bluuebunny/crossref_metadata_2025 huggingface dataset:
Existence of limbal epithelial crypt within the infant limbus
Authors: YEUNG AM , TINT NL , HOPKINSON A , DUA HS
Published: September 2008

Purpose The Limbal Epithelial Crypt (LEC) has been suggested to be the limbal epithelial stem cell niche and the limbus has been shown to demonstrate regional variations in association with the LEC. Our aims were to 1) to determine the existence of LEC in the infant age group and 2) compare and contrast the corneo‐scleral tissue between infant and the adult by use of immunofluorescent imaging.

Methods Donor eyes were processed and snap frozen in liquid nitrogen. Using a Leica cryostat machine, corneo‐scleral sections were prepared and examined under microscopy for presence of LEC structures. Limbal sections were fixed, and stained with a range of current postulated markers of stem cells and cell differentiation by standard immunofluorescent imaging techniques.

Results Immunostaining in the infant group demonstrates that both limbal and corneal epithelium consist of cells that are characteristic of cells with less differentiated nature. No classical adult LEC was discernable in corneo‐scleral rims of a 2 year old or a 4‐month old infant. However, adult LEC immunofluorescence, demonstrate similar characteristics to the infant limbus.

Conclusion We hypothesize that the absence of classical adult LEC in infants suggests that LEC may arise during the natural human growth, and may act as a repository for limbal epithelial stem cells in the human adult.
The effect of spongy layer (sl) isolated from amniotic membrane on ocular cells growth
Authors: LAZUTINA E , SULEMAN H , DUA HS , TINT NL , JAMES DK , HOPKINSON A
Published: September 2008

Purpose The extraembryonic coelom or spongy layer (SL) is the gelatinous, biochemically complex layer, which functions as a physical boundary between the vascular chorion and avascular amnion membrane (AM). SL often remains associated with the AM and is partially but variably removed during preparation for transplantation. We have shown that SL contains a similar profile of potentially beneficial factors as AM, but at considerably higher levels, which may explain in part the observed clinical variation. However, the effects of SL on ocular cell growth have yet to be established

Methods Soluble proteins were extracted from freeze‐dried SL to generate a soluble (sSL) and an insoluble structural SL fraction (iSL). Cultured corneal epithelial cells (CEC), keratocyte derived fibroblasts (KDF) and lymphocytes were stimulated with sSL and iSL fractions at varying dilutions, and the effects on cell proliferation (WST‐1) and cytotoxicity were measured.

Results At physiological concentration (16mg/ml) iSL killed all cell types within a few hours. Serial dilution of iSL (16mg/ml,8mg/ml,3.2mg/ml,0.32mg/ml) reduced rate of death, but death still occurred. Stimulation with sSL killed CEC at all concentrations, whilst the most dilute sSL fraction promoted KDF growth.

Conclusion SL exerts a powerful cytotoxic effect on ocular and immune cells. However, the depot of factors contained within the SL may over time be released over time to promote cell growth. Therefore in the current situation where SL is typically ignored during AM preparation for transplantation, may have significant implications for the clinical efficacy of AM.
SUMOylation during nuclear degradation in lens fibre cells
Authors: PRESCOTT AR
Published: September 2008

Purpose To investigate the role of SUMO (small ubiquitin‐related modifier) in organelle elimination and nuclear reorganisation during lens fibre cell differentiation.

Methods Antibodies raised against the small protein modifiers SUMO were localised by indirect immunofluorescence and laser scanning confocal microscopy in cryo‐sections of bovine lenses. The localisation of these antibodies was correlated with other antibodies targeted to several nuclear compartments previously shown to be rearranged during nuclear elimination in the lens (Gribbon et al. EJCB 81:557‐66).

Results In the lens epithelium and most recently differentiated fibre cells SUMO is present in a single small bright (as yet undefined) compartment in the nucleus and as a diffuse, fine punctate nucleoplasmic distribution. In the nuclei of deeper fibres the SUMO becomes associated with nucleolar caps, these caps are distinct from those containing proteins from other nuclear bodies; eg. coilin from Cajal bodies. Finally in the very last intact nuclei SUMO becomes associated with the nuclear membrane, and or the lamina, and or nuclear pores.

Conclusion The post‐translational modification of proteins by SUMO can have many consequences including the regulation of protein‐protein interactions, inhibition of transcription and regulation of enzyme activity. SUMOylation can occur on many, both cytoplasmic and nuclear proteins but little is known about its role in cell differentiation. Interestingly in the context of lens development SUMO has been implicated in the cellular responses to hypoxia ‐ a metabolic stress that has been suggested to be involved in lens fibre cell differentiation.
Analysis of a potential new model for neurovascular coupling in retina and its relation to the retinal relaxing factor
Authors: MAENHAUT N
Published: September 2008

Abstract not provided
f‐Visual evoked potentials (f VEPs), nystagmus vs. motor & neurological disorders in quadriplegia
Authors: TIGANITA S , KOZEIS N , TYRADELIS E , GATZIOUFAS Z , ZAFEIRIOU D
Published: September 2008

Purpose To correlate flash VEPs and nystagmus with the severity of the motor and brain disorder in spastic quadriplegic children.

Methods 52 quadriplegic children (2‐9 years of age) participated in this study. Flash VEPs (ICEVE), and brain MRI were performed, also nystagmus (clinical evaluation) and gross motor function (GMFCS) were evaluated.

Results 29 children were premature and 23 were full terms. 15 out of 52 (28.84%) had normal f VEPs and 37(71.15%) had abnormal. epilepsy, 13 (25%) had nystagmus (horizontal). 73.07% of the children had moderate to very severe motor disorders. 32 children (61.53%) had periventricular leukomalacia and 20 (38.47%) had various brain damages.

Conclusion Affected flash VEPs and nystagmus are common in quadriplegic children. There is a statistically significant relationship between VEPs, nystagmus and neurological and brain damage.
Regulators of angiogenesis in the vitreous
Authors: BISHOP PN , LE GOFF MM , TAKANOSU M , HENRY SP , MAYNE R
Published: September 2008

Purpose Preretinal neovascularisation is a form of angiogenesis i.e. growth of new blood vessels (into the vitreous) from the pre‐existing vessels (the retinal vasculature). The vitreous contains pro‐ and anti‐angiogenic molecules and normally the balance favours an anti‐angiogenic state. However in diseases such as proliferative diabetic retinopathy, excess pro‐angiogenic molecules, e.g. VEGF, stimulate preretinal neovascularisation. Anti‐angiogenic molecules identified in the vitreous to date include PEDF, thrombospondin‐1 and endostatin, but their relative importance in inhibiting preretinal neovascularisation remains unclear. Here we show that an endogenous glycoprotein of the vitreous called opticin has potent anti‐angiogenic properties, and provide evidence that it has a pre‐eminent role in inhibiting pre‐retinal neovascularisation.

Methods Opticin null mice were generated and bred onto a C57/BL6 background. The opticin null mice and wild‐type mice +/‐ intravitreal injection with recombinant opticin (at P14) were investigated using the oxygen‐induced retinopathy model (75% oxygen from P7‐12, and analysis at P17 by serial histological sectioning).

Results The opticin null mice demonstrated increased preretinal neovascular nuclei per cross section (109 +/‐ 6 S.E) compared to wild‐type controls (73 +/‐ 3) (P < 0.0001). The opticin injected wild‐type eyes showed a decrease in preretinal neovascular nuclei per cross‐section (38 +/‐ 3) compared to eyes injected with PBS alone (76 +/‐ 4) (P < 0.0001).

Conclusion Opticin inhibits preretinal neovascularisation in a dose‐dependent manner. This is the first time that a knockout mouse has demonstated increased neovascularisation using this model. Opticin, or molecules derived from opticin, represent potential therapeutics.
Enzymatic vitreolysis promises and potential pitfalls
Authors: DE SMET MD
Published: September 2008

Abstract not provided
Visual development in premature infants without serious events in their pre – and perinatal period.
Authors: AGGELIDOY E , KOZEIS N , FELEKIDIS A , KAPSOS A , PAPPAS K , HRISOGLOU M
Published: September 2008

Purpose To follow the visual development of premature neonates without serious health problems.

Methods 49 premies (GA 26 < β < 35 & βW 890 < β < 2240gr), with no neurological and ophthalmological lesions, participated in this study. Brain ultrasound, fundoscopy, cycloplegic refraction and assessment of the visual function (VFA‐K test) were performed in 10th and 16th adjusted month of age. All the babies had a psychokinetic assessment (twice) (DENVER test).

Results 41 out of 49 neonates had GA <32 weeks .and 30 out of 49 had βW <1500 gr. 26 neonates had normal brain echo and 23 appeared with mild enlargement of brain ventricles. During the 1st examination, 3 neonates appeared with refractive error >1.00 D, 4 had strabismus, 4 had mildly abnormal VFA‐K test score and 10 had reduced DENVER score. During the 2nd examination, the results were the same apart from an improvement in VFA‐K and DENVER score.

Conclusion In the vast majority of the premature infants with no serious health problems, the visual function develops normally.
Is diabetic retinopathy an inflammatory, oxidative stress, genetic, mediated process ?
Authors: DE SOUZA RAMALHO P , PEREIRA DA SILVA A , PEGO P , BICHO MP
Published: September 2008

Purpose Diabetic Retinopathy (DR)neurovascular degenerative process of systemic disease is one of the main causes of blindness in adults(20‐70 years).Multifactor machanisms with growing evidence of hyperglycaemia induced inflammation and oxidative stress with genetic influence can lead to retinal cell apoptosis in early STZ diabetic rats. Expression of inflammation and oxidative stress markers and their genetic phenotypes in diabetics under treatment and in controls were studied.

Methods Transmembrane Reductase (TMR), Erythropoeitin (EPO) activity and Haptoglobin (Hp) genotypes were determined in 60 type 2 diabetics, 26 with and 34 without retinopathy (mean age 64.2 ±11.64 years) of both sexes and in 44 non diabetic controls. TMR (mmol/l cell/h) was determined by spectophotometry, EPO(mIu/ml) by ELISA and Hp genetic phenotypes using polyachrilamide gel electrophoresis. Student t test, ANOVA,χ2 and Pearson correlation was used.

Results TMR activity was high in retinopathy subjects (5.29 ± 2.11 vs 4.11 ± 1.51 in controls p=0.016). EPO serum levels were high in retinopathy patients (15.15 ± 11.14 vs 9.47 ± 6.57 in controls p=0.043). Hp 2.2 allele genotype predominance in diabetics with retinopathy (40.9%).Hp 2.1 genotype higher incidence in diabetics without retinopathy (70.6%) p=0.028).

Conclusion High inflammatory/oxidative activity expressed by TMR,EPO,Hp and other markers in diabetic retinopathy,supports our hypothesis. EPO has also antiapoptotic, cell regenerative angiogenic properties. Its up‐regulation in retinopathy could be endogenous auto‐protective mechanism.
Driving performance in patients with homonymous visual field defects and healthy subjects in a standardized virtual reality environment
Authors: PAPAGEORGIOU E , HARDIESS G , VONTHEIN R , SCHOENFISCH B , MALLOT H , SCHIEFER U
Published: September 2008

Purpose The aim of this study was to assess whether visual field‐related parameters per se are able to predict driving performance of patients with homonymous visual field defects (HVFDs) and healthy controls in a standardized virtual reality (VR) environment.

Methods Thirty‐two patients with HVFDs due to cerebro‐vascular lesions and 32 healthy control subjects underwent testing on a driving simulator under two levels of traffic density. Driving performance was defined as the frequency of accidents under VR‐conditions. From the binocular visual field, as measured with kinetic perimetry, we assessed the area of sparing within the affected hemifield (A‐SPAR) and the perimetric reaction time (RT).

Results Frequency of traffic accidents was best explained by traffic density, age of individuals, A‐SPAR and RT. This model explained 78% of the total variability (Radj2 = 0.78). All factors were significant. The effect of traffic density explained 63.4 % of the total variance. Age, A‐SPAR and RT were minor effects explaining only 2.7%, 2.0% and 0.9% respectively.

Conclusion The extent of the visual field loss is weakly related to driving performance. This finding suggests that – at least for this group of patients – the visual field‐related parameters should not be taken as the sole indicator of fitness to drive. Some patients with HVFDs demonstrated sufficient compensatory driving behavior during the simulated test ride, presumably due to eye and head movements. Driving performance declined slightly with age; these changes were exacerbated in the presence of cerebro‐vascular disease.
Reading strategies in nystagmus
Authors: THOMAS MG , PROUDLOCK FA , MCLEAN RJ , GOTTLOB I
Published: September 2008

Purpose To understand how individuals with infantile nystagmus read in view of the sensory motor deficits associated with this condition.

Methods Eye movement recordings were carried out in healthy (n=7), IIN (n=7) and albino voulnteers (n=7) during reading for distance (1.2m) and near (0.33m) at five gaze positions (‐20°, ‐10°, 0°, 10° and 20°). Reading speeds (RS) and beating pattern were derived from these recordings. Visual acuity (VA) was also measured over the same eccentricities and distances. The nystagmus volunteers underwent a further fixational task (‐30° to 30°) to derive the waveform characteristics of nystagmus.

Results RS were significantly (p<0.05) slower in nystagmus volunteers when compared to age and IQ matched controls. VA is a good predictor of RS in IIN (R2 = 0.48, p<0.05) but not albinism (R2 = 0.08, p<0.05). Right beating waveform was associated with faster RS and left beating with slower RS (p<0.05). Intensity had a significant effect on RS in IIN (p<0.05); however, it was a poor predictor of RS (R2 = 0.12).

Conclusion We describe, for the first time, that visual acuity is a reliable measure of RS in IIN but not albinism. However, intensity does not predict RS. Therefore oculomotor recordings and VA measurements should be supplemented with reading tests to assess functional visual improvements. Furthermore, the direction of the fast phase and/or slow phase significantly affects RS. This could be because reading is an asymmetric task (English reading is from left to right). This has important implications because the null region does not always exhibit right beating pattern and faster RS. Therefore therapies aimed at broadening or shifting the null should be evaluated against whether such interventions will improve functional vision.
Torsional optokinetic nystagmus in strabismus
Authors: PROUDLOCK FA , FAROOQ SJ , MCLEAN RJ , GOTTLOB I
Published: September 2008

Purpose Torsional optokinetic Nystagmus (tOKN) in patients with strabismus since childhood has not been previously evaluated.The authors investigated the optokinetic response in horizontal, vertical and torsional directions in strabismus patients and in age‐matched normal volunteers.

Methods Monocular torsional, horizontal and vertical eye movements were recorded in 16 subjects with childhood strabismus and 15 normal volunteers.Constant velocity horizontal (nasalward and temporalward) and vertical(upward and downward) OKN stimuli were used at 10°/s, 20°/s and 40°/s.Torsional(intorsion and extorsion)OKN stimuli were rotated at velocities of 40° and 400°/s.

Results OKN responses from strabismus patients produced significant asymmetric responses in horizontal and vertical directions. The nasalward response was significantly greater than the temporalward and upward response was greater than downward. A significant high incidence of absent tOKN was present in both intorsion and extorsion. Eight of the 15 patients tested did not respond to any stimulus in either direction in their non‐dominant eye and 4 showed no response in their dominant eye.

Conclusion Torsional OKN is dramatically affected in the presence of strabismus with a high incidence of no response. The possibility of a lack of development in the binocular cortical structures that respond to torsional motion could explain these findings.
Straylight and the two domains of visual optics; small angle (0‐1 degree) and large angle (1‐90 degree)
Authors: VAN DEN BERG TJTP
Published: September 2008

Purpose Retinal straylight is the cause of important visual disturbances such as glare hindrance and contrast loss. It results from light scattering in the optical media, over angles of 1 to 90 degrees. So, it addresses part of the visual function not accessible with other means, such as visual acuity, contrast sensitivity and optical techniques. How independent are those two domains?

Methods A forced choice psychophysical assessment technique was developed for objective and at the same time functional assessment of straylight ("Compensation Comparison", implemented in a commercial product, C‐Quant from Oculus). Maximum likelihood estimation is performed, fitting a psychometric function to patient responses for 25 short comparisons, including a reliability estimate of the obtained straylight value. The outcomes were compared to classical visual function measures (visual acuity and contrast sensitivity) in 2400 subjects in the European GLARE study. Literature models for different aspects of the optical irregularities in the eye media were used to understand the independence between the two domains of the psf.

Results Straylight typically originates from irregularities in the optical media of small characteristic size (collections of particles sized 10 micrometer and below), as opposed to disturbances to the central part of the psf (<0.1 degrees), originating from large scale irregularities (refractile humps and bumps extending over 100 micrometer and more). As a consequence straylight is sensitive to disturbances like early changes to the lens, corneal haze, PCO, multifocal IOL artifacts, corneal scars, vitreous turbidity, etc.

Conclusion Straylight assess a domain of visual function not accessible with classical and optical means.

Commercial interest
Lamina cribrosa and peripapillary scleral histomorphometry in myopic and non myopic glaucomatous chinese eyes
Authors: JONAS JB , REN R , WANG N , LI B , LI L , GAO F , XU X
Published: September 2008

Purpose To study the glaucomatous optic nerve head in Chinese eyes.

Methods The histomorphometric investigation included a Normal group (non‐highly myopic eyes) of 40 human globes enucleated due to a malignant choroidal melanoma, a Glaucomatous group (non‐highly myopic eyes) of 55 eyes enucleated due to painful secondary angle‐closure glaucoma, and a Highly Myopic Glaucomatous group of 26 glaucomatous globes with an axial length >26.5 mm. Anterior‐posterior histological sections through the pupil and the optic disc were morphometrically evaluated and compared.

Results The lamina cribrosa was significantly (P<0.001) thicker in the Normal group than in the Glaucomatous group, in which it was significantly (P<0.001) thicker than in the Highly Myopic Glaucomatous group. The lamina cribrosa thickness decreased significantly (P<0.001) with increasing axial length and presence of glaucoma (p<0.001). The peripapillary scleral thickness close to the optic nerve scleral canal and just outside of the optic nerve meninges decreased significantly with increasing axial length (P=0.04 and P=0.02, respectively). The peripapillary scleral thickness did not vary significantly between the Glaucomatous group and the Normal Group. The distance between the intraocular space and cerebrospinal fluid space was (p<0.001) shorter in the two glaucomatous groups than in the Normal group.

Conclusion Lamina cribrosa thickness and peripapillary sclera thickness decreased significantly with axial length, in addition to a glaucoma‐related thinning of the lamina cribrosa. Within non‐highly myopic eyes, the peripapillary sclera thickness did not vary significantly between glaucomatous eyes and normal eyes.
The incidence of endophthalmitis after cataract surgery‐a retrospective study: evaluation of risk factors and impact of the introduction of intracameral cefuroxime
Authors: IBANEZ J , PEREZ D , MATEO OROBIA AJ , PEIRO C , VALYI S , ROJO M , MINGUEZ E , CRISTOBAL JA
Published: September 2008

Purpose Postsurgical endophthalmitis is an inflammatory reaction of the ocular tissues of infectios or non infectious origin as a consequence of the ocular surgery.Determine the most frecuent causes of endophthalmitis.

Methods Retrospective observational study registrating the cases of endophthalmitis after phacoemulsification among the surgeries practiced during the period of 1993 to 2007 in the Hospital Clinico Universitario Lozano Blesa Zaragoza, Spain.

Results The study included 92 eyes with postsurgical endophthalmitis, an incidence of 0,4%. In the 65% of the cases the microbiological samples were positive, the most frequent findings were gram positive bacterias. The type of anaesthesia, the location of the incision, the use of sutures, the type of IOLs and the existence of a systemic disease seem not to be significant risk factors for developing endophthalmitis

Conclusion Posterior visual acuity depended mostly of the virulence of the germ causing the infection. The use of intracameral cefuroxime was associated wit a significative descense of the percentage of endophthalmitis.
X‐linked retinoschisis
Authors: GIL ARRIBAS L , PINILLA I , GARCIA MARTIN E , IDOIPE CORTA M
Published: September 2008

Purpose To expose a case of X‐linked retinoschisis and to correlate findings obtained by Optical Coherence Tomography (OCT) images with visual acuity and macular lesions.

Methods We present a case report of a male child diagnosed of X‐linked Retinoschisis at the age of 6. About his family background, we know that his aunt has three sons diagnosed of the same disease. At the age of 18, his visual acuity was 0.5 for right eye and 0.1 for left eye by Snellen scale. The visual acuity did not change along all these years.

Results Cystic appearing macular lesions were observed both clinically and by tomography images. Cystic spaces on the foveal region, (as the image of a “cart wheel”), and peripheral retinoschisis were observed in the fundus examination. Optical Coherence Tomography showed cystic foveal blocked images located within the inner nuclear layer.

Conclusion The exposed disease has a very low prevalence (1 to 2 cases each 30000 inhabitants). The findings obtained by OCT images let make a diagnosis of localization within retina layers and also let follow up the macular lesions evolution.
Use of mobile‐learning amongst ophthalmic tutors and medical students
Authors: SULEMAN H , MATHEW N , DUA HS , DENNICK R , MATHEW M
Published: September 2008

Purpose As the use of SMART PHONE [mobile + personal digital assistant (PDA)] technology is on the increase, this study tried to analyze the attitude towards mobile learning amongst ophthalmic tutors and medical students and the impact of learning styles on the uptake of newer learning technologies

Methods Fourth year medical students undertaking their ophthalmology attachment and clinical tutors provided information about their views on their use of mobile technologies. Use of mobile (m‐learning) environment was compared with an assessment of the individual index of learning styles (ILS)

Results The mean age of the tutors was 40 years (n=17) and medical students was 26 years (n=46). The students were significantly younger than the tutors (p<0.001, chi square). Students and tutors had a fairly well balanced score (1‐3) on the two dimensions of the ILS scale. Students with moderate preferences for visual learning were more likely to enhance their clinical training and electronic‐based learning (p=0.003), download course materials (p=0.001) and access health and related information (p=0.004) using smart phone technology. Similar correlations were not found with other dimensions of ILS. There was no similar correlation found between tutors and ILS on any dimension. Medical students appeared enthusiastic to use the new PDA based technology whilst tutors, in general, were wary of such technology for use by medical students or themselves

Conclusion Medical students had a more positive outlook towards m‐learning with visual learners more likely to use smart phone technology. Tutors attitudes, however, were more reserved towards a potentially useful mode of learning
Effect of eye NGF application on NGF‐receptor expression in visual cortex and geniculate nucleous of rat with glaucoma
Authors: ALOE L , PARISI V , MANNI L , SPOSATO V
Published: September 2008

Purpose Glaucoma (GL) is an ocular disorder characterized by retinal ganglion cells loss and deficits of brain visual pathways. We have shown that eye topical application of nerve growth factor (NGF), a signaling molecule involved in neuroprotection, can reach brain NGF‐responsive neurons. In this study, we investigated whether (i) experimentally‐induced GL alters the presence of NGF and its receptors in the geniculate nucleus (GN) and visual cortex (VC); (ii) and whether application of NGF eye drops influences these biomarkers.

Methods GL was induced in rats with hypertonic saline injected into the right episcleral vein. After seven weeks, glaucomatous and control rats, untreated and treated with eye NGF application, were sacrificed and the presence of NGF, the expression of NGF‐receptors in brain visual areas determined using structural, biochemical and molecular analyses.

Results GL reduces the concentration of NGF in the CSF, GN and VC, enhances the presence of the NGF/TrkA receptor in the GN, decreases this receptor in the VC. The NGF/p75 receptor is unaffected in the GN and down‐regulated in the VC. In glaucomatous rats, topical eye NGF application for 35 consecutive days, enhances the concentration of NGF in the CSF, normalizes its presence in the VC and GN, and induces up‐regulation of NGF/TrkA receptor

Conclusion Our findings suggest that, GL induced by elevated intraocular pressure significantly impairs the presence of NGF and NGF receptors in the VC and GN. It remains to be established whether NGF application could provide a functional benefit for the protection of GN and VC damaged neurons. Supported by CNR and by “Fondazione Bietti” Roma”, Grant N° RF‐FGB‐2005‐150198
Aqueous humour ghrelin levels of eyes with and without glaucoma
Authors: ROCHA DE SOUSA A , ALVES‐FARIA P , FALCAO‐PIRES I , FALCAO‐REIS F , LEITE‐MOREIRA AF
Published: September 2008

Purpose Ghrelin is a recently described acylated peptide, which works as a somatosecretagogue and modulates smooth, skeletal and cardiac muscles contraction, including that of the eye’s muscle. Our purpose was to determine the levels of ghrelin and des‐acyl‐ghrelin in human aqueous humour collected from control and glaucoma patients undergoing cataract surgery.

Methods Blood and aqueous humour samples were collected from 24 patients (9 with open angle glaucoma and 15 from age matched cataract patients with no associated disease). The samples were analysed by ELISA to determine the levels of ghrelin and des‐acyl‐ghrelin.

Results There was a significant reduction of ghrelin levels in the glaucoma patients group, when compared to control (2.28±1.04 vs 4.26±2.56 fmol/ml, respectively), while those of des‐acyl‐ghrelin were similar (19.19 ± 6.64 vs 18.83 ± 4.92 fmol/ml, respectively). Both levels were not correlated to the duration of fasting. The ratio blood/aqueous humour of ghrelin and des‐acyl‐ghrelin were similar in all the groups.

Conclusion Ghrelin aqueous humour levels are significantly reduced in glaucoma patients, while the levels of des‐acyl‐ghrelin are maintained. So the intraocular secretion of ghrelin may be impaired in glaucoma patients, even if they have normal IOP levels.
Study of suspicious subjects of suffering glaucoma evaluated by means of HRT, OCT and GDx‐VCC. Representation by means of Venn's diagram
Authors: ALIAS EG , BORQUE E , LARROSA JM , POLO V , HONRUBIA FM
Published: September 2008

Purpose To compare the diagnostic coincidence of the confocal laser HRT3, the optical tomography of coherence Stratus OCT 3000 and the laser polarimetry GDx‐VCC, to discriminate against healthy eyes and glaucomatosos in subjects suspicious of suffering glaucoma.

Methods There were studied 312 eyes of 312 consecutive patients sent by ophthalmologists from the centers of speciality, for suspicion to be able to suffer glaucoma, (pressure intraocular> 21 mmHg, suspect optic nerve head morphology and / or standard automated perimetry). There were realized to each of them a clinical photographic study of the optic nerve head and of the retinal nerve fiber layer, and, an analysis by means of HRT, OCT and GDx‐VCC. There was valued the classification obtained by each of the analyzers of image and was represented by means of Venn's graphs.

Results They found more positive cases in the evaluation of the optic disk that in the study of the retinal nerve fiber layer so much in global like in the intersection of 3 tests, but fundamentally at the cost of the diagnostic criterion GPS of the HRT. The monochromatic photography studio of the retinal nerve fiber layer detects major number of positive cases, followed by OCT and finally by GDx.

Conclusion The diagnostic criteria Moorfields Regression Analysis of the HRT3 and of the OCT presents the results nearest to the clinical photographic evaluation; finding a high diagnostic coincidence of the different analyzers of image. Key words: suspect of suffering glaucoma, HRT, OCT, GDx.
Prevention of UVR cataract with Vitamin‐E
Authors: SÖDERBERG PG , XIAO Y , WANG J , MEYER L , GALICHANIN KONSTANTIN , AL‐SAQRY R , DONG X , MODY V , LÖFGREN S
Published: September 2008

Purpose To analyze the potential of Vit‐E for cataract prevention

Methods The experimental animal was 6 weeks old albino SD rat. Animals supplemented with Vit‐E received a daily dose per os for 4 w prior to exposure. Oxidative stress was induced by in vivo unilateral exposure to ultraviolet radiation (UVR) around 300 nm. Forward light scattering was measured in the lens 1 w after exposure. I: 40 animals were divided into supplementation (100 IU/day)/no supplementation groups. In all animals, one eye was exposed to 8 kJ/m2 UVR. II: 80 animals were divided into two exposure groups, (5 min, 15 min). Each group was divided into supplementation (100 IU/day), no supplementation subgroups. In all animals, one eye was exposed to 8 kJ/m2 UVR. III: 100 animals were divided into 5 dose groups (0, 5, 25, 50, 100 IU/day). All animals were unilaterally exposed to 8 kJ/m2 UVR. IV: 40 animals were divided into supplementation (20 IU/day)/no supplementation groups. Each group was subdivided into 5 dose subgroups. MTD(2.3:16) was estimated for both supplementation groups and the protection provided by Vit‐E was calculated as MTD(2.3:16) ratio between supplementation and no supplementation.

Results I: Vit‐E supplemented animals had a higher content of Vit‐E and expressed less light scattering than non‐supplemented animals. II: Vit‐E suppressed additional light scattering expressed after 15 min exposures as compared to 5 min. exposures. III: Vit‐E suppressed the UVR induced light scattering exponentially declining as a function of increasing supplementation. IV: Vit‐E supplementation provided a protection factor of 1.4.

Conclusion Vit‐E suppresses oxidative stress from in vivo exposure to UVR.
Impact of glaucoma medications on IOP, blood pressure and perfusion pressure: relevance for the daily practice
Authors: QUARANTA L , PIZZOLANTE T
Published: September 2008

Higher it will be the Perfusion pressure and higher it will be the blood flow in a determined body district. How it has been determined by several population‐based studies, low levels of diastolic ocular perfusion pressure (DOPP) are associated with an increased prevalence and incidence of POAG. As a matter of fact, the Baltimore eye study has shown that when DOPP decreases below 50 mm Hg the prevalence of POAG increases; similar results were obtained in the Egna‐Neumarkt in Europe, in the Projecto VER in Mexico, and in the Barbados Eye Study in Caribbean. In the Barbados eye study DOPP was 63 ± 14.9 mmHg in healthy subjects, and 53.8 ± 14.9 mmHg in POAG patients. As a general indication, it can be concluded that when DOPP is lower than 55 mm Hg there is an increased risk to develop POAG. In the present lecture it will analyzed the relationship between BF and POAG, and the correlation between circadian fluctuation of BF and the extent of damage in POAG patients. Twenty‐four hour Blood pressure and IOP will be detailed evaluated in the study of pathogenesis of glaucoma. Moreover it twill be analyzed the behavior of 24‐hour IOP and blood pressure in normal‐tension glaucoma patients. It will be also analyzed the influence of hypotensive drugs for glaucoma on BF and circadian IOP and blood pressure. The mean aim of the present lecture will be to give a comprehensive evaluation of the importance of the monitoring of blood pressure and IOP over the twenty‐four hour, in order to evaluate the risk of progression of each POAG patients, but also to know the effect of hypotensive glaucoma therapy not only on IOP but also on diastolic ocular perfusion pressure.
Treatment of conjunctival melanocytic neoplasms: the Paris experience
Authors: DESJARDINS L
Published: September 2008

Abstract not provided
Combined treatment of conjunctival melanomas. The experience of the Jules‐Gonin Eye Hospital of Lausanne
Authors: ZOGRAFOS L
Published: September 2008

Purpose The recurrence rate of conjunctival melanomas following a monotherapeutic approach (surgery, irradiation or Cryoapplication) is as high as 50%. The etiology of this high recurrence rate is partially related to the biological characteristics of the PAM and partially to the anatomic properties of the various parts of bulbar, limbus and tarsal conjunctiva.

Methods We developed a combined therapeutic strategy which associates surgical excision with Gamma or Beta brachytherapy, proton beam irradiation, and Cryotherapy with liquid nitrogen under pressure. This combined therapeutic modality is used in all the cases of primary and recurrent conjunctival melanomas which was referred in Jules‐Gonin Eye Hospital, during the last 20 years (190 cases).

Results Therapeutic results depend on the extension and location of conjunctival melanomas. Definitive loss of local tumour control is rare and occurs in cases in which both of the leads are invited by the tumor as well as in cases which present an unpigmented recurrence.

Conclusion Positive results may be obtained by the use of a combined therapeutic modality of surgical excision irradiation and Cryotherapy for the treatment of selected cases of conjunctival melanomas.
Comparison of Tono‐Pen Avia with Goldmann applanation tonometer
Authors: MUSCHART F , POURJAVAN S
Published: September 2008

Purpose 1. To compare the IOP readings taken by Tono‐Pen Avia (Reichert) With the GAT. 2. To assess the influence of central corneal thickness (CCT) on these measurements

Methods Prospective, controlled study including one eye at random of 30 glaucomatous patients and 30 healthy subjects. Patients with previous refractive surgery or corneal pathology were excluded. GAT measurement was followed by Tono‐Pen Avia after a 10 min break. Only Reading with 95% statistical confidence index were taken into account. Pachymetry measurements were done at the end of the examination. Pearson correlation coefficient to assess the correlation between GAT and Avia tonometer. The agreement between IOP readings from GAT and Avia was assessed using the Bland‐Altman plots

Results Mean IOP in glaucoma was 18.3 ± 6.7 mmHg with GAT and 16.7 ± 4.7 with Avia. Mean IOP in control group was 16.4 ± 3.8 mmHg with GAT and 15.2 ± 4.2 mmHg with Avia. Mean CCT was 545 ±101.2 µ in glaucoma and 546.7 ± 99.4 µ in control group. There was no correlation between CCT and the IOP readings with GAT or Avia in both groups(p<0.05)

Conclusion Tono‐Pen Avia is a very easy‐to‐use handheld applanation tonometer that functions in any position especially for in‐bed or wheelchair patients. It can be used for screening purposes providing a lower IOP value than GAT and indicating a need for further investigation in suspect cases
Visualization drugs for vitreoretinal surgery
Authors: TADAYONI R
Published: September 2008

Purpose To discuss data on the potential or real toxicity of intraocular visualization drugs, based on animal and human studies.

Methods The course will be based on last experimental and clinical data available in the literature or from our studies.

Results There is a larger choice of visualizations drugs with a clear benefit of helping the surgeon. Each of them has its own advantages and risks. The decision to use or not these drugs should also take into account the goal for which they may be used and the expected benefit from it.

Conclusion Visualizations drugs, as most drugs, may represent risks that have to be weighed up against awaited benefits.
Experimental and clinical studies of transconjunctival vitrectomy 20G, 23G and 25G
Authors: CHIQUET C
Published: September 2008

Purpose Microincision transconjunctival vitrectomy has gained popularity in the recent years. This surgical innovation needs to be evaluated in prospective and controlled studies.

Methods A prospective study concerning 23‐Gauge vitrectomy (with cryoapplication and gas tamponade) in 20 patients with retinal detachment and 4 patients with acute endophthalmitis was performed and litterature data (Pubmed database research) was analyzed.

Results Performance of microincision transconjunctival vitrectomy may be maximized with use of high duty cycle, largest internal diameter (23G), a sharp guillotine and a high cut rate. Sclerotomy construction is a key point of this technique. In retinal detachment surgery on a selected population, the rate of anatomic reattachment and visual recovery were similar between 23G PPV and 20G PPV. In one patient 23G PPV was complicated by a choroidal detachment secondary to a displacement of the infusion cannula. The redetachment in one 23G case was secondary to a sclerotomy related retinal tear. Microincision transconjunctival vitrectomy for acute endophthalmitis is feasible but has limited capacities as compared with 20G technique.

Conclusion The main advantage of sutureless vitrectomy remains the confort of patient after complicated surgeries, but this point should be analyzed with quality of life. This trend toward smaller incisions will lead to improvement of instrumentations, better understanding of the surgical techniques (wound construction, performance of vitreous cutters). 23G PPV is suitable for patients with retinal detachment treated with PPV‐cryo‐gas technique. Sutureless vitrectomy is usefull only in selected cases of acute endophthalmitis .
Eye‐Associated Lymphoid Tissue (EALT) – the local branch of the physiological mucosal immune system at the ocular surface and appendage
Authors: KNOP E , KNOP N
Published: September 2008

Purpose Eye‐associated lymphoid tissue (EALT) is the local branch of the mucosal immune system located at the ocular surface proper and its mucosal appendage: the lacrimal gland, conjunctiva (as CALT), and lacrimal drainage system (as LDALT). It is equivalent and follows the nomenclature of other parts of the mucosal immune system such as GALT in the gut or BALT in the bronchial tract.

Methods We investigated complete tissues of the human, rabbit, rat and mouse including the lacrimal gland, conjunctival sac and lacrimal drainage system by morphology and molecular biology.

Results A diffuse lymphoid tissue was regularly found in the lacrimal gland of all species. In the conjunctiva, a typical mucosal immune system with similar characteristics occurs in human and rabbit and is also reported in several other species. The same is true for the lacrimal drainage system. Hence, a continuous mucosal immune system is present in the embryologically connected tissues of the ocular surface from the gland via its excretory ducts into the conjunctiva and through the lacrimal puncta into the lacrimal drainage system. These tissues share common antigens and protective factors as well as specialised vessels for lymphocyte recirculation and hence act together as an efficient functional unit for ocular surface defence. As a surprise, the conjunctiva of the common laboratory animals rat and mouse, however, contains almost no lymphoid cells.

Conclusion The ocular surface and appendage together form an Eye‐Associated Lymphoid Tissue (EALT) that represents a part of the mucosal immune system of the body and provides cellular and secretory immunity. Deregulation of this system may explain important aspects of ocular surface disease.
Electronic compliance monitoring in glaucoma patients used to topical therapy
Authors: BRON AM , HERMANN M , DIESTELHORST M , CREUZOT CP
Published: September 2008

Purpose Individual compliance of glaucoma and ocular hypertensive patients with Brimonidine was studied with regards to total dose, dosage intervals, coverage, drug waste, attempts per application and risk factors for low compliance.

Methods Thirty‐eight men and 26women aged 70 ±11 years [42‐89] received conventional Brimonidine vials (Alphagan®, Allergan™) equipped with a microprocessor‐controlled monitoring device capable to record date and time of each eye drop application with a known detection sensitivity for eye drop applications ~ 99%. 48 glaucoma and 16 ocular hypertensive patients used to eye drop therapy for 11 ±8 years [1‐35] were enrolled and randomly assigned to Brimonidine therapy b.i.d or t.i.d daily for 4 weeks.

Results Electronic records revealed a mean of 1.4 applications per day (range: 0.7‐2.2) for patients assigned to Brimonidine 2x daily with a mean treatment interval of 18.2 hours (range: 11.2‐38.4 h). Patients on Brimonidine 3x daily showed a mean rate of 1.8 applications per day (range: 1.0‐2.7) and a mean treatment interval of 12.4 h (range: 9.1‐39.7 h). 10 patients ceased therapy before completing the 4 weeks period, therein 4 with side effects and 6 patients having emptied the bottle prematurely.

Conclusion Almost 10 percent of the patients emptied their vial in less than 4 weeks by using more than one drop per application and thereby do need refills more often than usually calculated. Our data confirm the need for larger studies on individual compliance with topical ocular therapy in glaucoma. Electronic compliance monitoring may be a useful tool in ophthalmic practice to recognize low‐compliant patients.
The action of pro‐inflammatory cytokines on retinal endothelial cell barrier permeability: protective effect of corticosteroids
Authors: AMBROSIO AF , AVELEIRA CA , WOLPERT E , ANTONETTI DA
Published: September 2008

Purpose The pro‐inflammatory cytokines interleukin‐1β (IL‐1β) and tumor necrosis factor‐alpha (TNF‐α) were found to be increased in the vitreous of diabetic patients and in diabetic rat retinas, and increased cytokine levels were correlated with elevated retinal vascular permeability. In this work, we investigated the mechanisms underlying IL‐1β‐ and TNF‐α‐induced retinal endothelial cell permeability and evaluated the ability of a glucocorticoid, dexamethasone (DEX), to prevent changes in permeability.

Methods Primary cultures of bovine retinal endothelial cells (BRECs) were grown on transwell filters and exposed to IL‐1β and TNF‐α. BRECs permeability to 70 kDa RITC‐dextran was measured. The content and localization of tight junction proteins was assessed by Western blotting and immunocytochemistry.

Results IL‐1β and TNF‐α increased retinal endothelial cell permeability in a concentration‐ and time‐dependent manner, but TNF‐α was more effective (increased permeability at a lower dose and shorter time‐point). The increase in permeability was not due to changes in cell viability. IL‐1β and TNF‐α altered ZO‐1 and claudin‐5 content. TNF‐α also decreased ZO‐1 staining at the cell border. Pre‐treatment with DEX prevented TNF‐α‐induced cell permeability, and the protective effect of DEX was partially abolished by the glucocorticoid receptor antagonist RU486.

Conclusion These data demonstrate that TNF‐α and IL‐1β potently induce endothelial cell permeability through alterations in tight junctions. Also, the study supports the potential therapeutic use of glucocorticoids to reduce retinal vascular permeability. Support: FCT (Portugal), NIH, JDRF and Allergan
Therapeutic implications and perspectives
Authors: SHIMA DT
Published: September 2008

Purpose Vascular endothelial growth factor‐A (VEGF‐A) has recentlybeen recognized as an important neuroprotectantin the central nervous system. Given its positionas an anti‐angiogenic target in the treatment ofhuman diseases, understanding the extent of VEGF’srole in neural cell survival is paramount.

Methods We have examined if VEGF‐A is necessary and sufficient for retinal neuroprotection in a model of ischemia‐reperfusion injury.

Results VEGF‐A effects on neurons have been documented in several experimmental systems, including now, the retina. VEGF‐A's effects are likley mediated by direct signaling in neurons via VEGFR2.

Conclusion These findings have implications for both neural pathologies and for the use of potent VEGF‐A antagonists in chronic ocular vascular diseases, such as diabetic retinopathy. Translateability of these animal findings to patients, and potential next steps will be discussed.

Commercial interest
Subconjuntival injection of bevacizumab in side of filtering bleb in the end of trabeculectomy : first experience
Authors: PICCIRILLO V , SAVASTANO A , SBORDONE S , FORTE R , TAMBURRINI L , SAVASTANO MC , SAVASTANO S
Published: September 2008

Purpose To evaluate safety and local effects of ‐in the end of trabeculectomy Avastin injection on filtering bleb vascularisation and bleb failing trend.

Methods 1 male patients 65yo with a clinical history of pharmacologically uncontrolled primary open angle glaucoma in right eye (IOP 36 mmHg,CCT=525 µ)underwent to trabeculectomy without use of antiproliferative agents. A traditional surgical approach with a 12 o’clock scleral wedge(4 x 4 mm) and a double Nylon 10/0 made sclerocorneal suture using modified Meduri’s technique was performed.At the end of the surgery ,0.05 ml of bevacizumab ( Avastin 25 mg/ml , Roche) were injected in the subconjutival space above the sclera wedge.The IOP and bleb vascularisation have been recordered in the post op each day during the first week and one time a week in the following three months.A digital camera mounted on slit lamp was used for images acquisition.

Results IOP was stable on 9 mmHg during the first three weeks , increasing to 16 mmHg during the follow up and stable until the end of the study despite removing Meduri’ sclerocorneal sutures . No complications were seen in the anterior chamber . Filtering bleb did not show any sign of inflammation or swelling with a “ quite “ vascularisation as clinical marker during the follow up .

Conclusion Our short experience demonstrates the safety of subconjuntival injection of Avastin and effects on bleb’s vascularisation regardless of incidence of bleb failure.Further investigations in multicentric randomized studies on larger sample size are necessary to confirm current results .