bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal arteriolar vascular reactivity to incremental changes in hyperoxic stimuli during isocapnia
Authors: HUDSON C , TONG A , HAN J , MARDIMAE A , WONG T , FISHER J
Published: September 2008

Purpose To determine the relationship between the magnitude of retinal arteriolar vascular reactivity and incremental changes in hyperoxic stimuli whilst maintaining isocapnia.

Methods Twelve healthy, young adults (mean age 27 years, SD 4) participated in a gas protocol consisting of 4 phases at varying fractional expired oxygen levels (FeO2): baseline (15%), hyperoxia I (40%), hyperoxia II (65%), and recovery (15%). End‐tidal carbon dioxide (ETCO2) was maintained at isocapnia throughout the experiment. Retinal arteriolar diameter, blood velocity, and blood flow were assessed non‐invasively using the Canon Laser Blood Flowmeter during each of these phases.

Results Repeated measures ANOVA showed that there were significant influences of incremental changes in FeO2 on retinal arteriolar diameter (p<0.0001), blood velocity (p<0.0001), and blood flow (p<0.0001). Paired t‐tests of these retinal hemodynamic parameters during each phase in the gas sequence showed they were significantly different (p<0.05) from each other, with the exception of baseline and recovery values. Incremental increases in FeO2 caused a linear decrease in group mean arteriolar diameter (R2 = 1, p = 0.002), group mean blood velocity (R2 = 0.9968, p = 0.04), and group mean blood flow (R2 = 0.9982, p= 0.03).

Conclusion Isocapnic hyperoxia elicits vasoconstriction and the reduction of retinal arteriolar diameter, velocity and blood flow in a dose‐dependent manner over the range of FeO2 explored in this study.

Commercial interest
DNA profile strongly associated with exudative age‐related macular degeneration
Authors: CARTER JG , ARISTODEMOU P , CHERRY J , CHURCHILL AJ
Published: September 2008

Purpose The genetics of age‐related macular degeneration (AMD) is slowly unfolding with the recent discovery that single nucleotide polymorphisms (SNPs) in 4 genes, Complement Factor H (CFH), ARMS2/LOC387715, HTRA1 and Vascular endothelial growth factor (VEGF) independently confer a greater risk of disease. We have taken this further and analyzed a combined DNA profile for the SNPs in these 4 genes.

Methods Patients with exudative AMD (n=45) and age‐matched controls (n=94) were genotyped for the CFH Y402H (rs1061170), ARMS2 A69S (rs10490924), HTRA1 ‐512 (rs11200638), and the VEGF +674 (rs1413711) polymorphisms, by RFLP, AS‐PCR and randomized sequencing. Statistical analysis was carried out for each individual loci and into a combined DNA profile using the PHASE program.

Results Association of the VEGF +674CC genotype with AMD has been previously reported. We observed strong associations with AMD and the CFH‐CC [OR=11.9 (4.5,31.3), p=0.0000000184], ARMS2‐TT [OR=4.7 (1.6, 13.8), p=0.0023] and HTRA1‐AA [OR=3.6 (1.3,10.1), p=0.0128] genotypes respectively. We also observed strong linkage disequilibrium between rs10490924 and rs11200638 (r2=0.9138), as seen in previous studies. However, possession of the 4 SNP DNA profile: CTAC (CFH/ARMS2/HTRA1/VEGF) is strongly associated with AMD [OR=63.0 (8.3, 475.4), p<0.00001].

Conclusion Past associations between CFH, ARMS2 & HTRA1 have already been reported, and this data further supports this. However, the possession of the CTAC ‘at risk’ DNA profile shows the potential combined effects of these three genes, and their strong association with AMD. It is now possible to identify those most at risk in the general population allowing lifestyle choices to be made that could reduce the overall risk of AMD.
The role of factor h macular degeneration secondary to pathologic myopia
Authors: BARBAZETTO I , YANNUZZI L , ALLIKMETS R
Published: September 2008

Purpose To compare the frequency of genes associated with age‐related macular degeneration (AMD), specifically the complement factor H alleles in patients with choroidal neovascularization (CNV) secondary to pathologic myopia (CNV).

Methods Patients with pathologic myopia (defined as axial length > 25.50mm or ‐ 6.00 dpt) were examined. The presence of choroidal neovascularization was confirmed by clinical examination and fundus photography; fluorescein angiography and autofluorescence images were analyzed when available. DNA samples from all study subjects were screened for variants in the CFH genes, commonly associated with age‐related macular degeneration.

Results Seventy‐three patients (47 female and 36 male; age 23 – 90 years; average: 59 years) were included into the study. Visual acuity ranged from 20/25 to count fingers in 1 meter. The frequency of the CFH Y402H as well as other common CFH polymorphisms in this cohort corresponded to that detected in the general population.

Conclusion Factor h variants commonly associated with AMD and other forms of CNV may not play a causal role in neovascular complications of pathologic myopia.
Phenotyping parallel visual pathways in autosomal dominant optic atrophy
Authors: REIS AA , VIEGAS T , MATEUS CD , SILVA ED , CASTELO‐BRANCO M
Published: September 2008

Purpose To characterize different phenotypes of Kjer optic atrophy along different visual pathways.

Methods Novel computerized psychophysical assessment methods (CCT ‐ Cambridge Colour Test and CSF ‐ Metropsis Contrast Sensitivity Function Test) were used to evaluate visual function in a population of 13 subjects (26 eyes) from 8 families with Autosomal Dominant Optic Atrophy (ADOA). This evaluation was completed with electrophysiological assessment (Pattern ERG, Pattern and Multifocal VEP) and Automated Static Perimetry (ASP).

Results CCT shows evidence for severe damage of all cone populations (p<<0.0001), and of similar magnitude, implying concomitant damage of parvo and koniocellular pathways. Achromatic contrast sensitivity is severely impaired for all six spatial frequency channels studied (p<0.002), suggesting mixed magno/parvocellular impairment. A decrease of both P‐50 and N‐95 amplitudes of PERG is found (p<<0.001), while implicit times are normal. MfVEP results show significant impairment in amplitudes of the most central rings (1, 2 ‐ p<0.001), with concomitant local increased implicit times, no significant changes being found at most eccentric rings. Pattern VEP impairment is consistent with these results. Amplitude values of MfVEP in visual quadrants are significantly correlated with the decreased retinal sensitivity obtained in the 4 quadrants by ASP.

Conclusion Our results suggest that all functional types of nerve fibers are damaged in ADOA, with a predominance of the parvocellular ones. Multimodal psychophysical and electrophysiological methods are good quantitative markers to understand the pathophysiology of damage of central and peripheral pathways in this condition.
OCT and small melanocytic tumors
Authors: GRANGE JD , GARNIER S , KODJIKIAN L , BENBOUZID F
Published: September 2008

Abstract not provided
PDT for amelanotic choroidal melanoma
Authors: BLASI MA , VALENTE P , TIBERTI AC , SCUPOLA A , BALESTRAZZI E
Published: September 2008

Abstract not provided
Modified enucleation for choroidal melanoma with large extrascleral extension
Authors: PARROZZANI R , URBAN F , GURABARDHI M , MIDENA E
Published: September 2008

Purpose To describe the technique and results of modified (enlarged) enucleation via lateral orbitotomy for choroidal melanomas with macroscopic periopticposterior extrascleral extension.

Methods 5 cases of choroidal melanoma with macroscopic periopticposterior entrascleral extension underwent modified enucleation via lateral orbitotomy. After lateral orbitotomy and orbital mass exposure with direct tumor visualization, a long optic nerve stump was cut and the orbital component of the tumor was completely (macroscopically) removed along with the globe in all cases. After haemostasis and orbital reconstruction an orbital implant was than placed. Follow up was longer than 12 months

Results After pathologic examination, the tumor result completely removed in 5 patients (100%). Excellent cosmetic outcome was achieved in all cases (100%) without operative or postoperative complications.

Conclusion Modified (enlarged) enucleation via lateral orbitotomy for choroidal melanomas with macroscopic perioptic/posterior extrascleral extension allows placement of an orbital implant avoiding the long healing process of orbital exenteration with excellent clinical and cosmetic outcome.
Small, fatal choroidal melanoma: a retrospective study of patients treated in Liverpool
Authors: DAMATO B , COUPLAND S
Published: September 2008

Purpose To review the Liverpool experience of small, fatal uveal melanomas.

Methods We searched the database of the Liverpool Ocular Oncology Service for British patients dying from metastatic disease after treatment of a uveal melanoma having a basal diameter less than 10.0mm (i.e., ‘small melanoma’). The cause of death was obtained from death certificates provided by the National Health Service Cancer Registry.

Results Of the 3186 patients first treated for uveal melanoma in Liverpool between January 1993 and July 2008, there were 994 (31%) with a small melanoma. In 803 of these patients residing in mainland Britain, the 15‐year actuarial survival was 88.4%. The 35 patients dying of melanoma (19 female, 16 male) had a median age of 72 years at primary treatment (range 43‐88). The tumours had a median diameter of 7.6mm (range 3.2‐9.9) with nine measuring less than 7.0mm. The posterior tumour margin was located in iris in 1 patient, ciliary body in 6 patients and choroid in 29 patients. The initial management consisted of brachytherapy (14 patients), proton beam radiotherapy (9), enucleation (5), local resection (2), transpupillary thermotherapy (3) and observation (2). Histological studies had been performed in 11 tumours, 9 of which contained epithelioid cells. Cytogenetic data were available for four tumours, two of which showed monosomy 3. Three patients had developed local tumour recurrence after their initial treatment. The median time to death was 4.8 years (range 0.1 – 13.7). This survival time was longer than in fatal cases with a medium‐sized or large tumour (Log rank, p<0.001).

Conclusion Multicentre studies are indicated to understand the metastatic process and how this is influenced by ocular treatment.
Ten smallest melanomas that killed the patient – a very long‐term analysis
Authors: KIVELÄ T , KUJALA E , TOIVONEN P
Published: September 2008

Purpose To characterise the nature and course of smallest uveal melanomas that were fatal in a very long‐term follow‐up study.

Methods Charts of 289 consecutive patients with choroidal and ciliary body melanoma treated in the Helsinki University Central Hospital district in 1962‐1981 were used to identify and those ten patients who died from the smallest tumours during the subsequent 30‐40 years. In this period, enucleation was the only treatment available.

Results Altogether 41 (14%) melanomas were <10 mm in diameter, and 10 (25%) of these were fatal long‐term. For this size of tumour, the 5‐, 10‐, 15‐, 20‐ and 30‐year actuarial survival, which cancels the effect of other causes of death, was 90%, 85%, 80%, 80% and 70%, respectively. The 10 patients who died of melanoma were a median of 54 y (compared with 54 y for those who survived) old at treatment (range 33‐73 vs. 30‐74). The median tumour diameter was 7.5 vs. 8 mm (range 6‐9 vs. 3‐9), with 2 of 10 (20%) vs. 5 of 31 (16%) tumours measuring <7 mm. The median tumour height was 4 vs. 4.5 mm (range 2‐8 vs. 1‐11), with 2 of 10 (20%) vs. 7 of 31 (23%) tumours measuring less than 3 mm; thus, not all were “small” melanomas. 1 (10%) vs. 3 (10%) tumours extended to ciliary body and 0 vs. 1 extended extrasclerally; none of the patients developed local tumour recurrence. The median time to death was 6.7 y (range 1.2‐33). The two smallest fatal tumors were 6 and 7 mm in diameter and 2 mm in height.

Conclusion The smallest ciliochoroidal melanomas that are fatal do not differ clinically at diagnosis from nonfatal melanomas in the same size range. A multicenter histopathologic and tumor cytogenetic analysis is necessary to characterise small melanomas as close to the time point when they acquire metastatic potential as possible.
Mapping of photoreceptor dysfunction using high resolution, three‐dimensional spectral optical coherence tomography
Authors: SIKORSKI BL , SZKULMOWSKI M , KALUZNY JJ , SZKULMOWSKA A , KOWALCZYK A , WOJTKOWSKI M
Published: September 2008

Purpose To introduce a novel method of 3‐D Spectral Optical Coherence Tomography (SOCT) data analysis called reflectivity maps.

Methods We introduced new software to perform segmentation of the junction between photoreceptor inner and outer segments (IS/OS) at 2‐D tomograms. After segmentation, each cross‐sectional image is transformed in such a fashion that posterior contour of the retina becomes a straight line but all radial distances within each cross section are preserved. It enables us to display the distribution of a back‐reflected intensity taken only from individual retinal layers located at specific distance from the reference plane and create reflectivity maps. We analysed the reflectivity maps of the IS/OS layer of 56 patients with photoreceptor dysfunction in course of age‐related macular degeneration, central serous chorioretinopathy, macular holes, retinal detachment, acute zonal occult outer retinopathy, multiple evanescent white dot syndrome, acute posterior multifocal placoid pigment epitheliopathy, drug‐induced retinopathy and congenital disorders.

Results The reflectivity maps of the IS/OS layer displayed the areas of photoreceptor dysfunction.

Conclusion Subtle changes in the IS/OS reflectivity can be detected and presented as SOCT reflectivity maps. The maps reveal the areas of photoreceptor dysfunction and can be correlated with standard techniques like fluorescein angiography and electrophysiological examination. We believe that the use of 3‐D analysis of segmented IS/OS layer in larger number of retinal pathologies may help in better understanding of photoreceptor dysfunction and allow for more accurate interpretation of the IS/OS layer on SOCT images.
Use of intravitreal Ketorolac tromethamine for postoperative cystoid macular edema
Authors: TSILIMBARIS MK , TSIKA CI , PANDELEONDIDIS V , PANAGIOTOGLOU T , KYMIONIS G
Published: September 2008

Purpose To investigate the effect of intravitreal ketorolac tromethamine in chronic post‐operative cystoid macular edema.

Methods Six patients diagnosed with chronic post‐operative CME non responsive in conventional therapies, were enrolled. 2 patients received 2 intravitreal injections of 300 μg (0.05ml) of ketorolac tromethamine (Toradol) with a 3‐week interval, three patients received 4 consecutive injections of 500 μg (0.05ml) weekly and 3 patients received 4 consecutive injections of 500 μg (0.05ml) daily. Patients were followed by means of biomicroscopy, fluorescein angiography and optical coherent tomography. Follow‐up lasted up to six months.

Results No adverse effect was noticed in any of the patients. A trend for visual acuity improvement and macular edema regression was noticed after initiation of the therapy. A rebound of the edema happened usually a week after the last injection. In the long follow‐up regression of the macular edema was noticed in three out of six patients.

Conclusion This pilot study indicates a possible role of intravitreal injection of ketorolac tromethamine in patients with chronic postoperative cystoid macular edema. Further research is warranted in order to obtain conclusive results concerning doses and timing of injections.
Ophthalmic microsporidiosis: Emerging pathogens or emerging awareness?
Authors: BONSHEK RE , IRION LD , CURRY A
Published: September 2008

Purpose We report and discuss an apparent increase in the number of ocular and adnexal microsporidial infections.

Methods We present cases of ocular microsporidial infection which were diagnosed by light (LM) and electron microscopy (EM) at our departments and review the literature.

Results Cases involved Encephalitozoon, Vittaforma, Trachipleistophora and Nosema sp. with infection of ocular surface, corneal stroma, canaliculi and nasolacrimal apparatus.

Conclusion Microsporidia are minute obligate intracellular parasites which infect via a polar tube. Human microsporidiosis is normally HIV/AIDS related, most infections being enteric with few ocular cases. With the success of antiretrovirals, the incidence of enteric microsporidiosis is now much lower. Ocular infection is now more prevalent and not usually HIV‐associated. Our cases had infection of ocular surface, cornea and lacrimal canal/sac. The diagnosis was not initially considered clinically. LM may be diagnostic if characteristic refractile ZN‐positive microspores are seen. If they are few or are not identified, LM is not diagnostic. LM does not permit speciation which usually requires EM. Diligent search for organisms may be necessary as distribution may be focal. Insufficient data exist to allow PCR‐based diagnosis of most microsporidial species. Sources and mechanisms of infection remain speculative. Insect infection is abundant. Spores are present in water. Microsporidia are poikilothermic. Microsporidiosis occurs in animals. Does the eye's immune status and lower surface temperature favour opportunistic infection by organisms adapted to lower temperatures in insects? Are animals vectors? Is travel to "exotic" places a factor? Are microsporidia emerging pathogens or are they simply not recognised?
Lyme borreliosis: different ocular aspects of the same disease in North‐West of Italy
Authors: ALLEGRI P , MASTROMARINO A , RISSOTTO R , MURIALDO U
Published: September 2008

Purpose To show different presentations of ocular Lyme disease in an endemic area (North‐West of Italy)

Methods In last ten years, at Lavagna (Genova) uveitis referral centre, we examined about a hundred people affected by Lyme ocular disease (57 males and 45 females; mean age 42 +/‐ 3.2 years) and we were able to recognize some different ocular manifestations of this affection in 133 eyes. Diagnosis was made by means of ELISA or Western‐Blot tests;sometimes by PCR test. Different systemic symptoms were present: 53% of patients had inflammatory arthropathy, 24% erythema migrans, 13% neuro‐ophthalmologic findings.

Results Five main groups of Lyme disease ocular involvement were detected from our long‐term study: 1 ‐ diplopia and periocular pain 2 ‐ diffuse or nodular episcleritis 3 ‐ acute anterior uveitis 4 ‐ retinal vasculitis and papillitis 5 ‐ retino‐choroiditis Group 4 and 5 were the more frequent bilateral presentation. Our study shows slit‐lamp, FA, ICG‐A and OCT pictures of these different Lyme disease presentations. Antibiotic treatment of early diagnosed infection allowed a complete recovery in 79 patients.

Conclusion Lyme ocular disease, because of its peculiar characteristic of being able to mimic a lot of ocular inflammations, may be underdiagnosed by ophthalmologists; aim of our work is to show and to point out some different ocular presentations of this disease
Developments in diagnosing the tubulointerstitial nephritis and uveitis (TINU) syndrome
Authors: MACKENSEN F , DAVID F , SCHWENGER V , LEVINSON R , RAJALINGAM R , BECKER MD , MARTIN TM , ROSENBAUM JT
Published: September 2008

Purpose Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare form of uveitis but there is reason to believe that this syndrome is underdiagnosed and renal manifestation may not be treated. Gold standard for diagnosisng TINU is invasive renal biopsy. Here, we show that performing beta‐2 microglobulin analysis in urine and HLA typing is helpful to find otherwise undiagnosed TINU cases with subclinical forms of nephritis.

Methods Beginning January 2006 we prospectively obtained Ub2MG levels in all children with AU attending our pediatric uveitis clinic for the first time. Mandeville criteria were used to grade certainty of diagnosis. We compared with a healthy control group of children. HLA typing on patients with AU but no nephritis (n =28) by a Luminex‐based PCR‐SSO typing method was performed in another study. We compared frequencies to normal published controls and a published TINU cohort (n=20).

Results The simple screening method of determining urinary Beta‐2‐Mikroglobulin showed in up to 2/3 of children with new‐onset AU subclinical renal manifestation. HLA Typing showed the TINU associated HLA DRB1*0102 in 12.5% of patients with AU with normal renal function opposed to 0.6% in healthy controls (p <0.0001; RR 14.3 (8.3‐32.0)). The allele was even more frequent in patients < 20 years with AU with 40%.

Conclusion Determining the right uveitis subset is essential for therapy and prognosis, therefore TINU has to be kept in mind when considering differential diagnosis of AU. Urinary Beta‐2 micorglobulin and HLA Typing can give helpful information to direct this process.
Changes in macular pigment optical density and serum concentrations of lutein and zeaxanthin, in response to weight loss
Authors: KIRBY M , HARRISON M , BEATTY S , NOLAN J
Published: September 2008

Purpose Studies investigating the relationship between macular pigment optical density (MPOD) and percentage body fat have consistently shown an inverse relationship between these variables. This study was designed to investigate changes in MPOD, and serum concentrations of lutein (L) and zeaxanthin (Z), in response to a weight loss.

Methods We plan to recruit 100 subjects into this 12 month, multi‐visit, randomized‐controlled study. Adiposity was assessed by dual energy x‐ray absorbtiometry (DEXA), MPOD was measured using customised heterochromatic flicker photometry (cHFP). Dietary and exercise intervention was provided to subjects enrolled into the intervention group of this study. Inclusion criteria were: age 18‐60 years; body mass index > 28; absence of any ocular pathology; lack of a family history of age‐related maculopathy.

Results To date, 93 subjects have been recruited. 22% of existing intervention subjects have lost ≥ 7 kgs in weight. A further 27% have lost up to 3.5 kgs in weight, and are maintaining this trend. Of note, preliminary statistical analysis of 11 subjects based on their 6 month data, indicate a positive, but statistically insignificant, relationship between MPOD and percentage body fat lost.

Conclusion Preliminary results indicate a positive relationship between MPOD and weight loss. We await completion of this study and analysis of final results to allow us to comment further on this interesting relationship.
Aspheric optics, theoretical considerations
Authors: UNSBO P
Published: September 2008

Spherical aberration is the largest higher‐order aberration in the human eye and it is the only aberration with a nonzero population average. Furthermore, in contrast to other aberrations such as, e. g., coma, spherical aberration can be corrected by rotationally symmetric optical surfaces, so called aspheric optics. These facts form the basis for an increasing number of both IOL’s and contact lenses which manipulate the spherical aberration in the eye. This talk will give a background on spherical aberration and state of the art aberration measurements in the human eye. Different aspects of ocular spherical aberration will be reviewed and the implications and possible visual benefits of correcting, or even inducing, spherical aberration will be discussed.
Clinical experience in aspheric IOLs ‐ a review of the world literature
Authors: LIU C
Published: September 2008

The natural crystalline lens continues to grow throughout life. In early adult life, the asphericity of the cornea and the lens more or less cancel each other out. Later in life, this balance is lost and older subjects experience poorer quality vision. During cataract surgery, there is an opportunity to redress this balance, or at least not add to the problem of positive spherical aberration by implanting IOLs with aspheric optics. Results from the emerging literature suggests that patients do have higher quality vision, including when an aspheric mulitfocal IOL such as the Alcon ReSTOR SN6AD3 is used. However, there may be problems with IOLs with deliberate negative spherical aberrations if decentration and tilt should occur. Also, the approach is one size fits all, and is not tailored to the optics of individual eyes. There is a great variation in corneal spherical aberrations in normal individuals.
Long‐term results of cataract surgery with implantation of a mechanically, reversibly adjustable intraocular lens: *Acri.Tec AR‐1 PC/IOL
Authors: JAHN CE , STEFIKOVA K
Published: September 2008

Purpose To investigate long‐term safety and function of a mechanically, reversibly adjustable intraocular lens in human eyes

Methods Clinical long‐term monitoring of the initial 38 eyes of 38 patients with senile cataract after implantation of the *Acri.Tec AR‐1 PC/IOL including a control group.

Results Median follow‐up was 25 (range 6 to 52 months). Throughout the entire period of observation all eyes were behaving clinically in the same way as if implanted with a conventionel PC/IOL. 2 eyes were adjusted surgically 2 weeks after implantation. 19/38 eyes underwent Nd:YAG laser capsulotomy after a median period of 12 (range 6 to 43) months after implantation. Median change of spherical equivalent between 1 month and the last visit was 0 (range – 0.5 to + 0.5) diopters. At the last visit median best visual acuity was 0.7 (range 0.2 to 1.0) for eyes with the *Acri.Tec AR‐1 PC/IOL and 0.8( range 0.3 to 1.0) for the control group. Both eyes having undergone adjustment surgery had visual acuity of 0.8 rsp 1.0 with stable refractions 45 rsp. 42 months after adjustment surgery.

Conclusion The *Acri.Tec AR‐1 PC/IOL implanted into the capsular bag of adult human eyes is a safe PC/IOL. Refraction is predictably adjustable after implantation. It remains stable before and after Nd:YAG laser capsulotomy or after surgical adjustment of the refraction. This type of IOL may prove helpful especially in pediatric cataract surgery to avoid the development of amblyopia and in adults when precise refractive outcome is important either because of individual preference of the patient for a preferred refraction or because of intendend monovision to reduce spectacle dependence to a minimum.

Commercial interest
Effect of dietary omega‐3 and omega‐6 fatty acids on IOP elevation, electroretinographic changes and retinal ganglion cell loss in a rat model of glaucoma induced by laser
Authors: BRON AM , SCHNEBELEN C , SALINAS‐NAVARRO M , ACAR N , PASQUIS B , CREUZOT CP , VILLEGAS‐PEREZ MP , VIDAL‐SANZ M , BRETILLON L
Published: September 2008

Purpose To test the efficacy of dietary omega‐3 and omega‐6 fatty acids in a rat model of glaucoma induced by laser photocoagulation.

Methods Rats were fed for 3 months with a diet containing either: 1) 17% of omega‐3 fatty acids (10% EPA + 7% DHA), 2) 10% of omega‐6 fatty acids (as GLA), or 3) a combination of both omega‐3 and omega‐6 fatty acids (10% EPA + 7% DHA + 10% GLA), by comparison with a control group of animals fed with a standard diet deprived of EPA, DHA and GLA. After 3 months of diet, glaucoma was induced in one eye of the animal by laser.IOP was regularly measured and the retinal function was evaluated by electroretinography (ERG) for 3 months. At the end of the experiment, the loss of the retinal ganglion cells in both operated and fellow eyes was evaluated after retrolabelling using Fluorogold.

Results A significant increase of IOP was observed in the laser treated‐eyes: 49±16 mmHg compared to 11±1.2 mmHg in the fellow eyes, after photocoagulation. IOP elevation was similar in each group. The ERG b‐wave amplitude was significantly reduced by approximately 70% 8 and 12 weeks in the laser treated‐eyes.None of the diets efficiently prevented the loss of the retinal ganglion cells.

Conclusion Neither dietary omega‐6 nor omega‐3 fatty acids efficiently prevented the development of glaucoma in our rat model, as illustrated by the absence of effects against IOP elevation and loss of retinal ganglion cells. Further works are warranted to elucidate the mechanisms and consequences of the effects of omega‐6 fatty acids on the retinal function as assessed by ERG.
Intracameral moxifloxacin (Vigamox): in vitro safety on human ocular cells
Authors: KERNT M , NEUBAUER AS , LIEGL R , DE KASPAR H , EIBL KH , LACKERBAUER CA , ALGE CS , KAMPIK A
Published: September 2008

Purpose The 4. generation fluorochinolon moxifloxacin covers most isolates causing endophthalmitis. It is safe and effective for systemic and topical use, however only very limited data is available on prophylactic intracameral administration to prevent endophthalmitis. This study investigates the safety of Viagamox (moxifloxacin) for intracameral application in a cell culture model

Methods Endothelial toxicity of Vigamox (moxifloxacin) was evaluated in cultured human corneas. Toxic effects regarding primary human RPE, trabecular meshwork cells (TMC) and corneal endothelial cells (CEC) were evaluated after 24h and under conditions of oxidative stress. By treating cells with TNF‐a, LPS and IL‐6 the effects of moxifloxacin on viability under conditions of inflammation were investigated. Toxicity was evaluated by measuring the inhibition of cell proliferation (MTT). Cell viability was quantified by a microscopic live dead assay

Results No corneal endothelial toxicity could be detected after 30 days treatment with 500µg/mL moxifloxacin. RPE,TMC,and CEC showed adverse effects on proliferation and viability at concentrations higher than 150µg/mL moxifloxacin only. Preincubation with TNF‐a, LPS, IL‐6 or H2O2 and subsequent treat with moxifloxacin concentrations up to 150µg/ml for 24h had no significant effect on proliferation and viability

Conclusion Moxifloxacin concentrations up to 150µg/mL had no significant toxicity on RPE, TMC, CEC and human corneas. The MIC90 of moxifloxacin for common pathogens of endophthalmitis is known to be in the range of 0.25 ‐ 2.5µg/mL. Therefore, intracameral use of moxifloxacin at concentrations up to 150µg/mL may be safe and effective to prevent endophthalmitis after intraocular surgery
Changes in ocular signs and symptoms when switching from preserved latanoprost 0.005% to preservative‐free tafluprost 0.0015%: phase IIIb study in patients with open‐angle glaucoma or ocular hypertension
Authors: UUSITALO HMT , CHEN E , PFEIFFER N , BAUDOUIN C , ROPO A
Published: September 2008

Purpose This open‐label, multinational, phase IIIb study investigated the changes in ocular signs and symptoms when patients were switched from preserved latanoprost 0.005% to preservative‐free tafluprost 0.0015% (q.d. at 20:00) for 12 weeks.

Methods Patients with open‐angle glaucoma or ocular hypertension who had received latanoprost for at least 6 months and had at least 2 ocular symptoms or one symptom and one sign were enrolled (n=158). Change from screening in ocular symptoms and signs were the main endpoints. Data from the 6‐week analysis are reported here.

Results After switching to preservative‐free tafluprost, the proportion of patients with at least mild symptoms decreased: irritation/burning/stinging sensation 56.3% to 30.8%, foreign body sensation 46.8% to 25.6%, tearing 49.4% to 28.8%, itching 55.1% to 25.6% and dry‐eye sensation 64.6% to 35.3%. Decreases in proportions for abnormal signs were: tear break‐up time 94.9% to 76.9%, corneal fluorescein staining 81.6% to 52.6%, conjunctival fluorescein staining 84.2% to 53.8%, blepharitis 60.1% to 42.3%, conjunctival hyperaemia 84.2% to 69.2% and tear production 71.5% to 61.5%. All changes were statistically significant.

Conclusion Switching patients from preserved latanoprost to preservative‐free tafluprost clearly reduced ocular symptoms and signs.

Commercial interest

ERRATA SHEET

Correction to order of ocular symptoms and respective values for percentage of patients with abnormal values:

After switching to preservative‐free tafluprost, the proportion of patients with at least mild symptoms decreased: irritation/burning/stinging sensation 56.3% to 30.8%, itching 46.8% to 25.6%, foreign body sensation 49.4% to 28.8%, tearing 55.1% to 25.6% and dry‐eye sensation 64.6% to 35.3%.

[Correction added after online publication 4 Sept. 2008]
Quantifying the abnormal macular pigment distribution in macular telangiectasia type 2
Authors: VAN DER VEEN LP , CHARBEL‐ISSA P , STIJFS A , HOLZ FG , SCHOLL HPN , BERENDSCHOT TJM
Published: September 2008

Purpose Recently, increased central confocal blue reflectance was reported to be a characteristic finding in patients with Macular Telangiectasia type 2. This was thought to be due to an altered distribution of macular pigment, namely depleted in the centre of the macula with a remaining peripheral ring at 6 degrees eccentricity. The goal of this study was to objectify the substance of which this ring is constituted unambiguously.

Methods We used the objective technique of fundus reflectometry, that enables to quantify absolute values of macular pigment optical density (MPOD), without the need of a reference point.

Results Measurements showed very low MPOD values at 2 and 4 degrees foveal eccentricity in all subjects. In the majority of eyes measured, MPOD values were clearly augmented at 6 degrees eccentricity with respect to measurements at other ecentricities.

Conclusion Macular pigment was depleted at 2 and 4 degrees foveal eccentricity. The aforementioned ring at 6 degrees foveal eccentricity proved indeed to be macular pigment. Further, the data showed a significantly more pronounced depletion at temporal compared to nasal eccentricity.
Scientific Community ‐ contact networking, research collaboration on a global scale
Authors: GRACZYNSKI M
Published: September 2008

Purpose In the era of globalisation and growing competitiveness research projects are conducted by big teams of scientists located in distant geographical locations. Management of collaboration of such diffused team is a big challenge even for experienced leaders, which requires a lot of efforts and careful logistics.

Methods Virtual Research Groups is an internet‐based platform for management and conduction of multi‐center research projects. The platform consists of four modules: research module, information module, communication module and administration module. The system allows complete supervision and control of investigators and approval of entered protocols if needed. Simple protocols can be set up easily by investigators but more complicated ones are custom‐made and contain validation algorhytms. Statistical tools are available and are set up individually for the project according to the investigators requirements. Information module provides up‐to‐date literature on the subject of investigation along with information on available grants and other financial support, conferences and even suggestion on scientists whos profiles match the subject of investigation, who might be invited to join the group if expansion is desirable. Financial and scientific settlement of the project is one of the new features of the Virtual Research Groups.

Conclusion The platform can be equally used for spontaneous creation of research teams as well as for management of structured research consortia or multi‐center clinical research

Commercial interest
Community Services enter professional territory ‐ what is in there for us?
Authors: GRZYBOWSKI A
Published: September 2008

International collaboration ‐ a cornerstone of today's research ‐ requires state‐of‐the‐art communication tools. There are a number of dedicated services for scientists in the internet which provide networking and social services, such as SciVee, SciLink, Community of Sciences and Index Copernicus, just to name a few of them. Each of them have unique functionalities which make the service useful and interesting. The ideal scientific service should provide maximum security and excellent networking capabilities. Scientists should be able to search for collaborators not only by specialty, keywords and geographical location, but also by special research skills and available lab equipment. It would be helpful if some kind of achievement evaluation could be added into the search service. The second important property of an ideal scientific service should be profiled information delivery which could save a precious researchers time. Last but not least a real collaboration tools should be added to enable online investigations. In my talk I will try to give an answer to the question "what is in there for us?".
Photodynamic therapy with verteporfin combined with intravitreal injection of bevacizumab for central serous chorioretinopathy: a case series
Authors: MAIER M , VALET V , FEUCHT N , FIORE B , WINKLER VON MOHRENFELS C , LOHMANN CP
Published: September 2008

Purpose To discuss the effect and outcome of a combined photodynamic therapy and intravitreal injection of Bevacizumab in treating central serous chorioretinopathy (CSC).

Methods 4 Patients with chronic central serous chorioretinopathy (CSC) were treated with intravitreal injection of 1,25 mg Bevacizumab administered within 24 hours after standard PDT laser treatment (83 sec., 689nm) with Verteporfin. (5,7ml Verteporfin over 10 min. intravenousely). Before, 3, and 6 month after treatment visual acuity, OCT examinations (retinal thickness) and fluorescein angiography were performed.

Results Mean visual acuity increased from baseline 20/50, to 20/25 after 3 month. Subretinal fluid almost resolved completely after treatment. OCT‐ and FLA‐ findings are presented in our patients. OCT 1, 3 and 6 month after combination therapy showed a reduced retinal thickness compared to baseline. 1 patient had full recovered vision after 6 month.

Conclusion Photodynamic therapy combined with injection of intravitreal Bevacizumab was very effective in our patients. Current literature depicts medical treatment, focal laser, SRT and PDT as treatment options for CSC. To our knowledge this is the first report of a combination therapy in CSC. The treatment was well tolerated and we did not see any complications. The patients presented with ongoing recovered vision during follow up. Further experience is necessary to evaluate the treatment option of PDT and Avastin® combination therapy especially in chronic central serous chorioretinopathy (CSC).
EphB4 is expressed in preretinal neovascularization in a mouse model of oxygen‐induced retinopathy
Authors: EHLKEN C , MARTIN G , LEINWEBER M , HANSEN LL , AGOSTINI HT
Published: September 2008

Purpose EphrinB2 is predominantly expressed in arteries, while its ligand EphB4 is predominantly expressed in veins. Activation of ephrinB2 and EphB4 by receptor dimers have been shown to enhance neovascularization, whereas inhibition of EphB4 reduced neovascularization both in vitro and in vivo in a mouse model of oxygen‐induced retinopathy (OIR). These data suggest a role of the ephrinB2‐EphB4 system in retinal neovascularization. We looked for expression of these membrane‐bound factors in a mouse model of OIR.

Methods Heterogenic EphB4lacZ+/‐ mice were examined in a well‐established mouse model of oxygen‐induced retinopathy. Mice were kept in 75% oxygen for postnatal days P7‐P12. Returned to room air, they underwent a relative hypoxia and developed a proliferative retinopathy within the next 5‐7 days. Eyes were enucleated on P17‐P19 during the peak of vascular proliferation, stained for LacZ, and embedded in paraffin. Sections were investigated for LacZ staining.

Results Sections show a strong expression of EphB4 in preretinal neovascularization both in small and larger vessels. EphB4 is also mildly expressed in vessels in the inner plexiform layer and in the ganglion cell layer.

Conclusion The expression pattern suggests a role of EphB4 in preretinal neovascularization in a mouse model of OIR. Further studies of the intracellular localisation of EphB4 are needed to add to understanding the role of the ephrin system in OIR.
Indocyanine green‐induced toxicity to retinal neurones in cultures is enhanced by light
Authors: LASCARATOS G , OSBORNE NN
Published: September 2008

Purpose To deduce whether light influences the effect of indocyanine green (ICG) in primary rat retinal cultures.

Methods 5‐day‐old primary rat retinal cultures were exposed to concentrations of ICG (0.01%, 0.05% and 0.1%) that are used clinically for 2 minutes. Some cultures were then additionally exposed to 3000lux of white light for 10 min. Twenty four hours later cell viability was assessed with the MTT assay. In addition, cultures were stained for the presence of GABA neurones, reactive oxygen species (ROS) using 2’,7’‐dihydroethidium (DHE) and DNA breakdown (TUNEL procedure) to indicate apoptosis.

Results 0.1% ICG was found to significantly reduce cell viability and the number of GABA‐immunoreactive neurones in primary rat retinal cultures. Lower concentrations of ICG also had an effect on these parameters suggesting dose‐dependence. 0.1% ICG also significantly increased the appearance of ROS and numbers of TUNEL positive cells in cultures. The effects caused by ICG were potentiated by light.

Conclusion Evidence is provided to suggest that the toxic effect of ICG to retinal neurones in culture is exacerbated by light. The relevance of these studies is self evident in relation to vitreoretinal surgery where use of a normally safe concentration of ICG may be rendered toxic because of the used light.
Maculopathy associated with angioid streaks
Authors: GUERRI MONCLUS N , TORRON FERNANDEZ‐BLANCO C , EGEA ESTOPINAN MC , HONRUBIA F
Published: September 2008

Purpose To present choroidal neovascularization and macular atrophy without neovascularization associated with angioid streaks by means of two case reports.

Methods Two middle aged man (42 an 46 years old) with angioid streaks were evaluated. The first pacient showed choroidal neovascularization and subretinal fibrosis, which was treated with intravitreal ranibizumab. The second case had macular atrophy in one eye in association with subretinal fibrosis in the contralateral eye.

Results A single dose of intravitreal ranibizumab improved the structural features of exudative maculopathy. Functional improvement (visual acuity) was less important because of subretinal fibrosis. Atrophic maculopathy was not susceptible to treatment.

Conclusion Angioid streaks diagnosis is usually late. It must be suspect in middle aged pacients with choroidal neovascularization and their visual prognosis depends on early treatment. Macular atrophy associated to angioid streaks is very uncommon.
Retinopathy in intravenous coaxil drug dependents
Authors: ARAKELYAN MA , BARDEEVA YUN , RYABTSEVA AA
Published: September 2008

Purpose To study the clinical manifestation, course and the outcome, as well as treatment variants and it's efficacy in retinopathy followed by intravenous coaxil (tianeptinum) injection.

Methods 23 heroine dependent males (age range 19‐36) were examined. 16 patients had lowering of the visual acuity (VA) from 5 to 20% within 3‐8 days before they applied to our clinic. In 7 patients a significant lowering of VA was attended by retinal neoangiogenesis; 4 of them appeared with hemophthalm and iris rubeosis. Increased intraocular pressure in 3 patients was a result of neovascular glaucoma. All patients had concomitant hepatitis B or C virus infection of different activity, one with neovascular glaucoma was HIV‐infected.

Results The mechanism of origin, clinical course and outcome of retinopathy induced by intravenous coaxil injection is similar to those described in “talc retinopathy”, which occurs after intravenous injection of solution made of crushed and dissolved in water talc‐containing tablets. The difference is in more significant retinal damage. The disease affects both eyes. In the acute stage of retinopathy it may manifest in vascular emboli of retina and choroid, confirmed by FAG. Ophthalmoscopic examination reveals large areas of ischemia and accumulation of crystals mostly in the central retina, hemorrhages are a result of arterial and venous thrombosis followed by neovascularization of the optic nerve head and the retina, as well as hemophthalm and neovascular glaucoma. Two cases of retinopathy progressed untill blindness.

Conclusion Development of the retinopathy depends on the cumulative dose in the amount of 4,500 tablets. Medical and laser treatment is unsuccessful. Thus, prognosis of retinopathy in intravenous coaxil users is unfavorable.
Visual loss following scoliosis surgery. A case report
Authors: TODOROVA MG , MESSERLI J , FLAMMER J , ORGUL S
Published: September 2008

Purpose We report a case of a 15‐year‐old boy who experienced visual loss in the left eye during the immediate perioperative period after scoliosis surgery. We observed a cherry‐red‐spot in the macula and a slightly swollen optic disc a day after spinal surgery and a disc pallor, hypopigmentation of the peripapillary choroid and constriction of the peripapillary vessels a week later. Risk factors of visual loss during non‐ocular surgery are assumed to be a long lasting surgery, hypotension, anaemia, excessive hydratation, systemic hypertension, direct external pressure of the eye. In young, otherwise healthy patients, the pathogenesis of this complication is likely to be the same, but further possible explanations of the pathogenesis should be considered.

Methods We conducted a complete vascular workout included perimetry, colour Doppler imaging, nail‐fold‐capillary microscopy, analysis of circulating endothelin‐1.

Results The results are very indicative for primary vascular dysregulation responding to various stimuli (cold, psychological stress,adrenalin) and showed pathological peripheral vasoconstriction. In this case, we postulate hypersympathicotonus occurred during scoliosis surgery and provoked massive vasospasm of the ophthalmic artery, followed by occlusion of the central retinal artery and short posterior ciliary arteries.

Conclusion Heavy blood loss or sympathomimetic medication are known risk factors for complications in the eye during spinal surgery. Mechanic irritation of the perispinal region could induce hypersympathicotonus and provoke peripheral vasospasm. Analysis of vascular dysregulation factors in young healthy patients holds the potential to increase our knowledge of the pathomechanism for visual loss after uncomplicated non‐ocular surgery.
Apocrine hidradenocarcinoma in eyelid with corneal invasion
Authors: EGEA ESTOPINAN MC , SOTA P , GUERRI MONCLUS N , ALFARO J , BORQUE E , PRIETO E
Published: September 2008

Purpose Apocrine hidradenocarcinoma has been named with different terms as apocrine carcinoma, malignant clear cell hidradenoma, nodular hidradenocarcinoma, eccrine acrospiroma, and some others. This wide terminology, together with the rarity of the tumour and variability of the cells that compose it, make it difficult to diagnose.

Methods Description of a case.

Results 81 years‐old female, with a history of pterygium, subject to enucleation of the eye globe after a preoperative diagnosis of squamous cell carcinoma affecting ocular adnexa, this tumor infiltrated bulbar conjunctiva and cornea.

Conclusion Malignant tumours of sweat glands are rare. Among these, hidradenocarcinoma has been described in multiple cutaneous locations and exceptionally in the eye. The frequency is not easy to determine because the terminology that has been used makes difficult to compare the data. In the eye, it may originate from glands of the eyelid or from lacrimal gland. The immunohistochemical study is not important for diagnosis. The neoplastic cells express low molecular weight cytokeratins, and cytokeratin 19. EMA and CEA are expressed in the luminal edge of glandular structures. It is an aggressive tumour, which can widely metastasize and can be cause of death.