bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasmapheresis and autologous serum eye‐drops in the treatment of acute ocular complications from toxic epidermal necrolysis (Lyell syndrome)
Authors: PINNA A , NUVOLI E , BLASETTI F , POSADINU MA
Published: August 2014

Purpose Toxic epidermal necrolysis (TEN) is a rare, life‐threatening, drug‐induced, mucocutaneous disease, which can affect the ocular surface. The purpose of this study was to evaluate the acute ocular complications from TEN and investigate on the efficacy of plasmapheresis and serum‐eyedrops in the treatment of this condition.

Methods A retrospective chart review of all Burn Unit patients admitted from 2009‐2013 identified 7 TEN patients (2 men, 5 women; mean age: 69.6±20.3 years). TEN was associated with allopurinol use in 4 patients, with gefitinib in 1, and with trimethoprim/sulphamethoxazole in 1. In the remaining patient, the causative agent was not identified. Acute bilateral ocular complications were observed in 5 patients; 3 showed mild ocular surface inflammation, whereas 2 had severe pseudomembranous conjunctivitis with corneal ulcers. All TEN patients were immediately treated with plasmapheresis.

Results In the 2‐3 weeks after plasmapheresis, there was a marked improvement of the patients' general condition. In those with mild ocular surface inflammation, the use of preservative‐free artificial tears and steroids was beneficial. In the 2 with pseudomembranous conjunctivitis and corneal ulcers, treatment with autologous serum eye‐drops and preservative‐free artificial tears was effective, resulting in corneal epithelium healing and mild conjunctival scarring.

Conclusion Not all TEN patients have ocular complications at onset. Plasmapheresis may be life‐saving and contribute to reduce ocular surface inflammation. Autologous serum eye‐drops prepared after plasmaferesis may be helpful in the management of the acute ocular complications caused by TEN.
Secondary, vocational crystalline keratopathy – case report
Authors: WYLEGALA E , SMEDOWSKI A , JANISZEWSKA D , TARNAWSKA D , NOWINSKA A , DOBROWOLSKI D
Published: August 2014

Purpose To present case of secondary, vocational crystalline keratopathy in patient with history of long‐time exposure to glass wool.

Methods The patient was consulted in Ophthalmology Outpatient Clinic because of suspicion of crystalline keratopathy of unknown origin. The following tests were performed: basic slit lamp examination, corneal scans using OCT Visante (Zeiss, Germany) and corneal confocal microscopy in vivo (Rostock Cornea Module, Heidelberg Engineering Retina tomograph III).

Results On a slit lamp examination we described macroscopic crystal deposits within epithelial layer. In the images from the OCT Visante ‐ hiperreflective deposits obscuring other structures of the cornea were present only in epithelial and subepithelial layers. Crystals were not crossing Bowman membrane border. The corneal confocal microscopy images described monomorphic needle‐like crystals without arborations, covered by epithelial cells and infiltrating epithelial layer, epithelial basal membrane and Bowman membrane. Anterior and posterior stroma presented no abnormalities. On anamnesis patient reported history of 25 years of occupational exposure to glass wool. Additionally we excluded other possible causes of crystalline keratopathy, such as hypercholesterolemia, hiperuricemia, cystinosis and hematopoietic disorders.

Conclusion Corneal confocal microscopy is a useful tool for the detection and differentiation of corneal keratopathies of uncertain etiology.
Circumferential lymphangiectasia haemorrhagica conjunctivae: a rare case of spontaneous resolution
Authors: ASCASO FJ , HUERVA V , TRAVESET A , SANCHEZ MC
Published: August 2014

Purpose Lymphangiectasia haemorrhagica conjunctivae (LHC) is a rare condition in which the lymphatic channels in the bulbar conjunctiva are dilated and filled with blood. LHC occurs as the result of a connection between conjunctival lymphatic and blood vessels. There have only been a few reported cases of spontaneous attacks followed by rapid resolution. Our purpose is to present the first reported case of LHC involving 360 degrees of bulbar conjunctiva.

Methods This case report shows the characteristics of LHC, such as segmental constrictions and balloon‐shaped dilations of blood‐filled lymphatic vessels in the conjunctiva. Anterior segment photographs confirmed that the blood resolved spontaneously in our patient without requiring any further intervention.

Results A 36‐year‐old woman complained of spontaneous ocular redness, showing a circumferential engorgement of the bulbar conjunctival vessels consistent with the diagnosis of LHC. One month later, varicose tortuous and transparent lymphatic vessels at the site of previously blood filled vessels were noted as linear bulbar swelling with the classic “string of pearls” appearance. No recurrence was observed after 18 months follow‐up. Surgical excision or laser treatment was not necessary.

Conclusion This case is exceptional because of the anatomic location, the full hemorrhagic component of the dilated vessels and the absence of recurrences following its complete resolution. Ophthalmologists should be aware of the possibility of LCH when examining conjunctival hemorrhages.
Anterior lens epithelial cells attachment to the basal lamina
Authors: ANDJELIC S , DRASLAR K , HVALA A , LOPIC N , STRANCAR J , HAWLINA M
Published: August 2014

Purpose The lens epithelium consisting of anterior lens epithelial cells (aLECs) is the first physical and biological barrier in the lens and the primary site of active transport and permeability. As the function of the lens epithelium is associated with the structural organization of the aLECs and the contacts the basal part of the aLECs have with the basal lamina (BL), we studied the aLEC structure, in particular aLECs attachment to the BL.

Methods The aLCs (BL and associated aLECs) were obtained from routine uneventful cataract surgery, prepared for and studied by scanning electron microscopy (SEM), transmission electron microscopy (TEM) and confocal microscopy.

Results SEM shows that the basal surface of the aLECs (~10‐15 m) in contact with the BL is wrinkled (~1‐3 m) and also the aLECs extensions (~0.5‐3m) attached to the BL. Confocal microscopy images of the basal sections of the aLECs after membrane staining also suggest that the basal part of aLECs is wrinkled (~1‐3 m) . TEM shows in the aLECs basal parts, toward BL, the structures that look like entanglement (~1‐4 m). In cases where there is a swelling of the cytoplasm and offset of the aLECs from the BL, individual pins (~0.5‐2 m) that extend to the BL are visible by TEM.

Conclusion We provide detail evidence about the structural organization of the aLECs, in particular about their basal side which is in contact with the BL. This is supported by the complementary use of 3 techniques, SEM, TEM and confocal microscopy, each of them showing the same morphological features, the extensions and the entanglements of the aLECs cytoplasmic membrane at the border with the BL. The basal surface of the aLECs is increased. It suggests the functional importance of the contact between aLECs and BL.
Caspase‐3 in ultraviolet radiation cataract
Authors: TALEBI ZADEH N , YU Z , KRONSCHLÄGER M , SÖDERBERG P
Published: August 2014

Purpose To determine the evolution of active caspase‐3 protein expression in normal lens and in the lens exposed to low dose UVR‐300 nm.

Methods Forty Sprague‐Dawley rats were unilaterally exposed in vivo to 1 kJ/m2 UVR 300 nm for 15 minutes. At 0.5, 8, 16, and 24 hours after the UVR exposure, the exposed and non‐exposed lenses were removed and processed for immunohistochemistry. The number and distribution of the cells labeled for active caspase‐3 in the exposed and contralateral non‐exposed lenses were compared among the four different time points after the exposure.

Results In normal lenses, active caspase‐3 expression was abundant in the anterior pole of the lens. The probability of a radial spatial distribution of the labelling was fitted to a logistic model. The increased rate of active caspase‐3 expression was at 23±3 cell‐1 and the inflection point was estimated at cell number 114±3 (0.95% CI). Active caspase‐3 expression was higher in the exposed lenses (95%CI= 0.18±0.02). The mean differences between the exposed and contralateral non‐exposed lenses were 0.17±0.02, 0.20±0.03, 0.21±0.03, and 0.11±0.04 (95%CI) for the 0.5, 8, 16, and 24 hour time groups, respectively. There were no differences in the expression of caspase‐3 between the 0.5 and 24‐hour groups or between the 8 and 16‐hour groups (95%CI= ‐0.02±0.03). There was a difference when comparing the 0.5 and 24 hours groups to the 8 and 16 hours groups (95%CI= 0.06±0.03).

Conclusion Active caspase‐3 is present in normal lens epithelial cells, with more expression at the anterior pole of the lens and less expression towards the periphery. After UVR exposure, the expression of active caspase‐3 in the lens epithelium increased. The peak of expression was detected approximately 16 hours after the exposure.
A case series of late postoperative capsular block syndrome treated by Nd:YAG laser posterior capsulotomy
Authors: MARTINEZ VELEZ M , HUERVA V , SANCHEZ MC , ASCASO FJ , SOLDEVILA J
Published: August 2014

Purpose To evaluate the clinical characteristics of the unusual late postoperative capsular block syndrome (CBS) and the effect of neodymium:yttrium‐aluminium‐garnet (Nd:YAG) laser posterior capsulotomy on visual acuity, refractive error as well as its possible complications

Methods Retrospective cohort study. Twelve eyes of 11 patients with late CBS who had undergone Nd:YAG laser posterior capsulotomy were reviewed. A complete examination including Scheimpflug camera and anterior segment optical coherence tomography (AS‐OCT) imaging had been performed before and after posterior capsulotomy

Results BCVA increased in 11 cases (91.7%). Only one eye showed a 0.5 diopter hyperopic shift following posterior capsulotomy. There were no post‐laser complications such as increased IOP or cystoid macular edema. In all patients, the posterior capsule was vaulted posteriorly and could not be seen clearly. AS‐OCT confirmed CBS in the studied cases, demonstrating a distended capsular bag. Rotating Scheimpflug imaging examination showed the white substance located behind the IOL

Conclusion Late CBS is usually not accompanied by shallow anterior chamber, forward IOL displacement or raised IOP. Nd:YAG laser posterior capsulotomy is a useful treatment and the prognosis of patients with this complication appears favorable. Although the AS‐OCT measurements are easier to get than Scheimplug imaging, both are useful to visualize the distended capsular bag containing the white material and the IOL position
Impact of lens thickness on hyper mature cataract surgical complications: preliminary results of a prospective study
Authors: ADDOU‐REGNARD M , FAJNKUCHEN F , CHAINE G , GIOCANTI‐AUREGAN A
Published: August 2014

Purpose There are no objective parameter allowing to predict the risk of surgical difficulties in white hyper mature cataracts. Lens density can be assessed by pentacam, but this tool is not commonly available. Our purpose was to assess the correlation between lens thickness (LT) and surgery complications.

Methods We conducted a prospective, observational, and monocentric study. We included all patients operated on for white hyper mature cataract from january 2013 to march 2014. We selected patients with a visual acuity (VA) lower than 20/200 on the Monoyer scale. We excluded patients suspect of zonula fibers weakness. Morphological features assessed were LT, axial length, depth of anterior chamber and vitreous length, measured by A or B ulrasound scan. The other parameters assessed were the surgical duration, complications during surgery, VA and corneal edema at the seventh day after surgery (analogic scale from 0 to 3).

Results We included 30 eyes of 29 patients. Mean LT was 4.11 ± 0.64 mm, with a median of 3,89 mm. The Pearson correlation coefficient (PCC) between LT and operative duration was 0.27. The PCC between lens thickness and length of anterior chamber was ‐0.32. The PCC between LT and BCVA at the 7th day after surgery was ‐0.53. Two groups were defined: group 1 with LT < 3.89mm, and group 2 with LT > 3.89mm. Mean length of the anterior chamber were respectively 3.48 and 3.02 mm (p=0.01). Three per operative complications were noted.

Conclusion LT in white hyper mature cataract did not seem to be correlated with duration of the surgery. However, it seemed to be inversely correlated with the depth of anterior chamber and with visual acuity at the 7th day.
Long term results of toric intraocular lens implantation for correction of astigmatism in cataract patients with corneal ectasia
Authors: PARIKAKIS E , CHATZIRALLI I , STRATOS E , PEPONIS V , KARAGIANNIS D , DAVID G , MITROPOULOS P
Published: August 2014

Purpose Our purpose was to examine the long‐term efficacy of toric intraocular lens (IOL) implantation in cataract patients with high astigmatism due to corneal ectasia, who underwent phacoemulsification cataract surgery.

Methods Seven cases, in which phacoemulsification with toric IOL implantation was used to correct high astigmatism in cataract patients with topographically stable keratoconus or PMD, were reported. Objective and subjective refraction, visual acuity measurement and corneal topography were performed in all cases before and after cataract surgery.

Results In all cases, there was a significant improvement in visual acuity, as well as refraction, which remained stable over time. Specifically, in subjective refraction, all patients achieved visual acuity from 7/10 to 9/10 with up to ‐2.50 cyl. Corneal topography also remained stable. Post‐operative follow‐up was 22‐32 months.

Conclusion Cataract surgery with toric IOL implantation seems to be safe and effective in correcting astigmatism and improving visual function, in cataract patients with topographically stable keratoconus or PMD.
Comparative study of anterior segment measurement with rotating dual Scheimpflug analyzer and optical low coherence reflectometry
Authors: ASCASO FJ , HUERVA V , SOLDEVILA J , LAVILLA L
Published: August 2014

Purpose The aim of the study was to compare the anterior segment measurements obtained with optical low coherence reflectometry (Lenstar LS 900, version 1.1, Haag‐Streit, Koeniz, Switzerland) and rotating dual Scheimpflug analyzer (Galilei Dual Scheimpflug Analyzer versión 3, Ziemer Ophthalmic Systems, Port, Switzerland).

Methods Prospective, comparative, observational study in which 59 eyes of 30 patients who needed a preoperative study for a refractive procedure or cataract surgery were studied with both the Lenstar 900 and Galilei systems. Central corneal thickness (CCT), anterior chamber depth (ACD), horizontal limbal distance (white‐to‐white distance; WTW), pupil diameter (PD), as well as the keratometric readings at the steepest meridian (Ks), the flattest meridian (Kf), the corneal astigmatism power, and the plus astigmatic cylinder axis were measured. Degree of agreement between Ks, Kf, astigmatism power, cylinder axis, CCT, ACD, WTW and PD were the main outcome measures.

Results Ks, Kf, corneal astigmatism power, cylinder axis, and WTW measurements with the Lenstar and the Galilei system showed narrow 95% limits of agreement (LoA), which implies good agreement (p>0.05, Bland‐Altman plot analysis). In contrast, range and 95% LoA were significantly different for CCT, ACD and PD values (p<0.05, Bland‐Altman plot analysis).

Conclusion In clinical practice, the Lenstar and the Galilei system can be used interchangeably for WTW measurements and K readings but not for CCT, ACD and PD values.
An aggressive small choroidal melanoma
Authors: LAUWERS N , DE GROOT V , DE KEIZER RJW
Published: August 2014

Purpose To describe a small non diffuse choroidal melanoma with extraocular extension.

Methods Case‐report

Results We describe the case of a 50year‐old patient presenting with visual loss and metamorphopsia. Fundus examination revealed a suprapapillary trilobular choroidal mass with inhomogenous pigmentation and lipofuscin. The optic nerve was slightly oedematous. On fluorescein angiography, the lesion revealed pin‐points and exsudation. Ultrasound sonography (20Mhz) showed a peripapillary lesion of 3mm thickness. MRI was performed and confirmed the diagnosis of choroidal melanoma. No extraocular extension was seen on MRI or ultrasound imaging. Because of optic nerve oedema we decided to perform an enucleation. On pathology, the lesion measured 9mm diameter and 3mm thickness. It was mostly composed of epithelioïd cells and it showed scleral, perineural , optic nerve and periocular soft tissue invasion. Complementary orbital radiotherapy was performed. Until now, after one year follow‐up, the patient has shown no metastasis or local recurrence.

Conclusion Extraocular invasion in a small thickness non diffuse choroidal melanoma is rare. In times of eye‐sparing choroidal melanoma treatment, the ophthalmologist should not forget the possibility of extra‐ocular involvement, even in small tumors.
Suggestion of optimal response criteria in patients with ocular adnexal mucosa associated lymphoid tissue lymphoma
Authors: JUNG S , PAIK JISUN , YANG SW
Published: August 2014

Purpose Ocular adnexal mucosa‐associated lymphoid tissue (MALT) lymphoma (OAML) has been recognized as most common primary orbital malignancy. However, little was known about the response criteria for OAML. Our aim was to suggest response criteria for nonconjunctival OAML, the response evaluation of which using the conventional response criteria is inappropriate.

Methods A retrospective chart review of 34 eyes from 30 patients diagnosed with nonconjunctival OAML was conducted, focusing on the change in tumor size based on linear bi‐dimensional, and three‐dimensional methods in magnetic resonance imaging (MRI) of the orbit. The maximum tumor response period of each case was investigated, and the expected optimal response period was calculated using regression analysis.

Results In the 30 evaluable patients, the median time taken for the maximum tumor response was 6 months (range, 3–18 months). More than 75% of patients attained a maximal tumor response in 6 months after initial therapy (median follow‐up period, 30 months; range, 15–77 months). Based on the regression analysis, it took 4.7 months for the maximum diameter (2r) of the tumor to decrease by 50% of the initial lesion size.

Conclusion We cautiously suggest that the optimal response could be defined as a 50% reduction of the maximum diameter within 6 months of treatment initiation and that only observation without additional therapy is adequate for nonconjunctival OAML if an optimal response is achieved.
Association between ocular optical components and refractive errors in bank’s Employees of Sari, Iran
Authors: YEKTA AA , HASHEMI H , NAKHAEE MA , KHABAZKHOOB M , OSTADIMOGHADDAM H , HERAVIAN J , AZIMI A , YEKTA R
Published: August 2014

Purpose To investigate the association between ocular optical components and refractive errors in bank’s employees of Sari, Iran

Methods In this cross sectional study 398 bank’s employees of Sari, Iran were selected, 232 of them used the eyes for close work (computers, etc…) for a minimum of 7 hours per day for the 5 past years. The other 166 bank’s employees acted as a control group and did not did a close work more than one hour daily for the 5 past years. Age of the participants were between 25 to 40 years old. Axial length, anterior chamber depth, lens diameter and vitreous depth were measured with Nidek biometer. Corneal radius and non cycloplegic refraction performed with autorefracto‐keratometer; refractive errors were checked by retinoscopy and subjective tests. There was a high correlation between equivalent sphere (ES) right and left eyes of the subjects (0.9) and data of the right eye was analyzed. Data were analyzed by using version 19 of SPSS software.

Results The results showed that the bank’s employees who had excessive use of the eyes for near work have more axial length (p<0.001), more anterior chamber depth (p=0.003) and more vitreous chamber depth (p<0.001) than the control group. There was no significant difference between lens diameter (p=0.525) and cornel radius (p=0.666) of the two groups. There was correlation between axial length and SE by increasing in axial length (p<0.000). The least amount correlation was found between lens diameter and ES (P< 0.000).

Conclusion The results of this study indicated that ocular optical components changed toward myopia in people who had excessive close work.
Using statistical decomposition to improve the identification of the photopic negative response of the erg
Authors: SAROSSY M , HADOUX X , TANG J
Published: August 2014

Purpose The Photopic Negative Response (PhNR) is known to be correlated with disease severity in animal models of glaucoma. The technique has found little utility in the clinical setting due to the difficulty involved in obtaining repeatable measures. . Inter‐Session reliability has been poorly successful because of the difficulty to consistently identify and define the PhNR. In this study we propose a robust PhNR measure based on curve fit modelling of the three components of the electroretinogram (ERG) response. The robustness of this measure comes from the use of a global 'shape' as a PhNR measure which is less sensitive to variations than measuring a single value on the ERG.

Methods 39 subjects with ‘normal’ eyes were recruited. Each subject underwent 2 sessions of bilateral ERG tests at five brightness levels. Raw data obtained from the tests was exported to the R statistical program. A parametric function consisting of a linear combination of three Gaussian functions was fitted to each averaged response . For each of these components, the optimal parameters were estimated using non‐linear least squares. The amplitude of the 3rd Gaussian was used as a measure of the PhNR.

Results Rapid convergence and successful fitting was achieved for 446 out of 457 traces. The amplitude of the third Gaussian correlated well with the manually measured PhNR (r=0.79). Bland Altman plots showed good agreement between modelled waveforms and raw data.

Conclusion By decomposing the ERG into three components the effect of variability of the baseline and the b wave can be decreased. Agreement between the 3rd Gaussian amplitude and manually estimated PhNR was reasonable. Inter‐session reliability of this new measure will be further assessed.
Changes in ocular factors according to motion‐in‐depth of 3D display and viewer age
Authors: YUM HR , SHIN SY , KANG HB , PARK SH
Published: August 2014

Purpose To compare changes in ocular factors according to the motion‐in‐depth of three‐dimensional(3D) images and viewer age after watching a 3D display.

Methods 30 healthy subjects were enrolled(17 in their 20‐30s, 13 in their 40‐50s). Subjects watched a 3D display with a 1° and 3° binocular disparity with two defined velocities(slow, 105mm/s; fast, 257mm/s)for 30 min. The near point of accommodation(NPA) and convergence(NPC), and tear break‐up time(tBUT) were measured before and after watching the display. All measures were remeasured until it returned to the baseline. Questionnaires on subjective symptoms were collected before and after watching the display.

Results NPA increased more in the fast motion‐in‐depth than slow motion‐in‐depth after watching 3D video. NPC increased more in the fast motion‐in‐depth than slow motion‐in‐depth after watching 3D video with 3° disparity only. According to the age, NPA increased more in the 40‐50s group than in the 20‐30s group after watching with 3° disparity/fast motion‐in‐depth only. NPC increased more in the 40‐50s group than in the 20‐30s group after watching with 3° disparity/fast motion‐in‐depth and slow motion‐in‐depth. The recovery time of NPA and NPC were same results as the change of NPA and NPC. However, the changes of tBUT were not significantly different between the two age groups and between the two motion‐in‐depths. Changes of subjective symptoms were different according to the motion‐in‐depth of 3D display and viewer age.

Conclusion We quantitiatively investigate the effect of motion‐in‐depth of 3D display and viewers’ age on the viewers’ visual function. The results indicate that motion‐in‐depth might be considered in determining visual comfort of 3D display, especially in older people.
Effects of long duration dive (8, 10 and 12 hours) with hyperbaric hyperoxia on Navy divers’ eye and visual function
Authors: VALERO B , CASTAGNA O , BRUGIER A , VIGNAL R , DE FARIA A , BOURNIQUEL M , SEKFALI R , BLATTEAU JE , GIRAUD JM
Published: August 2014

Purpose To assess anatomical and functional effects of long duration dive (8 to 12 hours) on the eye, by reproducing all the constraints undergone by professional divers, so as to prevent potential hazard to diver visual function.

Methods 18 male Navy divers performed prolonged dive sessions (8, 10 and 12 hours), breathing 50% Nitrox or 100% O2, according to immersion depth (7 to 20 msw), and amounting to 1.54 to 1.7 bar inhaled PO2. for each diver, we studied several parameters 24 hours before and 15 hours after immersion: visual acuity, low spatial contrast sensitivity, color vision, eye refraction, ocular examination, visual field, full‐field clinical electroretinography and multifocal electroretinography.

Results None of the 18 divers had any loss of visual acuity. No change occurred following dive in spatial contrast sensitivity, color vision, eye refraction, visual field parameters (corrected mean deviation, foveolar threshold). Ocular examination was normal for all the divers, before and after immersion. Regarding full‐field clinical electroretinography, b‐wave was significantly decreased after immersion (286,64 µV ± 60,34 vs 270,07 µV ± 57,64, p = 0,015) on scotopic response with white attenuated stimulation. No significant modification occurred in multifocal electroretinography.

Conclusion Thus long duration hyperoxic dive didn't cause any clinically significant eye modification. No immediate harm to diver eye and visual function appeared. The slight modifications on electroretinography could be due to intra or inter‐individual variations, but they raise question about subclinical functional effects of hyperoxia that could affect rod‐cell function.
A novel technique for measuring dark adaptation using a dual stimulus method: Effects of aging and AMD on dark adaptation
Authors: RODRIGO E , TAHIR HJ , PARRY NRA , KELLY JMF , ASLAM T , CARDEN D , MARRAY IJ
Published: August 2014

Purpose To study abnormal dark adaptation (DA) in aging and macular degeneration (AMD) using a new technique that measures DA at two retinal locations by using a dual stimulus. To establish whether there are localized regions of impaired rod function, especially the rate of the rod‐mediated recovery (S2) as it has been previously suggested

Methods Dual arc‐shaped white stimuli were presented on a black CRT monitor at locations 6º and 11º of eccentricity in the inferior visual fiel. Recovery of sensitivity to the two stimuli was measured concurrently using the method of adjustment, following a bleaching exposure of at least 30%. The dynamic range of the CRT was expanded using ND filters. DA curves were obtained after fitting the data by non‐linear regression to a seven‐parameter model. Three groups of observers (young, older and AMD) were tested to detrmine any differences between them and the effect of the testing location, focusing on parameters α (rod‐cone break) and S2 (slope of the post‐ α phase of rod recovery)

Results Both stimuli produced matched cone recovery curves within each group. Comparing groups (young vs. older) and (older vs. AMD), we found significant differences in the two DA parameters studied here. Regarding the AMD group, we found a trend in both parameters to be more affected at 6º than at 11º, however, these differences were not significant

Conclusion This technique has shown to be sensitive to detect changes in rod recovery in AMD patients compared to healthy subjects and allows the measurement of DA in two retinal locations simultaneously. It may help in the early diagnosis and monitoring of degenerative diseases of the macula, which are increasingly common
Color vision evaluation test
Authors: IONICA V
Published: August 2014

Purpose Color Vision Evaluation Test (CVET) is used to test sensitivity to color and makes it possible to identify and evaluate all color vision disabilities.

Methods CVET is made up of a set of 72 pseudoisochromatic images, a lamp that provides daylight illumination, and software to acquire a graphic representation of the results of the investigation. The test makes it possible to diagnose all deficiencies in seeing color, both hereditary and acquired, and measure the deficiencies on a ten level scale. Color vision has been calibrated in the same way as vision acuity. Normal color vision is considered 1, and an anopia (complete absence of a color from the chromatic spectrum) is considered 0. Between these two values there are 9 levels of an abnomal trichromacy marked from 0.9 to 0.1. The lamp provides a consistent and adequate illumination of the text charts so that the test can be replicated identically.

Results The software suggests a diagnostic of the deficiency, provides 3 graphic representations, and offers a simulation of the vision of the patient on pictures chosen by the person who administers the test to better evaluate the professional abilities of the person whose color vision is tested.

Conclusion The test provides accurate measurements that make it possible to evaluate the professional abilities in cases of hereditary dyschromatopsia as well as following the progress of vision disabilities or other illnesses that cause vision diasbilities.
Color perception levels in patients with hyperopia
Authors: BOGATYREVA E , KOVALEVSKAYA M
Published: August 2014

Purpose Evaluation of color perception levels in different types of hyperopia.

Methods 4 groups of patients: 1 (n=35) – low hyperopia; 2 (n=29) – moderate hyperopia; 3 (n=26) – high hyperopia; 4 (control, n=39) –emmetropia. The supplement ‐ Farnsworth‐Munsell 100 Hue Test (FM 100). Measures of assessing were: total error score (TES), the level of recognition of colors (LRC), color vision deficiency (CVD), the type of color deficiency (TCD). Color vision defects were studied using a special computer program for FM 100.

Results Group 1: TES=67±25 (р˂0,05), LRC 16‐100 TES, CVD 41‐100 TES, TCD individual abnormalities in blue color. Group 2: TES=93±25 (р˂0,05), LRC 16 and more TES, CVD 41‐200 TES, TCD cian, blue. Group 3: TES=180±25 (р˂0,05), LRC 101 and more TES, CVD 101 and more TES, TCD cian, blue, violet. Group 4: TES=53±25 (р˂0,05), LRC 16‐100 TES, CVD no more 100 TES, TCD individual abnormalities in blue color.

Conclusion We revealed correlation between stages of hyperopia and color level perception: in the 1st group LRC average, CVD slight; 2nd group: LRC average/low, CVD slight/moderate; 3rd group: LRC low, CVD moderate/severe; 4th group: LRC average, CVD none/slight. Also, hyperopic refractive errors are associated with defects of blue color. Quantitative analysis of color vision defects with FM100 provides the possibility for detecting condition of cone photoreceptor cells, which mostly damaged in the 3rd group.
Comparing short‐duration electro‐oculogram with and without mydriasis in controls
Authors: TÜRKSEVER C , ORGÜL S , TODOROVA MG
Published: August 2014

Purpose In order to obtain artefact‐free EOG recordings the subject’s cooperation is necessary. The aim of our study is to evaluate recording characteristics of the short‐duration EOG and to compare the effect of mydriasis on EOG recordings in a cohort of controls.

Methods EOG recordings were performed on a LED stimulus screen using a RETI‐port gamma plus2 system (RETIscanTM, Roland Consult). Dark phase included: pre‐adaptation (6min), alternate fixation (4min), fixation‐rest (20sek), 100 sweeps. Light phase included: light adaptation (4min), alternate fixation (10min), fixation‐rest (20sek), 250 sweeps. Amplifier was band pass filtered at 0.1‐50Hz. Background illumination in mydriasis was 100cd/m2 and in miosis 450cd/m2. Fast oscillations were set at 1.5sek (6 cycles; total duration 75sek).

Results A total of 55 controls divided in three age‐groups participated (number; mean (years, y); ±SD): group 1: 18‐ 20y (19; 19.49y; ±0.89); group 2: 20‐40y (18; 27.91y; ±5.39) and group 3: 40‐60y (18; 48.66y; ±4.00). Arden ratio (AR), dark‐trough (DT) and light‐peak (LP) did not differ between recordings with or without mydriasis (p=0.885; p=0.860; p=0.776, linear mixed‐effects model). Age did not influence the AR, DT, LP (p= 0.206; p=0.112; p=0.155). AR, DT, LP were comparable between eyes tested (p=0.998; p=0.196; p=0.324).

Conclusion Short‐duration EOG allows successful recording, where the application of mydriasis does not influence the quality of the recording.
Impact of preservatives' elimination on tolerance and efficacy of latanoprost
Authors: MISIUK HOJLO M , MULAK M , POMORSKA M , REKAS M , WIERZBOWSKA J , PROST M , WASYLUK J , LUBINSKI W , PODBORACZYNSKA‐JODKO K , ROMANIUK W , KINASZ R , ORTYL‐MARKIEWICZ R , MOCKO L , ZALESKA‐ZMIJEWSKA A , ROKICKI D
Published: August 2014

Purpose To compare the tolerance and efficacy of preservative‐free latanoprost (latanoprost‐PF) after switching from benzalkonium chloride containing agent (latanoprost‐BAK).

Methods 140 patients with glaucoma or OHT controlled by latanoprost–BAK were included into the study. At a baseline visit (D0) a new formulation of latanoprost‐FP (Monoprost ®, Laboratoires Thea) was introduced. An observation was conducted, including three visits after 15, 45 and 90 days from the baseline (D15, D45, D90 respectively). The following outcomes were evaluated: BCVA, IOP, TBUT, corneal fluorescein staining and subjective assessment of tolerance by patient using 10‐ point VAS scale (0 ‐ very good, 10 ‐ very poor tolerance).

Results Mean IOP during all subsequent visits was reduced compared to the baseline (p <0.006 vs D0) and measured 15.95 mmHg,15.37 mmHg, 15.33 mmHg and 15.27 mmHg at D0, D15, D45 and D90, respectively. TBUT was improved in 23.4% of patients at D45 and in 29.7% of patients at D90, but deteriorated in 8% of cases at both time points. It remained unchanged in 68.6% and 62%of patients at D45 and D90, respectively. A conjunctival hypaeremia was present in 56.8% and in 13,7%, 2,2% and 1,6% of patients at D0, D15, D45 and D90 visits, respectively. Subjective assessment of tolerance showed an improvement from 5.3 at baseline to 1.91 at D90 (p <0.0001).

Conclusion Preservative‐free latanoprost has at least the same IOP‐lowering efficacy in comparison to BAK‐preserved latanoprost. Latanoprost‐PF has a better tolerability profile which may translate into better control of the treatment and better quality of life for the patient.
IOP‐lowering effect and ocular toxicity of ONO‐0476, a prodrug of a novel prostanoid EP2 receptor agonist, in normotensive cynomolgus monkeys
Authors: GOTO Y , MORIYUKI K , YAMAMOTO H , YAMANE S , SUGITANI M , HIROTA Y
Published: August 2014

Purpose ONO‐0476 is a prodrug of ONO‐AE9‐078, a potent and selective prostanoid EP2 receptor agonist manufactured by ONO Pharmaceutical Co., Ltd. The purpose of this study is to evaluate the IOP‐lowering effect and ocular toxicity of ONO‐0476 in cynomolgus monkeys.

Methods The binding affinity and agonistic activity of ONO‐0476 and ONO‐AE9‐078 for the prostanoid receptors were evaluated. Male cynomolgus monkeys received single or repeated topical dosing of ONO‐0476 or current prostaglandin analogues (latanoprost, travoprost, tafluprost, bimatoprost) at a volume of 30 uL. The IOP was evaluated by using applanation pneumatonometer. Ocular toxicity was evaluated by using portable slit lamp, laser flare photometry, and ultrasound pachymetry in a 4‐week repeated dosing study in monkeys.

Results ONO‐AE9‐078 had high selectivity and high affinity for the prostanoid EP2 receptor (EC50 value was 2.3 nmol/L). Single dosing of ONO‐0476 (0.3 ug/mL or more) reduced IOP in a dose‐dependent manner. IOP‐lowering effects were sustained through 24 h following a single dosing. Repeated dosing (once daily for one week) of ONO‐0476 (0.3 ug/mL) reduced IOP more potently than the current prostaglandin analogues. During 4‐week repeated dosing of ONO‐0476 (1 ug/mL), there were no evidence of significant toxicity.

Conclusion ONO‐0476 causes potent and sustained IOP reduction, and has good tolerability following topical dosing. ONO‐0476 is an attractive candidate for treatment of glaucoma and ocular hypertension.

Commercial interest
The estimate prevalence of glaucoma & trend of glaucoma care in south korea based on national claim database
Authors: SEO SJ , BAE HW , LEE YH , LEE SY , HONG S , SEONG GJ , KIM CY
Published: August 2014

Purpose To estimate the prevalence and to analyze the trend of glaucoma care in South Korea from 2008 to 2012.

Methods Patients who diagnosed with glaucoma from 2008 to 2012 were retrospectively identified using the diagnostic code for glaucoma and the surgical codes for glaucoma surgeries in National Health Insurance (NHI) & Health Insurance Review and Assessment service(HIRA) database. The prevalence of glaucoma, glaucoma care cost, cost for glaucoma procedure and percentage of cost for glaucoma procedure were estimated.

Results The number of glaucoma patients was increased by 60% from 2008 to 2012. The estimated prevalence of glaucoma in the population aged ≥ 40 years was increase from 1.30% in 2008 to 1.90% in 2012(P<0.001, test for linear trend). The prevalence of glaucoma increased with age and was higher in men than in women(OR 0.9 (95% confidential interval 0.89~0.90) in 2012). Although the cost for glaucoma procedure has increased from 2008 to 2012, the percentage of cost for glaucoma procedure among total glaucoma care cost showed a decreasing trend annually(from 9.07% in 2008 to 5.21% in 2012).

Conclusion The number of glaucoma patients and the prevalence of glaucoma increased annually in South Korea. However, in this study, the prevalence of glaucoma was underestimated comparing with other population based study. This result mean glaucoma screening test was not enough to finding glaucoma patients in South Korea. In conclusion, to find glaucoma patients, it is necessary to develop glaucoma screening system in countries having similar health care circumstance with South Korea.
Cannabinoids: a novel treatment for glaucoma
Authors: SAMUDRE S , HOSSEINI A , LATTANZIO F
Published: August 2014

Purpose Synthetic cannabinoids are emerging novel agents for the treatment of glaucoma. Although increased intraocular pressure (IOP) is a risk factor, associated retinal damage is of prime concern. This study determines the ability of cannabinoids to decrease IOP and confer neuroprotection.

Methods Ocular hypertension was created in Sprague‐Dawley (SD) rats by ligating 3 of 4 episcleral veins. IOP increased by at least 5 mm Hg in the operated eye. Cannabinoids, O‐1812 (1%) or O‐2545 (1%), were administered topically. IOP was measured by Goldmann tonometry at baseline (‐30), 0, 30, 60 and 120 min. For neuroprotection experiments: excitotoxic retinal damage was induced by injecting NMDA (2 ul of 10 mM) intravitreally in SD rats. Cannabinoids were injected following NMDA induction. Full‐field Electroretinograms were recorded at baseline, 1 wk and 2 wk. ERG a‐wave amplitudes are expressed as a percentage of baseline.

Results After treatment with O‐2545, IOP was significantly reduced to 11±0.9 mmHg after 60 min and to 12±1.1 mmHg after 120 min compared to baseline of 14±0.6 mmHg (p<0.03, n=6). Similarly, O‐1812 treatment reduced IOP to 8.4±1.8 mmHg after 60 min and maintained for up to 120 min (p<0.001, n=6). After 1 wk, NMDA (control) reduced a‐wave amplitude by 38±0.1% (p<0.001, n=6) from baseline, O‐2545 by 46±0.02% (p<0.001, n=6) and O‐1812 by 23±0.1% (p=0.004, n=6). After 2 wks, NMDA further decreased a‐wave amplitude by 48±0.1% (p<0.001, n=6), O‐2545 by 39±0.03% (p<0.05, n=6) and O‐1812 by 8±0.1% (p=0.08, n=6).

Conclusion Topically applied cannabinoids are effective agents that reduce IOP and confer neuroprotection and are prime candidates for potential glaucoma treatment.
Position of the central retinal vessel trunk and location of visual field and parapapillary nerve fibers damage in early to moderate glaucoma
Authors: BESOMBES G , GRUNEWALD F , ROULAND J
Published: August 2014

Purpose To address the question of whether the position of the central retinal vessel trunk (CRVT) exit in the optic disc has a spatial relationship with glaucomatous damage

Methods This clinical observational study included patients with early to moderate primary open‐angle glaucoma. The position of the CRVT exit on the lamina cribrosa was evaluated on optic disc photographs. Visual field tests and retinal nerve fibers layer (RNFL) thicknesses, as measured by optical coherence tomography, were evaluated.

Results The study included 65 eyes with a CRVT mostly decentered into the nasal region followed by the temporal half of the optic disc. Comparing measurements between the opposite disc quadrants indicated that the RNFL thickness was significantly thinner in the inferotemporal quadrant when the CRVT was located in the superonasal quadrant compared with an exit in the inferonasal (p=0.0183) or temporal (p=0.0039) quadrant. The distance from the CRVT to the nasal disc border was significantly smaller and correlated positively with the occurrence of RNFL abnormality in the temporal region (p=0.0334). Visual field defect incidence was higher in the superonasal quadrant of the pattern deviation plot when the CRVT was located in the superonasal quadrant compared with an exit in the inferonasal quadrant (p<0.0003). Temporal visual field abnormalities occurred more often when the CRVT exit was located in the temporal part of the optic disc than when the CRVT exit was located in the nasal half (p=0.008).

Conclusion Local susceptibility for development of glaucomatous damage correlates with the distance to the CRVT, which may act as a stabilizing element against the deformation of the lamina cribrosa.
Progression rate in glaucoma using spectral‐domain optical coherence tomography
Authors: LEE Y
Published: August 2014

Purpose To evaluate the thining rates of retinal nerve fiber layer (RNFL), macular and ganclion cell‐inner plexiform layer (GC‐IPL) thickness in eyes with POAG, NTG and ACG.

Methods Retrospective cohort study included 145 eyes of 90 glaucoma patient(POAG 70; NTG 60; ACG 15). RNFL, macular and GI‐IPL thickness were measured by spectral‐domain optical coherence tomography (Cirrus SD‐OCT). Also all the patient was re‐classified as 3 groups according to visual field severity (early, moderate and advanced) and as 3 groups according to spherical equivalent (myopia, mild myopia and hyperopia). The meaningful thining was defined on exceed the age‐related physiological loss.

Results The mean (±SD) follow‐up period was 3.86±0.16 years. ACG eyes showed highest progression rate of RNFLT in all of quadrant and clock hour. NTG eyes showed no significant different in average RNFLT but significantly higher RNFL thining rates than POAG in inferior quadrant. In ACG eyes, RNFLT thining rate is highest in clock‐hour‐6. In NTG eyes showed highest in clock‐hour‐7 while similar rate in clock‐hour‐7 and clock‐hour‐12 in POAG eyes. Thining of macular thickness is highest at outer inferior sector and thining of GC‐IPL is highest in inferior sector and inferior hemifield. Thining rate of RNFLT is slower in myopic eyes than mild myopic and hyperopic eyes. In the advanced group, thining rate of RNFLT is slower than early and moderate groups.

Conclusion Reduction rate of RNFL, macular and GC‐IPL thickness calculated by Ciruss SD‐OCT is differ according to the types of glaucoma, spherical equivalent and severity of glaucoma.
Color Doppler imaging and glaucoma: comparison of Doppler Waveform and velocities of retrobulbar vessels between a glaucomatous patient and a healthy subject
Authors: VERTICCHIO VERCELLIN A , CUTOLO C , DELLAFIORE C , LAVA M , TINELLI C , CALLIADA F , MILANO G
Published: August 2014

Purpose To compare the colour Doppler imaging (CDI) waveform and velocities of the ophthalmic artery (OA), central retinal artery (CRA) and short posterior ciliary arteries (SPCA) of a patient with normal tension glaucoma (NTG) compared to a healthy subject.

Methods The right eye of two subjects (a patient with NTG and a healthy subject) were investigated. The same examiner performed CDI examination of the OA, CRA and SPCA using the CDI device ESAOTE MYLAB™ (probe LA533 13‐6 MHz small parts‐vascular linear array). The peak systolic velocity (PSV), the end‐diastolic velocity (EDV), the resulting resistivity index (RI) were evaluated. Two aspects of the Doppler waveform were considered: the Early Systolic Acceleration (the slope of the fastest moving portion of the systolic component, ESA) and the ratio between the mean velocities of the systolic and diastolic components (Sm/Dm).

Results All the measured velocities, except for the PSV in the ophthalmic artery, are reduced and the RIs are increased in the glaucomatous patient compared to the healty subject. Moreover, ESA is reduced and Sm/Dm increased if compared to the healthy volunteer.

Conclusion The values obtained are in agreement with the literature. Further studies are needed to evaluate the degree of the pathological alterations and their role in the progression of the optic nerve injury.
Analyze of visual field indices in ocular hypertension: PROG‐F3 study
Authors: DELBARRE M , GIRAUD JM , APTEL F , EL CHEHAB H , RENARD JP
Published: August 2014

Purpose To analyze visual field (VF) indices and their progression of patients treated for ocular hypertension (OHT).

Methods This retrospective study concerned 27.4% of a bicentric cohort (121 eyes of 441). These eyes with normal VF and without clinical structural defect at inclusion were monitored and treated for OHT at least 9.7+/‐1.65yrs. Patients underwent every 6 months an eye examination and a reproducible VF testing (Humphrey Field Analyser, SITA Standard 24‐2, Carl Zeiss Meditec). At the end of follow‐up, patients who developed POAG were included in evolutive group and patients without functional defects were considered stable. MD, VFI, and their rate of progression were analyzed. Statistical analyse compared populations by a Student t‐test and diagnostic performance was assessed by sensitivity (Se), specificity (Sp) and area under receiver operating characteristic curve (AUROC).

Results Evolutive group included 46 eyes and stable group included 58 eyes. Rate of progression of MD (dB/yr) for stable and evolutive groups were respectively ‐0.007 and ‐0.285 (p <0.001). Rate of progression of VFI (%/yr) for stable and evolutive groups were respectively ‐0.026 and ‐0.407 (p=0.001). Initial MD (dB) at beginning of follow up for stable and evolutive groups were 1.139 and 0.616 (p<0.001). Initial VFI (%) were 99.793 and 99.304 (p<0.001). AUC were, respectively, for MD and VFI rate of progression : 0.967 and 0.827. The best cut off value of AUROC was for MD rate of progression: ‐0.100 dB/yr (Se=93.5%, Sp=93.1%).

Conclusion Rate of progression of MD and VFI in OHT evolutive group were higher than in OHT stable group. This study reports a higher diagnostic power for rate of progression of MD. It could be used to screen OHT patients at risk of POAG.