNA was raised in all DR groups compared to healthy individuals, irrespective of presence or severity of DR (p < 0.02). With respect to healthy controls, circulating RPE65 mRNA levels were higher in diabetic patients with background and proliferative DR (p < 0.02). Patients with active proliferative DR (neovascularisation, vitreous and pre‐retinal haemorrhage, or retinal detachment) possessed higher RPE65 mRNA and lower rhodopsin mRNA levels than those with quiescent disease (p < 0.01).

Conclusion There is significant potential for use of these markers to screen for the presence of DR in diabetic patients in a quantitative manner using a blood test.
Risk markers for progression of mild nonproliferative retinopathy to clinically significant macular edema in type 2 diabetic patients
Authors: PEREIRA I , NUNES S , RIBEIRO ML , BERNARDES R , CUNHA‐VAZ J
Published: September 2008

Purpose To determine risk markers for the development of clinically significant macular edema (CSME) needing photocoagulation treatment in type 2 diabetic patients with mild nonproliferative retinopathy (NPDR), during a 7‐year period.

Methods Fifty‐one type 2 diabetic patients with mild NPDR, followed‐up for 2 years as controls of diabetic retinopathy clinical trials, were selected. Patients underwent ophthalmological examinations every 6 months, including stereoscopic color fundus photography, fluorescein angiography and vitreous fluorophotometry, and were metabolically controlled. These patients were thereafter followed‐up for the next 5 years by conventional general and ophthalmological care.

Results At the end of the 7‐year follow‐up period, 8 patients developed CSME, needing photocoagulation treatment. These patients presented a higher microaneurysm (MA) formation rate at the first year of follow‐up (p<0.001), a higher blood‐retinal barrier (BRB) permeability value (p=0.042), an abnormal foveal avascular zone (FAZ) contour on fluorescein angiography (p=0.009) and a higher HbA1C level at baseline (p=0.001).

Conclusion Microaneurysm formation rate higher or equal to 3 MA/year, BRB permeability values over or equal to 4.0 nm.s‐1, evidence of abnormalities in the FAZ, and hemoglobin A1C levels at baseline, are risk markers for progression of NPDR to CSME in patients with type 2 diabetes.
Screening diabetic retinopathy using a wide field imaging system
Authors: ARNDT C , NABHOLZ N , BOUSQUET E , NGUYEN F
Published: September 2008

Purpose The wide field (200°) imaging system (Optos, Great Britain) using a scanning laser ophthalmoscope (SLO) enables to visualize a large part of the retina including the periphery. The present study was designed to evaluate the imaging system for screening purposes in diabetic retinopathy.

Methods The SLO system was used in diabetic patients in stationary care. Screening for diabetic retinopathy was performed: An undilated and dilated retinal biomicroscopy was performed by a senior ophtalmologist. An undilated SLO image was taken by an orthoptist in training. The images were reviewed by a resident masked to results of the previous retinal biomicroscopy. The results of the clinical examination were compared with the results of the SLO image analysis.

Results A total of 251 patients were evaluated (n=503 eyes). Of the retinal lesions detected on the undilated SLO images, the undilated retinal biomicroscopy missed 24% and the dilated retinal biomicroscopy 11%. None of the retinal lesions detected with the undilated retinal biomicroscopy were missed on the SLO images.

Conclusion The diagnostic rate of diabetic retinopathy using undilated SLO images was significantly higher when compared with the diagnostic rate of undilated and dilated retinal biomicroscopy. Further work is necessary to evaluate the diagnostic yield of the wide field SLO system in comparison with standard non mydriatic retinography procedures.