bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic corneal wavefront aberrations and quality of vision in patients with dry eye disease
Authors: DENOYER A , RABUT G , BAUDOUIN C
Published: December 2011

Purpose This clinical, prospective, and comparative study was conducted to evaluate the time‐course of corneal optical quality along with patient‐centered visual deterioration in dry eye.

Methods Twenty patients diagnosed for dry eye and twenty controls were included. Clinical evaluation of the ocular surface included tear break‐up time (BUT) measurement, Schirmer's test, corneal and conjunctival staining scores. Dynamic corneal aberrometry was performed using KR‐1W aberrometer (Topcon, Tokyo, Japan). Patient‐centered quality of vision was evaluated according to the Ocular Surface Disease Index (OSDI). Corneal aberration (CA) dynamics were compared between both groups then analyzed regardless to other clinical data.

Results Mean slope for aberration time‐course was significantly higher in dry eye patients than in controls (P=0.01). Dry eye was associated with an increase in corneal high‐order aberrations from 3 to 10 seconds after blinking (P<0.001) mainly due to rapid increase in third‐ and fourth‐order CAs. Correlation matrix revealed significant relation between CA dynamics and BUT (P<0.001), corneal staining (P<0.001), OSDI vision‐subscore (P=0.009) and OSDI overall score (P=0.02). BUT and Oxford’s score were found to correlate with CA dynamics in multiple regression analysis.

Conclusion Dynamic corneal aberrometry appears as a new objective tool to better understand visual disturbances due to dry eye, and it could constitute a repeatable and reproducible method to follow the disease and improve the therapeutic management.
High‐mobility group box‐1 and biomarkers of inflammation in the vitreous from patients with proliferative diabetic retinopathy
Authors: ABU EL ASRAR A , NAWAZ MI , KANGAVE D , GEBOES K , OLA MS , AHMAD S , AL‐SHABRAWEY M
Published: December 2011

Purpose To measure levels of high‐mobility group box‐1 (HMGB1), and soluble receptor for advanced glycation end products (sRAGE) in the vitreous fluid from patients with proliferative diabetic retinopathy (PDR) and to correlate their levels with clinical disease activity and the levels of the inflammatory biomarkers monocyte chemoattractant protein‐1 (MCP‐1), soluble intercellular adhesion molecule‐1 (sICAM‐1), interleukin‐1 (IL‐1) and granulocyte macrophage colony‐stimulating factor (GM‐CSF). In addition, we examined the expression of HMGB1 in the retinas of diabetic mice.

Methods Vitreous samples from 29 PDR and 17 nondiabetic patients were studied by enzyme‐linked immunosorbent assay. Retinas of mice were examined by immunofluorescence analysis and Western blotting.

Results HMGB1 was detected in all vitreous samples and sRAGE was detected in 5 PDR samples. IL‐1 was detected in 3PDR samples and GM‐CSF was not detected. Mean HMGB1 levels in PDR with active neovascularization were 2‐fold and 3‐fold higher than that in inactive PDR and nondiabetic patients, respectively. Mean HMGB1 levels in PDR patients with hemorrhage were significantly higher than those in PDR patients without hemorrhage and nondiabetic patients (p=0.0111). There were significant correlations between levels of HMGB1 and levels of MCP‐1 (r=0.333, p=0.025) and sICAM‐1 (r=0.548, p<0.001). HMGB1 expression was also upregulated in the retinas of diabetic mice.

Conclusion Subclinical, chronic inflammation might contribute to the progression of PDR.
Alteration of plasmalogens in erythrocytes of patients with diabetic retinopathy
Authors: ACAR N , SAAB S , BERDEAUX O , BRON AM , CREUZOT C , BRETILLON L
Published: December 2011

Purpose Plasmalogens are phospholipids characterized by a vinyl ether bond and the preferential esterification of polyunsaturated fatty acids (PUFA). We have shown that the lack of plasmalogens leads to abnormal retinal vascularisation. Because we hypothesize that plasmalogens are negative regulators of vascular development, we aimed to check their circulating levels in patients having a retinal pathology with vascular proliferation.

Methods Blood samples were collected from 4 control subjects and 42 patients having proliferative or non‐proliferative diabetic retinopathy (DR). Patients were classified according to the stage of DR. The plasmalogen content and the fatty acid composition of erythrocyte phospholipids were determined using gas chromatography. Individual species of phospholipids, including plasmalogens, were quantified by liquid chromatography coupled with a triple quadrupole mass spectrometer (HPLC‐ESI+MS/MS).

Results Gas chromatographic analyzes did not reveal any change in plasmalogens. The analysis of individual species of phospholipids by HPLC‐ESI+MS/MS showed reduced levels of plasmalogens in patients with DR. Five species of plasmalogens having PUFA were at reduced concentrations in erythrocytes of DR patients. In parallel, the amounts of conventional phospholipids having docosahexaenoic acid (DHA) were altered in DR patients when compared to control subjects.

Conclusion Mechanisms responsible for the reduction in blood levels of plasmalogens and DHA in patients with DR are unknown. Since erythrocyte membrane lipid composition is admitted to reflect the lipid composition of nervous tissues, including the retina, one may suggest that DR patients have altered retinal concentrations of plasmalogens and DHA.
Health related quality of life in patients with diabetic retinopathy
Authors: TADROS C , KONTODIMOPOULOS N , FERETIS E , KABANAROU SA , PETO T
Published: December 2011

Purpose To assess Health‐Related Quality of Life (HRQoL) among Greek patients with Diabetic Retinopathy (DR) and Maculopathy(DMac) and to compare the results with data from existing studies.

Methods Patients were recruited from the Diabetic Eye Clinic of the Hellenic Red Cross Hospital while attending their scheduled appointment. The study comprises of 85 patients with DR/DMac. HRQoL was measured using three different types of measurement, the NEI VFQ‐25, the SF‐12 and the EQ‐15D independently of their treatment.

Results The response rate was 86.73%. There were 51 males, the average age was 57.7±16.4 years and the average duration of diabetes was 10.9±6.6 years.Patients with proliferative DR and existing DMac scored lower on all VFQ‐25 subscales compared to patients with non‐proliferative DR and those without DMac, respectively, especially in the dimensions "General Health"(34.2±24.9 versus 74.3±15.7 and 25.1±18.7 versus 69.8±19.2) and "Role Difficulties"(33.7±28.3 versus 87.7±25.2 and 23.6±23.1 versus 79.9±26.7). In the SF‐12 questionnaire the mean value in the Physical Component Scale (CS) was 45.6±11.3 and in the Mental CS was 45.2±16.8 while values in general Greek population are 49.4 and 48.9,respectively. In the EQ‐15D the mean value was significantly lower,0.761,while published values in Greek diabetic patients without DR are 0.813.

Conclusion This study confirms that Greek patients with DR and DMac report poorer HRQoL than the general population. Therefore, the prvention and management of DR and DMac is essential to improve quality of life for these patients.
Treatment accuracy and patient pain compared in Retinal Navigated Laser (Navilas®) versus conventional laser in diabetic macular edema
Authors: KERNT M , ULBIG MW , KAMPIK A , NEUBAUER AS
Published: December 2011

Purpose Treatment accuracy and patient pain were evaluated using a novel navigating laser (NAVILAS) compared to conventional laser treatment in clinically significant macular edema (CSME).

Methods Focal Navilas laser was performed in 42 patients. On color images (CI) and OCT laser spots were analyzed regarding accuracy spot placement compared to planning. Treatment pain was quantified on a visual‐analogue‐scale (VAS) and compared to a matched control. Up to one year clinical follow‐up investigated retreatment and visual acuity compared to a control of 113 patients treated by conventional laser.

Results 79% of laserspots were visible on CI, of which 96% were within 100µm from the planned target. OCT confirmed that laser effects were limited to the outer retina . The number of laser spots per patient was 115+/‐97 with Navilas, (43+/‐36) with conventional laser. Pain on VAS was mean 1.6 (SD 1.0), 4.4 (SD 1.8) for the control. Kaplan‐Meier analysis showed separation of the retreatment curves after 4‐5 months with less retreatments for Navilas.

Conclusion Compared to conventional laser, significantly more laserspots were placed with Navilas, patient reported pain was significantly lower. the tendency for lower retreatment rates tend with Navilas may be important when considering possible combination laser and anti‐VEGF drug therapy.

Commercial interest
Diabetic retinopathy macular edema : Treatment by series of 3 Ranibizumab injections after 3 years follow‐up
Authors: GONZALEZ C
Published: December 2011

Purpose To evaluate the functional, anatomical, vascular,anti‐exudative effects of intravitreal injections (IVT) for Diabetic Retinopathy Macular Edema, by a protocol with 3 Ranibizumab IVT series, and the recurrences frequency at 3 years evolution.

Methods 44 eyes of 26 patients, 16 men, 10 women, with Diabetic Retinopathy Macular Edema. Patients received intravitreous Ranibizumab, 3 times, every 4 weeks in an inductive treatment. The next injections (IVT) depended on the follow‐up results and were done by series of 3. First and 2 months’ interval follow‐up exam included ETDRS visual acuity (VA), complete ophthalmic examination, optical coherence tomography (OCT),fluorescein (FA) angiography. VA and OCT were done before each IVT. We want to evaluate the incidence of this protocol on the exudation and frequency of recurrence of exudation and so on the number of IVT needed.

Results VA improved in 79% cases, stabilized in 10,5%. Diffuse edema was 77% normalised ,total thickness was 55% less in the average follow‐up, cysts 100% disappeared in 75% cases, in 40% were diminished in size , volume and number, by OCT. At Angiography, no leakage in 64% cases, cystic macular edema disappeared, microaneurysm’s size and number diminished. Most of patients had good functional, anatomical results, with few IVT needed, no scars in the retina. Inductive treatment was sufficient in 6 cases, needed 2 IVT series in 30% eyes, failed in no cases. This protocol was compared ,discussed .

Conclusion The results, with improved visual function, reduction of exudation on OCT, lack of fluorescein leakage, few recurrences, suggest this protocol, with series of 3 Ranibizumab IVT seems effective, more retinal protective. This protocol seems attractive, specif
Cytokine concentration in aqueous humor of eyes with diabetic macular edema
Authors: JONAS JB , JONAS R , NEUMAIER M , FINDEISEN P
Published: December 2011

Purpose To measure cytokine concentrations in aqueous humor of eyes with diffuse diabetic macular edema.

Methods The study included a study group of 23 patients with diffuse diabetic macular edema and a control group of 22 patients undergoing cataract surgery were compared. Cytokine concentrations were measured in aqueous humor samples using a Luminex xMAP suspension array technology.

Results In the study group as compared to the control group, significantly higher concentrations were measured for epidermal growth factor (EGF)(P<0.001), human growth factor (HGF)(P<0.001), intercellular adhesion molecule‐1 (ICAM1)(P<0.001), interleukin 1a2 (IL1a2)(P=0.04), interleukin 6 (IL6)(P=0.001), interleukin 8 (IL 8)(P<0.001), interferon‐gamma induced protein (IP10)(P=0.004), monocyte chemoattractant protein‐1 (MCP‐1)(P<0.001), monokine induced by interferon gamma (MIG)(P<0.001), matrix metalloproteinase 1 (MMP1)(P=0.02), matrix metalloproteinase 9 (MMP9)(P<0.001), plasminogen activator inhibitor 1 (PAI1)(P<0.001), placenta growth factor (PlGF) (P<0.001), tissue growth factor beta (TGF‐ß) (P=0.003), vascular cell adhesion molecule (VCAM)(P<0.001), and vascular endothelial growth factor (VEGF)(P<0.001). Retinal macula thickness was significantly associated with the concentrations of the EGF, ICAM1, IL3, IL6, IL8, MCP‐1, MIG, MMP9, TGF‐ß, PlGF, VCAM, and VEGF. In multivariate analysis, macular thickness remained to be significantly associated with the concentration of ICAM1 (P=0.006;r=0.40).

Conclusion Numerous cytokines are associated with the presence and the amount of diabetic macular edema. Among these cytokines, ICAM1 was the most significantly associated with the disease parameters.
Experimental study of distinguishing small retinal heamorrhages from dust artefacts using HLS colour space
Authors: SUZUKI N , YAMANE K
Published: December 2011

Purpose Many ophthalmologists consider it difficult to distinguish small retinal heamorrhages of early diabetic retinopathy from dust artefacts on fundus cameras.

Methods Photographs of the fundi of five patients with diabetic retinopathy were taken. Paint Shop Pro v. 8.0 was used to measure HLS colour spaces of both hemorrhagic area and the area around the heamorrhage at two locations of each photograph. We constructed the experimental device, which has an illumination optical system and a photographic optical system separated by a mirror having a hole with 4 mm diameter. The device consists of a canon EOS 50D camera, an EF 50mm f/1.8‐2 camera lens, a Speedlite 270EX flash, an object lens, four double‐convex lenses, two aperture stops and four artificial eyes. The eye ground is a half sphere made of polythene terephthalate painted by four mat colour sprays: red, white brown, ochre and yellow. Five fragments of house dust on the object lens were photographed under each artificial eye. Paint Shop Pro 8.0 was used to measure the HLS colour spaces of dust artefacts and the area around the artefacts.

Results The evaluation space of house dust was calculated using the HLS data obtained from the experimental device. Hue was red, −7.1±16.9; white brown, −5.7±7.4; yellow, 3.4±1.6 and ochre 0.3±2.3. Lightness was red, 10.7±3.4; yellow, 9.9±3.0; ochre, 9.5±1.8 and white brown, 8.2±2.1. Saturation was red, 25.5±23.5; white brown, 22.6±12.2; yellow, 15.1±12.3 and ochre, 5.0±2.8.

Conclusion The lightness of the HLS colour space helped in distinguishing dust from heamorrhage in all colour spectra. However, hue and saturation could distinguish dust from heamorrhage only under certain conditions.
Nurse‐led glaucoma clinics‐ the pros and cons
Authors: ANSARI E , GAMBLE A
Published: December 2011

Purpose Addressing the need for increased capacity in glaucoma follow‐up clinics by delegating resposibility to a trained nurse practitioner. A specialist hospital‐based study.

Methods A senior nurse practitioner (NP) was trained by a glaucoma specialist in the management of glaucoma follow‐ups. Once training was completed, glaucoma cases were transferred to NP‐led clinic for follow‐up alongside consultant clinic. Certain criteria had to be met for inclusion in NP clinic: 1.Good compliance and control on topical treatment+/‐laser 2.Stability of visual fields over previous 3 years 3.No post‐surgical cases 4.No complex cases or co‐morbidities

Results 200 follow‐up cases were accomodated in NP clinic over a period of 3 years, thus adding capacity to an increasingly overburdened service.There were no cases lost to follow‐up, a non‐attendance rate of 2% and no cases had a progression of visual fields MD>0.75dB/year. The most frequent reasons for seeking advise of the specialist were the need to change treatment regime due to increasing IOP (10%),or poor comliance/tolerability to treatment (10%).

Conclusion 1.NP‐led clinics add capacity without compromising on standard of care 2.NP skills and confidence improved with regular practice 3.Patients' experience was excellent 4.Capacity was freed up in consultant clinic to see more complex cases in a timely manner 5.Training does take a long time 6.In order to run smoothly and safely the NP‐led clinic had to be alongside the consultant clinic 7.There is a limit to the number of cases that can be seen in NP clinic without compromising on quality of care.
CTNND2 is a genetic variant for high myopia
Authors: SAW SM , FAN Q , YOSHIMURA N , KHOR CC , TAI ES , GOH LK , YOUNG T , LI YL
Published: December 2011

Purpose To determine novel genetic variants for high myopia in Singaporean Chinese.

Methods A meta‐analysis of 2 genome‐wide association (GWA) datasets in Chinese and a follow‐up replication cohort in Japanese.Two independent datasets of Singaporean Chinese individuals aged 10 to 12 years (Singapore Cohort Study of the Risk factors for Myopia [SCORM]: cases = 65, controls = 238) and more than 21 years (Singapore Prospective Study Program [SP2]: cases = 222, controls = 435) for GWA studies, and a Japanese dataset aged more than 20 years (cases = 959, controls = 2128) for replication.Genomic DNA samples from SCORM and SP2 were genotyped using various Illumina Beadarray platforms (>HumanHap 500). High myopia, was defined by spherical equivalent (SE) ≤ ‐6.00 diopters (D) and controls defined by SE between ‐0.50 and +1.00 D.Single‐locus association tests were conducted for each dataset with meta‐analysis using pooled z‐scores. The top‐ranked genetic markers were examined for replication in the Japanese dataset. Fisher P was calculated for the combined analysis of all 3 cohorts.

Results Two SNPs (rs12716080 and rs6885224) in the gene CTNND2 on chromosome 5p15 ranked top in the meta‐analysis of our Chinese datasets (meta P = 1.14 × 10(‐5) and meta P = 1.51 × 10(‐5), respectively) with strong supporting evidence in each individual dataset analysis (max P = 1.85 × 10(‐4) in SCORM: max P = 8.8 × 10(‐3) in SP2). Evidence of replication was observed in the Japanese dataset for rs6885224 (P = 0.035, meta P of 3 datasets: 7.84 × 10(‐6)).

Conclusion This study identified a strong association of CTNND2 for high myopia in Asian datasets. The CTNND2 gene maps to a known high myopia linkage region on chromosome 5p15.
Identification of novel germline mutations in the VHL gene in Hungarian von Hippel‐Lindau patients
Authors: LOSONCZY G , FAZAKAS F , PFLIEGLER G , KOMAROMI I , BERTA A
Published: December 2011

Purpose Von Hippel‐Lindau disease is an autosomal dominantly inherited highly penetrant tumor syndrome predisposing to retinal and central nervous system hemangioblastomas, renal cell carcinoma and pheochromocytoma among other less frequent complications. Our goal was to establish genotype‐phenotype correlation in Hungarian von Hippel‐Lindau patients.

Methods Fourteen members (9 patients and 5 healthy family members) of 6 unrelated families with type 1 VHL disease underwent clinical and molecular genetic examination. The effect of a novel missense mutation was predicted using molecular modeling.

Results Retinal angioma was detected in seven patients; six patients had central nervous system hemangioblastoma and three patients developed RCC. Molecular genetic investigations detected four novel (c.232A>T, c.340+1G>A, c.163G>T, c.555C>A) and two previously described (c.583C>T and c.472C>G) germline mutations in the VHL gene, including four mutations leading to protein truncation and two missense mutations.

Conclusion RCC only associated to MLTP among our patients, in accordance with previous findings. The novel c.163G>T mutation associated to bilateral RCC and retinal angioma in a 15‐years‐old male patient, which is the earliest occurrence of RCC in VHL disease reported so far. Molecular modeling of the VHL‐Elongin C complex predicted that the c.232A>T mutation responsible for the p.Asn78Tyr amino acid exchange remarkably changes the 77‐83 loop structure of the VHL protein destabilizing the VHL protein and the VHL‐ Elongin C complex. Therefore it is predicted to cause type I phenotype, as seen in our patient indeed. Our results can be useful for genetic counseling and follow‐up of VHL patients.
iPS cells ‐ an alternative source of RPE?
Authors: CARR A
Published: December 2011

Purpose We have previously shown that human embryonic stem cells spontaneously differentiate into RPE, and, after transplantation into the dystrophic RCS rat, maintain visual acuity. Recent advances in the generation of stem cells from somatic cells have led us to investigate the use of induced pluripotent stem cells (iPS) as a potential source of therapeutic RPE.

Methods iPS cells spontaneously differentiate after removal of bFGF from the culture medium. Isolated pigmented colonies were dissociated for expansion. The enriched population was then characterised morphologically and at the gene and protein expression level. Functionality of iPS‐derived RPE cells was assessed by RPE phagocytosis of retinal debris in vitro and in vivo. The therapeutic effect of iPS‐derived RPE was examined by injection of cells into the subretinal space of the dystrophic RCS rat.

Results In culture iPS‐RPE were morphologically similar to, and expressed many markers of developing and mature RPE. These cells also phagocytose photoreceptor material, in vitro and in vivo following transplantation into the RCS dystrophic rat. Preservation of the neural retina layers and maintenance of visual acuity was observed 13 weeks following transplantation, however at this stage very few human cells remained and a number of large pigmented macrophages were observed in the subretinal space.

Conclusion iPS cells can readily differentiate into functional RPE which facilitate the short‐term maintenance of photoreceptors. However, long‐term maintenance of the dystrophic RCS rat neural retina is likely to be due to a protective host response initiated against the xenografted cells. The use of iPS‐RPE as a cell therapy requires further investigation, however these cells provide a new model system in which to study RPE specific diseases in vitro.
The role of RPE in the regulation of VEGF
Authors: KLETTNER A
Published: December 2011

Vascular endothelial growth factor (VEGF) has emerged as a major player in retinal diseases and is strongly involved in choroidal neovascularisation in exudative age‐related macular degeneration (AMD) or in the development of macular edema in diabetic retinopathy. An important source of VEGF in the retina is the Retinal Pigment Epithelium (RPE). The RPE is a highly polarized cell layer situated between the choroid and the photoreceptors and among its many functions is the secretion of cytokines. RPE‐derived VEGF is important for the development of the vasculature of the retina in the premature eye. In the adult eye, the RPE constitutively secrets low amounts of VEGF, mainly on the basolateral side, in order to maintain the choroid and protect endothelial cells. Also, neuroprotective properties of (apical) VEGF have been described. Main isoforms of RPE‐secreted VEGF are VEGF165 and, to a lesser extent, VEGF121. Also, minor amounts of VEGF189 are can be found. VEGF165b, an anti‐angiogenic isoform, might also be secreted by the RPE. Under different noxious stimulations, RPE cells increase their VEGF secretion, via several, stimulus specific, pathways. Among these stimuli, hypoxia, oxidative stress, hyperglycemia, several cytokines and endoplasmic reticulum stress might be closely connected to the pathogenesis of exudative AMD and other neovascular alterations of the retina. Loss of polarity might also contribute to inappropriate VEGF secretion and subsequent neovascular changes. The dichotomy of protective physiological and vision‐threatening pathological VEGF secretion renders the differences of physiological and pathological VEGF expression regulation a highly interesting target for the development of long‐term VEGF inhibiting drugs.
The role of Mas receptors in an experimental rat glaucoma model
Authors: VAAJANEN A , KALESNYKAS G , VAPAATALO H , UUSITALO H
Published: December 2011

Purpose To evaluate the neuroprotective and/or oculohypotensive effects of potent angiotensin system agents known to reduce intraocular pressure in the normotensive rabbits by using an experimental laser‐induced glaucoma model in rat eye.

Methods Experimental glaucoma was induced unilaterally using laser photocoagulation of the episcleral and limbal veins of male Wistar rats twice in one week intervals. The fellow eye was untreated, thus serving as a normotensive control. Mas receptor agonist angiotensin (1‐7) and antagonist A‐779 as well as their combination were injected intravitreally. IOP was measured by rebound tonometer during the follow‐up time of two weeks. At the end of the study the animals were sacrified. The eyes and the optic nerves were collected. The neurodegenerative changes were evaluated from the optic nerves using a modified Gallyas silver‐staining method.

Results Mean IOP in laser treated and untreated eyes were 27.4 mmHg and 10.5 mmHg during two weeks follow up time. A significant axonal destruction was detected in glaucomatous eyes vs fellow eye with normal IOP. Intravitreal administration of test compounds did not reduce IOP. However the group of rats that were treated with A‐779 had significantly lower area of neurodegenerative axons in the optic nerves as compared to the other groups.

Conclusion In laser induced glaucoma model IOP elevates rapidly leading to severe destruction of ganglion cell axons like occurs in normally slowly developing neuropathy. In this model Mas receptor antagonist A‐779 had an IOP‐independent neuroprotective effect on retinal ganglion cells whereas Mas receptor stimulation did not reduce IOP and had no influence on axonal damage.
Behçet's uveitis: why biologicals are predestined to become the first line treatments
Authors: ONAL S
Published: December 2011

Abstract not provided
Laser flare photometry: why is it going to be the gold standard for the assessment of intraocular inflammation
Authors: KHAIRALLAH M , KHOCHTALI S
Published: December 2011

Purpose Laser flare photometry is a noninvasive, objective and quantitative method to measure intraocular inflammation.

Methods The reproducibility and accuracy of flare measurements was proven by laboratory tests and by clinical studies showing low inter‐ and intra‐observer variability. Laser flare photometry values correlate with clinical grades of flare based on slit lamp examination. However, this technique provides a wide range of values for each clinical grade and there are overlapping ranges between grades. Besides,it allows the detection of subclinical blood aqueous barrier disruption.

Results Laser flare photometry has many clinical applications : 1‐Uveitis Laser flare photometry shows better sensitivity than the slit lamp grading of cells and flare in monitoring anterior chamber inflammation, in both acute and chronic inflammation. It helps to define the inflammatory profiles of various types of anterior and posterior uveitis. It allows the assessement of the response to treatment and the prediction of the disease relapse. Relationships of laser flare photometry with complications permit to determine the prognosis of uveitis. 2‐Post‐surgical inflammation An objective evaluation of the blood aqueous barrier disruption after different surgical procedures is provided. The effects of different molecules on the post‐surgical inflammation can be evaluated and compared. 3‐Several other conditions associated with some degree of blood‐aqueous barrier disruption such as diabetic retinopathy

Conclusion Laser flare photometry is an objective and precise technique. It should be the gold standard for the assessment of intraocular inflammation.
How OCT changed the appraisal of macular inflammatory disease
Authors: MARKOMICHELAKIS N
Published: December 2011

Abstract not provided
Vogt‐Koyanagi‐Harada disease : why indocyanine green angiography‐assisted therapy is going to become the standard of care
Authors: BOUCHENAKI N , HERBORT C
Published: December 2011

Purpose To assess the potential of ICGA in the monitoring of treatment of acute Vogt‐Koyanagi‐Harada (VKH) disease by detecting early recurrences.

Methods Retrospective/prospective study including patients in the initial acute phase of VH disease treated early with high dose inflammation suppressive therapy who were followed by indocyanine green angiography. (ICGA) at regular intervals.

Results The angiographic characteristics of ICGA in VKH in acute phase include hypofluorescent dark dots, fuzzy leaking choroidal vessels in the early and intermediate angiographic phase followed by diffuse choroidal hypperfluorescence in the late phase, and in very severe inflammation disc hyperfluorescence and pinpoints with subretinal fluid can be seen. All those signs disappear with early and intensive anti‐inflammatory therapy. ICGA was effective in objectively detecting recurrence in apparently controlled disease by showing re‐appearence of choroidal lesions (mainly dark dots) before biomicroscopy or fluorescein angiography manifestations, allowing early and fine adjustement of treatment during tapering period.

Conclusion By detecting subclinical choroidal inflammatory lesions ICGA allows detection of subtle recurrent lesion and refine therapeutic adjustement in order to avoid evolution toward chronic form and prevent sunset glow fundus.
Choriocapillaritis : why is ICGA due to become the standard to monitor evolution and response to therapy
Authors: HERBORT C
Published: December 2011

Abstract not provided
Inflammatory choroidal neovascularization: how combined anti‐VEGF and inflammation suppressive therapy is going to become the treatment of choice
Authors: NERI P , ARAPI I
Published: December 2011

Purpose To describe the treatment strategy in the management of inflammatory choroidal neovascularization (CNV).

Methods The current literature is reviewed and the experience of a tertiary referral centre is reported.

Results CNV can be one of the most severe sequela in patients with uveitis. The outcome of subfoveal inflammatory CNV is poor if untreated: several procedures have been considered, even though there is lack of guidelines. On the other hand, the better knowledge of CNV pathophysiology may suggest a suitable treatment strategy. The combination of steroids and immunosuppression represents an important aspect of inflammatory CNV treatment. This ensures suitable control of inflammation as well as the reduction concomitant steroids dose. Neverthless there are cases which do not show a fully satisfactory response. Recently, the role of intravitreal anti‐Vascular Endothelial Growth Factor (VEGF) has become primary in the treatment of neovascularizations. At this time, the combination of anti‐VEGF drugs and immunesuppressives has become the recommended strategy for the management of inflammatory CNV.

Conclusion CNV secondary to uveitis is a severe sequela, which can lead to significant visual impairment. Although no guideline is provided, the current medical literature can give the basis for a successful treatment strategy, suggesting that combination of immunesuppresives and anti‐VEGF is recommended.
Agreement between structural and functional classifications in glaucoma diagnosis
Authors: OTIN S , FERRANDEZ ARENAS B , CALVO P , GIL‐ARRIBAS L , GÜERRI N , ALTEMIR I , FERRERAS A
Published: December 2011

Purpose To evaluate the agreement between the Moorfields regression analysis classification (MRA) of the Heidelberg retina Tomograph 3 (HRT3; Heidelberg Engineering, Heidelberg, Germany) and the functional classification of white‐on‐white Heidelberg Edge Perimetry (HEP, Heidelberg Engineering).

Methods Fifty‐seven normal subjects and 89 age‐matched glaucoma subjects were selected.Only one eye per subject was randomly included in the statistical analysis. All glaucoma patients had an intraocular pressure higher than 21 mmHg and abnormal Humphrey visual fields. The glaucoma group was divided into three subsets, according to the subject’s level of visual field loss (Hodapp‐Parrish‐Anderson score). All participants underwent a comprehensive ophthalmic examination, at least a reliable Humphrey perimetry, at least a reliable HEP and imaging with the HRT3. The agreement between color‐coded classifications of both, MRA and HEP, was calculated for each sector of the optic nerve head: nasal‐superior

Results Mean age was 52.9 ± 9.5 years in the control group and 55.5 ± 9.7 years in the glaucoma group (p=0.104). In the control group, the best agreement was found for NI sector (100%), while the worst agreement was observed for TI sector (93%). Patients with mild glaucoma (n=59) had the best agreement at NS sector (79.7%) while patients with moderate glaucoma (n=18) had the best agreement at NS, TS and TI sectors (88.9%), and patients with severe glaucoma (n=12) had the best agreement at NS, TS, TI and T sectors (83.3%).

Conclusion In general, MRA and functional classification of HEP showed moderate to good agreement. The best agreement between both classifications was observed in healthy and patients with mild glaucoma.
Posture‐induced IOP changes in treated and untreated primary open angle glaucoma patients
Authors: KATSANOS A , DASTIRIDOU A , RUSSO A , RIVA I , DIMASI B , TSIRONI E , QUARANTA L
Published: December 2011

Purpose To compare posture‐induced intraocular pressure (IOP) changes in controls, medically treated, and untreated primary open angle glaucoma (POAG) patients.

Methods One eye from each of 20 age‐matched controls, 21 treated and 14 untreated POAG patients was included. IOP was measured with a Perkins tonometer and arterial pressure (AP) with a sphygmomanometer consecutively in the sitting, supine and 20 degrees Trendelenburg positions, allowing for a period of 5 minutes between positions. Differences in IOP and mean AP between the sitting, supine and Trendelenburg positions were calculated.

Results Mean±SD sitting IOP was 13.5±1.9 mmHg in the control group, 22.0±4.4 mmHg in the untreated POAG group and 13.5±2.5 mmHg in the treated POAG group (one‐way ANOVA, p<.001). The IOP change from the sitting to supine position was 0.9±1.3 mmHg in the control group, 2.3±1.7 mmHg in the treated POAG group and 3.1±1.9 mmHg in the untreated POAG group (one way ANOVA p<.001). The IOP change from the sitting to the Trendelenburg position was 1.7±1.6 mmHg in the control, 4.2±2.2 mmHg in the treated POAG and 4.3±3.1 mmHg in the untreated POAG groups, respectively (p<.001). Post hoc pairwise comparisons revealed significant differences between each POAG group and controls (p<.01). No difference was observed in IOP changes between treated and untreated POAG patients for the sitting‐to‐supine (p=.14) and the sitting‐to‐Trendelenburg transitions (p=.90). No significant posture‐induced AP change was observed in any group (repeated measures ANOVA p>.1).

Conclusion Irrespective of treatment, POAG patients exhibit a bigger posture‐related IOP change compared to controls. This change is bigger when assuming the Trendelenburg position.
Emil von Behring, the first Nobel prize laureate in medicine or physiology, and his ophthalmic interests
Authors: GRZYBOWSKI A , WILHELM H
Published: December 2011

Purpose Emil von Behring (1854‐1917) received the Nobel Prize in 1901 for his work on serum therapy, especially its application against diphtheria. There are many publications about the life and work. It is thus surprising, that his interests and relationship to ophthalmology were only rarely mentioned, usually presented incorrectly and never analyzed thoroughly. The aim of this work is to fill this gap.

Methods The study was based on the detailed analysis of materials from National Archives in Berlin and in Poznan, cities where Behring lived and and Behring's works, including his doctoral dissertation.

Results Behring was trained and worked as an ophthalmologist. He also wrote his doctoral dissertation on “Neurotomia opticociliaris” (optociliary neurotomy) whilst in Berlin under Carl Schweigger (1830‐1905). He later worked as an assistant and co‐worker with the prominent Polish ophthalmologist Boleslaw Wicherkiewicz (1874‐1915), in Poznan where he described an interesting ophthalmic case in a scientific journal.

Conclusion Behrings’ biography and achievements in serotherapy are well‐known, however his interest in ophthalmology was not previously analyzed in detail. Both his doctoral dissertation and later his work as an assistant to Wicherkiewicz’ ophthalmic hospitals in Poznan reveal his deep concern in ophthalmology in the early period of his medical career.
Detection of retinal nerve fibre layer defects in Alzheimers dementia using SD‐OCT
Authors: BEUTELSPACHER SC , SERBECIC N , HAUSNER L , KROHMER R , ABOUL‐ENEIN F , FROEHLICH L , JONAS JB
Published: December 2011

Purpose To examine the clinical value of spectral‐domain optical coherence tomography (Spectralis OCT) to detect retinal nerve fiber layer defects in patients with clinically defined Alzheimer´s dementia (AD).

Methods Design: Cross‐sectional study A heterogenous cohort of AD patients (n = 25; 50 eyes) underwent a series of high‐resolution OCT examinations of the peripapillary retinal nerve fiber layer (RNFL) thickness using the Spectralis 3.5‐mm circle scan protocol with ART‐Modus and eye tracking. The obtained results were compared to age‐ and sex‐matched healthy control subjects (n = 25, 50 eyes) and RNFL thickness correlated with vision testing scores (ETDRS chart), Humphrey visual field testing, visual evoked potential testing (VEP).

Results In the AD group, independently of disease duration, no significant difference in RNFL thickness compared to controls (mm vs mm) as well as normal VEP values were observed. In contrast, determination of RNFL thickness in eyes of severe AD patients showed minimally reduced RNFLT values (without statistical significance). The detected RNFL thinning in patients of severe AD correlated moderately with visual acuity and VEP.

Conclusion As examined by spectral domain OCT, patients with AD did not show marked changes in the retinal nerve fiber layer.
Dyschromatopsy and visual allesthesia in a glioblastoma multiforme patient
Authors: ALMALIOTIS D , REPTSIS A , DEMIRTZOGLOU I , NIKOLAKOPOULOS A , KARAMPATAKIS V
Published: December 2011

Purpose To report a case of glioblastoma multiforme with dyschromatopsy and visual allesthesia.

Methods A 46 – year old male presented in emergency ophthalmologic department with recent color perception disturbance complaints noticed during his occupation (PC technician). The patient underwent a thorough ophthalmological examination and then he was referred to the neurological department for further management.

Results Patient presented an atypical pattern of color perception disturbance revealed by color blindness Ishihara test and Fransworth‐Munsell D‐15 test. Patient’s best corrected visual acuity decreased progressively during his hospitalization and he also experienced paroxysmally illusory left homonymous transpositions of subjects viewed in the right homonymous visual field. The transposition occurred from normal to the defective visual field. This condition is called visual allesthesia. The visual field evaluation revealed homonymous left hemianopsia and magnetic resonance imaging revealed glioblastoma multiforme localized in the right occipital lobe with compressive effects on the occipital horn of the right lateral ventricle. The diagnosis was confirmed by biopsy.

Conclusion A thorough ophthalmologic and neuro‐imaging control in patients with sudden color perception disturbance is suggested. Visual allesthesia is a rare condition experienced by patients with temporal or occipital cortex damage. Glioblastoma multiforme localized in the right occipital lobe was the underlined causative lesion.
The pupil in pupillometry ‐ to dilate or not to dilate ..
Authors: NISSEN C , SANDER B , LUND‐ANDERSEN H
Published: December 2011

Purpose To evaluate the influence of the size of the light exposed pupil in one eye on the consensual reflex in the other.

Methods Using a prototype chromatic pupillometer, the left eye in each of 10 healthy subjects was exposed to 20 s of monochromatic light of luminance 300cd/m2, first red (660nm)and in a following session, blue (470 nm) light. The consensual contraction of the right pupil was measured simulataneusly before, during and after light exposure. Tropicamid or pilocarpine was subsequently instilled into the left eye and the entire sequence repeated after allowing the left pupil to dilate or contract.

Results The AUC (Area Under the Curve, i.e. the "integral" of contraction amplitude versus time) of the right pupil was determined for each individual sequence. Prior dilatation of the left pupil augmented the post light AUC to blue (p<0.0001), but not to red light. The contraction during light exposure did not change. Prior contraction of the left pupil decreased the late (10‐30s) post‐stimulus AUC to blue light (p<0.02), but not any other AUC.

Conclusion The size of the light exposed pupil influences the magnitude of the response to blue, but not not to red light of the contralateral pupil. Thus prior dilatation may prove useful, when the response to blue light (as a marker of melanopsin containing retinal ganglion cell function) is of interest, especially when this response is weak. Prior dilatation may also be useful in exchanging long duration of stimulus with short duration, thus making the examination faster, less prone to artefacts and not least, less tiresom to the patient.
Toxic optic neuropathy secondary to disulfiram: a case series
Authors: LUCAS RS , LEROY BP
Published: December 2011

Purpose To describe the presentation, ophthalmic features and electrophysiological findings in 4 patients with disulfiram (Antabuse) related optic neuropathy.

Methods Observational case series involving 4 patients. All patients underwent an extensive ophthalmological work‐up, including psychophysical and electrophysiological testing.

Results All patients took disulfiram (Antabuse) tablets in varying doses and length of time before developing profound, bilateral visual loss. Three patients were smokers and one patient suffered from schizophrenia. Ophthalmic examination in combination with automated and manual perimetry showed reduction of visual acuity, disturbed colour vision and visual field defects consistent with bilateral optic neuropathy. Electrophysiological testing revealed delayed and reduced amplitudes on pattern VEP. After cessation of disulfiram, visual acuity, perimetry and electrophysiological testing gradually returned to normal or near‐normal levels.

Conclusion Disulfiram is a rare cause of reversible toxic optic neuropathy. Patients who take disulfiram are more likely to abuse tobacco and possibly other drugs, or have psychiatric or psychological comorbidity. These patients may also be labelled as cases of malingering. Careful history and examination should alert the clinician to the possibility of disulfiram optic neuropathy.
Anisometropia and amblyopia in children
Authors: BOGDANICI C , BOGDANICI T
Published: December 2011

Purpose To asses the quality of life for children with anisometropic amblyopia.

Methods A retrospective study for 53 children (33 girls and 20 boys) performed in ambulatory clinic in 2010. The average age at first diagnosis is 7.1415 ± 2.9317 years old (limits between 2 and 16 years). During the study the average age of children is 9.4943 ± 3.8422 years (limits between 3 and 20 years). Tracking interval is 1 year in 33.95%, between 2 and 5 years in 60.37% and over 5 years in 5.64%. Clinical parameters observed are: sex, age, visual acuity, optical correction, the type of correction (glasses, contact lenses), strabismic deviation and genetic factor.

Results Uncorrected visual acuity average at the right eye is 0.4353 ± 0.3640 and for the left eye is 0.3934 ± 0.3158. Corrected visual acuity average at the right eye is 0.6626 ± 0.3552 and for the left eye is 0.6468 ± 0.3519. Mean objective refraction (in spherical equivalent) at the right eye is ‐5.8214 ± 4.4651 and ‐5.52 ± 5.89 for the left eye. The average cylinder value is ‐0,7783 ± 1,1671 (with a range between maximum = ‐4.75 and minimum = ‐1). For 60.37% of patients, cylinder value is less than 0,75. There is a genetic transmission in 23.21% of cases, predominantly in mother (9.43%) and sister (9.43%). In 39.62% of cases there was esotropia. For 11.32% of cases, optical correction was made with contact lenses.

Conclusion 1. As early the diagnosis of anisometropia is made, visual acuity is more easily recovered. 2. The average age of diagnosis in the our cases is 7.1415 ± 2.9317, noting that in Romania children are late diagnosed. 3. It is required a collaboration between the pediatrician, an ophthalmologist and the family for an early diagnosis of refraction errors. 4. Anisometropic amblyopia can be corrected using contact lenses.
A phase 2, randomized study evaluating the safety and efficacy of Catioprost® (unpreserved latanoprost 0.005% emulsion) compared to Travatan Z® in subjects with glaucoma and ocular surface disease
Authors: ISMAIL D , AMRANE M , GARRIGUE JS , BUGGAGE R
Published: December 2011

Purpose Ocular Surface Disease (OSD), recognized in 50% of glaucoma patients, can decrease anti‐glaucoma therapy compliance. Benzalkonium chloride (BAK) has been shown to induce OSD. Catioprost® is an unpreserved latanoprost 0.005% cationic emulsion. The design of a study comparing the efficacy and safety of Catioprost® versus a BAK‐free prostaglandin agonist, Travatan Z® (travoprost 0.004%) in patients with glaucoma and OSD is described.

Methods Patients with elevated IOP at baseline requiring treatment with ocular anti‐hypertensive therapy were enrolled in this multicenter, phase II, investigator‐masked, randomized study. Following a washout period, patients demonstrating OSD symptoms and signs (corneal fluorescein staining, CFS, score≥1 on the modified Oxford scale and a tear film break up time, TFBUT, ≤10) in at least one eye at the baseline visit were randomized to either Catioprost® or Travatan Z® QD with follow‐up study evaluations at month 1 and 3.

Results 105 patients were randomized. Change in diurnal IOP, a change in the global symptoms (ocular discomfort, burning, dryness, grittiness, stinging) and objective signs (CFS, TFBUT, conjunctival hyperemia) of OSD at month 1 and 3 will be presented. Safety outcomes will also be reported.

Conclusion Preservative free prostaglandin agonists reduce the risk of ocular toxicity associated with BAK. However, their effect on restoring ocular surface damage is unclear. In this study, the efficacy and safety of an unpreserved latanoprost 0.005% cationic emulsion relative to BAK‐free travoprost 0.004% solution on reducing IOP and improving the signs and symptoms of OSD will be revealed.

Commercial interest
Spectacle independence and subjective satisfaction of multifocal intraocular lens after cataract or presbyopia surgery
Authors: COCHENER B
Published: December 2011

Purpose Multifocal implantation represents nowadays in the world the first surgical option for presbyopic correction because of their ability to truly provide spectacle independence in more than 80% of cases, despite their goal is to only compensate the loss of accommodation and not to restore it.

Methods Actually the success of these lenses and the achieved visual performances have increased with last design refinements that have been brought on diffractive (aspheric, toric, trifocal) or refractive (bifocal aspheric, toric) multifocal IOLs in addition to the adjustment of calculation nomograms, for: better predictability of refractive correction, improved quality of vision with less pupil dependency and custom choice of the IOL model according to each patient needs. Moreover, the use of photoablation or LRI as an enhancement procedure in case of residual refractive error represent a nice option that has allowed to obtain glasses removal in more that 95% of operated patients.

Results However selection of patient appears to be the key factor and should be carefully considered in order to guarantee the good surgical outcome: beside anatomical contraindication such macular, retinal problem, severe amblyopia …, preoperative refraction, patient expectations and needs are very important to evaluate. No doubt at that time that hyperopia and age of more than 55 years determine the best candidate. However, indications can be widely enlarged, when informations about limits especially in qualitative vision, postoperative evolutive profile are well explained and accepted before the surgery.

Conclusion We will describe the interest of last generations of multifocal IOLs, and report some comparative results between the different concepts.
Would you recommend PresbyLASIK to your best friend ?
Authors: PISELLA PJ
Published: December 2011

Abstract not provided