bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence for efferent projections from the brain to the retina of the Mongolian gerbil (Meriones unguiculatus). A horseradish peroxidase tracing study
Authors: Larsen J. N. B. , Møller M.
Published: May 2009

Abstract Mongolian gerbils were injected into the vitreous body of the left eye with either horseradish peroxidase or horseradish peroxidase coupled to wheat germ agglutinin. After survival times ranging from 6 to 48 hours, the animals were sacrificed and perfused with glutaraldehyde. Cryostat sections were cut through the brains and reacted for peroxidatic activity. Labelled perikarya were observed in the dorsal nucleus of the lateral geniculate body, the medial and lateral nuclei of the optic tract, the pretectal nuclei and the superior colliculus. These results indicate the presence of an efferent innervation of the retina from the brain via the optic nerve in the Mongolian gerbil.
A statistical trap in the evaluation of visual field decay
Authors: Krakau C. E. T.
Published: May 2009

Abstract Computerized perimetry has made it possible to evaluate quantitatively the visual field decay in glaucoma and other cases. The performance fluctuates with considerable amplitude and therefore the heart of the matter concerns the detection of a signal in presence of noise. How insufficient number of observations and uncautious sampling may result in false conclusions as to the effect of therapy etc is described in the present paper.
Electrophysiology in pigment epithelial changes
Authors: Nilsson Sven Erik G.
Published: May 2009

Abstract The c‐wave of the ERG and the slow SP variations reflect mainly the activity of the pigment epithelium. However, both potentials are dependant upon the photoreceptors and/or the inner retina as well. In pigment epithelial abnormalities the c‐wave is reduced or abolished, and the slow SP variations, d.c. recorded directly or investigated with the EOG, reduced or abolished as well.
Prostagladin E2in tears
Authors: Gluud B. S. , Jensen O. L. , Krogh E.
Published: May 2009

AbstractProstaglandin E2(PGE2) concentration in tears was measured before and following cataract extraction, during acute anterior uveitis and in patients with chronic conjunctival complaints. Following cataract extraction a significant increased PGE2level in tears was observed, returning towards normal level within two weeks. In patients with acute anterior uveitis low levels of PGE2was found in tears. Half of the patients with chronic conjunctival complaints exhibited high levels of PGE2. Conjunctiva is proposed as a likely source of PGE2in tears.
Macular recovery time recorded by nyctometry ‐ a screening method for selection of patients who are at risk of developing proliferative diabetic retinopathy
Authors: Frost‐Larsen Kim , Larsen Hans‐Walther
Published: May 2009

Abstract a 5‐year study on the predictive value of the macular recovery time, as recorded by nyctometry, in the development of proliferative diabetic retinopathy in insulin‐dependent diabetes mellitus has been completed. Seventyseven patients with a median age of 30,8 years and a median duration of the disease of 15,8 years participated. In the follow‐up period, 16 out of 20 patients initially showing abnormally prolonged macular recovery time had developed proliferative diabetic retinopathy the median duration from the initial investigation to the diagnosis of retinal neovascularization being 34 months. Contrary to this finding, only 4 out of 57 patients initially showing normal macular recovery had advanced into proliferative retinopathy, and the median duration until diagnosis of this condition was 45 months. It is concluded that nyctometry can serve as an easily performed screening method in selecting those at risk of developing proliferative retinopathy within a few years.
Idiopathic uniocular juxtafoveolar retinal telangiectasis in a female patient
Authors: Teräsvirta M. , Tuovinen Erkki
Published: May 2009

Abstract This article describes a female patient with uniocular juxtafoveolar telangiectasis which previously has been reported in male patients only.
Out‐patient cataract surgery: First experiences from a large hospital department
Authors: Henning V. , Krogh E. , Movin M.
Published: May 2009

Abstract Out‐patient cataract surgery was recently introduced as a routine procedure in our department. Background population, selection criteria and practical‐administrative procedures for the first 33 patients are described. 19 females and 14 males, age range 45 to 90 years, were offered ambulatory surgery; 19 had extracapsular surgery and 27 intraocular lenses. Insignificant complications occurred in four cases, one of them related to the out‐patient procedure. It definitely seems possible to offer this modality to selected patients without compromising medical ethics, and the results have been met with unanimous satisfaction by the patients.
Myopia in insulin treated diabetes
Authors: Sjølie A. K. , Goldschmidt E.
Published: May 2009

Abstract Myopia occurs with excess frequency in diabetes mellitus (Fledelius 1983, 1985).

Refractive values in early onset insulin treated diabetic patients have been studied. The characteristics of the material are presented in more detail elsewhere (Sjølie 1985).

The original ophthalmological material consisted of the prevalence population of insulin treated diabetics with onset before 30 years of age as of 1.7. 1973 from the Fyn County. Our investigation originates from 1981/1982, and comprised a follow‐up examination of 577 patients of the original material, who were still alive.

Determination of the refraction was carried out subjectively without the use of a cycloplegic. If the patients had a visual acuity of 6/6 with spectacles, the strength of the glasses was employed as an expression of the refractive value.

Fortyfive percent of the patients were myopic, ‐0.5D or more. The frequency of hypermetropia was low, particularly with regard to the lower degrees; this is due to the fact that no systematic study of hypermetropia was carried out.

The frequency of myopia was highest in the age groups from 20–29 years, but comparatively high in all age groups.

A considerable variation in the frequency of myopia in the Danish population in relation to education and profession is well‐known; and therefore we have studied more thoroughly the question of whether myopic diabetics differ in this respect from the non‐myopics. Those with myopia had, on the whole, a somewhat longer education than the non‐myopics, and the difference was significant for both men and women. On the other hand, if we consider the distribution in respect of profession and compare the 262 myopics with a 10% random sample of the population of Fyn, there is no pronounced difference.

We have been unable to determine at what age the diabetic patients developed myopia in this investigation, but we have found, as did Fledelius, that the majority of myopics have rather low degrees of myopia. The number with more severe myopia does not seem to differ to any great extent from that of the background population. It thus appears that diabetics develop low‐degree myopia more frequently than non‐diabetics, and we will attempt to determine, in a new investigation, the factors likely to cause this type of myopia.
The blood‐retinal barrier permeability to fluorescein in juvenile diabetics treated with continuous subcutaneous insulin infusion
Authors: Krogsaa Bent , Lund‐Andersen Henrik , Lauritzen Torsten , Parving Hans‐Henrik , Christiansen Jens Sandahl
Published: May 2009

Abstract To determine possible quantitative changes of the blood‐retinal barrier permeability in juvenile diabetics treated with continuous subcutaneous insulin infusion (CSII), we studied seven patients (three females and four males, mean age 36 years) with a mean duration of the disease of 19 years. The pump treatment was continued for seven to eight days and during the treatment mean blood glucose level decreased to near‐normal values (before 13.7 mmol per liter ‐ during 6.2 mmol per liter). There was no changes in retinal appearance during treatment. Determination of the blood‐retinal barrier permeability showed no quantitative changes during the one week treatment with CSII (mean permeability before 7.6 10÷7 cm/sec ‐ mean permeability during 7.8 10÷7 cm/sec). In order to quantitate possible long‐term reversibility of break‐down of the blood‐retinal barrier we have design to extend the treatment period.
Microphotometry of the blood column and the light streak on retinal vessels in fundus photographs
Authors: Brinchmann‐Hansen Olaf , Engvold Oddbjørn
Published: May 2009

Abstract A scanning microdensitometric technique to be applied directly on negatives of fundus photographs is presented. Computer‐controlled high quality scans are performed across positions of interest on retinal vessels, and the width and the intensity profiles of both the blood column and its central light streak are analysed. From every scan, various parameters of microcirculatory interest are obtained by light reflection from arteries and veins. Different aspects of this technique are discussed in details: calibration of the film, the fundus camera, a marker technique, the scanning microphotometer, data analysis, the parameters from the scan profile, and the reproducibility of every procedural step. Some preliminary results of various light streak parameters are discussed and related to previous ophthalmoscopic observations.
Fundus photography of width and intensity profiles of the blood column and the light reflex in retinal vessels
Authors: Brinchmann‐Hansen Olaf , Heier Halvor , Myhre Kjell
Published: May 2009

Abstract Various optical properties of the fundus camera may have important implications regarding the use of photographs for image size measurements. By scanning across retinal vessels with a microdensitometer the width and the intensity characteristics of both the central light reflex and the streaming blood column may be measured. To establish a reliable basis for future measurements, we analysed the retina‐to‐film magnification, possible aberrations and the resolving power of our Zeiss camera. Furthermore, fundus photography was performed in 100 young men, and the necessary level of accuracy in focusing the camera was established. We also investigated the effects of various amounts of defocusing on width and intensity readings from densitometric scans across retinal vessels.
The apparent and true width of the blood column in retinal vessels
Authors: Brinchmann‐Hansen Olaf , Heier Halvor
Published: May 2009

Abstract Changes in the caliber of retinal vessels may be of haemodynamic and morphological significance in various local and systemic vascular diseases. In this paper we present a theoretical study on the effects of structural density changes of the vessel wall on the ‘true’ width of the streaming column of erythrocytes. By use of simplified models of an eye and a retinal vessel, we perform numerical experiments using a computer. The results show that variations in the index of refraction and in the thickness of the vessel wall have negligible influence on the apparent width of the blood column. The image of the vessel can safely be measured as a ‘true’ caliber of the retinal blood column. This might implicate that an early differentiation between vessel constriction caused by increased tonus of systemic‐hypertension versus irreversible arteriosclerosis is probably not within physical and optical reach, using ophthalmoscopy.
The occurrence of simple and capsular glaucoma in Middle‐Norway
Authors: Blika Sigmund , Ringvold Amund
Published: May 2009

Abstract  The records of all patients with simple and capsular glaucoma who visited our clinic in the period from 1.1.1972 to 31.12.1982, and who were alive at the 31.12.82, have been evaluated. In the population older than 49 years 0.54% had simple and 0.74% had capsular glaucoma, equally distributed on men and women. In average near 60% had capsular glaucoma, with great variation in different municipalities. Highest figures were found in a belt reaching from the coast into the inland. Both simple and capsular glaucoma showed increasing occurrence till 75–80 years, thereafter the curves decline.
Number of glaucoma patients in Finland in the year 2010
Authors: Raivio Ilkka
Published: May 2009

Abstract. Use of the various eye care resources for glaucoma patients has been studied in relation to the various age groups. The total population of Finland increases 4% between 1983–2010. The change is very different in the different age groups: a decrease in the age groups up to 44, 60% increase in the age groups over 75. The prevalence of glaucoma increases with the advancing age.

7719 persons used hospital beds for glaucoma in Finland 1983. If the same percentage of patients uses hospital facilities for glaucoma in 2010 in each of the age groups the total number of hospital patients treated for glaucoma will be 10 892 in 2010. The increase is 40%.

The number of patients registered for free glaucoma medication 1983 by the National Health Insurance was 28913. Estimated by the prevalence in the different age groups this figure would be 41 350 in the year 2010, also roughly 40%.

It is empasized, that although the total population only increases 4%, the need for glaucoma care facilities has to be incresased by 40% due to the ageing of the population.
Early post‐operative pressure rise with ciliary body incarceration into Watson type trabeculectomy fistula
Authors: Saari K.M. , Heikkilä L.A.
Published: May 2009

Abstract. We studied six patients with early failure after Watson's trabeculectomy done due to chronic simple, neovascular, or chronic angle‐closure glaucoma. After operation the eyes showed a maximum intraocular pressure (IOP) between 50 mmHg and 66 mmHg and no filtering bleb. Reoperation on the 5th to 14th post‐operative day showed incarceration of ciliary body into the trabeculectomy fistula in all cases. The uveal protrusion was replaced and a deep corneoscleral block was removed in front of the scleral spur in three cases, and electrocoagulation of the anterior edges of the trabeculectomy fistula was done in other three cases. After a 4 months to 1.5 years follow‐up IOP was 12 mmHg to 18 mmHg and only two eyes needed medical therapy. The results suggest that trabeculectomy in front of the scleral spur is indicated to avoid incarceration of the ciliary body into the trabeculectomy fistula.
The effect of amiloride on bovine corneal epithelium
Authors: Midelfart Anna
Published: May 2009

Abstract. Using a chemical analysis method, the Na and K concentrations and water content of bovine corneal epithelium and stroma were determined in corneae incubated in standard solution with or without amiloride. In the corneae exposed to amiloride, a loss of 30–40 mmol Na/kg dry weight accompanied by a loss of water was detected in the epithelium.
Epikeratophakia in children
Authors: Uusitalo Risto J. , Lehtosalo Juha
Published: May 2009

Abstract  In the past two years 29 patients (ages 9 months to 15 years) received 37 epikeratophakia grafts. 91.1 percent of the original surgeries were successful. The average change in refractive error was 16.7 diopters, and the average spectacle overcorrection was + 0.2 diopters. We have obtained good visual results in our very young patients were follow‐up is already over 1 year. We demonstrated also some improvement in visual acuity in older children especially those with traumatic or secondary cataracts.

The study demonstrates that we can add an average of + 17.1 diopters with an epikeratophakia graft and that the amount of correction obtained is remarkable predicted.
Combined corneal transplantation, extracapsular cataract extraction, and artificial lens implantation (Triple procedure)
Authors: Pedersen O. Øyvind
Published: May 2009

Abstract. The treatment of eyes with significant opacities of the cornea as well as cataract is a major challenge for the ophthalmic surgeon. Recent data indicate that these problems may be dealt with safely in a single combined operation which includes penetrating corneal tranplantation, exracapsular cataract extraction, and implantation of an artificial lens (triple procedure). In the present report the author's initial experience with the triple procedure is presented. In four patients with a minimum of 6 months follow‐up, clear media and marked visual improvement were achieved in all cases. The corneal pathology included two cases of Fuchs' dystrophy, and two cases of central scarring following interstitial keratitis. No complications ocurred. The visual rehabilitation time was short, and comparable to ordinary phakic grafting. The triple procedure should be considered in selected cases where there are no specific contraindications to corneal grafting, cataract extraction, or lens implantation.
After‐cataract in the rabbit eye following extracapsular cataract extraction—a wound healing reaction
Authors: Blomstedt Göran , Fagerholm Per , Gallo Juan , Philipson Bo
Published: May 2009

Abstract  The cellular response in lens remnants was studied after ECCE in the rabbit eye. Following capsulotomy, the lens content was gently exprimated. No aspiration/irrigation was performed. Degenerative changes were found in the lens fibers and lens epithelium at the equator. Proliferation of lens epithelium startet early. Lens fibers break‐down almost ceased when lens fibers had been enclosed by proliferating epithelium, that also formed new foci for lens fiber formation. In the opening between the anterior and posterior capsule fibroblastlike cells emerged proliferating on to the posterior capsule.
Lens Autofluorescence in Diabetes Compared with the level of Glycosylated Hemoglobin A1c
Authors: Kjer Birgit , Larsen Michael , Bendtson Inger , Binder Christian , Dalgaard Peter , Lund‐Andersen Henrik
Published: May 2009

Abstract  The autofluorescence of the crystalline lens has been measured by an ocular fluorophotometer in two comparable groups of patients with insulin‐dependent diabetes mellitus. One group has had a high level of HbA1c since the onset of diabetes (mean 10.1 per cent) and the other group a very low level (mean 6.5 per cent).

The group with low HbA1c during the disease period showed a significantly lower lens fluorescence than the group with high HbA1c.
Irrigation fluid pressure and flow in extracapsular cataract surgery—an optimalized system
Authors: Seland J.H. , Bertelsen T. , Myking J.
Published: May 2009

Abstract. A system of low pressure/low irrigation fluid flow is presented as the logical and safest option in extracapsular surgery.
Predicting Diabetic Retinopathy
Authors: Karma Anni , Gummerus Seppo , Kujansuu Eila , Pitkäjärvi Timo
Published: May 2009

Abstract  The purpose of this study was to determine the occurrence and severity of diabetic retinopathy and to clarify its association with the duration of diabetes and several other factors in an outpatient diabetic population. The material consisted of 328 diabetics, mainly (77%) C‐peptide negative, type 1 diabetics. The mean age of the patients was 45 years, and the mean duration of diabetes was 15 years. Retinal changes were assessed by ophthalmoscopy and widefield fundus photography.

All retinopathy was confirmed in 59% and proliferative retinopathy (PR) in 20% of the patients. The frequency of diabetic retinopathy was 15% in patients with diabetes for less than five years but 100% in those with diabetes for 30 or more years. In type 1 diabetics PR was seen only after 10 or more years' duration but, after 20 years' duration it was seen in half of the patients with type 1 and in one‐third of the patients with type 2 diabetes. The patients with diabetic nephropathy often had PR. In type 1 diabetics with onset of the disease <30 years peripheral sensory neuropathy, coronary disease, hypertension and leg‐vessel disease were also often associated with PR. Because one reason for visual handicapping in diabetes is the delay of the diagnosing of vision‐threatening lesions screening for treatable retinopathy should be intensive after 10 years' duration and in poorly‐controlled diabetics even earlier.
Experimental studies of photodynamic therapy in a retinoblastoma‐like tumour
Authors: Winther Jens , Overgaard Jens
Published: May 2009

Abstract  Combination therapy with a purified hematoporphyrin derivative, Photofrin II, and red light (photodynamic therapy) was investigated in a retinoblastoma‐like tumour growing in the eyes of rats in vivo and in cell cultures. There was a marked dose‐response relationship between Photofrin II and the light energy both in vitro and in vivo. Up to 33% of the tumours could be controlled in vivo. In vivo/in vitro assays indicated Photofrin II uptake in the tumour cells in vivo in relation to the administered doses. Studies of cell death kinetics suggested that the mechanisms of photodynamic therapy were both a primary cell kill effect and a secondary tissue destruction, probably as a consequence of vascular damage.
Uveal effusion syndrome—idiopathic serous detachment of the choroid, ciliary body and retina
Authors: Schutterman Jan
Published: May 2009

Abstract.A 72 years old woman who presented with what was clinically first thought to be an intraocular neoplasm in her left eye was examined clinically and with standardized echography. She was found to have a superior choroidal detachment combined with an inferior retinal detachment and dilated episcleral vessels. Her right eye showed only subtle changes. Following steroid treatment there was a regression after a few months. Less than a year later she presented with symptoms mainly from her right eye which was found to have a high bullous nonrhegmatogenous retinal detachment and a visual acuity which was highly dependent on her position. The echographic findings will be discussed.
Suppression of experimental autoimmune uveitis in guinea‐pigs by inhibition of phospholipase A2
Authors: Mahlberg Kaj , Uusitalo Risto , Uusitalo Hannu , Palkama Arto , Tallberg Thomas
Published: May 2009

Abstract  Retinal S‐antigen mixed with complete Freund's adjuvant was used to induce experimental autoimmune uveitis (EAU) in guinea‐pigs. Guinea‐pigs receiving no treatment, was compared with test animals which received topically and systemically administered KLM‐583B, a phospholipase A2 (PLA2) inhibitor, or subcutaneous (sub. cut) and topical corticosteroid treatment, as well as a test group which received cyclosporin A suc. cut. The best clinical suppression of EAU was obtained in the group treated suc. cut with KLM‐538B. Steroids also suppressed the inflammation in the eyes but was not as effective as KLM‐583B or cyclosporine A. PLA 2 activity in the aqueous humour and the myeloperoxidase (MPO) levels measured from iris‐ciliary body were signficantly lower in the groups treated suc. cut. with KLM‐583B or cyclosporin A. Guinea‐pigs treated suc. cut. with KLM‐583B and cyclosporin A had the lowest antiserum titres to retinal S‐antigen.
THE EXFOLIATION IN THE SCHEIMPFLUG PHOTOGRAPHY
Authors: Goder G. J. , Rechlin R. G.
Published: May 2009

Abstract. Scheimpflug photography is a very useful method in the diagnosis of exfoliation. It helps to differentiate between tiny subcapsular opacifications and supracapsular appositions. It is a valuable aid in the detection of early stages of exfoliation still unvisible at ordinary slit lamp examination. New phenomenons might be detected in the future like the elevation of a precapsular membrane in one of our patients.
INTRAOCULAR PRESSURE IN EXFOLIATION SYNDROME
Authors: Yanoff Myron
Published: May 2009

Abstract. Two studies, both retrospective, were done at our institution. The first study evaluated 100 consecutive patients with exfoliation (EX) syndrome found as an incidental finding in a private, general ophthalmology practice, to determine the incidence of glaucoma. The second determined the long‐term course of EX as it relates to the onset of elevated intraocular pressure (IOP). In the first study, of 124 eyes having EX 78 % had normal IOP, 15 % had intraocular pressure greater then 22 mm Hg but no cupping or field loss (ocular hypertension or glaucoma suspect), and 7 % had glaucoma. In the second study 347 patients who initially had normal IOPs and either unilateral or bilateral EX were followed over time. Elevated IOP developed in 35 patients (44 eyes) during the study. The cumulative probability for eyes with EX to develop elevated intraocular pressure was 5.3 % in 5 years and increased to 15.4 % in 10 years. These probabilities predict that patients with EX have a higher incidence of developing elevated intraocular pressure than would be expected in patients without EX of similar age.
THE PREVALENCE OF EXFOLIATION SYNDROME IN DIFFERENT AREAS OF FRANCE
Authors: Colin J. , Gall G. Le , Jeune B. Le , Cambrai M. D.
Published: May 2009

Abstract. A prospective study was performed by 30 ophthalmologists to determine the prevalence of exfoliation syndrome (ES) in different areas of France and its relationship with glaucoma. The prevalence of ES in France is 5.5 %; there are geographical variations: in Brittany and in the South East, the prevalence of ES is statistically higher than in the other areas. The percentage of patients with ES and glaucoma is 65.5 %. The mean age of patients with ES with glaucoma (74.8) is significantly lower than the meanage of patients with ES without glaucoma (76.9). The association of ES with glaucoma appears early and does not increase with age.
GLAUCOMA CAPSULARE IN PATIENTS WITH OPEN‐ANGLE GLAUCOMA IN HUNGARY
Authors: Sziklai Paul , Süveges Ildikó
Published: May 2009

Abstract. The data of 403 inpatients with open‐angle glaucoma were selected between 1977–1986, 155 had glaucoma capsulare (GC) and 248 suffered from primary open‐angle glaucoma (POAG). The incidence rate of GC was 38.4 % in the total material. In the GC group, the peak of age distribution was between the ages 70–79 (45.8 %).

The male/female ratio of the total GC material was 1.67, that in POAG was 0.85. The difference between the two glaucoma groups was significant.
EXFOLIATION SYNDROME IN THE SOUTHEASTERN UNITED STATES I. PREVALENCE IN OPEN‐ANGLE GLAUCOMA AND NON‐GLAUCOMA POPULATIONS
Authors: Cashwell L. Frank , Shields M. Bruce
Published: May 2009

Abstract. A prospective study of 2,121 patients, 30 years of age or older, examined in two clinics in the southeastern United States with dilated slit‐lamp biomicroscopy, revealed the exfoliation syndrome in 1.6 % of the total population and in 6.0 % of an open‐angle glaucoma subpopulation. All but one of the 33 patients with exfoliation syndrome were over age 60 years, and the prevalence of exfoliation syndrome in the subgroup over age 60 was 3.2 %. Among the patients over age 60 who did not have open‐angle glaucoma, 1.6 % had exfoliation syndrome. By chi square analysis, the prevalence of the exfoliation syndrome in the over age 60 population without glaucoma was found to be significantly less (P = 0.00009) than reported in studies from other geographic areas.
IS THE EXFOLIATION SYNDROME A CONTRAINDICATION FOR THE USE OF IOL IN CATARACT SURGERY?
Authors: Cambiaggi A.
Published: May 2009

Abstract. A questionnaire on the possibility of the use of IOL in cases of cataract with exfoliation syndrome (ES) was sent to several ophthalmic surgeons. The analysis of the answers to the questionnaire shows that the ES is a relative contraindication to the IOL implantation. Posterior chamber and sulcus fixation are recommended.
THE OUTCOME OF VISUAL FUNCTION IN CAPSULAR GLAUCOMA
Authors: Thorburn William
Published: May 2009

Abstract. In a retrospective study is found that 2.5% of subjects aged 70 years or more developed visual field defects due to capsular glaucoma within their lifetime. Before death 0.8% were amaurotic in one eye, and 0.3% had serious impaired visual function caused by bilateral capsular glaucoma. Advanced visual field defects present at diagnosis and central vein occlusion contributed to bad outcome. When glaucomatous disc cupping without visual field defects were present at diagnosis, 50% developed field defects during their lifetime. Of those with moderate visual field defects at diagnosis 59% advanced one or more stages.
CAPSULAR GLAUCOMA: MANAGEMENT PHILOSOPHY
Authors: Hetherington John
Published: May 2009

Abstract. This paper attempts to evaluate exfoliative glaucoma management. Exfoliative glaucoma is generally considered to be more severe than chronic open angle glaucoma. Pressures are generally higher and more resistant to the pressure lowering effect of various medications. Laser trabeculoplasty is generally more effective in exfoliative glaucoma in the first year but successful in only 50% of eyes at two years follow‐up. Filtration surgery is far more effective in exfoliative glaucoma than it is in chronic open angle glaucoma.
Correlation of optical components with ocular refraction among teen‐agers in Taipei
Authors: Lin Luke Long‐Kuang , Hung Li‐Fang , Hung Yung‐Feng Shih Por‐Tying , Ko Liang‐Shi
Published: May 2009

Abstract. From 2 senior‐high and 2 vocational schools in Taipei, 3251 children with age 16–19 were randomly selected to study the relationship between ocular refraction and its main optical components, corneal curvature and axial length. While the corneal curvature was found to play only a minor role in the determination of ocular refraction, the measurements of axial length parallelled the degree of myopia (r = 0.74). A two‐years' longitudinal study of additional 411 children from one junior‐high school (age 13 through 15) further pointed to the importance of axial length in the production and progression of myopia.
The role of bifocal and contact lenses in myopia control
Authors: Grosvenor T. , Goss D. A.
Published: May 2009

Abstract. This manuscript reviews the recent work on the use of bifocal spectacles and ‘hard’ contact lenses for the control of myopia, with emphasis on the studies conducted by the authors.
Loss of the ocular pulse in the acute phase of temporal arteritis
Authors: Bienfang Don C.
Published: May 2009

Abstract Severe cases of temporal arteritis often have infarctions of the optic nervehead. Such cases frequently have a decrease in the amplitude of the ocular pulse. This is in contrast to cases of anterior ischemic optic neuropathy not due to temporal arteritis. In addition to aiding in the diagnosis of temporal arteritis, monitoring of the ocular pulse may help in following the course of this disease.
The effect of corneal grafting on vision in bilateral amblyopia
Authors: Frucht‐Pery Joseph , Chayet Arturo S. , Feldman Sandy T. , Buckley Daniel J. , Brown Stuart I.
Published: May 2009

Abstract Two children with bilateral congenital corneal opacities (sclerocornea) received unilateral corneal transplants at the ages of 4 1/2 and 16 years, respectively. Both developed reading vision and reduced nystagmus excursions.
The effect of standardized keratoplasty technique on IOL power calculation for the triple procedure
Authors: Mattax James B. , McCulley James P.
Published: May 2009

Abstract Twenty‐one consecutive triple procedures (keratoplasty, cataract extraction, lens implantation) performed by one surgeon using identical suturing technique, donor size, and donor/recipient size disparity were analyzed for visual outcome and refractive error. Ninety‐five percent of all grafts were clear with an average follow‐up of 11.8 months. Of patients with good pre‐operative visual potential, 84% achieved 20/40 or better visual acuity, and the majority of these patients obtained 20/40 acuity within 6 months of surgery. Sixty‐three percent of eyes with 20/40 or better acuity had refractions within ±2 diopters of the predicted post‐operative refraction. The most recent 14 eyes in this series had IOL power calculations performed utilizing the SRK regression formula and 43.00 K's (surgeon's average post‐keratoplasty keratometry values). Within this group, 79% achieved 20/40 or better vision. Eighty‐two percent of these eyes had refractions within ±2 diopters, and 100% were within ±3 diopters of the predicted value. These findings demonstrate that a single surgeon using standardized keratoplasty can achieve good refractive results in the triple procedure.
Refractive surgery: through the looking glass
Authors: Kaufman Herbert E.
Published: May 2009

Abstract Historically, surgical procedures designed to change the refractive power of the cornea have been controversial at their inception, gaining acceptance only with time and study. From intraocular lenses to corneal remodelling with the excimer laser, and numerous procedures in between, including radial keratotomy, epikeratophakia, incisional keratotomy for astigmatism, and hydrogel and polysulfone implants, ophthalmologists have balanced the risks and benefits for their patients to produce the maximum benefit at the least cost. The present status and future potential of each of these are assessed as they appear today. There is no question that progress will continue, and that our patients will be the beneficiaries of our ongoing interest in improving older procedures and developing new techniques for the correction of refractive errors.
Epikeratoplasty for adult and pediatric aphakia, myopia, and keratoconus: the Massachusetts Eye and Ear Infirmary experience
Authors: Wagoner Michael D. , Steinert Roger F.
Published: May 2009

Abstract Between February, 1985 and February, 1987, 49 eyes of 47 patients underwent epikeratoplasty for one of the following indications: adult aphakia (21 eyes; 20 patients), pediatric aphakia (10 eyes; 10 patients), myopia (7 eyes; 6 patients), and keratoconus (11 eyes; 11 patients). Follow‐up at least 12 months (average = 18 months) is available for all 49 eyes. Of 49 eyes, 44 (90%) were anatomically successful with an intact, clear lenticule at least 12 months post‐operatively, with no significant difference between the four groups (adult aphakia = 90%, pediatric aphakia = 90%, myopia = 86%, and keratoconus = 91%). The functional success rate, however, was 91% for keratoconus, 81% for adult aphakia, 80% for pediatric aphakia, and only 43% for myopia. We conclude that epikeratoplasty can be an effective tool in the treatment of carefully selected patients with adult or pediatric aphakia and keratoconus, but has only limited applicability in the management of myopia.
Natural history of disease in a rabbit model for keratoconjunctivitis sicca
Authors: Gilbard Jeffrey P. , Rossi Scott R. , Gray Kathleen L. , Hanninen Laila A.
Published: May 2009

Abstract We have continued our study of the tear film and ocular surface in our full KCS (keratoconjunctivitis sicca) rabbit model up to 52 weeks post‐operatively. Tear film osmolarity remains elevated, conjunctival goblet cell density remains decreased, and the conjunctival epithelium remains abnormal. Corneal epithelial glycogen levels decreased progressively, and at 44 weeks post‐operatively rabbits developed abnormal rose Bengal staining of the affected cornea that was shown to be associated with morphologic abnormalities at 52 weeks. Rabbits began rubbing the affected eye after the development of corneal staining. Our full KCS rabbit model demonstrates the features of the human disease.
Evidence for the potential influence of cyclic nucleotides on maintenance of or reactivation from latency of herpes simplex virus in trigeminal ganglionic neurons
Authors: Foster C. Stephen , Opremcak E. Mitchel , Tolchin Neil
Published: May 2009

Abstract Herpes simplex virus infections are epidemic throughout developed countries, and recurrent herpes simplex keratitis is the most common cause of corneal blindness in these countries, NIH (1973). No available antiviral agent is capable of eradicating the state of viral ganglionic latency, and hence no effective treatment currently exists for prevention of viral re‐activation from latency, with resultant recurrent infectious viral clinical manifestations. Putative triggers of re‐activation include stress, sunburn, menses, trauma, and fever. These ‘triggers’ seem to share at least one common characteristic: the potential ability to influence intracellular cyclic nucleotide levels through the action of such first order messengers as catacolamines (stress, trauma) and/or ara‐chadonic acid metabolites (sunburn, fever, trauma, and menses). We exploited an in vitro model of HSV ganglionic latency, and developed a model of in vitro organ culture ganglionic viral reactivation from latency. We then examined the effect of a variety of agents on this model. We found that agents which have been shown to elevate cyclic AMP levels consistently produce increased viral shedding (compared to control, spontaneous reactivation rate) in our model of viral reactivation from latency. In contrast, agents which have been shown to depress c‐AMP levels and/or to elevate c‐GMP levels inhibit viral reactivation from latency in this in vitro model. We conclude that intracellular cyclic nucleotide levels may influence events which control herpes simplex genome transcription.
The optical quality of the peripheral cornea
Authors: Miller David , Atebara Neal , Stegmann Robert
Published: May 2009

Abstract The cornea can be considered to be an organ divided into a central and peripheral zone. Although the central cornea is responsible for producing a sharp retinal image, our experiments suggest that areas of isolated peripheral cornea can produce retinal images compatable to 20/30 visual acuity.
Late corneal opacities in the syndrome of interstitial keratitis and vestibulo‐auditory symptoms
Authors: Cogan David G. , Kuwabara Toichiro
Published: May 2009

Abstract Progressive clouding of the cornea may be a delayed complication of the interstitial keratitis‐vestibu‐loauditory syndrome. Two illustrative cases are presented. The first case illustrates progressive opacification about aberrant vessels in the deep stroma presenting a characteristic dendritiform pattern. The second case shows that the opacification is due, in this case at least, to formation of connective tissue with inclusion of lipid crystals and fat along with the blood vessels. Descemet's membrane is also thickened several fold.
Corneal endothelial damage caused by different types of incision
Authors: Krause Ulf H. , Alanko Hannu I.
Published: May 2009

Abstract The effects of corneal incisions of different types on the corneal endothelium in cadaver eyes was studied by scanning electron microscopy. In all cases the perforations were made with a diamond knife, but in case 1) the opening was enlarged in both directions with scissors, in case 2) a partly perforating groove was made on one side, and an enlargment only with sciccors on the other, and in case 3) a long full thickness incision with diamond knife only was made. The greatest damage to the endothelium was induced by the scissors, the damage was less when partial thinning was performed before the opening with scissors, and the least trauma was seen when a diamond knife only was used. The cell loss was maximally calculted to be about 8% of the endothelial cell population when incision with scissors was performed compared with 2–3% with diamond knife incision.
Low blood pressure—a risk factor for nerve fibre loss in institionalized geriatric glaucoma patients
Authors: Peräsalo Ritva , Raitta Christina
Published: May 2009

Abstract Twohundred and thirteen institutionalized geriatric glaucoma patients aged 64–99 years (mean 83,1 ± 6,9 years), at the Koskela Municipal Hospital were examined ophthalmologically and analyzed for blood pressure (BP). The mean systolic BP, measured in 208 patients, was 146 ± 25 mmHg and diastolic 82± 13 mmHg. Thirty‐eight of 208 patients (18%) had low BP (≤120 mmHg) and 38 had high BP (> 160 mmHg). The intraocular pressure (IOP) correlated significantly with the systolic BP, the correlation being highly significant in patients with BP >160 mmHg.

Fifty‐five of the 208 patients were considered blind: visual acuity (VA) in the better eye <0,05.

Patients with BP >160 mmHg had better VA (0,25 ± 0,23) and visual fields (VF) than the patients with BP ≤120 mmHg (0,13 ≤ 0,21).

Low systolic BP (≤120 mmHg) is associated with visual impairment, since twice as many blind patients occurred among those with low BP than among the rest, and 71% of those with low BP had glaucoma in both eyes, compared with 56% of the patients with higher BP.

When all the patients in whom VF could be plotted are considered, it can be concluded that low systolic BP was more frequent with VF progressing from grade 1 to grade 4.

Low systolic BP is a risk factor for old aged glaucoma patients.
Visual impairment in patients with chronic open angle glaucoma
Authors: Sverrisson T. , Viggosson G. , Björnsson G.
Published: May 2009

Chronic open angle glaucoma (COAG) is to a great extent a disease of the elderly,‐ a population often affected by other diseases reducing vision. The visual reduction in older patients affected by COAG is thus often the cause of other diseases than glaucoma. We looked at the visual function of 809 patients with COAG and tried to define the main cause of visual impairment, as well as classify visual reduction according to WHO recommendations from 1977. (fig.1). The study is also ment to serve as a referance for future evaluations of the visual function in our glaucoma patients
Pleoptic therapy
Authors: Erkkilä Heikki , Somersalo Mikko
Published: May 2009

Abstract The therapeutic results of 48 children treated for amblyopia were analysed in respect to the ophthalmological background factors, the way of referral to the ophthalmological care, including the role of screening procedures, compliance at previous therepeutic efforts and the age at diagnosis. An improvement of visual acuity by two Snellen lines or more was noted in 31 eyes (65%). There was a tendency towards a less favourable outcome in eyes with both strabismus and anisometropia compared with those with either of these background factors of amblyopia. The mode of referral did not seem to predict the outcome of treatment, nor had the age at diagnosis (inside the range of 1 to 7 years) any clear predestinating significance for the outcome of therapy. Good compliance at previous therepeutic efforts almost reached statistical significance as a predictor of successfulness of therapy.
Correlations between visual acuity, grating acuity and contrast sensitivity in amblyopia
Authors: Koskela Pentti U. , Alanko Hannu I.
Published: May 2009

Abstract In order to obtain a large set of data to analyse correlations between different measures of vision in amblyopia, we pooled the information on all 114 amblyopic patients contained in our earlier series (49 strabismic, 28 anisometropic and 37 combined strabismic/anisometropic children).

It was found that strabismus influenced visual acuity more than did anisometropia, but anisometropia influenced contrast sensitivity more than strabismus.

The correlation coefficients between visual acuity and contrast sensitivity and between grating acuity and contrast sensitivity were lowest at 1 c/deg and highest at 13 c/deg. The correlation between grating acuity and contrast sensitivity was slightly better than between visual acuity and contrast sensitivity. The highest correlation coefficients were found in cases of combined strabismic/anisometropic amblyopia and the lowest in anisometropic amblyopia, which was not expected on the basis of some earlier reports in the literature. The best correlation between visual acuity and grating acuity was in the cases of combined amblyopia.
Wound margin endothelial cell loss at anterior segment surgery and its prevention
Authors: Calel Bertil , Chung Jang‐Hyun , Fagerholm Per
Published: May 2009

Abstract An experimental systematic study was performed, assessing the endothelial cell loss at the wound margin after the use of individual instruments employed at anterior segment surgery. 1% sodium hyaluronate and surface modificat, heparine coated, instruments were employed for comparison and to determine the protective effect of these measures. After standardized employment of the instruments in the rabbit eye, the immediate endothelial cell loss was analysed in the light microscope after alizarine red/tryphan blue staining. Sharp instruments as the keratome or the threpine cause limited cell loss. 1% sodium hyaluronate and hydrophilic surface coating of instruments with heparine caused a considerable reduction of endothelial cell loss at the wound.
Molecular weight and concentration of hyaluronan in vitreous humour from diabetic patients
Authors: Laurent Ulla , Törnquist Per , Granath Kristi , Lilja‐Englind Karin , Ytterberg Dagny
Published: May 2009

Abstract Vitreous material was collected from 24 patients undergoing pars plana vitrectomy due to hemorrhage, proliferation or traction in the vitreous body or retinal detachment. Fifteen patients had a proliferative diabets retinopathy. The non‐diabetic group consisted of four patients with vascular disease: periphlebits (2), and branch vein occlusion (2) and five patients with a non‐vascular disease: retinal detachment (4) and macular pucker (1). Hyaluronan analyses of the samples, which constituted about 80% of the vitreous bodies, gave values from 3 to 2600 μg, corresponding to approximately 1–700 μg/ml in situ. Low values were recorded in patients operated on for cataract and especially in those who also had retinal detachment. Molecular weight distributions of hyaluronan were determined in 8/15 diabetics and in 5/9 non‐diabetics. Due to the low hyaluronan content it was not possible to perform molecular weight determination in more than one of the patients with retinal detachment. The hyaluronan was of high molecular weight in both diabetics and non‐diabetics; the weight‐average molecular weight (Mw) being 1.6–6.1 times 106 and 1.0–5.3 times 106, respectively. From this investigation there is no evidence that a change in the molecular properties of hyaluronan could be the cause of proliferative diabetic retinopathy.

The vitreous humour contains a comparatively high concentration of hyaluronan (HYA) (100–400 μg/g). It is of high molecular weight and does not normally seem to be degraded extracellularly in the eye (Balazs & Denlinger, 1984).

Proliferative diabetic retinopathy is characterized by pathological vessel formation. Recent investigations have shown that HYA can effect angiogenesis. High‐molecular weight HYA seems to inhibit blood vessel formation (Feinberg & Beebe 1983, Dvorak & al 1987, West & Kumar, 1989), while oligosaccharides produced by degradation of HYA induce an angiogenic response in the chick chorioallantoic membrane (West et al, 1985). West & Kumar (1989) have also shown in vitro that vascular endothelial cells endocytose HYA, probably mediated by a receptor. They have proposed the hypothesis that vasoproliferation in diabetic patients is brought about by a change in concentration and molecular size of HYA (West & Kumar, 1988). This led us to test the hypothesis that hyaluronan is degraded in the diabetic eye and that the degradation products could be at least partly responsible for vascularization of the vitreous body. However, we find no difference in the molecular weight of HYA in diabetic and non‐diabetic patients.
Progression in juvenile X‐chromosomal retinoschisis
Authors: Forsius H. R. , Eriksson A. W. , Damsten M.
Published: May 2009

Abstract Forty‐five males and one homozygotic female showing X‐chromosomal juvenile retinoschisis were re‐investigated in 1987 after an average follow‐up study of more than 22 years. Twenty‐two of them had been investigated by fundus‐photography for at least 14 years.

With time, the typical radial micro‐cystic macular area flattens out and atrophies. In very old persons only some large choroidal vessels are seen, covering the sclera in the previously radiating area. In young patients with additional peripheral schisis the veil ruptures, the schisis area flattens out, the holes grow and may unite. In the outer retinal layer pigment degeneration develops. In congenitally severe cases the atrophy is marked and rapid. The retinal vessels attenuate and the nerve head becomes pale. Total blindness results in cases of this cathegory. The severity of retinoschisis varies much in patients belonging to the same family and even in the two eyes of the same person.