bluuebunny/crossref_metadata_2025 huggingface dataset:
Spontaneous visual improvement in the presence of posterior capsule opacification
Authors: Moshegov Con , McClellan Kathleen , Pettinger Douglas
Published: November 2007

We report a case of a patient who had reduced visual acuity due to posterior capsular opacification after extracapsular cataract extraction and posterior chamber lens implantation. Capsulotomy was not performed. Over the subsequent two years visual acuity returned spontaneously to normal.
Haemangiopericytoma of the orbit
Authors: Sullivan Timothy J , Wright John E , Wulc Allan E , Garner Alec , Moseley Ivan , Sathananthan Nik
Published: November 2007

Orbital haemangiopericytomas are ideally managed by complete surgical excision in the first instance. This is frequently not achieved, because difficulty in making the diagnosis preoperatively results in incisional biopsy and the highly vascular nature of the tumour makes complete excision difficult. A series of 12 patients with orbital haemangiopericytoma seen over a 23‐year period is presented. The following combination of clinical and radiological features is suggestive of haemangiopericytoma.

1. Painless non‐axial proptosis with downward displacement of the globe.

2. Intermittent upper lid swelling.

3. A soft, superiorly located mass with poorly defined borders, especially with a blue hue.

4. A superiorly located, rounded or elongated extraconal mass on CT, isodense with brain, with smooth, well‐defined borders and moderate to marked enhancement with the injection of intravenous contrast medium.

5. Significant blush in all three phases of carotid angiography, without prominent arteriovenous shunting.

Once haemangiopericytoma is suspected, complete surgical excision is recommended.
The development of fixing and focusing behaviour in normal human infants as observed with the Otago photoscreener
Authors: Molteno A C B , Hodgkinson I J , Hewitt C J , Sanderson G F
Published: November 2007

The Otago photoscreener is an optical instrument which gives a very sensitive indication of the accuracy with which a subject's eyes are fixing and focusing. Early experience suggested that this instrument could be used effectively to screen for the presence of amblyogenic factors in pre‐verbal infants. This communication describes the development of ocular fixation and focusing in 137 normal infants who were followed at regular intervals during the first year of life. Accurate fixation and focusing was found in 13% of three‐month‐old infants, in 68% of six‐month‐old infants and in 76% of one year olds. The levels of ‘focusing’ visual acuity obtained from the photoscreen data are considerably better than the levels of cortical acuity measured by the standard behavioural and electrophysiological methods. This suggests that human infants fix and focus accurately for a considerable period before they are able to perceive all the details obtained in their retinal images.
Corneal storage at 4° Celsius in a chondroitin sulphate and dextran containing medium
Authors: Morton Maria
Published: November 2007

Corneas were stored at 4°C in a chondroitin sulphate and dextran containing medium from one to ten days. The viability of the corneal endothelium was assessed after storage with the vital stain, trypan blue.
The results of combined cataract extraction and trabeculectomy using separate incisions
Authors: FRACO WE Gillies , MD Anne MV Brooks
Published: November 2007

A method of combined cataract extraction with posterior chamber intraocular lens and trabeculectomy using separate incisions was tested in 44 operations on 38 patients. The mean preoperative intraocular pressure (IOP) of 28.1 ± 11.7 (range 12 to 56) mmHg on maximum medication was lowered to 13.9 ± 3.4 (9 to 23) mmHg at one year, with half the eyes still requiring topical medication. The IOP was 40 mmHg or more preoperatively in eight eyes and 20 mmHg or more in only two patients at one year. There were no rises in IOP above 20 mmHg in the early postoperative period (days 1 and 2). Visual acuity was 6/9 or better in 27 and 6/12 in three eyes. There was an expulsive haemorrhage in one case, rupture of the posterior capsule in two eyes and a choroidal detachment in one eye, but no flat anterior chambers. The two‐incision method allowed placement of an intraocular lens with good postoperative pressure control.
Histopathologic, immunophenotypic and genotypic analyses in ocular adnexal lymphoproliferative disorders
Authors: Gardiner Jane A , White Valerie A , Gascoyne Randall D , Rootman Jack
Published: November 2007

This study reports on fourteen biopsies from patients presenting to our orbital and oncology service with ocular adnexal lymphoid proliferations between November 1988 to September 1991. The biopsies were studied using histologic, immunophenotypic and genotypic analyses. By histologic criteria, there were two reactive, five indeterminate and seven lymphomatous lesions. On immunophenotypic analysis, there were two monoclonal and 10 polyclonal lesions in the 12 specimens analysed. Genotypic analysis confirmed the histopathologic diagnoses for the reactive lesions by showing them to be germline. It also confirmed that both the histopathologic lymphomas and immunophenotypically monoclonal lesions were clonally rearranged. Genotypic analysis was able to separate the histologically indeterminate group into two subsets: clonally rearranged, of which there was one, and germline, of which there were four. In addition, it demonstrated that immunophenotypic polyclonality cannot always be equated with genotypic polyclonality as was the situation in four out of 10 lesions in our series. The significance of clonal arrangements in the histologically indeterminate and immunophenotypically polyclonal groups can only be determined by prospective study.
Diazepam and its effects on visual fields
Authors: Elder M J
Published: November 2007

A patient who experienced severe visual field loss whilst taking 100 mg of diazepam that reverted to normal on cessation of the drug is described. Diazepam affects GABA inhibitory neurones and the physiology of this in the retina and visual cortex is reviewed.
Casemix – what is it and what does it mean to ophthalmology?
Authors: Goggin Michael , Michael Robin
Published: November 2007

The Australian government is committed to the establishment of a prospective payment system based on casemix information for acute hospital care in the near future, because these systems are demonstrably socially equitable and more efficient than present ‘historical’ systems. Since ophthalmology is an outpatient‐based speciality, the establishment of a good ambulatory casemix system is essential to this speciality. Considerable input from clinicians will be required to establish a satisfactory system, and to maintain it in years to come.
Detection of functional vision loss using the Ishihara plates
Authors: Bourke Robert D , Gole Glen A
Published: November 2007

Many techniques have been described for the detection of functional visual loss. We report four cases in which Ishihara pseudo‐isochromatic colour plates gave objective evidence of functional vision loss. In all cases the patients were able to read the first test pattern (No. 12), but could not distinguish any of the following pseudo‐isochromatic numbers (plates 2–17). However, they experienced no difficulty in tracing the winding lines (plates 18–24), demonstrating that they in fact had normal colour vision.
Corneal astigmatism induced by superior versus temporal corneal incisions for extracapsular cataract extraction
Authors: Wong Hong‐Chai , Davis Garry , Delia Neil
Published: November 2007

Purpose
: We tested the hypothesis that superior corneal sections induce a shift to ‘against‐the‐rule’ astigmatism and temporal corneal sections lead to

Methods
: We conducted a prospective randomised trial of superior versus temporal corneal incisions in extracapsular cataract surgery in a hospital practice. Thirty nine eyes of 37 patients were included. The induced astigmatism was analysed by three methods.

Results
: When analysed by Cravy's method of induced astigmatic cylinders, the superior incision induced a greater degree of ‘with‐the‐rule’ astigmatic cylinder prior to sutures removal on day 77 (P<0.049). Long term, the temporal incision produced 1.44 dioptre of ‘with‐the‐rule’ astigmatism, while the superior section produced 0.08 dioptre of ‘against‐the‐rule’ astigmatism (P<0.001).

Conclusion
: The results of this small trial indicates that the superior corneal incision produces significantly less astigmatism than the temporal incision. The temporal incision induces a moderate degree of ‘with‐the‐rule’ astigmatism.
Efficacy and side effects of botulinum toxin treatment for blepharospasm and hemifacial spasm
Authors: Price Jane , O'Day Justin
Published: November 2007

Purpose
: To analyse the effectiveness and rate of side effects of botulinum toxin treatment for blepharospasm and hemifacial spasm.

Methods
: In a prospective trial, 81 patients with blepharospasm and 70 with hemifacial spasm were treated with botulinum toxin A in the neuro‐ophthalmology clinic at St Vincent's Hospital, Melbourne. Some 989 treatments were given and the mean follow‐up time was 28.7 months.

Results
: The duration of action was longer for patients with hemifacial spasm than for those with blepharospasm (median 12.0 weeks compared with 7.0 weeks, P<0.0001). There was no change in the duration of effect over time with repeated treatments of the same dose (F = 0.4, P > 0.05). Once an effective dosage was reached, increasing the dose further did not prolong the duration of effect. There were no systemic side effects, but there were a number of local transient side effects. The most significant side effect was ptosis, which occurred in 12% of treatments given to those patients with blepharospasm and hemifacial spasm.

Conclusion
: Botulinum toxin is an effective treatment for blepharospasm and hemifacial spasm, but there are a number of side effects, the most significant being ptosis.
Edward J Curran and pupillary obstruction
Authors: Lowe Ronald F , Eliot. TS
Published: November 2007

Purpose
: To present the importance of the concepts of Edward J Curran in relation to primary angle‐closure glaucoma, and include a biographical sketch.

Method
: An historical method is adopted.

Results
: Curran's propositions of pupillary obstruction and its relief by peripheral iridotomy were conceded only after 30 years, and had to await laser surgery for fulfilment.

Conclusions
: Edward J Curran's name should be enshrined in the history of ophthalmology.
The ocular pathology in Leber's congenital amaurosis
Authors: Sullivan Timothy J , Heathcote J Godfrey , Brazel Sheila M , Musarella Maria A
Published: November 2007

Purpose:

To present the ocular pathology of a three‐year‐old child with Leber's congenital amaurosis (LCA) who died from an unrelated episode of presumed viral meningitis.

Methods:

Autopsy was performed, and in addition the globes were harvested for pathological examination. Before the child's death, known systemic disorders with infantile retinal dystrophy were excluded.

Results:

The outer nuclear layer and photoreceptor layers are the primary site of retinal pathology in LCA.

Conclusion:

This report of the pathological findings in LCA, early in the natural history of the disease, indicates that process appears to be a degeneration rather than an agenesis.
Acanthamoeba keratitis: a sobering case and a promising new treatment
Authors: Gray Trevor B , Gross Keith A , Cursons Ray TM , Shewan Jane F
Published: November 2007

This case report describing Acanthamoeba keratitis in a 41‐year‐old male disposable contact lens wearer, adds some sobering and some encouraging information for the future management of this infection. Initial treatment with topical propamidine isethionate (Brolene) and polymyxin B/neomycin/ gramicidin (Neosporin) led to an unsatisfactory clinical response. Topical miconazole 1%, prednisolone acetate 0.12% and oral itraconazole were then added to his treatment. This was later discontinued on noticing ipsilateral toxic cataract formation and an unresponsive pupil. The above medications were replaced with topical polyhexamethylene biguanide (PHMB) 0.02%, which we had shown to have superior in‐vitro amoebicidal activity when compared to the other antiamoebic agents used in this case. Withdrawal of the multitreatment schedule and commencement of PHMB was associated with resolution of his keratitis, healing of a large epithelial defect and settling of severe conjunctivitis. The identical Acanthamoeba strain was isolated from the patient's contact lens storage case and cornea, possibly implicating the contaminated contact lens case in the aetiology of his keratitis. This is the first Australasian experience using PHMB to treat Acanthamoeba keratitis. It appears to be a promising new treatment for this infection.
Phialophora corneal ulcer
Authors: Hirst Lawrence W. , Stallard Ken , Whitby Michael , Perrin Russell
Published: November 2007

Background: A corneal fungal ulcer, which appeared to be quite superficial clinically, was found by histologic examination to unexpectedly involve the full thickness of the cornea.

Methods: A patient with an apparent superficial corneal fungal ulcer due to Phialophora species was resistant to topical and intravenous antifungal therapy.

Results: Penetrating keratoplasty cured the condition with retention of normal vision with a follow‐up of two years.

Conclusions: If keratomycosis is unresponsive to topical and intravenous antifungal therapy, penetrating keratoplasty may be required to eliminate the infection. Resistance to medical therapy might suggest presence of fungus far deeper in the cornea than suspected clinically.
Validity of the Bruckner reflex in the detection of amblyopia
Authors: Gole Glen A. , Douglas Lisa M.
Published: November 2007

Purpose: To establish the sensitivity and specificity of the Bruckner reflex (comparison of the fundus red reflexes) in the detection of amblyopia or its risk factors.

Methods: A single masked study using a medical student's diagnostic ability against the gold standard of a full clinical examination by a paediatric ophthalmologist.

Setting: A university teaching hospital outpatient facility.

Patients: Three hundred and one patients consecutively referred for ophthalmic assessment.

Results: The sensitivity of the test for the detection of children with amblyopia risk factors was 86% and the specificity was 65%. Of 70 children with a definite diagnosis of amblyopia, the sensitivity of the test was 95%.

Conclusions: The Bruckner reflex is a useful screening test for primary eye care personnel. However, there is a significant false‐positive rate which will result in unnecessary referrals. We recommend that it form part of a battery of tests, including, for example, the modified base down prism test, which are useful in assessing the vision of preverbal children.
Uveitis associated with rifabutin therapy
Authors: Gioulekas John , Hall Anthony
Published: November 2007

Purpose: To highlight the association of uveitis with the use of rifabutin.

Methods: Retrospective study of two patients with acute anterior uveitis.

Results: Both patients were receiving rifabutin for treatment of atypical Mycobacterium infection associated with AIDS when they developed unilateral acute anterior uveitis and arthritis. The inflammation resolved and vision improved with introduction of topical corticosteroids, mydriatics and cessation of rifabutin treatment.

Conclusion: Use of rifabutin with clarithromycin may precipitate acute uveitis in patients with AIDS being treated for systemic Mycobacterium avium complex infection. Uveitis produced by rifabutin may be analogous to Herxeimer reaction as seen in syphilis. Clarithromycin and fluconazole elevate levels of rifabutin due to inhibition of metabolism through cytochrome p‐450 pathway. The differential diagnosis includes Reiter's syndrome, syphilis causing uveitis, metastatic endophthalmitis, and direct HIV‐related uveitis.
Activated protein C resistance — low incidence in glaucomatous optic disc haemorrhage and central retinal vein occlusion
Authors: Graham Stuart L. , Goldberg Ivan , Murray Barbara , Beaumont Paul , Chong Beng H.
Published: November 2007

Purpose: Activated protein C (APC) resistance has recently been reported as conferring a sevenfold increase in the risk of venous thrombosis. It is linked to a genetic mutation in the factor V gene which occurs commonly (about 2% to 4% of the community have the mutation). Glaucoma patients with nerve fibre layer (NFL) haemorrhages on the optic disc and patients with central retinal vein occlusion (CRVO) were tested for APC resistance to determine if there was an association.

Methods: Twenty‐three patients with glaucomatous NFL haemorrhages and 23 patients with CRVO were tested. The CRVO cases included 11 with relatively young age of onset (mean 45.1 ± 6.9 years) without conventional vascular risk factors. Eighty randomly selected Red Cross blood donor samples and 33 staff members were tested as controls. Clotting times with and without exogenous APC were recorded and an APC ratio determined. Cases with APC resistance were tested to confirm that they had the factor V Leiden gene.

Results: No cases of APC resistance were identified in the glaucoma patients and only one of the younger CRVO patients tested positive, but four of 113 controls tested positive. The difference in prevalence between groups is not significant. The mean APC ratios for the three groups were very similar: NFL haemorrhages 5.46(±1.62), CRVO 5.70(±1.56), controls 5.34(±1.19) p>0.5.

Conclusion: There was no clear association detected between glaucomatous NFL haemorrhages or CRVO and APC resistance in this sample of patients. This negative finding is important due its known association with venous thrornbosis elsewhere in the body.
Management of fixed divergent squint in third nerve palsy using traction sutures
Authors: Daniell Mark D. , Gregson Richard MC , Lee John P.
Published: November 2007

Background: Long‐standing fixed divergent squint is a difficult management problem, presenting marked cosmetic and functional symptoms in the patient, and a significant challenge for the squint surgeon to overcome.

Methods: We describe use of through‐the‐lid traction sutures in 24 consecutive patients with fixed divergent squint secondary to long‐standing third nerve palsy. Very large recessions of the lateral rectus were combined with large resections of the medial rectus and traction sutures placed through the insertions of the superior and inferior rectus were brought out through the extreme medial for‐nices and skin of the upper and lower lids. Sutures were tied overtarsorrhaphy bolsters and left in situ for six weeks.

Results: After removal of the traction sutures, the eye maintained a good cosmetic position in all but two cases. Postoperative motility was extremely limited or absent. Complications were limited to transient skin ulceration in two cases.

Conclusions: Supramaximal horizontal recess‐resect procedure combined with adducting traction sutures left in situ for six weeks is a safe and effective procedure to restore the eye to the centre of the palpebral fissure.
Acute posterior multifocal placoid pigment epitheliopathy: A long‐term study
Authors: Roberts Timothy V , Mitchell Paul
Published: November 2007

Purpose: To study the long‐term visual outcome in patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE).

Methods: Fifteen patients (28 eyes) with APMPPE were reassessed at Westmead Hospital Eye Clinic (Westmead, NSW, Australia) up to 18 years (mean 6.4 years) after their initial presentation to one of the authors (PM) or to their pnvate ophthalmologist. Stereo retinal photographs and visual acuities taken at the initial presentation were compared with those obtained at the most recent follow‐up visit.

Results: The last recorded visual acuity was 6/6 or better in 16 eyes (57%), 6/9–6/18 in four eyes (14%) 6/24–6/60 in five eyes (18%) and worse than 6/60 in three eyes (11%). Nine patients (60%) were treated with oral prednisone during the acute episode with little therapeutic effect observed. Six patients (40%) described a prodromal flu‐like illness.

Conclusion: This study suggests that the long‐term visual outcome following an acute episode of APMPPE may not be as favourable as initially portrayed by Gass. It confirms other study findings suggesting that APMPPE may not be a benign self‐limiting disease. Older age at onset and initial foveal involvement were associated with a worse visual outcome.
Detection and specificity of anti‐Staphy/ococcus intermedius secretory IgA in human tears
Authors: Lan J , Willcox MDP , Jackson GDF
Published: November 2007

Purpose:

Secretory IgA (slgA) is the predominant immunoglobulin present in tears that protects the ocular surface against various antigens. Staphylococcus intermedius is a member of the normal ocular microbiota.

Methods:

The presence and the specificity of immunoglobulin A to S. intermedius was determined by fluorescent assay, ELISA and western blots.

Results:

Three immunodominant antigens of S. intermedius were detected of 145, 127 and 61 kDa. Staphylococcus inter‐med/us‐specific IgA cross reacted with Staphylococcus aureus but not with Gram negative bacteria.

Conclusions:

This indicates that specific IgA may play an important role in the protection of the eye by limiting the levels of Gram positive normal microbiota and defending against the more pathogenic S. aureus.
Changes in the receptive fields of cat retinal ganglion cells affected by pressure on the optic nerve
Authors: Rose KA , (Neuroscience) GradDip , Levick WR , Burke W
Published: November 2007

In the cat optic nerve a lesion was induced by brief application of pressure. It selectively blocked impulse conduction in large diameter fibres of the retinal ganglion cells. Electrophysiological examination of single optic axons several weeks later demonstrated a gross alteration of the visual properties of the affected BT/Y ganglion cells. It is suggested that the alteration of receptive field properties may reflect the cellular and dendritic response to distant focal injury of the axon.
Duane's retraction syndrome and juvenile Batten's disease: A new association?
Authors: Marshman WE , Lee JP , Jones B , Schalit C , Holder CE
Published: November 2007

Background: Although Duane's retraction syndrome (DRS) represents less than 5% of strabismus patients presenting to an ophthalmology department, it is a difficult management problem that is often poorly treated. The developmental defect has been isolated to early in the embryonic period, but to date a chromosomal location is still uncertain. Neuronal ceroid lipofuscinosis (NCL) or Batten's disease is a lysosomal storage disease with autosomal recessive inheritance, which has been categorized according to the age of onset of symptoms.

Methods/Results: We report on a patient with DRS who developed juvenile Batten's disease.

Conclusions: These two abnormalities can both be inherited, but their association has not been previously documented.
Failure of sorivudine therapy in progressive outer retinal necrosis caused by varicella zoster virus
Authors: Rosenthal G , Bartz‐Schmidt KU , Walter P , Kirchhof B , Heimann K
Published: November 2007

Background: We report on the case of a 23‐year‐old female who presented with ocular signs of progressive outer retinal necrosis (PORN) syndrome and who failed to respond to acyclovir, ganciclovir, foscamet and oral sorivudine.

Methods: The patient was treated with the antiviral drugs acyclovir, ganciclovir, foscarnet and oral sorivudine.

Results: The patient failed to respond to a combination of antiviral drugs. Unfortunately, progression of the retinitis occurred, which led to blindness.

Conclusion: Despite new drugs, the prognosis of PORN is poor and recurrence is common.
Orbital cysticercosis
Authors: Pluschke M , Bennett G
Published: November 2007

Background: We report on a case of orbital cysticercosis in a 27‐year‐old Burmese man who presented with an orbital swelling 7 months after arriving in Australia.

Methods: The presenting history and findings are reviewed and treatment options are discussed. A brief review of the life cycle of the tapeworm Taenia solium is provided.

Results: The orbital lesion was successfully treated by surgical excision.

Conclusion: Cysticercosis should not be forgotten as a possible cause of unusual orbital lesions.
Optic neuritis following albendazole therapy for orbital cysticercosis
Authors: Tandon Radhika , Sihota Ramanjit , Dada Tanuj , Verma Lalit
Published: November 2007

Purpose: To report the occurrence of optic neuritis following oral albendazole therapy for orbital cysticercosis.

Methods: Two patients having definitively diagnosed orbital cysticercosis at the orbital apex developed an acute visual loss I week after initiation of oral albendazole. Ultrasonography and magnetic resonance imaging determined that the cause was optic neuritis due to disorganization of the cyst with inflammation of the adjacent optic nerve.

Results: Oral corticosteroids (prednisolone 1 mg/kg per day) given for a period of 4 weeks led to resolution of the optic neuritis, with full visual recovery.

Conclusion: Corticosteroids should be given in addition to albendazole in the treatment of orbital cysticercosis when cysts are in close proximity to the optic nerve.
Effect of tear secretory IgA on chemotaxis of polymorphonuclear leucocytes
Authors: Lan Jenny X , Willcox Mark DP , Jackson Graham DF , Thakur Archana
Published: November 2007

Purpose: The aim of the present study was to examine the effect of tear and purified colostrum secretory Iga (sIga) on polymorphonuclear leucocyte (PMN) chemotaxis.

Methods: The chemotactic effect of tear and purified sIga for PMN was studied using a modified Boyden chamber. Tears treated with anti‐human Iga, complement‐inactivated tears and albumin were used as controls.

Results: The data indicate that both tear and purified sIga are highly chemotactic for PMN. Anti‐sIga antibodies reduced the chemotactic effect of closed‐eye tears (34%) and tear collected during ocular inflammation.

Conclusion: The massive recruitment of PMN in tears during sleep may be partially attributed to the increased levels of tear sIga. This may play an important role in protecting the eye against bacterial infection.
Isolation, culture and characteristics of human foetal and adult retinal pigment epithelium
Authors: Zhu M , Provis JM , Penfold PL
Published: November 2007

Background: Current methods for the isolation and culture of adult retinal pigment epithelium (RPE) provide successful primary culture. However, most methods result in contamination with other cell types and low cell yields. The isolation and culture of human foetal RPE presents further problems associated with the limited size of the eye cup and adherence among cells. Reliable methods are necessary for the culture of human RPE and subsequent functional studies.

Methods: The present procedure is based on mechanical peeling of the whole RPE layer under the dissecting microscope. Dissected pieces are subsequently explanted to a 35 mm culture dish and are cultured with Dulbecco's modified Eagle's medium containing 10% foetal bovine serum. Peroxidase immunohistochemical methods were used to investigate cell phenotypes.

Results: Primary cultures were obtained within 10–14 days with high yields, good viability and purity in subsequent culture. Cultured cells were vimentin and cytokeratin positive and CD31 negative.

Conclusions: This mechanical dissection technique is recommended for the isolation of foetal and young adult RPE cells, while the enzyme digestion method is preferred for aged adult tissue.
Modulation of the resistance of a human endothelial cell line by human retinal glia
Authors: Diaz CM , Penfold PL , Provis JM
Published: November 2007

Background: Human umbilical endothelial cells were used to model the vascular component of the blood–retinal barriers and to examine the capacity of glial cultures to modulate endothelial cell resistivity in vitro.

Methods: Endothelial cell resistivity was monitored with and without cocultured human retinal glia. Immunohistochemistry indicated that both macroglia and microglia were present in one culture, while only macroglia were detectable in the second culture.

Results: Both cocultures produced increased resistivity in the target endothelial cells; however a further significant increase in resistivity was noted with the glial coculture containing microglia. The results suggest that the presence of microglia significantly increases the capacity of astrocytes and Müller cells to modulate endothelial cell resistivity.
Enkephalin, neurotensin and somatostatin increase cAMP levels in the chicken retina
Authors: Firth SI , Boelen MK , Morgan IG
Published: November 2007

Purpose: Enkephalin, neurotensin and somatostatin are released at high rates in the dark and at low rates in the light in the chicken retina. The present study examines the effects of these peptide transmitters on retinal cAMP.

Methods: Chicken retinas were incubated in vitro with various drugs for 10 min. Cyclic AMP was extracted with acidified ethanol and retinal levels of cAMP were measured using a radioassay kit.

Results/Conclusions: These peptides increased cAMP levels in the chicken retina in vitro, which is surprising as their receptors are generally thought to be negatively coupled to adenylate cyclase. The paradoxical increase in retinal cAMP may be due to unique types of peptide receptors that are positively coupled to adenylate cyclase. A more plausible explanation is that these peptides act indirectly and change the rate of release of another transmitter, whose receptor is coupled to adenylate cyclase.
Pirfenidone reduces fibronectin synthesis by cultured human retinal pigment epithelial cells
Authors: Zhang S , Shiels IA , Ambler JS , Taylor SM
Published: November 2007

Purpose: Pirfenidone is a novel anti‐fibrotic drug that has been shown to inhibit fibroblast growth and collagen synthesis induced by transforming growth factor (TGF)‐β1. In the present study we investigated the ability of pirfenidone to moderate fibronectin synthesis by cultured human retinal pigment epithelial (RPE) cells maintained in media containing 1% foetal bovine serum when stimulated with TGF‐β1.

Methods: Primary human RPE cultures were used. Treatments included TGF‐β1, pirfenidone and pirfenidone with TGF‐β1. After 72 h treatments, cell growth was determined by cell counting and fibronectin was measured by ELISA.

Results: Transforming growth factor‐β1 (1–10 ng/mL) increased the production of soluble fibronectin, while pirfenidone (300 μmol/L) significantly reduced the TGF‐β1‐induced synthesis of fibronectin. Pirfenidone alone had no effect on fibronectin synthesis by cultured RPE cells.

Conclusion: We conclude that the anti‐fibrotic effect of pirfenidone may be partly mediated through inhibition of TGF‐β1‐induced fibronectin synthesis.
Tele‐ophthalmic screening using digital imaging devices
Authors: Yogesan Kanagasingam , Constable Ian J , Eikelboom Robert H , van Saarloos Paul P
Published: November 2007

Background: Digital imaging systems provide immediate, magnified images that can easily be analysed, enhanced, archived, printed on near photographic‐quality paper and transferred electronically to remote computers. We have assembled a digital ophthalmic system and tested it on patients with some common causes of blindness: corneal scarring and cataract, diabetic retinopathy, macular degeneration and glaucoma.

Methods: Digital images were obtained using a variety of ophthalmic imaging devices ranging from slit‐lamp, fundus camera, indirect ophthalmoscope and scanning laser ophthalmoscope. These images were compressed in order to concentrate image information (image size reduced by 90–95%) and minimize transmission time (reduced by 97–98%). Standard or mobile telephone lines were used to transmit images to remote terminals.

Results/Discussion: Transmission time was reduced from 15–20 min to 20‐30s and the image size was reduced from 1.3MB to 20‐30kB by compressing the images before transmission. Image quality is still excellent
Electrode position and the multi‐focal visual‐evoked potential: Role in objective visual field assessment
Authors: Klistorner Alexander I , Graham Stuart L , Grigg John R , MB Francis A Billson
Published: November 2007

Purpose/Methods: To improve the performance of visual‐evoked potentials (VEP) in the assessment of the human visual field, the multi‐focal cortically scaled pattern VEP was recorded up to 25° of eccentricity in normal subjects. Monopolar and varying bipolar electrode positions were used.

Results: The monopolar response was strongly biased towards the lower hemifield. Bipolar leads straddling the inion (2 cm above and below) achieved approximately equal signals from the upper and lower visual field. Division into sectors of similar wave‐form augments the analysis compared with summed full‐field responses.

Conclusion: With this technique, the multi‐focal VEP can be used to objectively assess the visual field.
Extracapsular cataract surgery in Vietnam: A I year follow‐up study
Authors: Tobin Sean , Dat Nguyen Q , Bình Phàm , Nauze James La , Gillies Mark
Published: November 2007

Purpose: Unoperated cataract is the leading cause of blindness in the developing world. Many developing countries now use extracapsular cataract extraction (ECCE) with intra‐ocular lens insertion (IOL) in their cataract blindness‐prevention programmes. To date, little research has been directed at visual outcomes and complication rates of ECCE/IOL surgery in developing countries.

Methods: We conducted a follow‐up study of 155 eyes approximately 12 months after ECCE/IOL surgery by eight local eye surgeons in Central Vietnam. We report the findings for the 144 eyes (93%) successfully reviewed. All subjects underwent manual ECCE with insertion of a three‐piece posterior chamber IOL. All eyes were also assessed for the presence and severity of posterior capsule opacification (PCO) using a newly developed grading system.

Results: Overall, 110 eyes (75%) had uncorrected visual acuities ≥6/24 and 107 eyes (74%) had best spherically corrected visual acuities ≥6/18. Some degree of PCO was found in 40% of eyes, but was graded as visually significant in only 4% of eyes. No major sight‐threatening complications were noted. A portable neodymium: yttrium aluminium garnet (Nd: YAG) laser was used to perform capsulotomies on all eyes with visually significant PCO. There were no laser complications noted.

Conclusions: At approximately I year after ECCE/IOL, the visual outcomes for subjects in this cohort were favourable and complication rates were low. Posterior chamber opacification was not a major cause of vision impairment in this cohort. Portable Nd: YAG lasers may provide an effective solution to the problem of visually significant PCO occurring in developing countries as a late complication of extracapsular surgery. These findings support an increasing role for ECCE/PCIOL surgery by trained local eye surgeons in developing countries.
Comparison of extracapsular and phaco‐emulsification cataract extraction techniques when combined with intra‐ocular lens placement and trabeculectomy: Short‐term results
Authors: Chia Wei‐Lin Audrey , Goldberg Ivan
Published: November 2007

Background Methods: Fifty patients who had undergone combined extracapsular cataract extraction (ECCE), intraocular lens (IOL) placement and trabeculectomy (ECCE‐trab) and 50 who had undergone combined cataract phaco‐emulsification, IOL placement and trabeculectomy (phaco‐trab) were reviewed over a period of 12 months.

Results: Postoperatively, intra‐ocular pressure (IOP) in both eyes fell significantly (P < 0.005). Initially, IOP fell to roughly equal degrees (mean IOP being 14 mmHg at 3 months; P = 0.84). At 12 months, IOP in the phacotrab group was slightly lower than that in the ECCE‐trab group (13.4 ± 4.3 vs 15.4 ± 4.4 mmHg, respectively; P= 0.0312). The number of pre‐operative medications did not appear to affect outcome (P= 0.124).Visual recovery was approximately 3 months faster in the phaco‐trab group. By 12 months there was little difference in visual acuity, with an average improvement of two Snellen lines (P= 0.68). The mean change in astigmatism was significantly less in the phacotrab group (0.61 ± 1.25 vs 1.39 ± 1.46 D, respectively, P= 0.0063). Transient hypotony (IOP < 5 mmHg) was more frequent in the phaco‐trab group (66 vs 32%, respectively; P < 0.002). The frequency of other complications was not significantly different between the two groups.

Conclusion: Both ECCE‐trab and phaco‐trab procedures are safe and effective. However; the phaco‐trab procedure may have slightly improved IOP control, earlier visual recovery and less astigmatism.
Ocular anomalies in the branchio–oculo–facial syndrome
Authors: Su Charles S , O'Hagen Stephen B , Sullivan Timothy J
Published: November 2007

Purpose: To describe the ocular anomalies in two cases of branchio‐oculo‐facial syndrome (BOFS).

Methods: Two cases of BOFS are reviewed.

Results/Conclusions: Branchio oculo facial syndrome is a rare branchial cleft syndrome that is characterized by a typical facial appearance of pseudo‐cleft or cleft lip, subauricular branchial sinuses, deafness and ocular anomalies, which include nasolacrimal obstruction, telecanthus and colobomata. It has an autosomal dominant inheritance pattern.
Corneal scarring and irregular astigmatism following refractive surgery in a corneal transplant
Authors: Danjoux Jean‐Pierre , Fraenkel Graham , Wai David , Conway Max , Eckstein Robert , Lawless Michael
Published: November 2007

Background: Scarring may follow refractive surgery, causing irregular astigmatism and loss of visual acuity.

Methods: A case report of scarring and irregular astigmatism occurring in a corneal transplant following photorefractive keratectomy and arcuate incisions is presented.

Results: Following surgical excision of the scan unaided visual acuity improved from 1/60 to 6/12. Histopathology of the excised scar was obtained.

Conclusions: Refractive surgery following corneal transplantation may produce scarring. The origin of the scar in the present case has not been established.
Subretinal perfluorodecalin toxicity
Authors: Lee Graham A , Finnegan Sidney J , Bourke Robert D
Published: November 2007

Background: Subretinal injection of perfluorocarbon liquids (PFCL) can occur during vitreoretinal surgery. The long‐term effects of this complication are not well established.

Methods: A case report is presented of a patient with retained subretinal perfluorodecalin following retinal detachment repair for a giant retinal tear.

Results: In the early postoperative period, the macular retinal pigment epithelium (RPE) became opalescent in appearance and by 2 months postoperatively the patient developed macular RPE atrophy with resulting poor central vision.

Conclusions: Toxicity of subretinal perfluorodecalin causing RPE atrophy is proposed. We recommend all traces of PFCL should be removed if possible.
Perforating eye injuries from external rear vision mirrors
Authors: Thompson CG , Griffits RKS , Cottee L , Nardi W , Noble MJ
Published: November 2007

Purpose: To highlight external rear vision mirrors as a cause of ocular injuries in motor vehicle accidents.

Methods: Three cases of perforating eye injuries due to shattered external rear vision mirrors in motor vehicle accidents are described. The relevant Australian design rules are reviewed.

Results/Conclusion: External rear vision mirrors can be responsible for serious ocular injuries in motor vehicle accidents. Further investigation of the incidence of such injuries is required to determine whether vehicle manufacturing methods and the design rules covering their production warrant revision.
Complex motion stimuli localize higher‐order visual processing in normal observers and in patients with parietal lesions
Authors: Zanker JM , Patzwahl DP , Braun D. , Fahle M.
Published: November 2007

The present paper illustrates how modern techniques applied in neuroscience can help us to understand the processing of visual information in the human brain and, in turn, how they can be helpful to characterize functional deficits in patients with cortical lesions. Based on theoretical considerations, motion stimuli are developed that require very specific operations to be performed by the visual system. Computational models explaining the processing of these ‘Fourier’ and ‘second‐order’ motion stimuli are characterized by increasing complexity. The same types of stimuli are used to map the distribution of cortical activity during motion perception by measuring the magnetic and electrical fields on the head surface. Clinical investigations of patients with lesions in the parietal cortex indicate specific deficits in the perception of such stimuli that can be related to the lesion sites.
Congenital endophthalmitis following maternal shellfish ingestion
Authors: Marshman Wendy E. , Lyons Christopher J.
Published: November 2007

Purpose: To highlight an unusual organism causing a unilateral endophthalmitis by transplacental spread.

Method: We report a case of Plesiomonas shigelloides endophthalmitis, presenting in a newborn, with co‐existing septicaemia and meningitis. There was a significant maternal history of diarrhoea associated with the ingestion of oysters 2 weeks prior to delivery.

Result: The endophthalmitis was treated with parenteral antibiotics and topical mydriatics with complete resolution, although subsequent assessment of the affected eye suggests a poor visual outcome.

Conclusion: Endophthalmitis in the newborn is an unusual clinical finding and usually presents with other manifestations of bacteraemia. Plesiomonas shigelloides is fortunately an infrequent cause of neonatal infection, but is associated with a high degree of morbidity and mortality. We postulate that this neonate acquired P. shigelloides via the transplacental route, and suggest that this organism be included in the list of ‘other’ causes of transplacental infection that has been abbreviated to ‘O’ in the acronym TORCH.
Is the pollen‐limited mistletoe Peraxilla tetrapetala (Loranthaceae) also seed limited?
Authors: KELLY DAVE , LADLEY JENNY J. , ROBERTSON ALASTAIR W.
Published: November 2007

Abstract  Seed production in the endemic New Zealand mistletoe Peraxilla tetrapetala (Loranthaceae) has been shown to be consistently pollen limited, but to date there has been no test of whether the species is also seed limited. If it is not seed limited, then pollen limitation may have no effect on population size. We tested for seed limitation by sowing seeds onto host trees at high and low densities at two sites, and following survival for up to 69 months. Our rationale was that unless there is strong density‐dependent seedling mortality sufficient to negate increases in seed supply, the species would be seed limited. We simultaneously measured pollen limitation at both sites using pollen augmentation. Peraxilla tetrapetala was strongly pollen limited at both sites over 7 years at Ohau (mean Pollen Limitation Index 0.62), and 12 years at Craigieburn (mean PLI 0.44), before and during the seed‐limitation study. There was no significant overall negative effect of density on survival in sown P. tetrapetala seeds over 42–69 months. There was a significant positive effect: seeds were more likely to adhere to branches when sown at high densities. This initial advantage to high‐density seeds was gradually eroded by slightly (but non‐significantly) lower survival rates of adhered seeds at high density. By the end of the study there was no significant difference in overall survival in high and low density plantings. This means that P. tetrapetala was apparently both pollen limited and seed limited at both our sites. Hence, reduced densities of native bird pollinators caused by introduced mammalian carnivores are likely to reduce the density of adult mistletoes in the next generation. However, the generality of this result may be affected by the fact that mistletoes do not have a dense ‘seedling shadow’ under the parent mistletoe.
A review of habitat selection by the swamp rat, Rattus lutreolus (Rodentia: Muridae)
Authors: FOX BARRY J. , MONAMY VAUGHAN
Published: November 2007

Abstract  This review clarifies important points on habitat selection by the Swamp Rat Rattus lutreolus (Rodentia: Muridae), a species that has been the subject of much research in Australia and has provided a useful model for understanding ecological and biological processes. It also provides an opportunity to cite important earlier research, not readily available through electronic search engines, thus bringing it into current literature to avoid its disappearance into Internet obscurity. We comment on some papers in the literature to correct errors detected and to emphasize the importance of due care in all aspects of a research project, including its reporting. We show that both floristic and structural components have been reported as important to an understanding of habitat and microhabitat selection by R. lutreolus and conclude that it is vegetation density that is of paramount importance. Female R. lutreolus are clearly dominant in driving microhabitat selection, occupying the ‘best’ or densest habitats with male R. lutreolus occupying the next best and Pseudomys or other species, where present occupying the remainder. This demonstrates the important role that intraspecific and interspecific competition play in determining habitat selection. Direct predation and the perception of predation risk may also play a role in habitat selection, again perceived to be pushing individuals towards denser vegetation, representing ‘better cover’. Whether these effects operate as bottom‐up or top‐down needs careful consideration. Climatic variables, such as ENSO‐affecting productivity, and related variables such as temperature and humidity may also play important roles in habitat selection, as can disturbance effects such as wildfire. The relative importance of all of these potential determining factors may vary from place to place, particularly when climatic clines are involved.
Changes in hippocampal function of ovariectomized rats after sequential low doses of estradiol to simulate the preovulatory estrogen surge
Authors: Scharfman Helen E. , Hintz Tana M. , Gomez Juan , Stormes Kerry A. , Barouk Sharon , Malthankar‐Phatak Gauri H. , McCloskey Daniel P. , Luine Victoria N. , MacLusky Neil J.
Published: October 2007

In adult female rats, robust hippocampal changes occur when estradiol rises on the morning of proestrus. Whether estradiol mediates these changes, however, remains unknown. To address this issue, we used sequential injections of estradiol to simulate two key components of the preovulatory surge: the rapid rise in estradiol on proestrous morning, and the slower rise during the preceding day, diestrus 2. Animals were examined mid‐morning of simulated proestrus, and compared to vehicle‐treated or intact rats. In both simulated and intact rats, CA1‐evoked responses were potentiated in hippocampal slices, and presynaptic mechanisms appeared to contribute. In CA3, multiple population spikes were evoked in response to mossy fiber stimuli, and expression of brain‐derived neurotrophic factor was increased. Simulation of proestrous morning also improved performance on object and place recognition tests, in comparison to vehicle treatment. Surprisingly, effects on CA1‐evoked responses showed a dependence on estradiol during simulated diestrus 2, as well as a dependence on proestrous morning. Increasing estradiol above the physiological range on proestrous morning paradoxically decreased evoked responses in CA1. However, CA3 pyramidal cell activity increased further, and became synchronized. Together, the results confirm that physiological estradiol levels are sufficient to profoundly affect hippocampal function. In addition: (i) changes on proestrous morning appear to depend on slow increases in estradiol during the preceding day; (ii) effects are extremely sensitive to the peak serum level on proestrous morning; and (iii) there are striking subfield differences within the hippocampus.