bluuebunny/crossref_metadata_2025 huggingface dataset:
Methodology of retinal straylight assessment
Authors: VAN DEN BERG TJTP
Published: October 2007

Purpose: The psychophysical technique of “Compensation Comparison”, embedded in the C‐Quant instrument for clinical assessment of retinal straylight will be demonstrated. Retinal straylight is the cause of complaints such as glare hindrance and contrast loss. It results from disturbances in the optical media. Its assessment helps to decide on surgery of (early) cataract, or to evaluate corneal or vitreal problems.

Methods: The subject’s task is to compare in 20 short presentations two flickering half fields, and to indicate with push buttons which one flickers more strongly. Added value in comparison to visual acuity was assessed in 2422 active drivers of the European GLARE study. Repeatability of the obtained straylight value was tested for 17 naive subjects and several groups of patients. Absolute measurement precision of the C‐Quant was tested using a scattering sample with known straylight value in front of the eyes of the 17 naive subjects.

Results: Many individuals were found to suffer from increased straylight that is undetected in visual acuity: in 6% of cases with decimal visual acuity > 0.5 straylight was increased more than 4 times compared to normal. A psychometric function was derived and fitted to the patient responses, resulting in a straylight value including a reliability estimate. Repeated measures standard deviation for the method is about 0.07 log units, to be compared with differences of 1.0 log units or more units with (early) cataract or corneal disturbances. The check using known scatter samples showed virtually perfect (0.01 log units difference) correspondence.

Conclusions: Absolute precision and repeated measures standard deviation is very good compared with differences in the population. Straylight measurement promises important extra diagnostic power.
Effects of UDP on ARPE cells: possible involvement of P2Y6 receptors
Authors: JUDICE DE MENEZES RELVAS L , BOUFFIOUX C , MARCET B , COMMUNI D , BLERO D , BRUYNS C , CASPERS L , BOEYNANS JM , WILLERMAIN F
Published: October 2007

Purpose: We have studied the effects of nucleotides (ATPγS, UTP and UDP) on human retinal pigmental cells, in relation to their expression of functional P2Y receptors.

Methods: ARPE cells were grown in culture and stimulated with ATPγS, UTP and UDP. Cell proliferation was analysed by BrdU incorporation. Calcium flux and cAMP were measured by fluorometry and radio‐immunoassay. IL‐8 production was investigated by semi‐quantitative RT‐PCR and ELISA. P2Y2, P2Y4 and P2Y6 expression was analysed by RT‐PCR.

Results: UDP inhibited ARPE cell proliferation while ATPγS slightly stimulated it and UTP had no effect. This differential effect suggests the expression of other P2Y receptors than the already described P2Y2. Accordingly we detected transcripts for the P2Y6 receptor, which is a UDP receptor. UDP induced a calcium flux, like ATPγS and UTP, but no cAMP production. All nucleotides stimulated IL‐8 secretion.

Conclusions: Our results suggest that ARPE cells express functional P2Y6 receptors.
Corneo–conjunctival leukoplakia: histology and confocal microscopy
Authors: MALANDRINI A , FRUSCHELLI M , TRAVERSI C , MOTOLESE PA , MARTONE G , MOTOLESE E
Published: October 2007

Purpose: To explore corneo‐conjunctival leukoplakias using in vivo confocal microscope and to

compare images to histology and impression cytology specimens.

Methods: Twenty‐nine patients affected by corneo‐conjunctival leukoplakia, after evaluation with slit lamp exam, were investigated with the Heidelberg Retina Tomograph II, Rostock Cornea Module. Subsequently a diagnostic excision or impression cytology of the cornea and/or conjunctiva was performed.

Results: Histology identified seventeen Pterygia, six Pingueculas, two limbal stem cell deficiency (LSCD), one suture‐related corneal vascularization, one cicatricial Pterygoid and two corneal intraepitelial neoplasias (CIN). Confocal microscopy was compared to histopathologic sections and impression citology specimens.

In all patients typical white colour of lesions was attribuable to a different degree of reactive hyperkeratosis.

The main pathological features were visible on our confocal microscopy images: infiltration of conjunctival tissue surrounding lesions, vascularization, cellular morphology and activity, changes in extracellular matrix and modifications of limbar architecture.

Conclusions: Confocal microscopy may be a useful aid for diagnosis and follow up in primitive and secondary corneo‐conjunctival lesions. However the ability to provide high resolution, real‐time images of the full thickness of the living human cornea and conjunctiva is strictly dependent on surface transparency and additional studies are required to establish exact correlations between confocal microscopy images and histopatology.
Short‐term effect of topical brimonidine tartrate on intrastromal pressure. an animal study
Authors: BOLIVAR G , TEUS MA , GUTIERREZ C , CASTEJON MA
Published: October 2007

Purpose: To evaluate the effect of topical brimonidine tartrate on the intrastromal corneal pressure (ICP) , due to it have been postulated that the brimonidine tartrate could have an adverse effect on postoperative flap adherence to the stromal bed after LASIK surgery, and that the endothelial pump plays an important role in flap adhesion.

Methods: Interventional, prospective study. The ICP was recorded for 45 minutes in eight eyes of rabbits treated with topical brimonidine tartrate three times daily for three consecutive days and in eight rabbit eyes treated with artificial tears (control group). All the measurements were performed by the same masked investigator.

Results: The ICP averaged ‐4±2.9mmHg, ‐6.7±3mmHg y ‐9±4.5mmHg at 15, 30 and 45 minutes in the control group, respectively. In the study group (brimonidine treated eyes), the ICP readings were +2.75±2.9mmHg, ‐2.5±3mmHg y ‐8.5±5mmHg at the same time points, respectively. The differences in the ICP between both groups were statistically significantly different at 15 minutes (p=0.01), but neither at 30 nor 45 minutes (p=0.2 and p=0.8 respectively).

Conclusions: The acute treatment with brimonidine tartrate produces significant changes in the ICP. This changes could help to explain the alteration in the flap adherence that have been reported.
Correctable and non‐correctable refractive error in a population of young men in Poland
Authors: NOWAK MS , GOS R , SMIGIELSKI J
Published: October 2007

Purpose: To evaluate the prevalence of non‐correctable refractive error in a representative sample of Polish young men.

Methods: A retrospective study of medical records of Military‐Medical Commission of Lodz, Poland. Distance visual acuity (VA) was assessed in 105017 men examined during period 1993‐2004. Visual acuity was checked on Snellen's charts without vision correction. We chose for the study a representative sample of 994 induviduals. Refraction data were obtained of those men who had impaired distance vision‐ presenting VA of below 6/12 in any eye. Non‐correctable refractive error was defined as the best corrected visual acuity (BCVA) of below 6/12 in one or both eyes. We use statistic analysis to estimate the results in a whole population of young men examined during researched period.

Results: Mean age of researched individuals was 22.46 +/‐ 4.29 . Overall 13.28% subjects had impaired distance vision. After refraction, 90.15% of them could achieved VA of 6/12 or better with corrective lenses. Non‐correctable refractive error was found in 9.85% of men with impaired distance vision. Extrapolating these results to the whole population we estimate that 1.21% of Polish young men have non‐correctable refractive error‐ BCVA of below 6/12 in one or both eyes. Correctable refractive error was mainly due to myopia (78.10% right eye and 83.02% left eye).

Conclusions: The overall non‐correctable refractive error had a relatively low prevalence (1.21% of population). Appropriate refractive correction improved distance VA in 90.15% subjects with impaired distance vision. The commonest refractive error was myopia.
The prevalence of glaucoma and ocular hypertension in a population of Polish young men
Authors: NOWAK MS , GOS R , KLYSIK AB , SMIGIELSKI J
Published: October 2007

Purpose: To determine the prevalence of glaucoma and ocular hypertension (OHT) in a representative sample of Polish young men.

Methods: A retrospective study of medical records of Military‐Medical Commission of Lodz, Poland. Intraocular pressure (IOP) was measured in 105017 men examined during period 1993‐2004. We chose for the study a representative sample of 994 individuals. If the IOP was higher than 21 mmHg, the optic nerve and visual field were evaluated. We use the statistic analysis to estimate the results in a whole population of young men examined during researched period.

Results: The mean age of researched individuals was 22.46 +/‐ 4.29 . Glaucoma and ocular hypertension were diagnosed in 1.11% subjects. The data collected from Military‐Medical Commission did not differentiate glaucoma to OHT. Extrapolating these results to the whole population we estimate that the prevalence of glaucoma and ocular hypertension is around 1.0% of the population of Polish young men.

Conclusions: The study shows that the overall prevalence of glaucoma and ocular hypertension is relatively low (1.11%) in this population of young men. Further investigations are needed to compare these results to the group of women at the same age.
Comparison among bevacizumab, ranibizumab and pegaptanib on human umbilical vein endothelial cells viability, apoptosis and proliferation
Authors: CARNEIRO A , FALCAO M , SOARES R , AZEVEDO I , FALCAO‐REIS F
Published: October 2007

Purpose: The aim of the present study was to compare the short term in vitro effects of anti‐VEGF molecules available in ophthalmological practice in human umbilical vein endothelial cells (HUVECs).

Methods: Cultures of HUVECs were established and treated during 24 h with different concentrations (including intravitreal concentrations used in intravitreal injections) of either bevacizumab, ranibizumab or pegaptanib diluted in culture medium. Controls were incubated with excipient solutions. Effects on cell viability (MTT assays), apoptosis (TUNEL assay), and proliferation (using BrdU) were investigated.

Results: Viability of HUVECs incubated with bevacizumab, ranibizumab or pegaptanib did not significantly differ from controls in any of the concentrations examined. An increase in cell apoptosis by all anti‐VEGF agents was found. In clinically used concentrations apoptotic fold increase was higher in the bevacizumab group. A decrease in cell proliferation was found when HUVECs were incubated with any of the three agents.

Conclusions: These findings indicate that all investigated molecules inhibit cellular proliferation without inducing cytotoxicity. Bevacizumab at concentrations identical to the dose normally used in intravitreal injections had a greater fold increase in apoptosis than the other anti‐VEGF agents.
Diagnostic ability of GDx VCC to discriminate between healthy eyes, ocular hypertensive subjects and glaucoma patients
Authors: BORQUE E , FERRERAS A , POLO V , LARROSA JM , ALIAS EG , HONRUBIA FM
Published: October 2007

Purpose: To evaluate the diagnostic ability of laser polarimeter GDx VCC to discriminate between healthy eyes, ocular hypertensive subjects and glaucoma patients.

Methods: 417 eyes of 417 subjects were included. They were divided into 60 healthy controls, 289 ocular hypertensive subjects and 71 glaucoma patients. The GDx VCC parameters were compared among the study groups using analysis of variance. The receiver operating characteristic (ROC) curves were plotted for TSNIT average, superior average, inferior average, TSNIT standard deviation and nerve fiber indicator (NFI) between control and glaucoma eyes.

Results: All evaluated parameters of the GDx VCC showed significant differences between control and glaucomatous eyes and between ocular hypertensive eyes and glaucoma patients. NFI had the greatest area under the ROC curve (AUC=0.881). The AUCs for the inferior average, TSNIT standard deviation and TSNIT average were 0,834, 0.824 and 0.819, respectively. NFI presented a larger AUC than the other GDx VCC parameters.

Conclusions: The GDx VCC exhibited a good diagnostic ability to discriminate between healthy and glaucomatous eyes with damage in SAP. The best parameter was NFI.
Ultrastructure of diabetic epimacular tissue
Authors: SYNEK S , PAC L , SYNKOVA M
Published: October 2007

Purpose: Nowaday there are exist some different modalities of Diabetic cystoid macular oedema (DME) therapy. Authors compare results in laser coagulation against pars plana vitrectomy.

Methods: 20 eyes of patients with DME were randomized into two groups. One’s was treated only by laser focal coagulation the second’s only by pars plana vitrectomy with epimacular tissue removal without laser coagulation. Samples of epiretinal tissue from vitrectomized eyes were examined by transmissive electron microscopy (TEM).

Results: Median duration of DME at the time of PPV was approximately 18, 0 (12 ‐ 24) months. The median preoperative best‐corrected VA of 0.08, improved to a median postoperative VA of 0.25. 10 eyes without laser coagulation had a median VA improvement of 77%, while 10 eyes with macular laser treatment had a median VA improvement of 14.8%. In all 20 eyes, DME was no longer visible on microscopic examination after a median period of 3.0 months. TEM Epiretinal tissues samples demonstrate solid blocks of fibroblasts with firm skeleton from collagen fibres.

Conclusions: PPV resulted in the resolution of oedema, with an improvement in visual acuity in the majority of cases. A randomized controlled prospective trial of PPV versus laser is needed to determine the role of PPV as treatment modality for DME
Counting strategies for endothelial assessment of organ cultured corneas using image analysis: comparison of border versus center method
Authors: DEB‐JOARDAR N , ZHAO M , THURET G , ROBERT PY , GAVET Y , ACQUART S , PEOC'H M , MAUGERY J , GAIN PG
Published: October 2007

Purpose: To compare 2 cell count strategies, border and center methods for endothelial assessment during corneal storage

Methods: 7 observers determined the ECD, CV of cell area, and % hexagonality of 30 organ cultured corneas by the border (contour detection and manual retouch) and center method (indicating cell centers) using Sambacornea analyser. Interobs variability for ECD and agreement between the 2 methods was determined. The accuracy of the center method was verified on 10 standard photolithographic mosaics (called keratotest) by border (ref method) and center methods, first as fast and next as precise as possible (fast and slow modes respectively) and the time noted.

Results: For stored corneas, interobserver variability was ±9.6%(95%CI[6.5‐12.7]) for border method and ±9.3%(95%CI[6.3‐12.3]) for center method. ECD [mean±SD(range),median] was [2948±565(1644‐3878),3081] and [2961±568(1736‐3914),3037] respectively and showed excellent correlation (Pearson coefficient r=0.998, p<0.001). The center method underestimated the CV by a mean 9.5%95%CI[8.3‐10.7] and overestimated the hexagonality by a mean 2.5%(95%CI[1.4‐3.7])(p<0.001 for both). Precision of indication of cell center influenced only the CV (mean for slow and fast modes being 3.6±0.7% and 7.4±1.3% respectively, p<0.001) but was more time consuming (p=0.005)

Conclusions: The center method gives accurate and reproducible ECD and is comparable to the border method (reference). However, morphometric evaluation is not fully reliable. Given that center method is easier to use in poor quality images, we recommend its use only for these cases.

Grant: Etablissement Français des Greffes 2004
Correlation between global indices of short‐wavelength automated perimetry and GDx VCC parameters
Authors: FERRERAS A , PAJARIN AB , LARROSA JM , POLO V , BORQUE E , HONRUBIA FM
Published: October 2007

Purpose: To correlate the main indices of short‐wavelength automated perimetry (SWAP) with the peripapillary retinal nerve fiber layer thickness measured with the scanning laser polarimeter GDx VCC (Laser Diagnostic Technologies, Inc., San Diego, CA) in different diagnostic groups.

Methods: 400 eyes were divided into 56 control eyes, 211 ocular hypertensive subjects, 67 glaucoma suspects and 66 glaucomatous patients, depending on intraocular pressure, optic nerve head morphologhy and standard automated perimetry (Humphrey 24‐2 SITA standard). Only one eye was randomly chosen for the study. SWAPs were performed with a Humphrey perimeter and the 24‐2 full threshold algorithm. Pearson correlations between SWAP indices (mean deviation ‐MD‐ and pattern standard deviation –PSD‐) and GDx VCC parameters (Nerve fiber indicator –NFI‐, TSNIT average, superior average, inferior average and TSNIT standard deviation) were calculated for each group of subjects.

Results: Mild significant (p<0.05) correlations were observed between SWAP indices and most GDx parameters in the glaucoma suspect and the glaucomatous groups. Few GDx parameters showed mild correlations with the indices of SWAP in the normal group, but no significant correlations were found in the ocular hypertensive group. The TSNIT standard deviation exhibited the strongest correlation with the MD in the glaucoma group (0.33).

Conclusions: Laser polarimetry parameters showed mild correlations with SWAP defects in glaucoma subjects.
Training improves the identification of Retinal Angiomatous Proliferation in the UK network of ophthalmic reading centres
Authors: PATTON WP , PETO T , MULDREW KA , REEVES B , LENFESTY P , HARDING SP , STEVENSON M , CHAKRAVARTHY U
Published: October 2007

Purpose: To report on the identification of Retinal Angiomatous Proliferation (RAP) in the Network of Ophthalmic Reading Centres UK (NetwORC) for the Verteporfin Photodynamic Therapy (VPDT) cohort study. RAP tends to be bilateral and although it is accepted to be part of the spectrum of age‐related macular degeneration (AMD), no treatment has yet proved to be as successful as in other types of AMD. A diagnosis of RAP is therefore instrumental to the success of treatment decisions to be made.

Methods: The VPDT study involves the grading of more than 5000 angiograms per annum at the network of Reading Centres (RC) with regular training and concordance activities being performed. The grading database was queried for RAP lesions identified on a monthly basis between Nov 2005 and Oct 2006. Expert training on identification of RAP was given at 3 successive meetings during this period.

Results: In this 12‐month period, 5402 angiograms were graded (including both primary and quality assurance gradings). RAP was identified in 264 cases, with a step‐wise increase in the identification of RAP during this one year period. Using a simple chi‐squared for trend test, there is a highly significant increasing trend over the 12 months (p<0.0001) following training sessions at all three RCs, highlighting the benefit of structured training.

Conclusions: The present study has shown that consistent concordance and training exercises across the RC network improves the identification of specific lesion components such as RAP. With improved education, other clinical and grading staff can be trained to recognise RAP lesions and better identification may lead to improved treatment outcomes.
Development of an image analysis device to measure transparency, folding and gerontoxon of organ cultured corneas
Authors: ZHAO M , JOUBERT J , DEB‐JOARDAR N , PIPPARELLI A , ACQUART S , PEOC'H M , PRADES JM , MAUGERY J , THURET G , GAIN PG
Published: October 2007

Purpose: To develop an image analysis device devoted to the measurement of donor corneal transparency (T), folding (F) and clear corneal diameter excluding gerontoxon (G) during organ culture

Methods: High res digital images of a retroilluminated test chart comprising parallel lines viewed through the cornea were analysed using a dedicated software. T (%) was a ratio of local contrast of the test chart and F (%) was a ratio of mean of line profiles, each measured with and without the cornea. Area of clear cornea outside gerontoxon was calculated from a circle delineated by the observer. On each image, 3 independent experts classified T, F and G according to 3‐level score (++/+/0) which served as reference. 179 human corneas (fresh, stored and deswelled) were consecutively analysed to include a broad spectrum of T and F

Results: The device was able to discriminate between the 3 classes of T, F and G established by the experts. T was 20±4, 36±8 and 51±10% respectively for transparency deemed poor, average and excellent (P<0.01). F was 29±10, 22±6, and 17±6% respectively for folding deemed high, average and minimal (P<0.01). Diameter of clear central cornea was 7.7±1.1, 8.9±0.8, 10.4±0.6 mm respectively for gerontoxon deemed severe, moderate and absent (P<0.01)

Conclusions: This simple and original device provides reliable quantitative objective measures of T, F and G. It will help standardizing quality assessment of corneas among eye banks.

A trial designed to assess the ability of the device to select corneas before delivery in the setting of the routine practice of our cornea bank is ongoing.

Grants :Etab Français des Greffes 2004 and PHRC/AOL 2007
Ocular inflammation secondary to syphilis infection
Authors: PUECH C , CHIQUET C , PAVESE P , BOUILLET L , ROMANET JP
Published: October 2007

Purpose: to report ocular inflammation secondary to syphilis infection in a tertiary center.

Methods: Within a prospective study (2 years, 2005‐2007), we collected data on 7 male patients with ocular syphilis. Diagnosis was based on serology tests on blood sample and/or cerebrospinal fluid. All patients underwent a check up for ocular inflammation to rule out another etiological diagnosis and to detect another sexually transmitted infection.

Results: Coinfection with human immunodeficiency virus was reported in 4 patients, with a CD4 T lymphocyte count greater than 300/mm3 in all cases. The ocular lesions were variable ; chorioretinitis (1 eye), retinal necrosis (2), panuveitis with macular edema (1), episcleritis (1), anterior optic neuropathy (1), and retrobulbar optic neuropathy (1). Infection of the cerebrospinal fluid was detected in 4/4 cases. The lumbar puncture was refused in 3 cases. In all cases, the inflammation was unilateral, and the anatomical and functional prognosis was excellent. Only one patient with the anterior optic neuropathy required systemic steroid therapy associated with antibiotics. Sequelae were a sectorial atrophy of the optic nerve (1 eye), and abnormalities of the retinal pigment epithelium (3 eyes). 6/7 patients were treated with ceftriaxone 2g/day during 3 weeks, with a good tolerance. One patient was treated with penicillin G.

Conclusions: All patients with ocular syphilis exhibited a functional improvement and resolution of ocular inflammation after a specific antibiotic treatment. In our area, the incidence of syphilis increases in immunocompetent and immunocompromised patients. As a great imitator, syphilis should be considered in all patients with uveitis or optic neuritis, especially in men with unprotected sexual behavior.
4α‐PDD induces Ca2+ influx in human corneal epithelial cells by activating TRPV4 channels
Authors: MERGLER S , PAN Z , YANG H , LIU H , TACHADO SD , ZHANG F , PLEYER U , REINACH P
Published: October 2007

Purpose: Transient receptor potential (TRP) isoform expression is evident in human corneal epithelial cells (HCEC‐SV40). However, their role in maintaining corneal epithelial homeostasis is not fully understood. We probed for gene and protein expression as well as functional activity of the vanilloid subtype, TRPV4, in immortalized HCEC‐SV40 since they elicit Ca2+ dependent regulatory volume decrease (RVD) responses during exposure to a hypotonic challenge.

Methods: RT‐PCR and Western blotting analyses identified TRPV4 gene and protein expression. Functional activity was assessed based on determining whether the TRPV4 selective agonist, 4α‐PDD, induced transients increases in intracellular Ca2+ concentration.

Results: Single cell fluorescence imaging results showed that 4α‐PDD (3 μM) increased intracellular Ca2+ concentration. The fura2 fluorescence ratio (f340/f380) was 0.39 ± 0.03578 in the resting state (n = 5). After application of 4α‐PDD it increased to 0.904 ± 0.14363 (n = 5; p = 5.72077×10‐5). This increase was abolished by the TRP channel blocker ruthenium red or by Ca2+‐free Ringer's medium.

Conclusions: In conclusion, there is functional TRPV4 expression in HCEC‐SV40. TRPV4 expression may provide an osmosensor role to induce RVD behavior during exposure to a hypotonic challenge since this response is mediated through intracellular Ca2+ transients.

Supported in part DFG Pl 150/14‐1 and NIH, EY04795. CR: none
Phenotype characteristics of patients with Usher syndrome type 2
Authors: FARKAS A , LESCH B , VARSANYI B , VA'MOS R
Published: October 2007

Purpose: To investigate whether USH2A and USH2C genotypes are clinically distinguishable based on data described in the literature.

Methods: In a patient group diagnosed clinically as Usher syndrome type 2 (35 patients, aged 6‐64 yrs) best corrected visual acuity (BCVA), static visual fields (Octopus 101), full field and multifocal electroretinograms (RETIport and RETIscan, Roland Consult) and the structure of the central retina (optical coherence tomography, using Stratus OCT3 Zeiss) were examined.

Results: BCVA: LogMAR 0.3 or better in 19, 0.3‐1.0 in 13 and worse in 3 patients. Radius of the residual central field was between 25º and 10º in 11, between 10º and 5º in 21 patients and less than 5º in 3 patients. Full field ERG: both rod and cone responses were extinguished in 29 patients, while residual 30 Hz flicker cone activity was detectable in 6 patients. MfERG: subnormal b‐wave amplitudes were measured in the central 3 rings in 11 patients, 2 rings in 16 patients, in the central ring only in 3 patients and in 5 patients no response was recordable. OCT was carried out in 18 patients; decrease in TMV in 10 patients, blunting of the foveolar pit in 5 and cystic intraretinal changes in 3 patients were found.

Conclusions: This retrospective examination does not allow a correct differentiation of the two Usher subtypes. In the majority of patients clinical symptoms indicate the phenotype of USH2A. Three patients (with the most severe clinical condition) might represent a different genetic subtype.
Reconstitution of conjunctival epithelium under the influence of mesenchymal stem cells on a rabbit model of symblepharon
Authors: GARDEA E , GUEUDRY J , DUCLOS C , VANNIER JP , MARIE JP , LAMACZ M , MURAINE M
Published: October 2007

Purpose: Conjunctival fibrosis pathologies are hard to treat and liable to be recurrent. We worked out a project of cellular therapy by means of mesenchymal stem cells from the bone marrow so as to improve the therapeutic results.

Methods: We created an original model of symblepharon on the rabbit. We reconstructed the fornix thanks to an amniotic membrane covered, either with mesenchymal stem cells (MA/MSC), or conjunctival fibroblasts (MA/Fibro.) or with a single amniotic membrane (MA).

Results: The model of symblepharon presents a loss of anatomy with an average depth reduction of 60 % and a loss of function with goblet cells disappearance.

After reconstruction, we had an anatomical restoration in all the operated eyes with a depth close to normal 10 ± 2, 11 ± 3 ET 9 ± 2 mm respectively in the MA/MSC, MA and MA/fibroblasts group. The difference between the groups is not statistically significant (p>0,05).

The analysis of the conjunctival phenotype by immunochemistry MUC5ac shows a statistically higher density (p<0, 05) of goblet cells in the MA/MSC 109 ± 25 group, than in the MA 32 ± 10 and MA/fibroblasts 10 ± 5 cells/mm group.

Local inflammation estimated by histological analysis is lower and similar in the group MA/MSC and MA with a average of 550 ±50 inflammatory cells/mm in the forniceal area than in the group MA/fibroblasts with a average of 1165 ±50 cells/mm.

Conclusions: We demonstrated the feasibility of a reliable and reproducible animal model of conjunctival symblepharon. The anatomy is restored in the 3 groups but the presence of MSC allows us to find a conjunctival phenotype close to normal partly thanks to a decrease of the local inflammation.
Correlation between fluorescein angiography and optical coherence tomography in diabetic macular edema
Authors: GARCIA CAMPOS JM
Published: October 2007

Purpose: To compare the pattern of fluorescein angiography with the optical coherence tomography in diabetic macular edema.

Methods: 145 eyes ( 92 patients)with diabetic macular edema were included. The fluorescein angiography pattern were organized in focal, diffuse, cystoid +focal, cystoid, tractional and detachment of the neuroepithelium. Retinal thickness was measured by optical coherence tomography. Correlation between optical coherence tomography and fluorescein angiography were analyzed.

Results: Focal type was found in 93,79%, cystoid in 35,86% and diffuse in 3,44% of the cases.The optical coherence tomography revealed swelling component in 73,28%, cystoid in 41,78%, detachment of the neuroepithelium in 11,8% and tractional in 6,2% of the patients.The swelling image was observed in 79,1% of the patients with focal leakage, 80% of the diffuse and 73,2% of the focal + cystoid. The cystoid component in the 72,3% of the patients with focal+cystoid leakage and 40% of the diffuse+cystoid .The detachment of the neuroepithelium was associated with cystoid swelling in 70,58% of the cases and the tractional detachment with swelling type in 77,7% .None of the serous detachment could be detected with angiography fluorescein.

Conclusions: The fluorescein angiography do not correlate in all cases with OCT.Macular retinal thickness measurements were higher in the patients with detachment of the neuroepithelium pattern than in the other types of optical coherence tomography features.
Segmentation analysis of the age related retinal changes in patients with achromatopsia
Authors: VARSANYI B , LESCH B , VA'MOS R , FARKAS A
Published: October 2007

Purpose: Our previous results showed a significant reduction in the retinal thickness (RT) in the macular region of patients with congenital achromatopsia. In this study we investigated the age‐dependent changes of the different layers of the central retina.

Methods: The retina of eight patients with achromatopsia were examined by optical coherence tomography (OCT). Beside the total retina, the thickness of the retinal nerve fibre layer (RNFL), the inner (InR) and outer retina (OuR), and the pigment epithelium – choriocapillary complex (RPE‐CC) was analyzed. Measurements were taken in the fovea (RPE‐CC and InR only), at the parafoveal rim, and 3 mm away from the fovea using A‐scan analysis and callipers. The results of the “younger” (N=5; mean age: 10yrs, ±2.8) and “older” (N=3; mean age: 56.3yrs, ±15) patients were compared using Mann‐Whitney‐U test. The analysis was also performed on eight age‐matched control subjects.

Results: The InR and RNFL was significantly thinner (p<0.01; p<0.05) in the “older” compared to the “younger” patient group in all regions. The OuR and RPE‐CC was also thinner in the “older” group, but these changes were not significant (p>0.05). In the healthy control group only non‐significant changes were seen, mainly in the RPE‐CC layer. No significant changes were found between the two methods of the measurements.

Conclusions: These findings support our theory that the age‐dependent changes seen in the retinal morphology of the achromatopsia patients are due to the involvement of the cone‐related structures rather than the photoreceptors themselves.
Treatment of patients with late complications after filtering surgery
Authors: BEDNAR I , LACMANOVIC LONCAR V , KONJEVIC‐PERNAR S , MANDIC Z
Published: October 2007

Purpose: Demonstrate the possibilities of successful surgical treatment of patients with late

complications after filtering surgery.

Methods: This study shows patients who have developed a cystically dilated or leaking filtering bleb in the late post‐surgical period after filtering surgery. Excision of the indadequate filtering bleb has been performed in the patient with a cystic bleb. After the failure of less invasive methods of treatment, we have proceeded to bleb revision with a scleral patch graft in the patient with a leaking bleb.

Results: Patients treated with either bleb excision or scleral patch graft showed no signs of neither hypotonia nor secretion during the six‐months post‐surgical period. During that period, complicated cataracts developed. After cataract surgery the function of the filtering bleb was preserved.

Conclusions: During the several months of patients' follow‐up, reconstructive methods of treatment have shown to be successful in high‐risk patients who have developed post‐surgical complications

in the form of leaking or inadequate filtering bleb.
PCR identification of Rhizobium radiobacter in post‐operative endophthalmitis
Authors: VINH V , ROMANET JP , CREUZOT‐GARCHER C , BRON AM , GAIN PG , CORNUT PL , PALOMBI K , DENIS P , THURET G , CROIZE J , MAURIN M , PECHINOT A , VANDENESCH F , CHIQUET C
Published: October 2007

Purpose: To present 2 cases of PCR identification of Rhizobium radiobacter in post‐operative endophthalmitis.

Methods: Microbiological identification was carried out using samples from aqueous humor and/or vitreous. Conventional cultures were performed using a Brain Heart Infusion broth. We used broad‐range eubacterial PCR amplification followed by direct sequencing.

Results: In both cases, Rhizobium radiobacter was identified using eubacterial PCR and cultures of vitreous from vitreous tap. An 81‐year‐old female presented an endophthalmitis 4 weeks after an cataract surgery. Inflammation and infection were controlled after 2 intravitreal antibiotic injections and the final visual acuity was of 20/24 at the one‐year follow‐up exam. A 75‐year‐old male who underwent a cataract surgery presented an endophthalmitis 9 days after. This patient was treated by 3 intravitreal antibiotic injections and a vitrectomy. The 6‐month follow‐up exam showed an optic nerve atrophy with a poor visual outcome (20/120). Both patients had an initial marked anterior chamber inflammation with a hypopyon and a severe retinal vasculitis was observed in the second case.

Conclusions: Rhizobium radiobacter is a rare pathogen involved in postoperative endophthalmitis. As it is an environmental soil organism, we may assume that the patient's exposure to outdoor environnement and moist soil remains the source of this organism. This gram negative rod is resistant to vancomycin and have an intermediate resistance to most antibiotics used to treat post‐operative endophthalmitis. PCR allows a swifter bacterial identification than do cultures and may help choose the most efficient antibiotics.
Abnormal peripheral vascular response to occlusion provocation in normal tension glaucoma patients
Authors: WIERZBOWSKA J , STANKIEWICZ A , BURSA P , MANIEWSKI R , LIBERT A , ZBIEC A , WOJTKIEWICZ S , SIERDZINSKI J
Published: October 2007

Purpose: To assess peripheral vascular reactive hyperemia in response to occlusion provocation test, using two‐channels laser Doppler probe in patients with normal tension glaucoma (NTG) and normal subjects.

Methods: 15 patients with NTG (12 women and 4 men), mean aged 58,9 and 15 control subjects (13 women and 2 men), mean aged 60,6 were subjected to an occlusion test. The experiment comprised following steps: 1/ a 5‐minute baseline‐period 2/ a 2‐minute occlusion of the left hand using a 15 cm wide cuff located directly over the elbow (the pressure in the cuff was 50 mmHg higher than the systolic pressure measured on the arm 3/ a 15‐ minute final recovery period after occlusion. Finger hyperemia was assessed by two‐channels laser‐Doppler flowmeter MBF‐3d, Moor Instruments, Ltd., continuously during the experiment. For measurements of hyperemia two surface probes were attached to the pulp of the second finger (mean probe) and third finger (basic probe) of the left hand. The following hyperemia parameters were measured: RF (rest flow), BZ (biological zero), TM (time to peak flow), TH (half‐time of hyperemia), MAX (maximum of hyperemia) and hyperemia amplitude (MAX‐RF)/RF 100% was calculated. Kruskal‐Wallis test analysis was used to test the differences between the group of patients and normal subjects for TM1,MXF1 (basic probe) and TM2, MXF2 (mean probe) parameters.

Results: In NTG patients, TM1 was significantly higher comparing with healthy subjects whereas MAX was significantly lower as compared to the control group.

Conclusions: Occlusion provocation test elicits a different systemic hyperemia response in patients with NTG compared with healthy subjects.
Comparative study of commercially available antihistaminic drops in an animal model of early phase allergic conjunctivitis
Authors: MONTERO‐MORENO JA , SANCHIS‐MERINO ME , RUIZ‐MORENO JM , LUGO F , AMAT‐PERAL P , DE LA VEGA C
Published: October 2007

Purpose: To compare the relative efficacy of topical ocular antihistaminic drops with balanced saline solution (BSS) and benzalkonium chloride (BC) in the early phase of allergic conjunctivitis in animal model.

Methods: 80 male guinea pigs were sensitized with intraperitoneal egg albumin (EA) and alum. Eighteen days after sensitization the animals were topically challenged by conjunctival instillation of EA. The animals were treated 15 minutes before and 15 minutes after challenge with commercially available drugs. Ketotifen with and without preservative, olopatadine, azelastine, spaglumic acid and emedastine were tested. BSS and BC drops were tested as controls. Different drops were tested in the right and the left eye of each animal to avoid interanimal differences in allergic reactivity. The allergic reaction was measured by intravenous Evans blue extravasation (EBE) under general anaesthesia.

Results: Two animals could not be used for evaluation. EBE was highest in the eyes treated by azelastine, olopatadine and preservative free ketotifen, and lowest in the eyes treated by spaglumic acid. However, when the results of the right and left eyes of each animal were considered EBE was higher in the eyes treated by BSS and BC and lowest in the eyes treated by spaglumic acid and emedastine.

Conclusions: Spaglumic acid and emedastine seem to be the most useful drugs to reduce EBE in an animal model of early phase allergic conjunctivitis.
Crosstalk of Hsp70 molecular chaperone, lysosomes and proteasomes in macroautophagy‐mediated proteolysis in human retinal pigment epithelial cells
Authors: RYHÄNEN T , HYTTINEN J , KOPITZ J , MANNERMAA E , UUSITALO H , SALMINEN A , KAARNIRANTA K
Published: October 2007

Purpose: Pathogenesis of AMD involves chronic oxidative stress, impaired degradation of membranous discs and accumulation of lysosomal lipofuscin in retinal pigment epithelial (RPE) cells. It has been estimated that a major part of cellular proteolysis occurs however in proteasomes. Prior to the proteolysis heat shock proteins tend to refold misfolded proteins and thus prevent the accumulation of protein aggregates. Connection of Hsp70, lysosomes and proteasomes were evaluated in the protein aggregation process in human RPE cells (ARPE‐19).

Methods: Cellular localization of Hsp70 was studied by immunofluorescense. Confocal and transmission electron microscopy were used to detect cellular organelles and morphological changes in ARPE‐19 cells. Cell viability was analyzed by MTT ‐assay. The modulations of Hsp70 levels were done by using siRNA and overexpression vector techniques.

Results: Proteasome inhibitor caused formation of juxtanuclear protein aggregates. It also caused robust accumulation of Hsp70 protein which colocalized with the protein aggregates. The granulation of aggregates was clearly increased in response to proteasome inhibition and simultaneous hsp70 mRNA interference. We found that protein aggregation is an interim, a cease of proteasome inhibition led to autophagosome‐mediated cleaning of cytoplasmic protein aggregates. The Hsp70 colocalization was observed in both primary lysosomal fractions and in autophagosomes.

Conclusions: This study reveals that Hsp70, lysosomes and protesomes are connected each other in macroautophagy ‐mediated proteolysis in human RPE cells.
Grading for progression of Age Related Macular Degeneration in the London AMD Study
Authors: PETO T , SALLO FS , DANDEKAR S , LEUNG I , XING W , BUNCE C , BIRD AC
Published: October 2007

Purpose: The aim of this study was to assess interobserver variability when grading progression of Age Related Macular Degeneration (AMD) using the International Classification (IC) system and to assess agreement with clinical decision.

Methods: Fifty eyes with a minimum of 5 years disease duration documented by colour photographs were selected from the London AMD Study. Changes related to early and late AMD were graded in a random fashion while masked to the main purpose of the study (FS) and then independently by another grader (IL). Images in time‐sequence were independently analysed for clinical changes. Digitized time‐sequential fundus images were then aligned in uniform fashion, arranged into multi‐layered composites using Adobe Photoshop and clinical assessment made (TP, ACB). Results were compared and a consensus decision was made.

Results: Inter‐observer agreement was 89.4% for predominant phenotype (κ=0.84), 89.36%‐91.49% for CNV (κ=0.79‐0.83), 87.23%‐89.36% for GA (κ=0.62‐0.74) and 55.32% for area covered by drusen (κ=0.31). In 4 cases the clinical and IC classifications differed: drusen area in 2 and two of end‐stage disease grading; resulting in 97.8% concordance in identification of change. At baseline,34 eyes had soft drusen, 15 had CNV and one had GA. Of the 34 with Drusen, 14 developed CNV and 9 GA by the end of the study. Disappearance of drusen without end‐stage disease was recorded in two eyes.

Conclusions: Overall, changes observed clinically were reflected accurately by the IC grading in the majority of cases. This provides a quantitative basis for using this classification system in longitudinal studies. The accidental observation of regressing drusen without end‐stage disease merits further investigation.
Effect of mitomycin C on epithelial hyperplasia after laser‐assisted subepithelial keratectomy (LASEK)
Authors: TEUS MA , DE BENITO‐LLOPIS L , ORTEGA M , EGUREN M , FERRER B
Published: October 2007

Purpose: To study the effects of mitomycin C (MMC) on the corneal regrowth after laser‐assisted subepithelial keratectomy (LASEK).

Methods: We performed a prospective, observer‐masked study of 64 consecutive eyes (64 patients) scheduled to undergo LASEK to correct myopia. The patients were divided into two age‐matched groups. 32 eyes in which the ablation depth was ≤50 μm were included in group 1 and received no MMC. 32 eyes in which the ablation depth exceeded 50 μm were included in group 2 and were treated with intraoperative MMC 0.02% for 30 seconds over the ablated zone. A masked observer measured the corneal thickness 1 and 3 months postoperatively. We compared the increase in central corneal thickness (CCT) during the postoperative period between both groups, assuming that that increment would correspond mainly to the epithelial hyperplasia that occurs after surface ablation.

Results: The mean patient age was 31.5±4.6 years and 31.6±8.7 years in groups 1 and 2, respectively (P=0.9). Group 1 showed a mean CCT of 444.0±41.3 μm one month after surgery and 450.3±43.5 μm three months after surgery (P=0.04). CCT in group 2 was 399.7±31.2 μm one month and 407.9±32.6 μm three months after surgery (P=0.006). The difference between the CCT increments between both groups was not statistically significant (P=0.6).

Conclusions: A single intraoperative application of MMC 0.02% during 30 seconds after laser surface ablation did not seem to cause a substantial change in the postoperative corneal thickening after LASEK.
Glaucoma progression with GDx‐VCC
Authors: TOTH M , HOLLO G
Published: October 2007

Purpose: To analyse the stability or progression of glaucomatous damage with scanning laser polarimetry (GDx‐VCC) in a longitudinal prospective study.

Methods: 57 glaucoma patients and 54 healthy volunteers were examined with GDx‐VCC and standard automatic perimetry (SAP) in every 6 months. Stability or progression was assessed according to the standard visual field progression criteria. The relationship between the change of the retinal nerve fibre layer thickness (RNFLT) and the elapsed time was examined with linear regression analysis. The baseline SAP parameters were compared with unpaired t‐test. For each individual, the data of one eye were used.

Results: The follow‐up time varied between 18 and 32 months. SAP progression was detectable on 17 glaucomatous eyes. The baseline visual field mean defects of the eyes with stable and progressing glaucoma did not differ significantly (7.144 dB and 9.375 dB; p=0.33). On eyes with progression, a significant negative relationship was detected between Superior Average, Superior Maximum and Maximal Modulation, and time (p<0.05). On healthy eyes and glaucomatous eyes with stable visual field, the time had no effect on the RNFLT parameters (p>0.05).

Conclusions: The GDx‐VCC may be suitable for detecting mild glaucomatous progression.
Strong expresssion of matrix metalloproteinases in the melted corneas of rheumatoid arthritis patients
Authors: JUKLOVA K , JIRSOVA K
Published: October 2007

Purpose: To compare the expression and activity of matrix metalloproteinases (MMP) 1, 2, 3, 7, 8 and 9 in human corneal grafts obtained during penetrating keratoplasty for corneal melting with their expression in normal human corneas.

Methods: Ten control corneal buttons and six melted corneas were used. All patients suffered from rheumatoid arthritis (RA); in three of them RA was associated with Sjögren´s syndrome, while two suffered from peripheral ulcerative keratitis and one from keratoconjunctivitis sicca. MMP 1, 2, 3, 7, 8 and 9 were detected using indirect enzyme immunohistochemistry. The activities of MMP 2 and 9 were examined in 10 control and 4 melted specimens by gelatin zymography.

Results: Weak staining for MMP 1 and 2 and very weak staining for MMP 8 were detected in normal corneal epithelium. Moderate MMP 1, 2 and 9 staining and weak staining for MMP 3, 7 and 8 were observed in corneal epithelial fragments and in the anterior stroma of all melted corneas. Weak staining for MMP 1 and 2 was detected in the posterior stroma of the melted corneas. A strong presence of the zymogen and a weak presence of the active form of MMP 2 were detected in all control corneas. Only the active form of MMP 2 was observed in three of four melted corneas, while in one of them both forms of this enzyme were present. The presence of the zymogen and the active form of MMP‐9 was extremely strong in all tested melted corneas.

Conclusions: The markedly increased expression of MMP 1, 2 and 9 and the presence of the active forms of MMP 2 and 9 in melted corneal grafts suggest that these enzymes may be responsible for the destruction of the extracellular matrix seen in grafts undergoing corneal melting.