bluuebunny/crossref_metadata_2025 huggingface dataset:
Periocular cosmesis
Authors: TRAKOS NIKOS
Published: November 2010

Purpose Facial nerve paralysis is one of the most devastating peripheral nerve injuries which implies severe functional, cosmetic and psychological consequences to the patients. The periocular area can be improved cosmetically by raising the tissues that have been drooped. These techniques are brow lift for the forehead‐ brow area, midface lift for the mid part of the face and face lift for restoring the contour of the tissues of the lower face. These are static techniques and support the tissues that are not any more innervated and are atrophied and drooped by the force of gravity.

Methods In particular brow lift can be achieved by direct incision over the brow, by endoscopic forehead‐brow lift using anchoring systems or alternatively by small incision non endoscopic forehead brow lift through an eyelid incision. Midface lift can be achieved by subperiosteal or pre‐periosteal lift of the tissues or by using a suspension system. Face lift can be achieved with a deep planar rhytidectomy which can lift the tissues of the mid and lower face. Combination of forehead, midface and face lift can be necessary for the maximal possible symmetry of the face in a static position. There is a limitation of these techniques in regards to the dynamic reanimation of the face. There are several dynamic procedures helping at this direction.

Results In particular, in case of a transected facial nerve, the disrupted facial nerve can be restored by α) direct end–to‐end coaptation or by β) cable nerve graft interposition Other techniques include: • Temporalis muscle transfer • Free nerve‐muscle grafts • Ipsilateral nerve transposition • Facial nerve‐cross face anastomosis.

Conclusion The above available dynamic procedures may provide some degree of facial tone or voluntary facial movement.
Evaluation of macular morphology in patients with multiple sclerosis
Authors: TATRAI E , SIMO M , ILJICSOV A , NEMETH J , CABRERA DEBUC D , SOMFAI GM
Published: November 2010

Purpose To assess macular morphology in patients with multiple sclerosis (MS) with and without history of optic neuritis (ON).

Methods Twenty‐six MS patients were recruited in this study, and 26 randomly eyes were selected from 26 age‐matched healthy subjects as controls. Optical coherence tomography (OCT) examination was performed on each eye using a Stratus OCT device. The raw OCT data were exported from the device and further processed using a custom‐built algorithm (OCTRIMA). Thickness measurements of 7 intraretinal layers and the total retina were obtained. Eyes from MS patients were divided into 2 groups for statistical analyses. The ON+ group contained 26 eyes which had ON at least 6 months prior to enrollment. Twenty‐three eyes had no history of ON (ON‐ group). All thickness measurements were compared among the 3 groups using ANOVA with Newman‐Keuls post‐hoc analysis.

Results Significant decrease in thickness was observed in ON+ and ON‐ eyes compared to controls for the macula (290±6µm, 283±12µm and 267±12µm in the control, ON‐ and ON+ group, respectively), retinal nerve fiber layer (38±2µm, 35±2µm and 31±4µm, respectively) and ganglion cell layer and inner plexiform layer complex (71±4µm, 64±7µm and 53±7µm, respectively). No statistically significant difference in thickness was found for the remaining intraretinal layers between the 3 groups analyzed.

Conclusion Atrophy of the ganglion cells and nerve fibers in the macula of MS patients was observed even without previous history of ON. Therefore, thickness measurements of ganglion cells might be useful in the diagnosis and follow‐up of MS patients.
Immunohistochemical methods to evaluate vitreoretinal scaring
Authors: BOCHATON‐PIALLAT ML
Published: November 2010

Purpose Formation of scarlike epiretinal membranes (ERMs) constitutes potentially the end stage of evolution of proliferative vitreoretinopathy (PVR), proliferative diabetic retinopathy (PDR) and idiopathic vitreoretinopathy. Among various cellular populations, ERMs contain cells with contractile features typical of myofibroblasts. Myofibroblasts have been described in granulation tissue during wound healing and in practically all fibrocontractive diseases, in which they participate in the generation of isometric tension and in the synthesis of extracellular matrix components; these phenomena are in turn responsible for granulation tissue remodeling and retraction. The main marker of the myofibroblastic phenotype is the expression of alpha‐SMA. The transforming growth factor‐beta1 and the ED‐A splice variant of cellular fibronectin, an extracellular matrix component, are key players of the complex process of myofibroblast differentiation.

Methods Proteins were detected by means of immunohistochemical staining on paraffin sections from formol fixed tissues and double immunofluorescence staining on whole tissues. Samples were observed by using classical light and confocal microscopes.

Results The presence of alpha‐SM actin‐positive myofibroblasts was associated with the expression of TGF‐beta1, TGF‐beta receptor II, and ED‐A FN in all types of ERMs studied.

Conclusion The results furnish new data on the mechanism of alpha‐SM actin stimulation in fibroblasts in a human pathologic setting.
Analysis of gene expression in acute ischemic neuroretinas : a genome‐wide screen discriminating occlusion (BRVO) versus laser effects in rats
Authors: OROPESA C , MATTER JM , SCHAAD O , POURNARAS CJ
Published: November 2010

Purpose Identification of genes differentially regulated in rat neuroretinas submitted to an experimental acute branch retinal vein occlusion (BRVO), to a laser treatment, or to no treatment at all.

Methods We have developed an in vivo experimental model of venous occlusion by photodynamic thrombosis in rat retinas. After anaesthesia, a sodium fluorescein solution was injected in rat tail 15 minutes before laser treatments. To induce ischemia in tested retina, venous sites adjacent to the optic nerve head were photocoagulated with an argon laser. In one group of tested animals, the retina was exposed to laser treatment at sites located between major vessels. As this treatment may have an effect upon choroidal blood flow, control eyes were not subjected to laser treatment. RNAs were isolated from the neuroretina 30 minutes post treatments, and processed for Affymetrix gene‐chip analysis.

Results Genome‐wide screen enabled us to identify 308 and 348 genes which were up‐ or down‐regulated, respectively, by BRVO and laser treatment only. When we compared the transcriptomes of retinas subjected to vessel occlusion or laser treatment to the control one, we found that the expression profiles of, respectively, 116 and 126 genes were specifically modified. The majority of the up‐ and down‐regulated genes encode proteins involved in different aspects of early stress response, neuroprotection, inflammation and apoptosis.

Conclusion Our microarray analysis revealed changes in gene expression bearing similarities to gene expression results from other ischemia models. Furthermore, it revealed that laser treatment may have an unreported impact on retina’s metabolism.
Flow cytometry for the characterization of retinal neural populations and the quantification of retinal apoptosis
Authors: TSOKA PA , TSILIMBARIS MK
Published: November 2010

Purpose The primary purpose of this study was to evaluate the potential to quantify the different retinal neuronal populations, as also the retinal detachment‐induced apoptosis in Sprague–Dawley rats, in an accurate quantitative way by using flow cytometry.

Methods Retinal detachment was performed on the right eye of deeply anesthetized animals. The detachment was induced by a sub‐retinal injection of sodium hyaluronate. Rats were sacrifised and the eyes were enuclated to achieve retinal dissection. Tissue dissociation was accomplished with trypsin. The cells were mechanically dissociated into a single‐cell suspension. At least 100.000 cells were analyzed with a FACScalibur and FlowJo software. The primary antibodies were anti‐rhodopsin against rod photoreceptors, anti‐PKC against rod bipolars, anti‐calbindin against horizontals, anti‐ChAT against cholinergic amacrine cells and anti‐MAP1 against ganglion cells. Annexin‐V‐FITC/Propidium Iodide was used to identify apoptosis.

Results Quantification of retinal neuronal cells was possible using flow cytometry. Photoreceptors had the 53.99%, the ganglion the 7%, the bipolars the 2%, the horizontal the 4% and the cholinergic amacrine cells the 1,5% in the hole mixed retinal population. Quantification of the apoptotic rate was also possible. The early apoptotic cells was 22.4% while in the control eye was 6.28% after retinal detachment. The experiments were repeated ten times and these measurements are the mean value.

Conclusion Flow cytometry can be used to quantify the apoptotic neuronal cells as well as the healthy retinal neurons. It is quick and precise and it will be very useful in future in studies in neuroprotection and quantification of apoptosis during time.
The prevalence of anisometropia, amblyopia and strabimus in schoolchildren of Bojnourd, Iran
Authors: YEKTA AA , KHABAZKHOOB M , AZIZI E , OSTADIMOGHADDAM H , DERAKHSHAN A , HERAVIAN J , AZIMI A , YEKTA R
Published: November 2010

Purpose To determine the prevalence of anisometropia, amblyopia and starbimus in schoolchildren of Bojnourd, Iran.

Methods A random cluster sampling was used in a cross‐sectional study on 2020 schoolchildren in Bojnourd, northeast of Iran. The participants totaled 1551;643 boys and 908 girls. Mean age of the partipiciants was 11.12 years (respose rate=76.7%). Examinations included: uncorrected and best corrected visual acuity (UCVA and BCVA) measurements, cycloplegic refraction and cover test. Anisometropia defined as spherical equivalent (SE) refraction difference 1.00 D and more between two eyes. Amblyopia was defined as a reduction of BCVA to 20/30 or less in one eye or two lines introcular optotype acuity difference in the absence of pathological causes. Strabismus was characterized as a heterotropia at distance or near fixation.

Results The prevalence of anisometropia, amblyopia and strabismus were 2.7%, 2.2 and 2% respectively and were not related to the gender. The prevalence of exotropia, esotropia and hypertropia were 1.37%, 0.51% and 0.12% respectively.

Conclusion Prevalence of anisometropia, amblyopia and strabismus among the schoolchildren of Bojnourd were in the mid range and similar to that in most places of the world. Exotropia was the most common strabismus type and comparable to the other Asian countries.
The limits of manifest refraction: visual performance under low light conditions
Authors: CABEZA J
Published: November 2010

Purpose To present a method to optimize the prescription values of ophthalmic lenses based on ocular wavefront information. Those lenses provide improved vision under low light conditions to the patient.

Methods We will show first the influence of ocular aberrations on visual performance, and how do they change with pupil size. We will also show the way higher order aberrations affect the manifest refraction procedure. Finally, we will present a method to optimize the prescription values of ophthalmic lenses based on ocular wavefront information.

Results Independent studies have shown that such optimized ophthalmic lenses provide on average an improvement in visual acuity of almost one line under mesopic conditions, when compared to conventional opththalmic lenses.

Conclusion Visual performance under low light conditions can be improved by ophthalmic lenses whose prescription was optimized taking into account ocular wavefront information.

Commercial interest
Visual acuity loss with healthy ageing: can it be reversed by wavefront laser?
Authors: ELLIOTT D
Published: November 2010

Purpose To consider what levels of “super acuity” might be achieved by the correction of ocular aberrations in older patients by wavefront corrected ophthalmic surgery. Note that when comparing visual acuity (VA) of older patients with VA in the young, the average optimal monocular visual acuity of a young subject is about 6/4 (decimal VA 1.50) and not the often quoted ‘normal’ figure of 20/20 (6/6 or 1.0 decimal).

Methods Studies that attempted to isolate the cause(s) of deterioration in visual function with age in normal, healthy eyes were reviewed.

Results The majority of studies suggest that the deterioration in visual function with age is primarily due to changes within the neural system rather than optical factors. In addition, several studies have shown increases in ocular aberrations with age, but this is only found when comparisons are made across age groups with fixed pupil sizes. When natural pupil sizes are considered, there is no change in aberrations with age because of age‐related pupillary miosis

Conclusion There appears to be little scope for ocular aberration correction to be used to counteract the loss of vision with age. Reduced vision in patients with cataract is primarily due to increased forward light scatter, and aberrations play a minor role in reducing vision. Intra‐ocular lenses (IOLs) should be designed to keep ocular aberrations at a minimum after cataract surgery, but given that vision loss with age appears to be primarily due to neural changes, there seems little scope for IOLs to improve on the vision of phakic subjects under natural pupil conditions.
Comparison of the two domains of visual optics: the aberrometric domain and the straylight domain
Authors: VAN DEN BERG TJTP , FRANSSEN L , COPPENS JE
Published: November 2010

Purpose The ocular point‐spread‐function defines the functional problem originating from optical defects in the eye. Aberrations as well as scatter degrade the psf. How do these two types of defect differ with respect to their effect on the psf, and on functional measures?

Methods Literature models for different aspects of the optical irregularities in the eye media, in particular Thibos et al. JOSA A 2002 for the aberration structure and Van den Berg et al. VR 1999 for small particle scattering, were used to delineate their effects on the psf. The Thibos et al. model was extrapolated to allow inclusion of the high orders of aberration not normally included in aberrometry, but potentially visible with double pass. With respect to the visual function counterparts, straylight (C‐Quant from Oculus) outcomes were compared to visual acuity and contrast sensitivity in 2400 subjects.

Results As a reference the full scale psf standard model of Vos et al. CIE 1999 was used. The modeled aberration structures of the eye proved to predict the central part of the psf up till about 0.3 degrees if extreme high orders were included. For angles >1 degree predicted values were far below the actual values of the psf. Small particle scattering was essential to predict the psf for angles above 1 degree.

Conclusion In the assessment of disturbances to the optical media two domains must be discriminated: the aberration domain and the small particle domain, with corresponding parts (small angle vs large angle) to the psf. Straylight typically originates from irregularities of size 10 micrometer and below, as opposed to aberrations originating from refractile humps and bumps extending over 100 micrometer and more. Straylight has independent value.
Influence of tobacco during pregnancy in the optic nerve development
Authors: GUERRI MONCLUS N , PUEYO ROYO V , OROS D , VALLE S , VENTURA P , TUQUET H , EGEA ESTOPINAN MC , PRIETO E
Published: November 2010

Purpose Evaluate the influence of intrauterine exposure to tobacco in the development of visual function and the retinal nerve fiber layer (RNFL) in school‐age children.

Methods Retrospective cohort study with children from 5 to 14 years old. The studied subjects were divided into two groups according to the antecedent of exposure to tobacco during pregnancy: children of cigarette smoking mothers during pregnancy (exposed) and children of non‐smoking mothers (not exposed). In both groups were assessed visual acuity (VA), Ishihara test and RNFL average thickness obtained by optical coherence tomography (OCT). The mean and standard deviation of the variables were calculated, and U Mann‐Whitney test was performed for comparison of data.

Results 48 children were studied, 25 boys and 23 girls. The exposed group was composed of 8 children and 40 were in the non‐exposed group. The evaluation of the visual function (VA and Ishihara test), showed no statistically significant differences between groups. However, the RNFL average thickness was of 94.64 and 103.88 microm for the exposed and non‐exposed group, respectively; these data showed statistically significant differences between both values.

Conclusion The intrauterine exposure to tobacco is associated with a poor development of the optic nerve. This fact determines a lower RNFL thickness measured by OCT.
CX3CL1 is involved in the ocular surface inflammation induced by benzalkonium chloride
Authors: DENOYER A , GODEFROY D , FRUGIER J , BAUDOUIN F , ROSTèNE W , BAUDOUIN C
Published: November 2010

Purpose To investigate whether the chemokine CX3CL1 could play a role in the conjunctival inflammatory cell trafficking induced by an exposure to benzalkonium chloride (BAC).

Methods Expression of CX3CL1 was assessed in BAC‐exposed human conjunctival cell (HCC)line using flow cytometry and RT‐PCR. In vitro migration of leukocytes to BAC‐stimulated HCCs was assessed by migration assays and immuno flow cytometry with or without inhibition of CX3CR1. In vivo inflammatory cell trafficking was investigated by immunohistochemistry and confocal microscopy in the conjunctiva of wild‐type or CX3CR1‐deficient mice exposed to BAC.

Results BAC induced an overexpression of CX3CL1 in HCCs. Leukocyte chemotaxis was observed when HCCs are stimulated with BAC. Human monocytic cells (CD45+,CD14+) and NK cells (CD45+,CD56+) migration was inhibited by blocking the CXCR3 receptor. In a mouse model of BAC‐induced ocular surface toxicity, the inflammatory cell infiltration of the conjunctiva was altered in the CX3CR1‐deficient mice compared to wild‐type.

Conclusion The CX3CL1/CX3CR1 axis is involved in the BAC‐induced conjunctival inflammation. Specific blockade of this receptor could regulate the cell trafficking in the ocular surface.
Characterization of retinal expression of vascular cell adhesion molecule (VCAM1) during experimental autoimmune uveitis
Authors: MAKHOUL M , DEWISPELEARE R , RELVAS L , KOCH P , ELMALEH V , CASPERS L , BRUYNS C , WILLERMAIN F
Published: November 2010

Purpose Leukocyte adhesion to the blood retinal barrier is a critical step in the pathogenesis of autoimmune uveitis and is mediated through adhesion molecule expression. Here, we have investigated the retinal expression of VCAM1 in an adoptive transfer model of experimental autoimmune uveitis (EAU).

Methods C57Bl6 mice were immunized with interphotoreceptor retinoid‐binding protein (IRBP) peptide 1–20. Activated IRBP‐specific T cells were prepared from their draining lymph nodes and spleens, cultured with IRBP peptide 1‐20 and adoptively transferred in C57BL/6 mice. The animals were sacrified after 3 weeks and the eyes processed for immunohistology. The severity of the disease was determined by histological grading. The expression of VCAM1 was analysed by immunofluorescence. Co‐labelling with GFAP (glial cells markers) and endoglin (endothelial cell marker) were also performed in order to determine which cell type expressed VCAM1.

Results In eyes with low grade uveitis, VCAM1 was only expressed at certain location of the internal limiting membranes and epithelial cells of the ciliary body. In correlation with disease severity, the staining extend to all the limiting membranes, vasculitis lesions, Muller cells extension, the outer limiting membranes and RPE cells. VCAM1 expression on the inner limiting membrane and Müller cells extension co stained with GFAP. On vasculitis lesions, VCAM1 expression co localized with either GFAP or endogline.

Conclusion VCAM1 is expressed on blood retinal cells during EAU. Moreover, the intensity and extension of its expression correlates with disease severity. Those data suggest that VCAM1 plays an important role in EAU development.
Amblyopes have difficulty judging object distance but not size when reaching and grasping in habitual viewing
Authors: BARRETT BT , PANESAR GK , PACEY I , BUCKLEY J
Published: November 2010

Purpose Prehension deficits exist in amblyopes when reaching for a single/isolated object in binocular viewing. Here, we examine prehension for objects that are flanked by nearby distracters.

Methods Twenty amblyopes (36.4±11.7 yrs) & twenty visual normals (27.5±6.3 yrs) reached for a solid cylindrical object (height 12cm, diameter 3 or 4cm) located directly in front of the participant. The object was flanked by two similarly‐sized distracters placed either side of the object, or in front and behind it. The spacing between the object and distracters was scaled according to finger‐width of individual participants and was set at spacings of 2‐ and 4‐ finger‐widths. Shutter‐goggles prevented a view of spatial configuration until the movement was to be initiated. Opening the shutters provided the cue for participants to pick up the object in a singe, smooth movement. Movements of the arm, hand and object were recorded using an 8‐camera, Vicon‐IR recording system.

Results Amblyopia affects both the ‘reach’ and the ‘grasp’ phases of prehension. Maximum grip aperture is the same in both groups suggesting that amblyopes are no worse at scaling their grip size to the size of object. But amblyopes show more cautious prehension behaviour. This is because maximum grip aperture and maximum reach velocity occur earlier in their reach, and because there is a longer time from the end of the reach to initial contact with object, and a longer time from contact to lift.

Conclusion Our results suggest that amblyopes have more difficulty judging object distance than object size. However, the functional significance of these amblyopic versus visual‐normal differences in prehension outside the laboratory is as yet unclear.
Chronic progressive external ophthalmoplegia without ptosis
Authors: SZIGETI A , HARGITAI ZS , HARGITAI J , SZEPESSY ZS , SZAMOSI A , VAMOS R , NEMETH J
Published: November 2010

Purpose Chronic progressive external ophthalmoplegia (CPEO) is a rare mitochondrial myopathy characterized by slowly progressive paralysis of the extraocular muscles with onset around the age of 20. Patients usually experience bilateral ptosis before developing symmetric, multidirectional external ophthalmoplegia.

Methods 31‐year‐old woman with 10 year history of slowly progressive paralysis of the extraocular muscles was referred to our institute. Every action of extraocular muscles was reduced in both eyes. She could not adduct and elevate, there was only a slight abduction and depression function in both eyes. Patient had no ptosis or exophthalmus. BCVA was 20/20 in both eye. Slit lamp examination was normal. Dilated funduscopic examination revealed slight pigment disturbance in the periphery. Visual field and color vision tests were normal. Electroretinography showed lower borderline scotopic b‐wave amplitudes. Laboratory tests showed increased lactic acid and creatine phosphokinase values. The results of liver and kidney function, autoimmun and serologic tests were normal. All thyroid function tests yielded negative results. Urinalysis, chest x‐ray, heart ultrasound, brain and orbital magnetic resonance, nasal sinus CT scans were normal. Tensilon test excluded myasthenia gravis.

Results We considered the case as CPEO clinically, mitochondrial DNA analysis is in process.

Conclusion In CPEO, slowly progressive paralysis of the extraocular muscles may develop without ptosis. A careful differential diagnosis is very important.
The first experience of an optical coherenсe tomography in diagnostics of the primary and residual retinoblastoma
Authors: SAAKYAN SV
Published: November 2010

Purpose To determine diagnostic features of the primary and residual retinoblastoma documented by optical coherence tomography (OCT).

Methods 21 children with retinoblastoma were examined by OCT to analyze the changes in the retina before and during the different stages of treatment. In 21 eyes 36 foci have been examined: 9 were with primary retinoblastoma, 12 –residual tumours, 12‐ chorioretinal scar after local treatment by methods of brachytherapy and TTT, 3 ‐ calcified focus.

Results Tomographical features of the primary retinoblastoma were: thickening of retina at the level of the inside layers was up to 645 ± 77,02 microns (р<0,001) – 9. In 9 cases there was no differentiation but there was homogeneity of structure of retinal inside layers in the tumour centre. The chorioretinal scar after сhemotherapy and local treatment (12 patients) on tomograms were diagnosed as a flat bright red hyperreflective stripe replacing all layers of a retina. In 3 patients calcified focus was characterized by raised bright red hyperreflective layer under which the effect of a shade was marked on tomograms. In 12 patients with residual tumours the absence of differentiation of the inside layers of retina with the effect of a shade under undifferentiated inside layers of a retina, elevation of the inside layers of the retina into the vitreous, equal choroidal profile and on the periphery ‐ bright red flat hyperreflective retina were diagnosed.

Conclusion The OCT allows to reveal changes in retina and to diagnose tumoral, paunch, calcified tissue at primary and residual retinoblastoma that is necessary for definition of further tactics of treatment.
13qdel syndrome and corpus callosum agenesis in two identical twins
Authors: DE FRANCESCO S , RENIERI A , DEL LONGO A , PIOZZI E , BRACCO S , VENTURI C , MENICACCI C , MUNIER F , HADJISTILIANOU T
Published: November 2010

Purpose We report two (twin A and twin B) cases of unilateral retinoblastoma in identical female twins with 13q deletion syndrome. Family history for retinoblastoma was negative. Karyotypic analyses (peripheral lymphocytes) of the brother and their parents showed no abnormalities.

Methods Twin A has demonstrated unilateral, multifocal retinoblastoma (left eye), diagnosed at the age of 5 months, which was recalcitrant to systemic chemoreduction, than treated with intraarterial chemotherapy. Twin B has demonstrated unilateral unifocal retinoblastoma (right eye) at 9 months of age, successfully treated with brachytherapy. Both had prominent eyebrows, broad nasal bridge, large, prominent, low – set ears, bulbous tipped nose, large mouth, and thin upper lip. MRI revealed ventricles dilatation associated with corpus callosum agenesis. DNA analysis was performed with polymorphic microsatellite markers to confirm monozygosity. Single‐stranded conformation polymorphism and Southern blot analysis of the retinoblastoma gene were performed.

Results Molecular genetic analyses confirmed monozygosity.

Conclusion We describe two cases of 13q deletion syndrome in bicorial identical twins.
Uveal melanoma: neither fish nor fowl?
Authors: SEREGARD S
Published: November 2010

Purpose To outline recent development and future research avenues for molecular mechanisms in uveal melanoma

Methods Review of pertinent literature and unpublished personal data

Results While most eyes with uveal melanoma now can be treated with one or more of a range of sight‐conserving options, overall patient survival has not improved during recent years. It remains clear that overall survival for patients with uveal melanoma can only be improved if effective treatment for disseminated disease can be offered and that such treatment need to be provided early in the disease progression. The molecular mechanisms involved in uveal melanoma appear to be distinctly different from those identified in cutaneous melanoma. Although much progress has been made in mapping the pathways likely to play a role in uveal melanoma initiation, progression and dissemination has been made in recent years, much remains to be unravelled. Targeted therapy combined with early detection of disseminated disease or the identification of patients at high risk of tumour spread is likely to impact prognosis in the next decade to come.

Conclusion Recent progress in identifying molecular mechanisms involved in uveal melanoma initiation, progression and dissemination has been significant. The next decade is likely to see the translation of this knowledge to effective treatment which may result in improved patient survival.
Blephasteam® in clinical patients
Authors: CHIAMBARETTA F
Published: November 2010

Abstract not provided
Unmet needs in glaucoma
Authors: HOLLO G
Published: November 2010

Both glaucoma and ocular surface disease (OSD) are very common conditions in the elderly. In order to provide sufficient intraocular pressure (IOP) reduction and low target pressure, long‐term use of IOP lowering medication as well as optimal adherence to the prescribed medication are essential. Most topical glaucoma medications are preserved with benzalkonium chloride (BAK). Chronic exposition to BAK (as preservative of most preserved eye drops) was repeatedly shown to decrease tear film quality, increase the frequency of topical side effects, and worsen the existing ocular surface disease. In addition, chronic and multiple instillation of BAK in preserved topical IOP lowering medication is a risk for failure of later filtering surgery. Patients suffering from OSD use BAK‐free artificial tears, but the same patients if they also have glaucoma mostly use BAK‐preserved IOP lowering drops. This practice is obviously not optimal. Use of unpreserved glaucoma medications in routine clinical practice is needed for IOP lowering in glaucoma.
Glaucoma treatment and ocular surface health
Authors: LABBE A , BAUDOUIN C
Published: November 2010

Antiglaucoma medications are often associated with ocular adverse reactions such as dry eye, and burning or stinging sensations. These undesirable effects may lead to treatment discontinuation and reduced quality of life in patients with glaucoma. Antiglaucoma medications usually contain benzalkonium chloride (BAK) as a preservative. Animal studies, in vitro studies and in vivo experiments have demonstrated various adverse effects of BAK. Clinical studies have also shown an increased incidence of adverse events with BAK and have demonstrated that the withdrawal of preservatives reduces these effects. Collectively, these data suggest that preservative‐free antiglaucoma treatments have clinically relevant benefits for patients.
The regulation of retinal blood flow in the healthy and diseased eye
Authors: RIVA C
Published: November 2010

The maintenance of normal retinal structure and function depends on a tightly regulated environment. This requires intact blood‐retinal barriers as well as an efficient regulation of blood flow and delivery of oxygen and metabolic substrates to the retinal tissue. Thanks to the development of noninvasive techniques allowing the quantitative assessment of retinal hemodynamics in the human eye, much progress has been achieved in recent years in the understanding of retinal blood flow regulation and the mechanisms involved in this physiological process. Retinal blood ﬂow is regulated by the interaction of myogenic and metabolic mechanisms through the release of vasoactive substances by the vascular endothelium and retinal tissue surrounding the arteriolar wall. This regulation is achieved by adaptation of the vascular tone of the resistance vessels to changes in the perfusion pressure or metabolic needs of the tissue. This adaptation occurs through the interaction of multiple mechanisms affecting mainly the arteriolar smooth muscle cells. These mechanisms, which involve the close interaction between nitric oxide, lactate and arachidonic acid metabolites released by the neuronal and glial cells, optimize blood ﬂow according to the metabolic needs of the tissue. Impairments of structure and function of the retinal neural tissue and endothelium during the evolution of ischemic microangiopathies affect the interaction of the retinal metabolic pathways and alter blood ﬂow regulation. Assessing retinal blood flow and its response to various physiological stimuli and the mechanisms mediating and modulating these responses has provided important insight into these pathological processes, which lead to severe losses of vision.
Where is retinal OCT heading
Authors: DREXLER W
Published: November 2010

Purpose Novel high speed detection techniques as well as development of ultra broad bandwidth and tunable light sources have recently revolutionized imaging performance and clinical feasibility of OCT.

Methods Most recent technology enables to perform more than 300.000 measurements/second, allowing to perform 512x128 raster scans in 0.2 seconds, more than one order of magnitude better than state of the art commercial technology. Isotropic sampling over 512x512 pixels with 600 frames/second is therefore possible in less than a second. The development of light sources emitting at alternative wavelengths around 1060nm enabled not only unprecedented three‐dimensional OCT visualization of the entire choroid up to the choroid‐sclera interface but also improved OCT performance in cataract patients.

Results Adaptive optics using deformable mirror technology correct higher order ocular aberrations interfaced with three‐dimensional ultrahigh resolution OCT, recently enabled in vivo cellular resolution phenotyping of retinal pathologies. In addition, extensions of OCT have been developed that enable non‐invasive depth resolved functional imaging of the retina, providing spectroscopic, blood flow or physiologic tissue information that might allow differentiation of retinal pathologies via localized metabolic properties or functional state.

Conclusion In this view OCT is now the fastest adopted imaging technology in the history of ophthalmology and can now be considered as an optical analogue to computed tomography and magnetic resonance imaging, not enabling full body imaging, but non‐invasive optical biopsy, i.e. micron/cellular resolution three‐dimensional visualization of retinal morphology and function.

Commercial interest
Multiplex ligation‐dependent probe amplification analysis of uveal melanoma with extraocular extension demonstrates heterogeneity of gross chromosomal abnormalities
Authors: COUPLAND SE , DOPIERALA J , TAKTAK AFG , DAMATO BE , LAKE SL
Published: November 2010

Purpose The aim of this study was to determine if uveal melanoma (UM) with extraocular extension displayed heterogeneous copy number alterations in the intraocular and extraocular areas of the tumor. Multiplex ligation‐dependent probe amplification (MLPA) was utilised to determine copy number for the chromosomes of most interest in UM prognostic testing, 1p, 3, 6 and 8.

Methods MLPA was performed using the P027 UM assay (MRC‐Holland) on formalin‐fixed, paraffin‐embedded sections from nine UM. Whole tumor sections were analysed in addition to the intraocular and extraocular areas of the tumor that were microdissected and analysed separately.

Results Of the nine UM analysed four exhibited heterogeneous copy number for at least one chromosome arm. No heterogeneity of 1p or 8p was observed. The most frequently heterogeneous chromosome arm was 6p. One tumor was monosomy 3 in the intraocular area of the tumor but disomy 3 for the extraocular area of the tumor.

Conclusion Heterogeneity of chromosome arm copy number, between the intraocular and extraocular areas of UM with extraocular extension, does exist for chromosomes 3, 6 and 8q and is detectable by MLPA. These results suggest that for UM with extraocular extension both intraocular and extraocular areas of the tumour should be sampled for genetic prognostic testing.
Frequent gene copy number changes and BRAF V600E gene mutation in conjunctival melanoma
Authors: JMOR F , LAKE SL , TAKTAK AFG , DAMATO BE , COUPLAND SE
Published: November 2010

Purpose The molecular aetiology of conjunctival melanoma (CM) is poorly understood as few studies have investigated the genetic changes in this tumour. This study investigated the copy number of all autosome arms, genes known to be frequently altered in tumourigenesis, and BRAF V600E mutation, in CMs using multiplex ligation‐dependent probe amplification (MLPA).

Methods Three MLPA assays were performed (P027, P036, P206) using DNA extracted from 32 primary and metastatic, formalin‐fixed, paraffin‐embedded CM samples.

Results CDKN1A and RUNX2 were amplified in over 60% and 75% of primary CM, respectively. MLH1 and TIMP2 were frequently amplified, and MGMT and ECHS1 were frequently deleted, in metastatic CMs. BRAF V600E mutations were identified in 6/12 primary CMs and 4/6 metastatic CMs. The P036 assay detects copy number of genes, not known to be involved in tumourigenesis, in the subtelomeric regions of all autosomes. Genes found by this assay to be frequently deleted in metastatic CM were BDH, FLJ20265, PAO and OPRL1. No statistically significant association with BRAF mutation, or changes in copy number, and gender, age, histological cell type or survival time, were identified.

Conclusion Despite no copy number changes occurring exclusively in metastatic CM changes in the MLH1, TIMP2, MGMT and ECHS1 were observed more frequently. Amplification of subtelomeric genes BDH (3q), FLJ20265 (4p), PAO (10q) and OPRL1 (20q) may indicate common gain of the respective chromosome arms in metastatic CM. Further investigation of these loci in a larger cohort of tumours may identify those CM more likely to metastasize and elucidate the cell signalling pathways that are deregulated in CM, thereby facilitating future treatment of patients.
Receptors for luteinizing hormone‐releasing hormone (LH‐RH) in human uveal melanoma as potential molecular targets for cancer therapy
Authors: STEIBER Z , TRESZL A , ROZSA B , BERTA A , HALMOS G
Published: November 2010

Purpose The expression of luteinizing hormone‐releasing hormone (LH‐RH) receptors has been demonstrated in various human cancers. Over the past decade, a direct receptor‐mediated antiproliferative effect of analogs of LH‐RH on tumor cells was proposed. The receptors for LH‐RH on human tumors can also serve as targets for LH‐RH analogs that can be linked to various cytotoxic agents.

Methods In our study we investigated the expression of LH‐RH and transcript forms of LH‐RH receptor in human uveal melanoma specimens with RT‐PCR using gene specific primers. LH‐RH receptor protein were also evaluated by Western blot. Tumor specimens from 9 patients were collected at the University of Debrecen.

Results Expression of mRNA for LH‐RH receptor transcript forms were detected in 6 samples. No PCR products for pituitary type of LH‐RH receptors were found. In our study 8 specimens expressed mRNA for the LH‐RH ligand. The presence of specific LH‐RH receptor protein was detected in tumor specimens by Western blotting.

Conclusion We were able to detect the expression of LH‐RH and transcript forms of LH‐RH receptors in human uveal melanomas. Our results support the merit of further investigation of the expression of LH‐RH receptors and its transcript forms in human ophthalmological tumors as well as the application of LH‐RH analogs for receptor‐based treatment of such malignancies. These observations signify the importance of the development of new LH‐RH analogs with potential therapeutical applications.
Prevalence and risk factors of refractive errors among schoolchildren in Bojnourd, Iran
Authors: YEKTA AA , KHABAZKHOOB M , AZIZI E , OSTADIMOGHADDAM H , DERAKHSHAN A , HERAVIAN J , AZIMI A , YEKTA R
Published: November 2010

Purpose To determine the prevalence and risk factors of refractive errors among schoolchildren in Bojnourd, Iran.

Methods In a cross‐sectional study using random cluster sampling, 2020 schoolchildren 6 to 17 years of age were selected in this study. The participants totaled 1551; 643 boys and 908 girls of the elementary and middle schoolchildren of Bojnourd, northeast of Iran. Mean age of the participants was 11.2 years (response rate=76.7%). Refractive errors were measured under cycloplegia. Myopia defined as spherical equivalent (SE) refraction ‐ 0.5 dioptre (D) or worse, hyperopia as SE +2.00 D or more, and astigmatism as cylinder ‐0.75 D or worse.

Results The prevalence of myopia, hyperopia and astigmatism were 4.3%, 5.4% and 11.5% respectively and were not related to the gender. The prevalence of myopia and against‐the‐rule astigmatism increased with age (p<0.001).

Conclusion The results of this study showed that the prevalence of myopia in schoolchildren of Bojnourd was similar to that in most places excluding East Asian countries, and that of hyperopia and astigmatism were in the mid range.
Relations between refractive astigmatism and corneal astigmatism
Authors: TOUZEAU O , GAUJOUX T , BASLI E , ALLOUCH C , LAROCHE L , BORDERIE VM
Published: November 2010

Purpose To investigate the relationship between refractive astigmatism and corneal (anterior and posterior) astigmatism in normal eyes.

Methods We prospectively recorded refractive astigmatism and corneal astigmatism (Orbscan) of 500 healthy eyes (including ametropia) of 250 patients. Astigmatism data was analyzed using polar values (cylinder, axis) and rectangular coordinates (x,y) which respectively represent WTR/ATR component (Jackson 0°/90°) and oblique component (Jackson 45°/135°). Internal astigmatism and enantiomorphism (mirror‐image symmetry between both eyes) were calculated.

Results Anterior corneal cylinder showed higher correlation with subjective cylinder (r: 0.84 to 0.89 p<0.001) than posterior corneal cylinder (r=0.64; p<0.001). The relative proportion of both components of astigmatism (WTR/ATR and oblique) did not correlate with cylinder. Axis of astigmatism was unaffected by corneal or ocular cylinder (p>0.05). The relative proportion of the anterior corneal astigmatism in the subjective astigmatism increased with the subjective cylinder (r=0.54 p<0.001; 83% for cylinder ≥3.00D; 52% for cylinder ≤0.50D). The difference (absolute value) between subjective and corneal axis decreased with the subjective cylinder (r=‐0.42; p<0.001). Corneal astigmatism showed higher enantiomorphism than subjective astigmatism (17° vs 27°; p<0.001).The degree of enantiomorphism of astigmatism increased significantly with the cylinder (r=0.43 p<0.001).

Conclusion Anterior corneal astigmatism plays a major role in subjective astigmatism especially when the magnitude of the latter is important. Finally, taking into account posterior corneal astigmatism data did not improve the prediction of subjective axis or cylinder.
Correlation between eye axial length and corneal biometric parameters
Authors: CAYETTE S , TOUZEAU O , RODALLEC T , ADAM R , NORDMANN JP , LAROCHE L , BORDERIE VM
Published: November 2010

Purpose To investigate the correlation between the eye axial length and the corneal biometric parameters in a normal population.

Methods We prospectively recorded axial length, ultrasonic pachymetry and corneal topography (Orbscan) of 250 healthy eyes (excluding high myopia) of 125 patients aged from 10 to 80 years. Three refractive subgroups (hyperopia, emmetropia, myopia) were defined according to the subjective spherical equivalent (emmetropia ‐1D to +1D). Corneal biometric parameters were compared in these 3 groups and were correlated with the axial length.

Results No significant correlation was found between axial length and the corneal biometric parameters (i.e., pachymetry, anterior corneal curvature, corneal cylinder, corneal diameter, asphericity, irregularity, irregular astigmatism, location of thinnest point…)(r≤0.09 p≥0.07). The three subgroups were not significantly different for the corneal biometric parameters (p>0.13) except for the corneal curvature (hyperopia, 42.89D; emmetropia, 43.69D, myopia, 44.37D; p<0.001). Axial length showed a strong correlation with subjective spherical equivalent (r=‐0.82, p<0.001) but not with subjective astigmatism (p>0.14).

Conclusion Although corneal curvature is relevant to spherical refraction, axial length does not seem to have a significant influence on the biometric parameters of the cornea.
Changes in the spatial resolution and in the color contrast perception due to interjected face protector screens in the emergency situations in mesopic conditions
Authors: BONNIN ARIAS C , PEREZ‐CARRASCO MJ , CHAMORRO E , NAVARRO‐BLANCO C , GOMEZ‐VADILLO T , SANCHEZ RAMOS C
Published: November 2010

Purpose Assess the changes in the visual capabilities related to protector masks that are mandatory in emergency situations. The study was carried out in mesopic conditions.

Methods 36 adults were assessed. Everyone was from both genders, ranging 18 to 49 years old, with an average age of 30 +‐ 8 years old. Face protectors screens have been utilized on Individual Protection Kits for emergency situations. Every measure was conducted by the same examiner and into the same laboratory in mesopic conditions. Visual Acuity was evaluated by means of the Sloan´s test at 100% and 5% of contrast in logarithmic units, the Contrast Sensitivity with the CSV100 test and the colour perception with Ishihara´s test (each test was accomplished by the manufacturer´s recommendations).

Results The capacity for distinguishing details in the assessment carried out without a protector screen was of ‐0,05+‐0,05 logMAR, and with a protector screen was of 0,00+‐0,11 logMAR; being the difference statistically significant. Constrast Sensitivity values are lower when a protector filter is interjected, with p‐valor=0,013. Regarding colour perception, significative differences were detected after protector screen application and withdrawal.

Conclusion In mesopic conditions, spatial resolution, contrast sensitivity and colour perception are significantly more decreased due to face protector screens needed for emergency situations.
Visual acuity of people over 55 years old in habitual corrective conditions: drivers versus non‐drivers
Authors: NAVARRO VALLS JJ , RAMIREZ MERCADO G , GOMEZ TORTUERO E , LANGA MORAGA A , GENE A , SANCHEZ RAMOS C
Published: November 2010

Purpose Our aim is to investigate the habitual VA in a non‐clinical population aged 55 years and over without evident pathology in order to estimate needs for best correction, comparing drivers’ and non‐drivers’ condition.

Methods The 2449 subjects participating in the study were from amongst people in different shopping malls located in 21 provinces in Spain. All of them, (age range 55 – 89 years, both genders) were free of any ocular disease or pathology. Their monocular distance VA was determined under photopic and mesopic conditions.

Results About 35% of the people participating in this study, using their habitual corrective lenses, had a lower VA than others in their age range. The habitual photopic VA of the sample was 0.63 ± 0.25 and 0.26 ± 0.10 under mesopic conditions. Photopic VA for drivers was 0.67 ± 0.25 and 0.62 ± 0.26 for non‐drivers. Mesopic VA for drivers was 0.26 ± 0.11 and 0.25 ± 0.11 for nondrivers.

Conclusion Drivers’ habitual VA is about 11% better than non‐drivers’ in all age ranges, this difference being statistically significant in both photopic and mesopic conditions. Specifically, the mesopic VA for drivers prevent this collective from driving in legal and safety conditions that is a severe impairment compared to photopic VA (about 60% lower). Usually, examiners in driving medical centers are not required to evaluate on mesopic conditions, something that Health Authorities should be aware to improve. In addition, most of the people here evaluated undergoes a visual impairment that could be eluded by corrective lenses, in order to prolong the period of independent living and maintain quality of life.