bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal detachment after pneumatic trabeculoplasty:case report
Authors: PESCE G , MACINAGROSSA G , CANTATORE A , DE BELLIS A , MONTRONE L , DI GESU I , MONTRONE F
Published: November 2010

Purpose The authors report on a case of retinal detachment arising after treatment for ocular hypertension with pneumatic trabeculoplasty.

Methods Patient male,39 years old,previous surgery with excimer laser for correcting myopia in both eyes.The patient had various treatments of pneumatic trabeculoplasty;he came two days after to our attention with the presence of retinal detachment and retinal hole in left eye. The patient underwent surgery in encircling and sealing the break with ab external technique.

Results The postoperative course was smooth with reattachment of the retina and good recovery of vision in left eye.

Conclusion The pneumatic trabeculoplasty is a simple and safe procedure for treatment of patients with primary open angle glaucoma (POAG) or ocular hypertension (OH).Controindications are:monocular patients with <1 / 10 visual acuity in the other eye, patients with other ocular diseases or previous surgical procedures, diabetes. The results suggest that pneumatic trabeculoplasty was absolutely contraindicated in this patient.
Aqueous humor redox potential in pseudoexfoliation syndrome
Authors: PANTELI VS , KANELLOPOULOU D , KOUTSOUKOS PG , GARTAGANIS SP
Published: November 2010

Purpose To determine the overall oxidative status of the aqueous humor in patients with pseudoexfoliation syndrome, by measuring the reduction‐oxidation (redox) potential in the aqueous samples.

Methods Samples were collected during cataract extraction from 13 patients with pseudoexfoliation syndrome and 22 normal patients. A platinum electrode together with a reference electrode Ag/AgCl/KCl was used for the measurement of the apparent redox potential in the aqueous humor. Ten measurements were taken every five minutes from the acquisition of the sample and the average value of the measurements was recorded. The independent samples t‐test was used to compare aqueous redox potential between the study and control group. Statistical significance was set at 0.05.

Results The redox potential was found significantly higher in patients with pseudoexfoliation syndrome than in normal patients (p<0.05).

Conclusion Measurements of redox potential is an accurate, easy, time‐saving method for evaluating the oxidative situation in the aqueous humor. Redox potential was found significantly higher in the aqueous humor of the study group. These results support the role of increased oxidative stress in the development of pseudoexfoliation syndrome and suggest for the first time in the field of Ophthalmology a direct and convenient technique for the determination of the oxidative status in aqueous humor.
DHEA protects the retina from AMPA excitotoxicity in vivo: involvement of NGF receptors
Authors: THERMOS K , KOKONA D , CHARALAMPOPOULOS I , GRAVANIS A
Published: November 2010

Purpose The aim of the present study was to investigate whether DHEA and NGF could protect retinal cells from cell death in an in vivo model of AMPA excitotoxicity.

Methods Male and female Sprague‐Dawley rats (250‐300g) were administered intravitreally: AMPA (42 nmol per eye) or AMPA and DHEA (10‐6,10‐7M) or NGF (60pg/eye) or vehicle. A TrkA inhibitor (Calbiochem 648450, 10‐6M) was co injected with AMPA and DHEA (10‐6M). Twenty four hours after treatment, eye cups were removed and prepared for immunohistochemistry. Antibodies for retinal markers nitric oxide (NO) and cholinergic containing amacrine cells (ChAT‐, and bNOS‐containing, respectively), and calbindin‐containing horizontal and amacrine cells, were employed.

Results Intravitreal administration of AMPA led to retinal cell loss as previously reported [Kiagiadaki & Thermos, IOVS, 49:3080‐3089, 2008] twenty four hours after administration. Co‐ administration of AMPA and DHEA protected the retina in a dose dependent manner. The TrkA antagonist (10‐6M) employed reversed the neuroprotection afforded to the retina by DHEA (10‐6M). In addition, NGF (60pg/eye) mimicked the DHEA effects, thus protecting the retina from AMPA toxicity.

Conclusion The present results support that the endogenous neurosteroid DHEA protects the retina from AMPA excitotoxicity via a mechanism involving the TrkA receptor. This was substantiated by the reversal of the DHEA mediated neuroprotection by the TrkA antagonist and by the NGF neuroprotective effects in the retina. Further studies are essential in order to characterize further the mechanisms involved in DHEA neuroprotection and to evaluate the therapeutic relevance of these results.
Cyclosporine A topical administration in dogs affected by immune‐mediated keratoconjunctivitis sicca
Authors: DODI PL , BIANCHI E , QUINTAVALLA F
Published: November 2010

Purpose To study the effect of Cyclosporine A (CsA) on immune‐mediated canine keratoconjunctivitis sicca (KCS) or dry eye, and to evaluate the potential therapeutic action of this molecule.

Methods The present study was conducted on a sample of randomized dogs affected by immune‐mediated KCS. It consists of 12 cases (24 eyes), various ages (from 3 to 11 years old) and different sexes (9 males ‐ 3 females). All dogs exhibited: different stages of muco purulent filaments and redness; they were negative to fluorescein; STT I on right eye was 4,4 ± 2,5 mm/1 min on left one was 5,5 ± 2,3 mm/1 min; cytology showed many inflammatory cells. The dogs were topically treated with CsA ointment (0,2%) for 8 weeks 0,6 cm strip (1/4 inch) of ointment every 12 hours.

Results The result of these studies presented a significant improvement as evaluated by STT I . Thus, the right eye was 12 ± 4,6 mm/1 min (p < 0,05) and the left one was 11,8 ± 4,1 mm/1 min (p < 0,05). Moreover, dogs treated with CsA showed decreased purulent corneal secretion and marked regression of chronic corneal neovascularization and granulation tissue. Cytology analysis indicated a significant reduction in the number of corneal inflammatory cells.

Conclusion This report confirmed that CsA is involved in the regulation of tears production, most probably by acting on reduction lacrimal gland inflammation and possible regeneration of lacrimal acinar lobules. CsA caused also a marked anti‐inflammatory action of the dog’s cornea. Neverthless, further clinical studies are necessary to assess the consistency corneal toxic effect of this mulecole in the eye.
Comparative toxicology of BAK‐free and BAK‐preserved travoprost/timolol fixed combinations and latanoprost/timolol fixed combination in vitro
Authors: LABBE A , NAKIB Z , LIANG H , BAUDOUIN C , BRIGNOLE‐BAUDOUIN F
Published: November 2010

Purpose To compare, in vitro, the cytotoxicity of a new formulation of travoprost 0.004%/timolol 0.5% fixed combination (FC) ophthalmic solution containing polyquaternium‐1 0.001% (trav/tim BAK‐free) with commercial formulations of travoprost 0.004%/timolol 0.5% FC ophthalmic solution (trav/tim BAK) and latanoprost 0.005%/timolol 0.5% FC ophthalmic solution (lat/tim BAK).

Methods Human conjunctival epithelial cells were incubated with PBS, trav/tim BAK‐free, polyquaternium 1 0.001% (PQ), trav/tim BAK with 0.015% BAK, BAK 0.015%, lat/tim BAK with 0.020% BAK, and BAK 0.020%. Cell viability (neutral red, Alamar blue), apoptosis (YO‐PRO‐1, Hoechst 33342), and oxidative stress(H2DCF‐DA, hydroethidine) were assessed. Apoptosis and oxidative stress assays were reported according to cell viability.

Results Cells incubated with trav/tim BAK‐free had better viability than cells incubated with lat/tim BAK, trav/tim BAK, BAK 0.015%, and BAK 0.020% (P < 0.0001). Trav/tim BAK‐free produced less apoptosis than trav/tim BAK, lat/tim BAK, BAK 0.015%, and BAK 0.02% (P < 0.0001, YO‐PRO‐1 and Hoechst 33342 relative to cell viability). As assessed with H2DCF‐DA relative to cell viability, PBS, PQ 0.001%, trav/tim BAK‐free, and trav/tim BAK produced significantly less oxidative stress than lat/tim BAK (P < 0.0001). Additionally, as assessed with hydroethidine relative to cell viability, trav/tim BAK‐free produced significantly less oxidative stress than lat/tim BAK (P < 0.0001).

Conclusion Trav/tim BAK‐free exhibited significantly less cytotoxicity in vitro than lat/tim BAK and trav/tim BAK. Confirmation is needed in patients with open angle glaucoma or ocular hypertension.
Hydration and rehydration in camel and bovine cornea
Authors: KHAN F , ALMUBRAD TM , AKHTAR S
Published: November 2010

Purpose T0 investigate the hydration and rehydration of fresh camel and bovine cornea in sodium salt solutions during 20 minutes, 46 hours and 14 hours.

Methods During the 20mins study hydration of fresh corneal stroma was investigated in sodium chloride (NaCl), sodium bicarbonate (NaHCO3), sodium acetate (CH3COONa), sodium thio‐cyanate (NaSCN) and sodium fluoride (NaF) with 2 minutes time interval. During a 46hrs time period, the hydration study was carried out in NaCl (150, 300mM), NaF (150mM) at random intervals. The 14 hrs study was carried out to assess the rehydration of corneal stroma in NaCl (150, 300mM), NaF (150mM) after six hours of drying.

Results During the 20 minute swelling studies in the first two minutes the rate of hydration in both camel and bovine corneas was high but gradually reduced in the 2 – 20 minute period. The rate of hydration and level of hydration of camel and bovine cornea was not significantly different from each other in all the strengths of solutions. During the 46 hours swelling studies the rate of initial hydration (0 to 2 hours) of camel and bovine stroma, in all solutions was significantly higher compared to hydration during later hours (2‐46hrs). Camel stromal hydration in150mM NaCl was significantly higher compared to bovine stromal hydration in the same solution during 10 – 24 hrs, and 24 to 46 hrs time period. Rehydration in camel stroma was significantly lower than bovine in 150mM NaF.

Conclusion Above study showed that there was no selective affinity for particular ions in camel or bovine corneal stroma. The swelling in camel cornea is higher compared to bovine corneal stroma. This could be due to higher negatively charged KS‐PGs in the stroma. Less rehydration in camel cornea suggests the higher leaching of of PGs from stroma in NaF.
Efficacy and safety of a new ophthalmic preservative‐free formula of levocabastine 0.05% during a conjunctival allergen challenge
Authors: ALLAIRE C , SIOU MERMET R
Published: November 2010

Purpose To evaluate the efficacy and safety of preservative‐free levocabastine 0.05% ophthalmic solution (PFL) compared to preserved levocabastine 0.05% ophthalmic suspension (PL) and vehicle of the solution in the prevention of allergic conjunctivitis induced by a conjunctival provocation test (CPT).

Methods 92 healthy volunteers with a history of allergic conjunctivitis were randomized in this double‐masked study. 69 subjects received 1 drop of PFL in 1 eye and 1 drop of PL in the fellow eye, either 10 min [visit 3 (V3)] or 4 h [visit 4 (V4)] prior to CPT. 23 subjects received 1 drop of PFL in 1 eye and 1 drop of vehicle in the fellow eye, either 10 min or 4 h prior to CPT. The primary endpoint was the sum score of itching and redness assessed 3, 5 and 10 min after CPT at V3 and at V4. Other evaluations included tolerance, corresponding to study drug drop sensation and adverse events.

Results PFL was shown to be statistically superior to vehicle (p ≤ 0.01) at all time points with one exception at V4, 3 min after CPT. Sum scores varied from 0.7 to 1.6 with PFL and from 1.2 to 2.7 with vehicle. PFL was shown to be statistically superior to PL at V3 and non‐inferior at V4. At V3, the sum scores varied from 0.7 to 1.6 with PFL and from 1.2 to 2 with PL. At V4, sum scores varied from 1.1 to 1.7 with PFL and from 0.9 to 1.7 with PL. Upon instillation, PFL was better tolerated than PL (p<0.001). No serious adverse events were recorded.

Conclusion The efficacy of the preservative‐free solution of levocabastine is superior to the effect of the vehicle and, at V3, superior to the efficacy of the preserved suspension of levocabastine. The preservative‐free solution was better tolerated than the preserved suspension.

Commercial interest
Effect of topical administration of polycarbophil‐based formulation (DuraSite®) on an intact and surgically‐compromised corneal surface in rabbits
Authors: KRENZER K , ZHANG J , WARD K , RICHARDSON M
Published: November 2010

Purpose The purpose of this investigation was to examine the effect of a polycarbophil‐based formulation in intact eyes and eyes compromised with a penetrating corneal incision, a LASIK flap or a full‐thickness epithelial defect.

Methods New Zealand White rabbits were used. Polycarbophil (0.6 or 1.3%) was dosed in intact eyes TID for 1 year. The surgical models (penetrating surgical incision, LASIK flap, or 9 mm full‐thickness epithelial defect) were dosed with a 0.9% polycarbophil formulation. The eyes with the incision or flap were dosed QID for 14 days. Eyes with the epithelial defect were dosed 10 times in the first 24 h, then every 12 h for the next 2 days. The size of the defect was monitored with fluorescein. The eyes were examined histologically.

Results In the 1 year study, no adverse ocular effects were observed at either dose of polycarbophil. In the incision model, administration of polycarbophil did not result in adverse findings; no anterior chamber reaction was observed. In the LASIK model, there were no adverse effects considered related to the polycarbophil. In the epithelial defect model, approximately half of the eyes demonstrated re‐epithelialization by 72 hours. The re‐epithelialization was not different from a saline control. Microscopically, there were no indications of adverse effects of the polycarbophil in any of the models assessed.

Conclusion There are no adverse findings related to repeated topical administration of polycarbophil in uncompromised or surgically‐compromised rabbit eyes. These results support that polycarbophil (0.9%, DuraSite®) is safe to use in pharmaceutical preparations in both intact eyes and eyes with compromised ocular surfaces.

Commercial interest
Ocular surface reactions following exposure to BAK‐free travoprost/timolol fixed combination, and BAK‐preserved travoprost/timolol and latanoprost/timolol fixed combinations in vivo
Authors: LIANG H , LABBE A , PAULY A , RIANCHO L , BAUDOUIN C , BRIGNOLE‐BAUDOUIN F
Published: November 2010

Purpose To test in vivo the ocular surface reactions of a new formulation of the fixed combination travoprost 0.004%/timolol 0.5% ophthalmic solution (trav/tim BAK‐free) containing the antimicrobial preservative polyquaternium‐1 (PQ, Polyquad®), compared with commercial formulations of the fixed combinations travoprost 0.004%/timolol 0.5% ophthalmic solution (trav/tim BAK, Duotrav®) and latanoprost 0.005%/timolol 0.5% fixed ophthalmic solution (lat/tim BAK, Xalacom®).

Methods Phosphate‐buffered saline (PBS), trav/tim BAK‐free, trav/tim BAK, or lat/tim BAK were applied to the eyes of adult male New Zealand albino rabbits (N = 24), 1 drop, 15 times, at 5 min intervals. Ocular surface reactions were assessed at hour 4 and day 1 using slit‐lamp examination, in vivo confocal microscopy (IVCM), conjunctival impression cytology, and immunohistology for detecting CD45+ infiltrating cells and MUC‐5AC‐labeled cells.

Results Trav/tim BAK‐free was similar to PBS in regards to the clinical findings, the Draize test for ocular irritation, and epithelial and limbal aspects as evaluated with IVCM. Also, trav/tim BAK‐free and PBS produced no obvious inflammatory infiltration inside and outside the CALT follicles, yielded similar IVCM toxicity scores and CD45+ cell counts, and had normal goblet cell presentation. In contrast, trav/tim BAK and lat/tim BAK induced cytotoxicity in all tests, showing alterations of the ocular surface microstructures and inflammatory infiltration.

Conclusion Trav/tim BAK‐free exhibited better tolerance in vivo than trav/tim BAK and lat/tim BAK following repeated frequent instillations in rabbits.
Evaluation of spatial contrast sensitivity after the instillation of brimonidine tartrate 0.2% eye drops
Authors: KARAMITSOS A , CHATZIBALIS T , MIRTSOU‐FIDANI V , GEORGIADIS N , KARAMPATAKIS V
Published: November 2010

Purpose To evaluate the influence of Brimonidine tartrate on contrast sensitivity (CS).

Methods Thirty ophthalmologically healthy Caucasian individuals (15 male, 15 female), aged from 21 to 55 underwent CS testing. The examination was repeated 20 and 40 minutes after the instillation of brimonidine tartrate eye drops unilaterally. The fellow eye served as control.

Results All the examined individuals had normal visual acuity, color perception and CS before the drop instillation. Four of them complained for a temporary blurred vision at the eye in which brimonidine tartrate was instilled. These four individuals had impaired CS in high spatial frequencies (20 cycles/degree), in the examination performed 20 minutes after the instillation. The CS normalized again in the third CS evaluation performed 40 minutes after the instillation.

Conclusion The temporarily blurred vision of some individuals after brimonidine tartrate eye drop instillation is related with a decrease of spatial CS in high frequencies. Within this time period of 40 minutes after the instillation, individuals who experience visual disturbances should avoid activities that demand high visual efficacy or postpone the instillation for a more convenient time in relation to the visual disturbance they experience.
Effects of intravitreally injected bevacizumab on vascular endothelial growth factor in fellow eyes
Authors: MATSUYAMA K , OGATA N , MATSUOKA M , WADA M , NISHIMURA T , TAKAHASHI K
Published: November 2010

Purpose To determine the level of vascular endothelial growth factor (VEGF) in the fellow eyes after an intravitreal injection of bevacizumab in one eye.

Methods Eight patients who had similar findings of with proliferative diabetic retinopathy (PDR) in both eyes were studied (four patients had rubeosis, and four patients did not have rubeosis in the anterior chamber). All patients received an intravitreal injection of bevacizumab(1.25 mg) in one eye. Samples of aqueous humor were collected from the injected eyes just before and one day after the injection, and after 7 days from untreated fellow eyes. The concentration of VEGF was measured by ELISA.

Results After one day, the VEGF level in injected eyes was significantly reduced from 3230.3±2136.8 pg/ml to 3.1±3.6 pg /ml (P<0.05) in eyes with rubeosis and 465.0±78.8 pg/ml to 0 pg/ml (P<0.05) in those without rubeosis. After seven days, the VEGF levels of the fellow eyes were still significantly lower than that in the injected eyes before the injection (688.5±443.1 pg/ml in the rubeosis group, and 7.8±13.2 pg/ml in the no rubeosis group, P<0.05, P<0.05).

Conclusion A single intravitreal injection of bevacizumab significantly reduced the VEGF concentrations in the aqueous humor of the fellow untreated eye.
Retinal vessel diameter can be reliably determined in minipigs using Retinal Vessel AnalyzerTM with a microscope‐mounted fundus camera
Authors: PAPADOPOULOU DN , MANGIORIS G , PETROPOULOS I , MENDRINOS E , MAVROPOULOS A , POURNARAS CJ
Published: November 2010

Purpose Retinal Vessel Analyzer (RVA) is a validated instrument to measure retinal vessel diameter in humans. The purpose of this study was to assess the inter‐observer reproducibility and intra‐observer repeatability of RVA with a microscope‐mounted fundus camera to determine retinal vessel diameter in minipigs.

Methods The fundus image of 5 minipigs was recorded in digital videocassette for approximately 5 min under stable systemic arterial pH, pCO2, and pO2. In order to evaluate the inter‐observer reproducibility, each one of two investigators used RVA (Imedos GmbH, Jena, Germany) to measure the diameter of the superior temporal retinal artery on 5 separate 30‐sec recordings from each minipig. In order to evaluate the intra‐observer repeatability, one investigator performed 5 measurements on a single randomly selected 30‐sec recording from each minipig. Inter‐observer reproducibility was evaluated using Student’s t‐test for independent samples and Pearson’s correlation. Intra‐observer repeatability was assessed using coefficient of variation.

Results There were no statistically significant differences between the two investigators (p=0.347). The measurements performed by the two investigators were significantly correlated (r=0.999; p<0.001). Coefficient of variation was 0.2%, indicating very high intra‐observer repeatability.

Conclusion The results of the present study indicate that retinal vessel diameter can be reliably determined in minipigs using RVA with a microscope‐mounted fundus camera.
Peripheral endothelial function in ocular hypertensive patients after palmitoylethanolamide therapy: a flow mediated dilation study
Authors: STROBBE E , CELLINI M , GIZZI C , CAMPOS EC
Published: November 2010

Purpose To assess peripheral vascular endothelial function and IOP in patients with ocular hypertension (OH), before and after the use of Palmitoylethanolamide per os, using non‐invasive dependent flow mediated vasodilation (FMD).

Methods We studied 20 OH patients (12 females and 8 males) aged from 34 to 64 (mean 56.8+8.1 yrs). The diagnostic criteria for OH were: IOP exceeded 22 mm/hg, open anterior chamber angle, cup/disc ratio <0.4 and optic nerve related visual field loss (MD<3 dB, SF<2.5 dB and CPSD<3 dB). Patients assuming vasoactive drugs or with systemic diseases such as hypertension and diabetes mellitus were excluded. All patients underwent measurement of IOP with GAT and evaluation of FMD with high‐resolution 2‐dimensional ultrasonographic imaging of the brachial artery by a Philips ENVISOR echographic machine and a 4‐7Hz linear probe. To induce hyperemia a sphygmomanometer cuff was inflated to 250 mm/hg for 5 minutes. The cuff then was deflated rapidly and at 60 seconds after cuff deflation, 2‐D images of the brachial artery were recorded for 5 seconds. The measurement of FMD and IOP was made at baseline and after 3 months of Palmitoylethanolamide intake. A statistical analysis was made using the Student “t” test for unpaired data considering significant a p<0.05.

Results FMD before and after therapy with Palmitoylethanolamide was: 6.057±0.766% vs 8.856±1.142% (p<0.001); the IOP was, respectively: 23.11+0.93 mm/Hg vs 22.12+1.63 mm/Hg (p<0.023).

Conclusion Although it’s a small sample of cases, we found that in OH patients, after 3 months of intake, Palmitoylethanolamide improved the endothelial function and lowered the IOP without side effects.
The safety of intraocular beta2‐agonist in rabbit eyes
Authors: VAN CALSTER J
Published: November 2010

Purpose There is no known information on the use and safety of a long‐acting beta‐agonist, such as Clenbuterol when administered by intravitreal injection. Therefore, it is appropriate to perform this intravitreal injection in an animal model prior to start with a human experiment. The aim is to investigate the safety of an intravitreal injection of the beta2‐agonist Clenbuterol in rabbit eyes. This study is in preparation of using of this molecule in human eyes. That trial will be a monocentric, academic (investigator driven) trial to investigate the safety and efficacy of an intravitreal beta2‐agonist in patients with persistent subfoveal fluid after retinal detachment surgery. Approval of the ethics committee for the human trial has already been obtained, pending a re‐evaluation after the results of the animal study will be known.

Methods An intravitreal injection of 0,1 ml solution containing 0.08µg Clenbuterol or 0.1ml NaCl 0.9% was given in 10 eyes of 10 rabbits. The distribution occurred at random and was masked. A masked investigator examined both eyes after 1, 3 and 7 days (biomicroscopy, intraocular pression and ophthalmoscopy). After one week, the rabbits were sacrificed, the eyes enucleated and fixated for histopathological examination and electron microscopy by a masked investigator. Cell death was monitored by a DNase type I/II activity assay.

Results There was no clinical or histopathological difference between the clenbuterol and the control group.

Conclusion Clenbuterol is not toxic for the retina of rabbit eyes after intravitreal injection. It can be considered for the use in human eyes. Final approval of the ethics committee for the human trial is awaited.
Model of uveitis in rabbit
Authors: EPERON S , BALASKAS K , VAUDAUX J , RODRIGUEZ‐ALLER M , GURNY R , GUEX‐CROSIER Y
Published: November 2010

Purpose To develop a long‐term experimental model of uveitis using a new easier method for animals.

Methods A suspension of desiccated Mycobacterium tuberculosis H37RA was mixed with TiterMax® Gold Adjuvant to produce a water‐in‐oil emulsion. Pigmented rabbits were pre‐sensitized with a s.c. multisite injection (400 ul) of emulsion. Two challenges were performed by intravitreal injection of 100 ul of M. tuberculosis H37RA suspension, under systemic and topical anesthesia. Clinical examinations and aqueous humors punctures under systemic anesthesia were regularly performed till day 71. Hyperemia, chemosis, edema and secretion were clinically scored from 0 to 3. Ocular inflammation was assessed by: a) the clinical score mean (sum of individual scores divided by 4), b) the number of inflammatory cells in aqueous humor (AH) and c) the protein concentration in AH.

Results Rabbits presented a nodule at the sites of pre‐sensitization injection. Clinical score of inflammation reached a maximum 3 days after the first intravitreal challenge. The AH contained 835 cells/ ul and protein concentration in AH was 30 mg /ml. During the following days, inflammatory cell number and protein concentration in AH significantly decreased, whereas the clinical score returned to zero. The second intravitreal challenge induced an inflammation; six days after this challenge, 3800 cells/ul and 30 mg of proteins /ml were counted in AH. Inflammation remained high to moderate over 21 days at least.

Conclusion We developed a new model of experimental uveitis, whose schedule was simple. The use of TiterMax® Gold Adjuvant showed advantages over other adjuvants. And uveitis could be maintained during 21 days at least.
Demodex infestation and cylindrical dandruff
Authors: BONSHEK RE , IRION LD , ATAULLAH S , SAHA K
Published: November 2010

Purpose Cylindrical dandruff (CD) is usually bilateral and can be poor responsive to treatment. Demodex mites (DM) mites have been described to be associated with this condition.

Methods We present a series of cases of eyelid irritation and erythema associated with CD in which confirmation of infestation with DM was attempted through direct light microscopy of eyelashes. The following protocol for direct microscopy of eyelashes was performed: Lashes presenting adherent thick secretion at their insertion were collected from both sides and immediately mounted on glass slides with a drop of saline and a coverslip. A drop of alcohol was pipetted on to the slide to facilitate the identification of mites by increasing their movements. The slides were immediately examined under the microscope.

Results The presence of hair bulb was confirmed microscopically in all cases. DM mites were present in 4 of 6 cases. The mites were seen in the thick secretion adherent to the root of the hair. A few were loose adjacent to the hair.

Conclusion Direct microscopy of lashes is useful for confirmation of infestation with DM in cases of CD non‐responsive to treatment.
Posterior capsular opacification after cataract surgery in uveitis
Authors: ROUTLEDGE CE , HARDING J , TOMLINS PJ , MURRAY PI
Published: November 2010

Purpose Posterior capsular opacification (PCO) is commoner in uveitic eyes, yet the reasons for this are not fully understood. This study determines the incidence of PCO and Nd:YAG laser posterior capsulotomy after cataract surgery and implantation of a particular acrylic intraocular lens (IOL) in patients with uveitis, and identifies associated risk factors.

Methods A retrospective case series of patients with various types of uveitis, and a consecutive cohort of patients with age‐related cataract (controls) all undergoing phakoemulsification cataract surgery and implantation of a Rayner acrylic, hydrophilic IOL. Patients were identified from theatre and laser records. Patients from both cohorts were followed up for 2 years.

Results After 2 years, of the 219 control eyes identified only 4 (1.8%) had Nd:YAG capsulotomies performed. In the uveitis group, PCO occurred in 61 of 132 eyes (46.2%). Panuveitis was the commonest type of uveitis associated with the development of PCO (50.6%), and sarcoidosis (7/13 eyes, 53.8%), and Fuchs’ heterochromic cyclitis (7/16 eyes, 43.8%) were the most frequently associated conditions. The use of iris retractors or synechiolysis was not associated with PCO. Nd:YAG capsulotomy was required in only 10 of the 61 uveitic eyes (16.4%) with PCO.

Conclusion The Rayner acrylic, hydrophilic IOL appears to have a very low Nd:YAG rate after 2 years in patients having undergone uncomplicated phakoemulsification for age‐related cataract. Although almost 50% of uveitic eyes after 2 years developed PCO with this IOL, in the majority of those eyes it did not result in significant visual impairment as only 10 eyes required Nd:YAG capsulotomy.
Distribution of uveitis in a Belgian university referral center for ocular inflammation
Authors: JANSSENS S , WILLERMAIN F , MAKHOUL D , CASPERS L
Published: November 2010

Purpose : To study the clinical characteristics of patients with uveitis seen in our center.

Methods We have retrospectively analysed the charts of 567 patients with uveitis seen in the department of ophthalmology of the CHU St‐Pierre in Bruxelles, Belgium, between January 2004 and December 2008. Each patient was classified according to the clinical presentation, anatomic localization and results from the systemic work‐up.

Results Anterior uveitis was most frequent (61.9%) followed by panuveitis (21.7%), posterior uveitis (11.3%) and intermediate uveitis (5.11%). Anterior uveitis were non granulomatous in 59,8%, granulomatous in 29,1% and associated with keratitis in 11,1% of the cases. HLA‐B27 with or without seronegative SPA uveitis were the most frequent forms of anterior uveitis followed by herpes (including one third demonstrated by PCR). Intermediate uveitis were most often idiopathic or due to Fuchs uveitis syndrome. Behcet disease, followed by toxoplasmosis was the most frequent cause of posterior uveitis. Toxoplasmosis and sarcoïdosis were the most frequent causes of panuveitis.

Conclusion The distribution of the different forms of uveitis is relatively closed to other published studies for the referral tertiary center. Our high percentage of final diagnosis is in accordance with the more recent series. It might reflect a better definition of certain clinical entities and the development of new diagnostic tools.
Continuous oral versus single pulse intravenous corticosteroid in the prevention of inflammation following cataract surgery in uveitis patients
Authors: KAILEY A , TOMLINS PJ , RAUZ S , MURRAY PI
Published: November 2010

Purpose To compare post‐operative inflammation and development of cystoid macular oedema (CMO) in uveitis patients undergoing cataract surgery and intraocular lens (IOL) implantation who had either pre‐operative oral or intra‐venous (IV) corticosteroid.

Methods Retrospective case note study comparing uveitis patients undergoing phakoemulsification cataract surgery and implantation of an acrylic IOL (performed by one surgeon), having either oral corticosteroid (usually 40mg prednisolone two weeks prior to surgery and tapered by 5‐10mg weekly post‐operatively) or a single 500mg IV methylprednisolone pulse one hour prior to surgery.

Results 30 procedures (35 patients) were identified where pre‐operative oral corticosteroid had been given, and 93 procedures (76 patients) where IV corticosteroid was given. In the oral corticosteroid cohort there were 2 (7%) episodes of fibrinous uveitis and 4 (13%) episodes of CMO within 90 days of the surgery. In the IV cohort there were 3 (3%) episodes of fibrinous uveitis and 16 (17%) episodes of CMO within 90 days of surgery. There was no statistically significant difference in the number of episodes of fibrinous uveitis or CMO between the two groups.

Conclusion There was no difference in the incidence of post‐operative fibrinous uveitis or CMO in patients who were given either pre‐operative oral or IV corticosteroid. A single pulse of 500mg IV methylprednisolone appears a reasonable alternative to a course of oral prednisolone in uveitis patients undergoing cataract surgery.
Molecular epidemiology of adenoviral conjunctivitis in Athens, Greece
Authors: MOUSTAKA L , SPANAKI N , HALKIADAKIS I , STAUROPOULOU A , METAXAKI I , MAKRI T , VOYATZI A , TSAKRIS A
Published: November 2010

Purpose To investigate the genotypes (subgenera) and variant serotypes of adenoviruses (HAdV) causing epidemic keratoconjunctivitis (EKC) in Athens, Greece.

Methods Conjunctival swabs were collected from 55 patients aged 20 to 70 years old with a clinical presentation compatible with adenoviral conjunctivitis, during a four months period (from January until April 2010). Reverse transcription polymerase chain reaction (RT‐PCR) was performed to detect HAdV. The sequence of PCR products was analyzed to determine the subgenera of A,B,C,D,E, F and to identify variant serotypes of HAdV conjuctivitis by specific primers.

Results Of 55 samples, HAdV DNA was detected in 19 samples (34.5%). Severe keratitis diagnosed in about 42.1% of examined positive patients. The subgenera analysis showed HAdV‐D in all positive samples with serotypes HAdV‐8 (63.15%), HAdV‐19 (15.8%) and HAdV‐37 (21.05%). Abrupt of photophobia, tearing, pain and severe red eye with edema and pain of the upper lid occurred commonly with conjuctival scarring. Subepithelial corneal keratitis was developed and persisted for period up to three weeks.

Conclusion From the molecular analysis, HAdV‐8 was found to be the predominant serotype of the subgenus D of HAdV in Athens, Greece during the studied period.
Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema
Authors: EDWARDS P
Published: November 2010

Purpose To evaluate the safety and efficacy of intravitreal ranibizumab combined with prompt or deferred laser or intravitreal triamcinolone combined with prompt laser compared to laser alone for diabetic macular edema (DME).

Methods 691 study participants (854 eyes) with center‐involved DME and visual acuity 20/32 to 20/320 were enrolled in a multi‐center randomized clinical trial. Eyes were randomized to Group A: sham injection+prompt laser (n = 293), Group B: 0.5‐mg intravitreal ranibizumab+prompt laser (n = 187), Group C: 0.5‐mg intravitreal ranibizumab+deferred laser (n = 188), or Group D: 4‐mg intravitreal triamcinolone+prompt laser (n = 186).

Results The 1‐year mean change in the visual acuity letter score from baseline was significantly greater in Group B (+9, P<0.001) and Group C (+9, P<0.001) but not in Group D (+4, P = 0.31) compared with Group A (+3). Reduction in mean central subfield thickness in Group D was similar to Groups B&C and greater than Group A.. Traction retinal detachment (0.3%) and endophthalmitis (0.8%) occurred infrequently in Groups B&C, while cataract and elevated IOP occurred more often in Group D.

Conclusion At 1 year intravitreal ranibizumab with prompt or deferred laser is more effective compared with prompt laser alone for the treatment of center involved DME. Intravitreal triamciolone+ laser did not result in superior visual acuity outcomes compared with laser alone. Ranibizumab as applied in this study, although uncommonly associated with endophthalmitis, should be considered for patients with DME and characteristics similar to those in this clinical trial. Supported through a cooperative agreement from the NEI and the NIDDK, National
Clinical accuracy of focal laser treatment for diabetic macular edema using a retinal navigated laser (Navilas®)
Authors: KERNT M , WOLF A , HARITOGLOU CH , CHEUTEU R , ULBIG MW , KAMPIK A , NEUBAUER AS
Published: November 2010

Purpose To investigate accuracy of a navigating laser photo‐coagulator in clinically significant macular edema.

Methods Focal laser in 20 patients was digitally planned on fundus images and performed with navigation using Navilas® (OD‐OS GmbH, Teltow, Germany). On color images, OCT and autofluorescence we analyzed 784 laser spots (mean 39 per eye) at one week follow‐up and determined accuracy of spot placement using an image flicker method.

Results 76% of lesions were visible on color images, 95% were within 100 µm from the planned target. OCT confirmed that laser effects were limited to the outer retina.

Conclusion Navilas® laser effects were visualized to high percentage on post‐treatment images, location showed high concordance to preplanning.
Pegaptanib in diabetic macular edema (dme): vision related quality of life (qol) results from a phase 2/3, 2‐year, double‐masked trial
Authors: LOFTUS J , PLEIL A , MACUGEN 1013 STUDY GROUP
Published: November 2010

Purpose To compare self‐reported vision functioning and vision related‐QoL in patients with DME treated with intravitreous pegaptanib 0.3 mg versus sham injection.

Methods This randomized (1:1), controlled, multicenter trial included subjects with DME (center point thickness on OCT ≥250 µm) and visual acuity (VA) ≤65 letters and ≥35 letters. In Year 1, pegaptanib or sham was administered every 6 weeks with focal/grid photocoagulation at investigator discretion after week 18. Subjects received injections as often as every 6 weeks per prespecified criteria in Year 2. The primary efficacy endpoint was the proportion gaining ≥10 letters from baseline to week 54. Change in visual functioning from baseline to Weeks 54 was assessed with the National Eye Institute – Visual Functioning Questionnaire.

Results 133 pegaptanib‐ and 127 sham‐treated subjects were in the Year 1 modified intent‐to‐treat population. From baseline to Week 54, gains of ≥10 letters were seen in 49 (36.8%) pegaptanib and 25 (19.7%) sham‐treated subjects (odds ratio [95% CI]: 2.38 [1.32,4.30], P=0.0047). The subscales of Near Vision, Distance Vision, and Social Functioning (Week 54) demonstrated clinically meaningful (>5‐point between‐group difference) and statistically significant (P<0.05) benefits favoring pegaptanib. A positive numerical trend in favour of pegaptanib was observed for the Composite Score and the majority of other subscales.

Conclusion The vision improvement from pegaptanib treatment compared to sham is associated with improved visual functioning as reported by the DME patient.

Commercial interest
Association of endothelial lipase Thr111ile polymorphism with diabetic retinopathy in type 2 diabetic patients
Authors: LECLERCQ I
Published: November 2010

Purpose Identifying risk factors for diabetic retinopathy (DR) is a major challenge in order to meet the increasing screening workload. Endothelial lipase is a key enzyme in lipid metabolism, thus a polymorphism in the EL gene may be a candidate for modulating the incidence of microangiopathy in type 2 diabetic subjects.To characterize the features of diabetic retinopathy in case of polymorphism in endothelial lipase (EL) gene.

Methods In a group of 396 NIDD M patients (mean age=59.5 years, mean BMI=28.9 kg/m2, and mean HbA1C=8.2%), the c.584C>T polymorphism (rs2000813, p.Thr111Ile) was found in 225 males (frequency of c.584T=0.351) and 171 females (frequency of c.584T=0.304).

Results Homozygosity for the minor allele was significantly associated with the frequency of retinopathy (2=4.996, 1df, p=0.025) with homozygous subjects being more likely to have diabetic retinopathy (OR 3.505; 95%CI: 1.491‐8.239). In this group, proliferative DR was most frequently encountered (33,3%), followed by minimal non proliferative DR (28,5%), severe nonproliferative DR (26,2%) and moderate non proliferative (12%).

Conclusion The presence of this polymorphism of the EL gene might be useful to identify a subgroup of diabetic patients at high risk for developing sight threatening proliferative diabetic retinopathy.
Mechanisms underlying the protective effects of calcium dobesilate against the breakdown of blood‐retinal barrier induced by diabetes
Authors: AMBROSIO A , LEAL E , MARTINS J , VOABIL P , LIBERAL J , CHIAVAROLI C , BAUER J , CUNHA‐VAZ J
Published: November 2010

Purpose Calcium dobesilate (CaD) is used in the treatment of diabetic retinopathy, but its mechanism of action is not completely elucidated. We investigated the molecular and cellular mechanisms underlying the protective effects of CaD against the blood‐retinal barrier (BRB) breakdown induced by diabetes.

Methods Wistar rats were divided into: controls, diabetic (1 month diabetes duration) and diabetic treated with CaD (100 mg/kg/day; orally given) during the last 10 days. The BRB breakdown was evaluated using Evans blue. The content or distribution of occludin, claudin‐5, ZO‐1, ICAM‐1 and p38 MAPK was evaluated by western blotting and immunohistochemistry. Leukocyte adhesion was evaluated in retinal vessels and in vitro. Oxidative stress was evaluated by the detection of oxidized carbonyls and tyrosine nitration. NF‐κB activation was measured by ELISA.

Results Diabetes increased the BRB permeability and retinal thickness, decreased occludin and claudin‐5 levels, and altered the distribution of ZO‐1 and occludin in retinal vessels. CaD inhibited these changes, as well as the increase in ICAM‐1 levels and leukocyte adhesion to retinal vessels or endothelial cells induced by diabetes or high glucose. Moreover, CaD decreased oxidative stress, and p38 MAPK and NF‐κB activation caused by diabetes.

Conclusion CaD prevents the BRB breakdown induced by diabetes by restoring tight junction protein levels and organization and decreasing leukocyte adhesion to retinal vessels. The protective effects of CaD are likely to involve the inhibition of p38 MAPK and NF‐κB activation, possibly through the inhibition of oxidative/nitrosative stress. Support: OM Pharma SA, Switzerland
Evaluation of different automated fundus photograph analysis algorithms for detecting and grading diabetic retinopathy
Authors: VALVERDE C , GARCíA M , HORNERO R , DIEZ A , LOPEZ MI
Published: November 2010

Purpose Diabetic Retinopathy (DR) is an important cause of visual impairment in industrialised countries. Automatic detection of DR primary lesions can contribute to the diagnosis and grading of the disease. The aim of this study was to develop an automated algorithm and a computer assisted diagnosis system for the detection of DR and diabetic macular edema (DME).

Methods To achieve this goal, we extracted a set of colour and shape features from image regions and performed feature selection using logistic regression. Four neural network (NN) based classifiers were subsequently used to obtain the final segmentation of Hard exudates, Microaneurysms and Haemorraghes; multilayer perceptron (MLP), radial basis function (RBF), support vector machine (SVM) and a combination of these three NNs using a majority voting (MV) schema. The database was composed of 117 images.

Results Attending to performance and complexity criteria, the best results for primary lesions were obtained for RBF. Using an image‐based criterion, a mean sensitivity of 100%, mean specificity of 70.4% and mean accuracy of 88.1% were achieved for hard exudates and a mean sensitivity of 100%, and mean accuracy of 83.08% for haemorraghes.

Conclusion This study shows that algorithms based in NNs for computer‐aided diagnosis are a reliable alternative to time‐consuming manual screening of diabetic retinopathy.
Intravitreal ranibizumab and bevacizumab to treat diabetic macular edema
Authors: MONTERO MORENO JA , RUIZ MORENO JM
Published: November 2010

Purpose To report the comparative efficacy of intravitreal bevacizumab and ranibizumab in the treatment of diabetic macular oedema (DME).

Methods Interventional, case report series. Two patients who were on treatment for DME by monthly intravitreal ranibizumab in one eye, were started on treatment by intravitreal bevacizumab for DME in the fellow eye. The patients were monthly evaluated by complete ocular examination, best corrected visual acuity (BCVA) performed by certified optometrists and Stratus optical coherence tomography (OCT).

Results Eyes treated by intravitreal ranibizumab showed a complete resolution of DME as documented by OCT and significantly improved BCVA. DME recurred after two to three months requiring further injections. The fellow eyes showed a progression of DME and decreased BCVA while untreated. Intravitreal bevacizumab did not induce any significant change in macular thickness or BCVA and did not prevent DME progression.

Conclusion Intravitreal ranibizumab seems to improve BCVA and macular thickness in DME though recurrence of the condition makes it necessary to repeat intravitreal injections. Intravitreal bevacizumab does not seem to reduce macular thickness or improve visual function in patients with DME in whom good results had been observed after intravitreal ranibizumab.

Commercial interest
Retinal vascular reactivity and kidney function in type 2 NPDR
Authors: KHUU LA , PUZYEYEVA O , FLANAGAN JG , HUDSON C , LAM WC , WONG T , MARKOWITZ SN , BRENT M , MANDELCORN M , DEVENYI RG
Published: November 2010

Purpose To investigate the association between retinal vascular function and kidney function in non‐proliferative diabetic retinopathy (NPDR).

Methods 10 control subjects (mean age 55±12yrs), 22 type 2 patients with mild‐to‐moderate NPDR (61±9yrs) and 14 type 2 patients with moderate‐to‐severe (62±11yrs) NPDR were recruited. Retinal vessel diameter, velocity, velocity pulse amplitude and blood flow were assessed in the supero‐temporal arteriole using bi‐directional laser Doppler flowmetry and simultaneous vessel reflectometry. Retinal vascular reactivity (VR) was quantified as the difference in hemodynamic parameters between baseline and isocapnic hyperoxia. Forearm blood samples were taken to derive plasma sodium, creatinine, albumin, glomerular filtration rate (GFR) and hemoglobin (A1c) levels. Urine samples were taken to derive albumin:creatinine ratio (A:C ratio) and microalbumin. All parameters were compared between groups and VR was correlated with systemic markers.

Results VR for vessel diameter, velocity, pulse amplitude and blood flow were not different between groups. A:C ratio (ANOVA, p=0.010), microalbumin (p=0.005) and A1c (p=0.006) were elevated in patients with diabetes. The magnitude of VR for retinal vessel diameter was weakly correlated with GFR across the pooled groups (r=‐0.3992, p=0.006). Within the moderate‐to‐severe NPDR group, VR for vessel diameter was strongly correlated with GFR (r=‐0.8551, p=0.001). VR for pulse amplitude was also found to be moderately related to plasma Na levels in moderate‐to‐severe NPDR group (r=‐0.6809, p=0.007).

Conclusion Disturbance of retinal VR was related to kidney function in patients with NPDR, especially in the moderate‐to‐severe group.