bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of headache and associated eye conditions in Congolese patients
Authors: KAIMBO WA KAIMBO D , MISSOTTEN L
Published: October 2007

Purpose: To determine frequency of headache and associated eye conditions in patients from D R Congo.

Methods: A case‐control study was performed between April and September 2004 and inluded patients seen at an ophthalmologic clinic in the city of Kinshasa. Cases were all consecutive new patients with headache detected during the study period. Controls were all other patients seen in the same ophthalmologic clinic. Data were collected from 476 patients by medical examination and interview. Ocular examination included measurement of visual acuity, refraction, slit lamp examination and fundoscopy. Other examinations were performed when needed.

Results: There were 102 patients with headache (cases) and 374 patients without headache (controls), giving a frequency of patients with headache of 22%. Mean age was 39 years±14 for cases and 41 years±19 for controls (P=0.32). There were more female compared to male in cases (71%) than controls (55%)(P<0.0001). Eye conditions were found in 91 (89%) cases and 357 (95%) controls (P=0.018). Cases were more likely to have asthenopia than controls (15% vs 6%, P=0.006). There was no differences between cases and controls in the distribution of ametropia (20% vs 16%, P=0.39), presbyopia (30% vs 21%, P=0.07), pterygium (5% vs 4%, P=0.69). There were no significant differences between cases and controls in the distribution of hypertension, sinusitis and diabetes. The commonest locations of headache in cases were diffuse, the frontal, temporal areas.

Conclusions: Ocular examination could be necessary in patients with headaches.
Ocular surface retention time and extensions of TFBUT of a lubricating eye drop
Authors: IPINAZAR UNDURRAGA M , OUSLER III GW , SCHINDELAR MR , PAUGH J
Published: October 2007

Purpose: The tear film in subjects with ocular dryness is often unstable and incapable of maintaining the protective qualities that are intrinsic to its structure and function. Until recently, lubricating eye drops have provided only transient relief from ocular dryness. The purpose of these studies is to determine if a lubricating eye drop, containing PG/PEG/HP‐Guar, will extend ocular protection.

Methods: To compare the ocular residence time of lubricating eye drops, subjects with dry feeling eyes were administered a solution of Fluoroscein Isothiocyanate‐dextran mixed with a the eye drops. The residence time was measured by a scanning fluorometer. To compare TFBUT, subjects with moderately dry feeling eyes were administered a single drop of a lubricating eye drop. After instillation, TFBUT was measured at 0, 5, 10, 15, 20, 30, 45, 60, and 90 minutes.

Results: Tear film retention of the PG/PEG/HP‐Guar product was significantly greater than a HPMC and a CMC lubricating eye drop. The product containing PG/PEG/HP‐Guar was measured in the tear film as much as 37 minutes post instillation, while the HPMC and CMC drops were only 25 and 23 minutes, respectively. The PG/PEG/HP‐Guar tear yielded a significantly greater increase in TFBUT from baseline at 45, 60, and 90 minutes post‐installation compared to eyes dosed with a CMC/Glycerin drop.

Conclusions: Based on these results, it can be postulated that the extended duration of retention observed with the PG/PEG/HP‐Guar tear allows the necessary time for restructuring of the unstable tear film into a more stable tear film. This leads to a long‐term tear film stabilization and enhancement of TFBUT and ultimately, extended ocular surface protection
Relation of crystallin and ischemia/Reperfusion injury model of the rat retina
Authors: YANG YUNSIK , JANG JEONGUN , BAHK SONGCHUL , KIM JAEDUCK , CHUNG HUNTAEG
Published: October 2007

Purpose: Ischemic damage of organs has hypoxic stress and reperfusion of the organs induces oxidative stress. Crystallin family is known as a protector of various kind of stress. We wanted to investigated crystallin expression and what kind of crystallin is associated to the ischemia/reperfusion injury (I/R injury) of retina.

Methods: Twenty four Sprague‐Dawley (SD) rats were used in this study. I/R injury was made by clamping optic nerve with central retina artery for 30min and then set free. Groups were divided into normal control, 24h and 72h after I/R injury, 24h and 72h after I/R injury with pretreatment of Sn(IV) protoporphyrin IX dichloride(SnPP) and 24h, 48h and 72h after I/R injury with pretreatment of hemin. All of the vitreous bodies were obtained and two‐dimensional electrophoresis (2‐DE) was performed.

Results: Twenty‐three spots were identified by MALDI‐TOF/MS. Anti alpha A‐, alpha B‐, beta‐, phospho (ser19)‐alpha B‐, phospho (ser45)‐alpha B‐, phospho (ser59)‐alpha B‐crystallin, extracellular signal‐regulated kinases (ERK1/2), phospho‐ERK1/2 and heme oxigenase‐1 (HO‐1) antibody were used for Western blotting.

Beta‐crystallins were increased 1.7 fold and 1.3 fold in the groups of I/R injury and I/R injury with SnPP pretreatment, respectively. Interestingly, I/R injured vitreous body showed the increased ERK1/2. However, I/R injured vitreous body pretreated with hemin for 24 h showed highly phosphorylated ERK1/2.

Conclusions: This result might indicate that crystallin family is related to I/R injury. Phosphorylation of ERK1/2 was related with the hemin pretreatment.
Mapping candidate genes for familial high myopia in a polish population
Authors: RYDZANICZ MA , PODFIGURNA‐MUSIELAK M , MRUGACZ M , FRAJDENBERG A , LEAL SM , BEJJANI BA , GAJECKA M
Published: October 2007

Purpose: Myopia is the most common of all ocular conditions. The etiology of myopia is not known; in high myopia (myopia in excess of ‐ 6.0 diopters), genetic factors appear to play a predominant role. The purpose of this study is to map a gene(s) responsible for high myopia in Polish families.

Methods: To date, we have collected blood and purified genomic DNA from 418 individuals from 51 Polish unrelated high myopia families. A simulation study was performed to evaluate whether there is sufficient power to detect linkage in the ascertained pedigrees. Then, using DNA samples from 22 families we performed two series of experiments. First, to exclude specific syndromes associated with myopia in Polish families, we tested linkage to Stickler syndrome, Marfan syndrome, Knobloch syndrome and juvenile open‐angle glaucoma. Next, we searched for linkage to the high myopia‐associated loci [18p11.31 (MYP2), 12q21‐23 (MYP3), 7q36 (MYP4), 17q21‐23 (MYP5), 2q37, 4q22‐4q27 (MYP11), 3q26 (MYP8), 4q12 (MYP9), 8p23 (MYP10) and 10q21.1]. Additionally we performed the genotyping to test the linkage for mild/moderate myopia established in Ashkenazi Jewish families [22q12 (MYP6] and to the PAX6 gene region reported for dizygotic twins [11p13 (MYP7)].

Results: Simulation studies show that sufficient power exists to establish linkage in collected pedigrees (α=0.4, EMLOD=4.12). Linkage to Stickler syndrome, Marfan syndrome, Knobloch syndrome, juvenile glaucoma loci and to any of the candidate genes were excluded. Genome wide screen is in progress.

Conclusions: We have identified, collected and characterized a large cohort of polish families with high myopia and excluded previously suggested principal genetic cause of this phenotype.
Ocular surface in dry eye patients is improved after one month therapy with Systane
Authors: VERSURA P , PROFAZIO V , CAMPOS EC
Published: October 2007

Purpose: Systane® Lubricating Eye Drops (Alcon Forth Worth, Inc.) is designed to provide relief from dry eye by means of longer retention time on the ocular surface, based on the presence of the combination of PEG400_PG and HP‐Guar (gelling hydroxypropyl‐Guar) which is believed to mimic the mucin layer of tear film. The effect of Systane was evaluated in an open trial on subjects with moderate symptoms.

Methods: A total of 50 subjects were enrolled (age 57.6±15.4; 40 women, 10 men) ; inclusion criteria were based on a tear break‐up time (TBUT) < 10 sec without corneal epithelial staining. Six symptoms of ocular irritation were rated on a four‐point scale. Conjunctival hyperemia was graded. Patients were instructed to instill Systane four times a day for four weeks.. Satisfaction with the product was rated at the end of the study. Media of results in both eyes was considered for statistical evaluation; the Wilcoxon test for paired data was applied, p< 0,05 was considered as statistically significant.

Results: All patients regularly instilled Systane and completed the follow‐up; results are expressed baseline vs endpoint. Significant reduction was demonstrated for ocular irritation symptom scores (1.44 vs 0.94, p 0.0001) while improvement was shown for patient’s satisfaction score (3.41 vs 3.94, p 0.0001) and TBUT (6.9±0.9 vs 8.5±1.5 sec, p 0.0001). A significantly increased proportion of patients with normal conjunctival injection (10 vs 22, results in %, p 0.01) was observed after one month follow up.

Conclusions: Systane proved effective in reducing the symptoms of dry eye and it was overall well accepted. This finding is likely to be related with improved stability of tear film, due to the protective viscous layer bound to the corneal surface.
Repair of corneal endothelium after mechanical damage under tissue culture and hypothermic conditions
Authors: NEJEPINSKA J , JUKLOVA K , JIRSOVA K
Published: October 2007

Purpose: To evaluate the reparative capacity of corneas with mechanically induced endothelial damage stored under tissue culture (TC) or hypothermic conditions.

Methods: 8 pairs of human corneas with similar kvalitative and kvantitative endothelial parameters were used. An area of 0,8 mm2 in the central endothelium was damaged by a flat metal tool. The paired corneas were stored under TC (E‐MEM, 31˚C) or hypothermic (Optisol, 4˚C) conditions. The endothelial cell density (ECD), and the percentage of dead cells were assessed using a Lucia computer analysis system before and after damage and on days 7, 14 and 21 following 12 hours of deswelling in a medium containing 5% dextran.

Results: The mean ECD before damage was 2769±394/mm2. Immediately after the damage, a Descemet’s membrane denuded and dead cells were observed in the injured area. After 7 days of culture, polymeghatism and pleomorphism were observed in the central cornea, instead of little damage in the pericentral area. After 14 days, no damage or dead cells were observed in the injured area. ECD was 2229±470/mm2 and 2156±417/mm2 after 7 and 14 days of TC storage, respectively. A lesion with dead cells was observed after 7 and 14 days of hypothermic storage. The endothelium was completely repaired at day 21 in TC, while in hypothermy the corneas were cloudy and in poor condition.

Conclusions: The reparative capacity of the cornea is maintained under TC but not under hypothermic conditions. TC is therefore “the method of choice” for the storage of corneas with higher number of dead cells.
The comparison of the quality score of IOP and ocular pulse amplitude (OPA) values measured by dynamic contour tonometer
Authors: BOGHOSSIAN P , BERKOUK K , DETRY‐ MOREL M , POURJAVAN S
Published: October 2007

Purpose: The dynamic contour tonometer (DCT) is designed to measure the IOP independently of the corneal properties. It is foreseen of a digital LCD screen which displays the IOP, the OPA and the quality score (Q) of measurements varying from 1 (excellent) to 5 (poor). The manufacturer recommends discarding the IOP and OPA values with Q4 and 5. The aim of our study was to assess if IOP and OPA measurements with Q3 are acceptable for clinical and research purposes.

Methods: 2 consecutive GAT IOP measurements were followed after 10 minutes break by 3 consecutive DCT IOP measurements in 210 patients. Only 85 patients who had IOP and OPA values with Q score 1, 2 and 3 were included in this sub‐study.

The mean DCT IOP and OPA were taken for the statistical analyzes. DCT IOP Q3 was separately compared with Q2 and Q1 values. DCT IOP Q1 and Q2 were compared as well. The same comparison was performed for OPA. The Pearson correlation was used for correlation assessment.

Results: The mean age was 56±14 years. The mean IOP with GAT was 18.2±4.4 mmHg. The mean IOP Q3, Q2 and Q1 were respectively 17.8±3.3, 17.5±3.3 and 17.5±3.4 mmHg. The mean OPA Q3, Q2 and Q1 were respectively 2.5±1.0, 2.5±1.0 and 2.5±0.9 mmHg.

The Pearson correlation for DCT IOP Q3‐2, DCT IOP Q3‐1 and DCT IOP Q2‐1 were equal to 0.9 (r= 0.28, p<0.01).

The Pearson correlation for OPA Q3‐2 was: 0.8, for OPA Q3‐1: 0.7 and for OPA Q2‐1: 0.8. The difference between these value were not statistically significant.

Conclusions: The IOP and the OPA values with Q 1, 2 or 3 measured by DCT are not significantly different and can be taken into account for clinical and research purposes.
Autofluorescence and histological findings in cancer‐associated retinopathy caused by small cell lung carcinoma
Authors: SKET KONTESTABILE A , BRECELJ J , PIZEM J , ADAMUS G , HAWLINA M
Published: October 2007

Purpose: To present clinical and histological features of lipofuscin autofluorescence of the retinal pigment epithelium‐RPE in a patient with cancer associated retinopathy‐CAR,a paraneoplastic syndrome caused by small cell lung carcinoma‐SCLC.

Methods: 78 year‐old man with SCLC suffered bilateral blindness.Autofluorescence imaging was done using Topcon fundus camera and,post mortem,light microscopy with autofluorescence and electron microscopy of the retina were done.Retinal photography,fluorescein angiography,electrophysiology and auto‐antibody assay were also performed in vivo.

Results: Autofluorescence imaging showed diffuse hyperfluorescence suggesting accumulation of lipofuscin in the RPE,and few hypofluorescent atrophic regions due to age‐related changes.Autofluorescence microscopy showed lipofuscin accumulation in the RPE and electron microscopy revealed predominance of lipofuscin granules over melanin pigment.Western blot analysis was positive for anti‐recoverin antibodies.The electroretinogram and visual evoked potentials were non‐detectable.Histology showed complete loss of photoreceptor layer and outer nuclear layer as well as decrease in number of nuclei in the inner nuclear layer with no inflammation.Fluorescein angiography revealed severe atherosclerosis with no occlusions and patchy atrophic changes with no leakage.

Conclusions: In CAR,in vivo autofluorescence imaging showed diffuse hyperfluorescence suggesting increased phagocytic activity and lipofuscin accumulation due to autophagy of the destroyed photoreceptors in the RPE by autoantibody‐induced apoptosis,which was confirmed ex vivo by autofluorescence of lipofuscin in histological sections and by electron microscopy.
The influence of selective laser trabeculoplasty on diurnal intraocular pressure in POAG
Authors: KOTHY P , TOTH M , HOLLO G
Published: October 2007

Purpose: To investigate the influence of SLT on mean diurnal IOP (mean‐IOP) and diurnal IOP fluctuation.

Methods: 26 eyes of 13 POAG patients underwent a 4‐week washout before baseline diurnal IOP curve. Standard 360° SLT was performed. IOP was controlled at week 1 and month 1. The IOP curve was repeated after 3 and 6 months. IOP lowering medication was started (failure) if mean‐IOP was higher than 22 mmHg or any single IOP value exceeded 26 mmHg at any visit.

Results: Post‐treatment IOP elevation >5 mm Hg was found in 16 eyes (62%). An at least 20% decrease of the mean‐IOP was not reached. Baseline mean‐IOP and diurnal IOP fluctuation (mean+/‐SD) were higher for the 11 eyes requiring medication before the month 3 visit than for the other eyes (mean IOP: 28.8+/‐5.2 mmHg vs. 20.8+/‐3.1 mmHg, unpaired t‐test, p<0.0001; IOP fluctuation: 9.5+/‐3.7 mmHg vs. 6.8+/‐1.9 mmHg, p=0.0423). For the eyes with no medication mean‐IOP changed from 19.3 ± 1.4 mmHg (baseline) to 18.6 ± 1.4 mmHg (month 3, Duncan test, p=0.090) and to 18.2 ± 2.0 mmHg (month 6, p=0.017). No difference was seen between month 3 and 6 (p=0.351). Diurnal IOP fluctuation decreased from 7.2 ± 2.3 mmHg (baseline) to 4.3 ± 1.7 mmHg (month 3, p=0.0004) and to 5.1 ± 1.7 mmHg (month 6, p=0.004). No difference was found between the month 3 and the month 6 values (p=0.225).

Conclusions: SLT resulted in a decrease of the mean diurnal IOP and the diurnal IOP fluctuation.
The sensitivity of OCT in the diagnosis of clinically significant macular edema
Authors: VAN DIJK HW , KOK PHB , ABRAMOFF MD , SCHLINGEMANN RO , BERNARDES R , VERBRAAK FD
Published: October 2007

Purpose: To optimize the sensitivity of OCT in the diagnosis of clinically significant macular

edema (CSME) in patients with diabetes mellitus.

Methods: The retinal thickness (RT) of patients with diabetes mellitus and a clinical diagnosis of CSME based on biomicroscopy was measured with the time‐domain StratusOCT and the spectral‐domain Topcon OCT. We defined RT as pathological if (1) the difference was 2 standard deviation above the mean RT using the normative database provided by Zeiss (standard approach) or (2) local abnormalities were seen on the StratusOCT topographic map optimized with additional scanlines, an adjusted false color scale and 3D representation or (3) the spectral domain OCT 3D and B‐scan images showed intra‐retinal fluid.

Results: In total 50 patients were analyzed. Using the standard approach, OCT missed the

diagnosis of CSME in 20 patients. On the optimized Stratus OCT topographic map the diagnosis CSME was missed in 9 patients. When looking for intra‐retinal fluid on the spectral domain OCT 3D and B‐scan images, OCT missed the diagnosis CSME in 7 patients.

Conclusions: Even after the optimization of the StratusOCT topographic map or with the spectral domain OCT there was a difference in diagnosis of CSME between OCT and biomicroscopy. This difference in diagnosis could be explained by false‐positives based on biomicroscopy or false‐negatives based on OCT. Future studies are needed to evaluate the clinical relevance of this difference.
Bio‐avalibale zinc in the outer segments of short wavelength cones
Authors: LENGYEL I , ONWOCHEI N
Published: October 2007

Purpose: Zinc has been postulated to play a role in both normal and degenerative processes in the retina. Often these processes require zinc that is tightly bound to enzymes. However, new evidences indicate that the presence of bio‐available zinc is a better indicator for the involvemnt of zinc in retinal fuctions. Using autometallography on sectioned tissues suggested that bio‐available zinc is absent in photoreceptor outer segments. The purpose of this study was to re‐examine this observation using a zinc selective fluorescence probe and freshly dissected, flat mounted retinae .

Methods: Following deep anesthesia and decapitation, dark‐adapted retinae were immediately dissected from rat, goldfish and chicken eyes and flat mounted with the photoreceptor up. The retinae were immediately labeled with the zinc‐specific fluorescent probe ZP1 (Neurobiotex, USA). Readily releasable zinc was visualized using fluorescent and confocal microscopy.

Results: Only a subset of photoreceptor outer segments were labeled by ZP1 in rat retinae (>0.5 %). This labelling was localized to a subset of the cones. The cone localization of this labeling was confirmed by using goldfish retinae where the cones are readily distinguishable from rods morphologically. To identify the subtype of zinc postive cones we labeled chicken retinae where the characteristic oil droplets within the cones identify their sub‐type. Here zinc appeared to be localized to short wavelength cone outer segments.

Conclusions: This is the first demonstration that bio‐available zinc is present in photoreceptor outer segments. The specific localization to short wavelength cones suggest that zinc plays a selective role in visual processing of short wavelength light.
A new heavy internal tamponade in vitreoretinal surgery: an in vitro study
Authors: MICHELONE L , FANNI D , FANTIN A , PAOLONI M , TOGNETTO D , RAVALICO G
Published: October 2007

Purpose: To study the solubility of perfluorohexyloctane (F6H8) in silicone oil (PDMS 1000 – polydimethylsiloxane 1000) and to measure the viscosity and the specific gravity of this mixture.

Methods: The solubility diagram of the mixture was obtained with the turbidimetric method, indicating the miscibility of F6H8 and silicone oil 1000 at all the useful temperatures. The viscosity was measured in steady shear conditions by using a controlled stress rheometer (Haake RS150) and a double cone/plate (DC 60/4) system, both at 25 and 37°C for different volume percent compositions of the mixture. The specific gravity was measured at 37° using a digital densimeter.

Results: A mixture of F6H8 v30% and PDMS 70 v% was found to be transparent and stable at all the useful temperatures. By combining these proportions of the two substances a resultant density of 1.06 g.cm‐3 was obtained. The viscosity of the 30% F6H8 mixture was 203 mPas at 25°C and 163 mPas at 37°C respectively.

Conclusions: The ideal F6H8 and silicon oil mixture can be obtained combining 30% of F6H8 with 70% of silicon oil 1000.
Family with Brittle Cornea Syndrome
Authors: TOSOUNIDIS IH , MCKEAG D , AU L , AUTALLAH S , BLACK GC , BONSHEK RE
Published: October 2007

Purpose: We present a case of a 29‐year‐old woman presenting with corneal rupture after minor trauma. This is the third person in the same family with corneal rupture and other features of brittle cornea syndrome (BCS). This is the largest known family with this syndrome and the age at corneal rupture is the oldest described.

Methods: A 29‐year‐old woman presented with left corneal rupture evoked by minor trauma and received left evisceration and implant. Two of her younger sisters had also presented with corneal rupture when they were 3 and 4 years old. They had also blue sclera and several bone problems and they suffered ear problems. Another sister is known to have bilateral ketatoconus, but no history of corneal rupture. All the injuries affecting the family members were provoked by minor trauma.

Results: This is an interesting family with BCS. BCS presents with brittle cornea, blue sclera and red hair. Recurrent spontaneous corneal perforations, sometimes bilateral, are a feature. Other characteristics that have been described are hypermobility of the small joints, moderate skin hyperextensibility without excessive skin fragility, and hearing impairment.

Conclusions: The major differential diagnosis of BCS is Ehlers Danlos syndrome type 6, since VI Ehlers Danlos is associated with poorer prognosis. It also needs differentiation from osteogenesis imperfecta. The exact genetic abnormality in BCS is yet to be discovered. A recent article has implicated chromosome 16 and offered some candidate genes, among them the PCOLN 3 which has been implicated with collagen formation. BCS may be important in medico‐legal cases as potential misdiagnosis of non‐accidental injury may occur.
Glycoproteins of drusen and drusen‐like lesions
Authors: BONSHEK RE , D'SOUZA Y , JONES C
Published: October 2007

Purpose: Drusen are a marker of age‐related macular degeneration. Lesions similar to drusen, both in histology and their clinical appearance are also seen in choroidal tumours, chronic inflammatory and degenerative conditions of the eye, and in mesangiocapillary glomerulonephritis type II (MCGN‐II). This study aims to compare the saccharide composition of these drusen‐like lesions in the various ocular pathological groups and in MCGN‐II.

Methods: Formalin fixed and paraffin wax embedded tissue from 21 eyes was studied. The histological diagnoses included AMD, retinal detachment, malignant melanoma, long‐standing uveitis, glaucoma and MCGN II. Glycosylation was examined using a panel of twenty biotinylated lectins and an avidin‐peroxidase‐DAB‐cobalt revealing system, with and without neuraminidase pre‐treatment.

Results: High mannose, bi/tri‐nonbisected and bisected complex N‐glycan, N‐acetyl glucosaminyl, galactosyl and sialyl residues were found to be expressed by drusen, while treatment with neuraminidase exposed subterminal N‐acetyl galactosamine and galactosyl residues. Similar binding patterns were found in the various pathological groups studied.

Conclusions: As there was no significant difference in the lectin‐binding pattern in drusen in different pathologies, a common pathogenesis or at least a final common pathway for the elaboration of carbohydrate components of drusen is suggested.
Evaluation of clinical and HRT II quantitative parameters to detect suspect and early glaucoma patients
Authors: SANCHEZ CANO A , GUERRI N , EGEA ESTOPINAN MC , PEREZ OLIVAN S , PABLO JULVEZ LE
Published: October 2007

Purpose: To compare the different clinical and HRT II quantitative parameters among patients divided in three groups: control, suspect glaucoma and early glaucoma.

Methods: The relative importance of each of a set of independent variables was assessed by stepwise discriminate analysis to identify and combine the most useful parameters of both clinical and HRT II methods. Afterwards the most significative original variables were combined to generate a new variable in such a way that the measurable differences between the groups are maximized by means of using a linear discriminate function (LDF) to generate a receiver operating characteristic (ROC) curve for each set of clinical or HRT II parameters. The differences between the ROC curves derived from LDF analysis by each method (clinical or HRT II) were tested for significance.

Results: Two functions were found: Clinical = 9.69 ‐ 0.09*IOP + 0.05*Age ‐0.02*Pachymetry and HRT II = 5.83 + 0.71*FSM Mikelberg Function ‐ 7.43*RNFL cross‐sectional area + 32.44*mean RNFL thickness ‐ 10.25*rim/disc area. ROC curves were plotted and the areas for clinical and HRT II functions were 0.762 ± 0.042 and 0.757 ± 0.042 respectively.

Conclusions: Despite of good discriminate results for single parameters to detect suspect or early glaucoma patients, a linear combined parameters appeared more effective statistically than clinical and HRT II single ones.
Short‐term influence of antiglaucomatous medications on the ocular pulse amplitude (OPA) measured with the dynamic contour tonometer Pascal®
Authors: DETRY‐MOREL M , JAMART J , POURJAVAN S
Published: October 2007

Purpose: To assess the short and medium‐term influence of antiglaucomatous treatment on the OPA value by DCT.

Methods: Prospective non‐randomized study including 35 eyes of 25 patients (mean age: 63±10,9 years) with newly diagnosed POAG or OHT and treated with latanoprost, bimatoprost or Cosopt®. The IOP and OPA were measured with GAT and DCT before starting the study and after 1, 3 and 6 months of treatment. Central corneal thickness (CCT), systolic, diastolic blood pressure (BP) and cardiac frequency were recorded. Pearson coefficient was used to assess correlations.

Results: The mean GAT IOP was 25.0±5.6 mmHg at baseline, 17.7±3.6 mmHg, 17.9±3.2 mmHg and 17.6±3.3 mmHg at first,3 and 6 months post‐treatment respectively (p<0.001). From a mean baseline IOP of 24.2±3.9 mmHg, the mean DCT IOP was 17.9±2.6 mmHg, 17.6±2.5 mmHg, 17.5±2.3 mmHg at 1,3 and 6 months (p<0.001). Both mean IOP GAT and DCT were correlated with CCT (p<0.05). GAT and DCT IOP were strongly correlated at all visits. The mean pretreatment OPA was 3.3±0.9 mmHg. It was significantly reduced to 2.6±0.7 mmHg at first month, 2.6±0.7 mmHg at third month and 2.8±0.6 mmHg at 6 month, without difference between the post‐treatment visits (regression, p>0.05). The baseline OPA was significantly correlated with DCT IOP, systolic and diastolic BP. It was only correlated with BP at first month (p<0.05). The decreases in OPA and IOP were significantly correlated.

Conclusions: Antiglaucomatous medications are associated with a significant short‐term decrease in OPA which remains stable in the medium‐term.
Management of dumbbell‐shaped dermoid cysts in the temporal fossa and orbit
Authors: MISSOTTEN GS , DE KEIZER RJW
Published: October 2007

Purpose: Orbital dermoid cyst occur most frequently besides the lateral orbital wall. Rarely they also extend through the frontozygomatical suture to the temporal fossa. Here we describe two cases of dumbbell‐shaped dermoid cysts and their surgical treatment, from a larger group of (epi)dermoids of the temporal fossa.

Methods: Retrospective research

Results: Diagnosis and treatment process is shown.

Conclusions: Dermoid cysts are bening teratomes, filled with fluid, granulomatous tissue or fat. Excision is indicated when they give irritation in the surrounding tissues. It is important to think about the extension to the temporal fossa, when treating dermoids of the orbit.
Ultrastructure features of lens epithelium in intumescent white cataract
Authors: STUNF S , HVALA A , HAWLINA M
Published: October 2007

Purpose: To analyze the ultrastructure of lens epithelium in intumescent white compared to nuclear cataract and to connect the morphological features of the lens epithelium in intumescent white cataract to the mechanism of cortical cataract formation.

Methods: Samples of anterior lens capsule of 27 eyes with intumescent white and 27 eyes with nuclear cataracts were analyzed for ultrastructure of the lens epithelium by transmission electron microscopy. The Pearson Chi‐square statistics was done on the collected data.

Results: The lens epithelium of both groups showed similar changes: multi layer epithelium, detached epithelium, free spaces between the cells, intracellular vacuoles, degenerated cells, dark cells and star‐shaped nuclei.

Three samples of intumescent white cataract had extensive degenerative changes with unrecognizable lens epithelium and were not included in the statistical analysis.

Statistic analysis of the ultrastructure findings showed that the degenerated epithelial cells were more frequently present in the intumescent white thn in nuclear cataract. There was also a negative correlation between the ‘free spaces between the cells and intumescent white cataract.

Conclusions: The study proved that degenerative changes of lens epithelium in the intumescent white cataract are more frequent than in the nuclear cataract. This could be in concordance with the pathophysiological process of the cortical cataract formation, where dysfunction of the ionic pump on the cell membrane results in osmotic disbalance, cell swelling and destruction. The insignificant findings: multi layer epithelium and detached epithelium; and even the negatively correlated finding: free spaces between the cells; could all be artifacts. Further analysis has to be done to prove this.
Ultrasound biomicroscopy in non penetrating filtration surgery with 5‐Fluorouracil and without implant: long‐term results
Authors: GUTIERREZ C , VLEMING E , PAREJA J , BOLIVAR G , TEUS MA
Published: October 2007

Purpose: To evaluate the long‐term morphological changes in the anterior segment structures of the eye that appear after non penetranting filtration surgery (NPFS) supplemented with antimetabolites and without implant using ultrasound biomicroscopy (UBM).

Methods: 13 eyes of 13 consecutive patients who underwent NPFS with 5‐fluorouracil and without collagen implant were evaluated in an observational non‐randomised, consecutive case series. The study was conducted at least after 1 year of the surgery. The following parameters were assessed: (1) presence of subconjunctival filtering bleb, (2) presence and volume of an intrascleral cavity and (3) presence of a suprachoroidal hypoechoic area. IOP was evaluated before and after surgery.

Results: Mean intraocular pressure (IOP) decreased significantly from 24 ± 7.69 mmHg preoperatively to 13.76 ± 4.1 mmHg at the time of UBM (p=0.01). 69.2% of the patients had PIO≤21mmHg without medications and 84.6% with medication. UBM demonstrated a subconjunctival empty space in 92.3% of the eyes and in 84.6 %, an intrascleral cavity was observed. The mean volume of this cavity was 1.68 mm3 (range 0‐4.07). We found correlation between the height (r2=‐0.610), the width (r2=‐0.754), and the volume of the intrascleral lake (r2=‐0.558). In 92.3 %of the eyes a hypoechoic area in the suprachoroidal space also was observed.

Conclusions: UBM demonstrated an intrascleral cavity after NPFS without using an implant similar that are described when it is used. At least 1 year after the surgery the majority of the eyes have an intrascleral cavity and a suprachoroidal space.
Posterior sub‐tenon triamcinolone acetonide for the treatment of diabetic macular edema
Authors: OZKURT Y , EVCIMAN T , HABOGLU M , SENGOR T , KURNA S , AKI S
Published: October 2007

Purpose: To evaluate the use of posterior sub‐tenon triamcinolone acetonide (PSTA) injection on clinical, angiographic, and optical coherence tomographic (OCT) parameters in diabetic macular edema (DME).

Methods: In a prospective clinical sudy, 36 eyes of 33 patients with (DME). and a decrease in visual acuity were included. Posterior sub‐tenon injection of 40 mg of TA was given under topic anesthesia. All patients were evaluated at baseline and at 1 day, 1, 2, 4, 6, and 8 weeks, and 3, 6, and 9 months after injection. In some of the patients injections were repeated after 3 months. Complete ophthalmologic examination, fluorescein angiography, and OCT were performed before intervention and after 3 months. The main outcome measures were visual acuity (VA), central macular thickness(CMT), intraocular pressure (IOP), cataract progression, and frequency of complications.

Results: The mean baseline CMT for all eyes was 543μ. The mean CMT was 301μ at 1 month, Twenty‐one of the 36 treated eyes showed visual improvement in at least two lines of visual acuity. Nine eyes showed no improvement in vision. Most of them already had poor visual acuity (0.2 or less) before the injections. Complications of the treatment included cataract in three eyes, glaucoma in one. Injection of repository corticosteroids into the posterior sub‐Tenon space is of value in the treatment of CME secondary to uveitis. However, we have to beware of the complications of treatment.

Conclusions: PST injection of TA is effective in reversing CME and improving visual acuity in DME
Adjunctive use of tafluprost with timolol provides additive effects for reduction in intraocular pressure in patients with glaucoma
Authors: EGOROV E , ROPO A
Published: October 2007

Purpose: Beta‐blockers and prostanoid F2α (PF2α) analogues reduce intraocular pressure (IOP) by complementary mechanisms. A combination of treatments with additive effects may be beneficial to further reduce IOP in patients not sufficiently controlled with a single agent. This study aimed to investigate the efficacy and safety of tafluprost, a new PF2α derivative in development, as adjunctive therapy to timolol.

Methods: In this multi‐national, multi‐centre, parallel‐group, double‐masked, phase III study, 185 patients with open‐angle glaucoma or ocular hypertension and with IOP between 22‐30 mmHg on timolol, were randomised to tafluprost 0.0015% eye drops (n=96) or vehicle (n=89) as adjunctive therapy with timolol 0.5% eye drops for 6 weeks. The primary endpoint was change from baseline in the overall diurnal IOP at 6 weeks. Safety parameters were also analysed.

Results: At week 6, the additional effect of tafluprost, as compared to timolol baseline, was between 22‐24%. This additional effect was consistently larger than in the vehicle group. There were more ocular events, including conjunctival redness, iris colour and eyelash changes with tafluprost compared with the vehicle (overall 42% vs 29%), but most were mild in severity.

Conclusions: Tafluprost, when administered as adjunctive therapy to timolol, is effective and well tolerated for the treatment of glaucoma and ocular hypertension.
Elastic modulus of the iris with drug stimulation
Authors: KOTLIAR KE , WHITCOMB J , BARNETT V , OLSEN T , BAROCAS V
Published: October 2007

Purpose: Intraoperative Floppy Iris Syndrome (IFIS) syndrome occurs during cataract surgery in patients using Flomax. In oder to understand iris stiffening with different drugs we investigated how the elastic modulus (i.e., the stiffness) of the iris changes following stimulation by pilocarpine, phenylephrine, and tropicamide.

Methods: Irides (n = 20) were dissected from porcine eyes within 4 hr post mortem and mounted on a mechanical testing system. The samples were stretched up to 30% strain in the radial direction, and the modulus was calculated from the linear portion of the stress‐strain curve. One of the three drugs of interest was then added (80 ug/ml) to the bath surrounding the tissue and the experiment was repeated. Experiments were performed on intact irides and on strips cut from the iris.

Results: Changes in pupil diameter of free‐floating samples and in isometric force of mounted samples confirmed that the tissue was responsive to the drugs. For the strips, the untreated iris modulus was 4.0±0.9 kPa (mean ± s.d., n = 20), and the treated iris modulus was 7.7±2.0 (pilocarpine, n = 7), 6.9±2.2 (phenylephrine, n = 6), and 8.4±1.7 (tropicamide, n = 7). Whole irides (n = 10 total) gave similar trends but values were approximately 25% higher, presumably because the shape of the intact iris makes the stress and strain fields inhomogeneous within the sample.

Conclusions: Although pilocarpine, phenylephrine, and tropicamide work by different mechanisms, all three gave similar results – an increase in modulus of roughly two times. We conclude that in most normal situations, the iris stiffness varies within about a factor of two range, remaining quite compliant at all pupil diameters. How to address the problem of IFIS warrants further research.
Reduction in intraocular pressure is equivalent between preserved and preservative‐free formulations of tafluprost
Authors: HAMACHER T , AIRAKSINEN J , RICHTER U , ROPO A
Published: October 2007

Purpose: Tafluprost is a newly synthesized prostanoid F2α (PF2α) derivative that reduces intraocular pressure (IOP) and is in development for the treatment of glaucoma. Tafluprost is the first PF2α analogue with a preservative‐free formulation. This formulation may decrease the risk of side effects caused by chronic exposure to benzalkonium chloride. This study aimed to investigate the pharmacodynamics of preserved and preservative‐free tafluprost.

Methods: A randomised, investigator‐masked, multi‐centre, cross‐over phase III study evaluated the pharmacodynamics and safety of preserved and preservative‐free tafluprost 0.0015% eye drops administered for 4 weeks each in 43 patients with open‐angle glaucoma or ocular hypertension. The primary variable was change from baseline in the overall diurnal IOP at 4 weeks. Adverse events and other safety parameters were also analysed.

Results: A clear IOP lowering effect was observed with both formulations at Week 1. This effect was sustained and similar between groups at Week 4 with an estimated overall treatment difference (preservative‐free – preserved) for the intent‐to‐treat population of 0.01 mmHg (95% CI, ‐0.46 to 0.49; P=0.96). There were no unexpected safety findings. Both formulations were well tolerated with most adverse events being ocular, and mild in severity. There were no serious adverse events or withdrawals due to adverse events in this study.

Conclusions: Preservative‐free tafluprost resulted in an equivalent IOP lowering effect compared with the preserved formulation, and was generally well tolerated.
Persistent pupillary membrane remnants attached to the anterior lens capsule
Authors: CHATZIBALIS T , KARAMPATAKIS V , NTAMPOS K , VOUTAS S
Published: October 2007

Purpose: To present an interesting case of bilateral persistent pupillary membrane remnants without visual acuity impairment. Persistent pupillary membrane remnants are an ocular “congenital anomaly” and often affect both eyes.

Methods: A 12 year old dark‐haired boy presented on a routine examination with dense and wide pupillary membrane remnants attached to the iris collarette and the anterior lens capsule bilaterally. In OD the remnants covered almost the whole pupillary area however leaving some clear islands and among them a central one. In OS the remnants did not cover the central pupillary area.

Results: Uncorrected visual acuity was surprisingly good (9/10 OD and 10/10 OS). Although autorefraction was OD: +3.50 ‐2.25 X 180º and OS: +0.75 ‐0.25 X 170º, subjective refraction was OD: + 1.25 X 90º providing 10/10 and Jaeger 1 and OS: plano providing 10/10 and Jaeger 1.

Conclusions: The characteristic of the pupillary membrane remnants is the attachment to the iris collarette and this is the most important differential diagnostic feature from pupillary membranes of other origin. Surgical removal of these membranes or YAG‐laser membranectomy is sometimes necessary in cases with severe visual impairment. The surprisingly good visual acuity in the present case is not suggestive of any attempt to remove these pupillary membrane remnants. Excellent near and distant visual acuity was preserved in the right eye due to a “pinhole effect” of the central clear island which prevented the occurrence of amblyopia.
Interleukin1‐Induced apoptosis of keratocytes: effect of biglycan
Authors: KOULIKOVSKA M , SHARIPO A , FAGERHOLM P
Published: October 2007

Purpose: Biglycan is absent in the normal cornea, but UVR exposure leads to a significant expression of the biglycan gene in the rabbit cornea, an effect that decreases after healing is completed, indicating the envolvement of biglycan in the corneal repair process. In the present study, we have investigated possible involvement of biglycan in the modulation of the survival of keratocytes.

Methods: Keratocytes were grown either under serum free conditions to obtain quiescent keratocyte cell culture or in the presence of 10% fetal bovine serum to induce keratocyte transformation into myofibroblasts. Myofibroblastic phenotype was confirmed by immunocytochemistry with anti‐alpha‐smooth muscle actin antibodies. Cell death was induced in both cell cultures by interleukin‐1 in the presence or absence of biglycan.

Histone‐associated DNA fragments were assayed by using a cell death detection ELISA.

Results: Quantification of histone‐associated DNA fragments by the cell death detection ELISA showed that biglycan strongly protected quiescent keratocytes from dying whereas it enhanced the death rate of transformed keratocytes. Apoptotic death rate was elevated after the addition of IL‐1 in both keratocyte and myofibroblast cell cultures. Co‐incubation with biglycan markedly reduced the number of apoptotic keratocytes but markedly increased the number of apoptotic myofibroblasts.

Conclusions: IL‐1‐induces apoptosis of both quiescent and transformed keratocytes. However, biglycan has differential effect on apoptosis of these two cell types.
Use of Travalert® in routine clinical practice
Authors: STEWART WC , JASEK MC , STEWART JA
Published: October 2007

Purpose: To evaluate Travalert® in clinical practice.

Methods: Travalert® is a computerized bottle holder that reminds patients to instill their medicine, assists in the administration of the drop, and records the dosing time for travoprost (Travatan™) or the travoprost/timolol fixed combination (Duotrav™, Alcon, Inc., Fort Worth, TX). Technicians who dispensed the TDA completed a questionnaire regarding their experience with the device.

Results: 3198 questionnaires were completed at 120 sites. Physicians alone usually decided to dispense the Travalert® (n = 1858, 58%) typically because patients forget to take their medication (n = 1613, 50%). The technician usually instructed the patient how to use Travalert® (n = 2774, 87%). Patients were typically very receptive to using the device (n = 2046, 64%) with their most common concern being monitored (n = 345, 11%). In the office the Travalert® typically required < 10 minutes to explain (n = 2855, 89%) and < 2 minutes to initialize (n = 1873, 59%). Most offices reminded the patient to return Travalert® only at the visit in which it was dispensed (n = 1669, 54%) and most patients remembered to return it (n = 1613, 68%). The patient’s overall impression of Travalert® was favorable (n = 1846, 77%). Downloading the data did not usually affect patient flow (n = 1846, 77%) and it typically took < 5 minutes to discuss the findings with the patient (n = 974, 63%). Most patients chose to continue using Travalert® (n = 1956, 82%).

Conclusions: Travalert® offers a convenient method to monitor patient compliance with a high acceptability rate by the patient and clinical technician.
Anterior chamber depth changes and complications after Nd:YAG laser treatment for posterior capsule opacification in pseudophakic eyes
Authors: EVCIMAN T , OZKURT Y , SENGOR T , HABOGLU M , KURNA S , AKI S
Published: October 2007

Purpose: To investigate the effect of Nd:YAG capsultomy on anterior chamber depth changes and complications of Nd:YAG laser treatment for posterior capsule opacification in pseudophakic eyes.

Methods: Our study includes 26 eyes (23 patients) with posterior capsule opacification (PCO) after uncomplicated phacoemulsification surgery and intraocular lens implantation. Complete ocular examinations were performed for each patients . The best corrected visual acuity, intraocular pressure, keratometry and anterior chamber depth measurements were obtained in all examinations. In all patients Nd:YAG capsulotomy was performed. Data were analyzed statistically.

Results: Mean patient age was 53.73±13.53 years. Before Nd:YAG capsulotomy mean anterior chamber depth was 4,03± 0,58 mm and in the first day after capsulotomy mean value was 4,02± 0,46 mm . Mean spherical equivalent refraction before laser treatment was ‐0.53 diopters. Mean spherical equivalent refraction in the first day after laser treatment was ‐0.49 diopters. Before Nd:YAG capsulotomy mean best corrected visual acuity was 0.38±013, and in the first day after capsulotomy mean value was 0.93±0.11, there was statistically significant difference. There were no statistically significant differences between the anterior chamber depth, intraocular pressure (IOP) obtained at before laser capsulotomy and the post laser first day, first month and the third month exams.

Conclusions: Nd:YAG laser capsulotomy is an effective and safe method of treatment of posterior capsule opacification.
Function of macular area in retinopathy of prematurity
Authors: SHAMSHINOVA AM , KATARGINA LA , KOGOLEVA LV , SITNIKOVA DN
Published: October 2007

Purpose: To assess the bioelectric activity of the retina at different stages of the retinopathy of prematurity (RP).

Methods: 21 children with RoP (stage 1‐4, 6‐14 years old, born at 27‐32 week of gestation with the birth weight of 730‐1800g) were examined. In 4 of children the prophylactic laser coagulation of avascular retina was performed in the active phase. Visual acuity (VA) at the stage 1 of RoP amounted to 0,75; at the stage 2: 0,5; at the stage 3: 0,25 and at the stage 4: 0,02. Macular (MBN Moscow) and mf ERG( Roland Concult Germany) were examined.

Results: There was no correlation between VA values and parameters of multifocal (mf) and macular (m) ERG. Patients with RP of stage1 showed a moderate reduction of b‐wave magnitude of mERG at its normal latency. This correlated with mfERG data in central hexagons 15 degrees. The magnitude and latency of mERG were changed to a great extent in RP patients of stages 2‐3. The waves N1 and P1 of mERG were also heavily decreased at normal latency. The patients with severe retinal abnormalities, like retinal detachment, have subnormal mERG‐values with prolonged latency, and moderate decrease of retinal density in the central ring and considerable changes with eccentricity in mfERG.

Conclusions: RP patients 1‐4 stages showed considerable impairment of macular function

independent of the ophthalmoscopic changes. Even occult or weak‐manifested of the diseases in the macula might be accompanied with the moderate decrease of macular bioelectric activity, including the abrupt abnormalities of the electrogenesis and neuronal interactions in the macular area. Decline VA d'not always had relation with RP. The pathophysiologic rationale of the latter needs to be elucidated in the future studies.