bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic deletion of β1‐ and β2‐adrenergic receptors rescues the retina from hypoxia‐induced pathologic angiogenesis
Authors: DAL MONTE M , CAMMALLERI M , FORNACIARI I , CASINI G , BAGNOLI P
Published: August 2014

Purpose To investigate the effects of β1‐ and β2‐adrenergic receptor (AR) deletion in the vascular retinal response to hypoxia, to confirm and expand the role of β1‐ and β2‐ARs in regulating retinal angiogenesis and to get insights into the role of β3‐ARs.

Methods We used wild type (WT) and β1/β2‐AR knockout (KO) mice. The retinal angiogenic response to hypoxia was studied in a mouse model of oxygen‐induced retinopathy (OIR) using real time RT‐PCR, Western blot, ELISA and immunohistochemistry.

Results Our results show that β1‐ and β2‐AR deletion did not affect β3‐AR expression or norepinephrine (NE) levels. In KO mice, NE was less upregulated in response to hypoxia indicating a reduced stimulation of the β‐adrenergic system. In KO, the angiogenic response to hypoxia, including the formation of both a central avascular area and neovascular tufts, was nearly abolished while no improvements were observed in blood‐retinal barrier dysfunction typical of OIR. Unexpectedly, VEGF levels did not differ between WT and KO in spite of a recover of the angiogenic response, but a reduced activation of VEGF signaling was observed in KO, which may explain the reduced response to hypoxia. To get insights into the role of β3‐ARs, we treated OIR mice with a β3‐AR agonist, BRL37344 (2 mg/kg, s.c. injected), which resulted in an increase in VEGF levels and the formation of neovascular tufts in both WT and KO, indicating that β3‐AR stimulation may function as a proangiogenic switch.

Conclusion Taken together, our results confirm the notion that β1‐ and/or β2‐ARs play a role in retinal angiogenesis and indicate that β3‐ARs may potentiate the angiogenic response in WT and sustain the angiogenic drive in KO.
Tamoxifen retinopathy
Authors: HALFELD FURTADO DE MENDONCA R , LUZ LEITÃO GUERRA R , DE OLIVEIRA MAIA JR O , YUKIHIKO TAKAHASHI W
Published: August 2014

Purpose To report a rare and interesting case of retinopathy secondary to tamoxifen therapy. Setting: Tamoxifen is a selective estrogen receptor modulator widely used in the treatment of hormone‐responsive breast cancer.

Methods A 38‐year‐old white woman underwent right breast cancer quadrantectomy with axillary lymph node dissection. She was started on long term tamoxifen (20 mg daily).

Results After a total dose of 29.2 g of Tamoxifen over a period of 48 months, she complained of blurred vision. Her corrected visual acuity was 0.3 in the right eye and 0.1 in the left eye. The retinography showed yellowish‐white deposits, more heavily concentrated in the inferior and temporal macular area. A greyish alteration following the vascular arcade with some pigment changes were detected. Fundus autofluorescence showed bilateral paramacular rings of hypofluorescence and a central increased autofluorescence in the macula (punctate spots with bright autofluorescence signal) which was not clearly visible on fundus photography. Many hypofluorescence areas following the vascular arcade were detected. Retinopathy was diagnosed and tamoxifen was discontinued.

Conclusion Patients treated with tamoxifen who complain of visual problems should be immediately referred to an ophthalmological examination. In some cases, the retinopathy is not limited to the macula.
Intravitreal Bevacizumab in treatment of chronic central serous chorioretinopathy: the efficacy according to indocyanine green angiography findings
Authors: KU HC , RHIM WI , LEE MK , LEE EK
Published: August 2014

Purpose To evaluate the efficacy of bebacizumab according to baseline indocyanine green angiography (ICGA) findings for treatment of chronic central serous chorioretinopathy (CSC).

Methods Twenty‐two eyes of 22 patients with chronic CSC and symptoms for at least 3 months were treated with intravitreal injections of 1.25 mg (0.05 ml) bevacizumab. The mean follow‐up was 12.5 months. The degrees of hyperfluorescence of ICGA included intense, weak , or no hyperfluorescence . Main outcomes measures were the resolution of the subretinal fluid and visual acuity.

Results On the basis of ICGA, intense hyperfluorescence was found in 5 eyes (23%), diffusely weak hyperfluorescence in 6 eyes (27%), focally weak hyperfluorescence in 7 eyes (32%) and no hyperfluorescence in 4 eyes (18 %). The complete resolution rate of the subretinal fluid was higher in eyes with focally weak and no hyperfluorescence (4 eyes (57%) and 2 eyes (50%)) than in eyes with intense and diffuse weak hyperfluorescence (1 eye (20%) and 2 eyes(33%)). Visual acuty was increased in eyes with complete (n=9, 0.20) and partial (n=5, 0.11) resolution of the subretinal fluid. However, in eyes without response, visual acuity was rather decreased (n=8, ‐0.11).

Conclusion The efficacy of bebacizumab in eyes with chronic CSC was heterogeneous according to baseline ICGA findings and seemed to be higher in eyes with lower choroidal permeability on ICGA.
Follow‐up of IOP and central macular thickness after repeated dexamethasone implants in retinal vein occlusion, about 29 cases
Authors: VIE A , DOT C
Published: August 2014

Purpose To investigate the impact of intravitreal dexamethasone implant (ozurdex) on intraocular pressure and on central macular thickness in eyes with macular oedema secondary to retinal vein occlusion.

Methods Twenty‐nine patients diagnosed with macular oedema due to retinal vein occlusion (11/29 branch RVO‐18/29 central RVO) and treated with Ozurdex were enrolled in this prospective uncontrolled study. Patients were followed up at 1, 2, 3, 4 and 6 months for IOP (air pulsed tonometer) and central macular thickness (CMT, spectralis SD‐OCT).

Results The mean ozurdex injections was 2,4 (1‐5). Most of the patients increased their IOP less than 6mmHg from baseline and were considered as low responder. 27% of patients were « medium responder » and increased their IOP from +6 to 15 mmHg. Only one was a high responder (+19mmHg). OHT occurred during the first (12,5%) or the second month (24%). Two patients has developed OHT only at the second injection (24mmHg). thirty‐one % of patients need a topical hypotensive therapy. The mean initial CMT was 579 μm (+/‐162μm). The mean CMT reduction between M0 and M2 was 282 μm +/‐204μm for the first injection. The anatomic effect was reproducible for the second and the third ozurdex but decreased at the fourth injection (‐196μm). Only two patients had a chronic retinal oedema after two injections.

Conclusion OHT has been observed in some patients since M1, so visit at M1 and M2 must be keept to check this point for the first injection. We confirm that very few new patients present OHT during the following injections. Repeated injections of ozurdex provide an effective reduction of the CMT for at least the first three injections. Only one patient was suspected of tachyphylaxis.
REMIDO 2 Study: Retrospective Multicentric study of the dexamethasone drug delivery system, OZURDEX, in the treatment of macular edema following retinal vein occlusion; 2 years follow‐up
Authors: POMMIER S
Published: August 2014

Purpose To evaluate the long‐term visual prognosis and complications of patients who received intravitreal Ozurdex injections for the treatment of macular edema (ME) due to retinal vein occlusion (RVO).

Methods A total of 94 patients who received Ozurdex injections on an 'as‐needed' basis in our center network (P 1,5 network) as part of the REMIDO study were followed for examination and retreatment. Main outcome measures included changes in final visual acuity (VA), final central macular thickness (CMT), retreatment interval, number of injection, and incidence of side effects.

Results Mean follow‐up time was 26.3 months. A total of 94 eyes were included for studyt. Retreatment with Ozurdex was judged necessary after 5.3 ± 0.8 months. No tachyphylaxis effect was observed. Initial mean VA was 42 letters. It significantly improved to 62 letters after 2 years of treatment : the improvement was ≥ 15 ETDRS letters in 50% of patients. 51.2% of patients were cured at 2 years with a mean injection of 2.15. The profile of cured patients presented 64 % of naïve and 60% of branch RVO. Mean CMT decreased from 688 ± 117 µm (baseline) to 325 ± 54 µm. No serious adverse events were observed; Ocular hypertension greater than 25 mmHg, managed by topical treatment, is observed in 15% of patients. Switch was necessary for 18% of patients. Cataracts were extracted in 31 % of patients at 2 years.

Conclusion This is the first reported 2 years long‐term evaluation of patients treated with Ozurdex. Repeated intravitreal Ozurdex on an 'as‐needed' basis, with a retreatment interval <6 months, produce long‐term clinically meaningful benefits in the treatment of ME due to RVO.
Comparison of the time required for panretinal photocoagulation and associated pain between Navilas® and conventional laser therapy in diabetic retinopathy
Authors: KIM MS , KIM JS
Published: August 2014

Purpose To compare the pain scale and time necessary for panretinal photocoagulation (PRP) between Navilas® (OD‐OS, Teltow, Germany) and conventional laser in diabetic retinopathy.

Methods Fifteen patients who required PRP for diabetic retinopathy were enrolled in the present study. PRP was performed using Navilas® (5 X 5 array patterned system) in the superior, nasal and inferior areas, and using conventional laser at the temporal area 1 week later. Total time of laser application and number of laser shots were counted for calculating required time per 100 spots of each laser system. Immediately after the laser photocoagulation, patients were asked to quantify their pain on a visual analog pain scale (0 = no pain; 10 = worst pain).

Results PRP using Navilas® required shorter time per 100 laser spots (27.7 sec vs. 102.0 sec, p < 0.001) and subjects had lower treatment‐related pain than with the conventional laser system (3.3 vs. 6.9, p < 0.001).

Conclusion PRP using Navilas® can be considered as an efficient method for improving patient and operator’s comfort with faster laser application and lower treatment‐related pain.
The efficacy and safety of intravitreal bevacizumab in the treatment of diabetic macular oedema
Authors: MALYSKO K , KUOLIENE K , CIMBALAS A , ASOKLIS R
Published: August 2014

Purpose to evaluate the efficacy and safety of 1.25 mg intravitreal bevacizumab (IVB) in the treatment of diabetic macular oedema at Vilnius University Hospital Santariskiu Klinikos, Centre of Eye Diseases from July, 2012 to May, 2014.

Methods Clinical data (best corrected visual acuity (BCVA) and OCT findings at baseline and at the end of the follow‐up) of 52 patients (76 eyes) were reviewed retrospectively. Patients who received only one intravitreal bevacizumab injection or whose medical data were missing were excluded.

Results 76 eyes were treated with 1.25 mg intravitreal bevacizumab every 4 weeks at least with two injections for one eye and then continued if needed. The mean BCVA in patients with diabetic macular oedema at baseline (Snellen) was 0.31 (SD ±0.24). The mean number of intravitreal bevacizumab injections per eye was ‐ 3 (range 2‐8). Patients were observed for an average of 36 weeks. At the end of the follow‐up the mean BCVA increased to 0.4 (SD±0.31) and the central macular thickness detected on OCT decreased significantly (mean 325 (SD±228ϻm)). Four patients with resistant diabetic macular oedema underwent combined IVB and laser treatment. One case of endophthalmitis was observed.

Conclusion Intravitreal bevacizumab seems to be effective and safe in the management of diabetic macular oedema in this short term retrospective study.
Detecting recurrence of macular edema in patients with wet AMD after anti‐VEGF treatment using 3D‐CTAG test
Authors: MILYUTKINA S , FINK W , KOVALEVSKAYA M
Published: August 2014

Purpose To detect recurrence of macular edema inwet AMD patients after anti‐VEGF treatment using 3D‐Computer‐automated Threshold Amsler Grid testing (3D‐CTAG; Fink &Sadun, 2004).

Methods Wet AMD patients (n=10, 11 eyes) 6 months after 3 injections of Ranibizumab (Lucentis, Novartis). Group #1(n=5, 6 eyes): norecurrence. Group #2 (n=5, 5 eyes): recurrence confirmed by OCT. Indices: # of VF defects per eye (ND); lowest perceivable contrast level (CL); VF volume lost relative to hill‐of‐vision (VLRH); lost area grade (LAG): [scotoma area at lowest tested contrast sensitivity level/scotoma area at highest tested contrast sensitivity level]×scotoma depth (%).

Results Group #1:Visus=0,43±0,18logMAR; ND=0,67±1,2; CL=10±7,04%; VLRH=2,1±3,97%; LAG=150,92±341,35%. Group #2:Visus=0,51±0,49logMAR; ND=1,4±0,55; CL=38,8±12,03%; VLRH=15,18±10,56%; LAG=32,13±20,13%.

Conclusion In group #2 3D‐CTAG revealed scotomas typical for macular edema: VLRH=15,18±10,56% compared to 2,1±3,97% (p=0,05) in group #1 and LAG=32,13±20,13% compared to 150,92±341,35% (p=0,05) in group #1. Observed functional disorders show that 3‐fold injection of Ranibizumab, adopted as the standard, appears to be insufficient in 45,45% of the cases. 3D‐CTAG may be an effective method for self‐monitoring the recurrence of macular edema in wet AMD patients.

Commercial interest
Cost of complications for patients with non‐infectious non‐anterior uveitis
Authors: TUNDIA N , SKUP M , OYE B , OKALIBE X , CHAO J , BAO Y , DICK A
Published: August 2014

Purpose To estimate costs associated with eye‐related complications in non‐anterior non‐infectious uveitis (NIU).

Methods Cases were ≥18 years old, had ≥2 diagnoses for non‐anterior (intermediate, posterior, or pan) NIU (Truven Health, 1/1/2000−12/31/2010), and developed complications (glaucoma, cataracts, visual disturbance, blindness, retinal detachment, cystoid macular degeneration). Cases and controls (NIU patients without complications) were matched 1:1 by uveitis type, sex, age, region, index date, and enrollment and followed for 1 year post complication. Annual mean total costs differences (medical and drugs) post complication were compared (ANCOVA).

Results Annual total cost difference for any complication was significantly greater in patients with non‐anterior‐NIU overall ($7,596, N=1,327), posterior‐NIU (N=1,246, $7,117), and pan‐NIU ($24,595, N=27) vs controls (all P<.05); medical costs contributed more than drug costs. Annual mean total costs for visual disturbances, cataracts, and glaucoma combined were greater for non‐anterior‐NIU overall, posterior‐NIU, and pan‐NIU vs controls by $23,915, $23,182, and $50,213, respectively. Overall, the 1‐year post‐complication total cost burden was greater by $10,079,892 in non‐anterior NIU patients who developed complications vs controls.

Conclusion This medical claims analysis revealed a significant economic burden due to complications of non‐anterior NIU.

Commercial interest
Transient branch retinal artery occlusion as the first microvascular sing of systemic lupus erythematosus
Authors: PAWLOWSKI P , ZINCZUK M , PAWLOWSKA M , RESZEC J
Published: August 2014

Purpose To report a case of transient branch retinal artery occlusion (transient BRAO) in the course of lupus erythematosus preceding other systemic vascular complications.

Methods Detailed ophthalmological examination including fluorescent angiography, SOCT and mfERG was performed. Laboratory test including morphology, antinuclear antibodies (ANA), antiphospholipid antibodies (APLA) were obtained. The patient was followed‐up for six months and one and three years after.

Results An 29‐year‐old woman was presented with the reduced best corrected visual acuity (BCVA) (Vos= 0.1), and the acute retinal ischaemic lesion. Laboratory tests and the history of thrombocytopenia indicated the systemic lupus erythematosus. 6 months later the mean BCVA improved from 0,1 to 0,9. The scotoma observed in her central visual field had been reduced. Multifocal ERG (Espion E2, Diagnosys LLC, USA) demonstrated the impaired retinal function and spectral domain optical tomography (Nidek RS‐3000, Japan) revealed the macular thinning in the area of BRAO. Before the three‐year‐follow‐up patient had been referred to kindney biopsy were the advanced lupus nephritis was diagnosed, and had been operated due to aortic aneurysm.

Conclusion The retinal vascular occlusion disorders in systemic lupus erythematosus may be the rare cause of transient BRAO in young patients and precede other systemic vascular complications.
Changes in choroidal thickness and corneal parameters in diabetic eyes
Authors: NORVYDAITE D , LAURINAVICIUTE G , STECH S , SKVARCIANY I , GALGAUSKAS S , ASOKLIS R
Published: August 2014

Purpose To evaluate the effect of diabetes mellitus on the central corneal thickness (CCT), corneal endothelial parameters (endothelial cell density (ECD), their average size (Ave), hexagonality (A6), polymegathism (CV)) and the subfoveal choroidal thickness (SFCT). To determine whether these parameters depend on the duration of diabetes and haemoglobinA1c (HbA1c) level.

Methods 62 diabetic patients and 65 healthy subjects were examined using a non‐contact specular microscope, A‐scan ultrasound and spectral domain optical coherence tomography. The study parameters included medical history, age, axial length, SFCT, CCT, ECD, A6, CV, Ave. The duration of diabetes and HbA1 level of 2 latest tests (6 months period) were noted.

Results There was equal proportion of men and women 31(50%) in the diabetes group (62 patients, 124 eyes). The mean age was 45.5(±13.4) years, duration of diabetes – 9.3(±6.6) years, HbA1c level – 9.8(±2.3)%. Diabetic retinopathy (DR) was present in 22(17.9%) eyes, macular edema ‐ 10(8.1%). There were no differences in age, gender or axial length between the groups (p>0.05). SFCT (258.0±74.4µm) and ECD (2721.8±264.1cell/mm2) were significantly lower, CCT (566.7±35.7µm) ‐ higher in diabetic patients than in control group (313.1±88.5µm, 2967.3±220.6cell/mm2, 550.0±56.4µm) (p<0.05). DR and macular edema didn’t influence SFCT significantly (p>0.05). No differences in endothelial parameters between groups and no correlations between HbA1c, duration of diabetes and any of the examined parameters were found (p>0.05).

Conclusion Diabetic patients have thicker corneas, lower endothelial cell density and thinner subfoveal choroid than healthy subjects.
Scleral collagen crosslinking (SXL) by riboflavin and blue light inhibits eye growth of young rabbits
Authors: KORBER N , GOHLER C , KOCH C , KARL A , PENK A , HUSTER D , REICHENBACH A , FRANCKE M , WIEDEMANN P , ISELI HP
Published: August 2014

Purpose The application of riboflavin and blue light (for Collagen Crosslinking of scleral tissue; SXL) was proved as a possible therapeutic method to increase scleral stiffness and therefore, to inhibit eye growth in young rabbits.

Methods For eye growth examination the sclera of young rabbit eyes were treated with riboflavin and 10 mW/cm² blue light. MR‐Imaging and ultrasonic A scans were used to measure effects of SXL treatment on eye growth. Safety and efficacy parameters were determined using immunohistochemical and histological methods.

Results Immunohistochemical and histological examinations showed no neurodegenerative side effects or signs of glial reactivity in retinal tissue beyond a light intensity of 400 mW/cm². Young animals treated with a minimal effective light energy dose of 10 mW/cm² displayed a significant reduction of their eye growth. The eye growth inhibition after SXL treatment maintained for at least 24 weeks.

Conclusion The results confirm the idea that scleral collagen crosslinking by riboflavin/blue light is an applicable method to inhibit eye growth and therefore, it might be a treatment for pathologic myopia.
Influence of pterygium excision surgery on corneal biomechanical properties
Authors: CARAMELLO C , MATEO OROBIA AJ , PÉREZ D , IBAÑEZ J , HERRERA L , ZABADANI K , MARTINEZ M , DEL BUEY MA , PINILLA I , ASCASO J
Published: August 2014

Purpose To evaluate biomechanical corneal changes after pterygium excision surgery.

Methods Prospective, interventional study in which 22 patients with unilateral pterygium were enrolled. Patients underwent pterigyum excision surgery with conjunctival autograft transplantation. The following corneal biomechanical properties were studied using Ocular Response Analyzer (ORA), preoperatively and postoperatively: Corneal Resistance Factor (CFR), Corneal Hysteresis (CH), Goldman correlated intraolcular pressure (IOPg) and Corneal Compensated IOP (IOPcc).

Results CRF increased after pterygium excision surgery. Nevertheless, CRF returned to normal values at day 30. There was a decrease in CH parameters at day 7 and at day 30 compared with preoperative values. There was an increase in IOP, IOPg and IOPcc postoperatively.

Conclusion CH decreases after pterygium surgery probably because of the elimination of a biomechanical reinforcement provided by the fibrovascular tissue that invades the anterior stroma. The postoperative decrease in CH could influence the IOP measure, which could be infraestimated using the Golman applanation technique. ORA postoperavtive exploration provides more precise IOP values.
Engineering the corneal stroma: The effect of a three‐dimensional environment and growth factor supplementation on keratocyte phenotype
Authors: SIDNEY LE , DUNPHY SE , ROSE FRAJ , HOPKINSON A
Published: August 2014

Purpose A major challenge of producing a tissue‐engineered cornea is the recapitulation of the complex environment of the stroma. The resident cells of the stroma are keratocytes; a quiescent, dendritic cell type, responsible for maintaining the extracellular matrix. Upon injury, or during in vitro culture in foetal bovine serum (FBS), keratocytes differentiate into a fibroblastic repair phenotype. Differentiating these fibroblasts back to keratocytes is crucial in stromal tissue‐engineering. Methods previously suggested are three‐dimensional environments and serum‐free medium.

Methods Primary human corneal stromal cells (CSC) were cultured to achieve a fibroblastic cell type reminiscent of a mesenchymal stem cell. CSC were seeded in poly(lactic‐co‐glycolic acid) (PLGA) microfibre scaffolds. Constructs were maintained under 4 media conditions: 20% FBS; 2% FBS; insulin‐transferrin‐selenium supplementation (ITS); and bFGF and TGF‐β3 supplementation (GF). Proliferation, cell phenotype, gene expression and matrix production were assessed.

Results Scaffolds supported cell adhesion and proliferation in all media types. Gene expression and immunocytochemistry showed that scaffolds in ITS and GF media promote the keratocyte phenotype, with increased expression of CD34 and ALDH3A1. Collagen‐I deposition was seen to the greatest extent in GF cultures. Quantitative analysis showed expression of proteoglycans was greatest in GF

Conclusion PLGA microfibre scaffolds allow infiltration of CSCs and promote a keratocyte phenotype. This effect is augmented with the use of serum‐free medium and growth factor supplementation, leading to improved ECM production and deposition.
Bromfenac 0.09% BID after Nd:YAG laser posterior capsulotomy: evaluation of visual acuity and macular retinal thickness.
Authors: LOMBARDO S , TINELLI C , ANTONIAZZI ER
Published: August 2014

Purpose To investigate the clinical outcomes of Bromfenac ophthalmic solution 0.09% dosed twice daily (BID) for 2 weeks following Neodymium:YAG (Nd:YAG) laser posterior capsulotomy in terms of best‐corrected visual acuity (BCVA) and macular retinal thickness.

Methods 35 eyes with posterior capsular opacification were recruited, treated with Nd:YAG laser capsulotomy and subsequently with Bromfenac 0.09% BID for 2 weeks. Eyes with pre‐existing macular pathology were excluded. BCVA, a complete ophthalmologic assessment, macular scans by spectral domain optical coherence tomography (SD‐OCT Cirrus, Zeiss) were performed before YAG laser and after 2 weeks.

Results Post‐operative BCVA at 2 weeks was significantly better than pre‐operative one (p<0.001). Likewise post‐operative signal strength (SS) of OCT images improved (p<0.001). There were no statistically significant differences between pre‐ and post‐operative macular retinal thickness. After multivariate analysis controlling for potential confounders (age, sex, total energy, SS), a significant decrease in macular thickness was shown in superior and nasal sectors (p<0.5).

Conclusion Nd:YAG capsulotomy results in a measurable improvement in BCVA and in SS, allowing a more reliable examination of the posterior segment. It is also a safe procedure, resulting in no change in macular thickness. Bromfenac BID is effective for reducing ocular inflammation associated to laser surgery and for preventing the related complications (first of all macular cystoid edema). From a multivariate analysis Bromfenac even seems to determine a decreased macular thickness in some areas, due to a therapeutic efficacy and perhaps to an easier dosage with increased compliance.
Clinical outcomes after implantation of multifocal toric intra ocular lenses.
Authors: THOUVENIN R , ABRIEU M , BERGUIGA M , RAMBAUD C , CHENY T , SENDON D , FROUSSART‐MAILLE F , RIGAL‐SASTOURNE JC
Published: August 2014

Purpose To assess clinical outcomes and optical performances of refractive cataract surgery with mutifocal toric intraocular lens (IOL).

Methods This was a monocentric, retrospective review of cases, conducted at the Ophtalmology and Refractive Unit Percy, military Hospital, Clamart, FRANCE. This study included eyes presenting preoperative regular corneal astigmatism of 1D or greater, who underwent cataract surgery with implantation of a +3,75D multifocal toric hydrophilic IOL, by 2 differents surgeons. Ten eyes of seven patients were operated between 2012 and 2014. At the one month postoperative visit, we analysed visual acuity at various distances, spherical équivalent, refractive cylinder, spectacle independance, halos perception and patients satisfaction.

Results The mean spherical équivalent was ‐0,4D at one month. Mean pre‐operative réfractive cylinder increased from ‐2,89D (ranged from ‐1 to ‐6,75D) to ‐0,67D (ranged from ‐0,5 to ‐1,0D). Mean monocular uncorrected visual acuities were 7,42/10 at 4 m (Monoyer) and ‐0,28 logMAR at preferred near (40cm). Mean corrected visual acuities were 9,56/10 at 4 m and ‐0,18 logMAR at near. 8 of 10 patients reported freedom from corrective wear, and 6 of 10 complained about halos perception. The mean score that patients rated their uncorrected visual acuity was 7,3 +‐ 0,6 on a scale of 0 to 10.

Conclusion One month after implantation of a multifocal toric IOL, patients had significantly reduced spherical équivalent and refractive cylindre. They achieved good visual acuity across distances permiting spectacle independance for most of them.
Central nervous system abnormalities in retinoblastoma patients
Authors: DE FRANCESCO S , DE LUCA M , GALLUZZI P , HADJISTILIANOU T
Published: August 2014

Purpose Presence of CNS abnormalities on MR images in a large group of patients with retinoblastoma (rtb) is evaluated. Mental retardation and congenital brain anomalies are reported in patients with rtb, mostly in combination with 13q deletion syndrome. Pinealoblastoma is the most important and “life threatening” condition associated with hereditary rtb, but recent studies suggest an association with pineal cysts. This association is important because some pinealoblastomas mimic pineal cysts.

Methods CNS MR images of 420 consecutive patients with rtb from 2000 to 2014 were evaluated by neuroradiologists for tumors, structural anomalies, myelinization, and coincidental findings. Clinical records were reviewed for laterality, heredity, and the presence of the 13q del syndrome.

Results Patients with bilateral and unilateral proved RB1‐germline mutation were 42 (48.2%) out of 87 hereditary cases. 9 patients had 13q deletion syndrome. Normal findings on brain MR images were seen in 307 out of 420 patients. 1 pinealoblastoma was detected in a patient with hereditary rtb, one arachnoid cyst in a sporadic unilateral RTB girl, 1 cerebral and corpus callosum atrophy and 3 pineal cysts were detected (2 non hereditary, 1 in 13q deletion syndrome). Corpus callosum agenesis was found in 3 patients (2 13q deletion syndrome, 1 hereditary RTB), corpus callosum hypoplasia in 3 patients (2 twins, 1 sporadic RTB), both in combination with 13q deletion syndrome.

Conclusion Pinealoblastoma is associated with hereditary retinoblastoma, and structural brain abnormalities are associated not only with 13q deletion syndrome patients. Pineal cysts can be detected in patients with sporadic rtb and/or with 13q deletion syndrome.
Melanomalytic glaucoma secondary to iris melanoma
Authors: AJAMIL RODANES S , GARCIA‐ALVAREZ C , SAORNIL ALVAREZ M , LOPEZ‐LARA F , FRUTOS‐BARAJA JM , QUINONES M
Published: August 2014

Purpose To report on an unusual form of adult onset iris melanoma as melanomalytic glaucoma.

Methods A 35‐year‐old white male with a history of unilateral ocular hypertension and visual loss for six months.

Results At first visit,Best Corrected Visual Acuity was 80/20 in the right eye (OD) and 20/20 in the left one (OS).Intraocular pressure was 40 mmHg in the OD and 10 mmHg in OS.Anterior segment examination of the OD showed a melanotic elevated lesion on the base of the iris from 8:00 to 9:00.Gonioscopy revealed extension into the anterior chamber angle and that a dense, brown, pigmented band at the filtration portion of the trabecular meshwork. Ophthalmoscopy demonstrated glaucomatous changes to the right optic disc. The patient was unresponsive to medical treatment for glaucoma. The clinical differential diagnosis was melanocytoma, nevus and melanoma. Excisional biopsy ( iridocycloresection ) was performed. Light microscopy showed proliferation of fusiform cells with pleomorphic nuclei in the iris stroma, immunopositive for HMB45 and Melan‐A. The final hystopathologic diagnosis was iris melanoma with dispersion of pigment in anterior‐chamber and secondary melanomalytic glaucoma. Plaque radiotherapy was performed as a

Conclusion In patients presenting unilateral glaucoma and increased pigmentation in the trabecular meswork it is crucial to perform imaging studies, such as ultrasound, in order to rule out the presence of an intraocular tumor. Early diagnosis improves the patients visual prognosis and the morbidity of treatments. Resection by iridectomy with adjuvant epiescleral brachytheraphy is effective in controlling the disease.
Clinical application of 3D monitor in ophthalmologic field: Measurement of metamorphopsia
Authors: KIM YT , KIM JW
Published: August 2014

Purpose To develop a new tool of measuring metamorphopsia.

Methods Fifty‐eight patients diagnosed with macular disease were examined. Images for three‐dimensional monitor were prepared. Macular optical coherence tomography and the Amsler grid test were also performed.

Results The sensitivity of metamorphopsia was 66.7% with Amsler grid and 100% with three‐dimensional monitor. The specificity of metamorphopsia was 97.7% with Amsler grid and 90.7% with three‐dimensional monitor.

Conclusion The detection rate of metamorphopsia in macular disease with three‐dimensional monitor was significantly higher than with Amsler grid. The three‐dimensional monitor may be used for the detection of metamorphopsia, moreover, they can be used even at home for the self‐assessment.
Reproducibility of retinal oximetry measurements in healthy and diseased retinas
Authors: TÜRKSEVER C , ORGÜL S , TODOROVA MG
Published: August 2014

Purpose Retinal oximetry (RO) has been established as a non‐invasive method to analyse oxygen saturation in retinal vessels. The aim of our study was to determine the reproducibility of RO images in healthy and in diseased retinas.

Methods A total of 46 right eyes (184 oximetry images) in 46 subjects (21♂, 25 ♀) were examined: 16 controls, 10 glaucoma patients and 20 patients with inherited retinal diseases. Four test‐retest RO images were obtained in each subject. Oxygen saturation was measured with the oxygen saturation measurement tool of the Retinal Vessel Analyser (RVA, IMEDOS Systems UG, Jena, Germany). The test‐retest standard deviation within the subject (±SDw) of the mean vessel oxygen saturation in retinal veins and in arteries, its coefficient of variation (CoV) and the interclass correlation coefficients (ICC) were analysed.

Results The average test re‐test SDw in veins was ± 2.52% (CoV=4.30%) and in arteries ±1.62% (CoV=1.72%). Among controls, glaucoma eyes and eyes with inherited retinal diseases, the test re‐test SDw in veins were: ±2.17% (CoV=4.11%), ±2.81% (CoV=4.64%) and ±2.66% (CoV=4.28%) (p=0.361; one‐way ANOVA) respectively. The test‐retest SDw in arteries were: ±1.53% (CoV=1.65%), ±1.44% (CoV= 1.05%) and ± 1.83% (CoV=1.91%), respectively (p=0.633). The ICCs in veins were 0.77 in controls, 0.76 in glaucoma patients and 0.83 in patients with inherited retinal disease. The ICCs in arteries were respectively: 0.92, 0.77, and 0.93.

Conclusion Reproducibility of retinal oxygen saturation in healthy, as well as in diseased retinas is excellent. Measurements in arteries seem more reliable when compared to veins.
Intravenous hypertonic saline ‐ the effect of splitting the dose
Authors: TORVINEN P , HARJU M , KIVELÄ T
Published: August 2014

Purpose To compare the effect of a single vs. splitted dose of intravenous hypertonic saline (IVHTS) on intraocular pressure (IOP) among patients with open‐angle glaucoma (OAG).

Methods In a prospective, randomised, interventional trial, we enrolled OAG patients with an IOP of 22‐34 mmHg. We excluded patients using oral acetazolamide, those with heart or kidney failure, dementia or another systemic condition that notably decreased physical performance. Participants received 23.4% IVHTS trough an antecubital vein at a rate of 1 ml/s. Group 1 received a single dose of 1 mmol/kg, and Group 2 two doses of 0.5 mmol/kg sodium separated by 10 minutes. We measured IOP before IVHTS and repeatedly for 20 minutes after infusion.

Results A total of 32 participants (median age 69 years, range 35‐78); 20 patients in Group 1 and 12 in Group 2. The mean baseline IOP was 26.2 (SD, 2.7) mmHg in Group 1, and 25.4 (3.5) mmHg in Group 2 (P=0.15). In both groups, mean IOP was significantly reduced after IVHTS; mean reduction in Group 1 was 7.0 (2.8) mmHg 10 minutes after IVHTS (P<0.001), and 7.6 (2.6) mmHg (P<0.001) at 20 minutes. In group 2, the corresponding mean reductions after the 2nd dose were 8.1 (2.0) mmHg (P<0.001) and 8.2 (1.8) mmHg (P<0.001), respectively. The mean IOP reductions 10 and 20 minutes after IVHTS were comparable for Group 1 and 2 (P=0.24 and P=0.47, respectively). Within 1‐3 minutes of infusion, 16 patients in Group 1 felt pain at the infusion site as compared to 7 patients in Group 2. The 2nd dose in Group 2 induced more pain than the 1st dose according to 8 patients.

Conclusion A single dose of 1.0 mmol/kg and two sequential splitted doses of 0.5 mmol/kg of IVHTS reduce IOP comparably. Splitting the dose did not eliminate the pain felt at the infusion site.
Dynamic dark‐light changes in anterior chamber and iris parameters in angle closure patients with novel automatic algorithm using anterior segment optical coherence tomography (AS‐OCT)
Authors: LEE TL , ANG L , TIAN J , YIP L
Published: August 2014

Purpose To describe the dynamic dark‐light changes in anterior chamber (AC) measurements and iris parameters in angle closure patients compared to normal angle patients using a fully automatic algorithm developed for anterior segment optical coherence tomography (AS‐OCT).

Methods 10 patients (17 eyes with closed angles) and 8 patients (15 eyes with normal angles) on gonioscopic grading were recruited. We acquired images in both dark and light conditions using Visante OCT. Custom software analyzed the images using the iris rim as the landmark instead of the sclera spur. The parameters analyzed included angle opening distance and angle recess area, at 750μm from the iris rim (AOD 750 & ARA 750), AC depth and width, lens vault and iris curvature, thickness, length and area. We analyzed the amount of change from dark to light in both groups of patients.

Results In both conditions, angle closure patients had significantly smaller AOD and ARA, but there was no difference in iris parameters between the 2 groups. In both groups of patients, there was significant change in iris length, area, thickness and ARA when moving from dark to light conditions. The AOD changed significantly in normal patients but not in angle closure patients. There was no difference in the magnitude of change in the above parameters, when changing from dark to light conditions, in both groups of patients.

Conclusion The automated algorithm can identify differences between the AC measurements and iris parameters in both groups of patients. The lighting condition affects the measurements taken regardless of diagnosis. As such, lighting control should be consistent.
Comparison of prelaminar thickness between primary open angle glaucoma and normal tension glaucoma patients
Authors: JUNG Y , PARK H , PARK C
Published: August 2014

Purpose To investigate the difference in prelaminar tissue thickness between patients with primary open‐angle glaucoma (POAG) and normal‐tension glaucoma (NTG) and to determine the factors related to prelaminar thickness.

Methods Complete ophthalmic examination including standard automatic perimetry was performed in all patients. The prelaminar tissue thickness was measured in all patients by performing enhanced depth imaging with a Heidelberg Spectralis Optical Coherence Tomography. The prelaminar thickness was compared between patients with POAG and those with NTG. The retinal nerve fiber layer and optic nerve head parameters were obtained using the Heidelberg Retina Tomography II and Cirrus Optical Coherence Tomography and analyzed to verify factors related to prelaminar thickness.

Results The mean prelaminar tissue thickness was significantly thinner in patients with POAG than in those with NTG. The difference in the prelaminar thickness between patients with POAG and those with NTG was greater in the early field defect group than in the moderate and severe field groups. In multivariate analysis, the mean prelaminar thickness was related to the intraocular pressure, cup volume, and mean cup depth.

Conclusion The prelaminar tissue was thinner in patients with POAG than in patients with NTG, and the intraocular pressure had a strong influence on the prelaminar thickness in both patients with POAG and those with NTG.
Swept source optical coherence tomography artifacts in glaucoma patients
Authors: LEE SY , SEO SJ , LEE YH , BAE HY , KIM CY
Published: August 2014

Purpose To demonstrate the frequency and the type of swept‐source optical coherence tomography (SS –OCT) imaging artifacts in patients being evaluated glaucoma and to present common artifacts examples

Methods The SS–OCT images of 101 glaucoma suspect and glaucoma patients were used to evaluate image artifacts. We used a 3 dimensional imaging data set of 6x6mm raster scan centered on the optic disc (3D disc scan) and a 3 dimensional imaging data set of 12 mm horizontal line scan centered between optic disc and the fovea (3D side scan). For each scan, both printout report and the source image of printout report were examined.

Results In 101 patients, 101 3D disc scans and 97 3D wide scans were obtained. In 3D disc scan, there were 30 artifacts in source image and 23 artifacts in final report. In 3D wide scan, there were 24 artifacts in source image and 20 artifacts in final report. The most common type of artifacts for 3D disc scan source data was boundary misidentification (66.7%). That was also the most common type of artifacts of 3D wide scan source data. Ocular pathology accounted for 25% of the cause in 3D disc scan source data with artifacts and 38.9% in 3D wide disc scan source data with artifacts. Epiretinal membrane (ERM) was the most common cause of ocular pathologic artifacts

Conclusion The artifacts in SS OCT images can be made by ocular pathology or software error. Operator also can be the cause of SS OCT artifact. Those factors can make errors in interpreting OCT result. Although it is known that SS OCT has an advantage in image detection efficiency, we should consider possibility of artifacts in source data and final report. Especially, we should pay attention in patient who has ocular lesions such as ERM or vitreous traction.
Evaluation of peripapillary choroidal thickness in patients with glaucoma
Authors: MUMCUOGLU T , OZGE G , OZGONUL C
Published: August 2014

Purpose We aimed to compare peripapillary choroidal thickness measurements between normal and glaucoma eyes.

Methods Prospective, cross‐sectional comparative study. 46 eyes of 23 normal and 86 eyes of 45 glaucoma subjects were enrolled in the study. Peripapillary choroidal thickness was measured with spectral‐domain optical coherence tomography and enhanced depth imaging. After obtaining circular B‐scans around the disc, choroidal thicknesses were calculated for all quadrants. Difference in peripapillary choroidal thickness, retinal nerve fiber layer (RNFL), central macula thickness and macula volume between the normal subjects and the patients with glaucoma was analyzed.

Results There were no significant differences in age, gender or refraction between the two groups. RNFL in all quadrants and overall average thickness significantly thinner in the glaucoma group as compared to normal subjects (p<0.01). Peripapillary choroidal thickness of inferior (130 vs 112,6 μm, P < 0.01), temporal (180,1 vs 152,9 μm, P < 0.03) regions were significantly thinner and macular volume (8,42 vs 7,95 mm3, P < 0.015) were significantly lower in the glaucoma group as compared to normal subjects.

Conclusion As compared to normal subjects, peripapillary choroidal thickness was significantly thinner and macula volume decreased in the glaucoma patients. The structural features of the choroid may be associated with pathophysiology of glaucoma.
The association of nailfold capillaroscopy with systemic matrix metalloproteinase‐9 concentration in normal‐tension glaucoma
Authors: LEE N , PARK C
Published: August 2014

Purpose To investigate the association of nailfold capillaroscopy, heart rate variability (HRV), and clinical characteristics of glaucoma with the plasma matrix metalloproteinase‐9 (MMP‐9) level in normal‐tension glaucoma (NTG).

Methods We conducted a prospective, cross‐sectional study on 25 patients with NTG. Subjects with systemic diseases were excluded. The patients underwent a complete ophthalmic examination and were referred to the Rheumatology Department, where nailfold capillaroscopy and HRV assessment were performed. The patients were assigned to the lowest and highest HRV groups according to the standard deviation value of the qualified normal‐to‐normal intervals of the HRV assessment. Blood samples from all of the subjects were assayed for MMP‐9 concentrations.

Results The systemic MMP‐9 level was significantly associated with the nailfold capillaroscopy result (ρ=0.439, p=0.032). However, there was no significant association of HRV parameters, disc hemorrhage, or visual field progression with the systemic MMP‐9 level.

Conclusion The systemic MMP‐9 level was associated with the nailfold capillaroscopy results in patients with NTG but had no direct association with optic disc hemorrhage.
Management of secondary glaucoma in patients with uveitis
Authors: MUMCUOGLU T , OZGE G
Published: August 2014

Purpose To report the clinical course of patients with uveitic glaucoma.

Methods The medical records of the patients diagnosed with uveitic glaucoma at the Glaucoma Service of the Department of Ophthalmology were reviewed retrospectively.

Results Twenty eight patients (38 eyes) presented, of whom 20 were male and 8 were female. The mean age was 50.4±16.5. Eighteen patients had disease unilaterally and 10 bilaterally. Uveitis was associated Behçet’s disease in 6 patients, and idiopathic in 22 patients. All patients initially received topical medical therapy. Sixteen eyes were treated with monotherapy and 22 eyes with multitherapy. Surgical procedures (trabeculectomy or combined phacotabeculectomy) were performed in 20 eyes in which medical therapy failed. Secondary surgical procedures such as bleb revision or drainage implantation were needed in 6 eyes.

Conclusion Secondary glaucoma associated with uveitis is an underappreciated, vision‐threatening complication and a challenging condition to manage.
Lysyl Oxidase‐Like 1 gene haplotypes and their association with pseudoexfoliation glaucoma in the Spanish population
Authors: ALVAREZ L , GARCIA M , GONZALEZ‐IGLESIAS H , ESCRIBANO J , RODRIGUEZ‐CALVO PP , FERNANDEZ‐VEGA L , COCA‐PRADOS M
Published: August 2014

Purpose To investigate the potential association of genetic variants across the lysyl oxidase‐like 1 (LOXL1) gene in Spanish patients with Pseudoexfoliation Glaucoma (XFG).

Methods A case‐control study of 105 unrelated individuals from Spain with XFG and 200 unrelated healthy controls matched by age and ethnicity were enrolled. A region of 39,230 bp‐long of genomic DNA covering the entire LOXL1 gene and regulatory regions were sequenced in 99 patients using next generation sequencing. Variant frequencies were compared with those reported from the HapMap CEU study. Restriction fragment–length polymorphism (RFLP) analysis was conducted to genotype five SNPs in the LOXL1 gene (rs16958477, rs1048661, rs3825942, rs2165241 and rs3522) in all controls and in 6 XFG patients. A case‐control association study was performed using the HaploView 4.0 software.

Results The allelic frequency analysis of the five selected LOXL1 SNPs revealed that (with the exception of rs3522) they were significantly associated with an increased risk for XFG. The haplotypes CGGT and AGGT, which carry the risk alleles of rs1048661, rs3825942, and rs2165241 were significantly associated with XFG. In contrast, the haplotypes ATGC and AGAC were found to be protective.

Conclusion This study confirms that common genetic variants in the LOXL1 gene are associated with XFG in the Spanish population. To our knowledge this is the first study to demonstrate this association in a population of Western Europe.
Subfoveal choroidal thickness in myopic and non myopic children
Authors: FONTAINE M , SAUER A , GAUCHER D , SPEEG‐SCHATZ C
Published: August 2014

Purpose Since the recent development of Enhanced‐Depth‐Imaging program (Spectral domain OCT), most of the studies concerning choroidal thickness and myopia were performed on adults. The purpose of our study is to demonstrate a link between subfoveal choroidal thickness and ametropia in children.

Methods We included 115 healthy children aged between 3 and 15 years. We measured refraction with cycloplegia, axial length and subfoveal choroidal thickness with EDI program (Spectral domain OCT). We compared mean subfoveal choroidal thickness in the myopic population of children, to non myopic population of children, using t‐test. We correlated axial length and subfoveal choroidal thickness using Spearmann test.

Results We included 115 right eyes. The mean age was 7.8 years. The mean spherical equivalent refraction was 0.0 diopters,the mean subfoveal choroidal thickness was 314.82 µm. 78 children had a positive spherical equivalent refraction (emmetropic and hyperopic group), 35 had a negative spherical equivalent refraction (myopic group). In the emmetropic/hyperopic group, the mean subfoveal choroidal thickness was 332.3 µm. In the myopic group, it was 275.9 µm. The mean sufoveal choroidal thickness was significantly thinner in myopic children compared to the other group, with a difference of 53.4µm, p=0.032, IC 95% [18.29 ; 88.5]. The subfoveal choroidal thickness was significantly correlated to axial length (r= ‐0.4343, p<0.0001, IC 95% [‐0.5768; ‐0.2662].

Conclusion This study shows that subfoveal choroid is thinner in myopic children. This has been demonstrated in adult, but there are only a few studies about children. Our results confirm the recent literature. It leads to new projects of study: a thin choroid could be a predictive factor of myopia.