bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of saliva on an antimicrobial tissue conditioner containing silver–zeolite
Authors: Abe Y. , Ishii M. , Takeuchi M. , Ueshige M. , Tanaka S. , Akagawa Y.
Published: June 2004

summary  The purpose of this study was to evaluate the influence of human saliva on the antimicrobial effect of a tissue conditioner containing an antibiotic agent, silver–zeolite. Samples of each tissue conditioner with or without silver–zeolite were prepared and a plastic disk was used as a control. Candida albicans and nosocomial respiratory infection‐causing bacteria, Staphylococcus aureus, methicillin‐resistant S. aureus (MRSA), Pseudomonas aeruginosa and the Streptococcus milleri group (S. constellatus and S. intermedius), were selected as test microorganisms. Antimicrobial effects of samples after water or saliva immersion for 28 days were evaluated by counting the number of viable cells [colony forming unit (CFU)] in each microbial suspension (100 μL). All data were statistically analysed by one‐way anova and Bonferroni's test (P < 0·05). The antimicrobial effects of samples with silver–zeolite immersed in saliva against C. albicans, S. aureus and MRSA were observed while CFU of P. aeruginosa indicated no significant difference from that of the control. As for the S. milleri group, its CFU after saliva immersion showed the significantly smaller value than that of the control. It is concluded that the antimicrobial effects of samples containing silver–zeolite against all tested microbes except for P. aeruginosa and the S. milleri group are not influenced by saliva immersion for 28 days.
Functional impression and jaw registration: a single session procedure for the construction of complete dentures*
Authors: Utz K.‐H. , Müller F. , Kettner N. , Reppert G. , Koeck B.
Published: June 2004

summary  The conventional fabrication of complete dentures involves two separate clinical sessions for functional impression making and jaw registration. The presented method combines both procedures in one session. The aim of this study was to survey the three‐dimensional tooth positions in complete dentures with reference to the ridges to establish arbitrary guideline values that could be used for the manufacturing of tooth‐position analogue plastic rims on functional impression trays. New complete dentures were fabricated by supervised undergraduate students in the conventional manner for 104 edentulous patients. The position of the maxillary teeth was surveyed in the horizontal plane using the Schmuth ‘vizor‐measuring plate’. The vertical dimension of occlusion, represented as the distance between opposing ridge areas of the dentures in maximum intercuspation, was measured at different sites by means of a Gutowski gauge. The tooth positions on the dentures varied widely, e.g. the horizontal distances between the incisive papilla and the maxillary incisors was 7·1 ± 2·3 (3–14) mm. The vertical dimension of occlusion, which is most important in the jaw registration, varied equally with an anterior inter‐alveolar distance between 12 and 33 (20·4 ± 4·0) mm. Arbitrary moulding of the tooth position‐analogue plastic rims does not seems to be an ideal method of pre‐shaping functional impression trays, because the individual anatomical variation is considerable. Alternatively, the horizontal and vertical tooth positions of functionally and aesthetically pleasing dentures should be measured to pre‐shape the rims of functional impression trays in the maxillary and the mandibular jaw. Such trays are a valuable tool for functional impressions and an immediate preliminary jaw registration in the fabrication of new complete dentures. This method allows a first try‐in of the full set‐up in the third clinical visit without loosing precision.
Oral parafunctions and association with symptoms of temporomandibular disorders in Japanese university students
Authors: Miyake R. , Ohkubo R. , Takehara J. , Morita M.
Published: June 2004

summary  We examined whether oral parafunctions are associated with symptoms of temporomandibular disorders (TMD) in 3557 Japanese university students, aged between 18 and 26 years. Participants completed a questionnaire regarding various oral parafunctions and subjective symptoms related to TMD, and underwent a dental examination. The prevalence of temporomandibular joint (TMJ) noise, TMJ pain and impaired mouth opening was 41·7, 16·0 and 16·3%, respectively. The most prevalent parafunction was sleeping on one side (60·2%), followed by supporting the jaw by leaning on the palm of the hand (44·8%). Mean age, decayed, missing and filled teeth, and number of teeth were not significantly different between TMD positive and negative groups according to unpaired t‐test. The chi‐squared test revealed that the ratio of females was significantly higher among students with TMD than without TMD. Multiple logistic regression models adjusted for age and gender demonstrated that chewing on one side caused an increased risk of TMJ noise [odds ratio (OR) = 1·52, P < 0·001], TMJ pain (OR = 1·54, P < 0·001), and impaired mouth opening (OR = 2·00, P < 0·001). Tooth clenching also increased the risk of TMJ noise (OR = 1·86, P < 0·001), TMJ pain (OR = 1·79, P = 0·001) and impaired mouth opening (OR = 1·88, P < 0·001). Further prospective cohort studies, including other potential risk factors, are required to clarify these relationships.
Effects of a functional appliance on masticatory muscles of young adults suffering from muscle‐related temporomandibular disorders
Authors: Castroflorio T. , Talpone F. , Deregibus A. , Piancino M. G. , Bracco P.
Published: June 2004

summary  The aim of this study was to investigate the effects of an original orthodontic functional appliance [function generating bite for deep bite correction (FGB‐D)] on masticatory muscle activity in subjects suffering from muscle‐related temporomandibular disorders (TMD). Electromyographic (EMG) analysis was performed on 33 young adults (nine men, 24 women) to evaluate the contractile symmetry of the right and left masseter and anterior temporalis muscles. The subjects were divided into three groups: a muscle‐related TMD group requiring orthodontic treatment for deep bite correction (three men, eight women) and treated with FGB‐D; a muscle‐related TMD group not requiring orthodontic treatment (three men, eight women) and treated with a Michigan occlusal splint; and a TMD‐free group (three men, eight women) as a control group. Records were made by surface EMG of maximum voluntary teeth clenching, with and without the functional appliance or occlusal splint in place, before and after 12 months of therapy. A torque index was derived from the surface EMG recordings to estimate lateral displacement of the mandible. The results show that the FGB‐D corrects the torque index and thus the lateral displacement of the mandible.
Prediction of demand for treatment of temporomandibular disorders based on a 20‐year follow‐up study
Authors: Carlsson G. E. , Magnusson T. , Egermark I.
Published: June 2004

summary  The purpose was to test the hypothesis that signs and symptoms characteristic of temporomandibular disorders (TMD) at age 15 would predict demand for treatment during a 20‐year follow‐up period. Of originally 135 examined 15‐year‐old subjects, 103 completed a questionnaire and 84 were examined clinically at the 10‐year follow‐up (at age 25). After 20 years (at age 35), 114 completed a questionnaire and 100 were also examined clinically. During the 20‐year follow‐up period, 21 subjects received some kind of treatment of TMD. At baseline (age 15), the treated group reported tooth grinding at night more often than the non‐treated group (P = 0·0042). At the 10‐year follow‐up (at age 25), the treated group reported more symptoms of TMD and oral parafunctions than the non‐treated group. Among the clinical registrations, there was only one significant difference between the groups: anterior tooth wear was more extensive in the treated group. At the 20‐year follow‐up (at age 35), the treated group reported significantly more symptoms of TMD and oral parafunctions than the non‐treated group. The clinical dysfunction index was also higher in the treated group. Logistic regression revealed tooth grinding at night as a significant predictor of received treatment of TMD. However, the positive predictive value was low whereas the negative predictive value was high (90%). The findings indicate that nocturnal tooth grinding is related to demand for treatment of TMD.
The retentive effects of pre‐fabricated posts by luting cements
Authors: Sen D. , Poyrazoglu E. , Tuncelli B.
Published: June 2004

summary  The purpose of this study was to compare the retention of two different pre‐fabricated posts cemented to the root canal with four different adhesive luting cements and a zinc phosphate cement. The crowns of 100 freshly extracted human mandibular central and lateral incisors were removed at the cementoenamel junction and divided into two main groups (A = ParaPost and B = Flexi‐Post) and further divided into five subgroups to evaluate the effects of five different cements (Rely‐X ARC, Panavia F, ParaPost Cement, Flexi‐Flow Natural and Adhesor) each with 10 samples. Post‐holes were prepared on all of the roots following the manufacturer's instructions. Each sample was placed into a specialized jig and tensile strength tests performed by using testing machine with a crosshead speed of 0·638 cm min−1 and force applied until failure. The data were analysed with one‐way anova (Post Hoc a Scheffe's S test) and two‐way anova (P < 0·001). The Flexi‐Post dowels had a mean of 54·21 kg (s.d. = 9·37) and demonstrated statistically higher retention than ParaPost dowels with a mean of 33·93 kg (s.d. = 10·69) for all of the cement groups (P < 0·001). In Flexi‐Post and ParaPost dowel groups; Rely‐X ARC was statistically higher than the Panavia F, ParaPost Cement, Flexi‐Flow Natural and Adhesor (P < 0·05). Adhesor was significantly lower than the other subgroups (P < 0·05). Resin luting cements have demonstrated very high tensile strength potential for a strong bond to dentin.
The bitewing radiograph as an assessment tool in fixed prosthodontics
Authors: Purton D. G. , Ng B. P. , Chandler N. P. , Monteith B. D.
Published: June 2004

summary  Molar crown preparations, as described in the literature, have standard forms dictated by the demands of retention, resistance and the physical properties of materials. Standard designs may not be appropriate for all patients because of ethnic variations in tooth shape, pulp size and dentine thickness. Accurate data on these features could assist clinicians to minimize the risk of accidental pulpal injury. The aim of this study was to compare the first molar crown and pulp dimensions between Asian (Chinese, Korean, Malay) and other ethnic groups, using measurements from the bitewing radiographs of 121 subjects. Comparisons revealed the following significantly different features of Asian first molars: larger total pulp areas in uppers (P < 0·0005); shorter crowns (P < 0·0005); narrower upper teeth at the cervix (P < 0·0005); wider pulps at the cervix of lowers (P < 0·02); more bulbous crowns (P < 0·0005 for uppers; P < 0·01 for lowers), and finally significantly thinner dentine interproximally at the cervix (P=0·001 for uppers; P=0·011 for lowers). Preparations with wide shoulders could pose hazards to the pulps in Asian subjects. This study emphasizes the value of bitewing films in assessing crown and pulp size and shape before making crown preparations. The experienced practitioner may intuitively include tooth and pulp morphology in treatment planning, but this appears not to be taught or documented in textbooks.
The Liverpool Oral Rehabilitation Questionnaire: a pilot study
Authors: Pace‐Balzan A. , Cawood J. I. , Howell R. , Lowe D. , Rogers S. N.
Published: June 2004

summary  There are several validated health‐related quality of life (HRQOL) questionnaires designed to record patient‐derived outcomes in head and neck cancer. None deals specifically with oral rehabilitation. The aim of this study was to pilot a new questionnaire, the Liverpool Oral Rehabilitation Questionnaire (LORQ). The questionnaire consists of 25 items about oral function and denture satisfaction. A four‐point Likert scale is used. Sixty‐one consecutive patients attending oral rehabilitation clinics completed the LORQ in combination with the University of Washington Head and Neck questionnaire version 3 (UW‐QOL) and European Organisation for Research and Treatment of Cancer H&N quality of life questionnaire (EORTC H&N 35). Forty‐two patients received questionnaires at baseline, whereas the rest were provided with the questionnaires at various stages of oral rehabilitation. For each item on the questionnaire, a full range of possible responses were given by patients. Kappa coefficients of agreement for test–retest data indicated moderate to very good agreement between repeat questionnaires. There were significant correlations (P < 0·001) between items in the LORQ and those in the UW‐QOL and EORTC HN questionnaires. The LORQ also identified differences in responses between non‐cancer and cancer groups of patients undergoing oral rehabilitation. This study of the LORQ is encouraging, although data on its responsiveness over time and to intervention is awaited.
The effect of dentin desensitizers on thermal changes in the pulp chamber during fabrication of provisional restorations
Authors: Usumez A. , Ozturk A. N. , Aykent F.
Published: June 2004

summary  The purpose of this study was to evaluate the effect of two dentin desensitizers on the pulp chamber temperature increase during fabrication of provisional restorations by a direct method. Sixty intact extracted mandibular third molars were prepared for a metal‐ceramic complete crown. Then the teeth were randomly divided into three groups of 20 each. Group 1, no dentin desensitizer was used as the control group; group 2, a resin‐based dentin desensitizer was selected; and group 3, the prepared teeth surfaces were coated with polyurethane cyanoacrylate adhesive. Each of the three groups was further divided into two polymerizing systems (autopolymerizing and a photopolymerizing) of 10 each. After insertion of the resin‐filled matrix, the temperature change in the pulpal chamber was recorded with thermocouple connected to a data logger. anova indicated no significant differences for all combinations of desensitizing agents and curing methods (P > 0·05). When light cured composite or chemical curing acrylics were used to make temporary crowns, the presence of desensitizing agent did not reduce the temperature transmitted from the provisional material; the residual temperature rise transmitted was of such a magnitude as to cause concern regarding possible thermal injury to pulp.
Corrosion behaviour of high copper dental amalgams
Authors: Yap A. U. J. , Ng B. L. , Blackwood D. J.
Published: June 2004

summary  This study evaluated the corrosion behaviour of two high copper dental amalgam alloys [Dispersalloy (Dentsply‐Caulk) and Tytin (Kerr)] in different electrolytes. Amalgam specimens were prepared, coupled to a copper wire, cemented into glass tubes and polished to a 600‐grit finish. A corrosion cell was prepared using a carbon counter‐electrode, a standard calomel electrode as the reference and amalgam as the working electrode. The alloys were tested in the following mediums at 37 °C: (i) artificial saliva based on Fusayama's solution (FS), (ii) artificial saliva with citric acid adjusted to pH 4·0 (FC) and (iii) 1% sodium chloride solution (SC). Corrosion potentials (Ecorr) and corrosion rates (Icorr) were determined using potentiostatic and impedance spectroscopy methods. Data was subjected to anova/Scheffe's post hoc test at 0·05 significance level. For both alloys, the corrosion potential in FS was significantly greater than in SC. Corrosion potential of Tytin in FS and SC was also significantly greater than in FC. The corrosion rate of Dispersalloy in FC was significantly greater than in FS and SC. For Tytin, corrosion rate in SC was significantly greater than in FS and FC. Although no significant difference in corrosion potential/rate was observed between the alloys when tested in FS, significant differences were observed when electrochemical testing was carried out in FC and SC. The corrosion behaviour of high copper amalgam alloys are both material and environment dependent. Certain food substances may increase the corrosion of high copper amalgams.
The effect of an interocclusal appliance on bite force and masseter electromyography in asymptomatic subjects and patients with temporomandibular pain and dysfunction
Authors: Chandu A. , Suvinen T. I. , Reade P. C. , Borromeo G. L.
Published: June 2004

summary  The aims of this study were to assess the effect of clenching with or without the presence of an interocclusal appliance (IOA) on bite force (BF) and masseter electromyography (EMG) in patients with temporomandibular pain dysfunction disorders (TMPD) and to compare these results with an asymptomatic age‐ and gender‐matched control group. Ten patients with TMPD (mean age 26·9 years) were compared with eight healthy controls (mean age 25·3 years). Bilateral masseter EMG activity was recorded at rest, while clenching on the BF meter, while clenching on an IOA and while clenching on an IOA together with the BF meter. Significant left to right EMG activity asymmetry was found in the patient group at rest and during multiple clenching tasks in the control group. The patient group had significantly greater EMG activity at rest than controls. For all other tasks, the control group EMG activity was greater than the patient group. Use of an IOA significantly decreased EMG activity in both patient and control groups. BF was significantly greater in the control group on the right side for the different clenching tasks. Insertion of the IOA significantly increased BF in the control group. The results of this study indicate differences in EMG activity and BF during different clenching tasks and between patients with TMPD and asymptomatic subjects.
Use of bar‐clip attachments to enhance the retention of a maxillofacial prosthetic obturator: a clinical report
Authors: Etienne O. M. G. , Taddei C. A.‐M. I.
Published: June 2004

summary  Precision attachments are commonly used in prosthetic dentistry but are still questioned in maxillofacial prosthetics. The aesthetic enhancement and functional rigidity provided by attachments are favourable features to many challenging clinical situations such as class‐III defect (Aramany's maxillectomy classification). Surgical reconstruction is the standard treatment for this type of defect repair. However, owing to the need for dental rehabilitation and patient reserve, prosthetic rehabilitation was the modality chosen in this clinical case. The use of bar attachments is described in this paper as providing increased stability and retention of the prosthesis, and improved obturator water and airtightness.
Oral health‐related quality of life in southern Chinese following radiotherapy for nasopharyngeal carcinoma
Authors: McMillan A. S. , Pow E. H. N. , Leung W. K. , Wong M. C. M. , Kwong D. L. W.
Published: June 2004

summary  Although the complications of head and neck radiotherapy in the treatment of nasopharyngeal carcinoma (NPC) have been described, there is limited information on the effect of oral complications on oral health related quality of life. The aim of this study was to describe the psychosocial and functional impact of oral conditions in southern Chinese following radiotherapy for NPC. A cross‐sectional study design was used with a sample of 109 subjects including NPC survivors, newly diagnosed NPC cases and a control group. Oral health related quality of life was assessed through the SF‐36 and the Oral Health Impact Profile measures and a dry mouth measure. Data on socio‐demographic variables and treatment seeking were also collected. The psychosocial and functional impact of oral conditions as revealed by the health status measures was significantly greater in NPC survivors than newly diagnosed NPC cases and controls. The oral specific and condition specific measures appeared to discriminate more effectively between groups than the generic measure. NPC survivors sought significantly more dental treatment than the other groups. The oral complications of radiotherapy for NPC, notably sequelae of salivary gland damage, have a significant negative effect on oral health related quality of life and result in an increased burden of dental care in the long‐term.
In vivo confocal microscopy of Thygeson's superficial punctate keratitis
Authors: Cheng Lulu L , Young Alvin L , Wong Angus KK , Law Ricky WK , Lam Dennis SC
Published: June 2004

A 56‐year‐old Chinese man diagnosed with Thygeson's keratitis by clinical biomicroscopy was examined using a tandem scanning confocal microscope. Among normal superficial epithelial cells, clumps of markedly enlarged epithelial cells were identified. Multiple highly reflective filamentary structures were observed in the deeper layers. Most of these lesions were linear; some demonstrated curled ends and others demonstrated branching lesions with ‘sprouts’. No inflammatory cells were evident in the areas of corneal stroma sampled. In vivo confocal microscopy may be helpful in the diagnosis of Thygeson's superficial keratitis. To the best of our knowledge, we report the first in vivo confocal images of focal desquamation of epithelium and intraepithelial hyper‐reflective linear lesions in English literature.
Assessment of optic nerve head topographic parameters with a confocal scanning laser ophthalmoscope
Authors: Durukan A Hakan , Yucel Iclal , Akar Yusuf , Bayraktar M Zeki
Published: June 2004

Aim: To assess the disc area, age, sex, laterality (side of the eyes) and refractive error dependent differences in optic nerve head topographic parameters in a normal population.

Methods: Optic nerve head topographic analysis of both eyes of 551 healthy Turkish subjects aged 11−75 years (1102 eyes) was performed using a confocal scanning laser ophthalmoscope, the Heidelberg Retinal Tomograph II (HRT II). The effects of disc size, sex, laterality (side of the eyes), age and refractive error on optic nerve head topographic parameters were assessed. Subjects were divided into three different age groups (<30 years, 30−60 years, >60 years) and three different disc area groups (<2.00 mm2, 2.00−2.25 mm2, >2.25 mm2). Disc area, topography standard deviation and a total of 12 topographic parameters were calculated by HRT II for each subject. Statistical analysis was performed using Student's t‐test, multiple regression analysis, Tukey‐HSD test, anova and Pearson's correlation coefficient.

Results: A total of 543 subjects (298 women and 245 men) were included in the study. The mean disc area of the subjects was 2.12 ± 0.47 mm2 (range 1.16−4.98 mm2). The mean refractive error of the subjects was −0.58 ± 1.71 D (range −4.75 D to +4.25 D). The mean cup shape measure was −0.21 ± 0.07 (95% confidence interval −0.07 to −0.35). The disc area was significantly correlated with all of the topographic parameters but two; namely, the cup shape measure and the height variation contour. Significant age‐related differences were detected in four parameters (mean retinal nerve fibre layer [RNFL] thickness, disc area, cup‐to‐disc area ratio, cup area) and significant sex‐related differences were detected three parameters (mean RNFL thickness, height variation contour, RNFL cross‐sectional area). However, there were no significant differences in any of the parameters for laterality and refractive error. The parameter cup shape measure did not correlate with any of the five variables investigated.

Conclusion: Cup shape measure was the only optic nerve head topographic parameter that was independent of age, sex, disc area, laterality and the refractive error. It seems to be a promising parameter in evaluation and comparison of the optic discs of normal subjects, with different disc area, age, sex, refraction error and laterality, as being independent of the main variation factors of the disc topography.
In vivo confocal microscopic characteristics of iridocorneal endothelial syndrome
Authors: Grupcheva Christina N , McGhee Charles NJ , Dean Simon , Craig Jennifer P
Published: June 2004

Purpose: To analyse five cases of iridocorneal endothelial (ICE) syndrome and describe the microstructural characteristics observed by in vivo confocal microscopy.

Methods: All five subjects presented with clinical characteristics suggestive of ICE syndrome and were examined clinically by Orbscan II pachymetry and by in vivo confocal microscopy. At least 600 sequential digital confocal images throughout the z‐axis were analysed qualitatively and quantitatively for each cornea.

Results: Clinically, all subjects presented with: minimal to moderate corneal oedema, focal to diffuse ‘beaten metal’ appearance of the corneal endothelium, and varying degrees of iris atrophy. Three subjects had a history of elevated intraocular pressure. In vivo confocal microscopy highlighted two main patterns of endothelial change: small cells (mean maximal diameter of 13.6 ± 1.5 µm), with indistinct borders and very bright and prominent, uniform nuclei (two subjects) and larger, epithelioid‐like cells (mean maximal diameter of 26.6 ± 5.5 µm), with irregular borders and non‐homogenous, diversely shaped nuclei (three subjects). Different degrees of alteration of stromal structure, very prominent corneal nerves and unusual syncytia of keratocytes were also observed. Significant oedema of the basal epithelium with increased reflectivity of the intercellular spaces was prominent in all cases.

Conclusions: Although ICE syndrome is considered to be primarily an endothelial disease, in vivo confocal microscopy demonstrated structural alterations throughout the entire cornea even in clinically mild cases. The ability of in vivo confocal microscopy to localize and accurately measure various elements in different corneal layers will assist differentiation of various presentations of ICE syndrome as this technique becomes increasingly available in clinical practice.
Panoptic versus conventional ophthalmoscope
Authors: McComiskie Jayne E , Greer Ristan M , Gole Glen A
Published: June 2004

Background: The ‘ease of use’ and accuracy in measurement of the vertical optic cup/disc ratio (VCDR) was compared between the conventional direct ophthalmoscope (CO) and Panoptic direct ophthalmoscope (PO) in a group of ‘naïve’ first year medical students to determine which would be more suitable for non‐ophthalmologists.

Methods: In this quasi‐randomized method comparison study, eight students received an introductory session on ophthalmoscopy then examined 18 eyes (9 left, 9 right) with each ophthalmoscope in a private practice. The subjects were the eight students themselves plus two other subjects. Each subject (n = 10) had one eye dilated. Students determined a VCDR and a subjective score of ‘ease of use’ on a scale of 1 (difficult) to 10 (easy). A consultant ophthalmologist (GAG) determined the benchmark VCDR for each eye with each ophthalmoscope.

Results: Of 288 eye examinations, there were 111 measure­ments of VCDR using the CO (47 undilated, 64 dilated), and 140 measurements using the PO (75 undilated, 65 dilated). Differences in the students’ estimated VCDR and the benchmark were similar for the CO and PO (P = 0.67). ‘Ease of use’ was scored in 288 eyes and the median score was higher in the PO overall (CO: median 8, IQR 6−9; PO median 9, IQR 8−10; P < 0.0001), and within each session (P < 0.0001 for each session).

Conclusions: Medical students found the PO much easier to use, with accuracy of rating the VCDR similar to the CO. This comparison would support the wider use of the PO amongst medical students, general practitioners and other primary care providers.
Attitudes towards and perceptions of visual loss and its causes among Hong Kong Chinese adults
Authors: Lau Joseph Tak Fai , Lee Vincent , Fan Dorothy , Lau Mason , Michon John
Published: June 2004

Background: As part of a study of visual function among Hong Kong Chinese adults, their attitudes and perceptions related to visual loss were examined. These included fear of visual loss, negative functional impacts of visual loss, the relationship between ageing and visual loss and help‐seeking behaviours related to visual loss. Demographic factors associated with these variables were also studied.

Methods: The study population were people aged 40 and above randomly selected from the Shatin district of Hong Kong. The participants underwent eye examinations that included visual acuity, intraocular pressure measurement, visual field, slit‐lamp biomicroscopy and ophthalmoscopy. The primary cause of visual disability was recorded. The participants were also asked about their attitudes and perceptions regarding visual loss using a structured questionnaire.

Results: The prevalence of bilateral visual disability was 2.2% among adults aged 40 or above and 6.4% among adults aged 60 or above. Nearly 36% of the participants selected blindness as the most feared disabling medical condition, which was substantially higher than conditions such as dementia, loss of limbs, deafness or aphasia. Inability to take care of oneself (21.0%), inconvenience related to mobility (20.2%) and inability to work (14.8%) were the three most commonly mentioned ‘worst impact’ effects of visual loss. Fully 68% of the participants believed that loss of vision is related to ageing. A majority of participants would seek help and advice from family members in case of visual loss.

Conclusions: Visual function is perceived to be very important by Hong Kong Chinese adults. The fear of visual loss is widespread and particularly affects self‐care and functional abilities. Visual loss is commonly seen as related to ageing. Attitudes and perceptions in this population may be modified by educational and outreach efforts in order to take advantage of preventive measures.
Prospective randomized evaluation of diode‐laser and cryotherapy in prethreshold retinopathy of prematurity
Authors: Azad Raj Vardhan , Pasumala Laxminarayana , Kumar Harsh , Talwar Dinesh , Pal Raj , Paul Vinod Kumar , Chandra Parijat
Published: June 2004

Purpose: To study the efficacy of indirect diode laser photocoagulation and cryotherapy in prethreshold retinopathy of prematurity (ROP).

Methods: Thirty‐six eyes of 18 premature infants less than 34 weeks gestational age and/or less than 1600 g birth weight with prethreshold ROP were prospectively randomized to treatment with either indirect laser photocoagulation or cryotherapy. Prethreshold ROP was defined as any stage of ROP in zone I with plus disease; or stage 3 with three or more contiguous clock hours or five or more total clock hours of involvement of retina in zone II with plus disease but less than threshold disease. Regression of the ROP was assessed for a minimum period of 6 months.

Results: Regression of ROP occurred in all 36 eyes (100%) in both groups.

Conclusions: Excellent results are achieved if ROP is treated at the prethreshold stage with both indirect laser photocoagulation and cryotherapy. Although laser has definite advantages, cryotherapy can be considered as an alternative modality of treatment in developing countries due to economic reasons.
Refractive status and the 5‐year incidence of age‐related maculopathy: the Blue Mountains Eye Study
Authors: Wang Jie Jin , Jakobsen Kirsten B , Smith Wayne , Mitchell Paul
Published: June 2004

This study aimed to assess the longitudinal association between refraction and 5‐year incident age‐related maculopathy (ARM) in the Blue Mountains Eye Study population. The dataset included 3654 participants aged 49+ (82.4% of eligible) examined at baseline (1992−1994), and 2335 (75.1% of survivors) examined after 5 years. Retinal photograph grading followed the International ARM Classification. Incident ARM was assessed using a side‐by‐side comparison. Refraction was performed using autorefraction with subjective refinement. Spherical equivalent was calculated from spherical plus half the cylindrical power. After adjusting for age, sex and smoking, no association was found between baseline spherical equivalent and 5‐year incident late or early ARM. Hyperopic right eyes had slightly higher incident rates for late (0.8%) and early (6.3%) ARM, compared with myopic (0.4% and 4.1%, respectively) or emmetropic (0.5% and 5.0%, respectively) right eyes. After multivariable adjustment, this study found no significant association between hyperopia and the 5‐year incidence of late or early ARM. Left eyes or the combined data from both eyes had similar findings.
Menstrual cycle dependent changes in blue‐on‐yellow visual field analysis of young diabetic women with severe non‐proliferative diabetic retinopathy
Authors: Apaydin K Cemil , Akar Yusuf , Akar Munire Erman , Zorlu Gurkan C , Ozer Hilmi O
Published: June 2004

Purpose: To evaluate menstrual cycle dependent changes on blue‐on‐yellow visual fields of diabetic women, and to compare the results with those of healthy women.

Methods: Left eyes of 93 normally menstruating women were included in the study, comprising 45 with type‐1 diabetes mellitus and severe non‐proliferative diabetic retinopathy and 48 healthy controls. All subjects underwent baseline complete ocular examination and achromatic visual field analysis. Blue‐on‐yellow visual field tests (short‐wavelength automated perimetry) were performed in both follicular (days 7−10 of the cycle) and luteal phases (days 3−6 before the bleeding) of two consecutive menstrual cycles. Visual field analyses were performed using Humphrey Field Analyser II with full threshold, central 30−2 program. Visual fields were divided into four regions: superior temporal, inferior temporal, superior nasal and inferior nasal. Visual field mean sensitivity (MS) was calculated for all regions separately.

Results: The mean ages of diabetic and control subjects were not significantly different (P > 0.05). Mean MS values of the diabetic group were significantly lower than that of the control group (P < 0.05). Control subjects did not demonstrate any menstrual cycle dependent changes in MS values (P > 0.05). However, diabetic women demonstrated a significant decrease in MS values in the luteal phase (P < 0.05). The decrease in MS was most marked in the nasal visual field (P < 0.05).

Conclusion: Young diabetic women demonstrated a significant depression in visual field threshold sensitivity in the luteal phase of the menstrual cycle. Nasal visual fields are more prone to have menstrual cycle dependent threshold sensitivity depression. This should be taken into consideration in the clinical assessment of women with advanced diabetes who are at risk of glaucomatous optic neuropathy.
Effect of check size and stimulation rate on blue−yellow multifocal visual evoked potentials
Authors: Martins Alessandra , Klistorner Alexander , Graham Stuart , Billson Frank
Published: June 2004

Background: To determine the effect of different stimulus frame rates and check sizes on blue−yellow multifocal visual evoked potentials (mVEP).

Methods: Subjects were examined at the Save Sight Institute at the University Sydney. Experiment 1 involved five adult subjects who underwent binocular stimulation by the Accumap multifocal objective perimeter. The eyes were stimulated with a cortically scaled dartboard pattern consisting of isoluminant blue and yellow checks. These were arranged in three concentric rings extending to an eccentricity of 26° in the visual field. The stimulus pattern was driven by binary sequences resulting in pseudorandom binary exchange of two opposite checkerboard patterns at each of the 32 sites in the visual field. The mVEP were recorded at two different rates of display of the pattern stimulus. In experiment 2, mVEP were tested on 10 normal subjects. Each of the 36 stimulation sites contained a checkerboard pattern of 20, 30, 42 or 56 checks/site, the stimulation pattern was displayed at the optimum rate found in experiment 1. The size of the checks was inversely proportional to the number of checks per site.

Results: In experiment 1, the slow frame rate significantly increased the average amplitude throughout the field tested by 50 ± 10.1% (P = 0.001). Latency was significantly shortened by 6.3% (P < 0.01). In experiment 2, the average amplitude peaked at 30 checks per segment; however, this was only calculated to be significantly different from the smallest check size (Fcrit range 4,27 = 0.09 P < 0.05, anova, Tukey's T method). A similar difference was found in ring 1 (Fcrit range 4,27 = 0.09, P < 0.05, anova, Tukey's T method). In ring 2, however, there was also a significant difference between 56 checks and 20, 30 and 42 (Fcrit range 4,27 = 0.09, anova, P < 0.05). Altering the check sizes did not significantly affect the amplitudes in ring 3. The latencies were not significantly modified by altering check size at any eccentricity.

Conclusions: These findings suggest that slowing the stimulation rate and displaying 30 checks per stimulation segment optimizes the blue−yellow mVEP stimulus.
Increase in cataract surgery prevalence from 1992−1994 to 1997−2000: analysis of two population cross‐sections
Authors: Tan Ava Grace , Wang Jie Jin , Rochtchina Elena , Jakobsen Kirsten B , Mitchell Paul
Published: June 2004

Background: Monitoring temporal changes in the demand for and provision of cataract surgery will be useful to health planners to meet resource needs and to estimate likely costs. The aim of this report was to compare the prevalence of cataract surgery in two population cross‐sections of the Blue Mountains Eye Study (BMES), over an interval of around 6 years.

Methods: Cross‐section I (n = 3654; mean age 66.2 years) consisted of BMES I participants (1992−1994). Cross‐section II (n = 3509; mean age 66.7 years) consisted of BMES II (5‐year) participants (n = 2335) plus persons who had moved into the area and age category since BMES I (n = 1174), so were newly eligible (1997−2000). Cataract surgery history was collected during interview and confirmed at examination.

Results: Over this 6‐year period, there was a 32% increase in cataract surgery prevalence from 6.0% to 7.9%, or from 6.0% to 7.7% after age standardization. The increase in eye‐specific prevalence was 43% (from 4.4% to 6.3%). It was more marked among persons aged 80+ years and for bilateral (from 12.3% to 19.9%) than unilateral surgery (from 10.7% to 11.8%). Best‐corrected visual acuity (mean letters read correctly) after surgery (43 and 44 letters, respectively) was similar between cross‐sections I and II.

Conclusions: The findings from a representative older population confirm that prevalent cataract surgery has increased substantially over the average 6‐year period, from 1992−1994 to 1997−2000.
Effects of binocular form deprivation on the excitatory post‐synaptic currents mediated by N‐methyl‐D‐aspartate receptors in rat visual cortex
Authors: Qin Wei , Yin Zheng Qin , Wang Shijun , Zhao Yanjun
Published: June 2004

Purpose: To investigate the effects of binocular form deprivation (BFD) on the excitatory post‐synaptic currents (EPSCs) mediated by the N‐methyl‐D‐aspartate (NMDA) receptor (NMDA‐EPSCs), and the proportion of NMDA‐EPSCs relative to glutamate receptor currents (glutamate‐EPSCs) in rat visual cortex.

Methods: Binocular form deprivation was achieved by suturing the eyelids of Wistar rats at postnatal day (PD) 14, before eye‐opening. Visual cortical slices (300 µm) were prepared from normal and BFD Wistar rats aged PD 14, 21 and 28. Recordings were obtained in slices from layer II to IV using the whole‐cell patch‐clamp technique. Glutamate‐EPSCs were isolated in the presence of bicuculline methiodide (20 µmol/L) in the bathing medium, and NMDA‐EPSCs were isolated with a combination of bicuculline methiodide (20 µmol/L) and 6‐cyano‐7‐nitroquinoxaline‐2,3‐dione (CNQX, 20 µmol/L). In addition, D,L‐2‐amino‐5‐phosphonovalerate (AP‐5, 20 µmol/L) was applied to study the NMDA‐only mediated currents. For each cell, the ratio of peak NMDA to glutamate EPSCs was calculated.

Results: During visual development, the decay time constant of NMDA‐EPSCs became shorter after eye‐opening in normal rats (F = 5.949, P <0.05; PD 28 vs PD 14, P = 0.027), but not in rats with BFD (P > 0.05). The weighted time constant of NMDA‐EPSCs in the visual cortex became shorter after the rats’ eyes were opened in the normal group (F2,37 = 4.727, P = 0.015; PD 28 vs PD 14, P = 0.035), but not in the BFD group (P > 0.05). However, the rise time constant and peak value of NMDA‐EPSCs showed no significant changes in normal and BFD groups (P > 0.05). The ratio of NMDA‐EPSCs to glutamate‐EPSCs became gradually smaller with age in the normal rats (F = 4.661, P < 0.05; PD 28 vs PD 14, P = 0.025), but not in the BFD group (P > 0.05).

Conclusions: These studies reveal that the proportion of NMDA‐EPSCs relative to glutamate‐EPSCs and the decay time constant of NMDA‐EPSCs are influenced by BFD. These changes may reflect important experience‐dependent modifications of neuronal synapses in visual cortex.
Iris melanoma: pathology, prognosis and surgical intervention
Authors: Starr Oliver D , Patel Dipika V , Allen Jonathan P , McGhee Charles NJ
Published: June 2004

A case of an iris melanoma in a 58‐year‐old woman is described. The clinical and pathological findings are discussed, highlighting the correlations between histopathology and prognosis for iris melanoma, which differ markedly from choroidal melanoma. The mixed cellular pathology of this iris melanoma (containing both spindle B cells and epithelioid cells) carries a higher metastatic rate than tumours composed exclusively of either. This contrasts with choroidal melanoma, where the presence of epithelioid cells is the strongest pathological marker for a poor prognosis. The ocular outcome that can be achieved with local surgical excision of a well‐delineated iris melanoma that does not involve the angle is discussed.
Fatigable ptosis and pseudoretraction caused by myasthenia gravis
Authors: Morris Olivia C , O'Day Justin
Published: June 2004

The case is presented of a 59‐year‐old woman with myasthenia gravis. Fatigable ptosis and pseudoretraction caused by the myasthenia gravis are illustrated in a series of clinical photographs.
Tapioca melanoma of the iris mimicking a vascular tumour: a clinicopathological correlation
Authors: Viestenz Arne , Conway Robert M , Küchle Michael
Published: June 2004

Although vascular iris processes are usually benign, they may be a clinical manifestation of iris melanoma, and this should be considered in the differential diagnosis. The case is reported of a 20‐year‐old man with a highly vascularized tapioca melanoma of the left iris without involvement of the anterior chamber angle or ciliary body, but with observed growth tendency. Sector iridectomy was performed 2 months after first examination. In addition, two separate floating tumour nodules were observed in the anterior chamber angle at 6 o’clock and were removed by aspiration. After 1 year follow up, no recurrence of melanoma cells was observed. In tapioca iris melanomas, diagnostic differentiation from congenital, inflammatory, vascular and neoplastic iris processes is required. Careful biomicroscopic examination of the iris in patients with vascular iris tumours may help the ophthalmologist to identify malignant iris melanomas (tapioca type) and plan appropriate surgical treatment.
Optic neuropathy secondary to radiotherapy for nasal melanoma
Authors: Garrott Helen , O'Day Justin
Published: June 2004

Optic neuropathy is a rare but important complication of radiotherapy used in the treatment of cancers of the head and neck, usually resulting in rapidly progressive blindness in one or both eyes. The case is presented of a 77‐year‐old woman with bilateral optic neuropathy resulting in blindness, secondary to radiotherapy for a melanoma of the nasal cavity. The onset of optic neuropathy occurred 9 months post‐radiotherapy, at a cumulative dose of 6000 rad. The left eye was first involved, with the right eye becoming involved within 2 weeks. Despite treatment with oral anticoagulation and high dose intravenous methylprednisolone, there was progressive deterioration resulting in bilateral optic atrophy, with final visual acuities of perception of light in the right eye and no perception of light in the left eye. This case demonstrates that oral anticoagulation was ineffective in the treatment of progressive radiation‐induced optic neuropathy.
Visual loss despite anticoagulation in radiation‐induced optic neuropathy
Authors: Danesh‐Meyer Helen V , Savino Peter J , Sergott Robert C
Published: June 2004

Radiation therapy to the brain may produce necrosis and loss of function months after completion of the treatment. The case is presented of a 62‐year‐old man who developed radiation‐induced optic neuropathy 2 years after treatment for a glioma of the left temporal lobe, despite being on anticoagulation therapy. Although anticoagulation appears to be beneficial in cerebral radiation necrosis, its usefulness in the treatment of radiation‐induced optic neuropathy is unclear.
Progressive visual loss in a patient with presumed temporal arteritis despite treatment: how to make the diagnosis
Authors: Zborowska Bogna , Ell Jonathan , McGee‐Collett Martin , Scolyer Richard , McCluskey Peter J
Published: June 2004

Giant cell (temporal) arteritis is a severe potentially fatal systemic vasculitis characterized by focal involvement of the cranial arteries resulting in ischaemic arterial occlusion. The case is presented of a 75‐year‐old woman with presumed giant cell arteritis and normal bilateral temporal artery biopsies. Despite a seemingly adequate course of systemic steroid therapy, the patient developed sudden catastrophic vision loss. Cerebral angiography and ultrasonography were useful investigations to determine the most appropriate artery to biopsy to confirm the diagnosis of giant cell arteritis.
Pathological features of surgically excised polypoidal choroidal vasculopathy membranes
Authors: Kuroiwa Sachiko , Tateiwa Hisashi , Hisatomi Toshio , Ishibashi Tatsuro , Yoshimura Nagahisa
Published: June 2004

The histopathological features are reported of surgically excised specimens from five patients with polypoidal choroidal vasculopathy, which had been diagnosed by indocyanine green angiography. On stereomicroscopy, four of the five cases demonstrated large choroidal arterioles with an inner elastic layer. Disruption of the inner elastic layer and arteriosclerotic changes of the vessels were identified by light microscopy. Transmission electron microscopy demonstrated increased deposition of basement membrane‐like material, together with collagen fibres, in the arteriolar walls. This study indicates that large choroidal arterioles and venules can be found in excised specimens from patients with polypoidal choroidal vasculopathy and arteriosclerosis is an important pathological feature.
Anterior uveitis in a child with Takayasu's arteritis
Authors: McDonald Mark A , Ojaimi Elvis , Favilla Ian
Published: June 2004

Takayasu's arteritis is a rare idiopathic arteriopathy that produces narrowing and eventually closure of affected blood vessels. Ocular symptoms typically occur late in the disease process in those individuals who have severe involvement of the aortic arch and the carotid arteries. Visual loss typically occurs as a result of either systemic hypertension or concomitant ocular hypo‐perfusion. We describe an unusual case of Takayasu's arteritis presenting in a child who complained of painful blurred vision. In this individual, no carotid artery disease was identified on vascular imaging and no evidence of impairment of ocular perfusion was demonstrable. Vision loss in this instance was due to anterior uveitis and cystoid maculopathy. These are atypical and rarely described features of Takayasu's arteritis. The patient responded well to anti‐inflammatory treatment and his symptoms resolved. The clinical significance of these findings are discussed and the relevant literature reviewed.