bluuebunny/crossref_metadata_2025 huggingface dataset:
Straylight and corneal edema
Authors: PENTARI IG , GINIS HS , PENNOS A , PALLIKARIS IG
Published: November 2010

Purpose It is known that corneal edema is associated to increased light scatter. It was the purpose of this study to calculate the intensity and angular distribution of scattered light in a series of corneal samples at different hydration, using a sensitive optical technique.

Methods Sixteen fresh porcine eyes were obtained from a local abattoir. To isolate the role of corneal stroma the the epithelium was carefully removed with a mechanical brush. The central 8 mm of each cornea was harvested using a Barron's PKP trephine. To establish corneal hydration, corneal buttons were immersed in Dextran (300kDa) solutions, with concentrations ranging from 5 to 20% w/w, for at least 3 hours. The intensity and angular distribution of scattered light was measured for all corneas by means of a purposely‐developed camera lens that incorporated excised corneas between its glass elements. This lens was used with a CCD camera to record images projected on a computer screen. Before scatter measurements the thichness of each corneal sample was measured by means of a mechanical pachymeter (Mitutoyo IDC 112T, Japan).

Results The mean scatter coefficients for the corneas at normal hydration levels was 0.22 (SD=0.059). This value was effectively double (0.46 ; SD= 0.048) at a moderate increase of stromal thickness by 17% and reached a value of 0.56 (SD=0.079) at a relative increase of corneal thickness of 62%. The angular distribution did not significantly deppend on hydration.

Conclusion Scattered light intensity increases with corneal edema. Even small changes in corneal hydration affect significantly the narrow angle light scattering properties of corneal stroma.
Refractive and topographic outcome after intracorneal ring segment for the management of keratoconus
Authors: GAVRILOV JC , GAUJOUX T , TOUZEAU O , LAROCHE L , BORDERIE VM
Published: November 2010

Purpose To assess the refractive and topographic outcome after Intracorneal ring segment (ICRS) implantation in the management of keratoconus.

Methods Prospective case series of 10 keratoconic eyes (10 patients) with ICRS implantation (KERARING Mediphacos Inc., Belo Horizonte, Brazil). All patients were contact‐lens intolerant. The main outcome measure were uncorrected visual acuity (UCVA), best spectacle‐corrected visual acuity (BSCVA), refraction, keratometry, SAI and SRI. Patients were examined before ICRS implantation and 3 months afterward.

Results Mean preoperative keratometry was 50.94 ± 5.56 Diopters (D) (range 45.81 – 59.32). KERARING implantation decreased the spherical equivalent by 1.60 ± 3.31 D and the average keratometric values by 2.05 ± 1.49 D. UCVA significantly increased from 0.16 ± 0.16 to 0.26 ± 0.25 (P< 0.05). UCVA improved in 6 eyes (5 eyes experienced 2‐ to 4‐line gain, 1 eye experienced 1‐line gain), was unchanged in 2 eyes and worsened in 2 eyes (1 eye lost 5 lines, and 1 eye lost 1 line). BSCVA increased from 0.30 ± 0.21 to 0.39 ± 0.15 (P< 0.05), BSCVA improved in 5 eyes (5 eyes experienced 3‐ to 7‐line gain), was unchanged in 1 eye and worsened in 4 eyes (3 eyes lost 1 line and 1 eye lost 2 lines). Slight correlation was found between gain in UCVA and preoperative average keratometric values (R² = 0,61) (i.e, lower was preoperative keratometric value, higher was the improvement of UCVA). SAI decreased from 3.19 ± 0.83 to 2.94 ± 0.95 (P>0.05) and SRI increased from 1.30 ± 0.38 to 1.56 ±0.52 (P>0.05).

Conclusion ICRS implantation improved UCVA and BCVA in the majority of the keratoconus patients. The treatment was more efficient for patient with low preoperative keratometry values.
In vivo confocal microscopy of the ocular surface
Authors: LABBE A
Published: November 2010

Abstract not provided
Why is anterior segment optical coherence tomography useful in therapeutic decision making for corneal diseases?
Authors: RAMA P
Published: November 2010

Optical coherence tomography (OCT) system allows to image both posterior and anterior segment of the eye. Clinical cases of corneal diseases are presented to show the use of OCT for diagnosis and surgical planning in corneal diseases
Anterior segment OCT assisting new techniques in the field of corneal grafting
Authors: NUBILE M
Published: November 2010

Purpose Optical coherence tomography (OCT) after extended use in diagnosis of retinal diseases has now become a new cross‐sectional imaging approach useful for anterior segment (AS) imaging. The potential advantages and limits using AS‐OCT in the field of corneal grafting are presented.

Methods Systematic literature review search and clinical examples focused in the fields of corneal grafting procedures by using two different OCT systems (time domain and spectral domain).

Results AS‐OCT technology, using 1310 nm wavelength, offers some advantages as compared to high frequency ultrasound system, the main being the absence of contact with the eye. It provides relatively accurate morphology and measurements of different structures of the AS and of the cornea. Morphometry of corneal structures is particularly useful in the preoperative evaluation lamellar keratoplasty procedures, including anterior lamellar keratoplasty, deep anterior lamellar keratoplasty and endothelial keratoplasty. Morphology of the transplant, accurate measurements of lamellar graft, interface profile evaluation and complication assessment, including posterior lamellar disc detachment are feasible.

Conclusion AS‐OCT presents advantages in the clinical practice in the field of corneal disease and surgery. This technology alone should not substitute a comprehensive clinical examination but may offer valuable insights in the quantification and observation of fine details which can be obscured or not detectable during conventional slit‐lamp examination.
Wavefront aberration versus corneal topography
Authors: GICQUEL JJ
Published: November 2010

Abstract not provided
Keratoconus in refractive surgery candidates
Authors: PENA RUIZ D , CORTES MORA N , GALARRETA MIRA D , MARTIN R , CARRASCO HERRERO B , MERAYO‐LLOVES J
Published: November 2010

Purpose To report keratoconus incidence in refractive surgery candidates and to compare their characteristics in scanning‐slit topography variables versus candidates with prolate corneas and a group with previous diagnosis of keratoconus.

Methods All consecutive patients who underwent preoperative evaluation for refractive surgery in the last thirty‐six months were selected. Corneal scanning‐slit topography was performed in all the patients in the preoperative examination to detect patients affected by keratoconus and subjects with prolate corneas (K reading >47,2D). An additional group of keratoconic eyes was included. Age, gender, central corneal thickness (CCT), anterior best fit sphere (aBFS), posterior best fit sphere (pBFS), steepest simulated K (SSK), flattest simulated K (FSK), and irregularity index at 3 and 5mm (II3, II5) were studied.

Results A total of 1662 patients (3324 eyes) were included . Ninety‐six patients (190 eyes) had a steepest K reading higher than 47,2D and among them, 10 patients (20 eyes) were identified as keratoconus (0,6%). Keratoconus group included 182 eyes. Patients with prolate corneas (PC) were older (42,95 y± 9,6) than keratoconic candidates (KC) (38,22 y±11,39)(p<0,01) and keratoconus group (KG) (35,47y±11,5)(p<0,03). aBFS was higher in PC (44,94±1,38D) than KC (43,89±1,61D)(p<0,001) and than KG (44,31±1,97D)(p<0,03). II3 and II5 was lower in PC (1,54±1,38 and 2,85±7,2) than KC (4,48±2,94 and 10,43±2,1)(p<0,001) and than KG (5,18±2,69 and 6,1±4,17)(p<0,001). CCT was higher in PC (556,04±45,07 microns) than in KC (476,95±65,45 microns)(p<0,02) and than in KG (441,63±65,04 microns)(p<0,001)

Conclusion Keratoconus prevalence in refractive surgery candidates is high and has a similar profile to KG.
Definition and classification of MGD
Authors: SULLIVAN DA
Published: November 2010

Abstract not provided
Meibomian gland anatomy, physiology and pathophysiology
Authors: KNOP E
Published: November 2010

Abstract not provided
Tear film lipids, and lipid‐protein interactions, in health and disease
Authors: BORCHMAN D
Published: November 2010

Abstract not provided
Evaluation, diagnosis and grading of severity of MGD
Authors: BRON AJ
Published: November 2010

Purpose To evaluate current diagnostic tests and make future recommendations.

Methods An evidence‐based review of procedures.

Results MGD is a common symptomatic disorder leading to associated ocular surface disease including evaporative dry eye. A two stage diagnostic approach is recommended including an assessment of meibomian function based on lid morphology, gland mass, expressibility, lipid layer appearance and tear evaporation. A diagnosis of dry eye is based on measures of tear production and clearance, tear osmolarity, tear film stability and the presence of ocular surface changes revealed by tissue staining and inflammatory biomarkers. Quantification of MGD depends on grading meibum quality and expressibility. Newer, quantitative methods will make grading more accurate in the future and include quantitative meibomian expression, non‐invasive meibography, confocal microscopy, video‐interferometry and the use of inflammatory biomarkers. Meibomian gland dropout can be to monitor and stratify MGD in clinical trials.

Conclusion A provisional severity rating of MGD and MGD‐related disease has been proposed as a guide to the selection of treatment and the monitoring of disease progression.
Management and therapy of MGD
Authors: BENITEZ‐DEL‐CASTILLO JM
Published: November 2010

Purpose Treatment of Meibomian gland dysfunction varies greatly among eye care providers.Practitioners have noted widespread deficiencies in the patient education. As a result, suboptimal and ineffective therapy is commonly practiced and abandoned prematurely as ineffective.The aim of the subcommittee was to review the current practice and published evidence of medical and surgical treatment options for Meibomian gland dysfunction and to identify areas with conflicting or lack of evidence, observations, concepts or even mechanisms were further research is required.

Methods To achieve this a comprehensive review of clinical textbooks and scientific literature was performed and the quality of published evidence graded according to an agreed standard, using objective criteria for clinical and basic research studies.

Results Lid warming and cleansing, artificial lubricants, systemic tetracyclines, topical antibiotic and or antibiotic‐steroid combinations are commonly prescibed. Future developments are described.

Conclusion The subcommittee have prsented current and future treatment options for Meibomian gland dysfunction.
Design and conduct of clinical trials
Authors: AKPEK E
Published: November 2010

Abstract not provided
The presence of cells with stem cell markers and characteristics in the central cornea of the mouse
Authors: HOLAN V , POKORNA K , KRULOVA M , LENCOVA A , ZAJICOVA A , JIRSOVA K , FILIPEC M , FORRESTER JV
Published: November 2010

Purpose Purpose. To assess the distribution of cells with stem cell (SC) markers and characteristics in the limbus and central cornea of the mouse.

Methods Methods. The limbal tissue and the central part of corneas were separately dissected from the eyes of BALB/c mice. The expression of genes for SC markers ABCG2, p63 and Lgr5, limbal cell markers K19 and integrin alfa9, and cornea‐associated differentiation markers K12 and connexin 43 was determined by PCR and immunohistochemistry. Flow cytometry was used for cell sorting and characterization of the side population (SP) phenotype.

Results Results. A strong expression of genes for the SC markers ABCG2 and p63 was detected in the central cornea of the mouse. The markers specific for limbal tissue, K19 and integrin alfa9, were expressed predominantly in the limbus, while the cytokeratin K12 and connexin 43 were detected in the central cornea. A significant number of cells exhibiting the SP phenotype was detected in both limbus and central cornea, but the SP phenotype did not correlate with the expression of ABCG2 or p63. ABCG2+ cells were detected in both SP and non‐SP cells. Immunohistochemistry and PCR analysis revealed the presence of ABCG2+ and p63+ cells in all corneal layers with the strongest expression of SC markers in the epithelium.

Conclusion Conclusion. A high frequency of cells expressing SC markers and characteristics can be detected in the central cornea of the mouse. The mouse cornea thus exhibits an SC distribution distinct from the human or rabbit cornea.
Fluorodeoxyglucose Positron Emission Tomography (PET) scan input for the diagnosis of sarcoidosis in patients with unexplained chronic uveitis
Authors: RAHMI A , SEVE P , DESHAYES E , MAUCORT‐BOULCH D , BILLOTEY C , GRANGE JD , KODJIKIAN L
Published: November 2010

Purpose to assess the input of Fluorine‐18 Fluorodesoxyglucose Positron Emission Tomography (18F‐FDG PET scan) for diagnosis of sarcoidosis associated with unexplained chronic uveitis

Methods Retrospective study of 54 patients with unexplained chronic uveitis for whom a PET scan was done because of suspected sarcoidosis, between July 2004 and December 2009. All patients underwent a clinical examination, biological tests and high‐resolution computed tomography (HRCT) of the chest

Results 17 of 54 patients (31.5%) presented hypermetabolic foci on 18F‐FDG PET scan consistent with sarcoidosis, among them 8 patients (14.8%) underwent biopsy showing noncaseating granuloma. At the end of study, 10 patients (18.5%) were considered as having a presumed sarcoidosis, 7 patients (12.9%) as having indeterminate sarcoidosis, according to the criteria of Abad et al. (Abad S et al. Arthritis Rheum. 2004;51;974‐982) used for the diagnosis of sarcoidosis‐associated with uveitis. Furthermore, PET scan allowed the diagnosis of follicular lymphoma in 2 patients and metastatic solid cancer in 3 patients. Multivariate analysis of results demonstrated that patients with unexplained chronic uveitis with a positive PET scan were almost 37 times more likely to present with sarcoidosis (p<10‐3). Increasing age at diagnosis of chronic uveitis (p=0.01), presence of posterior synechiae (p=0.01) and positive chest HRCT (p=0.01) were factors associated with probability to have a PET scan with signs for sarcoidosis

Conclusion increasing age at the diagnosis of uveitis, presence of posterior synechiae and positivity of chest HRCT are associated with a positive PET scan for sarcoidosis
Low‐dose‐corticosteroids as long‐term monotherapy ‐ sufficient immunosupression in patients with chronic uveitis
Authors: DOBNER B , MACKENSEN F , BECKER M , MAX R
Published: November 2010

Purpose The aim of this study has been to identify a subgroup of patients with chronic uveitis that could be treated with low dose systemic corticosteroids alone in regard to prevent relapse of inflammation and associated complications of uveitis (including loss of vision) without important side effects.

Methods In a retrospective study we included consecutive patients > 18 years of age attending the Interdisciplinary Uveitis Center Heidelberg that met the following criteria: non‐infectious uveitis without regard to anatomical presentation, previous successful treatment with tapered prednisone dose and relapse after complete cessation. The systemic prednisone dose was tapered until dosage was below or equal 7,5 mg prednisone per day without relapse of disease for at least 60 days. The criteria that the efficacy of low dose prednisone treatment had been judged on were visual acuity and anterior chamber cells.

Results So far 20 patients (14 female and 6‐male) were included. Systemic diseases were found in 12 patients: 6 patients were diagnosed with sarcoidosis (2 histologically confirmed), 2 patients with psoriasis, one with colitis ulcerosa, one had autoimmune hepatitis, one with Lyme disease and one with multiple sclerosis. After a median observation period of 210 days (range 88‐810 days), 14 patients remained stable in regard to visual acuity and inflammation cells on a median final prednisone dose of 3,5 mg (range 1‐7,5 mg).

Conclusion In this retrospective study we could show that a low dose systemic prednisone treatment is effective in patients with chronic uveitis.
Surgical treatment of lacrimal gland tumours
Authors: BRISCOE D
Published: November 2010

Purpose The surgical treatment of Lacrimal gland tumors is often controversial and not so clear cut. Imaging and a full systemic evaluation lead to the decision as to which surgical approach best serves our purposes. The surgical management of Lacrimal gland tumors is discussed and the results of 31 cases in my experience are presented.

Methods The surgical approach used is carefully chosen according to the type of disease presentation. All 31 patients in this series had neuroimaging and full work up and 30 underwent incision or excision biopsy. Selected cases are discussed.

Results : Surgical Approaches chosen for the Lacrimal gland in this case series included Trans‐Septal Orbitotomy, and Lateral Orbitotomy. Disease spectrum included Idiopathic orbital inflammatory disease (8), Orbital Sarcoid (7), Lymphoma (3), Sjrogens disease (3), Benign Mixed Tumour (2), Infectious mononucleosis (2) Angiolymphoid Hyperplasia (2), Sebaceous Cell Carcinoma (1), Churge Strause syndrome (1), Dermoid Cyst (1), Epithelial Inclusion Cyst(1).

Conclusion Biopsy of a Lacrimal gland mass is relatively simple and is recommended. The approach should be considered carefully and an excision biopsy should be performed where possible. Surgical management and surprising pathology results can have significant implications for the patient.
Medical cancer therapy of lacrimal gland tumours
Authors: LE TOURNEAU C
Published: November 2010

Purpose The most common malignant epithelial cancer of the lacrimal gland is the adenoid cystic carcinoma (ACC). Despite a slow growth, ACCs are ultimately associated with a poor outcome.

Methods Given the rarity of this disease, there are actually no conclusive recommendations for optimal therapy of this tumor.

Results Surgery and postoperative radiation therapy is commonly used in the initial local treatment of ACC of the lacrimal gland. In high‐risk recurrence patients, concomitant platinum‐based chemoradiation should be discussed in an attempt to enhance radiosensitivity. While encouraging responses were reported with intraarterial neoadjuvant chemotherapy, this strategy was associated with substantial toxicity and should not be recommended outside of clinical trials. In the metastatic setting, systemic therapy is the only available option if no surgery and/or radiation is feasible. Although some tumour shrinkage has been reported with intravenous chemotherapy, only dismal objective response rates were achieved. Most active drugs remain anthracyclines and platinum compounds. Drug combinations do not seem to add much efficacy. More recently, non‐cytotoxic molecularly targeted agents have emerged and demonstrated significant efficacy in several tumour types. These agents modulate specific targets thought to be essential for tumour proliferation and/or angiogenesis. c‐KIT, PDGFRα, EGFR, and VEGFR are transmembrane receptors with oncogenic tyrosine kinase activity that are commonly overexpressed in ACC. The use of drugs triggering these targets has been disappointing so far.

Conclusion The recent identification of a hallmark gene fusion transcript thought to activate critical targets involved in apoptosis, cell cycle control, cell growth and angiogenesis, heralds new treatment promise.
Posture related IOP change in patients with primary open angle and pseudoexfoliation glaucoma
Authors: DASTIRIDOU A , KATSANOS A , DIMASI B , MAKRIS P , CHOLEVAS P , TSIRONI E
Published: November 2010

Purpose To compare IOP in the sitting, supine and Trendelenburg position in controls, primary open angle glaucoma (POAG) and pseudoexfoliation glaucoma (PXG) patients.

Methods 20 POAG, 18 PXG patients and 21 controls were included. Exclusion criteria were: diabetes, severe cardiovascular disease and previous ocular pathology or surgery. IOP was measured with a Perkins tonometer and arterial pressure (AP) with a sphygmomanometer consecutively in the sitting, supine and Trendelenburg positions, allowing for a period of 5 minutes between positions. The IOP and AP differences between the baseline sitting position and the supine and Trendelenburg positions were calculated.

Results There was no age difference between the groups (p=0.3). Mean sitting IOP for the control, XFG and POAG groups were: 13.6±1.9mmHg, 12.9±2.1mmHg and 13.9±2.9mmHg, respectively (one way ANOVA, p=0.4). There was a bigger IOP increase from the sitting to the Trendelenburg position, compared to the supine position in all groups (1.7±1.6 versus 0.9±1.3mmHg in the control group, 4.6±2.4 versus 2.7±1.5mmHg in the PXG and 4.4±2.2 versus 2.2±1.7mmHg in the POAG group, repeated measures ANOVA, p<0.05). Post‐hoc pairwise comparisons revealed significant differences between each glaucoma group and the control group (p<0.01), whereas no difference was observed in IOP change between POAG and PXG patients (p=0.5). There was no difference in mean AP in different body positions for any group (repeated measures ANOVA, p>0.1)

Conclusion POAG and PXG patients exhibit an exaggerated posture‐related IOP change compared to controls, especially when assuming the Trendelenburg position.
Ocular response analyzerTM (ORA) in ocular hypertension (OHT), open angle glaucoma (OAG) and pre‐perimetric glaucoma (PPG).
Authors: MAY F , HAMAM O , GIRAUD JM , FENOLLAND JR , MOUINGA ABAYI A , RENARD JP
Published: November 2010

Purpose To evaluate the corneal biomechanical parameters measured by ORA in OHT, OAG, PPG and normal subjects (NS): age influence, mean values comparisons, correlation and reliability.

Methods Prospective study, 317 eyes: 64 OHT, 46 OAG, 42 PPG and 165 NS. Were performed: Goldmann applanation tonometry (GAT), central corneal thickness (CCT), corneal hysteresis (CH), corneal resistance dactor (CRF), Goldmann correlated intra‐ocular pressure (IOPg), corneal compensated intra‐ocular pressure (IOPcc).

Results Age induces no significant influence on CH; CRF does not vary with age in OHT, OAG, and normal eyes. Whatever the group, CH, CRF and CCT present no significant difference whatever the age class. CH mean value in NS group is significantly different compared with OHT, OAG and PPG. CRF mean value in OHT is significantly different compared with NS and OAG. CH, CRF and CCT are well correlated. CH is correlated with IOPcc and not with IOPg and GAT; inversely for CRF. In all groups, there is a good reliability between CH and CRF (r = 0,49 to 0,77) and a strong reliability between IOPcc, IOPg and GAT (r= 0,5 to 0,8). IOPcc is independant from CCT, strongly correlated with CH, and statistically different between NS, OHT and OAG groups. CH mean value is lower in OAG eyes, and statistically different compared with OHT, OAG, PPG and NS, but there is an overlap of values between groups. Whatever ORA derived data, PPG is different from OAG; PPG eyes differ from OHT for CCT, and from NS for CH.

Conclusion ORA derived corneal biomechanical parameters are not influenced by age. IOPcc seems to be a good estimation of IOP. CH and CRF significantly differ between OAG and normal eyes.
Effect of acute increases of intraocular pressure on the intrastromal corneal pressure: an animal study
Authors: BOLIVAR G , CASTEJON M , GUTIERREZ‐ORTIZ C , TEUS MA
Published: November 2010

Purpose To evaluate the effect of acute intraocular pressure (IOP) increases on the intrastromal corneal pressure (ICP).

Methods The ICP and the central corneal thickness (CCT) were measured, “in vivo”, in 9 rabbit eyes with stable IOP, and in 9 rabbit eyes at baseline, and then after the IOP was set at 15mmHg and at 30mmHg.

Results The ICP reached similar levels in both groups at all time points (p=0.5, p=0.9 and p=0.6, respectively) although the CCT was significantly thinner (p=0.02) with higher IOP levels.

Conclusion The ICP, measured by intraestromal cannulation, tends to become more negative with time, and this behaviour does not change with the increase of IOP, in the range analyzed, even though the cornea shows the expected IOP‐induced compression.
Vasoregulatory and neuroprotective effects of oral antioxidants against glaucomateus damage
Authors: ENGIN KN , YEMISCI B , YIGIT U , OZTURK R
Published: November 2010

Purpose Glaucomateus damage proceeds from retinal ganglion cells to brain. Aside from their antioxidant effects, a‐tocopherol and Gingko Biloba known to be neuromediators with vasoregulatory effects on retina. In this clinical study, we aimed to evaluate vasoregulatory and neuroprotective effects of oral a‐tocopherol and Gingko Biloba beyond their antioxidant properties.

Methods Equally divided 4 groups were consisted of 120 eyes of 60 patients with glaucoma. Group A recieved no antioxidant. For 3 months, groups B,C,D patients have recieved a‐tocopherol, Gingko Biloba and a strong antioxidant formula, respectively. At the begining and end of the study, all the patients were exemined with Doppler USG, Central Visual Fields, OCT and serum oxidation parameters were studied. Parametrical statystical analysis were made.

Results Antioxidant intake have been confirmed with blood tests. Significant decreases in ganglion cell loss and pulsatility indexes of ophthalmic and cantral retinal arteries have been found in group C. In groups B and D, MD values and ophthalmic artery end diastolic volume were significantly higher.

Conclusion Neuroprotective efect in glaucoma can be obtained with oral antioxidant intake, in short term. Gingko Biloba and a‐tocopherol merit a concern beyond other antioxidants.
Correlation between basal IOP and functional damage in three different types of open angle glaucoma (OAG)
Authors: CASTEJON M , BOLIVAR G , AREVALO‐SERRANO J , ARRANZ‐MARQUEZ E , TEUS MA
Published: November 2010

Purpose To analyze the correlation between basal, untreated IOP and visual field damage in newly diagnosed Hyperbaric glaucoma (HB), Focal damage glaucoma (FG) and pseudoexfoliative glaucoma (PEXG).

Methods This is a prospective, cross sectional study. Basal, untreated IOP was measured in all cases. The Retinal fiber layer (RNFL) thickness was measured using the OCT stratus 3.0 and the fast RNFL thickness strategy. Visual field was evaluated using the Humphrey field analyzer, achromatic perimetry, SITA standard 24‐2 strategy. Corneal pachimetry was measured in all eyes. Only one eye per patient was included. Linear regression analyses and Pearson’s correlation coefficients between the basal IOP and the global Visual Field (VF) indices were performed. The ANOVA test was used for comparison of the means of quantitative parameters.

Results 36 HB, 43 GF and 28 PEXG eyes were included in the study. Untreated IOP was 30.9 mmHg in HB, 19.1 mmHg in FG, and 24.5 mmHg in PEXG eyes. (p=0.0001 for all comparisons). Central corneal thickness was also different in each group. PEXG eyes had the thicker corneas (568.56 microns) and FG had the thinnest corneas (527.43 microns). No significant difference was found in the RNFL thickness or in the Mean Defect of the visual field between groups. Basal IOP was significantly correlated with the VF Mean Defect in HG (p=0.006, r=0.44) and in PEXG (p=0.002, r=0.55). No statistically significant correlation was found between both parameters in FG eyes.

Conclusion Different types of Open Angle Glaucomas with a similar degree of glaucomatous damage, show a different correlation between untreated IOP and visual field damage.
A comparison of perimetric results with standard automated perimetry and HEP perimetry in a group of glaucomatous patients
Authors: GIL ARRIBAS L , CALVO P , FERRERAS A , OTIN S , ALTEMIR I , FERNANDEZ S , GUERRI MONCLUS N , PRIETO E , EGEA ESTOPINAN MC , GARCIA‐MARTIN E , IDOIPE M
Published: November 2010

Purpose To compare the results obtained between Humphrey Perimeter (Carl Zeiss Meditec, EEUU) and Heidelberg Edge Perimeter (HEP, Heidelberg Engineering, Alemania) tested in a group of glaucomatous patients.

Methods A total of 23 eyes of 23 glaucomatous patients were prospectively and consecutively selected. All of them had basal IOP values higher than 20 mmHg and glaucomatous optic nerve head. They were examined with Standard Automated Perimetry (SAP) using 24‐2 SITA standard and HEP perimetry using 24‐2 ASTA standard algorithm. They performed at least one reliable perimetry with each device. Spearman‘s correlation coefficients were calculated between global indices of both devices: mean deviation (MD), pattern standard deviation (PSD) and visual field index (VFI).

Results Mean age was of 65.07±8.67 years. Subjects had mean IOP values of 24.43±1.90 mmHg. The mean MD values were ‐6.73±6.23 and ‐2.89±3.26 measured with Humphrey and HEP perimeters respectively. And the mean PSD values were 6.07±3.62 and 3.80±2.45 measured with Humphrey and HEP perimeters respectively. The strongest correlations were observed between MDs (0.683; p=0.001) and between PSDs (0.619; p=0.003).

Conclusion Humphrey and HEP perimeter correlated well in some global values. Further studies are required to evaluate the clinical usefulness of HEP perimeter in glaucoma patients.
Analysis of progression with PeriDataTM and guided progression analysis (GPA) in glaucoma patients: interim analysis
Authors: FORTUNATI M , POURJAVAN S
Published: November 2010

Purpose To compare the rate of progression of GPA with the progression analysis calculated by PeriData in a mixed glaucoma group.

Methods Retrospective, observational study including 32 eyes (number needed: 76 eyes) of 17 known glaucoma patients with at least 5 reliable visual field examinations in minimum 2 years. Patients who underwent filtering surgery or laser trabeculoplasty during the follow‐up period were excluded.

Results Mean age was 70 ±18 yrs. Each patient performed a mean number of 13 ±4.6 (range: 9 to 28) standard automated perimetry visual test (Sita Standard 24‐2) per eye and with a mean follow‐up of 7.5 ± 1.3 yrs. The mean of progression by PeriData (dB/year) and GPA (%/year) were: ‐0.2 ± 0.38 and ‐0.55 ± 0.71 respectively. This difference in progression was not significantly different (p value= 0.06) There was an excellent correlation between Peridata progression analysis and GPA (<0.001).

Conclusion Rate of progression with GPA and progression analysis of PeriData are two trend analysis. This could explain the excellent correlation. They represent complementary information and methods for progression of VF. To date, our results didn’t show significant difference between GPA and PeriData.
Relationship between flicker FDF perimetry and standard automated perimetry in glaucoma patients
Authors: CALVO PEREZ P , GIL‐ARRIBAS L , FERRERAS A , ALTEMIR I , OTIN S , FERNANDEZ S , GARCIA E , GUERRI MONCLUS N
Published: November 2010

Purpose To compare the main indices of flicker FDF perimetry (FDF, Heidelberg Engineering, Germany) with standard automated perimetry (SAP) in glaucoma patients.

Methods Twenty‐three open‐angle glaucoma patients were prospectively and consecutively selected. Glaucomatous patients had an intraocular pressure higher than 21 mmHg and glaucomatous optic disc appearance. All of them underwent at least one reliable perimetry with each device. SAPs were performed with a FDF perimeter (24‐2 ASTA‐Standard test) and Humphrey perimeter (Carl Zeiss (24‐2 SITA standard algorithm). The Kolmogorov Smirnov test was applied to check that the data were normally distributed. Only one eye per subject was included in the study. Spearman correlations were calculated between both devices : mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI).

Results : Mean age was 65.07±8.67 years. MD of SAP was ‐6.73 ± 6.23 dB, and MD of FDF was ‐7.70 ± 5.84 dB (p=0,123); PSD of SAP was 6.07 ± 3.62, and PSD of FDF was 3.91 ± 1.89 (p = 0.953). The correlations between MDs were 0.736 (p<0.001) and between PSDs were 0.320 (p>0.05)

Conclusion Moderate correlations were found between main visual field indices both devices. Altough no differences were found, FDF tends to present MD values lower than Humphrey.
Evaluation of the optic nerve in early glaucoma diagnosis: standard automated perimetry, short‐wavelength automated perimetry, frequency doubling technology, pattern electroretinogram and visual evoked potential in glaucoma suspects
Authors: MILANO G , BOSSOLESI L , COLOMBO M , RAIMONDI M , BORDIN M , LANTERI S , ROSSI GCM
Published: November 2010

Purpose To compare the ability of different functional tests in detecting early glaucomatous damage

Methods 68 randomly selected patients screened by the glaucoma unit of the University Eye Clinic of Pavia were considered glaucoma suspects on the basis of the IOP and the morphometric analysis of the optic nerve with GDx‐VCC and HRT‐III. They were submitted to SAP and divided into two age‐matched groups according to Glaucoma Staging System II: group A (45 subjects, mean age 62±8 y) with GSSII 0 (MD≤‐2dB, PSD<2.7dB) and group B (23 subjects , mean age 64±6 y) with GSSII ≤ 2 (MD≤‐10dB, PSD≤9dB). The two groups were then submitted to a complete evaluation of the optic nerve function based on SWAP, FDT, PERG, VEP. Number of points significantly depressed <5% and <1% in the pattern deviation plot,MD,PSD, and test duration for all perimetric tests, amplitude and latency of P50 and N95 for PERG and P100 for VEP were compared using the Wilcoxon signed rank test

Results All parameters of SAP and SWAP pointed out a good correlation to glaucomatous damage.Only PSD and the number of points <1% were correlated to GSSII in FDT. PERG and VEP outcomes were not correlated to glaucatous damage.

Conclusion SITA‐SWAP can point out glaucomatous functional damage at least as well as SAP while FDT seems to be less efficient. In perimetric testing the global index PSD seems to be effective in pointing out glaucomatous damage. PERG and VEP are less sensitive but this could be due to the criteria based on VF outcomes to divide examined subjects.
Comparison of FD‐OCT mGCC and pRNFL for the early detection of glaucoma
Authors: ROLLE T , BRIAMONTE C , CURTO D , GRIGNOLO FM
Published: November 2010

Purpose To evaluate and compare the Glaucoma detection ability of macular GCC thickness with that of peripapillary RNFL measured by FD‐OCT (RTVue 100. Optovue Inc, CA) in patients with Preperimetric Glaucoma (PPG) and Perimetric Glaucoma (PG) at early stage according to Hodapp‐Parrish‐Anderson classification.

Methods 89 patients (178 eyes: 70 PPG, 56 PG and 52 healthy) were enrolled in this cohort study. Each subject underwent complete ophthalmic examination and imaging of mGCC, pRNFL, ONH and 3D disk using RTVue 100. The means of each parameters were compared with ANOVA test. ROC curves were generated for different GCC and RNFL parameters. For both GCC and RNFL protocols the OR‐logical disjunction (Boolean Logic Operator) was calculated. Areas under the ROC curves (AUC) of each parameter were compared ( Delong test).

Results The AUCs for Average, Superior, Inferior RNFL were not significantly different (0.72, 0.71, 0.75 respectively): the largest AUC for RNFL parameters was that of RNFL OR (0.79). Average, Superior, Inferior, FLV % GCC (0.74, 0.71, 0.77, 0.76 respectively) were not significantly different from each other and from RNFL AUCs. The largest AUC was that of GLV% GCC (0.81) which is significantly higher than both RNFL and GCC parameters AUCs. Even for the GCC scan, the GCC OR AUC (0.78) was better than others parameters, exception for GLV%.

Conclusion We found that GLV% had higher diagnostic accuracy than the simple average for the diagnosis of glaucoma: this must mean that, in some cases, pattern parameters are more sensitive or more specific. The computation of Boolean OR Operator have been found to boost diagnostic accuracy. In summary, analysis of GCC loss pattern further boosted diagnostic accuracy of RNFL measurements.
Logistic regression analysis for early glaucoma diagnosis using optical coherence tomography
Authors: EGEA ESTOPINAN C , PRIETO CALVO E , GUERRI MONCLUS N , FERRERAS AMEZ A , PABLO JULVEZ L , IDOIPE CORTA M
Published: November 2010

Purpose To determine and validate the diagnostic ability of a linear discriminant function(LDF) based on the retinal nerve fiber layer thickness at each of the 12 clockhour positions obtained using optical coherence tomography for discriminating between healthy eyes and eyes with early glaucomatous visual field loss

Methods We prospectively selected 62 consecutive healthy individuals and 73 patients with open‐angle glaucoma to calculate the LDF. Another independent prospective sample of 280 healthy eyes and 302 glaucomatous eyes was used to evaluate the diagnostic accuracy of the LDF

Results The proposed function was LDF=15.584 – (12‐ o’clock segment thickness_0.032) – (7‐o’clock segment thickness_0.041) – (3‐o’clock segment thickness[nasal side]_0.121). The greatest area under the receiver operating characteristic curve was observed for our LDF in both populations: 0.962 and 0.922. Our LDF and the average thickness yielded sensitivities of 74.5% and 67.8%, respectively, at a fixed specificity of 95%

Conclusion The LDF increased the diagnostic ability of the isolated retinal nerve fiber layer thickness at the 12 clock‐hour positions. Compared with optical coherence tomography–provided parameters, our LDF had the highest sensitivities at 85% and 95% fixed specificities to discriminate between healthy and early glaucomatous eyes
Comparison of the morphological characteristics of the glaucomatous optic nerve damage in different types of open angle glaucoma
Authors: BOLIVAR G , CASTEJON M , ARRANZ‐MARQUEZ E , AREVALO‐SERRANO J , TEUS MA
Published: November 2010

Purpose To analyze the morphological characteristics of the ONH damage in Hyperbaric Glaucoma (HG), Focal damage glaucoma (FG) and in Pseudoexfoliative Glaucoma (PEXG), using Optical Coherence Tomography (OCT).

Methods This is a prospective, cross sectional study. Basal, untreated IOP was measured in all cases. ONH and RNFL were evaluated using the OCT stratus 3.0 and the fast optic disc strategy and the fast RNFL thickness, respectively. Only one eye per patient was included. The ANOVA test was used for comparison of the means of quantitative parameters.

Results 36 HB, 43 GF and 28 PEXG eyes were included in the study. Untreated IOP was 30.9 mmHg in HB, 19.1 mmHg in FG, and 24.5 mmHg in PEXG eyes. (p=0.0001 for all comparisons). No significant difference was found neither in the RNFL thickness nor in the disc area between groups. In PEXG eyes the rim area and volume were significantly greater than in the other two groups (p=0.0001). No significant difference was observed in the ONH excavation between FG and HB eyes.

Conclusion Different types of Open Angle Glaucomas, with a similar degree of RNFL thickness, and similar disc areas, show different morphological ONH damage, as evaluated by the OCT. Automated morphological evaluation of the ONH may be useful to characterize different types of open angle glaucomas.
Correlation between structural and functional damage in three different types of open angle glaucoma
Authors: CASTEJON M , BOLIVAR G , ARRANZ‐MARQUEZ E , AREVALO‐SERRANO J , TEUS MA
Published: November 2010

Purpose To analyze the correlation between Optic Nerve Head (ONH) parameters, evaluated using Optical Coherence Tomography (OCT), and visual field damage in newly diagnosed patients with Pseudo Exfoliative Glaucoma (PEXG), Focal Damage Glaucoma (FG) and Hyperbaric Glaucoma (HG).

Methods This is a prospective, cross sectional study. Basal, untreated IOP was recorded in all subjects. When both eyes of the same subject fulfilled the inclusion criteria, only one eye was randomly chosen for analysis. OCT stratus 3.0, fast optic disc strategy and Humphrey conventional achromatic perimetry (sita 24‐2) were performed. Linear regression analyses and Pearson’s correlation coefficients between several ONH parameters and the global Visual Field (VF) indices were used for the statistical analysis.

Results 36 HB, 43 FG and 28 PEXG eyes were included in the study. We found strong and statistically significant correlations between the MD and the majority of the structural parameters of the ONH in the HB and PEXG groups. No significant correlation was found between any ONH parameter and MD in the FG group. We also found statistically significant correlations between most ONH parameters and the PSD in HB PEXG and FG groups.

Conclusion The correlation between morphological visual field damage is different in different type of Open Angle Glaucomas.
Ultrasound biomicroscopic characteristics of the anterior segment in eyes with glaucoma
Authors: KONOPINSKA J , MARIAK Z
Published: November 2010

Purpose To evaluate quantitatively changes in anterior chamber depth(ACD),angle width(AW) and intraocular pressure(IOP) induced by phacoemulsification and intraocular lens(IOL)implantation in eyes with glaucoma using ultrasoundbiomicroscopy(UBM).

Methods Foreword prospective study of 84 emmetropic eyes from 84 patients divided into two groups.Group I counted 49 eyes with cataract and open‐angle glaucoma(Ia, n=36)and angle‐closure glaucoma(Ib, n=13)underwent phacoemulsification and IOL implantation, group II‐25 control eyes of 25 age‐matched patients scheduled for phacoemulsiﬁcation. 2 control examination were made: before surgery and one month after operation(1).The main diagnostic tests included measuring refraction, aplanation tonometry, pachymetry, gonioscopy, ophthalmoscopy, and anterior chamber depth and angle width using UBM(Vu‐max I, Sonomed).

Results In both groups ACD and AW increased significantly after cataract surgery compared to the measurements obtained before surgery(p<0.05),the mean IOP declined in all groups.Group Ia:ACD=2.29±0.4 mm,AW=37.27±10.55°,IOP=17.92±3.76 mmHg; after operation:ACD1=3.68±0.4,AW1=49.64±10.47°,IOP1=15.3±3.1 mmHg; Group Ib: ACD=1.68±0.25 mm,AW=24.38±10.9°,IOP=19.23±6.72mmHg;ACD1=3.65±0.4mm,AW1=45.64±16.04°,IOP1=15.16±5.41mmHg,Group II: ACD=2.97±0.72 mm,AW=38.43±9.43°,IOP=15.2±2.81 mm;ACD1=3.55±0.48 mm,AW1=51.29±8.31°;IOP1=13.2±3.mmHg,(p<0.05)

Conclusion After cataract extraction and IOL implantation the width of the angle, and the depth of the anterior chamber increases. This effect is followed by the decrease in IOP in the postoperative period by an average of 2.16 mmHg in open angle glaucoma and 5.11 mmHg in angle closure glaucoma. The project was financed by Ministry of Science and Higher Education, Poland.
Angle configuration changes after phacoemulsification measured with anterior segment optical coherence tomography (AS OCT)
Authors: BRON AM , BIDOT ML , BIDOT S , CREUZOT C
Published: November 2010

Purpose To assess the changes of the irio corneal angle configuration and anterior chamber depth with anterior segment optical coherence tomography (AS OCT) after phacoemulsification.

Methods Prospective study including consecutive patients operated on age related cataract with phacoemulsification and intraocular lens implantation. An AS OCT was performed before and one month after cataract surgery on the horizontal meridian. The primary objective was to assess the changes of AC depth, iridocorneal angle, angle opening distance at 500 and 750 µm and trabeculum iris space area at 500 and 750 µm. The secondary objective was to evaluate intra ocular pressure (IOP) changes.

Results Thirty five eyes of 35 patients were included. Mean age was 72 ± 9 years. Anterior chamber depth increased from 2.62 ± 0.39 µm to 3.66 ± 0.21 µm after cataract removal Nasal AOD 500 and 750 increased by 75 and 73%, nasal TISA 500 and 750 by 69 and 65%, and nasal angle by 52%, respectively, p<0.01. Temporal AOD 500 and 750 increased by 70 and 71%, temporal TISA 500 and 750 by 55 and 64% , and temporal angle by 42%, respectively, p<0.01. A statistically significant but weak correlation was found for AC depth change and axial length, p=0.004, r2=0.22, but not for AC depth change and age and preoperative spherical equivalent, p= 0.52 and p=0.38, respectively. The pre and post operative IOPs were 16.7 ± 3.7 mm Hg and 14.0 ± 2.7 mm, respectively, p=0.0015.

Conclusion Cataract extraction leads to important changes of anterior segment configuration evaluated with AS OCT. In our series, all measured parameters showed an opening of the IC angle with wide variation among patients.
An in vivo confocal microscopy study and high frequency ultrasound analysis of filtering bleb functionality
Authors: CARDON A , NOCHEZ Y , BELLICAUD D , PISELLA PJ
Published: November 2010

Purpose To evaluate in vivo confocal microscopy (IVCM) analysis and high frequency ultrasounds (US) assessment in the follow‐up of filtering blebs.

Methods We retrospectively evaluated 38 filtering blebs (29 patients) which underwent filtering surgery for glaucoma with a mean follow‐up time of 16.4 ± 8.4 months. Examination included IVCM and high frequency US. Filtering blebs were classified in 3 functional clinical groups according to the final intra ocular pressure (IOP): target IOP reached without medication (group 1), target IOP reached with medication (group 2) and target IOP not reached despite medication (group 3).

Results Our results showed that failed blebs (group 3) present a low density of microcysts (p=0,0035). Microcysts density was correlated negatively to final IOP (r2=0,23 with p=0,002). We also noticed that eyes with a low microcyst density had been treated with more preserved drops per day prior to the surgery (r²=0,12, p=0,04).This point out the negative influence of preservatives on the conjunctiva creating ocular surface damage and modifying its healing process after filtering surgery. Moreover, IVCM examination did not find any relevant differences between ultrasound groups. In clinically efficient blebs we established a panel of microscopic criteria which could define a higher failure risk group not detected by clinical examination or US imaging.

Conclusion IVCM enables a precise imaging of filtering blebs at a microscopic level. It brings a panel of valuable criteria for the detection of microscopic signs associated with failed and fibrosed blebs, or with higher failure risk group.
Choroidal blood flow response to isometric exercise in patients with obstructive sleep apnea syndrome.
Authors: KHAYI H , TONINI M , PEPIN JL , RENARD E , BAGUET JP , ROMANET JP , GEISER MH , CHIQUET C
Published: November 2010

Purpose Obstructive sleep apnea syndrome (OSA) has been recently reported to be associated with ischemic and glaucomatous optic neuropathy. The physiopathology of these diseases includes an abnormal regulation in the optic nerve head vasculature. The aim of our study was to characterize the choroidal vascular reactivity to acute increase in ocular perfusion pressure due to exercise in OSA patients.

Methods Fourteen newly diagnosed OSA patients were included in this prospective study. Control subjects were matched with OSA patients for body mass index (BMI), gender and age. At the screening visit, each subject underwent a general exam, cardiovascular, neurologic and ophthalmological examinations, and underwent complete overnight polysomnography. The LDF instrument used in this study to measure subfoveal choroidal blood flow (ChBF) measured the following parameters: ChBVel (kHz); volume, ChBVol (in arbitrary units, AU) and the relative flow, ChBF = ChBVel  ChBVol (in AU). Vascular choroidal reactivity was tested during squatting.

Results OSA patients exhibited a similar choroidal reactivity during increase in OPP (i.e. stability of choroidal blood flow) than controls until an increase of OPP about 145%. We found a similar vascular resistance increase in both groups during increase of OPP.

Conclusion This prospective comparative study explored for the first time the choroidal blood flow of OSA patients and showed that subfoveal ChBF reactivity to gas in OSA patients differed from that of healthy control subjects. These preliminary results suggest that choroidal vasculature of OSA patients remained vasoconstricted when OPP increased, due to a chronic sympathetic activation.